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12/17/17

  11:23:00 pm, by MedBen5   , 273 words,  
Categories: Announcements, News, MedBen Employees

MedBen Employees Participate in Families Helping Families Program

Exchanging gifts with friends and family is fun, but sharing with those less fortunate is the true meaning of the holiday season... and once again, the MedBen staff has embraced the spirit of giving.

For 18 years and counting, MedBen has participated in the Licking County (Ohio) Families Helping Families program. Our employees worked together to raise funds and purchase presents, to ensure that the underprivileged children of our community enjoy a special holiday memory.

Families Helping Families

Licking County Job & Family Services (LCJFS), in conjunction with the Salvation Army, has coordinated the Families Helping Families program for four decades. Families Helping Families calls on individuals and groups to donate presents to brighten the holiday season for members of Licking County. Every year, approximately 600 children and 75 elderly community members receive a variety of gifts from anonymous donors.

This year, MedBen employees shopped for 16 children (from lists provided through LCJFS as well as House of New Hope, which helps foster children) ranging in age from seven months to 12 years old. Each child received clothing in addition to toys that were on their “wish list.”

MedBen has proudly partnered with multiple charities and non-profit organizations over the years. In addition to Families Helping Families, we've provided ongoing support to United Way, Food Pantry Network, A Call to College, Big Brothers/Big Sisters, the Midland Theatre and the Licking County Community Health Clinic, to name a few.

MedBen has called Licking Country home since 1938, and we've pleased to be able to assist the people of our community.

Individuals and groups who are interested in contributing to a future Families Helping Families drive are encouraged to contact LCJFS’ Jamie Spangler at 740-670-8736.

  11:14:00 pm, by MedBen5   , 228 words,  
Categories: Announcements, News, MedBen Employees

We're Home For The Holidays, But Still Open Online

wreath

Happy holidays from your friends at MedBen!

Our home office will be closed on Christmas Day, and will reopen at 8:00 a.m. Tuesday, December 26. We will close again on Monday, January 1 and reopen at 8:00 a.m. on Tuesday, January 2, 2018.

While we hope health matters don't interrupt your holiday enjoyment, should you have a question that needs a fast answer, we encourage you to visit us online. MedBen offers a variety of helpful services 24/7!

The MedBen Access website acts as your one-stop service center. Be it an inquiry about the status of a claim, the remaining balance in your FSA, or the cost of a prescription drug, MedBen Access has the information you need 365 days a year!

If you don’t already have MedBen Access bookmarked in your browser, the easiest route there is through the MedBen.com home page. Just click on “MedBen Access” (located on the top right corner of the page), type in your user name and password, and you’re in!

Also keep in mind that MedBen.com offers resources frequently requested by customers, such as a list of FSA-eligible expenses and instructions for reading EOBs. Just select the “Plan Sponsors” or “Plan Members” button on the home page, depending on your specific needs.

Oh, and if you haven't done so already, don't wait any longer to schedule your yearly wellness exam!

Best wishes for your continued health and happiness in 2018!

12/12/17

  04:00:00 pm, by MedBen5   , 256 words,  
Categories: Announcements, News, Privacy, Third party administration, Compliance, MedBen Employees

Fraker to Serve as SPBA Secretary/Treasurer

Caroline Fraker

MedBen Vice President of Compliance & Chief Privacy Officer Caroline Fraker will serve as Board Secretary/Treasurer of the Society of Professional Benefit Administrators (SPBA) for the 2018 year. Fraker joined the board in 2015.

As Secretary/Treasurer, Fraker will keep the minutes of the Board meetings, serve as custodian of certain SPBA records, and ensure that SPBA financial management policies are fulfilled in accordance with Board policy.

Fraker was a member of SPBA well before she was invited to join the Board, going back to when she started at MedBen in 1992. The organization performs an instructive role for third party administrators (TPAs) providing benefit services to private and public groups alike, she said.

“SPBA provides education and support to TPAs, and educates lawmakers on the finer points of health benefits," Fraker noted. "Not in any sort of lobbying capacity, but strictly to ensure they have the information they need to make informed legislative decisions.”

