Safety Focused Newsletter - December 2017

Preventing Sprains and Strains

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

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

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

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

 

The Hazards of Headphones

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

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

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

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

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

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

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

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

 

Download the December 2017 Safety Focused Newsletter PDF


Data transparency, debt consolidation and ID protection lead open enrollment wish list

In the thick of open enrollment season, savvy employers and benefit advisers have eased the onslaught of information with complex benefit jargon by spreading out employee sign-up before the mad fall rush. Employee Benefit Adviser spoke with Jeffrey Faber, HUB International Midwest’s chief operating officer, to discuss how employers are urging employees to save with data transparency tools, use interactive services to learn about new benefits and to sign up for identity protection.

EBA: How is open enrollment going for you and your clients?

Faber: We’re in the middle of open enrollment season and we are trying to lock down the last-minute decisions our clients have. Predominantly our business is a renewal business.

Our large groups have made their decisions already but our smaller groups are just finding out what their renewals are from the major medical carriers. We have our hands full trying to make sense of it all. But open enrollment is the focus. This is absolutely our busiest time of year. From mid-August to Halloween, and even mid-November, it seems to be getting longer and longer every year with all the nuances our clients require.

EBA: How does this enrollment season differ from previous years? Is there confusion over the ACA’s status? Is there a greater emphasis on voluntary benefits?

Faber: On the repeal of Obamacare, a lot of those decisions have been made too late for our employers to really have to pivot and they are unaffected largely by the executive orders and the talk from Congress. Of course, there's the specter that Congress will act and make a decision in the next couple of weeks, but that impact would probably be a 2019 event instead of a 2018 event.

On the voluntary benefits side, our clients are asking for financial and holistic tools to meet the employees where they live in regard to student loans, tuition assistance and debt consolidation services. ID theft has been a big conversation point in the last three or four months and has been heightened by the Equifax breach, but it started three years ago with the Target breach. A lot of employers want to understand their role in their employee’s lives,

And for voluntary benefits, most of our customers are moving to the consumer-driven model with higher deductibles, so accident insurance, critical injury insurance, and hospitalization – those are all nice bolt-on benefits for the medical benefits they have. It almost allows the employee to self-insure their own health. And HSAs and HRAs are still popular. We see a large uptick year over year over year.

EBA: Any other trends for this year’s open enrollment?

Faber: A few years ago, we joked that overall enrollment was the HR Super Bowl. It happened once a year, it was a three hour event with a bunch of commercials and no one really talked about it a week or two later.

Our clients have asked, what can we do the other 11 months a year? We have seen an increase in requests for interactive PDFs, on-demand video, and interactive guides directing folks to microsites or apps on their phone. We introduce these in April, May or June and if the employee needs this, they don't have to go back into their memory bank and access it, they can get it online. It is that year round learning that engages the customer.

EBA: Is this because employees are bombarded with information during open enrollment?

Faber: Yes and no. There is a lot of information that is required and that is distributed this time of year and there are a lot of decision points that they have to make for themselves and the benefit of their families. We put in place decision helping tools like Jellyvision’s ALEX and some other proprietary tools, that can help employees better make decisions.

But I think it is more toward trying to be a circuit breaker in an employee's head when they are accessing healthcare. That makes them stop and check, “Is this in network, do I have to get pre-authorization? How do I check for a lower cost across the street from a benefit provider?”

These things come out of the workshops this time of year, but if you are not hitting employees where they live at the time of use, you are missing those opportunities for significant cost savings. And not on just on the employer side but the employee side especially with high-deductible plans.

EBA: Is data transparency a big push for this open enrollment season?

Faber: Yes, especially when you consider that standalone imaging facilities are three to eight times less expensive than an in-house hospital facility. Employees need to understand that they will pay 100% of that cost until they meet that deductible in that consumer-driven plan, so there is every effort being made to make sure the employee is checking those transparency tools.

At open enrolment time, we make every effort to employees in the room to ID the nearest urgent care and ER facility, to write those down on a note card and put it in the visor of their car. So, they know at the moment of crisis to know where those places are and make decisions ahead of time.

EBA: Accountants say that from January to April 15, they don't see their families. Is it the same for you during open enrollment?

Faber: (Laughs) I grew up in an accounting family and I can attest to that. It is all hands on deck but our goal is to help clients get their decisions out of the way in Q1 and Q2. We try to help them with decisions that don't require immediacy and don’t have to be made right away, like life and disability insurance, and voluntary and wellness benefits. You can make a lot of those decisions in April, May and June.

 

 

Source:
Albinus P. (30 October 2017). "Data transparency, debt consolidation and ID protection lead open enrollment wish list" [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/data-transparency-debt-consolidation-and-id-protection-lead-open-enrollment-wish-list-says-hub-international-midwest-coo-jeffrey-faber?feed=00000152-1387-d1cc-a5fa-7fffaf8f0000

SaveSave

SaveSave


Safety Focused Newsletter - October 2017

Driver Safety After Dark

The approach of autumn brings less daylight, which results in an increase in traffic deaths. Follow these tips to stay safe during your evening commute.

