Does Your Organization Offer an On-Site Fitness Center? Here’s Why It Should!

Worksite wellness programs are becoming more popular these days, as companies increase their efforts to attract and keep top talent. A recent article in Employee Benefit News discussed reasons why companies are even starting to take worksite wellness one step further by offering on-site fitness centers.

This is a perk that all of us here at Diversified are fortunate to be able to utilize and enjoy! Our offices include a fitness room that offers yoga, spin classes, toning classes and more to all of our employees. Why do we think this is such a necessary benefit? The Diversified Group family of companies includes Corporate Fitness & Health (CF&H), our wellness consulting and services company, who believes that employee health is an investment. And, they know that when a company crafts and offers the right wellness program it can truly improve the overall health and productivity of its workforce.

Learn more about CF&H here! And, to learn the reasons why on-site fitness centers are becoming increasingly popular, read the full Employee Benefit News article below.

3 reasons employers are offering on-site fitness centers

This article was published on January 31, 2018 on Employee Benefit News, written by Ann Wyatt.

It’s no secret that employers are in a constant struggle for top talent. And, it’s only going to get tougher in the future. Current government statistics tell us the U.S. employment rate was 4.2% in September. That’s down by more than half of its peak of 10.2% in October 2009. At the same time, a large portion of the workforce will be retiring in the next 15 years. By 2030, every baby boomer will be 65-plus, which means a full 18% of the U.S. population will be at retirement age. That’s a lot of retirees — and a lot of jobs left to fill.

Essentially, there just aren’t going to be enough good people to fill all the open roles in the next 10-15 years. And that’s a serious problem for today’s modern business — one companies need to address. That’s why many organizations are offering up a slew of unique and useful employee benefits to attract and retain the best employees.


Photo Source:

Among those offerings are on-site fitness centers. Why are on-site fitness centers an increasingly popular employee perk? Three reasons come to mind.

1. Employees want a more personal touch. According to research, a vast majority of employees say a personal touch is important in their health, well-being and fitness program. That means employees are seeking access to “live experts” who are credible, engaging, easy to access and provide one-on-one support for their specific needs. Corporate fitness centers meet this need directly by offering up a physical space where employees can work with these coaches and fitness consultants to develop individualized plans to meet their unique health needs.

2. Convenience is everything. Nearly half of employees who are offered on-site fitness facility access chose to participate largely due to their convenience, inviting environment and low- or no-cost membership. After all, it’s a lot easier to get a workout in if you only have to travel two floors down on the elevator versus 10 miles in rush-hour traffic. Convenience counts for a lot with employees.

3. They help employees’ increasing need to manage stress. Employees are under more stress than ever before. The World Health Organization recently called stress the health epidemic of the 21st century. And, it’s costing employers significantly. One recent study found that work-related stress costs U.S. businesses $30 billion a year in lost workdays (some estimate it at $300 billion). On-site fitness centers can not only help employees better manage stress with a host of programs but they can also help employers make a dent in those lost productivity costs above.

Corporate Fitness & Health

Unnecessary Medical Care: More Common Than You Might Imagine

This article was published on February 1, 2018 on National Public Radio, Inc, written by Marshall Allen.

Photo Source: NPR, Inc.

It’s one of the intractable financial boondoggles of the U.S. health care system: Lots and lots of patients get lots and lots of tests and procedures that they don’t need.

Women still get annual cervical cancer testing even when it’s recommended every three to five years for most women. Healthy patients are subjected to slates of unnecessary lab work before elective procedures. Doctors routinely order annual electrocardiograms and other heart tests for people who don’t need them.

That all adds up to substantial expense that drives up the cost of care for all of us. Just how much, though, is seldom tallied. So, the Washington Health Alliance, a nonprofit dedicated to making care safer and more affordable, decided to find out.

The group scoured the insurance claims from 1.3 million patients in Washington state who received one of 47 tests or services that medical experts have flagged as overused or unnecessary.

