Top 10 catastrophic claims for self-funded employers
Great read on what may impact your self-funded plan by Jack Craver. See results from the study below.
Original Post from BenefitsPro.com on July 13, 2016
There are a range of illnesses that can prompt a self-funded employer to make a claim on their stop-loss insurance policy, but a new study by Sun Life Financial Inc. finds that a majority (53 percent) of the $5.3 billion in such claims paid by insurers from 2012 to 2015 came from 10 ailments.
The study shows the incredible impact of cancer. All types of cancer account for more than a quarter of all stop-loss claims, with breast cancer alone accounting for 13 percent of the total reimbursements.
Claims that exceeded $1 million continue to be rare — only 319 during the four-year period — but they account for nearly a fifth of the total reimbursements.
They have also steadily increased every year, from 60 in 2012 to 107 in 2015. The number of claims exceeding $2 million, however, has not risen steadily, jumping from two to 20 in 2013 but then dropping again in the subsequent two years.
"By highlighting the conditions that create catastrophic claims and providing insights into trends influencing high costs, we can help employers anticipate what they'll see when self-funding and raise awareness about the importance of cost-containment resources and stop-loss insurance,” says Brad Nieland, vice president of Sun Life Financial’s stop-loss division, in a press release.
Here are the top 10 ailments associated with self-funded employer claims:
10. Septicemia
A condition that arises when the body reacts violently to an infection, damaging critical organs in the process and in the most severe cases leading to septic shock, septicemia resulted in $54.7 million in reimbursements between 2012 and 2015, or 2.4 percent of the total.
9. Respiratory failure
Pulmonary collapse or respiratory failure was the ninth leading claim for self-funded employers, resulting in $55 million in reimbursements from stop-loss insurance policies. Risk factors for the condition include binge-drinking, smoking, and working in an environment that leads to inhalation of chemicals that irritate the lungs, all issues that employers can have a hand in improving.
8. Cerebrovascular disease
Most commonly manifested through a stroke, cerebrovascular disease or blood brain vessels prompted $57.4 million in reimbursements between 2012 and 2015, for 2.4 percent of the total. Although strokes are the fifth leading cause of death for Americans, but two-thirds of stroke patients are over the age of 65, suggesting the burden of caring for stroke patients falls mostly on Medicare, rather than employers.
7. Congestive heart failure
The condition that afflicts roughly 2 percent of the adult population and 5 percent of those age 60-69 resulted in $57.8 million in reimbursements from catastrophic insurance policies in 2012-15, accounting for 2.5 percent of the total.
6. Transplants
Transplants are becoming more common than ever, but the good news is that the operations are not as likely to force catastrophic coverage. While transplants increased 65 percent between 2012 and 2015, the total amount of stop-loss reimbursements paid because of transplants only ticked up 0.7 percent compared to 2011-14, to $62.2 million.
5. Premature births/low birth weight
Babies that are born prematurely and have to undergo long hospital stays in incubators or other treatment can prompt astronomical costs for patients and their employers. From 2012 to 2015, employers received $75 million in reimbursements related to such costs incurred by employees, or 3.2 percent of the total.
4. Congenital anomalies
The top claim that specifically relates to a condition at birth, congenital anomalies prompted $96.3 million in reimbursements from 2012 to 2015, holding relatively steady from the 2011 to 2014 period. That accounts for 4.1 percent of total reimbursements.
3. Chronic renal disease
Employers received $156 million from claims related to severe disease of the kidneys, accounting for 6.7 percent of the total. That is a 1 percent decrease from the 2011 to 2014 period. While the costs of treating the condition have decreased 21 percent in the past four years, the disease remains common and costly nonetheless. According to some estimates, chronic renal failure as much as 10 percent of the population, but it is the later stages of the condition that are the most severe and the most costly, often resulting in kidney transplants.
2. Leukemia/lymphoma/multiple myeloma
The second family of cancers is the No. 2 claim for catastrophic insurance. Its financial impact is great, but much smaller. Employers received $188 million between 2012 to 2015 from stop-loss reimbursements related to these conditions, accounting for 8.1 percent of total claims nationally. The value of such claims has remained steady in recent years.
