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Absent federal action, states take the lead on curbing drug costs

What's your state's stance on the cost of prescription drugs? See how Maryland has moved forward in their decision making for drug prices, giving themselves the ability to say "no" in this article from Benefits Pro written by Shefali Luthra.

You can read the original article here.

Lawmakers in Maryland are daring to legislate where their federal counterparts have not: As of Oct. 1, the state will be able to say “no” to some pharmaceutical price spikes.

A new law, which focuses on generic and off-patent drugs, empowers the state’s attorney general to step in if a drug’s price climbs 50 percent or more in a single year. The company must justify the hike. If the attorney general still finds the increase unwarranted, he or she can file suit in state court. Manufacturers face a fine of up to $10,000 for price gouging.

As Congress stalls on what voters say is a top health concern — high pharmaceutical costs — states increasingly are tackling the issue. Despite often-fierce industry opposition, a variety of bills are working their way through state governments. California, Nevada and New York are among those joining Maryland in passing legislation meant to undercut skyrocketing drug prices.

Maryland, though, is the first to penalize drugmakers for price hikes. Its law passed May 26 without the governor’s signature.

The state-level momentum raises the possibility that — as happened with hot-button issues such as gay marriage and smoke-free buildings — a patchwork of bills across the country could pave the way for more comprehensive national action. States feel the squeeze of these steep price tags in Medicaid and state employee benefit programs, and that applies pressure to find solutions.

“There is a noticeable uptick among state legislatures and state governments in terms of what kind of role states can play in addressing the cost of prescription drugs and access,” said Richard Cauchi, health program director at the National Conference of State Legislatures.

Many experts frame Maryland’s law as a test case that could help define what powers states have and what limits they face in doing battle with the pharmaceutical industry.

The generic-drug industry has already filed a lawsuit to block the law, arguing it’s unconstitutionally vague and an overreach of state powers. A district court is expected to rule soon.

The state-level actions focus on a variety of tactics:

“Transparency bills” would require pharmaceutical companies to detail a drug’s production and advertising costs when they raise prices over certain thresholds. Cost-limit measures would cap drug prices charged by drugmakers to Medicaid or other state-run programs, or limit what the state will pay for drugs. Supply-chain restrictions include regulating the roles of pharmacy benefit managers or limiting a consumer’s out-of-pocket costs.

A New York law on the books since spring allows officials to cap what its Medicaid program will pay for medications. If companies don’t sufficiently discount a drug, a state review will assess whether the price is out of step with medical value.

Maryland’s measure goes further — treating price gouging as a civil offense and taking alleged violators to court.

“It’s a really innovative approach. States are looking at how to replicate it, and how to expand on it,” said Ellen Albritton, a senior policy analyst at the left-leaning Families USA, which has consulted with states including Maryland on such policies.

Lawmakers have introduced similar legislation in states such as Massachusetts, Rhode Island, Tennessee and Montana. And in Ohio voters are weighing a ballot initiative in November that would limit what the state pays for prescription drugs in its Medicaid program and other state health plans.

Meanwhile, the California legislature passed a bill earlier in September that would require drugmakers to disclose when they are about to raise a price more than 16 percent over two years and justify the hike. It awaits Democratic Gov. Jerry Brown’s signature.

In June, Nevada lawmakers approved a law similar to California’s but limited to insulin prices. Vermont passed a transparency law in 2016 that would scrutinize up to 15 drugs for which the state spends “significant health care dollars” and prices had climbed by set amounts in recent years.

But states face a steep uphill climb in passing pricing legislation given the deep-pocketed pharmaceutical industry, which can finance strong opposition, whether through lobbying, legal action or advertising campaigns.

Last fall, voters rejected a California initiative that would have capped what the state pays for drugs — much like the Ohio measure under consideration. Industry groups spent more than $100 million to defeat it, putting it among California’s all-time most expensive ballot fights. Ohio’s measure is attracting similar heat, with drug companies outspending opponents about 5-to-1.

States also face policy challenges and limits to their statutory authority, which is why several have focused their efforts on specific parts of the drug-pricing pipeline.

Critics see these tailored initiatives as falling short or opening other loopholes. Requiring companies to report prices past a certain threshold, for example, might encourage them to consistently set prices just below that level.

Maryland’s law is noteworthy because it includes a fine for drugmakers if price increases are deemed excessive — though in the industry that $10,000 fine is likely nominal, suggested Rachel Sachs, an associate law professor at Washington University in St. Louis who researches drug regulations.

This law also doesn’t address the trickier policy question: a drug’s initial price tag, noted Rena Conti, an assistant professor in the University of Chicago who studies pharmaceutical economics.

And its focus on generics means that branded drugs, such as Mylan’s Epi-Pen or Kaleo’s overdose-reversing Evzio, wouldn’t be affected.

Yet there’s a good reason for this, noted Jeremy Greene, a professor of medicine and the history of medicine at Johns Hopkins University who is in favor of Maryland’s law.

Current interpretation of federal patent law suggests that the issues related to the development and affordability of on-patent drugs are under federal jurisdiction, outside the purview of states, he explained.

In Maryland, “the law was drafted narrowly to address specifically a problem we’ve only become aware of in recent years,” he said. That’s the high cost of older, off-patent drugs that face little market competition. “Here’s where the state of Maryland is trying to do something,” he said.

Still, a ruling against the state in the pending court case could have a chilling effect for other states, Sachs said, although it would be unlikely to quash their efforts.

“This is continuing to be a topic of discussion, and a problem for consumers,” said Sachs.

“At some point, some of these laws are going to go into effect — or the federal government is going to do something,” she added.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Source:

Luther S. (29 September 2017). "Absent federal action, states take the lead on curbing drug costs" [Web Blog Post]. Retrieved from address https://www.benefitspro.com/2017/09/29/absent-federal-action-states-take-the-lead-on-curb?page=2

by 6djina

How data analytics is changing employee benefit strategies

As technology continues to grow and expand, more employers are turning to digital platforms when it comes to managing their employee benefits program. With more access to technology, employers can use data accumulated from their employees to better personalize their employee benefits package to fit each individual's needs. Take a look at this column by Eric Helman from Employee Benefit Advisor and find out some more tips on how you can better leverage the data from an employee benefits program to fit your employees'es needs.

