A health insurance primer for your employees during Open Enrollment

The end of open enrollment season is quickly approaching. During open enrollment, employees have the chance to choose a benefits plan or change from the plan they currently have. Read this blog post for a few things employees should consider when choosing a plan.


Now is the time to choose the best health plan for you and your family. During open enrollment season, employers and the Health Insurance Marketplace (or Exchange) let you choose a plan or change from the plan you have. Making the right choice can impact your health and your wallet.

Even if your current coverage seems satisfactory, your employer or the Exchange may offer new options that better suit your needs. It is important to compare costs and to understand differences in benefits, networks and other rules. In some states, plans available outside the official Marketplace offer attractive, low premiums but may have dollar limits on benefits, or may not provide coverage for childbirth, mental health and other services mandatory for plans that qualify under the Affordable Care Act (the “ACA” or “Obamacare”). Review and compare such plans’ terms carefully.

The time for your decision is limited. Employers generally provide a month or more to make your selection. Open enrollment for the federal Marketplace runs only from November 1, 2019, to December 15, 2019. Exceptions may be made for life changes like the birth of a child or loss of coverage under a spouse’s plan, but if you miss open enrollment season, you will probably have to wait another year to enroll. Here are some things to think about when choosing a plan.

Costs

The first cost to consider is the premium — the payment, usually monthly, to maintain coverage. If you get your plan through your job, your employer may pay all or part of the premium. If you choose a Marketplace plan, you may qualify for a premium tax credit to reduce the premium.

Other insurance costs are known as cost sharing, because you share the cost of care with your plan. They may take the form of a copay (a fixed dollar amount for each service), coinsurance (a set percentage of the cost of a service) or a deductible (the amount you must pay before your plan starts paying for services). If you select a Marketplace plan, you may qualify for cost-sharing reductions to lower those expenses.

In principle, it would be nice if all the costs were as low as possible. But usually, low-cost sharing comes with a high premium. High-deductible health plans may offer lower premiums but you will pay more out-of-pocket before your insurance pays anything.

In shopping for a health plan, consider how high a premium you are willing to pay for the level of cost sharing you would like. For example, if you or a family member have a chronic illness, you may need regular treatment and may be at risk for hospitalization. In that case, you may be willing to pay a higher premium for low-cost sharing. But if you are a healthy, young, single adult who rarely sees a doctor, you might accept a high deductible in exchange for a low premium.

Bear in mind that if you have a high-deductible health plan, you might be eligible to set up a health savings account (HSA). An HSA provides tax savings that stretch the dollars you contribute to the account to help pay for qualified medical expenses.

Choice of Doctors

If you like your current doctors and want to keep seeing them, make sure they and their facilities belong to the network of providers who have contracted with the plan you are considering. Check the plan’s online provider directory to make sure those doctors and their facilities are listed in its network. Even if you do not have a regular doctor, make sure the network includes providers close to where you live and work.

If you want to choose freely among many providers, a plan with a broad network might be for you. That may be more expensive than a plan with a narrow network, which may cost less but has a more limited choice of providers.

Out-of-Network Coverage

As good as a plan’s network might be, you may still wish to consult providers outside the network from time to time. If so, consider a Preferred Provider Organization (PPO) or Point of Service (POS) plan; each provides out-of-network benefits. With such plans, you will still spend more for out-of-network than in-network care, but at least you will have some coverage. Two other types of plans, Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO), typically will not pay for out-of-network care except for emergencies.

Who’s in Charge of Your Care?

In HMO and POS plans, you choose a primary care physician (PCP) who acts as a form of “gatekeeper” for your care. Unless it is an emergency, when you need medical treatment, you go to the PCP first. The PCP either treats you personally or refers you to specialists in your network. If you like having a PCP’s guidance, this arrangement might work for you. But if you prefer choosing specialists directly, you might opt for a PPO or EPO.

ACA-Compliant versus Association and Short-Term Plans

Whatever plan you choose, it is important to consider whether it covers all the types of healthcare you might need and whether it limits the dollar amount of your coverage. Plans that comply with the ACA are comprehensive because they have to cover 10 essential health benefits. Short-term, limited-duration (STLD) health plans, do not have to cover all those benefits. They may, for example, not cover childbirth, mental health or prescription drugs. If you end up needing care that is not covered, you will have to pay the whole cost yourself.

