Live Well, Work Well – June 2011

June 1st, 2011

Home Safety Month

June is Home Safety Month and it’s the perfect time for you to make sure your home is as safe as possible for you and your family. The Home Safety Council provides the following tips to help you avoid various hazards in your home:

  1. Put a non-slip mat in your shower.
  2. Keep stairs clear of clutter and ensure proper lighting at the top and bottom. Use safety gates if you have young children.
  3. Make sure you have sturdy handrails on all stairs (indoors and outdoors).
  4. Wipe up spills when they happen.
  5. Keep the Poison Control phone number (1-800-222-1222) by each telephone and programmed into your cell phone.
  6. Install smoke and carbon monoxide detectors and regularly check the batteries.
  7. Read labels of all products you use in your home. Any that say “caution,” “warning” or something similar should be stored away from children, either locked up or on a high shelf.
  8. Keep all medications out of reach of children. Make sure they are not in purses, pockets or drawers where children could easily access.
  9. Keep original label on all medication and cleaning supplies.
  10. Always stay by the stove or grill when cooking.
  11. Keep grills at least 10 feet away from your house, garage and any trees or bushes. Keep children and pets away.
  12. Only light candles when an adult is in the room, and never leave candles burning unattended.
  13. Have a fire escape plan and hold a fire drill with your family. Make sure all adults in the house know how and when to use a fire extinguisher.
  14. If you have a pool or hot tub, install a fence around it.
  15. Always watch children carefully when in the bathtub or pool, even small, child-sized pools.

Easy Calorie Burning

Looking for an easy way to increase the number of calories you burn each day? Try tapping your foot or twiddling your thumbs! Research shows that people who consistently fidget while sitting burn more calories than those who sit still.

Other ways to boost calorie burning while at your desk or on the couch include:

- Standing up while talking on the phone

- Focusing on maintaining good posture

- Bouncing your leg or tapping your fingers

- Doing neck, arm or leg stretches

DID YOU KNOW?

A study conducted by Dr. James A. Levine, a researcher at Mayo Clinic, revealed that people who do more fidgeting and gesturing can burn as many as 350 extra calories per day. This would add up to 36 pounds lost in one year (assuming consistent food intake).

Email Precautions You Need to Know

Did you know that emails sent at work could be grounds for termination or create legal problems? It is essential you take precautions when using email, to protect your job and company.

-   Avoid jokes and sarcasm in an email. You may unintentionally offend someone or a recipient may misread your tone. Instead, be professional and clear.

-   Remember that emails are permanent and you do not own your email your company does. Do not send anything in an email that is inappropriate. The company may monitor your email and may use it as grounds for discipline, if appropriate.

-   Always proofread your email and double check recipients and attachments before sending.

-   Use care when using “Reply All.” Do all of the recipients need the information you are sending? Should all recipients be privy to the information?

-   Consider using the phone or face-to-face conversations for sensitive or complex information.

-   Do not send an email in anger. Give yourself time to cool down from the situation. You cannot “unsend” an email!

Healthy Eating on a Budget

Grocery shopping on a budget can be difficult – especially when trying to make healthy choices. Sometimes it can seem easier and less expensive to buy a cheap, processed meal (or swing through your local drive-through) than to plan a healthy, quality meal. But with these tips, you can balance health and budget.

  • Set aside time to clip coupons and plan weekly meals and snacks. This allows you to take advantage of items on sale and make the most of what you buy so nothing goes to waste.
  • Always have a list when you grocery shop and don’t go when you’re hungry!
  • Buy nonperishable items in bulk (especially when they’re on sale) and buy generic. This can add up to a lot of savings.
  • Cook larger portions of healthy dinners and freeze the leftovers for another day.
  • Experiment with marinades and spices to add variety to easy, inexpensive dishes like chicken, potatoes, soup, pasta or rice.
  • Make it a priority to keep fresh fruits and vegetables in the house and incorporate them into your meals.

Baked Spicy Cod

Serve this tasty entrée with brown rice and vegetables for an easy, balanced meal. Makes 4 servings (140 calories each).

  • 1 lb. cod fillets
  • 1/4 tsp. paprika
  • 1/4 tsp. garlic powder
  • 1/4 tsp. onion powder
  • 1/8 tsp. pepper
  • 1/8 tsp. ground oregano
  • 1/8 tsp. ground thyme
  • 1 tsp. lemon juice
  • 1½ tsp. melted margarine

Preheat oven to 350 degrees F. Separate fish into four fillets or pieces. Place fish in ungreased, 13x9x2-inch baking pan. Combine paprika, garlic and onion powder, pepper, oregano and thyme in a small bowl. Sprinkle lemon juice and seasoning mixture evenly over fish. Drizzle margarine evenly over fish. Bake 20-25 minutes (until fish flakes easily with fork).

Source: www.nutrition.gov.

BenefitsBuzz June 2011

June 1st, 2011

DID YOU KNOW

The U.S. Treasury Department in conjunction with the IRS recently announced the new Health Savings Account (HSA) annual contribution limits for 2012.

The 2011 HSA contribution limit is $3,050 for an individual and $6,150 for a family.

The 2012 HSA contribution limit is $3,100 for an individual and $6,250 for a family.

Deadline Approaching to Amend Plan Documents for New OTC Rules

One of the provisions of the Patient Protection and Affordable Care Act changes the rules regarding over-the-counter drugs and health spending accounts.

Beginning Jan. 1, 2011, over-the-counter drugs are no longer eligible medical expenses under an FSA, HSA or HRA, unless accompanied by a prescription (with the exception of insulin). This effective date applies regardless of when the employer’s plan year begins and regardless of any grace period for health FSAs.

