June2013CoverHSAs – Still Growing Strong (Even Under PPACA)
by Chris Bettner • Employers and employees will be affected by many rules and regulations under the Patient Protection and Affordable Care Act (PPACA) that take affect in 2014.
Health Reform–Five Things You Need to Know About Health Insurance Tax Credits
by Sean O’Connor • Consumers are increasingly wondering how the tax subsidies are going to work and whether they can expect to receive one.
What Brokers Need to Know About Health Reform
by Leila Morris • Word & Brown recently held events for brokers on the Affordable Care Act. One speaker called health reform a tremendous opportunity for brokers to have a long and prosperous professional life.
Cultivating Ancillary Benefits – Finding Fertile Soil for Dental, Prepaid Legal, Chiropractic, Acupuncture, Disability & Vision Sales!
Dental: Health Care Reform Creates New Opportunities for Dental Insurance Brokers
by Chris Swanker • The Affordable Care Act’s insurance market reform provisions are set to go into effect January 1, 2014. But many brokers still don’t know how these changes will affect dental benefits.
Dental: Healthy Habits Mean Healthy Savings
by James Bramson, D.D.S. • Employers can make a small investment in oral health and see big returns, such as increased productivity.
Dental: The Word of Mouth on Dental Insurance
by John T. Harmeling • American workers understand the value of having healthy teeth and gums: Dental coverage is the third-most-requested employee benefit after major medical insurance and retirement benefits.
Vision: How Eye Health Education Can Promote Smoking Cessation
Helping Employees See The Light At The End of Their Cigarette
by Vincent K. Young, M.D. • Many employees would take steps to quit smoking if they knew that it could hurt their eye health. So brokers and employers who don’t take the time to educate on this topic are doing a disservice to themselves and employees.
Online Educational Services As A Voluntary Benefit Option
Advance Your Clients To The Head Of The Class
by Elizabeth Halkos • Employers can help employees attain a better life through a new voluntary benefit option — online education.
Disability: An Expert Opinion on Contractual Language
by Arthur L. Fries, RHU • If you sell disability insurance and you are not sure about contractual language, seek an expert.
Legal Plans Represent Winning Proposition for Employers and Employees
by Alan Fearnley • The ultimate payoff for companies that offer legal plans is to improve the perceptions that employees have about their employer.
Legal Plans Are Proven to Enhance Employee Loyalty And Satisfaction
by Marcia L. Bowers • Many companies are expanding their non-traditional voluntary benefit offerings, including prepaid legal services, to improve employee satisfaction and retention without increasing cost or effort.
Chiropractic & Acupuncture
The Case for Complimentary and Alternative Medicine
by Leila Morris • Skeptics say that complimentary alternative medicine is not effective and simply adds to healthcare costs. But research has found just the opposite.
Education is the Key to Life Insurance
by Phil Bodine, LUTCF • Since the financial crisis that began in 2008, consumers have been bombarded with inaccurate information.
How to Engage Women in Retirement Planning
by Celeste Gurule • Employers are seeing benefits from offering retirement plans that are customized to meet their unique savings needs.

HSAs – Still Growing Strong (Even Under PPACA)

by Chris Bettner
Employers – and ultimately employees –
will be affected by many rules and regulations under the Patient Protection and Affordable Care Act (PPACA), that take affect in 2014. But there will be very little effect on health savings accounts (HSAs).

Employers and brokers are grappling with all the inherent issues under PPACA, such as what constitutes large group versus small group; penalties that apply to all of the employer mandates; tax credits that may apply; exchanges and how they may affect employer and employee choices; pay or play affordability issues; and on and on. The one certain thing about PPACA is that it will bring change.

But the actual effect on HSAs has been very limited. Two changes have already gone into effect — requirements for the purchase of over-the-counter healthcare products and higher (20%) penalties for non-qualified HSA withdrawals. The medical loss ration (MLR) rules for carriers are also in effect.

As of 2014, we know that HSA-qualified plans will fall into the Silver and Bronze plans in the exchanges. The $2,000/$4,000 maximum deductible limits only apply to small groups (currently two to 50), but flexibility language in the regulations may render them moot. Will we see HSA-qualified plans in the exchanges? Carriers must offer Silver and Gold plans per PPACA. One carrier has already stated that it will have more low-level than high-level plans. That may be a sign of what’s to come.

We already know that employer contributions to employees’ HSAs are not counted toward the premium costs since HSA funds may not be used to pay for health plan premiums. On the other hand, HRA funds do count toward the premium.  According to Roy Ramthun of HSA Consulting Services, “Mr. HSA,” the IRS will again raise the maximum HSA contribution limits for 2014 signaling yet another consistency with HSAs moving into a new year with more PPACA related changes. The maximum HSA contribution for individuals will be $3,300. For those with family coverage, the maximum contribution will be $6,550. Minimum deductibles will remain unchanged. However, maximum out of pocket costs will be $6,350 for individuals and $12,700 for families.

Since 2004 and the inception of HSAs, we have seen HSA deposits increase and account balances grow considerably in our book of business. This is true across the industry, according to a recent Devenir HSA Survey. Employees and individuals may elect to go to the higher deductible plans for cost savings as they have sufficient funds to cover that liability.

In the fall of 2013, we’ll see the plan design and pricing options available under PPACA. While we believe that healthcare reform is a disruption like no other in our industry, it may bring more opportunity than we understand.


Chris Bettner serves as executive vice president of Business Development for Sterling Health Services Administration. With over 25 years of experience in healthcare sales and management with health insurance carriers, (www.sterlinghsa.com). Prior to joining Sterling, Chris was Vice President of Sales for Blue Shield of California. She held similar positions at Lifeguard, FHP, Independence Blue Cross and MetLife. Chris is also a national spokesperson on HSAs and consumer directed healthcare programs.

Healthcare Reform–Five Things You Need to Know About Health Insurance Tax Credits

by Sean O’Connor
The health care reform law remains a bit of a mystery to many consumers, despite the fact that health reform fully goes into effect on January 1 of next year. Even before that, under the individual mandate of the Affordable Care Act, millions of Americans will begin enrolling themselves in coverage plans via the new online health insurance marketplaces. For those who qualify, the federal government will provide a tax subsidy to make buying coverage easier on their budgets.

Consumers are increasingly wondering how the tax subsidies are going to work and if they can expect to receive one. Here are five things that should help clear up a few concerns:

One: Tax credits are only available through government-run health insurance marketplaces. The health insurance marketplaces (also known as health insurance exchanges) are the key to receiving a tax credit. Coverage bought from any other outlet will disqualify you.

Two: Household income eligibility requirements: Americans with household incomes between 100% and 400% of the Federal Poverty Level (FPL) are eligible.

The 2014 FPL guidelines have not yet been released, but the 2013 guidelines are as follows:

• 100% FPL: individual $11,490, family of four $23,550

• 400% FPL: individual $45,960, family of four $94,200

Three: Credit amounts vary by income. A sliding scale is in effect here. If you fall on the lower end of the FPL percentage spectrum, you can expect more help from the government than someone closer to 400% FPL.

Four: Tax credits are advanceable. Advance payments of tax credits will be made directly to the health insurance company on behalf of individuals/families.

Five: If your income changes over the year, your tax credit will be adjusted accordingly. If your income increases, you will have to pay the difference at tax filing time. It will be important that you stay on top of any income changes so you have an idea of how much you will owe at tax time.


Sean O’Connor is a health insurance expert and media liaison at GoHealth (www.GoHealthInsurance.com). Sean received a Master of Science in Integrated Marketing Communications from Roosevelt University in Chicago and a Bachelor of Arts in Communications from DePaul University in Chicago. Based in Chicago, GoHealth is one of the fastest growing health insurance technology companies in the United States.

What Brokers Need to Know About Health Reform

by Leila Morris

Word & Brown recently held events for brokers on the Affordable Care Act. Paul Markovich, president and CEO of Blue Shield of California addressed Word & Brown’s Health Reform Summit in Orange. (The seminar was also held in Los Angeles.) He told brokers, “We are about to experience the most dramatic change in the health industry since the introduction of Medicare.”

