4 questions to ask before adding biometric screenings

According to the Kaiser Family Foundation (KFF), fifty-two percent of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening. Continue reading this blog post to learn more.


A growing number of employers are adopting workplace wellness programs to improve employee health and subsequently lower their health insurance spend. As they do, benefit managers are tasked with vetting options that will deliver meaningful health and financial results for their companies.

This vetting process typically involves answering questions that range from which types of participation incentives their organization should offer to what type of wellness programs will yield the greatest health-improvement outcomes.

But there’s a problem: Very few benefits managers ask for details about wellness biometric testing, even though most programs are, at least in theory, designed around the information that screening provides. Biometric screening typically involves one or more laboratory tests as well as physical readings, such as blood pressure and body weight, to identify markers of health risks if not an actual disease.

According to the Kaiser Family Foundation, 52% of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening.

Just as workplace wellness programs are not all the same, biometric screening can vary. Failure to question the specific details of a proposed biometric screening program can lead to suboptimal results.

Before moving forward with biometric screenings as part of a workplace wellness program, benefit managers should pause to ask themselves certain questions. Doing so will enhance the likelihood of favorable outcomes — both for employee wellness and the financial bottom line.

1. Why should we screen?

It sounds simple, but setting clear goals for biometric screening is a step too many benefits managers overlook. This may be because they do not know how to anticipate the kind of actions that will be available to them and their employees given the results.

Based on my experience, the most compelling reason to provide biometric screening as part of a wellness program is to help individuals identify risks for several chronic conditions that, if caught early, may be prevented. With insights from a biometric screening, an individual may be better able to take steps to reduce health risks. Common goals may be to reduce body weight, exercise more or visit a physician for treatment.

Biometric screening often can reveal disease risks an individual may not otherwise know. A study published in the peer-reviewed journal PLoS ONE, for instance, found that one in three first-time participants in a company-sponsored, lab-based wellness program by Quest Diagnostics were not aware they were at risk for a serious medical condition, such as diabetes or heart disease, according to biometric screening results. Many of these individuals were in a health plan, suggesting that healthcare access alone does not guarantee preventive care to identify risk for common chronic health conditions.

Biometric screening also can help an employer identify programs to target at-risk employee segments based on the type of risk with appropriate interventions. Reliable insight into disease risks for a workforce population may also aid the prediction of future healthcare costs.

2. What should we screen for?

Ideally, biometric screening should provide enough information into disease risks for both individuals and the employer in order to take meaningful actions. Here, many employers miss the mark by implementing bare bones biometric screening options. The result is potentially misleading results — and missed opportunities to identify individuals at risk.

Take diabetes screening, for instance. A non-fasting fingerstick glucose screening really doesn’t tell us anything considering the variety of food individuals might have eaten, and how that may have affected their measurement.

A fasting fingerstick glucose test may help identify diabetes risk in some individuals and be less costly to perform than a hemoglobin A1c test, which involves a venipuncture blood draw. However, a study from Quest Diagnostics found that some individuals in a workforce population with normal fasting glucose results were still at higher risk for diabetes, and a glycated hemoglobin (HbA1c) test identified them.

In a similar manner, many employers overlook screening for chronic kidney disease, one of the major causes of kidney transplantation. Eighty-nine percent of participants identified as at risk for chronic kidney disease did not know it, according to the aforementioned PLoS ONE study. The estimated glomerular filtration rate (eGFR) lab test can help identify this condition very cost-effectively, but it’s often absent in biometric screening programs. Other conditions that laboratory tests can help identify include metabolic disorders, thyroid disease, and colorectal cancer, among others.

3. How often should we screen?

Annual biometric screening reinforces the importance of management places on employee wellness. It can also help identify health risks in individuals who are new to the organization. An annual program also provides a regular cadence of engagement that is not too onerous on employees while minimizing the confusion that can occur when screening happens less frequently.

Annual screening has an added benefit of allowing the employee to track her progress over time. Quest provides graphic charts that show changes in an individual’s numbers year over year. This is a powerful motivator for those who have adopted healthful behaviors to stay the course. And longitudinal changes also can reveal patterns, like modest annual weight gain, that the individual may otherwise dismiss until they see the cumulative effect.

4. How can we connect employees to care and intervention?

Screening is just one facet of a successful wellness program. Some individuals who identify health risks may proactively modify their behavior or consult a physician. But not all will. Employers can improve the odds of at-risk employees accessing the care they need following biometric screening.