This rule does not include medical equipment and supplies, such as crutches, bandages and blood sugar test kits, which may still be reimbursed without a prescription.

Employers are required to amend their cafeteria plan documents to conform to

this new requirement. Generally, such cafeteria plan amendments may be effective only prospectively.

However, guidance released by the IRS allows employers to amend their plan documents to conform to the new OTC drug requirements, effective retroactively for expenses incurred after Dec. 31, 2010, as long as the amendments are adopted no later than June 30, 2011.

If you have not already amended your cafeteria plan document to comply with the new OTC regulations, you should make necessary changes by June 30, 2011.

The official IRS notice regarding this guidance may be found at: www.ecfc.org/files/legislative-news/n-10-59.pdf

 

CMS Issues Revised Medicare Part D Model Disclosure Notices

Group health plan sponsors that provide prescription drug coverage are required to provide a notice of creditable or non-creditable prescription drug coverage to Medicare Part D eligible individuals who are covered under the entity’s prescription drug plan.

The Centers for Medicare and Medicaid Services (CMS) provides model notices and recently released updated model disclosure notices for use on or after April 1, 2011. These updated notices comply with the new health care reform provision that changes the Medicare Part D Annual Coordinated Election period to Oct. 15 through Dec. 7 of each year.

Updated model notices are available in English and Spanish at:

www.cms.gov/CreditableCoverage/Model%20Notice%20Letters.asp#TopOfPage

Newsletter – May 2011

May 1st, 2011

BenefitsBuzz

 

DID YOU KNOW

The Form 1099 reporting requirement that was included in last year’s health care reform law has been repealed. This repeal measure received overwhelming support from Congress and was signed by President Obama on April 14, 2011.

The mandate would have required businesses to file a Form 1099 for any company from which it bought more than $600 in goods or services in one year. It was scheduled to go into effect in 2012 and was expected to increase both paperwork and accounting costs for businesses and landlords.

Study: Employee Moral Declines; Employers Oblivious

Employee morale is at a three-year low according to a recent study, but employers seem unaware of this steady decline.

The MetLife Study of Employee Benefits Trends recently released its ninth annual study. The report found a notable disconnect between employees and employers on the subject of loyalty.

Employee loyalty to their employers has declined for the past three years, as has their perception that the company is loyal to them. Conversely, employers remain oblivious to this decline, assuming employees are just as loyal now as they were three years ago.

Understandably, employers have been focused on surviving the economic downturn, but it seems many are unaware that their employees are becoming more and more dissatisfied. The survey found that over one in three employees (from all company sizes) hope to be working elsewhere within the next year.

Furthermore, a survey by the career website Glassdoor.com revealed that 4 in 10 workers believe it is likely they’ll find a new job matching their experience and salary in the next six months.

In light of these findings, it’s more important than ever for employers to focus on employee satisfaction. A good way to start is to survey employees about their satisfaction levels and ask how your company can improve.

Employers who fail to address falling employee morale may find themselves facing high turnover rates as the economy recovers and employees search for better opportunities.

Court Decision Has Wellness Implications

A recent decision in Seff v. Broward County is encouraging news for employers with wellness programs.

Broward County’s wellness program includes a biometric screening and health risk assessment. Employees enrolled in Broward’s health plan but not participating in the wellness program pay an extra $20 each paycheck toward their coverage.

Bradley Seff, a former employee, sued, claiming that this program violated the ADA by requiring employees to undergo a medical examination. The judge disagreed. He found that the plan was permissible because it fell within the ADA’s safe harbor provision as a bona fide employee benefit plan based on underwriting, classifying and administering risks.

This ruling provides some baseline guidance for employers offering similar wellness programs. Employers should still take caution that their health plans and wellness programs comply with all areas of the ADA, HIPAA, GINA and ERISA.

Live Well, Work Well – May 2011

May 1st, 2011

DID YOU KNOW?

Saving just $50 a month beginning at your child’s birth will yield $20,000 by age 17 (with a 7 percent return on your money).

Fit Physical Activity Into Your Routine

One of the best things you can do for your health is get regular physical activity. It can help you reduce your risk of disease, control your weight and reduce stress. However, exercising regularly is easier said than done. These tips can help you work physical activity into your daily routine.

 At home:

  1. Clean the house, wash the car or do yard work, rather than hiring someone else to do it.
  2. Stand up or walk around while talking on the phone.
  3. Get the whole family involved! Play with your kids or plan family hikes, bike rides and other activities.
  4. Lift weights or do other exercises while watching television.
  5. Walk the dog or push your baby’s stroller around the neighborhood.

 At work:

  1.   Take the stairs instead of the elevator.
  2.   Walk over to someone’s office rather than calling them.
  3.   Take walks at lunch or break time and ask a coworker to join.
  4.   Schedule walking meetings for short chats or brainstorm sessions.
  5.   Join a company sports team.

On the go:

  1.  Park in the back of parking lots to increase your walking time.
  2.  Get off the bus one stop early and walk the rest of the way.
  3.   Walk or bike to nearby destinations instead of driving.
  4.   Make plans to do physical activities with friends, such as play tennis,  hike, go swimming or join a recreation sports league.
  5.  When golfing, walk instead of using a cart.

Save for Their Future

College may seem a long way off for your children, but the sooner you start saving, the more you’ll be able to help your child fund his or her education. Consider these tips:

  1. Open a savings account the day your child is born.
  2. Put money away on a consistent basis, such as an automatic payroll deduction. Adjust this amount as your salary increases.
  3.  Save windfalls such as tax refunds and bonuses.
  4. Ask other relatives to contribute in lieu of gifts.

