3 ideas to ease the transition to a high-deductible world
With high-deductible health plans rising, employers may not be thinking about the drastic changes happening in the future. Here are some tips to make a transition into a high deductible industry painless.
We’re all familiar with the necessary evils of today’s society: paying taxes, going to the dentist and sitting in rush-hour traffic. Now, there’s another one to add to the list — high deductible health plans (HDHPs). They’re on the rise due to increasingly unmanageable health care costs caused by factors such as increased carrier and hospital consolidation, unregulated pharmaceutical prices, and a lack of financial awareness among medical providers.
In response, prudent employers who want to continue providing health benefits but can’t keep up with the costs are turning to HDHPs to share the financial burden with employees and encouraging those employees to become more disciplined shoppers. This is predictably being met with resistance.
But there’s a more urgent matter at hand: until we find a way to flip the health-care system on its head, we’re anticipating a future where networks get narrower and significantly limit options and deductibles rise to catastrophic heights.
Employers may not be thinking ahead for these drastic changes, which is why brokers can be instrumental in helping clients guide their employees toward the necessary mental and financial preparations. Here are a few ideas to get them started.
1. Shift gears to plan beyond the calendar year.
For most, health care is an infrequent experience that’s handled reactively: you get sick, you go to the doctor, your insurance foots the bill. However, now that employees are on the hook for potentially thousands of dollars, it’s crucial that they plan ahead.
To facilitate this shift in mindset, employers should encourage employees to:
- Utilize a health savings account (HSA):When it comes to HSAs, people tend to fall into one of two schools of thought: “HSAs are a silver bullet” or “HSAs are a terrible excuse by politicians to allow the existence of HDHPs.” Rarely is a situation so black and white, and this one is no exception. HSAs aren’t the best choice for everyone. Certain demographics can’t afford to juggle the high costs of health care (and life) while also contributing funds to an account. However, it’s important to keep in mind that as costs continue to rise, more people will be pushed above the HSA qualification line and having an account may be the only life raft available when drowning in high deductibles — a trend we’re already starting to see.In an ideal world, the HSA wouldn’t exist. Out-of-control health care costs bear the blame for solutions like HDHPs — and the HSA is our consolation prize. The reason I advocate the utilization of these accounts for long-term planning is because they are the only health care benefit we have that encourages people to think beyond 12 months. Unlike the flexible spending account (FSA), the money in an HSA rolls over every year and grows over time, so it lets people save for years down the road (maybe when the pediatrician bills pile up, or you finally have that major surgery) vs. scrambling to spend their funds before the end of the year. Also, if an employer is contributing to an employee’s HSA, it’s leaving money on the table not to sign up for an account.
- Shop for the best “deals”:Unless someone is a frequent flyer in the health care system, they might brush off shopping for healthcare since it seems like a lot of effort for a single doctor’s visit. However, considering the fact that the cost of an ACL surgery can vary as much as $17,000, those numbers certainly add up over time. (Even more so if a patient fails to find care that’s in network.) Helping employees understand this concept, and pairing it with an easy-to-use transparency solution, can save them tons of money in the long run — especially if the cost savings from each doctor’s visit are deposited into an HSA for future use.
2. Recognize that options are still available.
I’m not going to try to frame high deductibles in a positive light. It’s not the ideal situation for consumers or employers. But sometimes, just knowing there are options in a seemingly bleak situation can provide temporary relief. Here are some tips for employers to share with employees when they’re frustrated about their HDHPs:
- Ask questions:Employees shouldn’t be afraid to ask questions. Healthcare is known for being convoluted, so it’s likely they’re not alone in any confusion they experience. They should start with health insurance and take time with the HR manager to understand the specifics of their coinsurance, copays, deductibles, and benefits so they’re aware of all their options, such as free preventive services. Another great place for questions is at the doctor’s office. Asking about and negotiating costs (yes, you can do that!) can have huge payoffs — Consumer Reports found that only 31 percent of Americans haggle with doctors over medical bills but that 93 percent of those who did were successful, with more than a third of those saving more than $100.
- Stay educated:“Education” can be a tired term for brokers and employers. Employees never seem to read the emails and collateral materials that teams painstakingly curate each year. While disheartening, I think the focus on education is a long but ultimately rewarding process. Consider the 401(k). These plans struggled through the recessions in the early 2000s, but through constant behavioral reinforcement (helped largely by policies such as The Pension Protection Act, which made it easier for companies to automatically enroll their employees in 401(k) plans) and continued efforts by employers, 401(K)s bounced back and hold $4.8 trillion in assets today.The same lesson can be applied to your education efforts as well. That is, eventually the education will stick. So help create a new ecosystem for employees to navigate by getting timely information and resources out there about maximizing HDHPs and utilizing HSAs.
3. Stay optimistic because change is coming.
This point is a bit more abstract. Worrying about health care costs is exhausting, and things are likely to get worse before they get better. However, there’s been a lot of news in the health care space that should bring a glimmer of optimism.
For instance, we heard about the partnering of three industry powerhouses to create a new health care company for their employees. It’s been fascinating to see how much chatter this announcement has already generated and will likely keep traditional employer health care vendors on their toes.
While the trend of employers building coalitions to tackle health care costs is nothing new and it’s too early to tell how successful this initiative will be, the bigger point is that this is a strong signal that change is desperately needed. More and more companies — regardless of what industry they’re in — are starting to realize that they’re all in the business of health care. And as we gain power in numbers, I believe we will build the momentum to create some serious change.
It’s tough to win in today’s health care world, and it’s likely going to get even more challenging over the next few years. But if brokers and employers can provide the right level of guidance, education, and resources, they can help employees better mentally and financially manage their high-deductible futures.
