Number Of Uninsured Falls Again In 2015
Interesting article from Kaiser Health News about decreasing uninsured rates by Julie Rovner
The federal health overhaul may still be experiencing implementation problems. But new federal data show it is achieving its main goal — to increase the number of Americans with health insurance coverage.
According to the annual report on health insurance coverage from the Census Bureau, the uninsured rate dropped to 9.1 percent, down from 10.4 percent in 2014. The number of Americans without insurance also dropped, to 29 million from 33 million the year before.
The Census numbers are considered the gold standard for tracking who has insurance and who does not, because its survey samples are so large. It does change methodology from time to time, however (most recently in 2013), so years-long comparisons are not necessarily accurate.
Still, between 2013 and 2015, the first two full years the health law was in effect, the uninsured rate dropped by more than 4 percentage points. The total number of uninsured fell by 12.8 million. Meanwhile, the percentage of Americans with insurance for at least some part of the year climbed to 90.9 percent, by far the highest in recent memory.
“I don’t remember it ever being in the 90s before,” said Paul Fronstin of the Employee Benefit Research Institute, who has been tracking insurance statistics since the early 1990s.
The Obama administration was quick to take credit for the insurance improvements. “The cumulative coverage gains since 2013 have put the uninsured rate at its lowest level ever,” said members of the White House Council of Economic Advisers in a statement.
The 2015 report shows insurance gains across all income levels, ages and types of employment, although some groups did better than others. Young adults — specifically 26-year-olds — remain the most likely to lack coverage. Although the Affordable Care Act guaranteed that young adults could stay on their parents’ plans longer than in the past, that protection ends when they turn 26.
Among states, those that took the health law’s option to expand the Medicaid program for the poor saw greater gains in coverage than those that did not. “The overall decrease in the uninsured rate of 2.4 percentage points in expansion states, compared with 2.1 percentage points in no-expansion states,” said the report. The state with the highest percentage of uninsured residents remained Texas at 17.1 percent; the state with the fewest uninsured remained Massachusetts with an uninsurance rate of 2.8 percent.
The single largest source of health insurance remains plans provided by employers. An estimated 177.5 million Americans had employment-based coverage in 2015, which was up more than 3 million from 2013.
See the original article Here.
Source:
Rovner, J. (2016 September 13). Number of uninsured falls again in 2015. [Web blog post]. Retrieved from address https://khn.org/news/number-of-uninsured-falls-again-in-2015/
2016 Draft Forms & Instructions Released: Affordable Care Act Reporting Update
Great feature from The National Law Review by Damian A. Myers,
Since our last ACA Reporting Update, the extended deadlines to distribute Forms 1095-B and 1095-C to covered individuals and employees and to file the forms with the IRS have passed. The IRS has stated, however, that late forms can still be submitted via electronic filing and the forms that received an error message should be corrected. By many accounts, the first ACA reporting season presented numerous challenges. From collecting large amounts of data to compiling the forms, to working with service providers that faced their own unique challenges, to facing form rejections and error notifications from an inadequate IRS electronic filing system, employers and coverage providers faced obstacles nearly every step of the way. Nevertheless, most employers and coverage providers were able to get the forms filed and put the 2015 ACA reporting season behind them.
But, alas, there is no rest for the weary. In late-July, the IRS released new draft 2016 Forms 1094-B and 1095-B (the “B-Series” Forms) and Forms 1094-C and 1095-C (the “C-Series” Forms). Additionally, on August 1, the IRS released draft instructions to the C-Series Forms (as of the date of this blog, draft instructions for the B-Series Forms have not been released). For the most part, the 2016 ACA reporting requirements are similar to the 2015 requirements, subject to various revisions described below.
