Factoring in wellness programs during open enrollment

wellness-programs-webThis article was published on November 5, 2018 on Employee Benefit News, written by Ann Marie O’Brien.

This fall, millions of employees are deciding which health plan to select for 2019. They are reviewing and comparing a variety of factors when making this important decision, such as costs, benefits and care provider networks.

Another component that crops up to the surprise of many workers? Wellness programs.

Employers know that a healthy employee can make for a more productive, satisfied employee. And many workers want to improve their health and are often surprised to learn that employers offer wellness programs. That mutual interest is behind the rise of workplace wellness programs.

Wellness programs usually are made available to employees by their companies directly or through health benefit plans. In either case, employees can factor in the value of wellness offerings, such as weight-loss programs, tobacco-cessation programs or health screenings when determining a health plan that best meets their needs.

A recent UnitedHealthcare report, “Employee Wellness Programs Bring Results,” suggests that companies that strengthen their wellness offerings can yield cost-savings and improve employee health over the long-term.

Many companies, like those highlighted in the report, have successfully established a culture of well-being through their wellness programs.

While each company’s wellness program may be strongest when tailored to its employees’ needs, successful programs often include offering meaningful financial incentives, or a mental health focus through offerings like mindfulness classes and relaxation rooms, or a financial well-being component, like estate-planning seminars. And, many employers find offering the services of a wellness coordinator or nurse liaison onsite encourages a culture of health.

The report compared companies with award-winning wellness programs alongside a peer group of similar companies. It found those that make positive changes to their health offerings over the years may reap the rewards of healthier employees and reduced healthcare costs down the road.

For example, these companies experienced 14.2% per-member, per-month lower costs, even with a 7.5% greater claim risk score (based on their employees’ health status), than the peer group, and the employees at the high-performing companies experienced 24% fewer emergency room visits. Also, the report finds that it can take time for employer wellness programs to yield significant benefits.

Strengthening wellness programs strengthens employees.

The report revealed that the companies with the most effective programs had several common characteristics that contribute to their plan’s positive results and encourage a culture of health, including enthusiastic involvement by senior leaders, positive encouragement from internal advocates, offering employee incentives and putting in place measurable success barometers.

Also, these companies conduct health surveys and challenges, biometric screenings and financial well-being programs, and they all survey their employees to gather feedback to refine their programs.

The informational benefits meetings that are often part of open enrollment offer companies a good opportunity to collect and analyze employee feedback to further strengthen their wellness offerings. It is also an ideal time for employers who have not yet done so to consider offering a wellness program that supports their employees’ health and may improve their well-being while reducing costs for employees and the company.

Economies of Scale for Small Businesses

dgb-embIn late June, the Department of Labor introduced final rules on Association Health Plans (AHP), which will allow bonafide associations to offer healthcare plans to member companies. While we had hoped for a different approach to regulating these plans, association health plans will be regulated by states as MEWAs.

According to the final rules, an association that wants to establish a healthcare plan must already exist for another purpose. In other words, an association cannot be formed for the exclusive purpose of offering healthcare plans to its members. Another stipulation is that new self-funded association health plans cannot be established until April 1, 2019.

Association Health Plans will be exempt from the federal mandate on essential health benefits, but will remain consistent with popular Obamacare rules such as coverage of preexisting conditions and bans on lifetime limits.

While reserve requirements will vary from state to state, we expect that these plans will be quite costly to establish and closely monitored by state regulators. Nonetheless, for large associations with significant cash reserves, we expect this option to make it possible for thousands of small businesses to lower their cost of employee health benefits.


Benefits Communication Growing in Importance and Difficulty

This article was published on February 25, 2016 by the International Foundation of Employee Benefits, written by Neil Mrkvicka.

Half of all organizations responding to the Benefits Communication Survey say the number of participant questions they receive regarding benefits has increased in the past two years. Adding to the frustration, organizations identify their top challenge with benefits communication as participants not opening/reading materials. Despite challenges, benefits communication remains a high priority for most respondents.


A total of 341 organizations of a variety of sizes, industries/jurisdictions and regions across the United States and Canada participated in the survey. Key findings include:

What Is the Current State of Benefits Communication?

ben com survey 1Nearly two in five surveyed organizations (38%) have budgets specifically devoted to benefits communication, and one-quarter of these organizations (25%) likely will increase their budgets next year. A few organizations shared the size of their benefits communications budgets, which ranged from 3% to 10% of the total benefits budget.

Organizations are more likely to handle benefits communication in-house than to outsource, and more than one-third (35%) have staff specifically dedicated to benefits communications. Organizations are more likely to outsource via consultants, administrators and vendors (31%) compared with attorneys (6%). Large organizations are more likely than small organizations to have budgets and staff specifically dedicated to benefits communication.

