3 keys to creating an employee-centric wellness plan
Interesting read by Rae Shanahan highlighting how technology can be incorporated into your wellness plan. See the full article below.
Original Post from BenefitsPro.com on July 14, 2016
As smartphones become more entrenched in our daily lives, the wellness technology industry has exploded to more than $8 billion, driven largely by wearable devices and more than 160,000 wellness-relatedmobile apps.
Employers are capitalizing on the tech advances, making workplace wellness programs more digital, social, and connected.
Particularly as more mobile-focused millennials enter the workforce, companies are expanding web-based competitions and incentives for getting physically healthy.
Programs that allow employees to track FitBit data and awarding prizes for workers with the highest monthly step totals are becoming much more common. Even savvier companies are tying wellness to their overall benefits offerings, offering employees the chance to compete for an extra vacation day by reducing their body fat percentage.
While these incentivized programs are developed with the best of intentions to encourage employees toward better health habits, the unintended consequence is backlash from employees who are wary of revealing personal health data — especially on the internet.
Also, those employees who find themselves at the bottom of the online leaderboard may feel discouraged and demoralized, the opposite of an employer’s objective. Moreover, there is a concern that incentivized wellness programs tend to penalize those who don’t participate or are less successful.
Obviously, employers don’t want to disregard employees who don’t feel comfortable sharing sensitive health information. If employees don’t feel comfortable sharing these personal details with their employer, they should still have the opportunity to chase the incentives, and ultimately benefit from the wellness program.
Keeping all employees in mind, there are three keys to creating successful, employee-centric wellness programs that increase engagement while respecting privacy concerns.
Survey
A simple but effective first step is to survey employees on their thoughts and concerns around wellness programs. Providing employees a platform to voice their opinions allows employees to feel heard and for employers to empathize with their workforce while developing wellness programs. This step conveys the care and effort behind creating employee-centric programs that give everyone the opportunity to participate.
Accommodate
According to Businessolver’s Workplace Empathy Monitor, 1 in 3 employees would switch companies for equal pay if the other employer was more empathetic. The research reveals that embedding empathy in the workplace operations, such as wellness programs, is a key factor aspect of building trust and loyalty with employees.
At the end of the day, workplace wellness programs are designed to encourage a healthy lifestyle — not win points or prizes — and it’s important to keep that end goal in mind.
For example, rather than a competition to lower employee body weight or BMI, employers can instead offer employees a free yoga class once a week. This allows employees to participate in a healthy activity while connecting with colleagues, without having to worry about revealing personal and private information.
Being flexible with wellness programs is an empathetic behavior that broadens the circle of those wanting to participate, maintains the end goal of improving health, and ultimately benefits a company in recruiting and retention.
Communicate
Of course, the most fun, effective, and empathetic program does no good if employees don’t know about it and aren’t engaged.
So, the most beneficial step employers can take in creating a wellness program is effectively communicating with all employees that the program is open, what is necessary to participate, and keeping feedback channels open.
Make sure employees are completely briefed — maybe develop and share one-pagers for employees to quickly reference. Also, it’s imperative to provide an onsite contact who can be a champion for the program and answer any employee questions or concerns. With this, trust is built between employers and employees, and a wellness program has a stronger chance of succeeding right from the start.
Read original article here: https://www.benefitspro.com/2016/07/14/3-keys-to-creating-an-employee-centric-wellness-pl?ref=hp-in-depth&page_all=1
Source:
Shanahan, R. (2016, July 14). 3 keys to creating an employee-centric wellness plan [Web log post]. Retrieved from https://www.benefitspro.com/2016/07/14/3-keys-to-creating-an-employee-centric-wellness-pl?ref=hp-in-depth&page_all=1
5 Crucial Wellness Strategies for Self-Funded Companies
Original post careatc.com
Instead of paying pricey premiums to insurers, self-insured companies pay claims filed by employees and health care providers directly and assume most of the financial risk of providing health benefits to employees. To mitigate significant losses, self-funded companies often sign up for a special “stop loss” insurance, hedging against very large or unexpected claims. The result? A stronger position to stabilize health care costs in the long-term. No wonder self-funded plans are on the rise with nearly 81% of employees at large companies covered.
