Michigan’s House Denies Second Chance at State Based Exchange; Hope Still Held for Next Year.
November 29th, 2012
The Michigan Business and Professional Association (MBPA) and its sister group, the Michigan Food and Beverage Association (MFBA), make it priority #1 to keep you up to date on the federal healthcare law and how it affects you, your business, and/or clients. Today the Michigan House Health Policy Committee, when given a second chance to approve a state based exchange, rejected that opportunity. The Speaker of the House made a statement today that establishing a state based exchange in Michigan will not happen this year, but has potential in next year’s session.
As a refresher, in the state-based healthcare exchange, Michigan would be allowed to participate in essentially twelve different areas, making decisions on what is best for our region. In the state/federal partnership plan, Michigan is allowed to participate in two out of the twelve decision areas, which stated by law is Planned Management and Customer Service. Lastly, in the complete federal run plan, Michigan is not granted any decision making power. The continued inaction by the House of Representatives leaves no other choice but for Michigan to pursue a state/federal partnership, giving Michigan less decision making power.
Per the ACA, if Michigan chooses now to pursue the state/federal partnership, it still has the opportunity in 2013 to switch over to a state based exchange, if approved by the legislature and governor. Also, per the ACA, the 9.8 million dollars in federal grant funding to lay the ground work for establishing a state-federal partnership is still available. Your help is needed now, to contact your State Representative, telling them to appropriate the much needed 9.8 million dollars in federal funding our state desperately needs to become compliant with a state/federal partnership.
The 9.8 million dollars in federal grant monies in no way ties our state to any permanent healthcare decisions; it merely gives us much needed revenue to begin technical compliance, while saving our general fund dollars. The time to act is now. This is the last remaining option we have for Michigan to maintain some control over decisions made in regards to our healthcare. Please call your State Representative and strongly urge that they support and pass the 9.8 million dollars in federal funding our state desperately needs.
If you have any questions please do not hesitate to contact our government relations team by phone at: 586-393-8800 or by email: BBochniak@michbusiness.org
By Bonnie Bochniak
MBPA Government Relations
Dec. 11, 2012
The Michigan Business and Professional Association (MBPA) and its sister group, the Michigan Food and Beverage Association (MFBA), make it priority #1 to keep you up to date on the federal healthcare law and how it affects you, your business, and/or clients. Today the Michigan House Health Policy Committee, when given a second chance to approve a state based exchange, rejected that opportunity. The Speaker of the House made a statement mid-December that establishing a state based exchange in Michigan will not happen this year, but has potential in next year’s session.
As a refresher, in the state-based healthcare exchange, Michigan would be allowed to participate in essentially twelve different areas, making decisions on what is best for our region. In the state/federal partnership plan, Michigan is allowed to participate in two out of the twelve decision areas, which stated by law is Planned Management and Customer Service. Lastly, in the complete federal run plan, Michigan is not granted any decision making power. The continued inaction by the House of Representatives leaves no other choice but for Michigan to pursue a state/federal partnership, giving Michigan less decision making power.
Per the ACA, if Michigan choses now to pursue the state/federal partnership, it still has the opportunity in 2013 to switch over to a state based exchange, if approved by the legislature and governor. Also, per the ACA, the 9.8 million dollars in federal grant funding to lay the ground work for establishing a state-federal partnership is still available.
The 9.8 million dollars in federal grant monies in no way ties our state to any permanent healthcare decisions; it merely gives us much needed revenue to begin technical compliance, while saving our general fund dollars. The time to act is now. This is the last remaining option we have for Michigan to maintain some control over decisions made in regards to our healthcare
If you have any questions please do not hesitate to contact our government relations team by phone at: 586-393-8800 or by email: bbochniak@michbusiness.org
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This month we’re sharing an article entitled, “Do you have a Sales Plan for 2013?” Please feel free to use this article in any of your publications. Also, if you could please send us a copy of the article when it is published, it would be much appreciated.
If you haven’t already signed up to attend our Keeping On Track Open Line web conference entitled, “Selling Secrets: Connect UVP with Style” December 18th at 11am PT. Then please click on the following link to sign up http://lighthouseconsulting.org/openline/121812/.
Our programs are very interactive. Many participants invite their management team to attend and set up discussion time at the conclusion of the programs since we provide many pro-active ideas that organizations can begin to implement. Participants also receive a complimentary audio and slides for future use. Other programs are available for purchase on our website.