The most common benefits communication topics are:

  • Retirement benefits education (74%)
  • Health care benefits literacy (74%)
  • Wellness and mental health (72%)

The most frequently used benefits communications channels include:

  • Printed mail to homes (89%)
  • E-mail (73%)
  • Print distributed on site (69%)
  • Internal websites (66%)
  • External websites (58%)
  • Videos (29%)
  • Social media (23%)
  • Texts (10%)
  • Robocalls (9%)
  • Games (7%)

Two-thirds of all organizations (67%) reach out to retirees with benefits communication, 53% engage spouses/dependents and 52% personalize communication materials. The most common benefits communications strategies organizations use are simplifying complicated content (85%), year-round communication (73%), reaching out to retirees with benefits communication (67%), leveraging word of mouth (63%), engaging spouses/dependents (53%) and personalizing communication materials (52%). Less than half of all organizations customize communication benefits to multiple generations (49.6%), measure the effectiveness of communications (43%), communicate by life stage (41%) or communicate in multiple languages (31%).

What Are the Goals and Challenges?

ben com survey 2Survey findings reveal that 65% of organizations regard benefits communication as a high priority (28% very high and 36% somewhat high). However, the amount of time spent on various benefits communication efforts doesn’t always match up with organizations’ priorities. For example, 89% of organizations report helping participants understand and use their benefits as a top goal, but only 70% say that effort occupies most of their time. Fifty-two percent cite getting individuals to understand the value of benefits as a top goal, but 48% say it takes most of their time. Helping participants make smarter personal health and/or finance decisions is the third most cited goal (49%), with 30% saying it occupies most of their time. Data show how reactively responding to participant questions (57%) seems to be stealing time from organizations’ more proactive benefits communication goals.

ben com survey 3Each of the top challenges with benefits communication is centered on participants: Participants do not open/read materials (80%), don’t understand materials (49%) and do not perceive value in their benefits (31%). (Each is cited far more frequently than internal challenges such as benefits staff time, resources or expertise.) Large organizations are more likely to say participants not opening/reading communication materials is a top challenge. U.S. organizations are far more likely to view complying with mandated benefits communication as a top goal, challenge and consumer of time, compared with Canadian organizations.

ben com survey 4Few organizations believe their participants have a very high (3%) or somewhat high (16%) level of benefits understanding. Half (49%) say the number of participant questions regarding benefits has increased in the past two years, compared with just 7% reporting a decrease in questions. U.S. organizations are more likely to say the number of participant benefit questions has increased in the last two years compared with those from Canada. Some of the most common benefits topics about which organizations receive participant questions are the Affordable Care Act, health reimbursement arrangements and health savings accounts, plan design changes, accessing retirement funds and health care eligibility, coverage and costs.

The International Foundation deployed Benefits Communication Survey in December 2015 to member organizations across the U.S. and Canada. For a more in-depth analysis and data on which communication approaches are working the best check out the full results here.

How to Get Employees to Use Their Preventive Care

The article below was published on July 21, 2016 by the International Foundation of Employee Benefit Plans, written by Brenda Hofmann.

Preventive care is vital to keep your employees healthy. The more employees take advantage of available preventive care, the more cost-effective their care becomes. They stay healthy, you save on health care costs—It’s a win-win for employees and employers.

You know that the Affordable Care Act (ACA) requires that health plans cover recommended preventive services at no cost to the individual, but do your employees? If you’re not already doing so, consider communicating to your workforce the free preventive care benefits that are available to them.


You may want to adjust the language to best fit your plan or workforce, but here are some samples of communication to get you started:

Take Advantage of Free Preventive Care

Who: You! Men, women and children are all covered.

What: Depending on your age, you may have access to—at no cost to you—preventive services such as:

  • Blood pressure, diabetes and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on topics such as quitting smoking, losing weight, eating healthfully, treating depression and reducing alcohol use
  • Regular well-baby and well-child visits, from birth to age 21
  • Routine vaccinations against diseases such as measles, polio and meningitis
  • Counseling, screening and vaccines to ensure healthy pregnancies

See the full list at Healthcare.gov.

When: Now. These preventive services are already covered under our plan.

Where: Preventive services are free when delivered by an in-network doctor.

Why: Preventive care screening can detect disease in the early stages when it is most treatable. Following preventive care guidelines, along with the advice of your doctor, can help you stay healthy.

How: Know what’s considered preventive care and review the guidelines. For example, although a colonoscopy is a preventive care screening, it’s only covered for people aged 50 or older. Additionally, colonoscopies that are done to evaluate specific problems are usually classified as diagnostic procedures (not screenings) and are not covered.

Avoid unexpected costs by clearly stating when you make your appointment that your visit is for a covered preventive care service. For example, if you’re making your well-woman visit on the phone, say “I’m making an appointment for my free preventive care well-woman visit.”

Also, medical complaints aren’t preventive. If you discuss other issues with your doctor, the visit is no longer preventive and you’ll be charged a fee. For example, if during your well-woman visit, your doctor does blood work for thyroid problems you are having, these additional services won’t be covered under free preventive care. Don’t hesitate to ask your doctor whether screenings he or she recommends will cost you.