The quality of a therapeutic relationship depends on the ability of the healthcare provider to communicate effectively. The term “therapeutic communication” is often used in the field of nursing; however, the process isn’t limited to nursing. Other healthcare professionals, friends and family members of a patient can implement the strategies of communicating in a therapeutic manner. The ideal therapeutic exchange provides the patient with the confidence to play an active role in her care.

Facilitates Client Autonomy

Therapeutic communication techniques, such as active listening, infer autonomy or independence on the patient or client. Rather than making assumptions about the client who is almost a stranger, the healthcare professional facilitates therapeutic expression. The client, ideally, will then become more comfortable sharing potentially difficult information. The role of the healthcare professional is then to use this information to help the client to further investigate his own feelings and options. In the end, the client gains more confidence in making decisions regarding his care.

Creates a Nonjudgmental Environment

Perhaps the most important characteristic of a therapeutic relationship is the development of trust. Trust facilitates constructive communication; it also encourages confidence and autonomy. Being nonjudgmental is necessary in verbal and nonverbal communication. People are acutely adept at identifying nonverbal cues that may communicate something very different from what is said.

Provides The Professional With a Holistic View of Their Client

An individual does not usually exist without a network of family, friends and healthcare professionals. Therapeutic communication emphasizes a holistic view of a person and his network of people who provide support. A person’s individual perspective regarding his health and life is viewed through a lens built from the context of his experiences. Those experiences cannot be ignored when communicating in a way that is therapeutic. Within the therapeutic relationship, the individual is learning the skills of communication with other people in his life, ideally also improving those relationships.

Reduces Risk of Unconscious Influence By The Professional

It’s human nature to want to infer some part of yourself into an interaction; however, in order for therapeutic communication to occur, it’s important to temper your influence. Therapeutic communication requires maintaining an acute awareness of what is being said as well as any nonverbal cues. Communicating that you are open to hearing what a person has to say while folding your arms creates confusion and inconsistency that can mar a healthy interaction. Be aware of your tone of voice and any reactions.

Originally Published By LiveStrong.com

When most experts think of group healthcare plans, Preferred Provider Organization (PPO) plans largely come to mind—though higher cost, they dominate the market in terms of plan distribution and employee enrollment. But Consumer-Directed Health Plans (CDHPs) have made surprising gains. Despite slight cost increases, CDHP costs are still below average and prevalence and enrollment in these plans continues to grow in most regions—a main reason why it was one of the top 7 survey trends recently announced.

In 2017, 28.6% of all plans are CDHPs. Regionally, CDHPs account for the following percentage of plans offered:

Prevalence of CDHP Plans

CDHPs have increased in prevalence in all regions except the West. The North Central U.S. saw the greatest increase (13.2%) in the number of CDHPs offered. Looking at size and industry variables, several groups are flocking to CDHPs:

Regional offering of CDHPs

When it comes to enrollment, 31.5% of employees enroll in CDHP plans overall, an increase of 19.3% from 2016, after last year’s stunning increase of 21.7% from 2015. CDHPs see the most enrollment in the North Central U.S. at 46.3%, an increase of 40.7% over 2016. For yet another year in the Northeast, CDHP prevalence and enrollment are nearly equal; CDHP prevalence doesn’t always directly correlate to the number of employees who choose to enroll in them. Though the West held steady in the number of CDHPs offered, there was a 2.6% decrease in the number of employees enrolled. The 12.6% increase in CDHP prevalence in the North Central U.S. garnered a large 40.7% increase in enrollment. CDHP interest among employers isn’t surprising given these plans are less costly than the average plan. But like all cost benchmarks, plan design plays a major part in understanding value. The UBA survey finds the average CDHP benefits are as follows:

CDHP benefits

By Bill Olson
Originally Published By United Benefit Advisors

Many people in their 40s are facing an uncomfortable fact: They simply aren’t where they’d hoped to be financially. Fortunately, all their life experience can help correct for past mistakes.

“There’s a different trigger moment for everybody,” says Jay Howard, financial advisor and partner at MHD Financial in San Antonio, Texas. “But regardless of when it comes, people find themselves looking down the barrel of a gun as they consider retirement.”

One challenge is that it’s impossible to advise 40-somethings based on tidy “life stage” demographics. Some are just starting families, while others are sending offspring to college. They’re married, single, divorced, and just about everything in between.

But for those still grappling with financial instability, these four principles can help in moving forward with confidence:

1. Acknowledge what you’ve done right.
It could be one great decision sandwiched in between some fails, or just a single good habit that can mitigate the impact of a host of wrongs.

