New Employee Assistance Program (EAP) for COSE MEWA Life Groups


For many small businesses, the current health insurance landscape provides limited choice and flexibility when it comes to offering your employees quality coverage. With a COSE multiple employer welfare arrangement (MEWA) plan administered through Medical Mutual, your group gains access to health insurance, as well as dental, vision, and life insurance options. 

A new benefit of electing life insurance through your COSE MEWA plan is access to an employee assistance program (EAP). This EAP plan is administered by HealthAdvocate and provides 24/7 confidential and personal support for employees and their families for everyday challenges. This can include assistance with legal problems, life transitions, substance abuse and more. Access to the EAP plan is unlimited for short-term support, but if long-term treatment is necessary, trained clinicians from HealthAdvocate may refer members to an in-network behavioral health professional.

This new life benefit is effective as of Jan. 1, 2021 and will be automatically included at no additional cost for all COSE MEWA groups that elect life coverage. The EAP plan is a great way to support your employees through difficult circumstances and offer them the help they need.

For more information on the EAP plan or to learn more about various COSE MEWA product offerings, please contact your broker or Medical Mutual Sales representative. 

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  • Next up: New Option for Small Business Health Insurance
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  • Next up: New Precautions Eye Doctors Are Taking as Many Practices Reopen
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  • New Precautions Eye Doctors Are Taking as Many Practices Reopen

    As many parts of the country continue to reopen, VSP® eye doctors across the country are open and ready for routine eye care. And your next trip to the eye doctor might look much different than what you’re used to in order to protect your health and safety. Courtesy of our partners at VSP® Vision Care, here’s what to expect when you visit the eye doctor.

    VSP is partnering with network eye doctors to help ensure a healthy return to routine eye care services. Here are some of the changes you might see when you return to your eye doctor.

    What Eye Doctors and Staff are Doing

    While precautions may vary from practice to practice, many eye doctors have implemented new patient protocols to ensure everyone’s safety. Eye exams take place inches from your face, so many eye doctors and staff will have personal protective equipment (PPE), like masks, gloves, gowns, and face shields.

    In May, VSP Global manufactured and donated protective face shields to VSP network doctors across the country and provided other resources to help them access much-needed PPE.

    Patient Protocols

    Patients may be asked to wear masks to their appointment. In many cases, patient in-take forms have been moved online, and checking into your appointment will look a little different. In some practices, patients might be asked to use their cars as a “waiting room” and will be notified by staff when an exam room is available. Check with your VSP eye doctor ahead of your appointment to find out their current patient protocol.

    How to Prepare for Your Eye Doctor Visit

    1. Don't go if you're feeling sick. Your routine eye exam can wait. Don’t be surprised if someone takes your temperature upon arrival to ensure safety for everyone.

    2. Fill out forms in advance. If possible, fill out your intake forms online before your appointment. This will limit your face-to-face contact and your overall time within the office. Any additional information that's requested by your doctor can also be done over the phone.

    3. Follow social distancing guidelines. There may be new procedures in place to help with social distancing, from markers on the ground indicating where to stand, to a limited number of people allowed in certain areas. You will likely need to call from your car to check in. Every office is different, so be sure to check with your eye doctor’s office about their requirements.

    4. Go alone to your appointment. Most offices are only allowing the patient to enter the office, with the exception of those who require a caregiver or a guardian to attend the appointment with them. This limits the amount of people going in and out of the office, and helps maintain a more sterile, clean environment.

    5. Wear a mask to your appointment. Depending on your state, a mask may either be mandated or highly recommended when you are in public places. The Centers for Disease Control and Prevention highly advises people to wear a mask covering their nose and their mouth in order to help stop the spread of COVID-19.

    6. Ask before trying on frames. Lastly, if you need glasses, your frame selection experience might be somewhat different than before. Be sure to ask office staff prior to trying on any frames. Frames that patients try on will be disinfected prior to returning them to the frame board so that you feel safe and comfortable. This will ensure that the eyewear remains sanitary. In addition, many offices have placed an acrylic barrier between you and your optician. This might allow you to try on your frames mask-free. Be mindful that procedures are modified as needed and each doctor’s office might have a slightly different approach to ensuring everyone’s health and safety.

    To know exactly what to expect during your appointment, call your doctor’s office to find out how to best prepare for your visit. Many VSP® Premier Program locations, including private practice doctors and Visionworks retail locations, are open and ready to serve you. If you need to connect with a VSP network doctor but don’t have one or you aren’t able to contact your eye doctor, we can help! Call VSP’s Member Services at 800.877.7195 for assistance and we’ll help connect you with another eye doctor on the VSP network who is open and ready to assist you.

    See Well. Be Well.™ Make your eye health and eye care a priority. If you haven’t already, take advantage of your COSE member benefit and opt-in to VSP vision insurance. Contact your COSE sales representative or broker for more info.


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    Alex Gertsburg of the Gertsburg Law Firm explains innovative new billing strategies law firms and their clients are using.

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  • Next up: What to Know About Cuyahoga County's New Anti-Discrimination Commission
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  • What to Know About Cuyahoga County's New Anti-Discrimination Commission

    A recent Cuyahoga County ordinance establishes a new and different forum for employees to seek redress for workplace discrimination concerns.

    The ordinance, enacted by the county’s newly formed Commission on Human Rights, impacts employers in Cuyahoga County that have at least four employees. Employers are prohibited from firing, refusing to hire or otherwise discriminating against applicants and employees based on sexual orientation and gender identity. They are also prohibited from inquiring about an applicant’s sexual orientation or gender identity unless there is a reason related to job qualifications. And they’re forbidden from retaliating against any person who has made a complaint; opposed a practice forbidden by; or assisted in any investigation, proceeding, or hearing under the ordinance. 

