Feds exempt HRAs from reform’s annual limit requirements

The feds just announced health reimbursement arrangements (HRAs) are exempt from the annual limit restrictions in the healthcare reform law until Jan. 1, 2014.

Back in June, the Centers for Medicare & Medicaid Services (CMS) issued guidance that required HRA plans to renew or apply for a waiver by Sept. 22, 2011 if they wanted to be relieved from complying with the reform law’s restrictions on annual dollar limits.

But the Center for Consumer Information & Insurance Oversight has just issued new guidance rendering the CMS renewal/application process unnecessary.

It says HRAs have been deemed exempt from having to comply with the annual limit restrictions through 2013, as long as they comply with existing record retention and annual participant notice requirements.

Under the Patient Protection and Affordable Care Act (PPACA), group health plans need to start phasing out annual dollar limits on health benefits provided.

The reform law says plans cannot:

• impose limits lower than $750,000 for plan years beginning on or after Sept. 10, 2010
• impose limits lower than $1,250,000 for plan years beginning on or after September 23, 2011, and
• impost limits lower than $2,000,000 for plan years beginning on or after September 23, 2012.

By Jan 1, 2014, HRAs and health plans will not be allowed to impose any spending limits.

The CCIOO’s reasoning for allowing HRAs to be exempt from the limits until 2014: Requiring mini-med HRA plans to comply with the limits would likely result in a significant increase in mini-med premiums, which would cause many employers to drop coverage and leave workers without even minimal insurance coverage.

The new guidance also says any coverage that’s “integrated” with an HRA must meet the reform law’s annual limit requirements or obtain a waiver by Sept. 22, 2011.

However, no clear guidance was given as to when/how coverage is “integrated” with an HRA.

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Critical question to ask wellness participants

September 26, 2011 by Christian Schappel

There’s one question many companies aren’t asking that could pinpoint who would benefit most from your wellness program.

The question: How stressed are you?

The Mayo Clinic asked 13,198 employees who participate in one of the clinic’s wellness centers to rate their stress levels on a scale of 0 (as bad as it can be) to 10 (as good as it can be), as well as answer questions about their quality of life, fatigue, exercise, diet, smoking and health problems.

More than 2,100 employees rated their stress level 3 or below. And when those highly-stressed employees were compared to the rest of the group they were found to have poorer health and more fatigue. 

The highly-stressed group was more likely to suffer from high blood pressure, high blood sugar, high cholesterol and obesity.

Those in the high stress group also had less confidence than their peers in their ability to improve their health.

Improve their state of mind

As the research shows, stress levels are something employer wellness programs will want to monitor.

Some suggestions from the studies’ lead researcher Matthew Clark, Ph.D., a clinical psychologist at the Mayo Clinic: Find out which employees are in this at-risk group and offer them yoga, tai chi, meditation courses, stress management classes or sessions with a wellness coach who can help them improve their health.

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Tip Tuesday! Influenza “Flu” Vaccine

Did you know there is an estimated 25-50 million cases of the flu reported in the U.S. every year which leads to more than 200,000 hospitalizations and 39,000 – 40,000 deaths annually? Did you know that people with the flu can infect others before feeling symptoms? Did you know the flu can be passed to others up to seven days after symptoms start (children may be infected up to 10 days after)?

According to the Centers for Disease Control and Prevention (CDC), the single best way to protect against the flu is to get vaccinated each year. This year's seasonal flu vaccination protects against the H1N1 virus so a separate shot is not needed. Receiving vaccinations can prevent infections in about 70 – 90 percent of healthy persons younger than 65 years of age.

Take these everyday steps to protect your health:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. You can also use an alcohol-based hand cleaner.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• Stay home if you are sick until at least 24 hours after you no longer have a fever (100°F or 37.8°C) or signs of a fever (without the use of a fever-reducing medicine, such as Tylenol).
• While sick, limit contact with others as much as possible to keep from infecting them.

