• Inflation Allowances don’t allow much hope – your cost exposure has increased again

    July 17, 2019


    Under the Affordable Care Act, carriers are allowed to amend their plan designs each year under an inflation factor to keep their “exposure” constant,which means that the exposure for the patient will increase to also keep his exposure constant.  For 2020, the out-of-pocket maximum allowed is $8,150 for individual coverage and $16,300 for family coverage.

    When CMS announced these new limits, they also said that starting in 2020 plans are permitted, but not required, to exclude drug manufacturer coupons from counting toward a covered person’s annual out of pocket maximum IF a medically-appropriate generic drug is available.

  • How can you save for retirement when debt is a current reality? Study of 401(k) plans vs. Student Debt Paydowns show that millennials prefer the latter

    July 15, 2019

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    Of the recent college graduating class, nearly 70% took out some form of student loans, and the average student debt upon graduation is $29,800.  The total student debt equates to about $1.5 trillion spread out among 44 million borrowers.  At least the unemployment rate is low.

    Concern about debt will make it difficult for employees to participate in a 401(k) plan, so employers are starting to look at setting up a student loan repayment program.  There are some innovative ideas being put forward that even allow some of the repayment to be treated the same as a 401(k) contribution.

  • Is Wellness Doing Well Even When It is a Good Idea?

    July 10, 2019



    The evidence has always been anecdotal.  The evidence has also sometimes been pointed in the right direction, but not the direction researchers want to see – they want to see proof that participation in wellness programs actually improves blood pressure, sugar levels, etc.

    The latest “downer” is a report by the Journal of the American Medical Association (JAMA), which looked at the experience of 33,000 employees at BJ’s Wholesale Club over a year and a half.  The findings were that, despite exercise and weight watching, the employees experienced no significant long-term outcomes like lower blood pressure or improved sugar levels.  This adds to the recent Illinois Workplace Study, which also questioned the value of workplace wellness programs.  Proponents, of course, say that the JAMA study did not focus on enough variables, that not all programs are the same, and that education is not sufficient, especially given the often-irrational behavior attributed to everyone that can also defy measurement.


    So what happens to all the dollars spent on FitBits, Apple Watches and all the other buddy systems we need to keep us healthy?  It will require more research!

  • Of course, retirement doesn’t look good when you don’t have any savings

    July 8, 2019

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    The reports and the anecdotal stories of bankruptcy are piling up.  Some are blaming the Affordable Care Act, some the insurance carriers, some simply the high cost of medical care and of course the employers for cutting back on the level of coverage they provide (when they are not cutting back the amount they allow for premium payments).  In a new report titled “The US Healthcare Cost Crisis,” which surveyed more than 3,500 adults, it was estimated that seniors have pulled an estimated $22 billion from their long-term savings for healthcare-related expenses, an average of $3,789.  Major findings from the report are:


    10% of those 65 and older did not seek needed treatment in the past year due to cost

    About 7 million seniors could not afford to pay for prescriptions in the last year

    80% of the prescriptions that seniors can’t afford are used to treat serious conditions

    92% of seniors believe the cost of healthcare will not improve or will get worse

    45% are afraid they will have to file for bankruptcy if faced with a healthcare crisis

  • Failing to Save with No One Left to Save them if they Fail – 401(k) is up but not enough

    July 3, 2019

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    Almost half of Americans approaching retirement have nothing saved in their employer sponsored 401(k) or an individual account.  If there is any good news, this number has improved over a few years earlier.  Still, of those 55 or older, 48% had nothing put away, according to a recent GAO estimate.

  • Telemedicine Virtually Getting Better

    July 1, 2019

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    Doctors on Demand, currently the largest virtual care provider, has announced the launch of Synapse, a first-to-market and fully-integrated platform that can integrate into health plans’ existing networks and provide patients with improved access to full mind and body care.  Thus they will have “digital medical home” expanded clinical capabilities and “smart referrals.”

  • Moans and Groans: About Student Loans

    June 28, 2019

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    The statistics are startling:

    • The total burden of student debt in the United States is $1.4 trillion.
    • In 2017 the median millennial wage was $43,000.
    • In the same year, the median millennial debt was $37,000.
    • 59% of employees 22 to 44 have student debt.

    Debt is the #1 financial challenge to all Americans, and by a wide margin. This lack of fiscal health has a negative effect on both mental and physical health, both of which affect employee performance and motivation.

    In a time of reduced unemployment, the battle for talent and its retention is increasing. How do we get quality employees? What can we offer to keep them? If they stay, how can we help maximize appreciation and thus loyalty? The simple answer is to offer a meaningful compensation and benefits package. The more relevant, and complex, answer is to address specific employee needs and thus create a more meaningful employee experience.

    Medical and retirement may be a given, but how valued are those benefits if debt prevents participation or forestalls fulfilling medical needs? Do employees even know the risks of refusal? What will they deny themselves later by not attending to their long term wellbeing?

    Greater attention is thus being paid to employee education in the basics of finance, while offering products, tools, and services under the rubric of “financial wellness.” One of the key components of such a program is instruction in debt management. New offerings in the student loan sector allow employers to go even further.

    Paying off debt is expensive, with the “load” exceeding the interest earned on savings and potentially the tax and accumulation value of a 401k or other retirement instruments Thus, finding a way to alleviate the stress of a financial burden paves the way to take advantage of a significant savings opportunity.