In the realm of employee benefits, surveys, focus groups and anecdotes about specific employee encounters with the benefits program typically drive the discussions about how that program should evolve in the future. Unlike the situation at Outback, it is difficult to “observe” how people actually consume benefits and tailor a program that is attractive to them.

Fortunately, recent developments in data analytics have unlocked the potential of using consumer behavior insights to drive employee benefits strategy.

Leading practitioners are beginning to leverage these developments to change the annual renewal process. The technologies that support data aggregation, normalization and reporting have been aggressively developed to support the provider and payer communities. Only now have these advancements been made available to employers and their advisers.

The most successful practitioners point to the value of standardized claims reporting based upon credible data. By combining current claims data with industry benchmarks and predictive analytics, employers gain insight into the ongoing performance of their benefit plans. They “see” for themselves what industry professionals have been telling them for years. Plan performance is based upon claims, both in terms of the number of units of healthcare consumed and the price of those units. In recent surveys, benefit professionals report the difficulty they have in convincing CFOs and CEOs to make the necessary changes to benefit programs. Standardized reporting from a credible analytics platform can greatly enhance the ability for benefit professionals to communicate their agenda.

But standardized reporting is not the panacea. Benefits are complex. And the relationship between risk and consumption of healthcare add to the complexity. Even in the best reporting environments where executives are well informed about the performance of their plans and how the key metrics compare to industry norms, they are often perplexed about what to do with the information. Advancements in the realm of “actionable analytics” are beginning to address this problem as well.

While artificial intelligence or AI is all the rage, the underlying concept of having a computer suggest a course of action based upon data is not a new idea. The new application to employee benefits is the ability to provide “suggestions” in the context of standardized financial reporting. The number of ideas to bend the cost curve are numerous. The challenge is matching these ideas with the appropriate populations, convincing decision makers to invest and engaging the appropriate cohorts of employees to take specific actions necessary to realize the return on investment for these initiatives.

New systems are now available to close the gaps on this execution continuum. The foundation for these new systems is a robust analytics platform. But actionable analytics build upon this foundation by evaluating the employer’s data to discern whether a specific cost-saving initiative might generate savings worthy of the investment. These new systems present the output of that analysis in an easy to understand graphical format for benefit consultants and HR professionals to effectively communicate the potential of cost savings initiatives to decision makers.

Targeted engagement maximizes compliance and ROI
Getting executives to commit to intentional actions to affect the rising costs of benefits solves one half of the problem. The second half of the problem is one of focus. Rather than attempting to engage all employees with generalized messaging, these new systems use analytics to focus their engagement on a specific cohort of individuals in order to drive the greatest impact. This focus allows for a concentration of resources on the targeted populations, resulting in increased compliance and larger return on investment. The best implementations are integrated with benefits administration platforms and can incorporate multiple initiatives simultaneously. Point solutions, from an engagement perspective, have been proven to result in single-digit compliance. The power of an integrated engagement solution allows for initiatives that, because they are both focused and automated, can be executed simultaneously.

Advancements in technology have created a new era in which the democratization of big data allows for non-technical professionals to access detailed information and convert that information into intelligence. According to a recent survey, more than 65% of employers confess they are not strategic when it comes to benefits cost management. In spite of the many cost savings ideas available, more than 40% say they are not engaging in any new initiatives in the upcoming year. While the future of healthcare reform is in doubt, the potential for actionable analytics to significantly change the trajectory of the employer’s benefits costs is certain.

See the original article Here.

Source:

Helman E. (2017 September 5). How data analytics is changing employee benefit strategies [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/closing-the-execution-continuum-on-employee-benefit-cost-savings

Avoid these 12 Common Open Enrollment Mistakes

Open enrollment season is right around the corner. Check out this great column by Alan Goforth from Benefits Pro and find out the top mistakes employers and HR have made during open enrollment and what you can do to avoid them.

Every employer or human resources professional has made mistakes during open enrollment.

Trying to accommodate the diverse needs of the workforce in a short timeframe against the backdrop of increasing options and often bewildering regulations, can be a challenge even in the best-run companies.

Avoiding mistakes is impossible, but learning from them is not. Although the list may be limitless, here are a dozen of the most common pratfalls during open enrollmentand how to avoid tripping over them.

1. Failing to communicate

"What we've got here… is failure to communicate." – Cool Hand Luke

This mistake likely has topped the list since open enrollment first came into existence, and it will probably continue to do so. That's because enrollment is a complex procedure, and few challenges are greater that making sure employers, employees, brokers and carriers are on the same page.

Employers have both a stick and a carrot to encourage them to communicate as well as possible. The stick is the Affordable Care Act, which requires all employers subject to the Fair Labor Standards Act to communicate with employees about their health-care coverage, regardless of whether they offer benefits.

As a carrot, an Aflac study found that 80 percent of employees agree that a well-communicated benefits package would make them less likely to leave their jobs

2. Neglecting technology

The integration of new technology is arguably the most significant innovation in the enrollment process in recent years.

This is especially important as younger people enter the workforce. Millennials repeatedly express a preference for receiving and analyzing benefits information by computer, phone or other electronic devices.

The challenge is to make the use of technology as seamless as possible, both for employees who are tech-savvy and for those who are not.

Carriers and brokers are making this an emphasis, and employers should lean on them for practical advice.

See the original article Here.

3. Over-reliance on technology

At the other end of the spectrum is the temptation to rely on technology to do things it never was meant to do.

"Technology is so prevalent in the enrollment space today, but watch out for relying on technology as the one thing that will make or break enrollment," says Kathy O'Brien, vice president of voluntary benefits and nation client group services for Unum in Chattanooga, Tennessee. "Technology is great for capturing data, but it won't solve every problem and doesn't change the importance of the other work you need to do."

4. Succumbing to inertia

It can be frustrating to invest substantial time and effort into employee benefit education, only to have most of the staff do nothing.

Yet that is what happens most of the time. Just 36 percent of workers make any changes from the previous enrollment, and 53 percent spend less than one hour making their selections, according to a LIMRA study.

