Changes are coming to paid leave. Here’s what employers should know
Many states and local governments are enacting their own paid leave policies, making it difficult for employers to navigate employee paid leave. Read this blog post for what employers should know about the coming changes for paid leave.
A growing number of states and local governments are enacting their own paid leave policies. These new changes can be difficult for employers to navigate if they don’t understand the changes that are happening.
Adding to the confusion among employers, paid sick leave and paid family leave are often used interchangeably, when in fact there are some important distinctions. Paid sick leave is for a shorter time frame than paid family leave and allows eligible employees to care for their own or a family member’s health or preventative care. Paid family leave is more extensive and allows eligible employees to care for their own or a family member’s serious health condition, bond with a new child or to relieve family pressures when someone is called to military service.
The best-known type of employee leave is job-protected leave under the Family Medical Leave Act, where employees can request to take family medical leave for their own or a loved one’s illness, or for military caregiver leave. However, leave under FMLA is unpaid, and in most cases, employees may use available PTO or paid leave time in conjunction with family medical leave.
Rules vary by state, which makes it more difficult for multi-state employers to comply. The following is an overview of some new and changing state and local paid leave laws.
Paid sick leave
The states that currently have paid sick leave laws in place are Arizona, California, Connecticut, Maryland, Massachusetts, New Jersey, Oregon, Rhode Island, Vermont and Washington. There are also numerous local and city laws coming into effect across the country.
In New Jersey, the Paid Sick Leave Act was enacted late last year. It applies to all New Jersey businesses regardless of size; however, public employees, per diem healthcare employees and construction workers employed pursuant to a collective bargaining agreement are exempt. As of February 26, New Jersey employees could begin using accrued leave time, and employees who started after the law was enacted are eligible to begin using accrued leave 120 days after their hire dates.
Michigan’s Paid Medical Leave Act requires employers with 50 or more employees to provide paid leave for personal or family needs as of March.
Under Vermont’s paid sick leave law, this January, the number of paid sick leave hours employees may accrue rose from 24 to 40 hours per year.
In San Antonio, a local paid sick leave ordinance passed last year, but it may not take effect this August. The ordinance mirrors one passed in Austin that has been derailed by legal challenges from the state. Employers in these cities should watch these, closely.
Paid family leave
The five states that currently have paid family leave policies are California, New Jersey, Rhode Island, New York, Washington and the District of Columbia.
New York, Washington and D.C. all have updates coming to their existing legislation, and Massachusetts will launch a new paid family program for employers in that state. In New York, the state’s paid family leave program went into effect in 2018 and included up to eight weeks of paid family leave for covered employees. This year, the paid leave time jumps to 10 weeks. Payroll deductions to fund the program also increased.
Washington’s paid family leave program will begin on January 1, 2020, but withholding for the program started on January 1 of this year. The program will include 12 weeks of paid family leave, 12 weeks of paid medical leave. If employees face multiple events in a year, they may be receive up to 16 weeks, and up to 18 weeks if they experience complications during pregnancy.
The paid family leave program in Massachusetts launches on January 1, 2021, with up to 12 weeks of paid leave to care for a family member or new child, 20 weeks of paid leave for personal medical issues and 26 weeks of leave for an emergency related to a family member’s military deployment. Payroll deductions for the program start on July 1.
The Paid Leave Act of Washington, D.C. will launch next year with eight weeks of parental leave to bond with a new child, six weeks of leave to care for an ill family member with a serious health condition and two weeks of medical leave to care for one’s own serious health condition. On July 1, the district will begin collecting taxes from employers, and paid leave benefits will be administered as of July 1, 2020.
Challenging times ahead
An employer must comply with all state and local sick and family leave laws, and ignorance of a law is not a defense. Employers must navigate different state guidelines and requirements for eligibility no matter how complex, including multi-state employers and companies with employees working remotely in different jurisdictions.
These state paid leave programs are funded by taxes, but employers must cover the costs of managing the work of employees who are out on leave. While generous paid leave policies can help employers attract talent, they simply don’t make sense for all companies. For example, it can be difficult for low-margin businesses to manage their workforces effectively when employees can take an extended paid leave.
Not only must employers ensure compliance with state and local rules, but they also must make sure that their sick time, family and parental leave policies are non-discriminatory and consistent with federal laws and regulations. That’s a lot to administer.
