Change Allows Participants to Rollover FSA Funds

Image from savingsvillage.com

On October 31, the IRS and the U.S. Treasury Department announced a change allowing a limited carryover of unused health flexible spending account (FSA) contributions. The new guidelines allow employers to permit employees to carry over up to $500 of unused contributions to use for expenses in the next year with the same annual contribution limit of $2,500. Honestly, I thought this was some sort of Halloween joke at first. The change reverses decades of prior policies. For almost 30 years, employees using FSAs were subject to the use-it-or-lose-it rule which means their unused account balances were forfeited at the end of the plan year. The fear of misjudging how much money they'll need in any given year often prevents employees from participating in an FSA. 

Currently, employers have the option of allowing employees a grace period of up to two and a half months after the end of the year to spend unused funds. With this change, an FSA cannot have both a rollover feature and a grace period. ASHA's plan currently has a grace period; therefore, we will have to chose what works best for our staff going forward. My thinking is the rollover will be more beneficial to staff.

I’m looking into amending our plan to implement the rollover instead of the grace period for 2014. We won’t make any changes for 2013 because (1) I think it’s awfully late in the year to be changing the rules on folks, and (2) I’m not confident our vendor is set up to implement the rollover effectively for this year. (I've actually read quite a few articles that caution employers that vendors may not be ready to administer the new provisions for the 2013 plan year.)

I like the additional flexibility the change provides, but I'm curious why they would announce a change when most employers have already signed contracts and solidified their plans for 2014 and are in the midst of open enrollment. Even if you allow for the government shutdown, I would have considered two weeks ago late to be announcing a change too. But, like I said, it's a good change and I'm pleased to be able to enhance a benefit for our staff. 

Remember: If you're thinking of moving to a high deductible plan with an HSA next year. You and your covered dependents need to make sure you have a $0.00 balance in any existing FSA accounts, so that you can open an HSA at the beginning of the year. 

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Read more:

• Consumers Can Rollover $500 in an FSA ~WSJ 10/31/13
• FSA Use-It-Or-Lose-It Rule Modified ~SHRM 10/5/13    
• IRS details FSA $500 carryover-HSA contribution rules ~Business Insurance 3/28/14
• Flexible spending accounts' future uncertain as health care rules evolve: 
IRS allows new options for annual carryovers ~Business Insurance 4/6/14

How to Estimate Your Health Care Expenses

If you're trying to decide which healthcare plan is right for you and your family, it helps to estimate your expenses. I really like this tool from Wage Works. You answer a few simple questions about the plan design (comparison of ASHA plans below) and then estimate the number of office visits you'll have, the number of prescriptions you'll fill, and any other money you'll spend on health care. You quickly wind up with a neat graph that shows the difference in the cost between the plans you're considering.

If you want to take a more targeted approach, you can review your EOBs from the current plan year. If you're with UnitedHealthcare, log onto myuhc.com. Then, click view online statements. From there, you can see the allowed amount for each claim. This is the amount you would pay with the money from an HSA before meeting the deductible in a health plan with a high deductible. For example, my visit to an orthopedic surgeon was $208, but the allowed amount was $116.32. Remember well visits are covered in full and not subject to the deductible, so don't include them in your estimates. You can also look at your EOBs to see what claims you had for lab, x-ray and other diagnostics and rehabilitative services like physical therapy.

To see what you spend on prescriptions, you can go to the UnitedHealthcare Open Enrollment site. Click on the last link at the bottom of the page to price a medication. Type in the name of the medication, accept the disclaimer and you'll see an estimate of the cost of that drug along with some lower cost alternatives that might work for you. Often being in a high deductible health plan prompts people to discuss lower cost alternatives with their prescribing doctors.

If you elect an HSA, you can set aside money for vision and dental services too. Just remember, those items won't count toward your health plan deductible. If you decide to stay with a more traditional plan, you can set aside up to $2,500 in an FSA to cover your out-of-pocket expenses. 

  ASHA UHC Plan Comparison for 2014

Four Steps to Funding Your HSA

The IRS establishes how much you can contribute to an HSA each year. In 2014, an individual can contribute $3,300 and a family can contribute $6,550. If you're older than 55, you can contribute an additional $1,000 to your account as a catch-up contribution.

The HSA limits are set for the calendar year. If you're part of an HSA for a partial year, you can prorate your contribution limit based on the number of months that you participate in a high deductible health plan. 

Wondering where you will come up with the money to fund the account? 

The deductible is only $4,000!

