FEATURED ARTICLES SELF-FUNDED VS. FULLY INSURED PLANS OPTIMIZING YOUR OFFICE SPACE UNLOCKING WINDOWS EFFICIENCY
FEATURED
SELF-FUNDED VS. FULLY INSURED HEALTH PLANS
When it comes to providing health insurance for employees, employers typically choose between two main types of health plans: self-funded (or self-insured) and fully insured. Each option has its own set of advantages and challenges, and the right choice depends on various factors, including the size of the employer, risk tolerance, and administrative capabilities. In addition, choosing the right health plan not only affects the organization’s bottom line but also plays a crucial role in employee satisfaction and retention. Let’s explore the key differences between these two types of health plans, along with some public sector case studies.
WHAT IS A FULLY INSURED HEALTH PLAN?
In a fully insured health plan, the employer pays a fixed premium to an insurance carrier, which then assumes the responsibility for managing and paying all healthcare claims. This model offers predictable costs and minimal management duties, making it attractive to smaller organizations that favor stability and a hands-off approach.
PROS:
• Predictable Costs: Employers know exactly what they will owe each month, regardless of their employees’ actual healthcare costs. This makes budgeting easier and reduces financial uncertainty. This stability can also enhance job satisfaction as employees feel secure about their healthcare coverage.
• Ease of Administration: The insurance company handles all claims processing and benefits administration, significantly reducing the employer’s administrative burden. This can contribute to a more efficient and stress-free experience for employees.
• Risk Management: The insurer assumes the financial risk of high claims, protecting the employer from unexpected healthcare costs and providing peace of mind to employees that their healthcare needs will be met without impacting the organization’s finances.
• Regulatory Compliance: Fully insured plans are subject to state insurance regulations, which can provide an additional layer of protection for both employers and employees.
CONS:
• Less Flexibility: Employers have limited ability to customize the plan to meet the specific needs of their workforce, as the insurance carrier sets the terms and coverage options. This can lead to dissatisfaction if the plan does not meet the specific needs of employees.
• Potentially Higher Costs: Employers may pay more in premiums to cover the insurer’s profit margins and administrative costs, which can affect employee satisfaction if they feel the costs are not justified compared to the benefits received.
Case Study: Kentucky Municipality - A small city in Kentucky faced high healthcare costs with its fully insured health plan, paying nearly $600,000 annually for its 100 employees. Despite the high costs, the city struggled to make significant cost-saving changes due to the limitations of the fully insured plan. Eventually, the city transitioned to a partially selffunded plan, which allowed for more flexibility and cost management. This change resulted in substantial savings, reducing annual health benefits costs from $579,772 to $387,677. This case study highlights the challenges and potential savings associated with fully insured plans in the public sector.
WHAT IS A SELF-FUNDED HEALTH PLAN?
In contrast, self-funded health plans involve the employer setting aside funds to directly pay for employee medical claims. This model can offer significant cost savings by avoiding insurer profit margins and allows for greater customization of benefits to meet specific needs and goals.
PROS:
• Cost Savings: Employers only pay for the actual healthcare costs incurred by their employees, potentially saving money if claims are lower than expected. Any unused funds at the end of the year can be retained by the employer and reinvested into the organization or used to enhance employee benefits, further boosting satisfaction.
• Cash Flow Benefits: Employers retain control over the funds until claims are paid, which can improve cash flow management.
• Flexibility: Self-funded plans can be tailored to the unique needs of the workforce, offering employers more control over benefits design. This customization can lead to higher employee satisfaction as the plan can address unique health concerns and preferences.
• Improved Care: With more control over the plan, employers can implement wellness programs and preventive care initiatives that improve overall employee health and well-being.
CONS:
• Financial Risk: Employers assume the financial risk of high claims, which can lead to significant cost variability. Stop-loss insurance can mitigate this risk but adds to the overall cost. This uncertainty can affect job satisfaction and retention for employees.
• Administrative Complexity: Managing a self-funded plan requires more resources and expertise, as the employer is responsible for claims processing and compliance.
• Regulatory Environment: Self-funded plans are subject to federal regulations under the Employee Retirement Income Security Act (ERISA), which can be complex to navigate.
