Satisfaction with health plan costs improving
Originally posted July 23, 2013 by Andrea Davis on https://ebn.benefitnews.com
Employer satisfaction with health plan costs is going up, according to the J.D. Power 2013 Employer Health Plan Study, yet health plans may risk losing group business unless they improve satisfaction in other areas.
The study, now in its fourth year, measures six factors that affect employer satisfaction with health plans: employee plan service experience, account servicing, program offerings, benefit design, problem resolution and cost. Satisfaction with cost is improving as more consumer-driven health plans are offered to employees, which 82% of employers indicate are controlling costs.
Employer satisfaction with costs “went up significantly in all the attributes we measure. Significantly more employers are offering CDHP products to their employees and so that has been a cost shifting measure that they are satisfied with,” says Scott Hawkins, director, health care, J.D. “But one of the things we see on the member side is that when employees are put on those products and they don’t really understand them, their satisfaction is lower. So I think it’s really important that employers work with the health plans to help their members understand how to manage those costs once they’re on those products or they’re going to have dissatisfied employees.”
Fifteen percent of employers say they “definitely will not” or “probably will not” continue sponsoring coverage in five years.
Perhaps not surprisingly, cost satisfaction among employers that indicate they intend to continue sponsoring coverage in the future is 106 points higher (on a 1,000-point scale) than among those that intend to drop coverage (696 vs. 590, respectively.)
“You can minimize the impact on satisfaction with the members and employees if you offer value-added benefits. And one of the things we’re seeing in our data and the employer data is that while health plans are offering a lot of the primary and secondary services that the employees are asking for, a lot of the employers aren’t taking advantage of those things; they’re not offering them to their employees,” says Hawkins.
Simple things like gym memberships, health risk assessments, drug compliance plans for employees with chronic conditions, for example, “will help satisfy the members and help them feel they’re getting value for what they’re paying,” says Hawkins. “But what we see now is that a lot of plans are offering them to employers, but not many of them are taking them up on it.” He suspects cost is the main reason employers may be reluctant to offer these programs to employees.
In both the fully insured and self-funded groups, employer satisfaction with program offerings, such as preventive health programs, disease management or wellness initiatives, is a key area of differentiation between employers that intend to offer coverage in the future and those that intend to drop coverage. In the program offerings factor, the gap in satisfaction scores between fully insured employers that intend to offer coverage in the future and those that intend to drop coverage is 104 points — 705 among employers that intend to offer coverage, compared with 601 among those that intend to drop coverage. Among self-funded employers, the gap in satisfaction scores between those that intend to offer coverage in the future and those that intend to drop coverage is also 105 points — 689 among employers that intend to offer coverage, compared with 584 among those that intend to drop coverage.
The 2013 Employer Health Plan Study is based on responses from 5,857 employers.
Feds add exchange employer site
Originally posted August 2, 2013 by Allison Bell on https://www.benefitspro.com
Three federal agencies have joined to set up a Patient Protection and Affordable Care Act website for small businesses.
Business.USA.gov/healthcare offers a "wizard," or interactive tool, that offers to help business owners understand what they need to know about the new PPACA insurance options in a few quick steps.
The Small Business Administration worked with the U.S. Department of Health and Human Services and the U.S. Treasury Department to set up the site.
The wizard starts by asking visitors about their companies' location and size.
On the size menu, for example, the wizard asks whether the user is self-employed with no employees, has fewer than 25 employees, has up to 50 employees, or has 50 or more employees.
The site includes an explanation of how an employer can determine whether it has 50 or more full-time or full-time equivalent employees.
Users who, say, might want to set up group health plans will see information about the new PPACA Small Business Health Options Program small-group exchange program.
In most states, in the pages of information for employers interested in setting up health plans, the SBA gives an answer to the question, "Can I use an agent or broker to buy health insurance in the marketplace?"
"You will be able to use a licensed agent or broker to provide help or handle your SHOP business," the SBA says. "You won't pay more if you use a SHOP agent or broker."
For users in Vermont, a state that is trying to eliminate small-group market broker commissions, the SBA makes no mention of agents and brokers.
