An Early Look at 2018 Premium Changes and Insurer Participation on ACA Exchanges


Each year insurers submit filings to state regulators detailing their plans to participate on the Affordable Care Act marketplaces (also called exchanges). These filings include information on the premiums insurers plan to charge in the coming year and which areas they plan to serve. Each state or the federal government reviews premiums to ensure they are accurate and justifiable before the rate goes into effect, though regulators have varying types of authority and states make varying amounts of information public.

In this analysis, we look at preliminary premiums and insurer participation in the 20 states and the District of Columbia where publicly available rate filings include enough detail to be able to show the premium for a specific enrollee. As in previous years, we focus on the second-lowest cost silver plan in the major city in each state. This plan serves as the benchmark for premium tax credits. Enrollees must also enroll in a silver plan to obtain reduced cost sharing tied to their incomes. About 71% of marketplace enrollees are in silver plans this year.

States are still reviewing premiums and participation, so the data in this report are preliminary and could very well change. Rates and participation are not locked in until late summer or early fall (insurers must sign an annual contract by September 27 in states using Healthcare.gov).

Insurers in this market face new uncertainty in the current political environment and in some cases have factored this into their premium increases for the coming year. Specifically, insurers have been unsure whether the individual mandate (which brings down premiums by compelling healthy people to buy coverage) will be repealed by Congress or to what degree it will be enforced by the Trump Administration. Additionally, insurers in this market do not know whether the Trump Administration will continue to make payments to compensate insurers for cost-sharing reductions (CSRs), which are the subject of a lawsuit, or whether Congress will appropriate these funds. (More on these subsidies can be found here).

The vast majority of insurers included in this analysis cite uncertainty surrounding the individual mandate and/or cost sharing subsidies as a factor in their 2018 rates filings. Some insurers explicitly factor this uncertainty into their initial premium requests, while other companies say if they do not receive more clarity or if cost-sharing payments stop, they plan to either refile with higher premiums or withdraw from the market. We include a table in this analysis highlighting examples of companies that have factored this uncertainty into their initial premium increases and specified the amount by which the uncertainty is increasing rates.

Changes in the Second-Lowest Cost Silver Premium

The second-lowest silver plan is one of the most popular plan choices on the marketplace and is also the benchmark that is used to determine the amount of financial assistance individuals and families receive. The table below shows these premiums for a major city in each state with available data. (Our analyses from 201720162015, and 2014 examined changes in premiums and participation in these states and major cities since the exchange markets opened nearly four years ago.)

Across these 21 major cities, based on preliminary 2018 rate filings, the second-lowest silver premium for a 40-year-old non-smoker will range from $244 in Detroit, MI to $631 in Wilmington, DE, before accounting for the tax credit that most enrollees in this market receive.

Of these major cities, the steepest proposed increases in the unsubsidized second-lowest silver plan are in Wilmington, DE (up 49% from $423 to $631 per month for a 40-year-old non-smoker), Albuquerque, NM (up 34% from $258 to $346), and Richmond, VA (up 33% from $296 to $394). Meanwhile, unsubsidized premiums for the second-lowest silver premiums will decrease in Providence, RI (down -5% from $261 to $248 for a 40-year-old non-smoker) and remain essentially unchanged in Burlington, VT ($492 to $491).

As discussed in more detail below, this year’s preliminary rate requests are subject to much more uncertainty than in past years. An additional factor driving rates this year is the return of the ACA’s health insurance tax, which adds an estimated 2 to 3 percentage points to premiums.

Most enrollees in the marketplaces (84%) receive a tax credit to lower their premium and these enrollees will be protected from premium increases, though they may need to switch plans in order to take full advantage of the tax credit. The premium tax credit caps how much a person or family must spend on the benchmark plan in their area at a certain percentage of their income. For this reason, in 2017, a single adult making $30,000 per year would pay about $207 per month for the second-lowest-silver plan, regardless of the sticker price (unless their unsubsidized premium was less than $207 per month). If this person enrolls in the second lowest-cost silver plan is in 2018 as well, he or she will pay slightly less (the after-tax credit payment for a similar person in 2018 will be $201 per month, or a decrease of 2.9%). Enrollees can use their tax credits in any marketplace plan. So, because tax credits rise with the increase in benchmark premiums, enrollees are cushioned from the effect of premium hikes.

Table 1: Monthly Silver Premiums and Financial Assistance for a 40 Year Old Non-Smoker Making $30,000 / Year
State  Major City 2nd Lowest Cost Silver
Before Tax Credit
2nd Lowest Cost Silver
After Tax Credit
Amount of Premium Tax Credit
2017 2018 % Change
from 2017
2017 2018 % Change
from 2017
2017 2018 % Change
from 2017
California* Los Angeles $258 $289 12% $207 $201 -3% $51 $88 71%
Colorado Denver $313 $352 12% $207 $201 -3% $106 $150 42%
Connecticut Hartford $369 $417 13% $207 $201 -3% $162 $216 33%
DC Washington $298 $324 9% $207 $201 -3% $91 $122 35%
Delaware Wilmington $423 $631 49% $207 $201 -3% $216 $430 99%
Georgia Atlanta $286 $308 7% $207 $201 -3% $79 $106 34%
Idaho Boise $348 $442 27% $207 $201 -3% $141 $241 70%
Indiana Indianapolis $286 $337 18% $207 $201 -3% $79 $135 72%
Maine Portland $341 $397 17% $207 $201 -3% $134 $196 46%
Maryland Baltimore $313 $392 25% $207 $201 -3% $106 $191 81%
Michigan* Detroit $237 $244 3% $207 $201 -3% $29 $42 44%
Minnesota** Minneapolis $366 $383 5% $207 $201 -3% $159 $181 14%
New Mexico Albuquerque $258 $346 34% $207 $201 -3% $51 $144 183%
New York*** New York City $456 $504 10% $207 $201 -3% $249 $303 21%
Oregon Portland $312 $350 12% $207 $201 -3% $105 $149 42%
Pennsylvania Philadelphia $418 $515 23% $207 $201 -3% $211 $313 49%
Rhode Island Providence $261 $248 -5% $207 $201 -3% $54 $47 -13%
Tennessee Nashville $419 $507 21% $207 $201 -3% $212 $306 44%
Vermont Burlington $492 $491 0% $207 $201 -3% $285 $289 2%
Virginia Richmond $296 $394 33% $207 $201 -3% $89 $193 117%
Washington Seattle $238 $306 29% $207 $201 -3% $31 $105 239%
NOTES: *The 2018 premiums for MI and CA reflect the assumption that CSR payments will continue. **The 2018 premium for MN assumes no reinsurance. ***Empire has filed to offer on the individual market in New York in 2018 but has not made its rates public.
SOURCE:  Kaiser Family Foundation analysis of premium data from Healthcare.gov and insurer rate filings to state regulators.

Looking back to 2014, when changes to the individual insurance market under the ACA first took effect, reveals a wide range of premium changes. In many of these cities, average annual premium growth over the 2014-2018 period has been modest, and in two cites (Indianapolis and Providence), benchmark premiums have actually decreased. In other cities, premiums have risen rapidly over the period, though in some cases this rapid growth was because premiums were initially quite low (e.g., in Nashville and Minneapolis).

