Enrollment in vision plans remains high
Original post benefitsnews.com
Employers hoping to attract and retain employees need not look further than their vision benefit offerings. New research shows vision benefits have high engagement with employees, but some experts say employers need to work closer with advisers to build the benefit plan workers are seeking.
According to the 2016 annual Employee Perceptions of Vision Benefits survey conducted by Wakefield Research on behalf of Transitions Optical, eight in 10 people chose to enroll in employer-sponsored vision plans. It’s the only benefit to experience a year-over-year increase, the survey found, adding that some benefits such as life, dental and 401(k) plans saw a slight decrease in enrollment compared with 2015.
As more millennials enter the workforce, ancillary benefits such as vision may be considered a more immediate need than retirement plans or some medical benefits, Jonathan Ormsby, strategic account manager with Transitions Optical suggests.
“A competitive benefits package is a significant consideration and draw for workers,” he he says. “Nearly a third of survey respondents said they have, or know somebody, who has accepted a job in the last year because it offered a competitive benefits package – and one in five note that vision is the most appealing element of the package.”
The survey also found employees are increasingly making demands of their employers in terms of what options the vision plans cover. Forty-one percent say it is very important and 46% say it is somewhat important to have premium materials covered, including impact resistant polycarbonate lenses, photochromic lenses, anti-reflective treatment and others.
A desire for broader choice is also affecting the vision market, according to Srikanth Lakshminarayanan, senior director for the Center of Excellence at HGS Healthcare, which provides business process management and end-to-end services for healthcare payers and provider organizations.
“What we now hear from the customer is that they want a choice of options to be much broader,” he says. “They don’t want to be tied up to a particular vision care company” in order to obtain group discounts.
Education
“I think education is the top priority and one strategy we recommend for that is better collaboration between advisers and employers,” notes Ormsby.
For example, he says, “Advisers need to better educate employers on the materials especially the frames and lenses side of the benefits.”
Eighty-seven percent of employees say having premium material coverage is important when selecting their vision plan but more than a quarter are uninformed about the lenses covered by their vision plan, Ormsby says.
“So plenty of room for education,” he says.
Education should be a year-round initiative, he adds, something advisers should think about when working with employers. The survey found 29% of respondents felt a vision plan’s website was the most valuable resource in helping understand benefits, while 26% felt the benefits provider was valuable.
Top healthcare benefit trends to watch
Original post benefitsnews.com
The number of employers offering a healthy living/incentive program grew in 2015, and is one of several trends to watch as the year 2016 unfolds, analysts say.
Plan design changes and programs such as incentive and wellness were of increasing interest to employers last year and most “continue to turn to their brokers and consultants to learn more about new health plan benefit designs and distribution models,” says Tiffany Wirth, executive director of the Healthcare Trends Institute.
“Helping employees better understand the value of provided benefits and making cost-conscious benefit decisions continues to remain important to employers,” she says.
The number of employers offering a healthy living/incentive program grew from 29.8% in 2014 to 34.6% in 2015, according to the HTI’s 2015 Healthcare Benefit Trends Benchmark Study.
During a webinar unveiling the results, Wirth said 21.8% of employers are considering such a program and 16.7% are still learning about them. About 1 in 4 employers (24.7%) indicated they weren’t interested in offering such a program.
“We’re starting to see these types of programs take hold as [healthcare] reform is being adopted and companies are pushing employees to understand their decisions, their purchases, and all of the different things that go along with healthcare benefits,” she says.
As part of incentive program tracking, HTI has also been examining what sort of wellness programs companies are implementing, Wirth says.
Almost half (44.6%) offer at least one type of wellness program, the survey found. Thirty-one percent offer biometric screenings and about 30% offer an opportunity for health risk management.
Key differences from the 2014 benchmark study, Wirth says, included the ranking of top benefits offered by employers. The three highest company-offered employee benefits in 2014 (PPO, family plan and prescription drug) continued to rank high in 2015, but dental came in at No. 1 this year, with about 74% of employers offering it.
More than half (52.1%) of respondents said they had some familiarity with defined contribution plans and private exchanges, with the majority of those who indicated they were interested in offering a DCP identifying 2017 as the year they would likely do so.
