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Sunday April 20th 2014

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Domestic Violence Victims Face Grim Health Outcomes

HEALTHCARE
• Domestic Violence Victims Face Grim Health Outcomes
• Diabetes is a Ticking Time Bomb in the Workforce
• Legislation Would Tie Subsidies to Cost of Living
• Final Regulations on Employer Shared Responsibility
• Small Business Report Plan Cost Hikes
IN CALIFORNIA
• Covered California Boosts Staffing to Meet Demands
EMPLOYEE LEAVE
• Employee Leave Laws Continue to Challenge Employers
FINANCIAL PLANNING
• IRAs Comprise Nearly Half of an Advisor’s Book of Business
NEW PRODUCTS & EVENTS
• One Medical Group Expands Primary Care Service to Employers
• Retirement Seminar Series
• NAHU Capitol Conference
• Individual Health Enrollment Platform
• Flexible Premium Universal Life
• Whole & Term Life
• Single Premium Group Annuity
• Fixed Indexed Annuity

HEALTHCARE

Domestic Violence Victims Face Grim Health Outcomes

domesticvA survey by the National Family Justice Center Alliance finds that domestic violence victims and their children are often uninsured or underinsured; they rarely receive needed medical, dental, and vision services; and they often fail to understand the profound short and long-term effects of the violence and abuse. Major findings include the following:
• Abused women are 70% more likely to have heart disease, 80% more likely to experience a stroke, and 60% more likely to develop asthma.
• Abused women are three times more likely to have reproductive health complications.
• The trauma of growing up in an abusive home has a dramatic effect on a child’s life expectancy. The life expectancy of a child with a score of six (multiple adverse childhood experiences) in the Adverse Childhood Experiences study is reduced by 19 years compared to a child with no adverse childhood experiences.
• Less than one in four victims attributes their health problems to abuse. Many survivors of domestic violence do not realize the possible health effects from near-fatal strangulation assaults.
• The primary barriers to care are lack of insurance and the cost of insurance. Forty-four percent have no insurance. Sixty-five percent of  those with insurance have public insurance, such as Medicaid or Medicare.
• 70% of survivors reported at least one physical health need, but only 49% had a primary care provider, and only 30% saw a doctor in 2013.
• Victims are more likely to use emergency rooms for regular health care. Half went to an emergency room to meet their medical needs while only 30% saw their primary care provider in 2013.
• Forty percent would like to have dental services, and 43% would like to have vision services available in Family Justice Centers or domestic violence agencies rather than going to hospitals or doctor’s offices.
• Twenty-four percent of women will experience intimate partner violence in the United States. It is the most common cause of injury for women ages 18 to 44.
• The economic impact of violence is estimated at $5.8 – $8.3 billion each year; the vast majority attributed to healthcare costs and lost productivity (CDC, 2013).

Alliance CEO Gael Strack said, “Most community-based domestic violence agencies do not have the capacity to meet these needs. Criminal justice interventions, social services, civil legal services, mental health counseling, and other assistance is available in many communities, and multi-agency and multi-disciplinary approaches, such as Family Justice Centers, are bringing together more accessible services under one roof. But health related services are not generally included even in the most dynamic multi-agency, multi-disciplinary service approaches.”

The National Family Justice Center Alliance is working with the Verizon Foundation, Blue Shield of California Foundation, and other allied national organizations to address health needs of survivors of domestic violence and their children, particularly in Family Justice Centers or other types of multi-agency, multi-disciplinary service approaches that serve victims of domestic violence. The Alliance is calling for all domestic violence agencies, Family Justice Centers, and other community-based service providers to do the following:
• Screen survivors for pressing health needs in their intake and case management services.
• Build partnerships with community-based health clinics, hospitals, and health service providers to make sure that victims get the medical services they need.
• Help get survivors signed up for health insurance immediately pursuant to the Affordable Care Act.
For more information, visit www.familyjusticecenter.org.

Diabetes is a Ticking Time Bomb in the Workforce

Diabetes is a workforce time bomb. Employees with diabetes report more lost work time due to absence and impaired performance than do workers with normal blood glucose, according to research by the Integrated Benefits Institute. If current trends continue, one in three adult Americans will have diabetes by 2050.

“Given the ever-increasing rate of diabetes and its consequences, the time for employers to act is now. Introduce clinical screening programs; adopt lifestyle intervention programs for those in the pre-diabetic stage; and provide targeted disease management for those already diagnosed. Finally, broadly measure the results of your interventions so you can show the full value of your programs,” said IBI Research Director Kim Jinnett, PhD.

