Final numbers are in for 2012 health care costs, and as expected, the results are good. But MedBen solutions take “good” trends one better.
The New York Times reports that national health spending increased just 3.7% in 2012 to $2.8 trillion, according to a new report from the Centers for Medicare and Medicaid Services (CMS). Health spending averaged about $8,900 a person – the fourth consecutive year spending grew at a slow pace.
The report’s authors noted that the Affordable Care Act had only “a minimal impact on overall national health spending growth through 2012.” The White House feels otherwise: “[The ACA] reduced Medicare spending growth, and most experts believe that Medicare savings spill over into the private sector,” said Jeanne M. Lambrew, a health policy coordinator at the White House.
Regardless of which argument you believe, it’s smart not to assume that the slow growth will continue indefinitely. The same CMS that released this report also predicted that 2014 will see a jump in spending, coinciding with the full implementation of the ACA.
So how to keep your expenses below potential spending trends – even low ones? At MedBen, it’s not enough to rely on bureaucratic “help” and other external factors. Rather, we use proven measures to save you money.
We’ve developed a unique claims process that delivers the highest level of benefits at the best cost. Our pharmacy program brings more savings, and our wellness plan promotes cost efficiency through a healthier workforce.
To learn more about the ways that MedBen solutions save employers money, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
For millions of Americans, the subject of weight weighs heavy on the mind – not to mention, a little around the middle – as we begin a new year. As we pack away festive holiday decorations (and, perhaps, sneak in one last holiday cookie) many of us make a resolution to lose weight. Unfortunately, only 8% of people ultimately achieve this goal.
Maintaining a healthy weight isn’t important just because you want to fit into that special outfit – it also helps you prevent and control many diseases and chronic conditions. Being overweight increases one’s risk of developing heart disease, type 2 diabetes, gallstones, breathing problems, joint problems and certain cancers, to name but a few.
So how to go about reaching a healthy weight? Forget about “as seen on TV” magic pills or other short cuts. Instead, focus on reducing your caloric intake and becoming more physically active.
There are many factors that contribute to a healthy weight, including environment, genetics, and metabolism. These are all unique to an individual, which is why it’s beneficial to set realistic weight goals with the help of your family doctor. Once the program is in motion, follow-up visits to monitor progress are a must. With a little discipline, you can be among that elite – and lighter – 8% when the next new year rolls around!
Now that the holiday festivities are over, the reality of new and costly health care reform rules begins to sink in, particularly for midsize employers. Fortunately, MedBen has a cure for your bureaucratic hangovers: self-funding.
As USA Today notes, “The new year will bring tough new health care decisions for many businesses, especially those that are too small to easily absorb new costs and too big to think about dropping coverage, experts say.” And fully-insured midsize groups will especially feel the financial pinch of the Affordable Care Act:
New taxes. “Starting in 2014, businesses that are fully insured […] will be hit with an $8 billion tax that is estimated to add 2%-3% to premiums for each covered employee.”
Premium increases. Health cost growth has slowed among employers of all sizes, but “some midsize employers saw 20%-30% premium increases this year.”
Challenges getting insurance. “It’s becoming increasingly hard for some midsize businesses to even find insurance carriers willing to cover them.”
More than ever, self-funding your health care coverage through MedBen makes financial sense. Because many ACA rules don’t affect self-funded plans, the employer can set its own premium rates based on its claims history. If claims are lower than anticipated, the employer keeps any savings.
Self-funded employers assume a limited portion of the liability and risk associated with health care costs in exchange for reduced claim and administration costs, tax benefits and other financial advantages. MedBen can help businesses with as few as 25 employees minimize the risks while gaining from the benefits. And with our wide range of self-funding solutions, you save money.
Start 2014 off on the right note by exploring the advantages of self-funding through MedBen. To learn more, contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
To our customers, consultants and brokers:
On behalf of all of the entire MedBen staff, Kurt Harden and I want to wish you a Happy New Year! I don’t have to tell you that this has been a challenging year from an employee benefit plan perspective. But I do want to tell you that we appreciate your business and are committed to continue to provide the best service and best advice when it comes to the business of benefits administration.
No matter what the next few years bring in terms of “health care reform”, I guarantee that you will not find a more knowledgeable and skilled organization which is totally focused on helping you navigate the turbulent health care benefits scene.
Even through the health care reform turmoil, we have been busy developing new products and services for 2014. Our goal is to help you take control of every aspect of your health care plan in order to offer the best benefits possible within your budget.
We look forward to serving you in 2014 and beyond. And, please don’t ever hesitate to contact one of us if you have concerns or comments.
