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Apple, Fitbit to join FDA program to speed health tech

Wondering how technology can speed the process of developing health tech? In this article from BenefitsPro written by Anna Edney, gain a close insight on how Apple and Fitbit are working together with the FDA to make your health of vital importance.

You can read the original article here.


A federal agency that regulates apples wants to make regulations on Apple Inc. a little easier.

The Food and Drug Administration, which oversees new drugs, medical devices and much of the U.S. food supply, said Tuesday that it had selected nine major tech companies for a pilot program that may let them avoid some regulations that have tied up developers working on health software and products.

“We need to modernize our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate,” FDA Commissioner Scott Gottlieb said in a statement.

The program is meant to let the companies get products pre-cleared rather than going through the agency’s standard application and approval process that can take months. Along with Apple, Fitbit Inc., Samsung Electronics Co., Verily Life Sciences, Johnson & Johnson and Roche Holding AG will participate.

 

A new report and video from the Health Enhancement Research Organization (HERO) identifies six promising practices for effectively integrating wearables...
The FDA program is meant to help the companies more rapidly develop new products while maintaining some government oversight of technology that may be used by patients or their doctors to prevent, diagnose and treat conditions.

Apple is studying whether its watch can detect heart abnormalities. The process it will go through to make sure it’s using sound quality metrics and other measures won’t be as costly and time-consuming as when the government clears a new pacemaker, for example. Verily, the life sciences arm of Google parent Alphabet Inc., is working with Novartis AG to develop a contact lens that could continuously monitor the body’s blood sugar.

Faster Pace

“Historically, health care has been slow to implement disruptive technology tools that have transformed other areas of commerce and daily life,” Gottlieb said in July when he announced that digital health manufacturers could apply for the pilot program.

Officially dubbed the Pre-Cert for Software Pilot, Gottlieb at the time called it “a new and pragmatic approach to digital health technology.”

The other companies included in the pilot are Pear Therapeutics Inc., Phosphorus Inc. and Tidepool.

The program is part of a broader move at the FDA, particularly since Gottlieb took over in May, to streamline regulation and get medical products to patients faster. The commissioner said last week the agency will clarify how drugmakers might use data from treatments already approved in some disease to gain approvals for more conditions. In July, he delayed oversight of electronic cigarettes while the agency decides what information it will need from makers of the products.

Rules Uncertainty

As Silicon Valley developers have pushed into health care, the industry has been at times uncertain about when it needed the FDA’s approval. In 2013, the consumer gene-testing company 23andMe Inc. was ordered by the agency to temporarily stop selling its health analysis product until it was cleared by regulators, for example.

Under the pilot, the FDA will scrutinize digital health companies’ software and will inspect their facilities to ensure they meet quality standards and can adequately track their products once they’re on the market. If they pass the agency’s audits, the companies would be pre-certified and may face a less stringent approval process or not have to go through FDA approval at all.

More than 100 companies were interested in the pilot, according to the FDA. The agency plans to hold a public workshop on the program in January to help developers not in the pilot understand the process and four months of initial findings.

You can read the original article here.

Source:

Edeny A. (27 September 2017). "Apple, Fitbit to join FDA program to speed health tech" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/27/apple-fitbit-to-join-fda-program-to-speed-health-t

Wondering how technology can speed the process of developing health tech? In this article from BenefitsPro written by Anna Edney, gain a close insight on how Apple and Fitbit are working together with the FDA to make your health of vital importance.

You can read the original article here.


A federal agency that regulates apples wants to make regulations on Apple Inc. a little easier.

The Food and Drug Administration, which oversees new drugs, medical devices and much of the U.S. food supply, said Tuesday that it had selected nine major tech companies for a pilot program that may let them avoid some regulations that have tied up developers working on health software and products.

“We need to modernize our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate,” FDA Commissioner Scott Gottlieb said in a statement.

The program is meant to let the companies get products pre-cleared rather than going through the agency’s standard application and approval process that can take months. Along with Apple, Fitbit Inc., Samsung Electronics Co., Verily Life Sciences, Johnson & Johnson and Roche Holding AG will participate.

 

A new report and video from the Health Enhancement Research Organization (HERO) identifies six promising practices for effectively integrating wearables...
The FDA program is meant to help the companies more rapidly develop new products while maintaining some government oversight of technology that may be used by patients or their doctors to prevent, diagnose and treat conditions.