Using the B Impact Assessment - Firms With Benefits
Originally posted on https://www.economist.com
HE likes to do things differently. Yvon Chouinard changed his favourite sport, mountaineering, by introducing reusable pitons (the metal spikes you bang into the rock face and attach a rope to). Climbers often used to leave pitons in the cliff, which is environmentally messy, another of Mr Chouinard's peeves.
In business, Mr Chouinard, the founder of Patagonia, an outdoor-clothing firm, says he believes that well-treated employees perform better. (He wrote a book called: “Let My People Go Surfing”.) Before it was fashionable, Mr Chouinard preached a philosophy of sustainability and long-term profitability that he calls “the slow company”.
On January 3rd Patagonia was anything but slow in becoming the first firm to take advantage of a new California law designed to give businesses greater freedom to pursue strategies which they believe benefit society as a whole rather than having to concentrate on maximising profits for the next financial quarter.
According to Mr Chouinard, the new “benefit corporation”—usually referred to as a B Corp—creates the legal framework for firms like his to remain true to their social goals. To qualify as a B Corp, a firm must have an explicit social or environmental mission, and a legally binding fiduciary responsibility to take into account the interests of workers, the community and the environment as well as its shareholders. It must also publish independently verified reports on its social and environmental impact alongside its financial results. Other than that, it can go about business as usual.
The B Corp is a deliberate effort to change the nature of business by changing corporate law, led by B Lab, a non-profit outfit based in Pennsylvania. California is the sixth state to allow B Corps; the first was Maryland, in April 2010. Patagonia was followed immediately by another 11 Californian firms, including Give Something Back Office Supplies, Green Retirement Plans and DopeHut, a clothing retailer. Across America, there are now several hundred B Corps. Before Patagonia, the best-known was probably Seventh Generation, a maker of green detergents, paper towels and other household products.
California's B Corp legislation took effect alongside a new law creating the “flexible purpose company” (FlexC), which allows a firm to adopt a specific social or environmental goal, rather than the broader obligations of a B Corp. Another option in America is the low-profit limited-liability (LC3) company, which can raise money for socially beneficial purposes while making little or no profit.
The idea of a legal framework for firms that put profits second is not confined to America. Britain, for example, has since 2005 allowed people to form “community interest companies”. Similar laws are brewing in several European countries.
The impetus for all this comes from people like Mr Chouinard, who believe that existing laws governing corporations and charities are too restrictive. For-profit firms, they argue, often face pressure to abandon social goals in favour of increasing profits. Non-profit firms and charities are needlessly restricted in their ability to raise capital when they need to grow.
This prevents socially minded organisations from pursuing their goals as efficiently as possible. Existing laws for co-operatives and mutual companies are inadequate. Hence the need for B Corps and other novel structures, goes the argument. There is no tax advantage to being a B Corp, but there is to some of the new legal structures.
Whether these new legal forms will change business that much remains to be seen. Supporters of existing corporate law say it does not prevent firms, if they so wish, from setting social and environmental goals or rigorously reporting on their performance in delivering them—and that pursuing profit is often the best way to benefit society. Nor is it clear how much difference in practice will be made by the obligation of a B Corp to weigh interests other than profits. How does one measure such things? What counts for more: a clean lake or a happy neighbour?
Mr Chouinard argues that making a firm's social mission explicit in its legal structure makes it harder for a new boss or owner to abandon it. Perhaps so. B Corps will be tested in the market. Anyone who feels inspired by a B Corp's mission is free to invest in its shares, or work for it.
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NAHU: Employer mandate delay 'necessary' despite $12 billion cost
Originally posted July 30, 2013 by Alex Wayne (Bloomberg) and EBA staff on https://eba.benefitnews.com
A National Association of Health Underwriters spokeswoman says that while there are "short-term financial repercussions" to the employer mandate delay, "we believe this delay was necessary to continue the economic upturn we have seen in the past few months and ensure that American businesses will be able to provide their employees with the health insurance they want and need in the long term.”
President Barack Obama’s decision to give employers a year before they’re required to provide health insurance for workers will cost taxpayers $12 billion, the Congressional Budget Office says in a letter to members of Congress.
