Category Archives: Small Business Owners and Professionals

The risk takers who support the core of our country by running small businesses or offering professional services

Self-Insured Employers Address the “Sandwich Generation” Needs

The Self-Insurance Institute of America (SIIA) defines self-insured employers as those participating in “a self-insured group health plan (or a ‘self-funded’ plan…in which the employer assumes the financial risk for providing health care benefits to its employees. In practical terms, self-insured employers pay for each out of pocket claim as they are incurred instead of paying a fixed premium to an insurance carrier, which is known as a fully-insured plan.” Several reasons exist for self-funded employer options, one of which being to “customize the plan to meet the specific health care needs of its workforce, as opposed to purchasing a ‘one-size-fits-all’ insurance policy.”

As aging Gen X adults and boomers are caught between raising their own families and caring for aging parents (the Sandwich Generation) – or in some cases a single grand-parent or first-level relative (aunt/uncle, brother/sister) – the pressure on employees increases with more time needed away from work for caregiving.

Employers have responded with PTO/FTO options which are nice alternatives for some companies, but not all organizations share that trust-culture quite yet – especially if they’re not self-insured with the customization option.

The situation will not improve with time; it’ll get worse as both populations (caregiver and boomer parents) age. So what’s the solution? If you’re fortunate to be in a self-insured company, there may be options. Self-funded employers have more choices to meet their team members’ needs.

Because we’re talking “healthcare”, one can’t point to a single solution. That doesn’t exist in this space; but options do remain for self-insured employers (and others) to support aging in place digital health technologies that may reduce some of the PTO/FTO requests of their team members.

Setting up a shared fund (or FSA) for home modifications and smart home technologies (i.e. activity home sensors, remote monitoring for medication use, device reminders, etc.) is one option. These technology solutions have been around for over 10 years and continue to be upgraded with the advent of Internet of Things (IoT) and Artificial Intelligence (AI) products. The option as an employee benefit, however, may not yet be on the radar of the benefits specialists’ selecting benefit options for their company. Perhaps it’s time they should be…

Reducing PTO/FTO requests for family caregiving can be attained by companies providing a “customized benefit option” to reduce their staff’s time away from work. Some simple monitoring or smart home additions (e.g. medication reminders, Alexa-type interactive devices for seniors living alone) result in improving a caregivers’ peace of mind with potential incidents (let’s call it drama) that may result in an ER hospital visit and subsequently, more disruption to 2 or more families.

The conversations (and employee suggestions) for such technologies can start now – before an incident occurs and all stakeholders are in a “reaction” vs. “preventative” mode. If you work in a self-insured company, perhaps the time to open the discussion with your benefits specialist is sooner than later. Resources like are a good place to start researching your options.

steveneil, MPH, PMP®, CAPS

“Let us not look back in anger, nor forward in fear, but around in awareness.” – James Thurber


Business Owners Choose Different Delivery Model

There are alternatives to control your personal and employee healthcare costs!  Your insurance broker/rep may not be aware (or may be comfortable with the status quo) to present these options to you.  As more physicians opt out of a frustrating, penalizing insurance-based reimbursement system to choose direct medical practices, your options to control costs while increasing quality of care will improve.

You have options!  Consideration should be given as to how much “pain” you’re willing to endure before you change what you’re doing.  When we’re busy running a business it’s easy to procrastinate in making healthcare decisions until the situation becomes a crisis. Alternatives to the status quo can be a distraction.

What is not known is how much the alternative can save.  If you use a broker there are plusses and minuses.  One of the minuses is not getting all the options presented to you based on how that broker is incentivized.  That’s reasonable.  Why would you present something you know little about and are not sure how/if you’ll be paid for?

This is the case for telehealth, direct medical practices, medical travel and alternative healthcare delivery models that most employers don’t get presented but are really viable options that provide better quality of care for less money.   The options have been there for years; they’re not promoted because they’re not mainstream.

“Freedom is nothing but a chance to be better.” – Albert Camus