One reason may be that employees don’t feel assured they are making the right decisions.

Only 10 percent felt confident in their enrollment choices when they were done, according to a VSP Vision Care study. One good strategy for overcoming inertia is to attach dollar values to their choices and show where their existing selections may be leaving money on the table.

5. Cutting too many corners

One of the most difficult financial decisions employers make each year is deciding how much money to allocate to employee benefits.

Spending too much goes straight to the bottom line and could result in having to lay off the very employees they are trying to help. Spending too little, however, can hurt employee retention and recruiting.

Voluntary benefits offer a win-win solution. Employees, who pick up the costs, have more options to tailor a program that meets their own needs.

In a recent study of small businesses, 85 percent of workers consider voluntary benefits to be part of a comprehensive benefits package, and 62 percent see a need for voluntary benefits.

6. Not taking a holistic approach

"Holistic" is not just a description of an employee wellness program; it also describes how employers should think about employee benefit packages.

The bread-and-butter benefits of life and health insurance now may include such voluntary options as dental, vision and critical illness. Employers and workers alike need to understand how all of the benefits mesh for each individual.

Businesses also need to think broadly about their approach to enrollment

"Overall, we take a holistic approach to the customer’s enrollment program, from benefits communication to personalized benefits education and counseling, as well as ongoing, dedicated service," says Heather Lozynski, assistant vice president of premier client management for Colonial Life in Columbia, South Carolina. "This allows the employer to then focus on other aspects of their benefits process."

7. Unbalanced benefits mix

Employee benefits have evolved from plain vanilla to 31 (or more) flavors.

As the job market rebounds and competition for talented employees increases, workers will demand more from their employers.

Benefits that were once considered add-ons are now considered mandatory.

Round out the benefits package with an appealing mix of standard features and voluntary options with the objective of attracting, retaining and protecting top-tier employees.

8. Incomplete documentation

Employee satisfaction is a worthy objective — and so is keeping government regulators happy.

The Affordable Care Act requires employers who self-fund employee health care to report information about minimum essential coverage to the IRS, at the risk of penalties.

Even if a company is not required by law to offer compliant coverage to part-time employees, it still is responsible for keeping detailed records of their employment status and hours worked.

As the old saying goes, the job is not over until the paperwork is done.

9. Forgetting the family

The Affordable Care Act has affected the options available to employers, workers and their families.

Many businesses are dropping spousal health insurance coverage or adding surcharges for spouses who have access to employer-provided insurance at their own jobs.

Also, adult children can now remain on their parents' health policies until they are 26.

Clearly communicate company policies regarding family coverage, and try to include affected family members in informational meetings.

Get to know more about employees' families — it will pay dividends long after open enrollment.

10. Limiting enrollment options

Carriers make no secret about their emphasis on electronic benefits education and enrollment.

All things considered, it is simpler and less prone to copying and data-entry errors.

It would be a mistake, however, to believe that the high-tech option is the first choice of every employee.

Be sure to offer the options of old-fashioned paper documents, phone registration and face-to-face meetings. One good compromise is an on-site enrollment kiosk where a real person provides electronic enrollment assistance.

11. Letting benefits go unused

A benefit is beneficial only if the employee uses it. Too many employees will sign up for benefits this fall, forget about them and miss out on the advantages they offer.

Periodically remind employees to review and evaluate their available benefits throughout the year so they can take advantage of ones that work and drop those that do not.

In addition to health and wellness benefits, also make sure they are taking advantage of accrued vacation and personal days.

Besides maximizing the return on their benefit investment, it will periodically remind them that the employer is looking out for their best interests.

12. Prematurely closing the 'OODA' loop

Col. John Boyd of the U.S. Air Force was an ace fighter pilot. He summarized his success with the acronym OODA: Observe, Orient, Decide and Act. Many successful businesses are adopting his approach.

After the stress of open enrollment, it's tempting to breathe a sigh of relief and focus on something else until next fall.

However, the close of enrollment is a critical time to observe by soliciting feedback from employees, brokers and carriers.

What worked this year, and what didn't? What types of communications were most effective? And how can the process be improves in 2017?

"Make sure you know what is working and what is not," said Linda Garcia, vice president for human resources at Rooms to Go, a furniture retailer based just outside Tampa. "We are doing a communications survey right now to find out the best way to reach each of our 7,500 employees. We also conduct quarterly benefits surveys and ask for their actual comments instead of just checking a box."

Source:

Goforth A. (2017 Aug 22). Avoid these 12 common open enrollment mistakes [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/08/22/avoid-these-12-common-open-enrollment-mistakes?ref=hp-in-depth&page_all=1

4 Trends Shaping Cybersecurity in 2017

The threat of cyber attacks is increasing every day. Make sure you are stay up-to-date with all the recent news and trends happening in the world of cyber security so you can stay informed on how to protect yourself from cyber threats. Check out this great column by Denny Jacob from Property Casualty 360 and find out about the top 4 trends impacting cybersecurity this year.

No. 4: Growing areas of concern

Organizations with a chief information security officer (CISO) in 2017 increased to 65 percent compared to 50 percent in 2016. Staffing challenges and budgetary distribution, however, reveal where organizations face exposure.

Finding qualified personnel to fill cybersecurity positions is as ongoing challenge. For example, one-third of study respondents note that their enterprises receive more than 10 applicants for an open position. More than half of those applicants, however, are unqualified. Even skilled applicants require time and training before their job performance is up to par with others who are already working on the company's cybersecurity operation.

Half of the study respondents reported security budgets will increase in 2017, which is down from 65 percent of respondents who reported an increase in 2016. This, along with staffing challenges, has many enterprises reliant on both automation and external resources to offset missing skills on the cybersecurity team.

Another challenge: Relying on third-party vendors means there must be funds available to offset any personnel shortage.

If the skills gap continues unabated and the funding for automation and external third-party support is reduced, businesses will struggle to fill their cybersecurity needs.

No. 3: More complicated cyber threats

Faced with declining budgets, businesses will have less funding available on a per-attack basis. Meanwhile, the number of attacks is growing, and they are becoming more sophisticated.

