Hamilton Headlines
January 11, 2016


Many Employees Unaware of Hypertension
Some of the biggest annual price tags for employers include stroke and coronary artery disease, and many employees may be unaware they are at risk.

New research published in the Journal of Occupational and Environmental Medicine and released by Health Advocate shows that more than two-thirds of employees (68%) whose hypertension was discovered during workplace health screenings didn't previously know they had the condition.

The study analyzed more than 31,000 members of self-insured employer group plans. In addition to the high percentage who had undiagnosed hypertension, the study said prescriptions for hypertension medications spiked following the screenings, indicating that plan members were quick to respond to the bad news. 
More Employers Offer Plans That Provide Lump Sums For Critical Illnesses 
Insurance policies that pay a lump sum if workers get cancer or another serious illness are being offered in growing numbers by employers. Companies say they want to help protect their workers against the financial pain of increasingly high deductibles and other out-of-pocket costs. But it's important to understand the limitations of these plans before buying.

Critical illness plans have been around for decades, but they have become more common lately as employers have shifted more health
care costs on to their workers' shoulders.     
Forty-five percent of employers with 500 or more workers offered the plans last year, up from 34 percent in 2009, according to benefits consultant Mercer. Employees are generally responsible for the cost of coverage, although in some cases bosses contribute to the premiums.

Full Article    
Guardian Boosts Vision, Dental Business with Avesis Buy 

Guardian Life Insurance Company has announced plans to acquire Avēsis Incorporated, a vision, dental and hearing benefits administrator for government and commercial benefit programs.

Earlier this year, Guardian ranked No. 6 on Employee Benefit Adviser's list of top 10 large-group dental insurance carriers in the U.S., with a total market share of 3.91% and $272,529,054 of in-force dental premiums.

Chris Swanker, currently Guardian's vice president of group and worksite markets, will assume the role of  
chief executive office of Avesis.

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Affordable Care Act Rate Stabilization Program Results Should Guide Strategy for 2016

Earlier this year, the Centers for Medicare and Medicaid Services released the results of the first year of the reinsurance and risk adjustment provisions of the Patient Protection & Affordable Care Act.

These provisions are two of a three-part rate stabilization program designed to prevent adverse selection of individual members on the federal and state health exchanges by financially compensating issuers that have higher-risk members.

From a technical perspective, the first year of the reinsurance and risk adjustment programs was a resounding success. CMS reported that 99.7 percent of issuers who established Edge servers successfully submitted the data necessary to calculate reinsurance payments and risk adjustment transfers.
Since Affordable Care Act, More Men are Getting Colonoscopy Screening, Report Says   

Men are getting more screening colonoscopies since the health law reduced how much Medicare beneficiaries pay out of pocket for the preventive tests, a recent study found. The change, however, didn't affect women's rates.

The study, published in the December issue of Health Affairs, compared rates of screening for colorectal cancer among people age 66 to 75 before and after the health law passed in 2010. Starting in 2011, that law waived the Medicare Part B deductible (which totals $147 annually in 2015) and eliminated the requirement that beneficiaries pay 20 percent of the cost for screening colonoscopies.

Full Article
Dominion Finalizes Acquisition of
DentaQuest Mid-Atlantic and DentaQuest Virginia 
Alexandria, Va. - Dominion Dental Services (Dominion), a leading dental insurer and administrator of dental and vision benefits headquartered in Alexandria, Va., has finalized its acquisition of DentaQuest Mid-Atlantic, Inc. (DQ-MA) and DentaQuest Virginia, Inc. (DQ-VA) from DentaQuest Management, Inc.
The transaction adds over 90,000 members throughout Maryland, Virginia and
Washington, D.C. 
  -- ACA Reinsurance Fee
November 16, 2015 was the annual deadline to report enrollment count.

The entire 2015 benefit year contribution in one payment is due no later than January 15, 2016 reflecting $44.00 per covered life; or

In two separate payments for the 2015 benefit year, with the first remittance due by January 15, 2016 reflecting $33.00 per covered life, and the second remittance due by November 15, 2016 reflecting $11.00 per covered life. 
-- Marketplace/Exchange Open Enrollment starts on November 1, 2015 and ends on January 31, 2016.

-- ACA Reporting - Delay
Forms 1094-C and 1095-C to be filed with the IRS by May 31, 2016 (instead of February 29, 2016) or June 30, 2016 (instead of March 31, 2016), if filing electronically.

Forms 1095-C are due to employees by March 31, 2016 (instead of February 1, 2016).

Delay Announcement 
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Please note that Hamilton Insurance does not provide legal advice, and this does not constitute advice of any kind for any 
particular situation. Instead, this is intended as non-comprehensive general information serving as a starting point for further 
discussion. Please contact your tax and/or legal advisors for information about how these issues affect you.  
About Us
H amilton Insurance , a top ranked independent broker in the Washington DC/Metropolitan Area and the nation, has over 35 years of experience in providing insurance brokerage, risk management and employee benefit solutions. It represents a full suite of commercial, health & welfare, and personal insurance solutions, supported by risk compliance and group benefit administrative services. 

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