AHPs and STLD plans differ from ACA-compliant plans in other ways. For example, STLD plans can impose annual or lifetime dollar limits on coverage. If your care costs more than those limits, you have to pay the excess amount.

SOURCE: Gelburd, R. (5 December 2019) "A health insurance primer for your employees during Open Enrollment" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/a-health-insurance-primer-for-your-employees-during-open-enrollment


Improving your employee experience during open enrollment

Is your company open enrollment hosted on an online platform? Employers often struggle with employee participation during the open enrollment season. Hosting enrollments online is one way to increase employee participation this year. Read on for more tips to help ease this open enrollment season.d


For HR professionals, open enrollment is one of the most stressful and demanding times of the year. Many employers struggle with employee participation and expensive, time-consuming roll-outs. They also have to provide resources to help employees make the right plan selections for themselves and their families. As we head into another open enrollment season, consider these tips to ease the process.

Switch your open enrollments to online platforms.

If you’re still relying on paper enrollment forms, you are likely spending more money and time than you need to in pursuit of your manual work process and its many inconsistencies. Online platforms provide optimum efficiency, accuracy and convenience for your workforce, offering employee self-service options that encourage employees to take initiative in selecting the best plan for their situation. Not only will members of your workforce benefit from the convenience of being able to explore their options on their own time, but you’ll be able to offer them multi-lingual enrollment materials and have more time to assist them than ever before.

Prioritize and diversify communication.

One of the top ways to ensure a smooth open enrollment period is to use multiple communication channels, including frequent reminders regarding open enrollment deadlines. Without consistent outreach on the part of your HR officers and general managers, you will likely find yourself hunting people down to meet your enrollment and extension deadlines. Using an online self-service portal as well as traditional in-person meetings allow you to remind your employees of critical dates and changes as enrollment closes in.

The robust benefits administration system you choose should offer enrollment tracking and reporting features so you can see at a glance who still needs to begin open enrollment, who has left enrollment documents incomplete, who has made changes to their benefits (such as adding a dependent) and more. You can arrange for the system to send automatic reminders to signal the employee that further actions are needed. Providing multiple reminders will improve participation and the completion of on-time enrollments.

Help employees choose the best health plan for their situation.

In order to have the most successful open enrollment period possible, educating your employees on the different plan options available will go a long towards ensuring employee satisfaction. Studies have shown that most employees don’t have the necessary understanding of terms like “deductible” and “coinsurance,” let alone the tools to know which plan is best for their individual needs. Incorporating at-a-glance comparison tools and charts into your online or print enrollment materials can help employees make the most informed decision possible. It can also be helpful to provide educational materials like videos and simplified plan charts or cost calculators.

Keep Up with Benefit Trends and Voluntary Offerings.

Given the current labor shortage and competitive talent market, you’ll want to make sure your company is up to speed on which new benefits your competitors are looking to add, as well as which ones are appealing to specific roles, locations or generations within potential candidates from your hiring pool.

Voluntary benefits, for example, are playing an increasingly important role in employee benefits portfolios and they don’t cost you anything. Some of the most popular voluntary benefits right now include identity theft protection, pet insurance, long term care insurance and critical illness protection. If you aren’t currently offering these types of additional benefits, they could be a cost-effective way to boost employee morale, increase participation in enrollment and attract more workers to your business.

SOURCE: Smith, M. (2 December 2019) "Improving your employee experience during open enrollment" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/improving-your-employee-experience-during-open-enrollment


Key factors in choosing your benefits during open enrollment

Employers are now realizing that in order to attract and retain talent, they have to provide the best benefits. But, how do employees select the right benefits out of all the available options? Read the following blog post from Employee Benefit News for a few key factors to consider when choosing your benefits during open enrollment.


Even if you are a veteran in choosing employer-sponsored benefits, the landscape is shifting. Over the past years, we’ve seen changes to mental health counseling stipends, extended maternity/paternity leave and family building. Companies across industries are realizing that in order to attract and retain talent, they need to provide best in class benefits that save employers unforeseen costs in the long run, and shows employees that their employers are invested in their wellbeing — in and out of the office.

