National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year
In this article from Kaiser Family Foundation, we are going to take a brief look at the ACA sign-ups this year.
Overall ACA marketplace signups for 2018 dropped by 3.7 percent compared to last year’s enrollment period, a new analysis from the Kaiser Family Foundation finds.
11,760,533 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in advance of the open enrollment period, leading to increases in premiums but also increased premium subsidies for many consumers that in some cases led to reductions in what they had to pay for coverage.
As a group, the 15 states plus the District of Columbia with state-based marketplaces, including those using the Healthcare.gov enrollment platform, exceeded last year’s totals this year by .2 percent, while the 34 states that relied on the federal healthcare.gov marketplace saw total signups drop by about 5.3 percent. State-based marketplaces control their own funding for outreach and consumer assistance.
Fifteen states and the District of Columbia exceeded 2017 signups in 2018 – eight of these were state-based marketplaces, three were state-based marketplaces using the Healthcare.gov enrollment platform (KY, NV, and OR), and five were federal Healthcare.gov marketplaces.
Rhode Island (12.1%), Kentucky (10.4%), and Washington State (7.6%) saw the largest share increases in signups, while Louisiana (-23.5%), West Virginia (-19.5%), and Arizona (-15.6%) had the largest drop in shares of signups.
Read the original article here.
Source: Kaiser Family Foundation (7 February 2018). "National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year" [Web Blog Post]. Retrieved from address https://www.kff.org/health-reform/press-release/national-aca-marketplace-signups-dipped-a-modest-3-7-percent-this-year/
A Check Up on U.S. Global Health Policy, After One Year of the Trump Administration
From Kaiser Family Foundation, let's take a look at this informative article that reviews healthcare since the beginning of the Trump Presidency.
This month marks one year since Donald Trump became the 45th President of the United States after winning the election on a populist, “America-First”, platform. Since then, there have been many questions raised about what a Trump Presidency would mean for U.S. global health policy in light of statements on scaling back foreign aid and a skepticism of the value of multilateral institutions and key international agreements. Historically, global health has enjoyed bipartisan support and been highlighted as a major area of success for the United States. Funding for global health rose significantly in the last decade and, although it has leveled off, it still represents the largest component of U.S. foreign assistance (an estimated 24% in FY 2017).
In this brief, we take stock of the U.S. global health response on the occasion of one year of the Trump Presidency and look ahead to the global health policy issues that are likely to be front and center in the coming months and years. Overall, there are a mix of challenges facing the U.S. global health response, some of which pre-dated Trump and others that are the result of decisions and actions of the administration, including proposals to significantly scale back funding. At the same time, global health programs still enjoy strong bipartisan support in Congress and, according to our just-released poll, about half of the public still wants the U.S. to play a major or leading role in improving health in developing countries (see Figure 1 and Appendix).
Figure 1: Half of the Public Sees Leading or Major Role for the U.S. in Improving Health in Developing Countries
DIAGNOSIS
ADMINISTRATION ACTIONS HAVE LED TO FOREIGN POLICY UPHEAVAL
In keeping with the “America First” campaign and promises to re-examine the U.S. role in world affairs, the Trump Administration has made a number of notable changes in broader U.S. foreign policy that affect global health. These include the administration’s decision to withdraw from the Paris Climate Accord, its criticism of and new demands for U.S. engagement in the context of international trade agreements such as the Trans-Pacific Partnership (TPP) and North American Free Trade Agreement (NAFTA), and skepticism of, and intent to reduce U.S. support for the United Nations and potentially other multilateral organizations. More recently, the administration has proposed to cut foreign aid to countries that voted counter to U.S. government wishes at the UN. While this threat is not without precedent, it is a departure from U.S. policy over the prior two decades, and underscores the administration’s theme of emphasizing U.S. interests over other considerations.
The Trump Administration has also sought to make its mark on the agencies that carry out U.S. foreign policy, including the State Department and the U.S. Agency for International Development (USAID). Following a March 2017 White House Executive Order on reorganizing the executive branch, Secretary of State Rex Tillerson has attempted to re-organize and reform these agencies. One potential move that was feared by many was the idea of “merging” USAID and the State Department – the two currently exist as quasi-independent – but to date there is no evidence of such a change being actively pursued. At the same time, budget requests from the White House have demonstrated the administration’s desire to make significant cuts to these agencies’ budgets, and their day-to-day management has been criticized by current and former employees. In addition, there has been decidedly slow progress in nominating and appointing staff for key foreign policy leadership posts, along with a notable exodus of experienced staff over the last year. For example, as of this writing, President Trump had nominated far fewer candidates at the State Department (89) compared to Presidents Obama (137) and George W Bush (153) at the same point in their first terms.
And, whereas human rights has been a component of U.S. foreign policy that the Obama Administration sought to elevate in its foreign policy (even including it prominently in its national security strategy), Trump Administration officials have downplayed the importance of human rights, leading to worries in the foreign policy and development community, and letters of concern from members of Congress.
IMPLICATIONS FOR GLOBAL HEALTH
A lack of ambassadors in some countries, needed staff appointments in some positions, a shifting stance on human rights, and a shrinking foreign policy workforce have concerning implications for planning and carrying out U.S. global health programs. Such difficulties for global health have been compounded by certain policy decisions, including proposals to significantly cut U.S. global health funding (see Figure 2).
Figure 2: U.S. Global Health Funding, FY 2004-FY 2018 Request
The most concrete global health policy change of the administration to date came on the first Monday of President Trump’s term, in the form of a re-instatement and expansion of the Mexico City Policy. The Policy, which was in effect and applied to family planning assistance in previous Republican administrations, was not only re-instated but also expanded to encompass almost all global health assistance, increasing the number of organizations and the amount of funding affected by the policy. We found the expanded policy applies to more than $7 billion in funding and likely affects more than one thousand foreign NGOs. In addition, on March 30 the administration invoked the “Kemp-Kasten amendment” to withhold funding for the United Nations Population Fund (UNFPA), the lead U.N. agency focused on global population and reproductive health, as has been done in previous Republican administrations.
