Safety Focused Newsletter - December 2017

Preventing Sprains and Strains

Sprains, strains and tears to muscles and connective tissues are some of the most common injuries workers experience. Sprains and strains can result from lifting injuries, being hit by falling objects or even a simple misstep. Overusing your muscles can also cause these injuries.

To reduce your risk of experiencing sprains and strains on the job, keep the following tips in mind:

  • Use extreme caution if you are lifting something particularly heavy. When in doubt, ask for help.
  • Reduce repetitive movements if possible. Chronic strains are usually the result of overusing the same muscles.
  • Use proper form when completing tasks, as extensive gripping can increase the risk of hand and forearm strains.
  • Consider your posture when sitting for long periods of time and maintain an overall relaxed position.
  • Maintain a healthy fitness level outside of work to keep your body strong and flexible.
  • Stretch before you begin working, and take short breaks throughout the day to stretch and rebalance your body.

If you have any questions or concerns about sprains or strains, do not hesitate to contact your supervisor.

 

The Hazards of Headphones

In many workplaces, it’s common for employees to listen to music while they work. While this provides workers with entertainment while they perform their job duties, the overuse of headphones may lead to hearing loss over time, particularly if they listen to media at a high volume.

The following are some common symptoms to look out for if you are concerned that frequent headphone use is contributing to hearing loss:

  • Straining to understand conversations
  • Having to watch people’s faces closely to understand what they’re saying
  • Continuously increasing the volume on the TV or radio, especially to the point where others complain
  • Sounds seem muffled after listening to music
  • Ringing in the ears (tinnitus)

If you find that you have any of these symptoms, visit your doctor and ask for a hearing test. Your doctor will be able to tell you if you are at risk for further hearing loss.

To continue to use headphones at work safely, there are a number of strategies to keep in mind.

If you use a smartphone or MP3 player, check to see if you can set a volume limit on it. Many devices have this feature built-in and include instructions on how to set it in the manual.

Another way to reduce your risk of hearing loss is to purchase headphones that go over your ears, rather than ear buds. Ear buds fit inside your ear and don’t provide any noise isolation, which causes people using them to turn the volume up louder.

As a general rule, set your music volume no higher than 60 to 70 percent of the maximum, and limit listening to one hour per day. Doing so will ensure that you can enjoy your favorite media without harming your hearing.

 

Download the December 2017 Safety Focused Newsletter PDF


Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis

From Kaiser Health News, here is the latest: an interview with Dr. Mary Meengs, medical director at the Humboldt Independent Practice Association, on curbing opioid addiction through the reduction of prescription painkillers.


Dr. Mary Meengs remembers the days, a couple of decades ago, when pharmaceutical salespeople would drop into her family practice in Chicago, eager to catch a moment between patients so they could pitch her a new drug.

Now living in Humboldt County, Calif., Meengs is taking a page from the pharmaceutical industry’s playbook with an opposite goal in mind: to reduce the use of prescription painkillers.

Meengs, medical director at the Humboldt Independent Practice Association, is one of 10 California doctors and pharmacists funded by Obama-era federal grants to persuade medical colleagues in Northern California to help curb opioid addiction by altering their prescribing habits.

She committed this past summer to a two-year project consisting of occasional visits to medical providers in California’s most rural areas, where opioid deaths and prescribing rates are high.

“I view it as peer education,” Meengs said. “They don’t have to attend a lecture half an hour away. I’m doing it at [their] convenience.”

This one-on-one, personalized medical education is called “academic detailing” — lifted from the term “pharmaceutical detailing” used by industry salespeople.

Detailing is “like fighting fire with fire,” said Dr. Jerry Avorn, a Harvard Medical School professor who helped develop the concept 38 years ago. “There is some poetic justice in the fact that these programs are using the same kind of marketing approach to disseminate helpful evidence-based information as some [drug] companies were using … to disseminate less helpful and occasionally distorted information.”

Recent lawsuits have alleged that drug companies pushed painkillers too aggressively, laying the groundwork for widespread opioid addiction.

Avorn noted that detailing has also been used to persuade doctors to cut back on unnecessary antibiotics and to discourage the use of expensive Alzheimer’s disease medications that have side effects.

Kaiser Permanente, a large medical system that operates in California, as well as seven other states and Washington, D.C., has used the approach to change the opioid-prescribing methods of its doctors since at least 2013. (Kaiser Health News is not affiliated with Kaiser Permanente.)

In California, detailing is just one of the ways in which state health officials are attempting to curtail opioid addiction. The state is also expanding access to medication-assisted addiction treatment under a different, $90 million grant through the federal 21st Century Cures Act.

The total budget for the detailing project in California is less than $2 million. The state’s Department of Public Health oversees it, but the money comes from the federal Centers for Disease Control and Prevention through a program called “Prevention for States,” which provides funding for 29 states to help combat prescription drug overdoses.

The California doctors and pharmacists who conduct the detailing conversations are focusing on their peers in the three counties hardest hit by opioid addiction: Lake, Shasta and Humboldt.

They arrive armed with binders full of facts and figures from the CDC to help inform their fellow providers about easing patients off prescription painkillers, treating addiction with medication and writing more prescriptions for naloxone, a drug that reverses the toxic effects of an overdose.

“Academic detailing is a sales pitch, an evidence-based … sales pitch,” said Dr. Phillip Coffin, director of substance-use research at San Francisco’s Department of Public Health — the agency hired by the state to train the detailers.

In an earlier effort, Coffin said, his department conducted detailing sessions with 40 San Francisco doctors, who have since increased their prescriptions of naloxone elevenfold.

“One-on-one time with the providers, even if it was just three or four minutes, was hugely beneficial,” Coffin said. He noted that the discussions usually focused on specific patients, which is “way more helpful” than talking generally about prescription practices.

Meengs and her fellow detailers hope to make a dent in the magnitude of addiction in sparsely populated Humboldt County, where the opioid death rate was the second-highest in California last year — almost five times the statewide average. Thirty-three people died of opioid overdoses in Humboldt last year.

