Oklahoma Disaster Relief and Information
Our hearts go out to those experiencing loss and devastation in the aftermath of Monday's monstrous tornado. We encourage our community to participate in the relief efforts to help these communities recover and rebuild in any way that they can. In order to help you find a way to donate or get involved, we have outlined recognized sources getting aid to the areas in desperate need. These organizations and their contact information are as follows:
Employers getting pushy in drive to better health
Original article from benefitspro.com
By Allen Greenberg
Short of bribery and potentially violating anti-discrimination laws by not hiring obese smokers, there’s little employers can do to improve the health of their workforce.
Or is there?
What looks to be a growing number of employers are, in fact, embracing outcomes-based disincentives to prod employees to achieve specific health outcomes, rather than merely enroll in their wellness programs.
Off the bat, I know that sounds like Big Brother. But I also think it sounds like a constructive and fairly non-intrusive way for employers to try to regain some control in the losing battle to reign in health care costs.
The Midwest Business Group of Health, a Chicago-based nonprofit group with more than 120 large, self-insured public and private employers, dug into this question in one of its latest surveys and came up with some interesting findings about the carrots and sticks employers rely on.
Let’s start with what everyone enjoys.
Among employers offering incentives, 62 percent report they offer employees who follow their wellness programs reduced premiums. Another 38 percent use gift cards and 35 percent offer merchandise.
Not bad. Put down the Hershey’s Kisses between meals and get a nicely loaded Starbucks gift card at the end of the month.
Actually, in a lot of instances, we’re talking about something of much greater value. Twenty-two percent of the companies in the survey reported their incentives were worth $500-$1,000.
Seventy-one percent of the surveyed companies said they found their incentive strategy was “very successful” or “successful.”
So, how about the stick?
More than 37 percent said they have begun to rely on penalties in response to nonparticipation in their wellness rewards. Increased health care premiums and coverage plan limitations are among the more common sticks.
This is a new trend, to be sure, so there’s some measure of experimentation going on and certainly room for improvement. Just 45 percent of those surveyed viewed their disincentive strategy as “very successful” or “successful.”
That shouldn’t be taken to mean we won’t see more of this. As Cheryl Larson, vice president for the Midwest Business Group on Health, will tell you, employers are fairly desperate nowadays to find ways to save health care dollars.
Which is why more than 40 percent of those surveyed now expect their employees to kick in a higher share of their plan premiums if they don’t stay on track with the company’s wellness programs, while another 16 percent are considering doing so.
Wellness programs have been around for decades, but there’s still a lot for HR managers to learn about what works and what doesn’t, and there's naturally going to be squeamishness about pulling out disincentives.
One key lesson shared by an employer cited in the MBGH survey:
“Even though our employees were not happy about the implementation of the program, we have a very compliant population. We know they complain about it, but they end up participating to take advantage of the incentives.”
In other words, yes, incentives, are always going to be popular. But if they don’t work, you might try throwing a few disincentives into the mix, rather than tossing away millions more in benefits dollars.
Employers’ confidence in health plans rising
Original article from ebn.benefitnews.com
By Tristan Lejeune
The vast majority of employers are actively developing tactics to work within the Affordable Care Act and companies’ confidence in employer-sponsored health care is up. These are among the results of the International Foundation of Employee Benefit Plans’ 2013 survey, released ahead of the group’s Washington Legislative Update conference, held today and tomorrow.
Only 10% of employers are still in a “wait-and-see mode” regarding health care reform regulations, according to the survey 2013 Employer-Sponsored Health Care: ACA’s Impact; the rest are busy taking steps to deal with reform’s rules and regulations.
Sixty-nine percent of employers tell the IFEBP that they definitely plan to provide employer-sponsored health care when exchanges begin in 2014; in 2012, only 46% of companies were willing to commit to that. An additional 25% say they are very likely to continue the offering.
