Nearly 100 million workers, or two-thirds of the U.S. workforce, will be impacted by new vaccine requirements announced by President Biden yesterday. 

Prompted by a surge in COVID-19 infections, hospitalizations, and deaths - most especially among the unvaccinated - the requirement stipulates that employers with 100 or more employees require their workforces to be vaccinated or undergo weekly Covid-19 testing.

While it’s expected to be challenged in the courts, this new requirement is part of a six-point initiative the White House laid out yesterday to boost vaccinations, increase access to testing, and broaden the availability of Covid-19 treatments.

Final details of the plan will come by way of an "emergency temporary standard" issued in the next few weeks by the Labor Department’s Occupational Safety and Health Administration (OSHA). Businesses that don’t comply may face fines of up to $14,000 per violation. 

Per yesterday’s announcement, workers will be considered vaccinated if they receive a single Johnson & Johnson dose or two doses of the vaccines from Moderna or Pfizer. It’s unclear how a booster shot might play into things if/when approved by federal regulators.

Here are additional details of the plan.

Many employers are struggling to increase COVID-19 vaccination rates among their workforce, concerned not only about the safety of the workforce but also the costs of COVID-19 treatment that could be avoided through vaccination.

Some, like Delta Airlines, are turning to higher premium costs, or a surcharge, for any group health plan participants who remain unvaccinated. This decision by Delta, taken once an FDA-approved vaccine came on the market, should by no means be interpreted as a full-throated endorsement of this action. In fact, it’s quite likely that Delta’s decision will be tested in the courts.

Challenges are likely to come in three areas: wellness positioning, surcharge amounts, and possible discrimination. Nevertheless, Delta’s decision has prompted some employers to consider doing something similar.

Here are issues employers need to consider if they decide to take similar action.

As employee benefits consultants, we take our responsibility seriously to educate employers and employees on resources available to help reduce employee benefits program costs and out-of-pocket healthcare expenses.

This is especially true for those enrolled in High Deductible Health Plans (HDHPs), but even for those who aren’t. For without any effort, as a collective, to become more price-conscious consumers, healthcare providers will have no reason to reign things in.

In a recent blog, we discussed how consumers can save on prescription medications, including comparison shopping, manufacturer rebates and discounts, drug substitution, pill splitting, bulk buying, mail-order, and more.

As a complement to that blog post, today we’ll discuss various ways consumers can save on healthcare services and procedures. After all, when combined, hospitals and physician/clinical services account for 48% of healthcare expenses.

With nearly half of medical expenses centered around these areas, it makes sense for healthcare consumers to focus on these cost centers as target-rich environments for possible savings.

With over half of today's workforce enrolled in high-deductible health plans (51%), a majority of insured individuals are now on the hook for deductibles of at least $1,400. In addition, those with family coverage are responsible for at least $2,800.

While these higher deductibles are offset by cheaper monthly medical premiums and often by employer contributions to Health Savings Accounts (HSA), HDHP plans are nevertheless structured in such a way as to promote heightened "healthcare consumerism."

Judging by the sticker shock most consumers experience the first time they pay for medical services or prescription drugs without a copay, this heightened awareness of the "true cost of care" seems to be making an impact. As a result, consumers are indeed becoming more proactive about shopping for services and comparing prices, just as they would for any other consumer good.

Many employers, especially those that are self-funded, encourage this type of behavior since it can help them control costs and ultimately save significant dollars for both the company and its employees. (Employers with fully funded medical plans also have plenty of reasons to control their medical claims, though the potential savings often aren't recognized as immediately.)

And while consumers seem to have a love/hate relationship with HDHPs, many of those who take the time to fully calculate the total out-of-pocket cost of medical coverage and care realize that HDHPs, even with higher deductibles, can often save them money.

This isn't to say that HDHPs are for everyone, and if a company isn't helping its workforce adequately prepare for this change in consumer behavior, they are setting themselves up for failure.

Since we wouldn't want that to happen, here are eight suggestions to offer your workforce to help them save money on prescription drugs. In a future post, we'll offer tips on how to save money on common medical procedures.

Please share this information with your workforce. In doing so, you'll be helping them to become better consumers of healthcare and more satisfied enrollees in high deductible health plans.

Anyone who has ever signed up for cellular phone service with a mobile phone carrier knows what a burdensome service agreement looks like. It's pages and pages of terms and conditions, often delivered by an anxious salesperson consumed with an expectation that the customer desiring service will sign the carrier agreement on the spot.

While consumer law often provides protections to the little guy when big corporations require the signing of contacts like this, the courts aren't nearly as understanding when it comes to agreements between business parties. In many of these cases, the courts expect business-to-business agreements to be fully enforced.

This is particularly unfortunate given what's occurred over the last decade in the employer-sponsored group benefits space. These agreements have morphed from straightforward, comprehendible documents to verbose and cryptic agreements that shift virtually all risk to the plan sponsor (e.g., the employer) while relieving the vendor from almost all meaningful liability.

Plan sponsors have seen some of this behavior abate in recent years, fueled by their successful push back against commercially unreasonable contract provisions. Furthermore, the DOL's Fiduciary Rule, which went into effect July 1, 2019, has also helped neutralize some of these more unreasonable provisions.

Nevertheless, employers should resist the temptation to view the provisions of their employee benefits vendor contracts as minor details. The wrong provisions could easily bankrupt a small to medium-size business or cripple the growth of a larger one.

Although every single word of every vendor contract needs to be reviewed carefully by not only you and your employee benefits broker, but also qualified legal counsel, here is a list of five common provisions that require special attention.

By 2025, almost 23% of the U.S. workforce is expected to work fully remote, according to Upwork. That’s nearly double the percentage of people who were working remotely (full time) prior to the pandemic. 

While this prediction might be lower than some employers are expecting, (and some employees may be hoping for), any shift of this magnitude, or greater, will fundamentally change the way employers attract and retain talent.

With remote work quickly becoming one of the most desirable benefits an employer can offer in today’s tight labor market, employers are already discovering that they are competing for top candidates not only locally, but globally. 

For some highly desirable employers, this can be seen as a huge boon to their recruiting efforts. For other employers, especially those in less desirable industries, or those with poor reputations and/or employee benefit plans, this should be viewed as a tremendous concern.

Here are some unique qualities of strong remote workers and best practices for attracting and recruiting them. 

The COVID-19 pandemic is finally getting under control. As more Americans get vaccinated, states are gradually lifting restrictions, and life is returning to pre-pandemic normalcy. Finally, individuals can get to the tasks they’ve been postponing for more than a year.

Unfortunately for employers looking to retain employees, some employees are now ready to find new jobs.

Turnover is a common occurrence throughout any given year. However, during the COVID-19 pandemic, year-over-year turnover trends drastically reduced. Workers instead clung to their jobs as a way to maintain financial security, having seen countless others get furloughed or laid off.

Now, as the economy opens back up, employers are pushing for employees to return to the workplace. But, a significant number of employees are unwilling to return to the status quo that was established pre-pandemic.

Before working in employee benefits, I spent nearly a decade working for America Online (AOL). For those of you not old enough to remember, AOL was the gateway to the internet for tens of millions of people in the mid 1990's and early 2000's, as the "world wide web" went mainstream.

In those days, AOL's senior leadership placed bets on all sorts of industries they thought they could disrupt, from online dating and car shopping to airline bookings and online auctions. When asked what the company was learning from placing strategic bets in all of these commerce verticals, AOL's Founder Steve Case said, "it appears that anything that's easier to do online than offline will eventually transition to the web."

That very same insight can now safely be said of telemedicine. While both patients and providers were slow to embrace it, the popularity of telemedicine exploded this past year, while funding for almost anything telehealth-related has been booming.

According to technology vendor AthenHealth, they saw telehealth volumes in their network increase from less than 1% of total volumes pre-pandemic to as high as 32% during the pandemic, before settling in at around 10-11%.

And while it may be tempting to brush off telemedicine as a stopgap measure that served its purpose during this unprecedented healthcare emergency, new research shows that virtual care will long outlast the pandemic itself. In fact, experts predict that the telehealth market is expected to reach $185.6 billion by 2026.

Why? Because simply put, it's easier to do online than it is to do offline.

In a recent study by Doctor.com, telemedicine was shown to save patients over 100 minutes of their time compared to in-person office visits. Add to this that video visits often trigger a lower co-pay than an in-person appointment, and you have a winning combination – a savings of both time and money.

Employers bracing for a post-pandemic baby boom can rest easy. A spike in post-pandemic pre- and postnatal healthcare costs, as well as an influx of maternity and paternity leaves, aren’t likely to come to fruition. 

While nationwide data on birth numbers isn’t expected to come until later this year, an Associated Press analysis of data from 25 states indicates that the anticipated baby boom looks more like a bust. Recently released data by the CDC and the U.S. Census Bureau also supports much of the same. 

The data indicates that births have fallen dramatically in many states during the coronavirus outbreak. Births for all of 2020 were down 4.3% from 2019. Still, more tellingly, births in December 2020 and in January and February 2021 (nine months or more after the spring 2020 lockdowns) were down 6.5%, 9.3%, and 10%, respectively, when compared with the same periods a year earlier.

Together these declines account for an 8% decline versus a year ago, making this period the lowest the birthrate has dropped in over 40 years. This is good news for employers since childbirth and newborn care are oftentimes the most expensive medical conditions billed to employer-based insurers.

That said, falling birthrates present a host of other challenges that dwarf high claims costs.  

Visit most any restaurant these days and you’ll quickly interact with one of the “winners” of this pandemic. I’m talking about QR codes. These “bar codes on steroids”, now used to launch menus and online ordering apps, made a roaring comeback in 2020 thanks to their usefulness in the socially-distanced era of COVID-19.

That same can be said for telemedicine. While telemedicine has been around for decades, it’s acceptance by both patient and provider was somewhat anemic, at best, until the pandemic hit. Before COVID-19, it wasn’t at all uncommon to see telemedicine utilization rates in the single digits. Now it’s not unusual to see utilization rates in the 60 to 70 percent range.

While it’s wonderful to see a more widespread acceptance of this highly convenient and efficient healthcare delivery method, there is immense confusion over the set of terms used somewhat haphazardly (and interchangeably) to describe these virtual health services.

In the past year, we’ve heard carriers, employers, patients, policy makers, payers, and providers use everything from “telemedicine”, “telehealth”, and “telecare”, to “virtual medicine”, “virtual health” and “virtual care” to describe health services delivered via telecommunication technologies.

This post attempts to shed some light on the difference between these terms. While the differences might not seem all that important, they can be when working across different organizations, especially where reimbursement, data exchange, and data protection is concerned.

I’ll make a prediction. It’s going to be very difficult for all of us to become more informed consumers of healthcare when large swaths of that very system seem to be working against us at every turn.

For years now, my organization has championed price transparency in healthcare. We believe it to be the very best solution to bringing down runaway medical care and prescription drug costs, which have pushed up the cost of employer-sponsored health insurance by more than 50% this past decade.

We believe price transparency holds this power to improve group health insurance rates because it ideally allows employers to better ascertain which insurers offer the best discounts while at the same time allowing employees to shop around for healthcare services and prescription drug costs amongst various providers.

That’s why we were hopeful regarding a Trump administration rule that took effect in January, mandating that nearly all hospitals must make their prices public – a move that hospitals sued to stop but lost in both district and circuit courts.

For years now, it seems as if insurance companies have been the ones who have been made out to be the bad guys, and while they aren’t entirely off the hook, it’s nice to see hospitals finally identified as complicit in this mess.

On the flipside, we’re disappointed that just this week the Department of Health and Human Services (HHS) issued an order to delay the effective date for another Trump era executive order designed to lower prescription drug costs, again through actions which would bring about more pricing transparency. 