More than half (53 percent) of respondents noted an increase in the overall number of attacks compared previous years. Only half (roughly 50 percent) said their companies executed a cybersecurity incident response plan in 2016.

Here are some additional findings regarding the recent uptick in cyber breaches:

• 10 percent of respondents reported experiencing a hijacking of corporate assets for botnet use;• 18 percent reported experiencing an advanced persistent threat (APT) attack; and

• 14 percent reported stolen credentials.

• Last year’s results for the three types of attacks were:

• 15 percent for botnet use;

• 25 percent for APT attacks; and

•15 percent involving stolen credentials.

Phishing (40 percent), malware (37 percent) and social engineering (29 percent) continue to top the charts in terms of the specific types of attacks, although their overall frequency of occurrence decreased: Although attacks are up overall, the number of attacks in these three categories is down.

No. 2: Mobile takes a backseat to IoT

Businesses are now more sophisticated in the mobile arena. The proof: Cyber breaches resulting from mobile devices are down. Only 13 percent of respondents cite lost mobile devices as an exploitation vector in 2016, compared to 34 percent in 2015. Encryption factors into the decrease; only 9 percent indicated that lost or stolen mobile devices were unencrypted.

IoT continues to rise as an area of concern. Three out of five (59 percent) of the 2016 respondents cite some level of concern relative to IoT, while an additional 30 percent are either "extremely concerned" or "very concerned" about this exposure.

IoT is an increasingly important element in governance, risk and cybersecurity activities. This is a challenging area for many, because traditional security efforts may not already cover the functions and devices feeding this digital trend.

No. 1: Ransomware is the new normal

The number of code attacks, including ransomware attacks, remains high: 62 percent of respondents reported their enterprises experienced a ransomware attackspecifically.

Half of the respondents believe financial gain is the biggest motivator for criminals, followed by disruption of service (45 percent) and theft of personally identifiable information (37 percent). Despite this trend, only 53 percent of respondents' companies have a formal process in place to deal with ransomware attacks.

What does that look like?

Businesses can conduct "tabletop" exercises that stage a ransomware event or discuss in advance decisions about payment vs. non-payment. Payment may seem like the easiest solution, but law enforcement agencies warn it can have an encouraging effect on those criminals as some cases lead to repeated attacks of the same business.

Many cybersecurity specialists argue that the best way to fight a ransomware attack is to avoid one in the first place. Advance planning that might include the implementation of a governing corporate policy or other operating parameters, can help to ensure that the best cybersecurity decisions are made when the time comes to battle a breach.

See the original article Here.

Source:

Jacob D. (2017 August 25). 4 trends shaping cybersecurity in 2017 [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/08/25/4-trends-shaping-cybersecurity-in-2017?ref=hp-in-depth&page_all=1

Self-funding and Voluntary Benefits: The Dynamic Insurance Duo

Did you know that self-funded health insurance and voluntary benefits can be a dream team when used in conjunction with each other? Check out this great article by Steve Horvath and Dan Johnson from Benefits Pro and find out how you can make the most of this dynamic insurance duo.

In an era of health care reform, double-digit rising health care costs, and plenty of “unknowns,” many employers view their benefit plans as a challenging blend of cost containment strategies and employee retention.

But perhaps they need to better understand the value of a little caped crusader named voluntary benefits.

Employers of all sizes share common goals when it comes to their benefits. They seek affordable, and quality benefits for their employees.

Some companies achieve these goals by cutting costs and going with a high-deductible, self-funded approach. While many associate self-funding with larger employers, in the current marketplace, it has become a viable option for companies across the board.

Especially when paired with a voluntary benefits offering supported by one-on-one communication or a call center, employers are able to cut costs and offer additional insurance options tailored to their employees’ needs. But there’s more.

Voluntary enrollments can help employers meet many different challenges, all of which tie back to cost-containment, streamlined processes and employee understanding and engagement. But before we explore solutions, let’s first understand why so many employers are going the self-funded route.

For most large and small employers, the costs of providing health care to employees and their families are significant and rising.

For companies who may be tight on money and are seeing their fully-insured premiums increase every year with little justification, self-funding serves as a great solution to keep their medical expenses down.

Self-funding: An overview

Self-funding allows employers to:

Control health plan costs with pre-determined claims funding amounts to a medical plan account, without paying the profit margin of the insurance company.
Protect their plan from catastrophic claims with stop-loss insurance that helps to pay for claims that exceed the amount set by their self-funded plan.
Pay for medical claims the plan actually incurs, not the margin a fully insured plan underwrites into their premium, while protecting the plan with catastrophic loss coverage when large expenses are incurred. Plans may offer to share favorable savings with their employees through programs like premium holidays. These programs allow employee contributions to be waived for a period of time selected by the employer to reward employees for low utilization and adequate funding of their claims accounts and reserves.
Take advantage of current and future year plan management guidance.
Save on plan costs by using predictive analysis for health and wellness offered by the third-party administrator (TPA).

Beyond these advantages,self-funded plans may not be subject to all of the Affordable Care Act regulations as fully-insured plans, which is one of the reasons they provide a solution for controlling costs. Without these requirements, the plans can be tailored much more precisely to meet the needs of a specific employee group.

Boosting value: Advantages of adding voluntary benefits to a self-funded plan

Based on an employer’s specific benefit plan, and what it offers, employers are able to select voluntary benefits that can complement the plan and properly meet employees’ needs without adding extra costs to the plan.

Employees are then able to customize their own, personal benefit options even further based on their unique needs and available voluntary benefits.

This provides employees a myriad of benefits while also allowing them to account for out-of-pocket costs due to high-deductibles or plan changes, as well as provide long-term protection if the product is portable.

Voluntary solutions are about more than the products

Aside from the common falsehood that voluntary benefits are only about adding ‘gap fillers’ to your plan, you may be pleasantly surprised to learn that conducting a voluntary benefits enrollment can actually offer a number of services, solutions, and products, many of which may be currently unfamiliar to you.

Finding, and funding, a ben-admin solution

Some carriers offer the added bonus of helping employers install a benefits administration system in return for conducting a one-on-one or mandatory call center voluntary benefits enrollment.

