Why mental health in the workplace matters — and what you can do about it

Did you know: Nearly two-thirds of missed workdays can be attributed to mental health conditions. Workplace mental health issues are more prevalent than many may think. Read this blog post to learn more about mental health in the workplace and what you can do about it.


What keeps your employees from showing up for work every day: Flu? Bad back? Car trouble?

Not if your workforce is typical of U.S. employees. The fact is, nearly two-thirds of missed workdays can be attributed to mental health conditions.

Mental health issues in the workplace are much more prevalent — and more serious — than you might think — and Mental Illness Awareness Week (Oct. 6–12) is a great time to think about it. Mental illness is one of the top causes of worker disability in this country, and another insurance company's recent research with employers and employees on mental health in the workplace showed 62% of employees felt mentally unwell at some time in the past year. Even more startling: Among those diagnosed with a mental health issue, 42% have come to work with suicidal feelings.

This type of presenteeism — where employees try to battle through despite their symptoms — can affect the productivity, work quality and morale of your entire team. Not only are those suffering less effective, their co-workers are likely confused and concerned about the behaviors they’re seeing.

The good news is there’s a lot you and your company can do to help.

Mental illness can cover a wide range of conditions. Anxiety disorders are the most common, affecting 40 million adults. They’re highly treatable, yet only 37% of those suffering receive treatment.

Depression — one of several mood disorders that also include seasonal affective disorder and bipolar disorder — is a leading cause of disability worldwide. About 16 million people live with major depression.

But mental health concerns aren’t limited to employees who’ve been diagnosed with a mental illness. Health, finances, personal family relationships, and job satisfaction are all triggers that affect workers’ mental well-being, according to another insurance company’s survey. Even supposedly “happy” events — getting married, having a baby — can cause tremendous stress.

Many employers — hopefully, your company is one — offer mental health resources to their employees to better handle illness and everyday stresses. These can include medical care, employee assistance programs, counseling referrals, and financial and legal counseling.

So far, so good. The problem, however, is a major gap between what HR professionals say they offer and what resources employees are aware of.

For example, 93% of employers in another insurance company’s survey say they offer an EAP — but only 38% of employees realize they have this benefit. Similarly, 90% of employers say their company medical plan includes mental health resources, but only 47% of employees know that. And a quarter of employees surveyed say they’re not aware of any mental health resources at all.

One reason for the lack of understanding about mental well-being resources is the social stigma attached to mental health, and it’s not just among workers: another insurance company’s survey showed 61% of employees feel there’s a stigma in workplace, and 51% of HR professionals agree. And nearly half of both groups say the stigma has stayed the same or gotten worse in the last five years, despite national public campaigns to normalize the conversation about mental wellness.

Most employees (81%) say the stigma associated with mental health issues prevents employees from seeking help. Many of those struggling keep their issues secret for fear of discrimination, reputational problems or job loss. Sadly, more than a quarter don’t disclose their mental issue to their employer because they’re ashamed.

What you can do to help
There are many ways you and your company can open the conversation about mental well-being and provide the resources your employees need to be productive and effective.

  • Communicate with your workforce regularly about mental health resources available to them. Mental Illness Awareness Week (Oct. 6–12) and World Mental Health Day (Oct. 10) offer great opportunities to talk about the topic. Give these resources the same promotion as your other benefits.
  • Encourage senior leaders to participate in the conversation about mental well-being. Showing top-down support helps create a more open, accepting environment.
  • Educate managers about symptoms of mental health issues and how to accommodate employees who need help.
  • Consider the full range of your benefits, beyond health care. For example, financial stress is one of the top factors affecting mental well-being. If you don’t already, consider offering financial planning services or counseling to help employees better plan for their future needs. Benefits such as disability insurance and life insurance — even voluntary coverage that employees pay for themselves — can provide peace of mind and help ease a financial burden during a stressful time.
  • Offer flexible work schedules, including work-at-home arrangements to help employees create better work-life balance.
  • Learn more about mental health issues and solutions, including more tips and best practices for your workplace. Another insurance company’s recent Mental Health Report is a good place to start.

SOURCE: Jackson, M. (7 October 2019) "Why mental health in the workplace matters — and what you can do about it" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/why-mental-health-in-the-workplace-matters


The Open Enrollment Checklist: Are You Poised for a Successful Season

Are you prepared for open enrollment? According to a recent survey, 56 percent of U.S. adults with employer-sponsored health benefits said health coverage satisfaction is a key factor in deciding whether they should leave their current job. Read this blog post from Employee Benefit News to learn more. 


It’s here… the moment we’ve all been waiting for — or, in the case of HR, preparing for (at least we’d hope). That’s right, open enrollment season has arrived.

Open enrollment is a major opportunity for HR to contribute to their company’s performance — both in terms of healthcare savings and employee productivity. The better employees understand their benefits, the more likely they are to make cost-conscious decisions about their plan choices and their healthcare — saving themselves, and their employers, money. Not only that, but a recent survey found that 56% of U.S. adults with employer-sponsored health benefits said that whether or not they like their health coverage is a key factor in deciding to stay at their current job. And, interestingly, satisfaction with benefits and benefits communications have a tremendous impact on job satisfaction and engagement.

