Are You And Your Primary Care Doc Ready To Talk About Your DNA?

Knowing your genes could save your life, especially if a genetic mutation is hereditary. See why incorporating DNA testing is a crucial part of your primary care.


If you have a genetic mutation that increases your risk for a treatable medical condition, would you want to know? For many people the answer is yes. But such information is not commonly part of routine primary care.

For patients at Geisinger Health System, that could soon change. Starting in the next month or so, the Pennsylvania-based system will offer DNA sequencing to 1,000 patients, with the goal to eventually extend the offer to all 3 million Geisinger patients.

The test will look for mutations in at least 77 genes that are associated with dozens of medical conditions ranging from heart disease to cancer, as well as variability in how people respond to pharmaceuticals based on heredity.

“We’re giving more precision to the very important decisions that people need to make,” said Dr. David Feinberg, Geisinger’s president and CEO. In the same way that primary care providers currently suggest checking someone’s cholesterol, “we would have that discussion with patients,” he said. “‘It looks like we haven’t done your genome. Why don’t we do that?’”

Some physicians and health policy analysts question whether such genetic information is necessary to provide good primary care — or feasible for many primary care physicians.

The new clinical program builds on a research biobank and genome-sequencing initiative called MyCode that Geisinger started in 2007 to collect and analyze its patients’ DNA. That effort has enrolled more than 200,000 people.

Like MyCode, the new clinical program is based on whole “exome” sequencing, analyzing the roughly 1 percent of the genome that provides instructions for making proteins, where most known disease-causing mutations occur.

Using this analysis, clinicians might be able to tell Geisinger patients that they have a genetic variant associated with Lynch syndrome, for example, which leads to increased risk of colon and other cancers, or familial hypercholesterolemia, which can result in high cholesterol levels and heart disease at a young age. Some people might learn they have increased susceptibility to  malignant hyperthermia, a hereditary mutation that can be fatal since it causes a severe reaction to certain medications used during anesthesia.

Samples of a patient’s blood or spit are used to provide a DNA sample. After analysis, the results are sent to the patient’s primary care doctor.

Before speaking with the patient, the doctor takes a 30-minute online continuing education tutorial to review details about genetic testing and the disorder. Then the patient is informed and invited to meet with the primary care provider, along with a genetic counselor if desired. At that point, doctor and patient can discuss treatment and prevention options, including lifestyle changes like diet and exercise that can reduce the risk of disease.

About 3.5 percent of the people who’ve been tested through Geisinger’s research program had a genetic variant that could result in a medical problem for which clinicians can recommend steps to influence their health, Feinberg said. Only actionable mutations are communicated to patients. Geisinger won’t inform them if they have a variant of the APOE gene that increases their risk for Alzheimer’s disease, for example, because there’s no clinical treatment. (Geisinger is working toward developing a policy for how to handle these results if patients ask for them.)

Wendy Wilson, a Geisinger spokeswoman, said that what they’re doing is very different from direct-to-consumer services like 23andMe, which tests customers’ saliva to determine their genetic risk for several diseases and traits and makes the results available in an online report.

“Geisinger is prescribing DNA sequencing to patients and putting DNA results in electronic health records and actually creating an action plan to prevent that predisposition from occurring. We are preventing disease from happening,” she said.

Geisinger will absorb the estimated $300 to $500 cost of the sequencing test. Insurance companies typically don’t cover DNA sequencing and limit coverage for adult genetic tests for specific mutations, such as those related to the breast cancer susceptibility genes BRCA1 or BRCA2, unless the patient has a family history of the condition or other indications they’re at high risk.

“Most of the medical spending in America is done after people have gotten sick,” said Feinberg. “We think this will decrease spending on a lot of care.”

Some clinicians aren’t so sure. Dr. H. Gilbert Welch is a professor at the Dartmouth Institute for Health Policy and Clinical Practice who has authored books about overdiagnosis and overscreening, including “Less Medicine, More Health.”

He credited Geisinger with carefully targeting the genes in which it looks for actionable mutations instead of taking an all-encompassing approach. He acknowledged that for some conditions, like Lynch syndrome, people with genetic mutations would benefit from being followed closely. But he questioned the value of DNA sequencing to identify other conditions, such as some related to heart disease.

“What are we really going to do differently for those patients?” he asked. “We should all be concerned about heart disease. We should all exercise, we should eat real food.”

Welch said he was also concerned about the cascading effect of expensive and potentially harmful medical treatment when a genetic risk is identified.

“Doctors will feel the pressure to do something: start a medication, order a test, make a referral. You have to be careful. Bad things happen,” he said.

Other clinicians question primary care physicians’ comfort with and time for incorporating DNA sequencing into their practices.

A survey of nearly 500 primary care providers in the New York City area published in Health Affairs this month found that only a third of them had ordered a genetic test, given patients a genetic test result or referred one for genetic counseling in the past year.

Only a quarter of survey respondents said they felt prepared to work with patients who had genetic testing for common diseases or were at high risk for genetic conditions. Just 14 percent reported they were confident they could interpret genetic test results.

“Even though they had training, they felt unprepared to incorporate genomics into their practice,” said Dr. Carol Horowitz, a professor at the Icahn School of Medicine at Mount Sinai in New York, who co-authored the study.

