Disconnect between employers, employees over wellness, health plan satisfaction

Check out this great article from Employee Benefits Adviser about the disconnect between employees and employers about their company's wellness programs by Cort Olsen

More than 1,500 employer decision-makers surveyed about the future of healthcare say wellness programs within companies continue to show positive growth among employers and employees alike. However, the study by Transamerica Center for Health Studies also found a strong disconnect in communication between employers and employees regarding healthcare and benefit satisfaction and the commitment from employers to maintain a healthy workspace.

At least 28% of employers have implemented a wellness program for their employees in the past 12 months — a steady increase from 23% in 2014 and 25% in 2015. About four in five companies report their wellness programs have positively impacted workers’ health and productivity, and about seven in 10 have seen a positive impact on company healthcare costs.

More than half of the employers surveyed (55%) say they offer wellness programs to their staff, yet some employees seemed to be unaware that their company offers these programs. Of the 55% of employers who say they offer a wellness program, only 36% of employees with employer coverage say they work for an employer who offers a wellness program.

Employer versus employee perspective
This miscommunication may also contribute to the level of commitment employees think their employer has in maintaining a wellness program within the workplace. While 80% of employers say leadership is committed to improving the health of their employees, only one-third of employees say they agree with that statement.

When it comes to overall healthcare satisfaction there is a similar disconnect, with 94% of employers saying employees are satisfied with the health insurance plan their company offers, while only 79% of employees say they are satisfied with their health plan.

In addition, 90% of employers say employees are satisfied with the healthcare benefits other than health insurance, but only 79% of employees say they are satisfied.

However, while employers and employees may not share the same amount of satisfaction in their healthcare offerings, many companies are making the effort to reduce the cost of their healthcare for their staff.

At least 41% of companies have taken measures to reduce costs, while 71% of companies have taken positive measures in the last 12 months. The percentage of midsize businesses reporting to provide insurance for part-time employees has increased significantly since July 2013 from 13% to 21%.

Still, lack of communication continues over cost concerns as well. While about four in five employers feel their company is concerned about the affordability of health insurance and healthcare expenses, just over half of employees feel the same — even after employers said cost concerns would not be felt by employees.

See the original article Here.

Source:

Olsen C. (2017 January 05). Disconnect between employers, employees over wellness, health plan satisfaction[Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/disconnect-between-employers-employees-over-wellness-health-plan-satisfaction?brief=00000152-1443-d1cc-a5fa-7cfba3c60000


Obamacare Enrollment Is Beating Last Year’s Early Pace

Great article from Kaiser Health News about ACA enrollment by Phil Galewitz

Despite the Affordable Care Act’s rising prices, decreased insurer participation and a vigorous political threat to its survival, consumer enrollment for 2017 is outpacing last year’s, according to new federal data and reports from state officials around the country.

Americans’ anxiety about how a new Republican-controlled Congress and President-elect Donald Trump will repeal and replace the health law is helping fuel early enrollment gains in the online marketplaces that sell individual coverage, state exchange officials and health consultants said.

Healthcare.gov, the federal marketplace which handles coverage for 39 states, enrolled6.4 million people from Nov. 1 through Monday, about 400,000 more than at the same time a year ago, the Health and Human Services Department said Wednesday. Monday was the deadline in those states to sign up for coverage starting Jan. 1, but open enrollment will continue until Jan. 31 for 2017 coverage.

“The marketplace is strong … and now we know the doomsday predictions about the marketplace are not coming true,” HHS Secretary Sylvia Burwell said in a press briefing.

The surge in sign-ups on the federal marketplace mirrors activity on several state-run Obamacare exchanges, according to figures obtained from states independently by Kaiser Health News. Minnesota, with more than 54,000 enrollees as of Monday, doubled the number of sign-ups it had at the same time last year. Colorado, Massachusetts and Washington had enrollment growth of at least 13 percent compared to a year ago.

“Because of the new administration and the high likelihood of changes coming to the ACA, it is creating a sense of urgency” for people to enroll, said Michael Marchand, director of communications for the Washington Health Benefit Exchange. Enrollment exceeded 170,000 customers on the Washington exchange as of this week, up 13 percent compared to same time a year ago.

Other state exchanges saw moderate increases: Connecticut, 3 percent; Idaho, 4 percent; Maryland, 1 percent. California’s enrollment is about same as a year ago. Rhode Island’s enrollment dropped to 27,555 from 31,900 for the same period last year. State exchange officials cited a drop in customers who were automatically renewed because UnitedHealthcare dropped out.