Formed in 1975, SPBA strives to advance the goals of benefits administrators as well as to provide advice that helps members better serve their clients and their clients’ plans. SPBA Board members meet monthly via conference call to discuss issues of importance to the Society’s members and their customers. Board members also host twice-yearly conferences open to all SPBA members, which are preceded by Board-only meetings.

A 30-plus year veteran of employee benefits, Fraker assists MedBen clients with regulatory compliance, contractual and risk management issues. In addition to her SPBA responsibilities, she also serves on the Government Affairs Committee of the Licking County Chamber of Commerce.

12/03/17

  11:18:00 pm, by MedBen5   , 232 words,  
Categories: Cost savings, Third party administration, Self-funding

Flexibility Adds to Self-funding Appeal

MedBen building

With all the uncertainly in the fully-insured market nowadays, it's little wonder that the popularity of self-funding continues to grow. Today, nearly 70% of U.S. employees are covered under employer-funded plans, as more businesses are seeing for themselves the flexibility (and savings) these plans offer.

In its State of the TPA Industry & Forecast for 2018, the Society of Professional Benefit Administrators (an organization on which MedBen Vice President of Compliance Caroline Fraker serves as a board member) projects that "employers will continue to move to self-funding for the ability to design and fully customize health plans that fit their specific work populations."

It is that flexibility, coupled with greater regulatory freedom, that makes self-funding an appealing alternative to groups looking for ways to control health care costs. And when you consider that employers pay only for their actual plan expenses, the choice becomes even more obvious.

In short, self-funding provides multiple avenues for saving employers money... and MedBen is an expert in working with groups to create health plans that take full advantage of these benefits. We help fully-insured groups make a smooth transition to self-funding, and help self-funded groups find additional saving opportunities.

With nearly 80 years of experience in benefits management, MedBen knows the important distinctions that make every group unique. Learn more about our self-funded solutions by visiting MedBen.com or contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

  11:03:00 pm, by MedBen5   , 479 words,  
Categories: Health Care Reform, IRS

“Cash in Lieu of Benefits” Considerations

Capitol-Caduceus-Bills

With many employers updating benefit packages effective January 1st, it is easy to overlook certain basic benefit options. Offering cash in lieu of benefits is a growing trend among employers, especially those considered Applicable Large Employers (ALE) under the Affordable Care Act (ACA). While it is still permissible to offer a cash incentive to employees who opt out of the employer’s group health plan, there are several important things to understand and consider before implementing or renewing such a program.

  • First, remember that any cash benefit provided to an employee will always be taxable. This rule applies no matter what type of cash option arrangement the employer implements. (Note that benefits provided through a Section 125 plan are subject to different rules.)
  • The “cash in lieu” amount must be counted in the affordability calculation determination under the ACA if the opt-out arrangement is deemed “unconditional” by the IRS. An “unconditional” opt-out arrangement is one in which payment is made to the employee based solely on the employee declining the employer’s offer of group health coverage. In this case, the employer must report the opt-out payment in addition to the standard employee contribution amount as that employee’s cost on line 15 of Form 1095-C.
  • If the offer of cash in lieu of enrollment is “conditional,” the amount does not need to be included in the ACA affordability calculation. The IRS defines a “conditional” opt-out amount as a payment made to the employee only if the employee satisfies a specific condition – generally, the requirement to show evidence that the employee is covered under another health plan or other insurance coverage.
  • The cash option cannot be provided by the employer to enable the employee to buy an individual policy either on or off of the Marketplace (Exchange).
  • The cash option must be offered to all eligible employees (or employees who are eligible as a specific class of employees) in the underlying group health plan. Other IRS rules prohibit an employer from applying the cash option to highly compensated employees only or just those with high claims.

Full story »

12/01/17

  08:11:00 pm, by MedBen5   , 256 words,  
Categories: News, Wellness, Cancer, Research, Preventive care

Nearly Half of Cancer Cases Preventable, Study Finds

cancer definition

A new study suggests that nearly half of cancer cases in the U.S. can be attributed to unhealthy habits – habits that could be changed through a focus on wellness and maintaining a doctor-patient relationship.

The American Cancer Society study found that 45% of cancer deaths and 42% of diagnosed cancer cases can be attributed to what the authors call “modifiable” risk factors, such as smoking, poor diet, excess alcohol intake, and prolonged sun exposure.