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Various changes have been made to the forms and instructions to reflect that certain forms of transition relief are no longer applicable. For example, the non-calendar year transition relief (for plan years starting in 2014) that applied in 2015 does not apply in 2016. Similarly, changes have been made to reflect that the “Section 4980H Transition Relief” is still relevant only for non-calendar year plans though the end of the plan year ending in 2016. The Section 4980H Transition Relief exempts applicable large employers (“ALEs”) with 50-99 full-time employees from penalties under Section 4980H of the Internal Revenue Code (the “Code”) and reduces the 95% threshold to 70% for other ALEs. The relief also exempts ALEs from having to offer coverage to dependents if certain requirements are met. For calendar year plans, the threshold is at 95% throughout 2016 and dependent coverage must be offered during each month of the year.
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The draft instructions to the C-Series Forms provide more detail and examples on how ALEs should prepare the forms. Instead of referring to “employers” throughout the instructions, the IRS has replaced that term in most cases with “ALE Member.” The reason for this change is to highlight the fact that each separate ALE Member must file its own forms. Examples related to completing the authoritative Form 1094-C highlight that each separate entity (determined based on employer identification number) is required to file its own authoritative Form 1094-C.
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As promised by the IRS last year, there are two new indicator codes for Line 14 of Form 1095-C. These new codes ask employers to indicate whether a conditional offer was made to a spouse. An offer of coverage to a spouse is conditional if it is subject to one or more reasonable, objective conditions. For example, if a spouse must certify that he or she is not eligible for group health coverage through his or her employer, or is not eligible for Medicare, in order to receive an offer of coverage, the offer is considered conditional.
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The draft instructions to the C-Series Forms reflect that the good faith compliance standard applicable to 2015 forms (under which filers could avoid reporting penalties upon a showing of good faith) no longer applies for 2016 ACA reporting. Going forward, reporting penalties may be waived only upon the standard showing of reasonable cause.
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The draft instructions to the C-Series Forms include new information related to coding for COBRA continuation coverage. There has been some uncertainty regarding how to treat offers of COBRA continuation coverage since the IRS removed relevant guidance from its Frequently Asked Questions website in February 2016. Similar to the 2015 instructions, the draft 2016 instructions provide that offers of COBRA coverage after termination from employment should be coded with 1H (Line 14) and 2A (Line 16) whether or not the COBRA coverage is elected. The new instructions now state that this coding sequence also applies for other, non-COBRA post-employment coverage, such as retiree coverage, when the former employee was a full-time employee for at least one month of the year.
In the case of an offer of COBRA coverage following a reduction in hours, the basic coding requirement is the same as in 2015 – the offer of COBRA coverage is treated as an offer of coverage on Line 14 of the Form 1095-C. The draft instructions expand on this basic requirement to explain how to code Lines 14 and 16 when the offer of COBRA coverage is not made to a spouse or dependent. In general, for purposes of Code Section 4980H, an offer of coverage made once per year to an employee and his or her spouse and dependents is treated as an offer for each month of the year even if the coverage is declined for the employee, spouse, and/or dependents. Under general COBRA rules, only those individuals enrolled in coverage immediately prior to the qualifying event receive an offer of COBRA coverage.
So how does this play out when an employee with a spouse and dependents elects self-only coverage during open enrollment and later loses that coverage due to a reduction in hours? The draft instructions treat the initial offer of coverage at open enrollment and the offer of COBRA coverage as two separate offers of coverage. To determine the proper coding, the employer must look at who had the opportunity to enroll at each offer. During open enrollment, the employee, spouse and dependent had the opportunity to enroll. Thus, until the reduction in hours and loss of coverage, the coding should be 1E (offer to employee, spouse and dependent) in Line 14 and 2C (enrolled in coverage) in Line 15.
In contrast, the offer of COBRA coverage was only available to the employee and, therefore, after the reduction in hours, the coding should be 1B (offer to employee only) in Line 14. If the employee does not elect the COBRA coverage, code 2B (part-time employee) could be inserted in Line 16. If, however, the employee does elect COBRA coverage, it appears that code 2C (enrolled in coverage) should still be inserted in Line 16. Although this latter coding sequence is likely intended to protect the spouse and dependents from being “firewalled” from a premium credit, there appears to be nothing to indicate that the employer should not be assessed a penalty for failing to make an offer to the employee’s dependents.
