Family caregivers pay hefty price to care for loved ones
An exciting article about family caregivers from Benefits Pro by Marlene Y. Satter
It’s not just the late hours, the extra work or the emotional strain. Family caregivers are paying a big price to take care of loved ones who can’t adequately care for themselves, and part of the cost could be their retirement.
According to a new report from AARP, 78 percent of caregivers are incurring out-of-pocket costs as a result of caregiving. The 2016 report “Family Caregivers Cost Survey: What They Spend and What They Sacrifice” estimates that on average, family caregivers are spending roughly $7,000 per year ($6,954) on out-of-pocket costs related to caregiving in 2016.
If that statistic isn’t depressing enough, the report’s financial strain measure, consisting of annual caregiver expense divided by their annual income, shows that caregivers are spending, on average, nearly 20 percent of their income on caregiving activities.
Considering that, it should come as no surprise that many family caregivers have to cut back on other spending, “which can undermine the family caregiver’s future financial security,” the study said.
Sixteen percent have reduced contributions to their retirement savings, and approximately half have cut back on leisure spending (45 percent said they’ve cut down on eating out or vacations because of caregiving expenses).
So where and how are they spending this money?
Household expenses account for the lion’s share of family caregivers’ out-of-pocket spending, eating up 41 percent of it.
This can encompass everything from rent/mortgage payments to home modifications and other household expenses.
Medical expenses make up the second largest chunk, eating up 25 percent of caregivers’ spending on such items as assisted living or skilled nursing facilities, insurance costs and other medical expenses.
And while long-distance caregivers (defined as family caregivers living more than one hour from the care recipient) paid the highest out-of-pocket costs ($11,923), it was no bargain for caregivers living with their care recipient, who also incurred high costs ($8,616).
And if the recipient is older (more than 50 years old) or has dementia, their caregiver will be paying more, too: costs of $7,064 for a recipient older than 50, compared with $5,721 for one younger than the half-century mark, and costs of $10,697 for a recipient with dementia, compared with costs of $5,758 for adults who do not have dementia.
See the original article Here.
Source:
Satter, M. (2016 November 14). Family caregivers pay hefty price to care for loved ones [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/11/14/family-caregivers-pay-hefty-price-to-care-for-love?ref=hp-top-stories
Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile
Worried about your healthcare plan? Check out this interesting article from Kaiser Health News, by Michelle Andrews
President-elect Donald Trump has promised that he’ll ask Congress to repeal the Affordable Care Act on Day One of his administration. If you’re shopping for coverage on the health insurance marketplace, should you even bother signing up? If everything’s going to change shortly after your new coverage starts in January anyway, what’s the point?
While it’s impossible to know exactly what changes are coming to the individual market and how soon they’ll arrive, one thing is virtually certain: Nothing will happen immediately. Here are answers to questions you may have.
Q. How soon after Trump takes office could my marketplace coverage change?
It’s unlikely that much, if anything, will change in 2017.
“It’s a complex process to alter a law as complicated as the ACA,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. It seems unlikely that congressional Republicans could force through a repeal of the law since Democrats have enough votes to sustain a filibuster blocking that move. So Congress might opt to use a budget procedure, called “reconciliation,” that allows revenue-related changes, such as eliminating the premium tax credits, with simple majority votes. Yet even that process could take months.
And it wouldn’t address the other parts of the health law that reformed the insurance market, such as the prohibition on denying people coverage if they’re sick. How some of those provisions of the law will be affected is still quite unclear.
“It will likely be January 2019 before any new program would be completely in place,” said Robert Laszewski, a health care industry consultant and long-time critic of the law.
The current open enrollment period runs through January 2017. Shop for a plan, use it and don’t focus on what Congress may do several months from now, Rosenbaum advised.
Q. Will my subsidy end next year if the new administration repeals or changes the health law?
Probably not. Mike Pence, the vice president-elect, said on the campaign trail that any changes will allow time for consumers receiving premium subsidies to adjust.
Timothy Jost, an emeritus professor at Washington and Lee University School of Law in Virginia who is an expert on the health law, also predicts a reasonable transition period.
Congress and the new administration are “not eager to have a bunch of angry, uninsured voters,” Jost said.
Theoretical conversations about changing the health law are one thing, but “I think that Congress may be less willing to just wipe the subsidies out if a lot of people are using them,” Rosenbaum said. More than 9 million people receive subsidies on the marketplace, according to the federal Department of Health and Human Services.
