Acclaris Innovation Empowers Health Care Consumers

As deductible and co-pay amounts continue to grow in employer-sponsored health care plans, employees are taking greater advantage of the so-called account-based plans that help them pay for deductibles and co-pays with dollars that are set aside in a tax preferred account. Health Reimbursement Arrangements (HRAs) and Flexible Spending Accounts (FSAs) are helping millions of Americans save money on their out-of-pocket health care expenses.

However, the IRS requires that dollars claimed from these types of plans be approved, or “substantiated” by a third party administrator (TPA) who insures that they meet the requirements of a qualified medical expanse. In most instances, the TPA will require the employee to submit a receipt so the claimed expense can be verified.

The increased use of debit cards associated with these types of accounts has eliminated the need for some of this paperwork, but has created its own set of substantiation challenges. While the cards are able to “auto substantiate” many of the transactions that occur at drug stores and physician offices, some purchases still need to be verified manually by the TPA and this requires the employee to submit a receipt for money that has already been disbursed from the plan.

That happens if the employee no longer has a receipt, or if the purchase does not qualify as a medical expense? In most cases the employer must find a way to collect the non-substantiated amount from the employee, or add the amount as taxable income onto the employee’s W2 at the end of the year. Both of these alternatives create additional paperwork for the employer, and a potentially negative experience for the employee.
Now there is a better way to deal with these unsubstantiated debit card claims. Acclaris, a platform and business service provider leader that enables its clients to transform the way they offer and administer consumer-driven health and reimbursement accounts, has introduced an industry leading claims offset feature that allows the consumer to use yet unclaimed dollars to offset the amounts that were previously claimed, but for which the consumer does not have a valid receipt.

With this new feature, which is available online and on mobile devices, Acclaris enables its client’s consumers to make their own decisions about how to seek reimbursement for eligible expenses. Additional paperwork and potential embarrassment is eliminated as consumers can simply choose to scan and upload images of previously unclaimed paper receipts / EOBs, or use the portal to designate currently unclaimed carrier claims to offset previously unsubstantiated transactions.

About Acclaris, Inc: Through our clients we serve more than 1.8 million active account holders. Acclaris enables our clients to transform the way they offer and administer consumer-driven health and reimbursement accounts, maximizing their revenue and profit opportunity. Our integrated end-to-end operations, consumer focus and true private label approach help our clients increase revenue and lower costs, while delivering market leading CDH products and services under their own brand.
To learn more visit the Acclaris website at http://www.acclaris.com.

S.C. BlueCross Health Insurance Goes Mobile On Phones

COLUMBIA – A decade ago, BlueCross BlueShield of South Carolina members were the first in the country to go to their computers to see real-time claims information, find doctors and make requests that they used to do over the phone.

Now they can go back to their phones – smart phones – and have everything they need from their health plan while on the go. The company has made its secure website for customers, My Health Toolkit®, available for easy viewing and interaction on the small screens of mobile smart phones. Customers can see their claims, authorizations, eligibility for care, and policy details; view their ID cards; find the nearest network doctors, urgent care centers or hospitals with a GPS-enabled locator; and check their HSAs (health savings account), FSAs (flexible spending account) or HRAs (health reimbursement account) balances.

“Imagine that your child gets hurt at the ball park on a Saturday evening and you want medical attention, but it’s not bad enough to go to the emergency room. Now, you can log in from your phone, find the closest urgent care, call the number listed with the locator map to say you are on your way, and show your health plan ID at check-in – all from your phone and our mobile website,” said Jim Deyling, president of the BlueCross BlueShield division. “That’s just one example of many, many uses of our mobile Web access for our on-the-go members.” The tool is available to people who hold individual or group insurance through BlueCross or through BlueChoice® HealthPlan of South Carolina. The individual uses the phone’s browser to go to “member.SouthCarolinaBlues.com” (BlueCross members) or “member.BlueChoiceSC.com” (BlueChoice HealthPlan members).

Members then sign into their My Health Toolkit accounts. If members don’t have an account, they can access My Health Toolkit from a computer and create a profile. The mobile phone access is an extension of the more comprehensive My Health Toolkit, which contains a variety of resources in one location online to help BlueCross and BlueChoice HealthPlan members improve their health and access the health care system more efficiently and effectively.