Case Study: Denver School of Science and Technology (DSST) - The Denver School of Science and Technology (DSST) transitioned to a self-funded health insurance plan to combat rising health insurance premiums. By partnering with HUB International, DSST implemented a self-insurance program that resulted in substantial savings, improved care, and increased compensation for teachers. This case study demonstrates how a self-funded plan can benefit public sector organizations by providing cost savings and enhanced benefits.
KEY CONSIDERATIONS FOR CHOOSING BETWEEN SELF-FUNDED AND FULLY INSURED PLANS
DECIDING BETWEEN A SELF-FUNDED OR FULLY INSURED HEALTH PLAN DEPENDS ON SEVERAL FACTORS:
• Employer Size: Larger organizations with a stable cash flow are better positioned to absorb the financial risks associated with self-funded plans.
• Financial Stability: Employers with strong financial health can better manage the cost variability of selffunded plans.
• Risk Tolerance: Organizations must assess their willingness to take on the financial risk of high claims.
• Administrative Capabilities: Employers with the resources to handle the administrative demands of a selffunded plan may find this option more appealing.
• Employee Needs: Consider the specific healthcare needs of your workforce. Self-funded plans offer more flexibility to customize benefits, which can be a significant advantage.
In conclusion, both self-funded and fully insured health plans have their merits. Fully insured plans offer predictability and ease of management, making them suitable for smaller employers or those seeking stability. On the other hand, self-funded plans provide cost savings and customization opportunities, ideal for larger employers with the capacity to manage the associated risks and complexities.
LEARN MORE: For more information, please watch the recent Health Consulting Training series hosted by Business Development here.
Deja Holley
WELLNESS CORNER
Optimizing Your Office Space: ERGONOMICS 101
WHY IS ERGONOMICS SO IMPORTANT?
Whether at home or in the office, it’s important to cultivate a space that works for you. Ergonomics, or the study of people in their working environment, seeks to find ways to eliminate discomfort and minimize the risk of injury while working. Since the average person will spend over a third of their life at work, it’s crucial to make sure that your workspace is safe and optimized for comfort and efficiency. Ergonomically optimizing your workspace can help reduce the risks of many health problems, from pain in the neck, back, and wrist to eyestrain, headaches, and carpal tunnel. With that in mind, here are a few ways that you can improve your working environment.
OPTIMIZING YOUR MONITOR OR LAPTOP
Holding your head in unnatural ways can lead to tense muscles and an aching neck and back. To help reduce these pains, strive to work at a desk rather than holding a laptop in your lap. Consider using a monitor or an elevated laptop with a keyboard. Your screen should be directly in front of you with the top of the screen positioned just below eye level. For those who wear bifocals, your screen can be 1-2 inches lower.
Viewing computer monitors that are too close or too bright can place you at risk for Computer Vision Syndrome: headaches, eyestrain, eye fatigue, and dry eyes. To combat this syndrome, consider placing your computer or laptop an arm’s length away from your face so that the computer is not too close to you, but not so far you must strain to see. When using your computer, practice the 20-20-20 rule. For every 20 minutes of screen time, focus on something at least 20 feet away for 20 seconds. These small 20-second breaks can make a huge difference as changing your focal point reduces eye strain by relaxing the muscles inside your eye that are responsible for focusing.
OPTIMIZING YOUR SEATING
As comfortable as working from the couch can be, it shouldn’t be your go-to work setup. Sitting for prolonged periods (such as an 8-hour workday) without proper back support causes you to slouch, which flattens the natural curve of your spine. This places strain on your lower spine and can weaken your back muscles over time, leading to an increased risk of injury. Consider investing in a chair that provides support to the natural curve of your spine. You can also modify straight-backed chairs, such as kitchen or dining chairs, with cushions or pillows to improve their comfort without having to buy a brand-new ergonomic office chair. Whatever chair you decide to work from, it should allow your feet to rest flat on the floor and keep your knees parallel to your hips. If your feet don’t touch the ground, consider using a stool or footrest. Chair height is another important factor. Too low, and your chair will put excess pressure on your sitting bones, while too high can build pressure behind the knee and inhibit proper circulation. Your chair should also be high enough to ensure you use your mouse and keyboard without bending your wrist at an awkward angle. Lastly, when possible, your chair should have pivotable, adjustable armrests that support the length of your forearms at a height that allows your shoulders to fully relax. Properly adjusted armrests can help support the upper body, reduce stress on the spine, and relax the muscles responsible for most neck and back pain.