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The draft instructions for the C-Series Forms provide additional insight into how to calculate the number of full-time employees for purposes of column (b) in Part III of the Form 1094-C. The draft instructions clarify that the determination of full-time employee status is based on rules under Code Section 4980H and related regulations and not on other criteria established by an employer. Note that, currently, the draft instructions state that the monthly measurement period must be used for this purpose, but it appears that this is a mistake and that it should reference both the monthly measurement and look-back measurement methods. The IRS may clarify this in the final instructions.
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One important non-change in the draft instructions is that the specialized coding for employees subject to the multiemployer plan interim guidance remains in effect for 2016 reporting. The interim guidance provides that an employee is treated as having received an offer of coverage if his or her employer is obligated pursuant to a collective bargaining agreement to contribute to a multiemployer plan on the employee’s behalf, provided that the multiemployer plan coverage is affordable and has minimum value and the plan offers dependent coverage to the eligible employee. The coding for such as employee is 1H (no offer of coverage) for Line 14 and 2E (multiemployer plan interim guidance) for Line 16.
There will undoubtedly be tweaks to the draft instructions to the C-Series forms, but significant changes appear unlikely. Given that only five months remain in 2016, employers should start planning now for 2016 ACA reporting based on the draft instructions and make alterations as necessary when final instructions and other guidance is released.
See the original article Here.
Source:
Myers, D. A. (2016 August 4). 2016 draft forms & instructions released: affordable care act reporting update. [Web blog post]. Retrieved from address https://www.natlawreview.com/article/2016-draft-forms-instructions-released-affordable-care-act-reporting-update
Small businesses wait for verdict on 2017 health care costs
Here's an informative article on healthcare costs, from San Francisco Chronicle (SFGate) by AP Business Writer Joyce M. Rosenberg
NEW YORK (AP) — Autumn is an anxious time for many small and medium-sized business owners as they wait to learn whether their health insurance costs will go up for 2017 — and if so, by how much?
"There's always a lump in your throat because you don't know what you're going to get," says Darren Ambler, a managing director at Insight Performance, a Dedham, Massachusetts-based human resources provider.
Whether a business sees a minuscule rise, a double-digit percentage increase or even a decline depends on factors including the state where the company is located and how much its insurance carrier paid in claims over the past year. If the average age of a company's employees rose or fell significantly — quite possible in a business with 10 or fewer employees — that could also affect the outcome.
Most of the increase in insurers' costs is a result of rising prescription drug prices, Ambler says.
While companies with 50 or more workers are required to offer affordable insurance to them and their dependents, many smaller businesses also do so because they believe it's right or they want to attract and retain good employees. When their carriers hike the premiums, companies have to decide whether to absorb the costs, scale back their coverage or find other alternatives.
Several medium-sized clients of The Megro Benefits Co., a consulting company, are facing 38 percent increases in their 2017 premium costs. Surges like that have owners thinking about what's called self-funding, says Cheryl Kiley, an adviser at Conshohocken, Pennsylvania-based Megro.
In self-funding, a business pays for all or part of employees' medical costs and hires an insurance company to administer its health plan. Companies typically purchase special policies to reimburse them in the event of employees' or dependents' catastrophic illnesses. Insurance companies charge less to administer self-funded plans because they don't have any risk, and employers also save because self-funded plans aren't subject to a 6.5 percent federal tax on premiums.
Although companies may be forced to find alternatives, Megro isn't seeing clients dropping insurance, president Bob Violasays.
"People won't come to work for them unless they have health insurance," he says.
RizePoint, which makes software for the food, lodging and retail industries and has about 75 employees, is paying 16 percent more for premiums on a policy that renewed Sept. 1. It's already considering self-funding for next year.
"It's a little bit risky," says Peter Johnson, a vice president at the Salt Lake City-based company. "But I don't want to see another 16 percent increase — it's nowhere near sustainable."
Johnson had budgeted for a rise of 12 percent. When RizePoint's carrier said premiums were going up more than that, Johnson searched unsuccessfully for a cheaper policy.
Rocky Finseth had the opposite experience. His premiums fell 11 percent although the policy was virtually unchanged from a year ago.