Despite the rise in self-insured companies, employers are uncertain as to whether they’ll even be able to afford coverage in the long-term given ACA regulations. Now more than ever, employers (self-insured or not) must understand that wellness is a business strategy. High-performing companies are able to manage costs by implementing the most effective tactics for improving workforce health.
Here are five wellness strategies for self-insured companies:
Strategy 1: Focus on Disease Management Programs
Corporate wellness offerings generally consist of two types of programs: lifestyle management and disease management. The first focuses on employees with health risks, like smoking or obesity, and supports them in reducing those risks to ultimately prevent the development of chronic conditions. Disease management programs, on the other hand, are designed to help employees who already have chronic disease, encouraging them to take better care of themselves through increased access to low-cost generic prescriptions or closing communication gaps in care through periodic visits to providers who leverage electronic medical records.
According to a 2012 Rand Corporation study, both program types collectively reduced the employer’s average health care costs by about $30 per member per month (PMPM) with disease management responsible for 87% of those savings. You read that right – 87%! Looking deeper into the study, employees participating in the disease management program generated savings of $136 PMPM, driven in large part by a nearly 30% reduction in hospital admissions. Additionally, only 13% of employees participated in the disease management program, compared with 87% for the lifestyle management program. In other words, higher participation in lifestyle management programs marginally contributes to overall short-term savings; ROI was $3.80 for disease management but only $0.50 for lifestyle management for every dollar invested.
This isn’t to say that lifestyle management isn’t a worthy cause – employers still benefit from its long-term savings, reduced absenteeism, and improved retention rates – but it cannot be ignored that short-term ROI is markedly achieved through a robust disease management program.
Strategy 2: Beef Up Value-Based Benefits
Value-Based Benefit Design (VBD) strategies focus on key facets of the health care continuum, including prevention and chronic disease management. Often paired with wellness programs, VBD strategies aim to maximize opportunities for employees make positive changes. The result? Improved employee health and curbed health care costs for both employee and employer. Types of value-based benefits outlined by theNational Business Coalition on Health include:
Individual health competency where incentives are presented most often through cash equivalent or premium differential:
- Health Risk Assessment
- Biometric testing
- Wellness programs
Condition management where incentives are presented most often through co-pay/coinsurance differential or cash equivalent:
- Adherence to evidence-based guidelines
- Adherence to chronic medications
- Participation in a disease management program
Provider Guidance
- Utilization of a retail clinic versus an emergency room
- Care through a “center of excellence”
- Tier one high quality physician
There is no silver bullet when it comes to VBD strategies. The first step is to assess your company’s health care utilization and compare it with other benchmarks in your industry or region. The ultimate goal is to provide benefits that meet employee needs and coincide with your company culture.
Strategy 3: Adopt Comprehensive Biometric Screenings
Think Health Risk Assessments (HRAs) and Biometric Screenings are one and the same? Think again. While HRAs include self-reported questions about medical history, health status, and lifestyle, biometric screenings measure objective risk factors, such as body weight, cholesterol, blood pressure, stress, and nutrition. This means that by adopting a comprehensive annual biometric screening, employees can review results with their physician, create an action plan, and see their personal progress year after year. For employers, being able to determine potentially catastrophic claims and quantitatively assess employee health on an aggregate level is gold. With such valuable metrics, its no surprise that nearly 51% of large companies offer biometric screenings to their employees.
Strategy 4: Open or Join an Employer-Sponsored Clinic
Despite a moderate health care cost trend of 4.1% after ACA changes in 2013, costs continue to rise above the rate of inflation, amplifying concerns about the long-term ability for employers to provide health care benefits. In spite of this climate, there are still high-performing companies managing costs by implementing the most effective tactics for improving health. One key tactic? Offer at least one onsite health service to your population.
