UBP blog


Two small steps to cure the big $194 billion price tag of type 2 diabetes

Filed under: Wellness — ubpblogger @ 4:35 pm
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As early as 2007, here’s how much it cost to care for all Americans with type 2 diabetes:

• $116 billion in Direct Costs (i.e. their medical care)

• Approximately $58 billion in Indirect Costs (i.e. disability benefits, money lost through work absences, premature death)

This all adds up to a grand total of $194 billon, or 10% of all healthcare dollars spent in the United States.

Let’s take a look at this issue on an individual level. The medical care for a person with diabetes is twice as expensive as the care for a person without diabetes.

On top of this, 16% of Americans with serious health problems have delayed necessary medical treatments (according to the Kaiser Family Foundation). So, if diabetics are a big part of this 16%, by delaying treatment now they will become more expensive to treat in the future; this is because they will develop major complications if they cut back on disease management efforts.

At a very modest cost, employers can reap substantial long-term cost savings, just by doing a couple of things:

1. Blood pressure monitoring

Blood pressure monitoring is a great preventative measure to help both employees at risk for developing type 2 diabetes and those who have the disease as well.

The Center for Disease Control and Prevention (CDC) research has shown that blood pressure control can lower the risk of heart attack and stroke in people with type 2 diabetes 33-50% and lower the risk of eye, kidney and nerve diseases by approximately 33%. Lowering blood pressure also reduces diabetics’ decline in kidney functioning 30-70%.

One value-added service Universal Benefit Plans offers to many clients that could help achieve the above risk reductions is free health screenings. Each year, we have a registered nurse come in and check the blood pressure of all employees among other things.

Would it be helpful if your broker offered free health screenings to your employees as a value-added service?

2. Lifestyle interventions

Lifestyle interventions such as having employees work with fitness trainers and nutrition educators, can reduce diabetes development in high-risk adults by 58% (and an alarming 71% for high-risk adults ages 60 and up).

Reduced diabetes development in high-risk adults is just one of the many things that adding wellness benefits for everyone at your company can accomplish for your employees’ overall health.

As early as 2007 the SHRM’s Benefits Survey Report found that 68% of companies offer wellness benefits. Is your company one of them?


What the new healthcare reform bill means for you and your employees

Filed under: health care reform legislation — ubpblogger @ 2:07 pm
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On July 14th, The House of Representatives introduced America’s Affordable Health Choices Act of 2009 (HR 3200).

Legislators say that the bill will do these 2 things:

1.    Make quality, affordable health care accessible to all Americans

2.    Curb health care cost growth

If America’s Affordable Health Choices Act of 2009 is passed into law, here are a few things that would happen:

  • All Americans would be required to have health insurance or pay a penalty.
  • All businesses (except for those with annual payrolls of $40,000 or less) would be required to offer health insurance coverage to employees or pay a fee*.
  • Medicaid would be expanded to cover more of our nation’s poor.
  • New exchanges would be created for Americans to purchase insurance with the assistance of government subsidies.
  • A public plan option would be established.

This Act has an expected price tag of $1 trillion over the next 10 years; here’s how it will be paid for.

  • Reduced Medicare spending
  • Graduated income tax on the wealthiest Americans (Individuals with adjusted gross incomes of over $280,000 per-year and families making more than $350,000 per-year)

Opposition to the act:

The Congressional Budget Office (CBO) estimates that this Act will extend coverage to 37 million uninsured Americans by 2019. However, there’s still quite a healthy amount of opposition out there to this bill.

The National Federation of Independent Businesses spoke out against the bill—and its public insurance option—saying that it:

“threatens the viability of our nation’s job creators … destroys choice and competition for private insurance and fails to address the core challenge facing small business — cost.”

On the other side of the issue, President Obama advocated for a public insurance option stating that it would:

“make health care more affordable by increasing competition, providing more choices and keeping insurance companies honest.”

So, what do the people think?

Support for the bill among the general public is less than unanimous. 

A recent study conducted by Zogby International in conjunction with the University of Texas Health Science Center at Houston shows just 40% of voters are for it. Also, a national survey conducted in July by Rasmussen Reports revealed that only 35% of Americans support a government health insurance plan to compete with private insurers.

