The Open Enrollment Checklist: Are You Poised for a Successful Season
Are you prepared for open enrollment? According to a recent survey, 56 percent of U.S. adults with employer-sponsored health benefits said health coverage satisfaction is a key factor in deciding whether they should leave their current job. Read this blog post from Employee Benefit News to learn more.
It’s here… the moment we’ve all been waiting for — or, in the case of HR, preparing for (at least we’d hope). That’s right, open enrollment season has arrived.
Open enrollment is a major opportunity for HR to contribute to their company’s performance — both in terms of healthcare savings and employee productivity. The better employees understand their benefits, the more likely they are to make cost-conscious decisions about their plan choices and their healthcare — saving themselves, and their employers, money. Not only that, but a recent survey found that 56% of U.S. adults with employer-sponsored health benefits said that whether or not they like their health coverage is a key factor in deciding to stay at their current job. And, interestingly, satisfaction with benefits and benefits communications have a tremendous impact on job satisfaction and engagement.
Not sure you’ve done everything you could to turn this annual necessity into a true financial, educational game-changer for your organizations? Ask yourself, did you:
Take stock of last year’s enrollment? Before diving into enrollment for 2020, employers should have taken stock of how the company fared last year. Post-mortem meetings with the enrollment team (along with key internal and external stakeholders) to assess what went well (or didn’t) can ensure the coming enrollment season runs smoothly.
In particular, identify the most time-consuming tasks and discuss how they could be streamlined in the future. Second, determine what questions employees asked the most about last year — and be prepared to answer them again this year. Third, consider whether the company achieved its overall open enrollment goals, and what contributed to those results. By addressing the peaks and pitfalls of last year’s season, HR should have a head start on planning for 2020.
Plan your communications strategy?With a defined approach to open enrollment in place, HR at this point should have developed an organized, well-communicated strategy to keep employees informed about their plan options at enrollment and throughout the year. Have you:
· Defined corporate objectives and how to measure success? · Assessed what messages to share with employees, especially anything that is changing — such as adding or eliminating plans or changing vendors? · Determined what information is best delivered in print (e.g. newsletters, posters, postcards, enrollment guides), online or in person through managers or one-on-one enrollment support? Adopting a multi-channel engagement strategy will ensure key messages reach the intended audience(s).
Make sure employees understand the deadline and process for enrolling — and the implications of missing the enrollment window. They must understand whether their existing coverage will roll over, if they’ll default to a specific plan and/or level of coverage (perhaps different from what they currently have), or end up with no coverage at all.
Take a pro-active approach to open enrollment? Ninety percent of employees report that they roll over their same health plan year over year — though this doesn’t indicate overwhelming plan satisfaction. More typically, it’s because they’re intimidated about what they don’t know, are confused about their choices or just don’t care. Employees don’t have the information they need, and aren’t likely to seek it out on their own.
Offering — or even requiring — one-on-one meetings with benefit experts during open enrollment provides a forum for employees to discuss their individual needs and ensure they are selecting the right coverage. These services — often available through brokers or outside engagement firms — provide employees with a safe space to ask specific questions about their health conditions, family history and potential life changes that could affect their insurance needs. This is the ideal time to remind employees that there is no one-size-fits-all plan, and that the least expensive plan on paper may not, ultimately, be the most cost-effective plan over time.
Revisit your SPD? The document we all love to hate, summary plan descriptions (SPDs) remain the best source for information about how each plan works, what it covers and the participant’s rights and responsibilities under that plan.
Having an SPD that is current, appealing (or at least not off-putting) and easy to access can answer many employee questions before they find their way to HR. Simple fixes like adding charts, callout boxes or icons can make your SPDs easier to navigate. Many employers are taking it a step further and offering interactive SPDs, which include robust search functionality and links to definitions, important forms, modeling tools and calculators, vendor sites and even short video clips. By making SPDs digital and interactive, employers can provide employees access to important information about their coverage 24/7 via any device. And, by adding a data analytics component, HR can track which sections employees visit most and pinpoint knowledge gaps about their benefit options to enhance understanding and drive increased benefits usage.
Account for all demographics? With all the focus on today’s multigenerational workforce, it’s important to remember that there’s more to “demographics” than age and gender. Worksite (office vs. shop floor vs. construction site vs. road warrior) can have a tremendous impact on the communications channels you use and when you use them.
And while some “generational generalizations” hold true — many older workers prefer paper, and most young people prefer mobile communication channels — it’s more important to look at employee cohorts from the perspective of differing priorities (planning for retirement vs. retiring student debt), different levels of education and healthcare literacy, and experience with choosing and using benefits. Employees just starting their careers are likely to need more support and different information than a more seasoned worker who’s had years of experience with the enrollment process. Consider the most effective ways to engage the different demographics of your population to gain their attention and interest in choosing the right plan for them.
