Understanding And Preventing High Blood Pressure

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

High blood pressure (or hypertension) is a common but often underestimated health condition affecting millions of people. In fact, the American Heart Association (AHA) reports that nearly half of American adults (48%) have high blood pressure—and only 1 in 4 have their condition under control. This condition puts individuals at risk for heart disease and stroke, which are leading causes of death in the United States.

High blood pressure is a serious medical condition that, if left uncontrolled, can lead to severe complications such as heart disease, stroke and kidney problems. Understanding this condition, its prevalence, risk factors, prevention and management is crucial for maintaining good health.

This article highlights the basics of high blood pressure and tips for prevention and management.

Blood Pressure Overview

Blood pressure is the force exerted by the blood against the walls of the arteries as it is pumped through the body by the heart. It’s typically expressed in two numbers: systolic pressure (the top number) and diastolic pressure (the bottom number). Systolic pressure measures the pressure in the arteries when the heart beats, while diastolic pressure measures the pressure when the heart is at rest between beats. The AHA considers a normal blood pressure reading to be 120/80 millimeters of mercury (mm Hg).

It’s considered high once the blood pressure reading reaches 130/80 mm Hg or above. High blood pressure occurs when the force of the blood against the artery walls is consistently too high, which means the heart and arteries have to work harder than usual. As a result, this condition can damage arteries and increase the risk of serious health problems.

Symptoms

High blood pressure is often referred to as the “silent killer” because it rarely exhibits noticeable symptoms until it reaches a dangerous level. The only way to know whether someone has high blood pressure is by measuring it.

Risk Factors

Several factors increase the risk of developing high blood pressure. Factors that can’t be changed or are difficult to control include:

  • Gender (men are more likely to have high blood pressure than women)
  • Race/ethnicity (Black adults are more likely to develop this condition)
  • Increasing age
  • Family history of high blood pressure
  • Chronic kidney disease
  • Obstructive sleep apnea

Fortunately, some risk factors can be improved or treated, including:

  • Being overweight or obese
  • Cigarette smoking and exposure to secondhand smoke
  • Diabetes
  • High cholesterol
  • Physical inactivity
  • Poor diet that is high in sodium, low in potassium and includes excessive alcohol

Prevention and Management

The good news is that high blood pressure is often preventable and manageable. Consider these tips:

  • Adopt a healthy lifestyle. Healthy living includes a balanced diet low in sodium, rich in fruits and vegetables, and low in saturated and trans fats. Engage in regular physical activity, aim for a healthy weight, and avoid smoking and excessive alcohol consumption.
  • Limit alcohol. The AHA recommends limiting consumption to no more than two drinks per day for men and one for women.
  • Be physically active. Strive to get at least 150 minutes of moderate-intensity physical activity per week, such as brisk walking.
  • Reach and maintain a healthy weight. A health care professional can suggest healthy approaches for losing and maintaining weight. For example, they can help you determine how many calories you need for weight loss and advise you on the best activities.
  • Get regular checkups. Visit your health care provider regularly for blood pressure checks and follow their recommendations.
  • Take medication as prescribed. If lifestyle changes alone are insufficient to control your blood pressure, your doctor may prescribe medication. It’s essential to take prescribed medications as directed.
  • Manage stress. Practice stress-reduction techniques such as meditation, yoga or deep breathing exercises to help lower stress, which can contribute to high blood pressure.
  • Monitor blood pressure levels. If you have high blood pressure, monitoring your blood pressure at home can help you and your health care provider track your progress and make necessary adjustments to your treatment plan.

It comes down to knowing what your blood pressure should be and trying to keep it at that level. Your doctor can answer any blood pressure questions.

Summary

High blood pressure is a common but potentially serious health condition that affects a significant portion of the U.S. population. Understanding this condition is essential for maintaining good health. By adopting a healthy lifestyle, prioritizing routine health care and following medical advice, individuals can take control of their blood pressure and reduce the risk of developing high blood pressure and associated complications.

Contact a health care professional for a blood pressure reading and to discuss any risk factors or concerns.

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Responding to the EEOC’s Increased Focus on Mental Health Discrimination

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

As society’s understanding of mental health continues to grow, so has government acknowledgment and efforts to protect workers with such conditions. Workers who have a mental health condition, such as anxiety or depression, are often protected against discrimination and harassment at work because of the condition. They may also have workplace privacy rights and a legal right to reasonable accommodations to help them perform the essential functions of their jobs.

The U.S. Equal Employment Opportunity Commission (EEOC) enforces the Americans with Disabilities Act (ADA), a federal law that protects individuals with disabilities. In most cases, individuals with diagnosed mental health conditions are covered under the ADA.

This article highlights mental health conditions, outlines the EEOC’s enforcement plans and offers ADA compliance guidance for employers.

Mental Health and the ADA

The ADA only applies to employers with 15 or more employees. The law defines “disability” as a physical or mental impairment substantially limiting one or more major life activities. When qualified job applicants or employees have a mental health condition meeting those criteria, they have workplace rights under the ADA. The ADA Amendments Act of 2008 broadened the definition of disability to provide legal protections against employment discrimination for more individuals with disabilities, including people with psychiatric disabilities. “Psychiatric disability” and “mental illness” are often used interchangeably. The term “mental illness” is typically used in a medical context to refer to a wide range of emotional and mental health conditions. In contrast, “psychiatric disability” is typically used in a legal or policy context to refer to impairments covered under the ADA.

