Wednesday, September 28, 2011

Cost of Group Healthcare up, but why?

It is reported today in the newspaper and on the television that nationally premiums are up around 9% this year for group healthcare plans per family. Also reported is that the EMPLOYER is the one who is bearing the cost of this increase for the most part. Obviously, this gets passed on to the employee in the form of fewer and smaller pay raises in the coming year, as well as slowing hiring of additional employees.

However, for purposes of this article, I want to look at reasons WHY the premiums are up. There are a lot of political thoughts out there, such as:

---Premiums were raised with expectations of a faster economic recovery, which would lead to an increase in the use of health-care services by workers.

---The rising cost of health care services

---The drive for profit by insurance carriers.

---It has been suggested that insurance companies raised premiums “in anticipation of new rules that would, in 2012, require them to justify increases of more than 10%”.

Let’s look now at what I really believe the biggest culprit of increases in health care cost is in this country- the deteriorating health and increasing weight of Americans! In our agency, we have seen some accounts that have had large increases in their renewal premiums, but we have also seen some accounts that have had DECREASES in their renewal premiums as well. In most of these cases, the predominant factor for raising the premiums has been the health of the group, caused by severe obesity problems, along with other health issues.

Let’s consider these national factors:

1) Every single state in the U.S. now has more than 20% of its residents that are considered obese or morbidly obese. As a matter of fact, more than ½ of the states have more than 30% of their residents that are obese. Just 15 years ago, no states were over the 30% obese range. What does that tell you about our health care costs in the last 15 years?

2) Over 35% of American adults nationally have been diagnosed with Diabetes, High Blood Pressure, or high cholesterol. The strain this has put on our health care system is obvious. It has been stated that over 90% of these situations are caused because of obesity. As a matter of fact, the rate of growth of these diseases is growing at a 15% clip annually. Now what do you think the main cause of health care increases actually is?

3) Incidences of cancer diagnosis have more than doubled in the last 15 years. The leading cause of cancer? You guessed it- the type and amount of food we eat! In addition, an obese person is 40% more likely to get cancer of some form than a healthy person.


4) 1 out of 3 children in this country are now considered obese! That is staggering! The likelihood of those children being having debilitating diseases in adulthood because of their weight is 12 times greater! Do you think this might cause our healthcare to go up now and in the future?

I could go on and on about our health care crisis in the U.S., but I think you get the point. The problem is not the insurance carriers- they just reflect what is going on in our healthcare system. Healthcare services are going up, but mostly because of our deteriorating health as a country. Sugar is one of the leading causes of obesity in the U.S.- or should I say the overuse of sugar! There is nothing sweet about how much sugar people consume every day. According to the American Heart Association, the average adult in the U.S. takes in 30 teaspoons of added sugar a day, or a whopping 150 pounds a year, while teens pile in 50 teaspoons a day. That’s almost 3 times the amount of sugar we should be eating. The amount is shocking, and the potential health effects of excess sugar consumption are even scarier. Mounting evidence suggests that flooding your system with the sweet stuff can play a role in obesity, heart disease, and cancer. It can also impact how you look or feel, doing damage to your skin or altering your mood.

Below are 6 scary side effects of sugar overdosing that you may or may not know:

1) Tossing Back Sugary Drinks May Increase your Risk of Diabetes
Consuming sugar-sweetened beverages, such as soft drinks, fruit drinks, sugar tea and sports drinks, may increase your chances of developing Type 2 Diabetes. It has been estimated that 180,000 new cases of diabetes between 1995 and 2005 can directly be attributed to the increase in sugary drinks!

2) Following a High-Glycemic Diet May Cause Acne
According to a 2008 study published in the Journal of Molecular Nutrition & Food Research, what you eat can affect your skin. High glycemic foods, such as refined carbs, sugary drinks, and even certain fruits high in natural sugars, cause large spikes in blood sugar. Those on the high- glycemic diet experienced a 14% increase in acne problems. So your Mom was right- what you eat can affect your skin!

3) A Diet Rich in Sugar Can Hurt Your Heart
Mounting evidence suggest that sugar plays a direct role in the health of your heart. A study found that people who took in more than 17.5% of their calories from added sugars were 20%-30% more likely to have high levels of triglycerides. It also found that people who got 25% or more of their calories from added sugars were more than 3 times more likely to have low levels of HDL ( the good cholesterol).