What the group found should cause both doctors, and their patients, to rethink that next referral. In a single year:

  • More than 600,000 patients underwent a treatment they didn’t need, treatments that collectively cost an estimated $282 million.
  • More than a third of the money spent on the 47 tests or services went to unnecessary care.
  • 3 in 4 annual cervical cancer screenings were performed on women who had adequate prior screenings – at a cost of $19 million.
  • About 85 percent of the lab tests to prep healthy patients for low-risk surgery were unnecessary — squandering about $86 million.
  • Needless annual heart tests on low-risk patients consumed $40 million.

Susie Dade, deputy director of the alliance and primary author of the report released Thursday, said almost half the care examined was wasteful. Much of it comprised the sort of low-cost, ubiquitous tests and treatments that don’t garner a second look. But “little things add up,” she said. “It’s easy for a single doctor and patient to say, ‘Why not do this test? What difference does it make?'”

ProPublica has spent the past year examining how the American health care system squanders money, often in ways that are overlooked by providers and patients alike. The waste is widespread – estimated at $765 billion a year by the National Academy of Medicine, about a fourth of all the money spent each year on health care.

The waste contributes to health care costs that have outpaced inflation for decades, making patients and employers desperate for relief. This week Amazon, Berkshire Hathaway and JPMorgan Chase rattled the industry by pledging to create their own venture to lower their health care costs.

Wasted spending isn’t hard to find once researchers — and reporters — look for it. An analysis in Virginia identified $586 million in wasted spending in a single year. Minnesota looked at fewer treatments and found about $55 million in unnecessary spending.

Dr. H. Gilbert Welch, a professor at The Dartmouth Institute who writes books about overuse, said the findings come back to “Economics 101.” The medical system is still dominated by a payment system that pays providers for doing tests and procedures. “Incentives matter,” Welch said. “As long as people are paid more to do more they will tend to do too much.”

Dade said the medical community’s pledge to “do no harm” should also cover saddling patients with medical bills they can’t pay. “Doing things that are unnecessary and then sending patients big bills is financial harm,” she said.

Officials from Washington’s hospital and medical associations didn’t quibble with the alliance’s findings, calling them an important step in reducing the money wasted by the medical system. But they said patients bear some responsibility for wasteful treatment. Patients often insist that a medical provider “do something,” like write a prescription or perform a test. That mindset has contributed to problems like the overuse of antibiotics — one of the items examined in the study.

The report may help change assumptions made by providers and patients that lead to unnecessary care, said Jennifer Graves, vice president for patient safety at the Washington State Hospital Association. Often a prescription or technology isn’t going to provide a simple cure, Graves said. “Watching and waiting” might be a better approach, she said.

To identify waste, the alliance study ran commercial insurance claims through a software tool called the Milliman MedInsight Health Waste Calculator. The services were provided during a one-year period starting in mid-2015. The claims were for tests and treatments identified as frequently overused by the U.S. Preventive Services Task Force and the American Board of Internal Medicine Foundation’s Choosing Wisely campaign. The tool categorized the services one of three ways: necessary, likely wasteful or wasteful.

The report’s “call to action” said overuse must become a focus of “honest discussions” about the value of health care. It also said the system needs to transition from paying for the volume of services to paying for the value of what’s provided.


Maybe You Should Eat Earlier

eat-earlierThe old saying “timing is everything” may even apply to when you eat your meals, according to Michael Pollan, author of In Defense of Food. Skipping breakfast or having an occasional late dinner is fine, but sticking to an earlier eating schedule may contribute to healthier living by helping you maintain a healthy weight. Findings were based on a small study implemented over an 8-week period in which adults had three meals and two snacks between 8 a.m. and 7 p.m., followed by a two week break and eight weeks of a later schedule, which included three meals and two snacks eaten between noon and 11 p.m.

The later eating schedule resulted in weight gain and a negative impact on insulin levels, cholesterol and fat metabolism. The study also showed that when people ate earlier, they stayed satisfied longer, which helped them prevent overeating. Given our hectic schedules, eating later occasionally is hard to avoid. But it will help if you can make an effort to get back to an earlier schedule.


Is It Time to Self-Fund Your Benefit Plans?

After reading the article included below, we couldn’t help but agree that the question every employer should be asking this year is…Should I self-fund my employee benefit plan?

