How to Take your 2020 Benefit Change Rollout to the Next Level

Employers are faced with the challenge of how to engage employees each year during open enrollment. Instead of printouts and email campaigns, try a new communication method this year. Read this blog post for easy tips to try this open enrollment season.


With open enrollment right around the corner, employers are faced with the annual question: how are we going to get employees engaged, while helping them make the smartest benefit decisions for their individual situations?

This year, instead of plain old printouts and email, try a new method. Whether you are changing providers, introducing new features, or simply showcasing existing options, switching up your enrollment process can be easier and more enjoyable than you’d think. Give these quick and easy tips a try for a better time come January 1.

Have a Lunch & Learn

Who doesn’t love a lunch & learn? Free food and a little break from the status quo is a much-welcomed way to get on board with the changes 2020 will bring. Whether you are opting for an informative webinar or an in-person presentation, providing a free lunch is a great way to encourage employee participation while boosting team morale.

If you are hosting an in-person benefits presentation, be sure to have your information nicely (and concisely!) summarized. Having a paper takeaway or a digital follow-up is key, as sometimes open enrollment can be overwhelming. Many people prefer to have something they can reference at a later date to help make their decision, so be sure those materials are available.

Teamwork Makes the Dream Work

If it’s possible, why not get the whole team involved in asking questions and brainstorming? Benefit changes can be complex and confusing, and sometimes people feel too shy to ask questions during a formal presentation. Try breaking up into smaller groups and challenging each mini-team to answer ten questions related to open enrollment and benefits. The group that gets the most right answers wins a prize!

Design Your Rollout Mobile & Digital First

Mobile. It might seem like a no-brainer, but employees are going to be quicker to respond to changes if there’s an easy process that meets them where they are: their mobile devices. Reminding employees of a mobile registration option is a great way to capture high engagement rates. The key to a user-friendly registration is making it as turnkey as possible. If employees have to fish around for URLs, passwords, group numbers, et cetera, they are going to be less likely to complete these items in a timely fashion. Provide all the information you can upfront.

Add Social to Your Strategy. If you are not taking advantage of a social strategy such as Facebook, Slack, LinkedIn, Twitter, and more, the time is now! Digital quizzes, surveys, and chat channels can work wonders for engaging your employees during the open enrollment process while facilitating knowledge sharing. Why not create an internal Facebook group or Slack channel where your team can ask questions and exchange information? The outcome of benefits decisions usually lasts all year, so it’s important for people to have their questions answered in a casual, user-friendly environment. A big benefit for your HR team is that a digital-first strategy will cut down on “random question” drop-ins and interruptions at your office. Send everyone to one place in the digital space!

SOURCE: Olson, B. (15 October 2019) "How to Take your 2020 Benefit Change Rollout to the Next Level" (Web Blog Post). Retrieved fromhttp://blog.ubabenefits.com/how-to-take-your-2020-benefit-change-rollout-to-the-next-level


6 voluntary benefits your employees want

Today’s workforce is no longer finding the run-of-the-mill benefits plans adequate. This is making voluntary benefits more important than ever in this age of the multigenerational workforce and a tight labor market. Read the following blog post for six voluntary benefits employees want.


In this age of the multigenerational workforce and a tight labor market, a one-size-fits-all group benefits model with medical, prescription, dental, vision and a retirement plan just doesn’t cut it. A workforce with Baby Boomers, Gen X’ers, Millennials and Generation Z means that employees are going to find the run-of-the-mill benefits plan inadequate. Ditto for job seekers.

What follows is that voluntary benefits are more important than ever. Offering a range of voluntary benefits can help meet the needs of employees at all life stages.

Voluntary benefits add value to benefit plans and are typically easy to administer. They’re low-to-no-cost because employees pay for them, and maintenance is often handled through a payroll deduction. Many voluntary benefits also offer guaranteed acceptance at a lower rate than medical benefits, so even if a small group within your company chooses a particular benefit, they’ll be covered.

This landscape is changing quickly. Here are six trending voluntary benefits your employees want.

Student loan debt repayment assistance

Debt among college graduates has grown to nearly $1.6 trillion. It’s preventing the largest employee segment at most companies from buying houses or cars, saving for retirement, having kids and getting married. To help employees repay their student loan debt, some employers are helping employees pay down student loan debt through a direct payroll deduction.

