• 10 tips for building better retirement plans
• News You Can Use: COBRA subsidy extended
• Social media benefit communication picks up speed
• Employer wellness efforts hindered again by GINA restrictions
• One-third of health care dollars wasted
• News You Can Use: Reform bills would force employers to cover dietary counseling for 27-year-old dependents
• A tale of two companies
• Targeting surgery to reduce costs for employers
• EBN, EBA create new Twitter accounts
• A fix in six
• Exercise Corner: Hand-Wrist Deskercises
• Recipe Corner: Greek Black-Eyed Peas Salad

While employers with defined benefit plans have experienced the most immediate consequences of the financial crisis, those with defined contribution plans may also be facing a problem that is far greater than they realize, according to research on retirement plans.

In its recent white paper, "Building pensions for the future," AEGON Global Pensions, an international pension provider, acknowledges that while many companies have turned to DC plans as an effective way to mitigate risk, improvements need to be made to the plans if they are to provide adequate retirement income to workers.

DC plan sponsors need to find ways to help plan members save more, increase participation in their plans, increase contribution levels and encourage plan members to begin saving earlier.

The study offers the following 10 guidelines for building better retirement plans:

1. Be careful what you promise. Legislation and regulation often stipulate the way DB promises are made. Wherever you can, find a way to moderate the promises implicit in a DB plan.

2. Use de-risking mechanisms. The market provides a variety of mechanisms that trustees and sponsors of DB plans can use to effectively mitigate risk.

3. Save more. In DC plans, the first priority should be to ensure that members start saving early and save enough. Sponsors, trustees and legislators should introduce appropriate mechanisms to enable this

4. Invest better. DC investment strategies can be improved by offering a suitable degree of choice, well-defined life cycle strategies and guarantees, where appropriate.

5. Improve the payout phase. Improvements need to be made in the way that the payout phase in DC plans matches retiree needs, with alignment between the accumulation phase and payout phase.

6. Communicate and educate. Plan members require expert assistance and advice to be able to make informed decisions on how to best manage their DC assets.

7. Ensure effective delivery. Make sure proper processes are in place to run your pensions well. Outsource where appropriate.

8. Be engaged. Although plan sponsors may decide to remove risk from the balance sheet and outsource specific tasks to providers, sponsor engagement remains critically important to a successful pension strategy.

9. Exploit cross-border opportunities. Increasingly, multinational companies are exploring opportunities to benefit from their global reach.

10. Plan for change. Providing pensions is an ever-changing field. Develop strategies that are flexible and
adaptable to change.

Source: Employeebenefitnews.com, December 28, 2009

Looks like Congress is trying to make Santa’s “nice” list. The Senate, in particular, was quite busy over the weekend, not only clearing one of the last procedural hurdles in the way of a final vote on health care reform legislation, but also voting 88-10 on Saturday to extend the COBRA subsidy originally implemented in the stimulus package earlier this year.

Since the House already had approved the measure in the last few days, President Obama wasted no time today signing the bill to extend COBRA relief to unemployed workers.

Now, instead of applying to workers laid off through Dec. 31, the extension maintains the 65% subsidy on COBRA premiums for workers laid off through Feb. 28, 2010. In addition, the new law allows for another six months of subsidized coverage for unemployed Americans whose nine-month subsidy already had ended, and let individuals claim the subsidy retroactively.

And as a special holiday gift for employers (sarcasm), the extension law requires employers to notify and/or re-notify terminated workers about the new subsidy provisions.

So, enjoy a nice long holiday break, pros. Between overseeing the new COBRA extension notifications and keeping a watchful eye on health care reform, you’ll be hitting the ground running come January. Rest up while you can!

Source: Employeebenefitnews.com, December 21, 2009

More and more employers are jumping on the social media bandwagon to savvily communicate with their employees, but are they risking a flat tire when they attempt to convey complex messaging about business strategy and benefits?

