Consulting leaders advise employers to ‘be nimble’ amid changing health care landscape
By Tristan Lejeune
A roundtable discussion from benefits consulting leaders on what employers need to know and need to be thinking about going forward with their health strategies served as the wrap-up to a National Business Group on Health annual business agenda event last week in Washington, D.C. With cost-control still very much top of mind for employers, NBGH President and CEO Helen Darling aptly pointed out that, “If they were charging, this would be hundreds and hundreds of dollars an hour. So, this is your chance to get some free consulting from these leaders.”
The group included Julie Stone, health and group consulting leader at Towers Watson; Sharon Cunninghis, U.S. health and benefits regional business leader for Mercer; and Jim Winkler, Aon Hewitt senior vice president and chief innovation officer. Darling served as the panel’s moderator.
As employers plan for the realities of health care reform cost and compliance in 2014, Cunninghis said, “it’s really important to be nimble.” Employers may think they have a firm bead on health care changes at the moment, but many, she said, could use some help.
“You have to really stay on top of everything that’s happening, and I know that’s hard,” Cunninghis said. “Many of you have employees all over the world, so, to some degree, I would start leaning on others — whether it’s leaning on your health plan [or] other vendors that you work with. Make sure — literally on a weekly basis — that you’re on top of all the changes.”
Winkler agreed that it’s important benefits leaders seek assistance when they need it, but also cautioned that providers and vendors may be primarily seeking an opportunity, not necessarily serving an employer’s best interests. He urged employers to watch their backs and their bottom lines.
“One man’s cost savings is another man’s income reduction,” he said. “I think it’s a critical moment for employers to be activists … Work with your health plans, but don’t cede total control to them.”
Stone said that quality is tied to efficiency and warned that often, employers lose track of the former in search of the latter. “I think we need not to lose focus on quality,” she said, and that way employers can reach and enjoy the benefits of a cycle of good health among workers.
In addition to targeted messaging, Darling asked, how can employers move to the next stage of engagement on employee health care and wellness?
“You have to think of this as a marketing exercise, not a benefits communication exercise,” Winkler answered. He said “we have to take that targeted messaging to a new level,” to really squeeze every drop into return on investment, but he emphasized using language and formats that actually work.
“If you think about how we have all shifted to a new paradigm of communication — technology, texting, Skyping, — we changed our routines and patterns in a fundamental way and we’re not going back,” Stone said. “We need to change those same routines around health, health management, healthy eating, all of those things, so they really are routine” and health becomes a matter of natural course.
Cunninghis agreed about using natural English, but she said employer shouldn't be looking beyond targeted language, but at how to change it. “The next generation … is very into the notion of self-serving,” she said, and they can be taught to seek out their own best-case health solutions.
“I think we’ve been very limited in how we target to people, and I think we should take that a step further and ask, how do we get people to target to themselves?” Cunninghis asked.
The Check is NOT in the Mail
Source: https://analytics.ubabenefits.comBy Lesa Caputo, Benefit Advisor
The Reality of Health Care Budgeting Shortfalls and the Impact on Employers Now and in the Future
I can’t remember the last time that I went out to my mailbox to check for new mail on a Saturday afternoon but, nonetheless, I was shocked when I heard it announced on the morning news recently that Saturday mail delivery would be ending in order to help the U.S. Postal Service find some relief to its serious budgetary issues. However, my shock was not that the good old “snail mail” service was struggling or even that it needed the $2 billion it estimates it will save annually by ceasing Saturday mail delivery.1 My shock was that this new “savings” would not achieve even 50 percent of the pennies in the couch needing to be found to pay the $5.6 billion annual retiree health care fund that the USPS was unable to pay in 2012, despite federal law that they fund this benefit in advance for future retirees.2 So aside from the “benefits” of a tan and the great calf muscles received from many years of mail delivery, does this mean that those who have devoted their entire careers to a government entity with the expectation of certain other benefits (namely that their health care benefits will be paid as promised upon retirement and until death) just isn’t going to happen? The envelope please...
