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Free Telehealth Restored Under HSA Until 2023

Free Telehealth Restored Under HSA Until 2023

Free Telehealth Restored Under HSA until 2023

Effective April 1, 2022, high-deductible health plans can once again offer first-dollar coverage for Telehealth and other remote services without making participants ineligible for health savings account (“HSA”) contributions.  The relief runs only through the end of 2022. This relief allows individuals with High Deductible Health Plans  (“HDHPs”) to receive free telehealth services prior to the satisfaction of their minimum deductible and remain eligible to make Health Savings Account (“HSA”) contributions.

Background

Individuals may contribute to an HSA if they are covered by a qualifying HDHP and do not have other disqualifying coverage. Generally, telehealth or other remote health care services are considered other health care coverage that, if provided before satisfaction of the required deductible, may be disqualifying for purposes of contributing to an HSA. 

The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) were signed into law on March 27, 2020. Among other things, the CARES Act offered temporary relief related to telehealth and other remote care services when offered with an HDHP and HSA. Specifically, for plan years beginning on or before December 31, 2021, telehealth and other remote care services could be offered before satisfaction of the deductible without jeopardizing an individual’s eligibility to contribute to an HSA.

Employer Action

Employers offering HDHPs with HSAs should consider whether to re-implement (or continue) free telehealth as part of a benefit offering. Employers with calendar year plans may 

have already re-introduced a cost associated with telehealth for HDHP/HSA participants once the CARES Act relief expired and should consider whether to waive those costs again given the temporary nature of this relief. Additionally,  employers with non-calendar year plans should consider the administrative and communication burdens that may be imposed by providing relief that may expire prior to the end of the current plan year. 

It is important that employers review these changes with their carriers, Third Party Administrators and telehealth vendors to understand their approach and communicate any changes with participants.

Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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4 Strategies for Reducing Health Benefits Costs in 2022

4 Strategies for Reducing Health Benefits Costs in 2022

4 Strategies for Reducing Health Benefits Costs in 2022

Health care costs continue to rise each year, and 2022 will likely be no exception. In the new year, experts predict a 6.5% increase in medical expenses alone, according to Pricewaterhouse Coopers. In terms of health plan premiums, employers anticipate they may rise more than 5% in 2022, a Willis Towers Watson survey reports.

With these increases in mind, employers will want to strategize methods to rein in benefits spending. This article offers four ways to help.

 1. Alternative Plan Modeling

One common method for reducing benefits costs is to increase employees’ share of expenses. This could be done directly through premium increases, but that might generate more problems for an employer; after all, many employees are still struggling financially and are ready to leave their jobs for better benefits options thanks to the COVID-19 pandemic.

Considering this, a more careful approach to lowering expenses may be through alternative plan modeling. Instead of a traditional health plan, employers can think about other plan designs that can still benefit employees without excessive costs. Plan modeling alternatives include:

  • Consumer driven health plan models—High deductible health plans with savings options attached
  • Self-funding models—Health plans funded and managed by an employer rather than a carrier
  • Reference-based pricing models—Self-funded health plans with set spending limits on shoppable services
  • Level-funding models—Self-funded health plans where an employer pays a set amount to a carrier for claims, the remainder of which is refunded at the end of the year if there is any leftover

Each of these plan modeling alternatives has advantages and disadvantages, depending on an organization’s unique circumstances. Employers should reach out to World Insurance Associates, LLC to learn more about the potential of these and other plan models.

2. Health Care Literacy

Improving health care literacy for employees has seen a significant push in recent years. The idea is that if employees better understand their health care options, they can save money and improve their overall well-being.

Even limited health literacy can go a long way toward keeping health costs down in 2022. Arming employees with questions such as “How much will this cost?” and “Can I be treated in an equally effective but less costly way?” can help them take better control over their health choices and make wiser decisions. Further, employees should also be taught basic concepts such as when to visit an emergency room versus an urgent care, the difference between coinsurance and deductibles, and how to price shop for services.

