Tag Archives: Health Care

by | December 19, 2014 · 8:56 am

Hospitality Industry Management Update: “Assessing the Midterms’ Impact on Lodging”

AH&LA is hopeful that final action on a long-term TRIA extension occurs in the coming weeks during the lame duck session.Vote The Senate passed its reauthorization bill earlier this year on a huge bipartisan vote, but action has stalled in the House.

The new Senate Republican Majority, combined with a larger House Republican Majority, will significantly alter the policy landscape for the business community and the lodging industry, says the government affairs team at AH&LA.

The association anticipates a busy year legislatively that includes smaller, targeted measures getting to the President’s desk and being signed into law, though likely not any grand compromises on issues like immigration or the nation’s fiscal policy. When it comes to issues impacting the lodging industry, here’s what AH&LA expects to come down the pike:

For more: http://bit.ly/13kLmJr

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by | July 5, 2013 · 12:25 pm

Hospitality Industry Insurance Risks: Hotel And Restaurant Owners Relieved By Obama Administration’s One-Year Delay Of “Affordable Care Act (ACA)”; “Law Is Too Complicated And Costly”

“…employers are relieved that federal officials are delaying penalties for businesses that fail to provide health insurance for their workers, but they say the reprieve does not clear up worries that the requirement is too complicated and too costly…the hotel has 70 employees, many of health insurance nationalwhom do not buy the insurance coverage the hotel offers. The Ramada Inn pays half the cost of the insurance. Business leaders said the delay was inevitable…(employers) have not seen this big a change this ill-defined this close to the deadline…the question still is how this works, what we have to pay and what are the options…it’s just in terms of whether (employers are) going to be able to understand it…”

Businesses with more than 50 employees were to face escalating tax penalties if they did not provide workers with acceptable health insurance coverage by January 2014 as required in the national health overhaul law. President Barack Obama’s administration announced Tuesday it was pushing the deadline back to January 2015 because of confusion about the requirement.

The one-year reprieve is only for businesses. Individuals still must have insurance by 2014 or face penalties, and new online marketplaces called exchanges will help them find coverage, often at subsidized rates.

For more:  http://rapidcityjournal.com/news/businesses-relieved-by-insurance-delay/article_88b8e75c-e4fc-11e2-9b88-001a4bcf887a.html

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by | May 20, 2013 · 6:09 am

Hospitality Industry Health Insurance: Restaurant Chains Considering “Skinny Plans” That Offer “Acceptable Minimum Coverage” Under Federal Health Law; Preventative Services, Annual Doctors’ Visits And Generic Drugs Covered But Surgeries And Hospital Stays Are Not

“…(the “skinny plans”) cover minimal requirements such as preventive services, but often little more…Some of the plans wouldn’t cover surgery, X-rays or prenatal care at all…others will be paired with limited packages to cover additional services,  for instance, $100 a day for a hospital health insurance nationalvisit…Federal officials say this type of plan, in concept, would appear to qualify as acceptable minimum coverage under the law, and let most employers avoid an across-the-workforce $2,000-per-worker penalty for firms that offer nothing. Employers could still face other penalties they anticipate would be far less costly…”

San Antonio-based Bill Miller Bar-B-Q, a 4,200-worker chain, will replace its own mini-med with a new, skinny plan in July and will aim to price the plan at less than $50 a month, about the same as the current policy, said Barbara Newman, the chain’s controller. The new plan will have no dollar limits on benefits, but will cover only preventive services, six annual doctors’ visits and generic drugs. X-rays and tests at a local urgent care chain will also be covered. It wouldn’t cover surgeries or hospital stays.

Because the coverage is limited, workers who need richer benefits can still go to the exchanges, where plans would likely be cheaper than a more robust plan Bill Miller has historically offered to management and that costs more than $200 per month. The chain plans to pay the $3,000 penalty for each worker who gets an exchange-plan subsidy.

But, “those are going to be the people who will be ill and need a more robust plan,” and insuring them directly could cost even more, Ms. Newman said.

