The 2015 season of MedBen University will soon be in session! This promises to be one of the most extensive years for MBU ever, with a variety of events scheduled for the first half of 2015 alone.
If you’ve never had the opportunity to attend a MBU, we encourage you to join us at an upcoming session. Not only will you receive practical guidance about health care planning and timely information regarding regulatory developments, you’ll have the opportunity to pose questions to a team of benefit management professionals and discuss coverage concepts with other self-funded employers. And you're welcome to attend even if you're not a current MedBen client!
The following seminars will be held at the C. Arthur Morrow Conference Center, 1821 W. Main St., Newark, Ohio (located next to the MedBen home office):
Self-funding and the Affordable Care Act
Thursday, February 26
With the introduction of the ACA’s employer mandate and required benefit and plan changes, 2015 promises to be a challenging year for self-funded groups. We’ll highlight the new health care reform rules you need to know about and how to best comply with them – and help you steer around the law’s financial potholes.
Wellness in the Workplace
Thursday, May 14
With client worksite wellness programs in place for nearly a decade, MedBen has gained expertise on how an increased focus on preventive care and lifestyle changes can benefit workplace health and productivity, as well as the employer’s bottom line. We’ll produce useful advice for businesses thinking about implementing a wellness program and share success stories that current wellness clients can adapt to their own programs.
MedBen is among the companies spotlighted in a Newark Advocate article about methods employers use to motivate their workers toward better health.
As part of the company's wellness strategy, MedBen encourages its team to practice healthier lifestyles. One of the ways we do that is through our BeneFITNESS program, which rewards employees who exercise regularly with extra contributions to their HRAs. Advocate writer Kent Mallett highlights a recent BeneFITNESS addition:
"MedBen provides its 157 employees a 30-minute boot camp training three times a week at no charge.
"Caroline Fraker, vice president of compliance at MedBen, said the training takes place at the company's adjacent Morrow Conference Center, the former Bake 'N' Brew building.
"'We started it last year when the Advantage Club closed,' Fraker said. 'We had so many people going to the Advantage Club because it was so close. It's super easy. People can walk next door.'
"MedBen also subsidizes the cost of gym memberships at any location."
As Fraker notes, the closure of a nearby health club – one within walking distance of the MedBen home office and convenient for lunchtime workouts – prompted management to modify the company's wellness incentive program. By introducing the noontime boot camp at the conference center, employees continue to have easy access to exercise in a casual and supportive environment.
The boot camp is just one aspect of MedBen BeneFITNESS. Employees can also get rewards for gym workouts and walking programs, and participate in weight loss challenges and other special events.
Of course, for MedBen BeneFITNESS is more than an internal consideration – it also serves as a testing ground of sorts for the company's WellLiving program, which is available to employer groups. By "walking the walk," as it were, we can offer first-hand experience to our clients on ways they can incentivize their own employees to get fit... and have fun in the process!
We've read a fair amount of opinion pieces lately that question the need for an annual physical examination. Invariably, they come down to the same premise: Does the money saved from detecting a serious condition in its early stages offset the cost of preventive care for an entire population – many of whom may not have a major illness until later in life?
On LinkedIn, David L. Katz, MD, MPH, President of the American College of Lifestyle Medicine, addresses head-on the short-sighted approach of such thinking:
The annual exam may be the only real opportunity for lifestyle counseling in a healthy person. It may, at least occasionally, be part or even much of the reason that person remains healthy over the years. But again, that won’t show up as data in favor of the annual exam. It will only add to the tally of absent data – a bad outcome that doesn’t occur for reasons that are hard to discern.
The salient point here – and one that MedBen considers a cornerstone of its WellLiving program – is that preventive care is just one part (albeit an important one) of the wellness exam. Equally critical is the opportunity to establish a dialogue with a doctor about the patient's health, with yearly follow-up meetings. In this way, the doctor is more likely to detect crucial health changes, and the patient is more likely to feel comfortable about discussing areas of concern.
