Can a Doctor Really Diagnose Over Zoom?

Is zooming your doctor the new normal?

Imagine you’re in quarantine, beginning to feel early symptoms that align with Coronavirus, yet to keep others safe you feel you need to stay home. The symptoms begin to worsen, but you still don’t want to risk others safety by leaving the house. How can you ensure you will be okay without leaving the house? Telehealth services might be your saving grace. This begs the question, can a doctor really diagnose over Zoom?

The American Medical Association is working to maximize telemedicine service options in order to revolutionize healthcare– especially because COVID-19 is highly contagious. Not only does telemedicine help keep potential Coronavirus carriers quarantined, but it also helps those who have had non-urgent medical care postponed due to the pandemic. 

These services can be extremely beneficial for those who still need to go to work, or those who have to take care of their children at home. With children home from school, it can be more challenging to leave them home with a sitter, so what does that mean if you have to go to the doctor? Well, you can just hop on a Zoom call during their nap and get the same results as going to the doctor!

So how exactly does telemedicine work?

Drs. Francavilla Brown and Boyd told AMA that telemedicine “is easier than people think it is to incorporate into a practice.” 

With technological advancements typically come progress and challenges. Physicians who have tried implementing telemedicine have identified these challenges, and have come up with a few solutions. 

One challenge is patients may not have a good signal to support their doctor’s visit. Trouble with a weak signal may make the appointment longer, or impossible for someone who really needs it. Another challenge physicians have identified is booking appointments to be a televisit for doctor’s offices. The patient must call into the office to ensure their appointment is virtual. 

While telehealth services may not be the best option for detecting major issues, it has been great for reassessing and monitoring patients who have known problems. It can also be used to adjust medications, answer questions, and share information. Patients in areas where medical resources are limited also benefit greatly from these services. 

These services also help people avoid unnecessary hospital visits, which helps to give advice at a distance, save time, and reduce costs for both patients and doctors. Not only will it help avoid hospital visits when they aren’t necessary, but it will also give patients in the hospital the ability to discharge sooner by monitoring their vitals with telemedicine.

Zooming your doctor may begin to become the new normal in a post-COVID world. At SBMA, we offer telemedicine services at competitive prices. Contact us to learn more about how our benefit plans with telemedicine services today!

Can a doctor really diagnose over zoom?

Employee Retention is More than Just Health Care

Keeping employees engaged and excited about work can be a difficult task for some employers. There are a few things you can do as a leader within your organization to foster employee happiness. One of the main ways is to offer voluntary benefits. Employees are looking for insurance when they are looking for a company that will serve them, but they also require additional benefits, and other creative approaches to benefits. In the article below, you will see the best ways to keep employees engaged and excited about work, and how important it is to offer more than just health insurance. At SBMA, we have insurance options that include vision, dental, and other voluntary benefits. Check out our plan options here!

The Best Ways to Keep Employees Engaged and Excited About Work

Attract ENGAGE Retain. 

An engaged workforce is a productive workforce. 

But you can’t force someone to be engaged. 

Once you’ve got a candidate through the hiring, onboarding and training process, you really want to retain them.  But what about two years in, five years in.  What do you do as a company to re-engage and thereby retain your staff?

People are engaged when they feel they make a difference.  People are engaged when they feel appreciated.  People are engaged when they feel a sense of purpose.  People are engaged when they feel aligned with the company’s values.

So, here are 6 ways to align yourself as a company for the best possible chance of engaging, inspiring, and thereby retaining your workers. 

