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


Safety Focused Newsletter - September 2017

Safety Focused

Tips for Managing Workplace Fatigue

Not only does fatigue make you less productive and personable, it can also cause a serious safety risk if you work with hazardous equipment or materials. Read on to learn how to manage fatigue at work.

 

5 Ways to Eat Healthier at Work

Good nutrition is an essential part of a healthy lifestyle, and eating healthier can increase your productivity, lower the number of sick days you take and reduce your risk of being in an on-the-job accident. Read on to learn five tips for healthier eating at work.

NOT ONLY DOES FATIGUE MAKE YOU LESS PRODUCTIVE AND PERSONABLE, IT CAN ALSO CAUSE A SERIOUS SAFETY RISK IF YOU WORK WITH HAZARDOUS EQUIPMENT OR MATERIAL

Tips for Managing Workplace Fatigue

Hectic schedules, stress and lack of sleep can all contribute to fatigue, which is a common and dangerous workplace hazard. Symptoms of fatigue include moodiness, drowsiness, loss of energy, and lack of motivation and concentration.

These are not ideal qualities to display at your job. Not only does fatigue make you less productive and personable, it can also cause a serious safety risk if you work with hazardous equipment or materials.

To help manage workplace fatigue, consider doing the following:

  • Eat a snack that includes complex carbohydrates and protein (like an energy bar or half a peanut butter sandwich on whole-wheat bread).
  • Avoid sugar, which will make you crash later.
  • Go for a short walk to re-energize yourself.
  • Drink a glass of water.
  • Manage your stress, and get more sleep.
  • Exercise regularly.
  • Limit your caffeine intake to one or two drinks per day.

Fatigue can also be linked to an underlying medical problem, psychological condition or sleep disorder. Talk to your doctor if you experience chronic or debilitating fatigue.

5 Ways to Eat Healthier at Work

Most full-time employees eat at least one meal at work. Not only are a significant number of meals eaten in the workplace, but work is also where employees are most susceptible to distracted or stress-related eating.

Good nutrition is an essential part of a healthy lifestyle, and eating healthier can increase your productivity, lower the number of sick days you take and reduce your risk of being in an on-the-job accident.

To start eating heathier at work today, consider doing the following:

  1. Avoid junk food. Clean your desk or work area of junk food. This includes snacks like candy, chips or crackers.
  2. Make time to eat full meals. While work can get busy, it’s critical that you make time to eat a healthy meal. Not only does eating a nutritious breakfast or lunch increase your energy, but it can also help you remain fuller for longer, thus reducing snacking.

  1. Bring leftovers into work. When cooking your dinner each night, consider setting aside portions for your lunch the next day. Not only does this make meal planning easier, but it can also save you money.
  2. Bring in bottles of water. Make an effort to drink water throughout the day. This can help energize you, supress your appetite and aid in weight loss.
  3. Snack smart. Snacks aren’t entirely off the table when you’re trying to eat healthy. Foods like dried fruit, jerky, nuts and applesauce are all good alternatives to unhealthy chips and candy bars.

While eating home-cooked meals is one of the easiest ways to eat healthier, certain jobs require employees to be on the road often. This, unfortunately, can lead to eating out more.

In this case, being careful about the kinds of food you order and the portion sizes can make all the difference in managing weight gain.


OSHA Rule: Respirable Crystalline Silica

On March 25, 2016, the Occupational Safety and Health Administration (OSHA) issued a final rule regarding respirable crystalline silica. Under this rule, employers will be subject to new standards for protecting workers. The rule became effective on June 23, 2016, but employers in the construction industry have until Sept. 23, 2017, to comply with the rule. Employers in the maritime and general industries will have until June 23, 2018, to comply with the rule.

The rule includes standards that dramatically reduce the permissible exposure limit (PEL) for respirable crystalline silica to 50 micrograms per cubic meter of air (50 µg/m3). The rule also requires employers to implement specific measures to protect workers.

Links and Resources

·   Final rule on occupational exposure to respirable crystalline silica

·   OSHA FAQs on the respirable crystalline silica final rule

·   OSHA crystalline silica webpage; CDC silica webpage

·   Methods of sample analysis for construction, general and maritime industries

·   Medical surveillance guidelines for construction, general and maritime industries

 

This Compliance Overview presents a high-level summary of OSHA’s final rule regarding respirable crystalline silica.

HIGHLIGHTS

SILICA FINAL RULE

  • The final rule establishes a new permissible exposure limit for respirable crystalline silica.
  • Employers must implement specific measures to protect workers.
  • The intent of the rule is to reduce the risk of diseases caused by exposure to respirable crystalline silica.

