This year's Benefits Forum & Expo, held in New Orleans, was a great opportunity for readers to meet and interact with industry experts, take part in interactive workshops and get hands-on training on getting a jump on the upcoming rollout of more of the ACA provisions. Of course, there's never a bad reason to head down to the Big Easy for a couple of days, and attendees and presenters also enjoyed the Crescent City's historic backdrop to learn more about the strategies they can take in handling the sure-to-be-exciting months ahead. Here are three snapshots of sessions from the event.

-Andy Stonehouse, Editor-in-Chief



Health on wheels: Improving the lives of our workers

By Kathleen Koster

The workplace strategy for health improvement can be expressed as a cycling metaphor where cyclists struggle with the uphill stretches and use caution to coast on downward slopes. Gary Earl, former vice president of benefits and health care for Caesars Entertainment Corporation, suggests employers can learn from the cycling world when developing their wellness strategies.

"Our job [as HR professionals] is to improve the lives of human beings. We're responsible for that," said Earl, who is the founder and team captain of Journey for Health Tour, for which he and his team are cycling 3,000 miles across America to promote health improvement.

While working for Caesars, Earl transformed the company's outlook on wellness programs and health benefits, taking them from a cost-only perspective to an asset for the workforce and business.

"[My employer's] vision was the traditional vision: to offer affordable benefit plans to employees and to reduce costs. We turned that upside down. We wanted to move it from an expense to an asset," he said.

To prove his strategy would improve the population's health, he developed a mathematic equation to show company executives the value in this paradigm shift.

That equation illustrated how employees' positive health experience and positive attitude generates an increase in productivity, sustainability and satisfaction, which would lead to an improvement in company earnings.

"We have to look at health benefits as an opportunity, an asset," Earl stressed.

Earl believes HR and benefits professionals need to hold themselves accountable to improving population health and always passionately advocate wellness - not simply view this responsibility as part of a dry job description.

"Over time, we have created the problems afflicting our health system, and it's our responsibility as a community to fix today's prevalent issues," said Dr. David Whitehouse, M.D., chief medical officer, UST GLOBAL, and a fellow panelist at the session.

"The ecosystem of health and the obesity epidemic exist because of modernization. During World War II there were food shortages, and we developed preservatives [to make our food last longer]. We then wanted to make our lives more convenient, so we developed transport, and we stopped exercising and walking. We have, in fact, through modernization and our own design for comfort, created the epidemic," said Whitehouse.

Earl agreed, adding that health issues such as obesity "can't be viewed in isolation. They are systematic problems, which means that they are interconnected and interrelated. We need to approach this by connecting all aspects of the community, whether it's faith, safety, education, business or economic development - there's a real balance to be able to draw them all together."

He added that business owners can be instrumental in driving this change. "They don't own that change, but they can be a catalyst. Coming together in uncommon ways, but for a common purpose, stimulates the change," he said.

Employers and company leaders must connect with communities to make significant change. Applying the cycling metaphor again, Earl said that benefits professionals need to encourage each other when facing uphill challenges and learn from one another. And for those downhill stretches, Earl explained that, in cycling, you don't ever stop pedaling because "you want to keep that leg-mind momentum going." Likewise, employers must also use caution to stay in control of their wellness initiatives and keep forward momentum without swerving off the road.

"You're not going to improve an individual's health without understanding what those social and environmental elements are," Earl said. "You have to put in the energy."

Employers can align medical groups and local systems by working with the community. They create customized approaches through patient-centered medical homes, on-site clinics or accountable care organizations. Whatever employers develop within the community, they must work together to fix the dramatic health issues Americans struggle with.

"If we don't overcome our shyness and work collaboratively then we will live with the misfortunes of our unintended consequences," said Whitehouse.


Massive upcoming changes require better communication

By Andrea Davis

The monumental change - and opportunity - presented by the Affordable Care Act was a recurring theme at this year's BFE.

"I don't believe that we've ever seen the potential of a change to how benefits are offered and administered in the United States as significant as what we're witnessing today," said Teresa White, executive vice president and chief operating officer with Aflac Columbus, during her keynote speech. "That's why this year is very crucial for all of us. The decisions that we make now, and the actions that we take in implementing, educating and communicating all of the changes will have long-lasting impact in all of our organizations."

Her sentiments were echoed by others, including Michael L. Millenson, president of Health Quality Advisors LLC, who believes changes brought about by the ACA threaten what benefits professionals do.