One recent afternoon, Meengs paid a visit during the lunch hour to Fortuna Family Medical Group in Fortuna, a town of about 12,000 people in Humboldt County.

“Anybody here ever known somebody, a patient, who passed away from an overdose?” Meengs asked the group — a physician, two nurses and a physician assistant — who gathered around her in the waiting room, which they had temporarily closed to patients.

“I think we all do,” replied the physician, Dr. Ruben Brinckhaus.

Brinckhaus said about half the patients at the practice have a prescription for an opioid, anti-anxiety drug or other controlled substance. Some of them had been introduced to the drugs years ago by other prescribers.

Dr. Ruben Brinckhaus says his small family practice in Fortuna, Calif., has been trying to wean patients off opiates. (Pauline Bartolone/California Healthline)

Meengs’ main goal was to discuss ways in which the Fortuna group could wean its patients off opioids. But she was not there to scold or lecture them. She asked the providers what their challenges were, so she could help them overcome them.

Meengs will keep making office calls until August 2019 in the hope that changes in the prescribing behavior of doctors will eventually help tame the addiction crisis.

“It’s a big ship to turn around,” said Meengs. “It takes time.”

 

Source:
Bartolone P. (14 November 2017). "Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis" [Web blog post]. Retrieved from address https://khn.org/news/taking-a-page-from-pharmas-playbook-to-fight-the-opioid-crisis/

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ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurance Could Pay Less for Health Plan than Individual Mandate Penalty

Things are not looking up for the uninsured. Pay less and reach out to your health insurance professionals today. Want more facts? Check out this blog article from Kaiser Family Foundation.

A new Kaiser Family Foundation analysis finds that more than half (54% or 5.9 million) of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

Within that 5.8 million, about 4.5 million (42% of the total) could obtain a bronze-level plan at no cost in 2018, after taking income-related premium tax credits into account, the analysis finds.

Most people without insurance who are eligible to buy marketplace coverage qualify for subsidies in the form of tax credits to help pay premiums for marketplace plans (8.3 million out of 10.7 million). Among those eligible for premium subsidies, the analysis finds that 70 percent could pay less in premiums than what they’d owe as a tax penalty for lacking coverage, with 54 percent able to purchase a bronze plan at no cost and 16 percent contributing less to their health insurance premium than the tax penalty they owe.

Among the 2.4 million uninsured, marketplace-eligible people who do not qualify for a premium subsidy, 2 percent would be able to pay less for marketplace insurance than they’d owe for their 2018 penalty, the analysis finds.

The Affordable Care Act’s individual mandate requires that most people have health coverage or be subject to a tax penalty unless they qualify for certain exemptions. The individual mandate is still in effect, though Congress may consider repealing it as part of tax legislation.

Consumers can compare their estimated 2018 individual mandate penalty with the cost of marketplace insurance in their area with KFF’s new Individual Mandate Penalty Calculator.

The deadline for ACA open enrollment in most states is Dec. 15, 2017.

 

You can read the original article here.

Source:

Kaiser Family Foundation (9 November 2017). "ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurance Could Pay Less for Health Plan than Individual Mandate Penalty" [Web blog post]. Retrieved from address https://www.kff.org/health-reform/press-release/analysis-more-than-half-of-uninsured-people-eligible-for-marketplace-insurance-could-pay-less-for-health-plan-than-individual-mandate-penalty/


4 ways for advisers to protect and build business during fourth quarter

As the end of the year approaches, it's important for your business to thrive. In this article from Employee Benefit Advisors, Ron Goldstein addresses the fundamental ways to protect and build your business during your fourth quarter. Check it out below.


The fourth quarter is one of the busiest and most chaotic times for brokers. It is also the “make-or-break” period for protecting and building their respective books of business for the coming year.

It is wise for agents to move quickly during this busy season to help clients get a head start on health plan renewals, annual budgeting and more. Here are four tips for brokers to keep in mind:

1) Identify network disruptions. The time is now to proactively talk with clients about any network disruptions or problems they may have with their coverage. For instance, it is well-established that people want to see their own doctors, specialists, pharmacies and hospitals. But when they unexpectedly cannot — or when access requires expensive out-of-network and out-of-pocket costs — substantial upset will occur. The result can be a significant business threat for brokers. It is best, then, to identify any network “pain points” before the busy season is in full swing. This provides brokers with the needed time to work with clients to resolve any issues while also helping to assure that they are avoided and averted in the future.

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2) Understand plan disrupters and alternatives. This may seem obvious, but it is a vital point worth driving home. Whether a plan is bronze, platinum or somewhere in between, there are often adjustments made from one year to the next. Agents need to be intimately familiar with any changes, whether significant or minor, that might disrupt a client’s existing coverage. This can include network modifications, premiums, copays and so forth. So, clearly understand any variations and be prepared to discuss alternative options based on a business owner’s needs and expectations.

3) Address client budgets. Remember to talk with employers about any budgetary changes to their business. Depending on the discussion, this can be the optimal time to kick-start a conversation about alternative defined-contribution options. For instance, perhaps there are opportunities to raise the fixed-dollar amount for employees and/or to explore value-added benefits such as dental, vision, life insurance and other ancillary offerings. On the flip side, you can consider basing your client’s contribution on a different plan option that may provide costs savings if they’re looking to try and reduce their healthcare expenditure. Either way, addressing budgets early on helps brokers ensure they are tailoring plans that best meet client needs.

4) Move off a Dec. 1 renewal period: Moving off of this date may help provide clients with a better open enrollment and underwriting experience. Many renewals get stacked up right before this deadline, putting more pressure on agent customer service. At the same time, it can be easy to get bogged down and rushed with multiple clients requiring quoting, enrollment, plan administration and more to meet looming deadlines. Beginning the renewal process earlier in the quarter provides brokers and their clients with plenty of time to work together to address and select the right plan offerings. Additionally, it may make sense to also explore a larger array of options and pricing advantageous to brokers and clients alike.