1. Take note of the amount your employer will contribute. ASHA will contribute -- $1,000 for individual coverage and $2,000 for family. 
2. Calculate the difference in the premium from the plan you're in now and our new Choice Plus with HSA. I have Choice Plus family coverage, so that's $301 a month next year. The HSA is only $104, so I'll save $197 a month or $2,364 a year. 
3. Look at how much you're contributing to your FSA now. Mine is maxed out at $2,500. Remember you can't have an FSA if you have an HSA, so you can redirect that money. 
4. Add up the above.

2,000 + 2,364 + 2,500 = $6,864 

I've covered my $4,000 deductible. Maxed out my contribution of $6,550 and will have $314 back in my pocket. Easy Peasy!

If you and your spouse are both HSA eligible, then there are other factors to consider. I could spell them out here, but Barb Simmons wrote a very clear and instructive post on the topic and I wouldn't do a better job of it. If you're married, read Rules and Best Practices When Spouses Are Both HSA Eligible.

Keep in mind that you can only use your HSA to pay for expenses for the family members you have covered under your plan and that you can claim as a dependent on your taxes. If you cover your young adult children, please read Why Wouldn't I Want an HSA? 

I have my 23 year old son on my plan, so I'm still weighing my options. My initial thinking was that a plan with an HSA didn't make sense for us because we couldn't use the money in the HSA for Ian's expense, but now that I've done the math, I'm finding it hard to turn away from the HSA.

Four Reasons You Might Not Want an HSA

You've looked at the amount of money you can save in premium. You like the idea of paying yourself instead of the insurance company. You consider yourself, or are ready to become, a savvy healthcare consumer. So, why wouldn't you want a high deductible plan with an HSA? As attractive as the model is, it's not for everyone. Here are four groups of people that might want to take a pass for now. 

1. People entitled to medicare. You can't contribute to an HSA if you're entitled to medicare according to IRS rules. See Can I Have a Health Savings Account as Well as Medicare?
2. People with young adult, non-tax dependent children on their health plan. Unfortunately, when benefits were extended to children through age 25 in the ACA, no one coordinated with the IRS. The IRS rule is you can only use your HSA to pay for expenses for your tax dependents. Therefore, if your young adult child needs services, you'll have to pay for those separately. You can set up a separate HSA for your child, but the money you contribute would be deductible on your child's taxes, not yours. So, that's probably not too attractive to most of us. (I have my 23 year-old son on ASHA's plan.) 
3. People who currently have a FSA who will not have a $0.00 balance on December 31, 2013 if your FSA has a grace period (which ASHA's does.) This prohibition by the IRS is inclusive of a plan your spouse might have at his/her place of employment. So, if you're interested in establishing an HSA in 2014, spend your FSA money now!
4. People who use a lot of out-of-network services. Unfortunately, in and out-of-network deductibles will not cross accumulate in ASHA's coverage for 2014. Therefore you would have to pay the in-network deductible on the services you obtain in-network ($2,000 individual and $4,000 family.) Then, you'll have to pay the out-of-network deductible ($4,000 and $8,000) on the services you receive out of network. Raising your exposure to $6,000 if you have individual coverage and $12,000 if you have family coverage. We hope to be able to structure this differently in 2015, so stay tuned for more info. If you're reading this and you don't work for ASHA, be sure to inquire about how your plan works. 

If you don't fall into any of these groups, seize this opportunity to learn all you can about HSAs and make an informed decision about what's best for you and your family in 2014. 

Introducing A New HSA Option for ASHA Staff

Image from landauinjurylaw.com -

In addition to our Choice Network Only plan and our Choice Plus plan with an in and out-of-network benefit, we will be offering a Choice Plus with HSA to our staff next year. All the plans will be with UnitedHealthcare and they will all use the same network of providers. The Choice Plus with HSA is a consumer driven health plan (aka CDHP) with a higher deductible than what we are used to -- $2,000 for an individual and $4,000 for a family. Participants will set up and use an HSA account to cover this deductible and other health care expenses. 

Think of a HSA like a 401k for your health care expenses. You put money into an HSA just like a 401k. It's withheld pretax from your pay checks. You choose how to invest the balance in your account and it grows tax free. You then use the money in the account to pay for your deductible and any health care costs that aren't covered by our health plan. (The same kind of things you might use your FSA to pay for now.) 

