Americans will have an extra six weeks to buy health coverage before facing penalty
Originally posted by Sandhya Somashekhar, Amy Goldstein and Juliet Eilperin on https://www.washingtonpost.com
The Obama administration said last Wednesday night that it will give Americans who buy health insurance through the new online marketplaces an extra six weeks to obtain coverage before they incur a penalty.
The announcement means that those who buy coverage through the exchange will have until March 31 to sign up for a plan, according to an official with the Department of Health and Human Services.
Administration officials said that the rejiggered deadline is unrelated to the many technical problems that have emerged with the Web site, HealthCare.gov, in its first three weeks. Instead, they said, it is designed to clear up a timing confusion about the 2010 law, which for the first time requires most Americans to buy health coverage or face a penalty.
Under the law, health plans available through the new federal or state marketplaces will start Jan. 1, but the open enrollment period runs through the end of March. The law also says that people will be fined only if they do not have coverage for three months in a row. The question has been this: Do people need to be covered by March 31, or merely to have signed up by then, given that insurance policies have a brief lag before they take effect?
The administration made clear Wednesday night that people who buy coverage at any point during the open enrollment period will not pay a penalty.
It is the latest sign that the health-care law remains a moving target, even after the launch of the federal insurance marketplace, which has faced myriad problems that have frustrated many people trying to sign up for coverage.
Contractors and others have begun assigning blame for the Web site troubles, and the fault-finding will get its first extensive public airing Thursday, when four of the contractors involved in the project will testify before the House Energy and Commerce Committee.
In the written testimony submitted to the panel in advance, CGI Federal, the main contractor on the project, takes partial blame for the site’s shortcomings. But it also notes that the Centers for Medicare and Medicaid Services (CMS), an agency within HHS, was the “ultimate responsible party for the end-to-end performance” of the site. And it blames a piece created by another contractor, Quality Software Services (QSSI), for creating the initial bottleneck.
QSSI built part of the online registration system that crashed shortly after the Oct. 1 launch and locked out many people for days. In a statement, the company counters that it was not the only one responsible for the registration system, which is now working.
“There are a number of other components to the registration system, all of which must work together seamlessly to ensure registration,” said Matt Stearns, a spokesman for UnitedHealth Group, the parent company for QSSI. “The [QSSI-built] tool has been working well for weeks.”
But both contractors are likely to be taken to task by Republican and Democratic committee members. They were among the vendors who testified at a Sept. 10 Energy and Commerce Committee hearing that their parts of the project were moving along well, and that the Web site would be ready Oct. 1. Those assurances are likely to be questioned Thursday.
The hearing is the first of many planned by Republicans, who are expected not only to question the contractors but also to examine the administration’s management of the project. Some Republicans have called for the ouster of HHS Secretary Kathleen Sebelius, who is scheduled to appear before the panel next Wednesday.
President Obama and his deputies have given no indication that they are considering replacing Sebelius. White House press secretary Jay Carney has consistently defended her, and officials have been focusing on fixing the site rather than assessing blame for its defects.
The administration, however, has sought to assure jittery business leaders and insurers that can fix the enrollment system. On Tuesday, Vice President Biden told business supporters in a conference call that the nation’s best technology minds were working on the site and urged them to “stick with us.” And on Wednesday, top Obama advisers met with insurance executives to discuss system repairs.
CMS had enormous responsibility, and was charged with ensuring that there would be a mechanism for millions of Americans to easily sign up for coverage in time for some of the law’s main benefits to begin Jan. 1. Officials have said ease of signing up is critical to the administration meeting its goal of getting 7 million uninsured people — many of them young and healthy — to sign up.
But the agency assumed an outsize role in the management of the project, coordinating the activities of 55 contractors rather than hiring a separate firm to serve as a systems integrator. That is likely to be a key issue during Thursday’s hearing.
People familiar with the project have said the time frame was too tight for adequate testing, which one source said would have highlighted the problems.
There also have been inconsistencies about how and when the decision was made to scrap a key feature of the Web site, with QSSI telling congressional investigators that it did not know about the major change until the site’s launch. But in the written testimony the company plans to deliver Thursday, it says it found out shortly before the rollout date.
Republicans have been eager to learn more about how and when the decision was made to end that feature. The feature would have allowed people to browse plans and rates before signing up for an account. Technology experts have said the last-minute decision to stop it put too much pressure on a different tool that was set up to handle a small number of simultaneous users, crashing the site.
People familiar with the project give conflicting accounts of the reason for the move. The decision was made at a two-day meeting in late September to which CMS invited all its major contractors. According to one person familiar with the project, CGI gave a presentation that convinced CMS officials that the shopping feature was not ready.
