The quality of a therapeutic relationship depends on the ability of the healthcare provider to communicate effectively. The term “therapeutic communication” is often used in the field of nursing; however, the process isn’t limited to nursing. Other healthcare professionals, friends and family members of a patient can implement the strategies of communicating in a therapeutic manner. The ideal therapeutic exchange provides the patient with the confidence to play an active role in her care.

Facilitates Client Autonomy

Therapeutic communication techniques, such as active listening, infer autonomy or independence on the patient or client. Rather than making assumptions about the client who is almost a stranger, the healthcare professional facilitates therapeutic expression. The client, ideally, will then become more comfortable sharing potentially difficult information. The role of the healthcare professional is then to use this information to help the client to further investigate his own feelings and options. In the end, the client gains more confidence in making decisions regarding his care.

Creates a Nonjudgmental Environment

Perhaps the most important characteristic of a therapeutic relationship is the development of trust. Trust facilitates constructive communication; it also encourages confidence and autonomy. Being nonjudgmental is necessary in verbal and nonverbal communication. People are acutely adept at identifying nonverbal cues that may communicate something very different from what is said.

Provides The Professional With a Holistic View of Their Client

An individual does not usually exist without a network of family, friends and healthcare professionals. Therapeutic communication emphasizes a holistic view of a person and his network of people who provide support. A person’s individual perspective regarding his health and life is viewed through a lens built from the context of his experiences. Those experiences cannot be ignored when communicating in a way that is therapeutic. Within the therapeutic relationship, the individual is learning the skills of communication with other people in his life, ideally also improving those relationships.

Reduces Risk of Unconscious Influence By The Professional

It’s human nature to want to infer some part of yourself into an interaction; however, in order for therapeutic communication to occur, it’s important to temper your influence. Therapeutic communication requires maintaining an acute awareness of what is being said as well as any nonverbal cues. Communicating that you are open to hearing what a person has to say while folding your arms creates confusion and inconsistency that can mar a healthy interaction. Be aware of your tone of voice and any reactions.

Originally Published By LiveStrong.com

When most experts think of group healthcare plans, Preferred Provider Organization (PPO) plans largely come to mind—though higher cost, they dominate the market in terms of plan distribution and employee enrollment. But Consumer-Directed Health Plans (CDHPs) have made surprising gains. Despite slight cost increases, CDHP costs are still below average and prevalence and enrollment in these plans continues to grow in most regions—a main reason why it was one of the top 7 survey trends recently announced.

In 2017, 28.6% of all plans are CDHPs. Regionally, CDHPs account for the following percentage of plans offered:

Prevalence of CDHP Plans

CDHPs have increased in prevalence in all regions except the West. The North Central U.S. saw the greatest increase (13.2%) in the number of CDHPs offered. Looking at size and industry variables, several groups are flocking to CDHPs:

Regional offering of CDHPs

When it comes to enrollment, 31.5% of employees enroll in CDHP plans overall, an increase of 19.3% from 2016, after last year’s stunning increase of 21.7% from 2015. CDHPs see the most enrollment in the North Central U.S. at 46.3%, an increase of 40.7% over 2016. For yet another year in the Northeast, CDHP prevalence and enrollment are nearly equal; CDHP prevalence doesn’t always directly correlate to the number of employees who choose to enroll in them. Though the West held steady in the number of CDHPs offered, there was a 2.6% decrease in the number of employees enrolled. The 12.6% increase in CDHP prevalence in the North Central U.S. garnered a large 40.7% increase in enrollment. CDHP interest among employers isn’t surprising given these plans are less costly than the average plan. But like all cost benchmarks, plan design plays a major part in understanding value. The UBA survey finds the average CDHP benefits are as follows:

CDHP benefits

By Bill Olson
Originally Published By United Benefit Advisors

The end of the year is upon us and a majority of companies celebrate with an end-of-year/holiday party.  Although the trend of holiday parties has diminished in recent years, it’s still a good idea to commemorate the year with an office perk like a fun, festive party.

