Give Employees a Shot at Good Health

The telltale signs of autumn have arrived for many in the U.S. The temperature is cooler, the leaves are changing color — and the sounds of sneezes and coughs echoing through the office hallways may not be far behind.

The fall months traditionally serve as a time to promote flu prevention, and employers can play a key role in keeping their workforce — and their entire community — healthy as winter approaches.

Recent research by the Centers for Disease Control and Prevention notes that 13 percent of the population gets sick from the flu bug in an average year, with nearly 20 percent (62 million people) being infected during an active flu season, according to a PLANSPONSOR report. For U.S. businesses, loss of productivity from flu-related illness can cost more than $10 billion, according to several studies.

For employers, the highly contagious influenza virus can be especially dangerous because many workers try to “tough it out” and come to work when ill, a new poll finds. Seventy percent of employees admit they’ve gone to work sick, according to a Staples Advantage survey reported by PLANSPONSOR. These workers can pose a serious risk to the rest of the workforce by spreading sickness and may worsen the effects of a rough flu season.

If employees get ill, the company should provide them time off to encourage them to stay home and recover fully, said Alan Baker of the American Public Health Association in a recent BNA report. This is especially vital for companies with employees who interact in person with the public, Baker said.

Another key asset in combatting a flu outbreak is to prevent it from happening by promoting vaccinations and making them convenient, Roslyn Stone of Corporate Wellness Inc. told BNA. The best course of action, Stone said, involves creating a free, on-site clinic and allowing workers to get the vaccination on company time.

Healthcare of Arizona, has aggressively promoted flu shots with positive results, according to the BNA report. Marianne Young and Marcia Hick, who chair the company’s flu committee, said their program achieved a staff immunization level of 49 percent last year. About 30 percent is considered a good rate, according to Stone.

“This is the secret,” Hick and Young wrote BNA. “We go to the employee. Even in our health care centers, we have carts travel from department to department, or set up in a convenient location. There is no cost. Wait times are usually less than five to 10 minutes.”

If an on-site clinic is not feasible, Stone suggests mailing “flu gift cards” that allow workers to get the vaccination off-site at a time of their choosing.

Unfortunately, flu clinics cannot stamp out the risks entirely. Experts suggest promoting a few other healthy habits among workers, such as:

Using hand sanitizers and washing hands frequently.

Cleaning work areas, including keyboards. The Staples study noted that only 15 percent of employees clean their work area at least once a day, and less than 10 percent said they used disinfectants to clean their surfaces.

Appointing someone to be a “flu champion” who can educate their fellow workers and drum up participation rates for vaccinations.

Making managers lead by example. If they get sick, they should stay home, as well.

Sweating The Details: Health Reform Supporters Fret Over HHS Rules

PubliBehind the scenes, however, some worry that they are losing a few key battles to the insurance and business communities.

They point to a long-sought provision in the law that entitles patients to an external review if an insurer won’t pay for a medical service, but charge that recent regulations limit its effectiveness. One of their biggest gripes? It allows insurers to choose their own “external” reviewers.

“Advocates who have dealt with the external review process believe that it’s pretty clear that if [a reviewer] is being chosen by an employer [or insurer] it’s not independent,” said Timothy Jost, a professor at Washington and Lee University School of Law.

While consumers should be happy with some regulations, including one requiring health plans to summarize in simple language what their policies cover, Jost notes that other rules “feel like somebody from the Chamber of Commerce got to somebody in the administration.” He points to regulations that he believes are “more friendly” to employers and insurers than to individual consumers.

Erin Shields, a spokesperson for the Department of Health and Human Services, said the administration is balancing multiple interests as it implements the law. “The Affordable Care Act provides some of the most important protections for health care consumers in history,” Shields said. “As we implement these protections, we are working to ensure a balanced approach toward all stakeholders including patients, caregivers, doctors, hospitals, employers, and insurers to ensure that our system continues to provide world-class care effectively.”cly, consumer and patient advocates continue to cheer wildly for last year’s health care law.

By Mary Agnes Carey and Marilyn Werber Serafini

Most popular employee benefits identified

In a time of muted pay growth, a survey has identified the most popular employee benefits extended to UK workers.

Chief amongst these is a pension scheme, followed by healthcare provision and a salary sacrifice scheme, the Chartered Institute for Payroll Professionals (CIPP) have found.

