Dental Procedures Demystified!

Fear of the dentist is not uncommon, in fact, about 50% of Americans admit some fear of dental procedures and about 10% are so frightened they actually avoid dental care.  It is far worse to avoid dental care, as dental pain and issues only get worse over time.  If you are afraid of dental treatments, you can talk to your dentist about sedatives designed to ease your anxiety and get you through dental procedures.

Once thing that can also help you is knowing more about the following common dental procedures:

Extractions

Teeth may need to be pulled in the event of dental pain or infection.  A certain amount of blood and pain is to be expected, so anesthesia can be used to reduce pain.  You can also use an MP3 player to deaden any sound.  Remember that any blood you se is mixed with your saliva, so it actually looks like you are bleeding more than you actually are!

Fillings

Cavities are small holes in teeth caused by germ-containing plaque, is treated by removing the surrounding area and filling the hole with materials to rebuild the tooth.  If cavities are not treated early, the bacteria will continue to eat away at the tooth, possibly resulting in a need for a root canal.  One way to lessen fear of the drilling and filling is to bring an MP3 player or similar device to listen to music while your dentist is working.

Root Canal

During a root canal, damaged tissue is cleaned out from inside a tooth. It’s a long procedure (sometimes lasting about two hours), but it can save your tooth. You can also bring along an MP3 player or you can break the treatment down into more manageable time periods.

X-Rays

X rays are designed to help your dentist find little problems before they become worse.  It can become a problem is you have a strong gag reflex or fear of radiation exposure.   Your dentist can use a little topical anesthesia to help control your gag reflex during this short dental procedure. It also may help to remember that the actual radiation exposure from dental X-rays is relatively minimal compared with the radiation exposure you get naturally each day.

Crowns

Crowns are used to protect a worn-out or weakened tooth.  The worst part of the procedure is the gag-inducing mold made of your tooth to shape the crown.  One way to alleviate this problem is to sit upright and use a faster-setting mold.

Dental Implants

Implants are used to replace missing teeth. They look natural and are stable as they are molded to your bone below your gums.  If you are afraid you can consider anesthesia.

What Makes a Health Plan Enrollment Successful?

Its not an easy task to hold open enrollment meetings for your employees, and its also not easy for your employees to make decisions regarding their health plan choices.  Most employees are nervous about making a  decision, since their election must remain in place for the entire plan year.  Wouldn’t you be nervous too?

Below are some suggestions to assist you and your employees in making the best decision(s) regarding plan choices at open enrollment:

  • Allow employees adequate time to think about the choices and/or discuss the options with their family or providers.  One day or a weekend simply isn’t enough time.  Studies suggest that employees who are given three weeks to make a choice are 50% more likely to remain satisfied with their decision.
  •  Hold open enrollment meetings as far in advance as possible to the plan or carrier change.
  • Provide enough information regarding the plan choices available.  Research shows that employes can make an informed decision once they have an effective benefits education, with their personal questions addressed.  If at all possible provide printed information or access to information online.
  •  Personalized benefit statements can also help an employee to determine the amount they spend on insurance, and if this needs to be adjusted in light of their health care needs.
  •  Give employees the opportunity to ask personal or specific questions related to their health care needs.  Perhaps the enroller can remain on site to answer questions, or the employees can contact someone on their own time to ask questions.  Make someone available to your employees.

Our staff at HealthPlansOnline.com can assist you and your employees with health plan choices and enrollment.  Please contact us at (888) 474-6627.

 

Employers Can Help Battle Chidlhood Obesity

As childhood obesity in the United States has tripled over the past 30 years.  Obesity is a growing epidemic affecting children, their families and the nation. The United States currently has the highest percentage of overweight youth in its history. More than one-third of children in the United States are considered overweight or obese, leading to increased health risks, higher health care costs and decreased parental productivity at work., now is the time for employers to take the lead in the battle against the growing problem of overweight and obese children, according to the National Business Group on Health.

“Child obesity is impacting employers today and will into the future as these children become the workforce of tomorrow,” says Helen Darling, president and CEO of NBGH, whose members include 329 large U.S. employers. “Parents have an enormous impact on the childhood obesity epidemic. The good news is that employers can play a critical role in fighting the childhood obesity epidemic by helping families develop healthy lifestyles at work and in the home”.

A recent survey of 83 of the nation’s largest companies conducted by the National Business Group on Health identifies the following programs employers currenlty have in place to help fight childhood obesity:

- One third of employers (33%) offer online weight management tools to children.

