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Pop a Pill for Heartburn? Try Diet and Exercise Instead

SWIM Inc

Many Americans would rather take a drug than change their habits to control a persistent ailment. Yet, every medication has side effects, some of which can be worse than the disease they are meant to treat. Drugs considered safe when first marketed can turn out to have hazards, both bothersome and severe, that become apparent […]

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Aetna, UnitedHealth show increasing appetite for value-based care contracts

SWIM Inc

The biggest health insurers are moving quickly towards value-based care arrangements, their recent earnings reports show. While Aetna has long-held a goal to reach 75 to 80 percent of its medical spend in value-based relationships by 2020, Aetna’s medical spend is now 45 percent tied to value, CEO Mark Bertolini said during last week’s fourth […]

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Lower Back Ache? Be Active and Wait It Out, New Guidelines Say

SWIM Inc

Dr. James Weinstein, a back pain specialist and chief executive of Dartmouth-Hitchcock Health System, has some advice for most people with lower back pain: Take two aspirin and don’t call me in the morning. On Monday, the American College of Physicians published updated guidelines that say much the same. In making the new recommendations for […]

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From ‘Repeal’ to ‘Repair’: Campaign Talk on Health Law Meets Reality

SWIM Inc

Asked at a confirmation hearing two weeks ago if he was working with President Trump on a secret plan to replace the Affordable Care Act, Representative Tom Price, Mr. Trump’s nominee for secretary of health and human services, smiled broadly and answered: “It’s true that he said that, yes.” The committee room, filled with health […]

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How to Close a Gender Gap: Let Employees Control Their Schedules

SWIM Inc

The main reason for the gender gaps at work — why women are paid less, why they’re less likely to reach the top levels of companies, and why they’re more likely to stop working after having children — is employers’ expectation that people spend long hours at their desks, research has shown. It’s especially difficult […]

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Judge, Citing Harm to Customers, Blocks $48 Billion Anthem-Cigna Merger

SWIM Inc

A federal judge on Wednesday blocked a proposed $48 billion merger of Anthem and Cigna, derailing another effort by top health insurers to reshape the industry by combining. The ruling, by Judge Amy Berman Jackson of the Federal District Court for the District of Columbia, came two weeks after another federal judge blocked a proposed […]

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The Right Way to Say ‘I’m Sorry’

SWIM Inc

Most people say “I’m sorry” many times a day for a host of trivial affronts – accidentally bumping into someone or failing to hold open a door. These apologies are easy and usually readily accepted, often with a response like, “No problem.” But when “I’m sorry” are the words needed to right truly hurtful words, […]

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Get Up and Move. It May Make You Happier.

SWIM Inc

When people get up and move, even a little, they tend to be happier than when they are still, according to an interesting new study that used cellphone data to track activities and moods. In general, the researchers found, people who move are more content than people who sit. There already is considerable evidence that […]

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NY exchange scores F’s on some consumer features

SWIM Inc

The New York State of Health exchange lacks many of the features that other public Obamacare marketplaces, including Healthcare.gov, have added to make it easier for users to compare plans, according to a report released Tuesday by the Clear Choices Campaign, an advocacy group that seeks greater transparency in health care quality and pricing. Rather […]

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Repeal and Compete

SWIM Inc

Modern conservatism, at least in its pre-Donald Trump incarnation, evolved to believe in a marriage of Edmund Burke and Milton Friedman, in which the wisdom of tradition and the wisdom of free markets were complementary ideas. Both, in their different ways, delivered a kind of bottom-up democratic wisdom — the first through the cumulative experiments […]

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Senators Propose Giving States Option to Keep Affordable Care Act

SWIM Inc

WASHINGTON — Several Republican senators on Monday proposed a partial replacement for the Affordable Care Act that would allow states to continue operating under the law if they choose, a proposal meant to appeal to critics and supporters of former President Barack Obama’s signature health law. But the plan was attacked by Democrats as a […]

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New Contraceptive Regulations Announced by Governor Cuomo

SWIM Inc

“Governor Andrew M. Cuomo today announced a series of actions to firmly secure access to reproductive rights in New York State. Through regulatory action, the State will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles regardless of the future of the Affordable Care Act; contraceptives […]

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Getting Older, Sleeping Less

SWIM Inc

Insomnia is like a thief in the night, robbing millions — especially those older than 60 — of much-needed restorative sleep. As the king laments in Shakespeare’s “Henry IV, Part 2”: O sleep, O gentle sleep, Nature’s soft nurse, how have I frightened thee. That thou no more will weigh my eyelids down, And steep […]

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‘Weekend Warriors’ Show Survival Benefits

SWIM Inc

Working out only on the weekends or otherwise compressing your total physical activity into one or two prolonged runs or a single vigorous basketball or soccer game each week could lessen your risks of dying prematurely almost as effectively as more frequent, shorter workouts spread throughout the week, according to an interesting new study of […]

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Senate Takes Major Step Toward Repealing Health Care Law

SWIM Inc

WASHINGTON — Senate Republicans took their first major step toward repealing the Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster. The vote was 51 to 48. During the roll call, Democrats staged a highly unusual protest on […]

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Cost-Share Information for Oxford Member Claims Paid Between Nov. 12 – Dec. 1, 2016

SWIM received the following notice from Oxford. Please feel free to call us with any questions.  We want to make you aware of an error that may affect employees of some of your Oxford customers. We incorrectly reported the patient responsibility amounts on electronic claims statements sent to providers. As a result, this may cause, […]

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Work. Walk 5 Minutes. Work.

SWIM Inc

Stuck at your work desk? Standing up and walking around for five minutes every hour during the workday could lift your mood, combat lethargy without reducing focus and attention, and even dull hunger pangs, according to an instructive new study. The study, which also found that frequent, brief walking breaks were more effective at improving […]

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Muted Response From Health Lobby as Affordable Care Act Faces Repeal

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WASHINGTON — The speed of Republican efforts to repeal the Affordable Care Act has stunned health industry lobbyists, leaving representatives of insurance companies, hospitals, doctors and pharmaceutical makers in disarray and struggling for a response to a legislative quick strike that would upend much of the American health care system. The Senate is expected to […]

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Hooked on Our Smartphones

SWIM Inc

The many men, women and children who spend their days glued to their smartphones and social media accounts might learn something from Lin-Manuel Miranda, creator of the groundbreaking megahit “Hamilton.” Asked in an interview with Delta Sky magazine when and where he finds time to be creative, Mr. Miranda, an avid reader of books and […]

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Prices charged by NYC area hospitals vary widely, new report says

SWIM Inc

In the New York City area, hospitals with the biggest market share tend to charge the highest prices, according to a new report from the New York State Health Foundation. The report, prepared by Marlborough, Mass.-based Gorman Actuarial, studied pricing in three regions of the state. In downstate New York, the highest-priced facilities negotiated prices […]

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Keep It Moving

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By now it is pretty well accepted both that physical inactivity is bad — recently linked to 6 percent of all cases of heart disease worldwide and 11 percent of all premature deaths in the United States — and that exercise is good, because it tends to increase life span and protect against heart disease. […]

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Health Insurers List Demands if Affordable Care Act Is Killed

SWIM Inc

The nation’s health insurers, resigned to the idea that Republicans will repeal the Affordable Care Act, on Tuesday publicly outlined for the first time what the industry wants to stay in the state marketplaces, which have provided millions of Americans with insurance under the law. The insurers, some which have already started leaving the marketplaces […]

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The High Costs of Not Offering Paid Sick Leave

SWIM Inc

Maybe the person working near you, the one who dragged himself to work and is now coughing and sneezing, couldn’t afford to stay home. Each week about 1.5 million Americans without paid sick leave go to work despite feeling ill. At least half of employees of restaurants and hospitals — two settings where disease is […]

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SWIM President Jeff Ungvary Inducted into Ithaca College Athletic Hall of Fame for his Swimming Accomplishments

SWIM Inc

Strategic Wellness and Insurance Management, Inc. (SWIM, Inc.) president Jeff Ungvary was inducted into the Ithaca College athletic hall of fame on October 7, 2016 for his accomplishments in swimming.  Ungvary is only the fifth swimmer to be inducted into the Ithaca College athletic hall of fame since its inception in 1969. Jeff Ungvary was one of the […]

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Affordable Care Act losses land N.J. health insurer in rehab

SWIM Inc

Health Republic Insurance of New Jersey,  one of 23 nonprofit consumer-operated and -oriented health plans established under the Affordable Care Act, has agreed to be taken over by regulators because of its “hazardous financial condition,” the New Jersey Department of Banking and Insurance said Monday. The Newark, N.J., insurer lost $58.96 million in the six months ended June […]

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Parents Should Avoid Comments on a Child’s Weight

Medical

Should parents talk to an overweight child about weight? Or should they just keep their mouths shut? Parents in this situation are understandably torn. Say something, and they risk shaming a child or worse, triggering an eating disorder. Say nothing, and they worry they’re missing an opportunity to help their child with what could become […]

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It’s not the coffee that will give you cancer, it’s how hot it is

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There’s more to worry about from your hot morning coffee than just spilling it onto your lap. A new study by a cancer-research group has found that searing-hot liquid beverages — such as a steaming cup of joe — are carcinogenic. The International Agency for Research on Cancer said that it found that drinks and […]

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Computer Vision Syndrome Affects Millions

SWIM Inc

Joanne Reitano is a professor of history at LaGuardia Community College in Long Island City, Queens. She writes wonderful books about the history of the city and state, and has recently been spending many hours — sometimes all day — at her computer to revise her first book, “The Restless City.” But while sitting in […]

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A Chef’s Workout Helps Him Keep Up With the Demands of the Kitchen

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When Ryan Pera started talking about opening a second restaurant in 2013, his wife had one condition. He had to get back in shape. Mr. Pera, 43, chef and co-owner of three popular Houston restaurants, is married to Lori Choi, a vascular surgeon. “She laid down the law,” he says. “She’s on the front line […]

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Yoga May Be Good for the Brain

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A weekly routine of yoga and meditation may strengthen thinking skills and help to stave off aging-related mental decline, according to a new study of older adults with early signs of memory problems. Most of us past the age of 40 are aware that our minds and, in particular, memories begin to sputter as the […]

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IRS Ruling Considered An Obstacle To ACOs

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A ruling by the Internal Revenue Service creates a significant obstacle to a new type of health care network that the Obama administration has promoted as a way to provide better care at lower cost, industry lawyers and providers say. Health care markets are rapidly changing as independent doctors and hospitals race to form networks, […]

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Sorry, There’s Nothing Magical About Breakfast

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I don’t eat breakfast. It’s not that I dislike what’s offered. Given the choice of breakfast food or lunch food, I’d almost always choose eggs or waffles. It’s just that I’m not hungry at 7:30 a.m., when I leave for work. In fact, I’m rarely hungry until about lunchtime. So, other than a morning cup […]

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Potatoes Tied to High Blood Pressure Risk

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Eating potatoes four or more times a week may increase the risk for high blood pressure, a large new study has found. Researchers pooled results from three observational studies involving 187,453 men and women followed for more than 25 years. The participants returned health and diet questionnaires every two years, including whether a doctor had […]

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Supporting Children Who Serve as Caregivers

SWIM Inc

In the normal scheme of things, parents and grandparents take care of children when they’re sick or need help or sustenance. But in well over a million American families, this pattern is reversed, with children as young as 8, 9 or 10 partly or fully responsible for the welfare of adults or siblings they live […]

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Diet High in Saturated Fats May Be Linked to Dense Breasts

Medical

Teenage girls who eat a diet high in saturated fat are at increased risk of developing dense breasts, a study concludes. Dense breasts contain more fibrous and connective tissue than normal and are a risk factor for breast cancer. Researchers studied 177 girls, ages 10 to 18 at the start of the study, who periodically […]

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Exercise Tied to Lower Risk for 13 Types of Cancer

Medical

Anyone who still needs motivation to move more may find it in a new study showing that, in addition to its other health benefits, exercise appears to substantially reduce the risk of developing 13 different varieties of cancer. That is far more types than scientists previously thought might be impacted by exercise. The comprehensive study […]

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HSA Limits Released for 2017

SWIM Inc

On Thursday, the IRS released the 2017 inflation adjusted amounts for Health Savings Accounts (HSAs). The maximum contribution amounts for calendar year 2017 will increase by $50 for individuals with self-only coverage under a high deductible plan to $3,400, while the contribution maximum will remain flat for family coverage at $6,750. Sincerely,

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Health Insurance Proposed Rates 2017

SWIM Inc

You and your employees may be receiving mailings from health insurance carriers indicating their proposed rate filings for 2017 (adding confusion if you’ve yet to renew your plan in 2016).  In some instances, there are long grids with proposed rate increases from the single digits to nearly 20% (unfortunately, that’s not a typo). To be […]

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Immigrants, the Poor and Minorities Gain Sharply Under Health Act

SWIM Inc

LOS ANGELES — The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others who have long been left out of the health care system, a New York Times analysis has found. Immigrants of all backgrounds — including more than a million legal residents who are not […]

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Newest Policyholders Under Health Law Are Sicker and Costlier to Insurers

SWIM Inc

People newly insured under the Affordable Care Act were sicker, used more medical care and had higher medical costs than those who already had coverage, the Blue Cross and Blue Shield Association said Tuesday in a new study of its policyholders. Because insurers’ premiums have to cover their medical expenses, the new report helps explain […]

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Keep your Health Insurance Documents with Your Tax Records

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Gathering documents and keeping well-organized records make it easier to prepare a tax return. They can also help provide answers if the IRS needs to follow-up with you for more information. This year marks the first time that you may receive information forms about health insurance coverage. The information forms are: Form 1095-A, Health Insurance […]

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Schools Are Slow to Learn That Sleep Deprivation Hits Teenagers Hardest

SWIM Inc

As a pediatrician, I find that there are few topics that parents want to discuss more than sleep. Parents worry about their own sleep deprivation when babies arrive. Later, they worry about their children’s. I almost never encounter patients who are convinced that they’re getting the recommended amount of sleep. It’s harder than you might […]

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Obama administration backs off on ACA rules for 2017 health plans

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In a major win for the industry, health insurers will not be forced to have minimum quantitative standards when designing their networks of hospitals and doctors for 2017, nor will they have to offer standardized options for health plans. The CMS released a sweeping final rule (PDF) Monday afternoon that solidifies the Affordable Care Act’s […]

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An Insurance Penalty From Postpartum Depression

Medical

In January, a government-appointed panel recommended that all pregnant women and new mothers be screened for depression. Public health advocates rejoiced, as did untold numbers of women who had not known that maternal mental illness even existed before it hit them like a freight train. But the panel did not mention one possible consequence of […]

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Fasting Diets Are Gaining Acceptance

Medical

Mark Mattson, a neuroscientist at the National Institute on Aging in Maryland, has not had breakfast in 35 years. Most days he practices a form of fasting — skipping lunch, taking a midafternoon run, and then eating all of his daily calories (about 2,000) in a six-hour window starting in the afternoon. “Once you get […]

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Poll: Most Americans Believe They Have Not Been Impacted By The ACA

SWIM Inc

On its “Morning Edition” segment, NPR  (2/29, Kodjak) reports a poll it conducted along with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health revealed just “one-third of Americans say the health care they receive is ‘excellent,’” and an even lower number said they “are impressed with the system as […]

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The Big Problem With High Health Care Deductibles

SWIM Inc

When Bernie Sanders released his long-awaited health care plan last month, it was light on the details. But it did include one major, crowd-pleasing promise: Under his Medicare-for-all proposal, no American would ever have to pay a deductible or co-payment to receive health care again. Deductibles and other forms of cost-sharing have been creeping up […]

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Health Care Law Makes Tax Season Tougher for Small Companies

SWIM Inc

As more requirements of the health care law take effect, income tax filing season becomes more complex for small businesses. Companies required to offer health insurance have new forms to complete providing details of their coverage. Owners whose payrolls have hovered around the threshold where insurance is mandatory need to be sure their coverage — […]

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Aetna CEO Has `Serious Concerns’ About Obamacare Sustainability

SWIM Inc

The head of the third-biggest U.S. health insurer said he has “serious concerns” about whether or not Obamacare’s new markets are sustainable, echoing criticism from other top for-profit insurers. “We continue to have serious concerns about the sustainability of the public exchanges,” Aetna Inc. Chief Executive Officer Mark Bertolini said on a call Monday while […]

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Panel Calls for Depression Screenings During and After Pregnancy

Medical

Women should be screened for depression during pregnancy and after giving birth, an influential government-appointed health panel said Tuesday, the first time it has recommended screening for maternal mental illness. The recommendation, expected to galvanize many more health providers to provide screening, comes in the wake of new evidence that maternal mental illness is more […]

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As Population Ages, Where Are the Geriatricians?