Table 2: Monthly Benchmark Silver Premiums
for a 40 Year Old Non-Smoker, 2014-2018
State Major City 2014 2015 2016 2017 2018 Average Annual % Change from 2014 to 2018 Average Annual % Change After Tax Credit, $30K Income
California Los Angeles $255 $257 $245 $258 $289 3% -1%
Colorado Denver $250 $211 $278 $313 $352 9%  -1%
Connecticut Hartford $328 $312 $318 $369 $417 6%  -1%
DC Washington $242 $242 $244 $298 $324 8%  -1%
Delaware Wilmington $289 $301 $356 $423 $631 22%  -1%
Georgia Atlanta $250 $255 $254 $286 $308 5%  -1%
Idaho Boise $231 $210 $273 $348 $442 18%  -1%
Indiana Indianapolis $341 $329 $298 $286 $337 0%  -1%
Maine Portland $295 $282 $288 $341 $397 8%  -1%
Maryland Baltimore $228 $235 $249 $313 $392 15%  -1%
Michigan* Detroit $224 $230 $226 $237 $244 2%  -1%
Minnesota** Minneapolis $162 $183 $235 $366 $383 24%  6%
New Mexico Albuquerque $194 $171 $186 $258 $346 16%  1%
New York*** New York City $365 $372 $369 $456 $504 8%  -1%
Oregon Portland $213 $213 $261 $312 $350 13%  -1%
Pennsylvania Philadelphia $300 $268 $276 $418 $515 14%  -1%
Rhode Island Providence $293 $260 $263 $261 $248 -4%  -1%
Tennessee Nashville $188 $203 $281 $419 $507 28%  2%
Vermont Burlington $413 $436 $468 $492 $491 4%  -1%
Virginia Richmond $253 $260 $276 $296 $394 12%  -1%
Washington Seattle $281 $254 $227 $238 $306 2% -1%
NOTES: *The 2018 premiums for MI and CA reflect the assumption that CSR payments will continue. **The 2018 premium for MN assumes no reinsurance. ***Empire has filed to offer on the individual market in New York in 2018 but has not made its rates public.
SOURCE:  Kaiser Family Foundation analysis of premium data from Healthcare.gov and insurer rate filings to state regulators.

Changes in Insurer Participation

Across these 20 states and DC, an average of 4.6 insurers have indicated they intend to participate in 2018, compared to an average of 5.1 insurers per state in 2017, 6.2 in 2016, 6.7 in 2015, and 5.7 in 2014. In states using Healthcare.gov, insurers have until September 27 to sign final contracts to participate in 2018. Insurers often do not serve an entire state, so the number of choices available to consumers in a particular area will typically be less than these figures.

Table 3: Total Number of Insurers by State, 2014 – 2018
State Total Number of Issuers in the Marketplace
2014 2015 2016 2017 2018 (Preliminary)
California 11 10 12 11 11
Colorado 10 10 8 7 7
Connecticut 3 4 4 2 2
DC 3 3 2 2 2
Delaware 2 2 2 2 1 (Aetna exiting)
Georgia 5 9 8 5 4 (Humana exiting)
Idaho 4 5 5 5 4 (Cambia exiting)
Indiana 4 8 7 4 2 (Anthem and MDwise exiting)
Maine 2 3 3 3 3
Maryland 4 5 5 3 3 (Cigna exiting, Evergreen1 filed to reenter)
Michigan 9 13 11 9 8 (Humana exiting)
Minnesota 5 4 4 4 4
New Mexico 4 5 4 4 4
New York 16 16 15 14 14
Oregon 11 10 10 6 5 (Atrio exiting)
Pennsylvania 7 8 7 5 5
Rhode Island 2 3 3 2 2
Tennessee 4 5 4 3 3 (Humana exiting, Oscar entering)
Vermont 2 2 2 2 2
Virginia 5 6 7 8 6 (UnitedHealthcare and Aetna exiting)
Washington 7 9 8 6 5 (Community Health Plan of WA exiting)
Average (20 states + DC) 5.7 6.7 6.2 5.1 4.6
NOTES: Insurers are grouped by parent company or group affiliation, which we obtained from HHS Medical Loss Ratio public use files and supplemented with additional research.
1The number of preliminary 2018 insurers in Maryland includes Evergreen, which submitted a filing but has been placed in receivership.
SOURCE:  Kaiser Family Foundation analysis of premium data from Healthcare.gov and insurer rate filings to state regulators.

Uncertainty Surrounding ACA Provisions

Insurers in the individual market must submit filings with their premiums and service areas to states and/or the federal government for review well in advance of these rates going into effect. States vary in their deadlines and processes, but generally, insurers were required to submit their initial rate requests in May or June of 2017 for products that go into effect in January 2018. Once insurers set their premiums for 2018 and sign final contacts at the end of September, those premiums are locked in for the entire calendar year and insurers do not have an opportunity to revise their rates or service areas until the following year.

Meanwhile, over the course of this summer, the debate in Congress over repealing and replacing the Affordable Care Act has carried on as insurers set their rates for next year. Both the House and Senate bills included provisions that would have made significant changes to the law effective in 2018 or even retroactively, including repeal of the individual mandate penalty. Additionally, the Trump administration has sent mixed signals over whether it would continue to enforce the individual mandate or make payments to insurers to reimburse them for the cost of providing legally required cost-sharing assistance to low-income enrollees.

Because this policy uncertainty is far outside the norm, insurers are making varying assumptions about how this uncertainty will play out and affect premiums. Some states have attempted to standardize the process by requesting rate submissions under multiple scenarios, while other states appear to have left the decision up to each individual company. There is no standard place in the filings where insurers across all states can explain this type of assumption, and some states do not post complete filings to allow the public to examine which assumptions insurers are making.

In the 20 states and DC with detailed rate filings included in the previous sections of this analysis, the vast majority of insurers cite policy uncertainty in their rate filings. Some insurers make an explicit assumption about the individual mandate not being enforced or cost-sharing subsidies not being paid and specify how much each assumption contributes to the overall rate increase. Other insurers state that if they do not get clarity by the time final rates must be submitted – which has now been delayed to September 5 for the federal marketplace – they may either increase their premiums further or withdraw from the market.

Table 4 highlights examples of insurers that have explicitly factored into their premiums an assumption that either the individual mandate will not be enforced or cost-sharing subsidy payments will not be made and have specified the degree to which that assumption is influencing their initial rate request. As mentioned above, the vast majority of companies in states with detailed rate filings have included some language around the uncertainty, so it is likely that more companies will revise their premiums to reflect uncertainty in the absence of clear answers from Congress or the Administration.

Insurers assuming the individual mandate will not be enforced have factored in to their rate increases an additional 1.2% to 20%. Those assuming cost-sharing subsidy payments will not continue and factoring this into their initial rate requests have applied an additional rate increase ranging from 2% to 23%. Because cost-sharing reductions are only available in silver plans, insurers may seek to raise premiums just in those plans if the payments end. We estimate that silver premiums would have to increase by 19% on average to compensate for the loss of CSR payments, with the amount varying substantially by state.

Several insurers assumed in their initial rate filing that payment of the cost-sharing subsidies would continue, but indicated the degree to which rates would increase if they are discontinued. These insurers are not included in the Table 4. If CSR payments end or there is continued uncertainty, these insurers say they would raise their rates an additional 3% to 10% beyond their initial request – or ranging from 9% to 38% in cases when the rate increases would only apply to silver plans. Some states have instructed insurers to submit two sets of rates to account for the possibility of discontinued cost-sharing subsidies. In California, for example, a surcharge would be added to silver plans on the exchange, increasing proposed rates an additional 12.4% on average across all 11 carriers, ranging from 8% to 27%.

