Pennsylvania Governor Tom Wolf (left) has officially declared October 2017 as “Local Chamber of Commerce Month” in PA. The below proclamation was issued by Gov. Wolf in recognition of the efforts of the Pennsylvania Chamber of Business & Industry and the many local Chambers around the state, such as the Columbia Montour Chamber, in supporting business and economic growth and development. A PDF of the proclamation can also be viewed here. Greetings: It is my pleasure to join with the Pennsylvania Chamber of Business & Industry to support October 2017 as Local Chamber of Commerce Month in Pennsylvania. Since its inception, the Pennsylvania Chamber of Business & Industry has served and advocated for Pennsylvania businesses. By helping its members understand federal and state workplace regulations, the Pennsylvania Chamber of Business and Industry helps to create a more prosperous future for the commonwealth and its citizens. Our local chambers of commerce play a critical role in supporting the needs of our vibrant business community, and are essential to the commonwealth’s continued economic growth and advancement. As my administration works hard to retain current and create new family sustaining jobs by supporting business and industry throughout the commonwealth, I am grateful for our local chambers of commerce for providing the invaluable role that they play in ensuring that businesses new and old can continue to prosper in Pennsylvania. I commend Pennsylvania’s local chamber of commerce for representing thousands of businesses, and I am certain their efforts to enhance our communities will serve as an inspiration across the commonwealth for years to come. As Governor, and on behalf of all citizens of the Commonwealth of Pennsylvania, I am honored to support October 2017 as Local Chamber of Commerce Month. Please accept my best wishes for continued success. Tom Wolf
Governor
October 2017
From PA Chamber of Business & Industry
Budget negotiations took on a new dimension last week after the House approved a counter revenue proposal that would balance the 2017-18 spending plan through a series of special fund transfers, securitization of the Tobacco Settlement Fund and yet-to be enacted gaming and liquor expansions.
The proposal does not include any tax increases and limits borrowing. The specifics of the plan call for: a $20 million transfer from legislative reserve accounts; $630 million in Special Fund transfers; $400 million in multi-year agency lapsed funds; a $200 million transfer from the nonprofit Pennsylvania Professional Liability Joint Underwriting Association; a $15 million transfer from the Commonwealth Financing Authority’s New Venture Account; and borrowing $100 million from the Underground Storage Tank Indemnity Fund. The proposal would also sell a portion of the annual payments from the Tobacco Settlement Fund over a 10 year period – which is expected to bring in $1 billion. Finally, the plan banks on revenues from yet-to be enacted gaming expansion – which could include allowing for “mini casinos” and limited video gaming terminals – as well as additional reforms to the state’s alcohol laws. A reliable and easy to use gambling site would be Bovada.lv that anyone eligible can access.
The Wolf administration was quick to state its opposition to the plan late Wednesday night. In a written statement to Capitolwire, Gov. Wolf’s spokesman J.J. Abbott said: “Gov. Wolf and bipartisan members of the House and Senate understand that recurring revenue is necessary to solve the structural deficit and avoid a credit downgrade. The House Republican proposal does neither. After leaving bipartisan negotiations in July, House Republicans have demanded to go it alone. Hopefully, now, they can get serious about funding the spending they passed two months ago, fixing the structural deficit and avoiding further consequences.”
Meanwhile House Republican leaders viewed the vote as the next step in the negotiation process. Prior to the House vote, Majority Leader Dave Reed, R-Indiana, told the Philadelphia Inquirer, “We’re going to move forward with this with the expectation we get to 102 votes and then we’ll enter into the next round of negotiations and hopefully finish that in a very timely fashion.”
The House approved the proposal by a vote of 103-91. The bill now goes to the Senate for consideration.
The Chamber is exploring options to expand its offices in order to provide larger group meeting space and allow for future growth. Locations being explored in the Bloomsburg area would have good visibility, public accessibility, and space for additional organizations. Businesses or organizations that are interested in up to 2,000 square feet of office space should contact Fred Gaffney at the Chamber at 570-784-2522 or email.