I know what you’re thinking: employer-sponsored clinics are expensive and only make sense for large companies, right? Not anymore. There are a few innovative models out there tailored to small and mid-size businesses that are self-funded, including multi-employer, multi-site sponsored clinics. Typically a large company anchors the clinic and smaller employers can join or a group of small employers can launch their very own clinic. There are a number of advantages to employer-sponsored clinics and it is worthwhile to explore if this strategy is right for your company.
Strategy 5: Leverage Mobile Technology
With thousands health and wellness apps currently available through iOS and Android, consumers are presented with an array of digital tools to achieve personal goals. So how can self-insured companies possibly leverage this range of mobile technology? From health gamification and digital health coaching, to wearables and apps, employers are inundated with a wealth of digital means that delivering a variation of virtually the same thing: measurable data.
These companies curate available consumer health and wellness technology to empower employers by simplifying the process of selecting and managing various app and device partners, and even connecting with tools employees are already be using.
Conclusion:
Self-insured companies have a vested interest in improving employee health and understand that wellness is indeed a business strategy. High-performing companies are able to manage costs by implementing the most effective tactics for improving workforce health including an increased focus on Chronic Disease Management programs; strengthening value-based benefit design; adopting comprehensive biometric screening; exploring the option of opening or joining an employer-sponsored clinic; and leveraging mobile technology.
How Employers Should Respond to Increased DOL Audits
Original post benefitnews.com
The Department of Labor says it will be stepping up enforcement efforts and employer audits, which should prompt brokers, who formerly worried little about such regulatory efforts, to prepare to serve as a trusted adviser to clients concerned about such efforts, says Julie Hulsey, president and CEO of Amarillo, Texas-based Zynia Business Solutions.
Speaking at an industry conference in Hollywood, Fla. last week, Hulsey said employers are feeling pressured by the weight of increased DOL and health care reform regulations and brokers need to stay up to date on regulations, including those related to the Affordable Care Act and ERISA.
The ACA reporting requirements have brought increased scrutiny of employer-sponsored health care plans and the government is largely expected to respond to anomalies or red flags with an employer audit. But industry experts agree the government won’t limit its inquiries to ACA-related information only, and employers should be prepared for full-blown audits of health care plans.
Quoting from a DOL presentation in Austin, Texas, Hulsey says the Department said, “leniency is over; the EBSA has staffed up and is focusing its resources on health and welfare plan ERISA compliance.”
Additionally, in her small Texas town alone, she says she’s heard that the DOL has added 10-12 auditors, who are conducting random audits of employers, mostly on the smaller employee size.
Increased compliance needs can be a strain for small employers, some of which may not even have a designated Human Resources department or manager.
When a DOL audit is announced, an employer’s first phone call will be their broker or an attorney.
Among the topics that brokers should be aware,
- Variable Employee Testing: Based on employee classifications, an employer can group employees into different groups, such as part-time and seasonal.
- HR 3236-The Transportation and Veteran Health care Choice Improvement Act of 2016: This Act regulates that employees covered by Tricare can be excluded from counting employee numbers.
- Cadillac Tax: Although delayed until 2020, it is important to start planning now.
- Waivers: If employers offer a minimum-essential coverage plan that meets affordable and minimum value test and an employee declines coverage, it is important the employer have a signed waiver. “That waiver is gold,” Hulsey said.
- Individual Mandate: The period will run from Nov. 1, 2016 to Jan. 31, 2016.
- Special Enrollment Period: Presenting a sales opportunity to brokers, these enrollment periods take affect when an employee experiences any change that affects income or household size, such as becoming pregnant. Other special enrollments include marriage/divorce, changing place of residence and having a change in disability.
The DOL has the authority to audit for compliance with several laws, including the ACA, HIPAA and the Mental Health Parity and Addiction Equity Act. They also have the authority to audit for minimum loss ratio rebates and PECORI fees.
The Cadillac Tax: Myths & Facts
Original post benefitspro.com
Americans love a good story. From fairy tales to hair-raising films that leave us cowering in our seats, we enjoy when our hearts pound in anticipation. Sometimes, though, we keep ourselves up at night by creating myths about things that shouldn't be worrisome at all. One example: The Affordable Care Act's 40 percent excise tax on high-cost health care plans, commonly referred to as the Cadillac Tax.
