PFML Webinar
The MA Paid Family and Medical Leave Law -- Getting Ready for Prime Time on January 1, 2021
Join us for a webinar on Dec 15, 2020 at 10:00 AM EST
Two and a half years ago Massachusetts lawmakers enacted the Paid Family and Medical Leave (PFML) law creating wage replacement and job, health plan coverage and anti-retaliation protections beginning January 1, 2021. What seemed like a long way away at the time is now at our doorstep.
The MA Department of Family and Medical Leave (DFML) issued revised final PFML regulations in July, followed by administrative guidance informing employers with exempt private plans about the exemption renewal process. The DFML also delayed renewal of some private plan exemptions for three months -- until December 1st.
Pre-funding of the PFML trust fund has been ongoing since October 2019.
All DFML systems are apparently a go for the January 1, 2021 rollout. The DFML says it is ready for prime time. Are you ready for prime time?
Please join Business Benefits, Inc. on Tuesday, December 15th at 10:00 AM for this timely LIVE one hour webcast discussing the latest PFML guidance, led by our featured speaker: attorney Rick Szczebak of RAS Law PC.
After registering, you will receive a confirmation email containing information about joining the webinar.
PEO Article by Jim Edholm and Matt Hollister
Pros and Cons of Professional Employer Organizations (PEOs) Why a “Virtual PEO” May be the Better Option
Published in Employee Benefit Plan Review
Is a Professional Employer Organization (PEO) an appropriate option for your firm? For decades, such organizations have offered a co-employment model for employers. It incorporates employer-members into one mammoth organization, and one which treats their employees to benefits provided by a single organization under one tax ID number. Such an arrangement allows the employer-member to outsource many of the administrative functions to third parties, rather than carrying the full burden all by itself. This makes for an alluring cost-and-task sharing opportunity for many companies.
Read the whole article HERE.
ICHRAs
Individual Coverage HRA. What is it? What are the benefits and drawbacks? What companies are a good fit for ICHRAs versus group health plans? Kevin talks with Matt Hollister, President and CEO of Business Benefits, Inc about choosing ICHRAs and what you need to know to make sure you’re choosing the best model for your employees and company!
Listen to our Podcast HERE.
COVID-19 DOL Guidance on FFCRA Leave through 12/31/2020
Attached is the October 2K20 Compliance Alert. This Alert discusses DOL guidance issued in connection with COVID-19 and paid leave under the Family First Coronavirus Response Act (FFCRA) for the purposes
of child care. This is based on various approaches taken this Fall by school districts: Remote learning, hybrid learning and parental choice of in person/remote learning.
If you have any questions, please contact us.
Sincerely,
Matthew Hollister
CEO
BBI Partners with My Medial Shopper
MyMedicalShopper (MMS) is the industry’s leading healthcare comparison shopping platform. BBI and MMS share a passion for making health care more affordable and more efficient. With MMS, health plan members have access to real time costs for hundreds of common medical services such as X-Rays, MRIs and Colonoscopies. Knowing cost and quality of medical procedures can save thousands of dollars in out of pocket health care costs. MMS finds that employees often pay 5 to 10 times more than they should. The MMS app can be combined with a Health Savings Account or Health Reimbursement Arrangement to provide incentives for employees to search out value which can lead to lower overall premium.
Reach out to your BBI account executive today to find out more!
2021 MA PFML Bonding Rule
Attached please find the November 2020 Compliance Alert provided by Richard Szczebak, Esq. This Alert is addressing the Massachusetts Paid Family Leave (MA PFML) which is only one month away from its go-live date. The alert focus is on leave taken for child bonding in 2021, the date the child was born, adopted or placed for adoption in 2020, plus a few miscellaneous PFML items of note.
We will be sending out an email with an invitation to a PFML Webinar scheduled for Tuesday, December 15, 2020, at 10:00 AM EST.
If you have any questions, please feel free to contact us.
