Five Things You Don’t Know About Health-Care Reform
Originally posted August 21, 2013 by Susan Salka on https://www.businessweek.com
Insurance sign-ups are just around the corner for millions of Americans under health-care reform, yet there’s still much people don’t know about this landmark legislation, particularly those changes occurring over the next decade inside hospitals, clinics, and doctors’ offices.
It’s a workforce thing. All the attention is on politics, or who will receive what benefits and where the money will come from. But the most important question is who will deliver the care and how it will be done. Most of the change will be accomplished by the health-care workforce. Transforming health care is a huge management challenge. Many clinicians and staff will have to fundamentally change their professional objectives and standards, daily routines, compensation, patient relationships, and employer relationships. The scope of health-care reform and current market pressures are unparalleled in any other industry; the re-engineering of health-care workforce roles now underway may completely change relationships between patients and clinicians in the next decade.
Biggest long-term problem: clinician shortages. An additional 30 million Americans will receive health-care coverage by the end of the decade, during a time when a further 15 million patients will become eligible for Medicare. Who will take care of all those people? By 2020, a shortage of 91,500 primary care and specialist physicians is predicted. Shortages of nurse practitioners and physician assistants, who could help fill in the gaps in primary care, also are predicted. Without enough clinicians, effective health-care reform could be stifled.
Getting paid to keep you well, rather than cure your illness. Changes in compensation for doctors and nurses will dramatically transform from quantity of work to quality of work. Until very recently, compensation and reimbursement were entirely based on the volume of patients and treatments. Now they’re beginning to reflect value-based benchmarks that will increase every year. Some of these include patient satisfaction, readmission rates, health risk assessments, and patient wellness, among other benchmarks. For hospitals, making sure patients are satisfied will become a pocketbook issue. For clinicians, careful disease management and preventive care to keep patients out of the hospital could directly affect how much they are paid.
Independent doctors’ practices are quickly fading. Physicians who hang a shingle outside a private office are becoming rarer. A recent survey showed that 55 percent of practicing physicians work for someone else, usually a hospital or a practice owned by a hospital or health system. That figure grew 8 percent in one year. Meanwhile, nearly 40 percent of physicians younger than 45 have never worked in private practice. Doctors are moving to employed positions in hospitals and health systems in search of greater stability in the rapidly changing health-care environment.
Your doctor may not be a doctor. One of the most striking changes for consumers may be team-based care, with physicians, nurse practitioners, physician assistants, psychologists, pharmacists, and others working together to improve quality of care and lower costs. If your health-care provider employs a team approach, when you make an appointment with your doctor you may instead see a nurse practitioner or physician assistant, depending on a quick assessment of your health status. In more than a dozen states, nurse practitioners can diagnose, treat, or prescribe with no physician involvement. Laws and regulations on the scope of practice for these clinicians are changing rapidly.
Health-care reform isn’t just about getting coverage for millions of people who don’t have it. It’s also about changing the way health care is delivered to reduce costs and improve patient care. Unless we can accomplish those two goals, increasing coverage will become prohibitively expensive. Transforming health-care delivery requires the active participation of America’s 16-million member health-care workforce.
Investors Seek Help With 401(k) Plans, Survey Finds
Originally published August 26, 2013 by Mary Ann Tasoulas on https://www.financial-planning.com
This according to a nationwide survey of more than 1,000 401(k) plan participants, commissioned by Schwab Retirement Plan Services. Respondent findings show a high level of self-reliance. Approximately nine in 10 (89%) say they will be responsible for coming up with the money to support themselves in retirement. Five percent indicated that their financial help will be provided by the government upon completion of their full time employment.
This self-reliance is fueled by the anticipated use of 401(k) plans.
• 61% report the 401(k) is their only or largest source of retirement savings
• 55% have increased their savings rate in the last two years
• 70% say their 401(k) is in better shape now than ever before
“It’s gratifying to see so many people taking the reins of their retirement,” said Steve Anderson, head of Schwab Retirement Plan Services in a statement. “In our view, contributing to a 401(k) plan should be the number one savings priority for workers. Planning ahead, taking action and getting the help you need along the way are key steps to help build sufficient retirement savings.”
UNSURE HOW TO INVEST
The survey reveals that saving in a 401(k) is not enough to instill confidence for many participants.
