Go From “Great Candidate” to “Job Offer”

Moving from a great candidate to a great offer is not always easy. You need to make your coveted candidate an ideal offer. One that’s going to make them as excited to say those three little words as you are to hear them.

“Yes, I accept!”

Gone are the days of expecting an immediate yes. Employers, hiring managers, and human resource teams realize that making an offer is a nuanced process that needs to take both parties into account. Job seekers have more leverage than ever, and employers will have to adjust their expectations and procedures accordingly.

Get over the speed bumps

Because quality candidates are likely to have several leads, they may not be willing to wait too long for an interview or offer. Moving high-priority candidates through the process quickly can be the difference between being successful and being ghosted.

If your current search procedure involves multiple interviews, hiring committee meetings, and approval processes, now is the time to evaluate the necessity of each component. Get rid of any extraneous requirements, then find ways to streamline the critical pieces so your progress doesn’t get stalled, and your candidates don’t get frustrated.

You may also need to adjust your strategy and timelines regarding the acceptance of an offer. Today’s job seekers may need more time to fully evaluate their options and commit to a decision. This might sound like a double standard, but it’s important to remember that hiring isn’t just about what’s right for the hiring manager or the organization. For your candidate, it’s all about making sure you’re the best fit for them. If the answer is no, it’s in everyone’s best interest to have that person move on. If the answer is yes, the extra day or two will be well worth the wait.

Be flexible and honest

Hiring contracts have always been negotiable, but whether job seekers decide to do so depends largely on the market. When job demand is high and positions are few, candidates are much more willing to accept an offer as is. Likewise, employers should expect negotiations and counteroffers when jobs are readily available, and applicants are few and far between.

Once again, it’s time to look at your processes. Are you offering fair compensation, generous paid time off, and attractive employee benefits? If so, are you including these things in your job postings? Your future employees aren’t just making major career decisions. They’re major financial decisions as well. And to do that, they’ve got to have adequate salary information. Don’t let people get through the process only to find out they can’t accept the job. It’s a waste of their time and yours.

Be honest about what you’re offering. If, for whatever reason, you don’t have any wiggle room in your offers, be upfront about that from the start. If you neglect to make that clear to your candidates during the search and interview process, you could quickly get burned when it comes time to hire.

Let’s take a meeting

Candidates who negotiate during the offer phase aren’t doing it to be difficult or to offend you. It’s all part of the decision-making process. Being flexible on some of these things could give you a huge hiring advantage.

Keep in mind that negotiating with a potential new hire can easily create a happy, engaged, loyal employee. And in many cases, it’s not just about cash. Every applicant comes from a unique situation and has a fantastic set of personal and professional goals. Here are some common issues your future employees may be wrestling with:

  • Student loans
  • Stagnant salary
  • Long commutes
  • Inflexible schedules
  • Affordable childcare
  • Lack of paid time off
  • Toxic boss or culture
  • Non-existent career paths
  • Limited professional development
  • Health, vision, and dental coverage

If you can make life easier in any of these areas, it just might tip the scales in your favor.

Find the right fit

To make the negotiation process go smoothly, you’ll want to consider a few key things before going in:

  • What is the total salary range for the position, and where do new hires fall within it?
  • What maximum dollar amount can you realistically offer without offending your current staff members?
  • Are there additional ways to compensate employees that don’t involve increasing wages?
  • Do you have other qualified candidates in line for the position?

Never assume you know what your candidate wants from an offer. It could be an unrealistic expectation, but it could also be a simple and reasonable request.

If your hiring process is transparent and designed to filter for cultural fit, it will likely weed out any unrealistic expectation candidates— and you’ll be left with a talent pool that’s worth investing in.

 

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Time to Face the Strange (Ch-ch-changes)

Are you gearing up for some organizational change?

Whether it’s a complete restructure, new sales process, revised PTO policy, different employee benefits plan, or simply an office move…to the average employee, it all means the same thing.

Change.

In other words, the way you are doing things today is not the way you will be doing them tomorrow.

Let’s be honest. Change scares some people. Okay, a lot of people. And the longer your processes have been in place, the harder it will be to get the team onboard. Even if you know your plan will make things infinitely better for everyone in the long run, you’ll still run into plenty of folks who just want things to stay the same. “Free espresso all day? Bah! I prefer my daily 9:06 coffee break. Even if I have to walk three blocks and pay five bucks.”

So what should you do if change is in the air at your company?