Matthew T. Hollister
CEO
Transparency
By Jim Edholm
Recently, an article appeared in Revcycle Intelligence, a medical industry website (https://revcycleintelligence.com/news/patients-want-healthcare-price-transparency-but-few-seek-it-out). I was drawn to the headline because it seems to suggest a conflict your employees are dealing with — and it’s costing you money.
It also underscores a never-ending conflict between the desire for something and the willingness to do the work needed to acquire that something. Most of us stop short of actually going after the things we “want”.
The article was angled to medical practitioners, not employers, but in my opinion it has more value for an employer. The title was “Patients Want Healthcare Transparency, but Few Seek It Out.”
It referred to a recent Massachusetts survey stating
· 7 of 10 consumers said they wanted to know provider prices, but
· fewer than half ever thought about seeking it out.
· 70% were unaware that their carrier offered a cost estimator tool.
· And only 20% had ever tried to find pricing info before getting the procedure or service.
· 15% actually believed the cost would be the same irrespective of where they got it!!
· Only 10% knew how to get it
This despite transparency regulations that require the information be available. Mass law requires providers to give consumers if asked, within two days, the price of any procedure. Further, the law requires hospitals to divulge how much a given payer (insurance company, usually) will pay the hospital, and it also requires carriers to provide access to online cost estimator tools.
Doctors – the second-most-trusted source of cost info – fight against giving such info because they rightly point out that employees are most interested in their out of pocket costs, not how much the doctor receives.
Hospitals – only trusted for pricing info by 3% (!!!) of consumers – don’t want to give pricing out because every insurer has different discounts and agreements (which seems somehow anti-competitive to me), and hospitals don’t really want people to know just how much money they actually make. (Hint: It’s a lot!!)
Insurers are required to give info, but they don’t want to divulge their reimbursement levels. That’s a proprietary, confidential number. They don’t want competitors to know what they. And they very successfully hide their cost estimator tool where it’s really hard to find.
Granted, I’m a techno-troglodyte and represent someone with low-end online capability, but I just spent about 30 minutes poking around the BCBS site to find their tool. I never did get there.
I have the option to call Member Services, but I wonder how long I’d be on hold … it hardly seems worth it.
Why Do You Care?
Well, a lot of the waste is your money. National estimates say one-third of health care costs are completely wasted. Since the US spends $3.6 TRILLION on health care, that says we’re throwing $1.2 Trillion down the drain. Average cost for healthcare in the US is about $14,000 per employee, so your firm is currently spending about$4,600 per employee per year that you don’t need to spend.
At a certain size (roughly 40 employees on the plan) BBI can provide you tools that will help. Some of our employer clients use Nurse Advisor lines. Employees can call into a nurse 24/7 to get all kinds of information, including cost info but also including medical guidance and suggestions.
Truthfully, however, utilization on such services is spotty and fairly infrequent. It’s too much work. It’s intimidating. Employees might feel stupid for asking, worry about not understanding what the nurse tells them, expect hold times, etc. So, they don’t call.
Our favorite is a tool we make available to employers that gives employees continual access via their smart phones to a Artificial Intelligence service backed up by live nurses when needed. They can get referrals, appointments set, cost and quality input about various providers – all automatically.
And when needed, there is nurse follow-up, sometimes when requested; other times the follow-up is a direct outreach from the nurse or the AI software.
It gets much higher utilization because it’s NOT INTIMIDATING. It’s easy, and your employee always has his or her smart phone around. So, it gets accessed and used.
Cost Alone Isn’t Enough
Therein lies the problem with the Mass requirement. Cheap isn’t necessarily good, and good isn’t necessarily expensive. But poor quality is ALWAYS expensive in the end, irrespective of what it costs up front.
What do you and your employee gain if they go to an inexpensive provider who just happens to offer marginal quality or even a quack? So, you need both cost and quality. We believe what you and your employee want, or should want, is
· the best possible provider
· for this specific problem
· at this specific time, and
· you want to acquire that service or procedure at the right – not the lowest, but the right – price.
If you could have that for $7-$10 per employee per month (and you can) you would be all but guaranteed to save money on health care. We have seen ROIs of 3:1 and more with these services.
Is it right for you?? Just ask, we can find a way to make it work.