Standing Beside Alaska's Non-Profits

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by Stephen Issacs and Paul Jellinek

Recently two consultants who have helped with our group benefit plan -- Stephen Isaacs and Paul Jellinek -- provided an analysis of how the current debate could affect us.  Their report follows and originally appeared in the Foraker Group September newsletter.

When they return from summer vacation, members of the House of Representatives will consider a bill, known as the Tri-Committee Plan or Tri-Committee Bill, that represents the thinking of the three House committees with jurisdiction over the issue (Ways and Means, Education and Labor, and Energy and Commerce—which has issued a number of amendments to the Tri-Committee Plan to satisfy Blue Dog Democrats) and members of the Senate will consider a bill proposed by the Health, Education, Labor, and Pensions (HELP) Committee, chaired by Senator Edward Kennedy. Still to come is the bill of the Senate Finance Committee, though many of its views are known from its policy statements and interviews with the committee’s chairman, Senator Max Baucus.

Some of the elements of the pending bills pertinent to the Foraker Group Benefit Plan are outlined below.

Individual mandate. Both the Senate HELP and the House bills require individuals to have health insurance or pay a penalty. Those falling below certain income levels will be eligible for premium subsidies. The Senate Finance Committee is likely to issue a bill with a similar provision.

Employer mandate. Similarly, the Senate HELP and the House bills require all businesses above a certain size (Senate HELP bill: 25 employees; House bill: depends on payroll) to contribute a significant percentage toward premiums or pay a penalty. Some small businesses (based on number of employees and average wages) will be eligible for a tax credit. The Senate Finance Committee has indicated that its bill, too, will contain an employer mandate.

Central insurance pooling body. The two plans on the table include establishment of a central body—called the Gateway in the Senate HELP bill and the Exchange in the House bill—to serve as an intermediary, pooling those who need premium subsidies and linking them with certified health insurance plans. In both plans, states would be permitted to create their own insurance pooling body. The Senate Finance Committee is likely to adopt a similar provision.

The Public Option. Both the House and Senate HELP bills propose creation of a new public health insurance option to be offered through the Gateway or Exchange. The Senate Finance Committee has been cool toward a public option, preferring, according to press reports, the creation of very large purchasing cooperatives.

Medicaid and the Children’s Health Insurance Program. Both the Senate HELP and the House proposals would raise eligibility levels for these two programs.

Benefits. The benefits are not specified in either of the two bills that have been reported out of committee; each calls for a “comprehensive” package. The Senate HELP bill proposes a temporary, independent commission to advise the HHS Secretary on the essential benefit package. The House bill suggests creation of a Health Benefits Advisory Council to make recommendations on the benefit package and cost-sharing levels.

Insurance exclusions. Both bills require guaranteed issue and renewability, prohibit denial of coverage based on pre-existing conditions, and allow rating variability based on limited factors (The Senate HELP bill states that variability can be based only on family structure, geography, the actuarial value of the plan benefit, tobacco, and age. The House bill restricts variability to age, premium rating area, and family enrollment).

Prevention and wellness. Both plans emphasize prevention and wellness and encourage insurers to follow suit. The Senate Finance Committee is expected to report out a bill with similar emphases. The House plan proposes eliminating cost-sharing for proven preventive services in Medicare and increasing payments for certain [unspecified] preventive services. The Senate HELP bill proposes increasing the allowable premium discount to employees participating in wellness programs.

Quality of care. Both plans propose a variety of measures to improve the quality of patient care, including establishing a federal center to evaluate comparative effectiveness, testing different approaches to improving quality, and increasing public reporting.

Cost containment. The Senate HELP proposal does not really deal with cost containment, perhaps because that lies largely within the jurisdiction of the Senate Finance Committee. The House bill contains a number of recommendations, including simplifying health insurance administration, testing ideas such as medical homes and accountable care organizations, encouraging health information technology, bundling acute and post-acute payments, reducing payments for unnecessary hospital readmissions, and reducing Medicare Disproportionate Share Hospital payments (though not until 2019).

Commentary. This commentary must be preceded by a mild disclaimer. Since nobody knows what the final bill will look like when it emerges from a House-Senate Conference Committee (or, given strong Republican opposition and conservative Democrat doubts, whether any bill at all will emerge from Congress), the comments below are speculation, albeit informed speculation.

