Category Archive

Benefit Spotlight

Urgent Care vs. Standalone ERs

Keesha Maybank 2025 July, Benefit Spotlight June 18, 2025

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

Lynn White 2025 June, Benefit Spotlight May 6, 2025

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.

Give, Save, Spend: How to Adopt Healthy Financial Habits

2025 May, Benefit Spotlight April 23, 2025

Going off to work to pay for yesterday rather than tomorrow has become the norm for most Americans. The average debt reported in 2023 for each American was $103,215, with housing debt making the top of the list.

Credit card companies have increased the ability to get what you want now with an instant swipe or Apple Pay, and you can worry about it later. However, it is still possible to cut down debt and adopt healthy financial habits that can help you invest for you and your family’s future.

Saving for the Future

Investing your money for tomorrow’s unknown circumstances is important. Not only should you save for the unknown but for things you may want to do such as buy a house or car, retirement, college expenses, and vacations. It can be difficult to determine how much to save each month when expenses can consume most of your earnings, but starting small is best. As budgeting becomes more manageable, you will find that you can save more. Here are some more tips you can put in practice:

  • Start with what you can – If you can only save $10 a month, start there. As time progresses, pick up the value each month. Don’t beat yourself up if you must skip saving for a month or two.
  • Save unexpected money – There are times we receive birthday money, a bonus check at work, a nice tax refund, or sold some items for cash. These can be used to save extra as they don’t impact your monthly budget.
  • Automate savings – Whenever you receive pay from your job, you can set a portion automatically to your savings. This is helpful because you won’t need to set a reminder and will not feel tempted to take from your savings.
  • Audit your budget – As you create your budget, it’s best to perform an audit to see what expenses can be removed or reduce. Instead of going out to eat several times a week, limit that to two or three a month. Try at-home fitness or a run around the block instead of a monthly gym membership. Create small pockets of savings for large purchases like clothes, shoes, mini vacations, and tech gadgets.

Spending Wisely

If you can’t afford it today, it’s not worth purchasing. One of the best ways to avoid overspending or spending within your means is by creating a budget. A monthly budget will allow you to look over your income, focus on tackling your expenses, and seeing if you have room to enjoy. There are some ideas to consider when starting out on creating a budget or new habits you may want to incorporate:

Track your spending – Write down everything you spend your money on. Whether it’s on an app, spreadsheet, or pen and paper, tracking your money will help you know where it’s going.

Remove unnecessary expenses – There are some subscriptions or services that you might be paying for but no longer use. It’s time to cancel and reallocate that money.

Switch phone plan – Instead of having the latest phone or upgraded phone plan, switching them for cheaper can help you save money.

Refinance car or mortgage – You can save extra money by finding a better rate on your mortgage or car loan.

Pay off debt early – Before adding extra funds into your savings, see if you can try allocating more money towards credit cards, student loans, and other debt so that you can pay them off early.

50/30/20 rule – If you need help creating a budget, try sticking to the 50/30/20 rule for managing your income: 50% for essentials, 30% for extras, and 20% for savings and debt.

Why Giving Is Important?

Thinking about and managing money leaves many people feeling stressful. It falls within the top five reasons for divorce in the United States. You might be surprised but giving some of your money to charitable organizations after budgeting can help increase happiness and have long-lasting effects on your overall well-being. In a 2018 study, psychologists discovered that when people give often, their joy last longer. The opposite was also true. Those in the experiment who gave less experienced a decline in happiness over time.

Whether you decide to give for a personal connection to a cause that matters to you, for community support and projects, or for increased of happiness, your charitable giving will go beyond kindness and will help you feel less inclined to overspend.

