Category Archive

Benefit Spotlight

Generic Medication

Young pharmacist checking the shelves with a digital tablet at the pharmacy

Generic drugs are versions of brand-name medications that share active ingredients, strength, quality, safety, and intended use as their name-brand counterparts, but which are up to 85% cheaper.

Pharmacist and customer interact at pharmacy counter, exchanging payment and prescription.

Once a company develops a new drug, they are granted a patent under the Food and Drug Administration (FDA) to be the sole producer and seller of that medication. This is intended to help that company recover its losses from research and testing. After the patent expires, however, other drug companies are allowed to create generic versions of the newly developed medication. Generic drug manufacturers are not required to test the medication’s effects on animals or humans, which decreases the cost of production.

They also do not need to spend millions on research or marketing, since the original developer has already done the work. This cost reduction is reflected in the prices of the generic drugs, which are usually 80-85% cheaper than their name-brand counterparts. Even though generic brands are not required to do animal or clinical testing, they are still subject to strict guidelines, which means they’re just as safe as name-brand medications. Generic drug manufacturers must prove to the FDA that their version of the medication is identical to the name-brand in several ways, including:

  • Active ingredients: The active ingredient refers to the ingredient that makes the drug “pharmaceutically active” — in other words, the ingredient that makes the drug work against the disease or condition it’s targeting.
  • Strength
  • Dosage form (tablet, capsule, or injection)
  • Usage
  • How the medication is taken/applied
  • How the medication is absorbed by the body
  • Shelf life

Drug manufacturers are subject to the FDA Generic Drugs Program standards for drug approval. This means that the manufacturer must submit evidence to the FDA that proves the generic medication’s active ingredient matches the name-brand version. The manufacturers must further pass plant inspections to show that their product is produced in similar quality to the name-brand. The FDA also monitors plants to ensure drug safety.

The main difference between generic and name-brand medications (besides the price tag) is the inactive ingredients. Inactive ingredients are fillers, coatings, or preservatives that help your body absorb the medication. While these ingredients are referred to as “inactive,” they, like any other ingredient in medication, can cause adverse reactions. But other than personal allergies, there is no significant difference between generic or name-brand medications. Generic medications may absorb into the body slightly faster or slower than name-brand versions, but the difference is small enough to be clinically acceptable by the FDA.

Pharmacist explains side effects of generic drug to unrecognizable customer

Due to trademark laws, generic drugs cannot look identical to the name-brand versions, even though their ingredients match. As a result, generic and name-brand medications may have different shapes, colors, or flavors. These changes do not affect the efficacy of generic medication.

There are a few ways to check whether an FDA-approved name-brand drug has a generic version:

  • Drugs@FDA: Search for a name-brand medication and check the section called “Therapeutic Equivalents for [name-brand].” Medications labeled with ANDA are generic drugs.
  • Orange Book: Search for a brand-name medication and find the active ingredient. Next, do another search for the active ingredient. Medications labeled with an “Appl No.” or “TE code” that begins with an A are FDA-approved generic drugs.
Brand and Generic medicine bottles with red price tags. 3d rendering

Generic drugs are a great way to save money on the medications you need. Most states allow pharmacists to substitute name-brand medications for cheaper generic alternatives, unless your doctor has specified to “dispense [the medication] as written,” or if the drug has a “narrow therapeutic window.” The narrow therapeutic window refers to the slight difference in absorption rates between generic and name-brand medications, which could result in side effects or loss in efficacy. If you have any questions or concerns about choosing generic medications over name-brand versions, speak with your doctor for more information.

In 2024, generic drugs saved patients and the U.S. healthcare system $467 billion.

Understanding EOI

At its core, Evidence of Insurability is a process insurance companies use to assess an individual’s overall health before approving certain types or amounts of coverage.

When enrolling in workplace benefits, most decisions feel straightforward — pick a health plan, choose your coverage levels, and you’re set. But occasionally, you’ll come across a requirement that feels a bit more involved: Evidence of Insurability (EOI).

It’s most commonly associated with life and disability insurance. While not every employee will need to complete EOI, it typically comes into play when you’re requesting coverage beyond a Guaranteed Issue amount or enrolling outside of your initial eligibility window.

