February is all about hearts… and not just the chocolate-filled variety. This month is also dedicated to raising awareness about heart disease and increasing your knowledge about prevention.
According to the Centers for Disease Control, heart disease is the nation’s leading cause of death for both men and women. It’s estimated that 715,000 heart attacks occur in the U.S. every year, and approximately 600,000 Americans die from heart disease.
The first step to better heart health is to get your blood pressure and cholesterol checked. High blood pressure can cause hardening of the arteries and weakening of the heart muscles, leading to a stroke. Likewise, high cholesterol can cause plaque to build up in the arteries and starve the heart for oxygen – and that’s when a heart attack occurs.
If you have been diagnosed with hypertension and/or high cholesterol, MedBen Worksite Wellness can help you reduce the risk of heart disease. Through our specialty care program, an RN Health Consultant will contact you for disease-specific education and customized counseling. Our service supports the care you receive from your family physician, who can help you devise a sensible lifestyle plan… and keep your heart healthy for many years to come!
We’ve been telling you a lot about MedBen’s new captive reinsurance program in recent days, and with good reason – we think it’s an ideal way for midsize and smaller employees to realize the advantages of self-funding while still reducing the inherent risk.
But the captive program is hardly the only self-funded option MedBen has to offer. We’ve been administering self-funded plans since 1989, and along the way we’ve learned a lot about how to help employers control their costs. We’ve also learned that each type and size of business has unique self-funding needs.
Larger employers benefit most from a total self-funded plan, which provides ultimate flexibility and maximum savings opportunities. MedBen enables employers to be as hands-on as they want to be, helping them to build their benefits from the ground up or putting a plan together for them.
Once a group’s plan is in place MedBen will handle its daily operations, from claims processing to customer service. Money stays with the employer until claims are paid, so it can continue to earn interest. And of course, the employer keeps any money it doesn’t spend!
In addition to the captive program, MedBen offers split self-funding for smaller groups. Split Solution is a great choice for employers with 25 employees or more who still want budgetary predictability.
Split self-funding works much like a regular health plan, with an important difference: The employer gets to keep any savings, rather than an insurance company. Plus, Split Solution’s plan design options allow employers to make benefit decisions based on their own claims history, rather than regulatory mandates.
If you’ve been thinking about making the switch to self-funding your health plan, MedBen would be happy to review your needs and share more savings advantages with you. Simply contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
MedBen is the subject of a Columbus Business First article about the company’s new captive reinsurance program. Health care reporter Carrie Ghose spoke to MedBen President & COO Kurt Harden about the thinking behind captives, and how smaller self-funded employers can benefit from them:
“’One of the biggest frustrations employers have is that feeling of helplessness of sending their money to the insurance company, and they’re not feeling they can manage their costs,’ said [Harden].
”Smaller groups are more likely to be partially self-funded, Harden said. Their claims pool is smaller and they lean more heavily on reinsurance. With MedBen’s captive product, several clients pool their stop-loss risk and own that pool of funds as well. That means they can get rebates if there’s money left at year’s end.
”Going self-funded can help cushion some of the impacts of the Affordable Care Act, Harden said. The law’s new requirements that even out rate-setting mean that historically young and healthy groups are seeing premiums rise. Self-funded plans still reap the rewards of a favorable claims history.”
Employers interested in learning more about the MedBen captive reinsurance program can contact their agent or broker, or call Vice President of Sales & Marketing Brian Fargus at (888) 627-8683.
At the MedBen home office in Newark, Ohio, temperatures outside the building reached double-digit negatives this morning, and continued sub-freezing weather is expected for the rest of the week. When the thermometer dips this low, it’s not uncommon for local power outages to occur. Fortunately, MedBen prepared for such an eventuality… and recently, our safeguards got put to the test.
Last year, MedBen replaced its old generator with a bigger and better model. Boasting 250 kilowatts of power – over twice the capacity of our previous unit – the new natural gas generator allows us to keep all internal processes operational in the event of a power disruption. Plus, all websites housed on our computer systems, including MedBen.com and MedBen Access, will remain online, so clients continue to receive around-the-clock customer service.
On January 10, we experienced a power outage in our area that lasted the better part of the day… and when the loss of power was detected, our building’s systems automatically switched over to the generator, thereby providing uninterrupted service to our clients. When power was restored, the transition was, again, seamless.
Bottom line: Regardless of how cold it gets outside, the MedBen home office will remain up and running (and warm)!
While health insurance exchanges have gotten the lion’s share of the media coverage lately, several other new regulations have been introduced under the Affordable Care Act – and among the most significant for employers are the rules regarding group wellness programs.
According to Employee Benefits News, the Obama administration has made worksite wellness programs a priority in the battle against chronic diseases, which are predicted to cost the U.S. health care system an estimated $4.2 trillion annually by 2023. But unlike some of the more questionable decisions the government has made in hopes of fixing the system, a focus on wellness is a financially sound one – and one that MedBen has championed for years.
As EBN notes, “Evidence suggests that worksite wellness programs are cost-beneficial, saving companies money in health care expenditures and producing a positive return on investment. Researchers have calculated an average return of $3.27 in medical costs for every dollar spent on worksite wellness programs.”
The new wellness rules are meant to encourage appropriately designed, consumer-protective wellness programs. Such programs must be reasonably designed to promote health or prevent disease, and to be available to all similarly situated individuals. Additionally, individuals must be given notice of the opportunity to qualify for the same reward through other means.
As you are probably aware, employers who employ at least 50 employees as of their first plan year on or after January 1st of this year must cover all employees who work at least 30 hours per week under their health coverage. Starting January 1st of 2015, failure to do so will subject such employer to the “Pay or Play” penalties imposed under the Patient Protection and Affordable Care Act (ACA).