Speaking as a busy primary care practitioner, she questioned the feasibility of adding genomic medicine to regular visits.

“Geisinger is a very well-resourced health system and they’ve made a decision to incorporate that into their practices,” she said. In Harlem, where Horowitz works as an internist, it could be a daunting challenge. “Our plates are already overflowing, and now you’re going to dump a lot more on our plate.”

SOURCE:
Andrews, M (12 June 2018). "Are You And Your Primary Care Doc Ready To Talk About Your DNA?" [Web Blog Post]. Retrieved from https://khn.org/news/are-you-and-your-primary-care-doc-ready-to-talk-about-your-dna/


FBI Urges Consumers to Reset Their Routers to Prevent a Malware Attack

Your cyber security is important to us. Consider protecting yourself from the recent growing malware attacks and keep your data safe with these recommendations.


Recently, researchers at Talos—a cyber intelligence unit of Cisco—warned consumers of malware (malicious software) that specifically targets networking devices. The malware, which is known as VPNFilter, impacts an estimated 500,000 routers worldwide, particularly targeting devices from the following manufacturers:

VPNFilter Could Collect Your Information Without Your Knowledge

Once on your equipment, the malware could stop your router from working, collect information from any systems that run through it and even block network traffic. Experts are concerned over the scope of the attack, as anyone owning a router from the affected manufacturers could be at risk, including businesses and individuals.

Agencies like the FBI have also expressed concern over VPNFilter, as this particular brand of malware can be used in espionage attacks on military, security and other government organizations.

Reduce Your Risk by Resetting Your Router

Unfortunately, there’s no simple way to tell if your router is infected. To protect yourself, it is recommended that you:

  • Reset your router to disrupt the malware. This can be done by simply turning the router off and on or holding the reset button down on your device. For further protection, you may want to consider doing a factory reset of your router.
  • Install any firmware updates. These updates are typically found on the manufacturer’s website. You may need to search by your router’s model number, which can be found on the back of the device.
  • Create a new, secure password for your router.
  • Disable remote management settings.

For help performing any of the above steps, contact your router manufacturer or click the links provided in this News Brief.


Viewpoint: Coaching Your Employees to Finish Strong as They Near Retirement

10,000 people a day are retiring. Help your employees transition into retirement with these important strategies. ​


Baby Boomers are beginning to retire in large numbers. AARP says 10,000 people a day are retiring from work. Most companies have no formal program to aid these employees in this transition. Although we often have extensive onboarding programs, little to nothing is done when an employee is ending his or her career, except a goodbye party.

For many people, upcoming retirement means coasting until the day they are done. Dave was a senior-level manager who announced his retirement one year in advance. The problem was that Dave then became "retired on the job." He stopped innovating. He stopped moving new ideas forward. He avoided conflict by ignoring problems. He no longer aggressively led his team.

Dave had been very successful in his career but he ended poorly, so that was how everyone remembered him. His team suffered poor morale because its members felt they were stuck until Dave left his position. That is a problem for the whole company.

Help retiring employees to end strong at your company. Instead of letting employees coast and drain the company coffers, HR can support retiring workers as they end their careers in the best way possible, fully contributing up until the last day.

Some key strategies include:

  • Creating a planning-to-retire educational program.HR should develop a workshop to show employees how to plan out their future, paying special consideration to how they will handle all the free time they will have once they leave the company. The course can cover financial planning, too. The employee will be grateful for this assistance.
  • Coaching the employee's manager.Managers of departing employees need instruction on how to support someone leaving the group. The formal coaching should offer proven strategies to keep the employee engaged until his or her last day. The supervisor should encourage the employee to complete as many key projects as possible and accept the responsibility to not let the employee become retired on the job.
  • Documenting their knowledge.As many Baby Boomers walk out the door, their depth of experience and insight depart with them. Companies should have these employees document their knowledge by creating a training manual or by adding pages to the organization's intranet so other employees can learn from these folks.
  • Training a new employee.Ideally, the organization should promote or hire a replacement and have the departing employee train the new person. Having a two- to three-week training period helps the new employee get up to speed and be more productive, more quickly. 
  • Offering a "bridge job."Finding talented workers to replace departing Baby Boomers will become harder to do in our tight labor market. Developing a transitional or bridge job where the employee remains at work on a part-time basis may allow the company to avoid the quest for talent that is often not available. Baby Boomers want more flexibility and fewer work hours at the end of their career. In fact, 72 percent say they plan to work in their retirement. Annette was an IT specialist who wanted to leave the energy utility she worked for. The HR department was under the gun to deliver a new human resource information system and asked her to continue working three days a week with the ability to take more unpaid vacations. This new bridge job kept her in her role for 18 months until the big project was completed.

Final days may be a bittersweet time for employees to say goodbye to their co-workers, friends and the company itself. Having a supportive send-off is a great policy to ensure that everyone leaves on a positive note and will speak highly of your organization after the departure.