The administration’s request to significantly cut global health funding is unprecedented. For FY2018 the White House proposed cuts of over $2B to global health, representing a 23% overall reduction compared to FY2017; these included a proposed reduction to PEPFAR of more than $1 billion and a zeroing out of the family planning budget, among others. Multiple analyses of the potential impacts of such cuts conclude that serious negative health consequences would result, including many more infections and deaths from HIV and TB, and an increase in the number of abortions along with greater maternal mortality. None of these requested cuts have been enacted but this is the first time cuts of this magnitude have been proposed, and they mark a significant shift from the direction and emphasis of prior administrations.
Even as they have implemented more restrictive policies and proposed cuts, Trump Administration officials have publicly stated support for select U.S. global health priorities. In his first major speech to the United Nations in September, for example, President Trump highlighted three major U.S. global health areas of success: PEPFAR, the President’s Malaria Initiative, and the Global Health Security Agenda (GHSA). Secretary of State Tillerson has also spoken about the importance of PEPFAR and the GHSA; the U.S. has signaled its intention to remain engaged in the larger GHSA effort, and has even highlighted the importance of global health security in the newly revised U.S. National Security Strategy, and is expected to do the same in a forthcoming national biodefense strategy. Despite the foreign policy vacancies noted above, some global health and development leaders have remained in their roles since the Obama Administration, including the U.S. Global AIDS Coordinator and the Director of the National Institutes of Health, while other key positions have been filled by President Trump, including the new USAID Administrator who has a strong record in global health, the Director of the Centers for Disease Control and Prevention, and leadership on global health within the White House National Security Council.
CONGRESS PUSHES BACK
Congress has also continued to play a significant role in global health, including bipartisan and bicameral push back against proposed funding cuts. Funding for global health was kept at FY 2017 levels and, while not yet final, will likely be level in FY2018 as well. Moreover, Congress has asserted its role in directing global health efforts by including, for the first time, language in the FY 2017 budget legislation that prevents the administration from changing global health program funding levels. Congress also included language requiring a report before any reorganization of State and USAID could occur. Many stakeholders, including current and former U.S officials, the faith community, and members of the military, have also pushed back on the administration’s proposed cuts to global health and development.
U.S. PUBLIC SUPPORT FOR GLOBAL HEALTH CONTINUES, THOUGH WITH SOME DECLINES & PARTISAN DIVISIONS
Our latest (January 2018) tracking poll assessed public support for U.S. engagement in global health in the Trump era. The public perceives the Trump Administration as less supportive of global health, with half (53%) saying the Trump Administration has made global health a lower priority than previous administrations.
As mentioned above, about half of the public (54%) say they want the U.S. to play a leading or major role in improving health for people in developing countries. Support for such engagement is strongest among Democrats (73%), who also are more likely to support the U.S. playing “a leading role” (20%), and lower among independents (47%) and Republicans (49%), see Figure 3; Trump supporters are not interested in the U.S. playing a leading role (just 4% say they believe this). However, overall support fell slightly from 2016, when 61% said they think the U.S. should take a leading or major role.
Figure 3: Support for U.S. Role in Improving Health in Developing Countries by Party Identification
Most of the public (59%) believe the U.S. is spending the right amount or not enough on global health programs, but one-third (33%) believe the U.S. is spending too much – a significant jump from the 18% saying we were spending too much in 2016.
For overall global engagement, the poll numbers indicate a greater proportion of the U.S. public (69%) now believes the U.S. should take at least a major role in solving the world’s problems than in 2016 (57%). The share of Republicans agreeing with this statement grew from 20% in 2016 to 31% in 2018. However, confusion about the amount spent on U.S. foreign aid persists, with half (49%) saying too much is spent in this area but when presented with the actual amount – about 1% of the federal budget goes to foreign aid – people are much less likely (29%) to view that as too much spending (as found in previous polls). See Appendix and poll results for more detailed information.
PROGNOSIS
The push and pull in global health policy will likely continue in 2018 and potentially intensify. On the one hand, actions taken by the administration signal a reduced U.S. engagement in the world and intention to step back further in global health. On the other, U.S. global health programs have so far demonstrated resilience, buoyed by strong support from Congress and key stakeholders.
The tension will likely be tested again in the near term with the soon-to-be released FY 19 White House budget request, which many expect to propose at least the same level of deep cuts to global health. Negotiations will take place within the broader context of greater budget pressures and concerns about the deficit, particularly in wake of recently enacted tax legislation that could tighten discretionary spending, including for foreign assistance, even more.
Beyond that, there will be a number of other issues to watch, including:
- Mexico City Policy: The expanded Mexico City Policy, which has only begun to be implemented, will likely be felt in a much more pronounced way in these next months and years including potential gaps in services in the field;
- PEPFAR: The administration, Congress, and other stakeholders are beginning to assess whether they want to move forward to reauthorize PEPFAR – the program’s current authorization expires at the end of FY 2018 (though the program will not end and a new reauthorization is not needed to keep it funded). In addition, PEPFAR’s recently launched new strategy, which aims to focus most efforts on 13 priority countries, raises questions about the larger U.S. global AIDS response in the context of potential budget decreases;
- Global Health Security Agenda: Key decisions about the next phase of the GHSA, including what to do regarding an impending fiscal cliff as supplemental Ebola funds expire in FY2019, will soon be coming down the pike and the U.S., as a founding and leading member of the partnership, will figure prominently in its future direction; and
- Replenishment: Two major global health multilateral partners of the U.S. – the Global Fund and GAVI – will soon begin processes for launching their next replenishment conferences, marking an important moment for gauging future U.S. support.
The key question going forward, then, may very well be which vision of global health will end up holding sway in the political back-and-forth in Washington – that of the White House or Congress? Ultimately, the winners, or losers, of this “battle” will be the people that benefit from U.S. investments around the world.
Source: Kates J., Michaud J., Kirzinger A., Munana C. (29 January 2018). "A Check Up on U.S. Global Health Policy, After One Year of the Trump Administration" [Web Blog Post]. Retrieved from address https://www.kff.org/global-health-policy/issue-brief/a-check-up-on-u-s-global-health-policy-after-one-year-of-the-trump-administration/
Algorithmic Bias – What is the Role of HR?
How should HR professionals deal with the forthcoming algorithmic bias issue? Find out in this article.
