Should virtual patients worry about the side effects of telemedicine?

Although telemedicine is expected to become more prevalent, there are many boundaries this new technology still has to cross. Jay Horton gives more insight in the article below.

Original Post from BenefitsPro.com on June 28, 2016

As technological advancements heighten the accuracy and immediacy of medical consultations conducted remotely, the practice of telemedicine has blossomed alongside.

A Research and Markets study released this week announced the worldwide virtual health care market should jump from last year's estimated $17.9 billion to more than $40 billion by 2021.

Driven by the steadily-increasing capabilities of digital communication, medical professionals are now only a click away from even the furthest reaches of the globe, and the widening access has opened up avenues for diagnoses and treatment once unimaginable.

However, while the availability of far-flung examinations has aided the work of rural practitioners and Doctors Without Borders volunteers, the growth of telemedicine as a practical variant to traditional hospital visits has brought to light thorny regulatory issues and widespread concerns over such programs' inherent limitations.

Although the most technologically adept remote-care facilities may obtain real-time vital signs data and control precision optics able to convey the smallest visual detail, critics fear the physical absence of diagnosticians will necessarily raise the risk that less-obvious symptoms only recognizable through physical presence (clammy skin, eye tremors, sweetened scents) would be ignored.

At this point, telemedicine remains a relatively niche alternative largely undertaken by only those prospective patients within the United States otherwise unable to easily obtain traditional care. A recent HealthMine poll found nearly a third of web-friendly consumers had yet to take advantage of the services primarily because of questions about when they would be most appropriate.

These numbers are widely expected to leap in the coming years, however. As long as telemedicine consults cut the costs of face-to-face visits so dramatically — estimates range from 50 percent to 5000 percent depending upon the nature of the meeting — health insurance companies and the large firms that subsidize the majority of their policies will aggressively urge consumers to choose the cheaper option.

Further complicating matters, state licensing boards have so zealously guarded their dominion that many doctors are forbidden from even offering an opinion when expressly requested by a regular patient vacationing elsewhere.

Literally hundreds of legislative remedies have been introduced on the local level this year as state governments attempt to streamline the process of virtual care. Still, with no clear federal rulings to outline the boundaries of telemedicine, there's an ocean of gray area separating the proposed measures.

The sheer novelty of the practice has also stymied efforts to ensure remote treatment will be reimbursed under Medicaid. While most officials agree some aspects of telemedicine should deserve full compensation, the varying degrees of aid currently in use range from the occasional scan of vital signs to exhaustive video interviews and analyses.

Defending the necessity of immediate legislation last week, Pennsylvania state Rep. Marguerite Quinn stated her case bluntly: "We're trying to put down some basic guidelines here to match policy with technology and make sure we're not thwarting the growth of this in the meantime.”

Read the original article at: https://www.benefitspro.com/2016/06/28/should-virtual-patients-worry-about-the-side-effec?ref=hp-news&slreturn=1468614391

Source:

Horton, J. (2016, June 28). Should virtual patients worry about the side effects of telemedicine? [Web log post]. Retrieved from https://www.benefitspro.com/2016/06/28/should-virtual-patients-worry-about-the-side-effec?ref=hp-news&slreturn=1468614391


Study quantifies skyrocketing copays for the insured

Dan Cook provides insight on reasons for the Skyrocketing copays in the article below.

Original Post fro BenefitsPro.com on June 28, 2016

There’s been considerable focus on health insurance cost-shifting to covered individuals and families since the passage of the Affordable Care Act. But much of the shift occurred before Americans started looking to insurance exchanges for less costly coverage.

That’s what a research team composed primarily of University of Michigan scholars found when insurance records for 2009 to 2013 were examined. The study found that inpatient hospitalization costs paid by patients rose 37 percent from 2009 to 2013, to the point that the average insured individual was paying more than $1,000 annually in shared costs.

The biggest driver of the increase were deductibles, which rose a staggering 86 percent during that period. Coinsurance was the second largest factor, rising 33 percent during that time.

More people are worried about the rising costs of health care than last year.

Individuals bore a greater share of the cost increase than did those with family coverage, the study said.

“In 2013, total cost sharing was highest for enrollees in individual market plans ($1875 per hospitalization) and consumer-directed health plans ($1219). Cost sharing varied substantially across regions, diagnoses, and procedures,” the researchers reported.

But it wasn’t just the average amount that the research team found troubling. Some among the insured were hit much harder than others by out-of-pocket costs, and that bears further investigation.

“Wide variability in out-of-pocket spending merits greater attention from policymakers,” the report concluded.