Although we are several years away from its implementation, brokers are wondering what these health care changes will mean for their business. The Cadillac Tax is confusing and prompts questions from employers and benefits professionals — especially about when to make changes to benefits plans and whether voluntary insurance is affected.
Let's take some time to distinguish between the myths and facts so when you communicate with your clients about their plans this year — and in years to come — you have the facts to ensure you’re providing clients with accurate information to make effective business decisions regarding benefit offerings.
Myth: Employers should make benefit changes now to avoid the Cadillac tax.
Fact: The Cadillac tax has been delayed until 2020.
- As part of the Congressional spending bill signed into law in late December 2015, the Cadillac Tax is delayed until 2020.
- Considering implementation of the tax is several years away and regulations will evolve, employers can wait before considering changes to their policies.
Myth: All voluntary benefits are included in the tax.
Fact: Generally, voluntary insurance products do not count toward the Cadillac Tax calculation.
- Only two types of voluntary coverage — specified disease and hospital indemnity — are subject to the calculation of the tax, but only if they’re paid for with pretax dollars, such as through a cafeteria plan, or with excludable employer contributions. Otherwise, they are not subject to the calculation of the tax.
- Voluntary insurance products are defined as HIPAA-excepted benefits.
Myth: Employers should switch their pretax voluntary insurance products to after-tax versions.
Fact: Only employers with benefits plans considered “high cost” need to consider after-tax strategies.
- Employers and their workers receive tax advantages for retaining pretax voluntary products.
- Only two types of voluntary coverage — specified disease and hospital indemnity — are included in tax calculations, and only then if they’re paid with pretax dollars or the employer pays any portion of the premium. Other voluntary insurance benefits won't trigger the Cadillac Tax, regardless of whether they’re offered before or after tax.
Myth: Employers or workers will be responsible for paying the Cadillac Tax when it goes into effect.
Fact: In most cases, the insurance provider will be responsible for paying the tax.
- Most small businesses are fully insured, meaning the insurance provider sets the premium and pays the claims. When that's the case, the insurer, not the employer, is responsible for paying the Cadillac Tax when it goes into effect in 2020.
- If an employer is self-insured, meaning the employer sets the premiums and pays the claims, or the coverage offered is a health savings account (HSA) or an Archer medical savings account (MSA), the employer or the plan administrator will be responsible for paying the tax.
The bottom line is that myths and rumors have made the Cadillac Tax seem more confusing than it already is. It isn't even expected to take effect for another four years, so it shouldn't prompt your clients to exclude voluntary insurance from their benefits options. After all, the security voluntary coverage provides can help ensure your clients and their employees sleep well instead of worrying about medical costs that are continuing to rise.
The Dish with Lauri Hauer
April’s Dish is serving up Saxon’s own, Lauri Hauer’s favorites!
Dine In
Lauri’s favorite dish to serve when staying in is her Easy Summer Salsa, and this is not your traditional tomato salsa. It is black bean and corn based, and best enjoyed with friends and neighbors around the fire pit. The best thing about this salsa is, as the name alludes, it’s easy to make and perfect for entertaining. Also, it just gets better the longer it sits, so making it ahead saves you more time and makes it more delicious!
EASY SUMMER SALSA
1 can of black beans, drained and rinsed
1 can yellow/white corn, drained
1 medium sized red onion, chopped
Mix these ingredients together in a bowl
½ cup apple cider vinegar
¼ cup sugar
Mix these together and let sugar somewhat dissolve, pour over above ingredients
Chop a few cilantro leaves and mix through
Dine Out
For a night out Lauri recommends checking out the WOOD FIRED GRILL PIZZAS at The Works!!! This is a family fun spot OR a great date night by the bike trail in Downtown Historic Loveland. The Works is located in the old firehouse in Loveland. This place has an atmosphere you can’t find anywhere else around Cincinnati. Their wood fired pizzas are the BEST, Hauer says! Check out their pastas, salads, seafood, burgers, craft beers and so much more.