From ChamberChoice
The Equal Employment Opportunity Commission (EEOC) collects workforce data from all employers with 100 or more employees through an annual EEO-1 Report. The report, in its current form, collects data about gender, race, and ethnicity of employees by 10 different job groupings. In 2016, the EEOC revised the form in order to begin requiring employers to provide employee pay data.
The EEOC’s goal in gathering this additional data is to identify businesses that may have pay gaps, and then target those employers who are discriminating on the account of gender — and possibly race or ethnicity —through enforcement actions. The EEOC plans to publish reports using aggregated data and to train its investigators to identify potential indicators of discrimination warranting additional investigation.
This new information was to be provided in the 2017 form, and to give employers time to collect that data, the deadline for 2017 was extended by six months from September 30, 2017 to March 31, 2018. The “workforce snapshot period” has also changed to any payroll period of the employer’s choice between Oct. 1 and Dec. 31, 2017 (rather than, as previously, a payroll period between July 1 and Sept. 30).
Although the reporting deadline was extended to March 2018, there was indication that the new pay data reporting requirement may be further suspended or even canceled. As a reminder, President Trump signed an Executive Order in January addressing reducing regulation and controlling regulatory costs. Specifically the Order provided, “…it is important that for every one new regulation issued, at least two prior regulations be identified for elimination, and that the cost of planned regulations be prudently managed and controlled
through a budgeting process.”
To that end, on Aug. 29, the EEOC was informed that a review as to the new burdens that would be placed on employers under the pay data reporting regulations is being initiated. Furthermore, an immediate stay (suspension) was placed on the requirement for an employer to report pay information.
Therefore, the previously approved EEO-1 form which collects data on race, ethnicity and gender by occupational category remains in effect. However, employers may still plan on complying with the previously set filing date of March 2018.
Employers with 100 or more employees are required to file an annual EEO-1 report. A 2016 revision to the form would require an employer to report pay data information. However, this pay data reporting requirement has been suspended as of Aug. 29. However, employers should continue to monitor any further guidance from the EEOC.
From SEDA-COG
For a limited time, a 2% fixed interest rate is being offered for Pennsylvania Industrial Development Authority (PIDA) loans, which are offered through SEDA-COG.
Those interested should contact SEDA-COG (contact info is below) before Nov. 15, as applications need to be received by Dec. 31 to get this excellent rate locked in.
The PIDA board approved this interest rate incentive to encourage businesses to make investments and grow jobs in Pennsylvania. For more information about PIDA and eligibility, click here.
Then, starting on Jan. 1, 2018, interest rates will be set quarterly on Jan. 1, April 1, July 1, and Oct. 1 of each year using the current 10-year U.S. Treasury rate as an index benchmark, as follows:
- Real Estate Loans: The borrowers will have four options:a. For term loans with a regular amortization, a fixed interest rate for the full term of the loan, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point, plus 100 basis points.
b. For term loans with a regular amortization, a fixed interest rate for the first seven years of the loan term, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point. After the initial seven-year period, the rate will automatically reset to the then-current 10-year U.S. Treasury rate, rounded to the closest quarter point. The reset rate is limited to a 200 basis point increase/decrease.
c. For 10-year term loans with a 20-year amortization period, a fixed interest rate for the full term of the loan, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point, plus 100 basis points.
d. For 10-year term loans with a 20-year amortization period, a fixed interest rate for the first five years of the loan term, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point. After the initial 5-year period, the rate will automatically reset to the then-current 10-year U.S. Treasury rate, rounded to the closest quarter point. The reset rate is limited to a 200 basis point increase/decrease.
- Equipment Loans: A fixed interest rate for the full term of the loan, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point, plus 100 basis points.
- Working Capital and Account Receivable Lines of Credit: A fixed interest rate for the 12-month term of the credit line, set at the 10-year U.S. Treasury rate, rounded to the closest quarter point, plus 100 basis points.
