Understanding the Intersection of Medicaid and Work

Sometimes, healthcare is confusing. We know this, which is why today we are focusing on Medicaid and work. Check out the snippet below, and check out the link for the full article.

Medicaid is the nation’s public health insurance program for people with low incomes. Overall, the Medicaid program covers one in five Americans, including many with complex and costly needs for care. Historically, nonelderly adults without disabilities accounted for a small share of Medicaid enrollees; however, the Affordable Care Act (ACA) expanded coverage to nonelderly adults with income up to 138% FPL, or $16,642 per year for an individual in 2017. As of December 2017, 32 states have implemented the ACA Medicaid expansion.1 By design, the expansion extended coverage to the working poor (both parents and childless adults), most of whom do not otherwise have access to affordable coverage. While many have gained coverage under the expansion, the majority of Medicaid enrollees are still the “traditional” populations of children, people with disabilities, and the elderly.

Some states and the Trump administration have stated that the ACA Medicaid expansion targets “able-bodied” adults and seek to make Medicaid eligibility contingent on work. Under current law, states cannot impose a work requirement as a condition of Medicaid eligibility, but some states are seeking waiver authority to do so.  These types of waiver requests were denied by the Obama administration, but the Trump administration has indicated a willingness to approve such waivers. This issue brief provides data on the work status of the nearly 25 million non-elderly adults without SSI enrolled in Medicaid (referred to as “Medicaid adults” throughout this brief) to understand the potential implications of work requirement proposals in Medicaid.  Key takeaways include the following:

  • Among Medicaid adults (including parents and childless adults — the group targeted by the Medicaid expansion), nearly 8 in 10 live in working families, and a majority are working themselves. Nearly half of working Medicaid enrollees are employed by small firms, and many work in industries with low employer-sponsored insurance offer rates.
  • Among the adult Medicaid enrollees who were not working, most report major impediments to their ability to work including illness or disability or care-giving responsibilities.
  • While proponents of work requirements say such provisions aim to promote work for those who are not working, these policies could have negative implications on many who are working or exempt from the requirements. For example, coverage for working or exempt enrollees may be at risk if enrollees face administrative obstacles in verifying their work status or documenting an exemption.

Get the full report and findings.

Kaiser Family Foundation (5 January 2018). "Understanding the Intersection of Medicaid and Work" [Web Blog Post]. Retrieved from address https://www.kff.org/medicaid/issue-brief/understanding-the-intersection-of-medicaid-and-work/

How Are Health Centers Responding to the Funding Delay?

Unfortunately, the funding delay is impacting healthcare centers everywhere - and not in a great way. Get the information you need to know in this article.

Health centers play an important role in our health care system, providing comprehensive primary care services as well as dental, mental health, and addiction treatment services to over 25 million patients in medically underserved rural and urban areas throughout the country. Health care anchors in their communities and on the front lines of health care crises, including the opioid epidemic and the current flu outbreak, health centers rely on federal grant funds to support the care they provide, particularly to patients who lack insurance coverage. However, the Community Health Center Fund (CHCF), a key source of funding for community health centers, expired on September 30, 2017, and has since been extended through only March 31, 2018. The CHCF provides 70% of grant funding to health centers. With these funds at risk, health centers have taken or are considering taking a number of actions that will affect their capacity to provide care to their patients. This fact sheet presents preliminary findings on how health centers are responding to the funding uncertainty.


The Community Health Center Fund represents 70% of federal grant funding for health centers. Established by the Affordable Care Act, the CHCF increased federal grant fund support for health centers, growing from $1 billion in 2011 to $3.6 billion in 2017.1Authorized for five years beginning in 2010, and extended for two years through September 2017, the CHCF also provided a more stable source of grant funding for health centers that was separate from the annual appropriations process. Prior to the CHCF, federal 330 grant funds were appropriated annually. In fiscal year 2017, federal section 330 grant funding totaled $5.1 billion, $3.6 billion from the CHCF and $1.5 billion from the annual appropriation.

