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By: Nicola Crean, CHS Marketing Coordinator

The Health Insurance Marketplace, a key element of the Affordable Health Care Act, will officially open on October 1. Regardless of the public’s readiness, insurance exchanges nationwide will be open for business in hopes of providing more insurance options to individuals.

“The exchange is just a place where people can go to buy insurance, with subsidies,” said Raymond Hurd, acting New England regional administrator of the Centers for Medicare & Medicaid Services, in an article published in the Valley News. “It’s really just a website.”

There is a concern among many experts close to the development of the revised insurance system that Americans may not be completely educated on how the Marketplace operates and the value that it will bring. Many fear Americans have simply stopped listening to anything health care related, which has led to them being ill prepared for open enrollment season.

“There has been so much chatter about this healthcare law that if has just become background noise,” said Dr. Marilyn Singleton of the Association of American Physicians and Surgeons, in an article published in “People don’t care anymore, which is really very sad.”

The Insurance Marketplace, however, is something to pay close attention to. The overall goal of the Affordable Health Care Act is to provide more health insurance options to the entire American public, and one way the government has attempted to achieve this is through health insurance exchanges.

The exchanges that have been set-up are both national and statewide. The type of exchanges offered through the Insurance Marketplace will vary from state-to-state, making it important to be aware of the differences in the benefits offered.
“Research shows that consumers make better choices when offered fewer choices,” said Carrie Colla, an assistant professor at The Dartmouth Institute. “The exchange needs to balance the need for simplicity and ease of use with plans that are tailored well to individual purchasers.”

In the simplest form, the exchanges are websites that help make it easier for people to shop for insurance, compare benefits and out-of-pocket costs. In order to qualify for these government subsidized coverage options, individuals must meet a specific requirement.

People making between 138 percent of the poverty level and 400 percent are eligible to receive benefits through state or nationally set-up exchanges. The subsidies received through the Marketplace will be determined on a sliding scale, according to a Chicago Tribune article.

In dollar figures, the law says individuals making between $15,860 and $45,960, and families with income totaling of $32,500 to $94,200 are eligible to utilize the insurance exchanges, if coverage is not offered through their employer. Those who make less will essentially receive a higher subsidy amount in order to lower the out-of-pocket cost. The Kaiser Family Foundation estimates that the average subsidy amount will be approximately $2,672.

Another piece of the puzzle is the youth population in America. Among the government’s effort to reach the public, the administration has utilized social media to gain the attention of young Americans. Enrolling the uninsured youth population is particularly important to the success of this plan.

In order to contain costs, young, healthy individuals are essential to the exchanges. Having Americans participate without large health care bills will allow the insurance companies to regulate cost in order to keep expenses manageable.

“I think the enrollment strategy is both an effort to meet the needs of the uninsured but also the best political strategy as well,” said Drew Altman, president and chief executive of Kaiser Family Foundation in an article reported on “Because once it’s out there, once millions of people are enrolled, once states have programs up and running, it’ll be very hard to put the genie back in the bottle.”

With October 1 quickly approaching, national and state governments have put their public outreach efforts into high gear. Staff is on hand to assist individuals in utilizing the new Insurance Marketplace. Although it is likely the exchanges will see some operational challenges, the overall results will be very important to the success of the Affordable Care Act.


By: Nicola Crean, CHS Marketing Coordinator

E-cigarettes are the latest trend to emerge as a substitute to smoking cigarettes. Gaining in their popularity, it looks, and essentially, acts much like regular cigarettes, but does not have include tobacco or other toxins. Many individuals have seen an instant benefit from utilizing e-cigarettes versus doing the unhealthy alternative of smoking traditional cigarettes.

“I don’t think it’s very healthy to inhale anything, but it’s better to inhale this than it is all the chemicals you get from a cigarette,” said Todd Zimmerman, a consumer of Vapor Cafe, in the article. “It’s helping me get to where there shouldn’t be anything. It’s a process, and hopefully, I get there.”

From social norm to outlawed behavior, cigarette smoking has become quite a controversial topic within the U.S. and throughout the world. Even with smoking bans and increased taxes on cigarettes, Americans still resort to this habit.
The response towards smokers has seemingly shifted as research continues to demonstrate the negative health effects that result from the intake of tobacco. Using the e-cigarettes to substitute will eliminate the smell and smoke from traditional cigarettes, while decreasing the unhealthy chemicals that smokers ingest.

“People like that aspect because you don’t get frowned upon as much as if you’re a cigarette smoker,” said Mike O’Neil, the business manager of Smoke and Ashes Tobacco in Abington, in an article published in

The primary difference between traditional and electronic cigarettes is that e-cigarettes do not contain tobacco. Instead, they are made up of a nicotine-infused liquid, which is vaporized when used. The health effects of the liquid have not been fully determined, but many experts agree the lack of tobacco still make them a better choice than traditional cigarettes, according to a article.

“We agree that no health claims should be made without the appropriate science,” said Dr. Richard Carmona, a member of the NJOY Kings’ Board of Directors, in an article published on “If we stopped tobacco use today 80 percent of the lung cancers would go away—not today, but in the future.”

E-cigarettes, which have quickly become a $1 billion industry, have gained a substantial following in a short time. Beyond the upfront financial benefit, many Americans see a health benefit to using these electronic devices versus traditional, tobacco cigarettes.

E-cigarettes “just have a different delivery system [for nicotine] that reinforces the habit of holding a cigarette, but without those toxic, carcinogenic properties,” said Carmona.

Another substantial difference between tobacco and electronic cigarettes is that the government does not currently regulate e-cigarettes. Having no standard for what is included in the nicotine-containing liquid is also making it more difficult to research the health effects it can have, since the liquid composition will vary from one company to another.

Many manufacturers are anticipating regulations, so they have treated the e-cigarettes like any other tobacco product. Often contractually requiring vendors to only sell the product to individuals 18 and over, like Altria, as reported in a CNBC article. For those who have not implemented any standards, the Food and Drug Administration anticipates this industry will face regulations within the next 12 months.

Similarly to the government, experts advise employers to take a look at their smoking policies and update them as necessary. E-cigarettes are a sign of evolving times that employers must be a step ahead of. The National Business Group on Health reports that some state and local governments have already put policies in place regarding e-cigarettes, but overall, very few companies have addressed this growing trend.

While e-cigarettes may end up being medically beneficial in the long run, the introduction of this type of product will require everyone from human resource departments to lawmakers to get involved and determine how to regulate, standardize and adapt to the e-cigarette trend.


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 line.

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 participation.

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 this.


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 invoices
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 reform.