Archive for the ‘Employee Benefits’ Category

Don’t Overlook the True Value of Your Employee Handbook

Thursday, January 19th, 2017

Employee handbooks are a vital part of outlining and communicating your company policies while creating a “picture” of your company culture and mission.  All companies–regardless of their size, industry, or number of employees should have an employee handbook in place, be it hard copy, e-version, or on-line. A company handbook can be as robust and detailed or as simple and short as needed depending on your business and culture. Let’s review several of the major purposes and benefits of having a company handbook.

Legal Protection: A handbook should outline the company’s position on important legal or regulatory issues such as At-Will Employment, anti-harassment or discrimination policies, wage and hour compliance or drug testing policies. Should one of these situations become a workplace issue, an employer can support their actions based on what is outlined in their handbook. Handbooks are a great tool in helping set employee expectations.

Company Culture/Mission: A handbook provides employees with an understanding of the company’s mission and culture. By placing an emphasis on aspects of employment that the company values (volunteerism or code of conduct) the employees will have a better idea of the culture that is desired and supported by senior management. Understanding the company’s culture will allow employees to have clear and consistent expectations of conduct and performance.  The handbook is also a great place for the CEO to “tell the story” of the company to help employees understand why the company exists.

Guide for Employees: An employee handbook should be written with the employee in mind. The handbook should outline policies, practices and other key information that is pertinent to the employee.  Providing relevant and pertinent information to employees allows employees to understand and manage that what is important to them (such as benefits, pay cycle information, vacation schedules, etc.) as well as develop an understanding of the expectations and consequences of their actions.  An employee handbook can also serve as a source for creating positive employee relations such as internal dispute resolution rather than through an external source such as government agency.

Guide for Supervisors/Managers: Managers and supervisors need reference materials in order to help them lead their teams. Having an understanding of policies such as PTO (how to earn it, when to use it, what happens if it isn’t used at the end of the year) is just as important as reviewing the company’s discipline policy or time management policies. A handbook is a great starting place for supervisors and managers but they should refer to specific company policies and or consult with their HR team.

CAI members have access to handbook guides to help you get started. Our Advice & Resolution team also provides complimentary handbook reviews and our HR On Demand team can work with you to create a custom handbook for your organization.

Emily’s primary area of focus is providing expert advice and support in the areas of employee relations and federal and state employment law compliance as a member of the Advice & Resolution team for CAI. Additionally, Emily advises business and HR leaders in operational and strategic human resources areas such as talent and performance management, employee engagement, and M&A’s. Emily has 10+ years of broad-based HR business partnering experience centering around employee relations, compliance & regulatory employment issues, strategic and tactical human resources, and strong process improvement skills.

Two Considerations For The Marketplace Open Enrollment Period

Tuesday, December 20th, 2016

The post below is a guest blog from Jay Lowe who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

The Affordable Care Act provides the ability for individuals to buy coverage regardless of any underlying medical condition.  This guaranteed issue provision has provided millions of Americans the access to health care that was not there before.  Many who had access to group coverage have also shifted either themselves or dependents to individual plans when their group plans were too expensive or did not provide the coverage they needed.

This year’s annual Open Enrollment Period for the Marketplace has opened and we are seeing, on average, a 25% increase to the cost of individual plans.  This cost increase is forcing many who are enrolled there to re-evaluate if an individual plan is still the best option for them when other group coverage is available through an employer.  When making this decision around where to be covered, there are two important items that should be understood about moving onto or coming off of an employer-sponsored health plan.

First, the annual Open Enrollment Period for the Marketplace is not considered a qualifying event under the IRS guidelines to allow someone to drop their individual policy and enroll in an employer-sponsored group plan.  There seems to be a common misconception around this with both employers and employees.  As the costs for individual plans continue to rise, many are looking for ways to move back to an employer’s plan.  The only instance in which someone could leave their individual plan and move onto their employer’s group plan is if the group plan is in an open enrollment period.

Another thing to consider is that the Marketplace Open Enrollment Period is not a qualifying event that will allow someone to drop a spouse or dependent from their group plan (unless the group plan’s annual open enrollment period coincides.)  So those who may be considering moving a dependent to an individual plan would not have the ability to do so at that time.  However, a special provision in the rules does allow an employee the ability to make a mid-year revocation of their group plan (outside of the group’s open enrollment) and enroll in Marketplace coverage.  In order for an employee to move a spouse or dependent to an individual plan during the Marketplace Open Enrollment Period, the employee must also drop coverage for him or herself too.

Given the rising costs of individual plans it seems unlikely that many will want to shift away from the group coverage.  It is important for employers to know the rules around allowing employees to come on and off of their plans outside of their annual open enrollment period.  Employees should understand the potential pitfalls of shifting away their group plan as that could create the opposite impact of what they are trying to achieve.

Pharmacies, Big Pharma, and Rising Prescription Prices

Tuesday, June 28th, 2016

The post below is a guest blog from Steve Byrd who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

Rising health costsA key trend among medical plans lately has been the move away from traditional pharmacy tiers. In the traditional model, generics — regardless of cost — reside under the least expensive copay tiers on your medical plan. In contrast, brand- name medications reside under the higher, more expensive copay tiers.  For many years this model was the norm, and most consumers became very familiar with it.  However, continued pressure to reduce cost has forced insurers to re-evaluate this traditional view.  It is expected by some, that by the year 2024, pharmacy costs will equal half of our overall medical costs.

Many brand name medications are coming off of their patents, creating opportunity for generics to evolve.  Traditionally, these generics have offered great savings over their brand name counterparts. However, many of generics are now entering the market at prices much higher than historical levels, creating new pressure on insurers to hold down costs.

In response to these increasing costs, insurers are re-evaluating their pharmacy tiering.  Generic medications are being treated no differently than brand name medications; These drugs are being tiered based on their overall cost regardless of their designation as a brand or generic medication.  Pharmacy pricing changes are catching many people off-guard.  They don’t understand why their generic medication, which used to be offered in a more affordable tier on, might now be Tier 3 or Tier 4 on their carrier’s formulary.  Consumers are having to work even harder to understand their carrier’s pharmacy benefits. They are having more direct conversations with their providers and pharmacists to try to minimize their out-of-pocket costs, which are increasing with no end in sight.

If insurance carriers are going to be able to offer competitive priced medical plans, gaining better control over rising pharmacy costs is critical.  Pharmacy expenses account for a significant portion the average person’s overall medical expenses, and both consumers and carriers are feeling the pain.  One insurance carrier is even suing its Pharmacy Benefit Manager for $3 billion over questioned pharmacy charges.

Fortunately for consumers, there are many new Rx tools popping up that can help members navigate their benefits. Goodrx.com and healthiestyou.com are good examples. A recent Consumer Reports article provides additional guidance on ways consumers can save on pharmacy costs. Consumers also need to evaluate options at their local pharmacies, as they can often find some of the higher priced generics offered at lower costs through a local pharmacy’s prescription plan.

As healthcare spending continues to increase, and pharmacy costs continue to become a larger portion of the cost, more pressure will be applied towards controlling pharmaceutical costs. Consumers will continue to see changes to their pharmacy benefits and their carriers designated carrier’s prescription formulary.