"I was surprised not only about the drop, but how large of a drop," says Finseth, owner of Carrara Nevada, a Las Vegas-based company that does lobbying on state and local issues in Nevada. His policy, which covers seven staffers, renews Oct. 1.
Finseth didn't question why his premiums dropped. He decided to use the savings to add vision coverage for his employees.
Some companies find that their policies have been discontinued.
"The plan we had was mysteriously canceled, and we were slotted into what we were told was the same plan, but when you looked at it, it was a worse plan," says Joseph Nagle, marketing director at EverCharge, a maker of electric vehicle charging stations. Among other things, the new plan had a higher deductible — $6,000 versus $5,000.
EverCharge, based in Emeryville, California, began researching other carriers and plans, chose three and asked its seven employees which they preferred. The company, which previously paid for all its staffers' insurance, gave them an option of continuing to have fully funded coverage, paying about $10 per month for better coverage, or $120 for another. They chose the middle option, and EverCharge was able to keep its health care costs unchanged, Nagle says.
Jason Anderson, owner of Datagame, a Kansas City, Missouri-based maker of software for online market research, hasn't received his renewal package yet. Anderson pays 100 percent of his three staffers' premiums, and 50 percent of their dependents' premiums.
He had a 5 percent increase for his 2016 premiums, an amount he doesn't see as significant. He says he can handle a 10 percent increase, but if he's facing a 20 percent hike, he might have to cut back on coverage for dependents.
"I keep waiting for the shoe to drop," says Anderson, who acknowledges that he'd be angry at an increase in the 20 percent range. "I don't see 10, 20, 30 percent improvements in what I am able to charge my clients," he says.
See the original article Here.
Source:
Rosenberg, J. M. (2016 September 14). Samll businesses wait for verdict on 2017 health care costs. [Web blog post]. Retrieved from address https://www.sfgate.com/news/us/article/Small-businesses-wait-for-verdict-on-2017-health-9222107.php
U.S. Department of Labor Proposes Improvements to Form 5500
Released by the United States Department of Labor on July 11, 2016.
Form 5500 affects us all and the Department of Labor is looking for your input on the proposed revisions to the form. Below you will find the proposed revisions and some details about them.
The Form 5500 is the primary source of information about the operations, funding and investments of private-sector, employment-based pension and welfare benefit plans in the U.S. There are an estimated 2.3 million health plans, a similar number of other welfare plans and nearly 681,000 pension plans. Covering roughly 143 million private-sector workers, retirees and dependents, these plans have an estimated $8.7 trillion in assets.
The proposed revisions are intended to:
- Modernize the financial statements and investment information filed about employee benefit plans.
- Update the reporting requirements for service provider fee and expense information.
- Enhance accessibility and usability of data filed on the forms.
- Require reporting by all group health plans covered by Title I of ERISA.
- Improve compliance under ERISA and the Internal Revenue Code through new questions regarding plan operations, service provider relationships, and financial management of the plan.
The proposed regulations also would make improvements to the certification requirements for the limited scope audit requirements under 29 CFR 2520.103-8, and allow group health plans to use the Form 5500 to satisfy certain reporting requirements in the Affordable Care Act. The proposed changes to the DOL regulations are also needed to implement the form revisions.
“The proposed form changes and related regulatory amendments are important steps toward improving this critical enforcement, research and public disclosure tool,” said Assistant Secretary for the Employee Benefits Security Administration Phyllis C. Borzi. “The 5500 is in serious need of updates to continue to keep pace with changing conditions in the employee benefit plan and financial market sectors. We must also remedy the form’s current gaps in collecting data from ERISA group health plans.”
To read the full article from the Department of Labor, click here.
Top healthcare benefit trends to watch
Original post benefitsnews.com
The number of employers offering a healthy living/incentive program grew in 2015, and is one of several trends to watch as the year 2016 unfolds, analysts say.
Plan design changes and programs such as incentive and wellness were of increasing interest to employers last year and most “continue to turn to their brokers and consultants to learn more about new health plan benefit designs and distribution models,” says Tiffany Wirth, executive director of the Healthcare Trends Institute.