SOURCE:
Vivero, D (2 July 2018) "3 ideas to ease the transition to a high-deductible world" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/02/08/3-ideas-to-ease-the-transition-to-a-high-deductibl/
HSA How-To
Health Savings Accounts can be tricky, employees have the control, employers and insurance companies are there to guide them in the right direction. Here is a how to helping guide to assist your customers to the right HSA plan.
If an employer wants to offer employees pretax payroll deferrals to their health savings accounts, the employer needs to first create a Section 125 plan or cafeteria plan that allows HSA deferrals.
A cafeteria plan is the only way for employers to offer employees a choice between taxable and nontaxable benefits, “without the choice causing the benefits to become taxable,” the IRS says. “A plan offering only a choice between taxable benefits is not a Section 125 plan.”
Here are five things to know about HSAs and Section 125 plans.
1. A Section 125 plan is just one of several ways for employers to help employees with funding their HSAs.
Employers offering HDHPs face the choice of whether and how to help their employees with the funding of the employees’ HSAs. The options include the following:
- Option 1 – Employee after-tax contributions.Employers are not required to help with the employees’ HSAs and may choose not to. In this case, employees may open HSAs on their own and receive the tax deduction on their personal income tax return. This option allows for income tax savings, but not payroll taxes. A variation on this option is for employers to allow for post-tax payroll deferral (basically, direct deposit of payroll funds into an HSA without treating the deposit any differently than other payroll which may also be directly deposited into an employee’s personal checking account).
This does not change the tax or legal situation, but it does provide convenience for employees and will likely increase HSA participation and satisfaction.
- Option 2 – Employee pretax payroll deferral.Employers can help employees fund their HSAs by allowing for HSA contributions via payroll deferral. This is inexpensive and can be accomplished by adding a Section 125 cafeteria plan with HSA deferrals as an option. Employers benefit by not having to pay payroll taxes on the employees’ HSA contributions. Employees save payroll taxes as well. Plus, HSA contributions are not counted as income for federal, and in most cases, state income taxes. Setting up automatic payments generally simplifies and improves employee savings.
- Option 3 – Employer-funded contributions.Employers may make contributions to their employees’ HSAs without a Section 125 plan if the contributions are made directly. The contributions must be “comparable,” basically made fairly (with a lot of rules to follow). This type of contribution is tax deductible by the employer and not taxable to the employee (not subject to payroll taxes or federal income taxes and in most cases, not subject to state income taxes either).
- Option 4 – Employer and employee pretax funding.Employers can combine options 2 and 3, where the employer makes a contribution to the employees’ HSAs and the employer allows employees to participate in a Section 125 plan and enabling them to defer a portion of their pay pretax into an HSA. This is a preferred approach for a successful HDHP and HSA program, as it ensures that employees get some money into their HSA through the employer contribution and allows for the best tax treatment to allow for employees to contribute more on their own through payroll deferral.
- Options for more tax savings.Some employers go beyond these options to increase tax savings even more. Although a number of strategies exist to increase tax savings, using a limited-purpose FSA (or HRA) is a common one. Generally, FSAs are not allowed with HSAs; however, an exception exists for limited-purpose FSAs. Limited-purpose FSAs are FSAs limited to payments for preventive care, vision and dental care. This provides more tax savings and employees use the FSA to pay for the limited-purpose expenses (dental and vision) and save the HSA for other qualified medical expenses.
HRAs can also be used creatively in connection with HSA programs. The HRA cannot be a general account for reimbursement of qualified medical expenses, but careful planning can allow for a limited-purpose HRA, a postdeductible HRA, or other special types of HRAs.
2. There are several benefits for an employer using a Section 125 plan combined with an HSA.
- Employees can make HSA contributions through payroll deferral on a pretax basis.
- Employees may pay for their share of insurance premiums on a pretax basis.
- Employers and employees save payroll taxes (7.65 percent each on FICA and FUTA for contributions).
- Employers avoid the “comparability” rules for HSA contributions although employers are subject to the Section 125 plan rules.
3. The employer is responsible for administering the Section 125 plan.
For payroll deferral into an HSA through a Section 125 plan, the employer must reduce the employees’ pay by the amount of the deferral and contribute that money directly into the employees’ HSA.
The employer may do this administration itself or it may use a payroll service or another type of third-party administrator. In any case, the cost of the Section 125 plan itself and the ongoing administration are generally small and offset, if not entirely eliminated, by employer savings through reduced payroll taxes.
Another administrative element is the collection of Section 125/HSA payroll deferral election forms from employees. Employers that have offered Section 125 plans prior to introducing an HSA program are familiar with this process.
Unlike other Section 125 plan deferral elections, which only allow annual changes, the law allows for changes to the HSA deferral election as frequently as monthly.
Although frequent changes to the elections create a small administrative burden on the employer, the benefit to employees is significant. Employers are not required to offer changes more frequently than annually.
The full extent of the administrative rules for Section 125 plans is beyond the scope of this discussion.
4. Contributions to HSAs under Section 125 plans are subject to nondiscrimination rules.
A cafeteria plan must meet nondiscrimination rules. The rules are designed to ensure that the plan is not discriminatory in favor of highly compensated or key employees.
For example, contributions under a cafeteria plan to employee HSAs cannot be greater for higher-paid employees than they are for lower-paid employees. Contributions that favor lower-paid employees are not prohibited.
The cafeteria plan must not: (1) discriminate in favor of highly compensated employees as to the ability to participate (eligibility test), (2) discriminate in favor of HCEs as to contributions or benefits paid (contributions and benefits test), and (3) discriminate in favor of HCEs as measured through a concentration test that looks at the contributions made by key employees (key employee concentration test). Violations generally do not result in plan disqualification, but instead may cause the value of the benefit to become taxable for the highly compensated employees or key employees.
The nondiscrimination rules predate the creation of HSAs and how the rules apply to HSA contributions is an area where additional government guidance would be welcome.