Equip employees for smart healthcare choices year-round? For most employees, becoming an educated healthcare consumer is a work in progress — which is why many employers offer year-round resources to support smart healthcare choices. That said, these resources are often under-utilized because employees don’t know they exist.
Open enrollment is the perfect time to spread the word about these programs and address the key question for employees: “What’s in it for me?” For example, many employers offer transparency services, which enable employees to research the potential cost of care and compare prices across several providers in their area.
Other resources, such as benefits advocates, can answer questions from employees in real time — including where to get care, how to get a second opinion and what the doctor’s instructions really mean. When used in conjunction, transparency and advocacy services can lower out-of-pocket spending for the employee and reduce costs for the employer. Does your open enrollment communications strategy highlight that these resources exist, outline how they work and explain how they benefit the employee?
What if open enrollment is only a week away and you haven’t taken most, if any, of these steps? It’s not too early to start your to-do list for next year — perhaps by first tackling your SPD and drafting that communications plan. Most importantly, get that post-mortem meeting on the schedule now, while the lessons learned from this year’s open enrollment are still fresh.
SOURCE: Buckey, K. (3 October 2019) "The Open enrollment checklist: Are you Poised for a successful season" (Web Blog Post) https://www.benefitnews.com/list/the-employers-open-enrollment-checklist
‘Eye’ spy a savings opportunity for health and vision benefits
The National Eye Institute reported that 61 million adults are at high risk for serious vision loss. Conventionally, vision benefits were offered as an elective, with coverage is focusing on vision tests or discounts for corrective eyewear. Read the following blog post to learn more about vision benefits.
Sixty-one million adults are at high risk for serious vision loss, according to the National Eye Institute, but most U.S. employers don’t include eye care as part of their benefits package. Vision benefits have traditionally been offered as an elective, where coverage is focused on vision tests or discounts for corrective eyewear.
This often results in inadequate coverage for employees and dependents, which can result in unrecognized and untreated issues that impact employee health and productivity, as well as an employer’s bottom line.
Comprehensive eye exams are recommended for adults under the age of 65 at least every two years, according to the American Optometric Association (AOA). These exams are the only way a doctor can detect signs and symptoms of serious conditions without cutting into or scanning body parts.
The total economic burden of eye disorders and vision loss in the U.S. was $139 billion in 2013, which includes $65 billion in direct medical costs strictly due to eye disorders and low vision. Loss of vision among workers results in $48 billion in lost productivity per year.
When it comes to benefit management priorities employers often focus more on chronic condition management. Yet, eye health is often linked to common chronic conditions including diabetes and hypertension. Without early detection of eye and vision health issues, employees cannot properly manage these conditions. Delaying medical treatment can lead to increased absenteeism and reduced productivity, eventually resulting in treatment that comes too late, and at a much higher price tag for employers, employees and family members.
About 68% of Americans with diabetes have been diagnosed with eye complications, many of which could have been prevented through a comprehensive eye exam. Diabetes is the leading cause of blindness among adults, according to the National Institutes of Health. Its prevalence is increasing as one in 10 people worldwide may be affected by 2040, according to research from the International Diabetes Federation.
Nearly half of Americans don’t know that diabetic eye diseases have visible symptoms, according to a 2018 AOA survey. More than one-third of respondents didn’t know a comprehensive eye exam is the only way to determine if a person’s diabetes will cause blindness. These exams, considered the gold standard in clinical vision care, should be covered under the employees’ medical benefits.
Three years ago the Midwest Business Group on Health began a collaboration with the AOA to better understand how employers think about and implement eye health and vision benefits. As part of this partnership, a no-cost eye care benefits toolkit was developed to support employers in evaluating their current eye health and vision care benefits to:
- Understand the importance of early detection so that employees can effectively manage chronic and more serious conditions
- Recognize how to integrate primary and preventive eye care into an overall medical benefit design
- Educate employees on the importance of periodic eye examinations
It’s important that employers better understand the impact of vision care benefits, including lower costs, better employee health, improved job satisfaction, better employee quality of life, and work productivity.
SOURCE: Larson, C. (20 September 2019) "‘Eye’ spy a savings opportunity for health and vision benefits" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/vision-loss-resulting-in-billions-in-lost-productivity
Health insurance surpass $20,000 per year, hitting a record
According to an annual survey of employers, the cost of family health coverage has now surpassed $20,000, a record high. The survey also revealed that while most employers pay most of the costs of coverage, workers' average contribution for a family plan is now $6,000. Read this blog post from Employee Benefit News to learn more.