As the article discusses, this is a great time of year for companies to review their status, evaluate changes that have been made and consider new items for their 2018 benefit to-do list. The article includes 8 questions benefits managers should be asking themselves this year. But, we’d like to help you address one key question – Is Self-Funding Right for You or Your Client?

Whether you’ve been asking this question for some time or you’re new to the concept of self-funding, we’d be happy to explain the flexibility and potential for savings that a self-insured plan can offer. Gain control over your group health plan, eliminate the high costs of insurance premiums and obtain access to monthly claim reports – all with help from Diversified Group!

8 benefit management items to evaluate in 2018

This article was published on January 24, 2018 on Employee Benefit News, written by Zack Pace


Even 20 years into the benefits business, I still can’t always immediately remember details about my clients’ benefits plan — a given employer’s standard measurement period, affordability safe harbor or health savings account trustee, for example. That’s why I track all of these details across 32 columns in a simple spreadsheet.

While I use this reference tool most every day, I find that January is a great month to go even further with the employers I work with, carefully reviewing each company, considering how the employer’s circumstances have changed, and proposing items of consideration for our mutual 2018 benefit to-do list.

Employers are wise to have a similar benefit to-do list when it comes to their 2018 planning process. Here are eight common questions that benefits managers may find wise to ask.

1. For calendar year 2018, is your organization a “large employer” subject to ACA employer shared responsibility? Meanwhile, is your organization a “large employer” per your state’s fully insured group health plan market?

Generally, employers that averaged 50 or more full-time employees + full-time equivalents in calendar year 2017 are subject to ACA shared responsibility for all of calendar year 2018. Importantly, penalty risks generally now begin accruing in January, not when the plan year begins (if the date differs).


However, confusingly, in most states, the threshold to be considered a large employer for group health insurance contracts is an average of 51 or more full-time employee + full-time equivalents in the previous calendar year. How do the rules work in your state?

Now’s the time to finalize your 2017 calculation and determine your 2018 status for both employer shared responsibility and your state’s group health insurance market. And, yes, I’ve seen several employers average exactly 50 and be deemed a large employer regarding ACA employer shared responsibility and a small employer in reference to their fully insured group health plan contract. Talk about bad luck.

2. Is it time to self-fund the group medical plan?

The financial headwinds faced by fully insured plans have never been greater. Fully insured premiums are laden with the roughly 4% ACA premium tax (aka the Health Insurer Annual Fee), state premium taxes, the cost of various state-mandated benefits, and often robust retention and pooling point charges.

Thus, employers sponsoring group fully insured health plans should consider if moving to a self-funded contract (including so-called level-funding contracts) could be advantageous. Given the varying state regulations, state stop-loss minimums, organizational risk tolerance, reserve requirements and other variables, there is no one-size-fits-all answer to this question. Especially good times to perform a comprehensive self-funding evaluation are when your company crosses over from small group to large group and/or when meaningful claims experience becomes available from your fully insured vendor.

3. Is it time to self-fund the dental and short-term disability plans?

For most employers of size sponsoring plans that are not 100% employee paid (aka not voluntary), the answer to this question is simply “yes.” Run the math and make your decision.

4. Does benefit eligibility for life and disability vary by class?

For start-up companies, it’s not uncommon to offer better group life and disability benefits to certain classes, including management and executives. However, as employers grow, the budgetary and cultural reasons for doing so can quickly diminish or go away. A quick litmus test is simply asking yourself if the continuing benefit discrimination still makes sense.

Regardless if these benefits vary by class, is your group life plan compliant with the Section 79 nondiscrimination rules? Double-check with your attorney, accountant and benefits consultant.

5. Who is the health savings account trustee (i.e., the bank)? Is it linked to the health insurer?

If your organization sponsors a qualified high-deductible health plan, you likely allow employees to contribute to an HSA pre-tax through your Section 125 plan. Is the bank you selected still the best fit? Is the bank tied to your fully insured group health vendor? If yes, if you change your group health vendor, are your employees allowed to maintain the HSAs with this trustee with no fee changes? Should you consider moving to a quality stand-alone HSA vendor?