 

SOURCE:
Ryan R (4 June 2018) "Viewpoint: Coaching Your Employees to Finish Strong as They Near Retirement" [Web Blog Post]. Retrieved from https://www.shrm.org/ResourcesAndTools/hr-topics/benefits/Pages/Viewpoint-Coaching-Your-Employees-on-Finishing-Strong-As-They-Retire-.aspx?_ga=2.37756515.1310386699.1527610160-238825258.1527610159


Five Practical Ways to Support Mental Well-being at Work

Mental well-being impacts engagement, absenteeism and productivity. Discover how help make the workplace atmosphere and environment more pleasant with these tricks.


The American Institute of Stress reports that stress is the nation’s top health problem. This makes sense, as mental capacity is highly valued in the workplace but can also be highly vulnerable. Today’s workplace, with technology, fast-paced growth and decreased resources, can contribute to increased stress.

Companies should value the mental health of their employees as a top asset and fiercely protect it. Mental well-being impacts engagement, presenteeism, absenteeism and productivity — all of which impact businesses bottom lines. More importantly, supporting and protecting the mental health of your employees is the right thing to do.

Here are five best practices to support mental health in the workplace.

  1. Normalize the conversation.

Top-down support of mental health is crucial in creating an open dialogue, as is an open-door policy. Senior leaders should participate in the conversation about mental wellbeing to show buy in. Normalizing the occurrence of a grief reaction or stress disorder can insure that your employees seek help when it happens to them.

Establishing mental health champions within your organization is another way to encourage a healthy dialogue. People with mental health conditions who want to help others are great candidates for this role.

Use awareness days that focus on stress and mental health as external nudges to educate staff about these important issues. Importantly, remind staff that a diversity of perspectives, including those with lived mental health experiences, are valued and encouraged in inclusive environments.

  1. Implement strong policies and procedures.

Disclosure can help an employee seek the appropriate resources and care before conditions worsen, so having proper policies and procedures in place are important in removing barriers to disclose.

This includes protection against discrimination, which is usually a top concern for employees, as well as providing appropriate workplace accommodations. Ensure managers are aware of key resources, like employee assistance programs, and maintain confidentiality when an employee discloses information.

Beyond this, educate employees on policies, procedures and proper protocols to increase employee awareness. Here’s a tip: Repeat key messages and tailor your communications to better reach your staff.

  1. Prevention is better than cure.

It’s essential to remember that anyone is susceptible to stress and a resulting decline in their mental health, whether a preexisting condition exists or not. Big life events like having a baby or losing a loved one and every day struggles like money worries, relationship issues or work-related stress can cause or aggravate mental health conditions to the point of interfering with work. 

Mental wellness sessions or work/life balance programs can help. Bring in an expert and talk to your staff about how to safeguard their own mental health, build resilience and recognize signs of distress in others.

  1. Tailor your benefits package to support mental wellbeing.

Choose a major medical plan that gives employees access to quality mental health specialists in network, as these costs can add up significantly. Helping employees have access to and triage the right specialist support is crucial in managing conditions.

EAPs can act as a first line of defense for a wide range of problems – from money and relationship worries to support for working caregivers. They provide both practical and emotional support for employees through confidential counseling and can help prevent issues from escalating and impacting productivity. These programs are often offered as part of a major medical or disability plan, so your company may already have access to them.

Money worries can also take an emotional toll on wellbeing. In fact, financial concerns were the leading cause of stress across all generations in a recent consumer study conducted by my company, Unum.

Help your employees establish a strong financial foundation by offering financially-focused benefits, like life and disability insurance, retirement savings options and supplemental health benefits that can close the rising financial gap in medical plans.

If your budget doesn’t cover these benefits, consider offering them on a voluntary basis. Access to financial protection benefits are more affordable when offered through the workplace, even if the employee picks up the cost.

Flexible hours or remote working options can also help employees schedule their work days when they’re feeling most productive. This can help reduce presenteeism for mental ill-health, and it also signals to employees that you’re supportive of a healthy work/life balance.

  1. Encourage self-care.

Self-care plays a critical role in overall wellbeing. Encourage employees to do small tasks that’ll help them build resilience over time.

The basics like getting plenty of sleep, eating healthy, drinking water, and exercising are foundational in overall wellbeing.

Beyond these staples, developing appropriate time management and work/life balance skills are also important. Delegating and collaborating are also key to ensure healthy work behaviors which also decrease stress.

While technology and our always-on culture make it hard to disconnect, encourage employees to set device off-times so they can fully recharge before the next day. And most important, model this behavior to your staff and limit after hours work and emails.

Having a holistic mental well-being strategy that includes prevention, intervention and protection is essential for unlocking a workforce’s true potential.

 

SOURCE:
Jackson M (4 June 2018) "Five Practical Ways to Support Mental Well-being at Work" [Web Blog Post]. Retrieved from http://www.workforce.com/2018/05/18/five-practical-ways-support-mental-well-work/


4 perks to make your employees' lives easier and less stressful

Recruit top talent with ease and confidence when considering these tips on attractive, creative and innovative employment perks.


A 2016 survey from Glassdoor found that 57 percent of people looking for jobs said benefits and perks are among their top considerations when weighing offers. So how can a company stack the deck in its favor when recruiting top talent? Although some companies limit their benefits packages to traditional offerings such as health insurance, 401Ks and paid time off, a today’s forward-thinking employers know they need to find more creative ways to offer benefits that make a genuine difference in employees’ day-to-day work and personal lives.

