A Crash Course in Group Health Insurance Plans

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When it comes to health insurance, people want the right amount of coverage. They also want coverage for what they see as high value (doctor’s visits, medical procedures, etc.). There are many insurance plans out there—the traditional fully insured plan, the level-funded plan, the self-funded plan…and you may be wondering what the difference is between them, and where to even begin.

Welcome to our crash course in group health insurance plans.

Where it all began—fully insured plans

Fully insured plans are probably what come to mind when you think of group health insurance plans. Employers get the plan from an insurance company (carrier) and pay a premium to the insurance company. The yearly premium rates depend on how many employees are enrolled in the plan. When employees make a claim, the insurance company writes a check to the healthcare provider (hospital, doctor, etc.). Employees are responsible for paying the deductibles and co-pays defined in the plan.

A fully insured plan usually includes coverage for medical procedures, prescriptions, and doctor’s visits. Employers tend to go the route of fully insured for their business if they want to give their employees predictable benefits that remain consistent over time and provide the business with a regular monthly fee to manage cash flow.

New paths and steppingstones—level-funded plans

Level-funded plans are the go-betweens, the bridge between a fully insured plan and a self-funded plan (which we will discuss in a minute).

With level-funded plans, employers pay a set amount of money each month to the insurance company that funds a reserve account for claims and manages administrative costs and fees. Rates for a level-funded plan is defined by the number of employees and the estimated cost of anticipated claims. If the employer has a surplus of claims funds at the end of the year, they will receive a refund. If the claims are higher than estimated, they will receive a premium increase for any stop-loss coverage an employer has.

Employers usually choose level-funded plans if they anticipate employees not making many insurance claims and want to offer their employees insurance at an affordable cost. It also allows ease of access to utilization trends that show where employees might be overspending and allows employers to use education and wellness programs to improve claims costs.

Rise in popularity—self-funded plans

The popularity of self-funded plans is on the rise. A report published in 2020 found that 60% of workers in companies with three or more employees were on some kind of self-funded plan. But how does it work, exactly?

With self-funded plans, or self-insured plans, an insurance company provides administrative services. Like with level-funded plans, there is a fixed cost for administrative fees. But unlike level-funded plans, employers assume all the costs and financial risks in a self-funded plan. They pay for employee health claims from a bank account or trust fund set up for that purpose.

These plans have the highest amount of risk; however, employers can have stop-loss insurance that reimburses them for claims that exceed a predetermined level. There are two types of stop-loss insurance:

  • Specific stop-loss coverage, or individual stop-loss coverage, provides protection for employers against a high claim for any one employee. For example, if employers want a maximum liability of $150,000 per person, and an employee makes $200,000 in medical claims, specific stop-loss reimburses the employer for the $50,000 in excess claims.
  • Aggregate stop-loss coverage provides a set coverage ceiling on the amount of eligible expenses employers pay during that contract period. In other words, this is the coverage for all the employees total, not just for any one specific employee.

While self-funded plans can be expensive without stop-loss coverage, many employers find self-funded plans attractive. If they don’t need to pay fixed monthly premiums and they want to proactively manage claims costs with a hands-on approach, such as steering employees to high-value, low-cost providers and taking advantage of clinical wellness programs, self-funding may be a good fit.

One size doesn’t fit all

What’s right for one company may not be right for you. There are many different health insurance plans and different plan options, and taking a route doesn’t mean you take the route alone. Many advisors are well-educated in level-funding and self-funding.

Start a conversation with your broker to find out if this is in their area of specialty. Whether it is or not, do your research so you can fully participate in the conversations to determine what is the best for you and your employees.

 

 

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Non-Insurance Solutions That Make a Real Impact

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The world of employee benefits experienced significant growing pains since the pandemic hit a little over a year ago. With all the new challenges employees began experiencing (job loss, loss of childcare, financial instability, mental health, and so much more), employers learned, fast, that ensuring the wellbeing of their employees is essential.

Let’s break down some of the factors contributing to employee resilience and wellbeing that employers can effectively take action on.

Employee Wellness

It’s important to understand that while the term ‘wellness’ is singular, it encompasses a variety of factors that contribute to it. While someone may have good physical wellness, if they are experiencing hardship in other areas of their lives, their overall wellness will be affected. In this way, employers need to approach wellness holistically, focusing on more than one contributing factor in an employee’s overall wellbeing.

Financial stability

A 2018 report by the Federal Reserve found 40% of adults would struggle to pay off a $400 unexpected expense. According to the MetLife Employee Benefit Trends Study 2021, financial stress is both the top concern and the leading factor contributing to poor mental health among employees. A staggering 86% of employees reported financial stress was a leading source of anxiety now and going forward.

These numbers vastly differ between demographics, showing a disparity in the experience of white/Caucasian and Black and Latinx respondents. When asked if they had been worried about their financial health, 53% of white respondents and 70% of both Black and Latinx respondents said yes. These numbers are concerning not only because of the disparity they represent but also because they demonstrate the vast number of people suffering from financial stress.