Q. Can my insurer drop out once the new administration takes over, even if the law hasn’t been repealed?
No, insurers are generally locked in contractually for 2017, according to experts. But 2018 could be a whole different story, said Laszewski.
Many insurers are already losing money on their marketplace offerings. If they know that the health insurance marketplaces are being eliminated and replaced by something else in 2019, why would they stick with a sinking ship?
“The Trump administration could be left with a situation where Obamacare is still alive, the subsidies are still alive, but not the insurers,” said Laszewski. To prevent that, the Trump administration might have to subsidize insurers’ losses during a 2018 transition year, he said.
Q. My state expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level (about $16,000). Is that going to end if Obamacare is repealed?
It may. Trump has advocated giving block grants to finance the entire Medicaid program on the theory that it provides an incentive for states to make their programs more cost-effective. But that strategy could threaten the coverage of millions of Americans if the block grants don’t keep pace with costs, Jost said.
So far, 31 states and the District of Columbia have expanded Medicaid under the health law. Republican governors in these states may play a key role in arguing against taking the expansion money away, Rosenbaum said.
Q. I have a heart condition. Does this mean I’m going to have a hard time finding coverage?
It’s possible. The health law prohibits insurers from turning people away because they’re sick and may be expensive to insure.
Republicans have generally promised to maintain that guaranteed insurability, but what that would look like is unclear. Some of their plans would require people to remain continuously insured in order to maintain that guarantee, said Laszewski.
“I would advise people who are sick to get good coverage now and hang onto it,” said Jost.
Q. Since Republicans have pledged to repeal the law, can I ignore the law’s requirement that I have health insurance?
The individual mandate, as it’s called, is one of the least popular elements of Obamacare. As long as it’s the law, you should follow it, experts said.
Insurers have argued that the requirement that they take all comers who apply for health insurance only works if there’s a coverage mandate or other mechanism that strongly encourages people to have insurance. Otherwise why would they bother unless they were sick?
For the past few years, Republicans have been pushing hard to eliminate the mandate, Laszewski noted.
“One of the easy things they could do is just not enforce it,” he said.
See the original article Here.
Source:
Andrews, M. (2016 November 10). Concerned about losing your marketplace plan? ACA repeal may take awhile [Web blog post]. Retrieved from address https://khn.org/news/concerned-about-losing-your-marketplace-plan-aca-repeal-may-take-awhile/
Employer health plans could suffer in ACA repeal
From BenefitsPro by Marlene Satter
Although Congress may feel as if it has the bit in its teeth on repealing the Affordable Care Act, some experts are warning that it might not be all that easy—or even beneficial—particularly for employer-sponsored health plans.
In a Bloomberg report, Greta E. Cowart, a shareholder at Dallas-based Winstead PC, warned that an ACA repeal or major overhaul might put employers in the crosshairs; they could end up having to return money they previously received from the federal government for some initiatives, such as the early retiree reinsurance program, which provided financial assistance to employer-sponsored health plans.
In addition, Cowart said in the report that many of the mandates on what should be included in employer-sponsored health plans that were neither exempted nor grandfathered in will be hard to take out of employers’ plans, because employees would see that as a benefit reduction. And that, of course, would not make the employer look good.
In its report on the matter, HRDive.com warned employers to “keep an eye on” HHS secretary nominee Tom Price, a determined opponent of the ACA. His “empowering patients first” plan calls for complete repeal of the ACA—and that could lead to just such problems for businesses’ health plans.
Employers who have been calling for the repeal of the ACA might want to rethink their strategy, particularly since it could not only cost them money in the form of give-backs but also cost them employee loyalty if they take away health plan features once they’re no longer mandated by the ACA.
HRDive suggested that “employers should be prepared for all outcomes,” and perhaps consider offering their employees high-deductible health plans or health savings plans as cost-saving measures.
In addition, tracking prescription drug prices could help them keep an eye on costs.
See the original article Here.
Source:
Satter M. (2016 December 1). Employer health plans could suffer in ACA repeal[Web blog post]. Retrieved from address https://www.benefitspro.com/2016/12/01/employer-health-plans-could-suffer-in-aca-repeal?ref=mostpopula
Employers rate private exchanges positively, but use is still low
Great article from Benefits Pro by Gil Lowerre and Bonnie Brazzell
A recent Eastbridge survey of employers found that the use of private exchanges continues to be minimal among all size categories and that a positive correlation remains between use and employer size (with use increasing as employer size increases). Many times, it is the broker who influences these employers to adopt the exchange model, and to offer more options to their employees or to move to a defined contribution approach.