Take the example of Kiera Starboard, a 46-year-old controller at a San Diego software firm. A mom to two adult sons and a teenage stepson, she always made having sufficient life insurance—both term and permanent—a priority, the result of her previous training as a financial advisor. “Even if it was tight, I made the payments,” she says. “It was a priority for my family’s sake, and for my own peace of mind.”

Unlike the 40% of Americans who have no life insurance, Starboard was protected when the unthinkable happened last August. Less than two years into her marriage, her husband, Steve, was killed while riding his motorcycle to work—one month after they purchased a small, additional life insurance policy to supplement his employer coverage.

“To have had to deal with financial stress on top of everything else, it would have been unbearable, incapacitating,” says Starboard. “My stepson and I are certainly in a much better position today than we would have been, had Steve and I not followed the advice I used to give to others.”

2. Take action to shore up the decades ahead.
For many, the hardest part can be learning to put your own long-term future first—sometimes for the first time in your life.

“I see people focusing on their kids’ college savings, and not enough on retirement or an emergency fund for themselves,” says Starboard. Many advisors point out that kids can borrow for college if necessary, but no one can borrow for retirement.

The most important step is clear, says Howard: “You must have a written financial plan, period. Because that plan will dictate what you must do to be successful for the entirely of your life.

“The financial plan is your road map,” he continues. “In it will be your portfolio requirements, your savings goals, and your insurance-related needs.”

Finally, make sure your plan takes inflation into account, commonly estimated at 3% a year. Says Howard, “Inflation is the silent assassin that eats away at your nest egg.”

3. Apply the hard-fought wisdom you’ve gained.
“Treat the numbers determined by your plan—such as monthly savings—as bills that need to be paid,” advises Howard. When money comes in, it’s easy to start thinking of a new kitchen or a trip to Tulum. “Just be patient and keep the bills paid.”

Using that wisdom also applies to the big stuff. As the executor to her husband’s estate, Starboard has held back making any major decisions. “In a prior loss, I committed to real estate transactions and other things prematurely. At the time, it really felt like the right thing to do but my grief clouded my perception. I had a painful, expensive learning lesson.”

4. Focus on your shining future—really.
Forward thinking is an essential part of your financial plan, says Howard. “Get help really envisioning what kind of retirement you want. For each aspect, really drill down. For instance, where do you want to live? Do you want to be near your grandkids? Will you have the money to go see them? How often? It’s not just financial planning, it’s life planning.”

If all that forward thinking feels presumptuous, Howard recalls the eminently quotable Yogi Berra, who once said, “If you don’t know where you’re going, you might not get there.”

By Erica Oh Nataren
Originally Published By Lifehappens.org

I’m happy to report that this year’s UBA Health Plan survey achieved a milestone. For the first time, we surpassed 20,000 health plans entered—20,099 health plans to be exact, which were sponsored by 11,221 employers. What we were able to determine from all this data was that a tumultuous Presidential election likely encouraged many employers to stay the course and make only minor increases and decreases across the board while the future of the Patient Protection and Affordable Care Act (ACA) became clearer.

There were, however, a few noteworthy changes in 2017. Premium renewal rates (the comparison of similar plan rates year over year) rose nearly 7%, representing a departure from the trend the last five years. To control these costs, employers shifted more premium to employees, offered more lower-cost CDHP and HMO plans, increased out-of-network deductibles and out-of-pocket maximums, and significantly reduced prescription drug coverage as six-tier prescription drug plans exploded on the marketplace. Self-funding, particularly among small groups, is also on the rise.

Percent Premium Increase Over Time

UBA has conducted its Health Plan Survey since 2005. This longevity, coupled with its size
 and scope, allows UBA to maintain its superior accuracy over any other benchmarking survey in the U.S. In fact, our unparalleled number of reported plans is nearly three times larger than the next two of the nation’s largest health plan benchmarking surveys combined. The resulting volume of data provides employers of all sizes more detailed—and therefore more meaningful—benchmarks and trends than any other source.

By Peter Weber
Originally Published By United Benefit Advisors

Fall.  With it comes cooler temperatures’, falling leaves, warm seasonal scents like turkey and pumpkin pie, and Open Enrollment.  It goes without saying; employees who understand the effectiveness of their benefits are much more pleased with those packages, happier with their employers, and more engaged in their work. So, as your company gears up for a new year of navigating Open Enrollment, here are a few points to keep in mind to make the process smoother for both employees and your benefits department. Bonus: it will lighten the load for both parties alike during an already stress-induced season.

Communicate Open Enrollment Using a Variety of Mediums

Advertise 2018 benefit changes to employees by using a variety of mediums. The more reminders and explanation of benefits staff members have using more than one mode of media, the more likely employees will go into Open Enrollment with more knowledge of your company’s benefit options and when they need to have these options completed for the new year.