Chairman & CEO
President & COO
A quick reminder: MedBen will be closed on Wednesday, January 1 and reopen the following day. Should you have a claims or benefits question, please visit MedBen Access. Our online customer service center is available 24/7 for your convenience!
Warning to health FSA participants: You are officially on the clock!
Depending on when you read this – and whether or not your employer offers a grace period or allows you to carry over funds – you have less than two days to use the tax-free contributions you made to your health flexible spending account before the remaining funds are forfeited.
Hopefully, you’ve already checked your account to make sure that you haven’t left anything on the proverbial table. But if you haven’t, take a moment to double-check your balance:
If you still have remaining funds, check our list of IRS-Eligible Expenses to see what purchases are eligible for reimbursement under your FSA – popular items include bandages and gauze, eyeglass frames, contact lenses and saline solution. MedBen FSA clients with questions regarding eligible expenses are welcome to contact MedBen Customer Service at (800) 297-1829 or email@example.com.
Self-funding your health care plan not only saves employers money – it enables you to provide a custom benefits package that appeals to current and prospective employees alike. And for workers, that’s an important consideration.
The 2013 Health and Voluntary Workplace Benefits Survey reveals that the benefits employers offer weigh heavily in making a job decision. Moreover, most respondents said they don’t wish to change the health care benefits they currently have.
“By far, health insurance in particular continues to be the most important employee benefit to workers,” said report author Paul Fronstin of the Employee Benefit Research Institute (EBRI).
Adds Ruth Helman of Greenwald and Associates, which co-authored the report: “While there may be a lot of questions about the future of the American health insurance system, the majority of those who have health coverage like the plan they have.” One-half of respondents with employment-based health insurance coverage are extremely (12%) or very satisfied (39%) with their current plans, and 37% are somewhat satisfied.
In a time where it’s become all too evident that the Affordable Care Act doesn’t live up to President Obama’s “if you like your health care plan, you can keep it” pledge, self-funding offers a measure of benefit control not possible with fully-insured coverage. And MedBen can help you make the most of that control.
With self-funding, you choose the health plan options that best suit the needs of your team, and make you more attractive to job hunters. We’ll work with you to design a plan that offers the right benefit mix for your employees – coupled with savings opportunities to you.
For more information about the advantages of self-funding with MedBen, contact Vice President of Sales & marketing Brian Fargus at firstname.lastname@example.org.
MedBen will close at Noon on Tuesday, December 24, remain closed on Christmas Day, and reopen at 8:00 a.m. on Thursday, December 26. For the New Year’s holiday, we will be open regular hours on Tuesday, December 31, closed on Wednesday, January 1, and reopen at 8:00 a.m. on Thursday, January 2.
Remember that if you need assistance with your health plan when MedBen is closed, the MedBen Access website is your one-stop customer service center. Be it a question about the status of a claim, the remaining balance in your FSA, or the cost of a prescription drug, MedBen Access has the information you need any time of the day or night – even on major holidays!
If you don’t already have MedBen Access bookmarked in your browser, the easiest route there is through the MedBen.com home page. Just click on “MedBen Access” (located on the top right corner of the page), type in your user name and password, and you’re in!
The staff of MedBen wishes you Happy Holidays, and all our best for a healthy and prosperous 2014!
In the aftermath of the Supreme Court striking down the Defense of Marriage Act earlier this year, the IRS has issued additional guidance regarding same-sex spousal coverage under cafeteria plans and health savings accounts. Accounting Today reports.
On June 26, 2013, the Court’s ruling on United States v. Windsor stated that section 3 of DOMA, which prohibited the recognition of same-sex marriages for purposes of federal tax law, to be unconstitutional because it violates Fifth Amendment principles. Notice 2014-01 provides guidance on the application of the rules under Section 125 of the Internal Revenue Code relating to health FSAs, DCAPs, and HSAs in relation to the participation by same-sex spouses in certain employee benefit plans.
According to the notice, a cafeteria plan may treat a participant who was married to a same-sex spouse on June 26 as if the participant experienced a change in legal marital status. Similarly, a participant who marries a same-sex spouse after June 26 can make a mid-year election change due to a change in legal marital status.
Once the election has been made, the same-sex spouse may be treated as covered by the FSA (even if the participant had initially elected coverage under a self-only FSA) beginning on a date that is no earlier than (a) the beginning of the cafeteria plan year that includes the date of the Windsor decision or (b) the date of marriage, if later.
