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06/10/09

  06:17:54 pm, by MedBen5   , 264 words,  
Categories: News, Health Plan Management

Reform Update: Senate Group Releases First Health Care Bill

Capitol Building

The first substantive health care reform plan has been released, according to this article in Employee Benefit News. The Senate Health, Education, Labor and Pensions Committee, headed by Sen. Edward Kennedy (D-Mass.), today introduced the ‘‘Affordable Health Choices Act’’. The bill calls for a mandate that would require almost all Americans to have health insurance, except for those unable to afford it. It also recommends a government-sponsored public plan be available to give people an alternative to private insurance, though it doesn’t offer specifics. An often-discussed “employer mandate” that would require businesses to provide coverage is notably absent from the plan. The complete bill is available to read here.

An additional Senate bill is expected to follow later this month, followed by the first House bill. President Obama’s proposed timetable is for both chambers to pass legislation in August and have a final bill ready for Presidential approval no later than October.

With the push on to get legisation passed in only 4 months, the President has shown a willingness to compromise on the universal coverage mandate, a provision he rejected during the 2008 campaign (you can read about it here). He also will consider taxing employer-sponsored health benefits, even though he previously criticized Republican opponent John McCain for suggesting such a measure.

In related reform news, this Washington Post article details the difficulties involved in finding a consensus regarding the best way to provide across-the-board health care coverage. What is generally agreed upon by politicians, industry leaders, employers and consumers is that real reform must promote wellness while reducing unnecessary treatment and minimizing costly mistakes.

05/28/09

  05:15:04 pm, by MedBen5   , 273 words,  
Categories: Wellness, Discounts, Health Plan Management

Paying for Prevention?

Blood Pressure Check

An article on The Wall Street Journal website offers some cautionary food for thought regarding preventive care. It highlights multiple instances of patients who received such preventive services as colonoscopies and mammograms under the (correct) impression that they should be covered in full under their plans, only to later be billed when their insurers did not consider the treatments preventive. In most cases, the patients were able to eventually remedy the situation, but not without struggling through red tape first.

So what’s happening here? Sometimes, it comes down to miscommunication between patient, physician and insurer. If the doctor’s office is unaware that a health plan covers preventive care at 100%, the patient may still be billed for a copayment or deductible. Or, if medical codes on a claim do not indicate preventive care was provided, the insurer will not treat the claim as such.

While MedBen makes every effort to ensure that providers are informed about which services are treated as preventive care under group plans – and which services are covered in full – discrepencies do sometimes occur. As such, we encourage plan members to specify to their physicians that they are requesting a wellness exam covered under the plan (as opposed to requiring surgical procedures, treatment of existing conditions, or other care not generally classified as preventive).

Preventive care is essential to good health, which is why MedBen Worksite Wellness emphasizes annual checkups as well as early detection testing for cancer and other chronic conditions. To learn more about our wellness program, please contact contact the MedBen Sales and Marketing Department at (888) 627-8683. You can also read about MedBen Worksite Wellness at MedBen.com.

05/22/09

  05:04:40 pm, by MedBen5   , 159 words,  
Categories: News, Wellness, Health Plan Management

Vision Exams Reduce Disease Risk (and Not Just in the Eyes)

When it comes to saving money on medical care, the eyes have it. (Sorry, couldn’t resist the pun.)

Not only will a vision checkup reduce the risk of glaucoma and other eye diseases, it can potentially detect other serious conditions as well. A study conducted by The Human Capital Management Services Group (and reported in Employee Benefit News) found that five large U.S. employers saved over $1 million in health care costs and productivity through early detection of diabetes, hypertension and high cholesterol – all caught through basic eye examinations. You can read about it here.

MedBen offers early detection and treatment of vision abnormalities through its MedBen VisionPlus plan. Emphasizing regular exams and featuring an extensive provider network, MedBen VisionPlus is an affordable and convenient option for employers with 10 or more enrollees.

To learn more about MedBen VisionPlus, contact the MedBen Sales and Marketing Department at (888) 627-8683. You can also read about our vision offerings at MedBen.com.