What will happen to the burgeoning population of retirees in future decades who find not only their retirement underfunded but also their health care? And what will the impact of the difficult decisions that these generations will have to make be on Medicare, Medicaid, long-term care costs and the commercial health care insurance industry that already does a fair amount of subsidization for shortfalls that already exist in these programs now? Read on about the real date-sensitive material enclosed…
As America ages, U.S. employers face an emerging business challenge due to the impacts to both corporate health care costs and employee productivity resulting from the eldercare and caregiving crises. A recent study shows that eldercare costs U.S. businesses more than $33 billion in lost productivity annually through absenteeism, distraction, replacement, reduced hours and more. 1
The business disruption breaks down like this -- 12 percent take leaves of absences, 36 percent miss workdays and 40 percent rearrange their schedule. 2 And millions more fall into the category of presenteeism -- physically at work but mentally dealing with distractions that impair productivity. Employees who’ve faced caregiving issues are increasingly concerned about their own long-term care. With the average cost for a skilled nursing facility topping $79,935 per year, skyrocketing care costs are the No. 1 risk to a secure retirement for baby boomers.3 Not only is long-term care more costly than most people realize, but also (contrary to popular belief) health insurance, disability plans, even Medicare and Medicaid, don’t cover many of the care options most people would choose.
So what can employers do today to address these issues and reduce the amount of junk mail invading their employees mental inboxes? There are several solutions:
- Health and Wellness Initiatives: Whether your organization already embraces the investment in a truly integrated wellness program that rewards and incentivizes healthy behaviors or you are in the initial stages of investigating the true return on investment (ROI) in such a program, make sure that your wellness program includes mechanisms to help identify, address and provide resources for employees suffering the negative effects of stress -- including being a member of the “sandwich generation.
- Core Long-Term Care Benefits with “Buy Up” option: Although there has been a significant exodus of carriers from the long-term care insurance industry of late, there are still a couple of well-established carriers offering “true group” coverage, whereby the employer can purchase a basic group long-term care program to fund for their employees and allow employees to “buy up” to a higher level of benefits at their own cost on a voluntary basis. No matter how long-term care benefits are offered to employees, it is essential that caregiving awareness and education be coupled with the introduction, enrollment and implementation of a successful long-term care plan.
- Group Retiree Health Plans: More and more employers are finding that their current provider of medical benefits for their active employees and retirees under age 65 is not interested in insuring their retiree population of those age 65+ in coordination with Medicare. In response to this need, UBA’s Strategic Allies such as The Hartford are offering stand-alone group policies to employers that may be funded by the employer or paid by the retiree to fill the gaps in their Medicare medical and pharmacy benefits. Large employers that are self-funding their medical benefits may especially want to inquire with a UBA Partner advisor about the potential reduction to their claims liability from implementing an insured group retiree health plan.
- FMLA Absence Management: There is no doubt that larger employers experiencing a high volume of FMLA-related leaves of absence appreciate the peace of mind and convenience of outsourcing this labor-intensive and very complicated HR responsibility. But convenience aside, there is also a very quantifiable potential cost saving reason for employers to consider investing in a FMLA absence management program. When maternity is excluded, caregiving accounts for 40 percent of all FMLA leaves and those who are on FMLA leave for caregiving are four times as likely to file an LTD claim. LTD claims are typically coupled with high medical costs. And so thecirculation continues until the final notice arrives C.O.D.
The Megro Benefits Company has access to discounted premiums, fees and administration for all of these solutions and more. Contact us to discuss these ideas in more detail.
Employers who make it a priority to deliver a well-intentioned employee benefits package to ensure their employees peace of mind about their futures will find the return on their investment in the form of first-class employees reporting for work every day of the week -- and maybe even on Saturdays!
References:
- Washington Post: Mandate Pushed Postal Service into the red for first quarter, February 2013
- The MetLife Caregiving Cost Study: Productivity Losses to U.S. Business, June 2006
- The MetLife Market Survey of Nursing Home & Home Care Costs, September 2009
- Caregiving in the United States, National Alliance for Caregiving and AARP, 2004
New $63 Fee Announced to Help Offset Healthcare Reform Cost
Source: openforum.com
Original article by Ricardo Alonzo-Zaldivar
As the regulations for Healthcare Reform are formulated and finalized, small-business owners need to be aware of a new fee that will be assessed beginning in 2014. The fee will be collected for 3 years and is set at $63 per insured person in the first year and is supposed to decline after that.