The notice also states that same-sex married couples can elect family coverage under a high-deductible health plan tied to an HSA. The maximum annual family deductible contribution is $6,450 for the 2013 taxable year, and applies to same-sex married couples who are treated as married for federal tax purposes with respect to a taxable year (that is, couples who remain married as of the last day of the taxable year), including the 2013 taxable year.
MedBen clients who have questions regarding the IRS notice may contact Vice President of Compliance Caroline Fraker at email@example.com.
If your group health plan offers flexible spending accounts and you want to increase participation, MedBen recommends that you consider offering a debit card linked to your Health FSA plan.
The MedBen Visa “Benny” debit card allows FSA participants to pay for qualified health care expenses at the point of service. It provides convenience to the user while reducing the number of claims that are manually submitted for reimbursement.
The card can be used nationwide wherever Visa is accepted – the participant simply presents the card when making qualified purchases for medical goods and services. The debit amount will come directly out of the participant’s Health FSA account, as long as there is a balance in that account. The card is filtered for health care expenses only, so participants won’t inadvertently use the card at a restaurant, gas station or clothing store.
Groups typically introduce the card to FSA participants at the start of a new plan year as their funds are replenished. However, the card can be added to your plan at any time of your choosing.
MedBen clients who would like to receive additional information on the MedBen VISA debit card may contact Director of Administrative Services Sharon A. Mills at firstname.lastname@example.org.
Earlier this week, the Supreme Court ruled that statute of limitation periods written into plan documents are valid, as long as those periods are “reasonable.” But as Employee Benefit News notes, the court declined to define “reasonable.”
The plaintiff in Heimeshoff v. Hartford Life & Accident Insurance Co. claimed that her employer violated ERISA by failing to provide long-term disability benefits to which she was entitled under her employee benefit plan. The defendants, who had denied the claim in 2005 for failure to provide satisfactory proof of loss, argued that the plan’s three-year statute of limitations had passed.
During the October hearing, the Supreme Court focused on the question of When a statute of limitations should accrue for judicial review of an ERISA disability adverse benefit determination. Several lower courts had earlier dismissed the case, which was originally filed in 2010.
“The Supreme Court eliminated any uncertainty as to whether or not plan sponsors and/or employers can insert a contractual limitations period within the plan document itself,” said Nicole Eichberger of the law firm Proskauer. “It basically said this three-year period was reasonable and employers and plan sponsors are able to insert contractual statute of limitation periods within the plan document, as long as they are reasonable.”
MedBen was pleased to serve as the premier sponsor for last month’s 2013 Granville Turkey Trot (GTT). Presented by St. Luke’s Church, the 5K fun run/walk raised $78,000 for the Food Pantry Network, a cooperative which helps to ensure that members of Licking County have nutritious food available to them during the holidays and in other times of need.
On the morning of November 28, nearly 1,900 runners and walkers braved below-freezing temperatures to support the Food Pantry’s mission – and as a bonus, get in a workout before sitting down for Thanksgiving dinner. Hundreds of fans also turned out to cheer on participants, and volunteers gave generously of their time to make sure that the event ran smoothly. Many others who couldn’t attend in person donated online as “virtual runners”.
GTT committee members and sponsors, including MedBen Chairman & CEO Doug Freeman, gathered at Day Y Noche restaurant on December 13 to present the Food Pantry Network a check for $78,000 – an amount well in excess of the $65,000 that the event organizers had hoped to raise.
MedBen would like to thank everyone who made the Turkey Trot such a success – in particular, the MedBen employees who contributed a portion of their Thanksgiving morning to help needy Licking County families by volunteering or participating in the event. We look forward to seeing you all again next Thanksgiving!
MedBen Worksite Wellness encourages plan members to live healthier lives. The program monitors member health histories, and when guidance is warranted, RN Health Consultants work one-on-one with individuals to help them make smarter lifestyle decisions.
Sometimes, coaching requires multiple communications before the plan member chooses to takes action. But in many instances, just the simple recognition that someone is looking out for their well-being can make a difference, as a worksite wellness nurse coach shared with MedBen (the plan member’s name was kept confidential):
“A wellness coach completed an initial call with a 60-year-old employee identified with four health conditions: cholesterol, coronary artery disease, diabetes and hypertension. Their discussion included suggestions for modifying her diet and exercise to improve overall health, and also stressed the importance of completing an eye exam to identify and problems associated with diabetes that could lead to loss of vision.
“At the completion of the call, the employee thanked the nurse for her concern. She admitted that the had not been taking care of herself like she should have been, and said the call reminded her that she should do more to improve her health.”
Acknowledgement of the need to make personal changes is the first step toward a healthier individual. And with MedBen Worksite Wellness, the RN Health Consultants will follow up with the plan member to monitor progress and provide the appropriate “push” whenever needed. For the employer, it adds up to a more productive workforce and lower health care costs.
