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Employers with Health Plans: PCORI Fee Due July 31

Tue, 07 Jul 2026 00:41:22 GMT

Who Owes It, How Much It Is, and How to Pay on Time

If you sponsor a health plan, you’ve probably seen “PCORI fee” show up on a compliance calendar and wondered whet her it applies to you. Here’s some relief up front. For many employers it takes very little work, and some don’t have to do anything at all. Let’s walk through what the fee is, who actually owes it, and what to do before July 31.

What the PCORI Fee Is

The PCORI fee was created under the Affordable Care Act. It helps fund the Patient-Centered Outcomes Research Institute, which studies how well different medical treatments and care options work. Insurers and certain employers pay it once a year to support that research. The fee is currently scheduled to stay in place for plan years ending before October 2029.

Who Owes It

This is the part worth getting right, because it splits employers into two groups.

If you have only fully insured health plans , your insurance carrier handles the fee. You don’t file anything. The cost is built into your premium, so there’s nothing more for you to do.

If you sponsor a self-insured health plan , the responsibility is yours. That includes level-funded plans and most health reimbursement arrangements (HRAs), such as ICHRAs and QSEHRAs. You file and pay the fee directly to the IRS.

A few things are not subject to the fee, including standalone dental and vision coverage, most health FSAs, and HSAs.

How Much It Is

The fee is your average number of covered lives multiplied by a per-person rate that the IRS adjusts each year. For the filing due July 31, 2026, which covers plan years that ended in 2025, the rate depends on your plan year end date:

Plan years ending January through September 2025: $3.47 per covered life
Plan years ending October through December 2025: $3.84 per covered life

So a calendar-year plan that ended December 31, 2025, uses the $3.84 rate.

How to Count Covered Lives

The IRS allows a few methods to find your average covered lives, including the actual count method, the snapshot method, and the Form 5500 method. For an HRA, you generally count only covered employees, not their dependents.

Your third-party administrator can usually pull these numbers for you, though the fee itself stays your responsibility as the plan sponsor.

How to File

You report and pay the fee on IRS Form 720, the Quarterly Federal Excise Tax Return. A few details to keep straight:

File it on the second-quarter Form 720, even though PCORI is an annual fee
Use the most current version of the form, which the IRS updates each spring
If PCORI is your only excise tax, you file Form 720 just once for the year

One more note: The fee comes out of your company’s general assets. This means you can’t pay it from plan assets or employee contributions.

If the Deadline Sneaks Up on You

Unlike Form 5500, there’s no extension available for the PCORI fee, so July 31 is the date to circle. If you do file late, the IRS can apply failure-to-file and failure-to-pay penalties plus interest, though you may be able to request relief if you had reasonable cause.

The bottom line is simple. If your plan is fully insured, you can likely relax and let your carrier take care of it. If you’re self-insured or you offer an HRA, set aside a little time before the end of July to run your numbers and file. And if you’re not sure which group you fall into, that’s exactly the kind of question we’re glad to help you sort out.

This article is for general informational purposes only and is not legal or tax advice. The rules and rates can change, and your situation may differ. Confirm your obligations with a qualified benefits advisor, third-party administrator, or tax professional, and check the latest guidance at IRS.gov.

Paycheck Replacement When You’re Sick or Hurt: Disability Coverage

Wed, 01 Jul 2026 06:00:01 GMT

Why You Need Short- and Long-Term Disability Coverage

Nobody plans on getting hurt or sick. But the reality is that an unexpected illness or accident could sideline you from work for weeks, months, or even years. And while your paycheck stops, your bills don't. That's the gap disability insurance is designed to fill.

The Income Risk Most People Overlook

For many, the ability to earn a paycheck is their most valuable financial asset. Yet most of us insure our cars, homes, and even our phones long before we think to insure our income.

According to the Social Security Administration, about one in four of today's 20-year-old workers will experience some kind of disability, either short-term or long-term, before reaching retirement. And per the U.S. Bureau of Labor Statistics, only about 35% of private industry workers have access to employer-sponsored disability coverage. That leaves the majority of American workers, and their families, without a financial safety net for a significant risk.

Health insurance covers medical bills, but it doesn't cover your mortgage, your groceries, your car payment, or your kids' tuition if you find yourself unable to work. That's where disability insurance steps in.

What Disability Insurance Actually Does

Disability insurance replaces a percentage of your pre-disability income if you're unable to work due to illness or injury. This is why it is also commonly called income protection. It helps you keep paying the bills, maintain your standard of living, and protect long-term goals like retirement savings or your children's education.

There are two main types of policies to consider:

Short-term disability coverage typically replaces a portion of your income for a few months while you recover from a covered illness or injury.
Long-term disability coverage kicks in after short-term benefits end and may continue for years, depending on the policy.

Integrated short- and long-term coverage is an option that combines both into a single, coordinated plan. The right kind for you depends on your income, savings, dependents, and existing employer benefits.

Two Key Protection Features to Understand

When comparing policies, two terms come up frequently:

Non-cancelable. The insurance company cannot cancel your policy, raise your premium, or reduce your benefits as long as you keep paying your premium. This is often considered the strongest form of policy protection.

Guaranteed renewable. The insurer can't cancel your policy and must continue your benefits, but the company may raise premiums over time, typically across policyholders rather than individually.

Both kinds offer meaningful protection. The right choice depends on how much premium stability matters to you.

Common Policy Options and Riders

Beyond the base policy, you can often customize coverage with optional features called "riders." Here are some of the most useful ones to know about:

Additional purchase option: Lets you buy more coverage later, often without a new medical exam.
Coordination of benefits: Sets a target benefit amount across all your income-replacement sources. The policy makes up any difference not paid by other coverage.
Cost-of-living adjustment (COLA): Increases your benefit over time based on changes in the Consumer Price Index. This helps your benefit keep pace with inflation, though it usually comes with a higher premium.
Residual or partial disability rider: Allows you to return to work part-time, earn partial wages, and still receive a partial benefit while you continue to recover.
Return of premium: Refunds a portion of your premiums if you don't file a claim during a specified period. Terms vary by policy.
Waiver of premium: Pauses your premium payments once you've been disabled for a set waiting period, often 90 days, so your coverage continues without out-of-pocket cost while you're unable to work.

Don’t Put it Off

Disability insurance is about planning for a worst-case scenario so you feel prepared for just about anything. It's about protecting the life you've worked hard to build, so that a setback doesn't become a financial crisis. Whether you're early in your career, raising a family, or approaching retirement, having the right combination of short- and long-term coverage can help you focus on getting better instead of worrying about how to pay the bills.