Cancer rates have dropped in recent decades, due in large part to a drop in cigarette smoking. Even so, the ACS notes that smoking is still responsible for 30% of cancer deaths... and a nationwide spike in obesity has negatively impacted the overall decline.

A wellness program like MedBen WellLiving can play a crucial role in reducing cancer rates. Promoting preventive care through age- and gender-appropriate screenings greatly improves the chance a cancer can be detected and treated successfully. Moreover, the cost difference between treating an early cancer vs. a cancer in its advanced stages can be substantial.

Equally important, WellLiving encourages regular wellness exams with a family doctor. A sustained relationship allows the physician to serve as a mentor, providing advice and a gentle nudge in the right direction should the patient find themselves on a course that could lead to cancer down the road.

We have it in our power to reduce our risk of developing cancer... and MedBen WellLiving can be a valuable ally in the fight. Find our more by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

11/30/17

  04:48:00 pm, by MedBen5   , 513 words,  
Categories: News, Health Care Reform, IRS

Coming Soon: 2015 Employer Shared Responsibility Penalty Notices

IRS building

What does the IRS do while it awaits the outcome of tax reform? It works on identifying employers that are not complying with the Affordable Care Act’s (ACA’s) employer shared responsibility mandate.

In April, a Treasury Inspector General for Tax Administration (TIGTA) audit revealed that the IRS’ processes to ensure that applicable employers are compliant with the information reporting requirements mandated by the ACA were falling short. Well. that’s all changed.

The IRS has announced that they have begun issuing letters to inform applicable large employers (ALEs) of their potential liability for an Employer Shared Responsibility Payment (ESRP) in late 2017. The IRS determination of whether an employee may be liable for an ESR Payment is based on 2015 calendar year data reported to the IRS on Forms 1094-C and 1095-C during the first quarter of 2016.

IRS “Letter 226J” will notify employers that the IRS believes the employer owes money under the ACA’s Employer Mandate provisions for calendar year 2015. Two forms are included with the letter.

The first form, Form 14764 (Employer Shared Responsibility Payment Response), must be used to respond to the IRS’ inquiries. The other, Form 14765 (Employee Premium Tax Credit (PTC) Listing), lists each full-time employee that was allowed a PTC on his or her tax return for one or more months in 2015 and did not have an affordability safe harbor or other relief reported on such employee’s Form 1095-C. If an employer disagrees with all or a portion of the proposed ESRP, Form 14765 must be returned with the response marked to show corrections to Line 14 and/or 16 codes, as necessary.

Full story »

11/19/17

  11:07:00 pm, by MedBen5   , 275 words,  
Categories: News, Prescription, Wellness, Hypertension, Preventive care

New Blood Pressure Guidelines Add Millions to Hypertension Rolls

blood pressure

Nearly half of U.S. adults are now considered hypertensive, based on revised blood pressure guidelines developed by the American Heart Association and other medical groups. A reading of 130/80 will indicate stage 1 hypertension, a reduction from the previous standard of 140/90.

The new benchmarks mean that that an additional 30 million Americans (103 million overall) are now categorized as suffering from high blood pressure. People in the stage 1 or stage 2 (140/90 or higher) categories have a significantly increased risk of heart disease, stroke, and other cardiovascular conditions.

By lowering the hypertension threshold, family doctors will place an earlier emphasis on preventive care and healthier lifestyles for patients with elevated blood pressure readings.

The change is long overdue, said Dr. Luke Burchard, Medical Director for health care consultant (and MedBen partner) Avande. "The 140/90 threshold for treatment of hypertension never made sense to me, as we have known for decades that compared with 120/80, those patients had significantly more heart attacks and strokes. I've been a 130/80 target guy for years, and that's what I tell patients," he said.

The study authors noted that, despite the sudden surge of Americans considered hypertensive, only 2% of these new people need medication right away. Since nearly 90% of high blood pressure is caused by bad habits, the rest, they say, should go with such tried-and-true remedies as quitting smoking, better diet, and more exercise.

Still, in cases where medication is recommended, plenty of inexpensive generic options are available. "The meds have never been better and cheaper," Burchard said. "It's no more effort, and usually no more cost, to take the higher dose of a blood pressure drug than the lower, less effective dose to get to a target."