About 12.7 million people enrolled in the state and federal exchanges for 2016 coverage at the end of the previous enrollment season. HHS predicted in October that an additional 1.1 million people would sign up for 2017 coverage. Burwell said Wednesday that her department is sticking with that projection, even though “the headwinds have increased” since the election.

Obamacare, now in its fourth open enrollment season, took some heavy blows this year after several big insurers — including UnitedHealthcare, Humana and Aetna — withdrew from many marketplaces for 2017 because of heavy financial losses. At the same time, remaining insurers increased premiums by 25 percent on average.

All of that, plus a changed political climate in Washington, was expected to dampen enrollment. While the surprise presidential election outcome may have been the primary force for changing those expectations, other factors also have fueled enrollment growth this fall, state officials pointed out in interviews.

More people who don’t qualify for government subsidies are buying health plans on the exchanges because it’s an easier way to compare available plans in one place. Noting that trend, Premera Blue Cross in Washington recently stopped selling individual coverage off the exchange.

In Minnesota, higher government subsidies — which reduce premiums for people with lower incomes — is the main reason why more people have signed up, according to Allison O’Toole, CEO of MNsure, the state-run exchange. The subsidy amount is tied to the cost of the second-lowest silver plan on the exchange, so as premiums rise for that plan, the subsidy rises too. Premiums soared by an average 50 percent in Minnesota for second-lowest silver.

Another factor driving earlier enrollment in that state was caps set by several Minnesota insurers on the number of new enrollees they would accept. People signed up earlier to make sure they could get the plan they wanted, according to O’Toole.

Minnesota’s growth is surprising because one of its biggest carriers, Blue Cross and Blue Shield of Minnesota, stopped selling its most popular health plan on the exchange. That forced about 20,000 people to change insurers or switch from Blue Cross’ PPO, which has a broad provider network, to its HMO plan with a narrower network.

In Colorado, the 18 percent increase in enrollment so far has exceeded officials’ expectations, said Luke Clarke, the spokesman for Connect for Health Colorado, the state exchange. “We had an office pool and no one picked a number that high,” he said. “It was a healthy surprise,” particularly because premiums increased in the state by about 20 percent on average.

Conservatives warn it’s still too early for Obamacare supporters to celebrate.

“I suspect that some states saw big increases because local advocacy groups were able to tell their constituents that they should enroll before Trump is sworn in and Republicans take over Congress — thereby pretty much guaranteeing that they get a full year’s coverage regardless of what Republicans might do on repeal,” said Joe Antos, a health economist with the American Enterprise Institute, a conservative think tank.

Under that scenario, large enrollment increases this fall might be followed by a dropoff in January over the 2016 numbers and the final enrollment tally could end up similar this year’s, he said. Antos noted the true enrollment figures will be known once people pay for their coverage and stay enrolled for the full year.

“As with everything related to ACA,” Antos said, “it’s easy to find a happy story if you squint hard enough and don’t wait for the enrollment process to complete — or the plan year to end.”

See the original article Here.

Source:

Galewitz P. (2016 December 21). Obamacare enrollment is beating last year's early pace [Web blog post]. Retrieved from address https://khn.org/news/obamacare-enrollment-is-beating-last-years-early-pace/


Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile

Worried about your healthcare plan? Check out this interesting article from Kaiser Health News, by Michelle Andrews

President-elect Donald Trump has promised that he’ll ask Congress to repeal the Affordable Care Act on Day One of his administration. If you’re shopping for coverage on the health insurance marketplace, should you even bother signing up? If everything’s going to change shortly after your new coverage starts in January anyway, what’s the point?

While it’s impossible to know exactly what changes are coming to the individual market and how soon they’ll arrive, one thing is virtually certain: Nothing will happen immediately. Here are answers to questions you may have.

Q. How soon after Trump takes office could my marketplace coverage change?

It’s unlikely that much, if anything, will change in 2017.

“It’s a complex process to alter a law as complicated as the ACA,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. It seems unlikely that congressional Republicans could force through a repeal of the law since Democrats have enough votes to sustain a filibuster blocking that move. So Congress might opt to use a budget procedure, called “reconciliation,” that allows revenue-related changes, such as eliminating the premium tax credits,  with simple majority votes. Yet even that process could take months.