Every situation is different. A licensed insurance professional can help you compare options, understand the fine print, and find coverage that fits your budget and your needs.

Short- and Long-Term Disability for Your Workforce

Wed, 24 Jun 2026 06:00:30 GMT

Why Income Protection Matters for Your Team

As an employer or benefits manager, you already know that a strong benefits package is one of the most powerful tools you have for attracting and retaining talent. Health insurance, retirement plans, and paid time off are table stakes. But there's one coverage category that often gets less attention than it deserves: short-term and long-term disability insurance.

For your employees, it's a financial safety net during a tough phase. For your business, it's a meaningful way to demonstrate that you value the people behind the work.

A Coverage Gap You Can Help Close

According to the U.S. Bureau of Labor Statistics, only about 35% of private industry workers have access to employer-sponsored long-term disability insurance. That leaves the majority of American workers without protection against a significant financial risk.

Meanwhile, the Social Security Administration estimates that about one in four of today's 20-year-old workers will experience some form of disability before reaching retirement age. The conditions involved aren't always what people expect. Most long-term disability claims are tied to illnesses, not workplace accidents, including musculoskeletal issues, cancer, cardiovascular events, and mental health conditions.

For employers, this coverage gap creates an opportunity: offering disability insurance is one of the most cost-effective ways to round out a benefits package and stand out in a competitive labor market.

Why It Matters for Employers, Not Just Employees

Disability insurance is often viewed as a personal benefit, but the business case is just as compelling. Offering STD and LTD coverage can help:

Strengthen recruiting and retention. Comprehensive benefits packages consistently rank among the top factors employees consider when choosing or staying with an employer.
Reduce financial stress in the workforce. Employees who know their income is protected during a medical leave tend to focus on recovery rather than financial worry, which can support a smoother return to work.
Support productivity and morale. A clear, predictable disability benefit signals stability and care, which contributes to a healthier workplace culture.
Complement existing leave policies. Disability coverage works alongside FMLA, paid leave, and workers' compensation to create a more complete approach to employee well-being.
Offer favorable economics. Bureau of Labor Statistics data suggests employer costs for disability coverage are often a small fraction of total compensation, making it one of the more affordable benefits to add or expand.

Understanding the Two Layers of Protection

Many employer-sponsored disability programs include one or both of the following:

Short-term disability (STD) replaces a portion of an employee's income for a limited period, often several weeks to several months, after a brief waiting period. It's designed to bridge income during recovery from a covered illness, injury, surgery, or childbirth.

Long-term disability (LTD) kicks in after short-term benefits are exhausted and can continue for a longer duration, sometimes for several years or even until retirement age, depending on plan design. LTD is critical for protecting employees against serious, prolonged conditions that prevent them from returning to their occupation.

Many employers offer integrated STD/LTD plans so the two layers coordinate seamlessly, eliminating gaps and simplifying administration.

Key Plan Features to Evaluate

When evaluating group disability options, here are the features that tend to have the biggest impact on both cost and employee value:

Benefit percentage. Most plans replace a portion of an employee's pre-disability income. Industry benchmarks commonly fall around 60%, though plans vary.
Elimination period. This is the waiting period between the onset of disability and when benefits begin. Longer elimination periods generally mean lower premiums.
Benefit duration. STD durations typically run several weeks to several months; LTD durations can extend for years or to retirement age.
Definition of disability. "Own occupation" definitions provide stronger protection for employees, while "any occupation" definitions are typically more restrictive and less costly.
Maximum monthly benefit cap. Important to consider if you have higher-earning employees whose income may exceed the standard cap.
Coordination with other benefits. Group plans typically coordinate with Social Security Disability Insurance and other income sources.

Common Optional Features to Consider

You can often customize coverage with optional plan provisions, or "riders." Some that may add value for your workforce include:

Cost-of-living adjustment (COLA). Helps benefits keep pace with inflation over a long claim.
Residual or partial disability benefits. Allows employees to return to work part-time and still receive a partial benefit while continuing to recover.
Waiver of premium. Pauses premium payments after an employee has been disabled for a set period, often 90 days, so coverage continues uninterrupted.
Employee buy-up options. Lets employees voluntarily increase their coverage at their own cost, giving them flexibility without adding to your base benefit spend.
Survivor benefits. Provides a lump-sum payment to an employee's family if they pass away while receiving LTD benefits.

Employer-Paid, Voluntary, or a Mix?

You have flexibility in how to structure disability benefits:

Employer-paid plans cover the full cost, providing a baseline benefit for all eligible employees. This option tends to deliver the strongest recruiting and retention impact.
Voluntary (employee-paid) plans let employees choose and pay for coverage themselves, often at group rates that are more affordable than individual policies.
Contributory plans split the cost between yourself and employees, offering a middle path.

There are also tax implications. When you pay the premium with pre-tax dollars, benefits received by the employee are generally taxable. When the employee pays with post-tax dollars, benefits are typically tax-free. A licensed advisor or tax professional can help you weigh the options.

Getting Started

Adding or improving disability coverage doesn't have to be complicated. A few practical first steps:

Review what you already offer. Identify any gaps between your current STD and LTD coverage, or lack thereof, and what employees actually need or expect.
Benchmark against your industry. Comparable employers in your region and sector often set the bar for what your workforce expects.
Survey or talk to employees. Understanding what your team values helps you prioritize the right enhancements.
Consult a licensed group benefits broker. A knowledgeable broker can help you compare carriers, plan designs, and pricing without obligation.

Whether you're starting from scratch, expanding an existing benefits package, or simply re-evaluating your current plan, a conversation with a licensed group benefits professional can help you find the right fit for your business and your people.

ER, Urgent Care, or Primary Care?

Fri, 19 Jun 2026 06:00:00 GMT

A Practical Guide to Knowing Where to Go

It's Saturday afternoon. Your child takes a tumble at the park and his knee is swelling up. Your regular doctor's office is closed. The emergency room sounds like overkill. The urgent care across town is open, but you're not sure if it can handle this kind of thing.

Moments like these are exactly when knowing your options pays off, both for your peace of mind and your wallet.

It Matters More Than Most People Realize

Where you go for care can have a dramatic impact on what you pay. According to multiple healthcare cost trackers, the average emergency room visit can run anywhere from $1,200 to $3,000 or more, and copays are still typically several hundred dollars. Meanwhile, an average urgent care visit typically lands in the $100 to $250 range for the same kind of non-emergency issue, and copays for urgent care visits can be as low as $50.

