Connecting Millenials, Stress and EAPs

Source: https://ebn.benefitnews.com

By Sean Fogarty

Millennials are loosely defined as the 75 million young adults born between 1980 and 2000 and make up about one-third of today’s U.S. workforce. Although this generation has been called everything from "innovative" to "entitled," the recent "Stress in America" study from the American Psychological Association has different label for them: Stressed.

According to this survey, which has measured the stress of Americans since 2007, stress levels decreased across the board in 2012 except for those between the ages of 18 and 33. On the survey’s 10-point scale, where a 10 indicates ‘a great deal of stress,’ the average stress level of all Americans was 4.9. For millennials, it was 5.4. Millennials reported their top stressors as work (cited by 76%), money (73%) and relationships (59%).

An employee assistance program — through short-term counseling and work-life benefits, such as financial consultation — can have a positive impact on the aforementioned stressors. After reading this survey, I wanted to determine if there was any correlation between the study’s results and CuraLinc’s book of business EAP utilization data for 2012. What I found was interesting, to say the least:

• Millennials do have job stress. Despite only representing 29% of all EAP users, those between 18 and 33 years old constituted almost half (48%) of EAP cases where the primary presenting concern was ‘Job Stress’.

• Millennials are resolution-focused. Case resolution within the EAP was higher with Millennial employees (95%) than it was among all other age groups (87%).

• Millennials have personal financial concerns. Two in five cases (41%) involving financial consultation through the EAP were provided to Millennials, even though those between 18 and 33 years old made up only 29% of EAP users.

• Promoting benefits to Millennials requires a multi-pronged approach. Employees between the ages of 18 and 33 were twice as likely to learn about the EAP through electronic promotion (email messaging, a client’s web portal, eFlyers, etc.) than other generations.

In a nutshell, the trends across CuraLinc’s book of business are consistent with the findings in the APA’s "Stress in America" survey. Millennials will seek assistance from an EAP for their job stress – and will maximize their time with the program by focusing on resolution.

The key to leveraging this information into an actionable plan is to tailor a communication strategy that drives maximum awareness of the program to millennials. This approach should combine traditional EAP promotional vehicles such as brochures, flyers and orientation sessions with a technology-based marketing approach.

In 2025, three in four working Americans will be Millennials. By helping them manage stress and anxiety in their 20s and 30s, they’ll be more productive and better-equipped to assume leadership positions down the road.

 


How to prepare for a health and welfare compliance audit

Source: https://ebn.benefitnews.com

by John F. Galvin

When I speak with employers about health and welfare plan compliance, I’m often asked the question: “What happens if I don’t do everything?”

It’s not that employers don’t want to follow the rules. Rather, it’s that in the mid-market, especially with employers who have fewer than 500 employees, the benefit program is often managed by HR professionals who are wearing so many hats that they know the chances are high that something will fall through the cracks — and, thanks to ERISA, HIPAA and other laws, there are lots of cracks.

When I explain that they could be subject to an audit by the Department of Labor, I’m usually met with some doubts. Some want to know if the DOL really goes after mid-market employers, or if it just focuses on large corporations. Others will wonder if the DOL would be interested in their particular industry. But we’ve seen more and more DOL compliance audits in the mid-market, and with the myriad new compliance responsibilities that benefits professionals will need to deal with as a result of health care reform, this trend may continue to grow.

Summary plan descriptions

So what does the DOL tend to focus on with health and welfare audits? Much of the typical DOL audit goes back to employer requirements outlined in the original ERISA legislation – summary plan descriptions. SPDs were the government’s way of requiring employers to provide information on benefit plans that can be understood by the average participant.  However, unlike an average benefits summary, the requirements of what must be included in an SPD are numerous. Detailed descriptions of benefit provisions, eligibility, and a variety of legislation passed since 1974 all must be part of the SPD. In fact, by the time all this is information is included, the document can hardly be called a “summary.”

Given all of the work that goes into the creation of SPDs, it isn’t surprising to find out that many mid-market employers aren’t compliant. In the event of an audit, the chances are high that an SPD will need to be produced, along with some assurance that the document is actually making its way to employees correctly.

Many small and mid-market employers erroneously believe this is a requirement only for large employers. But employers of every size in any industry should review the guidelines for the creation and distribution of SPDs, and ensure their practices are compliant. In fact, once an SPD is in place, many of the other compliance responsibilities associated with health and welfare plans become much easier since the document becomes the plan’s “bible.”

