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Companies that have health insurance plans with low deductibles can save money by increasing the deductible, and then use some of the savings to ensure employees aren’t harmed by the change. “If you go from a fairly rich deductible of $250 to $2,500, the insurance carrier will provide you discounts of 25 to 35 percent in premium reductions,” says Dan Wilke, Vice President of Underwriting and Statistical Analysis at Benefitdecisions, Inc. “But if you tell employees their plan changed from a $250 to a $2,500 deductible, that’s a PR nightmare. Instead, you can create a health reimbursement account (HRA) or…
Business operations are subject to a number of internal and external risks, as are ownership interests in businesses. How organizations and their owners address these risks can have a significant impact on the value of businesses and interests therein. An enterprise risk management (ERM) process involves identifying risks relative to an organization’s objectives, assessing them for likelihood and impact, developing a response strategy and monitoring progress. A well-defined ERM process framework can protect and create value for organizations and their owners. Smart Business spoke with John T. Alfonsi, managing director at Cendrowski Corporate Advisors LLC, about how ERM precesses can…
Do these terms sound familiar? ■ Vision ■ Strategy ■ Quality ■ Mission ■ Commitment Come on, you can admit it. Aren’t there times when corporate-speak makes you nauseous? Don’t get me wrong; I live in the corporate world. It’s from there where my bread is buttered and bills are paid. Yet, those running the big businesses often forget what the keys for optimizing success are, thus garnering less than stellar results. The construction of a high-performance team needs to be centered on the how. Having worked intensely with executive teams in the last five years, we take an unconventional…
Count on Bob Lacy to be one of those business leaders who won’t be trying to calculate the hours his employees spend away from their work as they track their brackets or sneak a peek at the March Madness action on their computer, smartphone or tablet. “It’s fun to do and it’s a good thing for the culture,” Lacy says, referring to activities such as bracket wagers, Super Bowl squares and fantasy sports. “It’s just another form of camaraderie. Nobody is forced to participate. Much like our run club or the company employee lunch we do every month or our…
The Institute of Medicine estimated 30 percent of health care spending in 2009 was wasted. Patients get duplicate services, unneeded services or services that haven’t proven to have medical value, which is where medical management can help. Utilization management enables health plan members and network providers to contact a benefits manager to determine whether services are medically necessary before they are rendered, says Dr. Robert Sorrenti, medical director at HealthLink. Years ago, physicians, hospitals and providers strongly opposed utilization management, feeling it intruded upon their ability to make decisions. Today, there is acceptance, along with strong interest from those paying…
It’s a new year and a fresh start. While it could be construed as cliché to make resolutions, sometimes they are exactly what I need to refocus and recharge. By working with multiple organizations over my career, there have been recurring themes that have stayed with me. People want to work toward something together and belong to an organization that they believe in and trust. They want simple, clear directions as well as focus, and everyone always wants to see tangible results. With those thoughts in mind, here is how I approach my new year: Plan — for the day,…
Wellness in the workplace isn’t just implementing a program, it’s about establishing a culture of wellness that promotes healthier lifestyles, says Liz Howe, director of business development at Benefitdecisions, Inc. “It’s not something you try and then decide whether you maintain it. A good program requires a well thought out strategy and budget,” Howe says. Smart Business spoke with Howe about simple steps businesses can take to create a culture of wellness, and how to structure a program that delivers results. What’s involved in creating a culture of wellness? There needs to be champions within the organization, including total buy-in…
Friday, 03 January 2014 10:44

Weighing in on health care reform: Chicago

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The Patient Protection and Affordable Care Act, often called the Affordable Care Act represents some of the most far-reaching government overhaul of the U.S. healthcare system since 1965 when Medicare and Medicaid came into being. It will be phased in over time, but a number of changes have been delayed and won’t be in effect until 2015. The act focuses on increasing the rate of health insurance coverage for American and reducing health care costs. Here’s what some area businesses have on their minds about health care reform as the time nears for the full impact of the ACA: Craig…
Restaurants, hotels and other hospitality companies that have not traditionally offered health insurance benefits to employees are struggling to meet the mandate to provide a plan or face penalties starting in 2015 under the Affordable Care Act (ACA). That need has prompted the insurance industry to respond with cost-effective strategies to help companies with low-wage employees avoid some of the penalties for not providing health insurance coverage. “There are gaps in the regulations that have allowed the insurance industry to create products to address this issue,” said Daniel L. Meracle, a partner at Benefitdecisions, Inc. Smart Business spoke with Meracle…
