Health benefits – SWTOR Save http://swtorsave.com/ Wed, 15 Sep 2021 20:08:00 +0000 en-US hourly 1 https://wordpress.org/?v=5.8 http://swtorsave.com/wp-content/uploads/2021/08/default.png Health benefits – SWTOR Save http://swtorsave.com/ 32 32 Most Americans say the public health benefits of COVID-19 restrictions ‘were worth the cost’ http://swtorsave.com/most-americans-say-the-public-health-benefits-of-covid-19-restrictions-were-worth-the-cost/ http://swtorsave.com/most-americans-say-the-public-health-benefits-of-covid-19-restrictions-were-worth-the-cost/#respond Wed, 15 Sep 2021 20:08:00 +0000 http://swtorsave.com/most-americans-say-the-public-health-benefits-of-covid-19-restrictions-were-worth-the-cost/

More than a year and a half after the start of the COVID-19 pandemic, the closures, indoor capacity limits and restricted hours of operation could be a distant memory for some. But the economic toll of these COVID-19 restrictions cannot be denied – as much as 200,000 shops permanently closed due to the pandemic.

Still, Americans think the restrictions were worth it, according to a new Pew Research Center survey. He revealed that while a majority of Americans believe the coronavirus restrictions have hurt businesses and economic activity, they have been worth it in the end.

The survey, which surveyed more than 10,000 American adults, found that 69% believe COVID-19 restrictions on business have hurt businesses and economic activity “a lot,” while 26% believe that ‘they have harmed “certain” businesses. And 89% of Americans believe the restrictions have “kept people from living their lives the way they want,” either a lot or a portion.

But 73% of those polled said the restrictions helped prevent hospitalizations and deaths from COVID-19, either a lot or some, and 72% said the restrictions helped slow the spread of the coronavirus.

Related: Gen Z Students Overwhelmingly Support Strict COVID-19 Policies Upon Return To School

Overall, 62% of Americans said the public health benefits of COVID restrictions “were worth the cost.”

Overall, 62% of Americans said the public health benefits of COVID restrictions “were worth the cost.”

As COVID-19 cases continue to rise across the country due to the delta variant, some local governments have reinstated various COVID-19 restrictions. Los Angeles County brought back its mask mandate in July, and New York City began requiring all customers to prove vaccination in order to visit restaurants, bars, gyms, public shows, museums and other venues. The United States currently has an average of 152,177 new cases per day, 99,275 hospitalizations and 1,888 deaths, according to a New York Times tracker.

As of Wednesday, 74% of the eligible U.S. population had received at least one injection of one of three available coronavirus vaccines, according to a CDC Tracker.

The survey, which was conducted from August 23 to August 2. 29, before President Joe Biden announced his mandate on vaccines – also found that Americans often have divergent views when it comes to vaccines.

Overall, 51% said the phrase “there is too much pressure on Americans to get vaccinated against COVID-19” described their point somewhat or very well.

Before Biden announced his vaccine mandate – which will require companies with 100 or more workers to ensure their employees are vaccinated, or show a negative test result weekly or more frequently – employers were already enforcing vaccine warrants.

This includes some big companies like Disney DIS,
+ 1.10%,
Facebook FB,
-0.69%
and Google GOOG,
+1.26%.
Delta Air Lines DAL,
+ 0.51%
also said its employees would face a monthly health insurance surcharge of $ 200 if they remained unvaccinated.

Related: Biden meets with Disney, Microsoft and Walgreens executives on vaccine mandates

At the same time, 73% of those polled said the statement “vaccines are the best way to protect Americans from COVID-19” describes their point somewhat or very well.

Yet about a quarter of the adult American population has not received the vaccine at all. Experts now predict that 85% or 90% of the population will need to be immunized against the virus to gain herd immunity. And Dr Anthony Fauci said the United States could see 100,000 more deaths from COVID-19 by December 1, mostly among people who continue to refuse vaccination.

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Florida Businesses Can Create Diversity Through Health Benefits http://swtorsave.com/florida-businesses-can-create-diversity-through-health-benefits/ http://swtorsave.com/florida-businesses-can-create-diversity-through-health-benefits/#respond Wed, 08 Sep 2021 18:11:00 +0000 http://swtorsave.com/florida-businesses-can-create-diversity-through-health-benefits/

Health care benefits can be an employment tool.

