Fighting Depression in the Workplace

dgb-depression-blogWhile awareness of mental health concerns in the workplace is increasing, studies repeatedly show that not enough employees feel comfortable utilizing mental health benefits. Furthermore, many employees are often unaware mental health benefits are even available. With more than 40 million Americans living with depression, it’s more important than ever to make sure the workplace is taking positive steps to address it. Here are positive steps your company can take:

Take a holistic approach. Addressing the many areas of wellness, including physical, financial and mental, equally can help employees feel safe enough to seek treatment through employer provided healthcare plans. Stigma is still a major barrier to access, but employers can encourage accessing treatment by putting the necessary emphasis on mental health and wellness. Providing an open space for conversation, information and support can increase overall employee mental wellness. And of course, extending benefits to all family members can prove extremely valuable.

Keep employees informed. Though your company may have excellent programs and benefits to address mental illness and depression, it’s possible that your employees are unaware of how to access them. When bringing the discussion of mental wellness into the public space it’s important that the tools and avenues to accessing help are made very clear.

Promote flexibility. Certain industries deal with more critical situations, such as safety concerns, fatigue or a high risk of injury. While there is no “off the shelf” solution to mental wellness, employers can play a major role in bringing mental health out in the open. And today more than ever, a company is only as healthy as its employees.

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Why brokers should be afraid of Amazon & Co.’s new venture

This article was published on September 5, 2018 on BenefitsPro, written by Kevin Trokey.

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Source: BenefitsPro

You don’t have to scroll very far in your social media feeds to see posts of outrage and calls for transparency aimed at the players in today’s health care game. The waste, fraud and at times seemingly criminal behavior of some carriers, pharma and providers is a travesty. All of them need to be called to account for their contributions to this mess.

Oh, it’s happening sweetheart

The Bezos-Buffett-Dimon (BBD) health care venture is heating up. While I have serious doubts about their ability to solve the crisis (I believe that will happen on a much smaller, more local scale), there is one thing that this trio will certainly bring: visibility and outrage.

I predict BBD will open the floodgates of horror stories from victims of the travesty that has befallen our health care system. We will see and hear, at the most publicly visible level, stories we are already sharing within our relatively small inner circles on a daily basis:

  • Lives lost due to inaccessibility of care.
  • Couples who opt for divorce so their child can get the care they need.
  • Artificially inflated insurance premiums that have stifled business growth.

I can feel you getting excited. I can hear you saying, “Bring it on, BBD!”

Be careful what you wish for

The spotlight will be shone into every perceived dark corner of the system, with a particular intensity on anyone seen as a middleman. If you aren’t concerned yet, you should be. Make no mistake: benefits advisors will be next.

I know most of you work your asses off every day with the best interests of your clients in mind. I know the decisions you help your clients make are some of the most complex they face. I get it.

But, perception is reality, and you need to brace yourself for the picture BBD will paint. Be prepared to deal with the perception of being nothing more than a distribution channel for carriers—a middleman.

The carriers are going to be a big target. But when your compensation ties you directly to them, when you are contractually tied to them more closely than you are to your clients, it is going to be very difficult to separate yourself from the carriers.

No time to spare

Now is the time to re-engineer your business to separate yourself from the carriers and to formally serve your clients. I get that there are significant changes you will have to make, many of which are not going to be easy. But there are a couple of things that will take you in that direction.

  1. Sit down with each of your clients and have a stewardship meeting where you explain very clearly the various ways in which you bring them value.
  2. Have a transparent conversation about how much you are being paid for delivering that value. If possible, let them know you will be asking the carriers to remove your commissions and switch to a fee-based arrangement.
  3. Educate them about what is broken about the system and the solutions we are starting to see. Let them know you will be there to help them take advantage of every solution that makes sense.

These may be difficult discussions to have but I promise you, they are nowhere near as difficult as the discussion you will have to have if you wait for BBD to tell the story on your behalf.

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3 reasons self-funding is a great option for smaller companies

This article was published on September 10, 2018 on BenefitsPro, written by Darick Bradford.

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Source: BenefitsPro

“Wait, what’s a self-funded plan again? And why does it make sense for my clients?”

These are questions I hear from brokers all the time. And I get it. Self-funding can be complex. But it’s time to get smarter about self-funded health benefit plan designs as this type of product could be a game-changer for your smaller clients.

Let’s start with the basics. What is a self-funded plan? Self-funding is an arrangement where an employer sponsors a self-funded health benefit plan and is financially responsible for employee covered claims up to a certain dollar amount. Covered claims in excess of this dollar amount are reimbursed to the employer through stop-loss insurance.

Larger organizations have used self-funding for years as a way to save costs, but more recently we’re also seeing smaller businesses offering self-funded health benefit plans to their employees.

The numbers back it up. Between 2013 and 2016, the percentage of small employers offering at least one self-funded health benefit plan increased from 13.3 percent to 17.4 percent—a 31 percent increase.

Why are more small businesses offering self-funded health benefit plans? I see three big reasons:

1: Self-funding can be a great tool to attract and retain employees.

