Health on the Hill
 Democrats claim HSAs are Tax Shelters: This week the Ways & Means Committee’s Subcommittee on Health has scheduled a hearing on whether HSAs (Health Savings Accounts) are more tax shelter than affordable health insurance option. The hearing follows a Government Accountability Office (GAO) report that shows HSAs are attracting more higher-income individuals looking for tax shelters than previously uninsured seeking affordable health insurance coverage.The GOP will defend HDHPs/HSAs, but this hearing marks the beginning of what appears to be Democrat-led efforts to cut back, if not eliminate, the use of HDHPs/HSAs. Despite industry data that show HDHPs/HSAs increase coverage, especially among small business workers, too many Democrats see HSAs as no more than a tax shelter for the “healthy and wealthy.” If, as expected, Democrats gain strength after the November elections, AHIA is prepared to defend this small business friendly form of affordable health insurance coverage (see related Help Sustain HSAs article). AHIA’s education of lawmakers has begun in earnest, and will continue until all lawmakers understand the benefit of HDHPs/HSAs.
SCHIP Directive: Also this week, the House Energy & Commerce Health Subcommittee plans to hold a hearing on legislation introduced by Chairman Frank Pallone (D-N.J) and Rep. Carol Shea-Porter (D-N.H)., to void a Centers for Medicare and Medicaid Services (CMS) directive placing restrictions on the State Children's Health Insurance Program.
The so-called August 17 directive places conditions on state coverage of families that earn 250 percent above the poverty level. According to the subcommittee, 14 states cover moderate-income children and several other states were planning to expand their coverage until the directive.
Government Accountability Office (GAO) and the Congressional Research Service (CRS) insist CMS violated congressional review law in issuing the August 17 directive.
Mental Health Parity: Both S.558 and H.R.1424 would require health plans offering mental health coverage to provide the same benefits for mental illness as they do for other medical conditions. Employers with fewer than 50 workers would be exempt under both of the bills. However, there are some significant differences in the two bills, which are deep enough that House, and Senate lawmakers are having difficulty reaching consensus.
Currently, S.558 and H.R.1424 are in a House-Senate conference committee. There are a number of issues on which there is yet no agreement. The principal one appears to be the scope of mental health disorders covered by the legislation. The House bill would apply its parity provisions to any mental health condition described in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). The Senate bill is considerably narrower. One piece of the mental health parity legislation that is of particular interest to AHIA members and their clients is the sanction—a penalty of $100/day per violation. The mental health parity penalty tax is also included, as an offset in a House tax extenders bill.
AHIA and business interests prefer the Senate approach.
SHOP Act Includes Role for Agents: The SHOP Act will stipulate a role for health insurance advisors in its program to provide health coverage through the state pools. AHIA has discussed S.2795/H.R.5918, the Small Business Health Options Program (SHOP) Act, with its sponsoring Senators. As Senator Lincoln’s staff put it, many individuals will need the expertise of professional health insurance advisors to analyze and compare the choices of coverage available through the pools. Senator Blanche Lincoln (D-AR) is one of the SHOP Act’s authors.
The SHOP Act would create a state government-run insurance pool for small (under 100 workers) and the self-employed. The bill calls for private insurers to offer coverage through the state-run pool. The insurers would be prohibited from considering preexisting conditions. Employers (and the self-employed) would receive tax credits if they pay part of the premium for their workers. Workers would select the coverage from the choices available through the pool.