While the end of 2017 is ahead, the beginning to a successful 2018 is right now for brokers, agents and benefits professionals. Those who anticipate client needs early-on and take pre-emptive efforts now will be better positioned to lock-in and expand business for the coming year.

 

You can read the original article here.

Source:

Goldstein R. (20 October 2017). "4 ways for advisers to protect and build business during fourth quarter" [Web Blog Post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/4-ways-for-employee-benefit-brokers-to-protect-and-build-business-during-fourth-quarter


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5 SIMPLE STEPS TO DEVELOPING A COMPETITIVE PAY PRACTICE

Have you struggled with employee engagement and building a competitive pay practice? Fortunately, HR Morning has provided us and you with this awesome article, including five simple steps toward a competitive pay practice. Read more below.


In today’s competitive environment, employees are more educated than ever before about the current salary rates in their location and industry. If you want your business to remain competitive, and retain top talent, you need to stay one-step ahead of your competition, and have a solid pay strategy that’s based on accurate salary data – not speculation.

Here are a few simple steps to get you closer to a compensation strategy that retains talent and keeps your company ahead of the curve.

1)      Get a Pulse on Your Market

After a series of wage declines in 2009 and 2010, a number of industries are now seeing continual salary growth across multiple industries and locations. If your company’s compensation plan is based on the trends in those leaner years immediately after the recession, it’s probably time to revisit your pay strategy. Or you may be at risk of losing talent to competitors who’ve more quickly adapted to shifts in the market. Keep an eye on the PayScale Index to keep track of quarterly trends in pay by location, industry and job category.

 

2)      Benchmark Your Job Positions

It’s great to have a pulse on the overarching pay trends in your industry and area, but it’s another thing to have confidence that you’re actually paying top employees at the right rates for their job. By engaging in at least once-per-year salary benchmarking, you’ll be able to identify employees who are at a “high flight risk” of turnover, and be able to make smarter decisions about where you allocate your labor budget. Download PayScale’s How to Perform Compensation Benchmarking and Salary Ranges whitepaper for more information.

 

3)      Develop a Compensation Plan

Often times, businesses fear that having a compensation plan will limit their ability to make good business decisions, so they skip building a compensation plan in favor of fewer rules and less structure. But without a formalized compensation plan, companies often miss an opportunity to structure their pay decisions in a way that support business goals. As companies grow, the costs of compensation continue to rise, and without a formalized plan in place, companies often experience problems with pay inequities, employee retention, and engagement. Simply put, it’s easier, and more cost-effective to take small steps toward developing a smart compensation plan now, than it is to alter your course later down the line.

 

4)      Identify Pay Inequities

Some people live by the motto, “What you don’t know won’t hurt you.” That’s a motto your organization cannot afford to live by when it comes to internal pay inequities. Without a formalized comp plan, it’s often common for pay inequities to develop across organizations and departments. Those pay inequities can most definitely hurt you and your organization in the form of heightened turnover, over payment, and even litigation. Learn how to identify and resolve these inequities with PayScale’s guide to pay inequities.

 

5)      Communicate Your Compensation Strategy

If you go through the process of creating a compensation plan, don’t forget to let your employees know about it. In theory, your compensation strategy should reiterate and support your business goals. So, it’s important to communicate to employees how their work aligns with the goals of the organization, and how their compensation reflects that. If you share with your employees, and make your investments in talent clear to them, you’ll be surprised by the positive effect it has on employee morale. Check out PayScale’s Four Tips for Communicating Your Compensation Plan to Employees to help you get started.

 

Need help developing a competitive compensation strategy, or maintaining salary ranges for your workforce? PayScale offers access to the largest online salary database in the world. With data that’s updated on a daily basis, and software designed to help you maintain salary ranges, benchmark jobs, and allocate raises, PayScale is the choice for businesses who value accuracy and ROI in their pay practices. Request a demo of PayScale compensation software to learn how PayScale’s fresh, detailed data can support good compensation planning.

 

Read the original article here.

Source:

HRMorning.com (N.D.). "5 SIMPLE STEPS TO DEVELOPING A COMPETITIVE PAY PRACTICE" [Web blog post]. Retrieved from address http://pbpmedia.staging.wpengine.com/5-simple-steps-to-developing-a-competitive-pay-practice/


Don't Put Up with the Bull of Bullying

Bullying plagues our nation - and not just in high school. Here is an excellent article from our partner UBA Benefits on how to spot and handle bullying in the workplace.


Read the original article here.

Source:

Mukhtar G. (19 September 2017). "Don't Put Up with the Bull of Bullying" [Web Blog Post]. Retrieved from address http://blog.ubabenefits.com/dont-put-up-with-the-bull-of-bullying

 

There’s no place for bullying and that’s especially true in the workplace, yet many employees bully their co-workers. So, how does this happen? It used to be that bullying was confined to the schoolyard, but now it’s spread to cyberbullying and workplace bullying. Now, if there’s a culture of bullying at an organization, often it’s repeated as people climb the corporate ladder even though they were bullied themselves when they held lower positions.

An article on the website Human Resource Executive Online titled, “How to Bully-proof the Workplace,” says that “80 percent of bullying is done by people who have a position of power over other people.” Let that number sink in. That means four out of five people in positions of power will bully their subordinates.

One possible reason for the high number is that bullying may be difficult to identify and the person doing the bullying may not even realize it. Either the bully, or the victim, could view the action as teasing, or workplace banter. However, when one person is continually picked on, then that person is being bullied. Likewise, if a manager picks on all of his or her subordinates, then that person is a bully.

It’s important for organizations to have policies in place to thwart bullying and not just for the toll it takes on employees. It also begins to affect productivity. Those being bullied often feel like their work doesn’t matter and their abilities are insufficient. Worse is that bullies tend to resent talented people as they’re perceived as a threat. So, bullies tend to manipulate opinions about that employee in order to keep them from being promoted.