HIPAA compliance

The second-most frequent item in DOL audits is related to the Health Insurance Portability & Accountability Act, or HIPAA. HIPAA is like a large tree trunk with many different branches. When discussing HIPAA, one could be talking about its rules for handling pre-existing conditions under a health plan, rules for issuing certificates of creditable coverage to terminating participants, rules for informing participants about enrollment rights, protecting private health information, and more. Any one of those items might show up in a DOL audit. Employers should review HIPAA rules thoroughly to make sure their plan is in compliance.

One of the most common errors I see with mid-market employers is in regards to the requirement under HIPAA that plans inform participants about enrollment rights, or more specifically “special enrollment rights.” The HIPAA Notice of Special Enrollment Rights informs participants who are eligible for your health plan about when they can join your plan or change their election due to certain qualifying life events such as marriage, birth of a child, or loss of eligibility under another employer’s plan.

The notice is important because it informs your participants about the timeframes in which they must request these enrollment rights. While some employers may have trouble during a DOL audit because they don’t have this notice at all, more employers are making mistakes with the actual distribution of the notice. For example, it’s not uncommon for employers who have an SPD to include the notice right in that document. However, unless your SPD is being distributed to those employees who are eligible for the plan but choose not to enroll, then the distribution requirements for special enrollment rights under HIPAA are not being met. Employers should take the time to review the HIPAA notice and its requirements for distribution to make sure they are compliant.

 


Is There Room in the Medicare Reform Debate Climate?

Source: https://medicarenewsgroup.com

by Bob Rosenblatt

Medicare has been considered the blue-ribbon, A-plus health insurance plan since its inception in 1966, when it began covering millions of disabled and elderly.

But this perception may change in a big way on Jan. 1, 2014, when the Affordable Care Act (ACA) brings a new protection to consumers covered by private coverage. These policies will have annual out-of-pocket spending limits, offering protection for those facing big medical bills. The average maximum annual amount will be $6,400 for a single person and $12,800 for a family.

Suddenly, Medicare will be the lone health insurance policy without any protection on the catastrophic end, meaning there is no limit to the amount a patient may be forced to pay out-of-pocket.

This is already sparking a new policy debate on what sort of protections should be offered to Medicare beneficiaries against the threat of huge financial losses from medical bills. This question is becoming entangled with the discussion of Medicare’s fiscal future and the desire to slow its spending.

Debate “over these changes will be contentious,” warned the Kaiser Family Foundation in a recent study.

A Medicare beneficiary may face severe financial risk from medical costs. For a hospital stay, there is a deductible of $1,184 for a hospital stay of 1-60 days; $296 per day for days 61 to 90; $592 per day for days 91 through 150; and all costs for each day beyond 150. For outpatient visits to a doctor under Part B, there is a $147 annual deductible, and then a 20 percent co-payment for further expenses. In addition, there is the cost of the Part B premium at $104.90 per month (higher for individuals with income over $85,000 a year), and another premium if drug coverage under Part D has been selected. In addition, many beneficiaries also buy Medicare supplementary insurance, known as Medi-gap, back-up insurance to help with co-payment costs.

Add together the co-payments, deductibles and premiums, and it can become a financial struggle for many people, Kaiser Family Foundation Vice President Tricia Neuman told a Congressional health subcommittee of the House Ways and Means Committee in February, in a report titled, “Changing Medicare's Benefit Design: Implications For Beneficiaries.”

“Even with Medicare, and supplemental insurance, beneficiaries tend to have relatively high out-of-pocket health costs,” she said. “In 2009, half of all Medicare beneficiaries spent 15 percent or more of their income on health-related expenses, including premiums, cost sharing for Medicare-covered services, and services not covered by Medicare; more than one-third of all beneficiaries (39%) spent at least 20 percent of their income on medical expenses that year.”

The majority of people on Medicare derive their income from their monthly Social Security check. Social Security’s annual cost-of-living increase is pegged to the general rate of inflation in the economy. This provision, in effect since 1974, is designed to provide a measure of income security over time, so that the value of a retiree’s check keeps pace with expenses.

But the flaw here is that the cost of medical care is rising faster than the general rate of inflation, and thus it is eroding the value of the Social Security check. According to a 2011 Kaiser Family Foundation report, “Medicare the expense of Medicare—the total cost of the monthly premiums, the deductibles and co-payments—was equal to 27 percent of the average Social Security retirement check in 2010. By the year 2030, the report says, Medicare costs will consume 36 percent of the average Social Security check.

