Try a New Way of Doing Benefits

There’s a new way of doing employer-sponsored health insurance and it’s based on reimbursing employees for health insurance rather than buying it for them. It’s called a health reimbursement arrangement and it brings more cost control and flexibility to companies and more choice for employees.

What are the types of HRAs?

HRAs have been around a while, but the newer “flavors” – specifically the Qualified Small Employer HRA and the Individual Coverage HRA, are more recent defined contribution models.

The Qualified Small Employer HRA (QSEHRA) was established when President Obama signed the 21st Century Cures Act in 2016. It put small businesses on nearly the same playing field from a tax-advantage perspective as large employers with group plans. It has annual limits and is for businesses with less than 50 full time employees only.

The Individual Coverage HRA (ICHRA), which was created by regulatory rule updates in 2019, became available January 2020. It expands upon the advantages of QSEHRA and opens it up to business of all sizes without annual limits. One feature that ICHRA does that QSEHRA does not is allow for businesses to divide employees into classes and reimburse at different rates per class.


How HRAs work

The mechanics of an HRA are pretty simple. Business owners determine a set budget for their employees to reimburse for health insurance and workers choose the plan that works best for them. Some employers also reimburse for medical expenses.

Employers then “design” their HRA. They can choose to divide up by class, or scale rates by family size and age (which is the most common). Employees buy their own individual health insurance plan and are reimbursed through their paycheck. If they go to the doctor, they can submit a receipt and get reimbursed for the copay (if the plan allows for medical expense reimbursement).


Benefits of HRAs

HRAs are good for both employers and employees. Here’s why.

For employers:

  • Flexibility: HRAs make sense for a diverse workforce; it’s hard to find a plan that will work for all types of employees, especially part-time, hourly and remote workers.
  • Cost Control: Group premium prices can go up every year, but HRA allowances are predictable and set, and can allow for savings.
  • Risk De-management: Employers no longer have to worry about managing risk.
  • Compliant: HRAs, when set up and administered appropriately, can satisfy the employer shared responsibility provisions of the Affordable Care Act and the right HRA administrator ensures that the HRA offer remains compliant.
  • No participation rates to worry about

For employees:

  • Choice: Employees can choose any ACA-compliant plan on the market and select the level of coverage that best fits their family needs and that works with their preferred doctors and prescriptions.
  • Portability: QSEHRA and ICHRA allow employees to keep their coverage in the event they lose or change jobs.


Which HRA is right for my business?

Need help sorting through the details of your HRA options and finding the right one for you? Take Command’s team of experts are on hand to help. Please schedule a time to chat with our HRA Design team to see if an HRA is a good fit for you or check out one of our helpful guides on our favorite HRAs, like our ICHRA Guide and QSEHRA Guide. 


About Our Sponsor Take Command

Take Command is on a mission to accelerate the adoption of the reimbursement model of health insurance to help create a consumer-centric healthcare system. Take Command is a proud inaugural member of the HRA Council, a recognized leader in QSEHRA administration for small employers, launched the first-to-market Individual Coverage HRA platform, and is the only HRA administrator to also offer full service, in-house individual enrollment support.

USSSA Recognizes the Importance of the AAP Report on Prevention of Drowning

The United States Swim School Association (USSSA) recently reviewed the newly published Technical Report on Prevention of Drowning from the American Academy of Pediatrics (AAP) and we applaud the continued efforts to increase awareness and examine data to share important strategies to prevent tragedies. For over 30 years, members of USSSA have been advocating learning to swim as one of the important layers of protection to prevent drowning. We fully agree with the statement within the AAP report, “It must be stressed that swimming lessons, in isolation, will not drown-proof a child. The goal of swim lessons is to reduce the risk of drowning but also to promote and prepare for parent-child activities, exercise, fun, and enjoyment of the long process of acquiring aquatic learning and water competency.”

While much of the information shared in this report is well known among the learn to swim community, we need to do more to educate parents and the public on this lifesaving information.

  • Children ages 0 to 4 years are still the group with the highest rate of drowning, now at 2.26 per 100,000 population, however the age range in that group most at risk are the 12 to 36 month olds.
  • Those with the second greatest rate of drowning are the adolescents at 1.90 per 100,000 among boys 15 to 19 years old.
  • Boys account for approximately 75% of childhood drowning victims.
  • The Report also examined data to find that drowning rates from 2014 to 2018 are highest among black individuals at 1.79 per 100,000.
  • Among people younger than 30, one analysis of 11 years of fatal drowning data showed that American Indian and Alaska native individuals have the highest rate of fatal drowning at 2.57 per 100,000. They have the lowest drowning risk in swimming pools but the highest in natural water settings.

There is even more data to digest and extract from this Report, but it remains that we can all do more to reach and teach underserved populations. The USSSA is proud to partner with the Hope Floats Foundation that offers swim lesson scholarships to connect children living in poverty with high-quality swim lessons providers.