Most employees in biometric programs receive a personalized report of their screening results. Additionally, many participants can consult over the phone with a third-party administered physician.

At Quest, for instance, we offer programs that help at-risk employees access behavioral change programs. If an individual’s screening results suggest evidence of prediabetes, that employee may participate free of charge in a 16-week, CDC-based diabetes prevention program that includes coaching and lifestyle modification. An individual with a problematic cholesterol result may be able to access a similar program for heart disease prevention.

Biometric screenings can be a powerful facet of an employee wellness program. Understanding the reasons to screen, which methods to use and how often to use them, and the paths to connect employees to care are key. Benefit managers who do this well will be rewarded with a wellness program that results in healthier employees and lower healthcare costs over time.

SOURCE: Goldberg, S. (21 February 2019) "4 questions to ask before adding biometric screenings" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/4-questions-to-ask-before-adding-biometric-screenings


How to build a multigenerational benefits strategy

Employers and HR teams are now managing workforces that stretch across three to five different generations. Continue reading this blog post to learn more about why having a multigenerational benefits strategy is important.


Employers and HR teams are managing employees for a workforce that stretches across three to five generations. This workforce is complex, and its workers have varying needs from generation to generation. That’s why a multigenerational benefits strategy is in order.

Baby boomers preparing for retirement may have an ongoing relationship with doctors and a number of medical appointments in a given year. On the other hand, millennials and members of Generation Z— the latest generation to enter the workforce — may shy away from primary care doctors and focus more on options to pay off student loans and start saving for retirement.

Given these dynamics, it’s important that two separate departments, finance and HR, need to develop a benefits strategy that keeps costs as low as possible while being useful to employees. Finance leaders understand they need to retain employees — turnover is expensive — but they’re still interested in cost containment strategies.

Employers should approach their multigenerational benefits strategy on finding a balance between cost containment and employee engagement.

Cost containment

For the first time in six years, the number of employers offering only high-deductible health plans is set to drop 9%. But the idea of employee consumerism is here to stay as employers see modest rises in health insurance premiums.

To effectively contain costs, employers should first weigh the pros and cons of their funding model. While most companies start out with fully-insured models, employers should seriously evaluate a move toward self-funding. Sure, self-funding requires a larger appetite for risk, but it provides insight into claims and utilization data that you can leverage to make informed decisions about cost containment.

One way to move toward a self-funded model is with level-funding, which allows employers the benefit of claims data while paying a consistent premium each month. In a level-funded plan, employers work with a third-party administrator to determine their expected claims for the year. This number, plus administrative fees and stop-loss coverage, divided by 12, becomes the monthly premium.

A tiered contribution model might also help to contain costs without negatively affecting employees. In a typical benefit plan, employers cover a specific percentage and employees contribute the rest — say 90% and 10%, respectively. In a tiered contribution plan, employees with salaries under a certain dollar amount pay less than those high earners. That means your employee making $48,000 pays $50, while your employee making $112,000 pays more. It’s a way to distribute the contribution across the workforce that enables everyone to more easily shoulder the burden of rising healthcare costs.

Employee engagement

To create a roadmap that not only helps you gain control of your multigenerational benefits strategy but keeps employees of all ages happy, it’s necessary to consider employee engagement. While new options like student loan repayment could be useful to part of your workforce, it’s best to start much simpler with something that affects everyone: time away from work.

A more aggressive paid time off policy, telecommuting policies and paid family leave are becoming increasingly popular. Many companies are offering PTO just for employees to pursue charitable work — a benefit that resonates with younger workers and can improve company culture. And a generous telecommuting policy recognizes that employees have different needs and shows that employers understand their modern, diverse workforce. Beyond basic time away from work, an extended leave policy outside what the law guarantees is another tool that can keep employees engaged.

Making it easier for employees to get care is another trending benefit, which can keep employees happy and contribute to cost containment. Concierge telemedicine has been called the modern version of a doctor’s house call. This relatively inexpensive benefit provides your employees access to care 24/7 by phone or video chat, which is convenient regardless of the user’s generation.

Employees and other covered individuals can connect to a doctor to discuss symptoms and get advice, whether they are prescribed a medication or they need to seek further care. This is another benefit that’s useful for young workers who may not have a primary care doctor or older workers with families.

Finally, your tech-savvy workforce expects to access their plan information wherever they need it. Ensure your carrier offers a mobile app to house insurance cards, coverage and provider information.