As competition for employees intensifies, the race to improve employer-based services is likely to result in better options for employees. Unconventional benefits options come in many shapes and forms, but they share one thing in common: the goal of saving time for employees, reducing their stress, and ultimately improving their health and satisfaction at work.

All other things being equal, companies that offer innovative perks that speak to the well-being of their employees are more likely to attract and retain the top talent in their field. Here are a few such perks to consider.

Expectant-parent counseling

You’ve thrown the baby shower, cut the cake, helped carry staff gifts to the car—and you’ve explained the company’s parental leave policy in detail. As you wave Julie from accounting off with best wishes, you’re confident she’ll come back to her desk in a few months’ time.

But the truth is that 43 percent of women who have babies leave the workforce permanently within a matter of months. Many say it’s because they don’t have adequate support at home to enable them to resume their careers. That is why companies like Reddit and Slack use a service called Lucy that provides expectant employees help before, during, and after parental leave, including 24/7 messaging and one-on-one sessions that can be done in the home or online.

As Reddit VP of People Katelin Holloway put it, “It’s not enough to simply offer parental leave; every child and family is different and has independent needs.” By helping expectant parents find resources that meet their specific needs, you’re making an investment in your workforce that pays enormous dividends in retention, productivity, and morale.

Caregiving support

A Gallup survey revealed more than 1 in 6 full-time or part-time American workers has difficulty balancing caring for elderly parents with their work commitments. This results in decreased productivity and frequent leaves of absence. Companies can help their employees cope and stay engaged with their work by providing concierge services that offer amenities such as taking elderly parents to doctor’s appointments and eldercare coaching when choosing between assisted living options.

To help reduce stress (and retain highly specialized employees), take a cue from companies like Microsoft and Facebook, which provide caregiver paid-leave programs to help employees care for ailing family members or sick relatives.

Dry cleaning at work

Sometimes it’s the little things that save time during the workday that can push the needle in your favor as a potential employer. It may sound trivial, but company-provided dry cleaning is a perk that’s proving to be a big draw in workplaces from Wall Street to Silicon Valley. Service providers pick up employees’ laundry or dry cleaning items from work and return them to a designated employer closet in their office building—one less errand, and no more lost tickets. “People have lives to live, so I try to make it easy for them to deal with any of those personal errands that could take up time for them,” said Experian CEO Craig Boundy, speaking about his company’s employee benefits programs in an interview with the The Orange County Register.

Car maintenance and service

According to the U.S. Bureau of Labor Statistics, the average American household owns 1.9 vehicles and spends around 1.5 percent of its annual income on auto maintenance and repairs. Cars are a significant investment for most of us, so the more you can help potential employees save time and money on maintaining their vehicles, the more tempting you’ll become as an employer. Growing numbers of innovative companies provide car repair services to help employees save money, find the best quality mechanics, and reduce stress associated with the entire process.

Some firms also offer on-site car wash services, giving employees peace of mind and a positive outlook as they drive home after work. Several big Silicon Valley corporations —including eBay, SanDisk, Cisco, and Oracle—use BoosterFuels to fill employees’ gas tanks while they’re at work. It saves employees time and protects them from potential accidents or robberies at gas stations.

SOURCE:
Weiss Y (31 May 2018) "4 perks to make your employees' lives easier and less stressful" Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/05/11/4-perks-to-make-your-employees-lives-easier-and-le/


Paid Family Leave claims processing tips

New York is setting a trend with new Paid Family Leave policy. New law could trigger states to follow their lead in the near future.


While most of us realize that change is a part of life, few of us can afford to sacrifice our paycheck when it happens.

To help ensure that New Yorkers do not find themselves in this situation, the state signed into law the nation’s strongest and most comprehensive Paid Family Leave (PFL) policy. Effective Jan. 1, 2018, the law provides residents with job-protected, paid leave to bond with a newborn, care for a loved one with a serious illness, or tend to family matters when a loved one is called to active military service.

The new law encompasses numerous leave types, eligibilities and durations, so processing a PFL claim can be confusing. To unmuddy the waters, let’s dive into the who, when, how and what regarding PFL.

Who is eligible?

Added to a company’s Disability Benefits Law (DBL) policy as a rider, Paid Family Leave was created for private-sector organizations with at least one employee who works in New York State at least 30 days of the year. Public companies may opt to provide coverage as well, but it is not required.

To be eligible for PFL, applicants must be employed by a covered employer at the time they apply.

  • Employees with a regular work schedule of 20 or more hours per week are eligible after 26 consecutive weeks of employment. This includes sick or vacation time, but may not count other covered leaves.
  • Employees with a regular work schedule of fewer than 20 hours per week are eligible after 175 days worked, which do not need to be consecutive.

How it works

In 2018, both full- and part-time employees are eligible to take up to eight weeks of PFL and receive 50% of their average weekly wage (AWW). The weekly earnings under PFL are currently capped at $652.96, which is 50% of the New York State Average Weekly Wage (NYSAWW) of $1,305.92. (For details, visit www.ny.gov.)

New Yorkers stand to benefit even more in the years to come, as the state plans to increase PFL incrementally, reaching 12 weeks by 2021.