Many companies have found that forwarding our articles through email to be an easy way to share them with staff and friends. So, please feel free to share our articles in any way you would like to. If you have any questions, comments or problems reading our publication, please e-mail us at:reception@lighthouseconsulting.com.
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An employee who was fired for embezzlement starts circulating e-mails that inform people you are about to go out of business. A contractor is using your company e-mail to send out solicitations to people to visit a gaming site she has created. You are selling your business to a long-time, trusted employee and want to assure your customers that everything remains in good hands – should you set up a blog?
In today’s business environment, where e-mails spread faster than a bad cold and blogs are the order of the day, every business should have a plan for communicating during a transition or crisis.
Whether it’s embezzlement, workplace accident, natural disaster, lawsuit or layoffs, every business owner should be prepared to communicate to both internal and external audiences. These audiences include employees, vendors, customers, business allies and the media.
Here are some tips for creating a communications plan that will guide you during those times of transition or crisis.
Designate a spokesperson. Your business should have only one or two key individuals that may speak to the media and respond to customers, vendors and employees during a critical situation. A spokesperson may be the owner, CEO, PR counsel, HR manager, attorney or another trusted individual. Only these individuals may take and respond to media and other inquiries. Once these individuals are identified, communicate this information to all employees.
Speak to employees first and be frank. Put safety and people issues first.
Never lie, cover up or say “no comment.” Give the facts as you know them.
Make sure you tell your side of the story, including key messages. If necessary, issue a press release with the facts and get it out to all pertinent audiences. Post information on your website. If your business is responsible for what has happened, tell why it happened and how you will fix the problem.
Be timely in responding to inquiries. If a reporter calls, find out their deadline and ask if you can get back to them. Then prepare your message and call them back. Prepare a message ahead of time for when customers or vendors call.
Remember the three C’s – confidence, control and credibility. Have confidence when delivering the message. Exercise control over the message by having a designated spokesperson who communicates the key points. Maintain credibility at all times; if you don’t know an answer, say so and get back to the individual.
Create your communications plan, communicate it to employees and make sure they understand it. Remember, during any transition or crisis, your company’s hard-earned reputation is at stake. Take steps now to protect that reputation.
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1. How to remove a connection
Want to ditch a connection? Sometimes you need to give someone the boot. Maybe its a colleague, a competitor, an ex, or just someone you don’t want to be associated with. Getting rid of them is easy as pie. Even better, they won’t know you’ve given them the heave-ho.
How to wield this magic?
When you’re logged into LinkedIn, Select Contacts in the main navigation bar. At the far right, you’ll see two options: Add connections and Remove connections. Click Remove connections, check the box next to the contact’s name and click OK.
2. Hide your status updates
Sometimes it makes sense to operate in stealth mode. If you’re connecting with new business prospects or making changes to your profile in preparation for job seeking, you may not want to broadcast that activity to your network.
Click the drop-down menu under your name in the top right corner of the page, then select Settings In the profile section, click Turn on/off your activity broadcasts under Privacy Controls. Uncheck the box that appears in the pop-up window and click Save Settings. Easy as can be and now you’re flying below the radar.
One tip: Remember to turn this setting back on as soon as you’re done, otherwise, you’ll be invisible on Linkedln and that kind of negates the whole point.
3. Privacy matter to you? Opt out of ads
There was a big brouhaha about Linkedln and a few months back when it was discovered that a default setting called “social sharing” allows Linkedln to pair an advertisers message with the social content from a Linkedln user’s network.
If you don’t want your info showing up in random ads, opt out. Click Settings under your name, then click Account. Under Privacy Controls, select Manage Advertising Preferences. If you don’t want to see ads, uncheck the box that appears in the pop-up window and click Save Settings. You can also read more about each type of advertising, if you want to learn more.
4. Get a custom URL
It’s much easier to publicize your LinkedIn profile with a customized URL, rather than the clunky combination of numbers that LinkedIn automatically assigns when you sign up. Plus, if you use a consistent name across all of your social networks (and you should), this is a great way to boost your own “brand awareness.”
Laugh if you will, but its an important part of networking. And when it comes to networking, do you really want anything less than a custom URL on your business card? We think not.
How to get your own custom URL? Log in. Click Profile > Edit Profile in the main nay bar. At the bottom of the gray window that shows your basic information, you’ll see a Public Profile URL. Click “Edit” next to the URL and specify what you’d like your address to be. When you’re finished, click Set Custom URL.