Having an estimated 30 million people gain health insurance nationwide offers an enormous business opportunity. With health reform, brokers will have a tremendous opportunity for a long and prosperous professional life, he stressed. Small employers and individuals will have a greater need than ever for guidance from a trusted and knowledgeable advisor. He stressed that health reform can’t succeed without brokers. A perfect example is Massachusetts where agents and brokers played an important role in getting people into the system. A major part of the Affordable Care Act in our state is the new, state-run, exchange of private plans called “Covered California.” Individuals and small businesses will be able to purchase affordable health insurance for 2014 beginning October 1. Brokers can sell through the exchange and will receive commissions for doing so. However, they must be certified to sell through Covered California. The state has not yet announced when the training will be available, but the training is expected to be offered sometime this summer. State-employed navigators will also sell through the exchange, but they will focus on lower-income consumers who generally don’t purchase insurance through brokers.

Health plans will offer benefits outside of the exchange but the plans still have to meet the same actuarial values as the standardized Metal-Tiered Plans. However, tax credits only apply to coverage purchased through the exchange. Markovich noted that the California exchange is not a regulator, but its coverage decisions will influence what happens with plan designs outside of the exchange.

Along with health reform, Markovich expects to see more integration of care. There will be some blurring of the lines between HMOs and PPOs as physician groups begin to provide more coordinated care, he added. Narrower networks will become prevalent, particularly on the individual side. He notes that Blue Shield’s experiments with accountable-care organizations have already shown to bring down healthcare costs. The biggest changes from health reform will be in the individual market with fewer changes in the small group market and still fewer changes in the large group market. Standardization of products will make comparisons easier in the individual and small group markets, he added.

The Individual Market  

Seven million uninsured Californians will have the opportunity to buy individual coverage, and 2 million to 3 million could be eligible for subsidies, which will be a huge opportunity for the industry.  Premiums in the individual market are likely to go up due to age-band premium restrictions, guaranteed issue requirements, and requirements for richer benefits. The most important change in the individual market will be the elimination of medical underwriting, he explained. He notes that premiums for Blue Shield’s current individual plans average $200 per member/per month, but many of those affordable options are high deductible plans. Rates for small group plans are almost double because they come with copays coinsurance, much richer benefit designs, and guaranteed issue. They average $370 per member/per month. With age banding, premiums for older people cannot be more than three times higher than premiums for the youngest adults. The current ratio is about five to one.

Don Goldmann, vice president of Word & Brown University explained at a CE course in Glendale, that individual and small-group carriers will no longer be able to base their premiums on risk-adjusted factors. Premiums will be based on 19 premium-rating regions in California. People who live in more expensive areas will be charged more. The state is expected to announce the rates for those regions in mid-summer.  The Small Group Market Open enrollment for small groups will begin on October 1, 2013 for coverage in 2014. After that date, employers can begin participating at any time in the year (rolling enrollment), but employees can only enroll or change plans once a year unless they qualify for a special enrollment period.  Compared to individuals, Markovich expects to see a much smaller portion of small businesses purchase coverage through California’s small business exchange — the Small Business Health Options Program (SHOP).

Markovich explained that small businesses simply won’t get the same generous subsidies and tax credits that are available on the individual side. He also reassured brokers that, if one of your Blue Shield groups decides to purchase coverage through the exchange, you will still be the broker of record and thus will receive commissions on that group.

Small businesses with 25 or fewer employees and an average annual wage of less than $50,000 will be eligible for a 50% federal small-business tax credit for coverage purchased through the SHOP. Tax deductions will be available through 2016. An estimated 375,000 small California employers will qualify for the tax credit.

Large Groups

Goldmann said that brokers will need to help clients determine whether they are considered large employers under the ACA. Starting January 1, 2014, applicable large employers must offer “affordable” health plan coverage to full-time employees. They face a penalty if an employee receives federally subsidized coverage from the Exchange.  In 2014, California will define a small group as an employer with “at least one, but no more than 50” employees. Since the ACA applies to groups with more than 50 employees, there is no conflict between state and federal law in 2014 or 2015. However, in 2016, California redefines a small group as employers with up to 100 employees.  Determining a group’s size is far harder than it sounds. It involves adding up the hours of part time and seasonal workers to get an accurate number of full-time equivalent employees. The law includes very detailed procedures for classifying and calculating these hours. Group size is calculated looking back into 2013 and the result stands throughout 2014.

In case some large employers want to get around the large group requirements, Goldmann warns that the law has tightened the loopholes. Employers won’t be able to classify employees as independent contractors just to bring down the numbers. Providing paid vacations, sick days, paid maternity leave, and paid jury duty is a dead give away that a worker should be classified as an employee and not an independent contractor with a 1099.

Also, employers won’t be able to divide the company into separate businesses to reduce the size of their groups. Companies that have common ownership will be considered part of the same group.

Definition of Appropriate Group Coverage 

The ACA defines appropriate coverage for large groups as follows:

• Provides minimum essential benefits.

• Covers those benefits at a Bronze level.

• Does not ask employees to contribute more than 9.5% of their W2 reported income.

California Essential Benefits will involve the following:

• Contract language that is compliant with the Kaiser $30/1,500 plan.

• The federal pediatric vision benefit.

• The Healthy Families pediatric dental benefit.

• Four standard levels of coverage identified by metal colors. (An actuarial calculation of 60% of an average person’s medical costs defines Bronze-level coverage.)

No More Waiting Periods and Longer Premium Guarantees

As mentioned earlier, on January 1, 2014, carriers for groups of all sizes in California will not be able to exclude coverage for any individual based on a preexisting condition. Also on January 1, 2014, carriers cannot impose a waiting period based on pre-existing conditions, health status, or any other factor.  In addition, carriers must guarantee their premium rates at least 12 months.

Broker Disclosure Requirements

Brokers will have new responsibilities when presenting health plans, said Goldmann. A broker must do the following even when they are not making any specific recommendation about a health plan:

• Advise clients that the plan is obligated to offer any of its heath care plans to them.

• Upon request, provide rates and benefits for any plan.

• Notify of the clients that tax credits are available for certain employees consistent with PPACA and state law including any rules, regulations, or guidance issued in an ongoing manner.

When making recommendations, a broker must do the following:

• Before filling an application, provide a benefit summary and the premium for each of the plans offered by the recommended carrier.

• Notify the small employer that an evidence-of-coverage brochure for each contract offered by the plan will be provided upon request.

• Get a signed statement from the employer acknowledging that the employer has received these disclosures.

Carrier Marketing

Carriers must provide all benefit materials and premiums to brokers, agents, and consumers. Sales of 2014 policies must start October 1, 2013.

Enrollment Changes 

A health plan has 30 days to notify an employer of an offer of coverage as well as the total premium for that coverage. The employer has 30 days to accept or refuse the offer. Sending a check for the full premium, quoted by the carrier, is proof of acceptance.

Major Changes for Brokers

In conclusion, Goldmann said that the new small group definition will expand the size of the small-group market, which will be an opportunity for brokers. He noted that the ban on pre-existing condition exclusions will mean that many more people will be able to get insurance, especially those over 50. However, premiums are expected to go up, particularly for different age groups. Brokers will need to stay on top of new broker disclosure requirements. To view videos of the presentations, visit these links:

• www.icvclients.com/word_and_brown/intro

• www.icvclients.com/word_and_brown/markovich

• www.icvclients.com/word_and_brown/lujan

• www.icvclients.com/word_and_brown/goldstein

• www.icvclients.com/word_and_brown/goldmann.

Cultivating Ancillary Benefits

Finding Fertile Soil for Dental, Acupuncture, Prepaid Legal,

Chiropractic, Disability and Vision Sales!

For our June issue, we’ve assembled a series of articles on ancillary benefits.  We think the more agents discover the advantages of products including dental, vision, disability, acupuncture, chiropractic and prepaid legal plans, the more they’ll see these products as a way to rise to the top in today’s market.

Healthcare Reform Creates New Opportunities For Dental Insurance Brokers

by Chris Swanker

The Affordable Care Act’s (ACA) insurance market reform provisions are set to go into effect January 1, 2014. But many brokers still don’t know how these changes will affect how dental benefits are sold. If your target market is small businesses with less than 50 lives, you need to inform your clients about two sweeping changes.