About BlueCross BlueShield of South Carolina

Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina (www.SouthCarolinaBlues.com) and BlueChoice HealthPlan of South Carolina (www.BlueChoiceSC.com ) are independent licensees of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 30 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.

Docs and Patients Now Have More Ways to Get CIGNA’s Real-Time Itemized Cost Estimates

BLOOMFIELD, Conn., November 09, 2010 – CIGNA (NYSE: CI) announced today that it will expand access to its CIGNA Cost of Care Estimator® through four of the largest health information networks in the U.S.: Availity, NaviNet, Passport Health Communications Inc. and RealMed (an Availity Company). These companies service 90 percent of America’s physician practices, hospitals, and clinical facilities.

“The CIGNA Cost of Care Estimator is delivering on our promise to both our contracted physicians and our customers to make our health plans transparent,” said James Nastri, CIGNA vice president of product and service transparency. “By opening access to Estimator through the nation’s largest health information networks, we can help more individuals understand their plan coverage and address any cost issues upfront, so that both doctors and patients can focus on improving health rather than worrying about potential financial unknowns after the fact.”

Since it was launched nationwide in April 2009 on the CIGNA for Health Care Professionals website, (www.cignaforhcp.com), the CIGNA Cost of Care Estimator® has delivered real-time, pre-care itemized estimates of specific treatment charges and payments for 21,000 health care professionals. The Estimator’s Explanation of Estimate provides a simple, clear explanation of the key elements of payment for medical procedures and treatments and is designed to correspond with the award-winning CIGNA Explanation of Benefits.

Sekine, Rasner & Brock OB/GYN Practice Administrator Judi Lento says she prints out a CIGNA explanation of estimate for every CIGNA-covered patient: “The estimate really makes the whole process simpler for both our office and our patients. It is essential for defining the treatment, coverage and any potential out-of-pocket costs up front — so there’s no guesswork, confusion or administrative issues. Our patients really appreciate getting accurate information in advance, and the CIGNA Estimator has helped our practice save hundreds of thousands of dollars.

“The Estimator approach is truly revolutionary because unlike real-time claims adjudication, it does not require purchasing technology and re-keying information into our practice management system,” said Lento. “Because we will now be able to access CIGNA’s estimates through a multiple payer system, our office flow will be even better than before.”

The CIGNA Explanation of Estimate provides the key information individuals need to know about how their CIGNA medical benefits are applied to their physician’s services:

  • Total Cost: Estimation of the total cost of services, including both the amount to be paid by CIGNA and the amount the covered individual will owe;
  • Patient Cost: The anticipated amount covered individuals will owe after their plan benefits are applied to the estimated total cost, including any deductible, coinsurance, or co-payment;
  • Potential Fund Payment: This displays the estimated amount to be paid automatically to the health care professional at the time the estimate is run from available funds in the covered individual’s Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA) as well as any additional funds that may be owed. Ninety-two percent of individuals enrolled in CIGNA’s consumer-driven, account-based health plans have opted for automatic claims payment.

Beginning in the fall of 2010, health care professionals have the additional option of producing estimates for their patients enrolled in CIGNA health plans in targeted markets using:

  • Availity, a health information network supporting the exchange of more than one billion transactions per year on behalf of more than 200,000 physicians;
  • NaviNet Network, America’s largest health care communications network that connects 70 percent of the nation’s physicians to leading health plans and information for 121 million insured patients;
  • Passport Health Communications Inc., eCare Patient Access Suite includes revenue cycle software and services to help health care organizations verify patient demographic and insurance information, maintain payer compliance and accurately estimate and collect patient payments. Passport OneSource is used by one-third of all U.S. hospitals.
  • RealMed, an Availity Company, delivering revenue cycle management solutions to more than 30,000 health care professionals and processing more than half a billion transactions per year.

About CIGNA

CIGNA (NYSE:CI), a global health service company, is dedicated to helping people improve their health, well being and sense of security. CIGNA Corporation’s operating subsidiaries provide an integrated suite of medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance, through 60 million customer relationships with individuals in the U.S. and around the world. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss/. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cignatv and listen to CIGNA’s podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching “CIGNA” in iTunes.

Benefit Harbor and BenefitSpan Deliver Innovation and Value for CDHC Administrators and Participants.

Benefit Harbor, a leading provider of integrated benefit enrollment and administration services has formed a strategic partnership with Consumer Health Technologies, Inc. (CHT). CHT is a CDHC software technology leader, providing services to administrators, payers, and financial institutions for the delivery of optimal benefits administration solutions in the CDHC market segment.

