Study: What benefits do employees go for on private exchanges?
Jack Craver gives insight on the best benefits options for private exchanges
A new study offers insight into the types of benefits and benefit designs employees go for when given the choice.
The study, by the Private Exchange Research Council, analyzed hundreds of thousands of benefit purchases made by workers whose employer offers benefits through a private exchange.
The average employer that uses a private exchange offers 14 different benefits and six medical plans, the study found. Employees purchased an average of 4.4 products in 2015, up from 3.6 the previous year.
Older workers are more likely to buy more coverage, with 44 percent of Gen Xers and 42 percent of baby boomers buying more than four products, compared to only 30 percent of millennials.
While employers are increasingly demanding that employees accept high-deductible health plans accompanied by a health savings account, the majority of workers analyzed in the study appear to have traditional health plans, although the percentage with HSAs is rising. Forty-two percent of employees had an HSA in 2015, up from 38 percent in 2013.
Those who opt for high-deductible HSA-qualifying plans tend to be younger and healthier; that’s no surprise. However, the study also found that men and high-paid employees tend to favor such plans more than women and lower-paid employees.
Perhaps surprisingly, the study also found that nontraditional insurance products, such as pet insurance, legal insurance and identity theft insurance, are more likely to be offered by smaller companies.
Private exchanges and the employers that use them describe them as a way to increase employees’ engagement with their benefits. In a health care system that many have argued is overpriced and inefficient because the costs have been hidden behind health plans largely paid by employers, private exchanges are touted as a way to make individuals more sophisticated health care consumers that make conscious decisions about what services they want and need.
Private exchanges got a big boost earlier this year when Starbucks announced that it would be offering its employees an array of health plans to choose through an exchange run by Aon.
In a statement accompanying the study’s release, Christopher Condeluci, one of the principals of Private Exchange Research Council, described the group and its research as addressing a lack of data on the types of benefits that individual consumers favor.
"Knowing what plans people want and how they choose them will go a long way in helping the benefits industry better meet employers' and employees' needs,” he says.
See the original article Here.
Source:
Craver, J. (2016 October 20). Study: what benefits do employees go for on private exchanges? [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/20/study-what-benefits-do-employees-go-for-on-private?kw=Study:%20What%20benefits%20do%20employees%20go%20for%20on%20private%20exchanges?&et=editorial&bu=BenefitsPRO&cn=20161024&src=EMC-Email_editorial&pt=Daily
15 voluntary benefits trends heading into 2017
Alan Goforth lists the top benefits trends of 2017.
Predicting industry trends is as much a sign of the end of the year as after-Christmas sales and New Year's resolutions.
Although predicting the future is only an educated guess, one thing is certain — voluntary benefits are here to stay.
Carriers, brokers, employers and workers all give a thumbs-up to the increased flexibility and opportunities for cost control they bring to benefits packages.
Here is what may lie over the horizon in 2017.
THE MARKET IS BULLISH
As a result, the quantity and quality of voluntary benefits will continue to grow. Examples of traditional voluntary benefits employers are likely to add include gap coverage, short-term disability, cancer, critical illness, prescription, dental, life insurance and hospital supplemental policies. Brokers should make sure they have these products in their portfolios.
WELLNESS PROGRAMS GET FISCAL
Most businesses understand that the size of an employee's waistline can correlate to attendance, productivity and turnover. Many also are starting to realize the link between the size of their bank account and job performance.
Smart employers are adding voluntary benefits that can help workers reduce stresses associated with finances and debt. These can include financial education, financial counseling, employee purchase programs, parental leave, retirement planning and even short-term loans under certain circumstances.
A-WEAR-NESS IS INCREASING
Technology is taking the guesswork out of employee wellness programs. Nearly two-thirds of carriers surveyed expect wearable technologies to have a significant impact on their industry, according to Accenture's annual Technology Vision report. Fitbits and similar devices enable employees to quantify the results of their effort, which both inspires them and provides employers valuable feedback about the effectiveness of their programs. An increasing number of businesses now subsidize the cost of wearable devices or set up payroll deductions to cover the expense.
ENGAGEMENT GOES HIGH-TECH
Year-in and year-out, HR professionals cite employee engagement as one of their most vexing issues. Traditional tactics are becoming less effective with millennial employees, who often prefer voluntary benefit portals and enrollment platforms.
"Millennials get information on their own," said Aprilyn Chavez Geissler, owner of Geissler Agency Inc. in Albuquerque. "However, when it's time to purchase, they still want the personal service and an advisor to help them. As a large demographic, they are similar to the silent generation in that they think through their purchases and do research on their own."