The right benefits administration systems can help remove manual processes and allow HR to do what they do best—focus on employees and improving employee programs. No more headaches around changing coverage, change files to carriers, changing payroll-deductions or premiums.

Finding the benefits administration system that works best for your situation can make a big difference for your HR team.

Communication and engagement

Many employees are frustrated and scared about how changes to the insurance landscape will impact them. And with a recent survey noting that 95 percent of employees need someone to talk to for benefits information,¹they clearly are seeking ongoing communications and resources.

During the enrollment process, some carriers work with enrollment and communications companies who understand the employees’ benefit plan options and help guide them to the offerings that are best for them and their families.

At the same time, employers can enhance the communication and engagement efforts on other important corporate initiatives. For example, a client of ours increased employee participation in their high-deductible health plan (HDHP) via pre-communication.

Of the 90 percent of employees that went to the enrollment, nearly 70 percent said they were either likely or very likely to select the HDHP. Just a little bit of communication can go a long way toward employee understanding.

Providing education and engagement about both benefits and workplace initiatives increases the effectiveness of these programs and contributes to keeping costs down for employers. The more engagement employers generate, the healthier and better protected the employees.

Prioritizing health and wellness

Employers can also use the enrollment time with employees to remind them to get their annual exams. Many voluntary plans offer a wellness benefit (e.g. $50 or $100) to incentivize the employee and dependents.

The ROI for an employer’s health plan provides value as regular screenings can help detect health issues in the beginning stages so that proper health care management can begin and medical spend can be minimized.

Employers have also seized the opportunity of a benefits enrollment to implement a full-scale wellness program at reduced costs by aligning it with a voluntary benefits enrollment.

An effective wellness program will approach employee health from a whole-person view, recognizing its physical, social, emotional, financial and environmental dimensions. A properly implemented wellness program can ultimately make healthy actions possible for more of an employee population.

A formidable combination

What employers are seeking is simple -- quality benefits and a way to lower costs. With that in mind, offering a self-funded plan with complementary voluntary benefit products and solutions allows employers to take advantage of multiple opportunities while, at the same time, providing more options for their employees.

In today’s constantly changing landscape, self-funded plans paired with voluntary benefits is a formidable combination – a dynamic insurance duo.

See the original article Here.

Source:

Horvath S., Johnson D. (2016 November 23). Self-funding and voluntary benefits: the dynamic insurance duo [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/11/23/self-funding-and-voluntary-benefits-the-dynamic-in?page_all=1

Closing the execution continuum on employee benefit cost savings

Are you using big data to reduce your employee benefits costs? As more employers switch their employee benefits to a digital platform, big data can be a great tool for employers looking to reduce the costs associated with their benefits program. Check out this great article by Eric Helman from Employee Benefit Advisor and found out how you can leverage your data to reduce to cost of an employee benefit program.

A revolution in employee benefits is on the horizon, and 21st century analytics is at the core. Big data holds the promise to scan huge amounts of information in a near real-time environment for insights that will impact the current and future trajectory for a given area. The advancement of true cross-vendor analytics, prescription, engagement and measurement brought on by the democratization of big data is enabling employers, brokers and consultants to improve the performance of their employee benefits plans like never before.

Two decades ago, I had the opportunity to hear Chris Sullivan, one of the founders of Outback Steakhouse, speak to a group of executives about customer research. His sentiments: “We don’t do focus groups. People don’t know what they want. Who would say they would like to stand in line for 30 minutes to eat salty food in a very loud restaurant? But that is exactly what they wanted. And that is what made Outback a success. Instead of focus groups, we place very talented and engaged proprietors in our stores and teach them to observe what people want. Then, we replicate that experience.”

Analytics drive strategy
Fortunately, recent developments in data analytics have unlocked the potential of using consumer behavior insights to drive employee benefits strategy. Leading practitioners are beginning to leverage these developments to change the annual renewal process. The technologies that support data aggregation, normalization and reporting have been aggressively developed to support the provider and payer communities. Only now have these advancements been made available to employers and their advisers.

See the original article Here.

Source:

Helman E. (2017 September 5). Closing the execution continuum on employee benefit cost savings [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/closing-the-execution-continuum-on-employee-benefit-cost-savings?brief=00000152-146e-d1cc-a5fa-7cff8fee0000

The Risk of Being Uninsured (and the Hidden Bargain in Addressing It Now)

Are you aware of all the risks associated with being uninsured? Take a look at this great column by Erica Oh Nataren from Life Happens and find out how you are putting yourself in harm's way by being uninsured.

With all the expenses of everyday living, it’s tempting to think of insurance as just another cost. What’s harder to see is the potential cost of not buying insurance—or what’s known as “self-insuring”—and the hidden bargain of coverage.

The Important vs. the Urgent
We’ve all experienced it: the tendency to stay focused on putting out fires, while never getting ahead on the things that really matter in the long run. For most people, there are two big things that matter in the long run: their families and their ability to retire. And being properly insured is important to both those concerns.

Life Insurance: a Hidden Bargain?
It’s exceedingly rare, but we all know it can happen: someone’s unexpected death. Life insurance can prevent financial catastrophe for the loved ones left behind, if they depend on you for income or primary care—or both.

The irony is that many people pass on coverage due to perceived cost, when in fact it’s far less expensive that most people think. The 2016 Insurance Barometer Study, by Life Happens and LIMRA showed that 8 in 10 people overestimate the cost of life insurance. For instance, a healthy, 30-year-old man can purchase a 20-year, $250,000 term life insurance policy for $160 a year—about $13 a month.

Enjoy the Benefits of Life Insurance—While You’re Alive
If budget pressures aren’t an issue, consider the living benefits of permanent life insurance—that’s right, benefits you can use during your own lifetime.

Permanent life insurance policies typically have a higher premium than term life insurance policies in the early years. But unlike term insurance, it provides lifelong protection and the ability to accumulate cash value on a tax-deferred basis.

Cash values can be used in the future for any purpose you wish. If you like, you can borrow cash value for a down payment on a home, to help pay for your children’s education or to provide income for your retirement.

