Always Review Your Explanation of Benefits (EOB) Statements

 

Article by Sarah Nash
Training Director, CU Insurance Solutions 

Do you understand those EOB (Explanation of Benefits) statements you get from your health insurance carrier?  My health insurance carrier is Anthem.  It’s a lot of information.  There’s the service date, service, reason code, doctor charges, your discounts, due to your doctor (maximum allowed), Anthem paid, and then there’s the column of what you owe.  Most people probably wish they had a secret decoder ring to help understand these statements!

Recently I received an EOB from my health insurance carrier.  I saw two visits, on two different dates, that were for exactly the same thing within the same medical facility (Mercy Northern Light).  One visit was zero cost to me, and one was $44.98.  I thought that was a bit strange, so I called the insurance company.  I spoke to a very helpful person who looked at both claims.  She determined that one was coded strictly preventive, and one was coded Z392 which is preventive but had a post-partum notation.  Huh?  The one and only child I have had was born in 1994, and I don’t think post-partum pertains at this point in time.  She told me to call Mercy Northern Light’s billing department.  I spoke to another very helpful person who determined that because I already paid the bill, she’d have to transfer me to the Central Business Office of Mercy Northern Light to request a code review.  I spoke to the helpful person there who sent my information in for a code review.  Typically, you will get your EOB prior to your bill.  This was not the case; I received the bill first.  Because they offer you a small discount to pay before the due date, I take advantage of this when I am able.

I have not heard back yet whether the code review was changed in my favor or not.  If it is not found to be in my favor, I do still have another option to try and get this remedied.  I can appeal the claim.  There are instructions on your EOB statement on how to file an appeal.

We often trust that these EOB statements are correct, and most of the time they are.  Humans make mistakes, so this is just a reminder to look them over and if you have questions ask your health insurance carrier.  Please also keep in mind that we are experiencing many examples of businesses being short-staffed.  Patience is a virtue.

 

Beneficiary Updates

 

Article by Elizabeth Ingram 
Vice President of People Strategy, CU Insurance Solutions 

There are tasks that get put off because we don’t have time, those that we just don’t want to do, and those that we aren’t sure how to do.  Beneficiary forms may feel like they belong in all 3 categories, but the reality is that they only take a few minutes to complete.  They may not be fun to complete but can make a big difference in the event that something happens to you.

When I say beneficiary form, the first thing that comes to mind is life insurance (for you employers out there, consider reminding your staff to update beneficiary forms at your benefits renewal each year).  However, retirement accounts, investment accounts, college accounts, and HSAs are all accounts that ought to have a beneficiary form on hand.  If you aren’t sure about what you need forms for or how to get them, a good starting point is your employer and if you have one, your financial advisor.

Your employer probably has either the forms or links to access them for any employer-sponsored accounts and insurance (there may be multiple).   Generally, they’ll request a copy of the completed beneficiary forms for their files; you should keep a copy for yourself in a safe place.  Your financial advisor can do the same for any accounts through them.

Beneficiary forms should be updated whenever you have a major life event (marriage, divorce, children, name change, sometimes address changes, etc.).  Updated beneficiary forms make the process of gaining access to your assets in the event of your death significantly easier for your beneficiaries and can help keep your household running at a time of great loss.

Lastly, consider keeping a list of any accounts or insurance in place that is known to your loved ones or advisors, so they can find the information quickly if need be.

As we celebrate Valentine’s Day this month, consider giving the gift of financial security to your loved ones.

Mental Health Healing Through Sharing & Connection with Others

Article by: Heather Baird
Account Manager – Employee Benefits, CU Insurance Solutions

As I began contemplating what to share here, my heart and head battled. What do I have that could make a difference? So, in the words of one of my favorites, Brene Brown, “vulnerability is not weakness; it’s our most accurate measure of courage.” Here it is, a raw and real expression of the realizations and truths I’ve learned about myself and mental health.

Mental health is a topic close to my heart. My mom has battled with her mental health my entire life. She experienced a traumatic event at four and has never worked through that trauma. The first time I became aware of the depth of her pain was in third grade. She was hospitalized. Through that experience, and the turn of events that followed, we never talked about it. I don’t remember one person asking if I was ok or how I was feeling. This pattern has repeated several times throughout my life.

My parents grew up in a generation where you just didn’t talk about these things. There’s a stigma around it. It’s the hidden secret we keep. We don’t want to air our “dirty laundry!” In my own journey, I’m realizing how many of us have believed those lies. What if instead of hiding it, we brought it out into the light? After all, when you bring darkness out into the light, it disappears, and I’m here to tell you from personal experience that’s where you can find true healing!