Many more workers, she expects, will continue to go without insurance, despite the exchanges and the limited plan. Currently, only one-quarter of workers eligible for the mini-med plan take it. Ms. Newman said, “We really feel like the people who are not taking it now will not take it then.”

Tex-Mex restaurant chain El Fenix also said it would offer limited plans to its 1,200 workers, covering doctors visits, preventive care and drugs, but not hospital stays or surgery. “What our goal was all along was to make [offering coverage] financially palatable for the company as a whole, so we didn’t do damage and have to let people go or slow down our growth,” said Brian Livingston, chief financial officer of Dallas-based Firebird Restaurant Group LLC, owner of El Fenix.

For more:  http://online.wsj.com/article/SB10001424127887324787004578493274030598186.html

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by | November 5, 2012 · 7:10 am

Hospitality Industry Employment Risks: Hotels And Restaurant Groups Begin Limiting Employee Hours To Below 30 Hours Per Week To Avoid Health-Care Law Requirements

Several restaurants, hotels and retailers have started or are preparing to limit schedules of hourly workers to below 30 hours a week. That is the threshold at which large employers in 2014 would have to offer workers a minimum level of insurance or pay a penalty starting at $2,000 for each worker.

The shift is one of the first significant steps by employers to avoid requirements under the health-care law, and whether the trend continues hinges on Tuesday’s election results. Republican presidential nominee Mitt Romney has pledged to overturn the Affordable Care Act, although he would face obstacles doing so.

Pillar Hotels & Resorts this summer began to focus more on hiring part-time workers among its 5,500 employees, after the Supreme Court upheld the health-care overhaul, said Chief Executive Chris Russell. The company has 210 franchise hotels, under the Sheraton, Fairfield Inns, Hampton Inns and Holiday Inns brands.

“The tendency is to say, ‘Let me fill this position with a 40-hour-a-week employee.’ “Mr. Russell said. “I think we have to think differently.”

Pillar offers health insurance to employees who work 32 hours a week or more, but only half take it, and Mr. Russell wants to limit his exposure to rising health-care costs. He said he planned to pursue new segments of the population, such as senior citizens, to find workers willing to accept part-time employment.

He described the shift as a “cultural change” toward hiring more part-timers and not a prohibition against hiring full-timers.

CKE Restaurants Inc., parent of the Carl’s Jr. and Hardee’s burger chains, began two months ago to hire part-time workers to replace full-time employees who left, said Andy Puzder, CEO of the Carpinteria, Calif., company. CKE, which is owned by private-equity firm Apollo Management LP,  offers limited-benefit plans to all restaurant employees, but the federal government won’t allow those policies to be sold starting in 2014 because of low caps on payouts. Mr. Puzder said he has advised Mr. Romney’s campaign on economic issues in an unpaid capacity.

For more:  http://online.wsj.com/article/SB10001424052970204707104578094941709047834.html

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by | October 22, 2012 · 6:17 am

Hospitality Industry Insurance Risks: Restaurant Operators Face "Financial Hit" From New Health Insurance Benefit Programs That Take Effect In 2014

Under the Patient Protection and Affordable Care Act, companies with 50 or more full-time eligible workers must either provide basic coverage by Jan. 1, 2014, or face fines of $2,000 per employee. A full-time employee is defined as one averaging 30 or more hours per week over a 60-day period.

“We will have a financial hit,” said CEO Victor Ansara. “We first thought it was going to be $300,000, but maybe only $100,000 to $200,000. We just don’t know how many of our employees in their 20s, who are pretty healthy, will want coverage.”

Farmington Hills-based Ansara Restaurant Group, which operates 22 Red Robin outlets and five other restaurants in Michigan and northern Ohio, is bracing financially to expand its health insurance benefit program by as many as 665 full-time workers to accommodate expected federal health care reform.

The first 30 employees are excluded from the penalty. For example, an employer with 75 employees would pay the penalty for 45 workers, or $90,000.

Eligible employees that reject insurance coverage by their employer would have to pay a $95 tax, or 1 percent of income, whichever is greater, in 2014. The tax rises to $325 in 2015 and to a maximum of $695, or 2 percent of income, in 2016. Family coverage taxes would be about three times higher in those years. The penalty is estimated to raise $6.9 billion in 2016, said the Congressional Budget Office.

