California Advisory Board Taps McFadden & Associates Founder to Advise Covered California Board On Employer Health Care Legislation

Insurance Industry veteran, Gohn Marie McFadden joins twelve member board to ensure Covered California understands the needs of the small business owner.

Beginning in 2014, under Covered California, small businesses will have the opportunity to purchase employee health coverage through the Small Business Health Options Program or SHOP. To assist the California legislature implement what’s right for Californians, Covered California has assembled a twelve member advisory board of industry veterans to provide input to Covered California Board and staff on critical issues for small business customers.

The California Advisory Board is tasked to look toward the January 2014 compliance deadline and collect California-specific perspectives from key experts and stakeholders. Their assistance will provide valuable insight that continually refines the policies and strategies that ensures Covered California offers unique value to small businesses that purchase coverage through the SHOP.

Specifically, the advisory board will provide insight regarding:

 ~ small business owners healthcare reform, insurance, coverage options, employee benefits and qualifications for tax credits;

~ the best administrative practices for healthcare reform compliance within the healthcare industry;

~ inclusion of healthcare insurance brokers and agents as well as providers and carrier networks;

~ training schedules for the healthcare industry professionals and

~ the best methods of educating the public regarding changes, options acquisition of health care, insurance quotes and estimates available as of January 2014.

Members were selected based on the need to ensure a balance of expertise and viewpoints of the issues to be considered by the advisory group. Members represent California’s cultural, geographic and economic diversity.

“I’m extremely pleased to take part in such an important appointment,” said, Gohn Marie McFadden, founder of McFadden & Associates, LLC. “Californians have a wide and diverse set of employer based health care needs that must be understood and reflected within our upcoming health care legislation. I look forward to working with my other colleagues for the betterment of our citizens.”

The SHOP advisory board is a 2 year, voluntary commitment, and is comprised of:

- Small business representatives and self-employed individuals

- Health plans    – Health insurance agents

- Consumer advocates with direct and substantial experience in small employer health care issues

- Large employers or large employer coalitions with direct and substantial experience in purchasing health care

Click here for an overview of the SHOP Advisory Board, and a list of it’s members.

The SHOP Board meets once a quarter in Sacramento and is open to the public. Upcoming and past meeting minutes and presentations can be found here.

About McFadden & Associates LLC.

McFadden & Associates Insurance Services, LLC is a full service brokerage firm specializing in Insurance Services and Employee Benefits Consulting. Founded in 2005, McFadden & Associates LLC draws on over 60 years of senior management and technical experience to develop solutions unique to every clients’ needs. McFadden & Associates provides insight and direction on healthcare issues for Multiemployer, Corporate, NonProfits, and Public Sector Plans.

California Advisory Board Taps McFadden & Associates Founder to Advise Covered California Board On Employer Health Care Legislation

Insurance Industry veteran, Gohn Marie McFadden joins twelve member board to ensure Covered California understands the needs of the small business owner.

Beginning in 2014, under Covered California, small businesses will have the opportunity to purchase employee health coverage through the Small Business Health Options Program or SHOP. To assist the California legislature implement what’s right for Californians, Covered California has assembled a twelve member advisory board of industry veterans to provide input to Covered California Board and staff on critical issues for small business customers.

The California Advisory Board is tasked to look toward the January 2014 compliance deadline and collect California-specific perspectives from key experts and stakeholders. Their assistance will provide valuable insight that continually refines the policies and strategies that ensures Covered California offers unique value to small businesses that purchase coverage through the SHOP.

Specifically, the advisory board will provide insight regarding:

• small business owners healthcare reform, insurance, coverage options, employee benefits and qualifications for tax credits;

• the best administrative practices for healthcare reform compliance within the healthcare industry;

• inclusion of healthcare insurance brokers and agents as well as providers and                      carrier networks;

• training schedules for the healthcare industry professionals and

• the best methods of educating the public regarding changes, options                              acquisition of health care, insurance quotes and estimates available as of January 2014.

