Compliance Alert- Self-Funded Health Plans Must Obtain a Health Plan Identifier Number

Beginning November 5, 2014, employers with large self-funded health plans are required by federal government to obtain a national health plan identifier number (HPID). All health plans with more than $5 million in annual receipts must require an HPID, but since health plans don’t have receipts, the Department of Health and Human Services says insured plans should use the premiums from the prior plan year, and self-funded plans should look at claims paid for the prior plan year. Small health plans have an extra year to obtain an HPID with a deadline set for November 5, 2015.

The federal government requires this from all health plans, however, for practical purposes; the insurer will obtain the HPID for those plans that are fully insured. On the other hand, all self-funded plans must obtain an HPID, even if a third party administrator is involved to handle claims.

What exactly, is an HPID?

A health plan identifier number is 10 digits long and consists of only numbers and is used as an identifier for transactions covered by HIPAA.

Why are health plans required to have an HPID?

In an effort to make the claim processing more efficient, the HPID will help with electronic processing and faster automation. HPID’s will be required to be used in HIPPA transactions by November 7, 2016.

How do I know if my health plan is required to have an HPID?

First you must determine which health plan you have. There are two categories of health plans – a Controlling Health Plan (CHP) and a Subhealth Plan (SHP). A Controlling Health Plan is required to obtain an HPID, while a Subhealth Plan is eligible, but not required to get an HPID. To determine whether a Subhealth Plan should get an HPID, the CHP and/or the SHP should consider whether the SHP needs to be identified in the standard transactions. A CHP may get an HPID for its SHP or may direct a SHP to get an HPID. These categories can be confusing, and are intended for insurance companies to determine. If you need help determining which health plan you have, please contact us and we will be happy to help.

If you have a self-funded plan, how does one obtain an HPID?

Employers can apply at the Centers for Medicare and Medicaid Services (CMS) website. It is likely that most employers will be required to register and set up a health insurance oversight system (HIOS) account at https://portal.cms.gov/wps/portal/unauthportal/home/ .

After an account has been established, the employer can register for an HPID. More information on applying can be found here: https://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/Affordable-Care-Act/Downloads/HPOESTrainingSlidesMarchSlideDeck.pdf

We are always happy to help, so please contact us if you have any questions or need help obtaining an HPID.

 

 

 

 

 

by 6d-destani

Health plan costs moderate, but larger increases ahead

Originally posted May 15, 2014 by Dan Cook on www.benefitspro.com.

The rate of employer-provided health care plan costs is either going up or down this year, depending on who you talk to.

Either way, the difference won’t be much. And overall, the news is good: cost hikes are fairly stable.

Towers Watson and Buck Consultants this week each released their own projections for employer health care spending for 2014. Towers Watson surveyed 173 medical carriers from around the globe; Buck got input from 126 carriers and administrators.

Want good news? Look to the Buck survey. It says the rate of increases in all types of health plans will be less in 2014 than in either of the two prior years.

Costs for PPO plans, it said, rose 8.7 percent this year, lower than last year’s 9 percent growth and the 9.2 percent seen in 2012. HDHPs show the biggest decline in cost increases, rising 8.6 percent this year compared to 9.1 percent in 2014. HMO and POS plans fell as well. For plans that supplement Medicare, though, the health-cost hike spiked to 5.5 percent from 4.1 percent last year.

The average prescription-drug cost increase for this year is 9.2 percent, down from 9.9 percent a year ago.

Buck said reduced utilization was cited by some as the primary reason for the decreases.

“This may be a result of the economic slowdown and its impact on consumers’ willingness to seek medical treatment,” said Harvey Sobel, a Buck principal and consulting actuary who co-authored the survey. “Even though the decline is good news, most plan sponsors still find 8-9 percent cost increases unsustainable.”

Meanwhile, if you’re a pessimist, Towers Watson is for you.

After two years of 9.1 percent increases, non-U.S. American plans (North American plans outside of the U.S.) are projected to rise in cost by 9.7 percent this year, its respondent said.

Globally, Towers Watson’s survey indicated that employee health benefits costs will increase 8.3 percent this year, compared to 7.9 percent last year and 7.7 percent in 2012.

Further, its respondents expect costs to start to edge up again in the future.

“More than half (55 percent) of insurers in all regions anticipate higher or significantly higher medical trend over the next three years. Asia Pacific insurers are particularly pessimistic, with more than two-thirds (69%) saying they expect medical trend in the next three years to be higher or significantly higher than current rates,” the study said.

