Saturday September 22, 2018

This alarming healthcare trend has increased 87% in the past four years

Nine-digit health claims are becoming the norm rather than the exception.
In fact, the number of million-dollar-plus medical claims has risen 87% in the past four years, according to Sun Life Financial’s 2018 High-Cost Claims Report. The Sun Life report analyzed self-insured plans, but the trend affects plans of all stripes.

The Big Three

In order to combat this troubling healthcare trend, employers need to understand the conditions that are behind the sky-high claims.
Although 10 conditions make up over $3 billion in claims reimbursements, these three conditions are the most costly for employers year in and year out:

  • Malignant neoplasm (cancer)
  • Leukemia, lymphoma, and/or multiple myeloma (cancers), and
  • Chronic/end-stage renal disease (kidneys).

With a firm understanding of what’s behind the high-cost claims what’s being done to combat those conditions, employers can take some proactive steps to limit their exposure.

What can be done

The first step should be an analysis of both your company’s medical and its Rx spend. This will help you determine which conditions are already having the greatest impact on your healthcare spending.

Then, if you haven’t done so in a while, you may want to do a demographic analysis of your workforce to find out which conditions are most likely to occur.

You’ll also want to determine what procedures you have in place for high-cost and “specialty” drugs: pre-authorization, step therapy, tiering, etc.

Finally, you’ll want to check on the availability of a major cost-saving step regarding injectables. See if your plan allow injectables to be administered at home instead of a medical facility. Not only does this keep costs down, it’s something many workers will likely appreciate.

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New dads score $1.1M settlement in EEOC parental leave discrimination case

As parental leave policies are becoming increasing popular, HR pros need to keep this in mind: Not giving new fathers the same type of leave as new mothers to bond with a newborn or newly placed adopted or foster child can prove very costly. 

That’s a lesson Estee Lauder learned recently in what appeared to be the EEOC’s first-ever lawsuit specifically against a company’s parental leave policy. As a result of that lawsuit, Estee lauder will pay a total of $1.1 million to the class of male employees named in the EEOC.

 The primary v. secondary debate

The settlement is the result of a discrimination lawsuit against Estee Lauder Companies Inc. because of its parental leave and flexible leave policies.

According to the suit, Estee Lauder only gave new fathers two weeks of leave for “child bonding” when it offered new mothers six weeks.

The suit also claims female employees were given more flexible arrangements when they returned from work after childbirth. The agency took up the case after a stock worker at a Maryland store requested six weeks of leave for the birth of his child, but was only granted two.

The agency took up the case after Christopher Sullivan, a stock worker at a Maryland store, requested six weeks of leave for the birth of his child, but was only granted two. Sullivan told the company he would be the child’s primary caregiver, but was told the company only applied the “primary caregiver” designation in “surrogacy situations,” according to the suit.

A new policy

Estee Lauder’s policy, which was only adopted in 2013, gave six weeks of leave to new mothers and “primary caregivers” and two weeks of leave to “secondary caregivers.”

In addition, the company offered new mothers four weeks of “transition” time, which allows them to return to work on a flexible schedule until they get re-situated at work.

Acting director of the EEOC’s Washington field office, Mindy Weinstein, did commend the cosmetics maker for its parental leave policy and flexible work arrangements, which it called “wonderful” (… at least in their intent).

However, Weinstein went on to add the caveat that “… federal law requires equal pay for equal work, and that applies to men as well as women.”

‘Should not reflect stereotypes’

In addition to the payout, Estee Lauder is required to administer its parental leave and return-to-work benefits in a manner that ensures equal benefits for male and female employees and uses sex-neutral criteria, requirements and process. Plus, the company is required to provide training on unlawful sex discrimination and allow the EEOC to monitor its practices.

Since the lawsuit, Estee Lauder implemented a new parental leave policy that provides all eligible employees, regardless of gender or care­giver status, 20 weeks of paid leave for child bonding and the same six-week flexibility period upon returning to work.

Of the lawsuits and settlement, Senior EEOC Trial Attorney Thomas Rethage said:

“Parental leave policies should not reflect presumptions or stereotypes about gender roles. When it comes to paid leave for bond­ing with a new child or flexibility in returning to work from that leave, mothers and fathers should be treated equally.”