The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of American workers into plans that cover less or cost more, or force them out of the insurance market entirely.
“It’s as much as buying a basic economy car,” said Drew Altman, chief executive officer of the Kaiser Family Foundation, “but buying it every year.” The nonprofit health research group conducts the yearly survey of coverage that people get through work, the main source of insurance in the U.S. for people under age 65.
While employers pay most of the costs of coverage, according to the survey, workers’ average contribution is now $6,000 for a family plan. That’s just their share of upfront premiums, and doesn’t include co-payments, deductibles and other forms of cost-sharing once they need care.
The seemingly inexorable rise of costs has led to deep frustration with U.S. healthcare, prompting questions about whether a system where coverage is tied to a job can survive. As premiums and deductibles have increased in the last two decades, the percentage of workers covered has slipped as employers dropped coverage and some workers chose not to enroll. Fewer Americans under 65 had employer coverage in 2017 than in 1999, according to a separate Kaiser Family Foundation analysis of federal data. That’s despite the fact that the U.S. economy employed 17 million more people in 2017 than in 1999.
“What we’ve been seeing is a slow, slow kind of drip-drip erosion in employer coverage,” Altman said.
Employees’ costs for healthcare are rising more quickly than wages or overall economy-wide prices, and the working poor have been particularly hard-hit. In firms where more than 35% of employees earn less than $25,000 a year, workers would have to contribute more than $7,000 for a family health plan. It’s an expense that Altman calls “just flat-out not affordable.” Only one-third of employees at such firms are on their employer’s health plans, compared with 63% at higher-wage firms, according to the Kaiser Family Foundation’s data.
The survey is based on responses from more than 2,000 randomly selected employers with at least three workers, including private firms and non-federal public employers.
Deductibles are rising even faster than premiums, meaning that patients are on the hook for more of their medical costs upfront. For a single person, the average deductible in 2019 was $1,396, up from $533 in 2009. A typical household with employer health coverage spends about $800 a year in out-of-pocket costs, not counting premiums, according to research from the Commonwealth Fund. At the high end of the range, those costs can top $5,000 a year.
While raising deductibles can moderate premiums, it also increases costs for people with an illness or who gets hurt. “Cost-sharing is a tax on the sick,” said Mark Fendrick, director of the Center for Value-Based Insurance Design at the University of Michigan.
Under the Affordable Care Act, insurance plans must cover certain preventive services such as immunizations and annual wellness visits without patient cost-sharing. But patients still have to pay out-of-pocket for other essential care, such as medication for chronic conditions like diabetes or high blood pressure, until they meet their deductibles.
Many Americans aren’t prepared for the risks that deductibles transfer to patients. Almost 40% of adults can’t pay an unexpected $400 expense without borrowing or selling an asset, according to a Federal Reserve survey from May.
That’s a problem, Fendrick said. “My patient should not have to have a bake sale to afford her insulin,” he said.
After years of pushing healthcare costs onto workers, some employers are pressing pause. Delta Air Lines Inc. recently froze employees’ contributions to premiums for two years, Chief Executive Officer Ed Bastian said in an interview at Bloomberg’s headquarters in New York last week.
“We said we’re not going to raise them. We're going to absorb the cost because we need to make certain people know that their benefits structure is real important,” Bastian said. He said the company’s healthcare costs are growing by double-digits. The Atlanta-based company has more than 80,000 employees around the globe.
Some large employers have reversed course on asking workers to take on more costs, according to a separate survey from the National Business Group on Health. In 2020, fewer companies will limit employees to so-called “consumer-directed health plans,” which pair high-deductible coverage with savings accounts for medical spending funded by workers and employers, according to the survey. That will be the only plan available at 25% of large employers in the survey, down from 39% in 2018.
Employers have to balance their desire to control costs with their need to attract and keep workers, said Kaiser’s Altman. That leaves them less inclined to make aggressive moves to tackle underlying medical costs, such as by cutting high-cost hospitals out of their networks. In recent years employers’ healthcare costs have remained steady as a share of their total compensation expenses.
“There’s a lot of gnashing of teeth,” Altman said, “but if you look at what they do, not what they say, it’s reasonably vanilla.”
SOURCE: Tozzi, J. (25 September 2019) "Health insurance surpass $20,000 per year, hitting a record" (Web Blog Post). Retrieved from https://www.benefitnews.com/articles/health-insurance-costs-surpass-20-000-per-year
Illnesses, Deaths Tied to Vaping
New reports are showing that the use of electronic cigarettes (vaping) is believed to be responsible for five deaths and 450 severe lung injuries. Continue reading this article from SHRM to learn more.
