Employee benefit satisfaction has direct relation to job fulfillment
New reports say that employees would sacrifice pay increases for better benefits. Heres some tips on how to keep your employees satisfied.
A link between the satisfaction workers feel about their benefits — both employment based and voluntary — has a direct relation with retention opportunities for employers.
Eight in 10 employees who ranked their benefits satisfaction as extremely or very high also ranked job satisfaction as extremely or very high, according to Employee Benefit Research Institute’s recent 2017 Health and Workplace Benefits Survey. Additionally, nearly two-thirds of respondents who ranked benefits satisfaction as extremely or very high ranked their morel as excellent or very good.
“It is important for employers to understand that benefits continue to be valued by employees,” says Paul Fronstin, director of the health research and education program at EBRI. “Health insurance, retirement plans, dental, vision and life insurance continue to be highly important when making job change decisions.”
In fact, the survey finds that more than four in 10 respondents say they would forgo a wage increase to receive an increase in their work-life balance benefits, and nearly two in 10 state a preference for more health benefits and lower wages.
Employees continue to indicate benefits play a key role in whether to remain at a job or choose a new job. Since 2013, health insurance consistently remains one of the top benefits that employees consider in assessing a job change.
Last year, 83% say health insurance is very or extremely important in deciding whether to stay in or change jobs. A retirement savings plan is also one of the critical benefits, with 73% indicating it is extremely or very important in determining whether to stay in or switch jobs.
Although employees say they are generally satisfied with the employee benefits provide today, there is a growing concern benefit programs might start to dwindle. When asked, only 19% of respondents say they are extremely confident in what will be provided will be similar to what they have now in three years.
Other challenges remain
“The challenge is how employers can continue to provide the strong employee benefits package that employees want and need, while still controlling the costs of these benefits, particularly healthcare,” Fronstin notes.
Employee education on benefit offerings could use some beefing up. According to the study a little more than one-half (52%) of employees say they understand their health benefits and 43% indicate they understand their non-health benefits very/extremely well.
Some of this limited understanding of benefits may come from the lack — or perceived lack — of benefit educational opportunities that employees are receiving from their employer, according to the study.
Nearly one-third (31%) of employees indicate that their employer or benefits company provides no education or advice on benefits. Only 39% state that their employer provides education on how health insurance works, 24% say that their employer provides education on how a health savings account works, and 28% confirm that their employer offers education on how to invest money in their retirement plan.
In any case, Fronstin adds, “as employers weigh the future of benefits, they should consider that health insurance consistently remains one of the top benefits that employees consider in assessing a job change, with retirement savings plan also viewed as a critical benefit.”
SOURCE:
Otto N (4 June 2018) "Employee benefit satisfaction has direct relation to job fulfillment" [Web Blog Post]. Retrieved from https://www.benefitnews.com/news/employee-benefit-satisfaction-has-direct-relation-to-job-fulfillment
Five Practical Ways to Support Mental Well-being at Work
Mental well-being impacts engagement, absenteeism and productivity. Discover how help make the workplace atmosphere and environment more pleasant with these tricks.
The American Institute of Stress reports that stress is the nation’s top health problem. This makes sense, as mental capacity is highly valued in the workplace but can also be highly vulnerable. Today’s workplace, with technology, fast-paced growth and decreased resources, can contribute to increased stress.
Companies should value the mental health of their employees as a top asset and fiercely protect it. Mental well-being impacts engagement, presenteeism, absenteeism and productivity — all of which impact businesses bottom lines. More importantly, supporting and protecting the mental health of your employees is the right thing to do.
Here are five best practices to support mental health in the workplace.
- Normalize the conversation.
Top-down support of mental health is crucial in creating an open dialogue, as is an open-door policy. Senior leaders should participate in the conversation about mental wellbeing to show buy in. Normalizing the occurrence of a grief reaction or stress disorder can insure that your employees seek help when it happens to them.
Establishing mental health champions within your organization is another way to encourage a healthy dialogue. People with mental health conditions who want to help others are great candidates for this role.
Use awareness days that focus on stress and mental health as external nudges to educate staff about these important issues. Importantly, remind staff that a diversity of perspectives, including those with lived mental health experiences, are valued and encouraged in inclusive environments.
- Implement strong policies and procedures.
Disclosure can help an employee seek the appropriate resources and care before conditions worsen, so having proper policies and procedures in place are important in removing barriers to disclose.
This includes protection against discrimination, which is usually a top concern for employees, as well as providing appropriate workplace accommodations. Ensure managers are aware of key resources, like employee assistance programs, and maintain confidentiality when an employee discloses information.
Beyond this, educate employees on policies, procedures and proper protocols to increase employee awareness. Here’s a tip: Repeat key messages and tailor your communications to better reach your staff.
- Prevention is better than cure.
It’s essential to remember that anyone is susceptible to stress and a resulting decline in their mental health, whether a preexisting condition exists or not. Big life events like having a baby or losing a loved one and every day struggles like money worries, relationship issues or work-related stress can cause or aggravate mental health conditions to the point of interfering with work.
Mental wellness sessions or work/life balance programs can help. Bring in an expert and talk to your staff about how to safeguard their own mental health, build resilience and recognize signs of distress in others.
- Tailor your benefits package to support mental wellbeing.
Choose a major medical plan that gives employees access to quality mental health specialists in network, as these costs can add up significantly. Helping employees have access to and triage the right specialist support is crucial in managing conditions.
EAPs can act as a first line of defense for a wide range of problems – from money and relationship worries to support for working caregivers. They provide both practical and emotional support for employees through confidential counseling and can help prevent issues from escalating and impacting productivity. These programs are often offered as part of a major medical or disability plan, so your company may already have access to them.