    The commission is responsible for receiving and investigating complaints alleging discrimination based on sexual orientation, gender identity or expression, and it shares jurisdiction over these types of claims with the Equal Employment Opportunity Commission (EEOC). 

    If an employee files a complaint within 150 days of the alleged discrimination, and the commission finds that the employer engaged in discriminatory conduct, it may issue a cease and desist order. If the employer fails to comply, the order is subject to enforcement through a lawsuit brought by the county. The commission may also order civil administrative penalties of up to $1,000 for a first offense and more than double that for subsequent offenses. Attorney fees and costs may also be awarded to the complainant. 

    The ordinance creates a new forum for employers to recognize and navigate. It establishes rights not currently recognized under state law and imposes penalties rather than damages, which can be a critical distinction. Notably, penalties may not be covered by an employer’s insurance policy, so employers should contact their legal counsel and consult with their insurance broker to determine whether coverage exists. 

    Mark Fusco is an attorney at Walter | Haverfield who focuses his practice on litigation and labor and employment law. He can be reached at or at 216-619-7839. 

    James McWeeney is an attorney at Walter | Haverfield who focuses his practice on education and labor and employment law. He can be reached at or at 216-928-2959.

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  • Next up: NSBA study: Health Care Costs Continue to Hit Small Businesses
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  • NSBA study: Health Care Costs Continue to Hit Small Businesses

    As we near year-end, there is a lot being written about health insurance, the experience of small business owners and the impact of the Affordable Care Act on rates and access to health insurance.  “As I talk to my colleagues that work with small businesses across the country, increasing costs and increasing regulatory burdens are a theme among small business owners,” said Steve Millard, President and Executive Director of COSE.

    As we near year-end, there is a lot being written about health insurance, the experience of small business owners and the impact of the Affordable Care Act on rates and access to health insurance.  “As I talk to my colleagues that work with small businesses across the country, increasing costs and increasing regulatory burdens are a theme among small business owners,” said Steve Millard, President and Executive Director of COSE.

    COSE works closely with the National Small Business Association (NSBA) on federal advocacy for small business.  NSBA recently released the results from their 2015 national health care survey of small businesses that indicates that owners are continuing to struggle with health care costs.

    “The national picture isn’t pretty, but the good news is that we are doing a little better here in Northeast Ohio than in other parts of the country. Prior to ACA, Ohio already had a pretty active and competitive marketplace for insurance benefits already in place,” said Millard. “And, with COSE and Medical Mutual allowing grandfathered and grandmothered plans, we’ve seen a high percentage of members staying in the plans they had just prior to the implementation of the Affordable Care Act. That’s been a benefit to them overall.”

    Nationally, the survey indicated 90% of the more than 800 small businesses surveyed saw health care costs go up this year and one in five of them saw that cost increase by more than 20%.  Additionally, cost was reported to be the biggest driver of whether a small business can even offer health insurance at all.

    “Beyond the health insurance premiums, 55% of employers report additional health care related spending on average of $628 per month, per employee,” according to the report.

    The report added the majority of firms offer a PPO insurance plan as well as dental benefits. Most small firms said they pay for more than half the cost of these benefits offerings. Further, just 9% of these firms said they plan to buy health insurance through the Small Employer Health Options Program (SHOP exchange) or an individual exchange, down from 14% from last year.

    ACA impact

    Dealing with fallout from the Affordable Care Act has also proved to be a challenge for small businesses. Sixty-eight percent of those owners responding indicate that they are the person with primary responsibility inside their business for taking care of the health benefit offerings.  Unfortunately, that means they are spending a lot of time on the complexities of this issue. The report found the average time it takes per month for small businesses to keep up with ACA changes is 13 hours per month, which works out to about four weeks per year. More than half (51%) of respondents said they have limited or no understanding of how ACA is impacting their business.

    Also, one in four small companies said they are purposefully not expanding because of potential ACA ramifications. The businesses responding to the survey said it costs them on average $1,116.05 per month to comply with ACA.

    Other takeaways

    Other takeaways from the report include:

    • While 69% of respondents to the survey continue to believe that offering health insurance benefits is important in recruiting and retaining quality employees for their business, just 41% of businesses with five or fewer employees surveyed offer health benefits, down from 46% a year ago.
    • The total number of small businesses of all sizes surveyed that are offering health insurance dropped to 65% from 70% a year ago.
    • One in 10 small businesses reported having to lay off an employee because of rising health care costs.
    • Only 4% of small businesses said ACA is a factor in making health insurance easier or cheaper to provide to employees.
    • Of those that do not offer insurance, almost 40% plan to do so in the next year citing the need to attract quality employees with quality benefits and compensation as a key factor in wanting to provide benefits to their employees.

    This study was a national look based on a survey done by NSBA, a membership organization of small business owners. The environment in every state varies a bit as it relates to what kinds of coverages were available prior to ACA and what exists now. Nonetheless, the trend is that while the ACA has increased access to insurance, it has also increased costs and compliance concerns for small businesses. And, many small business owners have re-evaluated what they are providing employees.

    COSE continues to look for new ways to help small business owners gain better access and compete with employee benefits. Millard recently provided an overview on what small businesses should be thinking about as it relates to 2016 health care costs. You can watch that video here.

    The full NSBA 2015 Health Care Survey results can be found here.

    Questions about your 2016 health care outlook? Contact your broker or the COSE benefits team at 440-878-5930.

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