Wellness Programs A to Z

When it comes to health-coverage laws, there’s often a domino effect.

As individual states require insurers – and in some cases, businesss – to cover or offer coverage of specific people  and procedures, similar laws can spread rapidly to other states.

The effect on plan sponsors –  Some mandates can increase your costs by 20% to 45%.

Small firms targeted, too

States are no longer targeting  just the Wal-Marts and other giant companies anymore.  The pressure has increased on companys of all sizes.

That’s particularly true for the new “universal coverage” laws passed in Massachusetts and Vermont.

The Massachusetts law requires every firm with 11 or more workforce either to cover or contribute toward everyone’s health coverage, or else pay an annual fee of $295 per employee to a state fund.

Vermont’s similar version sets the annually fee at $365 per full-time equivalent worker.  The Vermont law also requires all uninsured, low-income hourly workforce to have access to a state-subsidized plan (called Catamount Health) sold through private insurance businesses.

It’s up to employers to deduct the monthly premiums – $60 to $135, depending on the person’s wages – and send it to the state.

There are rumblings in at least 10 states about lawmakers pushing for universal-coverage laws. A few have formed committees to study the Massachusetts law and see when a version may be altered to their state.

Here are three proactive steps to consider now. These could potentially save money, time and compliance headaches later –

• look into offering mini-med or similar lower-cost programs to satisfy minimum coverage requirements for uninsured staff members. Monthly premiums range from about $25 to $200

• educate low-income personnel about the earned income-tax (EIT) credit the federal government offers. This can make a mini-med plan free or nearly free to eligible personnel, and

• use flexible spending accounts to create a tax savings on premiums for other staff and your firm.

Required procedures

The universal-coverage laws draw national headlines, but far more businesss are currently affected by state laws requiring coverage for certain types of procedures. Three of the biggies –

• diabetes self-management. Nineteen states require your health plan to cover all the steps workers with diabetes take to control their condition, including nutritional therapy (if prescribed by a doctor)

• in vitro fertilization. This big ticket service adds 3% to 5% to your premiums, and is now a required benefit in 15 states, and

• cervical cancer screenings. In the last year, four more states have required all corporation plans to cover annually cervical cancer screenings for all covered female workforce, spouses and dependents age 18 and older. That brings the total to 24 states.

The good news about the diabetes management and cervical cancer mandates is they can decrease your  long-term costs, even when they increase them in the short-term.

Here is a good resource  for keeping abreast of mandatory coverage trends around the U.S..  The site also features  state-by-state breakdowns of changes in insurance laws  mandating the coverage of different treatments and conditions.

For  instance, this report from 2006 is the most robust coverage-mandate study that I’ve ever seen.