  • Consider explainer videos to simplify the amount of emails and paperwork individuals need to review come Open Enrollment time. These videos can increase the bottom line as well, eliminating the high cost of print material.
  • Opt for placards placed throughout your high-traffic areas. Communicate benefit options and remind employees of Open Enrollment dates for the new year by posting in such areas as the lobby, break room and bathroom stalls.
  • Choose SMS texting. Today, over 97% of individuals use text. Ninety-eight percent of those that use text open messages within the first three minutes of receiving them; 6-8 times higher than the engagement rate for email. Delivering a concise message to employees’ mobile devices creates more touch points along the Open Enrollment journey. The key, however, is making it quick so as to entice your employees to take action.
  • Promote apps and in-app tools. Push notifications and apps like Remind 101 can help drive employee engagement during Open Enrollment season simply by providing short messages reminding them to enroll. Notifications like these can also be tailored to unique employee groups based on location, job level, eligibility status and more.

Utilize Mobile Apps and Web Portals for Open Enrollment

Now that your company has communication down pat for Open Enrollment, simplify the arduous task employees have of enrolling for the coming year by going paperless. Utilize web portals through benefit brokers and companies like ADP to eliminate the hassle of employees having to fill out paperwork both at renewal, and at the time of hire.  With nearly three quarters of individuals in the United States checking their phone once an hour and 90% percent of this time is spent using one app or another as a main source of communication, mobile apps can make benefits engagement much easier due to the anywhere/anytime accessibility they offer.

The personal perks for employees are great too! Staff members with a major lifestyle event can make benefit adjustments quickly with the ease of mobile apps.  Employees recognize this valuable and time-saving trend and enjoy having this information at their fingertips.

Open Enrollment season can be a stressful time but hopefully these tips will help for a smoother transition into the next year for your business. Simple things like using explainer videos, placing reminders in high traffic areas and utilizing mobile apps and text messaging can save time and stress in the long run for your employees and benefit department.

On October 12, 2017, the White House released an Executive Order, signed by President Trump, titled “Promoting Healthcare Choice and Competition Across the United States.”

It is important to note that the Executive Order (EO) does not implement any new laws or regulations, but instead directs various federal agencies to explore options relating to association health plans, short term limited-duration coverage (STLDI), and health reimbursement arrangements (HRAs), within the next 60 to 120 days.

The Department of Labor is ordered to explore expansion of association health plans (AHPs) by broadening the scope of ERISA to allow employers within the same line of business across the country to join together in a group health plan. The EO notes employers will not be permitted to exclude employees from an AHP or develop premiums based on health conditions. The Secretary of Labor has 60 days to consider proposing regulations or revising guidance.

Practically speaking, this type of expansion would require considerable effort with all state departments of insurance and key stakeholders across the industry. Employers should not wait to make group health plan decisions based on the EO, as it will take time for even proposed regulations to be developed.

The Department of the Treasury, Department of Labor, and Department of Health and Human Services (the agencies) are directed to consider expanding coverage options from STLDI, which are often much less expensive than Marketplace plans or employer plans. These plans are popular with individuals who are in and outside of the country or who are between jobs. The Secretaries of these agencies have 60 days to consider proposing regulations or revising guidance.

Finally, the EO directs the same three agencies to review and consider changing regulations for HRAs so employers have more flexibility when implementing them for employees. This could lead to an expanded use of HRA dollars for employees, such as for premiums. However, employers should not make any changes to existing HRAs until regulations are issued at a later date. The Secretaries have 120 days to consider proposing regulations or revising guidance.

By Danielle Capilla
Originally Published By United Benefit Advisors

A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket health care costs for a participant as well as a participant’s spouse and eligible dependents. Health FSAs are employer-established benefit plans and may be offered with other employer-provided benefits as part of a cafeteria plan. Self-employed individuals are not eligible for FSAs.

Even though a health FSA may be extended to any employee, employers should design their health FSAs so that participation is offered only to employees who are eligible to participate in the employer’s major medical plan. Generally, health FSAs must qualify as excepted benefits, which means other nonexcepted group health plan coverage must be available to the health FSA’s participants for the year through their employment. If a health FSA fails to qualify as an excepted benefit, then this could result in excise taxes of $100 per participant per day or other penalties.

Contributing to an FSA

Money is set aside from the employee’s paycheck before taxes are taken out and the employee may use the money to pay for eligible health care expenses during the plan year. The employer owns the account, but the employee contributes to the account and decides which medical expenses to pay with it.