Not sure you’ve done everything you could to turn this annual necessity into a true financial, educational game-changer for your organizations? Ask yourself, did you:

Take stock of last year’s enrollment? Before diving into enrollment for 2020, employers should have taken stock of how the company fared last year. Post-mortem meetings with the enrollment team (along with key internal and external stakeholders) to assess what went well (or didn’t) can ensure the coming enrollment season runs smoothly.

In particular, identify the most time-consuming tasks and discuss how they could be streamlined in the future. Second, determine what questions employees asked the most about last year — and be prepared to answer them again this year. Third, consider whether the company achieved its overall open enrollment goals, and what contributed to those results. By addressing the peaks and pitfalls of last year’s season, HR should have a head start on planning for 2020.

Plan your communications strategy?With a defined approach to open enrollment in place, HR at this point should have developed an organized, well-communicated strategy to keep employees informed about their plan options at enrollment and throughout the year. Have you:

· Defined corporate objectives and how to measure success? · Assessed what messages to share with employees, especially anything that is changing — such as adding or eliminating plans or changing vendors? · Determined what information is best delivered in print (e.g. newsletters, posters, postcards, enrollment guides), online or in person through managers or one-on-one enrollment support? Adopting a multi-channel engagement strategy will ensure key messages reach the intended audience(s).

Make sure employees understand the deadline and process for enrolling — and the implications of missing the enrollment window. They must understand whether their existing coverage will roll over, if they’ll default to a specific plan and/or level of coverage (perhaps different from what they currently have), or end up with no coverage at all.

Take a pro-active approach to open enrollment? Ninety percent of employees report that they roll over their same health plan year over year — though this doesn’t indicate overwhelming plan satisfaction. More typically, it’s because they’re intimidated about what they don’t know, are confused about their choices or just don’t care. Employees don’t have the information they need, and aren’t likely to seek it out on their own.

Offering — or even requiring — one-on-one meetings with benefit experts during open enrollment provides a forum for employees to discuss their individual needs and ensure they are selecting the right coverage. These services — often available through brokers or outside engagement firms — provide employees with a safe space to ask specific questions about their health conditions, family history and potential life changes that could affect their insurance needs. This is the ideal time to remind employees that there is no one-size-fits-all plan, and that the least expensive plan on paper may not, ultimately, be the most cost-effective plan over time.

Revisit your SPD? The document we all love to hate, summary plan descriptions (SPDs) remain the best source for information about how each plan works, what it covers and the participant’s rights and responsibilities under that plan.

Having an SPD that is current, appealing (or at least not off-putting) and easy to access can answer many employee questions before they find their way to HR. Simple fixes like adding charts, callout boxes or icons can make your SPDs easier to navigate. Many employers are taking it a step further and offering interactive SPDs, which include robust search functionality and links to definitions, important forms, modeling tools and calculators, vendor sites and even short video clips. By making SPDs digital and interactive, employers can provide employees access to important information about their coverage 24/7 via any device. And, by adding a data analytics component, HR can track which sections employees visit most and pinpoint knowledge gaps about their benefit options to enhance understanding and drive increased benefits usage.

Account for all demographics? With all the focus on today’s multigenerational workforce, it’s important to remember that there’s more to “demographics” than age and gender. Worksite (office vs. shop floor vs. construction site vs. road warrior) can have a tremendous impact on the communications channels you use and when you use them.

And while some “generational generalizations” hold true — many older workers prefer paper, and most young people prefer mobile communication channels — it’s more important to look at employee cohorts from the perspective of differing priorities (planning for retirement vs. retiring student debt), different levels of education and healthcare literacy, and experience with choosing and using benefits. Employees just starting their careers are likely to need more support and different information than a more seasoned worker who’s had years of experience with the enrollment process. Consider the most effective ways to engage the different demographics of your population to gain their attention and interest in choosing the right plan for them.

Equip employees for smart healthcare choices year-round? For most employees, becoming an educated healthcare consumer is a work in progress — which is why many employers offer year-round resources to support smart healthcare choices. That said, these resources are often under-utilized because employees don’t know they exist.

Open enrollment is the perfect time to spread the word about these programs and address the key question for employees: “What’s in it for me?” For example, many employers offer transparency services, which enable employees to research the potential cost of care and compare prices across several providers in their area.

Other resources, such as benefits advocates, can answer questions from employees in real time — including where to get care, how to get a second opinion and what the doctor’s instructions really mean. When used in conjunction, transparency and advocacy services can lower out-of-pocket spending for the employee and reduce costs for the employer. Does your open enrollment communications strategy highlight that these resources exist, outline how they work and explain how they benefit the employee?

What if open enrollment is only a week away and you haven’t taken most, if any, of these steps? It’s not too early to start your to-do list for next year — perhaps by first tackling your SPD and drafting that communications plan. Most importantly, get that post-mortem meeting on the schedule now, while the lessons learned from this year’s open enrollment are still fresh.