From conversations with friends, family members, and co-workers who have struggled, or have someone they love who struggles, with mental health, addiction, domestic violence, etc., there’s a common theme of embarrassment and shame. We all have our battles, friend. It doesn’t make yours better or worse, or more or less, than mine. What if in our vulnerability and honesty to both ourselves and the world, we not only find healing for ourselves, but maybe, just maybe, we can help lead others down a path of healing too. “We repeat what we don’t repair.” – Christine Langley-Obaugh

As we’re nearing the two-year mark of this pandemic, many of us are feeling the weariness that has set in. Distancing has kept us safe physically, but what effects has it had on our emotional, mental, and spiritual well-being? As humans, we’re social beings. We need each other.

Recently I heard someone say they’ve become more efficient since going remote. They don’t have the little interruptions throughout each day. This is so true, but what have we lost from those personal interactions? As an employer, I implore you to evaluate ways you can bolster connection amongst your team. Set aside time during the day where employees can connect on a personal level.

To end, I wanted to share an image that’s grasped my spirit and I can’t let go of. On September 11th, like many of you, my husband and I watched several documentaries and specials commemorating the 20th anniversary of that monumental day. During one of the programs, a survivor and the widow of a victim both echoed one thing. After September 11th, there was a sense of unity in our country. We were all Americans. There was no black or white. No red or blue.

I keep seeing the image of people emerging from the rubble that day. My heart feels like we’re in that same place of survival, but instead of emerging hand in hand, we’re alone. We’ve forgotten each other. What if we could put aside our differences and lift up our neighbors, co-workers, and communities in their time of need? The image. Survivors emerging from the debris, dust, dirt, and blood covered, but shoulder to shoulder, holding hands, lifting one another up. Out of the fall, we rise stronger. Be the change you want and need in your life.

 

Budgeting for the New Year

 

Article by Elizabeth Ingram 
Vice President of People Strategy, CU Insurance Solutions 

There are several situations that may warrant readjusting your budget: salary changes, benefit renewals, life changes (marriage, divorce, addition of a child, moves, etc.), and the start of a new (tax) year.  Having a written budget that details your monthly income and expenses is a big help, but there are other considerations to keep in mind.

Tax Considerations

Dependent children, childcare, charitable deductions, and medical expenses can all impact what you pay in taxes.  To get a rough idea of what you’ll owe in taxes for the year, you can visit the IRS Withholdings Estimator (Tax Withholding Estimator | Internal Revenue Service (irs.gov)).  It isn’t available until early in the current tax year and you will need pay statements for yourself (& your spouse if you jointly file), but the 10 minutes you spend can help you maximize your income while minimizing your out-of-pocket expense at tax time.  Go back and rerun the numbers when you have changes (including any bonuses you may receive).

Benefits Renewal

When your benefits renewal occurs, you may see increased costs for your medical, dental, vision, life, or other coverage.  If you have a tight budget or like to plan ahead, keep in mind that what you pay in insurance premiums is often (but not always) pulled from your salary before taxes.  Pre-tax premiums decrease your taxable income, so the decrease (or increase) in your take-home (or net) pay isn’t the same number as the premium cost.  Post-tax premiums are pulled from your salary after taxes and do come out of your take-home pay at the same number as the premium cost.  If you aren’t sure whether your premiums are pre- or post-tax, check with your HR department.

HSAs and 401Ks

Additionally, keep in mind that some benefits such as HSAs and 401ks have maximum contributions which increase each year.  If you intend to maximize your contributions to this sort of benefit, be sure to take into account the increase each January.

Savings

Lastly, try to put some space in your budget to pay yourself (savings are hugely helpful when the unexpected occurs) and for any other priorities you may have for 2022.

The Importance of Health Insurance Transparency in New Positions

Article By: Trevor Pietila
Accounting Specialist

About 10 years ago, I gave my notice to a former employer, and during my exit interview, was given some great advice from the head of HR: “Make sure you don’t just leave for ‘more money,’ be sure you are looking at the total compensation package.” Being 22, I thought I had done enough due diligence: salary, retirement, short-term disability, vacation time. Everything looked great, until about 3 months in… I had to pick my health insurance plan. At this point, I truly understood what my former HR manager meant by “the total compensation package.” I was unfortunately met with a far less comprehensive plan with a higher deductible. At the time, being single with no dependents, it wasn’t really an issue, but looking at the employee+ children, and the family plan pricing, I realized that if my situation had been different, I would have unknowingly taken a pay cut, based on my previous employer’s much more attractive health insurance plan.

