The Wrong Type of Collaboration: Unions, Employers, Insurers, Et Al., and the Alliance to Fight the Forty


Last week I wrote a LinkedIn post urging employers to collaborate with insurers and other businesses and use their collective clout to hold the line on over the top hospital and other medical care costs. Little did I know at the time that employers were actually collaborating with insurers and others on a health insurance plan issue. Unfortunately, the issue that they see as most worth collaborating on involves maintaining the status quo. Specifically, employers are working with unions, big pharma, large health insurance companies, benefit association groups and others to repeal the Affordable Care Act’s (aka Obamacare) “Cadillac tax.”

Earlier this month 17 organizations including Cigna Corporation, Pfizer Inc., Laborers International Union of N.A., BCBS Association, American Benefits Council, and Independent Insurance Agents and Brokers of America
registered as the lobbying group, Alliance to Fight the Forty. The “forty” these groups are fighting is the 40% excise tax, included in the Affordable Care Act, on benefit plans worth more than $10,200 for individuals and $27,500 for families. The tax is effective starting January 1, 2018, and indexed to inflation thereafter.

The tax affects an extremely small percentage of health plans and individuals (in the future, not in 2018). Benefits up to the threshold amount are not subject to the tax, so participants in these plans only pay the tax for amounts above the $10,200 and $27,500 limits. In addition to generating revenue to increase access to health insurance to individuals without coverage, a goal of the tax is to discourage offering extremely generous health benefits with low employee premiums and cost sharing.

Wrong Side Of History

It is easy to understand why unions, brokers, insurers and large employers want to repeal the Cadillac tax. The tax is a potential major disruption to the generous benefits their constituents currently receive. Unions in particular have a long
history of thwarting meaningful national health care reform because of their focus on their members to the exclusion of everyone else. Continue Reading...


Technology Is Not The Answer To Better Benefits Communication and Education

Not all benefits communication and education programs are equal. Some employers can afford to provide a highly sophisticated and glossy communication experience while others are strictly old school, providing paper handouts. Some firms have their own in-house benefit enrollment and decision support systems while others still collect paper enrollment forms. And some firms hire writers, videographers and graphic artists to create branded open enrollment videos, infographics, and glossy brochures. While their poorer counterparts provide none of this.

Using the latest technology makes a big difference in the look of benefits communication and education plans. It can also mean the difference between a streamlined and efficient program versus a labor intensive one. But does a high-tech benefits communication and education program increase understanding of the benefits offered more than a low- or no-tech program? Not really.

Technology is really good at helping us get things done. It is also good at communicating a lot of information. However, it’s debatable if it helps us to understand and act on that information. This is my take on it... Learning requires you to reflect on the information you review, but using technology is mostly about getting the task over and done with. These goals seem somewhat at odds with each other. This may explain why despite the advent of online courses, webinars and training videos,
face-to-face communication is still the best way to train and learn.

Benefits Communication Gets Real

Employee benefit professionals have always used the latest technology to communicate their benefit plans. Initially they used props like flipcharts to highlight the most important aspects of the plans. Later they used overhead projectors to display plan information. Then came computer-based projectors, video, whiteboards, etc. Meanwhile, as communication and education technology methods expanded, benefit plan information became more complex.

To deal with this increasing complexity, the technology as communication and education camp went totally digital. They thought people would respond to video presentations starring talking pencils or other animated
Benefits Know It All characters. They also thought that creating videos that look like PowerPoint presentations was a new, smarter way to explain complicated benefits material. And they were kinda right… The technology is clever and entertaining, but still not conducive to real learning. Because after you take the online quiz after viewing the video, chances are you still don’t know how to use the information to make real world decisions. It was simply a fun an entertaining digital experience…

The Problem With Benefits Technology Continue Reading...


The Real Costs of Employer-Sponsored Health Insurance

The majority of Americans hate health insurance companies. They blame them for all that is wrong with the health care system in the country, but mainly its costs. But insurers do not deserve all, or even most of the blame for what ills American healthcare. There are other culprits including the medical, pharmaceutical, and medical device maker industries, politicians, policymakers and regulators. Employers and the American public are also to blame.

If health insurance companies are an extra cost layer in the health care cake, than so too are employers. They add costs to the health care system that receives little or no notice. Sure we talk about some of the costs of workplace health insurance, like the hundreds of millions of dollars in loss tax revenue due to the favorable tax treatment of these plans. And how these employer and government-subsidized plans leave workers with little skin in the game and no appreciation of the real cost of health care. But there are other costs that employers add to the country’s total health care bill that, if eliminated, could save a lot of money.

The Problem(s) With Employer-Sponsored Health Insurance

Employer-provided health insurance provides complexity to the health care system and, therefore, increases its costs. Because of the legislative and tax status of these plans, they require a regulatory system to monitor their compliance. The government hires attorneys and other specialists to perform these tasks. Also, because of their need to comply with government regulations, plan sponsors (employers) hire lawyers, consultants, brokers and other technical specialists to keep their plans in compliance and meet reporting and testing requirements. Employers also hire internal staff to work with the lawyers, consultants, brokers, etc.
Continue Reading...

Forget Trying To Defend Obamacare With Talking Points, Just Enroll More People

This past July 4th weekend the Obama Administration launched a mini PR campaign urging Affordable Care Act (aka Obamacare) supporters to defend the law at the family barbecue. Of course opponents of the law mocked the Administration’s efforts to counter their relentless negative attacks. They especially made fun of the suggested responses to typical complaints about the law. And although I sympathize with the frustration the Administration must feel about the criticism the law still receives, this campaign shows that they really don’t get it.

One look at any comment thread for any Obamacare article on sites like New Republic Online or Wall Street Journal Online and you know that defending the law with facts is a waste of time. Pointing out that opponents were wrong about everything is a waste of time. Why? Because different people interpret “the facts” about Obamacare differently and Obamacare opponents really hate and distrust President Obama. You ever try defending yourself against someone who hates you to the core? You can’t. So stop trying.

Repeal and Replace, Meet Enroll and Evolve

More Americans are familiar with the message of repeal and replace than are aware of the most important features of Obamacare, such as the availability of subsidies to help pay for health insurance coverage. Obamacare foes never miss an opportunity to say something negative about the law. Meanwhile, those who support the law often work behind the scenes. The work they do is great, but low-key and minimal. Ads on trains and buses and in medical facility waiting rooms are no match for consistent national news sound bites calling for repeal of the law.
Continue Reading...