The overall direction that health reform is likely to take is known from the plans already on the table and the papers issued by the Senate Finance Committee. Essentially whatever is passed (if something is passed) will look a lot like the Massachusetts plan, with individual and employer mandates and an outside authority to pool buyers and link them with health plans, plus a strong emphasis on prevention/wellness and cost containment. Important details and key elements—such as whether to have a public plan and how to pay for insuring an additional 46 million individuals—are still to be worked out and will depend as much on politics as on sound policy making.

Though it may be premature for the Foraker Group to make plans around what might transpire, it might keep in mind the following: (a) there will probably be a large number of previously uninsured people who will now need to buy health insurance; (b) a lot of employers will be looking to sign up for a health plan; (c) wellness, which the Foraker Group is already encouraging, will be heavily promoted. If the Foraker Group can offer competitive rates, it might have a leg up in the new health care marketplace.

Dennis McMillian discusses pursuing an affordable health insurance product for nonprofits for the past 25 years, and "a gradual, thoughtful process that allows nonprofit employers to provide adequate coverage for their employees."

Says Dennis, "Regardless of the current debate, I expect certain trends to emerge as a national plan evolves.  Employers and employees will likely be asked to do more to provide insurance coverage.  Today we can’t drive in most states without car insurance.  In the future, not having some form of health insurance won’t be an option, either.  Clearly, government will be part of a new health care system.  Already we have government-managed systems for senior citizens and people who can’t afford to pay for their care – Medicare and Medicaid – although both need revisions to become more effective.  And the concept of promoting wellness has universal appeal and will be a part of any solution."

The Foraker Group offers two “off-the-shelf” health insurance plans with the vision to shift to a true association plan when the numbers are right. Here are some of the recent highlights of Foraker's health initiative:

  • 318 employee lives are currently enrolled (as of 08/21/09).
  • 26 groups are enrolled.
  • Four groups with the potential to bring on 11 additional employee lives have inquired about the plan (as of 08/21/09).
  • In January 2009, approximately 130 employees were enrolled in the benefit plan.  The plan more than doubled that number in 7 months.   
  • In spring 2009, eight briefing sessions were held to provide updates to Partners and brokers.  
  • Two of our largest groups joined during June open enrollment – one group with over 70 employees and another with over 30.
  • Almost half our members have completed the online health assessment.  This is the highest rate of all Premera groups in Alaska, Washington and Oregon.  
  • To date, two wellness workshops have been held in Anchorage, the next wellness workshop will be held in Juneau in September.  Recently, interest surfaced in Fairbanks for a wellness workshop.
  • The requirement of funding dependent coverage has been lifted.
  • Waiting periods to enter the plan have been waived, although participants must still be Foraker Partners.
  • A group of preferred brokers has been identified.  These brokers are familiar with the plan and have sold and/or consistently promoted it.  Partners will be referred to preferred brokers. 

Read the entire Letter from the President.

If you have questions about The Foraker Benefit Plan, please contact Rebecca Savidis by phone at 907-743-1200, or by email at

How are you getting your health insurance coverage? How is your nonprofit handling health insurance?



In the old days, a blog was a place to post a list of links to other web sites, sometimes with commentary to give some context to the list, hence the term Web Logs or Blogs. Today, a blog can be the hub to your entire social media efforts, a place where you can link to your pages on social networking sites and accounts with other social networking tools.

While The Foraker Group dips a toe into the social media waters, we're using our blog as

  • a place to draw attention toward important articles and resources on The Foraker Group web site;
  • a place to comment on and link to interesting news stories regarding nonprofit issues;
  • a place to provide perspectives on the use of social media tools by nonprofits;
  • a place where we can hear from you to learn about your opinions on issues we blog about or on ones that you're facing.

It's the last objective where we need your help and participation. A blog can be an incredible community-builder, however, someone needs to be brave enough to come out from the shadows and not just read but respond. We know you're out there (our blog stats show an average of 100 readers per blog post).

Now's the time to introduce yourself. We'd like to turn this blog into a powerful community where we each have the opportunity to voice our opinions and tell our stories. This is not a broadcast medium.