Fast forward 8 years, I interviewed for my current job at CU Insurance Solutions; I now have a dependent on my health insurance plan that I cover. Compensation comes up. The salary was important to me; I knew the range. They, fortunately, have employer-paid health insurance (to this day, I am very thankful), but I also wanted to ask about the health insurance rates for covering a dependent. I began my new role with CU Insurance Solutions.  After I was hired, our VP of People Strategy, Elizabeth Ingram said one of the things that stuck out to her about me at the interview as I had asked about the insurance plan and rates upfront, and that wasn’t very common.

I discovered in a recent survey from Bank Rate that apparently 55% of people in the workforce are actively looking for a new job! 55% is a large number; with the pandemic, most employees are citing more flexibility, the ability to work from home, and higher salaries. You can look at a job description, and see qualifications, experience needed, the salary range offered, employer-paid insurance for the employee, 401k matches, etc. But for some prospective employees, the health insurance coverage and pricing is one of the most important parts of the compensation package!

Over the years, I’ve unfortunately seen several people take a higher salary only to realize once they sign up for the health insurance, they actually took a pay cut. I’ve had friends and family members go through multiple interviews at companies only to decline the job because they were finally able to see what health insurance was offered.

Why is it not common practice to ask for insurance rates upfront, or have them displayed to prospective applicants? Especially if you are an employer that helps cover the costs of dependents or family plans! Shout it from the rooftop; it’s a big deal!

If you are someone looking for a job, how much more willing would you be to apply for a position that was just as transparent about health insurance plans/pricing/rates as they were about the salary and expectation of the job?

 

Maine -The Way Life Should Be (and a great consumer information resource too!)

Article By: Bev MacMillan, AAI
Senior Vice President of Insurance & Compliance, CU Insurance Solutions 

I’m a real Mainer and proud of it…born here, love the lifestyle and everything that this beautiful state has to offer!  I’m thankful every day that I live in a state that is unique in so many ways and shines when it comes to a commitment to consumer protection.

Speaking of which, if you’re not already aware of the Maine.gov website (www.maine.gov) and the consumer information available to you, I’d like to take this opportunity to make sure you know that your state has a wealth of information that can help you, the consumer.  Many other states offer similar information on their state websites (i.e. www.nh.gov, www.mass.gov, www.vermont.gov, etc.).

Being a seasoned insurance and compliance professional, I’d like to focus on what resources are available as they relate to the insurance industry but encourage you to explore Maine.gov for other categories of information for which you may be seeking trustworthy guidance.

From the home page of Maine.gov, search “Insurance” in the field located at the middle top of the screen.  This will bring you to a myriad of different types of insurance products and consumer guides to help you better understand the policies you purchase: Personal and Business Auto, Flood, Homeowners, Workers Compensation, Health Insurance, Life, Annuities, and Medicare Supplements to name a few.  In addition, should the need arise, and you have a complaint involving an insurance matter that you are unable to resolve through your carrier or agent, this site can provide you with guidance on navigating how to proceed.

An educated consumer is a happy consumer!  Take advantage of everything our great State of Maine has to offer and be familiar with Maine.gov

3 Ways to Shift Your Mindset & Embrace Change

 

Article By: Sharon Little
Office Manager, CU Insurance Solutions

Change comes in many forms and can be especially difficult if you had your heart set on something that didn’t turn out the way you had hoped. However, if we look back at the changes we’ve experienced in the past, we often find that things worked out okay or often better than what we thought at the time. As the saying goes, “The only thing constant, is change,” so if we must change, we may as well embrace it and make it work for us instead of against us. Sometimes managing our mindset and positivity about change can come from a seemingly unrelated or unlikely place, like changing up your daily routine. The following are 3 tips to consider that have helped me to shift my mindset to embrace change; I hope these may be helpful to you as well.

 

Make a Little Time to Exercise
If possible, schedule a little time during the day for a brief workout, even if it’s 5 minutes. Working out in the morning has helped me to feel more awake and super-charge at the beginning of my workday. There are some great free apps available to help get your blood pumping (such as Daily Workouts Fitness Trainer iOS | Andriod ). You can alternate walking, running, weights and stretching throughout the week to keep your body guessing and use all your muscles.  If your job changed to work from home, you’ve likely found that your step counter is more idle, so doing a little extra and using that prior drive time may just be enough to stave off gaining a little weight, especially through the colder seasons. 

