A Turn For The Better

EBSO-joins-90DegreeBenefits

EBSO is proud to announce we are a 90 Degree Benefits Company! 90 Degree Benefits is a company formed of leading TPA’s across the country. Although we operate independently, 90 Degree Benefits is a part of the Blue Cross Blue Shield of Alabama family.

EBSO will still operate as the same TPA you have been working with for years, however we will now have more resources and vendor solutions available than ever before. You will also continue to work with the same great team of people you have in the past.

To learn more about 90 Degree Benefits, please Click Here to visit their site, email us at marketing@ebsobenefits.com, or contact your Marketing Representative.

HSAs Become More Flexible

hsaCurrently, patients with high deductible health plans and health savings accounts have to pay for treatment of chronic illnesses out-of-pocket until they have reached their required deductible. According to IRS Notice 2019-45, those with chronic conditions such as diabetes, high blood pressure or asthma, will reduce their financial burden prior to reaching their health plan deductible.

The notice, which becomes effective on January 1, 2020, states that the service or item needed must be low cost and supported by medical evidence showing that it will prevent the chronic condition from getting worse or causing other related health issues.

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Moving Patients Can Be a Win-Win

From hospitals to insurers, you’ve probably heard many say that the goal is to provide the right healthcare, at the right time, in the right place. When it comes to the infusion of high-priced specialty drugs, location can make a huge difference. As an example, the variance in the cost of hospital-administered multiple sclerosis drugs can be staggering. One third party administrator saved a self-funded health plan more than $30,000 by moving a patient from a local hospital to a beautiful treatment facility in the Cayman Islands. The patient not only received their prescription in a beautiful, clean, state-of-the-art facility, but air travel and lodging were included.

Other cases compare the administration of specialty drugs in independent physician offices and patient’s homes rather than hospital outpatient settings. Savings ranged from $16,000 to $37,000 annually and the patient received the same level of personalized care without the hassle of a hospital visit. While the patient’s condition and circumstances always take precedence, finding a more appropriate location for treatment can make a positive difference for the plan and the patient.

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Vaping in the News

As public health officials work to identify a respiratory illness putting people who vape in the hospital, negative reports continue to frighten parents. In the last month or so, two young people have died in Illinois and more than 20 others have been hospitalized throughout the state. The news is similar in other states, as more than 190 hospitalizations were reported by the Centers for Disease Control and Prevention. State and federal health officials are searching for answers, including details on what these people vaped.

While manufacturers say their e-cigarettes were always intended as an alternative to cigarettes for adult smokers, legal challenges are being directed at manufacturers for aggressive marketing to teenagers.

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Dress More Casual

millenialsNon-technical staffing company Randstad US reports that 79% of employers offer casual, business casual or no dress code at all. Even investment bank Goldman Sachs has reportedly relaxed its dress code in response to the changing nature of workplaces. While most employers are considering increased flexibility to be a welcome benefit, many employees appreciate being able to save money on their wardrobe and related expenses such as dry cleaning.

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Wellness Budgets Rising

medical-moneyWhile the National Business Group on Health has forecasted a 5% increase in the cost of healthcare benefits, others are expecting employers to dedicate more resources to health and wellness. More emphasis will also be placed on the use of digital tools to identify lower cost providers and boost employee engagement. Experts say the trend is in response to more and more employees looking to their employers to help them better manage their personal health.

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Allowing Imported Drugs

HHS Secretary Alex Azar announced new proposals from the administration that would allow Americans to pay less for high-priced prescription drugs. One enables drug manufacturers to negotiate new contracts to sell lower-priced foreign versions of certain biologics. The other would enable states, wholesalers and pharmacists to import certain FDA-approved drugs from Canada. The proposals are in line with the President’s pledge to lower prescription drug costs for Americans.

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Using Social Media More

The Binary Foundation reports that more than half of surveyed adults have used social media networks to search for healthcare providers – a six-fold increase since 2017. More important, 75% of respondents were influenced by online ratings and reviews, with many calling these reviews somewhat or very reliable. Only 9 percent said they do not use online platforms when selecting a provider, compared to 48% in 2017.

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Small Groups Will Celebrate New HRAs

The IRS recently published finalized rules easing restrictions on health reimbursement arrangements (HRAs) to allow employers to provide their workers with tax-preferred funds to pay for the cost of health insurance coverage they buy in the individual market. The regulation is part of the Trump Administration’s commitment to deliver more health coverage choices to Americans.

The HRA rule should be extremely valuable to small businesses that have had a really hard time providing group health coverage. So hard, in fact, that the Kaiser Family Foundation Employer Health Benefits Survey recently reported that the percentage of businesses with 25 to 49 workers offering group coverage has fallen from 92% to 71% since 2010.

Two New Options Will Be Available
Effective January 1, 2020, employers will be able to help employees buy individual health insurance policies by offering two different tax free HRAs. The first is an Individual Coverage HRA, which can only be offered to similar classes of workers when a traditional group health plan is not currently available. Classes refer to groups of employees with similar circumstances, such as full-time, part-time, seasonal, salaried, temporary, etc. A class must include at least 10 employees for employers with fewer than 100 employees and 20 or more employees for employers of 200 or more workers.

The other option, an Excepted Benefits HRA, is designed to be offered with a traditional group health plan, although employees do not have to enroll in the health plan. The maximum annual benefit for an Excepted Benefits HRA is $1,800.

Tax-Preferred Benefits Can Extend to Millions
The new HRA rules will make it easier for small businesses to compete with larger organizations that provide high quality group health benefits. More importantly, the employees who buy individual health plans financed by a new HRA will receive the same tax advantages as those with traditional group coverage.

The Departments of Labor, Health and Human Services and Treasury estimate that HRA expansion will benefit as many as 800,000 employers and more than 11 million employees and family members, 800,000 of whom will have been previously uninsured. To learn more about these new HRAs as you begin your planning for 2020, contact your account representative at your convenience.

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Judge Rules Against Drug Price Disclosure

prescriptionIn a very recent decision, a federal judge ruled against Trump Administration efforts to require drug manufacturers to include the price of prescription drugs in their television commercials. Filed in federal court in mid-June, the lawsuit claimed that HHS does not have the legal power to enforce the rule and that including prices will mislead patients and discourage them from seeking treatment. In the decision rendered on July 9th, U.S. District Court Judge Amit P. Mehta agreed, adding that the administration had overstepped its authority.

A spokesman for HHS was quoted as saying “we are disappointed in the court’s decision and will be working with the Department of Justice on next steps.” While the decision is a blow to the administration’s efforts to increase cost transparency and drive down drug prices, many expect their efforts to continue.

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