Eventually, talented employees decide to work elsewhere, leaving the employer spending time and money to find a replacement. But the bully doesn’t care. It just means they get to apply their old tricks on someone who isn’t used to them.

At some point, someone will fight back. Not physically, of course, but through documentation. An employee who is being bullied should immediately document any and all occurrences of workplace bullying and then present those documents to someone in HR. Most likely, this will result in identification of the bullying, stoppage of it, counseling for both the bully and the victim, and, if not already enacted, policies to prevent it from happening again.

 

Read the original article here.

Source:

Mukhtar G. (19 September 2017). "Don't Put Up with the Bull of Bullying" [Web Blog Post]. Retrieved from address http://blog.ubabenefits.com/dont-put-up-with-the-bull-of-bullying


Wellness Programs – Getting Started and Remaining Compliant

The overall health and wellness of your employees should be a top priority in your business. Why? Find out in this informative article from our UBA partner.


Where to Start?

First, expand the usual scope of wellness activity to well-BEING. Include initiatives that support more than just physical fitness, such as career growth, social needs, financial health, and community involvement. By doing this you increase your chances of seeing a return on investment (ROI) and a return on value (ROV). Qualitative results of a successful program are just as valuable as seeing a financial impact of a healthier population.

Wellness program ROI and ROV

Source: Katherine Baicker, David Cutler, and Zirui Song, “Workplace Wellness Programs Can Generate Savings,” Health Affairs, February 2010, 29(2): pp 304-311

To create a corporate culture of well-being and ensure the success of your program, there are a few important steps.

  1. Leadership Support: Programs with leadership support have the highest level of participation. Gain leadership support by having them participate in the programs, give recognition to involved employees, support employee communication, allow use of on-site space, approve of employees spending time on coordinating and facilitating initiatives, and define the budget. Even though you do not need a budget to be successful.
  2. Create a Committee or Designate a Champion: Do not take this on by yourself. Create a well-being committee, or identify a champion, to share the responsibility and necessary actions of coordinating a program.
  3. Strategic Plan: Create a three-year strategic plan with a mission statement, budget, realistic goals, and measurement tools. Creating a plan like this takes some work and coordination, but the benefits are significant. You can create a successful well-being program with little to no budget, but you need to know what your realistic goals are and have a plan to make them a reality.
  4. Tools and Resources: Gather and take advantage of available resources. Tools and resources from your broker and/or carrier can help make managing a program much easier. Additionally, an employee survey will help you focus your efforts and accommodate your employees’ immediate needs.

How to Remain Compliant?

As always, remaining compliant can be an unplanned burden on employers. Whether you have a wellness or well-being program, each has their own compliance considerations and requirements to be aware of. However, don’t let that stop your organization from taking action.

There are two types of programs – Group Health Plans (GHP) and Non-Group Health Plans (Non-GHP). The wellness regulations vary depending on the type of employer and whether the program is considered a GHP or Non-GHP.

Group health plan compliance table

Employers looking to avoid some of the compliance burden should design their well-being program to be a Non-GHP. Generally, a well-being program is Non-GHP if it is offered to all employees regardless of their enrollment in the employer’s health plan and does not provide or pay for “medical care.” For example, employees receive $100 for attending a class on nutrition. Here are some other tips to keep your well-being program Non-GHP:

  • Financial: Do not pay for medical services (e.g., flu shots, biometric screenings, etc.) or provide medical care. Financial incentives or rewards must be taxed. Do not provide premium discounts or surcharges.
  • Voluntary Participation: Include all employees, but do not mandate participation. Make activities easily accessible to those with disabilities or provide a reasonable alternative. Make the program participatory (i.e., educational, seminars, newsletters) rather than health-contingent (i.e., require participants to get BMI below 30 or keep cholesterol below 200). Do not penalize individuals for not participating.
  • Health Information: Do not collect genetic data, including family medical history. Any medical records, or information obtained, must be kept confidential. Avoid Health Risk Assessments (i.e. health surveys) that provide advice and analysis with personalized coaching or ask questions about genetics/family medical history.

 

You can read the original article here.

Source:

DeRocha H. (15 August 2017). "Wellness Programs – Getting Started and Remaining Compliant" [web blog post]. Retrieved from address http://blog.ubabenefits.com/wellness-programs-getting-started-and-remaining-compliant


The Killjoy of Office Culture

Sometimes, negativity in the office is hard to avoid. Read this article for some helpful tips to take care of those who may be aiding in the negative atmosphere.


One of the latest things trending right now in business is the importance of office culture. When everyone in the office is working well together, productivity rises and efficiency increases. Naturally, the opposite is true when employees do not work well together and the corporate culture suffers. So, what are these barriers and what can you do to avoid them?

According to an article titled, “8 ways to ruin an office culture,” in Employee Benefit News, the ways to kill corporate culture may seem intuitive, but that doesn’t mean they still don’t happen. Here’s what organizations should do to improve their corporate culture.

Provide positive employee feedback. While it’s easy to criticize, and pointing out employees’ mistakes can often help them learn to not repeat them, it’s just as important to recognize success and praise an employee for a job well done. An “attaboy/attagirl” can really boost someone’s spirits and let them know their work is appreciated.

Give credit where credit is due. If an assistant had the bright idea, if a subordinate did all the work, or if a consultant discovered the solution to a problem, then he or she should be publicly acknowledged for it. It doesn’t matter who supervised these people, to the victor go the spoils. If someone had the guts to speak up, then he or she should get the glory. Theft is wrong, and it’s just as wrong when you take someone’s idea, or hard work, and claim it as your own.

Similarly, listen to all ideas from all levels within the company. Every employee, regardless of their position on the corporate ladder, likes to feel that their contributions matter. From the C-suite, all the way down to the interns, a genuinely good idea is always worth investigating regardless of whether the person who submitted the idea has an Ivy League degree or not. Furthermore, sometimes it takes a different perspective – like one from an employee on a different management/subordinate level – to see the best way to resolve an issue.

