CFAHU MONTHLY MEETING

Tuesday, December 13, 2011, 11:30 AM

Hilton Orlando/Altamonte Springs

350 S. Northlake Blvd. Altamonte Springs, FL 32701

Exchange Update

presented by
Julian Lago, Plastridge Agency, Inc

Do you understand how the Exchanges will work? If not, you don’t want to miss our December meeting, as Julian Lago will fill us in on the latest information on Health Care Exchanges.

Julian currently serves on the NAHU working group as the Exchange Coordinator for the state of Florida. He served as FAHU President for 2009-2010 and is a Past President of the Palm Coast AHU. Julian currently serves as legislative chair for his local chapter and as HUPAC chair for the state.

Lunch will be

Caesar Salad
Chicken Toscana over herb Gorgonzola risotto with green beans Iced Tea and water
Black forest cake

Vegetarian option available upon request. Please request with RSVP.

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We will be collecting toys and chocolates at the December meeting for Loaves and Fishes. Please bring Hershey Kisses and/or Hershey Mini Candy Bars and/or games or toys. A list of suggestions are included here.

CE to immediately follow lunch.

Social Security Disability Benefits – 1 Hour CE

Presented by

Joanne S. Wilburne, Esq.

This CE will be useful to health insurance agents seeking a better understanding of how the SSD process works. It will cover the major steps an attorney takes in a disability case from intake to appeals, including:
· the five steps involved in a sequential evaluation of disability
· SSA and the Administrative Law Judge
· Medical opinions
· the distinction between SSD and SSI, and
· how long term disability insurance affects SSD and Medicare eligibility.

Joanne found her niche as a legal advocate and has been helping clients win disability claims for nearly ten years. Admitted to the Florida Bar in 1997, she has been a practicing attorney since 1998.

Also an educator, Joanne has combined her love of teaching with a passion for justice that began in her 20’s when her family’s business closed and the family suffered serious financial loss. Her continuing work as a legal advocate enables her to help often frustrated disability claimants learn to navigate the system, maintain their dignity and secure the monthly income and benefits to which they are entitled.

Her law career began when she relocated from New York to the Tampa Bay area and became the elder law advocate with Bay Area Legal Services, New Port Richey, Florida. In 2003 she took the helm of a 23-year old practice in Inverness that became Stepp & Wilburne, P.A., soon renamed Joanne S. Wilburne, P.A.

Today, with offices throughout central Florida, the firm’s concentration is in social security disability, VA disability, probate and guardianships, Medicare drug denials, and also handles wills, trusts and durable power of attorney.

In addition to court admissions in the U.S. Middle District of Florida and Florida Courts, Joanne is admitted to practice before the United States Supreme Court. In Social Security matters, she is able to practice in all 50 states.

She is a certified teacher in New York and Florida and was an adjunct professor of law for Argosy University at the Tampa campus.

Joanne earned her Juris Doctor in 1997 from City University of New York School of Law. She holds a Bachelor’s degree in elementary education from Syracuse University and in 1982 obtained a Masters degree in secondary education from New York’s Long Island University.

RSVP to rsvp@cfahu.org by Friday, December 9th Please note if you will stay for the CE.

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A Note from the President

It’s been said that the best way to experience all that NAHU has to offer their members is to attend a national event, such as Capitol Conference or National Convention and I couldn’t agree more. With the future of the industry in such a questionable state, I cannot think of a better time to become reenergized and the perfect place to do that is NAHU’s Capitol Conference. The upcoming 2012 Capitol Conference will take place January 23-25 at the Hyatt Regency Capitol Hill in Washington, DC.

It kicks off with a full day of health policy education and discussions lead by NAHU staff and subject matter experts. The second and third days are mixed between a range of speakers discussing the future of our industry and spreading NAHU’s message on Capitol Hill. There are also HUPAC fundraising events and networking opportunities scattered in as well.

