Health & Voluntary Benefits Association® (HVBA) and Health & Voluntary Benefits Institute® (HVBI) Unveiled as the New Names for the Voluntary Benefits Association® (VBA)

By Health & Voluntary Benefits Association® - In a strategic move to better reflect the evolving landscape of employee benefits, the Voluntary Benefits Association® (VBA) is excited to announce its name change to the Health & Voluntary Benefits Association® (HVBA). Read Full Article…

VBA Article Summary

1. Introduction of the Health & Voluntary Benefits Institute® (HVBI): The VBA has expanded its focus to include healthcare and health benefits, leading to the creation of HVBI. This new institute aims to concentrate on industry data, fiduciary consulting, health plan analytics, and the initiation of a unique Group Purchasing Organization (GPO). This development responds to the high demand from industry stakeholders for solutions that combine Voluntary Benefits with core Health Benefits and complementary clinical solutions, addressing the needs of employers, employees, carriers, and consultants.

2. Integration and Convergence of Benefits Industries: Jake Velie, Vice Chairman, President, COO of HVBA and HVBI, and Chairman and CEO of National Integrative Health, highlights the merging of Benefits Industries. The organization is committed to developing next-generation solutions with top carriers and service providers. The goal is to offer new resources and solutions to members, both individual and corporate, to help them grow their businesses by addressing employees' most pressing problems. This approach focuses on protecting and strengthening American households and the companies and associations serving them.

3. Role of Voluntary Benefits in Bridging Healthcare Gaps: Rob Shestack, Chairman and CEO of HVBA and HVBI, emphasizes the critical role of Voluntary Benefits in providing ancillary coverages and protecting against financial strains due to healthcare expenses. With rising healthcare costs and increasing out-of-pocket expenses, Voluntary Benefits serve as an affordable safety net, ensuring employees can maintain care and protect their savings. The integration of health and voluntary benefits into a comprehensive offering reflects HVBA's commitment to safeguarding the health and financial well-being of employees and employers, aligning with their mission to provide affordable and impactful solutions for the evolving workforce.

New Legislation and Regulations for Healthcare in 2024

By David Shulkin, M.D. - With significant regulatory relief seen during the pandemic, most people thought telehealth expansion was going to be a permanent fixture in healthcare. Read Full Article…

VBA Article Summary

1. Telehealth Legislation: The Telehealth Expansion Act, which aims to make pandemic-era telehealth regulations permanent, faces uncertainty despite bipartisan support. Key debates include the expansion of telehealth across state lines, the prescription of controlled substances, care disparities, and exemptions for specific worker groups. The CONNECT Act and the TREATS Act are notable bills in this area.

2. Drug Pricing Reforms: The impact of the Inflation Reduction Act on drug pricing will become more evident in 2024. Pharmaceutical companies have agreed to participate in price negotiations for specific drugs, and there is a focus on reducing coinsurance for Medicare Part B drugs. Future legislative efforts may include expanding drug price negotiation into the commercial market and other issues like generic drug incentives and import restrictions.

3. Pharmacy Benefit Managers (PBMs) Regulation: The Pharmacy Benefit Manager Reform Act aims to increase transparency and restrict practices like "spread pricing." It mandates the full disclosure and return of rebates and fees to health plans, spotlighting the role of PBMs in healthcare costs and access.

Here are the new state healthcare laws taking effect in 2024

By Hayley Desilva - Health providers and insurers will have to navigate a bevy of state laws that took effect with the new year, covering key issues such as reproductive care, patient documentation, wages and reimbursement. Read Full Article…

VBA Article Summary

1. Arizona: Arizona has revised laws impacting assisted living facilities and ambulance services. Assisted living facilities are now required to provide detailed information when discharging patients to emergency providers and must keep a copy of the resident's information. Additionally, they must contact the patient’s authorized representative if the patient is transferred to a hospital. Ambulances in Arizona are mandated to install electronic GPS devices to monitor response times.

2. California: California's healthcare legislation updates include several significant changes. Borderline personality disorder has been added to the list of mental illnesses eligible for pretrial diversion in non-violent offenses. New protections have been granted for providers distributing mail-ordered abortion pills or performing gender-affirming treatment, prohibiting law enforcement from cooperating in out-of-state investigations against these actions. Physician assistants can now provide surgical abortions without direct physician supervision. Furthermore, the minimum wage for healthcare workers will increase to $23 per hour in June, reaching $25 per hour by 2026.

3. Various States: Several other states have enacted notable healthcare laws. Colorado prohibits intimate examinations on sedated or unconscious patients without consent. Connecticut's law affects agreements between pharmacy benefit managers and 340B-protected organizations. Idaho restricts medical interventions related to gender or genitals except in emergencies. Illinois requires healthcare facilities to notify about mergers or acquisitions, with penalties for non-compliance. Maine has eliminated cost-sharing for abortion procedures in health plans. Minnesota updates include regulations on contraceptive care, doula services, and merger notifications for healthcare facilities. Nebraska extends Medicaid postpartum coverage, and Nevada increases medical malpractice damage caps. Oregon mandates coverage for primary care visits by insurance plans, and Pennsylvania requires electronic networks for prior authorization. Rhode Island allows pharmacists to prescribe hormonal contraceptives. Texas mandates health insurers to provide a website for coverage verification. Utah includes mental health treatment coverage for healthcare employees. Virginia introduces changes in health benefit plans and the Smartchart Network Program. Lastly, West Virginia lowers the copay for insulin and insulin devices and allows the purchase of ketone blood testing equipment without a prescription.