With all these available options and only a short window to select what’s right for you, here’s what should you look out for during open enrollment.

Which benefits matter to me?

The beauty of a diverse workforce is that employees may represent various walks of life. However, this means that not all benefits make sense for every person. Perhaps your boss is prioritizing childcare for his toddler while your colleague is looking to refinance student loans. Whatever your life circumstance, ask yourself, “Which benefits are most pertinent to my life and life goals in the coming year?”

For instance, fertility benefits may not be immediately attractive at first glance, even if you’re actively thinking about starting a family. But 1 in 8 couples will be impacted by infertility and treatment without coverage can be wildly expensive. It’s important to make sure you’re thinking critically and getting all the necessary information when browsing for your benefits. Rule of thumb: if this could impact you in the coming year, even if you’re not 100% sure, opt-in for coverage.

What’s actually covered?

During open enrollment, be sure to ask your benefits team about how robust each offering is and what’s included. A particular benefit may look like it has a lot to offer, but after further investigation, you may uncover restrictions, unforeseen out of pocket costs and other obstacles that may make it harder for you to utilize the benefit.

With fertility benefits, many conventional carriers offer coverage with a dollar maximum, meaning you’d max out on coverage before completing a full IVF cycle. Plus, there are additional costs outside of the basic IVF procedure, like diagnostic testing, medications, and genetic testing which may come with a hefty price tag you’d have to pay for. Without adequate coverage, many people have to make cost-based decisions, forgoing the technology they need to reach a successful outcome.

As an alternative, Progyny’s coverage is bundled, meaning your entire treatment event is covered and you do not have to worry about what is or is not included, or fear running out of coverage mid-way through. Many vendors have similar disruptive solutions to ensure they’re not leaving their members high and dry during difficult times.

When sifting through options, be sure you’re asking what’s covered and not covered under your plan. A lot of benefits may seem expansive, but make sure you’re getting the most out of the coverage that’s available to you. Ask: Are the best clinics in your area included in your plan as “in-network”? Do you have to meet medical necessity requirements before being allowed to access your benefits?

Which benefits are supported?

Once you’ve opted in for benefits during open enrollment, how do you access your benefit? How do you move forward with treatment? Does your benefit provide access to the doctors in your area? Since many of these offerings are complex and without proper onboarding, how can you be expected to understand the next steps?

With the growing emphasis on mental health and concierge member experience, companies like Progyny try to eliminate some of the member’s burden and create an easy to use benefit model that provides member support. For example, our dedicated Patient Care Advocates — a concierge-style fertility coach — helps members navigate the clinical and emotional aspects of your fertility treatment, making a difficult process a bit easier.

Another important factor to consider when shopping for benefits is access to care where you live — are the doctors that your insurance covers close by and easy to get to? When choosing your benefits, look out for any information about access to support. The goal of a benefit is to make your life easier, not leave you feeling confused and stressed in times of need.

What do I do if I’m unhappy with the benefits offered during open enrollment?

Often times, employers are unaware of what an employee wants until it’s brought to their attention. If you are unhappy with the benefits offered, raise the issue with your HR team! You are your own best advocate and change begins with you.

Not sure where to start? If you are comfortable, speak with your colleagues. Seek out a company resource group to see if others have similar needs. This way you can help form a plan or a way to approach HR. Once you have an idea of what you need, talk to HR to explain why the proposed benefit would be pertinent to you and your colleagues. Employers understand that the key to keeping good talent is making sure they’re happy.

Open enrollment can be overwhelming but take advantage of the resources you have. Ask questions, do your research, and discuss the options with experts in your office. With an arsenal of helpful information at your disposal, open enrollment should be stress-free and get you excited for all of the incredible employer-sponsored benefits in your future.

SOURCE: Ajmani, K. (25 November 2019) "Key factors in choosing your benefits during open enrollment" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-to-choose-benefits-during-open-enrollment


Consider these 4 strategies to boost employee engagement

One way HR departments can boost employee engagement is by developing a holistic employee benefits package. Making sure your benefits plan suits a diverse multi-generational staff is essential to keeping employees engaged. Read this blog post for four strategies to help boost employee engagement.


The foundation of any high-performing culture is always a strategic compensation and benefits package. Employee engagement at any company requires the involvement of the HR department — and one way HR teams can boost engagement is by developing a holistic benefits package.