Protect Your Vision

Eye health can become an afterthought, particularly for people who have never had vision problems. However, getting regular eye exams and protecting your vision is important to help avoid eye conditions and discover problems early so you can seek proper treatment.

The most important step for maintaining eye health is getting regular eye exams. Often, people don’t realize their vision has decreased and that glasses or contacts could help them see better. In addition, eye exams can help diagnose diseases such as glaucoma and diabetes, which may have no obvious symptoms. Don’t forget to take your kids in for regular eye exams as well; vision problems can decrease performance at school and make daily activities harder for your child.

Other steps to protect your vision include always wearing sunglasses when out in the sun, wearing protective eyewear when performing dangerous work and resting eyes periodically when at a computer for extended periods of time.

Stress Relief at Work

Do you often feel stressed or overwhelmed at work? Strive to reduce your stress with these suggestions:

  1. Plan your tasks. Create a to-do list each day, set realistic deadlines for yourself and prioritize tasks by importance.
  2. Recognize when you’re feeling stressed and address it. Take a short break and meditate, go for a quick walk, switch tasks or turn on some relaxing music.
  3. If a task or problem is overwhelming you, take a break and return to it later. Also consider asking for assistance, advice or tapping into other available resources.
  4. Consistently communicate with your manager about your workload and to clarify expectations and deadlines.
  5. Find healthy ways to cope with stress, such as physical activity, meditating, reading a book or chatting with a friend.

Banana Yogurt Shake

  1. 1-1/2 cup fat-free milk
  2. 4 small bananas, peeled
  3. 1 cup low-fat plain yogurt
  4. 1 tsp. vanilla
  5. 1/2 tsp. cinnamon
  6. 1/8 tsp. nutmeg
  7. 1 cup ice cubes

Combine all ingredients except ice cubes in blender; process until thick and creamy. Add ice cubes and process until smooth. Makes 4 servings (160 calories each).

Newsletter – April 2011

April 1st, 2011

BenefitsBuzz

DID YOU KNOW?

A recent study showed that health care costs rose at a 15 percent slower rate for employees who participated in a wellness program, compared to employees who didn’t.

This study, conducted by Highmark, Inc. and published in the American Journal of Health Promotion, surveyed employers who consistently provided a wellness program over a span of four years, and found a health care cost savings of $332 per wellness participant.

 

To Offset Health Care Costs Increases, Sweeping Plan Design Changes Expected

According to a survey recently released by Towers Watson and National Business Group, health care costs are projected to increase by 7 percent in 2011. Annual costs per employee are expected to reach $11,176 (up 7.6 percent from 2010).

Employers are concerned not only with these expected rising costs, but also with the effects health care reform will have on their health plans over the next several years. Many companies are implementing more comprehensive plan design changes to address these concerns, such as:

  1. Increasing contributions for dependents, either through per-dependent contributions or spousal waivers or surcharges
  2. Discontinuing employer-sponsored retiree medical coverage or restructuring retiree programs
  3. Offering incentives or penalties to providers based on performance
  4. Focusing on wellness and rewarding or penalizing employees based on biometrics like weight and cholesterol

In addition, adoption of consumer-directed health plans (CDHPs) with an HSA or HRA is rapidly growing. Many employers are promoting these plans by offering employees significant premium reductions. Companies with high CDHP enrollment have been able to keep costs flat and even reduce per-employee health care costs.

Celebrate National Employee Benefits Day!

Did you know there was a day (April 4th) set aside to acknowledge benefits trustees, administrators and advisors for their role in providing quality benefits for their colleagues?

In addition to a much-deserved pat on the back, this day serves as a perfect opportunity to evaluate your current employee benefit communication efforts and ramp up employee education about your benefit offerings. Here are some ideas to promote your benefits:

  1. Host a lunch-and-learn led by your Benefits Team.
  2. Send periodic emails or payroll stuffers to communicate benefits information.
  3. Host Q&A sessions for employees.
  4. Provide employees with Total Compensation Statements.
  5. Add a new benefit, such as walking programs, casual Fridays, monthly lunches or flexible scheduling.

Live Well, Work Well – April 2011

April 1st, 2011

Did You Know?

Each day, approximately 75 people receive organ transplants in the United States, but approximately 20 die each day waiting for transplants

Alcohol Awareness Month

April is Alcohol Awareness Month, and although talking with your kids about the dangers of drugs and alcohol can be very difficult, there are strategies that can help.

Following the five suggestions below can help you develop regular communication with your children, if you haven’t already. Talking with them about their day-to-day lives will make it much easier to bring up the harder topics, such as drugs and alcohol, when the time is right.

  • Listen. Make eye contact with your child, and let them know you’re paying attention. If it’s the end of a long day and you need time to relax, say so. Explain that you need a few minutes to unwind, and then you’ll be ready to give your full attention.
  • Do activities together. Do chores together and talk while you’re working. Or, run to the grocery store together – car rides can be a great time to spark up conversation.
  • Set up regular family meetings. Use this time to let every member of your family discuss what’s on their mind.
  • Role-play with your child and teach them how to say no. Simulate a situation where a friend is pressuring your child into drinking or smoking. Explain how to think through a situation like this and emphasize the potential consequences of their choices.
  • Support your child in everything they do. Regularly encouraging and supporting your child in school, sports and extracurricular activities shows them that you support them should peer pressure come into play.

Find more information and prevention strategies at www.samhsa.gov.

Donate Life

April is National Donate Life Month. With over 110,000 people on the national organ transplant waiting list, there’s no better time to become an organ and tissue donor. One donor can save up to eight lives.

