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Thursday, March 31, 2011

Sooner or Later

I've been saving this post for a very long time.  As we come to the end of another fiscal year, one in which we have much to celebrate, I want to take a moment to challenge the thinking of a sub-culture within our company that looks for signs of layoffs...constantly.

This was undoubtedly our comeback year so as we move forward to build a better Thomas Nelson I'd like to ask this simple question: how can we as Christians contemplate and come to terms with the gravity our own mortality and eternal destination and yet gyrate uncontrollably at the thought of losing a job?

Over lunch one day Sam Moore told me the story of how he came to buy Thomas Nelson from Lord Thomson.  Undoubtedly many of you have heard or read that story, although some of our newer or younger people haven't.  It is one of the great lines on this topic and what follows is the abbreviated version of what Sam told me.

Lord Thomson, British publishing magnate getting on in years, notices the success of Sam's upstart Royal Publishing on 7th Avenue in Nashville.  He calls Sam to lunch in New York and asks him to come work for him running Thomas Nelson, whose brand had lost its way in the marketplace.  Sam says, "I won't come to work for you but I'll buy it from you."  One of Lord Thomson's staff quickly jumps in the conversation and says, "Lord Thomson does not sell companies, he only buys them."  Sam replied, "Lord Thomson, the Good Lord has designed it so that eventually we all sell."

And so it is with our jobs...

I will eventually leave Thomas Nelson.  It could be after I get my gold watch for my 80th birthday like Jack Countryman (although thankfully he's still here!).  It could be next year in a disagreement with my bosses or in 10 years due to disability or an offer I can't refuse.  I'll eventually leave my job in some fashion just like I'll eventually die.  I've come to terms with both as much as anyone can in advance of it happening and so my work experience is generally positive.

The economic and financial paranoia of this recession is easing.  Our future looks bright.  As we move forward together I encourage you, whether you work at Nelson or elsewhere, to make plans for your retirement; to pay off your debts and to have an emergency fund. Come to work with the same surety and outlook with which you come to your Church.  To strain at job security and swallow mortality whole is illogical and makes your day, and mine, harder than it has to be.

Monday, March 28, 2011

A Thankful Monday

This morning as I was doing my usual 6:30 email and web news check the big story was another Abercrombie and Fitch stumble. Adding to its history of sexualizing pre-teens, the company recently made the news for selling a push-up padded bikini top marketed to girls as young as seven. 

The news caused me, on a groggy Monday morning, to pause and be thankful for where we work.  While we're not without our problems (what workplace isn't?), I wondered for a moment what it would be like as a person of faith working at A & F.  How could you be proud of your company?  How could you feel good about going to work knowing that you contributed to a product line and company culture that makes money turning second graders into sex objects?

By contrast last week I spent a day in Abilene visiting the missionaries who had come to Nashville for flood rebuilding and relief.  They reminded me that it was the inspiration of our products that caused them to form domestic mission teams.  They not only perform domestic mission work but have also built an orphanage for deaf children in Kenya.  This congregation of 250 supports 2 1/2 paid missionaries overseas.  They give us and our products a lot of the credit.

I went there to thank them, on behalf of Thomas Nelson, for their help with one of our own whose house had flooded.  Instead they thanked me for the inspiration of our products.

So fresh off that visit I read about A & F and said a quick prayer of thanks for working at a place whose products inspire the best in our readers.  I also said a quick prayer for those working for employers of which they are ashamed.  May they find a way out and support their families some other way.

Sunday, March 27, 2011

Why I've Not Blogged and What's Next

After posting almost daily I've been silent for about a couple of weeks.  Since my last post we've been at the individual counseling stage for employees making important and sometimes difficult benefits choices.  I've also been to Texas to do the same for our Live Events workforce.  The days have been too full to allow much blogging time.

I've also been avoiding topics other than Open Enrollment until April 1st.  We have been using this blog as a place to post FAQ-type information for Thomas Nelson's benefits plans.  This has driven traffic to the blog.  Because of this I've shied away from op-ed pieces; I don't want anyone thinking that I've driven them to my blog so they could be exposed to my opinions on one topic or another.

After April 1st I hope to get back to regular posts on more general workplace topics as our benefits enrollment deadline will have passed.  I may also have one more post on the CAN-DO ordinance before Metro Council, as its Final Reading is April 5th.

Meanwhile, if you're a Nelson employee, remember that Monday, March 28th is the deadline for your benefits decisions.  You legally have until the 31st and we'll honor elections up until that time, but it takes 2-3 days to get your elections in the system and your coverage will start a few days late.

Wednesday, March 16, 2011

So What Constitutes a Medical Emergency?

In the choice between P and S networks one of the most common concerns is emergency room care.  We always say, "Never drive past an ER", meaning that you should never think about in and out of network in emergency situations.  Another reason is that emergency care (which is different from emergency room care which could include going on the weekend for the flu) is covered in our medical plan at the same in-network rate at any hospital.

