employee health insurance Archives

The Opioid Epidemic: How Employers Can Be Part of the Solution

With the coronavirus pandemic dominating the news cycle, some of the focus has been taken off one of our country’s other major health crises: the epidemic of opioid addiction. This epidemic has claimed almost 600,000 lives over the past two decades, and it shows no signs of slowing down. In fact, the American Medical Association has recently said that it is “greatly concerned” that opioid overdoses seem to be rising in at least 30 states. It makes sense: stress levels have been high and many people have been feeling disconnected. Some people might also feel disconnected from their healthcare providers, and might be choosing the easiest option for dealing with chronic pain. Dr Mike Brumage, former director of the West Virginia office of drug control policy, puts it this way: “the opposite of addiction is not sobriety, the opposite of addiction is connection. Clearly, what we have lost with the pandemic is a loss of connection.”

Whatever the cause, opioid misuse is not something employers should ignore, whether or not they think it’s a problem in their workplace. You can make yourself a point of connection for an employee who might be struggling with addiction or who is dealing with chronic pain, and you can make your healthcare plan a part of the solution.

Treating Addiction

Opioid addiction is not someone else’s problem. It spans all socio-economic classes, genders, and cultures. It could very well reach into your workplace, if it hasn’t already. You would obviously want to help an employee who is struggling with addiction, not only for the sake of them and their family, but also for the sake of your business.

Whatever their job is, one employee who is abusing prescription painkillers can pose a physical risk to other employees, or a financial risk to your business if they make a mistake or are interacting with clients while under the influence. In fact, missed work days and lost productivity due to the abuse of prescription painkillers cost employers an estimated $25.6 billion a year. So it is in everyone’s best interest to provide care (or to prevent misuse, if possible, which we will discuss below) – and you can do this by simply offering an ACA-approved healthcare plan to your employees.

caucasian hands on a notebook while holding a pen — *All plans must cover behavioral health treatment, such as psychotherapy and counseling.*

Thanks to the Affordable Care Act (ACA), all healthcare plans have to cover 10 essential health benefits, and “mental and behavioral health services” is considered one of these essential benefits. Here’s what this means for your plan, and how it relates to substance abuse:

All plans must cover: behavioral health treatment, such as psychotherapy and counseling; mental and behavioral health inpatient services; and substance use disorder (commonly known as substance abuse) treatment.
Pre-existing mental and behavioral health conditions are covered, and spending limits aren’t allowed. This means that even if an employee was struggling with addiction before signing up for your plan, they will still be covered for it after signing up.
All plans have to provide “parity” of coverage, meaning that limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The rules have to be the same financially (for example, there can’t be a higher copay or deductible for mental health services), in terms of treatment (for example, there can’t be a limit on a number of mental health-related visits covered if there isn’t one for medical visits), and for how care is managed (for example, there can’t be a requirement to get authorization for treatment for one type of care and not the other).

Be very clear with your employees about what their options are when it comes to mental health services, and remember to make it clear that your workplace is a safe space and that employees should always take advantage of these services if they are needed.

Obstacles to Seeking Care

As long as you are offering your employees a quality healthcare plan (which you should be doing in any case!), then they are at least assured of basic care if they’re facing substance abuse issues. But the question is, are they accessing it? If not, why not?

Privacy concerns: Some employees may be reluctant to seek care because they’re not sure if their situation will be kept confidential. It should be made clear to employees that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) means that there are very strict rules surrounding who can see an employee’s claims and how they can use that information. They may need to be reminded that any claims that they make will be kept secure, and any communication they have with an Employee Assistance Program, for example, is strictly confidential.
Find a plan where employees have access to a doctor including telehealth services.

Authorization requirements: Some employees may benefit from going to an inpatient treatment facility, but many plans require that they first seek treatment at an outpatient facility, which may be difficult for some people. Take a closer look at your plan: it might allow authorization by phone for a medical or surgical inpatient stay. If it does, then it must do so for a mental health or substance abuse inpatient admission, as well.
Access to a provider: As with seeking authorization, sometimes barriers to care are simply that it’s too difficult, inconvenient, or even costly to seek help. Again, look at your plan: does your network include options? Will employees have to go out-of-network, and will it cost them a lot to do so? Are there treatment facilities or clinics available in your area, and would an employee feel comfortable going to one (say, for example, that you are in a small town or rural area, and an employee might feel that everyone will know their business)? If this is an issue, look into a plan that includes expanded access to telemedicine as a way to encourage employees to seek help.

