Should Employers Force Workers to Take Time Off?
Here's a good article with arguments for both perspectives:
Unlimited PTO has become a popular option for companies due to easy administration, end of employment cost efficiency, and attractiveness to potential new hires. Balancing effective use and preventing overuse are important concepts to consider:
Pre-tax student loan repayments are becoming a larger part of the total benefits discussion. "Employers can provide up to $5,250 in student loan repayment benefits tax-free through 2025".
Starting Saturday, private health insurers will be required to cover up to eight home Covid-19 tests per month for people on their plans. Americans will be able to either purchase home testing kits for free under their insurance or submit receipts for the tests for reimbursement, up to the monthly per-person limit.
Some great ideas for a 2022 New Years Resolution:
I often get asked if dental insurance is worth it. I recommend that most employers offer dental insurance. Unlike medical, life, and disability insurances which provide financial protection to cover catastrophic health issues, dental provides a different type of benefit. In some ways it can be thought of as an employee perk to:
1. incentivize good oral health
2. streamline the tedious process of finding and utilizing dental care
3. provide good financial protection against the cost of dental care
Here's a solid video from CNBC on the topic:
The IRS has released 2022 limits for HSA, HSA, etc.:
Big changes in the realm of healthcare pricing transparency coming to consumers effective January 1, 2022.
For healthcare services scheduled at least three business days in advance, providers must give the participant’s plan a good faith estimate of anticipated charges.
The era of "buy now, we'll tell you how much it will cost later" is hopefully coming to an end.
Some employers may consider a health premium surcharge for unvaccinated employees:
All Individuals, Insured Groups, and Self-Funded Accounts insured through a Blue Cross Blue Shield affiliate from February 7, 2008, through October 16, 2020 will be receiving a settlement notice with option to file a claim and participate in the pending class action lawsuit related to antitrust law violations.
The American Rescue Plan Act of 2021 (“ARPA”) includes a 100% COBRA premium subsidy for periods of coverage occurring between April 1 and September 30, 2021, for certain eligible individuals. Details on how this will be administered have recently been published:
The American Rescue Act included a provision where the US taxpayers will pay 100% of the premium for COBRA participants from April 2021 through September 2021. This applies to employees who were laid off or hours were reduced so they lost health coverage. Exactly how the reimbursement will work for employers and COBRA administrators is TBD.
The government has so far declined to provide Covid-19 liability protection for businesses. The first lawsuit against an employer is now being heard:
CA AB 744 took effect on 1/1/2021 and aims to expand access to telehealth. Employees need to be made aware of telehealth benefits, particularly when it comes to behavioral/mental health:
The powerhouse Amazon-Berkshire-JPMorgan healthcare joint venture Haven has disbanding. The moral of the story might be that even with unparalleled financial resources and marketplace leverage to disrupt the current system, healthcare is complex and regional in nature and there is no silver bullet:
The No Surprises Act, signed into law on December 27, 2020 will provide additional consumer protections for out-of-network emergency care and to out-of-network care provided at in-network facilities starting in 2021:
Big changes for CA employers with between 5-49 employees. Beginning in January, an expanded California leave law will require employers with as few as five employees to provide up to 12 weeks of unpaid medical and family leave each year.
Some employees prefer and thrive in a work from home environment, but many do not prefer it and are being forced to due to Covid. Here's a good list of WFH struggles that companies may want to address:
Thanks to all participants and volunteers who showed up to the 1st Annual VetCTAP Golf Tournament at Marine Memorial Golf Course on Camp Pendleton. I'm honored to be involved as a volunteer career coach and sponsor.
Insurance carriers and drug makers are often demonized as unjust profiteers of the US healthcare system. In practice, 20 out of 23 Obamacare Co-ops have failed. This is due to a variety of factors, but certainly provides evidence that the free market operates somewhat efficiently. Recently, California SB SB852 provides a path to get the State of California into the generic drug manufacturing business. It will be interesting to see if the state is successful in taking over the means of production for generic drugs.
Due to Covid, many remote employees are choosing to relocate their home address to a different geographic area. In some instances, this will impact their access to healthcare. Here's a summary of important considerations:
1. PPO members can usually find an in-network provider at their new geographic location.
2. HMO members often have emergency-only coverage outside of their local HMO network. If the change is more than a few weeks, members should consider switching to a local HMO medical group at their new locale(if possible) or switching to a PPO plan.
3. Most insurance carriers have expanded Telehealth options, providing access to care for HMO members outside of their geographic area.
4. Employees who "permanently" change their home address to another state(even if they are not planning on being there forever) will likely have income and payroll tax implications. It's a great idea to consult your payroll vendor and CPA if this comes up at your business.
As expected due to Covid-related shutdowns and delay of standard care, Covered California insurance rates for 2021 will increase only an average of 0.6%. This is a solid early indicator for employers can expect in the broader group marketplace in California for 2021.
Four executive orders were signed today to combat high Rx prices:
1. Directs federally qualified health centers to pass along massive discounts on insulin and epinephrine received from drug companies to certain low-income Americans.
2. Will allow State plans for safe importation of certain drugs, authorize the re-importation of insulin products made in the United States, and create a pathway for widespread use of personal importation waivers at authorized pharmacies in the United States.
3. Will prohibit secret deals between drug manufacturers and pharmacy benefit manager middlemen, ensuring patients directly benefit from available discounts at the pharmacy counter.
4. Ensures that the United States pays the lowest price available in economically comparable countries for Medicare Part B drugs.
Improving the US Healthcare System: 6 GREAT IDEAS AND 5 NON-SOLUTIONS
US healthcare system provides the highest quality of care on the planet. Our system has fully harnessed the power of free market economics for innovation and efficiency, but is still subject to systemic barriers. San Diego in particularly has amazing systems including Scripps, UCSD, Sharp, and others. Access to care and cost are a separate issue. In my career working as an insurance broker since 2005, I am often asked what actions could be taken to improve access to care and cost.
Here are some good ideas and non-solutions, in my opinion.
6 GOOD IDEAS
1. Improve population health:
1. State-by-state limiting Rx copays:
The CA Department of Fair Employment and Housing has released a free training tool to help companies comply with SB1343. For companies with 5 or more employees, the training is due by January 1, 2021.