CRITICAL ILLNESS REACHING CRITICAL MASS
Critical illness insurance was once a blip on the radar screen of voluntary benefits packages — but not anymore. It is becoming an increasing popular option as the workforce ages and companies reduce primary health coverage and shift the cost of primary medical onto
“Critical illness insurance is by far the fastest-growing insurance product on the market," said Mark Randall, a researcher for GoldenCare in Minneapolis. "Even though the market share is still fairly small, it's a hot product. The bottom line is that every broker should add this product to their portfolio.”
VOLUNTARY BENEFITS REDEFINED
One sure sign of growing demand for voluntary benefits is the fact that many definitions have become obsolete. In the past, voluntary benefits were limited to such bread-and-butter options as dental or vision insurance. Today, however, they are all about lifestyle benefits, such as health club memberships, legal services or pet insurance. A good working definition of a voluntary benefit is anything that can be deducted from an employee's paycheck.
CONSUMERS DRIVE PLANS
A well-designed consumer-driven health plan creates a win-win scenario. Employers hold the line on costs, and employees pay only for the coverage they need and want. This can mean a transition to high-deductible health plans and health savings accounts or health reimbursement arrangements that help employees pay their out-of-pocket expenses and allow them to retain unspent contributions.
TOOLS PROMOTE TRANSPARENCY
Information is a double-edged sword: Employees can be overwhelmed by the voluntary benefit options available to them, but they are also empowered to make smart choices. Benefits providers, brokers and employers are providing user-friendly tools that increase transparency. Studies show that this is especially important to younger workers.
Fifty-two percent of millennials report searching online for health or care-related information, and reliance on social media, patient portals and performance scorecards is growing. One-quarter of consumers say they have looked at a scorecard or report card to compare the performance of doctors, hospitals or health plans, compared to 19 percent two years ago. Among millennials who need medical care, scorecard use has grown from 31 percent to 49 percent.
THE DOCTOR WILL SEE YOU… ONLINE
Telemedicine is a natural byproduct of increased telecommuting. The practice is both a cost-effective option for employers and a perk for employees who are paying more out of pocket for health care. On-call services can bring virtual health care providers into the office with advice about preventive care and nonthreatening illnesses.
ANALYTICS REDUCING GUESSWORK
Anyone remotely involved in the benefits business knows that the industry is swimming in tons of data. Innovative employers are putting this information to work to design better plans that improve health care and reduce expenses. Claims data and historical use patterns demonstrate how much employees can save on new plans by making better decisions. This information also helps employers get a better handle on plan costs, employee adoption and administrative efficiency.
NONTRADITIONAL BENEFITS BOOMING
Employees continue to express interest in new, nontraditional voluntary benefits, and carriers are responding. According to a study by Eastbridge Consulting, 13 percent of employees have selected employee purchase programs; 8 percent have selected legal plans; 3 percent have selected identity protection; and 1 percent selected pet insurance. The relatively low numbers reflect the fact that these options are new, according to researchers.
These percentages are expected to grow. Nontraditional voluntary benefits offer workers a way to obtain products and services through convenient payroll deduction. Most nontraditional offerings provide immediate, tangible benefits that can be used any time, unlike many core benefits that employees need only when they are sick or injured.
CAREER DEVELOPMENT IS HOT
Employees are eager to improve themselves, especially if doing so is cost-effective. Financial planning and online educational services, including college courses, certifications and career development, are becoming popular. Look for more of these, such as Graduate Management Admission Test prep and Graduate Medical Education courses, to be added.
MINIMUM WAGE HIKES MAY SPIKE DEMAND
Although the drive toward a $15 per hour minimum wage in some cities has been controversial, it may have an upside in demand for voluntary benefits.
"With the California minimum wage going to $15 an hour, those employees will have extra money to opt for more voluntary benefits," said Wayne Sakamoto, owner of Health Insurance Interactive Inc. in Naples, Florida. "This extra money will help them get into a nicer apartment, buy a home, get a car or opt to purchase more voluntary benefits. Benefits such as dental and vision insurance are a goodwill gesture by the employer."
DEMAND CREATING COMPETITION
Brokers, employers and workers all may benefit from the increasing number of carriers offering voluntary benefits.
"Brokers now have a lot more different carriers in voluntary benefits than they did several years ago," said Kathy O'Brien, vice president of voluntary benefits and national client group services for Unum in Chattanooga, Tennessee. "They have to be very knowledgeable about the carrier, what they will do to meet the needs of their clients and what types of service they offer, not just in enrollment but also in plan administration, how they will deliver the services, how they will pay and handle billing information."
