PRESIDENT SIGNS ACA EXECUTIVE ORDER AND IMMEDIATELY FOLLOWS WITH ANOTHER BIG ANNOUNCEMENT ON ACA

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On Oct. 12, 2017, President Trump signed an executive order intended to change certain rules under the ACA, expanding access to association health plans, health reimbursement arrangements (HRAs) and short-term, limited-duration insurance. The executive order does not make any changes to existing regulations, but directs federal agencies to consider new regulations or guidance to implement the order’s policies. This Health Care Bulletin provides an overview of the executive order.  Click the attached document to continue reading…

President Signs Executive Order Designed to Change ACA Rules

On Oct. 12, 2017, the White House announced that it will no longer reimburse insurers for cost-sharing reductions made available to low-income individuals through the Exchanges under the Affordable Care Act (ACA), effective immediately. Because Congress did not pass an appropriation for this expense, the Trump administration has taken the position that it cannot lawfully make the cost-sharing reduction payments.

This decision follows the U.S. House of Representatives’ position in a lawsuit it filed against the Obama administration in 2014 challenging the federal government’s authority to fund these cost-sharing reductions. Click the attached document to continue reading…

White House Announces ACA Subsidies Will End 10-13-17

Workers’ Comp Drug Spend Continues to Drop, According to CompPharma’s 14th Annual Survey of Prescription Drug Management

MAGGIE VALLEY, N.C.–(BUSINESS WIRE)–CompPharma’s 14th Annual Survey of Prescription Drug Management in Workers’ Compensation showed an average 11 percent reduction in payers’ pharmacy spend, driven by a 13.3 percent reduction in opioid cost. The survey analyzed the 2016 pharmacy cost data of 23 workers’ compensation insurance carriers, third-party administrators, self-insured employers, and state funds.

Working with their pharmacy benefit managers, payers cut one of every six dollars in opioid spend, which the report called a “truly remarkable result.” In contrast, across all payer types, pain medication use declined by a scant 1 percent (Quintiles IMS).

“Clearly the efforts of workers’ comp regulators, payers, desk-level staff, PBMs and prescribers have paid off,” said Joseph Paduda, president of CompPharma, LLC. “While we have much left to do, this represents a dramatic improvement in the lives of thousands of patients.”

Payers are far from complacent, with all respondents expressing grave concerns about the risk of opioid addiction or dependency. Most are continuing to refine and improve programs to help patients address pain while minimizing use of opioids, relying on physician and/or pharmacist review of claims, early identification of potentially risky prescribing, and increased use of drug testing.

In contrast, compound drug utilization and spend has dropped dramatically and is no longer of great concern to payers.

A complimentary copy of the 2016 survey can be downloaded from https://tinyurl.com/CP2017RxSurvey.

Florida Orders Workers’ Comp Rate Decrease of 9.8%

Florida Insurance Commissioner David Altmaier has ordered a statewide overall workers’ compensation rate decrease of 9.8 percent, a slightly higher decrease than the 9.6 percent decrease filed by the National Council on Compensation Insurance (NCCI) back in August.

Altmaier’s order disapproving NCCI’s 2018 rate filing was issued by the Florida Office of Insurance Regulation on Tuesday, and stated NCCI’s rate request be amended and refiled by Nov. 7, 2017.

Altmaier’s order cited NCCI’s 2 percent allowance for profit and contingencies in its rate filing as the reason for rates being disapproved. The order states that the refiling should contain a profit and contingencies provision no greater than 1.85 percent.

The rate decrease will come as a welcome surprise for many Florida businesses that were expecting additional rate increases after the Florida Supreme Court issued two decisions – Castellanos v. Next Door Company and Westphal v. City of St. Petersburg, – in 2016 that sent rates up by double digits this year.

“Using new data, this experience based filing proposes a decrease in rate level based on data from policy years 2014 and 2015 valued as of year-end 2016,” the order states. “While some of the experience used as the basis for this filing occurred before the recent Florida Supreme Court decisions, a portion of the experience period includes claims that occurred after the decisions.”

At a rate hearing in mid-October, NCCI said a decline in claims frequency due, in part, to safer workplaces, enhanced efficiencies in the workplace, increased use of automation, and innovative technologies were partly behind the recommended decrease. NCCI said this trend is not unique to Florida but countrywide, and is expected to continue in the future.