05/20/09

  01:25:22 pm, by MedBen5   , 320 words,  
Categories: Wellness, Health Plan Management, Incentives

The Move Toward Value-based Health Plans

Jump Rope and Water Bottle

As we’ve noted previously on this blog, there is a growing movement in the benefits management industry toward value-based health plans, which promote wellness and personal responsbility through incentives and rewards. This Los Angeles Times article reviews some of the methods employers are using to encourage their employees to practice better health habits, with the expectation that their investment will pay long-term dividends through reduced claims and lower medical costs.

MedBen has been an advocate of the value-based approach for some time now. We offer employers wellness options that stress early detection of chronic conditions such as cancer and diabetes, as well as condition management and employee education. The use of strategic incentives help drive participation in the health plan, particularly when such incentives connected directly to that plan. For example:

  • Tying your worksite wellness program into your health plan’s wellness benefits, such as regular checkups.
  • Offering lower premiums to members who show a commitment to personal wellness.
  • Making employer contributions to HRAs and other member health accounts.

MedBen works with employers to develop an incentive program appropriate to the needs of the group.

A value-based design can positively impact an employer’s bottom line. For instance, this article cites a community that promoted accountability: “[A]nnual medical costs for… employees with diabetes decreased by $1,200 to $1,872 when the program was implemented. Sick days also decreased and increases in productivity were estimated at $18,000 annually.”

One final observation on the value-based movement: As this essay on Insureblog astutely points out, there’s a critical distinction between health care and medical care. Health care is essentially wellness – diet, exercise, sleep, proper hygiene, and so on – and is free to everyone. By focusing more on personal health care, we go a long way toward bringing medical care costs down. Moreover, any discussion of a nationalized care plan must include the importance of personal accountability, rather than limiting the debate to dollars and cents.

05/14/09

  02:03:54 pm, by MedBen5   , 260 words,  
Categories: Health Plan Management

One Reason Personal TPA Funding Accounts Make Good Sense

A recent bankruptcy case, recounted on the Employee Benefits Institute of America (EBIA) website, serves as a good example of why MedBen assists self-funded clients in opening their own bank accounts to pay member claims, rather than putting their plan assets in a bank account that MedBen maintains.

A third party administrator filed for bankruptcy after it ran short of funds to pay client claims. Some of the TPA’s bank accounts held client funds, and a bank that kept two of those accounts filed a judicial claim to have money owed to it by the TPA paid from those accounts. In addition, a former client that inadvertently sent money to the TPA even though it had terminated the TPA earlier, also filed a claim in bankruptcy court to retrieve its funds.

The bankruptcy court ruled that the funds in the account were protected under ERISA laws, and therefore could not be used to pay the bank’s claim. On appeal by the bank, an Indiana federal court upheld the earlier ruling. To our knowledge, the former client’s accidental payment has not been returned, either.

For the protection of its clients, MedBen does not hold TPA client funds in its own bank account, nor does it require clients to use a specific vendor for their bank arrangements. Clients maintain their own bank account and may move funds into it as MedBen notifies them of the need – no minimum or advance deposits are required. Funds are requested from the day of the check run and no checks are released without funds being deposited.

05/07/09

  08:25:29 am, by MedBen5   , 434 words,  
Categories: Health Plan Management

CDHCs Offer Long-Term Value, Balance Risk

As a 24-year insurance industry veteran, Jay Savan of Towers Perrin has witnessed first hand the evolution of health benefits from traditional insurance to consumer-directed health care (CDHC) plans. In an interview with CDHC Solutions magazine, Savan contends that health reimbursement arrangements (HRAs), high-deductible health plans (HDHPs) and other account-based plans will prove critical to fixing health care.

Savan says the differences between a CDHC plan and a traditional plan has less to do with actual cost than with long-term value and employer risk:

“…[F]rom an indemnification perspective, the difference is twofold. First, the fundamental difference is that traditional plans are essentially 1-year term insurance plans, while CDHC plans are cash-value insurance plans. That is, while all the features of traditional plans are unique to a single year, CDHC plans (can) contain a durable equity element — the health account — that can span multiple years.’