Health care benefits can be an employment tool.

PA

Employers across the country are making significant progress towards creating diverse, equitable and inclusive workplaces. As the eighth most diverse state in America and at home in almost 20 Fortune 500 companies, Florida has the opportunity to be a leader and a change maker in business diversity, equity and inclusion (DCI).

Beyond being the right thing to do, DEI makes business sense. Almost 80% of workers say they want to work for a company that values ​​DEI. With Florida’s shrinking workforce, employers are wise to consider all of the competitive advantages.

One of the most overlooked factors in building an inclusive workplace is health insurance, which also happens to be a benefit for employees. care about most. Growing evidence suggests that some common elements of insurance design, such as deductibles, act as barriers to care and exacerbate health disparities. Business leaders need to take an honest look at how health plan design contributes to disparities and be willingly engaged in driving change.

Designing a “one size fits all” plan is not enough. Coverage is inherently inequitable if it treats all employees as if they are the same – because they are inherently different – and health needs vary from person to person.

To truly help individuals achieve their best health, designing a personalized health plan should be embraced by employers. Benefits must be built to meet people’s unique needs and address the disparities inherent in a “one-size-fits-all” design.

Why not personalize the grants?

As an employer, you can choose what to cover and how much to cover. What if you reinvented the common practice of making grants equal for all and, instead, provide health coverage that prioritizes individuality, diversity and inclusiveness?

Truly inclusive health care coverage defines subsidy strategies to actively address known health inequalities. It also takes into account the needs of the whole person, including mental health and nutrition.

Custom Subsidy allows you to set coverages based on income level, giving you the ability to reduce cost sharing for low-income employees or hourly workers who may be more likely to avoid care due costs. This is especially important in Florida, as it ranks 49th for the worst income inequalities in America.

A 2018 CDC investigation found that 40% of Americans avoid medical tests or treatment, and 44% do not seek treatment when sick or injured because of the cost. He also found that 86% of those who delayed or skipped care had insurance. So, access to insurance coverage is not really the problem; it’s the blanket itself that doesn’t work.

Truly inclusive employers look to and support people who face greater challenges in accessing health care. They know and appreciate the difference between equality and fairness. Low-income people of all races are at a disproportionate risk of becoming sicker and dying at a younger age. It’s not good.

Health disparities

We know that addressing health disparities improves the overall quality of care and leads to a healthier population. We also know that inclusive workplaces demonstrate higher productivity, achieve greater innovation, and recruit and retain better talent. But to achieve inclusiveness, you must recognize that your workforce has individualized needs.

As an employer, you have the power to help your employees choose the treatments and providers that are best for them. You can give them contextualized choices based on their needs – a range of clinical providers, advocacy and support that reflect their unique racial, cultural, ethnic, and LGBTQ + needs.

You can refer your employees to providers who provide culturally, ethnically and linguistically appropriate care. You can give them health plans that show side by side treatment costs and quality ratings.

Contextualizing health coverage is celebrating the uniqueness of your employees. It’s about protecting their long-term health by helping them overcome barriers to care.

Personalized benefits

Rigid or “static” health plans often leave employees overinsured or underinsured. If employees aren’t paying too much premium for coverage they never use, they’re paying out of pocket for unforeseen or emergency care.

Personalized health benefits turn insurance into a decision-making platform that enables people to achieve their best health affordably and avoid unnecessary or low-value care along the way.

Imagine the peace of mind of visiting a healthcare provider and knowing the exact cost of your visit ahead of time – without worrying about a deductible or paying 20-30% coinsurance. Imagine the freedom of being able to shop for the cheapest and most profitable treatments. How much value would your employees place on such a health plan experience?

Personalized coverage allows your employees to choose the care best suited to their needs, while knowing the exact cost in advance.

Can your workplace be truly inclusive without inclusive benefits? We have to face the reality that the answer is no. One-size-fits-all approaches to everything, including health benefits, fail to leverage the superpower that comes from meeting the unique needs of our employees.

Now is the time to stand up and do something different. For anyone who has ever felt that their needs were not being met by health care. For all those who have held several jobs to afford a franchise. For all of us.

Florida’s richly diverse workforce deserves inclusive and personalized benefits that meet all identities, cultures, and healthcare needs. And it’s good for business. Employers who are motivated to act will have a head start in the talent race.

