Weight Loss Surgery Insurance Secrets: Revised List. For no extra charge, a good employee benefits broker or consultant should be able to do all of the legwork (including presenting the results to Finance) surrounding bariatric surgery and determine how adding it to your plan would impact your company. Case Study: Hawaii Pacific Health Hawaii Pacific Health (HPH) was one of the first employers in the country to cover weight loss surgery under their wellness program, and their program fully reimburses qualified employees for all expenses. Gail Lerch, HPH’s executive vice president of human resources, made the recommendation to add bariatric surgery because she felt that not to add it . In most cases, you will find that adding weight loss surgery will reduce your overall health care costs and increase the productivity of your morbidly obese employees. Following are the research- supported reasons to add bariatric surgery to your plan: 1. Direct Financial Benefit. According to the American Journal of Managed Care (AJMC) (1), an investment in bariatric surgery will break even within 2 years for laparoscopic surgery and within 4 years for open surgery (about 8. Click here to see how The HR Capitalist views this data. In addition, most major insurance companies have determined that bariatric procedures like the gastric sleeve or gastric bypass eliminates or improves obesity health problems to the extent that they have agreed to offer coverage as an option. And several states actually require that it be included. Table 2 of the AJMC study shows that following 1. A Duke University Medical Center study (3) also found that obese workers file twice as many workers compensation claims and have 7 times higher medical costs than non- obese workers. Indirect Financial Benefit. ![]() The same Duke study referenced above found that obese employees lose 1. A Journal of Occupational and Environmental Medicine (JOEM) study also concluded that moderately to extremely obese workers experienced a 4. This 1. 1. 8% difference equated to $5. In addition to confirming health care cost differences, a study posted by the National Center for Biotechnology Information (NCBI) found that severe and morbidly obese workers had 5. Legal Considerations. There are situations where you may be legally required to pay for weight loss surgery. In Boston’s Gourmet Pizza v. Adam Childers, for example, an Indiana court ruled that the employer must pay for bariatric surgery as a precursor to treating a work- related back injury (7). Adding it to your health plan now could prevent future legal issues and the added expense of paying for surgery on a “one- off” basis. Is your health insurance plan self- funded? Taxation Ruling TR 95/14 Income tax: employee teachers - allowances, reimbursements and work-related deductions. Sample Shopping List. Use the list below as a guide on your next trip to the grocery store. If so, the long- term cost savings of bariatric surgery will be much more apparent. If you are unsuccessful in getting surgery added to your plan, do your company’s policies allow the use of your “ex- gratia” plan provision? In other words, could your company agree to pay for the surgery on a one- off basis outside of the scope of your stop loss agreements for the employee who asked that you consider adding bariatric surgery? We have prepared a series of questions and a sample scenario that will help you or your broker/consultant determine whether bariatric surgery is a good business decision for your company. ![]() Weight Loss Surgery Insurance Secrets. There are several weight loss surgery insurance secrets that can save you money, time or even get coverage added to your plan.
![]() A GUIDE to the MENTOR PROGRAM LISTINGS: INCLUSION CRITERIA: To appear in this list of examples, mentor programs must meet specific criteria. Either the organization.![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
October 2017
Categories |