CHT develops BenefitSpan, an award winning Consumer Directed Healthcare software platform which offers a comprehensive solution for FSA, HRA, and HSA account administration. As part of its partnership with CHT, Benefit Harbor will make available through BenefitSpan a comprehensive continuum of services including benefit administration, enrollment, and customer services for group and individual benefit plans.

The CDHC market is evolving at a dramatic pace; therefore, it is crucial to remain current on the most leading edge solutions available. We help companies initiate, develop, and deliver innovation in an extremely demanding market space, and for that, BenefitSpan was the obvious choice because it is a unified destination for all stake holders, regardless of company size or complexity of benefit design, said Bill Lester, the President of Benefit Harbor. Mr. Lester further added, The open architecture platform offers a range of advantages, such as 100% private-label services for the total administration of all CDHC accounts while integrating with multiple financial institutions. Additionally, BenefitSpan offers very strong dynamic packaging capabilities of high-value CDHC products and services, including telemedicine, health advocacy and wellness. This empowers plan participants with a new level of service and efficiency along with maximum flexibility and transparency, resulting in measurable cost containment for the consumers.

Pradeep Goel, CEO of Consumer Health Technologies, Inc. commented that, Benefit Harbor brings a unique set of capabilities to the CDHC space with a broad range of consumer engagement tools and support services highly relevant to benefit consultants, health plans and financial institutions alike. We are very excited to count them as part of the CHT family. This strategic partnership will position both partners in such a manner as to make them highly competitive in the CDHC market space.

About Benefit Harbor:

Benefit Harbor delivers total benefit solutions that enable employee benefit and delivery strategies by leveraging strategic relationships with carriers, specialized administration and enrollment firms, brokers/consultants, and plan sponsors. Benefit Harbor is uniquely differentiated by our proprietary technology that supports the integrated administration and enrollment of group and individual benefit plans on a single platform. Founded in 2000, we currently serve more than 1 million employees, support $2 billion in annualized premiums, and interface with over 700 group and voluntary carriers.

Benefit Harbor is part of the Summit Alliance Companies, headquartered in Dallas, Texas. The group also includes Summit Alliance Financial, a full-service insurance brokerage agency, and Summit Alliance Investment Group, a broker-dealer serving independent investment advisors and credit unions.

To learn more about Benefit Harbor please visit www.benefitharbor.com.

Source: Consumer Health Tech

Senate Restrictions on Flexible Spending Accounts Spur New Campaign.

Save Flexible Spending Plans, a national grassroots organization dedicated to protecting flexible spending accounts (FSAs), today launched a new campaign, “Ten Before Ten,” that encourages Americans to voice their support for protecting the cost-saving benefit by sending 10,000 emails to their senators before the start of 2010. The campaign coincides with the Senate’s consideration of legislative provisions that would significantly restrict the use of FSAs to help fund a portion of health reform, as well as an amendment filed by Senator Charles E. Schumer (D-NY) to adjust for inflation a proposed cap on FSA contributions. In a demonstration of the support for protecting FSAs, more than 50,000 emails have been sent by supporters to Congress and the Obama Administration since the launch of Save Flexible Spending Plans in July 2009.

“Now is a critical time for consumers to take action to protect their FSAs as the Senate considers pending provisions that would significantly restrict access to the benefit through a contribution cap and an amendment offered by Senator Schumer that makes sure the cap is indexed with inflation,” said Joe Jackson, chairman of Save Flexible Spending Plans and CEO of WageWorks Inc., a benefits company based in San Mateo, California. “If the Senate fails to increase the proposed cap on FSA contributions and, at a minimum, index the cap to inflation, millions of Americans will face higher taxes, increased health care costs and a reduction in the value of this cost-saving benefit.”

The Patient Protection and Affordable Care Act, pending in the Senate, includes a $2,500 annual cap on FSA contributions, which unlike in legislation approved by the House of Representatives, is not designed to adjust with inflation. An amendment (SA 2993) filed earlier this week by Sen. Schumer would resolve this problem by indexing the cap, ensuring that access to FSAs stay in line with increasing costs. Failing to adjust the contribution cap will cause the value of a $2,500 FSA to plummet to less than half its worth within a decade.