Apple is studying whether its watch can detect heart abnormalities. The process it will go through to make sure it’s using sound quality metrics and other measures won’t be as costly and time-consuming as when the government clears a new pacemaker, for example. Verily, the life sciences arm of Google parent Alphabet Inc., is working with Novartis AG to develop a contact lens that could continuously monitor the body’s blood sugar.

Faster Pace

“Historically, health care has been slow to implement disruptive technology tools that have transformed other areas of commerce and daily life,” Gottlieb said in July when he announced that digital health manufacturers could apply for the pilot program.

Officially dubbed the Pre-Cert for Software Pilot, Gottlieb at the time called it “a new and pragmatic approach to digital health technology.”

The other companies included in the pilot are Pear Therapeutics Inc., Phosphorus Inc. and Tidepool.

The program is part of a broader move at the FDA, particularly since Gottlieb took over in May, to streamline regulation and get medical products to patients faster. The commissioner said last week the agency will clarify how drugmakers might use data from treatments already approved in some disease to gain approvals for more conditions. In July, he delayed oversight of electronic cigarettes while the agency decides what information it will need from makers of the products.

Rules Uncertainty

As Silicon Valley developers have pushed into health care, the industry has been at times uncertain about when it needed the FDA’s approval. In 2013, the consumer gene-testing company 23andMe Inc. was ordered by the agency to temporarily stop selling its health analysis product until it was cleared by regulators, for example.

Under the pilot, the FDA will scrutinize digital health companies’ software and will inspect their facilities to ensure they meet quality standards and can adequately track their products once they’re on the market. If they pass the agency’s audits, the companies would be pre-certified and may face a less stringent approval process or not have to go through FDA approval at all.

More than 100 companies were interested in the pilot, according to the FDA. The agency plans to hold a public workshop on the program in January to help developers not in the pilot understand the process and four months of initial findings.

You can read the original article here.

Source:

Edeny A. (27 September 2017). "Apple, Fitbit to join FDA program to speed health tech" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/27/apple-fitbit-to-join-fda-program-to-speed-health-t


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


Center Stage...Do You Have an Employer Return to Work Program?

A proven strategy to reduce workers compensation cost and shorten the length of a worker’s compensation time is a return to work (RTW) program.

Loss reduction overall can be greatly improved by an effective RTW program.

 

“Before RTW programs evolved, the role of an employee was a passive one. If an employee was injured and was unable to work, they ended up sitting at home and it became the doctor’s responsibility to decide when they were cleared for work. Hierl takes a proactive approach to getting these workers back on the job.” -Cathleen Christenson

Today, most disability or worker’s compensation insurers enact RTW programs to help facilitate injured workers return to work in a timely manner. Hierl recommends a policy where employers are more actively involved with the doctor and employee throughout the worker’s compensation claim. These policies clarify the employee’s late duty work, alternative job duties to keep workers engaged when they are on a leave, and any other expectations up front.

A study by the Department of Labor and Industry, produced that the chances of returning to any type of work drastically reduced the longer they are away from work. At just six months away from work, the employee only stands a fifty percent chance of getting back to any type of work. At twenty-four months, the study found the worker will most likely never return to productive work.

Key Points to a Successful Return to Work Program

  1. Have a dedicated person responsible

Having a dedicated return to work coordinator or specialist to facilitate the return to work process and provide individualized planning that adapts to the worker’s initial and ongoing needs shows that you care as an employer. This role will also be in charge of assigning modified work duties for the employee. Be sure to make sure the employee knows who they can contact if they have any questions or need help through the return to work process.

 

  1. Maintain active communication

An essential requirement for a successful early return to work program is good communication between the employer, the employee and the medical care provider. It can be very beneficial for employers to be able to develop a relationship with medical providers in their community to allow the medical provider to understand what the company does and accurately determine when an employee can return to their workplace.

  1. Actively engage employee in the return to work program

Often employees are injured and left to stay at home without work and they suffer a serious change to their normal routine. By spending time away from the office, it causes a disconnect from the human element that exists in the office. In order to ensure employees stay involved and return to work, it is crucial to keep them engaged usually through late duty work. Ensure that all employees know the company return to work policy and that they understand the company is committed to keeping them engaged in late duty work.