Many employers function under the misconception that their employees are financially stable, but there is no way of knowing what kind of financial burdens employees may carry. They may be a single parent, a caregiver of a family member with medical needs, or struggling to pay off staggering student loan debts. Whatever the case, employers that offer financially focused benefits can help make a significant difference in their employees’ lives.

Consider offering financially focused benefits aimed at developing financial stability for your employees now and into their future:

  • Student loan support
  • 401(k) and other retirement savings
  • Monthly wellness stipends
  • Financial coaching and education
  • Childcare support

Mental health

One of the positive side effects created by the pandemic has been the increased availability of accessible mental health support. Organizations like BetterHelp and Talkspace provide access to qualified therapists that provide therapy services online or over the phone, and these services have taken off over the past year as more Americans have reached out for mental health help. Offering programs designed to overcome cost barriers that may deter employees from accessing mental health services is a great way to help support your employees’ wellbeing.

Flex time

Another way to provide support to employees is to offer flex time. Many organizations have started to use flex time since the pandemic began, along with remote work. According to the same MetLife study, 76% of workers are interested in continuing alternative working arrangements developed during the pandemic such as remote work and flexible schedules, but 90% of employers who said they implemented these alternative solutions are planning to go back to pre-pandemic working arrangements when possible. That is a concerning disparity that may result in employee frustration when they are forced back into the office, expensive commutes, and less flexibility to manage their personal lives.

68% of employees working remotely want their employers to allow them to make the decision for themselves. Over half of workers in their 20s, including Gen Zs and young Millennials, are happier with their working arrangements now than before the pandemic.

Flexible scheduling, remote options, and unlimited PTO programs allow employees to better manage their personal commitments with less stress, enabling them to maintain their overall wellness with greater ease.

Social justice

2020 wasn’t just the Year of the Pandemic, but a year of great social unrest and change. 42% of all employees say that social justice issues are a source of anxiety for them. These issues reach across demographics, location, age, and economic status. All employers must do what they can to provide support in this area.

Consider offering:

  • Paid volunteer hours
  • Paid holidays or time off during election days
  • Inclusivity training for managers and employees

In it for the long haul

Employee wellness was a critical issue long before the pandemic and will continue to be one well into the future. Employers who are serious about developing a company that can drive growth, attract, retain, and engage employees, and leave a positive legacy behind them need to be considering these issues consistently throughout the years.

What’s good for your employees is good for you: employees who identify as mentally and physically healthy are 37% more productive than those that aren’t. And that’s just one statistic that shows how caring for your employees creates a positive ripple effect within your organization, their community, and the world.

It’s a win-win for everyone.

 

Content provided by Q4iNetwork and partners

Photo by fizkes

It’s Time to Expect More from Your Broker

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For most employers, the story is the same every year. They don’t hear from their benefits broker until renewal starts to appear around the corner, and then it’s spreadsheets, rising premiums, and more spreadsheets. The world of insurance is confusing and frustrating, and for many employers, this leads them to seek out second opinions from multiple brokers. Why wouldn’t you? Even if your goal is just to keep your current broker honest, it’s only common sense to get second opinions on a purchase that large.

But here’s the problem. Almost without fail, the brokers you talk to will get the same numbers from the carriers, bring in the same spreadsheets, and will likely tell you about their services, which are the same as every other broker. Benefits admin support, compliance support, HR services—the list goes on, and it’s almost always the same.

You still have to make that gut-wrenching purchase come renewal time, and you still feel in the dark about your options.

So how do you decide which broker to go with if everything they’re offering is the same? That’s where many brokers and employers alike would point to the “relationship” part of the business. They would say it all comes down to who you like the best.

But we disagree. There is a different kind of broker out there—one that doesn’t look the same as the rest and can offer you something different—something better.

What you really need

While every year you feel the same frustration and anxiety around having to make an extremely (and increasingly) expensive investment in your employees, how much do you really understand about why you’re making that particular purchase?

The reality is most employers simply don’t have enough real experience with the world of insurance other than that dreaded yearly renewal process. This leaves them at the mercy of their broker and relying on others to tell them what’s best for their business.

While this makes sense—the world of insurance is increasingly confusing and constantly changing—it’s simply not sustainable. What employers need is to have the power to make an informed and educated decision when it comes to their benefits plan. They need to have the kind of power only true understanding can bring.

How to differentiate

So it’s time to start looking for something different in your broker. Here’s how to spot it. While the benefits broker you’re used to will:

  • Only get in touch with you when it comes time to renew
  • Offer you the same spreadsheet and the same services every year
  • Assure you their service is the best and that’s what sets them apart
  • Hand you their non-insurance solutions and call it good
  • Completely fall off your radar once you’ve renewed

The benefits broker you want:

  • Shows up well before you have to start thinking about renewals
  • Starts off the conversation by uncovering your goals and challenges
  • Focuses on educating you about your options
  • Isn’t interested in forcing you to buy unless their solution improves your business
  • Continues to provide you with advice and education throughout the year
  • Supports the use of non-insurance solutions via training, communication, and education

The first type of broker wants you to buy from them and pick them out among the rest. While the second type also wants that, their first priority is to help you improve your business and make an impact in the lives of your employees. What you need isn’t a benefits broker—what you need is a benefits advisor.