Are you for or against having a public plan compete against private insurers? Why?

Also, what are your thoughts on essentially taking Massachusetts’ mandate for businesses to offer insurance to employees nationwide?

*In the Senate HELP Committee’s proposal, employers would need to contribute at a minimum 60 percent to employee premiums or pay $725 for each full time employee and $325 for each part-time employee. The House of Representatives’ proposal would require employers to pay 72.5 percent of premiums for individual coverage and 65 percent for family coverage. The fee for noncompliance with this would equal 8 percent of payroll.


Isn’t it time insurance actually insured us against medical debt and ensured our financial stability when we’re critically ill?

All across the nation, people are struggling to pay the bills and feed their families. Now, add to this the cost of healthcare, which we all know is on the rise. The economy is still in a recession and people are putting off doctor visits, delaying needed medical care and opting not to fill prescriptions.

Healthcare costs are a huge strain on the budgets of so many Americans, especially those who are critically ill. Many people—even those with employer-provided insurance—who are critically ill face a very difficult dilemma in light of economic pressures, they could either:

  • Keep up the treatments and fall into medical debt
  • Postpone or cut back on treatments they need to beat their disease (and in some cases stay alive) to avoid overwhelming debts

Keep up the treatments and fall into medical debt:

Here’s what could happen…

Meet Frank, an unemployed man with stomach cancer whose COBRA eligibility had run out. He’s forced to enroll in a plan with over $1,000 monthly premiums and a deductible. After having already burned through his 401(k) and skipping several mortgage payments to pay medical bills, he has fallen $60,000 dollars into medical debt and is growing deeper and deeper into debt each month.

Postpone or cut back on treatments:

Here’s what could happen…

Meet Susan, a nonprofit Finance Director in her early 50s who has breast cancer. Her employer-sponsored insurance covered 80 percent of her lumpectomy but after having the procedure done, she quickly met her plan’s annual maximum and had to pay for chemotherapy out-of-pocket. Because of the high costs, she decided to postpone her treatments until the next plan year.

As these two cases show, high cost-sharing and insurance plan maximums lead even the critically ill to plunge deeper and deeper into debt each month or to put off care that could help them beat their diseases.

Fortunately people like Frank and Susan now have a third option.

The third option, Supplemental Critical Illness Plans

  • Purchase a critical illness policy from your employer before your first diagnosis

What critical illness plans do is pay a lump sum benefit to your employees at their first diagnosis of a covered illness. Eligible employees choose the dollar amount of coverage (i.e. the amount of the lump sum that they would be paid if they got diagnosed with a covered illness) and have their premiums for this policy deducted directly from their paychecks.

A critical illness plan would have insured Susan against the prohibitively high costs of the chemotherapy her insurance didn’t cover. She would have been able to go ahead and start therapy instead of putting it off until next year when no one really knows what would be different. It also would have helped Frank pay his deductible expenses and save his 401(k) money for after he’s retired.

Think of your health insurance as a guarantee that you’ll get treated when you get sick and this voluntary benefit as “insurance” that you’ll be able to afford the bills.

We’d love the opportunity to discuss these plans with your company and see how we can help round out your employee benefit offerings at little to no cost to you. So give us a call at 617-859-1777 and we’ll work together to set a date and time.

In the meantime, visit our website at www.universalbenefitplans.com


Will preparation and health care proxy; two services employees need to know about

Everyone needs to know about wills and healthcare proxies. These documents are there to ensure that, in the event of an untimely severe illness, injury or death, all important decisions are taken care of for you in a way that you’d want them to be made.

Many carriers offer free will preparation services that help you create, execute and store your will.  A healthcare proxy is an important legal document that employees should know about and complete.

The following will tell you a little bit more about what will preparation and the healthcare proxy are and why they are important for your employees.

Will Preparation Services:

Will preparation services are there to help you create two important types of wills, your simple will and your living will. You create your simple will to designate and ensure who will get access to your property and all other financial assets, who will become the guardian of your children and who will manage your estate.

