by Medcon Benefit Systems Group, Inc.

Choosing A Benefits Broker

Choosing MedCon Benefit Systems Group, Inc. as your benefits broker – we aim to improve your bottom line and save you money – all at the same time.

We understand you need to save money on employee benefits.

With the rising cost of employee benefits, balancing employee needs with your capabilities and bottom line has never been more difficult. Let us help you meet your benefits goals, your employees’ expectations and your bottom line.

MedCon provides not only insurance, but also employee benefits consulting services. We save you money by delivering benefits solutions that meet your needs through strategic planning, professional services and technology-based solutions.

What You Should Expect from Your Insurance Broker

Your broker shouldn’t stop at obtaining competitive quotes for coverage and handling claims issues—you should expect more from your insurance broker.

MedCon goes above and beyond, providing quality service throughout the year. From custom employee communication materials to human resources tools and claims data analysis, we have the tools to make your benefits goals a reality.

The bare minimum doesn’t cut it anymore—get what you really need from your insurance broker.

Officially Obtaining Our Firm’s Services

There is no standard contract to sign to obtain services from an insurance broker. MedCon is an independent agency that works with a wide variety of carriers in order to provide you with the best possible benefits options.

Once you have chosen us as your insurance broker, you need only provide your current carriers with a letter establishing us as your broker of record. We even provide this letter for you—if you would like to see a sample, please let us know.

When we are established as your broker of record, we are able to do a detailed market analysis, getting quotes from more markets, better leveraging our relationships with carriers and taking advantage of a better negotiating position with carriers.

broker chart

Increase Value, Not Cost

Providing the best possible value and service to your employees is important—especially because they are paying a portion of the benefits costs and our commission.

While some brokers only provide quotes, we also provide clear and professional enrollment materials, wellness communication materials and other resources to help keep employees healthy and safe.

Saving You Money

The value-added services we offer can save your employees money and protect your bottom line. The educational materials we provide can do everything, from helping employees understand their health care needs to enabling them to make healthy lifestyle changes. Helping employees understand the benefits that are available and make educated decisions about which benefits are right for them allows them more say in their health care, and also saves you money.

Employees educated on the importance of preventive care may be less likely to rack up hospital bills resulting from leaving conditions untreated. Employees with large families and frequent doctor visits may choose a health plan with broader coverage than employees who live alone and visit the doctor infrequently.

Allowing employees to choose the level of coverage that is right for them saves you money in the short and long term.

Contact MedCon Benefit Systems Group, Inc. today to learn more about the value we can bring to your organization – we look forward to partnering with you!

by Medcon Benefit Systems Group, Inc.

Are You Effectively Using Your HSA

As we head into the second half of 2018, it is important that you check in with employees to make sure they are getting the most out of their HSA’s.  We have a flyer for that.  Ask for your copy today.  Although everyone uses their HSA differently, there are three things your employees should keep in mind to make sure they are using theirs effectively. Find out what these three things are by requesting your copy today.

Sharon N McReynolds

smcreynolds@medconbenefit.com

by Medcon Benefit Systems Group, Inc.

Where You Go Does Matter

Did you know that prices can be up to 10 times higher at a freestanding ER than Urgent Care center?  I just read it in an article put out by Blue Cross Blue Shield with a title that caught my attention, would you pay up to 10 times more for the same pair of shoes just because of the store location?  Now, I love shoes but I love a great deal much better !

I am having to incorporate into my employee benefit meetings an explanation of the newest trend in Emergency Rooms, the freestanding ER.  The freestanding ER is much different than the Urgent Care facility we have grown accustomed to.  They can treat a true emergency in most instances just as a hospital ER, except they are not attached to the hospital.  They can be found close to residential areas and because they are ERs, they charge a facility fee, just like the ER at the hospital.

If you ask up front if they will bill at the urgent care rate, provided it is a non emergency situation, most times they will- provided it is prior to 7:00 PM.  I recommend to my clients to know where the urgent care providers are in their area as opposed to ER in case they need to use them for colds, minor stitches or sprains.  It could save you significant dollars in claim costs-

 

Feel free to contact us with questions!

Sharon N. McReynolds

972/542-5047

by Medcon Benefit Systems Group, Inc.

