Workable Sentinel

Are Chairs Destroying Your Employees' Health?

2012-05-10T17:59:58Z

It seems like hyperbole that we are being killed by office chairs, but multiple studies show that excessive sitting shortens a person’s life by several years. So what are we to do about it? We live in a world of chairs…in our cars, in front of TVs, in front of computers at work. Short of quitting our desk jobs to hike to the Appalachian Trail, what can we do about it? Get vertical with a standing desk!

The History of Standing Desks

The chair is a bit like wheat, in that it’s a relative novelty to which our bodies have not adapted and yet it’s a cultural staple. The chair is designed to fit our bodies, but our bodies are not designed to sit in them. We are designed to hunt, gather and walk. Do we sit in order to seem more civilized?

Some of the most civilized and greatest men in history have used standing desks, including Leonardo Da Vinci, Benjamin Franklin, Thomas Jefferson, Abraham Lincoln, Winston Churchill, and Ernest Hemingway. Standing desks are increasingly popular and are readily available. Even Donald Rumsfeld uses a standing desk today. So, I wouldn’t consider standing desks to be a fad, but rather, a return to favor.

5 Reasons to Encourage Employees to Use a Standing Desk

1. Live Longer

Research by the American Cancer Society suggests that sitting down to work at least six hours a day can increase a woman’s chances of dying by 40% and a man’s by 20%. Sitting for extended periods of time can increase risk of diabetes, cardiovascular disease, obesity, and depression according to the study. People who have desk jobs also have almost twice the risk of developing colon cancer.

Do you think you’re in the clear because you hit the gym after work? Think again. Studies have shown that exercise does not counteract the negative effects of sitting.

2. Lose Weight

You burn more calories chewing gum than you do sitting. Sitting for 30 minutes only burns 33 to 63 calories (for 110-lb. up to 216-lb. individuals). But standing for 30 minutes burns 39 to 78 calories. So standing burns around 12 to 30 more calories per hour. For a full day of work (8 hours), standing might mean 96-240 more kcals used.

3. Eliminate Back Pain

Most chiropractic patients aren’t blue-colar workers that strained their backs doing hard labor, but rather white-collar workers that have spent too long sitting in a chair. We contort our bodies by slouching, reclining, sitting on a foot, etc. because sitting isn’t comfortable.

4. Increase Productivity

When muscles are active, you no longer get that afternoon sleepy feeling. Even when you are having to do boring technical reading, standing keeps you alert. Creativity is also heightened because you now have better blood flow. Pacing and shifting might just be the thing that shakes that next creative idea loose.

5. Sleep Better

Have you ever lain in bed feeling tired but your body felt as if it did nothing all day? When you spend a workday standing, you are actively doing something besides checking email. By the end of the day, you have earned a satisfying tiredness. You’ll be less likely to toss and turn because your body will insist on a restful night’s sleep.

Convinced yet?

Healthy employees are productive employees and healthier employees incur lower health care costs. They also miss fewer workdays. Employees with standing workstations are more energetic and more focused. It’s been shown that they take fewer breaks than sitters, which, once again, leads to greater productivity. So get your workforce standing, or at least support the ones who want to make the change.

IRS Announces HSA Limits for 2013

2012-05-02T18:26:03Z

The IRS released the limits and requirements for HSA participation in 2013. The changes are outlined below. Follow the link if you prefer to read the boring IRS document.

What is an HSA? HSAs are tax-exempt accounts that help people save money for eligible medical expenses. In order to participate in an HSA, you must meet the following requirments:

You must be covered under a high deductible health plan (HDHP).
You have no other non-HDHP coverage.
You are not enrolled in Medicare.
You cannot be claimed as a dependent on someone else’s tax return.

What’s new to HSAs in 2013?

HSA Contribution Limits

Individuals can contribute up to $3,250 in 2013 (up $150 from 2012)
Families can contribute up to $6,450 in 2013 (up $200 from 2012)

HDHP minimum deductible requirements

Individuals are seeing an increase in the required deductible for the first time in three years.