Marcus Thygeson, MD, MPH has served both sides of healthcare, as an attending physician and health plan executive. He is Link the benefits chief medical officer of health.

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Vegan vs. Vegetarian: Differences and Health Benefits http://swtorsave.com/vegan-vs-vegetarian-differences-and-health-benefits/ http://swtorsave.com/vegan-vs-vegetarian-differences-and-health-benefits/#respond Wed, 01 Sep 2021 16:46:11 +0000 http://swtorsave.com/vegan-vs-vegetarian-differences-and-health-benefits/
  • Vegetarians only avoid meat, while vegans avoid all animal products, including dairy and eggs.
  • Vegan and vegetarian diets can be healthy, nutritionally adequate, and beneficial to health.
  • Vegans may be more sensitive to nutritional deficiencies in iron, vitamin D, calcium, and protein.
  • Visit Insider’s Health Reference Library for more tips.

The difference between becoming vegan and vegetarian primarily focuses on the role of animals in food production.

“While both diets focus on consuming plant-based foods, vegetarians are allowed to include eggs, honey, and dairy products. Vegans omit any animal foods or products. animal origin, including meats, poultry, dairy products, honey and eggs, “says Lisa Moskovitz, RD, CDN, CEO of New York Nutrition Group, a private practice in New York.

Both of these diets can be perfectly safe if done correctly, Moskovitz explains. She notes, however, that you don’t need to eat vegan or vegetarian to achieve your health or weight management goals.

And while one diet isn’t necessarily safer than the other, if you’re new to it, it may be easier to try vegetarianism first. “Vegetarianism is a little less restrictive, and therefore easier to consume a more balanced intake of nutrients,” says Moskovitz.

Here’s what the experts know about the difference between being vegan and vegetarian and its health effects.

The difference between vegan and vegetarian nutritional deficiencies

Compared to omnivores, vegans and vegetarians “require more attention and effort to ensure that all nutrients are taken into account. It is easier to become deficient in B vitamins, iron,

Vitamin D
, calcium and protein, ”says Moskovitz.

However, vegans “will have a much higher risk of all of these deficiencies, whereas a vegetarian who properly plans and balances their meals will be at much lower risk of deficiencies in general.”

A study published in Nutrients in 2014, found that vegans had an average of 738 milligrams of calcium per day, which is well below the 1,000 milligrams per day recommended by the National Institutes of Health. In fact, it was the lowest daily calcium intake level of any group in the study.

Semi-vegetarians, on the other hand, consumed the most calcium at around 1,470 milligrams per day. The semi-vegetarians in the study were those who ate meat and fish once a week or less.

In another study, published in 2010 in the European Journal of Clinical Nutrition, researchers found that 52% of vegans were deficient in B12, compared to only 7% of vegetarians.

That said, vegetarians aren’t always healthier than vegans. It all depends on what you choose to eat, regardless of what diet you are on.

“It’s too hard to say that a specific nutrient would be more abundant in vegetarian diets compared to vegans,” says Moskovitz. “If vegetarians eat a lot of eggs and dairy products, they probably won’t have any deficiencies. However, if they only eat eggs and dairy products once or twice a week, they can have as many deficiencies as vegans, because that’s the main difference between diets. ”

If you’re not getting enough nutrients, you can try supplements to make up the difference. However, Moskovitz says, “it all varies from person to person and depends on other restrictions or preferences in their diet.”

“Most vegans and vegetarians would benefit from seaweed oil – [a] Superior plant form of omega-3 – a staple multivitamin as an insurance regimen. And maybe calcium, vitamin D, and B vitamins, ”she says.

The difference between the health benefits of vegans and vegetarians

In a review, published in 2017 in Critical Reviews in Food Science and Nutrition, the researchers analyzed the results of nearly 100 studies. They found that vegans and vegetarians had lower body mass index, lower total cholesterol levels, and lower glucose levels than people who ate meat.

This could explain why the review also concluded that vegetarians have a lower risk of dying from ischemia.

heart disease
and cancer. And vegans, in particular, had an even lower risk of dying from cancer than vegetarians or omnivores.

Another large study, published in JAMA Internal Medicine in 2013, found that, compared to people who ate meat and fish several times a week, vegans and vegetarians – including pescetarians – were less likely to develop and die from cardiovascular problems,

Diabetes
-related problems,

hypertension
, metabolic syndrome and renal failure.

