CenterStage: Help Us Fill The Truck!
For this month’s CenterStage, we’ve decided to do something a little different. Due to the holiday season being in full-swing, we wanted to spread the love and joy that fills our hearts this time of year by sharing with you our involvement with Fill the Truck as a sponsor.
"One of the best parts of Fill the Truck is being there to deliver the donated goods to our awesome charities. The expressions on their faces and their gratitude, makes all of the hard work and extra efforts worth every second."
-Kelly Ackerman, Sales Operations Director at Frames USA
Our Part & Yours
Saxon invites our local community to come together in donating things like personal care items, toilet paper, winter clothing and bedding to fill up boxes. These items allow us a chance to give back directly to our local community. Then, we load the boxes up onto the truck, overjoyed with the sensation of giving back to those in need.
The truck delivers to all charities involved – such as The Healing Center, who offers practical, social and spiritual support to individuals and families, and the Children’s Home of Northern Kentucky, who focuses on providing a better life for abused, neglected and at-risk children – around the 21st of December, and every donated dollar goes toward buying needed items with no administrative costs.
A Brief Fill the Truck History Lesson
Fill the Truck began when the CEO of Frame USA, Dan Regenold, envisioned filling a 54-foot semi-truck full of supplies for a local charity. His idea flourished into a full-blown charitable operation, including a team of packers, donation collectors, marketing & PR professionals and more.
This year, the 2017 vision is to fill multiple trucks and provide substantial donations to each charity, partnering with several businesses and corporate partners, including Saxon.
You can read the full Fill the Truck history here.
Donate Today
Are you ready to take action and join Saxon for this charitable Community Strong event? Donations can be dropped off directly to Saxon’s local office or any one of the participating locations. Unsure of what to donate? Monetary donations are accepted and will be used to purchase items to help finish Filling the Truck. Happy holidays from Saxon and we look forward to “Filling the Truck”!
Download the PDF
Do I Really Need Life Insurance?
At Saxon, we care greatly about others taking responsibility for their livelihood by applying for and obtaining life insurance. If you're not quite convinced you need to speak with one of our life insurance specialists, then take a glance at this article. Life insurance can help anyone - from single millennials to adults with mouths to feed. Don't let money or excuses keep you from protecting everything you've worked so hard for.
Let’s face it. Most people put off buying life insurance for any number of reasons—if they even understand it. Take a look at this list—do any of them sound like you?
1. It’s too expensive. In the ever-burgeoning budget of a young family, things like day care and car payments and possibly student loans eat up a good chunk of the money each month, and a lot of people think that life insurance is just outside those “necessities” when money’s tight. Life insurance is often not nearly as expensive as you might think, especially when you can get a good policy for less than the cost of a daily cup of coffee at the local café. If money’s tight now, what if something happens to you? Here’s more information about the true cost of life insurance.
2. That’s that stuff for babies and old people, right? People of a certain age remember Ed McMahon telling them their grandparents couldn’t be turned down for any reason and figure that’s the target demographic for life insurance. You might have been offered a small permanent insurance policy for your newborn, attractively presented with a cherubic infant on the envelope. The truth of the matter is that these are very specific insurance products—just as there are many insurance products for adults in their working years.
3. I’m strong and healthy! You eat right, you stay active, and everyone admires how grounded and centered you are. You passed your last physical with flying colors! That’s GREAT! But you’re neither immortal nor indestructible. It’s not even that something could happen to you—though it could—so much as when you’re at your strongest and healthiest, there’s no better time to get a policy to protect your loved ones. If you fall seriously ill or suffer significant injury later, it will make it tough to get that kind of policy, if any at all.
4. I have life insurance through my job. Many people are offered life insurance as part of their employee benefit coverage –and often, it’s the first time they encounter life insurance and have no idea that a $50,000 policy, or one or two times their salary, isn’t as much as they think it is. It sounds like a lot of money (and it is!), until you figure that it has to cover some or all the expenses for your loved ones in your absence. Plus, if you leave the job, it’s typically the type of insurance that doesn’t “move on” with you.
5. I don’t have kids. Sure, kids are a big reason why some people get life insurance, but that’s not the only reason for needing protection. If there is anyone in your life who would suffer financially from your loss—your spouse or live-in partner, a sibling, even your parents—a life insurance policy goes a long way in making sure everyone’s still OK even if something happens to you.
6. Life insurance—it’s on my list … eventually. There’s no deadline on life insurance, no mandate from the government on purchasing it. Your parents may have never talked to you about its importance, and it’s certainly not the most invigorating topic for conversation. But don’t let your “eventually” turn into your loved ones’ “if only.”
Don't wait to protect your livelihood. Have a chat with a specialist at Saxon Financial today by visiting this link.
Learn about the different types of life insurance here.
You can read the original article here.
Source:
Life Happens (n.d.). "Do I Really Need Life Insurance?" [Web blog post]. Retrieved from address https://www.lifehappens.org/insurance-overview/life-insurance/who-needs-life-insurance-reasons-dont-buy/
New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women
You can read the original article here.
