2009 Columbia Health Care Guide

Health & Wellness 2009 A N E M P LO Y ER'S G U I D E

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Who Do You Trust?

Your best friend … your folks … your doctor? Trust is earned, and for more than 60 years we’ve worked hard to earn your trust.

That’s why we give you 24-7 access to your private personal health record. We created a secure online tool where you can check eligibility, get benefits information, view claims status — even take a personal health assessment. It’s all available in the members’ areas on our Web sites. For general questions there’s even a Health Library and a section on Drug Interactions. We do more than insure your health — we help you manage it. Need information you can trust?

SM

Choose Blue .

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina Independent licensees of the Blue Cross and Blue Shield Association

SouthCarolinaBlues.com BlueChoiceSC.com

Who Needs Choices?

Beach or mountains … drive or fly … golf or tennis? While choices are o en personal preference, it’s nice to have options.

But options without information may lead to poor decisions. So along with offering you a variety of plans, we give you unlimited access to pertinent information — like our Plan Comparison Tool. It’s just what it sounds like, and it’s available on our Web sites in the members’ areas. You can also select a doctor or hospital from the largest provider network in the state. Whether you’re across town or across the country, we’re available online with the information you need to make informed decisions about your benefits, health dollars and overall health. When it’s time to choose a health plan …

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Choose Blue .

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina Independent licensees of the Blue Cross and Blue Shield Association

SouthCarolinaBlues.com BlueChoiceSC.com

Welcome from our sponsors From the desk of: David Pankau President, Chief Operating Officer BlueCross BlueShield of South Carolina

Publisher - Bob Bouyea bbouyea@scbiznews.com • 803.401.1094, ext. 200 Business Assistant - Erin Williams ewilliams@scbiznews.com • 843.849.3102

Dear Colleagues:

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Like you, I have had my apprehensions over the past year regarding the global business climate and financial situation. As businessmen and women, every choice we make, every issue we decide bears great importance. That is our job. Judge the facts — make the wise choices.

As a homegrown company, I am pleased to say that BlueCross BlueShield of South Carolina chose to sponsor this year’s Health & Wellness Guide. A great tool for all businesses in the Midlands, this accessible, easy-to-use guide helps you make informed business decisions involving health care. I’m confident the Health & Wellness Guide has information to help your business decisions.

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Spirit Telecom is proud to be a sponsor of this year’s Health & Wellness Guide.

As a South Carolina company, we value the role communication plays in providing us with the information we need to make intelligent decisions, especially when it comes to health care.

We’ve been helping people in the Palmetto State communicate since the late 19th century and currently provide voice, data, Internet and videoconferencing solutions to the state’s businesses and industries.

Our commitment to the Health & Wellness Guide continues our tradition of supporting efforts to bring quality health care to everyone in the state.

We hope you enjoy the publication.

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Contents South Carolina’s Media Engine for Economic Growth CEO and Group Publisher - Grady Johnson gjohnson@scbiznews.com • 843.849.3103

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Health insurance: Get the most for your money

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From the top down Companies find success with wellness programs, but there has to be buy-in at the top

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Keeping health care costs down

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COBRA subsidy reduces insurance premium for laid-off workers But eligibility rules disqualify some seeking coverage

Vice President of Sales - Steve Fields sfields@scbiznews.com • 843.849.3110

10 Consumers should ask questions about quality of care 12 Medical bank accounts growing in popularity

LISTS 14 Top 25 Health Insurance Companies 15 Hospitals 15 Employee Benefit Brokers 16 Urgent Care Centers

Health & Wellness 2009: An employer’s guide

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Health & Wellness 2009

Health insurance: Get the most for your money Staff Report

I

t has happened to everyone: You get a notice from the insurance company that it hasn’t paid for a major medical expense you were certain was covered in your plan.

When you review the fine print, sure enough, the insurance company is right, and you’re left footing the bill in a situation that could have been prevented.

Get smart Being a smart consumer starts with educating yourself about your current health insurance plan. By taking a little time to know the ins and outs, you not only save money, you can also use the plan to your best advantage — and ultimately improve your family’s health.

Lynne Bernthal, president of Benefit Concepts Inc., said, “If someone knows what their benefits are, when it comes time to use them, they will be smarter and get more value from it.”

Many people assume all health care plans are basically the same, but that is not the case, said Terry Peace, vice president of group and individual operations for BlueCross BlueShield of South Carolina. For example, it is not safe to assume that

because your last company covered pregnancy, your new plan will, too.

Not only do plans vary from employer to employer, but individual plans are often significantly different from group plans.

“Whether consumers choose their health care plan or their employer makes group coverage available to them, they need to take time to think about their health care needs and understand the benefits, exclusions and requirements of their plans,” Peace said.

And it is important to get to know your policy now, before your child breaks a bone or your spouse throws out his or her back.

“Often, people don’t take time to understand their benefits before an acute or emergency health care episode occurs,” Peace said. Your insurance company can answer your questions, but you can also get help from your company’s human resources benefits specialist. If you have an individual policy, consult with your agent.