Source:

https://www.merceradvisors.com/insights/personal-finance/the-benefits-of-charitable-giving/

https://www.usatoday.com/money/blueprint/debt/average-american-debt-statistics/

https://journals.sagepub.com/doi/abs/10.1177/0956797618814145?journalCode=pssa

https://www.forbes.com/advisor/banking/savings/why-is-it-important-to-save-

https://www.creditkarma.com/money/i/saving-money

Advantages and Disadvantages of Young Adults (Under 26) Staying on Their Parents’ Health Insurance

Kaylon Walton 2025 April, Benefit Spotlight March 7, 2025
Asian senior father and his adult son using laptop computer while sitting at home

Under the Affordable Care Act (ACA), young adults below the age of 26 are eligible to receive healthcare coverage under their parent’s medical plan.

Dependents are allowed to stay on even if they are married, in college, have kids, are not financially dependent on their parents, and are eligible to enroll in their employer’s plan.

The Pros of Staying on Your Parent’s Plan

Parents who have children over the age of 18 but under the age of 26 might want to consider keeping their child under their healthcare coverage. This could save your adult child hundreds or even thousands of dollars in medical expenses. Most young adults are not familiar in knowing which healthcare option is best for them and usually opt for the costly one. Some post-grad jobs don’t offer healthcare coverage or one that is suitable. Colleges can offer some that are also too pricey.

The Cons of Not Having Your Own Health Coverage

Some health insurance plans may charge high premiums when adding additional dependents. It’s best to compare healthcare coverages offered by your child’s job or college versus your company to see which offers the best coverage at a lower cost. You may want to consider different factors such as any chronic medical condition that your dependent may have as this could mean higher monthly premiums. Some health plan coverages charge for additional dependents added. Having more than one child on your health plan can increase premiums. Also, if your health insurance plan consists mainly of out-of-network doctors, this could also raise the cost of your insurance and out-of-pocket expenses.

Choose What’s Best

If you are considering whether keeping your child above the age of 18 on your health insurance is the best option, here are some key points you must keep in mind before enrolling.

  • Health insurance premiums can increase when adding dependents.
  • Compare the coverages of your family health plan and the one offered by your child’s employer.
  • Dependents with chronic medical issues can increase monthly premiums.
  • Healthy dependents help lower monthly premiums and increase higher deductibles which may allow you to be eligible for a Health Savings Account.

Having your dependent on your health plan can save them a lot of money in the long run. It’s best to look at different plans to see which works best for you and your dependent(s). If monthly premiums are too high with dependents but still seem like the better option, you can always have your child pitch in to cover costs if they are working full time.

Under the Affordable Care Act (ACA), young adults below the age of 26 are eligible to receive healthcare coverage under their parent’s medical plan.

Healthy dependents help lower monthly premiums and increase higher deductibles which may allow you to be eligible for a Health Savings Account.

Source:

https://www.cnbc.com/select/staying-on-parents-health-insurance-plan-under-age-26/

https://www.healthcare.gov/young-adults/children-under-26/

https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/young-adult-and-aca

https://www.healthinsurance.org/faqs/under-the-aca-can-young-adults-still-remain-on-their-parents-health-plans-until-age-26/

Menopausal Support Is Here

Lynn White 2025 March, Benefit Spotlight February 13, 2025

Over 73% of women in 2021 reported not receiving treatments necessary to deal with menopausal symptoms.

Menopause is a natural process that marks the end of a woman’s menstrual cycle and happens to all women around their 40s or 50s. During this time, the production of estrogen and progesterone hormones that prep the body for pregnancy ends. There are numerous symptoms and health issues that can result from menopause. However, every woman’s body is different, so it is crucial to find resources provided through medical plans or vendors that can help ease the transition more securely.

Do I Need the Resources?

In the past, menopause symptoms and treatments were almost unheard of and under-reported. An online survey conducted via social media found that over 80% of women reported receiving no menopause education at school. Some women said that they learned about menopause through websites and friends. In the past few years, menopause awareness has risen in public health, yet over 73% of women in 2021 reported not receiving treatments necessary to deal with symptoms. In another 2023 survey taken by 2,000 American and British women, 80% agreed that managing perimenopause or menopause at work is a challenge but may fear sharing information with their employers as it could impact career growth.

