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MedBen Closed Memorial Day, But We're Open Online 24/7

American Flag

The staff of MedBen want to wish you and your family a happy and safe Memorial Day!

Our home office will be closed on Monday, May 28 in observance of the holiday. We will reopen at 8:00 a.m. Tuesday, May 29.

During this time, please remember that clients can use the 24/7 online services of MedBen Access to check on benefit coverage and the status of any pending claims. Simply go to and select "MedBen Access". For those who use Ventegra or Pharmacy Data Management (PDM) as their pharmacy benefits manager, you can check on prescription claims and find lower cost drug options through MedBen Access by clicking on the "Rx" button located in the "My Claims" section of this website.

If you're a MedBen Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA) participant in addition to having other coverage, you also can use MedBen Access to see your FSA/HRA balances, claims submissions and payments. When you log in to MedBen Access, you'll find an "FSA/HRA Online Inquiry" option (visible only to groups offering MedBen FSAs/HRAs) under the "My Plan" section located on the left sidebar. By selecting this option, users are automatically taken to the MedBen FSA/HRA Online System.

Once again, have a good holiday... and thanks for your continued relationship with MedBen!

  07:45:00 pm, by MedBen5   , 241 words,  
Categories: Announcements, News, Heart, Preventive care, MedBen Employees

Team MedBen Runs and Jumps (and Zumbas) for Better Heart Health

MedBen joined other local businesses on the Newark (OH) Courthouse Square to engage in good-spirited competition while promoting better heart health at the 2018 Licking County HeartChase on Saturday, May 6. Created by the American Heart Association (AHA), the event raised over $136,000 to fight heart disease... a record for Licking County and ranking it as the second largest HeartChase in the nation.


MedBen fielded 9 teams to participate in the event. Teams earned points by partaking in a variety of fun (and heart-healthy) feats, such as tossing swim rings on teammates' arms, catching badminton birdies in buckets, and even participating in a brief Zumba class.

MedBen also co-sponsored the local HeartChase, with Chairman Doug Freeman heading the event's executive leadership team and serving as its master of ceremonies.

"Today, our community takes a big step toward better health and stands together in the fight against our nation's number one and number five killers – heart disease and stroke," Freeman said. "HeartChase is about building healthier behaviors and collectively, as a community, to start making lifestyle changes that will lead us all to better health and wellbeing."

As for how MedBen fared in the competition, our Heart & Sole Mates team took third place overall... plus, the MedBen Brave Hearts won the Team Spirit Award for their stylish attire!

Learn more about how your business can have a good time for a good cause in your community by visiting the HeartChase page at the AHA website.

  07:34:00 pm, by MedBen5   , 212 words,  
Categories: Wellness, Cancer, Preventive care, Women's Health, Mental Health

Woman’s Health Week Promotes Physical, Mental Well-Being

woman walking

In May, we observe National Women's Health Week – a reminder to women of all ages to take the time to focus on their personal well-being, both physical and mental.

One key to better physical health is getting an annual wellness exam from your family doctor or OB-GYN. Not only does it allow the physician to monitor your fitness, it's a great opportunity to discuss your health goals... what you're currently doing to stay well and possible changes you can make.

Likewise, preventive screenings are important for better health – and for woman ages 50 and over, mammograms are a must. Saving lives is, of course, a major benefit of catching breast cancer in its earliest stages, and recent research indicates that mammograms also reduce the likelihood of needing more aggressive treatment (i.e., chemotherapy) in the future.

As for better mental health, it begins with getting enough sleep. Going through your day exhausted negatively affects your disposition and your productivity. Equally important is finding ways to manage stress, such as by taking time for relaxation and talking about your problems with a friend, family member, or therapist.
Finally, avoid unhealthy behaviors. If you smoke, quit. And when you drive, don't text.

Get additional tips for improving your health at the National Women's Health Week website.


  07:36:00 pm, by MedBen5   , 182 words,  
Categories: Announcements, News, Consumer-driven Health Plans, IRS, Health savings accounts (HSAs)

IRS Announces 2019 HSA Inflation Adjustments

IRS building

The IRS recently announced its annual cost-of-living adjustments affecting health savings accounts (HSAs) for calendar year 2019. The annual limit on deductible contributions to an HSA will jump by $50 for individuals and $100 for families next year.