 

Meal Prep & Meditation
If your schedule is busier now than it used to be, you could consider meal prep. Prepping your lunch and dinner meals on Sunday night can help with healthier options for the week to come and free up some of your daily lunch hour for a little meditation. I know it may sound silly, but meditating is a great way to help improve your frame of mind and calmness throughout the day. There are many free meditations of various lengths online (such as Calm and Headspace).  There is no wrong way to meditate, even if thoughts come in… just let them back out and move on without judgment. Did you know that when one person meditates, it changes the vibe of those around them by 20%? I love the idea that meditating can help make life a bit easier for my loved ones, co-workers and even the community. 

 

Eliminate Clutter
If you work at home and look at the same four walls every day you can tend to get pretty frustrated at unfinished projects, piles of household papers and too much stuff.  I’m guilty there and have been doing a lot of cleaning out over the last few months.  Since I’ve cleaned out, I find I have more room to think, focus and enjoy the good things that life holds.  The idea to change was much harder than the actual change in this case.  Try it and see what it can do for you; maybe your space just needs a refresh to feel pleasing to you. 

Easing into change takes many forms, and it turns out that those forms have beneficial outcomes.  Change is good, change is beneficial, and change is necessary to get us to recognize what we have.  Life is good if you take responsibility for it and keep up on your home and body maintenance.  Change helps you be more resilient to new situations in the future. I think it’s worth it to embrace where you are, declutter your home, meditate with your family and go for a walk every day. Embrace what change comes to you and act on what you discover to fuel your future growth and wellbeing. 

 

Financial Wellness Tips for Medical Expenses

 

 

Article by Amber Hollo
Accounting Manager, CU Insurance Solutions 

Medical expenses can be extensive and aren’t always easily accessible.  Below are several suggestions to help you use your money wisely and still get the care you need.  Please note, that you may be able to get additional savings through programs with your health insurer or prescription company.

Ways to Save on Medical Expenses:

  • Contribute the maximum allowable to your HSA if you have an HSA compatible plan.
    Remember these are pre-tax dollars! More and more items are becoming HSA eligible, including many supplements, OTC medications and supplies.

 

  • Shop lab pricing.
    • I found Ulta Lab to be quite a savings for bloodwork
    • compairmaine.org is a great tool for comparing lab and medical procedure costs in Maine
    • maine.gov/bhr/oeh  provides a list of independent lab locations in Maine. A search returns the provider name, site name, address, and county for each option.

 

  • Apply for Care Credit.
    They offer multiple years of interest-free payments. I’ll give you my personal example – Lasik eye surgery 2 years ago after a discount for having Anthem insurance: $5000.00.  I did not have enough in my HSA to cover the procedure.  So, I opened a Care credit account. I put the entire amount on the card and set up payments for 24 months interest-free. I linked that payment to my HSA.  I was able to pay the whole amount using HSA pre-tax dollars. As a result, I paid just $5000.00.  Say I pay about 20% in taxes. If I had used post-tax dollars from savings/checking, it would really have cost me $6000.00.  If I had used a credit card at 25% interest….it would have cost even more.

 

  • Have a savings account for medical expenses.
    Ideally, this should have enough to cover a yearly out-of-pocket maximum after HSA total contributions. If you are someone who uses all your HSA yearly, having a savings account for the remainder of your yearly out-of-pocket maximum would mean
    no putting medical expenses on your credit card.

 

  • Work with medical practices in establishing payment plans.
    If you call their accounting department, many providers can allow/set up a payment plan with you. It’s not usually something advertised, but many do allow it. I’ve done it myself through Firstlight/Mercy and this allows for interest-free payments, either through personal funds or HSA funds as they become available.

 

  • Submit your reimbursements for wellness screenings.
    If you have voluntary benefits, they often provide an annual benefit for certain wellness screenings.

Obviously, not everyone has the same circumstances, but the point is, put in a little effort and make your dollars, not you, work harder. I hope you find this helpful!

 

Should You Offer a DCFSA (Dependent Care Flexible Savings Account) to your Employees?

 

Article by: Elizabeth Ingram 
Vice President of People Strategy, CU Insurance Solutions 

A DCFSA is an account that allows employees to pay for childcare (under age 13) expenses pretax.  As an employee, although they’ll need to provide invoices or proof of expenses to the DCFSA provider, there are tax savings.  Reimbursements cannot be made until after services have been performed, so if the daycare requires payments at the beginning of the week the employee cannot get reimbursed until the end of that week.  However, it’s a nice way to keep some extra funds in the employee’s pocket throughout the year, but that doesn’t mean it makes fiscal sense for the employer.