Medical

Ruth Miles, 83, sat in a wheelchair in a small exam room, clutching a water bottle, looking frightened and uncomfortable. She was submitting to the tender scrutiny of Dr. Elizabeth Eckstrom, who scooted her stool so close that she was knee to knee with her patient. Ms. Miles had broken her pelvis after tripping on […]

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Health Reform Realities

SWIM Inc

Health reform is the signature achievement of the Obama presidency. It was the biggest expansion of the social safety net since Medicare was established in the 1960s. It more or less achieves a goal — access to health insurance for all Americans — that progressives have been trying to reach for three generations. And it […]

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What’s New in the Dietary Guidelines

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There’s good news, and not-so-good news for some, in the new Dietary Guidelines for Americans, released Jan. 7 by the Agriculture and Health and Human Services Departments. If, like me, you are a fan of high-fat foods like nuts or avocados, high-cholesterol foods like shrimp or eggs, coffee or an occasional alcoholic drink, the new […]

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UnitedHealth says trouble looming for New York Obamacare plans

SWIM Inc

UnitedHealth Group Inc., the largest U.S. health insurer, said its rates for Obamacare plans in New York may be too low because the failure of a competing insurer last year might lead to shortfalls in payments designed to stabilize Obamacare markets. In states like New York, health insurers participating in the Patient Protection and Affordable Care […]

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Task force: Mammograms an option at 40, do more good at 50

Medical

The U.S. Preventive Services Task Force’s newest breast cancer screening guidelines reaffirm their 2009 recommendations that drew the ire of leading medical organizations. The government task force’s guidelines, published in the Annals of Internal Medicine on Monday, again recommend routine mammograms once every two years for women between the ages of 50 and 74 at […]

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Even Insured Can Face Crushing Medical Debt, Study Finds

SWIM Inc

Here is the surest way to enjoy the peace of mind that comes with having health insurance: Don’t get sick. The number of uninsured Americans has fallen by an estimated 15 million since 2013, thanks largely to the Affordable Care Act. But a new survey, the first detailed study of Americans struggling with medical bills, […]

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The Hidden Financial Incentives Behind Your Shorter Hospital Stay

Medical

After one of her operations, my sister-in-law left the hospital so quickly that she couldn’t eat for days; after other stays, she wasn’t discharged until she felt physically and mentally prepared. Five days after his triple heart bypass surgery, my stepfather felt well enough to go home, but the hospital didn’t discharge him for several […]

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Congressional budget deal may hamstring ACA funding

SWIM Inc

Congress is targeting funding sources for the Affordable Care Act as it works to reach a budget agreement before the end of the year. Republicans want the omnibus budget package to extend funding restraints that insurance companies and failing co-op insurers say are forcing them out of the ACA’s insurance exchanges. Also at risk are […]

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Affordable Care Act Plans Get 1 Million New Subscribers

SWIM Inc

A million new customers have signed up for health insurance during the Affordable Care Act’s third open-enrollment season, Obama administration officials said on Wednesday, and call centers have been deluged with requests from others eager to enroll. The officials brushed aside reports of rising premiums and deductibles and concerns expressed by UnitedHealth Group and other […]

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The 12 Worst Habits for Your Mental Health

Medical

Change these simple, everyday routines to live a happier life. Depression is usually brought on by factors beyond our control—the death of a loved one, a job loss, or financial troubles. But the small choices you make every day may also affect your mood more than you may realize. Your social media habits, exercise routine, […]

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Baby benefits are booming at U.S. firms: Aging millennials and growing concerns about employee engagement are driving improvements in parental leave

SWIM Inc

On her 14-week maternity leave, Sarah Galena isn’t thinking twice about her office job or the impact that her extended time off from work has on her family’s finances. And that’s precisely what her employer, Foothold Technology, wanted to accomplish when it revised its maternity policy earlier this year. The health technology firm, No. 69 […]

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Obamacare and drug prices push health spending to $3 trillion

SWIM Inc

Health spending reached $3 trillion last year, as millions of people gained insurance coverage under the Affordable Care Act and prescription drug prices rose. After years of sluggish growth in the aftermath of the recession, annual health spending in the U.S. jumped 5.3 percent to $9,523 per person, according to an analysis by the Centers for Medicare and Medicaid Services published in […]

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Health spending growth rate surges to 5.3% under ACA

SWIM Inc

The Affordable Care Act expanded health coverage to millions of Americans in 2014. Because more people had insurance to pay for healthcare services, demand and spending predictably went up more quickly. But the important question for the future remains the same: Will healthcare be able to avoid large spending spikes and move to a more […]

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How many weekly miles should I run to improve my health?

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Surprisingly few, it seems. According to a new review of studies related to running and health, jogging for as few as five or six miles per week could substantially improve someone’s health. The reviewers found that even with such skimpy mileage, runners generally weighed less and had a lower risk of obesity than people who […]

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New Diabetes Cases, at Long Last, Begin to Fall in the United States

Medical

After decades of relentless rise, the number of new cases of diabetes in the United States has finally started to decline. The rate of new cases fell by about a fifth from 2008 to 2014, according to researchers at the Centers for Disease Control and Prevention, the first sustained decline since the disease started to […]

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NYC’s Novel Salt Warning Rule Set to Take Effect at Chain

Medical

New York City begins a new era in nutritional warnings this week, when chain restaurants will have to start putting a special symbol on highly salty dishes. The first-of-its-kind rule, which takes effect Tuesday, will require a salt-shaker emblem on some sandwiches, salads and other menu items that top the recommended daily limit of 2,300 […]

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Health Care Law Forces Businesses to Consider Growth’s Costs

SWIM Inc

When LaRonda Hunter opened a Fantastic Sams hair salon 10 years ago in Saginaw, Tex., a suburb of Fort Worth, she envisioned it as the first of what would eventually be a small regional collection of salons. As her sales grew, so did her business, which now encompasses four locations — but her plans for […]

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Coffee Tied to Lower Risk of Dying Prematurely

SWIM Inc

More good news on coffee: A large study has found that drinking coffee is associated with a reduced risk of dying from heart disease and certain other causes. Researchers followed more than 200,000 doctors and nurses for up to 30 years. The participants had periodic physical examinations and completed questionnaires on diet and behavior, including […]

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Companies continue chipping away at health insurance benefits

SWIM Inc

Companies’ health care costs in 2015 rose at the lowest rate in at least 20 years, a report out Thursday shows, but workers’ share of costs continue to skyrocket. The average health care rate increase for mid-sized and large companies was 3.2% this year, the lowest since the consulting firm Aon started tracking it in 1996.  Despite this, […]

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Many Say High Deductibles Make Their Health Law Insurance All but Useless

SWIM Inc

Obama administration officials, urging people to sign up for health insurance under the Affordable Care Act, have trumpeted the low premiums available on the law’s new marketplaces. But for many consumers, the sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: […]

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Cutting Sugar Improves Children’s Health in Just 10 Days

Medical

Obese children who cut back on their sugar intake see improvements in their blood pressure, cholesterol readings and other markers of health after just 10 days, a rigorous new study found. The new research may help shed light on a question scientists have long debated: Is sugar itself harming health, or is the weight gain […]

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Placing a Cap on Americans’ Consumption of Added Sugar

Medical

Health experts have been nudging Americans to kick the sugar habit for years, and now it’s official: The Food and Drug Administration is recommending a daily cap on sugar for the first time. The goal is for Americans to limit added sugar to no more than 10 percent of daily calories, according to the proposed […]

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We Mapped the Uninsured. You’ll Notice a Pattern. They tend to live in the South, and they tend to be poor.

SWIM Inc

Two years into Obamacare, clear regional patterns are emerging about who has health insurance in America and who still doesn’t. The remaining uninsured are primarily in the South and the Southwest. They tend to be poor. They tend to live in Republican-leaning states. The rates of people without insurance in the Northeast and the upper […]

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Great News! We’re Not Doomed to Soaring Health Care Costs

SWIM Inc

It really matters who the next president is. But there are other things that matter just as much to the nation’s future prosperity. One of them is: What is happening to health care costs? If health care costs start to rise again the way they did before, then health care spending will swallow the economy […]

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Failed Co-ops Add Ammunition to G.O.P. War on Health Law

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New York is not alone in failed co-ops. Washington — The financial failure of more than half the nonprofit health insurance companies created under the Affordable Care Act has handed Republicans a new weapon in their campaign against the health law, thrown the Obama administration on the defensive once again and left more than a […]

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Death Rates Rising for Middle-Aged White Americans, Study Finds

Medical

Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling. That finding was reported Monday by two Princeton economists, Angus Deaton, who last month won the 2015 Nobel […]

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Thousands Who Didn’t File Tax Returns May Lose Health Care Subsidies

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Tens of thousands of people with modest incomes are at risk of losing health insurance subsidies in January because they did not file income tax returns, federal officials and consumer advocates say. Under federal rules, anyone who receives an insurance subsidy must file a tax return to verify that the person was eligible and received […]

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How Hospitals Coddle the Rich

Medical

When I saw my first red blanket as a young medical student, I thought little of it. One morning, as I rushed around a hospital in California on my daily rounds, I spotted an old man who lay in bed beneath a scarlet cover, a sharp contrast to the white linens wrapped around the other […]

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American Cancer Society Recommends Fewer Mammograms

Medical

One of the most respected and influential groups in the continuing breast-cancer screening debate said on Tuesday that women should begin mammograms later and have them less frequently than it had long advocated. The American Cancer Society, which has for years taken the most aggressive approach to screening, issued new guidelines on Tuesday, recommending that […]

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Talk Therapy Found to Ease Schizophrenia

Medical

More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors. Now, results of a landmark government-funded study call […]

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Dietary Supplements Lead to 20,000 E.R. Visits Yearly, Study Finds

Medical

A large new study by the federal government found that injuries caused by dietary supplements lead to more than 20,000 emergency room visits a year, many involving young adults with cardiovascular problems after taking supplements marketed for weight loss and energy enhancement. The study is the first to document the extent of severe injuries and […]

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Obamacare’s impact on employment: An early look

Before the Affordable Care Act went into effect last year, critics claimed it would lead to job losses and cuts in employee hours. But how is it really playing out? The dire predictions have so far proved to be unfounded, according to a new research paper from Federal Reserve Bank of New York economist Maxim […]

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Calcium Doesn’t Improve Bone Density, Analysis Finds

Medical

Calcium, eaten in foods or taken as supplements, has little or no effect on bone density or the risk of fracture in people over 50, according to two large reviews of studies in BMJ. One analysis reviewed 59 randomized controlled trials of the effect of dietary and supplemental calcium on bone density. Together, the trials […]

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Poll finds growing GOP support for paid family leave

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Paid family leave is well known to be a popular idea among New York City Democrats, but an increasing number of Republicans here also support it, with a significant number “strongly” in favor of such a policy, according to a new poll. Democrats saying they “strongly support” paid family leave increased to 81% in 2015 […]

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Why Big Changes Could Be Coming to the ACA

SWIM Inc

 A little-known provision of the Affordable Care Act (ACA) could significantly affect how the law is implemented in the future. Starting in 2017, Section 1332 of the ACA allows the federal government to give states waivers granting them considerable flexibility to modify how coverage is provided to uninsured populations. Depending on how the provision is […]

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Aetna Acquires Humana in $37B Deal

SWIM Inc

More fireworks as we head into the holiday weekend!  Following several other announced mergers and deals offered, Aetna now has announced its intention to acquire Humana.   Is it a good or bad deal for consumers and employers? Tell us what you think with an e-mail to info@swimincorp.com. The New York Times summed it up with […]

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Supreme Court Rules in Favor of Obama Administration

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The Supreme Court ruled in favor of the Obama Administration in the controversial King vs. Burwell court case.  The 6-3 decision confirms that the Affordable Care Act allows for tax subsidies to flow through both state-based marketplaces as well as the federally organized health insurance exchange.  While the political implications are significant, this ruling should […]

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NY health plans seek average 13.5% hike for 2016

Get ready to pay more for health care next year. The battle over setting next year’s health insurance premiums in New York is underway after proposals seeking double-digit rate increases on average were submitted to state regulators. Proposed rate adjustments vary widely, with an average increase of about 13.5 percent. While some health plans seek […]

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Cigna Rejects an Overture From Anthem

SWIM Inc

The world of American health insurance may soon become even smaller, with the biggest companies seeking to become even bigger. A scramble has broken out within the industry as various providers jockey for position and make overtures to rivals. Anthem made the first public move, unveiling a $47 billion takeover bid for Cigna on Saturday […]

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Poll: Americans Largely Oblivious to Supreme Court Case on Obamacare’s Future

SWIM Inc

7 in 10 Americans have heard little or nothing about the case A great deal of Americans will be taken by surprise should the Supreme Court rule against the Affordable Care Act in the coming weeks — a new poll finds seven in ten Americans say they’ve only heard a little or nothing at all […]

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To Lose Weight, Eating Less Is Far More Important Than Exercising More

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One of my family’s favorite shows is “The Biggest Loser.” Although some viewers don’t appreciate how it pushes people so hard to lose weight, the show probably inspires some overweight people to regain control of their lives. But one of the most frustrating parts of the show, at least for me, is its overwhelming emphasis […]

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Poll Marks a Love/Hate View of the Affordable Care Act

SWIM Inc

Public support for Obamacare tied its all-time low in the latest ABC News/Washington Post poll – even as most Americans say the Supreme Court should not block federal subsidies at the heart of the health care law. With the high court set to rule on the latest challenge to the ACA, the poll reflects the […]

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Employer-covered insurance doesn’t drop despite ACA, report finds

SWIM Inc

The percentage of workers covered by employer-sponsored health insurance has held steady, despite arguments that the Affordable Care Act would spur a decline. Between June 2013 and March 2015 just over 70% of U.S. workers were covered by a plan provided by their employer, according to a study released Wednesday by the Urban Institute Health […]

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Managing Your Medicare’s Out-of-Pocket Expenses

SWIM Inc

Medicare beneficiaries need to pay for a sometimes significant portion of their health care costs. Just like private health insurance, Medicare requires beneficiaries to pay premiums, deductibles and coinsurance. But there’s a lot you can do to keep these costs manageable. Here are some steps to minimize Medicare’s out-of-pocket costs. Premiums. Most people aren’t charged […]

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Employers Urge Repeal of Small Group Expansion

SWIM Inc

The Affordable Care Act’s mandated expansion of the definition of the small group market would limit employers’ health plan options, according to employer groups who are urging the repeal of the mandate before it takes effect in 2016. Expanding the small group market to include groups up to 100 would not only reduce choice for […]

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Health Care Spending Down, Cost Sharing Up

Medical

The growth in health care spending is slowing down, and one reason might be that cost sharing is rising. The proportion of insured workers with at least a $1,000 deductible was 41 percent in 2014, quadruple that in 2006. Hidden in the numbers is the fact that increasing cost sharing for patients with chronic illnesses […]

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Amenities, Perks, and Bonuses Trump Salary Raises

SWIM Inc

Yacht-size bonuses for Wall Street big shots and employee-of-the-month plaques for supermarket standouts are nothing new, but companies’ continued efforts to keep costs down have pushed employers to increasingly turn to one-off bonuses and nonmonetary rewards at the expense of annual pay raises. “There is a quiet revolution in compensation,” said Ken Abosch, a partner […]

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The ACA Incentives People to Attain Health Insurance

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Obamacare’s big stick doesn’t seem to be scaring many people into buying health insurance. The health law includes many inducements for people to obtain health insurance — including free Medicaid coverage for many low-income Americans and subsidies for those with moderate incomes. But it also includes the notorious “individual mandate,” a fine for those who […]

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Average Americans Can’t Afford Insurance Deductibles

SWIM Inc

Just because you have health insurance doesn’t necessarily mean you can afford all your medical bills, especially if you have a high deductible. So sometimes, it pays to negotiate. A Commonwealth Fund study released this week found that nearly a quarter of working-age Americans who had health insurance in 2014 were “underinsured.” The report cited […]

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Republicans Proposed Plan to Replace The ACA

SWIM Inc

The Washington Times reports that the list of Republican plans “to deal with the potential fallout” from King v. Burwell “is growing longer, although Republicans have yet to coalesce around a game plan with just six weeks before the court is expected to rule.” Rep. Tom Price (R-GA) unveiled a “revamped version” of his ACA replacement […]

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What Don Draper taught us about the Modern Man

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Don Draper is the ultimate 1960s ad man from AMC’s Mad Men, which came to end today.  Don is a man with perfect style. He is supremely confident, cool under pressure, and admired by everyone for his creative genius and ability to close a deal. Don’s ambition and drive overcame a traumatic childhood and a less than […]

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How Do You Get Patients to Engage?