And it wouldn’t address the other parts of the health law that reformed the insurance market, such as the prohibition on denying people coverage if they’re sick. How some of those provisions of the law will be affected is still quite unclear.

“It will likely be January 2019 before any new program would be completely in place,” said Robert Laszewski, a health care industry consultant and long-time critic of the law.

The current open enrollment period runs through January 2017. Shop for a plan, use it and don’t focus on what Congress may do several months from now, Rosenbaum advised.

Q. Will my subsidy end next year if the new administration repeals or changes the health law?

Probably not. Mike Pence, the vice president-elect, said on the campaign trail that any changes will allow time for consumers receiving premium subsidies to adjust.

Timothy Jost, an emeritus professor at Washington and Lee University School of Law in Virginia who is an expert on the health law, also predicts a reasonable transition period.

Congress and the new administration are “not eager to have a bunch of angry, uninsured voters,” Jost said.

Theoretical conversations about changing the health law are one thing, but “I think that Congress may be less willing to just wipe the subsidies out if a lot of people are using them,” Rosenbaum said. More than 9 million people receive subsidies on the marketplace, according to the federal Department of Health and Human Services.

Q. Can my insurer drop out once the new administration takes over, even if the law hasn’t been repealed?

No, insurers are generally locked in contractually for 2017, according to experts. But 2018 could be a whole different story, said Laszewski.

Many insurers are already losing money on their marketplace offerings. If they know that the health insurance marketplaces are being eliminated and replaced by something else in 2019, why would they stick with a sinking ship?

“The Trump administration could be left with a situation where Obamacare is still alive, the subsidies are still alive, but not the insurers,” said Laszewski. To prevent that, the Trump administration might have to subsidize insurers’ losses during a 2018 transition year, he said.

Q. My state expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level (about $16,000). Is that going to end if Obamacare is repealed?

It may. Trump has advocated giving block grants to finance the entire Medicaid program on the theory that it provides an incentive for states to make their programs more cost-effective. But that strategy could threaten the coverage of millions of Americans if the block grants don’t keep pace with costs, Jost said.

So far, 31 states and the District of Columbia have expanded Medicaid under the health law. Republican governors in these states may play a key role in arguing against taking the expansion money away, Rosenbaum said.

Q. I have a heart condition. Does this mean I’m going to have a hard time finding coverage?

It’s possible. The health law prohibits insurers from turning people away because they’re sick and may be expensive to insure.

Republicans have generally promised to maintain that guaranteed insurability, but what that would look like is unclear. Some of their plans would require people to remain continuously insured in order to maintain that guarantee, said Laszewski.

“I would advise people who are sick to get good coverage now and hang onto it,” said Jost.

Q. Since Republicans have pledged to repeal the law, can I ignore the law’s requirement that I have health insurance?

The individual mandate, as it’s called, is one of the least popular elements of Obamacare. As long as it’s the law, you should follow it, experts said.

Insurers have argued that the requirement that they take all comers who apply for health insurance only works if there’s a coverage mandate or other mechanism that strongly encourages people to have insurance. Otherwise why would they bother unless they were sick?

For the past few years, Republicans have been pushing hard to eliminate the mandate, Laszewski noted.

“One of the easy things they could do is just not enforce it,” he said.

See the original article Here.

Source:

Andrews, M. (2016 November 10). Concerned about losing your marketplace plan? ACA repeal may take awhile [Web blog post]. Retrieved from address https://khn.org/news/concerned-about-losing-your-marketplace-plan-aca-repeal-may-take-awhile/


Employer health plans could suffer in ACA repeal

From BenefitsPro by Marlene Satter

Although Congress may feel as if it has the bit in its teeth on repealing the Affordable Care Act, some experts are warning that it might not be all that easy—or even beneficial—particularly for employer-sponsored health plans.

In a Bloomberg report, Greta E. Cowart, a shareholder at Dallas-based Winstead PC, warned that an ACA repeal or major overhaul might put employers in the crosshairs; they could end up having to return money they previously received from the federal government for some initiatives, such as the early retiree reinsurance program, which provided financial assistance to employer-sponsored health plans.

In addition, Cowart said in the report that many of the mandates on what should be included in employer-sponsored health plans that were neither exempted nor grandfathered in will be hard to take out of employers’ plans, because employees would see that as a benefit reduction. And that, of course, would not make the employer look good.

