Global Connections Newsletter

Medicare Secondary Payor Reporting

CIEB always aims to keep our clients up to date regarding new laws and regulations relating to their benefit plans. In January of this year, new mandatory Medicare Secondary Payor reporting requirements for group health plans became effective. This means that reports must be submitted to the Centers for Medicare and Medicaid Services (CMS) for employer-sponsored group health plans. Outlined below are some of the details of this new reporting requirement.

What is the Purpose of the Reporting?

The report will assist CMS in enforcing the Medicare Secondary Payor (MSP) rules which determine whether Medicare or the group health plan should be the primary claim payor for individuals with Medicare coverage.

Who Must Report?

The following entities are directly responsible for submitting reports to CMS:

Insurers

Third party administrators providing claim administration for self-insured plans

Group health plans that are both self-insured and self administered

Employers are not responsible and are not permitted to submit the reports to CMS unless they are self-insured and administer their own claims.

What Information Must be Reported?

Eligibility information must be reported so that CMS may determine primacy. Items such as Social Security numbers, Health Insurance Claim numbers, Domestic Partner Status, and employer size. In some cases, more information might be required.

What is the Impact to You?

Our customers will be required to submit the required data elements to CIGNA International Expatriate Benefits (CIEB) for any employee and dependent who is a U.S. citizen or has permanent residency by June 15, 2009.

More detailed communication regarding the changes and requirements will be sent to all CIEB clients. For more information please contact your client manager.

Pandemic Preparedness

CIGNA remains committed to ongoing business continuity planning to better protect our employees and serve our customers and plan participants during an emergency situation. CIGNA has taken a leadership role as a stakeholder in the planning and development of federal policies and procedures for a potential flu pandemic. CIGNA medical directors have been content reviewers for the International SOS^® pandemic protocols and participated as liaison members to the CDC Advisory Committee on Immunization Practices. They are also involved in federal H1N1 flu pandemic planning, as well as industry-wide planning groups.

CIEB is an excellent resource for information on the most up-to-date and country-specific information on the H1N1 flu, including any alerts and/or recommendations specific to a person's country of assignment. CIEB's Health and Wellness Web site at www.CIGNAenvoy.com also offers information on a host of medical topics including flu prevention and other tips and recommendations for the health and safety of your employees. Or, click here to hear CIEB's podcast concerning Pandemic Preparedness.

All employers face the challenge of developing customized Pandemic Preparedness Plans for their organizations. For comprehensive information on pandemic preparedness, CIGNA recommends consultation with the WHO, the CDC, United States Pandemic Preparedness, or International SOS^®, all of whom have developed sets of pandemic preparedness protocols or checklists to assist organizations in developing a pandemic continuity plan. International SOS^® has a comprehensive tool currently available to help global organizations to design company-specific plans that are applicable to international situations. For more information about H1N1 Flu or pandemic preparation, the following sites may be useful:

Centers for Disease Control and Prevention (CDC) (http://www.cdc.gov/swineflu/)
World Health Organization (WHO) (http://www.who.int/csr/disease/swineflu/en/index.html)
US Government Pandemic Preparedness (www.pandemicflu.gov)
International SOS^® Preparedness Protocols (http://www.internationalSOS.com/pandemicpreparedness)

DISCLAIMER: 'CIGNA' refers to any one of the underwriting companies owned directly or indirectly by CIGNA Corporation and/or its subsidiaries and affiliates. Products and services are provided by these subsidiaries, affiliates and other contracted companies and not by CIGNA Corporation. 'CIGNA' is a registered service mark. 'CIGNA International,' 'CIGNA International HealthCare Benefits,' and 'CIGNA International Expatriate Benefits' are also service marks. Any reference to other organizations or companies and/or their products or services, including their Internet sites, is not an endorsement or warranty of the services, information, or products provided by them, nor should a reference to other organizations be construed as their endorsement or warranty of CIEB's products or services. All trademarks (registered and unregistered) and service marks are the property of their respective owners.

CIEB's web-based tools, such as CIGNA Envoy^SM, are available for informational purposes only. They do not constitute medical advice. CIEB's web tools are not intended to be a substitute for proper medical care provided by a physician and not intended as a means for self-diagnosis. CIGNA Envoy is a service mark of CIGNA Corporation.

This material is being provided for informational purposes only and should not be relief upon as legal advice. As always, we recommend that you consult with your independent legal and tax advisors.