Source:
Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/
The Trump Administration has issued new regulations that significantly broaden employers’ ability to be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement. The regulation opens the door for any employer or college/ university with a student health plan with objections to contraceptive coverage based on religious beliefs to qualify for an exemption. Any nonprofit or closely-held for-profit employer with moral objections to contraceptive coverage also qualifies for an exemption. Their female employees, dependents and students will no longer be entitled to coverage for the full range of FDA approved contraceptives at no cost.
On October 6, 2017, the Trump Administration issued two new regulations greatly expanding the types of employers that may be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement. These regulations are a significant departure from the Obama-era regulations that only granted an exception to houses of worship. One of the regulations allows nonprofits or for-profit employer with an objection to contraceptive coverage based on religious beliefs to qualify for an exemption and drop contraceptive coverage from their plans. The other regulation also exempts all but publicly traded employers with moral objections to contraception from rule. These new policies, effective immediately, also apply to private institutions of higher education that issue student health plans. The immediate impact of these regulations on the number of women who are eligible for contraceptive coverage is unknown, but the new regulations open the door for many more employers to withhold contraceptive coverage from their plans.
Contraceptive coverage under the ACA has made access to the full range of contraceptive methods affordable to millions of women. This provision is part of a set of key preventive services that has been identified by the Health Resources and Services Administration (HRSA) for women that must be covered without cost-sharing. Since it was first issued in 2012, the contraceptive coverage provision has been controversial. While very popular with the public, with over 77% of women and 64% of men reporting support for no-cost contraceptive coverage, it has been the focus of litigation brought by religious employers, with two cases (Zubik v Burwell and Burwell v Hobby Lobby) reaching the Supreme Court. This brief explains the contraceptive coverage rule under the ACA, the impact it has had on coverage, and how the new regulations issued by the Trump Administration change the contraceptive coverage requirement for employers and affect women’s coverage.
How do the new regulations change contraceptive coverage requirements for employers?
Since they were announced in 2011, the contraceptive coverage rules have evolved through litigation and new regulations. Most employers were required to include the coverage in their plans. Houses of worship could choose to be exempt from the requirement if they had religious objections. This exception meant that women workers and female dependents of exempt employers did not have guaranteed coverage for either some or all FDA approved contraceptive methods if their employer had an objection. Religiously affiliated nonprofits and closely held for-profit corporations were not eligible for an exemption, but could choose an accommodation. This option was offered to religiously affiliated nonprofit employers and then extended to closely held for-profitsafter the Supreme Court ruling in Burwell v. Hobby Lobby. The accommodation allowed these employers to opt out of providing and paying for contraceptive coverage in their plans by either notifying their insurer, third party administrator, or the federal government of their objection. The insurers were then responsible for covering the costs of contraception, which assured that their workers and dependents had contraceptive coverage while relieving the employers of the requirement to pay for it.
As of 2015, 10% of nonprofits with 5,000 or more employees had elected for an accommodation without challenging the requirement. This approach, however, has not been acceptable to all nonprofits with religious objections.1 In May 2016, the Supreme Court remanded Zubik v. Burwell, sending seven cases brought by religious nonprofits objecting to the contraceptive coverage accommodation back to the respective district Courts of Appeal. The Supreme Court instructed the parties to work together to “arrive at an approach going forward that accommodates petitioners’ religious exercise while at the same time ensuring that women covered by petitioners’ health plans receive full and equal health coverage, including contraceptive coverage.”2
On October 6, 2017, the Trump Administration issued new regulations greatly expanding eligibility for the exemption to all nonprofit and closely-held for-profit employers with objections to contraceptive coverage based on religious beliefs or moral convictions, including private institutions of higher education that issue student health plans (Figure 1). In addition, publicly traded for-profit companies with objections based on religious beliefs also qualify for an exemption. There is no guaranteed right of contraceptive coverage for their female employees and dependents or students. Table 1 presents the changes to the contraceptive coverage rule from the Obama Administration in the new Interim Final regulations issued by the Trump Administration.
Figure 1: Employers Objecting to Contraceptive Coverage: Exemptions and Accommodations Under the Trump Administration Regulations
The accommodation will be available to employers that previously qualified for the accommodation. They now will also have the choice of an exemption. The federal departments issuing the regulations posit that these new rules will have limited impact on the number of women losing contraceptive coverage. However, it is not clear how many employers previously utilizing the accommodation will now opt for an exemption, resulting in the loss of contraceptive coverage for their employees and dependents. In addition, there are also an unknown number of organizations that were not previously eligible for either the accommodation or exemption that may now opt for an exemption. These new regulations create two new categories of employers who can now qualify for an exemption or can voluntarily chooses an accommodation: 1) publicly traded for-profit companies with a religious objection and 2) nonprofit and closely held for-profit employers who have a moral objection to contraceptives, a considerably larger pool of employers than when the exemption was available only to those who were employees of a house of worship or who were eligible for an accommodation in the past.
| Table 1: Summary of Changes in the Contraceptive Coverage Regulations for Objecting Entities | ||
| Obama Administration August 2012 to October 5, 2017 |
Trump Administration Effective October 6, 2017 |
|
| What types of contraceptives must plans cover without cost-sharing? | At least one of each of the 18 FDA approved contraceptive methods for women, as prescribed, along with counseling and related services must be covered without cost-sharing. | No change |
| Are any employers “exempt” from the contraceptive mandate? |
|
|
| Who pays for contraceptive coverage for employees of organizations receiving an exemption? |
|
No change |
What type of employers may seek an “accommodation” to avoid paying for contraceptives in their plans? |
|
|
| Who pays for contraceptive coverage for employees of organizations receiving an accommodation? |
|
No change |
| When can entities change from an accommodation to an exemption? | N/A |
|
How has the contraceptive coverage rule affected women?