Why?

So you can make the most informed decision for your business without blindly relying on a handful of brokers at renewal telling you the same thing over and over. So you won’t make the mistake of simply sticking to what you know just because you know it, passing over opportunities to make massive savings because you don’t understand them, and thus don’t trust them (yes, this really happens).

The world of insurance is growing and changing, and employers need to be able to grow and change along with it—and that requires employers to become educated about their situation and their options.

Expect more

The bottom line is you don’t have to settle for the same type of broker. In fact, you shouldn’t. You and the people your business supports deserve the best service and the best benefits available—and you can only get that by having the power to make informed decisions yourself.

Start expecting your broker to teach you. Start asking questions and expecting answers. Look for a broker who focuses on education, year-round communication, and who takes the time to help you fully understand all your options. You deserve more than the same old story. It’s time to expect a new one.

 

Content provided by Q4iNetwork and partners

Photo by Volodymyr Melnyk

Congress Passes the American Rescue Plan Act

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Congress Passes the American Rescue Plan Act

Congress has passed, and President Biden has signed, the American Rescue Plan Act, 2021 (ARPA), the third COVID-19 stimulus bill.  This new $1.9 trillion stimulus package includes several health and welfare benefits-related provisions relevant to employers and plan sponsors, as summarized below.

FFCRA Paid Leave Extended and Enhanced

While COVID-19 vaccines are starting to become more readily available, the pandemic continues. In recognition, Congress extended through September 30, 2021, the refundable payroll tax credits for emergency paid sick leave (EPSL) and extended family and medical leave (E-FMLA), which were enacted pursuant to the Families First Coronavirus Response Act.  As with the extension through March 31, 2021 under the second stimulus package (the Consolidated Appropriations Act, 2021), only the tax credits are extended, which means compliance with the EPSL or E-FMLA requirements is voluntary for employers after December 31, 2020.

The ARPA expands FFCRA leave in several ways for employers who choose to offer it from April 1, 2021 through September 30, 2021:

  • The 10-day limit for EPSL resets as of April 1, 2021. Employees were previously limited to 80 hours from April 1, 2020 through March 31, 2021.
    • Paid leave continues to be limited to $511 per day ($5,110 total) for an employee’s own illness or quarantine (paid at the employee’s regular rate), and $200 per day ($2,000 total) for leave to care for others (paid at two-thirds of the employee’s regular rate).
  • A new “trigger” is added under both the EPSL and E-FMLA provisions. Employees qualify for leave if they are:
    • seeking or awaiting the results of a diagnostic test for, or a medical diagnosis of, COVID-19, and the employee has been exposed to COVID–19 or the employee’s employer has requested such test or diagnosis;
    • obtaining immunization related to COVID–19; or
    • recovering from any injury, disability, illness, or condition related to such immunization.
    • MBWL Note: The ability of an employer to receive a tax credit for providing paid time off for an employee to receive the vaccine is a clear indication of the federal government’s desire to facilitate employees receiving a vaccine.
  • Leave under the E-FMLA provision is increased from $10,000 to $12,000, with $12,000 being the maximum an employer may claim for an employee in 2021.
  • Leave under the E-FMLA provision is expanded to be available for any EPSL-qualifying reason, which is when an employee is unable to work or telework because the employee:
    • is subject to a federal, state, or local quarantine or isolation order related to COVID-19;
    • has been advised by a health care provider to self-quarantine due to concerns related to COVID-19;
    • has COVID-19 symptoms and is seeking medical diagnosis;
    • is caring for an individual who is subject to a quarantine or isolation order;
    • is caring for a child if the school or day care center has been closed, or the child-care provider is unavailable, due to COVID-19 precautions; or
    • is experiencing any other substantially similar condition specified by the regulatory agencies.
  • E-FMLA leave taken on or after April 1, 2021 is not subject to the 10-day elimination period that applied previously under FFCRA.
    • An employee’s eligibility for E-FMLA may depend on when they used E-FMLA previously and how the employer establishes its 12-month FMLA period (e.g., calendar year, fixed period, measure-forward, or “rolling” 12 months).
  • For leave taken on or after April 1, 2021, the employers may take a credit against Medicare payroll tax only (1.45%); however, the credit continues to be refundable.
    • ESPL and E-FMLA credits are available for qualified health plan expenses and for the employer’s share of Medicare and Social Security taxes.
  • ARPA clarifies that refundable credits may be received by state and local governments that are tax exempt under Code 501(a).
  • ARPA adds a new nondiscrimination requirement that eliminates the credit for any employer that discriminates in favor of highly compensated employees, full-time employees, or employees based on tenure.

