The current growth in the number of older adults in the United States is unprecedented in our Nation’s history. By 2050 it is anticipated that Americans aged 65 or older will number nearly 89 million people, more than double the number of older adults in the United States in 2010. As September is National Healthy Aging Month, older Americans should take the time to think about their daily health and well being.
Battle Against Chronic Conditions
Every day millions of people with chronic conditions struggle to manage their symptoms. Chronic conditions such as diabetes, chronic obstructive pulmonary disease, heart related conditions and asthma, can make life unmanageable for millions of older adults and force them to give up their independence too soon.
There are numerous ways for older adults to keep chronic conditions at bay. One of them is to make smart food choices. People aged 50 or older should choose healthy food every day from the following:
- Dairy: Three cups of fat free or low fat milk
- Fruits: One and half cups to two and a half cups
- Grains: Five to 10 ounces
- Oils: Five to eight teaspoons
- Protein: Five to seven ounces
- Vegetables: Two to three cups
Regular exercise is even more important for seniors than any other age group since the risk of disease and lost mobility is greater and the positive effects are realized more quickly. The amounts of physical activity older adults need to stave off chronic conditions are:
- Two hours and thirty minutes of moderate intensity aerobic activity (i.e. brisk walking) every week and muscle strengthening activities on two or more days a week that work all major muscle groups (legs, hips, abdomen, chest, shoulders, and arms).
- One hour and fifteen minutes of vigorous intensity aerobic activity (i.e. jogging or running) every week and muscle strengthening activities on two or more days a week that work all major muscle groups.
- An equal mix of moderate and vigorous intensity aerobic activity and muscle strengthening activities two or more days a week that work all major muscle groups.
Physical activity can also help with keeping your memory sharp as it increases blood flow to your whole body including your brain.
Reinvent Yourself During Healthy Aging Month
For older adults, now is the time to rethink and restructure your life:
- Do not act your age or at least what you think your age should act like. Picture yourself at your best age and be it!
- Be positive in your conversations and your actions every day. When you catch yourself complaining, check yourself right there and change the conversation to something positive.
- Walk like a vibrant, healthy person. Make a conscious effort to take big strides, walk with your heel first and wear comfortable shoes.
- Stand up straight. You can knock off the appearance of an extra few years.
- Make this month the time to set up your annual physical and other health screenings. Go to the appointments and then, hopefully, you can stop worrying about ailments for a while.
A study found that those with satisfying social relationships remained more mentally alert and had less age related mental decline than those who were isolated.
What IAA has to Say
Insurance Administrator of America wants older adults to take time this month to evaluate their health. If you need help managing a chronic condition or just want to work on your health and wellness goals, see if an IAA wellness program is right for you! IAA also offers health tips through your member portal—try to see if you can implement those in your daily life. Just think of IAA as your self-funded health and wellness counselor, leading you on the way to better health.
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According to a recent study, in 2015 more corporate workers will likely be offered a high deductible health plan (HDHP) –sometimes known as a consumer directed plan. Furthermore, at a rising number of companies it will be the only option on the health benefits plan menu.
How HDHPs can Help Your Business
A HDHP is an excellent way for business owners to reduce costs for their company, while still providing the same high level of medical coverage and benefits that employees expect and desire. In 2015, nearly a third of large employers will only offer high deductible health plans, up from 22% in 2014 and 10% in 2010, according to a study by the National Business Group on Health.
With HDHPs, consumers pay for all of their medical services (at the insurer’s negotiated rate) until they meet their deductible. After that, consumers typically pay coinsurance, which is a percentage of each service (say 10% to 35%) until they reach their out-of-pocket maximum.
HDHPs are often effectively combined with a health savings account (HSA) to help defray the cost of the deductible. HSAs are not a stand-alone coverage option, but rather a supplemental means of planning for medical expenses not covered by the company’s insurance plan. This is done by providing tax free funds to cover unexpected or uncovered medical costs. As long as the plan deductible exceeds $1,300 for a single person or $2,600 for families (in 2015) then employers and workers can deposit money into a HSA. The advantages of using a HSA are:
- Payroll tax savings for the employer
- Tax free money for the employee
- Employees become more conscientious healthcare consumers
- Allows employees to develop a long term healthcare strategy
As employers try to nudge employees toward healthier behaviors, they are increasingly tying their contributions to employee health expense accounts (like a HSA) to motivate healthier behavior. As employees are putting their own money into a HSA, employers hope that they will be more open to comparison shopping for medical services.