PFL benefits are funded through a small weekly payroll deduction. The deduction is a percentage of an employee’s weekly wage — up to the aforementioned cap.

To provide some perspective, the current payroll contribution is 0.126% of a New Yorker’s gross weekly earnings, capped at a total annual contribution of $85.56. For example, an employee earning $1,200 a week in 2018 would pay $1.51 per week. To calculate an employee’s weekly deduction, simply enter the required information at www.ny.gov/paid-family-leave-calculator.

A healthy dose of security

Not only will eligible applicants receive a portion of their wages while on leave, qualifying employees can rely on continued health insurance coverage while taking PFL. Employers are required by law to continue the existing health insurance benefits. If employees contribute to the cost of their health insurance, they are also required to continue paying their portion while on leave.

It is important to note that Paid Family Leave does notreplace disability benefits coverage. Disability benefits are meant to cover off-the-job personal illness or injury. PFL is designed to provide paid time off to care for family that need assistance.

In fact, some employees may be eligible for both PFL bonding and disability benefits for maternity at the same time, although they may not be taken simultaneously, according to the New York State Workers Compensation Board.

Leave categories

PFL is flexible and may occur in a variety of ways. The applicant has options when deciding how much time to take at any given time. While the law states that a 30 day leave notice is required, there are considerations for times when life surprises us.

There are four main PFL categories:

  • Continuous leave: The employee takes the entire 8 weeks of PFL without interruption.
  • Intermittent leave:The employee takes leave in increments as short as one day at a time.
  • Foreseeable event:The leave begins following a planned event such as a birth, adoption, surgery or military ceremony.
  • Non-foreseeable event:The leave is in response to an accident or an unexpected surgery.

PFL-worthy events

As mentioned earlier, an employee can request PFL for one of three reasons. The State of New York classifies these leaves as Bonding, Family Care and Military Exigency. Each type has its own eligibility terms and required documentation. If your company or agency does not have the required forms on hand, they are available at www.ny.gov. Employees requesting PFL are required to do so at least 30 days in advance, when possible, starting with Form PFL-1.

Bonding Leave A parent may take PFL during the first 12 months following the birth, adoption or foster placement of a child. To start the application process, an employee will need to obtain the “Bond with a Newborn, Newly Adopted or Fostered Child” forms package.

From there, the employee would complete a “Request for Family Leave” (Form PFL-1) and submit it to his or her employer, who will complete the employer section and then return it to the employee. A PFL-1 is required for all three types of leave. Also required is the “Bonding Certification” (Form PFL-2). The employee must complete and submit both forms, along with any supporting documentation (e.g., birth certificate, adoption certificate, etc.), to the employer’s insurance carrier.

Family Care Leave New Yorkers have the right to take time off to care for a loved one with a serious health condition. This individual could be a spouse or domestic partner, child or stepchild, as well as a parent, stepparent, parent-in-law, grandparent or grandchild.

After obtaining a “Care for a Family Member with Serious Health Condition” forms package, the employee must submit a completed PFL-1 to their employer, who will complete it and return it to the employee. Additionally, the employee’s family member (the care recipient), or their authorized representative, is required to complete a “Release of Personal Health Information Under the Paid Family Leave Law” (Form PFL-3). Upon completing the release, the individual will submit it to his or her health care provider.

The second form the employee is required to complete is the “Health Care Provider Certification” (Form PFL-4). Upon completion, this form will go to the employee’s health care provider for review, then to the care recipient and ultimately back to the employee. The employee must submit the PFL-4, along with his or her completed PFL-1, and PFL-3, to his or her employer’s insurance carrier.

Military Exigency Leave — If an employee’s spouse, domestic partner, child or parent is deployed abroad or has been notified of an impending deployment, the employee can take PFL to assist or support the military member and his or her family. Examples include making financial and/or legal arrangements on the military member’s behalf, attending military-related ceremonies for the deployed individual and tending to urgent childcare needs created by the family member’s deployment.

To begin the process, the employee must obtain the “Assist Families in Connection with a Military Deployment” forms package. Next, the employee will need to complete a PFL-1 and submit the form to his or her employer. The employee must then complete the “Military Qualifying Event” (Form PFL-5), attaching any supporting documentation (e.g., covered active duty orders, letter from the military unit confirming deployment, etc.). The employee will then submit his or her employer-approved PFL-1 and completed PFL-5 to the employer’s insurance carrier.

Employer obligations

For employers, when it comes to PFL claims, compliance is key. Here are a few important obligations:

  • New York employers are required to complete and return a submitted PFL-1 within three business days of receiving it.
  • If an employer provides health care, the employer must maintain coverage while the employee is out on leave.
  • As mentioned earlier, employers must provide the same or a similar job upon the employee’s return from leave.

While honoring these obligations are the law, doing so can be challenging for business owners, especially in the case of an intermittent leave. This new coverage will ramp up over the next four years, rates and benefit details are subject to changes by the New York Department of Financial Services (NYDFS).

It is critical to stay in-the-know about this new and developing coverage. Employers can look to their local insurance professionals for help navigating the ins and outs of this groundbreaking law, starting with filling out an employee census to determine their related premiums.