Ansara said his company covers about 130 management staff with various plans from Blue Cross Blue Shield of Michigan and Blue Care Network. Only about 35 of its estimated 350 eligible hourly workers have opted for the coverage, he said.

“It is very difficult to plan when we don’t know what our health care costs are going to be in 2014,” he said. “To comply with the regulation, we have to offer coverage to all full-time eligible employees.”

Of Ansara’s 2,300 employees, up to 700 hourly workers could become eligible for health insurance coverage, he said.

For more: http://www.crainsdetroit.com/article/20121021/SUB01/310219956/red-robin-group-among-restaurants-bracing-for-health-insurance-reform#

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by | August 9, 2012 · 6:46 am

Hospitality Industry Insurance Risks: Hotel And Restaurant Owners Face "Greatest Cost Increases" From Healthcare Reform Laws; Must Cover Employees Currently Not Eligible

“…Many retail and hospitality industry employers face a “double whammy” due to the upcoming health care reform law requirements…employers that do not offer qualified coverage face a $2,000 assessment per full-time employee—those working at least 30 hours a week—starting in 2014…”
Employers in the retail and hospitality industries face the greatest cost increases when provisions of the healthcare reform law imposing financial penalties on employers that do not offer qualified coverage go into effect in 2014, according to a survey released Wednesday.Forty-six percent of employers in the retail and hospitality industries and 40% of employers in the health care services industry expect health care cost increases of at least 3% due to health care reform law requirements, according to the Mercer L.L.C. survey of 1,203 employers.

Some will face stiff cost increases as they must extend coverage to employees who are not eligible for coverage currently. In other cases, the coverage they provide, such as through what are known as mini-med plans, will not meet 2014 standards. That includes a ban on annual dollar limits on essential benefits as laid down by the Patient Protection and Affordable Care Act.

Read more: Retail, hospitality industries face big reform costs | Modern Healthcare http://www.modernhealthcare.com/article/20120808/INFO/308089995#ixzz233mGPu1M

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by | September 16, 2011 · 6:32 pm

Hospitality Industry Lawsuit Risks: "Hotel Negligence" Lawsuits Are Proliferating To Include Hotel Physicians Who Provide Guests' Medical Care

“…Hotel negligence is so prevalent in a vacation destination like Florida, with so many people harmed, that an increasing amount of our practice focuses on so-called resort litigation…and the types of negligence are expanding…to cases involving hotel physicians — doctors with whom the hotels have arrangements, that are called in to care for hotel guests…”

 The problem, says Reboso, is that the hotels typically do not check the credentials of the doctors and house call services they provide to guests. “You don’t know if you’re getting the best doctor in Florida or the worst,” says the injury lawyer. “And neither does the hotel. It’s a recipe for disaster. The clients we’re representing in these kind of resort litigation lawsuits have been harmed by negligent medical care.”

Nor do the hotels give guests the real picture on prices, adds Reboso: “In one case we are handling, the hotel said the service would cost $600, while the credit card charge — which comes well after you’ve left the hotel — was $6,300. We have found plenty of other cases in Florida when a $500 charge suddenly turns into a $4,000 or $5,000 bill. Obviously, the hotel industry and the medical profession need to educate themselves about what is going on and do something about it.”

 

For more:  http://www.prweb.com/releases/2011/9/prweb8793265.htm

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by | April 8, 2011 · 10:53 am

Hospitality Industry Health Insurance: Law Firms Advise Hotel Ownership And Management To Prepare For Implementation Of Health Care Reform With "Wellness Programs" And State-Run "Insurance Exchanges" On The Way

Given the legal challenges to the proposed reform of the United States health care industry, there might be a temptation on the part of hoteliers to take a laid-back attitude toward preparing for the changes. That line of thinking, however, would be a mistake, said Scott Sinder, a partner in the Steptoe & Johnson law firm government affairs and public policy practice.