Wirth says continued interest is growing among employers to learn and understand more about DCPS.
Visualizing Health Policy: Recent trends in employer-sponsored health insurance premiums
Original post kff.org
This Visualizing Health Policy infographic charts recent trends in employer-sponsored health insurance premiums.
Between 1999 and 2015, premiums increased by 203 percent, outpacing both inflation and workers’ earnings. However, growth of premiums for family coverage slowed toward the end of that time period, from an average of 11 percent a year between 1999 and 2005, to 5 percent between 2005 and 2015.
In recent years, deductibles rose faster than both premiums and wages, with the average premium for single and family coverage increasing 4 percent between 2014 and 2015. There is considerable variation in the premiums at different firms; 8 percent of covered workers are enrolled in a family plan worth more than $24,000 and 4 percent are in plans worth less than $10,000 annually.
Over half of large employers conducted an analysis to determine whether they offered a plan which would be subject to the excise tax on high cost health plans slated to take effect in 2018.
Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). The full-size infographic is freely available on JAMA’s website and is published in the print edition of the journal.
What do the ICD-10 codes mean for health providers, employers and HR managers?
After two years of delays, the new ICD-10 codes are live in hospitals across the country.
The tends of thousands of new government-mandated codes describe diseases and hospital procedures in the billing process. The codes are aimed to cover everything that medical professionals may be called on to treat.
X98.0XXD Assault by steam or hot vapors, subsequent encounter #icd10
— EveryICD10 (@EveryICD10) October 1, 2015
Y31.XXXS Falling, lying or running before or into moving object, undetermined intent, sequela #icd10
— EveryICD10 (@EveryICD10) October 1, 2015
Y92.141 Dining room in prison as the place of occurrence of the external cause #icd10 — EveryICD10 (@EveryICD10) October 1, 2015
Read more codes via @EveryICD10 on Twitter.
How do these codes affect health insurance companies, employers and their human resource departments. Forbes.com contributor Bruce Japsen covers that part of the story.
From erroneous medical bills to denied health services, Americans may need patience grappling with insurance claims beginning today, the much-anticipated launch of tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures in the billing process.
At least one analysis says one in four of the nation’s doctor practices aren’t ready for the transition to International Classification of Diseases, Tenth Revision, known as “ICD-10.” After two years of delays, medical care providers have to be ready for the conversion to 140,000 new codes that they will use in order to bill government and private insurers.
Health insurance companies, employers and their human resources departments have been working with patients and health plan enrollees, warning of potential problems. Aon Hewitt (AON ), a large employee benefits consultancy, says there is potential for doctors and hospitals to use outdated codes and potentially bill patients for services that could be covered.
“This is a complex conversion that could initially lead to disruptions across the medical field,” said Chris Miles, senior vice president of Aon Hewitt’s health group. “Providers may see overall delays in claims processing, and some individuals may have insurance claims that are denied for services that were provided, but not properly coded.”
The conversion is being required by the Centers for Medicare & Medicaid Services to provide more specificity to the existing coding system. The outgoing ICD-9 codes have limited information about medical conditions and hospital procedures while the new ICD-10 code “sets provide flexibility to accommodate future healthcare needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers,” the Centers for Medicare and Medicaid Services (CMS) has told doctors.
“The impact of the ICD-10 switchover on the healthcare system will not be fully understood until after claims processing begins on Oct. 1,” American Medical Association president Dr. Steven Stack said earlier this week.
But physician groups admit there could be challenged based on surveys they’ve conducted of their colleagues.
Medical Group Management Association president and chief executive Dr. Halee Fischer-Wright said a recent “survey showed 20% or more of physician practices have not received the billing system updates necessary for ICD-10.”
“This could significantly disrupt the submission of patient claims,” Fischer-Wright added.
ICD-10 conversion has been a massive undertaking for private insurers as well since they will use the codes in their claims processing and paying doctors and other providers of medical care. It has added significant capital expenses to health insurance companies, impacting the likes of Anthem WLP +% (ANTM), Aetna AET -0.93% (AET), Cigna CI -0.75% (CI), Humana HUM +0.06% (HUM) and UnitedHealth Group UNH -1.75% (UNH).
Benefits experts say health plan enrollees could see a delay in authorization for certain tests and procedures if doctors aren’t adequately coding the services. Insurance claims also could be denied.