Table 4: Examples of Preliminary Insurer Assumptions Regarding Individual Mandate Enforcement and
Cost-Sharing Reduction (CSR) Payments
State Insurer Average Rate Increase  Requested Individual Mandate Assumption CSR Payments Assumption Requested Rate Increase Due to Mandate or CSR Uncertainty
CT ConnectiCare 17.5% Weakly enforced1 Not specified Mandate: 2.4%
DE Highmark BCBSD 33.6% Not enforced Not paid Mandate and CSR: 12.8% combined impact
GA Alliant Health Plans 34.5% Not enforced Not paid Mandate: 5.0%
CSR: Unspecified
ID Mountain Health CO-OP 25.0% Not specified Not paid CSR: 17.0%
ID PacificSource Health Plans 45.6% Not specified Not paid CSR: 23.2%
ID SelectHealth 45.0% Not specified Not paid CSR: 20.0%
MD CareFirst BlueChoice 45.6% Not enforced Potentially not paid Mandate: 20.0%
ME Harvard PilgrimHealth Care 39.7% Weakly enforced Potentially not paid Mandate: 15.9%
MI BCBS of MI 26.9% Weakly enforced Potentially not paid (two rate submissions) Mandate: 5.0%
MI Blue Care Network of MI 13.8% Weakly enforced Potentially not paid (two rate submissions) Mandate: 5.0%
MI Molina Healthcare of MI 19.3% Weakly enforced Potentially not paid (two rate submissions) Mandate: 9.5%
NM CHRISTUS Health Plan 49.2% Not enforced Potentially not paid Mandate: 9.0%, combined impact of individual mandate non-enforcement and reduced advertising and outreach
NM Molina Healthcare of NM 21.2% Weakly enforced Paid Mandate: 11.0%
NM New Mexico Health Connections 32.8% Not enforced Potentially not paid Mandate: 20.0%
OR* BridgeSpan 17.2% Weakly enforced Potentially not paid Mandate: 11.0%
OR* Moda Health 13.1% Not enforced Potentially not paid Mandate: 1.2%
OR* Providence Health Plan 20.7% Not enforced Potentially not paid Mandate: 9.7%, largely due to individual mandate non-enforcement
TN BCBS of TN 21.4% Not enforced Not paid Mandate: 7.0%
CSR:  14.0%
TN Cigna 42.1% Weakly enforced Not paid CSR: 14.1%
TN Oscar Insurance  NA (New to state) Not enforced Not paid Mandate: 0%, despite non-enforcement
CSR: 17.0%, applied only to silver plans
VA CareFirst BlueChoice 21.5% Not enforced Potentially not paid Mandate: 20.0%
VA CareFirst GHMSI 54.3% Not enforced Potentially not paid Mandate: 20.0%
WA LifeWise Health Plan of Washington 21.6% Weakly enforced Not paid Mandate: 5.2%
CSR: 2.3%
WA Premera Blue Cross 27.7% Weakly enforced Not paid Mandate: 4.0%
CSR: 3.1%
WA Molina Healthcare of WA 38.5% Weakly enforced Paid Mandate: 5.4%
NOTES: The CSR assumption “Potentially not paid” refers to insurers that filed initial rates assuming CSR payments are made and indicated that uncertainty over CSR funding would change their initial rate requests. In Michigan, insurers were instructed to submit a second set of filings showing rate increases without CSR payments; the rates shown above assume continued CSR payments. *The Oregon Division of Financial Regulation reviewed insurer filings and advised adjustment of the impact of individual mandate uncertainty to between 2.4% and 5.1%. Although rates have since been finalized, the increases shown here are based on initial insurer requests. 1Connecticare assumes a public perception that the mandate will not be enforced.
SOURCE:  Kaiser Family Foundation analysis of premium data from Healthcare.gov and insurer rate filings to state regulators.

Discussion

A number of insurers have requested double-digit premium increases for 2018. Based on initial filings, the change in benchmark silver premiums will likely range from -5% to 49% across these 21 major cities. These rates are still being reviewed by regulators and may change.

In the past, requested premiums have been similar, if not equal to, the rates insurers ultimately charge. This year, because of the uncertainty insurers face over whether the individual mandate will be enforced or cost-sharing subsidy payments will be made, some companies have included an additional rate increase in their initial rate requests, while other companies have said they may revise their premiums late in the process. It is therefore quite possible that the requested rates in this analysis will change between now and open enrollment.

Insurers attempting to price their plans and determine which states and counties they will service next year face a great deal of uncertainty. They must soon sign contracts locking in their premiums for the entire year of 2018, yet Congress or the Administration could make significant changes in the coming months to the law – or its implementation – that could lead to significant losses if companies have not appropriately priced for these changes. Insurers vary in the assumptions they make regarding the individual mandate and cost-sharing subsidies and the degree to which they are factoring this uncertainty into their rate requests.

Because most enrollees on the exchange receive subsidies, they will generally be protected from premium increases. Ultimately, most of the burden of higher premiums on exchanges falls on taxpayers. Middle and upper-middle income people purchasing their own coverage off-exchange, however, are not protected by subsidies and will pay the full premium increase, switch to a lower level plan, or drop their coverage. Although the individual market on average has been stabilizing, the concern remains that another year of steep premium increases could cause healthy people (particularly those buying off-exchange) to drop their coverage, potentially leading to further rate hikes or insurer exits.

Methods

Data were collected from health insurer rate filing submitted to state regulators. These submissions are publicly available for the states we analyzed. Most rate information is available in the form of a SERFF filing (System for Electronic Rate and Form Filing) that includes a base rate and other factors that build up to an individual rate. In states where filings were unavailable, we gathered data from tables released by state insurance departments. Premium data are current as of August 7, 2017; however, filings in most states are still preliminary and will likely change before open enrollment. All premiums in this analysis are at the rating area level, and some plans may not be available in all cities or counties within the rating area. Rating areas are typically groups of neighboring counties, so a major city in the area was chosen for identification purposes.


Absent federal action, states take the lead on curbing drug costs

What's your state's stance on the cost of prescription drugs? See how Maryland has moved forward in their decision making for drug prices, giving themselves the ability to say "no" in this article from Benefits Pro written by Shefali Luthra.

You can read the original article here.


Lawmakers in Maryland are daring to legislate where their federal counterparts have not: As of Oct. 1, the state will be able to say “no” to some pharmaceutical price spikes.

A new law, which focuses on generic and off-patent drugs, empowers the state’s attorney general to step in if a drug’s price climbs 50 percent or more in a single year. The company must justify the hike. If the attorney general still finds the increase unwarranted, he or she can file suit in state court. Manufacturers face a fine of up to $10,000 for price gouging.

As Congress stalls on what voters say is a top health concern — high pharmaceutical costs — states increasingly are tackling the issue. Despite often-fierce industry opposition, a variety of bills are working their way through state governments. California, Nevada and New York are among those joining Maryland in passing legislation meant to undercut skyrocketing drug prices.

Maryland, though, is the first to penalize drugmakers for price hikes. Its law passed May 26 without the governor’s signature.

The state-level momentum raises the possibility that — as happened with hot-button issues such as gay marriage and smoke-free buildings — a patchwork of bills across the country could pave the way for more comprehensive national action. States feel the squeeze of these steep price tags in Medicaid and state employee benefit programs, and that applies pressure to find solutions.

“There is a noticeable uptick among state legislatures and state governments in terms of what kind of role states can play in addressing the cost of prescription drugs and access,” said Richard Cauchi, health program director at the National Conference of State Legislatures.

Many experts frame Maryland’s law as a test case that could help define what powers states have and what limits they face in doing battle with the pharmaceutical industry.

The generic-drug industry has already filed a lawsuit to block the law, arguing it’s unconstitutionally vague and an overreach of state powers. A district court is expected to rule soon.

The state-level actions focus on a variety of tactics:

“Transparency bills” would require pharmaceutical companies to detail a drug’s production and advertising costs when they raise prices over certain thresholds. Cost-limit measures would cap drug prices charged by drugmakers to Medicaid or other state-run programs, or limit what the state will pay for drugs. Supply-chain restrictions include regulating the roles of pharmacy benefit managers or limiting a consumer’s out-of-pocket costs.

A New York law on the books since spring allows officials to cap what its Medicaid program will pay for medications. If companies don’t sufficiently discount a drug, a state review will assess whether the price is out of step with medical value.

Maryland’s measure goes further — treating price gouging as a civil offense and taking alleged violators to court.

“It’s a really innovative approach. States are looking at how to replicate it, and how to expand on it,” said Ellen Albritton, a senior policy analyst at the left-leaning Families USA, which has consulted with states including Maryland on such policies.

Lawmakers have introduced similar legislation in states such as Massachusetts, Rhode Island, Tennessee and Montana. And in Ohio voters are weighing a ballot initiative in November that would limit what the state pays for prescription drugs in its Medicaid program and other state health plans.

Meanwhile, the California legislature passed a bill earlier in September that would require drugmakers to disclose when they are about to raise a price more than 16 percent over two years and justify the hike. It awaits Democratic Gov. Jerry Brown’s signature.

In June, Nevada lawmakers approved a law similar to California’s but limited to insulin prices. Vermont passed a transparency law in 2016 that would scrutinize up to 15 drugs for which the state spends “significant health care dollars” and prices had climbed by set amounts in recent years.