Another person close to the project had a slightly different account, saying that CGI believed that the feature was, in fact, ready.
Republican lawmakers have alleged that the administration made the change to hide the cost of insurance plans from consumers.
“Evidence is mounting that political considerations motivated the decision,” said a letter sent to two administration officials Tuesday from members of the House Oversight and Government Reform Committee, including Chairman Darrell Issa (R-Calif.).
Lena H. Sun, Ed O’Keefe and Tom Hamburger contributed to this report.
Most workers worry benefits will fall short
Originally posted October 18, 2013 by Dan Cook on benefitspro.com
The twin promises of “affordable” and “protection” contained in the Patient Protection and Affordable Care Act sound great. But they’re not enough, at least yet, to assuage the health insurance concerns of most employees.
Because most folks still receive health insurance at work, the throw-the-cards-up-in-the-air nature of health care reform has people worried that their employer may not provide coverage that protects them from the vagaries of life.
That’s the major contention of a white paper from Colonial Life & Accident Insurance Co., which advises employers that they need to look at their benefits plan from a holistic viewpoint if they want it to serve as a recruiting and retention tool.
“Although medical insurance is the cornerstone of a good benefits package, we encourage employers to think about their benefits as a whole right now,” intoned Steve Bygott, assistant vice president of core market services at Colonial Life. “Small and large employers face ongoing cost concerns, in addition to new legal requirements, that challenge their ability to remain competitive. Taking their eye off the big picture of employee benefits could be a costly mistake.”
Employers need to reassure their workers that their coverage will protect them and their families from both routine and unforeseen medical costs — if it does. And if not, employers need to address coverage gaps and serve as a resource to employees for filling those gaps in a cost-effective manner.
When Colonial’s researchers delved into whether employees trusted that their coverage would offer enough protection and be affordable, here’s what they found:
- 83 percent of U.S. employees (full-time and/or part-time, with or without coverage) are at least somewhat concerned about their ability to pay for health premiums.
- 82 percent are concerned with expenses no longer covered by their health insurance plan and the addition of or an increase in co-payments and deductible amounts.
- 81 percent express concern about unexpected medical expenses (emergency room visits, major surgery, etc.).
Given this level of concern, Colonial’s white paper emphasized the need to master a way to talk to workers about health coverage so that their concerns could be alleviated.
“Both large and small employers will need to pay more attention to benefits communication in the years ahead to help them attract and retain a strong workforce,” said Bygott. “Workers will look to their employers to provide them with good, reliable information so they can make the best benefits decisions for themselves and their families.”
Colonial suggested that employers that can’t afford to pay for coverage for their workers offer them voluntary benefits combined with a clear education about how those benefits work and what they cost.
"Voluntary benefits and personalized benefits education can be a tremendous asset to employers looking for a cost-effective way to offer a competitive benefits package," says Bygott. "Though health care reform has everyone asking lots of questions now, staying focused on the big picture will help employers stay competitive in the long run."
To incent or not to incent
Originally posted October 18, 2013 by Rhonda Willingham on lifehealthpro.com
There is a lot of confusion and more than a few questions about the use of incentives in benefits these days.
What do the Health Insurance Portability and Accountability Act’s (HIPAA) new wellness regulations mean? How can we incentivize employees, without risking noncompliance with new regulations?
Incentives are an especially big question mark for employers because so many want to find ways to motivate, encourage and lower the health care costs for the 5 percent to 10 percent of their employee population that is driving 80 percent or more of their costs.
Often these are employees who have chronic conditions such as diabetes or heart disease, or who may be obese – a condition now classified by the American Medical Association as a disease. Often these are also valuable tenured employees who have the skills, knowledge and expertise a company may need; helping them helps the company.
Here’s what you can tell your group health employer clients about the complex issues surrounding incentives today:
1. Offer a health risk assessment
One of the first steps toward getting employees to improve their health is the health risk assessment (HRA), which is the entry point for most wellness programs. Employers frequently offer financial incentives, premium discounts, or even PTO to get people to take the HRA.
Yes, HRAs have come into question of late in benefits circles – but, despite the current controversy, they remain a very smart tool for employers. They provide important information about the health status of employees and what programs (based on aggregate, not individual data) could provide the most value to the organization.
But . . . and here’s where a lot of employers have gotten into trouble . . . you must fully explain their value, including how they work. Include the steps that need to be taken to protect privacy and ensure employees know they can opt out – preferably without penalties - if wanted.
2. Understand what new regulations do and don’t say
What employers can and can’t do with incentives is governed in part by the Patient Protection and Affordable Care Act (PPACA) and HIPAA.
One of the many provisions of PPACA is that it allows employers to link greater financial incentives to the achievement of predetermined health targets, such as smoking cessation or healthy weight. HIPAA also governs what group health plans can do with benefit programs.