“With pay rises few and far between the overall remuneration package is of vital importance to ensure employees feel valued,” commented Diana Bruce, Senior Policy Liason Officer at the CIPP.

“An employer may not be in a position to provide a bonus or pay rise but they can certainly help their employees by providing benefits such as a good workplace pension scheme where both the employer and employee can save on tax and National Insurance Contributions.”

With the introduction of automatic enrolment next year it is very encouraging to see a high percentage of employers already offering a pension scheme, the CIPP note. Salary sacrifice schemes continue to be a popular benefit, however the government does make the administration increasingly difficult for employers; the changes to Employer Supported Childcare in April 2011 being a prime example.

Other employee benefits which were rated highly in the survey were membership body fees, childcare and a car allowance. The results were taken from 380 people surveyed across the country in all professions and sectors.

Good Wellness Starts From Bottom — and Top

Rising health care costs aren’t just a challenge for big companies with expansive health coverage. Small businesses are feeling the pinch of skyrocketing costs, as well. Yet many smaller employers still haven’t tapped into wellness programs to help ease the pain of year-over-year insurance increases.

A recent survey by, a free online wellness resource, found that 28 percent of smaller companies (with 10 to 99 employees) supported wellness programs or were in the process of starting one, compared with 78 percent of companies with 100 to 2,499 employees.

While cost is always a concern for small businesses when considering a wellness initiative, the study suggests that small companies simply are unaware of the real financial benefits of wellness, said Lisa Gable, executive director of the Healthy Weight Commitment Foundation, in a recent UPI report.

Only 20 percent of polled small businesses said they strongly agreed that wellness benefits exceed costs, compared with 38 percent of larger companies, Gable said. However, Gable cited a National Business Group on Health study that shows employers can gain as much as $3.27 for every $1 spent on wellness. “Smaller companies have an even greater stake in the health and productivity of their workforce than larger employers,” Gable said.

These programs don’t have to be expensive to be effective, especially if they are championed by employees themselves. The Atlantic Eye Institute of Jacksonville, Fla., wanted to start a wellness program but couldn’t afford an outside consultant. So, they tapped Rochelle Cordero, a staff member, to start and manage a wellness program for the entire practice, which has more than 30 employees. Cordero was excited about the program and happily took on the endeavor, according to a report by American Medical News.

Cordero took advantage of free and low-cost resources, such as The President’s Challenge, which aims to increase participants’ physical activity. She also started a smoking cessation initiative and a lunchtime walking program. Under her direction, the practice also started supplying jump ropes and weights for staffers to use during breaks.
The practice is a strong example of how a small company can use internal resources to kick-start a wellness initiative that can save employers money and improve employees’ well-being.

“Any small company can do wellness for a low cost,” Fiona Gathright, president of Wellness Corporate Solutions, told American Medical News. “This is not something that has to cost a lot of money.”

While support from the rank-and-file can elevate a wellness initiative, leadership from the employer is key to any program’s ultimate success, experts say. Take Borislow Insurance Agency Inc. in Massachusetts, an independent employee benefit advisory firm and a United Benefit Advisors member with 26 employees, which started its own wellness program to serve as an example for its clients.

The addition of a new on-site gym — including access to personal trainers — is a testament to the commitment that the firm’s leaders have made to wellness.
“We have a leadership team that supports all of our initiatives, not only financially but really participate and are in there on a daily basis encouraging us to be as healthy as we can be,” said Karen L. Kelly, the firm’s director of health and wellness, in a recent Boston Business Journal report.

Experts: Don’t Overlook Disability Benefits

Rising health care costs and a tough economy can make health care benefits a primary focus for employees during benefit enrollment time. But experts advise that income-protecting benefits, such as life and disability insurance, deserve some attention, as well.

According to a new report by Prudential, workers are expressing interest in life (83 percent), disability (66 percent) and long-term care insurance (21 percent) this enrollment season.

“While the life insurance enrollment rate is reassuring, many Americans are not electing sufficient coverage to maintain their families’ standard of living in the event of an untimely death, or taking the time to really think through their benefit elections,” said Lori High, president of Prudential Group Insurance, in a report by

Disability can be a particularly hard sell for employers because many workers think they’ll never need it, experts say. A disabling condition, however, can spring from more than a fall at work, Barry Lundquist, president of the Council for Disability Awareness (CDA), told Kaiser Health News. While many people assume accidents are the main cause of disability claims, 90 percent of all claims actually stem from illnesses, including musculoskeletal conditions and cancer, Lundquist said.

