Smooth Sailing: Prepare For Open Enrollment Now

Open enrollment can overwhelm even the most seasoned benefits manager. But the time when employees can make changes to their benefits plans doesn’t have to be a time of stress. In fact, open enrollment is a great opportunity to introduce new tools and resources to a captive audience, and it’s the perfect time to help employees become better healthcare consumers all year long. Here are some tips for making the best of your open enrollment season.

• Focus on communication. Change is a big deal, so you need to develop and implement a strategy early to prepare employees for what’s coming. Employees need time to digest information, and you need time to reinforce it on a regular basis. Deploy a “multi-channel” communications campaign spread over time. Use a strategic combination of print, Web, email and face-to-face communication at open enrollment meetings to drive a consistent message. While it’s important to communicate thoroughly and introduce new ideas, don’t overload employees. Strike the right balance in what, how and when you communicate.
• Anticipate a rush. The most diligent of employees will call on the first morning open enrollment begins. Plan accordingly by having the necessary staff in place to anticipate an upsurge in calls. But don’t slack off, because 75 percent of all enrollments are done in the last three days, due to procrastination.
• Select reasonable enrollment deadlines. Make sure you’re giving employees reasonable business-related deadlines, such as a Wednesday at 5 p.m. EST. This approach will also give you the opportunity to remind them the day before and reduce the likelihood of a last-minute stampede. Setting deadlines on a Friday, a holiday or at midnight will only invite problems.
• Be available. Even if you have provided self-service options, people still like to talk to a live person during open enrollment. Set up and review a set of FAQs that cover what are likely to be common questions.
• Personalize. People relate much better to examples relevant to their situations than to abstract concepts. It helps to provide testimonials from other people in similar circumstances or to offer tools that allow employees to model and make decisions based on their own circumstances.
• Be honest and direct. Are costs increasing? Benefits shrinking? Be frank. At a minimum, ensure employees fully understand the “5 C’s of enrollment”— cost, coverage, changes to plans, comparisons to the previous year’s plans and current options. Be clear with employees on the actions they need to take.
• Expect “pushback.” In response to continued double-digit healthcare cost increases, you may be preparing to communicate aggressive health benefit changes to employees. If so, expect noise. Think of it this way: If all is quiet, you haven’t done your job.

Collect the wisdom

This year’s enrollment information can help you properly plan for the next open enrollment period. Did the HMO gain in popularity? Did employees sign up for plans that offered more choice? What were the questions, snafus and bottlenecks? That’s powerful information for future action. Gather data to help you learn about employees’ desires and predispositions — by job title, region, etc. — as well as to determine what your team can do better next time.

Smart Tip: Move Open Enrollment Dates

If the end of the year seems like a hectic time to prepare for open enrollment, consider moving your health plan’s start date from January 1 to another time of year, such as March 1. This can help avoid open enrollment rush as well as potential delays at the underwriting department of your insurer.

The Hidden Dangers of Shift Work
The Bureau of Labor Statistics reports that about five percent of American adults work in the evening. Permanent night workers and workers with irregular schedules make up another four percent. Still another four percent are rotating shift workers. These 15.5 million people face a higher risk of workplace injury. Read on to learn more about the hazards of shift work, and how you can minimize them.

The Occupational Safety and Health Administration considers a “normal” work shift one that lasts “no more than eight consecutive hours during the day, five days a week with at least an eight-hour rest. Any shift that incorporates more continuous hours, requires more consecutive days of work, or requires work during the evening should be considered extended or unusual.”

Individuals working outside these “normal” work hours have a much greater chance of experiencing a fall, fracture or laceration at work, found a 2004 study of Texas workers’ compensation injuries. Even when adjusting for different occupations and worker fatigue (individuals are more likely to be tired at the end of their shifts than at the beginning), the study found substantially higher injury hazards late at night than during regular daytime work hours.

Non-traditional shifts and extended work hours may disrupt the body’s regular schedule, leading to increased fatigue, stress and lack of concentration. These effects lead to an increased risk of operator error, injuries and/ or accidents.

This happens because body rhythms (also called circadian rhythms) tell night workers to be asleep at night. Night workers also must sleep during the day, when their circadian rhythm tells them to be awake. Because of this, day sleep is short and feels “light” or unsatisfying. Often, night workers don’t get enough sleep during the day to combat nighttime fatigue and sleepiness.

Those who work extended shifts also have problems, even if they work predominantly daytime hours. OSHA reports that working shifts longer than eight hours will generally result in reduced productivity and alertness. People who work an 8-hour shift will have 16 hours left in a day to do everything else, and also to get some rest. People who work a 12-hour shift have only 12 hours to do everything else and to rest. The extra work hours mean more tiredness and less time for rest.

What Employers Can Do

OSHA currently has no specific standard for employees working extended or unusual work shifts. Still, employers should be aware of the special safety challenges shift work creates.

When there is a choice, managers should limit the use of extended shifts and increase the number of days employees work. When there is no choice, the following steps can help minimize fatigue and the chance of accident:

• Learn to recognize the signs and symptoms of fatigue. These include weariness, sleepiness, irritability, reduced alertness, lack of concentration, lack of motivation, increased susceptibility to illness, depression, headache, giddiness, loss of appetite, and digestive problems.
• Monitor night and extended-shift workers diligently for the signs and symptoms of fatigue. Any employee showing such signs should be evaluated and possibly directed to leave the active area and seek rest.
• Provide additional break periods and meals when employees work night or extended shifts. In addition to formal breaks such as meal breaks, encourage the use of micro breaks to change positions, move about, and shift concentration.
• Schedule tasks that require heavy physical labor or intense concentration for the beginning of the shift if possible.
• Make efforts, whenever feasible, to ensure that unavoidable extended work shifts and shift changes allow affected employees time for adequate rest and recovery. Extended shifts should not be maintained for more than a few days, especially if they require heavy physical or mental exertion.
• Allow permanent night and shift workers time to acclimate to their schedules. Studies suggest that it can take up to 10 days to adapt to a nighttime work schedule.
• Monitor and limit exposures to hazardous chemicals or substances. Working extended shifts may prolong exposure to hazards, which could exceed established standards.