Pediatric Care Becomes Required Coverage

Starting in 2014, pediatric benefits for oral services will be considered essential health benefits for small groups and individual customers. Providing this baseline coverage for children up to age 19 is one of 10 essential health benefits required under ACA. The rules should come as no surprise. The ACA’s commitment to improving the oral health of American children is in response to the disturbing trends. There’s a clear cause for concern with tooth decay prevalent among children ages five to 19, according to the Centers for Disease Control and Prevention.

Earlier this year, the Dept. of Health and Human Services issued a final rulemaking clarifying the scope of the pediatric dental benefit and providing for equitable treatment of Americans with dental policies inside and outside of health insurance exchanges. Compliance with this rulemaking may require some changes in dental benefit plan design. Notable changes include the following:

• A separate, reasonable out-of-pocket maximum for stand-alone dental plans. For California, the out-of-pocket maximum has been established at $1,000 for one child and $2,000 for two or more. (The out-of-pocket maximum for one child is $1,000, with the Federally Facilitated Marketplace, and many states outside of California are setting the out-of-pocket maximum at $700.)

• Inclusion of medically necessary orthodontia.

Brokers and advisors take note: Medical carriers can exclude pediatric oral services from their offering of essential health benefits as long as there is an exchange certified dental plan covering the requirements. This means that your clients can still rely on the quality dental products and services from a qualified provider while remaining compliant with reform. A stand-alone dental carrier can offer a separate dental benefit and still have it satisfy the essential health benefit requirements, especially considering that 97% of dental benefits are provided separately from medical plans, according to the National Assn. of Dental Plans. The new pediatric dental requirement creates a large market opportunity when you consider the gap in the number of small business offering dental benefits. Just under 50% of employers with fewer than 25 lives offer dental coverage while 74% of employers with 25 to 49 lives offer dental coverage.

Small Businesses May Want to SHOP

In 2014, medical and dental benefits will also be available through online exchanges operated by states or the federal government to simplify choices, expand employee and employer options, and provide greater control. There are two types of exchanges: the American Health Benefits Exchange for individuals without group coverage and the Small Business Health Options Program (SHOP) for small businesses and their employees.

Both health insurance exchanges are expected to expand the dental marketplace, particularly among individuals and small firms that don’t have such coverage. In addition, a small-business tax credit is designed to encourage small employers to offer medical coverage through the public SHOP exchange:

• The credit is available to employers with fewer than 25 employees and average annual wages of less than $50,000.

• The full credit can be up to 50% of the employer’s contribution toward the employee’s health insurance premium. It is available to employers with 10 or fewer employees and average annual wages of less than $25,000.

• The credit decreases as firm size and average annual wages increase.

The good news for advisers and brokers is that employers need your help navigating the complexity of these new exchanges and understanding how their choices will affect dental benefits. It’s an opportunity to go beyond comparing carriers, plan designs, and price points, to advise clients on how to develop an optimal benefit strategy. This includes helping employers avoid tax penalties, determining the most beneficial funding mechanism (fully insured versus self-funded), and maximizing employer sponsored wellness. Many changes will be happening in the small group market over the next few months, and with change, comes opportunity for expert advice and guidance.


Chris Swanker is V.P. of Worksite and Specialty Markets Guardian at the Guardian Life Insurance Company of America.

Dental: Healthy Habits Mean Healthy Savings

by James Bramson, D.D.S.

Chronic medical conditions affect an estimated one out of every two adults over 21. In addition, periodontal or “gum disease” is a nationwide epidemic with 47% of Americans suffering from it at any one time, according to the Centers for Disease Control and Prevention.

A three-year oral health study, conducted by United Concordia and parent company, Highmark Inc., finds that regular dental care can improve overall health and reduce medical costs. The study is the largest of its kind showing a connection between oral health and medical costs. It was conducted by lead researcher Marjorie Jeffcoat, D.M.D., professor and Dean Emeritus of the University of Pennsylvania, School of Dental medicine,

The infographic shows how much health care cost savings are possible by treating a person for gum disease who also has diabetes, heart disease, cerebrovascular disease (stroke) or rheumatoid arthritis, or who is pregnant for the first time. When a person with diabetes receives at least seven treatments for gum disease, annual savings for that person increase by $1,477 due to declining drug costs for a total of $3,219.

This study underscores the need for a commitment to wellness and demonstrates a good practice for the dental industry to embrace. Why? Treating chronic health conditions comes at a very high medical cost while dental disease can be prevented at a much lower cost. The benefits of reduced medical costs are significant. Seventy-five percent of health care spending is for people with chronic conditions, such as diabetes, heart disease, and stroke, according to the Center for Chronic Disease Prevention and Health Promotion.

These findings highlight the need for brokers to educate clients about how important it is to invest in employee wellness. Brokers who understand how oral health affects overall health can help employers select the right partners, products, and services to encourage oral health and overall wellness, and reduce costs. When you consider the savings, it becomes clear that a dental wellness program can help employers realize these goals.

The study demonstrates that employers can make a small investment in oral health and see big returns, such as increased productivity. American workers miss 450 million days of work a year due to chronic conditions, according to the 2011 Gallup-Healthways Well-Being Index. That’s equal to $153 billion in lost worker productivity for today’s businesses.

The findings emphasize the connection between having a healthy mouth and having a healthy body for people with chronic conditions and those who are pregnant for the first time. In January, we conducted an online survey of people with chronic conditions. Thirty percent said that having a healthy mouth would have no affect on their chronic condition. That is simply is not the truth. A person’s entire body is healthier when they have a healthier mouth with less inflammation due to treatment for gum disease.

The study also reveals the financial repercussions that could come from failing to prevent or treat dental disease. Investing in a dental wellness program should be seen as investment in the health and well being of clients, companies, and employees.


Dr. James Bramson is chief dental officer at United Concordia where he directs the professional relations department, professional quality assurance activities, utilization review, claims review process, and clinical aspects of product offerings and communications. Dr. Bramson has 30 years of dental industry experience, including national experience as executive director of the American Dental Association (ADA) and secretary of the ADA Foundation. For more information about our findings, visit the UCWellness Oral Health Study on United Concordia’s website at www.ucci.com.

The Word of Mouth on Dental Insurance

by John T. Harmeling

Let’s get real: A dental visit isn’t high on the list of most people’s favorite activities. In fact, the American Association of Endodontists reports that about 80% of Americans are afraid of the dentist and up to 10% are so fearful that they avoid dental checkups altogether.

Still, despite their reluctance to settle into the dentist’s chair, American workers understand the value of having healthy teeth and gums: Dental coverage is the third-most-requested employee benefit after major medical insurance and retirement benefits.

One reason for the demand is that overall health and dental health are clearly linked. Numerous disorders have been connected to gum disease. Diabetes, rheumatoid arthritis, respiratory infections, kidney failure, and even premature birth are among the conditions directly tied to poor oral hygiene.

Drilling down: The High Cost of Poor Dental Care

Many of our nation’s large companies have recognized the need for dental benefits and are answering the call by providing employees with access to coverage. However, just 53% of companies with fewer than 200 workers offer or contribute to an employee dental plan. What’s more, 40% of American employees don’t visit their dentists because they can’t afford it or don’t have insurance.

Unfortunately, while avoiding dental-visits may save employees money in the short term, it can be wildly expensive in the long term to workers and the companies they serve. The Senate Committee on Health, Education, Labor & Pensions estimates that dental problems result in loss of productivity for American businesses to the tune of 164 million hours each year. And a recent Pew Center on the States study revealed that Americans are increasingly visiting hospital emergency rooms for routine dental care where treatment options are fewer and the cost is often 10 times higher than it is for preventive care. According to the Pew study, emergency-room visits for dental treatment increased 16% from 2006 to 2009, and the majority of those visits were for toothaches and other preventable issues.

Sally Gehshan, director of Pew’s children’s dental campaign said, “The care provided in an emergency room is much more expensive, and it generally doesn’t solve dental problems. Most hospital emergency rooms are not staffed with dentists, and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues.”

Empty Dental Chairs

In addition to taking note that smaller companies are the least likely to offer dental benefits, brokers should be aware of the great dental divide among U.S. states and regions. The Gallup Organization conducted 177,000 interviews as part of a well-being index, revealing that residents of the Northeast and upper Midwest are the most likely to have visited a dentist in the past 12 months. Residents of Southern states are least likely to visit a dentist. West Coast States fall into the higher- and mid-range dental-visit categories, with 64.6% of California residents making appointments in the 12 months prior to the survey. There is a high correlation between health insurance and dental care: The top 10 states for dental visits had an average health insurance rate of nearly 72%.