Health insurance premium increases have made a HDHP with a combined HSA the only solution for employers that find it too difficult to afford traditional health insurance premiums.
How IAA can Help
If you are interested in setting up a HDHP with a combined HSA, Insurance Administrator of America is here to help! IAA is there for employers and their employees every step of the way. Some advantages that IAA provides are:
- Plan design options
- Employee communication
- Account implementation
- Claim verification
- Detailed explanation of benefits
- Real time reporting
- Dedicated HSA team to manage your account
- Online access to complete account information 24/7
- Compliance with federal regulations
IAA’s HDHPs with a combined HSA can help employees fund those unexpected medical costs that come along, and help employers provide affordable healthcare benefits to their employees.
If you are interested in learning more about IAA’s HDHPs with a combined HSA please reach out! Remember, with IAA one call does it all.
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On August 22, 2014, the Obama administration proposed new regulations to address the religious objections a number of non-profit organizations and private companies have to providing contraceptive coverage for their employees.
How the Proposal Works
Under the new proposal, a religious college or other non-profit group would inform the Department of Health and Human Services (HHS) of its religious objections and HHS would then contact insurance companies and arrange birth control coverage at no cost to the employer or employees. The newly proposed system would work by:
- Objecting institutions telling the federal government which company administers their health plan
- The federal government would then contact the institution’s administrator and ask them to arrange contraception coverage for the non-profit’s employees
- Administrators would likely turn to an insurance company to fund the benefits and the insurance company would later be reimbursed by the federal government
Previously, the objecting organizations were required to notify the insurance companies directly. This was done by completing Form 700, which transfers responsibility for paying for birth control from the employer to the insurer. Filling out this form made some organizations feel it made them complicit in providing drugs they objected to.
Form 700 Alternative
An alternative for Form 700 was part of the proposal. The Form 700 alternative will require religious non-profits to send the federal government a letter that includes:
- The organization’s name
- The type of health plan the organization offers
- The name and contact information for the company’s insurance issuers or Third Party Administrator (TPA)
- An explanation of the types of birth control objected to
- A statement that the objection is based on sincerely held beliefs
Sending this letter to the government will prompt them to instruct a non-profit’s insurer or TPA to take on the responsibility of paying for the birth control at no cost to the employer. As with Form 700, the government will reimburse insurers through credits against fees owed under other parts of the health law.
The administration’s hope is that the new accommodation will work because it creates more distance between religious non-profits and the health services they oppose, by inserting the government as a middleman between non-profits and their insurers.
For Profit Companies
The administration is proposing for the first time to allow certain for profit companies that are not publicly traded to avoid the contraception mandate if they object to it on religious grounds.
Under the newly proposed rule for private companies, owners with religious objections to providing birth control would also be able to contact the federal government to express their religious objections. The proposed rule describes two alternative approaches for defining closely held for profits:
- The entity could not be publicly traded and ownership of the entity would be limited to a certain number of owners
- The entity could not be publically traded and a minimum percentage of ownership would be concentrated among a certain number of owners
The rule for private companies will be open to public comment for 60 days and could still change. After the 60 day period, the government will decide whether to make the rule final.
What IAA has to Say
Insurance Administrator of America is keeping on top of the changes to birth control coverage. The Affordable Care Act (ACA) has brought many changes and it is clear that things will continue to change as employers find these mandates do not work for their businesses. IAA is here to help guide you on any changes that might occur due to the ACA. Remember, with IAA one call does it all.
If you have decided to consider a self-insured level funded health plan for your business, you’ve made a smart decision. However, an important part of having a self-insured level funded plan is choosing the right Third Party Administrator (TPA).
Choosing a TPA Over a Carrier
Traditionally, TPAs are known for white glove service. They are in the business of customizing service and plan designs to meet the needs of each client. Insurance carriers administer self-insured level funded plans and fully insured level funded plans the same way. To them, the only difference is the financial aspect. This is why employers favor TPAs for their self-insured level funded plans.
There are a myriad of other reasons to choose a TPA:
- Group Size: Most insurance carriers will not provide self-insurance administration for groups under 500 people. This has led to a misconception that self-insurance is for larger groups. A good TPA, like Insurance Administrator of America, has created self-insured plans for as low as 35 lives.