“While the cost of providing health care benefits to employees has stabilized over the past few years, controlling rising costs remains a significant concern for employers worldwide,” said Francis Coleman, director, International Consulting, at Towers Watson. “In fact, in all regions, health costs continue to rise at twice the rate of inflation. That’s a major concern for employers, with many insurers projecting costs to again escalate in the coming years.”

by 6d-destani

Subsidies May Be Too High Or Low For Some Who Got Coverage

Originally posted May 19, 2014 on www.kaiserhealthnews.org.

More than a million Americans listed incomes on their health insurance applications that differ significantly from those on file with the Internal Revenue Service and therefore may be getting subsidies that are too high or low, The Washington Post says. Other media outlets report that states can decide whether to carry out a key part of the health law's small business exchanges for 2015 and that civil fines of up to $250,000 may be imposed on those who knowingly provide false information to get a subsidy.

The Washington Post: Federal Health-Care Subsidies May Be Too High Or Too Low For More Than 1 Million Americans

The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation. The problem means that potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. They are part of a large group of Americans who listed incomes on their insurance applications that differ significantly — either too low or too high — from those on file with the Internal Revenue Service, documents show (Goldstein and Somashekhar, 5/16).

The Wall Street Journal: States To Decide On Key Part Of Small-Business Health Exchanges

The Obama administration said Friday it would let states decide whether to implement a key part of the health law's small-business exchanges next year, extending an earlier delay. The Department of Health and Human Services said in rules released Friday that it would be up to state insurance commissioners to decide whether employees at small businesses using the health-insurance exchanges could choose from a range of plans or be limited to just one selected by their employer (Radnofsky, 5/16).

The Associated Press: $250K Fine For Lying On Health Insurance Forms

Lying to the federal health insurance man could cost you dearly. The Obama administration Friday spelled out civil fines of up to $250,000 for knowingly and willfully providing false information to get taxpayer-subsidized coverage under the new health care law (5/16).

The Hill:  HHS Opens Door To Extra Funds For Insurers

Health insurance companies can count on funds from the government if ObamaCare's risk corridor program does not sufficiently cover losses that are higher than expected this year.  This news was published in regulations Friday outlining how the law's health insurance exchanges will operate in 2015 (Viebeck, 5/16).

The Fiscal Times: Senators on Botched Obamacare Websites: You Break It, You Bought It

Republican senators are demanding answers from the Obama administration on the handful of failed state exchange websites that have cost taxpayers literally billions of dollars. Some even say that the states should reimburse the government for the cost of these exchange failures. So far, at least four largely inoperable state websites – in Massachusetts, Maryland, Nevada and Oregon – have cost the federal government $4 billion. That number is expected to rise as the states spend more money to replace or rebuild the bad sites (Ehley, 5/16).

by 6d-destani

15 ways to make employees happy

Originally posted May 2, 2014 by Dan Cook on www.benefitspro.com.

You can offer employees a lavish buffet lunch onsite every day, bring in a masseuse on Fridays and hold the company picnic at Disney World. But at the end of the day, if you have the wrong people in the wrong jobs, you will still not have a happy workforce.

That is the message from social-recognition software provider Globoforce in a white paper titled “The Science of Happiness.” Most of the material cited in the paper comes from sources other than Globoforce. However, the company teases out tips for creating a culture of happiness based on its research of others’ research. And therein one can find tasty tidbits of advice that may begin to transform your workplace into a happy one.

“HR leaders encounter a lot of advice about how to manage culture — to increase engagement, decrease turnover, and drive recruitment. But when it comes to creating a culture employees love and don’t want to leave, employee happiness is the metric that really matters,” Globoforce says in a preamble to its data and advice. “Happy employees are what make a culture great.”

The paper says happy employees:

• stay twice as long in their jobs as their least happy colleagues;

• believe they are achieving their potential twice as much;

• spend 65 percent more time feeling energized;

• are 58 percent more likely to go out of the way to help their colleagues;

• identify 98 percent more strongly with the values of their organization;

• are 186 percent more likely to recommend their organization to a friend.

“Unlike culture itself, we have hard numbers on the science of employee happiness and how to directly increase it. It all leads to one conclusion: concentrating your efforts on making employees happy is the most direct and powerful way to impact your organizational culture,” Globoforce says.

Now, to the tips for putting a smile on your workers’ face.

