What Should You Look for When Searching for an Employee Benefits Advisor?

When evaluating, expanding and maintaining your benefits, including self-funding, fully insured or voluntary benefits, look for these qualities in a broker:

1. Comfort and trust level: Do you feel comfortable working with your broker? Do you feel they have your best interests in mind? Do you trust their intentions – are they assisting you with meaningful benefits or merely “selling” benefits?

2. Resources: Does your broker have resources to evaluate how your plans are working? Can they compare them to other plans in the marketplace; do they have benchmarking tools? Are they providing any level of HR services or tools?

3. Experience: Has your broker implemented both self-funded and fully insured plans? Have they worked with large groups, small groups? Do they have experience in traditional and voluntary plans? Short- and long-term disability? Long-term care? Do they have a working relationship with various carriers? Enough to know who requires what and who provides exceptional service?

4. Strategy: Is your broker experienced enough to actually think out of the box and provide innovative solutions? Do they have a long-term strategy for your future over a three- to five-year plan, or do they just bring you a spreadsheet with a “pick a rate” strategy for the year?

5. Compliance and Regulation: Is your broker well-versed in all things ACA (Affordable Care Act) as well as the DOL, ERISA, HIPAA and Plan Document requirements, just to name a few?

6. Compensation Disclosure: Do you know each and every year exactly how much your advisor is compensated on each product?

All of these questions should be answered with confidence in your relationship with your benefits partner. You know up front exactly what to expect from your CPA and your lawyer. They are strategic business partners and have responsibilities in the success of your firm. We submit that your benefits is every bit as important, should not your partner be chosen just as carefully?

NAPEO White Paper Released: “PEO’s – Keeping Turnover Low and Survival High”

The National Association of Professional Employer Organizations (NAPEO) has released its second white paper entitled “Professional Employer Organizations: Keeping Turnover Low and Survival High.” MedCon’s sister company, Employee Resource Administration (ERA) – a Professional Employer Organization, has been serving clients of all sizes throughout the country with the significant issues addressed in the white paper.

 

Key findings highlight the lower employee turnover rate for small businesses in PEO arrangements, faster growth and significantly decreased failure rate.

 

As small businesses continue to struggle in a professional world of ever-changing compliance issues, MedCon and ERA strive to provide greater professional services tailored to meet specific needs of our clients. MedCon aims to provide provide custom employee benefit solutions specific to each client’s needs. ERA provides services to give relief from administrative functions that inhibit clients from doing what they do best – promoting, managing and expanding business. With 4 principals who have all spent their careers working in the insurance and administrative fields, the experience level provided to clients of all industries is unmatched.

 

If you have considered partnering with professional consultants, now is a crucial time to do so. With many changes imposed by the Affordable Care Act, small employers must have a resource to assist with various legislation and compliance matters. Instead of taking time away from the business you have built, consider partnering with the experienced team at MedCon and ERA to provide your professional solution.

 

 

The National Association of Professional Employer Organizations (NAPEO) is the largest trade association for professional employer organizations (PEOs) nationwide.  NAPEO advocates for the interests of its PEO members at all levels of government.

Health Care Consumerism: 22 Ways to Cut Health Care Costs

The way we purchase health care is unlike most other purchases we make. Many Americans will search through a newspaper for a coupon that saves them 50 cents at the local supermarket. However, when it comes to health care—a far more complex and expensive service—we rarely ask questions or consider all the options that could save us time and money.

Learn to shop for value when it comes to health care. With little effort you can save thousands of dollars on your medical bills. Share these helpful tips with your employees regularly to promote educated decisions when choosing health care.

1.     Let’s make a deal. Ask your doctor, hospital or dentist if they will accept less. Studies show that the majority of individuals who bargain succeed.

2.     Know how much it costs. You will be better armed to negotiate discounts when you know the real costs of care. You can find rates on the websites of large insurers like UHC, Cigna and Aetna.

3.     Pay in cash. You can often save up to 10 percent on your bill by paying in cash up front. Doctors lose thousands of dollars each year on credit card processing fees, unpaid bills and collection fees.