Dental and Employee Morale

When meeting with potential and current accounts, remind decision-makers that offering voluntary dental insurance can improve not only productivity, but also employee loyalty and retention. In fact, 38% of employees say that companies show they care about their workers by providing comprehensive benefit packages, according to the 2013 Aflac WorkForces Report. Employers that don’t provide robust packages can face serious consequences; nearly 40% of workers who say their employers don’t care about them say that they’re likely to leave their jobs in the next year.

Consider proposing voluntary employee-paid dental benefits as a simple and cost-effective way for employers to show their concern about workers’ health and generate employee loyalty and job satisfaction. Workers agree that benefits move the needle on job satisfaction (84%) and employee loyalty (70%) in addition to influencing their decisions to stay with a company.

The Easy Sale

There’s no need for a hard sell to employees: You can easily make the case for coverage. Remind them that dental insurance is about more than cavities and root canals; it’s also about regular dental visits that can keep problems from occurring in the first place. Encourage them to take their families’ needs into consideration, especially if they have children. Tooth decay is the most common chronic disease among children in the U.S. The Centers for Disease Control and Prevention reports that more than 40% of children have decay by the time they reach kindergarten.

Service After The Sale

Once you’ve sold the account and enrolled the employees, encourage your policyholders to use their dental coverage to the fullest and take advantage of any wellness benefits that are entitled to them under the plan. After all, employees who don’t use their benefits are less likely to renew their policies during re-enrollment.

Remember that looking out for the long-term health of your customers separates the salesperson from the benefit expert. Your ongoing advice and guidance will ensure that your accounts and their workers continue to turn to you when they are looking for benefit solutions.


John T. Harmeling is Aflac’s senior VP of Worksite Marketing. He is responsible for Aflac’s worksite segment, overseeing integrated sales and marketing programs and extending the company’s efforts to attract and retain customers. For more information about Aflac, call 800-99-AFLAC (800-992-3522) or e-mail:  addbenefits@aflac.com.

Helping Employees See the Light at the End of Their Cigarette: How Eye Health Educati on Can Promote Smoking Cessation

by Vincent K. Young, M.D.

Every day, we make decisions that affect our health. Some of our actions lead to positive results like finding time to hit the gym a few nights a week after work or making an effort to eat healthier. Other lifestyle choices, like avoiding exercise, eating fast foods, and simply not getting enough sleep, may have adverse effects on our health. With so many factors to consider, it’s hard for anyone to say they lead a perfectly healthy lifestyle. For example, how many people get the seven to nine hours of sleep each night that the National Sleep Foundation recommends? At least 30% of workers suffer from sleep deprivation, according to the Centers for Disease Control and Prevention.

Most employees know that exercising, eating better, and getting a good night’s sleep can make a difference in how they feel and perform at work. But far fewer connect their lifestyle choices to their vision and long-term eye health. With eye health so closely connected to overall health, this lack of awareness can be bad news for an employer’s bottom line.

Smoking is one of the costliest habits. It not only leads to serious overall health issues, but it has also been linked to vision loss and blindness – costing employers upward of $172 billion in health care dollars each year, according to the Centers for Disease Control. Smoking cessation programs are appealing to employers since as many as one in five adult workers is a smoker. The majority of these programs focus on overall health consequences, tips for quitting, and access to support groups. But the topic of eye health has traditionally been an afterthought, which is a huge missed opportunity.

Consider the results of a 2012 employee study from Transitions Optical. Nine out of 10 employees surveyed know that smoking could cause cancer and more than three out of four know it could lead to heart disease and death, but fewer than half know that smoking could affect their eye health. Even more alarming, the majority of employees surveyed only associated eye health consequences with yellow eyes and ocular irritation, which are two of the least intimidating side effects. Less than three out of 10 employees associated smoking with far more serious risks, such as vision loss and blindness.

Employee Awareness of the Eye

Health Risks of Smoking: Transitions

Optical 2012 Employee Survey

Despite the low awareness, the survey identified a silver lining for employers that are willing to provide some simple eye health education to employees. In fact, 84% of employees would take steps to quit smoking if they knew it could hurt their eye health – with 36% strongly agreeing with this statement. While these numbers may sound high or even overly optimistic, as an ophthalmologist, I know, first-hand, that going blind is viewed as one of the worst fates imaginable.

Smoking cessation has long been a taboo topic for many employers. They know that getting employees to quit would be extremely beneficial in terms of productivity and health care savings. But they don’t want to be the ones to tell them they have to quit. Employers can help turn an awkward conversation into an educational discussion that motivates employees to quit smoking. They key is to shift the focus to eye health education and provide information about the dangers of smoking and how regular eye care, through a vision benefit, can help protect long-term eye health.

Educating on the Dangers

Brokers can help employers enhance their smoking cessation efforts by providing education about the eye health risks of smoking. They can also remind them that employees who do smoke should get regular eye exams to detect and prevent eye health issues before vision loss or blindness occurs. Even those who live with a smoker or are frequently exposed to secondhand smoke are at risk for smoke-related vision problems.

Consider sharing these statistics from the New York State Department of Health:

• Smokers are 2.5 times as likely to develop age-related macular degeneration – an incurable disease that can lead to irreversible vision loss. Smokers are more likely to suffer from all types of age-related macular degeneration and to relapse after treatment. They also develop the disease 10 years earlier than do non-smokers.

• Those who smoke heavily (15 cigarettes a day or more) have three times the risk of developing cataracts, or the clouding of the naturally clear lens of the eye.

• Smokers are three times as likely to develop glaucoma.

• Smokers are twice as likely to develop diabetes, which can lead to serious eye health complications including diabetic retinopathy.

• Smokers are more than twice as likely to develop other eye health issues including dry eye syndrome, Grave’s disease, and thyroid eye disease.

In addition to eye diseases, smoking can lead to eye health issues ranging from abnormal eye movements to fungal eye infections. The ultimate price to pay is blindness. Many studies have shown that smokers are two to three times more likely to lose their sight than non-smokers.

Overcoming Obstacles

When implementing smoking cessation programs, it’s important to keep in mind that not all employees will be receptive to the messages. Even those who are open to quitting may not succeed the first time around. Mark Twain once said, “Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.” Many employees say they would take steps to quit if they knew that it could hurt their eye health. So brokers and employers who don’t take the time to provide education on this topic are doing a disservice to themselves and their clients.


Vincent K. Young, M.D. is a practicing ophthalmologist and director of Einstein Eyewear, a full-service optical center, at the Albert Einstein Medical Center in Philadelphia. Dr. Young is a member of the American Academy of Ophthalmology, the American Medical Association and the Philadelphia County Medical Society. He is on the advisory board of the International Vision Expo, is a member of the board of trustees for the Albert Einstein Healthcare Network, and is a member of Transitions Optical’s Diversity Advisory Board. Dr. Young has been recognized as a “Top Doctor” in Philadelphia magazine.  

Online Education As Voluntary Benefit Option

by Elizabeth Halkos

Employers can help employees attain a better life for themselves and their families through a new voluntary benefit option — online education. These innovative voluntary benefits allow employers to meet the diverse needs of their workforce without adding to the bottom line.

The Rising Cost of Education 

Each year, the cost of a college education escalates. Ninety-four percent of students are taking out loans to pay for education, and one in 10 who started paying their loan in 2009 have already defaulted, according to a study by the National Center for Public Policy and Higher Education and the Dept. of Education. Last year, outstanding education debt surpassed credit-card debt for the first time.

Working adults who want to return to school may get some financial relief from their employer through tuition assistance. But it’s not enough to cover the cost. In addition, many employees are cutting tuition assistance programs because they are getting expensive to offer. In addition, most tuition assistance programs don’t cover core classes and family members cannot utilize educational assistance programs.

It’s not just a four-year degree that’s important these days. As much as $70 billion is spent on industry-based certifications, apprenticeships, post-secondary certifications, and associate’s degrees for employees, according to statistics from the National Center for Public Policy and Higher Education.

Why Online Education?

Inc. Magazine named online education one of the seven game-changing trends for 2013.  There are a couple of reasons for its popularity. Traditional education is at a crossroads not only because it is difficult for families to budget and save for education, but also because the cost often outweighs the wages associated with the new skills. Online education offers a way to attain professional certifications and complete degree programs for those who started college, but didn’t graduate.

