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SIIA TRADE SHOW
Complete Health Systems has been long time supporters of the Self-Insurance Institute of America, Inc., or SIIA. This month we attended their 32nd Annual National Educational Conference and Expo, which was held in Indianapolis, Indiana. The organization recognized our 20-year commitment as an exhibiting company by awarding us a plaque demonstrating their appreciation for our continued support.
As in year's past, we had the opportunity to meet with fellow professionals within the healthcare industry. Thank you to everyone who stopped by and visited our booth.
Complete Health Systems was pleased to see the positive response from those of you who participated in our drawing this year. Even if you may not have been chosen as a winner, take comfort in knowing that, as promised, three charities have reaped the benefits of the drawings.
Every year, CHS conducts a raffle for gift cards or other valuable prizes at the SIIA Educational Conference. Last year, we gave our winners an opportunity to give back to worthy cause by donating their prize to a charitable organization. The U.S. continues to face a sluggish economy, and CHS felt giving back in hard times is important.
Similar to last year, we announced that we would give the winners of the drawing the prize of a $50 American Express gift card and they would have the opportunity to donate the funds to a charity. If they chose any of the following three charities, CHS made a commitment to match the donation for a total of $100.
- The Wounded Warrior Project
War is a terrible option, but sometimes necessary. The least those of us, non-military folks, can do is honor the dead and help the wounded. Those who serve in the military put themselves in harm's way on our behalf. We, at CHS, are proud to support this charity.
As the economy fights to recover, contributions to charities decrease and the need for help increases. CHS helps support this fine organization, so that they can help those in need.
- The Children's Miracle Network
This organization is a favorite of a member of the CHS team. This network works to increase awareness of healthcare for both sick and health children, in addition to raising funds in order to improve healthcare facilities.
|Winner: Sarah Wilcox
Charity: Children's Miracle Network
|Winner: Sherri Knoll
Charity: Children's Miracle Network
|Winner: Steven Bentley
Charity: Christian Foundation
|Winner: Jeff Circuitt
Charity: The Devine Intervention Foundation
RBS (REGULATORY BUDGET
HEALTHCARE IN 2013: INDUSTRY PREPS FOR ACA DEADLINES AND REFORMS
By: Nicola Crean, CHS Marketing Coordinator
As the dust settles from the fiscal cliff decisions, the healthcare industry begins to shift focus to preparation efforts for numerous Accountable Care Act deadlines in 2014. While various changes are not required to be implemented until next year, many companies are beginning to make progress towards meeting compliance deadlines.
With over ten insurance-related regulations becoming active on January 1, 2014, businesses have a range of standards to prepare for. Although there is speculation of some deadlines being postponed, experts say it is important for companies to plan ahead and make progress towards these initiatives sooner than later.
“With the countdown underway to the biggest overhaul of U.S. healthcare since the enactment of Medicare and Medicaid more than 50 years ago, it’s do-or-die time for many institutions,” says Steven Valentine, president of The Camden Group, a healthcare business advisory firms. “The changes are painful for all concerned, but they must adapt, while simultaneously operating under the current system or become increasingly irrelevant.”
Entities within the healthcare industry have varying degrees of preparation that is required. For employers and insurance companies, specifically, they face major modifications to the system that they have become accustom to. Many decisions must be made in 2013 for the upcoming year’s health coverage.
Originally, businesses with over fifty employees were required to provide a written notification of coverage options through Exchanges to their staff by March 1, 2013. The primary reason was if companies were unable to cover at least 60 percent of the “affordable” insurance plan offered to employees, they can provide them with additional options for health care coverage in the form of Exchanges.
The Department of Labor has postponed the deadline until late summer or fall, citing that this information will be released during open enrollment for Exchanges, according to an article published in the JDSupra® Law News. The creation of health insurance Exchanges will ultimately have a major effect on the industry as a whole.
