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 Trust Matters, August 2013 

Health care reform employer mandate delayed, notice due Oct. 1

Safety Catch

Building a healthy wellness program

MIT Health Benefits Trust changing pharmacy vendors

Underwriting reviews

Did you know?

Upcoming events

Do you have a healthy perspective?

Workers' compensation self audits due

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Health care reform employer mandate delayed, notice due Oct. 1

In the May issue of Trust Matters we wrote that January 1, 2014, is the year that employee and employer mandates take effect. However, on July 2nd the Department of the Treasury announced the Obama Administration’s plan to delay the implementation of the employer mandate until January 1, 2015. The Internal Revenue Service recently published a website that employers can use to gather information about their new responsibilities under health care reform law. The website, found here, also explains in detail why the changes have been delayed by a year. The employer mandate requires employers to provide health coverage to their full-time employees or pay significant penalties. The Administration stated the delay is designed to accomplish two goals: “First, it will allow us to consider ways to simplify the reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.” This delay raised a number of questions regarding certain provisions of the law that trigger a penalty under the employer mandate. Examples include the cost sharing limitations, the 90-day waiting period limitation and certain reporting requirements not tied to the employer mandate.

Employers Must Provide Notices of Health Insurance Marketplaces

Despite the delay in the employer mandate, the Individual Mandate remains in place for January 1, 2014, and employers are required to provide notice of Health Insurance Marketplaces, formerly referred to as Exchanges, by October 1, 2013. In 2014, new hires must be provided the notice within 14 days of the employee’s start date. The notice must be provided in writing and can be provided either electronically (under the Department of Labor’s electronic disclosure safe-harbor requirements) or by first class mail. This is explained on the Department of Labor website here.

The Department of Labor has issued model language that can be used. The guidance also included two model notices - one for employers who offer a health plan (click here to view this notice) and one for employers who do not offer a plan (click here to view this notice) - that may be used to satisfy the notice obligation. 

The marketplaces will allow individuals to select from an array of plans and navigators will be in place to assist with their selections. Subsidies will be available to those individuals making below 400 percent of the federal poverty level. Of course, if you are currently offering a plan at no cost to the employee, they will not have reason to access the coverage through the marketplace. Open enrollment begins on October 1, 2013. In North Carolina three carriers have been approved by the Department of Insurance to participate in the marketplace: Blue Cross Blue Shield, Coventry and First Carolina Care. Blue Cross Blue Shield is the only carrier that will offer subsidized coverage in all 100 counties of the state; while plans from Coventry Health Care will offer subsidized plans in some parts of the state and First Carolina Care will only be available in six counties (News and Observer July 31, 2013). The health plans await federal certification from the U.S. Department of Health and Human Services. A decision is expected in September. It is expected that 60 plans will be offered.

Safety Catch

Safety Catch, Risk Management Services’ online training resource for safety and loss control videos, continues to be a valuable tool for workers’ compensation and property and liability pool members.  During the first six months of this year, employees participated in almost 4,000 online training classes.   With over 60 training topics, there is a wide selection of training programs to meet many of the workplace training requirements our members face.  We continue to evaluate the workplace hazards our members encounter and look for resources to assist in their safety programs.

Many of the training videos meet the North Carolina Department of Environment and Natural Resources continuing education requirements for water and waste water employees. Risk Management Services provides the department with a list of the employee’s completed training courses to satisfy these requirements.

Tom Donlon from Carolina Beach said he and his crew were impressed with the presentations.

“They were not only entertaining, but educational and we seem to retain the information by participating in the quiz at the end. We expect to be using this on a regular basis.”

Each employee participating in Safety Catch creates an account that tracks their activity. This allows management to easily monitor and archive an employee’s online training activities. As another reminder, employers are required by OSHA to provide training on the revised hazard communication standard related to Global Harmonization and the new label elements and safety data sheets.  Training is required to be completed for all employees identified in your hazard communication plan by Dec. 1, 2013. This topic is just one of the many training opportunities offered by Risk Management Services’ online training. 

Safety Catch is free to all members of the League’s workers’ compensation or property and liability insurance pools. For more information please contact your risk management field consultant or Brenda Rich at brich@nclm.org.