  1. Benefits aren’t just a 401K: While health insurance is the #1 benefit employees look for, there are many other ways to keep employees feeling valued that are outside the traditional, raise, increase in benefits routes. Flexibility around work-life balance rates more highly among millennials than even health insurance in a study conducted in 2017 by Forbes magazine.  Bringing yoga into the workplace is another way to engage your teams in physical and emotional self-care right there on the job.  Don’t think of it as losing an hour of productivity, you’re not!  You’re donating an unproductive hour to the cause of engagement. Stress is the #1 reason people leave jobs.  So OHHHMMMMMM.
  2. Share your passion: If you’re passionate about running, donate 5% of your profits to a charity that uses running programs to get homeless people back on their feet.  If your passion is the environment, commit to a 100% plastic waste-free catering service… Whatever drives you will inspire others.  Sharing your passion with the team makes everyone clear that the CEO and owner cares deeply just like them.
  3. Get goofy: Not the dog that owns a dog… Get silly, be willing to be wrong.  Allow the company to see your human side. If that means outtakes and blooper reels go out on social media, do that.  If it means sharing that your dog died and you’re feeling really low… that’s vulnerability and as goofy as it may sound.  There’s tremendous strength in vulnerability (Brene Brown)
  4. Raise the bar: Raise up the mid-level managers in your company by bringing in training for them.  There are grants companies can apply for that pay for training effectively making that training free on the front end and so very profitable when your managers become leaders.
  5. Bang a gong: Employee of the month? Employee Spotlight, an actual gong for sales that close? There are so many ways to praise publicly (and reprimand in private).  These principles set out years ago by the likes of Ken Blanchard hold true to this day.  People want to be recognized for what they do well.  So give ‘em a hand.
  6. Ensure role alignment: Identify your company culture.  Hone in on it like a laser and protect it like it’s a crystal figurine your granny asked you to hold.  When you’re certain about your culture you can hire to align with it.  When you hire people who are aligned with the culture and get them in the right role, you’ll retain those people throughout their job lifecycle.

Intentional culture takes time and effort to build and only a small amount of neglect to destroy.  On that happy note, we’ll say, Happy retaining!

Encouraging and engaging employees can make a huge impact on your company’s culture. If you feel your company could use some adjustments to your current company culture, Culture Works can help!

Vision and Dental Add Value for Employees

How Can Vision and Dental Add Value for Your Employees?

Voluntary benefit plans are an important part of employee insurance opportunities. Among these voluntary benefits, vision and dental insurance are an important part of employees voluntary benefit plans. How can vision and dental plans add value to your employees’ wellbeing? Here are a few ways:

Vision:

  • Vision exams identify future problems: They can detect things like eyestrain, diabetes, and even high blood pressure. They can also identify common eye issues and diseases.
  • Cost savings: According to the National Alliance for Eye and Vision Research eye disease, vision loss, and eye disorders cost the U.S Economy $68 billion per year.
  • Increase productivity: The vision council reported that eye care delivers $7,800 in more productivity per employee.

Dental:

  • Dentists can identify disease: Dentists have the ability to identify over 120 diseases. This can help your employee long-term health with potential early detection
  • Young employees likely don’t have dental coverage: The American Dental Association states that millennials have untreated tooth decay. The main reasons for this issue are cost convenience and confusion surrounding dental care.
  • Those with dental coverage are more likely to use it: As more people offer dental insurance the number of adults who miss work for oral health-related issues dropped 7%.

At SBMA, we provide voluntary benefits that employees love. To learn more about our voluntary benefit programs, contact us today!

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Virtual Health is Saving Lives During Coronavirus

How Virtual Health Services are Saving Lives During the Coronavirus Crisis

With the outbreak of COVID-19 healthcare workers and providers have had to come up with better ways to diagnose and treat patients. The number of patients who need to be seen for health issues both related to and peripheral to the coronavirus has put a strain on our hospitals.  It is in this environment that Telemedicine has found its spotlight. Telemedicine or Virtual Health Care is the practice of performing virtual appointments and check-ups for patients. Especially now, this keeps both patients and healthcare workers safe while continuing to provide care for those in need. This is only the beginning of how virtual health is saving lives during the Coronavirus pandemic.

Virtual healthcare has slowly been taking hold as more and more of the norm in recent years. The cost savings alone make virtual care the right choice for many doctors, hospitals, and patients.  $7 billion of physicians’ time can be saved by switching in-person visits to virtual appointments.

These days, in quarantine, many people need the ability to have their doctor’s appointments at home. Even during the best of times, for many, the convenience is key to successful follow up appointments and check-ins.  Telemedicine allows for a safe environment to ask questions, get simple diagnoses and to get prescriptions from your doctor while remaining at home.  