5. An employer needs a Section 125 plan to allow for HSA contributions through payroll deferral.
Can an employer allow for HSA contributions through payroll deferral without a Section 125 plan? No, not if the goal is to save payroll taxes. Employers can offer HSA payroll deferral on an after-tax basis without concern over the comparability rules or the Section 125 plan rules. Amounts contributed under this method are treated as income to the employee and are deductible on the employee’s personal income tax return. The lack of any special tax treatment for this approach makes it unattractive for most employers and with just a small additional investment of money and time, a Section 125 plan could be added allowing for pretax deferrals.
Here is an example: Waving Flags, Inc. does not offer health insurance or a Section 125 plan to its employees. Waving Flags does provide direct deposit services to its employees that provide it with their personal checking account number and bank routing number. Maggie, an employee of Waving Flags, Inc., approaches the human resources person and asks to have her direct deposit split into two payment streams with $100 per month being directly deposited to her HSA and the balance of her pay being deposited into her personal checking account. She provides Waving Flags the appropriate account and routing numbers and signs the proper election forms.
Waving Flags is not subject to the Section 125 nondiscrimination rules for pretax payroll deferral, nor is Waving Flags subject to the HSA comparability rules. Waving Flags is simply paying Maggie by making a direct deposit into her HSA. The $1,200 Maggie elects to have directly deposited to her HSA in this manner will be reflected in Box 1 of her IRS Form W-2 from Waving Flags as ordinary income. She will be subject to payroll taxes on the amount. She can claim an HSA deduction on line 25 of her IRS Form 1040 when she files her tax return.
Maggie benefits from this approach by setting up an automatic contribution to her HSA, which often improves the commitment to savings. Most HSA custodians will offer a similar system that HSA owners can set up on their own by having their HSA custodian automatically draw a certain amount from a personal checking account at periodic intervals. Employer involvement is not necessary. Individuals with online banking tools available to them may be able to set it from their personal checking account as well to push money periodically to an HSA.
SOURCE:
Westerman, P (2 July 2018) "HSA How-To" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/01/01/hsa-how-to/
Amazon has just entered the drug-distribution business
Amazon is on top, knocking big competitors out one by one. Today, they take down pharmacies by offering online health-care services. See what Amazon has in store here.
Amazon.com Inc. agreed to buy the online pharmacy startup PillPack, jumping into the health-care business with a deal that will give the retail giant an immediate nationwide drug network.
The move represents a formidable threat to pharmacy chains including Walgreens Boots Alliance Inc., which earlier Thursday reported tepid U.S. same-store sales, and rival CVS Health Corp. Walgreens was down 10 percent at 10:18 a.m. in New York, while CVS shares shed 8.9 percent.
Terms of the deal weren’t disclosed. The transaction is expected to close in the second half of 2018, according to a statement from the companies.
The U.S. market for prescription medicine is huge. In 2016, U.S. consumers spent $328.6 billion on retail prescription drugs, according to the U.S. government. CVS reported prescription sales of $59.5 billion last year, and Walgreens sold $57.8 billion worth of drugs in its fiscal 2017.
PillPack has mail-order pharmacy licenses in all 50 U.S. states, which could allow Amazon to expand quickly. PillPack also has relationships with most major drug-benefit managers, including Express Scripts and CVS, and says it works with most Medicare Part D drug plans. Those ties will give Amazon access to much of the prescription drug market in the U.S.
PillPack sells pre-sorted packets of prescriptions drugs, delivering them to customers in their homes. The closely held firm has software that automates many routine pharmacy tasks, such as verifying when a refill is due, determining co-pays, and confirming insurance. That eliminates much of the manual work that pharmacists often are saddled with now.
The pact follows months of speculation about Amazon’s plans to get into the pharmacy or drug-distribution business. Despite the retailer’s vast reach, entering the market presented a daunting logistical challenge in terms of licensing and dealing with a range of private and government payers. Acquiring PillPack’s networks helps Amazon surmount those hurdles.
Michael Rea, chief executive officer of Rx Savings Solutions, said PillPack could transform the industry and that employers and health plans would benefit from the deal, which he called a “sign of the times.”
“This move signals just how big of a market opportunity there is to change the pharmacy landscape,” Rea said in an email.
Amazon has been disrupting businesses from electronics to household staples and even package delivery. Pharmacy and health-benefits companies have long fretted that they’d be next. Chief Executive Officer Jeff Bezos signaled his interest in health-care earlier this year when he teamed up with Berkshire Hathaway Inc.’s Warren Buffett and JPMorgan Chase & Co.’s Jamie Dimon to form a health-care company to manage the health plans of their more than 1 million employees.
The selloff in drugstore stocks was reminiscent of the food-industry swoon that resulted in June 2017 when Amazon said it was buying Whole Foods Market Inc. Kroger Co., the biggest U.S. supermarket chain, saw $2 billion in market value wiped out in one day. Big packaged food stocks also took a hit.
“When Amazon sneezes, everybody else catches a cold,” said Joseph Feldman, an analyst with Telsey Advisory. “And I think that that’s more likely than not what you’re going to see today.”’
Long time coming
Prescription drugs sales are largely intertwined with groceries and personal items like makeup and shampoo and Amazon already sells bulk packs of latex gloves, bed pads and syringes. It recently began selling medical devices and instruments, as well.
Bezos has been thinking about the drug business for nearly two decades; in 1999, Amazon purchased a stake in Drugstore.com. That effort ultimately failed and Walgreens purchased the money-losing startup in 2011 and ultimately shut it down.
Pharmacist TJ Parker and computer scientist Elliot Cohen founded PillPack in 2013 after meeting at a medical-technology program at the Massachusetts Institute of Technology. The company raised more than $118 million from brand-name investors including Accel, Sherpa Capital and New York rapper Nas’s Queensbridge Venture Partners.
A September 2016 funding round valued the Boston-based startup at around $360 million, according to venture-capital database PitchBook. In April, CNBC reported Walmart Inc. was in talks to buy the company for “under $1 billion,” citing unnamed sources.