VOLUNTARY BENEFITS MUST BE INTEGRATED
A well-designed package of voluntary benefits is more efficient when integrated seamlessly with traditional benefits, and not merely tacked on. Learning how best to do this is an ongoing challenge.
"Understanding how all of the different solutions work together is critical, especially when paired with a high-deductible health plan," said Paul Goedde, executive vice president of the Voluntary Employee Benefits Board and product management lead for Cigna in Philadelphia. "Not only does it help the employer attract and retain talent, it helps them manage their bottom line with more-productive and satisfied employees."
See the original article Here.
Source:
Goforth, A. (2016 October 25). 15 voluntary benefits trends heading into 2017. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/25/15-voluntary-benefits-trends-heading-into-2017?kw=15+voluntary+benefits+trends+heading+into+2017&et=editorial&bu=BenefitsPRO&cn=20161025&src=EMC-Email_editorial&pt=Daily&page_all=1
ACA exchanges report strong early application activity
Busy start to the 2017 open enrollment period 50 percent higher than last year, by Allison Bell
Managers of HealthCare.gov say the open enrollment period for 2017 has gotten off to a busy start.
The level of activity during the first six hours of the open enrollment period was 50 percent higher than during the comparable period in 2015, and HealthCare.gov took in 150,000 coverage applications during the first full day of the enrollment period, according to officials at the U.S. Department of Health and Human Services.
HHS set up HealthCare.gov to provide Affordable Care Act exchange enrollment and account administration services in states that are unable or unwilling to handle that job themselves.
The open enrollment period for 2017 started Tuesday.
A year ago, HHS officials said HealthCare.gov had taken in about 250,000 coverage applications during the first full day of the open enrollment period for 2016.
MNsure, Minnesota's state-based exchange enrollment system, was down much of the day yesterday because of some combination of heavy volume, technical glitches and efforts by ACA opponents to crash the system by flooding it with visits. In spite of the technical problems, about state residents used the system to apply for coverage for about 5,000 people, according to the Twin Cities Pioneer Press.
MNsure may have spurred consumers to try to sign up for exchange plan coverage early by announcing that it will impose enrollment caps for 2017 on coverage from most participating carriers. Blue Plus is the only exchange issuer selling coverage without protection from an enrollment cap.
George Kalogeropoulos, the chief executive officer of HealthSherpa.com, a San Francisco-based "Web broker entity" that helps retail insurance agents and brokers submit ACA exchange coverage applications for their customers, says HealthSherpa.com activity levels support the idea that the ACA exchange system has been very busy.
"As of day two of open enrollment, the traffic on HealthSherpa.com has been through the roof," Kalogeropoulos said in an email. "We know HealthCare.gov is getting 50 percent more website visits compared to last year, and our website is experiencing that surge as well."
See the original article Here.
Source:
Bell, A. (2016 November 04). ACA exchanges report strong early application activity. [Web blog post]. Retrieved from address https://www.lifehealthpro.com/2016/11/02/aca-exchanges-report-strong-early-application-acti?slreturn=1478548849
Beware: Losing health plan grandfathered status is an administrative nightmare
Some interesting points on grandfathered status' from HRMorning, by Jared Bilski
Employers that have managed to keep their grandfathered status until now may think they’re immune from the hassles of the ACA, but a recent DOL investigation is a good reminder that the feds are always watching for a slipup.
Sierra Pacific Industries Health Plan was one of the few remaining grandfathered plans in existence, and they managed to keep that status for years after the ACA took effect.
But, according to a DOL investigation, the plan made some changes beginning on Jan. 1, 2013, that prevented the plan from keeping its grandfathered status and led to a relinquishing of that status in the feds’ eyes.
Those plan changes, as well as how the plan made determinations on employee health claims, violated both the ACA (specifically the provisions on preventive health services and internal claims and appeals rules) and ERISA, the DOL claimed.
‘Operating as though it were exempt’
As the DOL’s Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi said:
“The Affordable Care Act put into place standards and protections for workers covered by employee benefit plans. The Sierra Pacific plan was operating as though it was exempt from such requirements, when indeed, it was not. This settlement means that workers improperly denied health benefits will have their claims paid. Corrections made to plan procedures will also mean that all future claims are processed and paid properly.”
No premium or deductible bumps
The end result of the feds’ investigation: A lot of administrative work and changes for Sierra Pacific.
As part of the settlement, plan fiduciaries agreed to comply with the ACA requirements for non-grandfathered plans moving forward, specifically the rules for internal claims and appeals and coverage of preventive health services.
Plus, for the 2017 plan year, the company will have to forgo any increases to participant premiums, annual out-of-pocket limits, annual deductible and coinsurance percentages in effect for the 2016 plan year.