5 Common Reasons for Injuries to New Employees

Almost one-third of workplace injuries involve workers who have been on the job for less than one year. Learn the most common injuries to new employees and how to prevent them.

Driver Safety After Dark

The approach of autumn brings less daylight, which results in an increase in traffic deaths. In fact, since drivers aren’t used to the decreased visibility, traffic deaths are three times more common after the sun goes down than during the daytime—both for drivers and pedestrians.

Studies suggest that it can take several days to adapt after daylight saving time ends. Although the extra hour of sleep is often celebrated, many people still feel fatigued. Whether you drive for your job or commute home from work in the evening, it is important to remember the following safety tips:

  • Test your headlights, and turn them on one hour before sunset and one hour after sunrise so other drivers can see you easily.
  • Do not look directly at oncoming headlights. Look toward the right side of the road, following the white line with your eyes.
  • Increase your following distance by four or five seconds to give yourself more response time.
  • If you have vehicle trouble, pull off the road as far to the right as possible. Set up reflector triangles near your vehicle and up to 300 feet behind it. Turn on your flashers and your dome light, and call for assistance.

5 Common Reasons for Injuries to New Employees

Thirty percent of all work injuries involve employees who have been on the job for less than a year, according to the Bureau of Labor Statistics. The following are the most common reasons for injuries to new employees, as well as ways to prevent them.

  1. Unfamiliarity with workplace hazards—Even if you will be doing the same job as you did elsewhere, don’t assume you’re aware of all potential job hazards and hazardous substances in your new environment. If you have questions, ask.
  2. Fear of asking questions—New employees may be too intimidated to ask questions. Remember that there is no such thing as a silly question when it comes to your safety. Also, be sure to use constructive criticism as a learning experience.
  3. Improper use of personal protective equipment (PPE)—Your past employer may have been lax with its PPE requirements. Don’t bring any bad habits to your new role. Feel free to ask for proper PPE training.
  4. Employer’s assumption of expertise—Some employers may be accustomed to dealing with employees who have been on the job for years and fail to realize the need to properly train new hires. Although your resume may be impressive, don’t assume that you’re qualified to do the job without proper training.
  5. Poor safety communication—A common cause of employee injuries is the inability to understand urgent safety messages. Make sure you’re familiar with emergency safety protocols and that you understand not only what to do in an emergency, but also the method your employer will use to communicate the safety message.


HRL - Employees - Happy

Who’s using what in P&C insurance

With the emergence of 21st century technology, there are bountiful risks for the cyber lives of millions. In this article written by PROPERTYCASUALTY360, learn how different companies grow to combat the threat of employer risk.

You can read the original article here.


Guidewire Software, Inc. has entered into a definitive agreement to acquire Cyence, a software company that applies data science and risk analytics to enable P&C insurers to grow by underwriting “21st century risks” that have gone underinsured or uninsured. These emerging risks include cyber, reputation, and new forms of business interruption risk. “As traditional actuarial approaches struggle to address the unique characteristics of emerging risks like cyber, Cyence’s next-generation approach will enable insurers to broaden the scope and value of the products their policyholders need,” , Guidewire Software CEO and Co-Founder Marcus Ryu said in a press release.

In other news from Guidewire: MetLife Auto & Home has begun deploying Guidewire’s InsurancePlatform™ in a new cloud environment for customers using its MetLife Auto & Home MyDirect portal. MetLife Auto & Home is the first P&C insurer in the United States to offer a 100-percent digital experience from quoting to claim service. Rollout of the platform is expected to continue over the next several quarters.

Hearsay Systems recently announced a strategic alliance with Microsoft to help financial services firms empower advisors to be both high-tech and high-touch at scale in the digital age. The companies will focus on addressing the specific challenges faced by financial institutions, including the need for compliant advisor-client engagement technology that will enable advisors to better manage client relationships and grow business. The alliance will bring together the data-driven relationship insights from Microsoft Dynamics 365 with the financial industry-specific workflows, data and compliance capabilities from Hearsay, allowing advisors to more effectively acquire, convert and deepen client relationships.

Allianz Global Corporate & Specialty® (AGCS) has teamed up with Silicon Valley-based software company Zeguro, whose mission is to simplify and streamline cyber security and risk management  in small to medium-sized businesses (SMBs). Through its easy-to-use platform, Zeguro will serve as a virtual Chief Information Security Officer (CISO) to those who purchase Allianz’s cyber insurance coverage to further manage their cyber exposure and decrease the overall risk of financial loss following a cyberattack.

