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employment

Employer-backed health insurance plans on life support?

April 12, 2013 by Mighty Casey 4 Comments

tipping point road sign image

tipping point road sign imageI’ve been heard in these precincts and elsewhere on the topic of employer-backed group health insurance, and the reasons why I believe it’s an idea whose time has gone. Granted, I’ve felt like a little voice crying in the wilderness, but  with a firm conviction that I was just an early adopter of this opinion.

So imagine my glee when a headline popped up in my Google+ news feed that the Robert Wood Johnson Foundation had published a study showing a distinct downward trend in the number of companies paying for employee health insurance.

The key findings:

  • The percentage of non-elderly people with employer-sponsored insurance declined 10.2 percentage points from 69.7% to 59.5% over the study period while pubic coverage increased 3.1 percentage points.
  • While most states saw “significant declines” in employer-sponsored insurance coverage, the range was wide—from New Hampshire (73.8% coverage) to New Mexico (48.0% coverage).
  • Employer-sponsored insurance coverage varied by income. It fell less (2.8%) for high-income groups (400% federal poverty level [FLP] or above) than for those with lower incomes (200& FPL or below) where the fall was 10.1%.
  • Nationally, the percentage of private-sector firms offering employer-sponsored insurance fell from 58.9% to 52.4% (although the percentage of workers eligible for coverage at firms that offered employer-sponsored insurance held steady). The take-up rate also fell from 81.8 percent to 76.3 percent. Small firms offering coverage declined (67.7% to 56.3%) while at large firms it remained essentially unchanged.
  • Single-person premium costs doubled ($2,490 to $5,081); family premiums rose 125 percent ($6,415 to $14,447); employee contributions increased (17.5% to 20.8% of the total premium).

In short, less than 60% of adults who are employed full-time now have employer-backed group health insurance coverage. My response in the G+ thread? HALLELUJAH.

The prospect of losing group health insurance scares the pants off of those who still have that coverage. What I say to those who are currently pants-ing themselves in fear of losing their coverage is: keep calm, and carry on. There is a path to group coverage – even keeping the coverage you now have – if your employer wants an exit strategy on paying for health insurance for their employees.

I’m not an HR expert. I’m not in the insurance industry. I’m a journalist and writer who has built up, over a couple of decades, a wealth of both research and anecdotal experience in buying healthcare, buying health insurance, and being a member of the great unwashed, um, un-insured. When it comes to healthcare and the purchasing of same, I’ve been there, done that, have the t-shirts/knife scars/stories to prove it.

glass spilling imageHere’s my recommendation on how the scenario of shifting group health insurance from “company pays” to “individual pays” unfolds:

Employer chooses give-employer-backed-the-Heisman option

  • Smart employers will raise this issue in a conversation with their employees, not as a done deal. This will take at least 3-6 months of discussion, team meetings, all-hands meetings, and will likely include at least a few opportunities for people to gnash their teeth and rend their garments, because this will scare the pants off of them. That’s the first rent garment: the pants.
  • The idea needs to be shared as an ultimate win for the employees (it is), not as “we don’t wanna pay any more” whinging.
  • Your HR and marketing teams will be invaluable resources here. Work with them ahead of making any announcements about the plan to create online and handout resources for your employees that will help them walk themselves through the plan and process. All of these resources should have a solid answer to any employee’s “what’s in it for me?” questions.
  • UPDATE: [added as a result of a conversation on Facebook] Employers need to look at what they’re paying in insurance premiums for their crew, and adjust salaries to help defray the premium costs that will, as a result of this decision/process, be coming directly out of their employee’s pockets. This should be (a) obvious and (b) freakin’ obvious.