Contraceptive use among women is widespread, with over 99% of sexually-active women using at least one method at some point during their lifetime.3 Contraceptives make up an estimated 30-44% of out-of-pocket health care spending for women.4 Since the implementation of the ACA, out-of-pocket spending on prescription drugs has decreased dramatically (Figure 2). The majority of this decline (63%) can be attributed to the drop in out-of-pocket expenses on the oral contraceptive pill for women.5 One study estimates that roughly $1.4 billion dollars per year in out-of-pocket savings on the pill resulted from the ACA’s contraceptive mandate.6 By 2013, most women had no out-of-pocket costs for their contraception, as median expenses for most contraceptive methods, including the IUD and the pill, dropped to zero.7
Figure 2: The Contraceptive Coverage Policy Has Had a Large Impact on Out-Of-Pocket Spending in a Short Amount of Time
This provision has also influenced the decisions women make in their choice of method. After implementation of the ACA contraceptive coverage requirement, women were more likely to choose any method of prescription contraceptive, with a shift towards more effective long-term methods.8 High upfront costs of long-acting methods, such as the IUD and implant, had been a barrier to women who might otherwise prefer these more effective methods. When faced with no cost-sharing, women choose these methods more often9, with significant implications for the rate of unintended pregnancy and associated costs of childbirth.10
Finally, decreases in cost-sharing were associated with better adherence and more consistent use of the pill. This was especially true among users of generic pills. One study showed that even copayments as low as $6 were associated with higher levels of discontinuation and non-adherence,11 increasing the risk of unintended pregnancy.
Do states with no-cost contraceptive coverage laws allow exemptions to objecting entities?
The federal standards under Affordable Care Act created a minimum set of preventive benefits that applied to most health plans regulated by the federal government (self-funded plans, federal employee plans) and states (individual, small and large group plans), including contraceptive coverage for women with no cost-sharing. States have also historically regulated insurance, and many have had mandated minimum benefits for decades. State laws, however, have more limited reach in that they only apply to state regulated fully insured plans, do not have jurisdiction over self-funded plans, where 61% of covered workers are insured.12 In self-funded plans, the employer assumes the risk of providing covered services and usually contracts with a third party administrator (TPA) to manage the claims payment process. These plans are overseen by the Federal Department of Labor under the Employer Retirement Income Security Act (ERISA) and are only subject to federally established regulations.13 The ACA sets a minimum standard of coverage for preventive services for all plans. However, state laws regulating insurance, including contraceptive coverage, can require fully insured plans to provide coverage beyond the federal standards.
Eight states have strengthened and expanded the federal contraceptive coverage requirement (CA, IL, MD, ME, NV, NY, OR, VT). Another 20 states have contraceptive equity laws that require plans to cover contraceptives if they also provide coverage for prescription drugs but they do not necessarily require coverage of all FDA-approved contraceptives or ban cost-sharing (Figure 3).
Figure 3: Many States Have Contraceptive Coverage Requirements
Many of the 28 states that have passed contraceptive coverage laws (both equity and no-cost coverage) have a provision for exemptions, but the laws vary from state to state and only apply to fully insured plans. This means that there may be a conflict between the state and federal requirements when it comes to religious exemptions. In some states with a contraceptive coverage requirement, some employers who are eligible for an exemption under federal law will not qualify for an exemption under state law (Table 2). Employers in those states will have to have to meet the standards established by their state even though they may qualify for an exemption based on the new federal regulations. This conflict may set the stage for future litigation.
| Table 2: State Requirements for No-Cost Contraceptive Coverage | |||||||
| StateDate Effective | Applies to | Coverage required without cost sharing | Exemptions allowed | ||||
| Private plans | Medicaid | With RX all FDA approved | OTC | Vasectomy | Religious | Moral | |
| CaliforniaJanuary 2015 | X | MCOs | X | Narrowly defined nonprofit religious employers | None | ||
| IllinoisJanuary 2017 | X | X | X except male condoms |
Any employer, or insurer with a religious objection | Any employer, or insurer with a moral objection | ||
| MarylandJanuary 2018 | X | X | X | X | X | Religious organizations if the coverage conflicts with the organization’s bona fide religious beliefs and practices | None |
| MaineJanuary 2019 | X | X | Narrowly defined nonprofit religious employers | None | |||
| NevadaJanuary 2018 | X | X | X | Insurers affiliated with a religious organization | None | ||
| New YorkAugust 2017 | X | X | Narrowly defined nonprofit religious employers* | None | |||
| OregonAugust 2017 | X | X | X | Narrowly defined nonprofit religious employers | None | ||
| VermontOctober 2016 | X | X – and all other public health assistance programs | X | X | None | None | |
| NOTES: *Requires the insurer to offer a rider to policyholders so that women will have contraceptive coverage. SOURCE: Kaiser Family Foundation analysis of state laws and regulations. |
|||||||
Conclusion
The Trump Administration’s new regulations substantially expand the exemption to nonprofit and for-profit employers, as well as to private colleges or universities with religious or moral objections to contraceptive coverage. It is unknown how many of these employers and colleges will maintain coverage through the accommodation as before and how many will now opt for the exemption leaving their students, employees and dependents without no-cost coverage for the full range of contraceptive methods. As a result of the new regulation, choices about coverage and cost-sharing will be made by employers and private colleges and universities that issue student plans. For many women, their employers will determine whether they have no-cost coverage to the full range of FDA approved methods. Their choice of contraceptive methods may again be limited by cost, placing some of the most effective yet costly methods out of financial reach.
