March 2007

In its attempt to make health insurance premiums affordable, a state board is giving the go-ahead to plans with high deductibles, but that is causing concern that many newly insured people may avoid getting treated when they're sick or may run up onerous debts to pay their medical bills. Read Full Article

Governor Deval Patrick yesterday unveiled significantly lower prices for the health insurance plans that uninsured residents will be required to buy starting July 1. Patrick said six weeks of intense negotiations, in which he personally called the chief executives of Blue Cross and Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and Tufts Health Plan, resulted in lower prices that will make the plans more affordable for uninsured residents. Read Full Article

Although industry surveys indicate that employers anticipate strong growth in consumer-driven healthcare plans (CDHC), low selection rates remain a significant stumbling block among employees offered such plans as one option among many, according to a report released today by The Conference Board, the international business research organization. Read Full Article

Massachusetts residents would have an extra 18 months to get what the state defines as minimum insurance coverage to comply with the landmark health care law, under preliminary regulations approved Tuesday. But residents would still be required to have some kind of health care plan as of July 1, when the law takes effect. Read Full Article

February 2007

A state panel yesterday outlined for the first time the minimum requirements for coverage under the state's new health insurance law, a package estimated to cost $380 a month on average for an individual, more than $100 above recent estimates. Read PDF - 79kb

When Cadmus Communications Corp. began requiring employees to undergo a health-risk assessment to qualify for medical coverage, some workers feared their medical conditions could cost them their jobs. But Stephanie Metzger credits the mandatory testing with possibly saving her life. Read PDF - 86kb

In April 2006, Massachusetts made history when Governor Mitt Romney signed thee landmark health care reform legislation into law. The goal of the law is to provide health insurance to most of the half-million Massachusetts residents who now have no coverage. Read PDF - 607kb

Effective January 1, 2007, the Health Care Reform Act (Chapter 5 of the Acts of 2006, as amended) requires that carriers with insured health benefit plans that provide for dependent coverage make coverage available for persons thought the earlier of their 26th birthday or the day two (2) years following the loss of their dependent status according to federal tax rules. Read PDF - 289kb

September 2006

Employers that develop plans connecting Family and Medical Leave Act benefits with disability programs are finding it easier to manage costs and track employee absences, according to insurers that have studied the trend and offer integration management services. Read Full Article

As more companies turn to pharmacy benefit managers for pharmaceutical services, some industry experts are asking whether accreditation standards are needed.

"There are many accreditation bodies for managed health care services, but there is no oversight of PBMs," says Marianne Fazen, a board member of the Utilization Review Accreditation Committee, a nonprofit health care group. Read Full Article

Although once the hare, prescription drug trend now is the tortoise. A withering pipeline of brand-name drugs, paired with a recent flood of generics and increased consumer skepticism regarding drug safety, led to a sleepy 5.4% increase in 2005 drug spending, according to Medco Health Solutions.

The annual change in year-to-year expenditures is the lowest since Medco began tracking such data in 1999. Last year's 5.4% increase is less than 2004's 8.5%, and a fraction of 1999's 16.4%. Read Full Article

August 2006

Something that exacerbates health problems, produces prolonged absences and worsens employers' headaches over medical costs is hard to ignore. So it's easy to see why businesses are starting to recognize the negative influence depression has on disability claims. Read Full Article

Get 20/40 vision in 20 minutes. However, despite achieving Food and Drug Administration approval less than two years ago, a new vision correction procedure already is making headlines for yielding such quick and positive outcomes for nearsighted patients who are not candidates for LASIK surgery.

This latest in surgical options involves making an incision in the cornea and inserting an implantable contact lens (ICL) - a refractive phakic implant made from a plastic material used in cataract operations - behind the iris of the eye. The procedure requires a local anesthesia and takes about 20 minutes. Read Full Article

Employers and health plans that rely on case managers to help workers with cancer have a new tool at their disposal: cancer-specific services that guide patients through the complexities of diagnosis, treatment and survivorship. Read Full Article

July 2006

Wellness programs and employee wellness incentives continue to gain in popularity in the wake of unrelenting spikes in medical costs for businesses and patients. Read Full Article

Dental plans these days come in many different shapes and sizes, but the average employee benefit manager may end up seeing nothing but spots through all the marketing spin - much like a patient leaving the dentist under the influence of laughing gas. Read Full Article

In tandem with the consumer-driven health care groundswell, disease prevention is getting a boost in coverage and attention from employers and health care insurers. However, when it comes to drugs, what's preventive isn't always cut and dried. Read Full Article

