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Topical Benefits Issues & Analysis

Engaging Consumers in Changing Health Behaviors

This article from Buck Consultants summarizes relevant concepts and findings from the fields of psychology, decision research, and social marketing and identifies best practices in developing consumer engagement to aid employers  in creating health care programs and tools to control costs and improve workforce health and productivity.

Self-Insured Health Plans: State Variation and Recent Trends by Firm Size, 1996–2013

A new EBRI analysis finds a growing percentage of workers in self-insured health plans nationwide. In 2013, 58.2 percent of workers with health coverage were in self-insured plans, up from 40.9 percent in 1998  .However, the data show that this trend is being driven by large employers (with 1,000 or more workers), and not small employers (those with fewer than 50 workers).

Utilization Patterns and Out-of-Pocket Expenses for Different Health Care Services Among American Retirees

Data reported in EBRI’s February 2015 Issue Brief finds that the recurring, more-predictable health costs in retirement tend to remain stable throughout retirement: Expenses such as doctor visits, dentist visits and usage of prescription drugs.  However, the non-recurring, less-predictable costs increase with age—overnight hospital stays, overnight nursing-home stays, outpatient surgery, home health-care and usage of special facilities.

2015 Retirement Health Care Costs Data Report

A new report from Healthview Services suggests health care costs will consume a rising percentage of Social Security benefits for future retirees.  The 2015 Retirement Health Care Costs Data Report draws upon claims data from year-end 2014, the company’s actuary and physician-reviewed cost projection methodology and a wide range of additional data sources. Year-over-year comparisons are between year-end 2013 and year-end 2014 data sets.

Utilization Patterns and Out-of-Pocket Expenses for Different Health Care Services Among American Retirees

This February Issue Brief from EBRI discusses how we spend our health dollars are we age.  The study separates the more predictable health care expenses in retirement for older Americans (ages 65 and above) from the less predictable ones. Based on utilization patterns and expenses, doctor visits, dentist visits and usage of prescription drugs are categorized as recurring health care services. Overnight hospital stays, overnight nursing-home stays, outpatient surgery, home health care and usage of special facilities are categorized as non-recurring health care services.

Gallup and Healthways Redefine ‘Wellness’

A February 4, 2015 article in Gallup’s Business Journal highlights a new approach to wellness advocated by Gallup and its partner, Healthways. The two have coined the term “well-being” to supplant wellness and have broadened the definition to encompass five measureable, interdependent elements.

EBRI Report on the 2014 Health Benefits Survey

The December 2014 issue of EBRI’s Notes discusses findings from the SHRM/EBRI 2014 Health Benefits Survey and how open enrollment might be affected by PPACA and the 2018 excise tax. The survey was conducted in February and March 2014 to better understand changes to health coverage in 2015.

Analysis Shows Upward Trend in U.S. Healthcare Cost Increases in 2014

In 2014, U.S. companies and their employees saw a slight uptick in the rate of U.S. healthcare cost increases, according to an analysis by Aon Hewitt.  The summary includes costs by plan type from 2010-2014, comments on managing dependent eligibility and subsidies and private health exchanges.

Preparing for a Health & Welfare Plan DOL Audit

This November 2014 article in Benefits Magazine, published by the International Foundation of Employee Benefits Plans, takes an ERISA health and welfare plan step by step through a DOL audit, from the initial notification and request for documents through the investigative process.

2014 Inside Benefits Communication Survey

The 2014 Inside Benefits Communication Survey, a collaborative research effort from the National Business Coalition on Health and Benz Communications, is a national survey that explores how companies are making investments in benefits communications and the return on those efforts.  The survey’s data was collected from more than 300 high-level business professionals and provides greater insight into how companies are planning and implementing benefits communication.

2014 Telemedicine Survey Executive Summary

This November, 2014 survey by law firm Foley & Lardner focuses on the rising interest in telemedicine.  The survey, while small in scale (just 57 respondents) was conducted among healthcare executives throughout the US in September and October 2014.  Among the issues the survey covered are the effect the ACA has had on telemedicine advancements as well as the challenges surrounding payment for healthcare providers for the service.

Surge in Employees’ Share of Health Costs

An article from the Society of Human Resource Management dissects a 2014 UBA Health Plan Survey and discusses how employers continue to shift more of the financial burden of health coverage to employees through out-of-pocket cost increases and reductions in family benefits.