- More than one in four employers (28%) offer telephonic or online coaching for weight management to children

Beyond promoting healthy lifestyles in the home, employers will soon face a growing demand for obesity treatment in children.

“With the new guidelines for screening under The Patient Protection and Affordable Care Act, many more children nationally will be identified as overweight or obese,” says LuAnn Heinen, vice president and director of NBGH’s Institute on Innovation in Workforce Well-being. “Employers can provide tools and resources to support and empower employees and work with health plans and community resources to develop and promote new approaches to childhood obesity prevention and treatment.”

Employer toolkit expanded

NBGH also announced that it has updated its employer toolkit, “Childhood Obesity:  It’s Everyone’s Business,” to include examples of family-focused wellness programs that four forward-thinking companies are doing to fight childhood obesity. The toolkit also includes a new section on how employers can design their benefit programs to ensure that they are in accordance with new screening guidelines required by PPACA and support obesitytreatment options for children.

The employer toolkit was developed and updated with support from the U.S. Department of Health and Human Services, Health Resources Services Administration’s Maternal and Child Health Bureau. It’s available free of charge and can be found at www.businessgrouphealth.org.

Gary Whiddon is a wellness consultant affiliated with WELCOA university and can assist you in forming a wellness program for your employees.  Please contact him at (888) 474-6627 for information on setting up a prgram for your employees.

 

HHS Announces Proposed Rule for Uniform Benefit Summaries

On August 17, the Department of Health and Human Services (HHS) released a Notice of Proposed Rulemaking for Uniform Benefit Summaries under the Patient Protection and Affordable Care Act (PPACA).

The intent of Uniform Benefit Summaries is to provide individuals with standardized information so they can review medical plans, compare insurers and make decisions about medical plan choices.  The proposed rule provides additional guidance on the information that must be provided to all individuals enrolling in a medical plan on or after March 23, 2012.

This provision applies to individual and employer-sponsored medical plans, regardless of grandfathered status or funding. It does not apply to retiree-only plans or to standalone dental and vision plans.

What Information Must be Included

Insurers and self-insured employers must provide a Summary of Benefits and Coverage (also referred to as an ‘SBC’ in the proposed rule) to individuals who apply for and enroll in medical plans. The Summary of benefits and Coverage is a required document that must be provided in the standard format.

There are four standard components:

  • A four-page Benefit Summary (double sided)
  • Medical Scenarios called “Coverage Examples” that  are patterned after the Food and Drug Administration food labels. They estimate customer costs based on the specific plan’s benefits for three medical scenarios – Maternity, Breast Cancer Treatment and Managing Diabetes
  • A standard glossary of medical and insurance terms
  • A phone number and website where individuals can get additional information including documents such as Certificates, Summary Plan Descriptions (SPDs) and policies

HHS asked the National Association of Insurance Commissioners (NAIC) to propose a format for the four components in the Summary of Benefits and Coverage. Here is a link to the documents proposed by NAIC: http://www.naic.org/committees_b_consumer_information.htm

The information on the NAIC website is not a guideline or example. It is the exact wording, format and layout that must be used. Insurers and employers will just insert plan details into the predetermined rows and columns.

The Benefit Summary must be a freestanding document and may not be incorporated into any other document. Supplemental
communication materials may be provided with it. Currently produced documents will not satisfy the requirements of the regulation.

The Coverage Examples must include three pre-defined medical scenarios: Maternity, Breast Cancer Treatment and Managing Diabetes. These scenarios are intended to show typical services and cost sharing under the plan. The numbers would be based on client-specific plans and costs. The estimates are based on national average costs and in-network benefit levels.

Who is Responsible for Providing the Information

For fully insured plans and HMOs, the insurer is responsible for producing and distributing the summaries. For self-insured
plans, the responsibility lies with the employer.

What is the Required Timing

Summaries must be provided when an employer or individual requests information about a plan, applies for coverage or enrolls in
a plan. They must also receive a summary if there are plan changes or if the individual has a HIPAA special enrollment event that prompts a new enrollment opportunity.

People enrolled in a health plan must be notified of any significant changes to the terms of coverage reflected in the Summary of
Benefits and Coverage at least 60 days prior to the effective date of the change. This timing applies only to changes that become effective during the plan or policy year but not to changes at renewal (the start of the new plan or policy year).

How Benefit Summaries will be Delivered

Summaries are required both before and after enrollment and may be delivered in paper and/or electronic format. There are
specific requirements for group vs. individual plans.

Penalty for Non-Compliance

The penalty for ‘willful’ non-compliance is up to $1,000 per enrollee for each failure to comply.