When it comes to a multigenerational benefits strategy, creating harmony between finance and HR might seem like a daunting task. But considering some relatively small benefit changes could be what allows you to offer a benefits package that pleases both departments — and all of your employees.

SOURCE: Blemlek, G. (26 February 2019) "How to build a multigenerational benefits strategy" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/how-to-build-a-multigenerational-benefits-strategy?brief=00000152-146e-d1cc-a5fa-7cff8fee0000


Younger generations driving lifestyle benefits

Millennials will make up seventy-five percent of the U.S. workforce by 2025, according to a study by Forbes. The self-confidence of younger generations is pushing companies to adopt more non-traditional benefits. Continue reading to learn more.


Younger generations are often characterized as entitled and demanding — but that self-confidence in their work is pushing companies to adopt benefits outside the traditional healthcare and retirement packages.

By 2025, millennials will make up 75% of the U.S. workforce, according to a study by Forbes. The first wave of Generation Z — millennials’ younger siblings — graduated college and entered the workforce last year. With these younger generations flooding the workplace, benefit advisers need to steer clients toward innovative benefits to attract and retain talent, according to panelists during a lifestyle benefits discussion at Workplace Benefits Renaissance, a broker convention hosted by Employee Benefit Adviser.

“Millennials came into the workforce with a level of entitlement — which is actually a good thing,” said Lindsay Ryan Bailey, founder and CEO of Fitpros, during the panel discussion. “They’re bringing their outside life into the workplace because they value being a well-rounded person.”

Catering benefits to younger generations doesn’t necessarily exclude the older ones, the panelists said, in a discussion led by Employee Benefit Adviser Associate Editor Caroline Hroncich. Older generations are accustomed to receiving traditional benefits, but that doesn’t mean they won’t appreciate new ones introduced by younger generations.

“Baby boomers put their heads down and get stuff done without asking for more — that’s just how they’ve always done things,” Bailey said. “But they see what millennials are getting and are demanding the same.”

In a job market where there are more vacant positions than available talent to fill them, the panelists said it’s important now, more than ever, to advise clients to pursue lifestyle benefits. While a comprehensive medical and retirement package is attractive, benefits that help employees live a more balanced life will attract and retain the best employees, the panelists said.

“Once you’ve taken care of their basic needs, have clients look at [lifestyle benefits],” said Dave Freedman, general manager of group plans at LegalZoom. “These benefits demonstrate to workers that the employer has their back.”

The most attractive lifestyle benefits are wellness centered, the panelists said. Wellness benefits include everything from gym memberships, maternity and paternity leave, flexible hours and experiences like acupuncture and facials. But no matter which program employers decide to offer, if it’s not easily accessible, employees won’t use it, the panel said.

“Traditional gym memberships can be a nightmare with all the paperwork,” said Paul O’Reilly-Hyland, CEO and founder of Zeamo, a digital company connecting users with gym memberships. “[Younger employees] want easy access and choices — they don’t want to be locked into contracts.

Freedman said brokers should suggest clients offer benefits catered to people based on life stages. He says there are four distinct stages: Starting out, planting roots, career growth and retirement. Providing benefits that help entry-level employees pay down student debt, buy their first car or rent their first apartment will give companies access to the best new talent.

To retain older employees, Freedman suggests offering programs to help employees buy their first house, in addition to offering time off to bond with their child when they start having families. The career growth phase is when most divorces happen and kids start going to college, Freedman said. Offering legal and financial planning services can help reduce employee burdens in these situations. And, of course, offering a comprehensive retirement plan is a great incentive for employees to stay with a company, Freedman said.

Clients may balk at the additional costs of implementing lifestyle benefits, but they help safeguard against low employee morale and job turnover. Replacing existing employees can cost companies significant amounts of money, the panelists said.

“Offering these benefits is a soft dollar investment,” Freedman said. “Studies show it helps companies save money, but employers have to be in the mindset that this is the right thing to do.”

SOURCE: Webster, K. (25 February 2019) "Younger generations driving lifestyle benefits" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/younger-generations-driving-lifestyle-benefits?brief=00000152-1443-d1cc-a5fa-7cfba3c60000


U.S. Department of Labor's New Compliance Assistance Tool

On February 6, 2019, the U.S. Department of Labor announced the launch of the electronic version of their Compliance Assistance Tool (Handy Reference Guide to the Fair Labor Standards Act (FLSA)). This new version will assist employers by providing them with basic Wage and Hour Division (WHD) information, as well as links to other resources.