Not only should women who are between the ages of 40 and 50 seek resources to help mitigate the challenges and questions brought on by menopause, but also those who received a hysterectomy or chemotherapy treatments may need additional support to help with the transition. If you fall between the age range for menopause or received certain treatments, it’s best to lookout for symptoms to know when it’s time to reach out such as:

  • Irregular periods
  • Hot flashes
  • Loss of bladder control
  • Trouble Sleeping
  • Loss of Libido
  • Mood Changes

Available Resouces

As the workforce ages and includes more women than ever before, employers recognize that menopause cause health challenges that may affect the productivity of some of their employees. To combat this, many jobs have teamed up with medical providers that offer resources in their health benefit packages for menopause support. Here are several options that are available through existing medical plans and vendors that might be beneficial to consider:

  • Ovia Health – Family health benefits platform that offers menopause support. Access education and guidance to better understand and effectively manage menopause with confidence.
  • Evernow – A subscription-based online platform that provides comprehensive care across all areas of menopause. Features include 24/7 in-app messaging with your provider, symptoms tracking, educational content, and access to community events. Membership plans are FSA/HSA eligible.
  • Gennev – Healthcare company that focuses specifically on menopause health. Available in all 50 states for those enrolled in Aetna, Anthem, or United Healthcare. You receive flexible scheduling, a fitness and weight management coach, and same-day prescription.
  • Midi Health – Women’s healthcare provider that is available through Aetna, United Healthcare, Health Net, Blue California, Anthem, and Cigna. It provides virtual visits, lifestyle coaching, and will assist in finding a facility near you for in-person care.
  • Maven Clinic – Provides employees and spouses through approved insurance plans support through all stages of reproduction from fertility to menopause. You receive free, 24/7 virtual access to menopause symptom management.

The number of healthcare companies that are now offering menopausal support is growing, and it is vital for women to know their options and seek out resources that will aid in their well-being during this natural stage of life.

Between 15 and 50% of perimenopausal and menopausal individuals may experience other menopause symptoms including anxiety and depression.
Sources:

Lifestyle Spending Accounts

Kaylon Walton 2025 February, Benefit Spotlight January 12, 2025
Woman enjoying herself in a café

A Lifestyle Spending Account (LSA) is a flexible benefit offered by employers to employees, designed to cover a wide range of personal well-being expenses that are not typically included in standard benefits packages.

Unlike traditional benefits like health insurance or retirement contributions, LSAs give employees the freedom to use a set budget for a variety of wellness-related or lifestyle-related activities, often beyond what’s covered by conventional benefits.

Common Uses for an LSA

  • Fitness and wellness: Gym memberships, fitness classes, personal training, or wellness apps.
  • Healthy eating: Subscriptions to healthy food delivery services or nutritional counseling.
  • Home office supplies: Desk chairs, ergonomic equipment, or other home office setup needs.
  • Travel: Fitness retreats, wellness vacations, or even transportation-related costs like commuting.
  • Professional development: Courses, seminars, or subscriptions for educational resources.

Key Features

  • Flexible: Employees can choose how to spend the funds within certain categories.
  • Annual or quarterly allowances: Employers may allocate a set amount of money each year or quarter for employees to spend on these approved services or products.

How Is an LSA Different From an HSA or FSA?

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can only be used for IRS-approved expenses such as medical copays, eyeglasses, or dental care, whereas Lifestyle Spending Accounts have fewer restrictions. The main difference, however, is that expenses submitted for reimbursement through a Lifestyle Spending Account are taxable to you. What does that mean? The reimbursed amount is considered income and is therefore subject to the same taxes as your normal wages. (In other words, your reimbursement will be the amount of the expense minus taxes.)

Girl on sofa with computer

Healthcare Transparency

2025 January, Benefit Spotlight December 23, 2024

Healthcare costs in the United States have long been a source of frustration for patients, with many unaware of the price of medical services until they receive a bill. This lack of transparency can lead to unexpected financial burdens, making it difficult for patients to make informed decisions about their care.