How to become a donor:

  1. Register with your state donor registry at your state’s Department of Transportation website.
  2. Designate that you are an organ donor on your driver’s license. You can do this when you obtain or renew your license.
  3. Download a donor card at organdonor.gov to fill out and carry with you until you can designate your donation decision on your driver’s license or join a donor registry.
  4. Talk to your family about your donation decision. Help them understand your wish to be an organ and tissue donor before a crisis occurs.

Seasonal Allergies

While the winter months typically provide some relief for allergy sufferers, spring is here – and so are the allergies associated with this seasonal change. Mold growth blooms indoors and out with spring rains. As flowers, trees and grasses begin to blossom, allergies will follow. And spring cleaning activities can stir up dust mites, so here are some tips:

  1. Wash your bedding every week in hot water to keep pollen under control.
  2. Shower before going to bed, since pollen and other allergens can accumulate in your hair throughout the day.
  3. Wear a painter’s mask when cleaning or vacuuming to limit dust and chemical inhalation. 
  4. Change air conditioning and heating air filters at least every 3 months.
  5. Limit the number of throw rugs in your home to reduce dust and mold. If you do have throw rugs, consider washing them once a week or vacuuming twice a week.

Give LTC Some TLC

Have you considered long-term care (LTC) insurance? Despite often being overlooked, it is likely that you or someone you love will require long-term care at some time. According to a recent study by Georgetown University, the cost of LTC is expected to triple by 2050. Here are some tips to consider when deciding on a long-term care policy:

  • - The most important factor when considering LTC insurance is to make sure you find a policy that has affordable premiums for you. This may require some shopping around for the best policy that fits your lifestyle.
  • - Even though LTC coverage may seem expensive, the average cost of a private room in a nursing home is $77,380 per year – a daunting price tag without LTC coverage.
  • - The younger you are, the lower your premiums will be for a LTC policy. And getting a policy when you’re young isn’t a bad idea – nearly 40 percent of those who need long-term care are under the age of 65. 

Fish Tacos

  1. 1 tsp. olive oil
  2. 2 cloves garlic, crushed
  3. 1 cup low-sodium chicken broth
  4. ½ tsp. ground cumin
  5. 1 lime
  6. 2 large tomatoes, diced
  7. 1 cup scallions, chopped
  8. ½ cup cilantro, chopped
  9. 1.5 lbs. halibut filets
  10. 12 corn tortillas

Sauté garlic and scallions until browned. Add chicken broth, tomatoes and cumin to the mixture and bring to a boil. Reduce heat to low and add halibut. Cook 15-20 minutes or until the halibut is easily flaked with a fork. Sprinkle with lime juice and garnish with cilantro. Wrap in warmed corn tortillas and serve. Serves 4. 

Increasing Health Care Costs and Your Employee Health Plan

March 25th, 2011

Health care costs, and consequently employee health benefits costs, have been increasing at an alarming rate for nearly a decade. Though cost increases had seemed to be leveling out based on 2009 data, cost increases actually jumped in 2010 and are expected to rise further in 2011. Avoiding rising health care costs is nearly impossible, but you can learn about why they continue to rise and what you can do to manage costs for your organization and your employees.

The next few pages will discuss the latest health care cost figures, the factors leading to nearly a decade of unprecedented rate hikes, and some strategies that firms around the United States are implementing to help manage costs. Also included is a prescription drug report released each year by Kaiser Family Foundation.

National Health Care Cost and Renewal Rate Projections

Overall national health care costs have been skyrocketing for over a decade. Exhibit 1A, right, depicts the percent change in average annual health care cost increases from 2003 to 2011. Cost increases leveled off between 2007 and 2009, and last year’s Hewitt Health Value Initiatives had projected 2010’s increase to remain at 6 percent. However, cost increases in 2010 actually jumped to 6.9 percent, and Hewitt expects an even larger spike in 2011.

The overall cost of health care has a direct impact on the rates employers pay for employee health benefits. However, health benefits costs have varied widely across the country for the last several years, hitting some metropolitan areas much harder than others. Exhibit 1B, right, illustrates health care cost increases in major metropolitan areas in 2010.

Experts expect significant annual increases in health care costs to continue. According to the 2010 Hewitt Health Value Initiative, the average cost of health care benefits for active employees rose to $9,028 per year in 2010 and is expected to grow to $9,821 in 2011. Employers are also passing more of these costs onto employees, as the percentage that employees are asked to pay is also increasing. In 2010 employees paid an annual average of $1,966 (21.8 percent of the total cost of their coverage); this figure is projected to grow to $2,209 in 2011 (22.5 percent of the total cost).

Exhibit 2A, below, shows the average total health benefit costs for active employees for the years 2004 to 2011. Exhibit 2B below depicts the 2010 health care costs per employee in U.S. major metropolitan areas.

Factors Leading to Increased Health Care Costs

                Why are U.S. health care costs skyrocketing? Several market conditions working in tandem have lead to a decade of unrelenting increases. Understanding why your annual health plan renewal rates may be significantly higher than the previous year is the key to formulating alternatives and solutions to your particular plan’s challenges. It is also important for educating your employees about the reasons behind any plan or contribution changes you may decide to introduce.