  10:50:00 pm, by MedBen5   , 351 words,  
Categories: News, Health Care Reform, Compliance

Labor FAQ Outlines Special Enrollment Guidance

Department of Labor

The Department of Labor (DOL) recently issued another FAQ in its series addressing implementation of the Affordable Care Act (ACA). In addition to guidance on the 21st Century Cure’s Act and other items, the DOL’s FAQ Part 35 focuses on new special enrollment requirements for group health plans.

As most plan sponsors know, group health plans are required to provide special enrollment periods to current employees and dependents when such employees or dependents lose eligibility under another group health plan or health insurance coverage in which the employee or their dependents were previously enrolled, and upon certain life events, such as when a person becomes a dependent of an eligible employee by birth, marriage, or adoption or dependents reach the plan’s limiting age.

DOL FAQ 35 now clarifies that employees and their dependents are eligible for special enrollment in a group health plan if they are otherwise eligible to enroll in the plan and, at the time coverage under the plan was previously offered, they had other group health plan or health insurance coverage (regardless of whether the coverage was obtained inside or outside of a Marketplace) for which they have lost eligibility.

Accordingly, if an individual loses eligibility for coverage in the individual market, including coverage purchased through a Marketplace (other than loss of eligibility for coverage due to failure to pay premiums on a timely basis or termination of coverage for cause, such as making a fraudulent claim or an intentional misrepresentation of a material fact), that individual is entitled to special enrollment in group health plan coverage for which he or she is otherwise eligible. These individuals will be eligible for special enrollment in the group health plan coverage regardless of whether they may enroll in other individual market coverage, through or outside of a Marketplace.

Plan sponsors should check their group health plans to make sure that the plan’s special enrollment provisions include an option for individuals losing eligibility for coverage inside or outside of the ACA Marketplace.

MedBen clients who have questions regarding this requirement are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or cfraker@medben.com.

While MedBen Closes for Thanksgiving, Online Services Always Open

horn of plenty

As the usual end-of-year festivities ramp up, the staff of MedBen would like to take this opportunity to wish you and yours a fun and stress-free holiday season.

While MedBen pauses to observe Thanksgiving Day, our offices will be closed on Thursday, November 23 and Friday, November 24. MedBen will reopen on Monday, November 27 at 8:00 a.m. EST.

Hopefully, you'll have bigger priorities than health care benefits during the Thanksgiving break... but should a coverage question arise, it's easy to find the answer by using our 24/7 online services.

  • MedBen.com: From the “Plan Sponsors” and “Plan Members” areas, you can view and download a variety of materials, including applications, prescription formularies, FSA/HRA reimbursement forms and provider network directories.
  • MedBen Access: Get detailed information about your health care coverage, such as specific plan benefits and claims status and history.
  • Rx Information: Available through MedBen Access (select the appropriate patient name under “My Rx Claims”), this useful site enables prescription plan members to check their Rx history, get detailed drug information and compare costs between brand-name medications and their generic equivalents.
  • FSA/HRA Online System: Available through MedBen Access (select “FSA/HRA Online Inquiry”), this site enables FSA and HRA members to check account balances, recent claims and payments.
  • Wellness Compliance: Available through MedBen Access (select “MedBen WellLiving”), this page allows MedBen WellLiving program members to check their compliance with recommended exams and screenings, and see when to schedule upcoming visits. (And by the way, don't forget to get your wellness exam before year's end!)

Once again, our very best wishes for an enjoyable Thanksgiving!

11/15/17

  11:26:00 pm, by MedBen5   , 209 words,  
Categories: Compliance

By the Numbers: Your 2018 Health Plan Budget

budget

Working on your 2018 health plan budget? If so, you’ll want to keep the following limitations and penalties in mind. The following apply as of the first day of your plan’s 2018 plan year:

Out-of-Pocket Maximums

  • $7,350 for self-only (employee-only) coverage.
  • $14,700 for other than self-only coverage.
  • Over these thresholds, employers must pay 100% of the benefits covered by the plan.

Employer-Shared Responsibility Penalties

  • $2,320 per employee (for all employees combined) if qualifying coverage is not offered to 95% of the employer’s employees working 30 or more hours per week.
  • $3,480 per each employee for whom the employer-offered coverage is deemed unaffordable.