Changes, however, are coming. Eighteen percent of employers have increased plan participants’ share of premiums, and a quarter plans to do so over the next year. Of those making changes, 25% are upping their emphasis on high-deductible health plans and health savings accounts, and 14% are assessing the feasibility of adding one.
“Employers across the country have to deal with the impact of implementing the ACA while still being able to provide competitive benefits for their employees,” says Julie Stich, research director for the IFEBP. “Employees across the board can expect to see changes in how their employer-sponsored health care plans operate.”
Benefits leaders are also doing more to spur healthy behavior: 19% are either developing an organized wellness program, or expanding an existing one. Fourteen percent of respondents are either adopting or expanding healthy-lifestyle financial incentives, and another 25% plan to do so in the next year.
“We are seeing trends that indicate more changes may be on the horizon. More and more organizations are losing their grandfathered status, dropping from 45% in 2011 to 27% in 2013,” says Stich. “Also many organizations are redesigning their plans to avoid the 2018 excise tax on high-cost or so called ‘Cadillac plans.’ In 2011, only one-in-ten indicated they were redesigning their plan to avoid the additional tax, but we’ve seen a steady increase over the past two years that shows the number will soon double.”
CBO lowers health reform 'Cadillac' tax, employer penalty estimates
Original article from businessinsurance.com
By Matt Dunning
The Congressional Budget Office has nearly halved the revenue it expects the federal government to collect from employers through the health care reform law's so-called “Cadillac tax.”
Excise taxes on employers' high-premium insurance plans are expected to generate about $80 billion over the next 10 years, the CBO said Tuesday in a report updating its federal budget projections for fiscal years 2013-2023.
The revised estimate is a nearly 42% decrease from the $137 billion in excise tax revenue that the CBO projected in February.
Beginning in 2018 under the Patient Protection and Affordable Care Act, the Internal Revenue Service will impose a 40% excise tax on employer-sponsored health benefits that cost more than $10,200 for individual coverage and $27,500 for family coverage.
In its report, the CBO said it reduced its estimate on excise tax revenue after examining recent cost trends in employer-sponsored health benefits.
“As a result, we now expect fewer employment-based plans to be subject to the excise tax on high-premium insurance plans and, consequently, have reduced our estimate of revenues from that tax by $58 billion over the 10-year period,” according to the agency's report.
Employer mandate
The CBO also lowered its projections for revenue collected through penalties included in the health care reform law's employer mandate. Under the law, employers with more than 50 full-time workers — defined as employees working 30 hours or more per week — will be required to offer qualified, affordable group health benefit plans to their employees beginning in 2014.
Failure to meet those requirements will result in a $2,000-per-employee tax penalty if an employer's health care plans are not offered to at least 95% of full-time employees and just one full-time employee uses a premium subsidy to purchase coverage offered through a state- or federally-facilitated health insurance exchange.
The CBO projects the federal government will collect about $140 billion from the employer mandate penalties for the 10-year period, down from the $150 billion it projected in February.
The agency said the revision is due mainly to refinements in the IRS' calculation of households' estimated marginal tax rates, which led to a slight increase in the number of the individuals predicted to be enrolled in an employment-based health plan.
However, the CBO also said the projected net decline in the number of lives enrolled in employer-sponsored plans largely offset those gains.
“That slight increase in projected employment-based coverage increases the estimated loss of government revenues from the exclusion from taxation of employers' payments of health insurance premiums for their employees,” the CBO said in the report.
Prepare Your Employees for Virtual Training?
Original article from https://safetydailyadvisor.blr.com
Virtual training is an effective new way to train … as long as learners are ready to engage with the new training environment. Today's Advisor presents part one of a two-part series in which we hear from one expert on virtual learning.
When making the move to virtual training, "we, as trainers, often get caught up with what we need to do to prepare," says Cindy Huggett, training consultant and author of Virtual Training Basics (www.cindyhuggett.com).
However, it is important to keep in mind that while virtual training is a new way for trainers to train, it is "a new way for learners to learn as well." As a result, trainers need to prepare learners to thrive in a virtual training environment.
