Posted by Company Wellness | Posted in Company Wellness, Wellness Programs | Posted on 03-12-2010
When it comes to health-coverage laws, there’s often a domino effect.
As individual states require insurers – and in some cases, companys – to cover or offer coverage of specific individuals and procedures, similar laws can spread rapidly to other states.
The effect on plan sponsors – Some mandates can increase your costs by 20 percent to 45 percent.
Small firms targeted, too
States are no longer targeting just the Wal-Marts and other giant businesses anymore. The pressure has increased on corporations of all sizes.
That’s especially true for the new “universal coverage” laws passed in Massachusetts and Vermont.
The Massachusetts law requires every firm with 11 or more personnel either to cover or contribute toward everybody’s health coverage, or else pay an annual fee of $295 per staff member to a state fund.
Vermont’s similar version sets the yearly fee at $365 per full-time equivalent worker. The Vermont law also requires all uninsured, low-income hourly workforce to have access to a state-subsidized plan (called Catamount Health) sold through private insurance businesses.
It’s up to companys to deduct the monthly premiums – $60 to $135, depending on the person’s wages – and send it to the state.
There are rumblings in at least 10 states about lawmakers pushing for universal-coverage laws. Several have formed committees to study the Massachusetts law and see if a version can be adjusted to their state.
Here are three proactive steps to consider now. These could potentially save money, time and compliance headaches later –
• look into offering mini-med or similar lower-cost programs to satisfy minimum coverage requirements for uninsured workforce. Monthly premiums range from about $25 to $200
• educate low-income staff about the earned income-tax (EIT) credit the federal government offers. This can make a mini-med plan free or almost free to eligible staff, and
• use flexible spending accounts to develop a tax savings on premiums for other staff and your firm.
Required procedures
The universal-coverage laws draw national headlines, but far more companys are currently affected by state laws requiring coverage for certain kinds of procedures. Three of the biggies –
• diabetes self-management. Nineteen states require your health plan to cover all the steps workers with diabetes take to control their condition, including nutritional therapy (if prescribed by a physician)
• in vitro fertilization. This large ticket service adds 3% to 5% to your premiums, and is now a required benefit in 15 states, and
• cervical cancer screenings. In the last year, four more states have required all business plans to cover yearly cervical cancer screenings for all covered female staff, spouses and dependents age 18 and older. That brings the sum to 24 states.
The good news about the diabetes management and cervical cancer mandates is they can lower your long-term costs, even if they increase them in the short-term.
Here is a good resource for keeping abreast of mandatory coverage trends around the country. The site also features state-by-state breakdowns of changes in insurance laws mandating the coverage of different treatments and conditions.
For instance, this report from 2006 is the most robust coverage-mandate study that I’ve ever seen.