5 ways to build alignment

1. Pay closer attention to job-person fit.

2. Fire people who don’t fit your culture.

3. Help employees find greater meaning in your values.

4. Show workers how your company fits into a bigger picture.

5. Cultivate more trust and flexibility into your policies.

5 ways to build positivity

1. Broadcast personal and team successes.

2. Offer fast, positive feedback.

3. Open up multidirectional communication lines.

4. Offer resources and emotional support.

5. Encourage employees to express gratitude.

5 ways to build progress

1. Set clear, measurable and achievable organizational goals.

2. Show employees how they fit into the bigger picture.

3. Offer training for mastery of new and existing skills.

4. Respect individualism.

5. Reward excellence and effort.

by 6d-destani

10 secrets to success

Originally posted April 17, 2014 by Michael Goldberg on www.lifehealthpro.com.

A piece in Investor’s Business Daily caught my attention. Anything titled 10 Secrets to Success will do that. Of course, there’s no such thing as a secret and there’s nothing new under the sun. But sometimes, sometimes something you read or heard or pondered over reminds you to think differently. It wakes you up. Reboots you. Gives you a jumpstart. Offers perspective.

Below are the 10 Secrets from Investor’s Business Daily that inspired me to offer my two cents.

1. How you think is everything. 

There’s a great audio of Earl Nightingale called The Strangest Secret  which was first recorded in 1956. He first played the recording for his sales team at his insurance agency. The response to the message had such an impact on his staff that requests for copies to share with friends and families grew. Columbia Records filled the requests and within a short period of time sales soared to over a million copies, earning a Gold Record — the first and only spoken word record to ever reach Gold! Today, more than 50 years later, The Strangest Secret remains one of the most powerful and influential messages ever recorded. It continues to transform the lives of everyone who hears and heeds it. The message is simple: We become what we think about. If you spend enough time thinking about something important, there’s a good chance your thinking will drive your actions.

2. Decide upon your true dreams and goals. 

Your goals (or goal — less is more) should reflect what you spend most of your time thinking about. If you think about making more money (how much?) then come up with a goal that you must accomplish to get you closer. If you’re looking to become more established in a marketplace, perform better in a sport, compete in a triathlon, or master a specific skill, craft it in the form of a goal. Write the goal on an index card and look at it every day. Every single day. Again, we become what we think about.

3. Take action. 

What do you need to do all day every day to continue thinking about your goal? Do you need to join an association? Hire a coach? Read a book? Get certified in an industry, profession, or area of expertise? Take a class? Meet and ultimately build relationships with people that are doing what you want to do? Thinking the way you want to think? Being who you want to be? Where do you need to go to meet these people? What do you need to say? And with whom? Goals are nothing without action. Don’t let excuses get in the way. Don’t convince yourself that you can’t. Think of all the reasons that you can. Don’t be afraid to get started. Just do it.

4. Never stop learning. 

Go back to school or read books. Get training and acquire skills. I’m always in the middle of a good book. Sometimes it’s about boxing (my passion) but usually it’s about business, or the business of business. As a speaker, coach, and author, my focus is helping sales agents grow their business through networking (my other passion!). That said, I’m always looking for better ways of doing that so when I’m not speaking and writing, I’m reading. I keep a stack of books on a shelf in front of my desk so when I’m in my office, I can’t help but to see them. As I write this and gaze at the books, the topics are pretty consistent — sales, relationships, public relations, finance, building a great business, referrals, and creativity. I try to tackle a new book every couple of weeks. And my index card that contains my goal is my bookmark.

5. Be persistent and work hard. 

Never give up! Get up early and set aside that time to work on your goal. Set a schedule for yourself over the next 30 days. If you wake up early and get to work over a cup of coffee in your dining room at 5AM and work until 6:30AM Monday through Friday, that’s an additional work day that you’ve carved out for yourself by the end of the week. And that’s not counting weekends!

6. Learn to analyze details. 

The devil is in the details. Figure out what you need to learn. Ask great questions. Talk to all the right people. Give yourself deadlines. What gets measured gets done! Have a system of checks and balances so you know if you’re on the right track. How do you know you’re going in the right direction if you don’t have a GPS? What’s the GPS that you need to create to insure you’re on the right path? Knowing you’re moving in the right direction will inspire you to keep going.

7. Focus your time and money. 

Stay focused! If a boxer loses focus, he gets caught with the hook. Professional athletes make investments in both time and money to do everything possible to become the best. If you know that it makes sense to invest in a book, program, course, certification, diet plan, coach, practice management system, pair of running shoes, whatever — do it! 