Accenture and Duck Creek Technologies recently teamed up to create several new digital and emerging technology solutions for P&C insurers that are designed to improve efficiency and value. The companies have integrated Accenture’s IoT and analytics technologies with Duck Creek’s core platform and launched a blockchain proof-of-concept for medical bill auditing. “These new tools are the product of our focus on providing a new generation of digital solutions to our insurance clients working in collaboration with our joint venture partners,” Cindy DeArmond, managing director and P&C Core Platforms Lead for Accenture in North America, said in a press release.

Louisiana-based Aparicio Walker & Seeling, Inc. (AWS Insurance) is live on TechCanary’s insurance platform replacing its outdated legacy agency management system.  TechCanary’s breadth and depth of insurance functionality built in Salesforce and flexibility to easily customize it further were key to the decision.

Speedpay, Inc., a Western Union company, and Nordis Technologies recently announced an alliance to offer cloud-based customer communications management services to Speedpay clients. This strategic agreement provides current and future Speedpay clients with the opportunity to add Expresso®, an easy-to-use, self-service application to organize, automate and execute print and electronic communications. Nordis also delivers print/mail and email production services, thus enabling a seamless end-to-end communications solution.

 

You can read the original article here.

Source:

PropertyCasualty360 (9 October 2017). "Who’s using what in P&C insurance" [Web Blog Post]. Retrieved from address http://www.propertycasualty360.com/2017/10/09/whos-using-what-in-pc-insurance-oct-9-2017?t=agency-technology?ref=channel-news


High-Performing ACA Navigators Mystified By Deep Cuts Less Than Year After Being Touted As ‘Superstars’

What's the latest on the effects of President Trump's executive order on health care? We pulled this article from Kaiser Health News, which includes multiple sources for information. Check them out and stay up-to-date with us!


You can read the original article here.

Source:

Kaiser Family Foundation (10 October 2017). "High-Performing ACA Navigators Mystified By Deep Cuts Less Than Year After Being Touted As ‘Superstars’" [Web Blog Post]. Retrieved from address https://khn.org/morning-breakout/high-performing-aca-navigators-mystified-by-deep-cuts-less-than-year-after-being-touted-as-superstars/

 

“We have yet to receive any explanation of the cut. We have met or exceeded every one of our performance metrics. There was never any feedback that gave us any indication that we were not going to receive the same amount,” says Lisa Hamler-Fugitt, the executive director of the Ohio Association of Foodbanks. The Trump administration slashed funding for theses navigators by more than 40 percent nationally, with some places seeing cuts of nearly 90 percent.

The New York Times: Trump’s Cuts To Health Law Enrollment Efforts Are Hitting Hard
Michigan Consumers for Health Care, a nonprofit group, has enrolled thousands of people in health insurance under the Affordable Care Act and was honored last year as one of the nation’s top performers — a “super navigator” that would serve as a mentor to enrollment counselors in other states. So the group was stunned to learn from the Trump administration that its funds for assisting consumers ahead of the open enrollment period that begins Nov. 1 would be cut by 89 percent, to $129,900, from $1.2 million. (Pear, 10/9)
Meanwhile, in other health law news —
The Hill: Trump Could Make Waves With Health Care Order 
President Trump's planned executive order on ObamaCare is worrying supporters of the law and insurers, who fear it could undermine the stability of ObamaCare. Trump’s order, expected as soon as this week, would allow small businesses or other groups of people to band together to buy health insurance. Some fear that these Association Health Plans (AHPs) would not be subject to the same rules as ObamaCare plans, including those that protect people with pre-existing conditions. (Sullivan, 10/10)
Politico: Republicans Privately Admit Defeat On Obamacare Repeal
For the first time, rank-and-file Republicans are acknowledging Obamacare may never be repealed. After multiple failures to repeal the law, the White House and many GOP lawmakers are publicly promising to try again in early 2018. But privately, both House and Senate Republicans acknowledge they may never be able to deliver on their seven-year vow to scrap the law. (Haberkorn, 10/9)
You can read the original article here.Source:Kaiser Family Foundation (10 October 2017). "High-Performing ACA Navigators Mystified By Deep Cuts Less Than Year After Being Touted As ‘Superstars’" [Web Blog Post]. Retrieved from address https://khn.org/morning-breakout/high-performing-aca-navigators-mystified-by-deep-cuts-less-than-year-after-being-touted-as-superstars/


HRL - Office - Collaboration - Write - Paper

Better risk management means balancing old, new skills

What changes are happening within the P&C industry? Read this informative article written by  STEVEN R. CULP  and DUNCAN BARNARD of Property Casualty 360 degrees to find out!

You can read the original article here.


The P&C industry is undergoing fundamental change, with significant consequences for the risk function. New approaches to data, the workforce, partners and customers are changing the way insurers operate.