Dependent Care Assistance Program Limit Increase

In February, the IRS released Notice 2021-15, which provides guidance related to the relief for health FSAs and dependent care assistance programs (DCAPs) contained in the second stimulus bill. Unfortunately, the Notice failed to clarify with any certainty whether an employee may be taxed on any DCAP reimbursements in excess of $5,000 for the calendar year.  That issue is now settled by the ARPA, which increases the DCAP exclusion from $5,000 to $10,500 (from $2,500 to $5,250 in the case of a separate return filed by a married individual) for 2021. This relief is only available for calendar year 2021; however, it also implies that an employee could elect to increase their DCAP election to the newly available $10,500 limit for 2021 (based on the relief in Notice 2021-15).  A DCAP must be amended by the end of the 2021 plan year to take advantage of the increased exclusion limit.

Temporary Premium Tax Credit Enhancements

The Affordable Care Act’s premium tax credit program is significantly enhanced for 2021 and 2022. The existing income limit of 400% of the federal poverty level, after which individuals will no longer qualify for a premium tax credit, is lifted for 2021 and 2022. In addition, the applicable percentage of household income that individuals must pay for Marketplace coverage has been reduced at all income levels.  Special rules also apply to those individuals receiving unemployment compensation during 2021.

MBWL Note: The increased eligibility for premium tax credits makes it ever more important for applicable large employers (ALEs) to offer affordable, minimum value coverage to their full-time employees to avoid potential penalty exposure.

Temporary PTC Percentages Under ARPA
In the case of household income (expressed as a % of poverty line) within the following income tier: The initial premium percentage is— The final premium percentage is—
Up to 150.0% 0% 0%
150% to 200% 0% 2%
200% to 250% 2% 4%
250% to 300% 4% 6%
300% to 400% 6% 8.5%
400% and up 8.5% 8.5%

 

2021 PTC Percentages (Pre-ARPA)
In the case of household income (expressed as a % of poverty line) within the following income tier: The initial premium percentage is— The final premium percentage is—
Up to 133.0% 2.07% 2.07%
133% to 150% 3.10% 4.14%
150% to 200% 4.14% 6.52%
200% to 250% 6.52% 8.33%
250% to 300% 8.33% 9.83%
300% to 400% 9.83% 9.83%
400% and up Ineligible for PTC

COBRA Subsidy

The ARPA provides significant assistance to employees and their families who are eligible for COBRA (or state mini-COBRA) due to an involuntary termination of employment or reduction in hours.  The law provides a 100% subsidy for COBRA premiums from April 1, 2021 through September 30, 2021. The subsidy applies to group health plans other than health FSAs.

Employers who are subject to COBRA under ERISA (private employers) or the PHS Act (state and local governmental employers) are responsible for complying with the COBRA subsidy provisions.  Insurance companies are responsible for complying with the COBRA subsidy provisions for insured group health plans that are not subject to federal COBRA (e.g., when state “mini-COBRA” requirements apply to small plans that are not subject to federal COBRA, or to large group plans after federal COBRA is exhausted).  Additional highlights include:

  • The subsidy applies to an “assistance eligible individual” (AEI) who is any COBRA qualified beneficiary who is eligible for, and elects, COBRA during the period of April 1, 2021 through September 30, 2021, due to an involuntary termination of employment or reduction in hours. (The reduction in hours is not required to be involuntary.)
  • AEIs must be offered at least a 60-day window within which to elect COBRA coverage.
    • The 60-day period begins April 1, 2021 and ends 60 days after the date the notice is provided to the individual.
    • AEIs include individuals in their COBRA election period, and individuals who would be AEIs but whose COBRA coverage lapsed due to non-payment prior to April 1, 2021.
    • MBWL Note: Many AEIs will still be within their COBRA election period as a result of the Department of Labor’s disaster relief (Notice 2021-01).
  • COBRA coverage elected during the subsidy period will be effective April 1, 2021; employees are not required to elect retroactive to the date of their qualifying event or any other date prior to April 1, 2021, nor are they required to pay outstanding premiums for prior periods of coverage in order to secure subsidized coverage.
  • Employers will be entitled to an advanceable, refundable tax credit against Medicare payroll taxes (1.45%) to pay for coverage during the subsidy period. The DOL will provide forms and instructions for employers to apply for the credit.
    • Additional guidance is expected for multiemployer (union) plans and professional employer organizations (PEOs).
  • The subsidy is available until the first to occur of:
    • the qualified beneficiary becoming eligible for other group health plan coverage (other than coverage consisting only of excepted benefits, such as dental or vision, coverage under a health FSA, or coverage under a qualified small employer health reimbursement arrangement (QSEHRA));
    • the qualified beneficiary becoming eligible for Medicare;
    • the end of the qualified beneficiary’s maximum COBRA duration; or
    • September 30, 2021.
  • Qualified beneficiaries who fail to notify the plan that they are no longer assistance-eligible can be liable for a $250 penalty, which may be waived if the failure was due to reasonable cause and not willful neglect. An intentional failure can result in a penalty of $250 or 110% of the amount of premium assistance received, if greater.
  • Employers may allow currently enrolled AEIs to select new plans. An individual has 90 days from the date they are notified of the enrollment option to elect a different plan.  This option is available only if:
    • the premium for such different coverage does not exceed the premium for coverage in which such individual was enrolled at the time such qualifying event occurred;
    • the different coverage in which the individual elects to enroll is coverage that is also offered to similarly situated active employees; and
    • the different coverage is not coverage consisting only of excepted benefits, such as dental or vision, coverage under a health FSA, or coverage under a QSEHRA.
  • Required Notices to Individuals
    • General Notice / Notice of Subsidy Availability. Individuals who become eligible to elect COBRA during the subsidy period (April 1, 2021 – September 30, 2021) must be provided a notice that describes the availability of the premium assistance. The notice requirement may be satisfied by amending existing notices or by including a separate attachment. The notice must include:
      • the forms necessary for establishing eligibility for premium assistance;
      • the name, address, and telephone number to contact the plan administrator and any other person maintaining relevant information in connection with such premium assistance;
      • a description of the extended election period;
      • a description of the obligation of the qualified beneficiary to notify the plan when they are no longer eligible for a subsidy and the associated penalty for failure to do so;
      • a description, displayed in a prominent manner, of the right to a subsidized premium and any conditions thereon; and
      • a description of the option to enroll in different coverage if the employer so permits.
    • Notice of Extended Election Period. AEIs must be offered at least a 60-day window within which to elect COBRA coverage.
      • The 60-day period begins April 1, 2021 and ends 60 days after the date the notice is provided to the individual.
      • This includes:
        • individuals terminated on or after April 1, 2021;
        • individuals in their COBRA election period on April 1, 2021 (including any COVID-19-related extensions); and
        • individuals who would be AEIs but whose COBRA coverage lapsed due to non-payment prior to April 1, 2021.
      • Notice of Subsidy Expiration. Informs AEIs that the subsidy period is ending.
      • The notice must disclose that:
        • premium assistance for the individual will expire soon and the date of such expiration;
        • the individual may be eligible for coverage without any premium assistance through COBRA or coverage under a group health plan.
      • The subsidy expiration notice is not required if the subsidy is ending due to the individual becoming eligible for another group health plan or Medicare.
      • This notice must be provided not more than 45 days but no less than 15 days before the premium assistance ends.
      • Model Notices. The DOL must issue model notices of subsidy availability and extended election period within 30 days of enactment, and a model notice of subsidy expiration within 45 days of the law’s enactment.

What Does This Mean For Employers?

Employers and plan sponsors should consider whether they will adopt the extended FFCRA leave provisions and/or use them to incentivize employees to receive a COVID-19 vaccine. They should also ensure their COBRA vendors are prepared to assist in identifying and notifying assistance eligible individuals within 60 days of April 1, 2021.  The DOL also plans to provide outreach consisting of public education and enrollment assistance relating to premium assistance. Their outreach will target employers, group health plan administrators, public assistance programs, States, insurers, and other entities as the DOL deems appropriate. The outreach will include an initial focus on those individuals eligible for an extended election period. We also expect the DOL and other agencies to issue guidance on various issues related to the subsidy in the coming weeks.

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 ERISA-governed and non-ERISA-governed retirement and welfare plans, executive compensation and employment law.

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.

© 2021 Marathas Barrow Weatherhead Lent LLP.  All Rights Reserved.

 

Wellness Plans: Q&A

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Are you thinking of implementing a wellness program? If so, check out answers to these common questions.

Q: What kind of wellness plans are there?

A: As employee wellness has increasingly gained attention and a spot on most employers’ priority lists, the variety of wellness plans has increased. Your wellness plan will change depending on several things: where your priorities are, what your budget is, and the demographic you want to reach. Some examples of standard plans are:

  • Wellness programs to help stop bad habits such as smoking
  • Paramedical plans that offer massages, chiropractic work, or acupuncture
  • Employee assistance plans and teletherapy to provide mental health support
  • Physical activity challenges such as community races or a team steps contest
  • Coaching services for leading a healthy lifestyle (cooking, physical activity, mental wellness)

Q: How do I choose a wellness plan for my business?

A: Not every wellness program will work for your business. First, ask yourself, “What is my primary goal for implementing an employee wellness program?” Your plan may look different if your goal is to reduce healthcare costs for your business than if your goal is to create more loyal employees by developing a positive culture.

In either case, the main thing you want is for people to participate. If you choose a plan that doesn’t interest your employees, they’ll be much less likely to participate, resulting in a low ROI. Send out a survey, taking the temperature of your employees’ feelings about a wellness program. Ask what interests them, what challenges they have and would like help with, and how they see themselves participating. Use what they tell you to inform your wellness plan choice.