Federal health center grants represent nearly one-fifth of health center revenues. Federal Section 330 grant funds are the second largest source of revenues for health centers behind revenues from Medicaid. Overall, 19% of health center revenues (including US territories) come from federal grants; however, reliance on 330 grant funds varies across health centers. Federal grant funds are especially important for health centers in southern and rural non-expansion states where Medicaid accounts for a smaller share of revenue (Figure 1).2 These funds finance care for uninsured patients and support vital services, such as transportation and case management, that are not typically covered by insurance

Figure 1: Federal Section 330 Grants as a Share of Total Health Center Revenues, 2016


Health centers have taken or are considering taking a number of actions that will affect their ability to serve their patients. Overall, seven in ten responding health centers indicated they had taken or planned to take action to put off large expenditures or curtail expenses in face of reduced revenue. Some of these actions involve delaying or canceling capital projects and other investments or tapping into reserve funds. Other actions, however, have or will reduce the number of staff or the hours they work, which may in turn, affect the availability of services. Already 20% of health centers reported instituting a hiring freeze and 4% have laid off staff. Another 45% are considering a hiring freeze and 53% said they might lay off staff. While health centers seemed to focus on shorter-term actions that could easily be reversed were funding to be restored, 3% of responding health centers had already taken steps to close one or more sites and an additional 36% indicated they are considering doing so (Figure 2).

Figure 2: Actions Taken or Considered by Health Centers in Response to Funding Uncertainty

Health centers are considering cuts to patient services. While most health centers have not yet taken steps to cut or reduce patient care services, many reported they are weighing such actions if funding is not restored (Figure 3). Over four in ten indicated they might eliminate or reduce some enabling services, such as case management, translation, or transportation services. Additionally, over a third of reporting health centers indicated they might have to reduce the dental, medical, and/or mental health services they provide while 29% said cuts to addiction treatment services are being contemplated. Fewer health centers reported that cuts to pharmacy services might be made.

Figure 3: Services Health Centers Are Considering Eliminating or Reducing in Response to Funding Uncertainty


Continued delays in restoring funding will likely lead to cuts in health center services and staff. To date, health centers have tried to mitigate the effects of the funding delay by forgoing major investments or dipping into reserve funds. However, the longer the funding delay continues, the greater the likelihood health centers will be compelled to cut services and staff, actions they are currently considering but have not yet adopted in large numbers. These cuts could reverse gains health centers have made in recent years in increasing patient care capacity and expanding the range of services they provide, particularly in the areas of mental health and addiction treatment. Health centers play a particularly important role in rural and medically underserved areas. The failure to reauthorize the CHCF and restore health center funding could jeopardize access to care for millions of vulnerable patients.

Read the full report.

Kaiser Family Foundation (1 February 2018). "How Are Health Centers Responding to the Funding Delay?" [Web Blog Post]. Retrieved from address https://www.kff.org/medicaid/fact-sheet/how-are-health-centers-responding-to-the-funding-delay/

Will Amazon-Berkshire-JPMorgan coalition kickstart a benefits revolution?

What will happen if the Amazon-Berkshire-JPMorgan coalition becomes a real thing? Find out in this article from Employee Benefit Advisor.

The announcement that Amazon, Berkshire Hathaway and JPMorgan Chase would form an independent healthcare company for their U.S. employees is just one more move in a growing, albeit relatively quiet, revolution inside the benefits industry: Employers banding together for more control over a health system they see as wasteful and inefficient.

Employee medical expenditures have been the driving factor behind these moves. Last year, premiums for employer-sponsored family coverage hit $18,764, up 3% from the previous year, with employees paying an average $5,714 toward the cost, according to the Kaiser Family Foundation.

Frustration with those costs — and the lack of quality that often goes along with them — has resulted in a number of employer initiatives. But the news of the three corporate behemoths’ coalition may propel even more employers to band together, looking for alternatives on how they provide coverage while driving transparency in an industry notorious for obfuscation.

While it didn’t make the same splash as the big three’s news, two years ago 20 of the country’s biggest companies, including American Express, Berkshire’s BNSF Railway, Caterpillar, Coca-Cola, du Pont, IBM, Ingersoll Rand, Marriott and Verizon, joined together to form the Health Transformation Alliance. The goal of the group is to use data analytics, collective leverage and shared expertise to lower costs for all members. The group has grown to almost 40 members.