Most importantly, HIPAA prohibits employers from charging different premiums based on health status. People can’t be penalized just because someone is overweight or has diabetes or heart disease.
HIPAA’s new wellness regulations, introduced in June of this year, state that:
…a group health plan…may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than [that] for a similarly situated individual enrolled in the plan on the basis of any health status related factor…
The other major component for HIPAA is guidance on the dollar amount allowed for incentives.
Health plans and insurers will be able to offer higher financial rewards to participants achieving healthy behaviors such as quitting smoking or reducing cholesterol. Specifically, as of Jan. 1, up to 30 percent of the total cost of health plan coverage (employer and employee cost of coverage with no cap) may be tied to an incentive. Tobacco cessation and usage reduction programs allow rewards to be increased to 50 percent. Now, in reality very few employers will go up to that 30 percent, but it is an option.
The real trick to compliance with HIPAA’s wellness regulations is that wellness programs will have to ensure they do not discriminate against people based on health factors. For example, if an employee is extremely obese and unable to participate in a walking program that provides financial incentives, there must be an alternative program for that employee.
3. Determine if you will use a carrot or stick
Employers have developed a range of approaches to incentives over the past few years. Most incentives today are based either on participation, outcomes or progress. Participation-based programs are simple.
You participate, sign a sheet that you came to the stop-smoking class or joined a gym, and you qualify for the incentive. Outcome-based programs usually include financial incentives.
Employers have learned over time that money is a great motivator for participation in either the HRA or a wellness program. The threshold for motivating employees seems to be right around $300 to $500 annually.
The key characteristic of an outcome incentive is that the employee doesn’t get that incentive unless he or she achieves a pre-determined goal or health standard, such as quitting tobacco use, losing 10 percent of body weight within six months, or bringing cholesterol levels within normal limits, etc.
Progress-based incentives are viewed as a “kinder, gentler” approach. They reward employees based on incremental, individually-attainable goals rather than a singular goal for all. In other words, you may need to lose 50 pounds, but the employer says, “We know losing even five pounds helps you and helps us, so you will still get the incentive.” (Studies show even small reductions in risk lower health care costs.)
Here again is where the incentive question gets tough and complicated. A Towers Watson 2012 survey reports that 62 percent of employers plan on switching from incentives for participation – which employees like – to incentives for improvements – which employers like – because it holds employees more accountable and the thought/hope is it will produce more tangible and measurable outcomes.
So what’s an employer to do when it comes to incentives? As we are learning from recent high profile news stories, employees will push back hard if they don’t support a wellness program and its goals (which typically happens if there is poor communication), or if they think non-participation penalties are too punitive. We all understand the need for accountability, but if that comes at the price of an unhappy employee population, what have you really won?
Every organization is different; I think it’s difficult to mandate you must do X, Y or Z. As part of my job with a leading health and wellness company and as a member of a number of key organizations evaluating worksite wellness programs and incentives, my recommendation is to consider a developing and evolving plan with incentives that engage, motivate and encourage all employees.
Start with simply incentivizing participation. Then as the program becomes better accepted with employees experiencing success – and as you do more education and communication – you can always migrate to the incorporation of a program that incentivizes progress.
Again, there is no one-size fits all, but we do know that what truly motivates people are programs that build intrinsic motivation. Program designs with the best chance of fostering such intrinsic motivation are those that use extrinsic tools (e.g., a weight loss program for employees) in a way that doesn’t make employees feel pressured but creates a supportive and empowering environment that promotes individual choice.
The last word on incentives is that the ultimate goal is not to get people to engage in behaviors for a short period of time just to get dollars. The objective is for employees to internalize the goal and learn how to make and sustain better lifestyle choices themselves.
Aon Hewitt Analysis Shows Lowest U.S. Health Care Cost Increases in More Than a Decade
Originally posted October 17, 2013 on https://www6.lexisnexis.com
In 2013, U.S. companies and their employees saw the lowest health care premium rate increases in more than a decade, according to an analysis by Aon Hewitt, the global talent, retirement and health solutions business of Aon plc (NYSE: AON). After plan design changes and vendor negotiations, the average health care premium rate increase for large employers in 2013 was 3.3 percent, down from 4.9 percent in 2012 and 8.5 percent in 2011. In 2014, however, average health care premium increases are projected to move back to the 6 percent to 7 percent range.
Aon Hewitt's analysis showed the average health care cost per employee was $10,471 in 2013, up from $10,131 in 2012. The portion of the total health care premium that employees were asked to contribute toward this premium cost was $2,303 in 2013, compared to $2,200 in 2012. Meanwhile, average employee out-of-pocket costs, such as copayments, coinsurance and deductibles, increased 12.8 percent ($2,239) in 2013, compared to just 6.2 percent in 2012 ($1,984).
