3 questions to ask before moving to a private exchange
Originally posted July 24, 2014 by Andrew Bloom on https://ebn.benefitnews.com
As employers grapple with how best to deliver health insurance to their employees, the concept of private insurance exchange or marketplace is quickly gaining traction. In a private exchange model, rather than continuing to assume the responsibility for making healthcare decisions for plan participants (or managing the risk on their behalf), an employer transfers responsibility to employees. This transfer of power enables employees to make important decisions on behalf of their families. Employers have something to gain, too: predictable healthcare costs.
But there is more involved here than simply choosing a private insurance exchange over a traditional benefits delivery model. This is not a simple switch you flip. In fact, the move to a private exchange could be difficult for employees who generally are not accustomed to making benefits plan decisions for themselves, or who balk at the potential of an increased out-of-pocket burden. It’s incumbent upon employers to guide them through the transition to help them accept the idea that having more power and choice is a good trade-off to taking on more risk. To do this, the employer must introduce a defined contribution approach to the workforce and embrace concepts like premium transparency, fixed dollar contributions and multiple plan options.
When done properly, a private exchange will help you achieve the three C’s of benefits: consumerism, compliance and cost-containment.
In short, there’s a tremendous upside toward embracing this strategy, which is a reason why most employers are investigating the option of private exchanges. For virtually every organization, it is not a matter of “if” joining a private exchange is right; it is a matter of “when.”
The key to answering “when” a private insurance exchange is right for your organization starts with understanding where you are on the course. This will help you determine what tools and resources are necessary to help get you there.
Here are three simple questions to consider:
1. How do your employees enroll in benefits today?
2. Do you have a health/wellness and cost management strategy in place?
3. How active are your employees in your current benefits decision-making process?
Depending on the answers to these questions, you may need to:
- Alter your benefits philosophy and design benefits plans and programs to help you move further down the path on the engagement spectrum.
- Design an aggressive wellness and health management strategy. While a private exchange may provide short-term cost savings, it is not a silver bullet. You must continue to drive better behaviors to control costs associated with your program over the long term.
- Execute an ongoing communication strategy that educates employees to become smarter consumers of benefits and better prepared to accept the responsibility and risks associated with making healthcare decisions.
- Implement benefits administration technology that will allow you the flexibility of managing your current program as well as a private exchange, thus affording you the flexibility of a smooth transition.
- Leverage an experienced third party, regardless of implementing a private exchange, to manage the administrative complexities and ever-changing regulatory requirements surrounding your benefits program. This is critical to eliminating costly mistakes and ensuring regulatory compliance.
Before pushing off from the starting line, consider if your organization and employees are ready for such a significant shift in benefits delivery. Keep in mind that preparation for a private exchange is a bit like running a relay. Before the starting shot is fired, everyone in your organization must fully trained to make it around the track.
Employers have an opportunity to transform the delivery, management and overall outcome of their health and welfare programs for the better. A private insurance exchange will be a critical component of your benefits program, but only after you determine your readiness and strategy before taking the first step.
Open enrollment checklist for employers
Originally posted July 23, 2014 by Alan Goforth on https://www.benefitspro.com
Wrestling with the implications of the Patient Protection and Affordable Care Act could make the upcoming open enrollment period one of the most challenging in memory. Mercer, a human resources and benefits company in New York City, encourages companies to approach the fall season with a plan.
Mercer’s proposed checklist includes:
- Consider offering a consumer-driven health plan. The momentum behind this type of plan continues to grow, with 39 percent of large of large employers offering one last year and 64 percent expected to do so within two years.
- Communicate early and often to the newly eligible. Mercer’s research indicates that one-third of employers still need to make changes to comply with the requirement to extend coverage to all employees working 30 or more hours per week. Start communicating right away with newly eligible employees about who is eligible, why they are eligible, how eligibility was determined, what this means and what they have to now consider. Information should also be delivered to those who still remain ineligible and the options these employees may have in the public exchange arena.
