EAP – The Benefit You Might Be Forgetting
By Alison Nelson, Employee Benefits Account Manager
Many employers offer a Long-Term Disability (LTD) policy to their employees, which allows people to maintain a portion of their income if they are no longer able to work. But did you know that most LTD policies include an additional benefit that can be used, even if you don’t have an LTD claim? This benefit is called an Employee Assistance Program.
An Employee Assistance Program (EAP) is a confidential program that allows you, or anyone in your household, to talk to a professional for any number of things that could impact your mental or emotional well-being. EAPs are a fantastic resource for counseling, stress-management, personal and professional relationships, grief, trauma, and so much more. If a family member become diagnosed with a serious illness, you can contact your EAP for help managing that stress and finding resources for that family member.
Most people don’t think about their Long-Term Disability policy unless they need it, which makes it easy to overlook the associated benefit of an EAP. Even if you don’t have an LTD policy, it’s worth checking with your Benefits Administrator to see if you have an EAP available to you. Mental health is something I’m very passionate about (I even wrote two blogs about it, here’s Part One and here is Part Two). I believe incredibly important to provide resources that aid in the mental and emotional well-being of employees and their families.
Not only does an EAP assist employees, it can help businesses to increase productivity and reduce employee absenteeism! After all, an engaged and productive employee is healthy AND happy. Here is an article that dives into the benefits of an EAP, which can be an all-around win-win. If you’d like to learn more, please don’t hesitate to reach out to RISQ Consulting!
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Travel Essentials
By Alison Nelson, Employee Benefits Account Manager
With the gloomy weather we’ve been having lately, you may find yourself with the hankering to travel to warmer destinations. This past Spring, I found myself chasing the sunshine across the world and, in preparation for my travel, I found myself overwhelmed with all the products touted as a “must have”. Some items were lackluster while others are newfound staples on my to-pack list. To ease you of the same trial-and-error turbulence, below is a list of items I found to be worth it, and hopefully you do too.
- Travel Insurance with Petersen International
- Travel Insurance is a must when visiting overseas. There are so many unknowns that can come up when traveling and this will help give you immense peace of mind. Deductibles are flexible and expenses such as hospital stays, medical evacuation, trip cancellation and even lost luggage are eligible for coverage. I highly recommend contacting RISQ for a quote.
- My Favorite Carry On Bag
- This carry on bag not only conveniently attaches to rolling carry-ons or suitcases, but it expands as needed. I always keep the bag smaller as I head to my destination and then I expand it on the way back to fit anything I may bring back with me.
- Memory Foam Neck Pillow
- I don’t know about you, but sometimes I use my neck pillow and sometimes I don’t. This often leaves me with the conundrum of not wanting to waste precious space in my carry-on, which is why I love this portable neck pillow! It’s super comfy and fits in a convenient bag.
- Cord Organizer
- Since it seems like every device needs its own charger, this cord organizer has spared me from having to detangle all my charging cords and makes them easier to find.
- Portable Charger
- I like this portable charger since it has two USB ports so I can charge two devices at once. Since most places wont ship portable chargers to Alaska, this one has the added bonus of usually being in-stock at Target.
- Eye Mask
- While I don’t have this exact pair, I have a very similar one and love it. Not having the fabric touch my eyes makes it so I forget I’m even wearing them.
- Compression Packing Cubes
- These packing cubes are a lifesaver when I inevitably pack too many clothes or buy too many souvenir shirts. I can pack them in a cube then compress out the air to ensure everything still fits in my suitcase!
- Luggage Scale
- If you’re not an over-packer you can probably skip this one. But if you’re like me, this nifty device has saved me from having to repack my suitcase in the luggage drop-off line on more than one occasion.
- Laundry Bag
- Keeping dirty and clean clothes separate while travelling can be a pain so this laundry bag is a good way to keep things organized.
- Travel Mirror
- I have found that often times the only mirror is in the bathroom, so getting ready is just a lot easier with access to another mirror with good lighting.
- Toiletry Bag
- My favorite toiletry bag is a convenient way to make sure all your toiletries are in one spot and that they don’t spill in your suitcase. Need I say more?