Doctors around the country have implemented telemedicine and online appointments to help keep all patients safe from COVID-19. Patients with a smartphone or computer can visit a provider in a secure network. Dr. Chris Davis, Medical Director for UCHealth’s Virtual Urgent Care says, “COVID-19 is quite infectious, so if you can stay home and get medical advice, that gives you two advantages. First, if you’re sick, you’re not going to be bringing your illness into a doctor’s office or a hospital. Second, you won’t be exposed to other patients.”

These changes to what we have thought of as normal healthcare have given people affordable, manageable options to care for themselves and others throughout this uncertain time. As we work to navigate COVID-19, the best thing we can do is keep ourselves and others safe from harm by ensuring we do everything we can to stop the spread.

How Does the FFCRA Affect My Employee’s Coverage?

The Families First Coronavirus Response Act is an Act of Congress meant to respond to the economic impacts of the ongoing 2019–20 coronavirus pandemic. The act will provide funding for free coronavirus testing, 14-day paid leave for American workers affected by the pandemic, and increased funding for food stamps. So, how does the FFCRA affect my employee’s coverage?

As the effects of Coronavirus continue to unfold, we have seen many changes to how companies have to adjust their benefits. Here are some strategies that employers can utilize to prepare for the changes:

Employer-provided health coverage: The Families First Coronavirus Response Act ensures that group health plans cover COVID-19 screenings without cost-sharing. The law, however,  does not require coverage for treatment without cost-sharing; treatment costs will be based on the terms of the benefits plan.

The IRS states that employees who have coverage with a high-deductible health plan are able to get COVID-19 testing and treatment without additional expenses. 

Paid leave and short-term/ long-term disability coverage: Employees with less than 500 employees must provide up to 12 weeks of leave related to child care with the expansion of the Family and Medical Leave Act, and up to 80 hours of emergency paid sick leave to employees who are full-time. 

Families first does not address employees who were on disability or leave before the outbreak. 

Employer tax credits for paid leave: The FFRCA has provided multiple tax credits to aid employers as they attempt to meet the new requirements. These tax credits are equivalent to 100% of the qualifying leave wages against the employer’s portion of Social Security tax. 

Continuing health coverage during furloughs and mandated leaves of absence. During unpaid leaves of absences that are extended, like a temporary layoff of furlough, health benefits are typically halted. 

Review your insurance contracts and stop-loss policies to determine how to regard employees who lose eligibility due to an extended leave of absence.Group health brokers can help you navigate extended leave coverage for W-2 employees. 

(COBRA), where furloughed employees can choose to remain on the group health coverage the employer must collect the amount of the employees premium. If an employee is receiving payments from accrued time-off, it is possible to collect premiums from those payments. 

Employer inquiries, screenings, and disclosures for infected employees: Asking employees about their health condition is  not a HIPAA violation. Other laws, like the ADA, don’t allow confidential information to be disclosed that concerns employees. If employers screen employees onsite, test results are not associated with a health plan.

Telemedicine programs: The use of virtual medicine gives employees the ability to remain home while being cared for medically, which helps halt the spread of COVID-19.  

Employer expenses with a quarantine employee: Some expenses incurred while an employee is quarantined can be considered deductible. 

As we continue to navigate through COVID-19 we will likely see more changes to benefits that are being offered to employees. Check back for updates

Worksite Benefits Benefit Everyone

The high cost of health care and the evolution of insurance plans with high deductibles has created a market for voluntary benefits. 

Employees can choose from a number of insurance products to complement their coverage and to help achieve a greater degree of stability. Worksite Benefits (voluntary coverage) plans may be 100% paid for by employees or cost-shared with the employer. Here’s why worksite benefits benefit everyone.

Creating a more comprehensive and competitive benefits package is good for the employer as they attract better talent, good for the employee as they get improved coverage and good for the broker who is providing cost-effective solutions. In 2017 nearly half of large employers offered at least one of the three major voluntary benefits: accident, critical illness, and hospital indemnity.