“The benefit structure has long been criticized for being too complex, and for promoting overutilization of care which, in turn, translates into higher costs for seniors,” Sen. Orrin Hatch (R-Utah) said in a recent call for a cap on out-of-pocket costs. “Streamlining the cost-sharing will make it easier for seniors to navigate Medicare more efficiently while also reducing costs. Most importantly, it will give seniors financial security in cases of high out-of-pocket costs.”

He sought to bring back into the debate the proposal put forth by the deficit reduction Simpson-Bowles Commission, which had been appointed by President Obama. In 2010, the commission called for a combined annual deductible of $550, instead of the separate Part A and Part B deductibles. It also called for a 20 percent co-payment schedule, and an annual out-of-pocket limit of $7,500. This would have saved the federal government approximately $110 billion over a 10-year period.

Putting an annual limit on financial exposure would save money for some of the sickest people on Medicare, but it would force nearly everyone else to pay more, Neuman said in the Congressional hearing.

She also said that a variation of the Simpson-Bowles plan would have offered some beneficiaries a 5 percent savings (an average of $1,570 a year) but 71 percent would have faced larger bills (an average increase of $180 a year).

The views of these proposals depend on politics. Conservatives, who worry about the deficit, say measures are needed to slow down Medicare’s growth, while limiting the financial threat to the Medicare beneficiaries with the biggest bills.

Liberals oppose any measure they say would shift expenses to already hard-pressed beneficiaries.

Liberals want more affluent people to pay more. The liberal Center for American Progress has offered this proposal: the out-of-pocket maximum should be $5,000 a year for those with incomes below 400 percent of the federal poverty level; $7,500 a year for people with income between 400 percent and 600 percent of the poverty standard; and $10,000 when income exceeds 600 percent of the poverty level.

AARP, the powerful lobby on behalf of those ages 50 and older, has been studiously neutral in discussions of this issue, offering ammunition to both sides of the argument in a brief by its Public Policy Institute.

“If an annual out-of-pocket spending cap were included in this redesign, Medicare beneficiaries—particularly those with high utilization—would have more financial protection from expenses caused by severe and often unexpected illnesses,” AARP said. “In addition, increased cost-sharing could make beneficiaries more price- sensitive in using health care services, resulting in lower utilization and greater Medicare savings. These savings would improve the long-term stability of the Medicare program for both current and future beneficiaries.”

Then, arguing for the other side, the AARP analysis said, “Medicare beneficiaries, especially those with modest incomes or no supplemental coverage, could find it difficult to afford these cost-sharing requirements. These beneficiaries may decide not to get the medical care that they need in order to avoid paying coinsurance or deductible amounts, which could lead to poorer health outcomes and higher Medicare costs in the long run.”

With AARP viewing the issue as an on-the-one-hand, on-the-other hand hard choice, Congress and the president are certain to tread delicately as they maneuver around this politically explosive issue.

 


A Consumer's Guide To The Health Law

By Mary Agnes Carey and Jenny Gold

Source: https://www.kaiserhealthnews.org

Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors.

While some of the key features don't kick in until 2014, the law has already altered the health care industry and established a number of consumer benefits.

Here's a primer on parts of the law already up and running, what's to come and ways that provisions could still be altered.

I don't have health insurance. Under the law, will I have to buy it and what happens if I don’t?

Today, you are not required to have health insurance. But beginning in 2014, most people will have to have it or pay a fine. For individuals, the penalty would start at $95 a year, or up to 1 percent of income, whichever is greater, and rise to $695, or 2.5 percent of income, by 2016.

For families the penalty would be $2,085 or 2.5 percent of household income, whichever is greater. The requirement to have coverage can be waived for several reasons, including financial hardship or religious beliefs.

Millions of additional people will qualify for Medicaid or federal subsidies to buy insurance under the law.

While some states, including most recently Alabama, Wyoming and Montana, have passed laws to block the requirement to carry health insurance, those provisions do not override federal law.

I get my health coverage at work and want to keep my current plan. Will I be able to do that? How will my plan be affected by the health law?

If you get insurance through your job, it is likely to stay that way. But, just as before the law was passed, your employer is not obligated to keep the current plan and may change premiums, deductibles, co-pays and network coverage.

You may have seen some law-related changes already. For example, most plans now ban lifetime coverage limits and include a guarantee that an adult child up to age 26 who can't get health insurance at a job can stay on her parents' health plan.

