More pay? Nah. Employees prefer benefits

Are you considering raising salary and cutting back on benefits? A new report reveals that workers would choose a job that offers benefits over a job that offers 30 percent more salary but does not offer benefits. Read on to learn more.


Workers across the country say you can't put a price on great benefits, according to a new survey.

By a four-to-one margin (80% to 20%), workers would choose a job with benefits over an identical job that offered 30% more salary with no benefits, according to the American Institute of CPAs, which released the results of its 2018 Employee Benefit Report, a poll this spring of 2,026 U.S. adults (1,115 of whom are employed) about their views on workplace benefits.

“A robust benefits package is often a large chunk of total compensation, but it’s the employees' job to make sure they’re taking advantage of it to improve their financial positions and quality of life,” said Greg Anton, chairman of the AICPA’s National CPA Financial Literacy Commission. “Beyond the dollar value of having good benefits, employees gain peace of mind knowing that if they can take a vacation without losing a week’s pay or if they need to see a doctor, they won’t be responsible for the entire cost.”

Employed adults estimated that their benefits represented 40% of their total compensation package, according to the study. The Bureau of Labor Statistics, though, states that benefits average 31.7% of a compensation package. Still, workers in the report see benefits as a vital part of their professional lives.

“Despite overestimating the value of their benefits as part of their total compensation, it is concerning that Americans are not taking full advantage of them,” Anton said. “Imagine how employees would react if they were not 100% confident they could get to all the money in their paycheck. Leaving benefits underutilized should be treated the same way. Americans need to take time to truly understand their benefits and make sure they’re not leaving any money on the table.”

Other notable findings from the report include:

  • 63% of employed adults believe that being their own boss is worth more than job security with an employer, while 18% added that they will likely start or continue their own businesses next year.
  • Millennials were the most likely generation to believe that being their own boss is worth more than job security. They were also the most likely generation to start their own businesses.
  • 88% of employed adults are confident they understood all the benefits available to them when they were initially hired at their current job. However, only 28% are "very confident" they are currently maximizing all of their benefits.
  • When asked which workplace benefits would help them best reach their financial goals, 56% of adults said a 401(k) match or health insurance, with 33% citing paid time off and 31% citing a pension.
  • Baby boomers favor health insurance and having a 401(k) match more than younger generations, while 54% of baby boomers also prioritized a pension, versus only 16% of millennials.
  • Millennials put the highest priority on work-life balance benefits, such as paid time off, flexible work hours, and remote work.

For the full report, visit the AICPA’s 360 Degrees of Financial Literacy site here.

SOURCE: McCabe, S. (3 December 2018) "More pay? Nah. Employees prefer benefits" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/workers-prefer-benefits-over-more-pay?brief=00000152-1443-d1cc-a5fa-7cfba3c60000


Creating a Culture of Recognition

Are you recognizing your employees for their hard work? Businesses can experience a rise in engagement, productivity and retention when employees are recognized for their work. Read on to learn more.


When employees are recognized for their work, employers can see gains in engagement, productivity and retention.

But such efforts must be more than a one-time event; to really enjoy the benefits, employers need a culture of recognition, experts say. This has to start at the top and include clearly defined company values.

Live the culture you want

"A purposeful, positive, productive work culture doesn't happen by default — it only happens by design," S. Chris Edmonds, founder of The Purposeful Culture Group, told HR Dive via email.

And while HR can influence culture, a recognition culture must start at the top, experts say. And it must be part of an employer's performance management strategy.

Management can signal what's important, what it needs employees to care about, Scott Conklin, VP, HR at Paycor, said. "You have to live your words," he told HR Dive, adding that "if not seen at all levels, people aren't going to do it."

Senior leaders must create credibility for these "new rules" by modeling valued behaviors and coaching on them every day, Edmonds said. Coaching means senior leaders must praise aligned behaviors everywhere they see them and redirect misaligned behaviors in the same way. Only when senior leaders model these behaviors will others understand that these new rules aren't optional, Edmonds said.