OPTIMIZING YOUR DESK SET-UP
A proper desk setup can be instrumental in reducing your risk of RSI or repetitive strain injury, caused by putting stress on your body through repetitive movements, awkward postures, and poor ergonomics. The way you interact with your keyboard, mouse, and other desk elements can impact your likelihood of these types of issues.
All objects in your workspace should be set up where they are easily accessible without having to stretch. Your keyboard and mouse should be close to your body, and any documents you frequently view should be on a document holder to reduce neck strain from continuously looking down. Your keyboard should be centered in front of you, and your wrists should gently hover over the keyboard in a neutral position. If you struggle to maintain this position, a keyboard wrist rest can be purchased and used with most standard keyboards. Your wrists should be straight and always aligned with your forearms. Just like your eyes, the muscles in your wrists and arms need a break! Take a 20-30 second break every 20-30 minutes to help stretch out your muscles.
THE BOTTOM LINE
While there are numerous products that tout their ergonomic capabilities, in the end, it’s what works best for you. How can you use your space more efficiently, in a manner that will reduce the risk of long-term health effects? With some simple swaps and behavior changes, you can help stave off injury and increase your productivity for years to come.
Written by Rachael Davis
TRENDING NEWS
POST-HELENE RECOVERY IN WESTERN NORTH CAROLINA: WHAT CHALLENGES NATURAL DISASTERS REVEAL FOR THE COMMUNITY
Although national attention has shifted, the impact of September’s hurricane and subsequent flooding remains evident in Western North Carolina. The storm’s devastating impact laid bare the vulnerabilities in the region’s infrastructure, from damaged roads and bridges to compromised water systems. Yet, amidst the destruction, the resilience and unity of the mountain communities have shone through. Below is an overview of the ongoing recovery efforts, the significant challenges faced, and the lessons learned about the importance of preparedness and robust infrastructure in the face of natural disasters.
Infrastructure Challenges: Hurricane Helene brought unprecedented infrastructure challenges to Western North Carolina, exacerbating existing vulnerabilities like outdated architecture and potentially harmful lead-filled pipes. The storm triggered over 2,000 landslides, washed out roads, and damaged bridges, making transportation and emergency response efforts extremely difficult. Critical infrastructure, including power grids and water systems, suffered extensive damage, leaving thousands without electricity and clean water. The flooding overwhelmed wastewater treatment plants and threatened dam failures. These challenges underscore the importance of resilient infrastructure planning and investment to protect communities from the increasing frequency and severity of natural disasters.
Water Treatment Difficulties: Subsequent severe flooding led to significant water treatment challenges. The storm damaged over two dozen water utilities, leaving towns like Spruce Pine and Asheville struggling to restore clean water. For seven weeks, residents had to boil water before drinking or cooking due to contamination with mud and microbes. Clean water wasn’t announced until 53 days post-hurricane. Temporary fixes like portable toilets and water deliveries became necessary due to the flooding that overwhelmed wastewater treatment plants. These realities spotlight the urgent need for better emergency preparedness to ensure safe water access during future natural disasters.
Reconstruction Efforts: Hurricane Helene caused extensive damage to bridges and roads in Western North Carolina, necessitating significant restoration efforts. The North Carolina Department of Transportation (NCDOT), along with federal agencies, has been working tirelessly to reopen over 1,000 roads and repair hundreds more. Emergency relief funds totaling $352.6 million have been allocated to restore critical infrastructure, including major routes like I-40. Temporary bridges have been constructed to ensure safe travel, and roadside debris sites are being cleaned up. DriveNC.gov provides live updates on road conditions throughout the state, including the reopened I-40 with restricted lanes and reduced speeds. Additionally, the state has launched the North Carolina Private Road and Bridge Program to assist property owners in repairing privately owned roads and bridges, which are vital for emergency services and daily transportation. These efforts are crucial for restoring mobility, supporting the local economy, and ensuring the safety of residents.