In its report on the matter, HRDive.com warned employers to “keep an eye on” HHS secretary nominee Tom Price, a determined opponent of the ACA. His “empowering patients first” plan calls for complete repeal of the ACA—and that could lead to just such problems for businesses’ health plans.

Employers who have been calling for the repeal of the ACA might want to rethink their strategy, particularly since it could not only cost them money in the form of give-backs but also cost them employee loyalty if they take away health plan features once they’re no longer mandated by the ACA.

HRDive suggested that “employers should be prepared for all outcomes,” and perhaps consider offering their employees high-deductible health plans or health savings plans as cost-saving measures.

In addition, tracking prescription drug prices could help them keep an eye on costs.

See the original article Here.

Source:

Satter M. (2016 December 1). Employer health plans could suffer in ACA repeal[Web blog post]. Retrieved from address https://www.benefitspro.com/2016/12/01/employer-health-plans-could-suffer-in-aca-repeal?ref=mostpopula


Study: What benefits do employees go for on private exchanges?

Jack Craver gives insight on the best benefits options for private exchanges

A new study offers insight into the types of benefits and benefit designs employees go for when given the choice.

The study, by the Private Exchange Research Council, analyzed hundreds of thousands of benefit purchases made by workers whose employer offers benefits through a private exchange.

The average employer that uses a private exchange offers 14 different benefits and six medical plans, the study found. Employees purchased an average of 4.4 products in 2015, up from 3.6 the previous year.

Older workers are more likely to buy more coverage, with 44 percent of Gen Xers and 42 percent of baby boomers buying more than four products, compared to only 30 percent of millennials.

While employers are increasingly demanding that employees accept high-deductible health plans accompanied by a health savings account, the majority of workers analyzed in the study appear to have traditional health plans, although the percentage with HSAs is rising. Forty-two percent of employees had an HSA in 2015, up from 38 percent in 2013.

Those who opt for high-deductible HSA-qualifying plans tend to be younger and healthier; that’s no surprise. However, the study also found that men and high-paid employees tend to favor such plans more than women and lower-paid employees.

Perhaps surprisingly, the study also found that nontraditional insurance products, such as pet insurance, legal insurance and identity theft insurance, are more likely to be offered by smaller companies.

Private exchanges and the employers that use them describe them as a way to increase employees’ engagement with their benefits. In a health care system that many have argued is overpriced and inefficient because the costs have been hidden behind health plans largely paid by employers, private exchanges are touted as a way to make individuals more sophisticated health care consumers that make conscious decisions about what services they want and need.

Private exchanges got a big boost earlier this year when Starbucks announced that it would be offering its employees an array of health plans to choose through an exchange run by Aon.

In a statement accompanying the study’s release, Christopher Condeluci, one of the principals of Private Exchange Research Council, described the group and its research as addressing a lack of data on the types of benefits that individual consumers favor.

"Knowing what plans people want and how they choose them will go a long way in helping the benefits industry better meet employers' and employees' needs,” he says.

See the original article Here.

Source:

Craver, J. (2016 October 20). Study: what benefits do employees go for on private exchanges? [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/20/study-what-benefits-do-employees-go-for-on-private?kw=Study:%20What%20benefits%20do%20employees%20go%20for%20on%20private%20exchanges?&et=editorial&bu=BenefitsPRO&cn=20161024&src=EMC-Email_editorial&pt=Daily


ACA exchanges report strong early application activity

Busy start to the 2017 open enrollment period 50 percent higher than last year, by Allison Bell

Managers of HealthCare.gov say the open enrollment period for 2017 has gotten off to a busy start.

The level of activity during the first six hours of the open enrollment period was 50 percent higher than during the comparable period in 2015, and HealthCare.gov took in 150,000 coverage applications during the first full day of the enrollment period, according to officials at the U.S. Department of Health and Human Services.

HHS set up HealthCare.gov to provide Affordable Care Act exchange enrollment and account administration services in states that are unable or unwilling to handle that job themselves.

The open enrollment period for 2017 started Tuesday.

A year ago, HHS officials said HealthCare.gov had taken in about 250,000 coverage applications during the first full day of the open enrollment period for 2016.

MNsure, Minnesota's state-based exchange enrollment system, was down much of the day yesterday because of some combination of heavy volume, technical glitches and efforts by ACA opponents to crash the system by flooding it with visits. In spite of the technical problems, about state residents used the system to apply for coverage for about 5,000 people, according to the Twin Cities Pioneer Press.