The AAP report shares that learning to swim and water competency is not learned in just a few lessons, but to be effective, swim lessons should provide repeated and progressive training in swim skills and water safety. The report also adds, “In addition to basic swim skills, water competency should include knowledge of local hazards in the aquatic environment, risk judgment and self-assessment of abilities, and recognition and response to a person in distress in the water, including safe rescue and CPR.”

Key evidence-based strategies to prevent drowning remain the same: barriers, supervision, swim lessons, life jackets and CPR, however this report highlights that more education is needed, especially for parents and caregivers, who will most likely be the most immediate layer of protection to prevent drowning. It’s important for caregivers to have a clear understanding of the child’s aquatic abilities and limitations, as well as an understanding that swimming ability is only one part of a multi layered protection plan and that nothing replaces undistracted adult supervision in and around water. Research has shown that with education, caregivers can be better prepared to provide proper supervision. USSSA swim schools members have been working to educate caregivers and are proud to partner with Stop Drowning Now to help get this information in the hands of educators and caregivers.

While the Report has not uncovered any additional data on early instruction, it recognizes that infant swim lessons may be beneficial and points out that medical problems from swimming are rare, treatable, and preventable events. The report also shares, “The World Aquatic Babies and Children Network has published guidelines for the operation of aquatic programs for children younger than 3 years. The guidelines recommend (1) required parental involvement, (2) a fun atmosphere with one-on-one teaching, (3) qualified teachers, (4) warm water to prevent hypothermia, (5) maintenance of water purity, and (6) a limited number of submersions to prevent water ingestion and hyponatremia.” This report also shared that a longitudinal study of children from birth to age 7 to 10 years of age had no increased risk of respiratory symptoms, allergy, or asthma with regular pool exposure and that in fact they showed that their lung function was better.

If you are looking for swim lessons and water safety education for a child in your care, visit to find lessons that embrace the data and best practices shared in the AAP Technical Report.

Drowning Rates Starting to Increase While Swim Schools Work to Rebuild Capacity

Unfortunately, we are starting to see an increase in drowning numbers. Industry experts have feared that lack of access to swim lessons combined with increased access to pools and use of open water would be a deadly combination. As more and more people purchased pools of all types over the last year, in addition to an increased use of open water with pools not being opened there is inherently an increased risk of drowning. And as the weather heats up and restrictions are being lifted across the country, we are unfortunately starting to see that increase.

According to Total Aquatic Programming’s monthly drowning tracker we started to see the increase in February of 2021 with a total of 79 drownings, as compared to 35 in 2020 and 66 in 2019. That increase has continued with March 2021 seeing 96 drownings as compared to 78 in 2020 and 80 in 2019. The trend in April with 120 drownings as compared to 95 in 2020 and 142 in 2019 is a little better but we are still headed in the wrong direction. Historically May, June, July and August see a significant increase in the number of monthly drownings as more people enjoy summer water activities.

Swim schools across the country have been reopening and slowly increasing capacity while following local guidelines. The challenge now is to hire and train staff to meet the increasing demand as local restrictions are lifted and parents are ready to get kids back in the pool. Prior to the pandemic, swim schools were challenged to find staff to meet the demand for swim lessons. Now faced with having to rebuild a team after months of being closed has proved to be an obstacle to offering the swim lessons needed in communities across the country. Swim schools are competing with other local job opportunities while also working with a smaller pool of applicants currently looking for a job. Increased efforts by swim school owners to attract and retain the quality staff they need has been a focus these last few months. The United States Swim School Association (USSSA) recently released a Hiring Toolkit for USSSA members to provide guidance and best practices to support their efforts.

Swim schools are looking for people that love kids and have a passion for learning. They want individuals who want to help create family memories, build self-confidence and be a role model. It takes a lot of love, a splash of dedication and a lot of passion to unlock the potential within swimmers and help save lives. If you know someone who is looking to make a difference, please encourage them to consider applying at their local swim school. The USSSA Job Board has thousands of opportunities and swim schools provide the training needed to be successful.

Drowning Doesn’t Look Like Drowning and Other Facts Parents Should Know

As a parent there are many things you need to know. How often does your child need a doctor’s check up? When is the best time to start solid foods? How do you properly fit a car seat? When can you move from rear to forward facing? And as kids get older, it still continues. It can be hard to stay on top of it all. 

So with all the demands on parents, it is easy to overlook these important facts. Drowning is the number one cause of accidental death for children under four and it is the second leading cause of accidental death for children under 14. While this information is scary, you can educate yourself to help prevent a tragedy. 