The Fidelity Investments Millennial Money Study: Facts, Figures and Findings

The results of Fidelity’s “Millennial Money Study”, conducted in April 2014, show many Millennials are fully engaged in their financial futures, and some of the results of its study challenge the common stereotypes about how this generation approaches planning for the future.

American Benefits Council: A 2020 Vision–Flexibility and the Future of Employee Benefits

The American Benefits Council has introduced its strategic plans for health and retirement policy, providing 46 specific regulatory recommendations for Congress to consider in easing the burdens on employees, employers and government agencies.  The strategy suggests the advocacy group will work to achieve public policy reform that more closely unifies healthcare and retirement outcomes.

Private Exchanges and the Rise of Retail Health Coverage

This report from PricewaterhouseCooper’s Health Research Institute is based on data from the organization’s 2014 Health and Well-Being Touchstone Survey. (A link to the full survey is also available on this site under Benefits Research & Surveys.)  The report discusses the four types of private exchanges and names the major players in each. It also illustrates factors that influence a company’s interest in moving to a private exchange and touches on the pros and cons of such a move.

An Examination of Controlling Health Care Costs Through Limited Network Insurance Plans

This September 2014 paper from the National Bureau of Economic Research looked at the effect of narrow networks on cost and quality by examining Massachusetts GIC, the insurance plan for state employees, which introduced a major financial incentive to choose limited network plans for one group of enrollees and not another. The report finds that overall spending decreased among those enrolled in narrow networks, although spending for primary care actually rose.

EBRI Report on HSA Quality of Care

With an ever-growing number of workers covered by health savings account (HSA) plans, this September 2014 Issue Brief from EBRI examines how HSA health plans—compared with traditional managed care plans—do in terms of health care quality.  The results of the study were based on data collected over a 5-year period from a single large employer in the Midwest with an HSA-eligible health plan for all employees.

Eighth Annual Study of Employee Benefits: Today & Beyond

Findings from Prudential Insurance’s 8th Annual Study of Employee Benefits: Today & Beyond show that  employers are taking a multichannel approach to meet the needs and preferences of their employees.   Some of the more traditional methods are still reporting in the top five, but there has also been a jump in employers reporting great success with newer communication vehicles.   The survey was conducted online  in August, 2013, and included three distinct groups:  employers, employees and benefits consultants and brokers.

“Crisis” Management: Uncertainty and the Workplace

This August 2014 Issue Brief summarizes EBRI’s 74th policy forum held in Washington, DC, on May 15, 2014. The symposium featured experts who examined the current and projected future of retirement readiness, employment-based healthcare, and the role that approaches like financial wellness can play in alleviating the strains of uncertainty.

Satisfaction with Health Coverage and Care Among Enrollees in CDHP, HDHP and Traditional Health Plans

This August 2014 issue of EBRI’s Notes looks at satisfaction with various aspects of healthcare based on the type of plan in which respondents were enrolled:  CDHP, HDHP and traditional.  Conclusions are based on findings from the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey.  (A link to the full report can be found elsewhere in the “Benefits Research & Surveys” section of this Resource Center.)  According to the report, overall satisfaction is highest among those with traditional healthcare coverage and lowest among those with a HDHP. The report also notes that the overall satisfaction rates are trending downwards on traditional plans while the trajectory is up for CDHC and HDHP plans.

2014 Benefits Strategy & Benchmarking Survey Report

This report, published in June 2014 from Arthur J. Gallagher & Co., provides an interesting look at data collected from 1,833 organizations across the country when they were surveyed about their current and future employee benefits strategies.

Hobby Lobby Decision Breaks New Ground

This alert from Nixon Peabody covers the Supreme Court’s controversial ruling in the Hobby Lobby case.  Read background on the case, the ruling and the far reaching effects for the future.

Report on the Economic Well-Being of U.S. Households in 2013

This July 2014 report based on survey conducted by the Federal Reserve Board in September 2013 captures a snapshot of the financial and economic well-being of U.S. households. The survey also examined the issues they face, their recovery from the Great Recession and perceived risks to their financial stability.

HSA Savings: Potential Accumulations

A July 2014 analysis in EBRI’s Notes shows that a person contributing for 40 years to an HSA could save up to $360,000 if the rate of return was 2.5 percent, $600,000 if the rate of return was 5 percent, and nearly $1.1 million if the rate of return was 7.5 percent, and if there were no withdrawals.