Others are offering a new, IRS-allowable retirement plan match swap where an employer can opt to increase its defined contribution match, enabling employees to reduce their retirement match and contribute funds to repaying student loans instead.

Interest in this benefit continues to grow. Employers looking to offer student loan debt repayment should be aware that not all platforms are created equal. Look out for high per-employee, per-month fees.

Individual long-term care

A growing number of people are beginning to understand the value of long-term care insurance because they have taken care of or currently care for a friend or relative who needs round-the-clock care. Long-term care insurance covers home or institutional care if a person is no longer able to perform at least two activities of daily living--eating, bathing, dressing, moving from a bed to a chair or using a toilet.

Employees are interested in buying long-term care insurance through their employer because they can offer better rates for simplified issue plans. If you plan to offer long-term care as an employer-sponsored benefit, I recommended rolling it out with a strategic project plan and a benefit counselor or a technology platform capable of providing decision-making tools for a smooth application process.

Executive reimbursement plans

Employee retention — especially executive retention — is on the minds of many employers in the midst of this thriving economy. Filling gaps in medical and prescription coverage is one way to provide executive teams with premium benefits they may be looking for.

Executive reimbursement plans provide reimbursement for out-of-pocket expenses, access to facilities and level of service not normally covered under most group health plans. Rather than simply increasing compensation to help cover out-of-pocket expenses, premiums for these plans are tax-deductible for the employer, and benefits are non-taxable for employees.

Executive individual disability insurance

Traditional employer-sponsored long-term disability (LTD) is likely not enough coverage for highly-compensated employees or some sales staff who depends heavily on commission and bonuses. Normally, LTD pays employees 50-70% of their salary up to a certain amount.

Employers can carve out additional coverage for employees based on their management level, performance or tenure. Individual disability insurance plans can protect employees until they turn 65; they can also protect job titles or levels until employees are well enough to return to work. Executive individual disability insurance, like executive reimbursement, can be offered as a form of compensation, or a form of financial asset protection for higher incomes.

Telemedicine

The rise of consumer-driven health plans has led to the need for telemedicine. Telemedicine provides a way for employees to see a physician or provider by video and get a diagnosis and/or prescription quickly. The success of telemedicine is leading some carriers to integrate it within their plan. However, standalones still exist and can provide employees with an easy way to get care faster and cheaper than before.

Pet Insurance

Pet parents spend nearly $70 billion on veterinarian costs for their pets, but just 10% of dogs and 5% of cats are covered by medical insurance. As pets begin to play a larger role in our lives, more employers are offering pet insurance to their employees to help defray the cost of unexpected medical expenses.

There are a number of plan options, and setting up a plan for employees’ pets is simple. However, it’s vital that employers do their research to ensure the veterinarian network includes the best vets.

As part of a voluntary benefit offering, be sure to develop a rollout strategy and communications plan so employees are thoroughly educated and you meet group minimums.

SOURCE: Park, N. (25 September 2019) "6 voluntary benefits your employees want" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/6-voluntary-benefits-your-employees-want


Health insurance surpass $20,000 per year, hitting a record

An annual survey of employers recently revealed that the cost of family health coverage has now surpassed $20,000, a record high. The survey also revealed that while most employers pay most of the costs of coverage, workers' average contribution for a family plan is now $6,000. Read this blog post from Employee Benefit News to learn more.


The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of American workers into plans that cover less or cost more, or force them out of the insurance market entirely.

“It’s as much as buying a basic economy car,” said Drew Altman, chief executive officer of the Kaiser Family Foundation, “but buying it every year.” The nonprofit health research group conducts the yearly survey of coverage that people get through work, the main source of insurance in the U.S. for people under age 65.

While employers pay most of the costs of coverage, according to the survey, workers’ average contribution is now $6,000 for a family plan. That’s just their share of upfront premiums, and doesn’t include co-payments, deductibles and other forms of cost-sharing once they need care.

The seemingly inexorable rise of costs has led to deep frustration with U.S. healthcare, prompting questions about whether a system where coverage is tied to a job can survive. As premiums and deductibles have increased in the last two decades, the percentage of workers covered has slipped as employers dropped coverage and some workers chose not to enroll. Fewer Americans under 65 had employer coverage in 2017 than in 1999, according to a separate Kaiser Family Foundation analysis of federal data. That’s despite the fact that the U.S. economy employed 17 million more people in 2017 than in 1999.