First, a few things to understand about drowning:

  • Drowning is silent, it is NOT like the movies with splashing and screaming.
  • It can happen in an instant. One minute your child is by your side and the next moment they are under water. Nine out of ten drowning deaths happen when a caregiver is supervising but not paying attention. And 77 percent of those involved in a home drowning accident had been missing for no more than five minutes when found in the swimming pool.
  • Drowning happens when you least expect it. 70 percent of drowning victims weren’t expected to be in or near the pool at that time.
  • Drowning does not discriminate. A drowning can happen to anyone, no matter your socioeconomic status or swimming ability.

The good news is, there are steps parents can take to better safeguard their families from drowning:

  • Formal swim lessons between the ages of one and four have been shown to reduce the risk of drowning by 88%. The American Academy of Pediatrics recommends swim lessons for all children starting as early as one year of age.
  • Undistracted adult supervision when kids are around or near water is critical. Assign an adult to be a “water watcher” when children are in and around water. At all times the water watcher should be within arms length of non-swimmers.
  • Caregivers should know how to swim and know CPR. CPR started quickly on drowning victims has shown to improve chances of survival as rescue personnel take time to arrive and access the scene.
  • Blow rafts, rings, water wings and floats are NOT safety devices. They have no safety requirements and can fail.  In fact, they can lead parents to have a false sense of security which can actually increase drowning risk.
  • Pools should have complete four-sided isolation fencing with a self-locking gate. Fencing could prevent 50 – 90% of child related drowning events. And don’t leave any toys in the pool area as it can attract the attention of a wandering, curious child.
  • Keep simple but effective lifeguard equipment poolside such as life rings, telescoping poles, shepherd’s crooks or lines with buoys.  Some are as inexpensive as $10 and can prevent a rescuer from getting pulled under creating a double drowning.
  • Wear a US Coast Guard-approved life jacket around open water even if you know how to swim. An injury while swimming in open water could prevent you from being able to swim to safety.

Enjoyment of the water doesn’t have to be scary. There are many great benefits to swimming, including physical health and development, as well as cognitive benefits for our brains and minds. Swimming offers the opportunity to exercise and use all of the parts of the body. Young children learning to swim have demonstrated increased cognitive skills compared to their peers. Swimming is an extremely low-impact activity, so it’s benefits are not just for the young. Swimmers at any age can enjoy stress release and improved quality of sleep. Swimming offers time away from screens and a chance to connect with family and friends, allowing for the development of social skills and meaningful relationships.

There is a lot swimming has to offer each of us. With a little knowledge and planning, you and your family can appreciate a lifetime enjoyment of swimming and water activities.

Parts of this article appeared in the May 27, 2021 Mediaplanet Home Safety and Security insert in the USA TODAY.

Swim Schools are Vital to the Community

The United Nations recently declared July 25th at World Drowning Prevention Day, encouraging all countries to take action to prevent drowning, which has caused over 2.5 million deaths in the past ten years. The World Health Organization (WHO) Global Report from 2014 on Drowning stated that “every hour of every day more than 40 people lose their lives to drowning.” Drowning is a public health crisis.

Strategies to prevent drowning have been identified by many organizations. The American Academy of Pediatrics (AAP) shared in their 2019 updated position statement on Drowning Prevention that “five major interventions are evidence based: 4-sided pool fencing, life jackets, swim lessons, supervision, and lifeguards.”

As identified by the AAP, learning to swim is an important layer of drowning prevention. Learning to swim has been shown to reduce the risk of drowning by 88% if children participate in formal swimming lessons between ages 1 – 4*. With learning to swim being an essential life skill, swim schools play a vital role to their community.

Swim schools offer dedicated services with instructors specifically trained in child development and learn to swim instruction. Many swim schools offer lessons in pools that have been designed specifically for teaching swim to young students. Pool designs include warm water temperatures, pool depths designed specifically for the purpose of swim lessons and facilities with a focus on everyone’s safety.

In addition to the benefits offered for drowning prevention, swim schools provide an opportunity for many other benefits to students and families in the community. Parent and baby participation in infant aquatic programs offer excellent parent bonding opportunities. Small class sizes allow for highly engaging activities in which the learner develops skills through fun, safe interactive programs. Swim lessons also offer a great social opportunity for young children, which for some starting at a young age may be their first group social experience. This social experience can further enhance wellbeing and offer better preparedness for other learning environments. Learning to swim has also been shown to increase cognitive and language development. Young students are exposed to important speech elements and useful concepts like shapes and colors. An as a student continues to work in swim lessons with new words, it can improve their own use of language.

Swimming offers the opportunity to exercise and use all parts of the body. It is an extremely low-impact activity, so its benefits are not just for the young. Swimmers at any age can enjoy stress release and improved quality of sleep. Swimming offers time away from screens and a chance to connect with family and friends, allowing for the development of social skills and meaningful relationships.

With the alarming data around drownings, there is an extreme global need for effective teaching of quality swimming and water safety. Swim schools are an important piece in the puzzle of drowning prevention, making them a vital and essential resource throughout the world and in your own community.