$1,250 deductible for individual coverage (up $50 from 2012)
$2,500 deductible for family coverage (down $100 from 2012)

Out-of-Pocket Maximums

Out-of-Pocket maximums include copays, deductibles and other out-of-pocket costs, but do not include health plan premiums.

$6,250 for Individuals (up $300 from 2012)
$12,500 for Families (up $600 from 2012)

A Comparison of Consumer-Driven Health Plans

2012-04-20T18:38:45Z

Need clarification as to which Consumer-Driven Health Plan (CDHP) is right for you? We lay out the different plans side-by-side for a clearer comparison. If you still have questions, contact us at 1-800-946-6342.

Feature	HSA	HRA	FSA
Account Funding	Account held by bank or insurance company in individual’s name. Timing of funding is determined by employee and/or employer, typically evenly over the year.	Determined by HRA account administartor, typically funded only when claims are presented for reimbursement.	Typically funded evenly over the year through payroll deductions.
What can the funds be used for?	Unreimbursed qualified medical expenses as defined by IRS Cade 213(d). The list is broad and typically includes all health plan services subject to deductibles & coinsurance, in addition to items such as dental work, eyeglass, and many other OTC medications (with a prescription).	At the employers discretion, the account can be used for all IRS code 213(d) services, or be limited. Generally used only to cover health plan costs subject to the deductible and/or coinsurance.	Same as HSA
Can it be used to pay for health insurance premiums?	Yes, when on unemployment, COBRA, or age 65 or over and for Medicare Part A and Part B premiums.	Yes, at emplayer’s discretion.	No.
Can it be used to pay for long-term care coverage?	Yes.	Yes, at employer’s discretion.	No.
Can it be used to pay for non-medical expenses?	Yes, but subject to tax and a 20% penalty (penalty waived if over age 65, disabled, or died during the year).	No.	No.
Are contributions taxed?	No.	No.	No.
Can you pair with secondary health insurance coverage?	No, except for policies with very limited benefits such as dental, vision, specific diseases.	Yes.	Yes.
Who can have an account?	Individuals covered by an HSA-qualified high-deductible health plan (HDHP)	An employee whose employer offers one.	An employee whose employer offers one.
What are the requirements?	HDHP where all services (including RX) are subject to deductible and coinsurance with the exception of preventive care.	No health plan requirements. HRAs can be used with any plan or as a stand-alone account.	No helath plan requirements.
Minimum Deductible (in network)	$1,200 Individual $2,400 Family	N/A	N/A
Out-of-pocket maximum (in network)	$6,050 Individual $12,100 Family	N/A	N/A
Who may contribute to the account?	The account holder, employer, or any other person.	Employer.	The employee or employer. Typically funded by the employee only.
What are the annual contribution limits?	$3,100 Individual $6,250 Family Age 55 and over may make additional catch-up contributions of $1,000.	No federal tax limits. Employers typically set a limit equal to or less than the plan deductible.	Capped at $2500 per plan year.
Are accounts portable?	Yes.	No.	No.
Can account funds be rolled over into the next year?	Yes.	Generally yes, but this is at the employer’s discretion.	No, but employers may allow a grace period of 2.5 months after year end to pay incurred expenses.
Does interest accrue on the account?	Yes.	Generally no, but this is at the employer’s discretion.	No.

Losing focus at work? Take a mental break.

2012-04-11T19:23:13Z

We all have experienced mental fatigue at work. We are probably not working as effectively at the end of the day, as we were at the beginning. A study published in the journal Cognition confirms our diminished focus and effectiveness during prolonged tasks. The study says that even a slight diversion from the task can greatly improve our ability to concentrate and focus on that task for a longer period.

In the study, 84 subjects were divided into four groups and asked to perform a Visual Vigilance Task (a sustained-attention, reaction-timed task that measures the speed with which subjects respond to a visual stimulus). Three groups performed the task without a break for 50 minutes. One group received two short breaks. It was observed that most of the participants’ performance had significantly declined over a period. However, in the group which had brief breaks, no such decline in the performance was noticed.