Merriam-Webster defines ‘algorithm’ as step-by-step procedure for solving a problem…In an analog world, ask anyone to jot down a step-by-step procedure to solve a problem – and it will be subject to bias, perspective, tacit knowledge, and a diverse viewpoint. Computer algorithms, coded by humans, will obviously contain similar biases.
The challenge before us is that with Moore’s Law, cloud computing, big data, and machine learning, these algorithms are evolving, increasing in complexity, and these algorithmic biases are more difficult to detect – “the idea that artificially intelligent software…often turns out to perpetuate social bias.”
“Algorithmic bias is shaping up to be a major societal issue at a critical moment in the evolution of machine learning and AI. If the bias lurking inside the algorithms that make ever-more-important decisions goes unrecognized and unchecked, it could have serious negative consequences, especially for poorer communities and minorities.”What is the role of HR in reviewing these rules? What is the role of HR in reviewing algorithms and code? What questions to ask?
In December 2017, New York City passed a bill to address algorithmic discrimination.Some interesting text of the bill, “a procedure for addressing instances in which a person is harmed by an agency automated decision system if any such system is found to disproportionately impact persons;” and “making information publicly available that, for each agency automated decision system, will allow the public to meaningfully assess how such system functions and is used by the city, including making technical information about such system publicly available where appropriate;”
Big data, AI, and machine learning will put a new forward thinking ethical burden on the creators of this technology, and on the HR professionals that support them. Other examples include Google Photos incorrect labeling or Nikon’s facial detection. While none of these are intentional or malicious, they can be offensive, and the ethical standards need to be vetted and reviewed. This is a new area for HR professionals, and it’s not easy.
As Nicholas Diakopoulos suggests, “We’re now operating in a world where automated algorithms make impactful decisions that can and do amplify the power of business and government. As algorithms come to regulate society and perhaps even implement law directly, we should proceed with caution and think carefully about how we choose to regulate them back.”
The ethical landscape for HR professionals is changing rapidly.
Read more.
Source: Smith R. (15 February 2018). "Algorithmic Bias – What is the Role of HR?" [Web Blog Post]. Retrieved from address https://blog.shrm.org/blog/algorithmic-bias-what-is-the-role-of-hr
A New Approach to Paid Leave: WorkFlex in the 21st Century Act
From SHRM, let's take a look a this innovative approach toward paid leave using WorkFlex.
Do you ever sit in your office and wonder about everyone else? Ponder whether anyone is dealing with the same things that you are in that very moment? The simple fact is that everyone independent of age, gender, race or title, wants to be there to support their family. For myself, that means advocating for clients, while caring for my mother and doing all that I can for my wife and two boys. It is quite a balancing act on the best of days. To be fair, I know that I am not alone in this balancing act. As I write this I am wondering if you know exactly what I mean. Perhaps not for yourself, but a colleague or a friend.
Now since we generally live, work or both in New Jersey and in particular within the Delaware Valley there are some things that impact our ability to balance. For example, if you work for an organization that has offices in Philadelphia, PA; Wilmington, DE; Trenton, NJ; Montclair, NJ and Haddonfield, NJ exactly how do you provide equal paid leave to employees? Why should you care? Because these specific locations differ in how they require paid leave to be provided to employees. Are you concerned about this? You are not alone, clients regularly ask what to do as it relates to dealing with paid leave. Often this is more challenging for us than in most places around the country due to the varying ways that towns as opposed to States or the Commonwealth deal with this issue.
Some time ago I was asked to assist SHRM with the creation of federal legislation to address the issue of varying applications of paid leave laws around the country. After a significant amount of discussions, revisions and hard work by a host of individuals we came up with a legitimate proposal to address our respective concerns. Recently the “Workflex in the 21st Century Act” (HR 4219) was introduced in the House by Representative Mimi Walters. This bill is designed to support the goals of everyone, not just employers or employees. You can read more about the specifics at: https://www.advocacy.shrm.org/workflex.
For now, allow me to give you three specific reasons (although there are more) that both you and your organization should support this legislation:
First, unlike federal mandates under the FMLA, FLSA, or ADA, this legislation is OPT-IN, which means as an employer in order for your organization to be held responsible under the bill it would have to decide to agree to it first. Put another way, an employer is not required to do it if it chooses to go in another direction.
Second, many federal employment laws bring with them a threshold beyond which every employer is held to the same standard, however that is not the case with the “Workflex in the 21st Century Act.” It is designed to grow with your organization. As a result the benefit thresholds change based on the number of employees in an organization, so that it supports growth rather than stifling expansion.
Third, contrary to the way things are currently going in our region, this bill provides a level of certainty and flexibility for both employers and employees alike to know the threshold of their leave benefits, which will result in more productive employees and organizations. Part of the reason for this certainty is that the various local leave laws would be preempted by this bill.
What does all this mean? I would suggest that this bill is a good compromise of interests across the spectrum of both employers and employees, as well as unions, who want to do the right thing. Allow for realistic time to care for a child, parent or for yourself. No one needs to change jobs to get a specific type of benefit and employers can choose if it makes sense for their workplace, rather than being dictated to in terms of the benefits to provide their employees.
Now I would like to challenge you to join me. This is the first piece of legislation that SHRM has created for the workplace and as you can see the goal is to address concerns that all workers have, independent of title, so we can all have the balance that we need and want in order to be better contributors in our respective organizations, supportive of our parents, children and ourselves. How can we achieve this together? We can all reach out to our federal legislators and let them know that you support the “Workflex in the 21st Century Act” (HR 4219). You can find more information on https://www.advocacy.shrm.org/workflex or on the SHRM Advocacy App. Let’s take this opportunity to make the workplace better for everyone, together.
Read more.
Source: Lessig L. (February 8th, 2018). "A New Approach to Paid Leave: WorkFlex in the 21st Century Act" [Web Blog Post]. Retrieved from address https://www.advocacy.shrm.org/shrm/app/document/26467137
What's Really Draining Employee 401(k) Accounts
Are your employees placing enough emphasis in their retirement? Here is a great article by Cynthia Loh from Employee Benefit Advisor on what employers can do to help their employees properly utilize their 401(k)s.