In addition, Edmonds said, the organization must measure how well leaders are modeling the valued behaviors. This measurement often comes in the form of a regular values survey, generally twice a year, where everyone in the organization rates their boss, next-level leaders and senior leaders on the degree to which those leaders demonstrate the company's valued behaviors. Only by rating leaders on valued behavior alignment can values be as important as results, Edmonds said.

And only when everyone — from senior leaders to individual team members — demonstrates valued behaviors in every interaction will the work culture shift to purposeful, positive and productive, Edmonds said.

Create an industrial constitution

Many employers don't communicate their values well, Conklin said.

The path to great team citizenship can be clearly defined by creating an organizational constitution that includes a servant purpose statement explaining how the organization specifically improves quality of life for its customers — and defines values and measurable valued behaviors, strategies and goals, Edmonds said.

If company values don't explicitly define exactly how you want people to behave, they'll struggle to model your values, Edmonds continued. If an organization values integrity but doesn't define it in measurable terms, people won't know exactly how they're supposed to behave, he explained.

Find what works

Traditional models of employee recognition are good, but they're becoming outdated in some cultures, Conklin noted. Your recognition program has to fit your culture, he said.

SOURCE: Burden, L. (26 November 2018) "Creating a culture of recognition" (Web Blog Post). Retrieved from https://www.hrdive.com/news/creating-a-culture-of-recognition/542845/


From HSA to 401(k) contribution limits, 11 numbers to know for 2019

Are health savings accounts (HSA), 401(k)s and flexible spending accounts (FSA) a part of your employer-sponsored benefits? Read this blog post for the 11 numbers you should know for 2019.


There are a slew of important figures companies and employees need to know regarding health savings accounts, 401(k)s and flexible spending accounts. While the IRS announced HSA changes in May, the agency only recently announced annual changes to FSAs and 401(k)s. From contribution limits to out-of-pocket amounts, here are the figures employers need to know — all of which take effect in January.

$19,000: 401(k) pre-tax contribution limits

The IRS in November said it is increasing the pre-tax contribution limits for employees who participate in a 401(k), 403(b) and most 457 plans to $19,000 from $18,500. That limit also applies to the federal government’s Thrift Savings Plan.

$6,000: 401(k) catch-up contribution limit

For participants ages 50 and over, the additional 401(k) catch-up contribution limit, which is set by law, will stay at $6,000 for 2019.

$6,000: IRA contribution limits

IRA contribution limits are being raised to $6,000 from $5,500 — the first time the IRS has increased the limits since 2013. The catch-up contribution limit for people 50 and over will still be $1,000.

$3,500: Annual HSA contribution limit for individuals

The 2019 annual health savings account contribution limit for individuals with single medical coverage is $3,500, an increase of $50 from 2018.

$7,000: HSA contribution limit for family coverage

For HSAs linked to family coverage, the 2019 contribution limit will rise by $100, to $7,000, above the family cap set for 2018.

$1,350: HDHP minimum deductible for individual

The minimum deductible for a qualifying high-deductible health plan remains unchanged for 2019: $1,350 for individual coverage.

$2,700: HDHP minimum deductible for family

The minimum deductible for a qualifying high-deductible health plan remains at $2,700 for family coverage.

$6,750: HDHP maximum out-of-pocket amounts (individual)

Deductibles, copayments and other amounts that do not include premiums will have a maximum limit of $6,750 for individual coverage next year, up $100 from 2018.

$13,500: HDHP maximum out-of-pocket amounts (family)

Deductibles, copayments and other amounts that do not include premiums will have a maximum limit of $13,500 for family coverage, up $200 from 2018.

$1,000: HSA catch-up contributions

Individuals 55 years or older can contribute an extra $1,000 to their health savings account in 2019. The amount remains unchanged from 2018.

$2,700: FSA contribution limit

The health flexible spending account contribution limit for 2019 is $2,700 — an increase of $50 over the 2018 limit. The increase also applies to limited-purpose FSAs that are restricted to dental and vision care services, which can be used in tandem with health savings accounts.

SOURCE: Mayer, K. (6 December 2018) "From HSA to 401(k) contribution limits, 11 numbers to know for 2019" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/from-hsa-to-401-k-contribution-limits-11-numbers-to-know-for-2019


Peer Support Strengthens Mental Health Offerings

Peer-support programs serve as an outreach for employees who are struggling with mental and emotional health problems. Read on to learn more about peer-support groups.