The odds of missing at least one day of work in the last month were 47% higher for workers with diabetes than for employees with normal fasting blood glucose. In contrast, the odds for a worker with pre-diabetes were only 16% higher than the odds for a worker with normal blood glucose.

Diabetic employees report slightly lower job performance than employees with normal blood glucose levels even after adjusting for other health conditions. Performance for employees with pre-diabetes levels of blood glucose is not discernibly different from that of employees with normal blood glucose, underscoring the potential for positive outcomes by achieving moderate blood glucose improvements.

IBI president Thomas Parry, PhD said, “Treatment could help limit the toll of the disease, but many employees with diabetes may be unaware of their condition. Employers could benefit by improving diabetes awareness, encouraging healthy lifestyles and facilitating disease management.”

Employers can take the following steps to help prevent Type 2 diabetes and help control the effects of diabetes among workers:
• Improve access to blood glucose testing, paying special attention to employees with a high likelihood of elevated blood glucose levels. Work with supplier partners to ensure that employees have access to education and services.
• Promote weight loss among employees with unhealthy body mass. Even moderate weight loss can improve blood glucose levels.
• Promote disease management. Diet, exercise and coping skills can be effective for people who have been diagnosed with Type 2 diabetes. Different types of insulin control mechanisms and medication may also be added. Employers should be aware that, for proper disease management, multiple providers must have excellent care coordination, and diabetic employees must be involved in their treatment.

For more information, visit www.ibiweb.org.

Legislation Would Tie Subsidies to Cost of Living

U.S. Reps. Mike Thompson (CA-5) and Anna Eshoo (CA-18) introduced H.R. 3986, the Fair Access to Health Care Act. The legislation would tie health insurance subsidies to the cost of living of a geographic area instead of to the national federal poverty level.

Under the ACA, those earning 138% to 400% of the federal poverty level qualify for premium tax credits to purchase health insurance through the exchanges. A person who earning up to $45,960 and a family of four earning up to $94,200 qualify for premium tax credits.

However, the income threshold doesn’t take into account the cost of living in different geographic areas. A family living in New York City or San Francisco is treated the same as a family living in a small town in South Carolina or Texas.

Thompson explained, “In some California cities, the cost of living is far higher than the national average…Some hard working families in high-cost areas like ours don’t qualify for subsides and therefore can’t get affordable insurance. This bill will help make affordable health insurance a reality, no matter where someone lives.”

Under the bill, the federal poverty level threshold will increase proportionally based on an area’s cost of living above the national average. The cost-of-living is determined using the Census Bureau’s Supplemental Poverty Measure. Using this calculation would yield the following results:
• In San Francisco-Oakland-Freemont, Calif., a family of four earning up to $125,757 and individuals earning up to $61,356 could qualify for premium tax credits to purchase health insurance through the ACA’s exchanges.
• In tVallejo-Fairfield, Calif., a family of four earning up to $109,743 and an individual earning up to $53,543 could qualify for premium tax credits.
• In the Napa, Calif., a family of four earning up to $116,808 and individuals earning up to$56,990 could qualify for premium tax credits.
• In the Santa Rosa-Petaluma, Calif., a family of four earning up to $113,746 and individuals earning up to $55,496 could qualify for premium tax credits.

There is precedent for such cost-of-living adjustments. The ACA accounts for the cost-of-living differences in Alaska and Hawaii by using a higher income threshold to determine subsidy eligibility. The Fair Access to Health Care Act would provide similar adjustments to the other 48 states. Individuals and families from low-cost geographical areas would not be affected by this legislation. Those earning up to 400% of the FPL would still be eligible for subsides and no region would see a reduction from their current subsidy level.

Final Regulations on Employer Shared Responsibility

The Dept. of Treasury and the IRS issued final regulations implementing the employer responsibility provisions under the Affordable Care Act (ACA) that take effect in 2015. In addition, the Administration will issue final regulations shortly that aim to streamline employer-reporting requirements for employers that offer highly affordable coverage to all or virtually all full-time employees.

This is how the policy affects employers:
• Small Businesses with fewer than 50 employees (about 96% of all employers): Under the Affordable Care Act, companies with fewer than 50 employees are not required to provide coverage or fill out any forms under the Affordable Care Act.
• Larger employers with 100 or more employees (about 2% of employers): The overwhelming majority of these companies with 100 or more employees already offer quality coverage. The rules phase in the percentage of full-time workers that employers need to offer coverage to from 70% in 2015 to 95% in 2016 and beyond. Employers in this category that do not meet these standards will make an employer responsibility payment for 2015.
• Employers with 50 to 99 employees (about 2% of employers): Companies with 50 to 99 employees that do not yet provide quality, affordable health insurance to their full-time workers will report on their workers and coverage in 2015, but have until 2016 before any employer responsibility payments could apply.