Why EOI Exists

Insurance is built on shared risk. To keep premiums fair and manageable for everyone, insurers need to evaluate the likelihood of a claim. That’s where EOI comes in. By reviewing basic health information, insurers can determine whether to approve, modify, or deny additional coverage.

From an employer’s perspective, offering Guaranteed Issue coverage — coverage you can elect without medical questions — is a valuable benefit. It ensures employees have access to a baseline level of protection quickly and easily. However, when coverage exceeds that threshold, EOI helps balance accessibility with sustainability, ensuring plans remain viable long term.

When You Might Need to Complete EOI

There are a few common scenarios where EOI may be required:

  • Electing higher coverage amounts: If you choose life or disability insurance above the Guaranteed Issue limit during enrollment.
  • Late enrollment: If you decline coverage when first eligible and decide to enroll later.
  • Increasing coverage after initial enrollment: Some plans allow increases during annual enrollment, but those increases may require EOI.

It’s important to pay attention to these moments, as they can impact not only your coverage approval but also how quickly your benefits take effect.

What the Process Looks Like

Completing EOI is usually simpler than people expect. Most insurers require you to fill out a short questionnaire about your medical history, current health status, and lifestyle habits (such as tobacco use). In some cases, additional information may be requested, like a medical exam or physician records, but that’s less common for employer-sponsored plans.

The key is to answer all questions honestly and completely. The insurer uses this information to make a fair and accurate assessment. Once submitted, the review process can take anywhere from a few days to a few weeks, depending on the complexity of the request.

What Happens After You Apply

After reviewing your EOI, the insurance carrier will make one of the following decisions:

  • Approval: Your requested coverage is accepted as-is.
  • Conditional approval: Coverage is approved but may include certain limitations or higher premiums.
  • Denial: Coverage is not approved based on the information provided.

If your application is denied, it doesn’t necessarily mean you’ll never qualify. Changes in health status or future enrollment opportunities may allow you to reapply.

Why It Matters to Employees

EOI can feel like an extra hurdle, but it ultimately plays a role in protecting both you and your coworkers. It ensures that benefit plans remain affordable while still offering meaningful coverage options. More importantly, understanding EOI helps you plan ahead — especially if you anticipate needing higher levels of coverage in the future.

One of the easiest ways to avoid the EOI process is to take advantage of your initial enrollment period. This is often your only opportunity to secure certain levels of coverage without medical underwriting. Missing that window could mean additional steps later on.

If you’re unsure whether EOI applies to your situation, your HR team or benefits administrator can help guide you.

EOBs: What Are They?

An Explanation of Benefits (EOB) is a statement from your health insurance company that outlines how a claim was processed. It’s not a request for payment — though many people mistake it for a bill. Instead, it’s a detailed summary of the services you received, what your provider charged, what your insurance covered, and what portion (if any) you may owe. Think of it as a receipt that shows the behind‑the‑scenes math of your healthcare costs.

What makes EOBs so valuable is the transparency they provide. They show whether your provider billed correctly, whether your insurance applied your benefits accurately, and whether you’re being asked to pay the right amount. In a healthcare system where costs can feel unpredictable, the EOB is one of the few documents designed to give you clarity rather than confusion.

Why EOBs Matter More Than You Think

It’s easy to overlook an EOB, especially when you’re juggling appointments, prescriptions, and follow‑up care. But reviewing it carefully can protect you from unnecessary expenses. Billing errors are more common than most people realize — duplicate charges, incorrect procedure codes, or services you never received can slip through the cracks. Your EOB is your first line of defense against these mistakes. Beyond error‑checking, EOBs help you understand how your insurance benefits are being used. They show how much of your deductible has been met, how close you are to your out‑of‑pocket maximum, and how cost‑sharing (like copays and coinsurance) is applied. This information can help you plan future care, anticipate costs, and avoid surprises. In other words, your EOB isn’t just paperwork — it’s a financial roadmap.

How to Read Your EOB

The layout of an EOB varies by insurer, but most include the same core elements. You’ll typically see the date of service, the provider’s name, the services performed, the amount billed, the amount allowed by your insurance, the portion paid by the insurer, and the amount you may owe. Once you understand these sections, the document becomes far less intimidating. A helpful next step is to compare your EOB with any bill you receive from your provider. The numbers should align. If they don’t, it’s a signal to call your provider or insurer for clarification. Many discrepancies are simple errors that can be corrected quickly when caught early. And if something doesn’t make sense, don’t hesitate to ask questions — your insurer’s customer service team is there to help you interpret the details. The more familiar you become with your EOBs, the easier it becomes to spot patterns, understand your coverage, and make informed decisions about your care.