“What we’ve been seeing is a slow, slow kind of drip-drip erosion in employer coverage,” Altman said.

Employees’ costs for healthcare are rising more quickly than wages or overall economy-wide prices, and the working poor have been particularly hard-hit. In firms where more than 35% of employees earn less than $25,000 a year, workers would have to contribute more than $7,000 for a family health plan. It’s an expense that Altman calls “just flat-out not affordable.” Only one-third of employees at such firms are on their employer’s health plans, compared with 63% at higher-wage firms, according to the Kaiser Family Foundation’s data.

The survey is based on responses from more than 2,000 randomly selected employers with at least three workers, including private firms and non-federal public employers.

Deductibles are rising even faster than premiums, meaning that patients are on the hook for more of their medical costs upfront. For a single person, the average deductible in 2019 was $1,396, up from $533 in 2009. A typical household with employer health coverage spends about $800 a year in out-of-pocket costs, not counting premiums, according to research from the Commonwealth Fund. At the high end of the range, those costs can top $5,000 a year.

While raising deductibles can moderate premiums, it also increases costs for people with an illness or who gets hurt. “Cost-sharing is a tax on the sick,” said Mark Fendrick, director of the Center for Value-Based Insurance Design at the University of Michigan.

Under the Affordable Care Act, insurance plans must cover certain preventive services such as immunizations and annual wellness visits without patient cost-sharing. But patients still have to pay out-of-pocket for other essential care, such as medication for chronic conditions like diabetes or high blood pressure, until they meet their deductibles.

Many Americans aren’t prepared for the risks that deductibles transfer to patients. Almost 40% of adults can’t pay an unexpected $400 expense without borrowing or selling an asset, according to a Federal Reserve survey from May.

That’s a problem, Fendrick said. “My patient should not have to have a bake sale to afford her insulin,” he said.

After years of pushing healthcare costs onto workers, some employers are pressing pause. Delta Air Lines Inc. recently froze employees’ contributions to premiums for two years, Chief Executive Officer Ed Bastian said in an interview at Bloomberg’s headquarters in New York last week.

“We said we’re not going to raise them. We're going to absorb the cost because we need to make certain people know that their benefits structure is real important,” Bastian said. He said the company’s healthcare costs are growing by double-digits. The Atlanta-based company has more than 80,000 employees around the globe.

Some large employers have reversed course on asking workers to take on more costs, according to a separate survey from the National Business Group on Health. In 2020, fewer companies will limit employees to so-called “consumer-directed health plans,” which pair high-deductible coverage with savings accounts for medical spending funded by workers and employers, according to the survey. That will be the only plan available at 25% of large employers in the survey, down from 39% in 2018.

Employers have to balance their desire to control costs with their need to attract and keep workers, said Kaiser’s Altman. That leaves them less inclined to make aggressive moves to tackle underlying medical costs, such as by cutting high-cost hospitals out of their networks. In recent years employers’ healthcare costs have remained steady as a share of their total compensation expenses.

“There’s a lot of gnashing of teeth,” Altman said, “but if you look at what they do, not what they say, it’s reasonably vanilla.”

SOURCE: Tozzi, J. (25 September 2019) "Health insurance surpass $20,000 per year, hitting a record" (Web Blog Post). Retrieved from https://www.benefitnews.com/articles/health-insurance-costs-surpass-20-000-per-year


IRS Releases Private Letter Ruling Regarding Section 213(d) Medical Care Expenses

A private letter ruling regarding DNA collection kits was recently released by the Internal Revenue Service (IRS). This letter addresses whether the price of these kits should qualify as Section 213(d) medical care expenses. Read this blog post from UBA to learn more.


The Internal Revenue Service (IRS) released a private letter ruling (Letter) regarding whether the price of a DNA collection kit – specifically services and reports related to a person’s health that are generated from analyzing the collected DNA – qualify as Section 213(d) medical care expenses.

Health services such as genotyping are medical care under Section 213(d) while reports that provide general information are not medical care. The IRS concluded that the DNA collection kit’s price must be allocated between health services that are medical care, such as genotyping, and the non-medical services, such as reports that provide general or ancestry information.