The fee is meant to help offset the cost for insurance companies as they comply with requirements to provide coverage for people with pre-existing conditions. The fee is expected to generate $25 billion most of which will be placed in a federally administered fund and the rest will be given directly to the Treasury Department. Employers will have to pay the fee in advance on behalf of their employees. Individuals who purchase their own policies and do not participate in group policies, as many small-businesses owners do, will still be responsible for the fee.
Learn more at The Huffington Post.
Benefits at the edge of the fiscal cliff - 4 areas to watch
Source: eba.benefitnews.com
As congressional leaders and President Obama attempt to hammer out a deal to prevent the nation from going over the “fiscal cliff” — a series of tax hikes for individuals and businesses that economists say could imperil the fragile recovery — HR/benefits professionals can prepare now, write benefit attorneys Diane Morgenthaler and Ruth Wimer, partners at law firm McDermott Will & Emery. Just in case we go over the “fiscal cliff,” Morganthaler and Wimer’s report outlines four benefit and payroll areas that should be top of mind for practitioners.
The 2% payroll tax cut from 2011 and 2012, which lowered employees’ Social Security payroll taxes, will expire, effective Jan. 1. Although the increase is on employee contributions, the increase also affects an employer’s withholding obligations, Morgenthaler and Wimer note. At the same time, they write, a new 0.9% Medicare payroll tax increase applies (from 1.45% to 2.35%) under the Patient Protection and Affordable Care Act on wages over $250,000 for married taxpayers filing jointly and $200,000 for single taxpayers. Again, though this increase is not an employer liability, employers must be prepared to withhold the additional 0.9% from wages for any employee with wages over $200,000.
The income tax exclusion for amounts paid by an employer under a qualified adoption assistance program is also set to expire on Dec. 31, Morganthaler and Wimer write. A qualified adoption assistance program allows an employer to reimburse an employee on a tax-free basis for as much as $12,650 in 2012 for expenses related to the adoption or attempted adoption of a child. Qualified adoption expenses include reasonable and necessary adoption fees, including court costs, attorney fees, traveling expenses and other direct adoption-related expenses.
Under PPACA, employee contributions to health care flexible spending accounts will be reduced to $2,500 per year for plan years beginning in 2013, the attorneys note. This new limit must be documented in a flexible benefits plan by Dec. 31, 2014, regardless of the fiscal year of the flexible benefits plan, and this change must be retroactive to the beginning of the 2013 plan year.
Certain reimbursements for employer-provided educational assistance will expire at the end of 2012. Section 127 of the Internal Revenue Code allows an employer to reimburse an employee on a tax-free basis up to $5,250 for certain educational expenses provided through a non-discriminatory educational assistance program. Even if employer-provided educational assistance programs no longer have tax subsidies in 2013, employers can still provide some type of educational reimbursements in a more limited manner if the educational reimbursements qualify as a business expense and meet certain requirements, such as enhancing the employee's performance but not qualifying the employee for a new position or career.
With the uncertainty of the approaching fiscal cliff, Morganthaler and Wimer write that employers should consider advising employees of the ambiguity surrounding educational assistance and adoption assistance benefits for 2013 and the possibility of a 2% payroll tax increase. Even if tax extensions for education assistance, adoption assistance and the 2% payroll tax increase are adopted in a new tax bill, the attorneys say employers should note that it is unlikely that the new limits on health care flexible spending accounts and/or the new 0.9% payroll tax increase for high-income employees will be altered or eliminated.
Younger workers fear rising health care costs
By Donald Jay Korn
Source: eba.benefitnews.com
Workers in Generations X, Y and beyond may be decades from retirement but they already have multiple concerns about their future finances.
In a Harris Interactive online survey for T. Rowe Price, more than half of respondents listed seven different retirement worries:
1. Health care costs (76%).
2. Rising taxes (67%).
3. Viability of Social Security (63%).
4. Inflation (61%).
5. Long-term care (58%).
6. Outliving their savings (52%).
7. Housing values (52%).
“Investors are concerned about rising health care costs, and they should be,” says Stuart Ritter, senior financial planner with T. Rowe Price. “According to the Employee Benefits Research Institute, health care costs are the second-biggest expense for those aged 65 and older, behind housing, and it’s the only spending category that steadily increases with age.”
