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Voluntary Worksite Benefits

By Walter Sprang, President & Owner, Employee Benefits & Communications

In today's tightening economy many employer groups are looking for ways to offer more incentives to existing employees and remain competitive for new employees as well. With the increasing cost of benefit plans, many employer groups have started to offer Voluntary Worksite Benefits (VWB). These benefits and policies allow employer groups to grow their benefits package with no hard dollar costs!

However, there are many considerations to offering these benefits: product selection, carrier selection, communication and implementation, and ongoing service. Below, I have briefly outlined a few considerations that employer groups should contemplate.

1. Which Insurance Carrier?
Many insurance carriers currently offer a wide variety of voluntary products already in the US, and the list grows longer every day, as startup companies try to delve into the marketplace and existing insurance companies either develop their own division of VWBs or procure smaller worksite companies.

It may be obvious, but the first criteria should be to check the financial stability of the company over the past several years. AM Best is a good place to start. Do not be lured in simply by name recognition of a carrier - instead, selection of which carrier to use should also involve the exact product selection you would like to offer, whether or not your company is multi-state, different billing options supported, minimum participation requirements, and rates.

2. Which Plans?
Several products are available to offer to your employees. More popular benefits include Specified Illness (Cancer, Heart, Critical Illness), Accident, Disability, Hospital Indemnity, and Life Insurance. Rates are typically $20 or less a month for most policies, making them affordable.

It is typically recommended to pair down each product to one offering, as well as a limitation of how many total plans are offered. The selection of products should be made in conjunction with your benefits Broker/Agent to ensure policies do not overlap or coordinate with existing core benefits that are being offered, keeping in mind voluntary worksite products pay direct to the policyholder to assist in out of pocket expenses.

3. How to Communicate & Enroll?
Certainly one of the most important aspects of implementing VWBs would be the consideration of how the products will be enrolled. Several strategies are available:

- group seminar style meetings
- person to person enrollment
- the use of a call center
- co-browsing enrollment
- a combination of these

Many brokers partner with enrollment firms who specialize in communicating the benefits. Truly, benefits that are not communicated properly will not be appreciated by the employees, leading to low understanding and ultimately low participation.

Proper implementation and eduction of VWBs to the employer & human resources will also minimize ongoing administration and service issues, thus allowing the full benefit and potential of the offering.

We have only scratched the surface of some of the aspects of Voluntary Worksite Benefits, but if you are interested in learning more please do not hesitate to contact SB&K Benefits to schedule an appointment on how your employees can benefit at minimal cost to you!

Employee Benefits and Communications (www.ebc-ywb.com), a professional enrollment firm, has offered voluntary worksite products since 1993 exclusively through the health insurance broker market. Based near San Antonio, Texas, EBC now serves over 270 clients in over 30 states throughout the US, ranging in size from 5 employees to 7500 employees. EBC also represents over 12 of the top Worksite Insurance Carriers, and employs several enrollment strategies including group, person to person, call center, and co-browsing electronic enrollment.

May is Disability Insurance Awareness Month

Becoming disabled and not being able to work and earn a living is one of the greatest financial risks people face. Many are not aware that:

• Disability causes nearly 50 percent of all mortgage foreclosures. That’s alarming, especially when you consider that 110 million Americans do not have long-term income protection.
• Three in 10 workers entering the work force today will become disabled before retiring.3

That’s why the Life and Health Insurance Foundation for Education (LIFE) is dedicating the month of May to educating the public on the benefits of having disability insurance. This month [name of employer] is working with Principal Life Insurance Company to make our employees aware of their disability insurance options and review their income protection needs.

Disability insurance protects your income if you are unable to work due to illness or injury. Now’s a great time to learn about the coverage you have, get more information about the need for disability insurance and make sure you have the right protection.

• To learn more about income protection, go to Principal Life’s From Here to SecuritySM website (www.principal.com/disabilitysecure). You can use an interactive calculator to help determine how much disability coverage you may need.

Swine Flu information

I just read this on my Vistage site:

The recent outbreak of swine flu has many business owners concerned for their employees’ health. The Centers for Disease Control and Prevention (CDC) has released detailed information on swine flu and says the symptoms are similar to the symptoms of the common influenza virus. The good news is that most people who become infected with swine flu will recover without hospitalization or long-term complications.

Symptoms
The most common swine flu symptoms include:
Cough
Congestion
Nasal Congestion
Body aches
Joint Pains
Fever
Chills
Sore throat
Headache
Fatigue
Diarrhea
Vomiting
Decreased energy
Those who are immune-compromised, older or pregnant may be at higher risk of complications or serious respiratory illness.

Transmission
This strain of swine flu is believed to be transmitted, like other human viral flus, by casual contact or through the air by sneezes or coughs. Touching or eating pork products will not transmit this flu.

According to the CDC infected people may be able to infect others beginning one day before symptoms develop and up to seven or more days after becoming sick. That means you may be able to pass on the flu to someone else before you know you’re sick, as well as while you are sick.

Prevention
Here are actions people can take to help prevent getting or spreading the flu virus:

- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Try to avoid close contact with sick people.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
If you get sick, the CDC recommends that you stay home from work or school and limit contact with others.
What to do if you suspect you have swine flu
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact your physician. Your doctor will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

Treatment
Currently, we are at the tail end of our normal flu season, and most people with flu symptoms simply have a viral infection and not the swine flu. Maintaining adequate hydration is highly important if you contract any viral illness.