Creating a benefits plan that suits a diverse multi-generational staff is key to keeping staff engaged at every age and in every department. What were once non-traditional benefits are now becoming mainstream. For example, offering student loan repayment plans instead of 401(k) incentives to motivate younger staff, or voluntary benefit choices for employees with specific health issues.

See Also: 5 reasons employers should offer student loan repayment benefits

Even the way an office is ergonomically designed can benefit employees. Adding a walking treadmill or offering a standing desk option helps foster productive work, which directly leads to greater employee satisfaction.

This is a complex equation, and getting it right is challenging. We have hard, candid conversations with employers surrounding what enjoyable, relevant work means. From there, we can establish the purpose behind engagement, creating goals and strategies that offer recognition, growth and the opportunity to voice ideas.

Employees want holistic support for their overall health and wellbeing. Employers are expanding their view of employee benefits to include many more aspects of health and wellbeing — from work environment, convenience services and onsite facilities, to attendance and leave policies, flexible work arrangements and organizational discounts.

See Also: ‘Lifestyle’ choice: An emerging benefit could attract and retain employees

What do employers gain from these benefits? A healthy, adaptable and engaged workforce prepared for the future of work and ready to drive business success.

What we know works

The key to engaging employees with benefits is to apply a strategic design thinking methodology, a planning method that starts with an understanding of an organization’s specific needs.

One size fits one, not all. In the past, efforts were made to make one program work for everyone, but every staff member in the workforce now expects answers for their individual needs, concerns and health risks. Offering flexible benefits or voluntary coverage is a powerful tool — and can help employers gain a productivity boost with a healthier, more engaged workforce.

Align benefits with the whole person. Benefits should align with all aspects of employees’ lives in order to truly support health, wellbeing and work-life balance. This includes the social systems they are part of, their passions, their work habits and personal life events. Nutrition advice, health literacy training and support for personal interests are all possibilities for boosting engagement, physical and emotional health and wellbeing.

See Also: Do I Still Need Life Insurance Once I Retire? Your Questions Answered

Look at the data. Organizations have access to more health data than ever before — and technology makes it easier to analyze — but few employers are fully leveraging this information to design benefits that engage their employees. By analyzing and correlating demographic, health and employee-provided data from varied sources employers can identify which benefit programs workers truly value — and which deliver value.

Use both new and traditional channels to communicate. Organizations must actively market benefits to employees using engaging, relevant and timely communications. Companies can also communicate through technology.

When staff have access to benefits that best support their individual health and wellbeing, organizations will benefit.

SOURCE: Rider, S. (30 October 2019) "Consider these 4 strategies to boost employee engagement" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/4-strategies-to-boost-employee-engagement-with-benefits


Employers can help employees catch some Z's with new wellness benefit

Employers are starting to offer employee benefits that are focused on a long-ignored but crucial aspect of employee health - sleep. Read this blog post to learn more about this new wellness benefit.


Employers are taking a greater interest in employees’ emotional and physical well-being by offering specialized programs focused on mental health, weight loss, financial health, and now one long-ignored yet crucial aspect of health — sleep.

Beddr, a sleep health technology company, has launched a comprehensive, personalized solution to identify and treat the root causes of chronic sleep issues, though a voluntary benefits platform. The program leverages clinical data captured from Beddr’s app that uses an optical sensor and accelerometer to measure blood oxygen levels, stopped breathing events, heart rate, sleep position and time in bed.

About 45% of the world’s population has chronic sleep issues, according to a study in the Journal of Sleep Research. Poor sleep costs U.S. employers an estimated $411 billion each year, according to a report from Rand.

Employees using the Beddr benefit will have access to an expert-led sleep coaching program and a nationwide network of sleep physicians to provide targeted treatment options to help employees improve their sleep health. The program has the potential to save an employer up to $5,700 per employee, per year in productivity improvements, lower healthcare costs and decrease accident rates, Beddr says.

“Sleep is the foundation to every employee’s mental and physical health. High quality sleep has been shown to both reduce healthcare costs as well as improve productivity, but most employers haven’t found a comprehensive program that addresses the primary root causes of sleep issues and that benefits their entire workforce,” says Michael Kisch, CEO of Beddr. “We have seen a dramatic increase among our users relative to the overall population in their understanding of their sleep health and how their choices impact their overall sleep quality.”