For 2014, average health care costs are projected to increase to $11,176 per employee. Employees will be asked to contribute 22.4 percent of the total health care premium, which equates to $2,499 for 2014. Average employee out-of-pocket costs are expected to increase to $2,470. These projections mean that over the last decade, employees' share of health care costs-including employee contributions and out-of-pocket costs-will have increased almost 150 percent from $2,011 in 2004 to $4,969 in 2014.
"There are many factors that contributed to the lower rate of premium increases we saw over the past two years that we don't expect to continue in the long-term. These include the lagged effect from the economic recession on health care spending and continued adjustments as employers and insurers phase out the conservatism that was reflected in earlier premiums due to uncertainty around economic conditions and health care reform. Additionally, employers and insurers will now be subject to new transitional reinsurance fees and health insurance industry fees," said Tim Nimmer, fellow of the Society of Actuaries, member of the American Academy of Actuaries and chief health care actuary at Aon Hewitt. "While we are seeing pockets of promising innovation in the health care industry, we expect to see 2014 premium increases shift back towards the 6 percent to 7 percent range overall."
Costs by Plan Type
On average, Aon Hewitt forecasts that companies will see 2014 cost increases of 7.5 percent for health maintenance organization (HMOs) plans, 6.5 percent for preferred provider organization (PPOs) plans and 6.5 percent for point-of-service (POS) plans. That means that from 2013 to 2014, the average cost per person for major companies is estimated to increase from $10,880 to $11,696 for HMOs, $10,222 to $10,887 for PPOs and $11,450 to $12,194 for POS plans.
| Year | HMO | POS | PPO | National |
| 2014* | $11,696 | $12,194 | $10,887 | $11,176 |
| 2013 | $10,880 | $11,450 | $10,222 | $10,471 |
| 2012 | $10,375 | $10,955 | $9,955 | $10,131 |
| 2011 | $9,833 | $10,553 | $9,508 | $9,662 |
| 2010 | $9,103 | $9,464 | $8,790 | $8,903 |
| 2009 | $8,461 | $8,778 | $8,363 | $8,380 |
| 2008 | $7,975 | $8,321 | $8,004 | $7,983 |
*Projections
Costs are plan costs (premium or budget rate) on a per employee basis. They include employee contributions, but not their out-of-pocket costs (i.e., co-payments, coinsurance).
2013 Cost Increases by Major Metropolitan Area
In 2013, major U.S. markets that experienced rate increases higher than the national average included Los Angeles (6.9 percent), Orange County (6.9 percent), Washington DC (5.3 percent) and San Francisco/Oakland/San Jose (4.8 percent). Conversely, New York City (1.6 percent), Milwaukee (2.1 percent) and Atlanta (2.4 percent) experienced lower-than-average rate increases in 2013. Of note, Minneapolis saw a decrease in rate increases at -0.1 percent.
Employer Actions to Mitigate Trend
"Health care remains a top priority for U.S. employers, and most are taking action to prepare for increasing cost, risk and change," said Jim Winkler, chief innovation officer for the U.S. Health & Benefits practice at Aon Hewitt. "As the health care industry continues to evolve, employers realize that a traditional 'managed trend' approach will be less effective in mitigating costs increases over time. Instead, they are exploring innovative new delivery approaches, requiring participants to take a more active role in their own health care planning, and holding health care providers more accountable to reduce unnecessary expenses and create more efficiency in the way health care is purchased."
Recent Aon Hewitt research shows that 72 percent of employers focus their health care strategy primarily on programs that improve health risk and reduce medical costs. As the health care landscape continues to evolve, employers will look to reduce costs using a mix of traditional and non-traditional approaches. These include:
Innovative Approaches to Providing Employer-Sponsored Coverage - Private health exchanges are becoming increasingly attractive to organizations that want to offer employees health care choice while lowering future cost trends and lessening the administrative burden associated with sponsoring a health plan.
In this model, employers continue to financially support health insurance, but allow employees to choose from multiple group plan options and insurance carriers via a competitive, health insurance marketplace.
According to Aon Hewitt research, about 28 percent plan to move into a private health care exchange over the next three-to-five years. Eighteen large employers, includingWalgreensand 2013 participantsSears Holdings,Darden Restaurantsand Aon plc, are offering health benefits this fall through theAon Hewitt Corporate Health Exchange, the nation's largest multi-carrier private health care exchange.
Plan Design Strategies - Aon Hewitt's research shows that consumer-driven health plans (CDHPs) have surpassed health maintenance organizations (HMOs) as the second most popular plan option offered by employers. A growing number ofemployers are offering CDHPs as the only plan option. While just 10 percent of companies do so today, another 44 percent are considering it in the next three to five years[1].