To raise the necessary cash, working longer may or may not be an option, but saving and investing more is often indicated. “One of the perennial lessons younger investors can learn from current retirees is to save at least 15% of their earnings and begin as early as possible,” Ritter stated. “The ones who do are the ones more likely to enjoy the retirement flexibility and lifestyle that financial independence can provide.”
Donald Jay Korn writes for Financial Planning, a SourceMedia publication.
Most small businesses don’t offer health coverage
Source: www.benefitspro.com
By Kathryn Mayer
A new study finds only 49 percent of workers in small businesses with fewer than 50 employees were offered and eligible for health insurance through their employer in 2010, down from 58 percent in 2003.
Larger firms are much more likely to provide health benefits. About 90 percent of workers in firms with 100 or more employees were offered and eligible for health insurance in both 2003 and 2010, according to the report from the Commonwealth Fund.
Low-wage workers in small businesses were the least likely to be offered and eligible for coverage: Just one-third of workers making less than $15 an hour in small firms were both offered and eligible to enroll in their employer’s health plan, compared to 70 percent of small firm workers making over $15 an hour.
Report coauthor and Commonwealth Fund Vice President Sara Collins says the report “highlights a nearly decade-long trend of declining health insurance coverage and rising costs for workers in small businesses, particularly those who make less than $15 an hour.”
“As a result, many people who work for small businesses can’t afford the health care they need or have medical bills they are unable to pay,” she says.
About half small business employees (45 percent) reported trouble paying medical bills in 2010, and 46 percent reported that they skipped needed medical care because of cost, the report says. That’s about ten percent higher than those workers working in larger firms.
Small business workers were also more likely to be dissatisfied with their health insurance, with 29 percent rating it fair or poor, compared to 16 percent of those at larger businesses. They also don’t have as much choice when it comes to health plan options.
But Commonwealth researchers say health reform should help address and solve some of these problems by offering premium tax credits to certain small businesses and by granting subsidies to many uninsured workers toward their purchase of health insurance beginning in 2014.
“The Affordable Care Act should mitigate this trend by improving the affordability and comprehensiveness of health insurance both for small-business owners who want to offer health benefits and for workers in small businesses who can't get coverage through their jobs.”
The Commonwealth Fund is a nonpartisan research foundation that supports PPACA. Though they argue the law will help small businesses, opponents say the law will burden small businesses while raising taxes.
Small business owners have poor grasp of health reform
Source: https://eba.benefitnews.com
By Health Data Management
A survey by online health benefits seller eHealthInsurance of 439 small business clients finds most do not understand applicable provisions of the Affordable Care Act.
The act requires employers with 50 or more full-time employees to provide coverage. Only two of the surveyed clients were large enough to fall under the requirement, yet 34% believed they had to provide coverage, and another 35% didn’t know. Thirty-one percent correctly knew that they were not required to pay a tax if they did not offer insurance because of the size of their business.
More than three-quarters of surveyed small businesses were not familiar with reform-mandated insurance exchanges, designed to be one-stop shopping sites for health benefits for employees and those who don’t have work-related benefits.
Sixty-eight percent of surveyed employers have no plans to drop coverage for employees in 2014, 29% would consider dropping coverage and 3% expect to drop it.
More than three-quarters of respondents are not doing long-term planning on how health reform, including insurance exchanges, may affect their business. In addition, 51% would consider increasing employees’ share of premium costs and 39% would consider increasing the deductible. More results are available here.
Countdown to Healthcare
Source: https://www.benefitspro.com
By Mark Roberts
America is just a few short days away from the election of a new presidential term, and the stakes have never been higher.
On one side is the juggernaut of the Federal government headed up by the incumbent Barack Obama, and on the other side is the locomotive traveling at breakneck speed toward the final depot, with engineer former Massachusetts Gov. Mitt Romney at the throttle. On Tuesday, Nov. 6, the nation will have either a new face in the White House come next January, or the same one inhabiting 1600 Pennsylvania Avenue for the last four years will just go back to the office for another term.
On the block is health care and either the demise or further propagation of the Patient Protection and Affordable Care Act. Both candidates have strong views about this landmark legislation, and both the Democrats and the Republicans have their own reasons why they love it or hate it. The PPACA has no middle ground, and it is fast becoming more entrenched into the fabric of the economy, both businesses and consumers, states and federal government agencies, and the health care environment. And health care is the focal point of much of the political landscape in this election year.
