Page 32 - Wire Rope News & Sling Technology - June 2019

continued from page 30 plans can backfire. “We’re seeing that
tracking which employees are signed many employees who select the least ex- Keep your employees well
up with which polices). But they offer pensive plans with the highest deduct- Every employer wants to increase
more choice and plan customization. ibles often avoid getting the medical productivity, reduce absenteeism, and
The private exchanges are most at- care they need because of the required boost workplace morale. One tool for
tractive to employers who want to re- out of pocket costs,” says Larson. “This doing all three: a wellness program.
duce internal administrative hassles. is a particularly serious issue with low “We favor what we call compre-
The exchanges often have technology wage workers who do not have the mon- hensive ‘well-being’ initiatives that
platforms that can provide a combined ey to pay high premiums and deduct- cover all aspects of the employees’
interface for reporting, billing, COBRA, ibles. The result for employers is often lives,” says Cheryl Larson, Presi-
and employee plan evaluation. a decline in productivity because work- dent & CEO of Midwest Business
Be aware, though, that such ex- ers may struggle with managing their Group on Health, a Chicago-based
changes are not panaceas. “We have health issues such as diabetes.” consortium of 125 employers of
helped several clients evaluate private Many states are setting up road- some 40,000 workers (mbgh.org).
exchanges, and we have consistently blocks to such plans, aware of their “We feel it’s the right thing to do.”
found them to be less favorable than limited coverage and fearing they will Do the programs pay off in dollars
other solutions,” says Jessica Du Bois, erode the strength of the ACA-mandat- and cents? “It is challenging to as-
benefits consultant with Business Ben- ed health insurance exchanges. sess return-on-investment (ROI),”
efits Group, an insurance brokerage out acknowledges Larson. “But the trend
of the D.C region that serves business- ASSOCIATION PLANS for many employers is to look at
es of all sizes (bbgbroker.com). “Market Yet another pathway to coverage value-on-investment (VOI). For ex-
data helps to reaffirm this, because less for smaller employers are association ample, the program might track how
than three percent of employers report plans. Severely limited by the ACA, many people actually change their
being in private exchanges. The reason these programs have gotten a new lease behavior. Are they taking their medi-
is that they do not seem to affect health on life from the Trump Administration, cations more regularly, or following
care costs, due to the expenses incurred in the form of Labor Department rules up with their doctors for treatments?”
by their administrative overhead.” expanding their legality. Although VOI is not a hard dollar
More information about private “Association plans let employers pool metric, employers can often judge
health exchanges can be found through within similar geographic locations or success by monitoring workplace
an organization called The Private Ex- industries,” says Du Bois. “I certainly productivity as people start focusing
change Evaluation Collaborative at understand their attraction. Spreading on health-seeking behaviors and ef-
THEPEEC.com. the risk over more people generally re- fectively managing disease. Bottom
sults in a lowering of premiums.” line: wellness programs can help ev-
CHEAPER PLANS Some four million people could be cov- eryone do their job better.
The Trump administration is at- ered by association plans in the coming
tempting to expand the insurance years, according to Labor Department some cases may open the door to fraud.
choices for smaller employers by cham- estimates. Federal regulations pro- For information go to dol.gov/gener-
pioning the availability of less costly hibit the plans from denying coverage al/topic/association-health-plans.
short-term policies, association health or charging higher rates to employees
plans, and more flexible health reim- with pre-existing conditions. But some HEALTH REIMBURSEMENT
bursement arrangements (HRAs). critics note that the plans are exempt ARRANGEMENTS
Employers with tight budgets may from many other consumer protections Finally, Health Reimbursement Ar-
be especially attracted to the short- detailed in the ACA. These include rangements (HRAs), another cover-
term plans which sometimes go under coverage of what the ACA deemed “es- age pathway blocked by the ACA, are
the rubric “fixed indemnity” and sport sential health benefits” such as mental getting a boost from the Trump Ad-
monthly premiums as low as $200. On health care, emergency services, ma- ministration. HRAs are tax-sheltered
the downside, such plans also come with ternity care, and prescriptions drugs. accounts, owned and funded by employ-
higher out of pocket maximums. And One problem with association plans is ers, from which funds are withdrawn
coverage is less comprehensive. “Bear that businesses with healthy individu- to reimburse employees for health care
in mind that a majority of such plans do als may end up subsidizing the steep they receive on the open market, includ-
not cover wellness visits, prescriptions, medical bills of others. “The reality is ing on the state public exchanges.
mental health and maternity,” says Du that association plans are not great fits Employers with fewer than 50 em-
Bois. A lack of prescription drug cover- for many companies,” says Du Bois. ployees can use HRAs to reimburse
age can be especially damaging, since “Economies of scale are only a significant employees purchasing insurance and
drug prices are rising much faster than advantage if you are the least healthy health care in the individual market.
other health care components. group in the association. If you have a These plans are called qualified small
Furthermore, there is often a ceiling healthy, engaged population, why would employer HRAs (QSEHRAs). “HRAs
on benefits. “I do not like plans that say you want to adhere to the risk of others?” can be a great option,” says Du Bois.
things in fine print like ‘we will cover Yet another potential problem is that “Some employers use them to self-
two days of a hospital stay if you need association plans may introduce costly insure a small portion of their health-
heart surgery,’ or ‘if you need chemo- administrative levels that may end up care. They increase their deductibles to
therapy, we will cover four visits,’” says bloating premium levels. save on premiums, then give employ-
Eastaugh. “The actual care takes a lot As is the case with short term plans, ees HRA funds to supplement a por-
more time than that. What is cheap is some state insurance regulators are block- tion, or all of the deductible.” These can
not always what is good.” ing association initiatives, fearful they will be especially valuable when a business
Employers, then, need to realize such undermine the state exchanges and in continued on page 78

32 Wire Rope News & Sling Technology June 2019