IMPORTANT DATES

  • Employers in the construction industry must comply by Sept. 23, 2017.
  • Employers in the general and maritime industries must comply by June 23, 2018.

Background

Crystalline silica (silica) is a common mineral found in materials like sand, concrete, stone and mortar. Silica becomes hazardous when it is reduced to a dust and released into the air where it can be inhaled (called respirable silica). This commonly occurs in operations that involve cutting, sawing, drilling and crushing materials that contain silica. Operations in which sand products are used, such as glass manufacturing, metal casting and sand blasting, also tend to generate respirable silica. When silica dust particles are inhaled, they can penetrate deep into the lungs and cause disabling and sometimes fatal diseases, including silicosis, lung cancer, chronic obstructive pulmonary disorder and kidney disease.

OSHA first set PELs for respirable silica in 1971, allowing 100 µg/m3 for general industry and 250 µg/m3 for construction and shipyards. Since then, numerous advanced scientific studies determined that much lower levels of silica exposure can causes serious health effects. After reviewing the scientific evidence, OSHA determined that even though significant health risks remain at the 50 µg/m3 PEL, this is the lowest level that most affected operations can reasonably achieve through the use of engineering controls and work practices.

Covered Employers

In its final rule, OSHA issued two separate standards for protecting workers from exposure to respirable crystalline silica, one for the construction industry and another for the general and maritime industries.

Both standards are similar and provide comparable protections for workers, but OSHA issued them separately to account for differences in work activities, anticipated exposure levels and other conditions unique to each industry. Although exposure to respirable crystalline silica has also been documented in the agricultural sector, OSHA did not issue regulations for this industry.

General Requirements for Covered Employers

Under both standards, employers subject to OSHA’s final rule must:

  •    Implement engineering and work-practice control measures;
  •    Establish and implement a written exposure plan;
  •    Restrict housekeeping practices that expose workers to silica;
  •    Offer medical exams to workers who are exposed to silica;
  •    Train workers on operations that result in silica exposure and on ways to limit exposure; and
  •    Keep records of workers’ silica exposure and medical exams.

Employers in the construction industry must also designate a competent person to implement their written exposure control plans.

Exposure Control Requirements

To comply with exposure control requirements, general industry and maritime employers must measure respirable silica levels in the workplace any time they may possibly be at or above 25 µg/m3 (action level). They must also ensure that employees are not exposed to levels above 50 µg/m3 by limiting access to areas with high levels, using dust control measures (such as wetting and ventilation), and providing workers with respirators.

Construction employers have the option of either using those same methods or following specific dust-control methods that are outlined in Table 1 of OSHA’s final rule. Table 1 provides a list of common construction tasks and specific actions construction employers can take to protect workers who perform each task.

Written Exposure Plan

The final rule allows employers to tailor their written exposure control plans to their particular worksites. Minimum requirements include a description of all tasks that workers may have to do that could expose them to respirable silica and a description of the employer’s methods for protecting workers, including procedures used to restrict workers’ access to potential high-exposure areas.

Construction employers must also designate an individual who is capable of identifying existing and foreseeable silica hazards in the workplace and who has authorization to take prompt corrective measures to eliminate or minimize them.

Housekeeping

If housekeeping practices may expose workers to respirable silica, employers must use any feasible alternative as a means of reducing or eliminating the exposure risk.

Medical Surveillance

Employers must offer medical exams to workers who may be exposed to respirable silica levels of 25 µg/m3 or more for 30 or more days per year. The exams must be offered every three years and must include chest X-rays and lung function tests.

Compliance Schedule

Each standard includes a compliance schedule for covered employers. The table below provides an overview of the relevant deadlines.

Industry Deadline Exceptions
General and Maritime June 23, 2018 ·    Medical surveillance must be offered to workers who will be exposed to 25 µg/m3 or more of crystalline silica for 30 or more days a year starting on June 23, 2020; and

·    Hydraulic fracturing operations must implement engineering controls by June 23, 2021.

Construction Sept. 23, 2017 ·    Laboratory evaluation sample requirements begin on June 23, 2018.

 

SOURCED FROM ZYWAVE – https://www.zywave.com


Workers' Compensation Services Overview

How is your broker helping you lower your workers’ compensation premiums?

  • Workers’ compensation is a large and necessary cost, but there are still opportunities to save. We’ll help you reduce claims and control costs by establishing workplace safety policies, streamlining your reporting procedures and identifying top loss sources.

How effective is your return to work program?

  • The longer a workers’ compensation claim stays open, the more it will cost you. Hierl Insurance Inc. can help you implement a comprehensive return to work program that will protect your bottom line, while still providing your employees with appropriate care.

Did you know that you can see a massive return on investment for every dollar you put into workplace safety and health?