The health law will now cost $1.375 trillion through 2023, an increase of $12 billion since May, the CBO says. The government will lose $10 billion in penalties that companies would have paid next year for not providing employee health plans, and taxpayers will spend $3 billion more on subsidies for workers who instead will buy coverage on the exchanges.
The White House announced the delay on July 2, in response to a lobbying effort from business groups. The Affordable Care Act requires companies with 50 or more workers to offer health insurance to their workers or pay fines of as much as $3,000 per employee if they don’t. Now, companies don’t have to provide coverage until 2015.
“Some large employers that would have offered health insurance coverage to their employees in 2014 will no longer do so as a result of the one-year delay of penalties for those that do not offer affordable coverage,” Douglas Elmendorf, the director of the CBO, wrote in the letter.
The costs of the delay were offset by about $1 billion because of “small changes,” CBO said, including an increase in income tax collections from people who don’t get coverage at work. The value of employer-provided health insurance isn’t taxed, while workers who get higher pay to buy insurance on their own would have to pay income tax on that compensation. CBO also reports that “one million fewer people are expected to be enrolled in employment-based coverage in 2014” than the group predicted in May, also due to the employer mandate delay.
Even with the mandate’s delay, the health law is projected to reduce the deficit, the CBO says, because of lower Medicare spending and other provisions that offset the cost of new coverage. The CBO said May 15 that repealing the law would cost the federal government $109 billion, a figure it didn’t update today.
Alternative Treatments Could See Wide Acceptance Thanks to Health Care Reform
by: KAISER HEALTH NEWS AND ANKITA RAO
The Affordable Care Act says that insurance companies "shall not discriminate" against any state-licensed health provider, which could lead to better coverage of chiropractic, homeopathic and naturopathic care. Photo by Joe Raedle/Getty Images.
Jane Guiltinan said the husbands are usually the stubborn ones.
When her regular patients, often married women, bring their spouses to the Bastyr Center for Natural Health to try her approach to care, the men are often skeptical of the treatment plan -- a mix of herbal remedies, lifestyle changes and sometimes, conventional medicine.
After 31 years of practice, Guiltinan, a naturopathic physician, said it is not uncommon for health providers without the usual nurse or doctor background to confront patients' doubts. "I think it's a matter of education and cultural change," she said.
As for the husbands -- they often come around, Guiltinan said, but only after they see that her treatments solve their problems.
Complementary and alternative medicine -- a term that encompasses meditation, acupuncture, chiropractic care and homeopathic treatment, among other things -- has become increasingly popular. About four in 10 adults (and one in nine children) in the U.S. are using some form of alternative medicine, according to the National Institutes of Health.
And with the implementation of the Affordable Care Act, the field could make even more headway in the mainstream health care system. That is, unless the fine print -- in state legislation and insurance plans -- falls short because of unclear language and insufficient oversight.
One clause of the health law in particular -- Section 2706 -- is widely discussed in the alternative medicine community because it requires that insurance companies "shall not discriminate" against any health provider with a state-recognized license. That means a licensed chiropractor treating a patient for back pain, for instance, must be reimbursed the same as medical doctors. In addition, nods to alternative medicine are threaded through other parts of the law in sections on wellness, prevention and research.
"It's time that our health care system takes an integrative approach ... whether conventional or alternative," said Sen. Tom Harkin, D-Iowa, who authored the anti-discrimination provision, in an e-mail. "Patients want good outcomes with good value, and complementary and alternative therapies can provide both."
The federal government has, in recent years, tapped providers like Guiltinan, who is also the dean at the Bastyr University College of Naturopathic Medicine, to help advise the federal government and implement legislation that could affect the way they are paid and their disciplines are incorporated into the health care continuum. In 2012, Guiltinan, based in Kenmore, Wash., was appointed to the advisory council of the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.
Proving that alternative medicine has real, measurable benefits has been key to increasing its role in the system, said John Weeks, editor of the Integrator Blog, an online publication for the alternative medicine community. The Patient-Centered Outcomes Research Institute, created by the health law, is funding studies on alternative medicine treatments to determine their effectiveness.
Weeks said both lawmakers and the general public will soon have access to that research, including the amount of money saved by integrating other forms of medicine into the current health system.