June 2006

In a groundbreaking move with far-reaching implications, Massachusetts adopted a law in April to require state residents to obtain medical insurance by July 1, 2007. Previously, no state had required people to carry medical insurance. Read Full Article

A June 2000 car crash in Southern California has reverberated all the way to the portico of the U.S. Supreme Court, and one way or another, employee health insurance plans will soon feel the aftershocks. Read Full Article

May 2006

"Perhaps the best deal on the eye care chart is the basic examination. To encourage utilization, providers usually charge $10, tops. VSP, the Microsoft of the vision industry, charges nothing for exams within its provider network." Read Full Article

It didn't take a fancy claims analysis or much shopping around for John Keach to add a wellness program to the employee benefits offered by his small bank. He signed on when the bank's health insurance company offered the program. Read Full Article

Call it the Great Awakening of the modern worker. The denouement of the Age of the Automaton. Employees ranging from the lowest wage earners to seasoned CEOs are rising up and demanding the freedom and flexibility to tend to their family and personal lives. That means looking beyond the size of their paycheck to all the perks and privileges that help strike a happy medium between life and work Read Full Article

April 2006

With the best of intentions, beginning in the 1950s, U.S. companies extended health benefits to retirees to encourage retirement and, after the adoption of Medicare in 1965, to fill in the gaps in the coverage that Medicare provided. Employees and retirees valued these benefits for obvious reasons - they made it possible to retire before age 65 and provided coverage for prescription drugs, which Medicare did not include. Read Full Article

March 2006

Should your company self-insure its health plan? The answer lies largely in your plan size, but there are plenty of other significant pros and cons to weigh, experts say. It's not a question that should be taken lightly, as it can have significant implications for benefit expenses and corporate cash flow. Read Full Article

HR professionals and providers collectively voice widespread dissatisfaction with health care quality but favor different solutions, according to a recent survey by EBN and State of Our Health. Read Full Article

For some, consumer-driven health care meant fully replacing their health benefits with high-deductible plans and health savings accounts. Others gave employees a choice between HSAs, health reimbursement arrangements and traditional health plans. Still others didn't adopt HSAs or HRAs, but kept their traditional plans and used online tools to help employees select health care providers based on price and quality. Read Full Article

The federal subsidy for providing retiree drug coverage has proven very popular among larger employers, at least for the first year it's available, according to a new survey of 300 mega-firms by Kaiser Family Foundation and Hewitt Associates. Read Full Article

February 2006

Regulation of Health Savings Accounts has been a hot topic since their creation in 2004, and it is likely that the HSA law will continue to evolve in 2006. New regulations and other guidance are expected from the IRS, and guidance may also be issued by other federal agencies. Also, it is possible that new state laws governing the tax consequences of HSAs will be passed. Read Full Article

Just as employers are adjusting to consumer-driven health, some say that it is already going the way of the first edition of the ubiquitous MP3 player, and that "managed consumerism" is its Nano.

Managed consumerism will combine the best of CDH with the best of managed care principles, says University of California Professor James Robinson, who coined the term. Consumers will be cost conscious, and medical services will be tightly integrated and efficiently delivered. The marriage is needed because both movements made the same fundamental mistake early on, that is, they tried to apply one strategy of cost control or quality improvement to all forms of medical care, Robinson says. Read Full Article

Dental plans rank as the third most important employee benefit, just behind health and retirement, according to the 2005 Group Purchaser Behavior Study commissioned by the National Association of Dental Plans. Read Full Article

January 2006

Somewhere in the traditional alphabet soup of required employment law postings, there should also hang - per a 2005 Department of Labor rule - something that reads "USERRA." Read Full Article

Some of the nation's largest and best-known employers want to give gay and lesbian couples the same tax breaks married couples enjoy in purchasing health insurance. Read Full Article

As conclusive research pours in every day on the effectiveness and cost-effectiveness of health and disease management programs, more employers are asking: Why not combine the two? Read Full Article

Pharmacy costs are expected to remain the fastest-growing component of health benefits spend this year. The challenge for employers and PBMs will be squeezing additional savings out of already carefully designed plans. Here are 10 cost-containment strategies that experts say will help cap costs and improve value to employees in 2006 and beyond. Read Full Article

December 2005

"How's this for a parting shot from an employee: "I'm sick and tired of your self-serving benefit communications!" Surely, you say, there are better things to gripe about on the way out. Like lumpy half-and-half or the lack of a subsidized soda plan." Read Full Article

"Expensive gasoline, due in part to the economic fallout from Hurricanes Katrina and Rita and the war in Iraq, is fueling new interest in transportation benefits, such as qualified transportation expense plans and carpooling arrangements." Read Full Article