Affordability Safe Harbors

  • 9.56% – Employee cost-share for employer-offered coverage must be less than 9.56% of one of the ACA safe harbor amounts (federal poverty level, W-2 salary or hourly rate of pay) for cost-share to be deemed affordable. Note: this is a reduction from the 2017 percentage.
  • $12,060 – Federal Poverty Level (FPL) Safe Harbor Amount for 2018.

PCORI Fee (Due July 31, 2018)

  • $2.39 per covered life for plan years ending on October 31, 2017, November 30, 2017 or December 31, 2017.
  • $2.26 per covered life for all other plan years.
  • A “covered life” means each and every individual covered under an applicable plan (i.e., employee, retiree, spouse, and dependent).

MedBen clients who have questions regarding these numbers are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or cfraker@medben.com.

11/09/17

  10:21:00 pm, by MedBen5   , 333 words,  
Categories: Wellness, Preventive care

See Your Family Doctor for a “Change”

doctor consultation

We see change happening around us every day... but as we approach the final months of the year, what changes have you seen in yourself over the last year? More importantly, what changes haven’t you noticed? Your family physician can tell you what you may be missing.

Developing a relationship with your family physician is very important. With regular visits, your doctor will learn your family history and to understand your “normal,” allowing them to detect early symptoms of conditions you might otherwise overlook... and early detection is key to a healthier lifestyle and lower medical bills.

A wellness visit should create a dialog between you and your physician, so be sure to be honest about any medical concerns you’ve encountered. Be mindful, too, that while preventative care is free, treatment of previous conditions are not. Be sure to remind your doctor and the other medical staff seeing you that you are there for a wellness visit and that it should be billed as such.

If a healthier life and lower medical costs weren’t already enough of an incentive to get your annual exam, many plans have added incentives for getting your exam (and other recommended screenings) prior to the end of the plan year. If your plan has these incentives, you’ll want to get your screenings scheduled soon!

Full story »

11/05/17

  11:35:00 pm, by MedBen5   , 279 words,  
Categories: News, Heart, Research

Study Calls into Question Value of Heart Stents

stent

British researchers have determined that a regimen of medications can be just as effective in treating heart patients as a coronary stent insertion to open blocked arteries. The results raise questions about the value of using stents for the treatment of stable angina – a procedure that can cost as much as $40,000 for the 500,000 Americans who receive it annually.

According to The New York Times, the study authors recruited 200 patients with a profoundly blocked coronary artery and treated them for six weeks with drugs to reduce their heart attack risk. All patients then underwent the stent procedure, but only half actually had the device inserted. Neither the patients nor the researchers knew who had received the stent, and both patient groups took additional drugs to prevent blood clots post-procedure.

Six weeks following the stent procedure, both groups said they had less chest pain and showed improvement on treadmill test.

If the results of the study hold and a stent was no more effective than a placebo (which, by the way, has consistently been proven to be quite effective) then another consideration is the risk to patients from a) the introduction of a foreign body into the patient, and b) the additional risk posed to the patient if a an anti-platelet such as Plavix is used and is ineffective because of genetic makeup or poor patient adherence. In those situations, the stent could have increased the risk of problems for the patient.

History has demonstrated that a combination of qutting smoking, proper diet and exercise, and drug treatment has been successful in preventing heart disease. MedBen recommends to clients that such measures have been thoroughly explored before invasive procedures are considered.

  01:55:00 am, by MedBen5   , 220 words,  
Categories: Health Plan Management, Cost savings, Research, Third party administration, Trend, Claims management

MedBen Beats Trend by Focusing on Claim Costs

MedBen building

Medical plan trend has kept stable over the last few years. Even so, MedBen has consistently remained under national trend by emphasizing the highest driver of plan costs – claims.

According to the 2018 Segal Health Plan Cost Trend Survey, medical trend* for active employees and retirees under 65 for the years 2012 through 2016 averaged 6.5%. By contrast, the MedBen medical trend for the same four-year period was just 2.1%. Even if pharmacy costs (which have lately experienced much higher trend) are also considered, our overall trend rises to only 3.2%.

Because "all claims are not created equal," MedBen approaches them differently depending on the type and size of the claim. For example, while every claim gets a thorough examination to ensure that it meets medical necessity and billing standards, large claims receive even closer scrutiny, including review by certified medical specialists.