You can read the original article here.
Source:
Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/
Long-Term Disability Insurance Gets Little Attention But Can Pay Off Big Time
Is disability coverage worth it? At Saxon, we love to keep you updated on the latest news in the retirement world, and today, we want to dive into disability coverage. Check out this engaging and helpful article we pulled from KHN.
“It won’t happen to me.” Maybe that sentiment explains consumers’ attitude toward long-term disability insurance, which pays a portion of your income if you are unable to work.
Sixty-five percent of respondents surveyed this year by LIMRA, an association of financial services and insurance companies, said that most people need disability insurance. But the figure shrank to 48 percent when people were asked if they believe they personally need it. The proportion shriveled to 20 percent when people were asked if they actually have disability insurance.
As the annual benefits enrollment season gets underway at many companies, disability coverage may be one option worth your attention.
Some employers may be asking you to pay a bigger share or even the full cost. That can have a hidden advantage later, if you use the policy. Or you may find that your employer has automatically enrolled you — or plans to — unless you opt out. A growing number of employers are going that route to boost coverage that they feel is in their employees’ best interests, not to mention their own, since insurers usually require a minimum level of employee participation in order to offer a plan.
Benefits consultants agree that although long-term disability coverage lacks the novelty appeal of some other benefits that companies are offering these days — hello, pet insurance — it can prove much more valuable in the long run.
“This is a really critical safety-net benefit,” said Rich Fuerstenberg, a senior partner at human resources consultant Mercer.
If you become disabled because of accident, injury or illness, long-term disability insurance typically pays 50 to 60 percent of your income, while you’re unable to work. The length of time the policy pays varies; some policies pay until you reach age 65.
Long-term disability generally has a waiting period of three or six months before benefits kick in. That period would be covered by short-term disability insurance, if you have it.
Many long-term disability claims are for chronic problems such as cancer and musculoskeletal conditions. According to the Council for Disability Awareness, the average duration of a claim is nearly three years — 34.6 months.
Not everyone has savings to support them through that time. When the Federal Reserve Board surveyed adults about household economics in 2015, 53 percent said they don’t have a rainy day fund that could cover them even for three months. More troubling, nearly half of respondents — 46 percent — said that faced with a hypothetical $400 emergency expense, they didn’t have the cash to cover it.
According to the Social Security Administration, 1 in 4 people who are 20 years old now will be disabled before they reach age 67.
Overall, 41 percent of employers offer long-term disability insurance, according to LIMRA, though the proportion of larger employers who offer it is generally much higher. Compared with health insurance, premiums cost a pittance — $256 annually in 2016 on average for group plans, LIMRA says. Many employers pick up the whole tab or charge workers a small amount.
However, as employers continue to shift benefit costs onto employee shoulders, long-term disability is no exception. Increasingly, they’re offering the coverage as a “voluntary” benefit, meaning employees pay the entire premium.
The upside is that if employees pay for the coverage themselves with after-tax dollars and they ever become disabled and need to use the coverage, the benefits will be tax-free.
“If an employee can choose to pay for coverage on a post-tax basis, or is paying on a voluntary basis, it’s better for them,” said Jackie Reinberg, national practice leader for absence, disability management and life at benefits consultant Willis Towers Watson.
Some employers may pay for a core basic benefit that replaces 40 or 50 percent of income and offer workers the opportunity to “buy up” to more generous income replacement of 60 or 70 percent.
Although voluntary coverage has a tax advantage, disability consultants are concerned that leaving it up to employees, especially if they’re choosing among several other voluntary coverage options like cancer insurance, critical illness coverage and yes, pet insurance, increases the odds they’ll skip buying long-term disability coverage.
“These coverages all feel the same, and if you’re going to choose one at all you tend to go with the one that’s cheapest and the one that you think you might use,” said Carol Harnett, president of the Council for Disability Awareness, a membership group of disability insurers that does education and outreach about disability issues.
Auto-enrollment can make a big difference. Employers that auto-enroll employees in voluntary long-term disability plans may get 75 percent of employees to participate, compared with 30 percent for employers that leave it completely up to workers, said Mike Simonds, CEO of disability insurer Unum US.
If you were offered long-term disability coverage when you were hired and didn’t sign up, it may be tougher to do so during the open enrollment period, said Fuerstenberg. A growing number of health plans require employees to show “evidence of insurability,” meaning they must answer a series of health-related questions before they’re approved. Some long-term disability policies may also have preexisting condition provisions that won’t pay benefits for a condition for up to a year, for example.
