Wednesday, July 30, 2014

Highlights from the World Congress on Employee Well-Being #WCEWB14

  1. The World Congress hosted the Employee Well Bootcamp for HR, Benefits and Wellness Professionals in Boston on July 23-24, 2014. When I attend events like this, I like to create a list of books, articles and resources that are mentioned and share what I compile.

    Susan Tufts from L.L. Bean kicked the conference off right with Health and Well-Being -- Build a Business Case for Your Employee Wellness Program.
  2. Susan shared a compelling slide that showed how their smoking rates decreased as they became a smoke-free environment. I've often thought that employer have the potential to have the same sort of impact on other health and wellness factors like diet and exercise as we have had on smoking in the U.S.
  3. Looking back at my notes from #wcewb14. Susan Tufts from @llbean shared this compelling slide.
    Looking back at my notes from #wcewb14. Susan Tufts from @LLBean shared this compelling slide.
  4. Fitness room utilization tripled @LLBean when they upgraded equipment & refreshed the fitness rooms. #WCEWB14

Tuesday, July 29, 2014

6 Ways to Spend Your Health Insurance Premium Rebate

Many ASHA staff received a letter from UnitedHealthcare informing us that ASHA will be receiving a rebate check. You may recall that last year's rebate was $6.58, so this year's $20.17 may feel like a windfall. Read on to see why you're getting a rebate and how it will be issued.

The Affordable Care Act essentially limits health insurance companies to spending no more than 20 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 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 $42,130.76. 

ASHA covers 87% of our premium, so 13% or $5,627.66 of the refund is due to employees and retirees participating in the plan. We will distribute this money by reducing employee premiums. We have 279 participants, so each participant will receive a premium credit of $20.17. Last year, I suggested that the premium credit might buy you a nice cup of coffee, but $20 opens up a whole host of possibilities. I ran across this article on that suggests you do something that will make a lasting change like (1) purchase a garden hose attachment to clean your windows, (2) invest in a personal finance book, (3) beef up your tool box, (4) have the interior of your car detailed, (5) plant some herbs, or (6) donate it to charity. 

My little herb garden at the start of the season.
  • Q. How much of a rebate did ASHA receive? A. $42,130.76 
  • 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 $5,627.66 
  • Q. How many employees (and retirees) currently participate in the plan? A. 279
  • Q. How much of the refund will each participant receive? A. $20.17
  • Q. How will this money be distributed? A. Active employees in our health plan will receive a premium credit reducing the amount owed for coverage. 
  • Q. When will participants receive this credit? A. In the check we receive for pay period 17 on August 22. (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 2015 if the insurance company is making so much money they have to issue refunds. Unfortunately, that's not how it works. 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. 

Wednesday, July 23, 2014

Getting ready to send your child to college? Complete this health related check list before you wave good-bye.

Getting ready to send your child off to college? Take a few moments to think about how their health care needs will be met while they are away.

Ian 2008
Thanks to the ACA, children can stay on a parent's health care plan until they reach the age of 26. If you're covering your child on your plan, do a quick search to find in-network providers near where he or she will be attending school. If you don't find any, call your insurance company and ask if they have any affiliate networks available where you child will be attending school. If you have no in-network options, find out if you have an out-of-network benefit. It may have a separate deductible that needs to be met. This deductible may be high, but if your child can seek routine care at home and use the school's health clinic for primary care when they're away, it may serve as sort of catastrophic coverage if needed. If your child is uninsured, see the articles at the end of this post for some options.

The school's health clinic can be a good source of primary care for your student. If you're child seeks care at the student health clinic, it is likely that the visit will be covered free of charge. Well, not exactly free, there is probably a fee to support the student health clinic tacked onto the tuition bill or included as part of a comprehensive fee. Many schools will bill your insurance for lab work and any prescriptions your child might need. Keep in mind that the healthcare provided by the school is not a replacement for health insurance. It typically won't cover procedures, tests, prescriptions or any type of inpatient care.

If your child takes any maintenance medications, renew the prescriptions and set up mail order delivery at the school. You may need to call the school to confirm that they'll be able to accept delivery of prescriptions if you child is assigned a P.O. box.

Schedule any routine visits while your child is at home. You'll probably need to complete a pre-entrance health form and provide proof of vaccinations, so request this information from the doctor's office if you don't have records at home. It's also good to get in a routine of scheduling dental visits in December and June when your child is more likely to be home. Remember teeth cleanings generally have to be six months apart to be covered under your preventive care benefit.

Identify which hospitals are in-network and then pull up the city or town where your child will be and see which hospitals earned the highest scores for safety on Hospital Safety Score. If you don't find any in-network options, the ACA specifies out-of-network emergency services must be covered as follows:
if a group health plan or health insurance coverage provides any benefits for emergency services in an emergency department of a hospital, the plan or issuer must cover emergency services without regard to whether a particular health care provider is an in-network provider with respect to the services, and generally cannot impose any copayment or coinsurance that is greater than what would be imposed if services were provided in network. At the same time, the statute does not require plans or issuers to cover amounts that out-of-network providers may "balance bill"
If your child decides to travel abroad, consider purchasing international medical insurance for the time he or she will be out of the country. You can learn more in this post -- 10 Health Care Tips for Travel.