• 52% find their 401(k) investment explanations even more confusing than that of their health care benefits (48%)
• 57% would like an easier way to figure out what 401(k) investments are right for them
• 46% don’t feel they know what their best investment options are
• 34% feel a lot of stress over correctly allocating their 401(k) dollars
SEEKING HELP
Many 401(k) plans offer some type of professional advice, which can be instrumental in helping people take better control of their investments. Of those surveyed, 61% want personalized investment advice for their 401(k). Participants requested the need for guidance on everything from asset allocation to risk tolerance and retirement income planning.
First and foremost, the survey showed that investment confidence nearly doubled when workers have the help of a financial professional. Approximately one-third (32%) of survey respondents expressed confidence in making the right 401(k) investment choices based on their own ability, compared to 61% if they also had the help of a financial expert.
“Getting more workers engaged in professional 401(k) advice should be a top priority for employers. We’ve seen the positive impact it can have on both behaviors and outcomes,” said Anderson. “At Schwab Retirement Plan Services, Inc., participants who used third-party, professional 401(k) advice tended to increase their savings rate, were better diversified and stayed the course in their investing decisions,” he said in the same statement.
Health Care Reform Heightens Employers' Strategic Plans for Health Care Benefits
Original article can be found at https://online.wsj.com
Original source: Towers Watson
NEW YORK--(BUSINESS WIRE)--August 21, 2013--
The breadth of health care reform is prompting changes and ushering in emerging opportunities for employers, according to a survey of 420 midsize and large companies by global professional services company Towers Watson (NYSE, NASDAQ: TW). While employers remain concerned about a predicted 5.2% increase in 2014 health care costs and the risk of triggering the excise tax* in 2018, most (82%) continue to view subsidized health care benefits as an important part of their employee value proposition in 2014.
However, the 2013 Health Care Changes Ahead Survey found that a majority of employers do anticipate making moderate to significant changes in their health benefit programs for all employees and retirees by the beginning of 2016. It also revealed a clear disparity in how employers view public and private exchanges. Nearly 30% of employers have confidence in public health insurance exchanges as a viable alternative to employer-sponsored coverage in 2015. In contrast, private exchanges are more appealing, with 58% having confidence in them as a viable alternative. In short, employers are intrigued by the potential of private exchanges to control cost increases, reduce administrative burdens and provide greater value.
Employers remain committed to sponsoring health care benefits, and nearly all (98%) plan to retain their active medical plans for 2014 and 2015. However, they will look to private exchanges as a potential delivery channel. This arrangement enables them to maintain their role as plan sponsor, but outsource certain aspects of plan management to an exchange operator. Nearly three-quarters (74%) of companies surveyed reported that as they evaluate private exchanges for active full-time employees, they will want evidence that private options deliver greater value than the current self-managed model.
"The health care landscape is changing rapidly thanks to health reform, continued cost escalation, the emergence of health benefit exchanges, and new provider contracting and care delivery arrangements," said Randall Abbott, a senior health care consultant at Towers Watson. "While employers are grappling with how to comply with health care reform right now, they are evaluating new health care designs and delivery approaches for their employee and retiree populations that will ultimately transform the look of employer-provided health plans over the next three to five years. In particular, employers recognize the impact of the excise tax requires strategic planning now to create a glide path to 2018."
Initiatives to Avoid the Excise Tax
More than 60% of employers believe that they will trigger the excise tax in 2018 if they don't make adjustments to their current benefit strategy. Nearly the same percentage also say the excise tax will have a moderate or significant influence on their strategy.
To combat the increase in employee health care costs and avoid the excise tax, nearly 40% of employers will be changing their plan designs for 2014. In addition to emphasizing employee wellness and health improvement approaches, employers are looking to increase their use of supply-side strategies and aggressive vendor management techniques. For 2015 or 2016, they are considering providing outcome-based incentives (49%), offering a benefit differential for use of high-performance networks (47%) and using value-based benefit designs (40%). Employers will also be focused on reducing coverage subsidies for spouses and dependents, as well as implementing spousal coverage exclusions or spousal premium surcharges when other health coverage is available.
