The Impact of the Opioid Crisis on the Healthcare Industry

The opioid crisis in the United States has reached a fever pitch. More than 115 Americans die every day after overdosing on opioids like prescription pain killers and fentanyl. Opioids are a class of drugs comprised of both illegal drugs (like heroin) and common pain relief drugs prescribed by doctors, such as hydrocodone, morphine, and codeine. These drugs have great capabilities in treating pain, but are extremely addictive.

The CDC has estimated the total cost of prescription opioid misuse alone in the U.S. to be $78.5 billion yearly, including the costs of healthcare, lost productivity, and treatment. Roughly 29% of patients that are prescribed opioids for chronic pain misuse them and eventually develop an opioid use disorder. 5% of those who misuse prescription opioids transition to heroin and there is substantial evidence to show that the majority of heroin use stems from misused prescription drugs.

This goes beyond a simple drug problem, this is a healthcare problem. The number of opioid prescriptions dispensed by doctors reached an all-time peak in 2012, topping at 282 million. This number has since declined to 236 million. Nevertheless, Americans represent about 99.7% of the world’s hydrocodone consumption; hydrocodone being a commonly prescribed opioid.

By extension, the opioid crisis has grown into an issue that is greatly impacting government contractors. Construction workers, in particular, are falling victim to the opioid crisis. In 2015, 92 Wisconsin construction workers died of opioid overdoses. Those deaths cost the state economy $524 million and the epidemic is hitting the construction industry in more states, as it spreads. Construction is one of the most dangerous and physically demanding professions out there and, as a result, construction workers are seeking relief for pain that results from worksite injuries, as well as day-to-day wear and tear on the body.

The reach of the opioid crisis goes well beyond targeting industries in which many government contractors participate. Opioid prescription use and spending has increased for several years among people with large employer coverage. While this number has tapered off following its peak in 2009, the cost of treating opioid addiction among people with large employer coverage has increased to $2.6 billion as of 2016. This trend shows that the cost of treating opioid addiction has risen even though opioid prescription use has fallen.

This comprehensive survey, from April 2018, of the trends of opioid use amongst those under employer coverage yields interesting results. For example, 53% of spending by people with large employer coverage went towards treating opioid addiction and overdose for employees’ children . Until the opioid crisis, as a whole, is resolved it will continue to have major impact on the healthcare industry and employees.

What has the response been to the U.S. Opioid Crisis? How will it impact the healthcare industry? Follow The Boon Blog for a follow-up on this topic and current discussion on all the latest industry news.

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The Boon Group Announces Mr. Taylor Boon as New President

AUSTIN, TX – October 24, 2018

The Boon Group, Inc. is happy to announce Mr. Taylor Boon as the company’s new President.

Mr. Boon has been with The Boon Group for 12 years. Recently, Mr. Boon served the company as Chief Strategy Officer. His responsibilities in that role included overseeing sales, implementation, business development, proposals and pricing, and marketing. Before that, Taylor set the highest standard as a top sales representative for numerous years.  Taylor Boon has dedicated his career in health insurance by working with the government contracting community as well as the adjacent brokerage community.

“Taylor has earned his place as President of The Boon Group, Inc. with hard work and a genuine love for this company” says, CEO Sterling Boon. “His vision for our future coupled with his fantastic work ethic makes him a perfect fit for the job.”

Mr. Boon is excited to ascend to this position during a time of great growth for The Boon Group. Taylor Boon steps into the role of President as The Boon Group moves toward our vision of increased sales and marketing focus, as well as providing an enhanced client experience.

“The government contract and limited medical markets that we service deserve an innovative and cost-conscious provider,” says Mr. Boon. “My immediate goal is to ensure we are that provider.”

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Top Four Headlines in Healthcare

Who says that the healthcare industry is boring?! 2018 has brought about many questions, changes, and updates. We’re going into four of the big ones that everyone should know about.

Read on to learn more!

1. Model Exchange Notice Expiration Date Extension

The Department of Labor (DOL) extended the expiration date on its Model Exchange Notice through May 31, 2020. The Model Notice is used to ensure compliance with the Exchange Notice requirement of the Affordable Care Act (ACA).