The stakes are high, and with interest rates low, revenue streams are under threat while new competitors are entering from all sides.

At the same time, insurers are encountering new obstacles — from regulatory uncertainty to reduced demand among millennials.  The Internet of Things, autonomous vehicles and other major shifts present major challenges along with large opportunities.

P&C insurers and insurance professionals can use these AI tools right now to run smarter, faster — and ahead of...

To survive — let alone thrive — insurers need to evolve. The scale of the evolution could be challenging, but many of the changes that are needed should add significant long-term value. For example, the availability of real-time data allows P&C insurers to think about new products and propositions to unlock predictive and opportunistic strategies.

 

Insurers are also rethinking their relationships with all stakeholders, becoming a "partner" to customers, brokers and other intermediaries while establishing deeper ties in adjacent industries such as automotive and home security. An openness to new technologies also demands a broader ecosystem of supply partners, including technology companies, insurtech firms, venture capitalists and digital specialists.

As we have done in alternate years since 2009, Accenture conducted extensive research in 2017 among nearly 500 global risk management executives in the financial services industry, including 190 in insurance.

We wanted, in part, to understand how insurers view the challenges facing the risk management function. We found that P&C insurers are facing the world with a bit more confidence than their life insurance counterparts. For example, only 61 percent of P&C respondents saw balancing the responsibilities for control and compliance with the need for effective customer service as a major impediment to effectiveness, versus 84 percent of insurers. And only 65 percent of P&C respondents reported being hampered by shortages of skills in new and emerging technologies, versus 71 percent of life insurers.

However, while there were some differences from sector to sector, we found that both P&C and life insurers are taking a more progressive approach to risk management when compared to our earlier research. They are investing to develop their risk functions in three key areas

Innovation is everywhere in insurance.

Innovation is everywhere in insurance. (Photo: iStock)

Harnessing digital innovation

Advances in big data and analytics are helping insurers better understand risk, build stronger predictive models and tailor customer relationships to suit personal preferences and risk attitudes.  At the same time, robot brokers are on the rise, new platforms are providing micro-pooling “social insurance” models, and sensors allow insured cargo to report every bump, scrape and drop impact it endures in transit. In parallel, some of the most transformative technologies are being implemented deep in the back offices of the world’s leading insurers.

P&C insurers and insurance professionals can use these AI tools right now to run smarter, faster — and ahead of...

The cloud is a great example. Our 2017 Global Risk Management Study finds that cloud technology is virtually ubiquitous—91 percent of insurers are using it — but just 26 percent are highly proficient in using cloud within their organization, 36 percent are not using it to its full potential, and 29 percent are only just introducing it. Respondents want to improve efficiency in response to cost pressures, and cloud is the top choice in this regard, with 77 percent indicating their risk function uses it to reduce costs.

Balancing old and new skills

New tools and processes change how risk teams interact with the business, alliances, regulators, customers and other external stakeholders, requiring new skills and a better balance of attributes across teams. Beyond quantitative skills, the risk management function needs to be able to deliver value by providing economic insights, generating new ideas and building strong relationships throughout the organization in pursuit of the overall strategic objectives.

To support these goals, some insurers are bringing staff into the risk function from other areas of the business to enhance credibility and facilitate relationships. Others are hiring from diverse disciplines, including economics, the law and engineering. There are few professionals who possess every skill the risk function needs. From general quantitative competencies to technology acumen, industry knowledge, niche risk specialties, communication skills, creativity and management experience, candidates with the whole package are extremely rare.

Integrating across the business

Currently, 54 percent of insurance respondents say there is limited coordination between risk management activities at the local level and the group level. While some aspects of centralization are desirable to enable a more aggregated and consistent picture for analysis and evaluation, the reality is that risk exists everywhere in the business and risk professionals need to be engaged throughout the business — not only at an aggregate level.

Central frameworks and tools help to provide a more standardized and coordinated response to regulation, a consistent set of rules for managing the portfolio of risks and the capability to perform complex and high-value calculations to measure risk exposure, liquidity and solvency. But decentralization is also valuable because local or specialized teams can focus on local regulatory requirements and market-specific topics. Any effective risk management function must be able to exist locally and centrally, being close to the business and connected across the organizational structure to manage the overall portfolio, including strategic and emerging risks.

As the study results indicate, the nature of risk is changing. It is up to P&C firms and their risk management functions to create and continually develop a dedicated emerging-risk working group that can identify and evaluate the nature of emerging risks and their potential impacts. That may be the best way to address the constant and disruptive change confronting the industry.

 

You can read the original article here.

Source:

Culp S., Barnard D. (6 October 2017). "Better risk management means balancing old, new skills" [Web Blog Post]. Retrieved from address http://www.propertycasualty360.com/2017/10/06/better-risk-management-means-balancing-old-new-ski?t=commercial-business%3Fref%3Dchannel-feature&page=2


Self funded health care – a big business advantage

Check out this article from Business Insurance by one of their staff writers. In this article, Business Insurance dives into the awesome advantages of self-funding for big businesses.