Employers should expect to see the changes in paid sick leave and family leave laws to continue. In the meantime, companies should make sure they have the people and internal processes in place right now to track these changes and ensure compliance across the board.
SOURCE: Starkman, J.; Johnson, D. (2 May 2019) "Changes are coming to paid leave. Here’s what employers should know" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/what-employers-need-to-know-about-changing-paid-leave-laws?brief=00000152-14a7-d1cc-a5fa-7cffccf00000
Getting employees up to speed with health literacy
Do your employees know how much sugar is in a granola bar or how much radiation is in a CT scan? If not, it's most likely because no one is teaching them. Continue reading to learn more on getting your employees up to speed with health literacy.
Your employees probably don’t know how much sugar is in a granola bar or how much radiation is in a CT scan. They may not even know how to reach your employee assistance program.
That’s because no one is teaching them. Which is what happens when wellness program education ends at eat more fruits and vegetables and avoid added sugar.
Sometimes the advice is even wrong. For example, below is a clipping from a popular health risk assessment. Focus on the lower right quadrant.
It isn’t entirely true that low-fat and nonfat dairy is healthier. In fact, full fat dairy does have health benefits, for example some studies suggest it could help protect against diabetes. By comparison, low-fat or nonfat yogurt could be a significant source of sugar.
This is why employee health literacy is so important. With easy access to mis-information, employees need to learn to sift through the noise to determine what is actually good for them.
Plus, there is plenty to learn. Spanning from everyday health, employee medical education and health benefits literacy. I’ve outlined just a few of the ways to employers can better educate their population.
Everyday health education
Sugar is one place where health education could be more impactful — but it should go beyond just telling workers to avoid added sugars. Education starts at work. Chances are your break room is stocked with granola bars, maybe Clif Bars. The first ingredient in a Clif Bar is organic brown rice syrup. That may sound healthy, but it’s really just sugar. In fact, there are almost 60 different sugars disguised with fancy names like turbinado or malted barley extract.
Another example is sleep. We all want employees to get enough of it, but do they know how? They may not know little bits of information that could help them get more shuteye, like there is a night shift setting on their iPhone or that energy-efficient light bulbs contribute to insomnia.
But teaching everyday health is just the beginning of health literacy. The real impact comes with employee medical education.
Employee medical education
U.S. consumers are voracious purchasers of healthcare services and yet our outcomes remain poor. Americans have about 240 CT scans per 1,000 people. To put that in perspective, only about 1 in 1,000 covered people in your employee population was hospitalized for diabetes last year. So 240 times more employees are getting scans than uncontrolled diabetes.
CT scans have risks. They have about 500 times the radiation of an x-ray and are especially concerning for children because their cells are dividing more rapidly than adults and are more sensitive to radiation exposure. The dye used intravenously also carries a risk.
But many employees don’t know about these risks. So it may be important to educate your workforce about these common medical procedures and how to decide whether or not it is right for them.
Health benefit education
Here’s a wild guess: your employees don’t appreciate the health benefits you provide for them. If so, you’ve got company. Most large organizations face the same issue.
Consider the employee assistance program. Do workers know you offer one? Do they know it’s confidential? They know their emails aren’t confidential, so don’t assume they know this. Do they know the URL, username and password? How many free sessions do they get?
Repeat a similar set of questions for all your benefits. You can’t expect that some memos and a website will implant your benefits firmly in their mind.
SOURCE: Lewis, A. (25 April 2019) "Getting employees up to speed with health literacy" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/educating-employees-through-health-literacy
Think your employee is faking sickness? Here’s what you can do
Have your employees misused their FMLA leave before? Navigating FMLA can be tricky, leading to costly lawsuits if a wrong move is taken. Continue reading this blog post to learn more about handling FMLA misuse.
Your employee’s gout flared up, so they took the day off using intermittent medical leave. Later on, a photo of the same employee sliding into home base surfaces on social media that day. How do you find out if the employee was misusing FMLA leave?
Bryon Bass, senior vice president of workforce absence at Sedgwick — a business solution tech company — says navigating FMLA can be tricky, and the wrong move can provoke costly lawsuits. But if an employer has reason to believe the absence isn’t valid, Bass says there’s a process they can follow to investigate.