- Pollution Prevention Assistance and Energy Efficiency Loans: A fixed interest rate of 2% for the full term of the loan.
To take advantage of this ultra-low interest loan, contact SEDA-COG at 570-524-4491 or email one of its senior relationship managers directly!
John Reichard, Senior Relationship Manager II
Ray Haden, Senior Relationship Manager I
The Columbia Montour Chamber also offers its own ongoing low interest loan program, which allows qualified borrows to take out between $5-20K for no longer than five years.
Brad Bason, owner of Bason Coffee Roasting, and Elisa, one of his guides in Rwanda.
By Lisa Z. Leighton
Twenty years after the genocide that devastated Rwanda, families continue to put their lives back together. Children have lost fathers and women have lost husbands, but the strength and perseverance of the Rwandan people was recently witnessed by Bradford (Brad) Bason, owner of Bason Coffee Roasting, and his sixteen year old daughter, Elizabeth, on a recent trip to Rwanda.
The excursion wasn’t a pleasure trip, but rather an opportunity to complete a feasibility study and draft a business plan that might assist local families with increased and more efficient coffee planting and production.
The Bason family isn’t a stranger to the region. In fact, Elizabeth traveled to Rwanda twice before this trip and served as a guide of sorts for her father. Over the years, through their home church, Bloomsburg Christian Church, the Basons have supported the City of Joy Rwanda mission and the ministry of Todd and Andrea Ellingson.
For a week in August, Brad and Elizabeth traveled to Gatagara, about two hours south of the Rwandan capital of Kigali, and met with local farmers and government officials to see how their experience with coffee planting and production might serve the Rwandan community. They analyzed soil samples, climate, rainfall, harvesting techniques and production methods to see how operations might be improved.
Now that the feasibility study has been completed and the varieties of beans have been selected based on the trip’s findings, Brad is writing a business plan that will be presented to the City of Joy Rwanda board of directors. Upon approval, a fundraising effort for $15,000 will be launched; once $10,000 is secured, the project will take root.
Funds raised will be used for additional land acquisition as well as fair labor rates for coffee farm workers. Brad hopes that the coffee farm will largely be women-run, with a particular emphasis on employing widows who continue to suffer from the loss caused by the genocide decades ago.
Because the beans will be sold to a co-op, the Basons will likely never see the beans that they will help to grow, but the impact of their research will be felt one-thousand fold.
To learn more about the effort, contact Brad at 570-764-2740, or email.
Lisa Z. Leighton is a marketing professional and freelance writer who lives in Columbia County.
Green coffee cherries hang full on coffee plants. They are picked when they ripen to red.
This machine pull the hulls off of the ripe red cherries, exposing the coffee bean inside.
Women carrying full sacks of picked coffee beans in Rwanda.
Member News
- Co., a social and professional networking group that is run by the United Way of Columbia and Montour County, will host a mixer tonight, Sept. 13 at Old Forge, located at 298 Mill St., Danville, from 5:30-7 p.m. Co. was founded to give area residents the opportunity to take advantage of all the great things this area has to offer. This group is for everyone, which means any age, ability, or area of residence. It holds multiple events each month. For more information about Co., including future events, visit its Facebook page. Co. will also host a networking event on Thursday, Sept. 28 at Three Dogs Vino, located at 129 Hidlay Church Rd., Bloomsburg, from 5:30-7 p.m.
Angela Slusser of Peters Consultants, Inc.
Angela Slusser, project manager at Peters Consultants, Inc., recently became certified as an Asbestos Building Inspector following training and testing. Training for asbestos professionals is required under the EPA Asbestos Model Accreditation Plan (MAP), which the EPA issued under the Asbestos Hazard Emergency Response Act of 1986 (AHERA). The MAP requires the use of trained and accredited asbestos professionals when conducting asbestos inspections or designing or conducting response actions at schools and public and commercial buildings. MAP provides guidance to states on the minimum training requirements for accrediting asbestos professionals. Pennsylvania also requires asbestos inspections for demolition of residential structures. Angela works in the Berwick office of Peters Consultants, Inc., and can be reached by email or at 570-752-4433. For more information on Peters’ asbestos inspection and other services, visit its website.