How You (and Your Healthcare Plan) Can Help Prevent Addiction

The old saying goes: “an ounce of prevention is worth a pound of cure.” Yes, all ACA-approved healthcare plans need to cover mental health and substance abuse treatment, but most people would agree that preventing addiction in the first place would be ideal. Consider this: Roughly 21-29%of patients prescribed opioids for chronic pain misuse them, and between 8-12%develop an opioid use disorder. What can employers do to stop their employees from becoming one of these statistics?

Education: You can educate your workforce on a variety of topics, such as: description of opioids and common brand and generic names, common risk factors for opioid misuse, reasons for opioid prescriptions (acute pain versus chronic pain), pain relief alternatives, and what to ask prescribers before filling an opioid prescription.

Policies: Have a clear, compassionate drug-free workplace policy, but also have a flexible medical leave policy, so employees don’t feel like they have to rush to come back to work after an injury or procedure. They might turn to stronger painkillers if they feel pressured to return to work, or they may end up taking these drugs more often or longer than they need to, which can lead to addiction.

Culture: Try to create a positive, low-stress work environment for your employees. Make sure to support your employees, encourage self-care, and show ways that they can prevent common or repetitive strain injuries. Consider adding a workplace wellness program in order to promote a culture of health and wellness.
Benefits: Covering essential mental health care is a great start in terms of preventing the psychological reasons for addiction, and in terms of treating addiction. But what about treating physical pain without using opioids? Unfortunately, some insurance companies have been slow to include alternative treatments in their health insurance policies, so it is up to you to look for a plan that allows employees to seek these types of therapies (think: acupuncture, chiropractors, and physical therapy) without having to rack up huge medical bills. To stop opioid use before it starts, you can also consider adding an Employee Assistance Program (EAP), which will include mental health-specific extras like counselling, or a pharmacy benefit management program, which can step in before an employee fills their first opioid prescription and offer advice and alternatives.

There’s a lot to consider when choosing a healthcare plan for your employees, especially if you’re looking to have the safest, most compassionate workplace that you can. It’s important to foster a positive work environment, but it is also important to find an insurance company that is willing to help keep employees from falling into addiction. EZ can help you in your search – we will sort through all the plans available to you, and find you one that will help you and your employees rest easy. Get started with us today for fast, accurate quotes: simply enter your zip code in the bar above, or you can call 888-998-2027.

4 Reasons Your Employees Aren’t Enrolling in Your Healthcare Plan (and What to Do About It)

Any way you look at it, offering health insurance to your employees is a good thing to do. Not only does a healthcare plan keep your employees healthy and protect them from huge medical bills, but studies have also shown that it is the most desired benefit you can offer. Employers who offer healthcare are more likely to attract high quality job candidates and also to retain the employees that they already have. So, if you’ve carefully researched and chosen a plan and offered it to your employees, but only a few have decided to enroll, what could be the problem? Here are 4 common reasons why employees choose not to enroll in an employer-based healthcare plan, and what you can do about it.

1. Your Plan Doesn’t Match Your Employees

The first reason employees choose not to enroll in your healthcare plan is that they don’t like it.

The first reason employees may choose not to enroll in your healthcare plan may seem obvious: they just don’t like it. Even if you’ve done hours of research and you think you’ve found the perfect PPO plan with a low deductible, you may not be taking into account your employees’ ages, family size, and financial situation. If most of your workforce is young, healthy, and childless, then they might prefer a high deductible health plan. But, if you have a very diverse workforce, then they might all have different needs. In that case you might want to look into an la carte healthcare plan, like a cafeteria plan.

Since asking your employees about their healthcare is a pretty sticky subject, you may be unsure how to solve this particular problem. The answer is actually very simple and will only take a little bit of time: give your employees a healthcare survey. Ask them all the relevant questions to gauge what they are looking for in a healthcare plan, and be sure to keep it anonymous to encourage participation. Their answers will give you a much better idea of what they want and where you should be looking for a plan.

2. The Network Isn’t the Right Fit

Most healthcare plans have a set network of providers that the insured can see without incurring out-of-network charges. So, even if your employees are happy with the PPO plan you chose for them, they might be unhappy with the providers included in the plan’s network. Some employees may find that their trusted doctors are not included in the offered plan – and that could be a deal breaker for them.

The solution to this problem can be the same as above: ask about your employees’ provider and network preferences in a survey. Be as specific as possible, asking about what doctors, hospitals, facilities, and prescription drugs they would like covered.

3. The Total Costs Are Too High

Even if you’re contributing 50% of your employees’ premium costs, that cost can still take a big chunk out of their paychecks.