When it comes to debating the root cause of why Americans, as a whole, are short at least $6.8 trillion in retirement savings, it’s never long before someone points a finger at fees.
But while fees do their part to erode retirement nest eggs, there’s actually something far more detrimental to a comfortable retirement: the investing behavior of savers themselves. In fact, behavioral mistakes could cost savers 1.56% per year.
How does poor behavior add up to such a cost? Here are three core employee 401(k) missteps, and how plan sponsors can limit them.
1. Employees often make poor fund selections
Employees generally find it challenging to choose their own investments, and the task often ends up costing them.
For many employees, the initial obstacle of setting up a 401(k) plan stops them in their tracks. A large fund line-up can cause analysis paralysis, and actually reduce participation rates. One study found that for every additional 10 funds added to a set of plan options, participation drops by about 2%.
For those employees who do participate, they are left to fend for themselves with complex fund lineups. Ideally, they would establish an asset allocation with a correct level of risk and an optimal diversification for that risk tolerance. Unfortunately, a 2015 study by Financial Engines found that 61% of unadvised plan participants had inappropriate risk levels.
Finally, it’s not uncommon for employees to attempt investment selection without fully understanding proper diversification. Instead of balancing risk, participants might divide their money evenly between the options on an investment menu. For example, if six out of 10 options are stock funds, they are likely to end up at roughly 60% stocks. If 18 out of 20 options are stock funds, they will end up with 90% stocks.
So, what should you, the plan sponsor, do when your employees face a 401(k) situation that seems to inhibit participation, leads to unnecessary risk, and fails to encourage proper diversification?
Solution: Consider offering managed 401(k) accounts as a Qualified Default Investment Alternative
If employees find it challenging to make fund selections confidently, why not build in default investment advice to your plan? A Qualified Default Investment Alternative (QDIA) provides a standard, default offer of a portfolio customized to each employee. By constructing a diversified, optimized portfolio for each employee as a standard service, your 401(k) plan can help employees avoid uninformed decisions about their investments. The fund selection process will be more straightforward for new employees. As such, they may be less likely to opt for unduly high risk levels, and, by default, their investments will then be properly diversified.
In other words, rather than providing employees with a list of ingredients, provide them with a prepared meal customized to their palate and set up to satisfy their financial health.
2. 401(k) participants often “set it and forget it”
For those participants that successfully navigate participation, asset allocation, and fund selection, the ongoing maintenance of a 401(k) still presents challenges. Many plan participants choose their deferral rates and funds on the first day of work and might not change anything for the entire time they’re at that employer — or even after they leave. Meanwhile, they’re missing out on the benefits that could be had by rebalancing or switching investments based on macro trends, such as an ETF price decrease.
Plan sponsors should consider all the options available to them for helping employees understand the right asset allocation, appropriate fund allocations, ongoing portfolio maintenance — and the path forward to a secure, stable retirement.
Solution: Enable automation to help your employees maintain their 401(k)
401(k) maintenance is essential, but it shouldn’t fall on individual employees to disrupt their daily lives to keep things up-to-date. Technology can make the task of maintaining 401(k) investments far easier for employees.
If employees don’t want to actively revisit their deferral rates and asset allocations on an annual basis, automation can handle the process of portfolio rebalancing and tax optimization for the participant. While target-date funds (TDFs) have offered limited automatic adjustment for years, today, 401(k) plans built with automated advice tend to offer more personalized optimization for employees. For instance, TDFs usually rely on a generic set of assumptions about their investors to determine how they rebalance and adjust risk over time. Automated 401(k) plans can offer personalized rebalancing, tax optimization, and asset reallocation, solving for an individual’s specific characteristics and goals.
3. Poor investing behavior is a workplace issue
Employees talk to each other about their benefits, worry together from time to time, and often ask one another for advice. In short, water-cooler talk plays a role in how participants behave with regards to their 401(k).
In any given office, there’s at least one employee — we’ll call him Gary — who fancies himself a stock trading guru. Gary checks the morning headlines and stock tickers. He’s always offering unsolicited financial advice to his fellow colleagues. And he spends a lot of time at the water cooler.
For novice employees, having somebody like Gary in the office can either inspire them to gain financial literacy or drastically sway their investing behavior. As the plan’s fiduciary, the 401(k) plan sponsor should make sure the right financial advice reaches all employees, so that water-cooler talk from people like Gary doesn’t play too large a role in employees’ investing behavior.
Solution: Offer personalized financial advice in your 401(k) plan
A responsible way to give employees the information they need to make good decisions is to offer personalized financial advice with your 401(k) plan. Advice from a fiduciary adviser helps participants make decisions for their own individual situation, removing the confusion of what they hear at work, see on television, or learn from their peers.
That advice becomes more valuable when it takes into account personal goals such as buying a home and covers all assets, including 401(k) assets. Some 401(k) platforms have educational features built in that can anticipate when a participant has a question or appears confused and serves up tailored information that can help employees make a sound decision. Others make use of customer service centers that make it easy for employees to ask questions to experts when they need to, rather than front-loading them with information during an orientation.
Save your employees the cost of poor investing behavior
When it comes down to it, plan sponsors often underestimate just how confusing 401(k) plans can be for employees. Most employees know that saving for retirement is important, but few actually understand all they should do to maximize the benefit of their 401(k) contributions.
Help your employees save money by selecting a 401(k) solution that helps to minimize behavioral mistakes. Poor fund selection, lack of account maintenance, and bad advice shouldn’t detract from employees’ results. With elegant solutions like a managed account QDIA, investment automation, and expert advice, you can save your employees time, money and anxiety.
See the original article Here.
Source:
Loh C. (2017 June 13). What's really draining employee 401(k) accounts [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/whats-really-draining-employee-401-k-accounts
3 HSA Facts Employers Need to Know
Take a look at this informative article from Benefits Pro about what changes to HSAs means for employers by Whitney Richard Johnson.
Health Savings Accounts offer employers a way to help employees with health care costs without being as involved as they might be with, say, a Flexible Saving Account. But what are some other advantages?
And what are employers' responsibilities? Although employers will want to research more indepth about HSAs, here is a quick look at some basic HSA questions and answers:
#1: What are the advantages to an employer of offering an HDHP and HSA combination?