Notably, high-deductible health plan (HDHP) out-of-pocket maximums for families will also increase in 2019, even though they were reduced earlier this year. HDHP minimum required deductibles remain unchanged.

  • HSA Contribution Limits – The 2019 annual HSA contribution limit for individuals with self-only HDHP coverage remains rises to $3,500, while the limit for individuals with family HDHP coverage goes up to $7,000.
  • HDHP Minimum Required Deductibles – The 2019 minimum annual deductible for self-only HDHP coverage stays at $1,350; for family HDHP coverage, $2,700.
  • HDHP Out-of-Pocket Maximum – The 2019 maximum limit on out-of-pocket expenses, including deductibles, for family HDHP coverage is $6,900... the same amount it was this year before it was lowered to $6,850 in response to the Tax Cuts and Jobs Act. The limit for self-only HDHP coverage (which was not affected by the Act) is $3,450.

MedBen clients with questions regarding these adjustments are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or


  06:37:00 pm, by MedBen5   , 355 words,  
Categories: Announcements, News, MedBen Employees

Harden Named MedBen CEO

Kurt Harden

Medical Benefits Mutual Life Insurance Co. (MedBen) is pleased to announce that at the Annual Meeting of the insurance and health benefits management company’s Board of Directors on May 17, President Kurt Harden was elected to serve as its Chief Executive Officer (CEO) as well. The Board also announced that current Chairman and CEO Doug Freeman has been named Executive Chairman.

Freeman praised the Board’s decision and Harden’s ascendancy to CEO. “Kurt has been a driving force with MedBen for over 25 years, and his leadership has been vital to our growth during that period. I can think of no better person to guide this company going forward,” he said.

As CEO, Harden will direct the company's daily operations and oversee the performance and promotion of its numerous service offerings, which include third party administration, worksite wellness (MedBen WellLiving), and bundled payment services (MedBen Analytics).

“I’m honored to be entrusted with this responsibility, and in my role as MedBen CEO I look forward to continue working with the great team we’ve assembled here to provide the best service available,” Harden said. “Together, we’ll build on our successes while finding new ways to innovate benefits management solutions for our clients.”

Freeman noted that these changes coincide with a significant benchmark in the company’s history. “MedBen just celebrated its 80th anniversary earlier this month, so it’s fitting that this should happen as we prepare for the next chapter in our story,” he said.

Full story »


MedBen Turns 80 Today

May 8 marks MedBen’s 80th Anniversary! Originally Hospital Service Association (HSA) of Licking County, we started out with two employees and a goal to provide employers and individuals with affordable health care coverage. And while our numbers have grown quite a bit since then, the goal remains unchanged.

MedBen 80th Anniversary

When HSA of Licking County (later HSA of Ohio) opened its doors in 1938, our business model was rather straightforward – we covered a plan member's hospital room and board, general nursing services, and drugs and dressing for up to 21 days per year. No coverage for physician or surgical fees, but at least the price was right: just a monthly premium of 60 cents for individual service (80 cents if you preferred a private room).

As we expanded our coverage to include such benefits as maternity, oxygen, and x-rays, we learned more about the specific health concerns of employer groups and how to best balance benefits and cost considerations. And it was this knowledge that ultimately led to our 1987 transition to a mutual life insurance company that provided comprehensive major medical care, including coverage of doctor charges.

Trust Building

MedBen Chairman & CEO Doug Freeman oversaw the changeover and has been instrumental in setting MedBen's direction for the past 31 years. "If our first 50 years of growth were slow but steady, I would say the last 30 were faster but focused," Freeman said. "We have always had a desire to find better solutions for our clients and expand our services to meet a wider range of employer needs."

MedBen has moved away from traditional fully-insured group coverage to offer of variety of benefits management services to self-funded employers, including third party administration and consumer-driven products like FSAs and HRAs. More recently, we introduced WellLiving, a worksite wellness program that promoted preventive care – and alters the way that employers see their health plan, says MedBen President & COO Kurt Harden.

"It's no longer just about, 'What benefits can we offer to our employees when they're sick,' to 'What steps can we take to help employees stay healthy in the first place?" said Harden, who joined MedBen in 1991 and was named President in 2012. "By approaching health coverage from a perspective of preventing disease or detecting it as early as possible, you cultivate a healthier workplace while reducing care costs."

