Health Wellness Newsletters

In fact, it varies.  In some cases, an HSA-eligible plan may cost the same as a non-HSA high-deductible plan. In others, the premiums can actually be more expensive, a recent NHPI report locates.

As a matter of fact, a non-HSA plan offering similar coverage can carry a monthly per-employee premium that’s about $15 to $25 lower and a deductible that’s $500 to $1,000 lower than the HSA choice.

Sometimes the difference is as a result of price-jacking -  the HSA plans are the ones that’ve been hyped in radio commercials and mentioned in newspapers in recent years.

Nowadays, fewer individuals  exploring high-deductible plans ask first about the non-HSA, so insurance businesses sometimes slash prices to drum up interest in those options, too. Another factor -  Not all deductibles work the same.

Deductible cuts both ways

Two deductibles can look similar but work differently, and the cost scales can tilt for either an HSA or a non-HSA plan. Example -  HSAs by law can no longer allow first-dollar coverage of prescription drugs. But a non-HSA plan can.

On the flip side, HSAs often feature better preventive-care coverage. In some non-HSA plans, a person who’s yet to meet the deductible must pay out of pocket for standard tests (example -  cholesterol testing) that’re part of the routine physical. Only the office visit itself is covered.

Additionally, HSA-eligible plans have to follow rules that limit total out-of-pocket costs. But this can push up the premiums paid on the front end.

Best bet -  Double-check with your broker to be sure you’re comparing apples to apples when investigating  the costs of HSA and non-HSA plans.

For most firms, voluntary benefits are a win-win arrangement. But there could be hidden risks.

On the positive side, voluntary benefits cost businesss next to nothing, yet boost employees’ morale and benefits satisfaction.  An Aon survey found 77 percent of companies offer at least one voluntary benefit.

But what happens when there’s a legal dispute between one or more of your staff members and the vendor?

In many cases, corporations unwittingly get dragged into court.  The vendor may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her corporation.

If the court agrees, the legal burden shifts.  Some courts have ruled that a voluntary benefits could  be covered under ERISA, even when it wasn’t an business’s intention to formally “sponsor” the plan.

When push comes to shove, the providers will protect themselves. Indeed, some attorneys warn that a voluntary plan insurer’s first move when sued by one of your workforce are going to be to try to get the legal burden shifted from itself to you.

Two seemingly innocent things that could be turned against you in court -

o  The written announcement to tell workforce about the new voluntary benefit, and

o  getting involved if there’s a dispute between an staff member and the plan provider.

Be careful with announcements When you offer a new voluntary benefit, the natural tendency is to attempt to get employees pumped up to participate. But you are able to get in trouble when people  get the impression the firm endorses the plan. Helpful practices -

o  Don’t put the announcement on organizational letterhead

o  Put a disclaimer on the description

o   either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and

o  hold open enrollment at a different time than for ERISA plans (401(k), primary health plan, etc.).

Likewise, when the vendor offering the voluntary plan has competitors, you may want to remind workforce the vendor of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing vendors.

Avoid involvement in disputes as with your ERISA plans, chances are employees will come to you when they have a problem with a voluntary plan. Your first inclination is to help.

But many specialists warn it’s better to stay out. Reason -  Courts see this as the action of a plan sponsor. But you can steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.

Good intentions gone bad

From an ERISA standpoint, the most perilous voluntary plan design is one that is partially compensated by the corporation, even if personnel pay the bulk of the cost.

In a major ruling several years ago (Burgess v. Cigna Life Insurance), a USA  district court ruled against an corporation with a voluntary supplemental disability plan in which the firm compensated a portion of premiums for its lower-compensated personnel.

While most staff compensated the entire premium â.” and firm made clear to individuals  the plan was a voluntary benefit â.”the court said it didn’t matter.  The act of contributing to some employees’ premiums made it an ERISA plan.

In many segments of society, we  hear about ethnic and racial profiling in negative ways. But what about when it comes to wellness programs?

When used for the specific purpose of starting â.” or analyzing  â.” a wellness or disease management program, profiling isn’t just legal. It’s also encouraged.