Reference Based Pricing

During my 30+ years in the benefits business one thing has remained constant, change.  What has remained the same is continued cost increases in healthcare and as a result in rates.  My issue has always been with the fact that we as consumers in the healthcare industry have never really been consumers in the true sense of the word.  How many individuals that you know have ever asked their provider or facility the cost of a procedure prior to having it done, telling the provider they are going to “shop” for the best price?  None of us think twice about having researched car prices prior to heading to a dealership and wheeling and dealing with the salesperson until we feel we have squeezed every last dollar out of the price.  The price of a surgery is comparable to that of a vehicle, or more but we do not even think to negotiate, maybe it is time to start-

At the very root of the healthcare crisis in the US is the lack of transparency, which is by design, most in the industry want to keep consumers in the dark.  Part of the problem is being addressed by a method called reference- based pricing.  It is a pricing mechanism that actually targets the billing system, the system that most of us never get to see until we see the end product, our explanation of benefits.

We all believe that by going to our network provider we are getting the best deal out there, after all we are being told by our insurance carrier to stay in network because they have done the negotiations for us.  While the networks have performed their magic and obtained sometimes up to 50-60% off of retail billing, the cost is still significantly higher than what Medicare pays for the same service.  In some instances up to double or triple the cost.

 

Reference based pricing allows the employers to pay for medical services based on a pre-determined percentage of Medicare reimbursements rather than a percentage discount negotiated by the PPO.  It is becoming increasingly more popular as more employer organizations consider the move to this type of transparency and as they move from fully insured to self funded programs.

As with any self funded plan, there is always risk, and with the added reference based pricing component you need to be working with an organization that has experience to ensure your employees are not balance billed.  Reference-based pricing is a forward thinking way to manage costs while providing a way to improve cost transparency and to mitigate the cost of delivery of healthcare.  If you would like to know more, please feel free to give us a call.

Sharon N. McReynolds

972/542-5047

 

by Medcon Benefit Systems Group, Inc.

Are You Familiar with the Term PEO?

Professional employer organizations (PEOs) are becoming more popular among small
businesses.  The National Association of PEOs, NAPEO sited in their recent study
"employment growth among PEO clients is 9% higher than other small businesses".

PEOs provide Human Resource related services, worker's compensation coverage,
payroll related administration, including being the employer of record for tax
purposes.  In short, the PEO lets you focus on your core business, the reason you
began your business, while outsourcing the payroll, the employee benefit 
administration, payroll, worker's compensation administration, safety and risk
management, not to mention the ever-growing compliance issues.

Maybe you have ownership in a company and have become familiar with the 
administrative burden the management of all of those mentioned above can do to a
small business.  It can be expensive, complex and most of all time-consuming.
Often times, taking you away from the core business of your business entity.  
With the complexities of workplace laws, it can also be a risky enterprise. 
That is where a partnership with a PEO can help you reduce costs and mitigate
liabilities, allowing you to get back to business, your business!

Contact us for information on just how a PEO can work for you-

Sharon N. McReynolds
MedCon Benefit Systems Group, Inc.
Employer's Risk Administrators, LLP
by Medcon Benefit Systems Group, Inc.

As We Let Go of Old Things That No Longer Serve Us, It Gives Us Room for the New-

As we begin a new year, trying to predict the changes that affect the benefits industry is typically a roll of the dice.  With a change in the White House, this year will be a year of uncertain change for the Affordable Care Act.  While I am hopeful that we let go of the old things within the Act that do not work, I am also wishing that we are able to facilitate a smooth transition to whatever replaces it.  While “wishing”, I do have a “wish list” of my own for the industry for 2017, I welcome you comments-

First and foremost, given that employers provide benefits and in most cases pay for the majority of the cost of those benefits for the employee for close to half of all Americans, it would be really helpful if the replacement strategy could come early and concisely.  Early so that employers could have direction in advance and actually have the opportunity to drive the change in the marketplace.  Concise, in the opposite of what ACA is and has been.  Please do not over-complicate the process, it does not have to read like an IRS publication.