Managing Dependent Eligibility and Subsidies - Many employers are reassessing the way they offer and subsidize health coverage for dependents. Specifically, they are:
Reducing the employer subsidy for covered dependents. Aon Hewitt's research shows that 54 percent of employers are considering reducing subsidies across all dependent tiers in the next three-to-five years. Implementing or increasing surcharges for adult dependents with access to coverage elsewhere. Aon Hewitt's research shows 69 percent of employers have implemented or plan to implement surcharges for adult dependents. Adopting a unitized pricing approach, where employerscharge per dependent. While just 4 percent of employers currently adopt this approach, another 47 percent are considering it in the future. Assessing the eligibility of covered dependents in their plans. A recent Aon Hewitt survey shows that two-thirds ofemployers have completed a program audit of covered dependents to ensure only those who are eligible will remain on the plan.
Increased Cost Sharing - As health care costs increase overall, the amount of money employees will need to contribute out of their paychecks-both in premiums and out-of-pocket costs-is continuing to climb. Today, employees' share of the overall health care premium is 22 percent, compared to just 18.6 percent a decade ago. Additionally, Aon Hewitt's research shows that 47 percent ofemployers have increased participants' deductibles and/or copays in the past year, and another 43 percent are considering doing so in the next three-to-five years.
According to Aon Hewitt, employers are increasing cost sharing through:
Altering plan designs, including shifting from fixed dollar copayments to coinsurance models, where employees pay a percentage of the out-of-pocket costs for each health care service. Increasing deductibles out of pocket limits and cost sharing for use of non-network providers.
Wellness and Health Programs - With employers facing the impacts of rising health care costs and declining health of the population, employees can expect to see more employers offering programs that encourage them to take a more active role in managing their health. For example, 75 percent of employers offer health risk questionnaires (HRQs) and 71 percent offer biometric screenings such as blood pressure and cholesterol.
New Provider Payment Strategies - A growing number of employers want to ensure that the health care services they are paying for are actually leading to improved patient outcomes and are seeking to hold providers more accountable. According to Aon Hewitt's research, 53 percent of employers said that moving toward provider payment models that promote cost effective, high quality health care results will be a part of their future health care strategy, and one in five identified it as one of their three highest priorities.
About the Data
Aon Hewitt's data is derived from the Aon Hewitt Health Value Initiative database, which captures health care cost and benefit data for 516 large U.S. employers representing 12.8 million participants, more than 1,200 plans and $61.2 billion in 2013 health care spending.
Flex your benefits
Originally posted October 16, 2013 by Kathryn Layer on benefitspro.com
In case you missed it, this week marked an interesting — and totally great — holiday called National Flex Day.
Haven’t heard of it? Well, it’s new. Yesterday marked the first official National Flex Day ever, as the brainchild of Working Mother Media.
The premise? To help promote the power of flexible work arrangements.
“Flexible work is important to every single employee, whether to help them accommodate child care responsibilities, elder care needs or a marathon training schedule,” says Carol Evans, president of Working Mother Media. “It’s time for people and companies to step out from the shadows and embrace workplace flexibility as a core business strategy that will enable employees and employers to compete and succeed in an increasingly competitive global economy — while also ensuring a healthy, productive and profitable workforce in the long run.”
In a video, Evans calls the benefit a “lifesaver,” and says that publicizing — and promoting — flexible work arrangements this year is especially important because the benefit has been “under attack.”
That’s in part thanks to people like Yahoo! CEO Marissa Mayer, who earlier this year took back employees’ work-from-home benefits, and Hewlett-Packard’s Meg Whitman who just followed suit.
Groups like Working Mother Media will tell you the problem with these examples is they’re setting a poor example for other employers — when powerhouse companies do it, won’t others follow? And these decisions reflect poorly on the executives, as well — are they really that untrusting of the people they work with? Do they not value their employees’ home lives?
Don’t get me wrong: Individual employers have to make the right decision for their company. They don’t have to allow everyone to hang out at home in their pajamas day after day, but being flexible about work schedules and understanding the ever-important work-life balance is another matter.
With benefits apparently not as important as they once were, and with many companies dropping employer-sponsored coverage, asking employees to pay a higher share of the cost, or cutting sick or vacation days — flex time is an easy, cheap and productive benefit for employers to implement.
It’s amazing people still don’t get it: When employees feel valued, appreciated and trusted, their work ethic improves, their happiness improves, they stay healthier and they’re much more likely to stick with the company. Wins all around!
According to research by Working Mother Media, a typical business saves half a million dollars in facilities costs for every 100 employees who telecommute full-time. By contrast, they spend 50 percent more in health care costs on stressed-out workers. (And flexible work lowers employee stress by 30 percent.)
