Archive for October 25th, 2012

San Antonio Employer Urges Employees To Vote In November

Thursday, October 25th, 2012

DATE:            October 19, 2012
TO:                 Distribution
FROM:           Bill Greehey and Curt Anastasio
RE:                 Benefits

Since Benefits enrollment started earlier this week, we have received a number of complaints regarding the reduction in the amount of money that employees are now allowed to put into their Flexible Spending Accounts. As you know, the NuStar plan has historically allowed employees to put as much as $7,500 per year into their Flexible Spending Accounts, which of course, was tax-free.

Unfortunately, the amount has now been capped at $2,500 by the Patient Protection and Affordable Care Act, which was signed into law by President Obama in 2010. We understand why many of you are disappointed by this reduction in your benefit options, but based on the new law we have no choice in this matter.

And while this change is one that directly impacts NuStar’s employees, it is only one of many problematic components of The Affordable Care Act, widely known asObama-Care. According to NuStar’s insurance broker, this program is projected to cost the company an additional $2.7 million once fully implemented and it will not provide any meaningful benefits beyond what we offer in our Healthcare package today.

The most costly component for NuStar is the “Cadillac Plan” excise tax, which imposes a non-deductible 40% tax for employer-provided healthcare coverage that exceeds the government-mandated maximum value for health care coverage.  Our insurance brokers estimate that this penalty — for NuStar to provide health care coverage that is above the government’s threshold — will cost almost $1.8 million by the close of 2019.

Unlike many companies, NuStar has no plans to reduce its benefits, but penalizing companies for providing superior healthcare coverage seems counter-intuitive and counter-productive for our country.  As you know,
the general election is less than three weeks away and we want to remind everyone just how important this election is to our future and we want to encourage all of you to vote for candidates that you believe will lead our nation, our employees and NuStar to a more prosperous future.

Paying Hospital Bills

Thursday, October 25th, 2012

Yesterday we met with a TPA from California who confirmed what we thought we already knew. His firm processes hospital claims at 130% of Medicare and gets very little push back from hospitals.

In Texas, we see the comfort margin with some hospitals between 135-150% of Medicare. Yet, we see managed care claims repriced to much higher Medicare reimbursment levels,  as high as 280% or more for in-patient services and 1000% or more for out-patient charges.

Managed care contracts are cost drivers, not cost savers, it seems. Managed Care Under Siege

On the other hand, we know of an East Texas hospital who, during a competitive RFP process, offered a direct contract with reimbursment levels generally below Medicare rates.

Pricing is all over the board and there seems to be no rhyme or reason other than geographic area and astute payers or lack thereof. But when push comes to shove, the magic number appears to be between 130-150% of Medicare.

Editor’s Note: Balance billing threats are easily combated. Acceptance of an Assignment of Benefits creates an implied contract.

California Bill Requires Insurers To Coddle Helpless and Ignorant Members

Thursday, October 25th, 2012

Here we go again! Another government mandate to coddle consumers who are too dumb and lazy to take care of themselves. It seems the general public is so helpless and lost in our health care delivery system that they cant pick up a telephone and call the doctor they want to see to determine if they are still in-network or not.

Maybe insurers need to consider getting rid of networks and just pay fair and reasonable rates. That is what more and more self-funded groups in Texas are doing.