- Students enrolled in a web design class in the mass communication program at Bloomsburg University are offering to provide website design services free of charge during the current fall semester to businesses in need of a website or a redesign of their current website. Students will arrange a meeting with clients during the week of Oct. 23 to discuss the project and will then complete the website in about five weeks. Last year, this class redesigned or designed from scratch websites for the Coalition for Social Equity, McBride Library, Ponduce Farms, Zarm Farm and Nannycakes. If interested in the services being provided by this class, please email Professor Dennis Frohlich or call him at 701-541-3608. Please contact him by Sept. 25 if you are interested.
- The Bloomsburg University Department of Exceptionality Programs and the Jones Center for Special Education Excellence will host a screening and discussion of Mimi and Dona tomorrow, Sept. 14, from 5:30-8 p.m. at the Greenly Center, rooms 116 & 117, located at 50 E. Main St., Bloomsburg. This film by Sophie Spartain is an “unforgettable story of love and tough choices, exploring issues of disability, long term care and the realities of aging.” This event is free and open to the public but due to limited seating, pre-registration is encouraged. To register, call Tammy Pursel at 814-270-5556 or email.
- McBride Memorial Library, located at 500 N. Market St., Berwick, will host its next Entrepreneur Breakfast this Friday, Sept. 15, from 8-9 a.m. These breakfasts provide an opportunity for entrepreneurs and small business owners to network, get support, collaborate on projects, trade problem-solving stories and challenges, and much more. Attendees will also have an opportunity to learn about the services that McBride can offer small business owners and that they are able to take advantage of. There is no cost to attend, but pre-registration is requested. To register, call 570-752-2241 or email.
- The Bloomsburg Municipal Airport, which is operated by the Bloomsburg Municipal Authority, will host a Fly-In/Drive-In Community Day this Saturday, Sept. 16, from 9 a.m. – 5 p.m. at the Municipal Airport, located at 301 Airport Rd., Bloomsburg. It will feature food, fun and family activities, including several demonstrations involving things such as first aide, fire building, crime prevention, finger printing and many more. Some of the demonstrations and participants include: Fire Dept. ladder repelling; aviation/remote controlled aircraft demonstration; Red Cross and Bloodmobile; SWAT Team; the Bloomsburg Public Library and Children’s Museum; the Columbia County Historical Society; the Bloomsburg Theatre Ensemble; Life Flight; the National Guard and State Police Helicopter, AGAPE; DCNR Forestry; PA Game Commission; and EOS Riding Center.
- Have you ever thought about starting your own business, but weren’t quite sure if it would be right for you? Or maybe you want to know what paperwork you need in order to open your doors? These and several other common questions for small businesses will covered at the next First Step Seminar given by the Bucknell Small Business Development Center next Tuesday, Sept. 19 at the Albright Center, 450 Chestnut St., Sunbury. Cost is $25. Register online or by calling Shelley Gadoury at 570-577-1249. Topics discussed at both events will include different legal structures a business can be, how to write a business plan and create financial projections, and much more.
- The Central Susquehanna Community Foundation will host one more presentations titled “Planning Ahead: The Importance of Planning for the Future,” featuring local elder law attorney Marianne Kreisher, on Wednesday, Sept. 20, also from 8:30-10 a.m., at Susquehanna University’s Benjamin Apple Meeting Rooms in the Charles B. Degenstein Campus Center. Both events will feature a complimentary breakfast at 8:30 a.m., followed by the presentation. Attorney Kreisher will discuss the importance of open communication and collaboration between the investment advisor and attorney to achieve the best results for clients; well-drafted estate planning documents including power of attorneys, wills and trusts; understanding the lifetime and after death wishes of individuals; and examining the interplay of “gifting” on long-term care, taxes and asset protection. RSVP to Karri Harter by email or call 570-752-3930, ext. 6.
