Posts Tagged ‘Joy Binkley’

Top 5 Resolutions For Maintaining A Strong Benefit Plan

Thursday, January 15th, 2015

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

resolutionsYou may think New Year’s resolutions only apply to bettering yourself, but don’t forget about the health of your benefit plan! Follow these five resolutions for keeping your benefits strong:

 

  1. Look for new opportunities to communicate the value of your benefits. Many employers pull their employees together once a year to review their benefit offerings during the annual open enrollment.  Make a point to pick 2 or 3 other times a year to stress the benefits of your health plan.  For example, distribute a hidden paycheck, highlight one of your benefit offerings at a staff meeting or hold a Lunch & Learn event supported by one of carriers during the year.
  2. Test your plan for ACA and overall compliance.List all of the notices you are required to release each year.  Take inventory of all of your employee categories and know which ones are eligible for coverage under your plan.  Make certain you are able to access contracts and policies without difficulty.  Review your time recording structure and be assured it will assist you with the new 2015 reporting requirements.
  3. Develop a health and wellness calendar.Challenge your organization to engage in a health and wellness event once a month.  Select a small group of employees or form a committee to develop an activity or event each month to support.  These events can range from a lunch time walk, encouraging others to eat more fruits and vegetables or supporting a team effort at a local charity walk.  With a little forethought, these activities can be a great way to remind your employees that their health is important.
  4. Plan ahead; don’t wait until the last minute to review your plan options for 2015.Review how things are running with your current benefits mid-year and see if they are supporting your overall business objectives for the year. Are your benefits helping you retain and attract the right talent for your organization to succeed?  If not, what may you need to change or initiate to help you meet this goal.
  5. Look for ways to enhance your plan offerings.Employees are looking to their employers to offer them more choices in plans that may meet their unique needs.  The worksite benefit landscape has evolved a lot over the past few years.  Introducing new voluntary benefits are a great way to enhance your benefit portfolio.  These benefits can provide additional financial assistance or incentives to many employees alongside their major medical plans.

Regardless of which direction you go in 2015, now is the perfect time to take a step back and assess what is working well for your plan.  Talk to your benefits consultant to identify different avenues to explore in the New Year!

 

Can Narrow Provider Networks Control Healthcare Costs?

Thursday, October 17th, 2013

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

HCW 10 16In July, leading computer chip company Intel Inc. announced that it had decided to contract directly with a single provider system rather than working with a national commercial health insurer for 5,400 employees at its manufacturing plant in Rio Rancho, N.M. This single provider system will administer Intel’s benefits for eight health plan options and better manage the firm’s healthcare costs, according to officials.

The decision to implement this system garnered national attention since it showed that one of the largest employers in the United States believes narrow provider networks is one solution to controlling healthcare expenses. This trend is also growing in popularity among some employers in North Carolina. The theory is that by establishing access to a small network of top-line providers for certain scheduled healthcare procedures and operations, employers will be offering medical services at a lower cost to both themselves and their employees (the patients).

Narrow networks have gained prominence in the wake of a recent government report detailing how even within the same region, hospital costs can vary more than $200,000 for same procedure. With narrow networks, employers and insurers can overcome such wide differences in expenses by directing employees to more affordable treatment options. Controlling these costs will keep employees and employers from overpaying for services and help manage claims and out-of-pocket expenses, while still producing the best outcomes for patients.

Tiered v. Limited Networks
There are two main types of narrow networks – tiered and limited. With a tiered network, employers can continue to offer a large carrier network to their employees, but out-of-pocket costs will vary based on chosen facility or service provider. Under limited networks, the number of providers and facilities the consumer will have access to is restricted. If a member elects to seek care from a non-participating location or provider, his or her claims may fall out of network at higher cost or be completely excluded from coverage.