But states face a steep uphill climb in passing pricing legislation given the deep-pocketed pharmaceutical industry, which can finance strong opposition, whether through lobbying, legal action or advertising campaigns.

Last fall, voters rejected a California initiative that would have capped what the state pays for drugs — much like the Ohio measure under consideration. Industry groups spent more than $100 million to defeat it, putting it among California’s all-time most expensive ballot fights. Ohio’s measure is attracting similar heat, with drug companies outspending opponents about 5-to-1.

States also face policy challenges and limits to their statutory authority, which is why several have focused their efforts on specific parts of the drug-pricing pipeline.

Critics see these tailored initiatives as falling short or opening other loopholes. Requiring companies to report prices past a certain threshold, for example, might encourage them to consistently set prices just below that level.

Maryland’s law is noteworthy because it includes a fine for drugmakers if price increases are deemed excessive — though in the industry that $10,000 fine is likely nominal, suggested Rachel Sachs, an associate law professor at Washington University in St. Louis who researches drug regulations.

This law also doesn’t address the trickier policy question: a drug’s initial price tag, noted Rena Conti, an assistant professor in the University of Chicago who studies pharmaceutical economics.

And its focus on generics means that branded drugs, such as Mylan’s Epi-Pen or Kaleo’s overdose-reversing Evzio, wouldn’t be affected.

Yet there’s a good reason for this, noted Jeremy Greene, a professor of medicine and the history of medicine at Johns Hopkins University who is in favor of Maryland’s law.

Current interpretation of federal patent law suggests that the issues related to the development and affordability of on-patent drugs are under federal jurisdiction, outside the purview of states, he explained.

In Maryland, “the law was drafted narrowly to address specifically a problem we’ve only become aware of in recent years,” he said. That’s the high cost of older, off-patent drugs that face little market competition. “Here’s where the state of Maryland is trying to do something,” he said.

Still, a ruling against the state in the pending court case could have a chilling effect for other states, Sachs said, although it would be unlikely to quash their efforts.

“This is continuing to be a topic of discussion, and a problem for consumers,” said Sachs.

“At some point, some of these laws are going to go into effect — or the federal government is going to do something,” she added.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Source:

Luther S. (29 September 2017). "Absent federal action, states take the lead on curbing drug costs" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/29/absent-federal-action-states-take-the-lead-on-curb?page=2


How data analytics is changing employee benefit strategies

As technology continues to grow and expand, more employers are turning to digital platforms when it comes to managing their employee benefits program. With more access to technology, employers can use data accumulated from their employees to better personalize their employee benefits package to fit each individual's needs. Take a look at this column by Eric Helman from Employee Benefit Advisor and find out some more tips on how you can better leverage the data from an employee benefits program to fit your employees'es needs.

In the realm of employee benefits, surveys, focus groups and anecdotes about specific employee encounters with the benefits program typically drive the discussions about how that program should evolve in the future. Unlike the situation at Outback, it is difficult to “observe” how people actually consume benefits and tailor a program that is attractive to them.

Fortunately, recent developments in data analytics have unlocked the potential of using consumer behavior insights to drive employee benefits strategy.

Leading practitioners are beginning to leverage these developments to change the annual renewal process. The technologies that support data aggregation, normalization and reporting have been aggressively developed to support the provider and payer communities. Only now have these advancements been made available to employers and their advisers.

The most successful practitioners point to the value of standardized claims reporting based upon credible data. By combining current claims data with industry benchmarks and predictive analytics, employers gain insight into the ongoing performance of their benefit plans. They “see” for themselves what industry professionals have been telling them for years. Plan performance is based upon claims, both in terms of the number of units of healthcare consumed and the price of those units. In recent surveys, benefit professionals report the difficulty they have in convincing CFOs and CEOs to make the necessary changes to benefit programs. Standardized reporting from a credible analytics platform can greatly enhance the ability for benefit professionals to communicate their agenda.

But standardized reporting is not the panacea. Benefits are complex. And the relationship between risk and consumption of healthcare add to the complexity. Even in the best reporting environments where executives are well informed about the performance of their plans and how the key metrics compare to industry norms, they are often perplexed about what to do with the information. Advancements in the realm of “actionable analytics” are beginning to address this problem as well.

While artificial intelligence or AI is all the rage, the underlying concept of having a computer suggest a course of action based upon data is not a new idea. The new application to employee benefits is the ability to provide “suggestions” in the context of standardized financial reporting. The number of ideas to bend the cost curve are numerous. The challenge is matching these ideas with the appropriate populations, convincing decision makers to invest and engaging the appropriate cohorts of employees to take specific actions necessary to realize the return on investment for these initiatives.

New systems are now available to close the gaps on this execution continuum. The foundation for these new systems is a robust analytics platform. But actionable analytics build upon this foundation by evaluating the employer’s data to discern whether a specific cost-saving initiative might generate savings worthy of the investment. These new systems present the output of that analysis in an easy to understand graphical format for benefit consultants and HR professionals to effectively communicate the potential of cost savings initiatives to decision makers.

Targeted engagement maximizes compliance and ROI
Getting executives to commit to intentional actions to affect the rising costs of benefits solves one half of the problem. The second half of the problem is one of focus. Rather than attempting to engage all employees with generalized messaging, these new systems use analytics to focus their engagement on a specific cohort of individuals in order to drive the greatest impact. This focus allows for a concentration of resources on the targeted populations, resulting in increased compliance and larger return on investment. The best implementations are integrated with benefits administration platforms and can incorporate multiple initiatives simultaneously. Point solutions, from an engagement perspective, have been proven to result in single-digit compliance. The power of an integrated engagement solution allows for initiatives that, because they are both focused and automated, can be executed simultaneously.

Advancements in technology have created a new era in which the democratization of big data allows for non-technical professionals to access detailed information and convert that information into intelligence. According to a recent survey, more than 65% of employers confess they are not strategic when it comes to benefits cost management. In spite of the many cost savings ideas available, more than 40% say they are not engaging in any new initiatives in the upcoming year. While the future of healthcare reform is in doubt, the potential for actionable analytics to significantly change the trajectory of the employer’s benefits costs is certain.

See the original article Here.

Source:

Helman E.  (2017 September 5). How data analytics is changing employee benefit strategies [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/closing-the-execution-continuum-on-employee-benefit-cost-savings


Avoid these 12 Common Open Enrollment Mistakes

Open enrollment season is right around the corner. Check out this great column by Alan Goforth from Benefits Pro and find out the top mistakes employers and HR have made during open enrollment and what you can do to avoid them.

Every employer or human resources professional has made mistakes during open enrollment.

Trying to accommodate the diverse needs of the workforce in a short timeframe against the backdrop of increasing options and often bewildering regulations, can be a challenge even in the best-run companies.

Avoiding mistakes is impossible, but learning from them is not. Although the list may be limitless, here are a dozen of the most common pratfalls during open enrollmentand how to avoid tripping over them.

1. Failing to communicate

"What we've got here… is failure to communicate." – Cool Hand Luke

This mistake likely has topped the list since open enrollment first came into existence, and it will probably continue to do so. That's because enrollment is a complex procedure, and few challenges are greater that making sure employers, employees, brokers and carriers are on the same page.

Employers have both a stick and a carrot to encourage them to communicate as well as possible. The stick is the Affordable Care Act, which requires all employers subject to the Fair Labor Standards Act to communicate with employees about their health-care coverage, regardless of whether they offer benefits.

As a carrot, an Aflac study found that 80 percent of employees agree that a well-communicated benefits package would make them less likely to leave their jobs

2. Neglecting technology

The integration of new technology is arguably the most significant innovation in the enrollment process in recent years.

This is especially important as younger people enter the workforce. Millennials repeatedly express a preference for receiving and analyzing benefits information by computer, phone or other electronic devices.

The challenge is to make the use of technology as seamless as possible, both for employees who are tech-savvy and for those who are not.

Carriers and brokers are making this an emphasis, and employers should lean on them for practical advice.

See the original article Here.

3. Over-reliance on technology

At the other end of the spectrum is the temptation to rely on technology to do things it never was meant to do.