MNsure may have spurred consumers to try to sign up for exchange plan coverage early by announcing that it will impose enrollment caps for 2017 on coverage from most participating carriers. Blue Plus is the only exchange issuer selling coverage without protection from an enrollment cap.

George Kalogeropoulos, the chief executive officer of HealthSherpa.com, a San Francisco-based "Web broker entity" that helps retail insurance agents and brokers submit ACA exchange coverage applications for their customers, says HealthSherpa.com activity levels support the idea that the ACA exchange system has been very busy.

"As of day two of open enrollment, the traffic on HealthSherpa.com has been through the roof," Kalogeropoulos said in an email. "We know HealthCare.gov is getting 50 percent more website visits compared to last year, and our website is experiencing that surge as well."

See the original article Here.

Source:

Bell, A. (2016 November 04). ACA exchanges report strong early application activity. [Web blog post]. Retrieved from address https://www.lifehealthpro.com/2016/11/02/aca-exchanges-report-strong-early-application-acti?slreturn=1478548849


Beware: Losing health plan grandfathered status is an administrative nightmare

Some interesting points on grandfathered status'  from HRMorning, by Jared Bilski

Employers that have managed to keep their grandfathered status until now may think they’re immune from the hassles of the ACA, but a recent DOL investigation is a good reminder that the feds are always watching for a slipup.  

Sierra Pacific Industries Health Plan was one of the few remaining grandfathered plans in existence, and they managed to keep that status for years after the ACA took effect.

But, according to a DOL investigation, the plan made some changes beginning on Jan. 1, 2013, that prevented the plan from keeping its grandfathered status and led to a relinquishing of that status in the feds’ eyes.

Those plan changes, as well as how the plan made determinations on employee health claims, violated both the ACA (specifically the provisions on preventive health services and internal claims and appeals rules) and ERISA, the DOL claimed.

‘Operating as though it were exempt’

As the DOL’s Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi said:

“The Affordable Care Act put into place standards and protections for workers covered by employee benefit plans. The Sierra Pacific plan was operating as though it was exempt from such requirements, when indeed, it was not. This settlement means that workers improperly denied health benefits will have their claims paid. Corrections made to plan procedures will also mean that all future claims are processed and paid properly.”

No premium or deductible bumps

The end result of the feds’ investigation: A lot of administrative work and changes for Sierra Pacific.

As part of the settlement, plan fiduciaries agreed to comply with the ACA requirements for non-grandfathered plans moving forward, specifically the rules for internal claims and appeals and coverage of preventive health services.

Plus, for the 2017 plan year, the company will have to forgo any increases to participant premiums, annual out-of-pocket limits, annual deductible and coinsurance percentages in effect for the 2016 plan year.

On top of all that, the company agreed to:

  • Revise plan documents and internal procedures.
  • Re-adjudicate past claims for preventive services, out-of-network emergency services, claims affected by an annual limit and pay claims in compliance with the ACA and ERISA.
  • Submit to an independent review organization claims were eligible for external review.
  • Pay claims that had been left on hold for a long time.
  • Comply with timelines for deciding claims as provided in the department’s claim regulation.

See the original article Here.

Source:

Bilski, J. (2016 October 14). Beware: losing health plan grandfathered status is an administrative nightmare. [Web blog post]. Retrieved from address https://www.hrmorning.com/beware-losing-health-plan-grandfathered-status-is-an-administrative-nightmare/


The demand for data transparency is mounting

Interesting thoughts on transparency data from Employee Benefit Adviser, by Suzy K. Johnson

December 2003 was a great time for health plans in America. This was when high deductible health plans and the underlying health savings accounts were enacted into law by the federal government.

With this law, we were provided the ability to engage employees more directly in the cost of their care with the elimination of copays and Rx cards under these plans.

What many brokers don’t realize is that the law allows anyone to fund the underlying health savings accounts. This means that employers can and should be shown how to use the savings in premiums created by moving to these types of plans to “fund” employees’ health savings accounts. This can result in a win/win for all.

When employers fund the employee’s HSA, they provide the employee the ability to direct additional money into a flex spending type of plan (HSA) that has much higher limits for funding, and allows the same expenses to be reimbursed along with long-term care premiums, COBRA premiums and Medicare Part B expenses. These accounts don’t have the “use it lose it” risk that flex medical reimbursement plans have always included.