1. Malignant neoplasm
The leading type of cancer is by far the leading reason that employers make claims on their stop-loss policies. These types of cancer accounted for 18.5 percent of all stop-loss claim reimbursements from 2012 to 2015, the study found, totaling a whopping $429 million. That represents a 0.9 percent increase over the 2011 to 2014 period.
See Original Article Here.
Source:
Craver, J. (2016, July 13). Top 10 catastrophic claims for self-funded employers [Web log post]. Retrieved from https://www.benefitspro.com/2016/07/13/top-10-catastrophic-claims-for-self-funded-employe?ref=hp-in-depth&page_all=1&slreturn=1468939510
Core Benefits Drive Satisfaction More Than Niche Offerings
Original Post from SHRM.org
By: Stephen Miller
Improving traditional core benefits could be the best way to increase employees’ satisfaction with their rewards mix, new research suggests.
The three offerings with the greatest effect on how employees rate their benefits are health insurance, 401(k) retirement plans and vacation/paid time off. Among these, health insurance was by far the biggest driver of employee satisfaction, according to a new study, Which Benefits Drive Employee Satisfaction?, from Glassdoor Economic Research, the research arm of career website Glassdoor.
At organizations where employee ratings of the employer-provided health coverage increased by 1 star (out of 5), there was also a statistically significant increase in average employee satisfaction with the overall benefits package. (See graph above, from Glassdoor Economic Research. *Denotes that the increase in the overall benefits rating was statistically significant.)
Notably, 4 in 5 U.S. workers report they prefer new benefits or perks to a pay raise. This finding supports a recent Glassdoor survey that found health insurance, paid time off and 401(k) plans are among the top benefits employees would prefer over a pay increase.
Benefits with Narrower Appeal
Two benefits that did not seem to have a significant impact on overall employee satisfaction were maternity/paternity leave and employee discounts.
“Though many employers have added generous maternity/paternity leave plans, it is possible benefits that are not used by a large subset of employees do not impact overall benefits package satisfaction,” the researchers suggested.
“We know benefits and perks are an important recruiting tool in today’s challenging hiring landscape, and this study shows that the flashiest or trendy benefits aren’t always better,” said Andrew Chamberlain, chief economist of Glassdoor. “Investing in core benefits programs like health care coverage, retirement plans and paid time off will go far with new and current employees. Other benefits, like maternity/paternity leave, are important to recruit and retain smaller subsets of employees—like new parents—though we saw little impact on overall satisfaction related to benefits that don’t touch a wide variety of employees.”
He advised, “Employers who have well-rounded compensation plans that include core benefits, fair and competitive pay, and desirable perks stand to attract and retain top talent.”
A separate Glassdoor Economic Research study, The Best Industries for Benefits, found that the best benefits packages, according to employees, are found in the finance and technology industries.
Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.
Have You Taken Any PTO Lately?
Original post benefitspro.com
Americans might be workaholics, but not necessarily because they’re in love with work. Studies show Americans yearn for vacation time, but some of them can’t bring themselves to take it.
A survey commissioned by Namely, a payroll and benefits company, finds that a majority of U.S. workers intend to take 15 days of vacation per year. It also found that 40 percent of employees have or would be willing to sacrifice pay to gain more paid time off. Similarly, more than two-thirds of workers said that vacation policies were at least somewhat critical when considering a new job.
But as a statement accompanying the survey from the company points out, another recent study found that the average American worker only take 11 days off per year.
The lower average is largely driven by the fact that many employees receive far less than three weeks of vacation a year, but there is some evidence to suggest that some workers who are entitled to generous PTO do not make use of it.
A quarter of workers in the Namely survey cited strict company policies as an obstacle to taking vacation, while a fifth cited “stress at the thought of missing time at work” and 16 percent reported a “negative perception” in their organization of taking time off.
“What this tells us is that despite the best intentions to take large chunks of time away from work and unplug from technology, employees are feeling confined and are using vacation time differently than previous generations,” said Matt Straz, founder and CEO of Namely.
In recent years, a number of major companies have made a point of offering generous vacation benefits. Some offer unlimited vacation, while others have put in place policies to encourage workers to make use of their vacation, including bonuses for taking time off.
