6 Ways to Help Your Staff Become Savvy Healthcare Consumers in 2021 It’s important to educate your employees on ways they can take control of how much they spend on healthcare. Help your employees make better healthcare decisions with these best practices. 1. Clearly communicate benefit options Employees can better control their out-of-pocket costs by […]
Is your district prepared for another ACA filing deadline? While staying compliant with the ACA is a yearlong task, all related filings are due to the IRS by March 2, 2021. To help your district meet all ACA filing requirements, please review SET SEG’s annual Year-End 1095-C Filing Checklist to make sure you are meeting […]
A: Yes, generally all non-grandfathered health plans are required to cover the costs of immunizations that are considered preventive services by the Patient Center Outcomes Research Institute (PCORI). The Coronavirus Aid, Relief, and Economic Security (CARES) Act requires the COVID-19 vaccination to be covered within 15 business days after the recommendation is made by PCORI for it to be considered a preventive service.
NOTE: This coverage must be provided for both in-network and out-of-network providers during the COVID-19 public health emergency.
A: Yes, employers can require employees to get vaccinated. However, make sure you consider how the following will interact with that approach:
A: No, COVID-19 vaccinations are not required by law, and employers are not required to implement vaccination mandates on their employees.
A: The COVID-19 vaccination is available in phases of prioritized groups. This list will expand with time to include more groups of the population, which you can review periodically here.
Currently, the State of Michigan is permitting vaccinations for the following groups:
A: Currently, vaccinations are available in Ingham County and the LMAS District Health Department. As this list grows, the State of Michigan will publish additional access sites here.
Patients
Superintendent at Meridian Public Schools in Sanford, Craig Carmoney was announced as the Michigan 2021 Superintendent of the Year award winner by the Michigan Association of Superintendents and Administrators.
It’s no surprise that the pandemic made a tremendous impact on healthcare. From cost to accessibility to benefit plan design, all aspects of the model are being reevaluated and analyzed in a new light. By reviewing how businesses and organizations across the nation are adapting their healthcare plans to address new challenges, we have a better understanding of what’s to come in 2021.
Despite reduced healthcare activity during 2020 as COVID-19 delayed both preventive and elective care for the majority of plan participants, according to the 2021 Large Employers’ Health Care Strategy and Plan Design Survey conducted by the Business Group on Health, premiums and out-of-pocket spending are expected to increase by roughly 5.3% in 2021.
Other recent studies suggest that medical cost increases would fall in the 4% to 10% range. As so many unknowns remain, it’s difficult to advise whether our members should anticipate a surge in care being delivered next year as the pandemic wanes (and assume an even larger increase in costs), or if they’ll see a continued reluctance among their employees to seek care into 2021.
With the reduction in elective surgeries and routine care, organizations with self-funded (or self-insured) health plans have generally realized some savings from decreased claims. In comparison, many fully-insured carriers have provided premium relief/refunds to groups on fully-insured health plans. While the savings have certainly helped, groups should be anticipating an increase in premiums and claims cost if/when the COVID-19 pandemic ends.
Have you received a full market analysis?
While there is no one-size-fits-all approach to health insurance, we believe many of our members would benefit from pursuing a full market analysis (both with fully insured and self-funded options) to determine if savings are available. Contact your Employee Benefits Account Executive for more information on how our experts can evaluate whether this is a viable, smart approach to managing costs within your organization.
As businesses and organizations quickly adapted to deliver no-contact services, healthcare institutions also simultaneously shifted to provide ways to virtually administer care and treatment to patients. Telehealth services, previously low-utilized methods of accessing healthcare, were widely embraced by patients as a way to safely see a doctor in 2020. Trends indicate that telemedicine will continue to grow as a welcomed alternative to traditional office visits.
Virtual care for musculoskeletal issues, such as physical therapy for back and joint pain, shows the greatest potential for growth and cost savings. In 2019 and 2020, musculoskeletal issues — such as knee, hip, and back pain severe enough to warrant surgery — was ranked the top condition impacting healthcare costs.
According to a recent study on virtual physical therapy services, patients rated their satisfaction 91.2% and $1,000 was the minimum cost reduction when post-surgery tele-rehabilitation was used.
This year, more than ever before, employers are recognizing the importance of supporting employees’ mental health needs. More than 69% of organizations provide access to online mental health support services, and that number is expected to increase to 88% in 2021. Employers are also addressing cost barriers by reducing out-of-pocket costs for mental health services.