What do I need to know?

A good place to start, Bernthal said, is with the “Explanation of Benefits.” It can be tricky to read,

Types of health plans Short-term medical insurance is a lowcost plan that expires after six months, at which time you must reapply for new coverage.

Managed-care plans or HMOs provide full coverage for pre-existing medical conditions but limit access to medical care through primary physician gatekeepers or participating provider networks.

Medical savings accounts are money market funds or investment accounts to which tax-deductible deposits may be made to pay out-of-pocket medical expenses.

Medical expense reimbursement plans are tax-deductible plans used by

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businesses to provide tax-free health care benefits to employees.

COBRA plans allow continuation of group insurance after an employee leaves an employer.

State mandate plans are sanctioned and made available to anyone without access to other types of medical insurance.

Group medical insurance plans are guaranteed-issue to businesses with one or more employees on a bona fide payroll.

PPO discount plans are not insurance plans but rather are preferred provider plans that offer access to network discounts with contracted providers.

Source: Medsave.com

Health & Wellness 2009: An employer’s guide

but most insurance companies offer tools on their Web sites to help consumers understand some of the more confusing parts. If nothing else, Bernthal recommends starting at the list of things not covered, because that tends to be shorter than the list of what the company covers.

Peace said other basics include understanding your share of the costs, such as deductibles, copayments and coinsurance. Bernthal recommended determining the “catastrophic expense” — the deductible added to your maximum out-of-pocket costs.

“That’s your worst-case scenario,” she said, and it’s reassuring to know you won’t be out tens of thousands of dollars, no matter what. If it does add up to a figure that’s more than you think you can handle, it might be time to find a new health plan or adjust your deductible or co-insurance accordingly.

Peace also recommended paying special attention to the definitions listed in the policy.

She suggested looking for requirements for preauthorization, studying each exclusion and limitation and reading through your appeal rights.

Getting the most out of your health insurance plan • Use in-network providers.

• Use mail-order prescriptions, if available.

• Use a nurse’s line, if available.

• Ask that prescriptions be filled with generic drugs.

• Go to the emergency room only in a true emergency. Try the doctor’s office or an urgent care center first.

• Take advantage of allied program discounts, which can include dental care, vision care, weight management and smoking cessation programs and discounts on infertility procedures.

• Pay attention to timing. Once deductibles are met, try to schedule procedures and visits before the year is out.

If you’re unsure about anything, make notes as you’re reading the policy and call the company to get a clear understanding.

Peace also recommends that when you receive a bill from a medical provider, be sure to check the amount against what your Explanation of Benefits says you should owe for that service. Or call your insurance company to report what you are being billed, and ask whether that is what you owe.

If the amount you owe differs from what the provider is billing, return the bill with a check for the amount your health plan says you should pay. You should include a note with the payment saying the billing office should contact your health plan for an explanation of why you are paying a different amount.

When coverage is denied What happens if, despite your thorough review of the policy, you disagree with your company’s denial of coverage of a particular expense?

The best cure is always an ounce of prevention, and Bernthal suggests getting a predetermination of benefits, if a procedure is at all questionable. A provider can request such a document from the insurance company showing whether the item will be covered and how.

If there’s no predetermination of benefits to fall back on, it’s time to appeal. A broker can handle that process, or you can look for the plan’s explanation of the appeals process and call the phone number listed.

“Understand your rights under the appeals process and follow the process carefully, if payment for a service is denied or reduced based on your understanding of the benefits of your plan,” Peace said.

Even if you have a disagreement, by having a thorough understanding of your plan, you are arming yourself for the best possible outcome. cr br

Health & Wellness 2009

From the top down Companies find success with wellness programs, but there has to be buy-in at the top

By Allison Cooke Oliverius, aoliverius@scbiznews.com

C

onsultants will tell you two main things about workplace wellness programs.

First, they will outline the benefits, which include improved health of employees, lower expenses related to employee health care, happier employees and increased productivity.

They will also tell you that a wellness program won’t get off the ground unless the directive filters from the top down.

“It’s like with any major program with any company: If the top Colonial Life employees are encouraged to participate in walking and running programs as person doesn’t buy in, it doesn’t well as utilize the 6,200-square-foot on-site wellness center. (Photos provided) happen,” said Sallie Bottorff, a coowner and partner at Human Re- which includes a full range of exer- ing employees more control.

The Internet offers many usesource Dynamics. cise equipment and offers 22 group Colonial Life Insurance Co. fitness classes a week. Employees are ful tools to help create a program. is an example. In the 1970s, then- encouraged to eat a healthy meal or Other companies will design and chairman Gayle O. Averyt was an snack in the company cafeteria and administer a program for you for avid health enthusiast with a vision to generally incorporate wellness a fee.

