by admin | Jun 24, 2024 | Health & Wellness
The old adage “an ounce of prevention is worth a pound of cure” rings truer than ever in today’s world. While reactive healthcare plays a crucial role in treating illness, a growing emphasis is being placed on the power of health prevention and wellness.
Investing in preventive measures and promoting overall well-being isn’t just about individual health; it’s a strategic decision with far-reaching benefits for individuals and communities. Here’s why:
Reduced Healthcare Costs:
Reactive healthcare, focused on treating existing conditions, can be incredibly expensive. Chronic diseases like heart disease, diabetes, and cancer often require ongoing treatment and management, placing a significant strain on healthcare systems and individuals’ finances.
Investing in preventive measures like healthy eating, regular exercise, and preventive screenings can significantly reduce the risk of developing these chronic conditions, leading to substantial cost savings in the long run.
Improved Quality of Life:
Health prevention isn’t just about avoiding illness; it’s about promoting overall well-being. By prioritizing healthy habits, individuals experience increased energy levels, improved mental clarity, and a greater sense of vitality. This leads to a higher quality of life, allowing individuals to be more productive, engaged, and fulfilled in all aspects of their lives.
Enhanced Productivity and Economic Growth:
A healthy workforce is a productive workforce. When individuals are free from chronic illness and experience better overall health, they are more likely to be present at work, focused on their tasks, and less prone to absenteeism due to health issues. This translates to increased productivity and economic growth for both individuals and organizations.
Strategies for Investing in Health Prevention:
Investing in health prevention can take various forms, both at an individual and community level:
- Individual Level: Prioritizing healthy eating habits, regular exercise, adequate sleep, and preventive screenings are essential steps individuals can take to safeguard their health.
- Community Level: Promoting access to healthy food options, safe parks and recreational facilities, and community-based wellness programs can significantly impact population health.
Investing in health prevention and wellness is a wise decision with far-reaching benefits. By prioritizing proactive measures and promoting overall well-being, individuals, communities, and societies can reap the rewards of a healthier, happier, and more productive future.
by admin | Jun 17, 2024 | Compliance
PREPARE NOW TO PAY THE PCORI FEE
The Patient-Centered Outcomes Research Institute (PCORI) fee funds research that evaluates and compares health outcomes, clinical effectiveness, and the risks and benefits of medical treatments and services. Effective through 2029, the IRS treats this fee like an excise tax, applied to all covered lives, including employees, retirees, spouses, and dependents. The fee is due on July 31, 2024.
For plan and policy years ending between October 1, 2023, and September 30, 2024, the PCORI fee is $3.22 per covered life, reflecting a 7.33% increase.
For plan and policy years ending between October 1, 2022, and September 30, 2023, the fee was $3.00 per covered life.
Employers with self-funded medical plans or applicable health reimbursement arrangements (HRAs) must use Form 720 to fulfill their reporting obligations and pay PCORI fees.
Calculating the PCORI fee requires employers to determine the average number of lives covered under a self-insured health plan using one of the IRS-approved methods.
EMPLOYER CONSIDERATIONS
Employers should be prepared to file Form 720 and pay the fee by July 31. Refer to the IRS Form 720 instructions, FAQs, and chart of applicable coverage types.
IRS RELEASES 2025 LIMITS FOR HDHPS AND HSAS
The IRS released the inflation-adjusted amounts for 2025 health savings accounts (HSAs), excepted benefit health reimbursement arrangements (EBHRAs), and high-deductible health plans (HDHPs).
2024 and 2025 HSA and HDHP Limits
|
2024 |
2025 |
|
Self-Only |
Family |
Self-Only |
Family |
| HSA Maximum Contribution |
$4,150 |
$8,300 |
$4,300 |
$8,550 |
| HSA Maximum Catch-up Contribution |
$1,000 |
$1,000 |
$1,000 |
$1,000 |
| HDHP Minimum Deductible |
$1,600 |
$3,200 |
$1,650 |
$3,300 |
HDHP Maximum Out-of-Pocket Expense
(In Network) |
$8,050 |
$16,100 |
$8,300 |
$16,600 |
Maximum EBHRA Contribution Limits
2024 $2,100
2025 $2,150
EMPLOYER CONSIDERATIONS
Employers offering these benefits must update all plan communications, open enrollment materials, and other relevant documentation to ensure that participants and beneficiaries are adequately informed about the new limits.