SOURCE:
Maas J (31 May 2018). "Paid Family Leave claims processing tips" [Web Blog Post]. Retrieved from address https://www.propertycasualty360.com/2018/05/25/paid-family-leave-claims-processing-tips/


HRL - Employees - Happy

The Most Desirable Employee Benefits

When it comes to hiring new employees, benefits can make or break the process. Hire with confidence when considering these tips on attractive and affordable employment perks.


In today’s hiring market, a generous benefits package is essential for attracting and retaining top talent. According to Glassdoor’s 2015 Employment Confidence Survey, about 60% of people report that benefits and perks are a major factor in considering whether to accept a job offer. The survey also found that 80% of employees would choose additional benefits over a pay raise.

Google is famous for its over-the-top perks, which include lunches made by a professional chef, biweekly chair massages, yoga classes, and haircuts. Twitter employees enjoy three catered meals per day, on-site acupuncture, and improv classes. SAS has a college scholarship program for the children of employees. And plenty of smaller companies have received attention for their unusual benefits, such as vacation expense reimbursement and free books.

But what should a business do if it can’t afford Google-sized benefits? You don’t need to break the bank to offer attractive extras. A new survey conducted by my team at Fractl found that, after health insurance, employees place the highest value on benefits that are relatively low-cost to employers, such as flexible hours, more paid vacation time, and work-from-home options. Furthermore, we found that certain benefits can win over some job seekers faced with higher-paying offers that come with fewer additional advantages.

As part of our study, we gave 2,000 U.S. workers, ranging in age from 18 to 81, a list of 17 benefits and asked them how heavily they would weigh the options when deciding between a high-paying job and a lower-paying job with more perks.

Better health, dental, and vision insurance topped the list, with 88% of respondents saying that they would give this benefit “some consideration” (34%) or “heavy consideration” (54%) when choosing a job. Health insurance is the most expensive benefit to provide, with an average cost of $6,435 per employee for individual coverage, or $18,142 for family coverage.

The next most-valued benefits were ones that offer flexibility and improve work-life balance. A majority of respondents reported that flexible hours, more vacation time, more work-from-home options, and unlimited vacation time could help give a lower-paying job an edge over a high-paying job with fewer benefits. Furthermore, flexibility and work-life balance are of utmost importance to a large segment of the workforce: parents. They value flexible hours and work-life balance above salary and health insurance in a potential job, according to a recent survey by FlexJobs.

Eighty-eight percent of respondents said they’d give some or heavy consideration to a job offering flexible hours, while 80% would give consideration to a job that lets them work from home. Both flexible hours and work-from-home arrangements are affordable perks for companies that want to offer appealing benefits but can’t afford an expensive benefits package. Both of these benefits typically cost the employer nothing — and often save money by lowering overhead costs.

More vacation time was an appealing perk for 80% of respondents. Paid vacation time is a complicated expense, since it’s not simply the cost of an employee’s salary for the days they are out; liability also plays into the cost. American workers are notoriously bad at using up their vacation time. Every year Americans leave $224 billion dollars in unused vacation time on the table, which creates a huge liability for employers because they often have to pay out this unused vacation time when employees leave the company. Offering an unlimited time-off policy can be a win-win for employer and employee. (Over two-thirds of our respondents said they would consider a lower-paying job with unlimited vacation.) For example, HR consulting firm Mammoth considers its unlimited time-off policy a successnot just for what it does but also for the message it sends about company culture: Employees are treated as individuals who can be trusted to responsibly manage their workload regardless of how many days they take off.

Switching to an unlimited time-off policy can solve the liability issue; wiping away the average vacation liability saves companies $1,898 per employee, according to research from Project: Time Off. And with only 1%–2% of companies currently using an unlimited time-off policy, according to the Society for Human Resource Management (SHRM), it’s clearly a benefit that can make companies more attractive.

Contrary to what employers might expect, unlimited time off doesn’t necessarily equal less productive employees and more time out of the office. A survey from The Creative Group found that only 9% of executives think productivity would decrease significantly if employees used more vacation time. In some cases, under an unlimited time-off policy, employees take the same amount of vacation time. We adopted an unlimited time-off policy at Fractl about a year ago and haven’t seen a negative impact on productivity. Our director of operations, Ryan McGonagill, says there hasn’t been a large spike in the amount of time employees spend out of the office, but the quality of work continues to improve.

Student loan and tuition assistance also ranked highly on the list of coveted benefits, with just under half of respondents reporting that these bonuses could nudge them toward a lower-paying job. A benefits survey from SHRM found that only 3% of companiescurrently offer student loan assistance, and 52% of companies provide graduate educational assistance. Although education assistance sounds costly, companies can take advantage of a tax break; employers can provide up to $5,250 per employee per year for tuition tax free.

Job benefits that don’t directly impact an individual’s lifestyle and finances were the least coveted by survey respondents, such as in-office freebies like food and coffee. Company-sponsored gatherings like team-bonding activities and retreats were low on the list as well. This isn’t to say these benefits aren’t valued by employees, but rather that these perks probably aren’t important enough on their own to convince a job candidate to choose a company.