And at about the same time, health and financial consulting firm Mercer started running employer collectives to help companies save on pharmacy costs. There also are individual efforts. Intel, notes American Benefits Council president James Klein, has been a leader in direct contracting with healthcare providers.

“When large and successful companies come together in this way, it’s potentially disruptive,” says Frank Easley, senior vice president of Aon’s health and benefits group, about the Amazon, Berkshire and JPMorgan partnership. “The healthcare system is ripe for positive disruption and is in need of new solutions that improve employee satisfaction and reduce costs.”

While the three giants did not detail what their new company would do, they did say in a statement that the entity’s focus will be on technology that will provide employees and their families with “simplified, high-quality and transparent healthcare at a reasonable cost.”

The collaboration will likely pressure profits for middlemen in the healthcare supply chain. Potential ways to bring down costs include providing more transparency in prices for doctor visits and lab tests, and by enabling direct purchasing of some medical items, a person familiar with the companies’ plans said.

Efforts to increase transparency have been an important focus for employers of late and have “enormous potential” when it comes to transforming employer healthcare, says benefits consultant Jack Kwicien. If employers can explain to employees how and where their healthcare dollars are going, it will not only give workers a better understanding of their own money, but it has the potential to build a better relationship between employer and employee.

In addition, Amazon’s e-commerce operation could be used to send medication direct to patient’s homes, saving them trips to a pharmacy. Its cloud-computing division can store patient healthcare records so they can be easily accessed by doctors anywhere. And its payments system could be used to automate payments with healthcare providers.

If Amazon, Berkshire and JPMorgan are successful in lowering costs, the weight of the big three might kick the transformation engine into high gear, leading to a dramatic shift in the benefits delivery as more employers look to use combined leverage to lower their health costs.

“Any time organizations of this caliber — these are world class organizations — say they are going to tackle healthcare, you have to pay attention,” says Mike Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions. The organization advises around 12,000 organizations that buy health plans for millions of employees.

Thompson says that given Amazon and Berkshire’s records, it’s clear “that they have the potential to truly change the consumer experience for their employees, and frankly, that could become a model that could be used by other employers.”

Some benefits insiders, however, express doubts that the three behemoths will spur a widespread industry disruption. Their two biggest doubts: that corporate America can successfully battle the nation’s largest healthcare players and, even if successful, if they can cut costs in a meaningful way.

“Most health costs are incurred by a small percent of the population with chronic conditions,” Klein says. “So if this initiative is just about how health costs are paid for, and does not promote ways to improve health itself, the impact will be minimal.”

Still, business groups say the potential is there for more employer involvement in controlling costs and delivering healthcare, and the need is real.

“New entrants with fresh approaches like these may be just the prescription our ailing healthcare system needs,” says Brian Marcotte, CEO of the National Business Group on Health. “The collective resources of these three companies, emerging technologies and Amazon’s customer obsession and supply-chain savvy gives me optimism that they will pursue a consumer-focused model that will transcend the fragmented, provider-centric delivery system that we have today.”

Read more.

Mayer K. (31 January 2018). "Will Amazon-Berkshire-JPMorgan coalition kickstart a benefitsrevolution?" [Web Blog Post]. Retrieved from address https://www.employeebenefitadviser.com/news/will-amazon-berkshire-jpmorgan-coalition-kickstart-a-benefits-revolution?feed=00000152-175f-d933-a573-ff5f3f230000

Health Care Lags As Hot-Button Issue - According to Battleground Voters

As it turns out - according to this poll conducted by Kaiser Health News - health care is not a key issue battleground voters wish to discuss. Instead, a large number of voters are more interested in dealing with issues regarding our economy and jobs.

Read further in this article below.

background-voters-poll-health careAs the midterm elections approach, health care ranks as the top issue, mentioned more frequently among voters nationwide than among those living in areas with competitive races, a new poll finds.