4) Sugar Can Increase Your Chances of Depression

Eating sugar and carbs can give you a temporary mood boost- it triggers your body to release the feel-good hormone serotonin- but overloading your system with sugar seems to have the reverse effect. In fact, researchers from Baylor College of Medicine found a correlation between sugar consumption and the annual rate of depression in six countries.

5) High Blood Pressure Can Increase Your Risk of Yeast Infection
Yeast grows by feeding on sugar, so if you drink a 48 ounce Big Gulp every day, your body is going to be a fermentation tank. Yeast infections, both vaginally and in your mouth- are typically caused by an overgrowth of the bacteria Candida. When your blood sugar is high, the extra sugars in your saliva and urine provide a perfect breeding ground for the bacteria.

6) Sugar May Increase Your Risk of Cancer
While it’s not proven (but highly suspected) that sugar fuels cancer growth in the body, we do know that obesity- a likely effect of eating too much sugar- increases your risk of developing a number of cancers.

The next time you listen to a bunch of politicians screaming about our healthcare costs going up and blaming the other party and the Insurance carriers for all the problems, put down the Coke your are drinking and the M&Ms you are eating and make a difference you YOUR health!

Bobby Bland PWCA, CIC
Vice President
Commercial Risk Service

Tuesday, September 20, 2011

8 Tricks that cut calories and Can help your business as Well!!!

We see it all the time- lists and lists of ways to cut calories and lose weight. Here is another list, but this time with a different twist. This is a list of something I read the other day that is very good advice on losing weight- here are 8 tips for cutting calories to our diet. I have added a little twist- each tip will also help you run your business better! Enjoy-

Tip#1 Take Note
Diet Tip   A study found that those who kept daily food logs lost twice as much as those who didn't. Many people lowball how much they eat- seeing it all in black-and-white can be a reality check.
Management Tip   If you are in sales, keep detailed notes of how much time you actually spend going after new business. If you manage other people, keep track of how much time you actually spend training and helping your employees. You may be shocked!

Tip#2 Find Balance
Diet Tip   Experts say that people with a lot of pounds to lose get overwhelmed by couting calories and give up. Keep it simple by divvying your plate into thirds: 1/3 protein, 1/3 vegetables, and 1/3 whole grains.
Management Tip   Managing a group of people while still handling all of your responsibilities is sometimes very overwhelming. Just like losing calories, remember to keep it simple: Prioritize your own projects, and spend time each day training your employees. Sharpening "their tools" will pay more dividends in the long run.

Tip#3 Swap Smart
Diet Tip    Restricting foods can increase your cravings and lead to off-the-wagon binges. Jonesing for a cookie? Have it, but swap it for your afternoon caramel macciato or pretzels.
Management Tip   Budgets for your business are sometimes very difficult to manage. Sometimes we can make cuts that are more detrimental to our business in the long run than the expense itself. Before cutting an expense, ask yourself this question- if I no longer have that expense, will it cost me in sales and/or profits? If the answer is yes, then you might want to rethink that decision.

Tip#4 Scale Back
Diet Tip   Serve dinner on a salad plate and pour cereal into a mug rather than a bowl. Experts say you'll think you're eating more than you actually are.
Management Tip   Do you need to drive a new car every year, just for the tax break? Sometimes we can fool ourselves into believing anything is good for us, can't we?

Tip#5 Slow Down
Diet Tip   Sip water and set your fork down after every bite. There's lag time between your stomach feeling fool and your brain getting the message.
Management Tip   Take time to explain what you really want from your employees. Many times we assume that they understand us by "reading our minds". Going too fast sometimes leads to costly mistakes.

Tip#6 Nosh Often
Diet Tip   Eat small amounts every few hours. It can help your body burn calories instead of holding on to them.
Management Tip   In managment terms, taking on too much or asking an employee to take on too much is termed "drinking from the fire hose". Remember, the only way to tackle a big project is one part at a time just like the only way to eat an elephant is one bite at a time!