Adam Wootton of Watson Wyatt doesn’t think so, provided employers intelligently consider what material they should be covering in this format and go about conveying messages and dialoguing with employees in a safe, controlled environment.

“If you’re communicating a change that is purely informational, you can use new media to get the message out in a way that people can easily understand,” says Wootton.

Example: employers using short, YouTube-style videos to share information and company changes. Blogs are also popular, as with one Watson Wyatt client that created a CEO Blog written by the company leader as he strove to live a healthier life. Thereby, they engaged and fostered a deep connection between leadership and line employees.

Best Buy increased enrollment in their 401(k) plan by staging a video contest among employees about the subject, a dramatic shift in communication as employees themselves conveyed a message the way they would like to receive it, all the while having fun.

Podcasts are good for employees with long commutes. Wikis (think Wikipedia) are also useful for translating benefits jargon. Employees, most likely in HR, that log into the company intranet can define confusing benefits vocabulary that others have queried.

“A lot of ideas of social media like user-generated content and support groups have been around for a long time. Many companies have had these programs; normally they were physical programs, now with social media we can make them virtual as well. The good thing is the employee doesn’t have to be at the meeting to benefit from it, they can come to the site anytime they like,” explains Wootton.

A scenario that’s very attractive to employers who have a wide geographical spread of employees.

According to a new survey from Watson Wyatt, almost two-thirds of companies plan to increase their use of social media in 2010. Of the 328 companies surveyed from across the globe, 78% have increased their electronic communication in the last 24 months, and 55% have increased face-to-face communication.

However, nearly half (48%) have diminished their print communication over the past 24 months.

“Companies continue to explore using social media as the next communication frontier,” says Kathryn Yates, global leader of communication consulting at Watson Wyatt. “Today’s workers are looking for authentic, timely messages that address how business changes affect them personally. Social media engages employees in real time and on a variety of topics.”

Nevertheless, many employers have yet to join the social media parade, citing common hurdles. Among employers who did not expand their use of social media, 36% report the lack of information technology support or inadequate technical capability. Forty percent indicate limited knowledge of the topic, and nearly half (45%) of companies mention the lack of staff of resources.

At the moment, the traditional communication channels remain the most popular mode of communication with 73% preferring to discuss changes to business performance via a staff meeting. Employers view financial education as best delivered through their intranet (43%). And employers still prefer communicating changes to pay and job security face-to-face (58% and 48% respectively).

“Social media definitely gives good advantages in some areas, but it won’t completely supplant the other technology techniques we use, but it can supplement [traditional communication modes],” Wootton says.
For example, employers will always need a long PDF posted on their intranet of their summary plan description, but the HR department can break down such a dense document using social media, such as with discussion forums.

Further, the tone of the message is also something to consider, you wouldn’t tweet, for example, that "employee health insurance contributions are going up." These types of communications would need to be introduced in a number of ways, one of which could include a discussion board or another opportunity for them to give feedback and ask questions in a controlled environment. This means that all discussion would take place behind the company’s firewalls away from the very public internet (unless, of course, the company wished to promote the news to the public and potential applicants). Employees will talk no matter what, using online discussion forums gives leadership a place at the table to correct misconceptions. In practical terms, anonymity should not exist so that the rules of decorum are not lost.

Still, employee engagement is imperative and can be achieved more effectively, at times, with social media than traditional media, says Wootton. He urges employers to trust their employees and open up the ways they communicate business decisions and benefits.

“[With social media] we can tailor messages much more effectively, we can help link people who have common ideas and can help each other. The benefits on the social media side are huge,” concludes Wootton.

Source: Employeebenefitnews.com, December 15, 2009

I wonder what's inside my jeans. Oh, correction, that would be genes. With the recent release of the final rule of the Genetic Information Non-Discrimination Act, it makes me wonder.

If I took a test, and it revealed that a family member or I had some sort of disorder, would there be a little insurance gremlin behind a computer database somewhere, stamping my name with a big fat red "G" and politely placing me in a high-risk category?