“The 2nd key difference is in the structure of risk: how risk is financed and how it is shared between the plan and the covered member. In insurance terms, there are 2 kinds of risk, fixed risk and variable risk. Fixed risk is represented by the health insurance premium, which is generally ‘fixed’ regardless of how many claims you have during a coverage period. Variable risk is just that — it varies based on your claim activity. These 2 risk elements are negatively correlated, which is to say when 1 increases, the other falls.”

Saban maintains that in the long run, health plan participants are better off financially by assuming more variable risk than fixed risk, even during periods of higher health expenses. Over the course of a lifetime, most people are healthy 80% of the time, and with a proper balance of fixed and variable risk, can see lower health costs even during episodes of illness or accident.

Sharon Mills, MedBen Director of Administrative Services, agrees with Saban’s conclusions. “Because your out-of-pocket expenses are capped under an HDHP, the likelihood is that you’ll save more money — particularly over multiple years — than you would under traditional insurance, even should you be part of the 20% with a higher need for health care.”

Saban also emphasizes that ultimately, health care costs go beyond plan choice to personal habits. Only by improving one’s quality of life can costs be controlled — a viewpoint, Mills says, that MedBen shares. “He makes the analogy of taking care of your car because failing to do so increases the chance of expensive repairs down the road. It’s just common sense that applies equally to our own well-being.”

You can read the complete interview here (free registration is required to view it).

04/30/09

  10:20:52 am, by MedBen5   , 318 words,  
Categories: News, Health Plan Management

MedBen Talks Transparency at Annual State & Local Government Benefits Association

La Brea Tar Pits

The La Brea Tar Pits are an unlikely but appropriate icon for transparency in employee benefit programs. During the 2009 State & Local Government Benefits Association (SALGBA) Annual Conference, MedBen Senior Vice President Kurt Harden walked benefit professionals through the variety of ways that fees are hidden in employee benefit arrangements, likening the murkiness of such tactics to the famed California tar pits.

From pharmacy rebates that are held by administrators, to portions of discounts that are withheld from clients, to hidden charges not disclosed, a wide range of what appear to be medical plan costs can be going to administrators and other third parties, leading employers to believe that they are getting a better deal than they actually are.

“It’s okay to make money,” Harden advised the audience. “But when employers believe that they are making an apples to apples comparison, they should truly know where all the income streams go.”

Harden reviewed several methods that organizations use to peel off portions of discounts, hide charges and charge for services not needed. He encouraged employers to seek out reporting that demonstrates that plan checks were cut to providers rather than third parties. He also encouraged attendees to ask for regular reporting of raw discounts.

He also discussed the idea of contract “translucency,” where an organization uses broad contract language to hide additional streams of income. “With translucency, the fees are hidden in vague contract language,” said Harden. “In essence, translucency is the process of simply telling a client that you are ripping them off.”

The proper approach is to pass all discounts and benefits on to clients, Harden explained. Especially today, employers are making tough decisions about benefits. Employers, not third parties, should be rewarded by the decisions. “If you encourage employees to take generic drugs, it makes sense that you should get the full reward for that rather than a large pharmacy benefit manager,” said Harden.

04/27/09

  05:16:07 pm, by MedBen5   , 204 words,  
Categories: Announcements, News, Wellness, Health Plan Management, Incentives

MedBen Achieves AHA Gold Fit-Friendly Status for Second Straight Year

AHA Gold Fit-Friendly Company 2009

For the second year in a row, MedBen has been named a Gold Start! Fit Friendly Company by the American Health Association (AHA). The award recognizes companies that demonstrate progressive leadership by making the health and wellness of their employees a priority.

MedBen retained its Gold status by promoting a wellness culture, through such things as employee discounts on health club memberships, weekly fresh fruit deliveries, and heart-healthy vending machine selections. Beginning in 2009, the company also began tying wellness directly to its health plan. Participants now earn contributions to their HRAs by keeping a workout record and attending quarterly meetings on better health.