Beginning a wellness program for improving his employees’ qual- into the corporate culture. ity of life. He’d heard that a handful But Jada Hubbard, who manag- can be as simple as educating your of big companies, including Gen- es Wellpower, said it’s not all about employees on the advantages, then eral Electric Co. and Coors Brew- physical health. Emotional health recruiting a committee of employing Co., had wellness programs in is important as well, and Hubbard ees to help develop a wide variety place, so went to visit them. works to create programs aimed at of programs to appeal to different When he rehelping employees types of employees.

Typical programs begin with turned, he put the find balance in their A wellness program is lives. A recent semi- a health assessment and, based on wheels in motion and designed to developed what is nar on single par- the wants and needs of the employnow Wellpower, the enting and was well- ees, could then include programs keep employees for weight loss or smoking cessaColumbia region’s received, she said. healthy while first and longestColonial Life’s tion. Employees might be invited running corporate wellness program, to walk during their lunch hour combating rising wellness program. It’s which has been in or sign up to run a race together. insurance costs. a voluntary program effect since 1983, has Monthly newsletters filled with available to all Colohad an impact on the health tips and nutritious recipes nial Life employees and it currently bottom line. For the past several could be sent to employees. Lunchhas a participation rate of more years, the company’s insurance pre- and-learn workshops might be orthan 40%. miums have been 3%-7.5% less than ganized, featuring local health and “Over time, it has become one the industry average. And company wellness professionals.

Some companies offer incenof those key cornerstones in how we officials know that the “big picture” think and what we do … in relation approach to wellness has become a tives to keep employees motivated, to our employees,” said Don Mont- useful tool in attracting and main- but building a support system among employees is more crucial gomery, assistant vice president and taining quality employees. to success. director of human resources at CoHow to begin Bottorff cautions that compalonial Life.

Companies vary in the design nies should be sure to be aware of Through Wellpower, employees can participate in fitness activities, of their wellness programs. Some the legalities involved in setting up workshops and seminars, health human resources departments take a wellness program. For example, screenings, and more. For $16.50 responsibility for overseeing the you must be in compliance with per month, employees can use the wellness program; other companies the Americans with Disabilities Act 6,200-square-foot wellness center, establish wellness committees, giv- and the Health Insurance Portabil-

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Health & Wellness 2009: An employer’s guide

ity and Accountability Act.

Benefits you can count Kaiser Health News reports that under current law, employers and insurers may give discounts of up to 20% on premiums, copayments or deductibles to workers who take part in wellness programs. Participation is enough to qualify under some programs, and others have specific goals employees must meet — reducing blood pressure or cholesterol for weight loss, for example.

At Colonial Life, employees qualify for a $4.50 reduction per pay period on medical benefits if they participate in voluntary health screenings. The reward is tangible, but as corporate communications and media relations director Jeannie Reynolds said, the impact is much broader.

Through wellness programs and health screenings, employees are able to detect diseases early, when they are most treatable — something that’s important “not only for our health and life, but also for controlling health care costs,” she said. cr br

Reach Allison Cooke Oliverius at 843-849-3149.

Get regular screenings Simply having an annual physical exam can lead to better health and lower health care costs. The frequency at which you have an exam depends on your age and family history.

Generally: • Have at least one physical while in your 20s.

• Have a physical every one to two years in your 30s.

• Begin annual physicals at age 40.

• Based on family history and physical health, a regular exam might be needed more frequently.

• Begin colon cancer screenings at age 50; begin at age 40 if you have a family history of colon cancer.

Health & Wellness 2009

Keeping health care costs down Staff Report

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roviding insurance is good for business. Employees who are insured are protected against high medical expenses and are more likely to receive the health care they need.

Insurance might be good for business, but it’s not so good for the bottom line. With the costs of health care rising, businesses are looking for ways to cut expenses on premiums rather than eliminating insurance altogether.

According to the Small Business Administration, more than 81% of businesses with 50 or more employees have adopted some form of wellness program. The most popular types include smoking cessation, stress management, weight loss and back care.

A recent National Worksite Health Promotion survey found that wellness programs save money, primarily through reduced turnover and absenteeism. Some insurance companies offer lower rates to companies participating in wellness programs.

The value of Delta Dental makes everyone smile.

The Wellness Councils of America provides examples of direct cost savings: • Johnson and Johnson reduced its absenteeism rate by 15% within two years of introducing its wellness program. The company also cut its hospital costs by 34% after three years.

• Honeywell Inc. offered a $200 cash incentive based on participation in certain program areas.

Program coordinators estimated a 70% to 150% return on investment from reduced medical claims alone.

Another way to keep costs down is to hunt for the best premiums.

“We just about have to shop around every year,” said Michael Taylor, executive vice president of Diversified Computer Solutions.

“I can’t remember a year when health care costs didn’t increase 10%. Sometimes we stay with the same company, but many times we bounce between two or three until we can find the best deal.”

For a small company like Tay-

When it comes to dental benefits, nobody protects you like Delta Dental

Tips for health insurance shopping • • • •

Shop carefully.

Be careful about changing policies.

Beware of pushy sales practices.

Look out for pre-existing conditions and other exclusions.

• Read the limitation and exclusion provisions carefully.