SWIM Inc

With more quality and pricing data available now than ever before, insurers and employers are trying to figure out how to steer patients toward high-performing, low-cost doctors. Companies such as the Leapfrog Group and nonprofits like FAIR Health are creating tools that make medical data easier to access, but turning patients into rational consumers is […]

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OSHA Releases New ‘It’s The Law’ Poster

SWIM Inc

The Occupational Safety and Health Administration (OSHA) has released a new version of its “Job Safety and Health – It’s The Law!” poster. Background Under the Occupational Safety and Health Act (OSH Act), employers have certain responsibilities, including the obligation to: Provide their employees with a safe workplace; Follow all relevant safety and health standards; […]

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ACA Rules for Foster Children

Medical

Nathan Cox-Reed has a toothache. He thinks he needs a root canal, but the full-time student, 22, is uninsured. He can’t afford a trip to the dentist. “I’m only working 30 hours a week. I wouldn’t have enough money to do something like that,” said Cox-Reed, a film and video student at Columbia College in […]

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IRS Releases 2016 Health Savings Account Limits

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The Internal Revenue Service (IRS) has announced the 2016 inflation-adjusted amounts for Health Savings Accounts (HSAs) as determined under the Internal Revenue Code. Annual Contribution Limitation For calendar year 2016, the annual limitation on deductions for an individual with self-only coverage under a high deductible health plan is $3,350. The annual limitation on HSA deductions […]

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IRS Fact Sheet: Determining Large Employer Status

SWIM Inc

Fact Sheet Includes Examples and Additional Resources A fact sheet from the IRS helps employers determine, based on their size, whether the ACA’s employer shared responsibility (“pay or play”) and information reporting provisions apply to their company. The fact sheet includes basic information on determining large employer status, along with information on: Determining the number […]

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On Demand Doctor Apps are Here

Medical

New smartphone apps can deliver doctors to your doorstep. Heal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door. Users download the app and then type in a few details such as address and the reason for the visit. After adding […]

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New York Moving to Value-Based Payment

SWIM Inc

Like the rest of the country, New York is moving—somewhat begrudgingly—toward a future in which hospitals and doctors are paid to keep patients healthy rather than be reimbursed based on the volume of procedures they perform on sick patients. Most providers and health plans agree that this shift from fee-for-service reimbursement to a model based […]

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Insurance Companies at The Capital to Lobby

SWIM Inc

Health insurance companies will descend on the state capital today for two days of lobbying—and might need both of them to explain the bill at the top of their agenda. The measure would allow businesses with 51 to 100 employees to continue purchasing stop-loss insurance next year. It’s sure to trigger a lot of quizzical […]

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Data Released to The Public on Medicare Prescription Spending

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The heartburn drug Nexium — whose advertisements have long been ubiquitous on television — was prescribed to 1.5 million Medicare patients in 2013, for a total cost of more than $2.5 billion, the largest amount spent on any drug prescribed through the government program, according to data released by Medicare officials on Thursday. The data was the most […]

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Reduce Your Exposure to The Cadillac Tax

SWIM Inc

The only way for employers to reduce their exposure to the “Cadillac tax” on high-value health care plans is to implement strategies to cut costs, though it’s likely they will still be affected, according to panelists at the Midwest Business Group on Health 35th Annual Conference in Chicago. Employers can also contact regulators and legislators […]

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FAQs For Small Group Expansion to 1-100 Employees

SWIM Inc

Q-1. What is the definition of “small group” as of January 1, 2016? A. Under New York law and the Patient Protection and Affordable Care Act (ACA), the definition of “small group” will be 1-100 employees as of January 1, 2016. See Q-6 thru Q-11 below for who is an employee. Q-2. Will New York […]

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Vision Insurance on The Uptick

Medical

Employees have their eyes set on vision insurance, as sales have increased close to 25% since 2013 and are leading the pack in worksite voluntary sales growth. In fact, voluntary benefits sales increased 5% in 2014 compared to 2013, marking the fourth straight year of growth for voluntary, according to LIMRA’s U.S. Worksite Sales survey. […]

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This is How The IRS Handles Marriage and Health Tax Credits

SWIM Inc

If you’re about to tie the knot, do you know how a change in marital status could affect the credit you got toward health insurance when you were single? You could end up having to repay a big chunk of the money. Here’s the question and an answer that lays out the way the IRS […]

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Consumers Aren’t Using Accessible Health Information

SWIM Inc

Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for the health care industry have historically been concealed and convoluted, unlike those for most other businesses. The 2010 health law aimed […]

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Nutrition: The Simple Rule for Eating

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Over the past few months, I’ve written a number of times on how nutrition recommendations are seldom supported by science. I’ve argued that what many people are telling you may be inaccurate. In response, many of you have asked me what nutrition recommendations should say. It’s much easier, unfortunately, to tell you what not to […]

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Most Doctors Don’t Follow Guidelines for Patients

Medical

For all their talk about evidence-based medicine, a lot of doctors don’t follow the clinical guidelines set by leading medical groups. Consider, for example, the case of cataract surgery. It’s a fairly straightforward medical procedure: Doctors replace an eye’s cloudy lens with a clear, prosthetic one. More than a million people each year in the […]

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Sneezing? It May Not be Allergies!

Medical

For the allergic, spring can be a roller coaster ride as pollen counts dip then spike, sometimes in reaction to fluctuating weather patterns. For the puffy, red-eyed and itchy, this year’s ride has begun. Pollen counts had been far below normal because of a colder-than-usual February, but they made up for it as temperatures rose, […]

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Wellness Programs at Work Clarified

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Federal regulators Thursday proposed limits on how employers use financial penalties and rewards to nudge staff to participate in fast-growing workplace wellness programs. The Equal Employment Opportunity Commission — which enforces laws against discrimination — said Thursday that employers can use financial incentives up to 30 percent of the cost of premiums for single coverage, […]

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Young Women Unaware of Heart Disease

Medical

Attention, American women, especially young women: Have you got the heart to save yours? Although long thought of as a man’s disease, heart disease afflicts as many women, though women tend to develop and die from it about 10 years later. And while coronary mortality rates have declined over all, there are signs that the […]

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Senate Approves Sweeping Changes to Medicare

Medical

The Senate on Tuesday overwhelmingly approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade. The 92-to-8 vote in the Senate, following passage in the House last month by a vote of 392 […]

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Shopping Limited Networks to Save Money

SWIM Inc

In all the turmoil in health care, one surprising truth is emerging: Consumers seem increasingly comfortable trading a greater choice of hospitals or doctors for a health plan that costs significantly less money. “Are they willing to trade choice and access for price? There’s no question about that,” said Mark Newton, the chief executive of […]

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National Divide Over ACA Affecting Medical Bill Payments

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The Los Angeles Times (4/10, Levey) reports that the “national divide” over the ACA “is beginning to affect Americans’ access to medical care and perhaps even their ability to pay medical bills, a new study of the country’s four largest states suggests.” Residents in Florida and Texas, which have resisted Medicaid expansion under the health […]

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Nearly 9 out of 10 Adults Have Health Insurance

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Underlining a change across the nation, nearly 9 out of 10 adults now say they have health insurance, according to an extensive survey released Monday. As recently as 2013, slightly more than 8 out of 10 had coverage. Whether the new number from the Gallup-Healthways Well-Being Index turns out to be a high-water mark for […]

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The War On Work and Sleep

SWIM Inc

There are a lot of advantages to earning more money, but getting a good night’s sleep may not be one of them. It turns out that, in general, the more money people make, the less they sleep. That’s been true for decades in the United States, and in other countries as well. On average, adults […]

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A Shift In How Businesses Offer Health Insurance

SWIM Inc

The Washington Post (4/8, Millman) reports in its “Wonkblog” that about 6 million Americans with employer-sponsored coverage in 2014 “received their health insurance through privately run health insurance exchanges, where employees can select coverage from a number of health plans — double the number from the year before, according to a new report from Accenture.” The […]

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Tylenol May Not Be As Effective As You Think

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Acetaminophen (Tylenol) is widely recommended for the relief of back pain and the pain of knee and hip arthritis. But a systematic review of randomized trials has found that it works no better than a placebo. Australian researchers reviewed three randomized trials that compared acetaminophen with a placebo for the relief of spinal pain, and […]

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The Case for Not Getting a Physical Exam

Medical

It’s a warm afternoon in Miami, and 35-year-old Emanuel Vega has come to Baptist Health Primary Care for a physical exam. Dr. Mark Caruso shakes his hand with a welcoming smile. Vega, a strapping man with a thick black beard, is feeling good, but he came to see the doctor today because his wife thought […]

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Lower Health Care Costs For Municipal Workers

SWIM Inc

The de Blasio administration Wednesday provided details of specific savings it had achieved from last year’s agreement with the Municipal Labor Committee to lower health care costs in the city’s contracts with municipal workers. Incorporated into contracts with the committee is an agreement to achieve $3.4 billion in health care savings from fiscal years 2015 […]

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Out-Of-Network Protection In Emergencies

SWIM Inc

New protections against big surprise medical bills are starting in New York. Enacted last year, they require insurance payments for out-of-network medical treatment in emergencies, when similar services or specialists are unavailable within the insurer’s network or when care is provided without the patient’s knowledge. “The surprise bill is only in a situation where they couldn’t choose in […]

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UnitedHealth Buys Cataman Corp.

SWIM Inc

The nation’s largest health insurer, UnitedHealth, will muscle up for its fight against rising prescription drug costs by spending more than $12 billion to buy pharmacy benefits manager Catamaran Corp. Pharmacy benefits managers, or PBMs, help negotiate the prices that customers pay for prescription drugs. They are seen as a key component in the push […]

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Final Versions of IRS Sections 6055 & 6056 Released

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The Internal Revenue Service recently released final versions of forms and related instructions that employers may use to report under Sections 6055 and 6056 for 2014. These forms are not required to be filed for 2014, but reporting entities may voluntarily file them in 2015 for 2014 coverage. The forms for 2015 must be filed […]

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H.S.A’s Can Become Your Rainy Day Fund

SWIM Inc

As savings vehicles go, Health Savings Accounts, or H.S.A.s, are rainy day funds with generous benefits. The funds are tax-advantaged accounts that have been available since 2003 to taxpayers with high-deductible health plans (currently plans with deductibles of at least $1,300 for individuals and $2,600 for families). They were intended to cover out-of-pocket medical expenses, […]

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The Scoop of High-Deductible Health Plans

SWIM Inc

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs. Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees […]

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Public Records Delayed Due To Affordable Care Act

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A heavy workload caused by the Affordable Care Act, government technology limits and staff shortages are causing unusually long delays in filling public records requests, federal health officials say. The waits in some cases could stretch out a decade or more. The Freedom of Information Act requires federal agencies to respond to records requests in […]

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Truths and Myths of Obamacare

SWIM Inc

The Obamacare debate has always been rife with myths, from the infamous “death panels” to the armed IRS agents that would arrest those who don’t buy insurance (really, this was an actual myth). But as the Affordable Care Act turns five, it appears one myth reigns above them all: the idea that the health-care law […]

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Affordable Care Act: Where Are We On Its Fifth Anniversary?

SWIM Inc

When Democrats passed the Affordable Care Act in 2010, they knew it wasn’t popular — poll after poll showed pluralities, if not majorities, opposed to the legislation after the bruising national fight that led to its passage. But Democrats had a theory about the law: as time went on, and Americans started to gain coverage, […]

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Lawmakers Are Seeking Transparency on Health Care Tax

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Some lawmakers are challenging the Cuomo administration’s push for a $69 million annual tax to fund the state’s health exchange, wondering how the state spends the more than $5 billion in annual health care related taxes it already collects. The Republican-led State Senate eliminated the proposed tax from its one-house budget. Cuomo set up the […]

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Americans View ACA More Favorably Since 2012

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The New York Times  (3/19, Goodnough, Subscription Publication) reports that the gap between Americans who view the ACA favorably and those who do not “is smaller now than at any time since the fall of 2012, a year before the law’s disastrous rollout, according to a monthly poll that has tracked attitudes about the polarizing law […]

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Employer Mandate Made Insignificant Impact On Enrollment

SWIM Inc

Obamacare’s employer mandate on large businesses barely had an impact on enrollment in employer-sponsored plans this year, according to a new survey. Human resources firm Mercer on Tuesday released a survey of 572 employers and found very little change between 2014 and 2015 in the average number of full- and part-time workers getting health coverage […]

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Medical Professionals Doubt Health Apps Capabilities

Medical

A bodybuilder presses the iPhone’s camera with a fingertip, and his heart rate and blood oxygen levels appear on the screen. A fellow in pajamas steps onto a scale, peers at his smartphone, and sighs dejectedly. A runner races along the waterfront, a cellphone strapped to her pumping arms. Apple’s television commercials for the iPhone […]

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Ask Your Physician Why They’re Running That Test?

SWIM Inc

The electrocardiogram you got at your most recent physical may have been a waste of time and money. A guideline from the American College of Physicians published Monday in The Annals of Internal Medicine concludes that routine cardiac testing of adults without symptoms has not been shown to improve patient outcomes, and can lead to […]

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A Pediatrician’s View On Alcohol and Marijuana

Medical

As my children, and my friends’ children, are getting older, a question that comes up again and again from friends is this: Which would I rather my children use — alcohol or marijuana? The immediate answer, of course, is “neither.” But no parent accepts that. It’s assumed, and not incorrectly, that the vast majority of […]

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A Push To Make Pregnancy A Qualifying Life Event

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More than 50 House Democrats are asking the Obama administration to add pregnancy to the limited list of reasons women may enroll year-round in coverage on the Obamacare exchanges. Once the second, extended enrollment period ends April 30, Americans may only sign up for marketplace coverage if they have experienced a major life event like […]

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Your Employer Can Force You To Buy Company’s Health Insurance

Medical

Under the health law, large employers that don’t offer their full-time workers comprehensive, affordable health insurance face a fine. But some employers are taking it a step further and requiring workers to buy the company insurance, whether they want it or not. Many workers may have no choice but to comply. Some workers are upset. […]

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Estimated Cost of Affordable Care Act Reduced

SWIM Inc

The Congressional Budget Office on Monday again lowered its estimate of the cost of the Affordable Care Act, citing slow growth of health insurance premiums as a major factor. Just since January, the budget office said, it has reduced its estimate of the 10-year cost of federal insurance subsidies by 20 percent, and its estimate of new Medicaid […]

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Mental Health Benefits In ACA Plans Are Disappointing

SWIM Inc

Insurance coverage for mental and physical illness remains unequal despite promises that Obamacare would help level the playing field, mental health advocates and researchers say. A new study by the Johns Hopkins Bloomberg School of Public Health found that consumer information on a quarter of the Obamacare plans that researchers examined appeared to go against […]

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Small Business Tasked to Tally Employee’s Health-Care Costs

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Small employers are facing an unexpectedly onerous task: tallying their individual employees’ monthly health-care costs. Starting in 2016, under the Affordable Care Act, employers with 50 or more full-time workers are required to file new tax forms laying out what individual employees are being charged for their employer-sponsored plans. The Internal Revenue Service released the […]

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Turn Down The Music, Your Hearing Will Thank You

Medical

Hey dude — can you turn your music down?” If anyone says this to you while you’re wearing your earbuds, take note: You are probably endangering your hearing. More than one billion teens and young adults are at risk of losing their hearing, according to WHO (that’s the World Health Organization, not the rock band). […]

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Being Physically Fit Improves Brain Function

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There are a lot of good reasons to stay physically fit into middle age. Better sleep, muscle strength, heart health, and even mental performance are all perks of keeping up with exercise. And now, a new study shows that staying in shape in your 40s might even help protect your brain from shrinking later on […]

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What Do You Know About Sleep?