“I think [a social media photo] casts doubt on the reason for their absence,” Bass said during a recent webinar hosted by the Disability Management Employer Coalition. “It merits a second look, along with some potential code of conduct talks with HR.”
When a questionable situation arises, employers can ask for the worker’s approved medical condition to be recertified, Bass said. This involves having the employee resubmit their original FMLA application. Afterward, employers can send a list of absences to the employee’s healthcare provider to authenticate the dates as valid medical absences. Typically, employers can only request recertification after a 30 day period, unless there’s reason to believe the employee is taking advantage of the system.
“If, for example, you notice two employees — who happen to be dating — are taking off the same days for their different medical conditions, that’s a valid reason for asking for recertification,” Bass said. “Patterns of absence are a common reason to look into it.”
Instead of requesting recertification, some employers make the mistake of contacting the employee’s physician directly — a process called clarification. Employers are only allowed to use clarification during the initial FMLA application, and only after obtaining the employee’s permission. Clarification is used to answer employer questions about the amount of rest an employee’s condition merits.
Employers might not trust the opinion of their employee’s doctor, but they can’t ask for a second opinion until it’s time for the employee to re-submit their annual certification, Bass says. When that time comes, employers can appoint a physician to reexamine the employee at the company’s expense. If the employee objects to the second doctor’s report, a third opinion can be sought.
“With third opinions, both the employer and the employee have to agree on the provider because their decision is final,” Bass said. “Employers are also required to cover this expense.”
Although employers are within their right to file recertification, Bass says it should be done sparingly and in situations where evidence suggests misuse. An employee using slightly more time for recovery isn’t automatically abusing the policy, he said.
“FMLA does not permit healthcare providers to provide an exact schedule of leave, just an estimate of absences necessary for the employee’s treatment and recovery,” Bass said. “Treatments are more predictable, but it’s still only an estimate. If someone takes a little more time than estimated, it doesn’t mean you need to ask for recertification; in fact, the Department of Labor discourages that.”
SOURCE: Webster, K. (24 April 2019) "Think your employee is faking sickness? Here’s what you can do" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/how-to-certify-medical-leave-and-handle-pto-requests?feed=00000152-a2fb-d118-ab57-b3ff6e310000
Adulting’ benefits: Employers’ new solution to burned-out employees
Generation Z and Millennials are expected to make up 50 percent of the workforce by 2020, leading many to believe that “adulting” benefits could be the next big trend in employee benefits. Read this blog post from Employee Benefit News to learn more.
In a time when globetrotting Gen Z and Postmates-loving millennials are expected to make up 50% of the workforce by 2020, could benefits that help with “adulting” be the next big trend?
Adulting is defined as “the practice of behaving in a way characteristic of a responsible adult, especially the accomplishment of mundane but necessary tasks.” Although millennials and Gen Z are well into adulthood, the struggle for them to accomplish day-to-day life management tasks is very real.
Many bemoan feeling busy all the time, tired and even burned out. In her Buzzfeed post, “How millennials became the burnout generation,” author Anne Helen Peterson strikes a chord with her “errand paralysis” reference. Pants going unhemmed for over a year, packages sitting in the corner waiting to be mailed for months, a car that desperately needs vacuuming — all part of a long list of never-ending low-priority, mundane tasks that get chronically avoided, yet still add to mental stress and anxiety.
Peterson blames underlying burnout as the culprit, even calls burnout the “millennial condition” affecting everyone, from the “people patching together a retail job with unpredictable scheduling while driving Uber and arranging child care to the startup workers with fancy catered lunches, free laundry service, and 70-minute commutes.”
So can convenience benefits — such as onsite errand runners — help with this problem?
There’s no denying those benefits might take aim at a big problem: employee stress. According to the American Psychological Association’s annual Stress in America report, members of Gen Z report the worst mental health of any generation. Only 45% of those in Gen Z reported “excellent” or “very good” mental health, compared to 56% of millennials, 51% of Gen X individuals, 70% of baby boomers and 74% of adults older than 73. Additionally, 27% of Gen Z respondents called their mental health “fair” or “poor,” and 91% said they had felt physical or emotional symptoms, such as depression or anxiety, associated with stress.