Since EOBs can provide both short- and long-term value, it’s a good idea to save your EOB at least until you get the final bill from your doctor or clinic.

Primary Care or Specialist? Making the Right Choice

A smiling mid adult female doctor listens as a female patient discusses her health.

Primary Care Physicians: Your First Point of Contact

Think of a Primary Care Physician (PCP) as your healthcare home base. They’re the provider you turn to for everyday concerns, annual check-ups, preventive screenings, and the “something isn’t quite right” moments that don’t clearly point in one direction.

What PCPs excel at:

  • Whole-person care: They look at the big picture — your history, lifestyle, habits, and changes over time.
  • Preventive health: Vaccinations, screenings, routine labs, physicals — they’re your partner in staying ahead of illness.
  • Early diagnosis: For most symptoms, a PCP can evaluate, diagnose, and treat without sending you elsewhere.
  • Coordinating care: If you do need specialized treatment, your PCP is the one who guides you to the right specialist and ensures communication stays clear.

In many ways, your PCP is the quarterback of your health team — calling plays, coordinating strategies, and helping you navigate every twist and turn.

Teenager at a Medical Appointment

Specialists: The Experts for Specific Conditions

A specialist steps in when a condition requires deeper, more targeted expertise. While PCPs have wide-ranging knowledge, specialists have laser-focused training in one specific area of medicine.

For example:

  • Cardiologists focus on the heart
  • Dermatologists focus on the skin
  • Endocrinologists focus on hormones
  • Orthopedic surgeons focus on bones and joints

Specialists bring advanced diagnostics, treatments, and procedures that go beyond the scope of primary care.

You might need a specialist if:

  • Your PCP identifies something that requires deeper evaluation
  • You have a chronic condition needing expert management
  • You need a procedure or specialized imaging
  • Your symptoms are complex or persistent

Specialists are crucial — but they work best with your primary care doctor, not instead of one.

How PCPs and Specialists Work Together to Create Better Outcomes

The most effective healthcare isn’t about choosing one over the other — it’s about having both in your corner. Primary care physicians and specialists form a coordinated system that keeps you healthy, supported, and informed.

Here’s how they complement each other:

  • PCPs provide continuity; specialists provide precision. Your primary doctor keeps track of your overall health while specialists focus on specific problems.
  • Better communication = better care. When a PCP refers you to a specialist, they share your medical history, medications, and relevant test results. This prevents duplication and improves accuracy.
  • You avoid unnecessary tests and visits. PCPs can often treat issues without specialist intervention — saving you time and money.
  • Chronic conditions stay on track. If you have diabetes, heart disease, asthma, or any ongoing condition, PCPs coordinate the bigger picture while specialists fine-tune your treatment.

In short, your PCP ensures everything fits together, while specialists handle the pieces that require expert-level attention.

When you’re unsure where to turn, start with your primary care physician. They’re trained to evaluate your symptoms, treat what they can, and guide you to the right specialist when needed.

85.2% of adults who had a visit with a doctor or other health care professional in the past year.

Is Online Therapy for You?

Young woman sitting on couch at her apartment and discussing with her therapist on digital tablet during online session

Online therapy, also known as teletherapy or e-counseling, has transformed the landscape of mental health care, offering new opportunities for support and healing. As technology continues to evolve, so does the accessibility of therapeutic services. While online therapy presents numerous advantages, it also comes with limitations that may affect its suitability for certain individuals and conditions. Understanding both sides of the equation is essential for making informed decisions about mental health treatment. 

The Pros of Online Therapy 

One of the most significant advantages of online therapy is accessibility. Individuals living in rural or underserved areas often face limited options for in-person counseling. Online platforms bridge this gap, allowing people to connect with licensed therapists regardless of geographic location. This is especially beneficial for those with mobility challenges, chronic illnesses, or transportation barriers. Additionally, online therapy can be more approachable for individuals who feel uncomfortable in traditional clinical settings, helping to reduce the stigma often associated with seeking mental health care. 