• Know whether and when a company can refuse to renew your policy.

• Fill out your application completely and accurately.

Source: S.C. Department of Insurance lor’s, which currently employs about 27 workers, hiring a full-time human resources person who would typically oversee the selection of a new insurance carrier, is not in the budget. So Taylor spends a great deal of his time talking to various companies and homing in on plans that are suitable and affordable.

Shopping around can be made easier with the help of an agent. The biggest advantage to using agents is that they can sort through all the

There are a lot of reasons why Delta Dental is the leader in oral health.

We offer a wide choice of innovative products to fit your company’s needs.

Access to care is easy with a provider network that includes three out of four dentists in the U.S. And, our innovative cost - saving measures saved our groups nearly $4 billion last year alone. So, if you’re looking for the best in dental benefits, look to Delta Dental.

We’ve got you covered.

Delta Dental Insuring South Carolina Smiles 200 Center Point Circle, Suite 150 Columbia, SC 29210 803.731.2495 or 800.529.3268 www.deltadentalsc.com

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Health & Wellness 2009: An employer’s guide

We improve oral health.

That’s the bottom line.

different coverage options for you.

They also can be an advocate between you and the insurance company if questions or issues arise and can keep you informed of products that are coming down the pike.

As a general agency, the David M. Gilston Insurance Agency Inc. does not sell insurance products; instead, it provides free training and support services to independent agents. Its employees are the “army behind the agents,” armed with intricate knowledge of insurance products and compliance issues.

Faith Reynolds, vice president of operations for the Gilston sales office in Columbia, added that the agents the company serves constantly work to contradict the supposition that quotes provided by insurance agents are much higher than those provided by carriers.

“Agents are commission-only, and it is in their best interest to find out what you need and design a policy that is lower-priced and one that is geared toward you,” she said. cr br

Big networks produce big smiles

Health & Wellness 2009

COBRA subsidy reduces insurance premium for laid-off workers But eligibility rules disqualify some seeking coverage

By Ashley Fletcher Frampton, aframpton@scbiznews.com

T

he future of health insurance access and affordability is up in the air as Congress debates reform. But in the meantime, some laid-off workers can get a break on premiums through a temporary federal subsidy.

The $787 billion stimulus act that Congress passed in February contained a provision that allows some jobless workers to stay on their former employer’s group insurance plan for nine months at 35% of the premium cost.

The provision is referred to as the “COBRA subsidy” because the federal government ultimately pays the remaining 65%, even though employers must front the cost.

COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act of 1986, is a federal program that allows all employees to remain on group insurance plans for a period after leaving a company.

Typically, continued employer coverage through COBRA requires that unemployed workers pay 100% of the premium costs — the portion they paid while working plus the portion their employers previously paid for them. That can be prohibitively expensive for people whose incomes have been slashed.

The new subsidy is available to workers who have been laid off since September 2008, and it remains an option for those laid off through the end of 2009.

Few takers The law took effect in February, and it set a deadline of April 18 for employers to disseminate information about the subsidy to former employees who might be eligible.

That left many businesses scrambling to notify all workers whom they had laid off in the preceding six months.

Particularly hard-hit were small to medium-sized businesses with-

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out an on-staff human resources expert or an insurance consultant or third-party administrator to handle the details.

Employees notified by the deadline had 60 days to re-join their company’s plan with the subsidy.

But some insurance officials report that — after companies rushed to comply with notification rules — relatively few people signed up.

“We sent out over 500 letters and had 17 people take it,” said Mark Riley, president of American Benefit Services, a thirdparty insurance administrator in Columbia.

Riley said one reason for the lack of participation is that many who were interested were disqualified. Laid-off employees who could have signed up for coverage through a spouse’s health insurance plan or some other group coverage — even if they didn’t do so — are not eligible for the COBRA subsidy.

And some people might have found the 35% cost still prohibitively expensive, Riley said. Still others might have chosen not to sign up for the subsidy because they are waiting to see what happens with health insurance reform in Washington.

“A lot of people on all sides are playing a waiting game to see what’s going to come out of Washington in the next few months to do anything long-term on health care,” Riley said.

In one situation, a laid-off worker who wasn’t notified of the program approached her former employer about the subsidy only to find out the company had dropped its group health insurance plan altogether to save money, said Colin Smoak, an insurance consultant with McLaughlin & Smoak in Charleston.

“Her appeal was for naught,” Smoak said, because there was no

Health & Wellness 2009: An employer’s guide

longer a group plan to re-join.

Employer responsibilities Businesses that missed the deadline for notifying employees and still have not done so are in a tough spot, some in the insurance industry say.

To send notices now might alert former employees that they could have been covered in previous months. And insurance carriers might not be obligated to add a former employee to the group plan at this point. That makes the employer financially liable for medical costs incurred during the gap if a former employee was eligible and didn’t have a chance to sign up.

On the other hand, employers could be fined by the U.S. Department of Labor for failure to notify former employees if someone presses the issue.