“Helping employees better understand the value of provided benefits and making cost-conscious benefit decisions continues to remain important to employers,” she says.
The number of employers offering a healthy living/incentive program grew from 29.8% in 2014 to 34.6% in 2015, according to the HTI’s 2015 Healthcare Benefit Trends Benchmark Study.
During a webinar unveiling the results, Wirth said 21.8% of employers are considering such a program and 16.7% are still learning about them. About 1 in 4 employers (24.7%) indicated they weren’t interested in offering such a program.
“We’re starting to see these types of programs take hold as [healthcare] reform is being adopted and companies are pushing employees to understand their decisions, their purchases, and all of the different things that go along with healthcare benefits,” she says.
As part of incentive program tracking, HTI has also been examining what sort of wellness programs companies are implementing, Wirth says.
Almost half (44.6%) offer at least one type of wellness program, the survey found. Thirty-one percent offer biometric screenings and about 30% offer an opportunity for health risk management.
Key differences from the 2014 benchmark study, Wirth says, included the ranking of top benefits offered by employers. The three highest company-offered employee benefits in 2014 (PPO, family plan and prescription drug) continued to rank high in 2015, but dental came in at No. 1 this year, with about 74% of employers offering it.
More than half (52.1%) of respondents said they had some familiarity with defined contribution plans and private exchanges, with the majority of those who indicated they were interested in offering a DCP identifying 2017 as the year they would likely do so.
Wirth says continued interest is growing among employers to learn and understand more about DCPS.
Is self-care the new health care?
Allowing employees more access to self diagnosis and treatment could reduce unproductive work time and save on healthcare costs.
John Scorza, an associate editor of HR Magazine, explains how selfcare could work for you via shrm.org.
Ten percent of visits to the doctor’s office are unnecessary, according to the Consumer Healthcare Products Association (CHPA). Those appointments cost U.S. employers billions of dollars in lost productivity and unnecessary health care costs. But what if employees knew how to recognize routine medical issues that they can treat themselves? And what if companies encouraged such self-treatment?
While no one expects to turn employees into diagnosticians, providing a little education and access to health information as part of workplace wellness efforts can mitigate the need to visit a doctor for a number of common ailments.
That’s precisely what some participants at the U.S. Chamber of Commerce Annual Health Care Summit want employers to do.
“Unhealthy workers are unproductive workers—and they’re expensive,” according to Scott Wallace, distinguished fellow at the Geisel School of Medicine at Dartmouth University. The cost of poor health is estimated to be 3 to 10 times the total cost of all employee benefits, he noted at the Oct. 20 summit in Washington, D.C.
“It’s essential that we continue our search for value,” added Scott Melville, CEO of the CHPA, an industry trade group.
The largest cost to employers is presenteeism: People who are at work but are unproductive because of their health problems. The cost of presenteeism is higher than the combined costs of medical care, prescription drugs and absenteeism. “By some estimates, it accounts for an estimated 10 percent of all labor costs,” according to Sean Sullivan, CEO of the Institute for Health and Productivity Management (IHPM), a nonprofit organization that advocates treating employee health as a business asset.
Promoting Self-Care, When Appropriate
The good news is that employers are in an ideal position to help employees change their behavior, Sullivan said. This is where self-care comes in. Self-care is defined by the World Health Organization as “personal health maintenance to improve or restore health and to treat preventative diseases.”
Self-care comes in various forms, according to Melville. These include:
- Prevention methods.
- Exercise.
- Healthy eating.
- Taking dietary supplements.
- Treatment of chronic conditions.
- Taking over-the-counter (OTC) medicines.
OTC drugs are a critical component of self-care because they can be an effective option to manage minor ailments and chronic conditions. One study cited by the IHPM estimated that every $1 spent on OTC medicines saved the U.S. health care system $6 to $7 due to fewer physician visits and less spending on medical care.
