business group writing on white board

How To Find The Best Group Health Plan For Your Business

The Group Health Insurance industry continues to change with premiums continuing to rise. You have probably changed insurance carrier’s multiple times hoping to secure for the deal of the year.

So, the question is: Is that all there is? Change carriers and tweak my benefits?

What To Consider In Your Group Health Plan Decision

Not all Group Health Insurance plans are the same and one of the largest problems we come across in the industry is that so few companies are aware of all of their options. Most of the time, the reason behind this is because businesses are often dependent upon their insurance agent to present them with their group health options. In doing so, it is important for businesses to note and understand that like the differing group health plans on the market, not all agents are alike. Agents often differ greatly in regard to their level of experience and general knowledge pertaining to new and emerging trends in the industry.

Here at Member Benefits, we specialize in providing businesses with creative solutions that can greatly reduce their health insurance premiums, while still maintaining a comprehensive list of benefits that satisfy your employees and promote attraction and retention.

Perhaps one of the latest trends that many businesses have found themselves considering over the course of the past two years is something called level-funding.

Level-Funding is a partially self-insured option that functions just like a fully-insured plan and has little to no risk involved due to the built-in stop-loss insurance provisions. If your business qualifies, your premiums could end up being 10 to 15 percent less than what they would have been with a traditional fully-insured plan.

With a level-funded plan, there is no need for a separate bank account and the hospital and physician networks are nationwide and very large. As an added bonus, if your business has had a successful year and the claims are low, you may be entitled to receive a refund of up to 50 percent of the claims surplus. Some level -funded plans now offer no network limitations, giving you access to any doctor or hospital across the country!

Are you worried about the possibility of your deductibles resetting if you make the change now? One of the many great things about level-funding carriers is that they will give you credit for any deductible you may have met up until the point of transition.

So, when closing out your year, rest assured that there is no rule or law stating that you must settle for your same Group Health Insurance as opposed to weighing your options. Be confident in your decision. It is important to take the necessary time when you are not busy to explore your options and a level-funded option may prove to be a great place to start.

business man sitting at a cafe discussing his health options on his cell phone

I Missed Open Enrollment and Need Health Coverage — What Are My Options?

The next official ACA Open Enrollment period isn’t slated to begin until November 1, 2019. But depending on your circumstances, you may not have to wait that long to obtain coverage.

Qualifying Life Events and Special Enrollment Periods

Sometimes our circumstances change, and if they change due to specific events, you and your dependents may be able to secure health insurance through a Special Enrollment Period. When this occurs, it is called a Qualifying Life Event, otherwise referred to as a QLE.

There are several types of Qualifying Life Events that may grant you a Special Enrollment Period. Some of the most common examples include:

  • Loss of health coverage
    • Losing existing health coverage – including job-based, individual, and student plans
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Turning 26 and losing coverage through a parent’s plan
  • Changes in household size
    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  • Changes in residence
    • Moving to a different ZIP code or county
    • A student moving to or from the place they attend school
    • A seasonal worker moving to or from the place they both live and work
    • Moving to or from a shelter or other transitional housing
  • Other qualifying events
    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe, or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service

Non-ACA Health Plans

Haven’t experienced a QLE but still need health coverage? A non-ACA health plan could be the answer. Also referred to as Short Term Medical Plans, recent legislative changes have loosened the restrictions surrounding these plans and have increased their appeal.

Previously, a Short-Term Medical plan could only provide coverage for up to 90 days. But due to recent regulatory changes, these plans can now be continued for up to a year.  Additionally, in some cases applicants may now renew their plan for up to three years.