In an article for our sister publication, Training Forum, Huggett offers three suggestions to help ensure that virtual training will be effective.
- "Define what you mean by virtual training. There are so many different definitions out there."
- "Be very purposeful about your design," she says. "What are the learning objectives, and what is the best way to accomplish them?"
- Make sure learners are familiar with the technology before training begins; that they understand "what learning online is going to be like"; and that they know how to minimize distractions.
"I'm a big fan of having a kickoff session," that is, a 20- to 30-minute prerequisite session to be completed before training actually begins, Huggett says. That helps familiarize learners with the content and the technology (e.g., learning how to submit questions, respond to poll questions). If they are new to the technology, they will experience what it is like to be in an online class."
She also suggests giving learners tips in advance to minimize disruptions during training, such as going to a reserved conference room alone to participate in the training. A checklist can be an effective tool, as well; and that can be as simple as instructing learners to set their phone to "do not disturb," turn their daily to-do list face down on their desk, and hang a “do not disturb” sign on their office door and ask them to enforce it, she says.
Why It Matters
- As more and more Americans get into social media, they will become more open to learning in a social media environment at work.
- As the economy continues to sputter, your employer may have less money to devote to training—and virtual training is inherently less expensive than face-to- face training.
- As younger generations, who've grown up with social media and mobile technologies, move into your workforce, you'll be ready to train them in formats they know well.
Putting the 'cent' in incentives
Original article https://ebn.benefitnews.com
By Kathleen Koster
In addition to popular incentives for participating in wellness program activities, employers and insurance carriers have turned to outcomes-based incentives hoping to lower plan costs and improve population health. While laws such as HIPAA, ERISA and, most recently, PPACA provide guidance for incentivizing employees to improve body metrics and sustain healthy behaviors, plan sponsors should tread cautiously around more aggressive incentives and premium surcharge strategies.
Employers' focus on rewarding healthy results "has been fueled by regulation," says Eric Herbek, vice president for consumer health product at Cigna. Specifically, the health care reform law increased the percentage employers can award as an incentive or disincentive from 20% of the individual health premium to 30% and up to a 50% differential if they include a smoking metric.
Activity-based incentives can spur participants to complete a health risk assessment or biometric screening, self-report physical activity, or join a pregnancy class or other program that requires action, but not necessarily achieve outcomes. "These can be highly effective tools to tailor action and identify risk for the individual and make a plan for a healthier lifestyle, but doesn't necessarily translate into financial results," says Herbek.
That's why the wellness industry is moving toward an outcomes-based incentive model that measures health outcomes such as tobacco use, BMI, cholesterol, blood pressure or blood glucose levels. Penalizing smoking is most popular among wellness programs, with many employers applying a premium surcharge against smokers. But employers can reward or apply a penalty for each metric. According to Frank Hone, managing director of Healthcentric Partners, Inc., many employers are considering structuring incentives as a tiered health plan, similar to the auto insurance market.
In terms of implementation, Hone suggests determining how a wellness incentive structure fits in with the employer's overall human capital approach and company culture. Another factor is whether the employer is more paternalistic or leans toward a model of accountability based on the insurance plan selected. A value-based plan or consumer-driven health plan would have accountability built into the overall structure. For example, employees could earn additional contributions into their health savings accounts by participating in a health coaching series or achieving a health goal.
"The employer wants to fund some aspect of the HSA, but also wants to ensure that there's skin in the game by the participant" so that they take action, adds Hone.
To keep incentive structures compliant with health laws and regulations, employers should give all participants an equal opportunity to earn the reward and not design specific incentives for any particular segment. Legal experts recommend having an alternative available to help individuals achieve their goals and for those unable to reach a goal. For example, they advise employers with premium surcharges for smokers to offer smoking-cessation programs and tools through their wellness program. For BMI goals, employers should consider offering employees with penalized BMIs a chance to enroll in a weight loss program or to make improvements to earn the premium discount.