If you contract the swine flu, there are two flu medications which can be helpful. The CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine flu viruses. The CDC says that the antiviral medications amantadine and rimantadine will not work against swine flu.

Young people under the age of 18 with fever or flu symptoms should not be given Aspirin or aspirin-containing products (such as bismuth subsalicylate – Pepto Bismol) due to the risk of Reye syndrome.

Travel
Susan Locke, M.D., Medical Director of Vistage Healthnetwork, discourages any nonessential travel to Mexico at this time. “If someone needs to go for business,” she said, “I would recommend seeing his/her physician prior to leaving and to get a prescription filled for either Tamiflu® or Relenza, both of which are effective against swine flu. These should be started at the onset of any flu-like symptoms.”

For those who have recently traveled to Mexico and have any flu-like symptoms, Susan recommends they go to their physician immediately and get tested for swine flu.


Swine Flu Vaccine
Currently, no vaccine is available to help prevent the swine flu. For those who received the flu vaccine this year, it does not offer protection against the swine flu.

Time to be patriotic???

What price nationalized healthcare?

I've been thinking a lot about the push towards nationalized healthcare. It's a scary thought. I'm not saying that as a benefit advisor, but as a citizen of the United States.

It seems we are taking an express train towards Big Government. The administration is pointing fingers at people who have worked hard, taken risks, and managed to earn big money. The administration insinuates to the masses that "Those rich people have all the money they need, so they don't need help". "If you earn over $xxxx dollars, this tax break/government subsidy/COBRA subsidy does not apply to you". "How could you possibly need help?"

This makes me sick. I've worked hard all my life and have gotten few breaks. Just out of college I ran the magazine department of a bookstore for $5.25 an hour. Did I grumble and complain? No. Because I knew that if I worked smart, looked for opportunities, took some big risks, then in America there is chance for big rewards. Big income. THE SKY IS THE LIMIT.

And guess what? It works. I took a risk, started a business. Pulled countless all-nighters doing the work. Woke up in cold sweats from the responsibility of it all. That is The American Way.

But now, if things continue as they are, what will our kids have? Will they be stuck in a socialized nation with salary caps, government run business, high taxes, and no incentive to take a risk? I hope not.

Like it or not, our country was founded on principles of freedom, enterprise, and God. Our Founders were fighting to escape the big government that was England, and they wanted to make sure it did not happen again in their new country. Let's not forget that.

And guess what else? I know the importance of giving back. Give to the Church, give to non-profits, give to those in need. Ask most successful people and they will mention something charitable that they are involved in. They give time and money. Because many of them started out with nothing and know what it is like to have nothing. They can relate. The hard times, the rice and bean dinners. The things that can blindside you at 4:00 on a Tuesday. The successful people I know are not the "greedy CEOs" you hear about on TV. 

What does Nationalized Healthcare have to do with all of this? It will remove our need to be responsible for our physical and financial health. It will remove our personal responsibility to look after our own well being. The American Way is to have options in regard to healthcare choices. Healthcare is not a right. I shop my health coverage each year to make sure I get the best deal, just like I look for the best options for cars, clothes, etc. I could choose to not have health insurance and pay as I go. Or I could pay an arm and a leg each month for a Cadillac plan. It is my choice and my responsibility. Go without, and pay the price. If you need it and cannot afford it, there are solutions already out there for you.

There, I am off my soapbox. 

What is Self Funding? Part 1 in a series

We will start with an overview of self-funded medical plans. Essentially, a self-funded plan is a fully insured medical plan that is broken into its different parts.

To an employee, the difference is not noticeable – they still have a plan deductible, a network of providers, co-pays, drug benefits, and other familiar parts of a medical plan. They go to the doctor, pay their portion, and the insurance pays the rest.

However, for an employer, things are much different. On a fully insured basis, the employer picks a plan, pays the monthly premium, and hopes the renewal is not too bad. With a self-funded plan, the employer creates their own schedule of benefits (more on that later), utilizes underwriting to create a claims pool, and gets to choose all the vendors that handle claims, insurance protections, drug benefits, etc. Also, because the employer pays claims, they get great information on what was paid, prescription drug and large claim information, and lots of transparency of where the money is going.

The biggest difference between Fully Insured and Self-Funding is who retains the un-used claims dollars. In a good claims year, Self-Funded clients keep un-used claim dollars. In a bad year, Self-Funded clients have insurance protections that cap the claims expense. In a Fully Insured plan, the insurance carrier keeps un-used claims dollars.

Now, the purpose of this article is not to sell a fully insured employer on going self-funded. There are benefits and a need for both types of medical plans. What you will learn from this series of articles is that a fully insured medical plan uses the same tools as a self-funded plan. By learning self-funding, you will have a better grasp on how your fully insured plan works.

So, let’s begin with an overview of the parts of a self-funded plan.

There are 3 parts of a self-funded plan:

1. Fixed cost (Administration, Specific Stop-loss and Aggregate Stop-loss Insurance)

2. Claims

3. Run-off (Terminal Protection)

On a monthly basis, the “premium” of a self-funded plan is made up of the cost of someone physically processing the claims (Administration cost), the potential claims liability per employee (Claims), and the cost of protecting the claims pool (Specific Stop-loss and Aggregate Stop-loss insurance). The Run-off (Terminal Protection) does not come into play until you either change administration companies, or decide to go back to a fully insured plan after being self-funded. Run-off acts like a “mini” self-funded plan (and yes – more on that later).

In the next coming articles I will talk about a specific section of a self-funded plan. Next topic – Fixed Cost. We will talk about Administration in a self-funded plan.