According to Alejandro Lleras, the lead author of the study and a Professor of Psychology at the University of Illinois, the brain slowly stops registering the feeling, sound or sight if the stimulus is constant for a long period. Sustained attention to any sensation makes it disappear from our awareness. When doing a long task it is better if we take brief mental breaks. This will help the brain to stay focused and aware.

If you find yourself fading in the late afternoon, download and assemble a 3-D Benny Benefit for your desk. The break will not only make you work more effectively, he’ll make you smile every time you look at him!

REFERENCE:
Brief and rare mental “breaks” keep you focused: Deactivation and reactivation of task goals preempt vigilance decrements
Cognition, Volume 118, Issue 3, March 2011, Pages 439-443
Atsunori Ariga, Alejandro Lleras

There is Little Affordable about American Healthcare

2012-03-28T18:24:00Z

See an expanded cost comparison of medical procedures by clicking on the image above.Let’s start off by comparing some numbers. In 2009, the per person cost of health care in France was $3,978. In Germany, $4,218. In Canada, $4,808. The United States spent almost exactly twice as much as the French at $7,960 per person that same year. Why do we spend so much more for our health care?

The culprit. Do we tend to be sicker, or visit the doctor more frequently? Or are we simply using more health care services? As it turns out, health researchers have largely discarded these theories. In fact, we spend less time in the hospital than Germans, and visit the doctor less often than Canadians. By eliminating these theories, researchers have isolated the real culprit behind the high cost of health care in the United States: the prices.

It’s a pretty basic equation. The United States spends more on health care without providing more services. Therefore the difference in spending comes down to the prices of goods and services.

One solution. But how do other countries manage lower prices? Health researcher Gary Anderson has the answer, “Other countries negotiate very aggressively with the providers and set rates”. In Canada and Britain, for example, prices are set by the government. In Germany and Japan, providers and insurers sit in a room and come up with an agreement, with their governments free to step in should the two groups fail in setting prices.

We use similar processes in the United States to negotiate prices for Medicare and Medicaid members. Other than that, however, provider charges can widely vary. The price you pay often depends on the insurance you use, and uninsured patients are often asked to pay more. Some say the reason costs are so high is that no one knows exactly what services cost. (Have you ever asked your doctor to give you the total cost for a recommended procedure). Up until now, most of the bill has been paid by insurance, so consumers were not all that concerned about the price. When health care is the difference between life and death, it will not be refused, regardless of the cost.

We tend to blame insurance companies for rising costs, because we see our premiums increase year after year. However, the pharmaceuticals industry and medical device industry are two of the five most profitable industries in the United States. Their 20 percent profit margins are greater even than that of the often criticized financial sector. Comparatively, health insurers maintained a modest 2.2 percent profit margin in 2009. Clearly, the sellers have the upper hand over the buyers.

Our solution. The problem may be simple, but the solution is complex. The first step in lowering health care costs is better educating consumers. In order for the free market to work its magic, participants need to understand the product better. They need to know exactly how much they are paying for services rendered, and the standard value of those services. Once consumers are educated enough and have access to published information pertaining to average costs for the full gambit of procedures, caregivers will start to feel the price pressure and competitive pricing will emerge.

The healthcare reform bill of 2010 contains some requirements to make costs more readily available, giving consumers the ability to filter choice of hospital by cost. The larger plan is to collect more data to discover which treatments are most effective, giving the government the opportunity to set prices based on the value of those treatments. Although the impending reform, set to fully arrive by 2014, won’t fully put an end to the rising costs of health care, it does contain some provisions to better inform consumers. Where educated consumers tread, price pressure will follow.

W-2 Reporting for the Value of Benefits Offered

2012-03-20T19:58:00Z

The IRS has just released a notice that provides important transition guidelines and relief on reporting the cost of employer provided health care coverage on Form W-2. Beginning with the 2012 Form W-2, most employers will be required to report the cost of health care coverage to employees. Below is a summary of the notice, in question and answer format.

Who is impacted?

All employers are required to report the cost of employer-sponsored health care beginning in 2013 with the 2012 W-2. However, employers who file fewer than 250 W-2’s for the prior year are not required to report for the current year, at least until further guidance is issued.