The WORKS is located @ 20 Grear Millitzer Lane, Loveland, OH 45140
5 things to know about the DOL fiduciary rule
Original post benefitspro.com
Tomorrow marks the last day the White House’s Office of Management and Budget will accept meetings with industry stakeholders hoping to influence the finalization of the Department of Labor’s fiduciary rule.
1. When will the DOL fiduciary rule be finalized?
That means a final rule could emerge as early as next week, but more likely by the end of the month, according to Brad Campbell, an ERISA attorney with Drinker Biddle.
Campbell and Fred Reish, who chairs Drinker Biddle’s ERISA team, addressed a conference call on the DOL rule’s potential impact.
Nearly 1,000 stakeholders participated, testament to the wide-ranging impact the rule is expected to have on advisors and service providers to workplace retirement plans and individual retirement accounts.
2. Will the DOL rule be stopped?
Several legislative efforts that would delay or defund the rule’s implementation, as well as strategies to address the rule through the appropriations process or the Congressional Review Act, are “real and substantive,” said Campbell, but stand little chance of blocking implementation of the rule.
“The likelihood that Congress can stop DOL is low,” said Campbell.
He expects more Democrats to find the rule to be problematic once it is finalized, but not enough to create the two-thirds majority needed to override a veto from President Obama, which would be all but guaranteed of any legislation Congress passes.
3. When would compliance be expected?
Campbell also said he expects the Obama Administration to waste little time making industry comply with the new rule. An end-of-year compliance date should be expected, he said.
“Obama is going to want to have a deadline in place before he leaves. That will make it much harder for the next administration to undue” the rule, said Bradford.
4. Will others try to block the rule?
While Congressional efforts to block the rule will likely prove impotent, Campbell said private lawsuits seeking to block the rule’s implementation are “a very real possibility.”
“DOL has done some things I think they lack the authority to do,” explained Campbell, who referenced a recent majority report from the Senate Committee on Homeland Security and Governmental Affairs.
That report alleged the Obama Administration was “predetermined to regulate the industry” and sought economic evidence to “justify its preferred action” in directing the DOL to write a rule that would expand the definition of fiduciary to include nearly all advisors to 401(k) plans and IRAs.
The report also claims DOL willfully ignored recommendations from the Securities and Exchange Commission, the Treasury Department and the OMB as it crafted its proposed rule.
Campbell called those arguments and others enumerated in the Committee’s report “legitimate.”
If lawsuits from stakeholders do emerge, courts may delay implementation of the rule as claims are litigated, but Campbell seemed to dissuade stakeholders from holding out too much hope for that possibility.
“No one can predict where the courts will go,” he said.
5. What will the fiduciary rule’s impact be?
Fully preparing for the rule’s impact is of course impossible before it is finalized.
Nonetheless, Campbell and Reish itemized the ways a final rule is likely to impact industry. They are hoping regulators address several vague areas of the proposal in the final weeks of the rulemaking process.
Still unknown is whether the rule will provide a grandfather provision for tens of millions of IRA accounts already in existence.
Also at question is the proposal’s education carve-out, which could greatly impact how service providers’ call centers interact with plan participants, and whether including specific funds in asset allocation models would rise to the level of fiduciary advice.
Campbell said he expects the DOL to finalize an education carve-out that is a bit more forgiving than what was initially proposed. He expects a final rule will allow specific investments to be mentioned, so long as a range of comparable options are offered as well.
There also is the question of whether or not 401(k) and IRA platform providers will be allowed to offer access to 3(21) and 3(38) fiduciaries, and whether or not doing so would be a fiduciary action.
But the biggest questions impacting a final rule’s ultimate impact relates to the proposal’s Best Interest Contract Exemption, said both Campbell and Reish.
How those exemptions are ultimately finalized will shape the IRA market and how providers and advisors recommend rollovers from 401(k) plans.
The attorneys said they expect a final rule to consider rollover recommendations a fiduciary act.
One concern for advisors will be when they need an exemption to advise on a rollover.