When you borrow money from a permanent insurance policy, you’re using the policy’s cash value as collateral and the borrowing rates tend to be relatively low. And unlike loans from most financial institutions, the loan is not dependent on credit checks or other restrictions. You ultimately must repay any loan with interest or your beneficiaries will receive a reduced death benefit and cash-surrender value.

In this way, life insurance can serve as a powerful financial cushion for you and your family throughout your life, in addition to protecting your family from day one.

Disability Insurance: For the Biggest Risk of All
The most overlooked of the major types of insurance coverage is the one that actually covers a far more common risk—the risk of becoming ill or injured and being unable to work and earn your paycheck.

How common is it? While no one knows the exact numbers, it’s estimated that 30% of American workers will become disabled for 90 days or more during their working years. The sad reality is that most American workers also cannot afford such an event. In fact, illness and injury are the top reasons for foreclosures and bankruptcies in the U.S. today. Disability insurance ensures that if you are unable to work because of illness or injury, you will continue to receive an income and make ends meet until you’re able to return to work.

It’s tempting to cross your fingers and hope misfortune skips over you. But when you look at the facts, it’s easy to see: getting proper coverage against life’s risks is not just important, but a bargain in disguise.

See the original article Here.

Source:

Nataren E. (2017 May 11). The risk of being uninsured (and the hidden bargain in addressing it now) [Web blog post]. Retrieved from address https://www.lifehappens.org/blog/the-risk-of-being-uninsured-and-the-hidden-bargain-in-addressing-it-now/

Why Employee Engagement Matters – and 4 Ways to Build It Up

An engaged employee is a productive employee. Employee engagement is a very important piece of a company's operations. They are some of the best assets a company can have and without engaged employees, your company's operations could be negatively impacted. Take a look at this great article by Joe Wedgewood from The Happiness Index and check out some of the helpful tips on how you can boost engagement across your organization.

Organizations with high employee engagement levels outperform their low engagement counterparts in total shareholder returns and higher annual net income.” — Kenexa.

Your people are undoubtedly your greatest asset. You may have the best product in the world, but if you can’t keep them engaged and motivated — then it counts for very little.

By making efforts to keep your people engaged, you will maximize your human capital investment and witness your efforts being repaid exponentially.

The benefits of an engaged workforce

Increase in profitability:

“Increasing employee engagement investments by 10% can increase profits by $2,400 per employee, per year.” — Workplace Research Foundation.

There is a wealth of research to suggest that companies that focus on employee engagement will have an emotionally invested and committed workforce. This tends to result in higher profitability rates and shareholder returns. The more engaged your employees are the more efficient and productive they become. This will help lower operating costs and increase profit margins.

An engaged workforce will be more committed and driven to help your business succeed. By focusing on engagement and investing in your people’s future, you will create a workforce that will generate more income for your business.

Improved retention and recruitment rates:

“Replacing employees who leave can cost up to 150% of the departing employee’s salary. Highly engaged organizations have the potential to reduce staff turnover by 87%; the disengaged are four times more likely to leave the organization than the average employee.” — Corporate Leadership Council

Retaining good employees is vital for organizational success. Engaged employees are much less likely to leave, as they will be committed to their work and invested in the success of the company. They will have an increased chance of attracting more qualified people.

Ultimately the more engaged your people are, the higher their productivity and workplace satisfaction will be. This will significantly reduce costs around absences, recruitment, training and time lost for interviews and onboarding.

Boost in workplace happiness:

“Happy employees are 12%t more productive than the norm, and 22% more productive than their unhappy peers. Creating a pleasant workplace full of happy people contributes directly to the bottom line.” – Inc.

Engaged employees are happy employees, and happy employees are productive employees. A clear focus on workplace happiness, will help you to unlock everyone’s true potential. On top of this, an engaged and happy workforce can also become loyal advocates for your company. This is evidenced by the Corporate Leadership Council, “67% of engaged employees were happy to advocate their organizations compared to only 3% of the disengaged.”

Higher levels of productivity:

“Employees with the highest levels of commitment perform 20% better than employees with lower levels of commitment.” — The Society for Human Resource Management (SHRM).

Often your most engaged people will be the most dedicated and productive, which will give your bottom line a positive boost. Employees who are engaged with their role and align with the culture are more productive as they are looking beyond personal benefits. Put simply, they will work with the overall success of the organization in mind and performance will increase.

More innovation:

“Employee engagement plays a central role in translating additional job resources into innovative work behaviour.” — J.J. Hakanen.

Employee engagement and innovation are closely linked. Disengaged employees will not have the desire to work innovatively and think of new ways to improve your business; whereas an engaged workforce will perform at a higher level, due to increased levels of satisfaction and interest in their role. This often breeds creativity and innovation.

If your people are highly engaged they will be emotionally invested in your business. This can result in them making efforts to share ideas and innovations with you that can lead to the creation of new services and products — thus improving employee profitability.

Strategies to increase employee engagement

Communicate regularly:

Every member of your team will have valuable insights, feedback and suggestions. Many will have concerns and frustrations too. Failure to effectively listen and respond to everyone will lower their engagement and negatively affect the company culture.

Create open lines of communication and ensure everyone knows how to contact you. This will create a platform for your people to share ideas, innovations and concerns with you. It will also bridge gaps between senior management and the rest of the team.

An effective way to communicate and respond to everyone in real-time is by introducing pulse surveys — which will allow you to gather instant intelligence on your people to help you understand the sentiment of your organization. You can use this feedback to create relevant action plans to boost engagement and make smarter business decisions.

Take the time to respond and share action plans with everyone. This will ensure your people know that their feedback is being heard and can really make a difference.

Recognize achievements:

“The engagement level of employees who receive recognition is almost three times higher than the engagement level of those who do not.” — IBM Smarter Workforce Institute.

If your people feel undervalued or unappreciated then their performance and profitability will decrease. According to a survey conducted by technology company Badgeville, only 31% of employees are most motivated by monetary awards. The remaining 69% of employees are motivated by job satisfaction, recognition and learning opportunities.

Make efforts to celebrate good work and recognize everyone’s input. Take the time to personally congratulate people and honor their achievements and hard work. You will likely be rewarded with an engaged and energized workforce, that will make efforts to impress you and have their efforts recognized.

