Kibble & Prentice Insider

Election News: Washington’s “Everything but Marriage” Law Placed on November Ballot

The signature check for Referendum 71 is almost complete and election officials indicate that the referendum’s sponsors secured enough signatures to place the issue on the November ballot.

As a reminder, Referendum 71 sought to halt the effective date of E2SSB 5688, the “Everything but Marriage Act,” and place the matter to a public vote this fall. The Act would require that, except for marriage, a registered domestic partner is treated the same as a spouse for all purposes under Washington State law. This would include, among other things, that insurance contracts written in Washington (including group health plans) treat registered domestic partners on an equal basis with spouses.

Because enough signatures were secured, the effective date of the Act is on hold pending the outcome of the election. We will keep you posted as information develops.

For more information see:

• Secretary of State Home Page
• E2SSB

Medicare Mandatory Insurer Reporting – Data Collection

Health insurance carriers and third-party administrators (TPAs) in a self-insured group health plan (generally the entity processing claims for the group health plan) are considered Responsible Reporting Entities (RREs) and are required to report certain data to the Centers for Medicare and Medicaid Services (CMS). This data is being used to better identify situations where the group health plan is (or should be) paying primary to Medicare.

Many RREs have reported difficulty in obtaining the information necessary to file a complete report to CMS. In particular, the collection of social security numbers and Medicare health insurance claim numbers (HICN) from covered participants has been burdensome.

CMS has issued an Alert and a sample letter to assist the RREs in securing this information.

Read full article to learn what you need to do.

Oregon Premium Tax

Effective October 1, 2009, a new law (House Bill 2116) will require insurers of health plans to pay a 1% tax on the gross premium earned from policies that:

• Insure Oregon residents, or
• Are delivered or issued in Oregon

Thus, the tax will apply to insurance contracts written and issued in Oregon, as well as policies written in other states that provide health insurance to residents of Oregon. In the second scenario, it appears the premium tax will only apply to the portion of the gross premium allocated to Oregon residents. As this is a state mandate, the premium tax should not apply to self-insured plans.

Read full article

Carrier Updates

GROUP HEALTH COOPERATIVE
Privacy and EOB’s
Beginning October 3, 2009, Group Health Cooperative changed their procedure for sending subscribers an Explanation of Benefits (EOB). An EOB is a statement outlining how a claim was paid. In order to better protect patient privacy, all subscribers and dependents over 18 will receive their own EOB and corresponding bill for medical services received. All services for dependents under age 18 will continue to show on the billing sent to the subscriber.

PREMERA BLUE CROSS
Ballard Emergency Physicians Rejoins!
Effective August 1, 2009, Ballard Emergency Physicians rejoined the Premera Blue Cross provider network. The physician group provides emergency room services for Swedish Medical Center in Ballard.

Please note, however, that Swedish Emergency Physicians (SEP) providing emergency room services for the Swedish Medical Center on First Hill are not in the Premera provider network.

Swedish Medical Center, the facility, is contracted with Premera Blue Cross, so facility charges and services received from physicians and providers other than SEP are paid at the in-network level, accordingly.

GREAT-WEST HEALTHCARE
Moving to CIGNA Pharmacy Services
As a reminder, effective November 1, 2009, Great-West will be transitioning their pharmacy services from Express Scripts, Inc. (ESI) to CIGNA Pharmacy Services. All plan participants with pharmacy coverage will receive a new ID card in mid-October. All network pharmacies will be notified so that the pharmacies are able to assist with the transition.

CIGNA Home Delivery will also be taking over the home delivery services currently provided by ESI. CIGNA Home Delivery will coordinate the transfer of any remaining, eligible refills. All current home delivery customers will receive a welcome packet in late October with additional details.

Ending a Non-Elective Safe Harbor Contribution

The safe harbor 401(k) has been a very popular plan design since the late 1990s. Its popularity stems from the fact that when a plan is not otherwise able to pass the ADP and/or ACP nondiscrimination test, the employer may make a safe harbor 401(k) contribution, thus allowing the plan to avoid discrimination testing and highly compensated employees to maximize their deferrals.

Full Article

Possible Green River Area Flood Preparedness

Kibble & Prentice recently mailed a letter to residents and businesses in South King County with regard to the possible flooding of the Howard Hanson Dam in South King County this winter. Click here to access our list of resources to help you be prepared, should you live or operate a business in that area, or to discuss flood insurance, please contact your representative in our offices.

One of the most beneficial services within our risk strategies group is the claims help they can provide. Successful resolution of our clients’ property and casualty claims requires the resources of a team of technical professionals with a wide array of talents. These experts all contribute to investigating, valuing and resolving each claim we undertake. Our team includes experts in business valuation, forensics accounting, engineering, risk management, economics and property appraisal.

We recently assisted a client with the resolution of a complex property claim arising from a catastrophic fire. While we focused on assessing, valuing, documenting and resolving their claim with their insurers, our client was able to stay focused on restoring their business operations.

Full story