The Kaiser Family Foundation employee health benefits survey for 2019 shows that the cost of annual premiums for employer-sponsored health insurance plans have reached $20,576. While there are differences between small and large employer groups, costs are rising faster than wages for both and average contributions by employees have reached $1,242 for single coverage and more than $6,000 for families. And while wages have increased by 26% in the past decade, contributions to healthcare premiums have gone up 71%.
With unemployment for college-educated people age 25 and above at just 2.2%, it’s been a long time since we’ve seen a jobs market this tight. To attract and retain workers in this environment, growing companies are offering more than just competitive health benefits, and this is especially true for smaller companies forced to compete with larger companies.
Executive search firms have shared examples of employers going above and beyond their health plan by offering additional compensation to cover a candidate’s projected out-of-pocket medical expenses going forward. Technology-related firms in competitive markets are adding wellness benefits like on-site clinics or pre-arranged access to nearby fitness centers. For early to mid-career employees, companies are expanding their family leave or flex-time policies to provide easier transitions for young parents returning to work.
Flexibility and More
Whether it be more paid time off or arranging your work day to meet outside demands on your time, flexibility is becoming increasingly important, especially when you’re dealing with millennials or X-ers. Equally important to young workers is the culture present at an organization and the opportunity to make a difference – to know that what they are doing is helping their community or the world at large.
From unique apprenticeship programs at manufacturing and industrial companies to help with retiring outstanding student debt, more employers are looking for creative ways to gain an edge that will appeal to qualified, prospective employees. In a really tight job market, it pays to be creative.
The American Institute of CPAs reports that its poll of 1,100 working adults revealed that by a 4 to 1 margin, workers would choose a job with benefits over an identical job that offered 30% more salary without benefits. Employed adults estimate that benefits represent about 40% of their total compensation. When asked which benefits are most valuable over the long run, 56% said a 401(k) match or health insurance while just over 30% said a pension.
Many employers will find it interesting that AHPs will continue to be categorized as MEWAs – Multiple Employer Welfare Arrangements. This consideration will make association health plans subject to some state regulations that severely restrict the formation of self-funded MEWAs.
Having to comply with the rules of each state will make AHPs more difficult to organize. While associations can create a plan that extends across state lines, they will have to follow the rules of the state they are in that has the most restrictive laws. As an example, an AHP based in New Jersey that extends into New York would still have to follow the more restrictive laws of New York.
Even though the regulations are more restrictive than many would like, AHPs should enable many small employers to offer their employees better health benefits at more affordable rates.
This article was published on October 3, 2018 on BenefitsPro, written by Emily Payne.
When the Kaiser Family Foundation started tracking employer health benefits 20 years ago, employee deductibles weren’t a concern. Over the years, though, the survey has adjusted to reflect not just the growing percentage of employees with a deductible (85 percent in 2018) but the growing amount of that deductible ($1,573 for an individual in 2018) .
In fact, according to the 2018 KFF Employer Health Benefits Survey, the burden of deductibles has tripled in the past decade and increased eight times faster than wages. Among small employers, 42 percent of workers pay a deductible of $2,000 or more.
“Rising health care costs absolutely remain a burden for employers, but they’re a bigger problem for workers, as cost-sharing has been rising much faster than wages in recent years,” KFF president and CEO Drew Altman said in a press briefing.
This year’s survey shows no dramatic shifts in the employer-sponsored health care space but continues to illuminate a number of trends, including increasing health care premiums, greater focus on employee wellness and alternatives to traditional health care providers.
Premiums have increased five percent this year, costing a family for four an average of $19,616. Of that cost, employees contribute $5,547, and employers pay the rest. For single-coverage, premiums increased 3 percent to $6,896.
“Premium growth is important, but it’s only part of the story,” noted Altman. “The bigger issue is rising cost-sharing. What happens with wages can be as important to closing that gap as what happens to cost-sharing itself.”
Almost half of employers continue to offer PPO plans, while three in 10 offer a high-deductible plan with a savings component. Some employers (13 percent) offer an incentive to encourage employees to opt for one plan over another.
HDHP adoption is stagnating, comprising 29 percent of all plans. Part of this slowdown may be due to the uptick in the economy. “Given the economy is good and health care costs are relatively tame, I think employers don’t have a strong incentive at the moment to push people into plans they may not be as comfortable with,” said Gary Claxton, KFF vice president and director of the Health Care Marketplace Project. “I think we’ve stalled a bit on the growth of HDHPs. Things will get more interesting if we move into a recession.”