On top of all that, the company agreed to:
- Revise plan documents and internal procedures.
- Re-adjudicate past claims for preventive services, out-of-network emergency services, claims affected by an annual limit and pay claims in compliance with the ACA and ERISA.
- Submit to an independent review organization claims were eligible for external review.
- Pay claims that had been left on hold for a long time.
- Comply with timelines for deciding claims as provided in the department’s claim regulation.
See the original article Here.
Source:
Bilski, J. (2016 October 14). Beware: losing health plan grandfathered status is an administrative nightmare. [Web blog post]. Retrieved from address https://www.hrmorning.com/beware-losing-health-plan-grandfathered-status-is-an-administrative-nightmare/
The demand for data transparency is mounting
Interesting thoughts on transparency data from Employee Benefit Adviser, by Suzy K. Johnson
December 2003 was a great time for health plans in America. This was when high deductible health plans and the underlying health savings accounts were enacted into law by the federal government.
With this law, we were provided the ability to engage employees more directly in the cost of their care with the elimination of copays and Rx cards under these plans.
What many brokers don’t realize is that the law allows anyone to fund the underlying health savings accounts. This means that employers can and should be shown how to use the savings in premiums created by moving to these types of plans to “fund” employees’ health savings accounts. This can result in a win/win for all.
When employers fund the employee’s HSA, they provide the employee the ability to direct additional money into a flex spending type of plan (HSA) that has much higher limits for funding, and allows the same expenses to be reimbursed along with long-term care premiums, COBRA premiums and Medicare Part B expenses. These accounts don’t have the “use it lose it” risk that flex medical reimbursement plans have always included.
A top priority
Now what we need is transparency data from the hospitals and providers. It is my belief that if every American was required to have a high deductible health plan paired with a health savings account only, the demand for transparency data would be palpable and the pressure forced on providers and hospitals to comply would amplify.
Right now the transparency data is not available and this needs to change. If the only plans employers could offer were HDHP plans with HSA accounts and if employers provided funding to help their employees to be able to afford the additional exposure shifted to them, the demand for transparency data would suddenly become top priority and the government would demand it of providers.
Yes, they are more complicated to understand, and yes, the programs require more employee education and hand holding. Nothing good happens when we sit on the sidelines. Let’s commit to becoming part of the solution!
See the original article Here.
Source:
Johnson, S. K. (2016 October 4). The demand for data transparency is mounting. [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/the-demand-for-data-transparency-is-mounting
2016 Draft Forms & Instructions Released: Affordable Care Act Reporting Update
Great feature from The National Law Review by Damian A. Myers,
Since our last ACA Reporting Update, the extended deadlines to distribute Forms 1095-B and 1095-C to covered individuals and employees and to file the forms with the IRS have passed. The IRS has stated, however, that late forms can still be submitted via electronic filing and the forms that received an error message should be corrected. By many accounts, the first ACA reporting season presented numerous challenges. From collecting large amounts of data to compiling the forms, to working with service providers that faced their own unique challenges, to facing form rejections and error notifications from an inadequate IRS electronic filing system, employers and coverage providers faced obstacles nearly every step of the way. Nevertheless, most employers and coverage providers were able to get the forms filed and put the 2015 ACA reporting season behind them.
But, alas, there is no rest for the weary. In late-July, the IRS released new draft 2016 Forms 1094-B and 1095-B (the “B-Series” Forms) and Forms 1094-C and 1095-C (the “C-Series” Forms). Additionally, on August 1, the IRS released draft instructions to the C-Series Forms (as of the date of this blog, draft instructions for the B-Series Forms have not been released). For the most part, the 2016 ACA reporting requirements are similar to the 2015 requirements, subject to various revisions described below.
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Various changes have been made to the forms and instructions to reflect that certain forms of transition relief are no longer applicable. For example, the non-calendar year transition relief (for plan years starting in 2014) that applied in 2015 does not apply in 2016. Similarly, changes have been made to reflect that the “Section 4980H Transition Relief” is still relevant only for non-calendar year plans though the end of the plan year ending in 2016. The Section 4980H Transition Relief exempts applicable large employers (“ALEs”) with 50-99 full-time employees from penalties under Section 4980H of the Internal Revenue Code (the “Code”) and reduces the 95% threshold to 70% for other ALEs. The relief also exempts ALEs from having to offer coverage to dependents if certain requirements are met. For calendar year plans, the threshold is at 95% throughout 2016 and dependent coverage must be offered during each month of the year.