You can read the original article here.


Health insurance benefits are expensive. The rising costs of health care has driven up insurance premiums to levels where many businesses have been forced to reduce these benefits or drop them altogether. There is, however another option that is less regulated, taxed less and typically results in cost savings: self funded health insurance. The problem is, it's not always the best option for all employers, particularly the smaller ones. And there's a number of reasons for this:
What is self funded health care a.k.a. self-insurance?

Self-insurance is a method of providing health care to employees by taking on the financial liabilities of the care instead of paying premiums to an insurance agency to do the same. In other words: when a person covered under a self-funded plan needs medical care, the company is financially responsible for paying the medical bill (minus deductibles). It's an alternative risk transfer strategy that assumes the risk and liability of medical bills for those covered instead of outsourcing it to a third party. It's a surprisingly common practice:

In 2008, 55% of workers with health benefits were covered by a self-insured plan….and 89% of workers in firms of 5,000 or more employees.
Most (but not all) self-insurance plans are administered by a third party, usually a health insurance company, in order to process claims. The bills are simply paid for by the employer. Health insurance companies act as a third party administrators in what are called ASO contracts (Administrative Services Only)

Another common component of self insurance plans is stop-loss insurance. This is a separate insurance plan that the employer can purchase to reduce the overall liability of claims. With this type of insurance, if claims exceed a certain dollar amount, stop-loss kicks in paying the rest. There are two kinds of stop-loss insurance:

Specific – covers the excess costs from larger claims made by individuals in the group
Aggregate – kicks in when total claims by the group exceed a set amount
For example, a company who self-insures their $1000 employees projects $100,000 in medical care claims for the year. If they purchase aggregate stop-loss insurance for claims that exceed 120% of the expected amount or $120,000, the insurance will pick up the bill for the remaining claims. If the company purchases specific stop-loss insurance at 200%, if any single claim exceeds $2,000, the stop-loss pays the remainder.

Typically, self-funded insurance providers will purchase both specific and aggregate stop-loss insurance unless the conditions are such that specific stop-loss provides enough financial protection.
Benefits of self-insurance

There are a number of financial and administrative advantages to using self-funded health insurance plans for employers. According to the Self-Insurance Institute of America (SIIA) these include:

The employer can customize the plan to meet the specific health care needs of its workforce, as opposed to purchasing a 'one-size-fits-all' insurance policy.
The employer maintains control over the health plan reserves, enabling maximization of interest income – income that would be otherwise generated by an insurance carrier through the investment of premium dollars.
The employer does not have to pre-pay for coverage, thereby providing for improved cash flow.
The employer is not subject to conflicting state health insurance regulations/benefit mandates, as self-insured health plans are regulated under federal law (ERISA).
The employer is not subject to state health insurance premium taxes, which are generally 2-3 percent of the premium's dollar value.
The employer is free to contract with the providers or provider network best suited to meet the health care needs of its employees.
There are, however, some drawbacks to self-insurance policies:

Health care can be costly, so heavy claims years can be extremely expensive
Self insurance isn't tax deductible the same way the costs of providing health insurance is.
Financial benefits are long-term, particularly with an investment component.
Small businesses at a disadvantage

Self insurance is much more prevalent for larger companies mostly because it is easier to predict health care costs from a larger group. The more people in the group, the less potentially damaging a single expensive claim will be to the plan overall. That's why less than 10% of companies with less than 50 employees use self-insurance. The graphic to the right [source: businessweek.com] gives a telling breakdown of its prevalence based on company size.

Because risk is more difficult to predict with smaller groups, stop-loss insurance is also more expensive for smaller businesses. The practice of “lasering”, or increasing deductibles for specific higher risk employees can also be much tougher on small firms. As a result, self-insurance tends to be a less cost effective option than it is for larger companies.

Another roadblock for small businesses is a lack of cash-flow that is necessary to finance self-insurance. This doesn't mean, however, that small businesses can't benefit from a self-insurance plan. In fact, an increasing number of small businesses still are. But fully understanding the risks and rewards for doing so can sometimes be difficult.
Regulations

Because the only 3rd party administration of insurance (stop-loss) is between the employer and the insurance company directly, it is not subject to state level regulation the way traditional insurance policies are. Instead, they're regulated by the department of labor under the Employee Retirement Income Security Act – ERISA. Benefit administrators must still comply with federal standards despite the lack of state regulation.

California SB 1431

California is considering a proposed legislation to regulate the sale of stop-loss policies to smaller businesses. On the surface, the regulation looks as though it is an attempt to prevent small businesses from taking on too much risk. But the true intentions of the legislation may be to prevent cherry-picking of generally healthier small businesses (effectively removing them from the health insurance pool). This cherry-picking would theoretically cause traditional insurance premiums to become more expensive.

