The Patient Protection and Affordable Care Act (PPACA) of 2010 will change the rules for purchasing over-the-counter (OTC) medicines or drugs using Flexible Spending Accounts (FSA), Health Reimbursement Accounts (HRA) or Health Savings Accounts (HSA).
The popularity of accounts like FSAs is driven by tax-saving benefits for both employees and employers. A typical employee can expect to save $420 annually* while the financial benefit for employers is avoiding the 7.65% FICA tax on employee wages diverted to an FSA. While the motivating tax benefits will remain intact under the new reform law, careful communication on how OTC medicines or drugs qualify for reimbursement will be key to continuing to benefit from tax advantages.
What will qualify as a tax-free & reimbursable FSA, HRA or HSA expense?
Starting January 1, 2011 expenses for medicines or drugs will qualify as tax-free and reimbursable by an employer-provided health plan, including an FSA, HRA or HSA, only if:
• the medicine or drug requires a prescription
• is an over-the-counter medicine or drug and the individual obtains a prescription; or
• is insulin
Therefore, for OTC medicines and drugs to be reimbursable an individual must obtain a prescription.
How will FSA, HRA and HSA debit cards be impacted?
These debit cards may not be used to purchase OTC medicines or drugs.
Since OTC medicines and drugs must be substantiated before a reimbursement can be made, individuals must pay out-of-pocket at the time of purchase and then submit a reimbursement claim along with a copy of the prescription.
Note: Debit cards may continue to be used for OTC items that are not considered a medicine or drug (ie. bandages, contact lens solution)
Saturday, October 23, 2010
How FSAs, HRAs & HSAs are impacted starting 1/1/2011
Friday, October 8, 2010
Working While Sick: An Epidemic?
By Kaitlin Madden, TheWorkBuzz.com -- Yesterday, a group of leaders in the food service industry gathered in Washington, D.C. to discuss the alarming findings of a new survey. The study, conducted by Restaurant Opportunities Centers United, found that two-thirds of restaurant workers go to work when sick.
While the study sheds light on some serious underlying issues in the food service industry — nearly 90 percent of workers reported they get no paid sick days and 60 percent said they did not receive any form of health insurance — the study also poses an obvious problem for the restaurant consumers who eat the food handled by sick workers.
June Lindsey, a Detroit woman with more than 30 years’ experience in the food service industry, knows a lot about going in to work sick. She shared the following story in the study:
“[One day] I had a really bad cold. My nose was running, I was sneezing, [and] I had a bad cough and a fever. I could not call in sick because no work meant no money and I couldn’t afford it at that time. My kids were very young, so I went to work to see if I can make it through the day. Half way through the day, the sneezing, coughing and runny nose got worse. I asked the manager, ‘I am really sick and need to go because I could make others sick and I am dealing with food.’ She laughed and told me ‘try not to cough then.’ So I had to work that day sick, and who knows how many customers I got sick because I couldn’t go to the back and leave the counter to wash my hands after every sneeze or nose wipe. Later on all of us got sick one by one, and all this came from another worker that came to work sick like me, but was not allowed to leave work!”
While food service is the most recent industry to address the problem, it’s not a problem that’s exclusively theirs. According to the website for MomsRising, a group that pushes for reform on issues like maternity leave, fair wages and paid family illness days, 55 percent of workers in the retail industry and 48 percent of workers employed in the general private sector don’t receive paid sick days.
Though coming in sick means there’s a good chance your co-workers and customers will catch your irksome illness — in some cases, passing on your poor health can cause potentially life-threatening situations.
Take the case of Amy*, for example. As the mother of a young son who is currently being treated for a blood disease — the recovery from which depends on his avoidance of illness — Amy pays vigilant attention to those who enter her son’s room at the renowned children’s hospital where he is staying. This past weekend, the poor health of one of the hospital’s staff members compromised the well-being of Amy’s son: “On Saturday, as I woke up, I noticed that our nurse was sick,” she says. “No one is supposed to be allowed on our floor if they are sick and definitely not in our rooms. This is a nurse whom we really like and who has been with us from the beginning. When I wouldn’t allow him back in the room, he explained that the hospital does have a policy that the nurses have to call in if they are sick. Unfortunately, the hospital has another policy that causes nurses to be written up if they call in sick. It’s a catch 22 that puts kids at risk.” Amy and her family are currently trying to get the hospital policy changed, since she says it caused “a good nurse to make a poor choice.”
While Amy’s incident may seem like it would be an isolated one in the health care field, a recent study by the Journal of the American Medical Association says otherwise. This summer, the AMA published the findings of a survey of 537 medical residents from around the country, in which 57 percent of residents said they’d worked while sick, the Kansas City Star reports.