Appropriately enough today is also Boss’s Day. Perhaps it’s a good time to tell your supervisor you’ll only wish him a happy Boss’s Day if he wishes you a happy Flex Day — and means it.
With debt ceiling near, employee benefits in the crosshairs
Originally posted October 16, 2013 by Gillian Roberts on https://ebn.benefitnews.com
Wednesday's last-minute negotiations on raising the nation’s borrowing limit could impact 401(k)s, Roth retirement vehicles and more, if similar past showdowns give any indication. Bob Christenson, partner at Fisher & Phillips LLP, says he’s seen these debates on the Hill before and past lessons show that employee benefits could be impacted when the conversation turns to raising revenue through taxes.
“There may be more of a restriction on 401(k) plan contributions because they’ve done that in the past,” says Christenson, of the firm’s Atlanta office. “Everyone talks about limits on Roth contributions and the secret behind all that was — that was a revenue raising measure, too.” He also says he wouldn’t be surprised if lawmakers “tinker” with ways to make distributions on retirement savings vehicles easier because again, that would be a tax increase.
“From an employee benefits policy perspective, it’s not smart … but it’s what’s been done in the past and I wouldn’t be surprised to see it again,” he says.
Bill Sweetnam, principal at Groom Law Group in Washington, agrees that revenue raisers may be part of the equation, but nothing on a large scale. “Early on I would have said if they had done a grand bargain over the summer they could have done something with tax reform, but they don’t have the time for tax reform, so I think the employee benefits world is not going to be impacted unless they’re used as a revenue raiser that people want,” he says.
Sweetnam thinks two things could be on the table for employee benefits at this point:
1) Extending the relief that defined benefit plan sponsors get from MAP-21 interest rates — in other words, “requiring people to make higher funding contributions and thus raise revenue for the government,” he says.
2) Provide relief to multi-employer pension plans, which has been a heavily lobbied topic recently and could be a positive gesture towards benefits in all this.
Christenson says he suspects that with fewer personnel at the Internal Revenue Service, the voluntary compliance program “that a lot of qualified programs use to correct errors” will probably be down. “They’re not going to advertise that they don’t have the usual personnel,” he says. And that also goes for IRS and DOL audits and Employee Benefits Securities Administration investigations as well.
Christenson points out that there was a time when both parties discussed necessary “tweaks” to the Affordable Care Act, but with the polarization in Washington at this point, “the legislative activity of those potential changes that everyone agrees on could get changed,” he says.
Tips to help with negativity in the workplace
Originally posted on https://www.hr.com
Tips for solving negativity in the workplace
A lot of the time people feel that the workplace can be pretty stressful and they are not always so lucky to like every single one of their coworkers and not everyone has the most amazing boss. These are things you must be aware of in the workplace. You have to expect the negatives but to keep it from driving you insane, you have to at least try to keep a positive attitude and potentially come up with solutions to these negative attitudes.
1. Vent: Do not let your negative feelings about something build up, that could lead to a big explosive confrontation, which is obviously something you want to avoid. After work talk to a friend/spouse/ even a pet or anyone that will just sit and listen to your frustration. It gives you an opportunity to share all of your negative feelings, no filter involved and to possibly get some suggestions that might help with the issues you are dealing with. Writing it all down is also a good way to cope. It gives a chance to see them all in front of you, and can potentially give you your own insight on how to solve the negativity.
2. Come to terms: Keep in mind that you do not have the power to change everything that may cause negativity in the workplace. Focus on the things that are in your power and make the appropriate changes to make the negatives into positives. Coming to those terms will help you to further yourself instead of being stuck in a pit of negativity. Stay positive and keep moving forward and you will boost your potential to be successful.
3. Embrace what you have: Remember that things will not always go the way YOU want them to. Just know it isn’t just in your place of business, that’s life. It goes along with step number two where there is a point where you just have to learn to come to terms and accept that yes, there are some negatives you can change but for the ones you can’t, embrace them. It is the only thing you can do.
Stick with the positives and you will be much more likely to succeed. The negatives will be there, but if you learn to get past them or at least learn to work with them, then you will be in the right mind set to get what you worked for.
Time for Open Enrollment
Originally posted by Susan M. Heathfield October 15, 2013 on https://humanresources.about.com
Open enrollment season is upon us, and as employers, we have an obligation to educate our employees about their benefits. Not just a "nice to," to help employees make good choices for their families, this education also lets employees know what their employer is spending for their benefits above and beyond their base salary. This helps employees understand and appreciate their complete compensation package.