Research has also suggested that 30% to 50% of emergency room patients could have been treated effectively at an urgent care center , often at a fraction of the cost. That's not just a financial issue. ER overcrowding can mean longer waits for people experiencing true life-threatening emergencies.

The lesson here is that choosing the right "door" for the right situation isn't just about money. It's about getting the best care.

What Urgent Care Does Well

Urgent care centers are designed for the gray zone: situations that need attention quickly, but aren't true emergencies. Most centers can:

Treat common illnesses like colds, flu, strep, and stomach bugs
Handle minor injuries such as sprains, mild burns, and shallow cuts
Perform basic X-rays, lab work, and rapid tests
Provide sports physicals, work physicals, and travel vaccines
Manage straightforward conditions outside regular business hours

For relatively healthy people with a one-off issue, it's often a great fit.

When Urgent Care May Not Fit

Urgent care has a few limitations that are important to keep in mind:

Complex or chronic conditions. Urgent care providers don't typically have access to your full medical history. For ongoing or complicated issues, your primary doctor is in a better position to connect the dots.
Severe or unusual symptoms. If something feels seriously wrong, the ER has the equipment, imaging, and specialists urgent care doesn't.
Older adults and people with significant medical histories. When an urgent care provider is meeting you for the first time, there’s a higher risk that they could miss a previous diagnosis or a medication interaction.
Routine preventive care. Annual physicals, screenings, and care plans are best handled by a primary care provider who can track your health over time.

A useful rule of thumb: urgent care is great for episodes, while primary care is built for patterns.

A Decision Framework

When you need medical support, you usually have four options to consider. Here's a rough framework:

1. Call 911 or go straight to the ER if:

Symptoms suggest a heart attack, stroke, or major trauma
There's uncontrollable bleeding, difficulty breathing, severe chest pain, or loss of consciousness
A serious injury to the head, spine, or possible broken bones with deformity
A child has a high fever that doesn’t come down after giving over-the-counter fever reducing medications

When in doubt, the ER is still your fallback plan. No financial concern is worth risking a life-threatening situation.

2. Visit urgent care if:

You're dealing with minor cuts, sprains, infections, sore throats, ear pain, rashes, urinary symptoms, or low-grade fevers
The issue is non-life-threatening but can't wait for a regular appointment
Your primary care office is closed or fully booked

3. Try telehealth or a virtual visit if:

Symptoms are relatively mild and don't require physical examination
You need a prescription refill, a quick consultation, or guidance on whether to seek further care
Your insurance plan includes it as a covered benefit

4. Call your primary care provider if:

The issue isn't urgent and can wait
You're managing a chronic condition or need ongoing care
You want continuity, meaning a provider who knows your full health history

Many primary care offices reserve same-day slots for sick visits, so a quick phone call to your doctor's office is often a smart first step before heading anywhere else.

A Few Insurance-Specific Tips

This is where a little preparation can save real money:

Know what's in-network. Both urgent care centers and ERs can be in or out of network, and out-of-network care typically costs more. Check your insurance card, member portal, or call the number on the back of your card to confirm before you go, when time allows.
Understand your copays. Look at the back of your insurance card or your benefits summary. Many plans list separate copays for primary care, specialist, urgent care, ER, and telehealth visits.
Ask about facility fees. Hospital-based urgent care centers, and freestanding ERs that look like urgent cares, may bill at higher rates than independent urgent care clinics. When in doubt, ask before you're seen.
Don't skip the after-visit summary. If you go to urgent care, request a summary of your visit and share it with your primary care provider.
Use telehealth when it fits. Many plans offer telehealth benefits at little to no out-of-pocket cost. It's worth checking what's included in your coverage.

A Little Prep Goes a Long Way

The best time to figure out your options isn't in the middle of an emergency. Before you need care:

Identify two or three in-network urgent care centers near your home and workplace
Save your insurance plan's nurse hotline or telehealth number in your phone
Know your primary care provider's after-hours protocol
Keep a list of your medications and allergies somewhere easy to grab

A few minutes of preparation now can save a lot of stress and poor decisions later.

Conclusion

Used wisely, urgent care is a fast, affordable bridge between your doctor's office and the emergency room. Knowing which door to walk through in different situations is one of the most practical health skills you can build.

If you have questions about what your specific health insurance plan covers, your insurance agent or member services team can help you understand the details.

Hidden Health Plan Cost Drivers Employers Shouldn’t Ignore

Mon, 15 Jun 2026 14:43:59 GMT

The Health Plan Cost-Reduction Opportunities That Are Flying Under Your Radar

Premium hikes get all the attention. But for many employers, the bigger cost problems a re hiding in plain sight. They're embedded in gaps your current plan may not be addressing at all, and year after year they quietly add up.

Here are three areas worth a closer look.

Addiction Support Services

Behavioral health, and particularly substance use disorders, remains one of the most expensive and least efficiently managed areas of employer-sponsored health care.

Untreated mental health and addiction issues contribute to higher medical claims, absenteeism, and lost productivity. According to the Center for Prevention and Health Services, untreated mental health concerns can cost a single organization tens of thousands of dollars annually and amount to more than $100 billion nationwide.

Despite those figures, addiction and recovery services have historically received less attention than other wellness initiatives. Inpatient treatment models can be disruptive for employees and expensive for employers, while high relapse rates have made some organizations hesitant to invest more heavily in this space.

But that hesitation has a price tag that shouldn't be ignored.

Employer opportunity: More employers are moving toward structured recovery programs that emphasize ongoing support, medication-assisted treatment, and measurable outcomes. It's a shift from one-time intervention toward sustained accountability, and early results are promising.

Improving Access to Specialty Care

Employees may technically have coverage, but long wait times for specialists can delay treatment and worsen underlying conditions. Nationally, more than 100 million specialty referrals are issued each year, yet patients in many metropolitan areas wait more than a month to see specialists such as gastroenterologists, dermatologists, or cardiologists.

When employees cannot access specialty care in a timely manner, they are more likely to rely on emergency rooms or urgent care, which drives up costs.

Employer opportunities: Some employers are responding by supplementing traditional plans with specialty telehealth solutions or third-party platforms that shorten wait times and improve care coordination.

Before adding anything, it's worth surveying your employees directly. You may find the gaps are more specific, or more serious, than you expected. This allows you to target the most impactful solutions.

Using Your Own Data

Most employers have more information about their workforce's health patterns than they realize, but many just aren't using it.

Carrier-provided dashboards, health risk assessments, and plan modeling tools can show you where utilization is running high, where employees aren't engaging with available programs, and where cost trends are moving in the wrong direction.