Setting aside what is hopefully just a temporary setback to the drug pricing transparency effort, one has to believe that the ruling on hospital price transparency alone holds great promise. And this would be true if it weren’t for the outrageous and rather nefarious transgressions being instituted by many hospitals around the country to circumvent this ruling.

These actions certainly have us wondering if consumer-directed healthcare even stands a chance.

Employer reimbursement of gym memberships was a popular employee benefit before COVID-19 hit the U.S. back in March 2020. Since then, workout facilities have suffered some of the highest pandemic-related losses and may not be a viable option for as many employers in the future.

From prolonged forced closures to capacity limits to time-consuming enhanced cleaning protocols, many fitness industry insiders and gym members themselves feel that gyms will never be the same as they were pre-pandemic. 

Despite these setbacks to the fitness industry, people are anxious to exercise again, especially after a long period of inactivity during quarantine. This is not to say that some people haven't doubled down on exercise during the pandemic, but the vast majority of people have not.

Faced with this quandary, employers may find it challenging to determine which fitness-related benefits to offer as we transition from lockdowns into such an altered physical and attitudinal landscape.

Today's blog post explores how the fitness landscape has changed and some potential options to consider in place of traditional gym memberships.

While my blog post yesterday provided an overview of the American Rescue Plan of 2021 (ARPA), I thought it might be helpful to take a closer look and deeper dive into the employment-related provisions of the ARPA, which President Joe Biden signed into law last night before his televised address to the nation.

Along with providing financial relief to individuals, schools, businesses, and state and local governments, the law contains the following measures of which will undoubtedly be of special interest to employers and their employees:

• A subsidy for COBRA premiums, funded through employer tax credits
• Extension of employer tax credits for FFCRA employee leave voluntarily provided through Sept. 30, 2021
• Expansion of employee earnings eligible for the FFCRA tax credit
• Inclusion of testing and immunization as reasons for FFCRA leave
• Extension of $300 increase in weekly unemployment benefits
• Extension of weekly unemployment benefits for workers who otherwise wouldn’t qualify for these benefits
• Expansion of subsidy for ACA premiums
• Increase in DCAP contribution limits
• Extension and expansion of the employee retention tax credit

Let’s discuss each of these in further detail;

Seven weeks into President Biden’s term, the American Rescue Plan Act, his first major piece of legislation, is set to become law. The House passed a final version of the $1.9 trillion relief bill yesterday afternoon, and just moments ago the President signed it into law, in advance of his first prime time address to the nation later today.

Most experts agree that the relief package is more than just a stopgap measure to shore up the economy or respond to the coronavirus pandemic. The bill contains major federal investment in low- and middle-income Americans, intended to drive economic growth by aiming money at people who are more likely to spend it versus those who might be more likely to save the money. (Critics of the bill argue that many of its provisions are aimed at strengthening the country’s social safety net and have little to do with the coronavirus pandemic.)

Highlights of the bill include extended unemployment benefits, direct checks to individuals, housing assistance, aid to schools and child care, and more.

While some of the bill was changed during its time in the Senate, it’s largely similar to the initial version passed by the House. However, some key provisions, such as a higher minimum wage, were scrapped amid efforts to pass the bill swiftly.

In addition, the bill does not include an extension of the eviction moratorium or an expansion of mandated paid sick and family and medical leave. While neither were included in the original House bill, these were popular provisions contained within one of the previous bills.

The $1.9 trillion package enjoys broad public support, with 70 percent of Americans expressing a favorable opinion of it, according to a Pew Research Center poll released yesterday. That includes nearly all Democrats and more than two in five Republicans, although it should be noted that no Republican lawmakers in Congress voted for the bill.

Here are the most relevant provisions included in the bill.

As COVID-19 vaccines become more widely available, many employers are starting to consider setting-up onsite COVID-19 vaccination programs.

For many employers, operationalizing an onsite service like this may seem like nothing new since many have offered onsite flu shots as part of their workplace wellness programs for quite some time. That said, and as we all know by now, COVID-19 is nothing like the seasonal flu. Therfore, employers need to take heed of this advice as they begin planning for onsite vaccination efforts.

Most of the advice that follows comes by way of guidance from the Centers for Disease Control and Prevention (CDC). As of this writing, vaccine programs are not yet available to very many employers. Nevertheless, vaccination programs will eventually extend to additional workplaces as vaccine availability increases, meaning that employers should begin planning accordingly. 

As I addressed in an earlier blog post about employer rights with regards to offering and/or requiring workforce COVID-19 vaccinations, employers are in a unique position to help propel vaccinations, accelerating the country towards the 75% vaccination target that has been cited by top infectious disease experts as being required to fully eliminate the need for social distancing.

Company leaders find themselves in this unique position because it's widely believed that they can, in most cases, legally compel most of their employees to get vaccinated, making it compulsory and a requirement for returning to work. Regardless, just making vaccinations more convenient and easily accessible will also go a long way in helping to accelerate inoculations.

As I stated in my earlier blog post, and wish to reiterate here, just because something can be done doesn't necessarily mean it should be done. Setting that aside, today's blog post simply addresses the guidance the CDC is currently providing with regards to employer-led vaccination programs.

With the pandemic entering its second year, many organizations have adopted remote work as part of their everyday business operations. Many employers plan to continue this practice, in whole or in part, once the pandemic subsidies. 

The sustainability of this practice is putting increased pressure on organizations to optimize their remote technology solutions for collaboration, communication, monitoring, security, and performance evaluation when working from a distance.

Of course, applying technical solutions to workplace challenges is nothing new for HR. For almost two decades, technological innovations have helped HR departments become far more efficient, eliminating redundancies while vastly improving data integrity.

By automating a wide range of time-consuming business functions, HR professionals have been liberated to shift their focus from rote administrative tasks to high-impact tasks like strategy, employee engagement, and change management. 

In fact, according to PwC’s 2020 Human Resources Technology Survey, the core issues driving HR technology decisions today include: 

• Finding, attracting, and retaining talent 
• Developing people to reach their full potential
• Improving the employee experience 
• Creating collaborative work environments 
• Workforce planning 
• Ensuring employee well-being, diversity, and inclusivity 

With HR technology solutions in abundance to help enhance the overall employee experience, transform businesses, and assist organizations responding to change, here are five HR technology trends to watch for in 2021.

As prescription drug costs continue to increase, it’s important for employers to understand the trends behind the rise and what they can do to better manage their health care expenses.

This blog post sets out to provide context for why prescription prices continue to rise and offers cost-cutting solutions for employers and employees.

Prescription Drug Cost Drivers

In 2019, the United States spent nearly $370 billion on prescription drugs, keeping trend with significant increases year over year. Although prescription drug spending has historically been a small proportion of national health care costs compared to hospital and physician services, it has grown rapidly in recent years—comprising about 10% of national health care spending.

A multitude of reasons led to this steady rise in prescription drug costs, including the following.

Influx of Specialty Drugs

Specialty medications account for a smaller portion of U.S. prescriptions than non-specialty drugs, yet they commanded nearly half of the pharmaceutical market in 2016 ($180 billion). And that dominance is likely to remain. Specialty drug spending is projected to experience rapid growth over the next several years, due to pricing increases.

Employers that are interested in cutting their health care expenses are likely familiar with telehealth. This is the process of communicating with a doctor via an app, or a webcam and computer. During the COVID-19 pandemic, telehealth usage skyrocketed, making it one of the most popular ways to receive health care.

As such, employers should stay apprised of notable telehealth trends to ensure they stay competitive and provide the best health care options to their employees. This article discusses five telehealth trends to watch for in 2021.

1. More Patient Utilization of Telehealth

As was stated, telehealth exploded in popularity during the COVID-19 pandemic. To put that into figures, nearly half (43.5%) of Medicare primary care visits in April 2020 were made using telehealth, according to the Department of Health and Human Services. And even before the pandemic, year-over-year utilization was up 33% in early 2020, according to Medical Economics.

If these statistics aren’t enough to prove that telehealth is here to stay, look instead at market projections. The telehealth market is estimated to surmount $185 billion by 2026, according to Fortune Business Insights. Considering the market was only worth around $34 billion in 2018, this shows how much of an impact telehealth has made on the health care industry.

Almost half of Americans state they will not get vaccinated against the COVID-19 coronavirus – at least not right away. Some of this stems from the speed at which the vaccines are being developed, but also from a segment of the population that has always been suspicious of any vaccines (so-called anti-vaxxers).

The possibility that large swaths of the U.S. population may refuse or delay getting any one of the COVID-19 vaccines presents a serious challenge to the nation's health and the health of our business economy.

Employers are in a unique position to help propel vaccinations, accelerating the country towards the 75% vaccination target that has been cited by top infectious disease experts as being required to fully eliminate the need for social distancing.

Company leaders find themselves in this unique position because it's widely believed that they can, in most cases, legally compel their employees to get vaccinated, making it compulsory and a requirement for returning to work.

Now just because something can be done doesn't necessarily mean it should be done. There are persuasive arguments to be made on both sides of the issue. There are also some exceptions to consider, and some basic questions to be answered, such as where to even start among the workforce. We'll do our best to answer a few of these questions today.

Given the tremendous challenges surrounding in-person gatherings, employers everywhere have been torn between hosting, postponing, or outright canceling their company holiday parties in the face of the COVID-19 pandemic.

In fact, according to Challenger, Gray & Christmas, a Chicago-based outsourcing firm that conducts an annual survey of workplace holiday festivities, most employers are either canceling their parties altogether or are hosting them virtually this holiday season. 

Their annual survey found that only 23 percent of organizations plan to host a year-end celebration in 2020, down from 76 percent in 2019 - a decline of more than two thirds. And of companies who are planning on holding a holiday party, three out of four are doing so virtually.

Since the vast majority of companies who plan to celebrate are embracing virtual as the ideal way to save the day, here are some suggestions and ideas for your party planning committee to consider.

Each presidential transition brings changes to the HR and employee benefits landscape. When President Donald Trump took office in 2016, he overturned or revised many of his predecessor’s federal regulations, a common trend between administrations of opposing parties. It is also something likely to continue under President elect Joe Biden.

With any legislative change - regardless of intent or outcome - employers must adapt quickly or risk penalties. This can mean redrafting internal policies, recategorizing workers, changing organizational priorities, rewriting employee handbooks, and any other HR responsibility. Essentially, the more prepared an HR team is, the easier it will be for them to succeed in a changing landscape.

Some of the policies upon which Biden campaigned may not come to fruition. Moreover, wide-sweeping workplace changes may be stifled due to congressional gridlock, though Biden will retain the ability to affect change through executive orders.

However, thinking about these issues early can help inform operational planning and prevent last-minute scrambling when change arrives. To that end, this week’s blog post discusses potential changes employers can expect during a Biden presidency. Here are nine areas to watch;

As of yesterday, Arizona’s new law legalizing recreational marijuana usage began its phased roll-out. Joining Arizona this year in passing less restrictive marijuana laws are Montana, New Jersey, and South Dakota, all of whom legalized recreational marijuana, and Mississippi, who voted in favor of legalizing medical marijuana.

While all marijuana use remains illegal under federal law, the approval of recreational/medical marijuana use at the local level in these states impacts the drug use policies and procedures employers have in place for both applicants and employees. These include how employers can approach testing and disciplinary procedures.

These states are not, of course, the first to legalize marijuana. Eleven other states previously voted in favor of recreational marijuana laws, and 22 have passed medical marijuana legislation. It is therefore helpful to use the experiences of employers in these states as an example to follow.

In this post we will discuss federal and state marijuana legislation, employer and employee rights and responsibilities, specifics about the five states enacting new legislation, and steps employers can take now to be prepared as these new laws roll out.

For the past 15 years United Benefit Advisors® (UBA), of whom JP Griffin Group is a proud member, has surveyed thousands of employers across the nation regarding their health plan offerings, their ongoing plan decisions in the face of significant legislative and marketplace changes, and the impact of these changes on their employees and businesses. 