- Make voluntary benefits a big part of the message. Voluntary benefits can deliver significant value to employees and are an important element of a thoughtfully designed benefits program. They can also be used to overcome misperceptions and confusion around other benefit offerings. These offerings also can assist employees who remain ineligible for the employer-sponsored medical plan.
- Use open enrollment as an opportunity to reinforce wellness campaigns. This is particularly important if any perceived compliance penalties are going to be introduced next year, such as increased premiums for those who do not participate in health screenings.
- Deploy decision support and mobile technology to support the accountability theme. Participants are being asked like never before to take accountability for their health benefit decisions and cost outlays. For example, some employers are providing digital “wallet cards” for smart phones and other devices that contain benefit information and contacts needed at the point of service or anywhere else a participant needs this information and/or advice.
Average worker needs to save 15% to fund retirement
Originally posted July 22, 2014 by Nick Thornton on https://www.benefitspro.com
A typical household needs to save roughly 15 percent of their income annually to sustain their lifestyle into retirement, according to a brief from the Center for Retirement Research at Boston College.
Generally, workplace retirement savings plans should provide one-third of retirement income, according to the study. For lower income families, defined contribution or defined benefit plans should provide a quarter of all retirement income. Higher income families will need their retirement plans to provide about half of all retirement income.
Middle-income families will require 71 percent of pre-retirement income to maintain living standards after they leave the workforce. About 41 percent of their retirement income is expected to come from social security.
Low-income families need an annual savings rate of 11 percent in order to sustain their lifestyle into retirement, which is lower than middle-income families (15 percent) and high-income families (16 percent). For lower income families, social security will replace a greater portion of pre-retirement income.
The Center’s National Retirement Risk Index says that half of Americans lack adequate savings to maintain their standard of living into retirement. A “feasible increase” in savings rates by younger workers can greatly affect their retirement wealth.
For those middle-income workers ages 30 to 39 who lack enough savings, a 7 percent increase in annual savings can provide adequate retirement funding. But middle-income workers age 50 to 59 who lack retirement savings would have to increase their annual savings rate by 29 percent, an unlikely expectation, the report adds.
For those older workers behind the curve, a better funding strategy would be “to work longer and cut current and future consumption in order to reduce the required saving rate to a more feasible level.”
Delaying retirement to age 70 greatly reduces the annual savings expectations workers need to meet in order to fund retirement.
A worker who starts saving at age 35 will need a 15 percent annual savings rate in order to retire at age 65. But if the same worker delays retirement until age 70, only a six percent annual savings rate is necessary.
A worker who starts saving at age 45 would need to save 27 percent annually to retire at 65. But by delaying retirement to age 70, the same worker only has to save 10 percent to maintain their standard of living after retirement.
What Americans think about health insurance & hiring practices
Originally posted July 25, 2014 by Lynette Gil on https://www.lifehealthpro.com
In a recent survey from Gallup, the majority (58 percent) of Americans said that they would justify charging higher health insurance rates to smokers. And about 39 percent said that they would justify raising health insurance rates to those significantly overweight.
Both percentages have gone down slightly since 2003, when Gallup asked these questions for the first time: from 65 percent for smokers having to pay higher rates and 43 percent for those significantly overweight.
The results are part of Gallup's July 7-10 2014 Consumption Habits survey, in which telephone interviews were conducted with a random sample of 1,013 adults, aged 18 and older, living in all 50 U.S. states and D.C.
The survey also asked participants if companies should be allowed to refuse to hire smokers or those significantly overweight. Most Americans agreed that there should not be discrimination against both. Only 12 percent said that companies should be allowed to refuse to hire people because they are significantly overweight (down from 16 percent in 2003); 14 percent said the same about smokers (up one percentage point from 13% in 2003).
Even though most Americans oppose “hiring policies that would allow companies to refuse to hire smokers or those who are significantly overweight,” it is unclear if those views are because they do not think smoking and obesity negatively affect workplace performance or they “simply reject discrimination of any kind in hiring,” the report says.