BENEFITS OF A YEAR-END CELEBRATION

  • Holiday staff parties are a perfect way to thank your employees for a great year. All employees want to feel appreciated and valued. What better way to serve this purpose, than with an end of the year office celebration. Hosting a night out to honor your employees during a festive time of year boosts morale. And if done right, your party can jump start the new year with refreshed, productive employees.
  • End-of-year celebrations allow employees to come together outside of their own team. The average American will spend 90,000 hours (45 years) of their life at work. Unless you have a very small office, most employees only engage in relationships within their department. When employees have a chance to mingle outside of their regular 9 to 5 day, they’ll build and cultivate relationships across different teams within the organization; creating a more loyal, cohesive and motivated
  • Seasonal parties can provide employers insight on those who work for them. Spending the evening with your employees in a more casual and relaxed atmosphere may reveal talents and ideas you may not have otherwise seen during traditional work hours.

CREATING THE RIGHT FIT

Regardless of office size, if planned right, employers can make a holiday party pop, no matter your budget. Whether this is your first go at an end-of-year celebration for your employees, or you host one every year, keep a few things in mind:

  • Plan early. Establish a steering committee to generate ideas for your holiday party. Allow the committee to involve all employees early on in the process. Utilize voting tools like Survey Monkey or Outlook to compile employee votes. This engages not only your entire workforce, but serves you as well when tailoring your party to fit your culture.
  • Create set activities. Engaging employees in some type of organized activity not only eases any social anxiety for them and their guests, it cultivates memories and allows colleagues to get to know each other. Consider a “Casino Night”, a photo booth (or two if your company can justify to size), an escape room outing—anything that will kick the night off with ease.
  • Incorporate entertainment during the dinner. Have team leads or management members come up with fun awards that emphasize character traits, strengths, and talents others may not know of. This is a great way to create cohesiveness, build relationships, and have your employees enjoy a good laugh at dinner.
  • Offer fun door prizes every 15 minutes or so. Prizes don’t have to be expensive to have an impact on employees, just relevant to them. However, with the right planning you may be able to throw in a raffle of larger gift items as well. Just keep in the specific tax rules when it relates to gift-giving. Gift cards associated with a specific dollar amount available to use at any establishment, and larger ticket items, can be subject to your employees having to claim income on them and pay the tax.
  • Make the dress code inclusive of everyone. Employees should not feel a financial pinch to attend a holiday office party. Establish a dress code that fits your culture, not the other way around.

 

TAKE AWAY TIPS FOR A SUCCESSFUL HOLIDAY PARTY

According to the Society of Human Resource Management, statistics show in recent years only 65% of employers have offered holiday parties—down from 72% five years ago. Consider the following tips when hosting your next year-end celebration.

  • Keep it light. Eliminate itineraries and board-room like structure. Choose to separate productivity/award celebrations and upcoming year projections from your holiday party.
  • Invite spouses and significant others to attend the party. Employees spend a majority of their week with their colleagues. Giving employees this option is a great way to show you value who they spend their time with outside of work.
  • Allow employees to leave early on a work day to give them time to get ready and pick up who is attending the party with them.
  • Show how you value your employees by chatting with them and meeting their guests.
  • Provide comfortable seating areas where employees can rest, eat and talk. Position these in main action areas so no one feels anti-social for taking a seat somewhere.
  • Consider tying in employees that work in different locations. Have a slideshow running throughout the night on what events other office locations have done throughout the year.
  • Create low-key conversation starters and get people to chat it up. This is valuable especially for those that are new to the company and guests of your employees. Incorporate trivia questions into the décor and table settings. Get them to engage by tying in a prize.
  • Keep the tastes and comfort level of your employees in mind. Include a variety of menu items that fit dietary restrictions. Not all employees drink alcohol and not all employees eat meat.
  • Limit alcohol to a 2 ticket system per guest. Opt for a cash bar after that to reduce liability.
  • Provide access to accommodations or coordinate transportation like Uber or Lyft to get your employees somewhere safely after the party if they choose to drink.

