Employers Push for Better Health Pricing
Originally published by Dan Cook on the BenefitsPro website.
Catalyst for Payment Reform told lawmakers this week that efforts to elicit better value for employer-sponsored health plans take a flawed approach to solving the pay-for-value problem.
The crux of the issue: health plans are being evaluated by the simplest measures rather than ones that dig deeper. For most purchasers of the plans, this only frustrates efforts to control costs and facilitate better outcomes for those covered.
“One of today’s biggest shortcomings is the separation of price and quality information,” Dr. Suzanne Delbanco, executive director of the group, said in an appearance before the U.S. Senate Committee on Finance.
“I think we have probably too many [quality metrics] now and not enough that focus on exactly those points where there’s the greatest opportunity for reducing harm and where there’s the greatest variation in performance. We tend to measure things that are easy to collect data on and that show very little difference between providers.”
Catalyst for Payment Reform represents major employers dedicated to finding better ways to evaluate their health plans to achieve greater efficiencies and better outcomes. Among the members: Safeway, Dow Chemical, 3M and CALPERS, the mammoth California employee pension fund.
Delbanco said her organization is promoting reference-based pricing, where purchasers establish the price of a particular service, and the patient pays any additional costs beyond that. CALPERS uses this approach in hip and knee surgeries.
Others who testified at the hearing on high prices and low transparency in healthcare included Giovanni Colella, CEO and co-founder of Castlight Health; TIME magazine contributing editor Steven Brill; and Dr. Paul Ginsburg, president of the Center for Studying Health System Change.
SHRM Research Spotlights Health Care Reform Strategies
Originally posted by Stephen Miller on the SHRM website.
New survey reports detailing how U.S. employers are responding to health care reform were released by the Society for Human Resource Management on June 16, 2013, in conjunction with its Annual Conference & Exposition.
Part one, Health Care Reform—Challenges and Strategies, examines the difficulties that HR professionals are facing and the strategies they are using to handle the new regulations. Part two, Health Care Reform—Impact of Health Care Coverage and Costs, focuses on future health care coverage benefits and expected costs.
In addition, a two-page summary of the survey findings is presented in SHRM Research Spotlight: Health Care Reform—Challenges and Costs.
The research was conducted in May 2013, using a randomly selected sample of SHRM members. The Society received 818 responses, half from members with the job function of benefits and compensation and half with the job title of HR manager or higher.
Increased Costs, Cost-Sharing Expected
A large majority of those surveyed (84 percent) expect their health care coverage costs to increase in 2014. Among these respondents, more than half (55 percent) predicted an increase of up to 10 percent, 19 percent forecast a 10 percent to 15 percent increase, and one-quarter (26 percent) expected an increase of 16 percent or more. Generally, small organizations expect greater jumps in costs.
Most responding organizations (83 percent) are likely or highly likely to pass on higher costs to their employees.
When asked what actions their companies are taking as a result of the Patient Protection and Affordable Care Act (PPACA), respondents mentioned the following:
- HR staff education. Nearly three-quarters of organizations are educating HR staff members through classes (74 percent) or working with legal/benefits counsel (73 percent) to help them understand the health care law.
- Redesigned plans. More than one-half are working with their benefits provider to design a compliant health care plan for 2014 (61 percent) or analyzing the short-term financial impact of the law (60 percent).
- Alternative plan options. More than one-half (56 percent) already offer (37 percent) or plan to offer (19 percent) their employees alternative, lower-premium coverage, including high-deductible plans with health savings accounts or health reimbursement arrangements.
- Self-insurance. Just over half of organizations (52 percent) have fully insured medical benefits. Larger businesses are more likely to be self-insured, as are publicly owned, for-profit companies.
- Spousal coverage. Thirteen percent of organizations have provisions to limit coverage for employees' working spouses, such as applying surcharges or exclusions, and 9 percent plan to implement them in 2014.
- Grandfathered status. About one-quarter (26 percent) indicated they will try to keep a grandfathered health plan, which is exempt from certain PPACA provisions. Fifty-five percent will not maintain grandfathered status, and 19 percent are unsure.
