2009 Columbia Health Care Guide

Health & Wellness2 0 0 9 A N E M P L O Y E R ' S G U I D E

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Health & Wellness 2009: An employer’s guide 1

Publisher - Bob Bouyea

[email protected] • 803.401.1094, ext. 200

Business Assistant - Erin Williams

[email protected] • 843.849.3102

Managing Editor - Andy Owens


Senior Copy Editor - Beverly Morgan


Special Projects Editor - Allison Cooke Oliverius


Staff Writer - Mike Fitts

mfi [email protected] • 803.401.1094, ext. 204

Senior Research Coordinator - Gini Rice


Research Assistant - Leslie Halpern


Research Assistant - Chelsea Hadaway


Art Director - Ryan Wilcox


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Account Executive - Angie Wingard


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From the desk of:

David Pankau

President, Chief Operating Offi cer

BlueCross BlueShield of South Carolina

Dear Colleagues:

Like you, I have had my apprehensions over the past year regarding

the global business climate and fi nancial situation. As businessmen and

women, every choice we make, every issue we decide bears great impor-

tance. Th at is our job. Judge the facts — make the wise choices.

As a homegrown company, I am pleased to say that BlueCross

BlueShield of South Carolina chose to sponsor this year’s Health &

Wellness Guide. A great tool for all businesses in the Midlands, this ac-

cessible, easy-to-use guide helps you make informed business decisions

involving health care. I’m confi dent the Health & Wellness Guide has

information to help your business decisions.

Best regards,

David Pankau

Spirit Telecom is proud to be a sponsor of this year’s Health &

Wellness Guide.

As a South Carolina company, we value the role communication

plays in providing us with the information we need to make intelligent

decisions, especially when it comes to health care.

We’ve been helping people in the Palmetto State communicate since

the late 19th century and currently provide voice, data, Internet and

videoconferencing solutions to the state’s businesses and industries.

Our commitment to the Health & Wellness Guide continues our tra-

dition of supporting eff orts to bring quality health care to everyone in

the state.

We hope you enjoy the publication.

Welcome from our sponsors

Contents

2 Health insurance: Get the most for your money

4 From the top down

Companies fi nd success with wellness programs,

but there has to be buy-in at the top

6 Keeping health care costs down

8 COBRA subsidy reduces insurance

premium for laid-off workers

But eligibility rules disqualify some seeking coverage

10 Consumers should ask questions about quality of care

12 Medical bank accounts growing in popularity

LISTS

14 Top 25 Health

Insurance Companies

15 Hospitals

15 Employee Benefi t Brokers

16 Urgent Care Centers



2 Health & Wellness 2009: An employer’s guide

It has happened to everyone: You get a notice from the insurance company that it hasn’t paid for

a major medical expense you were certain was covered in your plan. When you review the fi ne print, sure enough, the insurance com-pany is right, and you’re left foot-ing the bill in a situation that could have been prevented.

Get smartBeing a smart consumer starts

with educating yourself about your current health insurance plan. By taking a little time to know the ins and outs, you not only save money, you can also use the plan to your best advantage — and ultimately improve your family’s health.

Lynne Bernthal, president of Benefi t Concepts Inc., said, “If someone knows what their ben-efi ts are, when it comes time to use them, they will be smarter and get more value from it.”

Many people assume all health care plans are basically the same, but that is not the case, said Terry Peace, vice president of group and individual operations for BlueCross BlueShield of South Carolina. For example, it is not safe to assume that

because your last company covered pregnancy, your new plan will, too.

Not only do plans vary from employer to employer, but indi-vidual plans are oft en signifi cantly diff erent from group plans.

“Whether consumers choose their health care plan or their em-ployer makes group coverage avail-able to them, they need to take time to think about their health care needs and understand the benefi ts, exclusions and requirements of their plans,” Peace said.

And it is important to get to know your policy now, before your child breaks a bone or your spouse throws out his or her back.

“Oft en, people don’t take time to understand their benefi ts before an acute or emergency health care episode occurs,” Peace said. Your insurance company can answer your questions, but you can also get help from your company’s human resources benefi ts specialist. If you have an individual policy, consult with your agent.

What do I need to know? A good place to start, Bernthal

said, is with the “Explanation of Benefi ts.” It can be tricky to read,

but most insurance companies of-fer tools on their Web sites to help consumers understand some of the more confusing parts. If nothing else, Bernthal recommends starting at the list of things not covered, be-cause that tends to be shorter than the list of what the company covers.

Peace said other basics include understanding your share of the costs, such as deductibles, copay-ments and coinsurance. Bernthal recommended determining the “catastrophic expense” — the de-ductible added to your maximum out-of-pocket costs.

“Th at’s your worst-case scenar-io,” she said, and it’s reassuring to know you won’t be out tens of thou-sands of dollars, no matter what. If it does add up to a fi gure that’s more than you think you can handle, it might be time to fi nd a new health plan or adjust your deductible or co-insurance accordingly.

Peace also recommended pay-ing special attention to the defi ni-tions listed in the policy.

She suggested looking for re-quirements for preauthorization, studying each exclusion and limita-tion and reading through your ap-peal rights.