Additionally, more attention should be paid to cost-sharing trends among those with insurance rather than focusing just on the uninsured, the study’s lead author Emily Adrion told Fortune.

“There have been so many stories about how much hospital costs are for the uninsured and underinsured, but what’s lost is how much people with insurance are paying,” she said.

Read the full article at: https://www.benefitspro.com/2016/06/28/study-quantifies-skyrocketing-copays-for-the-insur?ref=hp-news&slreturn=1468802076

Source:

Cook, D. (2016, June 28). Study quantifies skyrocketing copays for the insured [Web log post]. Retrieved from https://www.benefitspro.com/2016/06/28/study-quantifies-skyrocketing-copays-for-the-insur?ref=hp-news&slreturn=1468802076


Civil Penalties Adjusted with Interim Final Rule for ERISA Violations

Released by the United States Department of Labor through The Federal Register on July 1, 2016.

Effective August 1, 2016, the amounts for civil penalties will be adjusted as required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015.

The interim final rule made adjustments to the civil monetary penalties enforced by the Employee Benefits Security Administration (EBSA) under the Employee Retirement Income Security Act of 1974 (ERISA). The adjustments apply to penalties assessed after August 1, 2016, whose violations occurred after November 2, 2015.
Some highlights of the new penalty amounts for ERISA violations include:
  • The maximum penalty for failure/refusal to properly file a plan annual report (Form 5500) increased from $1,100 per day to $2,063 per day the Form 5500 is late.
  • The maximum penalty for failure to provide a Summary of Benefits Coverage under the Public Health Services Act increased from $1,000 per failure to $1,087 per failure.
  • The maximum penalty for failure to provide an automatic contribution arrangement notice under ERISA increased from $1,000 per day to $1,632 per day.
  • The penalty for providing required CHIP notices under ERISA is increased from $100 per day to $110 per day
  • The maximum penalty for failure of a multiple employer welfare arrangement (MEWA) to file a report required by regulations issued under ERISA increased from $1,100 per day to $1,502 per day.
  • The maximum penalty for failure to furnish reports (e.g., pension benefit statements) to former participants and beneficiaries or maintain records increased from $11 per employee to $28 per employee.
  • The maximum penalty for failure to comply with ERISA requirements relating to genetic information increased from $100 per day to $110 per day.

To read the full release from The Federal Register, click here

Fact Sheet
FAQ


U.S. Department of Labor Proposes Improvements to Form 5500

Released by the United States Department of Labor on July 11, 2016.

Form 5500 affects us all and the Department of Labor is looking for your input on the proposed revisions to the form. Below you will find the proposed revisions and some details about them. 

The Form 5500 is the primary source of information about the operations, funding and investments of private-sector, employment-based pension and welfare benefit plans in the U.S. There are an estimated 2.3 million health plans, a similar number of other welfare plans and nearly 681,000 pension plans. Covering roughly 143 million private-sector workers, retirees and dependents, these plans have an estimated $8.7 trillion in assets.

The proposed revisions are intended to:

  • Modernize the financial statements and investment information filed about employee benefit plans.
  • Update the reporting requirements for service provider fee and expense information.
  • Enhance accessibility and usability of data filed on the forms.
  • Require reporting by all group health plans covered by Title I of ERISA.
  • Improve compliance under ERISA and the Internal Revenue Code through new questions regarding plan operations, service provider relationships, and financial management of the plan.

The proposed regulations also would make improvements to the certification requirements for the limited scope audit requirements under 29 CFR 2520.103-8, and allow group health plans to use the Form 5500 to satisfy certain reporting requirements in the Affordable Care Act. The proposed changes to the DOL regulations are also needed to implement the form revisions.

“The proposed form changes and related regulatory amendments are important steps toward improving this critical enforcement, research and public disclosure tool,” said Assistant Secretary for the Employee Benefits Security Administration Phyllis C. Borzi. “The 5500 is in serious need of updates to continue to keep pace with changing conditions in the employee benefit plan and financial market sectors. We must also remedy the form’s current gaps in collecting data from ERISA group health plans.”

To read the full article from the Department of Labor, click here


5 rules for engaging millennials in wellness

As wellness programs become increasingly popular, it is important to understand how to get your employees engaged. Dr. Rajiv Kumar lends 6 tips to engaging millennials in your wellness program in the article below.

Original Post from BenefitsPro.com on June 27, 2016

These days, you can’t pick up a newspaper or turn on the TV without hearing a new indictment of millennials.

You know the stereotype: this newest generation of employees is selfish, narcissistic, entitled, and impatient.