The benefits of offering employees an HDHP and HSA vary dramatically depending upon the circumstances. A major strength of offering an HSA program is flexibility.
Employers can be very generous and fully fund an HSA and also pay for the HDHP coverage. Alternatively, employers can also use the flexibility of the HSA to allow for the employer to reduce its involvement in benefits and put more responsibility onto the employee.
Generally, employers switch to HDHPs and HSAs to save money on the health insurance premiums (or to reduce the rate of increase) and to embrace the concept of consumer driven healthcare. The list below elaborates on strengths of HDHPs and HSAs.
Lower Premiums. HDHPs, with their high deductibles, are usually less expensive than traditional insurance.
Consumer-driven health care. Many employers believe in the concept of consumer-driven healthcare. If an employer makes employees responsible for the relatively high deductible, the employees may be more careful and inquisitive into their health care purchases. Combining this with an HSA where employees can keep unused money increases employees’ desire to use health care dollars as if they were their own money – because it is their own money.
Lower administration burden. Given the individual account nature of HSAs, much of the administrative burden for HSAs is switched from the employer (or paid third-party administrator) to the employee and the HSA custodian as compared to health FSAs and HRAs. This increased burden on the employee comes with significant perks: more control over how and when the money is spent, increased privacy, and better ability to add money to the HSA outside of the employer.
Tax deductibility at employee level. The ability of employees to make their own HSA contributions directly and still get a tax deduction is advantageous. Although it is better for employees to contribute through an employer, an employee can make contributions directly. An employer may not offer pretax payroll deferral or it may be too late for an employee to defer. For example, an employee that decides to maximize his prior year HSA contribution in April as he is filing his taxes can still do so by making an HSA contribution directly with the HSA custodian.
HSA eligibility. Becoming eligible for an HSA is a benefit that also stands on its own. Although not all employees will embrace HSAs, savvy employees that understand the benefits of HSAs will value a program that enables them to have an HSA.
#2: What are the employer responsibilities regarding employee HSAs?
If an employer offers pretax employer contributions, then the employer has the following responsibilities:
Make comparable contributions. If the employer is making a pretax employer contribution (nonpayroll deferral), it must do so on a comparable basis.
Maintain Section 125 plan for payroll deferral. If the employer allows pretax payroll deferral, then the employer must adopt and maintain a Section 125 plan that provides for HSA deferrals. This includes collecting employee deferral elections, sending the deferred amount directly to the HSA custodian, and accounting for the money for tax-reporting purposes.
HSA eligibility and contribution limits. Employers should work with employees to determine eligibility for an HSA and the employee’s HSA contribution limit. Although it is legally the employee’s responsibility to determine his or her eligibility and contribution limit, a mistake in these areas generally involves work by both the employer and the employee to correct. Mistakes are best avoided by upfront communication. Also, the employer does have some responsibility not to exceed the known federal limits. An employer may not know if a particular employee is ineligible for an HSA due to other health coverage but an employer is expected to know the current HSA limits for the year and not exceed those limits.
Tax reporting. The employer needs to properly complete employees’ W-2 forms and its own tax-filing regarding HSAs (HSA employer contributions are generally deductible as a benefit under IRC Section 106).
Business owner rules. Business owners generally are not treated as employees and employers need to review HSA contributions for business owners for proper tax reporting.
Detailed rules. There are various detailed rules that fall within the responsibility of the employer that are too numerous to list here but include items such as: (1) holding employer contributions for an employee that fails to open an HSA, (2) not being able to “recoup” money mistakenly made to an employee’s HSA, (3) actually making employer HSA contributions into employees HSAs on a timely basis, and (4) other detailed rules.
#3: How do employers switching from traditional insurance to HDHPs explain the change to employees?
Although there is no certain answer to this question, a straight-forward and honest approach to the change will likely work best.
Changing from traditional insurance to a high deductible plan with an HSA can be significant because employees likely face a higher deductible (although traditional health plan deductibles have been increasing to the point they are close to HDHPs).
Often the largest obstacle to the change is that employees feel something is being taken away from them. An employer that can show that the actual dollars contributed by the employer are level, or increased, versus the previous year helps a lot – especially if the employer makes a substantial HSA contribution for employees.
If the employer is making the change to reduce its health care expenses, then the employer will have to explain and justify that change to employees to get employees’ support for the change (e.g., the business is in a tough spot due to a difficult economy, etc.).
Depending on the facts, the change will likely be an improvement for some employees and HSA eligibility provides benefits to all employees. Some specific benefits include the following:
Saving money. The HDHP is generally significantly less expensive. Depending upon the circumstances, this fact often saves not only the employer money but also the employee. Highlighting the savings will help convince employees the change is positive. Although an actual reduction of the employee’s portion of the premium expense may be unlikely given increasing health insurance premiums, explaining that without the change the employee’s portion of the premium would have increased by more will help reduce tension.
Tax savings. The HSA enables tax savings. For some employees these tax savings are significant.
Control. HSAs give individuals control over their money and accordingly their doctor and treatment choices.
Flexibility. An HSA is very flexible and allows for some employees to put aside a large amount and get a large tax benefit. For those that prefer not to do so, the HSA allows that as well. Plus, even better, the HSA allows employees to change their mind mid-year. If an employee believes they are not going to need any medical services, the employee needs to contribute only a minimum deposit to an HSA. If it turns out that the employee does incur some medical treatment, the employee can contribute at that time and still get the tax benefits. Employees are often frustrated by HSA rules because of some confusion, but when explained that the rules are very flexible they appreciate HSAs more.
Distribution reasons. HSAs allow for more distribution reasons than FSAs: namely to pay for health insurance premiums if unemployed and receiving COBRA, to pay for some health insurance premiums after age sixty-five, to use for any purpose penalty-free after age sixty-five, to carry forward a large balance, and more.
See the original article Here.
Source:
Johnson W. (2017 May 11). 3 HSA facts employers need to know [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/05/11/3-hsa-facts-employers-need-to-know?kw=3+HSA+facts+employers+need+to+know&et=editorial&bu=BenefitsPRO&cn=20170514&src=EMC-Email_editorial&pt=Benefits+Weekend+PRO&page_all=1
Is Social Media Putting Employees’ Health, Safety at Risk?
