Employee Benefits Blog

When working on cost containment solutions, many employers completely overlook a critical component that could secretly be costing them tens of thousands of dollars: medication adherence. Medication nonadherence is associated with a higher rate of hospitalization (and at a higher cost) than those compliant with their medication regimen.

It seems simple enough — people are prescribed medications and they take the necessary doses, right? Well no, not necessarily. Medication adherence is a complicated topic with multiple, unrelated causes that are difficult to pinpoint and treat. And unfortunately, this problem doesn’t actually have a simple solution. But nonetheless, it’s important for employers to understand what it is so they know how they can help — and how it affects their budgets.

What Is Medication Adherence?

Simply put, medication adherence is when patients properly follow directions for taking medications as written by a doctor or pharmaceutical company on the label. For example, many over the counter pain medications allow for one or two pills to be taken every four to six hours, but never more than so many in a 24-hour period. Some asthma medications require once daily doses, while others require two (morning and night), and others require four (two in the morning and two at night). In addition, many blood pressure and cholesterol medications are taken once daily.

Some medication requires a change in diet (such as avoiding certain foods, like grapefruit, which can counteract the drug) or have strict instructions on how to take the medicine, like not eating for a certain period of time after consumption. Many times, these food restrictions have to do with a body’s inability to absorb the medication or vitamins if certain foods are present in the patient’s system.

According to the Centers for Disease Control (CDC) there are three different forms of medication nonadherence:

In the November 2016 general election, Arizona voters passed Proposition 206, which instituted an incremental increase in the state’s minimum wage, as well as mandated paid sick leave for all employees — not just full-time, but part-time, temporary, and seasonal workers as well. All HR professionals and business owners should be apprised to the changes this law will bring and what it means for themselves and their employees.

To assist with complying with the new law, we're providing you with sample paid sick leave policies, not only for employers with over 15 employees, but also for employers with under 15 employees. Feel fee to use these new sample policies in posters, updated employee handbooks, and wherever else you post your HR policies. Of course as always, you should consult with your legal council and benefits advisor to ensure accuracy and applicability to your business,*

Here's a recap of the new law.

Determined to pass health care legislation before the July 4th break, the Senate on Thursday night released a draft ACA replacement bill called the Better Care Reconciliation Act (BCRA). As of this morning, at least five Republican Senators have said they won’t vote for the bill. GOP Senate leaders can only afford to lose two members of their 52-senator caucus in order for the bill to pass. (The loss of two would require Vice President Pence to cast the tie breaking vote, assuming not a single Democrat supports the bill.)

While passage as the bill stands now seems dubious, Republicans and the White House see this as one of the last chances they have to pass healthcare legislation before they can move on to tax reform, so amendments are likely to win back some of these Senators. That process, however, could push the vote to after the July 4 break. Still, Majority Leader Mitch McConnell is a seasoned politician, and many pundits doubt he’d call for a vote before the recess if he didn’t have a few aces up his sleeve.

Let's look at several elements of the bill which are particularly pertinent to employers:

President Trump promised to repeal ObamaCare on “day one”. While it’s going to take a little longer than he had planned, it does look inevitable that an overhaul to the Affordable Care Act (ACA) will eventually pass both houses of Congress, even despite recent legislative setbacks.

One of the least popular provisions of the law, at least for employers, is the “employer mandate”, which requires certain employers with 50 or more “full-time equivalent” employees (FTEs) to provide an affordable healthcare plan. With the proposed law as it stands today, now in jeopardy, a pressing question is now looming over employers: if the employer mandate really is repealed, should they drop their health coverage?

The issue certainly isn’t cut and dry, with some believing that no matter what happens in Washington, employer-sponsored healthcare is dying and others predicting it will never really go away. Assuming the ACA’s employer mandate is repealed, every company will have an important decision to make, weighing the benefits and pitfalls of dropping coverage.

Repealing the Employer Mandate

Republican lawmakers have spoken on countless occasions about wanting to repeal the employer mandate. The Trump administration even ran on a platform of getting rid of it. In theory, this doesn’t seem like a big deal, but in practice, it’s more difficult than it seems. The employer mandate, after all, is the primary mechanism by which healthier people are brought into the overall risk pool, which is the only way a healthy insurance market works (healthy people subsidize the unhealthy, essentially). Without it, most experts predict that insurers would pull out of the healthcare exchanges and the entire program will collapse.

Some companies regrettably try to "go it alone" when it comes to crafting healthcare and employee benefits programs for their workforce. Perhaps because of a previous broker relationship which they feel didn't bear much fruit, some companies discount the impact a talented employee benefits broker can have on their business. Others fear that the services of a broker will be too expensive, or that it will be difficult to find one they can trust. Despite these objections, most HR professionals will concede that any decent employee benefits adviser knows far more about healthcare and the field of employee benefits than they ever could.

It's true that some employee benefits brokers are essentially "order takers" — simply taking instruction from employers who think they know best and/or are looking to get their benefit selections done as quickly as possible. The really good ones, however, will help companies approach their benefits programs in a highly strategic fashion, thereby driving impactful investment decisions while at the same time identifying critical savings opportunities.