While employers cannot solve all employee problems, they can go beyond the basics of competitive pay, comprehensive health insurance and career advancement opportunities. Forward-thinking employers can look to new convenience benefits to help simplify the mundane and incessant responsibilities of life, alleviate errand paralysis and give their employees back valuable time to actually live.
For instance, a number of companies—including a major law firm in Atlanta has an onsite errand runner who helps employees do everything from plan exotic vacation getaways, shop for Christmas presents and go on weekly Costco runs. The onsite errand runner is on call all day to take care of employees’ personal tasks so they can focus on work and clients. The reaction has been very positive, with employees saying the service helps them stay focused and physically present at work knowing that other things in their life are being handled capably. An added bonus: It helps employees better achieve work-life balance because errands are not cutting into their home life like it did before.
As more and more companies look to prioritize the employee experience and get creative with nontraditional benefits, it makes sense to consider growing trends in convenience and lifestyle benefits. For instance, providing an errand running benefit to pick up groceries for an employee or drop off that mailing package saves the employee countless hours, not to mention stress, and speaks to the challenges of the modern world.
SOURCE: Clark, A. (8 April 2019) "Adulting’ benefits: Employers’ new solution to burned-out employees" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/employers-address-burnout-through-adulting-employee-benefits
7 ways employers can support employee caregivers
Seventy-three percent of employees in the United States act as caregivers for a child, parent or friend, according to research from Harvard Business School. Continue reading for seven ways employers can support employee caregivers.
The number of caregiving adults in the U.S. has reached a tipping point.
As the baby boomer generation gets older, an increasing number of people in the workforce are taking on the role of unpaid caregiver for a family member or friend. Many also are in the midst of raising their own children, which means they’re pulled in many different directions, trying to keep up with work commitments and family responsibilities. In fact, according to researchers at Harvard Business School, 73% of employees in the U.S. are caring for a child, parent or friend.
What do all these statistics point to? They mean that employers have an opportunity to play a role in helping employees balance these often competing priorities.
The Harvard study highlights the impact of employee caregiving responsibilities on the workplace. While only 24% of employers surveyed believed employee caregiving influenced their employees’ performance at work, 80% of the employees who were surveyed admitted that caregiving had an effect on their productivity at work and interfered with their ability to do their best work.
The survey also found that caregiving can affect employee retention, with 32% of the employees surveyed saying they had left a job because of their caregiving responsibilities. In addition, employees who are caregivers are more likely to miss work, arrive late or leave early, which affects not only productivity, but also the employees’ ability to progress in their careers.
Employers can take a proactive role in supporting employees who are caregivers. That support, in turn, can have a positive effect on productivity, morale and employee retention. Here are seven strategies employers should consider.
Create an organization-wide understanding of the challenges caregivers face.
Employees who aren’t sure that their managers and leaders would understand the juggling they’re doing and the stresses they face are more likely to not only have problems at work, but — because they face high stress levels trying to get everything done at home and work — they also are at higher risk for a number of health problems such as depression and heart disease. By creating a culture that allows employees to openly express their challenges and ask for support, employers can not only keep employees healthy and productive, they also can reduce secondary costs associated with decreased productivity and chronic health problems.
Know what challenges employees face.
Regular employee surveys can help employers assess employees’ needs in terms of caregiving and tailor the benefits the organization offers to help meet those needs.
Communicate the benefits that are available.
In many cases, employers already offer programs and benefits that can help employees who are caregivers such as an employee assistance program and referral services for finding caregivers who can help when the employee isn’t able to. However, many employees aren’t aware these programs are available, so it’s important to continuously share information about them in company newsletters, emails and at meetings.
Consider flex time and remote work options.
Depending on the employees’ work responsibilities, employers can offer flexible work arrangements that allow employees to work different hours or to telecommute for a certain number of days per week.
Change the approach to paid time off.
Rather than dividing paid time off into vacation days, sick days and personal days, consider grouping all time off into one category. That allows employees to take time off for caregiving as needed. A growing number of companies, including Adobe, Deloitte, Bristol-Meyers Squibb and Coca-Cola, are also offering paid family leave benefits so that employees can take time off to provide care.
Connect employees with resources.