MedBen President & CEO Doug Freeman believes that wellness is fundamental to lowering health care costs. “Where personal health is concerned, we try to practice what we preach. As MedBen encourages clients to make wellness the foundation of their health plans, we do everything we can to provide our employees with proper wellness resources as well as appropriate financial incentives,” he said.

MedBen’s HRA contribution feature is offered in conjunction with its BeneFitness program, which brings a variety of individual and team wellness challenges to employees. The AHA Start! program serves as a further catalyst for positive change in the workplace.

04/23/09

  11:29:03 am, by MedBen5   , 209 words,  
Categories: Wellness

Heal Myself

Amidst the flurry of discussion about universal health care, high hospital bills and double-digit increases in prescription costs, a simple truth is frequently overlooked: The individual, far more than government agencies, doctors and insurers, has the greatest influence on the cost of medical care.

A piece in the Los Angeles Times stresses the importance of personal accountability in addressing the current health care environment. While it may not be politically fashionable to point a finger at those who suffer from illness, the author argues that too many people aren’t doing enough to maintain good health – and backs that claim with some sobering statistics:

  • More than 60% of the US population are overweight or obese.
  • 40 million Americans smoke regularly.
  • Fewer than 25% of adults eat five or more servings of fruits and vegetables every day, while over 60% of adults drink soda every day.
  • On average, people spend 2-3 hours daily watching TV, but exercise less than 20 minutes each day.

Such factors add in the neighborhood of $200 billion annually to medical costs. It’s a figure that even the best national health program cannot begin to counteract – unless that program emphasizes the need for greater responsibility. By shaping the discussion around personal wellness, we stand the best chance of turning things around.

04/17/09

  04:35:41 pm, by MedBen5   , 350 words,  
Categories: News, Wellness, Health Plan Management, Incentives

MedBen Execs Analyze CDHP Survey

An article in Employee Benefit News gives consumer-driven health plans (CDHPs) a somewhat lukewarm review. According to a poll, employers that offer a CDHP are generally pleased with their performance, but have difficulty determining their return on investment (ROI).

MedBen helps employers take the guesswork out of ROIs with a comprehensive mid-year plan analysis, according to Brian Fargus, MedBen Vice President of Sales and Marketing. “The analysis gives our clients information that is both measurable and actionable, so they can see exactly how their plan is working and where additional savings may be possible,” Fargus said.

Fargus also alluded to the article’s statement that, “sometimes, it can be difficult for employers to know how healthy (or unhealthy) their workforce is.” While understanding how that can happen, he said that MedBen offers a claims-driven approach to worksite wellness plans that gives employers a better idea of overall employee health, and promotes education and early detection of cancers and other chronic conditions. “With our wellness program, you know what percentage of your employees are getting screened for these conditions, and where to target your wellness resources,” Fargus added.

The article cites the survey finding that most public employers are reluctant to offer a CDHP, claiming that their higher out-of-pocket costs discourage employees to seek care. Sharon Mills, MedBen Director of Administrative Services, said her experience finds otherwise. “Our government clients have been largely receptive to consumer-driven plans, in particular HRAs [health reimbursement arrangements]. The greater control employers have in their design helps them to ensure that participants don’t neglect needed care,” Mills said. “Plus, the funds in the account can be rolled over and used toward retirement.”

Lastly, the researchers predict “that there will be a gradual shift away from consumer-driven health and toward value-based health plan design,” in which participants receive incentives to improve their health. Mills said that MedBen has long promoted this approach. “We encourage our clients to design their plan around personal wellness. For example, the employer can make HRA contributions based on a participant’s attending company health seminars and making an effort to exercise regularly.”

04/10/09

  06:05:04 pm, by MedBen5   , 209 words,  
Categories: News, Wellness

Wellness Bill Reintroduced in Congress

Woman Weighing Herself on Scale

As talk of a nation health care program continues with no working plan on the horizon, some legislators have decided to focus their energies on one specific area of potential medical cost savings: employee wellness. To that end, members of the House and Senate have reintroduced the Healthy Workforce Act, first proposed in 2007. The bill would provide a tax credit to businesses that offer comprehensive employee wellness programs.