If general education on rollovers is offered, without advice, one natural consequence is that investors will ask advisors what they should do, said the attorneys.
“Is no advice better than so-called conflicted advice?” asked Reish rhetorically. “Prudent advice can still be prohibited” under the rule’s proposal, he said.
That fundamental question is likely to make whatever rule that emerges “extraordinarily disruptive” to the IRA market, the attorneys said.
CMS Issues 2017 Benefit and Payment Parameters Rule, Letter to Issuers and FAQ
Original post healthaffairs.org
On February 29, 2016, the Department of Health and Human Services released its final 2017 Benefit and Payment Parameters Rule (with fact sheet) and final 2017 Letter to Issuers in the Federally Facilitated Marketplaces (FFMs). It also released a bulletin on rate filings for individual and small group non-grandfathered plans during 2016, a frequently asked questions documenton the 2017 moratorium on the health insurance provider fee recently adopted by Congress, and a bulletin announcing that CMS intends to allow transitional (grandmothered) policies to continue (if states permit it) through December 31, 2017, rather than requiring them to terminate by October 1, 2017, as earlier announced.
The final payment rule and letter include most of the provisions proposed earlier, but differ in important respects.Here are a few headlines, focusing on issues of particular interest to health insurance consumers.
Standardized Plans
To begin, the final rule and letter adopt with a few changes proposals regarding standardized plans. Beginning in 2017, qualified health plan insurers would have the option of offering six standardized plans: a bronze, a gold, and a standard silver, as well as three silver plan options, at the 73 percent, 87 percent, and 94 percent actuarial-value levels, for individuals eligible for cost sharing reduction payments. The plans would have
- standard deductibles (ranging from $6,650 for the bronze plan to $3,500 for the standard silver to $250 for the 94 percent silver cost-sharing variation),
- four-tier drug formularies,
- only one in-network provider tier,
- deductible-free services (for the silver level plan including urgent care, primary care visits, specialist visits, and drugs),
- and a preference for copayments over coinsurance.
Insurers will not be required to offer standardized plans and could offer non-standardized plans (as long as they met meaningful difference standards), but standardized plans will be displayed in the marketplaces a manner that will make them easy for consumers to find.
Network Adequacy Requirements
The final rule and letter adopt some, but not all of the network adequacy requirements that were proposed, and delay some until 2018. The NPRM payment rule would have required states to adopt time and distance network adequacy standards for 2017 and imposed a federal default time and distance standard in states that failed to do so. The final rule backs off this requirement but provides that the FFM will itself generally apply quantitative time and distance standards in determining network adequacy for qualified health plans.
Provider Termination Notice
The final rule requires that health plans give patients 30 days notice when terminating a provider and continue to offer coverage for up to 90 days for a patient in active treatment by a provider who is terminated without cause. The insurer would only have to pay network rates to a provider for continuation coverage and the provider could balance bill. CMS is proceeding with its proposal to label health plans as to their relative network breadth on HealthCare.gov.
Out-Of-Network Bills At In-Network Facilities
CMS is not finalizing until 2018 a requirement the insurers apply to the in-network cost sharing limit the cost of services provided by out-of-network providers at an in-network facility; the agency is also weakening this already weak requirement. As finalized, the requirement only applies to ancillary providers, such as anesthesiologists or radiologists; can be avoided by giving notice (including form notice) 48 hours ahead of time or at the time of prior authorization that treatment might be received from out-of-network providers; and does not apply to balance bills as such where the provider bills for the difference between its charge and the network payment rate.
Open Enrollment Period And Procedures
Open enrollment for 2017 and 2018 will last from November 1 until January 31, as was true this year, but in future years, open enrollment will run from November 1 to December 15, to align enrollment with the calendar year. CMS is not finalizing until 2018 a proposal to allow applicants to remain on a web broker’s or insurer’s non-FFM website to complete a Marketplace applicant and enroll in coverage. Until then, web brokers and insurers will have to use the current direct enrollment process.