Money worries can also take an emotional toll on wellbeing. In fact, financial concerns were the leading cause of stress across all generations in a recent consumer study conducted by my company, Unum.
Help your employees establish a strong financial foundation by offering financially-focused benefits, like life and disability insurance, retirement savings options and supplemental health benefits that can close the rising financial gap in medical plans.
If your budget doesn’t cover these benefits, consider offering them on a voluntary basis. Access to financial protection benefits are more affordable when offered through the workplace, even if the employee picks up the cost.
Flexible hours or remote working options can also help employees schedule their work days when they’re feeling most productive. This can help reduce presenteeism for mental ill-health, and it also signals to employees that you’re supportive of a healthy work/life balance.
- Encourage self-care.
Self-care plays a critical role in overall wellbeing. Encourage employees to do small tasks that’ll help them build resilience over time.
The basics like getting plenty of sleep, eating healthy, drinking water, and exercising are foundational in overall wellbeing.
Beyond these staples, developing appropriate time management and work/life balance skills are also important. Delegating and collaborating are also key to ensure healthy work behaviors which also decrease stress.
While technology and our always-on culture make it hard to disconnect, encourage employees to set device off-times so they can fully recharge before the next day. And most important, model this behavior to your staff and limit after hours work and emails.
Having a holistic mental well-being strategy that includes prevention, intervention and protection is essential for unlocking a workforce’s true potential.
SOURCE:
Jackson M (4 June 2018) "Five Practical Ways to Support Mental Well-being at Work" [Web Blog Post]. Retrieved from https://www.workforce.com/2018/05/18/five-practical-ways-support-mental-well-work/
4 perks to make your employees' lives easier and less stressful
Recruit top talent with ease and confidence when considering these tips on attractive, creative and innovative employment perks.
A 2016 survey from Glassdoor found that 57 percent of people looking for jobs said benefits and perks are among their top considerations when weighing offers. So how can a company stack the deck in its favor when recruiting top talent? Although some companies limit their benefits packages to traditional offerings such as health insurance, 401Ks and paid time off, a today’s forward-thinking employers know they need to find more creative ways to offer benefits that make a genuine difference in employees’ day-to-day work and personal lives.
As competition for employees intensifies, the race to improve employer-based services is likely to result in better options for employees. Unconventional benefits options come in many shapes and forms, but they share one thing in common: the goal of saving time for employees, reducing their stress, and ultimately improving their health and satisfaction at work.
All other things being equal, companies that offer innovative perks that speak to the well-being of their employees are more likely to attract and retain the top talent in their field. Here are a few such perks to consider.
Expectant-parent counseling
You’ve thrown the baby shower, cut the cake, helped carry staff gifts to the car—and you’ve explained the company’s parental leave policy in detail. As you wave Julie from accounting off with best wishes, you’re confident she’ll come back to her desk in a few months’ time.
But the truth is that 43 percent of women who have babies leave the workforce permanently within a matter of months. Many say it’s because they don’t have adequate support at home to enable them to resume their careers. That is why companies like Reddit and Slack use a service called Lucy that provides expectant employees help before, during, and after parental leave, including 24/7 messaging and one-on-one sessions that can be done in the home or online.
As Reddit VP of People Katelin Holloway put it, “It’s not enough to simply offer parental leave; every child and family is different and has independent needs.” By helping expectant parents find resources that meet their specific needs, you’re making an investment in your workforce that pays enormous dividends in retention, productivity, and morale.
Caregiving support
A Gallup survey revealed more than 1 in 6 full-time or part-time American workers has difficulty balancing caring for elderly parents with their work commitments. This results in decreased productivity and frequent leaves of absence. Companies can help their employees cope and stay engaged with their work by providing concierge services that offer amenities such as taking elderly parents to doctor’s appointments and eldercare coaching when choosing between assisted living options.
To help reduce stress (and retain highly specialized employees), take a cue from companies like Microsoft and Facebook, which provide caregiver paid-leave programs to help employees care for ailing family members or sick relatives.
Dry cleaning at work
Sometimes it’s the little things that save time during the workday that can push the needle in your favor as a potential employer. It may sound trivial, but company-provided dry cleaning is a perk that’s proving to be a big draw in workplaces from Wall Street to Silicon Valley. Service providers pick up employees’ laundry or dry cleaning items from work and return them to a designated employer closet in their office building—one less errand, and no more lost tickets. “People have lives to live, so I try to make it easy for them to deal with any of those personal errands that could take up time for them,” said Experian CEO Craig Boundy, speaking about his company’s employee benefits programs in an interview with the The Orange County Register.
Car maintenance and service
According to the U.S. Bureau of Labor Statistics, the average American household owns 1.9 vehicles and spends around 1.5 percent of its annual income on auto maintenance and repairs. Cars are a significant investment for most of us, so the more you can help potential employees save time and money on maintaining their vehicles, the more tempting you’ll become as an employer. Growing numbers of innovative companies provide car repair services to help employees save money, find the best quality mechanics, and reduce stress associated with the entire process.
Some firms also offer on-site car wash services, giving employees peace of mind and a positive outlook as they drive home after work. Several big Silicon Valley corporations —including eBay, SanDisk, Cisco, and Oracle—use BoosterFuels to fill employees’ gas tanks while they’re at work. It saves employees time and protects them from potential accidents or robberies at gas stations.
SOURCE:
Weiss Y (31 May 2018) "4 perks to make your employees' lives easier and less stressful" Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/05/11/4-perks-to-make-your-employees-lives-easier-and-le/
Managing Benefits for High-Turnover Employers Is Different. Here's How to Cope
High turnover employers who are constantly hiring and firing employees need to feel comfortable with their plans. These tips will help direct you on how to deal with rapid change.
