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Partners Benefit Group, Inc. Newsletter
October 2011

Greetings!

We hope you enjoy this month's newsletter filled with important information regarding Correct Classification of Employees, 2012 HSA Guidelines, Updates on the CLASS Act and the Walgreens/Express Script dispute, and much more.  As always feel free to contact PBG toll free at 877-993-5600 with any questions or comments you may have.  


DOL and IRS to Buckle Down on Proper Classification of Employees

The Associated Industries of Massachusetts published an article recently regarding the coordinated effort to enforce the Independent Contractor Law.  This is important information that could affect Massachusetts employers.

"The U.S. Department of Labor (DOL), the Internal Revenue Service (IRS) and several Massachusetts agencies signed a memorandum of understanding on September 19 allowing them to share information about employers they believe misclassify workers as independent contractors.

The agencies described the new enforcement program in a press release as an "effort to reduce the business practice of improperly classifying employees as contractors or other non-employees." Massachusetts joins 10 other states...that have established enforcement collaborations with the federal government...

Massachusetts employers should be aware that federal and state laws regarding independent contractor classification are not the same.  Even if you are in compliance with the IRS standards for independent contractor you will most likely not be in compliance with Massachusetts laws for independent contractors.

For example, a Massachusetts company looking to hire a software designer as an independent contractor must prove that the work done by the designer is not done within the company's usual course of business. Massachusetts employers also face the threat of mandatory treble damages for even inadvertent violations of state wage and hour laws.

The September 19 enforcement memorandum does not indicate how the federal and state governments will determine compliance for Massachusetts employers."

To read the above mentioned press release, click here .

Source .


HHS Will Not Implement CLASS Act Program

The Health and Human Services (HHS) has indefinitely suspended the long-term care plan that was signed as part of Obama's 2010 healthcare overhaul, known as the CLASS Act.  The Community Living Assistance Services and Support program, which was greatly advocated by the late Senator Ted Kennedy, has been deemed financially unsustainable for the long-term future.

The purpose of the CLASS act was to aid those disabled by either sickness or accident in need of long-term care.  Beneficiaries who had paid premiums while employed would have been eligible for at least $50 per day towards in-home health and support services and the program was determined to ultimately pay for itself.

The CLASS Act was intended to be a voluntary program and applicants could not be refused due to existing medical conditions. This however created the problem of healthy employees opting to not enroll in large enough numbers to offset unhealthy employees, needing the benefits.  Monthly premiums for the program could have been as high as $3000 if the majority of those enrolled in the program were in bad health.

Republicans see the CLASS Act's demise as a victory and the first of the PPACA's programs to inevitably fail.  Democratic supporters are more hopeful, however.  Connie Garner, who helped draft the CLASS Act while staffed under Kennedy has stated, "CLASS is a critical backsstop, giving working families a tool to protect themselves from being one illness or injury away from poverty.  The President promised to implement this program.  We expect him to keep that promise."


Walgreen's and Express Scripts Battle Continues

Millions of customer's may lose the ability to fill their Express Scripts prescriptions at Walgreen's beginning in January if the pricing dispute between the two companies does not come to an end soon.

In addition to filling presciptions Walgreens now offers help to patients in managing their medications, i.e. advising customers on appropriate doses and recommending switching to generic brands when appropriate.  Because of this added service, Walgreens believes that Express Scripts, a pharmacy benefit manager, should now reimburse them at a higher rate.  Thus far, Express Scripts refuses to reimburse Walgreens at the demanded rate and due to this response, Walgreens is now threatening to remove itself from the Express Scripts network as of January 1, 2012.

Express Scripts' members account for approximately 90 million of the prescriptions Walgreens filled every year.  Many members have already begun to switch pharmacies due to this dispute.

To learn more about this ongoing dispute, please click here  to view an article from the Wall Street Journal.


REMINDER: Upcoming PBG Benefit Breakfast Seminar

If you have not already RSVP'd for our upcoming Benefit Breakfast Seminar, you still have time!

Part I: National Healthcare Reform: State vs. National

Presented by: Jay Curley, SVP and Chief Government and Public Affairs Officer for Public, Goverment and Regulatory Affairs Division, Blue Cross Blue Shield of Massachusetts

Part II: New Patient Protection and Affordable Care Act Requirements: An HR Perspective

Presented by: Alden J. Bianchi (Mintz Levin)

When : Thursday, November 10, 2011
Where :  The Westin, 70 Third Ave, Waltham, MA 02451
Registration and Continental Breakfast : 8:30 AM
Presentation : 9:00 AM Sharp

Please send your RSVP to Kasey Southwick at ksouthwick@partnersbenefitgroup.com .

Include:
number of attendees
names of attendees
company name


Sincerely,

Maria Eramo
Partners Benefit Group, Inc.

In This Issue


Important Notice Regarding Termination for Non-Payment

Important Information for BCBS Group Plans:

Blue Cross Blue Shield of Massachusetts continues to reserve the right to terminate employer group plans if full payment of all charges is not received within 30 days of the due date.

As of October 7, 2011, plan termination for non-payment may be effective as of the last date through which premiums were paid.  Within 60 days of the termination date, all subscribers will receive a written termination notice with continuation of coverage options.  All claims made after the group plan termination date will be the subscriber's responsibility.


BCBS RI Recognizes Civil Union Law

Blue Cross Blue Shield of RI has updated its policies to reflect Rhode Island's recently enacted Civil Union law.  BCBSRI covers same-sex couples who are legally married or parties to a civil union and who reside in a state that recognizes same-sex marriage/civil union.  These couples are treated the same way as opposite-sex couples, and have all the rights of married couples. 

To learn more about BCBSRI's policy regarding same-sex couples and the Civil Union law, click here .


2012 HSA Guidelines

If you currently offer or are enrolled on an HSA plan, please take a look at the following HSA Guidelines and  list of eligible expenses.
HSA Guidelines 2012
HSA Eligible Expenses


Cigna to Acquire HealthSpring

On October 24, 2011, Cigna signed an agreement to acquire HealthSpring, one of the nation's largest and fastest-growing health plans, whose primary focus is Medicare-eligible individuals.

  HealthSpring currently serves approximately 340,000 Medicare Advantage customers in 11 states and Washington, D.C., as well as over 800,000 customers with their large, national stand-alone Medicare prescription drug business.

Read more...