Convenience and flexibility are other major benefits. Online therapy allows clients to schedule sessions around their daily routines, eliminating commute times and offering greater privacy. Many platforms also provide asynchronous communication options, such as messaging or email, which can be helpful for those who prefer written expression or need support between sessions. For busy parents, caregivers, or professionals, this flexibility can make therapy more sustainable and consistent. 

Cost-effectiveness is another appealing aspect. Therapists offering online services often have lower overhead costs, which can translate into more affordable rates for clients. Some insurance providers now cover online therapy, making it a viable option for those with limited financial resources. Moreover, the ability to choose from a broader pool of therapists, including specialists in niche areas, can lead to better therapeutic matches and outcomes. 

Doctor on video conference for medical consultation
Man using AI therapy chatbot and AI therapy app

The Drawbacks of Online Therapy

Despite these advantages, online therapy has its drawbacks. One of the most notable is the lack of nonverbal communication. In video or text-based sessions, therapists may miss subtle cues such as body language, facial expressions, or tone of voice, which are often critical for accurate assessment and deeper understanding. This limitation can affect the therapeutic alliance and reduce the effectiveness of treatment, especially for clients who struggle to articulate emotions verbally. 

Technology-related issues also pose challenges. Unstable internet connections, software glitches, or device malfunctions can interrupt sessions and hinder progress. For individuals in crisis or those with severe psychiatric conditions, such as schizophrenia or suicidal ideation, online therapy may not provide the immediacy or intensity of care required. In such cases, in-person intervention or hospitalization may be necessary. 

Privacy and confidentiality are additional concerns. While reputable platforms use encryption and secure servers, the risk of data breaches or unauthorized access remains. Clients must also ensure they have a private space for sessions, which can be difficult in shared living environments. Without a secure setting, the therapeutic process may be compromised, and clients may feel hesitant to share openly. 

Another limitation is insurance coverage and licensing restrictions. Not all insurance plans cover online therapy, and therapists may be limited to practicing within certain states or regions due to licensing laws. This can restrict access for clients seeking specialized care or continuity across state lines. 

African-American woman Video Conferencing With Doctor On smartphone while sitting on sofa in her home.

Choose What’s Best for You

Online therapy offers a modern, flexible, and often effective alternative to traditional counseling. Its accessibility, affordability, and convenience make it an attractive option for many, especially those facing logistical or emotional barriers to in-person care. However, it is not a one-size-fits-all solution. Individuals must weigh the benefits against the potential limitations, such as reduced nonverbal communication, technological challenges, and privacy concerns, to determine whether online therapy aligns with their needs. As digital mental health services continue to expand, ongoing research and innovation will be key to enhancing their effectiveness and inclusivity. 

As of 2024, approximately 54% of Americanshave participated in at least one telehealth visit,
with
nearly 38% of these visits pertaining to medical or mental health needs.
 

Considering a Limited Purpose FSA?

Making out-of-pocket payments for frequent trips to the eye doctor and dentist can add up to hundreds, if not thousands, of dollars — even with health insurance.

A High-Deductible Healthcare Plan (HDHP) often results in lower monthly premiums but can lead to significant healthcare expenses. A limited-purpose (also called limited-use) flexible spending account (LPSA) can help offset these costs, making regular or specialized treatment more affordable. While not everyone may benefit from an LPFSA, those who frequently pay for vision and dental treatments can significantly reduce their expenses with this type of account.

What Is an LPFSA?

A limited-purpose flexible spending account functions similarly to a general healthcare FSA, which employers offer to help employees save money on healthcare expenses. However, it provides more specific benefits for individuals with vision and dental needs. To determine whether an LPFSA is the right choice, it’s essential to weigh its advantages and disadvantages before enrolling.

Pros of an LPFSA:

  • 2025 contribution limit: Set to $3,300
  • Eligible expenses: Covers braces, fillings, eyeglasses (prescriptions), teeth cleaning, and eye exams
  • Tax-free funds: Contributions reduce taxable income
  • Employer contributions: Some companies contribute to employees’ LPFSA accounts
  • HSA compatibility: Employees can have a Health Savings Account (HSA) alongside their LPFSA to maximize savings
  • Additional expenses covered: Funds may be used for supplements, dental, and menstrual products

Cons of an LPFSA:

  • Eligibility: LPFSAs are only available to those enrolled in an HDHP with an HSA
  • Employment requirement: Self-employed or retired individuals do not qualify
  • Expiration of funds: Funds typically expire at the end of the year. For 2025, a rollover of up to $660 may be allowed, depending on the plan
  • Loss of funds upon job change: If you leave or are terminated, funds cannot be transferred to another account

Should You Enroll in an LPFSA?