"Technology is so prevalent in the enrollment space today, but watch out for relying on technology as the one thing that will make or break enrollment," says Kathy O'Brien, vice president of voluntary benefits and nation client group services for Unum in Chattanooga, Tennessee. "Technology is great for capturing data, but it won't solve every problem and doesn't change the importance of the other work you need to do."

4. Succumbing to inertia

It can be frustrating to invest substantial time and effort into employee benefit education, only to have most of the staff do nothing.

Yet that is what happens most of the time. Just 36 percent of workers make any changes from the previous enrollment, and 53 percent spend less than one hour making their selections, according to a LIMRA study.

One reason may be that employees don’t feel assured they are making the right decisions.

Only 10 percent felt confident in their enrollment choices when they were done, according to a VSP Vision Care study. One good strategy for overcoming inertia is to attach dollar values to their choices and show where their existing selections may be leaving money on the table.

5. Cutting too many corners

One of the most difficult financial decisions employers make each year is deciding how much money to allocate to employee benefits.

Spending too much goes straight to the bottom line and could result in having to lay off the very employees they are trying to help. Spending too little, however, can hurt employee retention and recruiting.

Voluntary benefits offer a win-win solution. Employees, who pick up the costs, have more options to tailor a program that meets their own needs.

In a recent study of small businesses, 85 percent of workers consider voluntary benefits to be part of a comprehensive benefits package, and 62 percent see a need for voluntary benefits.

6. Not taking a holistic approach

"Holistic" is not just a description of an employee wellness program; it also describes how employers should think about employee benefit packages.

The bread-and-butter benefits of life and health insurance now may include such voluntary options as dental, vision and critical illness. Employers and workers alike need to understand how all of the benefits mesh for each individual.

Businesses also need to think broadly about their approach to enrollment

"Overall, we take a holistic approach to the customer’s enrollment program, from benefits communication to personalized benefits education and counseling, as well as ongoing, dedicated service," says Heather Lozynski, assistant vice president of premier client management for Colonial Life in Columbia, South Carolina. "This allows the employer to then focus on other aspects of their benefits process."

7. Unbalanced benefits mix

Employee benefits have evolved from plain vanilla to 31 (or more) flavors.

As the job market rebounds and competition for talented employees increases, workers will demand more from their employers.

Benefits that were once considered add-ons are now considered mandatory.

Round out the benefits package with an appealing mix of standard features and voluntary options with the objective of attracting, retaining and protecting top-tier employees.

8. Incomplete documentation

Employee satisfaction is a worthy objective — and so is keeping government regulators happy.

The Affordable Care Act requires employers who self-fund employee health care to report information about minimum essential coverage to the IRS, at the risk of penalties.

Even if a company is not required by law to offer compliant coverage to part-time employees, it still is responsible for keeping detailed records of their employment status and hours worked.

As the old saying goes, the job is not over until the paperwork is done.

9. Forgetting the family

The Affordable Care Act has affected the options available to employers, workers and their families.

Many businesses are dropping spousal health insurance coverage or adding surcharges for spouses who have access to employer-provided insurance at their own jobs.

Also, adult children can now remain on their parents' health policies until they are 26.

Clearly communicate company policies regarding family coverage, and try to include affected family members in informational meetings.

Get to know more about employees' families — it will pay dividends long after open enrollment.

10. Limiting enrollment options

Carriers make no secret about their emphasis on electronic benefits education and enrollment.

All things considered, it is simpler and less prone to copying and data-entry errors.

It would be a mistake, however, to believe that the high-tech option is the first choice of every employee.

Be sure to offer the options of old-fashioned paper documents, phone registration and face-to-face meetings. One good compromise is an on-site enrollment kiosk where a real person provides electronic enrollment assistance.

11. Letting benefits go unused

A benefit is beneficial only if the employee uses it. Too many employees will sign up for benefits this fall, forget about them and miss out on the advantages they offer.

Periodically remind employees to review and evaluate their available benefits throughout the year so they can take advantage of ones that work and drop those that do not.

In addition to health and wellness benefits, also make sure they are taking advantage of accrued vacation and personal days.

Besides maximizing the return on their benefit investment, it will periodically remind them that the employer is looking out for their best interests.

12. Prematurely closing the 'OODA' loop

Col. John Boyd of the U.S. Air Force was an ace fighter pilot. He summarized his success with the acronym OODA: Observe, Orient, Decide and Act. Many successful businesses are adopting his approach.

After the stress of open enrollment, it's tempting to breathe a sigh of relief and focus on something else until next fall.

However, the close of enrollment is a critical time to observe by soliciting feedback from employees, brokers and carriers.

What worked this year, and what didn't? What types of communications were most effective? And how can the process be improves in 2017?

"Make sure you know what is working and what is not," said Linda Garcia, vice president for human resources at Rooms to Go, a furniture retailer based just outside Tampa. "We are doing a communications survey right now to find out the best way to reach each of our 7,500 employees. We also conduct quarterly benefits surveys and ask for their actual comments instead of just checking a box."

Source:

Goforth A. (2017 Aug 22). Avoid these 12 common open enrollment mistakes [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/08/22/avoid-these-12-common-open-enrollment-mistakes?ref=hp-in-depth&page_all=1


6 employee benefits trends in 2017

2018 is almost upon us. More employers are beginning to start their search for new talent next year. If you are in the process of hiring check out this great article put together by Marlene Y. Satter from Benefits Pro and find out the top employee benefit trends for attracting new talent in 2017.

Employers looking to attract the best new employees need to look closely at their benefits offerings.

That’s according to a CBS report that highlights the six trends in benefits that are of the most interest to prospective employees. With millennials having outpaced GenXers as the largest demographic in the workplace, the report says, “it has become abundantly clear over the course of the last half decade that millennials have very different career priorities than their predecessors.”

With that in mind, here are six types of benefits employers might want to consider, if they’re not already on offer.

Flex hours are high on the list for millennials, who regard life/work balance as very important. In fact, according to a PwC study, it’s more important to them than financial compensation. Flexible schedules provide a way for employers to give that balance to employees, allowing them to work hours other than 9-to-5, or from home part of the week. As a result, the report says, employees will have better job satisfaction and be more likely to stay.

Workplace wellness programs are another way to provide a perk that pays off for both employer and employee — and not necessarily at a high cost, the report says. Not only do such programs foster a strong sense of team unity that will help drive job satisfaction and productivity, they also cut health care costs.

Continuing education not only gives employees a leg up, but also provides employers with better-trained staff who are able to cope with modern challenges and less likely to jump ship in search of a more congenial workplace. While the report concedes that most small and midsize businesses don’t have the budget to provide postgrad tuition to employees, that doesn’t mean that companies can’t focus on such investments in language and software certification classes.

Digital health care solutions enable masters of the cyber world in the workforce to reach out to health practitioners via mobile devices and computers, resulting in faster and more personalized treatment. In addition, the report says, “digital health programs are also incredibly cost effective and are estimated to save billions in medical costs over the next four years.”

Fringe benefits and perks — even if not on the scale of big-budget Silicon Valley companies — are another way to woo millennial employees. Public transportation passes, reimbursing employees for yoga classes and massage sessions and providing free lunches or snacks, can give recruiting an edge over companies that do nothing along these lines, the report points out.

Last but not least, there’s a bigger budget of vacation days. Employers may think that’s too expensive, but employee burnout is responsible for 50 percent of employee churn— and the cost of replacing even an entry-level employee can cost a company up to 50 percent of his or her annual salary. The money spent on extra vacation to avoid burnout could be more than offset by the losses of not doing so. Plus, the knowledge that well-rested employees are more productive will also help to counter the down time that might be caused by those additional days off.

See the original article Here.

Source:

Satter M. (2017 September 5 ). 6 employee benefits trends in 2017 [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/09/05/6-employee-benefits-trends-in-2017?page=2&page_all=1


doctor and patient

Self-funding and Voluntary Benefits: The Dynamic Insurance Duo

Did you know that self-funded health insurance and voluntary benefits can be a dream team when used in conjunction with each other? Check out this great article by Steve Horvath and Dan Johnson from Benefits Pro and find out how you can make the most of this dynamic insurance duo.