Create an action plan

Spend some time examining your current structure and what changes will need to be made to support the new model. The more detailed you are in this process, the better. Choose several key people to weigh in to get a full perspective of the needs in various departments and areas.

Create an action plan and select individuals who are both knowledgeable and enthusiastic about overseeing each step of the process, not just for accountability purposes but also to be goodwill ambassadors of sorts. If Grumpy Gary is in charge of training everyone on the new database, it might not go so well. Friendly Fred? Now that’s more like it.

Be prepared

Recognize that people are going to react to change differently. Friendly Fred could surprise you by turning into an Angry Andy. You just never know. Be prepared to encounter any of the following:

  • Change embracers who can’t wait to get started. These dynamos are planning out the details before you’ve even finished explaining the goal.
  • Naysayers who sincerely believe the whole plan is doomed. These guys are already dreading implementation and will do their best to resist.
  • Non-committal fence-sitters who are somewhere in the middle. These folks aren’t sure what to think and could go in either direction.

Talk to your team

Now it’s time to get the word out. Share the details of your plan. Explain the benefits of it and the reasons behind it. Clarify what things will change. Give time frames and set expectations to make things seem less intimidating. Talk about the end goal for when everything is said and done.

After you’ve laid it all out, you’ll be faced with a couple of choices for how to handle the reactions you’ve already anticipated:

  1. Spend your time trying to convert the naysayers and convince the fence-sitters
  2. Spend your time recruiting the change agents and involving them in the process

While attempting to win over the naysayers may seem like a logical plan, trying to convince someone who doesn’t want to change is a good idea can be like trying to explain molecular biology to the average toddler. They just don’t get it. They don’t want to, and they’re not going to try. And all the time you’ve spent trying to convince them that all of this “will be okay” is time that you’re not moving ahead with your new plans.

On the other hand, if you decide to focus your attention on the supporters, you’ll be helping them help you. They can play an active role in the implementation and help with buy-in. You’ll start moving forward immediately, and they’ll be setting an excellent example for the fence-sitters, who are more likely to be influenced by their peers anyway.

Handle the fallout

There will likely be some employee fallout from the change, regardless of how well you manage it. Some people will just refuse to adjust and would rather leave than tough out the process. That’s okay. Let them go. Having people on board who don’t support the company’s goals and vision will eventually bring everybody down.

Have some fun

Once you’ve made it happen, reward your early adaptors, your hardworking implementers, and your former fence-sitters for jumping on board. Review how far you’ve come, and then have a little fun. Why not? You’ve earned it.

 

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Agencies Issue FAQs Regarding Coverage of Over the Counter COVID-19 Diagnostic Tests

Agencies Issue FAQs Regarding Coverage of Over the Counter COVID-19 Diagnostic Tests

On December 2, 2021, President Biden announced that federal agencies would soon issue guidance regarding the availability of coverage/reimbursement from group health plans and health insurance carriers for individuals who purchase over the counter, at-home COVID-19 diagnostic tests (“OTC COVID-19 tests”).  Accordingly, on January 10, 2022, the agencies released “FAQs About Affordable Care Act Implementation Part 51, Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Implementation” which, among other things, requires group health plans and health insurance carriers to reimburse participants, beneficiaries, or enrollees (“Individuals”) for no less than eight (8) OTC COVID-19 tests per calendar month beginning on January 15, 2022 (i.e., for tests purchased on or after January 15, 2022).

Background

During the COVID-19 public health emergency, the FFCRA requires group health plans (self-funded, fully-insured, grandfathered, and non-grandfathered plans, but not excepted benefits such as dental or vision) and health insurance issuers (“Plans and Carriers”) to cover testing or certain other items or services intended to diagnose COVID-19 without cost sharing (deductibles, copays, or coinsurance), prior authorization, or other medical management requirements.  It also permits the agencies to implement the FFCRA through sub-regulatory guidance, program instruction, or otherwise.  The CARES Act expanded the FFCRA to, among other things, include a broader range of reimbursable COVID-19 diagnostic items and services that must be covered without cost-sharing, prior authorization, or medical management during the public health emergency.

In 2020, the agencies implemented several FAQs intended to serve as statements of policy to implement the above-referenced requirements under the FFCRA and CARES Act.  Since that time, the FDA has authorized at-home OTC COVID-19 diagnostic tests that individuals can self-administer and self-read to diagnose COVID-19.  Accordingly, per the agencies, the FAQs issued on January 10, 2022 are intended to address both the FDAs approval of at-home OTC COVID-19 tests and the President’s request for additional guidance on group health plan coverage for these tests to address the ongoing COVID-19 public health emergency.