It’s Time to Prioritize Employees’ Financial Health

By Manisha Thakor - When an individual has financial health, they experience greater overall well-being and bring their best selves to the workplace. Unfortunately, 80% of employees report being financially stressed, and only 28% of employers offer financial wellness programs. Read Full Article…

VBA Article Summary

1. Acknowledge the Importance of a Personal Finance Ecosystem: The article stresses the need for employers to adopt an “ecosystem” approach to financial health. This involves considering unique factors such as an employee's financial knowledge, cultural influences, socioeconomic status, mindset, overall physical health, and living conditions. By recognizing these diverse aspects, employers can offer more nuanced and tailored benefits, supporting employees in achieving better financial health and well-being.

2. Develop Effective Employee Benefit Utilization: Despite being skilled in their jobs, many employees struggle to understand and maximize their benefit options. The article suggests that employers should provide sufficient time and resources for employees to understand their benefits, such as through webinars, FAQs, and regular check-ins. This approach can help employees make informed decisions about complex choices like retirement plans and health insurance, thereby reducing their financial stress and improving productivity.

3. Invest in Unbiased Financial Education and Guidance: The final step recommends hiring external firms or designating in-house experts to educate employees on financial well-being. These programs should be unbiased and not linked to the sale of specific financial products. Effective financial education can cover essential topics like financial literacy basics, debt management, retirement planning, and more. This investment in employees' financial health can yield high returns in terms of reduced financial stress and increased workplace productivity.

Family-first employer? 4 ways to boost retirement benefits with caregiver support

By Bryce Sanders - These statistics should grab your attention:  According to AARP, 19% of Americans provide unpaid care for an adult, 26% find it hard to coordinate care and 61% of family caregivers are working in their regular jobs. Read Full Article…

VBA Article Summary

1. Educating Employees about FMLA: The first essential step is to educate employees about the Family and Medical Leave Act (FMLA), which allows up to 12 weeks of unpaid leave for caregiving needs. The Act is particularly beneficial as it offers job protection during extended periods of absence, and the duration of leave can be even longer for those caring for a member of the military.

2. Support with EAPs and DCAPs: Companies can assist caregiving employees by offering Employee Assistance Programs (EAPs) and Dependent Care Assistance Plans (DCAPs). EAPs can provide emotional support, while DCAPs allow for pretax payroll deductions to cover the cost of paid caregivers. This support is crucial as about 41% of employers offer similar benefits.

3. Provide Respite Care: Offering respite care as an employee benefit is another way to support caregivers. Respite care involves bringing in someone to temporarily share or take over caregiving responsibilities, thereby reducing the stress and workload of the employee who is balancing their job with caregiving duties. This type of support can also extend to other roles, like childcare.

HR leaders share their total rewards resolutions for 2024

By Courtney Vinopal - In recent years, the definition of “total rewards” has expanded to include more than just compensation and benefits. Employers surveyed by consulting firm Mercer in April 2023 indicated they planned to make investments not only in compensation, but also mental and emotional wellness, career paths, and training and skill development in the next six to 12 months. Read Full Article…

VBA Article Summary

1. Enhanced Benefits and Perks: Going into 2024, various companies are introducing innovative employee benefits. For instance, Citizens Financial Group is offering "community sabbaticals," enabling employees to take 4-5 weeks off for community investment. Trust & Will is expanding anniversary benefits, including a 3-month paid sabbatical after 5 years and a $6,000 bucket list experience reimbursement after 6 years. Liberty Mutual Insurance is launching a virtual physical therapy solution with convenient and personalized support options.

2. Health and Wellness Focus: Companies are increasingly focusing on health and wellness benefits. Fountain is partnering with Prenuvo for annual whole-body MRI scans for early medical condition detection. UKG is enhancing parental leave, surrogacy benefits, and support for transgender employees for gender-affirming care. ezCater is providing access to Carrot for fertility care and Modern Health for mental health services. Wiley is offering menopause care benefits, and Deloitte is covering annual skin cancer screenings and digital physical therapy.

3. Remote Work and Connection: In response to the remote work trend, companies are exploring ways to foster employee connection. Khan Academy, a remote-first company, is considering platforms that facilitate employee meetups and connections. This approach addresses the challenges of remote work environments by enabling meaningful employee engagement and interaction.