4.     Look at your bill closely. You will often find mistakes. Keep track of your visits, tests and medications, and compare them against your bills. Request a corrected bill if you find an error and notify your insurance company.

5.     Follow instructions. Follow your health care provider’s instructions for medications. Most medications work most effectively when they are used according to doctor’s instructions. Ignoring instructions could result in additional prescription costs, extra trips to the doctor or even hospitalization.

6.     Visit a retail health clinic. Retail health clinics are growing in numbers. They are popping up in high-traffic retail outlets in metropolitan areas around the country. While these clinics lack the personal nature of seeing a family physician who knows your complete medical history, their appeal is the convenience and low prices advertised for all to see.

7.     Stay in-network. Your medical costs can increase greatly when you visit a provider not in your plan’s network. Make sure your primary care doctor and any specialists you may need to see are in your network whenever possible.

8.     It doesn’t hurt to ask. If you must see a specialist who isn’t within your network, call your insurance company’s pre-certification department and explain why you must use an out-of-network specialist. Often times you can get your insurance company to agree to pay at in-network rates in order to avoid the expensive appeal process. If that doesn’t work, ask your specialist to accept the in-network rate.

9.     Fight back. If your claim has been denied, start with a phone call to customer service. If that doesn’t work, follow your plan’s appeal process. Remember to document everything and keep copies.

10.     Choose your health plan wisely. Sticking with the same plan year to year may not be the smartest option. Anticipate your family’s medical expenses and look closely at each plan option to find the most appropriate and cost-effective one for you.

11.     Consider an HSA. Health Savings Accounts (HSAs) are growing in popularity. They are combined with a high-deductible health plan. The high-deductible policy protects you from the cost of a catastrophic illness or prolonged hospitalization. You control the savings account and use it for small and routine health care expenses. You will save about $1,500 in taxes for every $5,000 you put into an HSA. Funds you don’t use grow tax-free and can be rolled over from year to year.

12.     Take advantage of flexible spending accounts. A flexible spending account, or FSA, is an employee benefit program that allows you to set aside money on a pretax basis for certain health care and dependent care expenses. That means you keep more of your money. For every $1,000 you put in, you’ll save approximately $300 in taxes.

13.     Don’t skimp on preventive care. Be sure your child gets routine checkups and vaccines as needed, both of which can prevent medical problems (and bills) down the road. Also, adults should get preventive screenings recommended for their age to detect health conditions early. Many of these services are now provided at no cost through employer-sponsored health plans.

14.      Visit a dental school. Look into local dental schools where you will be treated by dental students, who perform the dental treatment closely supervised by their instructors. Expect to pay about 20 to 60 percent of what you’d pay for the same treatment by a private dentist.

15.     Don’t forget to floss. Studies have demonstrated that those who floss regularly have a decrease in periodontal disease, bad breath and cavity incidence. The cost of periodontal disease treatment can range from $200 to $2,000 per procedure.

16.   Discount contacts. Discount websites and stores can provide the exact contact lenses prescribed by your eye doctor, in factory-sealed packaging, at savings of up to 70 percent off what you would pay at the retail level.

17.   Chill out. Over 60 percent of doctor visits are for stress-related conditions. Studies show that relaxation techniques are effective in controlling anxiety, enhancing the immune system and reducing conditions such as high blood pressure, substance abuse and chronic pain.

18.   Quit smoking. On average, health care costs are $1,600 per year for a smoker. Plus, if you quit smoking you can expect to save approximately $1,800 a year on the cost of cigarettes alone.

19.   Live a healthy lifestyle. Focus on eating nutritiously, cutting down on fast food and getting more physical exercise. Striving toward a healthier lifestyle and maintaining a healthy weight can drastically reduce future medical conditions and diseases.

20.   Wash your hands. According to the Centers for Disease Control and Prevention, hand hygiene is the most important factor in preventing the spread of germs. In fact, health experts estimate that 80 percent of common infections are spread through hand contact. Save hundreds of dollars a year on cold and flu treatments.