Several factors that have contributed to climbing health care costs over the past decade include:

  1. Demographics
  2. Expansion of health care providers
  3. Consolidation of managed care companies
  4. Political environment/government regulation
  5. Increased utilization and consumer demand
  6. New medical technology
  7. Weakening of managed care system
  8. Health care spending and medical cost inflation
  9. Increased prescription drug costs

In addition, Hewitt has identified a couple specific factors that are contributing to current 2010 health care costs and projected 2011 figures that are the highest we’ve seen in five years:

An Aging Population

     Not only is the American population aging, but workforces are as well. This is partially due to slower hiring levels recently, which has resulted in older employee populations. Because older workers are more prone to health problems, companies are seeing a rise in chronic conditions, costly medical problems and the use of prescription drugs, plus an increase in the amount and frequency of catastrophic claims.

Health Care Reform Implications

     It is too early to know exactly what impact health care reform will have on health care costs in the long run, but there are some clearer early implications. There are several provisions going into effect that are expected to raise costs, at least in the short term, including:

  1. Covering dependents up to age 26
  2. Elimination of certain lifetime and annual limits
  3. Required coverage of preventive services
  4. Prohibiting coverage rescissions
  5. No pre-existing condition exclusions for children

What Can Employers Do?

                You and other employers are undoubtedly trying to determine how to keep accelerating health plan rates from having debilitating repercussions on your organization. After years of trying to absorb most of the costs because of attraction and retention issues, many firms are now trying to attack the root causes of rising costs with sustained, systemic changes. Especially with the uncertainty of the overall impact of health care reform, many employers are looking at strategies to manage costs both in the short and long term. 

Using Health Care Data to Drive Strategy

A separate Hewitt Associates survey found that employers cite using health care data to make strategic health plan decisions as their top cost-cutting strategy. However, the survey also discussed the importance of going beyond just accessing data, and understanding how to apply it to make decisions and implement strategic changes.

Greater Emphasis on Consumer-Driven Plans

An increasingly popular trend in the health care industry is the adoption of consumer-driven health plans, typically involving and HRA or HSA. These plans offer cost-savings for the employer, but also benefit the employee as well. With proper education, employees can become smarter health care consumers, which can save them and the company money.

Promoting Employee Health and Wellness

Health and wellness initiatives have become another popular health care cost management strategy in recent years, and remain one of employers’ top cost containment strategies. As more and more employers are realizing, improving employee health and wellness can effectively lower health care costs and increase productivity. As this trend continues, many employers are creating more comprehensive programs, targeting specific diseases and including dependents in the initiatives.

Incentives for participation are growing in popularity as well (including incentives for dependents), but it is important that effective incentives are used. Rewarding employees for participating in a program or meeting a health goal is much more impactful than incentivizing simply the completion of a health risk assessment. Many employers are instituting penalties for nonparticipation as well, often in the form of higher premiums or additional employee cost-sharing. It is also important to note that successful wellness and disease management initiatives are dependent on quality employee education and communication techniques.

Increased Employee Cost-Sharing

Though companies will continue to shoulder the burden of increasing health care costs, many are choosing to pass more and more costs to employees. These are a few of the strategies for doing so:

  1. Moving from fixed dollar copayments to a coinsurance model (employee pays a percentage of costs for each health care service)
  2. Increasing deductibles and out-of-pocket maximums
  3. Increasing employee cost-sharing for non-network providers
  4. Offering consumer-driven plans, either as an option along with a traditional plan, or as the primary plan

Dependent Management Strategies

Employers are changing the way the manage dependents and finding huge cost-saving opportunities. Dependent eligibility audits can save companies huge amounts of money, as studies show that an average of 3 to 12 percent of dependents are actually not eligible to be on the health plan. Many companies are also shifting to a per-member premium structure, rather than just “individual” and “family.” In addition, an emerging trend is companies requiring spouses to pay more in premium or assessing a surcharge, to encourage spouses to enroll in their own employer’s plan.

Strategic Vendor Management

A more recent trend involves companies more aggressively evaluating their vendor relationships and replacing or eliminating those vendors not producing measurable results. Employers are also increasingly looking for opportunities to consolidate vendor relationships to get the most for their money.

 Long-Term Solutions vs. Short-Term Fixes

                Particularly due to the financial pressure many employers are under, short-term tactics like employee cost-sharing are still prevalent. However, employers are increasingly exploring multi-year plans and longer-term initiatives to improve overall employee health and strategically manage costs into the future. Especially in the wake of health care reform, many employers are becoming more concerned with developing strategies that have sustainability in keeping costs down.

Which Solution is Right for You?

Should you pass costs on to employees at the risk of losing some of them? Or, should you try to manage costs in some of the other ways discussed in this report? Ultimately, it is a decision that you need to come to through thoughtful and detailed analysis of your plans and with the advice of your broker-consultant.

                Below are some questions you can address in order to begin developing an effective strategy that is right for your organization.

  1. Is our program structure, plan design and pricing appropriate?
  2. Do we have the right vendors, services, contracting and funding in place?
  3. Are our employee communication efforts appropriate and effective – especially in regards to employee health and wellness and/or consumerism?
  4. Do we have effective disease management and wellness programs for our employees?
  5. Do our pricing and plan design features encourage cost-conscious behavior on the part of our employees?
  6. Are we thinking about long-term solutions rather than simply quick fixes for this year?

What Should I Tell My Employees?

It’s a fact: health care costs and health benefit costs continue to increase at exceptionally high rates from year to year. You want to continue to offer valuable health benefits to your current and future employees, and you want those benefits to help you attract and retain quality employees. However, you also need to consider the cost-effectiveness of those benefits at a time when hefty rate hikes are the norm, rather than the exception.

The information contained in this report is designed to help you understand why your renewal rates may have increased, and to consequently help you educate your employees about the reasons for any plan or contribution changes you may have to make. If your employees understand current trends in the health care industry, they will be more supportive of changes and will appreciate the resources required to provide them with their health care benefits. 