SOURCE: Buckey, K. (3 October 2019) "The Open enrollment checklist: Are you Poised for a successful season" (Web Blog Post) https://www.benefitnews.com/list/the-employers-open-enrollment-checklist


‘Eye’ spy a savings opportunity for health and vision benefits

The National Eye Institute reported that 61 million adults are at high risk for serious vision loss. Conventionally, vision benefits were offered as an elective, with coverage is focusing on vision tests or discounts for corrective eyewear. Read the following blog post to learn more about vision benefits.


Sixty-one million adults are at high risk for serious vision loss, according to the National Eye Institute, but most U.S. employers don’t include eye care as part of their benefits package. Vision benefits have traditionally been offered as an elective, where coverage is focused on vision tests or discounts for corrective eyewear.

This often results in inadequate coverage for employees and dependents, which can result in unrecognized and untreated issues that impact employee health and productivity, as well as an employer’s bottom line.

Comprehensive eye exams are recommended for adults under the age of 65 at least every two years, according to the American Optometric Association (AOA). These exams are the only way a doctor can detect signs and symptoms of serious conditions without cutting into or scanning body parts.

The total economic burden of eye disorders and vision loss in the U.S. was $139 billion in 2013, which includes $65 billion in direct medical costs strictly due to eye disorders and low vision. Loss of vision among workers results in $48 billion in lost productivity per year.

When it comes to benefit management priorities employers often focus more on chronic condition management. Yet, eye health is often linked to common chronic conditions including diabetes and hypertension. Without early detection of eye and vision health issues, employees cannot properly manage these conditions. Delaying medical treatment can lead to increased absenteeism and reduced productivity, eventually resulting in treatment that comes too late, and at a much higher price tag for employers, employees and family members.

About 68% of Americans with diabetes have been diagnosed with eye complications, many of which could have been prevented through a comprehensive eye exam. Diabetes is the leading cause of blindness among adults, according to the National Institutes of Health. Its prevalence is increasing as one in 10 people worldwide may be affected by 2040, according to research from the International Diabetes Federation.

Nearly half of Americans don’t know that diabetic eye diseases have visible symptoms, according to a 2018 AOA survey. More than one-third of respondents didn’t know a comprehensive eye exam is the only way to determine if a person’s diabetes will cause blindness. These exams, considered the gold standard in clinical vision care, should be covered under the employees’ medical benefits.

Three years ago the Midwest Business Group on Health began a collaboration with the AOA to better understand how employers think about and implement eye health and vision benefits. As part of this partnership, a no-cost eye care benefits toolkit was developed to support employers in evaluating their current eye health and vision care benefits to:

  • Understand the importance of early detection so that employees can effectively manage chronic and more serious conditions
  • Recognize how to integrate primary and preventive eye care into an overall medical benefit design
  • Educate employees on the importance of periodic eye examinations

It’s important that employers better understand the impact of vision care benefits, including lower costs, better employee health, improved job satisfaction, better employee quality of life, and work productivity.

SOURCE: Larson, C. (20 September 2019) "‘Eye’ spy a savings opportunity for health and vision benefits" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/vision-loss-resulting-in-billions-in-lost-productivity


Health insurance surpass $20,000 per year, hitting a record

According to an annual survey of employers, the cost of family health coverage has now surpassed $20,000, a record high. The survey also revealed that while most employers pay most of the costs of coverage, workers' average contribution for a family plan is now $6,000. Read this blog post from Employee Benefit News to learn more.


The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of American workers into plans that cover less or cost more, or force them out of the insurance market entirely.

“It’s as much as buying a basic economy car,” said Drew Altman, chief executive officer of the Kaiser Family Foundation, “but buying it every year.” The nonprofit health research group conducts the yearly survey of coverage that people get through work, the main source of insurance in the U.S. for people under age 65.

While employers pay most of the costs of coverage, according to the survey, workers’ average contribution is now $6,000 for a family plan. That’s just their share of upfront premiums, and doesn’t include co-payments, deductibles and other forms of cost-sharing once they need care.

The seemingly inexorable rise of costs has led to deep frustration with U.S. healthcare, prompting questions about whether a system where coverage is tied to a job can survive. As premiums and deductibles have increased in the last two decades, the percentage of workers covered has slipped as employers dropped coverage and some workers chose not to enroll. Fewer Americans under 65 had employer coverage in 2017 than in 1999, according to a separate Kaiser Family Foundation analysis of federal data. That’s despite the fact that the U.S. economy employed 17 million more people in 2017 than in 1999.

“What we’ve been seeing is a slow, slow kind of drip-drip erosion in employer coverage,” Altman said.

Employees’ costs for healthcare are rising more quickly than wages or overall economy-wide prices, and the working poor have been particularly hard-hit. In firms where more than 35% of employees earn less than $25,000 a year, workers would have to contribute more than $7,000 for a family health plan. It’s an expense that Altman calls “just flat-out not affordable.” Only one-third of employees at such firms are on their employer’s health plans, compared with 63% at higher-wage firms, according to the Kaiser Family Foundation’s data.

The survey is based on responses from more than 2,000 randomly selected employers with at least three workers, including private firms and non-federal public employers.