Enjoy and safe travels! 😊
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I Screen, You Screen, We All Screen With Sunscreen!
By Jennifer Outcelt, Creative Content Architect
Ah, finally, the warm embrace of the Alaskan sun! While it brings joy to our frozen hearts and some much-needed Vitamin D, it also brings many potential risks. But just like you put on a down coat to protect your skin from the harsh winter, so must you put on daily layer of sunscreen protect against harmful ultraviolet (UV) rays. Let’s take a stroll (perhaps with a parasol?) through the history of sunscreen, exploring its development and the crucial role it plays in preventing cancer and other illnesses.
The quest for sun protection dates back centuries. Ancient civilizations instinctively sought ways to shield themselves from the sun’s scorching rays. While finding shade was always the simplest solution, it was not always the most practical for ancient people on the go. And since the umbrella hat would not be invented until 1880, alternative mobile sun shielding technologies were needed. Ancient Egyptians crafted primitive sunscreens using ingredients like rice bran and jasmine extract. In China, rice paste and white lead were employed, creating a pale complexion which doubled to symbolize social status through sun avoidance.
Fast forward to the 20th century, where brilliant minds began paving the way for modern sunscreen. In 1938, a Swiss chemist named Franz Greiter invented the world’s first commercial sunscreen, introducing the concept of Sun Protection Factor (SPF). However, it was not until the 1970s that sunscreen gained mainstream popularity and recognition for its vital role in safeguarding skin health.
With growing awareness of the link between sun exposure and health risks, the importance of sunscreen soared. Sunscreen formulations became more advanced, offering improved protection against both UVA and UVB rays. Research unveiled the direct correlation between unprotected sun exposure and skin cancer, prompting organizations like the American Cancer Society to advocate for regular sunscreen use.
The significance of sunscreen extends beyond preventing skin cancer. Prolonged exposure to UV radiation can lead to sunburn, premature aging, and eye damage, including cataracts. By applying sunscreen, individuals can shield themselves from these harmful effects and maintain healthier, more youthful-looking skin. Sunscreen also plays a crucial role in preventing other types of cancer. Lips, for instance, are susceptible to UV damage, making the use of lip balm or lip-specific sunscreens vital. Moreover, sunscreen protects against squamous cell carcinoma, basal cell carcinoma, and even melanoma— the most aggressive form of skin cancer. Any suspicious spots you find on your body (new or enlarging spots, larger than a pencil eraser head, irregular edges, discolored areas, scaly, etc.) should be looked at by a dermatologist.
With modern society fully aware of the importance of sunscreen (though some still choose to ignore it’s benefits), it is now an integral part of personal care as well as numerous industries. From lotions, clays, and sprays to gels and sticks, sunscreen has evolved to offer convenient and effective options for everyone. Outdoor workers, Lifeguards, athletes, and even children at schools and summer camps are encouraged to use sunscreen regularly. Moreover, clothing and accessories with built-in UV protection have become increasingly popular, providing an extra layer of defense against harmful cancer-causing rays.
Sunscreen has come a long way from ancient concoctions to modern-day sun shields. Its historical development and the mounting evidence of its importance in preventing cancer and other illnesses have solidified its status as a must-have in our daily routines. Hopefully this shed some light on why you might not want so much light shed on your skin. So say it with me folks, “I Screen, You Screen, We All Screen with Sunscreen!”
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What Employers Say About the Future of Employer-sponsored Health Benefits
By Casey Kirkeby, Strategy Consultant
Employer-sponsored health benefits have faced several threats over the past few decades, but just like hard-working employees they protect, they still endure and remain the primary method of coverage today.
One of the most impactful changes has been the introduction the Affordable Care Act (ACA). The Employee Benefits Research Institute (EBRI) recently published a report examining the ACA’s impact and other government health care solutions on employer-sponsored health plans. The study interviewed 26 benefits executives from various industries whose organizations covered over 1.2 million individuals and spent more than $6.5 billion on benefits in 2021. Their data reflected that both employers and employees still viewed employer-sponsored health benefits as an important feature of the employment relationship. Who would have though, right?! While this public option doesn’t guarantee ongoing success and stability, it will hopefully help shield employers from future challenges like legislative policy changes, economic difficulties and labor market shortages. Just like any good relationship, the employer/employee benefit relationship takes hard work, trust, and transparency.