According to LifeHealthPro, health insurance channel editor Allison Bell reports that “the two candidates engage in platform-to-platform combat over the future of commercial insurance, Medicare and Medicaid.”
There are 6 key differences on health care between the two:
1. Commercial health insurance system change. President Obama says PPACA already is improving health care access for millions of Americans and “ending insurance abuses” by letting young adults stay on their parents’ coverage up till age 26; forbidding health insurers from imposing lifetime benefits caps; limiting insurers’ ability to impose annual benefits caps; requiring insurers to pay for checkups, vaccinations and other preventive care without imposing out-of-pocket costs on the patients; and requiring that plans that spend more than a certain percentage of revenue on administrative costs send their customers rebates.
Gov. Romney says he would return responsibility for regulating local insurance markets and providing care for the poor, the uninsured and the chronically ill to the states, and his administration would limit moves to apply federal standards and requirements to private insurers, he says. The Republican candidate says he would encourage use of health insurance exchanges, and that he would promote the use of high-risk pools, reinsurance and risk adjustment mechanisms to help people with chronic health problems who cannot qualify to buy conventional health insurance. Also, he would work to “prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage” and “facilitate [health information technology] interoperability.”
2. Women’s health and abortion. The Obama team has worked to link the fate of PPACA to the fate of PPACA provisions that require most health plans to include benefits for contraceptive services in the package of basic preventive services that must be covered without imposing out-of-pocket costs on the patients; many insurance plans are beginning to fully cover birth control without co-pays or deductibles as part of women’s preventive care.
The Romney campaign website does not mention abortion or birth control in its discussion of health issues. The Republican Party, in its platform, says the following about federal health care policy and abortion: “Through Obamacare, the current administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life.”
3. Medicare. The PPACA, according to the Obama campaign, already has made important changes in Medicare, such as requiring basic Medicare to impose a package of basic preventive services without imposing out-of-pocket costs on the patients, and reducing the size of the Medicare Part D prescription drug plan “doughnut hole” — the gap between the point at which routine prescription coverage ends and catastrophic coverage begins.
Governor Romney wants to modernize entitlement programs and guarantee their vitality for future generations.
“Instead of paying providers directly for medical services, the government’s role will be to help future seniors pay for an insurance option that provides coverage at least as good as today’s Medicare, and to offer traditional Medicare as one of the insurance options that seniors can choose,” he says. “With insurers competing against each other to provide the best value to customers, efficiency and quality will improve and costs will decline. Seniors will be allowed to keep the savings from less expensive options or choose to pay more for costlier plans.” Medicare would stay the same for retirees and near retirees. Younger workers would get a fixed amount that they could use to buy either traditional Medicare coverage or private plan coverage, and they would have to make up the difference out of their own pockets if they wanted to buy more expensive coverage.
4. Medicaid. President Obama says of Medicaid—the program for poor people and for eligible nursing home patients—mainly that he believes Romney would cut federal Medicaid funding.
Governor Romney says he would replace the current Medicaid funding formula with a “block grant” program that would provide each state with a set amount of cash that it could use as it wished. He says he would “limit federal standards and requirements” for Medicaid as well as for private insurance.
5. Tort reform. President Obama says nothing in his comments aimed at voters about “tort reform”—the idea of controlling health care costs by reducing what doctors and other providers spend to protect themselves against lawsuits.
Romney says he would promote free health insurance markets by capping non-economic damages in medical malpractice lawsuits.
6. Health accounts. The president says nothing on his campaign website about health savings accounts or health reimbursement arrangements on his websites.
Candidate Romney states he would “unshackle HSAs by allowing funds to be used for insurance premiums.” Although he has vowed to streamline the tax code, he also mentioned he would “end tax discrimination against the individual purchase of insurance” and encourage independent entities to rate health plans. Plus, he also has talked about wanting to let health insurance companies sell coverage across state lines.
Regardless of the discussion over health care between now and the election, one thing is for sure. There is going to be a winner and a loser. The debate over Obamacare can ramp up the rhetoric about how good or bad the PPACA is, and the electorate certainly gets energized when it is up for discussion.