Emergency room overutilization is a prevailing problem for most employers. For example, looking at HealthLink’s book of business, almost invariably more than 65 percent of ER visits are for non-emergency reasons. They fall into the categories of disease and virus or symptom, such as headaches, gastroenteritis, sinusitis and influenza. “The cost of an average ER visit ranges from $1,300 to $1,500, but the average urgent care or client visit ranges anywhere from $120 to $500,” says Mark Haegele, director of sales and account management at HealthLink.“If you move any of those visits from the ER to other care settings, you’re…
Alco Packaging was a troubled company when Melvin Berlin purchased it in 1988. At the time, he offered his son, Andrew, the chance to be part of the negotiating process and then serve as general counsel and director of marketing at the newly acquired company. Within a year, Andrew became the company’s president. A second-year associate at a Chicago law firm, Andrew had grown up soaking in every bit of knowledge he could from his father about how to succeed in the working world. “I didn’t know he was my mentor at the time, I just knew he was my…
Strategic succession is essential in every work group within an organization, not just CEOs. It touches all aspects of the business: family ownership responsibilities, boards, executive teams, management teams, work groups and even new employee on-boarding. Here are six key areas that make up a complete and successful succession at any level. The transfer of knowledge, skills and abilities The first step in succession is to systematically move competency to the next generation of owners, leaders, managers and workers. This is done through targeted education, new work experiences, exposure to positive and negative results, individual coaching and thoughtful mentoring. Keep…
Problems with the launch of the federal health insurance exchange website are removing it as an option for many employers and employees this year. “How can I advise someone whether to enroll in an employer plan or buy from the exchange when I can’t get on the exchange to make a comparison before the employer’s open enrollment period is up? For the 33 states with a federal hand in operating the exchange, it’s nearly impossible to get any data,” says Paul J. Baranowski, CLU, ChFC, team leader in Account Management at Benefitdecisions, Inc. Smart Business spoke with Baranowski about strategies…
Although some aspects of the Affordable Care Act remain uncertain, the act overall is driving the health care market to figure out ways to control costs and allow employers to continue to offer health plans, says Mark Haegele, director of sales and account management at HealthLink. As a result, managed care companies are increasingly utilizing three tools —reference-based pricing, Domestic Centers of Excellence and narrow networks. “Some of these concepts are still new, so an employer might tackle one thing at a time,” Haegele says. “Maybe you start with narrow networks, and then move into reference-based pricing or Domestic Centers…
On Mondays, many high school, college and professional football teams get together in a dark room and do the same thing: they break down the game film. It’s often not a pleasant session after a team has lost. Their performance is under a microscope. Many plays are paused, replayed again and again in slow motion. Actions are scrutinized at a hyper-level. Because comments like, “I dropped that pass coach, but I want you to know my intention was to catch the ball” or “I did miss three easy tackles, but my plan was to not miss any” would not be…
In ruling that the Defense of Marriage Act (DOMA) was unconstitutional, the U.S. Supreme Court also created challenges for HR personnel in managing benefits related to employees in same-sex marriages. “It’s great that the decision ensures equality and there will no longer be a disparate impact on employees’ spouses,” says Stephanie Martinez, PHR, Director of HR Services at Benefitdecisions, Inc. “But it does present additional challenges for HR.” Smart Business spoke with Martinez about the ruling and its implications in administering employee benefits.What was the Supreme Court ruling? It struck down the DOMA definition of marriage as being between a…
The bulk of the Affordable Care Act (ACA) will be implemented on Jan. 1, 2014. Even though large employers don’t necessarily need to go through the chess game of whether or not to offer insurance — pay or play — a number of new initiatives still come online. The community rating rules, which limit how insurance carriers can classify small employer groups, the individual mandate and $8 billion insurer tax all will shape health care and premiums in the coming year. “You’ve got to keep your eyes open, and continue to see what’s going on,” says Mark Haegele, director of…
When employees are hired or leave a company, the process typically involves HR staff inputting or changing information in a variety of places. “HR is adding them or removing them from payroll, typing in information and sending it to the insurance provider, and using seven to 10 different systems to handle the various tasks,” says Liz Howe, director of Business Development at Benefitdecisions, Inc. Companies are alleviating that burden by automating processes through benefit administration systems. “They recognize the burden that HR people face. And employees are becoming more technologically savvy and want information at their fingertips,” says Howe. Smart…