The National Institute of Mental Health estimates that about 18% of U.S. workers have a mental health condition in any given month. This means that psychiatric disability is one of the most common types of disability covered under the ADA. Since mental health conditions can substantially limit brain function, individuals with such disorders will usually be determined to have an ADA-covered disability. The following mental health conditions may qualify under the ADA:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Bipolar disorder
  • Schizophrenia
  • Generalized anxiety disorder
  • Major depression
  • Obsessive-compulsive disorder (OCD)
  • Panic disorders
  • Personality disorders
  • Post-traumatic stress disorder (PTSD)

Examples of reasonable accommodations for an employee with a mental disability may include:

  • Allowing the employee to telework
  • Allowing more frequent breaks
  • Alternating supervisor methods (e.g., providing written instructions and providing more frequent or different reminders of tasks and due dates)
  • Changing the employee’s work schedule
  • Changing the employee’s work location (e.g., moving to a quieter space or allowing the use of a white noise machine or headphones)
  • Reassigning to a vacant position
  • Permitting a leave of absence under the Family and Medical Leave Act, state law or company policy

EEOC Enforcement Plans

In fiscal year (FY) 2021, employee allegations of unlawful discrimination based on mental health conditions accounted for about 30% of all ADA-related EEOC-filed charges. That figure significantly increased from the 20% reported in FY 2010. Anxiety and PTSD are the leading conditions contributing to this trend.

The EEOC recently released its strategic enforcement plan (SEP) for FYs 2024-28, emphasizing a greater focus on discrimination against vulnerable populations, including employees with mental health disorders. The plan aims to focus and coordinate the agency’s work to advance equal employment opportunities sustainably.

Employer Guidance

Supporting employees battling mental health conditions is not only important for compliance reasons. While organizations seek to avoid liability under the ADA, support and guidance can help foster an inclusive environment for employees with mental health conditions.

Consider the following employer strategies to stay compliant and create a supportive culture:

  • Monitor EEOC compliance. Organizations should stay current on all EEOC updates and consult local legal counsel before making any workplace changes. Employers can be proactive with compliance responsibilities by setting calendar reminders well before deadlines and meeting regularly to review compliance with EEOC guidance.
  • Review workplace policies. Various workplace policies have the potential to generate discrimination claims. Employers can review and assess policies such as background-check practices, pre- and post-hire personality or behavioral tests, inequitable leave policies and unnecessary physical requirements.
  • Review compensation practices. When reviewing their compensation practices, organizations may discover disparities that adversely affect employees based on certain protected characteristics. With a clearer picture, employers can then address those disparities to ensure equal opportunity.
  • Train managers. Supervisors and managers can be trained to identify and respond to requests for reasonable accommodation to ensure decision-making isn’t based on outdated biases or misunderstandings about mental health.
  • Train all employees. Mental health awareness can help fight the stigma often associated with conditions. Open and honest conversations about mental health can help foster an inclusive work environment. Training can help increase empathy and understanding to ensure all employees feel valued, respected and part of the team.

Summary

As outlined in the EEOC’s latest SEP, the federal government continues to crack down on organizations that discriminate against workers with mental health conditions. As such, employers should continually monitor for EEOC updates and review applicable workplace policies and practices that could cause a discrimination claim. Aside from compliance, mental health awareness is critical for fostering a successful and inclusive workplace environment.

Contact us today for additional workplace resources.

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Understanding an HRA

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

A health reimbursement arrangement (HRA) is an employer-funded account that is designed to reimburse employees for qualified medical expenses that are paid for out-of-pocket. There are no annual contribution limits on HRAs. However, the employer usually sets the contribution below the annual deductible. HRAs are often designed to operate with a high deductible health plan (HDHP), thereby reducing premium costs while encouraging employees to spend wisely.

Your employer sets up the HRA, determines the amount of money available in each employee’s HRA for the coverage period, and establishes the types of expenses the funds can be used for.

What are the benefits of an HRA?

You may enjoy several benefits from having an HRA:

  • Contributions made by your employer can be excluded from your gross income.
  • Reimbursements may be tax-free if used to pay for qualified medical expenses.
  • Any unused amounts in the HRA can be carried forward for reimbursements in later years.

Who is eligible for an HRA?

HRAs are employer-established benefit plans. These may be offered in conjunction with other employer-provided health benefits. Employers have complete flexibility to offer various combinations of benefits in designing their plan. You do not have to be covered under any other health care plan to participate. Self-employed persons are not eligible for an HRA. Certain limitations may apply if you are a highly compensated participant.

An HRA may reimburse medical care expenses only if they are incurred by employees or former employees (including retirees) and their spouses and tax dependents. HRA coverage must be in effect at the time the expense is incurred.

Are HRAs really best only for the young and healthy?

No. HRAs and other HDHPs are well-suited for a very wide demographic of people. According to Aetna, the average age of its HRA plan members is 42, the same average age as those who opted for more traditional plans.

What is an HDHP?

An HDHP has:

  • A higher annual deductible than typical health plans; and
  • A maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that you must pay for covered expenses. Out-of-pocket expenses include copayments and other amounts, but do not include premiums.

An HDHP may provide preventive care benefits without a deductible or with a deductible below the minimum annual deductible. Preventive care includes, but is not limited to, the following:

  1. Periodic health evaluations
  2. Routine prenatal and well-child care
  3. Child and adult immunizations
  4. Tobacco cessation programs
  5. Obesity weight-loss programs
  6. Screening services (e.g., cancer, heart and vascular diseases, infectious diseases)

Contributions to an HRA

Your employer funds the account, so it costs you nothing out-of-pocket. There is no limit on the amount of money your employer can contribute to the accounts. Additionally, the maximum reimbursement amount credited to the HRA in the future may be increased or decreased at your employer’s discretion. The maximum annual contribution is determined by your employer’s plan document. There may also be a cap amount for the HRA. Your employer can choose to fund your HRA with an annual contribution or on a monthly basis.