Repeal the Cadillac Tax- it has never made sense to tax benefits that are “rich” in their offering.  If a company happens to be in a position where they can offer better benefits than their peers, let them.  Additionally the law has not yet made provision to take into consideration how to account for the differences in cost due to demographics, the cost in Dallas Texas for an employee may be higher than the cost for an employee in say, Greenville Mississippi.  How are they going to level the field if my company has all employees over the age of 60 while the company next door has all employees aged 25?

IF the government feels they must keep employer reporting requirements, simplify them!

Offer tax deductions to all with health insurance-expand HSA accounts as well-

Stop the reduction , or worse yet, end of commissions paid to agents, brokers in the insurance industry.  With the reduction in the individual market in particular, most agents have reluctantly removed themselves from serving this segment while at the same time it has become a segment that is needing expertise now more than ever.

Bring back the state run “high risk” pools.  Combined with the “county” hospitals we in Texas had a system where you could purchase insurance even with a “pre-existing” condition for affordable costs.  The county hospitals were not allowed to turn people away who needed care and ours in Dallas/Ft. Worth are some of the best in the country-

As a consultant to many, having worked in the benefits industry, tied to a sister company offering HR, payroll, worker’s compensation, and compliance solutions, and a business owner myself, I am making a commitment to use this blog as a resource in 2017.  I am hopeful that our clients, our prospects, and our friends will find it useful this year.  If you have any comments or questions, please feel free to send us an email.  Also, let others who might be interested in our site, know about us!

Happy New Year!

Sharon N. McReynolds

by Medcon Benefit Systems Group, Inc.

Have you really considered the complexity of employment related government regulations? Choose your business partners accordingly-

Of the 400 plus government agencies at least 9 of them have a hand in regulating
various aspects of employment.  They have the power to actually implement 
compliance regulations.  Those new regs are published in The Federal Register or
via a press release.  Ask yourself, do you have someone on your staff assigned
to receive notice of each of these new rules and regulations?

For example, are you aware that beginning January 1, 2017, OSHA issued a rule 
requiring certain employers to electronically submit information regarding 
injuries and illnesses?

Based on information published by the US Government & Accountability Office, for 
every law that is passed by Congress (during the past five years) the federal 
agencies pass fifteen, which accounts for over 12,000.  Compound that number with 
the sheer complexity of employment regulations.  Take ACA, or Obamacare, as it is
commonly referred to, close to 2000 pages of it.  The act alone has been updated
too many times to count , at least 70 times and counting!

Bottom Line- your company has a burden, the burden is high risk and ever changing.
You are dealing with compliance related issues with increasing penalties looming.
Our sister companies, MedCon and Employer's Risk are in the business of helping
you identify the areas of risk and training you to mitigate or abolish the risk.
We want to become the trusted resource your company looks to for solutions in this
challenging landscape of government compliance.  Think about choosing a partner
with expertise in all aspects employment related.

For more information-give me a call, 214/347-7938 

Sharon N. McReynolds
by Medcon Benefit Systems Group, Inc.

Advantages of Self-Funding

Sharon McReynolds

As mentioned in a prior article, self-funding an employee benefit plan as a long-term strategy to save money works because it does afford an awesome opportunity for an employer to achieve savings plus cost control. Over history, the smaller employers, those traditionally under 250 or even 100 employees, have been hesitant to self-fund their health plan as in the past it was commonly believed that self-funding was only appropriate for “large groups.” Our previously owned third party administrator (TPA), Group Administrators, Inc., survived and flourished on companies with less than 250 employees and several with down to 25 employees. We were able to establish the right plan design, the correct specific deductible amount as well as placement of an aggregate coverage, often paired with a monthly accommodation feature, that allowed our clients to be confident in their determination that self-funding was in fact a formula for success.

The purpose of this article is to allow you to gain some insight into the key determining factors to consider for your company when deciding if self-funding is a viable option for you. The right health plan can and should be an integral part of the proper growth and success of your company, the wrong one can have very negative impacts. We believe you can offer the benefits much larger companies offer, taken down to a proper scale, to benefit you, the small employer.