To help staff get their HSAs started, ASHA will fund half of the deductible the first of the year -- $1,000 for individuals and $2,000 for families. One of the risks you assume when you first start an HSA is that you'll incur the expense before you've built up an account balance. For example, you have to have your appendix out on January 5 and receive a bill for your deductible. ASHA will help you minimize this risk by depositing half your deductible in your account at the beginning of the year. 

Why should you consider selecting this new plan? It's simple. You're essentially paying yourself instead of the insurance company. The monthly premium for the Choice Plus HSA is so much less than our Choice and Choice Plus plans that you can use the savings each month to fund part if not all of the deductible. Over time, you can build up a healthy balance in your account. Some people use an HSA as an additional retirement savings vehicle because of the favorable tax status. There are lots of other factors for you to consider and we'll delve into all of them over the course of the next few weeks. 

We will be offering many educational opportunities during open enrollment to help you make a fully informed decision. You are welcome to invite your family members to the face-to-face sessions we have planned. Start learning more now by watching the short video below and reading this article from Forbes -- How to Get the Most Out of Your Health Savings Account. You can also read this post where I shared how my sister chose between a traditional PPO and a HSA earlier this year. And, of course, stay tuned here for more info. 

Our Fitness Class Schedule

It's been awhile since I shared much about the exercise classes we offer on site. We do what we can to (1) encourage people to make a long term commitment to exercising, (2) make our classes affordable, and (3) maximize enrollment i.e., the number of people participating. We opened our classes up to spouses last session and we have two spouses participating. Last year, we changed our pricing structure and introduced an "all access pass" to give participants the flexibility to take any classes they're interested in for only $50 a month. Both changes have been well received, but it hasn't increased our enrollment the way we had hoped. 

We set aside a budget each year for our wellness program and we allocate a little over 60 percent of it to our onsite fitness classes. Given our current budget and level of enrollment, we can support 14 classes per week. We started off the year with 16 classes. We lost three instructors this year -- boxing, TRX and restorative yoga. We also combined two classes on Monday evenings, so we currently have 12 classes. We've been looking to add a class on Tuesday morning and Thursday afternoon. 

The challenge is to find instructors we like that are available to teach something we're looking for during one of our available time slots. We are excited to have a Dance Ballet Bar barre demo set up for next week that 20 people have signed up to try. Eileen Crowe introduced us to the instructor, Souzan Mills, and we're grateful. Souzan has a studio in the Kentlands called Booseh. We have been searching for someone to teach a class like this for about three years. The demo seems to be attracting some staff members that don't normally participate in our exercise classes, so we're optimistic that this will be a nice new addition to the array of classes we offer. 

In Search of Unprocessed Chocolate Bars

I like good chocolate and I know I'm in good company. I don't want to go without during October Unprocessed, so I went to Whole Foods today and read the labels. I walked away with four bars. 

1. Amore di Mona Chocolate with Currants $3.49 -- cocoa, butter, cocoa solids, raw organic agave nectar and dried currants
2. Sweet Riot Pure 85% Dark Chocolate $3.99 -- organic chocolate liquor, organic cocoa butter. organic cocoa, organic cane sugar, organic vanilla extract
3. Alter Eco Dark Quinoa Organic Chocolate $3.99 -- cocoa beans, raw cane sugar, cocoa butter, quinoa-rice crisps,vanilla beans (Tastes like rice crispies in good dark chocolate. Got good marks from Lisa Leake at 100 Days of Real Food.) 
4. Green & Black's Organic 85% Cacao Bar $3.99 -- organic chocolate, organic cocoa butter, organic cocoa, organic raw cane sugar, organic vanilla extract

I know the sugar is still not ideal, but at least none of these bars has soy lecithin like my favorite Chocolove Almonds & Sea Salt in Dark Chocolate bar. I'm still searching for my some little chocolate pieces to have on hand for my fellow October Unprocessed participants when they hit the 3:00 slump. If you've found any, please let me know. 

Pay Raises and Managing Up

I realize these topics have nothing to do with workplace wellness, but I've been involved in two things that I'd like to share. 

First, in the October issue of the ASHA Leader, there is an article I wrote called Make It Work: Manage UP. It includes six tips to help you cultivate a healthy working relationship with your boss. 

Almost everything I write appears online, so it is fun for me to see something I wrote in actual print. My son, Ian, helped me think through the content. He graduated from college a year ago and he's working with Walmart as an assistant manager. I love hearing his perspective on management issues, so writing it was fun too. Over the years, I've seen people make a lot of what I call "career limiting moves." Writing this piece gave me a chance to put together those observations with Ian's fresh perspective. 