According to Employee Benefit News, The bill has not been made public yet, but assuming it parallels the 2007 legislation, it would offer a $200 tax credit per employee to companies with less than 200 workers, and $100 per employee to companies with over 200 workers, for offering health awareness workshops, smoking cessation and nutrition programs, and other wellness initiatives.

Even without the added carrot of tax savings, employers are increasingly introducing wellness programs as a way to decrease health care costs through a healthier workforce. MedBen offers an innovative, claim-based approach to worksite wellness that can be customized to the needs of the group. By placing the focus on coaching, early detection of chronic conditions and employee education, we promote a healthier workforce and reduce the risk of costly diseases.

For additional information about worksite wellness, contact MedBen Marketing at marketing@medben.com or (888) 627-8683.

04/08/09

  04:08:48 pm, by MedBen5   , 153 words,  
Categories: Announcements, Health Plan Management

COBRA Beneficiary Notification Period Nears April 18 Deadline

April 18 will mark two months since the COBRA Subsidy Provision of The American Recovery and Reinvestment Act of 2009 (ARRA) was enacted into law. That date also serves as the deadline for employers to notify qualified beneficiaries that nine months of COBRA assistance is available. This includes former workers who were eligible for coverage on or after September 1, 2008, but declined the initial COBRA offer. Qualified beneficiaries have 60 days from the date of notification to decide whether or not they wish to take advantage of the subsidy.

In March, MedBen Specialty Services sent spreadsheets listing all qualified beneficiaries to its COBRA client groups. Based on the requested information they provided, we have set out the proper notifications to those beneficiaries. We will begin to administer the new COBRA benefit subsidies upon receipt of applications for continued coverage. Current COBRA recipients who have already made non-subsidized March and April payments will be credited for future months.

04/02/09

  05:10:30 pm, by MedBen5   , 263 words,  
Categories: News, Health Plan Management

COBRA News: IRS Provides Detailed Definition of "Involuntary Termination"

Capitol Building at Night

On April 1, the IRS provided additional assistance to administrators of the COBRA premium subsidy. Entitled “Premium assistance for COBRA benefits", this document offers an extensive explanation of the subsidy program. The topics addressed include a more detailed definition of “involuntary termination", which has heretofore been left somewhat vague as to its meaning.

The document can be downloaded here. The legal definition of “involuntary termination” can be found on page 5 of the document. For your convenience, we’ve provided a more user-friendly translation of the definition:

An involuntary termination means a severance from employment by the will of the employer even though the employee was willing and able to continue working, rather than by the decision of the employee to end their employment. This definition also applies to an employer’s failure to renew a contracted employee.

Events that result in the loss of dependent status, such as divorce, aging out of eligibility, death of an employee, or absence from work due to illness or disability, are considered involuntary termination of health coverage, not employment. As such, they do not qualify an individual for the premium reduction.

Facts and circumstances will be considered when determining if a termination is involuntary. For instance, if an employee leaves a job in which it can be shown that the employee had knowledge that the employer would have terminated services, the termination is considered involuntary.

Should an employee in the private sector wish to appeal a termination status, it can be done through The Department of Labor. Government employee appeals are handled through The Department of Health and Human Services.

03/26/09

  06:53:57 pm, by MedBen5   , 310 words,  
Categories: News, Health Plan Management

National Health Care Reform Takes Root... Sort Of

White House

With so much attention focused on the COBRA stimulus provision these days, you may get the impression that we’re focusing on it to the exclusion of noticing the even bigger health care reform movement currently underway. On the contrary – we’re keeping a close eye on government efforts to ensure that every American has access to medical treatment.

So exactly what is happening with national health care reform, then? Well… not much. Not at the moment, anyhow.

The 2009 approach to across-the-board coverage is 180 degrees different than what we saw back in 1993. Then, President Clinton presented a comprehensive package that in essence gave government total administrative oversight over every citizen’s health insurance. Its ultimate rejection meant that President Obama would require a different method for selling national health care – namely, get the money up front and take care of coming up with an actual plan after that.