  • Our clients have access to numerous employee safety materials, including newsletters, flyers, bulletins and comprehensive safety manuals that can help promote a safety-minded workplace.

 

STATE-SPECIFIC EMPLOYER REQUIREMENTS

Get a quick, clear understanding of all of your workers’ compensation requirements with these comprehensive summaries. With these materials, you can rest easy knowing that your workers’ compensation obligations are met.

 

EMPLOYEE SAFETY MANUALS

Take steps to reduce workplace injuries with these customizable safety manuals, which feature general safety policies and procedures to support safety programs. Choose from a general template or from over 25 industry-specific versions.

 

RETURN TO WORK RESOURCES

Use these return to work materials to reduce the length of workers’ compensation claims and support your employees. These policies, forms and employee communications will help ensure that everyone at your business is on the same page and focused on recovery.

 

INJURY AND ILLNESS INVESTIGATION PROGRAMS

Make sure the injuries and illnesses only cost you a single time. These resources can help you establish best practices for investigating the true sources of workplace incidents and reduce the chance of reoccurrences.

 

WORKERS’ COMPENSATION ARTICLES

 

Stay up to date on new workers’ compensation developments with informative and easy-to-read articles. These articles examine a variety of topics and can help your business stay prepared before, during and after a workers’ compensation claim.

 

 

Sourced from Zywave - https://www.zywave.com.

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Compliance Recap January 2017

Make sure you stay up to date on January's compliances thanks to our partners United Benefits Advisors (UBA),

January was a significant month in the employee benefits world because the new U.S. administration issued an Executive Order announcing its intent to repeal the Patient Protection and Affordable Care Act (ACA). However, January was a relatively inactive month for new laws and administrative rulemaking because the new administration placed a freeze on rulemaking until presidential nominations of agency heads are confirmed.

The Department of Health and Human Services (HHS) released the 2017 poverty guidelines. The Department of Labor (DOL) released its inflation-adjusted civil monetary penalty amounts and an FAQ regarding the contraceptive services objection accommodation. The DOL, HHS, and the Treasury Department released FAQs about family HRA integration with a non-HRA group health plan. The IRS released its 2017 version of the Employer’s Tax Guide to Fringe Benefits and a memo on fixed indemnity health plan benefits tax treatment.

President Trump Signs Executive Order

On January 20, 2017, President Trump signed Executive Order: Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.

The Executive Order directs the Department of Health and Human Services’ Secretary and the heads of all other executive departments and agencies with authority or responsibility under the Patient Protection and Affordable Care Act (ACA) to exercise all authority and discretion to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the ACA that would impose a fiscal burden on any state, or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

The Executive Order indicates that the Administrative Procedure Act and its rulemaking process still apply to regulatory revisions. Because confirmation proceedings are not concluded for the heads of the Departments of Health and Human Services, Labor, or the Treasury, the agencies are in a rule promulgation freeze until presidential nominations are confirmed.

HHS Releases 2017 Federal Poverty Guidelines

The 2017 poverty guidelines (also referred to as the FPL) were released by the Department of Health and Human Services (HHS). For a family/household of 1 in the contiguous United States, the FPL is $12,060. In Alaska, the FPL is $15,060 and in Hawaii the FPL is $13,860. Applicable large employers that wish to use the FPL affordability safe harbor under the employer shared responsibility/play or pay rules should ensure that their lowest employee-only premium is equal to or less than $97.38 a month, which is 9.69 percent of the FPL.

DOL Releases Inflation-Adjusted Federal Civil Penalty Amounts

On January 18, 2017, the Department of Labor issued the Federal Civil Penalties Inflation Adjustment Act Annual Adjustments for 2017 which is its first annual adjustment of federal civil monetary penalties. Here are some of the adjustments:

  • Form 5500: For failure to file, the maximum penalty increases from $2,063 to $2,097 daily for every day that the Form 5500 is late.
  • Summary of Benefits and Coverage: For failure to provide, the maximum penalty increases from $1,087 to $1,105 per failure.
  • Genetic Information Nondiscrimination Act: For violations, the maximum penalty increases from $110 per participant per day to $112.

The adjustments are effective for penalties assessed after January 13, 2017, for violations occurring after November 2, 2015.

DOL Releases FAQ Regarding Contraceptive Services Objection Accommodation

As part of implementing the Patient Protection and Affordable Care Act (ACA), the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued regulations to require coverage or women’s preventive services, which essentially includes all FDA-approved contraceptives, sterilization procedures, and patient education and counseling for women with reproductive capacity, as prescribed by the health care provider (collectively, contraceptive services).