Since brokers are often the ones suggesting an exchange for their clients, it makes sense that most employers (74 percent) continue to use a broker for their employee benefits after implementing a private exchange. Only 19 percent of the employers no longer utilize broker services.
While use has been low, employers that have implemented an exchange believe their employees’ experience with the private exchange has been positive. Forty percent indicated the experience was not only positive, but easier than previous enrollments, and 52 percent said it was positive, but not significantly different from previous enrollment.
The survey also pointed to future interest by employers in private exchanges. Over one-quarter of the employers that are not using a private exchange today are open to using this concept in the future, and another one-quarter are still undecided.
Whether or not to offer a private exchange is a decision that should be based on many factors. Nonetheless, it is important for brokers to at least consider broaching the subject with employer clients — or risk the chance that some other broker will. The fact that most employers rate the exchange process positively should provide comfort to those considering this approach to benefits.
See the original article Here.
Source:
Lowerre, G. & Brazzell, B. (2016 November 02). Employers rate private exchanges positively, but use is still low. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/11/02/employers-rate-private-exchanges-positively-but-us
Key deliverables in ACA implementation
As the slow march continues to implement the ACA, we should all be reminded that there are key deliverables for clients and their advisers to focus on. But while focused on the ACA, let’s not forget that there are additional bills being implemented or introduced — not just at the federal level — that impact a business in how it pays its employees, how their jobs are classified, and how an employer may consider managing its workforce.
With respect to the ACA, the recently delivered 1094 and 1095 tax reports require attention now be directed at preparing for the 2016 reporting year. Specifically, clients and advisers should:
- clean up data sources so the process is efficient and forms are accurate this upcoming year;
- address evolving rules / requirements for reporting and be sure the client is ready;
- advisers and clients should be prepared to deliver within the timeframes communicated, while clients should not assume that filing extensions will be available this upcoming year.
Other legislation
Also, as a client focuses on the ACA, they should direct their attention to the new rules related to white collar exemption status under the Fair Labor Standards Act wage and overtime rules, assuming it applies to them. For some clients this may represent a significant adjustment in how they classify an employee including a review of benefit eligibility for any re-classifications, write a job description, pay or compensate an employee, and manage their workforce. For most employers these rules apply starting this upcoming Dec. 1, 2016.
In some states and cities, bills addressing mandatory paid leave policies are continuing to be introduced and passed to compensate employees for time away. Not all states are focused on this. At the federal level, proposed bills have been considered and are currently in committees but are stalled. It is clear the trend to introduce and put these rules and regulations into place is growing. It would be prudent to monitor the situation.
Lastly, clients will still require advice and guidance on how to manage their employee benefit costs to a budget and to have a plan that attracts and retains employees while remaining cost competitive in a competitive marketplace.
See the original article Here.
Source:
Braun, P. (2016 October 25). Key deliverables in ACA implementation. [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/key-deliverables-in-aca-implementation
6 new solutions for benefits brokers and HR managers
Benefits brokers and HR benefits managers, you’re stressed, and for good reason.
So maybe you didn’t catch these new or redesigned HR and benefits-oriented products or announcements recently. Here they are, just in time for open enrollment.
#1: Help with open enrollment
Open enrollment can be confusing for employees, many of whom can't even define what "deductible" means. (It's true -- someone, somewhere, has studied this and counted the number of people who don't understand the concept.) PlanSource, a provider of cloud-based benefits and human capital management software, has created what it calls "an Open Enrollment Communications Kit" to help with this challenging time.
The kit is for brokers, human resources teams, and benefits professionals who need to communicate benefits information to employees.It includes examples of daily emails and text messages, customizable posters, flyers and postcards in a variety of themes, educational videos and messaging templates.
A sample timeline can help with marketing a communications campaign from beginning to end of open enrollment. The kit can be seen in a webinar you sign up for. Access it at the PlanSource website.
#2: Managing the hiring, onboarding, and benefits process
Isn't it gratifying when computers can actually take on duties you find tedious? Unless you find the onboarding and data entry process extremely interesting and life-affirming, of course. Software from Flock helps manage HR, benefits, and compliance, and now it's adding an applicant tracking system from Greenhouse for hiring, onboarding, and managing employees.
The partnership will let HR import candidate information into Flock, with the goal of streamlining the hiring and onboarding process. The HR platform is available for small to midsize businesses and insurance brokers can subsidize or sponsor the benefits administration module. Learn more at the Flock website.
#3: 5 ACA plans to be offered to Arizona residents
Okay, technically it's not a solution. Still, someone you know might want to know that five different Affordable Care Act plans will be available during open enrollment from Blue Cross Blue Shield of Arizona (BCBSAZ).
The five include EverydayHealth, Portfolio and SimpleHealth. Members who enroll in the plans use their primary care provider to coordinate their care. The ACA plans will be offered in 14 of Arizona's 15 counties, and, as you know, open enrollment runs from November 1, 2016 through January 31, 2017.
To help find the right plan, Blue Cross Blue Shield is pointing Arizonans toward their local broker or to Cover Arizona.
#4: Online benefits administration
This is the year of partnering in the benefits industry. Employee benefits, HR and payroll provider BenefitMall is partnering with EaseCentral to offer additional online benefits administration.
The goal is to help with completing enrollments in a timely way. Brokers will now be able to choose between EaseCentral's all-in-one software solution and BenefitMall's online benefits administration system, EmployerFocus. Learn more at the BenefitMallwebsite.
#5: New option to enroll employees in voluntary benefits
Did we mention partnering? Yes? Transamerica is partnering with Maxwell Health to expand enrollment options for key employee benefits.
The partnership will enable Transamerica to offer help to employers in streamlining enrollment, administration, reporting, communication, and engagement processes, while allowing benefit advisors to browse, compare and quote benefits in an intuitive way. To learn more, see the Transamerica website or call 866-872-6726.
#6: New ACA compliance and reporting solutions
Affordable Care Act reporting is pretty darn fun. Still, there's probably something else you'd rather be doing, like going to the dentist for a root canal. This newly designed product from SyncStream Solutions offers both Affordable Care Act compliance and reporting.
The new solutions were designed to meet compliance requirements through a guided workflow that marries employer data with ACA analytics to achieve ACA compliance and provide the assurance of auditability.
SyncStream's product offers employee tracking and ACA full-time status determination, generates the proper forms to meet IRS requirements, populates IRS indicator codes based on business logic, and normalizes employer data into ACA-compliant language, among other features. For more information, visit the SyncStream Solutions website.
See the original article Here.
Source:
Marwitz, C. (2016 October 24). 6 new solutions for benefits brokers and HR managers. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/24/6-new-solutions-for-benefits-brokers-and-hr-manage?kw=6+new+solutions+for+benefits+brokers+and+HR+managers&et=editorial&bu=BenefitsPRO&cn=20161025&src=EMC-Email_editorial&pt=Daily&page_all=1
Study: What benefits do employees go for on private exchanges?
Jack Craver gives insight on the best benefits options for private exchanges
A new study offers insight into the types of benefits and benefit designs employees go for when given the choice.
The study, by the Private Exchange Research Council, analyzed hundreds of thousands of benefit purchases made by workers whose employer offers benefits through a private exchange.
The average employer that uses a private exchange offers 14 different benefits and six medical plans, the study found. Employees purchased an average of 4.4 products in 2015, up from 3.6 the previous year.
Older workers are more likely to buy more coverage, with 44 percent of Gen Xers and 42 percent of baby boomers buying more than four products, compared to only 30 percent of millennials.
While employers are increasingly demanding that employees accept high-deductible health plans accompanied by a health savings account, the majority of workers analyzed in the study appear to have traditional health plans, although the percentage with HSAs is rising. Forty-two percent of employees had an HSA in 2015, up from 38 percent in 2013.
Those who opt for high-deductible HSA-qualifying plans tend to be younger and healthier; that’s no surprise. However, the study also found that men and high-paid employees tend to favor such plans more than women and lower-paid employees.
Perhaps surprisingly, the study also found that nontraditional insurance products, such as pet insurance, legal insurance and identity theft insurance, are more likely to be offered by smaller companies.
Private exchanges and the employers that use them describe them as a way to increase employees’ engagement with their benefits. In a health care system that many have argued is overpriced and inefficient because the costs have been hidden behind health plans largely paid by employers, private exchanges are touted as a way to make individuals more sophisticated health care consumers that make conscious decisions about what services they want and need.
Private exchanges got a big boost earlier this year when Starbucks announced that it would be offering its employees an array of health plans to choose through an exchange run by Aon.
In a statement accompanying the study’s release, Christopher Condeluci, one of the principals of Private Exchange Research Council, described the group and its research as addressing a lack of data on the types of benefits that individual consumers favor.
"Knowing what plans people want and how they choose them will go a long way in helping the benefits industry better meet employers' and employees' needs,” he says.
See the original article Here.
Source:
Craver, J. (2016 October 20). Study: what benefits do employees go for on private exchanges? [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/20/study-what-benefits-do-employees-go-for-on-private?kw=Study:%20What%20benefits%20do%20employees%20go%20for%20on%20private%20exchanges?&et=editorial&bu=BenefitsPRO&cn=20161024&src=EMC-Email_editorial&pt=Daily
15 voluntary benefits trends heading into 2017
Alan Goforth lists the top benefits trends of 2017.
Predicting industry trends is as much a sign of the end of the year as after-Christmas sales and New Year's resolutions.
Although predicting the future is only an educated guess, one thing is certain — voluntary benefits are here to stay.
Carriers, brokers, employers and workers all give a thumbs-up to the increased flexibility and opportunities for cost control they bring to benefits packages.
Here is what may lie over the horizon in 2017.
THE MARKET IS BULLISH
As a result, the quantity and quality of voluntary benefits will continue to grow. Examples of traditional voluntary benefits employers are likely to add include gap coverage, short-term disability, cancer, critical illness, prescription, dental, life insurance and hospital supplemental policies. Brokers should make sure they have these products in their portfolios.
WELLNESS PROGRAMS GET FISCAL
Most businesses understand that the size of an employee's waistline can correlate to attendance, productivity and turnover. Many also are starting to realize the link between the size of their bank account and job performance.
Smart employers are adding voluntary benefits that can help workers reduce stresses associated with finances and debt. These can include financial education, financial counseling, employee purchase programs, parental leave, retirement planning and even short-term loans under certain circumstances.
A-WEAR-NESS IS INCREASING
Technology is taking the guesswork out of employee wellness programs. Nearly two-thirds of carriers surveyed expect wearable technologies to have a significant impact on their industry, according to Accenture's annual Technology Vision report. Fitbits and similar devices enable employees to quantify the results of their effort, which both inspires them and provides employers valuable feedback about the effectiveness of their programs. An increasing number of businesses now subsidize the cost of wearable devices or set up payroll deductions to cover the expense.
ENGAGEMENT GOES HIGH-TECH
Year-in and year-out, HR professionals cite employee engagement as one of their most vexing issues. Traditional tactics are becoming less effective with millennial employees, who often prefer voluntary benefit portals and enrollment platforms.
"Millennials get information on their own," said Aprilyn Chavez Geissler, owner of Geissler Agency Inc. in Albuquerque. "However, when it's time to purchase, they still want the personal service and an advisor to help them. As a large demographic, they are similar to the silent generation in that they think through their purchases and do research on their own."
CRITICAL ILLNESS REACHING CRITICAL MASS
Critical illness insurance was once a blip on the radar screen of voluntary benefits packages — but not anymore. It is becoming an increasing popular option as the workforce ages and companies reduce primary health coverage and shift the cost of primary medical onto
“Critical illness insurance is by far the fastest-growing insurance product on the market," said Mark Randall, a researcher for GoldenCare in Minneapolis. "Even though the market share is still fairly small, it's a hot product. The bottom line is that every broker should add this product to their portfolio.”
VOLUNTARY BENEFITS REDEFINED
One sure sign of growing demand for voluntary benefits is the fact that many definitions have become obsolete. In the past, voluntary benefits were limited to such bread-and-butter options as dental or vision insurance. Today, however, they are all about lifestyle benefits, such as health club memberships, legal services or pet insurance. A good working definition of a voluntary benefit is anything that can be deducted from an employee's paycheck.
CONSUMERS DRIVE PLANS
A well-designed consumer-driven health plan creates a win-win scenario. Employers hold the line on costs, and employees pay only for the coverage they need and want. This can mean a transition to high-deductible health plans and health savings accounts or health reimbursement arrangements that help employees pay their out-of-pocket expenses and allow them to retain unspent contributions.
TOOLS PROMOTE TRANSPARENCY
Information is a double-edged sword: Employees can be overwhelmed by the voluntary benefit options available to them, but they are also empowered to make smart choices. Benefits providers, brokers and employers are providing user-friendly tools that increase transparency. Studies show that this is especially important to younger workers.
Fifty-two percent of millennials report searching online for health or care-related information, and reliance on social media, patient portals and performance scorecards is growing. One-quarter of consumers say they have looked at a scorecard or report card to compare the performance of doctors, hospitals or health plans, compared to 19 percent two years ago. Among millennials who need medical care, scorecard use has grown from 31 percent to 49 percent.
THE DOCTOR WILL SEE YOU… ONLINE
Telemedicine is a natural byproduct of increased telecommuting. The practice is both a cost-effective option for employers and a perk for employees who are paying more out of pocket for health care. On-call services can bring virtual health care providers into the office with advice about preventive care and nonthreatening illnesses.
ANALYTICS REDUCING GUESSWORK
Anyone remotely involved in the benefits business knows that the industry is swimming in tons of data. Innovative employers are putting this information to work to design better plans that improve health care and reduce expenses. Claims data and historical use patterns demonstrate how much employees can save on new plans by making better decisions. This information also helps employers get a better handle on plan costs, employee adoption and administrative efficiency.
NONTRADITIONAL BENEFITS BOOMING
Employees continue to express interest in new, nontraditional voluntary benefits, and carriers are responding. According to a study by Eastbridge Consulting, 13 percent of employees have selected employee purchase programs; 8 percent have selected legal plans; 3 percent have selected identity protection; and 1 percent selected pet insurance. The relatively low numbers reflect the fact that these options are new, according to researchers.
These percentages are expected to grow. Nontraditional voluntary benefits offer workers a way to obtain products and services through convenient payroll deduction. Most nontraditional offerings provide immediate, tangible benefits that can be used any time, unlike many core benefits that employees need only when they are sick or injured.
CAREER DEVELOPMENT IS HOT
Employees are eager to improve themselves, especially if doing so is cost-effective. Financial planning and online educational services, including college courses, certifications and career development, are becoming popular. Look for more of these, such as Graduate Management Admission Test prep and Graduate Medical Education courses, to be added.
MINIMUM WAGE HIKES MAY SPIKE DEMAND
Although the drive toward a $15 per hour minimum wage in some cities has been controversial, it may have an upside in demand for voluntary benefits.
"With the California minimum wage going to $15 an hour, those employees will have extra money to opt for more voluntary benefits," said Wayne Sakamoto, owner of Health Insurance Interactive Inc. in Naples, Florida. "This extra money will help them get into a nicer apartment, buy a home, get a car or opt to purchase more voluntary benefits. Benefits such as dental and vision insurance are a goodwill gesture by the employer."
DEMAND CREATING COMPETITION
Brokers, employers and workers all may benefit from the increasing number of carriers offering voluntary benefits.
"Brokers now have a lot more different carriers in voluntary benefits than they did several years ago," said Kathy O'Brien, vice president of voluntary benefits and national client group services for Unum in Chattanooga, Tennessee. "They have to be very knowledgeable about the carrier, what they will do to meet the needs of their clients and what types of service they offer, not just in enrollment but also in plan administration, how they will deliver the services, how they will pay and handle billing information."
VOLUNTARY BENEFITS MUST BE INTEGRATED
A well-designed package of voluntary benefits is more efficient when integrated seamlessly with traditional benefits, and not merely tacked on. Learning how best to do this is an ongoing challenge.
"Understanding how all of the different solutions work together is critical, especially when paired with a high-deductible health plan," said Paul Goedde, executive vice president of the Voluntary Employee Benefits Board and product management lead for Cigna in Philadelphia. "Not only does it help the employer attract and retain talent, it helps them manage their bottom line with more-productive and satisfied employees."
See the original article Here.
Source:
Goforth, A. (2016 October 25). 15 voluntary benefits trends heading into 2017. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/25/15-voluntary-benefits-trends-heading-into-2017?kw=15+voluntary+benefits+trends+heading+into+2017&et=editorial&bu=BenefitsPRO&cn=20161025&src=EMC-Email_editorial&pt=Daily&page_all=1
ACA exchanges report strong early application activity
Busy start to the 2017 open enrollment period 50 percent higher than last year, by Allison Bell
Managers of HealthCare.gov say the open enrollment period for 2017 has gotten off to a busy start.
The level of activity during the first six hours of the open enrollment period was 50 percent higher than during the comparable period in 2015, and HealthCare.gov took in 150,000 coverage applications during the first full day of the enrollment period, according to officials at the U.S. Department of Health and Human Services.
HHS set up HealthCare.gov to provide Affordable Care Act exchange enrollment and account administration services in states that are unable or unwilling to handle that job themselves.
The open enrollment period for 2017 started Tuesday.
A year ago, HHS officials said HealthCare.gov had taken in about 250,000 coverage applications during the first full day of the open enrollment period for 2016.
MNsure, Minnesota's state-based exchange enrollment system, was down much of the day yesterday because of some combination of heavy volume, technical glitches and efforts by ACA opponents to crash the system by flooding it with visits. In spite of the technical problems, about state residents used the system to apply for coverage for about 5,000 people, according to the Twin Cities Pioneer Press.
MNsure may have spurred consumers to try to sign up for exchange plan coverage early by announcing that it will impose enrollment caps for 2017 on coverage from most participating carriers. Blue Plus is the only exchange issuer selling coverage without protection from an enrollment cap.
George Kalogeropoulos, the chief executive officer of HealthSherpa.com, a San Francisco-based "Web broker entity" that helps retail insurance agents and brokers submit ACA exchange coverage applications for their customers, says HealthSherpa.com activity levels support the idea that the ACA exchange system has been very busy.
"As of day two of open enrollment, the traffic on HealthSherpa.com has been through the roof," Kalogeropoulos said in an email. "We know HealthCare.gov is getting 50 percent more website visits compared to last year, and our website is experiencing that surge as well."
See the original article Here.
Source:
Bell, A. (2016 November 04). ACA exchanges report strong early application activity. [Web blog post]. Retrieved from address https://www.lifehealthpro.com/2016/11/02/aca-exchanges-report-strong-early-application-acti?slreturn=1478548849
Beware: Losing health plan grandfathered status is an administrative nightmare
Some interesting points on grandfathered status' from HRMorning, by Jared Bilski
Employers that have managed to keep their grandfathered status until now may think they’re immune from the hassles of the ACA, but a recent DOL investigation is a good reminder that the feds are always watching for a slipup.
Sierra Pacific Industries Health Plan was one of the few remaining grandfathered plans in existence, and they managed to keep that status for years after the ACA took effect.
But, according to a DOL investigation, the plan made some changes beginning on Jan. 1, 2013, that prevented the plan from keeping its grandfathered status and led to a relinquishing of that status in the feds’ eyes.
Those plan changes, as well as how the plan made determinations on employee health claims, violated both the ACA (specifically the provisions on preventive health services and internal claims and appeals rules) and ERISA, the DOL claimed.
‘Operating as though it were exempt’
As the DOL’s Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi said:
“The Affordable Care Act put into place standards and protections for workers covered by employee benefit plans. The Sierra Pacific plan was operating as though it was exempt from such requirements, when indeed, it was not. This settlement means that workers improperly denied health benefits will have their claims paid. Corrections made to plan procedures will also mean that all future claims are processed and paid properly.”
No premium or deductible bumps
The end result of the feds’ investigation: A lot of administrative work and changes for Sierra Pacific.
As part of the settlement, plan fiduciaries agreed to comply with the ACA requirements for non-grandfathered plans moving forward, specifically the rules for internal claims and appeals and coverage of preventive health services.
Plus, for the 2017 plan year, the company will have to forgo any increases to participant premiums, annual out-of-pocket limits, annual deductible and coinsurance percentages in effect for the 2016 plan year.
On top of all that, the company agreed to:
- Revise plan documents and internal procedures.
- Re-adjudicate past claims for preventive services, out-of-network emergency services, claims affected by an annual limit and pay claims in compliance with the ACA and ERISA.
- Submit to an independent review organization claims were eligible for external review.
- Pay claims that had been left on hold for a long time.
- Comply with timelines for deciding claims as provided in the department’s claim regulation.
See the original article Here.
Source:
Bilski, J. (2016 October 14). Beware: losing health plan grandfathered status is an administrative nightmare. [Web blog post]. Retrieved from address https://www.hrmorning.com/beware-losing-health-plan-grandfathered-status-is-an-administrative-nightmare/