This electronic resource was created as a part of the WHD's efforts to modernize compliance assistance tools, as well as provide easy-to-use, accessible compliance information. In coexistence with worker.govemployer.gov, and other online tools, this tool will help improve employer understanding of federal labor laws and regulations.

View the digital Compliance Assistance Tool here.

Read the DOL's full press release here.

SOURCE: U.S. Department of Labor (6 February 2019) "U.S. Department of Labor Announces New Compliance Assistance Tool" (Web Press Release). Retrieved from https://www.dol.gov/newsroom/releases/whd/whd20190206-0


With the Advent of Remote Work, Is the ‘Sick Day’ Becoming Passé?

With many employees working remotely full time, is the practice of employee sick days becoming out of date? Read this blog post from SHRM to learn more.


Your advertising manager works from home full time. She has a nasty cold. But hey—she only needs to walk a few steps from her bedroom to her desk, can nap when she needs to and won't infect her colleagues. So she doesn't really need to take a sick day, right?

Well, she probably should, but as remote work continues to rise, workplace experts find that those who do their jobs from home are inclined to stay on the clock while soldiering through colds, the flu and other maladies—in part because they don't want to appear to be taking advantage of their work-from-home benefit.

"Remote workers find it hard to integrate work with the rest of their life because it is so easy to overwork and even plow through your work while you are sick," said Jeanne Meister, founding partner of Future Workplace, a New York City-based HR executive network and research firm. "If you are only traveling from your bedroom to your home office, remote workers may rationalize, 'What harm can be done if I work while I am sick? At least I'm not contagious.' "

In addition, the advent of remote working has introduced another trend: managers suggesting that onsite employees work from home when they're sick.

"It's no secret that many [workplaces] have cultures that encourage the 'always-on' mentality," said Erica Denner, head of people and culture at YouEarnedIt/HighGround, an Austin, Texas-based company that focuses on employee recognition, rewards and performance management. "In my experience, I've found that because of this, employees at these organizations can find it difficult to ask for time off when they're sick and are often encouraged to work from home instead."

Circumstances Matter

Thanks to technology that facilitates remote work, there are instances when working during what otherwise would have been a sick day may actually be a win for the employee and employer.

"There are all kinds of reasons to take sick days," said Ellen Galinsky, president of the Families and Work Institute and a senior research advisor for the Society for Human Resource Management. "If employees have a condition that affects their ability to be mobile, like a broken bone or torn tendon, they might have to take a sick day if they work in a traditional workplace because travel to work would be difficult, but they could easily work at home. I can think of other such illnesses, such as having something contagious and not wanting to infect others but feeling good enough to work or being postoperative and being able to work in short spurts. Working at home could be ideal for that."

Consider U.S. Supreme Court Justice Ruth Bader Ginsburg, who recovered from cancer surgery at home but nonetheless heard arguments in a case before the court. A court spokesperson said Ginsburg would participate "on the basis of briefs, filings and transcripts," CNBC reported.

But if working while ill prevents an employee from fully resting and recuperating, this will likely hinder performance—and even future productivity and morale.

"If an employee is really sick, he or she might power through and get a few things done but might not do them well," Galinsky said.

Working through your cold, sore throat or flu not only can lead to a decline in physical well-being but "also can present mental health challenges," Meister said.

Contractors, or so-called gig workers, in particular, may be wary of taking sick time. Lacking job security, they may fear that doing so would make them appear dispensable to their employers.

What Employers Can Do

To discourage employees from avoiding sick days because they're working remotely:

Communicate to employees that you expect them to take time off when they're sick. Or, encourage them to be open about how much work, if any, they feel they can accomplish. "If you can't produce high-quality work, even from the comfort of your own home, when you're under the weather, relay that message to your manager," Denner said. "If they value your contributions and are a good supervisor, they will understand and step in to help until you're feeling better."

At YouEarnedIt/HighGround, workers are asked to make it clear when they are out sick and unavailable. This includes setting up not only the typical out-of-office notification by e-mail but also notifications across productivity platforms the company uses, such as Slack. "It's remarkable how effective turning on the 'out sick' emoji in Slack is in terms of alerting colleagues you need time to recover," Denner said. "When employees are out on a longer-term medical leave, we actually remove their technology access so they can't check e-mails or Slack. This way, the employee doesn't feel guilty or obligated to respond to messages."