Pharmacy claims, too, merit a different kind of examination. The rise of expensive specialty drugs demands that such claims are reviewed to ensure that lower-cost medications aren't available or therapeutic alternatives haven't been overlooked.

More than ever, MedBen has the technical, analytic and personnel tools to keep client expenses in check and plan cost trend low. For additional insight into how we do it, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

* Includes open-access preferred provider organization (PPO) and point-of-service (POS) plans.

11/03/17

  10:23:00 pm, by MedBen5   , 204 words,  
Categories: Wellness, Cancer, Diabetes, Preventive care

With Worksite Wellness, the News Is Good

checkup

Three recent news items that caught our eye...

So, what’s the connection? All three of these positive findings coincide with increased efforts to detect and treat chronic conditions and diseases as early as possible... efforts that start with regular wellness exams and age- and gender-appropriate screenings.

The MedBen WellLiving program is based on the simple idea that an emphasis on preventive care delivers long-term advantages – financial in addition to physical. For diabetes and high cholesterol, early detection allows for plan members to receive specialized counseling on controlling their condition. And for a major disease like breast cancer, treatment in its earlier stages may save hundreds of thousands of dollars... to say nothing of its life-saving potential.

Better health is good news to your employees and your business. Learn the benefits of MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

10/31/17

  08:52:00 pm, by MedBen5   , 271 words,  
Categories: Announcements, News, Quality, ISO

MedBen Continues to Maintain ISO Standards, Latest Audit Finds

ISO 9001 Certified

MedBen continues to maintain ISO 9001 standards, according to a recent audit of the company's management system by independent auditor SAI Global.

Following an onsite audit on October 4th of various internal functions and processes, the auditor reported that, "Based on the evidence verified and findings of this audit, the management system is being managed and utilized by all employees interviewed.”

"The recommendation from this audit is that your certification continues."

For this audit, SAI Global verified that MedBen's 2017 Quality Objectives, which include an ongoing commitment to improving customer satisfaction and reducing operating cost in key processes, continue to be addressed and fulfilled.

The auditor also praised a new MedBen document called the "Risk Matrix." Created to support a new ISO 9001:2015 requirement that Certified companies consider risk and opportunities in their management system, the matrix provides an easy way to access relevant company issues (i.e., product expansion, security risks) and confirm that they have been thoroughly examined prior to implementation.

"MedBen has always identified risks and opportunities in the course of doing business, and always worked on mitigating risk," noted MedBen Chairman & CEO Doug Freeman. "The matrix is a simple demonstration method that we can use to review and document consideration of those risks and opportunities."

Back in June, SAI Global recommended MedBen for ISO 9001 recertification - the third such reassessment audit since we first earned certification in 2005. But between the triannual recertifications, MedBen also undergoes twice-yearly surveillance audits to ensure that quality standards continue to be met at all times.

SAI Global provides organizations around the world with information services and solutions for managing risk, achieving compliance and driving business improvement.

10/27/17

  07:25:00 pm, by MedBen5   , 214 words,  
Categories: News, Consumer-driven Health Plans, Flexible spending accounts (FSAs)

IRS Bumps Up Health FSA Contribution Maximum

IRS building

The Internal Revenue Service (IRS) has announced the annual inflation adjustment for flexible spending accounts (FSAs) for the 2018 tax year. As has been the case in previous years, contribution limits will see only modest increases or remain unchanged.

The 2018 dollar limitation on voluntary employee salary reductions for contributions to health FSAs is $2,650, up slightly from the current $2,600 maximum. Funds from these accounts can be used to pay for qualified medical expenses, including (but not limited to): deductibles, copays, and coinsurance; insulin, bandages, and other pharmacy items; eye exams and vision expenses; and dental and orthodontic expenses. Health FSA funds can also be used to pay for common over-the counter medications (i.e., aspirin, ibuprofen, and cough syrup), but only if accompanied by a doctor's prescription.

The dependent care FSA maximum annual contribution will hold steady at $5,000 in 2018. These accounts reimburse the employee for employment-related dependent care while the plan participant and spouse work (or look for work), such as payments to a day care center or baby-sitter, or expenses to care for a disabled spouse or other tax dependent.