We noticed gender differences regarding certain benefits. Most notable, women were more likely to prefer family benefits like paid parental leave and free day care services. Parental leave is of high value to female employees: 25% of women said they’d give parental leave heavy consideration when choosing a job (only 14% of men said the same). Men were more likely than women to value team-bonding events, retreats, and free food. Both genders value fitness-related perks, albeit different types. Women are more likely to prefer free fitness and yoga classes, while men are more likely to prefer an on-site gym and free gym memberships.

Our survey findings suggest that providing the right mix of benefits that are both inexpensive and highly sought after among job seekers can give a competitive edge to businesses that can’t afford high salaries and pricier job perks.

SOURCE:
Jones K (30 May 2018). [Web Blog Post]. Retrieved from address https://hbr.org/2017/02/the-most-desirable-employee-benefits


Benefit change could raise costs for patients getting drug copay assistance

Health plans may change with time. Know what to expect and how to respond with these tips on how to avoid unexpected changes.


Since Kristen Catton started taking the drug Gilenya two years ago, she’s had only one minor relapse of her multiple sclerosis, following a bout of the flu.

She can walk comfortably, see clearly and work part time as a nurse case manager at a hospital near her home in Columbus, Ohio. This is a big step forward; two drugs she previously tried failed to control her physical symptoms or prevent repeated flare-ups.

This year, Catton, 48, got a shock. Her health insurance plan changed the way it handles the payments that the drugmaker Novartis makes to help cover her prescription’s cost. Her copayment is roughly $3,800 a month, but Novartis helps reduce that out-of-pocket expense with payments to the health plan. The prescription costs about $90,000 a year.

Those Novartis payments no longer counted toward her family plan’s $8,800 annual pharmacy deductible. That meant once she hit the drugmaker’s payment cap for the copay assistance in April, she would have to pay the entire copayment herself until her pharmacy deductible was met.

Catton is one of a growing number of consumers taking expensive drugs who are discovering they are no longer insulated by copay assistance programs that help cover their costs. Through such programs, consumers typically owe nothing or have modest monthly copayments for pricey drugs because many drug manufacturers pay a patient’s portion of the cost to the health plan, which chips away at the consumer’s deductible and out-of-pocket maximum limits until the health plan starts paying the whole tab.

Under new “copay accumulator” programs, that no longer happens.

In these programs, the monthly copayments drug companies make don’t count toward patients’ plan deductibles or out-of-pocket maximums. Once patients hit the annual limit on a drugmaker’s copay assistance program, they’re on the hook for their entire monthly copayment until they reach their plan deductible and spending limits.

Catton put the $3,800 May copayment on a credit card. She knows her insurer will start paying the entire tab once she hits the pharmacy deductible. But, she said, she can’t afford to pay nearly $9,000 a year out-of-pocket for the foreseeable future.

“I’m talking to my doctor to see if I can I take it every other day,” she said. “I guess I’m winging it until I can figure out what to do.”

Drug copay assistance programs have long been controversial.

Proponents say that in an age of increasingly high deductibles and coinsurance charges, such help is the only way some patients can afford crucial medications.

But opponents say the programs increase drug spending on expensive brand-name drugs by discouraging people from using more cost-effective alternatives.

Switching to a cheaper drug may not be an option, said Bari Talente, executive vice president for advocacy at the National Multiple Sclerosis Society.

“Generally the multiple sclerosis drugs are not substitutable,” she said. “Most have different mechanisms of action, different administration and different side effect profiles.” Generics, when they’re available, are pricey too, typically costing $60,000 or more annually, she said.

Most MS drug annual copay assistance limits, if they have them, are between $9,000 and $12,000, Talente said.

Employers argue that the drug copayment programs are an attempt to circumvent their efforts to manage health care costs. For example, employers may try to discourage the use of a specialty drug when there’s a lower-cost drug available by requiring higher patient cost sharing.

There’s also the issue of fairness.

“From an employer perspective, everyone under the plan has to be treated the same,” said Brian Marcotte, president and CEO of the National Business Group on Health (NBGH), which represents large employers.

If someone needs medical care such as surgery, for example, that person doesn’t get help covering his deductible, while the person with the expensive drug might, he said.

According to an NBGH survey of about 140 multistate employers with at least 5,000 workers, 17 percent reported they have a copay accumulator program in place this year, Marcotte said. Fifty-six percent reported they’re considering them for 2019 or 2020.

If there is no comparable drug available, drug copayment programs may have a role to play if they can be structured so that participating patients are paying some amount toward their deductible, Marcotte said. But, he said, assistance programs for drugs that are available from more than source, such as a brand drug that is also available as a generic, shouldn’t be allowed.

In 2016, 20 percent of prescriptions for brand-name drugs used a drug copay assistance coupon, according to an analysis by researchers at the USC Schaeffer Center for Health Policy and Economics. Among the top 200 drugs based on spending in 2014, the study found that 132 were brand-name drugs, and 90 of them offered copay coupons. Fifty-one percent of the drugs with copay coupons had no substitute at all or only another brand drug as a close therapeutic substitute, the analysis found.

Advocates for people with HIV and AIDS say copay accumulators are cropping up in their patients’ plans and beginning to cause patients trouble. Drugs to treat HIV typically don’t have generic alternatives.