Do your employees know about all of the risks that can come from their social media? Find out how social media can affect your employee's safety and health in this article from Employee Benefit News by Jill Hazan.
The issue of personal online safety has finally crossed over into the healthcare arena — and employers need to step up and learn to best educate employees about keeping them safe.
A recent article in the Journal of the American Medical Association Pediatrics, “Parental Sharing on the Internet: Child Privacy in the Age of Social Media and the Pediatrician’s Role,” highlights how parents who post information about their children on social media put them at greater risk for identity theft. In addition, this trend toward oversharing compromises a child’s protected health information. What might happen when that child applies for a job in the future and a simple internet search reveals health information she would not want an employer to know?
While HIPAA protects the confidentiality of an individual’s medical records, it doesn’t provide comprehensive protections outside the healthcare environment. The laws around the privacy rights of children relative to their parents’ online disclosures are still evolving. The article recommends that pediatricians ask parents about their social media habits to help keep children safe and their data private. It is a natural extension that all primary care providers should be asking patients about social media behaviors, as the issues of identity theft and data privacy are relevant to children and adults alike.
This recommendation is increasingly significant from an employee benefit perspective.
So what should employers do?
Employers routinely provide healthcare benefits to employees. If health plans and physicians are acknowledging and addressing the risks of social media from a privacy and security perspective, shouldn’t employers extend that focus into the workplace? With the continued employer emphasis on wellness, it is incumbent on health plans and employers alike to educate employees on online security and the risks of identity theft.
There are a variety of resources and benefits that employers can access to assist employees in navigating the online world safely. A series of well-structured, engaging seminars on identity theft and online security that combine real-life stories with actionable advice are effective in educating employees and changing behaviors. Online tutorials, like those provided by the Center for Identity at the University of Texas, Austin, can guide employees on setting proper privacy settings on social media sites, such as Facebook, Twitter, LinkedIn and Pinterest.
Identity theft protection plans provide monitoring and restoration services, as well as education to help keep employees and their families secure. EAPs may provide guidance on identity theft and counseling for victims. Comprehensive legal benefit plans provide legal advice and representation for victims of identity theft. Employers may also provide employees access to online data protection tools for use at work and home with features that encrypt communication and block malware and phishing attempts.
Employees need to understand how to navigate the social media and online environment to keep their families safe. Identity theft of a family member affects more than just one person. It can register an emotional, physical and financial toll on the entire family. Employers need to structure a comprehensive approach to managing the health and wellness of employees as it relates to their online behaviors. A program with a combination of employee benefits, from healthcare to identity theft protection benefits, supplemented by onsite employee education, will support the goals of the health plan and, ultimately, the organization’s overall business objectives.
See the original article Here.
Source:
Hazan J. (2017 May 1). Is social media putting employees' health, safety at risk? [Web blog post]. Retrieved from address https://www.benefitnews.com/opinion/is-social-media-putting-employees-health-safety-at-risk?feed=00000152-18a4-d58e-ad5a-99fc032b0000
Photo Credit: HowToStartABlogOnline.net
7 Questions to Ensure Successful Benefit Technology Purchases
Do you need help figuring out your technology needs for an employee benefits program? Check out this interesting article by Veer Gidwaney from Employee Benefit Adviser about which technology you will need for your employee benefits program.
From quality to data integration, there are many factors to consider when purchasing benefit administration technology. With employers increasing turning to their adviser for guidance, here are some key questions advisers should make sure their client’s tech acquisition teams can answer:
1) How will you ensure data quality is maintained during the migration to the new system? Be it a mistyped entry, or incomplete form, errors are bound to happen in open enrollment, and if they’re not caught during implementation process, errors can go unnoticed for months or longer. This means inaccuracies in carrier files, delays in enrollment processing, and additional back-and-forth between you and your client or the carrier.
Don’t rely on human eyes to scan spreadsheets for potential errors, it’s 2017. Before you take the plunge with a technology partner, understand their data validation and backup data quality check processes to catch and correct errors before they’re entered into your system of record.
2) Will this technology require a printer or a fax machine for my team or my clients?
No benefits or HR platform should require any manual paperwork. It’s time-consuming, and more prone to human error, yet many benefits systems still rely on paper-based processes to run an enrollment or onboard an employee. Take a stand, for your team, your clients, and their employees.
Make sure you see a demo of the onboarding and enrollment process from start to finish before partnering with a technology platform, and expect employees and HR to demand the same expectations based on interacting with any other technology experience in their lives, at home or work. Does it look and feel like a modern experience? Is buying insurance as intuitive as any e-commerce experience an employee would be used to? If not, keep looking.
3) Is EDI with insurance carriers “full-service” or “self-service”?
Managing electronic data integrations (EDI) with carriers is complex and time-consuming, but something that many employers expect to have up and running smoothly to manage eligibility and enrollment ongoing. Any benefits administration technology that requires your team to set up their own EDI files, or interface directly with the carrier is sucking up unnecessary time and resources, and you must factor that time into the cost of partnership.
4) How does the platform partner with insurance carriers and other third-party vendors to make offering and managing benefits easier?
Insurance carriers aren’t going anywhere, so choosing a system that has advantageous relationships and deep integrations with your favorite carriers will save time and money in the long run, for both you and your clients.
Depending on the type of relationship a technology vendor has with the carriers you work with, that could mean internal efficiencies and cost savings like free EDI, automated eligibility management, and low minimum participation requirements on voluntary benefit products. Montoya & Associates has actually been able to streamline standard benefit offerings based on the Maxwell Health Marketplace, which makes implementations faster and easier for their team. Don’t take my word for it: check out a case study, in their own words.
5) How does the platform make it more efficient to manage ongoing employee changes throughout the year?
Routine qualifying life events such as marriage or birth of a child shouldn’t require hours of administrative work for you or your clients. While it’s tempting to ‘check the box’ with low-cost point solutions that handle only eligibility, or quoting, or enrollment, it’s important to consider the cost of wasted hours and the impact that disjointed processes will have on your clients’ experience.