The UBA Health Plan Survey has become the nation’s largest independent health plan benchmarking survey and the most comprehensive source of reliable benchmarking data for employers. 

In fact, UBA’s survey is nearly three times larger than the nations’ next two largest health plan benchmarking surveys combined. The resulting volume of data provides employers of all sizes more detailed—and therefore more meaningful—benchmarks and trends than any other source.

UBA recently released its 2020 Employee Benefits Health Plan Survey. This year’s survey aggregates inputs from over 11,788 employers, 21,980 health plans, and 1.3 million nationwide employees. 

The scope of this year’s survey allows regional, industry-specific, and employee size differentials to emerge from the data. In addition, the large number of plans represented allows for both a broader range of categories by plan type than traditionally reported, and a larger number of respondents in each category.

Employers looking to decrease their healthcare costs often rely on workforce adoption of High Deductible Health Plans (HDHPs), which offer both employers and employees lower premiums. Unfortunately, if employees are given a choice, this strategy doesn’t always work if enrollment in HDHPs fall short of forecasts.

Rightly or wrongly, HDHPs have been saddled with some baggage. Many people have difficulty making the cognitive leap from traditional healthcare plans to HDHPs for a variety of reasons; in part because change is generally difficult for people, but sometimes, it’s simply a fear of the unknown and a matter of not understanding how they work.

While we certainly aren’t advocating that HDHPs are suitable for everyone, they’re a great fit for some. Particularly, those who are otherwise overpaying for health insurance, meaning that they’re paying high premiums, but rarely using their plans.

Here are some reasons your employees might not be enrolling in your HDHP — and how you can increase HDHP enrollment.

As healthcare costs rapidly started to rise in the 2000s, insurance companies started to push high deductible health plans, which came with lower monthly premiums, but higher than average deductibles. That trend has continued to the present day, where HDHPs (high deductible health plans) are as popular as ever among employers.

According to the Kaiser Family Foundation, employers offering HDHPs with some kind of savings option has increased 25 percent over the past decade. In fact, 29 percent of workers covered by employer-sponsored health plans are now enrolled in a high deductible health plan.

One of the major perks of being enrolled in an HDHP is the ability for employees to open and contribute to an HSA (health savings account) — but what many employers (and employees) don’t realize is that not all health plans with high deductibles are eligible for this benefit. So how do you know if your high deductible health plan is HSA qualified?

What is an HSA?

An HSA is a tax-advantaged savings account designated for qualifying health expenditures. This means that funds which employees, employers (or both) contribute to an HSA are not subject to tax, thereby lowering the participant's taxable income for the year. While participants can contribute any amount they like, the government caps tax-advantaged funds for 2021 at $3,600 for individuals and $7,200 for families. 

For people who have experience with FSAs (flexible spending accounts), the concept is very similar. FSAs, designed to offset health and dependent care expenses, are sometimes made available through employer-sponsored benefit programs. The main difference is that funds contributed to an FSA  “expire” at the end of year in what’s called the “use it or lose it” rule. Net, if FSA participants don’t use their entire contribution, they forfeit whatever is left over.

The Kaiser Family Foundation (KFF) recently published the results of their highly anticipated Employer Health Benefits Survey for 2020. This year’s survey includes data from 1,765 non-federal private and public companies in the United States.

KFF’s annual report provides an in-depth perspective on trends in employer-sponsored health coverage. Their results span everything from medical premiums and funding mechanisms to wellness and health plan design.

The following is a summary of some important trends for you to know, along with a link towards the end of our summary for you to download the full report.

The IRS recently finalized adjustments to 2021 contribution limits on various tax-advantaged health and dependent care spending accounts, retirement plans, and other employee benefits such as adoption assistance and qualified transportation benefits. Many of these contribution limits, though not all, are indexed to cost-of-living adjustments.

Together, these annual announcements by the IRS detail any adjusted limits to the amounts employees can tuck away pretax into Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Commuter Benefits, and Retirement Plans such as 401(k)s for the upcoming year.

While IRS limits for HSAs are required, by law, to be announced by June 1st, limits for these other pretax savings vehicles always seem to come so late in the year that many employers have already completed their employee benefits open enrollments.

As frustrating as this is, employers would be well-served to get this information out to their employees so they can take full advantage of these pretax savings vehicles. That said, there are not all that many changes for 2021.

What follows is a summary of limits employers and employees need to know.

Retirement savings are on everyone’s mind these days, regardless of age or number of years in the workforce. Millennials are concerned they’ll never be able to retire, while baby boomers are choosing to delay retirement — in part because of employer demand for their expertise in the face of a low unemployment rate, but also because many of them haven’t sufficiently saved for retirement. In fact, according to Time’s Money division, 28 percent of boomers and seniors aged 55 and older don’t have any retirement savings whatsoever and just over half have less than $50,000 saved.

Even more surprising, the median amount Americans have saved for retirement is just $5,000, which means we have a long way to go in helping people prepare for their golden years. This number may seem staggeringly low — and it is. The average retirement savings among Americans age 32 to 61 is just under $96,000. However, averages are pulled up by super-savers, so this number seems artificially high.

With the prevalence of high deductible health plans (HDHPs), a lot of people are now enrolled in health savings accounts (HSAs). While people are mostly familiar with the short-term savings opportunities these accounts provide for healthcare expense reimbursement, many are also realizing that HSAs are a viable retirement savings option as well.

This begs the question — if people had to choose between investing in their 401(k) or maxing out their HSA for the year, which one is a better retirement savings option?

Voter turnout in the 2018 election was the highest our country has seen for a midterm election in the last century. Despite this, voter turnout in the U.S. remains lower than in other developed countries. In fact, during the past century, U.S. voter participation has hovered within a 12-percentage point range, from just under 50% in 1924 when Calvin Coolidge won, to over 61.6% in 2008, when Barack Obama won the White House.

While many factors contributed to the record rate of participation in the 2018 midterms, one notable action was that hundreds of companies, including Gap, Patagonia, and Target, encouraged their employees to vote. (Some companies even launched voting programs directed towards their consumers.)

As we've addressed in other blog posts, this dynamic of politics in the workplace requires delicate handling. After all, taking a partisan approach to civic engagement can alienate both employees and customers in today's hyper-partisan environment.

Nevertheless, a Harvard Business Review study suggests a "sweet spot" for companies who want to support the vote: being pro-democracy and pro-voter, without being partisan. Furthermore, there's evidence that companies who support and encourage political engagement derive a multitude of benefits.

A global pandemic. Social unrest. A presidential election. Now a Supreme Court confirmation. A perfect storm if ever there was one. Never before have I seen the country so divided over such a confluence of events, and never before have I seen such tremendous stress placed upon our collective workplace and individual mental health. I see it in my family, my friends, my neighbors, and even my employees.

With this in mind, I sat down over the weekend to watch a new Netflix documentary called The Social Dilemma. Frequent readers of this blog know that I've never really used it in the past to recommend a particular piece of media, except for some excellent Ted Talks related to the workplace and others tangentially related to employee benefits.

Nevertheless, I found The Social Dilemma so riveting, so concerning, and so timely, that I feel compelled to recommend that everyone sit down with their families and watch this film. In fact, I'm asking my entire workforce to do just the same.

This documentary cuts between "conscientious Silicon Valley defectors" from Facebook, Instagram, Twitter, and Google to sound the alarm about the incursion of data mining and manipulative technology into our social lives and beyond.

Even before the pandemic hit, working parents struggled to meet the needs of their employers and families. Then came the school and daycare closings, and working parents who were already at their breaking points got pushed even further. 

Seven months into the pandemic, things aren't much better for this group of caregivers. With most child care centers still closed around the country and the vast majority of schools practicing remote learning, working parents are dealing with the overwhelming task of once again juggling caregiving and work responsibilities as we head into the Fall.

And while much attention has been given to parents trying to balance their professional responsibilities with home-schooling and taking care of their children, there are also millions of people who are juggling remote work and eldercare for aging parents and other relatives.

Balancing work and caregiving responsibilities is contributing to decreased productivity, poor mental health, and increased stress among employees. All this is leading to lower morale, higher absenteeism, an increased risk for all sorts of health conditions, and higher health care costs.

Just consider a few of the stunning findings from a survey from Boston Consulting Group (BCG), conducted earlier this summer;

When helping employers cultivate employee benefits packages, we’re often asked to aggregate insights on what their peers are spending on their benefit programs. The answers vary widely based on multiple factors, including geography, industry, size of the workforce, the overall health of the workforce population, and the health of their respective businesses and the economy.

Employee benefits benchmarking is one of the best ways to figure this out and the best way to get at this data is through a combination of public and proprietary information (the latter of which can be costly, but also quite necessary).

Last week we addressed how this open enrollment season is shaping up to be like no other benefits enrollment period we've ever experienced. In that blog post, we offered a number of suggestions for how employers can best prepare for the choppy seas which lie ahead.

This week we want to share the shifts we're seeing in the employee benefits employers are offering, due to the altered landscape brought about by the COVID-19 pandemic; from products and services to policies and medical premiums.

What we've found to be most surprising is that despite some companies cutting costs through layoffs, furloughs, cuts in pay, and reductions to 401(k) matching programs, employers who can afford to do so are broadening their benefit programs due to the pandemic.  

Here are some of the most significant changes we're helping our clients roll-out.

A Brief History of Employer-Sponsored Healthcare [From the 1930s to Now]

As Americans continue to debate the impact of the Affordable Care Act (ACA), perhaps a quick look at the historical timeline of employer-sponsored healthcare will provide context for the state of American healthcare as it exists today.

Small Beginnings

Fall is just around the corner, which also means we're about to enter an employee benefits open enrollment season like no other that has come before. Many organizations are still operating fully remote. Others are still trying their best to reopen as safely as possible amid mixed messages and fluid guidelines from state and local governments.

Suffice to say, open enrollment planning is the last thing on anyone's mind, except that is, for your employees, who are more concerned than ever about having the right coverage and savings options in place during these uncertain times.

Procrastinating or allowing yourself to get too distracted from benefit decisions and enrollment planning is a recipe for disaster, given what's at stake this open enrollment season.

Here's what we're seeing out there and our advice on how best to prepare for open enrollment.

As of yesterday, Congress is back in session, but only for a few short weeks. If lawmakers can work together to produce another COVID-19 relief package, it's likely to be the last major piece of legislation passed before the 2020 election.

With prior stimulus measures slated to expire over the next few weeks, the economy continuing to falter as the pandemic resurges across the country, and a presidential election looming, the stakes simply couldn't be any higher.

Back in May, the House of Representatives passed its Phase 4 bill, known as the HEROES Act. The bill has been up for review since early July, though Senate Republicans, who prefer a measure with a far more tempered price tag, have been reluctant to consider it.

The House's $3.5 trillion relief bill would extend enhanced unemployment benefits, offer additional direct payments to taxpayers, and provide assistance to state and local governments, among other things.

The Senate is expected to introduce their own version of a relief bill this week that will have to be reviewed and negotiated between the two chambers before they recess in early August.

Several economic proposals impacting small and midsize businesses have been gaining consensus among lawmakers for weeks, so the final version of the Senate bill could contain elements of all of them.

Here are six things employers can likely expect from the Phase 4 bill; 

With fluctuating infection rates, predictions of a second wave, and conflicting official guidance, organizations need to adapt quickly if they want to survive, yet alone succeed in the midst of, and even after, the coronavirus pandemic subsides.

HR teams stand at the forefront of these efforts. For years, HR departments have been tasked with ushering in fundamental workplace changes, and this moment is no different.

While this list could be far longer, here are just five ways the coronavirus is reshaping HR and how departments can adapt to these new challenges.