We encourage you to take an active role in your health care and to partner with your doctor. The best time to protect yourself is now, before the flu season begins. Under some health plans, the flu vaccine is considered preventive care, and might be provided at no cost to you. If you have questions about the benefits, please contact Customer Care at the number listed on the back of your health plan ID card, or visit your member Website.

We help people live healthier lives.

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Can GOP repeal grandfather limits? Not likely, but it’s trying

House Republicans recently tasked three committees with writing legislation to repeal the healthcare reform law’s grandfathered plan restrictions.

Currently, for companies to hold on to their health plan’s grandfathered status — and avoid having to comply with several healthcare reform mandates — they are unable to pass much in the way of health plan costs on to their employees.

The general rule: If a plan increases co-payment levels or increases the percentage of premiums paid by participants by more than 5%, it’ll lose its grandfathered status — and that would mean having to meet new minimum medical loss ratio requirements and paying 100% of the cost for certain preventive services.

House Majority Leader Eric Cantor (R-VA) recently said the restrictions employers have to abide by to keep their plans’ grandfathered status will hurt wages and job growth.

So the House’s Energy and Commerce, Ways and Means, and Education and Workforce committees have been tabbed to create legislation to repeal those restrictions.

Looks like a long shot

Last year, a similar measure was shot down in the Democrat-controlled Senate.

And while a repeal proposal stands more of a chance in the Republican-dominated House, it’s all but guaranteed to be killed by a President Obama veto if it makes it to his desk.

So why do it?

Probably, because it keeps the wheels turning for the GOP’s main strategy: continuing the public debate over Obamacare, which the Republicans hope will erode voters’ support for Dems supporting the law.

The GOP has said all along it wants to make Democrats publicly vote to uphold the reform law’s mandates in hopes that will sway voters to its side by the 2012 elections, when Republicans hope to gain control of Congress and the White House.

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Ask the expert: Is it possible to get too much vitamin D?

By Michael W. Rosen, M.D.

Q: I keep hearing about the health benefits of vitamin D. But, isn't it also possible to get too much? 

Yes — that's right. With vitamin D, as with many other nutrients, you don't want too little or too much.

Vitamin D helps your body absorb calcium, which you need for strong bones. And, some research suggests it's good for you in other ways, too. For example, it may offer protection against some serious conditions, including cancer, diabetes, heart disease and depression.

But, again, more isn't always better. When people take vitamin D supplements at levels higher than recommended, it's risky. Over time, too much vitamin D can raise the level of calcium in the blood, which may harm the heart and kidneys.

Am I getting enough?
Whether you need extra vitamin D is a good question for your doctor. The answer may depend in part on how much you're already getting. You can get this vitamin from your diet, supplements — and the sun, as well.

Your body creates vitamin D when exposed to sunlight. It only takes about 10 minutes of sun exposure a few times a week to make enough. But, since this also exposes you to cancer-causing UV rays, some experts believe it's not a healthy way to get it.

Some foods that have vitamin D are salmon, tuna, egg yolks and a wide variety of fortified foods.

Before taking extra vitamin D — or any supplement — talk with your doctor. He or she may suggest testing your blood level to determine if a supplement is needed — and if so, in what amount. 

Nutrition news
Vitamin D is only one part of a healthy diet. For more information and the full article Click Here!

Tip Tuesday: Is it melanoma? In the know from A to E

By Tanise Edwards, M.D.

So, how well do you know the skin you're in? Being more than just a little familiar may help protect you from melanoma — the most serious form of skin cancer.

Melanoma can be deadly, but it's also highly curable when found early. In fact, the five-year survival rate for this type of cancer — before it has spread — is about 98 percent.

Catch it early!
Often, the first sign of melanoma is a change in an existing mole. When checking moles, freckles and other marks, here are the warning signs you're looking for:

A is for asymmetry — the two halves of a mole don't look the same.