Your child's school should provide all the information you need on its' website, but this list should give you a head start. If you think of anything I overlooked, please leave a note in the comment section below.

Health Care Essentials -- 
A check list for college students.
Connor 2013

  • Complete any required pre-entrance health forms. This is likely to require providing proof of immunizations (see list below), but not necessarily a physical for most students. Student athletes will probably be required to have a physical and complete additional paperwork. 
  • Find in-network medical providers near the school. If none are available, find out if you have any out-of-network benefits.
  • Make sure routine dental care is up-to-date.
  • Refill any prescriptions and arrange to have maintenance medications delivered by mail-order to the school address or transfer prescriptions to the student health clinic.
  • Make sure your child has these items in his/her wallet.
    • Insurance card
    • Student ID Card
    • List of medications taken routinely
    • List of any medications he/she is allergic to
    • Primary care physician's contact information
  • Confirm your child has these apps on his/her phone.
    • Your health insurance companies' app. If you're with UnitedHealthcare, it's Health4Me. Make sure your student has the login information
    • Hospital Safety Score to find the safest hospital whenever and wherever they need it.
    • ADA - Your Health Guide- searching health topics by symptom
  • Put together a first aid kit (see list below.)
  • If you student wears contact lenses, it's a good idea to have a back up pair of eyeglasses and pack a copy of his or her current prescriptions.
  • Contact the student health center to notify the school of any serious pre-existing conditions your student has including any mental health issues. 
  • Pack a copy of important medical records. 
  • Pack an EpiPen if prescribed and an updated prescription for additional medication if needed.
  • Students that are diabetic should have adequate quantities of supplies for glucose monitoring and insulin administration. Check with the student health center to find out about disposal of needles and syringes.
  • If your student will be using a bicycle, be sure to pack a helmet.

    • Vaccinations:

      My youngest son attends UVA and this is what they require. I think it's fairly typical. Medical and nursing students will likely have additional requirements. You should get a list of what's required at your child's school during orientation. You should also be able to look it up on the school's website. Look for a student health section. 

      My sons always give me a hard time about getting a flu shot, but I do my best to drag them to the CVS Minute Clinic for a flu vaccine. Having the flu when you're in college is particularly miserable. Especially if you live in a dorm. The school health clinic may offer the flu vaccine. You can also check with your health insurer to see where the vaccine is covered near your child's school.

      First aid kit for college students:

      I felt better sending our sons off with a first aid kit. My oldest son sent his home fully intact after college (expired soup cans and all.) At least, I bought myself some piece of mind.

      • Adhesive bandages (assorted sizes)
      • Adhesive tape (1" wide)
      • Antacids
      • Antibiotic ointment
      • Antihistamine (diphenhydramine hydrochloride - generic for Benadryl)
      • Antiseptic wipes
      • Can or two of chicken noodle soup (pull top or be sure to include a can opener)
      • Cold Pack (disposable)
      • Cough drops
      • Cotton roll and balls
      • Cotton-tipped swabs
      • Decongestant (pseudoephedrine hydrochloride - generic for Sudafed)
      • Digital thermometer
      • Elastic bandage (3" wide) (Ace wrap)
      • Flashlight (and extra batteries)
      • Gauze pads
      • Pain relief medicine (aspirin, acetaminophen, ibuprofen)
      • Scissors
      • Tissues
      • Sunscreen
      • Hydrocortisone cream

Learn More:

Thursday, July 10, 2014

Understanding Prescription Drug Pricing and Safety

According to the CDC almost half of Americans have taken at least one prescription drug in the past 30 days. Until recently, information wasn't readily available to consumers to compare the cost of prescription drugs from one pharmacy to another and to allow consumers to compare treatment options with various drugs, but those things have become much more transparent.

Lisa Roy and Eugenia Perna joined us from UnitedHealthCare to discuss prescription drug pricing, safety and the tools available to help us manage both.

Drug pricing is complicated and drug prices fluctuate like the price of gas. The same way gas may cost more on a heavily traveled holiday weekend the price of allergy medicines may be increased during allergy season. One factor in the pricing of drugs is ease of use. When drugs are going off patent, manufactures will create an extended release version or a combination drug to keep a patent. 

Azor is an example. It is a combination pill for blood pressure -- essentially two pills in one. You pay for the convenience of only needing to swallow one pill. Azore runs $280 per month. You could achieve the same effect by taking two generic pills. One at $24 per month and the other at $5 a month for a savings of $251 a month. 

Lipitor recently came off patent. In the first six months, the new generic, atorvastatin, had exclusivity. That typically means it's cheaper for consumers if they're only responsible for a copay; but three, four or maybe even five times more expensive than the brand during this time period. To make matters even more complicated Pfizer, the manufacturer of Lipitor, made a deal to provide rebates to insurers and pharmacy benefit managers (PBMs) to eliminate a lot of the cost advantage of atorvastatin. Just like many Facebook relationships, "it's complicated."