Members were selected based on the need to ensure a balance of expertise and viewpoints of the issues to be considered by the advisory group. Members represent California’s cultural, geographic and economic diversity.

“I’m extremely pleased to take part in such an important appointment,” said, Gohn Marie McFadden, founder of McFadden & Associates, LLC. “Californians have a wide and diverse set of employer based health care needs that must be understood and reflected within our upcoming health care legislation. I look forward to working with my other colleagues for the betterment of our citizens.”

The SHOP advisory board is a 2 year, voluntary commitment, and is comprised of:

• Small business representatives and self-employed individuals

• Health plans Health insurance agents

• Consumer advocates with direct and substantial experience in small employer health care issues

- Large employers or large employer coalitions with direct and substantial experience in purchasing health care

Click SHOP Advisory Board to get an overview, and a list of it’s members.

The SHOP Board meets once a quarter in Sacramento and is open to the public. Upcoming and past meeting minutes and presentations can be found here.

About McFadden & Associates LLC

McFadden & Associates Insurance Services, LLC is a full service brokerage firm specializing in Insurance Services and Employee Benefits Consulting. Founded in 2005, McFadden & Associates LLC draws on over 60 years of senior management and technical experience to develop solutions unique to every clients’ needs. McFadden & Associates provides insight and direction on healthcare issues for Multiemployer, Corporate, NonProfits, and Public Sector Plans.

GRIN! Spring / Summer Newsletter is here – Keep your smile healthy & happy!

Grin! – Delta Dental’s Spring / Summer newsletter for news, notes & entertainment to keep your smile healthy & happy, is now available! Download it by clicking the link below.

This issue features great articles on:

• Teens and teeth whitening

• The history of oral health:

• The tooth worm and other oral health myths

• How fluoridated water helps prevent tooth decay

And, 5 oral health tips for expectant mothers

Take a read and get mouth healthy.

GrinMagazine-Spring042013

Welcome to our home on the Web!

Welcome to McFadden & Associates, LLC’s new home on the Web – we hope you enjoy our new look and more complete overview of our service offerings.

We’d also like to announce the creation of our blog, “Healthy Insights”, an updated view into the world of Employee Benefits, Health Tips and Health Care Reform:
http://mcfaddenandassociates.net/blog/

You can also stay in regular contact with us by:

Liking us on Facebook:
http://www.facebook.com/pages/Mcfadden-Associates-Insurance-Services-LLC/571634406183002

or, following us on Twitter:
https://twitter.com/McFaddenAssocLL

See you online!

Gohn Marie McFadden, Principal & Sr. Consultant
McFadden & Associates, LLC

Employers’ ACA Notice Requirement Regarding Availability of Exchanges Delayed

Beginning on March 1, 2013, under a provision of the Affordable Care Act, employers were to be required to provide employees with a notice about the availability of the new health insurance exchanges.

The Department of Labor (DOL) recently announced that employers will not be held to the March 1, 2013 deadline. The Department acknowledged that it would be premature to issue a notice in March because specific exchange information is not yet available. As a result, upcoming guidance on the provision is expected to reflect a more realistic compliance date.
To serve as a reminder, we have listed below the details of the employer notice requirement.
All employers must notify employees of:

- The existence of the Health Insurance Exchange that will become operative as of January 1, 2014;
- The employee’s potential eligibility for federal financial assistance if the employer’s health plan doesn’t meet affordability and minimum value criteria under ACA and if employee household income is below certain thresholds; and
- Loss of the employer’s contribution to health care coverage if they purchase health insurance through the Health Insurance Exchange.

In order for employers to remain in compliance, the issued notice must:

- Be written;
- Be provided regardless of the size of the employer; and
- Include minimal information about the individual so as not to place a threat to individual privacy.

As always, we will monitor any change on this regulation and post another update once disclosed by the DOL.

Preventive Services Covered Under the Affordable Care Act

If you have a new health insurance plan or insurance policy beginning on or after September 23rd, 2010, the following preventive services must be covered without you having to pay a copayment or co-insurance or meet your deductible. This applies only when services are delivered by a network provider.