Full story »

  06:20:00 pm, by MedBen5   , 179 words,  
Categories: Prescription, Cost savings, Specialty Drugs

MedBen Rx Strategies Help Employers Face Pricing Challenges


A recent Washington Post article highlights the machinations that drug companies will use to ensure that insurers and other private-sector sources pay for their products, rather than price-controlled public services like Medicare. One common manufacturer practice is making tax-deductible donations to charities that cover out-of-pocket costs and insurance premiums... where, in the case of rare diseases, "the needs of a single patient can generate millions in pharmaceutical sales," the article notes.

While drug companies feel it is in their best interest to do what they can to shield themselves from government price controls, that's no comfort to employers that bear the brunt of higher costs. But with decades of experience in prescription benefit planning, MedBen will assist clients in designing prescription plans that take the full advantage of manufacturer coupons and rebates, in addition to our new Rx Advocate program which goes against traditional practice and uses the pharmacy's actual purchase price to determine your plan's drug costs, rather than an inflated wholesale price.

Learn more by contacting our Vice President of Sales & Marketing Brian Fargus at


  10:52:00 pm, by MedBen5   , 174 words,  
Categories: News, Wellness, Cancer

Prostate Cancer Screening Guidelines Questioned

cancer definition

The pros and cons of prostate cancer screening have been debated since the U.S. Preventive Services Task Force (USPSTF) advised against the testing for most men in 2012 – and consequences of that advice may be surfacing.

In a recent Medscape commentary, Dr. Arefa Cassoobhoy called attention to recent studies that found decreases in incidences of low-grade disease, but increases in more aggressive prostate cancer. She suggests that the increases could be adverse consequences of the USPSTF's recommendation.

MedBen WellLiving currently follows American Cancer Society guidelines, which recommend that men age 50 and above (or younger, in cases of high risk) should discuss testing options with their family doctor. Decision about testing should be based on family history, lifestyle, and symptoms. However, some WellLiving clients do encourage all male plan members of appropriate age to get tested, so be sure to check your plan's guidelines before scheduling your annual wellness exam.

MedBen clients who have any questions about USPSTF preventive care requirements under the Affordable Care Act are welcome to contact Compliance Manager Erin Kelly at


  11:21:00 pm, by MedBen5   , 387 words,  
Categories: News, Compliance, Legislation, Regulatory

Fraker and Fellow SPBA Members Meet with Congressional Offices

Fraker and SPBA Board Members

MedBen Vice President of Compliance Caroline Fraker was among a group of self-funded benefits professionals who recently visited the Capitol to offer their expertise to Congressional offices in the drafting of health care legislation.

In a series of meetings on April 3, Fraker and other members of the Society of Professional Benefit Administrators (SPBA) Board of Directors spoke with staffers in both the Senate and House of Representatives, including legislative assistants for Ohio Senators Sherrod Brown and Rob Portman, and Representative Steve Chabot. The SPBA also met with members of the House Ways and Means Committee Health Subcommittee staff.

"As a group that represents the concerns of self-funded employers, the SPBA sees itself as a non-political information resource to government officials," said Fraker, who also serves as the Board's Secretary/Treasurer. "The purpose of these meetings was to introduce ourselves to the people responsible for drafting health care legislation and offer SPBA as a resource and sounding-board to bounce off ideas... to ask us, if we did this, how would it affect existing employee benefits and heath care laws?"

Staffers in attendance at the meetings were selected by their respective legislators and legislative committees because of their knowledge about health care issues.

Fraker noted that SPBA already has well-established relationships with multiple regulatory agencies, including the Internal Revenue Service and Department of Labor – agencies that enforce legislation already on the books. "Our goal is to assist in the process of drafting legislation, so any potential conflicts can be addressed and avoided before the bills are signed into law," she said.

SBPA Board members plan to return to the Capitol in June for additional meetings with the hopes of making the exchanges a regular event.

Formed in 1975, SPBA strives to advance the goals of benefits administrators as well as to provide advice that helps members better serve their clients and their clients’ plans. SPBA Board members meet monthly via conference call to discuss issues of importance to the Society’s members and their customers. Board members also host twice-yearly conferences open to all SPBA members, which are preceded by Board-only meetings.