The CDA noted in a 2010 poll that 30 percent of Americans entering the workforce today will become disabled before they reach retirement. Only about a third of American workers have some sort of disability insurance, Lundquist said.

Unfortunately, fewer employers these days are offering the benefit, according to a LIMRA study published by KHN. Only 47 percent of employers offer long-term disability benefits, the study found. Of those companies that offered coverage in 2010, only 37 percent paid the entire premium, a decrease from 49 percent in 2002. When employers don’t pay any of the premium, only 40 percent of workers elect the benefit, Lundquist said.

The need for disability coverage will continue to grow as the U.S. workforce ages, experts say. By 2050, people over the age of 60 will outnumber those in younger generations, according to a news report by the Society for Human Resource Management.

“Workplaces must be ready to accommodate these employees, or there will be more disability claims,” said Susanne M. Bruyere of Cornell University in a recent webinar.

While Bruyere said companies shouldn’t make broad assumptions about the health and productivity of older workers, she noted that statistically the rates of disability increase with age.

Bruyere called for better education of employers about how they can make accommodations for the disabled and aging. She also suggested that employers examine their policies and procedures to ensure that they can accommodate these workers.

‘Best Companies’ Take Collaborative Approach to Benefits

Over the past decade, the “best” U.S. companies have adapted their benefits offerings to meet changing employee needs, according to The Principal Financial Group’s annual 10 Best Companies for Employee Financial Security competition.

The program honors growing companies (with five to 1,000 employees) for their commitment to outstanding benefits. The 2011 winners exemplify three major transformations that have taken place over the last 10 years, according to The Principal Financial Group, an employee benefits provider. These trends are:

• Shifting from do-it-for-them to do-it-with-them. As benefit programs have shifted from the employer making most decisions to employees facing more choices and taking personal financial responsibility, the “best companies” continue to share significantly in the cost. They engage employees through collaboration and strong education to help them make the best use of their benefit dollars.

All winners provide employer-paid one-on-one meetings with benefits specialists and financial professionals to help employees make informed benefit decisions. Companies use a wide range of methods to reach employees, from payroll stuffers to webinars. Employees are encouraged to help run benefit programs.

• Changing from cookie cutter to customized. The last decade witnessed a significant trend toward customized benefit programs tailored to specific employee needs and demographics. Winners actively designed their programs to engage employees, targeting young workers (with 529 tuition-savings plans, adoption insurance and mortgage assistance) and older workers (with 100-percent-paid long-term care insurance and phased retirement), for example.

In addition, “best companies” actively engaged employees in helping to shape benefit programs, using employee surveys, focus groups and employee committees to understand their needs and wants. Most offer flexible scheduling to accommodate changing life stages.

• Viewing security as financial and physical. “Best companies” use a holistic approach that ties financial security to an increased focus on wellness as a way to lower health care costs for both the company and the employee. Winners recognize reducing financial and health stress leads to greater engagement and higher productivity, which ultimately leads to a stronger bottom line. In addition, winners are more likely to offer biometric screenings, health risk assessments and health coaches, and to reward employees for making healthy choices by tying medical insurance premium discounts to wellness participation and offering health savings accounts or health reimbursement arrangements.

Nov. Webinar: Wellness Programs and Compliance

The Latest on Wellness Programs: What Can Employers Legally Do to Increase Participation?

Tuesday, Nov. 8
2 p.m. ET / 11 a.m. PT

Employer wellness programs are now a part of the benefits landscape. And employers that have tried the “soft” approach to implementing these programs (e.g. health risk assessments and biometric screenings) are now looking for ways that they can actually improve the wellness of their employees. That means greater incentives to participate in wellness programs — and sometimes even penalties for refusing to do so.

At the same time, employers are constantly reminded of the legal constraints they face in attempting to increase the level of wellness program participation. In this webinar, we’ll summarize those constraints and offer concrete examples of steps employers have taken to raise the participation level in their wellness programs. We’ll also look at some of the wellness-oriented provisions of last year’s health care reform legislation.