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Each year in the U.S., Sleep Awareness Week occurs in the first week of March, when Daylight Saving Time begins and most Americans lose an hour of sleep. The observance is a national public education and awareness campaign to promote the importance of sleep to one’s physical health, mental health and overall well-being. With lots […]

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Change Your Lifestyle by Sitting Properly

Medical

You’ve probably heard that “sitting is the new smoking.” Not only does it lead to aches and pains, edema, varicose veins, sciatica and more — according to a new study, too much sitting can actually kill you. Unlike smoking, however, we can’t just quit sitting. It’s a lifestyle reality that even the most athletic among […]

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Fringe Benefits and Same-Sex Marriages

SWIM Inc

Special Updates: Same-sex couples, legally married in jurisdictions that recognize their marriages,will be treated as married for all federal tax purposes (including employee benefits). More specific IRS guidance includes:  Agency guidance released by the U.S. Treasury Department and the IRS addresses the recognition of same-same marriage in the wake of the U.S. Supreme Court ruling […]

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New IRS Form for Third-Party Sick Pay Recap

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Employers should note that a new IRS Form replaces the “Third-Party Sick Pay Recap” previously reported on Form W-2, Wage and Tax Statement. For wages paid in 2014, new Form 8922, Third-Party Sick Pay Recap, is used to reconcile employment tax returns with Forms W-2 when third-party sick pay is paid. Background Third-party sick pay […]

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FMLA Definition of ‘Spouse’ Under Final Rule

SWIM Inc

Effective March 27, 2015, a final rule from the U.S. Department of Labor will extend the protections of the federal Family and Medical Leave Act (FMLA) to all eligible employees in legal same-sex marriages, regardless of where they live. Background Under the FMLA, an eligible employee of a covered employer (50 or more employees in […]

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Long-Term Care on the Rise, but Varied

Medical

Rates for long-term care insurance, which can help pay for care in your own house or in a nursing home, rose this year an average of nearly 9 percent, a new industry report finds. Still, rates vary greatly depending on the insurer and the specifics; increases for some policies were much larger, and in some […]

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The New Guideline on Nutrition

Medical

A nutrition advisory panel that helps shape the country’s official dietary guidelines eased some of its previous restrictions on fat and cholesterol on Thursday and recommended sharp new limits on the amount of added sugar that Americans should consume. The Dietary Guidelines Advisory Committee, which convenes every five years, followed the lead of other major […]

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IRS Delays Penalties for Small Business Offering HRAs

SWIM Inc

One of these days, employers will experience the full effects of Obamacare — but not yet. In the latest in a long string of delays in enforcing the rules under the health care overhaul, the Internal Revenue Service and Treasury Department announced on Wednesday that they will wait until summer to start enforcing financial penalties […]

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Healthcare Spending on an Uptick

SWIM Inc

Bloomberg News reports that a new analysis of preliminary government data by the Altarum Institute research group shows healthcare spending is on the rise again after “five years of historically slow growth.” The analysis shows “health spending increasing by 5 percent last year, compared to 3.6 percent in 2013.” If the final tally confirms the numbers, […]

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You Have Extra Time to Sign Up for Obamacare Plans

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Americans who couldn’t enroll in federal Obamacare insurance plans over the weekend because of computer glitches or long waits will now have until next Sunday to sign up, federal officials announced early Monday. “We are pleased that the vast majority of consumers were able to apply and pick a plan through HealthCare.gov or its call […]

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Anthem Members to Receive Credit Protection Services

SWIM Inc

Starting at 1 p.m. (CST) today, Anthem will be providing members affected by the recent cyber attack with the opportunity to enroll in credit protection services. Current and former members dating back to 2004 can visit www.AnthemFacts.com to learn more about credit monitoring and identity theft repair services provided by AllClear ID. All services are […]

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Are Your Children No Longer Eligible To Stay On Your Plan?

Medical

When your children are no longer eligible to stay on your plan, it’s time for them to get their own health insurance. Enrolling is easy – they can simply head to the NY State of Health Marketplace to find a quality, affordable plan that works for their lifestyle. Jeffrey R. Ungvary President

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Employer Responsibilities Under The Affordable Care Act

SWIM Inc

The Affordable Care Act does not require businesses to provide health benefits to their workers, but larger employers face penalties if they don’t make affordable coverage available. The Obama Administration announced “transition relief” under which the penalties will go into effect in 2015 for employers with 100 or more employees and in 2016 for employers […]

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Are All Fitness Trackers Created Equal?

SWIM Inc

Many of us have invested in the wristbands or other wearable devices that tell us how many steps we’ve taken, calories we’ve burned and other information. But an interesting new study that compared activity monitors found that while some are accurate when measuring step counts, others are way off. And few are more accurate than […]

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Medicare Patients Are in for a Surprise

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Imagine you’re a Medicare patient, and you go to your doctor for an ultrasound of your heart one month. Medicare pays your doctor’s office $189, and you pay about 20 percent of that bill as a co-payment. Then, the next month, your doctor’s practice has been bought by the local hospital. You go to the […]

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Health Insurance and Medicaid Enrollments High

SWIM Inc

About two million New Yorkers have signed up for insurance under the Affordable Care Act, with three out of every four of them poor enough to qualify for Medicaid, according to figures released Wednesday by the Cuomo administration. While Gov. Andrew M. Cuomo heralded the overall numbers as a sign of the success of the […]

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Anthem Members Impacted by Cyber Attack

SWIM Inc

Anthem, Inc., the parent company of Anthem Blue Cross and Blue Shield, has announced member data was accessed during a recent cyber attack. Please note, there has been no evidence of health data being compromised. Members will also receive free credit repair and ID protections services. Members can receive more information at www.anthemfacts.com or by calling […]

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Retirees Face Rise in Medical Costs

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Like many retirees, one couple from upstate New York visit doctors in their winter getaway in Florida. But on a recent routine checkup of a pacemaker, a cardiologist there insisted on scheduling several expensive tests even though the 91-year-old husband had no symptoms. “You walk in the door, and they just start doing things,” said […]

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The Argument for Vaccines

Medical

In the churning over the refusal of some parents to immunize their children against certain diseases, a venerable Latin phrase may prove useful: Post hoc, ergo propter hoc. It means, “After this, therefore because of this.” In plainer language: Event B follows Event A, so B must be the direct result of A. It is […]

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A.D.H.D. Medicine May “Normalize” Children’s Brains

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Dr. Mark Bertin is no A.D.H.D. pill-pusher. The Pleasantville, N.Y., developmental pediatrician won’t allow drug marketers in his office, and says he doesn’t always prescribe medication for children diagnosed with attention deficit hyperactivity disorder. Yet Dr. Bertin has recently changed the way he talks about medication, offering parents a powerful argument. Recent research, he says, […]

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Governor Cuomo’s New Tax on Health-Insurance Policies

SWIM Inc

Gov. Andrew Cuomo’s new budget includes a nearly $69 million tax on health-insurance policies to pay for the administrative costs of continuing New York’s ObamaCare health exchange, The Post has learned. The levy is intended to make up for federal funds no longer available to the states as of this year. Adding up to about […]

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Your Next Doctor’s Visit May Be With A Group

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In a typical doctor’s visit, you wait around for a while, get your vitals checked, and spend a few minutes alone in a room with a physician. It’s private and short. Some doctors, frustrated by a relentless schedule of 15-minute, one-on-one visits, are experimenting with appointments that are neither. According to the American Academy of […]

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Public Policy Reform Focusing on Mental Health Disparities

Medical

Chirlane McCray, the wife of Mayor Bill de Blasio, revealed on Wednesday that she had been surrounded by mental illness most of her life — first as a child of parents who had depression and later as a mother of a daughter who is recovering from depression, anxiety and substance abuse. In a public appeal, […]

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People With HIV Face Price Discrimination In Some ACA Plans

Medical

The New York Times  (1/29, Thomas, Subscription Publication) reports that drugs to treat HIV and AIDS “are being priced out of reach for many patients enrolled in insurance plans through the new health care exchanges, despite warnings that such practices are illegal under the Obama administration’s health care law, according to a new analysis by […]

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New Goals Shift to Value-Based Medicare Payments

SWIM Inc

In a “historic” announcement, the Department of Health and Human Services on Monday set new goals for tying Medicare payments to quality or value through alternative payment models. The news received widespread print and online media coverage and is portrayed as an ambitious step by the Administration. Most sources also report on the generally positive […]

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Alert: Winter Storm Juno Safety Tips

SWIM Inc

With winter storm Juno quickly approaching, take note of the following Red Cross Safety Tips for the inclement weather. •Winterize your vehicle and keep the gas tank full. A full tank will keep the fuel line from freezing •Water: Have on hand at least a 3-day supply; one gallon per person per day •Food: Have on […]

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Stop Sitting, It’s Killing You

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One of your favorite activities may actually be killing you. Our entire modern world is constructed to keep you sitting down. When we drive, we sit. When we work at an office, we sit. When we watch TV, well, you get the picture. And yet, a new study that’s running in the Annals of Internal […]

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How PPACA has Changed Health Care

Medical

People with individual health coverage used more health care in the third quarter of 2014, and people with group coverage used less. Katherine Hempstead, an analyst at the Robert Wood Johnson Foundation, is reporting that finding in an analysis of insurer data from the National Association of Insurance Commissioners (NAIC). Hempstead compared care utilization data […]

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Republicans Introduce Bill to Repeal the Individual Mandate

SWIM Inc

Leading Republican senators on Wednesday introduced a bill to repeal one of Obamacare’s most unpopular provisions – the individual mandate that requires most Americans to obtain health insurance or pay a penalty. Senator Orrin Hatch, chairman of the Senate Finance Committee, and Senator Lamar Alexander, who heads the Senate Health, Education, Labor and Pensions Committee, […]

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Start Walking During Your Lunch Break

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To combat afternoon slumps in enthusiasm and focus, take a walk during the lunch hour. A new study finds that even gentle lunchtime strolls can perceptibly — and immediately — buoy people’s moods and ability to handle stress at work. It is not news, of course, that walking is healthy and that people who walk […]

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What are Accountable Care Organizations?

Medical

In pursuit of greater efficiency in the United States health system, public programs and private insurers have begun to pay some hospitals and physicians differently. These new payment models take many forms, but they all impose greater responsibility for cost control and quality improvement on providers and bear some resemblance to failed health care financing […]

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What’s Next for Obamacare?

SWIM Inc

A pro-Obamacare nonprofit released a road map Monday for the next steps beyond the president’s health law, including getting every state to sign up for expanded Medicaid and pushing for universal dental coverage. The move served as a signal that President Obama’s allies don’t just want to play defense against GOP efforts to undercut Obamacare, […]

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Medical Debt has Gone Down for Americans

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The successes or failures of the Affordable Care Act seem to have no real bearing on the political debate surrounding the law. We know this to be true, of course, because if the efficacy of the law made a real-world difference, the debate would already be over. The number of Americans struggling to pay medical […]

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Obamacare likely to Stay, Despite Lawmakers’ Attempt to Repeal

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U.S. healthcare executives say Obamacare is likely here to stay, despite repeated calls from Republican lawmakers for repeal of the 2010 law aimed at providing health coverage for millions of uninsured Americans. Top executives who gathered in San Francisco this week for the annual J.P. Morgan Healthcare conference, say that while President Obama’s signature domestic […]

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New Yorkers Your Deadline is Today for Health Coverage

SWIM Inc

As the Feb. 15 deadline for enrolling in Obamacare through the NY State of Health approaches, the state said Wednesday that there has been a steady growth in enrollment. However, updated figures will not be available until around Feb. 1. In a teleconference with reporters organized by Families USA, Donna Frescatore, executive director of NY […]

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Hearing Loss May Be a Thing of the Past

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Driving to a meeting in 2008, Jay Lichter, a venture capitalist, suddenly became so dizzy he had to pull over and call a friend to take him to the emergency room. The diagnosis: Ménière’s disease, a disorder of the inner ear characterized by debilitating vertigo, hearing loss and tinnitus, or ringing in the ears. But […]

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One Year Anniversary of The Affordable Care Act

SWIM Inc

This month marks one year since health insurance coverage under the Affordable Care Act began, and from the president’s point of view: so far, so good. More than 10 million Americans who didn’t have health insurance before have signed up. But congressional Republicans are gunning for Obamacare. Even if they can’t outright repeal it, they […]

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House Passes Change to ACA Workweek Hours

SWIM Inc

  We are following this story closely, and we will bring you updates as soon as possible. Please note, this measure may not pass the Senate and is certainly going to get a veto from POTUS. Ignoring a veto threat from the President, the House on Thursday passed a measure to raise from 30 to […]

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Premium Increases on Plans Have Slowed, But Employees’ Are Paying More

SWIM Inc

In New York, premiums for employer-sponsored family plans have slowed since the passage of the Affordable Care Act, but premiums and deductibles now eat up a larger share of employees’ incomes, according to a Commonwealth Fund report released Thursday. Premiums for family coverage in the state grew 6% annually from 2010 to 2013, down from […]

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Communication Failure From Doctors Result in Serious Issues

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BETSY came to Dr. Martin for a second — or rather, a sixth — opinion. Over a year, she had seen five other physicians for a “rapid heartbeat” and “feeling stressed.” After extensive testing, she had finally been referred for psychological counseling for an anxiety disorder. The careful history Dr. Martin took revealed that Betsy […]

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Harvard Experts Are Not Too Happy With Their Health Care Remedies

Medical

For years, Harvard’s experts on health economics and policy have advised presidents and Congress on how to provide health benefits to the nation at a reasonable cost. But those remedies will now be applied to the Harvard faculty, and the professors are in an uproar. Members of the Faculty of Arts and Sciences, the heart […]

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A Terrible Flu Season on The Horizon

Medical

This flu season already seems to be a bad one. According to Dr. Sanjay Gupta, and mathematical methods and Google Flu, New York City may be hit with a flood of flu-stricken residents the week of January 10th . At Nazareth Academy, a Catholic high school just outside Chicago, a full quarter of the 780 students were […]

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U.S. Health Care Spending Capped

SWIM Inc

U.S. health care spending grew 3.6% in 2013, capping a five-year stretch of historically low growth, the Centers for Medicare and Medicaid Services said in December. That’s good news for health care payers, but is the slowdown — which was the smallest increase since 1960 — sustainable? What we’re seeing is “a slowing down of […]

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Super-Short Exercises May Increase Wellness

Medical

The big story in exercise science this year was the super-short workout. In one particularly useful study from May, scientists found that three brief sessions per day of interval-style exercise — consisting of one minute of brisk walking followed by another minute of strolling, repeated six times — allowed people at risk of diabetes to […]

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Businesses Finding Ways to Soften Impact of Health Reform

Medical

Many businesses in low-wage industries have hired more part-time workers and cut the hours of full-timers recently to soften the impact of new health law requirements that take effect Thursday, some consultants say. The strategies have had only a modest impact on job growth, which has accelerated substantially this year, but could take a somewhat […]

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Did You Forgo Health Insurance, You May Receive a Tax Penalty

SWIM Inc

If you decided to skip health insurance this year, consider this: Unless you can prove you have a valid excuse, you will be liable for a penalty during the coming tax season — and the time to start making your case is now. That’s not all. People who bought subsidized insurance through one of the […]

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The Economy Grew Due to Increased Consumer Spending and Investments

SWIM Inc

The U.S. economy grew at a sizzling 5% annual rate in the July-September period, the fastest in more than a decade, boosted by strength in consumer spending and business investment. The Commerce Department on Tuesday sharply revised up its estimate of third-quarter growth from a previous figure of 3.9%. Much of the strength came from […]

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How Many Calories Are in Your Favorite Meals?