On the other hand: a study, published in 2019 in BMJ, found that stroke rates were 20% higher in vegetarians than in non-vegetarians – mainly, according to the researchers, “due to a higher rate of hemorrhagic stroke.” A Hemorrhagic stroke occurs when blood vessels become weak and can burst and bleed in the brain.

It is possible that this association is due to lower amounts of protective substances, such as omega 3 fatty acids, in a vegetarian diet. However, with careful planning and perhaps supplementation, vegetarians and vegans can get these nutrients from non-animal sources.

Insider takeaways

Ultimately, according to the Academy of Nutrition and Dietetics, vegan and vegetarian diets can be healthy. Their official position is that “Appropriately planned vegetarian diets, including vegans, are healthy, nutritionally adequate and may provide health benefits for the prevention and treatment of certain diseases.”

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Beaufort Co. agrees to pay retirees $ 125,000 in addition to health benefits http://swtorsave.com/beaufort-co-agrees-to-pay-retirees-125000-in-addition-to-health-benefits/ http://swtorsave.com/beaufort-co-agrees-to-pay-retirees-125000-in-addition-to-health-benefits/#respond Wed, 25 Aug 2021 08:30:00 +0000 http://swtorsave.com/beaufort-co-agrees-to-pay-retirees-125000-in-addition-to-health-benefits/

Retired Beaufort County employees who were deprived of their retirement benefits in 2016 may soon be eligible to receive money, Beaufort County Council ruled Monday evening.

The county council on Monday agreed to pay around 50 to 60 former county employees who retired after July 1, 2016, a portion of $ 125,000.

The decision comes more than a year after the county agreed to settle a lawsuit over reduced health benefits for retirees in 2016. As part of the settlement, the county agreed to pay 40 former employees $ 695,000. .

The lawsuit, filed on behalf of 40 former Beaufort County and Bluffton Township Fire District employees, alleged the county severed its contract with employees in 2016 when it cut health benefits from several hundred current and former employees.

In March 2015, Beaufort County Council unanimously voted to cancel health insurance benefits for 95 retirees and 590 workers eligible to receive it upon retirement.

BlufftonFireEquipmentIMG_0078SUB.jpg
In this handout photo taken at Station 35 of the Bluffton Township Fire District Headquarters, Firefighter Scott Smith, left, and Firefighter / Paramedic Carson Stone showcase some of the personal protective equipment the service uses for them. emergency calls. Submitted

On Monday, several former county employees called on the council to correct the injustice and offer money to employees who did not sue for the lost benefits.

Council agreed and voted unanimously (10-0) to offer payment. Council member Gerald Dawson withdrew from the vote.

“I think it’s the right thing to do,” said board member York Glover, who has fought continuously for the issue over the past year. “It is the moral thing to do, that this council live up to its commitment to these retirees. “

The county plans to send letters to eligible retirees for review and sign next week, according to county spokesman Chris Ophardt. The amount of money each person will receive will be based on a formula that takes into account the employee’s length of employment, life expectancy on July 1, 2016 and the amount of the subsidy included in their health benefits, Ohardt said.

Employees who did not have health insurance when they retired are not entitled to payment, he said.

Loss of benefits

In November 2003, Beaufort County Council passed a resolution authorizing employees with at least 10 years of service to continue their medical and dental coverage through Blue Cross Blue Shield.

In 2008, the board revoked the policy for new hires, declaring that only grandfathered employees could continue to receive health benefits after retirement.

In March 2015, the council ended all county health benefits for already retired employees and for current employees who would have been eligible for retirement.

When the policy went into effect in June 2016, it removed health coverage for 95 retirees and 590 then-current employees who were eligible for retirement.

Ten more retirees from the Bluffton Township Fire District lost coverage and about 95 current employees were entitled to it.

The benefits have been reduced due to rising costs, officials said in 2015.

Beaufort County was making about $ 380,000 in annual contributions to health care premiums for retirees, former deputy county administrator Josh Gruber said in 2015. Retirees paid the remainder of the $ 323,000.

“The numbers are what the numbers are,” Gruber said in 2015. “The cost of continuing to provide this benefit has reached a tipping point that is no longer sustainable.”