"Employers are balancing many competing factors as they revisit their financial commitment to health benefits and their ability to maintain a sustainable plan in the face of annual cost increases and the excise tax. They see health care benefits as an important part of their total rewards mix. And as they weigh new options, they will be looking to keep their plans affordable and viable for the long term," said Ron Fontanetta, a senior healthcare consultant at Towers Watson. "In the next two years, many employers will evaluate their strategic options for active employees, and wait to see how exchanges evolve and the broader market responds. We are likely to see a much different -- and much faster -- pace of change in retiree medical plans."
Health Care Coverage for Retirees and Part-Time Workers
With the existence of proven exchange solutions for Medicare-eligible retirees, the percentage of employers that are somewhat or very likely to discontinue their employer-sponsored plan for post-65 retirees will grow from 25% in 2014 to 44% in 2015. And with the advent of public exchanges making new solutions available for pre-65 retirees, the percentage of employers that are somewhat or very likely to discontinue their plan for pre-65 retirees will jump from 10% in 2014 to 38% in 2015.
Less change is expected for part-time employees. Only 11% are considering changes to their total rewards mix or design for part-time employees. Many part-time employees are likely to seek coverage through public exchanges.
Other Notable Trends and Data Points from the Survey
-- CEOs and CFOs have become increasingly involved in health care strategy decisions (36% and 46%, respectively).
-- Seven in 10 employers have a stronger commitment to improving employee health because of health care reform, while 71% have a stronger commitment to work with health care providers and suppliers to improve health care delivery and quality.
-- The use of personalized digital technologies to improve employee health engagement is on the rise. Forty-three percent of companies plan to use the technologies by 2014, and another 31% are considering its use for 2015 or 2016.
-- Half the companies surveyed provided employee communications that go beyond meeting compliance standards in educating employees on the law and its implications; 36% meet minimum compliance standards, and 14% go significantly beyond compliance to prepare employees for planned and potential strategic changes.
*Excise tax: According to the Patient Protection and Affordable Care Act, the federal government will impose an excise tax of 40% on insurers of employer-sponsored health plans, including self-insured employers, with an aggregate value of more than $10,200 for individual coverage and $27,500 for family coverage.
About the Survey
The 2013 Towers Watson Health Care Changes Ahead Survey offers insight into the focus and timing of U.S. employers' planned response to the Patient Protection and Affordable Care Act and the start of open enrollment for health insurance exchanges in the fall. The survey was completed by 420 employers during July 2013 and reflects respondents' 2014 -- 2016 health care benefit decisions. The responding companies comprise a broad range of industries and business sizes, and collectively employ 8.7 million employees.
More on the Oct. 1 ACA notices: Who has to provide them
Originally posted by Keith R. McMurdy on https://eba.benefitnews.com
After last week’s reminder about the Oct. 1 deadline for Affordable Care Act communications, the following question came up frequently — Does the notice requirement apply to employers with less than 50 employees?
Further clarification is provided in Technical Release 2013-02 called “Guidance on the Notice to Employees of Coverage Options under Fair Labor Standards Act 18B and Updated Model Election Notice under the Consolidated Omnibus Budget Reconciliation Act of 1985.” Section 18B of the FLSA was added as a result of the ACA. And it is 18B of the FLSA that contains the notice requirement that employers must communicate about the ACA with their employees. Overall, it says that every employer that is subject to the FLSA must provide the notice about coverage options. Fact Sheet 14 from the U.S. Department of Labor tells us that businesses covered by the FLSA must have at least two employees, and are those that have an annual dollar volume of sales or business revenue of at least $500,000 or are hospitals, businesses providing medical or nursing care for residents, schools and preschools or government agencies.
So, if your business is subject to the FLSA, you have to give the notice to employees of coverage options to existing employees by Oct. 1, and to all new hires within 14 days. It does not matter if you have 10 or 35 or 50 or 100 employees. If you are subject to the FLSA, you have to provide the notice.
Keith R. McMurdy is a partner with Fox Rothschild, focusing on labor and employment issues. He can be reached at kmcmurdy@foxrothschild.com or 212-878-7919.
This alert is intended for general information and educational purposes and should not be taken as specific legal advice.
5 most popular voluntary benefits
Originally posted by Kathryn Mayer on https://www.benefitspro.com
As employers consider their health care and total rewards strategies with the context of the Patient Protection and Affordable Care Act, nearly half expect voluntary benefits and services to become more important than ever over the next five years, according to the Towers Watson 2013 Voluntary Benefits and Services Survey.