Beddr partners with benefits teams to design a customized program specific to each employer and their employees. The company developed a screening process that makes it easy for an employer to engage their employee base, while providing Beddr the ability to identify employees who are a good match for the program.

In some cases, the company heavily subsidizes the cost of the benefit to employees, while in others it is the full responsibility of the employee. In the latter instance, the company negotiates a discount that is passed on to all participating employees. That discounted price is less than what an employee would pay to purchase the program directly from Beddr.

“Beddr was founded on the belief that the most important thing a person can do to improve their physical and mental health is to get consistent, high-quality sleep,” Kisch says. “We see employers as natural partners in fulfilling this mission because the goals of a company and its management are highly aligned with the goals of our program — to improve the health and productivity of employees. ”

SOURCE: Shiavo, A. (23 October 2019) "Employers can help employees catch some Z's with new wellness benefit" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/beddr-app-helps-employees-get-more-sleep


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


Simple Open-Enrollment Tips That Can Make a Big Difference

Many employees associate fear, anxiety or apprehension with open enrollment, the annual period when they select which employer-sponsored benefits they will have the coming year. Read this blog post from SHRM For a few simple tips to help out with this open enrollment season.


Trepidation is what comes to mind for many employees when asked their feelings about open enrollment, the annual period when they select employer-provided benefits for the coming year.

According to a nationally representative sample of 1,000 employees polled earlier this year, 33 percent cited "annoyance" or "dread" as their primary emotions when they thought about open enrollment and just 10 percent of workers said they were "confident" in the benefits choices they made when the enrollment process was over, according to VSP Vision Care's annual Open Talk about Open Enrollment survey.

In another survey, HR software company Namely found that 31 percent of employees give their employer a "C" or lower when it comes to open enrollment.

Here are some tips from benefits experts that will help you raise your grade this open-enrollment season.

What to Do, and Not to Do

Jennifer Benz, national practice leader at benefits communications firm Segal Benz, shared three bad HR practices that undermine open enrollment and three best practices for doing open enrollment the right way.

  • Don't hide vital information from employees. Benz recalls how one company sent out its benefits materials but didn't include monthly costs. "A group of enterprising employees crunched the numbers and came up with estimates and circulated a rogue spreadsheet. Dealing with this communications fiasco took more work" than being upfront about costs, she noted.

Best practice: Be transparent and share the reasons you are making benefits changes. Break down the details and do the work for the employees. Provide scenarios so employees can better understand their options and cost breakdowns for different life situations.

  • Don't cram in every benefit at once. Some companies hand out pages and pages of text, jamming a year's worth of communications into a few weeks, and figure they have done what they need to do. "What they have done is confused their employees," Benz said.

Best practices: Communicate the technical details of your various benefits over time. "Don't assume employees will weed through all your materials to make sense of the benefits offered to them," Benz said. Also make full use of visual aids. "Photos, icons, infographics, memes, charts, graphics and more—they all help to attract, and more importantly hold, people's attention," noted Amber Riley, a communications consultant to Segal Benz. "Whether you're driving an open-enrollment campaign, creating a new benefits guide or promoting a wellness program, when you increase the visual pleasure of what you are communicating, your people are more likely to engage, learn, understand and ultimately take action."

  • Don't give employees too little time to process their open-enrollment choices. While many people wait until the last day to fill out the health care selection forms, they may have been considering their options with family members for weeks, so giving them just a few days to make decisions is not going to be enough.

Best practice: Build in a time frame that gives HR staff and employees the time they need. Benz recommended three weeks.

"People are always talking about learning from the best practices and success stories, but you can also learn a lot from other companies' mistakes," she noted. "When you prepare for enrollment in advance and anticipate issues—including those you and others have experienced in the past—you are better-equipped to avoid missteps. Your employees will notice and appreciate the extra effort."