To comply with HIPAA nondiscrimination requirements, the employer doesn't need to know the alternatives if an employee can't reasonably achieve a lower BMI, for instance, but they should clearly state in their plan document and notices outlining the wellness program that such alternatives exist. They can determine the alternative standard, if an employee asks for an alternative, with possible input from their individual's doctor, suggests Tiffany Downs, a partner with FordHarrison LLP.
"Our view is that employers don't have to offer a weight management program as an alternative, but we advise that employers with an outcome-based incentive program offer some form of alternative for participants who don't meet the optimal rates as a cultural shift [takes place]," advises Herbek. He suggests employers take a tempered approach and don't move from zero incentives to a rigid incentive approach immediately.
Downs recommends employers implement wellness incentives as part of a group health plan to avoid litigation under discrimination of employment laws. She adds that employers should pay attention to state laws because some states allow for smokers' rights.
The number one red flag she sees is prohibiting individuals from enrolling into a health plan until they lower their BMI or achieve another health outcome, which could violate HIPAA's discrimination rule.
To avoid penalties, she suggests that "the more aggressive the wellness program, the more cautious the employer should be before implementing it and getting legal counsel before applying incentives."
Cigna's Herbek believes the next stage in incentive programs will be making metric reporting easier to monitor. Instead of self-reporting data or measuring health status in a lab, self-monitoring devices that are objective will measure the individual's health.
Precise health testing by the participant will follow what auto insurance companies have started. The Progressive Snapshot program reports the speed of driving, through remote monitoring plugged into the car, and drivers can earn great rates if they drive safely.
Cigna already has teamed up with BodyMedia to measure health and fitness aspects with wearable devices. Eventually, these "can be used as a reinforcement mechanism to help people achieve healthy goals," he says, adding that Cigna professionals are looking at how to apply results to a premium incentive plan.
Hone believes that as employers look to address stress and emotional health in the workplace, they will need to move away from incentives that typically work as a stick for physical improvements.
"I'm hopeful that as an industry we can move away from these pay- for-performance ideas for individuals towards a tiered insurance plan structure that will educate individuals and guide them toward better lifestyles," Hone says.
"We're missing the big picture: the strategy of promoting healthy living. The industry has fallen into the trap of paying people to change their behavior instead of really investing in education, information, motivation and other aspects that influence and give individuals the personal reasons why they should behave differently, adjust their lifestyle or be happier."
He believes that incentives do play a role in promoting better health, but are best delivered in the context of a tiered health plan. Participants who pay more for premiums will be the same demographic that utilizes the health system at a higher rate because of the behavior they've chosen, not a genetic condition.
Employers report increased use of health incentives
A pair of recently released surveys from Aon Hewitt indicate that employers are increasingly turning to incentives to drive health programs and get employees to take actions to improve their well being. Eighty-three percent of 800 American employers use some form of incentive to get employees more aware of their health status, the consulting firm finds.
Out of the 83% that uses incentives, 79% offer rewards, 5% offer consequences, and 16% offer a mix of both. In terms of dollar amounts, 64% use monetary incentives of between $50 and $500, and 18% use incentives of more than $500.
"Employers recognize the first step in getting people on a path to good health is providing employees and their families with the opportunity to become informed and educated about their health risks and the modifiable behaviors that cause those risks," says Jim Winkler, chief innovation officer for health and benefits at Aon Hewitt.
"HRQs and biometric screenings are the key tools in providing that important information and serve as the foundation that links behaviors to action. Motivating people to participate through the use of incentives is a best practice in the industry, and these strategies will continue to be a critical part of employers' health care strategies in the future."
A separate Aon Hewitt survey - conducted in partnership with the National Business Group on Health and the Futures Company - reports that 86% of employees who received suggested action steps based on their HRQ results took some action.
Further, more than half of employers who offered incentives saw improved health behaviors and/or an increase in employee engagement.