According to the report, smoking and being overweight are associated with higher health care costs, and even the Patient Protection and Affordable Care Act (PPACA) allows for higher insurance premiums for smokers. Some would argue that allowing companies to refuse to hire smokers and people who are overweight, or charging them higher health insurance rates, might help encourage healthier lifestyles.
Revisiting Medical Loss Ratio Rebates
Originally posted July 5, 2012 by Bob Marcantonio on https://www.shrm.org
The Patient Protection and Affordable Care Act (PPACA or ACA) requires insurers to report their Medical Loss Ratios (MLRs) to regulators and to meet certain MLR targets. If an insurer exceeds the minimum MLR, the insurer must issue a rebate to the policyholder. The first of these annual rebates is due in August 2012. How are rebates determined?
Rebates are determined according to the prior year’s MLR. Rebates issued in August 2012 will depend on 2011 performance and are not group or individual specific. They are calculated at the carrier and market segment (i.e., individual, small group and large group) level. In some instances the individual and small group markets may be merged.
The ACA defines a small employer as an employer having at least one but no more than 100 employees. However, it provides states the option of defining small employers as having at least one but not more than 50 employees in plan years beginning before Jan. 1, 2016.
Generally, if you have fewer than 100 employees (using the definition for full-time equivalents) you will be purchasing coverage in the small group market.
The MLR is calculated by dividing the medical expenses of the carriers’ segment by the net earned premiums. Medical expenses include claims and activities to improve health care quality as defined in the rules. Net earned premiums include premiums paid by the policyholder minus taxes, licensing and regulatory fees. The MLR threshold for large groups (51+ benefits eligible) is 85 percent and the threshold for small groups (50 or fewer benefit eligible employees) is 80 percent. Certain states have received exemptions until 2014 that allow the MLR to be lower than those levels. In the case of states having more stringent MLR requirements, those requirements supersede the lower federal requirements.
Below are answers to common questions about MLR rebates.
My plan’s paid loss ratio is less than the target. Do I get a rebate?
Not necessarily. Rebates are not issued based on a single plan’s performance. Rebates depend on the insurer’s performance in a given market segment as outlined above.
How will insurers issue rebates?
For group health plans, insurers must issue the rebates to the plan. The plan must then pay out the rebates to the plan’s participants. If a group health plan terminates after the plan year but before the insurer issues rebates and the insurer cannot locate the plan, the insurer must attempt to issue the rebates directly to participants.
Who may receive a rebate?
Only fully insured policyholders are eligible. A policyholder can be an individual or an employer-sponsored group health plan. In the case of a group health plan receiving a rebate, Employee Retirement Income Security Act (ERISA) regulations regarding fiduciary duty apply. If the rebate is small—$20 or less for a group health plan—the insurer does not need to issue the rebate to the plan.
What should you do if your group receives a rebate?
The Department of Labor (DOL) issued Technical Release No. 2011-04 outlining the proper handling of rebates. The release states that:
"If the participants and the employer each paid a fixed percentage of the cost, a percentage of the rebate equal to the percentage of the cost paid by participants would be attributable to participant contributions. Decisions on how to apply or expend the plan’s portion of a rebate are subject to ERISA’s general standards of fiduciary conduct. Under section 404(a)(1) of ERISA, the responsible plan fiduciaries must act prudently, solely in the interest of the plan participants and beneficiaries, and in accordance with the terms of the plan to the extent consistent with the provisions of ERISA.
"With respect to these duties, the Department notes that a fiduciary also has a duty of impartiality to the plan’s participants. A selection of an allocation method that benefits the fiduciary, as a participant in the plan, at the expense of other participants in the plan, would be inconsistent with this duty. In deciding on an allocation method, the plan fiduciary may properly weigh the costs to the plan, the ultimate plan benefit, and the competing interests of participants or classes of participants provided such method is reasonable, fair and objective. For example, if a fiduciary finds that the cost of distributing shares of a rebate to former participants approximates the amount of the proceeds, the fiduciary may decide to allocate the proceeds to current participants based upon a reasonable, fair and objective allocation method.