- Savings: Be wary of the carrier or TPA that credits your account with a percentage of your savings. The employer should always keep 100% of the savings.
- Select a TPA that provides 24/7 access to your claims data. The broker and employer should have access to data and standard reporting at all times.
- Shell game: Some carriers present level funding as a new, exciting product, when it is nothing more than a funding method. The employer always has the option of paying for claims as they are incurred or paying a fixed amount (level funding).
- TPAs are the self-insurance level funding experts because that’s all they do. TPAs think outside the box, the type of creative thinking that leads to savings.
Of course the best benefit of all with a TPA is more money in the employer’s pocket.
How to Choose a TPA
When choosing a TPA there are many factors to consider:
- Years of existence/experience
- Funding options: Traditional and level funding
- Savings: Make sure your savings don’t turn into a TPA surcharge
- Education of staff
- Claims risk: Your TPA should be able to clearly estimate the maximum claim liability of your plan and provide multiple stop loss insurance policy limits and health plan design options to help lower the overall claims risk for the health plan.
- E&O insurance and bonding
- Claims system flexibility
- Internet capabilities
- Claims turnaround
- PPO re-pricing and UM
- Stop loss administration
- Termination: Even if and when you terminate with a TPA, claims that were incurred during the health plan year, but received after the termination date of the contract, should be managed by the TPA. Your TPA should be able to help manage payments for terminal liability costs easily, as well as provide accurate estimates of what terminal liability costs will be.
How IAA can Help
IAA has been a TPA for over 20 years. Our knowledgeable and dependable staff has been in the insurance business for over 20 years as well. IAA prides itself on being able to offer employers and brokers a personalized experience that comes with great advantages. As your TPA, IAA can offer:
- Access to multiple stop loss carriers so IAA can provide the one that works best for your business
- Employee web portals so they can keep track of their claims information
- Experienced, expert plan administration
- Reports that will help you keep track of your savings goals
- And so much more!
If you are interested in learning how IAA can become your TPA please reach out! You can reach IAA by phone at 856-470-1200. Remember, with IAA one call does it all.
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The Affordable Care Act (ACA) has created a multitude of questions and increased carrier rates. Employers want to know how their health plan is being managed and utilized, and what changes they should make (and be aware of) in the coming years.
Self-Insured Level Funding and the ACA
Self-insurance offers employers traditional and level funding options. Regardless of which funding option an employer chooses the results are the same, savings! Level Funding is not a product it is simply a funding option. Insurance Administrator of America has been offering traditional and level funding options for 20 years. Our clients decide on the funding option that works best for them. Some prefer to pay as they go and some want to make the same payment each month, either way they experience 100% of the savings.
- Monthly Administrative Fee: This is your fixed cost and paid monthly based on the employee count.
- Traditional Claim Funding: Pay for claims as they are incurred, this allows the employer to keep his money in the bank until it is needed.
- Level Claim Funding: Pay a monthly fixed amount for claims. This option feels more like a fully insured plan, which is comfortable for some employers.
With access to the IAA web portal, brokers and employers will be armed with information and knowledge that allows you to design the right health plan for now and in the future. With IAA, you can be sure that your health plan is ACA compliant.
IAA’s Affordable Care Solution
IAA is offering employers a solution designed to meet the ACA requirements. Our “Affordable Care Solution” (ACS) plans can save an employer up to 60% in healthcare costs and fulfill the employer ACA obligations.
- Platinum (IAA ACS National Network Plan): This plan option meets the ACA minimum value requirement; this plan design is for the employee looking for a buy-up option.
- Gold (IAA ACS National EPO Network Plan): This program option also meets the ACA minimum value requirement; this plan design has in-network benefits only and is for the employee looking for a buy-up option.
- Silver (IAA ACS Regulated Payment Plan): This option meets the ACA minimum value and affordability (9.5% of the employees W-2 salary for single coverage) requirements. It provides the employer with a very affordable plan for employees on a limited budget. This program mitigates the employer’s risk and cost by limiting provider payments.
- Bronze (IAA ACS Minimum Essential Coverage Plan):This preventative only coverage plan does not meet the ACA minimum value requirement. It can be offered with one of the above options as it meets the minimum essential coverage requirement of the ACA.
If you are interested in learning more about IAA, call 856-470-1200 and ask to speak with one of our ACA self-insurance experts.