Kenneth A. Mason, Partner – Spencer Fane Britt & Browne LLP
Ken heads the Employee Benefits Group. He concentrates on ERISA and other aspects of employee benefits law, including tax and fiduciary issues, retirement and welfare plans, executive deferred compensation, federal employment discrimination statutes and issues unique to governmental and other tax-exempt employers.

Julia M. Vander Weele, Partner – Spencer Fane Britt & Browne LLP
Julia practices in the Employee Benefits Group and is a member of the ERISA Litigation Group. Prior to Spencer Fane, Julia was in-house counsel for Fortis Benefits Insurance Company, where she managed ERISA litigation and advised senior management on ERISA issues.

Please contact us if you’d like to register for this webinar or if you have any questions.

Note: This webinar event has been submitted to the Human Resource Certification Institute to qualify for 1.5 recertification credit hours.

Ready, Set, Enroll: Employer Efforts Can Boost Morale, Compliance

Many employers and benefit managers with calendar-year plans are wading into the thick of enrollment season, filling their time with employee meetings and tracking the sign-ups. Enrollment, however, can be more than just presentations and forms — it can serve as a great opportunity to reconnect and communicate to employees the value of their compensation and benefits, experts say.

“In this difficult economic environment, there may be many reasons employee morale has not bounced back,” said Bill Dalicandro, vice president at Unum, in a recent report by the Society for Human Resource Management. “But our research shows that benefits education can be a highly effective, low-cost way to boost engagement.”

A study by Unum, however, suggests that many employers are missing the mark when it comes to enrollment communication. Data from the 2010 enrollment season show that nearly a third of workers said the benefit education materials from their employer was inadequate. Only about half of employees said they received printed materials about their benefits, the survey found. Slightly more than a third of poll respondents said their company sponsored some kind of question-and-answer session about their benefits.

To get the most out of enrollment, employers need to start with a plan, according to a recent article by Robert Ellerbrock of Constangy, Brooks & Smith, LLP. Ellerbrock suggests employers create checklists of all tasks and make sure they have enough time to train any staff members who would be responsible for answering employees’ questions.

Ellerbrock said employers should try to announce benefit meetings about three or four weeks in advance and should consider individual meetings, if that is possible. He warned employers about using electronic materials to promote benefit education. “Many employers find the idea of electronic enrollment appealing,” Ellerbrock wrote. “However, it is important to remember that providing benefit information electronically is subject to significant regulations.”

In addition to fostering morale and worker satisfaction, enrollment serves as a good time to distribute required employee notices.

Mary Bauman of the law firm Miller Johnson recently highlighted a number of notices that should be considered for an enrollment packet:

Women’s Health and Cancer Rights Act: This is an annual notice that can be issued as part of a summary plan description (SPD), as long as the SPD is reissued each year.

HIPAA: This notice, to be distributed every three years, explains an employee’s health information privacy rights.

CHIPRA: (Children’s Health Insurance Program Reauthorization Act). Employees have the right to enroll in an employer’s health plan if the participant becomes eligible for a state premium assistance subsidy under Medicaid or the CHIP.

PPACA Grandfathered Status: Employers with plans that are exempt from the Patient Protection and Affordable Care Act because they are grandfathered must notify participants of that exemption and must include contact information for questions.

Posted by UBA

Healthy workers are a benefit

For many employees, November is health care enrollment month. In recent years, re-signing has meant an increase in out-of-pocket expenses, higher premiums and deductibles, and/or less coverage — and sometimes all of the above.

The rising cost of health care affects not only the take-home pay of workers but the bottom line for companies. “It’s the gorilla in the room that is breaking the bank,” said Dave Rearick, medical director at gBehavior, an incentive-based behavior management firm. PricewaterhouseCoopers’ Health Research Institute predicted that corporate medical costs would rise 9.9 percent in 2008 and 9.6 percent in 2009. “Health care costs have become a top concern for CEOs,” Rearick said. “For manufacturers it’s usually a company’s third-greatest cost after labor and materials; for a service firm, it can be second, after compensation of employees.”

For the last decade, the trend has been to shift some of the cost to employees via higher premiums and co-pays or less coverage. “If the premium or cost of using the insurance becomes too high, of what value is the benefit?” Rearick asked. “The best way to control cost is to decrease utilization. It’s a lot cheaper to keep a well person healthy than [treat] a sick one. A healthy work force is a competitive advantage.” With chronic illness accounting for 75 percent of health care costs, organizations are beginning to integrate wellness programs, prevention education and disease management strategies into their benefit packages.