Deductibles are rising even faster than premiums, meaning that patients are on the hook for more of their medical costs upfront. For a single person, the average deductible in 2019 was $1,396, up from $533 in 2009. A typical household with employer health coverage spends about $800 a year in out-of-pocket costs, not counting premiums, according to research from the Commonwealth Fund. At the high end of the range, those costs can top $5,000 a year.

While raising deductibles can moderate premiums, it also increases costs for people with an illness or who gets hurt. “Cost-sharing is a tax on the sick,” said Mark Fendrick, director of the Center for Value-Based Insurance Design at the University of Michigan.

Under the Affordable Care Act, insurance plans must cover certain preventive services such as immunizations and annual wellness visits without patient cost-sharing. But patients still have to pay out-of-pocket for other essential care, such as medication for chronic conditions like diabetes or high blood pressure, until they meet their deductibles.

Many Americans aren’t prepared for the risks that deductibles transfer to patients. Almost 40% of adults can’t pay an unexpected $400 expense without borrowing or selling an asset, according to a Federal Reserve survey from May.

That’s a problem, Fendrick said. “My patient should not have to have a bake sale to afford her insulin,” he said.

After years of pushing healthcare costs onto workers, some employers are pressing pause. Delta Air Lines Inc. recently froze employees’ contributions to premiums for two years, Chief Executive Officer Ed Bastian said in an interview at Bloomberg’s headquarters in New York last week.

“We said we’re not going to raise them. We're going to absorb the cost because we need to make certain people know that their benefits structure is real important,” Bastian said. He said the company’s healthcare costs are growing by double-digits. The Atlanta-based company has more than 80,000 employees around the globe.

Some large employers have reversed course on asking workers to take on more costs, according to a separate survey from the National Business Group on Health. In 2020, fewer companies will limit employees to so-called “consumer-directed health plans,” which pair high-deductible coverage with savings accounts for medical spending funded by workers and employers, according to the survey. That will be the only plan available at 25% of large employers in the survey, down from 39% in 2018.

Employers have to balance their desire to control costs with their need to attract and keep workers, said Kaiser’s Altman. That leaves them less inclined to make aggressive moves to tackle underlying medical costs, such as by cutting high-cost hospitals out of their networks. In recent years employers’ healthcare costs have remained steady as a share of their total compensation expenses.

“There’s a lot of gnashing of teeth,” Altman said, “but if you look at what they do, not what they say, it’s reasonably vanilla.”

SOURCE: Tozzi, J. (25 September 2019) "Health insurance surpass $20,000 per year, hitting a record" (Web Blog Post). Retrieved from https://www.benefitnews.com/articles/health-insurance-costs-surpass-20-000-per-year


6 voluntary benefits your employees want

Multigenerational workforces are no longer finding the run-of-the-mill benefits plans adequate. This is making voluntary benefits more important than ever in this age of the multigenerational workforce and a tight labor market. Read this blog post from for six voluntary benefits employees want.


In this age of the multigenerational workforce and a tight labor market, a one-size-fits-all group benefits model with medical, prescription, dental, vision and a retirement plan just doesn’t cut it. A workforce with Baby Boomers, Gen X’ers, Millennials and Generation Z means that employees are going to find the run-of-the-mill benefits plan inadequate. Ditto for job seekers.

What follows is that voluntary benefits are more important than ever. Offering a range of voluntary benefits can help meet the needs of employees at all life stages.

Voluntary benefits add value to benefit plans and are typically easy to administer. They’re low-to-no-cost because employees pay for them, and maintenance is often handled through a payroll deduction. Many voluntary benefits also offer guaranteed acceptance at a lower rate than medical benefits, so even if a small group within your company chooses a particular benefit, they’ll be covered.

This landscape is changing quickly. Here are six trending voluntary benefits your employees want.

Student loan debt repayment assistance

Debt among college graduates has grown to nearly $1.6 trillion. It’s preventing the largest employee segment at most companies from buying houses or cars, saving for retirement, having kids and getting married. To help employees repay their student loan debt, some employers are helping employees pay down student loan debt through a direct payroll deduction.

Others are offering a new, IRS-allowable retirement plan match swap where an employer can opt to increase its defined contribution match, enabling employees to reduce their retirement match and contribute funds to repaying student loans instead.

Interest in this benefit continues to grow. Employers looking to offer student loan debt repayment should be aware that not all platforms are created equal. Look out for high per-employee, per-month fees.

Individual long-term care

A growing number of people are beginning to understand the value of long-term care insurance because they have taken care of or currently care for a friend or relative who needs round-the-clock care. Long-term care insurance covers home or institutional care if a person is no longer able to perform at least two activities of daily living--eating, bathing, dressing, moving from a bed to a chair or using a toilet.

Employees are interested in buying long-term care insurance through their employer because they can offer better rates for simplified issue plans. If you plan to offer long-term care as an employer-sponsored benefit, I recommended rolling it out with a strategic project plan and a benefit counselor or a technology platform capable of providing decision-making tools for a smooth application process.

Executive reimbursement plans

Employee retention — especially executive retention — is on the minds of many employers in the midst of this thriving economy. Filling gaps in medical and prescription coverage is one way to provide executive teams with premium benefits they may be looking for.