The key in successful return to work programs is making sure that any of your efforts aren’t perceived as punitive but instead convey to your employees that you care about them. Make sure that all levels of employees recognize that early return to work after an injury speeds up the recovery process and reduces the likelihood of a permanent disability. Studies clearly demonstrate that employees who are off work because of an injury for more than 16 weeks seldom return to the workforce, costing companies hundreds of thousands of dollars each year. Overall, workplace return to work policies have positive impacts on duration and costs of worker compensation.

Contact Hierl for guidance in enacting a return to work program or general employee safety practices. A good return to work program should be set up before it is needed.


Survey: Small Businesses Keeping Pace with Health Benefits Offered by Employers Nationwide

Find out how small businesses compare to major corporations when it comes to their healthcare benefits in this informative article from our partner, United Benefit Advisors (UBA) by Bill Olson.

Small employers, those with fewer than 100 employees, have a reputation for not offering health insurance benefits that are competitive with larger employers, but new survey data from UBA’s Health Plan Survey reveals they are keeping pace with the average employer and, in fact, doing a better job of containing costs.

According to our new special report: “Small Businesses Keeping Pace with Nationwide Health Trends,” employees across all plan types pay an average of $3,378 toward annual health insurance benefits, with their employer picking up the rest of the total cost of $9,727. Among small groups, employees pay $3,557, with their employer picking up the balance of $9,474 – only a 5.3 percent difference.

When looking at total average annual cost per employees for PPO plans, small businesses actually cut a better deal even compared to their largest counterparts—their costs are generally below average—and the same holds true for small businesses offering HMO and CDHP plans. (Keep in mind that relief such as grandmothering and the PACE Act helped many of these small groups stay in pre-ACA plans at better rates, unlike their larger counterparts.)

PPO Plan Average Annual Cost per Employee

Think small businesses are cutting coverage to drive these bargains? Compared to the nations very largest groups, that may be true, but compared to average employers, small groups are highly competitive

See the original article Here.

Source:

Olson B. (2017 August 24). Survey: small business keeping pace with health benefits offered by employers nationwide [Web blog post]. Retrieved from address http://blog.ubabenefits.com/survey-small-businesses-keeping-pace-with-health-benefits-offered-by-employers-nationwide


The COBRA Payment Process

Great article from our partner, United Benefit Advisors (UBA) by Danielle Capilla.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

Grace Periods

The initial premium payment is due 45 days after the qualified beneficiary elects COBRA. Premium payments must be made on time; otherwise, a plan may terminate COBRA coverage. Generally, subsequent premium payments are due on the first day of the month. However, under the COBRA grace period rules, premiums will still be considered timely if made within 30 days after the due date. The statutory grace period is a minimum 30-day period, but plans may allow qualified beneficiaries a longer grace period.

A COBRA premium payment is made when it is sent to the plan. Thus, if the qualified beneficiary mails a check, then the payment is made on the date the check was mailed. The plan administrators should look at the postmark date on the envelope to determine whether the payment was made on time. Qualified beneficiaries may use certified mail as evidence that the payment was made on time.

The 30-day grace period applies to subsequent premium payments and not to the initial premium payment. After the initial payment is made, the first 30-day grace period runs from the payment due date and not from the last day of the 45-day initial payment period.

If a COBRA payment has not been paid on its due date and a follow-up billing statement is sent with a new due date, then the plan risks establishing a new 30-day grace period that would begin from the new due date.

Notification

The plan administrator must notify the qualified beneficiary of the COBRA premium payment obligations in terms of how much to pay and when payments are due; however, the plan does not have to renotify the qualified beneficiary to make timely payments. Even though plans are not required to send billing statements each month, many plans send reminder statements to the qualified beneficiaries.

While the only requirement for plan administrators is to send an election notice detailing the plan's premium deadlines, there are three circumstances under which written notices about COBRA premiums are necessary. First, if the COBRA premium changes, the plan administrator must notify the qualified beneficiary of the change. Second, if the qualified beneficiary made an insignificant shortfall premium payment, the plan administrator must provide notice of the insignificant shortfall unless the plan administrator chooses to ignore it. Last, if a plan administrator terminates a qualified beneficiary's COBRA coverage for nonpayment or late payment, the plan administrator must provide a termination notice to the qualified beneficiary.