Technology: Talking to a Financial Coach Reboots Financial Wellness and Narrows Gender Gap
Original post businesswire.com
In a year marked by increased market volatility and slow economic growth, it’s not a surprise that overall financial wellness levels remained virtually unchanged. Employees appear stuck, hitting a brick wall with debt, lack of emergency funds and inadequate retirement savings. However, the latest study from Financial Finesse shows that the way forward to improved employee financial wellness – and to narrow the financial Gender Gap – could be human-to-human coaching, with technology playing a supporting role.
The Year in Review: 2015, an analysis of employee financial trends based on anonymous data collected by workplace financial wellness firm Financial Finesse, describes a year where most employees have been treading water in terms of their financial wellness. Overall financial wellness levels were unchanged at 4.8 out of 10 vs. 4.7 in 2014.
The study shows that while technology was helpful in increasing employee awareness of their financial vulnerabilities, online interactions alone did not improve employee financial wellness. By contrast, employees who had five interactions including conversations on the phone or in person with a financial planner professional showed substantial progress. Those repeat interactions with a financial coach appear to help an employee get “unstuck,” and advance in key areas. For these regular participants:
- 80% have a handle on cash flow, compared to 66% of online-only users
- 72% have an emergency fund, compared to 50% of online-only users
- 98% contribute to their retirement plan, compared to 89% of online-only users
- 48% are on track for retirement, compared to 21% of online-only users
- 64% are confident in their investment strategy, compared to 42% of online-only users
Employers who offer financial wellness programs consider tailoring communications to address these vulnerabilities in particular:
- 58% may not be saving enough for retirement, with only 16% of Millennials on track to achieve their retirement goals.
- 51% don’t have an emergency fund. While this declines with age, a worrisome 25% of employees 65 and older still don’t have an emergency fund.
- 34% may be living beyond their means. For employees with family incomes of $100,000 or lower, less than half pay off their credit cards every month.
- 33% may have serious debt problems. Debt may be hurting African American and Latino employees the most, with 75% of African American and 66% of Latino employees saying getting out of debt is a top concern.
- Concern over market volatility is high. Many employees grew nervous about their retirement plan savings and turned to their financial wellness program for guidance on how to handle these market fluctuations.
Percent of Plans Offering HRA/HSA Option Plummet
Original post benefitspro.com
A study of some 10,000 employer sponsored plans by United Benefit Advisors of health plans revealed that about 24 percent of all health plans offered either an HSA or HRA component — a 29 percent decrease in the number of health plans nationally. That drop indicates that plan designers and health plan sponsors are still out of sync on the value of these accounts.
“Faulty plan design, in some instances, has led to smaller pricing gaps between traditional plans and HSA compatible plans,” says Steve Salinas, benefits advisor at Bridgeport Benefits, a California-based UBA Partner Firm. “Many insurers have added stipulations to their contracts disallowing employer-funded accounts in the presence of a high deductible plan.”
UBA’s data supports the overview that “enrollment and contributions to these account-based plans varied wildly based on employer size, industry, and region.”
It offered a large employer/small employer illustration of this near-chaotic situation. “While large employers typically offer the lowest contributions to account-based plans, companies with 200 to 1,000+ employees saw the most dramatic increases in enrollment, ranging from 50 to 90 percent over the last three years.”
In some respects, plan designers and consumers in California may be closer to figuring out how to design plans with HRAs and HSAs that strike a balance between the objectives of all three parties. California offers the best HRA and HSA plans for singles and families.
- California leads the country with the highest HRA contributions for singles, which average $2,288;
- California is the only region in the country that increased contributions over the last three years, making them the most generous in the nation by contributing $981 to singles and $1,789 to families;
- Families in California receive the second highest average family contribution to HRAs at $3,950, a 13 percent decrease from three years ago when they led the nation at $4,537;
- The average employer contribution to an HSA was $491 for a single employee and $882 for a family.
“In California, health insurance costs are so high that employees very often gravitate to the lowest cost options, typically the HSA-compatible high deductible plans,” says Keith McNeil, benefits advisor at Arrow Benefits Group in California, a UBA Partner Firm. “HRAs have been under health plan scrutiny due to the trend of self-insuring the high deductible through an HRA, which the health plan believes raises the cost of their plans. They have threatened penalties for non-compliance. So in the small group market, it has been much easier to simply offer HSA compatible plans and include the HSA as an option to members.”