It is extremely important this year, not only that we make a strong showing, but that we are presenting our lawmakers with health reform ideas that work. The 2012 elections are looming over all of us and the political leaders’ response to health reform is of utmost significance. With your extensive knowledge of the insurance marketplace, the needs of the consumer and the inter- workings of the employer-based delivery system, you are more than the perfect audience to educate our lawmakers about implications and realities of health care reform.

Capitol Conference is also a great chance to network and learn from other fellow industry leaders, not just about health reform, but ideas about how to stay ahead of the curve in these tumultuous times. Remember, we need as many members as we can get in Washington, DC in January to help make our voices heard. I am excited to be heading up there to be a part of it and I really hope to see many of your faces standing next to me.

For more information about Cap Conference, please see click here for the conference website. Early bird registration goes until December 8 and the chapter has set aside funds to help a few of our members with this cost. If you are interested in this reimbursement, please email info@cfahu.org for more details.

-Ashley

Hilton Orlando/Altamonte Springs 350 S. Northlake Blvd. Altamonte Springs, FL 32701

Tuesday, December 13, 2011, 11:30 AM

Exchange Update

presented by Julian Lago

Do you understand how the Exchanges will work? If not, you don’t want to miss our December meeting, as Julian Lago will us in on the latest information on Health Care Exchanges.

Julian currently serves on the NAHU working group as the Exchange Coordinator for the state of Florida. He served as FAHU President for 2009-2010 and is a Past President of the Palm Coast AHU. Julian currently serves as legislative chair for his local chapter and as HUPAC chair for the state.

Lunch will be

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Caesar Salad

Chicken Toscana over herb Gorgonzola risotto with green beans Iced Tea and water
Black forest cake

Vegetarian option available upon request. Please request with RSVP.

CE to immediately follow lunch.

Social Security Disability Benefits – 1 Hour CE

Presented by Joanne S. Wilburne, Esq.

This CE will be useful to health insurance agents seeking a better understanding of how the SSD process works. It will cover the major steps an attorney takes in a disability case from intake to appeals, including: · the five steps involved in a sequential evaluation of disability
· SSA and the Administrative Law Judge
· Medical opinions
· the distinction between SSD and SSI, and
· how long term disability insurance affects SSD and Medicare eligibility.

Joanne found her niche as a legal advocate and has been helping clients win disability claims for nearly ten years. Admitted to the Florida Bar in 1997, she has been a practicing attorney since 1998.

Also an educator, Joanne has combined her love of teaching with a passion for justice that began in her 20’s when her family’s business closed and the family suffered serious financial loss. Her continuing work as a legal advocate enables her to help often frustrated disability claimants learn to navigate the system, maintain their dignity and secure the monthly income and benefits to which they are entitled.

Her law career began when she relocated from New York to the Tampa Bay area and became the elder law advocate with Bay Area Legal Services, New Port Richey, Florida. In 2003 she took the helm of a 23- year old practice in Inverness that became Stepp & Wilburne, P.A., soon renamed Joanne S. Wilburne, P.A.

Today, with offices throughout central Florida, the firm’s concentration is in social security disability, VA disability, probate and guardianships, Medicare drug denials, and also handles wills, trusts and durable power of attorney.

In addition to court admissions in the U.S. Middle District of Florida and Florida Courts, Joanne is admitted to practice before the United States Supreme Court. In Social Security matters, she is able to practice in all 50 states.

She is a certified teacher in New York and Florida and was an adjunct professor of law for Argosy University at the Tampa campus.

Joanne earned her Juris Doctor in 1997 from City University of New York School of Law. She holds a Bachelor’s degree in elementary education from Syracuse University and in 1982 obtained a Masters degree in secondary education from New York’s Long Island University.

RSVP to rsvp@cfahu.org by Friday, December 9th Please note if you will stay for the CE.

We will be collecting toys and chocolates at the December meeting for Loaves and Fishes. Please bring Hershey Kisses and/or Hershey Mini Candy Bars and/or games or toys. A list of suggestions are included on page 3 of their newsletter .