In areas with competitive congressional or gubernatorial races, the economy and jobs ranked as the top issue for candidates to discuss, with 34 percent of registered voters listing it as No. 1, according to the poll from the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.) Following economics was the conflict with North Korea (23 percent), immigration (22 percent) and health care (21 percent). The competitive areas are 13 states with statewide races and 19 House districts judged as toss-ups by the nonpartisan Cook Political Report.

Nationwide, 29 percent of registered voters ranked health care as the most important issue for electoral discussion — though it was far more important for Democrats than Republicans. Economy and jobs were close behind with 27 percent of voters rating it most important, and then immigration, with 24 percent listing it.

The poll found that nearly half of Americans believed there is still a federal requirement for everyone to obtain health insurance, even though Congress’ tax bill last year repealed the penalties for that requirement in the Affordable Care Act, known as the individual mandate. Only a third of the public was sure that those penalties had been repealed.

Fifty percent of the public expressed a favorable view of the health law, while 42 percent disliked it. Six in 10 people said that since President Donald Trump and the Republicans in Congress have altered the law, they are responsible for any problems. Like other opinions about the law, there was a strong partisan split: Only 38 percent of Republicans thought their party is now responsible, while 77 percent of Democrats thought so. Half of Republicans still listed repealing the health law as a top priority.

There was less of a partisan split over the importance that the president and Congress address the epidemic of prescription painkiller addiction. Among Republicans, 43 percent rated it a top priority; 54 percent of Democrats agreed.

There was no such comity over whether lawmakers should allow people brought illegally to this country by their parents — the so-called Dreamers — to stay in the country legally: 21 percent of Republicans called that a top priority, while 66 percent of Democrats did. And while 43 percent of Republicans said they wanted lawmakers to focus on passing federal funding for a border wall with Mexico, only 5 percent of Democrats and 19 percent of independents did.

The poll was conducted Jan. 16-21 among 1,215 adults. The margin of error was +/-3 percentage points. The poll included 298 people who said they were registered to vote in one of the areas the Cook Report identified as a battleground in the fall elections. The margin of error for results for this group was +/-7 percentage points.

Read the original article.

Rau J. (26 January 2018). "In Battleground Races, Health Care Lags As Hot-Button Issue, Poll Finds" [Web Blog Post]. Retrieved from address https://khn.org/news/in-battleground-races-health-care-lags-as-hot-button-issue-poll-finds/


CenterStage: February is American Heart Month - Are Your Loved Ones Knowledgeable?

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease, according to the American Heart Association.

Talking with your loved ones about heart disease can be awkward, but it’s important. In fact, it could save a life. At the dinner table, in the car, or even via text, have a heart-to-heart with your loved ones about improving heart health as a family. Engaging those you care about in conversations about heart disease prevention can result in heart-healthy behavior changes.

Source: Wellness Layers (27 June 2017). Retrieved from http://www.wellnesslayers.com/june-2017-american-heart-association-launched-its-new-heart-and-stroke-patient-support-network-and-patients-registry-powered-by-rmdy/

Here are three reasons to talk to the people in your life about heart health and three ways to get the conversation started.

Three Reasons You Should Talk to Your Loved Ones About Heart Health

#1. More than physical health is at risk

Millions of people in the US don’t know that they have high blood pressure. High blood pressure raises the risk for heart attacks, stroke, heart disease, kidney disease and many other health issues. Researchers are learning that having high blood pressure in your late 40s or early 50s can lead to dementia later in life. Encourage family members to be aware of blood pressure levels and monitor them consistently.


#2. Feel Younger Longer

Just as bad living habits can age you prematurely and shorten your lifespan, practicing good heart healthy habits can help you feel younger longer. On average, U.S. adults have hearts that are 7 years older than they should be, according to the Center for Disease Control and Prevention. Just beginning the conversation with the people in your life that you care about can begin to make changes in their heart health.


#3. You Are What You Eat

Even small changes can make a big difference. Prepare healthier versions of your favorite family recipes by making simple ingredient swaps, simply searching the internet is all it usually takes to find an easy ingredient alternative. Find a new
recipe to cook for your family members, or get in the kitchen together and you’ll finish with something delicious and possibly making some new favorite memories as well. When grocery shopping, choose items low in sodium, added sugar, and trans fats, and be sure to stock up on fresh fruits and vegetables.

