The Laymon Group

Archives for September 2016

Making Open Enrollment the Best Possible Experience

By Leave a Comment

Implementing a proper communication strategy can help make annual open enrollment better than it has been in the past. But to do this we’ll need to employ some fresh thinking and creativity. Here are three things you can do to improve your open enrollment process.

1. Communicate with your employees in the mode they’re most likely to respond to.

The best message in the world won’t carry any weight if your employees aren’t reading it. The ways we communicate with one another has rapidly increased over the past few years, thus making communication more complex than ever. This complexity makes it more important than ever to have a multi-layered strategy to communicate annual enrollment info.

Employees may want to receive this information in many different ways such as their computer at home, phone, company portal, or even standard mail. It is vitally important that we provides for reaching our employees in all these different mediums.

But as silly as it would be to only rely on one method for all employees, it would be equally as wasteful to rely on all methods for each employee. All of your employees differ in age, gender, education, and lifestyle. The key is being able to reach each of these employees by their preferred method of contact. A recent survey has shown that 95% of employees aren’t even consulted about their communication preferences. You’d do well to be in the other 5%. Start by simply asking your employees their communication preferences and your open enrollment is guaranteed to be more effective this time around.

2. Use analytical tools to show which plan offers the best value specifically for them.

Every employee looks at the plan selection process differently. When you stop and consider copays, deductibles, past usage, and future usage, there’s no clear cut way to choose a plan design–it’s unique to the individual. But just because the process is different for each employee, does not mean it needs to be a complicated one.

Amazing analytical tools exist now that process last year’s claims for each individual employee and recalculates them to the new plan design. This shows the employee their bottom line dollar amount of predicted out-of-pocket savings for choose one plan over another. Pretty cool right? In our experience most employees switch to the right size plan when they have this information available to them.

Another big issue during open enrollment is finding a physician that works for the employee and is also covered under the given network. Physician finder technologies exist today that provide employees a custom list of in-network choices near their home or workplace, and might even include helpful map snapshots.

If you don’t already offer these tools to your employees, it may be time to start considering it. Using them can add great value to your employees during the open enrollment process this year.

3. Apply predictive analytics to help employees stay engaged with their benefits throughout the year.

Your employees aren’t the only ones that should be thinking about benefits and the coming year. This is also a great time of year for employers to look ahead and set expectations for communicating with employees once they’ve made their selections. If you want your employees to get excited about the value of their health plan, demonstrate to them how their benefits help keep them healthy in the coming year.

Fortune 500 companies are now using the power of predictive analytics to optimize employee engagement and satisfaction with health benefit programs. This program replaces the old generic form of benefits of communication with hyper-personalized messages throughout the year, custom tailored to the health, financial, and lifestyle needs of each individual.

These messages have proven to encourage employees to take empowered action doing things such as preventive screenings or choosing a narrower network to save costs. Such encouragement reduces wasteful healthcare spending and leads to greater employee satisfaction.

5 Ways to Solve ACA Reporting Challenges

By Leave a Comment

Patient Protection and Affordable Care Act reporting was crazy for many Fortune 1000 employers in the first year.

The number one challenge to businesses was data as they tried to meet ACA requirements. According to a survey by Hager Strategic, ACA-reporting vendors saw that their clients (over 4,000 employers) were hampered by a variety of data gathering, accuracy and reporting hurdles in 2015. That’s not surprising. Data gathering for ACA reporting is complicated. Most employers are forced to bring together information related to benefit enrollment, hours worked, and contributions from contrasting systems, which leads to inefficient organizational methods and high compliance costs.

Penalties approach for non-compliance.

The word on the street is that the IRS is only getting started. The question is not whether  the IRS will impose billions of dollars in fines, but rather when they will do it. They already have the infrastructure ready to enforce ACA regulations and they project these fines will total $164 billion over the next decade.

Failure to deliver statemetns and filings may result in a $260 fine per each required form. This can total up to $3 million annually. And as for employers who do not offer coverage to 95% of their full-time employees, they face even more drastic fines–up to $2,000 per full-time employee.

End-to-End Compliance is the Key

Large employers are now turning to third-party solutions to meet these ACA requirements and deadlines. This also allows them to comply with the employer shared reporting stipulation.

Several benefits exist for employers who are willing to implement the right ACA reporting solution. Employers will see reduced costs, improved accuracy, and year-to-year repeatability. In order to cut down reliance on internal resources, eliminate rework, and avoid the variable hard and soft costs of using internal staff, many employers are looking to automate the process of data collection, application of regulations, and content determination for IRS forms.

There are a few things, going into this, that employers want to make sure they can do effectively:

  1. Gather and aggregate data from disparate systems.
  2. Review and validate the data to ensure accuracy.
  3. Identify full-time employees under the ACA rules.
  4. Determine affordability of coverage.
  5. Keep up with changing regulations from the IRS to assign accurate codes for lines 14 and 16.
  6. Deliver forms to employees on time.
  7. Manage the administrative burdens of the filing obligations with the IRS.

So if you’re a business looking to overcome the hurdles of ACA reporting, we’re here to help. Here are five tips you can employ to ensure the smoothest possible experience with these new regulations.