The rule changes the reenrollment hierarchy, requiring marketplaces to prioritize reenrollment in silver plans and allowing marketplaces to enroll consumers into plans offered by other insurers if their insurer does not have a plan available for reenrollment through the marketplace. Other proposals to change the reenrollment process were not adopted.
FFM User Fees In State Marketplaces
The final rule and letter finalize the status of state-based marketplaces using the federal enrollment platform, which this year included Hawaii, Oregon, Nevada, and New Mexico. In future years insurers in these states will pay a FFM user fee of 3 percent, but for 2017 the user fee will be 1.5 percent. The standard user fee for other FFM states will be 3.5 percent again for 2017.
Navigators In The FFMs
The final rule requires navigators in FFMs as of 2018 to provide consumers with post-enrollment assistance, including assistance with filing eligibility appeals (though not representing the consumer in the appeal), filing for shared responsibility exemptions, providing basic information regarding the reconciliation of premium tax credits, and understanding basic concepts related to using health coverage. Navigators will also be required to provide targeted assistance to vulnerable or underserved populations.
“Vertical Choice” In The FF-SHOPs
The final rule allows FF-SHOPs to offer a “vertical choice” option, under which employers could allow their employees to choose any plan at any actuarial level offered by a single carrier. This is in addition to the options currently available where employers can offer a single plan or any plans offered by an insurer at a single level. States could recommend against the FF-SHOP offering vertical choice in their states and states with state-based marketplaces using the FFM could opt out of making vertical choice available.
Fraud Prevention In The Medical Loss Ratio Calculation
CMS decided not to allow insurers to count fraud prevention expenses in the numerator in calculating their medical loss ratios, as it had suggested it might in the NPRM.
Other Topics
The insurer fee FAQ clarifies that insurers will not be charged the insurer fee for the 2017 fee year (which would have based the fee on 2016 data). Insurers are expected to adjust their premiums downward to account for the fact that they will not owe the fee.
CMS is allowing states to extend transitional plans, which antedate 2014 and do not have to comply with the 2014 ACA insurance reforms through the end of 2017. Earlier guidance had allowed insurers to renew transitional plans ending before October 1, 2017. CMS concluded that it would be better to allow people in transitional plans to transition into ACA compliant plans during the 2018 open enrollment period rather than having them start a new ACA compliant plan in October 2017 that would only last for three months, and then have to restart a new deductible on January 1, 2018.
There is much more in the rule and letter. The rule is well over 500 pages long, the letter almost 100. Watch for further installments over the next couple of days.
The Dish with Leigh Rathje
The March edition of The Dish is serving up Saxon's own Leigh Rathje's favorite foods.
When she's cooking for friends and family she enjoys making Dorothy’s Chicken Divan “Hot Dish." "It’s my Grandmother’s recipe, so I only make this when close friends and family are over," she shared. In Minnesota casseroles are called Hot Dishes, "so I like to share this funny fact with new friends," Rathje says. According to Leigh this Chicken Divan is best enjoyed around the dinner table, because you’re going to want a second serving!
Recipe: Dorothy’s Chicken Divan “Hot Dish”
3-4 Boneless Skinless Chicken breasts
2 Packages of 10oz Frozen broccoli spears
1 can of Cream of Chicken soup
2/3 cup Mayonnaise
1/3 cup evaporated milk
1 cup grated cheddar cheese
2 teaspoons of white wine
½ or 1 cup of fine bread crumbs
2 tablespoons of butter
Directions: Cook chicken and cube. Cook broccoli. Spray 9x13 pan and line with broccoli. Place chicken on top. Combine the next 5 ingredients and pour over top. Sprinkle bread crumbs and melt butter and pour over top. Bake at 350 for 1 hour.
On a night out, you can find her at Oak Tavern in Cincinatti, Ohio. She enjoys the unassuming digs of this typical, dive sports bar. "Nothing about the inside is special or even remotely looks like they serve food," she says. You come there to watch sports and eat chicken wings. And CHICKEN WINGS INDEED! At the Oak Tavern they smoke their large chicken wings all day, so you can smell them from the streets. The wings come smoked and lightly seasoned, then handed to you with an assortment of 6 different flavored sauces
She prefers the Carolina Gold, but everyone knows their secret spicy berry sauce is where it’s at!
