Employee Benefits Blog

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.

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.

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? 

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.

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.