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The draft instructions to the C-Series Forms provide more detail and examples on how ALEs should prepare the forms. Instead of referring to “employers” throughout the instructions, the IRS has replaced that term in most cases with “ALE Member.” The reason for this change is to highlight the fact that each separate ALE Member must file its own forms. Examples related to completing the authoritative Form 1094-C highlight that each separate entity (determined based on employer identification number) is required to file its own authoritative Form 1094-C.
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As promised by the IRS last year, there are two new indicator codes for Line 14 of Form 1095-C. These new codes ask employers to indicate whether a conditional offer was made to a spouse. An offer of coverage to a spouse is conditional if it is subject to one or more reasonable, objective conditions. For example, if a spouse must certify that he or she is not eligible for group health coverage through his or her employer, or is not eligible for Medicare, in order to receive an offer of coverage, the offer is considered conditional.
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The draft instructions to the C-Series Forms reflect that the good faith compliance standard applicable to 2015 forms (under which filers could avoid reporting penalties upon a showing of good faith) no longer applies for 2016 ACA reporting. Going forward, reporting penalties may be waived only upon the standard showing of reasonable cause.
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The draft instructions to the C-Series Forms include new information related to coding for COBRA continuation coverage. There has been some uncertainty regarding how to treat offers of COBRA continuation coverage since the IRS removed relevant guidance from its Frequently Asked Questions website in February 2016. Similar to the 2015 instructions, the draft 2016 instructions provide that offers of COBRA coverage after termination from employment should be coded with 1H (Line 14) and 2A (Line 16) whether or not the COBRA coverage is elected. The new instructions now state that this coding sequence also applies for other, non-COBRA post-employment coverage, such as retiree coverage, when the former employee was a full-time employee for at least one month of the year.
In the case of an offer of COBRA coverage following a reduction in hours, the basic coding requirement is the same as in 2015 – the offer of COBRA coverage is treated as an offer of coverage on Line 14 of the Form 1095-C. The draft instructions expand on this basic requirement to explain how to code Lines 14 and 16 when the offer of COBRA coverage is not made to a spouse or dependent. In general, for purposes of Code Section 4980H, an offer of coverage made once per year to an employee and his or her spouse and dependents is treated as an offer for each month of the year even if the coverage is declined for the employee, spouse, and/or dependents. Under general COBRA rules, only those individuals enrolled in coverage immediately prior to the qualifying event receive an offer of COBRA coverage.
So how does this play out when an employee with a spouse and dependents elects self-only coverage during open enrollment and later loses that coverage due to a reduction in hours? The draft instructions treat the initial offer of coverage at open enrollment and the offer of COBRA coverage as two separate offers of coverage. To determine the proper coding, the employer must look at who had the opportunity to enroll at each offer. During open enrollment, the employee, spouse and dependent had the opportunity to enroll. Thus, until the reduction in hours and loss of coverage, the coding should be 1E (offer to employee, spouse and dependent) in Line 14 and 2C (enrolled in coverage) in Line 15.
In contrast, the offer of COBRA coverage was only available to the employee and, therefore, after the reduction in hours, the coding should be 1B (offer to employee only) in Line 14. If the employee does not elect the COBRA coverage, code 2B (part-time employee) could be inserted in Line 16. If, however, the employee does elect COBRA coverage, it appears that code 2C (enrolled in coverage) should still be inserted in Line 16. Although this latter coding sequence is likely intended to protect the spouse and dependents from being “firewalled” from a premium credit, there appears to be nothing to indicate that the employer should not be assessed a penalty for failing to make an offer to the employee’s dependents.
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The draft instructions for the C-Series Forms provide additional insight into how to calculate the number of full-time employees for purposes of column (b) in Part III of the Form 1094-C. The draft instructions clarify that the determination of full-time employee status is based on rules under Code Section 4980H and related regulations and not on other criteria established by an employer. Note that, currently, the draft instructions state that the monthly measurement period must be used for this purpose, but it appears that this is a mistake and that it should reference both the monthly measurement and look-back measurement methods. The IRS may clarify this in the final instructions.
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One important non-change in the draft instructions is that the specialized coding for employees subject to the multiemployer plan interim guidance remains in effect for 2016 reporting. The interim guidance provides that an employee is treated as having received an offer of coverage if his or her employer is obligated pursuant to a collective bargaining agreement to contribute to a multiemployer plan on the employee’s behalf, provided that the multiemployer plan coverage is affordable and has minimum value and the plan offers dependent coverage to the eligible employee. The coding for such as employee is 1H (no offer of coverage) for Line 14 and 2E (multiemployer plan interim guidance) for Line 16.
