Posted by Jamie Rivard on Mon, Apr 25, 2011 @ 03:36 PM
Our online broadcast with WLKF's radio show Real Success was a success. Please feel free to listen to the broadcast.
http://wlkf.com/client-data/shows/successfulimage.aspx
Posted by Jamie Rivard on Mon, Apr 18, 2011 @ 10:51 AM
Tomorrow April 19th our very own Mike Martens will be a guest host on WKLF Talk 1430 AM's Tuesday show, Real Success Radio. The program is a weekly production and showcases local successful individuals sharing their insight on personal success and the success of their business.
The topics to be covered will be Health Care Reform and how it affects businesses and the consumer. There will be discussions on questions people have regarding new laws in place and why it is important to make sure your employees understand their benefits.
Tune into WKLF 1430 AM or wklf.com and click on schedules then scroll down to real success and click to listen.
We are excited and look forward to your comments, questions or concerns.
Posted by Jamie Rivard on Tue, Mar 08, 2011 @ 09:27 AM
The media has declared that the “mini-med” is dead! DON’T BELIEVE THAT FOR ONE MINUTE! Affordable health care plans for seasonal, part-time and traditionally non-benefit eligible employees exist and thrive under health care reform. We all know how expensive major medical insurance is and that it’s simply unaffordable for hourly employees. We have access to a major national carrier that is writing limited medical plans that are unaffected by PPACA. We can enroll your employees and have coverage in place almost immediately through an insurance carrier that is a household name. If you would like to learn more please let us know.
Posted by Jamie Rivard on Tue, Feb 22, 2011 @ 04:00 PM
One of the positive aspects of health care reform is that it has forced employers to evaluate their employee benefit programs on a consistent basis. No more planning 60 days out from open enrollment. In addition, the need to communicate changes and rules to employees are now mandatory. So you ask, how do we get started?
Learn how to communicate with your employees. That’s different from telling them something or sending out emails. Effective communications is both a function and a practice. Have you surveyed your employees and asked how to most effectively communicate? That might be a good starting point. As a company, you are spending 40% or more of your payroll on benefit cost. Are you also taking the next simple step of effectively communicating those benefits? A study done by Colonial Life shows that only 21% of employees fully understand their benefits.
Revisit the value of 1 on 1 meetings with employees. If you can logistically make this happen, you absolutely should. In this post-reform era of increasing deductibles and out-of-pocket cost to employees, they deserve to understand what their personal financial liability is and how the effective placement of voluntary benefits can reduce that risk. You just can’t communicate that in an email or newsletter. Allegiance Health Care in Jackson Michigan utilizes one on one meeting with their employees regarding their benefits. In fact, the meetings aren’t even mandatory, yet 80% of their employees attend.
Posted by Jamie Rivard on Fri, Jan 14, 2011 @ 12:31 PM
RISING DEDUCTIBLES COULD CAUSE “STICKER SHOCK” AT TIME OF SERVICE. As almost every group health insurance plan has or is going to face a price increase, employers are looking for ways to stabilize annual increases and maintain benefits. One of the more common methods to reduce overall premium cost is to increase deductibles and/or copayments. Many plans are able to retain copayments for doctor office visits and pharmacy, but are dropping copayments associated with out patient testing and diagnostics. This has led to a practice in the medical community that can be very disturbing to employees covered under group insurance plans as well as individuals who have been forced into the high deductible market due to premium affordability. What is happening is the way that contracted providers have been allowed to collect for services.
A classic example of this would be the person who has been scheduled to receive an MRI at a contracted provider under their insurance plan. If there is no copayment for this service, many times the individual will be asked pay the contracted rate at time of service. The practice in my area is to call the patient 24 to 48 hours prior to the appointment, to both confirm the appointment time and date and let them know that they will need to bring $1,000 (using the MRI as an example) with them to pay for the service. The provider indicates to the patient that they have received the contracted rate from the insurance carrier and this is the amount that will be due for the service. If you have a fully funded HSA, this is no big issue as you would swipe your HSA debit card and go on your way. If not, the insured is now in the position of dealing with the stress of the diagnostic test and it’s outcome, as well as having to find a large sum of money in a very short time to pay for the service in advance.
There are two reasons this really rubs me the wrong way. First, is the historical perspective. We have all received medical services, then the provider files the claim with our insurance company and we pay the balance due to the provider when we receive our Explanation of Benefits from our insurance carrier. As an insured, this has always been the process and therefore is the expectation for the majority of individuals. In an effort to protect their bottom line, certain providers in the medical community feel that it is OK to request payment in full at time of service. Most network contracts allow this practice, however it certainly would be more professional and ethical to indicate to the patient AT THE TIME THE APPOINTMENT IS MADE that payment in full is expected at the time of service. I can assure you, that in the vast majority of cases, the referring physician is not aware that this practice is occurring.
It is now imperative that you educate your clients on this practice and make sure that if they are sent for services that are deductible eligible and their deductible has not been met, they could be asked to bring the amount that will be due with them. If the testing is in a non-emergency environment, many times the insured can avoid this pre-payment foolishness by simply going to a network directory and finding a provider that has not adopted this practice.