The average out-of-pocket medical expense per capita in the U.S. has more than doubled from 1970 to 2022 and continues to rise. In 2024, Americans spent an average of $1,142 on medical bills, with individual costs varying based on healthcare needs. What sets an LPFSA apart from other FSAs is the ability to pair it with an HSA, which can maximize savings significantly.

Benefits of an HSA

Having an HSA alongside an LPFSA can increase savings over time. Unlike FSAs, health savings accounts (HSAs) are tax-free, never expire, and remain yours even if you leave your job. This means that withdrawals will not be taxed as long as the funds are used for eligible medical expenses. Since HSA funds roll over annually, pairing an LPFSA with an HSA allows individuals to save money year after year while reserving their HSA contributions for future expenses. This approach is ideal for those whose medical expenses are equal to or less than the $3,300 LPFSA contribution limit.

Drawbacks of an HSA 

To qualify for an HSA, individuals must be enrolled in an HDHP. HSAs are only compatible with LPFSAs, meaning other flexible spending arrangements do not qualify. Additionally, individuals cannot contribute to an HSA if they:

  • Are claimed as a dependent on someone’s tax return
  • Have Medicare coverage
  • Are included in a spouse’s healthcare plan

The IRS also limits contributions to HSAs. In 2025, singles can contribute up to $4,300, while families with HDHP coverage can contribute up to $8,550.

Choosing the Right Healthcare Plan

Making informed decisions about healthcare savings can lead to significant financial benefits in the long run. By carefully evaluating the advantages of an LPFSA and pairing it with an HSA, individuals can maximize tax savings while covering essential medical expenses. Planning ahead and utilizing employer-sponsored benefits ensures greater financial security, especially for those with frequent vision and dental needs. Ultimately, choosing the right healthcare plan means balancing current expenses with future savings, allowing individuals to feel confident in their financial and medical decisions. Taking proactive steps today can lead to better financial stability and improved healthcare access over time.

Since HSA funds roll over annually, pairing an LPFSA with an HSA allows individuals to save money year after year while reserving their HSA contributions for future expenses.

Lantern (Formerly SurgeryPlus)

Lantern is a benefit program offered by some employers to help employees and their families access high-quality, non-emergency surgeries.

Think of it like a concierge service for surgery — handling everything from finding a top-rated doctor to coordinating your travel (if needed). Lantern covers over 1,500 planned surgical procedures, including those in categories like spine, general surgery, orthopedic, ear, nose, and throat, cardiac, gastrointestinal, and injections.

The program partners with a nationwide network of carefully selected surgeons and facilities that meet strict quality and safety standards. And here’s the best part: when you use Lantern, your costs could be dramatically reduced — or even eliminated completely depending on your employer’s plan. This isn’t just a different way to schedule surgery. It’s a better, smarter, more supportive experience from start to finish.

Benefits

  • Lower (or No) Out-of-Pocket Costs – One of the biggest perks of Lantern is the cost savings. When you use the program, you may pay little to nothing out of pocket. That means no surprise bills later, and no guessing what your surgery is going to cost. Everything is explained upfront, so you can focus on healing.
  • Access to High-Quality Surgeons – Lantern doesn’t just partner with any providers. Every surgeon in the network has been vetted for training, experience, and outcomes. So instead of sorting through hundreds of options on your own, you’re matched with a specialist who’s proven to deliver great care.
  • Full-Service Support – From the first phone call to your post-surgery check-up, Lantern is with you every step of the way. You’ll be assigned a Care Advocate who will schedule appointments, help with paperwork, and even assist with travel arrangements if the best provider isn’t local. It’s like having a personal assistant just for your surgery.