Lisle, Ill.-based Navistar International, which manufactures commercial trucks, buses and defense vehicles, has successfully used self-care as a strategy to manage employee wellness and productivity, according to an IHPM white paper. The company gave its 16,500 employees self-care manuals that encourage the use of OTC medicines for common health problems. As a result, the company said it has saved between $1 million and $2 million annually (excluding savings from reduced presenteeism) for more than 10 years. (Wallace suggested that www.knowyourotcs.org is a useful website for employers and employees to learn about the proper use of OTC drugs.)
Common Conditions
A handful of conditions account for the bulk of the costs of presenteeism and reduced productivity on the job. These include:
- Mental health issues, chiefly depression.
- Musculoskeletal pain, such as lower back pain and repetitive motion strain
- Respiratory problems, primarily allergies.
- Gastrointestinal problems, including heartburn and gastroesophageal reflux disease (GERD).
But all of these conditions (excluding mental health) are ripe for self-treatment, Sullivan said.
And that could add up to significant savings. Bethesda, Md.-based Lockheed Martin, a global aerospace firm with 112,000 employees, determined that lower back pain, allergies and GERD cost the company $3.25 million every year in lost productivity at work.
While brand-name pharmaceutical companies run pricey TV ads encouraging consumers to visit their doctors and ask for the latest, frequently expensive treatment (especially for GERD), these conditions generally can be self-managed by employees cost-effectively through the use of OTC medicines, Sullivan remarked.
Before making a self-care program part of a health and wellness strategy, employers first need to know the health care needs of their employees, Wallace advised. Similarly, Sullivan suggested targeting the population of workers who have common conditions that cause presenteeism. “These are all really treatable,” he said.
How Obamacare’s Progress Makes Expanding Coverage Harder
Originally posted July 21, 2014 by Drew Altman on https://blogs.wsj.com.
The Affordable Care Act’s success meeting its initial enrollment goals and the repair of HealthCare.gov seem to have calmed the political waters for Obamacare. But the job of enrolling the uninsured gets harder, not easier, because the remaining uninsured will generally be tougher to reach.
Recent surveys show, roughly in line with expectations, that 8 million to 9.5 million fewer adults are uninsured compared with last year before the Affordable Care Act went into effect. Specific data are not yet available for uninsured children who probably got covered as well, and an earlier provision of the health-care law that allowed people to stay on their parents’ insurance up to age 26 is thought to have lowered the number of uninsured young adults by as many as 3 million.
But tens of millions of Americans are not yet covered.
Those who enrolled last year during the first open-enrollment season were more likely to want coverage and were best able to navigate the process to get it. After open enrollment this fall and the one after that, the uninsured will gradually become a smaller and different group. Increasingly, they will be people who have been without insurance for a long time or who have never had it; people who are even less familiar with insurance choices and components such as premiums and deductibles, as well as unfamiliar with the tax credits offered under the ACA. These people are more likely to be men, and minorities, and have limited education or language barriers. Increasingly they will fall into harder-to-reach high-risk groups, such as the homeless, who require very targeted outreach, and Hispanics who fear that seeking coverage could endanger undocumented relatives despite assurances from government that it will not.
On the plus side for the next open-enrollment season, many of the remaining uninsured waited out the first year but want insurance; a group of unknown size has been waiting to enroll this fall. Also, the penalties for not having insurance rise from the greater of $95 per adult or 1% of income this year to $325 or 2% of income next year. That is likely to motivate more of the remaining uninsured to enroll. Early studies show that the uninsured who have attained coverage are happy with what they got, and news will spread through family, friends and word of mouth to people who are uninsured, motivating some of them to seek coverage too.
As the job of reaching the uninsured gets tougher, the need will grow for targeted community-based outreach and enrollment services and, most of all, a realization that the remaining uninsured are a somewhat different group presenting new challenges.
Major work needed before enrollment
Originally posted July 10, 2014 by Kathryn Mayer on www.benefitspro.com.
The fall open enrollment period needs some major work, as new analysis out Thursday finds low satisfaction and little results, with many consumers remaining “uninsured and underserved,” after the first shopping experience in the exchanges under the Patient Protection and Affordable Act.