The use of electronic cigarettes, also known as vaping, is believed to be responsible for five deaths and 450 severe lung injuries in what appears to be a nationwide epidemic, according to new reports.
E-cigarettes are battery-operated and produce vapor that simulates smoking. They can resemble regular cigarettes, cigars, pipes, pens, USB sticks and other everyday items. They do not burn tobacco, but the device heats a liquid that usually contains nicotine, flavorings and other chemicals.
While most employers ban smoking in the workplace, their policies don't always extend to e-cigarette products. However, a Centers for Disease Control and Prevention (CDC) health alert on Aug. 30 warned that severe pulmonary disease is associated with using e-cigarette products. The agency, which is part of the U.S. Department of Health and Human Services, launched a multistate investigation into the lung illnesses on Aug. 1.
"Although more investigation is needed to determine the vaping agent or agents responsible," wrote Dr. David C. Christiani of the Harvard School of Medicine, "there is clearly an epidemic that begs for an urgent response." He shared his comments in the Sept. 6 issue of the New England Journal of Medicine, along with the preliminary report "Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin."
The CDC is working with the U.S. Food and Drug Administration, states and other public health partners and clinicians to determine what is sickening users, and in some cases resulting in fatalities. On Friday, it suggested that people refrain from using e-cigarette products during its investigation.
SHRM Online has collected the following articles about this topic from its archives and other trusted sources.
5 Deaths Linked to Vaping. Officials Are Urging Consumers to Stop. (Chicago Tribune)
How Are You Handling Vaping at Work? (SHRM Online)
More States Ban Vaping, E-Cigarette Use in Workplaces (Bloomberg)
Florida Adds Vaping to Regulated Indoor Smoking (SHRM Online)
SOURCE: Gurchiek, K. (6 September 2019) "Illnesses, Deaths Tied to Vaping" (Web Blog Post). Retrieved from https://www.shrm.org/hr-today/news/hr-news/Pages/Illnesses-Deaths-Tied-to-Vaping-.aspx
Employers look to virtual services to curb rising health costs
Employers are looking for ways to stem the rising costs of healthcare and find ways to better engage employees. According to the National Business Group on Health, 64 percent of employers believe virtual care will play a significant role in healthcare delivery. Read this blog post to learn more about virtual services.
WASHINGTON — With the continued cost of healthcare benefits expected to increase by another 5%, topping $15,000 per employee, employers are looking for ways to stem the increase and better engage employees in holistic well-being.
One of those ways is through virtual care. The number of employers who believe virtual care will play a significant role in how healthcare is delivered in the future continues to grow, up to 64% going into 2020 from 52% in 2019, according to the National Business Group on Health’s annual healthcare strategy survey.
“Virtual care solutions bring healthcare to the consumer rather than the consumer to healthcare,” Brian Marcotte, president and CEO of NBGH said at a press briefing Tuesday. “They continue to gain momentum as employers seek different ways to deliver cost-effective, quality healthcare while improving access and the consumer experience. Of particular note is the growing interest among employers to offer virtual care for mental health as well as musculoskeletal conditions.”
The majority of respondents (51%) will offer more virtual care programs next year, according to the survey. Nearly all employers will offer telehealth for minor, acute services while 82% will offer virtual mental health services — a figure that’s expected to grow to 95% by 2022.
Virtual care for musculoskeletal management shows the greatest potential for growth, the study noted. While 23% of employers will offer musculoskeletal management virtual services next year, another 38% are considering it by 2022. Physical therapy is the best way to address musculoskeletal conditions and help avoid surgery, but it can be inconvenient and costly, said Ellen Kelsay, chief strategy officer at NBGH.
“Where we’ve seen a lot of development in areas of virtual solutions is to provide remote physical therapy treatments,” she said. “Employees can access treatment through their virtual app wherever it’s convenient for them.”
Regardless, employee utilization of virtual services still remains low. For example, while roughly 70% of large companies provide telemedicine coverage, only 3% of employees use it, according to prior NBGH data.
But many resources are out of sight and out of mind, Kelsay said. However, employers are focusing on offering high-touch concierge services to help workers better navigate the healthcare system.
Employers are reaching a point of saturation with the number of solutions that are available, but from the employee’s perspective, they just don’t know where to start, she added. “These concierge and navigator services really help point employees in the direction to the solution at the point in time they need it.”
In addition, the use of predictive analytics and claims data is also an opportunity to help employers get the right programs in front of employees in the moment, Marcotte added.
“Some of these engagement platforms are getting at personal messaging and predictive analytics. It’s not where we want it to be yet, but as that continues to get better, I think you’ll see utilization go up,” he said.