The regulations exempt group health plans of “religious employers” (specifically defined in the law) from the requirement to provide contraceptive coverage. Later, amended regulations provide an accommodation for eligible organizations – which are not eligible for the religious employer exemption – that object on religious grounds to providing coverage for contraceptive services. Because of litigation, the Departments extended the accommodation to closely held for-profit entities.

Under the accommodation, an eligible organization that objects to providing contraceptive coverage for religious reasons may either:

  1. self-certify its objection to its health insurance issuer (to the extent it has an insured plan) or third party administrator (to the extent it has a self-insured plan) using a form provided by the Department of Labor (EBSA Form 700); or
  2. self-certify its objection and provide certain information to HHS without using any particular form.

Most recently, in 2016, the U.S. Supreme Court considered claims by several employers that, even with the accommodation provided in the regulations, the contraceptive coverage requirement violates the Religious Freedom Restoration Act (RFRA). The Court heard oral arguments and ultimately remanded the case (and parallel RFRA cases) to the lower courts to give the parties “an opportunity to arrive at an approach going forward that accommodates [the objecting employers’] religious exercise while at the same time ensuring that women covered by [the employers’] health plans ‘receive full and equal health coverage, including contraceptive coverage.’”

To address the Court’s statement, the Departments published their request for information (RFI) regarding the Court’s statement and received more than 54,000 public comments. Based on the comments submitted, the Departments released FAQs About Affordable Care Act Implementation Part 36 to indicate that they not making changes to the accommodation for the following reasons:

  • No feasible approach has been identified that would resolve the religious objectors’ concerns, while still ensuring that the affected women receive full and equal health coverage, including contraceptive coverage.
  • The process described in the Court’s supplemental briefing order would not be acceptable to those with religious objections to the contraceptive coverage requirements.
  • There are administrative and operational changes to a process like the one described in the Court’s order that are more significant than the Departments had previously understood and that would potentially undermine women’s access to full and equal coverage.

Agencies Release FAQs About Family HRA Integration with Non-HRA Group Health Plan

The Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) released FAQs About Affordable Care Implementation Part 37 to address health reimbursement arrangement (HRA) integration with group health plans.

The Departments indicate that, for purposes of determining whether a family HRA is “integrated” with a non-HRA group health plan, an employer may rely on an employee’s reasonable representation that the employee and other individuals covered by the family HRA are also covered by another qualifying non-HRA group health plan.

Also, a family HRA is permitted to be integrated with a combination of coverage under other qualifying non-HRA group health plans if all individuals who are covered under the family HRA are also covered under other qualifying non-HRA group health plan coverage.

For example, a family HRA covering an employee, spouse, and one dependent child may be integrated with the combination of (1) the employee’s self-only coverage under the non-HRA group health plan of the employee’s employer, and (2) the spouse and dependent child’s coverage under the non-HRA group health plan of the spouse’s employer, if both non-HRA group health plans are qualifying nonHRA group health plans.

IRS Releases 2017 Version of the Employer’s Tax Guide to Fringe Benefits

The IRS released its 2017 Version of Publication 15-B which provides information on the employment tax treatment of various fringe benefits. Fringe benefits are taxable unless an exclusion applies. The publication lists the qualified benefits that a cafeteria plan may include and examples of benefits that a cafeteria plan is not permitted to include. It also provides the 2017 dollar limits for various benefits.

IRS Issues Memo on Fixed-Indemnity Health Plan Benefits Tax Treatment

On January 20, 2017, the IRS released a Memorandum on the tax treatment of benefits paid by fixedindemnity health plans that addresses: (1) whether payments to an employee under an employerprovided fixed-indemnity health plan are excludible from the employee’s income under Internal Revenue Code §105, and (2) whether payments to an employee under an employer-provided fixedindemnity health plan are excludible from the employee’s income under Internal Revenue Code §105 if the payments are made by salary reduction through a §125 cafeteria plan.

Some examples of fixed indemnity health plans are AFLAC or similar coverage, or cancer insurance policies.

Generally, the Internal Revenue Code imposes taxes on wages paid with respect to employment. For federal income tax withholding, the Internal Revenue Code generally requires every employer who pays wages to deduct and withhold taxes on those wages.

The IRS concluded that an employer may not exclude payments under an employer-provided fixedindemnity health plan from an employee’s gross income if the coverage’s value was excluded from the employee’s gross income and wages. Further, an employer may not exclude payments under an employer-provided fixed-indemnity health plan if the plan’s premiums were made by salary reduction through a §125 cafeteria plan.

In the context of an employer-provided fixed-indemnity health plan, when the employer’s payment for coverage by the fixed-indemnity plan is excluded from the employee’s gross income, then the payments by the plan are not excluded from the employee’s gross income

In contrast, when the premiums are paid with after-tax dollars, the payments by the plan are excluded from the employee’s gross income.

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