A 30-plus year veteran of employee benefits, Fraker assists MedBen clients with regulatory compliance, contractual and risk management issues. In addition to her SPBA responsibilities, she also serves on the Government Affairs Committee of the Licking County Chamber of Commerce.


  03:51:00 pm, by MedBen5   , 328 words,  
Categories: Wellness, Diabetes

Diagnosing Diabetes

blood testing

Diabetes is a chronic condition that affects the body’s ability to use the energy found in food. The American Diabetes Association reports that 30.3 million Americans have diabetes. Shockingly, nearly 7.2 million Americans don’t even know that they have it.

Normally, the body is able to break down sugars and carbohydrates and turn them into glucose, fueling the body. However, insulin is needed to turn the glucose into energy. Type 1 diabetes is an autoimmune disorder in which the immune system mistakenly treats the cells in your pancreas that make insulin as invaders and destroys them. Type 2 diabetes is when your body does not or can not use insulin properly or is insulin-resistant.

Diagnosis of diabetes is imperative to your future health because if left untreated, it can lead to problems with the heart, blood vessels, eyes, and kidneys. Risk factors of developing the condition include family history, obesity, sedentary lifestyle, and an unhealthy diet.

Since symptoms of diabetes can take months or sometimes years to be detected, WellLiving recommends an annual visit to your family physician, who will decide if you need a blood sugar level screening. Common treatments for diabetes include insulin injections to manage type 1 diabetes, diet and lifestyle changes to treat type 2 diabetes, or sometimes, a combination of both.

The Screenings and the Numbers
Here are screenings your physician may use to measure your blood glucose levels.

  • The A1C test measures your average blood glucose levels for the past 2 to 3 months. Your doctor may administer this test more than once per year. Those testing 6.5% or more are considered diabetic.
  • Fasting Plasma Glucose (FPG) is a test that checks fasting (not eating for at least 8 hours) blood glucose levels. Those with fasting blood glucose levels of 126 mg/dl or higher, are considered diabetic.
  • An Oral Glucose Tolerance Test (OGTT) checks blood glucose levels before and after drinking a sweetened drink. Diabetes is diagnosed at 2 hour blood glucose of greater than or equal to 200 mg/dl.

SOURCES: American Diabetes Association (1,2), WebMD


  10:40:00 pm, by MedBen5   , 295 words,  
Categories: Prescription, Cost savings, MedBen University, Transparency

Rx Rebate Guarantees? Beware!

Brian Fargus

At a recent MedBen University event, MedBen Vice President of Sales & Marketing Brian Fargus warned attendees against drug rebate guarantees that promise a lot but deliver little… and end up costing the employer more.

“Some of the larger health care companies focus on getting as many rebates as possible and selling you on a guarantee of ‘per employee per month’ rebate savings,” Fargus said. But the only way to meet that guarantee is to encourage the use of the most expensive drugs, by placing them in your formulary’s preferred drug category. Meanwhile, lower cost equivalents that don’t offer rebates are considered “non-preferred” drugs, even when they cost less than a so-called “discounted” drug.

Fargus likened guaranteed rebates to a drugstore’s toothpaste aisle, in which Brand A offers a coupon and Brand B doesn’t… but even after the discount is applied, Brand A still costs more than Brand B. “The savings look good, but you still end up paying more,” he observed.

“Bottom line, you can go broke chasing rebates,” Fargus added.

MedBen opts for a different approach to pharmacy plan savings. While we return 100% of all paid rebates to the client, we don’t go looking for the rebate. Rather, we find the lowest net cost in every drug class, and help you point your plan members to those drugs.

And rebate transparency is just one way MedBen reduces your pharmacy costs. Our new MedBen Rx Advocate program eschews the standard industry practice of using a drug’s average wholesale price (AWP) as the starting price point in favor of the acquisition cost index (ACI)… the true price the pharmacy pays with no inflated mark-ups.

MedBen offers real savings on your pharmacy costs, with no gimmicks or artificial guarantees. To learn more, contact Fargus at

  09:58:00 pm, by MedBen5   , 257 words,  
Categories: Wellness, Research

Lack of Sleep Increases Risk of Health Problems, Early Mortality, Study Finds


Sure, work is important and sometimes burning the midnight oil is necessary for getting projects done on time. But making a habit of late nights and less sleep can have long-term health consequences, new research suggests.