Distributions from an HRA

Distributions from an HRA must be paid to reimburse you for qualified medical expenses you have incurred. The expense must have been incurred on or after the date you are enrolled in the HRA.

Debit cards, credit cards and stored value cards given to you by your employer can be used to reimburse participants in an HRA. If the use of these cards meets certain substantiation methods, you may not have to provide additional information to the HRA.

If any distribution is, or can be, made for other than the reimbursement of qualified medical expenses, any distribution (including reimbursement of qualified medical expenses) made in the current tax year is included in gross income. For example, if an unused reimbursement is payable to you in cash at the end of the year, or upon termination of your employment, any distribution from the HRA is included in your income. This also applies if any unused amount upon your death is payable in cash to your beneficiary or estate, or if the HRA provides an option for you to transfer any unused reimbursement at the end of the year to a retirement plan.

If the plan permits amounts to be paid as medical benefits to a designated beneficiary (other than the employee’s spouse or dependents), any distribution from the HRA is included in income.

Reimbursements under an HRA can be made to the following persons:

  1. Current and former employees
  2. Spouses and dependents of those employees
  3. Employees’ covered tax dependents
  4. Spouses and dependents of deceased employees

Qualified Medical Expenses

Qualified medical expenses are those specified in the plan that would generally qualify for the medical and dental expenses deduction. Examples include amounts paid for doctors’ fees, prescription medicines* and necessary hospital services not paid for by insurance. You can use your HRA funds for deductibles, copayments and coinsurance. An extensive list can be found in the IRS document, Publication 502 at www.irs.gov.

Balance in an HRA

Amounts that remain at the end of the year may be carried over to the next year depending on your employer’s plan design. Your employer is not permitted to refund any part of the balance to you. These amounts may never be used for anything but reimbursements for qualified medical expenses.

What if I terminate my employment during the plan year?

If you cease to be an Eligible Employee (i.e., you die, retire or terminate employment), your participation in the HRA Plan will end unless you elect COBRA continuation coverage. You will be reimbursed for any medical care expenses incurred prior to your termination date, up to your account balance in the HRA, provided that you comply with the plan reimbursement request procedures required under the plan. Any unused portions will be unavailable after termination of employment. The rules regarding COBRA are contained within your Summary Plan Description.

Will I have any administrative costs under the HRA plan?

Generally, no. Your employer bears the entire cost of administering the HRA plan while you are an employee.

How long will the HRA plan remain in effect?

Although your employer expects to maintain the HRA plan indefinitely, it has the right to terminate the HRA plan at any time. Your employer also has the right to amend the HRA plan at any time and in any manner that it deems reasonable, in its sole discretion.

Are my benefits taxable?

The HRA plan is intended to meet certain requirements of existing federal tax laws, under which the benefits that you receive under the HRA Plan generally are not taxable to you. Your employer cannot guarantee the tax treatment to any given participant, since individual circumstances may produce differing results.

What is the difference between an HRA and FSA?

HRAs are employer-funded, which means your employer determines the amount that goes into the HRA account. FSAs can be funded by employee and employer contributions. FSA contributions are deducted from your salary, usually on a pre-tax basis. You determine how much to contribute to your FSA account.

What does the IRS require me to report on my taxes concerning my HRA?

Nothing. Your HRA is a health benefit.

*Over-the-counter medications are considered to be qualified expenses only if purchased with a prescription (except for insulin, which is considered to be a qualified expense even without a prescription).

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Getting the Most Out of Your 2024 Open Enrollment Communications

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

Open enrollment is a crucial period for both employers and employees. It’s when employees can make important decisions about their benefits and an opportunity for employers to engage with their workforce effectively. As organizations continue to adapt to evolving workforce needs and changing regulations in 2024, open enrollment communication becomes more critical than ever.

This article highlights why open enrollment communication matters and provides tips on what to do before, during and after enrollment to maximize its effectiveness.

Why Communication Matters

Although open enrollment is critical, some employees make uneducated decisions or even miss deadlines. Some common reasons for this are that open enrollment information is often full of confusing jargon, employees may not receive enough communication from their employer or they simply don’t understand the enrollment process.

Communication matters because it enables employees to understand the open enrollment process in a clear and assessable manner, which can boost active participation in benefits selection. Employees who feel valued and informed about their benefits are more likely to appreciate their employer’s efforts and stay engaged with their work.

Before Open Enrollment

Educating and informing employees about their benefits package is integral to open enrollment. Effective communication is critical to educate and inform employees about new, returning or expanded benefits options.

Consider the following communication tips before the open enrollment period begins:

  • Review previous communications. It can be enlightening for employers to review and evaluate past open enrollment communications to identify what worked and what didn’t. This information can be used to improve the current communication strategy.
  • Develop key messaging. After solidifying benefits options, employers need to plan their communication strategies. The first step is figuring out key messaging, focusing on new or updated benefits offerings, and developing FAQs to address common concerns quickly.
  • Customize communication. Communication is often more successful when it’s tailored to different employee segments. Consider the needs of various age groups, life stages and demographics within the workforce.
  • Gather resources. Before the open enrollment period begins, it’s important for employers to have all the necessary resources—such as printed materials, digital platforms and support staff—ready.