You can read the original article here.
Source:
Andrews M. (10 October 2017). "Long-Term Disability Insurance Gets Little Attention But Can Pay Off Big Time" [web blog post]. Retrieved from address https://khn.org/news/long-term-disability-insurance-gets-little-attention-but-can-pay-off-big-time/
What's the Dish? A Family Recipe for Salsa Lovers
In this month's Dish, we bring you the delicious "Dine In" and "Dine Out" choices from our very own, Abby Graham!
Abby Graham is a Wellness Director Saxon Financial Services. She has been in the insurance, health and wellness industry for over 12 years. Prior to joining Saxon Financial, she spent the last 7 years working for Humana/HumanaVitality. She is passionate about making sure members understand their medical and wellness benefits as well as how to maximize their potential.
Abby holds a degree in Human Resource Development from the University of Tennessee. She has also received her Group Benefits Disability Specialist (GBDS) certification.
She is an active member and board member of the Cincinnati Modern Quilt Guild. Abby also enjoys sewing, quilting, and spending time with her husband, Jon and her son, Carter.
Stay In:
Abby's favorite family recipe is Corn Avocado Salsa. She and her husband make it together. It’s best in the summer when the tomatoes are ripe and the corn is sweet!
1 ripe tomato
1 avocado
1 ear of corn
½ cup chopped cilantro
1 sweet onion
1 jalapeno
2-3 garlic cloves
1 ripe lime
Salt to taste
Grill the tomato until the skin is cracked and peeling off. Cut the avocado and grill it face down for about 5 minutes. Grill the corn until it is cooked all the way. In the meantime, finely chop the onion, jalapeno, cilantro and garlic cloves. Squeeze ½ of the lime over onion, jalapeno, cilantro and garlic combination.
Once tomato, avocado, and corn are finished grilling, cut corn off of the cob, and peel skin off of tomato. Dice tomato and avocado and add to chopped mix. Add salt to taste and serve warm with tortilla chips!
Dine Out:
Her favorite place to Dine Out is Dilly Café. Want driving directions? Get them here.
Our favorite restaurant is the Dilly Café in Mariemont. The outside seating is perfect on a nice night and/or when we have our little one with us. They generally have a band playing, the food is excellent, and the beer and wine list are great! Their crab cakes, wings and burgers are my favorites!
YUM! We hope you enjoy Abby's recipe and dining suggestions. We know we will!
CenterStage...Open Season for Open Enrollment
In this month’s CenterStage, we interviewed Rich Arnold for some in-depth information on Medicare plans and health coverage. Read the full article below.
Open Season for Open Enrollment: What does it mean for you?
There are 10,000 people turning 65 every single day. Medicare has a lot of options, causing the process to be extremely confusing. Rich – a Senior Solutions Advisor – works hard to provide you with the various options available to seniors in Ohio, Kentucky and Indiana and reduce them to an ideal, simple, and easy-to-follow plan.
“For me, this is all about helping people.”
– Rich Arnold, Senior Solutions Advisor
What does this call for?
To provide clients with top-notch Medicare guidance, Rich must analyze their current doctors and drugs for the best plan option and properly educate them to choose the best program for their situation and health. It’s a simple, free process of evaluation, education, and enrollment.
For this month’s CenterStage article, we asked Rich to break down Medicare for the senior population who are in desperate need of a break from the confusion.
Medicare Break Down
Part A. Hospitalization, Skilled Nursing, etc.
If you’ve worked for 40 quarters, you automatically obtain Part A coverage.
Part B. Medical Services: Doctors, Surgeries, Outpatient visits, etc.…
You must enroll and pay a monthly premium.
Part C. Medicare Advantage Plans:
Provides most of your hospital and medical expenses.
Part D.
Prescription drug plans available with Medicare.
Under Parts A & B there are two types of plans…
Supplement Plan or Medigap Plan
A Medicare Supplement Insurance (Medigap) policy can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles, coverage anywhere in the US as well as travel outside of the country, pay a monthly amount, and usually coupled with a prescription drug plan.
Advantage Plan
A type of Medicare health plan that contracts with Medicare to provide you with all your Part A and Part B benefits generally through a HMO or PPO, pay a monthly amount from $0 and up, covers emergency services, and offers prescription drug plans.
How does this effect you?
Medicare starts at 65 years of age, but Rich advises anyone turning 63 or 64 years of age to reach out to an advisor, such as himself, for zero cost, to be put onto their calendar to follow up at the proper time to investigate the Medicare options. Some confusion exists about Medicare and Social Security which are separate entities. Social Security does not pay for the Supplement or Advantage plans.
Medicare Open Enrollment: Open Enrollment occurs between October 15th and December 7 – yes, right around the corner! However, don’t panic, Rich and his services can help you if you are turning 65 or if you haven’t reviewed your current plan in over a year – you should seek his guidance.
Your plan needs to be reviewed every year to best fit your needs. If you’re on the verge of 65, turning 65 in the next few months, or over 65, you should consult your Medicare advisor as soon as possible. For a no cost analysis of your needs contact Rich, Saxon Senior Solutions Advisor, rarnold@gosaxon.com, 513-808-4879.
