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SIIA TRADE SHOW
It is time for the annual SIIA National Conference and Expo. As in years past, Complete Health Systems will be exhibiting at the show, which will be held on October 1 - 3, 2012 in Indianapolis, IN. The conference's theme is "Raising the Game".
Be sure to stop by booth #500, so we can show you how CHS can help improve how you manage self-insured programs.
RBS (REGULATORY BUDGET
COURT DECISION TO UPHOLD LAW WILL AFFECT MANY ENTITIES
By: Nicola Crean, CHS Marketing Coordinator
After a long awaited announcement, the Supreme Court handed down their decision over the constitutionality of the health care law, which was passed in 2011. The Court ultimately decided to uphold the Patient Protection and Affordable Care Act.
The primary issue that the Supreme Court debated over was whether or not the government had the right to penalize individuals that chose not to pay for health insurance. Commonly referred to as the Individual Mandate, those who were opposed argued that forcing individuals to purchase insurance was unconstitutional.
In a 5-4 vote, the majority of the Court felt that the penalty the government was installing was, in fact, a tax and is a protected right of the government under the Constitution.
“Under the mandate, if an individual does not maintain health insurance, the only consequence is that he must make an additional payment to the IRS when he pays his taxes,” Chief Justice Roberts states in his written opinion. “That, according to the Government, means the mandate can be regarded as establishing a condition – not owning health insurance – that triggers a tax – the required payment to the IRS. Under that theory, the mandate is not a legal command to buy insurance.”
The health care law says that those who do not purchase health insurance would have to pay the penalty directly to the Internal Revenue Service when their taxes were filed. According to an article published on CNN.com (What the Health Care Ruling Means to You), starting in 2014, families would owe $285, or 1% of their household income. By 2016, the penalty would increase to 2.5% of the annual income.
After the judgment was made public, it was evident that the government in its entirety had mixed emotions about the Supreme Court decision. The clear divide among the government seemed to mirror what occurred in the U.S. public. According to a poll released by USA Today/ Gallup Poll, 46 percent agreed with the Supreme Court decision, while 46 percent reported that they were unhappy with the outcome.
The affects of the court’s decision will vary based on each individual’s circumstance. The CNN article cited how the PPACA being upheld will affect specific groups of the US public.
- Insured Individuals: Since the health care law is still in place, those that currently are paying for health insurance will be able to avoid a potential increase in their insurance rates.
- Individuals Under 26: Insurers are now required to cover children up to the age of 26. According to the U.S. Department of Health and Human Services, approximately 2.5 million individuals have received health coverage under this provision.
- Individuals with Pre-Existing Conditions: It is now unlawful for an insurance company to deny coverage to any individual, even those with pre-existing conditions. Those under the age of 19 cannot have limited benefits due to pre-existing conditions.
- Taxpayers: Those who participate in Flex Spending Accounts will now only be able to contribute $2,500 annually.
As each individual adjusts to the new standards that are being set by the PPACA, the government itself should see a significant decline in spending. The Global Post sites that the Congressional Budget Office found that the by the Supreme Court upholding the health care law, the government stands to save up to $84 million over the course of 11 years, as reported by Reuters.
Now that the Supreme Court has made their final decision, the public must get acquainted with the Obama administration’s health care law because it seems that it is here to stay. Businesses and insurance companies will continue to move forward and make progress towards compliance as the standards' deadlines approach.
FINANCIAL AND SOCIAL INCENTIVES PROVING SUCCESSFUL FOR WELLNESS PROGRAMS
By: Nicola Crean, CHS Marketing Coordinator
As wellness programs continue to become more prevalent in the workplace, companies often reevaluate the program’s initiatives in order to determine if there is progress being made. Continuing to engage employees and work towards the program’s goals may include evolving the wellness program, at times, to gain attention.
In a survey done by Towers Watson and the National Business Group on Health, they determined that after speaking with over 500 employers, they all seemed to face similar challenges. Their biggest obstacle, which was most often cited, was motivating employees to become more health conscious in an effort to keep health benefits affordable.
Ultimately, wellness programs primary objective is to lower costs by promoting healthier behavior among employees. As companies continue to invest in operating these programs, it is vital for them to see improvement in health costs to validate the expense of running the wellness program.
“Incentives are just one tool employers need to consider when implementing workplace wellness,” said Dr. Ron Losppke, MC, FACOEM, president-elect of ACOEM and vice chair of U.S. Preventative Medicine in an article published in Occupation Health & Safety. “To be effective, the incentive strategy must be part of a comprehensive workplace health improvement plan.”
