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RBS (REGULATORY BUDGET
SUPREME COURT TO MAKE DECISION ON HEALTH CARE REFORM
By: Nicola Crean, CHS Marketing Coordinator
While the medical industry continues to make progress towards complying with the new standards set forth by the Health Care reform, the Supreme Court has been faced with deciding the constitutionality of the reform, particularly with regards to one “individual mandate”. The long awaited decision is set to be publicized later this week, and the effects of the Supreme Court’s decision could have major repercussions.
On March 23, 2010, the Patient Protection and Affordable Care Act, commonly referred to as PPACA, officially became a law. The new act was put in place to reform the healthcare system in the U.S. There are various provisions of the law such as extended coverage for adult children up to 26 years old and eliminating the practice of excluding children from coverage based on pre-existing conditions, according to the HealthCare.gov website.
While this act passed through Congress and was eventually signed by President Obama, concerns were raised over the constitutionality of the new law. In particular, the individual mandate was in question since the law’s opposition felt it forced individuals to purchase health care, which they claim was overextending the reach of the federal government.
“The mandate represents an unprecedented effort by Congress to compel individuals to enter commerce in order to better regulate commerce,” said Paul D. Clement, the lawyer who brought the case to the Supreme Court and now represents the National Federation of Independent Business, 26 states and two individuals, according to an article published in Buffalo News (Health Reform’s Judgment Day).
The opposition’s primary argument lies in their belief that the mandate is unconstitutional because it requires the U.S. public to purchase a service, which in this case is health insurance coverage.
Additionally, those opposed to the law have rejected the notion that the mandate is valid under Congress’ right to tax. An article published by ABC News (How the Supreme Court’s Health Care Decision Affects You) says that Clement feels that the mandate was put in place in order to avoid an unpopular tax increase to cover healthcare costs.
Solicitor General Donald B. Verilli Jr. is the attorney leading the defense for the Obama Administration and claims that the act was created in order to provide some level of coverage to those who are uninsured. The Buffalo News article says that over 40 million uninsured Americans will still receive medical care, leaving the expenses to be paid by the government and the taxpayers.
“Under the Commerce Clause, what Congress has done is to enact reforms of the insurance market, directed at the individual insurance market, that preclude - - that preclude discrimination based on pre-existing conditions, that require guaranteed issue and community rating,” said Verilli during the Supreme Court debate over the law, according to court transcripts.
The Commerce Clause, according to Verilli, is what supports the government enacting the new Health Care Law. The clause, which many labor and environmental laws rely on, allows the government to regulate interstate commerce. Verilli told the Supreme Court that the individual mandate was created to allow the government to regulate the insurance market as they would any other.
While there is more depth to the both sides of the argument, the decision is left up to the Supreme Court to decide the fate of the Obama Administration’s Health Care law. The court has the option to declare solely the mandate as being unconstitutional or the law in its entirety. Both outcomes will undeniably have major effects on the federal government’s power in the future.
An article in NPR (Health Care Decision Hinges on a Crucial Clause), discussed the effects of the court’s decision with a George Washington University law professor, Jeff Rosen, who believed that this was a significant case to determining the scope of congressional power.
“Let’s not pretend that this is just a modest case of applying existing precedents,” Rose said. “The question is: Are you going to reverse decades of judicial deference in economic matters?”
While the health care industry and the American public awaits the final decision of the U.S. Supreme Court, the future of the U.S. health care system and the possibility of reform rest in the hands of the court justices. Regardless of their decision, it will undoubtedly have a lasting effect on the country and how government operates.
PERSONAL FINANCIAL STRESS AFFECTS EMPLOYEES AT WORK
By: Nicola Crean, CHS Marketing Coordinator
While traditional wellness programs primarily focus on employee’s health, there may be a new reason to expand such programs in order to address personal financial struggles that many employees are facing. Similar to how companies have been affected by the U.S. recession and economic troubles, employees are increasingly feeling the burden in their personal finances.
The 2010 National Financial Wellness Survey reported that 43 percent of employees have trouble covering their monthly expenses. Although employees claim to have decent salaries, it appears as though their overall expenses are more than they can afford.
In an Fox Business article (Financial Literacy Shares Spotlight with Health Wellness), Mark McAvoy, a member of the Organization Development Expertise Panel of the Society for Human Resource Management, claims that employees will spend an average of 20 hours a month dealing with their financial issues. An estimated 30 percent of the 40-hour work week will be spent tending to their personal problems, which decreases employee productivity.
Tthere are five specific risks that come from having financial stressed employees, according to the article Employee Financial Stress is Costing Your Company a Bundle. Loss of employee productivity, accidents caused by distracted workers, health and welfare issues, large employee turnovers and HR distractions are the result of stressed employees being a financial liability for companies. Addressing the cause would serve to greatly benefit employers.
More recent studies report that employees are becoming complacent within their own personal lives. According to Financial Finesse, they indicate that there has been a decline in employees’ overall stress levels, which may be suggesting that workers are sliding back into their previous bad habits.
“When employees grow complacent about their financial situations, they tend to ignore or forget about their long-term goals and needs,” said Liz Davidson, CEO and founder of Financial Finesse. “It is a delicate balance: too little stress and we have no motivation to overcome bad habits; too much stress and the brain and body shut down.”
Companies have an opportunity to promote a healthy balance between work and personal life. By providing employees with the necessary tools to relieve their financial burden, there is potential to increase employee productivity and overall willingness to be present in the workplace.
The Mercer Annual Workplace Survey shows that more companies are looking at ways to help employees’ financial state by providing them with resources and information to educate them. By taking an approach similar to traditional wellness programs, businesses are offering incentive-based initiatives to encourage employees to participate.
Companies are offering one-on-one financial counseling and personal budget program. According to the Fox Business article, McDonalds USA has been a major advocate of promoting financial education. The company has provided professional advisors who discuss debt and credit counseling. In addition, they offer other financial tools such as a smart phone budget application, educational videos and many other online resources to help their employees learn how to manage their finances better.
“We see this as part of lifestyle management,” said Joni Troester, assistant director of Human Resources at the University of Iowa, who recently added a financial element to their existing wellness program. “Financial stress can impede people from having an overall healthy lifestyle.”
While there is no evidence to directly suggest that companies will see a return on investment by addressing employees’ financial stress, their proactive way of thinking will at the very least lead to happier, more productive employees. Looking for ways to reduce stress in the workplace and at home can help to avoid any health related problems.
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