I thought that HIPAA was intended to protect my health information and keep it confidential for only those that needed to know. I guess I was wrong. The folks at The Coalition for Genetic Fairness must think otherwise, since their Web site states that over 500 organizations joined their voice to stop unfair discrimination in this arena. What about self-insured employer fairness? Pardon me, but we were kicked to the curb.

In the Library of Congress, I looked up and read the words of Louise M. Slaughter, in the House of Representatives, when she made an introductory speech on January 16, 2007 on GINA. She pointed out how individuals had been discriminated against in the 1970s, 1998, and in 2000 a railroad starting doing genetic testing without employee consent.

Okay, so there was a real problem. Does this still exist today, nine years later? I've surveyed several colleagues and searched the Internet to find the GINA Gnomes and have come up short.

You see, the final rules point out that if you have a mandatory health risk assessment process, even if it's after the individual is enrolled, you can't ask anything about family history because this is deemed genetic information.

And don't forget the delightful public comment from the EEOC in August of this year. In its opinion, if an employer is asking for health-related information in a health risk assessment or wellness program, the EEOC believes it violates the ADA if it's mandatory. Oh, I'm sure that chaps the hide of the underground employer group who meets in the dark basement of a restaurant on the shifty side of town and talks about ways they can discriminate, retaliate, and stick it to their employees.

If there were ever a group, I guarantee youd that I wouldn't be involved and certainly don't know a soul who would. But I guess the EEOC thinks they are out there.

Employers work hard

This stuff makes me grumpy. Employers have been working aggressively for years trying to make a difference in the way people view wellness.

Dr. Dee Edington from the University of Michigan forged the path when he told us that we needed to get involved in our employees' health. We were told to become aggressive with the data and to be clinically proactive to keep them from getting worse.

Disease management efforts have evolved from ineffective postcard reminders in the mail to actual integrated systems of nurses who politely nag diabetics to take their medication.

Huge sums have been invested in insurance provider systems attempting to streamline those that need help sooner rather than later. Everyone is coming up with solutions to our problems. All these efforts have shown to reduce costs for employer health plans, yet these recent decisions have stomped our efforts to the ground.

If you've been one the bright employers that has implemented a mandatory wellness program or health risk appraisal to improve health or increase disease management, hats off to you. Now you'll need to change that hat to a helmet as you've entered a minefield of legal danger zones.

Don't give up

There's always a way around anything, and the proponents of reducing health care costs for employers in this country won't give up. I'm sure they'll eventually figure out a way to modify their attempts at goodness. Perhaps they will figure out new questions to ask or provide new employer guidelines.

These complications, or hiccups, will more than likely result in creative solutions. I remember when I was faced with what seemed to be an impossible situation. I had 1,400 employees who needed open enrollment meetings in one 22-foot tin trailer.

The courteous invite to piggy-back on 50+ safety meetings with a generous allotment of 10 minutes didn't sit well with me. Just when I thought my open enrollment was going to be a disaster, the cream rose to the top. The big top that is. We rented a large heated tent in the parking lot and employees strolled in and out on their own terms. It was a huge success, but only after I was faced with adversity.

Employers won't give up. Proactive carriers and providers won't give up. Don't give up. These may be setbacks, but they are only temporary, and I'm hopeful the system will work itself out. I know it will. After all, I feel it in my jeans.

Source: Employeebenefitnews.com, December 2, 2009

A new study from Thomson Reuters Healthcare Analytics confirms one thing we all know about health care costs: fraud, paperwork, unnecessary care and other forms of waste combine to drain a mindboggling amount of money from the U.S. health care system. The new study pegs the total at around $700 billion a year — about one-third of the total U.S. health care spend.

“America’s health care system is indeed hemorrhaging billions of dollars,” says Robert Kelley, vice president of healthcare analytics at Thomson Reuters. The good news, however, “is that by attacking waste we can reduce health care costs without adversely affecting the quality of care or access to care,” Kelley believes.
He cites inefficient communication, which at $25 billion to $50 billion accounts for up to 6% of medical overspending, as one example. “It is waste when caregivers duplicate tests because results recorded in a patient’s record with one provider are not available to another, or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed,” Kelley asserts.