Enrollment in voluntary benefits can be streamlined by offering these benefits at the time of enrollment in a MEC or other benefits plan, by ensuring ease of use in a portal or enrollment documents and by informing employees of the benefits of Worksite Benefits. .

Voluntary benefits generate commissions that can be used to fund overall benefits administration costs and project work done by TPAs that would otherwise be paid by the employer. 

SUPPORT FOR PHYSICAL AND MENTAL HEALTH AND WELLNESS

On the employer side, there has been a national push for physical and financial wellness initiatives. Employers are recognizing the increased stress their employees deal with on a day-to-day basis and are offering solutions. Stress costs American businesses more than $300 billion a year. 

PERSONAL PREFERENCE DRIVES DEMAND

Employees want to have more control when it comes to deciding which options are useful for them.

When employers offer a wide range of benefits that address physical and mental health and wellness issues, employees can adapt the package to fit their lifestyle needs. 

Employees want a benefits package that feels personalized to them, so that they feel like they An Aflac survey found that employees who were offered voluntary benefits were 19 percent more likely to be satisfied with their job – and 14 percent less likely to be job searching.

THE IMPORTANCE OF TECHNOLOGY

The wide array of technology providers offering more streamlined technology also makes voluntary benefits easier to implement for employers and brokers. Online enrollment, automated processing of administrative tasks and the ability for employees to “self-serve” all make the voluntary benefits enrollment process more attractive to employees and employers.

Voluntary benefits are only going to increase in popularity for employers and brokers of all sizes as they become more essential in the lives of employees. Isn’t it time to take a look at your benefits offerings and make sure they are competitive? Call SBMA today.

Insurance Coverage and Coronavirus Testing

Will My Insurance Cover the Cost of Coronavirus Testing?

As we continue to navigate through the effects of COVID-19, many questions arise when it comes to insurance coverage. Does your specific insurance cover testing? Does it cover treatment? How can I find out my coverage options? 

The short answer is it depends on your coverage. Health insurance coverage varies widely, depending on where you live and how you obtain your coverage. Almost half of Americans receive their insurance coverage from their employers. Those plans are managed by both the federal and state guidelines, which depend on the group size and whether or not the plans are self-insured or fully-insured. So how does Coronavirus coverage fit into these health plans?

Let’s begin with testing. The Families First Coronavirus Response Act states the Medicare, Medicaid, and private health insurance plans are required to cover the cost of Coronavirus testing, without cost-sharing or pre-authorization requirements. This is including lab service costs and provider fees at doctor’s offices, urgent care clinics, and emergency rooms where tests are given. Because this act is federal law, self-insured and fully-insured plans apply to this rule. However, the testing coverage requirements that are imposed on some states are only applicable to fully-insured plans.

Plans that are not considered minimum essential coverage, for example short-term health plans, fixed indemnity plans, and healthcare sharing ministry plans, are not required to cover COVID-19 testing. Some of these plans do volunteer to cover COVID-19 testing, so look to your plan for specifics.

Some states, like Washington, have extended their testing coverage requirements to include these short-term plans, but most states have not imposed further requirements for these plans.

If you are uninsured, states can use their Medicaid programs to cover COVID-19 testing to cover their uninsured residents. There is $1 billion in federal funding to reimburse providers to cover COVID-19 testing for uninsured patients.

Now, let’s get into treatment coverage. As of right now, there is no specific treatment for COVID-19, most people will not need treatment, but around 20% of patients will be hospitalized, and 20% of those patients will need intensive care. This inpatient care is considered an essential health benefit for all ACA-compliant individual and small group health plans. Large group plans are technically not required to cover essential health benefits, but they are required to provide “substantial” coverage for inpatient care.

Even with coverage, inpatient care is expensive. The ACA states that all non-grandfathered/grandmothered plans must have in-network out-of-pocket maximums that can reach up to $8,150 for a single individual. Most COVID-19 treatment costs will not exceed this amount, but many health plans out-of-pocket limits are below that amount. Which leaves patients that need hospitalization with a four-figure invoice.