During Open Enrollment

During the open enrollment period, employer communication efforts take center stage, as it’s when employees actively make critical decisions about their benefits. Effectively guiding employees through this process is essential for ensuring they make informed choices that align with their needs and preferences.

Consider the following communication tactics to engage employees during the open enrollment period:

  • Vary communication channels. Use multiple communication channels such as email, printed materials, webinars and in-person meetings to reach employees effectively. Not everyone consumes information the same way, so a diverse approach is key.
  • Prioritize clear and concise messaging. Open enrollment messaging should be simple and easy to understand. Avoiding HR or benefits-related jargon is best to help make benefits easier to understand. Additionally, many benefits are acronyms, so employers should help decode and explain the alphabet soup to employees.
  • Make it digestible. It’s crucial to catch employees’ attention and present the key message immediately before they lose interest. Traditional benefits booklets can be lengthy; instead, employers could deliver bite-sized information to employees through videos and emails. If all open enrollment information is given at once, it’s easy for employees to become overwhelmed and, ultimately, disengage with the information. Digestible communication makes it easy for employees to know what to focus on and take action.
  • Use real-world examples. When possible, employers can put benefits offerings in context with real-world scenarios. Employees can relate to stories, so find ways to bring the options to life. For example, instead of describing telemedicine as a 24/7 benefit, highlight that an employee could get health care answers in the middle of the night when they or a child are running a high fever. The chances of employees needing to use health care benefits during the next year are highly likely, so help reiterate the importance of complete coverage.
  • Personalize communication. A personalized approach can help employers engage employees with open enrollment information. Additionally, employers may yield better results by personalizing communications to individual employees whenever possible. For example, communications could address employees by name and highlight benefits relevant to their circumstances. This builds off the earlier tip of segmenting employee groups based on age and other factors.
  • Remain available. Those leading open enrollment efforts should offer opportunities for employees to ask questions and get clarifications. This can be done through webinars, town hall meetings, dedicated question-and-answer sessions or HR open office hours.

After Open Enrollment

Although open enrollment is the most pivotal time to highlight employee benefits, employers can educate employees throughout the year. Ongoing communication after open enrollment can help employees understand and utilize their available benefits.

Consider the following communication strategies after the open enrollment deadline passes:

  • Follow up. Although the enrollment period is over, employers can continue communicating with employees to remind them of their choices and deadlines. Additionally, they can send reminders about important events or changes to benefits.
  • Collect feedback. Gather feedback from employees about the open enrollment process. Surveys or focus groups can be used to understand what worked well and where improvements can be made.
  • Evaluate and optimize. As with any workplace effort, analyzing the outcomes of open enrollment communication efforts is important. Check if goals were achieved and use the data to refine next year’s strategy.
  • Provide ongoing education. Employers shouldn’t limit communication to just the open enrollment period. They can periodically remind employees of the benefits and resources available to them.

Summary

Open enrollment communication is a crucial aspect of benefits administration that directly impacts employees’ well-being and satisfaction. By planning, customizing communications and continually improving their approach, employers can make the most out of their 2024 open enrollment period. Effective communication helps employees make informed choices and strengthens their connection with the organization, leading to a happier and more engaged workforce.

Contact us for additional open enrollment support.

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OSHA Launches New Compliance Initiative to Protect Stone Fabrication Workers from Silica Exposure

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

On Sept. 22, 2023, the Occupational Safety and Health Administration (OSHA) launched a new initiative focused on enhancing enforcement and providing compliance assistance to protect workers in the engineered stone fabrication and installation industries. This policy is effective as of the date of this memorandum and will be ongoing until otherwise directed.

Silica Hazard

OSHA and the National Institute for Occupational Safety and Health identify silica dust exposure as a health hazard for workers involved in manufacturing, finishing and installing natural and manufactured stone, including man-made, engineered artificial and cultured types of stone.

When inhaled, tiny crystalline silica particles expose workers to the risk of silicosis, an incurable, progressively disabling and sometimes fatal lung disease. Unsafe silica dust exposure can also lead to chronic obstructive pulmonary disease or kidney disease.

Compliance Initiative Overview

Supplementing OSHA’s current National Emphasis Program for Respirable Crystalline Silica, this initiative focuses enforcement efforts on industry employers to ensure they’re following required safety standards and providing workers with the protections required to keep them healthy. It establishes procedures for prioritizing federal OSHA inspections to identify and ensure prompt abatement of hazards in covered industries where workers face exposure to high levels of silica dust.

Industries subject to the prioritized programmed inspections include those engaged in cut stone and stone product manufacturing, as well as brick, stone and related construction material merchant wholesalers. Outreach efforts will continue to include additional industries that may work with engineered stone. Programmed inspections will be prioritized in the following two NAICS codes:

  • 327991 – Cut Stone and Stone Product Manufacturing; and
  • 423320 – Brick, Stone, and Related Construction Material Merchant Wholesalers.

OSHA area offices will focus enforcement efforts on these two NAICS codes using the targeting and site selection procedures outlined below. This initiative requires each area office in regions 1 through 8 to complete a minimum of five programmed inspections (i.e., targeting sites selected from NAICS 327991 and 423320) of establishments working with engineered stone within 12 months from the date of this initiative.

Workers involved in manufacturing, finishing and installing manufactured stone countertops are at risk for significant crystalline silica exposure. Facilities in NAICS codes 327991 or 423320 may be selected for inspection under this initiative if they meet one of the following criteria for work processes:

  • Manufacturing and/or finishing engineered or manufactured stone products at the facility; and
  • Finishing and/or installing engineered or manufactured stone products off-site.