- Staff and hour reductions. Few organizations (3 percent) have reduced or plan to reduce their staff. However, 9 percent have already limited part-time workers to less than 30 hours per week, and another 12 percent plan to do so.
- Resources. To help them comply with reform provisions, employers are turning to their insurance brokers (78 percent), SHRM resources (62 percent), legal counsel (48 percent), consultants (34 percent) and internal experts (20 percent).
How analytics can help employers measure and manage risks
Original article from https://ebn.benefitnews.com
By Jan Peter Ozga
“If it can’t be measured, it can’t be managed” is rapidly becoming the operating philosophy of the health care industry, aided in large part by more extensive use of electronic health care records, mobile applications and the growth of population health management. Using health care analytics — sometimes called business intelligence — researchers and consultants are mining clinical and claims data to discover gold standards and establish best practices for prevention, treatment and self care and, ideally, help reduce waste, abuse and fraud.
The goals are simple but have remained elusive: Identify what works, what should be charged, and how the cost should be shared, so maximum value can be derived from the $2.7 trillion being spent on health care. Potential beneficiaries include all of the five P stakeholders: providers, patients, payers (insurers), policymakers (legislators and regulators), and, of course, purchasers (employers), whose health plans cover nearly six out of ten employees and their dependents.
Population health management — historically confined to public health practitioners — seeks to provide positive health outcomes for a group of individuals, including the distribution of such outcomes within the group, as well reducing health inequities among high risk/vulnerable populations. As such, population health management goes beyond the individual-level focus of mainstream medicine and public health by addressing factors such as environment, social structure, and resource distribution. PHM has proved especially effective for wellness and disease management programs.
An essential element in population health management is the role social determinants play in achieving and sustaining good health. Social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness.
Health care analytics comes in two basic forms. One is real-time analytics, which examine clinical information at the point of care and support health providers as they make prescriptive decisions during a patient encounter. These real-time systems typically use two or more items of patient data to generate case-specific advice. The other form is batch analytics that retrospectively evaluate population data sets, i.e., records of patients in a large medical system, or claims data from an insured population.
Batch health care analytics, in turn, supports predictive modeling, which is used on multiple clinical conditions. This process can identify undiagnosed conditions for patients within an insurer’s patient population or suggest interventions to prevent conditions from developing. Such modeling uses historical data to anticipate with greater accuracy future events. By contrast, explanatory modeling documents how and why certain empirical phenomena occur.
Within the context of health care, predictive and explanatory modeling use patient health information to drive medical decision-making. Data are derived from a variety of sources, including point-of-care encounters, medical claims, pharmacy claims, lab values, health risk assessments, genetic markers, and biometrics. These data are combined with medical guidelines and patient profiles to reveal contraindicated care, gaps in care, and opportunities for cost savings.
“Health care analytics applies an additional level of science to the art of medicine, thereby validating the value proposition. When such assessments are performed by a qualified third-party, providers and insurers can devote more time to their core competencies — and the data are rendered more credible,” says Yvonne Wasilewski, senior research scientist with SciMetrika in Durham, N.C.
According to LiveHealthier founder and CEO, Mary Moslander, understanding how health care analytics supports PHM is fundamental to delivering a work place wellness program that provides measurable results.”
“Empathizing with employees and leveraging their behaviors, barriers to change, fears and motivations are as important as predictive modeling and biometric outcomes,” she says.
And all of this translates to a healthier bottom line. For example, according to the consulting firm Aon Hewitt, population health management can help employers save as much as $700 per employee per year when they focus on any three of these eight major health care behaviors (which contribute to 80 percent of the cases of chronic illness): poor diet, physical inactivity, smoking, lack of health screening, poor standard of care, insufficient sleep, excess alcohol intake, and, poor stress management.
Experts predict that more employers will embrace a more quantified, analytic approach to health care because of its potential to contribute to value-based purchasing of health services and to increase accountability and transparency. Helen Darling, CEO of the National Business Group on Health says that “health care analytics have become as essential to effective management as financial data are to business.”