Approximately 60 percent of the U.S. commercial population is self-funded today, and as health care premiums continue to rise under fully insured plans, self-funding looks to become even more attractive. However, many employers don’t realize how much self-funded health insurance has evolved with strategies and plans designed to help control costs. “Self-funding does not look the same as it did just a few years ago,” says Mark Haegele, director of sales and account management at HealthLink. Smart Business spoke with Haegele about how self-funding fits into health care today. What’s driving the increase in self-funded health insurance? Health insurance premiums…
Many employees are surprised when they learn how much employers are spending on them in addition to their salaries. Studies show that benefits can add 30 to 35 percent on top of the salary being paid. “A total compensation statement is a good way to illustrate this and make employees aware. Most employees will end up appreciating employers more if the information is communicated properly and in an effective manner,” says Dan Wilke, director of underwriting at Benefitdecisions, Inc. Smart Business spoke with Wilke about the value of providing employees with total compensation statements. What’s in a total compensation statement?…
Starting next year, the Affordable Care Act requires individual and small group insurance plans to cover 10 “essential” health benefits. But, these minimum essential benefits go beyond the coverage that many individuals and small businesses purchase today, so plan costs may increase to meet the coverage requirements. “Regardless of your funding type, whether you’re self-funded or not, your plan is required to provide the minimum essential benefits,” says Mark Haegele, director, sales and account management at HealthLink. “But something that wasn’t really contemplated is the difference by states based on price points from different providers.” Smart Business spoke with Haegele…
Businesses with many variable-hour and part-time employees are developing new strategies to address the employer mandate in the Patient Protection and Affordable Care Act (PPACA). Although implementation of the mandate has been delayed until 2015, companies continue to work on ways to avoid penalties when enforcement kicks in, says Daniel Meracle, a partner at Benefitdecisions, Inc. “We’re seeing four variable-hour strategies that employers are using,” Meracle says. “Some may be against the spirit of what Congress intended when they passed PPACA, but they are within the guidelines of the law.” Smart Business spoke with Meracle about these latest strategies for…
When the news came out July 2 that the Affordable Care Act (ACA) employer mandate — the enforcement of the shared responsibility requirement — would be postponed until 2015, you may have felt relief. But for many large-group employers, it’s not so simple. “This is not a reason to put your head back in the sand,” says Mark Haegele, director of sales and account management at HealthLink. “Keep your eyes open. See what’s going on. Run some cost benefit analyses of different scenarios of offering different levels of coverage, or not offering. The bulk of the health care reform law…
Business operations are subject to a number of internal and external risks, as are ownership interests in businesses. How organizations and their owners address these risks can have a significant impact on the value of businesses and interests therein.“An enterprise risk management process involves identifying risks relative to an organization’s objectives, assessing them for likelihood and impact, developing a response strategy and monitoring progress,” says John T. Alfonsi, managing director at Cendrowski Corporate Advisors.A well-defined enterprise management process (ERM) framework can protect and create value for organizations and their owners, he says.Smart Business spoke with Alfonsi about ERM to better…
Health care cost transparency is the ability of patients to learn how much a medical service or treatment costs, preferably before receiving the service or treatment. This is important because treatment and service costs vary widely from doctor to doctor and from facility to facility.“In all my travels, with all the different hospitals I visit — hundreds of them — only one had the general charges of fees and services, like cost per day in the hospital, posted up on the wall. It just doesn’t exist today,” says Mark Haegele, director, sales and account management, at HealthLink.“This system has made…
Sunday, 30 June 2013 20:00

Entrepreneurs change the world

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Recognized as one of the world’s most prestigious business award programs, the Ernst & Young Entrepreneur Of The Year Awards celebrate gravity-defying innovators who build and run great companies. This June, we gather here and in 24 other cities across the U.S. to honor all of our regional finalists and welcome the award recipients from the class of 2013 into our Hall of Fame. Entrepreneurs change the world and make it a better place to work and live. We honor them for their fortitude and resilience, and we celebrate their ability to forge new markets, navigate uncharted territory and fuel…
Health CareFINALISTT. Scott Law saw the trends developing as medical billing continued to get more and more complicated. Thinking there had to be a better way he set out to improve the medical delivery process for medical practices by founding Zotec Partners in 1998 as a solution.Now, insurance submissions and rejection appeals, which in the past had taken upwards of 13 minutes to prepare, can be completed more accurately in seconds using Zotec’s advanced Electronic Billing Center software programming and client-focused support personnel.Zotec has functioned as both a software licensor and a billing service provider, though these two arms originally…
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