5. Make yourself anonymous
If you’re gearing up for some serious Linkedln stalking, whether for competitive research, new business prospecting, or job hunting, you may want to switch your profile setting to anonymous so that individuals and companies can’t tell that you’ve been looking at their profiles.
To make your profile anonymous, choose Settings > Privacy Controls > Select what others can see when you’ve viewed their profile. From there, you have three options: Display your name and headline; Display an anonymous profile with some characteristics identified such as industry and title, or totally anonymous.
Once you’re done with your sleuthing, be sure to switch your settings back- remaining anonymous on Linkedln for a long period of time won’t do you much good when it comes to networking and lead generation.
6. Customize a link to your website
When you set up your profile, Linkedin lets you display links to up to three URLs. And although Linked In provides several choices when identifying the website content to which you’re linking (personal website, company website, blog, ASS feed, etc.), it’s better to customize those. For instance, mine says: The V3 Website, The V3 Blog, Shelly Kramer’s Facebook (which is where I’d like to send people if they want to know more about me).
To customize the URLs on your Linkedln profile, select Edit Profile from the Profile menu in the main nay bar. In the gray box that includes your photo, select Edit next to Websites. From there, choose Other from the drop-down menu. A new box will appear that lets you name the website and enter the URL. When you’re done, click Save Changes.
7. Add your blog feed
If you have a WordPress blog, we highly recommend feeding your blog into your LinkedIn profile (unless, of course, the content isn’t appropriate for a LinkedIn page.) To enable this setting, select More in the main nay bar and select Applications. From there, choose the WordPress application and enter the link to your feed. The blog will then appear in your profile and will update each time a new post is added.
Want to move where that blog application is appearing in your profile? Easy. Click Profile > Edit Profile and hover over the application title. Your cursor will change into a hand, and you can “grab” the element and move it to a different spot on the page. You can also use the BlogLink application if your blog isn’t a WordPress site.
8. Hide a recommendation
Ever get a recommendation you didn’t ask for? Or one that isn’t something you’d want to showcase on your Linkedln profile?
If you get a recommendation that’s poorly written or is unsolicited and don’t feel comfortable reaching out to the writer and asking for some revisions, no biggie. You can easily hide the recommendation. Select Profile > Edit Profile and go to the position with which the recommendation is associated. Click Manage. Uncheck the box next to the recommendation that you want to hide, and click Save Changes.
9. Add to your connection base
Duh. (Sorry, that just slipped out). A social networking site doesn’t do you much good if you don’t focus on building a network and adding to your connection base.
If you’ve mined your email contacts for possible connections and have exhausted Linkedln’s People You Should Know recommendations, there’s an easy way to expand your network-stalking. Yeah, I said stalking.
Simply go to a friend or colleague’s profile and click Connections in the main profile box. From there, you’ll see an alphabetized list of connections, and before long you’ll probably be saying to yourself: “Oh, I know her. And him. And I can’t believe I’m not connected to that guy.” And you can quickly and easily send invitations to connect.
For me, this is one of the easiest ways to build Linkedln connections—and candidly, I also get a little thrill out of stalking.
One last reminder: Don’t forget to customize the invitation before you send it. Nothing’s worse than getting the default, “I’d like to add you to my connections,” email for telling someone “you’re so unimportant to me that I can’t take the 20 seconds it would require to send you a personal note,” Just. Don’t. Do. It.
10. Block connections and group activities from competitors
If you’re using LinkedIn for new business development (or job seeking), its probably a good idea to slip into stealth mode again when you’re focused on this kind of work, in some cases, it makes sense that you’ll want to keep competitors (or current employers, if you’re job hunting) from seeing your new connections and group activity.
Its easy to do, Select Settings > Account > Customize the updates you see on your homepage. In the pop-up window under General, uncheck the box that says New Connections in your network. Scroll down and, under Groups, uncheck the box next to Groups your connections have joined or created. Click Save Changes and you’re set.
11. Get LinkedIn updates in an RSS feed
Want an easy button when it comes to Linkedln Updates? If so, you can add Linkedln updates to your feed reader. This is especially good when you’re focused on new business development. And when doing this, you can choose from the public feed and your personal feed, which contains private information from your network.