A top priority
Now what we need is transparency data from the hospitals and providers. It is my belief that if every American was required to have a high deductible health plan paired with a health savings account only, the demand for transparency data would be palpable and the pressure forced on providers and hospitals to comply would amplify.

Right now the transparency data is not available and this needs to change. If the only plans employers could offer were HDHP plans with HSA accounts and if employers provided funding to help their employees to be able to afford the additional exposure shifted to them, the demand for transparency data would suddenly become top priority and the government would demand it of providers.

Yes, they are more complicated to understand, and yes, the programs require more employee education and hand holding. Nothing good happens when we sit on the sidelines. Let’s commit to becoming part of the solution!

See the original article Here.

Source:

Johnson, S. K. (2016 October 4). The demand for data transparency is mounting. [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/the-demand-for-data-transparency-is-mounting


Small businesses wait for verdict on 2017 health care costs

Here's an informative article on healthcare costs, from San Francisco Chronicle (SFGate) by AP Business Writer Joyce M. Rosenberg

NEW YORK (AP) — Autumn is an anxious time for many small and medium-sized business owners as they wait to learn whether their health insurance costs will go up for 2017 — and if so, by how much?

"There's always a lump in your throat because you don't know what you're going to get," says Darren Ambler, a managing director at Insight Performance, a Dedham, Massachusetts-based human resources provider.

Whether a business sees a minuscule rise, a double-digit percentage increase or even a decline depends on factors including the state where the company is located and how much its insurance carrier paid in claims over the past year. If the average age of a company's employees rose or fell significantly — quite possible in a business with 10 or fewer employees — that could also affect the outcome.

Most of the increase in insurers' costs is a result of rising prescription drug prices, Ambler says.

While companies with 50 or more workers are required to offer affordable insurance to them and their dependents, many smaller businesses also do so because they believe it's right or they want to attract and retain good employees. When their carriers hike the premiums, companies have to decide whether to absorb the costs, scale back their coverage or find other alternatives.

Several medium-sized clients of The Megro Benefits Co., a consulting company, are facing 38 percent increases in their 2017 premium costs. Surges like that have owners thinking about what's called self-funding, says Cheryl Kiley, an adviser at Conshohocken, Pennsylvania-based Megro.

In self-funding, a business pays for all or part of employees' medical costs and hires an insurance company to administer its health plan. Companies typically purchase special policies to reimburse them in the event of employees' or dependents' catastrophic illnesses. Insurance companies charge less to administer self-funded plans because they don't have any risk, and employers also save because self-funded plans aren't subject to a 6.5 percent federal tax on premiums.

Although companies may be forced to find alternatives, Megro isn't seeing clients dropping insurance, president Bob Violasays.

"People won't come to work for them unless they have health insurance," he says.

RizePoint, which makes software for the food, lodging and retail industries and has about 75 employees, is paying 16 percent more for premiums on a policy that renewed Sept. 1. It's already considering self-funding for next year.

"It's a little bit risky," says Peter Johnson, a vice president at the Salt Lake City-based company. "But I don't want to see another 16 percent increase — it's nowhere near sustainable."

Johnson had budgeted for a rise of 12 percent. When RizePoint's carrier said premiums were going up more than that, Johnson searched unsuccessfully for a cheaper policy.

Rocky Finseth had the opposite experience. His premiums fell 11 percent although the policy was virtually unchanged from a year ago.

"I was surprised not only about the drop, but how large of a drop," says Finseth, owner of Carrara Nevada, a Las Vegas-based company that does lobbying on state and local issues in Nevada. His policy, which covers seven staffers, renews Oct. 1.

Finseth didn't question why his premiums dropped. He decided to use the savings to add vision coverage for his employees.

Some companies find that their policies have been discontinued.

"The plan we had was mysteriously canceled, and we were slotted into what we were told was the same plan, but when you looked at it, it was a worse plan," says Joseph Nagle, marketing director at EverCharge, a maker of electric vehicle charging stations. Among other things, the new plan had a higher deductible — $6,000 versus $5,000.

EverCharge, based in Emeryville, California, began researching other carriers and plans, chose three and asked its seven employees which they preferred. The company, which previously paid for all its staffers' insurance, gave them an option of continuing to have fully funded coverage, paying about $10 per month for better coverage, or $120 for another. They chose the middle option, and EverCharge was able to keep its health care costs unchanged, Nagle says.