Sarah Halzack wrote and article for the Washington Post titled In an uncertain economy, pay raises hover at a modest new normal. She interviewed me when she was working on it and includes a few quotes. We actually assign individualized salary ranges to each job (not each job category), but she captured the gist of what we do well and it's an informative article. Definitely worth reading if you work in the DC area. 

Hope you'll forgive the diversion. I usually rein in my impulses to write posts that are off topic, but what's the point of blogging if you can't exercise a point of personal privilege now and then. 

Flu Shot Clinic at ASHA October 9

​If 92% of our staff are vaccinated, we could basically stop the spread of the flu within our workplace. Please consider getting a flu shot to protect yourself and those around you. 

Our clinic will be held on October 9. Shots for staff members are free. Family members can receive a shot for $22. This flyer from LifeWork Strategies explains what you should expect.

If you have coverage through our health plan, you have additional options for obtaining a flu vaccination for free. Please see the second flyer below.

  LWS - What to Expect When Getting a Flu Shot

  UHC - Flu Shot Flyer 2013 Season

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Related posts: 

• Staffing Continuity, Flu Shots and Workplace Wellness
• Fighting the Flu with UHC
• Herbal Pharmacist's Tips on Staying Healthy Through Flu Season
• It's Not Too Late to Get a Flu Shot

Day 1 of October Unprocessed

Today kicks off our October Unprocessed challenge. If you haven't signed up yet, or you have and you're still wondering what to do, this is where you should start. First off, keep in mind that this is an exercise in awareness! I encourage you to read labels and make well informed, conscious decisions about what you choose to eat. This is not a test or a diet. We're in this to learn and maybe experiment a bit with some new foods. Still hesitant to commit? Here are a couple things that might ease your concerns.  

1. The 80/20 rule. Make a commitment to eat unprocessed foods 80 percent of the time and don't worry about the rest.
2. The deliberate exception. This could be that you'll drink Gatorade on runs over 6 miles or that you'll indulge in a piece of chocolate cake on your son's birthday. You could even choose a day each week where you'll indulge in some of your processed favorites. Just establish your exceptions before starting the challenge so they are a deliberate choice and not a default reaction to a habit. 

Here's what you need to do to get started:

An unprocessed version of my oatmeal
cookies from Red Mountain Spa. Recipe below.

1. Go to the Eating Rules website and sign the pledge. I also recommend that you subscribe to their email alerts.
2. If you're a member of the ASHA staff, go to ASHAnet and add your name to the list. This is simply so we know who to invite to our October Unprocessed events like the kick off we have planned for tomorrow. (You're not going to get any of the cookies pictured unless you sign up.) 
3. Read this Do's and Don'ts post. I also encourage you to explore the Eating Rules website and 100 Days of Real Food. They include tons of great resources. 
4. Think about sharing your experience with others. Post a comment to our Facebook page. Chat with your colleagues that are participating. Or, best of all, share your thoughts in a blog post. 
5. Subscribe to this blog, so that you don't miss any of the riveting content ;-) All the posts related to October Unprocessed will appear under the October Unprocessed tab.

Twenty ASHA staff members have signed up so far. We have a kick off planned for tomorrow at 3:00 in the lunchroom. On October 8, we will host a informational session with a nutritionist. Please pass along any ideas you have for how we can support you during this challenge. 

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Spa Cookies

I adapted this recipe from Red Mountain Spa. They were orginally called Oatmeal Fruit Cookies. This should make about 5 dozen cookies. 

Ingredients

3 eggs, well beaten
1 C dried Tart Montgomery Cherries (Trader Joe's)
1 t vanilla extract
1 C canola oil
1 C organic Mascobado cane sugar (in lieu of brown sugar)
1 C coconut palm sugar (in lieu of white sugar)
2 C white whole wheat flour (in lieu of regular flour)
1 t sea salt
1 t ground cinnamon
2 t baking soda
2 C oats (Bob's Red Mill)
¾ C toasted slivered almonds

• Combine eggs, dried fruit, and vanilla and let stand for 1 hour, covered with plastic wrap. 
• Combine mascobado and coconut palm sugars and cream with oil. 
• Add flour, salt, cinnamon and baking soda to sugar mixture; mix well.
• Blend in egg-fruit mixture, oats, and chopped pecans. Dough will be stiff. 
• Drop by heaping teaspoons onto ungreased cookie sheet. 
• Bake @ 350 for 8 minutes.