In workplace peer-support programs, employees are encouraged to talk to their co-workers before personal issues cascade out of control.

In peer support, employees who have experienced mental and emotional health challenges and learned to manage them help co-workers who are facing similar issues. It isn't meant to replace professional therapy but instead serves as an outreach to those who are struggling. Peers let their co-workers know they're not alone in dealing with mental and emotional health problems and encourage them to take advantage of counseling through an employee assistance program (EAP). Peers also provide ongoing support as employees work to resolve addiction, depression and other issues.

That's good for employees and good for the company, said Mike Weiner, EAP director for global consultancy EY, where peer counseling has proved successful. "It means people are more comfortable getting the care they perhaps had been uncomfortable reaching out for previously."

Two years ago, when the company introduced the peer-support program, it hoped for "a boost in people calling the employee assistance program to get support, and that's exactly what has happened," Weiner said.

EY is not alone. Other companies are creating peer-support systems for their workers.

"We have increased our EAP utilization and have decreased our sick leave, both short and long-term, related to mental health cases," said Lyne Wilson, assistant vice president for talent management at Nav Canada, a not-for-profit corporation that runs Canada's civil air navigation system. "There are employees who are at work today who [otherwise] would have gone out on sick leave, and we were able to prevent that."

Another Source of Support

Stéphane Grenier had served in the Canadian army for 29 years and was dealing with post-traumatic stress disorder and depression when a colleague's offer to talk opened the floodgates of inspiration. Grenier is the founder of Ottawa, Ontario-based consultancy Mental Health Innovations (MHI) and a past member of the Mental Health Commission of Canada.

Peer support at the worksite can help with issues that are no less debilitating just because they're common. "When you are getting a divorce, you are struggling emotionally. That is a mental health challenge," Grenier said.

As helpful as peer support can be, however, it should be considered part of an overall mental health benefits package that includes clinical expertise, he pointed out.

In the past two decades, large employers in the United States and Canada have "availed themselves of good employee assistance programs," Grenier said. Peer support "fast-tracks employees into the hands of care providers when they need it to ensure they get the best support available."

The problem is, he added, "people do not recover in their clinicians' office." In addition to health care and counseling with a professional therapist, "the third leg is to actually support people through the recovery process."

Nav Canada, an MHI client, launched a peer-support program called Light the Way in 2012. EY began its program, originally called r u ok?, in 2016. Other organizations contemplating peer support might look to these employers and their programs for best practices.

A Wider Scope

About a year ago, EY expanded its peer-support program beyond addiction and clinically designated mental illness (such as depression and anxiety) to cover emotional challenges, and it rebranded the program as We Care, Weiner said.

"We saw the rebranding as an opportunity to broaden the scope, and so we talk about issues like sleep, relationships and challenges that come up in the workplace," Weiner said the effort led to a 45 percent increase in calls to the EAP.

"That's a good thing," he said. "It doesn't mean there are more issues; it means people are more comfortable getting care."

Employers can customize the peer-support approach to fit their culture. In Nav Canada's case, trained employees who have gone through similar challenges provide support either in person or through a variety of communication technologies, Wilson said. The Nav Canada intranet includes contact and biographical information on each of the company's peer supporters.

"The description of their experience is written in their own words―whether they went through a marriage breakdown, child custody issues or whatever they dealt with," Wilson noted. "They struggled through that period of time, but they made it through and things are better for them."

Someone going through something similar can text or e-mail a supporter or, if they are in the same building, "just talk over coffee, and the peer supporter may just listen or may refer them to the EAP or a clinical professional, depending on the situation," Wilson explained.

At EY, employees companywide are trained to recognize when a colleague might be dealing with an emotional or mental health issue, and they are encouraged to act, such as by telling the colleague how the EAP can help, Weiner said.

He recognized that some might regard such action as "intrusive" and emphasized that peer supporters are instructed to be respectful.

Nav Canada convenes its 50 peer-support volunteers, divided into seven regions nationwide, at its Cornwall, Ontario, training center for a couple days every year to teach effective ways to reach out to colleagues and what is and isn't appropriate.

