As I was driving my three-year-old to day care the other day, he broke out in song: "A, B, C, D ..." It inspired me to create the 2011 employee benefits alphabet!

Access to relevant data and Benchmarking redefined

The March 2011 EBN article, "PPACA heightens the need to benchmark benefit programs," says "[PPACA] shakes up benchmarking because some businesses will use the data to determine whether they will continue to offer health benefits. Others, however, will use the data to ensure that their health benefits and costs fall in line with certain PPACA mandates, while still remaining competitive." You will want to consider pursuing benefits data that makes the most sense for your organization's goals and initiatives.

Control benefit costs

In a recent survey, 76% of respondents cited the "cost of providing health care benefits to active employees" as among their top five strategic challenges. Odds are, it is one of yours, too.

Discover new plan opportunities

According to an International Foundation of Employee Benefit Plans survey, 46% of corporations offer one or more high-deductible health plan options. The most common arrangement is a high-deductible plan with a health savings account.

Ensure compliance

Federal oversight of employee benefit plans is increasing. Plus, the Health and Human Services' Office for Civil Rights recently announced two HIPAA privacy rule enforcements within one week, including the first-ever use of civil monetary penalties for a HIPAA privacy rule violation. As such, it will be in your best interest to have compliance partners by your side.

Follow legal updates

Between the PPACA, ADA, HIPAA, and GINA, laws affecting benefits are evolving at a breakneck pace, and if you aren't watching the "benefits wire" on a daily basis, you are bound to miss something relevant.

Good news

If your organization is eligible, consider some of the benefit opportunities available within PPACA, including the small-business tax credit and grants for new wellness programs.


The volatility and complexities of state and federal employee benefits, coupled with new implementation requirements, financial modeling initiatives and communication challenges, warrant having strong internal and external resources to help you.

Introduce and Justify employee wellness

According to a Willis survey, 42% of those surveyed strongly agree that their leadership is committed to improving employee health. Bring ideas and supporting data to your executives now.

Keep tabs on carriers

Health insurance carriers are interpreting the PPACA in different ways. Remain cognizant of such decisions and interpretations as you review carriers.

Look internally and Maximize employee retention

Strategically rebuilding employee benefit programs, focusing on what matters most to employees (e.g., setting a reactivation date for company 401(k) match, benchmarking employee premium costs to ensure costs are in line with competition, etc.), should be a top priority for 2011.

Necessary resources and Open dialogue

Implementing employee benefit requirements will not only involve your department, but payroll, finance, legal, HRIS, IT and accounting as well. Ensure these areas understand the twists and turns (e.g., Form W-2 postponement) associated with federal and state benefit requirements.

Perform financial modeling

Whether calculating the financial impact of reform based on decisions already made (grandfathered vs. nongrandfathered) or projecting the financial impact of the play-or-pay provision in 2014, financial experts will become more engaged in the benefits function.

Quantify wellness success

Mercer's "National Survey of Employer-Sponsored Health Plans" finds medical plan cost increases in 2010 were about two percentage points lower, on average, among employers with extensive health management programs than among those employers offering limited or no health management programs. This data provides real return-on-investment hope as you make a business case to introduce wellness to your organization.

Revisit initiatives

Given the fact that greater attention is being paid to employee benefits, bring tabled initiatives to senior management's attention as opportunities to mitigate the cost impact in your organization (e.g., plan funding, plan design, cost sharing, wellness initiatives, etc.).

State legal challenges

A number of states have challenged the constitutionality of PPACA. The prevailing thought is that the U.S. Supreme Court will ultimately decide PPACA's fate. Until told otherwise, keep implementing the respective provisions affecting your organization.

Three degrees of communication

Between educating senior management, working with your functional areas/vendors/carriers, and providing a simple and clear message to your employees, effectively communicating benefits has never been more important.

Understand the Value of employee benefits

Employees consistently rate benefits, especially health care benefits, as one of the key factors in job satisfaction. According to SHRM's "2010 Employee Benefits Research Report," 46% of employees are taking a greater interest in understanding the benefits they receive through their employers. Now is the time to help employees better understand the true value of their benefits.

Waiting game

Patient-but-ready-to-act is your best approach as you wait for government regulatory guidance, including details around the non-discrimination requirement for fully insured, nongrandfathered plans and definition of essential health benefits.

Ex-PPACA provisions

Over the past year, some PPACA provisions have already been repealed, including the Form 1099 reporting requirement and free choice vouchers. It's important to remain cognizant of any repealed provisions, especially if you have taken action to manage the effects of such provisions. For example, if you modeled the financial impact of health care reform on your organization in 2014, you may need to redraft your model given the repeal of free choice vouchers.

Your well-being and Zigzagging through employee benefits

Your role as a benefits professional has become more complex and involved. You will be able to prepare six months in advance for some benefit initiatives, while having to reverse course on proper actions taken for others. It is more important than ever to surround yourself with good resources and talent so you can maintain your workload and sanity.

Contributing Editor Ed Bray, JD, is director of compliance for Burnham Benefits Insurance Services. He helps corporate clients establish and maintain regulatory compliance for their health and welfare benefits plans. He can be reached at

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