Ultimately, the more educated employees are about health care topics, the more money they can potentially save. In other words, the education employers invest in now will pay for itself later through healthier employees and reduced health expenses.

 3. Telemedicine Solutions

Telemedicine allows consumers to visit their doctor over the internet. Unsurprisingly, that made it extremely popular during the height of the COVID-19 pandemic.

And that popularity isn’t likely to go away in 2022. Rather, more businesses are likely to shift toward offering more telemedicine options. According to McKinsey and Company, only 11% of U.S. consumers utilized telemedicine in 2019, pre-pandemic. As of mid-2021, 46% of consumers were using telemedicine to replace the in-person health visits they had originally planned. Additionally, 76% of consumers said they were interested in using telemedicine going forward, according to a separate McKinsey and Company survey.

Employers who want to test out telemedicine capabilities can think about offering it in a limited capacity. For instance, an employee might see a doctor in person for an annual checkup, then follow up later with a virtual visit. If employees find this useful, employers can consider expanding their telemedicine offerings.

 4. Staffing Needs – On-Boarding and Terminations 

A minimum 75% of PPP loans must be spent on staffing costs.  Companies that had previously furloughed or terminated employees find they need to hire employees back. This comes with additional paperwork and many employee questions, such as whether benefits wait periods start over. 

Conversely, when businesses do need to furlough or terminate employees, the PEO is a great guide for compliance. The layoff process, COBRA,  paperwork including givernement reporting are supported. 

5. Prescription Drug Policy Revisions

Partnering with a PEO is much like gaining access to a full-service HR division, with a team of HR experts who are up-to-date with new and changing employment laws and able to identify ways to streamline your HR.

According to a report conducted by the National Association of Professional Employer Organizations (NAPEO), PEOs provide access to more HR services at a cost that is close to $450 lower per employee, compared to companies that manage their HR services in-house. 

 Studies show that businesses in a PEO arrangement grow 7-9 percent faster, have 10-14 percent lower turnover, and are 50 percent less likely to go out of business.

 6. Affordable and Better Benefits

By joining a large group risk-pool a a PEO can help employers gain access to high quality employee benefits, such as health insurance options with stable and affordable rates. Due to costs, small businesses often find high-quality employee benefits out of reach.  The savings on health insurance alone can pay for the PEO itself.  

Summary 

There are many approaches for controlling benefits spending, but not all will work for each organization. That’s why it’s important for employers to closely analyze their health plan data and assess where they spend the most. This will help inform strategy and allow employers to maximize their efforts.

Reach out to World Insurance Associates, LLC to discuss cost-saving strategies that will fit your unique workforce. If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

Health Insurers Cover Home COVID-19 Tests

Health Insurers Cover Home COVID-19 Tests

Starting January 15 at-home CIOVID-19 tests will be free of charge. This order was issued last week Biden-Harris Administration Requires Insurance Companies and Group Health Plans to Cover the Cost of At-Home COVID-19 Tests, Increasing Access to Free Tests.

Free At-Home COVID-19 Test available via USPS. On Jan. 18, every home in the United States can order up to four free COVID-19 tests. January 19, Americans will be able to order free at-home rapid COVID tests from the government at COVIDTests.gov.

The federal guidance requires commercial insurers and group health plans (both fully insured and self-insured) to reimburse consumers for the cost of Over-the-Counter (OTC) COVID-19 diagnostic tests, with or without an order or clinical assessment by a healthcare provider.

Types of COVID Tests:

  • Antigen tests, which test for an active infection by detecting specific virus proteins. Most at-home tests and “rapid tests” performed by healthcare providers fall in this category.
  • Molecular tests, which test for an active infection by amplifying genetic material from the virus. These are considered the “gold standard” for diagnosing COVID, as they are generally more accurate than antigen tests. The most familiar test from this category is the polymerase chain reaction (or PCR) test, which requires lab processing. 
  • Antibody tests, which are blood tests that determine if the body has had an immune response to the virus. These tests are not used for diagnosing an active infection.

How Will this work with your Insurer?