MedBen WellLiving subscribes to the "physician-first" approach. We believe that the doctor-patient connection is key to continued good health and lower care costs, which is why we promote office testing over on-site biometrics that lack the relationship dynamic and motivation to make improvements – and moreover, may lead to redundant testing.
But we also understand that the employer expects viable results from a wellness program. To meet this need, MedBen measures wellness success using multiple factors, including the member population's risk of developing a chronic condition, its compliance with recommended wellness tests, and its cost per member for each specific condition. We track these factors using a sophisticated reporting platform and analyze the numbers with our wellness clients on a regular basis to ensure that the program is fulfilling expectations.
In his State of the Union speech last night, President Obama touched on the progress of his signature legislative achievement. Business Insurance reports:
"Mr. Obama defended the Patient Protection and Affordable Care Act, pointing out that roughly 10 million Americans have gained coverage under its provisions and that the level of uninsured has dropped significantly since full implementation of the law.
“'We can't put the security of families at risk by taking away their health insurance, or unraveling the new rules on Wall Street, or refighting past battles on immigration when we've got a system to fix,' Mr. Obama said, speaking before a packed audience in the House chamber at the Capitol. 'And if a bill comes to my desk that tries to do any of these things, it will earn my veto.'”
And in their response to the President's remarks, Republicans restated their vow to eliminate the health care reform law altogether:
"Newly elected Sen. Joni Ernst (R-Iowa) criticized the reform law for canceling healthcare plans and claimed it has raised premiums and 'hurt … hardworking families.'
"'Americans have been hurting, but when we demanded solutions, too often Washington responded with the same stale mindset that led to failed policies like ObamaCare,' Ernst said in the GOP's rebuttal to Obama's speech.
"'We’ll … keep fighting to repeal and replace a healthcare law that’s hurt so many hardworking families,' she said."
While only a small percentage of small companies (100 or less full-time employees) currently self-fund their health care plan, the Affordable Care Act has created multiple regulatory incentives that has prompted more of them to consider making the switch from fully-insured coverage. And MedBen offers a variety of self-funding options to make the transition easier!
The Brookings Institution, a independent research organization, recently highlighted the five main regulatory benefits that small firms derive from self-funding their health care plan:
Additionally, self-funding allows for greater flexibility than traditional insurance policies, and total costs for such plans are generally lower.
Cara Delcher, a MedBen veteran for nearly three decades, is heading to the west coast… but, we’re happy to announce, will remain with the company.
Because the Delcher family will soon move to Los Angeles, Cara is stepping down from her current full-time position as Vice President of Risk Management and Quality Systems. However, she has accepted a new part-time role as Senior Business Analyst and Quality Coordinator.
“As sad as we are to see Cara leave our home base here in Ohio, we’re also pleased that she will still serve our clients from our new ‘satellite office’ in California,” said Doug Freeman, MedBen Chairman and CEO. “She’s been an important part of MedBen’s growth from its earliest days as a mutual company, and I hope she will continue to be so for many years to come.”
In her new role, Delcher will work as a member of MedBen’s Information Systems department and will play a key part in the development of the company's new service offerings. She will also continue to offer her expertise to co-workers on data analysis, reporting, risk management, quality-related functions and other duties.
Delcher joined MedBen as a Systems Coordinator in 1987, and was named a Vice President in 1992. She played a leading role in the company’s achievement of ISO 9001 certification in 2005, as well as its ensuing recertifications.
Cara and her husband Mark will soon relocate from their current residence in Newark with their daughter Hannah. Their adult sons Alex and Chris will remain in Ohio.
Delcher's last day working in-house will be Friday, January 16, but she can still be contacted following the move at email@example.com. We know you join us in wishing Cara well on this exciting new chapter in her life!
Despite this year's introduction of the employer mandate and uncertainty about the Affordable Care Act in general, most employers say they're committed to providing group health care coverage for the foreseeable future, a recent study finds.
Employer Benefit News reports that just 1% of the more than 3,300 HR professionals surveyed say they are planning to cut health coverage to their employees. For employers with less than 50 employees -- the segment many believed would end coverage when the employer mandate took effect -- just 2% planned to drop their plans, said Andrew Mariotti, a senior researcher at the Society for Human Resource Management, which conducted the study.
“It appears that health care benefits are still considered very important by our members for both attracting and retaining prospective employees and current employees,” Mariotti said.
In a separate Mercer survey, 4.4% of large employers say they will cease offering employees coverage over the next five years, down from the 6% prediction offered in 2013. Also, just 16% of small employers, those in the 50-199 employee range, plan to drop their plans, a drop from 2013’s 23%.
Lower health care cost trends are a major factor in the willingness of employers to continue self-funding their cpverage, said Beth Umland, director of employer research for health and benefits at Mercer: "Because employers feel like they have some tools to manage costs, it’s easier for them to picture continuing to offer their benefits programs into the future.”
The name notwithstanding, you usually don’t catch a cold simply by spending too much time in the wintery weather. Rather, the common cold is caused by a variety of viruses, which can be transmitted either by airborne droplets or by direct contact with contaminated objects.
Because of the sheer number of viruses lurking about, no person can develop complete immunity from colds, and no vaccine is available. Bottom line, if you’re a living, breathing human being, you’re going to have at least one cold this year... and probably more, depending on your age. Infants and young children are particularly susceptible.
Colds typically last about a week to 10 days. Symptoms include cough, headache, sore throat, nasal congestion, runny nose, and sneezing. You may also experience a mild fever, but if your temperature reaches higher than 101 degrees, you may actually have the flu – in which case you should probably pay a visit to your family doctor.
Even though there is no known cure for a cold, that doesn’t mean you can’t take steps to hasten its departure. Stick to such tried-and-true remedies as bed rest, fluids and chicken soup. Avoid antibiotics – they don’t work against viruses. And while lozenges and cough syrup may help relieve symptoms, they do nothing to shorten a cold’s duration. Your best bet is to get some sleep and help your body beat the bug!
In a 252-to-172 vote, the Republican-led House of Representatives yesterday approved a bill that would modify the Affordable Care Act's definition of "full-time employee" from 30 hours of work a week to 40 hours. Reuters reports that only 12 Democrats broke from their party to support the measure.
The legislation will move to the Senate, which now also holds a Republican majority. But if or when the Senate takes up the measure is likely immaterial, as President Obama threatened Wednesday to veto it.
Dan Danner, president of the National Federation of Independent Business, feels that raising the benchmark would reduce pressure on smaller companies. “By defining down the definition of full-time work, the law creates a terrible dilemma for small businesses,” he said. The U.S. Chamber of Commerce, the International Franchise Association and the National Restaurant Association have also supported the change.
White House press secretary Josh Earnest countered that the measure "would actually do a lot of harm" by putting more workers in danger of having their hours cut back. Additionally, the Obama administration has estimated that raising the eligibility criteria would cost about one million employees their current health care.
The House also voted in favor of a second bill that would permit small businesses to hire military veterans but not count them toward their company's total under the ACA, thereby making it easier for them to remain under the law's "pay or play" penalty mandated for employers with 50 or more workers.
According to The Washington Post, the bill's backers say the exemption would encourage small businesses to hire more veterans, who already receive health care coverage through the Defense Department or Verterans Administration. Similar legislation was passed by the House last year, but the Democratic-led Senate shelved the measure.
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 became effective January 1, 2015. As always, plan administrators with questions can contact their Group Service Representative, while plan members can call MedBen Customer Service at (800) 686-8425.
Self-funded 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. All fully-insured groups use the Focus formulary.
To determine if your group is fully insured or self-funded, check your MedBen ID card. If your account # is less than 10,000, your plan is fully insured; if it is more than 10,000, your plan is self-funded.
It's (hopefully) understood that getting a flu shot provides no guarantee that you won't get sick. But this season's virus has proven particularly troublesome.
Last month, the Centers for Disease Control and Prevention warned that a strain called H3H2 has mutated and this season's flu vaccine provides good protection for only about half the cases. And last week, the agency officially upgraded the outbreak to an epidemic.
Similar H3N2 outbreaks have nearly doubled the rate of hospitalization and death compared to other flu seasons. But because it takes 4-6 months to make a new vaccine, it's too late to produce a replacement for this season.
So knowing that, it getting a flu shot still worthwhile? Absolutely.
while this season's vaccine isn't as effective as in year's past, it still offers a measure of protection that beats nothing at all. And even if you haven't got a flu shot yet, the adage "better late than never" still applies here -- particularly since the CDC believes that the flu season won't peak until mid-February.
In addition to annual vaccinations for everybody six months and older, the best strategies for beating the flu bug include:
To our customers, consultants and brokers:
As the end of 2014 approaches, Kurt Harden and I and the entire MedBen staff want to wish you a Happy Holiday season! We also want to tell you that, as always and maybe especially this year, we appreciate and value your business, and again pledge to continue to provide the best service and best advice possible for your organization’s benefits plan.
As “health care reform” – a.k.a. the Affordable Care Act – has continued to roll out, our clients have often expressed the sentiment that the continuous stream of “fixes” and “clarifications” coming out of Washington, D.C. have served to only increase the confusion and uncertainty in dealing with their own health plan. We hear that and assure you that you will not find a more knowledgeable and skilled benefits organization and one totally focused on helping you navigate this turbulent health care benefits environment.
MedBen continues to create new products and services for 2015 and beyond to help you take control of every aspect of your health care plan.
We look forward to continuing our business relationship with you. As always, please don’t ever hesitate to contact one of us if you have concerns or comments.
Chairman & CEO
President & COO
A quick reminder: MedBen will be closed on Thursday, January 1 and reopen the following day. Should you have a claims or benefits question, please visit MedBen Access. Our online customer service center is available 24/7 for your convenience!
As we know from experience, advanced planning is the key to Affordable Care Act compliance. Even though we are currently focused on 2015, it is never too early to begin understanding the changes facing our health plans in 2016. To that end, the Department of Health & Human Services recently published the proposed 2016 Notice of Benefit and Payment Parameters which, among other things, provides some insight into the 2016 plan year changes affecting self-funded health plans. While MedBen will provide greater detail later, here are the highlights.
Changes to Essential Health Benefits
The 2016 Notice proposes changes to a couple of the Essential Health Benefits definitions. First, the Notice proposes to define Habilitative Services using the same definition currently used in the Glossary of Health Coverage and Medical Terms which can be found on the healthcare.gov website. Currently, the term is defined by each state. In addition, the Notice proposes to continue coverage for mandated pediatric dental and vision services until the end of the plan year in which the dependent child attains the age of 19 (not the child’s 19th birthday).
HHS also proposes that states select new benchmark plans in 2017 (which in turn will define Essential Health Benefits in that state) based on 2014 available plans. Along the same lines, HHS proposes to clarify that a health plan must publish an up-to-date, accurate, and complete list of all covered drugs on its formulary drug list, including any tiering structure and any restrictions on the way in which a drug can be obtained, in a manner that is easily accessible to plan enrollees, prospective enrollees, and others. Fortunately, MedBen always provides this information each year with our formulary recommendations.
Last week, the Obama administration announced that it would investigate complaints that some health insurance companies discriminate against people with costly chronic conditions by inflating the copays for specialty drugs, or eliminating certain medications for coverage altogether.
According to The New York Times, the administration will crack down on companies in the federal insurance marketplace that have developed such “discriminatory benefit designs” to discourage older individuals and the chronically ill from enrolling in their plans. Under the Affordable Care Act, insurers must accept all applicants for coverage and cannot charge higher premiums for pre-existing conditions – therefore, the government attributes higher specialty drug copays as a way to get around federal rules.
Unfortunately the real difficulty in keeping member Rx copays down, and reducing health care spending in general, comes down to the skyrocketing costs of specialty drugs – an issue the administration's actions fail to address.
The NYT article notes several chronic conditions that require expensive medications, all of which have been subject to substantial cost increases in the past five years. A representative sampling includes:
Based on these numbers, one could make a case that that ACA’s ability to achieve “affordability” – at least, on the “cost of production” side of the equation – has been non-existent. Further, it could be argued that the ACA has contributed to unprecedented inflation in the input cost side of care.
For the second consecutive year, MedBen was pleased to serve as the premier sponsor for last month’s Granville Turkey Trot (GTT). The 5K fun run/walk raised over $90,000 for the Food Pantry Network of Licking County, and additional contributions from St. Luke’s Church donors brought the total amount to $100,000.
On the morning of November 27, over 2,000 runners and walkers gathered in Granville, Ohio to support the Food Pantry’s mission of ensuring that area families have nutritious food available to them during the holidays and in other times of need. Participants' efforts were supported by hundreds of supportive spectators and helpful volunteers, all who gave generously of their time. Many others who couldn’t attend in person donated online as “virtual runners.”
GTT committee members and sponsors, including MedBen Chairman & CEO Doug Freeman, gathered at Day Y Noche restaurant earlier this month to present the Food Pantry Network a check for $100,000 – exceeding the $90,000 that the event organizers had hoped to raise.
MedBen would once again like to thank everyone who made the Turkey Trot such a success – in particular, the MedBen employees who contributed a portion of their Thanksgiving morning to help those less fortunate by volunteering or participating in the event. We look forward to seeing you all again next Thanksgiving!
Happy holidays from your friends at MedBen!
Our home office will be closed on Christmas Day and Friday, December 26, and will reopen at 8:00 a.m. Monday, December 29, 2014. We will close again on Thursday, January 1 and reopen at 8:00 a.m. on Friday, January 2, 2015.
On both Christmas Eve and New Year's Eve, we will be open normal hours -- 8:00 a.m. to 6:30 p.m. for Customer Service, and 8:00 a.m. to 5:00 p.m. for all other departments.
While we hope health care concerns 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!
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.
From our family to yours... best wishes for your continued health and happiness in 2015!
The best workplace wellness strategies aren't necessarily expensive -- in fact, some cost the employer only their time and encouragement. Experts at WebMD (via Employer Benefit News) offer these tips for building a better wellness culture.
1. Give your workplace a facelift. Because an employee can burn five times the number of calories by taking the stairs, employers should consider painting their stairwells or posting pictures to brighten up the area. They can also hang motivational or informational pictures near elevators encouraging employees to use the stairs or to think carefully about their vending machine purchases.
2. Consider cafeteria changes. Employers should highlight healthy eating options with attention-grabbing signage and discounted pricing. Having low-calorie entrees or stocking vending machines with healthy food choices can also help.
3. Model after leadership. Figures show that having senior leadership participation in wellness programs will add to employee engagement. Invite employees to walk with senior leaders, which will not only increase activity, but also allow for opportunities to network and ask questions.
4. Set achievable goals. Management competitions, which include team-based activities such as lose-weight challenges or even a hula hoop challenge, can translate into achievable benefits for all parties involved. The thrill of the competition can be a strong motivator for some employees.
5. Inspire through social interaction. Using employee wellness champions can lead to increased use and promotion of wellness events. Also, use of social media, such as Twitter or Instagram, can serve as an outlet where employees can support one another to achieve activity goals.
6. Ask employees to gauge the wellness culture. There is no easy way to figure out how your wellness program is being received. But a simple questionnaire may help. Send out surveys to gauge the overall effectiveness of, and feelings about, employer-sponsored programs.
With the imminent rollout of the Affordable Care Act's shared responsibility mandate for employers with 100 or more full-time workers, ERISA attorney Deborah Hyde cautions anyone hoping for a last-minute reprieve:
The most detrimental strategy for [ACA] compliance is for employers to deny the need to comply altogether. By now, it is clear that the employer mandate will be in effect in a matter of weeks. Employers should not hold out for significant changes to, or even a complete repeal of, the current law. A now-Republican majority in Congress brings with it much grandstanding and political rhetoric concerning a repeal of the ACA, but such discussion should be taken with a grain of salt. Any overhaul to the existing law won’t be seen for some time – if at all. And though the U.S. Supreme Court will soon be hearing arguments regarding the role of federally-established marketplace exchanges, the Court’s decision is not only many months away, but is unlikely to result in the unraveling of the employer mandate.
2015 will be the first year of enforcement for the employer shared responsibility rule, but in many instances, 2014 served as a prime guide for employers by highlighting not only the steps to take, but also the steps to avoid, in creating a successful compliance strategy.
Your can read more of Ms. Hyde's thoughts about ACA lessons learned in 2014 at the Employee Benefit News website.
If you're a MedBen client who had 100 employees or more during the last calendar year, you have likely already been contacted by our Compliance Department regarding setting up your plan language to enable you to count your employees for this purpose. If this language is not already in your plan, please contact MedBen Vice President of Compliance Caroline Fraker at firstname.lastname@example.org.
As a member of the Licking County (Ohio) community for over than three-quarters of a century, MedBen has been honored to serve the needs of area businesses and their employees. And in gratitude for all that Licking County has given to us, we do our best to give back as well.
For more than 30 years, the staff at Licking County Job & Family Services (LCJFS), in conjunction with the Salvation Army, has coordinated the Families Helping Families program. And for 15 of those years, MedBen has been pleased to contribute to this worthy cause.
Families Helping Families calls on individuals and groups to donate presents to brighten the holiday season for less fortunate members of Licking County. Every year, approximately 600 children and 75 elderly community members each year receive a variety of gifts from anonymous donors.
This year, MedBen employees shopped for 18 children (from lists provided through LCJFS as well as House of New Hope, which helps foster children) ranging in age from a newborn to a 15 year-old. Each child received clothing in addition to toys that were on their “wish list.”
To cover the costs of the gifts, our employees raised money in a variety of ways, from silent auctions to 50/50 raffles. And MedBen chipped in additional funds toward the purchase of clothes for the children.
Families Helping Families is just one of the charities and non-profit organizations MedBen has partnered with over the years. We've also been pleased to support 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 is proud to call Licking Country home, and pledge to continue doing everything we can do to help 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 Program Evaluator Kari Matheny at 740-670-8999.
Two recent studies suggest a grim future if national health trends continue on their current course:
The United Health Foundation study also showed that obesity has more than doubled in the past 25 years. Not surprisingly, that increase almost parallels a jump in reported adult diabetes, now at 10% compared to less than 5% 20 years ago.
As rates for diabetes, heart disease and other chronic conditions have gone up, so have the corresponding costs of care. Fortunately, there is a simple remedy to the health ills that currently ail the nation.
As individuals, we all have it in our power to live healthier lifestyles... and by doing so, reduce the chances of needing medical care beyond the yearly checkup. Moreover, you can potentially save yourself a great deal of money on hospital bills, prescription drugs and other costs of care.
Better health begins with making smart choices -- and one of the smartest choices is to schedule regular visits with a primary care provider. Your family doctor can monitor your health patterns to detect possible problems... and if you're going down the wrong path health-wise, he or she can help to steer you in the proper direction.
If you're a MedBen WellLiving plan member, you can use the MedBen Access website to check if you're up to date on annual wellness exams and recommended cancer screenings. Just go to MedBen.com, select "MedBen Access" and log in. If you find you're behind on needed care, give yourself an early gift and make an appointment today!