"Similarly, if distributing payments to any participants is not cost-effective (e.g., payments to participants are of de minimis amounts, or would give rise to tax consequences to participants or the plan), the fiduciary may utilize the rebate for other permissible plan purposes including applying the rebate toward future participant premium payments or toward benefit enhancements."
When will insurers issue the rebates?
Under the regulations, the first rebates are due Aug. 1, 2012, although the precise dates of receipt may be before the deadline, depending on the insurer. Insurers will send written notices to subscribers informing them that a rebate has been issued. Plan administrators should be prepared to field questions from employees who receive such notices.
Additionally, insurers not issuing a rebate must send letters to subscribers explaining the MLR rule notifying their health insurer had a medical loss ratio that met or exceeded the requirements.
How much might the rebates be worth?
The not-for-profit Kaiser Family Foundation released statistics garnered from insurers’ filings to the National Association of Insurance Commissioners. In the large-group segment, total reported rebates are $541 million nationwide. Among the insurers, 125 reported they expect to issue rebates to large groups covering 7.5 million enrollees. Insurers in 14 states do not expect to issue rebates in 2012. The largest average per-enrollee rebates projected are in Vermont ($386), Nebraska ($248), Minnesota ($146), New York ($142) and North Carolina ($121).
Among large group enrollees, 19 percent are projected to receive rebates nationwide. Taken in total, the average annual rebate in the entire large group segment per year will be $14 per enrollee, according to rebate estimates based on insurer filings to the National Association of Insurance Commissioners (NAIC).
Education heightens employee satisfaction with benefits, employers
Originally posted July 23, 2014 By Melissa A. Winn on https://eba.benefitnews.com
Employees are increasingly dissatisfied with their benefits, and therefore dissatisfied with their employers.
This trend, according to new research released by Unum, highlights the correlation between employers’ benefit offerings and the ability to attract and retain top talent. What’s more, the survey found employees who receive education about their employee benefits tend to be more satisfied with their benefits — and ultimately their employers. Benefit advisers working with employers can stress the importance of benefits education on employee satisfaction and how that translates into better employee attraction and retention.
The survey results released Tuesday show employee satisfaction with their benefits continues to closely relate to satisfaction with their employer. More than three-quarters (77%) of those workers who rate their benefits package as “excellent” or “very good” also rate their employer as an excellent or very good place to work. By contrast, only 17% of employees who consider their benefits package to be fair or poor rate their workplace as excellent or very good.
Also, 79% of workers who rated the education around their benefits as excellent or very good also rated their employer as excellent or very good — compared with only 30% of those who said the education they received was fair or poor.
“This research underscores the value of an effective benefits education plan because when an employee understands their benefits, they tend to value them more and in turn may then value their employers more for providing access to them,” says Bill Dalicandro, vice president of the consumer solutions group at Unum.
The Unum research reiterates recent findings from the Aflac Workforces Report that small business employees are not only dissatisfied with their employer’s benefit offerings but also willing to take a pay cut to work for an employer offering better benefits.
Unum’s online survey of 1,521 working adults, conducted by Harris Poll, finds that only half (49%) of U.S. workers rate their employer as an excellent or very good place to work and less than half (47%) of employees who were offered benefits by their employer rated their benefits as excellent or very good. This is the lowest rating of benefits in six years of conducting the research.
The survey also shows employees do not feel they are getting the information they need about the benefits they’re being offered. Only 33% of employees who were asked to review benefits in the prior year rated the benefits education they received as excellent or very good – a drop from 2012 and a reversal to the upward trend in ratings since 2009. In addition, nearly three in 10 (28%) rated their benefits education as fair or poor.
“With health care reform and other changes in employee benefit plans, employees have so much information to digest right now,” explains Dalicandro. “Employers can play such a great role in helping their employees understand their options so they will feel comfortable making benefits decisions.”
Benefit package critical for small businesses
Originally posted July 11, 2014 by Alan Goforth on https://www.benefitspro.com.