Selling the roll-your-own option to employees

  • If this is your first trip down the change-management path (if it is, how long have you been in business?? really??), hire a change management expert to work with you on this. If it’s not your first change-management rodeo, you already know you’ll be doing this. 
  • Work with that change management team and your health benefits broker – who will continue to be a critical player and your BFF throughout and after this process – to build a plan that will, over 6-12 months, shift from “company pays” to “individual pays” on health insurance premiums.
  • Your benefits broker will be the expert on maintaining the existence of “the group” under the new regime. Given that the same people are being covered, there should not be a big uptick in premium cost. If there is, your broker can horse-trade to keep premiums as flat as possible.
  • I strongly recommend shifting, over the two years conversations that follow “we’re changing this whole thing” and the implementation of same, to a high-deductible health coverage plan that includes a health savings account (HSA) if you have not already done this.
  • Here is where things get interesting (really) – you’re going to have to spend some money short-term to save money long-term. The money you’ll spend is to fully fund each and every employee’s HSA to the extend of their annual deductible. If their annual deductible is $5,000, you put $5,000 in their HSA. Yes, I can hear the screaming, but here’s the thing: you’ll only have to do that once. Once you’ve fully funded everyone’s first year’s deductible, they’ll make contributions (via payroll, pre-tax) each pay period to their HSAs. The amount of that contribution will be their choice.

leaning stack of quarters imageGroup health insurance, 12 months later

  • Premiums are paid by your employees, not by you. Your payroll deductions system will be funneling regular employee contributions to their HSAs. You can be a mensch and match HSA contributions if you want. Your payroll deductions system can also help your employees pay their health insurance premiums – your broker can advise you on how to set that up in the planning phase of setting up your Brave New Health Insurance World.
  • You’ll be devoting a bit of HR time to helping your employees and your broker work together on managing the group plan, but you will no longer be footing the bill for health insurance. As said in the last bullet, you can be a mensch and kick in on their HSAs – that’s now a true benefit of working for you, right?
  • Worried about the Obamacare penalties for not offering health insurance coverage to your crew? (Here’s a handy chart from the Kaiser Family Foundation that outlines those penalties.)Don’t, and here’s why: if you have fewer than 50 employees, you’re off the hook. If you have more than 50 employees, that penalty is $2,000/employee. Annual health insurance premiums currently average around $5,000 for individuals and $14,000 for family coverage. I’m not a mathematician, but all I need are basic arithmetic to know that $2,000 saves you between $3,000 and $12,000 per employee in that first year. There’s your salary increase funding mentioned in the getting-started bullet list.

Important considerations and actions

  • HSAs are currently not allowed to pay insurance premiums. Get your state and federal representatives to start looking at changing those laws.
  • Join those calling on state insurance commissions to make health insurance products more 50-state (like Geico and Allstate) rather than the state-by-state hodge-podge that currently exists.

Think I’m outta my mind? That I’m singing a solitary chorus of crazy here? Not so much. Sears and Darden Inc. (Red Lobster, Olive Garden, and LongHorn restaurants) have initiated health benefits changes that are mighty like what I outline above.

That’s my story, and I’m stickin’ to it. Got an opinion you’d like to share? Want to beat me up in the comments? Go for it.

 

Filed Under: Business, Find the funny, Healthcare, Politics, Storytelling Tagged With: Business, e-patients, employment, health care, health care reform, health insurance, Healthcare, humor, media, mighty casey media, Storytelling

Don’t wind up on the least-wanted list

December 5, 2011 by Mighty Casey 2 Comments

unfortunate xmas decisions

unfortunate xmas decisionsYes, kids, it’s that time of year again.

ChristmaHanaKwanzaKah is once again in the hearts and on the minds of everyone from sea to shining sea – and beyond – so it’s time for a remedial lesson on How to Succeed in Business Without Really Lying.

Here are the Mighty Casey Media rules for surviving the holidays with your sanity – and your client list – intact:

  • Don’t be a grinch. If you’re not a big fan of the holidays, don’t trash those who are. You don’t have to go overboard and wear a pair of reindeer antlers all month, yet neither do you have to tell the office Christmas Elf that s/he is crazy for loving the holidays.
  • Be a gracious guest. If you’re invited to a holiday celebration by a client or a colleague, accept with thanks. Attend with intent to find the cheer. Bring a friend along who could be a good prospect for the business. Holiday gifts can come in the form of customers. Take it from one who knows.
  • Be a thoughtful host. If you host a holiday gathering, make sure to keep the conversation and connection flowing. Configure your party so there’s plenty of opportunity to interact, and make the rounds continually to ensure that everyone is enjoying themselves. And have a defined end-time for the party, which saves having to shovel folks out the door.
  • If you can’t deal, deal yourself out. If the holidays drive you nuts, that seems like a great excuse to take off on a vacation, a retreat, or a sabbatical. Deal yourself out of the holiday merry-go-round, and return to the game refreshed after Santa’s blown town.