In recent years, there has been a growing push for cost transparency, driven by both consumers and policymakers. The goal is to give patients access to clear and accurate pricing information before they receive services, allowing them to compare costs and make choices that align with their budgets.

Several initiatives have emerged to promote transparency, such as the Affordable Care Act’s requirement for hospitals to publish standard pricing data, and new tools that allow consumers to estimate their out-of-pocket costs based on their insurance plans. These efforts aim to reduce the surprise medical bills that often result from unforeseen treatments or out-of-network charges.

Cost transparency can empower patients to take control of their healthcare spending, improve competition among providers, and ultimately drive down prices. As the demand for transparency grows, it could reshape the way we think about and interact with healthcare, fostering a more patient-centered and cost-efficient system.

Medical Transportation

2024 December, Benefit Spotlight November 18, 2024

Ambulance and helicopter services are crucial components of emergency medical response in the United States.

However, insurance coverage for these services can vary depending on several factors, including the type of insurance plan, the specific provider network, and the circumstances surrounding someone’s need for transport.

Ambulance Services Coverage

Most health insurance plans, including Medicare and Medicaid, cover ambulance services when they are deemed medically necessary. This typically includes transportation to a hospital in case of a medical emergency.

Like other medical services, ambulance companies may be in-network or out-of-network with specific insurance providers. In-network providers usually have negotiated rates with insurance companies, leading to lower out-of-pocket costs for the insured individual.

Some insurance plans may limit the number of ambulance rides covered per year or require pre-authorization for non-emergency transportation.

 

Air Ambulance (Helicopter) Services Coverage

Air ambulance services, often provided by helicopters, are typically used for transporting patients in remote or inaccessible areas or for rapid transport in critical medical situations. These services can be costly.

While many health insurance plans provide coverage for air ambulance services, there can be significant challenges. Some plans may only cover some of the costs, leaving patients with substantial out-of-pocket expenses. Additionally, air ambulance providers may not always be in-network with insurance plans, leading to higher patient costs.

Ambulance and helicopter medical care are typically reserved for situations where rapid transportation to a medical facility is necessary due to the severity or urgency of the medical condition, including:

  • Heart attacks
  • Stroke
  • Hemorrhaging
  • Severe trauma (car accidents, falls)
  • Spinal cord injuries
  • Respiratory failure
  • Injuries from natural disasters
  • Wilderness emergencies
  • Transfer of patients between hospitals for specialized care not available at the initial facility (e.g., transfer to a stroke center or a cardiac care center)

In these situations, ambulance services are typically utilized for ground transportation to the nearest appropriate medical facility.

Helicopter medical transport is often deployed when ground transportation is too slow or impractical due to distance, traffic conditions, or terrain obstacles.

Individuals should review their insurance plans carefully and understand the coverage limitations and potential out-of-pocket costs associated with ambulance and air ambulance services.

Source:

https://www.medicare.gov/coverage/ambulance-services

https://www.forbes.com/advisor/health-insurance/insurance-for-ambulance-rides/

https://www.thebalancemoney.com/does-your-insurance-cover-an-air-ambulance-2645679

https://www.opic.texas.gov/news/air-ambulances/

Medicare 101

Kaylon Walton 2024 November, Benefit Spotlight October 12, 2024
Older man talking with younger doctor

Medicare is a federal health insurance program in the United States primarily serving people over 65 and certain younger individuals with disabilities or specific medical conditions.

Medicare plays a vital role in providing healthcare coverage to millions of Americans by covering a wide range of healthcare services, including hospital care, medical services, and prescription drugs.

Medicare is broken down into different types of coverage:

  • Medicare Part A: Hospital Insurance, which covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.
  • Medicare Part B: Medical Insurance, which covers doctor visits, outpatient care, preventive services, and durable medical equipment.
  • Medicare Part C: Medicare Advantage Plans are offered by private insurance companies that Medicare approves. These plans provide all the benefits of Parts A and B, often including additional benefits such as prescription drug coverage (Part D) and dental, vision, and hearing coverage.
  • Medicare Part D: Prescription Drug Coverage, which helps cover the cost of prescription medications. Part D plans are offered by private insurance companies approved by Medicare.