Standing firm
For now, Walgreens indicated that it was in no hurry to find a deal to respond to Amazon, despite the damage to its stock. On an earnings conference call, Walgreens CEO Stefano Pessina faced multiple questions from analysts about the PillPack deal.
“It is a declaration of intent from Amazon,” said Pessina.
He said Walgreens knew that PillPack was for sale as “it had been for sale for a while,” but that the retailer wouldn’t do deals based on emotions or make moves that could destroy value. Pessina insisted that physical pharmacies would continue to be “very important.”
The slump in Walgreens shares weighed on the Dow Jones Industrial Average, which added the stock to its index of 30 companies this month, replacing General Electric Co.
SOURCE:
Langreth R and Tracer Z (29 June 2018) "Amazon has just entered the drug-distribution business" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/06/28/amazon-has-just-entered-the-drug-distribution-busi/
3 Ways to Reshape How You Communicate About Benefits with Millennials
Communicating the benefit needs amongst generations and can cause confusion when keeping up with the satisfaction of your younger employees. Ensure millennial happiness with these tips on their unique benefit standards.
As two millennials ourselves, we know what most people think about Generation Y. Many use terms like “techy,” “entitled” and maybe even “lazy” to describe our generation.
But, the reality is today’s millennials are more global, civic-minded and, though you may not expect it,financially conscious than any other generation. And, according to the Pew Research Center, we now represent 35 percent of today’s workforce.
Millennials are also now getting married and starting families. And yes, purchasing more benefits products through their employers as a result.
As we millennials grow up, it’s important to reconsider how you communicate with us about benefits—because it’s a lot different than how you’ve communicated with other employees in the past.
For example, consider your Gen X and Baby Boomer employees for a moment. When you communicate about benefits with them, it’s relatively straightforward. You probably use tools like email, in-person meetings, flyers and newsletters. And messaging probably revolves around safety, reducing risk and explaining the finer points of the benefits themselves.
But when you’re talking about benefits to millennials, things should be a little different. We’re more digitally fluent than other generations. We’re demanding more flexibility—in our work and family lives. And, we’re increasingly cost-conscious.
It’s a different approach. And, we want to talk about three key ways you can start to reshape how talk with millennials more effectively when it comes to benefits:
For millennials, it’s all about the emotion and sense of responsibility. One of the most interesting findings we’ve picked up over the last few years when communicating with millennials has been to focus messaging on making an emotional connection. Highlight the peace of mind benefits will provide. Discuss the fact that purchasing benefits like disability, life and critical illness insurance through their employer is the right, and responsible, thing to do.
In a recent survey conducted on behalf of Trustmark Voluntary Benefit Solutions “providing peace of mind” was the number one reason millennials gave for why they enrolled in key benefit areas. While this was true across all generations in the study, millennials chose “it’s the responsible thing to do” more than others as a secondary reason for purchase. That emotional connection tied in with responsibility is absolutely key when talking to this demographic.
Millennial stereotypes don’t apply. If you’re communicating with millennials, most people would think digital technologies like text messages and social media would be the way to go. However, that’s not the case. According to Trustmark research, millennials listed “meeting in person” and “calling a representative” as their top preferred channels for communicating during enrollment periods—followed by digital communications channels. Surprising, right? It probably shouldn’t be, given millennials’ desire for more personalization in multiple facets of their lives.
Value, convenience and high-level messaging are key. Through our research, we found that millennials react favorably to messaging around value and convenience—so be sure to hit on those points throughout the enrollment process. For instance, explain why coverage is needed or why an employer-paid policy is not enough. Talk about benefit policy costs in comparison to other low-cost items, like a daily cup of coffee. Discuss the value of employer contributions—and what those contributions can mean to millennials’ bottom lines. Also, make sure to share the convenience and ease of payroll deductions; how their employer is simplifying things by making the deduction and payment for them.
Finally, remember, when it comes to benefits, millennials aren’t as concerned about the details of their insurance plans. They want to understand the basics—what’s covered, how much it costs, and why they might consider a specific offering over another. Resist the urge to focus on the fine print, and keep messaging at the higher levels.
Magic number 3
One more thing that may help reshape your approach to communicating with millennials: The number three. That’s the minimum number of times you should be communicating with millennials during your enrollment process. Our research found that employees remembered and appreciated benefits more when they saw three or more distinct communications. In fact, 72 percent of employees who received three types of benefits communication rate themselves “likely” or “very likely” to recommend their employer based specifically on their benefits program.
Does that help give you some ideas for how to reshape your approach to communicating with millennials about benefits? Overall, just make sure to remember that we millennials are looking for personal and professional offerings from our employers that are unique to us—including benefits. And be sure you’re ready to talk with millennials using the right messaging, the right tools and the right cadence to ensure success.
SOURCE:
Dahlinger, M and Moser, C (27 June 2018) " 3 ways to reshape how you communicate about benefits with millennials" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/06/27/3-ways-to-reshape-how-you-communicate-about-benefi/
Quality trumps convenience among employees
Convenience, or quality? Take a look into why researchers are saying quality of a doctors visit outshines convenience when scheduling the next appointment.
Faced with the choice between going to a conveniently located doctor’s office or a more qualified physician, group health plan members are four times more likely to embrace the better-perceived medical professional.
“Traditional metrics like patient ratings, prescribing rates and volume of patients seen were not nearly as compelling to respondents as more qualitative, contextualized statements about a doctor’s clinical expertise,” according to Nate Freese, senior director of data strategy at Grand Rounds, a healthcare service provider for employees in need of local and remote specialty care.
The data is based on a study of 1,100 members covered by Grand Rounds, which is headquartered in San Francisco.
