Employee Benefits Blog

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).

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.

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?

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.

At this point, everyone knows the Affordable Care Act (ACA) requires all employers with 50 or more full-time equivalent (FTE) employees to offer affordable coverage to their workforce. This requirement is called the employer mandate.

What’s less clear for some employers is to whom the coverage must be extended. Do employers have to offer family health insurance coverage? Dependent health insurance? What about coverage for spouses? The answer is pretty straightforward, so let’s dive right in and clear up all that confusion.  

ACA Requirements for Employers

The ACA requires that applicable large employers (ALEs) offer affordable coverage to their full-time employees and their dependents up to age 26. However, the law makes no requirement for spousal coverage, nor does it mandate that employers pay for any portion of the premium for dependents.

So in short — employers are not required to offer family health insurance. That being said, many employers choose to offer coverage for spouses and families, regardless of whether dependents are older or younger than 26 years of age. In addition, most choose to subsidize a portion of the premium as well.

One trend picking up steam in the past decade is to only offer spousal coverage if the spouse isn’t able to obtain health insurance through his or her own employer (or if the spouse doesn’t work).

Another common practice is for an employer to levy an additional surcharge for spouses who can obtain insurance through their own employers, but prefer to be on their spouses’ insurance instead. The reasons for doing so are often wide and varied. Nevertheless, the surcharge is often relatively minimal — perhaps around $100.

When household budgets are already tight, the last thing your employees need is to be overburdened by unplanned and expensive medical bills. Even if they have a persistent cough that won't go away, an injury that just won't heal on its own, or a medical concern they know will eventually land them in the hospital, they may be less likely to see a doctor because they can’t afford to pay another bill.

Unfortunately, health problems often pop up without warning, which may leave some of your employees scrambling to pay the bill — and most likely, at the worst possible time. While most people find this subject embarrassing and would rather keep these matters private, you may have a few employees who confide in you, and seek your advice when it comes to needing help paying medical bills. It goes a long way when you point out to them that they have several outlets to explore before all hope seems to be lost.

Here are some suggestions you can put in your employee benefits guide or send to inquiring employees:

1. Don't Ignore the Bill

This is a really important first step: When you get the bill, don't ignore it. Most companies will bill you again after 30 days, again after 60 days, and then probably once more after 90 days. If you’ve still neglected to pay the bill, you may be sent to collections (the laws can vary, depending on many factors, including the type of medical debt), which will result in agents calling you to demand repayment, negatively impacting your credit history (and therefore, your credit rating).

In the never-ending quest to decrease employee benefits spending on healthcare, some employers are turning to a somewhat revolutionary concept called reference based pricing. This switch is most common among large employers (500 employees or more) who are self-funded, and is gaining popularity rather quickly. For those who may be interested in implementing such a program, it’s important to understand how it differs from traditional healthcare plans, as well as how it will affect those enrolled in it.

What Is Reference Based Pricing?

Reference based pricing (RBP) is a system that some employers have started to use for cost containment purposes. This method is different from more traditional pricing options in that the employer caps the amount they’ll agree to cover for certain non-emergent medical procedures that can vary greatly in price yet not in outcome, such as hip or knee replacements.

Are you missing the mark with your efforts designed to promote wellness, as well as target other population health issues? Is this inability to effectively target the right employees as well as drive real behavioral change driving up your claim costs, and ultimately your premiums?

If you’re like most small businesses, you’re relying on your employee benefits broker to help out in this area. Unfortunately, most brokers aren’t equipped to help you “unearth” these issues and they certainly aren’t staffed to help guide any effort towards taming your workforce’s true health issues. In fact, when faced with this challenge, most brokers typically hand their clients a set of somewhat generic carrier-generated posters and flyers and call it their “strategic communications plan.”

Here is what you should expect from your employee benefits broker and why customized content is far more effective than cookie-cutter fliers in the break room.

Flying Blind With Generic Marketing Pieces Just Doesn’t Cut It

Setting aside the inability to identify and target true population health risks for a moment, let’s just talk about the efficacy (or inefficacy more likely) of these communication materials. Generic fact-sheets frequently miss the mark because they are written for such a general audience that they fall flat and lack a meaningful call-to-action.

When starting a business, most entrepreneurs want to attract employees by offering them a robust benefits package. Then, reality sets in, and they realize that this will have to wait until they establish positive cash flow. Well regardless of if an employer is just starting out or if they’re already well established, employers need to realize that there are certain required employee benefits they MUST offer in order to maintain compliance with the law; failure to do so can trigger large penalties. Here are required employee benefits employers cannot skip — and some that are only applicable as a business grows.

Required Employee Benefits For Employers of Any Size

1. Social Security and Medicare Benefits

Every employer, regardless of size, is subject to the required employee benefit of matching their employees’ social security and Medicare contributions. The current rate for social security is 6.2 percent of the employee’s wage from each party, equalling 12.4 percent in total, up to the first $127,200 in earnings. This amount is also known as the “wage base limit.”

The upcoming election is just days away and includes Propositions 205 and 206 in Arizona, which places company benefits front and center in the minds of employers- accompanied by a collective sigh.

A quick review of what’s at stake in terms of considerations for Arizona employers reveals that questions are more prevalent than answers, especially regarding Proposition 205.

To place employers' questions in their strategic context, here is a framework in which to consider what to do:

• Consider the role your employees play in giving your enterprise a competitive edge. Benefits plans and policies are key employee attraction and retention tools, as savvy CEOs know.
• Consider that your benefits plans and policies can work to keep your workforce healthy and productive. It doesn’t end there: when the families of your employees are healthier, your employees remain more productive too.
• The right benefits policies strategically aligned to your workforce are likely to increase your employees’ engagement with their jobs—which leads to happier, more productive employees who are eager to pitch in outside their job descriptions.