Day: October 25, 2010

The El Paso Independent School District voted to discontinue their self-funded employee health insurance program effective January 1, 2011. Citing more competitive cost, the Board of Trustees approved the change last month.

Crest Benefits provided insurance consulting services for the district and was involved with the analysis and decision to make the change.

The current reserve funds of the EISD self-funded program, approximately $2 million, will be moved to general funds.

The EISD will continue to fund their on-site medical clinics through 2011, at the cost of $10 per employee per month.

The district currently employs in excess of 8,500 employees.

October 25, 2010

IronHealth, the specialty healthcare unit of Ironshore Inc., has developed a insurance program to address the risk exposure created by the specific reporting requirements of Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). IronHealth’s new Medicare Reporting and Secondary Payer Act Liability (MRSPAL) policy protects against the risk and subsequent penalties from failing to file, or from negligent filing, under Section 111 of the MMSEA or under the Medicare Secondary Payer Act (MSPA). Underwriting support and claims management services for the product will be provided by IronHealth and MGU Specialty Risk Services, Inc. (MGU), a Tampa, Florida company which focuses exclusively on federally-mandated reporting obligations. This product will be available on an open brokerage basis.

Section 111 of the MMSEA imposes requirements for reporting all payments involving Medicare beneficiaries under liability insurance – including self insurance, no-fault and Workers’ Compensation – to the Centers for Medicare and Medicaid Services. Responsible Reporting Entities (RREs) are obligated to report any liability payments or settlements made to Medicare/Medicaid recipients, thereby enabling the government to recoup amounts advanced for covered medical services and treatments in a timely manner.

“Failure of an RRE to report payments and settlements to Medicare recipients – whether they be patients, workers or other recipients – in a timely and accurate manner can result in significant penalties to the RRE resulting in fines of as much as $1,000 per day,” said Matt Dolan, president of IronHealth. “IronHealth and MGU have created the MRSPAL product to help manage these new costly, regulatory exposures.”

Source: Ironshore