As health care reform compliance deadlines loom and the trend of individual accountability comes to the forefront, planning for this year’s open enrollment season is proving to be complex and confusing for plan sponsors nationwide, Mercer says.
To better ensure successful open enrollment outcomes, Mercer developed a short checklist for employers to follow as they design, implement and roll out their 2015 health benefit program offerings.
Think about offering a consumer-directed health plan, Mercer suggests. The momentum behind consumer-directed health plans (CDHPs) continues to grow, with 39% of large employers offering one in 2013 and 64% expecting to do so by 2016. (See “CDHPs Climb Ranks of Health Benefits.”)
Offering these plans and encouraging participants to enroll makes sense, Mercer believes, since these plans can:
- Reinforce individual accountability for health care consumption;
- Reduce costs for employers and often for participants;
- Assist in meeting the “affordable coverage” requirement mandated by the Affordable Care Act (ACA);
- Help employers avoid the 2018 Excise Tax (i.e. the Cadillac Tax); and
- Provide a compliant auto enrollment default selection.
Communicate early and often to the newly eligible as well as those that are not. The coming year, 2015, is going to be the big year for the employer shared responsibility mandate under the ACA. Mercer’s research indicates a third of employers still need to make changes to comply with the requirement to extend coverage to all employees working 30+ hours per week (10% have already done so; the rest were in compliance before the ACA).
Mercer is urging sponsors who have large “newly eligible” populations to start communicating right away about who is eligible, why they are eligible, how eligibility was determined, and what eligibility actually means. Information should also be delivered to those who still remain ineligible covering the options these employees may have in the public exchange arena.
Sponsors are also urged to make sure voluntary benefits are a big part of the open enrollment message. Voluntary benefits can deliver significant value to employees and are an important element of a thoughtfully designed benefits program. Messaging can also be used to overcome misperceptions and confusion around other benefit offerings.
Mercer has worked with many clients who have introduced CDHPs, for example, which often come along with high participant deductibles. To help keep coverage affordable for employees, Mercer says it's important to also promote voluntary benefits like hospital indemnity plans to help assuage fears of potentially high out-of-pocket expenses. These offerings can also assist employees who remain ineligible for the employer-sponsored medical plan.
Use open enrollment as an opportunity to reinforce wellness campaigns, Mercer says. The firm is encouraging its clients with new or existing wellness campaigns to use open enrollment to reinforce the value and rules surrounding these programs. This is particularly important if any perceived compliance penalties are going to be introduced next year, such as increased premiums for those who do not participate in health screenings.
To support the accountability theme, Mercer advises deploying decision support and mobile technology. Participants are being asked like never before to take accountability for their health benefit decisions and cost outlays. Mercer helps clients identify the decision support and mobile technologies that empower this accountability at the exact time and place participants are making these important decisions. For example, some employers provide digital “wallet cards” for smartphones and other devices that contain benefit information and contacts needed at the point of service or anywhere else a participant needs information and advice.
Mercer will hold a complimentary webcast on August 7 to discuss compliance issues plan sponsors should consider before open enrollment. Click here to enroll.
Many sponsors have made the strategic decision to move to private exchanges, such as Mercer Marketplace, and many more are actively looking to do so over the next few years. In addition to supporting all of the open enrollment features found in Mercer’s checklist, private exchanges can deliver significant savings to both sponsors and participants while also enabling the personalization of benefits to a level far beyond that of traditional benefit programs.
More information is available at Mercer’s website.