6. Does your firm employ anyone in California, Hawaii, New Jersey, New York, Rhode Island or Puerto Rico?

Most employers headquartered in these states (and territory) are acutely aware of the state disability requirements. However, given the advent of liberal telecommuting policies, it’s becoming more common for employers without physical locations in these states to employ individuals in these states. If you answered yes to this question, double-check your compliance with the state disability requirements. Your disability insurer or administrator can assist.

And, please note that, just this month (January 2018), New York became the latest state/jurisdiction to require paid family leave.

7. For firms offering retiree health plan benefits, are benefits for Medicare-eligible retirees and spouses self-funded?

While retiree health benefits have generally gone the way of the American chestnut tree, these benefits remain fairly common among certain sectors, such as higher education, government and certain nonprofits. Historically, most employers simply allowed Medicare-eligible retirees to remain on the employer’s active health plan, with the employer’s plan paying secondary to Medicare for Part A and Part B expenses and primary for prescription drug costs.

This arrangement was just fine when a really high annual prescription claim was $15,000. Now, $90,000 claims are not uncommon and $225,000 claims are possible. Does it still make sense to self-fund this retiree risk? In states where it is permissible, would it be prudent to transfer the risk by adopting a fully insured group Medicare Advantage plan or supplement program?

Regardless, all employers self-funding retiree health benefits should double-check that their individual stop-loss policy includes retirees.

And, regardless if retiree benefits are offered, all employers sponsoring self-funded health benefits should double-check that their individual stop-loss policy covers prescription drugs.

8. Is your firm required to file health and welfare Form 5550s? If so, who is handling the filings?

Generally, employers subject to ERISA that sponsor benefit plans that, at the beginning of the plan year, cover 100 or more participants, are required to file health and welfare 5500s and the related schedules. Some smaller employers must also file. Most multiple employer welfare arrangements (MEWAs) must file.

It’s very easy for health and welfare Form 5500 filing requirements to fall through the cracks. While U.S. Treasury’s penalties for non-filers are substantial, Treasury doesn’t keep track of who is required to file and thus doesn’t individually remind employers of this requirement. Further, this requirement doesn’t seem to be on the checklist of most auditors and accountants.

Employers should review all enrollment counts of all plans at the beginning of each year and consult with their accountant, attorney, and benefits consultant on the filing requirement and next steps.

I recommend avoiding the shortcut of saying “5500” in these discussions. Always say “the health and welfare 5500.” This practice will mitigate the risk that someone hears “5500” and thinks retirement plan 5500.


Employees Are Spending More for Health Care, Using Less. Put a Stop to It!

Paying more for less is never a good thing, especially when it comes to employee health care costs. And while many people have become almost numb to this trend, Diversified Group is doing more than ever to help self-funded health plan clients fight back. With cost transparency tools contained in programs such as Pharamasense and RealTimeChoices, Diversified is providing employers and members the tools needed to compare out-of-pocket costs as well as quality.

Read on for a full article from BenefitsPro that discusses how employees are spending more on health care, but using it less.

Employees’ health care spending up, usage down

This article was published on January 24, 2018 on BenefitsPro, written by Jack Craver.

Drug Costs

Working Americans are using less care and paying more for health care.

Despite reducing their consumption of health care services, Americans with employer-sponsored insurance spent more than ever before on health care in 2016, according to a new study by the Health Care Cost Institute.

Spending is going up simply due to price increases for prescription drugs, operations and doctor’s visits.

Spending for those with employer health plans increased 4.6 percent in 2016. The previous year, spending increased 4.1 percent. In the prior two years, spending increased by less than 3 percent annually.

“Working Americans are using less care and paying significantly more,” Niall Brennan, president of HCCI, tells the Wall Street Journal. “That has huge implications for the health-care system, for the overall stability and growth for our economy as a whole.”

The study also examined how prices have increased for medical services and medication between 2012 and 2017. It found that spending on surgeries increased by an average of 30 percent during that time, while spending on administering drugs, such as chemotherapy, increased by 37 percent.

These spending increases coincided with a decline in the use of the services. Surgeries declined by 16 percent and the on-site administration of drugs declined by 4 percent.

The biggest increase, however, was for prescription drugs. The cost of brand-name drugs more than doubled, rising 110 percent during the five year period. That came despite a 38 percent decline in the number of prescription days filled.