Foster teamwork because many hands make light work. Or, as I like to say, competition breeds contempt. You compete to get your job, you compete externally against other companies, and you may even compete against your peers for an award. You shouldn’t have to compete with your own co-workers. The winner of that competition may not necessarily be the best person and it will often have negative consequences in terms of trust.

Get rid of unproductive employees. One way to stifle innovation and hurt morale is by having an employee who doesn’t do any work while everyone else is either picking up the slack, or covering for that person’s duties. Sometimes it’s necessary to prune the branches.

Let employees have their privacy – especially on social media. As long as an employee isn’t conducting personal business on company time, there shouldn’t be anything wrong with an employee updating their social media accounts when they’re “off the clock.” In addition, as long as employees aren’t divulging company secrets, or providing other corporate commentary that runs afoul of local, state, or federal laws, then there’s no reason to monitor what they post.

Promote a healthy work-life balance. Yes, employees have families, they get sick, or they just need time away from the workplace to de-stress. And while there will always be times when extra hours are needed to finish a project, it shouldn’t be standard operating procedure at a company to insist that employees sacrifice their time.

 

You can read the original article here.

Source:

Mukhtar G. (14 September 2017). "The Killjoy of Office Culture" [web blog post]. Retrieved from address http://blog.ubabenefits.com/the-killjoy-of-office-culture


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Are you addressing your employee’s financial health?

Do your employees find themselves bogged down with financial concerns? Maybe it's time to help them out. In this article, our partner, UBA, explores some of the ways your employees may be struggling with their financial health, and how you can help.


The importance of health and wellness in the workplace is more apparent than ever. It’s obvious why healthy individuals make better employees and the positive impact this has on your bottom line. When thinking about building a program to improve the well-being of your employees, don’t forget about the importance of their financial health.

In recent years, studies show that employees have a wide range of financial concerns that affect their work. Some financial issues are widespread, impacting a large number of employees, while others may be more unique based on an employee’s specific circumstances.

Financial stress in the workplace influences productivity, absenteeism, physical health, emotional well-being, and the overall happiness of employees. Nearly 25 percent of employees confirm personal finance issues are a distraction at work and 39 percent say they spend three hours or more each week at work dealing with personal financial issues.1

Some of the biggest financial stressors impacting employees today include:

  • Student loan debt – 2 million Americans collectively owe $1.3 trillion in student loans – that’s more than credit card and auto loan debt, and second only to mortgage debt 2
  • Retirement savings – 56 percent of Americans have less than $10,000 in retirement savings 3
  • Emergency funds – 46 percent are unable to cover a $400 emergency 4
  • Other debt – 48 percent of Americans have more credit card debt than savings 5

Unfortunately, financial stress can go unnoticed because it is usually not as openly discussed or addressed. Discussing personal finance with co-workers and even family members is still considered difficult for many. This makes it even more important to have a program in place to educate and empower your employees to make positive financial decisions.

There are a wide variety of financial wellness programs and services available. When developing a program, be sure that you include both educational resources and tools that support behavioral change.

  • Educational resources – Education is the backbone to any financial wellness program. Remember, financial issues can impact anyone in your company and not everyone learns the same way. Offer a variety of resources including workshops, seminars, books, online courses and access to financial consultations. It’s important to assure employees that they are in a safe environment where they can learn and feel comfortable asking questions and seeking more information.
  • Empowering behavioral change – Financial wellness doesn’t stop with education. Worksheets, budgeting tools, financial consultants, loan repayment plans and retirement savings plans are all tools that aid employees in making long-term behavioral changes that improve their financial health. Celebrating the small successes early on will help employees commit to making more long-term changes. Be sure to have programs in place that offer the tools and resources needed for employees to set goals, change their behavior and celebrate their success.

 

You can read the original article here.

Source:

Cannon N. (3 October 2017). "Are you addressing your employee’s financial health?" [web blog post]. Retrieved from address http://blog.ubabenefits.com/are-you-addressing-your-employees-financial-health


Data Note: Changes in 2017 Federal Navigator Funding

Are you looking for a run-down on Navigator programs and their funding? In this article from the Kaiser Family Foundation, we are offered an informative peak of the 2017 changes in federal Navigator funding within the Affordable Care Act (ACA).


Read the original article here.

Source:

Pollitz K., Tolbert J., Diaz M. (11 October 2017). "Data Note: Changes in 2017 Federal Navigator Funding" [Web Blog Post]. Retrieved from address https://www.kff.org/health-reform/issue-brief/data-note-changes-in-2017-federal-navigator-funding/

 

The Affordable Care Act (ACA) created Navigator programs to provide outreach, education, and enrollment assistance to consumers eligible for coverage through the Marketplaces and through Medicaid and requires that they be funded by the marketplaces.  For the past two years, the Centers for Medicare and Medicaid Services (CMS) has funded Navigator programs in the 34 states that use the federal marketplace through a multi-year agreement that was expected to continue for the current budget year.  In August, CMS officials announced significant reductions to Navigator funding for the 2018 budget year.  These funding reductions coming so close to the start of the 2018 open enrollment period will affect the help many Navigators can provide to consumers seeking to enroll in coverage.

This data note analyzes funding changes and discusses the implications for Navigators and consumers.  It presents results of a Kaiser Family Foundation online survey of federal marketplace (FFM) Navigator programs conducted from September 22, 2017 – October 4, 2017 about 2017 funding awards (for the 2018 open enrollment period), the relationship between funding amounts and program performance, and the likely impact of funding changes on programs and the consumers they serve. It also includes insights from a roundtable meeting of more than 40 Navigators co-hosted by the Robert Wood Johnson Foundation and Kaiser Family Foundation held on September 15, 2017, as well as analysis of administrative data.

BACKGROUND

In 2015, CMS signed three-year agreements with Navigator organizations to provide consumer assistance to residents of federal marketplace states.  The multi-year agreements promoted continuity and experience among Navigator professionals.  Multi-year agreement also spared CMS and Navigators the time and expense involved in reissuing grants during critical weeks leading up to open enrollment.  Under the agreements, Navigator programs in the FFM states are required to set goals and report performance data throughout the year relating to specific duties and activities.