Financial Assistance: The Federal Emergency Management Agency (FEMA) has extended the deadline for disaster assistance applications, providing crucial support for uninsured or under-insured losses. The American Red Cross has disbursed $11.1 million in direct financial aid to affected individuals and families. Additionally, the North Carolina Community College System offered emergency grants to students, while community colleges served as FEMA relief application centers. Nearly $850 million in federal funding has been allocated, with additional requests from state administrations to continue rebuilding efforts. This financial support has been vital in addressing immediate needs such as emergency housing, transportation, and other essential expenses, helping to mitigate the long-term impact of the disaster.
Ongoing Efforts: Officials are assessing further financial needs for repairs, while community leaders focus on reviving local economies. Support can be extended by visiting open tourist locations listed by Explore Asheville or volunteering for debris removal. The community’s resilience and unity remain strong, but ongoing support is crucial to fully restore and rebuild.
Support and Rebuild Together: As Western North Carolina continues to recover, the community’s resilience and unity remain strong. However, ongoing support is crucial to fully restore and rebuild. Local donations can make a significant impact, providing necessary resources for those still affected by the hurricane. Whether it’s contributing to rebuilding efforts, supporting small businesses, or aiding in debris removal, every bit helps. Consider donating to local organizations and charities dedicated to disaster relief and recovery. Together, we can ensure a brighter, stronger future for Western North Carolina.
Please click here to review a list of volunteer and donation opportunities with local organizations and charities.
TIPS & TRICKS
Unlocking Windows Efficiency
Mastering Keyboard Shortcuts
In today’s fast-paced digital world, efficiency is key. Whether you’re a seasoned professional or a casual user, mastering Windows keyboard shortcuts can significantly enhance your productivity and streamline your workflow. These handy combinations of keys can save you time, reduce repetitive strain, and make navigating your computer a breeze. From basic commands to advanced tricks, this guide will introduce you to the essential shortcuts that every Windows user should know. Get ready to transform the way you interact with your computer and unlock a new level of efficiency!
Basic Commands
CTRL C + Copy selected text or items.
CTRL V + Paste copied text or items.
CTRL X + Cut highlighted text or items. CTRL Z + Undo last action. CTRL Y + Redo last action. ALT + Switch between open applications.
A + Select all items on an open file or window.
Advanced Commands
Capture a screenshot of a selected area.
D Open the Quick Link menu to access system tools.
+ L Lock your computer.
D Show or hide your desktop.
D Restore or minimize the active window.
Move a window to a different monitor.
Whether you’re working on a single screen or managing multiple monitors, these tips and tricks will help you make the most of your Windows experience. Happy shortcutting!
Written by David Linares
THE CULINARY CHRONICLES
HEALTHY OFFICE LUNCH IDEAS MADE EASY
If you’re at the office and burnt out on fast food, try running to one of the nearby grocery stores on your lunch break and making one of these quick and healthy lunches. Here are some simple and delicious ideas that you can make from scratch in the break room using basic ingredients. These recipes are not only healthy but also quick and convenient for your busy workdays.
SIMPLE VEGGIE SALAD
Ingredients:
• Mixed greens (lettuce, spinach, etc.)
• Cherry tomatoes, halved
• Cucumber, sliced
• Carrots, shredded
• Olive oil and vinegar for dressing
Instructions:
1. In a large bowl, combine the mixed greens, cherry tomatoes, cucumber, and shredded carrots.
2. Drizzle with olive oil and vinegar, then toss to combine.
3. Enjoy a fresh and crunchy salad.
HUMMUS, TURKEY + VEGGIE WRAP
Ingredients:
• Whole wheat tortilla
• Hummus
• Sliced turkey
• Carrot sticks
• Cucumber sticks
• Bell pepper strips
Instructions:
1. Spread a generous layer of hummus on a whole wheat tortilla.
2. Add sliced turkey, carrot sticks, cucumber sticks, and bell pepper strips.
3. Roll up the tortilla tightly and slice it in half for a delicious and portable lunch.
THE CULINARY CHRONICLES
CHICKEN + RICE BOWL
Ingredients:
1. Microwaveable brown rice
2. Pre-cooked chicken breast, diced (store-bought or leftover)
3. Steamed broccoli (microwaveable steam-in-bag)
Instructions:
1. Microwave the brown rice according to the package instructions.
2. Heat the pre-cooked chicken breast in the microwave until warm.
3. Microwave the steam-in-bag broccoli according to the package instructions.
4. In a bowl, layer the brown rice, chicken, and broccoli. Mix well and enjoy a hearty and nutritious meal.
Estimated Calories: 400
Disclaimer: The calorie estimates provided are approximate and can vary based on specific ingredients and portion sizes used.