Another example: The average U.S. hospital spends a quarter of its budget on billing and administration, according to the report. Some other items include:

• Unnecessary care, including overuse of antibiotics and lab tests to protect against malpractice exposure: between $250 billion and $325 billion a year, or up to 40% of the total. 
• Fraud, including fraudulent Medicare claims and kickbacks for referrals for unnecessary services: between $125 billion and $175 billion a year, as much as 19% of the total.
• Administrative inefficiency and redundant paperwork: between $100 billion and $150 billion, as much as 17%.
• Provider errors: between $75 billion and $100 billion, as much as 12%. 
• Preventable conditions like diabetes: between $25 billion and $50 billion, as much as 6%.

Source: Employeebenefitnews.com, December 14, 2009

I admit, I’m just not going to read the more than 2,000 pages that are the House and Senate health care reform bills. Maybe it’s the environmentalist in me, or maybe it’s the knowledge that much of what I read would make me mad.

However, thanks to my many sources who — bless them — have read the bills in their entirety, I can gain valuable info that pacifies my inner greenie but unfortunately still gets under my skin. The latest nuggets come courtesy of Spencer’s Benefits Reports, which combed through H.R. 3962 (the bill passed last month in the House) and H.R. 3590 (the Senate’s stab at reform), and found some particularly jagged little pills for employers. Among them, SBR sussed out that H.R. 3950 would require employers to cover (at 100%, mind you):

• Certain evidence-based items (with A or B ratings) in line United States Preventive Services Task Force recommendations. Yes, that’s the same panel that lit a firestorm of controversy last month with its guidelines on mammography. Because of the controversy, though, the USPSTF recs for mammograms are exempt. 
• Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. 
• Evidence-based preventive care and screenings for children within guidelines supported by the Health Resources and Services Administration. 

Additional women’s preventive care and screenings in comprehensive guidelines supported by the Health Resources and Services Administration.

I don’t think anyone can argue that greater emphasis on preventive and evidence-based care is absolutely good and necessary. All the same, that’s a lot of mandates, no? According to SBR, here’s some of what’s included on that list of A or B-rated preventive screenings:

• Depression screening. 
• Dietary counseling for adults at risk for cardiovascular and diet-related chronic disease. 
• Fluoride supplements for preschool children. 
• High-blood pressure screening.
  * Substance abuse counseling/interventions.

Not only would employers need to cover all of these screenings, they’d need to cover them for a lot more people, since both the House and Senate proposals would cover dependents up to age 27 and 26, respectively. Wow. A dependent at 27?! I may need one of those depression screenings …

Source: Employeebenefitnews.com, December 15, 2009

Recently, I had the pleasure of interviewing senior managers at two completely different midsize companies, both of which have achieved remarkable health care cost management results.

As unlikely as this may sound - in a time where most companies are struggling to find effective ways to contain their health care costs - neither company had increased employee health care premiums for the last five years. Their results were so significant that both companies asked me not to disclose their names, for fear such a disclosure would anger employees who, despite the flat trend, had not received a reduction in premiums.

In 2004, Company A opened an onsite health clinic and implemented a consumer-driven health plan. To entice participation, employees could qualify for a $2,000 company contribution to a health reimbursement account by participating in an annual health risk assessment. Ninety-nine percent of all employees participated at the outset. In subsequent years, the requirements to qualify for the incentive were incrementally increased.

Today, 84% of Company A's employees use the onsite health clinic for sick visits, and nearly 100% participate in the health risk assessment. This model reduced health care premiums by 38% in four years. In 2010, the company plans to implement an outcomes-based health promotion program that will pay employees a $2,000 HRA contribution for achieving measurable health improvement objectives.