 

FAQ Guidance

Pursuant to the FAQs, Plans and Carriers must cover OTC COVID-19 tests that meet the criteria specified under the FFCRA even if they are not ordered by a health care professional, and must cover such tests without imposing cost-sharing, prior authorization, or medical management requirements.  This is so even if there is no order from a health professional for an Individual.

Coverage by the plan may be accomplished by directly reimbursing Individuals for their purchase upon submission of a claim by the Individual, or by reimbursing the entity who sold the OTC COVID-19 test directly, though the agencies strongly encourage plans to adopt the latter approach.

Note, however, there is no requirement for Plans or Carriers to provide coverage of OTC COVID-19 tests that are intended for employment testing, such as weekly testing an unvaccinated Individual is required to undergo pursuant to the OSHA Emergency Temporary Standard (“ETS”) or an employer’s own mandated testing program.

Plans and Carriers are required to reimburse OTC COVID-19 tests purchased from any retailer or pharmacy if the test meets the FFCRA statutory criteria, but if the test is administered without a health care provider’s assessment or order for testing and purchased from out-of-network pharmacies or retailers, then the Plan or Carrier may limit reimbursement to the lower of the actual price or $12 per test if the Plan or Carrier arranges for direct coverage (meaning the Individual who purchases the OTC COVID-19 test is not required to seek reimbursement post-purchase or make any up-front out-of-pocket expenditures) of OTC COVID-19 tests that meet the FFCRA criteria through both its pharmacy network and a direct-to-consumer shipping program.  Per the agencies, the direct-to-consumer shipping program may be provided through one or more in-network provider(s) or another entity designated by the Plan or Carrier.

In order to limit reimbursements for tests purchased from non-preferred providers, Plans and Carriers must ensure there are an adequate number of retail locations (in-person and online) with access to OTC COVID-19 tests and communicate necessary information about the direct coverage program, including when it is available and which retail pharmacies are available.

Per the agencies, whether access is adequate is determined based on all relevant facts and circumstances, including where Individuals are located and current utilization of the Plans’ or Carrier’s pharmacy network by Individuals.  Further, if there are significant delays for individuals to receive the OTC COVID-19 tests, such as through the shipping program, the Plan or Carrier must allow Individuals to purchase (and be reimbursed for) their OTC COVID-19 tests from any retailer.

The agencies also recognize the important need for adequate testing to be available to health care providers who are diagnosing and treating COVID-19, and that everyone has reasonable access to OTC COVID-19 tests.  Thus, to prevent stockpiling and provide adequate safeguards, the agencies permit Plans and Carriers to limit OTC COVID-19 tests purchased by Individuals without a health care provider’s involvement or assessment, the agency provides a safe harbor from agency enforcement action for Plans or Carriers that limit the number of OTC COVID-19 tests eligible for reimbursement per Individual to no less than eight (8) tests per 30-day period or per calendar month.  Plans and Carriers are not permitted to limit Individuals to a smaller number of tests over a short period of time (such as limiting Individuals to four (4) tests per 15-day period).  Plans can choose to be more generous by reimbursing a larger number of OTC COVID-19 tests (i.e., more than 8) per calendar month if they prefer.

Testing for Employment Purposes

Plans and Carriers are permitted to address suspected fraud and abuse, such as taking reasonable steps to ensure OTC COVID-19 tests are purchased for an Individual’s (or their covered family member’s) own personal use as long as the steps do not create significant access barriers.  This may include requiring attestations that the OTC COVID-19 test was purchased by the Individual for personal, non-employment related use, will not be reimbursed by another source, and will not be made available for resale as long as the attestation process is reasonable and does not result in undue delay of reimbursement.  Plans and Carriers may also require reasonable documentation as proof of purchase, such as the UPC code from the OTC COVID-19 test, when claims are submitted.

Finally, Plans and Carriers may assist Individuals by providing education and information resources to support Individuals seeking OTC COVID-19 testing as long as the materials clearly indicate the Plan or Carrier is required to cover all OTC COVID-19 tests that meet FFCRA criteria (subject to the safe harbors referenced previously).  The FAQs provide some examples of potential education and information resources Plans and Carriers may use.

What Does This Mean for Employers?