What's on your mind as someone working with or within a nonprofit organization?

Foraker president Dennis McMillian's latest Letter from the President discusses the need for board diversity and how to get there.

He elaborates on these ideas:

1. Use the tools we advocate in training for good board recruitment and retention.

2. Recruit true believers.

3.Tokenism is not a strategy.

4. Don’t rush to recruit.

"I found that almost every organization was encouraged to recruit a more diverse board," says McMillian. "Looking at my own board back then, I realized that it also lacked diversity. It especially lacked involvement of Alaska Natives. In other words, board diversity has been a big issue in this state for a while, and unfortunately almost 20 years later, we seem to have made little progress."


What are your thoughts regarding board diversity? Share them here in our blog comments.

Recently, we created a Facebook Page for The Foraker Group to explore the value of social media specifically as a communications tool throughout Alaska particularly for people working with Alaska nonprofit organizations as well as our Partners.

There are several things to note about the Page and the use of Facebook for communications:

1. Page Not Profile. Facebook Pages are tools that companies and nonprofit organizations can build to create a presence on Facebook. People can then show their support or interest by becoming a fan of the Page.

Note: Nonprofit organizations are not supposed to create Profiles on Facebook according to Facebook rules. If you have a Facebook account, then you have set up a Profile. Some organizations have incorrectly set up Profiles for their organizations instead of Pages and run the risk of having their accounts suspended by Facebook which means losing all the "Friend" connections and content.

2. Blog Feed. The Foraker Group is feeding its blog posts into the Facebook Page so you can now read this content in multiple platforms including on the blog itself, on the Foraker Facebook Page or by subscribing to the blog's feed (there are subscription options towards the middle of this blog page).

3. Events. We'll post The Foraker Group calendar events to the Facebook Events feature so you can also access information about upcoming classes and events from your Facebook account.

Note: By saying you'll attend on the Facebook Event Page does not confirm your reservation for the class or event. It simply notifies your friends on Facebook of an interesting event you are attending. You still must register via The Foraker Group web site as usual.

4. Discussion. There is a Discussion link at the top of the Foraker Facebook Page where you can click to start or join in on a conversation. We're testing out the value of an online discussion forum so feel free to leave some comments there.

If you're using Facebook, we hope you'll become a Fan of The Foraker Group Facebook Page to help us explore this new communications asset.

If you are using Facebook, what are you using it for specifically?


Are you always on the go? Do you have a long commute and want to spend that time learning something new? You might want to try podcasts. Podcasts are basically downloadable audio files, often in the format of a radio show with a host, sometimes guests, and in the case of nonprofit podcasts, timely and helpful information about issues of interest to nonprofits and philanthropic organizations.

Most well-produced and popular podcasts are under 30 minutes in length although some are longer and still others are under 10 minutes. You can listen to podcasts on the Web, however, the ideal way is to download the MP3 files onto your computer and load into your MP3 listening device like an iPod. A great source of weekly free podcasts is iTunes.

Here are some podcasts that might be of interest to anyone working at or with nonprofit organizations:

Philanthropy This Week - A new audio offering by The Chronicle of Philanthropy covering nonprofit news with expert guest views.

Social Good - Allison Fine offers her nonprofit consulting expertise and interviews guests (also offered by The Chronicle of Philanthropy).

Social Media Goodness - The Foraker Group communications consultant Aliza Sherman (your humble blogger), talks about the basics of social media geared toward nonprofits.

Craigslist Foundation Nonprofit Boot Camp - Based on workshops given by the Craigslist Foundation to discuss nonprofit issues with a lot of expert advice.

Conquering Nonprofit Chaos - Author Bradley Burck breaks down concepts from his book of the same name.

What are your favorite podcasts that can be helpful to nonprofit organizations and their staff, volunteers and board?


The Foraker Group recommends caution and prudence in your decision-making during this challenging financial downturn. This is not the time to panic or make rash decisions. The community you serve is depending on you to fulfill your mission promise. Your leadership and strategic decisions should guide your way as you navigate uncharted territory.

To keep you abreast of the resources and news related to the state of the economy and its impact on nonprofit organizations, we continuously post news, commentaries and perspectives from a variety of sources on the Foraker site under Economic Response.