Solving interconnected problems with disparate point solutions will result in disjointed processes, multiple data entry points, and client frustration. Look for solutions that manage all of that data in one place, both during enrollment and year-round.
6) How many team members are typically dedicated full-time to making the platform work at scale? If you have to hire additional full-time team members to complete tasks that could (and should) be automated or streamlined with technology (like EDI, enrollment paperwork, etc.), you should factor that into your decision from a financial perspective.
Implementing technology should streamline processes for your team in addition to your clients. Ask for references on how current clients have made the tool successful, and dig into the processes that any potential technology partner might help you solve to uncover the manual work that might hide below the surface.
7) What sort of technical and implementation support is available? Training on any new process is a time-consuming process that may require some hand-holding. Your technology partner is an extension of your brand and your company, so you need to make sure that they set up both you and your clients for success, initially and throughout the year. Ask about their support structure, and what resources are available to both you and your clients.
Both HR teams and employees should have tools to solve problems on their own, with the ability to get in touch with a live person for technical questions if needed. Certain technology platforms prioritize broker support at the expense of support for HR and employees, or might provide support during initial setup, and charge for support throughout the year. This often results in more time-consuming implementations than necessary and frustration at being unsure of what to do next or how to resolve any issues.
See the original article Here.
Source:
Gidwaney V. (Date). 7 questions to ensure successful benefit technology purchases [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/6-questions-to-ask-to-avoid-hidden-benefit-technology-costs
10 Misconceptions About Saving for Medical Care in Retirement
Are you properly prepared for your medical costs during retirement? Take a look at this great article by Marlene Y. Satter from Employee Benefits Advisors to find out what are the top misconceptions people have about medical costs when planning for their retirement.
Retirement isn’t the only thing workers have trouble saving for; the other big gap in planning is health care.
According to a Voya Financial survey, Americans just aren’t ready to pay for the health care they might need in retirement. Their estimates of what they might need are low—when they estimate them at all, that is—and their savings are even lower.
With worries over money woes keeping people up at night—so says a CreditCards.com poll—the only worry that surpassed “having enough saved for retirement” was “health care and insurance.”
And consider, if you will, all the turmoil in the health insurance market these days, what with potential changes to—or an outright repeal of—the Affordable Care Act waiting in the wings, not to mention the skyrocketing costs of both care and coverage.
In light of all this uncertainty, it’s no wonder that the little matter of paying for health care is keeping people awake.
But, considering all that, it’s even more surprising that there are so many common misconceptions about health care, its cost and how to pay for it at large in the general population.
American workers are not just ill prepared for retirement, they’re even more ill prepared for any illness or infirmity that may come along with it.
According to research from the Employee Benefit Research Institute (EBRI), a 65-year-old man would need $127,000 in savings while a 65-year-old woman would need $143,000—thanks to a longer projected lifespan—to give each of them a 90 percent chance of having enough savings to cover health care expenses in retirement.
But that doesn’t appear to have filtered its way down to U.S. workers, who are blissfully (well, maybe not so blissfully) ignorant of the mountain of bills that probably lies ahead.
While demographics play a role, there are smaller differences among some groups than one might otherwise expect. In addition, it’s also rather surprising where Americans plan to get the money to pay for whatever care they receive, and how far they think that money will stretch when it also has to pay for food, clothing, shelter and any activities or other necessities that come along with retirement.
Read on to see 10 misconceptions workers have about how and how much they think they’ll pay for medical care in retirement. As you’ll see, some generations are more prone to certain errors than others.
10. Workers just aren’t estimating how much health care will cost them in retirement.
Perhaps they’d rather not know—but according to the poll, 81 percent of Americans have not estimated the total amount health care will cost them in retirement; among them are 77 percent of boomers. Retirees haven’t estimated those costs, either; in fact, just 21 percent of them have. But that’s actually not that bad, when considering that among Americans overall, only 14 percent have actually done—or tried to do—the math.
And among those who have tried to calculate the cost, 66 percent put them at $100,000 or less while an astonishing 31 percent estimated just $25,000 or less.
9. People with just a high school education or less, and whites, are slightly more likely than those who went to college, and blacks, to have attempted to figure it out.
The great majority among all those demographic groups just aren’t looking at the numbers, with 88 percent of black respondents and 79 percent of white respondents saying they have not estimated how much money it will take to pay their medical costs throughout retirement.
And while 80 percent of those with a high school diploma or less say they haven’t run the numbers, those who spent more time in school have spent even less time doing the calculations—with 81 percent of those with some college and 82 percent of those who graduated college saying they have not estimated medical costs.
8. Millennials are the most likely to underestimate health care costs in retirement.
A whopping 74 percent of millennials are among those lowballing what they expect to spend on health care once they retire, figuring they won’t need more than $100,000—and possibly less.
Not that they really know; 85 percent haven’t actually tried to calculate their total health care expenses for retirement. But they must be believers in the amazing stretching dollar, with 42 percent planning to use general retirement savings as the primary means of paying for health expenses in retirement, excluding Medicare.
GenXers, by the way, were the most likely to guess correctly that the bill will probably be higher than $100,000—but even there, only 28 percent said so.
7. They have surprisingly unrealistic expectations about where they’ll get the money to pay for medical care.
Excluding Medicare, 34 percent intend to use their general retirement savings, such as 401(k)s, 403(b)s, pensions and IRAs, as the primary means of paying for care, while 25 percent are banking on their Social Security income, 7 percent would use health savings accounts (HSAs) and 6 percent would use emergency savings.
That last is particularly interesting, since so few people have successfully managed to set aside a sizeable emergency fund in the first place.
6. Despite their potential, HSAs just aren’t feasible for many because of their income.
HSAs do offer ways to set aside more money not just for medical bills in retirement but also to boost retirement savings overall, and come with fairly generous contribution limits. But people with lower incomes often can’t even hit the maximum for retirement accounts—so relying on an HSA might not be realistic for all but those with the highest incomes.
Yet people with lower incomes were more likely than those who made more to say HSAs would be the main way they’d pay for medical expenses. Among those who said they’d be relying on HSAs to pay for care in retirement, 5 percent of those with incomes less than $35,000 and 14 percent of those with incomes between $35,000–$50,000 said that would be the way they’d go.