• Covered Preventive Services for Adults
• Covered Preventive Services for Women, Including Pregnant Women
• Covered Preventive Services for Children

16 Covered Preventive Services for ADULTS

1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
2. Alcohol Misuse screening and counseling
3. Aspirin use for men and women of certain ages
4. Blood Pressure screening for all adults
5. Cholesterol screening for adults of certain ages or at higher risk
6. Colorectal Cancer screening for adults over 50
7. Depression screening for adults
8. Type 2 Diabetes screening for adults with high blood pressure
9. Diet counseling for adults at higher risk for chronic disease
10. HIV screening for all adults at higher risk
11. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
• Hepatitis A
• Hepatitis B
• Herpes Zoster
• Human Papillomavirus
• Influenza (Flu Shot)
• Measles, Mumps, Rubella
• Meningococcal
• Pneumococcal
• Tetanus, Diphtheria, Pertussis
• Varicella

13. Obesity screening and counseling for all adults
14. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
15. Tobacco Use screening for all adults and cessation interventions for tobacco users
16. Syphilis screening for all adults at higher risk

22 Covered Preventive Services for WOMEN, Including Pregnant WOMEN

The eight new prevention-related health services marked with an asterisk ( * ) must be covered with no cost-sharing in plan years starting on or after August 1, 2012.

1. Anemia screening on a routine basis for pregnant women
2. Bacteriuria urinary tract or other infection screening for pregnant women
3. BRCA counseling about genetic testing for women at higher risk
4. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
5. Breast Cancer Chemoprevention counseling for women at higher risk
6. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
7. Cervical Cancer screening for sexually active women
8. Chlamydia Infection screening for younger women and other women at higher risk
9. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs*
10. Domestic and interpersonal violence screening and counseling for all women*
11. Folic Acid supplements for women who may become pregnant
12. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes*
13. Gonorrhea screening for all women at higher risk
14. Hepatitis B screening for pregnant women at their first prenatal visit
15. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
16. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older*
17. Osteoporosis screening for women over age 60 depending on risk factors
18. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
19. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
20. Sexually Transmitted Infections (STI) counseling for sexually active women*
21. Syphilis screening for all pregnant women or other women at increased risk
22. Well-woman visits to obtain recommended preventive services for women under 65*

27 Covered Preventive Services for CHILDREN

1. Alcohol and Drug Use assessments for adolescents
2. Autism screening for children at 18 and 24 months
3. Behavioral assessments for children of all ages Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
4. Blood Pressure screening for children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
5. Cervical Dysplasia screening for sexually active females
6. Congenital Hypothyroidism screening for newborns
7. Depression screening for adolescents
8. Developmental screening for children under age 3, and surveillance throughout childhood
9. Dyslipidemia screening for children at higher risk of lipid disorders Ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
10. Fluoride Chemoprevention supplements for children without fluoride in their water source
11. Gonorrhea preventive medication for the eyes of all newborns
12. Hearing screening for all newborns
13. Height, Weight and Body Mass Index measurements for children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
14. Hematocrit or Hemoglobin screening for children
15. Hemoglobinopathies or sickle cell screening for newborns
16. HIV screening for adolescents at higher risk
17. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
a. Diphtheria, Tetanus, Pertussis b. Haemophilus influenzae type b c. Hepatitis A d. Hepatitis B e. Human Papillomavirus f. Inactivated Poliovirus g. Influenza (Flu Shot) h. Measles, Mumps, Rubella i. Meningococcal j. Pneumococcal k. Rotavirus l. Varicella
18. Learn more about immunizations and see the latest vaccine schedules.
19. Iron supplements for children ages 6 to 12 months at risk for anemia
20. Lead screening for children at risk of exposure
21. Medical History for all children throughout development Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
22. Obesity screening and counseling
23. Oral Health risk assessment for young childrenAges: 0 to 11 months, 1 to 4 years, 5 to 10 years.
24. Phenylketonuria (PKU) screening for this genetic disorder in newborns
25. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
26. Tuberculin testing for children at higher risk of tuberculosis Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
27. Vision screening for all children