The rising costs and increased regulation of employee benefits have become a distraction for even the most smoothly running U.S. employers.
For organizations characterized by constant workforce turnover, those distractions can prove detrimental to their bottom line.
Take for instance, the retailer that routinely adds 25 new hires a month. Or the restaurant group that holds semi-monthly training orientations to remain adequately staffed for each shift. Or the manufacturing company that hires and fires up to 40 people a week to keep up with the production schedules.
In the mad scramble for personnel in these high turnover industries, it’s common to see benefits get lost in the shuffle. Mid- and large market employers, by sheer volume alone, are even more susceptible to the pains of maintaining a compliant benefits program in the midst of persistent staff turnover.
If your book of business includes employers that fit this criteria, the following practices will serve you (and, most importantly, your client) well.
- Audit, Audit, Audit
Conducting frequent, meticulous audits of the insurance carrier bills and invoices is critically important for employers with high turnover.
At least once a month, a representative of the company, or the broker, needs to cross-reference the most recent carrier invoice with payroll. How many employees listed on the invoice have been terminated in the last thirty days? Are there any employees on payroll being deducted for coverage that do not appear on the invoice? For cost and compliance purposes, it is imperative that the employer knows the answer to both questions each and every month.
If bills from insurance companies are not being actively audited, it is probable that the employer is paying for coverage that they shouldn’t be. For ancillary coverages like vision or basic life insurance, an incorrect cost likely won’t break the bank. But if medical carrier bills are left unmonitored, the premium dollars for ex-employees can add up to thousands, even tens of thousands, of dollars each month depending on the size of the employer. Bill and payroll audits also add a second layer of protection for newly-hired employees. Let’s say a new hire elects his or her benefits after satisfying the company’s 60 day waiting period. The coverage effective date should be April 1st, but the employer or broker never enrolled them in the carrier systems.
April 1 rolls around and the employee presumes they have medical coverage. A month later, they have an accident that forces them to seek emergency treatment. At that point, the individual is told that the insurance company has no record of them being an active insured. Had the employer reviewed payroll and the April carrier bill, they would have avoided a potentially major compliance and coverage issue – not to mention a scary situation for their employee.
- Ongoing Communication
Ensuring that bill/payroll audits and other necessary managerial tasks are performed is a two-way street, though.
Today’s employers are not alone in the often tumultuous administration of employee benefits. Brokers, consultants and advisors have stepped in over the years to relieve their client organizations of the day-to-day benefits responsibilities. However, even the most involved third parties can’t manage the entire benefits program from end to end. An enduring communication stream must exist between client and advisor.
For employers with recurrent staff turnover, communication becomes even more critical. As employees come and go, these organizations must lean on their brokers for administrative counsel. Enrollments, terminations, eligibility, troubleshooting issues, carrier negotiations/interactions and the countless other administrative duties of a benefits advisor have become too burdensome for employers to take on alone.
Large, high-turnover companies are especially reliant on broker partnerships to ensure that the daily benefits tasks aren’t impeding their core business objectives.
Modern benefits advisors should understand their clients’ businesses inside and out and view themselves as an extension of the team. What are their organizational objectives? What are their three and five-year plans? How does the employee benefit program factor into those plans? And let’s face it… high turnover employers typically translate into higher maintenance clients. They require a greater level of administrative support than companies characterized by long employee tenure.
With more change comes more responsibility, and with more responsibility comes the need for more frequent communication. A dutiful broker should set the expectation that they will be available every day to handle any issue for these high-turnover clients.
- Benefit Administration Technology
The evolving role of technology in the administration of benefits is a saving grace to high-turnover employers. Ben-Admin Systems (BAS) have simplified every clerical process for companies of all sizes.
At the low-functionality end, BAS can serve as editable cloud-based storage houses for employee demographic info and benefits data. At the high end, BAS allows for an employee-user experience where benefit elections and terminations are integrated directly with the insurance or payroll companies at the click of a button. In either case, the emergence of BAS options has streamlined administrative processes, while greatly reducing the potential for human error. Cumbersome tasks like payroll audits are now systematized and can be completed in a matter of minutes.
Successfully pairing an employer with a ben-admin system requires strategic consideration and consultation. Despite what the system architects might tell you, these platforms are not “one size fits all.”
Let’s profile a 3,000 employee retailer, as an example: The group has 125 locations nationwide, with approximately 24 people employed at each store. 75% of the workforce is between the ages of 16 and 35, with the remaining 25% scattered in between 36 and 60 years old. 40% of the staff are considered part-time employees based on weekly hours worked, leaving 1,800 benefit eligible employees. The average monthly staff-turnover across the organization is 85 employees – meaning that the rate of annual turnover is 34%.
With all these moving parts, the retailer requires a technological solution to help manage their ever-changing business. The retailer needs data-housing capability to administer their benefits and payroll as a single large entity, rather than 125 separate ones. It needs payroll integration with insurance carriers so that their up-to-date employment numbers accurately reflect the $325,000 in premiums they pay each month for coverage. It needs a customized employee-user interface where their 1,800 benefit eligibles can enroll in or modify their elections. It also needs a solution capable of maintaining a compliant benefits program. COBRA, FMLA, Section 125, ERISA, Form 5500… – every government regulated standard for an employer of this size should be addressed within their ben-admin system.
Like any major business decision, this technology piece needs to be implemented thoughtfully. If selected and negotiated with precision, the right ben-admin system is capable of effectively managing even the most disjointed high-turnover employers.