Talk about the importance of taking sick days for one's physical and mental well-being. Bring up the topic during all-hands meetings with onsite as well as remote workers. In benefits materials and handouts, address the importance of taking sick days.

Ensure that managers and executives take sick days themselves. When a boss shows up at a meeting sniffling and coughing, she sends the clear message that work is too important to be interrupted by illness. And that only leaves her subordinates feeling guilty if they take sick days.

"We've found that [modeling sick-day behavior] actually goes a long way in not just encouraging our employees to do the same, but also in further solidifying a culture of trust and respect," Denner said.

Encourage remote workers to take time for themselves even when they're healthy—such as taking a midday break—and reinforce how this is important for their well-being and productivity.

SOURCE: Wilkie, D. (6 February 2019) "With the Advent of Remote Work, Is the ‘Sick Day’ Becoming Passé?" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/employee-relations/pages/remote-workers-and-sick-days-.aspx


Move over mainstream: Alternative health options a road to better value

A number of employers are seeking alternative ways to get better value for their healthcare spending. Read this blog post to learn more about alternative health options.


While employers may be the largest purchasers of healthcare outside of the federal government, rarely does one organization have enough influence when negotiating with the powerful health plans and provider systems. As a result, employers — and ultimately the consumers for whom they purchase healthcare services — pay the price.

Instead of taking these lumps of coal sitting down, there are a growing number of employers on the cutting edge of healthcare purchasing seeking alternative ways in 2019 to get better value for their healthcare spending. They are looking for the diamonds in the rough.

In more than half of the healthcare markets in the U.S., providers have merged reducing competition and leaving employers and consumers with little choice for their care. Employers must stop insisting that health insurance products provide access to the broadest network of healthcare providers — if providers know they’ll be kept “in network” no matter how they behave, employers and payers further reduce their negotiating position. Employers also should band together to be sizable enough to call the shots, but this rarely happens.

While this lack of market power and influence is a major frustration for employers, it’s far from the only one. Educated employers also know that the healthcare system produces uneven quality and high prices have nothing to do with excellent care. The amount an employer pays for a service merely represents the relative negotiating strength of the health insurance carriers and providers.

As prices continue to drive healthcare cost growth, Americans are finding their healthcare unaffordable and are willing to trade choice for affordability. Many Americans no longer view having the ability to pick any doctor they choose as essential if it means increased premiums and cost-sharing that comes at the expense of other basic needs. These shifting attitudes represent an opportunity for employers seeking diamonds to pursue the following new healthcare benefits options. Here are some.

Narrow networks: Health insurance plans built around a narrower network that cuts out care providers who are outlandishly expensive or have a particularly poor record on quality. Alternatively, center a smaller network around a direct contract with an accountable care organization selected for its potential to deliver higher quality and value. More commercial health insurance carriers and lesser known third-party administrators are offering and supporting these options. Premiums and cost-sharing are typically lower for the consumer than with broader network plans.

Centers of excellence (CoE): Steer patients to designated high-quality providers with expertise in a given medical area who are willing to enter into an alternative payment arrangement or offer a more reasonable price in return for more patients. Make CoEs attractive through more generous coverage or make them mandatory if employees want an elective or non-emergent procedure (e.g., bariatric or spine surgery). Either way, employers reduce the risk that employees will receive subpar or low value care.

Alternative sites of care: Increase access to and use of alternative sites of care including onsite or near-site clinics and telehealth services. These enhance the convenience of primary or behavioral healthcare for employees and can help the employer better control referrals to overpriced hospitals or specialists.

So, move over mainstream. When it comes to the tactics employers use to purchase healthcare, alternative is likely to become less fringe. Narrow networks, CoEs or alternative sites of care may not solve all of the frustrations. But employers’ pursuit of these new models sends a strong signal that lumps of coal aren’t going to cut it. Employers are on the hunt for a shinier, more attractive set of solutions.

SOURCE: "Move over mainstream: Alternative health options a road to better value" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/move-over-mainstream-alternative-health-options-a-road-to-better-value?brief=00000152-1443-d1cc-a5fa-7cfba3c60000


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Why chiropractic services could be the next big thing in wellness

Could chiropractic services be the next big thing in wellness? The American College of Physicians' care guidelines recommends the conservative, non-pharmacologic treatment chiropractors provide. Read on to learn more.


The next popular wellness perk could be offering chiropractic services at on-site medical centers.