TUNA SALAD
Ingredients:
• Canned tuna, drained
• Mayonnaise or Greek yogurt
• Celery, diced
• Onion, finely chopped
• Salt and pepper to taste
Instructions:
1. In a bowl, combine the canned tuna, mayonnaise or Greek yogurt, diced celery, and finely chopped onion.
2. Season with salt and pepper to taste.
3. Serve on whole wheat bread, crackers, or over a bed of lettuce for a light and protein-packed lunch.
Estimated Calories: 250
These easy-to-make lunch ideas are perfect for keeping your energy levels high throughout the workday. Enjoy experimenting with different ingredients and flavors to find your favorite combinations.
Written by Kaleb Johnson
UNDERSTANDING SELF-FUNDED HEALTH PLANS IN THE PUBLIC SECTOR
In today’s evolving healthcare landscape, some public sector organizations are adopting self-funded health plans to manage costs and provide tailored benefits, where the employer assumes financial risk and pays for medical claims directly. (Contributed by Kaleb Johnson)
NEW RULES FOR 1095-B AND 1095-C: FORMS AVAILABLE UPON REQUEST
Recent changes to the Affordable Care Act (ACA) now allow employers to provide Forms 1095-B and 1095-C to individuals only upon request, rather than automatically, starting with the 2024 calendar year. (Contributed by Kaleb Johnson)
FEDERAL HURRICANE RELIEF: EXTENSION OF TIME FRAMES FOR EMPLOYEE BENEFITS
In response to Hurricane Helene and Tropical Storm Helene, the federal government has extended certain employee benefit deadlines for affected individuals and organizations in North Carolina, Virginia, and South Carolina, providing additional time to manage benefits without added stress. (Contributed by Kaleb Johnson)
PRE-DEDUCTIBLE TELEHEALTH EXEMPTION ENDS FOR HDHPS WITH HSAS
The telehealth services safe harbor, which allowed High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs) to cover telehealth benefits on a pre-deductible basis, expired on December 31, 2024, affecting HDHPs with plan years starting on or after January 1, 2025. (Contributed by Kaleb Johnson)
Written by Kaleb Johnson
FIVE EMPLOYEE BENEFIT TRENDS IN 2025
In 2025, employee benefits are evolving to include long-term care planning, mental health resources, financial wellness programs, fitness incentives, and sustainable initiatives, reflecting a shift towards personalized, holistic, and flexible support for employees. (Contributed by Kaleb Johnson)
TERM LIFE VS WHOLE LIFE INSURANCE
Choosing between term life and whole life insurance involves understanding that term life offers affordable, temporary coverage, while whole life provides lifelong coverage with an investment component, and combining both can offer comprehensive financial security. (Contributed by Kaleb Johnson)
KNOW YOUR BENEFITS
EXPLORE MORE WITH ASSUREDPARTNERS’ TRAVELCONNECT PROGRAM 1:04 Watch
Created by Andrew Marinelli
ACTIVITY CORNER
Sit back, relax, and indulge in some fun brain breaks! Test your knowledge with the PGB themed crossword puzzle, try your hand at a couple rounds of Sudoku, zone out with some adult coloring pages, or challenge your eyes with find the hidden pictures!
PIERCE GROUP PERSPECTIVES PIERCE GROUP PODCAST
PIERCE GROUP PERSPECTIVES: THE MAGIC OF EMPLOYEE SERVICES
8:28 watch
Hosted by Andrew Marinelli and Kaleb Johnson, Edited by Andrew Marinelli
An Interview with Janice Wagstaff
CRYSTAL KOMINSKI
Client Relations Specialist
TOMEEKA WEST
Service Specialist
NEW TEAM MEMBERS
Please join us in extending a very warm welcome to our newest team members - congratulations and welcome! We look forward to working with and getting to know you.
UPCOMING BIRTHDAYS
Keep an eye out for these special days in Q2 HAPPY BIRTHDAY!