Funding amounts under the multi-year agreements have been determined annually — $60 million for the first budget year (which runs September through August), and $63 million for the second budget year.  CMS notified continuing programs of the grant amount available to them for the coming year in late spring; programs then submitted work plans, budgets, and performance goals based on that amount.  Once CMS approved these plans, final awards were made in late August.

In May 2017, continuing Navigator programs were notified of available third-year funding amounts, which totaled $60 million, with grants for most programs similar to the year-two funding amount. In June, programs submitted their work plans and budgets corresponding to these amounts. The Navigator programs expected final Notice of Awards (NOA) by September 1, 2017.

On August 31, one day prior to the end of the second budget period of the grants, CMS announced it would reduce Navigator funding by more than 40%. CMS issued a bulletin stating that funding for the third year would be based on program performance on its enrollment goals for the second budget period.  On September 13, 2017, two weeks into the third budget year of the grant, FFM Navigator programs received preliminary NOAs for third-year funding, which totaled $36.8 million, or 58% of the year-two awards. (See Appendix A for funding awards by program.)

2017 NAVIGATOR FUNDING REDUCTIONS

CMS notified Navigator program of their preliminary 2017 grant awards on September 13, 2017.  The full list of preliminary awards was obtained and released by a third party (see Appendix A). This section summarizes funding changes based on information from that list.

Funding changes at the state level for 2017 were uneven across states.  Three FFM states (Delaware, Kansas, and West Virginia) received no net reduction in year-three Navigator funding.  Among the other 31 FFM states, the funding reductions ranged from 10% in North Carolina to 80% or more in Indiana, Nebraska, and Louisiana (Table 1).

Table 1: 2016 Federal Navigator Funding Awards  and Preliminary 2017 Awards as of  September 13, 2017, by State
State 2016 Funding Award 2017 Preliminary Funding Award Percent Change
Alabama $1,338,335 $1,036,859 -23%
Alaska $600,000 $446,805 -26%
Arizona $1,629,237 $1,167,592 -28%
Delaware $600,000 $600,000 0%
Florida $9,464,668 $6,625,807 -30%
Georgia $3,682,732 $1,433,936 -61%
Hawaii $334,510 $185,143 -45%
Illinois $2,581,477 $1,792,170 -31%
Indiana $1,635,961 $296,704 -82%
Iowa $603,895 $226,323 -63%
Kansas $731,532 $731,532 0%
Louisiana $1,535,332 $307,349 -80%
Maine $600,000 $551,750 -8%
Michigan $2,228,692 $627,958 -72%
Mississippi $907,579 $382,281 -58%
Missouri $1,815,514 $729,577 -60%
Montana $495,701 $374,750 -24%
Nebraska $600,000 $115,704 -81%
New Hampshire $600,000 $456,214 -24%
New Jersey $1,905,132 $720,545 -62%
North Carolina $3,405,954 $3,061,034 -10%
North Dakota $636,648 $208,524 -67%
Ohio $1,971,421 $568,327 -71%
Oklahoma $1,162,363 $798,000 -31%
Pennsylvania $3,073,116 $1,988,501 -35%
South Carolina $1,517,783 $511,048 -66%
South Dakota $600,000 $236,947 -61%
Tennessee $1,772,618 $1,497,410 -16%
Texas $9,217,235 $6,110,535 -34%
Utah $902,681 $394,862 -56%
Virginia $2,187,871 $1,108,189 -49%
West Virginia $600,000 $600,000 0%
Wisconsin $1,338,306 $749,215 -44%
Wyoming $605,847 $183,654 -70%
Total $62,882,140 $36,825,245 -41%
Source: List of preliminary grant awards was obtained and released by a third party, not by CMS.

When the multi-year agreement was established, federal funding was allocated across FFM states based on the state’s share of the number of uninsured people, with a minimum amount ($600,000) reserved for each of the smallest states.  This allocation formula no longer seems to apply.  For example, total funding for Navigators in Indiana ($290,000) was less than that for Navigators in Alaska ($447,000) despite the fact that there are four times as many uninsured residents in Indiana compared to Alaska (422,000 vs 95,600 in 2016).  Similarly, funding for Navigators in Ohio was less than that for Navigators in Oklahoma ($568,000 vs $798,000) though there are more uninsured residents in Ohio (631,000 vs 409,000).1

Overall, the funding reductions varied widely across individual Navigator programs. The vast majority (82%) of Navigator programs experienced reductions, while 18% of programs saw their funding stay the same or increase compared to funding levels in 2016. Forty-nine percent of programs had their funding reduced by more than half and more than one-quarter experienced funding reductions of over 75% (Figure 1).

Figure 1: Changes in Navigator Program Funding, 2016-2017

NAVIGATOR PROGRAM FUNDING VERSUS PERFORMANCE

This section summarizes findings from the KFF Survey of FFM Navigators about 2017 funding changes and program performance on certain metrics during the second year of the multi-year agreement.  All Navigator programs were contacted, and 51% participated in the survey.

Navigators say the basis for 2017 funding decisions has not been clear.  Nearly half (49%) of respondents said that the rationale for the funding notice they received on September 13 was not provided at all, and another 40% said it was unclear (Figure 2).

Figure 2: Navigator Program Perception of Clarity of CMS Funding Rationale

The August 31 CMS bulletin indicated that funding for the Navigators would be based on performance against year-two “enrollment goals.” According to the bulletin, “a grantee that achieved 100 percent of its enrollment goal for plan year 2017 will receive the same level of funding as last year, while a grantee that enrolled only 70 percent of its enrollment goal would receive 70 percent of its previous year funding level, a reduction of 30 percent. The new funding formula will ensure accountability within the Navigator program.”