SOURCE:
Odishoo S (31 May 2018) "Managing Benefits for High-Turnover Employers Is Different. Here's How to Cope" [Web Blog Post]. Retrieved from https://www.thinkadvisor.com/2018/05/04/managing-benefits-for-high-turnover-employers-is-d/?slreturn=20180431130207
The Business Case for Providing Health Insurance to Low-Income Employees
Low income employees without health insurance could be detrimental for a business. This study explains why providing health insurance for low income employees is crucial for successful performance in the workplace.
After the failed negotiations over the repeal of Obamacare earlier in March, the Trump administration appears to be on the brink of proposing a new health care bill. While the details are still sketchy, it seems likely that the new bill will leave many lower-income Americans without access to health insurance.
I believe there is a case to be made that, should this take effect, the private sector has a strong incentive to step in. The provision of health insurance by organizations is a sensible business decision—especially for low-income individuals. In fact, a number of studies—including one that I co-authored—highlight that health insurance coverage can be beneficial to the bottom line of businesses, and should be endorsed by managers as good corporate strategy if they seek to increase their productivity.
Health insurance for low-income employees is good business for at least three reasons: it is linked with reduced levels of stress, more long-term decision-making, and increased cognitive ability, as well as (perhaps somewhat obviously) increased physical health — all of which are crucial components of higher organizational performance.
Health Insurance Can Reduce Stress
Among other positive outcomes, health insurance significantly decreases the level of stress employees experience, as a study described in a recent working paper shows. Johannes Haushofer of Princeton University and several colleagues worked with an organization in Nairobi, Kenya — the metalworkers of the Kamukunji Jua Kali Association (JKA) — and randomly allocated some employees to receive health insurance free of cost for one year. In other words, the researchers sponsored a health care plan for a proportion of JKAs’ employees, whereas others continued working for JKA as usual.
In addition to collecting data through surveys — for example on the employees’ self-reported health and well-being, and their household characteristics — the researchers did something rather unusual: they collected saliva samples from all respondents, which were later tested for the stress hormone cortisol. These measurements occurred at two time points, at the start of the study and at the end.
The researcher’s results were striking. Not only did employees who received free health insurance report feeling less stressed, but this decline correlated with a reduction in the cortisol measured in the saliva sample. The decrease in cortisol was comparable to roughly 60% of the difference between people who are depressed, and people who are not.
This is important for organizations because employees who experience higher levels of stress are more prone to burning out, and less likely to attain high levels of performance. Stressed employees hurt the bottom-line — and interventions that reduce stress benefit it.
Health Insurance Can Lead to More Long-Term Decision-Making
But health insurance can do more, too. A paper I co-authored with Elke Weber of Princeton University and Jaideep Prabhu of Cambridge University that was recently published in the Proceedings of the National Academy of Sciencesfocuses on one reason why low-income individuals have difficulties escaping their destitute situation. As research has found, we show that poor people are more likely to make decisions that favor the short term, even when these decisions involve smaller payoffs than larger payouts they might receive in the future.
In our study, we find that this is partially the case because low-income individuals experience more pressing financial needs than their richer counterparts. Because they are so pre-occupied with making ends meet, they are unable to even consider a possible larger payout in the future. This way, they remain captured in what Johannes Haushofer and Ernst Fehr of the University of Zurich so aptly call the “vicious cycle of poverty.”
However, we also find that interventions that serve to reduce levels of financial need that low-income individuals experience can make them more likely to make more long-term-oriented decisions. One such intervention may be the provision of health insurance. With a safety net they can draw on when health problems arise, poor people may be less likely to experience their financial needs as pressing — and as a result, make more long-term-oriented decisions.
This can lead to significant improvements for organizations as well. Companies require their employees to make many long-term decisions. In many cases, a more long-term orientation is necessary for companies to thrive.
Not Having Health Insurance Can Hinder Cognitive Ability
Finally, health insurance can give low-income individuals peace of mind. A seminal study led by Anandi Mani of the University of Warwick investigated the cognitive consequences of poverty. The researchers found — in concordance with an increasing body of evidence — that lack of money saps people’s attention. While they did not specifically study health insurance, it is easy to extrapolate their research to this question. Given that everyone’s attention is limited, the more people’s concerns weigh on their mind, the less attention they can pay to any one concern.
To illustrate this finding, imagine a case where a low-income employee uses her car to come to work every day. She lives paycheck to paycheck and depends on her steady stream of income. Every day, even when she isn’t driving, she worries about what she would do if her car broke down. Such thoughts circle in her mind incessantly — they are always there, no matter what else she tries to focus her attention on.
Obviously, such worrying thoughts have detrimental consequences for her performance. Constant ruminations make it more difficult to focus on tasks that matter in the moment. Now replace the car in the above scenario with her health; let’s assume she has a chronic condition that requires medical attention when it breaks out. This is not an uncommon case: over 34% of employees have chronic medical conditions, which are even more widespread amongst low-income individuals.
Although many of these physical ailments cannot be cured, their accompanying cognitive detriments can be. Thoughts such as, “How will I pay for the doctor? How can I afford my medication?” could be eradicated with the provision of health insurance. This is especially important for low-income individuals who are more likely to have such worries. And with an increased ability to focus on their work, employees are also more likely to be productive members of the organization.
It is unclear what will happen in Washington D.C. in the next few months. Will Obamacare be repealed? Will millions of low-income individuals lose their health insurance? In the absence of a resolution, managers may have to step up. There is a business case to be made for providing employees with health insurance, which may make them less stressed, improve their long-term decisions, and lead to increased attention on the task at hand — and the case is especially strong for low-income employees.
SOURCE:
Jachimowicz J (29 May 2018). [Web Blog Post]. Retrieved from address https://hbr.org/2017/04/the-business-case-for-providing-health-insurance-to-low-income-employees
A look at how the opioid crisis has affected people with employer coverage
The opioid crisis is affecting more and more people each day. Discover how the opioid crisis affects you with this study on employer coverage.