If you’re unsure about anything, make notes as you’re reading the policy and call the company to get a clear understanding.

Peace also recommends that when you receive a bill from a med-ical provider, be sure to check the amount against what your Explana-tion of Benefi ts says you should owe for that service. Or call your insur-ance company to report what you are being billed, and ask whether that is what you owe.

If the amount you owe diff ers from what the provider is billing, return the bill with a check for the amount your health plan says you should pay. You should include a note with the payment saying the billing offi ce should contact your health plan for an explanation of why you are paying a diff erent amount.

When coverage is deniedWhat happens if, despite your

thorough review of the policy, you disagree with your company’s de-nial of coverage of a particular ex-pense?

Th e best cure is always an ounce of prevention, and Bernthal sug-gests getting a predetermination of benefi ts, if a procedure is at all questionable. A provider can re-quest such a document from the in-surance company showing whether the item will be covered and how.

If there’s no predetermination of benefi ts to fall back on, it’s time to appeal. A broker can handle that process, or you can look for the plan’s explanation of the appeals process and call the phone number listed.

“Understand your rights under the appeals process and follow the process carefully, if payment for a service is denied or reduced based on your understanding of the ben-efi ts of your plan,” Peace said.

Even if you have a disagree-ment, by having a thorough under-standing of your plan, you are arm-ing yourself for the best possible outcome. cr

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Health insurance: Get the most for your money Staff Report

Health & Wellness 2009

Short-term medical insurance is a low-cost plan that expires after six months, at which time you must reapply for new coverage.

Managed-care plans or HMOs provide full coverage for pre-existing medical conditions but limit access to medical care through primary physician gate-keepers or participating provider networks.

Medical savings accounts are money market funds or investment accounts to which tax-deductible deposits may be made to pay out-of-pocket medical expenses.

Medical expense reimbursement plans are tax-deductible plans used by

Types of health plansbusinesses to provide tax-free health care benefi ts to employees.

COBRA plans allow continuation of group insurance after an employee leaves an employer.

State mandate plans are sanctioned and made available to anyone without access to other types of medical insurance.

Group medical insurance plans are guaranteed-issue to businesses with one or more employees on a bona fi de payroll.

PPO discount plans are not insurance plans but rather are preferred provider plans that off er access to network dis-counts with contracted providers.

Source: Medsave.com

Getting the most out of your health insurance plan

Use in-network providers.• Use mail-order prescriptions, if • available.Use a nurse’s line, if available.• Ask that prescriptions be fi lled with • generic drugs.Go to the emergency room only in a • true emergency. Try the doctor’s offi ce or an urgent care center fi rst.Take advantage of allied program • discounts, which can include dental care, vision care, weight management and smoking cessation programs and discounts on infertility procedures.Pay attention to timing. Once deduct-• ibles are met, try to schedule proce-dures and visits before the year is out.

http://www.carolinacareplan.com


From the top downCompanies fi nd success with wellness programs, but there has to be buy-in at the top

By Allison Cooke Oliverius, [email protected]


Consultants will tell you two main things about workplace wellness programs.

First, they will outline the bene-fi ts, which include improved health of employees, lower expenses relat-ed to employee health care, happier employees and increased produc-tivity.

Th ey will also tell you that a wellness program won’t get off the ground unless the directive fi lters from the top down.

“It’s like with any major pro-gram with any company: If the top person doesn’t buy in, it doesn’t happen,” said Sallie Bottorff , a co-owner and partner at Human Re-source Dynamics.

Colonial Life Insurance Co. is an example. In the 1970s, then-chairman Gayle O. Averyt was an avid health enthusiast with a vision for improving his employees’ qual-ity of life. He’d heard that a handful of big companies, including Gen-eral Electric Co. and Coors Brew-ing Co., had wellness programs in place, so went to visit them.

When he re-turned, he put the wheels in motion and developed what is now Wellpower, the Columbia region’s fi rst and longest-running corporate wellness program. It’s a voluntary program available to all Colo-nial Life employees and it currently has a participation rate of more than 40%.

“Over time, it has become one of those key cornerstones in how we think and what we do … in relation to our employees,” said Don Mont-gomery, assistant vice president and director of human resources at Co-lonial Life.

Th rough Wellpower, employees can participate in fi tness activities, workshops and seminars, health screenings, and more. For $16.50 per month, employees can use the 6,200-square-foot wellness center,

which includes a full range of exer-cise equipment and off ers 22 group fi tness classes a week. Employees are encouraged to eat a healthy meal or snack in the company cafeteria and to generally incorporate wellness into the corporate culture.

But Jada Hubbard, who manag-es Wellpower, said it’s not all about physical health. Emotional health is important as well, and Hubbard works to create programs aimed at

helping employees fi nd balance in their lives. A recent semi-nar on single par-enting and was well-received, she said.

Colonial Life’s wellness program, which has been in eff ect since 1983, has had an impact on the

bottom line. For the past several years, the company’s insurance pre-miums have been 3%-7.5% less than the industry average. And company offi cials know that the “big picture” approach to wellness has become a useful tool in attracting and main-taining quality employees.