Help Employees Ace Open Enrollment

"Open enrollment is often time-consuming and confusing for employees, but these choices can make a huge financial impact," said Julie Stich, CEBS, vice president of content at the International Foundation of Employee Benefit Plans, an association of benefit plan sponsors. She suggested that HR share the following advice with employees to help prepare them for the upcoming enrollment season:

  • Take your time. Take time to really read through the enrollment materials you receive. If you are invited to a face-to-face meeting, make time to attend. It's possible you'll be offered different plan options and coverages this year. The better you understand the changes, the better decisions you'll make.
  • Look ahead. Consider what the next year will look like for you and your family. Are you planning to have a baby? Knee replacement surgery? A root canal? Does someone need braces? New glasses? Keep this in mind as you look at your coverage options.
  • Dive into the details. It's important to note whether the plans' provider networks have changed. Make sure your doctors are still in-network. Is your chiropractor also covered? Does the plan cover orthodontics? Is your spouse's daily prescription drug covered, and did the coverage change? Also consider areas of need like access to specialists, mental health care, therapies, complementary and alternative medicine, and chronic care. Look at the options offered in all plans, including health, dental, vision and disability.
  • Get out your calculator. Add up the amount you'll need to pay toward your health premium plus deductibles, co-payments (flat-dollar amounts) for prescriptions and doctor office visits, and co-insurance (a percentage of the cost you'll pay) for services. Understand what you'll be asked to pay if you seek care outside your network. This will give you a clearer picture of how much you're likely to spend. The plan that looks to be the cheapest option may not really be the cheapest for you.
  • Determine what's right for you. Consider your comfort level with risk. If you want your family to be covered for every eventuality, a more traditional plan, if one is offered, might be right for you. If you're comfortable taking on some upfront costs, a high-deductible plan with a lower premium ight be your plan of choice.
  • Take advantage of extras. Your employer may offer the option to reduce your health premiums in exchange for your participation in a wellness program or health-risk assessment. It may match some or all of the money you save in your 401(k) plan. It might let you set aside tax-deferred money into a health savings account or flexible spending account. Also, check with your employer to see if it offers voluntary insurance with a group discount and payroll deduction for premiums—like critical-illness, pet, auto and homeowners coverage. If these options work for your situation, sign up.
  • Ask questions. Don't be shy about asking your HR or benefits department to explain something if you're not sure. They're there to help and want you to make the best decisions for your situation.

"Taking the time upfront to carefully choose the best options will help employees better manage their finances throughout the year, alleviating stress and promoting productivity," Stich said.

SOURCE: Miller, S. (24 September 2019) "Simple Open-Enrollment Tips That Can Make a Big Difference" (Web Blog Post). Retrieved from https://www.shrm.org/ResourcesAndTools/hr-topics/benefits/Pages/simple-open-enrollment-tips-make-a-big-difference.aspx


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


What Benefits and Perks Do Employees Actually Want?

What employee benefits does your organization offer? Today's benefit offerings have grown to include much more than just healthcare benefits. Read this blog post to learn what benefits and perks your employees want.


With open enrollment just around the corner for most companies, employee benefits are top of mind. Today’s offerings have grown to include more than just medical, dental, and vision coverage. Companies are now including perks like scheduling flexibility, tuition reimbursement, and even parental assistance as part of their overall package.

Let’s cut through the hype: what benefits and perks do employees actually care about? As someone who has administered his fair share of open enrollments, I’ve wondered the same thing. But over the years, I’ve learned that you sometimes just need to ask. By running benefits “pulse” surveys, HR teams can get the data and perspective they need to tailor their company’s offerings.

It’s also important to research what’s happening in the marketplace and what your competitors are doing. When was the last time you spoke to your benefits broker? They’ll have the greatest visibility into what types of claims employees are filing and where you might have coverage gaps. Working closely with your broker is one of the easiest ways to ensure you’re meeting employees’ expectations and the job market’s standards.

While studies have shown that traditional medical, dental, and vision coverage are still employees’ top priority, here are some non-traditional offerings that your employees may be clamoring for:

  • Parental assistance and leave: Companies are now enriching their policies with tools that assist new parents, including everything from post-birth specialist care to reimbursements for newborn necessities.
  • Virtual medical care: One of the hottest trends is virtual medical care. Employees can have access to a doctor 24/7 via a laptop or smartphone, all in the comfort of their own home.
  • Tuition reimbursement and assistance: Today, Americans owe over $1.3 trillion in student loans. That’s more than twice what they owed a decade ago. Needless to say, young employees are looking for companies that offer some type of student loan assistance.
  • Mental health: Over 18 percent of adults in the United States experience some form of anxiety disorder. Given the growing national focus on mental health issues, it’s no surprise that workplaces are joining the conversation. Increasingly, businesses are offering workers better access to mental health therapists and coaches.
  • Physical wellness: Two words: gym reimbursements. Sometimes the motivation to work out can be hard to muster, but when your gym membership is paid for by your employer, why not take full advantage? Healthier, more active employees could lead to lower medical insurance costs, too!