With deaths from opioid overdose rising steeply in recent years, and a large segment of the population reporting knowing someone who has been addicted to prescription painkillers, the breadth of the opioid crisis should come as no surprise, affecting people across all incomes, ages, and regions. About four in ten people addicted to opioids are covered by private health insurance and Medicaid covers a similarly large share.
Private insurance covers nearly 4 in 10 non-elderly adults with opioid addiction
In this analysis and a corresponding chart collection, we use claims data from large employers to examine how the opioid crisis has affected people with large employer coverage, including employees and their dependents. The analysis is based on a sample of health benefit claims from the Truven MarketScan Commercial Claims and Encounters Database, which we used to calculate the amounts paid by insurance and out-of-pocket on prescription drugs from 2004 to 2016. We use a sample of between 1.2 and 19.8 million enrollees per year to analyze the change from 2004 to 2016 in opioid-related spending and utilization.
We find that opioid prescription use and spending among people with large employer coverage increased for several years before reaching a peak in 2009. Since then, use of and spending on prescription opioids in this population has tapered off and is at even lower levels than it had been more than a decade ago. The drop-off in opioid prescribing frequency since 2009 is seen across people with diagnoses in all major disease categories, including cancer, but the drop-off is pronounced among people with complications from pregnancy or birth, musculoskeletal conditions, and injuries.
Meanwhile, though, the cost of treating opioid addiction and overdose – stemming from both prescription and illicit drug use – among people with large employer coverage has increased sharply, rising to $2.6 billion in 2016 from $0.3 billion 12 years earlier, a more than nine-fold increase.
Trends in prescription opioid use & spending among people with large employer coverage
Opioid prescription use among people with large employer coverage is highest for older enrollees: 22% of people age 55-64 had at least one opioid prescription in 2016, compared to 12% of young adults and 4% of children. Women with large employer coverage are somewhat more likely to take an opioid prescription than men (15% compared to 12%). Opioid prescription use among people with large employer coverage is also higher in the South (16%) than in the West (12%) or Northeast (11%).
Among people with large employer coverage, older enrollees are more likely to have an opioid prescription
Among people with large employer coverage, the frequency of opioid prescribing increased from 2004 (when 15.7% of enrollees had an opioid prescription) to 2009 (when 17.3% did). After reaching a peak in 2009, the rate of opioid prescribing began to fall. By 2014, the share of people with large employer coverage who received an opioid prescription (15.0%) was lower than it had been a decade earlier, and by 2016, the share was even lower, at 13.6% (a 21% decline since 2009).
The share of people with large employer coverage taking opioid prescriptions is at its lowest levels in over a decade
Among people with large employer coverage, this pattern (of increasing opioid prescription use through the late 2000s, followed by a drop-off through 2016) is similar across most major disease categories. Some of the steepest declines in opioid prescription use since 2009 were among people with complications from pregnancy or childbirth, musculoskeletal conditions, and injuries. The share of people experiencing complications from pregnancy or childbirth who received an opioid prescription peaked in 2007, when 35% received an opioid prescription, but this share dropped to 26% in 2016. Similarly, in 2007, 37% of people with large employer coverage who had a musculoskeletal condition received an opioid prescription, but the share dropped to 30% by 2016. The same decline can be seen among people with large employer coverage who experienced injuries and poisonings (37% in 2009, down to 30% in 2016).
Opioid use declined across disease categories, particularly pregnancy, musculoskeletal diseases, and injuries
We also see a sharp decline in the use of opioid prescriptions among people with cancer diagnoses, particularly in the most recent couple of years. In 2016, 26% of people with large employer coverage who had a cancer diagnosis received at least one opioid prescription, down from 32% in 2007. Despite declines in opioid prescribing for musculoskeletal conditions, people with large employer coverage who have musculoskeletal diagnoses still receive opioid medications more frequently (30%) than those with cancer diagnoses (26%).Overall in 2016, among those receiving an opioid prescription, a slightly larger share received only a single prescription in that year (61%) than did in 2006, a decade earlier (58%). The average number of prescriptions each person received also rose from 2004 until 2010 and then fell again, but this measure is imperfect because it does not adjust for the length of the supply or the strength of the drug received.
In total, large employer plans and their enrollees spent $1.4 billion in 2016 on opioid prescription painkillers, down 27% from peak spending of $1.9 billion in 2009. In 2016, $263 million, or 19% of total opioid prescription drug spending was paid out-of-pocket by enrollees.
Spending on opioid prescriptions peaked in 2009
Opioid prescriptions have represented a small share of total health spending by large employer plans and enrollees.
Treatment for Opioid Addiction & Overdose among People with Large Employer Coverage
In 2016, people with large employer coverage received $2.6 billion in services for treatment of opioid addiction and overdose, up from $0.3 billion in 2004. Of the $2.6 billion spent on treatment for opioid addiction and overdose in 2016 for people with large employer coverage, $1.3 billion was for outpatient treatment, $911 million was for inpatient care, and $435 million was for prescription drugs. In 2016, $2.3 billion in addiction and overdose services was covered by insurance and $335 million was paid out-of-pocket by patients. (This total only includes only payments for services covered at least in part by insurance, not services that are paid fully out-of-pocket and not billed to insurance, so it is likely an undercount of opioid addiction and overdose treatment expenses by this population.)
The cost of treating opioid addiction and overdose has risen even as opioid prescription use has fallen
Spending on treatment for opioid addiction and overdose represents a small but growing share of overall health spending by people with large employer coverage. In 2016, treatment for opioid addiction and overdose represented about 1% of total inpatient spending by people with large employer coverage and about 0.5% of total outpatient spending. In 2004, treatment for opioid addiction and overdose represented about 0.3% of total inpatient spending and less than 0.1% of total outpatient spending. On average, inpatient and outpatient treatment for opioid addiction and overdose added about $26 per person to the annual cost of health benefits coverage for large employers in 2016, up from about $3 in 2004.
