• Home
  • About
    • Contact
    • Client Survey
  • Services
    • Health Care Reform Navigators
    • Strategic Benefits Planning
    • Employee Benefits >
      • Group Private Exchange
      • Group Medical Plans >
        • Fully-Insured Health Plans
        • Self-Funded Plans
        • Consumer-Driven Plans
        • Cafeteria Plans
        • SHOP Plans
        • RKA Benefits Blend
      • Group Life Insurance
      • Group Disability
      • Group Dental Plans
      • Group Vision Plans
      • Group Voluntary Benefits >
        • Value-Added Services
      • RKA Benefits Blend
    • PEOs - HR Outsourcing
    • Pricing
  • Get Quote
  • Benefits Edge
  • "Bill Please!" Forum
  • Employee Solution
    • Calculators
Rylan Klaseen & Associates
909-243-4886

Benefits Edge

From our team to yours.

Contact Rylan

Employers Eye Moving Sickest Workers to ACA Exchanges

5/26/2014

 
Picture
"...resisting the temptation might be the smarter move."
Sure, offering to purchase a $6,000 platinum plan on the ACA exchanges for your employee who is a hemophiliac currently costing your company $300,000 a year is tempting.  Then all of that cost is shifted off your bottom line.  But resisting the temptation might be the smarter move.

Even though in the wild,wild west called the land of Obamacare, this practice has not yet been deemed illegal – it may only be a matter of time.

Many employers see the opportunity and have been asking us if this is allowed.  There are even some benefit specialists considering launching this move as a marketing campaign.  But beware!  Looking at similar situations, such as employers trying to move workers 65+ totally over to Medicare, have been declared illegal.  We’re advising companies given the Medicare precedent, Obamacare will likely do the same.  It’s just a question of when.

Health spending is largely driven by patients with chronic illness such as diabetes or who undergo expensive procedures such as organ transplants.

Let’s think it through.  Since most big corporations are self-insured, shifting even one high-cost member out of the company plan could literally save the employer hundreds of thousands of dollars a year.  But what are the consequences?  

First, with such an employer-dumping strategy, you would eventually see erosion in employer-based coverage.  Here's how it might work. The employer shrinks the hospital and doctor network to make the company plan unattractive to those with chronic illness. Or, the employer raises co-payments for drugs needed by the chronically ill, also rendering the plan unattractive and perhaps nudging high-cost workers to examine other options.  At the same time, the employer offers to buy the targeted worker a high-benefit "platinum" plan in the marketplaces.  
"You may have moved one sick employee off your plan, but at what cost to the rest of your employees..." 
You may have moved one sick employee off your plan, but at what cost to the rest of your employees who now see less hospitals & doctors to choose from in your network, as well as an increased co-payment for drugs, if they’re next to develop a chronic illness.  Then what do you do with them?  Do you keep whittling down your plan?  Do you keep trying to dump sick employees?  Where does it end?  How would this strategy affect your ability to attract and retain top talent?

Second, this approach would quite quickly increase the premiums you’re paying for those sick employees on the exchanges as well as increase the tax burden we all share to subsidize the exchanges. Again, let’s think about it.  You’re just playing a shell game.  You’re not reducing the cost – only shifting it to the exchanges and away from your bottom line.  It’s true that, to begin with, your company’s savings would seem worth it – until exchange insurers having all the sick employees shifted to them raise premiums, and the tax subsidies we all pay increase as a result.  And, eventually, this dumping strategy may very well spell the demise of the ACA and exchanges all together.  Then your company would be back to square one.

Perhaps, we all should instead be addressing the two elephants in the room – how to reduce healthcare costs and how to assist your employees in becoming healthier.  

Strategies much more sustainable and worthy of our time and money.

Source: Hancock, Jay. Kaiser Health News, “Employers Eye Moving Sickest Workers to Insurance Exchanges,” 5/8/2014 http://www.kaiserhealthnews.org/Stories/2014/May/07/shifting-employees-to-exchanges.aspx 2/3

Accident & Disability Coverage Reduces Workers Compensation Claims

5/22/2014

 
Picture
"It just makes sense that employees having access to accident and disability coverage would decrease worker's comp claims."
In addition to health plan costs, the costs related to worker's compensation claims can easily get away from a company.  In addition to the direct costs, companies struggle to capture the real cost of claims, factoring in absenteeism, and loss of productivity.

A recent workforce study commissioned by AFLAC, found that companies who offered their employees the opportunity to purchase voluntary accident and disability insurance saw a significant decrease in workers compensation claims.

It just makes sense that employees having access to accident and disability coverage would reduce workers comp claims.  Not only does voluntary accident and disability cost companies nothing, employees are covered on and off the job.  

It's impossible to measure the accidents that may not actually happen on the job, but turn into a workers compensation claim when employees don't have off-the-job coverage.  These incidents are eliminated when employees are covered no matter where they are.  
"42% of companies offering voluntary accident & disability saw a significant decrease in their worker's comp claims ."
The independent survey of 600 employers found that 42% of companies offering voluntary accident and disability saw a significant decrease in their worker's comp claims.  