I understand where this portrayal comes from — no one admires the guy with the selfie stick — but it’s an inaccurate generalization of my generation.

In fact, a growing body of data has revealed that the millennial generation is more altruistic, socially engaged, and health-minded than our predecessors, making us perfect consumers for employee well-being programs.

The trick is to speak the language of millennials, and as a millennial myself, I’ve got some advice to share.

Here are my five rules for engaging millennial employees in employee well-being programs.

Rule 1: Be legit.

The key to earning the trust of millennial employees is authenticity. Mine is a generation that has grown up with the internet, and thus has a very keen eye for public relations spin, marketing jargon, and advertising. Millennials have grown up truly surrounded by marketing, and they’re a bit immune.

Research has shown authenticity is of utmost value to millennials. 70 percent of millennials will stay loyal to a brand that has earned their trust. And 75 percent view themselves as authentic, meaning that being legit is the truest way to earn that trust.

When you’re considering your well-being benefits, create a brand that resonates and accurately represents your workforce. Use images of real people instead of photo-shopped models. Offer programs that allow people to set their own goals, rather than impose parameters and benchmarks.

Avoid jargon and long detailed benefits explanations. Instead, be straightforward. You’ll telegraph authenticity and your employees will connect with your brand.

Rule 2: Cut to the chase.

The millennial preference for all things direct and convenient is unsurprising given our obsession with authenticity. A marketplace devoid of middle men, where consumers are empowered to make their own informed decisions, is a millennial touchstone. Some of the country’s most impressive consumer companies have tapped into this preference. Consider Uber, Roku, and Airbnb.

The attributes that define the millennial marketplace — speed, convenience, transparency — are the ones that will also shape the future of well-being benefits.

45 percent of millennials say they’re more likely to participate in health and wellness programs if they’re easy or convenient to do. This means that we need to make enrolling in well-being programs straightforward and easy if we’re going to attract the next generation.

Seek out vendors that offer Single Sign On (SSO) integrations to relieve your employees of additional accounts, usernames, and passwords. When possible, offer programs that are flexible — that employees can tackle in their own time, on their own schedule.

This flexibility means programs can easily be accommodated and adopted within an existing or preferred schedule, and your engagement rates will climb.

Rule 3: There’s gotta be an app for that.

An appropriate motto for the millennial generation is “all mobile, all the time.” It may astonish older generations to hear that even a PC is passé to a millennial. Instead, we rely on our phones, tablets, and even our watches for all of the information we need.

Wellness and benefits cannot expect to be an exception to this rule. To remain relevant to millennials, you must allow them to enroll, participate, and access resources from their phone. This is absolutely critical, as millennials have little tolerance for anything else.

The good news is the industry is catching up to these preferences. Many well-being vendors have native apps that employees can download and access through their phones and smartwatches.

When selecting your wellbeing program, find a vendor that is committed to mobile innovation — this trend is advancing rapidly, and you’re going to want a partner that keeps up with the swift pace of mobile invention.

Rule 4: Sharing is caring.

For a generation that is constantly in touch, frequently checking in online, and publicly voicing our opinions, sharing is an important part of millennial life — professional and otherwise. Contrary to the stereotypes, this tendency to “overshare” isn’t just about self-involvement or grandstanding. In fact, sharing opinions, publicly voicing feedback, and reaching out to others serve an important purpose.

More than any other generational cohort, millennials rely on our friends, family, and peers for recommendations and suggestions. This is particularly true in the consumer arena — consider sites like Yelp and Amazon — but it has important implications for well-being benefits as well.

If you’re able to get an enthusiastic group of early adopters to enroll in your benefits program, you’ll likely enjoy a successful ripple effect with millennials. That’s because word-of-mouth is the most effective form of marketing for my generation. This ties back directly to our obsession with authenticity — we trust the recommendations and views of our friends and peers more than the promotional efforts of a corporate department.

When you’re implementing a well-being program, devote time and resources to building a champions network that will get the word out, share updates, and encourage others to join.

This will attract hard-to-engage populations and keep them invested throughout the program duration. Find a well-being vendor that has experience creating champion networks and your program will benefit immensely.

Rule 5: Offer well-being, not wellness.

Unlike previous generations who have used traditional milestones to measure success — climbing the corporate ladder, getting married, buying a house — millennials aspire towards balance, in life and in work. In fact, 97 percent of millennials named happiness as a primary interest. It’s nearly unanimous.

This focus on balance extends to the way millennials conceptualize health, which is much more focused on well-being than previous generations. 72 percent of millennials say they exercise once a week or more, and 95 percent say they care deeply about their health.