Three Ways to Start the Conversation

  1. Encourage family members to make small changes, like using spices to season food instead of salt.
  2. Motivate your loved ones to incorporate physical activity into every day. Consider a family fitness challenge and compete with each other to see who can achieve the best results.
  3. Avoid bad habits together. It has been found that smokers are twice as likely to quit if they have a support system. This applies to practicing healthier practices as well. Set goals and start by making small, positive changes, chances are they may have a big difference.

The key to heart health is a healthy lifestyle. It’s important to try to let go of bad habits that increase your risk of heart disease. By setting small, achievable goals and tracking those goals, you can possibly extend your life expectancy a little bit each day.

Heart disease can be prevented by making healthy choices and consciously monitoring health conditions. Making healthy choices a topic of conversation with your family and loved ones is a great way to open the door to healthier practices in all walks of life.

Download the PDF


Tax Bill Provision Designed To Spur Paid Family Leave To Lower-Wage Workers

Sen. Deb Fischer, R-Neb., arrives in the Capitol for a vote on Tuesday, Nov. 7, 2017. She recently proposed a tax credit to companies that offer at least two weeks of paid family or medical leave annually to workers. (Bill Clark/CQ Roll Call)

Tucked into the new tax law is a provision that offers companies a tax credit if they provide paid family and medical leave for lower-wage workers.

Many people support a national strategy for paid parental and family leave, especially for workers who are not in management and are less likely to get that benefit on the job. But consultants, scholars and consumer advocates alike say the new tax credit will encourage few companies to take the plunge.

The tax credit, proposed by Sen. Deb Fischer (R-Neb.), is available to companies that offer at least two weeks of paid family or medical leave annually to workers, but two key criteria must be met. The workers must earn less than $72,000 a year and the leave must cover at least 50 percent of their wages.

If contributing at the half-wage level, a company receives a tax credit equal to 12.5 percent of the amount it pays to the worker. The tax credit will increase on a sliding scale if the company pays more than 50 percent of wages. It could go up to a maximum credit of 25 percent of the amount the employer paid for up to 12 weeks of leave.

Payments to full- and part-time workers taking family leave who’ve been employed for at least a year would be eligible for the employer’s tax break. But the program, which is designed to test whether this approach works well, is set to last just two years, ending after 2019.

Aparna Mathur, a resident scholar in economic policy studies at the American Enterprise Institute, says the new tax credit sidesteps a pitfall for Republicans. They are wary of any legislation mandating that employers provide paid leave. The tax credit also is appropriately aimed at lower-wage workers who are most likely to lack access to paid leave, said Mathur, who co-authored a recent report on paid family leave.

But it’s not a big enticement.

“Providing this benefit is a huge cost for employers,” Mathur said. “It’s unlikely that any new companies will jump on board just because they have a 12.5 to 25 percent offset.”

That view is shared by Vicki Shabo, vice president for workplace policies and strategies at the National Partnership for Women & Families, an advocacy group, who said it will primarily benefit workers at companies already offering paid family leave. The new tax credit “just perpetuates the boss lottery,” she added.

Heather Whaling said her 22-person public relations company probably qualifies for the new tax credit, but she doesn’t think it’s the right approach. Whaling, the president of Geben Communication in Columbus, Ohio, already offers paid leave. The company provides up to 10 weeks of paid leave at full pay for new parents. Four employees have taken leave, and by divvying up their work to other team members and hiring freelancers they’ve been able to get by.

“It is an expense, but if you plan and budget carefully it’s not cost-prohibitive,” she said.

The tax credit isn’t big enough to provide a strong incentive to provide paid leave, said Whaling, 37. Besides, “having access to paid family leave shouldn’t be luck of the draw, it should be available to every employee in the country.”

Still, the tax credit may be appealing to companies that have been considering adding a paid family and medical leave benefit, said Rich Fuerstenberg, a senior partner at benefits consultant Mercer.

By defraying some of the cost, the tax credit could help “tip them over” into offering paid leave, he said. But  “I’m not even sure I’d call it the icing on the cake,” Fuerstenberg said. “It’s like the cherry on the icing.”