Activities occurring at manufacturing, finishing engineered or manufactured stone facilities include:

  • Cutting, grinding, chipping, sanding, drilling and polishing engineered or manufactured stone products
  • Opening bags of ground quartz, moving or mixing bulk raw materials, cleaning and scraping mixers, or cleaning dust collector bag houses
  • Changing filters on dust collectors
  • Making the engineered or cultured slabs—involves mixing crystalline silica, resins and pigments
  • Operating powered hand tools such as saws, grinders and high-speed polishers
  • Casting departments that mix and heat raw materials, including silica sand (which comprises more than 70% of each countertop by weight), epoxy resin, PA (a known respiratory sensitizer) and pigments

Employer Next Steps

Affected employers and stakeholders should become familiar with this OSHA initiative by studying the memorandum and the fact sheets on dust control methods and safer work practices for engineered stone manufacturing, finishing and installation operations. These employers should also review the OSHA silica standards and ensure their operations comply with the required regulations and prevent employee exposure to silica.

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Fertility Benefits Can Boost Employee Attraction, Retention and Productivity

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

Work and family are traditionally two of the most significant aspects of an employee’s life. Unfortunately, family planning doesn’t always go as intended. According to the World Health Organization (WHO), 1 in 6 people struggle with fertility issues. This can make the journey to parenthood costly, stressful and challenging. So, it’s not surprising that stress from family planning often impacts employees’ work performance. A 2023 survey by fertility care platform Carrot found that 65% of employees said they spent time at work researching fertility treatments, benefits and family planning, and 55% said fertility challenges had detrimentally impacted their work performance.

Fertility issues contribute to presenteeism, a term that describes employees who are less productive due to personal distractions. In addition to negatively impacting employee morale, engagement and performance, presenteeism is costly for employers. Harvard Business Review reports that presenteeism costs the U.S. economy more than $150 billion yearly in lost productivity, far exceeding absenteeism costs. Employers that provide fertility benefits may notice that employees are more engaged, productive and likely to stay at the organization long term.

This article provides an overview of common fertility benefits and how employers can leverage them to boost employee retention, attraction and productivity.

What Is Infertility?

Infertility has been recognized as a disease by the WHO and the American Medical Association since 2017. It’s defined as the inability to conceive after a full year of trying without contraceptives. Both men and women are affected by infertility. However, individuals don’t always show identifiable signs of infertility, making this condition difficult to diagnose.

There are two types of infertility: primary and secondary. Primary infertility refers to individuals who have never achieved pregnancy, while secondary infertility refers to individuals who have had at least one prior pregnancy. As a result, infertility can affect individuals who are both starting and adding to their families. This spans a wide age range of employees, who make up a crucial percentage of the workforce. Employers that provide comprehensive fertility benefits can greatly improve the retention and attraction of this talented demographic.

Reasons Employees Pursue Fertility Treatment

There are numerous causes of infertility. Although knowing the reason for infertility doesn’t guarantee a medical solution, it can help individuals understand their medical options if they’re struggling to conceive. The following are common conditions that cause individuals to seek fertility treatment:

  • Ovulation disorders—Numerous conditions can prevent or drastically lower the chances of ovulation. This means fewer eggs are present, which may force individuals to seek infertility treatments, such as in-vitro fertilization (IVF).
  • Uterine fibroids—Fibroids are benign tumors in the uterus that can interfere with pregnancies. These become more common as women age, especially during their 30s and 40s.
  • Endometriosis—When uterine tissue grows outside of the uterus, it can cause severe pelvic pain and affect how reproductive organs function.
  • Genetic disorders—Individuals concerned about passing on genetic disorders to their children may opt for procedures (e.g., IVF) that allow doctors to screen eggs in a lab for genetic disorders before reinserting them into the uterus.
  • Fertility preservation—Some treatments, such as chemotherapy, can reduce fertility. As a result, some individuals who must undergo these treatments may choose to preserve some of their eggs or sperm for fertilization later on.

Insurance plans often exclude same-sex couples or single parents by choice. Employers have an opportunity to read the fine print on plans and design fertility benefits that support modern family building.

The Cost of Infertility

According to Forbes, a single IVF cycle can cost more than $30,000. Furthermore, IVF doesn’t guarantee a pregnancy. On the contrary, research by the University of New South Wales Sydney in 2017 found that women have a 54%-77% chance of having a baby by their eighth IVF cycle. As a result, the cost of fertility treatments is a source of financial stress for those who are hoping to start a family.

The 2023 Carrot survey found that just 32% of individuals could afford fertility treatment if needed. To start a family, nearly half of the respondents were willing to take another job, 29% would need to go into debt and 39% said they would dip into their savings to afford fertility treatments. Struggling to conceive, taking on debt and worrying about paying for fertility treatment can contribute to lost productivity at work, increased stress and presenteeism. It can also strain employees’ relationships and contribute to feelings of shame, inadequacy and guilt. This can harm employees’ mental health and worsen underlying mental illness, such as anxiety and depression. Individuals who struggle to conceive also commonly report feeling isolated and that they’re not in control. This can greatly impact how an employee performs at work, including more missed workdays and greater distractions when working.

What Are Fertility Benefits?