But the shift to new codes is a good thing overall, particularly as doctors and hospitals move away from fee-for-service medicine to a healthcare system that pays providers based on outcomes and quality.
“Transferring to the new medical claim codes will allow key industry stakeholders to better track and manage diseases, measure the quality of care and evaluate patient outcomes—all of which support the shift toward value-based payment plans,” Miles said.
5 companies that dropped part-time employee health care
Originally posted on https://ebn.benefitnews.com.
Just 25% of companies that offered employee health insurance made coverage available to part-time workers in 2013, according to the Kaiser Family Foundation. That percentage will decline further with Walmart Stores Inc.’s announcement that it is dropping health insurance for part-time employees. Walmart joins a growing list of major retailers that have done the same.
Target announced in January 2014 that it was dropping coverage for part-time employees. The company said in a blog post that less than 10% of its total employee population participated in that plan.
The world’s largest home improvement retailer said in September 2013 that it was ending coverage for 20,000 part-time employees. Employees with fewer than 30 hours a week were no longer offered limited liability medical coverage, Bloomberg reported. At the time, 5% of the company’s 34,000 employees were enrolled in that plan.
In August 2013, the retailer sent a memo to staff that it was dropping coverage for part-timers, but giving them a check for $500 to find coverage through the public exchanges.
In August 2013, the retailer announced it was cutting some employees’ hours to 29.5 hours, or just under the 30 hour threshold at which the Affordable Care Act mandates coverage be provided. Forever 21 does not provide coverage to part-time employees. In a Facebook note, the company said the decision was made “independent of the Affordable Care Act” and that the change impacted less than 1% of all U.S. store employees.
On Oct. 7, the world’s largest retail chain said it plans to stop offering health benefits to employees who work less than 30 hours a week, or about 2% of its U.S. staff.
Taking an unconventional approach to wellness planning
Benefits managers often find themselves stranded in no-man’s land when it comes to bringing wellness to a workplace. As a concept, wellness is a thriving and transformative experience for many employers, but justifying those costs – or adopting a wait-and-see attitude to measuring a wellness program’s success – is a difficult case to make with a company’s financial decision-makers.
In tracing the wellness success story of Elkay Manufacturing – whose wellness program saw a 76% reduction in major health issues among staff most likely to incur substantial health care costs, not to mention a projected increase in 2015 health care premiums limited to just 1.8% - some of the secret may lie in the unconventional approach taken by the company’s wellness champion.
Carol Partington, corporate manager of compensation and benefits with the 3,000-employee maker of sinks and water coolers – speaking at last week’s EBN Benefits Forum and Expo – said her company’s unimpressive early results with wellness required her to take a more straight-forward tack.
“You need to get leadership support to create an effective program, but you also don’t want to scare the hell out of senior management,” Partington says. “My approach was, ‘I know where I’m going, I’m just not telling everyone where we’re going yet.’ You also can’t be too aggressive; you need to put disciplined steps in place, and be willing to be flexible.”
And while most company executives need to be shown the hard facts before committing to any additional wellness spend, Partington says she simply admitted to her company’s leaders – a business founded in 1920 – that return on investment is often impossible to demonstrate in a wellness effort, opting to emphasize value of the investment instead. Rogue as that may seem, Elkay’s current wellness results – and its low anticipated health care cost increases – earned her the respect of her managerial team.
“We have a company that’s 70% manufacturing workers, in 15 locations across the country, two of which are unionized, and I don’t get a lot of time with people,” she notes. “But my job is to remove distractions from our employees’ lives – we work in a setting where people can lose body parts if they’re worried about their own health, their parents, their sick kids. How can I give them a solution that works?”
Elkay first adopted biometric testing-based wellness in 1994, offering a $25 incentive to employees to participant, but Partington says that the company so almost no results after 12 years, with the company still paying approximately $23 million a year on its employee health care plan. Partington said a high-deductible plan never fit into Elkay’s culture, and costs continued to escalate. Evan a $700 premium differential for employees who demonstrated better health results wasn’t the answer, she says.