Beyond an EAP and referral services, employers can offer programs that connect caregivers with resources for both their caregiving role and for the self-care they need to remain healthy and able to handle both job and caregiving roles better. Those resources can include:
Beyond an EAP and referral services, employers can offer programs that connect caregivers with resources for both their caregiving role and for the self-care they need to remain healthy and able to handle both job and caregiving roles better. Those resources can include:
- Advisory services that help employees connect with healthcare providers for their parents, children and themselves
- Nurse managers, case managers and geriatric care managers who can help employees who are managing the care of a family member who’s living with a serious health condition or disability
- Advocates who can help employees who are dealing with complex insurance claims for the person they care for, planning for long-term care, or managing the legal and financial complexities that can arise when a parent or spouse dies
Internal caregiver resources groups that bring together employees who are dealing with the issues surrounding caregiving so that they can share ideas and experiences
Measure how well your support is working.
The first step to supporting caregivers in the workforce is to implement policies, programs and benefits that offer them the tools they need to balance work and caregiving. An equally important second step is to regularly review what is offered, how much the offerings are used, and by which employees. Ask employees for feedback on how effectively what the organization provides is in helping them with issues they face as working caregivers and solicit ideas for new approaches and tools they’d like to have.
SOURCE: Varn, M. (25 March 2019) "7 ways employers can support employee caregivers" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/7-ways-employers-can-support-employee-caregivers
DOL proposes new rule clarifying, updating regular rate of pay
The Department of Labor (DOL) recently released a proposal that defines and updates what forms of payment employers can include and exclude in the time-and-one-half calculation when determining overtime rates. Read this blog post to learn more.
For the first time in 50 years, the Department of Labor has proposed changing the definition of the regular rate of pay.
The proposal, announced Thursday, “defines and updates” what forms of payment employers include and exclude in the time-and-one-half calculation when determining workers’ overtime rates, according to the DOL.
The regulations the DOL is proposing to revise govern how employers must calculate the regular rate and overtime pay rate, including the types of compensation that must be included and may be excluded from the overtime pay calculation, says Tammy McCutchen, a principal at Littler Mendelson and former administrator of the Department of Labor’s Wage and Hour Division.
The regular rate of pay is not just an employee’s hourly rate, she says, but rather includes “all remuneration for employment” — unless specifically excluded by section 7(e) of the FLSA.
Under current rules, employers are discouraged from offering more perks to their employees as it may be unclear whether those perks must be included in the calculation of an employees’ regular rate of pay, the DOL says. The proposed rule focuses primarily on clarifying whether certain kinds of perks, benefits or other miscellaneous items must be included in the regular rate.
The DOL proposes that employers may exclude the following from an employee’s regular rate of pay:
- The cost of providing wellness programs, onsite specialist treatment, gym access and fitness classes and employee discounts on retail goods and services;
- Payments for unused paid leave, including paid sick leave;
- Reimbursed expenses, even if not incurred solely for the employer’s benefit;
- Reimbursed travel expenses that do not exceed the maximum travel reimbursement permitted under the Federal Travel Regulation System regulations and that satisfy other regulatory requirements;
- Discretionary bonuses;
- Benefit plans, including accident, unemployment, and legal services; and
- Tuition programs, such as reimbursement programs or repayment of educational debt.
The proposed rule also includes additional clarification about other forms of compensation, including payment for meal periods and call back pay.
The regulations will benefit employees, primarily, ensuring that employers can continue to provide benefits that employees’ value — tuition reimbursements, student loan repayment, employee discounts, payout of unused paid leave and gym memberships, McCutchen says.
“Remember, there is no law that employers must provide employees these types of benefits,” she adds. “Employers will not provide such benefits if doing so creates risk of massive overtime liability.”
Knowing when employers must pay overtime on these types of benefits, how to calculate the value of those benefits and overtime pay are all difficult questions, she adds. “Unintentional mistakes by good faith employers providing valued benefits to employees is easy. With this proposed rule, the DOL is embracing the philosophy that good deeds should not be punished.”
She notes the proposal does not include any specific examples of what reimbursements may be excluded from the regular rate.
“One big open question is whether employers must pay overtime when they provide employees with subsidies to take public transportation to work — as the federal government does for many of its own employees — I think around $260 per month in the DC Metro area,” she adds.