When it comes to providing fertility benefits, employers can elect to pay a portion of infertility treatment costs as a voluntary benefit or cover specific treatments under their health plan. The right choice will depend on employee preferences and the organization’s budget. Employers may choose to cover a variety of fertility treatments to help employees with family-building, such as:

  • IVF—This procedure involves egg retrieval, fertilization and an embryo transfer. It is relatively invasive and, like most treatments, can be very expensive. However, IVF remains a common fertility method.
  • Intrauterine insemination (IUI)—Artificial insemination has been around for decades and is one of the most popular options for individuals who need help conceiving. IUI is a type of artificial insemination. While there are many methods of artificial insemination, they all involve manually injecting semen into the uterus or cervix with medical devices.
  • Surgery—Procedures to remove ovarian cysts, clear fallopian tubes, remove adhesions from the uterus and collect semen from individuals who cannot otherwise produce it can all help resolve infertility issues.
  • Medications—There are a variety of medications, both prescription and over the counter, that can help increase fertility. Medications can stimulate ovulation, promote healthier egg growth, improve sperm count and prevent premature ovulation. Egg and sperm donors are also an option.

The Importance of Fertility Benefits

Most states don’t require private insurers to cover infertility treatment, making employer-provided fertility benefits even more important and valuable to workers. Fertility benefits can help employees start a family without going into debt or suffering undue financial stress, which makes them highly desired by employees. According to Carrot, 65% of employees said they’d change jobs to work for an organization that provided fertility benefits, and 72% said they’d continue working at an organization longer if it provided such benefits. Additionally, 3 in 4 respondents said fertility benefits were an important part of an inclusive company culture.

Many employers are responding with improved family planning support amid growing interest in fertility benefits that provide support for all types of families. According to the State of Fertility and Family Benefits in 2023 Report by Maven, of nearly 600 surveyed HR professionals, 63% said they planned to increase family health benefits in the next few years and 87% recognized family benefits as “extremely important” to current and prospective employees. This is largely due to family-building benefits’ impact on employees’ mental health, performance and loyalty.

Conclusion

Fertility struggles can negatively impact employees’ mental health, contribute to financial stress and increase presenteeism and absenteeism, which worsen job productivity. As employees continue to express interest in fertility benefits, employers who cover some or all of the costs of fertility treatments can experience significant improvements in productivity and satisfaction. It can also improve employee retention and help employers attract talented prospective employees.

Contact us today for more workplace resources.

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Preparing for the Fall and Winter Virus Season

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

Fall and winter are when viruses that cause respiratory disease usually circulate more heavily. Before the COVID-19 pandemic, influenza (flu) and respiratory syncytial virus (RSV) were the main causes of severe respiratory disease during these times of year. Although some people have mild symptoms when they catch the flu or RSV, others get sick enough to be hospitalized. Some seasons are more severe than others based on strains of the viruses circulating and immunity to these viruses.

Respiratory disease season lasts from October through May in the United States, peaking between December and February. The timing and duration of virus activity have been unpredictable since the start of the COVID-19 pandemic. As the U.S. Centers for Disease Control and Prevention (CDC) reports early increases in some viruses, employers can plan to prepare for peak activity. Furthermore, the CDC predicts a possible increase in hospitalizations due to new COVID-19 variants or a severe flu season paired with waves of COVID-19 and RSV cases.

With respiratory infections likely in the fall and winter seasons, it’s important for employers to consider ways to mitigate or address illness among employees to help keep workers healthy and productive. This article highlights best practices for employers during the 2023-24 respiratory season.

Employer Guidance

While the COVID-19 pandemic and the public health emergency have officially ended, the coronavirus still has the potential to disrupt workplaces for the foreseeable future. As other respiratory viruses and infections spread during the fall and winter, employers should do their due diligence and continue incorporating employee health and safety in current workplace plans, policies and benefits.

Consider the following best practices for addressing employee health and safety during the 2023-24 respiratory virus season:

  • Review organizational risks. Even though there are no longer any federal, state or local mandates related to COVID-19, employers can independently assess exposures and determine how to respond. Employers could identify the hazards and risks for their on-site workplaces and implement controls (e.g., personal protective equipment and administrative or engineering controls).
  • Establish remote work policies. If the workforce is primarily on-site, employers can consider having a backup plan to allow employees to work from home when dealing with virus-related symptoms. Some respiratory illnesses may not be debilitating in all cases, so employees can still work but remain isolated to reduce the chances of others getting infected.
  • Review paid time off and leave policies. Expanding leave policies, including allowing negative balances in paid time off banks and leave donation or sharing programs, could be helpful to employees battling illness in these seasons. Policies may also accommodate employees to take time off when they or their family members are sick.
  • Encourage healthy employee behaviors. Employee education is critical for healthy employee behavior changes. Vaccinations have been shown to reduce hospitalizations, so employers can encourage employees to get vaccinated. This fall, vaccines for the flu, RSV and COVID-19 are available. Aside from vaccinations, people need to get a good night’s sleep, stay active and drink plenty of water to keep their immune systems strong. Employers could also encourage workers to eat a nutritious diet of healthy grains, fruits, vegetables and fiber. Employee benefits could support these aspects of personal health and wellness or even incentivize healthy behaviors.
  • Keep cleaning supplies on hand. If employees are working on-site, it can be beneficial to have hand sanitizer and cleaning supplies available for employee use. Businesses can encourage good respiratory etiquette and hand hygiene to help prevent the spread of illnesses.
  • Foster open communication. Employers can encourage employees to talk to their managers if they’re experiencing any health issues, including long-lasting ones that may impact their performance. Training for managers could also help them respond appropriately to such conversations, which could properly address employee concerns, strengthen employee well-being and reduce legal risks.