While surprising, Freese says that result depends on the information and messaging that’s provided to employees. Just 14% of respondents based their choice on clinical expertise if they saw traditional physician profiles, whereas it was 69% if they saw contextualized profiles. Contextualized profiles offered more information in complete sentences compared to traditional profiles. These profiles also compared data against other doctors and specialists, such as appointment wait times, expertise and patient satisfaction.
Freese is encouraged by these findings, which were recently presented at the National Healthcare Ratings Summit. “Don’t sell employees short in terms of their ability to appreciate quality and willingness to sacrifice convenience,” he says.
Offering more subjective interpretation of hard quality metrics would be helpful, Freese explains, as long as employers and their advisers are careful not to “overstep what can be reasonably inferred based on available data.”
Another caveat to consider is that finding high quality providers may not be inherently more difficult in narrow networks. Rather, he says, the issue is when health plan members “lack the ability to identify them. And so, it’s more about presenting information in the right way.”
Providing compelling quality information can achieve the same results of a narrow network, he notes. But he hastens to add that even narrow networks must be sufficiently broad enough for members to have a reasonable amount of choice. Geography also plays a role. “You could be in the broadest network, but by virtue of where you live, have reduced choice,” he says.
Michael Hough, executive vice president and U.S. founder of Advance Medical, believes the quality metrics that are currently available are insufficient for several reasons. “We’re looking at things like frequency and whether the outcomes are horrible,” he says. “But just because the outcomes weren’t horrible doesn’t mean they were good, either.” Desired outcomes depend on what’s going on with patients and whether their objectives are being achieved.
The context of care is “extremely important,” Hough explains, noting the importance of relationships between the patient and a trained physician based on human interaction, as well as the delivery of services. Also, while he believes the rise of telemedicine and self-service “is good for many parts of our lives,” Hough cautions that it’s not necessarily true for healthcare because meaningful relationships trump convenience.
SOURCE:
Shutan, B (22 June 2018) "Quality trumps convenience among employees" [Web Blog Post]. Retrieved from https://www.employeebenefitadviser.com/news/quality-trumps-convenience-among-employees?tag=00000151-16d0-def7-a1db-97f0240f0000
How faking your feelings at work can be damaging
Putting up a fake smile on Monday morning is sometimes unavoidable. There could be consequences to carrying a heavy emotional labor load to get over the Monday Blues.
Imagine yourself 35,000 feet up, pushing a trolley down a narrow aisle surrounded by restless passengers. A toddler is blocking your path, his parents not immediately visible. A passenger is irritated that he can no longer pay cash for an in-flight meal, another is demanding to be allowed past to use the toilet. And your job is to meet all of their needs with the same show of friendly willingness.
For a cabin crew member, this is when emotional labour kicks in at work.
A term first coined by sociologist Arlie Hochschild, it’s the work we do to regulate our emotions to create “a publicly visible facial and bodily display within the workplace”.
Simply put, it is the effort that goes into expressing something we don’t genuinely feel. It can go both ways – expressing positivity we don’t feel or suppressing our negative emotions.
Unhelpful attitudes such as ‘I’m not good enough’ may lead to thinking patterns in the workplace such as ‘No-one else is working as hard as I seem to be’ or ‘I must do a perfect job’, and can initiate and maintain high levels of workplace anxiety - Leonard
Hochschild’s initial research focused on the airline industry, but it’s not just in-flight staff keeping up appearances. In fact, experts say emotional labour is a feature of nearly all occupations in which we interact with people, whether we work in a customer-facing role or not. The chances are, wherever you work, you spend a fair portion of your working day doing it.
When research into emotional labour first began, it focused on the service industry with the underlying presumption that the more client or customer interaction you had, the more emotional labour was needed.
However, more recently psychologists have expanded their focus to other professions and found burnout can relate more closely to how employees manage their emotions during interactions, rather than the volume of interactions themselves.
Perhaps this morning you turned to a colleague to convey interest in what they said, or had to work hard not to rise to criticism. It may have been that biting your lip rather than expressing feeling hurt was particularly demanding of your inner resource.
But in some cases maintaining the façade can become too much, and the toll is cumulative. Mira W, who preferred not to give her last name, recently left a job with a top airline based in the Middle East because she felt her mental wellbeing was at stake.
In her last position, the “customer was king”, she says. “I once got called 'whore' because a passenger didn't respond when I asked if he wanted coffee. I’d asked him twice and then moved to the next person. I got a tirade of abuse from the man.”
“When I explained what happened to my senior, I was told I must have said or done something to warrant this response… I was then told I should go and apologise.”
“Sometimes I would have to actively choose my facial expression, for example during severe turbulence or an aborted landing,” she says. “Projecting a calm demeanour is essential to keep others calm. So that aspect didn't worry me. It was more the feeling that I had no voice when treated unfairly or extremely rudely.”
During her time with the airline, she encountered abuse and sexism – and was expected to smile through it. “I was constantly having to hide how I felt.
Over the years and particularly in her last role, handling the stress caused by suppressing her emotions became much harder. Small things seemed huge, she dreaded going to work and her anxiety escalated.
“I felt angry all the time and as if I might lose control and hit someone or just explode and throw something at the next passenger to call me a swear word or touch me. So, I quit,” she says.
She is now seeing a therapist to deal with the emotional fallout. She attributes some of the problems to isolation from family and a brutal travel schedule, but has no doubt that if she hadn’t had to suppress her emotions so much, she might still be in the industry.
Mira is not alone. Across the globe, employees in many professions are expected to embrace a work culture that requires the outward display of particular emotions – these can including ambition, aggression and a hunger for success.
The way we handle emotional labour can be categorised in two ways – surface acting and deep acting
A few years ago, the New York Times wrote a “lengthy piece about the “Amazon Way”,describing very specific and exacting behaviour the retail company required of its employees and the effects, both positive and negative, that this had on some of them. While some appeared to thrive in the environment, others struggled with constant pressure to show the correct corporate face.