The DOL earlier this month proposed to increase the salary threshold for overtime eligibility to $35,308 up from the current $23,660. If finalized, the rule would expand overtime eligibility to more than a million additional U.S. workers, far fewer than an Obama administration rule that was struck down by a federal judge in 2017.
Employers are expected to challenge the new rule as well, based on similar complaints of administrative burdens, but a legal challenge might be more difficult to pass this time around.
SOURCE: Otto, N. (28 March 2019) "DOL proposes new rule clarifying, updating regular rate of pay" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/dol-proposes-new-rule-on-regular-rate-of-pay-calculation?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001
Half of older Americans have nothing in retirement savings
Almost half of Americans approaching retirement have nothing saved in a 401(k) or another individual account, according to the U.S. Government Accountability Office. Read this blog post to learn more.
The bad news is that almost half of Americans approaching retirement have nothing saved in a 401(k) or other individual account. The good news is that the new estimate, from the U.S. Government Accountability Office, is slightly better than a few years earlier.
Of those 55 and older, 48% had nothing put away in a 401(k)-style defined contribution plan or an individual retirement account, according to a GAO estimate for 2016 that was released Tuesday. That’s an improvement from the 52% without retirement money in 2013.
Two in five of such households did have access to a traditional pension, also known as a defined benefit plan. However, 29% of older Americans had neither a pension nor any assets in a 401(k) or IRA account.
The estimate from the GAO, the investigative arm of Congress, is a brief update to a more comprehensive 2015 report on retirement savings in the U.S. Both are based on the Federal Reserve’s Survey of Consumer Finances.
The previous report found the median household of those age 65 to 74 had about $148,000 saved, the equivalent of an inflation-protected annuity of $649 a month.
“Social Security provides most of the income for about half of households age 65 and older,” the GAO said.
The Employee Benefit Research Institute estimated earlier this month that 41% of U.S. households headed by someone age 35 to 64 are likely to run out of money in retirement. That’s down 1.7 percentage points since 2014.
EBRI found these Americans face a combined retirement deficit of $3.83 trillion.
SOURCE: Steverman, B.; Bloomberg News (27 March 2019) "Half of older Americans have nothing in retirement savings" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/half-of-older-americans-have-no-retirement-savings
Understanding Group Health Insurance
Health insurance can easily be defined as bookended in volumes of mystery. You know you need the coverage, you want to have the coverage for your employees, but chances are you simply do not know enough about it to make the first two points happen. For an employer thinking about introducing group health insurance to your employees, it can be unclear why you should provide something that is surrounded with much confusion. In this installment of CenterStage, Kelley Bell, a Group Health Benefits Consultant at SAXON, sheds some light onto the darkness that group health insurance so often casts.
What is Group Health Insurance?
In its most basic definition, group health insurance is a plan that covers all the employees who work for a given company or organization, and it potentially covers their spouses and other dependents. As the individual marketplace continues to change, Kelley noted the “increasingly difficult task of finding desirable plan designs, lower deductibles and doctors and hospitals that are in the network”. “Individuals with marketplace plans have even been told by many doctors and hospitals,” Kelley added, “that they will not accept the ACA plans from the individual marketplace. Here are reasons that considering a group plan makes more sense than leaving your employees at the mercy of the exchange:”
- Group Health Insurance has larger networks of doctors and hospitals.
- Employee premiums can be deducted pre-tax. The premium can be divided among pay periods, allowing them the convenience of paying less in from a total income perspective and allowing the premium to be broken in pieces versus a monthly sum income.
- The employer still selects the health insurance plan(s) to offer, thus choosing an appropriate plan for the staff versus allowing them to choose the “cheapest” that will hurt them financially if they need to pay for the large deductible.
- Employer contributions are tax deductible, allowing the company to save versus paying payroll tax on any compensation provided to the employee in lieu of offering health insurance.
Do I Need Group Health Insurance?
Why should you consider a group health insurance plan? Outfitting your team with health benefits simplifies the process for employees to include regular and urgent doctor visits, hospital stays and medical treatments such as physical therapy.
Health plans are the primary benefit (aside from compensation) individuals seek out when applying for employment. Your overall benefits offerings are crucial to your company or organization’s ability to attract and retain employees. Therefore, why would you not want to offer health coverage as a part of your overall compensation package?
