Employer Strategies

Employers nationwide - big and small, retail and high-tech - are watching and waiting keenly to see whether the public state exchanges created under health care reform will succeed when they open for business in 2014. Small employers and those with low-paid or part-time employees are especially interested in finding out whether funneling their employees into, or finding coverage for them through, an exchange would be beneficial.

Having spent about 30 years in health care benefits consulting, health plan management and health services delivery, I've witnessed many products, services, strategies and platforms introduced to the employer market, climb to the top of the solutions menu and eventually fade away as more effective alternatives emerge. One very popular solution today is the onsite health clinic.

As a CPA with 20+ years of experience, I'm a big supporter of accountability and company audits. (See a related story on page 10 on benefit plan audits.) Early in my career as an auditor, I made a living by ensuring companies said what they did and did what they said. The Statement on Auditing Standards No. 70: Service Organizations, commonly known as the SAS 70, has been an industry staple since its issuance in 1992 and a requisite for service providers to test internal controls.

Not complying with current law can be expensive in today's legal climate. Thus, employers should review their employee handbooks and employment-related policies to make sure they are up to date. More importantly, though, employers should draft their handbooks so their employees actually read them and follow their policies.

As a professional who assists in conducting hundreds of employee benefit plan audits each year, I have seen everything and heard so many lame excuses for the errors that we find. Some infractions range from plans allowing participation to ineligible participants, to not allowing eligible participants to participate timely, or even at all. Although the list of mistakes plan sponsors make is a long one, there are three common errors noted during our audits

Some employers are investing more time and resources to find out whether workers are tobacco-free and in the process are rewarding those who pass muster with lower health premiums or financial rewards.

In guidance issued on March 18, 2011, the U.S. Department of Labor: • extended the enforcement grace period previously provided for some of the new requirements relating to internal claims and appeals that are imposed on group health plans and health insurers under the Patient Protection and Affordable Care Act (PPACA), and • relaxes in some cases the prior requirement that plans and insurers must be working in good faith to implement the new requirements in order to take advantage of the grace period.

It’s no surprise that unhealthy employees cost employers big bucks. But a new workforce wellness index shows that the unhealthy behaviors of the U.S. workforce cost employers an average of $670 per employee annually.

Even though 68% of workers are saving for retirement, nearly half (46%) have less than $10,000 saved for retirement, and 50% are not confident they will have enough money to live comfortably in retirement, a survey by the Employee Benefits Research Institute found.

A new statewide survey by the Georgia Association of Physician Assistants is stirring debate about the extent to which insurance protocols serve as harmful barriers to patient care or necessary cost controls.