Employer opportunities: Reviewing claims data quarterly, rather than annually, gives you a much clearer picture of what's working and what isn't. Understanding which programs are being under-utilized can show you where you have education opportunities with your workforce. Closely assessing usage data for all areas of your benefits package can allow an employer to spot waste, redirect spending, and build a benefits package that actually reflects how employees use their coverage rather than relying on theoretical models. You can also quickly spot which interventions are producing results and which benefits areas are at risk.

That kind of visibility allows organizations to refine benefits with greater precision and financial discipline.

A Practical Starting Point

Rising health care costs aren't going away anytime soon, but understanding where the less obvious cost drivers are gives you a better chance of addressing them.

Start by auditing what data you already have access to. Work with your broker to find solutions to specialty access gaps in your area. And take an honest look at how your current plan handles behavioral health and addiction support.

Small adjustments in these elements of your health plan can have a real impact on the people who are depending on your plan, and on your bottom line.

Supplementing with Accident Insurance

Wed, 27 May 2026 06:00:06 GMT

A Smart Move for Those on an HDHP

High-deductible health plans (HDHPs) have become increasingly popular, especially among younger and healthier individuals looking to save on monthly premiums. But while these plans can lower upfront costs, they often come with a significant tradeoff: higher out-of-pocket expenses when you need care.

An unexpected accident, like a broken bone or a trip to the emergency room, can quickly add up to thousands of dollars in medical bills. Many plans have a $5000 or $6000 deductible that has to be paid before your health insurance begins to pay. For many households, that kind of financial hit can be difficult to manage.

That’s where accident insurance can help.

What Is Accident Insurance?

Accident insurance is a type of supplemental coverage that pays you cash if you’re injured in a covered accident. Benefits are typically paid as a lump sum or as scheduled payments, based on the type of injury and treatment received. And most importantly, unlike traditional health insurance, payments are made directly to you, not to the doctor or hospital. This means it’s flexible. You can use it for:

Deductibles, copays, and coinsurance
Emergency room and ambulance bills
Physical therapy or rehabilitation
Rent, groceries, or utilities
Childcare, transportation, or other daily expenses

Why It Works Well with HDHPs

HDHPs require you to cover more costs up front before insurance kicks in. A single accident can trigger expenses for ER visits, imaging, surgery, and follow-up care. All of that adds up quickly. With accident insurance, the policy pays cash benefits that can offset those out-of-pocket costs. It doesn’t replace your health plan; it simply adds an extra layer of financial protection.

What Does It Typically Cover?

Coverage varies by policy, but most accident insurance plans include benefits for common injuries and related treatments, such as:

Slips, falls, and sports injuries
Car or bicycle accidents
Burns, cuts, and concussions
Broken bones and dislocations
Emergency dental work after an accident
Hospital stays, surgery, or ICU care

Some plans also include benefits for more serious issues, such as coverage for paralysis, dismemberment, or accidental death.

Easy to Get, and Affordable

One of the biggest advantages of accident insurance is how simple it is to enroll. Many plans require little to no medical underwriting, meaning you may not need a medical exam. Coverage is often available through employers or directly from an insurance agent.

It’s also relatively affordable. Many individual plans cost between $6 and $20 per month, with higher premiums for family coverage. Pricing is usually based on age rather than health status. Keep in mind that accident insurance does not replace comprehensive health insurance. Benefits are paid according to a set schedule, with limits per accident or per year.

If you have a high-deductible health plan, accident insurance can help protect you from the financial impact of unexpected injuries. Let's talk about about available plans.

Helping Employees Understand and Use HSAs

Wed, 20 May 2026 06:00:03 GMT

A simple guide for employers to help teams maximize HSA benefits

Health Savings Accounts (HSAs) are one of the most powerful, and often underutilized, tools in an employer’s benefits package. While many employees have heard of HSAs, fewer fully understand how they work or how much value they can provide over time. As an employer, helping your team understand HSAs can lead to better engagement, smarter healthcare spending, and increased appreciation for your benefits offerings.

Below is a basic primer on the value of HSAs that you can share with your employees, or weave into your enrollment and education materials. For some of your team members, HSAs may be the most important benefit they aren’t using.

Why HSAs Are So Valuable

HSAs offer a unique combination of tax advantages and flexibility that make them stand out from other healthcare accounts.

Triple tax advantage
HSAs are one of the only accounts that offer three layers of tax benefits:

Contributions are tax-deductible
Funds grow tax-free
Withdrawals for qualified medical expenses are tax-free

Funds never expire
Unlike FSAs, HSA funds roll over year after year. Employees can build a balance over time and use it when they need it, whether that’s next month or years down the road.

Employee ownership
The account belongs to the employee, not the employer. If they change jobs or retire, the funds go with them.

Long-term savings potential
Some HSA providers allow employees to invest their balances, turning HSAs into a valuable tool for saving toward future healthcare expenses, including costs in retirement.

What HSAs Can Be Used For

HSA funds can be used for a wide range of qualified medical expenses , including:

Doctor visits and hospital services
Prescription medications
Dental and vision care
Medical equipment and supplies

In many cases, these expenses can be paid directly from the HSA or reimbursed later.

How Employees Enroll in an HSA

To open and contribute to an HSA, employees must be enrolled in a qualified High Deductible Health Plan (HDHP) .

Enrollment typically happens during:

Open enrollment , or
A qualifying life event

Once enrolled in an eligible plan, employees can:

Elect HSA contributions through payroll deductions
Receive employer contributions, if offered
Set or adjust contribution amounts (within IRS limits)

How Employees Use Their HSA

One of the most common questions employees have is: “How do I actually use the money in my HSA?”

The great answer is that there are a few flexible options .

1. Pay directly from the HSA
Most HSA accounts come with a debit card that employees can use to pay for qualified expenses at the time of service.

2. Pay out of pocket and reimburse later
Employees can choose to pay for medical expenses themselves and reimburse themselves from their HSA at any time—even years later, as long as they keep proper records.

3. A combination of both
Many employees use a mix of both strategies, covering some expenses directly while allowing their HSA balance to grow for future needs.

Supporting Employee Understanding

Because HSAs are different from other parts of a traditional healthcare plan, education is key. Employers can help by:

Providing simple, clear explanations during enrollment
Offering real-life examples of how HSAs are used
Encouraging questions and ongoing engagement
Highlighting both short-term and long-term benefits of HSAs

Key Takeaway

HSAs are more than just a way to pay for healthcare, they’re a financial tool that can support employees both now and in the future. By helping your team understand how HSAs work and how to use them effectively, you’re not just offering a benefit, you’re helping them build financial confidence and security. Education on HSAs demonstrates your business’s commitment to your employees’ overall health and well-being.