A self-funded plan affords all groups, regardless of size, the opportunity for savings. You have the opportunity to pay your own claims, while a TPA administers the claims, processing them, issuing ID cards, handling the tasks that the insurance companies typically do. The difference: they hire a “stop-loss” carrier on your behalf to take on a large piece of the risk, leaving you with the risk under the stop-loss amount. Your company pays for the everyday claims, the stop-loss carrier is there to protect you from the run-away claims. If designed properly, you know exactly what your risk is from one year to the next, and oftentimes, from one month to the next. Again, if designed properly, your risk should line up with what you were paying in a fully insured environment.

Obviously there is now some incentive for the employer and employees to be involved in the delivery of health care: cost savings. Wellness programs, HSA’s, consumer-driven health plans with high deductibles paired with programs allowing employees to participate in their own comparison shopping on their respective providers or hospital charges before they are incurred — all are great ideas to incorporate to save money on the overall health plans that we design.

Self-funding also aids the employer in knowing what and where you are paying for delivery of care. Wouldn’t you like to be able to dig into the amount your company is paying toward emergency room visits, or specific drug costs? How about the overall cost for in- and out-of-network claims, or wellness visits? Self-funding will afford you the opportunity to see exactly where your health plan dollars are spent month-to-month, giving you the chance to make informed decisions moving forward at renewal regarding benefit changes or employee contributions. You can tailor the benefits to meet your specific group’s needs. Employers with self-funded health plans see exactly how the plan performs, thus removing the element of surprise at renewal as it relates to substantial increases or decreases in premium.

With over 30 years of experience in the self-funding arena, we welcome the opportunity to discuss the concept in further detail. Please visit our contact us page to schedule a more in-depth discussion.

by Medcon Benefit Systems Group, Inc.

Are You Prepared for Looming Overtime Rules?

As business owners and HR professionals, we need to be paying close attention to developments on the proposed rulings to overhaul the current exemptions under the Fair Labor Standards Act – FLSA.

The U.S. Department of Labor has proposed a rule to increase the standard salary level for executive, administrative and professional exemptions and the minimum total annual compensation level of the “highly compensated employee” exemption under FLSA.

Under the current proposal, the salary limit for workers eligible for overtime pay would increase from $23,660 to $50,400. This change in amount would obviously impact millions of U.S. workers.

What do you need to do to prepare? While the regulations may not be final until late June or July 2016, employers need to pay attention to how their employees are classified now. Should they be reclassified as non-exempt and paid overtime, or should they receive a raise to meet the new threshold requirement?

In the proposed changes, the DOL clearly ties the changes to the salary. It did however, leave the door open to changes at some point that are currently tied to the duties test. Currently, exemptions are based on the duties an employee performs from day-to-day and determination as to whether or not they fall into the executive, professional or administrative exemptions.

The DOL is asking for comments about a percentage threshold test when evaluating whether the employee is performing duties that are actually exempt or non-exempt.

While “full-time” for health insurance regulations is 30 hours per week, for purposes of payroll employers need to ensure that any work exceeding 40 hours per week, or 8 hours per day in some jurisdictions, is paid at the appropriate rate.

There is no final ruling yet, but the time to prepare is now.

by Medcon Benefit Systems Group, Inc.

Legislative Brief: What is an ERISA Plan?

What is an ERISA Plan in the group health plan environment? ERISA has been amended many times over the years, expanding the protections available to welfare benefit plan participants and beneficiaries. ERISA violations can have serious and costly consequences for employers that sponsor welfare benefit plans, either through DOL enforcement actions and penalty assessments or through participant lawsuits.
ERISA applies to virtually all private-sector employers that maintain welfare benefit plans for their employees, regardless of the size of the employer. This includes corporations, partnerships, limited liability companies, sole proprietorships and nonprofit organizations. They exempt two types, those maintained by Governmental Employers and Church Plans.
ERISA generally applies to the following common employee benefits, regardless of whether they are insured or self funded:

  • Medical
  • Dental
  • Vision
  • RX
  • HRA’s
  • FSA’s
  • Group Life and AD&D Benefits
  • EAP’s
  • Short and Long Term Disability Benefits
  • Disease-specific Coverage (for example, cancer policies)

ALL Group health plans subject to ERISA are required to provide participants with a summary plan description (SPD). An SPD must be written in a manner calculated to be understood by the average plan participant and must be sufficiently comprehensive to inform the participant of his or her rights and obligations under the plan.

For additional information, please feel free to contact us at 214/739-5215.