SOURCE: Hsu, K. (24 September 2019) "IRS Releases Private Letter Ruling Regarding Section 213(d) Medical Care Expenses" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/irs-releases-private-letter-ruling-regarding-section-213d-medical-care-expenses


Illnesses, Deaths Tied to Vaping

The Centers for Disease Control and Prevention (CDC) recently released a health alert warning that severe pulmonary disease is associated with vaping products. Read this blog post from SHRM to learn more about vaping and how to address it in the workplace.


The use of electronic cigarettes, also known as vaping, is believed to be responsible for five deaths and 450 severe lung injuries in what appears to be a nationwide epidemic, according to new reports.

E-cigarettes are battery-operated and produce vapor that simulates smoking. They can resemble regular cigarettes, cigars, pipes, pens, USB sticks and other everyday items. They do not burn tobacco, but the device heats a liquid that usually contains nicotine, flavorings and other chemicals.

While most employers ban smoking in the workplace, their policies don't always extend to e-cigarette products. However, a Centers for Disease Control and Prevention (CDC) health alert on Aug. 30 warned that severe pulmonary disease is associated with using e-cigarette products. The agency, which is part of the U.S. Department of Health and Human Services, launched a multistate investigation into the lung illnesses on Aug. 1.

"Although more investigation is needed to determine the vaping agent or agents responsible," wrote Dr. David C. Christiani of the Harvard School of Medicine, "there is clearly an epidemic that begs for an urgent response." He shared his comments in the Sept. 6 issue of the New England Journal of Medicine, along with the preliminary report "Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin."

The CDC is working with the U.S. Food and Drug Administration, states and other public health partners and clinicians to determine what is sickening users, and in some cases resulting in fatalities. On Friday, it suggested that people refrain from using e-cigarette products during its investigation.

SHRM Online has collected the following articles about this topic from its archives and other trusted sources.  

5 Deaths Linked to Vaping. Officials Are Urging Consumers to Stop. (Chicago Tribune)

How Are You Handling Vaping at Work? (SHRM Online)

More States Ban Vaping, E-Cigarette Use in Workplaces (Bloomberg)

Florida Adds Vaping to Regulated Indoor Smoking (SHRM Online)

SOURCE: Gurchiek, K. (6 September 2019) "Illnesses, Deaths Tied to Vaping" (Web Blog Post). Retrieved from https://www.shrm.org/hr-today/news/hr-news/Pages/Illnesses-Deaths-Tied-to-Vaping-.aspx


Employers look to virtual services to curb rising health costs

Sixty-four percent of employers believe virtual care will play a significant role in healthcare delivery in 2020, according to the National Business Group on Health. With rising healthcare costs, employers are looking for ways to stem the rising costs of healthcare and find ways to better engage employees. Continue reading this blog post to learn more about virtual services.


WASHINGTON — With the continued cost of healthcare benefits expected to increase by another 5%, topping $15,000 per employee, employers are looking for ways to stem the increase and better engage employees in holistic well-being.

One of those ways is through virtual care. The number of employers who believe virtual care will play a significant role in how healthcare is delivered in the future continues to grow, up to 64% going into 2020 from 52% in 2019, according to the National Business Group on Health’s annual healthcare strategy survey.

“Virtual care solutions bring healthcare to the consumer rather than the consumer to healthcare,” Brian Marcotte, president and CEO of NBGH said at a press briefing Tuesday. “They continue to gain momentum as employers seek different ways to deliver cost effective, quality healthcare while improving access and the consumer experience. Of particular note is the growing interest among employers to offer virtual care for mental health as well as musculoskeletal conditions.”

The majority of respondents (51%) will offer more virtual care programs next year, according to the survey. Nearly all employers will offer telehealth for minor, acute services while 82% will offer virtual mental health services — a figure that’s expected to grow to 95% by 2022.

Virtual care for musculoskeletal management shows the greatest potential for growth, the study noted. While 23% of employers will offer musculoskeletal management virtual services next year, another 38% are considering it by 2022. Physical therapy is the best way to address musculoskeletal conditions and help avoid surgery, but it can be inconvenient and costly, said Ellen Kelsay, chief strategy officer at NBGH.

“Where we’ve seen a lot of development in areas of virtual solutions is to provide remote physical therapy treatments,” she said. “Employees can access treatment through their virtual app wherever it’s convenient for them.”

Regardless, employee utilization of virtual services still remains low. For example, while roughly 70% of large companies provide telemedicine coverage, only 3% of employees use it,according to prior NBGH data.