Because Short-Term Medical Plans are considered non-ACA health plans, it is worth noting that they may not cover all that an ACA health plan would. For example, applicants could be denied coverage due to a pre-existing medical condition, maternity care may not be covered, and there could be an annual dollar limit on coverage. However, these plans are also typically less expensive than ACA plans and could be a good alternative for individuals seeking more affordable options.

medical dna test tubes

What You Should Know: Home Breast Cancer DNA Tests

In March of this year, ancestry DNA testing giant, 23andMe, announced that they would begin testing user DNA for Breast Cancer genes, more specifically identified as the BRCA1 and BRCA2 genes. While technically able to test for these genes for years, it wasn’t until this past March that the FDA officially signed off on it, therefore, making the 23andMe at-home DNA test, the first FDA-approved direct-to-consumer test to evaluate one’s potential risk for cancer.

What Can Your DNA Reveal

The test is offered as an add-on to 23andMe’s standard ancestry report for a total of $199 and is delivered alongside a variety of other reports designed to tell you if you possess certain genetic markers which may suggest a predisposition to things such as:

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young woman wearing glasses and smiling

6 Best Online Stores to Purchase Eyeglasses From

With a variety of lens materials, types, and coatings available to choose from – sitting in your optometrist’s office listening to the tech rattle off your options can understandably feel overwhelming. For the most part, consumers want something to get the job done at the lowest possible price unless they have other very specific concerns.

However, depending on your location, prescription strength and needs, as well as your eye doctor, you could be spending anywhere from approximately $95 to over $1,000 for a pair of prescription eyeglasses. According to health.costhelper.com , consumers spend on average approximately $196 for a pair of eyeglasses, and until fairly recently they didn’t have much of a choice.

However, over the course of the past 10 to 15 years, a new kind of eyeglass business has hit the market, cutting out the middleman, and cutting the ultimate cost for consumers. Zenni Optical, for example, will sell the complete set of fashionable eyeglasses (frame and lenses) for as low as $12, and their competitors aren’t too far behind.

Just in the past five years, a number of these online eyeglass retailers have been the talk of the fiscally conscious eyeglass consumer community since their inception.

But with all of these new online retailers on the market, which ones are the best to purchase eyeglasses from?

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man and daughter filling out paperwork at a front desk

The Cost Of Not Having Dental Insurance

If you and your family have been skipping trips to the dentist, you’re not alone. “For every adult without health insurance, an estimated three lack dental insurance” this comes according to a quote issued by the Kaiser Family Foundation based off of research conducted by the National Association of Dental Plans.

A Key Component Of Overall Health and Hygiene

But what so few realize is the close relationship between one’s oral health and their overall health. A person’s mouth is a haven for potentially harmful bacteria, regular flossing, brushing, and cleanings can keep the bacteria at bay but when a person is neglecting their teeth, the bacteria can build and lead to infections, tooth decay, and gum disease. From there, it is possible for the bacteria to enter the bloodstream and travel to other parts of the body leading to other serious problems.

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People sitting on a bench looking at mobile devices

Myopia and Millennials: The Trend No One Saw Coming

According to a Nielson Company audience report, it is estimated that the average American spends over 10 hours behind a screen consuming digital media and content. But is this much screen time actually helping us or hurting us?

As it happens, a number of studies have recently come out against the rapid increase in screen time for everyone from toddlers to senior citizens. In fact, some of these studies have shown a correlation between increased screen time and the following:

  • Depression
  • Anxiety
  • Cynicism
  • Shortened Attention Span
  • Decreased Social Skills
  • Isolation
  • Changes In Sleep Patterns

These are just a few of the negative effects linked to the world’s growing dependency on media whether it comes from your television, computer, or myriad of smart devices.

But beyond the studied and documented negative mental and social effects, could our digital habits also be related to our actual physical health?

Millennials, Media, and Myopia

Based on the Nielsen Q1 2016 Total Audience Report, it is estimated that while U.S. adults spend an average of 10 hours and 39 minutes each day consuming media, for the Millennial generation, that number can be as high as 18 hours a day.

Interestingly enough, as the hours spent consuming digital media continues to increase, so do the recorded cases of myopia, more commonly referred to as shortsightedness, which is where a person is able to see things close up but has difficulty when trying to view things from a distance.