Executive reimbursement plans provide reimbursement for out-of-pocket expenses, access to facilities and level of service not normally covered under most group health plans. Rather than simply increasing compensation to help cover out-of-pocket expenses, premiums for these plans are tax-deductible for the employer, and benefits are non-taxable for employees.

Executive individual disability insurance

Traditional employer-sponsored long-term disability (LTD) is likely not enough coverage for highly-compensated employees or some sales staff who depends heavily on commission and bonuses. Normally, LTD pays employees 50-70% of their salary up to a certain amount.

Employers can carve out additional coverage for employees based on their management level, performance or tenure. Individual disability insurance plans can protect employees until they turn 65; they can also protect job titles or levels until employees are well enough to return to work. Executive individual disability insurance, like executive reimbursement, can be offered as a form of compensation, or a form of financial asset protection for higher incomes.

Telemedicine

The rise of consumer-driven health plans has led to the need for telemedicine. Telemedicine provides a way for employees to see a physician or provider by video and get a diagnosis and/or prescription quickly. The success of telemedicine is leading some carriers to integrate it within their plan. However, standalones still exist and can provide employees with an easy way to get care faster and cheaper than before.

Pet Insurance

Pet parents spend nearly $70 billion on veterinarian costs for their pets, but just 10% of dogs and 5% of cats are covered by medical insurance. As pets begin to play a larger role in our lives, more employers are offering pet insurance to their employees to help defray the cost of unexpected medical expenses.

There are a number of plan options, and setting up a plan for employees’ pets is simple. However, it’s vital that employers do their research to ensure the veterinarian network includes the best vets.

As part of a voluntary benefit offering, be sure to develop a rollout strategy and communications plan so employees are thoroughly educated and you meet group minimums.

SOURCE: Park, N. (25 September 2019) "6 voluntary benefits your employees want" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/6-voluntary-benefits-your-employees-want


8 renewal considerations for 2020

Are you prepared for open enrollment 2020? With renewal season quickly approaching, plan administrators have a lot of considerations to make regarding employee health plans. Read the following blog post from Employee Benefit News for eight things to consider this year.


The triumphant return of the Affordable Care Act premium tax (the health insurer provider fee).

This tax of about 4% is under Congressional moratorium for 2019 and returns for 2020. Thus, fully insured January 2020 medical, dental and vision renewals will be about 4% higher than they would have been otherwise. Of note, this tax does not apply to most self-funded contracts, including so-called level-funded arrangements. Thus, if your plans are presently fully insured, now may be a good time to re-evaluate the pricing of self-funded plans.

Ensure your renewal timeline includes all vendor decision deadlines.

As the benefits landscape continues to shift and more companies are carving out certain plan components, including the pharmacy benefit manager, you may be surprised with how early these vendors need decisions in order to accommodate benefit changes and plan amendments. Check your contracts and ask your consultant. Further, it seems that our HRIS and benefit administration platforms are ironically asking for earlier and earlier decisions, even with the technology seemingly improving.

Amending your health plan for the new HSA-eligible expenses.

In July of this year, the U.S. Treasury loosened the definition of preventive care expenses for individuals with certain conditions.

While these regulations took effect immediately, they won’t impact your health plan until your health plan documents are amended. Has your insurer or third-party administrator automatically already made this amendment? Or, will it occur automatically with your renewal? Or is it optional? If your answer begins with “I would assume…,” double-check.

Amending your health plan for the new prescription drug coupon regulations.

As we discussed in July of this year, these regulations go into effect when plans renew in 2020. In short, plans can only prevent coupons from discounting plan accumulators (e.g., deductible, out-of-pocket maximum) if there is a “medically advisable” generic equivalent.

If your plan is fully insured, what action is your insurer taking? Does it seem compliant? If your plan is self-funded, what are your options? If you can keep the accumulator program and make it compliant, is there enough projected program savings to justify keeping this program?

Is your group life plan in compliance with the Section 79 nondiscrimination rules?

A benefit myth that floats around from time to time is that the first $50,000 in group term life insurance benefits is always non-taxable. But, that’s only true if the plan passes the Section 79 nondiscrimination rules. Generally, as long as there isn’t discrimination in eligibility terms and the benefit is either a flat benefit or a salary multiple (e.g., $100,000 flat, 1 x salary to $250,000), the plan passes testing. Ask your attorney, accountant, and benefits consultant about this testing. If you have two or more classes for life insurance, the benefit is probably discriminatory. If you fail the testing, it’s not the end of the world. It just means that you’ll likely need to tax your Section 79-defined “key employees” on the entire benefit, not just the amount in excess of $50,000.

Is your group life maximum benefit higher than the guaranteed issue amount?

Surprisingly, I still routinely see plans where the employer-paid benefit maximum exceeds the guaranteed issue amount. Thus, certain highly compensated employees must undergo and pass medical underwriting in order to secure the full employer-paid benefit. What often happens is that, as benefit managers turnover, this nuance is lost and new hires are not told they need to go through underwriting in order to secure the promised benefit. Thus, for example, an employee may think he or she has $650,000 in benefit, while he or she only contractually has $450,000. What this means is the employer is unknowingly self-funding the delta — in this example, $200,000. See the problem?