One starting point that the President has offered is that the new package would allow businesses to continue providing insurance to their employees. That will certainly be welcome by plan participants who like their current coverage, but it also spurs a host of questions. Will employers be required to provide coverage? Will individuals be required to buy it? Will the government offer a public plan that would compete with private insurers? And bottom line, who’s going to pay for it all?

The Wall Street Journal reports that a collection of health care groups will soon release a set of suggestions for overhauling health care. But it conveniently skirts the issue of a goverment-run plan and other hot-button topics.

This recent health care reform primer in the Los Angeles Times does a good job of breaking down where we presently stand and the challenges that nationwide coverage poses. As the plan starts to take shape, we’ll keep you updated on all the latest developments.

03/20/09

  04:53:02 pm, by MedBen5   , 194 words,  
Categories: Announcements

MedBen Welcomes New Regional Sales VP

MedBen Building

MedBen is pleased to announce the addition of a new associate to its Sales and Marketing team. Michael DeBois will serve as Regional Sales Vice President in Northern Ohio, Northern Indiana and Michigan. A twelve-year veteran of the group medical insurance industry, Michael will assist his region’s broker network with the sales of all MedBen product lines.

Michael has been successful as a consultant and carrier representative for the fully insured and self-funded markets. A graduate of Urbana (OH) University, he has served on the boards of Northeast Ohio Health Underwriters, Big Brothers/Big Sisters, Red Cross and Habitat for Humanity. Michael resides in Dover, Ohio, with wife Julie and their two children Jack and Josie. Please join us in welcoming Michael to MedBen!

As we have consolidated our Sales and Marketing Departments, we have reassigned sales regions to better serve our clients and brokers. Mike Crum will now oversee sales efforts in Southern and Central Ohio and West Virginia, and Blair Pickerill will oversee MedBen sales efforts in Southern Indiana, Kentucky and Tennessee.

If you have any questions regarding Regional Sales VP territories, please call our Sales and Marketing Department at (888) 627-8683.

03/19/09

  02:32:27 pm, by MedBen5   , 313 words,  
Categories: News, Health Plan Management

COBRA Model Notices Available Online

Just in case you were in need of another COBRA paperwork fix…

Capitol Building

The United States Department of Labor has issued several notices for employers and insurance issuers to notify individuals who are eligible for COBRA benefits, or those who currently have coverage, about the new employer subsidy. The documents are designed for the sender to modify the contents based on the recipient’s eligibility dates and length of coverage.

You can access the COBRA Model Notices page at the Department of Labor website. On this page you will find links to four distinctive notices:

  • A full General Notice to qualified beneficiaries provides information about the new COBRA premium subsidy as well as information included in a standard election notice.
  • An abbreviated General Notice includes COBRA subsidy information but omits the election notice, for individuals who already have COBRA coverage.
  • An Alternative Notice can be used by certain insurance issuers based on state requirements. This notice may be adapted to meet the rules of the state in question.
  • A Notice in Connection with Extended Election Periods is created specifically for assistance eligible beneficiaries who qualified for COBRA coverage between September 1, 2008 and February 16, 2009 – that is, prior to the passage of the stimulus bill on February 17. This notice must be mailed to qualified beneficiaries by April 18, 2009.

If you’ve been following this blog during the past few weeks, you’ve undoubtedly noticed that the COBRA subsidy provision is making increased demands on employers – administrative in addition to financial. As you sort through the new rules, keep in mind that MedBen Specialty Services has an experienced team that can take care of your group’s COBRA administration, from initial notification and billing to employer reporting. And we can do it at a fraction of what it would cost you to perform these services in-house.

For more information about MedBen COBRA services, contact our Sales and Marketing Department at (888) 627-8683.

03/16/09

  11:40:37 am, by MedBen5   , 196 words,  
Categories: News, Health Plan Management

House Ways and Means Committee Releases COBRA FAQ

Capitol BuildingThe COBRA Premium Reduction provision of the recently passed Stimulus Bill has, not surprisingly, raised a number of questions. To address the most frequently asked questions, the U.S. House Ways and Means Committee has published a COBRA “How To” Manual to download and print.