The expiration date of the Model Notice is included as an administrative function of the DOL and has nothing to do with how applicable the Notices are. The content of this Model Notice does not change substantively, so the expiration date does not affect an employer’s ability to use it.

It’s advised that employers provide new hires with an exchange notice. However, according to guidance from the DOL, there is no fine or penalty under the ACA for failing to provide the Notice.

2. IRS and DOL Guidance on AHPs

The Department of Labor (DOL) published a final rule in June 2018 that expands the ability of employers to join together to form association health plans (AHPs).

An AHP is covered under ERISA and is a type of group health plan sponsored by a group of employers. We go into deeper detail on the final rule, what AHPs are, and how they work in this blog post.

If you are a small employer that is considering joining an AHP, it is important to understand the compliance obligations associated with these sorts of plans. While it’s true that AHPs do avoid some Affordable Care Act reforms for the small group market, they are still subject to many other legal requirements and regulations.

3. Limits for HSAs and HDHPs Increase for 2019

In May 2018, the Internal Revenue Services (IRS) released Revenue Procedure 2018-30 to announce the new 2019 limits for health savings accounts (HSA) and high deductible health plans (HDHP). These limits detail the maximum HSA contribution, the minimum deductible amount for HDHPs, and the maximum out-of-pocket expense limit for HDHPs. These limits vary based on whether an individual elects self-only or family coverage under an HDHP.

The HSA contribution limit increase will go into effect on January 1, 2019, and the HDHP limits will increase for plan years beginning on or after January 1, 2019.

Learn more about these limits and the specific costs and requirements here.

4. Final Rule Expands Short-term, Limited-duration Insurance

Short-term, limited-duration insurance is designed to fill any temporary gaps in coverage when an individual is transitioning from one plan or coverage to another. Short-term, limited duration insurance is exempt from the definition of individual health coverage and, therefore, not subject to the market reform requirements of the Affordable Care Act.

Originally, in 2016, the definition of short-term, limited-duration insurance was revised so that it would be excluded from the definition of individual health insurance coverage. This led to concerns that limiting the length of short-term, limited-duration insurance would reduce consumer options for affordable coverage. So in 2018, the 2018 final regulations lengthened the maximum period of short-term, limited-duration insurance, with the hope of providing more consumer choices for affordable healthcare.

As it stands, short-term, limited-duration insurance may offer a maximum coverage period of less than 12 months after the original effective date of the contract. This approach takes into account any extensions that may be elected by the policyholder without the issuer’s consent provided that the duration is less than 3 years in total.

Follow the Boon Blog for the latest in industry news and happenings at The Boon Group! You can also keep up with Boon on Facebook, Twitter, and LinkedIn.

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The 3 Cs of Government Contracting

There’s no manual for being a successful and competitive government contractor. But, there are three important principles to remember; we call them “The 3 Cs.”

Compliance. Cost Savings. Competitiveness. 

What are the 3 Cs? How do they help you win contracts? How do you master them?

Read on to learn more!

Compliance

SCA. DBA. ACA. There are a lot of intimidating acronyms floating around out there.

What’s worse? Failure to comply with all those rules, requirements, and regulations can result in withheld contractor funds, liability for the contractor, termination of crucial contracts, and (worst of all!) potentially being debarred from future government contracts. It is even possible for a contractor to be debarred for years!

Compliance can be tricky once you start to factor in health and welfare requirements, fringe obligations, responsibility over sub-contractors, and other concerns.

Boon’s in-house compliance department is here to provide support for any compliance issues that may arise, handling each situation with the utmost discretion and efficiency. Our team is here, adjusting to each new executive order and change in legislation and offering full support in the constantly evolving field of compliance and government contract standards.

Cost Savings

There are two options for hour government contractors can fulfill the fringe obligation:

  1. Paying those fringe dollars to their employees in cash.
  2. Putting those fringe dollars towards bona fide benefits (health and welfare benefits, in particular).

We recommend going with the benefits. Why?

Click here to learn more!

Investing the fringe obligation into health and welfare benefits has been reported to result in higher workforce productivity, less absenteeism, and significantly reducing healthcare expenditure overall.

Still need convincing? Did you know that employers spend two to three dollars on medical related productivity costs for every dollar they spend on pharmacy and healthcare costs? Did you also know that, in 2017, healthcare costs increased in 79 percent of organizations with an average yearly increase of 11 percent?