Educational Services through Employee Purchase Programs

Leading-edge employee purchase programs offer online educational services, such as college courses; SAT/ACT prep and tutoring courses; professional certification courses; and high school and career diplomas. The programs are offered at competitive prices. The employee pays for the courses over 12-months of payroll deductions, giving them the chance to graduate debt-free.

Providing online educational services through employee purchase programs helps employers attract and retain employees. Forty-eight percent of employees value the accessibility of voluntary benefits and the ability to pay through payroll deduction, according to a recent survey by Prudential.

Purchase programs are advantageous to the employee because they involve easy qualification; employees must simply be 18 years old and meet minimum salary and tenure requirements. Most employee-purchase programs have no finance fee or ballooning interest. Unlike a credit card, the payment term in a payroll deduction program is fixed over the course of 12 months. Many employees who have participated in these programs say they didn’t even miss the money because it was taken directly from their paychecks. The process is pain free, and the tangible benefit is almost immediate (as soon as the employee orders and receives the product).

How Producers Can Benefit

Producers can increase their revenue stream by including these non-traditional voluntary benefits in their product portfolios. Not only are these products a no-cost add-on for existing clients, but they can also be a door opener to new clients.

In addition to offering an attractive commission, non-traditional voluntary benefits can give advisors and brokers an advantage over competitors who only offer traditional voluntary benefits. One-size-fits-all products are a thing of the past.

With the Patient Protection and Affordable Care Act requiring 85 cents out of every dollar premium be used to pay claims, carriers will be left with just 15 cents of that dollar to pay their expenses, including broker commissions. There is no better time to add traditional and non-traditional voluntary benefits to your product portfolio.

What Employees Say

Many full-time employees say educational services are important to them and that they would consider using an employee purchase program to access those educational services, according to a recent online survey conducted by Harris Interactive on behalf of Purchasing Power.

Many employees are looking for educational services, such as SAT/ACT preparation, tutoring, career diploma course, college courses, and professional certifications. Fifty-three percent are at least somewhat likely to pursue such educational services for themselves or their family without considering the cost involved or how they would pay for them. Likewise, 53% of employees say they would be at least somewhat likely to pursue those educational services through an employee purchase program.

Innovative online programs, professional certifications, catch-up degree programs, and other traditional education replacements are the wave of the future. By providing educational services as a voluntary benefit, employers can play a key role in helping employees and their families improve their future while gaining a more educated workforce.

Offering employees an affordable way to pay for education through an employee purchase program shows that a company truly values its employees and their future. Brokers who introduce online education services through employee purchase programs help employers implement a more competitive benefit package while increasing their own recurring income.


Elizabeth Halkos is chief revenue officer for Purchasing Power.

Disability: An Expert Opinion on Contractual Language

by Arthur L. Fries, RHU

Often, a major insurance company purchases a block of individual disability business. Or a third party administrator is hired to handle claims for an insurance company that no longer writes disability insurance or no longer has the capacity to provide disability claim services.

Frequently, the new insurance company or TPA doesn’t know the intent of those who originally drafted the disability policy or how the policy was marketed to wholesalers or brokers/agents. Also, the new insurance company often has a different attitude than did the originating company. This disconnect had been evident in several cases for which I was hired to give an expert option.

The Insurance Company’s Attorneys 

One case involved an individual disability policy with benefits payable for life if a disability occurred before age 55 for sickness or accident. Handling the originating company’s disability policy was the company with which it had merged. The company’s attorneys claimed that the cost of living adjustment (COLA) option ended at age 65. They also said that, at age 65, the monthly benefit reverted to a lower level than existed before the claim began. I had never seen a disability policy with this language. The policy would pay a monthly benefit for life as long as the claimant continued to meet the definition of total disability. But the monthly benefit would be less than expected from age 65 and thereafter.

We convinced the defense attorneys that the COLA benefit did not end at age 65, which would have meant lowering the monthly benefit to the pre-disability amount. We showed that the COLA benefit did not level out at age 65 and the monthly benefit kept on increasing.

In almost all situations, the COLA option increases with simple or compound interest (with a maximum or minimum). It may be related to the Consumer Price Index. This increase occurs after a one-year waiting period from the date of total disability. It increases each year until age 65. At that point, the monthly benefit levels off and is paid for life. If the monthly benefit begins at $7,500, it may increase to $9,500 at age 65 with COLA adjustments. From that point, $9,500 is paid for life. But, the insurance company’s attorneys believed that, beginning at age 65, only $7,500 a month should be paid for life.

The COLA ends under the following scenarios:

• The date your total or residual disability ends.

• The date the maximum benefit for the rider ends. The rider extended by lifetime benefit.

• The anniversary on or after your 65th birthday. The insurance company is saying that it doesn’t have to pay any COLA benefit.  Note that there is no contractual description of the word “anniversary.” But I believe this to mean “policy anniversary.” The policy goes on to say how long the company will pay the increases. I interpreted this to mean, “COLA increase percentages.” The paragraph wording doesn’t say that the COLA benefit will not be paid. It doesn’t even say that the COLA increases will be eliminated at age 65.

My Opinion 

I have audited several thousand individual, group, and association trust policies in connection with a disability claim since 1995. I sold mostly individual disability policies from 1963 to about 1992. Except for one insurance carrier, every policy had the COLA option ending at age 65. The COLA option leveled off if the policy provided a lifetime benefit. Whatever it had leveled off to was the monthly benefit payable for life.

I was an undeclared expert for this case. If the insurance company’s attorney had not settled, I would have then been a declared expert with an opportunity for my deposition to be taken and heard in a trial. The insurance company’s attorneys would have been in for a shock when they found out that they hired me as an expert, many years earlier, in two cases and praised my work standards and ethics.

The threat of a class action lawsuit by others who were hurt by its wrongful interpretation was also a deterrent to the company continuing to proceed to trial and risking further embarrassment. As a result of my opinion, the lawsuit was settled for a much larger amount than even the claimant’s attorney anticipated.

As an aside, this carrier’s contract had a COLA option that did not level off at age 65. Like the Energizer Bunny, it kept going with the monthly benefit still increasing and payable for life, which was probably a mistake. The contract was created by a life insurance company that had gone into the disability business when many other disability carriers were no longer interested in providing disability insurance. The company used a TPA to handle its claims. I’m sure that the company was as shocked as the TPA was when it realized how much liability it had assumed.

If you sell disability insurance and you are not sure about contractual language, seek an expert who can provide an opinion. The answers are often provided at no cost since camaraderie has always been the mark of those involved in this end of the insurance business.


Art Fries is a disability claim consultant providing advice on a national basis in the U.S. He is located in Nipomo, Calif.  He can be reached at 800-567-1911or e-mail friesart@ hotmail.com the Web address is wwwafries.com.

Legal Plans Represent Winning Proposition for Employers & Employees

by Alan Fearnley

In a recovering economy, it can be hard for employers to budget financial rewards. Companies are offering employees everything from health spa memberships, to pet insurance, to discounted airline tickets. Tom Yopp, vice president of administration for the Hendricks Automotive Group had a lot of options when he was looking to enhance the company’s voluntary benefit package.

Hendricks, a Charlotte N.C-based company, operates 92 auto dealerships across the country. The company, which is highly selective of its benefits offerings, wanted to add a benefit that could help employees with the problem areas of their lives.

Yopp said Hendricks’ leadership team knew that the employees, like all people, regularly encounter legal situations and issues that they don’t know how to handle. He added that these issues often bleed over into the workplace, affecting employee attitudes and performance.

“The more we researched options, the more we realized that a legal protection plan made a lot of sense. People have health insurance, property insurance, life insurance and disability, and the like, but most people don’t have any help in dealing with the legal issues they face over course of their lives,” Yopp said.

Yopp’s assessment is correct. More than 57 million full-time working Americans experienced at least one legal event in the past year and nearly half faced their legal issue without professional help, according to a new national study sponsored by LegalShield and conducted by the research firm Decision Analysts. That figure rises to 70% of the country’s total population when you include non-working Americans — those unemployed, retired and disabled, according to the American Bar Association.