Leading the type of health plans that are embracing population health management and health care analytics are accountable care organizations and medical homes, encouraged by the Patient Protection and Affordable Care Action. A hallmark of ACOs is that providers agree to accept a flat payment for a given treatment plan for a disease or condition, in exchange for sharing in the savings they may produce.
The analyses associated with the medical home and ACO “exemplify how the population’s health needs have changed and how the marketplace must respond to this change," says Marci Nielsen, PhD, MPH, the chief executive officer of the Patient-Centered Primary Care Collaborative. “The success and impact of the medical home and medical neighborhood are critically dependent on gathering and analyzing health data from patient populations that will prevent leading causes of illness, manage and treat illness more effectively, and reduce costs to the system.”
The PHM movement is still a work in progress and its results need to be further documented. Consulting firm Mathematica has found that not all PHM programs are equal, referencing surveys that showed employers gave vendors mixed reviews on their ability to help employees make healthy lifestyle decisions and comply with preventive care guidelines. Thus, due diligence should be conducted before selecting a PHM provider.
Employers up estimated costs of health care reform law
Original article from https://www.businessinsurance.com
By Jerry Geisel
Employers are upping their estimates of how much the health care reform law will increase costs, according to a Mercer L.L.C. survey released June 12.
Two years ago, 25% of employers thought that complying with the Patient Protection and Affordable Care Act would increase their health care plan costs by less than 1%. But now, just 9% of nearly 900 employers surveyed by Mercer expect a cost increase that small.
Similarly, 15% of employers in 2011 expected the health care reform law to increase costs by at least 5%. Now, 19% of employers expect cost increases of at least 5%. In addition, 21% are projecting 2014 health care reform law related cost increases of 1% to 2%, while 18% expect cost increases of 3% to 4%; 32% of respondents said they didn't know the cost impact.
Mercer executives said there are several reasons why more employers are increasing their cost estimates.
“As employers get closer to implementation, they have a better idea of how many additional employees will become eligible for coverage. Some that thought they would cut hours have changed their position on that,” Beth Umland, Mercer's director of research for health and benefits in New York, said in an email.
Under PPACA, employers will be liable for a $2,000-per-employee penalty if they do not provide coverage starting next year to full-time employees, or those working an average of 30 hours a week.
In addition, Ms. Umland said, some employers in 2011 didn't know about the various fees that the health care reform law imposes. For example, employers will have to pay a fee of $63 per health care plan participant in 2014 to fund a program that will partially reimburse health insurers for providing coverage to high-cost individuals. While there was some awareness of the Transitional Reinsurance Program, it wasn't until last year that regulators announced the size of the fee employers would have to pay.
Check out our HCR Central for FREE PPACA Downloads, FAQ's, and compliance news to help you and your company prepare for PPACA requirements that take effect later this year and in 2014.
Health Care Law Remains Deeply Divisive
Original article from https://triblive.com
By Dayton Daily News
David Peabody is apprehensive about the new health care law. Ericka Haverkos is hopeful about it.
These Ohio residents — one the owner of a small landscaping business in Columbus and the other a college student who works part time as a cashier — are emblematic of millions of Americans who next year will have to adapt to the most sweeping changes in the delivery of health care since the establishment of Medicare and Medicaid in 1965.
To Peabody, the law will impose steep costs on his company and force him to decide whether to insure his 65 workers or pay a fine to the federal government. To Haverkos, who says she has a learning disability, it could mean access to a doctor who could prescribe the medication she needs.
All across the nation, millions of people are facing the reality of a new era in health care. Signed into law in 2010 by President Obama and known as the Affordable Care Act, the law will extend health care coverage to more than 20 million of the 47 million Americans without insurance.
“For people who haven't been able to find affordable insurance, they are going to love it,” said Elise Gould, a health insurance analyst at the Economic Policy Institute, a left-leaning nonprofit organization in Washington.
The law's critics contend it's going to frustrate Americans with its complexities, new regulations and blizzard of fees and taxes that they claim will deal a major blow to a fragile economy still recovering from the 2008 financial crash.