Wellness is getting more of employers’ attention. Seventy percent of large firms now offer health-risk assessments, and 81 percent use data from those assessments to better understand health risks, target their wellness program promotions, design new programs and/or measure health care costs. “As employers have gotten more involved in trying to develop programs to encourage employees to be healthy, having the info is necessary to determine what kind of programs to sponsor and what employees need information about,” Claxton said.
More employers are looking at workers’ activity data–21 percent now collect information from a wearable device as part of their wellness program, an increase from last year’s 14 percent.
Interest in telemedicine and retail clinics continues to grow. Among large employers, 74 percent offer telemedicine services, an increase of 63 percent since last year. In addition, 76 percent cover retail clinic services, and some offer employees a financial incentive to choose these services.
A number of factors, including wages and the economy, will continue to impact the employer health care space in the coming years. Ten percent of employers expect that the elimination of the individual mandate will result in fewer workers purchasing employer-sponsored coverage.
Another factor asked about during the briefing was the increase in prices by health care systems and providers. Consolidation among major health care systems continues to shift the balance of power when it comes to price negotiation. “We’re in a competitive health care system,” Claxton noted. “We rely on private insurers and employers to mediate prices. They haven’t been very successful in recent years. It is hard because most workers work for fairly large employers with multiple locations. It’s hard to develop narrow, efficient networks that would cover all of your employees, and the large health plans don’t really have an incentive to create these options.”
This article was published on August 13, 2018 on SHRM.org, written by Stephen Miller.
Plans are steering employees toward expanded telehealth options and high-value centers of excellence
With the cost of employer-sponsored health care benefits expected to approach $15,000 per employee next year, large U.S. employers continue to make changes, new research reveals.
Many want to hold down cost increases and are steering employees toward cost-effective service providers, such as telehealth options and high-value in-plan provider networks, according to the nonprofit National Business Group on Health (NBGH) survey 2019 Large Employers’ Health Care Strategy and Plan Design. The survey was conducted from May to June with 170 large employers as they finalized their 2019 health plan choices; more than 60 percent of respondents belong to the Fortune 500.
Cost Increases Hold Steady
Big employers project that their total cost of providing medical and pharmacy benefits will rise 5 percent for the sixth consecutive year in 2019. If they weren’t making benefit changes, their costs would rise 6 percent, the survey showed.
The total cost of health care, including premiums and out-of-pocket costs for employees and dependents, is estimated to average $14,800 per employee in 2019, up from $14,099 this year. Large employers will cover roughly 70 percent of those costs, leaving $4,400 on average for employees to pick up in premium contributions and out-of-pocket expenses.
Health benefit costs are still rising at two times the rate of wage increases and three times general inflation, “making this [cost] trend unaffordable and unsustainable over the long term,” Brian Marcotte, NBGH president and CEO, said at an Aug. 7 press conference in Washington, D.C.
Consumer-Directed Health Plans
“The most unexpected data point in the survey this year is that employers are dialing back their move to consumer-directed health plans”―or CDHPs―especially as a full replacement for other health plan options, Marcotte said. CDHPs typically combine a high-deductible health insurance plan with a tax-advantaged account that employees can use to pay for medical expenses, most commonly a health savings account (HSA) or health reimbursement arrangement.
“We may be at a tipping point in terms of cost-sharing with employees,” Marcotte said.
In 2019, the number of employers offering CDHPs as a sole option will drop by 9 percent, from 39 percent to 30 percent, “reflecting a move by employers to add more choice back into the mix” by also offering traditional health plans such as preferred-provider organizations, he noted.
To lessen the pain of high deductibles while maintaining incentives for cost-conscious spending, large employers are contributing to their employees’ HSAs, on average, $500 for an individual and $2,000 for a family, NBGH found.
The shift to CDHPs as a sole option over the last decade was driven, in part, by the Affordable Care Act and its 40 percent “Cadillac tax” on high-value health plans, originally to take effect in 2018, Marcotte said. “A lot of companies moved to high-deductible health plans to minimize the impact of the Cadillac tax or to delay its impact, but the Cadillac tax has been kicked down the road, first to 2020 and now to 2022,” Marcotte said. Many believe it may be further delayed or repealed altogether, “so employers are relaxing” about the need to reduce the scope of their plans. Continue reading
EBSO Benefits, an independently owned Third Party Administrator, helps employer groups self-fund their health benefits, thereby giving their clients an opportunity to reduce administrative costs, increase plan flexibility and expand the services they offer to their employees.