How to beginCompanies vary in the design

of their wellness programs. Some human resources departments take responsibility for overseeing the wellness program; other companies establish wellness committees, giv-

ing employees more control.Th e Internet off ers many use-

ful tools to help create a program. Other companies will design and administer a program for you for a fee.

Beginning a wellness program can be as simple as educating your employees on the advantages, then recruiting a committee of employ-ees to help develop a wide variety of programs to appeal to diff erent types of employees.

Typical programs begin with a health assessment and, based on the wants and needs of the employ-ees, could then include programs for weight loss or smoking cessa-tion. Employees might be invited to walk during their lunch hour or sign up to run a race together. Monthly newsletters fi lled with health tips and nutritious recipes could be sent to employees. Lunch-and-learn workshops might be or-ganized, featuring local health and wellness professionals.

Some companies off er incen-tives to keep employees motivated, but building a support system among employees is more crucial to success.

Bottorff cautions that compa-nies should be sure to be aware of the legalities involved in setting up a wellness program. For example, you must be in compliance with the Americans with Disabilities Act and the Health Insurance Portabil-

ity and Accountability Act.

Benefi ts you can countKaiser Health News reports that

under current law, employers and insurers may give discounts of up to 20% on premiums, copayments or deductibles to workers who take part in wellness programs. Participa-tion is enough to qualify under some programs, and others have specifi c goals employees must meet — re-ducing blood pressure or cholesterol for weight loss, for example.

At Colonial Life, employees qualify for a $4.50 reduction per pay period on medical benefi ts if they participate in voluntary health screenings. Th e reward is tangible, but as corporate communications and media relations director Jeannie Reynolds said, the impact is much broader.

Th rough wellness programs and health screenings, employees are able to detect diseases early, when they are most treatable — something that’s important “not only for our health and life, but also for control-ling health care costs,” she said. cr

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Reach Allison Cooke Oliverius at 843-849-3149.

A wellness program is

designed to

keep employees

healthy while

combating rising

insurance costs.

Get regular screenings

Simply having an annual physical exam can lead to better health and lower health care costs. The frequency at which you have an exam depends on your age and family history. Generally:

Have at least one physical while in • your 20s.Have a physical every one to two • years in your 30s.Begin annual physicals at age 40.• Based on family history and physical • health, a regular exam might be needed more frequently.Begin colon cancer screenings at • age 50; begin at age 40 if you have a family history of colon cancer.

Colonial Life employees are encouraged to participate in walking and running programs as well as utilize the 6,200-square-foot on-site wellness center. (Photos provided)

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Providing insurance is good for business. Employees who are insured are protected against

high medical expenses and are more likely to receive the health care they need.

Insurance might be good for business, but it’s not so good for the bottom line. With the costs of health care rising, businesses are looking for ways to cut expenses on premiums rather than eliminating insurance altogether.

According to the Small Business Administration, more than 81% of businesses with 50 or more em-ployees have adopted some form of wellness program. Th e most popu-lar types include smoking cessation, stress management, weight loss and back care.

A recent National Worksite Health Promotion survey found that wellness programs save money, primarily through reduced turn-over and absenteeism. Some insur-ance companies off er lower rates to companies participating in wellness programs.

Th e Wellness Councils of Amer-ica provides examples of direct cost savings:

Johnson and Johnson reduced • its absenteeism rate by 15% within two years of introducing its wellness program. Th e com-pany also cut its hospital costs by 34% aft er three years.Honeywell Inc. off ered a $200 • cash incentive based on partici-pation in certain program areas. Program coordinators estimat-ed a 70% to 150% return on in-vestment from reduced medical claims alone.Another way to keep costs down

is to hunt for the best premiums.“We just about have to shop

around every year,” said Michael Taylor, executive vice president of Diversifi ed Computer Solutions. “I can’t remember a year when health care costs didn’t increase 10%. Sometimes we stay with the same company, but many times we bounce between two or three until we can fi nd the best deal.”

For a small company like Tay-

lor’s, which currently employs about 27 workers, hiring a full-time hu-man resources person who would typically oversee the selection of a new insurance carrier, is not in the budget. So Taylor spends a great deal of his time talking to various companies and homing in on plans that are suitable and aff ordable.

Shopping around can be made easier with the help of an agent. Th e biggest advantage to using agents is that they can sort through all the

diff erent coverage options for you.Th ey also can be an advocate be-

tween you and the insurance com-pany if questions or issues arise and can keep you informed of products that are coming down the pike.

As a general agency, the David M. Gilston Insurance Agency Inc. does not sell insurance products; instead, it provides free training and support services to independent agents. Its employees are the “army behind the agents,” armed with intricate knowledge of insurance products and compliance issues.

Faith Reynolds, vice president of operations for the Gilston sales offi ce in Columbia, added that the agents the company serves con-stantly work to contradict the sup-position that quotes provided by insurance agents are much higher than those provided by carriers.