According to the SIIA, SB 1431 would prohibit the sale of stop-loss policies to employers with fewer than 50 employees that does any of the following:

Contains a specific attachment point that is lower than $95,000;
Contains an aggregate attachment point that is lower than the greater of one of the following:
$19,000 times the total number of covered employees and dependents;
120% of expected claims;
$95,000

This legislation would effectively limit the options of small businesses as it would force them to purchase a more expensive low deductible stop-loss policies. And according to the SIIA, with this legislation, almost no small business under 50 employees would (nor should they) consider self-insurance as an option.

If the legislation is passed in California, it has been suggested that it is only time before other states follow suit and/or enact even stricter regulations on small businesses. The SIIA even has a facebook page dedicated to defeating the bill they say is:

“…unnecessary and will only exasperate the problem that small employers in California face in being able to afford the rising cost of providing quality health benefits to their employees.”

So while self insurance can be a relatively risky option for small businesses, with legislation like this, it could no longer be a realistic option at all… And, in effect: another competitive advantage big businesses will have over their smaller counterparts.

You can read the original article here.

Source:

Staff Writer. (Date Unlisted). "Self funded health care – a big business advantage" [Web Blog Post]. Retrieved from address http://www.businessinsurance.org/self-funded-health-care-a-big-business-advantage/


SHRM Connect: Mental Health Issues in the Workplace - What Would You Do?

Are you a SHRM member and/or HR professional? In this article from SHRM by Mary Kaylor, she dives into what SHRM Connect is and how you can get involved!

You can read the original article here.


SHRM Connect is an online community where SHRM members can ask questions and get answers on a variety of HR topics. It’s a great place to network with other HR professionals and share solutions.

The conversation topics range from “HR Department of One” to Employment Law, are always insightful, and deal with some of the most pressing issues that HR professionals face in the workplace today.

While some of the conversations take on a more serious tone, others will deliver a bit of comic relief -- and on Fridays, I’ll be highlighting a conversation or two in hopes that you’ll take some time to visit. You may want to "lurk"… perhaps respond, but you’ll always learn something.

It’s a great community and I highly recommend checking it out.

While May is officially Mental Health Awareness month, HR must deal with employee mental health issues, and their effects on the workplace, all year long. This week’s highlighted conversations involve a few different scenarios. What would you do?

Subject: Self Harming

In the General HR area, a poster asks for advice on how to handle about a perceived case of self harming:

We have a new(er) employee that was observed by another employee to have cuts up and down her arm. The employee brought it to our attention out of concern. We thanked the employee and asked that she keep it confidential. We do not offer an EAP.

My thought is to speak with the employee that is self harming and let her know what was observed and just check in and see if she is ok. If she says everything is good, just leave it at that. If she mentions something is going on...or if she needs to seek treatment etc, go down that road.

For those of you who have experience with this, is this an ok approach? Is it best to not address it with the employee? Any other resources, since an EAP is not an option?

Thanks!

To read/respond to this conversation, please click here.

* * * * *

Subject: Alcohol and Discussion of Suicide

In the General HR area, another poster asks for advice on monitoring an employee:

Know of an employee with an alcohol problem who has gone through treatment and released to return to work by the treating facility. Prior to admittance, she talked about suicide. What follow-ups by the employer would you suggest, other than a monitoring agreement for a period of time?

To read/respond to this conversation, please click here.

* * * * *

Subject: WWYD

In the General HR area, yet another poster is wondering how others would handle a case of an employee with anxiety – and lots of absences:

I was hoping to get opinions on this situation, and I believe I know the correct way to follow up but I was interested to see what others would say.

We hired a non-exempt employee in July of this year. Since that time, this employee had 6 unexcused absences, and two preplanned days off. We accrue and allow employees to use their vacation leave from day one, and this employee essentially used all the time throughout the end of the year. Sick time is not available for employees until they've been employed for 90 days. This employee stated about a month ago after one of their absences that they has very bad anxiety, but does not have insurance they are unable to get medication or see a doctor. This employee never asked for any type of accommodation, and we actually even provided resources to assist with their anxiety. All of the times they called out after that conversation were simply because "i feel bad and can't come in". I received copies of the texts and they're pretty vague. They called out again on Tuesday after having a pre-planned half day off on Friday, and we decided to give the employee a final written warning with a 60 day timeframe to improve their attendance. Unfortunately the employee called out again yesterday with a very vague explanation and stated that 'I still feel pretty bad'.

After speaking with the managers over this department, we decided to terminate employment due to excessive absences. I explained that to the employee in the phone call and gave them an opportunity to explain themselves. I tried to create a dialogue in the event that we were missing something, but I just got 'heh. oh okay.'