What other parts of the law are now in place?

You are likely to be eligible for preventive services with no out-of-pocket costs, such as breast cancer screenings and cholesterol tests.

Health plans can't cancel your coverage once you get sick – a practice known as "rescission" – unless you committed fraud when you applied for coverage.

Children with pre-existing conditions cannot be denied coverage. This will apply to adults in 2014.

Insurers will have to provide rebates to consumers if they spend less than 80 to 85 percent of premium dollars on medical care.

Some existing plans, if they haven't changed significantly since passage of the law, do not have to abide by certain parts of the law. For example, these "grandfathered" planscan still charge beneficiaries part of the cost of preventive services.

If you're currently in one of these plans, and your employer makes significant changes, such as raising your out-of-pocket costs, the plan would then have to abide by all aspects of the health law.

I want health insurance but I can’t afford it. What will I do?

Depending on your income, you might be eligible for Medicaid. Currently, in most states nonelderly adults without minor children don't qualify for Medicaid. But beginning in 2014, the federal government is offering to pay the cost of an expansion in the programs so that anyone with an income at or lower than 133 percent of the federal poverty level, (which based on current guidelines would be $14,856 for an individual or $30,656 for a family of four) will be eligible for Medicaid.

The Supreme Court, however, ruled in June that states cannot be forced to make that change. Republican governors in several states have said that they will refuse the expansion, though that may change now that Obama has been re-elected.

What if I make too much money for Medicaid but still can't afford to buy insurance?

You might be eligible for government subsidies to help you pay for private insurance sold in the state-based insurance marketplaces, called exchanges, slated to begin operation in 2014. Exchanges will sell insurance plans to individuals and small businesses.

These premium subsidies will be available for individuals and families with incomes between 133 percent and 400 percent of the poverty level, or $14,856 to $44,680 for individuals and $30,656 to $92,200 for a family of four (based on current guidelines).

Will it be easier for me to get coverage even if I have health problems?

Insurers will be barred from rejecting applicants based on health status once the exchanges are operating in 2014.

I own a small business. Will I have to buy health insurance for my workers?

No employer is required to provide insurance. But starting in 2014, businesses with 50 or more employees that don't provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchange will have to pay a fee of $2,000 per full-time employee. The firm's first 30 workers would be excluded from the fee.

However, firms with  50 or fewer people won't face any penalties.

In addition, if you own a small business, the health law offers a tax credit to help cover the cost. Employers with 25 or fewer full-time workers who earn an average yearly salary of $50,000 or less today can get tax credits of up 35 percent of the cost of premiums. The credit increases to 50 percent in 2014.

I'm over 65. How does the legislation affect seniors?

The law is narrowing a gap in the Medicare Part D prescription drug plan known as the "doughnut hole." That's when seniors who have paid a certain initial amount in prescription costs have to pay for all of their drug costs until they spend a total of $4,700 for the year. Then the plan coverage begins again.

That coverage gap will be closed entirely by 2020. Seniors will still be responsible for 25 percent of their prescription drug costs. So far, 5.6 million seniors have saved $4.8 billion on prescription drugs, according to the Department of Health and Human Services.

The law also expanded Medicare's coverage of preventive services, such as screenings for colon, prostate and breast cancer, which are now free to beneficiaries. Medicare will also pay for an annual wellness visit to the doctor. HHS reports that during the first nine months of 2012, more than 20.7 million Medicare beneficiaries have received preventive services at no cost.

The health law reduced the federal government's payments to Medicare Advantage plans, run by private insurers as an alternative to the traditional Medicare. Medicare Advantage costs more per beneficiary than traditional Medicare. Critics of those payment cuts say that could mean the private plans may not offer many extra benefits, such as free eyeglasses, hearing aids and gym memberships, that they now provide.

Will I have to pay more for my health care because of the law?

No one knows for sure. Even supporters of the law acknowledge its steps to control health costs, such as incentives to coordinate care better, may take a while to show significant savings. Opponents say the law’s additional coverage requirements will make health insurance more expensive for individuals and for the government.

That said, there are some new taxes and fees. For example, starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will paya Medicare payroll tax of 2.35 percent, up from the current 1.45 percent, on income over those thresholds. In addition, higher-income people will face a 3.8 percent tax on unearned income, such as dividends and interest.

Starting in 2018, the law also will impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year and $27,500 for families. The tax has been dubbed a "Cadillac" tax because it hits the most generous plans.

