Viewing posts from: March 2012

Complimentary Webinar – Your Benefits Questions Answered Live!

Posted March 28, 2012 by Megan DiMartino

Join us today, March 28, for this complimentary, educational webinar and have all of your most challenging Benefits questions answered live by Benefits expert & ERISA Counsel Patrick Haynes Jr., of AP Benefit Advisors. During this live event, Mr. Haynes will answer the most complex and difficult Benefits and legal questions impacting employers today. You can submit your questions live during the webinar, or in advance at the time of registration. Topics for questions will include but are not limited to:

* National Healthcare Reform
* Legislative Updates
* HIPAA Issues
* COBRA Questions
* Regulatory Compliance

The webinar will be held from 12:00 to 12:40 PM ET. Click the following link to reserve your space now:

Chronic Disease May Up Out-of-Pocket Costs for Insured

Posted March 27, 2012 by Megan DiMartino

HealthDay News – Among families with employer-sponsored health care plans, those coping with chronic illness pay more out of their pockets than those without chronic illness, primarily because of higher prescription drug co-payments, a new study finds.

“Even when you are looking at the same level of total spending, families covering chronic conditions spent more out of pocket than those without chronic illnesses, and it doesn’t appear to be because the families are in different types of plans,” researcher Anne Beeson Royalty, a professor at Indiana University-Purdue University Indianapolis, said in a university news release.

“It looks as though the difference is because certain types of services — such as prescription drugs — are covered less generously,” she added.

Royalty and colleagues analyzed data from a 10-year national survey of more than 47,000 American families and found that those dealing with chronic conditions spent 1.5 to two times more on prescription drugs.

For example, among households spending a total of $7,000 on health care, those with chronic conditions spent an average of $2,215 of the $7,000 on prescription drugs, compared with $1,065 for other households.

“Because average coinsurance for prescription drugs is much higher than coinsurance on other health care services, that means that the households with chronic conditions pay more of that $7,000 out of their own pockets than do other households — roughly $500 more in this case. The differences grow more pronounced as total spending increases,” Royalty explained in the news release.

She and her colleagues said the study raises questions about how health care plans are designed. They suggested that employers and insurers should investigate whether better-designed health plans would promote the use of “high value” services (for example, taking prescription medicines) by cutting the patients’ out-of-pocket costs of these services.

“If a person can keep a chronic condition under control with medication, not only will that produce better health but also fewer expensive hospitalizations,” Royalty said.

Total spending was defined as what the insured family paid in out-of-pocket copayments and/or deductibles plus what the family’s insurance company paid health care providers. The chronic conditions were asthma, cancer, diabetes, anxiety and depression.

Health Insurance Cost & Reform Uncertainty

Posted March 20, 2012 by Megan DiMartino

“Let’s say a company pays $8,000 a head today, and the penalty to drop insurance is $2,000 or $3,000 or a substantial difference. They take the number of employees times that difference, and they generate a pool of money. With that money they say, ‘We want to bolster our 401(k) match, or a profit-sharing plan, or start a variable pay plan where everyone benefits from the company’s success.” For more, click here.

Employee Communication Enhancement & Benefits Administration

Posted March 15, 2012 by Megan DiMartino

Effectively communicating an employee benefits package to potential and current employees is essential to attracting and retaining talented employees. That’s why AP Benefit Advisors creates customized communications packages, developed specifically for each client. Communicating a new employee benefits plan is extremely important, as is addressing issues as they arise throughout the year. Employees need a communications program that is clear, concise, and relevant to their needs and interests.

Benefits plan documents can be very confusing and complex.  The key is to simplify this information and put it in laymen’s terms, greatly increasing the odds that employees will understand their options and make informed decisions. If you’re only providing insurance carrier booklets, you may be missing an opportunity to better communicate your program, especially the features that help control costs. Effective communication is vital if you want to see a return on your group health benefit investments and retain top talent.

AP Benefit Advisors employs a fully-equipped, in-house graphics department, staffed with experienced designers and writers. These designers create visually appealing, easy-to-read employee benefits communication materials that adhere to your corporate branding standards. When employee communications break down, it can cost a company with respect to retention and potential legal fees. The impact on employees can be similarly detrimental. Through clear, concise dissemination of employee benefits programs, companies and employees prosper. As Benjamin Franklin always said, an ounce of prevention is worth a pound of cure.