Employers are encouraged to work with their carriers or third-party administrators and stop-loss carriers to ensure these new requirements are implemented and to determine whether the plan will implement any of the permitted safe harbors so that this can be effectively communicated to employees and their family members.

The agencies clarified that they will not take enforcement action against Plans or Carriers for modifying health insurance coverage mid-year to meet these requirements or for failing to meet the 60-day advance notice requirements (for changes made to information required to be included in SBCs) if notice of these changes is provided as soon as reasonably practicable.

Finally, employers should clearly articulate to employees that the employer’s testing policy adopted pursuant to the OSHA ETS, if any, is not subject to this requirement and, employees are expected to pay out of pocket for weekly COVID-19 tests without seeking reimbursement from the employer’s group health plan if the employer does not pay for the applicable testing.  Further, pursuant to the OSHA ETS, while the employer may allow an OTC COVID-19 test to be used for purposes of applicable employment testing, the test may not be both self-administered and self-read unless observed by the employer or an authorized telehealth proctor.

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About the Author.  This alert was prepared for Employee Benefit Consultants, Inc. by Marathas Barrow Weatherhead Lent LLP, a national law firm with recognized experts on the Affordable Care Act.  Contact Stacy Barrow or Nicole Quinn-Gato at sbarrow@marbarlaw.com or nquinngato@marbarlaw.com.

 

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers or our clients.  This is not legal advice.  No client-lawyer relationship between you and our lawyers is or may be created by your use of this information.  Rather, the content is intended as a general overview of the subject matter covered.  This agency and Marathas Barrow Weatherhead Lent LLP are not obligated to provide updates on the information presented herein.  Those reading this alert are encouraged to seek direct counsel on legal questions.

© 2022 Marathas Barrow Weatherhead Lent LLP.  All Rights Reserved.

Breaking Down Full-Coverage Health Insurance

When it comes to attracting and retaining employees with various employee benefits, health insurance is at the top of their minds. A survey shows that “56% of U.S. adults with employer-sponsored health benefits said that whether or not they like their health coverage is a key factor in deciding to stay at their current job.” The same survey shows that “46% said health insurance was either the deciding factor or a positive influence in choosing their current job.”

With health insurance, the type of coverage is important. You may have heard the terms full-coverage health insurance or comprehensive coverage. Learn more about what this type of health insurance is, and why you should consider offering it to your employees.

What is full-coverage health insurance?  

Full-coverage health insurance, also known as major medical health insurance or comprehensive coverage, is a health insurance plan that provides overarching, broad coverage of a variety of healthcare services such as doctor visits, hospital visits, and emergency room visits.

In contrast to full coverage, limited-benefit plans (or supplemental policies) may cover only specific conditions (e.g., cancer) or specific types of services (e.g., hospitalization), or have a dollar cap on coverage. These plans are not considered comprehensive, nor are they considered minimum essential coverage, and are not regulated by the Affordable Care Act. However, they can be a good supplement to a full-coverage health insurance plan.

What should be included in a full-coverage health insurance plan?

At the minimum, a full-coverage health insurance policy, which includes all new individual/family and small-group major medical health insurance policies sold after January 1, 2014, must cover the ten essential health benefits outlined in the Affordable Care Act (ACA) with no annual or lifetime benefit caps:

  • Hospitalization
  • Ambulatory services (visits to doctors and other healthcare professionals and outpatient hospital care)
  • Emergency services
  • Maternity and newborn care
  • Mental health and substance abuse treatment
  • Prescription drugs
  • Lab tests
  • Chronic disease management, “well” services, and preventive services
  • Pediatric dental and vision care
  • Rehabilitative and “habilitative” services

What is considered a full-coverage health insurance plan?

  • Most group health insurance plans
  • ACA-compliant policies purchased in a state’s health insurance exchange/marketplace
  • ACA-compliant plans purchased off-exchange (purchased directly from an insurance company or through an agent or broker, outside of the ACA-created health insurance exchange)
  • Medicaid and Child’s Health Insurance Program (CHIP) plans (Medicaid has some exceptions. Some people qualify for limited-benefit Medicaid coverage; this is not considered comprehensive coverage.)
  • Medicare (either Original Medicare or Medicare Advantage, although Original Medicare is typically combined with a Medigap plan and Part D plan to provide comprehensive coverage)

Be aware that the term “comprehensive” regarding health insurance plans is like the term “natural” regarding groceries. It’s not an officially defined term and has no official marketing rules associated with its use.