Your living will allows you to specify in advance your end-of-life decisions and name a health care surrogate to make medical decisions on your behalf in the event that you are unable to do so. This document will help you ensure that your wishes are being carried out, for instance, when deciding whether you will be on artificial life support should you become terminally ill, are in an irreversible coma or in a vegetative state.

Healthcare Proxy:

The healthcare proxy is a simple, yet important legal document that everyone should have even if they are perfectly healthy. Under Massachusetts healthcare proxy law (Massachusetts General Laws, Chapter 201D), “any competent adult 18 years of age or over” may complete this document and appoint someone to be their Health Care Agent.

The Health Care Agent you appoint becomes authorized to make healthcare decisions on your behalf in the event that you’re unable to make them yourself. When this happens, your Agent’s decisions regarding your healthcare will have the same authority as yours would (if you were able to make them) and will be honored over those of any other person. If you give your Agent full authority to act for you, he or she may refuse or consent to any medical treatment for you, including treatment that would keep you alive.

Your Agent’s decisions will be on your explicit wishes or his/her assessment of your wishes, so it’s vital that you communicate with your Agent and inform them of decisions you’d want them to make for various situations.

Not sure if your providers offer will preparation services? Just give us a call at (617) 859-1777 for a list of providers that we know offer them.


If the Healthy Families Act became a law, would you be concerned with potential benefit cuts?

Filed under: Uncategorized — ubpblogger @ 10:38 am
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The Healthy Families Act would mandate that employers with 15 or more employees provide up to 56 hours of paid sick leave each year to both full-time and part time employees. Under this bill, workers would accrue one paid sick leave hour for each 30 hours that they work and would become eligible to use these benefits after 60 days of employment. Employees would be able to roll over unused sick leave into subsequent calendar years.

Under this proposed law, covered paid leave would include any of the following:

• Recovery from a routine illness or care for a family member that is ill

• A doctor’s appointment and other preventative care

• For victims of domestic violence, stalking, or sexual assault, time spent seeking help and service

Problem this bill seeks to solve:

About 48% of private sector workers—roughly 60 million employees in the United States– do not have paid time off benefits in the workplace. According to a June 2009 report from Human Impact Partners, 79 percent of our nation’s lowest paid workers do not have paid time off benefits. Workers who are living paycheck to paycheck and simply cannot afford to miss a day’s work often have no other choice but to go to work sick.

Should the Healthy Families Act bill become a law, it could reduce the spread of both pandemic and seasonal influenza outbreaks, protect the general public from the spread of diseases from sick service industry workers that would otherwise not have time off to get well and enable workers to stay home when they have an ill dependent child in need of care.

Potential Impact on Small Employers:

Although the Healthy Families Act would help lower income Americans to better fight illness and care for sick dependents, its implementation may leave a disproportionate impact on small businesses. Unlike with the Family and Medical Leave Act (FMLA) exemption which Congress extended to employers with fewer than 50 employees, should the Healthy Families Act pass, only employers with fewer than 15 employees will be exempt from offering the mandated paid time off.

For small businesses with 15 or more employees, a paid sick leave mandate could limit employers’ ability to maximize flexibility in benefit plan design. Especially given the current economy, employers can only offer a limited total compensation package. In order to absorb the costs of federally mandated paid sick leave benefits, employers may need to make cuts in some of the benefits they already offer that are not required by federal law.

If the Healthy Families Act were to become a law, what impact would it have on your company? Would you be at all concerned with any potential benefit cuts?

Had it up to here with double-digit rate increases? Partial self-funding could be your solution.

On July 1, 2009, a new plan design—the partially self-funded plan—became available in Massachusetts. This plan design saves small and mid-size firms anywhere from 5-50% in group healthcare costs and alleviates a couple of the biggest pains associated with traditional fully-funded health insurance.

Pain #1: Small employers with 50 employees or less have been getting double-digit rate increases because they are in the same claims pool.

Solution: Get out of the pool and into your own.