Of special notice to employers is that the FAQ defines “involuntary termination", which, although pivotal to qualifying for COBRA coverage, has received little clarification as to its actual meaning:

“QUESTION: How do I know whether or not I have been involuntarily terminated from employment?

“A. Involuntary termination is a termination that is at the direction of the employer. Note that termination for gross misconduct will generally disqualify an employee and his/her family from COBRA coverage. For more information on whether your termination is involuntary please call the Department of Labor’s Employee Benefits Security Administration’s Benefits Advisors at 1-866-444-3272.”

In addition to the FAQ, we’ve provided revised code sections for Ohio and Kentucky, applicable to each state’s “mini-COBRA” laws. You can download and print these documents below.

Frequently Asked Questions on the COBRA Premium Reduction

Ohio Continuation of Coverage (ORC 3923 38)

Kentucky Continuation of Coverage (KRS 304 18-110)

03/12/09

  11:46:40 am, by MedBen5   , 130 words,  
Categories: News, Health Plan Management

COBRA Subsidy Employer 2009 IRS Tax Forms

Washington Monument

As we’ve noted on this blog recently, employers who must pay the 65% COBRA subsidy will be able to offset such amounts by receiving a payroll tax credit against federal income and FICA taxes. For the convenience of these employers, below we have provided a downloadable version of the IRS Form 941 (updated January 2009), which they can use to receive credit for COBRA premium assistance payments. We’ve also included instructions for completing the form.

Please note that this is a quarterly tax form. The employer must file a new form by the end of April, July and October of 2009 and January of 2010 to receive the payroll tax credit for that quarter.

UPDATE: The IRS has posted on its website an FAQ about COBRA Coverage and Form 941.

  10:59:03 am, by MedBen5   , 143 words,  
Categories: News, Health Plan Management

ARRA's COBRA Provision Language

MedBen has received a number of requests to provide the actual Congressional language for the COBRA premium subsidy provision from the recently passed American Recovery and Reinvestment Act (ARRA), aka the stimulus bill. Below, you will find a link to the complete provision language that you can download and print.

If you find this document to be a tough read (not surprisingly, it’s a bit heavy on the legalese!), we’ve covered many of the most important points elsewhere on the pages of this blog. Click below to read more on the details of the COBRA provision.

03/09/09

  10:54:26 am, by MedBen1   , 284 words,  
Categories: Announcements, News, Prescription, Health Plan Management

Value of "unique" MedBen services: over $19 per employee per month

Currency in Hand

If MedBen partially self-funded clients use MedBen’s proprietary prescription drug program and the AWAC claim cost control program they will save an average of $19 per employee per month over MedBen competitors. This is above and beyond network discounts and plan design ideas that MedBen brings to clients.

A recent study of several competitors turned up the following:

  • Surprisingly, many third party administrators withhold from clients significant portions – if not all – of pharmacy rebates paid by manufacturers as part of the pharmacy benefit plan operation. Rebates are commonly paid by pharmaceutical manufacturers to pharmacy plans that distribute a drug formulary to clients. MedBen returns 100% of paid rebates to clients, averaging approximately $4.75 per employee per month.
  • Many third party administrators use national pharmacy benefit managers (PBMs) that withhold portions of the manufacturers’ discounts as part of their service fee. It is common for PBMs to withhold a portion of the generic drug discount. MedBen delivers the entire manufacturer’s discount to clients. In a recent comparison this resulted in a potential savings of $6.72 per employee per month for a MedBen client simply for using MedBen’s pharmacy program, which delivers significant brand and generic savings for clients.
  • MedBen is one of a handful of third party administrators using the advanced cost containment program available from AWAC to help self-funded plans control claim costs. The result has been been net savings of approximately $8.00 per employee per month for MedBen clients.

All totaled, these two decisions - MedBen’s proprietary pharmacy program and MedBen claim cost containment - translated to savings averaging over $19 per employee per month over the competition.

If you aren’t using both of the these programs, ask your broker and/or Regional Sales Vice President how you can.

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