The inaugural J.D. Power 2014 Health Insurance Marketplace Shopper Study, which looked at enrollment satisfaction among more than 1,600 consumers who shopped for coverage under PPACA November 2013 through April 2014, found that satisfaction during the first signup period averaged 615 on a 1,000-point scale.
The results indicate that health plans need to “retool” their efforts ahead of 2015 open enrollment, which begins Nov. 15.
“No doubt that ensuring a technologically error-free experience, along with streamlining the online enrollment process will be most impactful to future marketplace shoppers,” said Rick Johnson, senior director of the health care practice at J.D. Power. “While the uninsured are now a smaller group, they continue to be underserved, just as they were prior to the exchanges, and continue to need more information delivered in an easy-to-understand and personal way.”
J.D. Power found that many shoppers began the enrollment process but had problems completing their plan purchase at the time of the survey primarily due to three reasons:
- A combination of technical problems experienced during the enrollment process (40 percent);
- The application process taking too long (19 percent); and
- The website not having enough information about the plans to make a selection (18 percent).
Additionally, 49 percent of shoppers who didn’t complete enrollment did not choose a plan during their initial shopping experience because they had not yet decided which plan they wanted.
The technical problems for HealthCare.gov have been well-documented.
The survey found that satisfaction was higher among those enrollees who got in-person help from brokers and navigators.
When shoppers used a navigator — a certified agent or broker used by 17 percent of shoppers — during the shopping process, satisfaction rose to a score of 631 compared to 611 for those who didn’t use a navigator.
Though it was the least common way to sign up for a health plan, in-person enrollment had a higher satisfaction rate at 715 points. Online enrollment had a satisfaction score of just 597 while selecting a plan on the phone had a score of 623.
That’s in line with previous research from the Urban Institute and the Robert Wood Johnson Foundation, which found that brokers are the highest-ranked of all information sources on PPACA and enrollment help by consumers.
But that finding also means carriers and brokers have more work to do, too, in working to engage consumers. J.D. Power said that “health insurance companies and the exchanges should continue to find ways to personalize the insurance shopping experience for consumers.”
“When the dust finally settles later in 2014 and in 2015, for health insurance providers to thrive in this new environment, they will need to retool their marketing, information and enrollment efforts toward a new generation of uninsured to serve their needs,” Johnson said.
Look Beyond Health Care Financing to Workforce Health
Originally posted February 26, 2014 by Thomas Parry on https://ebn.benefitnews.com
Employer focus on employee health care will expand in 2014 beyond financing health coverage to managing employee health. We expect to see employers focusing more strategically on workforce heath — in particular, how to build business impacts such as lost work time and performance into their overall assessment of best practices — and how to connect investments in health back to business goals.
However employers’ decisions have been determined by the Affordable Care Act, the reasons to continue investing in employee health and productivity remain, given their impact on employers’ bottom-line costs and top-line job performance. The evidence is clear: poor workforce health has a profound impact on companies, regardless of their industry or size.
Research by our organization, the Integrated Benefits Institute, has investigated financial productivity losses due to worker illnesses including depression, diabetes, low back pain, stress and metabolic conditions. Our findings highlight the necessity for employers to think beyond how health issues impact medical costs. Our research shows:
- Depression costs employers approximately $62,000 annually per 100 employees in lost work time and medical treatments.
- Employees with diabetes are 47% more likely to miss at least one day of work per month than workers with normal fasting blood glucose.
- Low-back pain costs employers $51,400 annually per 100 employees in lost productivity and medical treatments.
- Employees with metabolic syndromeare three times more likely to have a work-disabling event such as a heart attack or stroke.
- Stress at work contributes more to poor job performance than either stress at home or financial worries.
Over the course of the year, I’ll be sharing more of our findings related to these illnesses, and the benefits to organizations with a strong commitment to employee health and performance. Our research reveals that employees in organizations with a strong health culture report that they spend more time working, work more carefully and concentrate better than employees at organizations with poor cultures of health.