On-site or near-site clinics typically offer services to employees including first aid, occupational health, condition management, wellness and ancillary services — and increasingly chiropractic care.

Employees, healthcare administrators and physicians are recognizing the health and employee satisfaction benefits of integrating chiropractic care into multidisciplinary settings, research suggests. Care guidelines from the American College of Physicians recommend the conservative, non-pharmacologic treatment chiropractors provide. Employers are finding that adding chiropractic care to their worksite health center teams reduces direct costs of care, decreases opioid prescriptions for neuro-musculoskeletal episodes and improves health outcomes.

Healthcare costs for employers are expected to reach $15,000 per employee in 2019, according to the National Business Group on Health. The direct and indirect costs associated with low back pain are estimated between $85 billion and $238 billion, and expenditures for back pain are rising more quickly than overall health expenditures. To help stem that growth, as many as 65% of large companies are expected to offer on-site or near-site care by 2020, NBGH reports.

Employer focus on improving workers’ health and wellness has gained momentum in recent years, as evidenced by last year’s announcement from Amazon, Berkshire Hathaway and JPMorgan Chase that they would form an independent healthcare company for their U.S. employees. Another example is employers with self-funded health plans contracting with narrow, high-quality provider networks and even negotiating directly with local hospitals on their prices.

Clinics offer similar cost control and oversight benefits. More importantly, they offer faster and easier access to care that keeps employees healthy, motivated and engaged — and out of the emergency room or hospital. As such, 54% of large employers currently offer on-site or near-site clinics, while another survey showed that 94% of employers reported their clinics improved employee health and 95% said they contributed to increased employee productivity.

Each clinic’s services, cost-sharing, use privileges and staffing can be customized to meet the needs of a specific organization and employer benefit plans. These decisions should be reflective of the objectives of the sponsoring employer and the healthcare needs of the population.

While most healthcare clinics are located on-site or close to the workplace, a growing number are near-site or shared clinic locations, serving populations from multiple locations of the same employer or various employers. Additionally, more care is being delivered virtually. The objective is to provide easy access and immediate attention for employees, at little or no cost, for a host of services and products that an employee would normally have to leave the work site to obtain.

According to a recent survey by the National Association of Worksite Health Centers, the majority of employers reported their workers had expressed interest in chiropractic services at their clinics. The nationwide cost for treatment and management of low back pain and arthritis has reached $200 billion annually. Another study attributes two-thirds of these costs to lost wages and reduced productivity.

The fact that chiropractors deliver drug-free therapies should be particularly meaningful to employers in light of the country’s opioid abuse epidemic. The good news is a recent study published in “The Journal of Alternative and Complementary Medicine” concludes that for adults receiving treatment for low back pain, the likelihood of filling a prescription for an opioid was 55% lower for those receiving chiropractic care than for adults not receiving chiropractic care.

In particular, chiropractors follow evidence-based and value-based guidelines to promote safety and effectiveness. Findings like these and many others show that by adding chiropractic care, employers will strengthen the opportunity for cost savings, improved outcomes, greater worker productivity and stronger employee retention.

SOURCE: Lord, D. (25 January 2019) "Why chiropractic services could be the next big thing in wellness" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/why-chiropractic-services-could-be-the-next-big-thing-in-wellness?brief=00000152-14a7-d1cc-a5fa-7cffccf00000


Developing guidance could free employers from ACA mandate

A future path for employers to avoid ACA employer mandate penalties was outlined in a recent IRS notice. Read this blog post from Employee Benefits News to learn more.


A recent IRS notice provides a future path for employers to avoid ACA employer mandate penalties by reimbursing employees for a portion of the cost of individual insurance coverage through an employer-sponsored health reimbursement arrangement.

While the notice is not binding and at this stage is essentially a discussion of relevant issues, it does represent a significant departure from the IRS’s current position that an employer can only avoid ACA employer mandate penalties by offering a major medical plan.

Here is everything employers need to know.

Background: As described in more detail in a previous update, the ACA currently prohibits (except in limited circumstances) an employer from maintaining an HRA that reimburses the cost of premiums for individual health insurance policies purchased by employees in the individual market.

Proposed regulations issued by the IRS and other governmental agencies would eliminate this prohibition, allowing an HRA to reimburse the cost of premiums for individual health insurance policies (individual coverage HRA) provided that the employer satisfies certain conditions.