To add a feed to your reader, go to LinkedIn’s feeds page. You can turn on the feed for network updates and add it to your reader using one of the reader buttons or by copying the link. Additionally, you can add an RSS feed of a LinkedIn Answers category, a great way to stay up-to-date on discussion about a particular industry or subject.
Before you add a personal feed to your reader, be warned that some Web-based readers will publish your feed URLs, meaning that information could show up in search results. If you want to avoid that disclosure, make sure your feed reader guarantees that your feeds are kept private (sorry, Google Reader fans).
12. Beef up your experience with projects
This is a relatively new LinkedIn feature and it is uber cool! You’ve probably listed a summary of your career experience, as well as individual jobs, to your Linkedln profile, but projects take it to a whole new level. It enables you to further showcase specific skills. Plus, you can add a relevant URL to each project and, if your team members are also on Linkedln, you can connect them (by name and by link to profile) to the project as well.
Want to add this to your profile? Click Profile > Edit Profile. Under the primary gray box of your profile, you’ll see a new Add Sections feature on a blue background. Click Add sections, Projects and enter a project description. You may want to add other sections, too, depending on their
relevance.
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As part of its service and commitment to the community, DTE Energy representatives are currently helping customers save energy and take control of their energy costs. Energy consultants are visiting homes throughout the DTE service area to provide personalized energy assessments and evaluate the energy efficiency of homeowners’ gas and electric usage.
The program, called the DTE Home Energy Consultation program, was created to advise homeowners on ways to conserve energy with a goal toward helping residents to better manage their energy costs. Energy consultants assess the customers’ energy usage, make energy saving recommendations and discuss ways to reduce energy usage that will help lower energy costs.
During the assessment, energy consultants will install:
Up to 40 compact fluorescent light bulbs which generally use 75 percent less energy than incandescent bulbs and can often last 10 times longer.
Water-saving faucet aerators in the kitchen and bathroom that can reduce water usage without lowering the water pressure in the pipes.
Water-saving showerheads that can save up to three gallons of hot water per minute which can reduce water-heating costs by 30 percent.
Wrap on the water heater pipes – up to nine feet from the hot water tank – an energy-saving measure that can reduce heat loss and increase water temperature in the pipes, which will save on water-heating costs.
In the first year of the program, DTE Energy visited more than 25,000 homes. This year, they plan to reach more than 30,000 households with energy-saving tips and products.
To learn more information about the DTE Home Energy Consultation program, or to schedule an appointment for DTE to visit your home, call (866) 796-0512.
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By Chuck Moss House Appropriations Chair Representative
The Fiscal Cliff is like the weather: everyone’s talking, but nobody’s doing anything—yet—about it. First off: what is the ‘Fiscal Cliff,’ and why does it matter to Michigan.
‘Fiscal Cliff’ is a phrase meaning the situation the U.S. Government will face at the end of 2012. For years the President and Congress have cobbled together a series of make-do, ad hoc compromises in tax and spending policies, because no one can agree on fundamental issues. What fundamental issues? Taxes, spending, and the proper balance between the two.
For years we’ve been spending more than we take in, which has led to a multi-trillion dollar deficit. Democrats want to cut the deficit by raising more “revenue,” which means raising taxes. They don’t want to cut a lot of spending, except for Defense. Republicans don’t want to raise taxes, and would cut the deficit by severe spending cuts. The President wants to tax more and spend more, and just won reelection. So what we have is an impasse, which is nothing new, and why we’re in this situation in the first place.
Because the House and the Senate can’t agree with each other or with the President, they’ve put off the day of reckoning by stopgap temporary measures. Biggest is the Budget Control Act of 2011. This law was passed in 2011 and according to Barron’s, over 1,000 government programs – including the defense budget and Medicare are in line for “deep, automatic cuts.” Next biggest is automatic tax hikes: the end of last year’s temporary payroll tax cuts (resulting in a 2% tax increase for workers), the end of certain tax breaks for businesses, shifts in the alternative minimum tax that would take a larger bite, the end of the tax cuts from 2001-2003, and the beginning of taxes related to President Obama’s health care law.
So that’s the Cliff: the combination of higher taxes and spending cuts would reduce the deficit by an estimated $560 billion, cutting gross domestic product (GDP) by four percentage points in 2013, sending the economy into a recession. At the same time, unemployment would rise by almost a full percentage point, with a loss of about two million jobs. In all, the tax increases and spending cuts make up about 3.5% of GDP, with the Bush tax cuts making up about half of that.