There are a variety of incentives that employers can offer to those who are successful in the workplace programs. Choosing rewards that will motivate employers to participate in living a healthier lifestyle is essential to the success of any plan. Determining what those incentives should be, however, can be difficult.
There are two different approaches that employers have taken to invoke action from their staff, which continues to be used in hundreds of wellness programs across the country.
One way they have motivated employees is by providing financial rewards to those who have successfully accomplished an objective within the program. Including outcomes-based incentives in the wellness program means that employers will reward those who meet a specific goal, while those who fall short will be penalized.
“As employers seek new ways to engage employees in programs that change health behaviors, their interest in outcomes-based incentives has grown considerably, as has the need for a unified voice on the issue,” said Jerry Noyce, president and CEO of the Health Enhancement Research Organization in an article published in Occupation Health & Safety.
In order to comply with regulations and HIPAA standards, the companies must ensure that monetary rewards and incentives are in line with specific HIPAA requirements.
Ensuring that rewards do not exceed 20 percent of the employees’ health care coverage cost and providing individuals with an opportunity to qualify for the reward at least once within a 12-month span are an example of what companies must consider when developing their incentive program.
The second approach that employees have more recently been considering is to incorporate the internet and social media in an effort to promote friendly competition within the workplace. Managing an online contest to see what team of employees can log the most time in the gym, for example, can increase individuals’ likelihood of participating in the wellness program.
“That social aspect creates some level of accountability,” says Brad Bell, an associate professor of HR at Cornell University, said in an article published in Bloomberg Businessweek (Wellness Games Encourage a Fitter Workforce). “You know that if you don’t show up, people are going to notice.”
The same article describes a competition that was held between over 400 employees that worked for the city of Charlotte. Teams were decided based on department, and the staff logged their workouts on a website, which kept track of their score. Employees bantered between each other regarding the scores, and if one department pulled ahead, it motivated others to work out more.
The participation from years past doubled when this 6-week challenge was enacted. The results were that 8,800 hours of work outs were logged, which broke down to each employee spending about a half an hour per day exercising.
This approach provides employees with a social network of people that are committed to the same cause. It allows them to feel as though there is a support team, in addition to members that rely on their dedication to the program.
Whether employers take a competitive, social approach to their wellness programs or look to engage individuals with financial incentives, it is vital that all companies consider what option would motivate their employees to participate in the program. Additionally, companies need to evaluate their incentive strategy on a regular basis in order to determine the success of the corporate wellness plan.
THERE ARE SOME BEHAVIORS
YOU JUST CAN'T REGULATE.
By: Chacko Kurian
Regulations depend on carrots and sticks. If you don’t
pay your taxes, there will be serious consequences – the
stick. If you buy a home with a home loan, we’ll let you
take the interest payment deduction on your taxes – the
carrot. The HITECH Act has a number of sticks associated
with the security of Protected Health Information (PHI). We
at CHS will be addressing the issue of security of PHI in
forthcoming articles. There is, under some circumstances,
one link in the security chain that no regulation can affect
-the uninformed behavior of the user. This article addresses
one method where cyber criminals make unwitting users
partners in a security breach.
Prior to founding
Apple Computers, the Steves (Wozniak and Jobs) could be
found ripping off Ma Bell using a blue box to make long
distance phone calls (domestic and international) for free.
The subculture that reveled in this activity called
“phreaking” was probably the progenitor of the subculture of
hackers who, today, like to hack computer systems just
because they’re there. There is the story of Steve Woz(niak)
actually making a “phreak” phone call to the Vatican and
asking to speak to the Pope while pretending to be Henry
Kissinger with a think German accent. These are the guys who
later found legal ways to take your money.
Before the age of digital telephone switching systems,
telephone switches reset trunk (long distance) lines with a
tone at a specific frequency – 2600Hz. This meant that the
trunk line was disconnected at one end and available for
dialing at the other end. The dialing was also accomplished
by tones at preset multiple frequencies. How did one get
those frequencies? Legend has it that the 2600Hz frequency
was discovered by accident by Joe Engressia, known among
phreakers as ‘Joybubbles’, at the age of 7! He was
apparently able to whistle at that frequency and so attach
himself to the dialing end of an available long distance
But how does one progress from knowing that you could get
a trunk line to using it to make free long distance calls.