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Policy changes? Here’s how to get employees on board

Nobody likes change. And when new policies go into effect, it can be tough to get everyone through the transition stress-free.

Employees will naturally have a lot of questions and concerns. But there are ways you can make the process run as smoothly as possible.

The more info, the better

KnowTechie, a business and technology blog, shared some pointers on how to get your employees on board with major policy changes.

1. Lead with how the changes benefit them. There’s no denying that policy changes can complicate things and cause a lot of confusion. One tactic to soften the blow is starting the conversation in a positive light. Before speaking to employees about the changes, look at it from their perspective and see what elements of the policy staff would consider a positive thing.

2. Explain the reasons behind the changes. Many employees won’t be happy with just knowing the basics. They want the “what” along with the “why.” Even if employees are upset with the changes, they’ll understand why the new policies were necessary if you give them all the information.

That being said, if a certain incident sparked a new policy, try not to point fingers at anyone. If it’s unavoidable, focus on the worker’s actions, not them personally.

3. Ask for feedback. Employees may have a lot of opinions about the changes, and will feel the need to express them. Make sure your staff knows how you’re accepting feedback. Not only will employee comments help the process go more smoothly, but they’ll feel respected and valued that you want to hear from them.

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Feeling the burnout? 3 ways to revive your employees

HR pros know how important it is to help employees avoid stress and burnout, and a lot of companies are doing their best to tackle this issue. 

But research is showing it’s still not enough.

A recent study by Deloitte, which surveyed 1,000 U.S. employees, found 77% have experienced burnout at their current jobs. Sixty-four percent reported that they were often stressed at work.

Despite some employers’ best efforts, workers are still wanting more. Sixty-nine percent felt their companies didn’t do enough to minimize burnout, and 21% reported their employers don’t offer any programs to help reduce stress.

Shifting the culture

The surveyed employees also pointed out what was causing the most burnout, and Deloitte’s Managing Director for Well-Being, Jen Fisher, shared some suggestions for tackling these issues:

  1. Encourage ‘real’ weekends and vacation days. Thirty percent of respondents claimed to consistently work weekend hours, and only 43% use all of their vacation days. Employees are most hesitant to disconnect on days off because they’re worried about potential issues in the office. Employers can help ease these fears by creating a culture where workers aren’t contacted at all on days off. For example, German company Daimler started a “Mail on Holiday” program. This automatically deletes a vacationing employee’s incoming emails, allowing them to completely disconnect. The sender is alerted that the email was deleted, and is encouraged to contact the employee when they return.
  2. Start health and wellness programs. Many employees expressed interest in more wellness programs, especially ones focusing on mental health. Fisher suggests employers offer preemptive stress management classes. Another idea: Aetna’s CEO started providing on-site yoga, meditation and fitness centers for his employees after going through a personal crisis of his own.
  3. Show appreciation in big and small ways. Research shows that when employees are consistently thanked for their work, they’re less likely to leave, and more likely to perform better. But that doesn’t mean big thank yous aren’t necessary too. Here’s an idea: To show its appreciation, Deloitte closed its doors the week between Christmas and New Year’s to make sure everyone enjoyed the holidays stress-free.

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Return of the ACA individual mandate: Could this incarnation catch on?

ACA, healthcare reform, obamacare

When the Tax Cuts and Jobs Act (TCJA) killed the penalty on the ACA’s individual mandate, most employers believed Obamacare was effectively dead. But some states didn’t think killing the mandate was such a great idea and put forward legislation to keep the mandate alive on the state level. 

As HR pros are well aware, the ACA’s individual mandate reguired people to carry health insurance or pay a penalty.

However, beginning in 2019, individuals will no longer be required under the federal law to maintain health insurance because of the TCJA. It’s a move that experts believe will cause volatility in the group health plan market.

Unfortunately for employers, the reporting requirements under the ACA are still in place — despite the repeal.

NJ, VT and Washington DC

Since the TCJA took effect, two states, New Jersey and Vermont, and DC passed bills to include their own individual mandate. NJ, VT and Washington, DC join Massachusetts, which had an individual mandate in place well before the ACA became law (2006). Of NJ, VT and DC, the Garden State is the locale with the most specific details on how the penalties will be assessed/calculated. Under the law, which takes effect January 2019, NJ residents without minimum essential health coverage will pay a fine equal to 2.5% of their household income or $695 per adult and $347 per child, whichever is greater.