The plan administrator is not required to inform the qualified beneficiary when the premium payment is late. Thus, if a plan administrator does not receive a premium payment by the end of the grace period, then COBRA coverage may be terminated. The plan administrator is not required to send a notice of termination in that case because the COBRA coverage was not in effect. On the other hand, if the qualified beneficiary makes the initial COBRA premium payment and coverage is lost for failure to pay within the 30-day grace period, then the plan administrator must provide a notice of termination due to early termination of COBRA coverage.

See the original article Here.

Source:

Capilla D. (2017 August 23). The COBRA payment process [Web blog post]. Retrieved from address http://blog.ubabenefits.com/the-cobra-payment-process-1


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.


Employers Broadening Health Programs

Employers are starting to change their approach on how they look at their employee benefits program. Take a look at this great article by Nick Otto from Employee Benefit Adviser and find out how employers are reclassifying their employee benefits program in order to expand their employees' well-being.

The siloed approach to retirement, healthcare and wellness is a thing of the past as employers are increasingly taking a holistic approach to addressing their employees’ health and wealth.

Employers are expanding their view of employee overall well-being, according to a new report from Optum, a technology-enabled health services company. That means that, while employers are still offering traditional wellness programs, there has been a significant shift in the last three years to those programs addressing workers’ financial, behavioral and social health.

“For example, we see increased interest among companies in developing new programs around mindfulness, positivity and creativity, which can reduce stress, improve eating and sleeping habits, and stimulate innovative thinking,” says Seth Serxner, Optum’s chief health officer.

While physical health still remains a significant focus for employee wellness programs, other dimensions are tracking with higher importance among large employers:

· 51% of such programs now address financial health, up from 38% in 2015;
· 47% address employees’ social health by using strategies like team-based activities to increase feelings of connectedness and a sense of belonging, compared to 37% in 2015; and
· 68% address behavioral health, up from 65% in 2015

And technology is helping employers to better engage these programs to workers. Since 2014, there has been a significant increase in the use of a variety of innovations, including online competitions, activity tracking devices, social networks, mobile apps and mobile messaging to help engage employees, the study notes.

Additionally, incentive strategies are helping to get workers in the wellness game.

Use of incentives is at an all-time high, Optum notes, with 95% of employer respondents offering incentives to their employees. Recognizing that workers can be highly influenced by their family members, 74% of employers also are offering incentives to family members. According to Optum, average incentives per participant per year equate to $532.

See the original article Here.

Source:

Otto N. (2017 August 15). Employers broadening health programs [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/employers-broadening-health-programs


How Health Coaching can Revitalize a Workforce

Do you need help revitalizing your workforce? Check out this great column by Paul Turner from Employee Benefit Advisor and see how health coaching can be a great way to increase engagement and productivity among your employees.

Nearly 50% of Americans live with at least one chronic illness, and millions more have lifestyle habits that increase their risk of health problems in the future, according to the Centers for Disease Control and Prevention. Type 2 diabetes, cardiovascular disease, cancer, pulmonary disease and other conditions account for more than 75% of the $2 trillion spent annually on medical care in the U.S.

Employers have a stake in improving on these discouraging statistics. People spend a good portion of their lives at work, where good health habits can be cultivated and then integrated into their personal lives. While chronic diseases often can’t be cured, many risk factors can be mitigated with good health behaviors, positive and consistent lifestyle habits and adherence to medication and treatment plans. Moreover, healthy behaviors — like smoking cessation, weight management, and exercise — can help prevent people from developing a chronic disease in the first place.

Companies that sponsor well-being programs realize the benefits of a healthier and more vital employee population, with lower rates of absenteeism and improved productivity. Investing in such programs can yield a significant return — particularly from condition management programs for costly chronic diseases.

Digitally-based well-being programs in particular are powerful motivators to adopt healthy behaviors. Yet for many employees, dealing with difficult health challenges can be daunting and digital wellness tools may not offer them sufficient support. Combining these health technologies with the skill and support of a health coach, however, can be a winning approach for greater workplace well-being. The benefits of coaching can also extend to employees that are currently healthy. People without a known condition may still struggle with stress, sleep issues, and lack of exercise, and the guidance of a coach can address risk factors and help prevent future health problems.