Only 15 percent of private-sector and state and local government workers had access to paid family and medical leave in 2017, according to the Bureau of Labor Statistics’ National Compensation Survey. Eighty-eight percent had access to unpaid leave, however.

Under the federal Family and Medical Leave Act, employers with 50 or more workers generally must allow eligible employees to take unpaid leave for up to 12 weeks annually for specified reasons. These include the birth or adoption of a child, caring for your own or a family member’s serious health condition, or leave for military caregiving or deployment. An individual’s job is protected during such leaves.

A tax credit that can be claimed at the end of the year is unlikely to encourage small businesses to offer paid family and medical leave, said Erik Rettig, an expert on family leave policies at the Small Business Majority, which advocates for those firms on national policy.

“It isn’t going to help the family business that has to absorb the costs of this employee while they’re gone,” Rettig said.

A better solution, according to Shabo and others, is to provide a paid family leave benefit that’s funded by employer and/or employee payroll contributions. Sen. Kirsten Gillibrand (D-N.Y.) and Rep. Rosa DeLauro (D-Conn.) last year reintroduced such legislation. Their bill would guarantee workers, including those who are self-employed, up to 12 weeks of family and medical leave with as much as two-thirds of their pay.

A handful of mostly Democratic states — including California, New Jersey, Rhode Island and New York — have similar laws in place, and a program in the District of Columbia and Washington state will begin in 2020.

“We know from states that this approach works for both employees and their bosses,” Shabo said.

Read the original article.

Andrews M. (23 January 2018). "Tax Bill Provision Designed To Spur Paid Family Leave To Lower-Wage Workers" [Web blog post]. Retrieved from address https://khn.org/news/tax-bill-provision-designed-to-spur-paid-family-leave-to-lower-wage-workers/


Despite Compressed Sign-Up Period, ACA Enrollment Nearly Matches Last Year’s

President Trump decided to take away ACA, but that didn’t stop people from signing up. Read this article for the shocking numbers of enrollment.

A day after President Donald Trump said the Affordable Care Act “has been repealed,” officials reported that 8.8 million Americans have signed up for coverage on the federal insurance exchange in 2018 — nearly reaching 2017’s number in half the sign-up time.

That total is far from complete. Enrollment is still open in parts of seven states, including Florida and Texas, that use the federal healthcare.gov exchange but were affected by hurricanes earlier this year. The numbers released Thursday by the Department of Health and Human Services also did not include those who signed up between midnight Dec. 15 and 3 a.m. ET on Dec. 16, the final deadline for 2018 coverage, as well as those who could not finish enrolling before the deadline and left their phone number for a call back.

And enrollment has not yet closed in 11 states — including California and New York — plus Washington, D.C., that run their own insurance exchanges. Those states are expected to add several million more enrollees.

The robust numbers for sign-ups on the federal exchange — 96 percent of last year’s total — surprised both supporters and opponents of the health law, who almost universally thought the numbers would be lower. Not only was the sign-up period reduced by half, but the Trump administration dramatically cut funding for advertising and enrollment aid. Republicans in Congress spent much of the year trying to repeal and replace the law, while Trump repeatedly declared the health law dead, leading to widespread confusion.

On the other hand, a Trump decision aimed at hurting the exchanges may have backfired. When he canceled federal subsidies to help insurers offer discounts to their lowest-income customers, it produced some surprising bargains for those who qualify for federal premium help. That may have boosted enrollment.

“Enrollment defied expectations and the Trump administration’s efforts to undermine it,” said Lori Lodes, a former Obama administration health official who joined with other Obama alumni to try to promote enrollment in the absence of federal outreach efforts. “The demand for affordable coverage speaks volumes — proving, yet again, the staying power of the marketplaces.”

“The ACA is not repealed and not going away,” tweeted Andy Slavitt, who oversaw the ACA under President Barack Obama.

The tax bill passed by Congress this week repeals the fines for those who fail to obtain health coverage, but those fines do not go away until 2019. Still, that has added to the confusion for 2018 coverage.

And it remains unclear whether Congress will make another attempt to repeal the law in 2018.