Affects health risks

Different racial and ethnic groups tend to be more at risk â.” for genetic and/or cultural reasons â.” of certain medical problems. Examples -

o  African-American, Latino, Native American and Pacific Islanders are  at higher risk of diabetes than Caucasian employees

o  Chinese women are statistically twice as likely to get cervical cancer

o  Caucasians have disproportionately high rates of obesity and high blood pressure, and

o  Latinos have higher rates of asthma and chronic obstructive pulmonary illness than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line -  By assessing  the ethnic breakdown of your staff member population, you can set disease management (DM) program priorities with greater confidence and accuracy.

Healthcare quality an issue

A few studies also show there’s an unfortunate relationship between ethnicity and quality of health care. Many times, minority employees receive inferior treatment and health education at the same facilities where others receive top-notch care.

This usually happens for innocent reasons. A common scenario -  a lack  of Spanish-speaking doctors in the network for your Latino employees. But the result is usually higher health care costs for you and, often,  greater reluctance among minority employees to seek needed treatments.

By profiling workers against the doctors in the network, you ultimately help workers get the care they need and the corporation to better control long-term costs.

Are your health care programs delivering on your providers’ promises?

Just as importantly, how can you hold vendors accountable if you’re not getting what you compensated for?

Here’s one proven way - Create a vendor scorecard. Scorecards alone won’t bring down your health care costs. But they’ll at least help be certain your company â.” and personnel â.” get everything you’re paying for.

The tool can help you measure plan performance with greater precision â.” and identify specific areas that need improvement. Best of all, any organization can adopt the technique to fit their needs. Here’s how it works.

1. Select specific rating areas

Benefit pros who’ve successfully adopted the scorecard system recommend grading providers on five to 10 measurable areas, like -

o  Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?

o  Disputed and resolved claims. Do worker questions and complaints about denied or still-pending claims get answered quickly and thoroughly? Just how often are you forced to go to bat for employees?

o  Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?

o  Reports. Do you receive timely paid claim and utilization reports?

o  Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?

o  Employee education. Do your workforce find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic conditions (like diabetes or depression)? Do you receive support in educating your workforce to make healthful lifestyle choices, like use of tobacco cessation?

2. Pick a workable rating scale

There are two schools of thought when it comes to choosing  a rating method -  subjective or objective. Many benefit pros â.” in particular those from smaller firms â.” use a simple pass/fail or 1 to 5 score to rate their satisfaction.

Others develop more elaborate, statistic-based ratings. One method -  take the vendor’s guarantees (e.g., addressing disputed claims within 3-5 business days) and then measure by percentage how often these goals are met.

These rating data could be obtained through quarterly performance reports, staff member surveys, issue and complaint files and, for bigger plans, external audits.

3. Feedback causes improvement

It’s good practice to share your scorecard system with the vendor before meeting to review the results. Reason -  This lets you iron out any vendor questions about the review categories and scoring system.

Once that’s settled, you can meet to go over the numbers and prioritize the areas that need improvement. Many firms then add a new scorecard category â.” vendors’ followup.

In the last few years, there’s been a rising trend for public employers â.” not just private companies â.” to ban smoking. Here is what your coworkers are doing.

What’s New in Benefits and Compensation lately surveyed 374 of our readers from both the private and public sectors to determine their organization’s policy on allowing personnel to smoke on-site and hiring smokers in the first place. Here’s what we found -

o  11% have created a policy of hiring only non-smokers

o  17% allow workforce to smoke offsite, but ban it on all business property

o  39% restrict use of tobacco to designated areas outside the building

o  30 percent allow tobacco use anywhere outside the building, and

o   3% allow use of tobacco in break rooms or other indoor areas.

Public businesss get aggressive

While much of the publicity about no-hire policies for smokers centers on private companies, it’s actually public companys in certain states who have been the most assertive of late.

For example, Florida is one of the states at the forefront of the movement. Sarasota County recently became  the third Florida county to take a no-hire stance in order to control healthcare costs.

New hires must take a drug test that detects nicotine and sign a pledge certifying that they haven’t smoked in the past 12 months.

The ban won’t affect current personnel, but the county has undertaken smoking cessation programs aimed at employees’ wallets.

Non-smokers pay less for coverage through various incentives and the county covers the cost of participating in use of tobacco cessation programs.

The reason why Florida public corporations have the ability to take these steps -  the state supreme Supreme Court has ruled that refusing to hire smokers doesn’t break discrimination laws.

But your state laws may vary, so proceed with caution before considering similar policies.