“This will be a sea change in how many Americans get insurance coverage with an estimated 30 million people who may be covered by the exchanges,” said Ketchum executive Nancy Hicks. “Insurance companies are working with HHS to define ‘essential benefits’ that must be covered in their plans, and they are gearing up to market their plans on the state exchanges.”
New standards imposed on employers and private insurance companies along with the addition of Exchanges is one way the ACA is working towards developing a competitive marketplace that aims at creating a culture with more knowledgeable insurance consumers. By making coverage plans more transparent, it provides the public with an opportunity to compare price and quality to determine what is the best fit for them.
For individuals, the increase in insurance choices comes at a particularly important time. Another regulation implemented in 2014 is the Individual Mandate, which requires all Americans to obtain health care or face possible fines. The responsibility has essential been put on the public to obtain insurance, whether through their employers or insurance exchanges.
Creating a competitive marketplace is a major goal of the ACA. Through reforms and new standards, the industry as a whole will work to account for changes and make plans to prepare for upcoming deadlines to ensure compliance by January 1, 2014.
While 2013 proves to be a year of transition, it is likely the first step towards creating a more efficient healthcare industry in the U.S.
SMOKERS TARGETED BY EMPLOYERS LOOKING TO REDUCE HEALTH COSTS
By: Nicola Crean, CHS Marketing Coordinator
Employers are obligated to be conscious of prohibiting discrimination in the workplace. Every stage of the employment process from interviewing to an individual’s last day on the job requires hiring managers and human resource departments, specifically, to ensure that employees do not feel any type of prejudice.
When it comes to discrimination, Title VII of the Civil Rights Act of 1964 prohibits discrimination for those under a particular set of protected classes. This law makes it illegal to show favoritism or bias towards one employee over another based on race or sex, for instance. This act is one of many that define individuals’ rights in the workplace.
With the continuous rise in health care costs, companies have been forced to look at how expenses can be reduced. Since a major concern is the cost of unhealthy workers, many employers have looked at implementing health initiatives to create a healthier workforce that essentially will cost the business less.
While some companies commit to wellness programs, others have opted for a nontraditional route. Recently, employers have vocalized their desire to only interview and hire non-smokers, making it a known public fact that essentially smokers need not apply.
“The general tone around smoking nowadays is that everybody knows it can be very hazardous to your health, said Delray Beach, a human resource executive for Bruce Koeser. “And beyond that, it can cost a self-insured city quite a bit in the way of additional dollars. So why not have a healthier place, a healthier environment and try to cut costs at the same time?”
The Centers of Disease Control and Prevention estimates that Americans employee that smoke cost approximately $200 billion in medical costs and lost workplace productivity. While banning employees who smoke from the healthcare industry has been a common practice in the past, it appears that increasingly more companies are considering this approach in order to save on the cost.
On average, smokers take a total of four 15-minute breaks throughout the average eight-hour work day in addition to the allotted time, according to the CDC. Also, it is more likely that an employee who smokes will call-in sick more often than non-smokers.
“We felt it was unfair for employees who maintained healthy lifestyles to have to subsidize those who do not,” said St. Francis Medical Center’s Chief Executive Steven C. Bjelich, in an article published in the New York Times. “Essentially that’s what happens.”
At this time, there are currently 21 states that permit companies to have a nontobacco hiring policy, according to an article published in the Clinical Advisor. Majority of states, however, have created an additional set of “lifestyle discrimination” policies to prevent limitations being put on who can participate in the hiring process.
“If enough of these companies adopt these policies and it really becomes difficult for smokers to find jobs, there are going to be consequences,” said Dr. Michael Siegel, a Boston University School of public health professor. “Unemployment is also bad for health.”
While this type of policy may prove to be controversial, it still remains to be legal practice based on the federal government’s standards. At this time, less than half of U.S. states allow this type of discrimination to occur. However, with the financial burden of medical costs as well as the struggle to maintain businesses, many states could follow suit and allow companies more leniency in hiring employee to reduce costs.
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