On July 21, 2016, 16 former employees from Beaufort County and the Township of Bluffton Fire District sued the County and Fire District for the loss of health coverage. Over time, more defendants were added to the trial.

The lawsuit was removed from the role in 2018, then added again in July 2019.

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A reporter for The Island Packet covering local government and development, Kacen Bayless is from St. Louis, Missouri. He graduated from the University of Missouri with a major in investigative reporting. In the past, he worked for the St. Louis Magazine, the Columbia Missourian, the KBIA and the Columbia Business Times. His work has earned him awards from the Missouri and South Carolina Press Association for his investigative, corporate, in-depth, health, growth, and government reporting.
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Calvo’s SelectCare, underwritten by Tokio Marine Pacific Insurance, has finalized the annual renewal of benefits and rates for its federal employee health insurance program with the Office of Personnel Management for 2022, according to a press release from Calvo’s SelectCare.

“We are delighted to continue to provide our health plans which include an expanded network of providers and services to federal employees and Guam and CNMI annuitants,” said Frank J. Campillo, health plan administrator for SelectCare. by Calvo. “We have seen significant growth in our federal membership population over the years and look forward to continuing to grow our membership.

Calvo’s Insurance serves as a managing agent and third party administrator for Tokio Marine Pacific Insurance Limited; a chartered insurance company from Guam and a subsidiary of Tokio Marine holdings. Tokio Marine Pacific Insurance is the only health insurance company in Guam ranked by AM Best and accredited by AAAHC, the statement said.

“Over the past 20+ years, we have developed consistent quality services and medical access to a comprehensive local and national medical network that now includes over 1.1 million providers through the UnitedHealthcare PPO network in the Americas. , Campillo said. “Our personal approach to providing access to quality care and our unparalleled service to our clients has allowed us to forge lasting relationships with them. The expanded network of providers and perks such as discounts on air ambulance services provide potentially life-saving member options. “

SelectCare by Calvo was launched in 2000.

“A strong testament to our services is that most medical clinics and providers in Guam make sure with our health plan. We look forward to continuing and expanding our relationship with federal employees and annuitants, ”Campillo said.

The company will offer federal employees and annuitants in Guam, CNMI and Palau the opportunity to learn more about SelectCare health plans during the “open season” later this year.

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ICHRA is changing the face of employer-sponsored health benefits http://swtorsave.com/ichra-is-changing-the-face-of-employer-sponsored-health-benefits/ http://swtorsave.com/ichra-is-changing-the-face-of-employer-sponsored-health-benefits/#respond Mon, 16 Aug 2021 15:23:38 +0000 http://swtorsave.com/ichra-is-changing-the-face-of-employer-sponsored-health-benefits/

When most business leaders are introduced to the concept of ICHRA, a relatively new model of employer-sponsored health benefits that offers long-term budget control and the potential for significant savings compared to group benefits traditional, their first reaction is somewhere along the lines of “sounds too good to be true.”

That’s the sentiment expressed by Jon Gaines, vice president of finance at WWBIC, a state-wide economic development company based in Milwaukee. The organization had been enrolled in a group health plan almost since its inception, but began weighing new options during the December 2020 renewal period to combat the surge in annual premiums – which topped 35%. WWBIC could not continue to shoulder the financial burden with high cost sharing.

“We are a small, fast growing company with a limited number of employees,” Gaines explained. “A lot of it was really the dollars involved – the [cost] It was just becoming very prohibitive for us to be able to support a health plan at WWBIC. “

When they turned to zizzl for a health insurance solution, WWBIC executives were surprised to learn about ICHRA, a new employer-funded health coverage option.

“I kept thinking ‘How come we haven’t heard of this?” said Patti Lohmann, who heads the company’s human resources. “The cost savings have been very positive, but they have also given our staff many options. Our employees were pleasantly surprised when they saw that they might not have to pay anything for this benefit.

The ICHRA, acronym for Individual Coverage Health Reimbursment Arrangement, allows employers to reimburse premiums for individual market coverage selected by employees, tax-free.

It allows businesses to control their budgets and allows employees to choose their own health care coverage, rather than having their employer choose a group plan on their behalf or purchase comprehensive insurance.

According to the HRA Council, more than 74% of companies offering health insurance offer their employees only one type of health plan.