"As more couples seek treatment for infertility, some consumer advocates are pushing to expand insurance coverage for assisted reproductive technologies such as in-vitro fertilization. They're enlisting citizens to contact elected officials and teaching workers how to ask their company to add infertility coverage to the health plan." Read Full Article

"Chronic diseases are hard enough to deal with on their own. Add clinical depression, and you've got a double whammy that can knock employees and employers for a loop." Read Full Article

"More Americans than ever are enrolled in discount plans that promise big savings on dental care but don't cover any of the costs." Read Full Article

November 2005

"Health care benefits are under attack from all sides. Management wants medical costs under control. Employees are tired of cost shifting. Benefit managers are caught in the middle." Read Full Article

"More employers have increased the financial incentives used to entice workers to participate in wellness and disease management programs." Read Full Article

"Engaging consumers in their health care has become a mantra for U.S. employers. Effective health care consumerism tools help companies meet their goals to provide needed health care benefits while controlling costs." Read Full Article

"To accomplish this challenging goal, some innovative companies have uncovered a way to transform a sleepy little benefit into a vehicle to support the message - and impact - of consumerism: the health care Flexible Spending Account (FSA), which allows employees to set aside pre-tax wages to pay for health care expenses not paid for by a traditional health care coverage." Read Full Article

October 2005

"Employees continue to spend big on voluntary benefits, as several new reports show. And employers are adding more of these products to their benefit plans." Read further at Read Full Article

"The results of the Employee Benefit News/Forrester Research 2005 Benefits Strategy and Technology Study reveal that about of third of employers today currently offer an employee benefits portal, and that another quarter of employers expect to do so over the next two years." Read Full Article

"With more National Guard and Reservists called up for lengthy tours in the Middle East, a nonprofit organization is offering a free online database to help employers find support programs for their employees on military duty." Read Full Article

September 2005

By the end of October, employers must decide whether to take the federal subsidy for retiree drug coverage. Most employers that offer this waning benefit have already made their choice; however, those choices come with trade-offs. Read Full Article

Stress and personal relationships have eclipsed substance abuse as a focal point for employee assistance programs. Read Full Article

Promoting healthy habits and consumerism is the most effective way to lower medical costs ....
Read Full Article

Employers that haven't yet offered a consumer-directed health plan are fast becoming the minority.
Read Full Article

August 2005

Read about how "Rising drug expenses are prompting more employers to consider limiting their retail pharmacy network to low-cost providers or cutting out retail pharmacies from prescribing non-emergency medication altogether." Read Full Article

Work-life benefits ... how do they fit in? Read Full Article

May 2005

Howard Weyers had had enough. He gave his employees at Weyco an ultimatum - quit smoking or quit your job - and just over one year to comply. Read Full Article

Some of the nation's largest employers have streamlined access to health information in an effort to engage employees in managing their health... Read Full Article

Employers may well make the health savings account a benefits star this year. President Bush has one. Vendors seem to be offering new HSA products by the day. And rising health trends are pushing companies to try tougher measures to stem costs... Read Full Article

Eyes are said to be the window to a person's soul, but to doctors, they're also the window to a person's health... Read Full Article

April 2005

The lack of insurance is a widely recognized problem in the United States, but what about the lack of adequate insurance? Read Full Article

Aware of low-wage workers' struggle to pay for their share of medical coverage, an increasing number of employers are embracing an income-based sliding scale for employees' health care contributions. Read Full Article

Maybe you thought that you were finished with HIPAA compliance when you sent out your Privacy Notices on April 15, 2003. Read Full Article

Lobbyists, now resigned to the fact that the Treasury Department has successfully punted the flexible spending account ball, have their sights set on Congress to end the use-it-or-lose-it provisions governing FSAs. Read Full Article

March 2005

Early adopters of health savings accounts are finding there's a big design flaw in their health plans - if they have large medical expenses at the beginning of the year, they don't have the balances in their HSAs to cover the costs. To solve this dilemma, some HSA vendors have considered adding credit lines to their products. . . Read Full Article

Employees are open to assuming more responsibility for their own and their families' health care, but they are woefully unprepared for the role, according to two new surveys. . . Read Full Article

As more Americans turn to medications to manage everything from heart disease to hair loss, employers are gazing anew at drug benefit designs in search of better ways to control costs. . . Read Full Article

February 2005

Evidence continues to mount that President Bush's administration is unlikely to legalize imported medicines. . . Read Full Article

It may not happen quickly, but retiree health benefits appear headed for extinction. . . Read Full Article

Banks, having tackled insurance sales, now are diving headlong into the new frontier of health savings accounts. . . Read Full Article