Choosing a health coach

Coaching is an investment, and the more rigor that employers put into the selection of a coaching team, the better the results. Coaches should be a credentialed Certified Health Education Specialist or a healthcare professional, such as a registered nurse or dietician, who is extensively trained in motivational interviewing. It also helps when a coach has a specialty accreditation in an area such as nutrition, exercise physiology, mental health or diabetes management. Such training allows the coach to respond effectively to highly individualized needs.

This sort of personalization is essential. A good coach will recognize that each wellness program participant is motivated by a different set of desires and rewards and is undermined by their own unique combination of doubts, fears and temptations. They build trust and confidence by helping employees identify the emotional triggers that may lead them to overeat, smoke or fail to stick with their treatment plans and healthy lifestyle behaviors.

What works for one employee, does not work for another. A 50-year-old trying to quit smoking may need the personal touch of a meeting or phone conversation to connect with her coach; a 30-year-old focused on stress management might prefer email or texting. It’s important for the coaching team to accommodate these preferences.

Working with our employer clients, WebMD has seen what rigorous coaching can achieve:
· A 54% quit rate for participants in a 12-week smoking-cessation program
· Successful weight loss for 68% of those who joined a weight-management program
· A nearly 33% reduction in known health risks for relatively healthy employees in a lifestyle coaching program
· A corresponding 28% health risk reduction for employees with a known condition who received condition management coaching.

Coaching is more likely to succeed when it is part of a comprehensive wellness program carried out in an environment where employee well-being is clearly emphasized by the employer and its managers. WebMD popularizes the saying that ‘When the coach is in, everybody wins.’ Qualified health coaching may be the missing ingredient that helps an employer achieve its well-being goals and energize its workforce.

See the original article Here.

Source:

Turner P. (2017 July 27). How health coaching can revitalize a workforce [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/how-health-coaching-can-revitalize-a-workforce?feed=00000152-1387-d1cc-a5fa-7fffaf8f0000


Determining COBRA Premiums for Fully Insured and Self-Funded Health Plans

Here is a great article from our partner, United Benefit Advisors (UBA) on what you need to know about COBRA when dealing with fully insured and self-funded health plans by Danielle Capilla.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. While some group health plans may provide COBRA continuation coverage at a reduced rate or at no cost, most qualified beneficiaries must pay the full COBRA premium. The COBRA election notice should include information about COBRA premiums.

For fully insured health plans, the premium is the cost to maintain the plan for similarly situated employees. For self-insured plans, the premium is the cost to maintain the plan for similarly situated employees as determined by an actuary or the past cost from the preceding determination period. The applicable premium calculation for both fully- and self-insured plans includes the cost of providing coverage to both active employees and COBRA qualified beneficiaries. All COBRA premiums must be calculated in good faith compliance with a reasonable interpretation of COBRA requirements.

Generally, COBRA payments are made on an after-tax basis. Qualified beneficiaries have 45 days after the election date to make an initial premium payment. The plan may terminate the qualified beneficiary's COBRA rights if no initial premium payment is made before the end of the 45-day period. In addition, plans must allow monthly premium payments and cannot require payment on a quarterly basis. As established under COBRA, premiums are due on the first day of each month with a minimum 30-day grace period. A plan may terminate COBRA coverage for nonpayment or insufficient payment of premiums after the grace period.

If a qualified beneficiary makes an insignificant underpayment, then the premium payment will still satisfy the payment obligation. An underpayment is deemed insignificant if the shortfall is no greater than the lesser of $50 or 10 percent of the required amount. However, if the plan notifies the qualified beneficiary of the shortfall and grants a reasonable amount of time to correct the underpayment (usually 30 days after the notice is provided), then the qualified beneficiary is required to make the payment; otherwise, COBRA coverage may be canceled.

Fully Insured Health Plans

Generally, the applicable COBRA premium amount for fully insured plans is the insurance premium charged by the insurer. The applicable premium is based on the total cost of coverage, which includes both the employer and employee portions. The premium amount is based on the cost of coverage for similarly situated individuals who have not incurred a qualifying event.

A group health plan may charge at most 102 percent of the premium during the standard COBRA coverage period for similarly situated plan participants (100 percent of the total cost of coverage plus an additional 2 percent for administrative costs). However, the plan may increase the premium for a disabled qualified beneficiary and charge 150 percent of the applicable premium during the 11-month disability extension period (months 19 through 29). In addition, COBRA regulations permit a plan to charge a 150 percent premium to nondisabled qualified beneficiaries as long as the disabled qualified beneficiary is covered under the plan. If the disabled qualified beneficiary is no longer covered under the plan, then the remaining qualified beneficiaries may continue coverage up to 29 months at 102 percent of the cost of the plan.

