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02/10/19

  11:14:00 am, by MedBen5   , 305 words,  
Categories: News, Pharmacy benefit manager (PBM), MedBen Rx

Biggest? Nope. Best? That’s the Goal.

mergers and acquisitions word collage

High-profile health care companies continue to buy each other in an effort to be “biggest and best.” Meanwhile, MedBen continues to grow as it has for over 80 years... by providing clients with superior benefits management services.

A quick recap: Anthem Health will soon launch its own pharmacy benefit management (PBM) company called IngenioRx, in partnership with CVS Health (which is also a PBM, but separate from IngenioRx). On March 1 Anthem will end its relationship with current PBM Express Scripts... which itself was recently acquired by the health insurer Cigna. And not to be left out, CVS Health is in the process of buying health insurer Aetna. (Got that?)

Why all the wheeling and dealing? In a word, money... specifically, your money. PBMs are buying major insurers with the huge profits they earn from their clients, much of in the form of spread between what they claim to pay for a drug (the client's cost) and what they actually pay the pharmacy.

In contrast, MedBen is steadfast in its desire to remain independent. We are accountable to the needs of our clients and policyholders. The only way that we succeed is to make sure that you succeed as well, with sound benefits management solutions that help your plan members stay healthy while keeping your costs as low as possible.

Furthermore, we believe that our independence enables us to innovate and introduce new ideas more quickly. This includes our recent rollout of MedBen Rx, a pharmacy program that essentially takes PBM out of the equation by ensuring that the client pays a fair cost for medications. No spread to conceal the real price.

We may not be the biggest, but MedBen strives to be the best by helping you be your best. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

02/09/19

  12:58:00 pm, by MedBen5   , 158 words,  
Categories: Wellness, Preventive care, Primary care, MedBen WellLiving

Primary Care Emphasis Pays Dividends

doctor and patient

A new JAMA Internal Medicine study has something in common with the MedBen WellLiving program – both find that primary care serves a valuable purpose in promoting preventive care.

As reported by Healthcare Dive, study respondents with a primary care relationship were more likely to have had a wellness exam in the past year. Moreover, they received more high-value cancer screenings and preventive tests.

MedBen WellLiving's "family doctor first" emphasis puts the primary care provider in charge. Maintaining a physician-patient relationship enables the family doctor to perform wellness tests and monitor potential symptoms over an extended period, helping to prevent complications for unmanaged health conditions.

For employers, this approach has an additional benefit: It eliminates the logistical headaches and potential redundancy of on-site biometric screenings, saving them time and money.

But primary prevention is just one reason why MedBen WellLiving works for your business. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

02/08/19

  08:53:00 pm, by MedBen5   , 158 words,  
Categories: Health Care Reform, IRS, Compliance, Affordable Care Act

Despite Shutdown, ACA Reporting Deadlines Still Apply

IRS building

Following the recent government shutdown, the question has arisen, "Have the IRS filing deadlines changed for my Employer Shared Responsibility Provision reporting?" The answer, regretfully: "No."

The health coverage data you collected during 2018 must be reported to your employees on IRS Form 1095, per the Affordable Care Act (ACA), no later than March 4, 2019. You must also provide an accurate accounting of full-time employee coverage to the IRS no later than February 28, 2019 (if filing by mail) or April 1, 2019 (if filing electronically 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. If you need more information on these requirements, you can download MedBen’s Summary of the ACA Reporting Requirements from MedBen.com.

MedBen clients with questions regarding this information may contact their Group Service Representative or Senior Vice President Caroline Fraker at 800-851-0907 or cfraker@medben.com.

02/07/19

  04:47:00 pm, by MedBen5   , 248 words,  
Categories: Announcements, Wellness, MedBen Employees, Mental Health, MedBen WellLiving, enCompass

MedBen Employees "Encompass" Total Health (and Time Off)

Like many of our clients, MedBen uses the WellLiving program to promote better physical health companywide. But because many of our staff fancy themselves overachievers, we've upped the ante with "enCompass" – a total wellness package to improve mind and body, and earn some well-deserved time off along the way.