8. Don’t be afraid to innovate; be different. 

Staying in the middle of the road will get you hit by oncoming traffic. Those that are successful often have found a creative way to get their message across or goal accomplished. Think of comedians that have a unique style, or a baseball player with a different stance, or the financial advisor with the unique marketplace. How about the Facebooks, Googles, and Apples that have changed the world forever?

9. Deal and communicate with people effectively. 

Everyone is different. How can you best relate to the specific needs of your prospects, clients, and referral sources? Learn to understand and motivate others. Help other people develop and achieve their goals. Listen! Ask questions and listen some more. We all know people that go on and on about themselves and never ask about you. (Are you one of them?)

10. Be honest and dependable; take responsibility. 

It’s important to know that others can count on you. Otherwise numbers 1-9 won’t matter!

by 6d-destani

Employer Mandate Repeal Won’t Relinquish Employers From ACA Compliance

Originally posted May 13, 2014 by Melissa A. Winn on https://eba.benefitnews.com.

Eliminating the Affordable Care Act’s employer mandate would not significantly reduce the number of insured Americans, according to a recent analysis by researchers at the Urban Institute in Washington. But, it would also not eliminate your employer client’s need to maintain an ACA-compliant plan, one industry expert notes.

Completely abandoning the employer shared responsibility rule would reduce the number of people in 2016 with health insurance from 251.1 million to 250.9 million, a decrease of just 200,000 people, the report says, adding that it would also eliminate labor market distortions in the law and lessen opposition to the law from employers.

Regardless of whether the mandate is eliminated, however, work will remain for benefit advisers helping employers meet ACA compliance, says Jessica Waltman, senior vice president of government affairs for the National Association of Health Underwriters.

“Maintaining an ACA-compliant plan requires a lot of other components,” she says. “Employers have to comply with all of the market reforms and notice requirements and offer all of the benefit mandates, as well,” requirements brokers and agents can assist employers with, she says.

“There are significant penalties for not maintaining ACA compliance” with other requirements of the health law, such as limits on mandatory waiting periods, she adds.

Also, employer-sponsored health plans will not go away if the employer shared responsibility rule is eliminated, she says, noting that the value of benefit advisers will remain there, as well. “The vast majority of businesses affected by the mandate offered coverage before the mandate.”

The authors of the analysis — Why Not Just Eliminate the Employer Mandate? — agree. About two thirds of American workers now have offers of employer coverage when there is no mandate to do so, they write. “Most employers would not drop coverage if the penalties were eliminated,” the report says.

Downfall?

Ending the employer responsibility rule would, however, eliminate the federal revenue expected from penalty payments that employers would pay under the law, which the authors estimate at just less than $4 billion in 2016. Slight increases in Medicaid and marketplace subsidies due to the elimination of the employer requirement would also cost the government about $46 billion between 2014 and 2023.

Alternative sources of revenue would have to be found to compensate for the federal loss of penalties, the analysis notes.

The Internal Revenue Service in February issued final guidance saying that employers with fewer than 100 employees won’t have to provide health insurance coverage until Jan. 1, 2016.

Previously, on July 2, 2013, the Obama administration delayed the need for all employers with 50 or more employees to provide health insurance coverage until Jan. 1, 2015.

by 6d-destani

IRS Urged To Broaden Preventive Coverage In High-Deductible Plans

Originally posted May 9, 2014 by Julie Appleby on https://capsules.kaiserhealthnews.org.

High deductible health plans paired with tax-free savings accounts — increasingly common in job-based insurance and long a staple for those who buy their own coverage – pose financial difficulties for people with chronic health problems. That’s because they have to pay the annual deductible, which could be $1,250 or more, before most of their medications and other treatments are covered.

In a white paper released Thursday, researchers at the University of Michigan say such plans would be more attractive if the IRS broadened the kinds of preventive care insurers were allowed to cover before the patient paid the deductible. Currently, only a limited set of preventive care benefits is included.

“I want the deductibles removed on those things I beg my patients to do,” such as getting annual eye exams if they are diabetic, says author A. Mark Fendrick, a professor of medicine and director of the University of Michigan Center for Value-Based Insurance Design.