Wyden Individual Health Insurance Bill Suggested To Be Revenue-Neutral: S.334, the health insurance reform legislation that requires individuals to buy health insurance, has been scored by the Congressional Budget Office (CBO) and the Joint Committee on Tax (JCT). The CBO/JCT scores suggest that the bill would be budget-neutral by the time it is fully implemented (in 2014, were it to be enacted this year). The “Healthy Americans Act,” crafted by Senator Ron Wyden (D-OR) and cosponsored by a bipartisan group of 14 Senators, would require individuals (except those covered by Medicare or with religious objections) to buy health insurance. Health insurance could be purchased through employers or through state pools. Subsidies would be provided for those who cannot afford coverage. Premiums would be paid through the federal government, although the insurance would continue to be offered by private insurers. The bill would also replace current tax rules (employer deduction and employee exclusion of the health insurance premium) with a fixed individual income tax deduction for health insurance. JCT and CBO said the shifts in process for obtaining coverage and tax rules governing acquisition of coverage would largely offset each other, leaving the federal budget largely unchanged once the bill’s provisions are fully implemented.
Health Insurance Connectors: AHIA believes both the SHOP Act and Healthy Americans Act will be significant entrants in the health insurance reform debate next year. These proposals include different versions of health insurance connectors.
The AHIA Board of Directors has adopted the following position to address the latest health care reform trend — the concept to develop an entity to serve as a clearinghouse through which insurance companies would offer health insurance policies to employees and individuals.
Connectors should not be created to the exclusion of the successful distribution that currently exists. AHIA and NAIFA believe that a marketplace delivers best value when consumers are presented with diverse options from many competitors. Consumers also need reliable information from which to make informed decisions.
AHIA and NAIFA believe that the health insurance agent plays a valuable role in the delivery of health insurance coverage and benefits and that it would be a significant mistake to assume that a health insurance exchange or connector arrangement could perform the many services currently done by the agent. The associations also believe that health insurance consumers should be able to select from a broad variety of options with respect to health insurance coverages and benefits. However, a given proposal will not be automatically opposed simply because such proposal would establish an exchange or connector arrangement so long as it includes appropriate safeguards designed to protect the rights of consumers. Such safeguards would include but not necessarily be limited to the following:
- Participation in the exchange should be voluntary and they should not be the sole means of access to health insurance.
- The exchange should be permitted and encouraged to contract for services with more than one insurance carrier or provider of health care services.
- More than one exchange must be permitted to operate in a given region or state.
- The current health insurance market should continue in existence as one of several options for the purchase of health insurance.
- Exchanges should be required to meet the same statutory and regulatory requirements with respect to benefit mandates, premium rates, underwriting and marketing as commercial carriers must comply with in order to provide a "level playing field" for all players. This would serve to establish a basis for an objective evaluation of the savings and quality of service provided by such programs.
- Insurance carriers which market their products through exchanges should be permitted to use health insurance agents to market and service their products. Commissions paid to agents for these services should be determined by normal contracting arrangements between the agent and insurance carrier.
- The exchange should be an information and eligibility resource portal for persons potentially eligible for publicly funded plans or public assistance in purchasing health insurance. Licensed professional health agents should be provided fair incentive and authorization to enroll and provide service to persons eligible for public support programs.
AHIA and NAIFA believe that choice, quality, competition and professional service must be a part of any health care reform effort. Furthermore, AHIA and NAIFA believe licensed, fairly compensated, insurance agents offer a cost effective means of achieving personal and professional assistance in the selection of insurance coverage for individuals and employers of all sizes in all markets.
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CMS Issues New Medicare Marketing Rules
 On May 8, the Centers for Medicare & Medicaid (CMS) announced new marketing standards for Medicare Advantage (MA) and Medicare prescription drug (Part D) plans. The new rules, which will be published in the Federal Register on May 16, would prohibit cold-calling practices and limit door-to-door solicitations. The new rule also proposes MA commission structures that would eliminate incentives for agents to enroll or move beneficiaries “improperly.” Also outlawed under the new rules would be cross-selling of non-health care related products to MA or Part D prospects, and selling at educational events and in provider waiting rooms. The new rules would also require MA and Part D plan sponsors to hire only state-licensed independent agents to sell MA, and to use a commission structure that is consistent across plan years and plan types and among all the sponsor’s product offerings.