Where is the amount reported?

You’ll find space to report the amount on the W-2, box 12, using code “DD”.

What types of coverage are reported?

The entire cost of a group health plan is required to be reported. Report the entire cost, regardless of the funding provisions of the plan, the portion paid by the employee, any imputed income to the employee as a result of the coverage or a discriminatory plan, and the scope of the coverage.

How is the cost of coverage calculated?

Several methods may be used to determine the cost for each period during the calendar year. Just make sure to use the same method for every employee receiving coverage.

COBRA applicable premium. Report the COBRA rate for the period in question, applying a good faith standard.
Premium charged. Report using the actual premium charged by the insurer for the employee’s coverage for that period.
Modified COBRA premium. If the employer subsidizes the cost of COBRA, then a reasonable good faith estimate of the COBRA applicable premium should be reported. If the actual premium charged is equal to a prior year’s COBRA rate, the reportable cost is determined using the COBRA premium for each period in the prior year.

What happens if there is a change in coverage during the year?

If an employee changes coverage during the year, then the amount reported must take into account the change in coverage for the period. The employer may use any reasonable method to determine the reportable cost for such a period, or the employer can average or prorate the reportable costs. The same method must be used for all employees who have coverage under the plan.

What if the policy year is not a calendar year?

The reportable cost under a plan must be determined on a calendar year basis. Click here to read the notice in its entirety.

Senate Reverses Cuts to Commuter Caps

2012-03-14T19:35:00Z

Legislation that would reverse cuts to pre-tax transit accounts has been approved by the US Senate and is now in the hands of the House of Representatives, where it is likely to pass. The law will increase the monthly amount that can be contributed on a pre-tax basis for public transportation expenses from $125 a month to $240 a month.

This tax credit for commuters is embedded in the Senate’s Surface Transportation Reauthorization bill and includes a retroactive extension of benefits dating back to January 1, 2012. The provision encourages commuters to use public transportation during a period of high gas prices and increasing utilization of public transit.

Don’t Procrastinate: SBC deadline is right around the corner!

2012-03-08T16:10:00Z

By now, you’re probably aware that the Department of Health and Human Services recently announced that employers who offer private health plans must provide their employees with summary of benefits coverage (SBC) documents. The original deadline for completed SBCs was scheduled for March 23 of this year, but after many employers expressed their desire for the deadline to be pushed back by as much as a year, it was changed to September 23, 2012. That gives you about six months to put your SBC together.

“It’s going to be a significant burden for employers to put all of this together because you have to provide a very specific document,” says J.D. Piro, senior vice president and leader of the health law group at Aon Hewitt, a human capital consulting firm in Chicago. “It has to be a four-page, double-sided, 12-point-font document, and you have to provide a uniform definition of standard insurance terms and a description of coverage, including cost sharing.”

The idea behind the SBCs is to make the process of comparing health plans easier for the consumer. Although the regulation is burdensome for employers and insurance providers, employees will have a better understanding of their benefits and appreciate them more because of it.

Don’t worry, we won’t let you go through this alone. To help you finish your SBC in time, we’ve compiled a checklist of the information you’ll need to include:

Uniform definitions of standard insurance and medical terms, along with an Internet address for obtaining a “uniform glossary” of key terms
A description of coverage, including cost sharing, for each category of benefits
Exceptions, reductions and limitations of coverage
Cost-sharing provisions of the coverage, including deductible, coinsurance and copayment information
Renewability and continuation of coverage provisions
Coverage examples
A statement that the SBC is only a summary and that the plan document or policy should be consulted
Contact information for questions and to obtain a copy of the plan document or insurance policy
If a provider network is used, an Internet address for obtaining a list of network providers
For plans that use formulary in providing prescription drug coverage, an Internet address for obtaining information on prescription drug coverage
Whether or not the plan provides minimum essetional coverage and minimum value

If you offer insurance coverage through an insurance carrier, the carrier will provide the SBC. However, if you also offer a MedFund HRA, you will need to include a paragraph in your SBC that describes how the HRA alters your insurance plan. Please note that whereas the initial regulations required that premiums charged be described, the updated regulations remove this requirement. One less step you have to worry about.