“Everyone that has come to rely on their FSA to hold down their health care costs has something at stake and should take the time to learn more and get involved in encouraging the Senate to protect the benefit,” added Jackson. “Our supporters have shown strong opposition to the proposed restrictions, and we hope they will continue to push the Senate to support Senator Schumer’s amendment and preserve this valuable benefit, which has empowered millions to play a more active role in managing their health care and getting the care they need.”

Proposed restrictions on FSAs will force approximately 7 million Americans who use their FSAs to cover out-of-pocket health care expenses greater than $2,500 to pay higher taxes and health care costs. As currently crafted, the Senate legislation will cut in half the $5,000 limit on FSA contributions enjoyed by Federal employees. Additionally, state employees in 46 states who currently have FSA contribution limits set at $3,000 or more will be negatively impacted. Sadly, those with the highest out-of-pocket health care costs — the sickest — will be hit the hardest by restrictions on FSA use.

About Flexible Spending Accounts

Flexible spending accounts are voluntary, account-based plans that enable millions of Americans to use pre-tax dollars to pay for eligible out-of-pocket health care expenses like prescription drug co-pays, vision and dental costs, office visits and medical supplies.

Most FSA participants are middle income Americans, earning approximately $55,000 annually. Currently, limits on contributions to FSAs are set by individual employers.

Individuals and families with chronic illnesses typically receive the most benefit from FSAs. Even when they are insured, they incur annual out-of-pocket expenses averaging $4,398 per year, the Robert Wood Johnson Foundation found — well above the proposed limit. Approximately 44 percent of Americans have one or more chronic conditions.

About Save Flexible Spending Plans

Save Flexible Spending Plans is a national grassroots advocacy organization that protects against the restricted use of flexible spending accounts in health care reform efforts. The campaign is sponsored by the Employers Council on Flexible Compensation (ECFC), www.ecfc.org, a non-profit organization dedicated to the maintenance and expansion of private employee benefit programs on a tax-advantaged basis. To learn more, take action and read the personal stories of FSA participants, please visit www.savemyflexplan.org.

Source: Save Flexible Spending Plans

Senate Health Bill Would Significantly Curtail Flexible Spending Accounts.

Following the introduction of the Patient Protection and Affordable Care Act by Senate Majority Leader Harry Reid (D-NV), Joe Jackson, chairman of Save Flexible Spending Plans and CEO of WageWorks Inc., a San Mateo, CA-based benefits provider issued the following statement:

“It is disappointing that the Senate is determined to fund health care reform by restricting access to flexible spending accounts (FSAs), a valuable benefit relied upon by more than 35 million Americans to help hold down health care costs. Severely curtailing the use of FSAs will not only force participants to pay more in health care costs, it flies in the face of President Obama’s pledge to not raise taxes on the middle class.

Especially damaging to plan participants is the Senate bill’s failure to index an already unreasonably low $2,500 cap on FSA contributions. Failing to adjust the cap for inflation will cause the value of a $2,500 FSA to plummet to less than half that amount within a decade.

Initially, the Senate will force approximately seven million hard-working Americans who use their FSAs to cover out-of-pocket health care expenses greater than $2,500 to pay higher taxes and health care costs. Federal employees who currently enjoy a $5,000 limit on FSA contributions will see their access to FSAs cut in half. Additionally, state employees in 46 states who currently have FSA contribution limits set at $3,000 or more will be negatively impacted. Sadly, those with the highest out-of-pocket health care costs — the sickest — will be hit the hardest by restrictions on FSA use.

The bottom line is FSAs work and should be persevered. They empower millions of Americans to play a more active role in managing their health care and getting the care they need while keeping costs down — a major goal of health care reform.”

About Flexible Spending Accounts

Flexible spending accounts are voluntary, account-based plans that enable millions of Americans to use pre-tax dollars to pay for eligible out-of-pocket health care expenses like prescription drug co-pays, vision and dental costs, office visits and medical supplies. Most FSA participants are middle income, earning approximately $55,000 annually. Currently, limits on contributions to FSAs are set by individual employers.

Individuals and families with chronic illnesses typically receive the most benefit from FSAs. They incur annual out-of-pocket expenses averaging $4,398 per year, the Robert Wood Johnson Foundation found — well above the proposed limit. Approximately 44 percent of Americans have one or more chronic conditions.