For wellness benefits to be relevant to millennials they can’t merely focus on the physical realm of health — clearly, millennials are already on that bandwagon.

Instead, they’ll be drawn to a range of programs that address other ways to find balance and achieve happiness. For example, financial wellness is of great interest to a generation that’s shouldering record levels of debt. My generation would also benefit greatly from emotional resiliency programs, since we are incredibly stressed.

To engage millennials in wellness, you have to extend the definition to embrace holistic wellbeing, incorporating programs that address the multiple factors that contribute to work/life balance, including mental, social, and emotional variables. Companies that adopt this millennial view of well-being will be much more successful in attracting, retaining, and engaging the most powerful generation in the workforce today.

Read the full article at: https://www.benefitspro.com/2016/06/27/5-rules-for-engaging-millennials-in-wellness?ref=hp-blogs&page_all=1

Source:

Kumar, R. (2016, June 27). 5 rules for engaging millennials in wellness [Web log post]. Retrieved from https://www.benefitspro.com/2016/06/27/5-rules-for-engaging-millennials-in-wellness?ref=hp-blogs&page_all=1


States Offer Privacy Protections To Young Adults On Their Parents’ Health Plan

Michelle Andrews gives insight on how the ACA is impacting HIPPA and privacy for young adults. See her article below.

Original Post from Kaisher Health News on June 28, 2016.

The health law opened the door for millions of young adults to stay on their parents’ health insurance until they turn 26. But there’s a downside to remaining on the family plan. Chances are that mom or dad, as policyholder, will get a notice from the insurer every time the grown-up kid gets medical care, a breach of privacy that many young people may find unwelcome.

With this in mind, in recent years a handful of states have adopted laws or regulations that make it easier for dependents to keep medical communications confidential.

The privacy issue has long been recognized as important, particularly in the case of a woman who might fear reprisal if, for example, her husband learned she was using birth control against his wishes. But now the needs of adult children are also getting attention.

“There’s a longstanding awareness that disclosures by insurers could create dangers for individuals,” said Abigail English, director of the advocacy group Center for Adolescent Health and the Law, who has examined these laws. “But there was an added impetus to concerns about the confidentiality of insurance information with the dramatic increase in the number of young adults staying on their parents’ plan until age 26” under the health law.

Federal law does offer some protections, but they are incomplete, privacy advocates say. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a key federal privacy law that established rules for when insurers, doctors, hospitals and others may disclose individuals’ personal health information. It contains a privacy rule that allows people to request that their providers or health plan restrict the disclosure of information about their health or treatment. They can ask that their insurer not send the ubiquitous “explanation of benefits” form describing care received or denied to their parents, for example. But an insurer isn’t obligated to honor that request.

In addition, HIPAA’s privacy rule says that people can ask that their health plan communicate with them at an alternate location or using a method other than the one it usually employs. Someone might ask that EOBs be sent by email rather than by mail, for example, or to a different address than that of the policyholder. The insurer has to accommodate those requests if the person says that disclosing the information would endanger them.

A number of states, including California, Colorado, Washington, Oregon and Maryland, have taken steps to clarify and strengthen the health insurance confidentiality protections in HIPAA or ensure their implementation.

In California, for example, all insurers have to honor a request by members that their information not be shared with a policyholder if they are receiving sensitive services such as reproductive health or drug treatment or if the patient believes that sharing the health information could lead to harm or harassment.

“There was concern that the lack of detail in HIPAA inhibited its use,” said Rebecca Gudeman, senior attorney at the National Center for Youth Law, a California nonprofit group that helps provide resources to attorneys and groups representing the legal interests of poor children. She noted that HIPAA doesn’t define endangerment, for example, and doesn’t include details about how to implement confidentiality requests.

Concerns by young people that their parents may find out about their medical care leads some to forgo the care altogether, while others go to free or low-cost clinics for reproductive and sexual health services, for example, and skip using their insurance. In 2014, 14 percent of people who received family planning services funded under the federal government’s Title X program for low-income individuals had private health insurance coverage, according to the National Family Planning and Reproductive Health Association.

Even though most states don’t require it, some insurers may accommodate confidentiality requests, said Dania Palanker, senior counsel for health and reproductive rights at the National Women’s Law Center, a research and advocacy group.

“Inquire whether there will be information sent and whether there’s a way to have it sent elsewhere,” Palanker said. “It may be possible that the insurer has a process even if state doesn’t have a law.”