“How we cope with high levels of emotional labour likely has its origins in childhood experience, which shapes the attitudes we develop about ourselves, others and the world,” says clinical and occupational psychologist Lucy Leonard.
“Unhelpful attitudes such as ‘I’m not good enough’ may lead to thinking patterns in the workplace such as ‘No-one else is working as hard as I seem to be’ or ‘I must do a perfect job”, and can initiate and maintain high levels of workplace anxiety,” says Leonard.
Workers are often expected to provide good service to people expressing anger or anxiety – and may have to do this while feeling frustrated, worried or offended themselves.
“This continuous regulation of their own emotional expression can result in a reduced sense of self-worth and feeling disconnected from others,” she says.
Hochschild suggests that the way we handle emotional labour can be categorised in two ways – surface acting and deep acting – and that the option we choose can affect the toll it takes on us.
Take the example of a particularly tough phone call. If you are surface acting you respond to the caller by altering your outward expression, saying the appropriate things, listening while keeping your actual feelings entirely intact. With deep acting you make a deliberate effort to change your real feelings to tap in to what the person is saying – you may not agree with the manner of it but appreciate the aim.
Both could be thought of as just being polite but the latter approach – trying to emotionally connect with another person’s point of view – is associated with a lower risk of burnout.
Jennifer George’s role as a liaison nurse with a psychiatric specialism in the Accident & Emergency department at Kings College London Hospital puts her at the sharp end of health care. Every day she must determine patients’ needs – do they genuinely need to be admitted, just want to be looked after for a while or are they seeking access to drugs?
“It’s important to me that I test my own initial assumptions,” she says. “As far as I can, I tap into the story and really listen. It’s my job but it also reduces the stress I take on.”
“Sometimes I’ll have an instinctive sense that the person is trying to deceive, or I can become bored with what they’re saying. But I can’t sit there and dismiss something as fabrication and I don’t want to.”
This process can be upsetting, she says. Sometimes she has to say no “in a very direct way”, and the environment can be noisy and threatening. “I stay as much as I can true to myself and my beliefs. Even though I need to be open to what both fellow professionals and would-be and genuine patient cases say to me, I will not say anything I don’t believe and that I don’t believe to be right. And that helps me,” she says.
When things get tough, she talks to colleagues to unload. “It’s the saying it out loud that allows me to test and validate my own reaction. I can then go back to the person concerned,” she says.
Ruth Hargrove, a former trial lawyer based in California, also faces tricky interactions in her work representing San Diego students pro bono in disciplinary matters. “Pretty much everyone you are dealing with in the system can make you labour emotionally,” she says.
One problem, says Hargrove, is that some lawyers will launch personal attacks based on any perceived weakness – gender, youth – rather than focusing on the actual issues of the case.
“I have dealt with it catastrophically in the past and let it eat at my self-esteem,” she says. “But when I do it right, I realise that I can separate myself out from it and see that [their attack] is evidence of their weakness.”
Rather than refuting specific, personal allegations, she simply sends back a one-line email saying she disagrees. “Not rising to things is huge,” she says. “It’s a disinclination to engage in the emotional battle that someone else wants you to engage in. I keep in sight the real work that needs to be done.”
Those who report regularly having to display emotions at work that conflict with their own feelings are more likely to experience emotional exhaustion
Hargrove also has to deal with the expectations of clients who believe – sometimes unrealistically – that if they have been wronged, justice will prevail. She understands their feelings, even as she has to set them straight.
“I empathise here, as a parent, with their thought that there should be a remedy, even when I know it’s not going to be achievable. It helps me that this feeling is also true to me.”
Remaining true to your feelings appears to be key – numerous studies show those who report regularly having to display emotions at work that conflict with their own feelings are more likely to experience emotional exhaustion.
Of course, everybody needs to be professional at work and handling difficult clients and colleagues is often just part of the job. But what’s clear is that putting yourself in their shoes and trying to understand their position is ultimately of greater benefit to your own well-being than voicing sentiments that, deep down, you don’t believe.
Leonard says there are steps individuals and organisations can take to prevent burnout. Limiting overtime, taking regular breaks and tackling conflict with colleagues through the right channels early on can help, she says, as can staying healthy and having a fulfilling life outside work. A “climate of authenticity” at work can be beneficial.
“Organizations which allow people to take a break from high levels of emotional regulation and acknowledge their true feelings with understanding and non-judgemental colleagues behind the scenes tend to fare better in the face of these demands,” she says.
Such a climate can also foster better empathy, she adds, by allowing workers to maintain emotional separation from those with whom they must interact.
Where it is possible, workers should be truly empathetic, be aware of the impact the interaction is having on them and try to communicate in an authentic way. This, she says, can “protect you from communicating in a disingenuous manner and then feeling exhausted by your efforts and resentful of having to fake it”.
SOURCE:
Levy, K (25 June 2018) "How faking your feelings at work can be damaging" [Web Blog Post]. Retrieved from https://www.bbc.com/capital/story/20180619-why-suppressing-anger-at-work-is-bad
3 questions advisers should ask about the potential CVS-Aetna deal
In a rapid changing market, stay ahead of the curve by asking these three questions on the potential CVS-Aetna deal to help determine how it will impact the health insurance industry.
The news that CVS has reportedly launched a $66 billion bid to buy Aetna shows that once unimaginable mergers are becoming the norm. But it also raises some important questions for brokers about the future of group benefits, and how to operate in a fast-moving and constantly changing landscape.
Here are three questions to ask when determining how this potential business deal will impact the employer-based health insurance market:
1) Will this move give Aetna a competitive advantage in the group space?
How are other carriers going to feel about having to compete with an insurer that has pharmacy data on the majority of Americans? Anthem may be at the top of the list with worries, as the company just last week announced that it will partner with CVS to launch its own pharmacy benefits manager called IngenioRx.
2) Are healthcare companies too focused on M&A?