Posted by Jamie Martens on Tue, Dec 14, 2010 @ 01:25 PM
My Pants are on Fire….Again
At the time of this writing, it is once again open enrollment season. All across this great country of ours HR and Benefit Professionals are hard at work trying to figure out how to minimize rate increases, communicate changes in plan design attributed to either health care reform or “cost controls” and stress levels are through the roof. Every HR and Benefits Department is trying to do more with less and positively communicate the changes that will take place after the first of the year to all aspects of their benefit programs. Calm down. Come up to the surface and take a deep breath…after all, this panic and stress, by and large, is really your own fault. I realize that you are likely steaming right now over that last comment, but hang with me and let’s take a moment to analyze the entire situation.
Benefit planning, strategy and communication are a process…not an event. How many of you (be honest!) look at your employee benefit plan strategically as a company asset? If you do, you are planning and developing a multi-year benefit strategy with contingencies that allow you to anticipate and communicate change in a positive way. In addition, you are focused through out the year on a strategy that allows you to identify how to best communicate to your employees about the value their benefits provide. Are you really satisfied with the communication strategies that you have in place to promote programs that you know will have a positive impact on your employee’s health and the bottom line of your benefit program?
The key to the castle is finding the time to do all of the above. You are likely in a situation where you feel that completing this weeks tasks is a challenge. In today’s economy, there are very few companies that have either the personnel or capital to be where they would they would like to be so far as benefit strategy. The good news is that, in many ways, health care reform has made strategic planning and communication a requirement and not a luxury. So, how do HR and Benefit Professionals get to where they need to be considering the restrictions of the corporate environment in which they reside? Here are some tips:
Begin the process of defining what your corporate goals for both budget and plan designs are going to be at least eight months in advance of your renewal. Think through and analyze your human capital needs and goals for at least the next two years. My crystal ball is no better anyone else’s, but take into account what you know about your business and industry, growth patterns, access to business capital and market fluctuations that pertain to your specific industry. Keep in mind how changes to your benefit plan design will be received by your employees. Utilize part of your strategy to analyze specific voluntary benefits that can be truly effective in controlling the employee’s financial exposure. Voluntary benefits can play a key role if they become part of your planning strategy. If you approach this as a process and not an event, you will find that small time commitments that are scheduled and planned pay huge dividends over time.
If you don’t have a good grasp on how to effectively communicate with (not to) your employees, set a goal to accomplish that within the next six months. Your planning should involve making sure that you are in tune with how your employees want to receive information. So many times, the failure in effective communication centers on the media method that was used. Look at factors like the age and gender of your employees, what internal communication tools you have used effectively in the past as well as those that did not work so well. This also includes the type of media that you are going to use to reach your employees and their dependents. Don’t forget that a reasonable portion of the risk that you carry in your employee benefit program is on the shoulders of your employee’s family members. Don’t be afraid to use the age old survey and even develop a focus group within your company to help answer some of these questions. With the right template, developing an effective communication strategy isn’t that complicated to implement!!
Here is the best news of the day! All of the above can be accomplished within the timeframes outlined without a huge fee to an outside consultant. How you ask? Are you already concerned about the time commitments outlined above? Again, relax. This one is not your fault! One of the positive aspects and outcomes of health care reform is that employers now have to look at their employee benefits from an entirely different angle. Planning and strategy processes have been moved to the front page and are now mandatory based on the changes the benefits landscape faces over the next three years. Seize the opportunity to work with your benefit professional now to both develop a benefit and communication strategy that will allow you to anticipate not only the changes to your core program, but how you can effectively communicate those changes to your employees. After all, wouldn’t life be a whole lot easier if you could make your open enrollment process just another company event?
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Posted by Jamie Martens on Tue, Nov 16, 2010 @ 01:55 PM
You will now be able to change your insurance company and maintain the “grandfathered” status of your health plan. Although this ruling does not apply to individual market policy holders, it does apply to group plans. The ruling basically says that group health plans may shop for coverage at a lower cost in an attempt to maintain current benefit levels. Plans must however still abide by the rulings that apply to lifetime limits on coverage, dependent children, annual limits and policy rescission. The action is due to a concern by HHS, Labor and the Treasury that incumbent insurance carriers might attempt to use the “grandfathered” status as leverage for renewal underwriting.
Posted by Jamie Martens on Tue, Nov 09, 2010 @ 01:18 PM
HR & Benefits Update: Do you know how the Medical Loss Ratio ruling of health care reform WILL impact your business?
Part of the health care reform legislation that goes into effect on January 2, 2011, is a sub section that requires insurance carriers to prove that a fixed percentage of premium dollars are used to pay medical claims. This ruling leaves the carriers with a defined amount of premium that can be allocated to administrative services, including client customer service. Your consultant’s commissions will be affected by this ruling. If the insurance companies reduce their internal customer service staff and your consultants commissions are reduced, what happens to your employees that need assistance with insurance issues? Many consultants hire internal agency staff to help you and your employees. Will reduced commissions lead to the termination of these employees? Are you willing to begin to pay a fee to your consultant to help cover the cost associated with this service? What planning or discussion have you had with your consultant concerning this issue?