Tip#7 Pick Protein
Diet Tip   Protein keeps you feeling full longer, burns calories as it digests, and helps your muscles recover.
Management Tip   Protein is the building block for your body. Without it, everything else doesn't matter. What is the "Protein" for your business? In almost every case, it's your people! Remember, people matter!

Tip#8 Beat Bloat
Diet Tip   Avoid excess salt, limit food like broccoli and beans, and add lemon to your water (it acts as a natural diuretic).
Management Tip   Avoid employees that cause "bloat" to your business. Good hiring practices will keep those types of employees from invading your company. Also, make sure to have a good return-to-work program in place before you hire. Just like lemons, the return-to-work program will act as a nautural "diuretic" to your business, getting rid of the "bad" employees!

Bobby Bland PWCA, CIC
Vice President
Commercial Risk Service

Thursday, September 15, 2011

Fighting Worker's Compensation Fraud

Worker’s Compensation fraud undermines a 100-year old social system originally designed to assist injured workers and their families with medical bills and partial wage replacement for on-the-job accidents. The added strain associated with Workers Compensation fraud places substantial pressure on the system’s infrastructure. When fraudsters “cheat the system”, the results are greater losses for employers and insurers, higher insurance premiums, lower revenues and possibly fewer jobs for honest workers.


The size and scope of Worker’s Compensation fraud is difficult to determine, but The Insurance Information Institute estimates that Worker’s Comp fraud makes up about $7.2 Billion per year, or 25% of all Insurance fraud in the U.S.

There are 3 types of Worker’s Compensation fraud that occur- Employee fraud, provider fraud, and employer fraud. However, for purposes of this article, we are only going to deal with employee fraud.

Employee fraud tends to be the most highly publicized type of Workers Compensation fraud. Businesses that employ a high number of contract, temporary, or seasonal workers are particularly susceptible to this type of fraud. While all claims should be treated as legitimate, managers should be trained to look carefully for suspicious signs of possible fraud. While these red flags do not confirm fraudulent activity, they can identify claims that warrant a closer look. Common red flags include:

• The injury is reported on Monday morning or after a vacation or holiday
• The injury is reported about the same time every year

• The injury is reported late

• The claimant is a new, seasonal, or contract employee, or claimant has a history of short-term employment

• Claimant has an attorney when injury is reported

• Claimant demands quick settlement

• The Claimant is facing possible layoff or termination

• The Claimant’s description of the accident and resulting injury are not consistent

• Claimant goes to the emergency room for treatment for a non-emergency condition

• Claimant refuses diagnostic procedures to confirm treatment

• The Claimant’s address is a post office box or hotel address

• Claimant is disgruntled

• There are no witnesses to the accident

Employers, be aware of these potential signs that there may be employer fraud. Please comment if any of you have been a victim to Worker’s Compensation fraud, and what the signs were for you.

Bobby Bland PWCA, CIC
Vice President
Commercial Risk Service

Thursday, September 8, 2011

Health Insurer Rate Hike Reviews Begin

Starting Thursday, state and federal regulators will review double-digit rate increase proposals from health insurers to determine whether the premium hike is reasonable.

The rate review program is under the Affordable Care Act, requires health insurers to submit a written request for a rate increase of 10% or more to independent reviewers. The Centers for Medicare and Medicare Services (CMS) will review in nine states that lack the authority to adequately review rates. The remaining 41 states will conduct their own reviews.

Experts that review rates will look for "underlying cost trends in health care to flag instances when insurance companies are unjustly raising costs."

According to the Department of Health and Human Services, insurers that have to go forward with rate increases must post their justifications on their website, and state and federal regulators will post online as well.

"Far too long, families and small employers have been at the mercy of insurance rate increases that often put coverage out of their reach. Rate review will shed a bright light on the industry's behavior and drive market competition to lower costs," Said Kathleen Sebelius, Secretary of Health and Human services, in a statement. We are pleased to team with states to bring this important new protection to consumers and employers."

The Affordable Care Act provides $250 million over five years to states that need help in order to perform stronger reviews. Over the last year, according to HHS, 42 states, the District of Columbia and the five U.S. territories have used $48 million in grants to help improve their oversight of proposed health insurance rate increases.