Of those employers who offer incentives, 24% say they offer them for progress toward, or attainment of ,acceptable ranges for biometric measures such as blood pressure, body mass index, blood sugar and cholesterol.
More than two-thirds say they are considering this approach in the next three to five years. Fifty-eight percent are planning, in the next few years, to impose consequences on participants who do not take appropriate actions for improving their health. -Tristan Lejeune
Who calls EAP resource lines for assistance and why
Original article https://ebn.benefitnews.com
Employees seek advice from EAP/work-life resource hot lines for myriad reasons ranging from professional and financial concerns to help with mental health issues and substance abuse problems. To give employers a better understanding of the issues their employees face and who is likeliest to make use of employee assistance program benefits, ComPsych Corporation, which fields millions of calls annually, recently analyzed gender, age and industry differences in millions of EAP/work-life calls over a 12-month period.
EAP calls analyzed by industry
Employees’ reasons for calling differed by industry, with EAP call volume suggesting construction industry workers are more prone to alcohol and chemical dependency issues, and work-life call volume suggesting that lower-income employees and hourly wage earners are more likely to need information related to government services.
EAP calls by gender
Though women callers still outnumber men (61% versus 39%), the percentage of men accessing EAP and work-life services has gradually but steadily risen from 35% 10 years ago. Though fewer men call assistance lines, more men called for help with relationship issues (22%) than women (18%). Further, men were almost five times as likely to call about alcohol and chemical dependency issues.
EAP calls by age
Younger individuals placed the highest percentage of calls for psychological reasons, and 20-somethings led the way in alcohol and chemical dependency calls. Not surprisingly, employees in 30s and 40s had the highest percentage of relationship calls. Yet, occupational-related calls — manager referrals for poor performance, absenteeism or interpersonal problems — increased in frequency according to age, with employees in their 50s and 60s placing the most calls.
Overall work-life calls
Requests for moving information and resources was the top reason for work-life calls for the second year in a row, perhaps reflecting changes in the economy and housing market that raise challenges for financially stressed individuals. After moving information, work-life callers most often sought help with child care, elder care or government services.
New OSHA code employers should know
Original article https://eba.benefitnews.com
By Martha J. Zackin
A spike in reports of temporary workers suffering fatal injuries on the job has spurred a new initiative to protect them. On April 29, the U.S. Department of Labor's Occupational Safety and Health Administration announced an initiative to protect temporary employees from workplace hazards. The initiative, announced through a press release and a memorandum sent to all of OSHA’s regional administrators, directs field inspectors to assess whether employers who use temporary workers are complying with their responsibilities under the OSH Act.
Inspectors will use a newly created code in their information system to denote when temporary workers are exposed to safety and health violations. Additionally, they will assess whether temporary workers received required training in a language and vocabulary they understand.
In many cases of recent injuries of temporary workers, OSHA reports, the employer failed to provide safety training or, if some instruction was given, it inadequately addressed the hazard, and this failure contributed to their death.
OSHA field inspectors are now directed to determine, within the scope of their inspections, whether any employees are temporary workers and whether any of the identified temporary employees are exposed to a volatile condition. In addition, inspectors are directed to assess — using both records review and interviews — whether those workers have received required training in a language and vocabulary they understand. A new OIS code has been established to identify temporary workers. In addition, field inspectors are directed to identify the workers’ staffing company, the company’s location, and the supervising structure under which the temporary workers are reporting (i.e., the extent to which the temporary workers are being supervised on a day-to-day basis either by the staffing client or the staffing agency).
OSHA has also begun working with the American Staffing Association and employers that use staffing agencies to promote best practices ensuring that temporary workers are protected from job hazards.
Both staffing firms and companies that use temporary workers are required to provide safe workplaces, as well as necessary safety and health training regarding workplace hazards. Although allocation of safety-related duties and responsibilities should be clearly spelled out in contracts between staffing firms and client companies, both entities may be held liable by OSHA and the courts. Please consult your employment counsel and OSHA consultants for further information and assistance.