Yesterday, the Equal Employment Opportunity Commission (EEOC) issued their seventh update to nearly 50 FAQs they have been publishing since March 18th, addressing how employers should comply with the Americans with Disabilities Act (ADA) while also observing all applicable emergency workplace safety guidelines during the coronavirus pandemic.

While their latest update primarily addresses antibody testing, the guidance, in its entirety, is quite informative, so much so that we wanted to share it here.

While it's a good idea for every employer to follow the CDC's latest guidelines for maintaining workplace safety, only employers with 15 or more employees are subject to the ADA (though smaller employers may be subject to similar rules under applicable state or local laws.)

Regardless, even smaller employers can benefit from the guidance provided in these EEOC FAQs about ADA compliance. 

Due to the coronavirus (COVID-19) pandemic, more employees are working remotely than ever before. And, even as businesses begin to reopen across the country, remote work will likely remain popular for the foreseeable future.

While remote work arrangements help keep employees healthy and safe in the midst of the COVID-19 pandemic, they create unique challenges for teams and managers. One of these challenges involves monitoring remote workers. Employers across the nation are leveraging various technologies and tools to monitor employee productivity, and active and idle time.

While these tools can help employers ensure employees are working while they’re at home, they come with their own set of legal risks. Moreover, the practice of using such tools to monitor employees may create tension between employees and managers, as employees may feel like they’re not being trusted.

There are benefits and drawbacks to monitoring remote employees, as well as a host of legal considerations. This article provides a general overview of the pros and cons of monitoring remote workers and outlines general best practices for doing so.

COVID-19 has brought massive upheaval upon the American workplace. Employers have found themselves drafting and implementing policies and procedures addressing a wide array of issues including remote work, layoffs, furloughs, pay cuts, workplace conditions and many more.

Not surprisingly, the uncertainty wrought by COVID-19 has left employers at an increased risk of exposure to employment-related claims alleging wrongful termination, discrimination, retaliation and many others.

In this post today we'll cover the most common potential causes of action related to COVID-19 that may lead to employment-related litigation. As is the case with all inherently legal issues, employers are strongly advised to seek the guidance of legal counsel when faced with any of the claims discussed here.

WORKPLACE HEALTH AND SAFETY

There have already been a multitude of safety violation claims filed under the Occupational Safety and Health Act (OSHA) and state equivalents. These safety violations typically allege that an unsafe workplace has caused sickness and/or death due to COVID-19, or that an employer failed to take appropriate measures to reduce COVID-19 exposure and spread within the workplace.

Such “appropriate measures” might include failure to provide hand-washing stations, sanitizers, masks, or adequate protective gear on location. Other claims have alleged that employees have been unable to practice social distancing due to the nature of their jobs.

With daycare centers closed and summer camps turning kids away, employees who socked away money in their Dependent Care Flexible Savings Accounts (DCFSAs) are worried their use-it-or-lose-it account balances are going down the drain.

This concern is also shared by those who tucked away pre-tax savings in Health Care Flexible Savings Accounts (HCFSAs) to cover eligible health care expenditures. With hospitals postponing elective procedures and patients skittish about entering health care facilities, savers simply aren't racking up enough receipts to deplete their FSA balances.

Both groups can now breathe a sigh of relief, since new guidance from the IRS will allow most employees to make midyear pre-tax contribution adjustments to their Health Care and Dependent Care FSAs, which typically aren't permitted once enrollment elections are set.

Historically, the only exception to this rule was if an employee experienced a Qualifying Life Event (QLE), defined by the IRS as a marriage, divorce, job change, birth or adoption of a child, or when a dependent child reaches age 26.

In addition to allowing midyear savings account adjustments, the IRS is also permitting midyear health plan enrollment changes.

As states begin to ease stay-at-home orders, businesses that shut down to minimize the spread of COVID-19 are starting to reopen. But as some employers are finding out, not every employee is ready to get back to work.

Companies that took out loans under the Paycheck Protection Program (PPP) are worried that their staffs' reluctancy to return to work will put their PPP loans in jeopardy of having to be paid back. (Loans under the PPP are only forgivable if employers rehire the same number of full-time employees they used to calculate their PPP loan amount in the first place.)

At the same time, employees who are turning down call-backs from their employers are worried they will no longer be able to collect unemployment benefits, made significantly richer under the CARES Act coronavirus stimulus bill. The New York Times estimates workers in more than half of states are receiving more in unemployment benefits than they did from their normal salaries.

Recognizing this quandary for employers and employees, here's what the Small Business Administration (SBA) and the Department of Labor (DOL) are doing to address this.

Employers are understandably confused when it comes to trying to predict how the coronavirus epidemic will impact their group health plans. Utilization is way down for preventive, elective, and non-emergent services, while expenses directly relating to the testing and treatment of COVID-19 are way up.

Employers aren't the only ones who are perplexed; many employee benefits experts are also in disagreement as to how all this will play out. Willis Towers Watson estimates that employer health care costs might increase by 4 to 7 percent for calendar year 2020, while Gallagher is predicting just the opposite, suggesting that a 15% decrease in medical expenses is possible. Others, as you'll read about later, are suggesting the potential for a staggering 40 percent increase in premiums next year. 

Employers, most notably those with self-funded group health plans, must be mindful of these wide swings in predictions. Regardless of which way things play out, they need to take careful steps to ensure the financial viability of their health plans during this crisis.

So how can employers forecast and prepare for these shifts in cost? It's especially difficult because the impacts of this pandemic are highly dependent on the geographic, demographic, and economic risks which impact every employer quite differently.

Here are some steps self-funded employers should take, along with some predictions on what might happen to various cost-drivers of medical plans.

Americans are suffering from "cabin fever." That's how both New York Governor Andrew Cuomo and President Trump described the American psyche this past weekend, with much of the country growing weary of spending so much time at home. President Trump went even further when he sent out Tweets encouraging citizens of three states to push for more immediate reopenings than planned.

Governors of those states, Minnesota, Michigan, and Virginia, were left confused, having been told just days earlier by the President that the decision to reopen would be left up to them, though just days prior they were told the opposite by the President, who claimed the decision to reopen the country rested solely with him.

Governors are understandably feeling a bit whipsawed by this flip-flopping. Still, it's fair to say that there isn't a governor across the country who isn't eager to ease restrictions that have crippled state economies. The vast majority of Governors, however, are balancing their decisions to reopen with local public health concerns and the White House's very own Guidelines for Opening Up America.

Reopening Means Renewed Opportunities for The Virus to Spread

American workers are also anxious to get back to work, and business owners are desperate to see the wheels of commerce turn again. But the fact of the matter is this - businesses are going to reopen before there is widespread testing for COVID-19, much less general availability of antibody testing, which will indicate if an employee was previously infected and has now mounted an immune response to the disease.

This is to say nothing of the 12-to-18 month roadmap to developing an actual vaccine for the virus, nor the manpower required to do meaningful contact tracking. This means that the coronavirus will have renewed opportunities to spread as workers return to the job.

Without Formal Guidance, Businesses Are Essentially Winging It

Without common and well-defined safety procedures for reopening, businesses are implementing ad hoc procedures with vastly mixed results and constant changes. OSHA is stressing that its guidance isn't regulation, but rather advisory.

Many frustrated business leaders are looking to "essential businesses" that never shut down for guidance, while others are looking for inspiration from companies in overseas markets where the curve of the pandemic subsided weeks ago.

So what should employers do to prepare for reopening? What actions can they take to make workplaces safe? What steps can they take to test workers and keep them healthy?

Here are some suggestions;

Employees who take qualifying leaves of absence are provided multiple protections by way of the Family and Medical Leave Act (FMLA), the Uniformed Services Employment and Reemployment Act (USERRA), and many state laws.

The most well-known protection is the guarantee of the same or an equivalent job when employees return to work, but there are also other protections. For example, many of these laws stipulate employers’ obligations regarding health insurance during employees’ qualifying leaves of absence.

The following is a breakdown of FMLA, USERRA, and some general state laws with regards to employer-provided health insurance coverage.

FMLA and Health Insurance

In order to meet the requirements for an FMLA-qualifying leave of absence, employees must meet four criteria.

With funds reportedly running dry overnight in the $350 billion Paycheck Protection Program, it was with great trepidation that I read an article in the Wall Street Journal this morning suggesting that a second round of coronavirus-related layoffs is already underway, and that very few industries will be spared this time around.

This prediction was further bolstered when the Labor Department announced, just a few hours ago, that 5.24 million more weekly jobless claims were filed last week, exceeding the 5 million expected from most economists. This brings total unemployment claims to just over 22 million, virtually wiping out ten years of spectacular U.S job growth in less than a month. 

It would be an understatement to say that that the damage to the U.S labor market has been profound. And economists say there's more to come. But there's also been considerable discussion recently about markets "opening back up", perhaps as early as the end of this month.

So which industries are next to be hit, can this be avoided, and how long might it take for things to bounce back once we return to what is sure to be a "new normal"?

Many employers hit hard by COVID-19 are wondering if they should cut payroll expenses through furloughs and layoffs. These temporary actions quickly reduce payroll expenses, while providing affected employees with access to the greatly enhanced unemployment benefits now available, thanks to the CARES Act.

Most furloughed and temporarily laid-off employees can also maintain their health benefits while collecting these unemployment benefits. However, the extent can vary based on medical carrier contracts with employers, and variations in state laws.

Just this morning, a piece in the Wall Street Journal discussed how more and more employers are going this route, though many are doing so on a voluntary basis since these richer unemployment benefits help some workers more than others. (In some cases, which we'll address a bit later, certain employees can actually make more on unemployment, at least for the moment.)

Complicating an employer's decision to pare back payroll expense in this way is another provision in the CARES Act called the Paycheck Protection Program (PPP). This program, which I covered extensively in my last blog post, is designed to encourage employers to maintain staff by providing forgivable loans to employers who resist cutting their workforce.

The PPP has already proven to be so popular that Congress is already moving to approve additional funding for the program. Congress has thus far approved $350 billion in potentially forgivable small-business loans, but early demand suggests the program may run dry. Treasury Secretary Steven Mnuchin confirmed in a tweet yesterday afternoon that his department will ask for an additional $250 billion for the small business program.

Which of these options is better for your employees, and which option is better for you as an employer? A lot depends on additional operating expenses incurred by an employer, employee income, duration of benefits, accessibility of each relief program, and the long-term impact of both decisions. And of course this dilemma is predicated on an employer not planning on ceasing operations altogether.  

Let's take a look at each option in greater detail.

While we've fielded thousands of questions these past few weeks about the COVID-19 pandemic, the vast majority of inquiries most recently have been about emergency financing relief for small business.

Here is what we know about three financial relief programs, each made possible by the CARES Act recently signed into law; 

• CARES Paycheck Protection Program (PPP)
• CARES Business Debt Relief Program
• CARES Economic Injury Disaster Loans (EIDL) & Emergency Economic Injury Grants (EEIG)

As a reminder, we update both of our COVID-19 Download Resource Centers daily with regulatory briefs, legislative summaries, newsletters, flyers, and posters for you to use as you see fit.

Make sure to bookmark this resource area for ease of reference later.

CARES PAYCHECK PROTECTION PROGRAM (PPP)

What is the Paycheck Protection Program?

The PPP is a program designed to minimize layoffs during the coronavirus pandemic. The PPP provides businesses with fewer than 500 employees with 100 percent federally-guaranteed loans, which may be forgiven, if borrowers maintain their payroll during this pandemic.

Must a PPP loan be paid back?

No, providing an employer maintains their payroll, the loan will be forgiven. We'll address the amount of loan forgiveness available later in this article.

To say that the Coronavirus (COVID-19) pandemic has put a significant strain on every aspect of daily life around the world would be an understatement. As the spread of the disease shows no sign of slowing down, there remains steadily increasing concern in this country, not only about the health of our citizens, but also our economy, which is now in tatters, through no fault of its own.