21.   Get a second opinion. Save thousands of dollars a year on cutting-edge medical tests, which usually are not covered by insurance by following the guidelines recommended by the U.S. Preventive Services Task Force – www.ahrq.gov/clinic/uspstfix.htm.

22.   Think twice about the emergency room. Don’t ever go to the emergency room (ER) when your regular doctor or an urgent care visit would suffice. If you or your child is feeling ill on Friday, get into the doctor that day to avoid overpaying at the ER during the weekend.

Providing your employees with resources to help them understand the complex health care system and pricing can benefit your employer-sponsored health plan tremendously. The more educated we are, the smarter decisions we can make when it comes to health care. Wise health care consumerism not only leads to more money in your employee’s pocket, but also more savings for you, the employer. If you are looking for innovative ways to manage your group health costs, please contact us. We have several clients of all sizes who have experienced exceptional success in educating employees and managing costs through a health care price transparency tool we offer. We welcome the opportunity to discuss if this tool woud be right for you employees as well.

HHS to Delay Part of Small Employer Exchanges

Beginning in 2014, individuals and small employers will be able to purchase health insurance through online competitive marketplaces, or Exchanges. The Affordable Care Act (ACA) requires each state that chooses to operate an Exchange to also establish a Small Business Health Options Program (SHOP) Exchange. The SHOP Exchange is intended to assist eligible small employers in providing health insurance for their employees.

HHS will establish and operate a federally-facilitated Exchange (FFE) in each state that does not establish its own Exchange. The FFE will include both individual market and SHOP components.

Small employers with up to 100 employees will be eligible to participate in the Exchanges. However, until 2016, states may limit participation in the SHOP Exchanges to businesses with up to 50 employees. Beginning in 2017, states may allow businesses with more than 100 employees to participate in the Exchanges.

On March 11, 2013, HHS issued a proposed rule that would amend some of the standards for SHOP Exchanges. Most notably, the proposed rule creates a transition policy regarding an employee’s choice of qualified health plans (QHPs) in the SHOP. The transition policy would delay implementation of the employee choice model as a requirement for all SHOPs for one year, until 2015.

FUNCTIONS OF THE SHOP EXCHANGE

On March 27, 2012, HHS issued a final rule on establishment of the Exchanges. This final rule describes the minimum functions of a SHOP. The final rule provides that a SHOP must allow employers the option to offer employees all QHPs at a level of coverage chosen by the employer—bronze, silver, gold or platinum. In addition, the final rule permits SHOPs to allow a qualified employer to choose one QHP for its employees.

In a separate final rule issued in March 2013, HHS provided that the federally-facilitated SHOP (FF-SHOP) would give employers the choice of offering only a single QHP, as employers customarily do today, in addition to the choice of offering all QHPs at a single level of coverage.

TRANSITION POLICY

In the proposed rule, HHS provides a transition policy for 2014 plan years that is intended to provide all SHOPs (both state SHOPs and the FF-SHOP) with additional time to prepare for the employee choice model.

Under the transition policy, for plan years beginning on or after Jan. 1, 2014, and before Jan. 1, 2015, state SHOPs would not have to allow employers to offer their employees a choice of QHPs at a single level of coverage. However, a SHOP may decide to provide this option to employers for 2014 plan years.

In addition, for plan years beginning on or after Jan. 1, 2014, and before Jan. 1, 2015, FF-SHOPs would not allow qualified employers to offer their employees a choice of QHPs at a single level of coverage. For 2014 plan years, the FF-SHOP would assist employers in choosing a single QHP to offer their qualified employees.

According to HHS, the transition policy would increase the stability of the small group market while providing small groups with the benefits of SHOP in 2014 (for example, choice among competing QHPs and access for qualifying small employers to the small business health insurance tax credit).

The 2012 final rule also included a premium aggregation function for the SHOP that was designed to assist employers whose employees were enrolled in multiple QHPs. Because this function will not be necessary in 2014 for SHOPs that delay implementation of the employee choice model, the proposed rule would make the premium aggregation function optional for plan years beginning before Jan. 1, 2015.