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Kelly made pumpkin bread for the kick off that was delicious. She posted the recipe to our October Unprocessed Pinterest board. 

Do's and Don'ts of October Unprocessed -- Choosy Moms Choose Jif No More

In last weeks introductory post, Kellie introduced us to October Unprocessed. If it can be made in a home kitchen with whole food ingredients, it's considered unprocessed. Simple enough, but the more I thought about it, the more questions I had, so I've been digging through the Eating Rules website and this is what I've learned. 

Can you guess which one is the Jif?

• Flours and Grains -- Eat whole grains like oats (steel cut or rolled), quinoa, brown rice, whole wheat flour. Bread should be labeled "whole wheat flour" NOT "wheat flour." You only need whole wheat flour, water, salt and yeast to make bread, so look for bread with just those ingredients. Bob's Red Mill is sponsoring October Unprocessed this year. When you sign the pledge on the Eating Rules site, you'll be able to print some great coupons. 
• Sugar -- you can use honey, real maple syrup, coconut sugar and if you're somewhat liberal with your definition turbinado, muscovado and demerara raw sugars. Kellie said the coconut sugar is actually really good, so I ordered Navitas Naturals Coconut Palm Sugar from Amazon to try. She said it's also available at Roots and Whole Foods. I already have turbinado sugar from Trader Joes. Obviously, all the fake sweeteners in little colored packets are uber processed. 
• Baking soda and baking powder are ok, just make sure they don't have corn starch in them. 
• Chocolate is ok if it doesn't have other junk in it. Usually cocoa powder is ok. I read Navitas Naturals Cacao Nibs are good. Usually the darker chocolate bars have fewer added ingredients. I'm headed to Whole Foods later to read labels. 
• Cooking oil -- Of course, olive oil is fine and most of us switched to it earlier this year in during our Mediterranean Lifestyle Challenge. Here's a chart of oils if you want to delve into this. 
• Salt is ok, but a lot of regular table salt has other junk in it so, again, read the labels. 
• Dairy -- eggs are fine, butter is fine if it doesn't have added ingredients, yogurt fine if it doesn't have junk in it, real cheese, real ice cream and sorbet. But, I suspect most store bought ice cream and sorbet is full of refined sugar. Read the labels or better yet, make your own. (I know sorbet isn't dairy, but it fits with ice cream.) 
• Meat -- you even have to read the labels on meat. Some have added crap. And, watch out for deli meats, most of those have junk in them. Obviously, hot dogs and sausage are out. 
• Fruits and Veggies are good -- frozen or fresh. Most canned stuff has other crap in it so read the labels before you but those. 
• Beverages -- coffee, tea, beer and wine are fine. Even other booze is ok if doesn't have added stuff in it. Real juice is ok, but again, read labels or squeeze your own. Obviously, no pop. (You guys know I'm from Pittsburgh, right?) I guess most milk is heavily processed, so watch what you buy there too. I'm a big fan of South Mountain Creamery. They deliver milk in old fashion glass jars along with other dairy and meat and they're reasonably priced.
• Condiments -- read the labels, most have added crap. I highly recommend making your own salad dressing anyway, it only takes a few minutes and they taste so much better. The fresh almond butter from Whole Foods is delicious and they have peanut butter too. I hear you can grind your own, but that sounds like too much trouble to me. I will try my making my Aunt Lissa's hot mustard with coconut sugar and I'll let you know what happens. 
• Avoid these things -- high fructose corn syrup, trans fats, natural and artificial flavors, soy lecithin (which is in most chocolate), carageenan, corn starch, food dyes, preservatives 

Everything you'd want to know and more is on the Eating Rules website They recommend establishing any deliberate exceptions on the front end which I like. This could be that you'll drink Gatorade on runs over 6 miles or that you'll indulge in a piece of chocolate cake on your son's birthday. 

They also talk about the 80/20 rule. You know that one, try to stick to it 80 or more percent of the time and don't worry about the rest. I really don't think it will be very difficult. What do you think? Are you in?

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Planning to try October Unprocessed with you family? Check out 100 Days of Real Food for additional resources. 

Send Health Care Exchange Notice √

Last week, the DOL announced that employers will not be penalized if they do not send the exchange notice to their employees by October 1. A survey by the Washington-based ERISA Industry Committee indicated 94% of employers plan to send the notice anyway. 

I just sent the notice to ASHA staff via email and checked it off my to do list. Some asked why I didn't just post it to our intranet which is how we usually share information, but that didn't meet the requirements Under the Patient Protection and Affordable Care Act. This is the note I sent along with the notice.

