Employee Benefits Blog

Author's note: This post is not intended to defend nor criticize the merits of the Affordable Care Act (a political lightening rod if ever there was one). Rather, this post is merely intended to dispel a few myths as it relates to the ACA's spill-over impact on the group insurance market. 

While its effects on the individual insurance market can be debated (though most agree the ACA did very little to contain healthcare costs but did a terrific job of making healthcare more accessible), it’s a common misconception that the Affordable Care Act (also known as the ACA, or Obamacare) is causing group health insurance rates to dramatically increase. This myth, along with others that play into it, have been perpetuated frequently since the law’s passage in 2010 — especially since the individual and small business health insurance marketplaces opened in 2014.

The truth is health insurance rates were increasing long before Barack Obama ever got close to the White House. According to data from the Kaiser Family Foundation, the average cost of premiums for individual coverage increased about 32.5 percent between 2010 and 2017. But compared to the 8-year period prior (when premiums increased about 56 percent) that amount seems low. For family coverage, the numbers are even worse, showing a 36 percent increase since 2010, compared to 67 percent in the 8 years prior. 

In addition, it would appear the ACA is actually helping to slow our national health expenditures (NHE) as a percentage of GDP. The Centers for Medicare and Medicaid Services (CMS) has been tracking this data since 1960. CMS defines NHE as “health care goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care.” In other words, NHE is what we collectively spend on healthcare each year between health insurance rates, out-of-pocket expenses, and any health programs we take part in.

Between 2010 and 2016 (the latest year for which data is available), NHE increased from 17.4 percent to 17.9 — a mere half a percent (although one could also argue this could be due in part to effects of the recession). By contrast, in the 7-year period beforehand, NHE increased nearly two percent, going from 15.4 percent of GDP to 17.3. 

In order to figure out how we could actually fix this system, we have to understand the differences between what’s really broken about it and the myths out there. Here are three myths we can easily bust.

Recent news that the rising cost of healthcare in America may actually be slowing is being met with resounding elation by those looking for ways to save money on their medical insurance. For those with high deductible health plans (HDHPs) and other forms of consumer-driven healthcare, this comes as especially welcome news.

If sustained, this tempering of rising medical care costs will hopefully begin to curb an alarming trend, that being dangerous cost-avoidance practices by some covered individuals, which sometimes includes such dangerous practices as skipping medications and postponing necessary medical procedures. (Many have also skipped out on preventative care, despite the fact that most all of it is covered at 100%.)  While in the short-term such actions will indeed bring down healthcare expenses, they are likely to trigger larger problems later on, which cost far more money.

There are much safer and more effective ways to curb healthcare expenses, but it takes a bit of effort and education to capitalize on them. Here are just a few we’ve found. Please feel free to use these money saving strategies with your workforce — and better yet — try them out yourself.

For many who work in human resources and employee benefits, open enrollment can be a stressful time of year. Focused on meeting tight deadlines and pleasing multiple stakeholders, many HR professionals often repeat sins of the past and fail to make annual, incremental improvements in their open enrollment processes.

Optimizing your open enrollment is critical to ensuring its ongoing success. After all, over time you learn more about how best to communicate with your organization, particularly as the employee benefits space evolves i.e. new benefit products and services, and new technologies.

In the spirit of continuous improvement, whether you're working off of a well-established checklist or with your employee benefits broker, be sure to avoid these common pitfalls during your next open enrollment.  

1. Ending Open Enrollment Outside of Normal Office Hours

Procrastinating employees will inevitably have last minute questions and may experience technology troubles. Make sure your deadline for open enrollment falls during the workweek and during normal office hours when your HR staff is still on duty to help them through those final steps in the process.

2. Ignoring Other Household Decision Makers

Often times your employee is not the only one weighing-in on benefit decisions. Make sure the communication materials and media channels you're using reach other heads of household and key decision makers such as spouses. Consider extending invitations to open enrollment meetings to the entire family.

It’s certainly up for debate whether or not an RFP (Request for Proposal) is really the best method of finding a new employee benefits broker for your business. Nevertheless, if you’re planning on issuing an RFP for a new employee benefits advisor, it’s important to do it right. 

After all, a relationship between you and your employee benefits broker can span 10 years or more. Shouldn’t you strive for the best partnership imaginable? The RFP process is a time-consuming one, but when it’s done well, it creates a fruitful relationship with a trusted and highly valued business partner for years (and hopefully decades) to come.

Here’s a complete guide to issuing an RFP for employee benefits — and don’t forget to download our RFP template for additional help with getting started!

Writing an Employee Benefits RFP

First Things First: What is an RFP?