How to Cover Your Expenses If You’re Sidelined by a Serious Illness

Wed, 13 May 2026 06:00:21 GMT

Is Critical Illness Insurance Right for You?

A serious illness can turn your life upside down in more ways than one.

While your health insurance may help cover ma ny of your medical expenses, it typically doesn’t replace your income, or cover the everyday bills that keep your household running. Think about your mortgage/rent, car payments, utilities, groceries, credit cards…. when you’re unable to work, those expenses don’t pause.

Even worse, stressing about these costs isn’t a good way to speed up your recovery.

So how do you bridge that financial gap?

A Financial Safety Net: Critical Illness Insurance

One option many people overlook is critical illness insurance —a type of coverage designed to provide financial support when you are struggling with health issues.

If you’re diagnosed with a qualifying serious condition, a critical illness policy can provide a lump-sum cash benefit that could make a meaningful difference while you are trying to recover.

Unlike some other types of coverage, this money is typically flexible. You can use it for whatever makes the most sense for your situation, such as:

Household bills (mortgage, rent, utilities)
Out-of-pocket medical costs like deductibles or copays
Transportation or caregiving expenses
Everyday living expenses while you recover

This flexibility can be especially helpful during a time when your focus should be on healing, rather than finances.

What Conditions Are Typically Covered?

Coverage varies by policy, but most plans focus on serious health events such as:

Heart attack or stroke
Cancer
Organ damage

Some policies may also cover additional conditions, including:

ALS (Lou Gehrig’s disease)
Blindness or deafness
Paralysis
Severe burns
Coma
Lupus or cystic fibrosis

Because coverage can differ significantly, it’s important to review the details of any policy carefully.

How It Compares to Disability Insurance

You may be wondering how critical illness insurance compares to disability insurance.

Both can help protect your finances if your health prevents you from working—but they work differently:

Disability insurance typically replaces a portion of your income over time if you’re unable to work.
Critical illness insurance provides a lump-sum payment after a qualifying diagnosis.

Critical illness coverage is often more affordable, though it generally provides a smaller total benefit compared to long-term disability insurance.

For some individuals, the two types of coverage can complement each other.

What Does It Cost?

One of the reasons critical illness insurance is gaining attention is affordability.

While premiums vary based on age, health, and coverage amount, many plans are relatively budget-friendly. For example, some plans cost as little as $10/month for $10,000 in coverage, and $20–$50/month for $50,000 in coverage.

These benefits can make a meaningful difference, especially for those with high-deductible health plans or limited emergency savings.

Important Things to Consider

Before choosing a policy, keep a few key points in mind:

1. Covered Conditions Vary

Some policies only cover cancer, while others include a broader range of illnesses.

2. Waiting Periods May Apply

Most policies have a waiting period (often 30–90 days) before benefits are payable.

3. Pre-Existing Conditions May Not Be Covered

If you’ve already been diagnosed with a condition, it typically won’t qualify for immediate coverage.

4. Coverage Limits Exist

Many policies cap benefits (often around $50,000, though higher limits may be available).

Is It Right for You?

Critical illness insurance isn’t one-size-fits-all, but it can be a valuable addition to your financial protection strategy. It may be worth considering if covering expenses during time off work would be challenging or if you want added financial flexibility during recovery.

How to Drive Employee Benefits Engagement

Thu, 07 May 2026 19:55:51 GMT

7 Strategies to Maximize Adoption of Benefits

Employers know that many valuable benefits go unused simply because employees forget about them or don’t fully understand how they work. So what can you do? The answer is simple, but requires continued attention: treat benefits communication like a marketing campaign to extend engagement after open enrollment.

In other words, benefits communication should not stop once enrollment is complete. Organizations that take a proactive, marketing-style approach to benefits education often see higher utilization and stronger employee satisfaction.

1) Treat Benefits Communication Like a Marketing Campaign

Many HR leaders are beginning to approach benefits communication the same way marketers approach customer outreach. Employees are busy and often overwhelmed with information. Research suggests people may need to see a message seven or more times before it truly sticks. Reinforcing key benefits messages throughout the year helps keep them top of mind.

2) Use Vendor and Carrier Marketing Materials

Insurance carriers and benefits providers often supply helpful educational materials such as videos, FAQs, infographics, and short guides. Rather than relying solely on lengthy benefits documents, employers can share these visual materials to explain coverage options and services in simpler ways. Some carriers also offer co-branded materials that can be tailored to your organization.

3) Lean on Your Broker and Insurance Representatives

Brokers and insurance representatives can be valuable partners in employee education. They can help organizations:

Host lunch-and-learn sessions
Provide educational webinars
Lead Q&A sessions during the year
Offer presentations about specific benefits

These events give employees an opportunity to ask questions and better understand their options.

4) Communicate Across Multiple Channels

Not every employee reads every email. That’s why benefits communication works best when it appears across multiple channels. Employers may want to share benefits reminders through:

Email announcements
Slack or Teams messages
Intranet posts
Digital signage or breakroom posters
Benefits portals

This multi-channel approach increases the chances employees will see and remember the information.

5) Segment Messages for Different Employee Groups

Different employees may be interested in different benefits depending on their life stage. For example, younger employees may focus on mental health resources or student loan benefits, while employees with families may be more interested in pediatric care or childcare support. Targeted messaging helps employees see the benefits that matter most to them.

6) Make Benefits Easy to Access

Employees are far more likely to use their benefits when information is easy to find. Creating a centralized benefits hub or intranet page can help employees quickly locate plan details, vendor materials, and contact information. Some employers also use QR codes on posters or flyers to direct employees to digital resources.

7) Use Real Examples and Testimonials

Employees often respond more strongly to real stories than to policy explanations. Sharing examples of how coworkers have used telehealth, wellness programs, or other benefits can help employees understand how those resources apply to their own lives.

Employers that adopt some or all of these tactics can improve employee engagement, increase satisfaction, and maximize the return on their benefits investment. Talk to your benefits advisor for recommendations.

Prescription Drug Costs Becoming a Major Challenge for Employer Health Plans

Wed, 29 Apr 2026 16:00:10 GMT

How some employers are tackling the challenge

For many employers, managing the cost of health benefits has always been a balancing act. Companies want to offer competitive coverage that supports employee health and retention, but they must also keep benefit costs sustainable. In recent years, one area has become increasingly difficult to control: prescription drug spending.