But many resources are out of sight and out of mind, Kelsay said. However, employers are focusing on offering high-touch concierge services to help workers better navigate the healthcare system.

Employers are reaching a point of saturation with the number of solutions that are available, but from the employee’s perspective, they just don’t know where to start, she added. “These concierge and navigator services really help point employees in the direction to the solution at the point in time they need it.”

In addition, the use of predictive analytics and claims data is also an opportunity to help employers get the right programs in front of employees in the moment, Marcotte added.

“Some of these engagement platforms are getting at personal messaging and predictive analytics. It’s not where we want it to be yet, but as that continues to get better, I think you’ll see utilization go up,” he said.

Source: Otto,N. (13 August 2019) "Employers look to virtual Services to curb rising health costs" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/employers-look-to-virtual-services-to-curb-rising-healthcare-costs

Survey: What Employees Want Most from Their Workspaces

In 2019, employers across the country are expected to spend an average of $3.6 million on employer-sponsored benefits such as onsite gyms, standing desks, meditation rooms and nursing hotlines. Continue reading this blog post to learn more about what employees want most out of their workspaces.


In an effort to support a healthier and more productive workforce, employers across the country are expected to spend an average of $3.6 million on wellness programs in 2019. Think onsite gyms. Standing desks. Meditation rooms. Nursing hotlines. These are just some of the benefits companies are investing in.

But is any of it paying off?

The results of a recent Harvard study suggest that wellness programs, offered by 80% of large U.S. companies, yield unimpressive results — and our findings mirror this. Future Workplace and View recently surveyed 1,601 workers across North America to figure out which wellness perks matter to them most and how these perks impact productivity.

Surprisingly, we found employees want the basics first: better air quality, access to natural light, and the ability to personalize their workspace. Half of the employees we surveyed said poor air quality makes them sleepier during the day, and more than a third reported up to an hour in lost productivity as a result. In fact, air quality and light were the biggest influencers of employee performance, happiness, and wellbeing, while fitness facilities and technology-based health tools were the most trivial.

Organizations have the power to make improvements in these areas, and they need to, both for their workers and themselves. A high-quality workplace — one with natural light, good ventilation, and comfortable temperatures — can reduce absenteeism up to four days a year.  With unscheduled absenteeism costing companies an estimated $3,600 annually per hourly worker and $2,650 each year for salaried workers, this can have a major impact on your bottom line.

Other research finds that employees who are satisfied with their work environments are 16% more productive, 18% more likely to stay, and 30% more attracted to their company over competitors. Two-thirds of our survey respondents said that a workplace focused on their health and wellbeing would make them more likely to accept a new job or keep the job they have. This means that companies willing to adapt to an employee-centric view of workplace wellness will not only increase their productivity, they will also improve their ability to attract and retain talent.

To get started, here are three steps you can take to improve your work environments and the wellbeing of your employees:

1.  Stop spending money on pointless office perks. A good rule of thumb is to never assume that you know what your employees want — but instead, find ways to ask them. If more employers did, they might put less emphasis on office perks that only a minority of employees will take advantage of (like an onsite gym), and more on changes in the workplace environment that impact all employees (like air quality and access to light).

The number one environmental factor cited in our survey was better air quality. Fifty-eight percent of respondents said that fresh, allergen-free air would improve their wellness. Fifty percent said they would work and feel better with some view of the outdoors, while one third said they would want the ability to adjust the temperature in their workspace. Only one in three survey respondents characterized their office temperature as ideal.

Noise distractions bothered more than a third of those surveyed, impacting their ability to concentrate. Employees said sounds like phones ringing, typing on keyboards, and distractions from coworkers all impacted their concentration.

Almost half of our respondents wanted to see their companies improve these environmental factors, and in many instances, more than they wanted to be offered office perks. The first step, then, is to take a look at where you are spending your money, and consider cutting expenses that aren’t worth the cost.

2. Personalize when possible. We’ve all gotten used to personalizing our outside-of-work lives. We binge the shows we want to watch and listen to the music we like to hear, even if our partners or friends have different preferences. We adjust our thermostats without having to get up off our couches, and dim our lights to our level of satisfaction.

