Category / Employee Benefits

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.

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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.

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.

by Medcon Benefit Systems Group, Inc.

Self-Funding: Points to Consider

Gaining popularity similar to it’s peak in the early 1980’s, self-funding is making a comeback. Many brokers / advisers are not well versed in this concept, and therefore are less likely to present the approach to clients. One point they will also likely not share with clients: commissions are paid on the stop loss premiums, not the entire premium amount.

There are reasons to consider self-funding that typically outweigh the reasons not to self-fund. Most importantly, you should be working with an experienced adviser. One who works with self-funded clients day-in and day-out. An adviser who has relationships with a number of Stop Loss Carriers, Third Party Administrators (TPAs) and Pharmacy Benefit Managers, just to name a few.

The first point to consider – self-funding is not a “one year” solution. I do not recommend self-funding to any of our clients if they are not willing to commit to an overall 3-5 year plan. Typically the concept is a win for the client on average four out of five years, but you must be prepared for the bad along with the good.

Additionally, the size of the group should not deter your group from exploring self-funding as an option for your plan. I hear many of my peers say a group has to be at least 200 or 100 employees to consider self-funding, and that is just not true. If a client is financially stable and the adviser understands and communicates all risks involved in the contract, self-funding can be offered successfully as an alternative for clients with as few as 20-25 employees. Some of our clients in the range of 25 employees have been self-funded for over ten years, and are very happy with the stability of the rates over that time period.

Many smaller to mid-size clients should consider a closer look at self-funding due to some distinct advantages under the Patient Protection and Affordable Care Act (PPACA).

This is the first in a series of posts that will focus on the concept of self-funding. With 30+ years experience in all things self-funded, we have a lot to share. We welcome questions and hope those who read will learn something. Continue to follow us for more information coming soon.

by Medcon Benefit Systems Group, Inc.

Price Transparency in Healthcare

As a business owner, one of the most appreciated benefit offerings to our own employees is a price transparency tool. As one of the first agencies in Dallas to deliver the valuable behavior modification tool, it is amazing to see the product now being offered across the entire nation in under a decade. With over 2,000,000 members now covered, from the Houston Rockets to the employees of Southwest Airlines and Michaels, your employees could also benefit from a true concierge program.

As we implement plans with increased deductibles and copays, we need to give employees the tools and skills to support their efforts to become good consumers of healthcare. All of us have tools to price a vehicle before we head to the car lot. Few of our employees have ever had a tool to price a surgery, the price of which could be comparable to purchasing a car. We do not stop to analyze how much the surgery, the surgeon, the surgery center or even an MRI or prescription drug will cost prior to the procedure being performed. Our transparency tool can compare many choices side by side, and will take it a step further and schedule the appointment, complete the follow up and review the bills after they have been processed if your employees have questions.

Think of the potential dollar savings to your plan, and just as important, the time saved by your employees and the increased satisfaction level as they truly have a patient advocate working for them, hired by you.

For more information, contact Sharon McReynolds: smcreynolds@medconbenefit.com or 214-739-5215.