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The nation’s largest restaurant chains have made a big deal in recent years about introducing smaller portion sizes. McDonald’s eliminated the Supersize menu, while T.G.I. Friday’s and others have introduced small-plate items. Yet the restaurants have also been doing something else, with less fanfare: continuing to add dishes so rich that a single meal often […]

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Over Two Thousand Enrolled in New York State Exchange

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The Syracuse (NY) Post-Standard (12/23) reports that the New York State Health Department announced Monday that 225,244 people have enrolled in coverage through the state health insurance exchange since Nov. 15. The figure “represents individuals who signed up and had not been enrolled in coverage for 2014.” The New York Daily News (12/23) reports in […]

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ACA Rates for 2015 Did Not Rise

Medical

The Hill    (12/22, Viebeck) reports that insurance premiums for ACA exchange plans “did not rise on the whole for 2015, though 10 states saw double-digit increases, according to a new analysis.” Researchers at the University of Chicago found that the average monthly premium for benchmark exchange plans went unchanged from 2014 to 2015, while […]

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Possible Discrimination Practices Being Investigated

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The New York Times   (12/23, A19, Pear, Subscription Publication) reports that the Obama Administration “said Monday that it would investigate prescription drug coverage and other benefits offered by health insurance companies to see if they discriminated against people with AIDS, mental illness, diabetes or other costly chronic conditions.” Officials said they had become aware […]

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H.M.O Plans Have The Lowest Premium Increase

Medical

Health insurers are selling more than 100,000 plans at a county level through the Affordable Care Act’s marketplaces, at radically different prices and varied designs. The carriers range from established local Blue Cross plans and national for-profit behemoths to upstarts like local hospital systems and the new consumer-oriented co-ops that were created under the federal […]

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Exercise Can Change Your DNA

SWIM Inc

We all know that exercise can make us fitter and reduce our risk for illnesses such as diabetes and heart disease. But just how, from start to finish, a run or a bike ride might translate into a healthier life has remained baffling. Now new research reports that the answer may lie, in part, in […]

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Single-Payer Health Care Bill Gets Wide Support

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The Affordable Care Act has made an unwieldy system of health insurance even more complicated, and should be replaced with a centralized, tax-funded health care system. That was the prevailing view at Tuesday’s all-day hearing on the New York Health Act, Assemblyman Richard Gottfried’s bill to create statewide single-payer health insurance that stands almost no […]

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Small Businesses See Boom in 2015

SWIM Inc

Like other local business execs involved in construction, Andrew Musci expects the city’s ongoing building boom to continue to be a positive for him in 2015. “We are seeing more opportunities for work,” said Mr. Musci, CEO of Altel Systems Inc., a Brewster, N.Y.-based commercial integrator of audio and video systems that has worked on […]

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No Fines for Sick-Leave Complaints

SWIM Inc

In the nine months since Mayor Bill de Blasio approved an expansion of the paid-sick-leave law, the city has received 289 complaints of violations. But so far, the city is on track to fine only seven of those potential violators, though probably not until 2015. Of the 289 complaints, 204 are still being investigated or […]

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Cost Effectiveness a Taboo Conversation

Medical

If I had a pill that would extend your life by one day, but it cost a billion dollars, it’s unlikely that many people would argue that health insurance should pay for it. We all understand that while the benefit might be real and quantifiable, it’s not worth the expense. But what if the pill […]

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The New York State Department Extends December 15th Deadline

SWIM Inc

The New York State Department of Health today announced an extension of the December 15 deadline for enrolling or renewing individual & family health insurance coverage through the NY State of Health (NYSOH) Marketplace. The deadline to apply for or renew coverage that takes effect January 1 has been extended through December 20. This affords […]

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Affordable Care Act and Essential Health Benefits

SWIM Inc

One criticism of the Affordable Care Act is that it imposes a costly, one-size-fits-all standard, drastically increasing premiums by requiring everyone to buy health insurance that covers the same mandated benefits. This is not so. It’s true that the health reform law imposes some requirements — “essential health benefits” — on what individual market and […]

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One Minute of Exercise Improves Your Overall Health

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For years, I’ve been writing about the benefits of short bursts of exercise. Studies and anecdotes suggest that 10 minutes, seven minutes, six minutes, or even four minutes of very hard exercise interspersed with periods of rest can lead to a robust improvement in fitness. But I suspect that this column is the least amount […]

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2015: The Year of Voluntary Benefits

SWIM Inc

Sales of voluntary products across the board will likely see a nice bump in 2015, as employers finalize their health care decisions and the War on Talent begins to heat back up. “Employers have had time to recover from the recession, and they’ve analyzed how the [Patient Protection and Affordable Care Act] is going to […]

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New York Fighting Over Medical Billing

Medical

Surprise medical bills have long been a battleground issue for Andrew Cuomo, both before and after he became governor. This year’s budget includes consumer protections against surprise bills from out-of-network providers. The new law takes effect in April. But four months before implementation, the law still is a work in progress. Two of the health […]

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Millennials Concerned of Out-of-Pocket Costs

SWIM Inc

Health plans that shift more up-front costs onto you are rapidly becoming the norm. But millennials don’t seem happy about taking on the risk, even in exchange for a lower price. Millennials want their parents’ old health insurance plan. A new survey from Bankrate found that almost half of 18-to-29-year-olds prefer a health plan with […]

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Your Flu Shot May Not Protect You

Medical

A sampling of flu cases so far this season suggests the current flu vaccine may not be a good match for the most common seasonal flu strain currently circulating in the United States, the U.S. Centers for Disease Control and Prevention said on Wednesday. The U.S. health agency issued an advisory to doctors noting that […]

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Spending Growth Dropped to Historical Low

SWIM Inc

The announcement that the rate of healthcare spending growth dropped to a historic low in 2013 is presented as a positive development for the long-term fiscal health of the country and welcome news for the Obama Administration. Many outlets are reporting that the Affordable Care Act contributed to the continued slowdown. For instance, USA Today […]

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Counting Calories Will be Easier in 2015

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Now it’s official. Starting next November, menus in many places where Americans eat — like chain restaurants and some movie theaters, convenience stores and amusement parks — will have to list calories. Consumer health advocates were jubilant when the Food and Drug Administration announced the new policy on Tuesday. Many had fought for the rule […]

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Mental Health Programs a Focus for Employers

Medical

With mental illness and substance abuse costing employers an estimated $100 billion annually in indirect costs alone, benefit decision-makers are seeing value in promoting employee assistance programs as a means to improve their workforce’s mental well-being. Thanks to an extension pushed forward by the Affordable Care Act, which helped to bridge the Mental Health Parity […]

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Tips for a Fit and Healthy Thanksgiving

Medical

Here is some serious food for thought: People probably consume 3,000 to 5,000 calories around the Thanksgiving dinner table — yikes. While eating often takes center stage during the holidays, that doesn’t mean we have to give up on good health. Here’s a portion guide to some of your favorite Thanksgiving dishes. We’ve also included […]

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Increasing Transparency Rules Provide Consumers Informed Choices

SWIM Inc

Consumer advocates are cheering the Obama administration’s plans to strengthen transparency rules (PDF) for provider networks and drug formularies so that insurance exchange customers will be able to make informed choices. “There are a lot of good things in here that are increasing transparency and adding to access for people with chronic conditions,” Eric Gascho, […]

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Health Coverage Expansion Could be a Trade-Off for Care

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One concern about the Affordable Care Act is that as more Americans get health insurance and start using it, those who already have coverage will have to wait longer for care. Recent research with a focus on Massachusetts suggests this may actually happen, but may not last long. Several years after the coverage expansion in […]

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Is Our Current Insurance Model the Best Health Policy?

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When the 48-year-old man from Oregon didn’t have insurance, he felt he had no place to go but the emergency room. The man, who has diabetes, went to the emergency room often when he suffered from kidney stones. “Emergency rooms, from what I understand, they can never turn you away,” he said. “I mean, you […]

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Most Excessive Alcohol Drinkers are Not Considered Addicts

Medical

Most people who drink to get drunk are not alcoholics, suggesting that more can be done to help heavy drinkers cut back, a new government report concludes. The finding, from a government survey of 138,100 adults, counters the conventional wisdom that every “falling-down drunk” must be addicted to alcohol. Instead, the results from the National […]

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Doctor’s Decisions Being Influenced by Financial Forces

Medical

When we are patients, we want our doctors to make recommendations that are in our best interests as individuals. As physicians, we strive to do the same for our patients. But financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital […]

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No Stipends for Employees to Buy Health Insurance

SWIM Inc

Since the implementation of the Affordable Care Act, many small businesses have been intrigued by the possibility that they might be able to stop dealing with health insurance entirely and instead offer their employees a stipend to go buy insurance on the individual exchanges. But in a clarification issued in early November, the federal government […]

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The Mutual Benefit of The Government and Insurance Companies

SWIM Inc

As Americans shop in the health insurance marketplace for a second year, President Obama is depending more than ever on the insurance companies that five years ago he accused of padding profits and canceling coverage for the sick. Those same insurers have long viewed government as an unreliable business partner that imposed taxes, fees and […]

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Candidates More Interested in Benefits Than Employment

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Multiple measures indicate the nation’s unemployment picture is changing for the better. The Bureau of Labor Statistics cites that payroll employment rose by 214,000 in October, with a slight edging in the unemployment rate to 5.8%. Meanwhile, Society for Human Resource Management noted that hiring activity hit a four-year high, as more than two-in-five manufacturers […]

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The SHOP is Underperforming

SWIM Inc

The Washington Post (11/13, Harrison) reports that enrollment on the ACA’s new small-business health insurance marketplaces “has fallen well short of the administration’s expectations,” according to a Government Accountability Report released Thursday. The GAO examined enrollment totals for SHOP exchanges in the 18 states that built their own portals, finding that fewer than 12,000 small […]

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The SHOP Falls Short on Enrollments

Medical

Remember those “other” new Obamacare exchanges—the ones that small businesses were supposed to use to sign up workers for health insurance? Yeah, well, apparently a whole bunch of small businesses forgot about them, too. A new Government Accountability Office report finds that a stunningly low number of workers have enrolled in insurance plans sold on […]

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The Complexity of Choosing a Health Plan

SWIM Inc

A confession: I am a health economist, and I cannot rationally select a health plan. I buy health insurance through the Federal Employees Health Benefits Program, or F.E.H.B.P., which is very similar to the Affordable Care Act’s exchanges. Like the exchanges, the federal employee program runs an online marketplace with a choice of plans, which […]

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Tips You Should Know to Avoid Hefty Medical Bills

Medical

Jeffrey Craig Hopper is a probate attorney and Little League coach in Austin, Texas, so he knows all about following the rules. Still, accidents happen. Last June on the Little League field, an errant baseball smashed into his face. His wife, Jennifer, remembers rushing to the field. “His eye was swollen shut enough that we […]

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Commuters May Receive The Same Tax Breaks as Drivers

SWIM Inc

Mass transit commuters should get the same tax break as people who drive to work, Sen. Charles Schumer said Tuesday. The New York Democrat said he has high hopes for a measure that would allow bus, subway and commuter rail riders to deduct up to $250 a month from their taxable income next year. Currently, […]

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High Deductible Plans on the Rise

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A growing number of Americans are paying lower health insurance premiums in exchange for high deductibles, taking a gamble that saving money now won’t put them in a tough financial situation if they’re hit with high medical bills. As we enter open enrollment season, it’s important to at least consider these low-premium plans to determine […]

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Window-Shopping for 2015 Health Plans

SWIM Inc

Potential Obamacare customers can peek at 2015 prices for the program’s health plans today after the government said it would release a “window-shopping” feature overnight. The preview feature, added to the government’s revamped healthcare.gov website, is intended to ease pressure on the system by allowing curious consumers a look at prices for health plans a […]

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Your Options if You Don’t Meet Minimum Participation

Medical

Small employers that don’t meet minimum participation requirements under the Affordable Care Act have a ‘secret’ or little-known window of time in which they can enroll for group health care coverage, but benefit experts say adviser help is imperative to avoid doing employees more harm than good. The Affordable Care Act requires health insurance issuers […]

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Small Businesses Sending Employees to The Exchange

SWIM Inc

Brian Adams, who sells fireplaces in Indianapolis, is like many of the nation’s small-business owners. As the cost of providing health benefits has climbed, he has struggled to afford coverage for his employees — a problem the new health care law was designed, in part, to address. But a year after the law’s introduction of […]

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Fifty Percent of Households Will Not Use Online Exchanges

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The Washington Times (11/4, Howell) reports that more than half of US households that used an ACA health insurance exchange last year said they will not do so again in the upcoming open enrollment period, according to a survey released Monday. Bankrate.com, which sponsored the survey “said 51 percent don’t want to use HealthCare.gov or […]

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We’re Using Less Health Care, But Spending is on a Rise

SWIM Inc

If you went to the doctor less or used fewer prescription drugs last year, but were surprised to learn that your health-care spending still went up, you’re not alone. Spending per enrollee in employer-sponsored health plans—in other words, most Americans—grew an average of 3.9 percent in 2013, despite the fact that people were using less […]

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The Rise of Urgent Care Centers in New York City

Medical

The new urgent care center on Broadway between 102nd and 103rd doesn’t look like a doctor’s office and definitely doesn’t look like a hospital. With its open floor plan, plush chairs and oddly placed modern art, it looks like a upmarket lobby, in part because the designer has a background in hotels. The waiting room […]

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Loopholes in Insurance Barring Mental Health Patients

Medical

A flood of patients who have become newly insured under the Affordable Care Act are visiting doctor’s offices and hospitals, causing some health workers to worry about how they can provide care to everyone in need. One group, however, isn’t lining up for care: People with mental health issues or substance use disorders. Though Obamacare […]

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Are Young Adults Heading to the Doctor?

Medical

I write about health and health care, but even I’m not immune to the “young and invincible” mentality. My annual dental checkup is more than six months overdue. A provision of the Affordable Care Act that took effect in 2010 aimed to make it easier for young adults to access preventive care by allowing them […]

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Analyzing Health Coverage Across America

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We know that about 10 million more people have insurance coverage this year as a result of the Affordable Care Act. But until now it has been difficult to say much about who was getting that coverage — where they live, their age, their income and other such details. Now a large set of data […]

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Do You Understand Nutrition Labels?

Medical

Are you among the half of Americans who say they check the nutrition labels on packaged foods when shopping? If you can read the information without a magnifying glass, do you understand what the many numbers mean to your health? Do you look only at calories, or do you also check the amounts of sugar, […]

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2015’s Open Enrollment Faces Several Hurdles

SWIM Inc

Fall open enrollment for the 2015 group health plan year is being dominated by employer frustration and uncertainty about implementing coverage and IRS reporting requirements under the health care reform law’s employer coverage mandate. “Open enrollment is going to present employers with some huge challenges this year,” said Steven Friedman, shareholder and employee benefits practice […]

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How Many Uninsured Have Health Insurance Now?

SWIM Inc

At its most basic level, the Affordable Care Act was intended to reduce the number of Americans without health insurance. Measured against that goal, it has made considerable progress. A perfect measurement of the numbers of people affected by the law is still difficult, but a series of private sector surveys and a government report […]

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CVS Health Prescription-Drug Plan Causing Controversy

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On the front of its Business Day section, the Wall Street Journal  (10/21, B1, Silverman, Ziobro, Subscription Publication) reports that a CVS Health prescription-drug plan will charge patients up to $15 more for medications from pharmacies selling tobacco products. The city of Philadelphia, with around 5,400 nonunion employees, is the first to enlist in the […]

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The Search for Family Health Insurance

Medical

The search for affordable family health insurance can get complicated given the intricate rules that determine eligibility for coverage, at times creating households where some relatives remain uninsured – while others can tap private and public plans. Challenges arise because eligibility guidelines can vary from one family member to another, depending on age, household income, […]

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What’s Your Fitness Age?

Medical

You already know your chronological age, but do you know your fitness age? A new study of fitness and lifespan suggests that a person’s so-called fitness age – determined primarily by a measure of cardiovascular endurance – is a better predictor of longevity than chronological age. The good news is that unlike your actual age, […]

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Employer Mandate Is A Bad Policy

SWIM Inc

If there’s one thing that the left and right can agree about on Obamacare it’s that the employer mandate is bad policy. The health care law’s requirement that companies with 50 or more full-time equivalent workers offer health insurance locks further in place our unique, and idiosyncratic employer-based health insurance system. But just because the […]

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Will Premiums Rise for Small Businesses?

Medical

Today we return to our series exploring lingering questions small-business owners have about the Affordable Care Act. Today’s question is a basic one: Will premiums for small businesses rise in 2015, and if so, how steeply? If you asked someone in the health insurance industry earlier this year — the executives at the insurance carriers […]

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Alternate Options to Offering Paid Healthcare Benefits

SWIM Inc

The cost for companies to provide healthcare benefits is at an all-time high, according to a new Towers Watson report. In 2014, healthcare costs reached an average of $9,560 per employee, and that’s just the employer’s share. The Affordable Healthcare Act mandates that companies with 50 or more full-time employees provide health coverage. However, small […]

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Employers Capping Health Care Procedures

Medical

In an effort to slow health care spending, more employers are looking at capping what they pay for certain procedures — like joint replacements — and requiring insured workers who choose hospitals or medical facilities that exceed the cap to pay the difference themselves. But a study out Thursday finds employers might be disappointed with […]

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Obamacare and The Individual Mandate Tax Dilemma

SWIM Inc

There are dozens of ways to escape Obamacare’s individual mandate tax — but good luck figuring that out come tax season. Tens of millions of Americans can avoid the fee if they qualify for exemptions like hardship or living in poverty, but the convoluted process has some experts worried individuals will be tripped up by […]

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Breast Cancer Resources

SWIM Inc

October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same. We have made a lot […]

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Skinny Networks are Being Offered to Reduce Costs

Medical

As the 2015 benefits enrollment season approaches and employers gear up for their second year of coverage mandates, as outlined in the Patient Protection and Affordable Care Act, it seems some employers still offer non-compliant health plans. A survey released in August by the National Business Group on Health revealed 16 percent of large employers […]

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Bill Passed for Employee Transit Tax Benefit

SWIM Inc

The New York City Council passed a bill Tuesday afternoon to require businesses with 20 or more full-time employees to provide access to a transit tax benefit. The heretofore optional program enables employees to pay for monthly train and bus fares with pretax earnings, potentially saving them hundreds of dollars on annual payroll and income […]

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Digital Health Records Have Become A Nuisance

SWIM Inc

As a practicing ear, nose and throat specialist in Ahoskie, N.C., Dr. Raghuvir B. Gelot says that little has frustrated him more than the digital record system he installed a few years ago. The problem: His system, made by one company, cannot share patient records with the local medical center, which uses a program made […]

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Do You Know Your Health Coverage?