We don’t yet have a sponsor for our December meeting. Interested? Contact Jim Scheib at (407) 975-1643 or james.scheib@avmed.org or Ashley Wynkoop at (407) 975-1646 or ashley.wynkoop@avmed.org.

A huge Thank You goes out to Melissa Atkins at Cigna and Natalee Otero-Newman at United Healthcare for sponsoring our Masquerade Party on October 25.

Everyone who attended had a great time!

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NOW, is the time to support HUPAC! It is our “March to a $ Million”

“Every man owes a part of his time and money to the business or industry in which he is engaged. No man has moral right to withhold his support from an organization that is striving to improve conditions within his sphere.” Theodore Roosevelt

Please go to : www.hupac.org and contribute online or send a check to HUPAC P.O. Box 20865, Indianpolis, IN 46220-0865
Ph 703-276-0220 Fax 317-253-9285

Upcoming Events

Take the first step and give hope to the kids of St. Jude!

Join us on Saturday, November 19, as St. Jude supporters in the Orlando community, and in 80 cities nationwide come together to participate in the St. Jude Give Thanks Walk to raise money for the children of St. Jude Children ’ s Research Hospital.

Location: Lake Eola Park-International Plaza, corner of Central and Osceola, Orlando, FL 32801

Walk Start Location: International Plaza on the corner of Central Blvd and Eola Drive

Walker Check-in Starts: 8:00am Walk Starts: 9:00am

To Register for the walk, please follow these instructions:

• Go to www.givethankswalk.org and click Find a walk. Locate the Orlando option and click for homepage.
• On the Orlando event homepage you can find all the details(venue address, time, patient stories, etc.). Click

  on the Register tab at the top.

• On the registration page, create a username and password. Then complete your registration form including the

  section for Participation Type . Here click on Join a team and enter Central Florida Association of Health

  Underwriters.

• Submit, and share! You can use e -mail, facebook, twitter or other forms of social media to spread the word to

  friends, family and colleagues about this event and how to support your team’s fundraising efforts.

  For further information please contact Community Service Chair, Alex Good at 407 – 659-6907 or email him at Alex_E_Good@uhc.com

  Supremes Fired Up over Health Care Case

  The high court sets aside an unusually large block of time for oral arguments; companies are advised to hold off on implementing provisions slated to take effect in a few years.

  Jeff Mamorsky Health Benefits November 16, 2011 CFO.com US

  As we predicted in prior articles, on November 14 the Supreme Court decided to hear legal challenges to the Patient Protection and Affordable Care Act, commonly referred to as health- care reform or Obamacare. The central issue in the case involves the constitutionality of the individual mandate; that is, the requirement that all, or at least most, individuals purchase a qualifying health-insurance policy starting in 2014.

  Contrary to the predictions of many legal experts, the Supreme Court also agreed to hear a number of other challenges to the law. The fact that the justices set aside five-and-a-half hours for oral arguments, more than for any other case in recent history, suggests the importance they are placing on the legal challenges.

  The 26 states, along with the National Federation of Independent Business, that have filed suits over the law insist that with the individual mandate, Congress overstepped its constitutional right

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to regulate interstate commerce. The Obama Administration argues that the mandate does not

require people to participate in commerce, but rather regulates how they pay for the health-care services that virtually everyone will require during their lifetime.

So far, two federal appeals courts have upheld the mandate, while one ruled it unconstitutional and another refused to reach a decision. (Concerning the law ’s expansion of Medicaid, another issue the Supreme Court agreed to consider, not a single lower court has agreed with the states’ position.)

What happens if the Supreme Court does not uphold Congress’s right to legislate the individual mandate? The provision is aimed at spreading risk and helping to control insurance premiums. Requiring every individual to carry a minimum policy will allow the federal government to prohibit insurers from denying coverage to patients with preexisting medical conditions. But without a mandate, Americans would likely reason that they could save money by postponing the purchase of an insurance policy until they needed one due to illness or injury. That would raise insurance premiums to unaffordable levels.