HHS FINALIZES SECTION 1557 NONDISCRIMINATION REGULATIONS
The U.S. Department of Health and Human Services (HHS) released new regulations under Section 1557 of the Affordable Care Act (ACA), known as the “Final Rule” nearly two years after the proposed rule was published. The regulations are set to become effective on July 5, 2024, though some provisions will be phased in later. The Final Rule reinstates certain provisions from the previous regulations and introduces additional clarifications and guidelines.
Section 1557 of the ACA aims to prevent discrimination in health programs or activities receiving federal financial assistance. The new regulations under the Final Rule extend coverage to all products offered by a health insurance issuer if any of these products receive federal financial assistance. This expansion will bring a significant number of entities under the purview of Section 1557 for the first time. Those entities may include:
- Insurers offering qualified health plans through the health exchange marketplace, large group market plans, excepted benefit plans, self-insured group health plans.
- Third-party administrators (TPAs) and pharmacy benefit managers (PBMs) if any part of their business is operated by an insurer subject to Section 1557 or if they are sub-recipients of federal financial assistance.
- Insurance agents or brokers paid by a covered entity receiving federal financial assistance.
EMPLOYER CONSIDERATIONS
The Final Rule significantly broadens the definition of a covered entity under Section 1557, extending its reach beyond the scope of the 2020 Rule. Consequently, insurers, TPAs, PBMs, insurance brokers, and other related entities need to review their business models to determine if they are now subject to Section 1557. If covered, these entities must ensure that their practices, policies, and products comply with the new regulations.
HHS updated its Frequently Asked Questions to offer further guidance on implementing the Final Rule.
MEDICAL DEBT CANCELLATION ACT INTRODUCED
On May 8, legislators introduced the Medical Debt Cancellation Act (S.4289), a proposal aiming to eliminate current medical debt in the United States. The Act involves the federal government paying off medical-related debts under specific conditions. Its multiple components, which would be phased in over time, seek to eradicate existing medical debt and limit the ways consumers can incur future debt. Currently in draft form, the Act is subject to amendment and further clarification before moving to a congressional vote.
A central provision of the Act is the establishment of a federal grant program administered by the Department of Health and Human Services (HHS) to fund the payment, or “cancellation,” of medical debts held by hospitals, provided the debt is out-of-pocket, unpaid, and owed for services rendered before the bill’s enactment. Excluded from the program are amounts covered by federal health care programs or other insurance plans. Hospitals would apply for these grants, with HHS prioritizing safety net hospitals that agree to cancel debts owed by low-income and vulnerable populations.
The Act also mandates that within one year of enactment, federally funded health care programs must eliminate medical debt collections. HHS would report annually to Congress on the progress of the debt forgiveness program, which would conclude once all eligible medical debt is canceled. Additionally, the Act proposes amendments to the Fair Debt Collection Practices Act, prohibiting the collection of pre-enactment medical debt and creating a private right of action for individuals harmed by violations.
While the Act aims to cancel existing medical debt, it does not ban future medical debt but imposes new billing and debt collection requirements on healthcare providers. These include assessing eligibility for charity care or financial assistance 45 days before the payment due date and providing related information to patients. The Act prohibits 501(c)(3) hospitals from charging uninsured patients more than generally billed amounts and bans interest on outstanding payments. Amendments to the Fair Credit Reporting Act would prevent credit reporting agencies from including medical debt information. The Act, still in the proposal stage, draws attention due to its potential broad impact.
GOVERNOR LAMONT SIGNS LEGISLATION EXPANDING CONNECTICUT PAID SICK DAYS LAWS
Governor Ned Lamont has signed new legislation expanding Connecticut’s paid sick leave laws to include a broader range of workers. The updated laws will ensure that more employees have access to paid sick leave, addressing gaps in the current system that covers only specific retail and service occupations. The goal of the legislation is to help retain young workers in the state, enhance employee productivity, and support economic growth by reducing the financial hardships of missing work due to illness.
Starting January 1, 2025, the law will apply to almost every occupation, excluding seasonal and certain temporary workers. The threshold for employer coverage will be reduced in phases: employers with at least 25 employees by January 1, 2025; those with at least 11 employees by January 1, 2026; and all employers by January 1, 2027. Additionally, the definition of a family member for sick leave purposes will be broadened, and the reasons for using paid sick leave will include public health emergencies.
EMPLOYER CONSIDERATIONS
Employers should prepare to update existing documents to reflect the new legislation.