For WWBIC, part of the appeal of ICHRA was giving employees choice, but with a reimbursement process as easy to navigate as a group plan.

“The most important thing was that we could offer more and better options,” said Gaines. “That sigh of relief from our team and not ‘Oh my God, here’s another raise, a cost-share that we have to do.’ “We’ve actually cut costs for our employees. For WWBIC too. It’s been a complete change to where we actually have savings… and can use those dollars to use them in other areas of our business.”

Since the ICHRA was first enacted by the federal government in 2019 to help reverse the declining percentage of employers in small businesses offering health insurance, the benefit model has largely gone under the radar. But the voluntary option is quickly gaining ground due to the extent of its quality coverage and cost savings.

At Milwaukee Cylinder, signing an ICHRA through zizzl meant the manufacturer could “step out of the benefits” and put the reins in the hands of their employees – with guidance from their team of zizzl brokers.

Earlier this year, the company’s vice president of finance, Justin Dahm, looked at renewal costs for “big projects that were out of this world.”

When he heard about ICHRA from zizzl, he was surprised at the number of quality plans available from major health insurers as part of the program and the support that would be provided to employees throughout the period. transition, many of whom were new to learning and selecting their own health coverage.

“We didn’t really have the knowledge or the ability to give all of our employees the information they needed to select the right deals,” Dahm said. “There was also a lot of hand held on our side. zizzl really explained all of this to us in layman’s terms for those of us who didn’t know the benefits. Dahm added that employees also benefited from zizzl’s on-site presentations on the ICHRA during the enrollment period, the broker’s online health plan review to help employees narrow down their coverage options, and the concierge service to help them choose the right diet.

When all was said and done, the company and its employees were thrilled with the results of an ICHRA benefits plan.

“We did business analysis and that was the right way to go,” Dahm explained. “We looked at different insurance plan options that were available. In the end, we were looking for a better solution. The ICHRA had great options for employees based in Wisconsin. We decided to go for it. “

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UnitedHealth to pay $ 15.7 million to settle mental health benefit parity case http://swtorsave.com/unitedhealth-to-pay-15-7-million-to-settle-mental-health-benefit-parity-case/ http://swtorsave.com/unitedhealth-to-pay-15-7-million-to-settle-mental-health-benefit-parity-case/#respond Thu, 12 Aug 2021 07:00:00 +0000 http://swtorsave.com/unitedhealth-to-pay-15-7-million-to-settle-mental-health-benefit-parity-case/

Health Net is an example of a health insurer who said they have witnessed a large number of fraud in drug rehab centers.

Many behavioral health professionals say they have such a hard time getting paid that they run cash-only practices and refuse to participate in health plan provider networks.

Consultants from Milliman, an actuarial consulting firm, argued in 2017 that patient use of out-of-network providers is a good indicator of the adequacy of reimbursement for the health plan.

Consultants reported that patients with preferred provider organization coverage were between 2.8 times and 4.2 times more likely to use out-of-network providers than users of other types of care. .

The allegations

James alleges in his complaint that Optum Behavioral Health has treated behavioral health care providers differently from other providers in two ways.

One was that the organization reduced the amount of reimbursement allowed for services provided by non-physicians, even though non-physicians provide the majority of behavioral health care. The organization reduced the authorized amount by 25% for services provided by psychologists with doctorates and 35% for services provided by therapists with masters degrees, according to James.

Optum has only applied these types of reimbursement rate reductions for medical treatments in limited circumstances, James says.

James says Optum has also treated behavioral health care providers differently by using a special usage review program, the Algorithms for Effective Reporting and Treatment (ALERT) program, on Behavioral Health Care and no other. form of care.

Until June 3, 2019, the ALERT program led Optum Behavioral Health to reject numerous patient behavioral health claims, based on claims that the level of care requested was not medically necessary,

For some other types of care, UnitedHealth used an outlier management program that was much less likely to result in denial of claims, and for other types of care, the company did not use any outlier management method. comparable use review, according to James.