Partial self-funding lets groups get out of the claims pool with everyone else and into their own pools. Also, with the new partially self-funded plans, employers have access to employee health data to help them best assume financial risk for funding health benefits.

Pain #2: Fully-funded health plans look like “all-you-can eat healthcare buffets”. You pay one price and it’s all the healthcare you can use. This isn’t the most cost-effective way to design a health benefit plan.

Solution: Design your own plan that’s not “all-you-can eat healthcare”. Instead, your plan will be “all that you need healthcare.”

With partial self-funding, employers have access to employee claims data every month as well as employee health data. This is what helps them to custom design an “all that you need” plan.

Two carriers in Massachusetts have begun to sell partially self-funded plans as of 7/1/09 and all of these plans meet the state’s minimum credible coverage (MCC) requirements.

We’d love the opportunity to discuss these plans with your company and see what we can save you, so give us a call at 617-859-1777 so we can get a conversation started.

DOL and CMS issue final applications for expedited review of denied ARRA COBRA subsidies

Filed under: ARRA Act COBRA Subsidy,COBRA — ubpblogger @ 10:23 am
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Under the American Recovery and Reinvestment Act (ARRA), COBRA premium Assistance Eligible Individuals (AEIs) who believe that they’ve been wrongfully denied subsidized coverage may apply for an expedited review of their status by one of two federal agencies, the Department of Labor (DOL) and the Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) . Once an AEI applies for expedited review, the DOL or CMS must complete the review within 15 business days.

Individuals who wish to apply for expedited review appeal directly to the federal agencies. Unless either of the agencies contacts them with inquiries for additional information, no further employer action is required.

The DOL and CMS have finalized the application forms that individuals must use and have published them to their websites respectively. Individuals may print a copy of the form and mail or fax it back to the respective federal agency. Individuals using the DOL form may alternatively elect to complete the form online. Which agency’s form the individuals complete is determined by the type of group health coverage they had at their former employer.

Only Assistance Eligible Individuals (AEIs) formerly covered under private-sector group health plans may download and complete the DOL application. Government employees (both federal and state) as well as covered under their state’s “mini-COBRA” law (i.e. companies with fewer than 20 employees for 50% or more of the past calendar year) must use the CMS’ comparable application.

What employers should keep in mind:

When determining COBRA subsidy eligibility for individuals formerly covered under private-sector group health plans, the DOL is not required to defer to your previous decision to deny coverage. The DOL is commonly inclined to rule in favor of an employee’s application.

Modernization techniques can save the healthcare industry $33.2 billion per-year, and UBP is ahead of the curve

Filed under: Uncategorized — ubpblogger @ 10:21 am
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Let’s face it, our nation is not getting the most out of the $2.6 trillion we spend on health care. As such, United Health Group’s Center for Reform and Modernization has looked in to ways the industry can achieve substantial cost savings via technology in a recent working paper.

United Health Group estimates that the healthcare industry’s administrative expenditures are about $290 billion per-year. If the industry puts their working paper’s suggestions into practice and leverages technology to its fullest, the Group estimates a total savings of $332 billion in national health expenditure over the next decade. That’s roughly 33.2 billion dollars per-year. Of the proposed savings, United Health Group estimates 30 percent will go to health plans.

United Health Group’s Executive Vice President Simon Stevens stated in a June 30th conference call that the healthcare industry’s manual administration processes cost doctors, hospitals and health plans alike considerable amounts of time and money. In order to illustrate how archaic the healthcare industry’s administrative practices are, he made a direct comparison to both the travel and banking industries. In administrative matters, if the processes used in banking and travel were as out of date as those in healthcare, everyone would do all of their banking face-to-face in brick and mortar establishments. Similarly, no one would be able to book travel or find the most economic travel deals online.

Among United Health Group’s recommended cost saving tactics was the elimination of the paper explanations of benefits issued with each claim. The Group suggested replacing these paper statements with electronic ones similar to the monthly statements you receive from your bank. They also recommended delivering the statements electronically and in a secure fashion instead of mailing them out.

All of this would reduce the cost of explaining benefits 68% per-claim and produce a $14 billion dollar cost savings over the next decade. The group also suggested utilizing technologies currently available to automate the entire claims payment process, which could save roughly $109 billion in a decade.