In addition, the law also imposes taxes and fees on several major health industries. Beginning in 2013, medical device manufacturers and importers must pay a 2.3 percent tax on the sale of any taxable medical device to raise $29 billion over 10 years. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.

Those fees will likely be passed onto consumers in the form of higher premiums.

Has the law hit some bumps in the road?

Yes. For example, the law created high-risk insurance pools to help people purchase health insurance. But enrollment in the pools has been less than expected. As of Aug. 31, 86,072 people had signed up for the high-risk pools, but the program, which began in June 2010, was initially expected to enroll between 200,000 and  400,000 people. The cost and the requirements have been difficult for some to meet.

Applicants must be uninsured for six months because of a pre-existing medical condition before they can join a pool. And because participants are sicker than the general population, the premiums are higher.

Enrollment has increased since the summer, after the premiums were lowered in some states by as much as 40 percent and some states stepped up advertising.

A long-term care provision of the law is dead for now. The Community Living Assistance Services and Supports program (CLASS Act) was designed for people to buy federally guaranteed insurance that would have helped consumers eventually cover some long-term-care costs. But last fall, federal officials effectively suspended the program even before it was to begin, saying they could not find a way to make it work financially.

Are there more changes ahead for the law?

Some observers think there could be pressure in Congress to make some changes to the law as a larger package to reduce the deficit. Among those options is scaling back the subsidies that help low-income Americans buy health insurance coverage. The amount of the subsidies, and possibly the Medicaid expansion as well, could be reduced.

It’s also possible that some of the taxes on the health care industry, which help pay for the new benefits in the health law, could be rolled back. For example, legislation to repeal the tax on medical device manufacturers passed the House with support from 37 Democrats (it is not expected to receive Senate consideration this year). Nine House Democrats are co-sponsoring legislation to repeal the law’s annual fee on health insurers.

Meanwhile, the Independent Payment Advisory Board (IPAB), one of the most contentious provisions of the health law, is also under continued attack by lawmakers. IPAB is a 15-member panel charged with making recommendations to reduce Medicare spending if the amount the government spends grows beyond a target rate. If Congress chooses not to accept the recommendations, lawmakers must pass alternative cuts of the same size.

Some Republicans argue that the board amounts to health care rationing and some Democrats have said that they think the panel would transfer power that belongs on Capitol Hill to the executive branch. In March, the House voted to repeal IPAB.


9 ways office food fuels employee satisfaction and productivity

Food can play an important role in motivating employees to spend more time in the office, work more effectively while there and generally view their workplace more positively, finds a nationwide survey of nearly 1,100 full-time professionals across more than a dozen different industries. The survey by Seamless, the leading service for ordering delivery and takeout from restaurants in the U.S. and U.K., also reveals the importance of food as a means for building and fostering relationships with clients.

Since the average employee works more than 40 hours a week, “food remains a relatively untapped perk that companies can use to measurably improve employee retention and happiness and show their appreciation, while separating themselves from competitors. Free food all the time is unrealistic for most companies, but the occasional pizza party or afternoon treat goes a long way,” says Nick Worswick, vice president and general manager of corporate at Seamless.

Here are nine positive ways food can be used to inspire healthy eating in the workplace and foster higher productivity levels among employees.

1. Employee Satisfaction

While a majority (60%) of employees say they are satisfied with their current employment situation, 69% feel that more perks – including gym memberships (40%), stock options (22%) and food perks (20%) - would have a direct positive impact on their job satisfaction.

2. Recruiting Advantage

Nearly half of the respondents note that the availability of free lunch would strongly influence their decision to accept a job offer.

3. A Pat on the Back

Sixty percent report that having more food at the office would make them feel more valued and appreciated by their employer.

4. Team Building

More than 60% of respondents agree that company-provided lunches would encourage them to eat with their colleagues, fostering more internal collaboration.

5. Motivation and Productivity

One-third of the employees surveyed divulge that it takes food to make them show up to optional meetings – and another 20% admit to making their decision after knowing what’s on the menu.

6. Client Camaraderie

Forty-three percent of employees say sharing food or a meal with clients helps foster a better working relationship. Food also tops the list in terms of the best client gifts, with 41% noting that food is the very best option for corporate gifts.

7. Time to Spare

More than half of employees say they would spend less time away from work if food were available. Half of the respondents (51%) report spending more than 10 minutes per day picking up lunch or other food outside the office.

8. Healthy Choices

More than half of employees also say having food perks in the workplace would help them eat healthier.