Department of Labor building in Washington. (Photo: Mike Scarcella / ALM)

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South Dakota to Advance Federal Employee Medicare Program http://swtorsave.com/south-dakota-to-advance-federal-employee-medicare-program/ http://swtorsave.com/south-dakota-to-advance-federal-employee-medicare-program/#respond Fri, 06 Aug 2021 20:30:26 +0000 http://swtorsave.com/south-dakota-to-advance-federal-employee-medicare-program/

Last year, the South Dakota congressional delegation successfully pushed forward federal legislation that will allow more than 100 tribal-controlled schools across the country to participate in the Federal Employee Medicare Program (FEHB ). The Office of Personnel Management (OPM) is working to get the word out, and we hope this short update provides useful information for newly eligible entities and other groups interested in efforts to expand eligibility. tribal as part of the FEHB program.

According to the Congressional Research Service, the FEHB program is the largest employer-sponsored health insurance program in the country, providing health care benefits to about 85 percent of federal government employees and 90 percent of federal retirees. Under the program, the federal government and the employee or retiree share the cost of health insurance, with the federal government typically contributing 72% of the weighted average premium of all plans, but no more than 75% of the cost. premium of a given plan. The OPM administers the program.

Many tribal employers have been eligible to participate in the FEHB program since 2012. The Patient Protection and Affordable Care Act (Pub. L. 111-148), enacted in 2010, established that an Indian tribe or tribal organization running programs under the Indian Self-Determination and Educational Aid Act (ISDEAA), or an urban Indian organization running programs under Title V of the Indian Healthcare Improvement Act , could participate in the FEHB program.

In 2011 and 2012, the OPM held consultations with Indian tribes and other stakeholders on the new program, and in May 2012, tribal employers began purchasing FEHB coverage, rights and benefits for their workers. employees. Under the Tribal Employer Program, the tribal employer is required to pay at least the government’s share of the premium, and the registrant pays the remaining share. Tribal employers are allowed to purchase coverage only for employees and their dependents, and coverage is not available for retirees.

The Tribal School Federal Insurance Parity Act, introduced at the 115th Congress, aimed to extend the benefits of the FEHB program to employees of schools controlled by tribes. Tribal controlled schools are generally defined as K-12 schools which 1) are operated by Indian tribes or tribal organizations, 2) are not considered a local education agency, and 3) are not directly administered by the Bureau of Indian Affairs (BIA). According to the Bureau of Indian Education (BIE), the BIA funds 183 schools serving Native Americans located on 64 reserves in 23 states. Of these schools, 57 are managed directly by the BIE and already participate in the FEHB program, and 126 are tribal controlled schools and do not. Prior to the enactment of the Tribal School Federal Insurance Parity Act, even BIE “contracted” schools (operated by Indian tribes through ISDEAA) were not eligible to participate in the FEHB program without changing the law.

Congresswoman Kristi Noem (R-SD) in the United States House of Representatives and Senators John Thune (R-SD) and Mike Rounds (R-SD) in the United States Senate sponsored the Tribal School Federal Insurance Parity Act at the 115th Congress. Congressman Dusty Johnson (R-SD-At Large) joined the two senators to reintroduce the legislation at the 116th Congress.

By the end of the 116th Congress, the South Dakota delegation had recruited a remarkably bipartisan coalition of cosponsors, including Congresswoman Deb Haaland (D-NM). The legislation has also received support from the National Congress of American Indians, the National Indian Health Board, the National Indian Education Association, the All Pueblo Council of Governors, the Great Plains Chairmen’s Health Board, the United Tribes of North Dakota and of the Saint Stephens. Indian School Educational Association, among others.

On May 1, 2019, the Senate Indian Affairs Committee held a legislative hearing on the Tribal School Federal Insurance Parity Act, in which John Tahsuda III, Senior Assistant Deputy Secretary — Indian Affairs, US Department of the Interior, and Cecelia Firethunder, President, Oglala Lakota Nation Education Coalition, testified in support of the bill. Deputy Assistant Secretary Tahsuda said the participation of IBE schools in the FEHB program has reduced costs and helped in the recruitment and retention of schools. Ms. Firethunder estimated that access to FEHB would save a single BIE-funded school on the Pine Ridge Reservation, the Little Wound School, to save $ 1,000,000 per year. The Indian Affairs Committee introduced the bill to the full Senate in July 2019, and the legislation was finally enacted in late 2020, in Section 1114 of the 2021 Consolidated Finance Act (Pub. L. No. 116-260).