“Agents are commission-only, and it is in their best interest to fi nd out what you need and design a policy that is lower-priced and one that is geared toward you,” she said. cr

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Keeping health care costs down

Tips for health insurance shopping

Shop carefully. • Be careful about changing policies.• Beware of pushy sales practices.• Look out for pre-existing conditions • and other exclusions.Read the limitation and exclusion • provisions carefully.Know whether and when a company • can refuse to renew your policy. Fill out your application completely • and accurately.

Source: S.C. Department of Insurance

Staff Report


http://www.deltadentalsc.com

http://www.trmchealth.org


The future of health insurance access and aff ordability is up in the air as Congress debates

reform. But in the meantime, some laid-off workers can get a break on premiums through a temporary federal subsidy.

Th e $787 billion stimulus act that Congress passed in Febru-ary contained a provision that al-lows some jobless workers to stay on their former employer’s group insurance plan for nine months at 35% of the premium cost.

Th e provision is referred to as the “COBRA subsidy” because the federal government ultimately pays the remaining 65%, even though employers must front the cost.

COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act of 1986, is a federal program that allows all em-ployees to remain on group insur-ance plans for a period aft er leaving a company.

Typically, continued employer coverage through COBRA requires that unemployed workers pay 100% of the premium costs — the por-tion they paid while working plus the portion their employers previ-ously paid for them. Th at can be prohibitively expensive for people whose incomes have been slashed.

Th e new subsidy is available to workers who have been laid off since September 2008, and it re-mains an option for those laid off through the end of 2009.

Few takersTh e law took eff ect in February,

and it set a deadline of April 18 for employers to disseminate informa-tion about the subsidy to former employees who might be eligible. Th at left many businesses scram-bling to notify all workers whom they had laid off in the preceding six months.

Particularly hard-hit were small to medium-sized businesses with-

out an on-staff human resources expert or an insurance consultant or third-party administrator to handle the details.

Employees notifi ed by the dead-line had 60 days to re-join their company’s plan with the subsidy. But some insurance offi cials report that — aft er companies rushed to comply with notifi cation rules — relatively few people signed up.

“We sent out over 500 letters and had 17 people take it,” said Mark Riley, president of Ameri-can Benefi t Services, a third-party insurance administrator in Columbia.

Riley said one reason for the lack of participation is that many who were interested were dis-qualifi ed. Laid-off employees who could have signed up for coverage through a spouse’s health insur-ance plan or some other group coverage — even if they didn’t do so — are not eligible for the CO-BRA subsidy.

And some people might have found the 35% cost still prohibi-tively expensive, Riley said. Still others might have chosen not to sign up for the subsidy because they are waiting to see what hap-pens with health insurance reform in Washington.

“A lot of people on all sides are playing a waiting game to see what’s going to come out of Wash-ington in the next few months to do anything long-term on health care,” Riley said.

In one situation, a laid-off worker who wasn’t notifi ed of the program approached her former employer about the subsidy only to fi nd out the company had dropped its group health insurance plan al-together to save money, said Colin Smoak, an insurance consultant with McLaughlin & Smoak in Charleston.

“Her appeal was for naught,” Smoak said, because there was no

longer a group plan to re-join.

Employer responsibilitiesBusinesses that missed the

deadline for notifying employees and still have not done so are in a tough spot, some in the insurance industry say.

To send notices now might alert former employees that they could have been covered in previ-ous months. And insurance carri-ers might not be obligated to add a former employee to the group plan at this point. Th at makes the em-ployer fi nancially liable for medical costs incurred during the gap if a former employee was eligible and didn’t have a chance to sign up.

On the other hand, employers could be fi ned by the U.S. Depart-ment of Labor for failure to no-tify former employees if someone presses the issue.

“Th ose people are sitting on a time bomb, because now the insur-ance carriers are off the hook,” said Mendel Boykin, president of Ben-efi t Coordinators Inc. in Colum-bia. “If someone comes and wants it, you are the insurance company now.”

Insurance industry representa-tives say it’s not yet clear how hard the Labor Department will come down on those businesses because the laws are so new and were passed down so quickly.

In addition to notifying former employees, businesses are also re-sponsible for fronting the cost of the 65% subsidy to their insurance carrier. Th e government allows employers to deduct that cost from their payroll taxes or request a re-fund separately.

For some businesses, that pay-and-deduct system has gone smoothly. For others, especially small employers that had substan-tial layoff s in recent months, mak-ing the payment has been harder, Smoak said.

“I have not heard from anybody that it just broke them,” Smoak said. “But you don’t budget for CO-BRA.”

Smoak said the requirements have compounded an already tough economic time for employers.

Liz Speidel, an employment at-torney with Haynsworth Sinkler Boyd, said she hasn’t heard any of her clients complain about the sub-sidy obligations.

“Employers seem to be relieved to be able to off er employees this benefi t upon termination,” Speidel said. “It certainly helps during a period of unemployment.”

Going forwardTh e second chance for employ-

ees laid off since September to get subsidized insurance passed with the April deadline and subsequent 60-day sign-up period.

Th e COBRA subsidy is avail-able to employees laid off through Dec. 31, unless Congress extends it. But notifi cation going forward shouldn’t create the same headache some employers experienced in the spring, some experts say.

Employers should provide the subsidy notifi cation to laid-off em-ployees in a package with regular COBRA information, Boykin said.