At the beginning of the plan year, a participant must designate how much to contribute so the employer can deduct an amount every pay day in accordance with the annual election. A participant may contribute with a salary reduction agreement, which is a participant election to have an amount voluntarily withheld by the employer. A participant may change or revoke an election only if there is a change in employment or family status that is specified by the plan.

Per the Patient Protection and Affordable Care Act (ACA), FSAs are capped at $2,600 per year per employee. However, since a plan may have a lower annual limit threshold, employees are encouraged to review their Summary Plan Description (SPD) to find out the annual limit of their plan. A participant’s spouse can put $2,600 in an FSA with the spouse’s own employer. This applies even if both spouses participate in the same health FSA plan sponsored by the same employer.

Generally, employees must use the money in an FSA within the plan year or they lose the money left in the FSA account. However, employers may offer either a grace period of up to two and a half months following the plan year to use the money in the FSA account or allow a carryover of up to $500 per year to use in the following year.

By Danielle Capilla
Originally Published By United Benefit Advisors

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

Grace Periods

The initial premium payment is due 45 days after the qualified beneficiary elects COBRA. Premium payments must be made on time; otherwise, a plan may terminate COBRA coverage. Generally, subsequent premium payments are due on the first day of the month. However, under the COBRA grace period rules, premiums will still be considered timely if made within 30 days after the due date. The statutory grace period is a minimum 30-day period, but plans may allow qualified beneficiaries a longer grace period.

A COBRA premium payment is made when it is sent to the plan. Thus, if the qualified beneficiary mails a check, then the payment is made on the date the check was mailed. The plan administrators should look at the postmark date on the envelope to determine whether the payment was made on time. Qualified beneficiaries may use certified mail as evidence that the payment was made on time.

The 30-day grace period applies to subsequent premium payments and not to the initial premium payment. After the initial payment is made, the first 30-day grace period runs from the payment due date and not from the last day of the 45-day initial payment period.

If a COBRA payment has not been paid on its due date and a follow-up billing statement is sent with a new due date, then the plan risks establishing a new 30-day grace period that would begin from the new due date.

Notification

The plan administrator must notify the qualified beneficiary of the COBRA premium payment obligations in terms of how much to pay and when payments are due; however, the plan does not have to renotify the qualified beneficiary to make timely payments. Even though plans are not required to send billing statements each month, many plans send reminder statements to the qualified beneficiaries.

While the only requirement for plan administrators is to send an election notice detailing the plan’s premium deadlines, there are three circumstances under which written notices about COBRA premiums are necessary. First, if the COBRA premium changes, the plan administrator must notify the qualified beneficiary of the change. Second, if the qualified beneficiary made an insignificant shortfall premium payment, the plan administrator must provide notice of the insignificant shortfall unless the plan administrator chooses to ignore it. Last, if a plan administrator terminates a qualified beneficiary’s COBRA coverage for nonpayment or late payment, the plan administrator must provide a termination notice to the qualified beneficiary.

The plan administrator is not required to inform the qualified beneficiary when the premium payment is late. Thus, if a plan administrator does not receive a premium payment by the end of the grace period, then COBRA coverage may be terminated. The plan administrator is not required to send a notice of termination in that case because the COBRA coverage was not in effect. On the other hand, if the qualified beneficiary makes the initial COBRA premium payment and coverage is lost for failure to pay within the 30-day grace period, then the plan administrator must provide a notice of termination due to early termination of COBRA coverage.

By Danielle Capilla
Originally Published By United Benefit Advisors

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee’s own cost. The length of the COBRA coverage period depends on the qualifying event and is usually 18 or 36 months. However, the COBRA coverage period may be extended under the following five circumstances:

  1. Multiple Qualifying Events
  2. Disability
  3. Extended Notice Rule
  4. Pre-Termination or Pre-Reduction Medicare Entitlement
  5. Employer Extension; Employer Bankruptcy

In this blog, we’ll examine the first circumstance above. For a detailed discussion of all the circumstances, request UBA’s Compliance Advisor, “Extension of Maximum COBRA Coverage Period”.

When determining the coverage period under multiple qualifying events, the maximum coverage period for a loss of coverage due to a termination of employment and reduction of hours is 18 months. The maximum coverage period may be extended to 36 months if a second qualifying event or multiple qualifying events occur within the initial 18 months of COBRA coverage from the first qualifying event. The coverage period runs from the start of the original 18-month coverage period.

The first qualifying event must be termination of employment or reduction of hours, but the second qualifying cannot be termination of employment, reduction of hours, or bankruptcy. In order to qualify for the extension, the second qualifying event must be the covered employee’s death, divorce, or child ceasing to be a dependent. In addition, the extension is only available if the second qualifying event would have caused a loss of coverage for the qualified beneficiary if it occurred first.