So what if you just cancel tax increases and spending cuts? National bankruptcy. Then the deficit keeps growing, and we end up in the same crisis as Europe. What if we take a middle course: cut a little spending and raise few taxes? Then we address the budget but sacrifice the anemic but real growth. Bottom line: more taxes means less growth and possible recession. Less spending cuts equals higher deficit, leading to fiscal meltdown like Europe. Cutting spending and keeping taxes low isn’t the platform of the guy who just got reelected to the White House. Hiking taxes and gutting the military isn’t the platform of the majority who got elected/reelected to the House of Representatives. The reelected President isn’t known for his ability to craft bi-partisan compromises—to say the least. Deadlock means disaster. Half-measures mean we limp along. Pick your poison.
What does it mean for Michigan? Well, we’ve seen this dynamic play out here at home, in Governor Jennifer Mulhern Granholm’s second term. Governor Granholm was reelected, but faced an opposition party Senate. She described her plan as “revenue, reforms, and reductions,” but the reforms and reductions never really came: just the ‘revenue enhancements’—taxes hikes. The GOP-led Senate said ‘forget it.’
Unwilling or unable to craft a solution to bring the GOP aboard, Granholm attempted to use her then-reputedly formidable popularity, communication skills, and bully pulpit to bully the opposition into submission. It didn’t work, and the Senate dug in. She then engaged in serious brinkswomanship, taking the state budget right up to the September 30th deadline, and twice into actual shutdown. That didn’t work either.
The Senate stayed dug in. Result: state government budgets were balanced with accounting gimmicks, the legislature’s reputation hit all time lows, and Jennifer Mulhern Granholm’s favorables dropped to the basement as well. In 2010 Michigan elected an un-partisan-ly problem solver, Rick Snyder, and chose a new course. But four years of deadlock and paralysis in the midst of the Crash made Michigan a poster child for decline and failure.
Now there is the possibility that reelected President Obama will channel his inner Bill Clinton (watch out, Michelle!) and triangulate a position to keep taxes low and spending reforms serious. I don’t see that happening, however. Obama is Obama, not Slick Willy. He just got reelected calling for higher taxes and minimal cuts, except for Defense. So let’s assume that Barack Obama stays his course, and calls for higher taxes and smaller cuts…except for Defense. Another possibility is that the Republican House agrees to join President Obama and the Dems for a big group Kumbaya. But after this election, with so many House members voted in to hold the line, I don’t see that either. Best bet: the GOP-led House says “forget it.” Next step: a Granholmian offensive of calling the GOP’ers nasty names–which gets no results. So one of two things happens:
Deadlock. Smashup. Off the Cliff. We get hammered with huge sudden tax bites as well as huge automatic spending cuts. The US economy slams into full stop, then rolls in reverse to decline. Consequences for Michigan: back we go to recession-land. Unemployment soars again, and the modest recovery evaporates. Our shy March-like springtime of real estate and housing recovery sees a blizzard. Cities, towns, school districts whose finances are shaky—or worse—continue their slide to insolvency. Welcome back 2010.
Stopgap Half Measures: weak growth. Michigan keeps limping along, but without robust recovery. State government stays on fiscal discipline, which is good. Tax collections stay low, because no one’s making any money, which is bad. Job growth slowly gains, which is better than decline, but still leaves people behind.
Weak growth means weak business activity in general, which means weak profits, which means weak hiring, which means weak payroll and wages. Weak profits and wages mean weak tax collection and revenue. Local governments and school districts with bad balance sheets and high pension/retiree costs are unable to grow out of their downward spirals, which is bad. We may actually start seeing municipal or school district bankruptcies.
If Michigan’s competitive position relative to other states continues to improve, we’ll do better than say California, New York, or Illinois. But it won’t feel like 1983 or 1993, because it won’t be.
So that’s the Fiscal Cliff: what it is and what it may mean for Michigan. I’m betting on a limp-along-with-half-measures, kick-the-can-down-the road scenario, because decision avoidance trumps catastrophe every time. Here in Michigan, that means no Economic Springtime, but more like a Permanent March. Better than February, but don’t break out the sunscreen, put away the snow shovels, or plant your garden. Summer, it aint. Not yet.