We urge you to check this section of our site often for new information, and feel free to send us relevant links or post them to comments here.

What resources are you using right now to weather these tougher economic times?

The next Foraker Certificate in Nonprofit Management begins in September 2009.

All classes will be held in Anchorage, Alaska. Applications are NOW available. Applications are due June 30, 2009

Classes begin in September and end in December 2009.

The Foraker Certificate in Nonprofit Management is a statewide program offered in partnership with the University of Alaska. This is a non-degree program offering 10.4 Continuing Education Units (CEU's).

The program is designed for Alaska nonprofit professionals in leadership positions who want to enhance their management skills and explore a full range of issues and best practices to use in their organizations.

Tuition for the certificate program is $2000 for Foraker Partners. Tuition for all other students is $2500 . All students will also be charged a $300 books and materials fee. Payment is due on the first day of class unless other arrangements are made. Please do not send payment with your application. Limited travel scholarships are available for those living beyond driving distance.

The application process is competitive. Applicants will be evaluated based on their current position in the organization, their career intentions, impact on the agency, and geographic distribution. Every effort is made to create a cohort of students that will both teach and learn from each other.

Read more about the Program.

Download the Application. (Word Doc)

Access the Fall 2009 Schedule. (Word Doc)

Have you gone through the program already? If so, we'd love to hear some of your feedback here.

Did you know the Obama Administration has launched a new online portal,, where organizations can list service opportunities and individuals can find openings of interest or develop their own projects?

From the site:

"This website is a new portal for you and all Americans to find your own ways to serve in your own communities. Just choose your keyword - "education," "environment," or whatever interests you - and type in your zip code to see what opportunities our partner organizations have in your area. Americans are putting their own country back on the right track, be a part of it."

The service effort will focus on:

1) promoting clean energy, energy efficiency, and public land restoration;

2) supporting education and literacy for all Americans;

3) increasing health care access, public health awareness, and prevention; and

4) providing community renewal to areas hardest hit by the economic crisis.

Federal agencies are also working on developing tools to assist service activities and to help to track the community impact of these efforts.

First Lady Michelle Obama and the Corporation for National and Community Service announced this initiative to help put volunteers "on a path to sustained service." The initiative launches officiallyon June 22 at the National Conference on Volunteering and Service and culminate in a National Day of Service and Remembrance on September 11.

Additional reading:

Press Release: First Lady Thanks Corporation for National and Community Service Employees

Remarks by the First Lady at a Corporation for National and Community Service Event

Time is running out for all qualifying Alaska nonprofits to apply for the 2010 PFD Contributions Program.

Here are some things to note:

1. Apply now. If you are working with an Alaska nonprofit interested in being considered for the 2010 PFD Contributions Program, you must apply. You can get to the application information via Pick. Click. Give.'s site.

2. Re-Apply. If you are an organization that qualified in 2009 for the program, you still must apply again in order to be considered for 2010. It is not a given that you will get into the program again, plus there are new questions to answer as well as modified guidelines.

3. Do You Qualify? Only qualifying organizations should apply. Guidelines for qualification are in the program's FAQ.

4. Apply Early. Think about submitting your application by May 31, 2009 to receive feedback on your application.

5. The Deadline Is...The final deadline to have your application postmarked is June 15, 2009.

For more information, you can call 1-888-785-GIFT (4438) or email

Customer Satisfaction

Our success at The Foraker Group is measured, in part, by the satisfaction of our customers. Only by meeting your expectations will we be able to fulfill our core purpose of strengthening Alaska nonprofits. Recently you should have received an email about our 2009 Customer Satisfaction Survey if you have worked with us in the last year.

Please take a few moments to complete this survey. It will be open for your participation until May 29. We ask that you select one person from your organization to take the survey -- preferably a senior member of your board or staff. Individual responses will be kept confidential. However, we will share a summary of them with Partners after the survey closes.

As an added incentive this year -- after you have taken the survey we will include your organization in a drawing for one free hour of consulting time. At the end of the survey you will be sent to a separate web page to enter your name, organization, phone and email. This extra step assures the anonymity of your responses.

Please email for a link to the survey if you haven't received our notice.

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