Employee Benefit Solutions, Inc.

IU Health has launched a virtual clinic to offer individuals in Indiana regardless of age free Coronavirus (COVID-19) screenings using the IU Health Virtual Visit app. Staffed 24/7 with IU Health physicians, advance practice providers and registered nurses, the clinic will screen patients from home, potentially eliminating the need to visit physician offices, urgent cares or emergency departments.

The team will recommend and facilitate appropriate pathways for care, and provide direct access and communication with local hospitals as medically appropriate.

https://iuhealth.org/news-hub/iu-health-virtual-clinic-offers-free-coronavirus-screening

Amid the growing concerns about the spread of COVID-19 in communities across the country, Anthem is looking to eliminate some burden of additional costs for members by providing coverage of the coronavirus screening test at no out-of-pocket cost.

Testing similar to what is offered now from the Centers for Disease Control will soon be offered more broadly. Anthem’s waiver of copays, coinsurance and deductibles and prior authorization will extend to this focused test used to diagnose COVID-19 for all of Anthem’s affiliated health plan fully-insured, Individual, Medicaid and Medicare members when medically necessary.

There’s a lot in the news lately about about coronavirus COVID-19. Here’s what you need to know to help you understand what it is and how you can protect yourself and the people you care about.

Learn more

Anthem is closely monitoring COVID-19 developments and what it means for our customers. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part.

We’re sharing information today to help explain what COVID-19 is all about, how to protect yourself and what to do if you think you might be infected. We also help to answer questions customers are asking about COVID-19 and how it impacts us all. We’ve developed an educational flyer and FAQ you can pass along.

Employers and members will receive the following message shortly. Please contact your Anthem representative with questions.

About coronavirus COVID-19

What is coronavirus and COVID-19?
Coronavirus is a type of virus that causes mild respiratory illness – an infection of the airways and lungs. COVID-19 is a new strain of coronavirus. It’s part of the same family of coronaviruses that includes the common cold.

What are the symptoms?
The most common early symptoms appear between 2 and 14 days after infection. Symptoms can be mild to severe. They include fever, cough, and shortness of breath.

How does the virus spread?
Like many other viruses, COVID-19 seems to spread from person-to-person through a cough, sneeze, or kiss.

What is the risk?
As of today, the Centers for Disease Control and Prevention (CDC) states that the risk in the U.S. is still low. They will update the status regularly on the CDC website.

Prevention and treatment

How to protect yourself
Frequent handwashing is the most effective way to protect yourself from infection. Other good habits to practice include covering your mouth and nose with a tissue when you cough and sneeze, and cleaning frequently touched items such as phones, keyboards, and doorknobs to help remove germs. Read our FAQ or visit the CDC website for more on prevention and treatment.

What to do if you have symptoms
Call your doctor if you develop a fever, have a cough, or have difficulty breathing. And let them know if you’ve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. You can also check to see if your plan offers telehealth benefits to see a doctor online. If you think you’re infected, using telehealth helps to prevent spreading a virus.

What your Anthem benefits will cover
Your Anthem health plan will cover the care you get if you’re diagnosed as having COVID-19, based on your plan’s benefits. It’ll also cover testing for COVID-19. You’ll pay any out-of-pocket expenses your plan requires, unless otherwise determined by state law or regulation.

Sources:

• Centers for Disease Control and Prevention: About Coronavirus Disease 2019 (COVID-19) (accessed March 2020): cdc.gov/coronavirus/2019-ncov/about/index.html.
• Centers for Disease Control and Prevention: Frequently Asked Questions and Answers (accessed March 2020): cdc.gov/coronavirus/2019-ncov/faq.html.

Nov. 28, 2018. CVS Health closes its $69 billion acquisition of Aetna.

Jan. 9. Mr. Merlo says CVS will kick-start specialized services for Aetna members with cardiovascular disease and pilot a readmission prevention program.

Jan. 14. CVS announces it will spend $100 million over the next five years on community health initiatives in three categories: improving local access to affordable, quality care; impacting public health challenges; and partnering with local communities. 

Jan. 30. Reports surface that CVS is piloting dental services. Under the program, CVS will help fit people for invisible braces via SmileDirectClub, six of its drugstores will add a SmileShopExpress for customers to receive a 3D scan of their teeth to create invisible braces.

Feb. 13. CVS Health unveils three redesigned health-focused concept stores in the Houston market called HealthHubs. They have space for services to help customers manage such chronic conditions as diabetes, hypertension and asthma. Each store also has an expanded health clinic with a lab for blood testing and health screenings.

Feb. 26. It is announced that CVS will spend $325 million and $350 million on technology to support offering more convenient healthcare.

March 20. CVS starts selling cannabis-based products in eight states

April 4. CVS expands its same-day prescription delivery service to 6,000 stores.

May 1. CVS Health and Allentown, Pa.-based Lehigh Valley Health Network sign a five-year agreement that allows Lehigh Valley Health to share its EHR data with CVS to help connect the dots between patients, pharmacies, physicians and other health networks. 