In April 2021, OPM hosted a government-to-government consultation which, among other things, covered OPM’s work with Tribes to enroll tribal employees in the FEHB program. During that consultation, the OPM noted that tribal-controlled schools are now eligible to purchase coverage for their employees, and the OPM has since officially launched the application process.

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BMA: Number of MAID plans offering social benefits linked to determinants of health tripled in 2021 http://swtorsave.com/bma-number-of-maid-plans-offering-social-benefits-linked-to-determinants-of-health-tripled-in-2021/ http://swtorsave.com/bma-number-of-maid-plans-offering-social-benefits-linked-to-determinants-of-health-tripled-in-2021/#respond Thu, 05 Aug 2021 14:30:00 +0000 http://swtorsave.com/bma-number-of-maid-plans-offering-social-benefits-linked-to-determinants-of-health-tripled-in-2021/

The number of Medicare Advantage plans investing in additional benefits to address the social determinants of health has tripled in a single year, but additional guidelines and standards from the Biden administration are needed, according to a new report.

The report, released Thursday by the Better Medicare Alliance, comes as the Biden administration has made health equity a priority and called for the collection of data on race and ethnicity from providers and payers.

“This report paints an encouraging picture of the significant investments Medicare Advantage plans and partners are already making in this space, with the number of Medicare Advantage plans providing [supplemental benefits] tripled more than three in a single year, ”Kenneth Thorpe, chairman of the board of the Better Medicare Alliance, said in a statement.

The report found that 845 separate Medicare Advantage plans offered special additional benefits for the chronically ill this year, up from 245 in 2020, according to data from the University of Chicago’s NORC.

Plans generally offer benefits that target social determinants of health such as social isolation, diet and housing. But a major hurdle among plans is trying to figure out how to identify the social determinants of a patient’s health.

“We lack a systematic approach to identify social needs, pay for interventions to meet those needs and assess the results of these programs,” Caroline Pearson, senior vice president of NORC, said in a statement.

RELATED: BMA: Medicare Advantage Enrollments Rise To 26 Million In 2021 Thanks To Plan Offerings And Employee Options

The Centers for Medicare & Medicaid Services (CMS) must add new standards for collecting social determinants of health in Medicare.

Some health plans said they included questions on the social determinants of health in their beneficiary surveys and extracted data and beneficiary interactions to obtain clues about risk factors.

But CMS can help by increasing data collection on the social needs of beneficiaries, according to the report. These include adding consistent social determinants of health “data elements to Medicare wellness visits,” the researchers said. “More comprehensive and standardized data collection would allow better data sharing and evaluation. “

CMS must also adjust its reimbursement and risk methodology to take more account of social risk factors.

This includes adjusting the MA payment in annual risk adjustments to include an assessment of social risk factors among plan beneficiaries. The agency should also consider modifying the performance metrics for the quality of the MA star rating to reflect risk factors.

CMS should also permanently allow the Value-Based Insurance Design Authority (VBID) to promote innovation in the social determinants of health, the report recommends.

VBID has grown steadily since its extension to a national program, but has been slow to expand to supplementary benefits.

“One potential reason could be the reluctance regarding VBID’s status as a demonstration program under the Center for Medicare and Medicaid Innovation and its resulting uncertain future,” the report said.

The report comes as the Biden administration has taken several steps to address health equity gaps in care.

Center for Medicare and Medicaid Innovation director Liz Fowler, Ph.D. said earlier this year that the agency’s payment models will explore health equity, including potential requirements for models to collect. data on race and ethnicity.

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Sandy Springs approves health benefits for elected officials who pay full cost http://swtorsave.com/sandy-springs-approves-health-benefits-for-elected-officials-who-pay-full-cost/ http://swtorsave.com/sandy-springs-approves-health-benefits-for-elected-officials-who-pay-full-cost/#respond Wed, 04 Aug 2021 23:02:06 +0000 http://swtorsave.com/sandy-springs-approves-health-benefits-for-elected-officials-who-pay-full-cost/

Correction: An earlier version of this article misidentified the Chairman of the Charter Review Commission, Gabe Sterling.

Sandy Springs will allow city council and the mayor to join the city’s health insurance plan provided they pay 100% of the premiums at no cost to the city.

Board member Chris Burnett’s proposal was unanimously approved at a meeting on August 3. This followed the rejection of a proposal by Board Member Andy Bauman for staff to obtain more detailed information on the provision of these benefits to elected officials.