Company B implemented an outcomes-based health promotion model that included two annual health risk assessments, face-to-face health coaching with an occupational health nurse and the achievement of mutually agreed-upon health improvements (one every 6 months). The plan offered employees a $2,000 incentive for participating.

Company B has maintained a flat medical trend since 2005 and achieved total cost-avoidance of more than 34%. With voluntary participation of well over 90%, Company B has successfully lowered its average health-risks profile from 2.6 per employee in 2005, to 1.7 as of May 2009. At the same time, the number of worker's compensation claims dropped by 50%, and the cost of those claims fell by 86.4%. Further, OSHA incidents also experienced a drop of 73.4%.

Even offering such large cash incentives, Company B achieved an overall return on investment of more than $6 to $1. Company B currently is expanding its existing onsite wellness clinic with a physician and nurse practitioner so that employees can schedule sick visits at a low cost and with minimal paperwork.

Both companies expect to continue their favorable medical claims experience for at least three to five years by combining health clinics with outcomes-based wellness programs.

Despite the fact that both companies took different approaches, both have regained control of health care costs by focusing their efforts on reducing health risks within their insured population. They understand that health risks are the building blocks for chronic conditions, which account for more than 75% of all health care costs. Simply put, employees with fewer health risks are both less costly to the company and significantly more productive on the job.

So, if you're ready say goodbye to cost-shifting, and want to regain control of your health care costs in order to create your own health care reform, follow the lead of these two companies and focus on reducing health risks within your insured population. The only thing you have to lose is an ever-inflating insurance premium.

Source: Employeebenefitnews.com, December 2, 2009

As employers continue to struggle with rising costs while ensuring that employees have access to high-quality care, surgery is beginning to gain attention as an area where savings can be realized and quality of care can be improved by educating employees about the benefits of minimally invasive surgery, or MIS, over traditional open surgery.

Unlike open surgery where large incisions are made, MIS uses specialized laparoscopic instruments inserted through small incisions in the body, resulting in reduced trauma.

A recent study analyzed data on 15,404 patients, comparing two types of minimally invasive hysterectomy procedures (vaginal and laparoscopic) with open abdominal hysterectomy. The results showed the minimally invasive approaches reduced rates of postoperative infection and length of stay in the hospital. Also, vaginal hysterectomy was associated with an average cost savings of more than $4,000 and laparoscopic hysterectomy an average of $2,000 when compared with the open approach.

Similarly, a 2008 study found that MIP reduced the risk of hospital-acquired infections by 52% compared with open surgery in a sample of more than 11,000 patients undergoing three common procedures. Still, 70% of hysterectomies are performed using the open approach.

A program that incentivizes employees to explore MIS before choosing open surgery is ideal because it requires no up-front investment, provides immediate benefits and keeps the employee on the job.

Patients who undergo MIS experience a host of benefits including: shorter hospital stays, resulting in lower hospital costs; reduced post-procedural pain, which minimizes or eliminates the need for prescription pain medication and leads to faster recovery; minimal scarring; reduced risk of hospital-acquired infections; and faster return to work and normal activities.

These benefits not only help employees recover quicker and experience fewer complications, they also extend to the employer through: reduced absenteeism because of faster recovery after surgery and quicker return to work; improved employee productivity resulting from reduced post-procedural pain, and decreased need for prescription pain medications.

Case study No. 1

Colorado Springs School District 11 is a K-12 school district with 6,000 members in its self-funded medical plan. The plan is governed by an Insurance Committee. In April 2007, the committee received approval from the Board of Education to launch a value-based plan design that would educate members about MIS and encourage them to consult with surgeons who are capable of performing it. The plan design became effective on July 1, 2007.

A study was launched to review the district's prior two-year claims data for laparoscopic procedures, covering June 1, 2005, to May 31, 2007. The evaluation determined that MIS increased overall value to the benefit offering.

The school district engaged in discussions with Memorial Health System, the network hospital and Medical Network, the third-party administrator, to select five surgical procedures based on their recommendations, which included colectomy, cholecystectomy (gall bladder), hysterectomy, appendectomy and bariatric surgery.