Our enCompass program brings together six distinct components that contribute to one's personal wellbeing – physical, intellectual, financial, social, occupational, and emotional. Each component offers a unique set of activities, from workout classes and nutritional seminars to tax tips and meditation sessions.

enCompass partcipants

By participating in enCompass activities, MedBen employees earn points that can be used toward extra vacation time. Nearly 20% of our employees participated in the program in 2018, and over two-thirds of those participating reached a vacation benchmark.

Ed Nydegger gained the most enCompass points, and in doing so, earned an extra day-and-a-half of vacation time. Nice job, Ed!

MedBen employees who earned a full day vacation include: Robin Becker, Ashlyn Degler, Caroline Fraker, Sheri Gutridge, Janice Harris, Tammy Jones, Caroline Keaser, Erin Kelly, Becky McCune, Brenda McLean, Jackie Turner and Cathy Valentine.

Half-day vacation earners include: Abbie Brown, Cindy Dittoe, Lynette Feliciano-Justice, Bobbie Painter, Stacy Spring and Brooke Wheeler.

In 2019, MedBen will continue to promote total wellbeing with additional enCompass programming. Congratulations to every MedBen employee who earned time off or participated in enCompass!

MedBen can work with WellLiving clients to offer similar activities and incentives to expand their wellness program. For more information, contact your Group Service Representative.

02/04/19

  05:03:00 pm, by MedBen5   , 203 words,  
Categories: News, MedBen Employees, Kurt Harden

MedBen President Harden Praises Coworkers, Clients, County in Profile

Kurt Harden, MedBen President & CEO

"I wake up every day excited about the work I get to do,” said MedBen President & CEO Kurt Harden in a February 4 Newark (OH) Advocate article. “I get to work with incredible people on a daily basis, both employees of MedBen and clients of the company.”

Harden was profiled in the paper's "Aces of Trades" series, which spotlights Licking County residents and their jobs. A lifelong resident of Newark, he says that his nearly three decades with MedBen has truly opened his eyes to everything the area has to offer… and not just in regard to career possibilities.

“I never realized all the opportunity available inside Licking County,” Harden said. “Great quality of life and a wonderful place to raise a family. I hope more young people continue to realize this.”

Harden, who joined MedBen in 1991 and was named President in 2012, noted that his interest in health insurance coincided with a major life event: “My wife and I were about to have our first child. I needed more money and was offered a job at MedBen.”

“It was a practical decision that has developed into a complete passion,” he said.

You can read more of Harden’s profile at the Newark Advocate website.

01/27/19

  02:39:00 pm, by MedBen5   , 264 words,  
Categories: Prescription, Cost savings, MedBen Rx

While Titans Battle Over Drug Costs, MedBen Rx Offers Solutions

pharmacist prepping prescription

A recent high-profile disagreement between Walmart and pharmacy benefits manager (PBM) CVS Caremark exemplifies the friction between pharmacies and PBMs about prescription pricing... and the power that PBMs possess to influence drug costs. MedBen Rx was designed to put that power back in the hands of the consumer.

As The Wall Street Journal reported, Walmart threatened to withdraw from the CVS Caremark network, accusing the PBM of taking excess profits. CVS countered that Walmart's request for larger reimbursements would result in higher consumer costs. The two parties ultimately settled their differences.

Pharmaceutical Horizons President Allan Zaenger says the conflict is endemic of the balancing act that even a big box retailer must perform to ensure it can offer affordable medications to customers while still minding its bottom line. "It points to the degree to which PBM reimbursement is now causing profit pain at another big-time pharmacy retailer already taking narrow margins for prescription foot traffic," he said.

MedBen Rx pharmacy programs remove the ability of the PBM to manipulate cost margins. We place a greater focus on what a pharmacy actually pays for a drug, rather than what the PBM claims to be the "right" price. And we make certain that the pharmacy is fairly compensated for its service while reducing drug costs for our clients.