Who is telling the truth? We’ll see come Nov. 6. Now, here is your obligation—exercise your inalienable right to vote. If you don’t and you find yourself on the losing side the next day, don’t blame the politicians.
Employer-Provided Healthcare: One Size Does Not Fit All
By Tom Starner
Source: hreonline.com
Offering all participants in a healthcare program equal access and opportunity to receive quality care and medical purchasing efficiency should be the goal of any organization. Experts say eliminating structural and language barriers, and respecting the cultural context of each individual employee or their family members, are the keys to success.
In the world of consumer decision-making, it's very common for buying patterns to be guided by ethnic and gender preferences and differences.
There is little doubt the same is true of healthcare, but in this case, that diversity can prove costly both for employers, via rising healthcare bills, and employees, who may not receive the best possible health outcomes.
Some call it "culturally competent healthcare." To others, it is described as "targeted" health.
Whatever it's called, the emerging trend is best defined as an approach that offers all participants in the healthcare process equal access and opportunity to receive quality care and medical purchasing efficiency. How? By eliminating structural/language barriers and respecting the cultural context of each individual employee or their family members.
While a quick search will find that the concept has existed for more than a decade, employers faced with rising healthcare-benefit costs across the country are turning to this strategy. In fact, eight such employers -- Aetna, American Express, Franciscan Missionaries of Our Lady Health System, H.J. Heinz, Verizon, Pitney Bowes (in partnership with UnitedHealthcare), Cigna and Wyndham Worldwide -- recently were recognized by the U.S. Department of Health and Human Services, the White House Business Council and the National Business Group on Health for their efforts in reducing healthcare disparities in the workplace.
Stamford, Conn.-based Pitney Bowes, for example, worked with UnitedHealthcare to improve the health status of the former's employees and engage the company's Spanish-preference employees. UHC brought in a dedicated team of Hispanic professionals -- Latino Health Solutions -- to improve the health and well-being of its Hispanic/Latino members.
Mary Bradley, director of healthcare planning at Pitney Bowes, explains that as the company began to develop an ethnically diverse workforce, it needed to do more to help specific employee populations get the most out of their healthcare benefits. In one case, the company acquired some new facilities where employees had a basic understanding of English, which was not enough to use their benefits appropriately.
"That was a defining moment for us, knowing we had to do something different," she says. "We started with a basic focus group that spoke both English and Spanish, and went from there."
For one, it was difficult for those employees to find Spanish-speaking providers. In many cases, their children were translating the benefits information. Also, an unexpected finding was "informal" local leadership felt pressured to provide translation for co-workers.
"People were always clustering around them, constantly asking them questions, and they were distracted from doing their own benefits decision-making," she says.
Of course, using informal trainers was not a good solution. Enter the partnership with UHC and its Latino Health Solutions group.
"LHS had initially focused on smaller markets," says Bradley, adding that Pitney Bowes, which is a $5.3 billion company with 29,000 employees worldwide, recently launched an Asian-American effort as well. "We were the first employer to integrate their services into a national self-insured program."
As far as bottom line value goes, Pitney Bowes is certain that the strategy is a win-win for both employees and the company.
"We know this is important work, because employee health is a huge driver of quality of life [for employees] and productivity [for Pitney Bowes]," says Johnna Torsone, the company's executive vice president and chief human resources officer. "It is equally important for leaders to share best practices so that more companies and people can benefit from these efforts and learnings."
Aetna, another company honored for its efforts, offers, among other tools and features, a dashboard that helps identify health conditions that are more common among ethnic and racial minority populations.This information is used to create targeted programs to improve health outcomes.
In the past 11 years, Aetna initiatives include Breast Health Ethnic Disparities Initiative, Beginning Right Maternity Program, African-American Hypertension Study, and ER Utilization in Minority Asthmatic Populations. Also, a key component of the effort has been the company-supported and employee-managed employee resource groups. ERGs have helped reduce barriers to collecting racial and ethnic data on a voluntary basis to help create more culturally focused disease management and wellness programs.
"We must continue to develop targeted programs that address differences in healthcare among people of different races and ethnic backgrounds," says Aetna's Dr. Wayne Rawlins, national medical director.
Another insurer, Philadelphia-based Cigna, launched its Health Disparities Council in 2008. It comprises more than 200 employee volunteers from across the company's departments who facilitate the exchange of ideas, share knowledge, and identify internal and external opportunities to address healthcare disparities in culturally sensitive and medically appropriate ways.