For additional information about MedBen Worksite Wellness, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
At MedBen, one of our foremost duties is helping employers strike a suitable balance between their employees’ premiums and deductible and out-of-pocket costs. Key to this is giving plan members sufficient incentive to be fiscally responsible about their medical spending without burdening them with overly high payments.
Achieving said balance requires the ability to recognize individual needs – financial as well as medical. But as The New York Times reports, some of the health plans offered under Obamacare have come up short in this regard:
“For months, the Obama administration has heralded the low premiums of medical insurance policies on sale in the insurance exchanges created by the new health law. But as consumers dig into the details, they are finding that the deductibles and other out-of-pocket costs are often much higher than what is typical in employer-sponsored health plans.
“Brian H. Snoddy, 35, of Palmyra, Va., said his wife and two children had a policy with a $330 premium and a $2,500 deductible, but it is being canceled. For new plans with comparable coverage on the federal exchange, he said, ‘the deductibles are way higher, $5,000 or $6,000.’
For visits to a medical specialist, many plans on the federal exchange require co-payments of $50 to $75 or more.”
With the regulatory freedom available through self-funding, employers can ensure that their health plan provides comprehensive coverage while avoiding excessive deductibles and out-of-pocket costs. And with MedBen’s decades of expertise in managing group benefits, we can help you put together a plan that’s right for your employees – and save you money in the process.
For more information about MedBen self-funded solutions, contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
To help clients determine the value of health care coverage to be reported on their employees’ W-2 Forms, this year MedBen will offer two different reporting information options: A basic eligibility report or a full W-2 report.
Full W-2 report – If you prefer that MedBen do the necessary math for you, you can receive a completed report for a $500 fee. If you select this service, we will provide a worksheet that lists each employee as well as his or her calculated coverage value for W-2 input.
If MedBen is NOT your COBRA administrator, you will need to send your group service representative a copy of your applicable 2013 COBRA premiums. And if your COBRA rates changed mid-year, please submit both sets of rates.
Should you desire one of these reports, simply send a request to your GSR. Please allow three business days from the date of your request to receive the basic eligibility report, and five days for the full W-2 report.
MedBen clients who have any additional questions regarding this service may contact Cara Delcher, Vice President of Risk Management and Quality Systems, at email@example.com or Morgan Antle, Group Underwriter and Quality Coordinator, at firstname.lastname@example.org.
Health care cost increases for self-funded employers managed by MedBen are coming in well under national and regional trends – and in some cases, are even decreasing.
According to Columbus Business First Mercer survey found that benefits costs for employer-based health care plans rose nationwide by an average of 2.1% this year. The stats weren’t quite as positive in Columbus and Central Ohio, where employers reported a 4.8% upward bump for 2013.
Now, compared to the double-digit cost jumps employers experienced in the past decade, these increases are relatively small. But they still look pretty huge when weighed against the cost trends of MedBen clients in Central Ohio and surrounding areas.
For example, in Zanesville and Muskingum County, where MedBen manages benefits for over 7,500 members, medical costs this year went up only 0.7% on average during the same period in 2012. Moreover, pharmacy costs – which typically see higher increases than medical costs – increased just a mere 0.3% among our clients.
The numbers for the 9,000 MedBen-managed members in Newark and Licking County are even more impressive. Not one of our self-funded groups in this area saw health care costs go up on a per employee or per member basis in 2013.
Overall, MedBen’s Licking County client costs went down by 16% when compared to the same period last year. In health care, that is a big deal.
Grown-ups and kids alike may wince at thoughts of “the needle”, but for most people getting a flu shot is definitely worth a moment or two of discomfort. The influenza vaccine protects against multiple viruses that will be most common during the upcoming season.
A flu vaccine is made to protect against three major flu viruses – H1N1, H3N2, and the B virus. When you receive a flu shot, antibodies develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.
Physicians recommend that you get a flu shot every year because the viruses are constantly changing. Studies conducted over different seasons and across vaccine types have shown that the body’s immunity to influenza viruses declines over time.
Flu vaccines are offered in many locations: doctor’s offices, clinics, health departments and pharmacies, as well as by many employers. If you don’t get a flu shot from your family doctor, it’s a good idea to let him or her know during your next wellness exam. And if your fear of “the needle” is too strong, talk to your doctor about using a nasal spray flu vaccine instead.
Happy Thanksgiving from the staff of MedBen! We hope that you and your family have a safe and relaxing holiday.