Traditionally, patients who require surgery are referred to a surgeon through a primary care provider or medical group and patients usually end up undergoing whatever type of surgical procedure the doctor performs. One of the key strategies used in the MIS program is to educate and incentivize patients to seek out doctors who perform both types of surgeries and, if appropriate, would be able to offer MIS. Thus, working closely with the network hospital and TPA was essential to making the program successful.

The district designed the plan so that a member who opted to undergo MIS over open surgery for the five procedures identified would be offered a reduced co-payment: $400 less for in-patient surgery and $200 less for outpatient surgery.

In an effort to ensure that surgeons were aware of the intent to increase the use of MIS, the Medical Network preauthorization process was modified so that a surgeon requesting an open procedure for the five surgeries identified would have to obtain approval from the preauthorization manager and the medical director of the TPA.

The district launched an educational campaign to inform members about the changes and informational materials and links to Web sites on MIS, such as MIPInfo.com, were provided to members as added educational resources.

Additionally, Medical Network communicated with the primary care physicians in the network to inform them about the program. The district's TPA highlighted surgeons trained in MIS on their Web site so members could evaluate their credentials and easily identify them.

A two-year review of actual claims data with emphasis on lengths of stay and return to work showed the district was able to save almost $1 million in direct hospital and surgeon claim costs. These savings are conservative because indirect costs from patient benefits such as lower costs from reduced prescriptions, physical therapy and complications arising from hospital-acquired infections were not included in the analysis.

Additionally, the monetary benefits realized through quicker return to work, improved productivity and reduced costs for classroom substitutes were not quantified and incorporated into the final savings figures.
The results after one year indicate that: the 28% MIS adoption rate for hysterectomies increased to 81%; the rate for gall bladder and bariatric surgery increased from 93% to 100%; the rate for colectomies increased from 33% to 100%.

Case study No. 2

Hannaford is a New England-based grocery store chain operating 167 stores in five states with 9,000 employees actively enrolled in the company's health plan. Hannaford has a self-funded health plan, but partners with Aetna to deliver online resources to associates. Its parent company, Delhaize Group, is based in Europe.

Hannaford found that for its U.S.-based employees, health care costs tended to be $5,000 to $7,000 higher per capita than in other countries, which created a significant economic disadvantage.

In order to reduce costs, Hannaford focused on value-based purchasing programs. The company identified the top primary care physicians in the immediate areas of store locations who were trained in performing MIS and provided employees incentives and discounts for using those PCPs, including a waived deductible for MIS.In addition, all of the major health systems in the same areas have agreed to get all of their surgeons trained to perform MIS. At each location, Hannaford contracts for a nurse who provides "teachable moments" to the associates.

Aetna's sophisticated software programs allow them to identify associates that require surgical procedures. For example, for certain procedures like hysterectomies, associates are required to speak with a dedicated Aetna nurse before they make their decision. If they are considering their surgical options, the nurse steers them toward choosing an MIS if they are appropriate candidates.

Additionally, the company adjusted the health plan design to include a strong financial incentive that reduced the out-of-pocket cost for employees who select MIS. The company covered 80% of the cost of surgery, compared with 70% for those who opted for open surgery. As Hannaford receives better data on how these programs translate into reduced health care costs, it provides this information to its associates.

The company has realized a significant economic advantage, with per capita costs running about 40% less than all available risk-adjusted benchmarks. In addition, 90% of the patients who spoke with a nurse advocate before undergoing a surgical procedure took the nurse's advice when making their final decision.

Due in part to Hannaford's efforts, so far the rate for MIS in general surgery has significantly increased in procedures such as gallbladder removal and hysterectomy.

Source: Employeebenefitnews.com, December 1, 2009

November 16, 2009
We have created new Twitter accounts and encourage you to follow us to get minute-by-minute updates from our magazines and blogs. Follow EBN at EBNmagazine, EBA at EBAmagazine and EBN Editor Kelley Butler at ebnews_editor. Please unfollow the old accounts: benefitnews, benefitadviser and ebneditor.