According to OIR’s order, from 2011 to 2015, the cumulative decreases in the indemnity and medical loss ratios were 19.9 percent and 12.3 percent, respectively. The primary reason for the declining loss ratios is a significant reduction in the lost-time claim frequency which declined by 45 percent from 2001 to 2015 with over 8 percent of the decline occurring in 2014 and 2015.

“Even after considering the impact of the Castellanos and Westphal decisions, other factors at work in the marketplace combined to contribute to the indicated decrease, which included reduced assessments, increases in investment income, decline in claim frequency, and lower loss adjustment expenses,” the order states.

However, the order also mandates that NCCI provide detailed analysis of the effects of the Castellanos decision by the Florida Supreme Court in future filings, which accounted for 10.1 percent of the 14.5 percent increase in Florida workers’ compensation rates this year.

“To ensure workers’ compensation rates are not excessive, inadequate or unfairly discriminatory … it is imperative that additional quantitative analysis be conducted to determine the effect the Castellanos decision is having on the Florida workers’ compensation market and the data used to support future rate filings,” the order states. “The analysis may include alternative data sources and should examine changes to the Florida workers’ compensation market that are attributed to or observed as a result of the recent court decision.”

Approval of a revised rate decrease is contingent on the amended filing being submitted with changes as stipulated within the order. If approved by OIR, the revised rate decrease would become effective on Jan. 1, 2018 for new and renewal business.

Read Order: Florida OIR Workers’ Compensation Insurance Rate Decrease

By Amy O’Connor of InsuranceJournal.com | November 2, 2017

NAPEO Forms Cybersecurity Task Force

As an fyi, NAPEO has formed  a Cybersecurity Task Force to better understand the exposures of PEO and how to mitigate them.  A very timely and critical task force that I am very proud to be a part of – This is by far the most misunderstood exposure to PEO today.

“NAPEO recognizes the critical business and compliance risks faced by our members concerning cybersecurity. Although many member resources such as PEO Insider and various conferences have featured helpful information and programs for members on this topic, NAPEO recognized more is needed and formed the NAPEO Cybersecurity Task Force to help fill that gap. The Cybersecurity Task Force is comprised of a cross section of professionals with expertise in insurance, law, technology and the business environment of PEOs. Its primary mission is develop a set of best practices which NAPEO members could use to strengthen their compliance efforts and minimize their legal and business risks. The Task Force’s first step will be to survey members to gain a deeper insight into the cybersecurity concerns and exposures of members, which will be used to help shape the best practices the task force will produce. For more information, please contact Farrah Fielder.”

CoAdvantage Acquires California-based Total HR Management

Just after the recent merger with “PEMCO”, a PEO located in Sarasota, FL, CoAdvantage Corporation (“CoAdvantage”) announced today that it has also acquired California based Total HR Management (“Total HR”).

This acquisition is different then the rest as this means CoAdvantage is jumping into the California market. Total HR is a comprehensive human resources administration firm located in Los Angeles, CA that provides outsourced HR services, benefits and payroll to a white-collar client base.

“The acquisition of Total HR provides CoAdvantage with a strategic entry-point to the California market through a strong regional provider with a history of success and service excellence,” said Mike Maseda, President and CEO of CoAdvantage.  “We look forward to coupling our scale with Total HR’s relationship-based service model to further expand our presence in providing high-quality HR support to California’s thriving small business community.”

“CoAdvantage’s scale and resources bring added value to our customers and the California market,” said James Harwood, Founder and CEO of Total HR.  “I am excited to join the CoAdvantage family and look forward to working with the broader CoAdvantage team as we grow our presence in California.” Total HR will form part of CoAdvantage’s West Region and James Harwood will continue with the combined Company as Vice President of California.

With these two recent acquisitions, CoAdvantage now serves approximately 90,000 work site employees in all 50 states, offering the resources of a national provider with a local focus to business owners around the country.

 

You can find our article on the PEMCO acquisition here:

CoAdvantage Acquires Progressive Employer Management Company (PEMCO)

Source:

https://www.bizjournals.com/orlando/prnewswire/press_releases/Florida/2017/10/25/FL24864

Florida WC Rate Decrease Hearing Set for Tomorrow

The Florida Office of Insurance Regulation will be discussing on the 18th of October NCCI’s proposed rate decrease of 9.6%.  Agenda shown below.  If you have any comments that you would like the state to hear, you can email ratehearings@floir.com with the subject line of your e-mail should read “NCCI” up until the 25th of October.