A variety of full-coverage plans

Employers can offer different types of full-coverage plans to cover specific needs. Here are some examples, as given by the official government healthcare website:

  • Exclusive Provider Organization (EPO):  A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network.
  • Health Maintenance Organization (HMO): Usually limits coverage to care from doctors who work for or contract with the HMO, and it generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.
  • Point of Service (POS):  A health plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor to see a specialist.
  • Preferred Provider Organization (PPO):  A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

Be well-informed and do your research

Buying health insurance means you should always do your research. It’s important to work with your advisor and legal counsel to help you understand the fine print and terminology (such as essential health benefits and minimum essential coverage) before offering plans to your employees. Full-coverage health insurance is what employees want from their employers, and implementing such a plan will lead to employee attraction, retention, and satisfaction.

 

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The Key to Purposeful Communication

When it comes to communication, are you a first responder? Do you answer emails instantly and pick up your phone no matter what? Are you proud of your 24/7, lightning-fast response times?

If so, you may be selling yourself and your business short.

Speed doesn’t always equal quality

Being speedy is relevant for certain situations—like if your house is on fire. The faster the fire department can get there, the better. But what about if you’re getting a massage? Or smoking your famous ribs? Or driving through a school zone?

Speed doesn’t necessarily equate with quality. And it sure as hell doesn’t equate with accuracy. Bottom line: The faster you go, the easier it is for you to lose control.

If you’re speeding through your communications, it’s easier for things to get missed, skipped, or lost in translation. Worse yet, in the rush to respond, you not only lose control of the conversation, but you also lose control of your time. In essence, you’re letting everyone who contacts you call the shots. Instead of carefully following through on the things you need to do, you’re constantly on your heels, jumping from one thing to the next, based on the agenda of whoever is contacting you now.

This kind of behavior may be optimal when speed is highly valued. Think paramedics, call centers, and fast-food employees.

But in many cases, speed comes at a cost. Consider this: Do your coworkers want a quick response or a thoughtful, honest, and accurate response? Do they want fast food, or would they rather have those award-winning, slow-cooked ribs?

Practice proactive, not reactive, communication

Ask any therapist, and they’ll tell you the key to quality communication isn’t spewing out ultra-quick answers. It requires active listening, careful synthesis of information, and clear responses.

If you’re skimming emails, firing back text messages, and responding hastily to keep your response time numbers up, you’re engaging in sub-par interactions. The fallout from this kind of fast-paced, reactive communication includes:

  • Confusion and misunderstandings
  • Missing details and erroneous information
  • Additional back and forth for clarification and corrections

It’s the ultimate irony. In your quest to save time and be efficient, you’re making more work for everybody.

Stop and take a breath

In a world where lightning-fast technology and instant gratification are hailed as the ideal standards, it can be hard to wrap your head around the idea that slower might be better. But unless you’re a firefighter or an ER doctor, your clients probably aren’t benefitting from a 911 emergency communications approach. This is doubly true if you are in any kind of problem-solving or consultative role.

Think about it. When it comes to the following professionals, do you want the fastest service or the best service?

  • Your auto mechanic
  • Your hairstylist
  • Your therapist
  • Your surgeon
  • Your lawyer
  • Your bank
  • Your insurance advisor

Don’t sell your customers, co-workers, employees, and significant others short with timely but inefficient communication tactics.

Reset your mindset

Sometimes, this is the most challenging part of implementing new processes. You need to change the mindset and expectations of those around you, and you also must change your mindset and the expectations you have for yourself.

If your business currently promises instant, around-the-clock response times, it’s time to consider whether that policy is doing more harm than good.

  • Is your commitment to speed hindering your forward progress?
  • Is requiring instant replies impacting the accuracy and quality of your client communications?
  • Is being in constant reactive mode exhausting your team, keeping them off-balance, and quietly sucking the time and life out of everyone’s day?

If any of these questions caused you to raise your hand, nod your head, or hesitate a bit, it’s time to make some changes. Stop promising fast responses and dedicate yourself to fantastic communication instead.

  • Implement new policies for acceptable response times
  • Encourage periodic email and phone checks instead of constant monitoring
  • Provide education and training on active listening and other communication techniques

When you drop the focus on instant replies, you give your team the freedom and focus they need to respond with more comprehensive, well-thought-out answers. Which is a gift to your customers as well.

 

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