health.wealth.life Fall 2018

70 health. wealth. life.

Years

In Pursuit of What Matters Most.

contents 3

A Letter from Terry Horan, President & CEO

EDUC AT ION

4 6 7 8 12 14 15 16

Where Do You Stand on the Retirement Readiness Escalator?

Five Tips for Maintaining a Compliant Wellness Program

Benefits:

What, Like it’s Hard?

SM

OurHealth: Clinics are Popping up Near You Understanding the Link between Breast Cancer and Lifestyle Choices Smart Tech for Smarter Money Breaking Down the Medicare Changes Coming in 2019 and 2020 The Importance of Sharing Family Values

HORAN in the Community

CL IEN T FE AT URE S

10 18

A Benefits-Focused Podcast to Educate & Engage Your Employees

Celebrating 70 Years of Providing Legendary Service

COMMUNIT Y

17

BENEFITS: WHAT, LIKE IT'S HARD? SM

Wellness Works: Cincinnati Ballet Client Spotlight: Columbus Arthritis Center

HORAN's Libby Allison and Morgan Peterson co-host this weekly podcast and share anecdotal stories and lessons learned to educate employees on the value of their benefits and how to be resourceful with them.

This podcast is intended to engage and educate your employees on their benefits.

We invite you to share this resource with employees.

Please join us in welcoming our new corporate clients!

- Angell-Demmel North America Corporation - Cincinnati Financial Corporation - City of Harrison - DuBois Chemicals, Inc. - Elovations Services Group

- Hamilton County - Leadership Council for Nonprofits - NorAm International Partners Inc. - St. Joseph Orphanage

Front cover: A collage of memories to commemorate HORAN's 70 years of providing legendary service.

Back cover: Featuring Jack Horan, founder of HORAN.

health. wealth. life.

Listen Now! Visit www.horanassoc.com/tunein to learn more and subscribe to the podcast on your listening app of choice.

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In Pursuit of What Matters Most.

HORAN is now 70 years and one month old as an organization! People often ask, “what has changed?” Well, nothing has really changed and yet a whole lot has changed.

What hasn’t changed? Face-to-face client service when discussing personal goals and aspirations for physical and financial well-being. This was true in 1948 and it is still true today.

What has changed? HORAN’s use of data to help drive better decision making for clients’ physical and financial well-being.

The topics for this edition of the HORAN magazine speak to both statements. You will find articles that support our foundation to deliver personalized service tailored to your needs. There are also articles that illustrate how we use data to drive better outcomes for you.

We have not changed our culture of listening to you for ideas on how we can create and deliver products and services. Our job is to enhance your ability to achieve productivity and abundance for yourself, your fellow employees and your family. This has been our engine for growth the last seven decades. We aspire to last another seven decades and beyond by listening to you and continuing to advance in this high-tech, high-touch world.

To celebrate our 70th, we created a cabinet of memories that includes pictures and artifacts of HORAN’s wonderful history. We invite you to our Cincinnati office to see this and thank you for permitting us to serve you over the years.

Enjoy the magazine and look forward to seeing you.

Sincerely,

Terence L. Horan, CLU, ChFC President & CEO of HORAN TerryH@horanassoc.com

A letter from Terry Horan

®™

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70th anniversary CELEBRATING 70 YEARS OF PROVIDING LEGENDARY SERVICE The world has changed vastly since 1948. 70 years ago the average cost of a new house was $7,700; the first polaroid camera went on sale at a Boston department store for $89.75; and the World Health Organization (WHO) was established.

Today, the median cost of a new home is $188,900; people are more likely to take selfies on their smartphone rather than a polaroid; and since its establishment, WHO has evolved to more than 150 offices supporting the world in times of crisis.

Since our establishment in 1948, HORAN has evolved from a one-person operation to a team of 140 associates serving clients around the country providing solutions in the areas of health, wealth and life. This year we are thankful to our clients, partners and employees for helping us reach our 70year anniversary.

HORAN takes great pride in having developed a vibrant workplace culture, attracting and retaining a talented group of

employees and helping our clients achieve their goals.

Our culture is rooted in 27 fundamental values. At HORAN, we work to bring these values to life for our clients in the products we sell and the advice and counsel we offer.

Our growth as an organization is based on listening to the needs of clients and tailoring our products and counsel to meet their expressed needs.

We are grateful to our clients for trusting us to help them prosper. It is our clients’ desires, challenges and feedback that helped us build additional services to answer their needs. Not only have our clients made us a part of their lives but also motivated us to expand throughout the region.