MedCon Benefit Systems, Inc. will continue to monitor health care reform developments and will provide updated information as it becomes available.

*This Legislative Brief is not intended to be exhaustive nor should any discussion or opinion be construed as legal advice. Readers should contact legal counsel for legal advice.

Introducing MedCon Connect

Your benefits consultants at MedCon Benefit Systems are excited to introduce a new comprehensive set of resources to our clients through our new client portal, MedCon Connect. Designed to provide you with time-saving tools and resources, MedCon Connect is a convenient, easy-to-use tool that enables you to manage your everyday tasks in the workplace. MedCon Connect allows you to:

  • Collaborate with our agency via the internet.
  • Quickly access timely news, information, and resources.
  • Connect with hundreds of thousands of peers in your industry.

If tackling your compliance with some of today’s most complicated legislation seems daunting, find clear, easily accessible answers with our set of comprehensive guides, frequently asked questions, quick reference and up-to-date briefs on salient topics including Health Care Reform, ADA, CHIPRA, COBRA, FMLA, HIPAA, HIPAA Privacy, Mental Health Parity, Section 125, Medicare Part D and more. In just a few clicks, access the following popular resources:

  • Health Care Reform – Find up-to-date information, including legislative updates, timelines and explanations to educate both you and your employees.
  • Questions and Answers – Resolve your doubts about federal legislation with daily questions and answers on popular, current legislative topics.
  • Legislative News – Educate yourself with updated benefits information on any specific legislative category, including COBRA, COBRA State, HIPAA, HIPPA Privacy and FMLA topics.
  • Compliance Forms – Choose election forms, eligibility forms and other general forms related to COBRA, HIPAA, FMLA and more. All forms can be downloaded in PDF or Word format, and many are available in Spanish.
  • Quick Links to Compliance – Find a comprehensive list of links to external government resources to help with compliance issues. Instead of spending hours searching the web for answers to your compliance questions and wondering which version is correct, you can now find your answers by category, directly from the government websites.

Clients will also have access to an extensive library featuring both employee-facing and informational documents for employers which allow you to quickly and effortlessly resolve a host of human resources and insurance-related issues. Find articles, brochures, forms, reports and more regarding:

  • Plan Design
  • Employee Newsletters
  • Wellness Programs

As our client, you have probably heard from us about the impact a health and wellness program can have on your overall health plan costs. MedCon Connect provides clients with an on-demand content library – communications promoting wellness and consumerism are pre-written and ready to distribute, saving you time and money. If you have never initiated a wellness program before, we have guides to get you started as well as research data to help you drive wellness initiatives and methods to evaluate your outcomes.

The nationwide benchmarking surveys administered through and available on MedCon Connect give insight into best practices across the industry. We are also connecting you with other HR professionals throughout the country via the Community Tab. MedCon Connect users have the ability to share industry-specific information and resources through an interactive forum that allows you to post questions to your peers, provide insight into others’ questions and share best practices.

Staying in compliance with OSHA is a snap with the practical and easily accessible collection of occupational safety resources you’ll find on MedCon Connect, including:

  • Compliance and FAQ – Information and answers regarding OSHA’s record-keeping guidelines, coupled with various related resources.
  • Instant OSHA Reporting – Generate up-to-the-minute OSHA reports and drill down by injury type, body part, group or division to identify trends and cost drivers.
  • Custom OSHA Forms – Generate a PDF with your OSHA 200 Log or Summary of Work-Related Injuries and Illnesses for a certain division or year.
  • Easy OSHA Log Maintenance – Edit, view and delete log entries quickly and easily with the log maintenance wizard, which makes maintenance simple and guarantees that your records are current.
  • View Recent Incidents – Stay on top of your company’s workplace safety with the online log’s handy at-a-glance view.

This is just another valuable tool we are proud offer to our clients. We encourage all of our clients to login to MedCon Connect by clicking here or using the link on the right-hand side of your screen on our home page. If you have not yet received your login information, please contact Maureen McReynolds: mmcreynolds@medconbenefit.com. We are looking forward to visiting with you and providing training on how to use this invaluable new tool.