While overall healthcare costs continue to rise, prescription drugs—particularly specialty medications—are now one of the fastest-growing components of employer health plan costs. As a result, many employers are rethinking how pharmacy benefits are designed and managed.

Prescription Drug Costs Are Rising Faster Than Overall Healthcare Spending

Recent employer health benefit surveys show that prescription drug spending is not only rising—it is growing faster than overall healthcare costs in many employer-sponsored plans. Pharmacy expenses have become one of the most rapidly increasing components of employer healthcare spending.

For example, Mercer’s National Survey of Employer-Sponsored Health Plans found that prescription drug spending increased about 9.4% among large employers in 2025, while the overall cost of employer health benefits rose about 6% per employee.

Several factors are contributing to this trend. New medications are entering the market at higher price points, more patients are using specialty drugs to treat complex conditions, and certain high-demand medications have become widely prescribed in recent years.

Specialty medications in particular play a large role. Although they represent a relatively small share of prescriptions, they account for a significant portion of total drug spending because of their high cost.

For employers sponsoring group health plans, this means pharmacy benefits can have an outsized impact on overall healthcare spending. Even a modest increase in prescription drug utilization—or the addition of a single high-cost therapy—can noticeably affect premiums and total benefit costs.

Specialty Drugs Drive a Large Share of Spending

One of the biggest drivers of prescription drug costs is the growing use of specialty medications. These drugs are often used to treat complex or chronic conditions such as cancer, autoimmune disorders, multiple sclerosis, and rare diseases.

Although specialty drugs represent a small percentage of total prescriptions, they account for a disproportionate share of overall drug spending. Many of these medications can cost tens of thousands of dollars per year for a single patient.

For employer-sponsored health plans, this means that even one or two employees requiring specialty medications can significantly increase pharmacy costs.

New Drug Categories Are Increasing Demand

In addition to specialty medications, newer categories of drugs are also attracting attention from employers and health plans. One example is the growing use of GLP-1 medications that are used to treat diabetes and obesity.

Drugs in this category have shown promising health outcomes for many patients, but they also come with substantial costs. Some treatments can cost hundreds or even thousands of dollars per month without insurance discounts.

As a result, employers are evaluating whether and how to cover these medications. Some plans cover them broadly, while others apply additional medical criteria or prior authorization requirements.

Increased Focus on Pharmacy Benefit Management

Another area receiving attention is how prescription drug benefits are administered. Most employer health plans rely on pharmacy benefit managers (PBMs) to negotiate prices with manufacturers, manage formularies, and process pharmacy claims.

However, there has been growing discussion about transparency in the PBM system. Employers and policymakers are increasingly interested in understanding how rebates, discounts, and pricing structures affect the actual cost of medications.

In response, some employers are exploring new PBM arrangements that emphasize clearer pricing models and greater visibility into drug spending.

Strategies Employers Are Using to Manage Costs

To address rising prescription drug spending, many employers are adopting new pharmacy management strategies. These approaches aim to balance cost control with appropriate access to medications.

Some common strategies include:

Encouraging the use of generics and biosimilars . These alternatives can provide similar therapeutic benefits at a lower cost than brand-name medications.
Prior authorization and step therapy . These programs help ensure that lower-cost treatment options are considered before higher-cost medications are approved.
Specialty pharmacy programs . These programs help control costs by directing certain high-cost medications to pharmacies that may have negotiated pricing with manufacturers or pharmacy benefit managers. These pharmacies also provide clinical oversight and patient support to help ensure medications are used appropriately and efficiently.
Employee education . Helping employees understand how their pharmacy benefits options, such as using preferred pharmacies or choosing generic medications, can also reduce overall plan costs.

Looking Ahead

Prescription drug costs will likely remain a major topic in employer health benefits discussions. As new therapies continue to emerge and demand for certain medications grows, employers will need to carefully evaluate how their pharmacy benefits are structured.

The challenge is finding the right balance: controlling costs while ensuring employees have access to the medications they need to stay healthy.

For employers, working closely with benefits advisors, pharmacy benefit managers, and carriers can help identify strategies that support both goals. By taking a proactive approach to pharmacy management, companies can better navigate one of the fastest-growing areas of healthcare spending.

Sources:
Mercer. 2025 National Survey of Employer-Sponsored Health Plans.

Business Group on Health. 2025 Employer Health Care Strategy Survey.

Kaiser Family Foundation (KFF). Employer Health Benefits Survey.

Healthcare Finance News. “Employers anticipate 6.7% jump in health benefits costs, finds Mercer.”

HR Dive. “Employers, workers to face healthcare ‘affordability crunch,’ Mercer warns.”

This Insurance Can Pay the Bills if You’re Hospitalized

Wed, 22 Apr 2026 16:00:17 GMT

Hospital Indemnity Insurance Provides a Financial Safety Net

A trip to the hospital can be physically and emotionally draining. It can also be financially stressful. Even with strong health insurance coverage, a hospital stay often leaves patients responsible for deductibles, copays and coinsurance.

Those out-of-pocket costs can add up quickly, especially if the hospital stay lasts several days or requires additional services. For this reason, many individuals and families are turning to hospital indemnity insurance, a type of supplemental coverage designed to help cover the financial gaps that traditional health plans may leave behind.

Hospital indemnity insurance provides cash benefits directly to the policyholder if they are admitted to the hospital. Unlike traditional health insurance, which pays doctors and hospitals directly, these benefits are paid to you. That means you can use the money however you need during recovery.

How Hospital Indemnity Insurance Works

Hospital indemnity insurance is relatively straightforward. When you enroll in a policy, the benefit amounts are predetermined.

Most plans provide a lump-sum payment when you are admitted to the hospital. Many policies also include a daily benefit for each day you remain hospitalized.

Some plans may also provide additional benefits for services such as outpatient surgery, ambulance transportation, emergency room visits, or diagnostic procedures. These payments are typically made regardless of what your primary health insurance covers. In other words, even if your major medical plan pays for most of the hospital bill, you may still receive the cash benefit from your indemnity policy.

Another advantage is that hospital indemnity plans are generally simple to access. Many policies have no deductibles or copays, and in many cases, coverage is available without a medical exam if you enroll when first eligible.

Hospital indemnity insurance is often offered through employers as a voluntary benefit, with premiums conveniently paid through payroll deduction. Some policies are also portable, meaning you may be able to keep the coverage if you change jobs. Or, you can purchase this coverage on your own.