The bulk of the total $2.6 billion in spending for treatment of opioid addiction and overdose among people with large employer coverage was treatment for young adults, totaling $1.6 billion in 2016, even though young adults are prescribed opioids less often than older adults. Males also used more treatment than women ($1.6 billion vs $1.0 billion).
Spending on opioid addiction and overdose treatment is mostly concentrated among younger people
The bulk of spending by people with large employer coverage on inpatient and outpatient treatment for opioid addiction and overdose was for employees’ children (53%) or spouses (18%), while just under a third (29%) was for employees themselves.
Among people with large employer coverage who had outpatient spending on treatment for opioid addiction and overdose, their average outpatient expenses totaled $4,695 (of which $670 was paid out-of-pocket) in 2016. Among those with inpatient spending on treatment for opioid misuse, their average inpatient expenses totaled $16,104 (with $1,628 paid out-of-pocket) in 2016. On average, inpatient expenses have risen sharply, up from $5,809 in 2004.
In 2016, 342 people per 100,000 large group enrollees received treatment for opioid overdose or addiction, including 67 people per 100,000 who received treatment in an inpatient setting.
Discussion
Among people with large employer coverage, utilization of opioid prescription painkillers has declined somewhat in recent years. Use of and spending on prescription opioids by this group peaked in 2009 and has since dropped to the lowest levels in over a decade. Across most major disease categories, we see a similar pattern of the frequency of opioid prescription use rising until the late 2000s and then declining through 2016.
Despite declining rates of opioid prescribing to those with employer coverage, spending on treatment for opioid addiction and overdose has increased rapidly, potentially tied to growing illicit use and increased awareness of opioid addiction. Opioid addiction and overdose treatment – the bulk of which is for dependents of employees – represents a small but growing share of overall employer health spending.
Methods
We analyzed a sample of claims obtained from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database (Marketscan). The database has claims provided by large employers (those with more than 1,000 employees); this analysis does not include opioid prescription or addiction treatment for other populations (such as the uninsured or those on Medicaid or Medicare). We used a subset of claims from the years 2004 through 2016. In 2016, there were claims for almost 20 million people representing about 23% of the 85 million people in the large group market. Weights were applied to match counts in the Current Population Survey for large group enrollees by sex, age, state and whether the enrollee was a policy holder or dependent. People 65 and over were excluded.
Over 14,000 national drug codes (NDC) were defined as opiates. In general, we defined “prescription opioids” as those with a primary purpose of treating pain. Only prescriptions classified under the controlled substance act are included. We excluded from this category Methadone, Suboxone (Buprenorphine with Naloxone), and other drugs commonly used to treat addiction. We also excluded medications not commonly prescribed (such as Pentazocine). Each opiate script was counted as a single prescription regardless of the quantity or strength of that prescription. The Marketscan database only includes retail prescriptions administered in an outpatient setting. Disease categories are defined by AHRQ’s chronic condition indicators, and based on the diagnosis an enrollee receives.
In our analysis of opioid addiction and overdose treatment, we include medications used to treat overdose (e.g. Naloxone) and drugs used to treat addiction (e.g. Methadone and Suboxone). We also include inpatient and outpatient medical services to treat opioid addiction or overdose, identified by ICD-9 and ICD-10 diagnosis codes. Midway through 2015, Marketscan claims transitioned from ICD-9 to ICD-10. While both systems classify diagnoses, there is no precise crosswalk between the two. In consultation with a clinician, we selected both ICD-9 and ICD-10 codes which are overwhelmingly used for opioid addiction or signify misuse. A list of these ICD codes is available upon request. Because of the change in coding systems, it is not possible to tracks trends between 2014 and 2016. Diagnoses related to heroin abuse were included as opiate abuse.
Because there is no precise way to identify costs associated with opioid addiction and overdose treatment, some of our rules for inclusion lead to an underestimate, while others lead to an overestimate. In general, we elected a conservative approach. For example, in some cases, opioid abuse diagnoses may be classified under a broader drug abuse diagnosis and therefore are not captured. Additionally, we do not include the costs associated with diagnoses that commonly arise from opioid abuse, such as respiratory distress or endocarditis, unless an opioid abuse diagnosis was also present. However, if a claim included an opioid abuse diagnosis along with other diagnoses, we included spending for all procedures during that day, even if some of those interventions were to treat concurrent medical conditions unrelated or indirectly related to opioid abuse. If an enrollee paid fully out-of-pocket and did not use their insurance coverage, this spending is also not included. Overall, we think these assumptions lead to an underestimate of the costs associated with opioid addiction and overdose treatment for the large employer coverage population.
SOURCE:
Cox C (24 May 2018). "A look at how the opioid crisis has affected people with employer coverage" Web Blog Post]. Retrieved from address https://www.healthsystemtracker.org/brief/a-look-at-how-the-opioid-crisis-has-affected-people-with-employer-coverage/#item-start
Are your employees scared to take time off?
Your employees might be feeling pressured and overworked. Avoid low productivity in your workplace with these tips on vacation impact.
They might be getting paid time off, but close to half of American workers aren’t taking it—or aren’t taking as much of it as they’re entitled to. And that’s making for a workforce that’s not only overworked and under stress, but actually being pressured to forego time that they’re entitled to.