In Health Law, Rx for Trouble

March 10th, 2011

By JANET ADAMY

Sandy Chung is grappling with a new kind of request at her pediatrics office in Fairfax, Va.: prescriptions for aspirin and diaper-rash cream.

Patients are demanding doctors’ orders for over-the-counter products because of a provision in the health-care overhaul that slipped past nearly everyone’s radar. It says people who want a tax break to buy such items with what’s known as flexible-spending accounts need to get a prescription first.

The result is that Americans are visiting their doctors before making a trip to the drugstore, hoping their physician will help them out by writing the prescription. The new requirements create not only an added burden for doctors, but also new complications for retailers and pharmacies.

“It drives up the cost of health care as opposed to reducing it,” says Dr. Chung, who rejected much of a 10-item request from a mother of four that included pain relievers and children’s cold medicine.

Though the new rules on over-the-counter drugs amount to a small part of the massive overhaul of the health-care system, the unintended side effects show how difficult it can be to predict how such game-changing legislation will play out in the real world.

Some doctors, irked by the paperwork and worried about lawsuits, are balking at writing the new prescriptions. Pharmacists and retailers say the changes mean they have to apply a personalized label on some 15,000 different everyday products for customers paying with certain debit cards.

The over-the-counter provision isn’t the only part of the health-care law that has defied expectations.

Health-policy experts predicted that new insurance pools for high-risk patients would attract so many expensive enrollees that funding would be quickly exhausted. In fact, enrollment is running at just 6% of expectations, partly because of high premiums.

A provision preventing insurers from denying coverage to children with pre-existing health conditions prompted insurers in dozens of states to stop selling child-only policies altogether.

And a piece of the law designed to centralize patient care by encouraging health-care providers to collaborate is running into antitrust concerns from regulators.

To the handful of congressional aides who came up with the idea to limit tax breaks on over-the-counter drugs, it was supposed to be a minor tweak to raise revenue and to discourage wasteful spending on health products.

Some 33 million Americans are in families that have flexible-spending accounts, which are funded through payroll deductions and allow consumers to pay for health expenses with tax-free dollars.

The change also applies to health savings accounts designed for consumers in insurance plans with high deductibles. If fewer people use these accounts to buy drugs, the government gets more tax revenue. Retail sales of over-the-counter medicines amounted to about $17 billion in 2010, not counting sales at Wal-Mart Stores Inc., according to Nielsen Co.

What the law’s writers didn’t anticipate was the determination of some people to squeeze every last drop of tax savings from their accounts.

When Dianna Greer of San Diego and her son came down with a cold, she wanted a $13 bottle of NyQuil and daytime cold medicine—and she wanted to pay for it by tapping the $5,000 in her flexible-spending account.

Ms. Greer says her doctor wouldn’t write prescriptions without an office visit, so she went without the drugs. Later, she got the prescriptions from a doctor at the emergency room, where she was diagnosed with pneumonia.

“It feels like you’re begging for something when it’s your money,” she says.

Much of the health law, which passed last year despite overwhelming opposition by Republicans, doesn’t take effect until 2014. The nonpartisan Congressional Budget Office has projected that an additional 32 million Americans will get insurance, and the law has already extended tax credits to small businesses for buying insurance and allowed many parents to keep their children on their health plan until their 26th birthday.

But opponents say it costs too much and gives the federal government too much control over health care. Republicans in the House voted this year to repeal the law, though the measure died in the Senate. Opponents are trying to get it struck down in the courts, a fight that is likely to last until at least next year.

As that larger battle plays out, the over-the-counter provision is emerging as a top target for change. Republicans in both the House and Senate have introduced legislation to repeal it and return to the old system. The largest chain drugstore lobbying group is backing the effort, arguing that the new rules are inefficient and limit access to the medicines. Asked whether she would support such legislation, Kathleen Sebelius, secretary of Health and Human Services, said: “I’d take a look at it.”

A spokeswoman for the Treasury Department, which oversees tax policy, says the provision “enjoyed bipartisan support in Congress, but, as the president said, anything can be improved, and we are always willing to listen to ideas about how to make health care better and more affordable.”

Tax breaks for over-the-counter drugs date to 2003, as popular drugs like the allergy medicine Claritin began switching to over-the-counter status. The Internal Revenue Service loosened the rules on flexible-spending accounts so consumers could use them to buy thousands of nonprescription medications. The tax-free dollars can also go for insurance co-payments, eyeglasses and other out-of-pocket health costs.

Critics say the accounts encourage overconsumption of medical services. Since consumers typically must forfeit unused funds by year’s end, they often ended up scrambling in December to drain their funds by loading up on aspirin, antacid and the like.

“The entire flexible-spending account thing is a waste of our taxpayer dollars,” says Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology and a former paid consultant on the health law to the Department of Health and Human Services. “If you’re going to scale it back, this is a natural place to start.” (Another part of the law limits the amount consumers can save in flexible-spending accounts to $2,500 a year, starting in 2013.)

Peeling back tax breaks for health plans was on the table in 2009 when lawmakers began drafting the health overhaul. Inside the Senate Finance Committee, aides to three Democratic and three Republican senators hashed out the blueprint for what ultimately became the final bill.

Some big ideas—like limiting the tax break for employer-sponsored health insurance—lacked support, so committee aides lowered their sights. Making people pay the full price for over-the-counter medicines seemed like a way to reduce wasteful spending and generate money for the law’s main goal: expanding health insurance to nearly every American.

An objection came from William Pewen, senior health-policy adviser to Maine Republican Sen. Olympia Snowe.

