by admin | May 10, 2022 | Health & Wellness, Hot Topics
“Suck it up,” “cheer up,” “snap out of it,” “but you don’t look sick”- these are just some of the phrases that well-meaning friends and family tell loved ones struggling with mental health issues. Research shows that one in five adults struggle with mental health conditions. Mental health struggles include depression, bipolar disorder, anxiety, schizophrenia, and eating disorders.
Mental illness is also becoming increasingly common among teenagers; studies indicate that approximately one in five teens between ages twelve and eighteen are diagnosed with a mental health disorder. These issues deeply impact day-to-day living and may also affect the ability to relate to others. When your mental health suffers, everything in your life will suffer as a result.
What is Mental Health?
Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices.
The fact is, a mental illness is a disorder of the brain – your body’s most important organ. Like most diseases of the body, mental illness has many causes – from genetics to other biological, environmental and social/cultural factors. And just as with most diseases, mental illnesses are no one’s fault. For many people, recovery – including having meaningful roles in social life, work and school – is possible, especially when you start treatment early and play a strong role in your own recovery process.
What Are the Warning Signs?
Each illness has its own symptoms, but common signs of mental illness can include the following:
- Avoiding friends and social activities
- Feeling excessively sad or low
- Feeling helpless or hopeless
- Extreme mood changes
- Thinking of harming yourself or others
- Inability to perform daily tasks like taking care of your kids or getting to work or school
- Feeling numb or like nothing matters
- Overuse of substances like alcohol or drugs
- Having unexplained aches and pains such as headaches or stomach aches
- Changes in sleeping habits or feeling tired and low energy
- Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
What Are Some Things You Can Do to Look After Your Mental Health?
- Talk About Your Feelings – Just being listened to can help you feel supported and less alone. Talking with a friend or loved one is helpful but remember, therapists are not only for those in the middle of crisis – they’re incredibly beneficial for people in all stages of life
- Exercise regularly – Exercise releases endorphins, which have mood-boosting effects. Aim to exercise about 30+ minutes at least five days per week
- Eat Well – Your brain needs a mix of nutrients to stay healthy and function well, just like the other organs in your body
- Stay Connected with Family and Friends – Close, quality relationships are key for a happy, healthy life
- Take a Break – a change of scenery or pace is good for your mental health
- Get Outside to Enjoy 15 Minutes of Sunshine – Sunlight synthesizes Vitamin D which experts believe is a mood elevator
- Send a Thank You Note – Let someone know why you appreciate them. Written expressions of gratitude are linked to increased happiness
- Practice Forgiveness – People who forgive have better mental health and report being more satisfied with their lives
- Pursue Your Passions – Enjoying yourself can help beat stress and achieving something boosts your self-esteem
- Sleep – Most adults need around 8 hours of sleep each night so try to make sure you’re getting enough shut-eye
Mental health is undoubtedly just as integral as physical health but it’s something that we often don’t prioritize. We all experience times when we feel stressed or overwhelmed but if these feelings persist, it’s time to slow down and re-evaluate your mental wellbeing.
Most people are afraid to ask for help, but seeking help is actually a sign of strength, not weakness. If you or someone you know is struggling with their mental health, please reach out to a local mental health professional.
by admin | May 4, 2022 | Compliance
The Departments of Health and Human Services, Labor, and Treasury (the Departments) released Transparency in Coverage (TiC) rules in late 2020 that will require fully insured and self-funded plan sponsors of non-grandfathered group health plans to make important disclosures about in-network and out-of-network rates beginning July 1, 2022. To be ready to meet that deadline, plan sponsors should be coordinating efforts with carriers and third-party administrators (TPAs), as the case may be, to ensure they have the necessary information in the proper format to comply with the new TiC requirements.
Devil in the Details
The TiC rules originally required certain employers to provide “machine readable” files that disclose in-network rates, out-of-network charges and information relating to prescription drug coverage and costs by January 1, 2022. Last year the Departments delayed enforcement of the prescription drug coverage rules indefinitely until they issue additional guidance. However, plan sponsors should be taking steps now to ensure they can publish the required in-network negotiated rates and out-of-network allowed amounts as laid out in the TiC rules by the new July 1 deadline.