    A burgeoning cottage industry has developed to help those with student loans, primarily through the channel of employer sponsorship. These services offer:

    • Employer payments to employees to reduce loan balances

    (example – PwC gives employees $100 per month for up to 72 months).

    • Access to lenders who will refinance the loan.
    • Education and counseling, not just on existing debt but how to finance a child’s college education (e.g. using 529 plans).

    For a modest fee, these companies expand the resources for employees, streamline services, help reduce debt, and also create a simplified method of repayment through payroll deduction.

    Various studies have cited:

    • 61% of employers polled said they believe student loan worries have hampered retirement plan participation.
    • 81% of millennials, and 65% of those over 50, want their company to offer student loan tools and resources.
    • A similar percentage of both populations would be more inclined to accept employment with a company that offered student loan tools – or stay with a company if they received student loan benefits.

    Granted, specific studies are skewed to favor the sponsoring student loan services, but there is little doubt that student loans place financial, and thus mental and emotional, stress on employees. Just ask them – and then ask how you can help. The more you can offer, the more appreciative they will be. Recognition and appreciation of a benefit’s value is the cornerstone of a successful compensation and benefits program, after all, so now is a good time to see how you can expand yours in a meaningful way.

  • Tech Wreck Puts Brokers on Deck

    June 26, 2019

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    Clover Health, which is backed by Alphabet (Google), is a major play for the Medicare Advantage market, but the company just laid off 140 tech employees in favor of beginning to hire those with a background in health insurance and clinical care.

  • States May be Given More Responsibility, but some are Taking it now

    June 24, 2019

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    Virginia has become the first state to require that health insurers count coupons for prescription drugs and copayments as applying to health plan deductibles.  Fair Health Care VA, an advocacy group, said “patients should not be denied one of the key benefits of copay assistance programs, particularly since insurers are already getting the value of negotiated drug price discounts while withholding these benefits from patients.”

  • Connecting Agility, Culture and Change Management

    June 20, 2019

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    Every company wants to lead their industry, and doing so means remaining competitive. With the rate of speed the world experiences change in this age that is a very difficult proposition. For an HR professional, it is increasingly more difficult to stay ahead of the curve.

    So, what are the critical pieces to the strategy?
    • Agility
    • Change Management
    • Culture
    Knowing that, how do the three concepts tie to one another?

    We start with agility.

    When it comes to this part of the strategy, what HR professionals really want is to be able to adjust at a moment’s notice. But it’s not enough to just be able to make the change. The HR professional wants to effectively implement the change in the organization.

    Of course, that change doesn’t just happen at the drop of the hat. It requires leadership and even some maintenance.

    That’s where change management comes into the mix. HR Exchange Network contributor John Whitaker says:
    “Change can and will come quickly. Change management is a helpful (and sometimes hopeful) way to plan the actions and responses needed during a change process. But you must take advantage of those times where you are thrown into a chaotic situation without the benefit of planning.”

    Finally, that brings us to culture.

    In addressing this concept, CultureIQ worked with Bloomberg to survey 300 senior executives about the Future of Work. In that research, one of the first things they learned is work is becoming more complex. How? Consider first that companies are becoming more agile either by force or organically. Executives know they have to do this in order to remain competitive. Optimizing a talented workforce, predicting talent needs and keeping retention rates high are critical to sustaining your organization’s competitive advantage.

    In fact, CEOs recognized that one of the most important factors in their organization’s performance for the next three years was ensuring their organization was agile.

    CultureIQ says agility ranked higher than other attributes like collaboration, engagement, or innovation.
    A company’s culture is imperative to its strategy especially when you consider this fact: culture influences whether talent is attracted or not attracted to the company. It’s also significant in the company’s ability to retain their best employees.

    According to Gallup, 4 in 10 U.S. employees strongly agree their organization’s mission and purpose makes them feel their job is important. Furthermore:

    “By doubling that ratio to eight in 10 employees, organizations could realize a 41% reduction in absenteeism, a 33% improvement in quality, or in the case of healthcare, even a 50% drop in patient safety incidents.”
    Gallup has studied organizational culture and leadership for years. They find some organizations have difficulty in successfully establishing their “ideal” culture and attribute that to the fact that culture is constantly in flux and is not the same one moment to the next.

    Earlier this year, researchers looked specifically at how HR leaders fit into the process of changing culture.
    “Our analytics show that in the world’s highest performing organizations, HR leaders play a central role in creating and sustaining the culture their organization aspires to have. As the stewards and keepers of the culture, HR leaders are responsible for inspiring desired employee behaviors and beliefs — and in turn, realizing the performance gains of a thriving culture.

    By owning their pivotal strategic and tactical roles in shaping work culture, HR leaders can cultivate exceptional performance and prove to senior leadership that they deserve a seat at the table.”

    For HR, Gallup set forth three roles that explain how leaders influence culture.
    1. Champion – Executive leaders create the vision of the perfect culture, but HR leaders champion it. They are responsible for turning words into deeds.
    2. Coach – HR leaders, as coaches, make sure managers and employees are on the same page and help the two entities take ownership of the culture.
    3. Consultant – HR leaders here consistently check culture metrics such as employee engagement, customer outlines and performance indicators. In this way, HR leaders can make sure the culture strategy stays on track.

    By Mason Stevenson
    Originally posted on

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