Employers shouldn’t fear expansion of Medicare
A new survey from the National Business Group on Health found that only 23 percent of large employers believe Medicare eligibility should drop to age 50. Read this article from Employee Benefits Advisor to learn more about the potential expansion of Medicare.
Like a significant chunk of American voters, a majority of large employers want to expand Medicare. Just not too much.
A new survey of 147 large employers from the National Business Group on Health found that 55% of them support a Medicare expansion that’s limited to older Americans. Only 23% think eligibility should drop to age 50, however, and 45% don’t think it should expand at all. A majority believe that a broader “Medicare for All” plan would increase health costs.
The same survey also highlights why employers should consider coming around on health reform that reduces their role in the system. The growth in health costs has outpaced inflation and wage growth for years, and the surveyed businesses expect it to rise 5% to $15,375 for each employee next year.
About 70% of those costs will fall on the companies, which plan to try everything from boosting virtual health services to investing in health concierges to rein them in, according to the survey.
History suggests that their best efforts might not amount to much.
Employer-sponsored insurance is America’s single largest source of health coverage. That’s mostly true because the IRS exempted employer health benefits from taxes in 1943, a move that created the federal government’s single biggest tax expenditure. Large companies derive some benefit from the current system because they can provide a significant tax-free benefit that helps them compete for talent and pay people less. But it comes with significant drawbacks. Employers have to devote substantial resources to providing healthcare and controlling costs. Many of them have no particular expertise or advantage in doing so.
The results are mixed. Yes, individuals with private insurance are generally satisfied with the quality of their coverage. They’re not nearly as happy about the cost as deductibles rise. The U.S. pays more than any other developed country for healthcare and medicines and receives worse results on a variety of metrics.
Employers pay particularly high prices and spend heavily on plans that have higher overhead than public alternatives. A recent RAND study found that employer-sponsored plans paid hospitals at 241% of Medicare rates in 2017. Employers are already effectively subsidizing public programs, not to mention the profitability of insurers, health care providers and drugmakers.
It’s not entirely their fault. The American system inherently fragments negotiating power, which gives providers a significant advantage and makes it difficult for even the largest employers to get a good deal. Turning a larger piece of healthcare over to the government would free companies to focus more time and resources on their actual business instead of on navigating the world’s most expensive and convoluted healthcare market.
Big businesses most likely fear big Medicare expansion in large part because it would lead to a significant tax increase. But looking at any tax increase as an enemy is a mistake. Those taxes represent a trade-off; they would replace some or all of the billions of dollars that employers are currently spending on care. Depending on what taxes are imposed and whether the public plan is able to control costs better than the current system — and it could hardly do worse — many employers could come out ahead.
There are a lot of unknowns when it comes to Medicare for All and plans that move the country in that direction. Employers are right to be skeptical until they know more, but the results could well shake out in their favor, and they shouldn’t be so quick to discount the approach.
SOURCE: Nisen, M. (15 August 2019)"Employers shouldn’t fear expansion of Medicare" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/employers-shouldnt-fear-expansion-of-medicare
Cadillac Tax May Finally Be Running Out of Gas
The Cadillac tax - a 40 percent tax on the most generous employer-provided health insurance plans - may be about to change. The Cadillac tax was supposed to take effect in 2018 but has been delayed twice and recently, the House voted to repeal this tax entirely. Read this blog post to learn more about this potential change.
The politics of healthcare are changing. And one of the most controversial parts of the Affordable Care Act — the so-called Cadillac tax — may be about to change with it.
The Cadillac tax is a 40% tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 for an individual policy or $30,150 for family coverage. It was supposed to take effect in 2018, but Congress has delayed it twice. And the House recently voted overwhelmingly — 419-6 — to repeal it entirely. A Senate companion bill has 61 co-sponsors — more than enough to ensure passage.
The tax was always an unpopular and controversial part of the 2010 health law because the expectation was that employers would cut benefits to avoid paying the tax. But ACA backers said it was necessary to help pay for the law’s nearly $1 trillion cost and help stem the use of what was seen as potentially unnecessary care. In the ensuing years, however, public opinion has shifted decisively, as premiums and out-of-pocket costs have soared. Now the biggest health issue is not how much the nation is spending on healthcare, but how much individuals are.
“Voters deeply care about healthcare still,” said Heather Meade, a spokeswoman for the Alliance to Fight the 40, a coalition of business, labor and patient advocacy groups urging repeal of the Cadillac tax. “But it is about their own personal cost and their ability to afford healthcare.”