“I think we’ll probably move on to other issues,” Senate Majority Leader Mitch McConnell (R-Ky.) said in an interview Friday with NPR.

Read further.

Rovner J. (21 December 2017). "Despite Compressed Sign-Up Period, ACA Enrollment Nearly Matches Last Year’s" [Web Blog Post]. Retrieved from address https://khn.org/news/despite-compressed-sign-up-period-aca-enrollment-nearly-matches-last-years/view/republish/

Here’s What the Health Insurance Renewals Process Looks Like

Between rising costs and health care reform, there are a lot of factors to consider for your renewal. With our visual presentation, it’s easy to understand all your options – and legal obligations – simplifying the conversation.

However, we understand you may be new to the renewal process or need a refresher on what it looks like, so we pulled this article from Just Works:

If your company provides health insurance plans to employees, or is considering offering it for the first time, you’ll have to become familiar with the annual renewals process.

Health insurance renewals are a yearly occurrence in which companies adjust their rates and offerings and allow employers to select the best plans. The process includes insurance companies, employers, and employees at various stages.

Why Do Health Insurance Renewals Happen Every Year?

For employees, renewals occur annually to allow you to change your plan based on your current needs. As an employee of your company, you’ll have the opportunity to switch plans, add a dependent, or opt out if needed. You can also keep things the same as they were in the previous year.

As an employer, renewals are an opportunity to change which plans your employees will have access to and your company’s contribution.

For insurance carriers, renewals happen annually to make sure plans are up-to-date with rules and regulations, adjust pricing to take into account inflation in the health insurance industry, and reassess risk.

What Does the Renewals Process Look Like?

  • Reassessment stage. Insurance companies reassess pricing for the upcoming year and then decide on any altered costs and services to the employer. These costs generally rise year-to-year with inflation rates in the healthcare industry due to technology, research, administrative costs, and other factors.
  • Presentation stage. Insurance providers present available plans to companies. You will be presented with the options your employees will have access to and pricing for the upcoming year.

  • Selection stage. You’ll have the opportunity to select the plans your employees will have access to. Your employees can have access to up to four plans, and you can make your selections online. Once you make your selections, you’ll choose your contribution amount (how much you want to contribute per plan for each of your employees).
  • Employee enrollment stage. Once you’ve selected which group plans your employees will have access to, open enrollment will begin for your employees. They’ll be presented the plans you’ve selected to be available for them. This is their opportunity to switch due to different life circumstances and based on their budgets.
  • Completion stage. Once your employees have selected their plans, coverage is effective on the date your insurance provider or PEO stipulates.

What is the Timeframe for Renewals?

Not all plans renew on the same calendar year schedule. If you’re with a PEO, you’re on a master policy that must renew at a specified time, regardless of when your company signed on. Although you can’t choose the renewal date, master policies are what allow PEOs to give small businesses enterprise-level rates.



JustWorks (1 September 2017). "Here’s What the Health Insurance Renewals Process Looks Like" [Web Blog Post]. Retrieved from address https://justworks.com/blog/healthcare-renewals-process

With Below Average Cost, Increasing Enrollment, CDHPs Have Big Impact

According to the UBA Health Plan Survey, enrollment in CDHPs continues to grow in most regions. Receive information like this but customized to your business by taking our Benchmark Survey.

When most experts think of group healthcare plans, Preferred Provider Organization (PPO) plans largely come to mind—though higher cost, they dominate the market in terms of plan distribution and employee enrollment. But Consumer-Directed Health Plans (CDHPs) have made surprising gains. Despite slight cost increases, CDHP costs are still below average and prevalence and enrollment in these plans continues to grow in most regions—a main reason why it was one of the top 7 survey trends recently announced.