In an era of health care reform, double-digit rising health care costs, and plenty of “unknowns,” many employers view their benefit plans as a challenging blend of cost containment strategies and employee retention.

But perhaps they need to better understand the value of a little caped crusader named voluntary benefits.

Employers of all sizes share common goals when it comes to their benefits. They seek affordable, and quality benefits for their employees.

Some companies achieve these goals by cutting costs and going with a high-deductible, self-funded approach. While many associate self-funding with larger employers, in the current marketplace, it has become a viable option for companies across the board.

Especially when paired with a voluntary benefits offering supported by one-on-one communication or a call center, employers are able to cut costs and offer additional insurance options tailored to their employees’ needs. But there’s more.

Voluntary enrollments can help employers meet many different challenges, all of which tie back to cost-containment, streamlined processes and employee understanding and engagement. But before we explore solutions, let’s first understand why so many employers are going the self-funded route.

For most large and small employers, the costs of providing health care to employees and their families are significant and rising.

For companies who may be tight on money and are seeing their fully-insured premiums increase every year with little justification, self-funding serves as a great solution to keep their medical expenses down.

Self-funding: An overview

Self-funding allows employers to:

  1. Control health plan costs with pre-determined claims funding amounts to a medical plan account, without paying the profit margin of the insurance company.
  2. Protect their plan from catastrophic claims with stop-loss insurance that helps to pay for claims that exceed the amount set by their self-funded plan.
  3. Pay for medical claims the plan actually incurs, not the margin a fully insured plan underwrites into their premium, while protecting the plan with catastrophic loss coverage when large expenses are incurred. Plans may offer to share favorable savings with their employees through programs like premium holidays. These programs allow employee contributions to be waived for a period of time selected by the employer to reward employees for low utilization and adequate funding of their claims accounts and reserves.
  4. Take advantage of current and future year plan management guidance.
  5. Save on plan costs by using predictive analysis for health and wellness offered by the third-party administrator (TPA).

Beyond these advantages,self-funded plans may not be subject to all of the Affordable Care Act regulations as fully-insured plans, which is one of the reasons they provide a solution for controlling costs. Without these requirements, the plans can be tailored much more precisely to meet the needs of a specific employee group.

Boosting value: Advantages of adding voluntary benefits to a self-funded plan

Based on an employer’s specific benefit plan, and what it offers, employers are able to select voluntary benefits that can complement the plan and properly meet employees’ needs without adding extra costs to the plan.

Employees are then able to customize their own, personal benefit options even further based on their unique needs and available voluntary benefits.

This provides employees a myriad of benefits while also allowing them to account for out-of-pocket costs due to high-deductibles or plan changes, as well as provide long-term protection if the product is portable.

Voluntary solutions are about more than the products

Aside from the common falsehood that voluntary benefits are only about adding ‘gap fillers’ to your plan, you may be pleasantly surprised to learn that conducting a voluntary benefits enrollment can actually offer a number of services, solutions, and products, many of which may be currently unfamiliar to you.

Finding, and funding, a ben-admin solution

Some carriers offer the added bonus of helping employers install a benefits administration system in return for conducting a one-on-one or mandatory call center voluntary benefits enrollment.

The right benefits administration systems can help remove manual processes and allow HR to do what they do best—focus on employees and improving employee programs. No more headaches around changing coverage, change files to carriers, changing payroll-deductions or premiums.

Finding the benefits administration system that works best for your situation can make a big difference for your HR team.

Communication and engagement

Many employees are frustrated and scared about how changes to the insurance landscape will impact them. And with a recent survey noting that 95 percent of employees need someone to talk to for benefits information,they clearly are seeking ongoing communications and resources.

During the enrollment process, some carriers work with enrollment and communications companies who understand the employees’ benefit plan options and help guide them to the offerings that are best for them and their families.

At the same time, employers can enhance the communication and engagement efforts on other important corporate initiatives. For example, a client of ours increased employee participation in their high-deductible health plan (HDHP) via pre-communication.

Of the 90 percent of employees that went to the enrollment, nearly 70 percent said they were either likely or very likely to select the HDHP. Just a little bit of communication can go a long way toward employee understanding.

Providing education and engagement about both benefits and workplace initiatives increases the effectiveness of these programs and contributes to keeping costs down for employers. The more engagement employers generate, the healthier and better protected the employees.

Prioritizing health and wellness

Employers can also use the enrollment time with employees to remind them to get their annual exams. Many voluntary plans offer a wellness benefit (e.g. $50 or $100) to incentivize the employee and dependents.

The ROI for an employer’s health plan provides value as regular screenings can help detect health issues in the beginning stages so that proper health care management can begin and medical spend can be minimized.

Employers have also seized the opportunity of a benefits enrollment to implement a full-scale wellness program at reduced costs by aligning it with a voluntary benefits enrollment.

An effective wellness program will approach employee health from a whole-person view, recognizing its physical, social, emotional, financial and environmental dimensions. A properly implemented wellness program can ultimately make healthy actions possible for more of an employee population.

A formidable combination

What employers are seeking is simple -- quality benefits and a way to lower costs. With that in mind, offering a self-funded plan with complementary voluntary benefit products and solutions allows employers to take advantage of multiple opportunities while, at the same time, providing more options for their employees.

In today’s constantly changing landscape, self-funded plans paired with voluntary benefits is a formidable combination – a dynamic insurance duo.

See the original article Here.

Source:

Horvath S., Johnson D.  (2016 November 23). Self-funding and voluntary benefits: the dynamic insurance duo [Web blog post]. Retrieved from address http://www.benefitspro.com/2016/11/23/self-funding-and-voluntary-benefits-the-dynamic-in?page_all=1


Closing the execution continuum on employee benefit cost savings

Are you using big data to reduce your employee benefits costs? As more employers switch their employee benefits to a digital platform, big data can be a great tool for employers looking to reduce the costs associated with their benefits program. Check out this great article by Eric Helman from Employee Benefit Advisor and found out how you can leverage your data to reduce to cost of an employee benefit program.

A revolution in employee benefits is on the horizon, and 21st century analytics is at the core. Big data holds the promise to scan huge amounts of information in a near real-time environment for insights that will impact the current and future trajectory for a given area. The advancement of true cross-vendor analytics, prescription, engagement and measurement brought on by the democratization of big data is enabling employers, brokers and consultants to improve the performance of their employee benefits plans like never before.

Two decades ago, I had the opportunity to hear Chris Sullivan, one of the founders of Outback Steakhouse, speak to a group of executives about customer research. His sentiments: “We don’t do focus groups. People don’t know what they want. Who would say they would like to stand in line for 30 minutes to eat salty food in a very loud restaurant? But that is exactly what they wanted. And that is what made Outback a success. Instead of focus groups, we place very talented and engaged proprietors in our stores and teach them to observe what people want. Then, we replicate that experience.”

In the realm of employee benefits, surveys, focus groups and anecdotes about specific employee encounters with the benefits program typically drive the discussions about how that program should evolve in the future. Unlike the situation at Outback, it is difficult to “observe” how people actually consume benefits and tailor a program that is attractive to them.

Analytics drive strategy 
Fortunately, recent developments in data analytics have unlocked the potential of using consumer behavior insights to drive employee benefits strategy. Leading practitioners are beginning to leverage these developments to change the annual renewal process. The technologies that support data aggregation, normalization and reporting have been aggressively developed to support the provider and payer communities. Only now have these advancements been made available to employers and their advisers.

The most successful practitioners point to the value of standardized claims reporting based upon credible data. By combining current claims data with industry benchmarks and predictive analytics, employers gain insight into the ongoing performance of their benefit plans. They “see” for themselves what industry professionals have been telling them for years. Plan performance is based upon claims, both in terms of the number of units of healthcare consumed and the price of those units. In recent surveys, benefit professionals report the difficulty they have in convincing CFOs and CEOs to make the necessary changes to benefit programs. Standardized reporting from a credible analytics platform can greatly enhance the ability for benefit professionals to communicate their agenda.