Stan Dorn, a senior fellow at Families USA, recently wrote in the journal Health Affairs that the backers of the ACA thought the tax was necessary to sell the law to people concerned about its price tag and to cut back on overly generous benefits that could drive up health costs. But transitions in healthcare, such as the increasing use of high-deductible plans, make that argument less compelling, he said.
“Nowadays, few observers would argue that [employer-sponsored insurance] gives most workers and their families’ excessive coverage,” he wrote.
The possibility of the tax has been “casting a statutory shadow over 180 million Americans’ health plans, which we know, from HR administrators and employee reps in real life, has added pressure to shift coverage into higher-deductible plans, which falls on the backs of working Americans,” said Rep. Joe Courtney (D-Conn.).
Support or opposition to the Cadillac tax has never broken down cleanly along party lines. For example, economists from across the ideological spectrum supported its inclusion in the ACA, and many continue to endorse it.
“If people have insurance that pays for too much, they don’t have enough skin in the game. They may be too quick to seek professional medical care. They may too easily accede when physicians recommend superfluous tests and treatments,” wrote N. Gregory Mankiw, an economics adviser in the George W. Bush administration, and Lawrence Summers, an economic aide to President Barack Obama, in a 2015 column. “Such behavior can drive national health spending beyond what is necessary and desirable.”
At the same time, however, the tax has been bitterly opposed by organized labor, a key constituency for Democrats. “Many unions have been unable to bargain for higher wages, but they have been taking more generous health benefits instead for years,” said Robert Blendon, a professor at the Harvard T.H. Chan School of Public Health who studies health and public opinion.
Now, unions say, those benefits are disappearing, with premiums, deductibles and other cost sharing rising as employers scramble to stay under the threshold for the impending tax. “Employers are using the tax as justification to shift more costs to employees, raising costs for workers and their families,” said a letter to members of Congress from the Service Employees International Union.
Deductibles have been rising for a number of reasons, the possibility of the tax among them. According to a 2018 survey by the federal government’s National Center for Health Statistics, nearly half of Americans under age 65 (47%) had high-deductible health plans. Those are plans that have deductibles of at least $1,350 for individual coverage or $2,700 for family coverage.
It’s not yet clear if the Senate will take up the House-passed bill, or one like it.
The senators leading the charge in that chamber — Mike Rounds (R-S.D.) and Martin Heinrich (D-N.M.) — have already written to Senate Majority Leader Mitch McConnell to urge him to bring the bill to the floor following the House’s overwhelming vote.
“At a time when healthcare expenses continue to go up, and Congress remains divided on many issues, the repeal of the Cadillac tax is something that has true bipartisan support,” the letter said.
Still, there is opposition. A letter to the Senate on July 29 from economists and other health experts argued that the tax “will help curtail the growth of private health insurance premiums by encouraging employers to limit the costs of plans to the tax-free amount.” The letter also pointed out that repealing the tax “would add directly to the federal budget deficit, an estimated $197 billion over the next decade, according to the Joint Committee on Taxation.”
Still, if McConnell does bring the bill up, there is little doubt it would pass, despite support for the tax from economists and budget watchdogs.
“When employers and employees agree in lockstep that they hate it, there are not enough economists out there to outvote them,” said former Senate GOP aide Rodney Whitlock, now a healthcare consultant.
Harvard professor Blendon agrees. “Voters are saying, ‘We want you to lower our health costs,’” he said. The Cadillac tax, at least for those affected by it, would do the opposite.
SOURCE: Rovner, J. ( 19 August, 2019) "Cadillac tax may finally be running out of gas" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/obamacare-excise-tax-may-be-at-an-end
Association Health Plans & Their Benefits
Many individuals do not understand various insurance terms and the plans available to them. Most employers have a hard time trying to find the best and the most affordable coverage for their employees. It is important you find an insurance company or agent that can break it down for you to get the best coverage.
We asked our founding partner and CEO, Jamie Charlton, to shed some light on Association Health Plans (AHPs) and also give their advantages and disadvantages.
What is an AHP, and How Does it Work?
According to Charlton, AHP or Association Health Plans are a conglomeration of smaller groups that come under the guise of a larger umbrella to leverage bulk buying power. They might not be small companies per se, but are those that come together under one industry or from the same geographic area to strengthen their negotiating power. They can be a group of manufacturers, printers or self-employed individuals from the same jurisdiction. An example of such an association is the Chamber Alliance.
Ideally, small businesses, including self-employed individuals in the same industry or geographic location, can merge to form larger groups to get healthcare plans as one large group. Coalitions are more or less the same as these associations, only that coalitions are groups made up of non-profit institutions such as schools. Associations are mostly businesses or organizations aimed at making profits.