“Those people are sitting on a time bomb, because now the insurance carriers are off the hook,” said Mendel Boykin, president of Benefit Coordinators Inc. in Columbia. “If someone comes and wants it, you are the insurance company now.”

Insurance industry representatives say it’s not yet clear how hard the Labor Department will come down on those businesses because the laws are so new and were passed down so quickly.

In addition to notifying former employees, businesses are also responsible for fronting the cost of the 65% subsidy to their insurance carrier. The government allows employers to deduct that cost from their payroll taxes or request a refund separately.

For some businesses, that pay-and-deduct system has gone smoothly. For others, especially small employers that had substantial layoffs in recent months, making the payment has been harder, Smoak said.

“I have not heard from anybody that it just broke them,” Smoak said. “But you don’t budget for COBRA.” Smoak said the requirements have compounded an already tough economic time for employers.

Liz Speidel, an employment attorney with Haynsworth Sinkler Boyd, said she hasn’t heard any of her clients complain about the subsidy obligations.

“Employers seem to be relieved to be able to offer employees this benefit upon termination,” Speidel said. “It certainly helps during a period of unemployment.”

Going forward The second chance for employees laid off since September to get subsidized insurance passed with the April deadline and subsequent 60-day sign-up period.

The COBRA subsidy is available to employees laid off through Dec. 31, unless Congress extends it. But notification going forward shouldn’t create the same headache some employers experienced in the spring, some experts say.

Employers should provide the subsidy notification to laid-off employees in a package with regular COBRA information, Boykin said.

“The only headache for employers right now is having to adjust their (payroll tax) quarterlies,” Boykin said. “The rush has already gone by, if they did notification, and they don’t have any big liabilities hanging over their head right now. Now it’s just back to normal.”

Regular COBRA benefits are available for 18 months. The subsidy is limited to nine months, but those who participate in the subsidy can continue on their group health plan for another nine months if they pay the full premium cost. cr br

Reach Ashley Fletcher Frampton at 843-849-3129.

What Do You Value?

Your coin collection … your car … your family? How about your good health — and good health care coverage? We work hard to help you gain both.

So we give you the tools to help manage your health … and manage your benefits … and manage your money. Imagine being able to estimate treatment costs or compare drug costs — or compare the quality among different hospitals. It’s all available on our Web sites anytime you need it. We even provide contribution calculators to help you open a health savings account. We value our members. So if you’re looking for a health plan with value-added benefits …

SM

Choose Blue .

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina Independent licensees of the Blue Cross and Blue Shield Association

SouthCarolinaBlues.com BlueChoiceSC.com

Health & Wellness 2009

Consumers should ask questions about quality of care Staff Report

M

any people trust their doctors and health care providers to make the best decisions for them. Patients might feel intimidated or too embarrassed to ask questions or seek a second opinion, but the role of a responsible health care consumer is to assess the quality of health care.

Even though insurance might limit health care choices, consumers can still ensure basic standards of quality are being met.

Currently, few national standards for health care quality exist, but organizations like the National Quality Forum and the Institute of Medicine are researching best practices and established standards for patient care.

The Institute of Medicine defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are

Inquiring minds = healthy bodies The following are 10 basic questions every patient should ask: • • • • • • •

What is this test for?

How many times have you done this (test/procedure)?

When will I get the results?

Why do I need this surgery?

Are there any alternatives to this surgery?

What are the possible complications?

Which hospital is best for my needs?

consistent with current professional knowledge.”

Both organizations see quality care as being safe, timely, effective, beneficial, patient-centered, equitable and efficient. Standards of care would establish a matrix for achievement of these requirements for quality care. An example of a performance mea-

•

How do you spell the name of that drug?

• Are there any side effects?

• Will this medicine interact with medicines that I’m already taking?

More questions can be found on the question builder at www.ahrq.gov/questionsaretheanswer/questionBuilder.aspx.

Source: Agency for Healthcare Research and Quality, www.ahrq.gov sure would be immediate administration of an aspirin to a heart attack patient to keep blood clots from forming.

Do your homework With health care costs expected to rise again in 2010, patients can’t afford to not be savvy consumers.

Employers should encourage

their employees to ask questions and understand their health care.

Several Web sites allow patients to compare hospitals and see how they rank in terms of services and overall quality. A little research can go a long way toward money savings and better care.

Patients should also take the time to understand their treatments, including tests and prescription medications. Medically sound Web sites can provide useful information on tests, drugs and potential treatments. Patients should arm themselves with some background research so they can ask questions and intelligently discuss their care with their physician.

Educating health care consumers The Agency for Healthcare Research and Quality, in conjunction with the Advertising Council, has

Clarke & Company Benefits and BlueCross BlueShield of South Carolina.

Working together to provide group health insurance for your company’s most important assets – your employees.

Authorized Representative

Employee Benefit Specialists | 803.253.6997 | www.clarkebenefits.com

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Health & Wellness 2009: An employer’s guide

launched a campaign to encourage patients to take an active role in their health care, especially by asking questions.