Small businesses are taking a cautious approach to hiring, compensation and employee benefits, according to the 2014 Aflac WorkForces Report for Small Businesses. The study of businesses with three to 99 employees also found that benefits are a key component to employee hiring, retention and satisfaction.
Although 63 percent of small-business employees are extremely or very satisfied with their job, many believe there is room for improvement when it comes to their benefits packages. Only 12 percent are extremely satisfied with their benefits, while only 14 percent believe their benefits package meets their current family needs extremely well.
These numbers are vital to employers, because 50 percent of small-company employees said they are likely to seek a new job in the next year. Of that number, 57 percent said they probably would accept a job with slightly lower pay but better benefits. On the other side of the coin, 47 percent said improving their benefits packages is one thing their employers could do to keep them in their job.
"Employees at a small business might be satisfied with their pay, enjoy their company environment, their colleagues and the work itself, but that doesn't mean better benefits offerings elsewhere won't entice them to leave," said Teresa White, executive vice president and chief operating officer of Aflac Columbus. "These findings should alert small-business decision-makers that robust benefits, including voluntary insurance, are an important way to keep employees engaged, productive and loyal."
The study found that 85 percent of small-business employees consider voluntary benefits to be part of a comprehensive benefits program. Six in 10 workers at small companies see a growing need for voluntary insurance benefits today, driven by:
- Rising medical costs (71 percent);
- Increasing price of medical coverage (63 percent);
- Increasing deductibles and copays (58 percent); and
- Reduced number of benefits and/or amount of coverage by their employers (29 percent).
Small-business leaders are well aware of employee concerns and the importance of benefits. Although 84 percent said they either maintained or grew sales and revenues in 2013, they are concerned about taking care of employees and continuing their benefits options. This may be one reason why they hired at a slower pace than medium or large companies last year.
Health care employers need cure-all for retirement epidemic
Originally posted Jully 11, 2014 by Michael Giardina on https://ebn.benefitnews.com.
Like other industries, health care employers and benefit plan managers in the health care sector are struggling mightily with their ability to address the retirement preparedness of their evolving workforces.
Whether it’s the remnants of the baby boomers or introduction of millennials, the workforce dynamic in the health care industry is going through a change as the it continues to cope with the ongoing hiccups of the Affordable Care Act. Plan fiduciaries at health worksites also caution the need to motivate their employees to save adequately and helping them learn how to invest wisely.
The health care segment includes more 4,000 defined contribution plans, with approximately 5,200 retirement plan participants. In total assets, the health care sector has more $317.8 billion, which is about 40% of the overall DC not-for-profit market.
Ty Minnich, vice president, not-for-profit institutional markets at Transamerica Retirement Solutions, says the root of the problem is the “pendulum shift” from defined benefit to DC retirement plans, which adds to the retirement confusion.
“The aging population, although affecting all industries, is creating a workforce management issue – particularly in health care, where the demand for younger employees is there,” says Minnich. “The technical expertise, the knowledge they need with the sophistication of the changes in medical delivery [is critical], yet they have employees entering the retirement period of their careers and they are not retiring because they are not ready to retire, from a financial perceptive.”
According to health care retirement plan sponsors, approximately 75% say that employee engagement is one of the most significant challenges in managing a retirement plan. Of the more than 100 hospital administrators and chief financial officers surveyed by Transamerica and the American Hospital Association, most agree that helping employees save for retirement and retaining employees are top goals for their retirement plan.
Another wrench in the operation of health care businesses has been the ACA, and its overnight transformation – according to some in consultancy space – of how business is done in the field.
“[Health care] is undergoing an enormous change, from the perspective on how they get reimbursed for their delivery model,” says Minnich. “What you seeing is that the smaller regional community-type organizations just can’t exist in this marketplace.”
David Zetter, of Zetter Healthcare Management Consultants, explains that he is seeing similar shifts in all aspects of benefits and services – from small practices to large groups and health systems that the health care accounting and consulting firm works with.
