Category: Human Capital Management

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Trends and developments to follow in the year ahead

By Stephen Miller, CEBS

January 5, 2022

s the new year gets underway,SHRM Online has collected the following predictions from experts on how compensation, benefits and workplace culture are likely to change.

Take Steps to Counter the Great Resignation

Employers facing worker shortages are now open to enacting certain changes, such as:

• Marketing the company as a “Best Place to Work.” With the rise in remote work, thecompetition is no longer just about the company next door, but also about the company across the country.
• Adopting a total rewards strategy. This involves expanding benefits beyond traditional health, dental, vision, disability and life insurance plans.
• Considering increased salaries if possible. Is your company paying competitively for the work it expects?
• Relaxing policies as appropriate. Amazon, for instance, is no longer screening for marijuana during drug testing.
• Being creative with work/life balance benefits. The pandemic showed that office employees can work virtually from anywhere in the country or the world and be just as productive as long as they have accommodations and flexibility.

—Bobbi Kloss is the director of human capital management services for the Benefit Advisors Network, a national network of independent employee benefits brokerage and consulting companies.

Expect Challenges Around DE&I and the Future of Work

Many workforce trends that will continue into the new year have implications for diversity, equity and inclusion (DE&I) strategies and outcomes. Examples include the following:

• Hybrid workplaces could lead to disparities. Having some employees working remotely and others performing their jobs onsite can create subtle inequities. Companies will need to be intentional about tracking promotions, pay scales and opportunities to ensure that remote employees are not treated less favorably.
• The Great Resignation shows no signs of stopping. In 2021, we saw people leave their jobs in droves in search of more money, more flexibility and more happiness. In response, we’ll see employers pressured to make changes such as offering increased wages, hiring incentives and competitive benefits to attract talent, and they’ll also focus on internal mobility, reskilling and upskilling to retain existing employees.
• Companies can no longer ignore mental health. The COVID-19 pandemic worsened workers’ mental health and emotional well-being. To create an environment that supports mental health, companies can appoint a senior leader in charge of mental health initiatives, offer mental health benefits that are on par with physical health benefits, ensure easy access to resources without stigma and measure how well they’re meeting employees’ needs.
• Parental leave will take center stage. The pandemic brought to light the challenges working parents and caregivers face. We’ll continue to see discussions around parental leave as workers demand better policies that put families first.

—Mandy Price is CEO and co-founder of Kanarys, a technology company that provides organizations with tools to address DE&I challenges.

Address Virtual Care and Health Equity Issues

Employers will seek increased telehealth availability and improved mental health while working toward health equity—ensuring the same access and quality of health care to all employees, including those from historically disadvantaged groups. Among these trends:

• Virtual health is here to stay, but integration with in-person care is key. Virtual health has a growing role in primary care and the management of chronic conditions. Harnessing its full value will mean helping patients to integrate care they received in person at a doctor’s office or clinic with care they receive via a telehealth service, as these providers may not be sharing clinical data. It will also be important to create a level playing field with regard to how insurers reimburse care providers.
• Virtual mental health services are expanding. The pandemic has exacerbated long-standing challenges pertaining to mental health and emotional well-being, including lack of locally available therapists and the stigma that often prevents people from seeking in-person care. Employers have responded by providing digital therapy, which can bridge access gaps for employees. Employers, however, must remain focused on the quality of these resources.
• Increased health equity is a focus. Employers are seeking to achieve health equity by offering inclusive and affordable health benefits and well-being programs, using health provider networks that are representative of the population, and analyzing claims for signs of unequal treatment. The aim is to mitigate differences in health outcomes across the workforce, including among those in under-resourced or marginalized groups.

—Ellen Kelsay is president and CEO of Business Group on Health.