9. Peace of Mind

Nearly half of respondents feel that more food perks in the workplace would make them more satisfied with their employer, in turn reducing 40% of respondents’ personal stress.

Source: https://ebn.benefitnews.com/gallery/ebn/9-ways-office-food-fuels-employee-satisfaction-productivity-2731438-1.html

 


Medical savings accounts on the upswing

By David Albertson

As of 2012 there was $17.8 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 11.6 million accounts, according to data from the latest EBRI/MGA Consumer Engagement in Health Care Survey, sponsored by the Employee Benefit Research Institute and Matthew Greenwald & Associates.

That’s up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2011, when 8.5 million accounts held $12.4 billion in assets.

The balances continue to grow as more employers adopt high-deductible, consumer-driven health plans combined with HSAs/HRAs. However, assumptions about these plans are not always proving true. For example, analysts predicted that individuals given more control over funds for health care services would become more cost conscious as they became more educated about the actual prices of those services. However, according to EBRI, no evidence was found to support this, nor was there evidence that healthy behaviors had any real correlation with account balance.

Among other findings from the EBRI/MGA survey:

After leveling off, average account balances increased. After average account balances leveled off in 2008 and 2009, and fell slightly in 2010, they increased in 2011 and 2012. In 2006, the   average account balance was $696. It increased to $1,320 in 2007, a 90% increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3% and 5% increases, respectively. In 2010, average account balances fell to $1,355, down 4.5% from the previous year. In 2011, average account balances increased to $1,470, a 9% increase from 2010. It increased to $1,534, or 4%, in 2012.

Total and average rollovers increased. After declining to $1,029 in 2010, average rollover amounts increased to $1,206 in 2011 and remained there in 2012. Total assets being rolled over increased: $9.7 billion was rolled over into HSAs and HRAs in 2012, up from $6.8 billion in 2011. The percentage of individuals without a rollover was 11% in 2012.

Differences in account balances. Men have higher account balances than women, older individuals have higher account balances, account balances increase with household income, and education has a significant impact on account balances, independent of income and other variables.

Individual providers of HSAs likewise report significant growth in account balances over the past year, and bullish expectations for additional increases.

Among the HSA leaders, UMB Healthcare Services, a division of UMB Financial Corporation, announced that account balances for its HSAs grew 55% during the previous 12 months, surpassing $615 million dollars as of Jan. 31, 2013. The number of HSAs also grew to nearly 320,000 individual accounts, up dramatically from the 220,000 following open enrollment last year.

UMB Healthcare Services also saw a 29% increase in the number of debit cards it provides for Flexible Spending Accounts (FSAs), HRAs) and HSAs. Today, the number of cards in circulation has grown to more than 2.8 million.

According to the January 2012 annual census by America’s Health Insurance Plans’ Center for Policy and Research, the number of people with HSA/HDHP coverage rose to more than 13.5 million, up from 11.4 million in January 2011.

“Our HSA growth continues to reflect the trend we are seeing nationwide as more individuals and employers move toward consumer-directed health accounts,” said Dennis Triplett, CEO of UMB Healthcare Services. “We are now challenged with educating the growing number of employers and account holders on all that these accounts can offer toward future financial stability, beyond day-to-day health care expenses.”

Source: https://ebn.benefitnews.com/news/medical-savings-accounts-on-upswing-2731569-1.html

 


Consulting leaders advise employers to ‘be nimble’ amid changing health care landscape

By Tristan Lejeune

A roundtable discussion from benefits consulting leaders on what employers need to know and need to be thinking about going forward with their health strategies served as the wrap-up to a National Business Group on Health annual business agenda event last week in Washington, D.C. With cost-control still very much top of mind for employers, NBGH President and CEO Helen Darling aptly pointed out that, “If they were charging, this would be hundreds and hundreds of dollars an hour. So, this is your chance to get some free consulting from these leaders.”

The group included Julie Stone, health and group consulting leader at Towers Watson; Sharon Cunninghis, U.S. health and benefits regional business leader for Mercer; and Jim Winkler, Aon Hewitt senior vice president and chief innovation officer. Darling served as the panel’s moderator.

As employers plan for the realities of health care reform cost and compliance in 2014, Cunninghis said, “it’s really important to be nimble.” Employers may think they have a firm bead on health care changes at the moment, but many, she said, could use some help.