Myopia is commonly attributed to what happens when the eye grows too long horizontally, causing the lens of the eye to focus what the individual is trying to view in front of the retina versus on the retina. Myopia can also be the result of an overly curved cornea or an overly thick lens.

The Epidemic No One Saw Coming

However, over the course of the past decade Ophthalmologists are now beginning to credit our various media devices with a third cause of myopia.

In an interview with WIRED correspondent Duncan Nicholls, ophthalmologist Andrew Bastawrous was quoted as saying “There’s definitely a myopia epidemic. Many more people are becoming shortsighted than they were a decade ago. The implications of this are not just that there are more people needing glasses, but that their condition is pathological. Their myopia is due to the eyeball growing, particularly in populations of Asian descent, at a rate that is causing even potential severe visual impairment, through glaucoma retinal detachment and other retinal problems.”

Bastawrous goes on to say use the country of Singapore as an example by asserting that “more than 90 percent of school children are leaving school myopic.”

In fact, it has been estimated that here in the United States myopia rates have doubled over the last generation. Leading countless Millennials to invest in preserving their eye health.

And what are Ophthalmologists claiming is a key factor in this uptick in shortsightedness? The numerous digital screens we place in front of us every day.

One theory is that as we spend increasing amounts of time in front of our televisions, computers, and smart devices, our eyes are gradually becoming more and more accustomed to only needing to see a few feet in front of us instead of long distances. A second theory is that our eyes are not receiving enough natural sunlight because we are spending more time indoors— a theory that yet again, may have significant ties to increases in screen time.

Protecting Your Eye Health

Do you find yourself needing to squint to try to see distant objects, do you often experience headaches, blink or rub your eyes frequently?

If so, it may be time to visit your eye doctor.

When was the last time you visited an optometrist? For those without perfect vision, it is recommended that one visit the eye doctor once every twelve months to look for any adjustments that may be needed in your eye prescription.

young african american woman on the couch wearing blue blocking eye glasses looking at her laptop

Blue Blocker Lenses: Are They Worth The Hype?

As our bodies continue to age, it is understandable that we begin to experience more changes. And whether we like it or not, doctors and other medical specialists are here to help us make sure that our bodies are operating at the very best levels that they can and when they are not, doctors are the people we visit to find out why.

For example, declining eyesight is one of the most common and most easily diagnosable issues our bodies may encounter throughout our lives. Worsening eyesight is often associated with getting older and while there are a variety of reasons and levels of severity, ultimately poor eyesight is typically very treatable except in certain circumstances.

As a general rule of thumb, it is suggested that you should visit the eye doctor once every one to two years. Even if you don’t feel your eyesight has changed, an optometrist will be able to know for sure and make any adjustments to your eye prescription as necessary.

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young female professional stressed at work

Could Workplace Stress Become A Workers’ Compensation Claim?

According to a CBS News article, it has been estimated that roughly 8.3 million Americans suffer from some form of psychological distress such as a general hopeless or nervous disposition or even clinically diagnosable depression and anxiety-related disorders such as PTSD. While the cause for the sudden uptick in depression, anxiety, addiction, and general stress has been linked to everything from overzealous doctors, supervisors, and hostile work environments, to politics and the economy, and the concern over the ever-increasing amount of “screen time” Americans spend per day, the truth is that no one is able to one-hundred-percent identify the source.

While psychology experts and the media keep digging into just what is causing the rise in stress-related disorders and situations, many of those suffering are plagued with the maybe more important question of what are we going to do about it?

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closeup of someone at their laptop holding a coffee cup

Invisible Disabilities And The Battles Within

Throughout the history of civilization, there have always been things that we did not understand— things that we believed to be real but couldn’t see. Faith, love— even germs all spring to mind though we may not have always had a scientific name for them.

While the human race has come a long way from our earliest beginnings, the simple truth is that science is ever-evolving and new things are discovered every day. Just as today we may laugh at some of the ancestral medical practices of the middle ages, our descendants may one day do the same to us.