Why Hospital Indemnity Insurance Can Make a Difference

The cost of a hospital stay can be substantial. Even with insurance, patients are often responsible for significant out-of-pocket costs.

At the same time, hospitalization can disrupt normal income if time away from work is required. If you don’t have paid leave or disability coverage, the financial pressure can increase just when expenses are rising.

A hospital indemnity policy can help ease that burden by providing cash benefits that can be used for a wide range of expenses.

For example, the benefit payment could help you:

Pay your health plan deductible or coinsurance
Cover mortgage or rent payments
Keep up with car payments or utility bills
Pay for transportation, meals or childcare
Avoid dipping into savings or using high-interest credit cards

One of the biggest advantages of hospital indemnity insurance is flexibility. Because the benefit is paid directly to you, you decide how the funds are used.

Who Could Benefit Most

While anyone can experience an unexpected hospitalization, certain individuals may find hospital indemnity insurance especially valuable.

People enrolled in high-deductible health plans often face significant out-of-pocket costs before their insurance begins covering services. If a deductible is $1,600, $3,000 or more, even a short hospital stay can create a financial strain.

Individuals with known health risks may also consider this type of coverage. A family history of heart disease, cancer, or other serious medical conditions may increase the likelihood of hospitalization at some point.

Families who are living paycheck to paycheck may find hospital indemnity insurance particularly helpful. Without a financial cushion or savings, unexpected medical costs can quickly become overwhelming.

Workers who lack strong disability or paid leave coverage may also benefit. If missing work would significantly reduce income, the cash benefit from a hospital indemnity policy can help bridge the gap while recovering.

Supplemental Coverage, Not a Replacement for Major Medical

It’s important to understand that hospital indemnity insurance is not meant to replace traditional health insurance. Instead, it is designed to supplement major medical coverage. Your primary health insurance continues to cover medical treatment and hospital care, while hospital indemnity insurance provides cash benefits that can help manage the financial side of recovery.

For many people, the combination of these two types of coverage can provide greater financial protection during unexpected health events.

Planning for the Unexpected

No one plans to be hospitalized, but it’s wise to consider how a hospital stay might affect both your health and your finances.

Supplemental coverage such as hospital indemnity insurance can help reduce the financial stress that often accompanies medical emergencies. By providing cash benefits when you need them most, this type of policy can offer an additional layer of financial protection and peace of mind.

If you’re concerned about how you would handle the expenses that could follow a hospital stay, it may be worth exploring whether hospital indemnity coverage could fit into your overall insurance strategy.

Open Enrollment Is Over — Help Employees Maximize Their Benefits?

Wed, 15 Apr 2026 16:00:18 GMT

5 Ways to Help Employees Make the Most of Their Benefits

Open enrollment often receives the most attention during the benefits cycle. Weeks are spent selecting plans, communicating changes, and guiding employees through enrollment decisions. But once open enrollment ends, many organizations shift their focus elsewhere.

The reality is that the real value of employee benefits happens throughout the year, when employees actually use the programs available to them.

Here are several ways organizations can help employees make the most of their benefits by encouraging a few simple post-enrollment actions.

1) Encourage Employees to Set Up Carrier Accounts

Most insurance carriers offer online portals or mobile apps that allow employees to manage their benefits. These platforms typically provide access to digital ID cards, claims tracking, provider directories, and telehealth services.

Sending a short reminder email encouraging employees to create or update their accounts can make it easier for them to access their benefits when they need them.

2) Remind Employees to Watch for New ID Cards

If employees changed plans during open enrollment, they may receive new insurance cards for themselves or their dependents. Encourage employees to review these cards, store digital copies, and share them with family members who may need them.

3) Promote Preventive Care Early in the Year

Many health plans cover preventive services at little or no cost to employees. Reminding employees early in the year to schedule annual physicals, screenings, or dental checkups can help them begin using their benefits right away while supporting long-term health.

4) Highlight Lesser-Known Benefits

Employees are often surprised to learn about additional programs included in their benefits package. These may include telehealth services, nurse lines, wellness programs, mental health support, or virtual care options.

A short communication campaign highlighting these resources can increase awareness and encourage employees to explore benefits they may not realize they have.

5) Encourage Employees to Review Payroll Deductions

A simple but important step is asking employees to review their first few paychecks after open enrollment. This helps confirm deductions are correct and ensures any enrollment errors are addressed quickly.

While these reminders help employees get started, long-term engagement requires a broader communication strategy.

Closing Words

Open enrollment may be the most visible part of the benefits cycle, but it should not be the only time employees hear about their benefits.

When employees actively use their benefits, everyone benefits. Employees gain better access to healthcare and support services, while employers see improved engagement, stronger workplace wellness, and a greater return on their benefits investment.

Rethinking Your Soft Drink Habits

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

As the summer sun beckons and thirst levels rise, it's tempting to reach for a cold, fizzy beverage. But before you pop open that soda can, consider this: your drink choice has long-term implications for your health.

The Hidden Risks in Your Glass

A comprehensive study by the International Agency for Research on Cancer (IARC) analyzed data from over 451,000 individuals across 10 European countries over a 16-year period. The findings revealed that consuming two or more 250 ml glasses of soft drinks daily—whether sugar-sweetened or artificially sweetened—was associated with a higher risk of all-cause mortality compared to those who drank less than one glass per month .

Delving deeper:

Artificially Sweetened Beverages : Individuals consuming two or more glasses daily had a 26% higher risk of death compared to those who consumed less than one glass per month. Specifically, there was a 52% increased risk of death from circulatory diseases .
Sugar-Sweetened Beverages : Those consuming one or more glasses daily faced a 59% higher risk of death from digestive diseases .
All Soft Drinks : A notable association was found between soft drink consumption and increased mortality from Parkinson's disease .

Alternatives That Aren’t Any Healthier

Think fruit juice or energy drinks are a safer bet? A study involving 13,440 U.S. adults aged 45 and older found that each additional 12-ounce serving of sugary beverages, including 100% fruit juice, was linked to an 11% higher risk of all-cause mortality. Specifically, each additional 12-ounce serving of fruit juice was associated with a 24% increased risk. Watch the sugar content of iced coffee beverages and alcoholic cocktails as well.

Lifestyle Factors Matter, Too

It's essential to note that high soft drink consumption often correlates with other unhealthy lifestyle choices. The IARC study observed that individuals who drank more soft drinks typically had higher body mass indexes and were more likely to smoke. Even after adjusting for factors like diet, physical activity, smoking, and education, the association between soft drink consumption and increased mortality risk remained significant .