Worth the Cost

Annual costs for a company of 2,000 to contract with MHI to launch a peer-support program amounts to "a middle manager's salary," Grenier said.

Calculating whether a peer-support program is worth the cost is not an easy dollars-and-cents equation, however.

"I know [return on investment] comes up," Weiner said. "What's most important to me is that people are using the services. If people are getting help through the employee assistance program, that means they are getting help proactively before there is a very serious issue."

"You don't know what you're preventing," Wilson said. "It is an investment in creating a healthy [and] an engaged workforce."

"Anyone can implement this kind of program," Weiner added. "This is all on a voluntary basis; employees do this because they want to. The size of the program may be smaller at a smaller company, but anyone can do it."

SOURCE: Goth, G. (29 November 2018) "Peer Support Strengthens Mental Health Offerings" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/peer-support-strengthens-mental-health-offerings.aspx/


Who let the dogs in? More companies are welcoming pets

Do you have bring your pet to work policies set in place? Seven percent of employers are now allowing employees to bring their pets to work. Read on to learn more about setting up pet policies.


The list is growing of companies that now have bring your dog to work “paw-licies.” Is yours next? 

Google, Zappos and Amazon are some big companies that are pet-friendly, but smaller businesses are going to the dogs too, adding to the now 7% of employers that permit pets.

‘Ruff’ day? Take your dog to work

For example, electronics maker Crutchfield Corp. has a dog-friendly office, which the company says reduces stress.

Walking a dog helps to keep its owner fit, says Adrienne Webster, HR VP, Carfax, another pet-friendly company. But she adds that her employees are responsible for making sure their pets are well behaved.

Many companies implement policies that stipulate dogs need to be healthy, clean and up-to-date on vaccinations.

Dog-friendly office? ‘Paws’ for a foolproof pet policy

If you’re not quite ready to let the dogs in on a full-time basis, you might “paws” to allow your folks’ four-legged friends to sit, stay and play for a day, and see how it works out.

“Policies around bringing pets to work should be clear,” says employment attorney Karen Michael. “To be successful, careful attention and respect for all employees must be considered.”

Since allowing pets into the workplace creates a whole list of concerns – “from unruly, jumpy, biting, irritating dogs, to those that relieve themselves inside to those that bark and disrupt the workplace,” she urges employers to put certain rules in place:

  • Written pet policy that dictates a pet owner’s responsibilities, who’s responsible for animal bites, etc.
  • Sign-up calendar (to prevent too many pets at the same time)
  • Zero-tolerance policy for bad-behaving pets (barking, biting, etc.)
  • Pet-free zone (for those with allergies or a fear of animals)
  • Liability insurance (employers might ask workers to get as well)
  • Employee discipline (for those who fail to clean up after their pets)

SOURCE: Mucha, R. (30 November 2018) Who let the dogs in? More companies are welcoming pets" (Web Blog Post). Retrieved from http://www.hrmorning.com/who-let-the-dogs-in-more-companies-are-welcoming-pets/


How to make on-demand fitness work for wellness

Virtual fitness is making it easier for people to engage in physical activity. The demand for this new technology is growing. Continue reading to learn more about virtual fitness.


The way we work out is changing. Technology makes it possible to watch movies, order meals, even rent bikes on our own terms, and people increasingly expect their fitness options to be just as easy. Enter on-demand, virtual fitness.

The demand for virtual fitness is booming. In the United States alone, the virtual fitness market is expected to reach $2.6 billion by 2022. Whether people are too intimidated to go to the gym, have difficulty finding time in their schedules to attend a class, or have difficulty finding classes that fit their needs — virtual fitness makes it easy for them to engage over time.

As a result, more employers are realizing the value of investing in employee health and the benefits of keeping employees physically active. Lack of physical activity contributes to numerous health risks, which can lead to increased healthcare costs and lost productivity. Physical activity has also been found to have a positive impact on mental health and well-being. For example, it’s been estimated that employees who are in poor health are twice as likely as their healthier coworkers to be disengaged from work.

On-demand, virtual fitness is an option that can be more affordable than establishing an on-site gym, and with 35% of employees working remotely, on-demand fitness allows employers to offer the workouts to more employees.