The biggest impact for the community their organizations serve may be for PrEP, a daily pill that helps prevent HIV infection, said Carl Schmid, deputy executive director at the AIDS Institute, an advocacy group. A 30-day supply of PrEP (brand-name Truvada) can cost nearly $2,000. Drug manufacturer Gilead offers a copay assistance program that covers up to $3,600 annually in copay assistance, with no limit on how much is paid per month.

“They’re at risk for HIV, they know it and want to protect themselves,” Schmid said. “It’s a public health issue.”

Earlier this month, the AIDS Institute was among 60 HIV organizations that sent letters to state attorneys general and insurance commissioners across the country asking them to investigate this practice, which has emerged in employer and marketplace plans this year.

Compounding advocates’ concerns is the fact that these coverage changes are frequently not communicated clearly to patients, Schmid said. They are typically buried deep in the plan documents and don’t appear in the user-friendly summary of benefits and coverage that consumers receive from their health plan.

“How is a patient to know?” Schmid asks. They learn of the change only when they get a big bill midway through the year. “And then they’re stuck.”

SOURCE:
Andrews M (25 MAY 2018). [Web Blog Post]. Retrieved from address https://khn.org/news/benefit-change-could-raise-costs-for-patients-getting-drug-copay-assistance/


April 2018 Safety Matters: Elevator Best Practices

Elevator Best Practices

Millions of employees use elevators each day at work. While elevators are considered one of the safest forms of transportation, it is important to follow best practices and safety precautions when using an elevator.

Boarding the Elevator

Take note of the following procedures for entering an elevator:

  • Make sure you are aware of the risks associated with riding the elevator prior to boarding, such as falls and accidents.
  • Allow all passengers to fully exit the elevator before you begin boarding.
  • Watch your step when entering the elevator, as it may not be exactly level to the floor.
  • Steer clear of the doors once you enter the elevator. Keep all clothes, carry-ons and body parts within the car. Never attempt to stop a closing door.
  • Pay attention to the elevator’s capacity limit. Do not attempt to board an elevator that has reached capacity.

Riding the Elevator

Keep in mind the following procedures for riding an elevator:

  • Stand as close to the elevator wall as possible. Be sure to leave as much room as possible for others.
  • Pay close attention to floor indications and transitions to ensure you are able to exit at the right time.
  • Press the “door open” button in the event of the elevator stopping on a floor without opening its doors.
  • Be courteous of other passengers on the elevator. Do not push other riders in front of you when exiting and be sure to move out of the way of passengers when they exit the elevator.

Watch your step as you exit to avoid tripping on uneven ground.

In Case of Emergency

Although rare, elevator accidents and malfunctions do happen. Keep in mind the following procedures in the event of an elevator emergency:

  • Never use an elevator in the event of a fire. Always take the stairs.
  • Remain calm at all times. If you are in a stalled elevator, utilize the alarm button or phone button to contact emergency services.
  • Reassure those who are panicked in the situation. Remind everyone that they are safe inside the elevator.
  • Do not engage in horseplay.
  • Do not try to exit the elevator or pry open the doors. Always wait for trained professionals to arrive.

While elevators are considered one of the safest forms of transportation, it is important to encourage best practices and safety precautions to all employees or building occupants that frequent the elevator.

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You May Want To Rethink Your 'Cultural Fit' Mentality, and Here's Why

 

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Why achieving diversity in tech requires firing the industry’s ‘cultural fit’ mentality

If you have interviewed for a technology job, there’s a good chance the words “culture” and “fit” made an appearance during the phone-screen phase, or in early rounds of interviews. It is no longer enough for a candidate — especially early to mid-career — to arrive to job interviews with a stellar resume and relevant technical skills. They might also have to come with their best “I’m normal and will fit into the overall team culture of this company” outfit on. Over the past decade, the idea of hiring for “cultural fit” has become as important as, and at times superseded, hiring to fit a job description across forward-looking industries, from tech to transportation.

The nuance of this shift may be a cause for concern — especially for a global tech sector in search of a clear route to workforce diversity. Many of today’s tech human resources teams are tasked with recruiting a diverse group of people and retaining star employees. However, they still tend to supplement those pursuits with cultivating a unified office culture. While the industry has largely moved on from using ping pong tables as a recruiting tool, hiring people who pass the Beer Test — an applicant that hiring managers could work with in the office and hang with at happy hour — remains commonplace. Further, hiring based on a hiring manager’s own narrow set of requirements needed to fit their idea of a relatable person opens the door to all sorts of unconscious biases. Taking this recruiting shortcut also raises the bar for candidates from already under-represented groups, including minorities and women.

The main casualties: the pursuit of diversity and business bottom lines. It is true that research-backed conventional wisdom suggests happy workplaces are productive workplaces. What that line of thinking doesn’t account for is the fact that exclusively hiring talent for interpersonal compatibility can negatively impact the quality of work and focus of employees. In other words, employee camaraderie does not equal workplace compatibility. It definitely does not equal workforce diversity. And while a company may benefit from a general aspect of like-mindedness, there’s a great chance that the actual work is suffering due to the lack of diversity — both in people and ideas. Here in Toronto, hiring managers still focus heavily on likeability, which at times can be seen as more important than technical skills. My team and I recently began to see to potential impacts of “cultural fit” as we started to dive into the findings of our new report on the state of talent in Toronto’s emerging tech sector.

—techcrunch.com