When we give this response the first very reasonable question we get is, "So what is emergency room care to Blue Cross?"  The concern is that a person might go to an out of network hospital thinking something is serious, find out that it isn't, and then be stuck with a big ER bill for out-of-network treatment.

Here, exactly, is the Blue Cross Blue Shield definition for emergency care.

An emergency situation is defined by a "prudent layperson" who possesses an average knowledge of health and medicine, as a medical condition that develops itself by symptoms of sufficient severity, including severe pain.  Failure to provide such treatment could reasonably be expected to result in:
  • Serious impairment of bodily functions
  • Serious dysfunction of a body organ or part
  • Could reasonably be expected to place the person's health in serious jeopardy
  • Threat to the health and safety of a pregnant woman who is having contractions or to an unborn child
  • Danger to self (including psychiatric conditions and intoxication
While there is room for debate after the fact, here are three things for you to consider.  We have had the same possible situation historically with in and out of network ER care before ever going to BCBS.  In ten years of managing the plan we've never had an issue with ER care charged as non-ER care.  Also there is an appeals process and you should use your HR department to help as your advocate if there ever is an issue.  Finally I've reviewed the list of acceptable medical billing codes that count as emergencies and it is 138 pages long.

Remember, if its an emergency go to the nearest ER.  We'll help you sort it out after the fact if there is a problem, but the chances of you having a problem are slim.

Thursday, March 10, 2011

Why Are We Moving the Book Archive?

While plans are not yet finalized, the word appears to be out that we're planning on moving the company's archive to space in the warehouse building.  All manner of speculation ranging from dead-right to ridiculous has made its way around the building.  I'll take responsibility for not getting out ahead of this story; it is a proverb in HR and PR that if you fail to tell your story someone will tell it for you, facts or no facts.  So what's the real story?

We are out of space. 

With the recession-era move of all offices into the Corporate building, and subsequent subleasing of our other spaces, we are committed to one location for our publishing operations.  We are about to embark on a new budget year with less than five spaces left in our building.  When the new budget year rolls around on April 1st we will begin to receive requisitions to hire those approved positions and we have no place for them to go.

Our options were to reduce all cubicles down to 6x8, making more work spaces in this building by cramming people closer together and cutting down on the amount of counter and file space for every person.  We eliminated that idea as too disruptive and detrimental to the work environment.

We could lease more space.  This is not only unacceptably expensive, but it reverses the operational advantages we gained from having Publishing, Sales, Marketing, Operations and Administration in one building. 

Our other option was to look for something to move out of this building.  This building houses people, storage, archives and equipment.  Much of our storage is in rooms where we can't put people, including our mechanical rooms.  The building HVAC and servers can't move, and we're not splitting our team. That leaves the archive, which can go anywhere so long as we provide the correct humidity and temperature.

There is more to be determined and written about this at a later date as decisions are made.  For now its sufficient to articulate what we're doing and why.  Questions and comments are, as always, welcome.

Monday, March 07, 2011

If "Preventative Services" are Free, How are They Defined?

The Patient Protection and Affordable Care Act (the law behind Congressional Healthcare Reform also known as PPACA) mandates that all preventative services be delivered at no cost to the insured patient (that's you if you participate in our health plan).  So since most everyone at some point or other has been burned by the specificity of how an insurance carrier defines covered services, the big question so far as been, "What exactly is considered a preventative service?" 

Here from the Blue Cross Blue Shield of Tennessee PPACA flier "Preventative Services" is how BCBS defines these services. 

All Members

• One-a-year preventive health exams. More frequent preventive exams are covered for children up to age 3

• All standard immunizations adopted by the CDC

• Screening for colorectal cancer (age 50 – 75 ), high cholesterol and lipids, high blood pressure, obesity, diabetes and depression

• Screening for HIV and certain sexually transmitted diseases, and counseling for the prevention of sexually transmitted diseases

• Screening and counseling in primary care setting for alcohol misuse and tobacco use; tobacco cessation counseling in the primary care setting will be limited to eight visits per year

• Dietary counseling for adults with hyperlipidemia, hypertension, Type 2 diabetes, obesity, coronary artery disease and congestive heart failure; limited to six visits per year


• Cervical cancer screening

• Screening of pregnant women for anemia, iron deficiency, bacteriuria, hepatitis B virus and Rh factor incompatibility

• Advice to promote and aid with breast-feeding

• Mammography screening at age 40 and over, and evaluation for genetic testing for BRCA breast cancer gene

• Osteoporosis screening (age 60 or older)

• Counseling women at high risk of breast cancer for chemoprevention, including risks and benefits


• Prostate cancer screening at age 50 and older

• Abdominal aortic aneurysm screening at age 65 – 75


• Newborn screening for hearing, phenylketonuria (PKU), thyroid disease, sickle cell anemia and cystic

• Development delays and autism screenings

• Iron deficiency screening

• Vision screening

• Screening for major depressive disorders

Please note that annual limits apply to some: for instance, I have two physicals a year to monitor a personal health condition. One of those will be considered a free preventative health screening, the other will be considered diagnosis-related and applied toward my HDP deductible.
Never neglect your health, but it is always a good idea to have your doctor check with BCBS for coverage before undertaking any potentially expensive procedure. Knowing up front prevents surprises after the fact.