When asked to describe how efficiently the law is being implemented, Thomas Miller, a health policy analyst at the conservative oriented American Enterprise Institute in Washington joked: “Coming along just fine. Steady as she goes right into the cliff. Don't mind that iceberg. The Titanic got past it.”
A Kaiser Family Foundation survey in April found that 49 percent of Americans lack the information to understand how the law works. More alarming to the Obama administration, a recent Wall Street Journal/NBC News poll showed that 49 percent of Americans believe the law is a bad idea while just 37 percent call it a good one.
The law extends coverage in two ways. It expands the eligibility for Medicaid, which provides health coverage to low-income people. For those making too much money to qualify for Medicaid, the law offers federal subsidies for families of four earning $33,000 to $94,000 a year so that they can buy their plans through exchanges operated by the federal government or their state.
“I do believe folks underestimated the enormity of this law,” said Kevin Kuhlman, a Washington lobbyist for the National Federation of Independent Businesses. “In order for it to be a success, not only does the government have a massive project ahead of it managing and operating these exchanges, but private businesses also will have to come along and make a lot of drastic changes.”
Haverkos, a student at the Columbus College of Art and Design, said she lost her health insurance more than two years ago when her mother's term on the state Board of Education ended. The health law lets adult children remain on their parents' health plan until age 26, but Haverkos said that's not an option for her.
She said her employer doesn't offer insurance to part-time employees like her. She said she has emergency coverage through the college. Under the law, her insurance through the college will be upgraded if she remains enrolled there.
Supporters of the health care law say people like Haverkos can get access to coverage because government subsidies make the coverage more affordable. Comprehensive coverage would help relieve the symptoms of her persistent allergies and, she said, give her security - a sense of comfort knowing that it's there.”
For some people, the subsidies would amount to considerable savings. According to the Kaiser Family Foundation, a single 45-year-old earning $28,735 a year would pay $5,733 a year in premiums under a typical plan. Using the ACA's graduated scale, which calls for more subsidies for lower-income people, that person would have $3,420 of the premium paid for by the government.
“Those people who have found it very difficult to have access to coverage will find it a good deal,” said Kenneth Thorpe, a one-time senior health official under former President Bill Clinton.
Others are scrambling to determine what the law will cost them.
Many small companies that have not been offering insurance will have to under the new law. That will force some into a choice between providing insurance for their workers or paying thousands of dollars in federal taxes.
The ACA will require a company with 50 or more full-time workers to provide insurance or pay a $2,000 per-person fine for every uninsured worker. The only exception is the first 30 workers in the company are excluded from the fine.
Peabody, who years ago took pride in covering the entire cost of his employees' health coverage, said he now has to calculate what he can afford.
Last year, his company paid $48,000 of the $119,000 in premiums charged by his insurer, with the workers picking up the rest.
Not all of his workers accept the company-provided insurance, Peabody said.
“A lot of people can't afford health insurance,” he said. “That's why they choose not to take it.”
Other businesses are facing similar choices. Jamie Richardson, vice president of White Castle, which has 406 hamburger shops across the country, said his company spent $36 million last year on health coverage for its 5,000 full-time workers. All told, the chain employs about 10,000 people.
Under the new law, White Castle must offer its full-time workers (or anyone working 30 hours or more a week) insurance within 90 days of their hire date. That's a change from current White Castle policy, which offers health insurance to workers six months after they are hired. The company could reduce the number of hours for some workers — as a few companies have said they would do — but the chain said it does not want to do that.
“If someone's full time, we want them to stay full time,” Richardson said. “We don't want people to lose benefits.” He did say the additional costs could mean fewer people are hired.
Opponents argue that adding 20 million into the health care system along with requirements for minimum federal coverage is likely to cause premiums to rise for everyone insured in the United States. By contrast, supporters say the new law will restrain the growth rate of health care because insured people will not be flooding emergency rooms for care.
Jennifer Tolbert, director of state health reform for the Kaiser Family Foundation, said the true costs of the new law will be difficult to calculate.