It is not clear what metric CMS used to determine funding levels since Navigators have been required to track a number of activities relative to goals, all of which could result in or contribute to enrollment in health coverage.  These include:

  • Number of consumers assisted with qualified health plan (QHP) selection/enrollment (including reenrollment);
  • Number of one-on-one interactions with consumers, including both general and specific inquiries; and
  • Number of consumers assisted with applying for Medicaid/CHIP, including referral of consumers in non-expansion states to the state Medicaid office;
  • Number of consumers reached through outreach and public education activities.2
NAVIGATOR-ASSISTED QUALIFIED HEALTH PLAN SELECTION METRIC

The number of consumers assisted with QHP selections is the most direct measure of marketplace enrollment tracked by Navigators, although as discussed below, it does not capture all marketplace enrollments that involved Navigator assistance.

There are two measures of Navigator-assisted QHP selections, one self-reported by the programs and one based on data collected by healthcare.gov – the Multidimensional Information and Data Analytics System, or MIDAS data.  The healthcare.gov online application includes a field where Navigator staff can enter their identification number for each consumer whom they assist. Navigators report that program staff have not been trained on this data entry and did not consistently enter it. Several weeks after the start of the fourth open enrollment period, some Navigator programs said they were encouraged by their CMS project officers to improve consistency of staff identification numbers on applications.  Some say they subsequently received reports from CMS staff during the project year comparing MIDAS and self-reported data on QHP selections that did not match – in some cases by a factor of two – and programs did not know why.  Other programs said they did not receive reports from CMS on their MIDAS data.  Navigators expressed concern about the accuracy of data counting QHP selections, especially if this will become the basis for future funding decisions.

The survey asked Navigators to provide both their goal and self-reported performance data for Navigator-assisted QHP selections as reported to CMS for the second budget period. Navigator performance relative to the goal was compared to the change in funding from 2016 to 2017.  Among programs that provided the performance data, findings include:

For 22.5% of programs, 2017 funding matches performance on the self-reported QHP selection metric (Figure 3).  Included in this group were:

  • 15.0% of programs that exceeded or met at least 95% of the goal and whose 2017 funds were not reduced; and
  • 7.5% of programs that did not meet the goal and had funding reduced by the same or similar percentage (+/- 5%).

For 77.5% of programs, 2017 funding does not reflect performance on the QHP selection metric.  Included in this group were:

  • 22.5% of programs that exceeded or met at least 95% of the goal and whose 2017 funds were reduced;
  • 27.5% of programs that did not meet the goal and had funding reduced by a greater percentage; and
  • 27.5% of programs that did not meet the goal and had funding changed by a smaller percentage.

Figure 3: Change in Navigator Funding Compared to Performance on QHP Selection Metric

The QHP selection metric tends to undercount enrollment that is connected to assistance provided by Navigators. Through the survey and at the roundtable, Navigators expressed concern that the QHP selection measure does not reflect the number of consumers whom they help and who ultimately enroll in marketplace health plans.  This metric, as defined by CMS, counts only those consumers who select a plan in the Navigator’s presence, a fraction of the total number of individuals who enroll in coverage and who were helped by Navigators.  For example, if a Navigator helped a consumer complete her application and reviewed plan choices, but the consumer went home to consider her options and made a final selection that evening, that visit could not be reported as a Navigator-assisted plan selection.3 According to the Kaiser Family Foundation 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers, 18% of assister programs reported that nearly all consumers they helped who were determined eligible to enroll in a QHP made their plan selection during the initial visit. Thirty-five percent said they knew the final plan selection of all or nearly all such consumers whom they helped.

OTHER NAVIGATOR PERFORMANCE METRICS

Funding changes for 2017 also do not appear to align with performance on other metrics.  Navigators reported goals and performance data on other key metrics that relate to enrollment (Figure 4). Most programs met or exceeded these goals, so these metrics do not appear to be related to the funding reductions.  Among programs that answered these questions, Eight in ten programs (83%) met their goals for one-on-one consumers interactions, 71% met their goals for helping consumers enroll in Medicaid or CHIP, and three quarters met their outreach and education event goal.

Figure 4: Most Navigators Met Other Enrollment-Related Goals

One-on-one assistance: The most comprehensive measurement required by CMS is the number of consumers provided one-on-one assistance.  A one-on-one encounter can involve helping a consumer with any step along the process that ends with enrollment:  educating consumers about the availability of plans and assistance, completing a marketplace application for financial assistance, appealing a marketplace decision, reviewing and understanding plan options, or selecting a QHP.  Navigators also provide one-on-one assistance to consumers after they enroll so that they can remain covered.  Such help includes answering tax reconciliation questions, resolving premium payment disputes, and referring consumers for help with denied claims.  Once they have resolved the problem they came in with, many consumers leave and complete the enrollment process on their own.  The one-on-one assistance metric would also count consumers who are helped but who do not enroll in coverage.  On average, the number one-on-one encounters Navigators reported was 15 times higher than the number of QHP selections.

Medicaid/CHIP enrollment assistance or referrals: The ACA requires a “no wrong door” application process through which consumers can apply through the marketplace, using a single streamlined application, for either private health insurance subsidies or Medicaid/CHIP.  Navigators are required to help all consumers with the application.  Navigators from Medicaid expansion states noted that most consumers who sought help were ultimately determined Medicaid eligible.  At the roundtable, some commented that, when the August 31 bulletin was released, they assumed CMS would base funding on enrollment under both types of coverage.

Outreach and public education: Four years after implementation, the public’s understanding of ACA benefits and requirements remains limited.  For example, many consumers continue to be unaware that signups for private non-group health insurance, generally, must take place during open enrollment.4  Turnover in marketplace plans is high, as most participants need non-group coverage only while they are between jobs or other types of coverage.  Navigators report that consumers are less likely to seek, or be receptive to, information about the marketplace until they actually need it.

IMPACT OF NAVIGATOR FUNDING REDUCTIONS

This section summarizes findings from the KFF Navigator survey as well as insights from the Navigator Roundtable meeting on program changes that may result from the funding reductions.