Regardless of the type of network chosen, employers are learning that employees would like guidance regarding where to schedule surgeries. Employees are just as frustrated as employers about overpaying for services that can be found at considerably lower cost at nearby facilities. At the same time, employers are using more in-depth health management through member advocacy groups or trained health professionals. This allows the employers to further review treatment options with consumers and make them more aware of what is involved with costs.

Given these facts, can narrow provider networks used by Intel and other employers really save costs substantially for other businesses? Can their goals and results be adopted by other employees and replicated elsewhere?

Results May Vary
Narrow networks may serve well for limiting healthcare costs for employers through scheduled services such as a knee replacement or MRIs. Catastrophic injuries and illnesses are by definition going to services, such as a knee replacement or MRIs. Catastrophic injuries and illnesses are by definition going to require specialized assistance, however, so providing a list of predetermined locations approved for certain types of treatments or surgeries will not help when emergency care is needed.

Having said that, limiting the network of providers may not yield the same results for all employers. This is due to three primary factors:

  1. Location – Little to no competition in a specific area often means minor cost variance for services, so limiting access will not impact overall cost. Most carriers are able to run a network comparison based on home zip codes to determine if these limited networks will be beneficial. A general rule of thumb is that there is more competition in urban areas than rural ones, so companies based in the latter likely will see little benefit with narrow networks.
  2. Level of engagement – Members may have to understand there will be more responsibility expected from them for their healthcare costs. Perhaps they will have to utilize a member advocacy program to get certain types of service pre-authorized before seeking care, or conduct their own price comparison for certain services. Regardless, more guidance will be required in the plan itself to help clarify the variance in cost versus outcomes.
  3. How your health plan members consume care – Employers need to be more informed of how employees within their own group have used provider networks in the past. At HCW, we offer clients with 100 or more employees a tool to analyze group-specific data about high-cost, high-diagnosis procedures and determine how much they are costing the business. The results of either approach may support or rule out using narrow networks.

Even if your business meets these factors, realize that employees may view narrow networks as providing fewer healthcare options than previously offered. Remember that you are gently guiding your employees into understanding why they may have visit a new healthcare provider to save costs. Some may have to travel further than in the past in order to meet the terms of these networks.

Data mining tools can be used to provide an analysis of where plan members are consuming the most cost. At HCW, we use such a tool to aid the discussion on determining if a narrow network may work in our client’s favor. We can also work with various carriers to determine if the limited network aligns well geographically to incent savings as well. Contact HCW if you have questions or would like more information on these services.

Image courtesy of sippakorn / FreeDigitalPhotos.net

Misclassifying Employees Can Have Unintended Consequences

Tuesday, February 14th, 2012

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

The Internal Revenue Service (IRS) has announced a new, voluntary correction program that allows employers to reclassify employees who are currently misclassified as 1099 “independent contractors” when they should actually be reported as “W-2 paid” employees. Known as the Voluntary Classification Settlement Program (VCSP), employers who are not currently being examined by the IRS are allowed to eliminate years of past employment tax liabilities for “pennies on the dollar,” an amount equaling just greater than one percent of the wages paid to the reclassified workers for the past year.

For health and welfare benefits, employers will want to consider the compliance and contractual impacts to their plan. From a compliance perspective, it all starts with control groups and eligible employees. This impacts traditional regulatory issues such as COBRA, HIPAA, ERISA, FMLA and discrimination testing. When you add in the additional impact of healthcare reform, employers will need to consider the implications on provisions that apply to varying sizes of groups, such as “Pay or Play,” tax credits and medical loss ratios.

Of course, there is also the issue of repercussions that might be felt from employees that were previously misclassified and, as a result, were denied benefits.

From a contractual perspective, employers should be aware of the requirements the insurers or reinsurers impose. This might mean a re-rating of coverage if there are material adjustments to the covered population. With clearer definitions of employees and control groups, employers may want to tighten up their eligibility monitoring to prohibit unreported carve outs. As can be seen, all of this impacts more than just tax withholdings.

To read the expanded article, feel free to view our Eyes on Benefits monthly newsletter.