The new CMS rules could help defuse some of the Congressional angst over reports of seriously unethical marketing of MA and Part D plans in some places. AHIA agrees with the need to keep the unscrupulous away from our nation’s vulnerable senior citizens, but is concerned that some of the marketing restrictions are overreaching. The AHIA Legislation Committee and Board of Directors are reviewing the proposed standards in order to submit comments to CMS prior to the July deadline.
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Help Sustain HSAs
 In order to strengthen AHIA’s educational efforts regarding the use of high-deductible health plans (HDHPs) in conjunction with Health Savings Accounts (HSAs), AHIA is gathering successful HSA stories illustrating that low income workers have and like them — not just the healthy and wealthy. There is no better way to present the advantages of HSA products than with personal experiences.
Critics blast HSAs as a magnet for the healthy and wealthy, warning that their deductibles are a poor fit for lower-income Americans who cannot pay out-of-pocket for health care services. In announcing a recent Ways and Means Health Sub-Committee hearing on HSAs, Chairman Stark (D-CA) said, "HSAs and high-deductible plans are a flawed policy approach to making health care more affordable. They make things worse, not better. Instead of using the tax code to encourage people to purchase coverage that may be woefully inadequate, we should focus on providing comprehensive health care coverage to those most in need in the most cost-efficient way possible."
Supporters of HSAs have asked for our help and AHIA has been able to provide a number of illustrations. However the hearing this week is just the beginning of attacks expected to be launched on HSAs. You can help by sharing the value your clients receive from HSA products. Simply provide the following information about HDHP/HSA plans you’ve put in place:
- Your name
- The employer’s name and contact information – Will he/she be willing to talk to be interviewed and photographed?
- Number of employees
- Average income of the employees if possible
- Lowest salaried employee
- Cost savings by switching
- Individual and Family Deductible amounts
- Amount of employer contribution to the employees’ HSAs
- Preventative care covered prior to meeting deductible
- Brief description of why you offered this approach and why they accepted
- Favorable response by employees
- Unique features (i.e. Employees vote the amount of the deductible)
Please send your real world HSA experiences to ahia@naifa.org.
These case studies will be used in a number of ways. First, they will be shared with their respective congressional representatives – Members of Congress appreciate hearing about their constituents opposed to general data. Select illustrations may be used in a brochure or highlighted on AHIA’s website.
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Building Relationships to Offer Better Benefits
AHIA–NAIFA Health and Employee Benefits partners with Employee Benefit Adviser to offer free online forums. These monthly Online Forums serve as virtual AHIA monthly meetings and are designed to bring you a full meeting experience, directly from your desktop. If you haven’t previously participated, visit Online Forums to see what you’ve been missing the first Wednesday of each month.
Building on the existing partnership, AHIA has joined Employee Benefit Adviser in offering the 3rd Annual Employee Benefit Adviser Summit in New York City, Chicago and Washington, DC. The Summit has been expanded to include easy-to-attend, regional locations with the same great content. This intensive one-day seminar will provide you with:
- Actionable techniques for building and growing a “million dollar” practice
- Various methods to differentiate your business from your competitors
- Tools to sell real value-not products-to your clients
- Access to best practices in sales and marketing
- New ways to add value to brokers’ portfolios
- An understanding of the regulatory and compliance issues that are vital to your businesses
- Techniques on how to become a “must-have” employer resource
AHIA members receive a $100 discount so register today at www.ahia.net and hear from industry leaders as they help you to build your business and become an indispensable counselor to your clients.
"Using the technique recommended by one presenter during the 2007 Summit, I was able to out-perform my competitors and close a multi-year contract on a large case. Securing that group will pay for my attendance to the Summit for many years!" -Bill Foudy
“I have been attending industry seminars for over 30 years and this one was without question one of the most profitable I have experienced.” -Fred Bean
One Show. Three Locations. Your Choice.
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New York City, NY
Monday, August 4, 2008
The Roosevelt Hotel |
Chicago, IL
Monday, August 11, 2008
Hilton Chicago |
Washington, DC(Located in National Harbor, MD)
Monday, September 22, 2008
Gaylord National Resort & Convention Center |
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AHIA Presents:
2008 Employee Benefits Educational Symposium
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SEPTEMBER 5-6, 2008
Manchester Grand Hyatt • San Diego, California
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Choose from educational sessions in the following 10 tracks:
- CHDCs/HSAs
- HIPAA Privacy
- Self-Funding 101
- LTD Contracts
- COBRA
- Medical Plan Cost Realities
- Required Plan Disclosures and Operating Requirements
- Wellness
- FLEX Plans
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SAVE $50 by taking advantage of our early registration!
Go to http://www.naifa.org/convention and register before June 27th
to get our special reduced rate!
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Preliminary Schedule of Events
Friday, September 5
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Employee Benefits Symposium Breakout Sessions
Choose from a variety of workshop sessions focusing on employee benefit issues. Participants will attend three workshop sessions in the morning and two in the afternoon.
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Employee Benefits Symposium Luncheon Presentation:
When Everything Goes WRONG!
A dramatic presentation of an HR/Benefits department at it’s worst! Come to enjoy lunch, have a few laughs, and see what can go wrong in the world of employee benefits.
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Employee Benefits Symposium Wine and Cheese Reception
Join the speakers and panelists from the Employee Benefit Symposium as well as other attendees for networking and refreshments!
Saturday, September 6
Breakfast Presentation
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Tom Carter, Vice President, Sales and Broker Relations, Kaiser Permanente California
Tom Carter is Vice President of Sales and Broker Relations for Kaiser Permanente. In this role, Tom is able to utilize over 26 years of healthcare industry experience in the areas of sales, marketing, and account management. Tom leads the new group sales team statewide and co-leads the broker development strategy to enhance both the retention of existing business and the acquisition of new Kaiser Permanente customers.
Employee Benefits Symposium Expert Panels
Building Your Agency
Neil Simons, REBC, RHU, GBA, Founder and President, Independent Benefit Services
Simons will demonstrate how agents can successfully develop an employee benefits agency. Since it’s founding, Simons has grown Independent Benefit Services into one of the most respected benefit advisory firms in the region. Participants attending this panel aim to walk away with leadership strategies, directional approaches and other many valuable resources on how to run a prosperous employee benefits agency.
Emeric McCleary, CEO and Founder of Hispano Employee Benefits
With over 20 years of experience, McCleary is recognized for his valuable advice regarding Hispanic employee benefits and has advised numerous Fortune 500 companies in the employee benefits arena. McCleary intends to share his core principles of running a successful practice. Attendees can expect to gain valuable start up-strategies for their employee benefits agency, motivation, and retention strategies.
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Legislative Update
Join us for an informative legislative update and an engaging discussion on the status of health reform at both the state and federal level.
Meeting Expectations
Tom Carter, Vice President, Sales and Broker Relations, Kaiser Permanente California
With over 26 years of healthcare industry experience participants attending this panel will learn about the different expectations large carriers, employers and the public have of employee benefits agents.
Nick Bond, Vice President and General Manager of Russ Moore Transmission, Inc.
Mr. Bond knows well the expectations small carriers have of the employee benefits agent. Attendees will hear Bond’s key strategies to meet and exceed expectations of employee benefits agents.
Monday, September 8
AHIA Annual Meeting & Luncheon
Building a Million Dollar Practice
Roger Schultz, CLU
This presentation will address the critical steps necessary to a successful practice. Having already successfully established 250 direct reimbursement plans covering 200,000 participants in 21 states, it is evident Schultz knows the industry. Schultz has also proven his knowledge in the field by publishing over 50 articles on employee benefits. Through his expertise, Schultz will show agents how to develop innovative services, products and concepts. Schultz will also give agents advice on how to position their firm in the marketplace, adapt to the changing environment and differentiate their firm from competitors. By showing agents a few practical applications and techniques agents will be able to efficiently compete in the highly competitive field of employee benefits.
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State Legislative Information Network In Action
Virginia was the first state to take advantage of the new State Legislative Information Network. Marie Crawford contacted AHIA inquiring about universal application language. A notice was drafted and distributed to AHIA Health Chairs and State Executives. Within minutes, Marie had her first response with several others following.
This strategic program is designed to allow states to share and advance ideas, research, and policy solutions to help each other with state legislative challenges. AHIA hopes to stimulate dialogue and develop a workable exchange of intelligence on state health issues through the network.
To take advantage of the network, associations simply send an email to AHIA at ahia@naifa.org with SLIN in the title and clearly state the health issue of concern. AHIA will facilitate getting the message to the AHIA State Health Chairs who will respond directly to the inquiring association. Associations will provide the status of the initiative in their state, convincing arguments used to sway legislators, unexpected questions, coalition partners, effective and ineffective strategies.
As the bridge to intelligence sharing, AHIA is certain that the network will position the state associations as the strongest advocates on behalf of the interests of health insurance advisors in the state legislatures and with state insurance departments.
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'08 Health Care Debate
Republican presidential candidate Sen. John McCain recently released details of his proposal to expand health insurance coverage taking a drastically different approach from democratic candidates Sen. Hillary Clinton and Sen. Barack Obama. McCain proposed tax incentives to encourage people to get coverage while the democrats would use mandates. Democrats advocate building on the current employer-based system and McCain would shift to a more individual approach. Employers would no longer be allowed to deduct health care costs from their taxes under his plan.
AHIA supports reform efforts that build on the employer-based system and would use a series of tax credits and deductions to increase insurance coverage. To learn more about AHIA’s reform suggestions read Rx for Health Care – the Advisors’ Perspective.
To learn more about the presidential candidates’ health care efforts see
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Remember: May is Disability Insurance Awareness Month
 May is Disability Awareness month. AHIA members are encouraged to discuss the valuable of disability income insurance with clients and prospects. Following are a couple of resources you can use to reach out to your clients if you have not already done so:
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Promoting AHIA and the Role of the Advisor
In addition to its regular communication with members and leadership, AHIA Board members continue to spread the AHIA message through appearances in various press and industry magazines as well as participation in state and local NAIFA chapter meetings, and various conferences and forums. Recent visits/appearances include:
- AHIA President Thomas Vander Wal – Employee Benefits Expo, GA. AALU Annual Meeting, DC
- AHIA Secretary William Foudy – National Leadership Conference, VA
- AHIA Treasurer Sam Cunningham – Various state and local meetings with NAIFA-WA officers, Media training for NAIFA-WA and WAHU state officers.
- EVP Diane Boyle – National Leadership Conference, VA, AALU Annual Meeting, DC and various congressional meetings.
Here are a few way in which you can help communicate your association’s message:
Contact AHIA Marketing Coordinator Caitlin Kubler to request the AHIA Booth for an upcoming meeting.
Download the AHIA Rx For Health Care PPT and present at a local civic or business group (remember to view in the notes format for a ready-to-use script).
Forward an application to a non-AHIA member.
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2007-2008 AHIA Board of Directors
 PRESIDENT
Thomas J. Vander Wal
PRESIDENT-ELECT
Robelynn H. Abadie, LUTCF, CSA, RFC, RDA
SECRETARY
William J. Foudy, LUTCF
TREASURER
Sam J. Cunningham, CLU, ChFC, RHU
IMMEDIATE PAST PRESIDENT
Lawrence E. Lounds, CLU, ChFC, LUTCF
DIRECTORS
Christopher K. Schneeman, CLU, LUTCF
Ed Anderson, CLU, LUTCF
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