Also, a key part of Cigna's work has been improving the cultural competency and linguistic sensitivity of its staff. More than 20,000 employees have completed cultural competency training and all bilingual employees are tested for proficiency. The company has also adapted into Spanish and traditional Chinese its "Words We Use" guide for simpler communications.
"It gets back to the concept of 'know me as an individual,' which is fundamental to our strategy," says David Cordani, Cigna's president and chief executive officer. "If we're going to be successful at helping people improve their health, we have to reach them at an appropriate time with meaningful messages that relate to their unique status."
While the eight companies cited are leading the way, there is still much work to be done within the HR and employers. For example, a study by the Joint Center for Political and Economic Studies calculated the direct and indirect costs of racial and ethnic disparities in healthcare in the United States for the period 2003 through 2006 was $229.6 billion.
Also, a 2008 survey by the Harvard School of Public Health of 609 large public and private employers and 252 health plans showed that nearly all health plans (90 percent) and most employers (58 percent, with the percentage increasing with size of employer) cite healthcare disparities. However, only three percent of employer respondents analyzed differences in health plan performance by race and ethnicity or chose plans that addressed racial and ethnic disparities.
Jim Winkler, the chief innovation officer for health and benefits consulting at Aon Consulting, in Norwalk, Conn., says he sees this growing trend as a part of a broader strategy that requires employers to finally stop thinking that everyone is the same.
"It is about being culturally aware, age and gender aware, and understanding the different mindsets these groups have," he says. "This is finally getting more traction. Employers for a long time were all using fancy words to say 'we print [our] manuals in English and Spanish'."
Winkler adds all of the companies honored go well beyond just communicating differently or changing a phone prompt to both English and Spanish.
"It's clear that in different cultural settings people think and act differently in how they view health and using the healthcare system," he says. "This is much more frequently discussed as a topic."
The fact that this is only the second annual Healthcare Disparities award alone speaks volumes about how new it all is in terms of real action, Winkler notes.
"Today, there is movement away from recognizing just language differences to recognizing cultural differences," he says. "The makeup in the U.S. is changing and employers are focusing on the workforce globally. We know from years of banging our heads against the wall that traditional disease management programs don't work. Today we all think and act differently."
Most employers to continue offering health care plans in 2014
Source: Business Insurance
By Jerry Geisel
The overwhelming majority of employers say they will continue to offer health care plans after core provisions of the health care reform law take effect in 2014, but most say they will need to make plan changes later to avoid a new excise tax on the most costly plans, according to a new survey.
Eighty-eight percent of employers surveyed by Towers Watson & Co. said they have no plans to terminate coverage in 2014 or after for full-time employees, while 11% were not sure. Just 1% said they planned to terminate coverage for some employees.
Under the Patient Protection and Affordable Care Act, starting in 2014, employers with at least 50 employees are liable for a fee of $2,000 per full-time employee if they do not offer qualified coverage to employees working at least 30 hours a week.
The Towers Watson survey results mirror numerous other surveys also reporting that most employers intend to continue to provide coverage. Benefit experts say there are several reasons for that continued employer commitment to offering coverage, including the penalty imposed by the law for not offering coverage, the costs employers would face in grossing up employees’ salaries to enable them to buy coverage on their own and the need for employers to stay competitive.
On other hand, 83% of employers say they are planning to take steps to control costs to avoid a health reform law-imposed excise tax that takes effect in 2018. Under that provision, a 40% excise tax will be imposed on premium costs that exceed $10,200 for single coverage and $27,500 for family coverage. Insurers will pay the tax on plans they insure, while third-party administrators will pay the tax for self-funded plans. Insurers and TPAs are expected to recover the taxes they paid from employer plans.
Other findings include:
• Employers expect health care plan costs to rise—after plan changes—by an average of 5.3% in 2013, boosting total costs to an average of $11,507 per employee. That compares with an expected 2012 average cost increase of 5.9%.
• Employer interest in offering account-based health care plans, such as plans linked to health savings accounts and health reimbursement arrangements—continues to grow. While nearly 60% of respondents now offer account-based plans, by 2018, 80% expect to be offering them.
The survey is based on the responses of 440 employers.