“I don’t see how health care practices are going to do it,” explains Zetter, also a board member of the National Society of Certified Healthcare Business Consultants. “It’s just getting so expensive, and reimbursements are going down. It’s tough for a doctor to make ends meet at this point in time and if they keep wanting to be the employer of choice they are going to have to ante up. Unfortunately that’s going to cost them quite a bit of money, especially from a benefits standpoint.”
Meanwhile, there has been a change in how plan sponsors measure plan success in the medical industry. There is more of a focus around retirement readiness rather just solely participation rates, according to the study. And this intensified focus on improving employee interaction and tailoring print and electronic education touch points exemplifies how health care retirement plan sponsors are reacting.
“It all indicates that the plan sponsors are not only realizing they have to do more to help participants get ready for retirement, but also helping participant to help themselves,” says Grace Basile, assistant director of market research at Transamerica Retirement Solutions. “There’s no more ‘set it and forget it,’ there’s no more just getting into the plan.” Instead, she says it’s all about “increasing [engagement] over time, [and] making sure your investments are appropriate for where you are in your age and career.”
Overall, employers and their employees have been riddled with uncertainty of retirement since the recession. However, according to the Employee Benefit Research Institute, retirement confidence reported some meager gains from the losses over the past five years. Approximately 18% of Americans are very confident and 37% are somewhat confident with the future financial needs.
Nevin Adams, co-director of the Employee Benefit Research Institute Center for Research on Retirement Income, adds that all employers – not just those in the health care space – are faced with the challenges of finding the sweet spot of automatic enrollment, default rates and participation.
“One of the things that we are really hearing from employers is that employee benefits are going to continue to be sort of a differentiating factor,” Adams tells EBN. He says that demographic shifts are one of the biggest challenges for employers to deal with.
“The baby boomers [are] kind of hanging around, and the millenials looking for a place to come in,” he notes. “The benefit package and how it’s put together really will make a difference.”
Hobby Lobby ruling spilling over to corporate world
Originally posted July 10, 2014 by Alan Goforth on https://www.benefitspro.com.
Both proponents and opponents of the recent ruling by the U.S. Supreme Court in the Hobby Lobby contraception case agree on at least one thing: The case may be settled, but how it will play out in the workplace is far from certain.
The court ruled that the 1993 Religious Freedom Restoration Act prevents certain employers from being forced to pay for contraceptives they oppose for religious reasons. However, the definition of which types of corporations are excluded remains murky.
"Nobody really knows where it is going to go," said Richard Primus, professor of constitutional law at the University of Michigan. "I assume that many more businesses will seek exemptions, not just from the [Patient Protection and] Affordable Care Act, but from all sorts of things they want to be exempt from, and it will put courts in a difficult position of having to decide what is a compelling government interest."
About 50 lawsuits filed by corporations nationwide, which were put on hold during the Hobby Lobby appeal, must now be resolved or re-evaluated. "We don't know ... how the courts will apply that standard," Primus said.
The decision also has ramifications beyond the courtroom. Even closely held companies with sincere religious beliefs must carefully consider the potential marketplace ramifications of crafting health-care coverage according to religious beliefs.
"Many owners of companies don't want to distinguish the difference between what's good for them personally and what's good for their business," said John Stanton, professor of food marketing at Saint Joseph University in Philadelphia. "I believe that if a business owner believes something is the right thing to do — more power to them. That's his business. However, he's got to be ready for the negative repercussions."
Eden Foods of Clinton, Mich., a natural-foods manufacturer, has filed a lawsuit and is balancing religious beliefs and business concerns. Since Eden initially filed its lawsuit last year over mandates to cover birth control in PPACA, some customers have taken to social media to express disapproval and outrage, even threatening a social boycott. However, the corporation also has gained new customers who support its stance.
"It's very conceivable they could lose business," said Michael Layne, president of Marx Lane, a public relations firm in Farmington Hills, Mich. "And they could lose employees, too."
Experts agree that the myriad issues raised by the Hobby Lobby decision could take a while to play out. "I think there will be a rush of litigation in the next year or two," Primus said. "I think that the exemptions are likely to get broader before they are limited."