Medicaid expansion could spell trouble for patients
Original article https://www.benefitspro.com
By Kathryn Mayer
Medicaid is poised to expand in a big way — thanks to the Patient Protection and Affordable Care Act — but just who is going to treat those new patients?
That’s the major flaw of Medicaid expansion, according to new analysis from HealthPocket, a website that compares and ranks health plans.
HealthPocket’s research found that physicians across the board report low acceptance rates for Medicaid patients — and physician assistants and nurse practitioners are unlikely to fill the gap, raising the question of whether Medicaid expansion will simply leave more Americans insured but with no one to go to for their care.
Only 43 percent of doctors report that they currently accept Medicaid patients. At the same time, physician assistants and nurse practitioners — viewed by many as a potential solution to the primary care physician shortage — report that only 20 percent of them accept Medicaid.
Results of HealthPocket’s study were based on data from National Provider Identifier registry which included information self-reported by more than 1 million health care providers.
“Ensuring there are sufficient health care providers available to the newly insured — even those with private insurance — is a major public health challenge right now,” Kev Coleman, head of research and data at HealthPocket, said in a statement. “But if the current Medicaid acceptance rates hold true for 2014, timely access to care for those relying on Medicaid is likely to become more difficult as enrollees increase for an already inadequate pool of doctors.”
Historically, Medicaid payments to doctors have been lower than payments from both private insurance and Medicare despite being for the same service. According to the Kaiser Family Foundation, Medicaid pays doctors only 66 percent of the amount Medicare pays for the same service.
PPACA includes provisions to raise reimbursements rates of Medicaid compared to Medicare and other plans, but those have not fully been implemented and offer only a temporary two-year increase.
Previous reports also have found that physicians are hesitant to accept Medicaid patients, but HealthPocket’s survey is different because it also examines Medicaid acceptance rates for PAs and NPs, potentially signaling a greater problem than initially thought.
That’s already on top of a continuing — and growing — doctor shortage. The Association of American Medical Colleges predicts there will be a shortage of 90,000 doctors by 2020, half of whom are primary care physicians. The influx of new patients under PPACA will have profound implications for patient access to medical care, doctor groups have warned.
Many states have been struggling with whether not to expand Medicaid, the government health insurance program for the poor, despite the fact that the federal government will pay the full cost of the new enrollees for three years, and much of the costs thereafter, under health reform. Though the administration had intended for the expansion to be mandatory, the Supreme Court ruled last year that states could opt out, leading many Republican governors to do so.
A recent Gallup report also signaled challenges and costs ahead for an expanded Medicaid program: The research found that Medicaid patients are significantly worse health than those with employer-sponsored coverage.
A third of Medicaid patients are obese, while another 22 percent are being treated for depression and 24 percent are being treated for high blood pressure, according to the latest Gallup-Healthways Well Being Index. Medicaid patients are also more likely suffer from diabetes and asthma.
Some researchers worry that those who most need treatment simply won’t be able to access it.
“No matter if you live in a city with a high or low average income, finding a Medicaid provider is a challenge,” Coleman said. “New Medicaid enrollees are going to have to do some digging to make sure they can find a doctor or another type of practitioner willing to see them and accept these reimbursement rates.”
Saxon named a finalist in the 2013 Small Business Excellence Awards
We are honored and excited to be named a finalist in the 2013 Small Business Excellence Awards run by Cincinnati USA Regional Chamber.
Small businesses play an important role in our community with contribution to economic and social well-being. Each small business serves the economic growth of our region through creating local jobs, hiring new workers, creating innovative products and services that improve our area and make us more competitive in the global market. It is such an honor to be recognized for the efforts we have made as well as be ranked among other such small businesses.
The winner's for the 2013 Awards will be announced on Thursday, May 16, 2013, 11 a.m.-1:30 p.m., at the Millennium Hotel in downtown Cincinnati. We would love to see you there.
To attend register with Cincinnati USA: