The 2015 ABC's of employee benefits
December 15, 2014 7:22 AM
Ed Bray, senior vice president, compliance at Ascension Benefits and Insurance, offers up the 5th annual edition of the ABCs of employee benefits. Here, he covers A to M.
[Image: Fotolia]
[Image: Fotolia]
Act now.
Although complying with the 2016 Affordable Care Act IRS reporting requirement seems like a lifetime away (given everything else on your plate), start preparing for it now for the following reasons: 1) You may not have the required employee (and potentially dependent) information to be reported; 2) Your systems/vendors may not be prepared to provide the required information; and 3) You want to enjoy your 2015 holidays. Plus, you do not want to complete an IRS form incorrectly.
[Image: Fotolia]
[Image: Fotolia]
Budget appropriately.
Annual health insurance budgets have been impacted by significant new costs associated with the ACA. Your 2015 budget could include PCORI and transitional reinsurance fees as well as internal/external support costs associated with preparing for the IRS reporting and play-or-pay measurement requirements. Work with your broker and finance department to determine and estimate the ACA costs that will impact your organization in 2015.
[Image: Fotolia]
[Image: Fotolia]
Consider wellness initiatives.
According to the 2014 PwC Health and Well-being Touchstone Survey, 71% of employers offer wellness programs (up from 68% in 2013). Focus on gathering and analyzing as much employee data as allowable by law (through health risk assessments, biometric screenings, self-insured claims, etc
) to determine which types of wellness initiatives will have the biggest productivity and cost control impact on your population.
[Image: Fotolia]
[Image: Fotolia]
Determine if self-insurance is right for you.
Some 59% of employers with 500-1,000 employees are self-insured, up from 55% in 2013, according to the 2014 PwC Health and Well-being Touchstone Survey. This is not surprising given the increased flexibility afforded to employers who are self-insured, especially around state laws and the ACA requirements. Plus, specific and aggregate stop loss is available to minimize exposure and risk. If you are a mid-sized employer with fully-insured plans, running a self-insured cost/benefit analysis may be beneficial.
[Image: Fotolia]
[Image: Fotolia]
Expect more from your broker.
If your broker is not providing comprehensive compliance, administrative, communications, and analytical guidance and support, its time to hire a new one. You are already busy enough in your day job and the upcoming employee benefits requirements will be overwhelming to even the most seasoned benefit professionals. Its a buyers market and theres a very good chance you will find a quality firm to support you in all of these areas at the same (or less) fee than you are paying now.
[Image: Fotolia]
[Image: Fotolia]
Follow state and local laws.
With so much attention being paid to federal benefits compliance (ACA, HIPAA, etc.), its easy to miss the fact that some states and cities are enacting their own legislation (e.g., paid sick leave laws, same-sex marriage opportunities, health care ordinances, etc.). As such, ensure you have the resources in place to assist you with following state and local laws.
[Image: Fotolia]
[Image: Fotolia]
Growing interest in telemedicine and technology.
37% of employers are expected to implement telemedicine (exchange of medical information to improve health using two-way video, email, smart phones, etc.) by 2015 with another 34% considering doing so by 2017, according to Towers Watsons 2014 Health Care Changes Ahead Survey. Depending on your demographic, this could be a great opportunity to save health insurance costs by minimizing office and hospital visits.
[Image: Fotolia]
[Image: Fotolia]
HIPAA never sleeps.
While the primary focus in 2013/14 was on omnibus rule compliance, the attention has switched to Health Plan Identifiers. While the government has currently suspended enforcement of the HPID requirements, it will likely be lifted at some point and you will need to obtain an HPID if you offer a self-insured plan.
[Image: Fotolia]
[Image: Fotolia]
Increase in PTO plans.
58% of organizations, compared to 47% in 2010, offer PTO plans allowing employees to better budget their time out of the office, according to the 2014 Employee Benefits: A Research Report by the Society for Human Resource Management. If you are analyzing the pros and cons of moving to a PTO plan, dont forget to review how state and local laws, especially the paid sick leave laws, will impact your PTO plan.
[Image: Fotolia]
[Image: Fotolia]
Just waiting and wondering.
Between continuing to wait for the ACA nondiscrimination rules for fully insured, nongrandfathered plans and automatic enrollment provision regulations (including an effective date) and wondering what impact the new Republican-led Congress will have on the ACA, uncertainty will continue into 2015. Keep an ear to the ground as there could be some significant developments over the next year.
[Image: Fotolia]
[Image: Fotolia]
Keep the C-Suite satisfied.
According to Towers Watsons 2014 Health Care Changes Ahead Survey, two-thirds of CEOs and CFOs will be more directly involved in health care strategy decisions than they were three to five years ago to help control costs and reduce exposure to the 2018 Cadillac tax. If you would like to continue holding the organizations health insurance reins, you will need to learn how to speak your CEO and CFOs languages and proactively communicate and present the ACAs impact on organization health care costs, including the actions you propose taking to mitigate such costs. Your broker should be able to assist.
[Image: Fotolia]
[Image: Fotolia]
Learn new strategies.
Employers are starting to seriously evaluate value-based payment methods, where payment is based on criteria for improving efficiency, quality, and outcomes (29% for 2015), plus the use of value-based designs and differentials that drive employees to high performance or narrow networks for medical care (14% will use value-based designs by 2015 and 20% will offer benefit differentials by 2015), according to Towers Watsons 2014 Health Care Changes Ahead Survey. Evaluate whether any or all of these are viable strategies for your organization.
[Image: Fotolia]
[Image: Fotolia]
Mitigate costs.
According the 2014 HR@Moore Survey of Chief HR Officers, companies are taking the following approaches to help mitigate rising health care costs: have moved or will move employees to high-deductible health plans (73%), have raised or will raise employee health insurance contributions (71%), have or will move their pre-65 retirees to ACA exchanges (30%), have or will cut back coverage eligibility (27%), have or will more rigorously ensure part-time workers work fewer than 30 hours per week (24%), have or will increase the proportion of part-time workers (12%), and have or will limit the number of full-time hires (10%). You may find these approaches valuable when developing short- and long-term cost mitigation strategies for your organization.
[Image: Fotolia]
[Image: Fotolia]