AHP Expansion
United States (US) President, Donald Trump, issued an executive order to promote healthcare coverage in the US on October 12, 2017. The order aims at expanding access to small businesses to get the same competitive advantage as large corporations when purchasing health insurance. This order was meant to provide more affordable health insurance plans to as many individuals as possible. These individuals include farmers, wage earners and employees of any small business in the US.
Charlton has a slightly different view of this expansion. Though it has helped a few individuals, the expansion does not present any advantage as the rates keep going higher with age. He explained, “AHPs don’t have an advantage in the long run, unless they have a long-term sponsor.” AHPs have always been in existence, and the expansion is just political rhetoric that will give the plans some credibility.
Advantages of an AHP to Smaller Employers
There are some advantages that come with AHPs, both to the employer and the employees. These include:
- Negotiating power
- Spreading the risk
- Maintaining lower rates instead of lumping them into unverified age groups
- No charging different premiums to employees based on health status
- No charging different rates to employers based on the health status of their employees
- Healthy, younger groups will be fully underwritten
- Self-employed individuals with a few employees and those with no employees are also eligible
- Will not cherry pick or discriminate based on the status of an applicant pre-existing or previous health condition.
There are also some disadvantages. They include:
- Many of these plans might not allow single person groups.
- An individual must be a bona-fide member of a group and pay a membership fee.
The Role Saxon Plays in Helping the Employer
Saxon prides itself as a top provider of AHPs. The company has experts with knowledge of how this system works. Writing these plans for the last four years, Saxon can offer stable rates and consistent, professional assistance.
For more information regarding employee benefits and competitive benefits packages that fit your business strategy, you can contact Jamie Charlton at 513-573-0129 or via email at jcharlton@gosaxon.com.
Technology Influencing the Healthcare and Employee Benefits Industry
Technology is taking the world by storm and the healthcare/employee benefits industry is no exception. Whether you are an employee or an employer shopping for benefits can be the same for both parties. Here’s how technology will influence the industry in the future.
Apps will push value-based care
This tech shift to shopping for benefits will bring with it the rise of platforms and app-based insurance. The hope is that apps and platforms will make it easier to buy and understand insurance, and easier to get the best healthcare fast. That means high-quality care at a low price at a time that’s convenient for patients.
Emerging tech platforms should provide employees with more options for insurance — and a better understanding of those options — and make it easier to manage wellness, healthcare and insurance coverage. Apps will put more information in front of the average employee, giving them more freedom to make choices about their care.
The idea is these emerging platforms and apps tie together payroll and HRIS with wellness and healthcare navigator apps to help workers live healthier lives.
Here’s how it could work: When an employee isn’t feeling well, they first turn to their telemedicine app instead of picking up the phone to make a doctor’s appointment or visiting urgent care. Telemedicine is more convenient for them and costs less than a traditional doctor’s visit. If the telemedicine provider refers them to a specialist, they can then turn to a health navigator app to find a high-quality specialist at the lowest price for their next appointment.
When they're feeling better, they can use a connected wellness app to record gym visits, meditate, speak to a therapist and earn points for wellness activities like reaching a step-count milestone or getting a preventive checkup. These points can contribute to a real-time insurance premium discount that they can easily view from an app. The app can also present them with the opportunity to add or change voluntary benefits and, during the open enrollment, learn about their benefits choices and decide on the best plan.
Apps specific to shopping for benefits will provide more information to healthcare consumers and the necessary tools to make better care decisions. The hope is this technology will help people become healthier, get better care and use insurance more efficiently.
How HR fits in
Though employees will have the ability to make easy changes to benefit plans — especially voluntary benefits — the role of HR may change, depending on the employer’s size.
Large, more than 1,000 life employers will likely partner with a technology company and a benefits consultant who will manage the platform and the insurance-buying process for employees. Representatives from the HR technology platform, the benefits consultant and human resources staff will be responsible for educating employees about their options. Importantly, the employer will continue to sponsor employee benefits. They may present cafeteria-style benefits plans and provide a dollar amount toward the purchase of benefits.
Bigger changes may come for small companies with fewer than 100 employees. Many of these businesses may turn to a professional employer organization or other HR outsourcing arrangements with a built-in technology platform. Though healthcare insurance costs will continue to rise, small employers will continue to contribute to employee benefits premiums to help attract and retain talent.
The imperative for employers: communicate and educate
The only way this shift to platforms, apps, and other technology-based solutions will work is if employers, benefits brokers and platform companies themselves work to educate and communicate with employees about how this all works. Insurance platforms can no longer be staffed with technologists only; they need experts who understand health and welfare benefits in order to onboard employees and teach them how to get the most from their benefits platform.
