Heart disease is the leading cause of death among Americans under the age of 80, followed by cancer, stroke, and asthma, according to new Centers for Disease Control and Prevention (CDC) data. But there's good news, too ‒ between 2010 and 2014, the CDC saw notable declines in deaths from cancer, heart disease and stroke.
These declines happen to coincide with a growing effort to better personal health: Over two-thirds of U.S. employers currently offer some form of worksite wellness. MedBen WellLiving has also grown during that period, and is using its experience to put in place wellness programs with a proven record of success.
By controlling the chronic conditions that lead to disease, we significantly reduce the odds of developing the disease in the first place. A study published by JACC found that patients without hypertension, obesity, or diabetes had much lower risks of incident heart failure than patients with these risk factors, and lived an average of 3 to 15 years longer.
WellLiving acts as a proper complement to diet, exercise and other healthy habits. By tracking health changes through annual wellness exams and regular screening, individuals reduce the risk of developing chronic conditions while improving energy and productivity.
Through MedBen WellLiving, employers benefit from a healthier workplace and long-term savings on medical costs. Learn more about how it can work for your group by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
The increasing popularity of specialty drugs has brought new challenges to health plan management. However, MedBen has closely followed their growth, and works with clients to develop strategies that balance their medicinal advantages with realistic cost considerations.
Back in 1990 ‒ roughly the same time MedBen launched its third party administration services ‒ there were just 10 specialty drugs on the market. Today, there are around 300 available, with a projected 700 more in various stages of development. Since 2010, half of all FDA approvals are for specialty drugs.
But those numbers don't tell the real story. While specialty drugs make up only 1% of all prescriptions, in 2014 they comprised 32% of total drug spending. That same year, spending on specialty drugs rose over 30%, compared to 6% for traditional medications.
When determining whether to cover a specialty drug, self-funded groups must consider its benefits (i.e., the potential to replace more expensive and prolonged medical treatment) along with its drawbacks (high cost, no assurance of effectiveness). MedBen, working in conjunction with our pharmacy advisor, offers clients recommendations on coverage levels as well as alternative medications and therapeutic options.
By providing educated guidance on the costliest drugs, last year MedBen limited average client trend on per-member pharmacy spending to just 4.1%, compared to 12.2% nationally. Learn more about how we can do the same for your group by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
9.3%. 29.1 million. Both representations of the number of Americans who have been diagnosed with diabetes. The 7th leading cause of death in the United States, the American Diabetes Association states that an additional 86 million Americans are at risk of developing the disease.
Generally, people with diabetes either have a total lack of insulin (type 1 diabetes) or they have too little insulin or cannot use it effectively (type 2 diabetes). Type 1 diabetes accounts for 5% of diabetic diagnosis while type 2 diabetes accounts for the remaining cases in the U.S. at 95%.
Type 1 diabetes has no known prevention. Risk factors for developing type 2 diabetes include obesity, having a family history of diabetes, and having diabetes while pregnant (gestational diabetes). Many people with type 2 diabetes can control their blood glucose (sugar) with lifestyle changes such as healthier eating and being active. Others may require oral medications or insulin injections.
As with caring for other chronic conditions, it is essential that you monitor the status, including regular visits to see your family physician. Even if you are not diagnosed with diabetes and live a healthy life, visiting your family physician at least once a year for an annual wellness visit is a good idea. In doing so, your physician could detect any early onsets of the condition and help guide you through a prevention or management plan, tailored to you.
The presidential election of Donald Trump, coupled with the Republican majority in both houses of Congress, has suddenly put the future of the Affordable Care Act into serious doubt. For the short term, however, it's business as usual... and MedBen is helping clients to prepare for health care reform in 2017.
As a timely reminder of what the ACA has in store for employers next year, the MedBen Compliance team has compiled a summary of its various costs, fees and potential penalties. You can download "2017 By the Numbers" from the MedBen website.
But what will become of the ACA after 2017? For all the talk of "repeal and replace" during the election, it's still a more likely scenario that less successful elements of the ACA are scrapped or changed (i.e., marketplace insurance out, individual health savings accounts in), while more popular provisions, like dependent coverage to age 26 and no pre-existing condition limitations, remain. Indeed, President-elect Trump has already indicated that he would likely keep these rules in place.
Most of the post-election chatter on ACA changes has focused on what will happen to the 20 million Americans who have purchased coverage through the marketplaces; there's been comparatively little talk about the rules directly affecting employers, such as health coverage data reporting and PCORI fees. Again, there's a strong probability that at least some of these provisions will stay put or get tweaked... though at this point it's all pure speculation.
One employer-related element that seems almost certain to be scrapped or revamped is the Cadillac tax. Already delayed until 2020 and unpopular with Republicans and Democrats alike, this penalty on benefit-rich health plans was pretty much doomed regardless of which party took the White House.
Whatever the future of health care reform may be, MedBen Compliance is always ready to assist clients with their ACA questions and concerns. Simply contact Vice President of Compliance Caroline Fraker at 800-851-0907 or firstname.lastname@example.org.
Is there anything a dental checkup can't do? In addition to ensuring the continued health of your teeth (and often getting a free toothbrush in the bargain), dentist visits may even help to keep your lungs clean.
HealthDay News reports that a new study suggests that regular dental cleanings could lower your risk of pneumonia by reducing levels of bacteria that cause the lung infection. The review of over 26,000 medical records found that people who never saw a dentist were 86%t more likely to get bacterial pneumonia compared to people who got dental checkups twice a year.
While "clean lungs" may sound comparatively trivial to things like healthy teeth and gums, the study does serve to show that the advantages of dental care go beyond the obvious ‒ and why dental coverage offers a value-added benefit to your group health care plan.
In addition to promoting preventive care through regular exams, MedBen Dental allows businesses to provide employees with restorative services at reasonable prices. And because frequent cleanings could actually reduce the risk of heart attack and stroke, a good dental plan complements a company's wellness program.
Dental care is among the least expensive benefits that employers can offer, and one of the most popular. Whether as a stand-alone service or part of a total health benefits package, MedBen Dental offers valuable care at an affordable cost. Learn more about its advantages by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
On Friday, November 18, 2016, the Internal Revenue Service released Notice 2016-70, effectively extending the due date for furnishing IRS Forms 1095-B and 1095-C to individuals offered and/or covered under employer-provided health plans. The extended deadline for distribution of these forms to employees and covered individuals is now March 2, 2017. The Notice also extends good-faith transition relief from penalties to the 2016 information reporting requirements. The Notice can be found at the MedBen website.
According to the Notice, the Treasury Department has determined that there is no similar need for an extension of time to file the Forms with the IRS which means that a plan sponsor's 1094-B (and accompanying 1095-Bs) or 1094-C (and accompanying 1095-Cs) are still due on February 28, 2017 (if filing via paper) or March 31, 2017 (if filing electronically).
The Notice extends transition relief from penalties under sections 6721 and 6722 to reporting entities that can show that they have made good-faith efforts to comply with the information-reporting requirements under sections 6055 and 6056 (both for furnishing to individuals and for filing with the Service) for incorrect or incomplete information reported on the return or statement. This relief applies to missing and inaccurate taxpayer identification numbers and date of birth, as well as other information required on the return or statement. No relief is provided in the case of reporting entities that do not make a good-faith effort to comply with the regulations or that fail to file an information return or furnish a statement by the due dates.
MedBen clients who have questions regarding the deadline extension are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or firstname.lastname@example.org.
Happy Thanksgiving from the staff of MedBen! We hope that you and your family have a fun, safe, and relaxing holiday.
To observe the holiday, MedBen will be closed on Thursday, November 24 and Friday, November 25. We will reopen at 8:00 a.m. on Monday, November 28.
Our hope is that health care concerns are the furthest thing from your mind this holiday, but should you be in need of information about your plan, our online service is always open and ready to help. Just go to the MedBen.com home page, click on the “MedBen Access” link, and log in.
MedBen Access offers claims and benefit information, and more. Plan members can see their accumulated deductibles and out-of-pocket costs, read up on medications and compare drug costs, and send questions to MedBen Customer Service (which will be answered by the next business day). Additionally, FSA and HRA plan members can review their account payments and balances, and WellLiving members can check their compliance with wellness exams and screenings.
Plan administrators can also take advantage of MedBen Access' various features, such as enrolling new members, adding or changing dependents, requesting ID cards, and notifying MedBen of COBRA events. The site offer drop-down convenience that makes navigation easy.
Again, our best wishes to you and yours for a great Thanksgiving holiday!
Earlier this year, Health and Human Services (HHS) and the Office of Civil Rights (OCR) published a final rule implementing Section 1557 of the Patient Protection and Affordable Care Act (ACA). This rule prohibits discrimination on the basis of race, color, national origin, sex (gender), age, or disability, for any health program or activity, any part of which receives federal funding or assistance from HHS.
HHS put out guidance on how employers can determine whether or not they are subject to the new Section 1557 rules. These rules are complex, and even more complicated is making a determination as to whether or not your organization and your health plan must comply. Making the rules more complicated is the fact that only HHS has put out guidance about how to determine if an organization is subject to the rules based on HHS-provided federal assistance.
The MedBen Compliance Department has put together a downloadable summary on the rules, including how to determine if the law applies to you and what changes you need to make if it does. For more information or if you have questions, please contact Vice President of Compliance Caroline Fraker at 800-851-0907 or email@example.com.
Formulary updates for prescription plans administered by Pharmacy Data Management, Inc. (PDMI) are now available at MedBen.com – simply click on “Plan Sponsors” (for employers) or “Plan Members” (for insureds) and select “Prescription Formularies” from the “Form” drop-down menu.
The new formularies become effective January 1, 2017. As always, plan administrators with questions about the formularies can contact their Group Service Representative, while plan members can call MedBen Customer Service at (800) 686-8425.
Groups use either the Focus formulary or the Outcomes formulary. Focus offers the most cost-effective drug options, while Outcomes offers broader choice while still delivering significant cost savings. If you're not sure what type of formulary you use, check with your plan administrator or log on to MedBen Access.
Should you still need a 2016 formulary, they will remain available on the MedBen website until the end of the year.
The tax-free benefits of flexible spending accounts (FSAs) helps plan members to save money on their health care spending... but using FSAs to their maximum advantage requires a bit of prior planning.
Many FSA members are currently deciding how much of their salary they want to place into their account. To determine the proper contribution amount, the best strategy is to consider health-related purchases over the past several years and use that as a starting point. MedBen clients can review their recent spending activity by logging into MedBen Access and clicking on “FSA/HRA Online Inquiry” under the “My Plan” section.
In 2017, the FSA contribution limit will be $2,600, though employers do have the option of setting a lower amount. If you're certain that you'll spend the set limit on qualified medical expenses, you can maximize the value of your FSA by making the full allowed contribution. Otherwise, consider your standard annual costs ‒ dental expenses, vision exams and materials, recurring prescriptions, and so forth ‒ and use them as your contribution baseline. Funds will be taken from your paychecks throughout the year, but the full contribution amount will be available for use on January 1.
When planning, it's critical to remember that a "use it or lose it" rule applies to FSAs. While some employers will offer a 2-1/2 month grace period to use up your remaining funds or let you roll up to $500 into the next year, ultimately any unused funds must be spent or forfeited. FSA members unsure about their group's policy should check with their plan administrator or call the MedBen Flexible Spending Unit at (800) 297-1829.
The shift from fully-insured group health plans to self-funded coverage continues, with more and more businesses realizing its savings potential. And not just large companies, either... as benefit managers like MedBen offer solutions to minimize risk, even smaller businesses are successfully making the transition.
According to Benefits Pro, a recent study by the Employee Benefit Research Institute found that between 2013 and 2015, the percentage of mid-sized companies offering at least one self-insured health plan increased from 25% to 30%. Among small businesses, the percentage jumped from 13.3% to 14.2%.
Meanwhile, self-funded businesses may soon benefit from lower rate increases. Willis Towers Watson’s Marketplace Realities report forecasts 2017 cost growth of just 4-5% for self-funded plans, compared to 7-8% for fully-insured plans.
But cost savings is just one reason more businesses are making the switch to self-funding. Plan control, access to analytic information, and the ability to design wellness initiatives have all increased self-funded appeal. MedBen helps clients of all sizes take advantage of these and other benefits.
If your business has 25 covered lives or more, you can gain from the cost-saving potential of self-funding while getting maximum use out the design and regulatory freedoms it offers. Contact MedBen Vice President of Sales & Marketing Brian Fargus to learn more.
MedBen continues to maintain high standards of quality, says the latest independent audit of the company's ISO 9001 compliance.
According to the auditing firm SAI Global, MedBen's management system, which was put in place to ensure process consistency across the company, is being followed and utilized. Additionally, MedBen management provides "appropriate input and support" to ensure that the established ISO standards are met.
"The recommendation from this audit is that your certification continues," the audit report reads.
The audit, conducted on October 20, reviewed MedBen processes in performance monitoring and measurement, management responsibility and review, and product realization. In these and other areas, the staff has implemented and improved on the company's quality management system.
Having ISO standards only works when every employee is invested in following them, noted MedBen Chairman & CEO Doug Freeman. "It takes a companywide effort to maintain quality and consistency, and I'm pleased that these audits repeatedly show that everyone here has bought in to the idea," he said.
MedBen achieved ISO 9001 Certification in 2005, and undergoes semi-annual follow-up audits to ensure continued quality performance. In 2017, the company will undergo an extensive multi-day review in order to receive recertification.
Back in May, MedBen highlighted new wellness rules from the Equal Employment Opportunity Commission (EEOC) regarding the use of incentives to promote participation in corporate wellness programs. These rules, which go into effect on or after January 1, 2017, place a limit on how much financial incentive employers can offer to their employees to encourage healthier habits.
To give more detail about the EEOC rules and how it will affect their wellness plans, the MedBen Compliance team has put together a summary document containing additional information. The document was recently e-mailed to our clients by their Group Service Representatives, but in case you missed it, it is also available for download from the MedBen website.
As was noted in the earlier article, the EEOC rules provide guidance to ensure that wellness programs comply with the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA). The ADA prohibits employers from making disability-based inquiries or requiring medical exams for employment or benefit purposes, while GINA restricts employers from requesting, requiring or purchasing genetic information which includes information about an employee's or family member's disease state or medical history.
Common to both ADA and GINA rules is a set limit on wellness incentives that employees can offer to employees and their spouses ‒ no more than 30% of the total cost of self-only coverage. It's important to note, however, that this amount must take into account both financial and in-kind incentives, such as time-off awards, prizes, and any other item of value.
MedBen is currently assisting WellLiving clients that need to make changes and working with them to ensure that their wellness programs are compliant with the new rules, but all clients with questions regarding the final EEOC rules are welcome to contact Caroline Fraker at 800-851-0907 or firstname.lastname@example.org.
When discussing hypertension, we tend to focus on its physical effects, such as its link to heart disease, stroke and diabetes. But doctors warn that high blood pressure may affect your mental capacity as well.
According to HealthDay News, a new scientific statement from the American Heart Association warns that having high blood pressure may increase one's risk of dementia. Statement author Dr. Costantino Iadecola said that hypertension is "the worst possible thing for the brain," as damage to its blood vessels leads to hardening of the arteries and an inability to control blood flow critical to normal brain operations.
While high blood pressure is a pervasive condition (about 1 in every 3 American adults have it), it's also treatable through such basic lifestyle changes as a healthier diet and regular exercise, as well as prescribed medication. Equally useful for individuals is having access to a proven worksite wellness program for advice and motivation.
Through MedBen WellLiving, plan members have a two-pronged approach to controlling high blood pressure and other chronic conditions: primary prevention that promotes annual wellness exams and building a doctor-patient relationship, which allows earlier detection and treatment; and specialty care that identifies high-risk members and offers individualized coaching from registered nurses.
For the employer, WellLiving provides regular reports, one of which includes their population’s compliance with various wellness categories and nurse coaching calls.
Effective preventive care addresses the body and mind alike, and helps employers promote a healthier workplace, which in turn leads to increased productivity and reduced absenteeism. Learn more about the benefits of MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
Following lengthy speculation, the Internal Revenue Service (IRS) has at last formally announced the annual inflation adjustment for health flexible spending accounts (FSAs) for the 2017 tax year.
The 2017 dollar limitation on voluntary employee salary reductions for contributions to health FSAs is $2,600, marking a slight increase from the current $2,550 maximum. Additionally, the dependent care FSA maximum annual contribution for next year is $5,000, unchanged from 2016.
The announcement comes some months after the IRS released 2017 contribution limits and out-of-pocket maximums to health savings accounts (HSAs) tied to a high-deductible plan. In most cases, the amounts were frozen in place, with a small increase in single contribution limits ($3,400, from $3,350 in 2016) being the sole exception.
MedBen clients who wish to implement FSA changes, 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 firstname.lastname@example.org.
Verisk Health, the company that MedBen has partnered with to provide clients with detailed reporting services, recently rebranded to Verscend Technologies (Verscend). But while their name is different, the company's commitment to analytic solutions remains unchanged.
Since 2010, our relationship with Verisk has enabled us to offer an unprecedented level of visibility in the health status of client populations, giving us the resources to pinpoint opportunities for improving care and reducing costs. Under the Verscend name, the company will further optimize health care and create even better outcomes, says Verscend CEO Dr. Emad Rizk.
Through the data analytics and reporting platform developed by Verisk/Verscend, MedBen clients receive unique insight into the financial and clinical risks they face, allowing them to chart an effective course of action. Leading-edge processes include drill-down functionality that indentifies high-risk members in need of medical interventions, a population analyzer that tracks utilization and cost trends, and outcome tracking through sophisticated cohort tools.
Clients that have questions about any aspect of our reporting services may get in touch with their Regional Sales Manager. Employers not currently working with MedBen who would like to learn more about advanced analytic solutions are encouraged to contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
The CDC states that more than 40% of adults have felt pain in their mouth in the last year. So, it’s easy to see why you should be brushing, flossing, and rinsing regularly. But these tasks could do more than just keep teeth clean – they could also help protect you from other chronic conditions.
Though the connection between oral hygiene and other certain chronic conditions is still being debated, evidence has shown a correlation between the two. Periodontics disease has been linked to conditions such as heart disease, diabetes, dementia, and rheumatoid arthritis. In addition, gum disease has been linked to poor heart health, including heart attacks.
Some researchers believe that one link can be found when oral bacteria escapes into the bloodstream, injuring major organs. It’s also thought that inflammation related to oral conditions can lead to inflammation in other parts of the body.
Whether the connections prove to be coincidence or a direct link, MedBen WellLiving has always suggested being proactive. Properly cleaning your teeth and gums, monitoring changes in your mouth such as red, inflamed gums, bleeding, or sores that will not heal, as well as visiting your dentist twice a year are highly recommended.
If you have concerns with your oral health or want more information on how to properly care for your mouth, pay a visit your dentist or family physician.
The ongoing issue of high prescription drug costs have led to media scrutiny, congressional hearings, and charges of price-gouging. MedBen prefers to remain above the fray, and instead focus on ensuring that our clients pay as little as possible for their pharmacy coverage.
"Drugmakers Point Finger at Middlemen for Rising Drug Prices," reads a recent Wall Street Journal headline. Those "middlemen" include pharmacy benefit managers (PBMs), which serve as consultants and price negotiators for employers that offer drug plans.
While it strains credibility to lay too much blame at the feet of a "middleman," it is true that many PBMs do retain a portion of the rebates and discounts they receive on behalf of their clients. Drugmakers argue that their cost increases reflect, in part, the money that PBMs hold back.
At MedBen, we follow a simple rule: "The client's money belongs to the client." Not most of it... all of it. That is why we enlisted the services of a PBM that shares our attitude.
MedBen clients can be assured that 100% of paid pharmacy rebates go directly into their health plan. We offer a transparent, full pass-through Rx model that results in better client savings. The same applies to pharmacy discount rates, including generic discounts that are among the best in the industry.
Regardless of all the finger-pointing happening over drug prices, there are genuine opportunities for employers to save money on their pharmacy plan costs, and MedBen specializes in providing timely client solutions. Learn more about how we do it by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Just like in sports, the best offense is a good defense ‒ and the same goes for your health. Promoting healthier lifestyles and practicing preventive care leads to better outcomes.
According to WebMD, a recent Danish study determined that individuals who suffer a heart attack before the age of 50 are nearly at twice the risk of an early death compared to the general population. This higher risk is driven mainly by conditions such as high blood pressure, diabetes and obesity, which are more common among people who've had a heart attack. All of these conditions leading to the heart attack, if detected and managed early, could help to eliminate the risk of a chronic condition imploding.
Following such healthy habits as regular exercise, good diet and not smoking, can reduce heart attack risk by as much as 92%. And having access to a proven worksite wellness program like MedBen WellLiving provides individuals with an additional layer of support.
By offering WellLiving, your employees have a solid foundation on which to build better lifestyles. Our "physician first" approach promotes plan members getting regular wellness exams from their family doctors, which offers a forum to discuss ways to improve and maintain healthy habits. Plus, plan members who have a higher risk of developing a chronic condition can receive individualized nurse coaching through our specialty care program.
Living a healthy lifestyle may not always be easy, but the rewards are well worth it. Learn what wellness can do for your workplace by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
Hard though it may be to believe, we've already entered the final quarter of 2016. If you're a self-funded employer, that means it's time to get serious about preparing for a critical health care reform mandate: Providing the IRS with an accurate accounting of health coverage for full-time employees. MedBen offers helpful services to complete this task.
Per the Affordable Care Act, health coverage data collected during 2016 must be aggregated and reported to employees no later than January 31, 2017 on IRS Form 1095, and reported to the IRS no later than February/March 2017 (depending on filing requirements) on IRS form 1094. Applicable Large Employers (those with 50 or more employees), or ALEs, must report using the IRS’ C-series forms, and small employers (those with fewer than 50 employees) offering coverage must report using the IRS’ B-series forms.
MedBen has again partnered with MyBenefitsChannel (also known as Five Points Technology) to provide reporting assistance for ALE clients. MyBenefitsChannel has several service options available to help ALEs create and distribute Form 1095-C to employees and prepare and file Form 1094-C with the IRS. MedBen will also be available to assist clients who are small employers by offering related IRS Forms (1095-B – employee notice and 1094-B – IRS transmittal) services for a nominal fee.
Even though the January deadline is over three months away, we strongly recommend that our clients purchase these services as soon as possible.
Regardless of your preferred approach, it is important that you start planning now.
MedBen clients with questions regarding this information may contact their Group Service Representative or Vice President of Compliance Caroline Fraker at 800-851-0907.