Surprising savings

“Seeing employers make innovative changes aimed at prevention and wellness instead of just shifting costs around is like a breath of fresh air,” said Nancy Kennedy, executive director of Northwest Georgia Healthcare Partnership. This not-for-profit organization, whose members include the city of Dalton and Hamilton Health Care System, is dedicated to improving the health of residents in Murray and Whitfield counties.

The organization was chosen to participate in the Diabetes Ten City Challenge in 2007, an initiative to teach employees with diabetes how to take better care of themselves. Based on the successful Asheville Project (1997) that has become a model for diabetes care by reducing payer costs and improving employee health, the challenge was sponsored by the American Pharmacists Association Foundation and funded by GlaxoSmithKline and participating employers.

“We had four employers with a total of about 5,000 employees, out of which about one in eight had diabetes,” Kennedy said. “When a patient gets into care, you’d think the health care costs would increase, but actually the opposite happens. The medication costs increase, but hospital, doctor and emergency room visits caused by uncontrolled symptoms and complications go down. We saw the cost per participant decrease by $1,460 in the first year.”

Employers paid for the medication and doctor visits of diabetic employees who agreed to meet regularly with a pharmacist trained in diabetes education. The pharmacist tracked the patients’ glucose levels and showed them how to make healthy changes to their lifestyles. Face-to-face consultations were key in getting people to take responsibility for managing their disease, Kennedy said.

By Laura Raines

Watch for dramatic declines in employer-provided health insurance

By John Barrasso
Most American workers value their employer-provided health insurance. It gives them the security of knowing they can get the care they need, from the doctor they want, at a price they can afford.

All that will change drastically if the president’s health care law remains on the books.

That’s not just a warning from a conservative Republican — the administration’s own chief actuary of Medicare estimated that more than 14 million people would lose their employer coverage during the next eight years.

Even some of the administration’s most ardent supporters are starting to complain. The Service Employees International Union, or SEIU, is on record as saying it would be “financially impossible” to follow this law.

In a study co-authored with my colleague, Sen. Tom Coburn, R-Okla., we reported the disturbing fact that more than half of all employers could have to stop offering employee health benefits altogether by 2013.

A June study by McKinsey and Co. concluded that 30 percent of employers would definitely cease offering employee benefits altogether by 2014.

That same study showed that among those employers who know how the law will affect them, as many as 50 percent could drop out.

The Obama administration already has handed out waivers exempting more than 3 million Americans from the law’s mandates. About half have gone to people who get their health insurance through unions like the SEIU.

If the terms of this onerous law now are “financially impossible” to meet for unions, why did they lobby for it in the first place?

And, more important, why can’t all Americans get waivers, too?

The answer to both these questions is that the new health care law is designed to ultimately end employer provided coverage altogether.

Under the law, businesses are permitted to drop out of paying for employer-provided coverage so long as they pay a fine of $2,000 per employee.

This number is far smaller than the $15,000 it costs businesses to provide family health benefits to each of their employees.

Small businesses face an even clearer incentive to drop coverage for their employees. They are not required to pay this fine for the first 50 workers who lose coverage.

And where are those workers supposed to go?

The new health care law has set up health care “exchanges” for them to enter.

These “exchanges” are shorthand for insurance markets where as much as 80 percent of the cost of a family’s insurance could be borne by taxpayers.

Under these circumstances, the natural response is for businesses to drop coverage for their employees altogether and simply offer them less expensive cash benefits.

Meanwhile, the employees will have to replace the coverage they like with a plan Washington mandates.

The really bad news for taxpayers is that the annual cost of providing these huge subsidies — about $900 billion — is more than nine times what the White House is willing to admit.

This is because the estimates Washington uses to claim this law is “deficit neutral” assume that no employers will drop coverage at all, even though it is clearly in their financial interest to do so.

The facts are clear. The health care law takes away the coverage that Americans have and will drive America further into debt.

It is bad for patients, bad for providers and bad for taxpayers. I am working to repeal and replace this law with patient-centered reforms.

Americans want high-quality, affordable health care coverage. The president’s health care law doesn’t come close to achieving that goal.

Sen. John Barrasso, R-Wyoming, is an orthopedic surgeon.