Universal Benefit Plans is ahead of the modernization curve:

At Universal Benefit Plans, we have already implemented several of United Health Group’s suggested modernization tactics. Our proprietary double-encrypted HRIS system, The HR in a Box™, not only streamlines all benefit administration processes but makes benefit communication much easier with employee self-service. The HR in a Box™ allows companies to maintain all vital plan documentation and information in a secure online database and facilitates the transition of any such documentation whenever necessary from employer to broker via a double-encrypted electronic mail mechanism.

To learn more about how you can leverage our HRIS technology to reap considerable cost savings, give us a call at (617) 859-1777 or visit our website at www.universalbenefitplans.com.

Is your third-part service provider in compliance with 201 CMR 17.00?

In recent years, there have been multiple high profile data breaches involving third-party providers of credit card and other financial services. One of the many ways identity thieves access personal information these entities maintain is by hacking into non-password protected, unencrypted databases. Under the Massachusetts identity theft law 201 CMR 17.00, companies that work with these third-party providers will be liable for any data security breach involving personal information of Massachusetts residents if they did not take any action to ensure that the provider was operating in full compliance with the law.

For small and mid-size businesses that work with online credit card processing companies, it is no longer safe to just assume that these companies are in compliance with the law. You must now take a look deeper and investigate them to ensure that they are in compliance. It is vital as well to make sure that you include in all contracts with these providers an explicit requirement that they maintain data security safeguards compliant with 201 CMR 17.00.

Although January is still several months away, the time to start preparing for Massachusetts law 201 CMR 17.00 to go into effect is now. That means identifying all records of personal information on any Massachusetts resident within your organization and bringing together an inter-departmental team to craft your organization’s Written Information Security Plan.

To help companies out with their 201 CMR 17.00 compliance efforts, Universal Benefit Plans will hold a free 35 minute educational webinar July 21st at 11:00 am.

Register to attend at: https://www2.gotomeeting.com/register/660426874

Does your company have a severance pay policy?

In these tough times especially, it is highly recommended that employers have set guidelines in place to govern severance pay.

For employers and HR professionals that may not have a severance policy in place, we’ve answered a few questions for you on what you should know about severance. Specifically, we’ll touch on when you need to pay it, to whom you need to pay it, and when you need to spell out your policy in writing.

Are we required to pay severance?

Unless you have a contractual obligation (i.e. a collective bargaining agreement or an explicitly written promise to pay severance in employee handbooks or policy documents), you are generally not required by law to pay severance.

Who should be eligible for severance?

Generally speaking, severance packages should be given to employees as assistance to help them cover expenses while they are searching for a new position after being involuntarily terminated for reasons beyond their control. Examples are employees who were laid off as a result of a plant closure or whose jobs were eliminated entirely.

Limiting eligibility for severance pay to full-time, permanent employees who meet length of service requirements (such as a one year of service minimum) is common in many organizations.

Severance should not generally be offered to employees terminated for performance reasons or in most cases, for violating work rules. Also, it should not be offered to employees who voluntarily terminate employment (or refuse a transfer) for reasons other than a major pay cut or significant negative changes in working conditions.

Do we need a written severance policy?

Since most severance plans are covered by the Employee Retirement Income Security Act (ERISA), they should generally be in writing. Plans are subject to ERISA when they involve a significant amount of discretion on the part of the employer to determine employee eligibility and the amount of severance benefits payable to employees for different triggering events. This type of plan is contrasted to one that is applicable to a single large-scale event (i.e. a major plant closure).

In terms of what goes in the employee handbook, some employers keep their written severance policies short and sweet, leaving the detailed benefits-related information to the benefit plan material. They then include a reference to the benefit plan material in the handbook and a call to action for employees to direct any inquiries they might have to the HR department.

In any and all handbook references to severance pay, it’s vital that you make it clear that not all employees will meet the eligibility requirements necessary for automatic entitlement to severance pay. You should also make sure you have an attorney review your severance policy to make sure it complies with federal and state laws.

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