“You have to really stay on top of everything that’s happening, and I know that’s hard,” Cunninghis said. “Many of you have employees all over the world, so, to some degree, I would start leaning on others — whether it’s leaning on your health plan [or] other vendors that you work with. Make sure — literally on a weekly basis — that you’re on top of all the changes.”

Winkler agreed that it’s important benefits leaders seek assistance when they need it, but also cautioned that providers and vendors may be primarily seeking an opportunity, not necessarily serving an employer’s best interests. He urged employers to watch their backs and their bottom lines.

“One man’s cost savings is another man’s income reduction,” he said. “I think it’s a critical moment for employers to be activists … Work with your health plans, but don’t cede total control to them.”

Stone said that quality is tied to efficiency and warned that often, employers lose track of the former in search of the latter. “I think we need not to lose focus on quality,” she said, and that way employers can reach and enjoy the benefits of a cycle of good health among workers.

In addition to targeted messaging, Darling asked, how can employers move to the next stage of engagement on employee health care and wellness?

“You have to think of this as a marketing exercise, not a benefits communication exercise,” Winkler answered. He said “we have to take that targeted messaging to a new level,” to really squeeze every drop into return on investment, but he emphasized using language and formats that actually work.

“If you think about how we have all shifted to a new paradigm of communication — technology, texting, Skyping, — we changed our routines and patterns in a fundamental way and we’re not going back,” Stone said. “We need to change those same routines around health, health management, healthy eating, all of those things, so they really are routine” and health becomes a matter of natural course.

Cunninghis agreed about using natural English, but she said employer shouldn't be looking beyond targeted language, but at how to change it. “The next generation … is very into the notion of self-serving,” she said, and they can be taught to seek out their own best-case health solutions.

“I think we’ve been very limited in how we target to people, and I think we should take that a step further and ask, how do we get people to target to themselves?” Cunninghis asked.

Source: https://ebn.benefitnews.com/news/consulting-leaders-advise-employers-be-nimble-amid-changing-healthcare-land-2731519-1.html


Employers taking 'bold steps' with health benefits

https://www.benefitspro.com/2013/03/04/employers-taking-bold-steps-with-health-benefits

By Kathryn Mayer

Don’t count on employers to stop offering health benefits altogether, but do count on big changes in how they offer the benefits.

That’s the main finding from recent analysis by Aon Hewitt. The vast majority of large and mid-size U.S. employers — 94 percent — say they’ll continue to offer health benefits to their employees in the next three to five years, but almost two-thirds plan to move away from a traditional “managed trend” approach to one that requires participants to take a more active role in their health care planning.

The consulting firm surveyed nearly 800 large and mid-size U.S. employers covering more than 7 million employees.

“The health care marketplace is becoming increasingly complex,” says John Zern, executive vice president for Aon Hewitt. “New models of delivery, new approaches to managing health and new compliance requirements are challenging employers to think differently about their role in owning health insurance responsibilities for employees and their dependents.”

Aon Hewitt says the amount employers spend on health care has increased by 40 percent in the past six years to approximately $8,800 per employee. Meanwhile, employee premium and out-of-pocket costs have increased 64 percent to almost $5,000 per year. Aon Hewitt estimates that health care costs for both employers and employees will continue to rise 8 percent to 9 percent per year for the foreseeable future.

Zern says though employers are staying in the health benefits game, they are taking “bold and assertive steps to achieve more effective results” — and they are doing so at a faster pace than has been seen in previous years.

Almost 40 percent of employers expect to migrate toward a “house money/house rules” approach in the next three to five years. For example, participants who take health risk questionnaires and biometric screenings may be rewarded in the form of lower premiums or access to broader health coverage. Other employers may waive prescription drug co-pays if an employee demonstrates they are following their doctor’s orders with regard to a chronic condition. Lastly, some leading-edge employers are working with health plans to incentivize participants to use a small provider network of high quality, cost-efficient providers, Aon Hewitt finds.

Though just 6 percent of employers plan to exit health care completely in the next three to five years, 28 percent say they’re planning to move to a private health care exchange.

Jim Winkler, chief innovation office the U.S. Health & Benefits practice at Aon Hewitt, says that private exchanges are an “increasingly attractive option” 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.

“The allure of exiting completely is strong until you look at the numbers,” Winkler said. “Between the Affordable Care Act penalties for failing to offer coverage and the ensuing talent flight risk, most employers believe they need to continue to play a role in employee health, but want a different and better outcome.”