But standardized reporting is not the panacea. Benefits are complex. And the relationship between risk and consumption of healthcare add to the complexity. Even in the best reporting environments where executives are well informed about the performance of their plans and how the key metrics compare to industry norms, they are often perplexed about what to do with the information. Advancements in the realm of “actionable analytics” are beginning to address this problem as well.

While artificial intelligence or AI is all the rage, the underlying concept of having a computer suggest a course of action based upon data is not a new idea. The new application to employee benefits is the ability to provide “suggestions” in the context of standardized financial reporting. The number of ideas to bend the cost curve are numerous. The challenge is matching these ideas with the appropriate populations, convincing decision makers to invest and engaging the appropriate cohorts of employees to take specific actions necessary to realize the return on investment for these initiatives.

New systems are now available to close the gaps on this execution continuum. The foundation for these new systems is a robust analytics platform. But actionable analytics build upon this foundation by evaluating the employer’s data to discern whether a specific cost-saving initiative might generate savings worthy of the investment. These new systems present the output of that analysis in an easy to understand graphical format for benefit consultants and HR professionals to effectively communicate the potential of cost savings initiatives to decision makers.

Targeted engagement maximizes compliance and ROI
Getting executives to commit to intentional actions to affect the rising costs of benefits solves one half of the problem. The second half of the problem is one of focus. Rather than attempting to engage all employees with generalized messaging, these new systems use analytics to focus their engagement on a specific cohort of individuals in order to drive the greatest impact. This focus allows for a concentration of resources on the targeted populations, resulting in increased compliance and larger return on investment. The best implementations are integrated with benefits administration platforms and can incorporate multiple initiatives simultaneously. Point solutions, from an engagement perspective, have been proven to result in single-digit compliance. The power of an integrated engagement solution allows for initiatives that, because they are both focused and automated, can be executed simultaneously.

Advancements in technology have created a new era in which the democratization of big data allows for non-technical professionals to access detailed information and convert that information into intelligence. According to a recent survey, more than 65% of employers confess they are not strategic when it comes to benefits cost management. In spite of the many cost savings ideas available, more than 40% say they are not engaging in any new initiatives in the upcoming year. While the future of healthcare reform is in doubt, the potential for actionable analytics to significantly change the trajectory of the employer’s benefits costs is certain.

See the original article Here.

Source:

Helman E. (2017 September 5). Closing the execution continuum on employee benefit cost savings [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/closing-the-execution-continuum-on-employee-benefit-cost-savings?brief=00000152-146e-d1cc-a5fa-7cff8fee0000


Why Employee Engagement Matters – and 4 Ways to Build It Up

An engaged employee is a productive employee. Employee engagement is a very important piece of a company's operations. They are some of the best assets a company can have and without engaged employees, your company's operations could be negatively impacted. Take a look at this great article by Joe Wedgewood from The Happiness Index and check out some of the helpful tips on how you can boost engagement across your organization.

Organizations with high employee engagement levels outperform their low engagement counterparts in total shareholder returns and higher annual net income.” — Kenexa.

Your people are undoubtedly your greatest asset. You may have the best product in the world, but if you can’t keep them engaged and motivated — then it counts for very little.

By making efforts to keep your people engaged, you will maximize your human capital investment and witness your efforts being repaid exponentially.

The benefits of an engaged workforce

Increase in profitability: 

Increasing employee engagement investments by 10% can increase profits by $2,400 per employee, per year.” — Workplace Research Foundation.

 There is a wealth of research to suggest that companies that focus on employee engagement will have an emotionally invested and committed workforce. This tends to result in higher profitability rates and shareholder returns. The more engaged your employees are the more efficient and productive they become. This will help lower operating costs and increase profit margins.

An engaged workforce will be more committed and driven to help your business succeed. By focusing on engagement and investing in your people’s future, you will create a workforce that will generate more income for your business.

Improved retention and recruitment rates:

“Replacing employees who leave can cost up to 150% of the departing employee’s salary. Highly engaged organizations have the potential to reduce staff turnover by 87%; the disengaged are four times more likely to leave the organization than the average employee.” — Corporate Leadership Council

Retaining good employees is vital for organizational success. Engaged employees are much less likely to leave, as they will be committed to their work and invested in the success of the company. They will have an increased chance of attracting more qualified people.

Ultimately the more engaged your people are, the higher their productivity and workplace satisfaction will be. This will significantly reduce costs around absences, recruitment, training and time lost for interviews and onboarding.

Boost in workplace happiness:

“Happy employees are 12%t more productive than the norm, and 22% more productive than their unhappy peers. Creating a pleasant workplace full of happy people contributes directly to the bottom line.” – Inc.

Engaged employees are happy employees, and happy employees are productive employees. A clear focus on workplace happiness, will help you to unlock everyone’s true potential. On top of this, an engaged and happy workforce can also become loyal advocates for your company. This is evidenced by the Corporate Leadership Council, “67% of engaged employees were happy to advocate their organizations compared to only 3% of the disengaged.”

Higher levels of productivity:

“Employees with the highest levels of commitment perform 20% better than employees with lower levels of commitment.” — The Society for Human Resource Management (SHRM).

Often your most engaged people will be the most dedicated and productive, which will give your bottom line a positive boost. Employees who are engaged with their role and align with the culture are more productive as they are looking beyond personal benefits. Put simply, they will work with the overall success of the organization in mind and performance will increase.

More innovation:

“Employee engagement plays a central role in translating additional job resources into innovative work behaviour.” — J.J. Hakanen.

Employee engagement and innovation are closely linked. Disengaged employees will not have the desire to work innovatively and think of new ways to improve your business; whereas an engaged workforce will perform at a higher level, due to increased levels of satisfaction and interest in their role. This often breeds creativity and innovation.

If your people are highly engaged they will be emotionally invested in your business. This can result in them making efforts to share ideas and innovations with you that can lead to the creation of new services and products — thus improving employee profitability.

Strategies to increase employee engagement

Communicate regularly:

Every member of your team will have valuable insights, feedback and suggestions. Many will have concerns and frustrations too. Failure to effectively listen and respond to everyone will lower their engagement and negatively affect the company culture.

Create open lines of communication and ensure everyone knows how to contact you. This will create a platform for your people to share ideas, innovations and concerns with you. It will also bridge gaps between senior management and the rest of the team.

An effective way to communicate and respond to everyone in real-time is by introducing pulse surveys — which will allow you to gather instant intelligence on your people to help you understand the sentiment of your organization. You can use this feedback to create relevant action plans to boost engagement and make smarter business decisions.

Take the time to respond and share action plans with everyone. This will ensure your people know that their feedback is being heard and can really make a difference.

Recognize achievements:

“The engagement level of employees who receive recognition is almost three times higher than the engagement level of those who do not.” — IBM Smarter Workforce Institute.

If your people feel undervalued or unappreciated then their performance and profitability will decrease. According to a survey conducted by technology company Badgeville, only 31% of employees are most motivated by monetary awards. The remaining 69% of employees are motivated by job satisfaction, recognition and learning opportunities.

Make efforts to celebrate good work and recognize everyone’s input. Take the time to personally congratulate people and honor their achievements and hard work. You will likely be rewarded with an engaged and energized workforce, that will make efforts to impress you and have their efforts recognized.

Provide opportunities for growth:

Career development is key for employee engagement. If your people feel like their careers are stagnating, or their hard work and emotional investment aren’t being reciprocated — then you can be certain that engagement will drop.

By meeting with your people regularly, discussing agreed targets and time frames, and clearly highlighting how they fit into the organizations wider plans, you can build a “road map” for their future. This will show that their efforts and hard work aren’t going unnoticed.

Improve company culture:

“Customers will never love a company until the employees love it first.” — Simon Sinek.

Building a culture that reflects your brand and creates a fun and productive working environment is one of the most effective ways to keep your employees engaged. It’ll also boost retention and help recruitment efforts. If your culture motivates everyone to work hard, help each other, become brand ambassadors, and even keep the place clean — then you have won the battle.

An engaged and committed workforce is a huge contributor to any organization’s bottom line. The rightculture will be a catalyst to help you achieve this.