Saxon Welcomes a New Senior Solutions Specialist
Saxon is excited and proud to announce a new employee added to our team, Leigh Rathje!
Leigh’s background in group health insurance has led her to a new path with Saxon as a Senior Advisor. She helps her clients in the day to day needs when it comes to Medicare questions, enrollments, claims issues, and billing concerns.
Self funded health care – a big business advantage
Check out this article from Business Insurance by one of their staff writers. In this article, Business Insurance dives into the awesome advantages of self-funding for big businesses.
You can read the original article here.
Health insurance benefits are expensive. The rising costs of health care has driven up insurance premiums to levels where many businesses have been forced to reduce these benefits or drop them altogether. There is, however another option that is less regulated, taxed less and typically results in cost savings: self funded health insurance. The problem is, it's not always the best option for all employers, particularly the smaller ones. And there's a number of reasons for this:
What is self funded health care a.k.a. self-insurance?
Self-insurance is a method of providing health care to employees by taking on the financial liabilities of the care instead of paying premiums to an insurance agency to do the same. In other words: when a person covered under a self-funded plan needs medical care, the company is financially responsible for paying the medical bill (minus deductibles). It's an alternative risk transfer strategy that assumes the risk and liability of medical bills for those covered instead of outsourcing it to a third party. It's a surprisingly common practice:
In 2008, 55% of workers with health benefits were covered by a self-insured plan….and 89% of workers in firms of 5,000 or more employees.
Most (but not all) self-insurance plans are administered by a third party, usually a health insurance company, in order to process claims. The bills are simply paid for by the employer. Health insurance companies act as a third party administrators in what are called ASO contracts (Administrative Services Only)
Another common component of self insurance plans is stop-loss insurance. This is a separate insurance plan that the employer can purchase to reduce the overall liability of claims. With this type of insurance, if claims exceed a certain dollar amount, stop-loss kicks in paying the rest. There are two kinds of stop-loss insurance:
Specific – covers the excess costs from larger claims made by individuals in the group
Aggregate – kicks in when total claims by the group exceed a set amount
For example, a company who self-insures their $1000 employees projects $100,000 in medical care claims for the year. If they purchase aggregate stop-loss insurance for claims that exceed 120% of the expected amount or $120,000, the insurance will pick up the bill for the remaining claims. If the company purchases specific stop-loss insurance at 200%, if any single claim exceeds $2,000, the stop-loss pays the remainder.
Typically, self-funded insurance providers will purchase both specific and aggregate stop-loss insurance unless the conditions are such that specific stop-loss provides enough financial protection.
Benefits of self-insurance
There are a number of financial and administrative advantages to using self-funded health insurance plans for employers. According to the Self-Insurance Institute of America (SIIA) these include:
- The employer can customize the plan to meet the specific health care needs of its workforce, as opposed to purchasing a 'one-size-fits-all' insurance policy.
- The employer maintains control over the health plan reserves, enabling maximization of interest income – income that would be otherwise generated by an insurance carrier through the investment of premium dollars.
- The employer does not have to pre-pay for coverage, thereby providing for improved cash flow.
- The employer is not subject to conflicting state health insurance regulations/benefit mandates, as self-insured health plans are regulated under federal law (ERISA).
- The employer is not subject to state health insurance premium taxes, which are generally 2-3 percent of the premium's dollar value.
- The employer is free to contract with the providers or provider network best suited to meet the health care needs of its employees.
There are, however, some drawbacks to self-insurance policies:
Health care can be costly, so heavy claims years can be extremely expensive
Self insurance isn't tax deductible the same way the costs of providing health insurance is.
Financial benefits are long-term, particularly with an investment component.
Small businesses at a disadvantage
Self insurance is much more prevalent for larger companies mostly because it is easier to predict health care costs from a larger group. The more people in the group, the less potentially damaging a single expensive claim will be to the plan overall. That's why less than 10% of companies with less than 50 employees use self-insurance.
Because risk is more difficult to predict with smaller groups, stop-loss insurance is also more expensive for smaller businesses. The practice of “lasering”, or increasing deductibles for specific higher risk employees can also be much tougher on small firms. As a result, self-insurance tends to be a less cost effective option than it is for larger companies.
Another roadblock for small businesses is a lack of cash-flow that is necessary to finance self-insurance. This doesn't mean, however, that small businesses can't benefit from a self-insurance plan. In fact, an increasing number of small businesses still are. But fully understanding the risks and rewards for doing so can sometimes be difficult.
Regulations
Because the only 3rd party administration of insurance (stop-loss) is between the employer and the insurance company directly, it is not subject to state level regulation the way traditional insurance policies are. Instead, they're regulated by the department of labor under the Employee Retirement Income Security Act – ERISA. Benefit administrators must still comply with federal standards despite the lack of state regulation.
California SB 1431
California is considering a proposed legislation to regulate the sale of stop-loss policies to smaller businesses. On the surface, the regulation looks as though it is an attempt to prevent small businesses from taking on too much risk. But the true intentions of the legislation may be to prevent cherry-picking of generally healthier small businesses (effectively removing them from the health insurance pool). This cherry-picking would theoretically cause traditional insurance premiums to become more expensive.