To observe the holiday, MedBen will be closed on Thursday, November 28 and Friday, November 29. We will reopen at 8:00 a.m. on Monday, December 2.
Hopefully, questions about your health care plan won’t arise during the holiday weekend. But should you be in need of claims or benefit information, MedBen Access is available to help you around the clock, 365 days a year.
In case you haven’t visited MedBen Access in a while, getting there is simple. Just go to the MedBen.com home page and click on the “MedBen Access” link. Once you’ve logged in you can use the website to view individual claims data, note a change in participant status, order ID cards, and perform a variety of administration functions. Plan members can check the status of a health claim, review benefit coverage or see cumulative deductibles, to name just a few of the site’s features.
If your group uses Pharmacy Data Management, Inc. (PDMI) as its pharmacy benefits manager, you can also take advantage of the services available on MedBen Access by clicking the “My Rx” link. Plan administrators can review member utilization and cost of drugs by brand/generic and retail/mail order, while members can get detailed medication information and compare prices of brand name drugs with their generic equivalents, among other things.
Should you need to check FSA or HRA account balances, the site’s “FSA/HRA Online Inquiry” link will get you the information you need. You can even check your compliance with recommended wellness exams by visiting the “iHealth Information” page.
Again, our best wishes for a happy holiday!
Formulary updates for prescription plans administered by Pharmacy Data Management, Inc. (PDMI) are now available at MedBen.com – simply click on “Plan Sponsors” (for employers) or “Plan Members” (for insureds) and select “Prescription Formularies” from the “Form” drop-down menu.
The new formularies become effective January 1, 2014. If you still need a 2013 formulary, they will be available on the website until the end of December. As always, plan administrators with questions can contact their Group Service Representative, while plan members can call MedBen Customer Service at (800) 686-8425.
Self-funded groups use either the Focus formulary or the Outcomes formulary. Focus offers the most cost-effective drug options, while Outcomes offers broader choice while still delivering significant cost savings. All fully-insured groups use the Focus formulary.
To determine if your group is fully insured or self-funded, check your MedBen ID card. If your account # is less than 10,000, your plan is fully insured; if it is more than 10,000, your plan is self-funded.
Can you believe we’re less than six weeks away from 2014? For flexible spending account (FSA) plan members, the end of the year often means a mad scramble to use up remaining funds from their accounts… though a recent rule may change that.
Last month, the Obama administration announced that FSA plan members can carry over to the following year up to $500 of unused funds. However, the employer determines how much money can be rolled over, or can choose to retain the full forfeiture.
If you can’t carry funds over (or your employer doesn’t offer a grace period to spend remaining dollars), all is not lost. First of all, you can still squeeze in a dental or vision exam before year’s end and use your FSA dollars toward copays and coinsurance, as well as such necessities as contact lenses and eyeglass frames.
Second, a trip to your local drug store can help you deplete your funds. Stock up on bandages and gauze pads, saline solution, rubbing alcohol and other health-related odds and ends. If you need a list of what items qualify for reimbursement under an FSA, visit MedBen.com, click on “Plan Members” and select “IRS-Eligible Expenses” from the “Additional Resources” drop-down menu.
Finally, you can use FSA funds to purchase aspirin, ibuprofen and some other over-the-counter medications, so long as you have a prescription. So should you happen to visit your family doctor between now and December 31, it may not be a bad idea to request one!
MedBen Worksite Wellness can help to take up where a physician leaves off. Because most family doctors have packed schedules, it leaves them precious little time for discussion following an examination – and in the case of a chronic condition like diabetes or hypertension, questions inevitably come to a patient’s mind after leaving the doctor’s office.
A worksite wellness nurse coach recently shared with MedBen a perfect example of how one-on-one coaching complemented a doctor’s care. The plan member’s name was kept confidential:
During an examination for an ear infection, the doctor noticed that the patient’s blood pressure was higher than normal. At a follow-up appointment two weeks later, the doctor diagnosed the patient with hypertension and started her on medication.
Following the initial exam, an RN Health Consultant contacted the patient to discuss her high blood pressure and address the patient’s questions about her condition. The RN also scheduled a second session to take place after the follow-up appointment.
During the second session, the patient said that she wanted more information on how to control her hypertension. The nurse provided education on diet and exercise, mailed information about the condition, and provided a phone number for a local exercise and weight management program. The patient thanked her for following up and was very appreciative for all of the information provided.
Even with a wealth of health information available on the Internet, there’s no substitute for professional consultation. With MedBen Worksite Wellness, patients get the best of both worlds – a physician-first approach to personal care for chronic conditions backed by a team of RN specialists ready to address questions and concerns. To learn more, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.