Most Navigator programs say they will continue to operate in 2018 despite the funding reductions.However, three programs said they will terminate work for year-three.  These include two programs – one statewide and one nearly statewide5 – that had been the only Navigator service providers for consumers in most areas of their respective states.  Their decision to withdraw was based on the level and timing of funding reductions.  The September 13 NOA directed that no more than 10% of the grantee’s award could be spent by programs pending CMS review and approval of the final budget and work plan.  Because the preliminary award was announced two weeks into the plan year with final awards scheduled to be made as late as October 28, grantees were faced with maintaining staff payroll and other expenses for as long as two months without assurances they would be reimbursed. The terminating programs, both operated by nonprofits, determined this was not feasible.

Most programs report they will likely reduce their geographic service area and limit help to rural residents. Among programs whose funding was reduced, 45% of statewide programs and two-thirds of regional programs said it is somewhat or very likely they will have to limit the territory their program will serve in year three. Programs emphasized their inability to afford the same level of travel expenses and/or the cost of satellite offices that they had previously incurred in order to offer in-person help to consumers living farther away.  Consumers living in rural communities may be the most affected.  Most (55%) statewide Navigator programs and 72% of regional programs expect to limit services to rural residents this year (Figure 5).

Figure 5: Navigator Programs Reducing Geographic Service Area and Services in Rural Areas

Nearly all programs (89%) expect to lay off staff as a result of funding reductions (Figure 6).  Some programs expect to cut Navigator staff by 75% or more.  The KFF 2016 Assister Survey found that continuity among staff has been high to date.  One advantage of the multi-year agreement was to allow staff experience to grow over time.  To fill in the gaps left by staff lay-offs, some programs plan to rely more heavily on less experienced volunteers.

Figure 6: Navigator Program Response to Funding Reductions

Most Navigator programs expect to reduce services in other ways, as well.  Nearly all programs (81%) say they will likely reduce outreach and public education activities as a result of budget reductions.  In addition, 89% of programs say they will likely reduce spending on marketing and advertising. Nearly six in ten programs (57%) said they will likely reduce the number of months in which they offer Navigator assistance.  Some programs expect to close following open enrollment, others will cut back to a skeletal staff.  As a result, consumers who need assistance at tax time, or help with special enrollments or post-enrollment problems during the year, may have difficulty finding it.

Over four in ten programs say it is likely they will curtail help to consumers related to Medicaid.  At the roundtable, some discussed a strategy of pre-screening consumers during open enrollment to identify those likely eligible for Medicaid/CHIP.  These consumers might be asked to come back at a later date, if they do not have an immediate medical or coverage need, because Medicaid and CHIP enrollment is year round.  Other expressed concern that, if CMS bases future funding on QHP plan selections, Navigators in Medicaid expansion states could be disadvantaged.

In addition, 57% of programs say they will likely limit time staff can devote to helping consumers with complex cases.  These cases include consumers experiencing identity proofing problems (for example, faced by young adults who have not previously filed income tax returns or established credit ratings).6  They also include consumers with income data-matching problems (for example, self-employed individuals who have difficulty estimating income for the coming year).  People who cannot resolve identity or other data verification problems within 90 days risk losing their marketplace coverage or subsidies.

Another 54% of programs say they will likely limit the number of limited English proficiency (LEP) consumers they can serve.  Programs often pay a premium for bi-lingual staff, an expense they may no longer be able to afford with reduced funding.

Consumers who need these kinds of assistance may have difficulty finding it elsewhere.  Many consumers seek help from other types of marketplace assister programs.  Federally qualified health centers (FQHCs) also receive funding from the federal government to provide in-person enrollment assistance, although the authorization for most federal funding expired September 30 and has yet to be extended.  In addition, Certified Application Counselor (CAC) programs provide in-person help in the marketplace, though are not paid by the marketplace.  The KFF 2016 Assister Survey found that all three types of programs play an important role in helping consumers.  They also tend to differ from Navigator programs in some key respects.  In particular, Navigator programs typically undergo a higher level of training; they are more likely to operate statewide, sponsor outreach and enrollment events, handle complex cases, and provide help throughout the year.

The KFF 2016 Assister Survey also found that agents and brokers are less likely than marketplace assister programs to serve consumers who need translation services, help with complex cases, and help with Medicaid applications. Brokers and agents are also less likely to help uninsured consumers, immigrants, and consumers who lack internet at home.

DISCUSSION

The Administration’s decision to reduce funding for Navigator programs comes at a challenging time for consumers who rely on coverage through the marketplaces. High-profile insurer exits from the marketplaces, rising premiums, and uncertainty over the federal commitment to funding the cost sharing subsidies are likely sowing confusion among consumers about whether coverage and financial assistance remain available. This confusion, coupled with a shortened open enrollment period, increases demand for the consumer education and in-person enrollment assistance Navigators provide. At a time when more help may be needed, the funding reductions are likely to reduce the level of in-person help available to consumers during this fall’s open enrollment and throughout the 2018 coverage year.

Navigator programs generally report that they do not understand the basis for the funding decisions, and our survey results suggest that there is not a clear link between funding and performance of programs relative to goals on the measures they are required to track and self-report. This ambiguity makes it difficult for programs to plan for the future.

Both the magnitude of the reductions and the timing has caused disruption to Navigator program planning and operations.  Programs plan to adopt various strategies in response to the reductions, including reducing their geographic service area and cutting services, such as outreach and assisting with complex cases. Three programs report they will terminate operations, leaving consumers in their states with very limited access to in-person help. While consumers may be able to turn to other assister programs or brokers, less in-person assistance will be available in some areas, especially for people with complex situations or who live in remote or rural communities.

 

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Source:

Pollitz K., Tolbert J., Diaz M. (11 October 2017). "Data Note: Changes in 2017 Federal Navigator Funding" [Web Blog Post]. Retrieved from address https://www.kff.org/health-reform/issue-brief/data-note-changes-in-2017-federal-navigator-funding/