If an employer maintains more than one plan, then a separate applicable premium is calculated for each plan. Also, the applicable premium for a single plan may vary due to factors such as the coverage level, the benefit package, and the region in which covered employee resides. For instance, single employees may pay a different applicable premium than employees who include their spouse on the plan. Thus, the plan may charge different premiums based on the varying coverage levels.

The most common tier structures include employee-only, employee-plus-spouse, employee-plus-children, and employee-plus-family. According to Internal Revenue Ruling 96-8, a fully insured plan that pays different premiums for individual versus family coverage must use those same premium tiers for COBRA continuation coverage. Thus, COBRA premiums are divided into multi-rate and single-rate tier structures.

See the original article Here.

Source:

Capilla D. (2017 August 1). Determining COBRA premiums for fully insured and self-funded health plans [Web blog post]. Retrieved from address http://blog.ubabenefits.com/determining-cobra-premiums-for-fully-insured-and-self-funded-health-plans-1


How to Meet Growing Demands for Bigger, Better Voluntary Plans

Has there been an increase in demand from your employees to offer more voluntary benefits? Check out this great article by Whitney Ehret from Employee Benefits Adviser on what you can do to meet your employees' demand for more voluntary benefits.

Over the years, voluntary benefits or worksite products have unfortunately earned a negative reputation in the marketplace. This is largely due to overzealous carriers with aggressive sales tactics and brokers purely seeking higher commissions.

With the introduction of the Affordable Care Act in 2010, employers began to shift more of the benefits cost to employees via high-deductible health plans, increased coinsurance costs and copays. The majority of today’s workforce is comprised of millennials, coupled with Generation Z quickly entering the workforce. There’s no question: traditional employer benefit offerings are about to undergo some major changes.

With a new administration in place and increasing generational challenges, employers are becoming more open to creative ideas to improve their total benefits offering. Today’s voluntary benefits market isn’t shy of options, which in turn makes things quite confusing. Companies will need to shift focus from traditional offerings and begin to get more resourceful — not only with the products they offer, but also with their entire strategy. Communications, enrollment and marketing will all become especially critical in retaining and attracting top talent in the coming months and years.

For the most part, the majority of brokers and employers are somewhat familiar with the top voluntary products in the market: dental, vision, accident, critical illness, cancer, hospital indemnity, disability and life insurance. Those are traditionally the products that spark initial voluntary benefit conversations, although there are many more — including legal, identity theft, auto/home, pet, employee purchasing programs, unemployment gap, tuition and loan assistance programs.

For the remainder of 2017, the conversation is predicted to still involve the top voluntary products, but shift to a new focus. Nearly two thirds of employers are looking to voluntary benefits to reduce overall financial stress on employees, the 2016 Xerox HR Services Financial Wellbeing & Voluntary Benefits Survey found. Integrating voluntary benefits with core benefits may reduce financial stress that ultimately leads to health issues and higher overall benefit costs.

The main goal of these products is to provide employees with cash resources, paid directly to the insured, should they experience an unexpected life event. Insureds can use these payments for anything they choose: mortgage, rent, groceries, deductibles, coinsurance payments, copays and more. Compared to state disability programs, these payments are generally made more quickly and offer a simpler claim filing process. If an employee is faced with a difficult situation, these conveniences can greatly reduce stress during a highly sensitive and vulnerable time.

Financial wellbeing is the focus
A recent Employee Benefit News article found 89% of millennials are interested in receiving financial advice, yet only 58% have been offered this type of assistance. With the majority of the workforce now comprised of millennials, employers will need to offer more diverse benefit options that are tailored to this population.

Millennials aren’t the only ones who are concerned about their financial wellbeing. The MetLife’s U.S. Employee Benefit Trends Study found 49% of employees are concerned, anxious, or fearful about their current financial situation, 72% said that a customized benefits package increases loyalty and only 27% are satisfied with their progress toward paying down student loans. These statistics demonstrate the immediate need for a comprehensive voluntary benefit offering.