Reminder: Expiring Benefits Plan Relief Provisions Under pandemic relief rules, employers can let participants in health care flexible spending accounts (FSAs) or dependent care FSAs carry over unused balances from a plan year ending in 2021 to a plan year ending in 2022, or extend to 12 months the grace period for spending unused FSA funds for plan years ending in 2021. Employers can choose to provide either or neither of these extensions. Other relief provisions ended at the close of 2021, even though the pandemic has not ended. Expired relief provisions include: The amount that employees can reduce their salary to fund a dependent care FSA goes back to the statutory limit of $5,000 in 2022, down from $10,500, for single taxpayers and married couples filing jointly. It reverts back to $2,500 for a married person filing separately, down from $5,250. Employees can no longer change their salary reduction elections to a health or dependent care FSA in the middle of the year unless the change in election is due to a change in status event such as marriage, divorce or new child; such midyear election changes were permitted in 2021. If an employee leaves a job in 2022 without using all the dollars in a health FSA, the employee will have to forfeit that unused amount; in 2020 and 2021, employers could allow terminated employees to access those unused amounts for health expenses until the end of the plan year. High-deductible health plans linked to health savings accounts (HSAs) will no longer be able to subsidize telehealth services before the deductible limit is met. In 2020 and 2021, insurance coverage that subsidized the cost of telehealth services pre-deductible did not prevent a worker from making HSA contributions. Despite these relief provisions ending as 2022 begins, it’s important to show employees the value of continuing to participate in employer-sponsored FSA and HSA programs. —William Sweetnam is the legislative and technical director at the Employers Council on Flexible Compensation.

Related SHRM Article:

As Work Changed in 2021, Employee Pay and Benefits Stepped Up, SHRM Online, December 2021

If the pandemic were to magically disappear on 12/31, what news would benefits advisors like to see make headlines in 2022?

By BenefitsPRO Editors | December 29, 2021 at 09:46 AM

If the pandemic were to mysteriously disappear on the last day of 2021, what big trends or topics would you like to see take its place in the headlines during 2022?

Extra, extra!

Here are some themes I think it would be nice to see:

Reiterating the importance of maintaining/resuming preventive services that were disrupted by the COVID-19 pandemic. For example, the pandemic led to a significant decrease in cancer screening, which could mean that some early cancers may have gone undetected, leading to later diagnoses and worse (and more costly) outcomes. Getting preventive services back on track should be a major priority.

The other thought I had was a focus on embracing and expanding employee access to mental health benefits. It’s no secret the pandemic wreaked havoc on the average person’s mental health. Many even turned to drugs and alcohol to cope. So it should come as no surprise to employers when they see a major increase in demand for mental health benefits. Nor should it be surprising to employers to find themselves falling behind in attracting and retaining top employees should they fail to provide the appropriate resources.

Here’s a headline I hope to see in the near future:

“Employers refocus efforts on improving employee health care consumerism, see major breakthrough: benefits literacy rates climb, health care costs plunge”

Matt Derus, content attorney & market analyst, Zywave

Refocus

In 2022, I hope that as benefits professionals, we will stop and reflect on what access actually means. Having insurance or being eligible for a health plan does not equal access to care. Unfortunately, it is not enough to just offer a benefit for the sake of offering it; that’s shortsighted, expensive and unsustainable.

We have to focus on the outcomes we’re trying to achieve, and build the programs from there. When we do that, we are better able to address (or plan around) weak links early on. Focusing on access and outcomes means we have to understand the supply chain. In health care, as we’re seeing today with mental health resources, the strength or weakness of each link of the chain affects access to care. We also see these issues in other areas of health care, including critical access to specialists. On a related note, when we fail to diversify our vendors, there’s so much we miss–issues that could have been addressed early on that were not seen or contemplated.

Uche Enemchukwu, co-founder and CEO, Nelu Diversified Consulting Solutions

Addition by subtraction?

Here’s the message I’d like to see from Mark Zuckerberg in 2022:

“Since its inception, Facebook has done a world of good as a conduit of social networking, helping to establish and re-establish relationships. But people today can connect in a myriad of different ways. Where Facebook was once a unique, singular beacon of constructive pathways, it has turned dark. It’s morphed into an ugly ‘too big to fail’ behemoth.

“Though I’m immensely proud that I achieved my goals, a toxic atmosphere has permeated my organization, both inside and out: racism, sexism, political and religious antagonism/hatred, homophobia, etc. Also, the crass monetization of those very things. I’m a wealthy man because of Facebook. And because I am, I can afford to shut it down, which I’m doing so effective immediately (Dec 31, 2021).

“With the pandemic now over, please take advantage of every opportunity to meet your friends and loved ones in person, and cherish the time you and your fellow citizens of the world have to spend together in unity and harmony. Life’s too short for impersonal and irrational hatred. Peace and love to all!”