But the challenges of introducing alternative care don't stop with science.
Because under the health care law each state defines its essential benefits plan -- what is covered by insurance -- somewhat differently, the language concerning alternative medicine has to be very specific in terms of who gets paid and for what kinds of treatment, said Deborah Senn, the former insurance commissioner in Washington and an advocate for alternative medicine coverage.
She pointed out that California excluded coverage for chiropractic care in its essential benefits plan, requiring patients to pay out of pocket for their treatment. Senn thinks the move was most likely an oversight and an unfavorable one for the profession. Four other states -- Colorado, Hawaii, Oregon and Utah -- ruled the same way in the past year.
"That's just an outright violation of the law," she said, referring to the ACA clause.
Colorado and Oregon are in the process of changing that ruling to allow chiropractic care to be covered, according to researchers at Academic Consortium for Complementary and Alternative Health Care.
Some states, like Washington, are ahead of the rest of the country in embracing alternative practitioners. The Bastyr University system, where Guiltinan works, treats 35,000 patients a year with naturopathic medicine. Sixty percent of the patients billed insurance companies for coverage.
Guiltinan said a change in the system is not only a boon for alternative medicine doctors, but helps families of all income levels access care normally limited to out-of-pocket payment. That's why some alternative medicine aficianados like Rohit Kumar are hoping the law will increase the ability of his family -- and the larger community - to obtain this kind of care.
Kumar, a 26-year-old business owner in Los Angeles, said his parents and brothers have always used herbs and certain foods when they get sick, and regularly see a local naturopath and herbalist. He's only used antibiotics once, he says, when he caught dengue fever on a trip to India.
While the Kumar family pays for any treatments they need with cash -- the only payment both alternative providers accept -- they also pay for a high-deductible health plan every month to cover emergencies, like when his brother recently broke his arm falling off a bike.
Paying for a conventional health care plan and maintaining their philosophy of wellness is not cheap.
"We pay a ridiculous amount of money every month," Kumar said of the high-deductible insurance. "And none of it goes toward any type of medicine we believe in."
Even so, he said the family will continue to practice a lifestyle that values wellness achieved without a prescription -- a philosophy that Guiltinan also adopted in her practice.
As a young medical technician in a San Francisco hospital, she decided that the traditional medical system was geared more toward managing diseases and symptoms rather than prevention. Naturopathic medicine, on the other hand, seemed to fit her idea of how a doctor could address the root cause of illness.
"The body has an innate ability for healing, but we get in its way," Guiltinan said. "Health is more than the absence of disease."
Pet insurance growing as an employee benefit option
Originally posted on https://www.stockhouse.com
An increasing number of companies in North America are offering pet insurance to employees in an effort to attract better hiring candidates, U.S. experts say.
According to Veterinary Pet Insurance president Scott Liles, around 3400 companies and associations offer the benefits as an employee enticement and retention tool.
Nevada's largest employer, MGM Resorts International (NYSE: MGM, Stock Forum), added pet insurance for employees in 2006 and Chipotle (NYSE: CMG, Stock Forum) has been offering the benefits since 2002.
Of the 165 million pets estimated to reside in the United States, only a small portion are covered by pet insurance, but as veterinary costs rise, an increasing number of employers are providing it as part of their benefits package, with Chipotle subsidizing $10 per month, per pet, for up to three per employee.
The organization says only around a hundred employees take them up on the offer, which covers the low end of pet insurance costs of anywhere up to $57 a month, according to a company official talking with UPI.
Pet retailer PetSmart (NYSE: PETM, Stock Forum) offers insurance for employee pets, offering comprehensive coverage for illness and accidents, coverage for tests, X-rays, medication, hospitalization and surgery, a 5 per cent group rate discount and enrolment fee waiving, and death benefits.
-Chris Parry, Stockhouse.com
How to Best Inform Employees About PPACA
Originally posted July 29, 2013 by Thom Mangan on https://eba.benefitnews.com
Benefit education has long been considered a key component of a successful employee benefit program. However, engaging employees and helping them recognize the value of their program is not easy. It takes ongoing efforts of HR Managers with support from senior management.