Employees are beginning to expect these same privileges in the workplace. Our survey revealed that employees, by a margin of 42% to 28%, would rather be able to personalize their work environment than opt for unlimited vacation. Specifically, what employees want to personalize:

  • Workspace temperature: Nearly half want an app that will let them set the temperature in their workspace.
  • Overhead and desk lighting: One-third wants to control their overhead and desk lighting, as well as the levels of natural light streaming in.
  • Noise levels: One-third would like to “soundscape” their workspace.

While these asks may sound exclusive to the personal offices of higher-ups — they’re not. Hewlett Packard Enterprise headquarters is just one example of a company that has managed to help employees control the noise level in an open floor plan. Their building was actually designed to manage ambient sound in order to reduce worker distractions. Some companies like Regeneron Pharmaceuticals, have gone a step further, allowing employees to control the amount of natural light streaming in through the glass of their office windows with a cell phone app.

But for organizations that don’t want to invest in a completely new building, there is a more organic route. Cisco, for example, has managed the acoustic levels in their space by creating a floor plan without assigned seating that includes neighborhoods of workspaces designed specifically for employees collaborating in person, remotely, or those who choose to work alone.

This same strategy applies to light or temperature. You can position employees who want a higher temperature and more light around the edge of your floor plan, and those who like it quieter and cooler in the core.

3. Create a holistic view of workplace wellness. When deciding what changes to make to your organization, remember that workplace wellness is not just about the physical health of your employees. It includes physical wellness, emotional wellness, and environmental wellness. To create a truly healthy work environment, you must take all three of these areas into consideration:

  • Emotional wellness: Give employees access to natural light, and quiet rooms where they can comfortably focus on their work.
  • Physical wellness: Provide people with healthy food options, and ergonomically designed work stations.
  • Environmental wellness: Make sure your workspaces have adequate air quality, light, temperature, and proper acoustics.

Companies that adapt to a more holistic view of workplace wellness will soon realize no one department alone can solve the puzzle. Our study results, along with the results from the World Green Building Council report, push organizations to take a closer look at what changes they can make that will actually matter. My suggestion: consider how you can get back to the basics employees want, and invest in the core areas that will have the most impact.

SOURCE: Meister, J. (27 August 19) "Survey: What Employees Want Most from Their Workspaces"(Web Blog Post). Retrieved from https://hbr.org/2019/08/survey-what-employees-want-most-from-their-workspaces


Cadillac tax may finally be running out of gas

The Cadillac tax, a part of the Affordable Care Act, may be in for a change. This tax was supposed to take effect in 2018 but has been delayed twice and recently, the House voted to repeal this tax entirely. Read this blog post to learn more about this potential change.


The politics of healthcare are changing. And one of the most controversial parts of the Affordable Care Act — the so-called Cadillac tax — may be about to change with it.

The Cadillac tax is a 40% tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 for an individual policy or $30,150 for family coverage. It was supposed to take effect in 2018, but Congress has delayed it twice. And the House recently voted overwhelmingly — 419-6 — to repeal it entirely. A Senate companion bill has 61 co-sponsors — more than enough to ensure passage.

The tax was always an unpopular and controversial part of the 2010 health law because the expectation was that employers would cut benefits to avoid paying the tax. But ACA backers said it was necessary to help pay for the law’s nearly $1 trillion cost and help stem the use of what was seen as potentially unnecessary care. In the ensuing years, however, public opinion has shifted decisively, as premiums and out-of-pocket costs have soared. Now the biggest health issue is not how much the nation is spending on healthcare, but how much individuals are.

“Voters deeply care about healthcare still,” said Heather Meade, a spokeswoman for the Alliance to Fight the 40, a coalition of business, labor and patient advocacy groups urging repeal of the Cadillac tax. “But it is about their own personal cost and their ability to afford healthcare.”

Stan Dorn, a senior fellow at Families USA, recently wrote in the journal Health Affairs that the backers of the ACA thought the tax was necessary to sell the law to people concerned about its price tag and to cut back on overly generous benefits that could drive up health costs. But transitions in healthcare, such as the increasing use of high-deductible plans, make that argument less compelling, he said.

“Nowadays, few observers would argue that [employer-sponsored insurance] gives most workers and their families’ excessive coverage,” he wrote.

The possibility of the tax has been “casting a statutory shadow over 180 million Americans’ health plans, which we know, from HR administrators and employee reps in real life, has added pressure to shift coverage into higher-deductible plans, which falls on the backs of working Americans,” said Rep. Joe Courtney (D-Conn.).