Source: Employeebenefitnews.com, November 16, 2009

Much has been said about how best to reform the U.S. health care system. Yet, for all the opinions and proposals, I haven't seen one that truly makes sense.

There are pieces of each proposal that are great ideas, but we have to take those pieces and put them together to formulate a plan that makes sense. Most politicians don't fully understand the health care system and the staggering costs that employers face year after year as they cover their employees.

Yet most employees, and most Americans overall, are happy with their health care - they just want it to cost less. It's possible to control costs while keeping the employer based health insurance model in place by following my six steps to health care reform - six steps that don't total anywhere near the $1 trillion pricetag of current proposals.

1. Impose an individual mandate.

Require all individuals to carry health care coverage, and note on their tax returns proof of coverage for themselves and dependents. Those without coverage should be assessed a fine no less than $4,000 a year - simple as that.

Some will say this is harsh and that the poor will not be able to afford it. To that I say: States require drivers to maintain car insurance to drive; why not require health insurance to live? By controlling costs and requiring employers to provide health benefits, coverage will be more affordable for everyone - including the poor. Medicare and Medicaid still will be available for seniors and poor families.

2. Impose an employer mandate.

All employers with 25 or more employees must provide health insurance to workers who work more than 30 hours per week. Benefits must be available on date of hire, and employers should be required to contribute no less than 50% of the cost of coverage for their employees and employees' children. Employee spouses and domestic partners coverage should be offered without the contribution requirement, as many spouses or domestic partners will have access to coverage through their own employer.

Employers that fail to comply with this mandate should be fined no less than $12,000 per employee per year.
Again, some will say this is harsh and will hurt business. However, other countries have employer mandates, and without significant fines employers won't follow through. One congressional proposal imposes an employer mandate, but places the fine at $750 per employee per year. That is way too low and would encourage employers to drop health care coverage and simply pay the fine.

Although some argue some employers - particularly those with high-risk populations - cannot afford to cover all employees, I believe that a mandate spreads risk around more people in the system, costs will be lower for everyone, including employers.

3. Reform the group insurance marketplace.

Some components of this step already are among current proposals, including making benefits tax-free for employees and prohibiting carriers from denying coverage on the basis of pre-existing conditions.

In addition, though, state mandates need to be streamlined. Currently, each state has different mandates, with some adding as much as 5% to the cost of health insurance. Streamlining mandates and preventing states from passing individual mandates can help keep costs in check.

Further, insurance companies should be prohibited from passing along more than a 15% increase to an employer group during any given year, regardless of claims. For pooled employer groups, that increase cap should be 10% for each employer in the pool.

Insurance companies should be required to offer a plan equal to the minimum coverage option for individuals to employer groups at a maximum cost similar to the maximum individual costs.

All plans, fully insured and self-insured, should be prohibited from offering lifetime maximums on benefits.

4. Reform the individual insurance marketplace.

Establish a plan with minimum benefits and a maximum price point that insurance carriers can set for this plan. Just as car insurance has a minimum coverage option, so should health insurance.

Potential features of the minimum coverage option might include in-network coverage only, a deductible of $2,000 single and $4,000 family, and 80% coinsurance after the deductible.

The deductible and coinsurance do not apply to primary care and specialist office visits, which are covered at a $30 copay to the primary care and $50 copay to the specialist. They also do not apply to lab work, also a $50 copay.

Prescription coverage is included at 30% of cost for generic drugs, 40% for brand formulary-list drugs and 60% for brand nonformulary drugs. The maximum price point for this plan that insurance companies can charge should be equal to $250 for single coverage, $500 for employee/spouse coverage, $400 for parent/child(ren) coverage, and $750 for family coverage.

Richer plans can be available at higher rates, but all insurance carriers, regardless of state, must offer the minimum coverage/maximum price plan to individuals. Maximum price adjusts each year for inflation.