The Affordable Care Act creates another new wrinkle for HR managers. I caught up with UBA Partner, Greg Smith of R.W. Garrett Agency, to find out how best to get your employee’s attention — and why it’s so important.
Thom: In addition to the mandated communication material and benefit changes, how does PPACA affect an employer’s communication efforts?
Greg: With the new health insurance marketplaces and Medicaid expansion in most states, the government has a daunting task of educating and informing millions of the nation’s uninsured of the new coverage and subsidies available to them.
To get the word out, the government will spend hundreds of millions of dollars in a broad and expansive advertising campaign starting this month (July).
Employers are also participating in the campaign, as they are required to send out a Model Notice regarding coverage and options in the New Health Insurance Marketplaces.
The Marketplaces and corresponding advertising campaign are focused on the uninsured, who may be eligible for “free” coverage (through Medicaid) or subsidized, reduced premium coverage (in the New Insurance Marketplaces). However, if the employer’s plan provides adequate and affordable coverage, the employees eligible for the plan will not qualify for any subsidized coverage in the New Insurance Marketplace (unless eligible for Medicaid).
Thom: So where does the trouble come in?
Greg: The wrinkle comes from two sources – confusion and human nature:
1. Confusion – Unless explained adequately, the employee may be confused as to why his employer is sending him notice of a New Insurance Marketplace with subsidized coverage, when, in fact, he is not eligible for a subsidy.
2. Human Nature – Employees may misinterpret or misunderstand the message of the government’s advertising and think that by dropping coverage, they may get a better deal in the Marketplace or, worse, believe that their benefits are not as valuable as they are.
Thom: So what is an employer to do to get around these problems, or “wrinkles”?
Greg: I believe employers can get out ahead of the “wrinkle” by pre-empting the government’s advertising with communications of their own. They can lay out the facts of the advertising campaign and reinforce the quality of their own plan.
Just because the White House has delayed the implementation of the employer mandate part of the Affordable Care Act doesn’t mean employers don’t have to communicate options to employees. On the contrary, they would be wise to use the extra year to make sure they and their employees are adequately prepared for the pending changes of 2015.
Rethink rewards on a personal level
Originally posted July 30, 2013 by Tristan Lejeune on https://ebn.benefitnews.com
Estimates from organizations including Mercer and WorldatWork put next year’s average U.S. base salary increase at approximately 3% -- a healthy gain for most of the industrial world, which actually saw pay fall this year, but a disappointing “new normal” for benefits pros who remember sunnier days. With budgets for rewards and compensation stretched like sausage casings – thin and fragile, but holding it all together – companies will be looking for even more low- and no-cost ways to recognize top performers and achievers than they have in years past.
That works just fine for David Olson and Dr. Bob Nelson, co-founders of Recognition PRO. Olson and Nelson have spent years tracking incentivized behavior and corporate rewards, and, like the song says, the best things in life are free. They say the best-motivated workforces aren’t driven by plaques, coffee mugs or even bonuses; they’re driven by deeper personal connections with their managers and coworkers, and personalized recognition that comes from those relationships.
“I’m a culture consulting coach with CEOs” Olson explains how he and Dr. Bob connected a few years ago. “[We] recognized the need to improve employee recognition culture within workforces, and we came up with a unique way to go about doing that,” Olson adds. “Most of the $50 billion [incentive] industry has tried to solve the problem by throwing merchandise at employees. That doesn’t really create a culture of recognition; creating a culture of recognition comes down to strengthening manager-employee relations …”
Nelson, the best-selling author of “1001 Ways to Reward Employees” looks at the problem from a psychological perspective. The ultimate goal of psychology, some say, is to improve behavior – in this case, group behavior. “I’m not in the incentive industry,” Nelson says. “I’m really a behaviorist.” Out of the 13 most-motivating management behaviors, he says, the top nine cost an organization nothing at all.
High-level executives often do not understand company risks
Originally posted July 25, 2013 by Rodd Zolkos on https://www.businessinsurance.com
A new report from Forbes Insights sponsored by Zurich Insurance Group Ltd. suggests that many executives don't understand their companies' exposure to risks or their strategies to manage them.