Q: Do wellness plans work?

A: There’s been some back and forth about whether or not wellness programs work. Critics point to studies showing a lack of clear improvement or healthcare savings for employers who offer wellness programs. There have also been studies showing that while people who participated in the programs cited feeling happier and healthier, their participation didn’t result in decreased healthcare costs for employers. Other studies show that programs aimed at increasing physical health are most often used by those already in good health and can possibly alienate those who aren’t.

However, the conversation of employee wellness has become a top concern for employers and employees alike. Employees expect more from their organization and value jobs that support their overall wellness. Proponents of wellness programs point to studies linking them to increased employee retention, satisfaction, engagement, and much more.

Q: How do I keep my wellness plan in compliance?

A: In the past few years, regulations for ADA-covered wellness programs that include employee participation incentives have come under some scrutiny. Critics say wellness programs that require employees to pay higher premium costs for not participating or not meeting specific health-related goals are immoral and violate the Americans with Disabilities Act (ADA).

This year, the EEOC has proposed new regulations, requiring only “de minimis” incentives for employee participation. Under the new rules, health-contingent wellness programs would still be allowed to offer incentives of up to 30% of the total cost of insurance, but no more. So far, the new regulations haven’t been published yet and will likely be challenged. To stay in compliance, be sure to know what kind of wellness program you’re offering and how it may be affected.

 

Photo by Vasyl Yakobchuk

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Empowering Women in the Age of COVID

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While the pandemic has highlighted many staggering inequalities in our economic and social system, one of the most significant is its disproportionate effect on women in the workforce. To get a broad idea of the affect coronavirus has had on women, let’s look at some numbers.

So what does this mean for employers? It’s time to lean into strategies designed to empower, educate, and support women in their workforce.

Start with education

A critical factor in working against the inequalities exacerbated by the pandemic is to build awareness within your company and your community about the effects that recessions have on women and minorities.

The more awareness you build, the more effectively you can push your community towards working against those detrimental consequences.

Financial empowerment

One significant way employers can affect positive change is by developing wellness programs that focus on financially empowering their employees. The 2020 Workforce Benefits Report by Bank of America determined that because women and men have different financial goals, they also have varying challenges and needs.

According to that report, women are less likely to feel they have control over their credit card debt, citing it as one of their top three financial concerns. It found women are twice as likely not to have money left over after paying their monthly expenses, and saving for retirement was a top financial goal.

As employers develop wellness programs and benefits packages for 2021, these are critical components to keep in mind.

Consider implementing debt management support. As women are much more likely to have credit card and student loan debt than men, offering services to help them address their debt would be a targeted way to enable them to become financially stable in 2021.

Your employees may also greatly appreciate the ability to talk to an expert who can help them plan for their financial goals and mitigate challenges. Partnering up with a financial consultant who offers this type of support, enabling employees to become more financially literate, can help them gain long-term stability.

Holistic wellness

The pandemic hasn’t just taken a toll on financial situations—it also puts people’s mental and physical health at risk. To support your employees as they navigate the pandemic, consider offering assistance programs such as an EAP or virtual mental healthcare services.

Remember, wellness isn’t just financial, or mental, or physical. It’s a combination of everything. Employers who focus on supporting their employees in each category see increased engagement, loyalty, and productivity. Plus, it’s just the right thing to do. In times like these, businesses, employees, organizations, and communities all have to work together to protect and support one another. Together, we’re strong.

 

Photo by Marina Pissarova

Content provided by Q4iNetwork and partners 

Creating a Remote-Friendly Benefits Strategy

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As organizations settle into offering remote work as a long-term solution, it’s time to re-evaluate their employee benefits strategy to match the needs of remote employees. It’s not surprising that employees working from home have different needs than those working in an office. While it may seem obvious, it will still take time and effort to design a strategy that matches these new needs.

With open enrollment approaching, benefits strategies are top of mind for employers, many of whom are concerned about shrinking budgets as the economy continues to feel the impact of COVID-19. With that in mind, we’ve created a list of employee benefits and perks designed for employees working from home, which can be worked into a variety of different budgets.

Home office support

Consider offering employees a budget to help them adapt their homes into functional workspaces. Small things like folding partitions, ergonomic keyboard and mouse supports, back pillows, and desk lamps can make a big difference in someone’s experience working from home. The more comfortable and functional their space is, the more attention they will have to get work done.

Mental health services

As many employees adjust to working in more isolated environments, and a growing number of adults in the United States say they are suffering from mental health issues, offering virtual wellness services can make a meaningful impact on your employees’ health. Services like BetterHelp and TalkSpace offer virtual therapy over phone, text messaging, and video calls. Giving employees an accessible format for meeting their mental health needs—especially as they learn to navigate the challenges of the pandemic—can help improve their quality of life and their ability to bring their best self to work.