In response, on Friday, the United States Congress passed a $2 trillion package to provide a jolt to our economy, reeling from the deadly virus. This is the third aid package from Congress and is it designed to keep businesses and individuals afloat during an unprecedented freeze on the majority of American life.

This will most likely not be the last stimulus package Congress will have to enact. This is especially true given that President Trump, just yesterday, extended his administration's social-distancing guidelines through the end of April, as the peak death-rate from the virus is expected to hit in two weeks. (The death toll from COVID-19 past 2,000 over the weekend.)

Most economists are in agreement that last Friday's $2 trillion package isn't a stimulus plan at all, but rather a relief package. Senate Majority Leader Mitch McConnell (R-KY) described the legislation this way; "No economic policy can fully end the hardship, so long as the public health requires that we put so much of our commerce on ice. This isn't a stimulus package. It is emergency relief. Emergency relief. That's what this is."

All Americans would do well to understand the provisions of this latest stimulus/relief package, as it will offer direct relief to businesses and individuals alike. Here are the details.

The American history of medicine and organized healthcare is quite a bit different than that of most other first world countries.

While the Civil war propelled the progress of American medicine much faster than what would have probably transpired without it, our staunch belief in capitalism has prevented us from developing the kind of national healthcare the United Kingdom, France, and Canada have used for decades.

As a result, we have our own unique system that has evolved drastically over the past century into something that is both loved and hated by its citizens.

Whichever end of the spectrum you lean toward, there’s no doubt about it: the history of medicine and organized healthcare in America is a long and winding road. How we've gotten to where we are today is quite a story, so let’s dive in...

The History of Medicine and Organized Healthcare: From the 1700’s to Now

The 1700’s: Colonial Times

Medicine was fairly rudimentary for the first few generations of colonists who landed in the new world, primarily because very few upper-class physicians emigrated to the colonies. Women played a major role in administering care in these early days, most especially when it came to childbirth.

Mortality in those early days was extremely high, most notably for infants and small children. Malaria was particularly brutal, as was diphtheria and yellow fever. Most of the sick were treated with folk remedies, though smallpox inoculation was introduced earn-on (long before it was embraced in Europe.) In these early days, there was virtually no government regulation or attention paid to public health.

“As frightening as yesterday’s unemployment numbers were, it’s merely a preview of how bad things are going to get.” That’s a quote from today’s Wall Street Journal, and it’s probably an understatement.

With businesses all around us temporarily shutting down, and some outright going out-of-business, the U.S. economy is headed off a cliff, into uncharted territory, and our leaders know it.

With Senators on both sides of the isle disagreeing over how best to help individual Americans during the coronavirus pandemic, they are at least unified in the pressing need to get something more done - and as fast as possible.

If met, tonight’s midnight deadline, declared just an hour ago by Senate Majority Leader Mitch McConnell, would make it possible for the legislation to be drafted at breakneck speed over the weekend. This would allow Senators to vote as early as Monday on what is sure to be a wide-ranging stimulus package which is likely to top $1 trillion.

Here's what they are considering.

Note: Since publishing this post (as seen below), the FFCRA legislation has been revised. While it's been billed as a "technical correction" by Democratic leaders, the changes are substantial. The new measure will still provide two weeks of paid sick leave to workers affected by the pandemic, but the next 10 weeks paid leave will be limited to only those workers caring for a child whose school or day care has been shut down. (Workers who had been in quarantine, or caring for a family member affected by the crisis, will not be eligible for the additional 10 week of paid leave.)

In a press conference just a few hours ago, Senate Majority Leader Mitch McConnell (R-Ky.) announced that the Senate will, in fact, pass the Families First Coronavirus Response Act (FFCRA) which was passed by the U.S. House of Representatives over the weekend.

Senators had been critical of the House legislation, describing it as a “non-comprehensive bill” that simply doesn’t do enough to help small business. Earlier today Senator McConnell went so far to say that the the Senate would not pass the bill unless it included “significant and bold new steps”.

Realizing that changes to the bill would result in the measure having to go back to the House for approval, the Senate reversed course this afternoon, anxious to show the country bipartisanship in the face of a global pandemic.

"A number of my members think there were considerable shortcomings in the House bill. My counsel to them is to gag and vote for it anyway," McConnell said.

McConnell then pledged not to adjourn the Senate until passing the House bill, as well as a third stimulus package, which is expected to top $850 billion and focus on small business and industry.

Here are the details of the "phase two" package the Senate looks to pass as early as this evening.

Yesterday, in an effort to prevent the spread of coronavirus (Covid-19) on its campus, Eli Lilly became yet another high-profile U.S. company outside the state of Washington to ask some of its employees to work from home.

This comes on the heels of similar actions last week by several Seattle-based companies; Amazon, Facebook, Microsoft, Twitter, and Google have all told their employees to remain home.

With a prediction by Harvard epidemiologist Dr. Mark Lipsich that 40-70 percent of the global population will eventually become infected with Covid-19, U.S. companies are all taking note. And with Health and Human Services (HHS) Secretary Alex Azar acknowledging that this is now a public health emergency, government and non-governmental agencies are finally in lockstep.

Accordingly, the Department of Homeland Security (DHS) has issued Covid-19 preparedness guidelines which call for, among other things, stockpiling a 2-week supply of water and food, and obtaining "a continuous supply in your home of prescription medications".

Having Extra Medications on Hand Is An Excellent Idea

The advice of having an emergency supply of medications on hand "is excellent," according to Peter Jacobson, with the University of Michigan's School of Public Health. In an interview yesterday with National Public Radio, Mr. Jacobson went on to say, "People should not be caught short of having enough heart medication, diabetic medication, and anything potentially lifesaving, that they need on a routine daily, weekly, or monthly basis."

That said, and as you and your employees are probably finding out, stocking-up on prescription medications is not as easy as it sounds. Here's why.

"It has a 9/11-like feel." That's how the CEO of Southwest Airlines last night described the impact of coronavirus on its business. While this might not be a surprising assessment from a global carrier like United Airlines, it's somewhat shocking to hear from Southwest, since it doesn't even serve Asian and European markets.

So what's going on here? Is this coronavirus (Covid-19) really something to fear here in the United States, or is this mass hysteria nothing more than a media-driven panic, as Dr. Drew suggested as recently as this morning on Fox News?

So much distrust of the mainstream media and our government institutions has been sewn into the fabric of our country these past few years that it's admittedly very hard to tell. At this point, it probably doesn't really matter if it's real or not. The perception is that it's real, and as we've been taught for decades now, perception is reality.

In fact, just moments ago, while writing this blog post, the first U.S. college announced it was closing down for the semester, moving 50,000 students to online learning. And as I was adding this to my post, I received an alert that the Mayor of Austin just cancelled the South by Southwest music festival and conference.

I don't know about you, but this feels pretty real to me.

It's not a matter of if, but when. That's what Federal authorities finally said yesterday regarding the likelihood of the coronavirus spreading across the United States.

Infectious disease experts are now calling on businesses, schools, and communities to brace themselves for what they see as the inevitable outbreak of the coronavirus across the country.

"The disruption to everyday life might be severe," said Dr. Nancy Messonnier, Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC).

Strategies to contain the virus on our shores, now officially named Covid-19, have thus far been based on isolating those who have contracted the virus, as well as quarantining those who may have been exposed to those individuals.

Authorities now admit that as the virus becomes more widespread, containment strategies will likely expand to the closing of schools, the canceling of mass gatherings, and the implementation of widespread telework for employees.

With financial markets across the world tanking and President Trump now scheduled to address the nation tonight, it now appears as if the threat of a global pandemic can no longer be ignored nor minimized by those who have thus far claimed that talk of a pandemic was nothing more than fear-mongering by the media.

So what exactly is behavioral economics and why is it a useful tool for motivating behaviors?

Behavioral economics is the use of psychological, social, cognitive, or emotional factors to influence a person's behavior when it comes to making economical decisions. 

An excellent example of this in workforce wellness is when employers use incentives to encourage or discourage a specific thought or action.

In a blog post earlier this year, Compensation Cafe used smoking as an example of a behavior that many employers may want to discourage, since it's both unhealthy and disruptive. The challenge is doing so in an effective and non-offensive manner.

The following are five different types of behavioral economics to facilitate change, using smoking cessation as an example.

Today the first official votes will be cast, both in Iowa and California, for the 2020 presidential election. A hot button topic in the discourse leading up to this moment has been whether the country should migrate to a single-payer healthcare system commonly referred to as "Medicare-for-all."

While every Democratic candidate still in the running supports some level of change to the current healthcare system, Medicare-for-all is a solution championed primarily by Vermont Senator Bernie Sanders and Massachusetts Senator Elizabeth Warren.

Both are pushing for a single-payer solution where Americans would be enrolled automatically in a government-run medical insurance plan. Both of their policies call for essentially disbanding private insurance, or relegating it to something only needed to supplement care outside of the provisions provided in their single-payer solutions.

Should Employers Embrace Medicare-for-all?

Would this transition to Medicare-for-all be a good thing for employers, 4.5 million of which are providing employer-sponsored group health insurance to over 160 million Americans representing 49 percent of the country's total population?

There are several comprehensive federal statutes that impact workplace wellness programs. While employers who invest in wellness initiatives almost always do so with the best of intentions, violations of these regulations can be costly.

Today we'll focus on three key federal laws which employers should keep in mind when building out a wellness plan. They are as follows;

1. The Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act (HIPAA) includes nondiscrimination rules that apply to wellness plans being offered in connection with group health plans. Under HIPAA, workplace wellness programs are divided into two categories: participatory wellness programs and health-contingent wellness programs.  

Here are the main differences between these two types of programs;

The new year is often a time for people to pause and reflect on the past year and consider things they’d like to change. This leads to new year’s resolutions, which frequently include health-related outcomes. Soon after, however, resolve to keep these resolutions starts to get a bit shaky.

Some of the most common new year’s resolutions including losing weight, eating better, exercising more, and engaging in more self-care. Anyone who belongs to a fitness club knows that January is the busiest month of the year, but the crowds start to thin out around mid-February, if not sooner. By that point, most people have given up on their new year’s resolutions and the steady gym members get their favorite machines back.

The bad news is the failure to implement the healthy lifestyle changes your employees were working on might have adverse effects on their mindsets. By the end of February, if they’ve abandoned their new year’s resolutions, they’re back to their old habits, picking up fast food at lunch, downing cans of soda, and probably feeling bad about themselves.

The good news is that you can help them turn things around. Maybe they need a little extra encouragement and support to follow through with their new year’s resolutions, both of which you can provide to them with a bit of effort.  

Crafting an employee benefits program for your workforce can be a daunting task, not to mention a great deal of work that often falls outside an employer’s area of expertise. After all, we don’t meet many small to midsize business owners who cherish having to become experts in human resources and employee benefits.

This is precisely why most companies (even and especially large ones), lean on outside resources and subject matter experts for assistance with their employee benefits program.  

While some very small businesses bundle the procurement of benefits with their payroll provider or property/casualty broker (a practice we’d strongly recommend against - and a topic for a future blog post) most businesses elicit the assistance of a professionally licensed and trained employee benefits expert. 

There’s only one problem: most HR professionals are confused as to whether they need an employee benefits broker, an employee benefits consultant, or an employee benefits advisor. Many are also unclear of the difference between these professionals - and many wrongly assume it’s just merely semantics.

Last week we wrote about a recently issued Executive Order by the White House to hopefully usher in healthcare price transparency from hospitals and insurance carriers, both of whom hold their secret price negotiations close to the vest. We expressed optimism over the order’s ability to tame runaway consumer and employer healthcare costs. Sunlight, after all, is said to be the best disinfectant.