QUESTION OF THE MONTH
Q: We have a client that never filed their 2022 plan year D1 and P2 files for RxDC reporting (assuming the carrier filed the D2-D8). Was the $100-a-day penalty in place for this filing in 2023?
A: There was penalty relief for 2020 and 2021, but not for 2022 filings. The penalty is found in Internal Revenue Code Section 4980D. The good faith relief came from the Departments of Labor, Health and Human Services, and Treasury in the form of FAQ 56 issued on December 23, 2022.
©2024 United Benefit Advisors
by admin | Jun 3, 2024 | Employee Benefits
A Baby Boomer is someone born between 1946 and 1964. This generation is currently between 58 and 78 years old (in 2024). They tend to have a strong, loyal work ethic and excel at face-to-face communication and building relationships with colleagues. Boomers have a wealth of experience accumulated over long careers. They value jobs that allow them to leverage this experience and be seen as mentors or leaders. They are also loyal and expect loyalty in return.
Security for Boomers: Health Insurance a Top Priority
As medical expenses climb, health insurance remains a critical benefit for all ages. But for Baby Boomers nearing retirement, it takes on even greater significance. With chronic health conditions becoming more common, 71% of Boomers say health insurance is the key to achieving their financial goals. This highlights the peace of mind and financial security a robust health plan provides, allowing them to focus on enjoying their golden years without worrying about unexpected medical bills.
Boomers Say “Yes” to Wellness!
84% of Boomers actively seek out employers with wellness programs. These programs not only help control healthcare costs by keeping everyone healthier and reducing medical bills, but they also tap into Boomers’ desire to stay active and youthful. These programs offer a fun and engaging way to maintain their well-being, making them a highly valued benefit for this generation.
Why Boomers Value Flexibility and Paid Time Off
We often associate flexible work arrangements with Millennials, but don’t underestimate Boomers! A surprising 56% of Boomers value work flexibility just as much. In fact, they often prioritize it over higher salaries.
In the US, companies are getting creative to attract and retain top Baby Boomer talent. One unique approach? “Grandternity” leave. This leave allows grandparents to take time off to support their adult children when a new grandchild arrives, recognizing the expanding roles that Boomers play within families.
Another modern twist on work flexibility? Snowbird programs. These programs allow older workers to enjoy the flexibility of working remotely from two different locations throughout the year.
Imagine this: during the winter months, Boomers can choose to work from a warmer climate, giving them a taste of retirement living. This “test drive” helps ease the transition when they’re ready to fully step away from the workforce, boosting morale and overall satisfaction.
Snowbird programs and grandternity leave are just a few examples of how US companies are offering innovative benefits that cater to the desires and needs of the Boomer generation.
Boomers: Experienced and Eager to Learn
Forget the stereotype – Boomers are ready to embrace change! While they may not have grown up with today’s technology, their optimistic outlook and desire to stay relevant make them valuable assets. The key? Providing opportunities for continuous learning and development.
According to Gallup, only 30% of Boomers feel they have access to these opportunities at work. This is a missed opportunity! By investing in their ongoing professional development, you unlock the full potential of their experience and keep them engaged and motivated. This translates to a loyal and highly skilled workforce, ensuring your company stays competitive in a rapidly evolving market.
by admin | May 27, 2024 | Health & Wellness, Hot Topics
Mental health isn’t just the absence of illness. It’s a continuum ranging from severe symptoms such as panic attacks and major depression to excellent mental strength and well-being.
Sometimes you’re not ill, but you aren’t well either – and you need help. If you’re feeling down about work or a problem in your life and need to talk to somebody, an Employee Assistance Program (EAP) is a great solution.
What is an EAP?
EAPs are mental health services available at work, and they can be beneficial in helping you work through problems. An EAP provides voluntary, confidential services that help you manage personal difficulties and life challenges under the guidance of a professional counselor.
An EAP can provide counseling, support groups, and other resources to help you cope. An EAP is usually offered 24/7, so you can always access it when you need it most. These programs are usually an employee benefit offered by your employer at little or no cost to you.
Employee Assistance Programs aren’t just for crisis situations. They can also provide advice and practical support for:
The Bottom Line
EAPS offer free benefits like short-term therapy, stress management, financial counseling, and relationship support, among other services. Even though they’re short-term, EAP benefits can help you to address issues that have been building up. The end goal of an EAP is to improve your well-being, using a plan that works for your unique circumstances.