Premiums, deductibles, copays, coinsurance…there are a lot of costs to add up when it comes to a healthcare plan. Even if you’re contributing 50% of your employees’ premium costs, that cost can still take a big chunk out of their paychecks. And premiums aren’t the only thing they need to budget for: around 80% of covered workers have a deductible they need to meet before their healthcare costs are covered. The average deductible for covered workers in small businesses is over $2,000, which is a very significant sum for a working family.

One way to help offset these costs and encourage your employees to enroll in your plan is to consider putting money into a tax-advantaged account like a flexible spending account (FSA) or health savings account (HSA). Both you and your employees can make pre-tax contributions to these accounts, and your employees can use the funds in them to pay for qualified healthcare expenses. An FSA can be used with any kind of healthcare plan, but the contributions are “use it or lose it.” In contrast, an HSA must be combined with a qualified high deductible health plan but the contributions can roll over each year.

4. Your Employees Don’t Understand Their Options

There are some that believe that effectively explaining and communicating the importance of benefits to your employees is just as important as offering the right plan. As a business owner, you already know that people don’t buy what they don’t understand. Employees need to understand the benefits you’re offering them and how important they are to themselves and their families in order to want to spend their money on them.

A recent survey by Colonial Life found that one-third of employees spent less than 30 minutes looking at their benefits options, and another third spent less than an hour. And this doesn’t just affect them: the same survey found that the employees who sped through their benefits choices were 55% more likely to leave their jobs, 32% more likely to feel dissatisfied with their jobs, and 18% less likely to feel cared for by their employer.

The solution to this problem is simple: communication. As the employer, you need to find an effective communication strategy that works for your employees. In addition to the printed or digital material you offer, consider holding individual and/or group meetings to talk about benefits. And don’t assume that just because some of your workers are younger, they want everything to be done online. Another Colonial Life survey found that Gen Z and Millennial workers are actually slightly more likely to want human interaction when learning about or enrolling in benefits: 91% for Gen Z and 83% for Millennials, as compared to 76% of employees overall.

At EZ.Insure, we know that you’re working hard to find the best options for your employees, but sometimes you just need someone to point you in the right direction. That’s what we’re here for. When you come to us, you’ll get your own personal agent who will give you instant, accurate quotes, answer all of your questions, and never, ever hound you with endless calls. And we do it all for free. You’ve got your employees’ best interests at heart, and we’ve got yours at heart, so get started with us today. Simply call 888-998-2027, or enter your zip code above.

Survey Says: Find Out What Benefits Employees Want

If you run a small business, odds are you’re on a tight budget. But you’re still looking to recruit and keep the best employees. So you may have to make choices when it comes to the compensation you offer your workforce. Should you pay them a little bit more? Should your benefits package be more generous?

drawing of a blue wallet with cash sitcking out of it. — *If you are on a tight budget considering ways to make employees happy, syrvets show they would prefer health insurance over more pay.*

While your first instinct might be to think most people would choose extra cash, most employees would actually choose more perks, most notably healthcare coverage. It is worth your time to ask your employees what perks are most important to them, and to survey them about their healthcare priorities.

How Valuable Are Benefits?

Consider this: various studies have been done asking employees whether they would prefer better benefits or more pay, and the results are clear. The tests might be different but the results were the same: around 80% chose benefits over money. Employees feel happier with their job and are more likely to stay (or join your team) if they are offered perks that improve their lives and make them feel valued.

Some of the things you can offer are relatively low-cost, such as more vacation time, more flexible hours, or work-from-home options. However, the most coveted benefit is also the most expensive: healthcare.

What Employees Want Most

young caucasian woman in light vlue button up with side braid and both thumbs up. — *Healthy employees who feel valued are going to be more productive and loyal.*

If your business has fewer than 50 employees, there is no law requiring you to offer group health insurance. However, studies about employee benefits also show that what workers want most is health insurance. While paid time off was an obvious second-runner up, a majority (at least 40%) said that healthcare was their top priority in all studies.

So if you’re feeling pulled in all directions financially, this is a clear indication that your money is best spent on offering a group health plan to your employees. After all, healthy employees who feel valued are going to be more productive and loyal – not to mention there are perks in it for you, too (like tax advantages).

Take the Time to Ask

As stated above, it just so happens that the most desirable benefit is also the most expensive. But there is an often overlooked way to find the best plan for your employees: a health benefits survey. If you find out what your employees’ wants and needs are, you can then find a plan that is as tailored to them as possible. You will also get more accurate pricing if you know exactly what you are looking for, and will save money by cutting out any unnecessary extras.