Provide opportunities for growth:

Career development is key for employee engagement. If your people feel like their careers are stagnating, or their hard work and emotional investment aren’t being reciprocated — then you can be certain that engagement will drop.

By meeting with your people regularly, discussing agreed targets and time frames, and clearly highlighting how they fit into the organizations wider plans, you can build a “road map” for their future. This will show that their efforts and hard work aren’t going unnoticed.

Improve company culture:

“Customers will never love a company until the employees love it first.” — Simon Sinek.

Building a culture that reflects your brand and creates a fun and productive working environment is one of the most effective ways to keep your employees engaged. It’ll also boost retention and help recruitment efforts. If your culture motivates everyone to work hard, help each other, become brand ambassadors, and even keep the place clean — then you have won the battle.

An engaged and committed workforce is a huge contributor to any organization’s bottom line. The rightculture will be a catalyst to help you achieve this.

Here’s how you can improve the company culture within your organization:

Empower your people: Empowered employees will take ownership of their responsibilities, solve problems and do whatever it takes to help your company succeed. This will drive your company culture forward. Demonstrate you have faith in your people and trust them to fulfill their duties to their best of their abilities. This will ensure they feel valued, which can lead to empowerment.
Manage and communicate expectations: Your people may struggle to understand your cultural vision. By setting clear and regular expectations and communicating your vision via posters, emails, discussions and leading by example, you will prevent confusion and limit deviation from your desired vision.
Be consistent: To sustain a consistent culture, you must show uniformity with your actions and communications. Make efforts to have consistent expectations and standards for all your workers, and communicate everything in the same way.

By focusing on employee engagement and investing in your people, they will repay your efforts with an increase in performance, productivity and — ultimately — profit.

See the original article Here.

Source:

Wedgewood J. (2017 June 8). Why employee engagement matters - and 4 ways to build it up [Web blog post]. Retrieved from address https://www.hrmorning.com/employee-engagement-ways-to-build-it-up/

5 tips to make this the best open enrollment ever

Open enrollment season is right around the corner. Did you know that most people find open enrollment season more burdensome than tax season? As employers begin engaging their employees on healthcare offerings, check out these great tips by Kim Buckey from Benefits Pro on how you can make this year the best open enrollment yet.

Learn from last year’s enrollment

Look back on how your company fared during last year’s open enrollment period.

What were the most time-consuming tasks, and how can they be streamlined this year? What were the top questions asked by employees? Did you achieve your enrollment goals?

Hold a meeting with key internal and external stakeholders on the team and review what worked and what didn’t work last year. Knowing where you are, what your challenges are and will be, and where you’re on the right track will enable you to create a meaningful plan for this year.

Start with strategy

Once you know where you are, figure out where you want to be, how you’re going to get there, and how you’ll determine if you’ve achieved your goals. Make sure your strategy includes:

An assessment of all of your audiences. Remember, you’re not just communicating to employees, you’re reaching out to family members and to managers as well. Keep in mind that not every audience member has the same education level or understanding of even the most basic benefits concepts.
What’s changing. Are you adding or eliminating plans? Is cost-sharing changing? Is there a new vendor? Having a thorough understanding of what’s changing will help determine what your messaging should be.
Defining your corporate objectives. Are you looking to increase participation in a particular plan option, or shift a percentage of your population to a new plan offering? Increase participation in a wellness plan? What percentage? Define your objectives and how you plan on measuring success.
Your overall messages — and any specific messages targeted to your audiences. You may communicate differently to people already in the plan in which you want to increase participation, for example.
A schedule. People need to hear messages multiple times before they “register.” Make sure you’re communicating regularly — and thoughtfully — in the weeks leading up to, and during, the enrollment period.
Media. What messages will you deliver in print (newsletters, posters, postcards, enrollment guides)? What should be communicated in person, through managers or one-on-one enrollment support?

Make this year’s enrollment more active

Eighty percent of Americans spend less than an hour researching benefit options, and 90 percent keep the same plan from year to year. Yet for most employees, their circumstances change annually — whether it be the number of their dependents, their overall health and health care usage or their pay.

Active enrollment — where an employee must proactively choose a plan or go without coverage — can be an important step in getting employees more engaged in their benefits.

Active enrollment has benefits for the employer as well — it provides an opportunity to collect key data (such as current dependent information) and to direct employees to the most cost-effective plans for them.

But helping employees choose the “right” plan requires a robust communication plan, combining basic information about plan options, decision-making tools that address the total cost of coverage (both premium and point-of-service costs) and even one-one-one enrollment support.

Many employees don’t have the information they need to make good decisions, and aren’t likely to seek it out on their own — it must be ‘pushed’ to them.

Take demographics into consideration

When engaging employees around their benefits options, consider the wants, needs, and communication preferences of each demographic. Employees just starting their careers are the most underinsured (and generally least informed) group, often seeing student debt rather than health coverage as a more pressing priority.

A Harris/Accolade poll reveals that when results are broken out by age cohort, workers under 30 are having the greatest difficulty finding their way through the healthcare labyrinth.

Only 56 percent say they are comfortable doing so, compared to 76 percent of retirees. They also report more challenges in making the best care decisions, including understanding cost, coordinating care, choosing and understanding benefits, and finding a doctor they can relate to.

Understand the limitations of decision support tools

Decision support tools enable people to take an active role in managing their health care. While they can certainly help, remember that employees must seek them out and use them, and these tools often assume a level of benefits knowledge your employees might not have.

And, these tools recently have come under scrutiny for their ultimate lack of measurable results. To see the return on investment and value, you must also provide education and communications to provide some context for, and drive usage of, these tools.

By applying these five steps along with setting your team up with designated roles, responsibilities, and deadlines, you’re well on your way toward a more seamless, efficient and effective open enrollment period and to saving both your organization and your coworkers time and money.

But remember, benefits communication isn’t “one and done” at enrollment. You’ll need a year-round plan to help employees make good decisions about their care once they’ve chosen their coverage.

See the original article Here.