If the fine is based on a per-person charge, the max household/family penalty will be $2,085.

Even if you don’t have employees in these locations, you should keep an eye on this trend.

Several other states have expressed interest in such a law. In fact, right after the TCJA was passed as many as nine states were strongly considering state-level individual mandate legislation. So there’s a very good possibility the three recently passed state laws will not be the only ones we see moving forward.

We’ll keep you posted.

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Congress aims to greatly expand HSAs: What HR pros should know

Congress recently passed two bills that could drastically expand the usage of HSAs.

If these bills become law, HR pros will have a lot to communicate to their staffers about the many ways in which they can now use their HSAs.

The bills, H.R. 6199 and H.R. 6311, are both Republican-backed bills with some Democratic support and would allow account-holders to use there HSAs for several things that are currently prohibited.

H.R. 6199

The Restoring Access to Medication and Modernizing Health Savings Account Act (H.R. 6199) passed by the greatest margin of the two bills (277-142).

Some of the more significant changes the legislation would make to HSAs (changes that are covered in much more detail in a recent article by the Society for Human Resource Management or SHRM):

  • Undo the ACA’s ban on using tax-advantaged accounts to purchase over-the-counter medications and product.
  • Allow individuals with HSA-qualifying family coverage to contribute to an HSA if their spouse is enrolled in a medical FSA, a move that currently isn’t allowed.
  • Allow HDHPs to cover up to $250 (self-only) and $500 (family) annually for nonpreventive services that may not be covered pre-deductible. This would help workers, on a limited basis, use HDHPs to cover things like chronic-care treatment outside the deductible.

H.R. 6311

The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act (H.R. 6311) passed (242-176) would expand how low- and moderate earners could use the ACA’s premium tax credit and:

  • Raise the HSA contribution limit to $6,650 (individuals) and $13,300 (families), which is combination of annual limit for out-of-pocket and deductible expenses for 2018.
  • Allow HSA to pay for qualified medical expense at the start of HDHP coverage is HSAs are opened within 60 days of HDHP start date.

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ADA: Is attendance automatically an essential job function? Court says …


As HR pros already know, disabled employees still need to be able to perform the essential functions of their job, with or without an accommodation. 

But what happens if an employee can’t come into work because of their condition, but can still get their work done? Is attendance in the workplace necessary then?

In Hostettler v. College of Wooster, an employer tried to argue attendance is always an essential function.

Part-time accommodation

Heidi Hostettler was a full-time HR generalist at the College of Wooster. After having a baby and taking 12 weeks of maternity leave, Hostettler informed her employer she had a severe case of postpartum depression and separation anxiety. Her doctor recommended she only go back to work on a part-time basis for a few months.

The college allowed Hostettler to work half days in the office. Even after going home for the day, Hostettler would still do her work and be available if anyone needed her.

When those two months were up, Hostettler was still unable to come back to work full-time. The college fired her, citing full-time attendance as an essential function of the position. Hostettler sued the company for violating the ADA.

Case-by-case basis

The college claimed Hostettler’s part-time schedule put a burden on the department, and it could no longer accommodate her in that way — a full-time employee needed to be in that position.

But Hostettler showed the court she was able to complete all her core job functions at home. Her co-workers even confirmed there were no issues with Hostettler working from home, and she finished all her tasks in a timely manner. At one point, Hostettler received a performance review while she was working her modified schedule, and the evaluation was positive.

The court first ruled that attendance isn’t automatically an essential job function, and it needs to be evaluated on a case-by-case basis. Attendance is only essential when an employee’s physical presence at the worksite is required to complete the job.

In this case, the court felt Hostettler could complete her job remotely, adding, “full-time presence at work is not an essential function of a job simply because an employer says it is.”

Keeping this in mind, it’s a good idea for employers to re-examine job descriptions. Determining which functions can only be performed on-site and which can be done remotely will give you a good idea of whether attendance is essential — and save you from making the same costly ADA mistake as the College of Wooster.



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4 ways open office spaces can do more harm than good

While many companies are eliminating cube walls in an attempt to foster more collaboration between employees, a recent study shows this could be achieving the opposite effect. 