  • One of the biggest issues hotel companies will have to wrestle with will be whether to retain grandfather status, which refers to plans in place prior to 23 March 2010
  • Grandfathered plans, for example, can allow for changes to the network of providers but cannot impose new or decreased annual spending limits
  • The potential introduction of a wellness provision that provides funding for employers to establish wellness programs…will be the biggest key to keeping health-care costs down
  • The U.S. Bureau of Labor Statistics reports that just 38% of the employees in the hospitality sector had access to health care as of March 2010 compared with 71% across all industries
  • Every state will eventually have an Insurance Exchange as most state lawsuits against health care reform will be settled before Presidential Election

For more:  http://www.hotelnewsnow.com/Articles.aspx/5314/Hoteliers-should-assume-health-care-changes

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by | September 5, 2010 · 9:03 am

Hospitality Industry Health Insurance: American Health Strategy Project Aims To Lower Health Insurance Costs Through Increased Data On Employees Medical Leaves, Drug Utilization, Disability Claims And Demographics

 Until now, most employers setting up value-based insurance designs have relied primarily on medical claims data, which may or may not provide a complete picture of health risks lurking in their workforces, said Marianne Fazen, executive director of the Texas group.

In addition to medical claims data, employers participating in the American Health Strategy Project will collect data on family medical leaves, pharmaceutical and prescription drug utilization, short- and long-term disability claims, workers compensation claims, employee assistance program usage, disease management and employee demographics

The Texas Health Strategy Project is one of five initiatives announced in May by the Washington-based National Business Coalition on Health as part of the American Health Strategy Project, which intends to help employers use data from multiple sources to develop and implement value-based insurance designs. Such designs remove barriers that might prevent employees from receiving necessary health care, such as preventive screenings and maintenance medications.

While the Texas project is under way, the four other projects involving other coalitions—the Midwest Business Group on Health in Chicago, the Oregon Coalition of Health Care Purchasers in Portland, the Pittsburgh Business Group on Health and the Virginia Business Coalition on Health in Virginia Beach—are in various stages of deployment.

For more:   http://www.businessinsurance.com/article/20100905/ISSUE01/309059972

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by | August 18, 2010 · 7:28 am

Hospitality Industry Health Care: Smaller Hotel Owners Will Struggle With “Medical Loss Ratio” And Must Find Hospitality Industry Health Care Insurance Specialist

The Affordable Care Act sets a minimum threshold for what’s known as the “medical loss ratio” — the percentage of premium dollars that go into medical care (a “loss” from Wall Street’s view) rather than into overhead or profits. For plans sold to small businesses or directly to individuals, that ratio must be at least 80 percent; for plans sold to large groups, it must be at least 85 percent.

For big insurance companies that sell predominantly to big employers, the medical loss ratio shouldn’t be hard to meet. With their economies of scale, these insurers and employers together provide coverage at relatively low administrative cost (although, it should be noted, Medicare’s overhead is even lower). But smaller insurers that deal primarily with individuals or small businesses will have a tougher time. Among other things, they typically lose 8 percent of premiums on commissions to agents and brokers who sell policies on their behalf. (Once the insurance exchanges exist, much of that cost will disappear.) These are also the insurers most likely to bilk consumers, since individuals buying coverage on their own typically lack the knowledge — or ability — to bargain as shrewdly as corporate benefits managers do. (The exchanges should also help with improved information and bargaining leverage.)

There’s leeway in the rule in two key places. The law doesn’t dictate a precise formula for calculating the medical-loss ratio. It’s up to the administration which “care management” activities count as medical care, whether taxes should be part of the calculation, and the extent to which carriers can average out the ratio among different plans. And while the law calls for the requirement to take effect starting in January 2011, the Department of Health and Human Services has the authority to phase it in; Sebelius could, for instance, set the floor at 70 percent for 2011 and then gradually ratchet it up until 2014. Some insurance and employer lobbyists have urged the administration to move slowly, lest insurers unable to meet those requirements go out of business. Then again, insurers that can’t meet those requirements are, by definition, less efficient.

For more:   http://www.tnr.com/blog/jonathan-cohn/77080/get-ready-sebelilus-v-insurers

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