In general, employers must stay agile and accommodating while adapting to the post-pandemic workplace. Without local, state or federal COVID-19-related mandates, employers have more ownership of how they address the respiratory season while protecting and supporting their workforces.

For More Information

Along with the flu and RSV, COVID-19 has become a part of the respiratory virus season. As infections and hospitalizations are expected, employers can review workplace policies and consider ways to protect and support employees who may catch a respiratory infection this season.

For the latest updates about the current respiratory disease season, visit the CDC’s website. Contact us today for additional workplace strategy guidance.

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The Industry Impact of Medicare Drug Price Negotiations

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

The Biden administration recently unveiled the first 10 prescription drugs subject to Medicare price negotiations. The Medicare Drug Price Negotiation Program—part of the Inflation Reduction Act (IRA)—is the Biden administration’s latest effort to combat rising health care costs. According to a Kaiser Family Foundation survey, more than 60% of the 65 million people on Medicare take prescription medication, and 25% take at least four prescriptions. Medicare drug price negotiation aims to lower out-of-pocket costs for millions of seniors and offer savings for taxpayers.

The first round of Medicare Part D drug negotiations will begin this year, with the new prices becoming effective in 2026. Over the next four years, Medicare plans to negotiate prices for up to 60 Part D and Part B drugs—and up to an additional 20 drugs every year after that. This article outlines the potential impacts of the Medicare Drug Price Negotiation Program on the health care industry.

Overview of Medicare Drug Price Negotiations

Under the IRA, the Medicare Drug Price Negotiation Program allows the federal government to negotiate directly with drug manufacturers to improve access to some of the costliest brand-name drugs. Many Medicare Part D enrollees depend on medications to treat life-threatening conditions, such as diabetes and heart failure, but may not be able to access them due to costs.

The following Medicare Part D drugs will be the first ones subject to these negotiations:

  • Eliquis, for preventing and treating blood clots
  • Jardiance, for treating diabetes and heart failure
  • Xarelto, for preventing and treating blood clots; risk reduction for patients with coronary or peripheral artery disease
  • Januvia, for treating diabetes
  • Farxiga, for treating diabetes, heart failure and chronic kidney disease
  • Entresto, for treating heart failure
  • Enbrel, for treating rheumatoid arthritis, psoriasis and psoriatic arthritis
  • Imbruvica, for treating blood cancers
  • Stelara, for treating psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis
  • Fiasp/Novolog, for treating diabetes

These 10 drugs are among the highest costs in total spending in Medicare Part D. In fact, Medicare enrollees taking these drugs paid a collective $3.4 billion in out-of-pocket costs in 2022 to obtain them. However, according to the Centers for Medicare and Medicaid Services’ (CMS) guidelines, if a biosimilar enters the market and finds substantial buyers, the agency will cancel or adjourn negotiations for the corresponding name-brand drug listed for negotiations. For example, two biosimilar versions of Stelara are set to launch in 2025. If they are successful, the CMS will no longer be able to negotiate a lower price for Stelara.

Pharmaceutical companies have until Oct. 2, 2023, to present data on these drugs to the CMS. The CMS will then make initial price offers in February 2024, which will start the negotiation process. Negotiations are scheduled to end in August 2024, with the new prices becoming effective in January 2026. However, several pharmaceutical companies have filed lawsuits to stop the Medicare Drug Price Negotiation Program. Some of these lawsuits argue that the IRA’s price negotiation process violates the U.S. Constitution by allowing the federal government to impose its preferred price unilaterally. According to legal experts, it’s unclear whether these lawsuits will be successful since Medicare is a voluntary program for drug companies. However, these lawsuits could delay the timing of Medicare drug negotiations.

Impact of Medicare Drug Price Negotiations

Medicare has been setting prices for services as well as physician and hospital payments but has not been allowed to be involved in pricing prescription drugs, which Medicare started covering in 2006. Therefore, allowing Medicare to negotiate drug prices could have a significant impact on the health care industry. While the first 10 drugs subject to price negotiations are used by only 9 million Medicare beneficiaries, the CMS plans to negotiate prices for 50 drugs by 2029. These 10 drugs include some of the most expensive for Medicare, costing a combined $50 billion in 2022; however, the impact of Medicare drug price negotiations may be slow at first but grow with time.

Short-term Impacts of Medicare Drug Price Negotiations

The initial impact of the Medicare Drug Price Negotiation Program may have muted financial impacts on manufacturers and the federal government, at least for the first round of negotiations, according to analysts. This is largely due to factors that impact the revenue and profits of the 10 drugs scheduled for negotiation. For example, many of these drugs currently face competition from other branded medications or patent expirations, which will allow generic alternatives to hit the market. Additionally, some of these drugs do not contribute significantly to pharmaceutical companies’ businesses, so any decline in drug sales may have little impact on a company’s overall business and profitability.

Moreover, Medicare Part D plans (prescription drug plans) and pharmacy benefits managers have already negotiated rebates for the first 10 drugs set for negotiation. Further, many of these drugs come with manufacturer discounts, decreasing their prices well below the list price. As a result, the negotiated prices for these first 10 drugs may not be significant or reduce what the federal government currently pays for them.

Long-term Impacts of Medicare Drug Price Negotiations

While the commercial impact of negotiations may be limited for the initial list of drugs, this could change in future rounds of negotiations. In 2028 and beyond, Medicare drug price negotiations will begin to target Medicare Part B drugs, which cover more specialized medications that are administered by health care providers rather than pharmacies. Many of these drugs offer fewer rebates than the ones currently listed for negotiation. Additionally, some of these drugs are biologics, which will likely have a more significant impact on drug companies because they are much more expensive and have a greater impact on the earnings and growth of these companies.