Oak Tavern is @ 3089 Madison Rd. Cincinnati, OH 45209
Agencies Propose Revised SBC Template and Uniform Glossary
Original post shrm.org
The federal agencies overseeing the Affordable Care Act announced a 30-day comment period ending on March 28, 2016, regarding proposed revisions to the Summary of Benefits and Coverage (SBC) and related documents that employers must provide to eligible employees for each of their health plans, following the Feb. 26 publication of an official notice in the Federal Register.
The revisions could be effective for employer-provided plan years beginning with the second quarter of 2017.
On Feb. 25, the Departments of Labor (DOL), Treasury, and Health and Human Services (HHS) released the proposed revised SBC template and revised uniform glossary, along with revised instructions for group plans. Under the Affordable Care Act, SBCs and the uniform glossary must be given to new hires and to employees during open enrollment.
The agencies had issued a final rule regarding SBCs and related documents in June 2015. However, revisions to the SBC template and the uniform glossary were delayed to allow the agencies to complete consumer testing and receive additional input from the public and stakeholders.
Providing Plan Details
In an analysis posted at the Health Affairs Blog, Timothy Jost, a professor at the Washington and Lee University School of Law in Lexington, VA., noted that among the proposed changes the revised documents would:
• Better identify services covered before the deductible applies.
• Disclose whether the plan has “embedded” deductibles and out-of-pocket limits (under which enrollees in family coverage can meet individual deductibles or out-of-pocket limits before the family limits are met).
• Disclose more information on tiered networks in relation to coverage of common medical events.
Though it may not provide the clarity employers and employees are looking for, "on the whole, the proposed revised SBC is a distinct improvement over the current SBC,” commented Jost.
4 Ways to Talk to Employees So They Listen
Original post entrepreneur.com
No one likes to be lectured in the workplace.
As a leader, you need to communicate with your employees to deliver strategic direction, reinforce corporate culture and rally the troops to achieve company goals and objectives. To be effective, you need to deliver these messages in a way that creates energy and enthusiasm, rather than deflating your team.
Here are four tips for talking to employees in a way that energizes them rather than depleting them:
1. Use humor. No matter how big or small your operation may be, there is often tension and emotional distance between the boss and employees. To diffuse that, I regularly use humor, a tactic that makes me more approachable. In my experience, the best kind is self-deprecating humor. When I showed up to meet new employees for the first time at a Midwest location, I started the conversations by poking fun at my pronounced "New Yawk" accent. It got a laugh and made me seem more accessible.
2. Ask open-ended questions. And then be quiet. My favorite question to ask is “Tell me about [insert topic here].” When you ask a new employee about his ideas or a technologist about a new device, you are asking them to do more than give you a pat sentence or two in response. You have the opportunity to access that person’s deep knowledge and passion. Ask a question that opens the conversation wide and then hold still and listen.
3. Bring others into the conversation. A boss-employee conversation may seem casual to the boss but can feel like an interrogation to the employee. To diffuse this situation, I like to bring others into the conversation to even out the experience. I may turn a one-on-one discussion into a larger conversation by inviting people to join us and share their thoughts and experiences. It benefits me, because I get to hear more voices, and it helps put everyone else at ease.
4. Let the little stuff slide. If you are the kind of hands-on person who helped build the business from the ground up, you probably have insight or advice on everything from the capital budget to color of the carpet. But you don’t have to communicate every thought to the staff. If it’s not an important critique, let it go. I visited a flower shop in my company once and noticed the manager was not lining the trashcans with plastic bags. I know from experience that liners make the job easier, but I also know that I don’t need to communicate every idea that comes into my head. It just creates a climate of nitpicking.
Conversations that take place up and down the food chain – between supervisor and staff, people of different departments and the boss and the new employee – are often the source of great new ideas.
As the boss, it’s your job to get those conversations started and keep them going. You have a chance to make that happen (or achieve the opposite) every time you open your mouth.