Support or opposition to the Cadillac tax has never broken down cleanly along party lines. For example, economists from across the ideological spectrum supported its inclusion in the ACA, and many continue to endorse it.

“If people have insurance that pays for too much, they don’t have enough skin in the game. They may be too quick to seek professional medical care. They may too easily accede when physicians recommend superfluous tests and treatments,” wrote N. Gregory Mankiw, an economics adviser in the George W. Bush administration, and Lawrence Summers, an economic aide to President Barack Obama, in a 2015 column. “Such behavior can drive national health spending beyond what is necessary and desirable.”

At the same time, however, the tax has been bitterly opposed by organized labor, a key constituency for Democrats. “Many unions have been unable to bargain for higher wages, but they have been taking more generous health benefits instead for years,” said Robert Blendon, a professor at the Harvard T.H. Chan School of Public Health who studies health and public opinion.

Now, unions say, those benefits are disappearing, with premiums, deductibles and other cost sharing rising as employers scramble to stay under the threshold for the impending tax. “Employers are using the tax as justification to shift more costs to employees, raising costs for workers and their families,” said a letter to members of Congress from the Service Employees International Union.

Deductibles have been rising for a number of reasons, the possibility of the tax among them. According to a 2018 survey by the federal government’s National Center for Health Statistics, nearly half of Americans under age 65 (47%) had high-deductible health plans. Those are plans that have deductibles of at least $1,350 for individual coverage or $2,700 for family coverage.

It’s not yet clear if the Senate will take up the House-passed bill, or one like it.

The senators leading the charge in that chamber — Mike Rounds (R-S.D.) and Martin Heinrich (D-N.M.) — have already written to Senate Majority Leader Mitch McConnell to urge him to bring the bill to the floor following the House’s overwhelming vote.

“At a time when healthcare expenses continue to go up, and Congress remains divided on many issues, the repeal of the Cadillac tax is something that has true bipartisan support,” the letter said.

Still, there is opposition. A letter to the Senate on July 29 from economists and other health experts argued that the tax “will help curtail the growth of private health insurance premiums by encouraging employers to limit the costs of plans to the tax-free amount.” The letter also pointed out that repealing the tax “would add directly to the federal budget deficit, an estimated $197 billion over the next decade, according to the Joint Committee on Taxation.”

Still, if McConnell does bring the bill up, there is little doubt it would pass, despite support for the tax from economists and budget watchdogs.

“When employers and employees agree in lockstep that they hate it, there are not enough economists out there to outvote them,” said former Senate GOP aide Rodney Whitlock, now a healthcare consultant.

Harvard professor Blendon agrees. “Voters are saying, ‘We want you to lower our health costs,’” he said. The Cadillac tax, at least for those affected by it, would do the opposite.

SOURCE: Rovner, J. ( 19 August, 2019) "Cadillac tax may finally be running out of gas" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/obamacare-excise-tax-may-be-at-an-end 


Employers shouldn’t fear expansion of Medicare

A new survey from the National Business Group on Health found that 55 percent of large employers support a Medicare expansion that's limited to older Americans. In this article from Employee Benefit Advisor, Nison discusses the potential benefits and downfalls of an expansion to Medicare.


Like a significant chunk of American voters, a majority of large employers want to expand Medicare. Just not too much.

A new survey of 147 large employers from the National Business Group on Health found that 55% of them support a Medicare expansion that’s limited to older Americans. Only 23% think eligibility should drop to age 50, however, and 45% don’t think it should expand at all. A majority believe that a broader “Medicare for All” plan would increase health costs.

The same survey also highlights why employers should consider coming around on health reform that reduces their role in the system. The growth in health costs has outpaced inflation and wage growth for years, and the surveyed businesses expect it to rise 5% to $15,375 for each employee next year.

About 70% of those costs will fall on the companies, which plan to try everything from boosting virtual health services to investing in health concierges to rein them in, according to the survey.

History suggests that their best efforts might not amount to much.

Employer-sponsored insurance is America’s single largest source of health coverage. That’s mostly true because the IRS exempted employer health benefits from taxes in 1943, a move that created the federal government’s single biggest tax expenditure. Large companies derive some benefit from the current system because they can provide a significant tax-free benefit that helps them compete for talent and pay people less. But it comes with significant drawbacks. Employers have to devote substantial resources to providing healthcare and controlling costs. Many of them have no particular expertise or advantage in doing so.