There will undoubtedly be tweaks to the draft instructions to the C-Series forms, but significant changes appear unlikely. Given that only five months remain in 2016, employers should start planning now for 2016 ACA reporting based on the draft instructions and make alterations as necessary when final instructions and other guidance is released.
See the original article Here.
Source:
Myers, D. A. (2016 August 4). 2016 draft forms & instructions released: affordable care act reporting update. [Web blog post]. Retrieved from address https://www.natlawreview.com/article/2016-draft-forms-instructions-released-affordable-care-act-reporting-update
Small businesses wait for verdict on 2017 health care costs
Here's an informative article on healthcare costs, from San Francisco Chronicle (SFGate) by AP Business Writer Joyce M. Rosenberg
NEW YORK (AP) — Autumn is an anxious time for many small and medium-sized business owners as they wait to learn whether their health insurance costs will go up for 2017 — and if so, by how much?
"There's always a lump in your throat because you don't know what you're going to get," says Darren Ambler, a managing director at Insight Performance, a Dedham, Massachusetts-based human resources provider.
Whether a business sees a minuscule rise, a double-digit percentage increase or even a decline depends on factors including the state where the company is located and how much its insurance carrier paid in claims over the past year. If the average age of a company's employees rose or fell significantly — quite possible in a business with 10 or fewer employees — that could also affect the outcome.
Most of the increase in insurers' costs is a result of rising prescription drug prices, Ambler says.
While companies with 50 or more workers are required to offer affordable insurance to them and their dependents, many smaller businesses also do so because they believe it's right or they want to attract and retain good employees. When their carriers hike the premiums, companies have to decide whether to absorb the costs, scale back their coverage or find other alternatives.
Several medium-sized clients of The Megro Benefits Co., a consulting company, are facing 38 percent increases in their 2017 premium costs. Surges like that have owners thinking about what's called self-funding, says Cheryl Kiley, an adviser at Conshohocken, Pennsylvania-based Megro.
In self-funding, a business pays for all or part of employees' medical costs and hires an insurance company to administer its health plan. Companies typically purchase special policies to reimburse them in the event of employees' or dependents' catastrophic illnesses. Insurance companies charge less to administer self-funded plans because they don't have any risk, and employers also save because self-funded plans aren't subject to a 6.5 percent federal tax on premiums.
Although companies may be forced to find alternatives, Megro isn't seeing clients dropping insurance, president Bob Violasays.
"People won't come to work for them unless they have health insurance," he says.
RizePoint, which makes software for the food, lodging and retail industries and has about 75 employees, is paying 16 percent more for premiums on a policy that renewed Sept. 1. It's already considering self-funding for next year.
"It's a little bit risky," says Peter Johnson, a vice president at the Salt Lake City-based company. "But I don't want to see another 16 percent increase — it's nowhere near sustainable."
Johnson had budgeted for a rise of 12 percent. When RizePoint's carrier said premiums were going up more than that, Johnson searched unsuccessfully for a cheaper policy.
Rocky Finseth had the opposite experience. His premiums fell 11 percent although the policy was virtually unchanged from a year ago.
"I was surprised not only about the drop, but how large of a drop," says Finseth, owner of Carrara Nevada, a Las Vegas-based company that does lobbying on state and local issues in Nevada. His policy, which covers seven staffers, renews Oct. 1.
Finseth didn't question why his premiums dropped. He decided to use the savings to add vision coverage for his employees.
Some companies find that their policies have been discontinued.
"The plan we had was mysteriously canceled, and we were slotted into what we were told was the same plan, but when you looked at it, it was a worse plan," says Joseph Nagle, marketing director at EverCharge, a maker of electric vehicle charging stations. Among other things, the new plan had a higher deductible — $6,000 versus $5,000.
EverCharge, based in Emeryville, California, began researching other carriers and plans, chose three and asked its seven employees which they preferred. The company, which previously paid for all its staffers' insurance, gave them an option of continuing to have fully funded coverage, paying about $10 per month for better coverage, or $120 for another. They chose the middle option, and EverCharge was able to keep its health care costs unchanged, Nagle says.
Jason Anderson, owner of Datagame, a Kansas City, Missouri-based maker of software for online market research, hasn't received his renewal package yet. Anderson pays 100 percent of his three staffers' premiums, and 50 percent of their dependents' premiums.
He had a 5 percent increase for his 2016 premiums, an amount he doesn't see as significant. He says he can handle a 10 percent increase, but if he's facing a 20 percent hike, he might have to cut back on coverage for dependents.
"I keep waiting for the shoe to drop," says Anderson, who acknowledges that he'd be angry at an increase in the 20 percent range. "I don't see 10, 20, 30 percent improvements in what I am able to charge my clients," he says.