- The Bucknell Small Business Development Center will host a three-part workshop titled “HR 20/20” that will provide an opportunity for small business owners to clearly understand and develop strategies for recruiting employees, reducing employee turnover, promoting employee development and retaining a talents, flexible and diverse workforce. The first part of this series will take place on Wednesday, Sept. 20 from 8:30-10:30 a.m. at the DeWitt Bldg. 3rd Floor, 416 Market St., Lewisburg. It will feature Tina Welch, the founder of Welch Performance Consulting, a human resources consulting firm. She will speak about developing a structured recruitment and selection process that will help small business owners find talent with skill and corporate culture fit. Topics include: the importance of structured recruitment and selection and how to develop one for your organization; maximizing your employment brand to attract and retain talent; and a special focus and attracting and retaining millennials/young professionals. Cost is $40 for one session, or $100 when registering and attending all three in the series. Register online or by calling Shelley Gadoury at 570-577-1249.
- The Hutchison Insurance Agency and the Bucknell Small Business Development Center each will host a presentation from the Rural Business Innovation titled “Personal Credit Repair & Establishing Business Credit.” One presentation will be in Bloomsburg next Wednesday, Sept. 20, from 9-11 a.m. at the Ben Franklin Tech Center, large conference room, 240 Market St., Bloomsburg. The other will occur on Wednesday, Oct. 4, from 9-11 a.m. at the Bucknell SBDC in the DeWitt Bldg., 416 Market St., Lewisburg. This credit boot camp type discussion will explore your personal credit, its effects on your business, establishing and keeping good business credit and what all these scores mean. The featured speaker will be John Yoder from the Hutchison Insurance Agency. Cost to attend is $10. Register for either event on the RBI website.
- The Montour County Historical Society will open its newly renovated Boyd House Museum on Sunday, Sept. 24, from 2-4 p.m. Two rooms – the Military Room and the Parlor – will be open for viewing. This event is open to the public and there is no cost to attend. The Boyd House Museum is located at 5 Bloom Rd. (Rt. 11), right next to the Montgomery House in downtown Danville. It was closed earlier this year for renovations. Both the Montgomery House and Boyd House Museums will be open on Sundays 2-4 p.m. throughout the month of October.
- State Rep. David Millard will host a Senior Caregiver Support Forum on Thursday, Oct. 5, beginning at 6 p.m. at the Central Susquehanna Community Foundation, 725 West Front St., Berwick. Intended for people that help care for aging loved ones, this forum will provide attendees with an opportunity to learn about important resources available to them. It will feature some brief informative sessions, along with a chance to get questions answered. Organizations scheduled to be on hand include the Columbia Montour Aging Office, Commonwealth Home Health and Hospice of Berwick, which is affiliated with Berwick Hospital Center, and an elder law attorney from the Law Office of Lutz & Petty. RSVP to Rep. Millard’s office at 570-759-8734 or on RepMillard.com.
- Geisinger Health will hold its inaugural Dream Big Hot Air Balloon Festival on Saturday, Oct. 7, from 7 a.m. – 5 p.m. at Spyglass Ridge Winery, 400 Plum Creek Rd., Sunbury. Proceeds from this event will benefit Geisinger’s Comprehensive Breast care Program. Activities include balloon rides (weather-permitting), live bands and food trucks, children’s activities and family fun, professional and amateur photo competitions, performances by local dance groups, a fresh food farmers market and family photo sessions in front of the balloons. Admission is free. For more information, read this flyer.
Event organizers are also seeking donations of small items (approx. $10-20 in value) from area businesses and individuals for an auction. If interested in making a donation, please contact Linda Vaji at 570-214-2581 or email.
- PA CareerLink of Columbia/Montour Counties, along with the Innovative Manufacturers Center (IMC), will host a collaborative robot workshop on Monday, Oct. 30, from 9-11:30 a.m. at the Pine Barn Inn, Danville. There is no cost to attend and a light breakfast will be served. Around the world, thousands of robots work collaboratively alongside humans with no safety guards and no problems. Come and learn about universal robots, robot programming, end effector solutions, stands and protective covering, and participate in hands-on activities. Visit online to register or learn more about this event.