Insurance carriers can no longer exclude pre-existing conditions from coverage. Insurance carriers can not offer a lifetime maximum on benefits.

Rates may be defined based upon age and gender, but not on health condition. Rates charged can not be more than the maximum price points set for the minimum coverage plan. Richer plans are available to be purchased at higher prices.

Premiums paid for an individual plan should be deductible on tax returns, making individuals able to achieve the same tax benefits as those who receive coverage through employer plans.

5. Reform health care providers.

We need to stop having providers practice "defensive medicine."

For that to truly happen, we need reform on medical malpractice. Standards need to be stricter on providers, and frivolous lawsuits need to be prohibited.

This should be tackled in separate legislation, however this bill should require that this issue be discussed and decided on separately, with a deadline in place for doing so.

Electronic medical records are a must. Since there is a large cost involved in this as well, how to go about doing this and how to pay for it should be discussed and decided on in separate legislation. Again, a deadline should be in place as to when this separate legislation will be completed.

6. Make America healthy.

Each American needs to take responsibility for their own health and offered incentives to do so.
I propose that if individuals can prove they have gone to the doctor for a physical exam and routine blood tests, they'll receive a $300 tax credit. Individuals that can prove they went to a gym or exercise class at least 150 times during the year will receive a second $300 tax credit.

There they are: six steps to health care reform that can be accomplished without enormous costs and without a government plan option. Washington, do you hear me?

Source: Employeebenefitnews.com, December 2, 2009

Reach Out and Touch Your Fingers

This simple hand exercise will help to increase the mobility of your fingers. It's easily done at your desk several times a day..

Do each hand individually. Touch the tip of your thumb to the tip of each finger in turn, making the circle as round as you can. Straighten your fingers in between touching each finger.

Source: thefitlist.com

Black-eyed peas may not be part of the Greek New Year’s tradition, as they are in the American South, but this recipe still makes a great, light dish.

Recipes for Health
Each week this series will present recipes around a particular type of produce or a pantry item. This is food that is vibrant and light, full of nutrients but by no means ascetic, fun to cook and a pleasure to eat.

1 1/2 cups black-eyed peas, washed and picked over
1 bay leaf
Salt to taste
1/4 cup extra virgin olive oil
1 red pepper, diced
2 plump garlic cloves, green shoots removed, minced
1 teaspoon cumin seeds, lightly crushed in a mortar
1 red onion, halved and sliced (optional)
Freshly ground black pepper
1/4 cup chopped fresh dill
2 tablespoons chopped fresh parsley
2 tablespoons red wine vinegar
1/2 cup crumbled feta

1. Place the beans in a pot with the bay leaf and cover with water by 2 to 3 inches. Bring to a boil, reduce the heat, add salt to taste and simmer gently until peas are tender but not mushy, about 45 to 50 minutes. Drain through a colander set over a bowl. Transfer the black-eyed peas to a salad bowl.

2. Meanwhile, heat a medium skillet over medium-high heat, and add 1 tablespoon of the oil. When it is hot, add the red pepper and cook, stirring often, until just crisp-tender, about 2 to 3 minutes. Add the garlic and cumin seeds, and stir together for another minute or two until the garlic is fragrant. Remove from the heat and toss with the black-eyed peas. Toss with the vinegar, remaining olive oil, 1/4 cup of the bean broth, and salt and pepper to taste. Cool to room temperature.

3. If using the red onion, place it in a bowl, cover with cold water, and soak for 5 to 10 minutes. Drain and rinse. Add to the salad along with the dill and parsley. Toss well. Sprinkle the feta over the top, and serve.

Yield: Serves four to six.

Advance preparation: You can make the dish through step 2 up to three days before you wish to serve. Keep well covered in the refrigerator. Proceed with step 3 shortly before serving.

Source: http://www.nytimes.com/2009/12/29/health/nutrition/29recipehealth.html?_r=1