More importantly, EBSO is leading the way in a new phase of employee healthcare by helping employer groups take control of their healthcare plan. And taking control means more than self-funding. It means really managing the plan, doing some heavy lifting and shaking things up when what was commonplace is no longer working.
One example EBSO is proud to reference is that of a Midwest-based food processor that has not only stabilized costs for its 700+ employee group but seen the cost of its self-funded health plan drop by approximately 8 percent over the past 4 years. There’s no magic involved – taking ownership of the plan and managing it each and every day has made the difference. New steps have also been taken over time, like adding on-site clinics and contracting directly with high value providers for certain procedures.
As shown, navigating care in a self-funded environment can achieve high quality, affordable healthcare over time. Employees value the many resources available to them, such as an online benefits portal, mobile apps and day-to-day support. They also learn to share in the responsibility.
If moving from carrier to carrier isn’t working out well for your company, it’s time you discovered the freedom, flexibility and control that self-funding with an independent TPA can offer. Contact EBSO and learn more today.
Whether it comes as a shock or not, it’s a simple truth that the majority of employees don’t fully understand their health benefits. And, even if the benefit managers fully understand, sometimes they don’t have the tools to administer the kind of change needed to actually reduce healthcare costs.
Alithias is a platform that allows EBSO to give providers, employers and patients everything they need to take control of and better understand healthcare benefits. Sure, there are plenty of “transparency tools” out there that promise to make healthcare easier to understand and more affordable while also helping to engage employees. But, the people behind Alithias know that transparency tools have a utilization rate of less than 5%. That’s why Alithias is different – it offers features that truly help people “get it” and get the benefits assistance they need.
Compare Actual Prices
Something the average patient does not realize is that more than 30% of healthcare costs are “shoppable”. Alithias’ technology lets patients begin a search by first choosing a common medical procedure within a certain radius of their zip code. The search results then list options of available physicians or groups along with their location, average price for that chosen procedure and quality ratings. And, as if that weren’t simple enough, the patient will also see a detailed description of the procedure and the option to start a live chat with someone who’s ready to give them online support if they need it.
We believe that offering a personal relationship or live help might just be the only approach to ensure plan members seek appropriate care. Because, let’s face it, when people don’t understand their healthcare sometimes their only solution is to avoid it all together, especially when the fear of the unknown cost kicks in. Alithias uses assigned individuals, called Care Navigators, that are there to answer questions that patients don’t know the answers to and teach them what they need to know about healthcare, while also helping them find the best costs or the best doctors. With this kind of help, employees become more educated and involved in their own healthcare, ultimately making smarter decisions and saving on costs. In fact, the average savings for plan members using a Care Navigator is greater than $1,000 per procedure!
These are just two of the beneficial features Alithias can offer. If you’re struggling to give your employer groups and employees the benefits help they need, it’s time you talked to EBSO about Alithias.
Even though this issue also discusses the importance of reaching millennials, it seems an appropriate time to explore this topic from an even broader perspective. Studies like the 2015 Aflac Workforce Report show that more than 7 of 10 employees seldom, if ever, understand what is covered in their healthcare plan. On top of that, a USA Today analysis of government records shows that 1 in 5 invasive surgeries may be unnecessary. On the other side of the coin, we know that when employees fail to obtain the preventive care they need, serious health risks and the potential for even larger health claims exist.
So with the value of your health benefit plan and its cost control and wellness enhancement features hanging in the balance, let’s consider a few thoughts that may motivate your employees to care enough about their benefits to make smarter healthcare decisions.
Timing is Everything – It isn’t a lack of information keeping people from understanding their benefits; it’s how and when people are choosing to get their information. While benefit booklets and plan documents are required, they simply can’t compete with push notifications, text alerts and other “real time” communication. In a world where too many people still pay little or no attention to their healthcare plan until they need it – plan, provider and cost-related information must be more personal and more accessible.
Consumers Rule The Day – In many areas of their lives, your employees are behaving as informed and empowered consumers every day. While this behavior isn’t carrying over to healthcare as quickly as we would like, new products and services are making actionable information easily accessible to both employees and employers. HealthiestYou and Real Time Choices are just two services capable of delivering more personalized, comparative data to individuals when they are making a healthcare decision.
One Stop Shop – More and more TPAs are taking steps to offer one integrated, online “hub” where members can access their benefit plan, claims data and much more. From network providers to cost and quality comparisons to individualized wellness incentives and rewards, the ability to provide one place where members can find the information they want is critical.
As these and other technologies continue to evolve, they will do more and more to connect your employees with the right information at the right time – the real key to engaging employees in their health benefits.