1. Use a Database to Unify Data and Consolidate Employee Records.

The problem for employers is that the data they need is disparate but it’s also essential. This data must be managed properly for pin-point calculations, as well as IRS filings and employee statements. One issue with this is that the information is not typically kept in one spot. Usually employers will use separate systems to house data for payroll, benefits administration, plan data and other functions. There has never been a reason for data standardization before.

To counter this, businesses should find a way to securely accept a monthly feed of employee eligibility, enrollment and plan data, extracted from their systems. This data should be archived and consolidated into a master employee record database (encrypted, of course).

2. Know Your Time Frames and Deadlines!

Employers must get their statements out to participants by January 31, 2017 and file electronically to the IRS by March 31, 2017. Here are a few things employers should do to keep these deadlines:

  1. Gather data during the year so you can avoid the year-end stresses of trying to meet the deadline.
  2. Test regularly for quality and review sample statements based on data from part of the year to make sure you’re ready for the year-end statements.
  3. Have a demonstrated process for printing and mailing a high volume of statements of participants in a short timeframe to meet compliance deadlines.

3. Calculate Your Data Monthly.

Businesses should validate data and then apply business rules to figure out eligibility and affordability at least once per month. They can then generate reports that watch compliance and benefit planning during the year.

4. Provide Live Support to Help Answer Tax Questions from Employees.

If you aren’t looking for ways to provide support to your employees, you’re missing out. They are going to have a horde of questions about tax statements and you should be ready to answer them and fulfill their requests in an efficient manner. This will free your staff up to think strategically in other areas.

5. Integrate Electronic Consent and Distribution.

By getting your employees’ consent to receive their 1095 forms electronically, they will receive their forms more quickly and provide a postage savings to the employer as well.

Large employers are meeting ACA reporting regulations with solutions that include data gathering and integration, tax reporting, form generation, call center support, and print distribution and fulfillment. By employing the very best practices for simplifying the reporting process, businesses are effectively reducing risk, frustration, and wasted resources. And even more importantly, businesses are solving ACA issues once and for all.

3 Places Trump and Clinton Differ on Healthcare Policy

By Leave a Comment

Most families these days spend more on their health insurance than any other household bill. That’s right, the cost of healthcare has surpassed that of many mortgages. If healthcare issues don’t linger near the top of your voting priorities in the 2016 presidential election, perhaps it’s time they should.

In fairness, however, these issues have become a bit overwhelming and difficult to follow. In a lot of areas it seems that both candidates (Clinton and Trump) are saying the same thing, but I encourage you pay careful attention and look at the subtle differences.

Below I’m going to break down three areas where the candidates speak much of the same language and yet have different conclusions in mind.

1. The Affordable Care Act

Clinton and Trump both want to make changes to the Affordable Care Act (ACA). The ACA is what we typically know as Obamacare but Obamacare is actually only one of many parts of the ACA. But that’s not important for now. All we’re concerned with here is, how is Obamacare changing with each candidate?

Both parties want to do away with the Cadillac Tax. The Cadillac Tax forces employees to spend less than $10,200 in healthcare coverage in 2020. Anything over this amount will be taxed heavily. With household healthcare costs on the immediate rise it isn’t practical to think this could work, and both Clinton and Trump agree.

Where they differ on the ACA is that Clinton wants to keep the ACA intact but tinker with the way prescription drugs are handled (which is a very broad field and Clinton has not been specific), and Trump wants to do away with the ACA but keep the conditions where anyone with a pre-existing condition can obtain healthcare.

While Trump means well in doing away with the ACA, it does not make much sense to maintain the pre-existing condition waiver without the other parts of the ACA, such as the tax penalty for not having coverage. Trump has not offered a logical explanation on how this will work.

It would make more sense to either keep the ACA with the pre-existing conditions, or do away with them both. However, this impacts a lot of families that were able to obtain coverage under the ACA that could not do so pre-ACA.

2. Cost of Coverage

Both Clinton and Trump want to stop bigger insurance companies (known as carriers) from absorbing smaller companies because it creates monopolies and ruins any chance of a fair market. Not a good things for us, the consumer.

Clinton wants to control this through legislation which could be quite effective if she’s able to get it passed in Congress, but establishing new healthcare legislation has proven to be no easy task in past attempts. Trump, on the other hand, wants to increase competition by allowing consumers to purchase coverages beyond their state line. This would hold the in-state companies accountable in continuing to provide the most affordable healthcare despite whose name is on the building.

3. Cost Transparency

If you call a doctor and want to know the cost of a procedure (both total cost and after insurance), they likely won’t tell you. Both Clinton and Trump want see cost transparency in healthcare. Just like you can compare the cost of organic pop-tarts between grocery stores, you should be able to compare the cost of a primary care visit between doctors.

This sounds good in theory but as long as people remain on managed care health plans (paying copays), it is unlikely they will care enough about what the insurer is paying when price shopping. In fact, it could have the reverse effect where people will pick the most expensive doctors because they feel like they will get better care for the same copay cost.

So far Clinton doesn’t have answer for this but Trump is pushing incentives to go on plans such as Health Care Savings Accounts (HSAs) that would motivate insureds to be accountable for the price of visits and procedures.

Concluding Thoughts

Healthcare policy is a tricky issue, no doubt, and the ambiguous comments we’ve received from the candidates hasn’t made it any easier to understand. However, when we take the time to analyze Clinton and Trump’s policies we begin to put the puzzle together and come up with these very obvious differences between the two of them.