The same could also be said for the discovery and further understanding and treatment of ailments previously attributed to an imbalance of the four humors or even demons.

The New Science On Invisible Disabilities

Most recently there has been a renewed focus on debilitating illnesses and diseases that may not always visible to the naked eye or even some advanced diagnostic testing techniques available to doctors and hospitals throughout the world. These ailments have been given the term invisible disabilities.

According to the Invisible Disabilities Association, in simple terms, an invisible disability is considered to be a physical, mental, or neurological condition that limits one’s mobility or senses to the point where the severely impact the individual’s everyday life and activities. Unlike other disabilities, invisible disabilities are imperceptible to onlookers and therefore can sometimes lead to misunderstandings, false perceptions, and judgment.

For example, according to the American Physical Therapy Association, “Chronic fatigue syndrome (CFS) has come a long way since the 1980s when it was widely dismissed as ‘yuppie flu’ and was suspected by many health care providers of being a psychological rather than a physiological condition.” To date, there is no definitive test for CFS and it is instead considered to be diagnosed but exclusion.

Another well-known illness for which there is no definitive test to confirm its existence is fibromyalgia. The reigning Queen of Pop (disagree, if you dare) Lady Gaga, has recently (and very publicly) brought the topic of fibromyalgia front and center in the media. Gaga, born Stefani Germanotta, has struggled with the illness for years, and though invisible— she has chosen to bravely document her struggle with its debilitating effects in the recent Netflix documentary Five Foot Two and has even been forced to cancel a number of shows on her most recent Joanne tour due to the incredible debilitating pain associated with the illness.

Mental illnesses such as individuals who struggle with Depression, Anxiety, ADHD, Obsessive-Compulsive Disorder (OCD), Bipolar Disorder, and more are also considered to have an invisible disability (if the symptoms they experience are severe enough); however, in these cases there are often more definitive ways of testing and diagnosing cases.

In addition to those previously listed, below are a number of other known invisible disabilities. Please note that though extensive, this is in no way to be considered a complete list of possible invisible disabilities.

  • Allergies
  • Arachnoiditis
  • Asperger Syndrome
  • Asthma
  • Autism
  • Brain injuries
  • Charcot-Marie-Tooth disease
  • Chronic fatigue syndrome
  • Chronic pain
  • Circadian rhythm sleep disorders
  • Coeliac Disease
  • Crohn’s disease
  • Diabetes
  • Ehlers Danlos Syndrome
  • Endometriosis
  • Epilepsy
  • Fetal Alcohol Spectrum Disorder (FASD)
  • Food allergies
  • Fructose malabsorption
  • Hereditary Fructose Intolerance
  • Hyperhidrosis
  • Hypoglycemia
  • Inflammatory bowel disease
  • Interstitial cystitis
  • Irritable Bowel Syndrome
  • Lactose Intolerance
  • Lupus
  • Lyme Disease
  • Metabolic syndrome
  • Migraines
  • Multiple Sclerosis
  • Multiple Chemical Sensitivity
  • Myasthenia Gravis
  • Narcolepsy
  • Personality disorders
  • Primary immunodeficiency
  • Psychiatric disabilities
  • Reflex Sympathetic Dystrophy
  • Repetitive stress injuries
  • Rheumatoid arthritis
  • Schnitzler’s Syndrome
  • Schizophrenia
  • Scleroderma
  • Sjogren’s syndrome
  • Spinal Disorders
  • Temporomandibular joint disorder
  • Transverse Myelitis
  • Ulcerative Colitis

Testing The Odds

According to Disabled World, it is estimated that approximately ten percent of Americans have been diagnosed with a medical condition that could be labeled as an invisible disability. “Ninety-six percent of people with chronic medical conditions live with a condition that is invisible. These people do not use a cane or any assistive device and act as if they didn’t have a medical condition. About twenty-five percent of them have some type of activity limitation, ranging from mild to severe; the remaining seventy-five percent are not disabled by their chronic conditions.”

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