See the original article Here.
Source:
Rosenberg, J. M. (2016 September 14). Samll businesses wait for verdict on 2017 health care costs. [Web blog post]. Retrieved from address https://www.sfgate.com/news/us/article/Small-businesses-wait-for-verdict-on-2017-health-9222107.php
Majority of workers cannot define copay, deductible
Do your employees understand the healthcare acronyms? Vlad Gyster explains how educating your employees can have a major impact on proper usage of healthcare benefits.
Very soon, thousands of employees across the United States will be choosing their health insurance. That’s scary, because there’s an emerging body of data that shows that most people don’t understand the basics of how health plans work. That knowledge gap may be causing some serious issues: From sick people not going to the doctor, to employees over-paying for health insurance.
If you're like most employers, there's a good chance that you're moving to consumer-driven health plan designs that employ a high deductible. In 2006, only one in 10 employees had a general health insurance deductible of $1,000 or more for single coverage. Today, nearly half do.
As adoption accelerates, benefit professionals find themselves in the midst of a developing crisis: Though HDHPs clearly help cut healthcare costs new research indicates that they do so in the worst way possible. Instead of shopping for better prices, sick people are simply not getting the care they need. As one of the study’s authors puts it: “We [didn't] find any evidence [employees] look for a lower cost. They just don't go."
Here's what’s puzzling: This isn't necessarily happening because of cost. This research is based on an employer that fully funded the deductible. As Vox explains: “In some cases, you could chalk this up to a liquidity issue: A worker might not have enough money in her checking account to pay for all the care below the $3,750 deductible. But that explanation doesn't work here: In this case, the employer put a $3,750 subsidy in workers' health savings accounts.”
So, what could it be? There could be many complex reasons. But there could also be a very simple one: 86% of people cannot define deductible, copay, coinsurance and out-of-pocket maximum. And people can’t properly use what they don’t understand.
A central assumption in consumer-driven plan design is that people can get the same care at a lower price and avoid care that they don’t actually need. To do that, employees need to be educated healthcare consumers, and companies have added tools to help. Utilization modeling and cost transparency technologies are becoming more and more broadly available. But there's a much more foundational piece of the puzzle that's been taken for granted.
In a paper published in Journal of Health Economics, researchers found that 86% of participants couldn’t define all of the following four terms on a multiple choice questionnaire:
· Deductible
· Copay
· Coinsurance
· Out-of-pocket maximum
While the healthcare industry is focused on utilization prediction and cost transparency tools, which are hard to create and implement, something quite basic is slipping right under our noses: Teaching people basic terms that they need to know to make informed decisions.
Understanding these terms is a building block of healthcare consumerism, without which a lot starts to unravel. If an employee doesn’t understand the terms that make-up every health plan design, it's hard to convince an employee to even switch to a high deductible health plan, even when it saves the employee money. It may also cause the employee to avoid care that she needs, because she has trouble predicting what she'll pay.
As more employers adopt HDHPs, a troubling reality is on the horizon: A healthcare crisis may be around the corner due to employees not getting the care that they need.
What to do about it
The good news is that healthcare consumerism isn’t a one-time event. It requires ongoing education and now is as good a time as ever to begin.
Here is something completely free you can do:
· Survey your employees to see what percentage understand basic health plan concepts.
· Send a weekly email to all employees defining each healthcare term, one at a time.
· Re-survey your employees with the exact same questions to measure the change.
This alone will give you a measurable starting point, a way to make progress, and measure the progress made.
See the original article from BenefitNews.com Here.
Source:
Gyster, V. (2016, June 27). Majority of workers cannot define copay, deductible [Web log post]. Retrieved from https://www.benefitnews.com/opinion/majority-of-workers-cannot-define-copay-deductible
Take out the earbuds
Intriguing artile from Benefits Pro by Marty Traynor
Walk around any workplace and unless there's a safety issue, almost every employee under 50 is wearing earbuds and remains focused on their own personal music zone. What a perfect metaphor for the barriers we must overcome to gain the attention we need for benefit purchase decisions.
With the fall enrollment season approaching, let's consider some of the ways we should work to “remove the buds” and focus employee attention on the process of benefit enrollment.
- Employer's earbuds must come out first. Employees are not the only ones ignoring the importance of benefit-related communications. Employers often think a simple introductory email is sufficient. That kind of communication is enough if the goal is to tell employees about an event. However, in no way does this type of message convey importance or opportunity. You must convince the employer that a well-designed campaign will be a big positive for them, both in terms of employee engagement and happiness with employee benefit options.