“We believe a large part of our success in creating great client outcomes is our culture. We strive to make our company a great place to work. We achieve this through dedication, a strong work ethic and enthusiasm for our work,” said Terry Horan, President & CEO of HORAN.

We recently received a note from a client expressing her gratitude for HORAN’s services over the years. “Congratulations on 70 years—what an accomplishment! Having been a client for quite a few of those years, I want to thank you for all you do to make me feel safe and comfortable with my financial situation. I’m sorry that I won’t be able to join the celebration on September 27. I am leaving that morning for several weeks in Italy.” That is the kind of result we want for each of our clients.

At HORAN, everyone plays a role in the growth of the company. It is their enthusiasm, support and dedication that allows us to offer exemplary service and counseling to our clients.

Our future for the next 70 years will be built on our culture, our fundamental values and our core desire to assist clients as they grow their companies and reach their individual dreams.

QUOTES FROM CLIENTS "Congratulations on 70 years. Glad to have you as my financial advisor for 30 of them."

health. wealth. life.

"I wish you decades more of continued success. Thanks for being such a great partner to CVG (Cincinnati/Northern Kentucky International Airport)."

"Jack (Horan) would be so proud of all you have accomplished going from a two-man operation to what you have grown to." |4 |

®

“We believe a large part of our success in creating great client outcomes is our culture. We strive to make our company a great place to work. We achieve this through dedication, a strong work ethic and enthusiasm for our work.”

– Terry Horan

HORAN employees celebrate our 70th anniversary with clients and partners at our 70th Anniversary Open House Reception.

Our Clients Celebrate HORAN's 70 Years "HORAN always puts customers first—they lead with passion."

"HORAN is committed to providing value.

Thank you for caring for your clients."

"I have worked with HORAN for over 30 years. They all have been so helpful, patient and caring.

They help me do my job better and many have become friends." |5 |

education WHERE DO YOU STAND ON THE

Retirement Readiness Escalator?

On the face of it, escalators do not typically invite comparisons to your retirement plan.

However, for employers and participants alike, the similarities are worth considering and can have a real impact not only on one’s personal savings but also on an employer’s annual health care costs.

The stress associated with working beyond retirement age does not simply affect the individual...

On the Retirement Readiness Escalator, the first step is the point at which someone enters the workforce. In the ideal scenario, a person begins saving for their future on that first step and continues to save as they progress upward through their professional career. Over time and with careful planning, those funds accrue until they reach the optimal age of retirement. Because that person has planned accordingly, they have sufficient savings to replace the necessary portion of their income outside the workplace. The employee is now prepared to step off the escalator and into their life in retirement.

different conclusion for far too many people. When a person is poorly saved, they reach the top of the Retirement Readiness Escalator and find that they do not have the savings to replace their income. As a result, the only option is to remain in the workforce. As more and more poorly saved individuals at or near retirement age crowd the top, the model breaks down—our escalator has become a logjam.

A poorly saved workplace is populated with individuals who live paycheck to paycheck, unable to stop working or plan appropriately for their future. The stress associated with working beyond retirement age does not simply affect the individual; it also begins to have a negative impact on the cost of health care in the workplace.

When individuals do not employ a successful retirement planning strategy, the associated higher cost of care may be shared

among the employee population in the form of higher premiums.

At HORAN, we believe that a comprehensive retirement plan is a critical part of every employer’s overall health care strategy. Our team of dedicated specialists works to craft a solution that fits an employer’s culture and values. By implementing effective plan design techniques and dynamic employee engagement, HORAN works to ensure that the workplace becomes an effective venue in which to improve the overall financial wellness of all employees.

??!

65+

51-64

Life does not always progress according to the ideal and our example has a very

41-50

31-40 21-30

health. wealth. life.

Ryan Horan

Vice President - Department Director HORAN Retirement Advisors

|6 |

ÂŽ

Five Tips for Maintaining a Compliant Wellness Program HORAN recently offered an education seminar discussing the various types of wellness programs and the compliance considerations you, as an employer, need to be aware of to ensure your program is compliant with current legislation. Below are some of the key takeaways from the session.

1 2 3 4 5

KNOW WHAT TYPE OF WELLNESS PROGRAM YOU OFFER

Wellness program design directly impacts which regulations apply to your program. It is important to know the type of wellness program you offer. Programs can be participatory or education based, health-contingent activities based or health-contingent outcomes based.

UNDERSTAND WHAT LEGISLATION APPLIES

Depending on the type of wellness program you offer, it is important to know and understand the regulations that may apply including: the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).