When it comes to health care, employees want choice and affordable options. Self-funded health benefit plans can give your employees both. From comprehensive medical to preventive-only coverage, your employees will have a variety of options. And, they’ll have those choices at affordable prices. That can be a key tool to attracting and retaining employees in an increasingly tight labor market.

2: Self-funding provides flexibility.

Employers can customize their self-funded health benefit plans with different deductibles and coinsurance choices to fit their needs, whether it’s a preferred provider organization (PPO) plan design, consumer-directed health plan (CDHP) design, or a reference-based pricing or preventive-only plan design.

3: Self-funding can help lower employer costs.

There are a variety of ways self-funded health benefit plans can help employers lower costs. First, employers can receive refunds if there is a surplus of claim dollars in their prefund account at the end of the plan year. Second, claim dollars are not subject to state health insurance premium taxes, which can help lower costs (premium taxes average around 2 percent). And finally, self-funded health benefit plans give employers access to aggregate health claims data and demographic information. This data — available exclusively under a self-funded arrangement versus traditional health insurance — allows employers to better manage costs and encourage cost-savings measures their employees can practice, such as switching to generic medications, using in-network providers, and selecting a different level of care.

In the end, better understanding the ins and outs of self-funding will mean more choices for your small employer clients—and more success for you.

With some research and education on how self-funding works and the carriers/TPAs that offer administrative services, self-funded health benefit plan designs and stop-loss insurance, you can become well-versed in what’s available in the marketplace and learn if and when a self-funded health benefit plan design could be a potential fit for your smaller clients. Having a solid knowledge is a good start to have the advantage over another broker who didn’t evaluate self-funding as a viable option.

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Medicare D Credible Coverage Notices Due by October 15th

dg-medicare-partd-blogThe Medicare Prescription Drug Improvement and Modernization Act of 2003 implemented prescription drug coverage under Medicare (Medicare D), requiring all employers that offer prescription drug benefits to provide an annual notice of Medicare open enrollment. The notice must go to all Medicare eligible plan participants and qualified beneficiaries before October 15th each year. The notice requirement applies to all employers offering prescription drug benefits regardless of size, whether fully-insured or self-funded, or regardless of ACA grandfathered status. Notification must go to all Medicare eligible plan participants, including active employees and their dependents, retirees and COBRA participants. For most employers, it is easier to issue the notice to all participants as a blanket notice than to identify Medicare eligible employees.

The notice requires that the plan sponsor first determine if their plan offers creditable coverage (meaning it is on average at least as comprehensive as Medicare D coverage), or non-creditable. The Centers for Medicare and Medicaid Services (CMS) provides a simple process to determine whether prescription drug coverage is creditable or not. Once that determination is made, CMS provides model notices to send to participants in both English and Spanish. Notices may be sent separately, included as part of open enrollment or other benefit related materials, or electronically as long as the DOL’s rules on electronic delivery are followed.

Additionally, all plan sponsors are required to notify CMS within 60 days of the start of each plan year as to whether or not their prescription drug plan is creditable or not creditable. This notification is done online at CMS here.

For Diversified Group clients who have elected to have Diversified Group handle your Medicare D notices, DG will determine if the plan is considered creditable or not and will then send the notice either to the client or directly to the plan participant depending upon which service was elected.

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Student Loan Benefits Catch On

student-loanConsulting firm Willis Towers Watson expects more than a third of employers to offer student loan consolidation programs by 2021. This represents huge growth, since the Society of Human Resource Management says only 4% of employers offer student loan repayment benefits now. Willis also expects 35% of employers to offer student loan refinancing arrangements by 2021. Many employers offering this benefit are doing so by distributing a lump sum benefit over 5 to 8 years. It’s no surprise that this approach seems to be boosting employee retention rates – since millennials and Gen Z employees are strapped with about $30,000 of student loan debt and in many cases, lower wages than their parents were making at their age.

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Apple Winning in Mobile Health

mobile phoneAfter rolling out a software update for its iPhone earlier this year, Apple announced that its Health Records feature is now being piloted by 39 health systems across the U.S. The feature enables patients who have medical information from multiple institutions to organize their data in one bucket containing allergies, conditions, immunizations, lab results, medications, procedures and vitals. Data from all participating healthcare organizations can be viewed by patients, however Apple Health Records does not currently enable patients to send messages to providers or schedule appointments. Apps from electronic health record vendors Epic and Cerner currently offer this functionality.

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Getting People to Use Telemedicine

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24/7 physician access by phone or video has the potential to do great things for health plans and consumers. Getting a doctor’s help without waiting in a medical office is a great convenience, especially if you’re traveling or your primary care physician is unavailable. The challenge, however, is that telemedicine does not sell itself – it needs to be communicated over and over again if we want members to remember they have this great, easy-to-use benefit instead of driving to an urgent care center. Technology is great, but it won’t activate itself. People are creatures of habit and it takes a good deal of effort to change behavior. Low tech tactics like email reminders, flyers or refrigerator magnets may just be what the doctor ordered when trying to drive home the benefits of telemedicine.

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