There’s another area of equal concern which has been driving up the cost of employer-sponsored healthcare for quite some time - prescription drug pricing. In a word, it is skyrocketing, with no end in sight.

The price of pharmaceutical drugs is rising 3x faster than wages, and 5x faster than inflation. In fact, more than 3,400 drugs have boosted their prices in the first six months of 2019, an increase of 17 percent in the number of drug hikes from a year earlier. And the average price hike across all prescription drugs stands at 10.5 percent.

A new coalition of health advocate groups was formed in October to make their voices heard on drug price transparency, caps on drug price increases, and other price reducing strategies. The coalition has identified drug manufacturers and pharmacy benefit managers (aka the middlemen) as the culprits, but it’s literally going to take an act of congress to get this under control.

The drug hikes come at a time when (or perhaps because) lawmakers and the Trump administration have vowed to address the problem of rising prescription costs.

The Trump administration, hungry to notch a win on healthcare prior to the 2020 election, continues to push ahead on initiatives designed to reign in healthcare costs. We applaud these efforts and are disappointed and dismayed by those in the healthcare industry opposed to these undertakings.

Announced November 15, the White House’s price-disclosure initiative would most certainly upend the $3.5 trillion healthcare industry. In fact, the requirements called for, by executive order, are far more extensive than many industry experts predicted. Somewhat expectedly, they have drawn the ire of hospitals and healthcare delivery providers caught in its crosshairs.

The Executive Order On Healthcare Transparency

Issued jointly by the Department of Labor (DOL), Department of Health and Human Services (HHS) and the Treasury Department, the proposal imposes new transparency requirements on group health plans and health insurers in both the individual and group markets.

In the simplest of terms, the proposed rule will force hospitals and insurers to disclose the highly secretive rates they negotiate with each other for an extensive list of services, including doctor and facility fees, supplies, and even drug costs.

Over half of U.S. workers will shop online while on the job this Cyber Monday. That's double the number of "work shoppers" from just a few years ago, according to recent research conducted by Robert Half Technology. 

Once an activity only those with desk jobs could get away with, experts point to the ease in which retailers have now made shopping from smartphones as one of the primary drivers of this dramatic increase in online shopping while at work. 

And while most workers will browse during their lunch breaks, a surprising number will shop all day long, with 44% admitting that their productivity suffers as they surf for the best deals.

Among 28 U.S. cities in the survey, Phoenix tops the list of cities with employees who admit to this hit in productivity, with San Diego and Austin following close behind.

So what can be done about this workplace productivity killer? In a nutshell, not much. Resistance is futile, as they say. In fact, in a separate survey also conducted by Robert Half, 77% of technology leaders said their firms allow "workshopping", but more than half of these same respondents (52%) indicated a preference for employees to not shop from work. (See infographic.)

So here are four ways that you, as an employer, can embrace Cyber Monday in ways designed to minimize workplace disruption and maintain employee productivity.

Every business owner is concerned about their company’s reputation. It not only affects their ability to attract customers, but also the talent they’re able to recruit. And these days, the internet is providing a much louder voice to a much wider audience, making business reputation management both more difficult and more complicated.

Ideally, you want current and former employees to leave shining endorsements of your company and all it has to offer, but the reality is that not everyone will do so. Whether your role in a company is one of ownership, leadership, marketing, or human resources, part of your job is to engage in business reputation management and luckily, the very same internet making the process more difficult has managed to provide some useful tools to help you out.  

The Role the Internet Plays in Company Reputation

One of the most positive things the internet has bestowed upon us is the ability to be more transparent. We don’t buy anything without researching it and reading every review we can find, so why would job-seeking be any different? People can read the company’s website, but let’s face it: what they really want is the inside scoop. They want the dirt. They want to know why employees leave, what they’re upset about, what they wish they could change, and how good the employee benefits really are.

It wasn’t long ago employers feared that the growing popularity of more portable employee benefits such as Health Savings Accounts (HSAs) might lead to a drop in workforce loyalty and employee retention.

Coupled with the ACA’s provision striking down preexisting conditions, HR professionals were fearful this would cause an exodus of workers who perhaps weren’t loyal out of choice, but rather because of their employer-sponsored healthcare coverage and yet-to-vest retirement benefits.

It turns out that these fears have been mostly unfounded. In fact, the rate at which employed workers move to new jobs has been depressed for more than a decade and has only recently approached levels seen before the 2008 financial crisis, according to data from the U.S. Census Bureau.

More precisely, and according to a Wall Street Journal article published earlier this week, 5.8% of U.S. workers switched jobs in the first quarter of 2018 (the most recent period available), compared to an average of 7% per quarter back in 2000 and 3% per quarter in 2009, the latter of which represents an historic low during this period. 

Today's still relatively low level of job switching has economists calling into question a key economic model of our time, called the Phillips Curve. It predicts that inflation rises as unemployment falls, but that hasn't happened lately. So what's going on? And what does this have to do with employee retention?

You don’t have to be a health insurance expert to know that healthcare coverage makes up a significant portion of businesses’ operating costs. Looking ahead to next year, Willis Tower Watson predicts the average annual per-employee cost for health insurance will increase 5.3% to $12,850 (up from $12,200 in 2017).

Understandably, employers are always looking for ways to get a firmer handle on rising healthcare costs and often turn to wellness programs as a possible solution.   

Three Important Federal Laws That Affect Wellness Plans

Before you launch a wellness program, it’s important to do your homework. Mistakes can be costly for both your employees and your bottom line. One area you should pay particularly close attention to is the intersection of wellness plans and federal law.

There are several comprehensive federal statutes that impact workplace wellness plans, so before you put your plan in place, make sure you consult with a legal expert who can help you stay on the right side of the law.

The term “work-life balance” has gotten quite a bit of buzz in recent years, thanks in part to the new priorities millennials are bringing to the workplace. This idea captures the desire to work and grow in a career, but also the desire to enjoy one’s life outside of work — with the goal of creating a meaningful sense of balance between the two.

However, it’s not just millennials who crave a healthy balance between their working lives and time spent outside the office.

The workforce is currently juggling three different generations (not including the bookend demographic groups of Generation Z and The Silent Generation) who view the working world in different ways. It’s important to define what “work-life balance” truly means to each of them, as it may change how employers can effectively motivate employees.

This afternoon the IRS officially announced the final 2020 election/contribution limits for Flexible Spending Accounts (FSAs), qualified Commuter Benefits, and several retirement savings vehicles. (See comparison tables, below.)

Considering that many employers have already held their employee benefits Open Enrollments for 2020, today’s announcements by the IRS can best be filed under the “better late than never” category.

These IRS statements finally set official contribution limits for Health Care FSAs, Dependent Care FSAs, Limited Purpose FSAs, Qualified Parking and Qualified Transportation Saving Plans, 401(k)s, 403(b)s, most 457 plans, IRAs, SIMPLE Plans, and the Federal Government’s Thrift Savings Plan.

All of these saving plans provide participants with the opportunity to save money, either by paying for qualified expenses with pre-tax savings contributions, or by saving for retirement with pretax elections. 

Like all business owners, you’re trying to navigate the murky waters of health insurance and other employee benefits. It’s time-consuming, frustrating, and ultimately not a subject you're well- versed in.

In an effort to help, someone recently suggested you use an employee benefits broker. You’re not even sure what they do and you don’t want to spend extra money on them. You've also heard of other options, such as PEOs, payroll vendors, HR software platforms and the SHOP exchange. How do you sort through all of these options and confidently make the right decision?

We're admittedly a little bias on the topic, but we highly recommend you start this process by simply talking to a benefits broker. If you don't know any (and even if you do), gather a few recommendations from your peers within other organizations. Just make sure you initiate your consultation with a trusted broker who is well regarded in the industry and your market. A broker with a solid reputation will help you quickly assess all of your options and will, in all likelihood, be completely upfront with you in the event they aren't your best option.

If requesting proposals from employee benefits brokers, it's important to inquire about specific capabilities of prospect organizations, most especially as they relate to your primary needs.  Download our free guide for 100+ sample questions and scoring template.

Once you decide to move forward with an employee benefits broker, they'll guide you through sound analytical and strategic reasoning for the benefit decisions you are making for your workforce.  Employee benefit brokers are far more affordable than you might think and good ones can be invaluable to a business, paying for themselves many times over in the savings they generate for you. Brokers are especially helpful to small businesses with skeleton HR departments but are equally as useful to well-staffed operations. 

With budgets stretched and attendance down, more and more employers seem to be doing away with face-to-face employee benefits open enrollment meetings. That's a shame, especially since healthcare coverage options are more complicated than ever before.

This drop in attendance and lack of interest in holding benefit information sessions is all the more surprising considering that healthcare literacy is still at alarming low rates. One would think that this knowledge gap would trigger anxieties which would motivate more of the workforce to attend these annual benefit presentations.

So what can employers do to help bridge this education divide? After all, if employees aren't educated on things such as HDHPs with HSAs, Limited Purpose FSAs, or even telemedicine, then how will they ever embrace these benefit options - all of which are becoming more and more popular with employers and employees alike.

Here are some employee engagement ideas you might want to try in an attempt to reengage and educate your workforce during open enrollment season;

1. Go Digital.

For better or worse, mobile devices are in our hands throughout the day. Take advantage of this and reach out to your employees through one (or several) streams.

• Send a text message telling employees that open enrollment is coming and reminding them to read their product literature and talk to their spouses so they’ll be ready to enroll.

• Ask them questions via email beforehand, as well as during the meeting. Try a Poll Everywhere, Kahoot, or Google Forms format to engage employees and encourage participation. These tools allow employees to answer questions anonymously while you tally responses. This is a great way to find out, in real time, which topics merit more attention, especially if employees demonstrate a lack of understanding about a particular benefit.

Autumn is here, the leaves are changing, and before you know it, a new year will start. For many employers, a rapidly approach new year means annual benefits open enrollment meetings.

But it seems like every year, it’s more difficult to get employees to attend the meetings, pay attention, and learn how they can make the most of their benefits.

All the while, the push to consumer-driven healthcare is making things more complicated. From HSAs and HDHPs to HRAs and Limited Purpose FSAs, how are employees supposed to take full advantage of the great benefits you offer if they don't take the time to learn about these new products and services? Perhaps it’s time to try something new to spice up your annual open enrollment and really engage your employees.

Here are four ideas to try to mix things up with your benefits open enrollment this year.

Companies across the U.S. are chasing a Monday deadline to provide the federal government with full disclosures of how they compensate workers of all genders, races and ethnicities. The data collection exercise, the largest and most detailed ever, is part of an effort by the government to close gaps in earnings.

Subject to the requirement are the more than 70,000 private U.S. companies with more than 100 workers. Collectively these companies employ more than 54 million American workers. These firms must submit their compensation information to the Equal Employment Opportunity Commission (EEOC) by September 30th.

This deadline comes almost two years after the rule, issued under the Obama administration, was originally scheduled to go into effect. In 2017 the Trump administration pumped the breaks on the rollout of the new rule, arguing that the collection and aggregation of such in-depth salary information was a burden on companies. (Advocacy groups sued the EEOC to get the pay-reporting requirement reinstated.)

EEOC officials say that this detailed compensation data, which will span virtually every industry and region of the county, will help them quickly ascertain which discrimination complaints deserve closer scrutiny, from the tens of thousands that are filed with the EEOC annually. (They received over 75,000 in 2018 alone.)

Many companies stick with their employee benefits broker for years on end, not giving too much thought to whether a change is warranted. HR directors always have long to-do lists full of time-sensitive issues, so finding a new broker is typically the last thing on their minds — except maybe during contract renewal season if the news isn’t good (and it never seems to be with health insurance these days).

The issue here is that there is a point when it’s time to fire your broker, but recognizing it when the time comes is difficult because you have a million things on your mind and far more pressing matters at hand.