“For most people with employer-sponsored coverage, the cost of that coverage has been increasing over the past decade,” she said. Determining how much of those costs are due to general trends as opposed to the new law will be “hard to disentangle.”
HHS Issues Final Rule on SHOP Exchange Program
This content was originally published on the IFEBP.org website.
The Department of Health and Human Services (HHS) released a final rule implementing Affordable Care Act provisions relating to the Small Business Health Options Program (SHOP). This rule finalizes the amendments in the proposed rule of March 11, 2013, regarding triggering events and special enrollment periods. It implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.
- The final rule changes the special enrollment period from 60 days to 30 days in most instances.
- If an employee or dependent becomes eligible for premium assistance under CHIP or loses eligibility for Medicaid or CHIP, the employee or dependent would have a 60-day special enrollment period to select a Qualified Health Plan.
- There is a transitional rule regarding what QHPs an employer may choose to offer.
The regulations are effective July 1, 2013.
HHS also published a
The Hundred Years’ War for Healthcare Reform
Original article from https://inthesetimes.com
By A.W. Gaffney
The story of healthcare reform in the United states begins not with Obama, Clinton or even Johnson, but almost a century ago, in the years leading up to World War I. Although the Socialist Party of America had called for insurance for workers “against accident, sickness and lack of employment” as early as 1904, it wasn’t until 1912, when the platform of Theodore Roosevelt’s Progressive Party called for a system of health insurance, that it emerged as a major political issue. Roosevelt lost the election, but progressives were nonetheless optimistic that healthcare legislation could be passed at the state level, and in 1916, progressive state legislators submitted “compulsory” health insurance bills to the legislatures of New York, Massachusetts and New Jersey. Much like the “employer mandate” of the Affordable Care Act, these plans would have required industrial employers to contribute to medical coverage and sick pay for workers and their families.
These were bold ideas, but they met with unfortunate timing, as two developments in Europe furnished powerful ideological weapons to those who opposed the legislation: in April 1917, the United states entered the war against Germany, and the following October, the Bolsheviks seized power in Moscow.
These global events proved politically useful to physicians in the American Medical Association (AMA), who had come to see health insurance legislation as a threat to both their independence and income. The AMA could now paint state-based health insurance as both pro-German (given its roots in Otto von Bismarck’s 19th-century social insurance) and pro-Bolshevik. Though the former claim had far more basis in fact, the latter smear was to prove the more enduring—throughout the healthcare reform debate of 2009-2010, even the most moderate of reform proposals were lambasted as communist by the Right. The effect in 1918 was a turning of the tide against the promising state plans that ended in their total defeat and decades of inaction.
For the next 90-odd years, efforts at sweeping healthcare reform in the United States were a series of failures. New Dealers picked up healthcare reform again in the 1930s, seeking to weave it into the new social safety net. However, fear of the physician lobby—which had flexed its newfound political muscle so effectively in the state-based campaigns of 1916-1918—encouraged Franklin D. Roosevelt to leave health insurance out of his landmark Social Security Act. Still, over time, Roosevelt leaned toward a system of universal healthcare, arguing in his famous 1944 “Second Bill of Rights” State of the Union Address for the “right to adequate medical care and the opportunity to achieve and enjoy good health.”
Though Roosevelt died the following year, the New Deal conception of universal healthcare lived on in the series of “Wagner-Murray-Dingell” (WMD) health bills of the Truman years. In its 1945 version, the WMD bill would have established universal national health insurance based on the European model. The AMA, still opposed to reform, again won the old-fashioned way, by red-baiting WMD to its grave.
Branding the bill with the hammer and sickle turned the fight over universal healthcare into yet another front of the developing Cold War, so much so that when the Johnson administration again sought to remake American healthcare in the 1960s, it strategically pursued reforms only for those individuals who were the least able to afford medical care and therefore the most politically inoffensive: the poor and the elderly. Thus Medicare and Medicaid were born.
Subsequent decades saw a number of universal healthcare proposals crash and burn: Ted Kennedy’s “health security” plan in 1970, Nixon’s plan in 1974, and Clinton’s in 1993.