The results are mixed. Yes, individuals with private insurance are generally satisfied with the quality of their coverage. They’re not nearly as happy about the cost as deductibles rise. The U.S. pays more than any other developed country for healthcare and medicines and receives worse results on a variety of metrics.

Employers pay particularly high prices and spend heavily on plans that have higher overhead than public alternatives. A recent RAND study found that employer-sponsored plans paid hospitals at 241% of Medicare rates in 2017. Employers are already effectively subsidizing public programs, not to mention the profitability of insurers, health care providers and drugmakers.

It’s not entirely their fault. The American system inherently fragments negotiating power, which gives providers a significant advantage and makes it difficult for even the largest employers to get a good deal. Turning a larger piece of healthcare over to the government would free companies to focus more time and resources on their actual business instead of on navigating the world’s most expensive and convoluted healthcare market.

Big businesses most likely fear big Medicare expansion in large part because it would lead to a significant tax increase. But looking at any tax increase as an enemy is a mistake. Those taxes represent a trade-off; they would replace some or all of the billions of dollars that employers are currently spending on care. Depending on what taxes are imposed and whether the public plan is able to control costs better than the current system — and it could hardly do worse — many employers could come out ahead.

There are a lot of unknowns when it comes to Medicare for All and plans that move the country in that direction. Employers are right to be skeptical until they know more, but the results could well shake out in their favor, and they shouldn’t be so quick to discount the approach.

SOURCE: Nisen, M. (15 August 2019)"Employers shouldn’t fear expansion of Medicare" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/articles/employers-shouldnt-fear-expansion-of-medicare

 


The “Official” Lowdown on Physical Activity

Are you looking for wellness tips and information on staying active? The Physical Activity Guidelines for Americans is the official voice of authority when it comes to physical activity and health. Continue reading this blog post for guidelines and recommendations from the Physical Activity Guidelines for Americans.


You can read fitness magazines or online blogs, get tips from friends and neighbors, or make up your own rules and regimens for staying active. But when the federal government speaks, you should probably listen.

The Physical Activity Guidelines for Americans is the voice of authority when it comes to physical activity and health. The guidelines are based on scientific evidence and provide recommendations for Americans of all ages. The second edition of these guidelines came out in 2018 and includes some intriguing facts:

  • About half of all American adults have at least one chronic disease.
  • Seventy percent of the most common of these diseases can be improved by physical activity.
  • A full 80 percent of adults aren’t getting the aerobic and muscle-strengthening activity recommended.
  • This lack of activity has been linked to 10 percent of premature deaths.

Yikes! Not good, right? If this gets your attention and you’d like to up your activity level, here are the top recommendations from the guide:

  • Kids ages 3 - 5 should be active at least 3 hours a day.
  • Kids 6 - 17 should strive for at least an hour of moderate to vigorous activity per day. This should include aerobic activity (anything that speeds up heart rate) and muscle-strengthening activities. This activity has been shown to help with things like bone health, heart health and even learning.
  • Adults need at least 150 to 300 minutes of moderate-intensity activity per week and at least two days of muscle-strengthening activity (lifting weights, push-ups). Physical activity brings immediate health benefits, like lowering blood pressure and improving sleep. Over time, physical activity can lower the risk of heart disease, diabetes, dementia, weight gain, and eight different cancers, among other health risks. It also helps improve overall quality of life.
  • For people who already have a health condition, physical activity can help with pain, slow the disease’s progress, keep depression and anxiety at bay, and improve brain function for people with Alzheimer’s disease, MS, Parkinson’s, and other conditions.

When it comes to government, you might not like everything you hear and read. But for the real scoop on activity levels and health, our friends in Washington seem to know what’s best. Remember, any activity is better than none, so get out of your chair, step away from your desk, or otherwise get moving!

Source: Health.gov. Physical activity guidelines for Americans, 2nd edition. health.gov/paguidelines/second-edition/10things (Accessed 6/20/19)

SOURCE: Olson, B. (14th August, 2019). "The “Official” Lowdown on Physical Activity" (Web Blog Post). Retrieved from: http://blog.ubabenefits.com/lowdown-on-physical-activity