Employers that don’t offer solid healthcare options are at a huge disadvantage and the costs are just as large.

Competitiveness 

When it comes to providing health and welfare benefits to employees, government contractors have a choice. Maximizing those fringe dollars by developing a benefits plan that meets the unique needs of an employer keeps contractors compliant and allows ample opportunity to save money. The Boon Group can help contractors by offering bona fide benefits, which creates a tax cost savings by reducing additional expenses in the form of payroll burden.

In the arena of government contracting, projects are won or lost on mere dollars and cents. Being able to offer a low bid and quality service through your healthy, productive workforce makes you top competitor material.

Compliance and cost savings are the factors that add up to more competitive bids. You can have the full 3 Cs and start winning even more contracts.

Boon’s Mission

At Boon, our mission is to offer competitive rates and comprehensive care, with affordability and flexibility in mind. A little goes a long way and Boon recognizes that lowering costs on a contract today means bigger savings tomorrow.

Not only is The Boon Group competitive in our industry, but we want to help you be competitive in yours by offering you benefit plans that facilitate the savings that lead to lower contractor bids and more opportunity. At Boon, we understand that benefits are more than just solutions; when it comes to employee care, they are a boon to contractors themselves.

Follow the Boon Blog for the latest in industry news and happenings at The Boon Group! You can also keep up with Boon on FacebookTwitter, and LinkedIn.

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The Top 5 Reasons that Cybercriminals Target the Healthcare Industry

You’d be hard-pressed to find something that is of higher priority than your health and, subsequently, your healthcare. The information provided to your healthcare providers is just about as personal as it gets and it must be fiercely protected. The healthcare industry has seen a significant increase in cyberattacks and cybersecurity is becoming a huge part of the industry conversation. Why do cybercriminals target the healthcare industry and what do they want with your information? Read on to find out more:

1. Healthcare is the Perfect Target

Did you know that medical records are a hot ticket item on the black market? An electronic health record (EHR) goes for anywhere from $50 to thousands of dollars versus the low price of $1 for a stolen social security number. WHOA! Why are medical records so valuable among criminals?

Because your medical records create more opportunities for crime. Cybercriminals get all the personal information they need for garden variety identity theft, while also gaining access to purchasing drugs, creating a fake ID, and opening up claims with your insurer.

Additionally, because healthcare organizations hold the valuable data of thousands of people, cybercriminals can possibly obtain a huge stolen data haul all in one concentrated cyberattack.

2. Insufficient Updates and Awareness

Let’s be honest. Technology often moves way faster than the rest of us and there are several industries that are trailing behind the trends in technology. The healthcare industry is notorious for underspending, when it comes to cybersecurity. The industry often places more of an emphasis on hiring better doctors or having more customer service on hand to help answer your coverage questions. This is a noble and very human pursuit, and we’re not discounting it. But, for many, this emphasis on the human aspects of healthcare means that the technology aspects get neglected. At Boon, we’re continually working to keep healthcare flexible and accessible … just not at the expense of dotting our “I”s and crossing our “T”s when it comes to IT (Information Technology).

3. Bigger Organization, Bigger Target

Healthcare is a giant industry. Not just in impact but in literal numbers. Hospitals and insurers and various other healthcare providers serve thousands of people and all those names and other personally identifiable information are stored in electronic data. The more people in the system, the more chances to steal and exploit that information. Thankfully, standards for the protection of that information are exceptionally high and there is training available on HIPAA compliance. At Boon, for example, every single one of our employees is rigorously trained in HIPAA protocol so that your information is protected at every level.

Another issue created by the sheer size of entities in the healthcare industry is that many operations require multiple shared networks. There are simply too many people and too much information that must be accommodated. Problems happen when, across these networks, there is no consistency in the security standards and processes. With so many devices moving between networks, all it takes is one weak spot and one more (unwanted) device sneaking into a system to create a major problem.

4. Good “Ole Fashioned” Ransomware and Scams

Remember those scam emails where some ousted foreign prince promises you riches beyond your wildest dreams if you will just fork over your bank information? Almost laughable to think about now, right? Well, cybercriminals have gotten smarter and online scams and cyberattacks are becoming more and more difficult to spot. In the healthcare industry, many employees (for all their HIPAA training) have not had much of an education on cybersecurity.