Please pick up your group life insurance certificate and confirm that the entire employer-paid benefit is guaranteed issue. If it is not, negotiate, change carriers, or lower the benefit.

Double-check that you haven’t unintentionally disqualified participant health savings accounts (HSAs).

As we discussed last December, unintentional disqualification is not difficult.

First, ensure that the deductibles are equal to or greater than the 2020 IRS HSA statutory minimums and the out-of-pocket maximums are equal to or less than the 2020 IRS HSA statutory maximums. Remember that the IRS HSA maximum out-of-pocket limits are not the same as the Affordable Care Act (ACA) out-of-pocket maximum limits. (Note to Congress – can we please align these limits?)

Also, remember that in order for a family deductible to have a compliantly embedded single deductible, the embedded single deductible must be equal to or greater than the statutory minimum family deductible.

Complicating matters, also ensure that no individual in the family plan can be subject to an out-of-pocket maximum greater than the ACA statutory individual out-of-pocket maximum.

Finally, did you generously introduce any new standalone benefits for 2020, like a telemedicine program, that Treasury would consider “other health coverage”? If yes, there’s still time to reverse course before 2020. Talk with your tax advisor, attorney, and benefits consultant.

Once all decisions are made, spend some time with your existing Wrap Document and Wrap Summary Plan Description.

For employers using these documents, it’s easy to forget to make annual amendments. And, it’s easy to forget, depending on the preparer, how much detail is often in these documents. For example, if your vision vendor changes or even if your vision vendor’s address changes, an amendment is likely in order. Ask your attorney, benefits consultant, and third party administrators for help.

SOURCE: Pace, Z. (Accessed 9 September 2019) "8 renewal considerations for 2020" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/healthcare-renewal-considerations-for-2020


Illnesses, Deaths Tied to Vaping

New reports are showing that the use of electronic cigarettes (vaping) is believed to be responsible for five deaths and 450 severe lung injuries. Continue reading this article from SHRM to learn more.


The use of electronic cigarettes, also known as vaping, is believed to be responsible for five deaths and 450 severe lung injuries in what appears to be a nationwide epidemic, according to new reports.

E-cigarettes are battery-operated and produce vapor that simulates smoking. They can resemble regular cigarettes, cigars, pipes, pens, USB sticks and other everyday items. They do not burn tobacco, but the device heats a liquid that usually contains nicotine, flavorings and other chemicals.

While most employers ban smoking in the workplace, their policies don't always extend to e-cigarette products. However, a Centers for Disease Control and Prevention (CDC) health alert on Aug. 30 warned that severe pulmonary disease is associated with using e-cigarette products. The agency, which is part of the U.S. Department of Health and Human Services, launched a multistate investigation into the lung illnesses on Aug. 1.

"Although more investigation is needed to determine the vaping agent or agents responsible," wrote Dr. David C. Christiani of the Harvard School of Medicine, "there is clearly an epidemic that begs for an urgent response." He shared his comments in the Sept. 6 issue of the New England Journal of Medicine, along with the preliminary report "Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin."

The CDC is working with the U.S. Food and Drug Administration, states and other public health partners and clinicians to determine what is sickening users, and in some cases resulting in fatalities. On Friday, it suggested that people refrain from using e-cigarette products during its investigation.

SHRM Online has collected the following articles about this topic from its archives and other trusted sources.  

5 Deaths Linked to Vaping. Officials Are Urging Consumers to Stop. (Chicago Tribune)

How Are You Handling Vaping at Work? (SHRM Online)

More States Ban Vaping, E-Cigarette Use in Workplaces (Bloomberg)

Florida Adds Vaping to Regulated Indoor Smoking (SHRM Online)

SOURCE: Gurchiek, K. (6 September 2019) "Illnesses, Deaths Tied to Vaping" (Web Blog Post). Retrieved from https://www.shrm.org/hr-today/news/hr-news/Pages/Illnesses-Deaths-Tied-to-Vaping-.aspx


Survey: What Employees Want Most from Their Workspaces

This year, employers across the country are expected to spend an average of $3.6 million on employer-sponsored wellness programs. Some of the benefits companies are investing in include onsite gyms, standing desks, meditation rooms and nursing hotlines. Continue reading this blog post to learn more about what employees want most out of their workspaces.


In an effort to support a healthier and more productive workforce, employers across the country are expected to spend an average of $3.6 million on wellness programs in 2019. Think onsite gyms. Standing desks. Meditation rooms. Nursing hotlines. These are just some of the benefits companies are investing in.

But is any of it paying off?

The results of a recent Harvard study suggest that wellness programs, offered by 80% of large U.S. companies, yield unimpressive results — and our findings mirror this. Future Workplace and View recently surveyed 1,601 workers across North America to figure out which wellness perks matter to them most and how these perks impact productivity.

Surprisingly, we found employees want the basics first: better air quality, access to natural light, and the ability to personalize their workspace. Half of the employees we surveyed said poor air quality makes them sleepier during the day, and more than a third reported up to an hour in lost productivity as a result. In fact, air quality and light were the biggest influencers of employee performance, happiness, and wellbeing, while fitness facilities and technology-based health tools were the most trivial.

