Prostate cancer is one of the most common cancers among men. Fortunately, it is seldom fatal – in fact, more than two million adult males can today call themselves survivors of the disease.
While there is no known cause of prostate cancer, researchers do know that it begins when some cells in the prostate become mutated, changing the DNA. The cancer usually grows slowly and may not cause any harm, though in rare cases it spreads at a much quicker pace.
Detecting prostate cancer can be difficult, as symptoms may develop only as the disease becomes more aggressive. There are many symptoms and signs related to this cancer, but some of the most common include trouble urinating, pelvic discomfort, and bone pain.
Prostate cancer testing is no longer recommended as a standard measure for men 50 and over. Instead, the American Cancer Society (ACS) encourages men to discuss options with their family doctor, who can then help them make an educated decision about testing based on family history, lifestyle and symptoms.
The ACS also offers these suggestions to help men protect themselves from the disease: Eat at least 2½ cups of a wide variety of vegetables and fruits every day, keep physically active, and stay at a healthy weight.
What does sub-Saharan trade with the United States have to do with health care reform? Both were modified as part of the Trade Preferences Extension Act of 2015 (TPEA), passed into law earlier this year.
As part of this trade bill, Congress passed several tax provisions, including the increase in penalties applicable to employer plan sponsors’ Affordable Care Act reporting requirements. In particular, the TPEA increased penalties for an employer’s failure to file or furnish “information returns and payee statements.” This includes W-2 and 1099 forms as well as the newly required 1095-B and 1095-C forms first due this coming January, 2016.
Where prior to the passage of the TPEA the penalty for failing to file an information return was $100 for each return with respect to which a failure occurs, now the penalty is $250 per failure – more than twice the original penalty. Maximum annual penalties for non-willful failures to file increase to $3,000,000, double the original $1,500,000 penalty. (See Internal Revenue Code Section 6721.) Below is a listing of the penalty increases mandated by the TPEA that affect employer informational returns:
There are additional penalties that apply to other delinquencies, including penalties for intentional disregard, that have been increased along with the above.
These penalties are particularly worrisome given the complicated nature of next year’s 1095 series reporting requirements. That means that if you miss an employee’s 1095 form, there will be both a penalty for failing to deliver it to the employee as well as a penalty for failing to file it with the IRS. The good news? The IRS has indicated that they do not intend to impose these penalties on employers who file the ACA reporting forms (1094/1095 series) in a timely manner, if the employer completes the forms in good faith.
MedBen is currently negotiating with vendors to assist you in completing these forms. We will let you know when we select one that we feel will provide you with quality service for a reasonable price. In the meantime, MedBen clients who have any questions may contact Vice President of Compliance Caroline Fraker at email@example.com.
The state of health care costs in 2015, summed up in two new surveys (per Business Insurance):
"Large employers are projecting health care costs before implementing plan design changes to increase an average of 6% in 2016, according to a National Business Group on Health survey published earlier this month.
"And according to an Arthur J. Gallagher & Co. survey of smaller employers, most of which have less than 1,000 employees, released Friday, 44% reported premium rate hikes of 6% or more in 2014. Twenty-three percent saw rates in the double digits, the survey showed."
Surveys like this, coupled with other recent reports, portend larger health care spending increases in the coming years following nearly a decade of slow growth -- and emphasize the need for sound benefits management solutions like those offered by MedBen. Because unlike national trends, on average, our clients actually saw lower costs in 2014 than in the prior year.
A closer look at MedBen’s municipality and hospital employers, two of the company’s biggest blocks of business, reveals that municipal claims costs increased just 2.5% in 2014, while hospital costs decreased by 1%. Likewise, our clients' pharmacy plan spending only rose an average of 0.5% in 2014, compared to 13% nationwide.
As to how we help businesses keep their costs down... well, we invite you to visit our website and learn about The MedBen Advantage. Or contact our Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Dental benefits are sometimes an afterthought for employers when developing a group health care plan. But as a recent USA Today article makes clear, such coverage offers a valuable advantage -- financial as well as health-wise.
According to the article, "an analysis of the most recent federal data by the American Dental Association shows dental ER visits doubled from 1.1 million in 2000 to 2.2 million in 2012, or one visit every 15 seconds." Most of those patients lack adequate dental coverage.
People with dental problems typically visit ERs when the pain from a toothache becomes overwhelming. Unfortunately, the most help they can provide are painkillers and antibiotics -- short-term fixes at best. Even so, the cost is more than three times as much as a routine dental appointment, averaging $749 a visit.
MedBen Dental helps employers reduce the potential risk of unnecessary ER visits. Much like an annual wellness exam from the family doctor, regular dental exams enable a dentist to monitor the condition of the teeth and gums over time, making it easier to detect subtle changes before a condition escalates to the point where far more costly care is required.
For employers, offering MedBen Dental also serves as an inexpensive incentive for potential employees to join your company, especially when offered as part of a larger health care package.
Dental coverage is relatively inexpensive, but it pays huge dividends. To learn more about how it can benefit your employees and your bottom line, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Turns out there's quite a number of "benefit-rich plans" out there -- that is, if you define "benefit-rich" by the Obama Administration's criteria of which employers are likely to take a financial hit when the so-called "Cadillac tax" rolls out in 2018.
Forbes.com reports that, based on research by the Kaiser Family Foundation, 26% of employers could initially be affected by the regulation if they don't scale down their benefit structures. That number could rise to 30% of employers in 2023, and jump up to 42% by 2028 "if their plans remain unchanged and health benefit costs increase at expected rates."
Under the Affordable Care Act, employers will pay a 40% tax on costs of health plans that are above $10,200 per individual and $27,500 for family coverage.
The KFF brief also notes that employers are already taking measures to sidestep the tax, such as raising copays and deductibles, reducing covered services and narrowing provider networks. "For the most part these changes will result in employees paying for a greater share of their healthcare out-of-pocket," wrote Kaiser vice presidents Gary Claxton and Larry Levitt.
As we posted on the MedBen Blog earlier this month, the IRS has requested feedback on a recent Notice pertaining to the Cadillac tax. Here's how to share your thoughts by the October 1, 2015 deadline:
As always, MedBen clients with questions about any aspect of the ACA are welcome to contact Vice President of Compliance Caroline Fraker at firstname.lastname@example.org.
Employee awareness is critical to the success of a company wellness program, yet many employees apparently aren't getting the message... which is why MedBen WellLiving takes an "all in" approach to worksite wellness.
About 7 out of 10 employers offer some type of wellness program, a Society for Human Resource Management (SHRM) study recently found. But when a separate survey by communications firm Brodeur Partners asked employees if their company had such a program in place, only about one-third of respondents said they did.
Why the disparity? Brodeur Partners CEO Andrea Coville has two theories: One, employers have a wellness program but they haven’t fully communicated its existence to their workers; or two, the plan is so weak employees don't consider it to be a wellness program.
MedBen WellLiving wellness programs put participant awareness front and center, working with clients to ensure that employer and employer alike benefit from it. We start by using an "opt-out" approach, meaning that all employees and their dependents on the health plan are considered participants in the wellness program unless they indicate otherwise.
Of course, automatic enrollment doesn't ensure actual participation. So WellLiving helps clients build further awareness through program handouts, posters and a monthly WellCare newsletter. Incentives are introduced and promoted to encourage buy-in. And when a plan member is determined to be at risk for developing a chronic condition, an RN Health Consultant reaches out to provide individualized counseling.
Having a wellness program is a good start, but real success only comes when employees are fully engaged -- and MedBen WellLiving can help your business achieve that goal. To learn more, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Government statistics suggest that the maximum amount employees will be able to contribute to their flexible spending accounts in 2016 will remain unchanged, reports Business Insurance (free registration may be required to view).
According to U.S. Bureau of Labor Statistics, the consumer price index (CPI) rose just 0.2% in the past 12 months ending in July. Based on this slow growth, and barring a large surge in August, experts say the current $2,550 FSA maximum is likely to remain in place next year.
Per the Affordable Care Act, FSA limits are set based on CPI increases, rounded down to the nearest $50. Last year, the CPI rose just enough to bump the maximum contribution up to $2,550.
Prior to the passage of the health care reform law, employees could contribute up to $5,000 to their FSAs. Because the reduced maximum essentially eliminated the ability for individuals to shelter larger amounts of money in pretax accounts, the Obama administration in 2013 allowed health FSA participants to roll over a portion of unused funds from year to year at the employer's discretion.
MedBen clients with questions regarding FSA contribution limits are welcome to contact Director of Administrative Services Sharon A. Mills at firstname.lastname@example.org.
"Reports Of The Death Of Employer Sponsored Health Insurance Are Greatly Exaggerated," reads the headline of a recent Forbes article. Blogger Todd Hixon cites a 2011 study that foretold a 30% drop in employer-sponsored health insurance (ESHI) would occur by 2014 -- a prediction that has yet to come to pass, with no indication that will happen anytime soon:
"At a portfolio company retreat last week, I heard several health plan experts talk about the future of the ESHI market. The consistent message was: many employers and their employees continue to place high value on health benefits; there’s no sign that they will be discontinued; and in fact employers and employees are actively looking for ways to create more value in this arena."
As Hixon notes, employers believe that providing health care benefits is an effective method of attracting and retaining employees -- and for that reason alone, most businesses will continue to offer coverage for the foreseeable future. But the ability to promote workplace wellness through preventive care also holds an appeal to cost-conscious companies, as do the tax advantages of ESHI.
We'll throw out another reason here for the continued popularity of group health plans, specifically for those businesses that self-fund their coverage -- employers have greater flexibility in the benefits they provide, allowing them to design a plan that best suits the needs of their employees. Moreover, self-funding offers fewer regulatory restrictions, and allows employers to keep any money that doesn't go toward paying claims.
At MedBen, we recognize that an employer's need to attract the best workers must be balanced with financial considerations. So we make it our priority to help businesses put together health benefits packages that serve employee needs while still offering opportunities to save employers money.
MedBen is in the business of helping employers succeed, by providing health care solutions that appeal to employers and employees alike. To learn more about how we can benefit your business now and in the long run, contact Vice President of Sales & Makreting Brian Fargus at email@example.com.
Back in June, the ERISA Industry Committee, an employer lobbying group, asked the Obama administration to eliminate the "embedded" maximum out-of-pocket limit, a controversial Affordable Care Act regulation. And now, members of the GOP have chimed in on the rule as well.
"In an August letter to Health and Human Services Secretary Sylvia Mathews Burwell, the chairmen of the House committees on Ways and Means, Energy and Commerce and Education and the Workforce also discussed the rule, questioning the administration’s authority to institute the changes. The federal health law, the letter said, states that there are two distinct types of coverage, each with its own out-of-pocket limit.
“'We have become increasingly concerned about agencies’ actions to implement the law that appear to exceed the authority delegated to them by Congress,' the Republican chairmen said in the letter.
"The Department of Health and Human Services declined to comment on whether it is reconsidering its position on the issue."
The embedded maximum rule, published in February, requires health plan sponsors to cover a plan member's costs once the individual out-of-pocket limit has been reached, even if that plan member has family coverage. For 2016, the individual spending limit will be $6,850, and the family limit $13,700.
If you have questions regarding the embedded maximum requirement or any aspect of the health care reform law are welcome to contact Vice President of Compliance Caroline Fraker at firstname.lastname@example.org.
MedBen was named Business of the Year by the Licking County Chamber of Commerce at the Chamber's 12th Annual Dinner & Awards Celebration on August 11.
MedBen received the award based, in part, on its excellent record of customer service as well as its long-standing support to the Licking County community. The company's nomination for the award also noted its family-oriented work environment, continuing educational opportunities and charitable contributions to such organizations as the Licking County Community Health Clinic, the Food Pantry Network and the Midland Theatre, to name just a few.
MedBen Chairman and CEO Doug Freeman accepted the award on behalf of the company. “I didn’t start anything, but had the pleasure of continuing a long legacy of service,” said Freeman, who joined MedBen as President in 1987.
Also at the event, MedBen Vice President of Compliance Caroline Fraker was honored for her work as Chairman of the Chamber's Board of Directors. Fraker joined the Board in 2011 and was named Chairman last September.
MedBen was founded in 1938 as a hospital service association based, then as now, in Newark, Ohio.
Recently, the Department of Labor updated its position on a couple of topics relating to the Fair Labor Standards Act (FLSA). Below is a summary of these new rules.
Definition of Exempt Employee
First, the DOL has promulgated new rules which will revise the Fair Labor Standards Act (FLSA). Specifically, these new rules propose a revision to the minimum wage and overtime exemption rules. As things stand now, an employee is considered “exempt” if the employee meets certain minimum criteria pertaining to the primary job duties and paid an annual salary of at least $23,660. If the DOL gets its way, that annual salary amount will go up to $50,400 beginning in 2016. That means that any employee making less than that amount, will not be considered exempt and may be eligible for overtime pay and other benefits. The proposed rule also discusses the current duties test and solicits suggestions for additional occupation examples. Comments on the proposed rules are due no later than September 4, 2015.
Definition of Independent Contractor
Next, the DOL recently updated its definition of Independent Contractor. Until recently, the DOL used a set of 20 “tests and triggers” as its criteria for determining whether an individual was the employer’s employee or an independent contractor. The DOL has now replaced that list with a new set of criteria aimed at assisting employers solving definitional problems related to the employee-employer relationship under the FLSA.
According to the DOL, the “goal of the analysis is to determine the underlying economic reality of the situation and whether the individual is economically dependent on the supposed employer." In general, an employee, as distinguished from an independent contractor who is engaged in a business of his own, is one who "follows the usual path of an employee" and is dependent on the business that he serves.” This revised guidance may prove helpful, particularly as each Applicable Large Employer (ALE) attempts to determine which individuals he must deem an employee for Affordable Care Act purposes. Below are the factors that the Supreme Court has considered significant and which are now listed on the DOL’s webpage. As they point out, no one single factor is regarded as controlling.
August is National Immunization Awareness Month... and because MedBen WellLiving encourages preventive care, here's a timely reminder to make sure your vaccinations are up to date. Shots may not be fun, but they can provide years -- or in some cases, a lifetime -- of protection against diseases.
Vaccines reduce the risk of infection by working with the body's natural defenses to safely develop immunity to disease. When a vaccine enters your body -- in essence, imitating an infection -- your immune system springs into action, releasing white cells to attack the "wannabe" infection. Once vanquished, the cells remember how to fight the disease in the future.
The use of vaccines have nearly eradicated such once-common diseases as polio and diphtheria. We emphasize the word "nearly" because no matter how rare a disease has become, only by completely eliminating it are we safe from it. And the only way to achieve that goal is through immunization.
It's important to note than immunizations shouldn't end when you turn 18 years old. While childhood vaccines are certainly critical, adults also need to remain vigilant about preventable diseases as they get older.
Your family doctor will often recommend vaccines as part of your annual wellness exam, or will schedule them as a separate visit. In either case, the procedure takes only a few minutes, and the rewards are invaluable.
A new report says that only a small fraction of businesses are fully prepared to deal with cyber attacks. MedBen counts itself among them.
According to BenefitsPro, the report by consulting firm Accenture found that only about half of the 900 companies surveyed had a "continuity plan" that is regularly updated to anticipate future attacks. Moreover, less than 10% run test attacks to test the strength of their security systems.
At MedBen, we committed to the safety of client information. As such, we have a comprehensive cybersecurity plan in place -- including conducting periodic penetration tests, in which outside firms attempt to break into our system.
During our last test in 2014, IBM’s Consulting Unit was unable to breach our defenses, and offered suggestions that improved our security further still. Additional tests are forthcoming, and naturally, MedBen is given no advance notice when they will occur.
The penetration test is critical to our cybersecurity strategy, but it's just one of the many defenses we employ to ensure the safety of medical data. Earlier this year, we posted an article that highlights the external, internal and physical safeguards we currently have in place. And we continually look for additional ways to protect client information.
MedBen clients with questions regarding our cybersecurity measures are welcome to contact Vice President of Information Systems and Chief Privacy Office Rose McEntire at email@example.com.
The Internal Revenue Services is looking for public input on one of Obamacare's more controversial regulations -- the so-called "Cadillac tax."
Scheduled to take effect in 2018, the tax would penalize employer health care plans that exceed $10,200 for a single person or $27,500 for a family per year. Those limits were established back in 2010, and at the time were more than twice as much as the average annual health insurance contributions made by employers. But as 2018 draws closer and health care costs continue to rise, what once could be deemed "Cadillac" is now closer to, say, "Ford Fusion."
Because the tax has been something of a political hot potato, the IRS has been slow to publish final regulations. Instead, they recently released a Notice calling for public comments on a number of related issues, including who may be liable for the tax and how it is to be paid. You can download Notice 2015-52 at the IRS website.
If you'd like to throw in your two cents about the Cadillac tax, you can do so by regular or e-mail. Forbes.com has everything you need to know about the feedback process; the deadline is October 1, 2015.
As always, MedBen clients who have questions regarding the tax or Obamacare in general are welcome to contact Vice President of Compliance Caroline Fraker at firstname.lastname@example.org.
On June 26 the Supreme Court held in Obergefell v. Hodges that the “Fourteenth Amendment requires a state to license a marriage between two people of the same-sex and to recognize a marriage between two people of the same-sex when their marriage was lawfully licensed and performed out-of-State.” As you may recall, this issue first came before the Supreme Court in United States v. Windsor (2013). At that time, the Supreme Court struck down a portion of the federal Defense of Marriage Act (DOMA) as an unconstitutional deprivation of equal protection. The 2015 Obergefell v. Hodges case was a compilation of six lawsuits in four states (all part of the Sixth Circuit) that defined marriage as a union between one man and one woman. Reasoning that the fundamental rights protected by the Fourteenth Amendment’s due process extended to personal choices, they held that a state must license a marriage between two people of the same-sex.
As a result, all states are now required to permit same-sex couples to marry and to recognize a marriage between two people of the same-sex when their marriage was lawfully performed out-of-state by a state that recognizes same-sex marriage. For employee benefits purposes, the Supreme Court’s ruling means that same-sex spouses are legally entitled to the same benefits under federal law as opposite-sex spouses.
But what practical implications does this decision have for plan sponsors? To properly address that question, the MedBen compliance team has put together a white paper that details the legal responsibilities employers have in light of the court's decision, including recommendations for changes to plan language and additional special enrollment periods.
One important observation that the paper makes, and which we'll reiterate here, is that the case in front of the Supreme Court was not about health coverage or employee benefits – it was about the definition of marriage. So, while nothing has changed which would require an employer to offer benefits to spouses, if an employer does offer benefits to spouses, the plan must now define ‘spouse’ as including both opposite-sex spouses and same-sex spouses.
You can download the white paper from the MedBen website. MedBen clients who have any questions regarding the same-sex marriage ruling and its implications to their plan are welcome to contact MedBen Vice President of Compliance Caroline Fraker at email@example.com.
Health care spending rose 5.5% in 2014, according to a new report published on in the journal Health Affairs -- the first comparatively large increase following multiple years of more modest growth.
Economists from the Centers for Medicare and Medicaid Services also predict that health care spending increases will average 5.8% between 2014 and 2024, spurred in part by the influx of new insureds under health care reform, faster economic growth, and the aging Baby Boomer population.
Also playing a large part in last year's increase and the projected growth is prescription drug spending. In 2014 alone, drug spending leapt 12.6% compared to just 2.5% the previous year. The debut of expensive hepatitis C drugs over the last two years is the primary reason for the increase, and last week's introduction of the cholesterol medicine Praluent will likely factor into future growth.
While these increases hardly rival the double-digit spending jumps we experienced last decade, they nevertheless demonstrate the usefulness of a benefits management partner who can help your health care costs stay below current and future trends. At MedBen, we offer a variety of savings solutions for self-funded groups.
MedBen provides an interactive data analytics platform that enables clients to see where their health care spending is going, and why. Our innovative claims surveillance system uses sophisticated software to find savings opportunities. These and other MedBen cost containment services work together, allowing self-funded employers to make informed plan decisions and keep their health care costs as low as possible.
Let MedBen help your business beat the current national spending trends. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
The introduction of a blockbuster cholesterol drug has the health care community abuzz -- but its potential to help millions of Americans comes at a steep price.
Last week, the Food and Drug Administration approved Praluent, an injectable medicine designed to lower cholesterol in people who are at high risk for heart attack or stroke, but can't adequately control their condition with existing drugs called statins. Praluent is expected to be available to patients this week.
In tests, Praluent reduced low-density lipoprotein (LDL), or “bad" cholesterol, by as much as 60%. In its initial offering, the drug will be available in both 75 milligram or 150 mg doses, so doctors have the option of starting a patient at the lower dose.
Such benefits don't come cheap, however. The initial cost for Praluent is expected to run $1,144 for a 28-day supply, or about $14,851 per year.
Based on FDA approval criteria, MedBen recommends coverage of Praluent to patients 18 and over who have a diagnosis of one of the following:
Additionally, the patient in question has been taking a high dose statin for at least 4 weeks or has an intolerance to high dose statin therapy, and has an LDL level greater than 70mg/dL.
MedBen will be providing its clients with specific information about how to best incorporate Parluent into their pharmacy plan design. In the meantime, clients with questions are welcome to contact President & COO Kurt Harden at email@example.com.
A recent survey aptly demonstrates the effectiveness of employer-sponsored wellness programs... and likewise, MedBen WellLiving is showing businesses the health and financial benefits of promoting primary prevention.
According to the survey by Healthmine, 46% of the people who discovered they had a previously undiagnosed chronic condition (i.e., diabetes or hypertension) received the diagnosis through their employer wellness program. Nearly one third of the 750 survey respondents were diagnosed with a chronic condition, MedCity News reports.
Numbers like these reinforce how annual wellness exams and recommended screenings can improve the overall health of an employee population while realizing long-term financial savings for the employer. MedBen WellLiving believes that exams performed through the plan member's family doctor increases the probability of spotting a chronic condition in its earliest stages, and improves the likelihood of successful treatment. And we back up our primary prevention approach with actionable reporting that not only demonstrates the overall progress of their program, but shows in pure dollars-and-cents whether or not the plan is benefiting the business financially as well.
Learn more about how MedBen WellLiving can improve employee health and productivity while helping your bottom line by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org
"Two dozen business groups are urging federal lawmakers to work together to pass legislation to ease the cost and compliance burdens of the health care reform law.
“'There are numerous bipartisan bills that could bring real relief to the employers we represent and their employees. We encourage you to work together to help advance these bipartisan changes' to the Affordable Care Act, the business groups wrote in their letter to members of the House and Senate.
"Those groups include the National Association of Wholesaler-Distributors, the National Federation of Independent Business, the National Retail Federation and the Retail Industry Leaders Association.
"While the letter did not mention any specific bills, an NRF spokesman said bipartisan bills the group backs include those that would repeal the Patient Protection and Affordable Care Act provision that would, starting in 2018, impose a 40% excise tax on health insurance premiums that exceed $10,200 for single coverage and $27,500 for family coverage; and another measure that would bump up the health reform law's definition of full-time employees to those working an average of 40 hours per week from the law's 30-hours-per-week definition."
Provider choice is significantly more limited for individuals covered through the Affordable Care Act's marketplaces, Modern Healthcare reports:
"A report released Wednesday by consulting research firm Avalere Health found that plans offered through the ACA's exchange offered an average of 34% fewer providers in network compared to the choices provided by the average employer-based or individual non-exchange commercial plan.
"The study found plan networks offered 32% fewer primary-care and behavioral health providers, 42% fewer oncology and cardiology physicians, and nearly a quarter fewer choices of hospitals."
The survey also found that respondents say they prefer lower costs over provider choice. And while that may be true, MedBen sees no reason that plan members can't have both.
Self-funding your group's health care plan offers you the freedom to select a provider network that best serves your employee population while still offering contracted discounts that help to keep costs in check. MedBen maintains relationships with networks throughout the country in order to find the best client fit.
Of course, provider discounts are just one part of the MedBen Advantage. Through a combination of discount, plan design, medical management and leading-edge cost controls, we offer clients quality, low-cost health care backed up with verifiable savings. Learn more about our money-saving solutions by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.