As would-be fitness fanatics increasingly turn to apps to help tone their abs, what should employers know to ensure success? Here are a few strategies.

1. Make it personal. It’s a simple concept: People will be more likely to exercise if they find a workout that appeals to them. The best on-demand options offer classes for a wide range of interests — from cycling to yoga to kickboxing, to mom-and-baby fitness or simple stretching.

2. Make it flexible. People come in all shapes, sizes, and fitness levels. Make sure classes work even if your employees aren’t super fit. Even better, look for something that offers users a natural progression from wherever they start to higher levels of fitness.

3. Make it accessible. The whole point of virtual fitness is that people can take part anytime and anywhere. Look for programming that makes classes available online from a desktop or laptop computer and on both Android and iOS-based smartphones or tablets. This allows employers to make fitness available during lunchtime in the break room, while also giving employees access to short exercises they can do during a break at their desks or even on the road.

4. Make it trackable. Virtual fitness programming can be integrated into your benefits portal to allow for tracking of wellness incentive points. This encourages employees to track their progress and to create a virtual community that encourages the success of all its members.

Today’s workforce is tech-savvy, and that dynamic is only going to become more prevalent. Using mobile devices or apps to give employees what they need to balance life and work will continue to be a smart move for employers.

SOURCE: Von Bank, J. (30 November 2018)  "How to make on-demand fitness work for wellness" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/tips-to-make-on-demand-fitness-work-for-your-wellness-program?brief=00000152-146e-d1cc-a5fa-7cff8fee0000


4 trends in employee wellness programs for 2019

According to a white paper by MediKeeper, employee wellness programs will be impacted by intelligent personalization, social recognition, virtual wellness and smarter analytics. Continue reading to learn more.


Employee wellness programs will likely be transformed in the coming year by intelligent personalization, social recognition, virtual wellness and smarter analytics, according to MediKeeper’s white paper, “Four Emerging Employee Wellness Trends for 2019.”

“Embracing change and knowing what organizations need to keep driving wellness offerings forward in the next few years will help them lay the groundwork for building stronger employee wellness programs and increasing employee engagement,” says MediKeeper’s CEO David Ashworth. “With health care costs on the rise, companies that pay attention to these key trends will have the greatest success investing in their employees’ overall well-being.”

Intelligent Personalization

Intelligent personalization allows companies to make more informed decisions based on understanding risks and their causes and identifying what is driving present and future cost, according to the white paper.

“Every person is different, so it only makes sense that everyone’s wellness portal experience should also be different — this includes personalization, targeted messages and offerings.,” the authors write. “Adding business intelligence/data mining capabilities delivers the ability to take data captured within the portal, manipulate it, segment it and merge with other sets of data to perform complex associations all within each population groups’ administration portal will be the key to truly managing the population’s health.”

Social Recognition

In the coming year, workplace wellness programs will also implement a multitude of ways to include social recognition that fosters a team-oriented atmosphere intended to encourage people to perform to the best of their abilities, according to the white paper.

“Through social recognition, which can include posting, sharing, commenting and other virtual interactions, employees can help motivate each other to reach their goals,” the authors write. “These interactions foster both a competitive and team-oriented atmosphere that encourages people to perform to the best of their abilities.”

In addition to support from coworkers, managers can also promote their employees’ achievements by offering praise in an online public forum or even further boost morale by handing out incentive points that can be redeemed for tangible rewards.

Virtual Wellness Programming

In 2019, the importance of offering virtual wellness programming will grow as more employees work remotely or set flexible hours, according to the white paper.

“Since employees may work variable hours or work in several locations around the world, it simply doesn’t make sense to solely rely on lunchtime health seminars that may not be accessible to much of the workforce,” the authors write. “Instead of providing physical classes, consider hosting virtual programs that can be viewed at any time or any place. By making your wellness program available online, you’re able to reach a broader audience and make more of an impact within the entire working population.”

Smarter Analytics

Smarter analytics will also be at the forefront in 2019, according to the white paper.

“Now you can generate reports targeted specifically to the information that you are seeking, as well as layering various reports including biometrics, incentives, health risk assessments and challenges, to see what is working and what is not,” the authors write. “You can use these results to inform and better customize the intelligent personalization side of your wellness program. You’ll also be able to send messages from the reports, making them actionable instead of just informative.”

As employers continue to evaluate the effectiveness of their wellness programs, they should keep these four emerging trends in mind in order to ensure that their business is providing all the tools necessary to keep their employees both happy and healthy, according to the white paper.

“Remember that just because you’ve seen success in the past, you can’t just sit back and relax now,” the authors write. “Continual advances in wellness technology mean that you need to stay on top of the trends and adjust frequently in order to remain relevant in an increasingly competitive workplace environment.”

SOURCE: Kuehner-Hebert, K. (28 November 2018) "4 trends in employee wellness programs for 2019" (Web Blog Post). Retrieved from https://www.benefitspro.com/2018/11/28/4-trends-in-employee-wellness-programs-for-2019/


Association Health Plans Meet the 2018 Form M-1

The 2018 version of the Form M-1 can be used to register for a new plan and to file the annual report for an in-force plan. Continue reading this blog post for more information about the new Form M-1.


The Employee Benefits Security Administration (EBSA) is continuing to do what it can to help bring the new class of association health plans (AHPs) to life.

EBSA, an arm of the U.S. Department of Labor, unveiled the 2018 version of the Form M-1 Monday.

Administrators of multiple employer welfare arrangements (MEWAs) that provide medical benefits use Form M-1 to report on the MEWAs’ operations to the DOL.

The administration of President Donald Trump completed work on major new AHP regulations in June. The administration is hoping small employers will use the new AHPs to shield themselves from some state and federal mandates and to get a chance to benefit from being part of a large coverage buyer.

Any AHPs out there, including any AHPs formed under the new regulations, will need to file the 2018 Form M-1 with the Labor Department, EBSA said Monday.

An AHP, or other MEWA, can use Form M-1 both to register a new plan and to file the annual report for an in-force plan.

The 2018 annual report for an AHP or other MEWA in operation now will be due March 1, 2019.

If agents, brokers, benefit plan administrators or other financial professionals are trying to start AHPs, they are supposed to use Form M-1 to register the AHPs at least 30 days before engaging in any AHP activity.

“Such activities include, but are not limited to, marketing, soliciting, providing, or offering to provide medical care benefits to employers or employees who may participate in the AHP,” EBSA officials said in the form release announcement.

Resources

Links to AHP information, including information about the 2018 Form M-1, are available here.

SOURCE: Bell, A. (4 December 2018) "Association Health Plans Meet the 2018 Form M-1" (Web Blog Post). Retrieved from https://www.thinkadvisor.com/2018/12/04/association-health-plans-meet-the-2018-form-m-1/


It’s Flu Season...Again

Employee absenteeism and productivity is affected when flu season hits. One step employers can take to combat the flu is by offering their employees the flu vaccine every year. Continue reading this blog post to learn more.


When flu season hits, absenteeism skyrockets and productivity drops. In a recent articleEmployee Benefit News points out that the first step is the "ounce of prevention,” the flu vaccine. Providing for vaccination can be a smart benefit to offer employees, and it requires navigating misinformation about the vaccine, motivating employees to act, and contending with supply issues. For employers who want to increase vaccination rates, experts suggest making the process more convenient or incentivizing getting a shot. On-site programs are more effective since they are not only more convenient but also allow employees to be motivated by seeing their coworkers getting the shot. Regardless of approach, careful planning – from scheduling to ordering to addressing employee concerns – can help an office place stay healthier.

Last year’s flu season was the worst on record, per the CDC. Shared spaces and devices make offices and workplaces perfect places for flu germs to spread. As an article in HR Dive shows, 40% of employees with the flu admit to coming to work and 10% attend a social gathering while sick. Should an employee contract the flu, employers need to have policies in place that empower and encourage workers to stay home when sick.

In “Threat of Another Nasty Flu Season Prompts Workplaces to Be Proactive,” Workforce echoes the importance of the flu shot and a no-tolerance policy toward sick employees coming to the office. Policies and a culture that encourages self-care overpowering through an illness can help foster calling in when needed. The article also reinforces other preventative behaviors like hand washing, staying home while feverish, and coughing into your elbow.