In a climate where the major players are fighting for a bigger share of your pharmacy dollars, MedBen Rx offers sensible solutions that help you keep more of your money.

Get the details by visiting MedBenRx.com or contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

01/26/19

Thinking Outside the Coverage Box

thinking man

"Think outside the box" may be an overused expression, but when it comes to health care coverage, more and more employers are taking the advice.... and MedBen has a few thoughts on the subject.

Many self-funded employers still rely on PPO plans that control costs primarily through contracted provider network discounts. While there's certainly nothing wrong with that approach, MedBen also features alternative coverage solutions that offer the same access to quality care as PPOs, but with savings that go "beyond the discount."

  • The 2018 Employee Benefits Survey found that nearly 18% of health care plans now contract directly with hospitals and physicians to reduce care costs. MedBen has been facilitating direct-to-employer contracting for the past decade, bringing together employers and providers in plans that promote effective use of regional care.
  • Reference-based pricing (RBP) plans are another outside-the-box strategy gaining popularity. MedBen offers a variety of options, such as RBPs that use Medicare as the primary source of claim repricing and layered RBPs that carve out high-cost treatments. These services can be implemented individually or in combination with each other.
  • As value-based care models gain more mainstream appeal, commercial bundled payment services are finding favor with employers. MedBen draws upon its experience with Medicare bundled payments to provide the same cost-saving benefits to clients.

Contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com to discuss what alternative coverage strategies may work best for your business.

01/25/19

  01:30:00 pm, by MedBen5   , 181 words,  
Categories: Cost savings, Claims management, Reference-based pricing

"The Case of the Overpriced Robot"

robotic surgery

MedBen claims management uses multiple measures to ensure that your plan pays the proper price for health care services, but at the core is our team of experienced claim examiners.

To cite one example, a plan member of a MedBen client underwent robotic hernia repair for a ventral hernia. The client was billed $310,000 for 15-minute usage of robotics – over 10 times the usual allowed amount for robotic surgery.

As part of MedBen’s claims evaluation process, an examiner reviewed the claim, noted the excessive billed amount, and paid it in accordance with the client reference-based pricing (RBP) plan language. Based on the RBP formula of a standard Medicare payment for the surgery plus a set added percentage, the provider received $60,000.

The client saved $250,000 on the billed charge for robotic hernia repair under the RBP plan. The provider accepted the payment with no “balance billing.”

MedBen combines 80 years of benefits experience with forward-looking technology to keep your health care costs as low as possible. Learn more about our claims management advantage by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

01/24/19

  09:44:00 pm, by MedBen5   , 229 words,  
Categories: Wellness, Research, Preventive care

How Sleep Can Impact Your Heart Disease Risk

sleeping

Getting less than six hours of sleep a night doesn't just leave you drowsy during the day – it can be doing some serious damage to your body. A new study finds that insufficient and poor sleep may increase your risk of heart disease.

The New York Times reports that researchers monitored the sleep habits of nearly 4,000 healthy men and women (average age: 46) over seven nights. After controlling for smoking, diabetes, cholesterol and other factors, they found that people who slept less than six hours were 27% more likely to be in the highest one-third for the amount of plaque in their arteries compared to those who slept seven to eight hours.

Studies like this demonstrate how small lifestyle changes – in this case, an extra hour or two of sleep – can make a big difference to your health. The MedBen WellLiving program encourages another beneficial change: Getting regular wellness exams and tests from your primary care provider.

WellLiving's "family doctor first" emphasis on primary prevention promotes awareness of your population's personal health while helping to prevent complications from unmanaged heart disease, in addition to detecting the onset of cancer and other chronic conditions.