The court will consider two procedural issues that will be significant concerning the law’s implementation. One is the issue of severability — whether the mandate can be considered unconstitutional without destroying the rest of the law. There is concern from the Obama Administration that if the mandate were to be deemed unconstitutional, then the denial of exclusions for preexisting conditions would also have to be removed, as the two are intertwined for the reasons explained above. It is because of this entanglement that the states insist the entire law rests on the fate of the mandate.

Second, the court will closely review the issue of ripeness. Essentially, the justices stated that they will hear arguments about whether they can reach a decision now at all. One lower-court judge said the constitutional questions about the mandate will have to wait until 2014 because of the Anti-Injunction Act, a federal law that says a tax must take effect before citizens can try to overturn it in the courts. Under this 19th-century law, the individual mandate could not be challenged in court until 2015, when the first tax penalties for failing to purchase health insurance are scheduled to be paid.

No one can predict how the Supreme Court will decide the case. The fact that a majority of circuit courts have upheld its constitutionality has no bearing on that decision. Still, it is likely that the Supreme Court’s four liberal justices will uphold the law in its entirety. The outcome, therefore, will depend heavily on the five conservative justices. Although conservatives tend to vote on the side of limiting federal power, it is not at all clear that will be the outcome in this case, especially because several conservative appellate judges have already preserved the law.

Until the Supreme Court issues a final ruling on the various challenges to the health-care law, we continue to recommend that companies begin preparations for implementing its provisions. If the Supreme Court upholds the act’s constitutionality while severing the individual mandate, the act will remain on the books but will have costly results. It would likely need to be revised or amended.

Therefore, we suggest that companies should not be overzealous in adopting the act ’s far- reaching measures. Provisions nearing their effective date should be implemented, but those slated to take effect in the future should not be adopted until their effective dates draw closer.

Until a final decision is reached, it is important for CFOs as well as human-resources officials to continue familiarizing themselves with the act and to discuss its implementation. We will continue to monitor developments in the case and keep you informed as they unfold.

www.cfahu.org | www.fahu.org | www.nahu.org

PO Box 160790 | Altamonte Springs, FL 32716-0790

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A Note from the President

“A man too busy to take care of his health is like a mechanic too busy to take care of his tools.” Spanish Proverb

As I was contemplating topics for this month’s newsletter, I started browsing October on the internet and found that October is National Breast Cancer Awareness month, National Cholesterol Awareness month, Disability Employment Awareness month, Emergency Care month, National Mental Illness Awareness month, and Self-Improvement month. And these are just a few! While the thought of focusing on Country Music month did occur to me, I figured I may have the wrong audience for such an article; something more relevant to us and our clients would probably be health and self improvement.

If you know me, you could probably guess that reading self-improvement, self-help or wellness books begin as a priority to me. However, as I try to get through the first chapters I find myself spending more time rolling my eyes than taking in the material. Most of these books seem too general in nature to me and combined with my “I think I know everything” attitude (I do not by the way), I find it tough to keep my focus. However, I would gather that several of us share the same issue. We know there are healthy initiatives that we should be focusing on, but who has the time? So many of us focus our time and resources on our clients, we forget to worry about ourselves.

Education and prevention need to be just as important in our own lives as it is for those we are working with. One of the most positive benefits to health care reform is the preventative benefits. Health carriers are now offering 140+ preventative tests to us at no cost. Without expense being an issue, the problem then becomes spending the time, so let me share a few statistics with you:

Cancer is the leading cause of death in the world. In fact, 13.5% of all causes of deaths in the world are caused by various forms of this disease. There are more than 100 types of cancer with breast cancer being the most common in females. In men, the highest number of deaths is caused by these five types of cancer: lung, stomach, liver, colorectal and esophagus. According to the World Health Organization, 30% of cancers can be prevented by no use of tobacco, healthy diet and physical exercise. Almost a third of cancers can be cured if they are detected in early stages.

In the US, death rates from breast cancer in women have been declining since 1990. This is in part due to early detection by mammography screening and improvements in treatment. Currently, 60% of breast cancers are diagnosed at a localized stage, for which the five-year survival rate is 98%.