Group health insurance involves assuming the shared risk and shared costs. Kelley defines shared risk as covering a multitude of individuals who are fairly, healthy people. “This can help keep your premium rates lower than individual plans whose rates are based solely on a person’s age and assumed risk versus the sharing of risk over a pooled premium. This relationship creates savings that reward good behavior,” Kelley said. Shared costs mean the premium can be shared between you the employer and employees. Employers have the flexibility of paying varying percentages of the premium, which could reduce the amount the employee pays versus the individual market premiums.
Working alongside a broker such as SAXON is highly recommended for smaller businesses. SAXON specializes in assisting employers with 1 to 50 employees on how to discover and purchase the benefits they need within their budget. SAXON begins each engagement process by listening to you – the employer – to develop and discover the best course of action for your business or organization. We have a proven history of discovering healthcare plans that are vital to the recruitment and retainment of talented employees.
Saxon’s Role When Considering Group Health Insurance
It is important to understand the needs of every client and educate their employees on how to use their healthcare. SAXON values client education and service above all else. We make educating employees a priority and ensure their benefits are understood and easy to use, making them value the relationship they have with you that much more. SAXON represents you, allowing us to secure the best plans and rates for you and your staff, which we review annually.
If you are considering offering group health insurance to your employees, contact Kelley Bell today at (513) 774-5493 or (937) 672-1547 or via email at kbell@gosaxon.com to begin exploring the benefits of adding this superior level of coverage today.
Digital health revolution: What we’ve learned so far
Digital health devices provide personalized feedback to users, helping improve their health. Continue reading this blog post to learn more about the evolving digital health revolution.
The promise of the digital health revolution is tantalizing: a multitude of connected devices providing personalized feedback to help people improve their health. Yet, some recent studies have called into question the effectiveness of these resources.
While still evolving, many compelling use-cases are starting to emerge for digital health, including a set of best practices that can help guide the maturation of this emerging field. In the near future, many people may gain access to individual health records, a modern medical record that curates information from multiple sources, including electronic health records, pharmacies and medical claims, to help support physicians in care delivery through data sharing and evidence-based guidelines.
As these advances become a reality, here are several digital health strategies employers, employees and healthcare innovators should consider.
Micro-behavior change.
Part of the power of digital health is the ability to provide people with actionable information about their health status and behavior patterns. As part of that, some of the most successful digital health programs are demonstrating an ability to encourage daily “micro-behavior change” that, over time, may contribute to improved health outcomes and lower costs. For instance, wearable device walking programs can remind people to move consistently throughout the day, while offering objective metrics showcasing actual activity patterns and, ideally, reinforcing positive habits to support sustained change. Technology that encourages seemingly small healthy habits — each day — can eventually translate to meaningful improvements.
Clinical interventions.
Big data is a buzz word often associated with digital health, but the use of analytics and technology is only meaningful as part of a holistic approach to care. Through programs that incorporate clinical intervention and support by care providers, the true value of digital health can be unlocked to help make meaningful differences in people’s well-being. For instance, new programs are featuring connected asthma inhalers that use wirelessly enabled sensors to track adherence rates, including frequency and dosage, and relay that information to healthcare professionals. Armed with this tangible data, care providers can counsel patients more effectively on following recommended treatments. Rather than simply giving consumers the latest technologies and sending them along, these innovations can be most effective when integrated with a holistic care plan.
Real-time information.
One key advantage of digital resources, such as apps or websites, is the ability to provide real-time information, both to consumers and healthcare professionals. This can help improve how physicians treat people, enabling for more customized recommendations based on personal health histories and a patient’s specific health plan. For instance, new apps are enabling physicians to know which medications are covered by a person’s health plan and recommend lower-cost alternatives (if available) before the patient actually leaves the office. The ability to access real-time information — and act on it — can be crucial in the effort to use technology to empower healthcare providers and patients.
Financial incentives.
Nearly everyone wants to be healthy, but sometimes people need a nudge to take that first step toward wellness. To help drive that engagement, the use of financial incentives is becoming more widespread by employers and health plans, with targeted and structured rewards proving most effective. From using mobile apps and comparison shopping for healthcare services to encouraging expectant women to use a website to follow recommended prenatal and post-partum appointments, financial incentives can range from nominal amounts (such as gift cards) to hundreds of dollars per year. Coupling digital health resources with financial rewards can be an important step in getting — and keeping — people engaged.