With flu season rapidly approaching, it can be tough to know what to do in a situation where you know you are too sick to go to work, but are worried about the repercussions of skipping a day. Here are a few ideas to help you find a better alternative to working while you’re sick:
1. Switch shifts: If you work in a restaurant, hospital or retail environment where workers are scheduled in shifts, try switching hours with a co-worker. Create a list of all your co-workers phone numbers and keep it at home. That way, if you’re feeling too sick to work, you can call a colleague and ask if they can cover your shift. Just make sure that you offer to cover one of theirs in return, or to repay the favor when a co-worker isn’t feeling well.
2. Get a doctor’s note: Though asking your doctor for a note may make your feel like you’re back in the fifth grade, doing so will lessen your chances of being reprimanded — and provide you proof of your illness should your employer think you were “playing hooky.”
3. Work from home: If you have a desk job or another occupation that doesn’t necessarily require your physical presence, working from home can be a good alternative for those who don’t want to — or can’t — take a sick day. It will prevent you from spreading your condition to colleagues and clients, and will also allow you to recuperate while still getting your work done.
4. Check out the legalities: While the Healthy Families Act — which would require employers to provide employees with one hour of paid sick leave for every 30 hours worked — has recently been reintroduced to Congress, it has yet to pass. In the meantime, many occupations do have guidelines when it comes to working while sick — which means you have the right to, or may be required to — take the day off if you’re not feeling well. Most large employers, for instance, must legally allow workers to take up to 12 weeks of unpaid sick leave per year, under the Family and Medical Leave Act.
5. Ask for a substitute duty: If you feel you must go to work while sick, talk to your employer about alternative duties. Instead of working directly with customers at a retail store, for example, ask if you can work in the stockroom instead. If you work at a hospital, ask to cover a floor that won’t put you in contact with patients that have compromised immune systems.
Click here to read the article on TheWorkBuzz.com
Tuesday, October 5, 2010
CBHCare offers free community screening program
Posttraumatic stress disorder (PTSD) has been receiving greater attention in recent years as reports of the high incidence of the disorder among soldiers returning from deployment in Iraq has increased awareness and research of this condition. However, soldiers are not the only people who can develop PTSD. PTSD affects approximately 8 percent of the United States population, with between a quarter and one-third of people who experience a significant trauma developing PTSD.
Significant trauma is considered any event that is dangerous or upsetting, such as an assault or violent attack, combat, natural disaster or vehicle crash. Symptoms of PTSD, which can occur anytime after the event, include re-experiencing the event, such as having recurring nightmares, avoiding reminders of the event, being less responsive including feeling detached and less interested in life activities, and increased arousal, such as having angry outbursts or difficulty sleeping.
The good news is if you or someone you know has been experiencing symptoms such as those described above treatment is available. CBHCare offers you the opportunity to take a screening for PTSD as well as other common mental health conditions. The screenings are free, anonymous, and only take a few minutes. To take the first step, click here.
Friday, October 1, 2010
First Wave of Insurance Reforms Go into Effect
On Sept. 23, 2010, the first set of consumer protections in health insurance included in the Patient Protection and Affordable Care Act (federal health care reform) went into effect. These protections include:
• Prohibiting denials or limits on coverage or benefits for children under age 19 who have a pre-existing condition. This will benefit children living with mental illness who are covered by their parent's plan.
• Prohibiting lifetime dollar limits on most health insurance benefits, including mental health benefits, in all policies issued or renewed after Sept. 23, 2010. This will help protect enrollees, particularly those who experience multiple hospitalizations or have chronic and intensive mental health care needs.
• Extending dependent coverage for adult children up to age 26 in all individual and group health insurance policies. This will make it possible for young adults--at a time when many first experience mental illness--to be covered under a parent's plan.
• Bans on cancelling (“rescinding”) insurance coverage due to honest mistakes or omissions in insurance applications. Insurance companies will have to prove fraud to justify cancelling insurance policies.
• New rights to appeal adverse insurance decisions, such as denials of care. For most plans, plan holders must be provided a copy of the rationale for any denial of coverage and, importantly, there will now be an independent external appeals process in all states and for most plans.
Additionally, many plans will now offer certain preventive services, dependent on age, with no cost-sharing or deductible. For example, individuals will now be covered for blood pressure, diabetes and cholesterol tests.
To find out more about these and other insurance reforms going into effect today, visit www.healthcare.gov.
The federal health reform law contains many other provisions that will make an impact on health and mental health care. These changes will be implemented over the course of the next few years. For a list and timetable of these changes, go to http://healthreform.kff.org/timeline.aspx