Although the deadline is still half a year away, Piro recommends employers start preparing their SBCs now.

Wellness Enforcement

2012-02-29T19:47:00Z

As we discussed in the last newsletter, Wellness initiatives are a rising trend among employers. Rewarding employees for living healthy lifestyles is an effective way to maintain a productive workforce and keep insurance costs low. However, a growing number of employers are beginning to tackle wellness initiatives from the opposite angle and punishing employees for poor health.

That’s right, if you’re overweight, smoke, have high blood pressure or high cholesterol, you may soon be hit with higher insurance premiums, deductibles and out-of-pocket expenses. Call it a health enforcement initiative.

According to Dr. Paul Berger, chief medical officer at Aon Hewitt, a human resources and benefits consulting company, employers “want you to take some responsibility, and if you don’t do certain things [they] want you to do, you’ll only be eligible for the bad [health insurance] plan with a $3,000 deductible as opposed to the $1,000 deductible. That gets your attention.”

Unhealthy workers do cost more in health insurance and lost productivity, so are the penalties fair? Lewis Maltby, president of the National Workrights Institute, argues that because employers aren’t required to prove how much an employee’s poor health choices increase the company’s cost, they are not. “If you smoke or are too fat because of your diet, and the company is charging you more than the cost you’re creating, you’re out of luck,” he said.

Still, many employers are invested in keeping their employees healthy. To help workers and their dependents quit smoking, Health Care Service Corp. requires smokers to pay more for their health insurance, but they also reimburse employees for nicotine replacement products, and provide one-on-one counseling.

Here is the difference: Classic wellness initiatives might reward employees for simply completing a confidential biometric screening. An employee under the newer wellness enforcement plan, however, might not receive his reward until any health risks diagnosed in the screening are dealt with through free health coaching and online assistance programs. In the meantime, his insurance premiums will be higher than his healthier coworkers’.

An unhealthy worker may be responsible for higher premiums, but he or she is also given access to free resources to curb the unhealthy behavior attributed to those higher premiums. In fact, in order to keep wellness enforcement in compliance with genetic anti-discrimination laws, the Americans with Disabilities Act and the Health Insurance Portability and Accountability Act, alternatives to higher premiums must be offered.

So is it punishment, or do we have to recognize that some people respond better to the risk of losing $100 than to gaining $100? This new trend may be hard for an overweight smoker with high blood pressure to swallow. What are your thoughts? Post your comments below.

Health Insurance Stores

2012-02-24T20:46:00Z

Unless the Supreme Court rules against it, in a little less than two years, nearly everyone will be required by law to carry health insurance. This healthcare mandate, coupled with a steady decline in employer coverage, has driven health insurers to adopt a new approach in selling coverage. In an attempt to better serve this impending consumer-centric environment, several health insurance providers have opened retail stores where shoppers can buy policies, check the status of claims, and much, much more. These stores offer an alternative to individuals who do not have a relationship with a professional insurance agent.

Highmark in Pennsylvania and Blue Cross and Blue Shield of Florida have made the biggest commitment to retail-based policies, each opening several stores in their respective states. Blue Cross of Florida in particular has modeled their store as a sort of community center, with monthly health fairs, weekly free massages, entertainment areas for children, free access to in-store nurses, and even a conference room that is free to rent for members and non-members alike.

In this day and age, it seems counterintuitive to transition from a largely web-based market to a brick-and-mortar store. But people aren’t used to buying health insurance on their own; they’ve grown accustomed to their employers taking care of it for them. A physical store is a great place to foster consumer comfort and educate shoppers to the point where they feel confident purchasing insurance themselves. At a retail store they can ask questions, get lots of one-on-one attention, and even go through diagnostic health procedures.

Consumer education is a high priority for these retail stores; welcome news considering thousands of people may be purchasing personal health insurance plans in the coming years. One day, retail health insurance stores like these may be made obsolete by web-based markets, but for now they are a much-needed resource for an emerging customer base that is not yet confident enough to purchase insurance online.