Developing this symbiotic relationship with your benefits broker is a two-way street; these consultants and advisors can’t do all the work alone. To maximize impact, they need your assistance and cooperation. In that regard, here are a few things you can do to ensure you’re getting the best work out of your employee benefits broker — not just during open enrollment, but all year round.

Since the inauguration of a new president in January, healthcare legislation to replace the Affordable Care Act (ACA) has been a hot topic of conversation, not only among employers and healthcare providers, but many American citizens as well. Multiple rumors have been making their way down from Capitol Hill, but it appears as though we finally have some concrete ideas from House Republicans — even if they aren’t fully fleshed out in terms of finances. 

Regardless of what healthcare legislation is passed, it is largely expected that the employer mandate will be repealed, which will have some sort of effect on many American employers. Let’s take a look at the proposed healthcare legislation and other documents from the Department of Health and Human Services (HHS) to determine what employers might be able to expect from lawmakers in the coming months.

The New GOP Healthcare Bill

On Monday, March 6, 2017, House Republicans released what is being collectively referred to as the American Health Care Act (AHCA), which is intended to partially repeal, but also replace the ACA. As anyone might expect in a heated political climate, the proposed healthcare legislation has been met with mixed reviews.

The proposed bill would keep some of the popular components of the ACA, such as the provisions that prohibit insurance companies from denying coverage based on pre-existing conditions or capping the amount of benefits received in one year (or a lifetime). In addition, people would be allowed to remain on their parents’ health insurance plans up to age 26.

While pre-existing conditions would no longer be a reason insurance companies could deny coverage, they would be allowed to charge up to 30 percent more for enrollees who let their coverage lapse. Coverage lapses are common among those suffering from chronic illnesses or serious medical conditions because they are likely to miss work for an extended period of time. Since the Family Medical Leave Act (FMLA) only protects workers for 12 weeks, those receiving extensive treatments (such as chemotherapy) are some of the most commonly affected by lapses.

Creating a truly competitive and compelling employee benefits package can be a struggle — especially for smaller companies. As an employer, you are required to offer certain benefits, like social security taxes, unemployment insurance, and worker’s compensation, plus some others based upon the size of your company, not the least of which is medical insurance per the ACA's "employer mandate".

Providing employee benefits can get expensive fast, but you can only do what you can afford to do. The goal is to remain competitive in the marketplace, not to become a total outlier. And remember, cost-sharing with employees is normal these days and employees expect to pay a portion of insurance costs.

In addition, there are plenty of low cost (and even no cost) benefit options at your disposal to help sweeten the deal. But where to start? Here is a list of typical benefits packages offered by American businesses.

List of Common Employee Benefits

1. Health Insurance Benefits

This one is a no-brainer. Applicants view medical coverage as one of the most important factors in an employee benefits package and as a result, the majority of employers offer it. According to the Bureau of Labor Statistics (BLS), 70 percent of civilian companies (and 67 percent of private firms) offered medical insurance to employees in March of 2016 in their company benefits packages.

Health insurance is the #1 employee benefit. According to the US Department of Labor, health insurance makes up the largest share of non-cash benefits received by private industry workers. Fast Company lists health insurance as #1 on its list of "Top 5 Employee Benefits".

Adding value through an employee health plan might just be the competitive edge your company needs to attract and retain top talent. A benefits broker who understands your company, industry, workforce demographics, AND geographic region can help do just that.

Here's how:

Healthcare: A Love/Hate Relationship

While healthcare is indeed a critical benefit, it's also a critical area of concern. A recent survey from Reuters found that healthcare is the top concern in the upcoming election, with 62 percent from both parties saying they want to know what their candidate plans to do about rising healthcare costs.

Americans are concerned about the future of their health care system—and for good reason. It's projected that we will spend 4.5 trillion dollars on health care in 2019 and five trillion by 2022.

According to a recent study from the Society for Human Resource Management, 79 percent of employers that provide health insurance are "very concerned" about rising health care costs. HR professionals know health care concerns go well beyond the effects on the organization's bottom line. Health care benefits play a critical role in recruitment, retention, employee morale, and productivity.

SCOTUS Gay Marriage Decision: How Will It Impact Employee Benefits?  

How will the recent Supreme Court ruling legalizing same-sex marriage affect employee benefits? The short answer is that it will streamline the administration of benefits packages, but may complicate things in the near term as employers adapt to the new rules.

The Supreme Court, in a 5-4 ruling, has effectively made same-sex marriage the law of the land in all 50 states. While political and legal wrangling remains where this new right may conflict with religious belief, same-sex marrige have effectively become, in the eyes of the law, the same as what may consider "traditional marriage". Marriage Equality Now the Law of the Land

The decision is the culmination of a long struggle by gays and lesbians to gain the same marriage rights that heterosexual couples already enjoy. The legal battles that have consumed the courts and the political fights that have roiled state legislatures have effectively come to an end: marriage equality is the law of the land.