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Hi All,

You’ve probably heard about the health care exchanges that are expected to be up and running the first of next year. In preparation for that, employers are required to share the attached marketplace notice with their employees. The notice is intended to explain your right to buy coverage through the newly established health insurance marketplace (what you’re hearing referred to as the exchanges.) The opportunity to enroll in the marketplace will begin October 1, 2013, with coverage effective January 1, 2014. 

A few key points that stand out to me:

• Everyone must have health insurance coverage on January 1, 2014 or pay the penalties. 
• Because ASHA provides coverage for us, staff are unlikely to qualify for any of the subsidies available to people who seek coverage through the exchanges. 
• If staff did seek coverage through the exchange in lieu of the coverage ASHA provides, the individuals would lose the contribution ASHA makes toward our coverage. 
• The small portion of the premium staff do contribute now is paid pretax. Premiums paid through the exchanges will be paid after taxes. 

I realize some of us have friends and family members that may be interested in seeking coverage through the exchanges. The second document I’m attaching is a pamphlet presented in Q&A form. I think it does a nice job of explaining the obligation to have coverage, what the penalties are if you don’t have coverage, and what your options are for obtaining coverage. I hope you find this information helpful. You can learn more by going to www.healthcare.gov.

Janet

October Unprocessed -- Guest Post by Kellie Rowden-Racette

Oh, the irony of working on this post today. I spent last weekend in Bristow, Oklahoma celebrating my Aunt Lois' 80th birthday. My Uncle Jack prepared a mountain of smoked meat for the occasion and I'm pretty sure I ate my weight in smoked bologna. Bologna is pretty much the antithesis of how I normally eat, but it reminds me of childhood and college, when a big hunk of bologna wrapped in red plastic from the Food Lion in Five Points was a major source of protein. When you pair the bologna with my Aunt Lissa's hot mustard and some Bud Light Lime; well, I simply make a pig of myself.  

Last Spring, ASHA staff and our friends and family took part in a 30 Day Mediterranean Lifestyle Challenge. Throughout the challenge we focused on eating whole, unprocessed food and Kellie shared her experience with October Unprocessed in her Unprocessed Schunprocessed post. I was intrigued and made the commitment to participate in October Unprocessed this year. (I'm looking forward to it as a bologna detox of sorts at this point.) If you've wondered away from the healthy Mediterranean habits you adopted last spring, you can use October to re-examine your choices and get back on course.

Kellie and I hope you and your families will join us in our October challenge. Getting started is simple, read Kellie's post and then go to the Eating Rules website and take the October Unprocessed pledge. You can even enter to win a gift pack of food from Bob's Red Mill and print off some coupons.

We'll also have a way of signing up here at ASHA, so we can identify who is participating and provide support. So, stay tuned...

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My birthday is in October and I used to brag gleefully that I would always spend my birthday getting jacked up on Halloween candy that I bought way too early to be practical. To me October was a free pass to eat birthday cake and anything that was “fun sized.” Well it was all very fun until November would roll around and I felt exhausted, sluggish, and was faced with the looming holidays, complete with non-stop cooking and eating.

So last year I tried something different and it worked so well that I’m doing it again this year. I took the October Unprocessed challenge, which challenges you to go an entire month without eating processed food. Crazy, you say? Maybe a little but totally doable. Here’s the deal: There is a lot of processed food out there—chips, cookies, canned soup, ready-to-cook meals, frozen everything—and our lives revolve around convenience to the point that we are eating food that sometimes isn’t even … food. So what appealed to me about this challenge was to relearn what to expect from food and to set a good example for my kids. Instead of it being solely convenient, I was more interested in it being good and even good for me. So I read through the website and two things made this seem doable, even to a working mom like me:

1) The “Kitchen Test”

2) The “80/20” Rule

The “Kitchen Test”

When word got around my neighborhood that I was doing this (how does that HAPPEN?) one of my neighbors asked me if I was churning my own butter in my spare time. Absolutely not because I don’t have any spare time. Here’s where the “Kitchen Test” steps in. You can still buy food in the grocery store, but it just means you have to read labels more carefully. The definition of the “Kitchen Test” is:

“Unprocessed food is any food that could be made by a person with reasonable skill in a home kitchen with whole-food ingredients.”