The first required file (In-Network Rate File) must show a plan’s negotiated rates for all covered items and services between the plan or carrier and all in-network providers. The second file (Allowed Amount File) will show both the historical payments to, and billed charges from, out-of-network providers. Plan sponsors must be sure this file includes at least 20 historical entries to safeguard individual privacy. The departments have indicated they will provide more specific guidance as to format and content, but so far have not released more details than what we know from the final rules.
Machine-Readable Files
The machine-readable files must include:
• For each option a group medical plan or carrier offers, the identifier for each such option. The identifier is either the insurer Health Insurance Oversight (HIOS) identifier, or if the plan or insurer does not have a HIOS number, the employer identification number (EIN).
• A billing code, which can include a Current Procedural Terminology (CPT) code, Healthcare Common Procedure Coding System (HCPCS) code, Diagnosis-related Group (DRG) code, or a National Drug Code (NDC) or any other common payer identifier. This content element also requires a plain language description for each billing code of each covered item or service.
In-Network Rate File
The In-Network Rate File must show:
• In-network rates for each item or service provided by in-network providers, including any negotiated rates, fee schedule rates used to determine cost-sharing, or derived amounts, whichever rate is applicable to the plan.
• If a rate is percentage-based, include the calculated dollar amount, or the calculated dollar amount for each National Provider Identifier (NPI) identified provider, if rates differ by providers or tiers. Bundled items and services must be identified by relevant code.
Allowed Amount File
The Allowed Amount File must show:
• Unique out-of-network allowed amounts and billed charges with respect to covered items or services, furnished by out-of-network providers during the 90-day period that begins 180 days prior to the publication date of the file.
• The plan or insurer must omit data for a particular item or service and provider when the plan or insurer would be reporting on payment of out-of-network allowed amounts for fewer than 20 different claims for payment under a single plan or coverage. These amounts must also be expressed as dollar amounts and associated with the NPI, Taxpayer Identification Number, and Place of Service Code for each network provider.
What Should You Do?
Plan sponsors will need to update the information in the required files no less frequently than monthly. This will likely require strong coordination with the carrier in an insured plan and with the TPA in a self-funded plan.
The Departments will require the files to be posted to a public website that consumers can use without providing individually identifiable information. The website should be open access and not require passwords, account setup, login credentials or any other barriers to accessing the required information.
The TiC rules recognize that a plan sponsor might not have its own public website on which it will be able to house the required files. But the rules permit plan sponsors to contract with a carrier, TPA or other third party to produce and house the information on a plan’s behalf. However, plans should be aware that they might ultimately remain responsible for any failures.
A carrier will be responsible for any failure if a plan has required it in writing to ensure a plan’s compliance. Self-funded plans can contract to have another entity provide and update required files, too, but the TiC rules do not provide the same level of protection for any failures by a third party in the self-funded context, so plans should be sure to review relevant indemnification provisions in any third-party vendor service agreement.
Many carriers and TPAs have begun reaching out to employer plan sponsors offering to assist in in providing, preparing, updating, and hosting the required files. Employers should be carefully reviewing their service agreements and related contracts to make certain they include specific provisions dealing with all aspects of the required transparency disclosures.
Conclusion
We will continue to monitor the guidance we expect to be coming soon as to certain administrative requirements regarding formatting and hosting of the required forms and provide updates as needed.
© UBA. All rights reserved.
by admin | Apr 28, 2022 | Cybersecurity
Cybersecurity is no longer an emerging risk but a clear and present one for organizations of all sizes, panelists on a panel at Triple-I’s Joint Industry Forum (JIF) said. This is due in large part to the fact that cybercriminals are increasingly thinking and behaving like businesspeople.