According to the SIIA, SB 1431 would prohibit the sale of stop-loss policies to employers with fewer than 50 employees that does any of the following:
- Contains a specific attachment point that is lower than $95,000;
- Contains an aggregate attachment point that is lower than the greater of one of the following:
- $19,000 times the total number of covered employees and dependents;
- 120% of expected claims;
- $95,000
This legislation would effectively limit the options of small businesses as it would force them to purchase a more expensive low deductible stop-loss policies. And according to the SIIA, with this legislation, almost no small business under 50 employees would (nor should they) consider self-insurance as an option.
If the legislation is passed in California, it has been suggested that it is only time before other states follow suit and/or enact even stricter regulations on small businesses. The SIIA even has a facebook page dedicated to defeating the bill they say is:
“…unnecessary and will only exasperate the problem that small employers in California face in being able to afford the rising cost of providing quality health benefits to their employees.”
So while self insurance can be a relatively risky option for small businesses, with legislation like this, it could no longer be a realistic option at all… And, in effect: another competitive advantage big businesses will have over their smaller counterparts.
You can read the original article here.
Source:
Staff Writer. (Date Unlisted). "Self funded health care – a big business advantage" [Web Blog Post]. Retrieved from address https://www.businessinsurance.org/self-funded-health-care-a-big-business-advantage/
15 Most Expensive States for Long-Term Care: 2017
Are you reaching retirement? Then, perhaps, you've already looked into the affordability of long-term care, and - well - it's not as affordable as you thought. If you're looking to get the most out of your retirement budget, then you may want to stray away from these 15 most expensive states for long-term care, as of 2017.
This article is brought to you by Think Advisor, and it was written by Marlene Y. Satter. You can read the full article here.
Genworth’s annual study on the cost of care nationwide, which includes home care, assisted living facilities, etc., is not reassuring
The price of long-term care insurance is high—for everyone involved. Not just the patient but also the caregivers pay in more than money to make sure that the person in need of care is given the best care they can manage.
In this year’s version of Genworth Financial’s annual study on the cost of care nationwide—not just in nursing homes, which are less and less on the forefront, but also care provided at home, adult day care and assisted living facilities—the news is not reassuring. Costs have risen steadily, with those for licensed homemakers—those who provide what the study calls “hands-on personal care” for patients still in their homes—rising the fastest, increasing 6.17% just since last year.
And of course since people would prefer to stay in their homes, that’s going to hit a lot of people hard.
Less-skilled “homemaker care,” such as cooking, cleaning and running errands (not included in the breakdown that follows) has risen pretty quickly as well, increasing by 4.75% since last year. But both versions of homemaker assistance are at the low end on the price scale, coming in at $21 for homemaker care and $22 for licensed homemaker care. The big bucks are elsewhere.
They may not have risen as quickly percentage-wise as the two already mentioned, but adult day care increased by 2.94% since last year to a national median rate of $70 per day. Assisted living facilities now average a median monthly rate of $3,750, an increase of 3.36% from last year, while nursing homes, at an increase of 5.50% for a private room, now run a median daily rate of $267. No matter how you look at it, that’s a lot of money.
And caregivers often sacrifice their own financial well-being to care for their family members, forking over an average of $10,000 out of their own pockets for expenses that range from household expenses, personal items, or transportation services to payment of informal caregivers or LTC facilities.
A whopping 62% are paying for these expenses out of their own retirement funds; 45% have seen those costs cut their basic quality of living; and 38% have cut the amount they devote to savings and retirement to meet the costs of care.
And another sad side effect of all this stress is that 27% say it’s had a negative impact on their relationship with the person they’re caring for.
The penalty for all this devotion is that absences, reduced hours and chronic tardiness can end up cutting a caregiver’s pay. About a half of caregivers estimate that they lost approximately a third of their income.
Check out the 15 most expensive states for LTC.