Adding WellLiving to your health care plan is just one of the many ways MedBen can help you foster a healthier workplace. Get additional details by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

01/23/19

  06:48:00 pm, by MedBen5   , 369 words,  
Categories: Wellness, Preventive care

Making Your New Year’s Resolutions Stick

pointing to January 1 on calendar

Are you among the 8% of Americans who made a New Year’s resolution last year and stuck to it? If so, congratulations! If not, a new year has begun, and it is full of new opportunities. And there are simple steps you can take to help successfully achieve your wellness goals this year.

Think positive. For example, instead of making your goal to “lose weight,” try making it to “eat healthier” or to “exercise more.” Positive resolutions will keep you more motivated than negative ones.

Make it measurable. Creating a measurable and specific goal, such as “exercise three times each week after work” instead of just “exercise,” will make it easier for you to know when you have accomplished something. And be sure to remember that even the small successes add up in the big picture.

Be realistic. It is not sensible to go from watching television all day to being able to “run a six-minute mile” or “bench press 300 pounds.” Something more realistic would be to begin walking thirty minutes each day and gradually increase the time or intensity as you get used to it.

Surround yourself with supportive friends and family. Not only will this keep you working towards your resolution, but it may also make those around you consider making healthier choices as well. In addition, we encourage you to talk to your family doctor before making any lifestyle changes in order to make sure you are doing what is best for your health.

Full story »

01/13/19

  11:22:00 am, by MedBen5   , 217 words,  
Categories: Prescription, Discounts, Cost savings, Research, MedBen Rx, Rebates

Fight Back Against New Year’s Drug Price Increases

pills and bill bottle

New year, higher drug prices. According to The Wall Street Journal, a representative analysis of major pharmaceutical companies found that the prices of their brand name and generic drugs have risen by an average of 6.3% in 2019 – modest compared to previous years, but still well outpacing price increases of other common household goods.

Similarly, Reuters reports that prices of more than 250 prescription drugs have already gone up in January, with additional increases expected to be announced later this month.

Pharmaceutical company spokespersons cited multiple explanations for the price increases, including operational expenses and the need to offset payer rebates and discounts. But whatever the reason, it's clear that drug prices will continue to rise disproportionally for the foreseeable future.

MedBen Rx offers pharmaceutical solutions that help employers to avoid the artificial pricing markups that allow for the so-called discounts... an approach that in no way reflects the real cost of the drug.

Regardless of your business type, MedBen Rx offers a pricing strategy that will work with your pharmacy plan to ensure that you pay less. And we feature a variety of benefits management services that further your cost saving potential.

Find out more about how MedBen Rx can help you beat drug pricing trends by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

01/12/19

  03:03:00 pm, by MedBen5   , 216 words,  
Categories: Wellness, Research, Influenza

Rising Flu Activity Calls for Preventive Measures

flu shot

If you haven’t got a flu shot yet this season, do it soon! The Centers for Disease Control reports that flu activity has been on the rise of late, with 24 states reporting widespread influenza activity and 19 states reporting high levels of influenza-like illness activity.

These increases come on the heels of the 2017-18 flu season, which caused the deaths of an estimated 80,000 Americans – the most flu-related deaths in at least four decades. This season isn’t expected to be quite that severe, but the rise in activity still underscores the need for preventive measures, starting with a flu shot.

The CDC recommends that everyone aged six months and older should get vaccinated for influenza. If you haven’t had your annual wellness exam yet, it’s the perfect opportunity to get two things done at once. Your family doctor can give you a shot provided you’re not already sick.

Keep in mind that the vaccine takes about two weeks to begin working, so be sure to take other steps to reduce your risk of flu. Wash your hands frequently, stay away from people who are sick, and keep your hands away from your face (especially your eyes, nose, and mouth). And it’s important to get vaccinated each year, as influenza strains are always changing and the vaccinations change as well.

01/11/19

Spousal Coverage Limitations a Smart Strategy

family's hands

The latest Employee Benefits Survey by the International Foundation of Employee Benefit Plans (IFEBP) revealed that just one in five employers (20.1%) use spousal surcharges or carve-outs for health care coverage when other employer-provided health insurance is available.