In 1954, the then undivided Bell System published an article
in the Bell System Technical Journal about the basics of
signaling using multi-frequency tones. This piece of
information by itself was of little use. The second and
final piece of the puzzle was published, again courtesy of
Ma Bell, in the November 1960. Bell System Technical Journal
in an article called “Signaling systems for control of
telephone switching”. This article published the actual
multi-frequency tones used to control the switches. From
that information to the creation of the reputed “Blue Box”
that became a clandestine product was a short step. With one
of these boxes, anybody was able pick up a phone and make
free long distance calls.
To be able to win this questionable prize, the phreaker
required two pieces of information and they were found in
two locations, but once they were combined, the information
became quite powerful. Today – cybercriminals put two pieces
of information discovered from different locations together
to achieve their nefarious goals..
Spear Phishing is the technique by which pieces of
information stolen from different locations are put
together, by cybercriminals, to steal your identity, your
money and anything of value. How does this work? Unlike the
shot gun approach taken by those Nigerian scam artists who
send out millions of emails, the Spear Phisher is looking
for prey with a small email blast to very targeted
prospects. All they need to start the process is one piece
of information – your email address and sometimes your name.
They don’t need anything like a credit card number, the
password to your on-line bank account or your social
security number– well, not yet. The attack is quick and over
in less than a day, before security and software companies
have an opportunity to react.
A typical Spear Phishing attack starts with an email that
comes to you and looks something like this, courtesy of the
Microsoft Safety and Security center
Remember they already have your email address and
sometimes your name so the “Hello” salutation is not so
innocuous. It looks very familiar but the highlighted items
should make you suspicious. If you examine the links you
will find that they link to unsecured and unfamiliar sites
as shown below:
Once you click on the link and enter the information
they’re asking for, they’ve got you.
Another variation of this technique is to send you an
email making you an offer that sounds reasonable on the
surface, but requires you to open an attachment with the
details of the offer. Again, once you open that attachment,
they’ve got you. What happens behind the scenes is that the
attachment has a robot program that can do almost anything
that they want it to do. It can install a keystroke logger
and send your internet banking or credit card passwords to
the cybercriminal. It can give control of your computer over
to the cybercriminal and so enable more of these schemes to
be run from your computer. The possibilities are endless.
Sometimes the Spear Phisher makes the email look like its
coming from your boss – again remember he has email
addresses and names. The email may require you to give up
password and other authentication information in order to
perform a “security audit” or an “account verification”.
Key to making this criminal endeavor work is that it
requires your participation to either provide the missing
information or open the attachment. So the best defense it
to verify the email by contacting the sender by phone or
alternate method if the email looks suspicious. A good
antivirus program installed on your computer can help
too.Remember for the scheme to work it requires your
We might as well brace for a number of these email
attacks. Recently Epsilon, a division of Alliance Data
suffered an illegal entry on its client’s email databases.
This is the company that processes marketing communications
for loyalty programs like Marriott Rewards, Citibank
Advantage and many other large organizations. Imagine the
rich information for cybercriminals that email addresses,
names and loyalty program associations can provide. If you
belong to the Marriott Rewards program like I do, expect an
incredibly valuable offer to come to you via email. Do not
open the attachment even though the logo looks almost right
and the text has only one or two spelling mistakes.
There’s lots of regulations coming from Washington DC
these days, but I don’t think they can think one up for
CHS SOFTWARE UPDATE
CHS Software you may want to use
Often, we at CHS, are
guilty of not informing you of products or features that we
have implemented over the past year that you may want to
use. This year we have rounded out our individual
enrollment, billing and administration offering with a full
cycle product. If you sell individual policies or sell
voluntary products in addition to your regular employer
sponsored group health offerings, this may interest you.
"Full Cycle" in this context means the following:
i) taking the application for enrollment of the
individual/family on the web, after getting their responses
to qualifying/underwriting questions,
ii) enrolling them in the plan of choice,,
iii) billing their credit card or bank account at the
appropriate frequency, i.e. monthly, quarterly,
semi-annually or annually,
iv) applying the payments received against the appropriate
v) disbursing premium/commission and other payments to
carriers, brokers/agents and other suppliers
vi) updates to Accounts Receivable, Accounts Payable and
General Ledger without manual intervention after set-up.
We would like to say that all of the above happens
"automatically" (a grossly over-used word) but it doesn't.
It happens with minimal, but appropriate, human
intervention. For example, there are checks and balances in
place to make sure that premium billing adjustments owing to
changes in family composition or product choices are made
accurately. The web enrollment product, CHS iCoverNow, has
to be customized with your logo, color palette, questions
and response logic. Users of our product like it. It has
allowed them to grow into areas where they couldn't before.
We believe that this will interest administrators of
individual health plans who sell to the public at large and
may become a valuable tool in the context of health care