January 2005

Workers tend to blame the health care industry, not their employers, for rising health costs, and they show a strong preference for employer-sponsored health insurance, two recent polls demonstrate. . . Read Full Article

Disease management companies promise good returns on investment. Many firms deliver, but employers should be wary about how vendors calculate return, experts say. . . Read Full Article

Because many workers lack health insurance, cash-strapped state governments are using an array of methods to expand job-based coverage. . . Read Full Article

December 2004

If you own a home or drive a car, you already know that opting for a high-deductible insurance plan can save you hundreds of dollars per year, as long as you're financially secure enough to meet the deductible in case disaster strikes. . . Read Full Article

Suppose one of your employees falls off a ladder this weekend while repairing his roof. The doctor tells him he needs shoulder surgery, which can be done through a traditional open procedure or through a far less invasive arthroscopic approach. . . Read Full Article

Pharmacy benefit managers are integral players in the health care system, so it is not surprising that their role has come under scrutiny by those trying to determine the reasons for continued drug cost increases. . . Read Full Article

November 2004

Small and midsize employers are strong believers in employee benefits, and they anticipate maintaining or expanding their offerings in the next two years, reveals research by Employee Benefit News and Genworth Financial Employee Benefits Group. . . Read Full Article

Employers should be careful to not overstate the capabilities of health savings accounts to workers because they cannot cover all health expenses in retirement, even if participants save the maximum permissible amount and avoid using the funds to pay for current expenses. . . Read Full Article

Evidence continues to mount that the growth in health care costs is slowing. . . Read Full Article

October 2004

Against the objections of the pharmaceutical industry and the Food and Drug Administration, more states and municipalities are guiding their citizens and employees to Canada to save money on prescription drugs. . . Read Full Article

Voluntary benefits are gaining extra luster in the eyes of employers who continue to look for ways to reduce their benefit costs, experts say. . . Read Full Article

It's official: Health savings account holders now can invest in certain types of coins, but not art or wine, according to the latest HSA guidance from the IRS. . . Read Full Article

September 2004

It's been smooth traveling along the consumer-driven health itinerary so far, report insurers and third-party administrators. Early results show consumer-driven health plans - either based on a health reimbursement arrangement (HRA) or the newly available health savings accounts (HSAs) - are having the intended effect of getting consumers to question health-seeking behaviors and reduce discretionary spending. . . Read Full Article

In structuring work-life and employee assistance program benefits, it's important to consider that almost half of working caregivers identify emotional issues as their main cause of stress. . . Read Full Article

On May 26, 2004, the Department of Labor (DOL) issued final rules implementing the notice requirements under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), the federal law that requires employers to offer the opportunity to temporarily continue group health plan coverage at group rates when such health coverage would otherwise end due to certain qualifying events such as job loss, divorce or death. COBRA has always contained several notice requirements applicable to employers, covered employees, qualified beneficiaries and plan administrators. However, the new rules markedly modify the existing notice requirements and impose two new notice requirements. . . Read Full Article

Health care cost concerns are permeating every aspect of benefits these days. . . Read Full Article

August 2004

A wide gap exists in perceptions of health care consumerism among American workers and their employers. . . Read Full Article

For the first time in nearly a decade, health care spending per privately insured American slowed in 2003, reports the Center for Studying Health System Change (HSC). Spending rose 7.4% last year, down from 9.5% in 2002 and from a 10% peak in 2001. . . Read Full Article

In today's world of gene therapy and noninvasive surgery, dentistry doesn't seem that high tech. When fighting tooth decay and gum disease, dentists still use sharp metal objects to do their work. . . Read Full Article

July 2004

Now that many over-the-counter drugs and medical products can be reimbursed through flexible spending accounts, consumers are beginning to show more interest in the plans, according to FSA administrators. . . Read Full Article

As a greater portion of health care costs are pushed onto employees, employers and brokers are concerned this could cause a drop in demand for important voluntary benefits, such as income replacement and life insurance. . . Read Full Article

High blood pressure and high cholesterol don't often keep employees off the job, but left untreated, they can lead to serious, budget-busting cardiovascular disease.Creating heart-healthy workplaces... High blood pressure and high cholesterol don't often keep employees off the job, but left untreated, they can lead to serious, budget-busting cardiovascular disease. . . Read Full Article

June 2004

For better or for worse, many employers are using cost-sharing as a way of focusing employees' attention on health care costs and prodding them to become better consumers of care. Their efforts are paying off in the form of lower health care costs now, even if the long-term effect on employee health is still hazy. . . Read Full Article

Total compensation - the concept of creating synergies when benefits, pay and work life are presented as a single entity - was the talk of the industry in the late 1990s. Has the sluggish economy of recent years dampened its spirit? Not at all. . . Read Full Article