He believed the tax-free treatment could lower health costs and thought everyone should have access to a flexible-spending account. He told the group that he takes over-the-counter Prilosec, a heartburn medication, which meant he didn’t need a more expensive prescription drug.

“I didn’t want to see us set up perverse incentives for people to use more costly drugs than they needed,” Mr. Pewen says.

He proposed a compromise that he concedes “was not the ideal solution.” People could spend tax-free dollars on over-the-counter drugs, but only if they got a doctor’s prescription. It wasn’t exactly a new idea: Medicaid, the federal-state program for the poor, already covers some over-the-counter drugs if they are prescribed.

Congress’s number-crunchers estimated the change would generate $5 billion over a decade. Hardly anyone noticed it, even as it stayed in the bill through passage in March 2010.

Only after the president’s signature was dry did the American Medical Association realize what had happened and send a letter to the government warning of unintended consequences, including more office visits and extra paperwork.

Sure enough, when the change took effect Jan. 1, patients began bringing lists of over-the-counter drugs to office visits and also requesting over-the-counter prescriptions by phone, doctors says.

While it may not be worth the trouble for some patients, the savings can add up for those with chronic conditions, especially if the doctor writes multiple refills. A survey late last year by Nielsen found that nearly half of consumers with flexible-spending accounts would request the prescriptions as a result of the changes.

Among those most upset by the changes are pediatricians, who say that small sizes of children’s medicines and multiple children per family make the requests particularly burdensome.

“It’s an amazingly disruptive policy,” says Jesse Hackell, a Pomona, N.Y., pediatrician who is charging $5 to fill such requests via phone. “I am now doing the IRS’s work, and that’s what I resent most.”

After writing two over-the-counter prescriptions free of charge in January, pediatrician Richard Schwartz of Vienna, Va., says he began imposing a $10 surcharge for each prescription, on top of the office co-payment. That is likely to discourage some patients from asking for a prescription, as the surcharge could outweigh the tax savings from using a flexible-spending account.

Doctors are also concerned about malpractice lawsuits, since a prescription potentially puts them on the hook for any problems a patient suffers from over-the-counter drugs.

Some malpractice insurers are urging doctors not to write any prescription without seeing the patient in person, says Lawrence Smarr, president of the Physician Insurers Association of America, which represents malpractice insurance providers.

Retailers and pharmacies, meanwhile, say another aspect of the change caught them flat-footed. Many flexible-spending accounts come with a debit card, making it easy for consumers to draw down the money in the accounts when they shop at a pharmacy. But under the original IRS guidance, people couldn’t use those cards for the prescribed over-the-counter medications.

An industry group representing Wal-Mart, CVS Caremark Corp., Visa Inc. and other large corporations warned that could temporarily halt use of the debit cards for any pharmacy purchase. The IRS eventually decided the cards could be used—as long as the pharmacist labels and processes the over-the-counter item exactly like a prescription.

That had another unintended effect. Thousands of over-the-counter products now must pass behind the pharmacist’s counter when the customer pays with the special debit card.

“At the moment it’s considered a prescription, it’s subject to all the regulatory requirements,” says Mike DeAngelis, a spokesman for CVS. “It runs through our quality assurance process. We have to generate a label.” The chain also puts each of the prescribed drugs in an individual paper bag.

Despite the hopes of Mr. Pewen in the Senate, some consumers think they will be better off getting a prescription-only drug in place of an over-the-counter medication.

In the Nielsen survey, 37% of flexible-spending account users said they would ask their doctor about prescription drugs that could replace their over-the-counter medicines.

Dr. Chung, the pediatrician in Fairfax, Va., says she recently imposed a policy under which her office writes prescriptions only for chronic conditions, like allergies. That deflects pleas from parents wanting a quick Rx for their child’s cold, but she’s worried about pushback. “It makes us look like the bad guy,” she says.

Adamy, J. (2011, March 9). In Health Law, Rx for Trouble. Retrieved from The Wall Street Journal: http://www.facebook.com/l.php?u=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052748704692904576166554110739560.html%3Fmod%3DWSJ_myyahoo_module&h=5d867

Newsletter – March 2011

March 1st, 2011

BenefitsBuzz

Benefits and HR tips brought to you by the insurance professionals at Benefit Logic.

DID YOU KNOW?

On Feb. 10, 2011, the IRS announced that breast pumps and lactation supplies will now be eligible medical expenses for reimbursement from HSAs, FSAs and HRAs. They will not need a prescription or note from a doctor in order to qualify as reimbursable.

This is a reversal from the IRS’s previous position regarding breast pumps and medical spending accounts.

Will Congress Repeal Health Care Reform?

Controversy has surrounded the health care form legislation since it was signed into law on March 23, 2010. This debate entered Congress once again when Republicans took control of the House of Representatives in November 2010.

As promised, House Republicans attempted to repeal the law. Thus far, these efforts have not been successful, due to a Democrat-controlled Senate and the promise of a veto by President Obama.

However, because full repeal of the law would be difficult, Republicans have indicated that they will try to replace or repeal parts of the law instead. Provisions that may be revised or repealed include:

  1. The requirement for businesses to report payments in excess of $600 on a Form 1099. (This is already being discussed, as the U.S. Senate recently approved a bill to repeal this measure and the House has similar bills proposed.)
  2. The provisions in which employers can face penalties for not providing health coverage to employees
  3. The individual responsibility requirement, which imposes penalties on individuals who do not obtain coverage
  4. The Cadillac Plan tax on high-cost, employer-sponsored health plans
  5. The tax on manufacturers of medical devices
  6. Cuts to Medicare

At this point, it is uncertain what will happen with the health care reform law. Though there may be changes, it may also remain intact. Therefore, employers should make sure they are implementing the requirements as they become effective, until more is known about potential changes.