Jason Marcewicz, content and communications specialist, Advanced Medical Strategies LLC

Looking ahead

I’d love to see better HSA investment vehicles. Target-date funds have changed 401(k)s by making it easy, and by increasing allocation to stocks, which do better over time, all with low fees. Something similar for HSA dollars could help boost HDHP enrollments, the percentage of people who invest their HSA balances, and HSA savings. As little as $150/month, invested to hedge health care inflation, goes a long way to neutralizing out-of-pocket costs in retirement.

Joe Andelin, founder, Olavi Group

Outside the box

If fueled by economic stagnation and monetary inflation, 2022 will drive employers to seek alternative funding strategies. The introduction of cost transparency will inject a new sense of “consumerism” at the C-suite level, resulting in fundamental change and executing on long-term strategic initiatives. We will also see a hastening of larger benefit practices also embracing the health care cost-containment train.

As a result of greater pricing transparency, the PPO value will begin to weaken not only for employers, but also for providers. Through more direct engagements, providers will strengthen relationships with stakeholders (employers), driving greater value for each party while benefiting the community as a whole. Patients benefit by gaining access to quality providers at little to no cost, with some expectation of an improved health care experience.

Doug Hetherington, CEO & program architect, HealtH2Business

Accentuate the positive

Although I predict 2022 headlines to continue grasping at the ugly to attract audiences with clickbait, my evolutionary story in 2022 dreams of a less radical society with words like “harmony,” “generosity,” “kindness,” and “honesty” dominating the headlines. Particularly at this challenging time, let’s all work to emphasize the positive, reflect on the constructive and ignore the unpleasant.

Let’s change “If it bleeds, it leads” to “Good, better, best….never let it rest.”

Rina Tikia, managing director, Risk Strategies Company

Time to reconnect

Poof! It’s January 1st, 2022 and all of those hopeful pleas for normalcy to return have suddenly been answered. The phrases “masking up,” “covid testing,” “quarantining,” “social distancing,” etc. aren’t quite a distant memory but are less prevalent. Now that we can return to more “normal” conditions, there are plenty of initiatives I’m excited to see reoccur in the workplace:

• On-site biometric screenings so employees can be proactive about their health. We’ve seen too many employees defer preventive and wellness visits. Let’s catch those potentially dangerous and costly conditions early!
• Provide in-person dietician-led sessions to teach employees some healthy recipes and prep ideas to set them up for a successful day of eating. In addition to Domino’s Pizza stock price soaring over the past 18 months, so did people’s waist sizes. The U.S. already had an issue with obesity pre-COVID; lets get in front of this issue and help people eat healthier diets.
• Organize yoga in the park to stretch our minds and bodies.
• Help employees relax with chair massages.
• Invite employees out for happy hour, meals or appetizers as a way to reconnect with employees.
• Plan a “bring your child to work” day as a fun way to show off your workplace to your family and let your coworkers meet your children.

As we head into the new year, I’m excited to help employers get back to some in person activities that promote healthy physical and mental living while reestablishing the human connection.

Brian Lacher, vice president, employee benefits, Nielsen Benefits Group

The business of health equity

I’d love to see us focus on health equity as a solution to cost waste and quality deficiencies. Employers should be at the center of leading this effort, as they are uniquely positioned to leverage their own data to get a view on race/ethnicity, medical claims, short-term disability etc. They are paying more than $22,000 per family in premiums, therefore having the financial leverage with medical systems and health plans to get real action steps in place. It should not be left up to the health care system to “own” this, as it has been for our lifetimes and beyond. The problem has to be disrupted by purchasers/patients and employers at the top!

Frankly, centering health equity is centering our front-line doctors who are burnt out, depressed and disenfranchised. There are many solutions created and led by people of color who consider these issues, yet they aren’t getting in the door at the rate of other innovators.

Equity is the top economic, social, and human-centered opportunity of this era! Those who think of it and approach it as merely an option will contribute to capping our potential in this country, and will be accountable for the many lives lost and harmed physically, emotionally, and financially. Bad care costs us billions upon billions. This is a business issue.

Jessica Brooks Woods, President & CEO, Pittsburgh Business Group on Health Founder

Wishful thinking

“HR strategists are given an extra week of paid time off” “Ping pong tables are back in the rec room” “Mask? What’s a mask?”