 

Ultimately, holiday parties can still be a value-add for your employees if done the right way. Feel free to change it up from year to year so these parties don’t get stale and continue to fit to your company’s culture. Contemplate new venues, ideas and activities and change up your steering committee to keep these parties fresh. Employees are more likely to enjoy themselves at an event that fits with their lifestyle, so don’t be afraid to get creative!

Many people in their 40s are facing an uncomfortable fact: They simply aren’t where they’d hoped to be financially. Fortunately, all their life experience can help correct for past mistakes.

“There’s a different trigger moment for everybody,” says Jay Howard, financial advisor and partner at MHD Financial in San Antonio, Texas. “But regardless of when it comes, people find themselves looking down the barrel of a gun as they consider retirement.”

One challenge is that it’s impossible to advise 40-somethings based on tidy “life stage” demographics. Some are just starting families, while others are sending offspring to college. They’re married, single, divorced, and just about everything in between.

But for those still grappling with financial instability, these four principles can help in moving forward with confidence:

1. Acknowledge what you’ve done right.
It could be one great decision sandwiched in between some fails, or just a single good habit that can mitigate the impact of a host of wrongs.

Take the example of Kiera Starboard, a 46-year-old controller at a San Diego software firm. A mom to two adult sons and a teenage stepson, she always made having sufficient life insurance—both term and permanent—a priority, the result of her previous training as a financial advisor. “Even if it was tight, I made the payments,” she says. “It was a priority for my family’s sake, and for my own peace of mind.”

Unlike the 40% of Americans who have no life insurance, Starboard was protected when the unthinkable happened last August. Less than two years into her marriage, her husband, Steve, was killed while riding his motorcycle to work—one month after they purchased a small, additional life insurance policy to supplement his employer coverage.

“To have had to deal with financial stress on top of everything else, it would have been unbearable, incapacitating,” says Starboard. “My stepson and I are certainly in a much better position today than we would have been, had Steve and I not followed the advice I used to give to others.”

2. Take action to shore up the decades ahead.
For many, the hardest part can be learning to put your own long-term future first—sometimes for the first time in your life.

“I see people focusing on their kids’ college savings, and not enough on retirement or an emergency fund for themselves,” says Starboard. Many advisors point out that kids can borrow for college if necessary, but no one can borrow for retirement.

The most important step is clear, says Howard: “You must have a written financial plan, period. Because that plan will dictate what you must do to be successful for the entirely of your life.

“The financial plan is your road map,” he continues. “In it will be your portfolio requirements, your savings goals, and your insurance-related needs.”

Finally, make sure your plan takes inflation into account, commonly estimated at 3% a year. Says Howard, “Inflation is the silent assassin that eats away at your nest egg.”

3. Apply the hard-fought wisdom you’ve gained.
“Treat the numbers determined by your plan—such as monthly savings—as bills that need to be paid,” advises Howard. When money comes in, it’s easy to start thinking of a new kitchen or a trip to Tulum. “Just be patient and keep the bills paid.”

Using that wisdom also applies to the big stuff. As the executor to her husband’s estate, Starboard has held back making any major decisions. “In a prior loss, I committed to real estate transactions and other things prematurely. At the time, it really felt like the right thing to do but my grief clouded my perception. I had a painful, expensive learning lesson.”

4. Focus on your shining future—really.
Forward thinking is an essential part of your financial plan, says Howard. “Get help really envisioning what kind of retirement you want. For each aspect, really drill down. For instance, where do you want to live? Do you want to be near your grandkids? Will you have the money to go see them? How often? It’s not just financial planning, it’s life planning.”

If all that forward thinking feels presumptuous, Howard recalls the eminently quotable Yogi Berra, who once said, “If you don’t know where you’re going, you might not get there.”

By Erica Oh Nataren
Originally Published By Lifehappens.org

Recently, the Internal Revenue Service (IRS) issued the instructions for Forms 1094/1095 for the 2017 tax year, announced PCORI fees for 2017-18, and announced cost-of-living adjustments for 2018. The IRS provided additional guidance on leave-based donation programs’ tax treatment and released an information letter on COBRA and Medicare. Here’s a recap of these actions for your reference.IRS Announces Cost-of-Living Adjustments for 2018

The IRS released Revenue Procedures 2017-58 and Notice 2017-64 to announce cost-of-living adjustments for 2018. For example, the dollar limit on voluntary employee salary reductions for contributions to health flexible spending accounts (FSAs) is $2,650, for taxable years beginning with 2018.