So says “The PTO Pressure Report” from Kimble Applications, which finds that not only have 47 percent of employees not taken as much PTO as they’re entitled to, 21 percent admit to having left more than five vacation days unused. According to survey respondents, workload-related stress is the top reason so many are failing to use all the PTO they’re entitled to: 27 percent say they just have too many projects or deadlines to take time off, and 13 percent dread the heaps they’ll find on their desks when they get back.
Their bosses aren’t helping, either, with 19 percent of respondents saying that they’ve felt pressured by employers or managers to abstain from vacation. Not only that, more than a quarter are actually nervous or even anxious at the thought of submitting a time-off request; 19 percent worry about being away from work, while 7 percent fear that their requests will be denied.
But businesses could actually be shooting themselves in the foot by keeping such a tight rein on employees. Says the report, “These managers likely don’t realize that this is having a direct, negative impact on the business, as past research indicates that employees who take most or all of their vacation time each year perform better and are more productive than those who do not.”
Even if they get to go on vacation, it’s not doing a lot of them much good. They’re too wired into the job, with 48 percent saying they proactively check in on vacation. A surprising 19 percent do so every day, with another 29 percent doing so periodically. And the boss isn’t making it easy to be on vacation once they get to go; 29 percent of workers say they’re expected to be available for emergencies, and another nine percent say they’re expected to check in frequently. Can’t exactly unwind too well with that hanging over their heads, which means they get back to work stressed out from making sure they satisfy vacation’s employment obligations.
They think they’ll get ahead that way, though—at least 14 percent believe that if they leave that vacation time on the table, they’re more likely to succeed and move up in the ranks. And 19 percent say that’s more important to them than the vacation time they’re abandoning—they’d give up their vacation time for a whole year if it meant they’d nail a promotion.
Younger employees are more willing to work instead of take time off than their elders ; 25 percent of those aged 25–34 feel this way compared to only 17 percent of those aged 55–64.
What businesses may not realize is how important PTO is for the company’s bottom line. Mark Robinson, co-founder of Kimble Applications disagrees. “I am an advocate of giving people a reasonable vacation entitlement and then encouraging them to take it,” he says in the report. ”My experience is that businesses work best if there is clarity about this and people feel confident about planning their vacation well in advance. That is better for the individuals and it allows the business to forecast and budget better too.”
Robinson adds, “American businesses sometimes offer unlimited time off—but they know that in most cases that ends up with people taking less time off. Also, in businesses where people don’t feel confident enough about taking vacations to plan them well in advance, there can be an issue at the end of the year when they suddenly all disappear at once. Successful, sustainable organizations learn to plan their business around PTO time.”
SOURCE:
Satter M. (22 May 2018). “Are your employees scared to take time off?” [Web Blog Post]. Retrieved from address https://www.benefitspro.com/2018/05/22/are-your-employees-scared-to-take-time-off/
10 states with the most Social Security recipients
Which state economies will face a greater impact when cutting social security payments? Find out in this article for BenefitsPro.
More than 51 million American retirees or their survivors collected Social Security benefits last year, according to the Social Security Administration.
Those payments function as the foundation for their economic security during retirement, providing 90% or more of the income of almost one-third of those beneficiaries and the majority of the cash income for about 60% of them, according to a new report from the Democratic staff of the Joint Economic Committee (JEC).
The report, “Social Security: A Promise to American Workers and Families,” focuses not only the benefits to recipients who depend on those payments but also the broader economic costs of reducing them, which has been a priority for the Republican leadership in Congress.
Democratic members of Congress expect Republicans will continue to push for those cuts especially because the U.S. deficit is expected to grow by more than $1 trillion over the next 10 years as a result of the recent tax cut legislation.
“Slashing Social Security would not only have a negative impact on beneficiaries and their families, but have a devastating impact on the economy as a whole,” said Sen. Martin Heinrich, D-N.M., ranking member of the JEC, in a statement accompanying the release of the report.
According to the report, Social Security supports about $1.4 trillion in goods and services in the U.S. economy, accounting for more than 9 million jobs nationwide. Reducing benefits by 25% across the board would cost $349 billion in economic output, 2.3 million jobs and about $83 billion in employee compensation, the report notes, adding that such cuts would also put pressure on the families of beneficiaries to make up the difference.
In the gallery above are the 10 states with the most Social Security recipients and their average monthly benefit.
Source:
Napach B. (7 May 2018). "10 states with the most Social Security recipients" [web blog post]. Retrieved from address https://bit.ly/2HWmHnt
Student loan benefits more popular with workers than employers
"While a student loan benefit is the most-requested financial benefit, it’s only third on the priority list for HR professionals." Find out more in this article.
If you ask them, 78 percent of employees laboring under a load of student debt will tell you that they want their bosses to provide a student loan benefit that will help them dig out.
Bosses, not so much. While a student loan benefit is the most-requested financial benefit, according to an HRDive report, it’s only third on the priority list for HR professionals.
Related: The problem with student-loan repayment benefits
It’s not just younger workers who want it, either. The 78 percent of employees who wish their jobs came with a student loan benefit includes 65 percent of workers over age 55 who have problems with current or future loan debt.
The report points to a CommonBond study that finds student loan benefits not only help to keep employees on the payroll and even better their job performance, but they also help in recruiting new talent. The study finds that 75 percent of all workers have paid for their own education via student loans, and 21 percent plan to take out student loans for a child or another family member in the next five years.
Oh, and another disconnect between boss and worker: while 75 percent of HR executives think their benefits offerings are innovative, only 50 percent of workers agree.
Money, of course, is a big worry for workers—and it’s not all about salary, with 44 million Americans weighed down by some $1.4 trillion in student debt. Worrying about lingering student loans also cuts productivity at work, in addition to subjecting workers to increasing stress, so it’s really an employer’s problem too.