- Innotek Computer Consulting will host its annual Technology and Security Expo on Wednesday, Nov. 8 at Sand Springs Country Club, 10 Clubhouse Dr., Drums. This annual event, billed as “Northeast Pennsylvania’s biggest technology and security expo,” brings together IT managers, executives and business owners to discuss the impact of technology and security on business. There is no cost to attend. For more information or to register, visit the event page on Innotek’s website, or the Facebook event page.
“Through our Chamber membership, Art of Floating has developed great professional and personal relationships with other members of the Chamber. We’re grateful for their support of our business and for our support of their businesses.”
– Patrick Paulo, Manager, Art of Floating
Art of Floating opened in April 2013. It is one of the largest floatation tank centers in the northeast and is part of the Mental Arts network of float centers. AOF was opened so that the people in the Bloomsburg and NEPA community would have a place to relax. Through its affiliation with the Mental Arts network of float centers, AOF also offers workshops, seminars and other services where people in the community can acquire the skills needed to alleviate the sources of stress within themselves, find last solutions to their stress and find their purpose in life. As the saying goes “it takes a community to build a business” and that was certainly true with AOF, which has found immense satisfaction in becoming friends with its clients and watching them become the best versions of themselves.
Elise Cummiskey is the owner of AOF. She has a remarkable story about how she used floating and some of the practical tools taught here at AOF to reduce stress and overcome some traumatic events in her life. When someone floats, they access a center of awareness most commonly related to meditation. The Mental Arts workshops, seminars and services are where AOF’s clients learn to utilize this center of awareness in their business and personal pursuits. Through sensory-deprivation, an alternative pathway for problem-solving can be realized. AOF can help clients relax, reflect and reach new heights.
AOF is the only Mental Arts float center in Pennsylvania. Got stress? Come float. Want to acquire lasting solutions to stress? Take one of the workshops or utilize some of the other Mental Arts services. That combination is what sets AOF apart, and was part of the reason why AOF was the recipient of the 2015 Community Progress Award at the Columbia Montour Chamber’s Annual Membership Meeting.
For more information on AOF, please visit its website.
Member spotlights are chosen via a random drawing from members that submit their business cards at a Business After Hours event. The next Business After Hours is scheduled for Sept. 20 at Kawneer, 500 East 12th St., Bloomsburg.
Danville is presented with plaques and signage officially designating it as a Susquehanna Greenway Partnership River Town on Friday, Sept. 8, 2017. (L-R) Trevor Finn, Montour County Commissioner;, Tom Forrestal, Merck Cherokee Pharmaceuticals and Danville Business Alliance Board of Directors; Matt Beltz, Columbia Montour Chamber; Dr. Ed A’Zary, Danville Borough Council; John Rodman, Danville Borough Council and Danville Business Alliance Board of Directors; Trish Carothers (kneeling), Susquehanna Greenway Partnership; Jamie Shrawder, Danville Borough; Ken Holdren, Montour County Commissioner; Gail Kulp, Susquehanna Greenway Partnership; Bob Stoudt, Montour Area Recreation Commission; Lauren Stoudt (front); David ‘Otto’ Kurecian, Columbia Montour Visitors Bureau; Dan Hartman, Montour County Commissioner; Ben Stoudt; Brian Stoudt.
Danville has successfully completed the process to be designated a River Town by the Susquehanna Greenway Partnership and a brief ceremony was held on Friday, Sept. 8 to unveil the official River Town signage at River Front Park in downtown Danville.
The Montour County Commissioners and representatives from Danville Borough, Columbia Montour Chamber, Columbia-Montour Visitors Bureau, Danville Business Alliance and the Montour Area Recreation Commission were all on hand to celebrate this achievement.
