Understanding the real risks of changing employee benefit plans

In an environment of constant change, corporations are looking to alter employee benefits programs to make them more responsive to employee and business needs. A complete risk assessment process is the key to preparing for changes to employee benefits programs by providing employers with an analysis of cost savings against the potential negative ramifications of change. This article outlines the steps involved in a complete review of risk assessment. It then discusses how employers can develop successful change management communication strategies if, after conducting a risk assessment, employers decide to move forward with alterations to their employee benefits programs.     

Health risk management: well-being for the employee and the bottom line

For most employers, a small percent of the employee/participant population accounts for a large percent of health care costs. However, the population of this high-cost group changes from year to year. The fundamental problem is keeping employees out of the high-risk/high-cost segment, something plan design changes cannot address but that integrated health risk management (IHRM) can help achieve. This article explains how employers can implement an IHRM program to significantly lower health care costs to a degree unattainable through traditional cost-control strategies, while simultaneously raising workers' productivity and well-being.     

Integrating benefits decision making

Integrated employee benefit decision making helps employees use their benefits more wisely and identify opportunities to balance their immediate benefits needs (such as health care) and future benefits needs (such as retirement). This article discusses how employers can overcome employees' behavioral barriers to making integrated employee benefit decisions by changing the ways benefits are communicated and employees are presented with action decisions. Undertaking these steps allows employers to not only improve their employees' overall financial perspectives, but also furthers plan sponsors' goals of actively promoting personal responsibility with respect to retirement funding and changing employee behavior with respect to controlling health care costs.     

Employee contributions: a primer on their use, historical trends and overall fit within benefits strategy

This article focuses on the use of employee contributions as a strategic tool within employee health plans. While most employers require some form of employee contributions for health care, there is no clear "one-size-fits-all" solution. A myriad of strategies are in place, some active and some passive. This article reviews both common and emerging strategies and how they differ based on industry, employer size and region; discusses how employee contribution strategy fits within overall benefits strategy; and provides a strategic framework for approaching employee contributions in the future.     

Employee communications and health care reform

The Patient Protection and Affordable Care Act (PPACA) has made health care reform a reality. Although many of PPACA's details are still unclear to many employers, and most of the act's major reforms will take effect over the next several years, companies have reason to begin preparing for change and enough information to begin a communications effort with employees. The authors describe a number of immediate actions that employers should take to make the most of their own understanding of PPACA as it develops, as well as help their employee benefits leaders make the most informed decisions about when and how to communicate with employees about the law and its impact on their group health plan coverage.     

Disability, absence and the health reform era

The total cost of employee absence for many employers is high, and the correlation between employee health and disability is clear. This article reviews several challenges employers face in managing employee health and absence in a well-integrated manner. Although such an undertaking is not easy, the additional cost national health care reform may bring makes the interrelationship between employer profitability and employee absence, health and disability more crucial than ever for employers to recognize and manage.     

Health care consumerism: engaging the real buyers--employees

Many employers have begun moving toward health care consumerism strategies designed to encourage employees to take more responsibility for their health care and the cost of that care. Recent surveys suggest ways employers can ensure their consumerism strategies succeed in engaging employees and, ultimately, encourage employees to change their behavior. This article describes what those surveys reveal about employer and employee perspectives on consumerism and suggests steps employers can take to align their interests with those of their employees in order to manage the demand for and use of health care.     

Controlling human capital costs in the new millennium

Low productivity and high turnover can be more costly to employers than insurance premiums and medical claims. This article discusses the need for coordinated management of all behavioral health benefits. It provides two case studies that illustrate how such coordination can avert possible long-term costs and loss of a valued employee.     

The consumer-driven approach: defining and measuring success

Employers' reluctance to implement consumer-driven health plans (CDHPs) is at least in part due to their not understanding how to define and measure the success of CDHPs. To assist employers, the authors define potential points of success for CDHPs in the areas of consumer engagement, consumer financial considerations and employee health and productivity. They then offer ways of measuring success in those areas, as well as in the area of employer cost control. By taking a carefully considered approach to the decision of whether to offer a CDHP, employers can grasp potential opportunities to control health care costs.     

HIV and AIDS--employers grapple with difficult issues

HIV infection and AIDS pose special challenges to employers. Myriad laws affect how the employer must respond when an applicant or employee is infected with HIV or is ill due to AIDS. An overall compliance strategy should include thorough knowledge of those laws and a policy on HIV and AIDS, put in place before a crisis occurs.     

Communicating the new benefits deal

Communication is critical to changing employees' attitudes toward increased responsibility for benefit decisions and health and wellness. As employers shift responsibility, they not only must provide the right decision-making tools; employers must also maintain a safety net for those who don't want the responsibility. This article discusses the experience of four organizations that implemented the "new deal" of increased employee responsibility while also balancing employee needs.     