APRIL
Taylor Palmer – April 1st
Donna St. Claire – April 3rd
Cindy Blackley – April 11th
Gray Spivey – April 14th
Jim Dubovec – April 14th
Deb Sahr – April 17th
Ben Ceja – April 19th
JUNE
Brittany Turner – June 8th
Laura Shelton – June 14st
Chris Pierce – June 20th
Missy Adams – June 20th
Monica Nixon – June 21st
MAY
Shanisse Spencer – May 8th
Nina Elghossain – May 8th
Rachael Davis – May 16th
Meghan Ezzell – May 21st
Andrew Marinelli – May 21st
WORK ANNIVERSARIES
WORKAVERSARIES
Thank you for the work you do for PGB and our clients!
APRIL
Michael Delahanty – 1 year
Tyler Blackwell – 2 years
Nichole Cayia – 4 years
Wyndham Murray – 4 years
Robin Craver – 26 years
MAY
Missy Adams – 2 years
Antonio Dinkens – 2 years
Kaleb Johnson – 2 years
Meghan Ezzell – 2 years
Dave Welker – 3 years
Carla Carr – 7 years
JUNE
Rachael Davis – 1 year
Sean Harbert – 1 year
Deb Sahr – 1 year
Adam Main – 2 years
Kerri Gilliam – 4 years
Artina McKnight-Coard – 4 years
Emily Kesead – 8 years
Laura Shelton – 11 years
Janean Kilgore – 27 years
EMPLOYEE SPOTLIGHT
KERRI GILLIAM
Account
Executive
Kerri has been a dedicated professional in the insurance industry since 2005, starting as a Benefits Counselor with PGB and transitioning to an Account Executive in June 2021. She enjoys building lasting relationships with clients and takes pride in assisting them with their needs. Kerri holds a BA in Psychology from UNC Wilmington, which helps her connect with clients on a personal level.
Outside of work, Kerri enjoys reading and taking walks. Her ideal day off is spent with friends and family, cherishing moments of togetherness. Kerri’s dedication and approachable nature make her a valued member of the PGB team.
“Kerri’s dedication to her clients and her readiness to assist make her an invaluable asset to our team. Her positive contributions consistently enhance our Client Services department.”
Monica Nixon Regional Client Services Manager
GRAY SPIVEY
Client
Relations Specialist
Gray has been a dedicated member of the PGB team for nearly 10 years, where he currently excels as a Client Relations Specialist. He loves meeting new people and enjoys building relationships that extend beyond work, often getting to know clients and their families personally. Gray holds a BS in Psychology and is proud of being the first annual recipient of the Glenn Pierce Cup.
Outside of work, Gray is actively involved in his children’s extracurricular activities and enjoys participating in recreational sports like softball and basketball. His ideal day off is spent with family and friends during their annual beach week, where they relax and enjoy each other’s company. Gray’s enthusiasm and personable nature make him a valued member of the PGB team.
“Gray’s jovial personality continually strengthens his network. He is always willing to assist team members and share the Pierce Group story. Gray had a fantastic 2024 sales year and is off to a great start in 2025, leading the charge through the strength of his growing relationships. People view him as a trusted advisor.”
David Charland Chief Revenue Officer
WANT TO SPOTLIGHT AN EMPLOYEE?
Leadership members are welcome to nominate managers, and managers are encouraged to nominate team members. To submit a nomination, please email marketing@piercegroupbenefits.com with the following information:
• Nominee’s name and job title
• A 1-2 sentence quote about the nominee’s skills and contributions
Q2 IMPORTANT DATES & REMINDERS
Upcoming Holidays: Interdepartmental
MEMORIAL DAY
MONDAY, MAY 26TH
JUNETEENTH
THURSDAY, JUNE 19TH
DEPARTMENT CONTACT DIRECTORY
DEPARTMENT EMAIL
Data Management enrollmentdept@ piercegroupbenefits.com
Data Management enrollments@ piercegroupbenefits.com
Data Management edi@piercegroupbenefits. com
Data Management benselect@ piercegroupbenefits.com
Data Management 365support@ piercegroupbenefits.com
Data Management dm-managers@ piercegroupbenefits.com
Business Development partnership@ piercegroupbenefits.com
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“IT’S NOT ABOUT IDEAS. IT’S ABOUT MAKING IDEAS HAPPEN.”