Organizations have the power to make improvements in these areas, and they need to, both for their workers and themselves. A high-quality workplace — one with natural light, good ventilation, and comfortable temperatures — can reduce absenteeism up to four days a year.  With unscheduled absenteeism costing companies an estimated $3,600 annually per hourly worker and $2,650 each year for salaried workers, this can have a major impact on your bottom line.

Other research finds that employees who are satisfied with their work environments are 16% more productive, 18% more likely to stay, and 30% more attracted to their company over competitors. Two-thirds of our survey respondents said that a workplace focused on their health and wellbeing would make them more likely to accept a new job or keep the job they have. This means that companies willing to adapt to an employee-centric view of workplace wellness will not only increase their productivity, they will also improve their ability to attract and retain talent.

To get started, here are three steps you can take to improve your work environments and the wellbeing of your employees:

1.  Stop spending money on pointless office perks. A good rule of thumb is to never assume that you know what your employees want — but instead, find ways to ask them. If more employers did, they might put less emphasis on office perks that only a minority of employees will take advantage of (like an onsite gym), and more on changes in the workplace environment that impact all employees (like air quality and access to light).

The number one environmental factor cited in our survey was better air quality. Fifty-eight percent of respondents said that fresh, allergen-free air would improve their wellness. Fifty percent said they would work and feel better with some view of the outdoors, while one third said they would want the ability to adjust the temperature in their workspace. Only one in three survey respondents characterized their office temperature as ideal.

Noise distractions bothered more than a third of those surveyed, impacting their ability to concentrate. Employees said sounds like phones ringing, typing on keyboards, and distractions from coworkers all impacted their concentration.

Almost half of our respondents wanted to see their companies improve these environmental factors, and in many instances, more than they wanted to be offered office perks. The first step, then, is to take a look at where you are spending your money, and consider cutting expenses that aren’t worth the cost.

2. Personalize when possible. We’ve all gotten used to personalizing our outside-of-work lives. We binge the shows we want to watch and listen to the music we like to hear, even if our partners or friends have different preferences. We adjust our thermostats without having to get up off our couches, and dim our lights to our level of satisfaction.

Employees are beginning to expect these same privileges in the workplace. Our survey revealed that employees, by a margin of 42% to 28%, would rather be able to personalize their work environment than opt for unlimited vacation. Specifically, what employees want to personalize:

  • Workspace temperature: Nearly half want an app that will let them set the temperature in their workspace.
  • Overhead and desk lighting: One-third wants to control their overhead and desk lighting, as well as the levels of natural light streaming in.
  • Noise levels: One-third would like to “soundscape” their workspace.

While these asks may sound exclusive to the personal offices of higher-ups — they’re not. Hewlett Packard Enterprise headquarters is just one example of a company that has managed to help employees control the noise level in an open floor plan. Their building was actually designed to manage ambient sound in order to reduce worker distractions. Some companies like Regeneron Pharmaceuticals, have gone a step further, allowing employees to control the amount of natural light streaming in through the glass of their office windows with a cell phone app.

But for organizations that don’t want to invest in a completely new building, there is a more organic route. Cisco, for example, has managed the acoustic levels in their space by creating a floor plan without assigned seating that includes neighborhoods of workspaces designed specifically for employees collaborating in person, remotely, or those who choose to work alone.

This same strategy applies to light or temperature. You can position employees who want a higher temperature and more light around the edge of your floor plan, and those who like it quieter and cooler in the core.

3. Create a holistic view of workplace wellness. When deciding what changes to make to your organization, remember that workplace wellness is not just about the physical health of your employees. It includes physical wellness, emotional wellness, and environmental wellness. To create a truly healthy work environment, you must take all three of these areas into consideration:

  • Emotional wellness: Give employees access to natural light, and quiet rooms where they can comfortably focus on their work.
  • Physical wellness: Provide people with healthy food options, and ergonomically designed work stations.
  • Environmental wellness: Make sure your workspaces have adequate air quality, light, temperature, and proper acoustics.

Companies that adapt to a more holistic view of workplace wellness will soon realize no one department alone can solve the puzzle. Our study results, along with the results from the World Green Building Council report,  push organizations to take a closer look at what changes they can make that will actually matter. My suggestion: consider how you can get back to the basics employees want, and invest in the core areas that will have the most impact.

SOURCE: Meister, J. (26 August 2019) "Survey: WHat Employees Want Most from Their Workplaces" (Web Blog Post). Retrieved from https://hbr.org/2019/08/survey-what-employees-want-most-from-their-workspaces

Employers look to virtual services to curb rising health costs

Employers are looking for ways to stem the rising costs of healthcare and find ways to better engage employees. According to the National Business Group on Health, 64 percent of employers believe virtual care will play a significant role in healthcare delivery. Read this blog post to learn more about virtual services.


WASHINGTON — With the continued cost of healthcare benefits expected to increase by another 5%, topping $15,000 per employee, employers are looking for ways to stem the increase and better engage employees in holistic well-being.

One of those ways is through virtual care. The number of employers who believe virtual care will play a significant role in how healthcare is delivered in the future continues to grow, up to 64% going into 2020 from 52% in 2019, according to the National Business Group on Health’s annual healthcare strategy survey.