The survey of 414 U.S. executives in the banking and financial services, real estate, health care and construction industries found that 28% indicated their company had suffered financial damage as a result of operational risk, 27% because of regulatory or compliance risk and 26% as a result of financial risk.
But when asked about the top barriers to effective risk management, 36% of executives in banking and financial services and 29% of those in real estate cited a lack of understanding of how to mitigate exposures as the top barrier. Among construction executives, 43% cited a lack of understanding of the sources of risk as the top barrier, while insufficient risk management budget was cited as the top barrier by 33% of health care executives.
A lack of understanding of how to mitigate risks was the second-greatest barrier cited by construction executives, at 27%, and health care executives, at 30%.
However, large percentages of executives in each industry category indicated they would manage risk no differently in the next three years: 41% of banking and financial services executives, 50% of construction executives, 42% of health care executives and 47% of real estate executives.
Of the total group, 76% of executives rated the need to align risk management with their company's growth strategy as very or extremely important, and 68% said they thought their company was doing so. But only 54% said they were confident or very confident of how aware they were of the risks associated with their company's growth strategies.
The report, “The Sharp Side of Risk: Understanding, Anticipating and Managing Business Risk,” is available here.
Boating, Biking, and Beaching: Summer Safety Tips for Employees
Originally posted by Chris Kilbourne on https://safetydailyadvisor.blr.com
According to the Centers for Disease Control and Prevention (CDC), in one recent year, more than 3,000 Americans were injured and over 700 killed in boating incidents. Of the people killed, more than 70% drowned, and more than 90% of those who drowned were not wearing life jackets.
So the very first boating safety tip to emphasize and reemphasize to employees is that everyone in a boat should be wearing a life jacket, whether or not they can swim.
Alcohol is another factor contributing to boating accidents, injuries, and fatalities. CDC says that alcohol use affects judgment, vision, balance, and coordination, and is involved in about a third of all recreational boating fatalities. Boating under the influence of alcohol is just as deadly as drinking and driving. Not only is it dangerous to operate a boat while under the influence of drugs or alcohol, it's also illegal in every state in the United States.
A third point to emphasize about safe boating is that people who pilot pleasure craft should know what they are doing. This means that they should have taken a safe boating course. CDC reports that more than 7 out of every 10 boating incidents are caused by operator error. Boating education courses teach the rules for safe operation and navigation of recreational boats, and can help boat operators keep their passengers safe.
Safe Biking
In 2010, 618 cyclists were killed and an additional 52,000 were injured in motor vehicle traffic crashes, says the National Highway Traffic Safety Administration (NHTSA).
To prevent bike accidents, injuries and fatalities, NHTSA suggests the following safety precautions:
- All bicyclists should wear a properly fitted bicycle helmet every time they ride. A helmet is the single most effective way to prevent head injury resulting from a bicycle crash.
- Bicyclists are considered vehicle operators. They are required to obey the same rules of the road as other vehicle operators, including obeying traffic signs, signals, and lane markings. When cycling in the street, cyclists must ride in the same direction as traffic.
- Drivers of motor vehicles need to share the road with bicyclists and be courteous, allowing at least 3 feet clearance when passing a bicyclist on the road. Motorist should also look for cyclists before opening a car door or pulling out from a parking space. And they should always yield to cyclists at intersections and as directed by signs and signals. Motorists should be especially watchful for cyclists when making turns, either left or right.
- Bicyclists should increase their visibility to drivers by wearing fluorescent or brightly colored clothing during the day, dawn, and dusk. To be noticed when riding at night, cyclists should use a front light and a red reflector or flashing rear light, and use retro-reflective tape or markings on equipment or clothing.
Safety at the Beach
The United States Lifesaving Association (www.usla.org) offers beachgoers many lifesaving safety tips on their website, including these:
- Don’t swim alone. That way if you have a problem, there is someone there to help.
- Don't swim under the influence. Alcohol impairment affects swimming ability and judgment.
- Swim near a lifeguard. Your chance of drowning at a beach protected by lifeguards is slight.
- If you are caught in a rip current, don't fight it by trying to swim directly to shore. Instead, swim parallel to shore until you feel the current relax, then swim to shore.
- Never dive head first into unknown water. Check for depth and obstructions like rock formations first.