Even more troubling are figures in the Legal Needs of American Families Study. The study reveals that nearly half of working Americans who experienced a legal issue last year did not seek professional advice or assistance for even serious concerns, such as IRS audits, arrests for DWI, or identity theft. Study participants said they were reluctant to seek professional legal help because of cost, confusion, and fear.

“The study confirmed what we’ve known intuitively for a long time. Too many American workers are facing significant legal challenges alone and the impact goes far beyond their personal lives. It affects them at work as well.

Stresses brought on by personal legal issues are indeed taking a toll on employee productivity and morale. Personal issues, such as divorce, bankruptcy, and child custody issues cost American businesses more than $300 billion in lost hours due to absenteeism, lost productivity, and morale issues, according the American Institute of Stress. The Legal Needs Study reveals that 66% of American workers who experienced a legal event in the past year took at least one day off from work to deal with it. Ninety percent said they were distracted at work and that their legal issues affected their productivity and attitude.

Yopp of Hendricks Automotive Group said, “Productivity was not the main reason we decided to offer a legal plan. But we knew that would be one of the benefits for us. We knew this would be a way to help our employees avoid or deal with legal situations before they became big issues that would affect them at work.”

Yopp says that about one-fifth of Hendricks’ 5,000 benefit-eligible employees are enrolled in the company’s legal plan. Employees pay the entire cost of the plan, which is less than $20 per month. Yopp says that informal feedback reveals that employees are pleased with the benefit. “We think the take rate by our employees is a good indicator of its popularity, and we know they are using the plan and that the services provided have been very helpful,” Yopp said.

Although the legal plans are among the fastest growing voluntary benefits, they’re still largely unknown among most American workers. The Legal Needs Study reveals that only 10% of American workers have access to a legal plan through their jobs. Even more surprising is that nearly two-thirds of American workers don’t even know that legal plans exist.

The study does show that when legal plans are explained, more than 60% of American workers say they would be interested in enrolling at their own expense. The number jumps to more than 70% if the cost is split 50/50 with their employer.

Legal plans are where health insurance was 40 years ago. We have a lot of work to do in terms of educating employers and employees about the value of having legal plans. But the more employers and employees learn about how legal plans work, the more popular they will become. We know that once someone enrolls in a legal plan, they use it quite frequently.

The new study points out that 70% of workers enrolled in legal plans use the plans at least three times and nearly 75% of workers say they are very satisfied with the services provided and the overall experience.

Yopp said that, when choosing a benefit provider, Hendricks Automotive Group looked for an established company with a proven track record of providing quality services. He said the company also needed a provider that could deliver services in 13 states that span from the East to West Coast. Under the plan Hendricks offers, employees pay less than $20 a month to have nearly unlimited access to dedicated law firms in their home states. Plan attorneys have an average of 19 years of experience in the areas of law — family, financial, and estate planning, wills and medical directives, tax, real estate, etc. — areas that affect individuals and families the most. With one call, employees are connected with an attorney to discuss their legal problems or needs no matter how serious or trivial the issue.

The Legal Needs Study reveals that, if legal service were more affordable, 90% of American workers would seek legal assistance for issues as small as a traffic ticket or the review of a rental agreement. Respondents reported paying an average of $284 an hour for legal help with 24% reporting in excess of $400 per hour.

Yopp said, “One of the things that we found most valuable is that having a legal plan allowed our employees to get help with the little things that can make life very stressful. A landlord may be totally unresponsive to returning a security deposit, but if an attorney sends a letter, those things usually get resolved pretty quickly.”

Legal plans with dedicated firms also make it easy for employees to find a qualified attorney when they need one. More than two-thirds of American workers wouldn’t know a particular lawyer to call if they needed one. Ninety percent find a lawyer randomly through an online search or through some sort of advertising. Nearly 75% of American workers say they are hesitant to call an attorney for reasons ranging from worrying about the cost to being fearful that a lawyer will take advantage of them.

“Employees don’t usually say much when a benefit is useful and is meeting their expectations. But, believe me, we hear a lot from them when service is poor. I think the fact that we don’t have any complaints about our legal plan is a good indicator it’s meeting their needs,” Yopp said.

Yopp said that the ultimate payoff for companies who offer legal plans is in the improved attitudes and perceptions that employees have about their employer.  The Legal Needs Study reveals that 93% of American workers have higher job satisfaction when their employers offered legal plans.

“I think it’s been a very good thing for our company. We’ve been able to help employees deal with issues that cause major stress and worry in their lives. As a result, those employees are more focused and productive and are happier in their jobs.” q


Alan Fearnley is the president and Chief Commercial Officer of LegalShield.

Legal Plans are Proven to Enhance Employee Loyalty and Satisfaction

by Marcia L. Bowers

Until recently, the correlation between voluntary benefits and employee satisfaction was fuzzy at best. Everyone knew it existed, but to what extent? These days, we have more insight into this correlation, which is made even clearer by MetLife’s 11th Annual Study of Employee Benefit Trends published this year. -Strikingly, 67% of employees who were very satisfied with the range of voluntary benefits offered by their company also felt very loyal to their employer. In contrast, only 35% of employees who were dissatisfied with their range of voluntary benefits felt the same loyalty.

The study also addressed common misperceptions among employers — one being that employees are quite satisfied with their voluntary benefit offerings. On the contrary, 62% of employees surveyed are interested in a wider array of voluntary benefits. Seventy-seven percent of employees value benefits that are geared toward their circumstances, such as accident insurance, auto insurance, critical illness insurance, and prepaid legal services.

Prepaid Legal Services to Support HR Objectives

The survey findings support a growing trend among organizations that are adopting legal plans to meet hiring and retention goals. Nearly 70% of organizations that offer prepaid legal services do so to improve employee satisfaction. The second most important objective for offering a legal plan is to boost employee retention (cited by 44% of survey participants), according to a recent SourceMedia study, conducted on behalf of Hyatt Legal Plans, a MetLife company.

Furthermore, 93% of survey respondents that offer legal plans say they are likely to continue offering them, indicating strong perceived value among workers and employers alike.

A One-Size-Fits-All Voluntary Benefit

Legal matters are not confined to a particular age group or demographic. An American Bar Association study reveals that 71% of Americans face at least one new or ongoing legal issue each year. The same study also finds that more than half of Americans with legal issues try to resolve matters on their own because they are hesitant to work with an unfamiliar attorney or they simply cannot afford one. Here are some examples of legal matters common to each workforce generation:

• Generation Y (ages 18 to 31): credit card debt and debt collection defense, traffic tickets, landlord negotiations, and DUIs.

• Generation X (ages 32 to 47): real estate matters, foreclosure, estate planning, adoption, school hearings, and will creation.

• Baby Boomers (ages 48 to 66): tax audits, property sales, identity theft, powers of attorney, living wills, and Medicare questions.

Misperceptions About Time And Cost

According to the SourceMedia survey, approximately two-thirds of employers that don’t offer a legal plan would be open to offering one if they had additional insights. They need more information to convince upper management. They also need to be assured that a legal plan wouldn’t add to the administrative burden or overall cost.

Legal plans offer a low-cost benefit because they are employee-funded. Human resources staff only need to manage a simple payroll deduction. Employees contribute an average monthly rate of $18 (the same rate for everyone) for a broad list of covered services and access to a national attorney network. A simple math calculation indicates potential savings for employees: Average hourly rates for experienced attorneys range from $290 up to $365 per hour — more than an entire year of group legal services.

Sixty-four percent of employers who participated in the survey consider legal plans easier to administer than other voluntary benefits, and 35% consider them equally easy. Implementation involves three simple steps:

1. Offer the plan during open enrollment.

2. Collect payroll deductions.

3. Submit one monthly file. There are no claim forms, deductibles, or limits on usage.

Benefit professionals are challenged with creating competitive benefit packages that improve employee satisfaction and retention without increasing cost or effort. Many companies are meeting this challenge by expanding their non-traditional voluntary benefit offerings, including prepaid legal services. For more information, download the study on using legal plans to meet HR objectives at www.legalplans.com/eguide.


Marcia L. Bowers, group sales director of Hyatt Legal Plans, joined Hyatt in 1991 and holds a JD. She has implemented hundreds of group legal plans for top organizations, including FedEx, Shell, Target and the University of Michigan. She earned a BA from Hiram College and an MA from Kent State University. Prior to her career at Hyatt Legal Plans, Marcia was a television anchor for an ABC affiliate station and held executive and creative positions at several advertising agencies.