PROVIDE APPROPRIATE NOTICES AND DISCLOSURES

Based on the type of wellness program offered and whether the program is also considered a group health plan, employers may be responsible for providing employees with appropriate notices and disclosures. The notices you may be required to provide are: an Equal Employment Opportunity Commission (EEOC) Notice, Notice of Availability of Reasonable Alternate Standard, Summary Plan Description (SPD) and COBRA notices. These notice requirements are often overlooked or misunderstood when it comes to wellness programs.

CALCULATE INCENTIVES PROPERLY

The type of wellness program you offer also determines the incentive limit (if any) an employer can provide to employees for participating in the program. Limits apply to certain programs under HIPAA, the ACA, the ADA and GINA and the limits are calculated differently depending on applicable regulation. Employers should include all rewards, cash and in-kind, in any calculations. It is also important to consider that current EEOC guidance under the ADA and GINA is vacated as of January 1, 2019, and employers must assess the variable level of risk associated with incentives tied to the collection of health information on an ongoing basis.

CONSIDER TAX IMPACT OF OFFERING INCENTIVES

Any incentive provided to an employee through a wellness program is taxable requiring the employer to include the incentive in income except for goods or services that are considered de minimus. De minimus amounts are rewards for goods or services that are so small as to make accounting for them by the employer unreasonable. It is important to note that cash rewards are never considered de minimus.

WANT TO LEARN MORE? Subscribe to HORAN's Health Benefits Compliance Blog to stay up-to-date and on-track with health benefits compliance.

Visit www.horanassoc.com/subscribe to subscribe.

Shelly Hodges-Konys, CBC Director of Compliance

Rakel Sanchez

Health Management Director

|7 |

education

Clinics are Popping Up Near You Health care is expensive. It is also confusing and complicated. If you have had any recent medical experience requiring layers of care between doctors' offices, hospitals, urgent care centers and/ or pharmacies, you probably know it is overwhelming for even the savviest of health care consumers.

HORAN was asked to perform a study of cost and outcomes for an employer utilizing a near-site employee health clinic compared to similar employers whose employees used the traditional health care market for care. The results were staggering. In short, the employer: • Saved 30% on total health care spend over a three year period • Saw an increase in utilization of primary care services • Created a benefit that employees loved—free primary care and prescription drugs for employees and their families The good news was we uncovered a better way to deliver quality, affordable and coordinated care to employees. The bad news was this near-site clinic model was out of reach for small to mid-sized companies whose employees aren’t in one single location. As a result of the findings, HORAN went on a mission to solve this for employers and we are excited to share the results.

OurHealth's MyClinic model is a regional network of independent, primary care medical clinics designed to offer employees and their families’ access to quality health care at little or no cost, while still protecting employers from the rising costs of health care. These beautiful, modern medical clinics will be built in the communities where employees live and work; making them easily accessible to spouses and children…not to mention close to your nearest Starbucks or Chipotle!

health. wealth. life.

| 86 |

®

By The Numbers $140 million

health care dollars saved since 2009

5 minutes

or less average wait time

Employees and their families will have a simplified health care experience in a comfortable environment where they can access holistic primary care services, including preventive and acute care, routine physicals, chronic condition management, health coaching, blood work, diagnostics tests and 150+ free prescription medications. Designed to be much more comprehensive than a nearby “Little Clinic”, the OurHealth MyClinic network offers more robust services, gives employees more options for accessing care beyond a single onsite workplace location and manages costs for employers, all while simplifying the health care experience for employers and patients alike.

96%

average patient satisfaction score

10,000+

independent referrals each year

Last but not least, OurHealth coordinates claims data with your respective claim administrator, and integrates the claims data with prescription and clinical data to provide a comprehensive view of your population’s health, helping employers make more-informed decisions that lead to healthier outcomes and reduced costs for everyone involved.

OurHealth is scheduled to open its first three Cincinnati clinics in early 2019. To learn more about OurHealth and the MyClinic model please call us at 800.544.8306.

Dominic Franchini, CBC Vice President & Partner

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wellness works Cincinnati Ballet Offers Opportunities to Live a Life of

Abun

DANCE

SETTING THE STAGE

A 2017 New York Times article written by Gretchen Reynolds entitled "Walk, Stretch or Dance? Dancing May Be Best for the Brain" reported on a study conducted by researchers at the University of Illinois which examined the effects of many different types of exercise on the function of older people’s brains. The results of the study found that the participants who engaged in dance actually showed improvement in brain health compared to six months before (the dancers had denser white matter in their fornix, a part of the brain involved with processing speed and memory). We sat down with the Cincinnati Ballet to discuss their thoughts on the study and how they are inspiring people throughout the region to get moving.