Building a healthy wellness program

It is a team effort to build and maintain a good wellness program in an organization. The Health Benefits Trust truly believes in our wellness programs and we are here to help you and your employees live healthier lifestyles. We offer several programs free to members, like the Wellness Initiative, which offers onsite wellness assessments to all of your employees, and our grant program, which offers free money to start or enhance a current wellness program you may already have in place. The Town of Edenton has taken advantage of a couple of those programs.  Edenton’s Town Manager Anne-Marie Knighton recently sent us a copy of a letter she sent to all employees after receiving a group profile report showing employees’ health as a group.

She wrote to the employees, “These statistics are of grave concern to me and should be to you.  I know how very busy you are, especially those with families and children.  It is difficult to make time to exercise and prepare healthy meals.  But if we do not make changes, if we continue making the choices we are making, the majority of us will be dealing with debilitating and life-threatening diseases such as diabetes, heart disease, stroke and heart failure.”

In the following paragraph, she shows that management believes in wellness and is truly interested in their employees.  She wrote, “The Town is committed to helping provide all of us with the information we need to make healthy choices and live a healthy lifestyle. Lunch and Learns will continue to be offered to all employees. We will continue to require mandatory participation in the health and wellness screens. We are in the process of purchasing blood pressure machines. We will set up a program to teach employees how to measure and track their blood pressure and provide information and advice on how to reduce it. We have other ideas too, but we want to hear from you, tell us what the town can do to help motivate us to make better decisions about our lifestyle.”

The Town of Edenton also received a Wellness Grant in April to help purchase blood pressure monitors.  They now have Blood Pressure Wednesdays where the wellness coordinator from the local hospital comes to the town and employees have their blood pressure checked and receive individual coaching if needed.

This really looks like the beginning of a great Wellness Program.  We want to thank Anne-Marie for sharing her letter with us and acknowledge the Town of Edenton’s commitment to wellness.  We also want to remind all of our membership that if you do participate in the health program, you, too, can apply for a grant to receive free money for your wellness program and request the Wellness Initiative to come in to do free assessments.  All you need to do is pick up that phone and call us. We are here to help you build healthy wellness programs.

MIT Health Benefits Trust changing pharmacy vendors

In an effort to continually manage costs, the MIT Health Benefits Trust of NC will be changing pharmacy benefit managers this fall.  A formal RFP was issued this summer to several pharmacy vendors and we are still in the process of determining who will be the best fit for our Health Benefits Trust. We expect to be able to make a formal announcement soon that will include the name of the vendor and a timeline for the mailing of new ID cards to employees.  These cards will house the information for our medical, dental and pharmacy benefits, so they will replace the existing cards your employees now hold.   

MIT Health Benefits Trust Focus Group

The MIT Focus Group met on Aug. 28 to bring suggestions and ideas to help our staff make decisions on our MIT Health Benefits Trust. We anticipate them being very busy this renewal with Healthcare Reform on the horizon. We have representatives from across our state helping us with our plan decisions and representing the voice of employees from every region. Please thank the following members for their participation in this very important role: 

Carol Dorsey, City of Oxford

Donna Armbrister, Town of Hillsborough

Harriett Thomas, City of Marion

Beverly Kissinger, Town of Kill Devil Hills

Julie Bullock, City of Lumberton

Lisa B. Silverthorne, Plymouth Housing Authority

Darlene  Bullins, Stokes County

Marcenda Rogers, Northampton County

Joetta Guist, ONWASA

Jackie Edwards, Town of Canton

 

Underwriting reviews

Underwriting staff conducts a limited number of on-site visits each year to explain coverages; review property, auto, and equipment listed on the insurance; and other risk management issues. For members with less insured property, we can discuss your insured property and other insurance needs over the phone. Additionally, we are available to perform a site visit and help inventory water and wastewater treatment facility structures after a treatment plant expansion. Meetings with staff from multiple departments can be arranged as needed to provide basic information on how the insurance program works; sometimes these meetings might include our Loss Control, Claims and Member Services staff. Finally, please call our underwriting staff for any insurance, contractual risk or liability questions you may have.

Did you know?