Consistent with the guidance Insurers will utilize existing member claims submission procedures to provide benefits without cost-share for OTC COVID-19 tests that members purchase, either online or through other retailers. In addition to the member demographic information that is normally filed with member-submitted claims, the members will be required to certify that the test was purchased for personal use and not for employment purposes.

Customers may receive reimbursement for up to 8 COVID-19 OTC tests per covered individual per calendar month without a health care provider prescription or individualized clinical assessment. For a family of four covered individuals, that equates to 32 tests per month.

Members with Empire Blue Cross, for example, will utilize A.I. apps such as Sydney App or online.  Separately, Insurers such as UnitedHealthcare will initially offer for at-home COVID-19 tests are Walmart Pharmacy and Rite Aid Pharmacy. When using Walmart or Rite-Aid there will be no up-front cost and you will not have to submit a form for reimbursement. Note, you may be required to go to the pharmacy counter to obtain the test kits at no cost.

Note, only tests that are FDA approved and sold by an authorized reseller are eligible for reimbursement. For updates, go to Approved COVID-19 Home Tests | NC COVID-19 (ncdhhs.gov).

Insurance Resources:

Aetna

CIGNA

Empire BlueCross / Anthem

Halthfirst

Horizon Healthcare NJ

Oxford/Unitedhealthcare

If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

Winter Action Plan to Battle COVID-19

Winter Action Plan to Battle COVID-19

On December 2, 2021, the Biden administration issued a nine-pronged plan to combat COVID-19 as the winter months approach and the new Omicron variant poses risk of new infections. The plan covers:

1. Boosters for adults

2. Vaccinations to protect children and keep schools open

3. Expanded free at-home testing

4. International travel protections

5. Workplace protections

6. Rapid response teams to battle rising cases

7. Supplying treatment pills to help prevent

hospitalizations and death

8. Continued commitment to global vaccination efforts

9. Steps to ensure preparation for all scenarios

Aspects of this plan will affect employers and group health plans, as follows:

Expanded free at-home testing. The Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) are directed to issue guidance by January 15, 2022, to clarify that individuals who purchase over-the-counter (“OTC”) COVID-19 diagnostic tests can seek reimbursement from their group health plan or health insurance issuer to cover the cost of the OTC test during the public health emergency.

The plan notes that consistent with current guidance, group health plans are not required to cover testing for public health surveillance or employment purposes.

PTO for booster shots. While all federal employees currently receive paid time off to get booster shots,  employers are called upon to provide the same paid time off for their employees, if they are not doing so already, including paid time off for family members getting their first, second, or booster shots.

Targeting outreach to Medicare beneficiaries. CMS  is launching an initiative to get Medicare beneficiaries booster shots. CMS will be sending all Medicare beneficiaries a notice providing information on access to booster shots in their community as well as emails.

Protecting Workplaces to Keep Businesses  Open. The administration is calling on businesses to move forward with requiring their workers to get vaccinated or be tested weekly. No new guidelines or requirements are part of this provision. The emphasis on encouragement is likely in response to the ongoing legal challenges to the federal vaccine mandates.

Currently, the courts have issued an enforcement stay with respect to the OSHA Emergency Temporary  Standard (“ETS”), applicable to private employers, and a nationwide preliminary injunction with respect to both the CMS interim final rule applicable to health care workers and the federal contractor mandate.

Future guidance is expected to clarify and implement the provisions outlined in this plan. We are monitoring this information and will report on developments.

 

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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5 Tips to Staying Healthy During Flu Season

5 Tips to Staying Healthy During Flu Season

You can get ahead of cold and flu season by embracing a few habits that can help support a healthy immune system. 

Plus, boosting your natural immunity doesn’t have to be time-consuming or expensive. 

You may be doing some of these things already. If not, take baby steps to build new habits, because trying to do too much too soon may lead to frustration. 

What steps can you take to fit these five tips into your life?

1. Get a good night’s rest. 

Like stress, sleep deprivation can reduce the effectiveness of your immune system and lead to a longer recovery time if you do get sick. 