As health care costs rise, employers are looking at any option to control costs. One arrangement that has been quite popular in the Lower 48 is the ICHRA (Individual Coverage Health Reimbursement Arrangement). Since it’s inception in January of 2022, many employers have adopted the ICHRA, directing their employees to private exchanges so that the employee is able to make plan design decisions for themselves apart from the traditional one-size-fits-all model. There are important considerations to take into account before an employer jumps to this model and the process is still clunky, but it can be a good fit for some employers. However, employers and employees have been slow to embrace the ICHRA because it lacks control over healthcare costs and creates additional administrative burdens that the employer has to absorb.
Another survey conducted by the National Business Group on Health concluded that most employers plan to continue offering health benefits to their employees as part of their overall compensation package. Specifically, the survey found that 92% of large employers offer health benefits and expect to continue doing so in the future, with an increasing focus on virtual health and digital solutions.
Employers are always exploring different ways to control costs, such as offering high-deductible health plans, Wellness Programs, Employee Assistance Programs surrounding mental health, and incentivizing employees to use cost-effective providers. But for now, employers remain confident in their ability to provide affordable health benefits to employees as an important attraction and retention tool.
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Employee Satisfaction With Benefits Falls to New Low
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 recent study from Metlife found that an increasing number of employees feel they are not receiving the benefits they need from employers. Employee satisfaction with benefit offerings has fallen to 61% in 2023 from 64% in 2022, reaching its lowest point in the past decade of the study’s history. One significant reason for this decrease in satisfaction is higher employee expectations due to financial and mental health struggles in the wake of the pandemic.
“Feeling cared for at work is a key driver of employees’ holistic health and happiness, which are strongly connected to employee productivity and job loyalty.”
– Bradd Chignoli, senior VP at Metlife
In general, employees continue to expect robust traditional offerings such as health insurance, paid leave and retirement. But they have also heightened their expectations regarding modern benefit options, such as financial wellness and caregiving assistance. While employers have started to increase their benefit offerings to coincide with employee desires, most have not been able to meet the newfound expectations quickly enough.
What’s Next?
With employee satisfaction with benefits falling to a new low, it’s important employers reevaluate their benefits packages. When employee needs are met, employers are likely to find their workforce happier and more satisfied with their everyday tasks. Each organization’s employees may desire different benefit offerings, so it’s important to consider the needs of the workforce before considering what to offer in the future.
For more information on employee benefit satisfaction, contact RISQ Consulting today.
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PBM Drug Pricing Transparency Bill Heads to Senate
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 Senate Committee on Commerce, Science and Transportation recently advanced a bill to increase pharmacy benefit manager (PBM) transparency and combat what some legislators called “deceptive practices.” The proposed bill received bipartisan support in the committee, with an 18-to-9 vote, and is supported by many health care and consumer organizations.
The Pharmacy Benefit Manager Transparency Act identifies activities that would be unlawful for PBMs to engage in, including the following:
- Spread pricing, a practice in which PBMs charge health plans and payers more for prescription drugs than they reimburse pharmacies
- Clawing back reimbursement payments from pharmacies
Additionally, PBMs would be required to direct 100% of any rebate to the plan or payer and disclose the cost and reimbursement to the health plan.
PBMs were initially formed to process claims and negotiate lower drug prices with drug makers. Today, they administer prescription drug plans for hundreds of millions of Americans and manage many aspects of the prescription drug process for health insurance companies, self-insured employers, unions and government programs. This includes developing lists of covered medications, negotiating rebates from drug manufacturers and contracting with pharmacies for reimbursement. According to the Pharmaceutical Care Management Association, PBMs play a positive role in creating savings and options and providing expertise for employers regarding prescription drug benefit design and coverage.
What’s Next?