For more suggestions on improving the safety of shift and other workers, please contact us.

Sources: National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA)

Enhance Your Benefit Plan with Cancer and Dread Disease Insurance
Cancer now accounts for about 10 percent of all healthcare costs in America. And one in three Americans will receive a cancer diagnosis in their lifetime, according to the American Cancer Society. With many Americans uninsured or underinsured, no wonder the idea of low-cost cancer insurance holds appeal. But is it worth it?

By 2002, 32 percent of employers surveyed by the Society for Human Resource Management offered some type of cancer or dread disease insurance. Today, with more employers adopting high-deductible health plans or cutting coverage altogether, the appeal of limited benefit plans, such as cancer and “dread disease” insurance, is growing.

But do these plans make financial sense? They cover only limited conditions and often carry high deductibles. But today a diagnosis of cancer or other dread diseases often means dealing with a chronic condition rather than a death sentence. People with these conditions often face skyrocketing costs for chemotherapy. In addition, adjunctive therapies, those that ease chemotherapy symptoms, can cost as much as $10,000 per round of treatment. It’s no wonder that many people with cancer exhaust even catastrophic insurance policy limits.

The evolution in treatment of dread diseases, coupled with consumer-driven healthcare, demands new products. Current-day dread disease insurance owes its existence to Dr. Marius Barnard, brother of heart-transplant pioneer Dr. Christiaan Barnard. He invented the product to address the financial difficulties heart transplant recipients dealt with.

Modern dread disease coverage bears little resemblance to the cancer insurance marketed in the 1960s and ‘70s. Dread disease insurance offers coverage for heart attack; stroke; kidney failure; coma; coronary artery bypass; loss of sight, speech or hearing; major organ transplant; paralysis; severe burns; as well as several types of cancer.

The policies fall into two types, lumpsum payment and reimbursement. Under lump-sum payment policies, the beneficiary receives a lump sum for a covered diagnosis according to a policy schedule. Policy face amounts range from $5,000 to $100,000, but average around $20,000. Reimbursement policies pay on a per-event basis. Although these policies pay set per diem rates for hospitalization and recuperation time, they often cover items that are not covered by catastrophic health plans. For instance, some policies cover transportation and lodging for family members who transport a patient to see a specialist.

Underwriting is relatively lax for these policies. Workers who can demonstrate being cancer-free for ten years generally can find cancer coverage. Only extreme family histories, such as a parental death by stroke prior to age 60, preclude coverage under a cancer or dread disease policy.

“Sandwich generation” baby boomers appear to be the hot market for dread disease insurance. As they face their own health problems, they are often arranging care for elderly parents. They face hidden health care costs such as private duty nurses, transportation and lodging costs to see specialists, and uncovered, possibly experimental or off-label use of drugs. Aging boomers in particular face heightened risk of stroke and heart attack. Stroke rates for men 45 to 54 run about 2 percent. That figure doubles for men ages 55 to 64.

Dread disease insurance can be another benefit employers can use to help retain valuable baby boomer workers. Employers can offer it as either a paid benefit or voluntary (employee-paid) benefit. As a voluntary benefit, employees who opt to buy coverage enjoy group rates, which might be lower, along with the convenience of payroll deduction payment. For more information, please call us.

Prepare for New Healthcare Reporting on W-2s
For tax years beginning after December 31, 2010 the Patient Protection and Affordable Care Act requires all employers that provide health coverage to calculate and report the cost of that coverage on employees’ W-2 forms. This amount will not be included in employees’ taxable income. The law requires employers to report this information so the IRS can track the value of socalled “Cadillac” health plans, which will be subject to a 40 percent excise tax beginning in 2018. Employers must report the value of the following employer-sponsored benefits, whether provided through a fully insured or self-insured plan:

• Major medical coverage
• Amounts received under health reimbursement arrangements (HRAs)
• Employer contributions to a health savings account (HSA) or Archer medical savings account (MSA)
• Employer-provided Medicare Advantage plans
• The value of treatment from on-site medical clinics, except for “de minimis” care
• Limited benefit plans.

Employees’ salary reduction contributions to health flexible spending arrangements (FSAs) are exempt, as are stand-alone vision or dental insurance, long-term care insurance, hospital indemnity and cancer or “dread disease” coverage (if the employee pays with after-tax dollars), and accidental death and disability insurance.

Employers must calculate the value of coverage using rules similar to those that apply to calculating COBRA continuation coverage premiums. Although most employees will need their W-2s for 2011 in January 2012, employees who leave your employ before that can request their W-2s early. Therefore, all employers should be prepared to report this information on W-2s no later than February 1, 2011.

This Just In...

Ninety percent of companies surveyed expect to lose the grandfathered status of their health plan by 2014, according to Hewitt. The Patient Protection and Affordable Care Act exempts grandfathered plans from having to comply with only certain provisions of the law. Plans lose their grandfathered status by reducing benefits, significantly raising copayments and/or deductibles or changing carriers. Employers told surveyors they would most likely lose grandfathered status because of plan design changes (72 percent) or changes to subsidy levels (39 percent). They also cited consolidation of health plans (16 percent), changes to carriers (16 percent) and union negotiations (15 percent) as additional reasons.