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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.

Silver-loading

Silver-loading refers to health insurers loading premium increases on the popular silver-level exchange plans to make up for the loss of Cost Sharing Reduction (CSR) payments. Loading premium surcharges onto silver plans boosted the size of the premium tax credits available to people with incomes below 400% of the federal poverty level. – The Trump Administration in an effort to end silver-loading has proposed changes to the current regulations.

Employee Benefit Advisor’s blog tends to focus on Human Resource and Benefit group related issues, like our monthly HR & Benefit Advisory publication. However, we believe silver-loading is an issue of interest to all in our field.

 

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

E-cigarettes: an effective quit smoking aid?

This may seem like a common sense Q&A. However, with the increasing popularity among younger employees you might want to arm yourself with solid stats and a good non-smoking educational program.

Part of the appeal is pod vapes look like a sleek high tech. Users try pod vapes because of the flavors. Problem is with every puff of flavor comes a high dose of nicotine. Some pod vapes have as much nicotine as an entire pack of cigarettes. Nicotine damages blood vessels and increases the risk of heart disease. Nicotine also affects the development of brain circuits and may increase the risk of mood disorders and problems with impulse control.

Users report feeling hooked on nicotine within days. Once hooked, there is a greater risk of using regular cigarettes or other tobacco products. Vape devices are also being used to smoke marijuana, which can affect how the brain develops in teens.

Many e-liquids contain nicotine and e-cigarettes deliver nicotine directly to the lungs. Vapes don’t have tar and some of the other chemicals that regular cigarettes have, they do have toxins that can harm your health. Toxins found in vapes include heavy metals, diacetyl – a chemical that can cause serious lung disease when inhaled, ultrafine particles that can damage lungs, and chemicals known to cause cancer.

The FDA has not approved e-cigarettes as a tobacco quit aid. There are seven FDA-approved cessation aids and medications that are proven safe and effective. Three types of nicotine replacement therapy (NRT) are available without a prescription: the patch, gun and lozenge. Two types of NRT are available with a prescription: the inhaler and nasal spray. There are two non-nicotine medications: Bupropion (Wellbutrin) and Varenicline (Chantix). None of the approved, regulated cessation aids deliver nicotine to the lungs.

Need help developing a cessation program? Tobacco Free Florida offers FREE nicotine replacement patches, gum or lozenges and FREE community, worksite, and clinic groups

 

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

2020 Cost Sharing Limits

Out-of-pocket expenses may not exceed $8,150 for self-only coverage or $16,300 for family coverage in 2020. – Ouch!

Employers will need creative solutions to help employees afford these limits. Hint: EBA can help.

 

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

AHPs are out – For Now

A federal judge has ruled that two parts of the Department of Labor (DOL) rule expanding employers’ ability to join in Association Health Plans (AHPs) violate ERISA. The DOL AHP rule was formed to allow employers to band together to create health plans based on industry or geography.

The federal court opinion stated that the rule was an “end-run” around the Affordable Care Act, and that the DOL exceeded its authority when it defined “employer” in the rule to include associations of dissimilar employers. The court also struck down a part of the DOL rule that expanded memberships in AHPs to working owners without employees.

The plans at issue allow groups of small businesses and sole proprietors to band together to offer lower-cost coverage that doesn’t have to include all the benefits required by “Obamacare.” The plans also can be offered across state lines. The Judge ruled against AHPs because they go against established definitions of what constitutes an employer under federal law that governs workplace health and pension benefits. In particular, a decision that sole proprietors can be counted both as employers and employees.

The judge ruled treating sole proprietors like major employers “creates absurd results.” For example, said the judge, consider a hypothetical association of 51 sole business owners with no employees. Under the administration’s rule, they would in effect be counted as having 51 employees. Not only that, each of the 51 working owners would also be counted as an “employer” although they have “zero” people working for them. And the association also would count as an employer, for a total of 52 employers.

The Trump administration disagrees with the judge’s ruling on association health plans and is “considering all available options,” including an appeal.

EBA’s opinion is that anything that can help sole proprietors and small companies lower their health care cost is good thing. The judge made a bad ruling.

 

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

Telemedicine – Impact your health care costs

Group health insurance premium are expected to rise 15-18% in 2019 and Telemedicine can be an important cost containment tool, for both employer and employee.

In a study of 17,000 telemedicine participants, hospital admissions dropped by 30% and doctor visits were reduced by 60%, for a savings of 45% in unnecessary doctor and emergency room visits. The American Medical Association states that 70% of doctor visits can be handled over the phone, and 50% of the emergency room visits are non-emergencies. Telemedicine’s savings in claim costs range from $300 for a single employee to more than $1,000 per year for a family of 4.

Telemedicine provides 24/7 medical access to employees as part of their benefit package. Advances in communication technologies make accessing professional medical opinions easier. This is particularly important if the network is strictly local, employees live in rural areas, or employees are worried about access to doctors while traveling.

In addition to the obvious convenience – patients/employees do not have to take time away from work for a medical appointment, sitting in the doctor’s waiting room, eliminating travel time – patients/employees have increased access to medical experts in many fields. Telemedicine puts the employee in touch with US Board Certified physicians in their state to treat common ailments; cold/flu, sinus infections, allergies, pink eye, etc.

What can employers do? – Employee Benefit Advisors recommends companies build a communication program to educate employees. In addition to informing employees the services that can be accessed via telemedicine be sure to include instructions on downloading your health insurance carrier’s app and login.

Interestingly, a bill submitted in New York proposes creating a task force to study how telehealth and telemedicine might help employees in workers comp. The task force would examine how connected health technology could improve outcomes for workers on worker’s comp, increase access to care providers and enable those providers to improve compliance with worker’s comp guidelines. The committee would also explore how telehealth and telemedicine could help employers and reduce fraud.

 

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

Group health insurance premiums to rise by 15-18% in 2019

Actuaries are predicting group health insurance premiums to increase 15-18 percent increase in 2019 due to a rise in health inflation.

Medical inflation is in the range of 18-24 percent across the country due to a rise in costs for medicines, medical equipment and hospitalization. Inevitably this will lead to a direct impact on the insurance costs for companies.

The premiums under group health plans are significantly lower than those of individual health insurance products. This is because of the number of people covered under the master plan and because the incidence of claims are lower.

Group health insurance loss ratios are almost 140 percent since some insurers were involved in heavy discounting to retain clients.

Increased non-communicable diseases are expected to increase employer-sponsored healthcare costs over the next three years. These diseases include heart disease, cancers, stroke, chronic respiratory diseases, diabetes, Alzheimer’s disease, mental illness and kidney diseases.

 

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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