The study of over 400,000 British adults found that people who regularly deprive themselves of sufficient sleep have a 10% higher risk of early mortality compared to those who follow the "early to bed, early to rise" adage. Stayer-uppers also fared worse with diabetes (25% higher risk) and respiratory diseases such as asthma (22% higher risk), in addition to other health problems.

"It is important for people who are night owls to learn there may be health consequences, but there may be things they can do to help overcome those problems," said lead researcher Kristin Knutson, an associate professor of neurology at Northwestern University Feinberg School of Medicine in Chicago. "There's hope, but it may take some effort."

So how much sleep is enough? It varies from person to person, but 7-9 hours is a generally accepted target. Of course, some people can get by fine with less, while others do better with an extra hour or two. A good rule of thumb: If you rely on your alarm clock to wake you up, then chances are you need to hit the hay earlier.

Finally, if a lack of slumber is due not to personal choice but because of insomnia or another sleep disorder, don’t just rely on pills to solve the problem. Talk to your family doctor to help you determine potential causes and solutions.


  10:59:00 pm, by MedBen5   , 231 words,  
Categories: Cost savings, MedBen University, Claims management

“The Case of the Painful Pinkie”

Kurt Harden

Clinical reviews are an essential component of MedBen claim management, as our team of medical specialists ensures that your plan’s claims are paid accurately and in line with prevailing regional costs. At our recent MedBen University roundtables, MedBen President and COO Kurt Harden has highlighted several examples of actual clinical reviews … including an incident involving, of all things, an unfortunate pinkie finger.

As Harden tells the story, a police officer smashed his pinkie, causing its fingernail to grow in improperly. “The deformed pinkie nail interfered with the officer’s job performance, as he was unable to grip his service revolver properly,” Harden noted. The decision was made to have the nail removed via a laser procedure at an outpatient surgery center.

In its claim to MedBen, the surgery center charged $35,500, its standard rate for a nail removal. Our contracted discount brought the claim charge down to a more reasonable $28,000… but before the claim was paid, our claims surveillance system flagged it for clinical review.

After studying the claim, a medical specialist noted that Medicare pays no more than $500 for nail removal, and recommended that $2,000 was a fair cost for the procedure. So MedBen worked with the surgery center until they agreed to the lower cost.

For more examples of how MedBen’s cost containment solutions help employers reduce their health care spending, contact Vice President of Sales & Marketing Brian Fargus at


  10:33:00 pm, by MedBen5   , 212 words,  
Categories: Announcements, Mental Health Parity (Federal), Health Care Reform, Compliance, MedBen Employees, HIPAA

MedBen Compliance Director McNair Retiring

Annette McNair

It is with warm wishes – and yes, understandable sadness – that MedBen announces the retirement of Director of Compliance Annette McNair on April 30, 2018.

In a way, Annette’s retirement marks the end of an era at MedBen. Annette was part of the first generation of our dedicated Compliance Department, and with her expertise in the law and background as a IRS agent, she brought a unique perspective to her work.

Annette has seen MedBen and its clients through the implementation and application of HIPAA, CHIPRA, Mental Health Parity and the Affordable Care Act, to name a few noteworthy regulations. She has been instrumental in finding viable compliance solutions for our clients for the past 23 years.

Because of Annette’s influence and hard work, MedBen’s Compliance Department is better than ever. Now six employees strong, the team serves our clients with insight and commitment.

“While Annette’s departure leaves a void, her unwavering professionalism will continue to inspire us,” said Caroline Fraker, MedBen’s Vice President of Compliance. “We are dedicated to bringing regulatory information and plan solutions to our clients, and will continue to provide the in-depth compliance services that have become a MedBen hallmark.”

Annette plans on spending time with her family, friends and pets. We wish her well in this new chapter of her life!


  09:25:00 pm, by MedBen5   , 227 words,  
Categories: News, Prescription, Cost savings, Transparency

MedBen Rx Advocate Closes the Price Gap


Newly appointed Health and Human Services Secretary Alex Azar says he wants to see greater transparency in drug pricing. In an address to the Federation of American Hospitals last month, Azar noted that “in both healthcare services and pharmaceuticals, the huge gaps between the list price and the actual price are notorious.”