“We asked our employees why they took part in the health screenings, and most said they were doing it just to get the premium. I realized we’d failed in our mission,” she notes. “And with no dedicated wellness staff at our company, wellness is only 15% of what I can pay attention to – it’s one of my many responsibilities.”
Partington opted to join forces with Interactive Health to introduce an evidence-based program that could seriously improve her employees’ health, especially those with the most potential health risks, as well as actively addressing those escalating health plan costs. The use of aggregated health data was instrumental in finding some customized solutions for workers.
She says it was also critical to match any incentive programs to company culture, a task somewhat more difficult as Elkay has manufacturing sites in more than a dozen very different and often remote parts of the country. In some rural sites, hunting and fishing licenses were seen as extremely valuable commodities, or even Jiffy Lube coupons for oil changes.
Partington also shied away from gamification efforts, given employees’ limited access to email and smartphones, and also did not establish fitness challenges as a company-wide initiative. She says she also had to be mindful of other cultural differences: Championing the company’s successful tobacco-cessation efforts at a manufacturing site in the middle of tobacco-growing country, where employees’ spouses and families were often employed in that business, required a bit of extra sensitivity.
In the end, by personalizing the incentives and communication, Elkay has created an almost $1,200 differential in its better-health insurance rates, resulting in a 20% savings. Of 636 employees tracked with a litany of five serious current or potential health indicators, Elkay produced a 76% reduction in those health issues. And 77% of employees taking part in more personalized health tracking met their personal health goal in the second year of the enhanced program.
“Change is hard,” Partington says. “So you gotta talk a lot.”
10 states with the highest uninsured rates post-ACA
Originally posted on https://ebn.benefitnews.com.
While the uninsured rate has dropped to a record low of 13.4% nationwide, according to Gallup figures, rates differ dramatically across states. Here are the 10 states with the highest uninsured rates in the aftermath of health care reform implementation, according to WalletHub.
A decreasing rate of uninsured Americans shows the Affordable Care Act has impacted the number of individuals with health care coverage, but that impact varies widely by state. We’ve already highlighted the 10 states with the lowest uninsured rates post-ACA. Here are the 10 states with the highest uninsured rates, according to WalletHub, which analyzed data from the Kaiser Family Foundation, the Centers for Medicare and Medicaid Services, the Department of Health and Human Services, and the U.S. Census Bureau. Seven states were excluded from analysis because of data limitations.
Pre-ACA uninsured rate: 21.66%
Post-ACA projected uninsured rate: 18.16%
Difference before and after: -3.50%
Pre-ACA uninsured rate: 18.92%
Post-ACA projected uninsured rate: 18.29%
Difference before and after: -0.63%
Pre-ACA uninsured rate: 19.76%%
Post-ACA projected uninsured rate: 18.33%
Difference before and after: -1.43%
Pre-ACA uninsured rate: 20.48%
Post-ACA projected uninsured rate: 18.96%
Difference before and after: -1.52%
Pre-ACA uninsured rate: 26.52%
Post-ACA projected uninsured rate: 19.58%
Difference before and after: -6.94%
Pre-ACA uninsured rate: 24.29%
Post-ACA projected uninsured rate: 19.59%
Difference before and after: -4.69%
Pre-ACA uninsured rate: 24.73%
Post-ACA projected uninsured rate: 19.61%
Difference before and after: -5.12%
Pre-ACA uninsured rate: 22.41%
Post-ACA projected uninsured rate: 20.91%
Difference before and after: -1.50%
Pre-ACA uninsured rate: 18.11%
Post-ACA projected uninsured rate: 21.46%
Difference before and after: 3.34%
Pre-ACA uninsured rate: 26.8%
Post-ACA projected uninsured rate: 24.81%
Difference before and after: -1.99%
The components that will make or break a wellness plan
Originally posted October 1, 2014 by Elizabeth Galentine on https://ebn.benefitnews.com.
When shopping around for a wellness program partner, it’s the details that matter. All comprehensive wellness platforms should consist of four core programs — wellness, disease management, EAP and work life components — says Yale Mallinger of wellness company HMC-HealthWorks, but it’s what makes up those components that will make or break a plan. Therefore, advisers must do their due diligence when choosing a wellness provider to work with, he says.
