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First health insurance rules may boost employer costs
By Jim Kendall | Daily Herald Columnist
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Published: 7/22/2010 10:51 AM

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It may be time to have lunch with your health benefits adviser:

• The first of new health coverage regulations, announced by federal agencies last week, require new health plans - those written on or after Sept. 23 - to provide preventive care measures that, ultimately, could reduce health care costs.

Initially, however, the requirements seem more likely to boost employer costs. For one thing, the plans must "eliminate cost-sharing requirements for such services," the government says.

"Holy moly, we're going to have to sell a lot of widgets" is the reaction veteran insurance underwriter Stephanie Smith-Howard anticipates from employers who, she says, "aren't yet aware of all the changes."

Smith-Howard, president of Design Insurance Brokers, Mundelein, may be right on.

• Health insurance plans in existence on March 23, 2010, are mostly grandfathered out of the new rules. Even so, it's probably best to figure your health plan will be covered by the new rules.

One reason is that a grandfathered plan can lose its exemption by, among other things, increasing the deductible or out-of-pocket limit; increasing coinsurance; or decreasing the employer-paid portion of coverage. There's a formula for those exemptions.

• According to, the more than 50 required preventive services range from blood pressure screening to diet counseling for adults to height, weight and body mass index measurements for children.

The goal, says the government, is to change the health care system from one that focuses on treating the sick to one that focuses on keeping us healthy.

For employers seeking better productivity from employees who are healthier and miss less work, preventive programs often make sense.

Take a look, for example, at data from Interactive Health Solutions, Inc., an Arlington Heights company that provides preventive health screenings and health education programs to employers with as few as 20 employees.

For a company's participating employees, the process begins with an on-site blood pressure check and blood draw that IHS Vice President Christopher Parks says "allows us to conduct 36 different tests."

"We screen every major organ of the body," he says.

Within 48 hours, employees can view the results on a secure website; IHS also mails a more in-depth analysis to the employee's home address. In situations where tests turn up a life-threatening condition, an IHS physician or nurse calls with a "go to the doctor or ER" message.

Interestingly, Parks says the IHS screenings reveal that 58 percent of employees have some type of condition that should result in a visit to the doctor - although, he adds, 63 percent of those screened have not seen a doctor in at least five years.

There typically is no cost for the IHS screening to either employer or employee; the cost is covered by health insurance.

• Questions, comments to Jim Kendall, JKendall@

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