“Th e only headache for em-ployers right now is having to ad-just their (payroll tax) quarterlies,” Boykin said. “Th e rush has already gone by, if they did notifi cation, and they don’t have any big liabili-ties hanging over their head right now. Now it’s just back to normal.”

Regular COBRA benefi ts are available for 18 months. Th e sub-sidy is limited to nine months, but those who participate in the subsidy can continue on their group health plan for another nine months if they pay the full premium cost. cr

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Reach Ashley Fletcher Frampton at 843-849-3129.

COBRA subsidy reduces insurance premium for laid-off workersBut eligibility rules disqualify some seeking coverageBy Ashley Fletcher Frampton, [email protected]


What Do You Value?Your coin collection … your car … your family? How about your good health — and good health care coverage? We work hard to help you gain both.

So we give you the tools to help manage your health … and manage your benefi ts … and manage your money. Imagine being able to estimate treatment costs or compare drug costs — or compare the quality among diff erent hospitals. It’s all available on our Web sites anytime you need it. We even provide contribution calculators to help you open a health savings account. We value our members. So if you’re looking for a health plan with value-added benefi ts …

Choose BlueSM.






Employee Benefi t Specialists | 803.253.6997 | www.clarkebenefi ts.com

Clarke & Company Benefi ts and BlueCross BlueShield of South Carolina.

Working together to provide group health insurance for your company’s most important assets – your employees.

Authorized Representative

Many people trust their doc-tors and health care provid-ers to make the best deci-

sions for them. Patients might feel intimidated or too embarrassed to ask questions or seek a second opinion, but the role of a respon-sible health care consumer is to as-sess the quality of health care.

Even though insurance might limit health care choices, consum-ers can still ensure basic standards of quality are being met.

Currently, few national stan-dards for health care quality exist, but organizations like the National Quality Forum and the Institute of Medicine are researching best practices and established standards for patient care.

Th e Institute of Medicine de-fi nes quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are

consistent with current profession-al knowledge.”

Both organizations see qual-ity care as being safe, timely, eff ec-tive, benefi cial, patient-centered, equitable and effi cient. Standards of care would establish a ma-trix for achievement of these re-quirements for quality care. An example of a performance mea-

sure would be immediate ad-ministration of an aspirin to a heart attack patient to keep blood clots from forming.

Do your homeworkWith health care costs expected

to rise again in 2010, patients can’t aff ord to not be savvy consumers.

Employers should encourage

their employees to ask questions and understand their health care.

Several Web sites allow patients to compare hospitals and see how they rank in terms of services and overall quality. A little research can go a long way toward money sav-ings and better care.

Patients should also take the time to understand their treat-ments, including tests and pre-scription medications. Medically sound Web sites can provide useful information on tests, drugs and po-tential treatments. Patients should arm themselves with some back-ground research so they can ask questions and intelligently discuss their care with their physician.

Educating health care consumers

Th e Agency for Healthcare Re-search and Quality, in conjunction with the Advertising Council, has

Consumers should ask questions about quality of careStaff Report


Inquiring minds = healthy bodiesThe following are 10 basic questions every patient should ask:

What is this test for?• How many times have you done this • (test/procedure)?When will I get the results?• Why do I need this surgery?• Are there any alternatives to this • surgery?What are the possible complica-• tions?Which hospital is best for my needs?•

How do you spell the name of that • drug?Are there any side eff ects?• Will this medicine interact with • medicines that I’m already taking?More questions can be found on the

question builder at www.ahrq.gov/ques-tionsaretheanswer/questionBuilder.aspx.Source: Agency for Healthcare Research and Quality, www.ahrq.gov

http://www.clarkebenefits.com


B A N K I N G I N S U R A N C E I N V E S T M E N T S

Insurance Services

JOHN SMITH – 123 MAIN STREET – CITYVILLE, ST 12345 – 000-000-0000[ ]

Insurance services are provided by BB&T Insurance Services, a wholly owned subsidiary of Branch Banking and Trust Company. Insurance products may not be available in all states.

Insurance products are not a deposit; not FDIC insured; not guaranteed by the bank; not insured by any government agency. BBT.com © 2007 BB&T.

At BB&T Insurance Services, we know how important it is to be able to attract

and retain the best talent. We also know that every business we work with is

as unique as its employees. That’s why we design your plan with you – for you.

From competitive benefits to retirement, we’ll provide a plan that will not only

accommodate your needs, but also grow with you.

Melissa Shealy, Vice President, Employee Benefi ts Manager1710 Gervais Street - Columbia, SC 29201 - 803-231-6144

At BB&T Insurance Services, we know how important it is to be able to attract and retain the best talent. We also know that every business we work with is as unique as its employees. That’s why we design your plan with you – for you. From competitive benefi ts to retirement, we’ll provide a plan that will not only accommodate your needs, but also grow with you.

Protect your most valuable resource.

launched a campaign to encourage patients to take an active role in their health care, especially by ask-ing questions.

Materials available on the agency’s Web site, www.ahrq.gov/questionsaretheanswer, include a question builder that lets patients customize a list of questions to their own needs.