“Large employers (1,000+ employees) have not typically offered competitive HRA or HSA plans because they are able to offer other types of more generous plans,” says Les McPhearson, CEO of UBA. “But this is the sector to watch: If they see the kind of double-digit cost increases other employer groups already have, they may have no choice but to offer more attractive HRA and HSA plans in an effort to control costs.”
Seeking mindfulness at work: Helping employees find focus
Originally posted May 12, 2014 on https://hr.blr.com.
New research by Steelcase shows that 41 percent of workers report not being able to concentrate easily, while the average person loses 86 minutes per day due to distractions.
The recent 14-country Steelcase/Ipsos study conducted as part of its wellbeing research revealed the growing lack of mindfulness in the workplace. The workplace research addressed how the physical environment can support or hinder mindfulness, along with five other dimensions of wellbeing. The researchers found that the physical environment offers behavioral cues that can promote, or hinder, employee's physical, cognitive and emotional states and long-term health.
Only 59 percent of employees reported their environment enabled them to feel relaxed and calm, while only 58 percent reported being able to work in teams without being interrupted or disturbed. Nearly half of all workers surveyed reported not having adequate spaces that support mindfulness and focus. Ongoing Steelcase research also found that workers in North America lose 86 minutes per day due to a variety of distractions in the workplace.
"Mindfulness means balancing the intense pace of life with being fully present in the moment," said Donna Flynn, director of Workspaces Futures at Steelcase. "With the proliferation of technology and growth of distributed work across time and space, workers are facing unprecedented distractions combined with pressures to be always on, leaving them stressed, tired, and overwhelmed. Healthy and mindful employees are a competitive advantage in today's business world, but to achieve it workers need supportive environments that give them the emotional capacity to interpret and experience events in a way that leads to productive, positive actions."
The Steelcase researchers identified and developed design concepts that companies can incorporate into their workplace to help encourage mindfulness by enhancing employees' ability to concentrate and make thoughtful choices amid distractions and disturbances.
Steelcase key ideas when designing for mindfulness include:
- Offer spaces where people can seek solitude and respite, or connect with others without distractions or interference.
- Design areas that allow workers to control the amount of sensory stimulation they are exposed to and enable them to amp it up or down.
- Create spaces that help people stay focused as they interact with others one-on-one and eye-to-eye
- Offer places that are calming, through the materials, textures, colors, lighting and views.
"Given the mental fatigue that comes with high cognitive load, workers need physical spaces that help them manage the cognitive load and be fully present in the moment," says Beatriz Arantes, senior researcher and environmental psychologist with Steelcase Workspace Futures.
Employers more flexible on telecommuting
Originally posted April 30, 2014 by Dan Cook on www.benefitspro.com
Are company executives all taking yoga? How else to explain the increased flexibility showing up in the workplace?
A study from the Society for Human Resource Management and Families and Work Institute — the 2014 National Study of Employers — indicates that corporate policies about how, when and where people work is loosening up in a number of ways.
The massive study contains considerable detail on trends in the workplace, comparing what’s happening today to what was going on in 2008. And, in just the space of six years, significant policy changes were identified.
For instance, telecommuting is becoming commonplace at two-thirds of workplaces. Earlier studies have demonstrated that telecommuting doesn’t diminish one’s productivity, and may even enhance it. Further, the courts are starting to endorse it as a reasonable accommodation for certain workers.
The SHRM/FWI data reveals that, while 50 percent of respondents in 2008 said they permitted at least some employees to occasionally work some paid hours remotely, in 2014, 67 percent offer the option to at least some workers occasionally.
In 2008, 23 percent of respondents said they offered telecommuting as a regular option; by this year, that percent had climbed to 38 percent.
Other signs of increased flexibility showed up in these comparisons of 2008 responses to 2014 input:
- Workers have control over breaks (from 84 percent to 92 percent);
- workers have control over overtime hours (from 27 percent to 45 percent);
- workers can take time off during the workday when important needs arise (from 73 percent to 82 percent);
- workers have control of starting and quitting times on daily basis: 38 percent vs. 41 percent.
In some areas, the study showed, employers have reduced flexibility. For instance:
- sharing jobs fell from 29 percent in 2008 to 18 percent;
- working part-year on an annual basis dropped from 27 percent to 18 percent;
- sabbaticals as a flex option fell from 38 percent to 28 percent;
career breaks for personal or family responsibilities dipped from 64 percent to 52 percent.