C

incinnati Ballet, currently in its 55th season, has been the cornerstone professional ballet company of the region since 1963.

communities, Cincinnati Ballet reaches beyond the stage in programs that allow every person in the region to be part of the continued evolution of dance.

Under the artistic direction of Victoria Morgan, Cincinnati Ballet has become a creative force within the larger dance community, commissioning world premiere works and exploring unique collaboration.

Their offerings include a youth outreach program called CincyDance! and ballet training classes for every level.

With a mission to enrich, expand and excel in the art of dance through performance, a high-caliber academy and impactful education and outreach in local to global

health. wealth. life.

CincyDance! is one of the Ballet's most popular programs. Over 2,000 local third grade students from 38 different Greater Cincinnati and Northern Kentucky schools get the opportunity to learn a dance set to a mix of classical and contemporary music.

After the six-week program, two to three students from each elementary school are invited by the Ballet to attend its Ballet Foundations course. Each year the top five Ballet Foundations students are offered the opportunity to receive a scholarship to join the Cincinnati Ballet Academy.

"Last year one of our male students graduated from the Ballet Academy who had been with us since third grade when he participated in CincyDance! as a student from St. Joseph Catholic School," said Julie Sunderland, Vice President of Community & Inclusion at Cincinnati Ballet. "He is now on

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®

"Movement at its very basics is a manifestation of the act of existing. It’s so connected to so many aspects of physically, mentally and emotionally leading a healthy life."

- Victoria Morgan, Artistic Director & CEO, Cincinnati Ballet

scholarship attending College-Conservatory of Music (CCM) at the University of Cincinnati."

Cincinnati Ballet offers public classes and hosts outreach programs in an effort to give back to the community and to inspire individuals to lead a healthier life.

"Movement at its very basics is a manifestation of the act of existing," said Victoria Morgan, Artistic Director and CEO of the Cincinnati Ballet. "It’s so connected to so many aspects of physically, mentally and emotionally leading a healthy life."

Sunderland believes ballet provides the critical components for practicing holistic wellness.

"The best thing about dance is that it tends to be an energy raiser. Anyone can lose

weight and exercise but if you don’t enjoy it, it becomes this drudgery," said Sunderland.

"If you can use dance as something that will bring your energy up, then you are more likely to continue with it."

Morgan believes that practicing holistic wellness and being physically active by engaging in exercise such as dance becomes even more important as you age.

"The act of moving is such an important part of aging gracefully," said Morgan. "As you get older you want to have the physical capability to do the things you were able to do when you were younger. You also want to have the physical and mental stamina to lead your day-to-day life."

CINCINNATI BALLET 2018/19 SEASON PETER PAN October 25-28 THE NUTCRACKER December 13-24 THE SLEEPING BEAUT Y February 14-17 DIRECTOR'S CUT March 21-24 AL ADDIN March 30-April 7 BOLD MOVES April 25-28

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education

Understanding the Link between Breast Cancer and Lifestyle Choices How Much Does Breast Cancer Really Cost? $23,228

AVERAGE COSTS FOR BREAST CANCER CLAIMANTS WITH A MAMMOGRAM

$28,142

AVERAGE COSTS FOR BREAST CANCER CLAIMANTS WITHOUT A MAMMOGRAM

At HORAN, our mission is to help employers provide a better quality of life for employees and their families. This mission drives our investment in the HORAN Financial Analyst think tank. The think tank is fueled by the team’s ability to analyze claims data to guide clients and drive action, we call this HORANalytics®. Recently, our Financial Analysts concluded that breast cancer claimants who did not get a mammogram cost the health plan $4,914 (or 21.2%) more than those who did get a mammogram.

HORAN is a strong advocate of mammogram screenings in an effort to better employees’ quality of life and improve health plans.

To underscore these findings, HORAN interviewed Lisa Larkin, MD, FACP, NCMP, IF, (pictured right) a board-certified internist practicing internal medicine since 1991.

She is the owner and President of Lisa Larkin, MD, and Associates, an independent, multispecialty practice offering direct and concierge primary care. Larkin is a breast cancer survivor and frequently lectures on women’s health topics, writes articles for community publications and appears on local news outlets to discuss women’s health issues. Through her research, Larkin has shed light on specific factors that impact a woman’s risk for breast cancer including lifestyle choices.