The survey also found that the importance of voluntary in companies’ total rewards strategy will grow 27 percent in the next half-decade.
For now, these five voluntary benefits are the most commonly offered by employers.
5. Accident insurance
Accident insurance is among the most prevalent voluntary benefit offerings provided by employers: 68 percent offer the protection to their employees.
Other voluntary products that might be making the list in the next couple years? Towers Watson reports critical illness, identity theft and financial counseling are the top voluntary benefits to watch in the coming years.
4. Dental
Dental insurance remains a popular voluntary benefit, with 80 percent of employers offering the benefit.
Diabetes, heart disease, blindness and pregnancy complications all can be affected by dental hygiene and inflate health costs overall.
3. Disability
Benefits experts have long argued disability insurance is just as important as life insurance. And employers seem to agree: Eighty percent of employers surveyed by Towers Watson offer it.
According to the Social Security Administration, a staggering 30 percent of people will encounter a disability of three months or longer at some point during their working years.
2. Vision
Employers also see big value in vision insurance: 84 percent offer it.
Voluntary vision coverage is typically a popular product.
“We use it as a recruiting tool,” Spencer Peery, business manager at Bailey Lauerman & Associates, an advertising agency in Lincoln and Omaha, Neb., told Benefits Selling in August.
“These benefits keep our employees healthier," he said. "They use dental and vision coverage almost as much as they use health insurance, for both prevention and general care.”
1. Life
The survey reports that life insurance is the most popular voluntary benefit: 94 percent of the 320 large employers surveyed offer it.
Individual life policies were some of the first voluntary products sold in the U.S. workplace. Today, 81 percent of individuals with life insurance have workplace coverage, while half of individuals look to their employer as the only source for coverage, according to a 2012 ING study.
But despite life insurance offerings at work, industry experts say most Americans are underinsured, if they're insured at all.
Five misconceptions that come with health care exchanges
Originally posted by Samuel H. Fleet on https://ebn.benefitnews.com
The creation of health care exchanges has done little to quiet the noise. Exchanges require that retirees navigate this uncertainty on their own, buying directly from the carrier with no familiarity or direction. Additional options come with more questions, but working with the right partner helps ease the minds of an organization’s former employees so they can enjoy their retirement. Group plans have customer advocacy centers that cater specifically to an elderly population and can reinforce trust during such an ambiguous time.
The following misconceptions about health care exchanges will help shine light on some of this misinformation and show how group plans are a better option that individual plans in the post-65 space.
1. Individual plans are cheaper than group plans
Not necessarily. A retiree who is 65 may be able to find an inexpensive individual plan, but that likelihood decreases exponentially as an individual ages. One reason is because individual plans have costs built into them to help the carrier recover adverse selection. And because there is a “take it or leave it” component built into individual plans, meaning the individual can always go look for another plan if one isn’t to their liking, they will often have a charge (usually around 10%) to protect themselves.
Some carriers try to build-in other underwriting characteristics in an attempt to circumnavigate this situation, often with a questionnaire. Individuals who “pass” the underwriting questionnaire may then receive a preferred rate, but it isn’t an exact science. This maneuvering doesn’t exist with group plans, which are rated across the entire retiree segment rather than on an individual’s particular characteristics. Additionally, multiple plans are available to a retiree in a group setting, but with literally hundreds of individual plans available it can be difficult for one to feel assured that he or she is choosing the right plan. A retiree can certainly pick the most inexpensive plan, but going that route almost guarantees poor coverage.
2. Moving to an exchange eliminates employer financial liability
FASB106 liability is based on an obligation to pay for retiree benefits, regardless of whether these benefits are offered to the individual or a group. The reality is that these liabilities will continue to exist as long as the employer makes contributions in any form, and in any amount, to a retiree’s plan. This standard requires reporting of costs as well as advance mechanisms that ensure future payments to retirees will be available.
3. Retirees want more coverage options at different price points
Choice is a good thing, but too much choice is often overwhelming. In a recent survey conducted by AmWINS Group Benefits, a pool of more than 1,500 retirees enrolled in a group plan was asked if they wanted more options, and responses came back 50/50. Of those who wanted more, 82% said they only wanted two or three options at the most. Health care is critical to an aging population, and retirees are likely to have many questions when it comes to choosing their individual plans. Retirees want comfort in not only their coverage, but the stability that comes with consistent care.