Merry ChristmaHanaKwanzaKah to all, and to all a way to make the end-of-year insanity work for you!

Filed Under: Business, Find the funny, PR, Storytelling Tagged With: brand, branding, Business, casey quinlan, comedy, employment, entrepreneurs, mighty casey media, personal branding, PR, Social media, Storytelling

Why is business expected to pay for healthcare in the US?

October 31, 2011 by Mighty Casey 4 Comments

image of gold caduceus casting shadow of dollar sign

I’ve asked this question frequently over the years, starting in the ’80s, continuing to today … and I’ll keep it up until someone realizes that it’s a failed paradigm.

What we have here, kidz, is what happens when a society decides that socialism is anathema, but doesn’t empower and educate its citizens about how to take responsibility for themselves in ways that will keep them healthy, productive community members.

Business started picking up the tab for healthcare during World War II, when stiff wage controls made it impossible for defense plants to give their employees raises. In place of more money, they started to pay for health insurance – which state and federal government were more than happy to turn into mandated employee benefits over the next 20 years.

What happened then was predictable: three generations have been out of touch with the true cost of  healthcare, and the true cost of their choices about their health. If you’re a good little American consumer, you do whatever your television tells you to do: eat this. Buy that. Otherwise the terrorists win!

Three generations of disconnection from the real costs of our medical care have delivered us an epidemic of obesity – thanks to plentiful empty calories, courtesy of agri-business, and our willingness to beach ourselves on our sofas, in our SUVs, or at our computers, the better to receive more messages about what we should buy and eat.

Health insurance costs have skyrocketed as we’ve become a nation of couch potatoes. Companies are scaling back their employee health benefits as those costs continue to rise, putting more and more people in the un-insured or under-insured bucket. Is that rise in healthcare costs, which in turn drives higher premiums, combining with the federal mandate that all companies offer employees health insurance or face the wrath of Khan, er, the feds the real “job killer”? I think so.

Here’s a suggestion: sell health insurance like auto, home, and life insurance are sold. Put consumers in charge of shopping for, and purchasing, their own insurance. Let business help their employees, if they choose to do so, as a true benefit rather than a mandate. Help every consumer set up a Health Savings Account for their healthcare expenses. And stop the state-by-state divvy-up that lets health insurers essentially gerrymander the health insurance marketplace.

Put consumers fully in charge of their insurance, and their care. Turn the health insurance market into a car-insurance model. People can buy minimum levels of insurance, and assume the risk of that choice. They can opt out completely, and assume all the risk for their healthcare costs. Make it a true marketplace, rather than the giant mess that we currently call health insurance. Employers are certainly able to help their employees with HSA deductions and matching contributions; smart companies will help their teams figure out managing and negotiating for insurance as a group. But they shouldn’t be expected to foot the bill.

Radical? Perhaps. Necessary? I’d say it’s essential.

Until we’re put in touch with the costs of our healthcare, we won’t be encouraged/empowered to take control of our health. As long as we’re using other people’s money to pay for healthcare, we’re stuck where we are.

Which is a very bad place to be.

That’s my story, and I’m stickin’  to it …

Filed Under: Business, Entrepreneurs, Healthcare, Social media, Storytelling Tagged With: Business, casey quinlan, e-patients, education, employment, entrepreneurs, health care, health care reform, health insurance, Healthcare, mighty casey media, Social media, Storytelling

How far would you go for medical treatment?

August 22, 2011 by Mighty Casey 2 Comments

medical tourism image

medical tourism imageNo, not how far you’d go in the Denzel Washington/John Q/hold-a-hospital-hostage sense. In the get-on-a-plane-toward-care sense.

Medical tourism has seen an exponential rise with patients in the US as health care costs and the number of uninsured patients have risen over the last 15 years. In a TIME magazine piece in 2006, Curtis Schroeder, CEO of Bumrungrad Hospital in Bangkok – somehow, I don’t think he’s Thai – said that in 2005 their census of US patients rose 30% (to 55,000).

That trend has continued, even with the advent of “health care reform” – health insurance reform, really – since health care costs have continued their hockey-stick rise, with no end in sight, for two decades.

50 years ago, patients from across the globe saw health care in the US as the holy grail. Now, US patients are traveling to Costa Rica, Thailand, Mexico, New Zealand, even Cuba to get access to high-quality, low-cost care.

US companies have started to explore medical tourism, and some are offering  incentives to their employees – incentives including getting to pocket some of the savings gained from traveling abroad for treatment. Not enough, however, to make medical tourism a healthy industry here in the US of A.

An August 2011 article in Workforce Management includes a story about a nurse in Louisiana (irony is our favorite thing here at Mighty Casey Media) who traveled to Costa Rica a few years ago for dental work, including oral surgery. She paid $2,700 out of pocket for what would have cost her $10,000 at home, with her employer covering $1,500 of her care expenses. Her net cost for the procedures was $1,200, plus her travel expenses – which travel was negotiated and arranged by a broker, Companion Global Health Care Inc.

I’m sure that, even after travel expenses, her savings were still solidly in the thousands of dollars.

So why aren’t more US companies encouraging their employees to take advantage of medical tourism? According to the CEO of Companion Global, David Boucher – who certainly has a dog in this fight, and who is quoted in the Workforce Management article linked above – the rising costs of health care make the health-tourism choice a no-brainer. He says that their customers are seeing a 2- or 3-to-1 return on investment for medical tourism, and patients – their customers employees – are very satisfied with the quality of their care.

However, according to Joe Marlowe, senior VP of health and productivity at the risk-management and HR consulting firm Aon Hewitt who’s also quoted in the WM story, employers are risk-averse, particularly at the idea of making themselves liable for medical care far from home that turns out badly for the patient.

What do you think? Would you travel 8,000 miles for a knee replacement, or 3,000 for chemotherapy, to save a significant amount of money and still receive high-quality care? Or would you want to be closer to your support system – family, friends – while receiving care?

I would most certainly travel to Bangkok or San Jose for a knee replacement. Not sure about oncology, since that follow-up can be so long-term.

You? I really would like to know.

That’s my story, and I’m stickin’ to it …

Filed Under: Business, Healthcare Tagged With: Business, cancer, casey quinlan, chemotherapy, e-patients, employment, entrepreneurs, health care, health care reform, health insurance, mighty casey media, politics, Storytelling

The Story on the Whole Jobs Thing (at Least AFAIC…)

December 9, 2008 by Mighty Casey Leave a Comment

Jobs numbers have, to quote Forbes Magazine, fallen “off the table”.

Everyone knows at least a dozen people who are un-, or at least under, employed. And several more who are decidedly nervous about their continued employment.

Here’s what I’ve been thinking for quite a long time now: jobs are dead. Long live daily individual value delivery.

This is a multi-channel challenge. I can hear the benefits administrators of the world saying, “oh, HELL no!”

I can hear the education system, in this country and many others, protesting that they’re teaching to the test already (pumping out potential employees), and if they have to start teaching critical thinking again…well, things could get ugly.

I can hear the legions of job-holders around the world winding up their best roundhouse kick to knock my block off.

Change happens. If you’ve been on the employee train for a long time, trying to wrap your mind around not finding another job when you lose the one you’ve got can be downright scary. Just ask Paul Nawrocki, who lost his in February 2008 when the toy company he worked for went under.

Nawrocki has become both internet, and news-network, famous, thanks to his self-propelled mobile advertising (f/k/a “sandwich board”) – what a great opportunity to recast himself as a buzz marketer!

I’m kidding. But not really.

What times like the present call for is a change in thinking, for all of us.

The job may not be dead, but it is on life support. Start thinking like a consultant, a freelancer, a solopreneur, even if you toil alongside thousands of co-workers at a Fortune 100.

If you don’t bring it – “it”, in this instance, being that daily value delivery I mentioned above – the out-of-work sword will constantly dangle just above your cranium.

Don’t hug that job. It’s unlikely to hug you back for very long, and it’s highly likely to be unfaithful.

And don’t ever neglect your daily value delivery requirement.

That’s my story, and I’m stickin’ to it….

Filed Under: Business, Entrepreneurs, Media commentary, Storytelling Tagged With: Business, career, employment, entrepreneurship, job, job-hunters

SnagAJob.com – Helping People Find the Right Jobs & Companies Find the Right People

August 6, 2007 by Mighty Casey Leave a Comment

This is the text from a press release the Greater Richmond Technology Council sent out today about their monthly breakfast this coming Friday – if you’re in the Richmond area, come hear what Shawn Boyer and Wei Wang have to say.

Richmond, VA. Aug. 6, 2007 – Eight
years ago, a friend asked Shawn Boyer, then a transactional attorney at Brown
& Wood LLP, to help him look for a summer internship online. When Boyer found very few sites listing
available internships, and almost no sites offering part-time or full-time
hourly jobs, he had the “a-ha” moment that led to founding SnagAJob.com, the
on-line hourly job board that now has more than 7 million registered
users. Mr. Boyer will tell the
SnagAJob.com story, and talk about the online recruiting industry, at the
Greater Richmond Technology Council (GRTC) Good Morning Technology breakfast on
Friday, August 10, 2007 at
The Place at Innsbrook. The breakfast
will start at 7:30am and end at 9:00am.

Mr. Boyer,
SnagAJob.com’s President & CEO, will give an overview of the company’s
services, as well as a history of online recruiting. SnagAJob.com is now the nation’s largest
hourly-wage job board, and in addition to racking up close to triple-digit
growth every year since 2000, the company has become the recruitment tool of
choice for a wide array of businesses, including Jiffy Lube and 7-Eleven.

Testimonials
from customers like Veronica Thomas, regional recruiter at Jiffy Lube, saying,
“We use SnagAJob.com because it works. It has proven to boost our applicant
flow by 50 percent. The customer service is in a class of its own,” are an
indication of why the company is successful. Customer service, ease of use, and quality of candidates make employers
happy customers – and those seeking work are equally complimentary about their
experiences with SnagAJob.com. One
job-seeker quoted on the company’s website is Miya E., who says that
SnagAJob.com is “the No. 1 source for hourly employment (and a
friend to the hourly worker).”

SnagAJob.com’s
Chief Technology Officer, Wei Wang, will join Mr. Boyer in addressing the GRTC
membership. Mr. Wang, who holds a
Masters in Electrical Engineering & Computer Science from MIT, will talk
about the IT infrastructure initiatives the company has undertaken to manage
its success and rapid growth. Mr. Wang
recognizes the human side of SnagAJob.com’s business, “I
believe that people are our best asset, and my duty is to create a scalable
organization to maximize everyone’s potential and to allow each person to live
a more fulfilling life.” That sentiment
is echoed by each member of the company’s leadership team who, along with their
impressive array of degrees and business experience, list their first
hourly-wage jobs in their bios on the SnagAJob.com website.

The August GRTC
Good Morning Technology breakfast is sponsored by Monument Consulting, a
Richmond-based firm that delivers flexible and cost-effective recruiting
models, including recruiting process outsourcing. Monument Consulting helps its customers
recruit the great talent that is crucial to their business success.

The
Greater Richmond Technology Council is an association of businesses and
organizations working together to promote the success of technology companies,
and the growth of the technology sector of the Central Virginia economy.

Filed Under: Business, Entrepreneurs, PR, Storytelling Tagged With: Business, employment, jobs, richtech, Shawn Boyer, SnagAJob.com, Storytelling, web

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