Pharmaceutical companies claim that the drug price negotiations will curb the development of new drugs. As a result, Medicare drug price negotiations may result in pharmaceutical companies altering their drug development strategies over time. However, according to the Congressional Budget Office’s estimates, only a few drugs would not be developed each year because of Medicare drug price negotiations.

Impact on Individuals

Due to the high costs of these prescriptions, many Americans are forced to choose between paying for vital medications or buying food and other necessities. While some individuals may save money on their prescriptions because of price negotiations, the Medicare Drug Price Negotiation Program aims to lower overall Medicare costs. By doing this, the Medicare program and taxpayers could see significant savings. Moreover, starting in 2025, the IRA will deliver further relief to Medicare beneficiaries by limiting their drug spending to $2,000.

However, the impact of drug price negotiations on individuals not receiving Medicare is currently unclear. Some experts believe that by reducing how much drug companies can charge Medicare beneficiaries, they will increase prices for privately insured individuals. Others believe that Medicare drug price negotiations may enable private health plans to negotiate for lower drug prices for the medications they cover. Additionally, Medicare drug price negotiations could incentivize pharmaceutical companies to lower listed gross prices for medications, which could lower out-of-pocket payments for privately insured individuals.

Employer Takeaway

Medicare drug price negotiations allow the federal government to negotiate prices for a limited number of drugs to lower out-of-pocket costs for millions of seniors and offer savings for taxpayers. While the drugs scheduled for negotiation are among the most expensive, it will likely be some time before the impact of these negotiations is seen. Even if the negotiated prices do not result in large savings for the federal government and taxpayers, Medicare beneficiaries may still experience some savings. The ultimate savings will likely depend on how successfully the federal government negotiates prices.

Contact us for more health care resources.

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Assessing the Viability of AI as a Self-diagnosis Tool

This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.

Artificial intelligence (AI) has created revolutionary advances across many industries. Now, it’s paving its way as a tool to self-diagnosis medical conditions or get answers to health-related questions. Self-diagnosis is a growing practice, as people’s primary access point for health care information has shifted from professionals to the internet. Especially when you’re having trouble getting an appointment, the internet has proven itself as a fast, easily accessible and free source of information. Given the internet’s popularity in answering some of your most urgent health-related questions, you may wonder how AI can help. Keep in mind that while AI is new and exciting, it’s not a replacement for professional health care.

This article explores the use of generative AI for medical self-diagnosis and its benefits, limitations and viability.

Generative AI for Health Care

Generative AI is a type of technology that produces text, images, audio or other content. With the introduction of AI chatbots, more people may be turning to them to answer their health-related questions. Some common tools used for this purpose include OpenAI’s ChatGPT and Google’s Med-PaLM. These types of large language model (LLM) chatbots can predict the next word in a sequence to answer questions in a human-like style.

Amid a shortage of health care workers, bots could help answer your questions. Initial tests by researchers so far suggest these AI programs are more accurate than a standard Google search.

The Pros

AI tools can potentially reduce medical costs for patients and health care providers. Here are some more potential benefits of using generative AI for medical self-diagnosis:

  • Increased accessibility
  • Quicker triaging
  • Boosted health literacy
  • Preserved anonymity

All of these factors contribute to an enhanced patient experience and improved engagement. Chatbots are also considered easier to use than online symptom checkers.

The Cons

While generative AI has great potential, it’s important to understand that there are also some limitations and pitfalls, including the following:

  • False information
  • Misinterpretation of information
  • Ethical concerns (e.g., data privacy and bias)
  • Risk of ignoring medical advice

Due to these risks, some LLM chatbots include disclaimers that they shouldn’t be used to diagnose serious conditions, provide instructions for curing conditions or manage life-threatening issues.

Using Generative AI in Medical Self-diagnosis

While generative AI tools may help you quickly answer health-related questions and self-diagnosis conditions, relying solely on them could be unsafe. Similar to their use in other applications, AI tools are meant to be complimentary and an additional source of information. They are great sources for general information and help simplify it so you can be an educated health care consumer.

Generative AI is not a replacement for medical advice from a professional, but it can be used to supplement professional medical advice. If you plan to use AI to answer your nonurgent health-related questions, consider the following best practices:

  • Be aware of the potential ethical concerns of AI-driven health care, such as data privacy.
  • Verify the AI information with trusted medical sources.
  • Consult a health care professional for conclusive diagnoses and treatment plans.

The Future of AI-assisted Self-diagnosis

According to data from business consultant Accenture, health care AI applications could save up to $150 billion annually for the U.S. health care economy by 2026. AI offers numerous potential benefits, but it’s important to recognize the limitations and concerns associated with medical self-diagnosis. Health care providers will likely strive to harness AI’s power instead of solely relying on it. By layering AI into health care systems and making them user-friendly, providers can gain access to insights to provide better care.

AI is in the early stages of its development. However, as it advances, the future of medical self-diagnosis will likely involve even greater collaboration between AI developers and health care providers.

Summary

In today’s digital world, it’s easy to become overwhelmed when researching health-related information. Obtaining accurate health advice and information comes down to using all available sources but understanding their limitations. LLM chatbots could take provider-AI collaboration and diagnosis to the next level, but it has yet to be seen.

While generative AI is not meant to replace professional health care, it can be a good supplementary source and help you increase your health literacy and get answers quicker. Contact your doctor for the most accurate and personalized health care information and guidance.

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