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Should you get a second opinion?

If you find yourself asking questions like:

  • Do I have the right diagnosis?
  • Am I on the best treatment path and medications?
  • Is this surgery or procedure the best option for me?
  • How can I find the best local doctor for my medical needs or my surgery?

2nd.MD will get you help and answers.

Here are some quick stats:

  • 24% of consults lead to an alternate diagnosis
  • 82% of consults result in an improved treatment plan
  • 29% of surgery consultations result in surgery cancellation

2nd.MD provides support for any condition. Your support starts with a Care Team Nurse. Within days, 2nd.MD will collect your pertinent medical records and imaging and connect you via phone or video to a world-class specialist, uncovering all the possibilities and taking control of your health outcome through local and national in-network referrals.

Service is at no cost to if you are enrolled with a participating organization/employer as part of your benefits package. Many people have their service through their insurance carrier and don’t even know it! The benefit of 2nd.MD is also available to individuals. Contact them directly for pricing.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

IRS Guidelines – Indexed for 2020

FICA
Social Security Tax is 6.2% on income up to $137,700
Medicare Tax unlimited 1.45% to Unlimited

High Deductible Health Plans
Minimum Annual Deductible (Individual/Family) $1,400 / $2,800
Maximum Out-of-Pocket Limit (Individual/Family) $6,900 / $13,800

Health Savings Accounts
Individual / Family $3,550 /  $7,100
Catch-up Contribution $1,000

ACA Plan Limits
Out-of-Pocket Limits Individual / Family $8,150 / $16,300

Flexible Spending Accounts
Health Care Flexible Spending Account Maximums $2,750
Dependent Care Spending Account Maximum $5,000
The dependent care FSA maximum is set by statute and is not subject to inflation-related adjustments.

Mileage & Transportation
Standard Mileage Rates
57.5 cents per mile for business miles driven
17 cents per mile for medical or moving purposes
14 cents per mile driven in service of charitable organizations

Parking (monthly) $270
Mass Transit Passes (monthly) $270

Compensation
Compensation Limit $285,000
Highly Compensated Employee Salary Amount $130,000
Annual Compensation for Key Employee $185,000
Defined Benefit Plan Limit $230,000
Defined Contribution Plan Limit $57,000

Retirement Plans
401(k) $19,500
401(k) Catch-up $6,500
403(b) $19,500
457(b)(2) and 124(c)(1) $19,500
457(b) Catch-up $6,500

IRA Limit $6,000/$7,000 for age 50+
Simple IRA Limit $13,500/$3,000 Catch-Up

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Proposed Transparency in Coverage Rule vs. American Hospital Association

A proposed rule would require plans and issuers to disclose cost-sharing estimates to participants, as well as post in-network provider-negotiated rates and historical out-of-network allowed amounts on their websites. The rule would apply to group health plans and insurers in the individual and group markets and sponsors of self-insured group health plans. They would not apply to grandfathered plans. The Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued the rule.

The American Hospital Association and other hospital groups have filed a lawsuit in the U.S. District Court in Washington that claims the Centers for Medicare and Medicaid Services rule violates the First Amendment by provoking compelled speech and goes beyond the intended meaning of “standard charges” transparency in the Affordable Care Act.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

2020 EMPLOYEE BENEFITS UPDATE

As we head into a new year, there will be some noticeable changes in employee benefits that you and your clients should be made aware of. The following list encompasses a few of the items you may expect to change:

Required Reporting
Effective January 1, 2020, Medicare Secondary Payer reporting will now include prescription drug coverage. Right now, this is an optional procedure. It is handled by insurance carriers and third-party administrators. Employers should be aware that they may get requests for information from those carriers and third-party administrators. A more detailed explanation can be found here.

PCORI Fee Elimination
The PCORI fee will be eliminated for plan years ending before October 1, 2019. If an employer’s plan year ends between October 1, 2018 and December 31, 2018, then the last PCORI fee for that plan should have been paid by July of 2019. This would generally include plans that have plan years beginning November 1, December 1, or January 1. All other plans will make their last PCORI fee payment by the end of July 2020.

Out-of-Pocket Maximum Increase
In 2020, out-of-pocket maximums will increase to $8,150 for self-only coverage and $16,300 for family coverage. This represents an increase of about 3.20% from last year. HHS requires that the individual out-of-pocket maximum be embedded for each individual within the family OOPM. You can refer to the 2020 Benefit and Payment Parameters found here.

Health Insurance Tax
The Health Insurance Tax (HIT) which has been on a moratorium for 2019, will make a return in 2020 unless Congress acts on pending legislation to delay or repeal. This would result in increased premiums ranging from 2.7% to 4% according to actuarial experts.