Small Business Report Plan Cost Hikes

Ninety-one percent of small businesses surveyed by the National Small Business Assn. (NSBA) were hit with cost increases during their most recent health insurance renewal. Twenty-five percent were hit with increases exceeding 20%. NSBA President Todd McCracken said, “These costs have real-world implications: one-third of small businesses held off on hiring a new employee and more than half say they held off on salary increases for employees.”

While the majority of employers say that offering health insurance is very important to recruiting good employees, just 51% of the smallest firms offer health benefits. Among the 70% of small firms that offer health insurance, the majority pay for more than half of the cost of their employees’ plans.

The average monthly per-employee cost of health insurance premiums for a small firm is $1,121 compared to just $590 in 2009. Small businesses spend an average of 13 hours and $1,274a month on the administrative side of understanding the Affordable Care Act. For more information, visit www.nsba.biz

IN CALIFORNIA

Covered California Boosts Staffing to Meet Demands

Covered California is increasing staff to answer consumer calls, adding phone lines, improving its website efficiency, expanding its live Web chat function, and upgrading its Spanish-language Web pages. The improvements are in response to a flurry of signups in the new state health exchange over the past two months and in preparation for even stronger consumer interest as the March 31 enrollment deadline approaches.

A large-scale hiring wave is now under way to add 350 Covered California Service Center representatives by the end of March, including more bilingual staff. As part of that expansion, more than 250 new representatives recently began training at the Fresno Service Center, including 28 representatives who are Spanish speaking. Covered California is dedicating more representatives to its live Web chat function, available in English and Spanish; expanding phone line capacity; and adding self-service online tools, such as the ability to reset passwords and change user names.

Covered California will post subsidy-eligible applications in Spanish, Chinese, Vietnamese, and Korean on its website. Consumers can also use a search tool to find information, including frequently asked questions. The exchange also launched dedicated support phone lines for its certified enrollment counselors and, this week, will establish a dedicated support phone line for licensed certified insurance agents.

EMPLOYEE LEAVE

Employee Leave Laws Continue to Challenge Employers

The Family and Medical Leave Act (FMLA) and other leave laws have been integrated into corporate processes. However, legal and regulatory changes present challenges for employers. These changes also offer new sources of business for their vendors, according to a recent survey by the Disability Management Employer Coalition (DMEC).

New rights for same-sex spouses are driving changes in corporate leave practices. These rights arise from the 2013 Supreme Court decision (United States v. Windsor) on the Defense of Marriage Act (DOMA) . Employees who live in states that recognize same-sex marriage must be allowed to take FMLA leave to care for a same-sex spouse who has a serious health condition or attend to child care and related activities when a same-sex spouse is called to active duty.  Key survey results include the following:
• Almost half of employers say that it is extremely difficult to train supervisors in leave processes.
• More than half of employers say that the relationship between HR/benefits and risk management functions is successful or positive
• More than half of employers use internal legal resources to manage leave laws.
• 68% of employers centralize leave management
• 90% of employers say that HR is involved in tracking and managing leave
• Leave outsourcing has increased by 16% over 2012 with 34% of employers outsourcing FMLA leaves.
• Employers with 500 to 999 employees are most likely to use externally developed leave tracking systems, but run them internally.
• A new trend is that 5% of employers outsource ADA accommodation leaves
For more information, visit www.dmec.org.

FINANCIAL PLANNING

IRAs Comprise Nearly Half of an Advisor’s Book of Business

Retail individual retirement accounts (IRAs, SEP) make up nearly half of a financial advisor’s book of business, according to a survey by Cerulli Associates. Financial advisors play a key role in the ability of asset managers to win flows from rollovers. However, these rollover assets are hard to acquire, according to Bing Waldert, director at Cerulli.

Financial advisors, on average, capture larger rollovers than direct providers, with the largest balances going to existing advisory relationships. Rollover assets are a key component of an asset manager’s retirement strategy. However, advisors view rollovers as just another source of funds for their practice instead of as a key market to be cultivated.

