The Republican lawsuit targets reinsurance that helps insurance companies provide universal coverage without accounting for pre-existing conditions.
SPOTLIGHT: EMPLOYEE BENEFITS
If you have employer-sponsored benefits, then you know this process all too well:
There's the annual notice about open enrollment, the group meeting with human resources and the thick packet that explains your options. You'll make your selection, return the forms and maybe not give it a second thought until doing it all over again next year.
It's an area that Dani McCauley has lived and breathed for more than 25 years as a benefits specialist So she also knows it can be "the driest subject on the planet."
"It's a tough topic," said McCauley, the executive vice president of sales and marketing for Univers Workplace Solutions, a Hammonton-based employee benefits firm. "You may as well be talking about oil and gas."
Tough or dry as it may be, experts say employees are searching for answers more than ever before, as they grapple with higher out-of-pocket costs and a sudden abundance of options under the Affordable Care Act. So when it comes to benefits, employer-toemployee communication and education are all the more important.
"Employees are asking, 'What does health care reform mean to me?"' McCauley said, so for a company that plans to continue offering health care, it's critical to "give an employee enough education without overburdening them with details."
McCauley said that since Jan. 1, many employees have found themselves paying more when visiting the doctor. That's because businesses are turning to higher-deductible plans as a way to keep premiums down, as required by the law, while eliminating traditional options such as preferred provider organization or PPO plans.
Those employees may have been warned months earlier during open enrollmentand there's been no shortage of news about health care reform - but McCauley said many didn't quite grasp the impact until that first visit of the year.
"So employees are raising their hands at a really elevated level," she said. "And it's ... creating a bit of a panic with HR because it can't answer all of the questions."
It's a far cry from past years, she said. Employees are accustomed to getting an envelope with their benefits information once ayear, and "maybe if you're lucky, there will be one meeting that... you'll all go to and somebody will go through all the benefits."
But employees only care about a portion of the content, McCauley said, and the ACA has made the options increasingly complex. So it's now better for employers to "(make) tools and resources available" weeks or months before an employee has to make a decision.
Joseph Torella of HUB International, a benefits brokerage and consulting firm, said employee education has become more important than ever because changes in health care policy "are so rapid and so misunderstood - and sometimes presented in the media in a way that doesn't make it clear to employees what they should be doing."
But it's also hard for "employers to do all the things that they need to and also continuously meet with employees."
So HUB offers its clients the option to hold meetings throughout the year, with sessions that focus on alternatives to traditional plans, along with classes and forums to ask questions well before the open enrollment period, Torella said. For employers, it's a balance between spending more on consultants and "(wanting) your employees to make better, smarter, more informed decisions."
"We really try to help people make very, very good decisions," said Torella, HUB's Northeast president and head of its employee benefits national practice. "It doesn't always happen, everybody is not always happy, but we find that the bulk of employees feel really good when you go through that process because you've introduced it so often."
McCauley said transparency should be a top priority for employers going forward. That means helping employees understand that health care is as much about out-of-pocket costs as it is about their premiums.
"From an education standpoint ... employees will be better health care consumers if they understand that," she said, equating it to price-shopping and trying to find good value when buying a television. "Historically employees haven't thought about health care that way, and if you really educate an employee on the total cost of health care, they will."
And for firms that will continue offering health care and meet the ACA's requirements, McCauley said another priority is to let employees know "we've got you covered." That would "alleviate a lot of panic from employees" and save them the time of looking on exchanges.
Those efforts are taking place as employers fret over compliance with the ACA, said Colleen Coyle, the group benefits practice leader for Brown & Brown Metro Inc. Aside from new reporting requirements by the 1RS and mandates for enhanced coverage, businesses must distribute a host of employee notices ranging from benefits summaries to advance notices of any changes they plan to make.
But keeping employees in the loop about the law is every bit as important, said Coyle, whose firm is based in Florham Park. Whether it's dispelling misconceptions about Obamacare or helping employees get the most value from their selections, communication "for us, has taken on a life of its own."
That can require many different platforms and a year-round approach, especially "when you have a population that's not working in an office or is all over the country," Coyle said. Education now entails webinars, videos and other technology along with face-to-face meetings, on-site counselor visits and literature around the office.
And communication doesn't always have to be about teaching your employees about the law, Coyle said. If a company is absorbing the added costs to help keep their benefits competitive, there's no shame in broadcasting that to the staff.
"The truth is that if a company is paying more money so an employee can get preventive care for free, they want the employee to know that," Coyle said. "That's a great thing."
Communication is key
Univers Workplace Solutions has taken steps to meet the demand for increased education and communication to its clients' employees. Last fall, the company had more than 1,000 seats at its benefits call center, more than double the size from five years ago, McCauley said.
And, starting in 2012, it moved to ensure its counselors were "educated to educate," launching a nearly two-year training and certification program for anyone who deals with clients.
"We had to figure how (to) make sure that they're telling the right story," McCauley said. "We wanted to make sure we broke it down into the most simple, straightforward message possible to allow an employee to really walk away understanding how health care reform really affects them."
She noted that in 2014, Univers' business "has been explosive in the best of ways" because clients are asking them to help educate employees, ensure they're compliant and boil down the complexities to their simplest form without overwhelming their staffs.
Want better service? Pick a different time to choose your plan
Everyone knows that fall is benefits season - the time when countless companies have their open enrollment for employees to pick their benefits for the coming year.
But if you want better service from your insurance carriers and their partners, pick another season.
So says Dani McCauley, an executive vice president with Univers Workplace Solutions. She noted that around 80 percent of employers have a Jan. 1 effective date for their health plans, meaning the vast majority of open enrollments nationwide happen in September, October and November.
"Think about how much activity is condensed into a couple of months of the year," McCauley said. "If you could move your plan anniversary date, you would immediately see an improvement in customer service."
So, what would happen if your effective date was July 1?
"A company could give an employer their best 'A' team in April, whereas in November there are only so many A teams out there, and you've got to go to B and C," McCauley said. "So the quality of customer service is dramatically improved if you can get outside of the rush."
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