Just 9 percent of those with incomes between $50,000–$75,000, 7 percent of those with incomes between $75,000–$100,000 and 9 percent of those with incomes above $100,000 chose them.
5. A few are planning on using an inheritance to pay for medical bills in retirement.
It’s probably not realistic, and there aren’t all that many, but some respondents are actually planning on an inheritance being the chief way they’ll pay for their medical expenses during retirement.
Millennials and GenXers were the most likely to say that, at 2 percent each—but they may not have considered that the money originally intended for an inheritance might end up going to pay for other things, such as caregiving or child care, and indeed much of their own retirement money could end up paying for care for elderly parents. A lot more people end up acting as caregivers—especially among the sandwich generation—and may find that relying on inheriting money from the people they’re caring for was not a realistic expectation.
4. Women don’t know, guess low.
Just 13 percent of women have gone to the trouble of estimating how much health care will cost them during retirement, but that didn’t stop 32 percent from putting that figure at $25,000 or less.
And that’s really bad news. It’s particularly important for women to be aware of the cost of health care, since not only do they not save enough for retirement to begin with—42 percent only contribute between 1–5 percent, the lowest level, compared with 34 percent of men, often thanks to lower salaries and absences from the workplace to raise children or act as caregivers—but their longer lifespans mean they’ll have more years in which to need health care and fewer options to obtain it other than by paying for it.
Men are frequently cared for by (predominantly female) caregivers at home, while women tend to outlive any family members who might be willing or able to do the same for them.
3. Men don’t know, but guess higher.
While the same percentage of women and men have not estimated their retirement health care expenses (81 percent), men were more likely than women (24 percent, compared with 15 percent) to come up with an estimate higher than $100,000.
2. The highest-income households are most likely to have tried to estimate medical cost needs during retirement.
Probably not surprisingly, households with an income of $100,000 or more were the most likely to have tried to pin a dollar figure to health care needs, with 21 percent saying they’d done so.
Households with incomes between $50,000–$75,000 were least likely to have done so, with just 11 percent of them trying to anticipate how much they’ll need.
And just because they have more money doesn’t mean their estimates were a whole lot more accurate—only 38 percent of those $100,000+ households thought they’d need more than $100,000 to see them through any needed medical care during retirement, while 59 percent—the great majority—figured they could get by on $100,000 or even less.
1. Where they live doesn’t seriously affect their estimates, although it will seriously affect their cost of care.
Among those who have tried to anticipate how much they’ll need in retirement for medical care, there’s not a huge difference among how many guessed too low—even though where they live can have a huge effect on how much they’ll end up paying, particularly for long-term care.
While the most expensive regions for LTC tend to be the northeast and the west coast, and the cheapest are the south and midwest, there’s not a great deal of variance among those who estimate they can get by on care for $100,000 or less—even if people live in one of the most expensive regions. Sixty-seven percent of those in the northeast said care wouldn’t cost more than that, while 63 percent of those in the midwest, 71 percent of those in the south and 61 percent of those in the west said the same thing.
When it came to those who said they’d need more than $100,000, 24 percent of those in the west thought they’d need that much; so did 20 percent of those in the midwest, just 18 percent of those in the northeast and 17 percent of those in the south.
See the original article Here.
Source:
Satter M. (2017 April 24). 10 misconceptions about saving for medical care in retirement [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/04/24/10-misconceptions-about-saving-for-medical-care-in?ref=hp-news&page_all=1
Millennials, Gen X Struggle With the Same Financial Wellness Issues
Millennials and Generation X have a lot more in common than they think. Check out this great article by Amanda Eisenberg from Employee Benefit News and find out about the major financial issues facing both Millennials and Generation X.
From student loans and credit card debt to creating an emergency fund and saving for retirement, older millennials are beginning to face similar financial well-being problems as Gen Xers.
Financial stress among millennials decreased to 57% from 64% last year, which is more in line with the percentage of Gen X employees who are stressed about their finances (59%), according to PwC’s “Employee Financial Wellness Survey”.
“As much as millennials want to be different, life takes over,” says Kent Allison, national leader of PwC’s Employee Financial Wellness Practice. “You start running down the same path. Some things are somewhat unavoidable.”
Half of Gen X respondents find it difficult to meet their household expenses on time each month, compared to 41% of millennial employees, according to PwC.
Seven in 10 millennials carry balances on their credit cards, with 45% using their credit cards for monthly expenses they could not afford otherwise; similarly, 63% of Gen X employees carry a credit card balance, especially among employees earning more than $100,000 a year, according to the survey.
“The ongoing concern year after year — but they don’t necessarily focus on it —is the ability to meet unexpected expenses,” Allison says. “It’s stale but there are reoccurring themes here that center around cash and debt management that people are struggling with.”
With monthly expenses mounting, employees from both generations are turning to their retirement funds to finance large costs, like a down payment on a home.
Nearly one in three employees said they have already withdrawn money from their retirement plans to pay for expenses other than retirement, while 44% said it’s they’ll likely do so in the future, according to PwC.
Employees living paycheck to paycheck are nearly five times more likely to be distracted by their finances at work and are twice as likely to be absent from work because of personal financial issues, according to PwC.
The numbers are alarming, especially because Americans are already lacking requisite retirement funds, says Allison.
“Two years ago, the fastest rising segment of the population in bankruptcy is retirees,” he says. “I suspect we’re going to have that strain and it may get greater as people start to retire and they haven’t saved enough.”
Employers committed to helping their employees refocus their work tasks and finances should first look to the wellness program, he says.
“Focus on changing behaviors,” says Allison. “The majority of [employers] use their retirement plan administrators. You’re not going to get there if you don’t take a holistic approach.”
Meanwhile, employees should also be directed to build up an emergency fund, utilize a company match for their 401(k) plans and then determine where their money is going to be best used, he says.
They can also be directed to the employee assistance program if the situation is dire.
“It’s intervention,” Allison says. “At that point, it’s too late.”
See the original article Here.
Source:
Eisenberg (2017 April 27). Millennials, gen x struggle with the same financial wellness issues [Web blog post]. Retrieved from address https://www.benefitnews.com/news/millennials-gen-x-struggle-with-the-same-financial-wellness-issues