Making an Employee Healthcare Survey

How do you go about making a healthcare survey for your employees? The first thing to remember is that, because of HIPAA (Health Insurance Portability and Accountability Act), you cannot ask them specific questions about their health. The survey must also be anonymous. Think questions related to the type of coverage they want. Here are some examples:

paper with green checkmarks on it and lines with a pencil over it. — *Make an employee health insurance survey but make sure to not ask specific questions about their health.*

How important is it that your employer offers health insurance to you? You can then ask them to rank their answer based on a number scale or from “not important at all” to “very important”

How much would you be willing to spend each month for health insurance coverage?

Would you prefer paying more each month for insurance but paying less when you see a doctor? Or would you prefer paying less each month and more when you see a doctor? You may be able to offer them a high deductible health plan that includes a tax-advantaged HSA.

What type of network of doctors and specialists would best meet your needs? You can ask them if they would be comfortable with a smaller local network instead of a larger or even nationwide network.

Are there any doctors or hospitals that you would specifically like to be included in your healthcare network?

How many family members would you like to cover with your plan?

By taking the time to ask the simple questions above, you will have a good idea of where to start when looking for a plan to cover your employees. Offering the right benefits might seem like an expense or a headache, but it can make all the difference in finding – and keeping – the right employees. And remember, EZ.Insure is here to help you every step of the way with finding the right plan for you and your employees. We can connect you to your own personal agent who will steer you in the right direction – for free! You will never be hounded by endless calls and you will always get the most accurate information. We promise everything will be quick, easy – and did we mention, free? To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing or calling 888-998-2027.

Do You Qualify For The Small Business Health Care Tax Credit?

If you offer health insurance to your employees, it can be costly, but luckily there is a silver lining- the small business health care tax credit! One of the provisions of the Affordable Care Act, ACA, is the Small Employer Health Care Tax Credit which allows certain businesses to save money while offering health insurance to their employees. While it is a great financial saver for businesses, not all businesses can get the tax credit. There are some qualifications that a small business must meet in order to get the health care tax credit.

a list with 3 checkmarks and a pencil next to it insude a blue circle. — *You must meet certain qualifications in order to receive a tax credit.*

The Small Business Health Care Tax Credit

This credit allows small businesses to receive a tax credit for paying at least half of their employees health insurance premiums. In the beginning, the small business health care tax credit was not much, ranging only 35% of eligible health insurance premiums. But luckily, over the years it has changed. The tax credit now equates to up to 50% of employer-paid health insurance premiums.

cartoon figure sitting on top of "50%" numbers — *The tax credit now equates to up to 50% of employer-paid health insurance premiums.*

Small business owners cannot take the tax credit for insurance premiums paid on their own behalf. This includes partnerships, and sole proprietors.

Qualifications

In order to qualify for the health care tax, a business must meet the following criteria:

Have fewer than 25 full-time employees.
Your average employee salary must be less than $54,000 as of the 2019 tax year.
You pay at least 50% of your full-time employees health insurance premiums, also known as a “qualifying arrangement.”

Flexible Credit

An advantage of having this kind of credit is that it is flexible. It can be carried toward the next year, or back to other tax years. So, if your business does not owe tax in a certain year, then claiming the tax credit will not do you any good. However, if you owe tax for a prior year, you can apply your credit to that. Or you can choose to keep the tax credit and save it for next year.

Claiming the Tax Credit

The health care tax credit can be calculated and claimed using the Form 8941. The form must be attached to the business’s tax return, and then after it is processed, the credit reduces any income tax the business owes.

Tax-exempt organizations should file Form 990-T. This tax credit is non-refundable, although it can be carried towards either the following or prior tax years. Also, tax-exempt organizations that have no taxable income can qualify for a refund of the credit, as long as it doesn’t exceed their Medicare tax liability and income tax withholding.

calculator and pen on top of a sheet with numbers on it. — *If your business does not qualify for the tax credit, there is still hope on saving money with tax deductions.*

Small Business Tax Deductions

If your business does not qualify for the tax credit, there is still hope on saving money. There is a deduction for employee premium payments. Some businesses may be able to get both the deductions and tax credit!

The small business health care tax can help a small business offer their employees health insurance without fearing the great costs. As long as you meet the qualifications to receive the tax credit, then you will be eligible. The fewer employees you have, for example, less than 10 full-time employees who are paid an average of $25.000 or less will get you a bigger credit. And if you do not qualify for the tax credit, at least you can get deductions!

If you are looking to provide health insurance to your employees and want to save money, EZ.Insure can help. We will find a plan that meets your needs financially. We will find the plan that gives you deductions and notify you on whether you qualify for both deductions and the tax credit. Our goal is to save you as much money, while providing you with the best plan. Call 888-350-1890, or email us at replies@ez.insure to speak directly with one of our agents, or enter your zip code in the bar above to get free instant quotes. We will never sell your information to telemarketers as others do.

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