Workers with better work environments — such as favorable workloads, work-life balance, good relations with managers and fewer demands on their time — also report fewer sick days than those in less healthy workplaces.
Employers can take several steps to acting more strategically about investing in employee health:
1. Assess where you are. Use key metrics to know where your organization currently is and what you have achieved to date regarding employee health. Work with your benefits supplier partners to obtain data and determine your company’s performance relative to organizations, especially organizations within your industry.
2. Use comparisons to identify the greatest opportunities to improve employee health. Since organizations have limited resources, start by focusing on the biggest problems — and the biggest opportunities — facing your company.
3. Measure outcomes. Determine beforehand how you will track results — and track them beyond health care costs alone. Simply saying a program is successful isn’t enough to convince the CFO of the business case for health improvement — results must be measured quantitatively. Senior management is more responsive to requests for investment when HR professionals are able to demonstrate the value of programs in business-relevant terms with metrics demonstrating changes over time.
Employers will find that their investments in workforce health and performance will be most effective when integrated with a broader strategy that includes an understanding of how their organizations can positively or negatively influence workers’ health.
Medical savings accounts on the upswing
By David Albertson
As of 2012 there was $17.8 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 11.6 million accounts, according to data from the latest EBRI/MGA Consumer Engagement in Health Care Survey, sponsored by the Employee Benefit Research Institute and Matthew Greenwald & Associates.
That’s up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2011, when 8.5 million accounts held $12.4 billion in assets.
The balances continue to grow as more employers adopt high-deductible, consumer-driven health plans combined with HSAs/HRAs. However, assumptions about these plans are not always proving true. For example, analysts predicted that individuals given more control over funds for health care services would become more cost conscious as they became more educated about the actual prices of those services. However, according to EBRI, no evidence was found to support this, nor was there evidence that healthy behaviors had any real correlation with account balance.
Among other findings from the EBRI/MGA survey:
After leveling off, average account balances increased. After average account balances leveled off in 2008 and 2009, and fell slightly in 2010, they increased in 2011 and 2012. In 2006, the average account balance was $696. It increased to $1,320 in 2007, a 90% increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3% and 5% increases, respectively. In 2010, average account balances fell to $1,355, down 4.5% from the previous year. In 2011, average account balances increased to $1,470, a 9% increase from 2010. It increased to $1,534, or 4%, in 2012.
Total and average rollovers increased. After declining to $1,029 in 2010, average rollover amounts increased to $1,206 in 2011 and remained there in 2012. Total assets being rolled over increased: $9.7 billion was rolled over into HSAs and HRAs in 2012, up from $6.8 billion in 2011. The percentage of individuals without a rollover was 11% in 2012.
Differences in account balances. Men have higher account balances than women, older individuals have higher account balances, account balances increase with household income, and education has a significant impact on account balances, independent of income and other variables.
Individual providers of HSAs likewise report significant growth in account balances over the past year, and bullish expectations for additional increases.
Among the HSA leaders, UMB Healthcare Services, a division of UMB Financial Corporation, announced that account balances for its HSAs grew 55% during the previous 12 months, surpassing $615 million dollars as of Jan. 31, 2013. The number of HSAs also grew to nearly 320,000 individual accounts, up dramatically from the 220,000 following open enrollment last year.
UMB Healthcare Services also saw a 29% increase in the number of debit cards it provides for Flexible Spending Accounts (FSAs), HRAs) and HSAs. Today, the number of cards in circulation has grown to more than 2.8 million.
According to the January 2012 annual census by America’s Health Insurance Plans’ Center for Policy and Research, the number of people with HSA/HDHP coverage rose to more than 13.5 million, up from 11.4 million in January 2011.
“Our HSA growth continues to reflect the trend we are seeing nationwide as more individuals and employers move toward consumer-directed health accounts,” said Dennis Triplett, CEO of UMB Healthcare Services. “We are now challenged with educating the growing number of employers and account holders on all that these accounts can offer toward future financial stability, beyond day-to-day health care expenses.”
Source: https://ebn.benefitnews.com/news/medical-savings-accounts-on-upswing-2731569-1.html