Gilroy Today 2011 06 Summer - Page 27

Understanding Healthcare Reform


Villar , President Pacific Coast Benefits LLC ,
Dave Villar is the President of Pacific Coast Benefits LLC . He was a founder and partner of PDI Insurance Services . Dave is an active member of the National Association of Health Underwriters and a member of the Anthem Blue Cross Agent Advisory Council . He has specialized in Employee Benefit Planning for businesses since 1987 . To find out more about Pacific Coast Benefits and upcoming Healthcare Reform Seminars , visit www . pacbenins . com or call ( 408 ) 847-1000 .

Health and Wellness has been largely unreported by the media as it relates to the healthcare reform bill , PPACA ( Patient Protection and Affordable Care Act ) and healthcare reform in general . Inside the PPACA , there are a number of mandates that could benefit both employers and employees with the implementation of wellness programs . The goal of the PPACA is to “ bend the cost curve ” in healthcare spending through wellness and prevention along with incentives to help promote healthier lifestyles .

According to the Centers for Disease Control and Prevention , chronic diseases such as heart disease , stroke , cancer , diabetes , and arthritis are among the most common , costly and preventable of all health problems in the United States . Additionally , a 2008 Pricewaterhouse Coopers ( PwC ) Health Research Institute survey identified that preventable risk factors such as smoking , obesity , poor adherence to drug regiment and alcohol abuse are drivers in healthcare spending . Approximately $ 303 billion to $ 493 billion is spent annually treating these types of preventable illnesses .
The PPACA is written with language that addresses disease prevention via wellness and incentives for employers who implement wellness programs .
The following wellness and prevention provisions , mandated in PPACA , are worth special consideration :
Elimination of Co-payments for Screening and Preventive Care Starting September 2010 , Non- Grandfathered health plans are prohibited from requiring co-pays for all preventive services as recommended by the United States Preventive Service Task Force . Essential Health Benefits
Beginning in 2014 , the Secretary of Health and Human Services is tasked with defining essential health benefits which will include preventive and wellness services along with chronic disease management .
Employer Wellness Discounts Currently allows employers to reduce the cost of health insurance premiums for employees practicing healthy behaviors , up to 20 % of the employee premium costs . Effective in January 2014 , wellness discounts are increased to 30 % with the possibility of being expanded to 50 % at the discretion of HHS .
Federal Wellness Grants Small businesses with less than 100 employees that have not had a wellness program in place prior to March 23 , 2010 will be eligible for a federal grant to establish a wellness program . The PPACA legislation contains $ 200 million in funds to be awarded to small businesses over five years beginning in 2012 .
It is apparent from the above provisions mandated in PPACA , wellness is now a national priority . With the discounts available today and the federal grants coming next year , corporate wellness is something all small businesses should be considering . Our agency is currently working with First Vitals , a company on the forefront of Corporate Wellness Programs and Health Care Reform . If you would like more information about Corporate Wellness or Health Care Reform in general , please feel free to give us a call . At Pacific Coast Benefits we are here to help you and your business navigate healthcare reform .
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