Since PBMs have largely operated out of the view of regulators and consumers, this bill could impact how PBMs operate, potentially increasing prescription drug transparency. There’s currently no timeline for the Senate to consider the bill. Last year, the Senate Committee on Commerce, Science and Transportation passed the same bill, but it was never put to a full vote on the Senate floor.
Employers should continue to monitor the situation closely. [B_Official] will keep you apprised of notable changes.
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Virtual Second Opinions
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.
There may be a time in employees’ lives when they receive a medical diagnosis or feedback they feel uncertain about. Second opinions allow patients facing medical challenges to seek additional medical information on their condition, which can provide clarity and other treatment options available. With the increase in the popularity of telehealth, there is even the option of virtual second opinions, which can provide convenience by saving employees time and travel.
A virtual second opinion can help ease some of an employee’s stress after a serious diagnosis or when looking for a diagnosis for ongoing symptomatic issues. It can be difficult for a patient to find an appointment, especially if they need specialty care. Therefore, offering health coverage that includes virtual care gives a more accessible and efficient option for care. This article explains the additional benefits of receiving second opinions virtually.
Benefits of Virtual Second Opinions
Access to a second opinion can help relieve worry about diagnosis or treatment uncertainty. A virtual second opinion can provide easier access to different opinions, creating peace of mind for a patient. Additional benefits to this virtual care option can include:
- Improved patient care—The most significant benefit patients find from seeking a virtual second opinion is an improvement in overall care. This is due to having access to a large library of doctors nationwide. No matter where a patient is located, they may potentially receive access to any specialist they need.
- Increased timeliness—Receiving a virtual second opinion is often more efficient than going in person to receive one. The virtual process may allow patients to receive in-depth care and a treatment plan from a physician in about two weeks; in contrast, in-person visits are booked months out in most cases.
- Individualized care—It’s easier to make informed health decisions when all the facts are present. With a virtual second opinion, doctors can take the facts and ease patient anxiety by answering questions and creating a clear plan.
- Expanded care—Offering the benefit of virtual second opinions to employees helps those who live in areas of the country that do not have adequate access to health care.
- Eased anxiety—Virtual second opinions can ease the anxiety and stress of employees that may have received a diagnosis or care option they’d like analyzed in-depth. It can also empower an individual to take charge of their health and increase overall health literacy.
It’s important to note that there are different virtual second opinion program levels available. For example, these programs can include quality care for cancer and musculoskeletal disorders. Other programs offer care from specialists and subspecialists, such as surgeons and oncologists, that may be required for a patient’s care.
Summary
The level of care offering needed at each organization will vary, so it’s important to survey the needs of employees to find out which coverage options will receive the most use. Providing the option of virtual second opinions can give employees comfort in knowing they have access to additional care when they need it most. For more information on virtual second opinions, contact RISQ Consulting today.
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A Primer on Medical Stop-loss Insurance
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.
Catastrophic and unexpected health care claims are on the rise. This increase in catastrophic claims is, in part, the result of medical and pharmaceutical advances, such as specialty drugs and cell and gene therapies, as well as medical price inflation. As a result, many employers with self-funded health plans are actively looking for ways to minimize their financial exposures to potentially catastrophic claims. A common strategy these employers have leveraged is purchasing stop-loss insurance.
This article provides a general overview of stop-loss insurance and outlines some considerations for employers to keep in mind when deciding whether to purchase this coverage.
What Is Stop-loss Insurance?
Generally speaking, stop-loss insurance helps self-funded employers protect themselves from higher-than-anticipated health claim payouts by limiting their exposure to employee medical claims that exceed a predetermined amount. In other words, such coverage can prevent abnormal claim frequency and severity from draining employers’ financial reserves.
Stop-loss insurance plays an important role in helping employers manage their health care costs and protecting against unexpected or catastrophic claims, as it sets a ceiling for the amount they pay in health claims. This coverage is not a form of medical insurance, but rather a policy employers can purchase to manage their financial risks.
How Does Stop-loss Insurance Work?