Harvard University found that face-to-face communication between employees decreased by 70% after office floorplans were opened up. The study discovered workers withdrew from each other socially, preferring to communicate via email or instant messages.

Other employees reported feeling less creative, citing the need for quiet, secluded spaces to work most efficiently.

Other harmful effects

Not only can open offices hurt collaboration and productivity, but they can actually do damage to employees’ physical and mental health.

Business writer Geoffrey James shared on some more unintended side effects of open office spaces that can cause problems for employees.

  1. Managers are inescapable. A recent poll by Gallup shows that bad bosses are the top reason workers leave companies. For those who stick around, a bad boss can cause stress or even depression. And in an open office, managers are unavoidable, which can make the stress even worse. It’s important for employees to have a private space they can go to decompress.
  2.  Sickness spreads more easily. Germy coughs and sneezes can travel up to 26 feet, and particles can stay in the air for ten minutes. When there are no cubicles or walls acting as barriers, the whole office can quickly get contaminated.
  3. Introverts will be uncomfortable. Roughly 50% of the population consider themselves to be more introverted than extroverted. This means the constant presence of other people can cause a lot of employees to feel anxious and uncomfortable. For some workers, forced interaction throughout the entire day can be too much to handle.
  4. It’s impossible to fully focus. When people around us are saying and doing things, our brains unconsciously pay attention to them. This makes it impossible for employees to work without any distractions in an open office. Constant multitasking can do major damage to workers’ productivity.



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Could employees and companies benefit from a digital detox?

For busy HR pros, the idea of a digital detox may seem as out of reach as winning the lottery. But in this guest post, the folks at, a Los Angeles-based international telecommunications provider, explains why it may be easier — and more beneficial — than you think.

Technology has transformed the way companies and their employees operate every day. While the benefits of a more connected world are numerous—we can do business with customers around the world, and they can communicate with us through 1800 numbers—could we benefit from occasionally switching off from the digital world?

Here, we explore the growing concept of the “digital detox.” As digital technology further engrains itself into every aspect of our lives, how might we benefit by reducing our exposure when we leave the office?

What Is a ‘Digital Detox?’

The term digital detox, which is now listed on, can come in whatever form the participant feels is necessary. Undergoing a digital detox is the act of refraining from using digital or electronic devices for a certain period of time, with the intention of avoiding the distractions that come from always being connected.

Some examples include:

  • A set time every day where all devices, such as laptops and smartphones, are switched off
  • Not engaging in any work-related communications, such as email, outside of working hours
  • Actively engaging more in conversations and interactions in the “physical” world and less in the “digital” world

Does digital affect our mental state?

Behind the concept of a digital detox is the idea that while technology makes our lives easier, it doesn’t necessarily make us happier. Studies that connect technology with a decline in well-being are beginning to add up.

In 2012, The University of Gothenburg did an extensive study on the effects of computer and smartphone usage and found that excessive use can be linked to stress, sleep disorders and depressive symptoms. For those who used both computers and mobile phones combined, the risk was amplified.

Research has also been conducted around smartphone addiction in college students. In 2015, for example, a study showed users had negative physiological and psychological symptoms, such as increased blood pressure, an increased heart rate, and anxiety. This suggested that, for this generation, a dependency had developed, and when the tech was removed, “withdrawal” symptoms occurred.

Sleep, and how technology can have a negative impact on it, is of particular interest for those looking at how technology changes our lives.

Ellen Wermter of Charlottesville Neurology and Sleep Medicine notes how waves of blue lights, prominent in mobile devices, are disrupting our sleep patterns:

“There is one biological phenomenon that will improve communication, creativity, productivity, endurance, reaction time, concentration, memory, mood, and more—and that is proper sleep. One of the main influences of our sleep patterns is light, particularly that which we get through our phones, tablets and laptops, which are often close to our face and that many of us use late into the evening and even take into our bedrooms.”

Why is sleep so vital to workplace performance? A study from Hult International Business School showed that, due to a depreciation of skills such as communicating effectively, assessing risk and producing innovative solutions that come from a lack of sleep, organizations lose $2,280 a year per sleep-deprived employee.