If insurers were allowed to offer high-deductible plans that covered “secondary prevention,” such as eye exams, or insulin for diabetics, they would attract 5 million buyers on the individual market, the report projects.  Many consumers would see the policies as an improvement over more “bare-bones” coverage, even if the premiums were higher, said co-author Steve Parente, a professor of finance at the Carlson School of Management at the University of Minnesota.  At least 10 million in job-based insurance might also switch, some of them from more expensive plans that have limited networks of doctors and hospitals, Parente said. Such plans would be most attractive to those with chronic conditions such as diabetes, asthma or high blood pressure.

“If it is attractive to the chronically ill, it could be a major change,” said Parente. The Gary and Mary West Health Policy Center, a nonpartisan research group in Washington, D.C, funded the report.

Still, such plans would carry premiums at least 5 percent higher than current high-deductible health saving account plans, according to the report.

Whether the IRS would consider changing the rules for high deductible plans connected with health savings accounts is unclear.  The agency did not respond to questions.  If it altered the rules, insurers would also have to choose to offer the plans.

Currently, more than 15 million Americans have high-deductible plans that can be paired with tax-free savings accounts, called HSA-eligible plans, according to America’s Health Insurance Plans, the industry trade group.  Of those, about 2 million buy their own policies and the rest get them through their jobs.

Under federal rules, such plans must have at least a $1,250 annual deductible for singles and a $2,500 deductible for families.  Workers can contribute money pre-tax to the special savings accounts to help pay those deductibles. Most large employers offer such a plan as an option and an estimated 15 percent of firms offer only HSA plans or a similar arrangement, called a health reimbursement account, according to the benefit firm Towers Watson.

IRS rules say only primary prevention can be fully covered by the plan outside of the deductible, including such things as routine prenatal and well-child care, some vaccines, and programs to help people lose weight or quit smoking. The rules say such preventive care does not generally include treatments for “existing illness, injury or condition.”

Fendrick and colleagues want the definition changed to allow insurers and employers more options, including allowing coverage of any kind of medical services, including drugs that would prevent complications from or a worsening of a chronic condition, such as diabetes, heart disease or major depression.

“This would be entirely optional for health plans,” Fendrick said. “One plan could [cover] just about everything before the deductible, and another might say they cover five or six drugs, some doctor visits and maybe glucose test strips.”

by 6d-destani

Seeking mindfulness at work: Helping employees find focus

Originally posted May 12, 2014 on https://hr.blr.com.

New research by Steelcase shows that 41 percent of workers report not being able to concentrate easily, while the average person loses 86 minutes per day due to distractions.

The recent 14-country Steelcase/Ipsos study conducted as part of its wellbeing research revealed the growing lack of mindfulness in the workplace. The workplace research addressed how the physical environment can support or hinder mindfulness, along with five other dimensions of wellbeing. The researchers found that the physical environment offers behavioral cues that can promote, or hinder, employee's physical, cognitive and emotional states and long-term health.

Only 59 percent of employees reported their environment enabled them to feel relaxed and calm, while only 58 percent reported being able to work in teams without being interrupted or disturbed. Nearly half of all workers surveyed reported not having adequate spaces that support mindfulness and focus. Ongoing Steelcase research also found that workers in North America lose 86 minutes per day due to a variety of distractions in the workplace.

"Mindfulness means balancing the intense pace of life with being fully present in the moment," said Donna Flynn, director of Workspaces Futures at Steelcase. "With the proliferation of technology and growth of distributed work across time and space, workers are facing unprecedented distractions combined with pressures to be always on, leaving them stressed, tired, and overwhelmed. Healthy and mindful employees are a competitive advantage in today's business world, but to achieve it workers need supportive environments that give them the emotional capacity to interpret and experience events in a way that leads to productive, positive actions."

The Steelcase researchers identified and developed design concepts that companies can incorporate into their workplace to help encourage mindfulness by enhancing employees' ability to concentrate and make thoughtful choices amid distractions and disturbances.

Steelcase key ideas when designing for mindfulness include:

  • Offer spaces where people can seek solitude and respite, or connect with others without distractions or interference.
  • Design areas that allow workers to control the amount of sensory stimulation they are exposed to and enable them to amp it up or down.
  • Create spaces that help people stay focused as they interact with others one-on-one and eye-to-eye
  • Offer places that are calming, through the materials, textures, colors, lighting and views.

"Given the mental fatigue that comes with high cognitive load, workers need physical spaces that help them manage the cognitive load and be fully present in the moment," says Beatriz Arantes, senior researcher and environmental psychologist with Steelcase Workspace Futures.

by 6d-destani

Employers Eye Moving Sickest Workers To Insurance Exchanges

Originally posted May 7, 2014 by Jan Hancock on www.kaiserhealthnews.org.

Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants.

"It's all over the marketplace," said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. "Employers are inquiring about it and brokers and consultants are advocating for it."

Health spending is driven largely by patients with chronic illness such as diabetes or who undergo expensive procedures such as organ transplants. Since most big corporations are self-insured, shifting even one high-cost member out of the company plan could save the employer hundreds of thousands of dollars a year -- while increasing the cost of claims absorbed by the marketplace policy by a similar amount.

And the health law might not prohibit it, opening a door to potential erosion of employer-based coverage.

"Such an employer-dumping strategy can promote the interests of both employers and employees by shifting health care expenses on to the public at large," wrote two University of Minnesota law professors in a 2010 paper that basically predicted the present interest. The authors were Amy Monahan and Daniel Schwarcz.

It's unclear how many companies, if any, have moved sicker workers to exchange coverage, which became available only in January. But even a few high-risk patients could add millions of dollars in costs to those plans. The costs could be passed on to customers in the form of higher premiums and to taxpayers in the form of higher subsidy expense.

Here's how it might work. The employer shrinks the hospital and doctor network to make the company plan unattractive to those with chronic illness. Or, the employer raises co-payments for drugs needed by the chronically ill, also rendering the plan unattractive and perhaps nudging high-cost workers to examine other options.

At the same time, the employer offers to buy the targeted worker a high-benefit "platinum" plan in the marketplaces. The plan could cost $6,000 or more a year for an individual. But that's still far less than the $300,000 a year that, say, a hemophilia patient might cost the company.

The employer might also give the worker a raise to buy the policy directly.

The employer saves money. The employee gets better coverage. And the health law's marketplace plan --required to accept all applicants at a fixed price during open enrollment periods -- takes on the cost.

"The concept sounds to[o] easy to be true, but the ACA has set up the ability for employers and employees on a voluntary basis to choose a better plan in [the] Individual Marketplace and save a significant amount of money for both!" says promotional material from a company called Managed Exchange Solutions (MES).

"MES works with [the] reinsurer, insurance carrier and other health management organizations to determine [the] most likely candidates for the program."

Charlotte-based consultant Benefit Controls produced the Managed Exchange Solutions pitch last year but ultimately decided not to offer the strategy to its clients, said Matthew McQuide, a vice president with Benefit Controls.

"Though we believe it's legal" as long as employees agree to the change, "it's still gray," he said. "We just decided it wasn't something we wanted to promote."

Shifting high-risk workers out of employer plans is prohibited for other kinds of taxpayer-supported insurance.

For example, it's illegal to induce somebody who is working and over 65 to drop company coverage and rely entirely on the government Medicare program for seniors, said Amy Gordon, a benefits lawyer with McDermott Will & Emery. Similarly, employers who dumped high-cost patients into temporary high-risk pools established by the health law are required to repay those workers' claims to the pools.

"You would think there would be a similar type of provision under the Affordable Care Act" for plans sold through the marketplace portals, Gordon said. "But there currently is not."

Moving high-cost workers to a marketplace plan would not trigger penalties under the health law as long as an employer offered an affordable companywide plan with minimum coverage, experts said. (Workers cannot use tax credits to help pay exchange-plan premiums in such a case, either.)

Half a dozen benefits experts said they were unaware of specific instances of employers shifting high-cost workers to exchange plans. Spokespeople for AIDS United and the Hemophilia Federation of America, both advocating for patients with expensive, chronic conditions, said they didn't know of any, either.

But employers seem increasingly interested.

"I have gotten probably about half a dozen questions about it in the last month or so from our offices around the country," says Edward Fensholt, director of compliance for the Lockton Companies, a large insurance broker and benefits consultant. "They're passing on questions they're getting from their customers."

Such practices could raise concerns about discrimination, said Sabrina Corlette, project director at the Georgetown University Center on Health Insurance Reforms.

They could also cause resentment among employees who didn't get a similar deal, Fensholt said.

"We just don't think that's a good idea,” he said. "That needs to be kind of an under-the-radar deal, and under-the-radar deals never work," he said. Plus, he added, "it's bad public policy to push all these risks into the public exchange."

Hill, Chesson & Woody is not recommending it either.

"Anytime you want to have a conversation with an employee in a secretive, one-off manner, that's never a good idea," Yates said. "Something smells bad about that."

by 6d-destani