2024 Outlook: Drug price negotiations, Braidwood highlights top legal cases to watch

By Noah Tong - Legal experts indicated they will be paying close attention to lawsuits surrounding the Medicare drug price negotiation program and Braidwood v. Becerra, a case that threatens a key aspect of the Affordable Care Act. Read Full Article…

VBA Article Summary

1. Litigation on Inflation Reduction Act's Drug Price Negotiations: The Inflation Reduction Act's implementation, particularly its drug price negotiation program, has led to several lawsuits against the Department of Health & Human Services and the Centers for Medicare & Medicaid Services. These lawsuits, brought mainly by pharmaceutical companies, challenge the constitutionality of the program. Despite a failed preliminary injunction to halt the program, the legal battles are expected to intensify and continue for several years, with the likelihood of multiple appeals due to different legal grounds for any favorable decisions for the pharmaceutical industry.

2. Challenges to the Affordable Care Act (ACA) in Braidwood v. Becerra: The Fifth Circuit is currently reviewing Braidwood v. Becerra, a case challenging the ACA's requirement for insurers and health plans to cover preventative services without cost-sharing. The plaintiffs, citing religious objections and constitutional grounds, argue against the coverage of certain services like HIV prevention medication. This case follows previous legal battles against the ACA and could have significant implications for over 150 million people who benefit from these preventative services annually.

3. Potential Impact and Uncertainty of Court Decisions: Both legal battles present significant uncertainty and potential for major impact on the healthcare industry. If the drug price negotiation program is upheld, it could lead to lower out-of-pocket costs for consumers and increased transparency, albeit at the possible expense of pharmaceutical innovation. Conversely, a ruling in favor of Braidwood could lead to decreased access to preventative healthcare services, particularly affecting marginalized communities. The outcomes of these cases are difficult to predict due to the unpredictable nature of court decisions.

Workplace benefits help get employees in the door — and keep them there

By James Reid - In today’s competitive hiring environment, attracting and retaining top talent are key concerns for employers. And while offering a comprehensive benefits package has long been a significant tool to help attract talent, more employees — particularly younger employees — are looking for additional protections and options from their employers. Read Full Article…

VBA Article Summary

1. Redefining Priorities and Opportunities for Employers: The current economic climate has led a significant majority of workers (83%) to reevaluate key aspects of their lives, with a higher tendency among younger generations like Generation Z (91%) and millennials (89%). This shift towards reassessing personal finances and life goals presents a unique opportunity for employers. By offering comprehensive workplace benefits and retirement plans, employers can enhance employee satisfaction, reduce attrition, and address the strategic priority of employee benefits, as highlighted by 82% of small-business owners in Lincoln Financial Group’s survey.

2. The Impact of Benefits on Recruitment and Retention: A well-rounded benefits package is crucial in today's competitive job market, with 77% of employees considering non-health insurance benefits essential or very important in job decisions. As millennials form the largest segment of the U.S. labor force, offering and educating them about various benefits, including disability, accident, and critical illness insurance, is vital. These benefits not only attract new employees but also foster loyalty, as evidenced by 80% of employees who value group benefits.

3. The Importance of Education and Financial Wellness: Understanding and choosing workplace benefits can be complex, with 54% of employees expressing a need for better understanding to enroll in more benefits. This need is particularly acute among younger generations. Digital tools and resources can help demystify these benefits, aiding employees in making informed decisions. Additionally, addressing financial stress, which affects 93% of employees, through financial wellness resources can lead to positive outcomes, including reduced stress and increased loyalty, with 56% of employees more likely to remain with an employer who provides such benefits.

What is the Centers for Medicare and Medicaid Services’ New AHEAD Model?

By Alice Burns - In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new opportunity for states to leverage federal funding on health care: the Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. Read Full Article…

VBA Article Summary

1. Overview and Goals of the AHEAD Model: The AHEAD (Advancing All-Payer Health Equity Approaches and Development) model, running from 2024 to 2034, is a CMS initiative aiming to transform healthcare payment and delivery in participating states. It encourages states to use federal funding for health reforms, involving multiple payers like Medicaid, Medicare, and private payers. The model focuses on increasing primary care spending, shifting hospitals to global budgets for predetermined patient populations, and integrating social services to enhance health outcomes. It also emphasizes prospective lump sum payments and mandates the development of health equity plans and performance targets.

2. State Participation and Multi-payer Models: Participation in the AHEAD model is voluntary for states, which are required to engage hospitals and potentially private insurers. It builds upon existing multi-payer models in states like Maryland, Pennsylvania, and Vermont, aiming to reduce overall healthcare costs and improve care quality. States participating in AHEAD will receive planning grants and must involve at least one private payer by the second year. The model's structure is designed to curb healthcare spending growth and promote equity through various operational and financial reforms.

3. Challenges and Evaluation of the AHEAD Model: The implementation of AHEAD poses several challenges, including engaging private payers, addressing potential political resistance, and managing spending targets. States with significant Medicaid managed care or Medicare Advantage enrollment must collaborate with these plans to meet spending goals. CMS will evaluate the model's impact on health outcomes, equity, and quality of care using demographic data and a range of quality measures. The model also raises questions about the effects on hospital practices, such as potential vertical consolidation and the ability to meet broad quality and health goals.