Colorectal cancer (CRC) is the third leading cause of cancer death in the US in men and women. The relative five-year survival is 90% for CRC patients diagnosed at an early, localized stage; however, only 39% of cases are diagnosed at this stage. Of the 49,380 people expected to die of CRC in 2011, screening (or use of early detection tests) could save more than half.

This information is not designed to make me look like “Debbie Downer” or darken your mood, but to remind you that you have to take care of yourself before you can really take care of others. The best way to lead our clients is by example, so let’s start showing them how it’s done. And remember if we are not around to take care of our clients… who will be?

In closing, I would like to personally thank Linda Richards and her crew for putting together a fantastic membership event at Maison & Jardin last month. It was a wonderful evening, with great food, wonderful company and generous sponsors. Thanks again to all who joined and made it happen.

Join us for our October monthly meeting in our NEW location!

Hilton Orlando/Altamonte Springs 350 S. Northlake Blvd. Altamonte Springs, FL 32701

Tuesday, October 25, 2011, 11:30 AM

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PPACA – The Clock is Ticking!!!

Joan Galletta, JD, NAHU Legislative Council Vice-Chair, will be discussing real time issues being addressed in DC and other states, News from the Exchange Working Groups, the fall of the CLASS Act and recent shake ups within the HHS.

Joan Galletta is an Employee Benefits Consultant with JP Perry Insurance, Inc, specializing in group benefits. Joan’s areas of expertise are plan design, compliance issues and legislation associated with group health plans. She earned her law degree (Juris Doctor) from the University of Florida College of Law in 1987, where she specialized in contract law. She also holds degrees in Political Science and Criminal

Justice.

Joan served as State Legislative Chair for the Florida Association of Health Underwriters from 2003-2006 and as Regional Legislative Chair for the National Association of Health Underwriters for the southeast region of the United States from 2007-2009. She currently serves on NAHU’s 14 member National Legislative Council as Vice Chair and will chair the National Legislative Council in 2012-2013.

Joan was appointed to the Florida Health Insurance Advisory Board in 2006 by Insurance Commissioner Kevin McCarty, and continues to serve on that board. She is frequently asked to speak on the topic of the implementation of healthcare reform and serves on various carrier advisory panels.

Joan has been with JP Perry Insurance, Inc as an Account Executive since 2003.

Lunch will be

Garden Salad
Roast Pork Tenderloin with Granny Smith Calvados sauce Garlic Yukon Gold mashed potatoes

Grilled marinated vegetable tower Iced Tea and water
Carrot cake

Vegetarian option available upon request. Please request with RSVP.

CE to immediately follow lunch.

Limited Medical Benefit Plans – 2 Hour CE

Presented by Sam Skora of Pan-American Benefit Solutions

RSVP to rsvp@cfahu.org by Friday, October 21st Please note if you will stay for the CE.

October Meeting Sponsored by J.L. Herring & Associates

PLEASE JOIN US FOR A

MINI MASQUERADE PARTY

COME ON OUT, HAVE A BALL, SHOW US ALL YOUR MONSTER CRAWL!

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OCTOBER 25, 2011 6 PM – 8 PM

TAPS (WINTER PARK VILLAGE – ACROSS FROM MITCHELL’S) 480 N Orlando Avenue
Winter Park, FL 32789
407-677-5000

Members: $10 (INCLUDES ONE DRINK TICKET & HORS D’OEUVRES)

Spouses welcome at Member price!!

Non Members: $15 (INCLUDES ONE DRINK TICKET & HORS D’OEUVRES)

***First 20 attendees receive a FREE mask***

Note – Some Sponsorships are still available;
please contact Natalee Otero Newman for more info at 407-659-6956

Upcoming Events

Please join the Central Florida Association of Health Underwriters in volunteering!!!

Friday, November 4, 2011 9 AM to 12 Noon

Second Harvest Food Bank of Central Florida
3533 Mercy Drive
Orlando, FL 32808

Second Harvest Food Bank of Central Florida is a private, nonprofit organization that collects and distributes donated food to more than 400 nonprofit partner agencies in six Central Florida counties: Brevard, Lake, Osceola, Orange, Seminole and Volusia.