For example, most reputable wellness companies will offer two types of diagnostic questionnaires, behavioral and medical, but advisers should request to sample those tests themselves, Mallinger says. “You should be able to go to their portal and participate, get a score, test it out,” he told attendees during a breakout session Tuesday at EBA’s Workplace Benefits Summit.
Mallinger also recommended breaking down the diagnostic testing process itself. For medical testing, ask the vendor if blood tests are done intravenously, through a finger prick, or both and what the benefits of each method are for a particular employer client. Some employers will want the instant results that a finger prick can provide, while others will be willing to wait a week or two for more comprehensive results from lab, says Mallinger, project director at HMC-HealthWorks.
Then, for clients interested in the lab testing route and submitting the testing to their insurance carrier as a preventative health measure, Mallinger recommends going even further by having their insurance company do a trial run with that billing code to ensure it works.
The whole package
As you look at potential wellness partners, consider whether or not the company offers unbundled plans, Mallinger continues. Although he says “it does no good to put a wellness program in place if you don’t take care of all the problem [areas] for employees,” such as debt management and legal assistance, not every employer will want the top-tier package.
Presenting the benefits of a wellness plan in an unbundled format allows the clients to pick and choose for themselves, he says. Such benefits include:
- A personal health and wellness portal;
- A health library;
- Health risk assessments;
- Mobile app capabilities;
- Reporting capabilities;
- Diabetic supplies;
- Concierge services;
- Coaching services;
- Disease management;
- Biometric screenings;
- Employee assistance programs, and more.
Additionally, as far as mobile technology, every wellness company has an app — “it’s what they do with it and what you can do with it” that counts, Mallinger says.
Some apps have the ability to report a range of statistics to employers, such as what people are reading or if they take a health assessment, he explains, adding that such reports are beneficial not only on an annual basis but also quarterly.
In turn, Mallinger says some wellness companies are primarily software-focused, so advisers should be sure to analyze the type and quality of any wellness coaches they provide. What kind of training do they have? How are they certified? “Take the time to break it down,” he says, and never be afraid to ask for credentials.
There are currently at least three lawsuits related to wellness plans going through the U.S. court system, Mallinger points out, so advisers should also be cautious that plans are in compliance with the Affordable Care Act, Americans with Disabilities Act and others.
7 ways to keep your sanity during open enrollment
Originally posted on https://ebn.benefitnews.com.
‘Tis the open enrollment season in the benefits world. For many benefit managers, that means stress, panic and very long days (and nights). But there are ways to make this time of year less frantic and more productive.
HR cannot run open enrollment in a vacuum. So lean on consultants and communication pros to craft your messaging. Turn to senior leaders for top-down messaging on why changes are happening. Bring in your benefit vendors to explain the impact of changes and walk employees through the enrollment process. Like many things, open enrollment takes a village, so use yours.
Few things can set off a fire drill like systems crashing and just plain misbehaving – especially with online enrollment. Get ahead of the game by partnering with IT to determine how people will enroll, how data will be handled and how it needs to flow between departments (like HR and payroll). Map out contingency plans and decide who will be on point if things go awry.
Be straight-up with employees about what’s changing, why and what they need to do. No spin. No sugar. If you’re making significant plan changes this year, use personas to help people understand how this will affect them. And provide decision guides that walk them through all the variables (particularly deductibles, co-payments, HSA contributions, covered services and provider network details) so they can make the best choice for themselves and their families.
We all put a ton of blood, sweat and tears into benefit planning and open enrollment communications – so much so, that it can become a bit of a one-way street. Keep in mind that this is a time when employees are sitting up straight and paying attention. Ask for their feedback. How do they feel about what’s changing? The benefits overall? Why? What could be done differently? Whether you’re talking with employees at a town hall, engaging with them over social media or asking for their honest responses to a survey, really listen to what they have to say, thoughtfully respond and act on their feedback as much as you can.
We know – right now, it’s all you can do to stay focused on the enrollment at hand. But it’s less daunting than it sounds: what we’re suggesting is that you take employee feedback and lessons learned from this enrollment period and start compiling them for next year. That might be possible benefit changes, new benefits to add or ways to communicate differently. You know what they say about the early bird … and in this case, the sooner you nail down what 12 months from now looks like, the more proactive (and effective) you’ll be when it comes to next year’s systems and communications.
Why not make open enrollment fun – and an opportunity to earn points and prizes? Launch an Open Enrollment Challenge and reward employees for taking various actions, like attending an open enrollment info session, updating beneficiary details and enrolling by a certain date. Or plan an Open Enrollment Walk, where people can head out for a stroll with HR and colleagues, giving them an opportunity to ask benefit questions along the way (and make time afterward too).
Although you may feel like you just don’t have time to take a break, right now you need it more than ever. Along with those enrollment meetings, town halls, social media replies and survey reviews, block time for yourself on the calendar. Go for a run, head out for a relaxing healthy lunch, read a great book, meditate, take a yoga class – whatever makes you happy and keeps you sane.
8 tips to share with employees to ensure a successful open enrollment
Originally posted on https://ebn.benefitnews.com.
As open enrollment season approaches, benefit managers are moving into high gear as they prepare to answer employee questions and concerns about their 2015 benefits. And as employees take on more responsibility for their health care, it’s more important than ever for them to understand how they can make the most of the programs and benefits their employers are offering.
Here are eight tips from benefits consulting firm Aon Hewitt that benefit managers can share with employees to help ensure open enrollment runs smoothly.
Employers are taking steps to make enrollment quicker and easier. “Many companies are designing the process so it is similar to an online retail shopping experience, where employees can access decision support tools and other resources that can help them narrow down their choices and weigh them against their specific needs,” says Joann Hall Swenson, health engagement leader at Aon Hewitt. “Employers are also stepping up their efforts to clearly communicate what is changing from previous years, using a variety of communication methods.” Encourage employees to take advantage of the resources you provide.
Understanding their past needs and estimating their future needs will help employees determine what adjustments they may need to make in their benefits selections for 2015. Encourage employees to start by reviewing how much they’ve spent in the past year out-of-pocket, the costs of their regular prescriptions and the number of doctor visits they’ve had. If they are participating in a flexible spending account, encourage them to re-evaluate their contribution levels based on their actual and anticipated expenses for 2015. It’s also important to think about any life changes that may impact their decisions, such as an addition to the family or the development of a new medical condition that may impact health care expenses.
Over the past few years, there have been many changes taking place in the provider community, including doctor’s groups joining together and hospitals and health systems re-contracting with insurers. As a result, health plan options may include vastly different combinations of doctors and hospitals than in the past. Most employers and health plans offer a number of tools and resources that can help employees assess the cost impact and quality of different providers as they make their enrollment decisions.
CDHPs often have lower premiums, which make them an attractive option for individuals who want to reduce the costs taken out of their paychecks each month. While employees may have a higher deductible to meet, many employers couple these plans with health reimbursement accounts or health savings accounts, which employees can use to help pay for eligible out-of-pocket health care costs. HSAs are the most common, and allow employees to save money by contributing, on a pre-tax basis, up to $3,350 in 2015 or $6,650 if they have family coverage, with no use-it-or-lose-it rule. In addition, employers may also contribute to the HSA. It’s important for employees to understand how the employer’s contributions work so they can maximize this subsidy.
If an employee’s spouse, partner or adult children have access to health coverage elsewhere, including through their employer, it may be more cost effective for them to enroll in this coverage instead of being covered by you. Encourage employees to carefully review and compare these plans to ensure they are choosing the coverage they need at the most favorable cost.
Many employers offer a wide range of health and wellness programs, such as health assessments, weight loss programs and health coaching, to help employees get and stay healthy. Taking part in these programs can help employees understand their current health status, and they might even be able to take advantage of a financial incentive for doing so.
2015 will be the second year of coverage available to Americans through the marketplaces, commonly referred to as “public exchanges.” In most cases, individuals with coverage through their employer will not be eligible for federal tax credits for purchase of insurance through the marketplaces. Employees can visit healthcare.gov to learn more about the marketplaces.
As employees assess their health plan options for 2015, it’s important for them to look holistically at their health and financial well-being, including health care, income protection (e.g., life and disability insurance) and retirement planning. Does their spending reflect their needs and priorities? For example, if they aren’t contributing to your 401(k) plan, remind them that now might be a good time to start. Beginning to save earlier in their careers will help ensure they’re on track to meet their long-term savings goals.