Cerulli expects that advisors will continue winning rollovers. Financial advisors who deliver a holistic view of a client’s financial picture will benefit from integrating all assets into an overall financial plan. As a result, asset managers working closely with advisors should continue to benefit. For more information, visit cerulli.com

NEW PRODUCTS & EVENTS

One Medical Group Expands Primary Care Service to Employers

One Medical Group, a primary care network, will allow companies nationwide to offer the One Medical service as an employee health benefit. Over 40 companies have already enrolled in One Medical’s enterprise program, including Adobe, NBC Universal, and Quantcast. Employees of participating companies enjoy access to top primary care physicians, as well as same-day appointments, online and mobile scheduling, 24/7 telehealth services, and integrated health and wellness solutions. For more information, http://www.onemedical.com.

Retirement Seminar Series

MassMutual is offering a new lineup for its RetireSmart educational series. The series opens Feb. 26 with a focus on helping participants understand how the stock market, fiscal policy, and the global economy affect retirement planning. The RetireSmart seminar series will include the following topics:
* April 9: Retirement Planning for the Ages.
* June 11: Strategies for Pre-Retirees.
* Aug. 6: The Art of Negotiating a Deal.
* Dec. 3: Maximizing your Workplace Benefits.
For more information visit massmutual.com/retire.

NAHU Capitol Conference

NAHU’s annual Conference in Washington, D.C. will be held
February 25 to 26. For more information, visit http://www.nahu.org/meetings/capitol/2014/index.cfm.

Individual Health Enrollment Platform

Through GoHealth Marketplace, individual licensed health insurance agents can now quote health insurance rates instantly, calculate tax subsidies, and enroll Americans in insurance plans under the Affordable Care Act. Norvax, a GoHealth company, is using the GoHealth Marketplace to provide these capabilities to licensed insurance agents nationwide. It streamlines the enrollment process to offer an enhanced experience for both insurance agents and individuals.  The platform helps agents manage customers, quote plans in 50 states, and enroll consumers in on-exchange plans in 36 states. Agents can  get instant subsidy-eligibility information and sell on-exchange plans to subsidy-eligible individuals. For more information, visit www.Norvax.com/Marketplace.

Flexible Premium Universal Life

AXA launched BrightLife Protect, an affordable universal life insurance policy for individuals, families, and businesses. The flexible, premium universal life insurance policy with an index-linked interest option, offers the following: premiums can be allocated to a fixed account (guaranteed interest account) that offers a guaranteed rate of return and/or to a select account, an index-linked interest option tied to the S&P 500 price return index, subject to a cap, that offers upside cash value accumulation potential, and a guaranteed 0% floor which protects from losses due to market performance. It also features flexible premium payments and a long-term care rider. For more information visit http://www.axa-equitable.com.

Whole & Term Life

Aflac is offering two newly enhanced insurance plans: Aflac Whole Life and Aflac Term Life. Plan highlights include face amounts up to $500,000 and a guaranteed-issue option. Cash benefits can be used for a variety of financial needs, including replacing lost income, funding a college education, and paying for a mortgage or final expenses. Aflac’s Whole Life insurance plan provides coverage and builds cash value for the life of the policy. The Term Life insurance plan offers coverage at a fixed rate, typically for a 10, 20, or 30-year plan. Aflac’s whole life and term life insurance face amount options are offered for up to $500,000 for individuals under 50 and up to $200,000 for people 51 to 70 or 51 to 68 for the whole and term plans. Guaranteed-issue is also available for the primary insured for $20,000 or $25,000 of term life coverage. For more information, visit aflac.com

Single Premium Group Annuity

American United Life introduced Pension Risk Transfer, a single premium group annuity. The guaranteed buy-out product allows plan sponsors to transfer pension risk to AUL. The pension risk transfer offered by AUL includes record keeping of individual employee data and tax withholding and reporting administrative services and is supported by professionals with extensive experience in defined benefit administration. Enrolled actuaries and compliance attorneys are also available for consultation. For more information, call 877-285-3863.

Fixed Indexed Annuity

Nationwide Financial and Annexus launched Nationwide New Heights, a fixed indexed annuity product built to capitalize on what companies see as a market poised for robust growth. New Heights offers uncapped earning potential, a rarity in the fixed indexed annuity world, said Eric Henderson, senior vice president of Life Insurance and Annuities for Nationwide Financial.
Annexus, a leading fixed indexed annuity product designer, will market and distribute the product through independent marketing organizations. New Heights  will also be available to Nationwide’s exclusive agents, independent distributors and bank and wirehouse channels next month. For more information, visit www.annexusgroup.com.