Employee Benefits Blog

Employers of every size continue to struggle with the rising costs of healthcare, which ultimately increases the cost of medical premiums for everyone.

While employers have traditionally worried about large medical claims, the growing popularity of exorbitantly-priced specialty drugs is creating an entirely new category of potentially catastrophic healthcare spend. 

In fact, after raising the prices of more than 1,400 prescription drugs in 2022, pharmaceutical companies started 2023 off with a 5% increase for more than 450 medications. Add to that considerable pipeline of new medicines to treat specialty diseases, including gene cell therapies, RNA therapies, immuno-oncology treatments, etc., and you have a recipe for disaster.

One solution means looking inward: transitioning from the fully funded model of healthcare benefits to self-funded health plans featuring stop-loss insurance. Stop-loss insurance is essential for a self-funded plan because it enables an employer to cap medical claims expenses at a specific amount. 

The SECURE Act 2.0 contains dozens of changes to retirement plans, but perhaps none bigger than these two: New 401(k) and 403(b) plans will be required to automatically enroll participants in the respective plans, and employee salary deferral rates will automatically escalate each year.

This rule will apply to employers who have started retirement plans after December 29, 2022, and take effect for plan years starting in 2025.

There is an exception for new companies in business for less than three years, employers with 10 or fewer employees, and governmental and church plans.

For plan sponsors, the details include: 

Employers who offer health benefits are  required each year to hold a benefits enrollment "window", commonly referred to as an open enrollment period. 

During open enrollment, employees can renew, adjust, or waive benefit options. Outside of a Qualifying Life Event, open enrollment is essentially the only time an employee can make changes to most (though not all) of their benefits. 

While an employer is required, by law, to hold an open enrollment, what's not defined is whether the enrollment needs to be structured as "active" or "passive". A passive enrollment period is one where an employee's benefit selections from the previous year simply roll-over and/or auto-migrate (within reason) to similar options. An active enrollment, on the other hand, requires an employee to elect, renew, adjust, and sometimes actively decline benefit elections. (The SPD and other plan documents will usually spell out these rules for employees.)

In a nationwide survey conducted by the JP Griffin Group this April, 2019 amongst full-time, benefit-eligible employees in the U.S., 50 percent (half) reported participating in a passive enrollment this year. Compared to a 2011 survey of employers, where 71% reported holding passive enrollments, these new findings represent a 30% decrease in the number of companies conducting their open enrollments passively.