Mammogram Screening Guidelines Cause Confusion
In November, the federally funded U.S. Preventive Services Task Force
issued a report indicating that routine mammograms were not necessary for
women in their 40s who have normal cancer risk. Specifically, the panel
said the downsides of mammograms could outweigh the benefits for many
women in their 40s. The report was controversial and, after years of
urging women to get annual mammograms, many doctors and patient groups
joined forces to counter the new federal guidelines. The health overhaul
bill now working its way through Congress may effectively nullify the new
guidelines by promising mammogram coverage for women starting at age 40.
The NCMS Plan has no plans to change its current screening
mammogram provisions. The NCMS Plan's PPO products cover one screening
mammogram per female member per calendar year beginning at age 35 subject
to a copayment. More frequent or earlier mammograms will be covered as
recommended by a doctor. The NCMS Plan's HDHP/HRA products cover screening
mammograms 100% in-network, not subject to copayment, deductible or
coinsurance. If a screening mammogram is abnormal, or treatment is
required, these services will be subject to the deductible and
coinsurance. This is a summary of preventive mammograms. For a more
detailed description of this benefit including all terms and conditions,
please refer to your benefit booklet.
Women should always discuss
the appropriateness of various health screening tests with their personal
physicians, based on their individual health histories. The NCMS Plan
recognizes and respects the importance of the relationship between our
members and their health care professionals in making these decisions.
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2010 HSA Contribution Limits
The IRS recently released the 2010 cost-of-living adjustment for Health
Savings Account (HSA) contribution limits.
Employees who have
"employee only" coverage are eligible to contribute $3,050 to their HSAs.
This has increased from the 2009 limit of $3,000. Employees with "family
coverage" are eligible to contribute $6,150 to their HSAs, which is an
increase over last year's maximum of $5,950. Family coverage is defined as
coverage for an eligible individual and at least one other individual.
Individuals can make contributions to an HSA for 2009 until April 15,
The annual "catch up" contribution for those HSA-eligible
individuals who are age 55 or older remains set at $1,000. For those
individuals age 55 or older under "employee only" coverage, the 2010
contribution limit is then $4,050. Those individuals age 55 or older with
"family coverage" can only contribute up to $7,150 for 2010.
more information about HSAs please contact your account representative or
call us at 800-662-7917. If your employees have established HSAs through
Mellon, you may also contact them directly with questions. Mellon has a
dedicated employer support line, 866-712-4551.
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Group Life Through the NCMS Plan
Did you know the NCMS Plan offers group term life coverage?
Employers participating in the NCMS Plan can choose from a wide
variety of plans:
- Single flat options in the amounts of $15,000, $25,000, $30,000,
$50,000 or $75,000
- Dual flat options: a combination of two flat options giving
employees the choice of a higher coverage amount
- Salaried option: 1x, 2x, or 3x salary
- Guaranteed issue amounts: up to $50,000 for flat options and up to
$150,000 for salaried options (maximum of $250,000).
- Accidental Death & Dismemberment (AD&D) coverage is included
when you purchase one of the life options.
The NCMS Plan requires 100% employee participation including those
employees declining health, and the premium is 100% employer paid.
Practices offering the dual flat option can charge employees the
difference in premium between the low and high option.
choosing life coverage through the NCMS Plan you get the convenience of
integrated billing. Your practice will receive one monthly billing
statement for both your health and life coverage, which means you only
have to write one check. NCMS Plan group term life coverage is
underwritten by USAble.
For more information about NCMS Plan group
term life coverage, please contact your account representative, call
800-662-7917, or visit www.ncmsplan.com.
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Update on COBRA Subsidy Extension
As expected, Congress and the President extended and expanded the COBRA
premium subsidy, allowing a greater number of individuals to take
advantage of federal assistance and introducing additional COBRA notice
and administrative requirements for employers.
legislation, part of the Department of Defense Appropriations Act of 2010,
extends the COBRA subsidy�s eligibility period for two months and extends
the maximum duration of the federal assistance from nine months to 15
months. It also provides additional notification requirements.
Changes under the new subsidy extension provision:
- The end date of eligibility for the ARRA subsidy changes from
December 31, 2009, to February 28, 2010.
- The ARRA premium subsidy expands to 15 months, increased from
current nine months.
- Participants whose subsidy ran out and who did not pay the full
premium will get a second chance to opt for coverage. For example, a
participant whose nine months of subsidized coverage ran out November 30
and who did not pay the regular unsubsidized December premium could pay
the 35 percent premium share in January and receive coverage for
- Involuntary terminations that occur on or before February 28, 2010,
would be eligible for the subsidy, regardless of when the individual's
COBRA eligibility period begins. This addresses a Congressional
oversight in the original bill pertaining to December 31, 2009,
Ceridian will continue to guide practices through administrative
changes resulting from the extension. As Ceridian did for the original
COBRA subsidy provision in the American Recovery and Reinvestment Act of
2009 (ARRA), they will answer your questions about the COBRA subsidy and
explain how they will manage the new legislative requirements. If your
practice is currently using Ceridian's COBRA administration services, you
can contact them directly for support at 1-800-488-8757.
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, 1-800-662-7917.
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Question: We have an employee that has been with our practice for
many years who will be retiring soon but won't be eligible for Medicare
for several years. She would like to maintain coverage but COBRA will not
extend coverage for this employee beyond 18 months. What options does she
have until she is eligible for Medicare?
Answer: The NCMS Plan
has made a special eligibility class available for physician and
non-physician retirees to keep their group health coverage until they are
eligible for Medicare. A practice has the option of offering this retiree
coverage or not.
The criteria for eligibility differs for
physicians (MD's) and non-physicians (all other staff) but hinges on the
practice's continued participation in the NCMS Plan and the individual not
becoming eligible for another group's health plan.
elect the retiree coverage at any age and at any time as long as they were
a member of the NCMS Plan immediately prior to retirement, maintain
membership in the NC Medical Society after retirement and do not become
eligible for any other subsequent group health plan.
non-physician employees must meet the following criteria: the employee
must be at least age 55, be employed by the participating employer for at
least 10 years, and be a member of the NCMS Plan immediately prior to
retirement. If these criteria are met, the employee is eligible for
continued until Medicare eligibility.
Retiree benefit elections
for eligible physicians and non-physicians should be submitted to the NCMS
Plan on group letterhead indicating member information and date of
retirement. You will receive written confirmation of receipt and the
member will continue to appear on your group billing statement. If you
have questions or would like to review your retiree coverage options,
please contact me at 919-878-7561 or [email protected].
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Customer Survey Coming Soon
The NCMS Plan will soon mail its annual customer survey to solicit your
feedback. The requested response date is February 12th. This brief 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.
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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 www.ncmedsoc.org.