A year ago, Aetna was trying to acquire Humana, and Anthem was trying to buy Cigna. Brokers everywhere were concerned about carrier consolidation and what a lack of competition would do to group prices. How have things pivoted to pharmacy so quickly?
The CVS deal may represent gains for both parties. The deal would give Aetna a new avenue for business growth, and CVS would gain some much needed ground against Amazon’s rumored entrance into the drug business.
But what does this emphasis on inorganic, M&A growth say about the healthcare industry? Healthcare consolidation has been a trend for years, but it hasn’t always worked in consumers’ favor, which could leave brokers wary of this deal.
3) Why should employers care?
What impact will this deal have on prescription prices for employers? Prescription drug costs are one of the largest drivers of employer healthcare spend, so the question is critical. Will Aetna and CVS be able to improve efficiencies and lower costs, or monopolize their group markets?
Another point of interest for employers is the possibility of narrowed prescription options. With narrowing provider networks becoming standard, this deal could result in limited consumer options when it comes to prescription drugs.
On the other hand, the deal could spark cost-saving changes in healthcare delivery. It’s not hard to imagine CVS augmenting their MinuteClinic operations with Aetna’s volume.
Employees might find they like having retail access to primary care at a lower price point, with after-hours service, easy-to book appointments, and pharmacy services built right in. This partnership may be the push retail healthcare needs to become a cornerstone of the primary care model.
SOURCE:
Tolbert, B (22 June 2018) "3 questions advisers should ask about the potential CVS-Aetna deal" [Web Blog Post]. Retrieved from https://www.employeebenefitadviser.com/opinion/3-questions-advisers-should-ask-about-the-potential-cvs-aetna-merger
Five steps to becoming a trusted retirement plan adviser
Discover creative ways to deliver the best retirement plan to your employees with these five steps in retirement plan advising.
Many trends within the employee benefits industry challenge advisers to think creatively on behalf of their clients. For instance, millennials are more likely to pay off student loans and less likely to contribute to their company’s 401(k) plan. They lose the benefit of compound interest over all those years to retirement, which over decades, can amount to up to 80% of a millennial’s nest egg.
When companies experience low participation rates with new hires, the overall health of the plan will suffer and many of the more highly compensated and key employees may not be able to defer as much as they would like into the plan. Advisers must develop relationships with business owners to establish customized retirement plans that work best for their and their employees’ needs.
When advisers overcome these challenges they expand their client base and move toward success. The following five steps will help retirement plan advisers bring their career to the next level:
Understand the fiduciary requirements and minimize the risk of the employer
Strive to impart knowledge on the employer and the participants to make them confident in their retirement plans. Company owners will feel more comfortable if an adviser helps to reduce the fiduciary risk associated with the creation and ongoing operation of a plan. Advisers can share and even take over most of the fiduciary responsibility with the employer to lessen the pressure. With the right information, a business owner can understand the requirements of the plan and is motivated to establish a 401(k) or other type of plan for the benefit of their employees and overall business objectives.
Know the best plan options for the companies you’re serving
Not every company should have a 401(k) plan. While 401(k) plans may be optimal for large and even small companies, small companies may benefit from other types of plans. Small businesses often operate at a loss or minimal profit for many years before they generate significant profit. As a result, business owners may seek a plan — such as a defined benefit plan — that allows them to contribute more toward their retirement. In some cases, this may more than triple the amount of yearly contributions an employer can make compared to a 401(k) plan. Employers can contribute to a defined benefit plan and take a tax deduction equivalent to the contributions made to the plan.
Understand the tax advantages of retirement plans
Successful plan advisers should understand the tax advantages associated with the chosen retirement plan for both the owners and the participants. Traditional 401(k) plans tend to provide the most benefits to employees with tax-deferred contributions. On the other hand, small company owners can benefit from the tax advantages of properly designed cash balance or defined benefit plans. These frequently overlooked plans enable employers to deduct the cost of the company’s plan from their taxable income to secure tax savings.
Employee benefit advisers must have this foundational understanding of the tax advantages to successfully serve their clients. Partner with a retirement company record-keeper and a third-party administrator to learn the details for each option.
Discover profitable prospects among small companies too
Many employee benefit advisers in search of success avoid talking to small companies. However, these small companies have significant potential and are vital to success in an otherwise crowded market. Small companies, even with only three to five employees, are great to work with, especially if you help them establish a defined benefit plan, and if it’s the best plan for them. Through these plans, retirement plan advisers can receive the fees needed to provide the service because the company is making larger contributions than to a profit sharing or 401(k) plan.
Target underserved, yet vibrant markets
According to a recent study from the Pew Charitable Trusts, only 53% of small to midsize companies have retirement plans in place. Owners may think they are too small to be able to afford and monitor a program. These businesses are important prospects to pursue. Make yourself known to these companies and show the employer that there is a retirement plan that will work for their employees and company, no matter the size. Explain what program the company can implement and easily administer with your guidance.
Small companies provide great opportunities for advisers to become successful and differentiate themselves from other industry professionals. Keep in mind that these small companies are also more dependent on advisers because of the costs and risk associated with retirement plans. They will require more frequent contact for advice and personalized service. If you do not have the right expertise in the beginning, partner with someone in your office or a TPA until you have the credentials and knowledge to advise small companies on your own.
SOURCE:
Weintraub, M (19 June 2018) "Five steps to becoming a trusted retirement plan adviser" [Web Blog Post]. Retrieved from https://www.employeebenefitadviser.com/opinion/five-steps-to-becoming-a-trusted-retirement-plan-adviser?brief=00000152-146e-d1cc-a5fa-7cff8fee0000
Top 10 health conditions costing employers the most
Conditions that impact plan costs can be problematic. Here is a look into the top 10 health conditions hitting the hardest on employers wallets.
As healthcare costs continue to rise, more employers are looking at ways to target those costs. One step they are taking is looking at what health conditions are hitting their pocketbooks the hardest.