How confused are employees about their benefits?According to Forbes, "How confusing is it? Three-quarters of Americans admit to making mistakes during open enrollment, according to a 2011 Aflac WorkForces Report. Just 40% of employees feel well-informed about the benefits their companies offer, and less than half (46%) feel their HR departments are extremely or very knowledgeable about those benefits, Aflac found."
This is why I have written about how educating employees is critical for their understanding and so they make good choices about coverage for themselves and their family. But, benefits are definitely misunderstood. In one recent study, employees estimated that benefits added 30% to their employer's costs to employ them. In fact, the figure was 43%.
I recommend an annual evening benefits review event, so spouses can attend, that emphasizes the cost of the benefits and how employees can best take advantage of the benefits they have for themselves and their families. You want to promote employee appreciation of their benefits.
What better time to offer such an event as during open enrollment when employees are making changes? Employers are already making insurance representatives available to talk to employees - or they should be - as employers are not benefits experts and should trust professionals that they have vetted. Why not extend an educational opportunity?
To provide the basics about open enrollment and to emphasize some must do areas for employers, I email interviewed Erich Sternberg, president of AlwaysCare Benefits of Baton Rouge, Louisiana. Take a look at our interview for a concise overview of open enrollment. Additionally, Erich supplies a list of steps he recommends every employee take during open enrollment.
Additional information about open enrollment is available from About.com's Michael Bihari, MD.
Brace yourselves, winter is coming: Tips to survive an ICE I-9 compliance audit
Originally posted October 15, 2013 by Holly Jones on https://hr.blr.com
Despite months of legislative inactivity on a stalled federal immigration reform bill, federal immigration enforcement activities have not slowed. Just before Labor Day, 1,000 businesses across the U.S. were notified by U.S. Immigration and Customs Enforcement (ICE) that they would need to prepare documents for I-9 compliance and worksite enforcement audits. This is the largest round of these inspections, known as "silent raids," since 2009.
The newest round of audits hit restaurants, food processing, high-tech manufacturing, agriculture, and other industries, but no industry is insulated from the possibility of I-9 audit. In the last 4 years, the government has audited at least 10,000 employers and imposed more than $100 million in administrative and criminal fines, and this enforcement push is unlikely to slow.
So, what can you do to ensure that you are prepared for a visit from ICE?
What to expect during an ICE audit
The first step of an administrative inspection is receipt of a "Notice of Inspection" (NOI), which requires the employer to produce all Forms I-9 within 3 business days. In some cases, supporting documentation such as payroll records, employee lists, and licenses may be required.
After thorough examination of these documents, ICE will issue any of several notices, depending on its findings. The "Notice of Suspect Documents" and "Notice of Discrepancies" are issued when employees are either determined to be unauthorized to work or when a determination cannot be made. Employers will be given the opportunity to present additional documentation to establish employment eligibility—otherwise, employers will be advised to terminate the work relationship.
If errors in the Forms I-9 are found, a "Notice of Technical or Procedural Failures" will be issued, and employers will have 10 business days to correct these errors (otherwise they will become substantive violations.) When the review is complete, a Notice of Intent to Fine will be issued, upon which the employer may negotiate a settlement or request an administrative hearing within 30 days. If no further action is taken, a Final Order will be issued and the employer will be liable for all penalties assessed.
Fines for knowingly hiring or continuing to employ unauthorized workers can reach as much as $16,000 per violation, while substantive and uncorrected technical violations can be as much as $1,100 per violation. What’s more, certain "enhancements" can be added to fines based on business size, history of violation, and seriousness of the violation.
It’s not all about immigration
It is important to note that, while civil and criminal fines for employing undocumented workers can be quite extensive, the possibility of a hefty ICE fine is not limited to those who hire unauthorized labor. The fines for technical I-9 violations can also add up quickly. Further, though the new revision of Form I-9, as released in March, 2013, includes anextensive instruction handbook to walk employers through the documentation process, there is significant room for error on this seemingly innocuous form, whether in storage methods, documents accepted, or even proper correction of previous errors.
So, what can employers do to avoid I-9 violations and the subsequent fines? Find out now in part 2 of this article.
Holly K. Jones, J.D., is a Legal Editor for BLR’s human resources and employment law publications. She understands the existing and emerging needs and challenges of human resources professionals thanks to several years of experience managing, writing, and editing key legal and compliance publications for BLR. Prior to joining BLR, Ms. Jones worked for the Tennessee Legislature's Office of Legal Services.
She graduated magna cum laude and Phi Beta Kappa with a B.A. in English Rhetoric and Writing, Political Science, and Psychology from the University of Tennessee in Knoxville, Tennessee, where she also received a 2001 Citation for Extraordinary Academic Achievement. She received her law degree from Vanderbilt University Law School and is licensed to practice law in Tennessee.