The Susquehanna Greenway Partnership is a nonprofit that seeks to:
- Determine the status of regional greenway efforts;
- Build upon public participation activities previously conducted in the corridor;
- Promote the importance of strong community involvement in present and future greenway development;
- Provide a diverse and inclusive program to maximize input from all segments of the population; and
- Promote local ownership of the greenway plan and its implementation!
The SGP’s River Town program provides assistance to communities that are located on the Susquehanna Greenway “that seek to revitalize and celebrate their River connection, based on four key principles:
- Respect and work with the nature of the Susquehanna River
- Connect with the River (physically, visually, spiritually)
- Involve people with the River and with their River Town
- Recognize that economic development favors River Towns
Communities that would like to become an official SGP-designed River Town need to go through a process including a River Town assessment, define a community vision and goals, develop an action plan for revitalization projects, identify partners for implementation and collectively promote all River Towns. Through the help of many local community leaders and partners, Danville recently joined its nearby neighbors Lewisburg and Selinsgrove, among many others, as a SGP-designed River Towns. Berwick is also currently in the process of becoming a River Town.
From ChamberChoice
In June 2017, the U.S. Departments of Labor, Treasury and Health and Human Services provided guidance under the Mental Health and Parity and Addiction Equity Act (MHPAEA). Released in the form of a Frequently Asked Question, the guidance also included a model form as assistance to participants for requesting a plan’s mental health or substance use disorder benefits, or to obtain documentation in support of an appeal.
Background
The MHPAEA requires that financial requirements and treatment limitations for mental health and substance use disorder be in parity with the financial requirements and treatment limitations applicable to medical and surgical benefits. In plain language this means a plan’s coverage limits on mental health and substance use disorder benefits may not be more restrictive than medical and surgical benefits. Financial requirements include deductibles, copayments, coinsurance and out-of-pocket maximums. Treatment limitations reference limits on the number of days or number of visits covered and/or limits on the scope or duration of treatment.
Group health plans are required to disclose certain information to plan participants regarding coverage of mental health/substance use disorder benefits under the MHPAEA. Under the disclosure requirements, plan and insurers must:
• Disclose the criteria for medical necessity determinations related to mental health/substance use disorder benefits to current participants, beneficiaries, or contracting providers on request; and
• Provide the reason for denials (often referred to as an “adverse benefit determination”) of reimbursement or payment of mental health/substance use disorder benefits.
Plans that are subject to ERISA (private employer plans) include further disclosure requirements to plan participants, upon request, about the processes, strategies, evidentiary standards, and other factors used
to make a determination under its claim denial procedures.
Model Participant Request Form
The Departments issued a model form in June that may be used by health plan participants and their representatives to request plan documents concerning a plan’s or insurer’s MHPAEA related compliance. Along with other general information, the request form reminds employers subject to ERISA that the plan must provide plan documents addressing benefits upon request from a plan participant within 30 days of receiving a written request. The form further allows for a participant to seek information on a specific condition or disorder by requesting:
• Specific plan language regarding limits;
• Identify the factors used in the development of the limitations and evidentiary standards used to evaluate the factors;
• The methods and analyses used to develop limits; and
• Provide evidence showing that the limit is applied no more stringently to mental health/substance use disorder benefits than medical/surgical benefits.
The draft form is not required to be used by a participant when requesting information and a plan/insurer must respond to information requests even if the form is not used. However, the Departments indicated that a model form is helpful to participants when asking for information, and is more uniform and streamlined.
Eating Disorders
The same FAQ issued by the Departments in June also provided that an eating disorder is a mental health condition. As such, the benefits for the treatment of an eating disorder must be in parity with a plan’s medical and surgical benefits.
Conclusion
The provision of benefits for mental health/substance use disorder treatments continues to be on the radar of the regulatory Departments. Employer plans that are subject to ERISA should know that the issue of parity under the MHPAEA is a major issue under a DOL investigation. Plans may want to review the draft model request form in order to be prepared for any requests. This would also be a good opportunity for an employer to review the plan document’s claims and appeals process and procedures, to ensure compliance with ERISA. The model form can be used until finalized.