How to Use Lantern

Getting started with Lantern is easy, and your HR team or benefits provider can confirm if it’s part of your plan. Once you’re enrolled, just follow these steps:

  1. Call the Lantern Member Services Line: You’ll speak with a friendly Care Advocate who will walk you through the process and ask a few questions about your needs.
  2. Get Matched With a Top Surgeon: Based on your procedure and location, you’ll be paired with a high-quality provider. If travel is required, they’ll help you plan that too — and in most cases, those travel costs are covered!
  3. Schedule and Prepare: Your Care Advocate will coordinate everything, from the consultation to surgery day and follow-up appointments. You’ll know what to expect every step of the way.

If you or a family member has a planned surgery coming up, check with your HR department or benefits provider to see if Lantern is available to you.

Pet Insurance

Taking your pet to the vet, even for a routine check-up, can be an expensive experience.

The bill tends to increase if your pet needs surgery, prescription medications, or treatment for illness. Enter pet insurance, a benefit offered by many employers because they know how expensive our furry, and some not-so-furry, friends can be.

What Is Pet Insurance?

Essentially, pet insurance is a policy offered in your benefits plan. It’s a policy that can help cover the costs of your pet’s medical care, from routine checkups to cancer treatments. In most cases, you pay a monthly premium and then submit a claim for any eligible expenses after going to the vet. It’s really that simple! Some plans may need you to hit a deductible before coverage kicks in.

What Does It Cover?

Pet insurance covers a wide variety of treatments, procedures, and injuries. Here’s a list of some of the things you could have coverage for:

  • Broken bones
  • Foreign object ingestion
  • Cancer
  • Hip dysplasia
  • Ligament tears
  • Cataracts
  • Medication
  • X-rays, blood tests, or MRIs
  • Emergency exam fees

What’s in It for You?

Enrolling in benefits can be overwhelming and adding in an extra cost for your pet may seem like something you can pass up. However, the American Veterinary Association encourages all pet owners to enroll in pet insurance because it can offset costs that will only keep rising due to the field becoming more technologically advanced. Better technology, equipment, facilities, and training required to perform procedures and implement modern medicine are rapidly increasing the costs of anything pet related.

Pet insurance can ease your mind by taking your thoughts off the financial burdens that come with a vet visit. This way, you can focus on your pet’s health instead of what it’s going to cost you. It allows you to choose the best treatment options without the financial constraints, and most of all, protects you financially by covering bills you would normally have to pay in full.

If you’re hesitant about pet insurance, you can always talk with your Benefits Department and can even consult your veterinarian on the best plan option for you and your pet.

Urgent Care vs. Standalone ERs

Have you ever found yourself in a situation of not knowing if you should go to an urgent care or an emergency room?

While they seem similar, the two differ in several ways. Knowing where to go can help you save time and money.

Standalone ERs should be utilized by those experiencing life-threatening conditions. If you require immediate medical attention, the ER is your best bet. Urgent Cares, on the other hand, are the middle ground between your primary care physician (PCP) and the emergency room, according to Mayo Clinic. If the injury or illness is not life-threatening but it can’t wait until you can see your PCP, head to an Urgent Care. The following list goes into detail on some factors to consider before choosing where to go.

Standalone ER

Severity: Life-threatening conditions such as chest pain, severe abdominal pain, head injuries, and uncontrolled bleeding

Hours: 24/7

Cost: More expensive due to a higher level of care and resources available

Staffing: Board-certified emergency physicians and nurses trained in emergency care

Urgent Care

Severity: Mild conditions like sprains, minor cuts, urinary tract infections, and earaches

Hours: Typically operate during normal business hours with some weekend and evening hours; not 24/7

Cost: Less expensive than ERs; shorter wait times

Staffing: Mainly physician assistants (PAs), nurse practitioners, and sometimes physicians

The next time you find yourself in a situation trying to decide where to go, reference this list so you can make the best decision based on your needs.

Biometric Screening

A biometric screening usually measures height, weight, blood pressure, cholesterol levels, blood sugar, and waist circumference.

A biometric screening is a clinical test that measures various physical characteristics of the body, to determine an individual’s overall health. More importantly, the results of a biometric screening provide insights into potential health risks such as diabetes and heart disease. It is conducted by taking a blood sample, usually in the form of a finger prick.

Many employers use biometric screenings to assess their employees’ overall health. This allows them to implement personalized, helpful strategies into their wellness program to improve employee health.

Biometric screenings encourage individuals to make healthier lifestyle choices and urge them to participate in activities that promote good health. Our health is the most valuable asset we have and taking care of it should always be a top priority.