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The Michigan Business and Professional Association (MBPA) and its sister group, the Michigan Food and Beverage Association (MFBA), make it priority #1 to keep you up to date on the federal healthcare law and how it affects you, your business, and/or clients. Today the Michigan House Health Policy Committee, when given a second chance to approve a state based exchange, rejected that opportunity. The Speaker of the House made a statement today that establishing a state-based exchange in Michigan will not happen this year, but has potential in next year’s session.
As a refresher, in the state-based healthcare exchange, Michigan would be allowed to participate in essentially twelve different areas, making decisions on what is best for our region. In the state/federal partnership plan, Michigan is allowed to participate in two out of the twelve decision areas, which stated by law is Planned Management and Customer Service. Lastly, in the complete federal run plan, Michigan is not granted any decision-making power. The continued inaction by the House of Representatives leaves no other choice but for Michigan to pursue a state/federal partnership, giving Michigan less decision-making power.
Per the ACA, if Michigan chooses now to pursue the state/federal partnership, it still has the opportunity in 2013 to switch over to a state-based exchange, if approved by the legislature and governor. Also, per the ACA, the 9.8 million dollars in federal grant funding to lay the groundwork for establishing a state-federal partnership is still available. Your help is needed now, to contact your State Representative, telling them to appropriate the much needed 9.8 million dollars in federal funding our state desperately needs to become compliant with a state/federal partnership.
The 9.8 million dollars in federal grant monies in no way ties our state to any permanent healthcare decisions; it merely gives us much-needed revenue to begin technical compliance, while saving our general fund dollars. The time to act is now. This is the last remaining option we have for Michigan to maintain some control over decisions made in regards to our healthcare. Please call your State Representative and strongly urge that they support and pass the 9.8 million dollars in federal funding our state desperately needs.
If you have any questions please do not hesitate to contact our government relations team by phone at: 586-393-8800 or by email: BBochniak@michbusiness.org
On November 9, the Department of Health and Human Services (HHS) extended the deadline for submission of the State-based Exchange Blueprint application from its original date of Nov. 16 to Dec. 14, 2012. The deadline for submission of the Declaration Letter for a State-based Exchange will remain Friday, Nov. 16, 2012. HHS will approve or conditionally approve a State-based Exchange for 2014 according to the statutory deadline of Jan. 1, 2013. Please find a copy of the announcement below:
Q1: When does a state have to tell the Centers for Medicare & Medicaid Services (CMS) that it wants to establish a State-based Exchange for 2014?
A1: In order for CMS to provide a state with technical resources and support necessary to meet the January 1, 2013, approval/conditional approval statutory deadline, a state that intends to establish a State-based Exchange must submit a Declaration Letter by Friday, November 16.
Q2: If a state wants to establish a State-based Exchange, when is the Blueprint Application due? What about the Declaration Letter?
A2: In order to provide states with more time to create a comprehensive Blueprint Application that is fully representative of their work, the Department of Health and Human Services (HHS) extended the deadline for State-based Exchange Blueprint Applications to Friday, December 14, 2012. Declaration Letters for State-based Exchanges remain due on Friday, November 16, 2012. CMS encourages states to begin working with the Center for Consumer Information and Insurance Oversight (CCIIO) on their Blueprint Applications as early as possible in order to identify any issues early and to receive feedback on their Blueprint Applications. A state may also submit its Blueprint Application prior to the deadline.
Q3: My state is ready to declare that it intends to establish a State-based Exchange, but still needs more time to determine whether it will establish and operate Risk Adjustment and Reinsurance programs. What should my state do?
A3: If a state knows what Exchange Model it intends to pursue, and who is the appropriate designee to execute the Declaration Letter, CMS encourages each state to submit a Declaration Letter on or before November 16, 2012. If a state has concerns about whether its decisions will be made by mid-November 2012, please talk to your CCIIO State Officer about your options. An interested state must commit to running either program in their Blueprint Application (Sections 5.1 and 5.2) that is due December 14, 2012. Please keep in mind that only a State that has elected to operate a State-based Exchange (not a State that has elected to participate in a State Partnership Exchange) can operate a risk adjustment program, or the State-based Exchange can defer its operation to the federal government. A state may elect to establish and operate a reinsurance program regardless of the Exchange model selected.
Q4: My state is not sure it wants to establish and operate a State-based Exchange, but we want to be involved in our Exchange. What options do we have?