However, there are some definite signs it’s time to find a new employee benefits broker and it’s important to keep an eye out for them. Here are some of the big ones.

Sex, politics, and religion. That was the list of topics I was taught when growing up to never discuss when we had guests over for dinner. Those were pretty much the ground rules Google set-out to establish last month when it issued new guidelines limiting employee discussion of politics in the workplace.

Google claimed their guidelines were intended to protect a “productive work environment” by corralling what has already become very heated water cooler talk in the run-up to the 2020 presidential election. Nevertheless, late last week the National Labor Relations Board ordered Google to stand down. In its ruling, it instructed Google to affirm employees’ rights to express their views, within the workplace environment, on political and workplace issues.

The settlement was born less out of Google’s issuance of new guidelines but rather as a result of recent complaints from conservative employees who claim they were fired due to their political views.

According to a recent New York Times article, accusations of political bias at major tech companies has become a powerful rallying cry among conservatives. This includes accusations by President Trump that engineers in Silicon Valley intentionally skewed the way their systems display content online to reflect liberal positions. For their part, major technology companies deny these accusations of bias.

To be fair, Google’s new guidelines didn’t forbid discussing politics at work, but they did require managers to address conversations that became disruptive. The updated guidelines were an attempt to dial back what has historically been the company’s wide open discourse. In addition to politics, Google also advised employees to avoid name-calling, including making blanket statements about groups or categories of people.

We are about to witness an important change in workforce demographics – one that has implications for virtually every company recruiting college-educated adults.

Women, you see, are about to become the majority of the college-educated workforce in this country. Back in 2007, women surpassed men as the majority of college-educated adults in the United States, but it’s taken 12 years for this change to reach the labor force.

Responding to this change, savvy companies are striving to become more attractive to female job candidates. Some of these new practices include the ways in which companies are redrafting job descriptions with more gender-neutral language, as well as changes companies are making to compensation and culture.

Changes to employee benefits programs are even more widespread, and include;

With the rising cost of health insurance, many consumers are opting for high deductible health plans (HDHPs) to keep their medical premiums affordable, especially when they’re relatively young, comparatively healthy, and don't spend much of their budget each year visiting a doctor. However, many people enrolled in qualified HDHPs are disappointed to learn they can no longer, by law, participate in a traditional flexible spending account (FSA). 

The nature of how these plans are designed leaves some wondering how they’ll cover all the expenses incurred prior to reaching their deductible, which has led to the rise of health savings accounts (HSAs) and limited purpose flexible spending accounts (LPFSAs).

Only those enrolled in qualified HDHPs are eligible to open an HSA and reap the tax benefits, but many are unaware that they’re also eligible to open a limited purpose FSA (providing their employer offers one), which frees up the money in their HSA for future use — even retirement. 

What Is a Limited Purpose FSA?

HSAs are usually a major selling point of HDHPs. They allow participants to set aside a portion of their income from each paycheck in order to pay for qualifying healthcare expenses. Limited purpose FSAs are like HSAs in that participants can contribute a specific amount from each paycheck. LPFSAs are like traditional FSAs in that they make funds available immediately, rather than forcing you to wait until enough money has accumulated to access the money you need for necessary vision and dental care (whereas HSAs require funds to be in the account before reimbursement can occur).  

Employees, customers, suppliers, and even community neighbors all moved in front of shareholders yesterday as the primary audiences publicly held companies should utmost serve in the future.

That’s according to a statement released by the Business Roundtable, a group of CEOs representing 200 corporations around the country. This new vision recasts the prime directive of corporations from first and foremost serving shareholders (e.g. maximizing profits) to serving these new audiences.

The new mission suggests that corporations should; invest in employees, deliver value to customers, deal ethically with suppliers, and support outside communities. “Shareholders ride the caboose in this new code of corporate purpose,” said a dissenting opinion piece in yesterday’s Wall Street Journal.

Jamie Dimon, chairman and CEO of J.P. Morgan Chase and chairman of Business Roundtable, said yesterday, “Major employers are investing in their workers and communities because they know it is the only way to be successful over the long term. These modernized principles reflect the business community’s unwavering commitment to continue to push for an economy that serves all Americans.”

New this year, per the U.S. Department of Labor, is the ability for employers nationwide to auto-enroll employees in disability insurance coverages for ERISA-covered plans.

The implications of this decision are far reaching and merit serious consideration by employers offering disability benefits, which are designed to prevent income disruption in the event of a qualifying disability. (As with other auto-enrollment options such as 401(k) contributions, employees retain the opportunity to opt-out if they choose not to take the coverage.)

For those employers who don’t yet offer disability coverage, we strongly encourage you to read our blog post from earlier this year on why disability insurance is one of the most valuable benefits you can offer.

The Gap Between Interest and Action

At present, one in four 20-year-olds in the workforce can expect to be out of work for at least a year before they reach retirement, due to a disabling condition - that’s according to probability tables developed by the Social Security Administration.

The IRS has added care for a range of chronic conditions to the list of preventive care benefits that can be provided by a High Deductible Health Plan (HDHP) without a deductible.

This expansion of preventive care services is in response to an executive order signed on June 27 by President Trump. The order, designed to improve price and quality transparency in health care, directed the Treasury Department and IRS to improve the attractability of HSA-compatible HDHPs which cover low-cost preventive care, before the deductible.

The IRS issued Notice 2019-45 in response to this executive order. With this order now in place, it now classifies certain medical care services and items, including prescription drugs for chronic conditions, as preventive care for individuals with certain chronic conditions. 

Employers with HDHPs should review their plan documents and consult with their benefits broker, carriers and benefit administrators to determine how their plans might cover these new preventive care benefits on a go-forward basis. 

Employers looking to decrease their healthcare costs often rely on workforce adoption of High Deductible Health Plans (HDHPs), which offer both employers and employees lower premiums. Unfortunately, this strategy doesn’t always work out if enrollment in HDHPs (assuming employees are given a choice) fall short of forecasts.

Rightly or wrongly, HDHPs have been saddled with some baggage. Many people have difficulty making the cognitive leap from traditional healthcare plans to HDHPs for a variety of reasons; in part because change is generally difficult for people, but sometimes, it’s simply a fear of the unknown and a matter of not understanding how they work.

While we certainly aren’t advocating that HDHPs are suitable for everyone, they’re a great fit for some — especially those who are otherwise overpaying for health insurance, meaning that they’re paying high premiums, but rarely using their plans.

Here are some common pitfalls to avoid when designing and marketing a high deductible health plan and suggestions on how to avoid them.

Many employees feel like they have to check-in with work even when they’re supposed to be enjoying paid time off. More often than not, this is a cultural issue within a company.

Supervisors might be checking-in and sending emails in the evening or on weekends. This leads their direct reports to believe they need to respond immediately, and they may even start adopting these behaviors themselves. 

Yet, research has shown time and time again that workers need frequent breaks and unfortunately, Americans leave a lot of that paid time off on the table every year. It might seem like workers would be more productive if they aren’t using all their vacation time, but in reality, skipping our vacations actually makes us less productive. To keep employees operating in top shape, we need to encourage them to enjoy their downtime — and perhaps it’s fitting to begin with the July 4th holiday. Here are 5 ways to encourage employees to enjoy their independence...and their paid time off this weekend.

Maintaining a competitive edge often comes down to retaining a talented workforce. The growing popularity of so-called “portable” employee benefits, such as Health Savings Accounts (HSAs), certainly hasn't made this any easier. Employers trying to entice workers to remain loyal may want to focus their efforts on providing benefits which are simply too good to surrender. Offering benefits that accrue significant value over time, or improve with tenure, will help keep employees from abandoning that progress for greener pastures, lest they have to start over someplace else.

How the ACA Impacted Employee Retention

Prior to the passage and implementation of the Affordable Care Act (ACA) there was considerably less job mobility for many Americans with pre-existing health conditions. The moment insurance carriers were barred from discriminating based on pre-existing conditions, the need for individuals to stay with a company for insurance reasons essentially vanished. Many employees who were previously stuck in their jobs for fear of losing benefits were now free to explore other opportunities.

Similarly, many budding entrepreneurs set off to start their own businesses while acquiring individual health insurance via the ObamaCare exchange or through other means. One could argue that this new freedom was a benefit to both employers and employees — after all, who really wants an employee who is sticking around just because of benefits? Nevertheless, this new found “employee mobility” has made the search for "sticky" benefits all the more important.

There are countless online employee benefits enrollment systems out there today. While each is designed to make our lives easier (employees, employers, insurance carriers, payroll providers and benefits advisors), some don't quite live up to the hype.

While the initial transition from paper enrollment to any one of these online enrollment systems typically yields tremendous upside from an efficiency, speed and data integrity perspective, it's highly unusual for an enrollment system to be fully optimized for peak performance at first launch.

Tweaking and perfecting the system in the quest to maximize performance and outcomes should be an ongoing activity within your organization. Most agree that the goal of optimizing these systems is to make them as easy and intuitive as possible for your employees to use, while also guiding educated, informed and appropriate employee benefit decisions for your workforce.

Much of what’s considered “best practice” in online benefits enrollment has been adopted from best practices in eCommerce. After all, enrolling in benefits these days isn't that far off from purchasing something off Amazon, comparing cars at AutoTrader, or configuring a laptop at Dell.

While this list is by no means complete, here are some best practices you should consider adopting to optimize the configuration of your online benefits enrollment system for peak performance.

Paid time off is one of the most commonly provided benefits as well as one of the most highly regarded.

The Bureau of Labor and Statistics reports that more than 70 percent of employees have at least one form of paid time off, and the rate is much higher among certain types of employers such as large private companies and local, state and federal government entities.

In fact, in a Glassdoor survey, vacation and paid time off proved to be more important for employees than pay raises. Yet despite the desire for it, the United States remains far behind much of the world in both providing and using this benefit.

Even though there’s been a recent uptick in the number of days U.S. employees are taking off annually, they still take very few days off -- and that’s not good for anyone.

The following is an exploration of why paid time off is important to offer and why it's important to take, along with what’s normal in the U.S. and throughout the world. 

HR professionals know the value of staying connected and informed better than almost anyone else in the workplace.

Often asked to stretch resources and "make do" with limited budgets, HR professionals have learned to survive by being resourceful and self-sufficient.

Life-long learners at heart, those who work in the field of human resources often tap into the wide range of information resources now available at their fingertips, thanks to the internet. 

As follow-up to a blog post we published last year, "Best Twitter Hashtags for HR Directors to Follow", here are some of our favorite resources beyond Twitter, spanning associations, books, podcasts and blogs.

All across the country, a sweeping movement to combat surprise medical bills has been slowly percolating and is now finally gaining traction on a national level.

What began as grievances filed by wronged patients has grown into government officials at both the state and federal level championing legislation against this industry practice.

A law that recently went into effect in Arizona and recent remarks from President Trump are merely the latest in an ongoing trend that has the force to reshape how patients are billed for out-of-network expenses.

Unexpected Out-of-Network Charges Result in Surprise Medical Bills

Surprise medical billing isn’t so much an intentional practice of healthcare companies, as much as it’s a byproduct of the fractured healthcare industry. Specifically, it’s a result of multiple institutions and providers treating patients simultaneously while working for different employers.

In its simplest form, a surprise medical bill is an unexpected medical bill that patients receive for out-of-network services that they thought were in-network. The bill is sent after the services are provided, leaving patients with little recourse and high fees since out-of-network charges tend to be much higher than those in-network.

An all too common scenario shows how easy this can happen to patients. A patient goes to a hospital for a covered surgical procedure. They’ve done their research and have made sure that both the hospital and the surgeon’s practice are within their insurer’s network. In completing this due diligence, they then assume that the entire procedure will be covered as an in-network expense. Seems reasonable, right?

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.