15. Maryland
Average Annual LTC Cost: $60,305
- Adult day care: $2,150
- Licensed home care: $52,281
- Assisted living: $49,800
- Nursing home (private room): $118,990
14. Rhode Island
Average Annual LTC Cost: $60,789
- Adult day care: $19,500
- Licensed home care: $57,772
- Assisted living: $61,860
- Nursing home (private room): $104,025
13. California
Average Annual LTC Cost: $61,239
- Adult day care: $20,020
- Licensed home care: $57,200
- Assisted living: $51,300
- Nursing home (private room): $116,435
12. Washington
Average Annual LTC Cost: $61,704
- Adult day care: $16,900
- Licensed home care: $60,632
- Assisted living: $55,920
- Nursing home (private room): $113,362
11. Vermont
Average Annual LTC Cost: $63,139
- Adult day care: $34,320
- Licensed home care: $57,200
- Assisted living: $49,527
- Nursing home (private room): $111,508
10. North Dakota
Average Annual LTC Cost: $64,010
- Adult day care: $25,480
- Licensed home care: $63,972
- Assisted living: $36,219
- Nursing home (private room): $130,367
9. Maine
Average Annual LTC Cost: $64,423
- Adult day care: $28,080
- Licensed home care: $53,768
- Assisted living: $58,680
- Nursing home (private room): $117,165
8. New York
Average Annual LTC Cost: $65,852
- Adult day care: $20,800
- Licensed home care: $54,340
- Assisted living: $47,850
- Nursing home (private room): $140,416
7. New Hampshire
Average Annual LTC Cost: $66,044
- Adult day care: $18,720
- Licensed home care: $60,357
- Assisted living: $58,260
- Nursing home (private room): $126,838
6. Delaware
Average Annual LTC Cost: $68,472
- Adult day care: $18,850
- Licensed home care: $50,908
- Assisted living: $72,180
- Nursing home (private room): $131,948
5. New Jersey
Average Annual LTC Cost: $68,833
- Adult day care: $23,400
- Licensed home care: $52,624
- Assisted living: $69,732
- Nursing home (private room): $129,575
4. Hawaii
Average Annual LTC Cost: $71,820
- Adult day care: $18,200
- Licensed home care: $59,488
- Assisted living: $51,000
- Nursing home (private room): $158,593
3. Connecticut
Average Annual LTC Cost: $72,671
- Adult day care: $20,800
- Licensed home care: $52,624
- Assisted living: $55,200
- Nursing home (private room): $162,060
2. Massachusetts
Average Annual LTC Cost: $73,307
- Adult day care: $16,900
- Licensed home care: $59,488
- Assisted living: $67,188
- Nursing home (private room): $149,650
1. Alaska
Average Annual LTC Cost: $117,800
- Adult day care: $43,709
- Licensed home care: $63,492
- Assisted living: $72,000
- Nursing home (private room): $292,000
You can read the full article here.
Source:
Satter M. (2 October 2017). "15 Most Expensive States for Long-Term Care: 2017" [Web Blog Post]. Retrieved from address https://www.thinkadvisor.com/2017/10/02/15-most-expensive-states-for-long-term-care-2017
Apple, Fitbit to join FDA program to speed health tech
Wondering how technology can speed the process of developing health tech? In this article from BenefitsPro written by Anna Edney, gain a close insight on how Apple and Fitbit are working together with the FDA to make your health of vital importance.
You can read the original article here.
A federal agency that regulates apples wants to make regulations on Apple Inc. a little easier.
The Food and Drug Administration, which oversees new drugs, medical devices and much of the U.S. food supply, said Tuesday that it had selected nine major tech companies for a pilot program that may let them avoid some regulations that have tied up developers working on health software and products.
“We need to modernize our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate,” FDA Commissioner Scott Gottlieb said in a statement.
The program is meant to let the companies get products pre-cleared rather than going through the agency’s standard application and approval process that can take months. Along with Apple, Fitbit Inc., Samsung Electronics Co., Verily Life Sciences, Johnson & Johnson and Roche Holding AG will participate.
A new report and video from the Health Enhancement Research Organization (HERO) identifies six promising practices for effectively integrating wearables...
The FDA program is meant to help the companies more rapidly develop new products while maintaining some government oversight of technology that may be used by patients or their doctors to prevent, diagnose and treat conditions.
Apple is studying whether its watch can detect heart abnormalities. The process it will go through to make sure it’s using sound quality metrics and other measures won’t be as costly and time-consuming as when the government clears a new pacemaker, for example. Verily, the life sciences arm of Google parent Alphabet Inc., is working with Novartis AG to develop a contact lens that could continuously monitor the body’s blood sugar.
Faster Pace
“Historically, health care has been slow to implement disruptive technology tools that have transformed other areas of commerce and daily life,” Gottlieb said in July when he announced that digital health manufacturers could apply for the pilot program.
Officially dubbed the Pre-Cert for Software Pilot, Gottlieb at the time called it “a new and pragmatic approach to digital health technology.”
The other companies included in the pilot are Pear Therapeutics Inc., Phosphorus Inc. and Tidepool.
The program is part of a broader move at the FDA, particularly since Gottlieb took over in May, to streamline regulation and get medical products to patients faster. The commissioner said last week the agency will clarify how drugmakers might use data from treatments already approved in some disease to gain approvals for more conditions. In July, he delayed oversight of electronic cigarettes while the agency decides what information it will need from makers of the products.
Rules Uncertainty
As Silicon Valley developers have pushed into health care, the industry has been at times uncertain about when it needed the FDA’s approval. In 2013, the consumer gene-testing company 23andMe Inc. was ordered by the agency to temporarily stop selling its health analysis product until it was cleared by regulators, for example.
Under the pilot, the FDA will scrutinize digital health companies’ software and will inspect their facilities to ensure they meet quality standards and can adequately track their products once they’re on the market. If they pass the agency’s audits, the companies would be pre-certified and may face a less stringent approval process or not have to go through FDA approval at all.
More than 100 companies were interested in the pilot, according to the FDA. The agency plans to hold a public workshop on the program in January to help developers not in the pilot understand the process and four months of initial findings.
You can read the original article here.
Source:
Edeny A. (27 September 2017). "Apple, Fitbit to join FDA program to speed health tech" [Web Blog Post]. Retrieved from address https://www.benefitspro.com/2017/09/27/apple-fitbit-to-join-fda-program-to-speed-health-t