Friday, March 04, 2011

High Deductible Plans and Medicare Part B Don't Go Together

Those of you who have reached or are approaching age 65 have an extra decision to make regarding our Open Enrollment. You are or soon will be enrolled in Medicare Part A, which is free and automatic for U.S. citizens. This covers hospitalization, nursing homes, skilled nursing facilities, and some home health. This does not impact your group insurance decision at all.

What is an issue is whether or not you should take Medicare Part B, which covers physicians, outpatient procedures, and durable medical equipment. Part B must be elected and will cost you, for this year, at least $1,384.80 for the next 12 months. In our opinion, and that of our broker Corporate Benefits Alliance, this coverage will not pay more in benefits than you'll pay in premium (see chart).

Now before your eyes gloss over, let's walk through it.

Medicare pays 80% (you pay 20%) after a $162 deductible. Medicare is always the payer of last resort, but it will pay its portion between the $162 Medicare deductible and the $1,200 Blue Cross deductible. That totals $830 in benefits ($1,200 - $162 deductible = $1,038 x 80%).

After you've reached $1,200 in medical bills your Blue Cross insurance kicks in at 80%, making Medicare secondary. In the coordination of coverage rules for Medicare, it will pay whatever Blue Cross does up to the limits of Medicare's coverage. Because Blue Cross pays 80%, and Medicare pays 80%, Medicare will pay nothing else. You pay 20% until your total out of pocket reaches $8,800 (a rarity)and then Blue Cross pays 100%.

The coordination of these two coverages means that you'll pay $567 more in Part B premium that you'll ever receive in benefits.

Bottom line: if you have Parts A and B you don't need to elect our coverage. If you have Part A and want a Blue Cross High Deductible Plan you should not elect Medicare Part B.

Thursday, March 03, 2011

Guest Post: "Why was that High Deductible Plan so SCARY?" by Matt McCurry

Let’s face it : most of us like security. When it comes to our health I would venture to guess that we all love security. Health, and the lack there of, can be a scary thing , and that’s why I was willing to pay for “peace of mind”. Two years ago I subscribed to the theory that paying the highest insurance premium had to be cheaper than paying the doctor or hospital for their services out of my own pocket. It also gave me the sense of security I was looking for in regard to my family’s health. I was married , we had just had our son , and I knew we would be going to the doctor quite a bit because that’s what infants like to do.

So what changed my our mind? Our wonderful HR department had just sent out the new insurance premiums , and after I picked myself up off the ground I decided that I really need ed to weigh out every option. I read up on this crazy thing called an HSA and found it to be quite intriguing. Not only was it a way for us to save up for medical expenses , but it was also an investment opportunity. What!?! I know - how amazing is that? So after looking at the traditional PPO premium (which I think was around an appendage per pay period ) and the High Deductible Plan premium I decided to dig in and run the numbers.

I won’t bore you with the details but the numbers blew my mind . It was painstakingly obvious that the HDP was the better option. When I came to work that Monday I discussed it with a coworker who had gone through the same exercise that weekend. After we ran the numbers about 50 different ways, and even though it was counterintuitive to everything we had known, I decided that this was our new plan.

Instead of paying money to an insurance company on the front end that would pay my bills IF we had them, it would be better to save that money and pay the higher deductible. By applying the difference between the two premiums into an HSA , in six months we had the funds available to cover the higher deductible. What about those first six months? It can be a concern , but it went by faster than I thought and the funds were in place before I knew it.

This is my experience and I have to say it was one of the best decisions my family has made in regard to our finances. We have been doing this for two years and this year we met the full deductible. At the end of the day we still spent less. I encourage everyone to at least consider the High Deductible Plan ; you might just be surprised.

Tuesday, March 01, 2011

S and P Network Hospitals

With the start of Open Enrollment, one of the biggest issues for Tennessee staff is whether to take a plan with the Blue Cross Blue Shield network S or network P. The most common question is, "What's the difference?"

Well, here you go:

Hospitals in the S Network include Vanderbilt, St. Thomas, Baptist, Nashville General, Williamson Medical Center (Franklin), University Medical Center (Lebanon), and Middle TN Medical Center (Murfreesboro).

The HCA hospitals, which are in the P network but not in the S Network, include: Centennial, Southern Hills, Summit, Skyline, Stonecrest, & Hendersonville Medical Center.

A complete list of P and S network providers can be found here. Note that there are several network listed on that page but only P and S are available in our plan.

A complete list of HCA hospitals, none of which are available in the S network, can be found here.

As always, see any member of your Human Resources team with any questions you might have.