- Know your audience. Many otherwise great campaigns have failed because they are tone deaf to their audience. A program benefitting union members better not be littered with “employee” references. The graphics used to illustrate the benefit plan should also be carefully designed to match the demographics of the employee audience. Designers often tend to show “beautiful people,” but benefit plans need to be shown benefitting real people.
- Use multiple approaches to connect with people. You often hear about the importance of multi-channel benefit communications. Unfortunately, we cannot just say, “Alexa, create a multi-channel campaign to teach employees about their benefits and get them to enroll to best meet their needs.” We must do what's next best and create a campaign that gives employees information in multiple ways: web details, calculators, videos, printable pieces with brief, explanatory, and detailed options. Use on-site materials such as break room table tents and bulletin board posters to augment e-campaigns.
- Use “real speak” whenever possible. The benefits business is full of jargon. Studies have shown that words we use all the time are confusing; even a term like “premium” isn't clear. Most people think of premium as an adjective, meaning “expensive, special or high class.” They don't see it as an everyday expenditure, but rather as a luxury type of item. So when we say “your premium is affordable,” employees may immediately think we are trying to scam them. Watch the jargon, and use terms that make sense to employees.
- Get people in front of people. The best way to communicate is in person. Regardless of how effective an employer's enrollment system is, the most effective communications campaigns still have a human element. Personal meetings, group meetings or call center-based enrollments can all add the personal touch. Without a personal touch, a benefit enrollment campaign may seem empty to many employees.
- Make sure employees know what's in it for them. They need to understand the importance of good benefit elections for themselves. This helps ensure they credit their employer for offering a valued program, and ensures they will understand the importance of good choices in enrollment.
Good luck with your fourth quarter enrollments. Earbuds are not noise cancelling headphones, so there is still a great opportunity to break through to employees and make your benefit communications campaigns your best to date.
See the original article Here.
Source:
Traynor, M. (2016 September 13). Take out the earbuds. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/09/13/take-out-the-earbuds?slreturn=1474041704
Healthcare strategies that can save employers money
Todd Rolland compares the traditional strategies to new stratigies for healthcare savings in the artilce below.
It is no secret that employee benefit costs are rising. As an employer, we wonder what can be done to reduce costs and as an employee, we are curious if we are getting the best deal. Medical insurance costs are rising faster than many companies’ profit margins and outpacing inflation on a year-to-year basis.
Rising healthcare costs are eroding revenue unlike any other element within a business. Government regulations and rising premiums are also affecting cash flow which can impact all areas of business operations. Separating rhetoric and marketing from meaningful, impactful company-wide solutions is becoming increasingly difficult. However, as the paradigm shift of healthcare strategies gains momentum, sustainable solutions are becoming clearer.
There are evolving options with this new paradigm shift of healthcare strategies: traditional, direct contracting, reference-based pricing and bundled pricing. A strong market push for pricing transparency has created additional opportunities for employers to save money and control costs, and they are doing just that. Employers now have the ability to function much like the traditional PPO has historically functioned by negotiating directly with providers.
The traditional approach includes elements such as reinsurance, administration, PPO networks, pharmacy benefit managers, population health management, predictive modeling, multiple plan designs and wellness strategies.
New options
Direct contracting is also a viable option because providers are much more willing to contract directly with employers than ever before. The idea is to establish a delivery and pricing contract that accomplishes two primary objectives:
- An agreed-upon fee schedule for services performed that is less than typical insurance company PPO-contracted rates.
- Incentive for participants to utilize contracted providers for the care needed.
The third option, reference-based pricing, allows employers to structure partial self-funding plans that reimburse a certain percentage of Medicare reimbursements levels for claims. PPO fee schedules can be 100-200% higher than these Medicare rates. As a result, the reimbursement plan can save employers a considerable amount. However, there is still a risk in balanced billing. The direct contracting option protects the employer with balanced billing issues that they would otherwise experience with reference-based pricing methodologies.
Bundled pricing is rapidly evolving and creates a significant opportunity for employers to save money. Employers simply pay agree-upon cash pricing for surgeries performed on an outpatient basis, and in certain cases, an inpatient basis. The price includes all services including facility, surgeon, anesthesiology, pathology, radiology, etc.
Additionally, two strategies that are gaining attention around prescription costs are average script pricing and pass-through average sales price prescription pricing. Both offer employers opportunities to find significant claims savings.
See the original article posted on EmployeeBenefitAdvisor on August 9, 2016 Here.
Source:
Rolland, T. (2016, August 9). Healthcare strategies that can save employers money [Web log post]. Retrieved from https://www.employeebenefitadviser.com/news/healthcare-strategies-that-can-save-employers-money