Some states, like New Mexico and Massachusetts have required state-regulated insurers to cover treatment and testing without cost-sharing. Minnesota is encouraging their providers to do the same. 

Most states are both encouraging and requiring state-regulated providers to allow testing and treatment as in-network, whether or not the medical providers are in the plan’s network. Patients may still be subject to balance billing because out-of-network providers do not need to accept the payment as payment-in-full.

Here are some ways to ensure that you are protected during these uncertain times:

  • If you are uninsured there is a COVID-19 special enrollment period in some states. If your state is included, an ACA-compliant plan is a great option. If you have a low income, you could also be eligible for Medicaid.
  • If you currently have health insurance, understand what your plan covers, and how your cost-sharing responsibilities for in-patient and out-patient care may apply.
  • Look at your health plan to see how it handles prior authorizations.
  • Look at the details of your health plan’s provider network. If you see in-network providers you have a better chance of avoiding balance billing.
  • Check to see if telehealth is covered, for less-severe cases, this is the best way to help prevent the spread of COVID-19. Some health plans are eliminating or reducing cost-sharing for telehealth services.
  • If you have an HSA-qualified plan, you can devote your pre-tax money to your account for the year. The money you contribute to your plan is able to be withdrawn tax-free for out-of-pocket health care expenses.

What You Need to Know about 2020 1094/1095 Filing

Due to the Coronavirus outbreak, the IRS has pushed back the tax filing deadline to June 15, 2020, for individuals, but there have been no specific details into filing for 1094/1095. The only information they gave was that the 30-day extension that can be filed past March 2 can be extended an additional 30 days. Here’s what you need to know about 2020 1094/1095 filing.

Form 1094-C/1095-C

Form 1095-C, which is filed to any full-time employee of an Applicable Large Employers member (employers with 50 or more full-time employees), who is full-time for one or more months of the tax year. These members report information regarding each employee for all 12 months of the year.

The information that is reported from both 1094-C and 1095-C is used to determine employer liability for payment under the employer’s shared responsibility provision, section 4980H, and the amount, if any, that is owed. 

Employers that are subject to the ACA must distribute 1095 reporting forms to employees and transmit copies to the IRS, with a few exceptions:

Form 1095 B, Health Coverage

  • . Transmittal Form 1094-B to accompany Form 1095-B
  • Instructions for Forms 1094-B and 1095-B
  • Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
  • Transmittal Form 1094-C to accompany Form 1095-C
  • Instructions for Forms  1094-C and 1095-C

Forms 1094-B/ 1094-B

Information in form 1095 B is reported to the IRS and taxpayers regarding employees who are covered by minimum essential coverage (which includes government-sponsored programs, eligible employer-sponsored plans, individual market plans, other Department of Health and Human Services coverage). Eligibility for this coverage may affect a taxpayer’s eligibility for the premium tax credit.

Everyone who provides minimum essential coverage to employees during a year must file an information return that reports the coverage, using forms 1094-B and 1095-B.

There is an automatic 30-day extension for both forms 1094-B and 1095-B, which you can receive by completing Form 8809 and filing it with the IRS on or before the due date. There is no need for a signature or explanation to receive the extension, but form 8809 must be filed before the due date of the returns. You may also apply for an additional 30-day extension under certain hardship conditions.

At SBMA, we take the complexity of 1094/ 1095 filing off your plate.  Our team will take care of all of the filings and, in the event the IRS sends a letter saying the filing was incorrect, we will take care of the refiling on your company’s behalf. 

Penalty A and B Compliance

What You Need to Know About Penalty A and B Compliance

If you are a business owner and qualify as a “large employer” —  any company with 50 or more full-time or full-time equivalent employees (employees who average 30 hours per week) — there a few things you need to know regarding employee coverage. If you don’t comply with the regulations set for you, you will face significant penalties, which can quickly add up. 

ALE employers must offer affordable or minimum value medical coverage to their full-time employees and their dependents until the age of 26. This minimum essential coverage includes various programs that comply with ACA’s provisions to employer health care. 