This series of missteps and lost opportunities gives a sense of the stakes when the healthcare debate again took center stage after the election of Obama in 2008. But Obama also had to contend with a corporate healthcare industry that had grown enormously in power and influence in the hundred years between the WWI-era campaigns and his first term. Indeed, the relatively crude public relations campaign of the AMA in the 1910s was nothing compared to the massive lobbying machines of the insurance and pharmaceutical industries in the 21st century. These corporate “stakeholders” were to critically influence the terms of the healthcare reform debate of 2009-2010.
For instance, the health insurance lobby agreed to support the elimination of “pre-existing” conditions in exchange for a number of industry-favorable provisions, such as an individual mandate. Similarly, the pharmaceutical lobby agreed to support reform legislation so long as it did not allow Medicare to negotiate directly with pharmaceutical companies over drug prices, areform that by one estimate could have saved the government between $230 billion and $541 billion over ten years. And there’s no doubt that industry influences limited reform in other, less obvious ways, whether it was the early exclusion a single-payer system or the elimination of a “public option” from the final bill.
But clearly, these various, intertwined historical dynamics—stretching back 100 years—contributed crucially to the final form of the landmark legislation that lay upon Obama’s desk on March 23, 2010.
With a $2,000 deductible Is the Affordable Care Act 'affordable'?
Original article from https://money.cnn.com
By Tami Luhby
Until now, much of the debate swirling around the Affordable Care Act has focused on the cost of premiums in the state-based health insurance exchanges. But what will enrollees actually get for that monthly charge?
States are starting to roll out details about the exchanges, providing a look at just how affordable coverage under the Affordable Care Act will be. Some potential participants may be surprised at the figures: $2,000 deductibles, $45 primary care visit co-pays, and $250 emergency room tabs.
Those are just some of the charges enrollees will incur in a silver-level plan in California, which recently unveiled an overview of the benefits and charges associated with its exchange. That's on top of the $321 average monthly premium.
For some, this will be great news since it will allow them to see the doctor without breaking the bank. But others may not want to shell out a few thousand bucks in addition to a monthly premium.
"The hardest question is will it be a good deal and will consumers be able to afford it," said Marian Mulkey, director of the health reform initiative at the California Healthcare Foundation. "The jury is still out. It depends on their circumstances."
A quick refresher on Obamacare: People who don't have affordable health insurance through their employers will be able to sign up for coverage through state-based exchanges. Enrollment is set to begin in October, with coverage taking effect in January. You must have some form of coverage next year, or you will face annual penalties of $95 or 1% of family income (whichever is greater) initially and more in subsequent years.
Each state will offer four levels of coverage: platinum, gold, silver and bronze. Platinum plans come with the highest premiums, but lowest out-of-pocket expenses, while bronze plans carry lower monthly charges but require more cost-sharing. Gold and silver fall in the middle.
The federal government will offer premium subsidies to those with incomes of up to four times the federal poverty level. This year, that's $45,960 for an individual or $94,200 for a family of four. There will be additional help to cover out-of-pocket expenses for those earning less than 250% of the poverty line: $28,725 for a single person and $58,875 for a family of four. The subsidies are tied to the cost of the state's silver level plans.
Related: I'm signing up for Obamacare
California offers insight into how much participants will actually have to pay under Obamacare. The state, unlike most others, is requiring insurers to offer a standard set of benefits and charges in each plan level. The only variables are monthly premiums, doctor networks and carriers in your area.
For those in need of frequent medical care, the platinum or gold plans would reduce out-of-pocket costs for treatment. These plans have no deductible, and doctors' visits and medication are cheaper. But the trade-off is that they have higher monthly premiums. California has not yet released the premium range for these tiers.
On the flip side, a young man who never visits the doctor and wants to minimize his monthly charge could opt for a bronze plan. A 40-year-old enrolling in this plan could pay as little as $219 a month. But, if he did get sick, he'd get socked with a $5,000 deductible, $60 co-pays for primary care visits and a $300 emergency room charge.