Cultivating a truly competitive employee benefits package can sometimes seem like an insurmountable task. Most employers work in earnest to put in place the very best benefits they can afford, without compromising coverage. This is especially true when it comes to the medical portion of their program.

Telemedicine, rapidly growing in popularity, is an excellent way to supplement a medical plan without driving up costs - but it does have some drawbacks as well. So what exactly is telemedicine, and is it a good fit for your company? 

The verdict is in – employer adoption of high-deductible health plans (HDHPs) as the sole medical option for employees is beginning to fade.

Brought on, in part, by the need to offer richer medical benefits in the face of a tightening labor market, a recent survey by the National Business Group on Health (NBGH) indicates that 23% of large employers who currently offer an HDHP as the sole medical option for employees are planning to introduce other medical options this year. 

This represents a drop from 39 percent to 30 percent of large employers who only offer an HDHP to their workforce. Similar surveys by the Kaiser Family Foundation (KFF) and Mercer support these findings. 

The intense competition for talent (who may be seeking richer plans) is only one reason for the decline in popularity of HDHPs as an employer’s sole medical plan option. Also contributing to this waning interest has been the ongoing postponement of the Affordable Care Act’s “Cadillac tax” on higher-value plans, which was initially a driving force for HDHP adoption by employers. 

The threat of the tax has abated to the point where it seems dubious if the tax will ever come to fruition. (The 40 percent tax on high-value health plans was originally set to take effect in 2018 but was then postponed to 2020 and then again to 2022.)

In an effort to mitigate rising health insurance premiums and increase overall efficiency within the healthcare industry, an increasing number of insurers and employers are integrating value-based insurance design into their group health plans. 

For everyone involved -- including insurers, providers, employers and employees -- insurance plans integrating value-based design help to spotlight and migrate healthcare to services that have been proven to yield better results vs. those which are less effective.

Value-Based Insurance Design Recognizes Value

Value-based insurance design recognizes that not all healthcare services provide patients with the same level of value. Simply put, some health services are more effective than others.

These insurance plans seek to encourage employees to use services that have proven to be more effective and beneficial. Decisions on which services to encourage aren’t made on conjecture, but rather are based on research that shows which services have the best positive impact on patient health given the resources invested. In most cases, encouragement is created in the form of financial incentive (e.g. lower copays).

Some of the highest value services are outpatient treatments offered at clinics, and most value-based designs focus on promoting clinical services. There is a particular surgical example, however, that illustrates how these plan designs work.

Smoking has been in steady decline in the United States for decades, with Gallup reporting that smoking rates among adults have dropped from 45 percent in 1953 to 16 percent in 2018.

Nevertheless, according to the CDC,  almost 38 million adults in the country still smoke cigarettes regularly (defined as “every day” or “some days”). This doesn’t even take into account anyone who enjoys pipe tobacco, cigars or other cigarette alternatives.

The malignant effects of these habits are well documented. In addition to the personal health issues individuals suffer, smoking also impacts non-smokers, both in terms of health risks and more expensive healthcare.

The following is an exploration into just how much smoking costs businesses each year and what measures employers can take to reduce smoking rates among their employees.

The Added Cost of Employing Smokers

CDC research places the increased cost of employing a smoking adult at nearly $6,000 per smoking employee, per year. Much of this figure comes from lost productivity and increased healthcare costs, but it also takes into account other less obvious expenses.

From Uber and Lyft to TaskRabbit and Fiverr, the gig economy is now firmly established as a fixture of today’s workplace. 

Gallup surveys show that about 36 percent of U.S. workers have some sort of gig, and 29 percent rely on an "alternative work arrangement" (as it's sometimes called) as their primary source of income.

With such a strong presence in the labor market, the gig economy is altering the shape of employment. The numbers from Gallup are lower than some respected economists originally reported (and lower than some less established source’s statistics), but they still show that the gig economy is here to stay. Few aspects of employment will remain unaltered by it, and employee benefits certainly isn’t immune to its impacts.

In fact, multiple issues related to employee benefits in the gig economy have already been raised. Moving forward, both government agencies and businesses will need to rethink employee benefits programs so that they adequately compensate independent contractors, online platform workers, contract firm workers, on-call workers, temporary workers and others with alternative work arrangements.

Here’s what’s being done for both the distant and near future.

An increasing number of married employees are obtaining health insurance coverage through their own plans rather than their working spouses’.

Regardless of whether this reflects sound economic strategy (depending on employer contributions), personal preference, or is the result of spousal carve-outs instituted by employers as a cost-mitigation strategy, having two working spouses each go on their own individual high-deductible health plans (HDHP) increases the chance of overfunding health savings accounts (HSAs). This is not unlike the situation some married couples find themselves in when they accidentally overfund their Dependent Care FSA by each accidentally maxing out their contributions through their individual employers.

HSA Contribution Limits for 2019

Unlike last year when the IRS adjusted HSA contribution limits multiple times during the year, the 2019 HSA contribution limits are set and fairly straightforward. They are as follows:

• $3,500 self-only contribution limit
• $7,000 family contribution limit
• $1,000 catch-up limit for people age 55 and over

These represent a $50 increase for individuals and a $100 increase for families compared to last year’s numbers. The catch-up limit has remained unchanged. (All of these figures include both employer and employee contributions.)

When just one person is contributing to an HSA, these limits are easy to apply. A bank representative can explain the account to them and help them make contributions that don't exceed the applicable limit.

In situations that involve two spouses, however, staying within the contribution limit becomes a little more involved. 

It’s considered conventional wisdom that the fiercest competitors can be found in the world of professional sports. After almost 30 years working in employee benefits, I beg to differ.

Greatly exacerbated by today’s low unemployment rate, the competition for talent in the business world today is as fierce as I’ve ever seen it, most especially in the fields of construction, dining, cybersecurity, nursing, and finance, just to name a few. Bryce Harper and Tom Brady have nothing on today’s business professionals in charge of talent acquisition.

As if competing for customers wasn’t enough, companies often compete against each other for the same pool of talent, whether that be within specialized industries or simply within an overlapping geographic region.

In the quest to attract the best talent, employee benefits benchmarking is crucial. This practice allows employers to gauge their organization's position in terms of benefits versus the competition. Some companies regularly conduct benchmarking as part of a strategy of good governance, while others perform benchmarking in response to something specific, such as an acquisition, the need to fill a specific role, or the launch of a new division.

Introducing Our New Partnership & Benchmarking Study

This year the JP Griffin Group joined with United Benefits Advisors to produce the nation’s largest independent health plan benchmarking survey. In doing so, we’ve created the most comprehensive source of reliable benchmarking data for employers of all sizes.

The popularity of self-funded group healthcare plans continues to rise. Already immensely popular with large employers, small businesses continue to embrace self-funding as a remarkably effective way to manage costs, navigate changing regulations, and expand medical plan options.

The genesis of self-funding’s popularity amongst smaller employers can be traced back to the Affordable Care Act. When the ACA was enacted back in March of 2010, its requirements prompted many small to mid-size companies to re-examine how they were offering - and funding - employee benefits.

Self-funding used to be considered an alternative funding method that was ONLY feasible for large companies who could take on greater risks and handle cash flow fluctuations in exchange for upside savings potential. Self-funding, after all, is a mechanism by which companies are essentially insuring themselves.

With the advent of the ACA, the benefits of self-funding expanded beyond just those of potential financial upside. The benefits of the transition are now far more reaching, and now benefit employers and employees alike.

Because of this, small and mid-size employers have been taking the plunge into self-funded group medical plans in large numbers. And as the industry has continued to evolve, self-funding among small groups has become quite common.

Here’s why:

There are three key FSA-related terms that every company which offers flexible spending accounts to their employees should review around this time of year.

While human resources professionals likely are well-aware of what FSA rollovers, grace periods and run-out periods are, employees frequently don’t know the difference between these (and sometimes don’t know they exist at all).

Rollovers: Letting Employees Use Some Previous Funds This Year

Rollovers are an optional feature that the IRS made available starting in plan year 2013 (plan year 2014 for plans with grace periods). Despite being strictly an optional feature that employers can elect or not elect to offer, rollovers have been widely adopted since they were first made available. Only 8 percent of employers who had FSA plans offered the option early on, but by 2015 it was adopted by 60 percent of employers with plans.

Last week, President Donald Trump delivered the 2019 State of the Union Address (SOTU). The SOTU is an annual message delivered by the president to a joint session of Congress at the beginning of each year.

At this year’s SOTU, President Trump discussed issues that have the potential to impact the employee benefits industry, as well as employers offering healthcare and benefits to their employees. The issues he discussed included pre-existing conditions, lower prescription drug prices, and nationwide paid family leave.

While the SOTU is just a speech, often times packed with lofty aspirations, it does sometimes lead to policy. Here is a recap of what was addressed:

Pre-existing Condition Protection

In a departure from 2018 Department of Justice actions, President Trump announced in the address that people who have pre-existing conditions should receive protections. If the administration holds true to this goal, they will likely find cross-aisle support, as pre-existing condition patient protection was a key campaign issue in the midterm elections.

At the start of this calendar year, Arizona became the latest state to adopt a mini-COBRA law, which impacts small employers. The new law specifically applies to employer-sponsored medical plans issued or renewed on or after January 1, 2019. (Employers with plans that were issued or renewed prior to this date have a little more time to comply with the law.)

The law requires small employers – those that offer group health plans, including medical, dental and vision - to offer continuation coverage to eligible employees and qualified dependents who experience Qualifying Events that would typically result in a loss of coverage.

These events include such things as loss of employment (for reasons other than gross misconduct), divorce or separation from the covered employee, or death of the covered employee.

Employers impacted by this new legislation are those that have fewer than 20 employees for more than fifty percent of its typical business days during the prior calendar year.

Although the new mini-COBRA continuation coverage requirements are very similar to the Federal COBRA requirements that apply to larger employers, there are some key differences. We invite you to download our side-by-side comparison of COBRA and Arizona’s Mini-COBRA of how these requirements compare with one another.

Staff of private sector employers – those who have immediate family members affected by the government shutdown - are asking employee benefit questions of their employers which are entirely new to them.

Chief among them is the question of if the government furlough is considered a Qualifying Life Event (QLE) for any affected government employee. A QLE would allow the impacted individual to move over to their family’s private sector, or unaffected public sector health plan if the worker is otherwise eligible. This event would also trigger a Special Enrollment Opportunity.

According to benefits compliance experts ThinkHR, employees who choose to quit their jobs during this tumultuous period do, in fact, create a QLE. This would simply be considered a “change in employment status”, which includes:

• Quitting a job or being laid off
• Being hired (keeping in mind waiting periods, if applicable)
• Gaining or losing benefits by moving from part-time to full time employment status (or vice versa)

What’s less clear is if a furloughed employee who doesn’t intend to quit their job can jump to their family member’s health coverage, either permanently, or for a shorter period of time.

While dental and vision care are typically the second and third most popular employee benefits after health insurance, employers should look long and hard at short term disability and long term disability insurance as "must haves" in their benefits portfolio.

Why? Well, when someone in the organization misses a considerable amount of work due to an injury or illness, there isn't a business owner we've met who doesn't then struggle with the incredibly difficult decision of how best to resolve the issue. 

Not only is the impacted employee struggling with a loss of income, but the employer is also struggling with compensation decisions regarding this individual during their absence, not to mention compensation investments that might have to be made to fill the position left open in this person's absence. 

Everyone is spared these difficult decisions if disability insurance is in place. That's because disability insurance protects your employees from a disruption in income in the event of an injury or accident. (This should not be confused with Workman's Compensation. While they are similar, the main difference is that Workman's Compensation only covers employees for illnesses or injuries which are work-related.)

So let's examine the trends in long term and short term disability insurance and discuss tactics to improve employee participation. 

Employee Benefit Perks That Make The Holidays Merry