B is for borders — the edges are irregular or look ragged.

C is for color — there's a mix of shades or colors.

D is for diameter — it's more than 6 millimeters, about ¼ inch, across.

E is for evolving — a mole or spot has been changing over the past weeks or months, in size or color, for example.

A few self-check tips
Try to make checking your skin a habit — some experts say you should aim for about once a month. Do your checks in a well-lit room. Use a full-length mirror, as well as a hand-held one for hard-to-see areas, such as your back. You might also want to ask a family member or friend for help.

Look everywhere, including the soles of your feet and between your toes. And, don't forget your scalp and genital area. Seeing all your skin is important.

Alert your doctor to any of the warning signs above — as well as other possible signs of skin cancer. Those include new growths or slow-healing sores — as well as any mole that bleeds, oozes, itches, flakes or that reappears after being removed.

These signs don't always mean it's cancer. But, your doctor should still check any skin changes. 

Defend your skin
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Shifting health costs to employees? 3 things to consider first

It’s no secret many employers plan to shift more costs on to employees as healthcare premiums climb. If you’re in that group, here are three things you’ll want to consider before the shifts potentially disrupt morale.

1. Employees may stop going to the doc

One thing some employers may not realize when they decide to shift some healthcare cost increases toward employees: It may lead employees to put off going to the doctor for routine checkups — or when they’re sick.

When the cost of going to the doctor goes up (whether it’s through increases in co-pays or deductibles) more people will put off routine/preventive care.

That means the short-term cost savings your company would see by shifting costs onto employees may quickly be swept away if the overall health of your workforce declines due to diminished care — resulting in more major medical claims or being placed in a higher risk pool by your insurer.

2. Wellness workers — in the long run

If you’re in the group that believes increasing out-of-pocket costs would diminish employees’ health, there is another option that can reduce healthcare costs — but it won’t help overnight: Ramp up your wellness initiatives.

Whether you increase incentives to motivate employees to participate in your wellness programs or add activities — like blood pressure screenings, cholesterol tests, or flu shots — improving the health of your employees can save you big bucks in major medical costs in the long run.

3. There are other benefits employees want

If cost-shifting is the only option, there are ways to soften the blow to your workforce.

Examples:

• Offering more voluntary benefits. Even when they’re asked to cover most of the costs, many employees look at voluntary benefits (disability, dental coverage) as being financially beneficial.
• Offering flexible spending accounts (FSAs). These can help employees put away pre-tax dollars to cover increasing healthcare costs.

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Asthma alert: Grown-ups get it, too

By William Weese, M.D.


Lately, your morning walks leave you out of breath and wheezing. Or, maybe you've been having bouts of coughing in the evening. A friend suggests your breathing troubles could be asthma. And, you think, But, doesn't that start when you're a kid?

Indeed, asthma is diagnosed most often in children. But, adults of any age can develop it, too.

4 signs it may be asthma
If you have asthma, it means your airways become inflamed and narrow. The result is limited airflow into your lungs. This can cause episodes of:

• Coughing. It may be worse at night or early in the morning.
• Wheezing. You may hear a whistling or squeaky sound when you breathe.
• Shortness of breath, which might happen when you exercise.
• Chest tightness. It may feel as if you can't take a deep or satisfying breath.

You can have just one of these symptoms and still have asthma. And, it's not the only possible explanation. Other conditions can cause similar symptoms, including:

• Gastroesophageal reflux disease (GERD)
• Angina — chest pain or discomfort that occurs when the heart doesn't get enough oxygen
• Certain lung problems

That's why seeing your doctor for a proper diagnosis is so important. Providing a clear description of your symptoms — and what seems to trigger them — can help your doctor determine the cause. You may need medical tests, as well — such as those used to measure lung function.

Why now? If you've never had breathing problems, you might wonder why you'd develop asthma as an adult. Often, allergies play a role. Even an allergy you've had for years may just now be triggering breathing problems. Or, over time you may have become sensitive to substances in your environment, which are causing your symptoms.