“People spend more time men-tally preparing when they go to see the car mechanic,” said agen-cy director Dr. Carolyn Clancy. “People arrive (at the doctor) and expect me to be the conductor. Many people will say they don’t get enough time with doctors. Th ey are probably right, but if you think ahead and prepare with questions, you will get more out of the encounter.”

As an example, Clancy said that patients with a chronic illness who are engaged and active in their treatment have better results than those who are not.

In addition, asking questions can help you avoid becoming a victim of a medical error. Clancy points to a report her agency pub-lished with the American Hospital Association that focuses on fi ve steps to safer health care:

Online ResourcesThese sites can help you compare hospitals and research doctors.

Ask questions if you have 1. doubts or concerns. With each medical encounter, people ask an average of 1.4 ques-tions, Clancy said, including questions about parking. “As a doctor, I can’t know what is in someone’s head.”Keep a list of all medicines you 2. are taking. Get the results of any test or 3. procedure. “What many people don’t appreciate is that there is no standard expectation for how to notify people about test results,” Clancy said. “Some doctors think no news is good news. You need to know the results.”Talk to your doctor about which 4. hospital is best for your needs.If you’re having surgery or some 5. other procedure, understand the procedure.“Th ese are steps you can take

even if you have limited choices (because of health insurance guide-lines),” Clancy said. “Th e more you participate, the better off you are.”

For a copy of “5 Steps to Safer Health Care” call the Agency for Healthcare Research and Qual-ity at 800-358-9295 or e-mail [email protected]. cr

br

Agency for Healthcare Research and Qualitywww.ahrq.gov

American Hospital Directorywww.ahd.com

American Medical Associationwww.ama-assn.org

DocFinderwww.docboard.org

Federation of State Medical Boardswww.fsmb.org

Healthfi nderwww.healthfi nder.gov

Institute of Medicinewww.iom.edu

Joint Commissionwww.jointcommission.org

National Institutes of Healthwww.nih.gov

National Quality Forumwww.qualityforum.org

S.C. Hospital Associationwww.scha.org

U.S. Department of Health & Human Services Hospital Comparewww.hospitalcompare.hhs.gov

http://www.bbt.com

http://www.dgilston.com/agents/mid-med.cfm


Medical bank accounts growing in popularityStaff Report


Even in the best of economic times, business owners are constantly searching for ways

to reduce expenses. And the recent economic downturn has caused em-ployers to target health insurance as a benefi t they must re-examine.

In a recent survey of employers conducted by Colonial Life & Accident Insurance Co., half of those who re-sponded said the economy has aff ected the benefi ts they off er employees.

Of the 750 human resource managers and benefi ts administra-tors surveyed, 26% said their com-panies had to increase employee contributions, and 12% eliminated benefi ts altogether.

Cost-cutting optionsInsurance agents say an increasing

trend is for companies to opt for high-er deductibles or copays to reduce premium costs. Th ey might then off er a consumer-directed health plan that involves setting money aside to help employees manage medical expenses not covered by the new plan.

Examples of these consumer-directed plans include health sav-ings accounts, health care fl exible spending accounts and health reim-bursement accounts.

Health savings accountsHealth savings accounts provide

a lifetime savings vehicle for medi-cal expenses. Th e accounts are ob-tained either through a bank or an insurance agency. Th ey are owned and managed by the employee, who must also have a high-deductible insurance policy — oft en through an employer. Th e employee is re-sponsible for depositing up to the deductible amount into the savings account. Contributions are made before taxes, and the maximum amount, set by the Internal Revenue Service, changes each year.

Account holders are issued checks and a debit card to pay for “qualifi ed medical expenses.” Th e IRS lists qualifi ed expenses on its Web site. Th ey range from costly surgical procedures to inexpensive over-the-counter medications.

Employees with health savings

accounts have no copayment. Th e account is used to pay the full cost of all procedures, medications, etc. Once the deductible is met, how-ever, 100% of health care costs are paid by the insurance company.

An employer may make contri-butions to such an account, but be-cause the employee owns it, the ac-count and any employer contribu-tions will go if the employee leaves.

Any unused money can be rolled over, until age 65. Employ-ees can use their accounts for other expenses, but they must pay for do-ing so. Individuals younger than 65 must pay income tax and a 10% penalty on the amount withdrawn. For those 65 and older, the amount withdrawn is taxed as income.

Th e advantages of savings accounts include more employee control over how medical dollars are spent and a reduction in taxable income when the employee fi les his or her taxes.

“But the plan is not for everyone; it depends on the demographics of your group and the culture of your company,” said Meredith Adams, account executive with First Caro-lina Financial Services.

Flexible spending accountsA fl exible spending account can

be used along with any health insur-ance plan. Th e accounts are mostly funded by employees through a pre-tax payroll deduction, though employers can contribute. Th e ac-counts are held in trust by the em-ployer and used to reimburse em-ployees for medical expenses not covered by their health plan. An employee may also use the account to pay for dependent care expenses, up to a predetermined maximum.

Th e advantages include an im-mediate discount on eligible health care and dependent care expenses — equal to the taxes you would oth-erwise pay on the money, because pre-tax dollars are used.