Q: HOW DID YOU BECOME INTERESTED IN BREAST CANCER RESEARCH? LISA LARKIN (LL): As a physician who has practiced internal medicine for 27 years and a breast cancer survivor, I am an advocate for research and innovation in women’s health. From young adulthood, women worry about their risk of developing breast cancer; we understand that just by being female, we are at risk. Most of us know the statistic, “1 in 8,” or 12% of women will develop breast cancer over the course of their lifetime.

What some don’t know is that many women are actually at much higher risk of developing breast cancer than the 12% risk of the general population, they just don’t know it.

The question I ask myself is, “how can we do better about educating women about their individual risk?”

LL

Q: WHAT ARE THE COMMON MISCONCEPTIONS AROUND BREAST CANCER THAT YOU EXPERIENCE? People are focused on the fact that we need to get our annual mammograms. They are very important and a necessary part of preventive screening, but they can’t be the only thing we rely on because they aren’t perfect. If you look at 1,000 women, they all have a different

LL

health. wealth. life.

risk when it comes to breast cancer, but we are screening them the same way. I want to change the conversation and give women a more personalized approach to breast cancer risk analysis with an emphasis on precision medicine (tailoring treatment to the individual characteristics of each patient).

Q: CAN YOU TALK ABOUT THE RESEARCH YOU HAVE CONDUCTED REGARDING HOW LIFESTYLE CHOICES IMPACT BREAST CANCER RISK? Most women understand if they have hypertension (high blood pressure) and high cholesterol that their risk of cardiovascular disease is elevated.

Breast cancer works the same way. If you have certain risk factors, you have an increased risk of getting it. It’s not hard and fast that you are going to get breast cancer, but it is a marker for increased risk. I developed a breast cancer risk assessment and prevention program for women using readily available validated risk assessment models that incorporate reproductive data, biometrics, menopause status, breast density, family history and lifestyle choices. As a part of the program, I take an individual’s information and put it into the algorithms using the results to guide recommendations for each woman.

LL

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®

30% of Breast Cancer May Be Lifestyle Related

Eating a plant-based diet

Breast Cancer Prevention Lifestyle Considerations

limiting alcohol consumption to no more than 3 drinks a week

exercising three times a week

Cris Collinsworth ProScan Fund Offers a Full Spectrum of Early Detection Services

maintaining a healthY bMI

Q: WHAT LIFESTYLE FACTORS ARE LINKED TO AN INCREASED RISK OF BREAST CANCER?

LL

We believe 30% of breast cancers are lifestyle related. Not all breast cancer can be prevented but we can definitely make a difference. Prevention considerations include: maintaining a healthy body mass index (BMI), not drinking too much alcohol (no more than three drinks a week), eating a plant-based diet and exercising three times a week.

Q: HOW ARE YOU SHARING THE BREAST CANCER RISK ASSESSMENT WITH THE PUBLIC?

LL

I hold events for employers looking to inform and educate their employees on breast cancer awareness and prevention. Prior to the event, I send the attendees an electronic version of the breast cancer risk assessment and provide them with a results packet the day of the event which includes their risk score, how the score was calculated and recommendations based on their data. I also make specific recommendations based on their risk such as if they should see a genetic counselor to consider genetic testing or if they meet criteria for an expanded screening with a Breast MRI. The report is educational only and intended to be shared with their doctor to make informed decisions on how to move forward.

Q: WHAT WAS THE MOST SURPRISING FINDING IN YOUR RESEARCH? The most surprising part of all of this is the magnitude of women who underestimate their risk and the unawareness of the importance of lifestyle in prevention. I ask the women who attend my events if they think their risk of breast cancer is higher, lower or the same as the national population’s risk (12% risk of breast cancer) and 57% of the women think their risk is lower when in fact their report data came back showing that their risk was higher.

LL

THIS WAS BROUGHT TO YOU BY SM

The Cris Collinsworth ProScan Fund (CCPF) is a non-profit organization founded in 2002 with the mission to improve women’s health through their Pink Ribbon Programs.

The Pink Ribbon Programs began with a passion to raise the bar for women’s health, particularly in mammography. Now operating three freestanding women’s imaging centers and offering six Pink Ribbon Programs, CCPF has served tens of thousands of women throughout the region and provided support for breast cancer patients around the country through their Pink Ribbon Bag Program.

The ProScan Pink Ribbon Centers offer some of the newest technology available for breast cancer screening, including tomosynthesis, which is a 3D mammogram that provides more clarity for increasing cancer detection rates, especially in a dense breasted woman.

Additionally, CCPF offers the Breast MRI Program to allow women with dense breasts to get additional necessary screening. Utilizing a Breast MRI in a screening capacity is a huge benefit to women with dense breasts and those with a family history of breast cancer.

Do you know how preventive screenings are impacting your health plan?

Call 800.544.8306 to schedule a deep dive into your data with HORANalytics®. | 13 |

education SMART TECH FOR SMARTER MONEY How Financial Aggregators Paint a Clearer Financial Picture More data and information has been created over the past two years than in all of human history combined. With the explosion of technological advances over the past few decades, businesses and consumers alike have more computing power in their pocket than the Apollo 13 had to land man on the moon.

WHICH FINANCIAL AGGREGATOr is the right fit for your financial goals?

With all of this information literally in the hands of people, why do we continue to make poor financial decisions? How can we utilize this information to be smart with our money?

Ask yourself these simple questions: What is my net worth?

How much did I make last month?

Where did I spend that money?

These questions can be answered with a basic budget and net worth statement yet very few people seem to have one. Those that do usually have a clunky excel spreadsheet with broken formulas that need manual updating.

Well let me tell you, the days of spreadsheets and balancing checkbooks are dead! Allow me to introduce you to Financial Aggregators: a new technology that is here to stay.

Financial Aggregators are programs that combine all of your financial accounts into one location for a seamless view of account balances and spending habits. Account values update daily so you never have to guess your net worth.

Good FoR: Spending Analysis

In addition, you can create a custom budget and the aggregator will automatically classify your transactions. That $10 Chipotle burrito shows as a restaurant expense and that Cincinnati Bell bill as a utility.

The ability to view every transaction provides clearer insight into where your money is going and a greater ability to spot unauthorized transactions.

Some aggregators even allow the user access to a monthly credit report, view upcoming bills and track investments.

Now I know what you are thinking, “No way am I putting all my financial information in one location just to have it all stolen by hackers!” Although it should come as no surprise, these programs typically have data encryption standards that are twice that of your financial institution. is

The ability to view every transaction provides clearer insight into where your money going and a greater ability to spot unauthorized transactions.

health. wealth. life.

Good FoR: MONEY MAnagement

In addition, they are not transactional, meaning if someone was able to gain

Good FoR: budgeting, investments and financial forecasting

access, they cannot transfer money to or from the accounts.

The majority of these programs are “free” to use. They profit by selling alternative services. With their growth in popularity, many financial institutions are starting to offer their own versions of these programs.

I would encourage you to check with your trusted financial institution before using any of these “free” alternatives. At HORAN, we provide clients access to our own aggregation platform.

I hope this has sparked your interest to learn more about Financial Aggregators. They are a great tool for bringing clarity to your financial picture and planning for the future.

Michael Hermes, CFA, CFP® Vice President, Wealth Advisor

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®

BREAKING DOWN THE MEDICARE CHANGES COMING IN 2019 & 2020 "Where's the BEEF...or rather F?" (Sorry, I’m a sucker for outdated references). In a little over a year from now, many seniors may be asking this question in reference to Medicare Supplement Plan F. In Medicare there are two main types of insurance plans: Medicare Advantage and Medicare Supplement. For those who choose the Medicare Supplement path there is a major change happening that you need to be aware of, specifically with Medicare Supplement Plans F and C. Legislation was passed in 2015, called the Medicare Access and CHIP Reauthorization Act (MACRA), which made changes to Medicare Supplement policies (also called Medigap) stating that in the year 2020, supplement plans can no longer cover the Part B deductible. Currently, the Part B deductible is an annual amount of $183.

Here is what you need to know: • Anyone who turns 65 on or after January 1, 2020, will not be able to purchase Plans F and C. At that point, the most comprehensive Medicare Supplement plan will be Plan G. • Anyone who turns 65 before January 1, 2020, can enroll in Plans F and C even after 2020 and can keep their plans as long as they choose.

• Those already enrolled in Plans F and C are considered "Grandfathered" and not required to take any action and they will not lose their plan.

Currently in 2018, you pay 44% of the cost of your generic drugs and 35% of brand drugs (after a manufacturer discount of 50%).

In 2019, the percentages that you will need to pay are decreasing to 37% of the cost of your generic drugs and 25% of brand name drugs.

Another major change is that you will get out of the "Donut Hole" earlier compared to previous years. For 2019, in order to get out of the "Donut Hole" your total out of pocket costs must reach a total of $5,100. Included in this total is how much you have spent plus the manufacturer discount you get on brand name drugs. That manufacturer discount is increasing in 2019 from 50% to 70%. For example, if you have a $300 brand name drug, you will pay 25%, which is $75. That $75 amount plus the 70% manufacturer discount, which is $210, will be applied towards the $5,100.

$300 Brand Name Drug Brand Name (you pay) Percentage of $300 total applied to your out of pocket Total amount applied toward your out of pocket

2018 35% ($105) 50% ($150)

2019 25% ($75) 70% ($210)

$255

$285

If you need assistance understanding the changes to Medicare and how they may impact your health care selections, please do not hesistate to contact me at 513.745.6808 or email me NateE@horanassoc.com.

There is some good news happening in the Medicare world, specifically with the infamous "Donut Hole".

The prescription part of Medicare (Part D) is divided into four stages. How much you pay for your prescriptions changes from stage to stage as your drug costs add up over the calendar year.

Nate Epp

Account Executive, Individual Health & Medicare

Stage Three is called the Coverage Gap also known as the "Donut Hole". In this stage you are paying a percentage of your medications, which is typically the stage where seniors struggle with affordability.

| 15 |

education The Importance of Sharing

Family Values Traditional estate planning focuses on efficiency—passing assets to the next generation while minimizing taxes or the hassle from probate. There may be a nod toward charity or protecting assets for future generations, but there is usually minimal focus on the values accumulated by families over decades. While this efficiency is a necessary part of leaving an inheritance, it lacks the depth needed to prepare heirs to be good stewards of a legacy.

Why does this all matter? A statistic tells a painful story: 90% of wealth earned by generation one dissipates by generation three.

Inter-generational wealth has the propensity to decay over time due to poor family communication, weak preparation and a lack of shared vision.

Successful preservation of family wealth requires you to pass along your family’s bedrock values well in advance of your assets. This emphasizes the importance and responsibility we have as parents to teach our kids life lessons. The educational process should begin early as youngsters embark on their financial life cycle.

The financial life cycle begins with simple concepts about money and savings. It’s why we’ve all had a piggy bank at some point in our lives. The cycle progresses through allowances, banking and budgeting. It develops into harder concepts that require time and energy such as building credit, investing, philanthropy and wealth protection.

Progression through the entire cycle requires designed programs and strong communication. It’s very reasonable, and frankly appropriate, to create expectations for your kids. How much should they save, spend and give? Encourage questions and candid conversation about money and finance, so that children are well-equipped to handle bigger questions and more complex circumstances as they age.

Being a steward of wealth requires the ability to make smart financial decisions. Our accumulation, management and use of money are guided by and manifest those principals we hold dear. Family values tend to expose themselves through the ways by which families invest, give to charity and plan for another generation.

It’s wise to seize teachable moments and lead with your own actions.

Model the money behaviors you wish to instill in your children and involve them in meaningful decisions. Hands-on lessons take conversations a step further because they allow you to express guiding values in real time.

Think: “We’re buying your birthday cake from the Brown’s bakery because we want to support the local economy and they use all organic, locallysourced ingredients.”

Once younger generations begin to show maturity, share your personal values with them and why they are so important to you. We often encourage families to have a meeting to discuss values and wealth. These may be formal or informal, but nonetheless, they require preparation.

Having the forum to share worries, life goals and personal stories will most certainly assist in setting a clear path of wealth perpetuation in the future.

Anna K. Pfaehler, CFP®, AEP®

Director of Financial Planning

health. wealth. life.

Nick Reilly President & Principal HORAN Capital Advisors

Effective estate planning, which successfully transmits values as well as wealth, takes ongoing time and effort well after the documents are signed.

It's not efficient—it's effective.

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community

®

HORAN in the Community

Brandon Christin, Terry Horan, Michael Johnson, Dominic Franchini (left to right)

Diana Small

West Chester/Liberty Alliance Leadership 21, Class of 2019

This year’s United Way Campaign was HORAN’s most successful to date.

Employees exceeded the firm’s goal and raised $148,533 (109% of goal).

To kick off this year’s campaign, HORAN welcomed representatives from Brighton Center, Children’s, Inc. and Lighthouse Youth and Family Services to learn more about how United Way benefits their organizations. During the campaign employees were invited to participate in a variety of fun, hands-on activities to benefit the community including assembling healthy snack packs for St. Joseph’s Orphanage and a playground clean up at Children, Inc.’s Montessori Early Learning Academy. Our successful campaign was concluded with a grand finale where we were joined by Michael Johnson, President & CEO, United Way of Greater Cincinnati; Rob Faingold, Relationship Manager, United Way of Greater Cincinnati; Tom Maultsby, President, United Way of Greater Dayton; and Antoinette Hampton, Relationship Manager, United Way Greater Dayton.

Mike Lakin

Cincinnati Business Courier, 2018 Forty Under 40

HORAN was named one of the Healthiest 100 Workplaces in America in 2018. The Cincinnati Business Courier and the Dayton Business Journal recognized HORAN as a winner of the 2018 Healthiest Employer awards in Cincinnati and Dayton.

Shannon Schumacher

Leadership Northern Kentucky, Class of 2019

HORAN Capital Advisors was ranked #477 in Financial Advisor Magazine’s 2018 Annual RIA Ranking and they were named a “Best Managed Firm” by Charles Schwab for two consecutive years (2017, 2018).

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client feature

HWL • CLIENT FEATURE

Client Spotlight: Columbus Arthritis Center

Committed to Providing the Highest Quality

Patient Care

Creating trusted partnerships in the communities in which we live and work is something for which HORAN continually strives. We are always grateful for our partners who trust us to help them grow and prosper.

When HORAN opened its Columbus office in 2015, with Cheryl Mueller as our Central Ohio Market Leader, our main priority was to develop relationships with premiere organizations who would be dedicated, long-term partners.

really became our trusted partner,” said Sarah Williams, Human Resources Manager at CAC. CAC’s success and growth can be attributed to their compassionate staff and to their team approach for treating patients. CAC currently has nine physicians on staff and is

“When we decided to go forward with HORAN, I felt like they really became our trusted partner."

Sarah Williams, Human Resources Manager at CAC

Shortly after establishing a presence in Columbus, Cheryl met with the Columbus Arthritis Center (CAC) team. CAC has been serving Central Ohio since 1955, specializing in the diagnosis and treatment of rheumatoid arthritis and related diseases.

The practice prides itself on providing comprehensive, patientcentered care with a compassionate and highly-trained medical support staff. CAC is currently one of the largest rheumatology centers in the nation.

looking forward to welcoming two new physicians in 2019. The physicians and physician assistants all have a positive impact on the practice because of the personal connections they build with patients.

Upon meeting with CAC, the HORAN team presented plans for the next five years and shared relevant trends in the market to benchmark CAC’s employee benefit offerings. HORAN listened to CAC’s goals and discussed their plans for future growth.

“It starts at the top with the physicians. They take wonderful care of our patients, and the rest of the staff follows through with that as well,” said Nan Irwin, Practice Administrator at CAC.

“When we decided to go forward with HORAN, I felt like they

In order to maintain their culture of providing quality patient

health. wealth. life.

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®

Pictured: Sarah Williams, Human Resources Manager (left), and Nan Irwin, Practice Administrator (right) at Columbus Arthritis Center.

care, Williams takes on the role of ensuring potential new hire candidates are able to demonstrate an ability to provide compassionate care.

The CAC team has seen 11,748 patients in the last six months.

“Our patients come from out of town and from out of state,” said Williams. “Making sure all of these patients receive compassion when they visit us is very important.”

CAC has created a comprehensive treatment center that eliminates the barriers for patients to receive care. By offering a variety of complex services including x-rays, bone density testing, MRIs and an infusion suite, they are able to serve their patients as a one-stop-shop for treatment.

by establishing a wellness program with the help of one of HORAN’s Health Management Directors, Rakel Sanchez.

“As an HR department of one, it would be difficult for me to manage, implement and track. Rakel helped me come off of the ledge a little bit. She told me it is going to be planned, thoughtful, scheduled and strategic,” said Williams. “This helped me feel confident and comfortable in taking our first steps into wellness.”

HORAN is proud to call CAC a valued client.

“We love working with the HORAN team. I think there is a lot of synergy between our primary team at HORAN and our management team,” said Williams.

In 2019, CAC will enhance their employee benefit offerings

Cheryl Mueller, CEBS, CBC HORAN Relationship Manager for CAC

Jennifer McCormick

HORAN Account Manager for CAC

Rakel Sanchez

HORAN Health Management Director for CAC

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PRESORTED STANDARD US POSTAGE PAID CINCINNATI OH PERMIT # 8093

4990 East Galbraith Road Cincinnati, Ohio 45236

Celebrating

Years TM

CORPORATE HEADQUARTERS

DAYTON

COLUMBUS

KENTUCKY

4990 East Galbraith Road Cincinnati, Ohio 45236 513.745.0707 800.544.8306

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www.horanassoc.com