Men's Mental Health, HSA Analysis, & Compliance Updates: Issue 55

June is Men's Health Month and the facts are, for lack of a better word, depressing

If you don't know whether you may be suffering from an undiagnosed condition, take this free, quick, and confidential screener for depression, bipolar disorder, anxiety, PTSD, and substance use disorders.

6 million men are affected by depression every year, much of it undiagnosed. I personally have suffered from depression and anxiety at a few different points in my life and went undiagnosed for quite some time in every case.

If you're worried someone you know many be experiencing signs of a mental illness, look for: fatigue, irritability and a loss of interest in work or hobbies. Other major mental health issues for men include:

• Anxiety: ~19 million adults 18-54 have an anxiety disorder
• Bipolar disorder: ~2.3 million Americans are affected by bipolar disorder, half of whom are men. The typical age of onset for men is between 16 and 25 years old
• Psychosis and schizophrenia: ~3.5 million adults are diagnosed with schizophrenia and it's one of the leading causes of disability. 90 percent of those diagnosed by age 30 are men.
• Eating disorders: Men account for about 10% of those with anorexia or bulimia and 35% of those with a binge-eating disorder.

Let's zero in on suicide, where we find:

• The elderly are at particular risk: The highest rates of suicide are found among white men over the age of 85. This was surprising to me, despite my involvement with suicide prevention for about a decade.
• Rising rates, a negative trend: Male suicide has been rising since 2000, with the number of deaths increasing nearly 25 percent since 2010. Nearly all other causes of mortality have been decreasing, comparatively.
• Men are at particular risk: More than 4 times as many men as women die by suicide. Deaths by suicide were estimated to be about 49,000 in recent years, of which about 80 percent are men.
• Increased risk for non-cis men: Gay and bisexual men are at an increased risk for suicide attempts, particularly before they reach age 25. Contributing factors include heightened prevalence of mental health disorders and higher rates of substance abuse compared to straight men.
• Risk factors to note: Social isolation, substance abuse, unemployment, military-related trauma, family history, and other mood disorders

These stats can be found on this infographic from Mental Health America . Keep these statistics and health concerns in mind ahead of your next renewal. In our case, one of the key goals we have for our groups is to help them better address the mental health needs of their employees through the benefits plans we design, the culture they develop, and the conversations we have.

Lots of teachers are going through menopause, are their benefits helping?

This article from Education Week highlighted many of the issues that teachers with menopause deal with in the workplace. Menopause is one of those health issues that can be debilitating for people suffering from it but because menopause support doesn't fit neatly into the care box as health plans are currently designed, they're left unaddressed.

Here's the issue:

Health plans are designed to facilitate "sick-care" such as doctor's visits, drugs, procedures, and other interventions, not to provide well-care or quality of life care. But the latter is where we can really flip things around for many employees.

This is where integrating benefits like Elektra Health comes into play. Bring in specific care programs that are particularly relevant to your employees to make your benefits stand out. This is core to making your benefits a Competitive Advantage.

Satisfaction With Various Aspects of Health Care Is Okay but Shows Cracks

HDHP and traditional plan enrollees are both generally satisfied with the quality of care received and choice of doctors but concerns exist elsewhere.

With nearly half of people unsatisfied with the costs they pay for prescriptions and over half unsatisfied with the cost they pay for healthcare services, we know that most health insurance plans aren't designed well for consumers.

Especially for those on high-deductible health plans, there is immense dissatisfaction with the costs they pay for drugs and services. We've talked about issues with HDHPs and HSAs in the past in this space and while I myself have benefited from mine, I know as a health strategist that the design sometimes doesn't work well from a population health perspective.

For example, HDHP/HSA plan enrollees fill fewer prescriptions than PPO enrollees. Is that a result of plan selection by members, or is that an issue to probe about how plan design interferes with medication adherence?

Things to think about...

??Compliance Updates

The Rise of Fiduciary?Health Plan Litigation: Plan fiduciaries should:

1. Carefully review their PBM programs
2. Fully understand the direct and indirect compensation and revenue flows between all brokers, consultants, PBMs, pharmacy manufacturers and distributors, and other service providers
3. Consider establishing a Health and Welfare Committee
4. Maintain a prudent process, including conducting periodic RFPs, and monitoring service providers
5. Continuously provide training and education for plan fiduciaries to mitigate that risk where available.

Read more analysis on the recent Lewandowski decision here.

Back to the Future: HHS?Publishes ACA Section 1557 Nondiscrimination Final Rule?Similar to 2016-Era Regulations: Covered entities have until July 5, 2025 to comply with the Final Rule's policies and procedures and notice of availability requirements. Health insurance coverage or other health-related coverage, including coverage that was not subject to Section 1557 prior to the Final Rule's publication, must make changes to their benefit designs by the first day of the first plan year beginning on or after January 1, 2025. Read more here

Congress Seeks to Extend COVID-19 Telehealth Flexibilities Through 2026 and Expand Reimbursement: The Telehealth Modernization Act of 2024 (HR 7623 ) largely seeks to continue Medicare's hospital-at-home program through 2029, which provides resources for at-home care for patients who need acute-level care. The Bill would also eliminate the geographic originating site restrictions on telehealth visits through 2026. Absent these changes, the programs will expire at the end of 2024. Read more here

CMS Redesigns the Medicare?Part D Prescription Drug Program Beginning in 2025:?Employers are not required to offer creditable prescription drug benefits, and there is no penalty for employers who do not. The impact is only to Medicare eligible employees or their eligible dependents who are not offered creditable coverage and who do not enroll in Medicare Part D when they are initially eligible for benefits. Read more here

Gag Clause Prohibition Compliance Attestation:?Annual Submission Instructions: By submitting a Gag Clause Prohibition Compliance Attestation (GCPCA) to the Departments, a plan or issuer is attesting that, for the period of the attestation, it has not entered into any agreement that violates Code that violates Code Section 9824, ERISA Section 724, and PHS Act Section 2799A-9. Read submission instructions from the relevant departments here

That's it for this week's Competitive Advantages. Let's connect if you have any questions!