 


Obama Administration Unveils Health Insurer Fees

March 1, 2013

By Kathryn Mayer

The Internal Revenue Service unveiled its proposal to raise billions of dollars through annual fees on health insurers, a “$100 billion health insurance tax rule” that the industry says will significantly drive up costs for consumers.

The rule as part of the Patient Protection and Affordable Care Act imposes annual fees on health insurers that start at $8 billion in 2014, increases to $14.3 billion in 2018, and will increase every year after that. The Joint Committee on Taxation estimates the tax will exceed $100 billion over the next ten years.

The proposed rule will be published Monday for public consideration in the Federal Register. The IRS will accept comments for 90 days, beginning Monday.

Not paying on time will result in a $10,000 penalty for insurers, plus $1,000 for every day they miss deadline.

America’s Health Insurance Plans blasted the rule as a tax that will financially drown both employers and consumers. They warn that the costs will have to be passed along to consumers in the form of higher premiums, a claim that the Congressional Budget Office has also verified in its analysis.

“Imposing a new sales tax on health insurance will add a financial burden on families and employers at a time when they can least afford it,” AHIP President and CEO Karen Ignagni said Friday. “This tax alone will mean that next year an individual purchasing coverage on his or her own will pay $110 in higher premiums, small businesses will pay an additional $360 for each family they cover, seniors enrolled in Medicare Advantage will face $220 in reduced benefits and higher out-of-pocket costs, and state Medicaid managed care plans will incur an additional $80 in costs for each person enrolled.”

There is currently legislation to repeal the fees, recently introduced by Reps. Charles Boustany, R-La., and Jim Matheson, D-Utah, which AHIP strongly supports.

A 2011 report by Oliver Wyman found that nationally the health insurance tax alone “will increase premiums in the insured market on average by 1.9 percent to 2.3 percent in 2014,” and by 2023 “will increase premiums 2.8 percent to 3.7 percent.”

Families purchasing coverage in the individual market will be hit the hardest in New York while those getting coverage from a small employer will be most impacted in West Virginia, Oliver Wyman analysis also found. Medicare Advantage beneficiaries in New Jersey and the Medicaid managed care program in Washington, DC top their respective lists of those that will be hardest hit by the tax.

Source: https://www.benefitspro.com/2013/03/01/obama-administration-unveils-health-insurer-fees


5 Steps to Assess Employees' Benefits Eligibility Under PPACA

Source: https://ebn.benefitnews.com

By Laurie S. Miller

"Health care reform is overrated," a broker responded flippantly to his (now former) employer-client after the employer initiated the call. "I'll email you a one-page cheat sheet." The client had reached out to his broker following a two-hour presentation about the impact of health care reform from the broker's competitor. This was the same broker who, for the last two years, had faxed over the client's renewal and had delegated the servicing of the employees to the client's bookkeeper. Shaking his head, the client hung up the phone, then dialed his broker's competitor and moved the business.

Consulting firms around the nation have deployed significant resources and compliance teams to help clients proactively manage the strategic, financial and operational impact of the Patient Protection and Affordable Care Act. There are significant penalties for noncompliance so it is important that employers keep up with the regulations. In addition, employers may see increased enrollment as employees seek to comply with the individual mandate, which requires coverage.

Eligibility for coverage is one area that employers need to assess. PPACA defines a full-time employee as working 30 hours per week. Many employers currently set their eligibility threshold at a higher level, such as 35 or 40 hours a week.

"We could potentially have 40 new enrollees on our plan," pointed out one human resources executive at a recent health care reform seminar, as she weighed the cost impact.

If your plan defines eligibility as greater than 30 hours a week or excludes certain classes of employees (for example, a nine-month non-certified employee at a school vs. a 12-month employee), this is the time to assess the impact of the legislation and determine an action plan. Here's a checklist to get you started:

1. Review employees who currently waive the plan. Model potential plan costs if these employees join the health plan.

2. Review employees who are currently ineligible due to higher eligibility thresholds (greater than 30 hours per week.) Assess the financial impact of newly eligible employees joining the health plan.

3. Review variable-hour employees. If they exceed an average of 30 hours a week during the measurement period, they may be eligible for benefits.

4. Are partial-year employees eligible for coverage? (i.e., nine-month employees who don't work during the summer months?) If currently excluded, assess potential impact if they exceed 30 hours per week.

5. Review seasonal employees. Do they exceed 120 days per year? They may be eligible for benefits.

There are many other components to developing a strategic approach to health care reform. Look for a broker that offers a proprietary financial modeling tool that can help your company determine a cost-effective strategy for the future.