Childcare support

With many schools continuing to stay closed going into the rest of the year, families are under a lot of pressure to support their children who are learning virtually while they’re also working from home. Consider offering financial support for childcare services, giving parents some much needed relief. If this isn’t an option for your company, offering flex-time can be a significant help to parents who need to be available to support their children during the day.

Subscription benefits

One way to support employees as they work through the pandemic is to offer grocery subscription services. This can provide higher risk employees relief from going to the grocery store and can provide support to working families who are already crunched for time and resources. Home Chef, Instacart, and HelloFresh are some of the many popular meal and grocery delivery services available.

People-centered design

In the end, your employee benefits should reflect the needs of your team. Consider running a company-wide survey to identify the most common needs your employees share, and find solutions that can work for both them and you. Your benefits package is a wonderful way to help build strong and long-lasting relationships with your employees. By designing a benefits plan that meets their needs, you’re showing them you care about their wellbeing, which can positively impact not only their quality of life but the quality of your business.

 

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Content provided by Q4iNetwork and partners 

Effectively Communicating Employee Benefits Plans

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As open enrollment approaches, employers and HR departments need to be thinking about the most effective ways to communicate with their employees about the benefits package. This is especially true if your company is functioning with newly remote employees. Benefits are expensive. And ensuring your employees know what they have and how to use them is a critical part of ensuring a positive ROI on your benefits package.

Here are several things to keep in mind as you work out your communication strategy.

Pick your purpose

Defining a messaging plan around your benefits package should be a critical part of your benefits strategy. For messaging to be successful, you need to define a clear purpose behind the communication.

  • Are you implementing new benefits designed for remote employees?
  • Are you attempting to increase engagement with your benefits?
  • Are you trying to educate employees about what’s available to them?
  • Are you trying to educate employees about how to use their benefits?

An easy way to lose your audience and miss the mark on your message is to get your goals jumbled. To create clear, easily consumable information around your benefits, identify a goal for each piece of content you create, and stick to it. Ask yourself if everything in that piece of content aligns with the goal, removing everything that doesn’t.

This leads us to the next piece of the puzzle: what content, and where?

Pick your platforms

Depending on your provider, the demographics of your employees, and the benefits themselves, you may want to use a variety of ways to communicate your benefits package. Whether you’re using a website, a string of emails, in-person/video meetings, or shared documents, there are several things to keep in mind.

  1. For the sake of ease and efficiency, have a place where employees can access all the documents they may need to learn about and use their benefits.
    1. If you’re sending documents through the mail or over email, make sure you also store them somewhere they can access later. Use DropBox, Google Drive, or any file sharing platform to keep all documents in one place.
    2. If you’re using a website or page on your website for employee benefits, create a clearly marked and easily accessible place for employees to find any documents they might need. Keep this accessible year-round.
  2. Consider the different demographics within your team and develop a communication strategy that meets their differing needs. Older employees may find in-person or video training sessions useful when learning to use their benefits platform. Younger generations who may be new to having their own benefits plan may need extra help understanding their benefits as well.

Keep it going

One of the most effective ways to increase ROI on your benefits plan is to create a year-round benefits communication strategy. Keep it top-of-mind for your employees by regularly checking in with them.

  • Consider adding it to your company-wide newsletters
  • Hold quarterly training sessions or meetings to help your employees use and understand their benefits
  • Survey your employees and keep close tabs on how they feel about their benefits plan, including:
    • How easy it is to use
    • How relevant the benefits are to their needs
    • How often they use their benefits
    • How satisfied they are with their plan and what they would like to see changed

Effectively communicating employee benefits plan takes time and effort. Be ready to hear and act on the feedback you receive. Pay careful attention to who uses their benefits and who doesn’t. If you’re serious about creating a benefits plan that works for your business and your employees, then take the time to work out your communication strategy. It’ll pay off for you and them.

 

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Employee Benefits: Planning Ahead

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In the past year, employers have had to make significant adjustments to their benefits packages to cope with the pandemic. Most significantly, employers with less than 500 employees have had to adopt new paid leave policies to help employees combat COVID-19 and new childcare demands, with 44% planning on expanding their paid leave benefits in 2021.

But that isn’t the only thing that’s changed. As employers look ahead to upcoming open enrollment and prepare for the year ahead, there are a few things to keep in mind.

1. Virtual enrollment

Since in-person meetings are sharply declining for safety concerns, employers are shifting the yearly in-person meeting with their broker to virtual walk-throughs over the phone, or doing it themselves online. But it’s more important than ever that employers get the most help they can when it comes to their employee benefits plans.

The changing needs of the workforce, the blowback from delayed elective surgeries, and new regulations mean there’ a lot employers have to navigate if they want to see solid ROI on their benefits packages.

To best prepare your business for the upcoming virtual enrollment period, start by checking off this list:

  • Do some preliminary research and see what’s out there. Get a feel for what other employers of a similar size and industry are doing.
  • Ask your employees what they need the most. Create a tiered list of benefits they express a need for, and benefits they would appreciate, but don’t require.
  • Create a detailed list of questions.
  • Call your broker with your questions and the information you gathered and walk through what’s available to you, making sure to take note of everything.