Private Insurance Exchanges Continue to Evolve

This article by Carol Harnett appeared in the April 9, 2014, edition of HR Executive Online. The Q&A format makes for a good “primer” on the topic of private exchanges and explores issues that employers should consider before making the jump to this new model for group benefits.

Incentives to Shape Health Behaviors

This February 2014 article published in the Journal of Workplace Behavioral Health examines the use of incentives to shape health behavior and looks at the differences between “patient-centered” and “person-centered” approaches. The authors conclude that while it isn’t possible to create incentives that will be appealing to everyone, a person-centered approach would  allow individuals to self-match to incentives and engage them in the decision-making process. This could lead to better outcomes.

Due Diligence for Target Date Funds Goes Beyond Examining the Glide Path

This White Paper by Vanguard argues that looking solely at the glide path of target date funds-how its asset allocation changes over time– is an incomplete approach to the due diligence plan sponsors should perform on these widely used defined contribution investments.  The paper identifies other areas that deserve scrutiny as part of any due diligence effort.  These include glide path stability, sub-asset allocation and cost.

Value-Based Benefit Design Seen as a Tool to Change Behavior

A study of a large employer by the Academy of Managed Care Pharmacy looking at drug adherence among two populations–those with diabetes and those with high cholesterol–concludes that a value-based benefit design offering zero copay for generic drugs improved adherence.

EBRI Report on Contributions to HRAs and HSAs, 2006-2013

This report published in the February 2014 issue of EBRI Notes looks at the level of employer-employee contributions to HRAs and HSAs between 2006 and 2013. Based on its 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, this report shows that the percentage of employers who contribute to these plans has increased and that employees with family coverage contributed to the accounts at a steady level while contributions by those with single coverage fell.

Explanation of the Affordable Care Act’s December 2013 and January 2014 FAQs

This Aon Hewitt Bulletin discusses the provisions in the December 19, 2013, and January 9, 2014 FAQs released by HHS, DOL and Treasury in connection with implementation of the Affordable Care Act.  Topics covered include cost sharing, wellness, preventive services and the transitional reinsurance fee.

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

The Kaiser Family Foundation offers a clear and detailed explanation of the Affordable Care Act’s risk adjustment, reinsurance and risk corridor provisions, which are intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform.  Using text and, side-by-side comparisons and other graphics, the article offers a basic primer on these provisions.

Healthcare Cost Variations – A Comparison of 24 U.S. Urban Areas

This August 2013 study by the Benefits Services Group and HCTrends examined the cost-per-episode of providing care in 22 different medical practice areas across 24 urban areas in the United States and also looked at the efficacy of treatment. The differences among the cities highlight how difficult it is to make generalizations about costs and effectiveness of medical treatment.

PPACA’s Out-of-Pocket Maximums and Preventive Services

This analysis from Towers Watson examines the implications of the 20 questions included in the DOL’s Frequently Asked Questions #15.  The analysis focuses on out-of-pocket limits for 2014, preventive services without cost sharing and changes that may be necessary for most plans in order to be compliant.

Impact of ACA’s 90-Day Enrollment Waiting Period Rules

This March 2013 commentary from Aon Hewitt discusses the ACA’s proposed regulations limiting enrollment waiting periods for group health plans to no more than 90 days. The article also highlights the fact that after 2014 there will no longer be a need to issue HIPAA Creditable Coverage Certificates.

Views on Employment-Based Health Benefits After ACA

This December 2012 article by EBRI’s Dr. Paul Fronstin uses data from the 2012 Health Confidence Survey to examine the impact the Affordable Care Act will have on the future of employer-sponsored healthcare benefits.

A Review of the Workplace Wellness Market

This study of employer-sponsored wellness programs was prepared for the Department of Health and Human Services and the Department of Labor in conjunction with provisions under ACA that expand the use of incentives in nondiscriminatory programs. It is based on a review of the current literature on the topic and summarizes typical program components, the prevalence of wellness programs among employers and their impact, and the use and effect of financial incentives in these programs.

Are Private Health Insurance Exchanges the Wave of the Future?

This EBRI Issue Brief examines the growing interest among employers in private health insurance exchanges as an alternative to the traditional model of employer-sponsored healthcare benefits. The article provides a good explanation of how private exchanges might operate.