“We’ve seen a large increase in ransomware attacks for the sensible economic reason that they are lucrative,” said Milliman managing director Chris Beck. Cybercriminals also are becoming more sophisticated, adapting their techniques to every move insurers, insureds, and regulators make in response to the latest attack trends. “Because this is a lucrative area for cyber bad actors to be in, specialization is happening. The people behind these attacks are becoming better at their jobs.”
As a result, the challenges facing insurers and the customers are increasing and becoming more complex and costly. Cyber insurance purchase rates reflect the growing awareness of this risk, with one global insurance broker finding that the percentage of its clients who purchased this coverage rose from 26 percent in 2016 to 47 percent in 2020, the U.S. Government Accountability Office (GAO) stated in a May 2021 report.
Panel moderator Dale Porfilio, Triple-I’s chief insurance officer, asked whether cyber is even an insurable risk for the private market. Panelist Paul Miskovich, global business leader for the Pango Group, said cyber insurance has been profitable almost every year for most insurers. Most cyber risk has been managed through more controls in underwriting, changes in cybersecurity tools, and modifications in IT maintenance for employees, he said.
By 2026, projections indicate insurers will be writing $28 billion annually in gross written premium for cyber insurance, according to Miskovich. He said he believes all the pieces are in place for insurers to adapt to the challenges presented by cyber and that part of the industry’s evolution will rely on recruiting new talent.
“I think the first step is bringing more young people into the industry who are more facile with technology,” he said. “Where insurance companies can’t move fast enough, we need partnerships with managing general agents, with technology and data analytics, who are going to bring in data and new information.”
“Reinsurers are in the game,” said Catherine Mulligan, Aon’s global head of cyber, stressing that reinsurers have been doing a lot of work to advance their understanding of cyber issues. “The attack vectors have largely remained unchanged over the last few years, and that’s good news because underwriters can pay more attention to those particular exposures and can close that gap in cybersecurity.”
Mulligan said reinsurers are committed to the cyber insurance space and believe it is insurable. “Let’s just keep refining our understanding of the risk,” she said.
When thinking about the future, Milliman’s Beck stressed the importance of understanding the business-driven logic of the cybercriminals.
If, for example, “insurance contracts will not pay if the insured pays the ransom, the logic for the bad actor is, ‘I need to come up with a ransom schema that I’m still making money’,” but the insured can still pay without using the insurance contract.
This could lead to a scenario in which the ransom demands become smaller, but the frequency of attacks increases. Under such circumstances, insurers might have to respond to demand for a new kind of product.
Originally posted on Insurance Information Institute
by admin | Apr 18, 2022 | Human Resources
Today’s offices potentially span five full generations ranging from Generation Z to the Silent Generation. A coworker could just as easily be raised with a smart phone in hand as they could have used a typewriter at their first job. Some see differences between generational colleagues as an annoyance (“kids these days!”) and many rely on generational stereotypes as fact. Truth of that matter is that generational stereotypes have about as many holes in them as a piece of Swiss cheese. Current research questions the validity of generational stereotypes. This series uncovers top generational myths as a strategy to support a diverse and healthy employee population.
Next, we progress to a group whose eldest members reached adulthood in the year 2000: Millennials (also known as Generation Y). This cohort was born between 1981 and 1996. The top three myths of Millennials include:
- They are the laziest generation at work. Millennials have been called the “trophy” generation with the implication that they receive accolades for just showing up. The impression this leaves in the workforce is that they are lacking motivation to go above and beyond, and may be comfortable phoning it in. The data doesn’t support this critical generalization! Most Millennials are inspired by big, hairy goals at work. In fact, 59% of Millennials reported that competition is “what gets them up in the morning.”
- Millennial employees need life instructions on “adulting.” Children of the ‘80s and ‘90s were raised with a teacher, coach, or parent nearby to instruct or help them figure out a solution. For that reason, they often get labeled as incapable. This may lead you to believe that this generation is lacking smarts, and this couldn’t be further from the truth. Close to 40% of adults aged 25 to 37 have a bachelor’s degree, a percentage that overshadows both Baby Boomers and Generation Y at this same point in their life. Millennials are more educated and more technology savvy than prior generations. One sign of their life skills aptitude? Check out their retirement accounts. Dave Ramsey, personal finance guru, summed it up like this: “Even though Millennials have had less 20 years to build their retirement wealth, they are not that far behind many of those who are closest to retirement.” Yes, they may ask a lot of questions, but don’t let this fool you.