4. Exchanges eliminate the employer’s administrative burdens
Because health care is critical to an aging population, they are likely to have questions and concerns along the way. A large American auto manufacturer switched to an exchange model and knew what to expect – the noise level from retirees was deafening and it continued for nearly a year. The company had no choice but to take it. If administrative obligations and burdens are a concern, consider changes to the administrator, not the plan.
5. The move to an exchange won’t cause any disruption for the retiree
The confusion that comes with a shift to an exchange model is likely to have a detrimental impact on the retiree, which can cause great disruption within the employer’s organizational structure. Retirees, the same group that built the company and carried it through hard times to prosperity, can feel forgotten once they are thrown into the exchange model. Often the people who made promises to former employees about their health care needs in the future are long gone, replaced by players in a management structure with no relationship with these retirees.
While inevitable, change is never easy. It’s not too late to support loyal, former employees in the midst of health care reform by removing some of the anxiety around change and overwhelming choices.
Don't forget about employee ACA communication due Oct. 1
Originally posted by Keith R. McMurdy August 16, 2013 on https://eba.benefitnews.com
With the recent employer mandate delay, some businesses might be overlooking the requirement to provide a notice to employees about health insurance coverage that may be available through a public exchange.
Employers must provide a notice to each employee, regardless of plan enrollment status or part-time or full-time status, by Oct. 1. The notice must be provided automatically, free of charge, and written in language that the average employee can understand. It may be provided by first class mail or electronically, if the requirements of the U.S. Department of Labor’s electronic disclosures safe harbor are met. It must also be provided to new hires — for 2014, the DOL will consider a notice delivered timely to a new employee if it’s provided within 14 days of the start date.
The notice must inform each employee of three things:
- The existence of state or federal health insurance exchanges.
- If the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60%, then the employee may be eligible for a federal premium tax credit if the employee purchases a qualified health plan through an exchange.
- If the employee purchases a qualified health plan through an exchange, then the employee may lose the employer contribution to any health benefits plan offered by the employer; also, all or a portion of such contribution may be excludable from income for federal income tax purposes.
The good news is that employers don’t have to create the notices from scratch. The DOL published model notices, one for Employers Who Offer Health Plans, and one for Employers that Do Not Offer Health Plans. If employers have questions about how to complete the forms, this is an opportunity for an employee benefit adviser to step in and provide guidance. Above all, advisers should remind employers that they need to issue them. Just because employers have a year to wait on the coverage mandate does not mean they can ignore other compliance rules like this one.
Medicare Part D Notice Due Before October 15th
- You have flexibility in the form and manner of providing the Notice
- You may use the model notice form published by the Centers for Medicare & Medicaid Services (CMS) (although you are not required to do so).
- You are not required to send the Notice as a separate mailing. You can provide it with other participant information materials (although note that certain formatting requirements may apply)
- A separate disclosure must be provided if you know that the spouse or dependent resides at a different address than the participant.
- You may distribute the Notice electronically if you follow the same electronic disclosure requirements that apply to summary plan descriptions (SPDs), except you should inform the participant that he/she is responsible for providing a copy of the disclosure to his/her Medicare-eligible spouse and/or dependents eligible for coverage under the plan (otherwise, you will need to separately send them a hard copy notice) And you must post the Notice on your website (if you have one) with a link on your home page to the Notice.
- If you have not yet finished your 2013 offerings, the Notice should still be provided now based on your current 2012 offerings. If the status of those offerings changes from creditable to non-creditable (or vice versa), you will need to provide an additional Notice within a reasonable period of time (maximum 60 days) after the change occurs. You should indicate on your Notice that it will not be updated if coverage changes but it remains creditable or non-creditable (as applicable)
4 calls for medical help from employees
Originally posted on https://ebn.benefitnews.com
The Grand Rounds’ recent Employee Benefit Expectation survey, the results of which were announced Wednesday, emphasizes the high value employees place on medical plans that can extended to newer shapes of families – same-sex couples, aging parents and medical dependents much older than 21. "The modern employee," the survey reads, "is looking for employers that recognize the changing state of familial responsibilities."
Access to medical opinions and expert advice is very important to today’s employees – rated more desirable than free annual flu shots. Here are four things workers crave out of medical coverage and information, and how employers can benefit from meeting those needs.