Th e main disadvantage is that employees must use the money in each year or they lose it.

Health reimbursement accountsHealth reimbursement accounts

are employer-owned, employer-funded, tax-free health savings ac-counts set up to reimburse employ-ees for certain health care expenses.

An account can be set up with

any health plan but is typically es-tablished aft er an employer has purchased an insurance plan with a low monthly premium. Oft en, this means the deductible has gone up or the plan does not cover as much.

Under such an account, the em-ployer will take the money it saves from a lowered monthly premium and put that money into a savings account. Th e employer and em-ployee will agree at the outset on the amount of medical expenses the employee will cover, and the em-ployer will pay for the rest out of the reimbursement account.

For example, if a deductible has gone from $500 to $1,500, the em-ployee might be responsible for the fi rst $500 and the employer would cover the rest.

“Th e employer is taking on a risk, but they have bought a (health) plan that lowers their monthly pre-mium, and they are in eff ect giving that savings back to the employee, so the employee doesn’t feel a large amount coming out of their pocket,” said Mark Riley, owner of American Benefi t Services.

Under this plan, unused funds can be carried over to the next year.

Consumer awarenessTh ese plans off er many benefi ts,

including more control for employ-ees over their medical spending and tax benefi ts for employers. But with more control comes more respon-sibility, and employees will need to track their contributions and ex-penses to be sure they are getting the most out of their medical sav-ings plan.

First Carolina Financial Servic-es’ Adams said this is a good thing, because the plans make consumers more aware of how they are spend-ing their health care dollars.

“We got used to our employers paying 100% of the premium and all we had to pay as employees was the $20 copay. But those days are gone,” she said. “Th at’s what got us in trou-ble. You pay $20 for your visit, but the actual cost was $300. It’s a case of overutilization and not using the money in the best way.” cr

br

FAQs about personal health care spending accounts What is a health savings account? It en-ables you to pay for current health expenses and save for future qualifi ed medical and retiree health expenses on a tax-free basis.

What is a high-deductible health plan? It is an inexpensive health insurance plan that generally doesn’t pay for the fi rst several thousand dollars of health care expenses (i.e., your deductible) but will generally cover you after that.

What are qualifi ed expenses? They range from surgical procedures to over-the-counter medicines. A partial list is available at www.irs.gov.

What is a fl exible spending account? This employee-funded pre-tax account is used to pay for medical expenses not reim-bursed by the health plan. You may also use it to pay for dependent care expenses up to a predetermined maximum.

How can a fl exible spending account benefi t me as an employer? You can

save in several ways: cut payroll taxes, cushion rate increases, lower your health insurance costs, cut your retirement plan expenses and cut the cost of other insur-ance premiums.

How can a fl exible spending account benefi t me as an employee? By paying premiums and medical expenses with pre-tax dollars, you reduce the taxes you pay, eff ectively increasing your take-home pay.

What is a health reimbursement ac-count? This is a medical reimbursement plan that is paid for solely by the employer.

How does it work? They are established by a plan document, which outlines the types of medical expenses, as well the an-nual maximum each employee can receive. The plan then reimburses employees for verifi able expenditures not covered by their group health plan.

Source: American Benefi t Services

www.lexmed.com

JOEL WATTSNurse Recruiter11 years

Joel has a unique ability to

build a personal rapport

with all candidates, which is

one of the most important

skills in recruiting for

high-demand professions.

We wouldn’t have been voted best hospital ten straight years without people like Joel

For ten consecutive years, readers of The State newspaper have voted us the area’s best hospital. But a hospital is only bricks and mortar; it’s the people working here who have earned us that honor, dedicated people such as Joel Watts, our RN Recruiter. Thanks Joel, and thanks to more than 5,000 of our Lexington Medical Center employees, each committed to serving the people in our community with the highest degree of excellence.

http://www.lexmed.com





No. of Full-Time Agents/No. of Full-Time Support Staff



Doctors Care – Beltline511 Beltline Blvd.

Columbia, SC 29205

Phone: 803-782-4051

Fax: 803-790-6612

Web Site: www.doctorscare.com

Hours: 8 a.m.-8 p.m. Mon.-Fri.; 9 a.m.-5

p.m. Sat.-Sun.

Services: Cough, cold, sore throat, fever,

dizziness, shortness of breath, painful

sinuses, ear problems, headache, chest

pain, stomach problems, diarrhea, high

blood pressure, high cholesterol, arthritis

and circulation problems, diabetes manage-

ment, allergies and rashes, women’s care,

urinary conditions, injuries, lacerations, auto

accident evaluation, sprains and fractures,

removal of skin lesions, abscess treatment,

burns

Doctors Care – Cayce977 Knox Abbott Drive

Cayce, SC 29033

Phone: 803-794-0476

Fax: 803-791-0971



p.m. Sat.-Sun.











burns

Doctors Care - Columbia East7653 Garners Ferry Road

Columbia, SC 29209

Phone: 803-783-2661

Fax: 803-776-8882



p.m. Sat.-Sun.


dizziness, shortness of breath, painful sinuses,

ear problems, headache, chest pain, stomach

problems, diarrhea, high blood pressure, high

cholesterol, arthritis and circulation problems,

diabetes management, allergies and rashes,

women’s care, urinary conditions, injuries,

lacerations, auto accident evaluation, sprains

and fractures, removal of skin lesions, abscess

treatment, burns

Doctors Care - Forest Acres4416 Forest Drive, Suite A

Columbia, SC 29206

Phone: 803-738-9522

Fax: 803-787-8026



p.m. Sat.; 10 a.m.-5 p.m. Sun.











burns

Doctors Care – Lexington247 Columbia Ave.