Employer Mandate Affordability
The affordability percentage used in the safe harbors will be reduced to 9.78% in 2020. Employers should review their contribution levels to make sure they are within the new percentage requirement.

Individual Mandates in the States
Effective January 1, 2020, California and Vermont will have an individual mandate that will require employer reporting to be completed in 2021. New Jersey, which already has an individual mandate in place, will have to complete the employer reporting in 2020.

Self-Funded Plans
Employers that self-fund may have different benefits that cannot be subject to annual and lifetime limits. Self-insured employers should reevaluate which state plan they use as their benchmark for purposes of determining which benefits cannot be subject to annual and lifetime limits.

2020 Employer Mandate Penalties
As they do each year, the Department of Health and Human Services (HHS) calculates the health insurance premium growth rate. That rate is then used to adjust the amount of the ACA employer mandate penalties. Although not finalized, the 2020 employer mandate penalties could be $2,570 for the (a) penalty and $3,860 for the (b) penalty.

There is a lot of pending legislation that Congress could still take up before the recess. Issues pertaining to a Cadillac Tax repeal, transparency in prescription drug prices (H.R.3), redefining a full-time employee, surprise billing, and employer reporting can all be potentially addressed in the coming weeks.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Top 10 health conditions costing employers the most

Employee Benefit News recently published a list of the 10 health conditions that are costing employers the most. They are:

  1. High-Risk Pregnancy
  2. Smoking
  3. High Cholesterol
  4. Depression/Mental Illness
  5. Hypertension/High Blood Pressure
  6. Heart Disease
  7. Arthritis/back/musculoskeletal
  8. Obesity
  9. Cancer
  10. Diabetes

Employee Benefit Advisors would like to point out that a least half the list is related to one’s weight. It prompts reposting the meat of EBA’s November 19th, 2014 blog.

The following was posted by one of my fellow CEBS (Certified Employee Benefit Specialist) colleagues. Employee Benefit Advisors has seen, time after time with our own clients, that weight loss is the number one factor to controlling health care costs.

“One of the most effective ways to ensure quality healthcare services is to not need it in the first place… All those overweight, please raise your hand. All those currently being treated for a preventable healthcare issue raise your hand.

My husband is 68 years old and was on high blood pressure, diabetes and cholesterol meds–pretty typical at this age. Oh, yes, and frequently had terrible heart burn. Lost 38 pounds and just had his annual physical. Doc took him off all his prescription meds and he no longer ever has heart burn. Go figure… How’d he do it? Cut way back on consumption of carbs/sugar. That’s it. Pretty simple. Nothing else…not even exercise. Now that he feels so good he has started to exercise on a regular basis.”

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Employer medical benefit costs projections for 2020

Employer-provided medical benefit costs are forecast to rise 6.5% in 2020, outpacing general inflation by 3.8%. The expected increase for medical plans is due to a combination of higher costs for specialty drugs, moderate price increases for care and flat or decreasing health utilization. (Medical costs in the U.S. will rise more slowly compared to other regions around the world.)

Prices, not utilization, are the leading cause for healthcare spending. High deductibles and other cost sharing are two reasons for the decrease in utilization.

The primary drivers of health care claims are musculoskeletal, cancer, cardiovascular, diabetes and high blood pressure. It’s important to note the growing risks from unhealthy personal habits, i.e. physical inactivity, obesity, bad nutrition, ageing and excessive alcohol and substance abuse. Many of those risk factors can lead to chronic conditions that are difficult to treat and can contribute to long-term increases in medical costs.

2020 Global Medical Trend Rates Report

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

What Is Blue Light? Why You Need to Protect Your Eyes

If you spend any time during the day looking at a screen, whether it be a smartphone, tablet, e-reader, LED TV, or computer, your eyes are exposed to blue light.

 What is blue light?

Natural sunlight is made up of many colors of light, from red to indigo to violet. We can’t see these colors because they blend together to make white light. Because the light looks white, it is hard to tell if your eyes are exposed to blue light. On the color spectrum, blue light is right next to UV light—both can be dangerous and damaging to the eyes.

But it’s not all bad. Blue light has some benefits. It can help you feel more alert and awake, improve your mood, and help you sleep better. We need blue light to feel healthy and happy.

The problem is when you spend too much time looking at a screen, you increase your eye exposure to blue light. Too much exposure to blue light can cause tired eyes, sore eyes, and difficulty focusing. Studies have shown that too much exposure to blue light can also cause age-related macular degeneration which can lead to blindness.