Take the first step and give hope to the kids of St. Jude!

Join us on Saturday, November 19, as St. Jude supporters in the Orlando community, and in 80 cities nationwide come together to participate in the St. Jude Give Thanks Walk to raise money for the children of St. Jude Children’s Research Hospital.

Location: Lake Eola Park-International Plaza, corner of Central and Osceola, Orlando, FL 32801

Walk Start Location: International Plaza on the corner of Central Blvd and Eola Drive

Walker Check-in Starts: 8:00am Walk Starts: 9:00am

To volunteer or for further information on either event, please contact Community Chair, Alex Good at 407-659-6907 or email him at Alex_E_Good@uhc.com

CFAHU LEG REPORT

by Donald W. Marx, CFAHU’s Legislative Chair

Capitol Conference Registration is Open!

Mark your calendars! This year’s Capitol Conference will take place from January 23-25, 2012 at the Hyatt Regency Capitol Hill and the theme will be Taking Care of Business: Our Response to

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Health Reform Moving Forward. Registration for this exciting event will begin later this week, so

watch your inbox for more information!

NAHU is Moving!

NAHU is moving its offices! In order to facilitate the move, the office will be closed October 28 and re-opening in our new offices on Monday, October 31. The NAHU website will also be down during that time, and NAHU staff e-mails will be unavailable. The new contact information for NAHU’s national office is:

1212 New York Avenue, NW, Ste. 1100 Washington DC 20005
Phone: 202-552-5060
Fax: 202-747-6820

HHS Names Federal Exchange Vendors

HHS took a big step towards the creation of a federal fallback health benefit exchange when it announced its intent to contract with several key vendors to assist with the development of the federal exchange’s framework. These vendors are also expected to work with the states who opt for the state/federal “partnership” model that was announced by HHS several weeks ago.

CGI Federal Inc. was awarded a five-year contract worth approximately $93.7 million to create and support the integral IT portion of the federally run exchange. Approximately $55 million will be paid to the company in the next year to get the federal exchange framework up and running. HHS also announced a $68 million, five-year contract with Quality Software Services Inc. to set up a “data services hub” that will provide eligibility verification (general eligibility, Medicaid and CHIP) for all exchanges. Three separate contracts were also awarded to the consulting firm Booz Allen Hamilton. One is to work on the federal exchange eligibility appeals process, and another is to handle exchange certification, implementation and oversight. The final contract covers exchange eligibility and enrollment strategy and planning. The total of these contracts exceeds $77 million over five years.

Senate Democrat Leader Looks for Alternative Ways to Finance Obama Jobs Act

Senate Majority Leader Harry Reid (D-NV) is looking for new ways to pay for President Obama’s proposed American Jobs Act, since many of the plan’s existing “pay fors” are not too popular. This would include eliminating a change to the tax treatment of employer-sponsored insurance benefits for wealthier Americans, which is a provision strongly opposed by NAHU.

FAHU Day on the Hill was this week

Monday October 18, 2011 began this year’s “Day on the Hill”. Tours of the Supreme Court, New Capitol and the Historic Capitol were taken.

The winning ticket was drawn for the brand new Kindle winner. 125 tickets were sold to raise money to support our legislative activities.

Jacksonville Essay wins again this year.

Congratulations to Jacksonville AHU for submitting the winning essay again this year. The winning essay was written by Joseph Jumber of Jacksonville Beach. He joined the JAHU delegates touring the Capitol, meeting his State Representative, participating in tell the NAHU story to our State Legislators as well as being honored at our Monday evening dinner.

CFAHU was represented by the following members:

Buddy Anderson, Laurie Anderson, Barbara Coggins, Paul Deininger, Mike Dwyer, Paul Forney, David Gentry, Steve Lindsey, Dale Maloney, Don Marx, Barbara Rennard, Dave Sherrill and Ashley Wynkoop

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