Those are just some of the unique benefits that you should consider offering employees. At the end of the day, I’ve learned that each workplace has different needs and wants. Be sure to regularly survey employees on their preferences and keep tabs on what peer companies are offering.

SOURCE: Cosme, J. (14 November 2018) "What Benefits and Perks Do Employees Actually Want?" (Web Blog Post). Retrieved from https://blog.shrm.org/blog/what-benefits-and-perks-do-employees-actually-want


How to create a strong communication plan for open enrollment

What is your communication plan for open enrollment? Now that you have your plan changes locked in, it's time to focus on communicating those changes to your employees. Read this blog post to learn more.


Ready or not… the Benefits Super Bowl is here! Whether you are a broker, benefits manager or anywhere in between, you have been knee-deep on plan updates, rate reviews and benefit changes for months. Now that the plan changes are locked, it’s go-time! The focus is now on communicating and educating employees about their benefit options.

It takes an enormous amount of planning and execution to provide a productive open enrollment experience for employees. But, it is well worth it as this is often the only time during the year that employees stop to consider their benefit options.

Learn from past wins and misses

Consider previous years’ open enrollment communications and ask yourself the following:

  • What is the feedback you received from employees (the good, the bad and the ugly)?
  • What were the most common questions?
  • Were there key pieces of information employees had difficulty finding?

Learn from the answers to these questions and then craft your content in a clear and concise manner that is easier for employees to digest.

The communication medium is key to your success

Now that you’ve developed the content to communicate, the next equally important step is determining how, when and where you deliver this information. Is there a centralized location where employees can find information for both core and voluntary benefits? Is the information in a format that the employee can easily share with his or her significant other?

It is critical to have multi-channel communications to reach your audience. Some employees may naturally gravitate to a company-wide email and the company intranet, while others lean on more interactive mediums like E-books, text messages, webinars or lunch and learns. Providing a variety of communication avenues ensures you are reaching employees where they want to receive information.

Make sure your communications campaign provides educational materials at each of the key milestones during the open enrollment journey–such as prior to enrollment, midway through enrollment, and right before enrollment closes. Wherever possible, always support employees through the process and give them options to reach out for help.

How to communicate the same benefits to a diverse workforce

You are likely communicating to a group of employees with diverse needs and wants. What may be appealing to an entry-level recent grad may not resonate with a senior-level employee nearing retirement. For example, employees with young children may be especially interested in accident insurance or pet owners might look to pet insurance to help offset the costs of well-visits and routine care. If possible, tailor your communications to different segments of the employee population.

Communicating voluntary health-related benefits

Core medical benefits are what employees gravitate to during the enrollment period. Are you offering voluntary benefits to employees? The most successful voluntary benefit programs are positioned next to core medical plans on the enrollment platform. This shows employees how those voluntary benefits (critical illness, accident insurance and hospital indemnity) complement the core offerings with extended protection.

When voluntary benefit programs are positioned as an integral part of the employee benefits experience, employees are more likely to understand the value and appreciate the support provided by their employer. For example, a critical illness program can help to bridge the gap of a high-deductible health plan in the case of a covered critical condition. Communicate that voluntary benefits can be an integral part of a “Total Rewards Package” and can contribute to overall financial wellness.

Review and refine

Finally, don’t miss your opportunity at the end of enrollment to review how your communication campaign performed. Pull stats and analyze your communication campaign for next year’s open enrollment… it is never too early to start! HR managers can glean valuable information and metrics from the employee experience.

SOURCE: Marcia, P. (1 November 2018) "How to create a strong communication plan for open enrollment" (Web Blog Post). Retrieved from https://www.benefitspro.com/2018/11/01/how-to-create-a-strong-communication-plan-for-open/