For example, allergens or irritants — such as mold, dust, tobacco smoke and even strong smells — may make your airways swollen and sensitive. In some people, colds or other infections can trigger asthma.

Partner with your doctor to form a plan
If you're diagnosed with asthma, it's vital that you keep it controlled. Untreated, your symptoms may get worse — and put you at risk of a severe asthma attack. This is a medical emergency and can be fatal. Approximately 3,500 people die from asthma each year in the United States — more than nine people a day, according to the Centers for Disease Control and Prevention.

Work with your doctor to create an asthma action plan. See "Plan in hand: Control is the goal!"

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Tip Tuesday: 7 stay-slim tips for social events

By Melanie Polk, M.M.Sc., R.D., F.A.D.A., and Arleen Fitzgerald, L.I.C.S.W.


Wherever groups gather, it's likely you'll find tempting food. Social eating is part of the fabric of life. But, if you're not careful, get-togethers can strain other fabric — such as that around your waistline.

This doesn't mean you need to stay home to stay healthy. For starters, before your next gathering, try adjusting your mindset a bit. How exactly? Make your first priority to enjoy the company. Your mantra can be: Friends over food!

Here are a few other ideas to curb overeating — without making it a big deal or spoiling the fun:

Scenario: You're out to dinner with friends
1. Don't get swept up by what others order. If you're familiar with the restaurant, decide ahead of time on a healthful option or two. Or, preview the menu online, if possible.

2. Savor the moment. When your food comes, try to be the last person to start eating — and take your time. To avoid overeating, consider asking for half your meal pre-packaged to go.

3. Cut liquid calories. Sip low- or no-cal beverages, such as club soda. Keep in mind that drinks with alcohol can have a lot of calories. You might even offer to be a designated driver.

Scenario: You're facing a bountiful buffet or party spread
4. Scout it out. Before dishing up, scout out what's available. Look for tasty, wholesome options that will leave you feeling satisfied.

5. Ditch the dinner plate. Choose a smaller one, if available, to help limit portions. If a large plate is the only option, reserve at least half of it for fruits and veggies. And, so you won't feel deprived: Select small portions of higher-calorie favorites.

Scenario: It's a potluck or family gathering
6. Deliver the goods. Tip the scales in your favor by making sure the dishes you bring are healthful contributions — and by eating what you bring!

7. Celebrate what's special. Maybe your mom's made her signature meatballs. Or, a certain dish is a seasonal delight. Enjoy small, but satisfying, portions of these "love it, can't resist it" items. And, pass on high-calorie foods that are regularly available — and just not as fabulous. 


Click here for the full article, Tasteful Tips and links!

Employers can play critical role in battling childhood obesity

By Lisa Gillespie August 29, 2011

With the prevalence of childhood obesity in the United States nearly tripling over the past 30 years, now is the time for employers to take the lead in the battle against the growing problem of overweight and obese children, according to the National Business Group on Health.

Obesity is a growing epidemic affecting children, their families and the nation. The United States currently has the highest percentage of overweight youth in its history. More than one-third of children in the United States are considered overweight or obese, leading to increased health risks, higher health care costs and decreased parental productivity at work.

“Child obesity is impacting employers today and will into the future as these children become the workforce of tomorrow,” says Helen Darling, president and CEO of NBGH, whose members include 329 large U.S. employers. “Parents have an enormous impact on the childhood obesity epidemic. The good news is that employers can play a critical role in fighting the childhood obesity epidemic by helping families develop healthy lifestyles at work and in the home. In fact, a number of forward thinking companies are already leading the charge.”

A recent survey of 83 of the nation’s largest companies conducted by the National Business Group on Health identifies the following programs employers have in place to help fight childhood obesity:

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Endangered species: 21 employee benefits

August 31, 2011 by Christian Schappel

More than three quarters of HR pros say their benefits offerings have been hurt by the slumping economy, found a recent study. Which benefits have taken the biggest hit?

