April 2009 Newsletter

EMPLOYEES NEED TO CALLUSABLE TO GET CLAIMS ANSWERS

Your employees’ protected health information is important to us. When employees have claims questions, they can contact USAble Life directly at 800-370-5856. NISI is unable to access claim information from USAble Life for employees because of HIPAA (Health Insurance Portability and Accountability Act) regulations.

SHORT-TERM DISABILITY FORM NEEDED TO RECEIVE BENEFITS

Receiving benefits in a timely manner makes a huge difference to disabled employees. If you have an employee on partial disability, be sure to ask if they have completed a Short-term Disability Update Form. USAble Life needs this form to process claims. Payment will be delayed without it. To obtain the form:

  • Go to www.MyNISI.com.
  • Click on the Forms tab.
  • Click on the Short-Term Disability Update Form in the Short-Term Disability Claim section.

    An eligible employee may receive the weekly benefit selected or 100 percent of your predisability earnings less your partial disability earnings if the following conditions apply:
  • Partial disability begins within 31 days of the date total disability stops.
  • Earning less than 80 percent of pre-disability weekly earnings at the time partial disability employment begins.

UPDATE YOUR FAX NUMBERS FOR USABLE

Please update these USAble fax numbers to ensure speedy service.

  • Wellness Claims: 501-235-8400
  • Disability Claims: 501-235-8417
  • Premium Accounting: 866-823-3788 or 501-235-8406.

FLEX DEBIT CARDS MAY BE DENIED AFTER JUNE 30

Stating July 1, you may see changes regarding where you can use your health Flexible Spending Account (FSA) debit card. According to IRS regulations, you must go to pharmacies and drug stores that use an Inventory Information Approval System (IIAS) to track whether your purchases are eligible. The automated system matches the item’s stock-keeping unit (SKU) to a list of eligible expenses when you purchase the item and helps reduce the substantiation you must submit under IRS guidelines.

The IRS originally allowed pharmacists and drug stores until December 31, 2008, to install an IIAS, but the IRS has extended the deadline to June 30. After June 30, health FSA debit cards will be denied at pharmacies that do not have an IIAS. Employees can use paper forms to be reimbursed.

If your local pharmacy does not have an IIAS, please encourage the pharmacy to contact Discovery Benefits. The pharmacy will be asked to provide proof that 90 percent or more of the store’s gross receipts during the prior taxable year consisted of items that qualify as expenses for medical care.

CHECK DISCOVERY WEB SITE REGARDING YOUR PHARMACY OR DRUG STORE

Discovery Benefits has communicated to pharmacist associations nationwide reminding them of the IIAS requirement and how it will affect reimbursement account participants. “It is the store’s responsibility to implement the IIAS or certify compliance with the 90 percent rule,” Discovery officials said.

  • To find out if your favorite pharmacy or drugstore is eligible, review the list of eligible IIAS merchants at discoverybenefits.com.
  • If your favorite pharmacy or drugstore is not listed, Discovery Benefits encourages you to share this information with the store’s pharmacy manager.

Regardless of this inconvenience, FSAs can be beneficial to employees and employers. Employers can save money on payroll and tout an FSA as a great benefit, and both employer and employees can save on Social Security taxes.

TELL EMPLOYEES TO TAKE ADVANTAGE OF WAIVER OF PREMIUM

If you have an employee who is unable to work because of disability, many voluntary insurance plans will waive premiums if the employee informs them. Please tell employees out on leave or planning a leave to go to the NISI web site.

Details may vary from program to program, but the following programs will waive premium payments during the period an employee is receiving benefits. However, it is the employee’s responsibility to inform the plan.

Voluntary programs include:

  • Lincoln Mutual Voluntary Group Life
  • USAble Short-Term Disability
  • USAble Long-Term Disability
  • USAble CancerCare Elite
  • USAble HealthCare Plus

LONG-TERM CARE MYTHS CAN PUT YOUR EMPLOYEES AT RISK

Long-term care can be a confusing topic. Sadly, many employees incorrectly believe they are already covered for long-term care. As a result, they lack the coverage they may need.

It is a myth that health or disability insurance will cover long-term care needs. Many employees are surprised to discover long-term care is not covered by health insurance, including an HMO or long-term disability insurance. Long-term disability and long-term care are two separate types of insurance.

Only long-term care insurance, which is typically a voluntary product, covers day-to-day personal care assistance when you are unable to perform activities such as bathing and dressing.

Another misconception is that Medicare or Medicaid will cover long-term care expenses. Medicare pays for skilled care in a nursing home up to 100 days, when you are recuperating following a hospital stay for a related condition.

Once your condition is stable, and you need personal or custodial care, Medicare will not cover these costs. Medicare pays for care at home under very limited circumstances.
Medicaid pays for long-term care only for people with very low assets and limited income.

STANDARD & POOR’S RATES USABLE AS STRONG

USAble Life received an A (Strong) rating from Standard & Poor’s. Ratings range from AAA to CC. An insurer rated BBB or higher is regarded as having financial security characteristics that outweigh any vulnerabilities and highly likely to have the ability to meet financial commitments.

A.M. BEST GIVES USABLE ‘A’ EXCELLENT RATING

A.M. Best has awarded USAble Life an A (Excellent) rating. A.M. Best is the leading provider of insurer ratings, ranging from A++ (Superior) to S (Rating Suspended). The ratings are based on a company’s financial strength and ability to meet its obligations to policyholders.
The rating was based on:

  • Competency of underwriting
  • Control of expenses
  • Adequacy of reserves
  • Soundness of investments
  • Capital sufficiency

USABLE MAKES WARD GROUP’S TOP 50 LIST

Each year, the Ward Group analyzes the financial performance of more than 850 life and health insurance companies in the U.S. and lists the top 50 performers. USAble Life was among the top 50.

The top 50 companies have passed all safety and consistency screens and achieved superior performance over the five years analyzed, according to the Ward Group. The companies produced a 17.5 percent or greater return on average equity from 2002 to 2007, compared to 13.1 percent for the life and health industry overall.

DID YOU KNOW?

  • In the U.S., a disabling injury occurs every second, and a fatal injury occurs every four minutes, according to the National Safety Council.
  • Almost three in 10 workers entering the work force today will become disabled before retiring.
  • Distracted driving is an increasingly visible safety issue, as evidence mounts that driver inattention is responsible for about 80 percent of U.S. traffic crashes.
  • Cell phone use is the No. 1 source of driver inattention. It is estimated that more than 100 million people use cell phones while driving. The annual cost of crashes caused by cell phone use is about $43 billion.
  • Flexible Spending Account deductions come out of a worker’s paycheck on a pretax basis. Taxes aren’t calculated on the contributions. For example, a $1,000 annual contribution could save an employee $250 in taxes if the employee is in the 25 percent bracket.

 

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