Can Obamacare Beat Your Employer's Insurance?
Originally posted October 14, 2013 by Susan Ladika on https://finance.yahoo.com
If you already have health insurance through your job, you're probably wondering whether Obamacare will give you some new options. Will you be able to comparison-shop for a plan on the new online exchanges that might be better than your employer health insurance? The answer is a big, resounding "maybe."
Like almost everything else having to do with health care reform, there are plenty of nuances and caveats. Trying to decipher them and choose the best health insurance plan for your situation "makes homeowners insurance seem really simple," says Brian Haile, senior vice president for health policy at the tax services company Jackson Hewitt.
Exchanges will be open to all, but ...
The exchanges are online health insurance marketplaces set up under the Affordable Care Act. In 34 states, the marketplaces operate through the federal government's HealthCare.gov website, while 16 states and the District of Columbia are running their own exchanges.
Even if your employer already offers health insurance, there's nothing to prevent you from shopping on your state's exchange. However, if you decide to leave your work-based plan and purchase coverage on the exchange, you "may not qualify for some of the benefits that the uninsured have," notes E. Denise Smith, a professor of health care management at Gardner-Webb University in Boiling Springs, N.C.
Here's the big hiccup: Unless your employer's coverage for an individual is considered unaffordable under the law (that is, if your share of the premiums costs more than 9.5 percent of your household income) or inadequate (picking up less than 60 percent of the cost of covered benefits), you aren't eligible for a government subsidy to help pay for your insurance. Subsidies are one of the things that can make plans on the new state exchanges appealing.
Subsidies in the form of tax credits are available even if you earn up to 400 percent of the federal poverty level, currently about $46,000 for an individual and $94,000 for a family of four. The subsidies vary based on income and the size of your family.
Trade in your employer plan?
And that brings us back to the central question: If you have employer health insurance, should you check out the Obamacare exchanges anyway? There are differing opinions.
"It would generally not benefit an employee to leave their employer-sponsored plan," Smith concludes, adding that your employer would be under no obligation to help pay for an exchange plan.
Haile says you may not be able to do better than your work-based coverage. "Look at how robust your employer plan is" and the benefits it provides, such as whether it includes dental and vision care, which are not part of the essential health benefits that must be offered with plans sold in the Obamacare exchanges, he says.
Still, if your employer-sponsored health insurance seems to eat up a big chunk of your budget, you might want to explore your options on the state exchange, Haile says.
Few workers have 'unaffordable' plans
Again, one of the key criteria of whether you'd qualify for subsidized insurance through your state's exchange is if your share of the premium for an individual health plan where you work would amount to more than 9.5 percent of your household income. Whether you take more expensive family coverage doesn't matter; the benchmark is what an individual policy would cost.
The rule means that someone earning $40,000 a year and paying $3,775 for individual coverage would not be eligible for a subsidy, says Brian Poger, CEO of Benefitter, a software company that's helping employers navigate their way through health care reform. That same worker paying even more for family coverage would still not be eligible because, again, the premium for an individual is less than $3,800 (or 9.5 percent of $40,000).
The 9.5 percent-of-income threshold is one that few workers would meet, according to one recent study. The ADP Research Institute found that only 8.6 percent of employees are required to pay premium contributions that would meet the Affordable Care Act's definition of "unaffordable."
How will you know whether your premiums and income put you in that group and make you a good candidate for an exchange plan? Right now, it's a little unclear.
"The answer is sort of a mish-mash," Haile says. Many of Obamacare's employer requirements were delayed until 2015, though companies were still supposed to provide notices by Oct. 1 telling workers whether their current coverage would be considered affordable. But the U.S. Labor Department says there's no fine or penalty for failing to provide the notices.
Exchange coverage for family members
Under those same delayed "employer mandate" provisions, companies with at least 50 full-time workers will be required to offer health insurance to their workers and the workers' dependent children in 2015. But coverage for workers' spouses will not be mandatory, notes Christine Barber, senior policy analyst at Community Catalyst, a health care advocacy group.
"If your spouse isn't covered by your employer's insurance and doesn't have insurance through his or her own employer, your spouse could shop for insurance on the exchange and potentially qualify for a subsidy," Barber says.
Others who might find it valuable to shop on the exchanges are working singles under the age of 30 who don't have health issues and would be able to purchase a catastrophic plan, Haile says.
Catastrophic plans available on the state exchanges will have low monthly premiums but high deductibles. According to Haile, they're not eligible for subsidies.
All workers at a particular company often pay the same rate for their employer health insurance, regardless of age or medical history, he says. Opting for an Obamacare catastrophic plan "could be cheaper if you're the young kid on the block," especially if your co-workers are decades older, which could drive up everybody's insurance costs.