In 2017, 28.6% of all plans are CDHPs. Regionally, CDHPs account for the following percentage of plans offered:

Prevalence of CDHP Plans

CDHPs have increased in prevalence in all regions except the West. The North Central U.S. saw the greatest increase (13.2%) in the number of CDHPs offered. Looking at size and industry variables, several groups are flocking to CDHPs:

Regional offering of CDHPs

When it comes to enrollment, 31.5% of employees enroll in CDHP plans overall, an increase of 19.3% from 2016, after last year’s stunning increase of 21.7% from 2015. CDHPs see the most enrollment in the North Central U.S. at 46.3%, an increase of 40.7% over 2016. For yet another year in the Northeast, CDHP prevalence and enrollment are nearly equal; CDHP prevalence doesn’t always directly correlate to the number of employees who choose to enroll in them. Though the West held steady in the number of CDHPs offered, there was a 2.6% decrease in the number of employees enrolled. The 12.6% increase in CDHP prevalence in the North Central U.S. garnered a large 40.7% increase in enrollment. CDHP interest among employers isn’t surprising given these plans are less costly than the average plan. But like all cost benchmarks, plan design plays a major part in understanding value. The UBA survey finds the average CDHP benefits are as follows:

CDHP benefits


Read the original article.

Olson B. (7 December 2017). "With Below Average Cost, Increasing Enrollment, CDHPs Have Big Impact" [Web blog post]. Retrieved from address http://blog.ubabenefits.com/with-below-average-cost-increasing-enrollment-cdhps-have-big-impact


Health Resolutions You Can Stick To In 2018

 Picture: PA Photo/thinkstockphotos.
Picture: PA Photo/thinkstockphotos.
It has once again reached that time of year when we start to think of New Year resolutions to make and break. But do we ever really keep them?

We ask the experts which resolutions we should be making this year, and how we can actually stick to them.

Whether it's giving up smoking, exercising more, or getting our 5-a-day, most of us have usually given up before January ends.

But with a little help from the pros, you can live a happier, healthier life in 2018...

1. Drink more water

Health and fitness mentor Sarah-Anne Lucas (birdonabike.co.uk) says starting a daily ritual is the answer to New Year resolutions. She suggests drinking more water: "Water intake is massive. Most people do not drink enough, but what we'd all like is more energy. That comes down to what you put in, so increase your water intake. It's the first thing you put in your body in the morning. Go and get yourself a minimum of 100ml water and get it into you. To progress that practice, add lemon, to make the body alkaline. Lemon water is amazing, it also adds a bit of flavour."

2. Learn to meditate

Life-coach and mindfulness practitioner Dr Caroline Hough (aspiring2wellness.com) says we can train our minds to reduce stress, making us more likely to achieve our goals: "It involves sitting and meditating for 20 minutes. Bring yourself into the moment and be aware. That's an awareness of your external environment, so just looking at the flowers and the trees and the sunshine and appreciating it instead of rushing through life. Be aware of your internal environment, by noticing if you're very stressed, for example if you're clenching your muscles. We tend to live our lives at a level of stress which is unhealthy."

3. Start self-watching

Professor Jim McKenna, head of the Active Lifestyles Research Centre at Leeds Beckett University, advises we record our successes to motivate ourselves: "Whatever you want to do, whenever you achieve, write it down. You're trying to achieve it every day, so it needs to be nice and small, and all your job is then is to keep the sequence running. It's really as simple as that. What you're capitalising on there is positive self-regard, but also the fundamental process of self-watching. There's a lot of success in seeing your own achievements. When you collect all that up, you can start saying, 'Actually I've got nearly 10 occasions there when I did well, I'm doing well, I'm someone who can change'."

4. Look after your skin

Louise Thomas-Minns (uandyourskin.co.uk), celebrity skin therapist, recommends we pay more attention to protecting and caring for our skin: "Wash your skin nightly. Not removing make-up, daily dirt, oil, grime and pollutants from the skin every night will result in infections and outbreaks. Your skin regenerates at night too, so give it a helping hand. And don't pick! Picking at your skin will result in scarring and create more spotty outbreaks. Wear SPF every day to slow ageing and protect from the harmful effects of UV rays. Find out your skin type from a skin health expert, so you stop wasting time and money on incorrect products."


Read the original article.

Go Active (6 December 2017). "Health Resolutions You Can Stick To In 2018" [Web blog post]. Retrieved from address http://www.goactiveincumbria.com/get-started/other/article/Health-Resolutions-You-Can-Stick-To-In-2018-e9f9d40d-ca39-48ed-be2e-b2f88f4061eb-ds