Next Steps

Comments on this proposed rule – including the specific request for expatriate plans – are due 60 days from the published date.

New HHS Guidelines for Women’s Preventative Services

 On Aug. 1, 2011, the Department of Health and Human Services (HHS) released new health  plan coverage   guidelines that will require health insurance plans to cover women’s preventive services such as well-  woman visits, domestic violence screening, and U.S. Food and Drug Administration (FDA)-approved contraception, without charging a copayment, coinsurance or a deductible.

Authorized under provisions of the Patient Protection and Affordable Care Act, these guidelines, developed by a committee of the Institute of Medicine of the National Academies, expand the previous list of preventive services that must be covered without charging a copayment, coinsurance or a deductible to include:

  • Well-woman visits
  • Screening for gestational diabetes for all pregnant women
  • Human papillomavirus DNA testing for all women 30 years and older
  • Annual sexually transmitted infection counseling for all sexually active women
  • Annual counseling and screening for HIV for all sexually active women
  • FDA-approved contraception methods, sterilization procedures and contraceptive counseling
  • Breastfeeding support, supplies, and counseling, including costs for renting breastfeeding equipment
  • Domestic violence screening and counseling

New health plans and non-grandfathered plans and issuers are required to provide coverage consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012.  It is possible that your current health plan covers these services now, but may have a copay or co-insurance percentage.

When Do You Need to Take Your Child to the ER?

The typical emergency room experience can be difficult or scary for a sick child.  When is it best to take your child to the ER or wait for your pediatician’s office to open the next day?  Below are a few tips to help you decide:

1. Bumps on the head- every new walking toddler (or those that are already walking or running) hit their heads and get a few bumps and bruises during the early years. If your child gets right back up after the impact and stops crying after some serious soothing, an ice pack and some TLC is probably all she needs. Go to the ERor call 911 if your child loses consciousness or has an indentation in her head for emergency medical attention.

2. Mouth injuries – Why do all parents panic over mouth injuries?  The mouth is rich in blood vessels, so cuts and scrapes bleed a lot (and it’s often hard to see where all that blood is coming from at first). Applying ice, having her suck on an ice pop or  drink some cold water will soothe and stop bleeding.  Go to the ER when there is a gaping wound or a cut that won’t stop bleeding after you’ve applied ice is a true emergency.

3. Fever – Most fevers, even high ones, are just a sign that your toddler is fighting off an infection, but many parents worry that a fever signals something worse.  The American Academy of Pediatrics says Moms and Dads need to make a feverish tot comfortable, instead of trying to bring the temperature down to normal. Don’t be alarmed if that pain reliever doesn’t bring down her temperature right away. Instead, keep giving your little one plenty of fluids (and hugs) and check in with your pediatrician.  Go to the Pediatrician when your child has a fever higher than 102.2°F or has had a fever for more than 24 hours (for a child younger than two) or 72 hours (for kids two and older). Go to the ER if your child’s fever is 102.2°F and she has a stiff neck, can’t stop crying or vomiting, is so lethargic it’s difficult to wake her up, or has a blue tongue or blue lips or nails (which means she’s not getting enough oxygen). Also go to the ER when a baby under three months has a fever of 100.4°F.

4. Vomiting-  Persistent vomiting is another common reason parents head to the ER. But vomiting is usually caused by a stomach bug or infection and isn’t serious in and of itself. A bigger danger is dehydration, so be sure to offer your tot extra fluids (or Pedialyte), even if she just takes a sip at a time, as well as liquid-based foods like soups, fruits, and fruit pops. Most stomach bugs that cause vomiting last only 24 hours, so if your child is throwing up for more than a full day, call your Doctor. Call the pediatrician or go to the ER if there are signs of dehydration, such as : dry mouth, lack of tears, and dry diapers (or not much pee in the potty). Call your doctor or 911 if your child is vomiting after she’s hit her head, or is throwing up greenish fluid, blood, or what looks like coffee grounds (blood mixed with stomach acid).

5. Skin Rashes – Most rashes are not dangerous.  Some are caused by allergies, while others are symptoms of viruses like fifth disease. It is recommended that your pediatrician  check out a nasty or weird-looking rash, most rahses are not a cause for alarm.  Go to the ER if your tot breaks out in a rash and has trouble breathing at the same time. Another rash that warrants an emergency room visit and a call to the doctor is petechiae, which is flat purplish dots caused by broken blood vessels that are usually a sign of a serious infection or bleeding problem.

Please always remember that there may be increased charges on your insurance coverage for emergency room visits.  Please consult your plan booklet for information regarding the benefits available.