The preamble of the proposed regulations noted that the IRS would issue future guidance describing special rules that would permit employers who sponsor individual coverage HRAs to be in full compliance with the ACA’s employer mandate. As follow up, the IRS recently issued Notice 2018-88, which is intended to begin the process of developing guidance on this issue.

On a high level, the ACA’s employer mandate imposes two requirements in order to avoid potential tax penalties: offer health coverage to at least 95% of full-time employees (and dependents); and offer “affordable” health coverage that provides “minimum value” to each full-time employee (the terms are defined by the ACA and are discussed further in these previous updates).

Offering health coverage to at least 95% of full-time employees: Both the proposed regulations and notice provide that an individual coverage HRA plan constitutes an employer-sponsored health plan for employer mandate purposes. As a result, the proposed regulations and notice provide that an employer can satisfy the 95% offer-of-coverage test by making its full-time employees (and dependents) eligible for the individual coverage HRA plan.

Affordability: The notice indicates that an employer can satisfy the affordability requirement if the employer contributes a sufficient amount of funds into each full-time employee’s individual coverage HRA account. Generally, the employer would have to contribute an amount into each individual coverage HRA account such that any remaining premium costs (for self-only coverage) that would have to be paid by the employee (after exhausting HRA funds) would not exceed 9.86% (for 2019, as adjusted) of the employee’s household income.

Because employers are not likely to know the household income of their employees, the notice describes that employers would be able to apply the already-available affordability safe harbors to determine affordability as it relates to individual coverage HRAs. The notice also describes new safe harbors for employers that are specific to individual coverage HRAs, intending to further reduce administrative burdens.

Minimum value requirement: The notice explains that an individual coverage HRA that is affordable will be treated as providing minimum value for employer mandate purposes.

Next steps: Nothing is finalized yet. Employers are not permitted to rely on the proposed regulations or the notice at this time. The proposed regulations are aimed to take effect on Jan. 1, 2020, if finalized in a timely matter. The final regulations will likely incorporate the special rules contemplated by the notice (perhaps with even more detail). Stay tuned.

This article originally appeared on the Foley & Lardner website. The information in this legal alert is for educational purposes only and should not be taken as specific legal advice.

SOURCE: Simons, J.; Welle, N. (17 January 2019) "Developing guidance could free employers from ACA mandate" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/developing-guidance-could-free-employers-from-aca-mandate?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001

 


No primary care doc, no problem: How millennials are changing healthcare

Do you have a primary care physician? Forty-five percent of 18- to 29-year-olds reported that they do not have a primary care physician. Read this blog post from Employee Benefit News to learn more.


Millennials, and Generation Z behind them, are changing the way they access healthcare. In fact, 45% of 18- to 29-year-olds say they don’t have a primary care physician. Instead, they’re opting for on-demand healthcare.

Traditionally, individuals and families see primary care physicians several times a year and build relationships with their doctors over time. Visiting the same primary care physician when an illness strikes, or for an annual wellness checkup, can help the doctor notice changes in a patient’s health and catch issues before they become more serious (and costly).

But for millennials, having a primary care physician isn’t necessarily a priority.

That’s in part because they seem to prefer on-demand healthcare options, such as urgent care, drug store clinics and telemedicine services, which are easily accessible and typically include shorter wait times. The number of urgent care centers reflects the trend — they’re projected to grow by 5.8% in 2018, according to the Urgent Care Association.

Then there is employers’ shift away from health maintenance organizations, which often required that each employee choose a primary care doctor at the start of the plan. HMOs also require a referral from the primary care physician to see specialists. Recent research shows that most often, employers offer preferred provider organizations (84%), while 40% offer consumer-directed health plans and 35% offer HMOs.

Finally, physician shortages are leading to longer wait times for appointments. The U.S. population continues to grow and age, which may lead to a shortage of 120,000 primary and specialty doctors by 2030, according to the Association of American Medical Colleges.

For employers, it’s important to understand the reasons behind the shift to on-demand healthcare and educate employees to ensure they can get appropriate medical attention when they need it.

One crucial part of this education is helping employees understand when they should visit urgent care versus the emergency room, and reminding them that telemedicine is available. More than 95% of large employers and just over one-third of small- and mid-size employers offer telemedicine benefits. But adoption rates among employees remain low — only 20% of large employers report utilization rates above 8%, according to the National Business Group on Health.

Ensure your employees know that the service is available throughout the year and help them understand the cost if any is associated with the service. You may consider offering $0 copays for telemedicine visits to encourage employee use.