The Patient Protection and Affordable Care Act provides protection for those who need a lot of care by placing a cap on out-of-pocket expenses. The maximum a person in an individual platinum plan will spend a year is $4,000, while those in the other tiers will shell out no more than $6,400.
"Insurance is expensive. It's hard for anyone who isn't well off to afford it," said Gary Claxton, director of the health care marketplace project at the Kaiser Family Foundation. "But it is good enough that you can afford to get sick without bankrupting yourself."
Whether potential enrollees find these plans affordable will depend on how healthy they are and whether they are currently insured.
Many individual insurance offerings currently available come with much higher deductibles, cover fewer expenses and limits on how much they'll pay out in a year. Plans on the exchange, on the other hand, are required to cover a variety of "essential benefits," including maternity care, mental health services and medication.
"In many cases, depending on the plan, the coverage will be more comprehensive than what the enrollee currently has," said Anne Gonzalez, a spokeswoman with Covered California, which is running the state's exchange.
Ways to improve employee benefits communications
Original article from https://www.businessinsurance.com
Benefit management experts' recommendations for improving employee benefit communications
DO
• Make it relevant: “Instead of one version of the information that contains everything an employee could ever want to know, regardless of their situation, why not create multiple versions of that information tailored to the specifics of your business units or demographic groups,” said Ruth Hunt, a Minneapolis-based principal at Buck Consultants L.L.C.
• Scale down, if necessary: Where larger employers may roll out robust Web platforms loaded with plan information and decision-support tools, smaller employers could distill their content down to a few pages of key information alongside a blog or online newsletter. “It doesn't have to be flashy,” said Jennifer Benz, founder and CEO of San Francisco-based Benz Communications. “People want really simple, actionable information, and that's certainly within the realm of what most small and midsize employers can support.”
DON'T
• Flood them with jargon: “Keep things simple, and in as plain a language as possible,” Ms. Benz said. “Benefit managers usually assume a much higher level of understanding among employees in terms of how health care works. Additionally, your corporate counsel is going to want to be very cautious and make doubly sure that the communications are legally compliant, even at the expense of basic understandability.”
• Wait for annual enrollment: “One of the biggest missteps we see, especially among mid-market employers, is treating annual enrollment like it's the Super Bowl,” said Joann Hall Swenson, health engagement best practice leader at Aon Hewitt in Minneapolis. “It might be compliant with the law and it might get people enrolled in your benefit plan, but it's not going to drive any of your employees to get healthier. Instead, what if you spread some of that money and effort over the course of the full year, and focus your communications on actually helping people use the benefit plans?”
• Tell them what they already know: “What we've found is that consumers already know what to do to be healthier,” Ms. Swenson said. “About 90% of employees can recite to you that they should eat right, exercise, not smoke, etc.”
Large employers won't cut worker hours due to PPACA
Original article from https://www.businessinsurance.com
By Jerry Geisel
Nearly all large employers are not considering reducing the number of hours employees work in response to the health care reform law, according to a survey released Thursday.
Ninety-eight percent of employers surveyed by Towers Watson & Co. said they have not and are not considering asking full-time employees to move to part-time status due to the Patient Protection and Affordable Care Act.
Under the health care reform law, employers must extend coverage to employees working at least 30 hours a week starting next year or pay a $2,000 penalty for each full-time employee.
The threat of the penalty has led to numerous predictions that some employers would reduce hours of employees now working at least 30 hours per week who are not offered health care plan coverage to avoid the penalty in the future.
But few employers appear willing to take such action.
“It's clear that most employers are hesitant to rush and implement changes that will negatively affect workers,” Laura Sejen, New York-based global head of rewards for Towers Watson, said in a statement.
In fact, some employers are easing health care plan eligibility requirements. Earlier this week, for example, Cumberland Gulf Group of Framingham, Mass., said employees working as few as 32 hours a week will be eligible for group coverage effective Oct. 1, down from the current 40-hour-a-week requirement.
The Towers Watson survey is based on the responses of 113 employers, all of which have at least 1,000 employees.