Eligibility

Most people become eligible for Medicare when they turn 65 years old. Individuals may also qualify for Medicare before age 65 if they have specific disabilities, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease). Enrollment in Medicare typically occurs during specific enrollment periods, including the Initial Enrollment Period, the Special Enrollment Period, and the Annual Enrollment Period.

Senior woman consulting female doctor through video call using laptop at home
Senior couple medicating at home with medical prescription

Coverage Coordination

Medicare may work alongside other types of health coverage, such as employer-sponsored insurance, Medicaid, and Veterans Affairs (VA) benefits. Coordination of benefits ensures that healthcare costs are covered appropriately, with Medicare often serving as primary or secondary insurance depending on the situation.

The Future of Medicare

Various factors will likely influence Medicare. As the population ages, the number of Medicare beneficiaries is expected to increase significantly. This demographic shift will strain the Medicare program and may necessitate adjustments to funding, benefits, and delivery models to meet the healthcare needs of an aging population.

Healthcare costs, including those associated with Medicare, are expected to continue rising due to medical inflation, advances in medical technology, and the growing prevalence of chronic diseases. Controlling healthcare costs while maintaining access to high-quality care will be a crucial challenge for Medicare in the future.

Happy senior couple looking at medical plans with their home caregiver

Medicare has been moving toward value-based payment models that reward healthcare providers for delivering high-quality care and achieving positive health outcomes, rather than simply reimbursing for the volume of services provided.

Policy reforms may be necessary to address the Medicare program’s challenges, such as funding adequacy and disparities in access to care. Potential reforms could include changes to the eligibility age, adjustments to benefit design, modifications to payment mechanisms, and efforts to reduce waste, fraud, and abuse.

Sources:

https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare
https://www.usa.gov/medicare
https://www.investopedia.com/terms/m/medicare.asp
https://www.ama-assn.org/about/research/trends-health-care-spending
https://www.cms.gov/medicare/coordination-benefits-recovery/overview/coordination-benefits
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/what-does-medicare-cost

Airrosti vs. Massage Therapy

Kaylon Walton 2024 August, Benefit Spotlight July 7, 2024
Man getting massage

The primary goal of manual therapies, such as Airrosti and massage therapy is to alleviate pain, improve mobility, and promote overall physical wellbeing to avoid pharmaceutical or surgical intervention.

Through individualized treatment plans, practitioners use a variety of techniques, including joint mobilization, soft tissue manipulation, and muscle energy techniques to address specific musculoskeletal issues and promote recovery.

Airrosti

Short for “Applied Integration for the Rapid Recovery of Soft Tissue Injuries,” Airrosti utilizes a unique blend of hands-on manual therapy and personalized exercises to address musculoskeletal issues at their source. While Airrosti is often described as painful, it targets the root cause of your pain with pinpoint accuracy, offering rapid relief and lasting results in just a few visits. At each visit, the patient will receive a thorough, detailed assessment, hands-on manual therapy, and active care exercises/stretches designed to restore function and eliminate pain.

Massage Therapy

Through the gentle manipulation of soft tissues and muscles, massage therapy stimulates blood flow, relieves tension, and promotes relaxation on a profound level. Whether you prefer the soothing strokes of Swedish massage, the targeted pressure of deep tissue work, or the energetic flow of shiatsu, there’s a massage modality to suit every need and preference.

Both types of treatments can be applied to injuries such as back, knee, hip, shoulder and neck, as well as IT band issues, plantar fasciitis, and even migraines and tension headaches.

Many insurance carriers are covering treatments like Airrosti and massage therapy as part of comprehensive physical therapy benefits. Read your plan to see if these benefits are available to you.

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