Jason Anderson, owner of Datagame, a Kansas City, Missouri-based maker of software for online market research, hasn't received his renewal package yet. Anderson pays 100 percent of his three staffers' premiums, and 50 percent of their dependents' premiums.

He had a 5 percent increase for his 2016 premiums, an amount he doesn't see as significant. He says he can handle a 10 percent increase, but if he's facing a 20 percent hike, he might have to cut back on coverage for dependents.

"I keep waiting for the shoe to drop," says Anderson, who acknowledges that he'd be angry at an increase in the 20 percent range. "I don't see 10, 20, 30 percent improvements in what I am able to charge my clients," he says.

See the original article Here.

Source:

Rosenberg, J. M. (2016 September 14). Samll businesses wait for verdict on 2017 health care costs. [Web blog post]. Retrieved from address https://www.sfgate.com/news/us/article/Small-businesses-wait-for-verdict-on-2017-health-9222107.php


Majority of workers cannot define copay, deductible

Do your employees understand the healthcare acronyms? Vlad Gyster explains how educating your employees can have a major impact on proper usage of healthcare benefits.

Very soon, thousands of employees across the United States will be choosing their health insurance. That’s scary, because there’s an emerging body of data that shows that most people don’t understand the basics of how health plans work. That knowledge gap may be causing some serious issues: From sick people not going to the doctor, to employees over-paying for health insurance.

If you're like most employers, there's a good chance that you're moving to consumer-driven health plan designs that employ a high deductible. In 2006, only one in 10 employees had a general health insurance deductible of $1,000 or more for single coverage. Today, nearly half do.

As adoption accelerates, benefit professionals find themselves in the midst of a developing crisis: Though HDHPs clearly help cut healthcare costs new research indicates that they do so in the worst way possible. Instead of shopping for better prices, sick people are simply not getting the care they need. As one of the study’s authors puts it: “We [didn't] find any evidence [employees] look for a lower cost. They just don't go."

Here's what’s puzzling: This isn't necessarily happening because of cost. This research is based on an employer that fully funded the deductible. As Vox explains: “In some cases, you could chalk this up to a liquidity issue: A worker might not have enough money in her checking account to pay for all the care below the $3,750 deductible. But that explanation doesn't work here: In this case, the employer put a $3,750 subsidy in workers' health savings accounts.”

So, what could it be? There could be many complex reasons. But there could also be a very simple one: 86% of people cannot define deductible, copay, coinsurance and out-of-pocket maximum. And people can’t properly use what they don’t understand.

A central assumption in consumer-driven plan design is that people can get the same care at a lower price and avoid care that they don’t actually need. To do that, employees need to be educated healthcare consumers, and companies have added tools to help. Utilization modeling and cost transparency technologies are becoming more and more broadly available. But there's a much more foundational piece of the puzzle that's been taken for granted.

In a paper published in Journal of Health Economics, researchers found that 86% of participants couldn’t define all of the following four terms on a multiple choice questionnaire:

· Deductible
· Copay
· Coinsurance
· Out-of-pocket maximum

While the healthcare industry is focused on utilization prediction and cost transparency tools, which are hard to create and implement, something quite basic is slipping right under our noses: Teaching people basic terms that they need to know to make informed decisions.

Understanding these terms is a building block of healthcare consumerism, without which a lot starts to unravel. If an employee doesn’t understand the terms that make-up every health plan design, it's hard to convince an employee to even switch to a high deductible health plan, even when it saves the employee money. It may also cause the employee to avoid care that she needs, because she has trouble predicting what she'll pay.

As more employers adopt HDHPs, a troubling reality is on the horizon: A healthcare crisis may be around the corner due to employees not getting the care that they need.

What to do about it
The good news is that healthcare consumerism isn’t a one-time event. It requires ongoing education and now is as good a time as ever to begin.

Here is something completely free you can do:

· Survey your employees to see what percentage understand basic health plan concepts.
· Send a weekly email to all employees defining each healthcare term, one at a time.
· Re-survey your employees with the exact same questions to measure the change.

This alone will give you a measurable starting point, a way to make progress, and measure the progress made.

See the original article from BenefitNews.com Here.

Source:

Gyster, V. (2016, June 27). Majority of workers cannot define copay, deductible [Web log post]. Retrieved from https://www.benefitnews.com/opinion/majority-of-workers-cannot-define-copay-deductible