The Case for Complimentary and Alternative Medicine

by Leila Morris

Skeptics say that complimentary alternative medicine (CAM) is not effective and simply adds to healthcare costs. But research has found just the opposite. A 2010 study by the National Institutes of Health (NIH) finds that patients who took advantage of CAM therapies had only $3,797 in healthcare expenditures compared to $4,153 of those who did not. Among patients with the heaviest disease burden, those who had CAM therapies had $1,420 lower healthcare expenditures. While CAM users spend more on outpatient care, they spend less on inpatient care and imaging.

Patients who used CAM providers for at least part of their care for back pain, fibro-myalgia, or menopause symptoms had slightly lower overall expenditures than those who only used conventional providers. According to researchers, “Given the expected $356 lower expenditure for each CAM user, we would expect an overall $9.4 million lower expenditure in a group of 26,466 CAM patients.” One researcher explains that CAM therapies offer inexpensive remedies while harnessing the body’s natural ability to heal itself.

A New Generation of Doctors Embraces CAM

Traditional doctors have been some of the biggest skeptics of CAM. But that is beginning to change. The Integrative Medicine elective has become a top choice for fourth year medical students, reports the Univ. of Maryland School of Medicine.

A study by UCLA and the Univ. of California, San Diego reveals that 70% of medical students say it would be more effective to integrate conventional medicine with complementary and alternative medicine than it would be to provide either type of medicine independently.

“Integrating CAM into mainstream health care is now a global phenomenon, with policymakers at the highest levels endorsing the importance of a historically marginalized form of health care,” said study author Ryan Abbott, a researcher at the UCLA Center for East-West Medicine. (The study findings are in the online edition of the peer-reviewed journal Evidence-based Complementary and Alternative Medicine.)

“Although the content of integrative medicine programs remains controversial, medical schools across the country are moving forward with ambitious new programs to teach the next generation of health care leaders,” said Dr. Ka-Kit Hui, chair of UCLA’s Collaborative Centers for Integrative Medicine.

Hui said that integrative medical education is increasingly being recognized outside of UCLA. Forty-four highly esteemed academic medical centers are now part of the Consortium of Academic Health Centers for Integrative Medicine, which was established to advance the principles and practices of integrative health care within academic institutions.

The next generation of healers is also benefiting directly from alternative medicine. A recent study, published in Medical Education Online, describes how an innovative course is helping medical students manage stress and use mind-body skills with their patients. “Our study provides compelling evidence that mind-body approaches have benefits for medical students and could have a positive impact on their interaction with peers and patients,” says study author Allison Bond.

“An effective career in medicine requires technical competence and expertise, but just as important is the ability to empathize and connect with others, including patients,” says Robert Saper, director of integrative medicine at Boston Medical Center and associate professor of family medicine at Boston University School of Medicine.

The 11-week course teaches students about mind-body approaches to help their patients achieve better overall health. Offered for the first time in spring 2012, the class met once weekly and included a 30-minute lecture about the neuroscience of yoga, relaxation, and breathing exercises followed by a 60-minute yoga, deep breathing, and mediation session. Each student was asked to practice the techniques (breathing, yoga, etc.) at least three times a week. Overall, responses indicate a statistically significant increase in self-regulation and self-compassion. There also was a decrease in perceived stress and an increase in empathy, although not statistically significant.

It’s no surprise that CAM is being taken more seriously as research is bearing out its effectiveness.

Chiropractic for Low Back Pain

A recent study in the medical journal, Spine, finds a strong association between getting chiropractic care and avoiding lumbar spine surgery. About 43% of patients who saw a surgeon first for low back pain went on to have surgery compared to only 1.5% of those who saw a chiropractor first.

An article in the Journal of the American Medical Association (JAMA) recommends that patients try chiropractic services for low back pain and only consider surgery if more conservative therapies fail. “Research confirms that the services provided by chiropractic physicians are not only clinically effective, but also cost-effective, so taking a more conservative approach at the onset of low back pain can also potentially save both patients and the health care system money down the line,” according to a statement by the American Chiropractic Association (ACA).

Acupuncture for Fertility Treatment

Researchers at the Center for Integrative Medicine, at the University of Maryland’s School of Medicine found higher rates of clinical pregnancies, ongoing pregnancies, and live births when acupuncture took place on the day of embryo transfer. In addition, a German study, published in the journal Fertility and Sterility in 2002 found that 42% of women became pregnant after receiving acupuncture just before and after an assisted-reproductive therapy, such as IVF, compared to only 26% of women who got pregnant without it.

Acupuncture for Colorectal Cancer Patients

NIH researchers found that colorectal cancer patients who received electro acupuncture had an average post-operative hospital stay of 2.2 days compared to 4.8 days for those who did not get the therapy.

Acupuncture for Stress

In a series of studies at Georgetown University Medical Center (GUMC), researchers are demonstrating how acupuncture can significantly reduce the stress hormone response. The latest study was published March 14 in the April issue of Journal of Endocrinology.

The study’s lead author Ladan Eshkevari, PhD, CRNA, L.AC. said, “We’re starting to understand what’s going on at the molecular level that helps explain acupuncture’s benefit. We found that electronic acupuncture blocks the chronic, stress-induced elevations of the HPA axis hormones and the sympathetic NPY pathway.”

Meditation for Blood Pressure

The American Heart Assn. (AHA) published a recent report recommending Transcendental Meditation to lower blood pressure. Researchers found that Transcendental Meditation lowers blood pressure (on average 5 mmHg systolic, and 3mmHg diastolic.) By some accounts, it’s a modest reduction. But Dr. Schneider says that it may be enough to help millions of people with high blood pressure get into a more normal range. It may prevent patients from needing hypertension medication, thus avoiding the attendant side effects and costs.

Robert Schneider, MD, FACC, director of the Institute for Natural Medicine and Prevention said, “This is the first time that the Transcendental Meditation technique has been recognized and recommended for consideration by a national medical organization that provides professional practice guidelines to physicians, health care payers, and policymakers. This type of guideline statement has been what health insurance companies have been requesting for many years.”

Trends in Insurance Coverage

The vast majority of California’s 38 million residents are likely to gain a basic level of acupuncture coverage starting in 2014 under Affordable Care Act (ACA), according to the California State Oriental Medicine Assn. The base coverage will be equivalent to that provided under the Kaiser Small Group HMO plan, which offers up to 20 covered acupuncture visits per year. However, plans purchased outside of the Exchange could establish higher limits or no limits.

Under PPACA, the Secretary of Health and Human Services is charged with defining Essential Health Benefits. Acupuncture services could potentially be included for maternity care, mental health, rehabilitative services, preventative wellness, chronic disease management, and pediatric care.

The American Chiropractic Association (ACA) is working with key congressional supporters on several bills being introduced in the 113th U.S. Congress. The Chiropractic Care Available to All Veterans Act (S. 422) and companion bill, H.R. 921, would require the VA to have a chiropractic physician on staff at all major medical facilities by 2016.

The Chiropractic Health Parity for Military Beneficiaries Act (H.R. 741) would extend chiropractic services to military retirees, dependents, and survivors as part of TRICARE.

Under the Chiropractic Membership in the Public Health Service Commissioned Corps Act of 2013 (H.R. 171) doctors of Chiropractic would be included in the U.S. Public Health Service Commissioned Corps. — an elite team of public health professionals dedicated to promoting public health, disease prevention programs and advancing public health science.

It’s clear that science and public policy are moving alternative medicine into the mainstream. The hope, for many, is that employee benefit plans will go along with the tide.


Leila Morris is senior editor of California Broker Magazine.

Education is the Key to Life Insurance

by Phil Bodine, LUTCF

Misinformation about life insurance is commonplace. Since the financial crisis that began in 2008, consumers have been bombarded with inaccurate information. They are overwhelmed with competing messages from financial entertainers who broadcast to loyal audiences through radio and television.

A bevy of data is available about investments, do-it-yourself financial planning, and even life insurance on the Web and through the media. With so much misinformation, many consumers are being persuaded to think that what is often wrong is right. I remind my clients that they don’t know what they don’t know.