Materials available on the agency’s Web site, www.ahrq.gov/ questionsaretheanswer, include a question builder that lets patients customize a list of questions to their own needs.

“People spend more time mentally preparing when they go to see the car mechanic,” said agency director Dr. Carolyn Clancy.

“People arrive (at the doctor) and expect me to be the conductor.

Many people will say they don’t get enough time with doctors.

They are probably right, but if you think ahead and prepare with questions, you will get more out of the encounter.”

As an example, Clancy said that patients with a chronic illness who are engaged and active in their treatment have better results than those who are not.

In addition, asking questions can help you avoid becoming a victim of a medical error. Clancy points to a report her agency published with the American Hospital Association that focuses on five steps to safer health care:

1. Ask questions if you have doubts or concerns. With each medical encounter, people ask an average of 1.4 questions, Clancy said, including questions about parking. “As a doctor, I can’t know what is in someone’s head.”

2. Keep a list of all medicines you are taking.

3. Get the results of any test or procedure. “What many people don’t appreciate is that there is no standard expectation for how to notify people about test results,” Clancy said. “Some doctors think no news is good news. You need to know the results.”

4. Talk to your doctor about which hospital is best for your needs.

5. If you’re having surgery or some other procedure, understand the procedure.

“These are steps you can take even if you have limited choices (because of health insurance guidelines),” Clancy said. “The more you participate, the better off you are.”

For a copy of “5 Steps to Safer Health Care” call the Agency for Healthcare Research and Quality at 800-358-9295 or e-mail ahrqpubs@ahrq.gov.

Protect your most valuable resource.

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]

I N V E S T M E N T S

Insurance services are provided by BB&T Insurance Services, a wholly owned subsidiary of Branch Banking and Trust Company. Insurance products may not be available in all states.

Insurance products are not a deposit; not FDIC insured; not guaranteed by the bank; not insured by any government agency. BBT.com © 2007 BB&T.

cr br

Online Resources These sites can help you compare hospitals and research doctors.

Agency for Healthcare Research and Quality www.ahrq.gov American Hospital Directory www.ahd.com American Medical Association www.ama-assn.org

Institute of Medicine www.iom.edu

National Quality Forum www.qualityforum.org

Joint Commission www.jointcommission.org

S.C. Hospital Association www.scha.org

National Institutes of Health www.nih.gov

U.S. Department of Health & Human Services Hospital Compare www.hospitalcompare. hhs.gov

DocFinder www.docboard.org Federation of State Medical Boards www.fsmb.org Healthfinder www.healthfinder.gov

Health & Wellness 2009: An employer’s guide

11

Health & Wellness 2009

Medical bank accounts growing in popularity Staff Report

E

ven in the best of economic times, business owners are constantly searching for ways to reduce expenses. And the recent economic downturn has caused employers to target health insurance as a benefit they must re-examine.

In a recent survey of employers conducted by Colonial Life & Accident Insurance Co., half of those who responded said the economy has affected the benefits they offer employees.

Of the 750 human resource managers and benefits administrators surveyed, 26% said their companies had to increase employee contributions, and 12% eliminated benefits altogether.

Cost-cutting options Insurance agents say an increasing trend is for companies to opt for higher deductibles or copays to reduce premium costs. They might then offer a consumer-directed health plan that involves setting money aside to help employees manage medical expenses not covered by the new plan.

Examples of these consumerdirected plans include health savings accounts, health care flexible spending accounts and health reimbursement accounts.

Health savings accounts Health savings accounts provide a lifetime savings vehicle for medical expenses. The accounts are obtained either through a bank or an insurance agency. They are owned and managed by the employee, who must also have a high-deductible insurance policy — often through an employer. The employee is responsible for depositing up to the deductible amount into the savings account. Contributions are made before taxes, and the maximum amount, set by the Internal Revenue Service, changes each year.

Account holders are issued checks and a debit card to pay for “qualified medical expenses.” The IRS lists qualified expenses on its Web site. They range from costly surgical procedures to inexpensive over-the-counter medications.

Employees with health savings

12

FAQs about personal health care spending accounts What is a health savings account? It enables you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.

What is a high-deductible health plan? It is an inexpensive health insurance plan that generally doesn’t pay for the first several thousand dollars of health care expenses (i.e., your deductible) but will generally cover you after that.

What are qualified expenses? They range from surgical procedures to over-thecounter medicines. A partial list is available at www.irs.gov.

What is a flexible spending account?

This employee-funded pre-tax account is used to pay for medical expenses not reimbursed by the health plan. You may also use it to pay for dependent care expenses up to a predetermined maximum.

How can a flexible spending account benefit me as an employer? You can accounts have no copayment. The account is used to pay the full cost of all procedures, medications, etc.

Once the deductible is met, however, 100% of health care costs are paid by the insurance company.

An employer may make contributions to such an account, but because the employee owns it, the account and any employer contributions will go if the employee leaves.

Any unused money can be rolled over, until age 65. Employees can use their accounts for other expenses, but they must pay for doing so. Individuals younger than 65 must pay income tax and a 10% penalty on the amount withdrawn.