Practice good sleep habits like putting away your devices before bed and creating a wind-down routine to help you relax.

2. Watch your stress levels.

Stress can weaken your immune system, making it harder to fight off a cold or the flu. Try practicing stress-reduction techniques such as daily meditation or breathing exercises.

3. Keep your hands clean. 

Wash your hands often, especially when entering or leaving public places or touching surfaces. Cleaning your hands with soap and water for at least 20 seconds can be the best way to remove germs. When that’s not possible, use a hand sanitizer with at least 60% alcohol.

4. Stay active. 

Exercise can help alleviate stress and support your immune system — and physical activity doesn’t have to be intense to make a difference. To get started, you can try taking a daily walk or practicing gentle yoga poses.

5. Focus more on nutrition.

A healthy diet supports a healthy immune system. In addition to the supplements, you may already take, try to eat foods rich in vitamins and minerals, such as:

  • Citrus fruits
  • Spinach
  • Green tea
  • Shellfish

 

Cleveland Clinic:  We’re now several months into the coronavirus pandemic, and we’re also fast-approaching peak season for yet another viral illness: influenza. Infectious disease specialist Kristin Englund, MD, explains the differences between COVID-19 and the flu, and shares steps we can all take to help us stay healthy this flu season. 

 

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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OSHA Issued COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS)

OSHA Issued COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS)

CMS and OSHA released interim final rules this week detailing the implementation of national vaccine requirements established by President Biden’s executive order in September.Yesterday, the Department of Labor released an unpublished version of the OSHA Emergency Temporary Standard (ETS).

 The ETS is effective immediately and will cover 2/3rds of private employers. The OSHA ETS puts into effect the Biden Executive Order mandating all private employers with 100 or more employees ensure their employees are vaccinated against COVID-19, or submit negative weekly tests.

KEY Summary:

Covered Employers

    • Private employers with 100 or more employees enterprise-wide (across US locations) at the time these rules become effective
      • Independent contractors not included
      • Special franchisee, construction and staffing agency rules
      • Companies who grow will move into the covered group
    • State/local governments, including schools
    • Only state/local ordinances/laws that are not conflicting will have effect (i.e., if the state law prohibits vaccine mandates, OSHA ETS will supersede state law. OSHA ETS will be mandated.)
      • States with state OSHA plans may adopt these federal rules or similar rules. Some states are threatened with removal of state plan authority for failure to comply with laws as stringent as federal (e.g., UT & AZ)

Compliance Deadline

    • Within 30 days of publication (December 5)
    • Testing requirements within 60 days (January 4)

Mandate

    • Determine vaccination status of each employee
      • Obtain acceptable proof –
      • Maintain records/roster
    • Unvaccinated must test negative weekly if worker in workplace at least once a week or within 7 days before returning to work if worker is away from workplace a week or longer
      • Must wear face covering indoors or in occupied vehicle for work
      • Employer not required to pay for testing unless required by law or collective bargaining agreement
      • Employer not required to pay for face coverings
    • Notice
      • Employee must promptly notify of positive COVID test or receive diagnosis
        • Employer must remove employee from workplace, regardless of vaccination status
        • May not return to work until meeting criteria
    • Must provide paid time off for vaccination and recovery from side effects

OSHA is offering robust compliance assistance to help businesses implement the standard, including a webinarfrequently asked questions and other compliance materials.  

 

Conclusion

In conclusion, employers subject to the ETS must determine whether they will take a vaccine-only or combined vaccine and testing/face covering approach to compliance and must develop the required written policies and communicate those policies to employees so they have ample time to receive their COVID-19 vaccines.  Employers should work with legal counsel to develop their written policies and to address any reasonable accommodation requests received by employees.

If needing employment law assistance in implementing these new rules, contact your World Insurance Associates representative so that they can connect you a Jackson Lewis P.C. council in order to receive the WIA arrangement. For our PEO clients, please speak with in-house council and HR. 

 

 

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers, or our clients.  This is not legal advice. Rather, the content is intended as a general overview of the subject matter covered.  

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.