Lexington, SC 29072

Phone: 803-359-5533

Fax: 803-359-0127



p.m. Sat.-Sun.











burns

Doctors Care – Northeast110 Atrium Way

Columbia, SC 29223

Phone: 803-788-1153

Fax: 803-736-3243



p.m. Sat.-Sun.










treatment, burns

Doctors Care – Seven Oaks100 Jimmy Love Lane

Columbia, SC 29212

Phone: 803-772-5030

Fax: 803-551-5477



p.m. Sat.-Sun.










treatment, burns

Doctors Care – West Columbia3240 Sunset Blvd.

West Columbia, SC 29169

Phone: 803-796-4251

Fax: 803-796-4449



p.m. Sat.; 10 a.m.-5 p.m. Sun.











burns

Doctors Care-Ridgeview4214 Hardscrabble Road

Columbia, SC 29223

Phone: 803-736-8955

Fax: 803-699-8049



p.m. Sat.-Sun.










treatment, burns

Lexington Medical Center – Batesburg-Leesville338 E. Columbia Ave.

Batesburg-Leesville, SC 29070

Phone: 803-604-0066

Web Site: www.lexmed.com

Hours: 8 a.m.-7 p.m. Mon.-Thurs.; 8 a.m.-5

p.m. Fri.-Sat.

Services: Urgent care, family medicine, OB/

GYN services, X-ray and lab facilities

Lexington Medical Center – Chapin557 Columbia Ave.

Chapin, SC 29036

Phone: 803-932-0655



p.m. Sat.-Sun.

Services: Urgent care, OB/GYN services,

family medicine, digital mammography

screening, X-ray and lab facilities

Lexington Medical Center – Gilbert4080 Augusta Highway

Gilbert, SC 29054

Phone: 803-892-1800


Hours: 8 a.m.-5 p.m. Mon.-Tues., Thurs.-

Fri.; 8 a.m.-noon Wed.

Services: Urgent care, family medicine,

X-ray and lab facilities, wellness center

Lexington Medical Center – Irmo7035 St. Andrews Road

Columbia, SC 29212

Phone: 803-749-0924


Hours: 7 a.m.-10 p.m. seven days a week

Services: Urgent care, outpatient surgery,

lab facilities, radiology, CT scan, MRI, fl uo-

roscopy, women’s imaging, full-fi eld digital

mammography, bone densitometry, physical

therapy, physician offi ces

Lexington Medical Center – Lexington811 W. Main St.

Lexington, SC 29072

Phone: 803-358-6100


Hours: 8 a.m.-10 p.m. seven days a week

Services: Urgent care, outpatient surgery,

radiology, X-ray, PET/CT scan, CT scan,

MRI, lab, women’s imaging, full-fi eld digital

mammography, bone densitometry, cardiac

rehabilitation, physical therapy, physician

offi ces

Lexington Medical Center – Swansea935 W. Second St.

Swansea, SC 29160

Phone: 803-568-2000


Hours: 8 a.m.-7 p.m. Mon.-Thurs.; 8 a.m.-5

p.m. Fri.-Sat.; Noon-5 p.m. Sun.

Services: Urgent care, family medicine,

internal medicine, OB/GYN, X-ray and lab

facilities

MinuteClinic – Columbia – Clemson RoadInside CVS/pharmacy No. 2250

121 Clemson Road

Columbia, SC 29229

Phone: 866-389-2727

Web Site: www.minuteclinic.com

Hours: 8:30 a.m.-7:30 p.m. Mon.—Fri.; 9

a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun.

Services: Diagnosis and treatment of com-

mon illnesses

MinuteClinic – Columbia – Hardscrabble RoadInside CVS/pharmacy No. 2269

4310 Hardscrabble Road

Columbia, SC 29229

Phone: 866-389-2727



a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun.


mon illnesses

MinuteClinic – IrmoInside CVS/pharmacy No. 5549

1008 Lake Murray Blvd.

Irmo, SC 29063

Phone: 866-389-2727



a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun.


mon illnesses

MinuteClinic – Lexington – Lake Drive NorthInside CVS/pharmacy No. 7334

5608 Sunset Blvd.

Lexington, SC 29072

Phone: 866-389-2727



a.m.-5:30 p.m. Sat.; 10 a.m.-5:30 p.m. Sun.


mon illnesses

Urgent Care Centers Listed alphabetically

2009 Columbia Health Care Guide

Documents

health plan

health library

health dollars

overall health

health wellness2

personal health assessment

private personal health

bene ts information