For those 65 and older, the amount withdrawn is taxed as income.

The advantages of savings accounts include more employee control over how medical dollars are spent and a reduction in taxable income when the employee files his or her taxes.

“But the plan is not for everyone; it depends on the demographics of your group and the culture of your company,” said Meredith Adams, account executive with First Carolina Financial Services.

Health & Wellness 2009: An employer’s guide

save in several ways: cut payroll taxes, cushion rate increases, lower your health insurance costs, cut your retirement plan expenses and cut the cost of other insurance premiums.

How can a flexible spending account benefit me as an employee? By paying premiums and medical expenses with pre-tax dollars, you reduce the taxes you pay, effectively increasing your takehome pay.

What is a health reimbursement account? This is a medical reimbursement plan that is paid for solely by the employer.

How does it work? They are established by a plan document, which outlines the types of medical expenses, as well the annual maximum each employee can receive.

The plan then reimburses employees for verifiable expenditures not covered by their group health plan.

Source: American Benefit Services

Flexible spending accounts A flexible spending account can be used along with any health insurance plan. The accounts are mostly funded by employees through a pre-tax payroll deduction, though employers can contribute. The accounts are held in trust by the employer and used to reimburse employees for medical expenses not covered by their health plan. An employee may also use the account to pay for dependent care expenses, up to a predetermined maximum.

The advantages include an immediate discount on eligible health care and dependent care expenses — equal to the taxes you would otherwise pay on the money, because pre-tax dollars are used.

The main disadvantage is that employees must use the money in each year or they lose it.

Health reimbursement accounts Health reimbursement accounts are employer-owned, employerfunded, tax-free health savings accounts set up to reimburse employees for certain health care expenses.

An account can be set up with

any health plan but is typically established after an employer has purchased an insurance plan with a low monthly premium. Often, this means the deductible has gone up or the plan does not cover as much.

Under such an account, the employer will take the money it saves from a lowered monthly premium and put that money into a savings account. The employer and employee will agree at the outset on the amount of medical expenses the employee will cover, and the employer will pay for the rest out of the reimbursement account.

For example, if a deductible has gone from $500 to $1,500, the employee might be responsible for the first $500 and the employer would cover the rest.

“The employer is taking on a risk, but they have bought a (health) plan that lowers their monthly premium, and they are in effect giving that savings back to the employee, so the employee doesn’t feel a large amount coming out of their pocket,” said Mark Riley, owner of American Benefit Services.

Under this plan, unused funds can be carried over to the next year.

Consumer awareness These plans offer many benefits, including more control for employees over their medical spending and tax benefits for employers. But with more control comes more responsibility, and employees will need to track their contributions and expenses to be sure they are getting the most out of their medical savings plan.

First Carolina Financial Services’ Adams said this is a good thing, because the plans make consumers more aware of how they are spending their health care dollars.

“We got used to our employers paying 100% of the premium and all we had to pay as employees was the $20 copay. But those days are gone,” she said. “That’s what got us in trouble. You pay $20 for your visit, but the actual cost was $300. It’s a case of overutilization and not using the money in the best way.” cr br

J OEL WAT TS Nurse Recruiter 11 years

We wouldn’t have been voted best hospital ten straight years without people like Joel

Joel has a unique ability to

For ten consecutive years, readers of The State newspaper have voted us

build a personal rapport

the area’s best hospital. But a hospital is only bricks and mortar; it’s the

with all candidates, which is

people working here who have earned us that honor, dedicated people

one of the most important

such as Joel Watts, our RN Recruiter. Thanks Joel, and thanks to more

skills in recruiting for

than 5,000 of our Lexington Medical Center employees, each committed to

high-demand professions.

serving the people in our community with the highest degree of excellence.

www.lexmed.com

Health & Wellness 2009

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Health & Wellness 2009: An employerâ&#x20AC;&#x2122;s guide

15

Health & Wellness 2009

Urgent Care Centers Doctors Care – Beltline 511 Beltline Blvd.

Columbia, SC 29205 Phone: 803-782-4051 Fax: 803-790-6612 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care – Cayce 977 Knox Abbott Drive Cayce, SC 29033 Phone: 803-794-0476 Fax: 803-791-0971 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care - Columbia East 7653 Garners Ferry Road Columbia, SC 29209 Phone: 803-783-2661 Fax: 803-776-8882 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care - Forest Acres 4416 Forest Drive, Suite A Columbia, SC 29206 Phone: 803-738-9522 Fax: 803-787-8026 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.; 10 a.m.-5 p.m. Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes manage-

16

Listed alphabetically

ment, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care – Lexington 247 Columbia Ave. Lexington, SC 29072 Phone: 803-359-5533 Fax: 803-359-0127 Web Site: www.doctorscare.com Hours: 8 a.m.-10 p.m. Mon.-Fri.; 9 a.m.-7 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care – Northeast 110 Atrium Way Columbia, SC 29223 Phone: 803-788-1153 Fax: 803-736-3243 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care – Seven Oaks 100 Jimmy Love Lane Columbia, SC 29212 Phone: 803-772-5030 Fax: 803-551-5477 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care – West Columbia 3240 Sunset Blvd.