Insurers’ perspective on these types of rules vary. In California, after some initial concerns about how the law would be administered, insurers in the state worked with advocates on the bill, Gudeman said. “I give them a lot of credit,” she said.

Restricting access to EOBs can be challenging to administer, said Clare Krusing, a spokesperson for America’s Health Insurance Plans, a trade group. A health plan may mask or filter out a diagnosis or service code on the EOB, but provider credentials or pharmacy information may still hint at the services provided.

There’s also good reason in many instances for insurers and policyholders to know the details about when a policy is used, experts say. Policyholders also may have difficulty tracking cost-sharing details such as how much remains on the deductible for their plan.

In addition, “if a consumer receives a filtered or masked EOB, he or she has no way of knowing whether their account has been compromised or used as part of fraudulent activity,” Krusing said.

Read the full article and learn more at: https://khn.org/news/states-offer-privacy-protections-to-young-adults-on-their-parents-health-plan/

Source:

Adnrews, M. (2016, June 27). States offer privacy protections to young adults on their parents’ health plan [Web log post] Retrieved from https://khn.org/news/states-offer-privacy-protections-to-young-adults-on-their-parents-health-plan/


5 Top Employee Benefits Questions and How to Answer Them

Original Post from BenfitsPro.com

By: Monica Majors

Legislative changes continue to markedly affect the health benefits marketplace. Employers and their workers face challenges on a number of fronts. Along with those challenges come questions that range from current and future requirements of health care reform, to providing adequate plan coverage that serves employees well.

By understanding the top-of-mind employer benefit issues and responding to them appropriately and effectively, brokers and advisors can better serve existing clients, attract new ones, and help employees protect themselves and their families going forward.

1.     How can I meet my employees’ needs?

A key concern of today’s employers is making sure benefits they offer for both prospective and current employees are competitive. Businesses recognize the role a solid benefit program plays in attracting and keeping good talent, and they want to know what is included in plans offered by their competitors.

Brokers serving the health benefits marketplace can best serve customers by knowing the current market landscape well, speaking confidently about it and sharing that knowledge with customers. Key to this knowledge is understanding what the employer currently offers, what types of employees make up its workforce, what their needs are, and what gaps may currently exist.

Then, talk with insurers and learn what industry and market insight they may possess based on geographic and industry-specific factors. Search out findings made available from insurance- and customer-specific industry research organizations and trade associations. You can also mine data from within your own office, such as aggregated customer information by industry.

Integrate all of this information with comprehensive benefit offerings available from the carriers you represent, and show employers how they can gain a competitive market advantage with the right benefit plan.

2.     How can I control my costs?

The question of controlling costs is common for obvious reasons. Small groups, in particular, are looking for creative ways to keep their health benefit expenses down. Brokers can address this question by understanding current offerings and combining that with knowledge of the plans available through the carriers they represent.

Understanding the various coverage tiers available and sharing that knowledge with employers is key. Often, implementing a health benefit program that meets the minimum required coverage levels brings the lowest cost.

Other cost-reduction strategies include addressing coverage for dependents or part-time employees. Some employers may consider eliminating dependent coverage or reducing contributions for this coverage. Also, determine with the employer the cost versus the benefit of including part-time staff in the plan. Employers may need to make tough decisions to maintain viable programs for employees.

Employers need to consider other costs that may come into play. For example, new IRS and ACA reporting requirements for employers to notify employees about new mandates bring with them administrative expenses. While they may not be able to eliminate these costs, brokers can help provide guidance and increase awareness around the changing requirements. They can also recommend approaches that might help employers streamline the process to reduce the impact of the requirements.

3.     What about exchanges?

Employer questions about health benefit exchanges are prevalent. How do the exchanges align with the employer’s desire to deliver benefits in a cost-effective manner? What advantages do they offer? What are the drawbacks? Brokers need to be familiar with individual and group exchanges — both private and public.

Brokers working with some employers may find that certain tax advantages come along with using a public exchange. Private exchanges offer other benefits, from cost-management tools to a broader set of administrative support options and a choice of benefit options that extend beyond basic medical coverage. Group or employer-focused exchanges are becoming increasingly popular as a way to efficiently manage health benefits. Brokers should become familiar with the pros and cons, as well as processes involved.

It’s important to understand the advantages for different employer groups, as well as the reputation and satisfaction levels of exchanges, and use that knowledge to help employers select the right option.

4.     What’s on the horizon?

Large employers are concerned about looming changes. They wonder how new regulations—for example, the Cadillac tax —may affect them in the future. Brokers need to be knowledgeable about what is coming down the pike, and how to minimize negative resulting impacts.