Ancillary Plans Get a New Spin
Originally posted June 9, 2014 by Amber Taufen on https://www.benefitspro.com
Employers struggling with new mandates for basic health care programs probably don’t even want to think about offering their employees ancillary benefits like vision and dental insurance.
However, as many experts have noted, these two particular ancillary benefits can save employers money in the long run because regular dental and vision screenings can detect some chronic health conditions early.
Employer-provided flexible spending accounts and health savings accounts can be one alternative option to traditional health and dental insurance, but sometimes employees have difficulty understanding the parameters of these programs, or can’t find affordable out-of-pocket care on their own. So many employers are turning to alternative ways to provide vision and dental coverage to their employees – new, innovative methods of coverage that provide both flexibility and cost-savings. And the biggest trends all revolve around cost transparency and empowering employees to make educated care decisions.
Jason Szczuka, general manager of Brighter PRO, says that his tech company has helped fill a need for more cost-effective employee dental coverage – a need he says will definitely continue to grow.
“Traditional dental insurance does not work for employers and employees as a cost-effective benefit offering,” Szczuka says. “And there’s been zero innovation in this industry for the past 20 years. However, by leveraging newer technologies, our platform aligns the interests of patients, providers, and payers alike to lower claims costs through new efficiencies in benefits payments, network fee schedules, utilization review and group plan designs.”
Although the Brighter PRO set-up looks somewhat similar to a traditional preferred provider organization insurance plan, it’s actually a cost-transparency technology resource that creates new efficiencies to create lower overall dental costs.
Brighter PRO maximizes the savings it generates through a transparent online marketplace so members can easily shop for providers based on price and quality, while participating providers can compete for more patients by improving their prices and quality scores, and payers can lower their claims by optimizing how and where members use their benefits.
“We’ve built the technology that helps transform health care consumers into health care shoppers,” Szczuka says. “They can compare dentists side-by-side on cost, quality and convenience. Schedule their appointment online 24/7. And when the appointment is over, the user’s electronic dental record is updated so they can more easily and affordable maintain their oral health.”
Derek Moore, a senior benefits consultant with Leavitt Group, says his clients have appreciated the addition of Brighter PRO to his portfolio of benefit offerings.
“Some of my clients are saving 70 percent on their premiums for something they can do online – if you have a computer or a phone, you can use this service,” he notes. “Everything in today’s market seems to be quick, so it was only a matter of time before these technological innovations made its way into health care.”
Gene Erdman, director of human resources for the Southern California Pizza Co., likes the program because he’s able to offer a dental benefit for all of his employees – including his part-time workers.
“The adjustability and flexibility offered with a service like this fits our employee base very well,” he notes. “Our workforce skews toward millennials, and the concept of them being able to shop and price and make a decision about a care provider from data they can access from their iPad or phone or computer and really individualize that decision is significant for us.”
A clearer vision
And while companies like Brighter PRO look at new ways to provide dental coverage options for employers, other companies like Careington address the vision component of ancillary benefits.
“We’re a discount plan, and we’ve developed a somewhat exclusive network with vision carriers,” explains Greg Rudisill, senior vice president of strategic partnerships at Careington. “Many times, we can go into a big group and bundle all of these carrier networks together so that our members have the broadest access available.”
Rudisill notes that many Careington clients use the service in conjunction with FSAs or HSAs to help their employees manage their vision needs.
“Everything is very transparent, so the member can see what it would cost them for different services before they go in. If they know what it’s going to cost them in advance, they can set aside that specific aside of money in their FSA. And there are no claims to file, so providers love it because they don’t have to do a lot of administrative work like they would with an insurance plan.”
“The Patient Protection and Affordable Care Act is building our market for us,” Szczuka says, “because, although the need for dental coverage has been around for a while, the adult dental gap is going to continue to grow as the premium-to-benefit value of traditional dental insurance erodes even more quickly than it already has been.”
And if those trends continue in the ancillary world, employers will increasingly seek new, innovative methods to provide health care value to their employees.