A request for proposal is “a type of bidding solicitation in which a company or organization announces that funding is available for a particular project or program, and companies can place bids for the project's completion.” In the case of employee benefits, a company is saying that they’re interested in hiring an employee benefits broker and that they’re open to new advisors.

In a way, an RFP is a little bit like a job description, stating exactly what the issuing company needs, from resources to reporting to cost-saving initiatives, and will ultimately help them codify the evaluation criteria on which the vendors’ proposals will be assessed. Essentially, the RFP should ensure all parties are on the same page in terms of requirements.

Additionally, RFPs should include background on the issuing organization, such as its lines of business, needs and expectations, as well as a set of specifications that describe the ideal solution.

Why an RFP?

It’s important to ask yourself why you’re issuing an RFP in the first place. Do you have performance issues with your current employee benefits broker? Is it a required diligence obligation? Are you simply canvassing the marketplace to see if there are better options available than your current benefits broker? Or are you looking to hire an employee benefits advisor for the first time?

Today’s workforce spans four different generations and reaching all of them can be a challenge. Employers can no longer solely rely on traditional employee benefits communication materials like email, printed brochures, break room posters, table tents, and payroll stuffers. While those may be effective with certain members of your workforce, younger employees are far more difficult to reach through these traditional forms of communication.

Rather, savvy employers are embracing today’s social media platforms to reach their most elusive workers — millennials and generation Z. Social media was created by millennials and gen Z are digital natives who aren’t likely to remember a time before computers. They spend quite a bit of time online, making social media one of the best avenues to connect with them in a contemporary, timely, and non-intrusive way.

Keep reading to find suggestions on how to integrate social media in your employee benefits communications, and download our free guide on this topic here.

Best-in-class employee benefits evolve with the times and our changing values. We saw marriage equality granted to all people in this country after Obergefell v. Hodges, opening employee benefits to many additional spouses and families. Now, we’re seeing more and more employers (including Fortune 100 and 500 companies) embrace transgender-inclusive health insurance plans as gender identity awareness improves. However, medical professionals have been stressing the importance of transgender health for years.

In 2008, the American Medical Association (AMA) first voiced its concerns for the discrimination of transgender individuals when it published a guidance supporting “public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient's physician.” (This policy was updated in 2016).

In order to truly be an equal opportunity employer, you should have at least one transgender-inclusive health insurance plan in your employee benefits package. It’s not as complicated or expensive as it may sound. In fact, right here in our home state of Arizona, there are quite a few employers already offering such benefits.

Here are some practical issues you should consider when expanding your employee benefits to make sure they include transgender employees and how doing so could help you recruit and retain the workforce of the future — namely, millennials and generation Z, who see inclusivity as an important attribute of prospective employers.

Employers oftentimes worry about how to tailor employee communication for those who are digitally disconnected — meaning they don’t have access to email or the internet — but this concern is largely blown out of proportion.

According to Pew Research, only 11 percent of Americans aren’t using the internet. Research also suggests that “non-adoption [of the internet] is correlated to a number of demographic variables, including age, educational attainment, household income and community type.”

As the numbers suggest, internet adoption is picking up steam, leaving fewer and fewer people disconnected every day — especially among older Americans and those with less education. The research center points out that 86 percent of senior citizens didn’t use the internet in the year 2000, but that the current data shows a dramatic increase in older adults’ online activity (only 34 percent don’t use the internet now). Among those who didn’t finish high school, non-adopters dropped a similar amount during the same time period, going from 81 percent to 35 percent.

Regardless, it’s wise for employers who want to ensure no one in the workforce is overlooked to deploy both digital and more traditional methods of employee communication. In addition, because digital access spans multiple device types (computers, smartphones, tablets) and various ways to attain connectivity (home internet, public internet, cellular data), it’s important to take the following into account when connecting to these audiences:

Employee Communication for the Connection-Challenged

Some employees may be connected, but face some challenges in doing so. They aren’t totally cut off from the internet because they have library access or use the web browser on their smartphone, but they’re not particularly internet-savvy either. Here are some suggestions for making sure these employees can read the communications you’re sending:

There are countless online employee benefits enrollment systems out there today. While each is designed to make everyone’s lives easier — employees, employers, insurance carriers, payroll providers and benefits advisors alike, 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.

Capitalize on Nudge Theory 

While "nudge theory" won Richard Thaler a Nobel prize in economics, the concept is quite simple. It’s a subtle policy shift that encourages people to make decisions that are in their broad self-interest.

Put into practice, it simply means using "opt-out" as the default option for certain benefit selections. This requires someone to actively deselect an option. Failure to do so results in auto-enrollment in that benefit. A great example of nudging is pre-selecting a 3% contribution into an employee's 401(k) vs. leaving the field blank. This simple change will have a massive impact on 401(k) participation.

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 employees 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.