Any employer who does not offer minimum essential coverage to at least 95% of their full-time employees and their dependents is subject to penalty, and at least one employee obtains coverage through the Marketplace Exchange. This penalty includes a $2,320 fine per full-time employee after the first 30 employees. If you have 150 employees, this penalty would be $308,400.

If employers offer coverage, but the coverage is not affordable or does not meet a minimum value, they may still receive a penalty. If your employee’s share of the premium for the coverage you provide is more then 9.78% of their household income, the coverage is deemed unaffordable. 

The penalty includes either a $3,480 fine per full-time employee receiving a federal subsidy for coverage purchased on the Marketplace or a $2,320 per full-time employee, not including the first 30, depending on which is the lower cost for the company.

As you can see, these penalties can add up to a lot of expenses for your business. At SBMA, we want to help you avoid any potential penalties for lack of proper insurance. Contact us for more information regarding your employer benefit needs. 

Virtual Care and the Telemedicine Revolution

During this time of uncertainty, there has been an increase in consumer demand for virtual healthcare services, which has put added pressure on providers and payers to expand delivery options for on-demand health services.

A survey from Accenture, which included 1,501 consumers who answered questions online, found that most people are willing to utilize virtual healthcare services. For the 20% of respondents who had received care virtually, the reasons they cited most often for seeking virtual care are:

  • Greater convenience than traditional in-person healthcare services (37%)
  • Familiarity using technology to manage their health (34%)
  • Curiosity to try virtual health (34%)

Consumers said they would be more likely to “try virtual” if encouraged by a physician or familiar healthcare provider.
According to the research, today’s consumers are demanding a combination of in-person and virtual health services. More than 75% of those surveyed said they would be interested in receiving healthcare virtually some or most of the time.

What is Virtual Health?

Virtual health includes health care innovations like virtual appointment kiosks and portals, remote consultations, and electronic personal health records. These components work together to allow for easier access to care, such as virtual wellness coaching, remote monitoring, video visits, and online health chats, among several other benefits that we will examine more closely below.
Virtual health combines clinical care and professional collaboration through telemedicine, telehealth, and collaboration at-a-distance to connect clinicians, patients, care teams, and health professionals to provide health services, support patient self-management, and coordinate care across the care continuum.
Specific to physician-patient encounters, virtual health enables live and asynchronous clinical interactions, clinical practice, and patient management supported by a wide range of communication, collaboration, and cognitive computing technologies along with digital devices and data.


Benefits of Virtual Health and Telemedicine

As you can see, there are many benefits of offering Virtual Health. For patients and medical practices, the use of telemedicine technology allows patients to receive follow up care and chronic illness management from their own home on the devices they already own and use. This follow-up care is especially crucial for those who are homebound or have difficulty arranging travel.
For healthier patients, it reduces travel time and costs and requires less time away from work. As an added benefit, patients do not have exposure to other potentially contagious patients. In short, telemedicine removes many of the barriers preventing people from actively managing their health.

Here are the main benefits for most patients:

Improved Access – Not only does telemedicine improve access to patients, but it also allows physicians and health facilities to expand their reach beyond their own offices. Telemedicine has a unique capacity to increase service to millions of new patients.

Cost Efficiencies – Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.

Improved Quality – Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations.

Virtual Health Care technology is excellent for providers as well. It can help extend clinical services to reach more patients efficiently and profitably. It helps improve health outcomes by increasing patient compliance with follow up and chronic illness management. Virtual Health Care strengthens patient relationships without putting additional strain on the medical staff.
There are significant benefits to medical practice, as well. By utilizing virtual health, your practice can expand access to care. It improves clinical workflows by helping your staff capture each patient’s reason for the call or visit quickly, prioritize care delivery, suggest the best treatment guidelines, and identify additional information resources. Virtual health care can also support communication along the care continuum.

What does this mean for my practice?

Technology is providing new methods to assist your clients by responding to the need for better communication. It’s also creating a competitive landscape the medical field has never seen before. Embracing this new trend will enable you to maintain your patients for years to come.

Contact SBMA for more information on employee benefits packages that include virtual health services!