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What Employers Need to Know About EBSA’s COVID-19 Employee Benefits Deadline Extensions

The Employee Benefits Security Administration (EBSA), IRS, and Department of the Treasury issued a joint announcement on April 28th stating that they are extending a variety of timeframes related to employer sponsored healthcare coverage, portability, and continuation under COBRA.

Generally speaking, these extensions are designed to maximize healthcare accessibility during the ongoing COVID-19 outbreak, continue coverage for as many Americans as possible, and loosen up claims negotiating windows in a way that prevents a processing bottleneck from weakening the system as a whole.

In this post we’ll explore:

  • Extensions of employee healthcare deadlines under ERISA Section 518
  • A few examples of what the extensions mean for employers
  • The meaning of the HHS “measured enforcement period”

ERISA Section 518 Relief

Section 518 of ERISA allows for the extension of certain benefits-related filing and documentation deadlines by up to one year in the event of a presidentially declared national emergency.

With this week’s joint announcement, the government has declared that all employee health plans, disability plans and other employee welfare plans must disregard the period from March 1, 2020 until sixty (60) days after the announced end of the COVID-19 national emergency (“the Outbreak Period”) when determining the following periods and dates:

  • The 30-day special enrollment periods for employees
  • The 60-day COBRA benefit continuation election
  • Dates for making COBRA premium payments
  • The date for individuals to notify the provider of a qualifying event or determination of disability
  • The date range within which individuals can file benefit claims
  • The date by which claimants must file an appeal for an adverse determination
  • The date range within which individuals can request an external review of an adverse determination
  • The date range within which individuals may file information to perfect an external review of an adverse determination

For employers, this means that your plan administrator can’t count dates occurring during the Outbreak Period against employee deadlines. The spirit of these extensions is extremely employee-friendly, but it’s also HR and administrator-friendly, as it significantly reduces the pressure to process claims and push laid off or furloughed employees through off-boarding as quickly as possible.

To see the full text of the joint announcement’s final rule, click here.

What Will This Look Like in Action?

Open-Enrollment Examples

If an employee has a baby during the Outbreak Period, the child can be brought onto employee healthcare via special enrollment until 30 days after the Outbreak Period ends (90 total days after the announced end of the national emergency).

Similarly, if an employee got married shortly before or during the Outbreak Period, the new spouse’s special enrollment period will last until 30 days after the Outbreak Period ends (90 days total after the announced end of the national emergency).

COBRA Election Example

If an employee has been furloughed to the point where they no longer work enough hours to qualify for employer-sponsored coverage due to the national emergency, their COBRA election period must remain open until 60 days after the Outbreak Period ends (120 total days after the announced end of the national emergency).

COBRA Premium Payments Example

If an employee was receiving COBRA coverage at the beginning of the Outbreak Period, premium payments for COBRA coverage during the Outbreak Period will be considered timely if the payments are made within 30 days of the end of the Outbreak Period (90 days total after the announced end of the national emergency). As long as premiums for all months during the Outbreak Period are paid in a timely manner, the employee is eligible to continue coverage.

Claim Filing Example

If an employee has a 365-day filing window for any claim, that window will not begin for any claims made during the Outbreak Period until the Outbreak Period ends. Similarly, the entire date range of the Outbreak Period should be excluded from claims deadline calculations for care that occurred shortly before the national emergency.

The “Measured Enforcement” Period

The Department of Health & Human Services (HHS) officially concurs with the relief announced by EBSA in the joint statement and is relaxing enforcement for public healthcare, while encouraging states to adopt the spirit of the extensions EBSA is creating for private employer-sponsored programs.

No official end date has been announced for this period.

Takeaways

EBSA’s COVID-19 employee benefits deadline extensions are designed to help as many Americans as possible maintain their access to employer-sponsored healthcare during the coronavirus outbreak. While they’re largely employee-friendly, the extensions also help HR departments and benefits administrators reduce the bottleneck that COVID-19 has created.

Remember:

  • The “Outbreak Period” is defined as March 1, 2020 until 60 days after the COVID-19 national emergency is declared over.
  • Dates falling within the Outbreak Period should not be counted against employees for:
    • Special enrollment windows
    • COBRA enrollment windows
    • COBRA premium payment due dates
    • Filing claims
    • Requesting a claim review
    • Perfecting a claim review

How Does COVID-19 Impact Your Employee Benefits Program?

There’s never been a moment in recent history where access to healthcare and other employee benefits was quite so important. As we enter the predicted “surge week” here in the United States, HR and business leaders across the country are scrambling to determine how COVID-19 and the laws that have gone into effect this month will affect their employee benefits program.

The challenge is: everyone’s program and carrier are different, so there’s no one right answer to the question of “What does this mean for benefits?”

That means you’re likely going to have to work internally and with your benefits broker to figure out exactly how COVID-19, the FFCRA, CARES Act, etc. will impact your benefits program. With that said, however, we can provide you with some general guidance to ensure you’re asking the right questions, viewing your benefits through the right lenses, and doing everything you can to support your employees and continue your business in a compliant way.

In this post we’ll explore:

  • Extension of benefits to cover COVID-19 care
  • How your FSA grace period can spread out coronavirus-related expenses
  • How special enrollment periods can help you connect employees with coverage right now
  • What the FFCRA & CARES Act say about employee benefits
  • The value of providing access to telemedicine as part of your benefits strategy

Benefit Extension During the Coronavirus Outbreak

Anytime you terminate an employee who is disabled or hospitalized or has a dependent who fits those criteria, benefits are generally extended until one of the following occurs:

  • The terminated employee returns to work
  • The terminated employee finds new work or access to coverage
  • The terminated employee’s dependent/spouse is discharged from the hospital

Of course, with all the layoffs and furloughs surrounding the coronavirus outbreak, those requirements carry a heftier responsibility than ever before.

That means there is no benefit to terminating workers who are already away from the office due to COVID-19, as you will continue to remain liable for their family medical expenses. It’s not an advisable strategy to reduce your employee benefits program costs by terminating people.

Thanks to the Employee Retention Credit provided by the CARES Act, retaining those employees on FMLA leave may actually be advantageous in the long run, as they will decrease your tax burden.

Keep in mind that if you’ve already laid off employees, you’ll have to extend coverage to COBRA-eligible workers for up to 18 months if they don’t find new jobs.

Understanding the FFCRA’s Paid Leave Grace Period

The Families First Coronavirus Response Act significantly expanded paid leave for small and medium-sized employers, but it also provided a grace period of non-enforcement, which lasts through April 18th.

In essence, that means that employers cannot be punished for non-payment of employee leave until mid-month as long as they are acting in good faith and not delaying payments for reasons other than logistical constraints.

However, that doesn’t mean employers can negligently ignore the mandate until April 18th. If you’re dragging feet or waiting for the enforcement period to begin before playing by the rules, you could be putting your business at risk. The Department of Labor will be applying Sections 16 and 17 of the FSLA judiciously to minimize non-compliance and abuse of employees requesting leave at this time.

Leveraging Special Enrollment Periods

A special enrollment period represents any time where employees or individuals may enroll in health insurance outside of the typical renewal window.

While a national ACA special enrollment window has been shot down from legislation several times since the COVID-19 outbreak, several states have announced special enrollment periods for uninsured individuals and families looking to protect themselves during this crucial time.

If there’s a special enrollment period occurring in your state, it’s vital that you communicate that information to employees that previously opted-out of a healthcare plan and encourage them to get the care they need.

Encouraging Employees to Use Your FSA Grace Period Effectively

Flexible spending accounts, healthcare reimbursement accounts, and other benefits that help employees fight out-of-pocket healthcare costs generally need to be used within a given calendar or plan year. However, employees usually have a few extra months to make sure they use those funds before they disappear. For example, if your plan year ended on December 31, that means your grace period likely extended through mid-March.

If your benefits program plan year ended in mid-January or later, your employees are likely still able to incur FSA or HRA expenses for plan year 2019. That’s good for you because it means that the funds your employees and their families need to fight COVID-19 and stay healthy might already be allocated to them from the prior year.

If your plan year ended in November or December, your grace period is likely over, but employees can still use FSA and HRA expenses to pay for the medications, treatments, doctor’s visits, and so on they need to survive this time. For those lucky enough to have plan years starting between January and June, employees will be able to “double-dip” this year, significantly increasing their ability to meet out-of-pocket medical costs.

The Value of Telemedicine

Telemedicine (access to doctors via video conference, phone call, etc.) has grown significantly over the last decade, and if it’s a part of your employee benefits program as you’re reading this, you’re already going a long way to support your employees during this challenging time.

Telemedicine is powerful because it gets employees a doctor’s appointment without the need to travel to the doctor’s office. During this time of social distancing, that technology has the power to provide care for patients without exposing them to the COVID-19 health risks that will be present in most of our U.S. hospitals for months to come.

If you’re offering telemedicine to employees, you need to be sure they’re aware of it and are clear on how to access it. Communicate via email blast with your team to help them understand what services are available through telemedicine and how they can access them.

If you’re not currently providing telemedicine opportunities through your employee benefit offerings, now would be a perfect opportunity to talk to your benefits broker about how to maximize access to care while minimizing the need to visit a doctor’s office.

Takeaways

As we said when we began, there’s no one answer to the question of “How is COVID-19 affecting my employee benefits program, and how can my employee benefits program help affect change in the fight against COVID-19?” You need to dive deep into your program offerings and speak with your benefits broker to understand what this really means for your business.

In the coming days and weeks, however, it will be important for everybody to think about:

  • Benefits extension: What will the real cost be of laying employees off while also continuing to support their benefits? Can we maintain our team and leverage the tax credits of the CARES Act to keep us afloat this year?
  • The paid leave grace period: How will we be sure we’re fully compliant with FFCRA leave requirements by April 18?
  • Special enrollment periods: Is there one in your area? Can you help previously unenrolled employees protect themselves through special enrollment?
  • FSA/HRA grace periods: Does your plan year allow for employees to use both 2019 and 2020 funds to fight coronavirus? If sure, make sure they know.
  • Telemedicine: Are you currently offering it? Do your employees know? How can you start offering it if you aren’t already?

In the Midst of the COVID-19 Outbreak Telemedicine Is More Important Now Than Ever More

The ongoing COVID-19 pandemic has put telemedicine in the spotlight and directed new resources towards this crucial healthcare innovation. Over the past few years, telemedicine has gained traction with forward-thinking growing businesses and benefits brokers as a cost-saving way for employees to get the medical advice they need – without having to miss work to do it. However, many businesses and healthcare professionals have treated it as a handy supplement at best and an unnecessary expense at worst.

But as the nation locks down under quarantine and a trip to the doctor means potentially exposing yourself and others to the risk of infection, telemedicine is coming to light as a critical point-of-care option.

Let’s take a look at why employers should leverage telemedicine to keep their employees healthy and contribute to containment efforts, explore plus the ins-and-outs of getting employees access to telehealth during the outbreak, including:

  • Why COVID-19 makes telemedicine more important than ever
  • How telemedicine is becoming more accessible due to the outbreak
  • How to get your team members the telehealth care they need

Why Telemedicine Is More Important Than Ever

There are almost limitless reasons to use telemedicine during the COVID-19 outbreak. On an individual and societal level, at this point in time our safety relies upon two things: limiting physical interactions through social distancing and preventing the healthcare system from getting overwhelmed. Telemedicine is a powerful tool to facilitate both of these goals.

Quarantine orders and the very real risk of exposure – or exposing others – mean that seeing a healthcare professional in-person should be the option of last resort for you and your employees. Your team members should still get physical assistance if their health condition becomes serious, but telemedicine can minimize the risk of the disease spreading to or from your employees. And given the fear of exposure, telemedicine will likely increase your employees’ access to healthcare in a very real way. People who would otherwise avoid a doctor’s visit for fear of leaving the house will be able to get the care they need.

Telemedicine is also quicker and easier for providers compared to a regular office visit. And it puts a significantly lighter burden on the healthcare system than an urgent-care or emergency-room visit. That means that it can limit the amount of strain that employees put on an already overburdened system, potentially saving lives.

While telemedicine can help employees safely get medical advice for issues not related to COVID-19, it is especially important for employees who suspect that they have the virus to use telemedicine as a first resort. As long as the symptoms are mild, doctors are encouraging home-treatment akin to mild flu. Unless the case is severe and requires urgent attention and physical treatment, telemedicine can resolve employees’ fears and get them the advice they need without causing COVID-19 carriers to go out into the world and potentially spread the disease. And while it is impossible to administer a COVID-19 test remotely, the current limited supply and application of the tests mean that mild cases would not be tested even if employees went to the hospital or doctor’s office.

Telemedicine Is Becoming More Accessible

The medical community and government have recognized the utility of telemedicine in combating the crisis of a rapidly spreading disease and an overwhelmed healthcare system. The good news for individuals and businesses alike is that they are increasing access to telemedicine as a result, generally at reduced or zero cost.

For example, the CMS has expanded Medicare to cover telemedicine and eliminated all requirements regarding the location of both patient and provider. They have also loosened restrictions to allow consultations over platforms such as Skype and FaceTime in addition to formal platforms. Some states have also similarly expanded their Medicaid coverage. While these expansions are unlikely to be directly applicable to your employees if you offer health benefits, it is a strong sign of the general support for telemedicine. And employers should inform their team members of the expansions as they may well have parents or loved ones on Medicare or Medicaid.

States are also starting to mandate that private insurance companies cover telemedicine for all members in the state. Thus far only Massachusetts has implemented the measure but more states will likely join Massachusetts as the situation continues to develop.

In the meantime, many if not most major private insurers are temporarily expanding their telemedicine coverage to address the outbreak. UnitedHealth and Aetna have both extended telehealth coverage to all members and waived co-pays, while Humana has followed suit for urgent-care telemedicine calls. CIGNA has also added the option to make a telemedicine appointment with a CIGNA doctor through their website at no added cost, which increases care but does not waive co-pays for standard telemedicine. As of today, Blue Cross Blue Shield is one of the only major insurers to not expand telemedicine coverage in light of the outbreak, though they have promised to “encourage the use of virtual care and will also facilitate member access and use of nurse/provider hotlines.”

How to Leverage Telemedicine to Get Your Employees The Care They Need

By now, it should be clear that telemedicine isn’t just an added employee benefit but a true necessity during the COVID-19 pandemic. But as with so many issues related to the outbreak, the situation is constantly changing in terms of access to care. So how can you ensure that your employees can take advantage of telemedicine to keep themselves and their communities safe and healthy?

The first thing you should do is to talk to your benefits broker and your insurance provider to evaluate your current telemedicine coverage. You should also ask about any changes that they may have made in light of the current COVID-19 situation. And if your employees aren’t covered, lobby your insurance company to expand their telemedicine coverage and consider shelling out for additional telemedicine coverage, at least temporarily. Also consider the fact that a prescription delivery option makes it easier for employees to follow-up on their telemedicine visit to get the treatment they need without added risk of exposure.

You might also consider making these changes permanent additions to your employee benefits, if they aren’t already. Telemedicine is an effective way to reduce healthcare expenses and health-related absenteeism even when there isn’t an ongoing health crisis.

Final Thoughts

During this unprecedented health crisis, it can be hard to tell what you should do to protect yourself, your employees, and your business. Telemedicine is emerging as one method that is certain to improve the situation. Talk to your employee benefits broker today to see how you can leverage telemedicine to address the COVID-19 outbreak.

Preventing Discrimination in Your Employee Benefits Program

“Discrimination” is a word that no human resources professional ever wants to hear. Unfortunately, many HR leaders are unaware that discrimination can easily be lurking where we expect it least: in our employee benefits programs.

Moving forward, we’ll explore:

  • The difference between unfairness and discrimination
  • How employee benefits can unknowingly be discriminatory
  • What HR needs to do identify and eliminate discriminatory benefits practices

Discrimination vs. Unfairness

Discrimination is the unjust or prejudicial treatment of different categories of people, particularly on grounds of race, age, or gender.

Unfairness is a lack of equity; that is to say, a situation in which not everybody is treated the same way.

Those concepts are closely tied – and they can certainly occur at the same time – but they’re not exactly synonyms.

Fairness is an ideal, a target we should be able to hit the vast majority of the time. As an HR department, nobody is ever going to love every policy or initiative, but if your policies and the way you treat people feels consistent, you’ll be fine. When fairness issues become systemic and begin to affect work or culture, then you have a problem.

On the other hand, it’s never okay to be discriminatory from a moral or legal/compliance standpoint.

How does this apply to employee benefits?

By nature, insurance isn’t always “fair.” For example, if a 30-year-old employee and a 68-year-old employee are on the same health plan, making the same employee contribution, the 68-year-old will see much more value due to their increased likelihood of medical need.

If you’re the 30-year-old in that scenario, that doesn’t feel very fair, but it’s not discriminatory. That’s because, if that 30-year-old had the same medical needs as the 68-year-old, the plan would be just as valuable to them. There’s no unfair barrier in place blocking access due to age.

The EEOC dictates that programs are not discriminatory in that exact scenario as long as they provide either equal cost or equal benefit.

HR directors and benefits managers hear a lot from employees about why their benefits offerings are imperfect, but it’s crucial to sort out a fairness issue from actual discrimination.

How can employee benefits be discriminatory?

As their name implies, employee benefits are valuable perks that positively impact people’s lives. When you start offering different employees different levels of benefits, you encounter a real fairness issue, but depending on the way you’re classifying employees when you make those offers, you might be discriminating and not even knowing it.

The law states that in order to offer two employees different benefits packages, you need to demonstrate those two individuals are on different levels in terms of “bona fide employment-based classifications.”

Those bona fide classifications include:

  • Full Time vs. Part Time status
    • It’s okay to offer full-time employees benefits that part-timers don’t receive
  • Geographic location
    • It’s okay (even necessary) to offer eligible employees different benefits packages based on where they live
      • This generally applies to businesses that operate across multiple states
  • Different dates of hire and lengths of service
    • It’s okay if senior employees have been “grandfathered in” with an old plan

So, the bottom line is, if you have two full-time employees working in the same office who got hired on the same day, they should have equitable access to the same employee benefits programs.

What about managers and executives?

The most common way businesses inadvertently commit benefit discrimination is by the way they structure benefit offerings to so-called Highly Compensated Employees (HCEs). An HCE is someone who:

  • Makes more than $130,000 or
  • Owns more than 5% of the business

If your business is self-insured, the ACA prevents you from offering preferential benefits packages to HCEs. If your business is fully insured, you can offer a higher tier of benefits (or lower premium costs) to HCEs if your business does not offer a cafeteria plan. In the event you are insured and have a cafeteria program in place, it’s unlikely you will be able to offer different plans to your executives, but always double check with your broker.

Regulations concerning benefits discrimination

If you would like to explore the compliance frameworks to fully grapple with the problem, here are some places you can find discrimination regulations specifically tied to employee benefits policies.

What does HR need to do?

There are three compelling core reasons to review your employee benefits programs through the lens of checking for discrimination:

  1. Reducing discrimination is simple the right thing to do
  2. An employee dispute over a discriminatory program could become a long legal battle
  3. If regulators discover or catch wind of discriminatory practices, your business will be fined

As an HR leader, you need to be proactive and be sure you:

  • Lead an internal audit of your employee benefits offerings to ensure packages are offered in a way that is nondiscriminatory
  • Contact your benefits broker to ensure they are aware of all relevant regulations and can describe to you how and why your program is compliant
  • Inform your legal and compliance teams as quickly as possible if you detect any issues, shortcomings, or possible areas of discrimination
  • Take ownership over correcting all issues as quickly as possible

When you work to eradicate hidden discrimination from your policies and offerings, you’re strengthening your organization for the long-term and doing your part to create a better work experience for all professionals.

Takeaways

Employee benefits discrimination unfortunately occurs often because the situations in which businesses can or can’t offer different packages can confusing at times.

Just remember:

  • Insurance isn’t necessarily “fair” (because there’s no guarantee people will get the same value out of it), but it should never be discriminatory
  • All differences in benefits offerings should be based on bona fide employment-based classifications, like part time vs. full time, location, or date of hire
  • If you are self-insured or have a cafeteria plan, you cannot offer preferential benefit packages to highly compensated employees
  • All HR departments should lead an audit of their offerings in collaboration with your benefits broker and legal team

The Top 11 Employee Benefit Challenges Facing Today’s Businesses

At Launchways, we pride ourselves on working closely with each individual client to identify their workforce’s unique needs, navigate their business model’s unique challenges, and leverage emerging best practices to help them create employee benefit packages that truly support their workers without breaking the bank.

As we near the end of 2019, we’ve been reflecting on the most common client challenges we saw this year, and we’ve decided to share this list of the Top 11 Employee Benefit Challenges Facing Today’s Businesses.

Here are the most pressing challenges we see assist our clients with on their employee benefits programs:

Rising Healthcare Costs

Doctor visits, prescription drugs, and medical procedures are more expensive than ever before, and it’s difficult to envision that paradigm reversing in the near future. Media coverage surrounding healthcare costs does a good job illustrating the impact on individual patients, but the increased burden on businesses often goes unvoiced.

Every business wants to support their employees’ and their families in times of personal and medical need, but the incredible costs associated with certain long-term courses of treatment is causing some businesses to feel nervous about the financial impact of offering comprehensive coverage.

These tensions reinforce why it’s so important to partner with the right employee benefits broker who you know is working in the best interest of both your employees and your business to deliver maximum benefits value at the lowest possible cost.

Understanding Employee Healthcare Needs

One of the biggest areas of loss in all of human resources is the lack of alignment between employee healthcare needs and the benefits packages offered. If benefits plans are too rich, it can cause undue waste of business resources.

At the same time, however, shortfalls in coverage can be financially and personally devastating to employees. That’s why tailoring your benefit offerings to employee needs is crucial to hitting the sweet spot of comprehensive coverage and well-scaled costs.

Analyzing employee healthcare usage data, available through your carrier, can be extremely useful in this diagnostic work. Only when you know what your employees truly need can you optimize your offerings.

ACA Compliance

The Affordable Care Act presents different challenges to organizations depending on their scale, with specific regulations based on employee headcount. Many growing or early-stage businesses break into different tiers as they develop, and without proactive management, that can lead to accidental non-compliance.

Knowing the ACA inside and out is a must for any employee benefits specialist, and it’s also important to allocate co-planning time between HR and finance to discuss how employee benefits programs will need to grow to account for regulations as the business progresses.

If you don’t understand what the ACA demands of your business, engage a compliance partner to help you navigate these complex issues.

The Rising Relevance of Mental Health

Our shared cultural understanding of health and well-being have shifted a great deal in recent years, and simply taking care of employees’ bodies is no longer enough. Mental wellness is just as important to success at work and away from the office as our traditional understanding of physical health and therefore must assume its proper place as a cornerstone of your overall employee benefits strategy.

There are many businesses out there today who are failing to provide their employees with an affordable and accessible framework to get the therapy and medication they need, and businesses are often unaware this gap exists. Across the industry, support for mental health must catch up to awareness.

Due to decades of stigma and denial, even talking about mental health at work can be challenging at first, but in the 2020s, the businesses with the strongest approach to mental health will be the ones with the highest-performing teams.

Overreliance on Narrow Networks

A decade or so ago, benefits were trending toward narrow networks, with the thought being that both patients and their employers could save more money by staying relatively local and working with a tighter healthcare team. In reality, narrow networks provide the most benefit to the professionals who are doing the billing, not the paying, by ensuring a steady patient flow.

Narrow networks can be a nightmare for new employees who have existing relationships with out-of-network doctors or team members who get life-changing diagnoses and want to pursue all options. They also prevent patients from price shopping, which means you and your employees are stuck paying whatever the in-network provider dictates, even if it’s not the best deal.

Legacy narrow network healthcare is an underappreciated obstacle to talent recruitment and retention, especially for organizations targeting a younger or more diverse talent pool.

Offering a Qualified HDHP, but Not an HSA Strategy

High-Deductible Health Plans are always a great option for young or single employees who do not require much coverage, and they also provide tremendous savings for employers. With that said, however, an HDHP can easily fail an employee who has sudden or unexpected medical needs that transform their medical care into a mountain of debt.

If you offer HDHPs, it’s crucial that you protect your employees by extending a Health Savings Account option. Using the HSA, you can help your employees fill in the gaps in their HDHP coverage and limit their out-of-pocket expenses, while still saving money compared to the price of a lower-deductible plan.

As an employer, you must build benefits and incentives for employees who have helped you out by selecting less expensive coverage options, and the HSA is a best practice for returning that value back.

Educating the Workforce on Benefits

As we said earlier, one of the biggest areas of unnecessary spend for many businesses is unused benefits. The root cause of that disuse is often a lack of awareness, either because employees don’t know the benefits exist or they don’t know understand how they would benefit from them.

Additionally, millions of workers who don’t know which benefit package is right for them unwittingly set themselves and their employers up for failure every year. As a proactive business leader, it’s your job to give your team members the knowledge and tools they need to help themselves (and you) when it comes to benefit elections.

Employee education is fundamental to any organization getting benefits right at scale. Finding the right approach requires thinking like a teacher and having a clear vision of what an optimized system will look like.

Out-of-Date Dental and Vision Plans

People used to think dental and vision were “the easy part” of employee benefits, but as technology has improved both fields, new approaches have been innovated and care has gotten more expensive. For many businesses with a legacy approach to benefits, their dental and vision plans are simply out-of-step with the times.

Dental plans need to account for new approaches like implant dentistry and cover a wider range of surgical procedures to make great dentistry accessible to more people. Similarly, vision plans must account for corrective laser procedures, innovative cataract removals, and so on.

Accessibility to dental and vision care greatly impact employees’ and their families’ long-term health and well-being. If your insurance offerings only cover procedures that were common in the ‘90s, you should look at revising your plan.

Benefits Administration and Integration with Payroll & HRIS

As we all know, HR professionals balance an incredible number of responsibilities, both human and administrative. One of the things that makes those day-to-day tasks so frustrating is the lack of integration between the tools they require to do their work.

For example, some HR professionals utilize an HRIS to archive employee data, an HCM for people management, a benefits administration system, and a payroll portal for financial transactions. Without backend integration between these apps and tools, professionals have to do a great deal of repeat data entry, leading to lost productivity and potentially costly transposition errors.

In order to run an efficient HR department that can manage benefits and other concerns in a daily, proactive manner, every organization needs to move towards a single integrated system for employee benefits, payroll, human capital management, and beyond.

Managing Short-Term Disability and FMLA

Disability and Family and Medical Leave provide a crucial safety net for all workers. However, as an employer, you have a variety of obligations and responsibilities when an employee applies for leave.

Too many organizations lack clear procedures for leave application and approval, leaving themselves open to strained relationships with employees and potentially costly lawsuits. The more proactive you can be in laying out policy for giving employees the family or recovery time they need while maintaining internal productivity, the better a support you can be for your team members and your organization as a whole.

Each business should have a clear approach to the leave application process, transparent approval criteria, and an established re-entry plan for employees when their leave is over.

Finding Alternative Funding Strategies

As our first ten challenges have illustrated, providing strong employee benefits is increasingly about flexibility and scale. The best programs are the ones tailored to the specific needs of your employees with maximum value and accessibility in mind.

With that said, it can be tough to achieve that bespoke feel with a traditional fully-funded health insurance program. The total freedom of self-funding might not be possible for all businesses, but there are a variety of new and innovative ways you can connect with alternative funding to build something more personalized.

If you’re intrigued about changing your funding model to create a more open-ended, employee-centric approach to healthcare, talk to your leadership team and benefits broker about exploring new possibilities.

The Top 5 Challenges of Open Enrollment (And How HR Departments Can Manage Them Successfully)

The open enrollment period between November 1 and December 15 can be one of the most challenging times of year for HR professionals. Getting enrollment right in a timely manner is crucial to supporting your workforce and maximizing the two-way value of employee benefits.

With that said, open enrollment is tricky because it is such a complex challenge. There’s no one thing an HR leader or department can do to make the enrollment season go smoothly – it requires proactive planning and strategizing for a variety of factors and concerns.

Moving forward, we’ll explore:

  • Introduce five of the biggest challenges, concerns, and areas of opportunity for HR professionals before and during open enrollment
  • Provide actually strategies HR leaders can use to navigate or plan for these challenges

Open Enrollment Challenge #1: Logistics

Part of having a successful open enrollment period is having a very clear vision ahead of time for what that enrollment is going to look like and how you will ensure success. Without a logistical vision for how you’re going to pull off enrollment, you’re leaving your ability to have a successful open enrollment up to chance.

As a department, your first concern is understanding whether you’ll be leading an active or a passive enrollment. If you’ve recently rehauled your benefit offerings or you have internal data suggesting that many employees are on suboptimal plans, then an active enrollment can make a big difference for your benefits program On the other hand, passive enrollments work best in organizations with many long-term employees who are generally happy with their coverage.

If you’re going to leverage technology to streamline your enrollment procedure (and in 2019, you definitely should) that means your logistical planning needs to involve your IT team, as they’ll be the people determining the actual look and feel of the system that your employees will use to enroll in their benefits. HR and IT must work together to ensure the user experience is easy, clear, stress-free, and built right into the systems that employees use for their day-to-day work to maximize accessibility and invite engagement.

Open Enrollment Challenge #2: Communication

Communication is the probably the single biggest key to a great open enrollment season, but it may also be the single biggest challenge.

As an HR professional, it’s your responsibility to ensure that nobody can forget about open enrollment season. At the same time, however, benefit election time is also when HR departments can actually harm buy-in and hurt long-term employee engagement by providing the wrong kind of communication or using the wrong tone with employees.

For example, weekly email reminders to make benefit elections are useful for employees who have not completed the process, but they can seem annoying or impersonal to professionals who were sure to make their elections early in the cycle. Creating a communication strategy that maximizes that valuable communication while eliminating repetitive or unnecessary messaging is key to short-term success during enrollment and long-term success maintaining a great relationship with your talent.

One of the best ways to be successful is by spreading your message across multiple platforms. If your organization uses an ERP that all employees work through, partner with IT to get reminders in highly visible spaces that your team members can’t help but see. If your company has a preferred messaging system or bespoke communication app, you can use those channels to send enrollment reminders as well.

Open Enrollment Challenge #3: Education

Education is your greatest weapon to ensure employees choose their ideal benefits package, maximizing two-way value for talent and the organization alike. With that said, out of all these challenges, education can be the toughest one to truly embrace and hold yourself accountable to because it takes a lot of work.

In order to provide employees with the information they need to select the plans that are best for their families, you need to think like a teacher, providing multiple access points to the information and presenting things in a variety of ways to make sure that everybody understands the material, regardless of their personal learning style. That means just passing along the literature from your provider isn’t nearly enough.

Employees require a blend of independent learning opportunities (like brochures and manuals), large group learning opportunities (like formal training sessions), and small group (or even one-on-one) support from benefits-savvy HR team members to maximize their educational level and resultant engagement potential. Making time for those initiatives requires buy-in from senior leadership, but education is truly the difference between setting up your team for enrollment success and leaving them dangling in the wind.

Open Enrollment Challenge #4: Engagement

Engagement is the special sauce that makes every single aspect of operations at your organization run smoothly. When it comes to open enrollment, engagement means a workforce that cares about maximizing the value of their benefits and getting those elections made in a timely manner.

Health and wellness are crucial points of employee engagement for any business, but when they are active pillars of the employee culture, it significantly streamlines the yearly dance of open enrollment. When talent is engaged in terms of health and wellness, they work toward building their own understanding of how they’re using their benefits, what they need, and how they could be making smarter selections. That translates directly into making the right choices in November.

If that culture doesn’t already exist in your organization, the lead-up to enrollment season is a great time to brainstorm some incentives that invite engagement and build a positive, empowered attitude toward enrollment throughout the organization. The more you can create a positive buzz for health and wellness, the more active a role your employees will take in enrollment.

Open Enrollment Challenge #5: Picking the Right Benefits Partner

Of course, the over-arching challenge that hangs above the other four is the challenge of offering your employees the very best, most valuable benefits you possibly can.

Many employee benefits providers try to build a standardized definition of a “great benefits package,” but for your open enrollment to be successful in the long term for your department, your organization, and your talent, you should never settle for a one-size-fits-all approach. If you’re a small or medium-sized business, this can require working with a white glove service to help you connect with exactly the coverage you need to support your team.

Partnering with the wrong benefits broker can and will cost the organization in the long-term, whether it’s over-spend on unused benefits or employee dissatisfaction with limited offerings. Finding a benefits partner who understands your organization, your team, and your goals is crucial to maximizing employee experience and business value through enrollment.

Key Takeaways

Open enrollment is a complex challenge, but when you understand each individual aspect of the challenge and can formulate a proactive strategy that addresses each concern, you maximize your chances to deliver wins for your employees and organization as a whole. Remember…

  • You must plan ahead in the lead up to open enrollment and create a roadmap for success
  • You must communicate positively with your team in a way that guarantees awareness and provides them with the information they need to enroll
  • You must educate your team in a way that ensures they are able to make the best benefit enrollment selections for their families
  • You must engage your team in a positive manner that builds their enthusiasm for wellness in general
  • You must find the best possible benefits partner for your size and goals