I’m convinced that all consumers, especially our clients, need to be educated about life insurance now more than ever. Through proper instruction and with our guidance, our clients can avoid the financial misinformation of the marketplace and work with us to design the best strategies for wealth creation and preservation. We can help them offset taxes, social security, inflation, and stock market volatility with expert financial tools, such as life insurance, which can preserve their wealth and offer guarantees and protection.

With constant media messages in print, television, and online, many consumers think they have all the tools they need to be their own financial experts. When I meet with clients about planning for their financial future, I always discuss the Five-100 rule with them:

After five years, 100% of their financial ideas/illustrations are going to be wrong. There are too many uncertainties. We have already mentioned the volatility of the stock market, taxes, etc. However, health, income, legal, planned obsolescence, technological change, and environmental factors are also of growing concern for our clients — all of which could affect their finances.

When a prospective client is skeptical about life insurance, I take the opportunity to educate them about life insurance concepts before I ever begin discussing how it can help them. A few years ago, I met with a successful small business owner. As he entered my office, his very first comment to me was, “I’m not interested in discussing life insurance.” So, I approached our discussion as a session of instruction. I asked him a series of questions. I inquired about his ideal way to position money in his financial storehouse. If we could create the ideal financial tool, what would it look like? If so, would it include tools that involve tax deferred growth, tax-free distributions, and liquidity/access to capital guarantees?

As most successful entrepreneurs would, he answered  yes to all of the above. I asked him how much money he would be willing to give me to position him in this type of financial tool and he replied, “Every last dollar that I have.”

I told him that this financial tool did exist. As he leaned forward, I told him that one product is whole life insurance. I redirected his stereotypical opinion of life insurance, captivated his interest, satisfied his desire for creating an ideal financial tool, and reminded him that we hadn’t even discussed rate of return! He was in total disbelief.

People often think that the rate of return is the most important thing when it comes to investing. We educate our clients about all the benefits that life insurance offers, and de-bunk the myths doing so. When they are educated, they can see the need to have this product as part of their holistic financial plan. As one of my clients says, “Nothing I own is guaranteed — not my investment portfolios, my marriage, or my businesses. Life insurance is the only thing I own that is guaranteed.”

After the financial meltdown, “guarantee” has come to have a different meaning than it did five years ago. The bottom line is that life insurance will always be protected. I have found that cash value life insurance offers clients more security, better productivity, and additional liquidity.

My goal is also to keep my clients educated beyond the sale. Owning the policy is for the protection of my clients and their families, but the ultimate goal is for clients to use their policy as a strategy in the success of their overall financial plan. My clients look to me to make that strategy happen.

So many consumers are looking for that magic bullet to make them successful, not realizing that there has to be a strategy in place. You can purchase all of the best drivers to help you play a better golf game, but it is the coordinated swing — the strategy that goes along with that driver — that makes you successful. It is how they work together effectively to get there.

As I mentioned, one of my most important jobs is to continually educate my clients. I offer educational seminars every two months as much to promote my practice as to continually educate my clients. Even with a proper plan in place and ongoing maintenance, clients are still barraged with misinformation and need to be reminded of the benefits of their life insurance policy years down the road.

One example was a client with a dental practice that experienced a decline in business for the first time in several years. During their annual review, they said they were not able to take their annual family vacation because funds were too tight.

What they didn’t realize was that they had $400,000 in a whole life policy that could have easily been accessed for that vacation — money that belonged to them! When we reviewed again how their policies worked, they experienced a mix of relief and sadness.

They had the money they needed, but they missed the opportunity to take their family vacation. We scheduled a time for them to attend an upcoming seminar to refresh their knowledge.

Life insurance offers a better quality of life to our clients. It is up to us to make sure that the client understands the benefits of life insurance and how it can be part of a strategy for the financial security of themselves and their family as well as their business.


Phil Bodine, LUTCF has been associated with Ohio National Financial Services since September of 1991 and is based in Granite Bay, Calif. His numerous awards and honors from Ohio National Financial Services include two Pacesetter Awards, 16 Wall of Fame memberships, nine Council of honor qualifications, seven Executive Council qualifications and four President’s Inner Circle qualifications. Bodine’s Verdeo Financial and Insurance Services can be reached at 916-878-1045.


Life Insurance – How to Engage Women in Retirement Planning

by Celeste Gurule

Today, employers are taking a closer look at their employee base to see what can be done to help boost retirement readiness for every type of participant. Employees can benefit from retirement plans that are customized to meet their unique savings needs.

Understanding participants and how they save is a great starting point for structuring a retirement plan that helps women as well as men achieve retirement readiness. The following Q&A details what advisors need to know to help women prepare for retirement:

And for employers seeking to reach the women within their ranks, a recent study of female plan participants of employer-sponsored retirement plans offers insights to how women take action with retirement savings. This gender analysis explores how women think about retirement, as well as how and when they engage in the retirement planning process. Findings can help advisors and their clients better understand the unique retirement plan savings behaviors of women. Here are some of the key questions and answers that to ask when addressing the retirement planning needs of women.

Q: What Influences Women As They Save For the Future?

A:Research shows that hope and fear (emotional influencers) play a larger role for women in retirement planning while men rely more on intellectual influencers, such as hard facts and previous experience. In fact, women tend to be more concerned than they are optimistic about retirement issues, such as paying for day-to-day expenses, converting savings to retirement income, maintaining their lifestyle in retirement, and saving enough to retire.

To reach women in a meaningful way, organizations should focus on optimistic, action-oriented messages rather than fear tactics.

Q:How Engaged Are Women In the Retirement Planning Process?

A:Research shows that very few women are fully engaged in their retirement plans. In fact, many rely on their partners to be the decision-makers. Only 35% of women participants who are married or living with partners say they are the primary decision maker when it comes to saving, compared to 53% of men, according to a study by Lincoln Financial.

Advisors can help plan sponsors put the person first in their retirement planning efforts. Demonstrating how a specific plan can meet practical needs can help sponsors engage employees and let them know they’re speaking their language. An employer’s communication and educational programs should address participants’ concerns and provide ways to help them achieve their goals. If possible, plan sponsors should offer couples planning seminars and provide other resources to help engage women and their partners in the savings process.

Q:What Kind of Retirement Plan Communications Do Women Prefer?

A: The majority of women prefer one-on-one communication. But, they’re also interested in group sessions. Women want to hear from and ask retirement planning questions from a person who is experienced, qualified, and knowledgeable.

Relationships and interpersonal dialogue may help women overcome the hesitation that holds many back from taking action. Rather than relying solely on their partners, women are willing to work with a financial professional. Having in-person communication doesn’t preclude other options, such as calculators, model portfolios, e-mails and Website content. Each of these tools can be used as a conversation-starter or as a follow-up to in-person sessions. The key is to put personal experience at the center of the experience while using other communication channels and tools to support that model.

Q: What Does It Take to Implement A Successful Retirement Plan?

A:Organizations stand to gain by helping their employees — both men and women — better understand the retirement savings process and the tools available through their employer-sponsored plans. Here are several tips for plan sponsors when choosing a provider and structuring a successful plan:

• The power of choice. Research shows that not all employees can be grouped by gender. Sponsors can engage participants by offering information and guidance through a variety of communication methods, including phone, online, mail and e-mail.

• Make it personal. Communication and educational programs tend to be smoother and more effective with professional, personable representatives guiding the way. Some retirement plan providers offer retirement consultants to meet with employees for one-on-one guidance to boost retirement readiness.

• Help define goals. It is critical to help participants define where they want to go and how to get there. Since participants can get caught up with investment choices and their plan’s day-to-day performance, it’s important to help them keep the end-goal in sight.

• Simplify big decisions. Difficult decisions, such as enrolling in the plan, deciding how much to save, and selecting investments, can be barriers for hesitant investors — many of whom are women. Plan innovations, such as automatic features, including automatic enrollment, can help participants overcome some of these obstacles.

• Provide clear choices. Participants, particularly women, are influenced by multiple factors. They try to take in a lot of information when making retirement decisions while balancing other daily priorities. When it comes to investment, they appreciate anything that simplifies the decision-making process. Help participants organize the available investments into meaningful categories and narrow down the funds or strategies that suit them best.

Armed with the right information and tools, plan sponsors can help make retirement planning and saving a priority for all employees.


Celeste Gurule is managing director retirement plan services, Lincoln Financial Group. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.