MedBen clients are already well familiar with pharmacy benefit transparency, by a pass-through pricing approach that delivers 100% of paid rebates back to the plan, and reporting that shows exactly how their prescription drug dollars are being spent. And with the recent introduction of MedBen Rx Advocate, we have taken price transparency to another level.

MedBen Rx Advocate lowers the pharmaceutical price gap considerably. Instead of taking a “list-less” approach (average wholesale price (AWP) minus a discount), MedBen takes the acquisition cost, and adds a reasonable dispensing fee that fairly compensates the pharmacy's services. This "cost plus" method eliminates the potential for margin manipulation that is common with the traditional AWP “list-less” approach.

By using a drug's acquisition cost as a baseline, you reduce your prescription costs in turn... and we work with your team to ensure that you get maximum value from your pharmacy plan, through innovative plan designs. If you're interested in hearing more about MedBen Rx Advocate and the "cost plus" difference, contact Vice President of Sales & Marketing Brian Fargus at

  09:14:00 pm, by MedBen5   , 241 words,  
Categories: Wellness

Walk it Out!

woman walking

The American Heart Association recommends 150 minutes or more of moderate intensity physical activity, or 75 minutes of vigorous activity, per week. That number may seem high, but don’t fret: AHA goes on to say that even short 10-minute activity session, such as a brisk walk, can add up to help to achieve this goal.

If you’re not used to frequently walking, begin with short distances. Though it is most commonly recommended to walk at least 10,000 steps per day, if you are below that, try adding just 1,000 steps each day, one week at a time, until you reach 10,000. So, if you walk 5,000 steps per day, try walking 6,000 steps per day for one week, then moving up to 7,000 steps per day the following week.

Sometimes, it’s hard to get in a walk during the day, but there are other creative ways to gain those extra steps. These include taking the stairs instead of the elevator, walking to your lunch location, walking to talk to someone you would normally call or send an email to, and even parking your vehicle further out in the parking lot so that you must take more steps to get to your destination.

The benefits of walking go well beyond a number on your pedometer. The Mayo Clinic suggests that a daily brisk walk can help you to live a healthier life by improving your balance and coordination, maintaining weight and blood pressure, and even strengthening your bones and muscles.

  09:02:00 pm, by MedBen5   , 259 words,  
Categories: News, Wellness, Preventive care, Primary care

Primary Care Best Bet for Back Pain Treatment

drinking water

We frequently note the critical role primary care physicians (PCPs) play in preventing and detecting chronic conditions As the name infers, a PCP also serves as the "go to" source for treating many common ailments, including one of the most pervasive in today's deskbound society: low back pain.

In a new series of papers published in The Lancet, researchers concluded that low back pain should be managed by a PCP, who can provide the patient with guidance and encouragement to stay active and working. Instead, many people seek emergency care, take time off from work, receive unnecessary surgery, or are prescribed opioids or other painkillers.

"The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work," said series co-author Rachelle Buchbinder, professor of epidemiology and preventive medicine at Monash University. "Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed."

Approximately 31 million Americans experience low back pain at any given time, spending an average of $50 billion a year on treatment. Various estimates have placed the annual cost of the condition to U.S. businesses at $300 billion or more, considering lost productivity and missed workdays.

A successful doctor-patient relationship begins with preventive care, but also allows for better management of back pain and other everyday patient ailments… and helps to keep medical and absenteeism costs in check as well. Learn more about the advantages of “family doctor first” by contacting MedBen Vice President of Sales & Marketing Brian Fargus at


  07:42:00 pm, by MedBen5   , 218 words,  
Categories: News, Preventive care, Health savings accounts (HSAs)

IRS Ruling Affects Male Sterilization Coverage in HDHP/HSA Plans

IRS Building

A recent IRS notice will no longer allow first-dollar coverage of male sterilization and other forms of male contraception under high-deductible health plans (HDHPs) paired with health savings accounts (HSAs)... a decision that effectively overrules current laws in several states.