The digital health market will continue to grow, with some studies estimating that the industry will exceed $379 billion by 2024. To make the most of these resources, healthcare innovators will be well served to take note of these initial concepts.
SOURCE: Madsen, R. (14 March 2019) "Digital health revolution: What we’ve learned so far" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/digital-health-revolution-what-weve-learned-so-far?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001
What HR pros should know about clinical guidelines
Sets of science-based recommendations, also known as clinical guidelines, are designed to optimize patient care in areas such as screening and testing, diagnosis and treatment. Read this blog post for what HR professionals should know about these guidelines.
Your employees and their family members frequently face tough questions about their healthcare: How do I know when it’s time to get a mammogram? When does my child need a vision screening? Should I get a thyroid screening? If I have high blood pressure or diabetes, what is the best treatment for me?
For the providers who care for them, the key question is: How do we implement appropriate, science-backed treatments for our patients, testing where needed, but avoiding potentially harmful or unnecessary (and expensive) care? The answer is to seek guidance from and use clinical guidelines —along with existing clinical skills — wisely.
Clinical guidelines are sets of science-based recommendations, designed to optimize care for patients in areas such as screening and testing, diagnosis and treatment. They are developed after a critical review by experts of current scientific data and additional evidence to help inform clinical decisions across a spectrum of specialties.
Based upon this process, guidelines are then released by a number of sources and collaborations, including academic and non-profit healthcare entities, government organizations and medical specialty organizations.
From preventive care to treatment protocols for chronic conditions, guidelines provide a framework healthcare providers use with patients to help guide care. However, it’s important to note that clinical guidelines are not rigid substitutes for professional judgment, and not all patient care can be encompassed within guidelines.
The impact on healthcare and benefits
Clinical guidelines are used in myriad ways across the healthcare spectrum, and providers are not the only ones who utilize them. Insurers also may use guidelines to develop coverage policies for specific procedures, services and treatment, which can affect the care your covered population receives.
To illustrate a key example of an intended impact of guidelines on health plan coverage, consider those issued by the U.S. Preventive Services Task Force, whose A and B level recommendations comprise the preventive services now covered at no cost under the mandate of the Affordable Care Act.
As another example, the National Committee for Quality Assurance, which accredits health plans and improves the quality of care through its evidence-based measures, uses the American Heart Association guidelines when creating its quality rules for treating high cholesterol with statin drugs.
Other examples exist among commercial coverage policies. For example, some cancer drug reimbursement policies use components from nationally recognized guidelines for cancer care.
Because science is rapidly changing, guidelines are often updated, leading insurers to revisit their policies to decide if they will change how services and medications are covered for their members. Providers and health systems may modify processes of patient care in response to major changes in guidelines and/or resultant changes in payer reimbursement.
Not all guidelines are updated on a set schedule, making it even more important for providers and organizations that rely on guidelines to stay on top of changing information, as it can have a direct impact on how they work. Attending conferences, visiting the recently established ECRI Guidelines Trust, and regularly reviewing relevant professional association websites and journals can help ensure needed guidelines are current. Lack of current information can affect care decisions and potential outcomes for patients. Those who have access to the most up-to-date, evidence-based information are able to work together to make well-informed healthcare decisions.
Why it matters for employers
As employers or benefits consultants, it’s critical to ensure that your health plan, advocacy or decision support providers, and other partners that depend on this information to guide their practices and decisions understand and follow current, relevant guidelines.
Further, by combining information from relevant guidelines and data from biometric screenings, health risk assessments, claims and other sources, it’s possible for clinical advocacy and other decision support providers to identify employees with gaps in care and generate targeted communications (through a member website and/or mobile app) to help them take action to improve their health.
Clinical guidelines are science distilled into practical recommendations meant to be applied to most patients for quality healthcare. By maintaining current, relevant guidelines, organizations and providers who work with your covered population can ensure that all parties have the key information they need to make the best decisions for their health.
SOURCE: Sivalingam, J. (18 March 2019) "What HR pros should know about clinical guidelines" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/what-hr-managers-should-know-about-clinical-guidelines?feed=00000152-a2fb-d118-ab57-b3ff6e310000