“Virtual care solutions bring healthcare to the consumer rather than the consumer to healthcare,” Brian Marcotte, president and CEO of NBGH said at a press briefing Tuesday. “They continue to gain momentum as employers seek different ways to deliver cost-effective, quality healthcare while improving access and the consumer experience. Of particular note is the growing interest among employers to offer virtual care for mental health as well as musculoskeletal conditions.”

The majority of respondents (51%) will offer more virtual care programs next year, according to the survey. Nearly all employers will offer telehealth for minor, acute services while 82% will offer virtual mental health services — a figure that’s expected to grow to 95% by 2022.

Virtual care for musculoskeletal management shows the greatest potential for growth, the study noted. While 23% of employers will offer musculoskeletal management virtual services next year, another 38% are considering it by 2022. Physical therapy is the best way to address musculoskeletal conditions and help avoid surgery, but it can be inconvenient and costly, said Ellen Kelsay, chief strategy officer at NBGH.

“Where we’ve seen a lot of development in areas of virtual solutions is to provide remote physical therapy treatments,” she said. “Employees can access treatment through their virtual app wherever it’s convenient for them.”

Regardless, employee utilization of virtual services still remains low. For example, while roughly 70% of large companies provide telemedicine coverage, only 3% of employees use it, according to prior NBGH data.

But many resources are out of sight and out of mind, Kelsay said. However, employers are focusing on offering high-touch concierge services to help workers better navigate the healthcare system.

Employers are reaching a point of saturation with the number of solutions that are available, but from the employee’s perspective, they just don’t know where to start, she added. “These concierge and navigator services really help point employees in the direction to the solution at the point in time they need it.”

In addition, the use of predictive analytics and claims data is also an opportunity to help employers get the right programs in front of employees in the moment, Marcotte added.

“Some of these engagement platforms are getting at personal messaging and predictive analytics. It’s not where we want it to be yet, but as that continues to get better, I think you’ll see utilization go up,” he said.

Source: Otto, N. (13 August 2019) "Employers look to virtual Services to curb rising health costs" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/employers-look-to-virtual-services-to-curb-rising-healthcare-costs

Employers shouldn’t fear expansion of Medicare

A new survey from the National Business Group on Health found that only 23 percent of large employers believe Medicare eligibility should drop to age 50. Read this article from Employee Benefits Advisor to learn more about the potential expansion of Medicare.


Like a significant chunk of American voters, a majority of large employers want to expand Medicare. Just not too much.

A new survey of 147 large employers from the National Business Group on Health found that 55% of them support a Medicare expansion that’s limited to older Americans. Only 23% think eligibility should drop to age 50, however, and 45% don’t think it should expand at all. A majority believe that a broader “Medicare for All” plan would increase health costs.

The same survey also highlights why employers should consider coming around on health reform that reduces their role in the system. The growth in health costs has outpaced inflation and wage growth for years, and the surveyed businesses expect it to rise 5% to $15,375 for each employee next year.

About 70% of those costs will fall on the companies, which plan to try everything from boosting virtual health services to investing in health concierges to rein them in, according to the survey.

History suggests that their best efforts might not amount to much.

Employer-sponsored insurance is America’s single largest source of health coverage. That’s mostly true because the IRS exempted employer health benefits from taxes in 1943, a move that created the federal government’s single biggest tax expenditure. Large companies derive some benefit from the current system because they can provide a significant tax-free benefit that helps them compete for talent and pay people less. But it comes with significant drawbacks. Employers have to devote substantial resources to providing healthcare and controlling costs. Many of them have no particular expertise or advantage in doing so.

The results are mixed. Yes, individuals with private insurance are generally satisfied with the quality of their coverage. They’re not nearly as happy about the cost as deductibles rise. The U.S. pays more than any other developed country for healthcare and medicines and receives worse results on a variety of metrics.

Employers pay particularly high prices and spend heavily on plans that have higher overhead than public alternatives. A recent RAND study found that employer-sponsored plans paid hospitals at 241% of Medicare rates in 2017. Employers are already effectively subsidizing public programs, not to mention the profitability of insurers, health care providers and drugmakers.

It’s not entirely their fault. The American system inherently fragments negotiating power, which gives providers a significant advantage and makes it difficult for even the largest employers to get a good deal. Turning a larger piece of healthcare over to the government would free companies to focus more time and resources on their actual business instead of on navigating the world’s most expensive and convoluted healthcare market.

Big businesses most likely fear big Medicare expansion in large part because it would lead to a significant tax increase. But looking at any tax increase as an enemy is a mistake. Those taxes represent a trade-off; they would replace some or all of the billions of dollars that employers are currently spending on care. Depending on what taxes are imposed and whether the public plan is able to control costs better than the current system — and it could hardly do worse — many employers could come out ahead.

There are a lot of unknowns when it comes to Medicare for All and plans that move the country in that direction. Employers are right to be skeptical until they know more, but the results could well shake out in their favor, and they shouldn’t be so quick to discount the approach.

SOURCE: Nisen, M. (15 August 2019)"Employers shouldn’t fear expansion of Medicare" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/employers-shouldnt-fear-expansion-of-medicare