June 4. After success with its pilot sites in Houston, CVS Health announces plans to open 1,500 HealthHub stores by the end of 2021.

June 11. CVS Health launches a platform that will allow its pharmacy benefit management clients to better manage contracts with third-party health and wellness vendors. The tool, Vendor Benefit Management, will offer CVS Caremark clients access to data on negotiated pricing, real-time eligibility verification and simpler billing and payment processing.

July 10.  MinuteClinic, CVS Health’s retail medical clinic, launches telehealth programs in eight more states. Patients with minor illnesses, injuries or skin conditions now can seek care through virtual video visits, including in Indiana

July 17. CVS Health starts clinical trials of a home kidney dialysis device, HemoCare — a move that could shake up the end-stage kidney care market and create a new healthcare business for the retail pharmacy giant. The move to provide at-home dialysis matches other trends to provide more medical care in the home setting.

July 24. CVS Health launches a network to help connect Aetna’s most vulnerable patients to support services in their communities. CVS will collaborate with Unite Us, a social care coordination platform, to help Aetna’s Medicaid and dual-eligible Medicaid and Medicare members more easily access social services in their communities.

Aug. 5. CVS Health expands its pharmacy loyalty and membership program nationwide. The CarePass program offers delivery of products ranging from shampoo to prescription medications. To participate, program customers pay $5 a month, or $48 annually, for one- to two-day delivery of drugstore products and prescription drugs, 24/7 access to a pharmacist helpline and a 20 percent discount on CVS Health-branded products. 

Full article at Becker’s Hospital Review

Employers like you often struggle to find healthcare benefits options that give you the control, flexibility and value you need – until now. With Starmark, you get better control over your health benefits, the flexibility to tailor your self-funded plan design to your specific needs, and the opportunity to receive a refund if your group’s claims are lower than expected.

Starmark Healthy Choices^SM combines reference-based pricing, a strategy of provider reimbursement that has been leveraged by large employers to help control plan costs, with greater provider choice* for member care.  With all the benefits of a self-funded health benefit plan for small to mid-sized employers, Healthy Choices is an innovative plan design that gives employers flexibility to tailor the plan design to their specific needs and the opportunity to receive a refund if the group’s claims are lower than expected.

Additional advantages of Healthy Choices:

• Claim advocacy through a market leader in Medicare-based pricing
• Increased provider cost transparency
• True provider choice within the United States* – no network restrictions
• Stop-loss protection from Trustmark® Life Insurance Company
• Seamless integration of claims payment, administration and benefits

*Except in the instance of organ transplants, where benefits are available when performed at a designated transplant facility, and specialty drugs, where benefits are available when provided by the designated specialty pharmacy as outlined in the plan document.  

Contact us today for more information!

“In light of rising health care spending, benefits are evolving from simply providing coverage to fully integrated care coordination with one-on-one advocacy,” said Kevin Cassidy, president of Employer Solutions for Blue Cross and Blue Shield in a recent article.

“More employers are looking for plans that further integrate pharmacy and behavioral health programs in an effort to look at employee health more holistically.”

Similarly, a recent study by Cigna found positive health outcomes for individuals in integrated care programs and lower medical costs for employers —  an average of $193 annually for each covered person, and $9,792 per year for those with a specialty condition such as multiple sclerosis or rheumatoid arthritis.

More at Inside Indiana Business:

http://www.insideindianabusiness.com/story/40294403/integrated-healthcare-a-boon-for-employees-and-employers

Many doctors say they spend half their day or more clicking pull-down menus and typing rather than interacting with patients. An emergency room doctor can be saddled with making up to 4,000 mouse clicks per shift. This has fueled concerns about doctor burnout, which a January report by the Harvard T.H. Chan School of Public Health, the Massachusetts Medical Society and two other organizations called a “public health crisis.”

More from WVPE: https://www.wvpe.org/post/why-promise-electronic-health-records-has-gone-unfulfilled

“In the final days of 2018, the agency started issuing notices to assess penalties against employers that failed to file Forms 1094-C and 1095-C with the IRS or to furnish 1095-C forms to employees under IRC Sections 6721 and 6722 for the 2015 or 2016 tax year.

These penalties are separate from the IRC Section 4980H penalties for failing to offer the required healthcare coverage.

It appears the IRS is calculating these IRC 6721 and 6722 penalty assessments for certain employers based on the number of W-2s the employers filed with the IRS. These IRC 6721/6722 penalty assessments are proposed using Letter 5005-A and Form 886-A.”

More Info: https://www.accountingtoday.com/opinion/the-irs-is-issuing-new-aca-penalties-against-employers

Consumers who used the terms “ACA enroll,” “Obamacare plans,” and “cheap health insurance” to shop online for insurance last fall were often drawn to websites that promote short-term health plans or other non-Affordable Care Act-compliant plans, according to a study by researchers at Georgetown University’s Center on Health Insurance Reforms. Researchers found that only 19% of searches using the common terms directed users to websites providing only ACA-compliant plans during open enrollment.

More from KHN/RWJF: https://khn.org/news/ads-for-short-term-plans-lacking-aca-protections-swamped-consumers-online-searches/