Sometimes, cybercriminals don’t even have to hope for a human error, they’ll go straight for the source. Ransomware goes directly into a healthcare organization’s IT system and prevents company access to valuable files and information. The cybercriminal holds the file hostage and demands a ransom, hence the name. In an industry like healthcare, where access to patient information can be urgent and a matter of life and death, these entities are more likely to pay out and this makes them more attractive targets.

5. Pitfalls of Bringing Your Own Device

The healthcare industry is all about streamlining the process and making healthcare more efficient and affordable. Great, so what’s the issue? There is an increasing trend in healthcare to allow employees to work off of their own personal devices. While this may seem like an appealing way to cut costs on equipment, the reality is that personal devices do not have the same level of security and are subject to all the risks that may come up while that employee is not at work (theft, viruses, you name it).

The Boon Advantage

Boon strives to keep your healthcare close to home. Because your health is important to us, when you’re under our roof, we’re taking all known precautions to keep your information safe. The Boon Group runs a tight operation at our Austin headquarters under the watchful eye of our in-house professional teams. Every single one of our employees has designated devices and systems with the highest standard of protections in place. The personalized experience isn’t limited to our members, it’s keeping our employees guarded too!

Follow the Boon Blog for the latest in industry news and happenings at The Boon Group! You can also keep up with Boon on Facebook, Twitter, and LinkedIn.

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Medicare Part D Notices Due Soon: Coming Up in Compliance

Medicare Part D notice must be provided to employees by October 15, 2018. Here’s everything you need to know.

The Basics

Every year, Medicare Part D requires employers, as group health plan sponsors, to disclose to  employees eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether prescription drug coverage on the employer’s health plan is creditable. It’s required that this this information be disclosed to eligible individuals by October 15, 2018. This marks the beginning of annual enrollment for Medicare Part D.

How do you do it?

Disclosures to CMS must be made on an annual basis or any time that a change occurs that impacts whether the prescription drug coverage is creditable. Employers should confirm whether prescription drug coverage on their health plan is creditable or non-creditable. Medicare Part D disclosure notices should be prepared for sending before October 15, 2018. To streamline the process, it helps to include the Medicare Part D notice in open enrollment packets that are provided to employees prior to October 15, 2018.

What is creditable coverage and who is eligible?

Prescription drug coverage is considered creditable if the actuarial value equals or exceeds the value of standard Medicare Part D prescription drug coverage. Actuarial determination measures whether the expected amount of paid claims under the group health plan’s prescription drug coverage is at least as much as the expected amount of paid claims under the Medicare Part D prescription drug benefit.

This creditable coverage disclosure notice must be provided to employees who are eligible under Medicare Part D  and are covered by, or apply for, prescription drug coverage under the employer’s group health plan. An individual is considered eligible under Medicare Part D if the employee is entitled to Medicare A or enrolled in Medicare Part B, or if the employee lives in the service area of a Medicare Part D Plan.

Dates and Deadlines

At the minimum, the disclosure notice for CMS creditable coverage must be provided at the following times:

  • Prior to the annual coordinated election period for Medicare Part D. This year that’s October 15 thru December 7;
  • Within 60 days following the start date for the plan year;
  • Within 30 days following the termination of the prescription drug plan;
  • Within 30 days following any change in the creditable coverage status of a prescription drug plan;
  • Prior to an individual’s initial enrollment period for Medicare Part D;
  • Prior to the effective date of coverage for any eligible individual that joins the plan;
  • When prescription drug coverage ends or any major change that impacts whether its creditable occurs; or
  • Upon the request of the beneficiary.

How to Deliver

Plan sponsors have three options in how they may provide their creditable coverage disclosure notices.

  • Disclosures notices may be provided separately;
  • Disclosure notices can be provided with other plan participant materials, if certain conditions are met; or
  • Disclosure notices can be sent electronically.

Generally, a single notice may be provided to the covered individual and all of his eligible dependents covered under the same plan. However, if any spouse or eligible dependent lives at a different address than where the participant materials were mailed, a separate notice must be provided.