Under a stop-loss insurance policy, an employer’s claims liability is limited to a certain amount (also called an attachment point), therefore ensuring abnormal employee health claims do not drain the employer’s financial reserves. An employer can add stop-loss insurance to an existing plan or purchase it independently.
If an employer’s health claims exceed a predetermined amount, their insurer will usually reimburse them for all additional claims. For example, if an employer has a stop-loss insurance policy with an attachment point of $500,000, their insurer will typically begin providing reimbursement after the plan’s claims exceed $500,000. It’s worth noting that since stop-loss coverage only reimburses an employer for claims that exceed their policy’s attachment point, the employer is initially responsible for paying employee claims before they reach the established cost ceiling.
Types of Stop-loss Insurance
There are two types of stop-loss insurance: individual (or specific) and aggregate (or total claims). Understanding the difference between individual and aggregate stop-loss insurance can help self-funded employers evaluate and determine which coverage best meets their needs and reduces their financial exposures. Because health plan usage can be unpredictable, some employers choose to purchase both individual and aggregate stop-loss insurance to provide their organizations with maximum financial protection.
Individual Stop-loss Insurance
Individual stop-loss insurance limits an employer’s liability when an individual employee’s medical claims exceed the attachment point. As such, this coverage can protect employers against unexpectedly high claims from individual employees.
Aggregate Stop-loss Insurance
Aggregate stop-loss insurance can help safeguard employers from the total sum of health claims for an entire group of employees rather than any one individual. Under this coverage, an employer is usually reimbursed when their expenses for all employees’ medical claims exceed the attachment point for the plan year.
Stop-loss Insurance Considerations
Each organization is unique. Deciding whether stop-loss insurance is necessary depends on an organization’s specific needs, workforce characteristics and risk tolerance. Reviewing all relevant factors (e.g., rates, policy terms and potential exposures) can help employers decide whether purchasing this coverage makes sense. Employers can consider the following factors when evaluating whether to purchase stop-loss insurance.
Understanding the Attachment Point
The attachment points for individual and aggregate stop-loss insurance differ. Generally, the attachment point for an individual stop-loss policy is a specific dollar amount. As a result, an employer is only responsible for an individual employee’s claims up to that amount.
For aggregate stop-loss insurance, the attachment point is usually a percentage of expected claims. The typical attachment point for aggregate stop-loss insurance tends to be between 120% and 125% of expected health claims. In any case, a stop-loss insurance policy’s attachment point can vary depending on factors such as the employer’s size, employee demographics and overall risk profile.
Evaluating Coverage Limitations
Stop-loss insurance plans are medically underwritten; therefore, an insurer may refuse to cover certain conditions or require higher claim thresholds for those conditions. For example, if a plan enrollee consistently has high-cost claims, a stop-loss insurer may refuse to continue to cover that enrollee or require a higher claim threshold for the enrollee. This practice is known as lasering.
Additionally, since stop-loss contracts typically last for one year, an employer’s high-cost claimants may only be covered for a few months before the insurer excludes them from the policy upon renewal. Thus, the employer will likely be financially exposed to those claims the following year.
Monitoring Increasing Costs
While stop-loss insurance can help employers reduce their financial exposures when health claims are higher than anticipated in a given year, the cost of such coverage can increase annually. Rising claims can also make it more difficult to obtain rates from other providers.
Ensuring Stop-loss Coverage Aligns With Health Plan Provisions
Some stop-loss policies may exclude certain medical treatments or classes of individuals covered by employers’ health plans. Consequently, employers may be on the hook for expensive claims that aren’t covered under their stop-loss policies. Therefore, employers should consider reviewing their stop-loss policies and health plan provisions to ensure they align to limit their potential financial exposures.
Summary
Selecting the right insurance policies can have major financial repercussions for employers. Having sufficient coverage can lower employers’ insurance costs, reduce their risks and keep their workers healthy. Stop-loss insurance can make all the difference in helping employers mitigate their financial risks, especially as catastrophic health claims are increasing. Understanding stop-loss insurance will allow employers to make the best policy decisions for their respective organizations.
For more health care resources, contact RISQ Consulting today.
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