Medical advances often come in terms of new drug treatments and new treatments are often costly. We talked about Sovaldi as an example. It is a new treatment for Hepatitis C. It costs about $1,000 per pill and more than $84,000 for a course of treatment. It represents a cure for a chronic and often fatal condition, so most employers are including it in their coverage, but the cost has an impact.

Let's think safety first though. Mistakes are routinely made when dispensing medications. When you pick up a prescription, talk to the pharmacist or look up a picture of the medication to confirm you received what you expected. 

In the book, Where does it hurt? by Jonathan Bush, there is an example of a woman who had been fainting. It turned out that she had been prescribed twenty-seven different medicines by eleven different doctors, most of them specialists. Seven of these were for hypertension alone -- four of them were the exact some drug. This example is less surprising than it is appalling. Unfortunately, we can't trust the system to manage our health. Keep a record of all the medications and supplements you take and discuss possible interactions with your doctors and pharmacist. 

If you're insured with UnitedHealthCare, you have some good tools at your disposal. To use them, log into and select "manage my prescriptions." From there you can look up drug information which includes a picture of the pill and see what each drug will cost at a retail pharmacy and through mail order. You can see possible lower cost alternatives to a medication. You can even print out a report to show to your doctor to faciliate your discussion. See the flier below for more details. 

To save money, you may consider using a pharmacy that offers a generic discount program. Pharmacies like Target and Walmart often offer very low prices on a select list of generic drugs used to treat common conditions like diabetes, mental health, high blood pressure and infections. Their prices may be less than your copays and are likely to be less than what you would pay out-of-pocket with a high deductible plan. If you use one of these programs, the cost will not track toward your deductible though.

If you're not in our health plan, Good RX is helpful for pricing medications. Costco, Walmart and Target are generally cheaper than pharmacies like CVS and Walgreens. You may be able to negotiate with a convenient pharmacy to match a price if you find a drug cheaper at another place nearby. Giant will typically do this. It certainly doesn't hurt to ask.  

And, since were in vacation season, if you're traveling and forget your meds, go to a pharmacy and request a vacation override. Show the pharmacist your card and he or she will call UHC to obtain the override for you. You might also be interested in this post -- 10 Health Care Tips for Travel.

Learn More:

Monday, July 7, 2014

30 Day Challenges and a Green Smoothie Formula

You may recall my initial attempts at green smoothies. Gag! So, when I heard about this 30 Day Green Smoothie Challenge, I figured I'd give it a shot. Surely I'd learn to make a decent green smoothie after 30 attempts and if I replaced one meal a day with a green smoothie, maybe I'd knock off the couple of pounds that I've gained since I fractured my foot. With luck, they might even have magical healing powers (stupid foot is taking forever to heal.) 

I find 30 day challenges educational. I did the 30 day Mediterranean Lifestyle challenge that we held here and learned  a lot from my colleagues' blog posts about the hurdles people encounter when trying to eat well. This lead me to participating in October Unprocessed with a group of staff where we tackled label reading with new vigor. During both challenges, I picked up a variety of new healthy habits that have stuck. 

It's only week two of this challenge. (Although I did get excited and start almost a week early on June 24.) I've already learned to make a decent green smoothie thanks to this simple infographic. I'm pretty sure I'd have never mixed broccoli and chocolate if I'd had this when we first got our Vitamix. Seriously, they should imprint this on the machine! Kale, coconut water, mango and banana is my current favorite. And, thanks to this infographic I can make one or two portions that fit neatly in our Klean Canteens. Before I always had too much. Here are a couple of my favorite recipes. You can find a great selection on
If this challenge interests you, I hope you'll join me. If not, find a challenge that helps you hone in on something you'd like to learn more about. You can always go back to our Mediterranean Diet Challenge and start with Wave 1. Or, try August Unprocessed. (I find eating well easiest in the summer when the Farmers Markets are filled with gorgeous produce.) Or, maybe you want to create your own 30 Day Challenge -- planks, squats, yoga, swimming, cold showers (no kidding, Google it) -- the options are limitless.

Sunday, July 6, 2014

ASHA Recognized as One of The Washington Post Top Workplaces

We're thrilled that ASHA has been selected as one of The Washington Post Top Workplaces. This recognition is particularly meaningful because it's based solely on employee responses to a survey conducted by WorkplaceDynamics, LLP, a leading research firm on organizational health and employee engagement. 

This recognition is wonderful, but we're even more excited that the Washington Post is helping us let everyone know that ASHA is a great place to work. Associations Now aided that cause when they did a follow up piece on What it Takes to be a Top Workplace and highlighted two of the associations that were recognized -- the American Chemistry Council and ASHA. 

Interested in working in a top workplace? Check out our job openings. We're always looking for talented folks to join our team. 

The Washington Post published the complete list of Top Workplaces on June 22nd. For more information about the Top Workplaces lists and WorkplaceDynamics, please visit and