The extended 36-month period is only for spouses and dependent children. In order to qualify for extended coverage, a qualified beneficiary must have elected COBRA during the first qualifying event and must have been receiving COBRA coverage at the time of the second event. The qualified beneficiary must notify the plan administrator of the second qualifying event within 60 days after the event.

Example: Jim was terminated on June 3, 2017. Then, he got divorced on July 6, 2017. Jim was eligible for COBRA continuation coverage for 18 months after his termination of employment (the first qualifying event). However, his divorce (the second qualifying event) extended his COBRA continuation coverage to 36 months because it occurred within the initial 18 months of COBRA coverage from his termination (the first qualifying event).

The health plan should indicate when the coverage period begins. The plan may provide that that the plan administrator be notified when plan coverage is lost as opposed to when the qualifying event occurs. In that case, the 36-month coverage period would begin on the date coverage was lost.

By Danielle Capilla
Originally Published By United Benefit Advisors

OSHA Injury Tracking Application Electronic Portal

As of August 1, 2017, the Occupational and Safety Health Administration’s (OSHA) new electronic portal, the Injury Tracking Application (ITA), is available for employers to file web-based reports of workplace injuries or illnesses.

Under OSHA’s electronic recordkeeping rule, covered employers with at least 250 employees must submit the following forms electronically:

  • Log of Work-Related Injuries and Illnesses (Form 300).
  • Summary of Work-Related Injuries and Illnesses (Form 300A).
  • Injury and Illness Report (Form 301).

Access the ITA and read about electronic submission

2017 VETS-4212 Reporting Opened

The 2017 filing season for the VETS-4212 started on August 1, 2017 and ends on September 30, 2017. The Vietnam Era Veterans’ Readjustment Assistance Act of 1974 (VEVRAA) requires federal contractors and subcontractors subject to the act’s affirmative action provisions who enter into or modify a contract or subcontract with the federal government, and whose contract meets the criteria set forth in the law, to annually report on their affirmative action efforts in employing veterans.

The U.S. Department of Labor’s Veterans’ Employment and Training Service has a legislative requirement to collect, and make available to the Office of Federal Contract Compliance Programs, reported data contained on the VETS-4212 report for compliance enforcement.

File the 2017 VETS-4212 Report

OSHA Revises Online Whistleblower Complaint Form

On July 28, 2017, the Occupational Safety and Health Administration (OSHA) revised its online whistleblower complaint form to help users file a complaint with the appropriate agency. OSHA administers more than twenty whistleblower protection laws, including Section 11(c) of the Occupational Safety and Health (OSH) Act, which prohibits retaliation against employees who complain about unsafe or unhealthful conditions or exercise other rights under the Act. Each law has a filing deadline, varying from 30 days to 180 days, that starts when the retaliatory action occurs.

The updated form guides users through the complaint process, providing essential questions at the start to assist users in understanding and exercising their rights under relevant laws. The new system also includes pop-up boxes with information about various agencies for individuals who indicate that they have engaged in protected activity that may be addressed by an agency other than OSHA.

In addition to the online form, workers may file complaints by fax, mail, or hand-delivery; contacting the agency at 800-321-6742; or calling an OSHA regional or area office.

View the new online form in English or Spanish

Prevailing Health and Welfare Fringe Benefits Rate Announced Under the McNamara-O’Hara Service Contract Act

On July 25, 2017, the U.S. Department of Labor (DOL) released an all agency memorandum (number 225) announcing that under the McNamara-O’Hara Service Contract Act (SCA) the employee-by-employee benefit will be $4.41 per hour, or $176.40 per week, or $760.40 per month. Additionally, the average cost fringe benefit rate will also be $4.41 per hour.

The McNamara-O’Hara Service Contract Act requires contractors and subcontractors performing services on prime contracts in excess of $2,500 to pay service employees in various classes no less than the wage rates and fringe benefits found prevailing in the locality, or the rates (including prospective increases) contained in a predecessor contractor’s collective bargaining agreement. The DOL issues wage determinations on a contract-by-contract basis in response to specific requests from contracting agencies. These determinations are incorporated into the contract.

The new rate became effective August 1, 2017.

Originally Published By Thinkhr.com

Switching over to AEIS Advisors was the best decision we’ve made this year. Ronald and his team were able to identify discrepancies on our billing statements which got missed by our last broker, and they saved us over $8,000 in credits! AEIS has proven to be an attentive and caring company, looking out for the best needs of their clients."

- Director of Operations

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