About Save Flexible Spending Plans

Save Flexible Spending Plans is a national grassroots advocacy organization that protects against the restricted use of flexible spending accounts in health care reform efforts. The campaign is sponsored by the Employers Council on Flexible Compensation (ECFC), www.ecfc.org, a non-profit organization dedicated to the maintenance and expansion of private employee benefit programs on a tax-advantaged basis. To learn more, take action and read the personal stories of FSA participants, please visit www.savemyflexplan.org.

Source: Save Flexible Spending Plans

Web Site: http://www.savemyflexplan.org/
http://www.ecfc.org/

Senate Finance Committee Considering Excise Tax on Health Benefits.

Word is coming out of the Senate Finance Committee that consideration is being given to imposing an excise tax on health care benefits that exceed a specified threshold beginning in 2013. Although the threshold amount has not been finalized, reports suggest that the Committee may be considering $21,000 for family coverage. Reports also indicate that contributions to Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs) and Health Reimbursement Arrangements (HRAs) would be included in determining whether the health benefits package exceeds the threshold. If employees receive benefits exceeding the overall threshold employers and/or insurers would pay a 35 percent excise tax on the amount in excess of the threshold.

In addition, reports indicate that the Senate Finance Committee is also considering imposing a $2,000 cap on contributions to FSAs beginning in 2013. This, coupled with a House plan to eliminate the use of HSAs and FSAs for over the counter drugs, is placing the burden of financing healthcare reform squarely on the shoulders of middle class workers.

Here are some fundamental problems with these ideas:

  • FSAs, and more recently HSAs, have become important health care tools for both employers and their employees. They help Americans afford their out-of-pocket health care costs. Even under a reformed health care system, patients will still face out-of pocket expenses and we need these tools to help us afford these expenses.
  • Placing additional caps on the contributions that may be made to these accounts will disproportionately harm patients with chronic illnesses who tend to face very high out of pocket costs.
  • Further capping contributions to FSAs and HSAs is effectively a tax on health care and a tax on middle class Americans.
  • Including FSAs and HSAs in the calculation of the excise tax threshold will cause employers to scale back or eliminate these plans (and potentially dental, vision, and other health benefits) to ensure they don’t exceed the overall cap on employee benefits and trigger the excise tax.
  • Imposing an overall cap would be extremely complex and burdensome for employers. Employers would have to calculate the excise tax for each employee and their varying benefits and coverage levels and likely have to account for benefits provided to spouses and dependents under their employer’s plan.

Below is a list of Senate Finance Committee members and their contact information. If you value your FSA or HSA, this is the time to reach out to one or more of the committee members and let them know where you stand.

MemberDC Office PhoneDistrict DirectorDistrict Phone
Lincoln(202) 224-4843Donna Kay Yeargan(501) 375-2993
Kyl(202) 224-4521Kim Wold(602) 840-1891
Carper(202) 224-2441Larry Windley(302) 573-6291
Nelson(202) 224-5274Celeste Brown or
Sherry Hupp Davich
(407) 872-7161
Grassley(202) 224-3744Bob Renaud(515) 288-1145
Crapo(202) 224-6142Layne Bangerter(208) 334-9044
Roberts(202) 224-4774Chad Tenpenny(913) 451-9343
Bunning(202) 224-4343Debbie McKinney(859) 341-2602
Kerry(202) 224-2742Drew O’Brien(617) 565-8519
Snowe(202) 224-5344Gail Kelly(207) 945-0432
Stabenow(202) 224-4822Teresa Plachetka(517) 203-1760
Baucus(202) 224-2651Barrett Kaiser(406) 657-6790
Conrad(202) 224-2043Marty Boeckel (West)
Scott Stofferahn (East)
(701) 258-4648
(701) 232-8030
Menendez(202) 224-4744Michael Soliman(973) 645-3030
Bingaman(202) 224-5521Terry Brunner(505) 346-6601
Ensign(202) 224-6244Sonia Joya(702) 388-6605
Schumer(202) 224-6542Martin Brennan(212) 486-4430
Wyden(202) 224-5244Lisa Rockower(503) 326-7525
Cornyn(202) 224-2934David James(512) 469-6034
Hatch(202) 224-5251Melanie Bowen(801) 524-4380
Cantwell(202) 224-3441Chris Endresen(206) 220-6400
Rockefeller(202) 224-6472Rochelle Goodwin(304) 347-5372
Enzi(202) 224-3424Robin Bailey(307) 682-6268