Following the President’s signing of the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act of 2020 into law, we wanted to provide a brief overview of the two primary financing options for businesses that have been negatively impacted by the COVID-19 pandemic: (1) U.S. Small Business Administration (“SBA”) Economic Injury Disaster Loans (“EIDLs”) and (2) SBA 7(a) loans under the CARES Act.
As more and more employer-sponsored health plans become self-funded, the trend from PPOs to direct provider contracting is growing. High quality health plans continue to demonstrate that direct contracting promotes a more level playing field where both parties can agree on pricing that is fair rather than trying to determine the real value of network discounts.
“The information shared below was received from our legal services partner, Enquiron. It is one of the best, most comprehensive employer guides that I have received. I hope you find it equally as informative and helpful. Thank You and Stay Well.”
– Bruce Flunker, Bruce Flunker, President of EBSO, A 90 Degree Benefits Company
EMPLOYER ALERT – EMERGENCY PREPAREDNESS IN THE WORKPLACE – GUIDE TO PREPARE FOR COVID-19
In the midst of dealing with an emerging situation in the workplace, which can include natural disasters, mass shootings, or pandemic such as COVID-19, employers may have questions related to their workplace and their employees. This Alert is designed to address common questions that affected businesses and employers may be asking in the midst of such a situation – and remember we are here to help!
Read the full Enquiron alert here.
If Florida House Bill HB59 becomes law, Floridians will be able to use video conferencing technology to speak with a pharmacist and obtain prescription drugs dispensed by automated pharmacy systems or vending machines. The systems, manufactured by Canadian company MedAvail, are currently in use in hospitals located in Jacksonville and Miami, Florida.
The Kaiser Family Foundation employee health benefits survey for 2019 shows that the cost of annual premiums for employer-sponsored health insurance plans have reached $20,576. While there are differences between small and large employer groups, costs are rising faster than wages for both and average contributions by employees have reached $1,242 for single coverage and more than $6,000 for families. And while wages have increased by 26% in the past decade, contributions to healthcare premiums have gone up 71%.
According to a new Harris pole conducted for TD Ameritrade, more than half of Americans age 40 and older plan to continue working after they retire. The Federal Reserve Bank of New York adds that the number of workers 55 and older has been rising since 2000. While the percentages dropped for older workers, it remained above 50% for those 70 to 79 years of age. Financial need was important to most, but many over 55 cited a desire to remain sharp and avoid boredom as their main concern.
A recent study in the State of Texas revealed that when health systems acquire physician practices, patient costs go up. The study was in response to a wave of consolidations across all facets of healthcare, from institutions to individual physician practices. Results showed that the share of physician practices owned by hospitals in Texas rose from 14% in 2012 to 29% in 2016.
When two years of claims data was analyzed, it showed that PPO members spent nearly 6% more when treated by doctors in hospital-owned practices, versus physician-owned practices. A breakdown revealed that higher costs were attributable to additional services being provided rather than higher fees. Higher costs for imaging, durable medical equipment and operating and recovery room use were common contributors, with no evidence of improved quality shown.
Communication and helping plan members get the most out of their health plan should be an all year round endeavor. Surveys continue to indicate that even highly educated employees describe benefits, insurance and the enrollment process as “very confusing.”
Consider academic research by the Commonwealth Fund and a recent study by Accenture. While one points to higher deductibles and co-pays as the leading financial barrier to medical care, the other cites low health literacy as a hidden cost adding billions in administrative expense to our healthcare system. While it may never be possible for your plan to do away with co-pays and deductibles, high performance TPAs are doing many things to help plan members make more informed healthcare decisions. Here are a few ideas.
1. Simplify Summary Plan Descriptions – Remember that these are more than compliance documents. They are communication pieces and need to be written so that regular people can read them. Make it easy for employees to find information on eligibility, how they enroll, what the plan covers, what isn’t covered and how to file a claim. Move as much legal information as humanly possible to the end.
2. Put an End to Boring Content – To make things easier on the eyes and draw attention to information people care about, use different kinds of headings and add visuals or infographics to any benefit-related communications. Include links to your TPA’s website or other websites that employees can learn from. You don’t need a Hollywood producer to use video clips and after all, video is pretty much all that younger people look at these days. Seriously!
3. Create a Decision Support Taskforce – It sounds challenging, but look outside HR to recruit a team of individuals who feel comfortable with your health plan and healthcare in general. Let people know they can reach out to these individuals with questions about plan options, coverage, how to file a claim, provider networks, etc. People will appreciate this, especially your younger employees, who studies show are particularly confused and stressed over everything insurance related.
Improving your communications can make people feel much more confident about the decisions they have to make. You don’t have to tackle everything at once and even a little progress will improve morale and help people avoid making decisions they may regret later.
It’s doubtful that many technology companies are concerned about employees nearing age 65. Other employers, however, may want to brush up on Medicare eligibility in order to help older workers understand their options and avoid any potential gap in coverage. Here are just a few Medicare-related concerns:
- For employees who will lose access to employer-sponsored group health coverage at age 65 or who choose to sign up for Medicare upon becoming eligible, the Initial Enrollment Period (IEP) is 3 months before to 3 months after the month they turn 65.
- Medicare-eligible workers who leave employment with a retiree health plan or COBRA coverage are classified as “former workers” and therefore need to enroll in Medicare during their IEP.
- Employees who have enrolled in Social Security before their 65th birthday will automatically be enrolled in Medicare Parts A and B. In order to avoid paying for 2 health plans, they may need to inform the Social Security Administration that they do not want Medicare Part B at this time.
- Finally, for companies with fewer than 20 employees, Medicare becomes primary coverage. Workers and/or their spouses who are 65 or older must enroll in Medicare Parts A & B.
While employees must enroll in Medicare on their own, a little help from HR can go a long way. When questions about Medicare eligibility and enrollment arise, never hesitate to encourage a visit to a local Social Security Administration office or Medicare.gov.