More than one in four (28%) employees tell Grand Rounds they wouldn't know how to find a qualified medical specialist for a serious illness affecting them or a loved one, and 35% say they would pay $5,000 or more for the world’s leading specialist to review their own or a loved one’s case. “Today’s employee is hungry for better access,” Grand Rounds says.
Some 60% of respondents would be more likely to stay with their employer if free access to expert medical opinions was offered, versus only traditional health insurance. Additionally, when choosing between multiple employment offers, 68% say they would be more likely to select a position that includes free access to expert medical opinions that extends to their family.
"There is a real talent war going on in this country, especially here in Silicon Valley,” says Rick Foreman, CFO and VP of business operations for Wealthfront, a Grand Rounds client. “This means that recruiting and retaining top-notch talent no longer means providing weekly happy hours or a Ping-Pong table. It’s about adding real value to our employees' lives."
As part of the so-called Sandwich Generation, 47% of adults in their 40s and 50s have a parent aged 65 or older and are either raising a young child or financially supporting a grown child, according to the Pew Research Center. Increasingly, employees want help with their older family members: 60% of employees with living parents tell Grand Rounds that it's important health care benefits extend to them. “As employees widen their definition of family, they expect employers to do the same,” Ground Rounds says.
A whopping 89% of those surveyed say they would travel to receive a second opinion from a medical expert on a disease or condition. More than a third (35%) would go anywhere in the United States, and 22% say they would travel anywhere in the world – such is the extent of their desire for the best possible medical help.
6 solutions to the retirement crisis
Originally posted by Paula Aven Gladych on https://www.benefitspro.com
Chad Parks, president and CEO of The Online 401(k), wants to find a solution to the retirement crisis in America. He and some colleagues drove cross-country last year interviewing people from all walks of life about their retirement savings and their ability to retire. They put their findings into a film called, “The Looming Retirement Crisis in America.”
After doing his research, Parks believes there are six major obstacles to retirement in America, but the good news is that there are also solutions.
(By the way, if his solutions seem a bit obvious to you, it’s because you’re in the business and have been paying attention. And if that’s the case, Parks’ list could only help you make your case with prospects).
Coverage
According to Parks, people need to save at work but to do that, they need an employer that offers a retirement plan. More than 40 million workers cannot save at work because they don’t have access to any sort of plan.
The solution? Mandated retirement savings plans, like auto IRAs, USA Retirement Accounts, 401(k)s and others.
Participation
Getting people to actually save money can be difficult. Some individuals won’t save for retirement even if they have access to a work-based plan.
The solution? Automatic enrollment. Features like this, added to an existing 401(k), have been shown to improve participation rates because the number of people who opt out of plans after being automatically enrolled is very small.
Saving enough
Many people don’t save enough for retirement and, even if they do save, they never increase the amount they save over their lifetime. A lot of workers save 3 percent their entire working lives, which isn’t enough to provide lifetime income in retirement.
The solution? Automatic escalation. Plans that offer this feature have had great success in building employee account balances. Every year, automatically, these plans increase employees’ deferrals into their retirement savings plan by at least 1 percent. The goal is to have everyone save between 10 and 15 percent of their pay in retirement savings over time.
Investing appropriately
Workers need to invest their money appropriately for their age, their ability to take on risk and with current market conditions in mind, according to Parks.
The solution? Cost-effective professional advice. Studies have shown that workers who confer with a financial professional save and invest more appropriately for their own situation than those who don’t work with an advisor.
Accumulation/adjustment
Accumulation of money is not the only goal, according to Parks. It also is important to adjust a person’s savings as their life changes.
The solution? Regular annual checkups. Plan participants should revisit their accounts at least once a year to make sure they are in the right investments and not taking on more risk than they can handle.
Retirement/decumulation/lifetime income
Many investors continue to invest in riskier options well into the years when they should be scaling back on the risk and preserving their savings. They also don’t know how to prudently “decumulate” their money and haven’t explored lifetime income options.
The solution? According to industry experts, many retirement plans don’t advise individuals to annuitize even if it would be in their best interest to do so. Instead, they handle longevity risk by setting a higher age for the end of the planning period. Seeking advice about annuitization can help individuals decide whether purchasing an annuity for guaranteed lifetime income is a good option for them.