Student loan debt is an issue for all generations in the workforce. Whether the individual is a millennial trying to get established and create wealth, a Gen X employee who is struggling with existing student loan debt family debt and saving for retirement, or a baby boomer who is trying to help support the family’s educational needs — namely children and grandchildren — everyone, at some level, has a need for student loan assistance.

Additionally, most voluntary products offer wellness benefits, which is a direct payment to the individual for completing an annual wellness exam. With amounts ranging between $50-$200 (employer selected), this is pure profit to the individual, since ACA requires preventative exams to be covered 100% by insurance carriers.

In addition, this benefit helps to subsidize the actual cost of the product annually. There are carriers in the market that will pay this benefit multiple times in a single year for a single insured.

Increasingly, companies are getting involved with wellness specific initiatives and incentives for their employees to hopefully drive healthy habits that will, in turn, lower healthcare costs and increase workplace satisfaction. To promote these wellness programs, employers offer reduced pricing on their medical plans or make contributions into a medical savings account if employees complete their annual exams or participate in various wellness activities. Offering voluntary products with a wellness benefit is another way to enhance a company’s total health portfolio at no cost to the employer.

Carrier selection Is key
Like many other industries, this business is all about relationships. Brokers and employers need to be able to trust and rely on their voluntary benefits carriers. As HR staffing has shrunk and brokers are required to provide more services with the same resources, it’s imperative that the appropriate carrier is selected for each unique case.

Voluntary benefits, as “cookie-cutter” as we may perceive them to be, are just not that. Since their onset, voluntary benefits have come with administrative obstacles that have historically taken up too much of HR’s time.

Unfortunately, while these products do provide a valuable benefit to employees, they are not the priority for most employers. Employers don’t often care about how many products they are offering as long as the plans aren’t administrative-heavy, the 2016 Employee Benefit News annual survey found. Carriers recognize this issue, and have steadily made improvements to these processes over recent years.

There are carriers in the marketplace today that allow clients to self-bill and self-pay, which is essentially what employers are already used to doing on their basic and supplemental group life and AD&D plans. For claims issues, they have also made this process easier by making it electronic and not requiring extensive information from the employees in the claims-filing process.

Core carriers (traditional medical carriers) are also beginning to get into the worksite market and are further simplifying the claims process by linking their medical system with their voluntary system. This allows the carrier to proactively initiate claims and file complete claims for the insured since the majority of the claims information is already within the single carrier system.

The other benefit to offering voluntary plans with the core medical carrier is that often some products may provide additional benefits if employees have a certain medical condition. For example, voluntary dental plans will provide more cleaning exams per year if an insured is pregnant. Most insureds would not realize they have this benefit, but by linking these systems with a core carrier, the insured makes sure to get the most out of their plan.

Communication style and strategy are imperative 
Not only is it important to consider the products and carriers that are offered, but also how they are enrolled and communicated. From the voluntary benefits perspective, these products have typically been enrolled face to face with employees. While this may be the best way to fully educate employees on their benefit options, that is no longer the future of employee benefits enrollment.

ACA has also helped enrollment move to the electronic platform because of the requirements made on employers for reporting. Millennials are the technology generation, making them naturally comfortable using technology to enroll and learn about benefits and even be treated by a virtual doctor.

Employers are trending toward a more self-service enrollment environment, which brings its own challenges. Most of these systems are built with decision tools that allow for the enrollment experience to be customized to the employee. These tools will make plan recommendations for the employees based on the answers to health and financial questions. Often, videos within the enrollment site are used to further enhance the educational experience.

Some of the main problems with electronic enrollments include keeping employees engaged, offering voluntary benefit products and carriers that work with the system, keeping costs low or free for the employer and ensuring data accuracy and security.

A company’s overall benefits package is becoming increasingly important in the decision-making process for prospective employees, as well as to retain top industry talent. Employers, rightfully so, are concerned about cost and maintaining this delicate balance while still attempting to manage the complex administration of these plans.

More and more, employers are looking for voluntary benefits to solve this need by offering “free” technology and enrollment solutions to their groups. There is no doubt that if employers want to retain and attract top talent, they are going to have to adapt with the market and offer their employees a wide array of benefit options and new technology that is tailored to their employee needs.

See the original article Here.

Source:

Ehret W. (2017 July 24). How to meet growing demands for bigger, better voluntary plans [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/how-to-meet-growing-demands-for-bigger-better-voluntary-plans