Preparing for the Cadillac tax, for example, may require a strategy shift. While the tax is primarily levied against health plans for coverage deemed “too rich,” it will ultimately affect employers and workers. Health plans are likely to pass off at least some of the costs to employers in the form of higher premiums. Employers may then pass costs off to workers in the form of higher cost-sharing arrangements. Of course, employers will have to consider how this will impact employee retention and recruitment.

The Internal Revenue Service posts helpful information about the ACA’s requirements on employers on its website: irs.gov/affordable-care-act. The Centers for Medicare & Medicaid Services website is another valuable resource: cms.gov/cciio/.

5.     Why you?

The final top question may be one employers don’t explicitly ask; but it’s one you need to answer: “Why should I use you as a broker?” How is it that you set yourself apart from other brokers — industry knowledge, market strategy or customer service? Brokers need to carefully and clearly explain benefit plan designs, educate employers, guide them through the maze of changes in the benefits arena, and explain all the implications.

Building knowledge is the first part of the answer. Learn about laws, regulations and your employers’ workforce attributes. Learn more about the products offered by carriers and through the exchanges. Combine that knowledge with employer and employee data you capture to design programs that can help employers attract and retain good workers. Work with financially strong carrier partners to find and deliver the right benefit plans, and consider offering your clients a multi-year strategy where appropriate. And leverage administrative, technology, client portals and other resources your carrier partners offer.

Be sure to document and explain the advantages you can bring to the employer. Also, encourage satisfied customers to provide testimonials, directly and on social platforms, and then share these testimonials and references to help differentiate yourself and your shop from your competitors.

By understanding the needs of your clients, offering cost control solutions and keeping businesses apprised of changes on the horizon, you set yourself apart from other brokers and demonstrate your value as a trusted adviser. New and existing clients will come to you year after year for help in designing affordable health benefit plans that will attract and hold onto good workers.


3 Key Takeaways of Designing Employee Benefits Programs

Original Post from BenefitsPro.com

By: Nate Randall

Throughout my career, I’ve had the good fortune to work for a variety of industry leading organizations from stratospheric startup Tesla Motors to Fortune 100s Safeway and Washington Mutual.

I planted myself knee deep in managing, analyzing, and creating everything related to employee benefits and have learned more than a few finer points along the way.

The common thread across these three companies was a genuine desire and drive to apply innovative, forward-thinking approaches to change and improve the way employee benefits are delivered.

I’ve reflected on my experiences to give you three takeaways that helped these companies make the biggest impact possible with their benefits and employee experience programs.

Innovation isn’t easy

Much has been written about long work hours. Stories abound of people sleeping in their cars or under their desks and subsisting on Top Ramen and frozen vegetables. That might exist for you at some point along the path, but that’s not the type of innovative environment that I’m talking about here. I am talking about an atmosphere that applies a conscious drive for change which can lead to meaningful acceptance of new ideas.

Whether you’re rethinking the value of the way health insurance is delivered to families or trying to disrupt a 100-year-old automotive industry, mindfully striving for innovation isn’t a cakewalk.

That’s because humans are programmed not to like change, and for many, working through innovation doesn’t come naturally. It takes a laser-focused and cognizant decision to examine the way things are traditionally or typically done. To do that, you’ll need to gather data, build a team, prove a case, influence, iterate, fail, and to achieve success, you’ll need to do all of these things quickly with minimal errors and missteps.

In my experience, it all comes down to the team that you surround yourself with. When hiring or building your team, I always advise to think creatively about your problems and look for passion in those you recruit. More important than having “done it before” is an intense drive to solve problems and an underlying interest in the core subject.

Early in my career at Tesla, an HR manager said to me, “there are three reasons people come to Tesla. Either they are passionate about cars, passionate about the environment, or passionate about their chosen profession. And Tesla is the best place in the world to be for all three of those things.” Notice there is nothing about money, benefits, or perks. That brings me to the second lesson I’ve learned..

Top talent doesn’t care about perks (until you take them away)

Rarely do candidates and their families make the decision to change their lives — in some cases moving across the country or world — because of the benefits and perks you offer.

Attracting top talent is about storytelling. It’s about having a mission and purpose that a person (and his or her family) can identify with through hard work. I have literally witnessed thousands of people join a common mission early on with little more than unlimited cereal and coffee being offered as the perk. And this was in the geographic backyard of arguably the most intense company perk culture on the planet in Silicon Valley. At the end of the day, people want to feel like they are contributing to something bigger than themselves.