MedBen clients who would like to increase their Health FSA employee maximum to $2,650, or who have any questions regarding FSA contributions, are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or smills@medben.com.

10/22/17

  08:23:00 pm, by MedBen5   , 213 words,  
Categories: Wellness, Reporting, Cost savings

Claims-Based Wellness Approach Pays Healthy Dividends

heart and EKG

Unlike traditional wellness programs that require employees to complete imprecise and unreliable health risk assessments, MedBen WellLiving takes a claims-based approach. And that distinction makes a big difference on the long-term success – and savings – of your program.

Right at the start, MedBen WellLiving uses claims data analysis to identify plan members that could benefit from specialized nurse coaching. Likewise, our “physician first” emphasis not only eliminates the redundancies of on-site biometric screenings, it provides data for future analyses.

Additionally, WellLiving clients get ongoing wellness progress reports, such as the prevalence of chronic conditions and the costs of treating disease states within the population. They also receive compliance rates for early detection testing... again, based solely on the group's claims data.

Why does all this matter? By having a wellness program built on actual claims data and timely reporting, employers are better positioned to see where the program is working, and where incentives may be focused to improve compliance, thereby creating a healthier population

As for the savings, the numbers speak for themselves: From 2014 to 2016, WellLiving clients experienced an average claims cost trend of just 1.6%... just a fraction of national trend.

Learn more about the ways MedBen WellLiving can benefit your business by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

  08:15:00 pm, by MedBen5   , 273 words,  
Categories: Privacy, MedBen Employees, HIPAA

MedBen HIPAA Training Stresses Proper Use of PHI

HIPAA training

As part of ongoing efforts to ensure the privacy of client PHI (protected health information), all MedBen employees recently attended HIPAA (Health Insurance Portability and Accountability Act) refresher training, with sessions led by Vice President of Compliance Caroline Fraker.

While employees get regular HIPAA training at the department level, this companywide training was given to advise employees about the regulatory and contractual requirements of HIPAA and to provide an overview of technical and physical safeguards in place to protect the data we manage.

At the training session, Fraker said that "HIPAA defines how protected information can be used, discussed, accessed, and accounted for. And that goes not just for medical information, but all personal data."

Attendees reviewed the rights that all individuals have under HIPAA, as well as MedBen’s internal policies for safeguarding clients protected health and individually identifiable information. Our HIPAA Workforce Policy is accessible to all employees through the company's internal website.

"Make sure to verify who you are talking to in person, on the phone and via e-mail," Fraker said. "If you receive mail or an e-mail that looks suspicious, call the person who sent it at a verifiable phone number to make sure they sent it before providing PHI."

MedBen’s role as a business associate of its clients was also reviewed... in particular, the rules regarding the disclosure of data to vendors and stop-loss partners. "Any individual or organization that wants protected health information from us must prove that they are a business associate of the client," Fraker cautioned.

MedBen clients who have questions about HIPAA or the use of PHI are welcome to contact Fraker at 800-851-0907 or cfraker@medben.com.

10/20/17

  08:54:00 pm, by MedBen5   , 192 words,  
Categories: News, Prescription, Transparency, Pharmacy benefit manager (PBM)

Pharmacy Benefit Transparency? Nothing New for MedBen Clients

pills

Pharmacy benefit transparency has been given a national spotlight with Anthem’s well-publicized allegations that Express Scripts overcharged them for prescription drugs (creating, in Anthem's words, an “obscene profit windfall”). In the latest development, Anthem has announced a partnership with CVS designed to “bolster transparency” for clients beginning in the year 2020.

While MedBen applauds such efforts, our clients have experienced pharmacy benefit transparency for the last 15 years. And while transparency is important since all self-funded health plans should understand what happens to their money, it is only part of the equation. The other part is another critical element of MedBen’s pharmacy offering: pass-through pricing.

What pass-through pricing means is that the pharmacy discounts and paid rebates are passed on the client, rather than being shaved by a middleman. This is how MedBen has practiced pharmacy benefit management with our clients since we developed our program. The result is superior pharmacy benefit performance for MedBen clients.

There’s no need to wait until 2020 for true pharmacy benefit transparency... MedBen can deliver it to you today. It is how we do business. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

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