Posted by
Stephanie Castro
on
11/30/2011 at 12:21 PM
On November 17, 2011, the Departments of Health & Human Services, Labor, and the Treasury (the "Departments") issued an FAQ document that addressed the concern of many health plans about being able to meet the proposed March 23, 2012 deadline for the summary of benefits and coverage (SBC) requirement that is part of the Patient Protection and Affordable Care Act (PPACA).
The document states that health plans are not required to comply with the regulation until final regulations are issued. As of today, the Departments have not yet issued final regulations, and there is no word on the final release date. While the Departments’ FAQ may have eased concern over the tight deadline, they may have raised additional questions for health plans on how they should implement given an extended timeframe.
Most health plans have come to the same conclusion about the SBC regulation: as one recent prospective VUE Software client put it, “This is a software issue”. Plans have recognized that in order to comply with various aspects of the SBC, an automated solution is necessary. Previous to the deadline extension communication, many health plans were scrambling to find a vendor who could assist, feeling pressured into making hasty decisions on important investments.
Now, plans have more time to figure out how to go about acquiring the right software for the SBC. Many who were considering building a solution in-house may have the time to do so with a looser deadline. Still, with no final regulations, many development efforts may be wasted trying to hit a moving target. And, since the Departments have stated neither the final regulation release date, nor the duration between time of issue and new deadline, health plans who wait to begin implementation until after the regulations are issued may find that they still don’t have enough time to meet the new deadline.
With such uncertainty, smart health plans will take the extended deadline lightly, and move forward on implementing a flexible infrastructure that will allow them to comply with the final regulations, no matter what their final form. For more information on VUE Benefit Summary Tool, which functions both as a flexible infrastructure for storing plan data and creating benefit summaries – and comes out-of-the-box with the current format for SBCs and includes free updates to future formats – register now for an informational call with a product consultant.
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Posted by
Joseph Westlake
on
6/15/2011 at 11:59 AM
The Patient Protection and Affordable Care Act (PPACA) has created an anticipation of growth for small group and individual health plans that offer cost-effective and customer-oriented products. With new potential customers flooding the market, health plans possessing easily adaptable sales processes will come out on top. Also, health plans will do well to consider how their systems will interoperate with state Health Insurance Exchanges to best provide their coverage plans to uninsured Americans.
These issues are important for health plans to consider before performing organization-wide technology updates. The AHIP Institute 2011 conference is especially timely for insurers needing information and answers. The sessions at Institute 2011, to be held in San Francisco between June 15th and 17th, will offer ideas and solutions to some of your most complicated questions.
The Institute helps in your understanding of how states are creating the IT infrastructure to support an interactive portal, the thoughts of the employer community, and strategies to prepare for operational aspects of Exchanges. The Institute's Exhibit Hall also offers the newest products and services focused on reform implementation.
You can also attend a health care reform implementation workshop where you’ll have a better understanding of the impact of the Affordable Care Act. Get exposed to topics that include long-term care, disability income insurance and wellness.
At the Institute, VUE Software will provide a free opportunity to AHIP attendees to register for a webcast “CRM for Insurance – Increase Revenue and Agent Productivity”. The webcast will be presented in association with Microsoft and Insurance Networking News. Prominent speakers, Don Desiderato Principal, Novarica and Alan Dulin, U.S. Director of Insurance Microsoft will share how CRM for Insurance, built specifically for the needs of insurance organizations, can improve revenue and member retention.
Click here to Register Now.
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Posted by
Stephanie Castro
on
10/28/2009 at 11:29 AM
The week of October 10th saw the release of the first batch of H1N1 (swine flu) vaccines. The release could have been sooner, considering that the CDC is already reporting abnormally high levels of influenza, especially H1N1, for this time of year, according to The AIS Report on Blue Cross and Blue Shield Plans, an independent monthly newsletter on business strategies, products and markets, mergers and alliances, and financing of BC/BS plans (not affiliated with BlueCross BlueShield Association or its member companies).
The report states that in September, the Blue Cross and Blue Shield Association (BCBSA) said that all member plans will cover administration costs for H1N1 vaccine. The cost of the vaccine itself is borne by the federal government, which spent a total of $1.5 billion to pay for 251 million doses of H1N1 vaccine.
The five target groups most at risk will receive the first doses. These include pregnant women, people caring for children under six months of age, health care and emergency medical personnel, persons between six months and 24 years of age, and those between 25 and 64 years old with chronic health disorders or compromised immune systems.
Various Blue Cross plans have acknowledged a focus on education and prevention. Plans are using their web sites to post H1N1 Advisories, which include information on benefit coverage and basic prevention methods. Some companies also distribute information via social media sites such as Facebook and Twitter.
Other plans are using other methods such as postcard reminders, member newsletter articles, and targeted mailings. WellPoint, Inc, which controls a number of Blues Plans, also communicates about the flu and H1N1 with its brokers, consultants and employer groups.
For more information on H1N1, visit www.cdc.gov/h1n1flu/update.htm. For more information on the AIS Report, visit AIShealth.com.
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