Request UBA’s 2018 desk reference card with an at-a glance summary of the various limits.

IRS Announces PCORI Fee for 2017-18

The IRS announced the Patient-Centered Outcomes Research Institute (PCORI) fee for 2017-18. The fee is $1.00 per covered life in the first year the fee is in effect. The fee is $2.00 per covered life in the second year. In the third through seventh years, the fee is $2.00, adjusted for medical inflation, per covered life.

For plan years that end on or after October 1, 2016, and before October 1, 2017, the indexed fee is $2.26. For plan years that end on or after October 1, 2017, and before October 1, 2018, the indexed fee is $2.39.

For more information, view UBA’s FAQ on the PCORI Fee.

IRS Provides Additional Guidance on Leave-Based Donation Programs’ Tax Treatment

Last month, the IRS provided guidance for employers who adopt leave-based donation programs to provide charitable relief for victims of Hurricane and Tropical Storm Irma. This month, the IRS issued Notice 2017-62 which extends the guidance to employers’ programs adopted for the relief of victims of Hurricane and Tropical Storm Maria.

These leave-based donation programs allow employees to forgo vacation, sick, or personal leave in exchange for cash payments that the employer will make to charitable organizations described under Internal Revenue Code Section 170(c).

The employer’s cash payments will not constitute gross income or wages of the employees if paid before January 1, 2019, to the Section 170(c) charitable organizations for the relief of victims of Hurricane or Tropical Storm Maria. Employers do not need to include these payments in Box 1, 3, or 5 of an employee’s Form W-2.

IRS Releases Information Letter on COBRA and Medicare

The IRS released Information Letter 2017-0022 that explains that a covered employee’s spouse can receive COBRA continuation coverage for up to 36 months if the employee became entitled to Medicare benefits before employment termination. In this case, the spouse’s maximum COBRA continuation period ends the later of: 36 months after the employee’s Medicare entitlement, or 18 months (or 29 months if there is a disability extension) after the employment termination.

 

By Danielle Capilla
Originally Published By United Benefit Advisors

We recently unveiled the latest findings from our 2017 Health Plan Survey. With data on 20,099 health plans sponsored by 11,221 employers, the UBA survey is nearly three times larger than the next two of the nation’s largest health plan benchmarking surveys combined. Here are the top trends at a glance.

Cost-shifting, plan changes, and other protections influenced rates

  • Sustained prevalence of and enrollment in lower-cost consumer-driven health plans (CDHPs) and health maintenance organization (HMO) plans kept rates lower.
  • For yet another year, “grandmothered” employers continue to have the options they need to select cheaper plans (ACA-compliant community-rated plans versus pre-ACA composite/health-rated plans) depending on the health status of their groups.
  • Increased out-of-network deductibles and out-of-pocket maximums, with greater increases for single coverage rather than family coverage, as well as prescription drug cost shifting, are among the plan design changes influencing premiums.
  • UBA Partners leveraged their bargaining power.

Overall costs continue to vary significantly by industry and geography

  • Retail, construction, and hospitality employees cost the least to cover; government employees (the historical cost leader) continue to cost among the most.
  • As in 2016, plans in the Northeast cost the most and plans in the Central U.S. cost the least.
  • Retail and construction employees contribute above average to their plans, so those employers bear even less of the already low costs in these industries, while government employers pass on the least cost to employees despite having the richest plans.

Plan design changes strained employees financially

  • Employee contributions are up, while employer contributions toward total costs remained nearly the same.
  • Although copays are holding steady, out-of-network deductibles and out-of-pocket maximums are rising.
  • Pharmacy benefits have even more tiers and coinsurance, shifting more prescription drug costs to employees.

PPOs, CDHPs have the biggest impact

  • Preferred provider organization (PPO) plans cost more than average, but still dominate the market.
  • Consumer-driven health plans (CDHPs) cost less than average and enrollment is increasing.