AHRQ: U.S. healthcare spending highly concentrated

Posted March 12, 2012 by Megan DiMartino

Written by Evan Godt,

One percent of the U.S. population accounted for 22 percent of all healthcare spending in 2009 while the lower spending half of the population accounted for only 2.9 percent, according to a report from the Agency for Healthcare Research and Quality (AHRQ).

A statistical brief on the data released by AHRQ also noted some trends in the numbers. While the concentration of healthcare spending among the top one percent has waned somewhat since the mid-1990s when the top one percent of spenders accounted for 28 percent of healthcare spending in 1996, a large number of healthcare spenders retained their ranking from the previous year. Of the individuals in the top percent of spending for 2008, one-fifth maintained this ranking in 2009; three out of four individuals in the bottom half of spending maintained their ranking.

AHRQ’s report also provided characteristics of those most and least likely to be big healthcare spenders.

“Relative to the overall population, those who remained in the top decile of spenders were more likely to be in fair or poor health, elderly, female, non-Hispanic whites and those with public-only coverage,” wrote the authors. “Those who remained in the bottom half of spenders were more likely to be in excellent health, children and young adults, men, Hispanics and the uninsured.”

Overall, 2.8 percent of the total U.S. population reported poor health in 2009, with another 8 percent reported to be in fair health. The percentages of individuals in the top decile of spenders reporting poor or fair health were 23.9 percent and 29.6 percent, respectively.

Some other notable findings:

  • More than one-fourth of those in the bottom half of spenders for 2008 and 2009 were uninsured.
  • Nearly 60 percent of patients in the top 10 percent of spenders were women.
  • More than 80 percent of patients in the top 10 percent were white.
  • Individuals 65 and older make up 13 percent of the overall population, but account for 43 percent of the top decile of healthcare spending.

Just how much healthcare spending gets an individual into the top group of spenders? The average per capita spending for the top one percent was $90,061, while the top 10 percent accounted for just under $24,000 in per capita expenses. Individuals in the bottom half of the healthcare spending distribution had a mean expenditure of $232.

The total healthcare bill in the U.S. was $1.26 trillion in 2009, according to AHRQ.

“Studies that examine the persistence of high levels of expenditures over time are essential to help discern the factors most likely to drive healthcare spending and the characteristics of the individuals who incur them,” wrote the authors.

How to Cut Health Care Costs and Make Wellness Work

Posted March 6, 2012 by Megan DiMartino

Looking to cut healthcare costs at your organization? Who isn’t?

With obesity rates high and chronic diseases like hypertension and diabetes on the rise, it takes more than just some pamphlets in the break room to improve employees’ wellbeing and see a decrease in related health costs. A recent study sponsored by Wellsteps illustrates the role that various factors play in the behavior change process among individuals.

The data suggests that “awareness and education” are only about 5% effective at instigating a change in lifestyle habits while “policy and environment” typically result in a 40% rate of success in rallying workers to health. The other factors of behavior change, according to the previously mentioned study, include “motivation” (30% successful) and “skills and tools” (25% successful). This data is invaluable when it comes to designing and implementing wellness programs because it helps companies determine how to budget efficiently.

So policy and environment are key. It is important for companies to reward behavior itself, and not merely required healthy activities. If using a wellness portal or reading educational materials is incentivized, employees lack motivation to engage in any activity beyond whatever earns them points (ie money, benefits, perks). If, however, actual weight loss, or minutes of exercise, or hours of sleep are incentivized, an employee is more likely to embrace these healthy habits and incorporate them into their day to day life.

As Rachel Permuth-Levin of Sodexo recently stated in The 2012 Workplace Trends Report: “It’s important to evaluate drivers of success, revenue generation, and operational efficiency” without sacrificing the core values of a company.

Popular Compliance and Group Benefits Blogs

Posted March 1, 2012 by Megan DiMartino

With all that’s been happening in the healthcare and group health insurance industry, from HHS and PPACA to ERISA compliance and FMLA regs, we felt it was time to review and highlight some of the most popular and relevant blogs from recent months.

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