CMS has indicated that health plan sponsors may use electronic disclosure under the Department of Labor (DOL) regulations. These regulations permit a plan sponsor to provide a creditable coverage disclosure notice electronically to plan participants that can access electronic documents at their place of work, provided that they have access to the sponsor’s electronic information system as part of their regular, daily work duties.

The DOL also requires that the plan sponsor use appropriate and reasonable means to ensure that the information is being properly transmitted and received; that notice is provided to the plan participants on the significance of the document; and that a paper version of the document is available upon request.

Additionally, if a plan sponsor opts to use electronic delivery, the sponsor must inform the plan participant that they are responsible for providing a copy of the electronic document to their eligible dependents covered under the plan.

The Boon Blog is your source for the latest in healthcare industry news and updates. You can keep up with the world of healthcare and all things Boon on our FacebookTwitter, and LinkedIn.

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The Davis-Bacon Act: Everything You Need to Know about DBA Compliance

Compliance tops the list, when it comes to government contractors’ priorities. Construction contracts with the federal government are governed by the Davis-Bacon Act (DBA), so it’s best to brush up on your DBA basics. Read on to learn more about the DBA.

The primary function of the Davis-Bacon Act is to protect local communities from economic upheaval caused by federal government contracts. The DBA requires that workers employed on federal contracts be paid a local prevailing wage rate and fringe benefits. This applies to any contract valued in excess of $2,000 and levels the playing field by preventing outside contractors from coming into an area and underbidding local contractors and unions.

Compliance with the DBA

During the performance of the contract, employees must be paid at least once a week with full wages and the employers’ option of a) fringe benefits or b) cash, in lieu of those benefits. Companies are required to maintain basic records for all workers during the course of their work and for at least three years after. These records must contain:

  • The basic info of each employee (name, address, social security number);
  • Hourly rates of pay, including rates associated with fringe benefits and cash equivalents;
  • Daily/weekly number of hours worked;
  • Deductions made and actual wages paid;
  • Details on the fringe benefit plans and programs and documentation that the program has been communicated in writing to the workers.

By identifying the requirements of the DBA from the outset, it’s easy to set yourself up with strategies for compliance and, by extension, maximizing your competitiveness. Knowing key information, like the wage requirements, early on allows you to capture the highest level in profitability in the bidding process.

One of the critical strategies for successful compliance is putting forth an integrated effort. Bringing in legal, human resources, accounting, and other knowledgeable professionals cuts down on the likelihood of errors and gives you the full force of a capable team to ensure your compliance. At Boon, we’re 100 percent committed to this strategy. Boon offers comprehensive, legal, licensing, compliance, and accounting services, in addition to our friendly customer service and simple enrollment methods.

Annualization Basics

Annualization is the computation strategy used to determine the hourly rate of contribution that is creditable towards a contractor’s prevailing wage obligation on DBA covered projects. The concept of annualization is incredibly important because the amount of credit a contractor may claim can be just as crucial to determining DBA compliance as the particulars of a fringe benefit plan under the DBA.

Annualization was applied in the 1970s in health insurance plans that called for the same rate of contribution for all hours worked by laborers that were employed on both DBA covered projects and other, non-covered endeavors.

In practical application, annualization limits Davis-Bacon credits to an amount equal to the hourly cost of the fringe benefit averaged across all the hours an individual works during a year. This prevents individuals from using Davis-Bacon work as the exclusive source of funding for continuous benefits and compensation for all of an employee’s work.

Penalties Associated with the DBA

The Wage and Hour Division (WHD) of the Department of Labor is responsible for administering and enforcing the DBA. The WHD is notorious for being unwilling to negotiate and quick to drop the legal hammer to punish non-compliant contractors and any subcontractors that contractor is responsible for. Some examples of those penalties include:

  • Paying of back wages and fringe benefits to employees
  • Termination of the contract
  • Personal liability of company officials
  • Prohibition from all government contracts for a three-year period
  • Withholding payments due to the contractor

Developing a benefits plan that is flexible to your needs and keeps you compliant will allow you and your employees to save money, which keeps you competitive! That’s what we do at Boon.

Visit our website to learn more and catch us on Facebook, Twitter, and LinkedIn! Follow the Boon Blog for the latest in industry trends, updates, and news.

 

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