A review of ethical considerations in benefits planning

The rising cost of employee benefits and ongoing pressure to improve existing benefits is forcing employers to make difficult decisions. Most employers are truly concerned about the welfare of their employees and attempt to make these decisions in an ethical manner. This article offers practical advice on maintaining an ethical perspective, which the authors contend is necessary to maintain when facing these challenging responsibilities. The article identifies the various stakeholders as well as the necessary steps to consider when attempting to make an ethically sound decision involving employee benefits.     

Medical records: information gathering and confidentiality

This article focuses on protecting the confidentiality and privacy of workplace medical records. All employers should be concerned about the potential legal liability for unauthorized and improper disclosure of confidential employee medical data. Employers should adapt and follow a corporate policy governing the use and maintenance of confidential employee hiring, benefits, personnel and medical information. If there is any question concerning the confidentiality of records, employers should consult with legal counsel or other outside advisers.     

Engaging employees in health care can contain costs and improve quality

Employers need to do much more to change some of the deep-seated employee attitudes and behaviors that are driving health care costs. This article debunks common employer misconceptions about employees' attitudes and behaviors with regard to health care. It then discusses the results employers can obtain by taking specific initiatives that provide employees with the motivation and resources they need to effectively manage health risks and make informed health care decisions.     

Cash balance pension plans: A case of standard-setting inadequacy

Accounting for and ownership of U.S. private employee pensions has long been a controversial and politically contested terrain. The uniqueness in the U.S. of using employers as the principal provider of pensions makes the reporting of pensions more problematic since the corporate employers providing pensions are not strictly accountable to only the pensioners. Over the last quarter century there has been a marked swing in power toward management and away from employees making it possible for increasing numbers of U.S. companies to switch from conventional defined benefit plans to cash balance plans. This paper provides a “case” study of how accounting standard-setters framed the pension reporting problem vis-à-vis how they frame the “reporting problem” in general. Utilizing various sources of commentary about the phenomenon of cash-balance conversions, we triangulate on the pension problem to demonstrate how current FASB disclosure rules fail to satisfy the condition of neutrality and how those rules have facilitated the shifting of economic risk from shareholders to employees.     

Health Benefit Downward Rigidity: Employers’ Responses to Rising Insurance Costs

The article examines employers’ responses to rising insurance costs using Census Bureau Medical Expenditure Panel Survey–Insurance Component data from 1997 to 2005. The findings confirm that employers did not take dramatic actions to reduce benefit in response to the rising insurance cost during our study period. Most employers did not drop health insurance coverage, reduce workers’ eligibility for insurance, or substantially scale back their health insurance coverage. Instead, companies controlled the insurance cost in more subtle ways by adopting cost‐efficient health plans and requesting employee contribution to the insurance premium and out‐of‐pocket expenses for medical treatments. Our results show that the effect of those tactics was limited. The share of employee spending did not rise along with the growth of insurance premiums. Employers absorbed a large portion of the increased insurance cost.     

The mental health paradox

The authors review the evidence that mental health coverage pays for itself by reducing overall health care costs, satisfies and helps patients who receive it, reduces employee absenteeism and improves employee functioning. They then explain the factors contributing to the decline in mental health services valuations and what employers can do to minimize them.     

Facing the new facts of retirement income adequacy

A range of new factors is responsible for the current problem with insufficient retirement resources. Changes inside and outside the organization share partial responsibility, as do employee behaviors. In addition, other factors simply have been overlooked as employers and employees think about retirement income adequacy. The authors describe the current situation, discuss the significant risks it creates for both employers and employees and advise employers on what they should do to help employees build a more secure future in retirement.     

An investigation of internal marketing and its effects on employees in the banking sector in Saudi Arabia

A survey of the impact of internal marketing on perceptions of organizational commitment to employees and employee identification with their employers was conducted among a convenience sample of Saudi Arabia banking employees. The results indicate that internal marketing impacts perceptions of organizational commitment to employees (PBCMT), and rewards, employee empowerment and PBCMT impact employee identification with the organization (EBID). In addition, PBCMT partially mediates the internal communications – EBID and employee empowerment–EBID relationships, and it fully mediates the training – EBID and rewards–EBID relationships. Research and managerial implications are discussed, as are limitations and suggestions for future research.     

How aware are employees of their benefits? Findings from two companies

This study examines benefit awareness of employees in two companies. Contrary to previous research, the results show that employees are generally accurate in their perceptions of the benefits available to them. However, the results also show a lack of awareness of unemployment insurance and disability insurance as benefits. In addition, employees were somewhat uncertain regarding costs of benefits to employers. These findings suggest that employers should monitor employee awareness of benefits and target communications to specific problem areas.