And while HR’s role may change slightly, those teams are still in charge of helping employees learn about the benefits landscape and plan their healthcare and financial well-being for the next plan year. HR teams need to focus on communicating through any channel necessary, whether it’s email, social media, in-person education meetings or podcasts. It benefits everyone when employees understand how to choose the best plan and make decisions about appropriate care.
Putting more healthcare and insurance information in front of employees when they’re shopping for benefits and seeking services can drive them to make smarter decisions and look for better options when possible, but only if they understand how it all works.
SOURCE: Lisa, Mike. (24 July 2019). “Shopping for benefits: What technology holds for clients” (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/what-technology-holds-for-employee-healthcare-benefits?brief=00000152-1443-d1cc-a5fa-7cfba3c60000
The unpaid caregiver crisis is landing on employers’ doorsteps
According to new data, 43 million Americans currently are tending to a family member in need, which can be both physically and emotionally taxing on the caregiver. Read this blog post for more on the unpaid caregiver crisis.
Scott Williams knows firsthand what it is like to support a sick relative. But even after spending 20 years tending to his ailing mother, he didn’t consider himself a caregiver.
“She suffered from multiple chronic conditions, but I never considered myself a caregiver,” he says. “I just thought I was a son who loved his mom.”
Williams, who is vice president and head of global patient advocacy and strategic partnerships at the biopharmaceutical company EMD Serono, realized that because he didn’t think of himself as a caregiver, he wasn’t able to take advantage of the benefit offerings his company had in place for these workers.
“Until I really started to think about it, I didn’t realize how burned out I really was,” Williams says. “I was in that sandwich generation, which is a situation that many caregivers find themselves in sometimes.”
Williams dilemma is not uncommon. There are 43 million Americans currently tending to a family member in need, according to data from LIMRA. AARP estimates that caring for a loved one can cost close to $7,000 out of pocket.
"I never considered myself a caregiver, I just thought I was a son who loved his mom.” Scott Williams
It is also both physically and emotionally taxing — 57% of caregivers need medical care or support for a mental health condition, according to an Embracing Carers survey. About 55% of caregivers say their own physical health has diminished, 54% say they don’t have time to tend to their own medical needs and 47% report feeling depressed.
The caregiving crisis puts employers in a unique position to offer benefits, policies and resources that can ease some of this stress. Indeed, there are some employers that already stepped up. For example, Starbucks launched a new caregiver benefit last year. Amgen and Brinker International, use digital tools to offer caregiving benefits to their workers.
Regardless, the need for employer-provided backup child, adult and senior care options is still largely unmet. Only 4% of employers offer backup childcare services and only 2% offer backup elder care, according to data from the Society for Human Resource Management.
The breakdown of communication between the company and the worker may be keeping the majority of employees from accessing the assistance they need. If employers ignore this issue or simply fail to communicate with employees, it can end up becoming a burden that costs the company money or result in the loss of a worker.
But there are some steps employers can take. The first is to identify the responsibilities of the family caregiver so that employers can better address their needs. One of the biggest responsibilities caregivers face is the amount of time they have to spend transporting loved ones, says Ellen Kelsay, chief strategy officer for the National Business Group on Health citing recent data on the subject. These employees often have to leave work early, come in late or take off to get an ill family member to their doctor’s appointments.
“The financial impact is considerable, many of these employees are paying out of their own pocket to support the medical care of a loved one. So there is financial assistance that they need,” Kelsay says. “When you think about the impact on the employee, they [struggle from a] physical, mental and emotional wellbeing perspective.”
About half of unpaid caregivers work full time outside of their home and many have to take leaves of absence or cut back their work hours due to the demands of caring for a family member, LIMRA research shows. A significant portion of employees had to stop working in order to better care for their loved one — about 22% say they voluntarily quit their jobs, 18% had their employment terminated and 13% chose to retire early.
Unlimited PTO, remote work, shared sick time and an employee resource group are just a few offerings employers can offer staff, Williams says. For instance, EMD Serono created an employee resource group for caregivers, a peer to peer network where employers can find dedicated resources, while also having an exchange with colleagues who are going through similar situations.
But there is still more that can be done, Williams says. Training managers to be more understanding of an employee’s needs can go a long way toward bridging the gap. Another option companies should consider is enhancing employee assistance programs to include caregivers, he adds.
“One of the things we see employers doing that can really help is being able to raise the visibility of [the available] resources,” Williams says. “To really ensure that whether you’re a new employee or an established employee in an unpaid caregiving situation that you have access to them.”
SOURCE: Schiavo, A. (11 July 2019) "The unpaid caregiver crisis is landing on employers’ doorsteps" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/improving-caregiving-challenges-through-the-workplace