Generally, DCFSAs are administered by third parties (your broker can help you with this if you don’t have a relationship yet) which means there is a cost associated with this benefit.  An annual cost is typical, and some third parties have other fees as well.  But there are 2 easy ways to determine whether those fees are worth it.

  • If you aren’t worried about the expense ($500-$1000/year for a small business) and it makes your employees happy, it may pay for itself in happy, productive employees.
  • If you want a hard number comparison, gather your annual costs and take a few minutes to play around in your payroll system.  Payroll systems typically allow you to run what I call dummy paychecks through a paycheck calculator.  Run 2 calculations on each employee enrolled in the DCFSA; one with their current withdrawal and one without a DCFSA withdrawal.  Now, calculate the difference in the employer taxes and multiply it by the number of pay periods per year.  If the savings in employer taxes are more than the cost of your DCFSA administration, it’s saving you money.  Remember this may change from year to year.

Some benefits you offer may benefit the whole team, while others don’t.  But a willingness to consider employee-requested benefits shows you care.

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Consumerism – What does that actually mean?

Article by: Pam Huntington
Employee Benefits Specialist – CU Insurance Solutions 

In relation to healthcare, it’s defined as, “transforming an employer’s health benefit plan into one that puts economic purchasing power—and decision-making—in the hands of participants”*. It’s about supplying the information and decision support tools you need, along with financial incentives, rewards, and other benefits that encourage personal involvement in altering health and healthcare purchasing behaviors.”* It’s safe to say we’re good consumers when we’re shopping for our next vehicle or the items we put in our carts at the grocery store but are we good consumers when it comes to shopping for our medical procedures and prescriptions? We often go to the medical facility recommended by our providers and grab our prescriptions from the most convenient pharmacy, but is this the most cost-effective?  With the increase in health insurance costs and high deductible health plans, now more than ever, we need to shift our mindset around healthcare and begin to take control of how and where we spend our hard-earned dollars.

 

Check your Carrier portals  Register for your carriers’ portals. Not only will you have access to your electronic ID cards, plan, and claim information, but you may also be eligible for additional programs and add-ons. Many carriers offer wellness initiatives with rewards and discounts.

 

Comparing Bills with Explanation of Benefits  It’s important to take the time to compare your provider invoices with the explanation of benefits (EOB) you receive from your insurance carrier.  The EOB will show your financial responsibility, which should match the bill you receive from the provider.  Don’t just pay without completing this key step.  Overpayments can take 60 days or more to be refunded, and if you underpay you may be subject to an unexpected charge down the road.

 

Comparison Tools  Most insurance carriers provide cost comparison tools to help you “shop” diagnostic procedures and lab testing.  Being a savvy consumer can save you a significant amount of money in your out-of-pocket health insurance expenses. See the below examples from Harvard Pilgrim.  Same procedures, but the cost difference can be substantial.  Many of these programs offer additional reward incentives for choosing lower-cost facilities. Taking a few minutes to shop for your next procedure or lab test can save you money and put extra cash back in your wallet.

 

 

Prescription Resources  The convenience of picking up our prescriptions at the same time we grab our groceries seems like a no-brainer, but this might not be the most cost-effective option.  Did you know you can “shop” your prescriptions? GoodRx offers a website and mobile app, specifically designed for this purpose. Simply by entering your prescription and zip code information they’ll show you the cost of your prescription at all pharmacies in your area. PLEASE NOTE if you utilize a coupon through GoodRx this will not count towards the deductible/cost-sharing of your medical plan.  This is something to consider before using one.

 

Another tool is to research your drug manufacturers’ websites. Some manufacturers offer coupons as well as financial support. There is a process to apply for financial support, but it can be a momentous financial relief and provide direct assistance towards the deducible/cost-sharing on your medical plan.  I’ve personally witnessed the benefits of both these options. I recently had a member whose prescription cost was over $1,000/month through their medical plan and with a coupon, the cost was reduced to roughly $100/month.  This is an instance where utilizing a coupon made financial sense.

 

Essentially you’ve purchased your health insurance. It can be a substantial investment when you consider insurance premiums in addition to the deductible and out-of-pocket expenses. Just like a new vehicle, don’t you want to get the most bang for your buck? Knowledge is power. By just taking a little time you can protect and stretch your dollar.

 

As always, your Employee Benefits Team is here to assist and answer your questions.

 

* What Is Consumerism in Healthcare? It’s Lasting Impact On The Industry (nrchealth.com)

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