Source:

Buckey K. (2017 Aug 25). 5 tips to make this the best open enrollment ever [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/08/25/5-tips-to-make-this-the-best-open-enrollment-ever?page_all=1

5 Crucial Wellness Strategies for Self-Funded Companies

In the article below from Care ATC, you will learn the importance of health care coverage - self-funded or not - and how to leverage different programs to the benefit of your company and its employees. Explore these five strategies for self-insured companies and find what will work best for you.

You can read the original article here.

Instead of paying pricy premiums to insurers, self-insured companies pay claims filed by employees and health care providers directly and assume most of the financial risk of providing health benefits to employees. To mitigate significant losses, self-funded companies often sign up for a special “stop loss” insurance, hedging against very large or unexpected claims. The result? A stronger position to stabilize health care costs in the long-term. No wonder self-funded plans are on the rise with nearly 81% of employees at large companies covered.

Despite the rise in self-insured companies, employers are uncertain as to whether they’ll even be able to afford coverage in the long-term given ACA regulations. Now more than ever, employers (self-insured or not) must understand that wellness is a business strategy. High-performing companies are able to manage costs by implementing the most effective tactics for improving workforce health.

Here are five wellness strategies for self-insured companies:

Strategy 1: Focus on Disease Management Programs

Corporate wellness offerings generally consist of two types of programs: lifestyle management and disease management. The first focuses on employees with health risks, like smoking or obesity, and supports them in reducing those risks to ultimately prevent the development of chronic conditions. Disease management programs, on the other hand, are designed to help employees who already have chronic disease, encouraging them to take better care of themselves through increased access to low-cost generic prescriptions or closing communication gaps in care through periodic visits to providers who leverage electronic medical records.

According to a 2012 Rand Corporation study, both program types collectively reduced the employer’s average health care costs by about $30 per member per month (PMPM) with disease management responsible for 87% of those savings. You read that right – 87%! Looking deeper into the study, employees participating in the disease management program generated savings of $136 PMPM, driven in large part by a nearly 30% reduction in hospital admissions. Additionally, only 13% of employees participated in the disease management program, compared with 87% for the lifestyle management program. In other words, higher participation in lifestyle management programs marginally contributes to overall short-term savings; ROI was $3.80 for disease management but only $0.50 for lifestyle management for every dollar invested.

This isn’t to say that lifestyle management isn’t a worthy cause – employers still benefit from its long-term savings, reduced absenteeism, and improved retention rates – but it cannot be ignored that short-term ROI is markedly achieved through a robust disease management program.

Strategy 2: Beef Up Value-Based Benefits

Value-Based Benefit Design (VBD) strategies focus on key facets of the health care continuum, including prevention and chronic disease management. Often paired with wellness programs, VBD strategies aim to maximize opportunities for employees make positive changes. The result? Improved employee health and curbed health care costs for both employee and employer. Types of value-based benefits outlined by the National Business Coalition on Health include:

Individual health competency where incentives are presented most often through cash equivalent or premium differential:
Health Risk Assessment
Biometric testing
Wellness programs
Condition management where incentives are presented most often through co-pay/coinsurance differential or cash equivalent:
Adherence to evidence-based guidelines
Adherence to chronic medications
Participation in a disease management program
Provider Guidance
Utilization of a retail clinic versus an emergency room
Care through a “center of excellence”
Tier one high quality physician
There is no silver bullet when it comes to VBD strategies. The first step is to assess your company’s health care utilization and compare it with other benchmarks in your industry or region. The ultimate goal is to provide benefits that meet employee needs and coincide with your company culture.

Strategy 3: Adopt Comprehensive Biometric Screenings

Think Health Risk Assessments (HRAs) and Biometric Screenings are one and the same? Think again. While HRAs include self-reported questions about medical history, health status, and lifestyle, biometric screenings measure objective risk factors, such as body weight, cholesterol, blood pressure, stress, and nutrition. This means that by adopting a comprehensive annual biometric screening, employees can review results with their physician, create an action plan, and see their personal progress year after year. For employers, being able to determine potentially catastrophic claims and quantitatively assess employee health on an aggregate level is gold. With such valuable metrics, its no surprise that nearly 51% of large companies offer biometric screenings to their employees.

Strategy 4: Open or Join an Employer-Sponsored Clinic

Despite a moderate health care cost trend of 4.1% after ACA changes in 2013, costs continue to rise above the rate of inflation, amplifying concerns about the long-term ability for employers to provide health care benefits. In spite of this climate, there are still high-performing companies managing costs by implementing the most effective tactics for improving health. One key tactic? Offer at least one onsite health service to your population.

I know what you’re thinking: employer-sponsored clinics are expensive and only make sense for large companies, right? Not anymore. There are a few innovative models out there tailored to small and mid-size businesses that are self-funded, including multi-employer, multi-site sponsored clinics. Typically a large company anchors the clinic and smaller employers can join or a group of small employers can launch their very own clinic. There are a number of advantages to employer-sponsored clinics and it is worthwhile to explore if this strategy is right for your company.

Strategy 5: Leverage Mobile Technology

With thousands health and wellness apps currently available through iOS and Android, consumers are presented with an array of digital tools to achieve personal goals. So how can self-insured companies possibly leverage this range of mobile technology? From health gamification and digital health coaching, to wearables and apps, employers are inundated with a wealth of digital means that delivering a variation of virtually the same thing: measurable data. A few start-ups, including JIFF and SocialWellth, have entered the field to help employers evaluate and streamline digital wellness offerings.
These companies curate available consumer health and wellness technology to empower employers by simplifying the process of selecting and managing various app and device partners, and even connecting with tools employees are already be using.

Conclusion:

Self-insured companies have a vested interest in improving employee health and understand that wellness is indeed a business strategy. High-performing companies are able to manage costs by implementing the most effective tactics for improving workforce health including an increased focus on Chronic Disease Management programs; strengthening value-based benefit design; adopting comprehensive biometric screening; exploring the option of opening or joining an employer-sponsored clinic; and leveraging mobile technology.

Which strategies or tactics are you considering to implement in 2015?

Source:

Spears, T. (2014 December 19). 5 Crucial Wellness Strategies for Self-Funded Companies[Web blog post]. Retrieved from https://www.careatc.com/ehs/5-wellness-strategies-for-self-funded-companies

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