Medical

Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, […]

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Employers Facing Health Insurance Deadlines

SWIM Inc

The clock is ticking for Tommy Cain and thousands of other U.S. employers facing deadlines to make changes to the health insurance they offer their employees under the Affordable Care Act. Mr. Cain has already met one of the law’s key requirements: offer health insurance to at least 70% of full-time staffers by 2015, or […]

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The Freelancers Union No Longer Providing Health Insurance

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The Freelancers Union, which provides health insurance to 25,000 of its members in New York State, is ending an experiment in providing low-cost insurance to independent workers, saying the new landscape created by the federal Affordable Care Act makes it impossible to do so. The union’s decision came after the state gave the Freelancers Insurance […]

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Another Ruling on Subsidies by a Federal Judge

SWIM Inc

Though New York is unaffected, yet another ruling that affirms enrollees in the Federal Exchange cannot receive subsidies. A federal judge in Oklahoma has ruled that Obamacare subsidies cannot go to residents of states that are not running their own insurance exchanges, a second blow to the Obama administration on a issue that threatens a […]

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Doctor Quality Data Unuseful to Consumers

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Consumers searching this fall for the best doctor covered by their new public or private insurance plan won’t get very far on a federal database designed to rate physician quality. The Affordable Care Act requires the Centers for Medicare and Medicaid Services to provide physician quality data, but that database offers only the most basic […]

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Incentives Moderately Effective on Medical Spending

Medical

Health plans that cover two-thirds of commercially insured Americans used incentives this year to motivate hospitals and doctors to improve quality and manage costs, according to a survey. Those contracts were responsible for 40% of insurers’ medical spending. The survey is the second by Catalyst for Payment Reform, a health policy not-for-profit founded and funded […]

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Employers Misclassifying Workers to Avoid Offering Health Coverage

Medical

Since the onset of the recession, there has been a surge in worker misclassification litigation and enforcement against employers that are trying to effectively manage their finances, but are incorrectly classifying their workers. There is also concern around the Affordable Care Act’s employer mandate, which may make misclassifications a tempting alternative to offering group health […]

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High Number of Young Adults Signing Up For Health Insurance

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The Affordable Care Act’s supporters and detractors have consistently agreed on one thing: the success or failure of the law hinges on the whether young adults, who tend to be healthier and less expensive to insure, enroll. New data released last week shows that more young people are getting health coverage, and in stunning numbers. […]

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Decrease in Health Care Spending Leads to Shrinking Deficit

SWIM Inc

Conventional wisdom in Washington surrounding health care spending has been doom and gloom — the solvency of federally mandated programs like Medicare and Medicaid has even been brought into question. The pace of growth in costs seemed unsustainable, with projected payouts threatening to strain an already worrisome federal budget deficit. But it appears there’s a […]

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New York Market Shrinking While Others Increase

SWIM Inc

Contrary to the national reports, the New York market is shrinking as carriers exit the market due to their requested rate increases being denied by the review board. Several high-circulation outlets and beltway sources report the news of more insurers joining the marketplaces created under the Affordable Care Act. The news is seen as good […]

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Millions of Children to Lose Health Benefits if CHIP Funding Not Renewed

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The Hill (9/23, Ferris) reports on a study from the American Action Forum that found “as many as 2.7 million children could lose health coverage or benefits” beginning next year if Congress does not move to reauthorize CHIP funding. While many on both sides of the aisle in both chambers of the legislature have “pushed […]

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Are These Marketplaces Affordable?

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In the Affordable Care Act marketplaces, which now serve 7.3 million Americans, some premiums are going up while others are going down. Based on data available so far, we reported last week that the average premiums for last year’s most popular plans would rise 8.4 percent, but that people willing to switch plans could get […]

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Business Owners See Respite in Health Insurance Costs

Medical

A steady rise in health insurance costs appears to be slowing down for business owners. But with several important changes still looming under the health care law, it’s unclear whether that will continue in the years ahead. Health costs for employers increased only 3 percent last year, according to the Kaiser Family Foundation’s recently released […]

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Companies Turning to Private Exchanges for Lower Costs

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Companies that turned to a new private exchange concept of giving their workers money to buy health benefits via online marketplaces continue to see lower health care costs than trends for most other employers, saving “more than $750 per worker” for 2015, according to benefits consultancy Aon Hewitt (AON). Across companies on its private exchange, […]

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When You Were Born Affects Health Insurance

Medical

Whether Americans had health insurance before Obamacare had a lot to do with when they were born. This chart from the Census Bureau’s new report on health coverage shows the rate at which Americans of different ages were uninsured in 2013. Between 5 percent and 10 percent of kids have no health insurance. That rate […]

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Number of Americans Without Health Insurance Has Dropped

SWIM Inc

Federal researchers reported on Tuesday that the number of Americans without health insurance had declined substantially in the first quarter of this year, the first federal measure of the number of uninsured Americans since the Affordable Care Act extended coverage to millions of people in January. The number of uninsured Americans fell by about 8 […]

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Alt-Labor Groups Find Partnership with the Affordable Care Act

SWIM Inc

Officials at Working America, the AFL-CIO’s non-union affiliate, believe they may have found a path toward long-term financial viability — and it runs through the Affordable Care Act. The big question for so-called alt-labor groups like Working America — which have been sprouting up as the ranks of traditional unions dwindle — is how they […]

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Health Care Spending on the Uptick

Medical

Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show. But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth […]

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The Skinny on Narrow Health Care Networks

SWIM Inc

Lots of people shopping in the new health care marketplaces this year picked health plans that limited their choice of doctors and hospitals. The plans were popular because they tended to cost less than more conventional plans that covered nearly every health care provider in a region. The proliferation of these more limited plans, called […]

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ACA Has Little Impact on Health Care Attained Through Employers

SWIM Inc

Politico (9/11, Norman) reported that a survey released Wednesday by the Kaiser Family Foundation showed that the Affordable Care Act “so far has had little impact on the insurance people get through their jobs,” and that premiums increased 3% in the first year of healthcare exchanges. According to Politico, the survey also found that roughly […]

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Myths and Truths to Pesky ACA Questions

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The Affordable Care Act has been a topic heavily covered in the news for over four years now, and it’s not showing any signs of slowing down. All the buzz has inevitably led to some confusion of facts and inaccuracies of truth when it comes to what employers should know about the ACA. Between the […]

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Severe Respiratory Illness Hitting Children, More Families Covered

Medical

Federal health officials are asking physicians to watch for clusters of a rare and severe respiratory illness that is landing children in the hospital and hitting children with asthma particularly hard. The enterovirus D68, or EV-D68, has led to increases in pediatric ER visits, hospitalizations and intensive care-unit stays in Kansas City and Chicago, and […]

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Young Adults Have Reduced Their ER Visits

SWIM Inc

Emergency department use slowed for young adults up to age 26 once they were allowed to stay on their parents’ health plans under the Affordable Care Act, according to new research. A new study from Stanford University researchers published Monday in the September issue of the journal Health Affairs showed young adults ages 19 to […]

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Employers Adjusting Employee Benefits

SWIM Inc

Large businesses expect to pay between 4 and 5 percent more for health-care benefits for their employees in 2015 after making adjustments to their plans, according to employer surveys conducted this summer. Few employers plan to stop providing benefits with the advent of federal health insurance mandates, as some once feared, but a third say […]

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Health Care Spending Down, For Now

Medical

The latest federal estimates of health care spending offer some good news: The growth rate for spending in 2013 will remain at a low level for the fifth straight year. But the bad news is, spending is expected to rise faster than growth in the economy over the next 10 years. The big unanswered question […]

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September is Life Insurance Month

SWIM Inc

How can your health or lifestyle affect your insurance rates? When you apply for individual life or health insurance, you provide answers to detailed questions regarding your health. Your answers provide insurance companies with an idea of your overall health. Based on your answers, insurance companies may ask for additional medical information or tests prior […]

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New IRS Forms for Tax Credits

SWIM Inc

If you got health coverage through President Barack Obama’s law this year, you’ll need a new form from your insurance exchange before you can file your tax return next spring. Some tax professionals are worried that federal and state insurance marketplaces won’t be able to get those forms out in time, creating the risk of […]

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Here are a Few Resources for Mental Illness Treatment

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More than 60 million American adults — one in every four — suffer from some form of mental illness, ranging from panic disorders to depression, according to mental health professionals. Nearly 14 million live with a serious mental illness, such as bipolar disorder, schizophrenia and severe depression. Americans often don’t know where to turn when […]

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Big News Regarding Medicare

SWIM Inc

You’re looking at the biggest story involving the federal budget and a crucial one for the future of the American economy. Every year for the last six years in a row, the Congressional Budget Office has reduced its estimate for how much the federal government will need to spend on Medicare in coming years. The […]

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More High-Deductible Plans to be Offered

SWIM Inc

Anita Maina was working on an arts and crafts project she found on Pinterest — creating a table out of wood and cork — when she ripped off a fingernail while removing staples from a piece of wood. “It is one of those things that really hurt, and I thought I should go to urgent […]

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End-of-Life Coverage May Be Covered as Soon as 2015

Medical

Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year. Bypassing the political process, private insurers have begun reimbursing […]

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CVS Pushing for More Hospital and Health Care Affiliations

Medical

CVS Caremark pushed further ahead of rival Walgreen in launching today more partnerships with hospitals and health care systems as clinical affiliations become more common in the era of the Affordable Care Act. CVS/Caremark’s announcement today that it has entered into a clinical affiliation with MedStar Health, a 10 hospital system in Maryland and the […]

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The Cost of Patient Care, The Rise of Tech

Medical

Health insurance companies, now required to spend the lion’s share of premium revenue on patient care, are looking for higher investment returns elsewhere. As a result, they’re increasingly putting money into technology ventures where they expect to realize higher returns. The medical-loss ratio standard under the Patient Protection and Affordable Care Act requires insurers to […]

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Administration Proposing Workaround on Contraceptive Coverage

SWIM Inc

The Obama administration is proposing a workaround to provide contraceptive coverage to employees of closely held companies that object on religious grounds. It was not immediately clear whether this latest compromise would finally defuse the controversy that has yielded dozens of lawsuits challenging the administration’s policies on the coverage. Under a proposed rule issued Friday, […]

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Why Employees are Taking Advantage of Group Health Insurance

SWIM Inc

In an earnings call last week, Walmart announced that its workers were signing up for health insurance en masse. The news was bad for the company’s shareholders, since the added $500 million it will cost to cover them will eat into expected profits. But it also means that many more low-income families have health insurance […]

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Large Employers Expect a Jump in Healthcare Cost for 2015

Medical

The Los Angeles Times (8/14, Terhune) reports that on Wednesday, the National Business Group on Health released its annual survey, which shows that “large employers expect their healthcare costs to jump 5% next year, and nearly a third of businesses will offer only higher-deductible plans to workers.” The Times notes that when “asked what’s driving […]

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The Obama Administration Hires Google Professional

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Faced with the politically devastating collapse of HealthCare.gov last year, President Obama’s White House staff lured Mikey Dickerson away from Google to save the day. Mr. Dickerson will lead a new government team that is intended to identify and fix the government’s other failing computer systems and websites, officials said Monday. The decision to hire […]

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The Case for Startups Offering Employee Benefits

SWIM Inc

In years past, companies of all shapes and sizes needed to offer a good employee benefits program, with which to attract the best candidates. That was even true for early-stage startups, since that was one of the hooks to get someone to leave their big company jobs and rich benefits packages. But, a lot of […]

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Changes to The Small-Business Health Market

SWIM Inc

Several thousand of the nation’s smallest business owners—sole proprietors and the self-employed—were kicked off their small-business plans by carriers earlier this year. That is because new guidelines define “employers” as having at least two full-time employees, not including a spouse, in order to be eligible for group plans. In all, more than 78% of the […]

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Women and the Battle for Quality Facilities to Give Birth

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As a husband and father of three (girls), this is of interest to me. Where a woman delivers her baby can make a major difference to her own health — a quality gap that remains largely hidden from mothers-to-be. A new study comparing hospitals nationwide finds that women who delivered at low-performing facilities suffered more […]

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Five Minutes of Exercise has Great Impact on Longevity

Medical

Running for as little as five minutes a day could significantly lower a person’s risk of dying prematurely, according to a large-scale new study of exercise and mortality. The findings suggest that the benefits of even small amounts of vigorous exercise may be much greater than experts had assumed. In recent years, moderate exercise, such […]

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Mayor de Blasio Incentives Unions to Reduce Health Costs

Medical

When Mayor Bill de Blasio announced his first labor agreements with New York City unions this spring, he was sharply criticized for granting long-awaited wage increases in exchange for promises of unspecified though sizable savings on health care expenses. Now, some of the specifics are coming into focus: City officials and union leaders say they […]

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The IRS Issues Group Insurance Compliance Form Draft

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The Internal Revenue Service has issued draft versions of the reporting forms most employers will begin using next year to show that their group health insurance plans comply with the health care reform law. The long-awaited draft forms, posted late Thursday afternoon to the IRS’ website, are the first practical application of employers’ health care […]

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What You Need to Know About 2015 Renewals

SWIM Inc

If you have health insurance on your job, you probably don’t give much thought to each year’s renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises. Insurance exchange customers who opt for convenience by automatically renewing their coverage for 2015 are likely to […]

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Have You Disagreed with Your Doctor Before?

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So what do you do if you don’t agree with your doctor’s advice? Amber Taufen, a 33-year-old freelance writer and editor in Denver, Colorado, was surprised to learn at age 25 that she had high cholesterol. Taufen had gone to the doctor six weeks after her father died to get a prescription for the anti-depressant […]

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Court Rules: No Subsidies for Individuals for Health Insurance

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A federal appeals court has ruled the Obama administration cannot subsidize insurance premiums for nearly 7 million Americans, dealing a serious blow to the Affordable Care Act (this does not impact state funded exchanges like New York and Connecticut). The ruling sets up an almost-certain appeal to the U.S. Supreme Court. Two judges with the D.C. […]

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The Obama Adminstration Setting Standards for Health Plan Networks

Medical

The Obama administration and state insurance regulators are developing stricter standards to address the concerns of consumers who say that many health plans under the Affordable Care Act have unduly limited their choices of doctors and hospitals (mostly individual, not group plans), leaving them with unexpected medical bills. Carriers are looking to further stratify their […]

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Long-Term Implications of ACA and Employers

SWIM Inc

While employers are continuing to feel the impact from a multitude of changing laws and regulations, worries about the Affordable Care Act have begun to subside, to some degree. But the jury is out on the long-term implications of the ACA, and the ways benefits managers will live up to its stipulations in coming years. […]

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Google Contact Lenses a Reality

Medical

Remember Google’s smart contact lenses? Well, now the giant Swiss pharmaceutical company Novartis is turning them into a commercial reality. The two companies have announced that Novartis is licensing Google’s technology to create special contact lenses for diabetic patients. The new lenses will analyze tear fluid in the eye and provide real-time, constant measurement of […]

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HSAs Popular Among Employers

Medical

Health savings accounts are gaining in popularity with small to mid-size employers at the same time the appeal of health reimbursement accounts is waning. A recent United Benefit Advisors survey finds HSAs are outpacing HRAs in both adoption and participation rates. The number of employers offering HSAs increased from 14.7% to 15.1% in 2013, and […]

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Human Resource Professionals State Health Benefits Key to Attracting Workers

SWIM Inc

Employers have offered employees a greater variety of health and wellness benefits in the past five years, including coverage for mental health care and contraception, according to a report by the Society for Human Resource Management. The 2014 SHRM Employee Benefits report showed that 87% of employers offer mental health coverage in 2014, down from […]

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Are You Fearful of Your Employer Dropping Health Coverage Due to Obamacare?