So if I needed butter, I bought it. I would not buy, however, a “soft butter-tasting spread” that has a bazillion ingredients in it, because there’s no way I could have reasonably made that in my kitchen. Same with pasta, beans, produce, cheese, yogurt, etc. The idea is, if you could make it (within reason) you can buy it. I still can’t make an Oreo or Nutella, so those are off the list.

The “80/20” Rule
Here’s where sanity comes in. So what if during the month you slip up and have some candy corn or a Pepsi? Really, what happens? Nothing. No biggie. What if you’re out at a restaurant and you can’t be sure that they are using whole ingredients in the kitchen? Again, nothing, please just enjoy your meal. The point is that you can do your best and not sweat the 20 percent of the time that it’s unavoidable. If you keep up the 80 percent portion, by the end of the month you should still feel a difference anyway, so why beat yourself up?

The Fallout
I survived my first foray into this challenge. Last year I made a lot of soup, uber-healthy muffins and breads, a few awesome casseroles, and let’s not forget smoothies. I even figured out how to make unprocessed brownies using coconut sugar and maple syrup. My family ate some of it with me (my husband more than my kids) and here’s what happened: I stopped craving sugar. When my birthday came around, I didn’t even really want my cake that I had decided would be an allowable cheat. I did eat some Halloween candy toward the end of the month, but not much. Bottom line, I had more energy and felt great going into the holidays. Oh, you want to know what happened to my husband who did this mostly by default? He lost five pounds. Seriously.

We kept some of the eating habits throughout this year and now are going to do it again (now with more enthusiasm from my husband, I might add). I’m already cooking for it – making soups and freezing casseroles and looking up recipes. If you want to join me go to the Eating Rules website and take the pledge. I’ll share some of the recipes I’m trying and hoping you will share, too! What do you have to lose? You can do anything for a month, right?

Retail or Mail Order for Your Maintenance Meds?

Have you ever stopped to think about the cost implications of choosing to fill a maintenance medication at a retail pharmacy rather than through a mail order pharmacy? Insurance companies are able to negotiate significant discounts with mail order pharmacies because they direct a high volume of business. These discounts generally average about 8%. When you consider a plan like ASHA's spends over half a million dollars a year on prescriptions drugs, that 8% is a significant amount of money. Right now, only 13% of our prescription drugs are filled through mail order.

Approximately a dozen states have laws in place that prohibit insurance companies from directing consumers to use mail order pharmacies. Maryland is one of these states. In Maryland, fully-insured plans are forbidden from requiring a co-payment for a prescription filled at a retail pharmacy if a similar fee is not required for a mail-order prescription. These laws protect the interests of retail pharmacies, but not necessarily consumers. A 2005 Maryland study examined the effects of laws that impede insurance plans from offering incentives for consumers to use mail order pharmacies. The study indicated that removing these restrictions would save Maryland consumers 2-6% on retail drug purchases overall and insurance carriers an additional 5-10%. 

Since ASHA's plan is currently fully-insured, consumers make a choice about whether to use a retail or mail order pharmacy without an immediate cost impact. I understand the convenience of picking up a prescription at your neighborhood pharmacy. However, the choice to use a retail pharmacy drives up the overall cost of coverage for ASHA and every individual in the plan over the long run. This is something you should consider the next time you fill a prescription for a maintenance medication. If you choose to use a retail pharmacy now, would you make the same choice if you had to pay the additional cost out-of-pocket? 

If ASHA decides to self-insure our medical plan, we won't be subject to the Maryland mandate and will be free to differentiate the co-pays for maintenance medications filled at a retail pharmacy and mail order. Therefore, this could very well be a decision you face in the near future. 

Happiness Comes to Those Who _____

Want to be happier? Read this article in Fast Company -- 10 Simple, Science-Backed Ways To Be Happier Today  by Belle Beth Cooper -- and practice the simple things that have been scientifically proven to lead to greater happiness. For a sneak peek and to fill in the blank, flip through the slide deck below. 




Sometimes you run across something that's just too good not to share. Thanks to Fran Melmed for pointing this article out. 

ASHA Recognized as One of Greater Washington's Healthiest Employers

We're honored to be included in the Washington Business Journals' list of the areas healthiest employers again this year. The award honors companies whose policies and initiatives promote the health and well-being of their employees. The Washington Business Journal partnered with Healthiest Employer, LLC to select the areas 50 healthiest employers. This is the third year the award has been given in our area and ASHA has been recognized each time. 

Healthiest Employer, LLC uses an online assessment tool and measures wellness programming in six key categories to select the winners -- culture and leadership commitment, foundational components, strategic planning, communication and marketing, programming and interventions, and reporting and analysis. 