Read more:

HR’s recurring headache: Persuading employees to get a flu shot

40% of workers admit coming to work with the flu

Threat of Another Nasty Flu Season Prompts Workplaces to Be Proactive

SOURCE: Olson, B. (20 November 2018) "It’s Flu Season...Again" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/its-flu-season...again


The benefits issue that costs employers big: Ineligible dependents on company plans

Are you paying insurance premiums for dependents who are ineligible for your company health plan? Almost 10 percent of enrolled dependents are ineligible for the programs they are enrolled in. Read on to learn more.


Are you paying insurance premiums for people who aren’t qualified to be on your company plan?

For some employers, too often the answer is “yes.”

In our experience, we find that nearly 10% of dependents enrolled in employee health and welfare plans are not eligible to be in the program. And for a company with a couple of hundred employees that spends around $2 million a year on benefits, ineligible dependents can become a significant financial issue.

When employers pay for ineligible dependents, costs increase for them and employees. Unfortunately, it’s an all-too-common issue that employers need a solid strategy to combat.

So how do ineligible dependents get enrolled in the first place? There are a couple of common ways that employers end up paying health insurance premiums for ineligible dependents. The most basic factor is a change in a person’s situation — children pass the age of 26, spouses get jobs, people get divorced, etc. — and the employee is unaware of the need to notify the plan sponsor. Most often, these situations arise because the employer doesn’t have a process in place.

But some situations are more nefarious: An employee mischaracterizes someone as a dependent. They may claim that a nephew is a son, or that they’re still married to an ex-spouse. In either of these situations, the employer loses.

Prevent ineligible dependents with best practices

Prevent paying for ineligible dependents by putting into place best practices that begin when a new employee joins the company.

During onboarding, investigate each potential plan member when the employee applies for insurance coverage. That means seeking documentation — such as marriage certificates and birth certificates — to verify that a person is, in fact, married, or that their kids are their kids and not someone else’s. Following these processes at the outset prevents the awkwardness of having to question employees about their various family relationships. Nobody wants to ask a colleague if the divorce is final yet.

To make it easy for employees to verify everyone’s eligibility, provide access to a portal where they can upload scans or images of relevant documents. This will also make it easier to track—and keep track of—onboarding documents and dependent audits when the time comes.

Once this best practice is established, it’s important to conduct periodic dependent eligibility audits, as required by ERISA. The employer can conduct an audit or hire an external auditor. This decision is usually driven by the size of the workforce.

The most logical time to conduct an audit is during benefit enrollment. Employees are already considering options for the next plan year, and they likely won’t be confused by the need to submit verifying documents. (During this exercise, it’s also a good idea to ask plan participants to verify beneficiaries on employer-provided life insurance.)

Some employers — again, depending on the size of the workforce — will conduct random sample audits of 20-25% of their employee population. Obviously, the larger the sample size, the better. Benefits administration platforms typically streamline this process.

What happens when employers identify an ineligible dependent?

Many employers offer workers an amnesty period during which an employee can come forward to say they have someone that should be taken off the plan. If the plan sponsor identifies an ineligible dependent, employees are typically offered a one-time pass. Then, they must sign an affidavit attesting that they can be terminated if it happens again.

If the employer has processed insurance claims for an ineligible dependent, they can declare fraud and seek back payment of claims payouts. Again, most in this situation prefer a more benevolent approach and will ask the employee to make monthly differential payments until the account is even. Conducting regular dependent eligibility audits as part of the benefits administration process needs to be handled with finesse for the good of organizational culture.

Some employers may shy away from conducting audits out of concern for creating awkward situations. But frankly, it’s the plan sponsor’s job to help them navigate the waters, educate them and keep them engaged in the process by becoming their best advocates. This will not only help enhance the efficiency and accuracy of employee benefit offerings, but it will result in a smoother ride for everyone involved.

Ensuring that a health and welfare benefits program follows eligibility best practices is the responsibility of the plan sponsor. But employees have a share in that responsibility, too.

SOURCE: O'Connor, P.(28 November 2018) "The benefits issue that costs employers big: Ineligible dependents on company plans" (Web Blog Post). Retrieved from: