Their Health, Your Premium, Our Plan
The NCMS Plan Wellness Initiative
As a practice manager, you face the dual challenges of decreasing
revenues and increasing costs of doing business. Balancing that equation
in regards to your employee health benefit coverage is increasingly
difficult. While many participating physician practices have reduced the
level of benefits offered and/or increased the employee contribution
towards benefits, practices continue to see rising benefit costs.
Rising benefits costs within the NCMS Plan are being driven by (i)
general increases in the price of medical services, (ii) medical expenses
associated with high cost claimants, and (iii) pharmacy costs. Taking
action in these areas will help to control these ever-rising costs.
The NCMS Plan is committed to helping you control the increasing
costs of employee health benefits coverage with information, programs and
As a leader within your practice, you are uniquely
positioned to help educate your employees about the relationship between
their health, the premium they pay, and the ultimate cost of health
benefit coverage to the practice. And the NCMS Plan is here to support you
in that effort with information, programs and resources to help your
employees improve their health and manage their chronic medical
Upcoming "special" editions of CHOICES will
provide more information about the NCMS Planís Wellness Initiative.
Contact your NCMS Plan representative with any questions or requests for
assistance in promoting wellness and chronic disease efforts within your
Partnering with you, we can encourage healthier
lifestyles and control costs with wellness programs that work.
Preventive Care Reminders
The NCMS Plan administrator, BCBSNC, has implemented a new Preventive
Services Reminder program. The Reminder sent to members incorporates seven
preventive health screenings recommended by the US Preventive Services
Task Force including mammograms, pap smears, and colon cancer screenings.
The reminders are member-specific, highlighting those specific screenings
for which the member is overdue.
Mailed each month to members with
an upcoming birthday, the reminders feature a tear-off portion listing
those screenings for which a member is overdue, with an accompanying "Date
Scheduled" write-in column to aid members in scheduling needed
Group Insurance Continuation
Did you know that your employees may be eligible to continue their
group insurance coverage if their employment ends or if they are no longer
eligible for benefits? The following is the first part of a two-part
series providing a snapshot of the continuation provisions mandated at the
federal and state level. As the employer, you are responsible for
understanding these laws and meeting the obligations outlined. For more
complete continuation information, visit the U.S.
Department of Labor or the
North Carolina Department of Insurance.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
employers who normally employed 20 or more employees on at least 50
percent of its working days during the prior calendar year are covered by
COBRA. Individuals and eligible dependents provided insurance under the
employer's group health plan are entitled to elect COBRA coverage upon the
occurence of a "qualifying event" that results in the loss of coverage. A
"qualifying event" may include, but is not limited to, the following:
- a reduction in hours
- the termination of employment (unless for gross misconduct)
- the death of a covered employee
- a divorce or legal separation
- a child is no longer a dependent
A covered employer must give each employee and spouse covered under the
plan a general notice of what COBRA is and their rights under COBRA within
90 days of initial coverage. Employers must also notify their plan
administrator (the NCMS Plan) of a qualifying event within 30 days. The
eligible employee then has 60 days to decide whether to elect COBRA
continuation coverage. The 60 day period is measured from the later of the
date coverage terminates or the date the "qualifying event" notice is
given. If the employee elects COBRA, the employer must notify the plan
administrator so the employee can be reinstated as a continuant.
Coverage can continue for up to 18 months after an employee's
termination or reduction in hours. For any other qualifying event,
coverage may be continued for up to 36 months.
Coverage can be
terminated by the group health plan if premiums are not paid in full by
the continuant on a timely basis and/or continuant gets health coverage
under another group health plan.
The NCMS Plan provides COBRA
administration services through Ceridian. These services include initial
COBRA eligibility notification, notification of qualifying event and right
to elect COBRA, as well as administration of billing and collecting COBRA
premium. If you are covered by COBRA and interested in Ceridian's services
(at no additional cost), please contact us for more information,
In the next issue of CHOICES, we will
explore the North Carolina law governing continuation.
Question: We recently enrolled as a new practice with the NCMS Plan
and want to be certain that future employee enrollments and changes are
processed quickly and accurately. What is the best way to send you our
NCMS Plan health insurance enrollment and change information?
Answer: On a typical day at the NCMS Plan, we receive a
substantial volume of health insurance enrollment and administrative
documentation. The NCMS Plan Employee Enrollment Application and Change
Form is used for indicating any enrollment information subsequent to
your practice's initial enrollment. This form is available at http://www.medicalmutualgroup.com/mmic/employee_benefits/applications_and_forms.html.
Remembering to include some key items on the form will make any enrollment
or change process quickly and smoothly. Always write your six-digit group
number in the upper right hand corner of the application in the shaded
area entitled "Completed by Group Administrator Only". In this same area,
also complete the Effective Date of the enrollment or change being made.
If making a change, Section A. has the most common change
options with a box that can be checked. Just select the change you need
processed. Completing Section B. will ensure your employees are
enrolled on the right plan and type of coverage. Section C. has the
indispensible employee birthdate, hire date, name & address as well as
a field for employer name. Applicants should indicate any dependents to be
covered in Section D. Complete Sections E. & F. to show
any prior coverage or coordination of benefits with another carrier.
In Section G., an employee can name a beneficiary for the
NCMS Plan life coverage (if offered) and, finally, have the employee sign
the form for validation.
For most efficient processing, forwarding
the form to our dedicated enrollment representative at BCBSNC is your best
course of action. You can submit any health insurance enrollments and
changes directly to BCBSNC, ATTN: Kim Pryor (fax) 919-765-3564 or (e-mail)
Be Sure to Complete the Customer Survey
The NCMS Plan has mailed a customer survey to solicit your feedback.
The requested response date has been extended. The short survey will take
5-10 minutes to complete. The information is a valuable resource for
ensuring that the NCMS Plan stays on the right track and continues to meet
your expectations. Thank you in advance for your participation.
This year, the survey highlights employee wellness. Our focus in
2009, as indicated in an article above, will be health and wellness and
promoting available resources to your employees to help them improve their
health and contain medical costs. The questions relate to what you and
your employees know about health and wellness resources available through
the NCMS Plan and our plan administrator, BCBSNC, and what activities or
programs you may already have in place. Your feedback will help set a
benchmark that we hope to see rise over the next year and beyond.
Mellon Announces Change to HSA Interest Rate
Effective February 1, 2009, the interest rate paid on Mellon HSA
checking accounts changed from 0.500% to 0.250%. This change will appear
on bank statements that Mellon HSA customers receive beginning in early
March. The last rate adjustment was April 1, 2008 and Mellon was able to
sustain that rate for the last 10 months, despite falling interest rates.
While the reality of the current economic climate requires this action,
Mellon will continue to closely monitor interest rates and make responsive
An updated fee sheet can be found at http://www.medicalmutualgroup.com/mmic/media/pdf/ncmedsoc_plan/BlueOptionsHSA_Fees071008.pdf.
Changes to Wellness Discount Programs
The NCMS Plan's administrator, BCBSNC, is making changes to the
wellness discount programs available to all BCBSNC members. Effective
April 1, 2009, discounts will be available to Gold's Gym, Curves,
eDiets.com, Kronos, and LA Weight Loss. Other discounts available
- Chiropractic discounts
- Vitamins and supplements
- Vision and LASIK discounts
- Hearing aids
The following discounts will be discontinued effective April 1, 2009,
due to underutilization:
- Cosmetic surgery
- Cosmetic dentistry
- Alternative medicine services, including acupuncture, massage
therapy, personal trainers, tai chi, and yoga
About the North Carolina Medical Society
As the largest physician organization in the state, the North Carolina
Medical Society (NCMS) is devoted to representing the interests of
physicians and protecting the quality of patient care. The NCMS Plan,
sponsored by the NCMS, is the only statewide employee benefits plan
designed specifically for North Carolina physicians.
information about many other benefits of NCMS membership, visit http://www.ncmedsoc.org/.