How significant?  15% of companies who offered accident coverage reported reductions of 50% or more, while 9% reported declines of 25-49%.  18% of companies who offered disability coverage reported reductions of 50% percent or more, while 17% reported declines of 25-49%.

Talk about a positive impact on the bottom line that couldn't be easier and more cost-effective (free) to implement.

Now, back to the serious challenges of bringing health plan costs down.

Source: Bell, Alison. LifeHealthPro: 
"Disability benefits may cut workers'comp costs"
http://www.lifehealthpro.com/2014/04/04/disability-benefits-may-cut-workers-comp-costs

Giddens, Tom.  Small Biz Trends: "Reduce Workers’ Compensation Claims with Accident and Disability Insurance"
Apr 28, 2014 http://smallbiztrends.com/2014/04/reduce-workers-compensation-claims-disability-accident-insurance.html

ACA's Workplace Wellness Incentives Lower Premiums

5/7/2014

 
Picture
Small employers – with fewer than 100 employees who work 25 or more hours per week – are eligible for workplace wellness grants when they provide a comprehensive workplace wellness program for all employees. And larger employers also can help save their employees money
(up to 30 percent of the cost of the employee’s premium) through these programs, as well.
While Annual health insurance premium rate increases may seem inevitable, and removal of payers' ability to deny coverage based on pre-existing conditions seem to spell doom to the idea of ever getting premiums under control, the Patient Protection and Affordable Care Act (PPACA) includes workplace wellness incentives to help steer your workforce towards health while reducing your premiums.

Small employers -- with fewer than 100 employees, working 25 or more hours per week -- are eligible for workplace wellness grants when they provide a comprehensive workplace wellness program for all employees.  And larger employers can also help save their employees money (up to 30 percent of the cost of the employee's premium) through these programs, as well.

There are so many options to qualify for a small-business wellness grant.  Of course, the workplace wellness program must reduce chronic-disease rates, address health disparities, and develop a stronger evidence base of effective prevention programming. This can be accomplished through strategies such as employee education,
smoking-cessation challenges, diet and exercise challenges, and other tactics that help promote
employee wellness.  Use your imagination! 

New businesses are flooding in that aim to help employers fulfill these requirements.

“For some time now, I think the big health insurance providers have realized that it’s more economical to pay for health coaching than to pay for medical care,” explains Stan Reents, PharmD, president and chief executive officer of AthleteInMe.com.  The former health care worker turned health coach provides educational talks in the Phoenix area for such insurance carriers as Blue Cross Blue Shield.
...the workplace wellness program must reduce chronic-disease rates, address health disparities, and develop a stronger evidence base of effective prevention programming...
Reents also works directly with large employers to create wellness programs for their employees.  In one company, an annual weight-loss competition is held and he helps by providing one-on-one health coaching with staff members.

“Every year, they get a large grant to put on corporate wellness programs,” he says, which
helps pay for his services.  Reents sees health coaching as the missing link in the health care team.

“So much chronic disease in adults is due to lifestyle,” he notes, “The average visit in a primary care office is about 15 minutes; they don’t have time to talk to somebody about exercise and diabetes or
exercise and heart disease.”

Reents cautions that employers hiring coaches need to seek out those certified through credible institutions, such as the American College of Sports Medicine (ACSP).

Technology is also creating wellness opportunities. Russell Benaroya is the chief executive officer of EveryMove, an app that allows users to accrue points for activities, tracking steps and check-ins at healthy venues or events (like gyms or races). Users can swap the points for rewards that will net them
anything from designer jeans to workout supplements – or even the ability to contribute to a
charitable organization.

“It’s incredibly important to the employer that they’re fashioning perks that are fun and
engaging, and that create a healthy, more productive workplace,” he notes.

"We’re moving toward programs to meet the employee where they are in their life and finding solutions that are consumer-driven."

Sounds like the right direction.

Source: BenefitsPro "Other Ways to Make Wellness Work" captured 5-7-14

    RSS Feed

    Picture
    Rylan Klaseen

    Rylan Klaseen & Associates

    Serving Southern California:
    Tailored Benefits Delivery
    316 W 2nd Street
    Suite 500

    Los Angeles
    CA 90012
    Cell: (909)243-4886

    Archives

    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013

    Categories

    All
    About Rylan Klaseen & Associates
    Affordable Care Act
    Consumer Driven Health Care
    Employee Benefits
    Healthcare Costs
    Healthcare Quality
    Recruiting
    Retention
    Voluntary
    Workplace Wellness

    Stay informed! Subscribe to our mailing list

    * required

    RSS Feed

    Insurance Agents Rancho Cucamonga
    Tweets by @RylanKlaseen
Rylan Klaseen & Associates          Tailored Benefits Delivery          Serving Southern California
316 W 2nd Street, Suite 500, Los Angeles, CA 90012 Cell 909-243-4886