Encourage employees to get a wellness visit each year to help uncover health issues and take steps to prevent others. One way to do this without forcing employees to wait for an appointment or commit to a doctor is to bring the service in-house. Increasingly, large employers are adding this service to help employees stay healthy. In fact, one-third of employers with more than 5,000 employees and 16% of employers with 500-4,999 employees now have onsite clinics. Another 8% of midsize employers plan to add clinics in 2019.

Providing health assessments as part of a health and wellness program is another way to get employees, especially money conscious millennials, in front of a doctor. Younger workers are likely to embrace incentives or premium discounts that are tied to a physician visit.

Direct primary care is yet another employer option to provide easy-to-access primary care. With direct primary care, employers partner with primary care physicians to offer a designated doctor for their employees. The benefit for employees is more face time with a doctor and the opportunity to get personalized care.

Importantly, employees who have known chronic issues should see a primary care doctor regularly to help monitor and manage their condition.

The trend toward seeking on-demand healthcare at alternative sites isn’t likely to reverse direction any time soon. Instead, it’s up to employers to understand why it’s happening and educate employees of all ages on their options for care.

SOURCE: Milne, J. (7 January 2019) "No primary care doc, no problem: How millennials are changing healthcare" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/no-primary-care-doc-no-problem-how-millennials-are-changing-healthcare?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


When every day is bring-your-kid-to-work day

Canopy, a software developer, has adopted many family-friendly employee benefits, including a benefit that allows employees to bring their newborns to work up until they are about 6 months old. Continue reading this blog post to learn more.


When recent college graduate Hanna Arntz first interviewed for a job at Canopy, a Utah-based startup that develops practice management software for accounting firms, the recruiter asked her about her long-term career goals. Arntz wasn’t sure about what she wanted, but she was sure of one thing: She wanted to be a mom.

The recruiter told Arntz that Canopy was developing benefits for pregnant and working mothers. Arntz was interested, and accepted a position at the company in 2017. She is now a talent acquisition manager, a role that allowed her to witness the company’s development of family-friendly benefits firsthand.

“We had a lot of focus groups for parents within Canopy to understand what parents need in the workforce and how to retain them, particularly mothers,” she says.

Canopy now offers 10 weeks of maternity leave, plus a two-week ramp period where parents can work part-time to readjust to work. The company also offers two weeks of paternity leave. In addition to these policies, Canopy has an unusual offering: It allows parents to bring their newborns into work every day up until they are about 6-months-old.

Canopy CEO Kurt Avarell says many of the employees on the more than 300-person team have children, and there is a level of understanding when new parents bring their little ones to work. The company also welcomes older children into their office from time to time.

“Pretty much any day is a bring-your-kid-to-work day,” he says. “It’s pretty typical to have kids in the office.”

Arntz gave birth to her son, Jude, seven months ago. After taking maternity leave, she returned to the office with her newborn. Initially, she was nervous about bringing him to work.

“I was worried he was going to be crying in meetings,” she says. “There was so much anxiety around that.”

Since she has returned to work, though, colleagues have not treated her any differently, she says. Balancing her work with taking care of her son can be tough, she admits, but the company has been supportive.

“Even if the baby was crying and I was bouncing him, they’d still be looking at me in the eye and engaging me in conversation,” she says.

Employers like Canopy are beginning to recognize the value of adding family-friendly benefits with many beefing up paid parental leave, breast milk shipping, and free babysitting services. For example, dozens of companies including Bristol-Myers Squibb, CVS Health, Dollar General, Eataly and General Mills made changes to their paid parental leave benefits in 2018. Meanwhile, Home Depot, Trip Adviser, Vox Media and Pinterest added breast milk shipping benefits, and Starbucks began offering subsidized child care as a benefit.

In addition to its maternity and paternity leave benefits, Canopy has a flexible paid time off policy that allows new parents to work from home. The company also has separate mothers’ and fathers’ rooms in the office and provides new parents with a gift of diapers, clothes, baby care products and gift cards.

Avarell says offering family-focused benefits is a good way to retain employees because it shows workers that they are supported at home and in the office. It’s a part of Canopy’s culture that he hopes to maintain long-term.

As for Arntz, the benefits have played an integral part of her staying at the company.

“The company has invested in me for a reason,” she says. “They want to retain me.”

SOURCE: Hroncich, C. (7 January 2019) "When every day is bring-your-kid-to-work day" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/when-every-day-is-bring-your-kid-to-work-day?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


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