A good night’s sleep can improve each of the following productivity boosters:

  • Memory
  • Creativity
  • Energy levels
  • Attention span
  • Lower stress levels

As upcoming workplace generations instill technology even more deeply into their lives, these detrimental effects pose a significant problem for workplace productivity. So, how can companies address this?

How can you encourage employees to detox?

Some businesses are encouraging staff to cut down on technology at home and take regular breaks at the office as a means of boosting productivity during working hours.

Using technology to work in the office is one thing, but there can be drawbacks to technology when working remotely. Chady Tawil of Mozaico found a problem of this nature at his company:

“As we work within a fully remote team with staff located all around the world, instant messages and notifications from our productivity platform can be received literally 24 hours a day.”

Smartphones may allow us to always be connected with work, but here it led to employees unable to disconnect. In response, Tawil removed apps such as Trello and Slack from employees’ personal phones, allowing them to get some downtime outside of work.

German automotive company Daimler AG implemented a similar email-based solution in 2014. Dubbed the “Mail on Holiday” system, any emails sent to an employee while they were on vacation were automatically deleted, and details of who to contact were forwarded to the sender.

The policy intended to give employees an opportunity to enjoy their time away, promoting a healthier work/life balance so they could return to work free of stress and ready to hit the ground running again.

It’s not only individual businesses who are getting involved with digital detox initiatives. In France, the government intervened in 2016 by implementing the “right to disconnect” policy.

The measure was intended to tackle the “always-on” work culture. Companies with more than 50 workers were required to draw up guidelines around the use of email and work-related smartphone use outside of office hours. Employees could negotiate a total ban on sending emails outside of office hours.

Detoxing while at work

In addition to a home-based digital detox, an alternative is to offer a break from tech during work hours. Consider implementing some of the following work policies to further enhance productivity:

  • Encourage regular breaks away from the computer screen
  • Organize well-being or recreational classes (such as yoga) at lunch, helping employees to get away from their desks
  • Have tech-free meetings, allowing staff to rely only on their interpersonal skills to communicate ideas

We spoke to businesses who have adopted workplace digital detox policies. One extreme example comes from Mexico-based travel comparison site El Mejor Trato, who has completely eliminated email from their workplace.

“Instant messaging apps and emails are our worst enemies,” VP of HR and Co-Founder of El Mejor Trato, Cristian Rennella told us. “The key for employees to effectively manage workplace stress and achieve full productivity is to learn how to handle instant messaging apps and emails.”

By “handling,” Rennella meant completely remove. Studies have found that workers spend almost 30% of their day with emails—so El Mejor Trato took the drastic step of removing them altogether.

Another example comes from Their CEO, James Pollard, found technology was negatively impacting staff:

“Due to the nature of the business, a lot of people work from home and there are a lot of Skype calls, Zoom webinars, email support, live chat, my employees are glued to their devices all day. I noticed that people seemed a little burned out or sluggish around 2 pm every day.”

To counter the problem, Pollard started a new policy where staff were to detach themselves from all technology and do whatever they pleased between 1:30 p.m. and 2:30 p.m. every day.

How you And your employees could benefit

We’ve seen how a reduction in tech in our lives can help us to lower stress, increase creativity and, ultimately, improve productivity levels—and business leaders are already onboard.

Gianluca Boncompagni, CEO at Massage Tables Pro, took a digital detox and found it beneficial personally and professionally:

“Even during my days off, I’m answering emails, putting fires off, or figuring out how to make a better profit margin. Needless to say, stress levels have affected me, resulting in a bad quality of sleep, or trouble not thinking about work.”

But thanks to a digital detox, Boncompagni has reduced those negative effects:

“After five days of not touching my laptop, and putting my phone on silent, I had the most relaxing long weekend probably of my life. I came back to work the next week with renewed energy, a clearer mind, and fresh ideas. After that day, every two months I take a small detox to charge my batteries and get things going again.”

And in each of the three detox initiatives above, business leaders also found positive results amongst staff. “After eliminating instant messaging and emails, our biannual internal survey found stress levels of our employees decrease by 47%,” Rennella commented.

Pollard also said his workers at reacted positively to the change: “I’ve found that my end of day productivity has greatly increased. We just set up an auto-responder telling all my customers that we will return at 2:30. Business has not been negatively impacted.”