Not only do students owe an average of more than $25,000 by graduation, figures from The Student Loan Report indicate that the loan default rate and delinquency rates are more than 10 percent and 5 percent, respectively—not exactly conducive to either peace of mind or high productivity at work. So employers are increasingly getting involved, considering tuition payment programs for employees who want to pursue a degree or add new skills.
And that can help both groups as employers become increasingly desperate for a more skilled employee base. It also helps employers as employee stress falls, potentially cutting health care costs as well and making workers more productive.
Source:
Satter M. (7 May 2018). "Student loan benefits more popular with workers than employers" [web blog post]. Retrieved from address https://bit.ly/2wi9yA0
Resisting Popular Healthcare Trends and Getting Creative
In this article, experts explore the idea that companies need to use the many tools at their disposal, as opposed to relying specifically on one popular trend.
A recent study found that substantial wellness incentives and high-deductible health plans are not the quick fix to improving health care costs they were originally thought to be.
Employers pinned their hopes on high-deductible health plans, but HDHPs only represent 30 percent of medical plans offered by employers, according to the “2018 Medical Trends and Observations Report” released in early March by DirectPath and research and advisory company Gartner.
“Increasingly, employers are realizing that true, long-term cost management will come from a combination of tools and that they need to enlist employees in the effort in a meaningful way,” said Kim Buckey, vice president of client services at employee engagement firm DirectPath.
Employers have explored different options starting with managed care plans and health maintenance organizations the past several decades, moving toward consumer directed health plans years later and considering wellness programs and private exchanges after that, according to Buckey. These solutions could provide short-term relief but not singlehandedly solve the problem, she said.
The logic behind HDHPs was that if employees had skin in the game, they’d be more conscientious about looking for lower-cost options in medical care and become smarter health care consumers, Buckey said. But what this idea did not address the larger issue: employees’ lack of health literacy and little understanding of health insurance comprehension.
“Employees historically just hadn’t had the knowledge or the tools to truly become educated consumers,” she said.
The report, based on an analysis of 900 employee benefit health plans, also found that fewer companies are offering wellness incentives. Some 31 percent of employers offer them today, according to the 2018 report. This number is considerably lower than the 2017 report, which found that 58 percent of employers offered incentives, and the 2016 report, which found that 50 percent did.
“That was surprising because using incentives to drive employee behavior was a big component of most companies’ strategies across the past couple years,” said Brian Kropp, HR practice leader at Gartner. “What companies are finding in a lot of cases is that the incentives were most likely used by healthiest people whose health care costs were already quite low.”
For many companies, incentives have been cutting health care costs for employees who were already spending less rather than making prices more reasonable for people with higher expenses, he said.
This is not the ideal result since the idea behind incentives was, for example, to convince unhealthy people to get an annual physical. This would supposedly help them find health problems before they became serious and more expensive to treat.
“The idea that incentives as currently structured at most companies are becoming of less interest because they’re not as effective as we thought,” Kropp said.
The decline in incentive use may also have to do with concerns about the future legality of these plans, according to the report. A federal judge ruled in December 2017 that the EEOC’s incentive rules — which deem a wellness program voluntary if the incentive or penalty was no more than 30 percent of the cost of the health plan — will only continue until the end of 2018.
Other reports have found different data on wellness incentives. Jessica Grossmeier, vice president of research for the think tank Health Enhancement Research Organization, shared that a Mercer report in 2016 found that two-thirds of employers were using incentives to encourage employee to participate in wellness programs and that 29 percent provided incentives for achieving, maintaining or showing progress toward specific health status targets.
Whether employers will maintain their commitment to using financial wellness incentives will depend on the individual employer and what happens with the EEOC incentive rule. For the time being, employers can take the conservative approach and offer no incentives, take the middle-ground approach and offer modest incentives, or take the aggressive approach and offer up to 30 percent incentives as usual, according to law firm K&L Gates.
Privacy is another concern with wellness programs, Buckey said. Despite generous incentives, some employees may hesitate to participate in these programs because of privacy concerns. Some wellness programs provide employers with aggregate data about the current health status and health risks of their employee population. “With financial and health data breaches increasingly in the news, I think we will see a leveling off or even a lack of interest in participating in programs whether data — even in aggregate — is collected about an employee’s health,” Buckey said.
While strategies such as relying on wellness programs to lower health care costs or using HDHPs to make employees smarter health care consumers have not become the ultimate fix, there are some ways employers can get more creative with their strategy, according to Buckey. She suggested several ways for employers to take a multi-pronged approach to health care cost management.
Employers can offer transparency services, which allow employees to compare pricing for the same service near their home, when they are planning an elective high-cost service like diagnostic tests or surgeries. Employers can also provide better enrollment support in open enrollment so that employees choose the right plan and more carefully manage pharmacy costs by adding measures like mandatary generics or step therapy.
Buckey also mentioned that some of her company’s clients provide patient-advocacy services.
“[It] helps employees identify billing errors and resolve disputes with providers and insurance companies,” she said. “This frees up the employees to focus on their work, rather than financial and medical concerns.”
It’s important for companies to get creative with their health care benefits more than ever before, Kropp said. In the past, employees knew that the health insurance they received at one company was comparable to what they’d receive at many other companies. What the insurance was exactly didn’t matter because most employees felt the plans were more or less the same, he said.
Now companies are starting to realize that better health care plans are a significant differentiator for attracting talent in a competitive labor market, he added. As information for employees and candidates became more transparent and accessible, it became easier as a candidate to understand what health plan offerings looked like at other companies.
“It is a relatively new phenomenon of companies becoming much more vocal about their benefits offerings as a way to compete in a tight labor market,” Kropp said.
This article is from Workforce written by Andie Burjek on April 10, 2018.