In 2021, 51% of organizations plan to have at least one advanced primary care strategy, like contracting directly with primary care providers. In mid-Michigan, SET SEG members are already taking advantage of this cutting-edge approach and receive efficient, cost-effective healthcare at the SET SEG Family Healthcare Center.
The SET SEG direct primary care model has improved the delivery of preventive services, chronic disease management, and mental health for over 2,000 school employees and their families. Click here to learn more.
In 2021, we expect employees will weigh healthcare benefits more heavily when considering employment opportunities and innovative healthcare offerings will be an integral piece of employee satisfaction. When planning engagement and retention efforts, make sure to consider healthcare as an important component.
Education is listed in the top five most targeted industries for a cyber attack? A cyber breach can wreak havoc on a public school system — compromising students’ private information, diminishing a community’s confidence in the school, and ultimately costing the district and the Pool membership thousands of dollars.
The arrival of the global pandemic has provided cybercriminals with the perfect cover for ramping up email attacks. According to Beazley, SET SEG’s trusted cyber security partner, since the increase in remote work, employees have been more likely to fall for social engineering scams, or email phishing techniques used to manipulate someone into providing confidential information like log-in credentials. SET SEG members have access to a team of nationwide industry experts, robust tools, and local support to help grow and strengthen cyber security within their organization.
Though they’re the largest at-risk group, your employees also provide the most powerful first line of defense to protect against cyber hackers and misuses of sensitive information. Access the SET SEG COVID-19 Resource Center for:
KnowBe4: Security Awareness Training
Phishing continues to be one of the greatest risks for organizations and one where employees pose the greatest vulnerability. SET SEG provides members discounted access to KnowBe4, the world’s largest integrated platform for security awareness training. This training combines a library of information with simulated phishing attacks to teach employees to make smarter security decisions every day.
To access your discount or learn more information, click here.
A cyber breach isn’t always a disaster, but mishandling it is. To ensure an immediate and proficient response to a cyber attack, SET SEG members have access to our partner, Beazley, a global company that utilizes its own in-house breach response team to resolve any cyber incidents with a member district.
For additional resources and a list of cyber security best practices, visit our COVID-19 Resource Center.
SET SEG is proud to serve on a task force organized by Michigan Education Technology Leaders (METL), a workgroup of Michigan Association of Intermediate School Administrators (MAISA), to develop a guide to help Michigan K-12 school districts identify and improve their cybersecurity practices.
MISecure.org lists a variety of resources, from essential cybersecurity practices for K-12 to assessments and guides to implement in your organization. To learn more about this tool created for Michigan schools by Michigan technology experts, visit misecure.org/resources.
As your organization prepares to renew employee health insurance benefits, remember your SET SEG employee benefits expert is here to help simplify the process!
While analyzing market trends helps to manage expectations, there is no one-size-fits-all approach to health insurance. Each of our members is unique and faces a different set of opportunities when it comes to providing quality health insurance plans for employees. SET SEG works to structure the best health insurance coverages to meet the individual needs of our clients while working within their budget.
Identifying and evaluating trends in the market will provide guidance and insight into your health insurance plan. Though the full impact of COVID-19 has yet to be realized, many insurance pools and carriers are anticipating an increase in claims and an increase in healthcare costs.
Many factors contribute to an organization’s health insurance renewal process – from the group’s size and geography to its demographics and the overall health of the employee population.
When faced with an increase, districts should utilize SET SEG’s employee benefits expertise for a comprehensive market analysis. The benefits of this may result in:
Although evaluating your renewal and market options is important, the following examples are additional areas to consider as you move forward in renewing your health insurance plan.
An acceptable MLR of claims paid to premium paid typically ranges between 75% and 85%. Click here for information related to calculating your organization’s MLR.
What’s the best way to speak to the media during a district crisis? Don’t! That’s according to Jason Russell of Secure Education Consultants (SEC) who has decades of experience working with schools during times of crisis. “Think about a time when you saw media coverage of a crisis at a school. Did it reflect positively […]
While challenges like employee turnover, consuming COVID-related demands, and steep workloads seem to grow in frequency and complexity, so do the risks and potential exposures at your district. Now that school has resumed, review our back-to-basics refresher below on the process of reporting a claim. When disaster strikes, there are two things your team must […]
The Gus Kihlstrand Award, created in 2019 and named after a valued, long-tenured member of the SET SEG family, honors the legacy of public-school personnel who exemplify exceptional hard work and commitment to their district. We are proud to announce that Rick Johnson, Maintenance Supervisor at Wexford-Missaukee ISD is the 2020 recipient of the Gus […]