SWIM Inc

Obamacare requires most employers to offer coverage next year, but fears persist that many will dump workers onto the insurance exchanges instead. Fear not, for now. Q: I’ve heard that some firms may drop their health plans and have workers purchase a plan on the government exchanges. Will that happen to me? A: Nine months […]

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The Future of Data Collection for Health Care

Medical

Companies like Fitbit and Nest Labs have realized there’s a lucrative business in selling the data collected by wearable devices and smart home automation devices. The technology can be used for much more than turning down the temperature in your home or tracking how many calories you’ve burned today. It can be utilized to address larger […]

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Predictive Health Analytics are Forecasting your Health Care Consumption

Medical

There may be a link between your Internet use and how often you end up in the emergency room. At least that’s one of the curious connections to emerge from a health care analysis project at the insurance division of the University of Pittsburgh Medical Center. U.P.M.C. is a $12 billion nonprofit enterprise that owns […]

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No Need to Visit HealthCare.gov to Renew Insurance

SWIM Inc

The Obama administration announced Thursday that most people would be able to renew subsidized health insurance coverage without filing an application and without going back to HealthCare.gov, the website that frustrated millions of consumers last fall. But some people will have to go into the marketplace again — if, for example, their income has changed […]

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SCOTUS Rules on Contraceptive Requirement

Medical

SCOTUS ruled on Monday that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom. It was, a dissent said, “a decision of startling breadth.” The 5-to-4 ruling, which applied to two companies owned by Christian families, opened the door to many challenges from […]

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People Enrolled in ACA Have Higher Rates of Health Problems

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The Wall Street Journal (6/25, A1, Mathews, Weaver, Subscription Publication) reports in a front-page story that an analysis of medical claims, conducted by Inovalon Inc., a health-technology firm, shows that people enrolled in new plans under the ACA have higher rates of serious health problems than other consumers, which according to insurers, could result in […]

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Five Things Naturally Fit People Do Differently

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I read a lot of articles every day on wellness, insurance, underwriting, and many other topics. This article really spoke to me, and I wanted to share it with you. Some simple, everyday tips on how to live a fit life. I hope you enjoy the read! We all know those people — the ones […]

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Students’ Options for Health Insurance

Medical

With the Affordable Care Act, twenty-somethings now have the opportunity to remain on their parents’ plan until they reach the age of 26. While this is good news for the struggling grad-students, this also means that some of you (or most of you) will choose to remain uninformed about health insurance options until it’s absolutely […]

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Premium Proposals Vary Across States

SWIM Inc

As insurers across the country continue to finalize their rate proposals for 2015, several outlets carry assessments of these filings. In a front-page analysis of the 2015 insurance rates from the 10 states that have completed their filings so far, the Wall Street Journal (6/19, A1, Radnofsky, Subscription Publication) reports that in all but one […]

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More Insurance Plans Sold Through Private Exchange

SWIM Inc

Employers are moving more quickly than forecasted to offer health insurance to their workers through private exchanges, according to new data from Accenture, a consulting firm. Three million people signed up for workplace health coverage for this year through private exchanges, Accenture said. That’s roughly three times the number of people the firm had estimated […]

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Wellness Tips Advisors Can Help Employers Avoid

Medical

1. Imposing goals on employees rather than empowering them to set their own goals Every employee is unique. Yet most wellness programs present cookie-cutter program goals that may not tailor or attract much of the employee population, says Bierbower, adding that effective wellness programs ask employees what they want to accomplish and encourage them to set […]

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Insurers to Revamp Law to Reduce Catastrophic Plan Premiums

Medical

Insurers want to change President Barack Obama’s health care law to provide financial assistance for people buying bare-bones coverage. That would entice the healthy and the young, the industry says, holding down premiums. So-called catastrophic plans are currently not eligible for the law’s subsidies, and only 2 percent of the 8 million consumers who signed […]

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Wide Gaps in Healthcare Prices

SWIM Inc

A patient insured through an employer in Dallas might pay as little as $15 or as much as $343 for a cholesterol test, and a patient in Philadelphia could pay anywhere between $264 and $3,271 for a head CT scan, according to a new cost-comparison map from Castlight Health. The company, which sells price transparency […]

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ACOs Push for Telemedicine Regulation Changes

Medical

A band of industry, trade groups and accountable care organizations has sent a coordinated series of three letters to new HHS Secretary Sylvia Mathews Burwell pushing potential changes to the ACO program to better accommodate telehealth and remote patient monitoring. That aspect of the connected health sector has been frustrated by a patchwork of regulations […]

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Careful How You Label Your Contractors and Employees

SWIM Inc

Like many startups in the city, online fitness community BuiltLean relies on a collection of contractors to tackle projects from video production to Web development. “I think they enjoy the flexibility of freelancing,” said founder and Chief Executive Marc Perry, who turns to sites like oDesk for the talent he needs to keep his traffic […]

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A Look at Wellness Program Strategies

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With the impact of health care reform still evolving, employers are taking a fresh look at their strategies for keeping employees healthy and productive. Optum research shows that despite the still struggling economy, wellness program budgets have largely remained stable. In fact, more than one-fifth of employers we surveyed reported spending more than last year. […]

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IRS Issues Penalties for Pre-Tax Money to Buy Individual Insurance

SWIM Inc

The IRS has issued an update on employer penalties, specifically citing employers offering pre-tax monies to their workers to purchase individual insurance. The IRS calls this an employer payment plan, and is viewed as a group health plan that does not meet the Affordable Care Act (ACA) rules. For example, employer payment plans do not […]

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Hospital Systems Scaling Back Financial Assistance

SWIM Inc

Hospital systems around the country have started scaling back financial assistance for lower- and middle-income people without health insurance, hoping to push them into signing up for coverage through the new online marketplaces created under the Affordable Care Act. The trend is troubling to advocates for the uninsured, who say raising fees will inevitably cause […]

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Thirty Percent of World’s Population is Obese

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Nearly 30 percent of the world’s population is overweight or obese, and not one country has reduced its obesity rate in 33 years, according to a new study combining three decades of data from 188 countries, published in The Lancet last month. Though there are patterns, obesity is not evenly distributed by region, by ethnic […]

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Cost for Common Hospital Procedures Keep Going Up

Medical

Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday. While it has long been known that hospitals bill Medicare widely varying amounts — […]

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A Look Into Doctors Treating Patients Like Themselves

Medical

New York Times Blog Hard Cases delves into the unpredictable outcomes of doctors taking care of patients who are exactly like themselves. Dr. Abigail Zuger explores interpersonal chemistry, gender, and ethnicity to determine what binds and estranges patients and doctors. Furthermore, if this type of connection causes any different outcome in patients’ health. “Professional training […]

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New York to Create Medical Record Highway

SWIM Inc

In a much-anticipated move, the New York state Legislature recently agreed to spend $55 million to create a statewide digital highway for New Yorkers’ medical records. Known as the State Health Information Network of New York, and called “Shiny” for its acronym, SHIN-NY, the project will connect millions of patients, thousands of doctors and scores […]

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Affordable Care Act Divides Workers and Employers

SWIM Inc

Disputes between unions and employers over paying for new costs associated with the Affordable Care Act are roiling labor talks nationwide. Unions and employers are tussling over who will pick up the tab for new mandates, such as coverage for dependent children to age 26, as well as future costs, such as a tax on […]

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Tips on Staying Safe This Summer

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Memorial Day is this weekend and the official start of summer, beaches, Hamptons, rooftop, and BBQs. Summer is also the start of many preventable accidents. Here are some tips from an emergency room physician Dr. Brady Pregerson who has seen his fill of accidents. Here are some tips on staying safe while having fun this […]

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Organization of Economic Research and Development to Measure the ACA

SWIM Inc

Research by the Organization of Economic Research and Development has gathered 15 years of data on diseases to measure the effectiveness of the Affordable Care Act. Charting the numbers number of deaths from diseases that could have been prevented if the patient had access to appropriate health care, called the “amenable mortality” rate, shows that the […]

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Government Paying Incorrect Subsidies to Over 1 Million Americans

SWIM Inc

The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable to fix the errors, according to internal documents and three people familiar with the situation. The problem means that potentially hundreds of thousands of people are receiving bigger subsidies […]

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Insurance Giants Join Forces to Create Healthcare Transparency

SWIM Inc

The public has been demanding healthcare transparency. Finally, three of the largest health plans have joined forces to finally shed light on claims payment data. UnitedHealthcare, Aetna, and Humana announced they will be working together with the Health Care Cost Institute to focus on healthcare transparency. They will create a payment database that will be available […]

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Consumers Who Have Insurance Through The Exchange Have Buyers Remorse

Medical

Some consumers who bought insurance under President Barack Obama’s Federal Exchange are experiencing buyer’s remorse after realizing that their longtime doctors aren’t accepting the new plans. Before the law took effect, experts warned that narrow networks could impact patients’ access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are […]

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May is National Melanoma/Skin Cancer Awareness Month

Medical

May is National Melanoma/Skin Cancer Awareness Month, here’s a quick guide on identifying lesions. Click here to see. Jeffrey R. Ungvary President  

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Five Million Uninsured People Gained Insurance Because of Obamacare

Medical

According to the Department of Health and Human Services, about 87% of people who signed up through federal health care exchanges were previously uninsured. Here’s how the percentage was determined: Of the 5.45 million people who signed up through the federal exchange, 5.18 million (or 95%) applied for financial assistance in their insurance plans. In […]

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The LinkedIn for Doctors

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Did you know there’s a good chance your doctor is sharing casework and referrals about you over such a network, and they don’t really want you there getting in the way, either. The network’s called Doximity, and it claims that 4 out of 10 doctors in the U.S. now uses it to meet other doctors, […]

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Misconceptions About Who Pays for Health Care

Medical

Eight million people have signed up for subsidized private health insurance under the Affordable Care Act, President Obama said this month. Millions more obtained new coverage through the Medicaid program for the poor. Full implementation of the health law has renewed discussions of winners and losers, makers and moochers. To read more, click here. Jeffrey […]

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Pretax Money for Subway Fares May Become Required

SWIM Inc

Currently an optional benefit, this mandate would require many employers to establish the accounts. We’ve been assisting groups with these accounts for years, so look to us for assistance. To read more, click here. Jeffrey R. Ungvary President

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Restrictions to New York Affordable Care Act Health Plans

Medical

New York State health officials said on Friday that they would not require out-of-network coverage on Affordable Care Act health plans next year, a decision likely to disappoint customers who have complained that they can no longer use their favorite doctors and hospitals. To read more, click here. Jeffrey R. Ungvary President

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The Culprit Behind Insurance Cancellations

SWIM Inc

A study by Harvard Professor Benjamin Sommers supports the Obama Administration’s claims that last year’s health insurance cancellations were part of the normal churn of the individual health market. The study states “found that the market was characterized by high turnover before the Affordable Care Act was implemented.  Additionally, most people who left the nongroup […]

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IRS Announces Inflation-Adjusted Increase for HSAs

Medical

The IRS released increases for HSAs and high-deductible health plans (HDHPs) for 2015. The maximum annual HSA contribution for self-only HDHP coverage will increase from $3,300 to $3,350. The maximum annual HSA contribution for family HDHP coverage will increase from $6,550 to $6,650. The age 55 catch-up contribution continues to be $1,000 The minimum HDHP […]

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Medicare vs. Private Insurance

Medical

CNNMoney analyzed the “allowed charges” for five common procedures, using data provided the Centers for Medicare and Medicaid Services and Truven Health Analytics, a research firm. The differences can be stark. Private insurers allow an average of $1,226 for low-back disc surgery, while Medicare will only permit $654, for instance. To read more, click here. […]

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Federal Government Approves $8B for New York Health Care Systems

Medical

After three months of scrupulous negotiations between the state and the U.S. Department of Health and Human Services, New York will be able to spend up to $8 billion of the $17.1 billion in federal savings generated by the state’s Medicaid reform. To read more, click here. Jeffrey R. Ungvary President

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Kathleen Sebelius Resigns as Health Secretary

SWIM Inc

After a storm of criticism for a poor launch of the Healthcare.gov website, Kathleen Sebelius has resigned. President Obama will appoint Sylvia Mathews Burwell, the Director of the Office Management and Budget. To read more, click here. Jeffrey R. Ungvary President

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Victory for Health FSAs, HRAs, and HSAs

Medical

In early April, President Obama signed the Protecting Access to Medicare Act, which repeals a troubling provision of the Affordable Care Act (ACA) for small group market health plans. This law has an indirect, but positive effect on account-based plans for small employers. To learn more regarding the repeal, click here. Jeffrey R. Ungvary President

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Happy National Employee Benefits Day

SWIM Inc

Today is National Employee Benefits Day. According to the Employee Benefits Research Institute, almost nine in ten people don’t think they’ll have enough saved when they get to retirement. Study after study provides data pointing to the same conclusion: A crisis is coming. Are your plan participants prepared for it? Learn more at the International Foundation […]

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April’s Hope Health is Here

Blog-Icons-Life

April’s issue of Hope Health Newsletter is ready for you to read! Click here to read this month’s PDF. Ch, ch, chia Getting couch-potato pals to embrace exercise From night owl to early bird Controlling your control issues The ABCs of IRAs Rethinking drinking Fill up on fiber We hope you enjoy reading these articles from Hope […]

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Obamacare Deadline and The SHOP

Medical

Leading news stories this week focus on Obamacare enrollment reaching their 6 million mark and extending enrollment for those who began the process. However some states like New York have set a hard deadline for March 31st. To read more, click here. Also reaching headlines is the Small Business Health Options Program (SHOP). Business with 50 […]

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SWIM Joins the Bronxville Chamber of Commerce

SWIM Inc

SWIM Inc. is proud to be part of the Bronxville Chammber of Commerce. With one of our offices in the Bronxville area, it was important for us to be part of our community and be able to assist local businesses with their insurance needs. To read more about SWIM Inc and the Bronxville Chamber of […]

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Tax Subsidies the New Challenge for Health Law

SWIM Inc

A new argument that may cause woes to Obamacare came to United States Court of Appeals for the District of Columbia Circuit. The plaintiffs state the language in the Affordable Care Act makes subsidies available only to people who buy insurance through marketplaces established by states. Stuart F. Delery, an assistant attorney general, told the appeals court […]

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Push for Consumer Protection from Out-of-Network Medical Bills

SWIM Inc

Benjamin M. Lawsky, Superintendent of Financial Services is urging New York State Legislatures to push a state budget protecting consumers for surprise out-of-network medical bills. Joined by consumer advocates, Superintendent Lawsky implores Legislators to protect New Yorkers who have done everything right and then are hit with a surprise bill that can run into the […]

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Paid Sick Leave is Now a Law

Medical

New York City Mayor Bill de Blasio signed the paid sick leave bill into law today. The new measure will take effect April 1st. More than a half-million New Yorkers will now be able to take up to five sick days without fear or losing their job at businesses with five or more employees. To […]

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Section 105 Plans and Other Reimbursement Arrangements

SWIM Inc

This is one question we get time after time. Here is an article form Health Insurance Underwriter which covers this topic extensively and reviews the law and what you can and can’t do.  To read the article, click here. Jeffrey R. Ungvary President  

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Do you Really Need Those Medical Tests?