The finding came as something of surprise for us, as many MedBen clients have adopted spousal coverage limitations as a risk reduction strategy.

Back in 2013, the United Parcel Service (UPS) made headlines when it announced that it was removing thousands of spouses from its medical plan because they are eligible for coverage elsewhere. UPS blamed the Affordable Care Act for its action, but MedBen introduced the strategy well before health care reform became a topic of everyday conversation. And we’ve found that employers that have taken our advice have avoided higher costs due to the elimination of that risk.

Effective spousal plan management can greatly reduce the chance of adverse selection, which can negatively impact an employer health care plan. It also allows employers to offer quality benefits to employees and their families for a longer period of time.

Of course, helping to shape plan design is just one of MedBen’s proven ways to reduce risk. Our benefits management solutions range from leading-edge claims surveillance to advanced reporting – all of which can benefit your business. For additional information about the MedBen Advantage, contact MedBen Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

01/10/19

  04:27:00 pm, by MedBen5   , 225 words,  
Categories: Wellness, Dental, Research, Preventive care

Regular Dental Checkups Can Prevent, Detect Multiple Diseases

dentist

They say that eyes are the windows to the soul, but the mouth can reveal quite a lot, too. Your semi-annual dental checkup can reveal symptoms of multiple diseases in their earliest stages.

Multiple studies have indicated that a healthy set of teeth and gums can reduce the risk of heart disease, stroke, high blood pressure, diabetes, and dementia. One recent analysis even suggested that cancer patients who visit a dentist prior to surgery reduce their risk of postoperative pneumonia or dying within 30 days of treatment.

So, the next time you're think of postponing a teeth cleaning, remember that its benefits can go well beyond an attractive smile. And of course, prevention and early detection translates to lower medical costs.

Adding MedBen PreceDent to your health care plan promotes proper dental habits to your employees. Plan members can choose to use our extensive network of dentists and dental specialists or visit non-network providers if they prefer.

Another advantage of offering MedBen PreceDent: Dental care is among the least expensive benefits employers can provide for their health plan members and serves as an attractive incentive for prospective employees.

Whether as a stand-alone service or part of a total health benefits package, MedBen PreceDent offers valuable care that goes beyond the surface. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at 888-627-8683 or bfargus@medben.com.

12/30/18

A Note from Our Executive Chairman and President

To our customers, consultants, and brokers:

Doug Freeman and Kurt Harden

Happy new year from MedBen! In 2018 we celebrated our 80th anniversary, which gave us a chance to reflect on our beginnings and growth as a health benefits manager. It's great to reminisce but we prefer to look forward… so in 2019, we're all about what's ahead for MedBen and, more specifically, for our clients.

In recent months, we've read multiple articles that extol “innovative” new ideas other benefit managers are using to lower their clients' health care costs. We agree that they are great ideas and many of our clients have had these strategies in place for years and already benefit from healthier employee populations and reduced coverage costs.

Benefits management is an ever-changing enterprise, and simply staying the course can be a poor decision. Instead, MedBen remains proactive – anticipating, researching, and experimenting with ways to help you enhance your health care coverage.

Traditional plan designs are giving way to such alternative cost-saving solutions as direct-to-employer contracting, reference-based pricing, and bundled payments... all currently available through MedBen. Likewise, we've moved away from conventional prescription drug coverage to offer pharmacy plans built around the actual cost of the drug, rather than an artificial wholesale price. In the coming months, we’ll be talking to you directly about these and other ways MedBen can improve your plan.

We should note that MedBen never makes changes just for the sake of change itself. Our continual goal is to take what's already good and make it better, be it a better savings opportunity or a better service technique. We’re excited about what MedBen has in store this year and look forward to sharing it with you.

As always, we appreciate the trust you place in us and pledge to continue working hard to earn that trust. Should you ever wish to talk directly to us about your plan or MedBen services, please call us at the numbers listed below.

On behalf of the entire MedBen staff, we offer you our thanks and very best wishes for a healthy and prosperous 2019!

Sincerely,

Doug Freeman
Executive Chairman
(740) 522-7339

Kurt Harden
President & CEO
(740) 522-7345

A quick reminder: MedBen will be closed on Tuesday, January 1 and reopen on Wednesday, January 2 at 8:30 a.m. EST. Should you have a claims or benefits question, please visit MedBen Access. Our online service center is available 24/7 for your convenience!

  05:06:00 pm, by MedBen5   , 195 words,  
Categories: Wellness, Cancer, Preventive care, MedBen WellLiving

Study: Following Colonoscopy Guidelines Reduces Cancer Risk, Death

cancer definition

Newly released research suggests that timely colon cancer screenings offer long-term benefits. As reported by UPI, the study found that men and women whose first colonoscopy detected no evidence of cancer had a 46% lower risk of getting a cancer diagnosis in the follow-up screening 10 years later. Those men and women also had an 88% lower risk of death related to colon cancer.

"Our study shows that following a colonoscopy with normal findings, there is a reduced risk of developing and dying from colorectal cancer for at least 10 years," said Jeffery Lee, Kaiser Permanente gastroenterologist and study lead author, in a news release.

Colon cancer is the second leading cause of cancer-related deaths in the U.S. and the third most common cancer in men and in women.

The MedBen WellLiving program recommends that adults get a colonoscopy screening once every 10 years, from ages 50 to 75. WellLiving members can check their compliance with colonoscopies and other critical wellness examinations by visiting the MedBen Access website and clicking on the "MedBen WellLiving" link under “My Plan”.

To learn more about the advantages of promoting preventive screenings through MedBen WellLiving, contact Vice President of Sales and Marketing Brian Fargus at bfargus@medben.com.

  03:46:00 am, by MedBen5   , 357 words,  
Categories: Prescription, Discounts, Cost savings, MedBen Rx, Rebates

AWP Smoke and Mirrors

drugs

Drug pricing can be a confusing business… and much of the confusion stems from a drug’s average wholesale price, or AWP.

On the surface, the AWP might seem to be… well, the average wholesale price or the average price of a drug. But the price to who? As straightforward as the acronym sounds, the reality behind the AWP is more complicated.

AWP is a calculated price that is a markup of 1.20 on the drug companies’ “list price” to wholesalers (wholesale acquisition cost, or WAC) or to large buyers (direct price, or DP). The 1.20 markup is the result of a consent decree requirement from a 2009 legal settlement that applied to the industry due to price file manipulation by First DataBank and Medispan, managers of large drug price files for many administrative service vendors. However, pharmacy benefit managers (PBMs) and other vendors that use price file services are under no obligation to provide the actual cost of a drug, so the AWP is more akin to a car's "sticker price" – a starting point from which the actual purchase price can be manipulated.

When administering prescription plans for insurers and self-funded employers, PBMs apply discounts and rebates to the AWP before landing on a final price. But not only is this price arbitrary at best, the PBM may hold back a portion of the discounts and rebates for themselves. So what you ultimately pay bears little resemblance to the actual cost of the drug.

Additionally, some PBMs classify certain generic drugs as brand drugs, further manipulating the AWP in order to take advantage of a greater margin between the actual cost of the drug and the AWP brand discount applied to claims for brand name drugs.

MedBen Rx gets around this margin manipulation by avoiding the AWP altogether. Instead, we use a pricing methodology that reflects what something much closer to what pharmacies pay for drugs. Our pharmacy solutions save clients, on average, 11% compared to the AWP approach. And the rebates go back to the plan.

The MedBen Rx difference simplifies pricing while reducing your costs. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

  03:36:00 am, by MedBen5   , 389 words,  
Categories: News, Wellness, Incentives, Compliance, Regulatory

EEOC Instructed to Revise Wellness Incentive Safe Harbor Regulations

doctor and patient

On December 20, 2018, the Equal Employment Opportunity Commission (EEOC) issued two final regulations that remove from the EEOC’s final Americans with Disabilities Act (ADA) and Genetic Information Nondiscrimination Act (GINA) wellness regulations the safe harbors for determining whether participation in such a wellness program is voluntary. This was in response to the U.S. District Court for the District of Columbia vacating the EEOC's wellness rule effective January 1, 2019 and instructing the EEOC to revise the regulations as to the voluntary nature of the safe harbors.

Prior to the regulatory change, the EEOC’s regulatory safe harbors were as follows:

  • The ADA regulations permitted a reward/penalty of up to 30% of the cost of single coverage in exchange for an employee’s participation in a wellness program.
  • The GINA regulations permitted a reward/penalty up to 30% of the cost of single coverage in exchange for a spouse’s participation in a wellness program (for a total reward of up to 60% of the cost of single coverage).

Given this late-in-the-year change, what does this mean for employer’s wellness programs in 2019? We believe that things will remain status quo for the time being. Why? Because the question of whether participation in a wellness program is voluntary for purposes of the ADA and GINA wellness regulations is a grey area that will likely not be addressed until at least June 2019.

The court case that set all of this in motion did not take the position that the 30% reward/penalty level was an inappropriate level to use. Instead, it took the position that the EEOC failed to provide a reasoned explanation for its decision to adopt the 30% levels in both the ADA and GINA wellness regulations.

Since the EEOC was clearly comfortable with the 30% level, it may still try to provide a reasoned explanation in its next round of regulations as to why the 30% number is appropriate. It is not likely that the EEOC will take issue with this approach until new regulations are issued, as long as an employer maintains its wellness program in accordance with the prior safe harbor rules. However, employers should be aware that employees might use the recent regulatory change to claim that their wellness program is not voluntary.

MedBen will continue to monitor this issue and provide updates as information is released. For more information, contact Caroline Fraker, Senior Vice President & CPO at 800-851-0907 or cfraker@medben.com.

12/28/18

  11:17:00 pm, by MedBen5   , 126 words,  
Categories: Announcements, Prescription, Cost savings

2019 Formularies Now Available at MedBen.com

pills

Formulary updates for prescription plans administered by Ventegra and 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.

A formulary defines the copayment tier status of the medicines most commonly prescribed. Tier 1 medicines require the lowest member copayment.

The new formularies become effective January 1, 2019. 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.

Ventegra

PDMI

MedBen clients who use drug administrators other than Ventegra or PDMI can typically find formulary information on that company's website.

12/26/18

  07:25:00 pm, by MedBen5   , 366 words,  
Categories: Wellness

Germ Warfare: The Importance of Handwashing

washing hands

For most of us, staying well isn’t complicated. Simple lifestyle choices can go a long way toward our better health... and one of the simplest, yet most important, things we can do is wash our hands frequently. And that goes double during the winter months, when the flu is in season.

The importance of handwashing can be summed up in one word: Germs. Human and animal feces are prime sources of the germs that carry Salmonella, E. coli and norovirus, which cause diarrhea and can cause respiratory infections. And once the germs are on your hands, you not only risk getting yourself sick, you risk spreading the germs to others.

Hopefully you know that washing your hands after using the bathroom is a must-do, but it’s hardly the only time a good cleaning is in order. Wash before, during, and after preparing food, as well as before you eat. If you blow your nose, cough or sneeze... wash. Just took out the trash? Wash. Petted a puppy or kitten? Wash. Bottom line, if there’s a risk of getting or spreading germs, then wash those hands pronto!

Soap and running water are the most effective tools for handwashing. Bar soap is okay, but can itself become contaminated, especially if used by multiple people – so liquid soap is a better alternative. Or if you’re going somewhere that soap and water won’t be readily available, bring along an alcohol-based hand sanitizer that contains at least 60% alcohol.

Full story »

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