A4: CMS established the option for states to pursue a State Partnership Exchange, where a state can work with CMS and elect to operate the Plan Management functions, Consumer Assistance functions, or both within the Federally-facilitated Exchange established for your state. States have until Friday, February 15, 2013, to submit a Declaration Letter and Blueprint Application declaring what partnership role they would like to have in operating the Exchange in their states. Ultimately, CMS wants as many states involved in operating Exchange as possible and we encourage states to talk with their CCIIO State Officer to discuss the partnership options.
Q5: If a state is ready to submit its Blueprint Application, does it have to wait until December 14, 2012?
A5: No, a State may submit its Blueprint Application for State-based Exchanges any time before December 14, 2012, and for State-Partnership Exchanges any time before February 15, 2013.
Q6: If a state applies to establish a State-based Exchange and later decides it would rather be a State Partnership Exchange in 2014, can it change its mind?
A6: Yes, if a state applies to establish a State-based Exchange for plan year 2014 and later decides it is more prepared to operate as a State Partner, it can move into a State Partnership model. States should contact their CCIIO State Officer as early as possible to begin the transition.
Q7: If a state has a State Partnership Exchange in 2014, can it move to a State-based Exchange in 2015?
A7: Yes. If a state decides to be a State-based Exchange for plan year 2015, it will have to submit its State-based Exchange Declaration Letter and Blueprint Application, completing all the relevant additional sections. For the 2015 plan year, the Declaration Letter and Blueprint Application are due November 18, 2013, and December 16, 2013, respectively. It can also establish a State-based Exchange in subsequent years.rom 2014 through 2006, each state that operates an Insurance Exchange is required to establish a temporary reinsurance program for the individual market, to which health insurers and group health plans are required to contribute, as provided in PPACA, Pub. L. No. 111-148, Section 1341 (2010), as amended by PPACA, Pub. L. No. 111-148, Section 10104(r) (2010). This program shifts the risk of covering high expenses from the primary insurer to a reinsurer.
If you have any comments or questions regarding any of above information, please do not hesitate to call (708) 717-9638 or e-mail larry@larrygrudzien.com.
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AGENTS – MORE ROBUST & COMPLIANT SPD’s & SECTION 125’s
AT NO COST TO MEMBERS!
To help members reduce their costs, the Associations are providing complimentary services such as Summary Plan Descriptions (SPD) and Section 125 plan documents to all dues paying members in good standing. Our adoption agreements are compliant reflecting ALL the Health Care Reform Law changes as of January 2013. These documents are FREE to our members…Effective 5/1/12, the cost to non-members is $50 each.
What’s Different about MBPA/MFBA’s Summary Plan Description (SPD)?
The Employer Retirement Income Security Act (ERISA) guidelines make it mandatory for all businesses with 2 or more employees to provide employees with a Summary Plan Description (SPD). We continue to take a leading role in informing and helping our members meet their obligations under ERISA.
Types of benefits covered by Summary Plan Descriptions include: Medical, Long Term Disability, Short Term Disability, Life/AD&D and freestanding Dental/Vision.
The MBPA SPD is a comprehensive document that satisfies the all Department of Labor (DOL) requirements for SPDs.
The MBPA SPD can be tailored to cover all of an employer’s employee benefit plans, and is not limited to only insured medical or medical/vision bundled programs.
The MBPA is essentially a “wrap plan SPD” under which an employer can combine all of its benefits into one plan and one plan document for ease of administration and for purposes of DOL reporting requirements (e.g. Form 5500s) for those employers subject to such reporting.
The MBPA SPD can be used for both insured and self-insured benefits.
New Summary of Benefits Coverage (SBC) Option Available with our SPD’s:
Simply send us your clients SBC and MBPA will make a combined SPD/SBC customized document available to all Association Members who have BCBSM insurance through MBPA or MFBA.
MBPA will create a combined document in its original DOL mandated form with no alterations, as permitted pursuant to the DOL final regulations.
MBPA will issue this combined document with a letter containing clear disclaimers about differences in distribution requirements for SBC’s and SPD’s, consulting their own legal counsel, etc…
We have SBC templates available for self-insured members.
NEW Material Modification Sheet Available for the SPD’s
NOW, Two Easy Ways to Get Your Client’s SPD for all Active Members:
Let Us Do It
Create Your Own On-Line
Please contact our Member Services Team at 1-888-277-6464 or 1-586-393-8800 We look forward to continuing to provide you and your clients with the most up to date and easily accessible services in this important area.