“About half of employers use disease management programs to help manage the costs of these very expensive chronic conditions,” says Julie Stich, associate vice president of content at the International Foundation of Employee Benefits Plans. “In addition, about three in five employers use health screenings and health risk assessments to help employees identify and monitor these conditions so that they can be managed more effectively. Early identification helps the employer and the employee.”
What conditions are costly for employers to cover? In IFEPB’s Workplace Wellness Trends 2017 Survey, more than 500 employers were asked to select the top three conditions impacting plan costs. The following 10 topped the list.
10. High-risk pregnancy
Although high-risk pregnancies have seen a dip of 1% since 2015, they still bottom out the list in 2017; 5.6% of employers report these costs are a leading cost concern for health plans.
9. Smoking
Smoking has remained a consistent concern of employers over the last several years; 8.6% of employers report smoking has significant impact on health plans.
8. High cholesterol
While high cholesterol still has a major impact on health costs- 11.6% say it's a top cause of raising healthcare costs- that number is significantly lower from where it was in 2015 (19.3%).
7. Depression/ mental illness
For 13.9% of employers, mental health has a big influence on healthcare costs. This is down from 22.8% in 2015.
6. Hypertension/ high blood pressure
This is the first condition in IFEBP's report to have dropped a ranking in the last two years. In 2015, hypertension/ high blood pressure ranked 5th with 28.9% of employers reporting it is a high cost condition. In 2017, the condition dropped to 6th with 27.6% of employers noting high costs associated with the disease.
5. Heart disease
This year's study found that 28.4% of employers reported high costs associated with heart disease. In 2015, heart disease was the second highest cost driver with 37.1% of employers citing high costs from the disease.
4. Arthritis/back/musculoskeletal
Nearly three in 10 employers (28.9%) say these conditions are drivers of their health plan costs, compared to 34.5% in 2015.
3. Obesity
Obesity is still a top concern for employers, but slightly less so than it was two years ago. In 2017, 29% of employers found obesity to be a burden on health plans. In 2015, 32.45 cited obesity as a major cost driver.
2. Cancer (all kinds)
Cancer has become more expensive for employers. Now, 35.4% of employers report cancer increasing the costs of health plans, compared to 32% in 2015.
1. Diabetes
The king of raising health costs, diabetes has topped the list both in 2015 and 2017. In the most recent report, 44.3% of employers say diabetes is among the conditions impacting plan costs.
SOURCE:
Otto. N (18 June 2018) "Top 10 health conditions costing employers the most" [Web Blog Post]. Retrieved from https://www.employeebenefitadviser.com/slideshow/top-10-health-conditions-costing-employers-the-most
7 wellness program ideas you may want to steal
Need more energy and excitement in your office? Keep your employees healthy and motivated with these fun wellness program ideas.
Building your own workplace wellness program takes work–and time–but it’s worth it.
“It’s an investment we need to make,” Jennifer Bartlett, HR director at Griffin Communication, told a group of benefits managers during a session at the Human Resource Executive Health and Benefits Leadership Conference. “We want [employees] to be healthy and happy, and if they’re healthy and happy they’ll be more productive.”
Bartlett shared her experiences building, and (continually) tweaking, a wellness program at her company–a multimedia company running TV outlets across Oklahoma –over the last seven years. “If there was a contest or challenge we’ve done it,” she said, noting there have been some failed ventures.
“We got into wellness because we wanted to reduce health costs, but that’s not why we do it today,” she said. “We do it today because employees like it and it increases morale and engagement.”
Though Griffin Communication's wellness program is extensive and covers more than this list, here are some components of it that's working out well that your company might want to steal:
- Fitbit challenge.Yes, fit bits can make a difference, Bartlett said. The way she implemented a program was to have a handful of goals and different levels as not everyone is at the same pace-some might walk 20,000 steps in a day, while someone else might strive for 5,000. There are also competition and rewards attached. At Griffin Communications, the company purchased a number of Fitbits, then sold them to its employees for half the cost.
- Race entry.Griffin tries to get its employees moving by being supportive of their fitness goals. If an employee wants to participate in a race-whether walking or running a 5k or even a marathon, it will reimburse them up to $50 one time.
- Wellness pantry.This idea, Bartlett said, was "more popular than I ever could have imagined." Bartlett stocks up the fridge and pantry in the company's kitchen with healthy food options. Employees then pay whole sale the price of the food, so it's a cheap option for them to instead of hitting the vending machine. "Employees can pay 25 cents for a bottled water or $1.50 for a soda from the machine."
- Gym membership."We don't have an onsite workout facility, but we offer 50 percent reimbursement of (employees') gym membership cost up to a max of 200 per year," she said. The company also reimburses employees for fitness classes, such as yoga.
- Biggest Loser contest.Though this contest isn't always popular among companies, a Biggest Loser-type competition- in which employees compete to lose the most weight-worked out well at Griffin. Plus, Bartlett said, "this doesn't cost us anything because the employee buys in $10 to do it." She also insisted the company is sensitive to employees. For example, they only share percentages of weight loss instead of sharing how much each worker weights.
- "Project Zero" contest.This is a program pretty much everyone can use: Its aim is to avoid gaining the dreaded holiday wights. The contest runs from early to mid- November through the first of the year. "Participants will weigh in the first and last day of the contest," Bartlett said. "The goal is to not gain weight during the holidays-we're not trying to get people to lose weight but we're just to not get them to not eat that third piece of pie."
- Corporate challenges.Nothing both builds camaraderie and encourages fitness like a team sports or company field day. Bartlett said that employees have basically taken this idea and run with it themselves- coming up with fun ideas throughout the year.
SOURCE:
Mayer K (14 June 2018) "7 wellness program ideas you may want to steal" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2015/10/10/7-wellness-program-ideas-you-may-want-to-steal/