- They are job hoppers. They don’t commit to companies. They leave jobs at the drop of a hat. This tune may sound familiar because you have heard it before. A Pew Research study showed that when you freeze data for age, Generations X and Millennials had similar tenures at work. Workers in the first few decades of their career are more open to looking for new opportunities to explore new jobs and learn. The data show that this sentiment is more closely aligned with a stage in life that all generations have experienced. So, let’s give Millennials a break here. Just because they don’t intend to stick around at one company to receive a glass retirement plaque doesn’t mean they have any less value than other generations.
Despite what you may have heard, Millennials are hard workers with the know-how to quickly pick up new knowledge or skills. They value stability just as much, or more, than prior generations.
© UBA. All rights reserved.
by admin | Apr 14, 2022 | Benefit Plan Tips, Tricks and Traps, Hot Topics
Health insurance is essential to protecting your health but the high cost of coverage may leave you feeling sick. Even after employers pick up a substantial amount of the cost, every year Americans spend thousands of dollars on healthcare while costs are continuing to rise. By taking certain steps, you can stretch your healthcare dollars and still receive the care you need to stay healthy.
- Understand How Your Health Plan Works
Review your plan to learn how to maximize your benefits. You need to know what is covered (and what is not!) and what procedures you need to follow to ensure your claims will get paid. Know what your copayment, coinsurance and deductible costs are before your visit.
Most health insurance plans cover more of your costs if you use their preferred or in-network doctors. If you visit an out-of-network doctor or medical facility, you’ll pay more and may end up being responsible for 100% of the bill. Use your insurer’s online tools to search for in-network providers.
- Choose the Right Places to Get Care
Running to the emergency room when you get sick after hours could drain your wallet. All too often, those suffering from minor illnesses or injuries visit the ER when they don’t need to. The ER should be your last resort – consider using more affordable options like telemedicine or an urgent care center instead. You can still get the care you require in off-hours without having to schedule an appointment.
If you need surgery, you may save money by having it done at an ambulatory surgical center (ASC) which is a modern healthcare facility focused on same-day surgical care, including diagnostic and preventive procedures. Typically, these centers charge less than a hospital.
- Use a Health Savings Account (HSA) or Flexible Spending Account (FSA)
Opening a HSA or an FSA is a handy way to save for medical expenses and reduce your taxable income. They are like personal savings accounts but the money in them is used to pay for health care expenses. HSAs are owned by you, earn interest, and can be transferred to a new employer. FSAs are owned by your employer, do not earn interest, and must be used within the calendar year.
- Ask Your Doctor About Remote Patient Monitoring (RPM)
RPM is the use of digital technologies to monitor and analyze medical and other health data from patients and electronically transmit this information to healthcare providers for assessment and, when necessary, recommendations and instructions. This type of monitoring is often used to manage high-risk patients, such as those with acute or chronic health conditions such as those with diabetes, hypertension and heart conditions.
- Use Your Preventive Care Benefits
Many health plans pay the full cost for important preventive care. These regular screenings, exams, and immunizations help detect or prevent diseases and medical problems early when they are easier to treat. Annual check-ups, mammograms (usually after the age of 40), flu shots and colonoscopies (usually 1 every 10 years after the age of 50) are examples of preventive care. These checks can save you a lot of money because they catch problems early.
Health insurance isn’t mandatory – there’s no law requiring you to buy it – but, health insurance is an important part of staying healthy, financially and physically. Since most people who don’t have insurance made that decision based on money instead of what is best for their health, they usually don’t have doctor appointments for the same reason – it’s too expensive. But skipping routine care can end up being more expensive than your premiums, especially if you have serious health issues that aren’t caught early. Think of it like care maintenance: regularly changing your oil might be a hassle but it is essential to prevent a major breakdown down the road.