Now this morning, I received a page long email stating this employee has rights under HIPAA that they didn't have to disclose the anxiety disorders that they have (we never asked, they disclosed it voluntarily). Also stated that they would have expected a written warning for their excessive absenteeism but not the fact we separated employment. They go on to blame us for other areas of lacking (training, etc) but said we amplified the anxiety problem because of the amount of training we were giving them.

I feel like this employee is looking for anyone to blame. It's an unfortunate situation but as an employer, we cannot read employees minds. If an employee needs an accommodation due to a medical condition, aren't they supposed to request it? How are we supposed to help with vague callouts?

Thoughts?

You can read the original article here.

Source:

Taylor M. (22 September 2017). "SHRM Connect: Mental Health Issues in the Workplace - What Would You Do?" [Web Blog Post]. Retrieved from address https://blog.shrm.org/blog/shrm-connect-mental-health-issues-in-the-workplace-what-would-you-do


Absent federal action, states take the lead on curbing drug costs

What's your state's stance on the cost of prescription drugs? See how Maryland has moved forward in their decision making for drug prices, giving themselves the ability to say "no" in this article from Benefits Pro written by Shefali Luthra.

You can read the original article here.


Lawmakers in Maryland are daring to legislate where their federal counterparts have not: As of Oct. 1, the state will be able to say “no” to some pharmaceutical price spikes.

A new law, which focuses on generic and off-patent drugs, empowers the state’s attorney general to step in if a drug’s price climbs 50 percent or more in a single year. The company must justify the hike. If the attorney general still finds the increase unwarranted, he or she can file suit in state court. Manufacturers face a fine of up to $10,000 for price gouging.

As Congress stalls on what voters say is a top health concern — high pharmaceutical costs — states increasingly are tackling the issue. Despite often-fierce industry opposition, a variety of bills are working their way through state governments. California, Nevada and New York are among those joining Maryland in passing legislation meant to undercut skyrocketing drug prices.

Maryland, though, is the first to penalize drugmakers for price hikes. Its law passed May 26 without the governor’s signature.

The state-level momentum raises the possibility that — as happened with hot-button issues such as gay marriage and smoke-free buildings — a patchwork of bills across the country could pave the way for more comprehensive national action. States feel the squeeze of these steep price tags in Medicaid and state employee benefit programs, and that applies pressure to find solutions.

“There is a noticeable uptick among state legislatures and state governments in terms of what kind of role states can play in addressing the cost of prescription drugs and access,” said Richard Cauchi, health program director at the National Conference of State Legislatures.

Many experts frame Maryland’s law as a test case that could help define what powers states have and what limits they face in doing battle with the pharmaceutical industry.

The generic-drug industry has already filed a lawsuit to block the law, arguing it’s unconstitutionally vague and an overreach of state powers. A district court is expected to rule soon.

The state-level actions focus on a variety of tactics:

“Transparency bills” would require pharmaceutical companies to detail a drug’s production and advertising costs when they raise prices over certain thresholds. Cost-limit measures would cap drug prices charged by drugmakers to Medicaid or other state-run programs, or limit what the state will pay for drugs. Supply-chain restrictions include regulating the roles of pharmacy benefit managers or limiting a consumer’s out-of-pocket costs.

A New York law on the books since spring allows officials to cap what its Medicaid program will pay for medications. If companies don’t sufficiently discount a drug, a state review will assess whether the price is out of step with medical value.

Maryland’s measure goes further — treating price gouging as a civil offense and taking alleged violators to court.

“It’s a really innovative approach. States are looking at how to replicate it, and how to expand on it,” said Ellen Albritton, a senior policy analyst at the left-leaning Families USA, which has consulted with states including Maryland on such policies.

Lawmakers have introduced similar legislation in states such as Massachusetts, Rhode Island, Tennessee and Montana. And in Ohio voters are weighing a ballot initiative in November that would limit what the state pays for prescription drugs in its Medicaid program and other state health plans.

Meanwhile, the California legislature passed a bill earlier in September that would require drugmakers to disclose when they are about to raise a price more than 16 percent over two years and justify the hike. It awaits Democratic Gov. Jerry Brown’s signature.

In June, Nevada lawmakers approved a law similar to California’s but limited to insulin prices. Vermont passed a transparency law in 2016 that would scrutinize up to 15 drugs for which the state spends “significant health care dollars” and prices had climbed by set amounts in recent years.

But states face a steep uphill climb in passing pricing legislation given the deep-pocketed pharmaceutical industry, which can finance strong opposition, whether through lobbying, legal action or advertising campaigns.

Last fall, voters rejected a California initiative that would have capped what the state pays for drugs — much like the Ohio measure under consideration. Industry groups spent more than $100 million to defeat it, putting it among California’s all-time most expensive ballot fights. Ohio’s measure is attracting similar heat, with drug companies outspending opponents about 5-to-1.

