Consumer Driven Health Plans

The term, Consumer Driven Health Plans, has been gaining a lot of momentum over the last couple of years with the cost of health insurance premiums spiraling out of control. There's been discussion for some time in small business circles about shifting more of the responsibility for health care needs to the employees rather the employer. Business owners of all walks of life are quickly coming to the realization that they are ill-equipped to manage and administer the complexities of employee benefit plans. Aside from that, they also know that the days of low deductible health plans are all but a thing of the past. The premiums for these low deductible plans are chocking them financially. The biggest, and maybe, the only way to make a significant impact on health insurance premiums, is raising the deductible thresholds that employees are responsible for meeting before the plan covers expenses. Many employers are reluctant to pursue this necessary strategy to get a handle on their cost but it's completely unavoidable in today's economy.

So, it begs the question. What can an employer do to lessen the impact of employees being responsible for meeting higher deductibles? The answer is; doing it in conjunction with a Health Savings Account(HSA) for each of their employees. Each employee has this HSA set-up in their name for the purpose of making tax-free contributions into their account to ultimately cover the qualified medical expenses they're now responsible for with a High Deductible Health Plan. This gives the employee greater control and flexibility over making their own health care decisions. The IRS regulates the type of health plans that qualify for an HSA, as well as, how much money the employee can contribute to their HSA's.

Whether, it's the increasing trend toward higher health care premiums or the Federal and State regulations (COBRA and Mini-COBRA) of certain health plans - business owners are now faced with the very real task of shifting the responsibility for health care to the employees. Experts predict that Consumer-Driven Health Plan enrollment will spike in 2010 Read Full Article

For more information on Consumer Driven Health Plans, HSA's or how to effectively shift more of the burden for health care to your employees, email me at bknauss@employeemployersolutions.com visit us on the web at www.employeemployersolutions.com or twitter me at http://twitter.com/mployebenefits

Employee Benefits - Do More Without Spending More?

Many businesses are in the same boat today - trying to figure out the paradox between doing more with less. The arena of employee benefits is no different. Try suggesting to a small business owner the prospect of expanding his/her benefits package for their employees in today's economic climate and you're likely to get booted right out the door. Well, there is some daylight on this particular topic and the answer seems to be in a very hot trend right now in area of employee benefits and that is - Voluntary Benefits. If I were to ask you if you would like to expand your companies benefit offering without it costing you one more dime, you'd probably think I was trying to pull a fast one. Well, this is one "to good to be true" proposition that really is legit. The voluntary benefit market is one marked with very low-costs, low maintenance, very little administration and high pays high dividends on employee morale. You see, with the current climate of higher deductibles, co-pays and less coverage for existing health insurance plans, the voluntary benefit market is a welcomed sight. Disability and Hospital Confinement policies help with covering higher deductibles that employees have to pay. They also help with unanticipated expenses for extended hospital stays or long periods of being unable to work like groceries, transportation and child care expenses.

There are a full range of voluntary benefits that can be 100% employee paid such as dental, vision, limited-medical benefit plans, disability, cancer and critical illness policies, life insurance, accident and hospital confinement plans. That best part is, many of the plans are portable for the employee. That's right they can keep the coverage no matter where they go. Here's just a small sampling of some of these voluntary benefits:

1. Disability Insurance – An individual supplemental short-term
   disability income product that replaces a portion of income if
   someone becomes disabled due to a covered accident or
   covered sickness. There are plans that cover on and off-job or
   off-job accidents/sicknesses and a wide choice of benefit
   periods and elimination periods. This product features total
   and partial disability, portability, worldwide coverage and
   waiver of premium.
2. Accident Care/Public Sector Accident Care –
   A composite-rated, guaranteed renewable accident
   product that provides indemnity benefits for on and off-the-
   job, or off-job only accidents. Stand alone coverage
   for employee, spouse and dependent child may be
   purchased. Features include the same benefits for
   employee, spouse and dependent child; worldwide
   coverage and portability. Optional riders, such as disability,
   are available.
3. Cancer – An individual specified-disease product that
   pays a cancer screening benefit for specified screening
   tests. Upon diagnosis of cancer, provides benefits for
   treatments and resulting costs that individuals may
   require to care for their cancer.
   
4. Critical Illness – An individual specified-disease product
   that can help individuals pay out-of-pocket expenses
   associated with home health care, caregivers they may
   require for home, automobile modifications, mortgage
   payments, utility bills, other everyday living expenses and
   travel costs to and from treatment centers.

For more information about adding voluntary benefits to your existing benefits package, or even if you don't have a benefits package, email me at bknauss@employeemployersolutions.com or visit my website at http://www.employeemployersolutions.com/

COBRA In Pennsylvania

It wasn't all that long ago that I was exploring the benefits of being an employer with fewer than 20 employees. One of them being the exemption for COBRA laws. What a difference a few weeks can make. That's no longer the case in Pennsylvania - thanks to Governor Rendell. For all you proponents of "big government" takeovers - here's what you get. Here's an overview of the new regulations for small businesses:

On June 10^th Governor Rendell signed into law the state’s Mini COBRA legislation. Employers who employ 2-19 employees will now be required to offer health insurance continuation post employment and also will be obligated to comply with the Federal subsidy of COBRA under the American Recovery and Reinvestment Act (ARRA).