Faced with having to pay out more each year in health care premiums despite a good claims history, the Bank of Geneva in Geneva, Ind., last year decided it had no choice but to pass more of its health plan costs on to its employees. Like many other companies, it decided to raise its employee deductible, in this case from $500 to $2,500. . . Read Full Article

May 2004

Health benefit plans for Medicare-eligible retirees got a huge boost from Congress in the Medicare Reform Act, which includes billions in tax subsidies for employers that provide prescription drug benefits to retired employees. . . Read Full Article

When it comes to measuring disease management programs, finding return on investment (ROI) savings can be a bit like searching a "Where's Waldo?" picture. You know he's in there somewhere, you just can't find him. . . Read Full Article

Massachusetts officials have a new plan for tackling rising prescription drug costs: bulk purchasing. The state intends to secure lower prices from drug companies by pooling drug benefit programs for some 910,000 people, including state employees, retirees and Medicaid recipients. . . Read Full Article

After a three-year jaunt with ordinary Americans at the wheel, consumer-driven health plans (CDHPs) say consumers have quickly learned to read the road signs, maps, and travel guides. Among the mile-markers, generic drug usage is up and emergency room visits are down as consumers seize the chance to educate themselves about appropriate and cost-efficient medical care. . . Read Full Article

April 2004

Massachusetts officials have a new plan for tackling rising prescription drug costs: bulk purchasing. . . Read Full Article

Employers and employees appear convinced that disability income insurance is a necessary part of financial well-being. Increasingly, though, they seem to be focusing on the most cost-effective coverage they can find. . . Read Full Article

Domestic partner benefits and recognition of same-sex unions are increasing, generating debate in the courts, on the campaign trails and in benefits departments. . . Read Full Article

March 2004

Consumer-driven health plans are ramping up for rapid growth, poised to attract 2.7 million members and $16 billion in premiums by 2005, according to Forrester Research Inc. The plans are likely to grab 24% of the health insurance market and $413 billion in premium income by 2010, as 40% of PPO and point-of-service plan members switch coverage. . . Read Full Article

Everyone agrees that health plan costs are too high, and much of the expense can be attributed to increased use of prescription drugs. . . Read Full Article

New Medicare legislation provides tax-advantaged health savings accounts (HSAs) for virtually anyone who has coverage under a high-deductible health plan. In a surprising twist, the law allows HSAs to be funded on a pre-tax basis through a cafeteria plan, opening a whole new avenue for funding consumer-driven health care. . . Read Full Article

Every big idea for reforming the health care system these days revolves around behavior change - it's simply a question of whose behavior. . . Read Full Article

February 2004

Let's say you wake up on a Tuesday morning with a rash on your leg. You recognize the symptoms of poison ivy, which you think you may have contracted over the weekend on a wilderness hike. . . Read Full Article

Employers are wielding effective new weapons in the war on health care costs by pushing patients to increase utilization of lower-cost generic drugs and mail-order pharmacy programs, or else pay the difference out of pocket. . . Read Full Article

The recovery of the global economy is being restrained by a whole host of factors, and the impact is being felt in benefit programs around the world. . . Read Full Article

January 2004

Workers are indeed becoming better health care consumers as employers ask them to share more of the costs, new evidence suggests. . . Read Full Article

Common pain conditions are a leading cause of lost employee productivity and disability, yet experts say the ailments are often poorly diagnosed and treated. . . Read Full Article

Though disagreement persists on senior citizens' gains under the Medicare reform act, industry analysts are touting the new law's provisions - especially the addition of Health Savings Accounts - as a boon to plan sponsors. . . Read Full Article

December, 2003

Doctors may not be able to listen to a patient's heartbeat or do a throat culture without a face-to-face visit, but that's not stopping some Metroplex physicians and their patients from meeting in cyberspace. . . Read Full Article

As the notion of consumer-driven health care begins to take hold in medical insurance, dental plans are adopting some of its precepts. . . Read Full Article

Let's say you wake up on a Tuesday morning with a rash on your leg. You recognize the symptoms of poison ivy, which you think you may have contracted over the weekend on a wilderness hike. . . Read Full Article

November, 2003:

The slumping economy and surging health care costs are squeezing many employers, who are trimming back benefits in response. . . Read Full Article

State legislatures appear to be experiencing a change of heart over the multitude of health care mandates passed during the last decade, given the review commissions and so-called "bare-bones" insurance policies springing up across the country. . . Read Full Article

Until they help change consumer and physician behavior, employers are just nibbling around the edges of the health care cost problem. . . Read Full Article