Sharp Rise in Audits for Illegal Alien Hiring Practices

Among the many employment laws that companies must follow is the Immigration Reform and Control Act (IRCA), which prohibits employers from hiring illegal aliens and imposes strict penalties on those who do. One of the primary responsibilities associated with this law is verifying employee citizenship status through the filing of the I-9 Form.

The federal government can audit any company and require it to provide I-9 documents for examination. Failure to do so or a finding of noncompliance with the law can result in penalties ranging from $110 to several thousand dollars. Recently, U.S. Immigration and Customs Enforcement has greatly increased the number of these audits across the country, as many lawmakers push for tougher immigration enforcement.

It is important that you understand the rules of this law, maintain all necessary forms and conduct internal audits to make sure you are prepared in case of an audit. For more information, visit www.uscis.gov.

Live Well, Work Well – March 2011

March 1st, 2011

Healthy Colors

The 2011 National Nutrition Month® theme is “Eat Right with Color,” which means making sure your plate has a variety of color and nutrients at each meal. The American Dietetic Association offers a color guide:

Red fruits and vegetables are heart-healthy, help immunity and may reduce cancer risks. Try beets, cherries, cranberries, pomegranate, red grapefruit, red potatoes, red grapes, rhubarb, tomatoes and watermelon.

Orange and yellow fruits and vegetables contain nutrients that contribute to vision, immunity and may reduce the risk of some cancers. Great choices include apricot, cantaloupe, carrots, grapefruit, mango, papaya, peach, pineapple, sweet potatoes, yellow corn and yellow peppers.

Green fruits and vegetables have a high antioxidant potential. Try artichoke, asparagus, avocado, apples, broccoli, grapes, green peppers, honeydew, kiwi, lime and spinach.

Blue and purple fruits and vegetables may have antioxidant and anti-aging benefits. They may also help with memory, urinary tract health and reduce cancer risks. Great choices include blackberries, blueberries, eggplant, plums, purple cabbage and raisins.

White, brown and tan fruits and vegetables promote heart health and may reduce cancer risks. Try bananas, brown pears, cauliflower, dates, mushrooms, onions, parsnips, turnips, white potatoes, white corn and white peaches.

Choose a variety of colors when shopping for produce. And if you’re looking for fruits or vegetables that are out of season, opt for frozen or dried choices that are available throughout the year. Colorful meals are not only more flavorful, they contain a variety of nutrients that are essential to you and your family’s health.

For more information on National Nutrition Month, visit www.eatright.org.

Poison Prevention

National Poison Prevention Week is March 20-26 – are you informed on how to protect yourself and your family from hazardous substances?

According to the Poison Prevention Week Council, more than 2 million instances of poisoning are reported each year in the United States – and more than 90 percent of these poisonings occur in the home.

Prevent poisonings by following these tips:

Lock or secure all medications and chemicals. This is the easiest way to keep children away from hazardous substances in your home.

Never leave loose pills out. Even if you’re leaving the room for a few seconds, this can be enough time for children or pets to ingest the pills.

Be mindful when children or pets visit your home. You may not have children or pets of your own, but it’s important to put away any medications or chemicals when you have visitors.  

Never use cups or soft drink bottles for household chemicals or cleaners. Both children and adults could mistake these for actual drinks.

Never refer to medicine as “candy” when administering it to a child. The child may remember this and be tempted to take medicine on his or her own.

Pay attention to tamper-proof and child-resistant packaging. If a product looks like it’s been tampered with, do not risk using it.

Always read the labels and instructions of potentially hazardous products and medications. This is the best way to avoid adverse effects or recognize an adverse effect should the product or medication be ingested.

Never create your own cleaning solutions. A poison control center will not be able to give you proper instructions should anyone ingest the cleaning solution.

Keep children out of the way when using pesticides. Make sure toys are removed from the area before applying, and never leave pesticides unattended while in use.

If you think someone has been poisoned from ingesting medication or a household chemical, call 1-800-222-1222 to be connected to your local Poison Control Center any time, 365 days a year. Post this number by your home telephone or save it in your cell phone in case of an emergency. 

Watch for IRS Tax Return Scams

Protect yourself from online identity theft and other scams that increase during the tax filing season by taking the following precautions. Tax return scams have been known to impersonate the logo, names and design of the IRS or U.S. Department of Treasury to mislead taxpayers and lure them into providing personal and financial information.

Watch for e-mails that:

  • Threaten to add additional taxes or withhold the tax refund should you not respond to the e-mail.
  • Request personal or financial information. The IRS does not request such information through e-mail, nor do they send any communication requesting tax account information, PINs, passwords or similar access information for credit cards, banks or financial accounts.

If you receive a suspicious IRS-related e-mail do not reply, do not open any attachments and do not click any links. Forward the e-mail to the IRS at phising@irs.gov. After forwarding the e-mail delete it from your inbox and outbox. 

Turkey Meatloaf

Looking for a low-fat, low-sodium twist to an old favorite?

Try this heart-healthy recipe for turkey meatloaf.

  • 1 lb. lean ground turkey
  • ½ cup regular dry oats
  • 1 large egg
  • ¼ cup chopped sweet onion
  • ¼ cup low-sodium ketchup

Combine all ingredients and mix well. Bake in a loaf pan at 350 degrees F for 25 minutes or until the internal temperature reaches 165 degrees F. Slice and serve with your favorite side of vegetables. Serves 5.