States also face policy challenges and limits to their statutory authority, which is why several have focused their efforts on specific parts of the drug-pricing pipeline.

Critics see these tailored initiatives as falling short or opening other loopholes. Requiring companies to report prices past a certain threshold, for example, might encourage them to consistently set prices just below that level.

Maryland’s law is noteworthy because it includes a fine for drugmakers if price increases are deemed excessive — though in the industry that $10,000 fine is likely nominal, suggested Rachel Sachs, an associate law professor at Washington University in St. Louis who researches drug regulations.

This law also doesn’t address the trickier policy question: a drug’s initial price tag, noted Rena Conti, an assistant professor in the University of Chicago who studies pharmaceutical economics.

And its focus on generics means that branded drugs, such as Mylan’s Epi-Pen or Kaleo’s overdose-reversing Evzio, wouldn’t be affected.

Yet there’s a good reason for this, noted Jeremy Greene, a professor of medicine and the history of medicine at Johns Hopkins University who is in favor of Maryland’s law.

Current interpretation of federal patent law suggests that the issues related to the development and affordability of on-patent drugs are under federal jurisdiction, outside the purview of states, he explained.

In Maryland, “the law was drafted narrowly to address specifically a problem we’ve only become aware of in recent years,” he said. That’s the high cost of older, off-patent drugs that face little market competition. “Here’s where the state of Maryland is trying to do something,” he said.

Still, a ruling against the state in the pending court case could have a chilling effect for other states, Sachs said, although it would be unlikely to quash their efforts.

“This is continuing to be a topic of discussion, and a problem for consumers,” said Sachs.

“At some point, some of these laws are going to go into effect — or the federal government is going to do something,” she added.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Source:

Luther S. (29 September 2017). "Absent federal action, states take the lead on curbing drug costs" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/29/absent-federal-action-states-take-the-lead-on-curb?page=2


Risk Insights: Donating to Disasters and Avoiding Scams

Hurricane Harvey is the strongest storm to make landfall in the United States since Hurricane Charley in 2004. News of the damage it has caused to southeastern Texas is prompting people to help in whatever ways they can. Unfortunately, there are dishonest people who prey upon people’s good intentions, creating fake charity campaigns to exploit victims and take advantage of those who want to help.

How to Avoid Scams

Despite the sense of urgency to help when disaster strikes, it is important to do some research before donating. Consider the following best practices to ensure that your resources go to a legitimate charity with experience in disaster relief:

  • Never wire money to someone who claims to be a charity. Legitimate charities do not ask for wire transfers. Once you wire the money, you’ll probably never get it back.
  • Be cautious about bloggers and social media posts that provide charity suggestions. Don’t assume that the person recommending the charity has fully researched the organization’s credibility.
  • Only donate through a charity’s official website, never through emails. Scammers have a knack for creating fake email accounts that seem legitimate.
  • Ensure that the charity explains on its website how your money will be used.

  • Be wary of charities that claim to give 100 percent of donations to victims. That is often a false claim, as well-structured organizations need to use some of their donations to cover administrative costs.
  • Never offer unnecessary personal information, such as your Social Security number or a copy of your driver’s license. However, it is common for legitimate charities to ask for your mailing address, and it is safe for you to provide it.

Despite the sense of urgency to help when disaster strikes, it is important to do some research before donating money. Don’t let dishonest people take advantage of your good intentions.

How to Choose a Charity

Even legitimate charities need to be considered with care. The Federal Trade Commission suggests avoiding new charities because, despite their legitimacy, they may not have the resources needed to get your money to its intended recipients.

Donors looking for a worthy charity can access an unbiased, objective list on a website called Charity Navigator. The site receives a Form 990 for all of its charities directly from the IRS, so it knows exactly how

the charities spend their money and use their donations. It also rates charities based on their location, tax status, length of operation, accountability, transparency and public support.

Gaining popularity for charitable donations is a crowdfunding website called GoFundMe, which allows people to raise money for a wide variety of circumstances. Despite its popularity, visitors to the site should be cautious about the campaigns to which they donate. Visitors can report suspicious campaigns directly to GoFundMe via its official website or to their state’s consumer protection hotline.

National Organizations

The following national organizations have long-standing reputations for providing disaster relief and accepting donations:

  • The American Red Cross provides shelter, food, emotional support and other necessities to people affected by disasters.
  • AmeriCares takes medicine and supplies to survivors.
  • Catholic Charities USA supports disaster response and recovery efforts that include direct assistance, rebuilding and health care services.
  • The Salvation Army provides shelter and emergency services to displaced individuals.

Remember that there are other ways to provide disaster relief that don’t involve monetary donations, especially if you live near the affected area. Local food banks and blood centers commonly ask for donations during relief efforts.

 

Sourced from – Zywave.com