Wellness programs are on the rise despite increased regulations and scrutiny

Metal levels drive plan decisions

  • Most plans are at the gold or platinum metal level reflecting employers’ desire to keep coverage high. In the future, we expect this to change since it will be more difficult to meet the ACA metal level requirements and still keep rates in check.

Key trends to watch

  • Slow, but steady: increase in self-funding, particularly for small groups.
  • Cautious trend: increased CDHP prevalence/enrollment.
  • Rapidly emerging: increase of five-tier and six-tier prescription drug plans.

By Bill Olson
Originally Published By United Benefit Advisors

As 2017 comes to a close, it’s time to act on the money sitting in your Flexible Spending/Savings Account (FSA). Unlike a Health Savings Account or HSA, pre-taxed funds contributed to an FSA are lost at the end of the year if an employee doesn’t use them, and an employer doesn’t adopt a carryover policy.  It’s to your advantage to review the various ways you can make the most out of your FSA by year-end.

Book Those Appointments

One of the first things you should do is get those remaining appointments booked for the year. Most medical/dental/vision facilities book out a couple of months in advance, so it’s key to get in now to use up those funds.

Look for FSA-Approved Everyday Health Care Products

Many drugstores will often advertise FSA-approved products in their pharmacy area, within a flyer, or on their website. These products are usually tagged as “FSA approved”. Many of these products include items that monitor health and wellness – like blood pressure and diabetic monitors – to everyday healthcare products like children’s OTC meds, bandages, contact solution, and certain personal care items. If you need to use the funds up before the end of the year, it’s time to take a trip to your local drugstore and stock up on these items.

Know What’s Considered FSA-Eligible

Over the last several years, the IRS has loosened the guidelines on what is considered eligible under a FSA as more people became concerned about losing the money they put into these plans. There are many items that are considered FSA-eligible as long as a prescription or a doctor’s note is provided or kept on file. Here are a few to consider:

  • Acupuncture. Those who suffer from chronic neck or back pain, infertility, depression/anxiety, migraines or any other chronic illness or condition, Eastern medicine may be the way to go. Not only are treatments relatively inexpensive, but this 3,000 year old practice is recognized by the U.S. National Institute of Health and is an eligible FSA expense.
  • Dental/Vision Procedures. Dental treatment can be expensive—think orthodontia and implants. While many employers may offer some coverage, it’s a given there will be out-of-pocket costs you’ll incur. And, eye care plans won’t cover the cost of LASIK, but your FSA will. So, if you’ve been wanting to correct your vision without the aid of glasses or contacts, or your needing to get that child braces, using those FSA funds is the way to go.
  • Health-boosting Supplements. While you cannot just walk into any health shop and pick up performance-enhancing powder or supplements and pay with your FSA card, your doctor may approve certain supplements and alternative options if they deem it to benefit your health and well-being. A signed doctor’s note will make these an FSA-eligible expense.
  • Smoking-cessation and Weight-Loss Programs. If your doctor approves you for one of these programs with a doctor’s note deeming it’s medically necessary to maintain your health, certain program costs can be reimbursed under an FSA.

Talk to Your HR Department

When the IRS loosened guidelines a few years ago, they also made it possible for participants to carry over $500 to the next year. Ask Human Resources if your employer offers this, or if they provide a grace period (March 15 of the following year) to turn in receipts and use up funds. Employers can only adopt one of these two policies though.

Plan for the Coming Year

Analyze the out-of-pocket expenses you incurred this year and make the necessary adjustments to allocate what you believe you’ll need for the coming year. Take advantage of the slightly higher contribution limit for 2018.  If your company offers a FSA that covers dependent care, familiarize yourself with those eligible expenses and research whether it would be to your advantage to contribute to as well.

Flexible Spending/Saving Accounts can be a great employee benefit offering tax advantages for employees that have a high-deductible plan or use a lot of medical. As a participant, using the strategies listed above will help you make the most out of your FSA.