They'll announce the ranking of each company during an event on Thursday, September 19. Last year we were ranked #4 in the 250-499 category. It looks like they shifted the categories a bit this year. 

I live in Reston, Virginia so I'm especially happy to see Reston Association being recognized again this year. Congratulations to all the other winners! 

2013 Honorees

(2-99) Employees

American Society of Landscape Architects
Audax Health Inc.
Corporate Network Services Inc.
Destination D.C.
Dynaxys LLC
Herren Associates
Mental Health Association of Montgomery County
Reston Association
Sigal Construction Corp.
Wellness Corporate Solutions LLC

(100-499) Employees

Airlines Reporting Corp.
Akridge
American Speech-Language-Hearing Association
Ashby Ponds
Continental Realty Corp.
IntelliDyne LLC
Nova Medical Group
PhRMA
Van Metre Cos.
Washington Real Estate Investment Trust

(500-1,499) Employees

Baker, Donelson, Bearman, Caldwell & Berkowitz PC
CapitalSource Inc.
Choice Hotels International Inc.
City of Rockville
Crowell & Moring LLP
Duke Realty
Greenspring
LMI
Radio One Inc.
ServiceSource
Unity Health Care

(1,500-4,999) Employees

CareFirst BlueCross BlueShield
The City of Alexandria
Gaylord National Resort & Convention Center
The Liaison Capitol Hill, An A finia Hotel
Lockton Cos.
MedImmune LLC
Neustar Inc.
Orbital Sciences Corp.
Ryan LLC
USI Insurance Services LLC

(5,000+) Employees

Accenture
AOL Inc.
BAE Systems
Capital One Financial Corp.
Jones Lang LaSalle
Kaiser Permanente of the Mid-Atlantic States
Loudoun County Public Schools
Northrop Grumman Corp.
Quest Diagnostics Nichols Institute
SRA International Inc.

Health Insurance Premium Rebate Might Buy You a Cup of Coffee

Many ASHA staff received a letter from UnitedHealthcare informing us that ASHA will be receiving a rebate check. I heard some folks were pretty excited and ready to go shopping. Before you break out your credit card, you might want to read this. 

The Affordable Care Act essentially limits health insurance companies to spending no more than 15 percent of premiums on administrative costs like salaries, sales and advertising. Employers are not reviewed individually, we're lumped into a group based on our size and the state our plan is written. 

Last year, UHC collected 0.4% over this allowed amount from its' policy holders in Maryland. The Affordable Care Act requires that they refund this money by August 1 of the following year. ASHA received a check for $12,329. 

ASHA covers 87% of our premium, so 13% or $1,632 of the refund is due to employees and retirees participating in the plan. We will distribute this money by reducing employee premiums. We have 251 participants, so each participant will receive a premium credit of $6.50. In after tax dollars, that might just buy you a nice cup of coffee. 

In Q&A form:

• Q. How much of a rebate did ASHA receive? A. 0.4% or $12,329 
• Q. What percentage of the premium for our health insurance do staff members and retirees contribute? A. 13% 
• Q. How much of the refund will ASHA distribute back to the staff? A. 13% or $1,632 
• Q. How many employees (and retirees) participate in the plan? A. 251 
• Q. How much of the refund will each participant receive? A. $6.50 
• Q. How will this money be distributed? A. Active employees in our health plan will receive a premium credit which will reduce the amount owed for coverage. 
• Q. When will participants receive this credit? A. In the check we receive on August 23. (Retirees will be mailed a check.) 

On the off chance you find all this fascinating and want to learn more, you can start with this information from the IRS on Medical Loss Ratio (MLR) FAQs. 

I heard a staff member express the expectation that our costs would not increase in 2014 if the insurance company is making so much money they have to issue refunds. Unfortunately, that's not the case at all. Our claims are very high right now and claims represent 85% of the cost of our coverage. There are also new taxes related to the Affordable Care Act going into effect in 2014 that will increase our costs. We're carefully reviewing our situation and the broader landscape and considering all the things we can do to provide affordable, comprehensive coverage to our staff, their families and our retirees. Stay tuned. 

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Update 8/7/13: We had three people leave in the last pay period, so the rebates will be $6.58. Gary Dunham says that $6.58 will buy a beer during Happy Hour at That's Amore. A cold beer sure sounds good after all this hassle. I'd hate to calculate what it is actually costing ASHA to distribute this rebate.