Medical

A recent AARP article  sheds light on certain common tests that may be unnecessary and may be greater harm than good. “The American Board of Internal Medicine Foundation asked more than 50 medical societies — of family doctors, oncologists, cardiologists and other specialties — to identify tests and treatments that are often unnecessary. AARP is […]

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Two-Year Extension for Non-Compliant Policies

Medical

The Obama Administration today announced another delay in the implementation of the Affordable Care Act (ACA). The latest delay allows individual policyholders with current plans that do not meet the ACA’s minimum coverage requirements to keep their plans for another two years if permitted by their state and the insurer continues the plan. As a […]

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Simple Changes to Food Labels are Eye Catching

Medical

Proposed changes by the FDA to food labels are simple, yet impactful. Take a look at the proposed changes here. Jeffrey R. Ungvary President

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Open Enrollment is Closing Soon

Medical

For those who are waiting to get coverage, your time is coming to a close and soon. March 31st is the last day to sign up for coverage, and if you don’t you’ll have to wait for 2015 and the rates set for that year. Since February, there have been 700,000 enrolled raising the total […]

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Beat the Winter Blues with these Recipes

SWIM Inc

Summer is coming, but we have a few more weeks before we transition into spring then summer.  Don’t be blue though, we’ve found some great recipes to get you through the next few weeks, view them here. Jeffrey R. Ungvary President

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Long-term Jobless may Finally get a Break

SWIM Inc

The rhetorical back-and-forth  regarding the Affordable Care Act can figuratively give you whip lash (unless you have multiple browsers open, then it maybe literal). The recent Congressional Budget Office reported back a few weeks ago that the Affordable Care Act would eliminate two-million jobs, but the reaction to that should be positive. As PBS reports, […]

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Pediatricians vs. Retail Medical Clinics

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The American Academy of Pediatrics stands to reason that kids should not receive primary care from clinics at retail outlets.  To read more on the American Academy of Pediatrics’ argument on seeing your PCP, click here. Jeffrey R. Ungvary President

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Flu Strikes the Young Invincibles Hardest this Year

Medical

The Center for Disease and Control reported people between the ages of 18 and 64 represent 61% of all influenza-related hospitalizations recorded during the current flu season. To read more, click here. Jeffrey R. Ungvary President  

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Private Exchanges are Popular

Medical

Due to unpopularity of HealthCare.gov and other woes, private exchanges have become increasingly popular. Recent success for private exchanges can be attributed to many reasons, but not qualifying for federal help pushed them to seek other remedies. To read more, click here. Jeffrey R. Ungvary President

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A Morning of Heart Healthy Talks with The Local Community

SWIM Inc

Valentine’s Day conjures up chocolates, roses, dinners, and other gifts, but  President of SWIM Inc, Jeffrey Ungvary, wanted to give his community something a little more from the heart. Celebrating the launch of his Bronxville office, Jeff took this opportunity to celebrate with local business owners and open the floor to any questions they may […]

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One in Five Haven’t Paid Their Premiums

SWIM Inc

A follow up on f one of our previous posts, many who signed up for health care through The Exchange did not pay. Under federal rules, people must pay the initial premium to have coverage take effect. To read more, click here. Jeffrey R. Ungvary President  

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Uninsured Adults Down, how the Government is Tackling this Issue

SWIM Inc

The government has been focusing steadily on lowering the percentage of uninsured adults aged 18-34. One of the many goals of the ACA was to sign up young, healthy adults to offset costs. The governments tactics to reach and sign this demographic has been somewhat effective. Here are two articles focusing on their progress. Reuters: […]

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Funding Won’t Help Struggling Hospitals

Medical

Federal health officials agreed to funnel $8 billion dollars to overhaul New York state’s health care system. Crain’s New York states that even with the injection of money into struggling hospitals won’t keep them from failing. To read the article, click here. Jeffrey R. Ungvary President  

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Affordable Care Act is Here to Stay

Medical

A great article to understand why the Affordable Care Act is here to stay. To read the article, click here. Jeffrey R. Ungvary President

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ICD-10 Code to Increase Doctor Fees

SWIM Inc

Beginning October 1, 2014, HIPPA has set a new set of doctor codes that will increase medical costs. To learn more, click here. Jeffrey R. Ungvary President

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The Joys and Woes of Freelancers

SWIM Inc

In New York City alone, the Freelance Union’s membership has surged since the Great Recession, jumping to 146,477 last year from 76,760 in 2008.  To read more, click here. Jeffrey R. Ungvary President

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ACA Mandate for Medium Size Employees Extended to 2016

Medical

The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full-time workers. To read more, click here. Jeffrey R. Ungvary President

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Unemployment Down but so is Payroll

SWIM Inc

This weekend’s The New York Times article, stated that although the unemployment rate was down to 6.6%, payroll data shows a lag in wages signaling a momentum loss for the economy. To read more, click here. Jeffrey R. Ungvary President

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Geotargeting the Uninsured

SWIM Inc

The Associated Press reports that the Obama administration will target the uninsured with geographic campaigns. To continue reading, click here. Jeffrey R. Ungvary President

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Health Care Law to Reduce Employment

Medical

According to a new analysis by Congressional Budget Office,  people are scaling back how much they work and instead getting health coverage through the Affordable Care Act. To read more, click here. Jeffrey R. Ungvary President

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CVS to Stop Selling Cigarettes

Medical

In an effort to push wellness, beginning on October 1st, 2014, you will no longer be able to pick up smokes at CVS. Click here to read more. Jeffrey R. Ungvary President

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New York Last in Minute Clinics

Medical

Nationwide there are 800+ CVS minute clinics. In New York, there are only six. Click here to read more. Jeffrey R. Ungvary President

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Let’s Beat Cancer

Blog-Icons-Life

Today is World Cancer Day! Awareness is the first step to early detection and improving cancer outcomes. To learn more about what you can do, click here. Jeffrey R. Ungvary   President    

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February’s Hope Health Is Here

Medical

February’s issue of Hope Health Newsletter is ready for you to read! Click here to read this month’s pdf. Featured Articles The juicy truths about oranges Roll away soreness A prescription for avoiding medical mistakes Keeping up with the e-Joneses The basics of biweekly mortgage payments Dental emergencies: a survival guide for parents Clever ways […]

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Prescription Lenses Coming Soon for Google Glass

Blog-Icons-Life

Google announced it will add Google Glass options for prescription glasses, a move to make the eyewear more fashionable. To read more click here. Jeffrey R. Ungvary President

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Doubt Conjured by Slow Enrollment of Small Group to The Shop

SWIM Inc

Article from Bloomberg states, “Enrollment in Obamacare health plans for small businesses is off to a slow start, leaving in doubt whether the U.S. program can attract enough customers to satisfy insurers.” To read more, click here. Jeffrey R. Ungvary President  

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The Confusion for Insurance Hikes

Medical

A common question we hear from our clients is “why are insurance rates going up.” Back in October 2013, we blogged about this burning question; here’s a link to our post to as a refresher. Three months later, The New York Times reports, people signing up through the Affordable Care Act’s marketplaces tend to be […]

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Young New York Health Care Subscribers Run Into Obstacles

Medical

From the New York Times, New York is enrolling a significant number of young subscribers on its health insurance exchange, but many of those already enrolled have raised questions about rules that limit which doctors they can see, or are having problems finding out if their doctors are covered, according to testimony at a State Senate […]

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FAQS About Affordable Care Act Implementation (Part XVIII) And Mental Health Parity Implementation

Medical

The U.S. Department of Treasury Labor (DOL) and Health and Human Services (HHS) issued FAQs Part XVIII (18), which includes 12 questions and answers on various Patient Protection and Affordable Care (PPACA) implementation areas as well as on the Mental Health Parity and Addiction Equity Act (MHPAEA). Jeffrey R. Ungvary President    

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Health Care Coverage Cost and Tax Season Compliance

SWIM Inc

Are you an employer that offers or provide group health coverage to your workers?  Were you required to file 250 or more Forms W-2 for tax year 2012?  If so, an Affordable Care Act/IRS requirement to report health care coverage costs on Forms W-2 for 2013 applies.  What follows below is important information so that you can […]

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President of SWIM Featured in Life Health Pro

SWIM Inc

Look at the insurers’ own provider directories. Jeff Ungvary, president of Strategic Wellness & Insurance Management Services Inc., said he thinks brokers should also talk about the ramifications of network decisions when helping customers choose health coverage. When he helps midsize employers analyze networks, he gets a list of the enrollees’ primary care doctors and […]

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A Look Back on 2013’s Road to Health Care

SWIM Inc

Although the Federal Exchange had a lot of hiccups and fumbles, New York hit the mark just right. Take a look back on 2013, with NY1’s Health in Review, here.   Jeffrey R. Ungvary President

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One Day Extension to Sign Up for Obamacare

Medical

Breaking News from CNN: The federal government is extending the deadline to apply for Obamacare coverage until Christmas Eve. Americans can now sign up as late as Tuesday and still get coverage that kicks in on January 1, CNN producer Adam Aigner-Treworgy reports. “This is similar concept as Election Day: if you are in line […]

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One More Option for Those with Canceled Plans or Seeking Coverage

Medical

If you’re facing financial hardship, you now have the option to either purchase a catastrophic plan or avoid the requirement to have health coverage. The Washington Post states: “The rule change was issued in a bulletin from the Department of Health and Human Services. It is the second major response by the Obama administration to […]

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With Affordable Care Act, Canceled Policies for New York Professionals

SWIM Inc

From the New York Times:   Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay […]

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Just Keep Swimming

SWIM Inc

A recent article in the New York Times discusses the health benefits of swimming vs. other aerobic exercises. To read the New York Times article, click here.     Jeffrey R. Ungvary President

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ERISA Explains It All

Medical

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for retirement and health benefit plans in private industry. ERISA does not require any employer to establish a plan. It only requires that those who establish plans meet certain minimum standards. ERISA covers retirement, health and other welfare […]

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SWIM’s “Cash For My Stache” Team Raises Over Two Thousand Dollars for Movember

SWIM Inc

  Movember has come and gone, moustaches shaved and money donated to support world-class men’s health programs that combat prostate and testicular cancer and mental health challenges. As wellness providers and advocates, SWIM Inc’s team was able to raise $2,603.00.  To celebrate the Mo Bros and Mo Sistas achievement, Movember puts together Gala Partés.  Our very […]

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The Case for Long-Term Care

Medical

What could be messier and more complicated than the Exchange? Long-term care (LTC) planning! According to LifeHealthPro, most Americans still have some kind of public or private health insurance. However, few have any kind of protection against LTC costs. So, why do you need LTC insurance? Well, it will protect your against risks such as […]

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WSJ.com – Insurers Cut Doctors’ Fees in New Health-Care Plans

Medical

Last night, Wall Street Journal had an article regarding insurance companies paring down their networks, and specifically mentioned United Healthcare in New York. To be clear: the article – without explicitly stating it – refers to the Compass network (which is the individual exchange network, not the Oxford and United networks offered to group plans). […]

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Register for Our Wellness Webinar

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Limited number of spaces available! Register for The Straight Talk about Corporate Wellness Programs: What are you doing and how is it working? When: Dec 10, 2013 10:30 AM EST How to register: click here *For attending, if you’re in New York, New Jersey, or Connecticut, you will receive a FREE assessment with Lunch-and-Learn and […]

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New York Likely to Not Renew 2013 Health Plans

Blog-Icons-Newsletter

To deter from sending multiple communication regarding President Obama’s announcement on renewing 2013 health plans for 2014, we waited for a nod that New York would not be renewing 2013 health plans. Thirteen states have decided to move forward with renewing cancelled plans, and many will decide how they will move forward this week. Before […]

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New Rules Announced to Bolster Mental Health Parity and Addiction Equity Act

Medical

Continuing forward momentum to improve health care to the masses, Health and Human Services Secretary Kathleen Sebelius announced new guidelines to strengthen the 2008 mental health equity law. The Mental Health Parity and Addiction Equity Act requires doctors and insurers to treat mental illness the same as physical illness–although it hasn’t been the case. The […]

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Attention: Important News from The Department of Financial Services

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Yesterday, Tuesday November 5, The Department of Financial Services (DFS) made an important announcement regarding early renewal in the small group market. If you have elected to renew health insurance coverage in 2013 that would not renew in 2014 to avoid the requirements of the Affordable Care Act you will be in violation of the […]

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Tips for Businesses Navigating Obamacare

SWIM Inc

1. Tax credits, tax increase . Under the Affordable Care Act, millions of uninsured Americans will have access to health insurance regardless of their medical history. Under the mandate, insurance has to be “affordable” and in order to meet those standards. The federal government will supply tax credits. To pay for the tax credits, a […]

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November’s Hope Health is Here

Blog-Icons-Newsletter

November’s issue of Hope Health Newsletter is ready for you to read! Click here to read this month’s pdf. Featured Articles: What makes sweet potatoes so sweet for you? Burning off the calories from Thanksgiving binge Don’t be duped by a diabetes same Less is more – Learn to live the simple life Debt collector […]

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You Received Notice that your Policy is Cancelled…Now What?

Medical

You’ve seen it on the news, read it on the paper, and have neighbors yelling “Hide yo’ kids, hide yo’ wife, they’re cancelling everyone’s health insurance plan over here!” Scratching your head thinking why? Now what? Wait…I thought I could keep my plan?! Why? Under Obamacare (ACA), the current “individual market” doesn’t work for many […]

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Health Care Law Fails to Lower Prices for Rural Areas

Medical

The New York Times reports that roughly 2,500 counties served by the federal exchanges, more than half, or 58 percent, have plans offered by just one or two insurance carriers, according to an analysis by The Times of county-level data provided by the Department of Health and Human Services. In about 530 counties, only a single […]

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The Burning Question: Why is Insurance Going up?

SWIM Inc

With the various rhetorical arguments being thrown around, it’s not surprising most people are confused to why there‘s a hike in insurance rates. We’re here to provide you with a foundation and help guide you through reform. First, it’s important to know the difference between the individual and employer mandates. For large employers (50 or […]

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Early Planning for Retirement can save you Money

Medical

As we consider retiring, it’s imperative that pre-retirees and early retires prepare themselves for their healthcare expenses in retirement. Pre and early retirees should know once they hit age 65, they’re allowed to apply for Medicare, but they’re also allowed to buy a plan through the Exchange. If you’re considering buying through an Exchange, it’s […]

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October’s Hope Health is Here

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October’s issue of Hope Health Newsletter is ready for you to read! Click here to read this month’s pdf. Featured Articles Understanding Cooking Oil Options Mind Over Matter Matters When Preparing For A Race Outsmarting Cold And Flu Symptoms Beyond The Boiling Point The Lowdown On Layaway Plans Walk Your Way To Wellness Jeffrey R. […]

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5 Ways CIOs Need to Prepare for Obamacare

Medical

Some sound advice for leaders in the tech industry from CIO.com, with a quote from yours truly, excerpt below…read the whole article here. Americans without health insurance are encouraged to use health insurance exchanges to “shop” for plans that offer the coverage that best fits their needs. Subsidies are available for those who qualify. Those […]

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Complimentary HRCI CE Credit/LTC Insurance Webinar

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Are you a Human Resource professional and in need of HRCI CE credits? Do you have an interest for Long Term Care insurance? Mark your calendar for this webinar! Date: Tuesday, October 8th Time: 2:00 PM Eastern Location: Register for Webinar Access How to Register: Please RSVP via GoToWebinar What Will I Learn? Caregiving Impact […]

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E-mail Updates

SWIM Inc

In an effort to better serve and create a dynamic experience for you, we have moved our emails to our new domain: swimincorp.com. You may have noticed that we have begun the transition already. Moving forward, please update your address book with the contact information in the right side-bar and note that we will be […]

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Exchange Notices/ACA Update

Medical

Exchange Notices/ACA Update Do you feel like an inflatable tube man with all the information and news about The Affordable Care Act (ACA)? Well, sometimes we do as well. Last week we sent you four Model Notices to assist with your obligation to notify your employees of the upcoming Exchanges. As I cautioned in my […]

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REMINDER: Exchange Notices required by October 1, 2013

Medical

Please note this email from Strategic Wellness & Management Services, Inc. (SWIM) serves as a compliance reminder regarding the Exchange Notice Requirement under the Affordable Care Act (ACA), aka “Obamacare”. By October 1, 2013, you are required to provide notice to your employees of coverage options available through the Health Insurance Marketplace, formerly referred to […]

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September is Life Insurance Awareness Month

Blog-Icons-Life

September has arrived and we’re well underway. As time passes us and we wave hello and goodbye to each day, it’s important to have a set plan for our future. With September being Life Insurance Awareness Month (LIAM), now is the perfect time to reevaluate your Life Insurance plan. Organized by the LIFE Foundation, LIAM, […]

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September’s Issue of Hope Health is Ready For You

Blog-Icons-Newsletter

September’s issue of Hope Health Newsletter is ready for you to read! Click here to read this month’s pdf. Featured Articles What’s your weight personality? It’s time to ‘HIIT’ it 5 reasons to call 911 Don’t put a gag order on gossip and rumors Budgeting when you’re busy (or just don’t want to do it) […]

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Investing in Employees or Cutting Corners: The New Wave of Hiring After Obamacare

SWIM Inc

Business hiring strategies will be changing in the wake of health care reform. Forever 21 has come under scrutiny for reducing the number of hours on full-time non management positions to 29.5 hours per week. The time cut will prevent employees from receiving medical and ancillary plans effective August 31st. Forever 21 has vehemently denied this […]

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Mark Your Calendar! Time to Stay in Compliance

Medical

What You Need to Know About The NY Health Benefit Exchange

Medical

I hope this e-mail finds you well, and you’re enjoying the final few weeks before school starts. Yesterday, Donna Frescatore – Executive Director of the NY Health Benefit Exchange – announced that New York’s Health Benefits Exchange will be called “New York State of Health”. Click here to visit the New York State of Health […]

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