Don’t get me wrong, I don’t mean to imply employees don’t care about the benefits offered to them. They must be satisfied knowing that the basics — health, disability, life insurance, and retirement — are covered. But in my experience, top talent doesn’t make the decision to join a company because of free lunches and massages on Wednesdays.

Keeping that in mind, it is extremely important to construct benefits and perks with care and thought. Once implemented, any experienced HR manager will tell you his or her sad tale of trying to take something away that people are accustomed to.

It’s also imperative to align benefits with perks. Trust me, employees notice if either appears alien to the company culture and mission. I learned this lesson at Safeway during a program that linked the amount of premium a person paid for health insurance to their biometric measures like blood pressure and cholesterol. Employees scratched their heads wondering why the company cafeteria featured cheap burgers and sodas in comparison to the healthy (but pricey) salad bar if poor eating habits could potentially equate to higher health insurance premiums. To promote the healthy lunch options, we had to align its costs with the culture we were trying to foster.

Silicon Valley has become legendary for perks and what many of my colleagues across the country consider frivolous and extravagant benefits. While I agree that many of the Valley’s largest and most iconic brands along with many wannabe cool kids are foolishly wasting time, resources, and money on programs that really do not serve any identifiable goal, I will argue that offering smartly aligned, personalized benefits and perks are the wave of the future. And that brings me to my third and final take-away...

Let the people choose

We have a lot of choice in our lives. We choose the items, price points, and brands to put into our carts when shopping at Safeway. Every Tesla purchase is made to order, built to the specific requirements of the buyer. Google organizes information to make it individualized and useful. Amazon provides a personalized online shopping experience. Uber and Airbnb tap into excess individual capacity in existing systems to create value. We all have different needs, priorities, family situations, and interests, so is it so difficult to offer benefits that can be personalized, too?

The traditional way of offering limited choice employee benefits and perks for everyone (i.e., group benefits) is outdated and bloated with waste. Upwards of 30 percent of compensation costs are funneled to these traditional benefits and American companies spend over a trillion and a half dollars on these inefficient benefits per year.

And that doesn’t even include any so-called perks. In my own research, most employers are paying anywhere from $7,000 to $25,000 per year for a single traditional benefits package. That’s a huge chunk of change and much of those benefits will never be used by the individual if it doesn’t apply to their situation or they find no personal value in it.

Instead of these antiquated and engorged traditional benefits, smart people are creating systems and methods whereby employees can build personalized benefits packages that meet individual needs and circumstances. Giving people the choice and ability to craft what they need can and will make a real difference in people’s daily lives.

Adoption by forward-leaning employers along with regulatory cooperation will finally result in a system for employee benefits and perks that is modern, flexible, and valued. A system that looks like the rest of our world: personalized.


Health Care Consumerism Is More Than A Benefit Design

Original Post from BeneftisPro.com

By: Steven Auerbach

The shift to health care consumerism is well underway. Trends continue to point to increased financial responsibility for consumers with rising deductibles, increased consumer out-of-pocket responsibilities, and accelerated adoption of consumer-directed health care plans (CDHPs), health savings accounts (HSAs), and other account-based benefit offerings.

According to Mercer, enrollment in CDHPs among large employers nearly doubled in the past three years from 15 percent to 28 percent of covered employees.

Employer adoption of these consumer-directed benefit designs will continue to grow for the foreseeable future, driven by the need for cost control, the impact of health care reform and the looming excise tax. The costs of providing health care continue to rise, surpassing $25,000 for an average family for the first time in 2016 (Milliman Medical Index).

However, the fact that the term “consumer-directed health care (CDH)” has become almost synonymous with CDHPs and HSAs is a bit of a misnomer. In reality, CDH is much more than a benefit design – it is a paradigm shift for how consumers must manage their health care and make health care decisions going forward.

Dimensions of consumer-directed health care  

The underlying premise of CDH is that, if given more financial responsibility for health care and empowered to make informed decisions, consumers will make better choices – leading to improved health outcomes and decreased overall health care costs. Implicit in this definition are two equally important dimensions:

  1. Benefit designs that require increased consumer financial accountability
  2. Empowerment and engagement to support decision-making

The market has made considerable progress shifting to benefit models that increase consumer financial responsibility, as evidenced by the data above. While new plan designs have been created and successfully implemented, financial accountability is only the beginning— behavior must change too, not just costs. We have only just begun to unlock the second dimension of health care consumerism.

Giving somebody new responsibility without the education, tools and support to manage those responsibilities is like giving a teenager the keys to the car without teaching them to drive.