"Whether that threat turns into opportunity is really based on your knowledge," he said during a separate panel discussion, and emphasized the law is "a professional opportunity to make a difference for your company and for your workers that, literally, has not come along since World War II."

And employers that don't have a plan for helping workers understand what health care reform means for them could be in for a rude awakening, said White.

"If you think that your employees aren't expecting you to assist them, I think you're sorely mistaken, because they're depending on employers to assist them through this process," she said.

Indeed, 75% of employees surveyed by Aflac for its annual workforces report agree with the statement: "I believe my employer will educate me about changes to my health care coverage as a result of health care reform."

There are two phases to reform, said White: compliance and implementation.

"We are all trying to comply with the law," she said. "However, most employers aren't focused on the second phase, and that is actually implementing the changes and teaching the employees about those decisions. Most employers aren't focused on this and really need to be."

To try to better engage employees in their benefits programs, she suggested employers learn from the world of marketing and use the four Ps associated with that industry: the right product, at the right price, in the right place, with the right amount of promotion.

"Historically, the benefits department did all of the analysis and all of the selection," she said. "Now, we are attempting to help the employees understand how to engage in this process."

Sixty-five percent of workers in an Aflac survey said their employer only communicates about benefits at open enrollment or new hire enrollment and "we need to change that," said White.



Restaurant association shows that exchanges can be successful

By Tristan Lejeune

What's the first thing any employee asks about changes to his or her health care offerings? The most important thing to them is always: "Do I get to keep my doctor?"

One of the best things about a full-service private exchange is that it allows for highly local tailoring and solution finding, so providers, as well as physicians and everything in between, can be selected to fit.

This is particularly true of groups like the National Restaurant Association, said health consultant Randy Spicer, speaking to a standing-room-only crowd at BFE. The "other" NRA is more than 100 years old and it runs from "mom-and-pop operations" to massive chains, representing more than 380,000 restaurant locations.

"Our view of the Affordable Care Act, our view of global benefits, is just a little different," Spicer says. "So we started out trying to figure out how we help the largest membership."

Working on an unbundled basis, the restaurant association is trying to serve the needs of workers ranging from C-suite execs to part-time busboys and dishwashers. Spicer and the NRA think that private exchanges work especially well for the hospitality, retail and service industries, with this wide range of employee models and work schedules.

"You've got to figure out, 'How am I going to provide a solution that improves things without raising cost?'" Spicer asks. "Keeping within our traditional roles as we work in this marketplace is real important, so we're trying to leverage traditional benefits solutions, convert them as a company into multiple exchange options."

Any exchange, public or private, will eventually service the previously uninsured. Communications and presentation are key, Spicer says, particularly when dealing with employees who may never have had health care coverage before. Choices and interface may have to be educational, not just clear and concise.

"A big part of our customer base are the individuals in companies of less than 50 - the 'mom and pops' - and in our industry, you question whether it's best if they even offer a plan," he says. "The vast majority of those employees wouldn't even be eligible, most likely, or could get assistance on the federal exchanges, but connecting those individuals [with their best options] is part of our exchange model."

Notification on the ACA public exchanges should long since have gone out, but don't forget to inform new hires. The requirement to notify comes with each new employee - an important issue in an industry with as much turnover as food service - and it is not voluntary, even though the Labor Department says it comes with no fine; you have 14 days from an employee's start date.

"In our industry," Spicer says, "when we send out notifications to homes, 40% of them come back 'Addressee not known,'" so don't forget the communication challenges specific to your organization. Providing notice means actually reaching the worker, and it's always a good idea to have proof of that.

"We intend to keep those records indefinitely," Spicer says. There's no penalty yet, but it's possible that some day, when the uninsured are running up tremendous costs in the emergency room, the doctor will say, "'Don't you work somewhere, why don't you have coverage there?' 'Well, I work part-time.' 'Why didn't you go to the exchange? At your income level, you could have gotten really good coverage.'" And, eventually, it could be the employer who gets in trouble for lack of notification.

Organizations with franchise structure need to be particularly careful about compliance, Spicer says. Know the responsibilities of corporate versus local offices and make sure everyone stays in line. What's more, trust your local offices to know the needs of their population best and don't be afraid to reach out to public exchange navigators, either.

Can others get in on the NRA's private exchange? Unfortunately, not yet.

"In spite of my best efforts," Spicer says, "we're still member-only."

He added: "But if you're really big, come and talk to us."

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