PUBLIC HEARING AGENDA
NATIONAL COUNCIL ON COMPENSATION INSURANCE
WHEN: October 18, 2017, 1:00 p.m.
WHERE: 412 Knott Building
404 South Monroe Street
Florida Capitol Complex
Tallahassee, FL 32399
GENERAL SUBJECT MATTER TO BE CONSIDERED: National Council on Compensation Insurance (NCCI) has
proposed an overall average decrease in rate levels of 9.3% for the voluntary market for all new and renewal workers’
compensation insurance policies written in the State of Florida, effective January 1, 2018. The filing also requests a
decrease to the fixed expense cost applicable to every workers’ compensation policy in Florida from $200 to $160 which
when combined with the rate level decrease results in an overall average workers’ compensation premium decrease of
9.6%.
1. Opening Remarks Office of Insurance Regulation (Office)
a) Introduction of Office personnel
b) Introduction of participating parties
2. Presentation National Council on Compensation Insurance
3. Public Comment Open to the Public
4. Closing Remarks
5. Adjourn
Any comments or concerns not addressed at the public hearing may be forwarded to ratehearings@floir.com; the subject
line of your e-mail should read “NCCI”. The record will be open for public comment until October 25, 2017.

CoAdvantage Acquires Progressive Employer Management Company (PEMCO)

CoAdvantage Corporation (“CoAdvantage”) is a leading provider of strategic human resource solutions for small to mid-sized companies whom announced Tuesday that they have acquired Progressive Employer Management Company (“PEMCO”) – one of the country’s largest private PEOs.

Both companies are Professional Employer Organizations, providing HR services, payroll, benefits and risk management. CoAdvantage President and CEO, Mike Maseda said “This is one of those businesses where scale really matters. There are advantages to being one of the bigger players. PEMCO is a large, growing, and skillfully managed Professional Employer Organization (PEO) that has experienced rapid transformation into one of the country’s quality providers.”

Clint Burgess, who was CEO of PEMCO, will become Chief Operating Officer at CoAdvantage, and Peter Grabowski, will continue his role as CFO with CoAdvantage.”Merging with CoAdvantage solidifies our leading presence in Florida, and continues our mission of providing high quality outsourced HR solutions,” said Burgess. Burgess and Maseda maintained a good relationship over the years and both worked for CoAdvantage up until 2014, when Burgess left to run PEMCO.

A report from Tampa Bay Biz Journal back in July of this year listed the largest PEO’s, which shows CoAdvantage at No. 6 with 50,000 leased employees and PEMCO at No. 8. This acquisition will leave CoAdvantage with roughly 4,000 clients and 85,000 employees, according to Maseda. CoAdvantage will have dual headquarters, both in Tampa and Sarasota with about 500 total internal employees.

 

More information can be found here:

http://www.prnewswire.com/news-releases/coadvantage-acquires-progressive-employer-management-company-pemco-300533929.html

https://www.bizjournals.com/tampabay/news/2017/10/10/tampa-human-resources-company-buys-competitor.html

 

 

New Jersey Governor Signs PEO Bill into Law

From NAPEO: Governor Chris Christie (R) signed Senate Bill 2512 into law 9/13/2017. The new law allows a client or PEO to provide workers’ compensation coverage for worksite employees. Previously, New Jersey law only permitted the PEO to provide such coverage for worksite employees. A client company that assumes the responsibility of providing workers compensation coverage to worksite employees will be required to provide a copy of the client service agreement to its insurance carrier prior to the issuance of the policy or upon partnering with a PEO. In the event that a client company’s policy is canceled pursuant to New Jersey law, the insurance carrier is required to provide the PEO with copies of all notices required to be issued to the client company by regular mail.

In addition, the law modernizes the state’s PEO statute by:

  • Allowing the PEO and client company the flexibility to allocate responsibility for the direction and control over management of safety, risk and hazard control at the client worksite; and
  • Requiring the client to accurately report wages to the PEO.

In recent months, both chambers passed the bill by unanimous vote. NAPEO worked to enhance the legislation throughout the legislative process and testified in support of the bill. The new law goes into effect immediately, though insurance carriers will have up to 180 days following enactment of SB2512 to comply with the new notice provisions. For more information, please contact Daniel Harris.

Source: The National Association of Professional Employer Organizations