West Columbia, SC 29169 Phone: 803-796-4251 Fax: 803-796-4449 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.; 10 a.m.-5 p.m. Sun. Services: Cough, cold, sore throat, fever,

Health & Wellness 2009: An employer’s guide

dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Doctors Care-Ridgeview 4214 Hardscrabble Road Columbia, SC 29223 Phone: 803-736-8955 Fax: 803-699-8049 Web Site: www.doctorscare.com Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5 p.m. Sat.-Sun. Services: Cough, cold, sore throat, fever, dizziness, shortness of breath, painful sinuses, ear problems, headache, chest pain, stomach problems, diarrhea, high blood pressure, high cholesterol, arthritis and circulation problems, diabetes management, allergies and rashes, women’s care, urinary conditions, injuries, lacerations, auto accident evaluation, sprains and fractures, removal of skin lesions, abscess treatment, burns

Lexington Medical Center – Batesburg-Leesville 338 E. Columbia Ave. Batesburg-Leesville, SC 29070 Phone: 803-604-0066 Web Site: www.lexmed.com Hours: 8 a.m.-7 p.m. Mon.-Thurs.; 8 a.m.-5 p.m. Fri.-Sat. Services: Urgent care, family medicine, OB/ GYN services, X-ray and lab facilities

Lexington Medical Center – Chapin 557 Columbia Ave. Chapin, SC 29036 Phone: 803-932-0655 Web Site: www.lexmed.com Hours: 8 a.m.-7 p.m. Mon.-Fri.; 10 a.m.-6 p.m. Sat.-Sun. Services: Urgent care, OB/GYN services, family medicine, digital mammography screening, X-ray and lab facilities

Lexington Medical Center – Gilbert 4080 Augusta Highway Gilbert, SC 29054 Phone: 803-892-1800 Web Site: www.lexmed.com Hours: 8 a.m.-5 p.m. Mon.-Tues., Thurs.Fri.; 8 a.m.-noon Wed. Services: Urgent care, family medicine, X-ray and lab facilities, wellness center

Lexington Medical Center – Irmo 7035 St. Andrews Road Columbia, SC 29212 Phone: 803-749-0924 Web Site: www.lexmed.com Hours: 7 a.m.-10 p.m. seven days a week Services: Urgent care, outpatient surgery, lab facilities, radiology, CT scan, MRI, fluoroscopy, women’s imaging, full-field digital mammography, bone densitometry, physical therapy, physician offices

Lexington Medical Center – Lexington 811 W. Main St. Lexington, SC 29072 Phone: 803-358-6100 Web Site: www.lexmed.com Hours: 8 a.m.-10 p.m. seven days a week Services: Urgent care, outpatient surgery, radiology, X-ray, PET/CT scan, CT scan, MRI, lab, women’s imaging, full-field digital mammography, bone densitometry, cardiac rehabilitation, physical therapy, physician offices

Lexington Medical Center – Swansea 935 W. Second St. Swansea, SC 29160 Phone: 803-568-2000 Web Site: www.lexmed.com Hours: 8 a.m.-7 p.m. Mon.-Thurs.; 8 a.m.-5 p.m. Fri.-Sat.; Noon-5 p.m. Sun. Services: Urgent care, family medicine, internal medicine, OB/GYN, X-ray and lab facilities

MinuteClinic – Columbia – Clemson Road Inside CVS/pharmacy No. 2250 121 Clemson Road Columbia, SC 29229 Phone: 866-389-2727 Web Site: www.minuteclinic.com Hours: 8:30 a.m.-7:30 p.m. Mon.—Fri.; 9 a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun. Services: Diagnosis and treatment of common illnesses

MinuteClinic – Columbia – Hardscrabble Road Inside CVS/pharmacy No. 2269 4310 Hardscrabble Road Columbia, SC 29229 Phone: 866-389-2727 Web Site: www.minuteclinic.com Hours: 8:30 a.m.-7:30 p.m. Mon.—Fri.; 9 a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun. Services: Diagnosis and treatment of common illnesses

MinuteClinic – Irmo Inside CVS/pharmacy No. 5549 1008 Lake Murray Blvd.

Irmo, SC 29063 Phone: 866-389-2727 Web Site: www.minuteclinic.com Hours: 8:30 a.m.-7:30 p.m. Mon.—Fri.; 9 a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun. Services: Diagnosis and treatment of common illnesses

MinuteClinic – Lexington – Lake Drive North Inside CVS/pharmacy No. 7334 5608 Sunset Blvd.

Lexington, SC 29072 Phone: 866-389-2727 Web Site: www.minuteclinic.com Hours: 8:30 a.m.-7:30 p.m. Mon.—Fri.; 9 a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun. Services: Diagnosis and treatment of common illnesses