July marked the end to another successful renewal period for the three insurance trusts administered by the League’s Risk Management Services. The Workers’ Compensation and Property and Liability Insurance Trusts provide stability and value for the members. The workers’ compensation trust began in 1981 with 125 municipal members and continued growing this year with 461 current members. Risk Management Services welcomes several new or returning members to the workers’ compensation pool to include East Carolina Council, Town of Forest City, Town of Snow Hill, Town of Oakboro, Town of Boone and Piedmont Triad Airport. 

The Property and Liability Insurance Trust began in 1986 with 200 members and has 383 members in the program. New or returning members to the program this year include East Carolina Council, City of Cherryville and Town of Oakboro. 

“It was a pleasure working with NCLM staff as it related to seeking out a carrier for liability insurance for our city. The League was able to quickly identify our needs and construct a coverage plan which addressed our operations and risks specific to the City of Cherryville. The overall coverage and minimum costs involved exceeded our expectations, especially when compared to other liability insurance carriers. I would gladly recommend to anyone to explore the NCLM’s Risk Management program when shopping for insurance coverage,” Ben Blackburn, the town manager of Cherryville, said.

The programs have remained solid during various cycles of the insurance market and continue to provide members with professional resources in underwriting, claims management and loss control services. 

This was also a year of new opportunities for the League’s Health Benefits Trust.  Approval was given for counties and county related entities to participate in our health insurance program. Risk Management Services welcomes Northampton and Stokes counties into our program along with Town of Swansboro, Sunset Beach ABC and Warren County ABC. 

The evolving structure of health care brought on by the Affordable Care Act has League members and many professionals in the health insurance industry trying to determine how the new law impacts their operation and options. As we did during the 2013 Spring Workshops, Risk Management Services will continue to monitor the ever changing landscape of health care and provide members with resources to make decisions based on the best information available.

Risk Management Services looks forward to providing our members with stable and professional insurance programs. We continue to add to the list of value added services, such as the Wellness Initiative, EAP Grants, online safety training, body armor grants for law enforcement, and specialized loss control programs to help our members control claims and reduce costs. Members have expressed their gratitude for having Risk Management Services as their resource for insurance.

Upcoming events

Mark your calendars for the following upcoming events!

MIT Medical participants are invited to attend one of the following HealtheReports Webinars:

  • Sept. 9 at 10:30 a.m. and 3:00 p.m.
  • Sept. 10 at 10:30 a.m. and 3:00 p.m.
  • Sept. 17 at 10:30 a.m. and 3:00 p.m.
  • Sept. 19 at 10:30 a.m. and 3:00 p.m.
  • Sept. 23 at 10:30 a.m. and 3:00 p.m.
  • Sept. 25 at 10:30 a.m. and 3:00 p.m.

The RMS Board Strategic Planning Workshop will take place Oct. 2 - 4.

Don't forget to register by Sept. 13 for the 2013 North Carolina League of Municipalities Annual Conference in Hickory on Oct. 13 - 15! Click here to view the schedule and register. 

Do you have a healthy perspective?

We do!  With the beginning of a new plan year, we have made an exciting change to our Wellness Newsletter. Not only have we moved to a new vendor, Healthy Perspectives, but we also changed our method of distribution. For many years, our membership enjoyed the Wealthy and Wise newsletter that was mailed to home addresses on a quarterly basis, but as times change, so must we. We now distribute our new newsletter via email to the person designated at your town as the Health Benefits Trust contact and request that they either email to the town’s employees or place a copy in a common area for all to see. Healthy Perspectives was chosen because it offers us a dynamic electronic newsletter that allows us three times the opportunity to reach our membership. It is packed full of articles and information to help you and your family live healthier lifestyles. We hope you find our new wellness newsletter refreshing and welcome any feedback. 

Workers' compensation self audits due

Workers’ compensation premium audits gather very important information that the NCIRMA pool reports to our reinsurers. They also confirm the actual payroll that the member had for the previous year. This can result in an additional premium, return premium, or no change at all. Some members receive a visit by Carol Regina or Steven Hulme, our workers’ compensation auditors. These on-site audits are usually performed when there are substantial payrolls or complex situations. However, more than 70 percent of all workers compensation audits are performed by using a self-audit form. The self audit forms were emailed to those members in July. We have set a due date of August 30 to receive these in our Raleigh office. It is most important that we have these completed and returned as soon as possible. Risk management staff enters this payroll data for underwriting purposes and summary data is reported to the reinsurers in early January.