The following list — based on a survey off 600 HR professionals by the Society for Human Resource Management (SHRM) — was recently published by U.S. News & World Report.

In alphabetical order, here are 21 benefits the SHRM survey found to be disappearing from U.S. workplaces since 2007:

1. Adoption assistance
2. Casual Dress Day
3. Company picnics
4. Contraceptive coverage
5. Executive club memberships
6. Health maintenance organizations (HMOs)
7. Home ownership assistance (this includes mortgage assistance and down payment assistance)
8. Incentive bonus plans (this includes executive bonuses)
9. Legal assistance
10. Life insurance for dependents
11. Long-term care insurance
12. Paid family leave
13. Professional development opportunities
14. Relocation benefits
15. Retiree healthcare coverage
16. Rewards for job tenure and performance
17. Sports team sponsorship
18. Take Your Child To Work Day
19. Tickets to sporting events and theater performances
20. Traditional pension plans
21. Travel benefits

For more information, stats on how quickly these benefits are being phased out and the complete article Click Here

Tip Tuesday! Use of wellness penalties growing: 2 ways to keep ’em legal

August 30, 2011 by Christian Schappel

Wellness programs are “in” for employers – and so are penalties for workers who make unhealthy choices.

Over the next three to five years, 73% of employers said they’ll offer a wellness program and tie incentives or penalties to it to motivate their employees to make healthy choices, found a 2011 Aon Hewitt survey.

Carrot v. stick

Currently, the penalties appear to be getting a stronger foothold in companies’ wellness strategies.

Reason: Many businesses have found in their wellness programs that people are more motivated by the risk of losing money than gaining it.

How many companies operate under that belief? Here’s a rundown compiled by a 2010 Aon Hewitt survey:

• 64% of employers impose or plan to impose penalties for smoking
• 50% for not taking part in disease management/lifestyle behavior programs
• 45% for not participating in biometric screenings
• 25% for not consulting with health coaches, and
• 17% for not making biometric improvements, like lowering blood pressure or losing a set amount of weight.

2 things to remember

When it comes to offering incentives or penalties, there are two things employers need to remember to avoid breaking the law:

1. The size of any incentives or penalties in a wellness program can’t exceed 20% of the total cost of health coverage for employees (in 2014 that limit will be bumped up to 30%, thanks to the healthcare reform law), and
2. If an employee is unable to earn an incentive — or avoid a penalty — due to a health condition, the wellness program must create an alternate way for that employee to do so.

EEOC clarifies stance on using medical history in wellness programs

August 19, 2011 by Christian Schappel

Many companies have been operating wellness programs under the belief that when a participant’s medical history is used, no incentives/penalties can be tied to the program. Now th

e feds are saying that’s not the case.

In a recent informal guidance letter, the Equal Employment Opportunity Commission (EEOC) says employers and other entities covered by the Genetic Information Nondiscrimination Act (GINA) …

“may use the genetic information voluntarily provided by an individual to guide that individual into an appropriate disease management program.”

As far as incentives go:

“If that program offers financial incentives for participation and/or for achieving certain health outcomes, the program must also be open to employees with current health conditions and/or to individuals whose lifestyle choices put them at increased risk of developing a condition.”

This is good news for employers. It means you can collect genetic info (a.k.a., family medical history) and use it to help employees improve their health.

The catch: It has to be done on a voluntary basis. Employers must first obtain written authorization from a plan participant before requesting the individual’s genetic information.

In addition, while individualized genetic information may be provided to an individual receiving health services — and to his/her service providers — employers can only obtain genetic info in aggregate form (meaning it must be lumped together with other individuals’ info and not reveal the identity of specific participants).

Finally, employers cannot offer any financial inducement (rewards/penalties) for individuals to provide genetic info.

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