The methods of counting the number of hours an employee works are set forth in rules issued by the federal government, which include specific rules for counting the hours of employees who either are not expected to regularly work 30 or more hours per week as of their date of hire, or for whom it cannot be determined on their date of hire how many hours such employees will work on average. These types of employees are considered Variable Hour Employees, and applicable large employers are required to determine the average number of hours worked by these employees so they know to whom to offer coverage if they wish to avoid the penalty.
During the next few weeks, all MedBen self-funded clients and their agents/brokers will be contacted by the MedBen Compliance Department with information about how to set up the counting method to be used by such employer for this purpose. There are variables allowed under the federal rules that an employer may want use in setting up their counting system that will be explained in this information.
Because the “Pay or Play” penalty may hit a particular employer mid-plan year, we are attempting to have these issues resolved by the beginning of the plan’s 2014 plan year to avoid any issues with the plan’s stop-loss carrier, or as soon as possible for those groups with a January plan year. It is also important that the counting method elected by the employer group be included in the plan to avoid any issues with a stop-loss carrier as to whether a particular employee is eligible for the health coverage in the event that such employee meets the plan’s specific deductible level.
MedBen clients with questions regarding this service may contact MedBen Director of Compliance and Medical Management Annette McNair at email@example.com.
To learn more about “Pay or Play” penalties, watch MedBen’s Shared Responsibility Penalties & Affordability Strategies presentation on YouTube.
During the lead-up to the introduction of health insurance exchanges under the Affordable Care Act, speculation ran rampant as to whether large employers would continue to self-fund their group health plans, or drop their coverage altogether in favor of the public marketplaces. At this point, most employers have chosen to keep their plans intact… and are already seeing the wisdom of that decision.
That the exchanges have had a rough rollout is hardly headline news at this point, but underlying all the website drama was the question of just who would enroll. Specifically, would enough younger and healthier people sign up to subsidize the higher health care costs of older enrollees?
Based on the age breakdown of the 2.2 million Americans who have enrolled so far, the numbers don’t look promising. As reported by Avik Roy on Forbes.com:
“Here are the key figures. 59% of non-elderly adults who selected an exchange plan were older than 45, compared to just 32% of the uninsured population: a skew of 27%. On the other hand, 25% of non-elderly adults who selected an exchange plan were younger than 35, compared to 47% of the uninsured: a skew of 22%, for a total skew of 49% (27 plus 22).”
(Roy also notes that West Virginia has the biggest skew toward older exchange participants at 66%, with Ohio in fifth at 60%. Conversely, Kentucky has one of the lowest skews, at 39%.)
If you’re expecting a new MedBen debit card for use with your flexible spending account but have yet to receive it, chances are good you’ll getting it any day now. We’ve been notified that the mailing of some cards was slightly delayed, due primarily to the Target store data breach last month.
As explained in the update we received from Evolution1, the company that embosses and distributes our FSA cards:
“The Target store card breach has resulted in an inordinate volume of card reissues across numerous banks and financial institutions. This is heavily impacting card fulfillment processors.
“As we were trying to clear through the backlog at the fulfillment facility there was a 2 day blizzard shutdown of Indiana roads impacting productivity.”
Evolution1 adds that during normal business times, cards typically take 3-5 business days from the date the card is embossed to when the cards are placed in the US postal system. During the recent holiday season, when open enrollment increases card demand, the turnaround expands to 7-10 business days. Currently, the fulfillment is running at approximately a 10 business day timetable, and “working 24/7 to process volume as quickly as possible,” the update notes.
Should you not receive your new MedBen FSA debit card within the next week, please feel free to contact our FSA service team at (800) 297-1829.
Better prevention, screening and treatment are primary factors for a multi-decade drop in cancer deaths, finds new research from the American Cancer Society.
According to HealthDay News, the overall risk of dying from cancer has fallen 20% over the past 20 years. During the years 2006 to 2010 (the most recent years for which data is available), death rates from cancer declined by 1.8% per year among men and 1.4% per year among women, researchers found.
Ahmedin Jemal, ACS vice president for surveillance and health services research and co-author of the report, noted that most of the progress has been made in colon, breast and prostate cancer. These cancers can be screened for and, when caught early, have better outcomes, he said.
As this study indicates, timely preventive care has been shown to improve the chance that a cancer or other disease can be detected and treated. That’s why MedBen promotes regular colon and breast cancer screenings, as well as prostate cancer screenings folowing a doctor’s consultation, through the MedBen Worksite Wellness program.
In addition to cancer screenings, our program encourages annual wellness exams and other appropriate testing to increase plan members’ awareness of personal health, and to help prevent long-term complications from unmanaged health conditions. By educating their employees about prevention and positive lifestyle changes, employers can reduce medical costs as measured through health care utilization and claims – as well as potentially saving a life.
To learn more about the healthful and financial benefits of promoting wellness in your business, contact MedBen Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Benefits management company MedBen has introduced its first reinsurance captive program for businesses that self-fund their health plans, according to its President and COO Kurt Harden. Offered in partnership with HCC Life, this unique coverage option gives employers the opportunity to receive a significant portion of their annual reinsurance premiums back by spreading risk among multiple groups.
“Businesses and organizations of all sizes that self-fund their health plan already save money by not paying large premiums to insurance companies,” said Harden. “This captive program offers employers all the advantages of self-funding plus the opportunity to get a significant portion of reinsurance premium back at the end of the year.”
The initial captive offering was marketed in the 4th Quarter of 2013 and consists of 24 small- to medium-sized employers representing over 1,000 employee lives. The program started on January 1, 2014.
MedBen Vice President of Sales & Marketing Brian Fargus said that another captive is being developed for July 1 groups. “We marketed the January one to a fairly targeted group of employers. For the July captive program, we plan on broadening our efforts.”
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.”