Refreshing Alternatives for the Season

Looking to quench your thirst without compromising your health? Here are some delightful, healthier options:

Infused Water : Add slices of citrus fruits, cucumbers, or berries to your water for a refreshing twist.
Herbal Iced Teas : Brew teas like hibiscus or mint, chill them, and enjoy over ice.
Sparkling Water with a Splash : Mix sparkling water with a splash of 100% fruit juice for a fizzy treat.
Homemade Lemonade : Use fresh lemons, water, and a touch of natural sweetener like honey or stevia.
Coconut Water : A natural source of electrolytes, perfect for rehydration.

Final Thoughts

Summer is a time for relaxation and enjoyment. By making informed beverage choices, you can savor the season while prioritizing your health. So, the next time you're reaching for a drink to beat the heat, consider these healthier alternatives. Your body will thank you!

7 Healthy Travel Tips

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

Whether you’re planning a weekend getaway or a long-awaited international adventure, setting off on a trip is always exciting—but can also be unpredictable. That’s why preparing for the unexpected, especially when it comes to your health, is essential. Knowing what your medical coverage includes (and doesn’t) while traveling can help you stay healthy, avoid costly surprises, and soak up the unforgettable moments on your journey.

Let’s walk through some proactive steps you can take before packing your bags—from vaccinations and insurance to emergency planning and fraud protection.

1. Know What Your Health Plan Covers—And Where

Medical surprises aren’t on anyone’s itinerary—but it’s best to be prepared. Start by knowing how your insurance policy covers (or doesn’t) the region you’re traveling to.

Individual health policyholders, review your insurer’s network coverage. Some plans only cover in-network or state-specific services, while others offer broader emergency coverage or travel-specific riders. Consult your insurance agent to get help reviewing your policy.

Medicare beneficiaries, Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan representative before traveling.

2. Consider Supplemental Insurance

If you're a frequent traveler or heading abroad, look into some options to help cover you. Some options include:

Travel Medical Insurance : Plans offer emergency coverage during trips outside the U.S. and tend to be affordable.
Evacuation Insurance : This covers transport to a qualified medical facility if the nearest care is inadequate. An evacuation clause is often, but not always, included in a travel insurance plan.
Medicare Supplement Insurance (Medigap) : Some Medigap policies cover emergency care abroad, typically up to plan limits and with a deductible.
Critical Illness Insurance : A lump-sum payout can provide financial flexibility in case you’re diagnosed with a covered condition like a heart attack or stroke during travel.

Be sure to read the fine print—some policies require you to be under a certain age, and preexisting conditions may not be covered. Your licensed insurance agent can help talk you through your options.

3. Keep Your Medical Info Handy

Consider using a secure health app or digital wallet to access all your health records quickly. But just in case your phone is inaccessible, bring physical copies of these important documents as well:

Your insurance or Medicare cards
Emergency contact numbers (include the country code +1 if you’re traveling abroad)
A medication list with dosages
Allergy and medical condition alerts

Pack all essential paperwork together in a waterproof sleeve in your luggage, and leave a second copy with someone back home.

4. Schedule Preventive Care Before Departure

Most insurance plans cover preventive care services like wellness visits, vaccinations, and screenings. Before your trip, check these tasks off your list:

Get vaccinated : Make sure you’re up to date on your flu, COVID-19, and tetanus shots. If traveling internationally, check the CDC recommendations for the region you’re visiting, which may include Hepatitis A/B, typhoid, or yellow fever vaccinations.

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

websitehelp@agencybloc.com (Agency Bloc) — Tue, 01 Jul 2025 15:35:31 GMT

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested—and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on.

The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam” —a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

What Is the Grandparent Scam?

These scams usually start with a phone call from someone pretending to be your grandchild (or another close relative). They’ll say they’re in trouble—maybe stuck in jail or in a hospital—and they need money fast for bail, legal fees, or emergency expenses.

To make things even more convincing, they may hand the phone off to someone pretending to be a lawyer or a police officer. And they’ll likely ask you not to tell anyone—saying it’s a “private” or “sensitive” situation.

That sense of urgency is key to the scam. It’s meant to bypass your instinct to double-check and make you act fast—before you have time to think it through or talk to someone else.

Why It Works—and Why It’s Dangerous

These calls often come late at night or early in the morning, when you’re more likely to be caught off guard. The scammer might not even say who they are—just “Grandma, it’s me”—and hope you fill in the blank for them. From there, they use that information to sound more convincing.

Some victims have been asked to send money via wire transfer, cryptocurrency, gift cards, or even in cash via courier—all methods that are difficult or impossible to trace or reverse. According to the FCC, scammers using this method have stolen tens of millions of dollars from seniors across the U.S.

Watch for These Warning Signs

If you or someone you love receives a call like this, here are some red flags that it could be a scam:

High pressure and urgency – You’re told to act immediately

Vague or strange details – They may not identify themselves clearly, or hope you’ll say the grandchild’s name for them

Unverifiable location or story – They say they’re in jail overseas or in a place where you can’t easily check on them

Unusual payment requests – Gift cards, Bitcoin, wire transfers, or cash deliveries

Calls at odd hours – Scammers try to catch you when you’re less alert

What To Do If You Get a Suspicious Call

If something doesn’t feel right, trust your gut. Here’s what you can do to stay safe:

✅ Hang up and verify – Call your grandchild or their parent using a phone number you know is theirs

✅ Talk to someone you trust – A second opinion from a friend or family member can make all the difference

✅ Don’t rely on caller ID – Scammers often “spoof” numbers to make it look like someone you know is calling

✅ Block the number – Use your phone’s settings to block suspicious calls

✅ Report the scam – Contact the National Elder Fraud Hotline at 833-FRAUD-11 and file a complaint with the FCC

What If You’ve Already Sent Money?

First of all, don’t panic—and know that you’re not alone. Scammers are incredibly convincing, and even smart, cautious people have been tricked.

Here’s what to do:

Call your bank or payment service right away – They may be able to stop or reverse the transaction if it's recent
Report it – Contact the FCC, your local police, and the FBI’s Internet Crime Complaint Center at ic3.gov
Let your family know – They can help protect you and others from future attempts

Help Protect Others, Too

The more people know about this scam, the harder it becomes for criminals to succeed. Please share this information with friends, neighbors, and especially your older loved ones. A quick conversation now could prevent a heartache later.

And remember—if you ever get a call like this and aren’t sure what to do, don’t rush. Take a breath, hang up, and check in with someone you trust. Real family emergencies don’t come with secret demands or payments via gift cards.