This law becomes effective on July 10, and will mirror the federal COBRA regulations in many ways. Highlights of the Mini COBRA provisions:

• Requires employers who employ 2-19 employees and offers health insurance to offer COBRA
• Only applies to Medical Plans (does not include HRAs, FSAs, dental, or vision)
• To be eligible, an employee must have been on the employer’s insurance for at lease 3 months prior to the qualifying event
• COBRA qualifying events remain the same as those under Federal regulations
• Eligible for COBRA coverage lasting up to 9 months
• Employers (or their designated administrator) are responsible for notification to eligible individuals
• Assistance Eligible Individuals are included in State COBRA
• Employers may charge up to 105% of the medical premium
• Timeline for getting out notices differs from federal COBRA

The state plan lacks the lookback feature of the federal COBRA Subsidy program in that only individuals terminated on or after July 10th will be eligible to participate. The federal program, enacted in February, allowed participation of individuals separated back to September of 2008.

For more information on this and other government regulations on employee benefits email me at bknauss@employeemployersolutions.com

Healthy Employees Are Productive Employees!

Small businesses constantly struggle with the rising cost of health care premiums to cover their employees. I've talked in recently blogs about some of the very effective short-term fixes such as higher deductibles, implementing "Health Saving Accounts" on qualifying plans and the onslaught of great voluntary benefits designed to fill in some of the gaps left by higher deductibles. These solutions are, however, short-term and in and of themselves don't provide a long-term solution. So what's the answer? Employee wellness! That's right, there's no current solution to get us out of this health care mess other than promoting employee wellness. I liken this to the analogy of fixing a car. If your car is leaking oil, one of the short-term fixes would be to add more oil as needed. Very inexpensive and easy to do. However, we would all agree that this isn't a long-term solution that gets down to the root of the problem. To do that, you need to go to a professional, spend a lot more money then just adding oil but you're on your way to providing a more lasting solution. The health and well being of our valued employees is really no different. Until your employees make long lasting life changes about their own health and well being they will continue to be a drain on an already over-burdened health care delivery system. As the employer, you have an obligation to try and facilitate that healthy lifestyle because it will benefit you as well. This is definitely an example where the old saying, "a healthy employee is a productive employee" is true. Think of all the lost productive time being saved on employee absenteeism! How much happier and eager are healthy employees to want to come into work everyday?

I know what some of you business owners are saying, "it sounds very time-consuming and difficult to implement for a small business". Well, it's not at all. In fact, many times either health care or network providers offer it as a free service to participating businesses. Take Valley Preferred of example. They're a local health network of doctors and hospitals in the greater Lehigh Valley area. They offer to participating members a comprehensive employee wellness and education program called BeneFit. BeneFit offers a comprehensive range of health screenings (through corporate health fairs), worksite wellness programs, health awareness profiles and more to help Valley Preferred clients promote better health among employee populations.

Employee Wellness - the only way to create lasting reductions in you company's health care premiums. For more information on implementing an employee wellness program in your company email me at bknauss@employeemployersolutions.com or visit my website for a "Free Report" on employee wellness at www.employeemployersolutions.com/free_report.html

Out of Work and Out of Insurance??

Unfortunately, one of the many casualties of this new economy are lots people out of work and struggling to figure out how to keep their health insurance - even with the recently changes to COBRA. In fact, many workers being left go work for employers that don't even have to comply with COBRA (having less than 20 employees). Well, there are some very practical ways to cover your families most basic needs at an affordable monthly premium.


Short-term or Limited Medical Benefit plans, as they're called, are just a few practical solutions for someone who finds themselves out of work for the foreseeable future. As the names imply, they're designed to provide coverage for a short range of time such as 6 or 12 months,as well as, benefits for hospital confinement or some routine procedures. Typically they come with a choice of deductibles and lifetime maximums. They're not designed to cover catastrophic claims or be in place for the long-term. They cover such things as doctors visits, hospital benefits, emergency room care, outpatient services and much more. The premium is very affordable and you can be approved in a day or so.

Here are some situations that Short-term or Limited Medical Benefits make sense:

1. Between jobs - For about half the cost of COBRA, Short-term Medical offers next day coverage.
2. Waiting for Employer Benefits - New employers often impose a waiting period before you're eligible for health benefits. With Short-term Medical, you stay insured and can choose the length of your plan.
3. Temporary or Seasonal Employees - When your employment schedule is unpredictable, it's hard to maintain health coverage, Short-term Medical provides flexibility.
4. Newly Independent - Young adults and recent graduates may no longer be eligible for health insurance through a student plan or their parents plan. Short-term Medical is an affordable way to fill the gap.

Highlights:

• Coverage as soon as the next day.
• You may keep your own doctors.
• Access doctors 24/7/365 - from your phone.
• Low monthly premium.