December 1, 2017 is the deadline for certain employers to use the Occupational Safety and Health Agency’s (OSHA) Injury Tracking Application (ITA) portal to report information from their 2016 Form 300A regarding employee illnesses and injuries. We previously reported (Breach Forces OSHA to Shut Down Reporting Portal) that OSHA suspended employer reporting through the ITA portal in August due to a possible security breach; however, the ITA portal is currently open for reporting.

OSHA announced that it is considering a proposed rule to modify the final rule on tracking and reporting illnesses, which could change some aspects of electronic reporting. Key topics for consideration include not making the reports public and eliminating the rule’s anti-retaliation provisions. At this point, however, there is no timeline for rule changes or any indication that electronic reporting will not be enforced beginning on December 1.

With just over a month before the reporting deadline, impacted employers are encouraged to review electronic reporting requirements in order to complete the online reporting process on time. Here is a summary of requirements:

Who must comply with the December 1, 2017 deadline

  • Most establishments with 250 or more employees that are currently required to keep OSHA injury and illness records.
  • Employers with 20-249 employees from certain industries with historically high rates of occupational injuries (high-risk industries) and illnesses.

States exempt from electronic reporting

Some states with OSHA-approved state plans have not yet adopted a requirement that illness and injury reports be submitted electronically. Establishments in the following states are currently not required to submit their reports using the ITA portal:

  • California
  • Maryland
  • Minnesota
  • South Carolina
  • Utah
  • Washington
  • Wyoming

Establishments in these states may contact their state plan for more information about reporting requirements.

State and local governments exempt from electronic reporting

State and local government establishments in the following states with OSHA-approved state programs have not adopted OSHA’s final rule requiring electronic reporting of illness and injury and are not required to submit their reports through the electronic portal:

  • Illinois
  • Maine
  • New Jersey
  • New York

How to submit data and get help

OSHA’s ITA portal offers three options for submitting data. Employers can:

  • Manually enter data on the site;
  • Upload a comma separated values (CSV) file; or
  • Transmit records electronically from an automated recordkeeping system using an application programming interface (API).

OSHA offers instructions for both the CSV and API processes as well as frequently asked questions related to the reporting process.

How long submission takes

For employers with 20-249 employees who are required to report, OHSA estimates that it will take approximately 20 minutes to complete the reporting process.

For employers with 250 or more employees, OSHA estimates it will take 32 minutes to complete the reporting process.

Additional reporting requirements will be rolled out over the next two years for impacted employers.

 

Originally Published By ThinkHR.com

I’m happy to report that this year’s UBA Health Plan survey achieved a milestone. For the first time, we surpassed 20,000 health plans entered—20,099 health plans to be exact, which were sponsored by 11,221 employers. What we were able to determine from all this data was that a tumultuous Presidential election likely encouraged many employers to stay the course and make only minor increases and decreases across the board while the future of the Patient Protection and Affordable Care Act (ACA) became clearer.

There were, however, a few noteworthy changes in 2017. Premium renewal rates (the comparison of similar plan rates year over year) rose nearly 7%, representing a departure from the trend the last five years. To control these costs, employers shifted more premium to employees, offered more lower-cost CDHP and HMO plans, increased out-of-network deductibles and out-of-pocket maximums, and significantly reduced prescription drug coverage as six-tier prescription drug plans exploded on the marketplace. Self-funding, particularly among small groups, is also on the rise.

Percent Premium Increase Over Time

UBA has conducted its Health Plan Survey since 2005. This longevity, coupled with its size
 and scope, allows UBA to maintain its superior accuracy over any other benchmarking survey in the U.S. In fact, our unparalleled number of reported plans is nearly three times larger than the next two of the nation’s largest health plan benchmarking surveys combined. The resulting volume of data provides employers of all sizes more detailed—and therefore more meaningful—benchmarks and trends than any other source.

By Peter Weber
Originally Published By United Benefit Advisors

Dear Ron, Thank you so much for generously supporting [us] and our AIDS walk team this year. It was a lovely foggy Sunday morning in Golden Gate Park, with thousands of folks walking to fight AIDS. It has been a pleasure working with you over the years. You have saved us LOTS of money! I want you to know how much we appreciate all that you do!

- San Francisco, Non-profit organization

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