Here’s how you can improve the company culture within your organization:

  • Empower your people: Empowered employees will take ownership of their responsibilities, solve problems and do whatever it takes to help your company succeed. This will drive your company culture forward. Demonstrate you have faith in your people and trust them to fulfill their duties to their best of their abilities. This will ensure they feel valued, which can lead to empowerment.
  • Manage and communicate expectations: Your people may struggle to understand your cultural vision. By setting clear and regular expectations and communicating your vision via posters, emails, discussions and leading by example, you will prevent confusion and limit deviation from your desired vision.
  • Be consistent: To sustain a consistent culture, you must show uniformity with your actions and communications. Make efforts to have consistent expectations and standards for all your workers, and communicate everything in the same way.

By focusing on employee engagement and investing in your people, they will repay your efforts with an increase in performance, productivity and — ultimately — profit.

See the original article Here.

Source:

Wedgewood J. (2017 June 8). Why employee engagement matters - and 4 ways to build it up [Web blog post]. Retrieved from address http://www.hrmorning.com/employee-engagement-ways-to-build-it-up/


5 tips to make this the best open enrollment ever

Open enrollment season is right around the corner. Did you know that most people find open enrollment season more burdensome than tax season? As employers begin engaging their employees on healthcare offerings, check out these great tips by Kim Buckey from Benefits Pro on how you can make this year the best open enrollment yet.

Learn from last year’s enrollment

Look back on how your company fared during last year’s open enrollment period.

What were the most time-consuming tasks, and how can they be streamlined this year? What were the top questions asked by employees? Did you achieve your enrollment goals?

Hold a meeting with key internal and external stakeholders on the team and review what worked and what didn’t work last year. Knowing where you are, what your challenges are and will be, and where you’re on the right track will enable you to create a meaningful plan for this year.

Start with strategy

Once you know where you are, figure out where you want to be, how you’re going to get there, and how you’ll determine if you’ve achieved your goals. Make sure your strategy includes:

  • An assessment of all of your audiences. Remember, you’re not just communicating to employees, you’re reaching out to family members and to managers as well. Keep in mind that not every audience member has the same education level or understanding of even the most basic benefits concepts.
  • What’s changing. Are you adding or eliminating plans? Is cost-sharing changing? Is there a new vendor? Having a thorough understanding of what’s changing will help determine what your messaging should be.
  • Defining your corporate objectives. Are you looking to increase participation in a particular plan option, or shift a percentage of your population to a new plan offering? Increase participation in a wellness plan? What percentage? Define your objectives and how you plan on measuring success.
  • Your overall messages — and any specific messages targeted to your audiences. You may communicate differently to people already in the plan in which you want to increase participation, for example.
  • A schedule. People need to hear messages multiple times before they “register.” Make sure you’re communicating regularly — and thoughtfully — in the weeks leading up to, and during, the enrollment period.
  • Media. What messages will you deliver in print (newsletters, posters, postcards, enrollment guides)? What should be communicated in person, through managers or one-on-one enrollment support?

Make this year’s enrollment more active

Eighty percent of Americans spend less than an hour researching benefit options, and 90 percent keep the same plan from year to year. Yet for most employees, their circumstances change annually — whether it be the number of their dependents, their overall health and health care usage or their pay.

Active enrollment — where an employee must proactively choose a plan or go without coverage — can be an important step in getting employees more engaged in their benefits.

Active enrollment has benefits for the employer as well — it provides an opportunity to collect key data (such as current dependent information) and to direct employees to the most cost-effective plans for them.

But helping employees choose the “right” plan requires a robust communication plan, combining basic information about plan options, decision-making tools that address the total cost of coverage (both premium and point-of-service costs) and even one-one-one enrollment support.

Many employees don’t have the information they need to make good decisions, and aren’t likely to seek it out on their own — it must be ‘pushed’ to them.

Take demographics into consideration

When engaging employees around their benefits options, consider the wants, needs, and communication preferences of each demographic. Employees just starting their careers are the most underinsured (and generally least informed) group, often seeing student debt rather than health coverage as a more pressing priority.

Harris/Accolade poll reveals that when results are broken out by age cohort, workers under 30 are having the greatest difficulty finding their way through the healthcare labyrinth.

Only 56 percent say they are comfortable doing so, compared to 76 percent of retirees. They also report more challenges in making the best care decisions, including understanding cost, coordinating care, choosing and understanding benefits, and finding a doctor they can relate to.

Understand the limitations of decision support tools

Decision support tools enable people to take an active role in managing their health care. While they can certainly help, remember that employees must seek them out and use them, and these tools often assume a level of benefits knowledge your employees might not have.

And, these tools recently have come under scrutiny for their ultimate lack of measurable results. To see the return on investment and value, you must also provide education and communications to provide some context for, and drive usage of, these tools.

By applying these five steps along with setting your team up with designated roles, responsibilities, and deadlines, you’re well on your way toward a more seamless, efficient and effective open enrollment period and to saving both your organization and your coworkers time and money.

But remember, benefits communication isn’t “one and done” at enrollment. You’ll need a year-round plan to help employees make good decisions about their care once they’ve chosen their coverage.

See the original article Here.

Source:

Buckey K. (2017 Aug 25). 5 tips to make this the best open enrollment ever [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/08/25/5-tips-to-make-this-the-best-open-enrollment-ever?page_all=1


4 Reasons Employers Should Offer Supplemental Life Insurance

Is life insurance included in your employee benefits program? For many employees, their only form of life insurance they have is the basic group life plan provided by an employer. This standard version of life insurance is usually not enough to maintain most employees financial wellness. Supplemental life insurance plans can enhance the standard coverage provided by most employers by providing employee financial security for their futures. While these plans can be a great way to boost an employees financial wellness only about one-half of employers across the nation offer supplemental life insurance with their employee benefits. Take a look at this great list put together by Mike Wozny from Think Advisor and find out the top 4 reasons why you should be offering your employees supplemental life insurance.

Depending on an individual family’s needs, supplemental life insurance can build on the employer-provided life insurance benefit, and helps employers give their employees the future financial security their employees need. For those employers who are not currently offering supplemental life, here are four key reasons they should start:

  • Many employers can offer employees the financial security of supplemental life insurance without increasing their benefits budget. Because supplemental life insurance is opt-in and chosen by individual employees as appropriate for their situations, employers can offer supplemental life insurance as an option at no additional cost to the employer. Employees can then customize their coverage to their needs depending on their financial responsibilities.
  • Many group carriers offer employers help in enrolling employees in supplemental life. Employers can host on-site enrollment sessions lead by a life insurance expert or hold a webinar led by the carrier followed by online enrollment. Many carriers even offer customized enrollment materials for each employee — all without adding to the employer’s human resources teams’ workload.
  • Financial security is tied to employees' productivity. The Consumer Financial Protection Bureau has found that when employees have to spend time and energy worrying about providing for their families, they are more productive. Appropriate life insurance is a key factor in overall financial health, and provides employees with the peace of mind that lets them focus their energy elsewhere.
  • Comprehensive benefits packages contribute to higher employee satisfaction and retention.The Society for Human Resource Management has also found that benefits offerings are important to employees’ decisions about what companies to work for and how long to stay. Offering a benefits package that includes supplemental life insurance coverage allows employees to customize benefits to their own needs.

With the loss of a loved one, many families also lose their income, which can be not only emotionally devastating, but financially devastating as well. When employers offer a complete benefits package, including one that promotes financial wellness, it gives their employees peace of mind, and helps attract and retain top workers.

Though life insurance is rarely a topic that families want to think about, employers can help employees obtain the right amount of insurance to protect their finances by offering supplemental life insurance options. For those employers who are not currently offering these benefits, in many cases they can be added at no expense, with little additional time required to administer them, and at great potential benefit to both the company and its employees.

See the original article Here.

Source:

Wozny M. (2016 October 19). 4 reasons employers should offer supplemental life insurance [Web blog post]. Retrieved from address http://www.thinkadvisor.com/2016/10/19/4-reasons-employers-should-offer-supplemental-life