Research preparation will help you cover all the bases and avoid any gaps or lost opportunities. Make sure you give yourself enough time to do sufficient research and get answers to your questions.

2. Shifting the basics

As you plan for the year to come, take stock of all the changes your organization has gone through in the last months. Have you gone partially or fully remote? Are you considering offering remote positions at your company moving forward? Do you have young parents on your team who are juggling new childcare challenges?

Your benefits strategy may very likely need to be updated to meet the challenges relevant to your employees today. To attract, retain, and engage talent, it’s essential you understand their needs and offer resources for them to maintain a healthy life, both physically and mentally.

And that looks different for remote employees, parents with children at home, and employees suffering from increased strain on their mental health due to the isolation and anxiety caused by the pandemic. The basics of employee benefit packages need to shift around these new and different challenges to adjust appropriately.

3. Benefits communication

With the vast majority of organizations still working remote and expecting to continue doing so into the year to come, employers must create a solid virtual communication strategy around their employee benefits.

Depending on the technical skill level and abilities of your employees, you may want to offer varying types of education and support around how to use their benefits. Especially with heightened awareness around healthcare, employees may be more anxious to learn everything they can about their benefits to help ease some of their anxiety.

4. Planning for changing costs

With so much up in the air, leaders in healthcare are warning that cost projections for next year are cloudy at best. Increased demand for mental health services, the blowback from delayed elective surgeries, and potential vaccine costs are making it difficult for employers to prepare financially for the unknowns. To help with this, talk with your employees about what services they expect to need. Work with your broker to define a strategy that works best for your business.

Stay tuned

As circumstances change, be sure to keep a finger on the pulse of the insurance industry. Keep tabs on how your employees are feeling and what their concerns are moving forward. Although this can feel overwhelming, remember that there are many resources available to you to help guide you through the confusion and change.

Work closely with your broker and expect them to provide you with objective, informative information. Your broker should be your right-hand man during the next few months, and if they aren’t preparing you with strategies, education, and support, you may need to look elsewhere. As you move through the upcoming six months, stay informed, in touch, and open to new solutions and ideas, and you will come out the other side successfully.

 

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Employers, It’s Time to Talk About Telehealth

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It’s been a hard year. For businesses, families, individuals, the economy, Australia—basically everyone but our pets. The strain on our collective psyche has worried healthcare professionals who are struggling to adapt to increased demand while trying to deal with disrupted delivery of their services caused by the pandemic.

In late July, the Center for Disease Control released a report that showed 40% of adults reporting they were struggling with increased mental health difficulties and substance abuse coping due to the pandemic.

The world of healthcare has seen a massive shift towards virtual healthcare or telehealth services in recent months. A study from the NYU Grossman School of Medicine found that NYU Langone Health experienced a 683% increase in urgent virtual care visits and a staggering 4,345% increase in non-urgent virtual doctor visits.

What does this mean for employers?

While employers have slowly been integrating teleservices into their benefits packages for some time, they may not have seen much enthusiasm towards the services until now. And that increase isn’t expected to go away. It’s projected that the telehealth industry will see a compound annual growth rate of nearly 40% over the next five years.

So, what exactly does that mean for employers? That it’s well past time to ensure they are offering telehealth services to their employees, not just as a quick fix, but as a long-term solution. Because of the pandemic, most providers have successfully made the switch to offering virtual care, allowing those already with insurance to stick to what’s available to them.

But that may not be enough. Employers must make telehealth services available to their employees—not just in the form of physical wellness, but behavioral and mental health.

As the effects of the pandemic continue to wear on individuals and families, it will be increasingly less likely that organizations will avoid seeing these effects in their employees. They must take steps now to help prevent further harmful effects from manifesting in their employees by creating systems that can successfully address these issues as they arise.

Where to go, and who to ask

There’s a lot of information about different services and how they’ve made a difference for employers. To get a handle on all of it, take these steps:

  • First, do your research. Ask your broker about telehealth services you can provide and read up on them.
  • Survey your employees. Find out what they want and need.
  • Create an implementation plan. Educate your employees, not just once, or in one way. Some of your employees may not be as comfortable adapting to new technology as others, so make sure you provide ample training and assistance to use it successfully.

Going forward

Like any new system, benefit, or practice you introduce to your employees, it’s critical you don’t just set it up and forget about it. Monitor the program closely and follow up with your employees to find out what’s working and what isn’t. Identify areas that can be improved and locate issues to address.

Now is not the time to be haphazard about your process. While the pandemic may make telehealth services easier to implement in some ways, remember that it is an attempt to address a critical issue that can quite literally mean life or death depending on its success or failure.

In the end, the best thing that employers, leaders, organizers, and advocates can do is work together to provide the best quality care to the largest number of people. Make sure you’re doing your part to support your employees and set them (and your business) up for success.

 

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Content provided by Q4iNetwork and partners