According to IRS Notice 2018-12, vasectomies and male contraception do not meet the definition of preventive care, and therefore individuals in a qualified HDHP paired with an HSA will not receive coverage until the annual deductible is met. With the introduction of this rule, a participant who receives male contraception benefits before meeting the HDHP deductible will not be eligible for HSA contributions. (The ruling does not affect female contraceptive coverage, which is still considered preventive care.)

Prior to this IRS guidance, multiple states, including Illinois, Vermont, and Maryland, required that health insurance policies issued in those states must cover vasectomies or male contraceptives without a deductible or with a deductible below the minimum deductible for an HSA-qualifying HDHP. The IRS is allowing these states until 2020 to transition to the federal rule, so individuals covered by HDHPs that paid for male contraception expenses below the deductible will still be able to make contributions to their HSA.

MedBen clients with questions regarding the IRS Notice are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or


  10:48:00 pm, by MedBen5   , 337 words,  
Categories: Wellness, Cancer

Cervical Screenings for Women

doctor consultation

The American Cancer Society projects that in 2018, about 13,240 new cases of invasive cervical cancer will be diagnosed. The good news is that death rates from cervical cancer have dropped significantly with the increased use of the Pap test.

Pap tests don’t diagnose cancer, but they detect 95% of cervical cancers at a stage when they cannot be seen with the naked eye. And we know that the earlier a chronic condition is detected, the better the prognosis and the lower the incurred costs. So, it’s easy to see why women ages 21 and older are recommended to receive a pap test every three years.

This pelvic exam performed by either a gynecologist or family doctor, will collect tissues from a woman’s cervix. The tissues will then be sent to a lab to be evaluated to determine if there is a presence of abnormal cells. Your physician may also recommend that tissues be tested for HPV (human papillomavirus), a virus that can cause cell change in the cervix.

Though one in ten tests come back with abnormalities, most of those abnormalities are not serious. Your physician will discuss with you in detail your results. In the case that you do receive a positive test (meaning abnormal cells are present) your physician may ask to conduct additional tests.

Full story »


  11:37:00 pm, by MedBen5   , 371 words,  
Categories: Prescription, Cost savings

Zaenger Outlines Benefits of “Cost Plus” Difference, Offers Rx Plan Suggestions

Allan Zaenger

A featured speaker at several of this year's MedBen University sessions is pharmaceutical consultant Allan Zaenger, President of Pharmaceutical Horizons. At recent roundtables, Zaenger outlined plan design options employers should consider to reduce prescription costs – among them, the "Cost Plus" pricing approach now available through MedBen Rx Advocate.

Unlike traditional prescription plans that take an inflated average wholesale price (AWP) and take discounts from there to get to the allowed prescription drug price, MedBen Rx Advocate pays the pharmacy based on the acquisition cost index (ACI) plus a set dispensing fee that fairly compensates the pharmacy's services for filling a prescription.

"The ACI takes the prices network pharmacies pay to acquire a medicine and collects these drug prices into an index that is refreshed every 24 hours," Zaenger said. "On average, the 'cost plus' difference will save the employer 4-6% across all plan prescriptions."

Zaenger also cautioned employers against the practice allowing plan members to buy 90-day supplies of high-cost specialty medicines. To demonstrate his point, he passed around an actual unused portion of a 90-day supply of the multiple sclerosis drug Tecfidera, which cost the employer $30,000... but because the prescription changed and the patient no longer used this drug, the unopened bottles of this medicine cannot be reused under state law, so "this $30,000 drug will get put in a paint can and destroyed," Zaenger noted. "That's an expensive lesson in why specialty drugs should only be bought in 30-day supplies."

Many expensive brand prescription medicines can also be defined as discretionary or elective drugs. Because of the high costs of the brand name medicines in certain drug classes and the general availability of lower-cost alternatives, Zaenger recommended that the plan member be responsible for 100% of the claim charge after the discount is applied.

"Additionally, brand name medicines in the discretionary classes would not count toward the accumulation of the out-of-pocket maximum," Zaenger said. MedBen can provide discretionary drug class lists to clients interested in promoting more cost-effective drug usage.

Zaenger will be among the featured speakers at the MedBen Annual Employer Benefits Roundtable to be held in April. For additional information about MedBen Rx Advocate and the "cost plus" difference, contact MedBen Vice President of Sales & Marketing Brian Fargus at

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