After his removal of work-related apps from smartphones, Tawil also saw a boost in productivity at Mozaico:

“We have seen a more concentrated period of work within normal working hours for each member of the team. With that, higher levels of productivity and improvements reported in work-related stress levels.”

Tips on how to Digital Detox

Here are four tips for getting started with a digital detox for you or your business:

  • Consider an allowance: Give yourself a daily “tech-free” allowance where you can switch off devices and email and remove yourself from everything that comes with it
  • Focus on sleep: A good night’s sleep is key to improving each negative aspect tech brings with it; make a more productive and happier you by switching off your devices at least 30 minutes before you attempt to go to sleep
  • Set up a detox buddy system: You might find it easier if you have someone else to bounce digital detox ideas off of
  • Leave your gadget behind for a day: Try a day where you use no technology whatsoever and monitor your mood and well-being.

Cite:, a is Los Angeles-based international telecommunications provider, and this post was originally published on its company blog.


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California aims to prevent marijuana-use discrimination: Start of a trend?

marijuana, drug policies

If this bill passes, medical marijuana users in California will be classified as a protected class and employers will be unable to discriminate against them because of their marijuana usage.

While the California Supreme Court has made it clear employers don’t have to accommodate medical marijuana use, AB 2069 would prohibit employers from discriminating against workers based on their status as card-carrying medical marijuana user by placing them in a protected class.

The legislation would amend the current definition and prohibit discrimination based on “race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender identity, gender expression, age, sexual orientation, or military
and veteran status.”

The bill passed a Committee vote, but is currently on hold as lawmakers look to tweak the language of the legislation.

We’ll keep you posted on any upcoming developments.

The new role of marijuana

Legislation to ban marijuana-use discrimination is part of a growing trend of general acceptance for the substance that was once a workplace taboo.

In fact, many believe it’s only a matter of time before we see medical marijuana as part of prescription drug plans.

Their reasoning: A total 29 states and the District of Columbia have legalized medical marijuana, and a slew of others have taken it a step further and OK’d the recreational use of the substance.

Plus, in light of the opioid crisis, many see medical marijuana as a safer alternative to opiates because it doesn’t carry the risks of overdosing.

All of these factors are leading some experts to surmise that medical marijuana will be a reimbursable option in employers’ prescription drug plans in the near future.

Why it could happen

According to Michele Hibbert-Iacobacci, head of information management and support for Mitchell Casualty Solutions in San Diego and the co-author of a white paper that covers medical marijuana reimbursement, the marijuana industry has the momentum to make prescription drug reimbursement a reality, but it just needs a bit more on the medical safety side of things.

As Hibbert-Iacobacci puts it:

“I don’t see how this train will stop rolling. The [marijuana] industry is huge. It employs a lot of people. They just have to show that its use is safe from a medical perspective.”

And employment attorneys like Larry Casey, of the Davis, Malm & D’Agostine law firm, see a potential recruiting benefit for employers who do wind up covering medical marijuana in their health plans. In a recent SHRM article, Casey said:

“In an industry or area of the country that is progressive about the use of marijuana for medical purposes, covering medical marijuana could help an organization be seen as a progressive employer.”

The biggest barrier

Regardless of how much momentum the medical marijuana reimbursement movement gains or how many states legalize the substance, there is still one giant problem: The federal government classifies marijuana as a Schedule I drug — a designation it uses on substances like heroin, LSD and ecstasy.

This classification gives marijuana the harshest range of criminal penalties and is the reason why the U.S. Food and Drug Administration hasn’t approved medical marijuana and, in all likelihood, won’t until it is reclassified to a lower schedule.

The Schedule I tag is also why, even if employers would like to offer medical marijuana reimbursement, they will likely have a difficult time finding an insurance provider that’s willing to offer health insurance or workers’ comp plans that cover medical marijuana.

Self-insured plans can cover medical marijuana. However, the patchwork of state and local regs combined with the uncertainty of the feds’ stance, makes this a far from easy proposition for employers, too.

As Mary Kay O’Neill, an MD and partner with Mercer, says: “It is difficult to come up with policies for national employers, who are often reluctant to administer a patchwork benefit.”

Still, many believe the push for legalized marijuana will lead to a reclassification of the current Schedule I designation. And when that happens, it’ll only be a matter of time before medical marijuana finds its way into employer-sponsored health plans.

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