When taking into account generic drugs, the spending increase on medication was still significant: 27 percent. Of course, many of the most notable price increases in recent years have involved generic drugs.

The dramatic increases in spending for prescription drugs helps explain why the American College of Physicians took the step two years ago to recommend that doctors prescribe generic versions whenever possible, reasoning that the high prices of branded drugs make it less likely that patients will fill their prescription.

High drug prices have also led a group of hospitals to team up to manufacture their own drugs, in an attempt to bypass a pharmaceutical industry that they believe has gone off the rails with its pricing.

Fittingly, on Wednesday the American Psychological Association released findings from a survey showing that roughly two-thirds of Americans say that the cost of health insurance is a source of stress in their household. Smaller majorities also report that changes to federal health care policy and the cost of medications cause them stress.

While the APA study found a high level of stress across all demographic groups, Hispanics and those who live in cities are far more likely to say they’re worried about them or a loved one losing access to health care services. Fifty-five percent of millennials said they are stressed by the lack of access to mental health services, compared to only 25 percent of baby boomers and 14 percent of older adults.


Questions for Your Doctor

doctor-questionsAccording to a Medscape survey of more than 19,000 physicians, the average patient spends between 13 and 16 minutes with their physician during an office visit. Given the short amount of time, it is probably best to focus on two or three things you want your doctor to address. It may also help to prepare a list of questions ahead of time. Here are a few you may want to consider.

1. Which health websites do you trust?
2. What is this medication I’m taking and why am I taking it?
3. If you’re a smoker, how can I get help to stop?
4. Are my screenings and vaccinations up to date?
5. What is a healthy weight for me and how can I get to that?
6. What do you do to stay in shape?
7. If you’re taking a prescribed opioid painkiller, ask if it’s really necessary and what else you might take?
8. What are some things I can do before my next appointment to make me healthier?
9. If a test is ordered, ask what it is for and what are you trying to learn from it.
10. When a specific treatment is recommended, don’t hesitate to ask about other alternatives.


Strong Growth Forecast for Telemedicine

This article was published on January 15, 2018 on HealthLeaders Media, written by John Commins.


Telemedicine has been a hot topic in healthcare for some time. And, while plenty of content has discussed its potential of added convenience and lower costs, plenty of other content has pointed out its low utilization. It’s true that most people are not pursuing the consumer-like behaviors that telemedicine can offer, such as video doctor visits via mobile device or prescription drug cost comparison tools. However, the article included below recently discussed the strides that Teladoc, a telemedicine provider, made in 2017, leading some in the industry to expect fast growth within the telemedicine space.

At Diversified Group, we believe strongly in telemedicine and we offer telemedicine solutions. We work closely with our clients to help them zero in on the needs of their employees and explore possible cost control measures, such as telemedicine. Please read the full article below.

The industry is riding sustained tailwinds that will push growth 30% to more than 40% in coming years. Factors include a growing dearth of clinicians, an aging population, and technological innovations that will improve patient access and experience.

If Teladoc, Inc. is a bellwether for the telemedicine industry, the outlook is bright.

Jason Gorevic, CEO of the Purchase, NY-based telemedicine provider, called 2017 “a landmark year as we redefined the virtual care delivery landscape with our acquisition of Best Doctors.”

“Through rapid integration, Teladoc has brought to market innovation that gives members a single point of access for a wide array of medical needs. We are seeing a tremendous reception from both clients and prospects to this unique, comprehensive solution,” he said.

Preliminary numbers provided by Teladoc support Gorevic’s claims. According to unaudited 2017 financial results, the company saw:

  • Total revenues of $232 million, an 88% increase over 2016
  • Total membership of 23 million, a 31% increase over 2016
  • Total visits of 1.46 million, a 53% increase over 2016, and representing utilization of 7%, compared to 6% utilization in 2016.

Teladoc finished 2017 on an upswing, with unaudited fourth quarter results showing:

  • Total revenues of $76 million, a 103% increase over 2016
  • Total adjusted EBITDA of $2.5 million compared to a loss of $8 million in the fourth quarter 2016
  • Total visits of 460,000, a 48% increase over 2016, and representing utilization of 2%, compared to 1.8% utilization during the same period in 2016

Continue reading