Most of us use computers and other electronic devices not only in our jobs every day, but at night when we get home. In other words, it is difficult to reduce our screen time! So how can you protect your eyes? Here are a few tips:

  • If you can’t reduce your amount of screen time, try to take breaks at least every hour to rest your eyes.
  • Filters or computer glasses are available that can reduce how much blue light is reaching your eyes. There are filters for nearly every electronic device that can help alleviate eye fatigue.
  • Avoid looking at a bright screen for two or three hours before bedtime, and sleep with the lights off rather than leaving on a lamp or night light. This will help you to improve your quality of sleep.

Thanks to Brooke Ellis, Director, Strategic Sales Communications at Solstice Benefits
https://blog.solsticebenefits.com/solstice-member-blog/what-is-blue-light-why-you-need-to-protect-your-eyes

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Preventive Care Benefits Expanded

A new IRS notice expands the list of preventive care benefits that may be covered. Expansion provides coverage without a deductible for some chronic conditions.

“This notice expands the list of preventive care benefits permitted to be provided by a high deductible health plan (HDHP) under section 223(c)(2) of the Internal Revenue Code (Code) without a deductible, or with a deductible below the applicable minimum deductible (self-only or family) for an HDHP.”

Carriers / Plan Sponsors can now use a lower than the minimum deductible for the preventive care benefits, but still need a minimum deductible for the other services. The new change doesn’t affect what is generally considered “free preventive” but instead simply allows carriers / plan sponsors — if they wish — to start offering CDHPs which cover these additional items, while not endangering their ability to be combined with an HSA.

Thus, employees could still contribute to an HSA now that these services are considered to be preventive. These services would not need to be “free”; for non-HDHP group plans, it will not make a difference to the participant, but for someone in an HDHP plan who wants to contribute to an HSA, it’s a big deal.

The following treatments have now been classified as preventive care for the chronic conditions indicated.

  • Angiostatin converting enzyme (ACE) inhibitors (for congestive heart failure, diabetes, and coronary artery disease);
  • Anti-resorptive therapy (for osteoporosis and osteopenia)
  • Beta-blockers (for congestive heart failure and coronary artery disease)
  • Blood pressure monitors (for hypertension)
  • Inhaled corticosteroids (for asthma)
  • Insulin and other glucose-lowering agents (for diabetes)
  • Retinopathy screening (for diabetes)
  • Peak flow meter (for diabetes)
  • Glucometer (for diabetes)
  • Hemoglobin A1c testing (for diabetes)
  • International normalized ratio testing (for liver disease and bleeding disorders)
  • Low-density lipoprotein (LDL) testing (for heart disease)
  • Selective serotonin reuptake inhibitors (SSRIs) (for depression)
  • Statins (for heart disease and diabetes)

The change is effective July 17, 2019.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Is transparency coming to healthcare pricing?

President Trump recently signed an executive directing federal agencies to increase healthcare price and quality transparency. The order specifically directs the of Departments of Labor, Treasury and Health and Human Services to issue guidance and propose regulations that would disclose negotiated rates, cost-of-care and de-identified federal healthcare data, and to expand the availability of Health Savings Accounts.

The order includes five main provisions instructing federal agencies to issue guidance that would:

  • require hospitals to disclose information about their negotiated rates in a format that’s understandable and usable by patients.
  • require insurance companies to provide patients with information about cost of care, including out-of-pocket costs, before they receive services.
  • develop a comprehensive roadmap for consistent, limited, consumer-centric quality metrics.
  • disclose de-identified federal healthcare data that protects patient and consumer privacy, enables transformation of the healthcare marketplace, and allows researchers to develop tools and analytics to allow patients to be at the center of their healthcare.
  • expand the availability of HSAs to cover direct primary care arrangements and healthcare sharing ministries, include more preventive services and products that can be covered in the deductible period, and issue guidance on the amount of funds that can be carried over at the remainder of the year for FSAs.

Employee Benefit Advisors has long advocated greater price and quality transparency in healthcare and we commend the Trump Administration for putting forth this proposal.

The executive order is the president’s third major executive action on healthcare since taking office, after the order issued on his first day in office directing federal agencies to ease the regulatory burden of the ACA, and the order issued in October 2017 that led to the development of the rules on Association Health Plans, short-term plans and HRAs..

As with previous executive orders issued by President Trump, this order does not immediately trigger any executive action apart from the instructions issued to the federal agencies to develop regulatory actions. These will need to go through the traditional rulemaking procedures of providing a proposed rule for public comment before being able to enact any final rules.

It’s a good start.

Thanks to the National Association of Health Underwriters, NAHU,  for the blog content.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

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