Unlocking consumer engagement

So where does the health care industry really stand in terms of engaging and empowering consumers to make better choices?  The health care industry is still struggling to drive meaningful consumer engagement.

Consumer fluency is low. Alegeus research is clear that consumers still don’t have a good grasp on how the plans work, how to predict and manage out of pocket costs, how to determine coverage, etc.  Engagement overall is low. The average consumer interacts with their health plan just one or two times per year – and more than 40 percent of members have never taken the time to log-on, dial-in, subscribe, or download any content from their benefit providers.

And in many cases, consumers are resistant to change. When asked whether they wanted to take a more active role in managing their health care, 50 percent said no thanks.

Employers are now spending nearly $700 per employee on various employee engagement programs related to health care, per Fidelity. There are more tools and resources than ever before. Yet most of these programs are delivered with a “one-size-fits-all” approach, and the consumer experience is still very fragmented.

However, by its very nature, CDH may be the key to unlocking consumer engagement. CDHP members are significantly more engaged than their counterparts in traditional coverage for one very important reason…

People pay attention to their money

According to our research, people enrolled in CDHPs scored universally higher on all measures of engagement.  CDHP members:

  • Are considerably more fluent in the details of health care coverage, costs and billing
  • Are more value-conscious - 50 percent more likely to research and compare costs for health care purchases
  • Interact more frequently– the average CDHP member interacts with their account 10-50 times per year
  • Leverage available resources & channels - one-third more likely to consume content and engage with their benefit service providers through available channels
  • Are more likely to participate - twice as likely to participate in employer engagement and wellness programs

Although CDHP members interact more frequently, the key to true engagement and behavior change is not just driving more interactions, it is driving strategic engagement that is targeted, timely and relevant.

Health & wealth must converge

The path to true, meaningful engagement in health care may lie in the convergence of these financial components with the traditional health care domain.  No matter what age, health status, or consumer segment, the responsibility for managing finances and costs will become universal.

The convergence of claims, financial transactions and other behavioral and demographic data will provide a robust foundation for targeted engagement.

The fact that consumers pay closer attention to their finances presents a unique opportunity to tap into a captive audience with personalized offers, messages and value-added tools designed to improve engagement, influence behavior and enhance decision-making.

For the vision of consumer-directed health care to be fully realized, it is imperative that employers and benefit providers do not overlook the critical importance of education and targeted engagement to empower better decision making – and better outcomes for all stakeholders.


Core Benefits Drive Satisfaction More Than Niche Offerings

Original Post from SHRM.org

By: Stephen Miller

Improving traditional core benefits could be the best way to increase employees’ satisfaction with their rewards mix, new research suggests.

The three offerings with the greatest effect on how employees rate their benefits are health insurance, 401(k) retirement plans and vacation/paid time off. Among these, health insurance was by far the biggest driver of employee satisfaction, according to a new study, Which Benefits Drive Employee Satisfaction?, from Glassdoor Economic Research, the research arm of career website Glassdoor.

At organizations where employee ratings of the employer-provided health coverage increased by 1 star (out of 5), there was also a statistically significant increase in average employee satisfaction with the overall benefits package. (See graph above, from Glassdoor Economic Research. *Denotes that the increase in the overall benefits rating was statistically significant.)

Notably, 4 in 5 U.S. workers report they prefer new benefits or perks to a pay raise. This finding supports a recent Glassdoor survey that found health insurance, paid time off and 401(k) plans are among the top benefits employees would prefer over a pay increase.

Benefits with Narrower Appeal

Two benefits that did not seem to have a significant impact on overall employee satisfaction were maternity/paternity leave and employee discounts.

“Though many employers have added generous maternity/paternity leave plans, it is possible benefits that are not used by a large subset of employees do not impact overall benefits package satisfaction,” the researchers suggested.

“We know benefits and perks are an important recruiting tool in today’s challenging hiring landscape, and this study shows that the flashiest or trendy benefits aren’t always better,” said Andrew Chamberlain, chief economist of Glassdoor. “Investing in core benefits programs like health care coverage, retirement plans and paid time off will go far with new and current employees. Other benefits, like maternity/paternity leave, are important to recruit and retain smaller subsets of employees—like new parents—though we saw little impact on overall satisfaction related to benefits that don’t touch a wide variety of employees.”

He advised, “Employers who have well-rounded compensation plans that include core benefits, fair and competitive pay, and desirable perks stand to attract and retain top talent.”

A separate Glassdoor Economic Research study, The Best Industries for Benefits, found that the best benefits packages, according to employees, are found in the finance and technology industries.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.