Bobbi Kloss, director, Human Capital Management Services for the Benefit Advisors Network (BAN)

Be happy

I believe one ideal will ring true… people will find their happiness.

We just went through a time that gave us the awareness of what we truly value in our lives, it’s time to take action and achieve. Life is too short.

I believe happiness should be free or at least low-cost. I do believe there will be more cost-effective mental health solutions that give people much easier and affordable access to therapy. It’s no longer a taboo subject, and if it is to you, I urge you to take an internal look and realize everyone has struggles. No one has a perfect mindset all the time, doesn’t our society laugh at “happy people” all the time anyway? That just shows how normal it is to not be the best version of ourselves.

It’s time we take care of each other and our neighbors and seek to understand and respond rather than to judge. Plus, it feels better when we can fill each other’s cups. Let’s be happy together.

Ed Ligonde, executive vice president, Nielsen Benefits Group

Back on track

Multiple studies have demonstrated that when the pandemic hit, people delayed critical preventive health care, and many continue to do so. Moving into a 2022 without COVID-19, it would be great to see everyone get back on track with their health and well-being and get the care they may have put off for the past 18+ months. Ideally, this would start with biometric screenings to measure any changes since early 2020. Along the same lines, I would envision a surge in wellness and related program utilization as we now have even more capabilities than we did pre-pandemic to personalize employees’ experiences to get the right content and care for their health and well-being goals.

Marcia Otto, vice president, product strategy, Health Advocate

Roaring 20’s, take 2

I’d like to see more headlines focusing on economic growth, prosperity, employment gains and increased savings rates for all Americans. The data we’re seeing today amid inflation, rising health care costs, and more is painting a bleak picture of what tomorrow may bring. At the same time, I think that all of this will help to push many to just do better – and hopefully be nicer. Here’s to brighter days ahead, and a fun Roaring 20’s 2.0.

Derek Winn, benefits consultant, Business Benefits Group

Time to hit the books

After the holiday vacations are over, it’s back to school with health literacy in 2022. As new transparency rules are in place, multi-generational employees will be looking to get more from their benefits, and ongoing education will be critical in health care. Despite ongoing efforts by employers and advisors alike, it’s important to understand that health care is still complicated for most employees and consumers.

Advisors should be ready to support clients by promoting ongoing education to employees and improving the consumer experience with their benefit plans by leveraging technology, engagement, and decision support tools. Similar to consumers shopping online for nearly everything they purchase, they should have the same access and information for health care, written in language blue collar, white collar and everyone in between can easily understand. While some consumers–usually those of the younger generations – are more comfortable with technology, the reality is they still rely on their providers for guidance and direction. Let’s get back to helping employees take control of their health care journey.

Denise Stefanoff, interim executive director, Benefit Advisors Network (BAN)

Time to hit the books

After the holiday vacations are over, it’s back to school with Health Literacy in 2022. As new transparency rules are in place, multi-generational employees will be looking to get more from their benefits, and ongoing education will be critical in healthcare. Despite ongoing efforts by employers and advisors alike, it’s important to understand that health care is still complicated for most employees and consumers. Advisors should be ready to support clients by promoting ongoing education to employees and improving the consumer experience with their benefit plans by leveraging technology, engagement, and decision support tools.

Similar to consumers shopping online for nearly everything they purchase, they should have the same access and information for healthcare, written in language blue-collar, white-collar, and everyone in between can easily understand. While some consumers – usually those of the younger generations – are more comfortable with technology, the reality is they still rely on their providers for guidance and direction. Let’s get back to helping employees take control of their healthcare journey

Bobbi Kloss, director, human capital management services, Benefit Advisors Network (BAN)

Rule aims to identify medical and drug pricing trends to control costs

By Stephen Miller, CEBS

November 19, 2021

The U.S. Department of Labor (DOL), working with the Department of Health and Human Services (HHS), the Department of the Treasury, and the Office of Personnel Management, issued an interim final rule that spells out upcoming requirements for self-funded health plan sponsors and insurers of fully funded plans to report annually the cost of prescription drugs and certain medical expenses under their plans. The rule also delays enforcement of these reporting requirements by a year, until the end of 2022.

The rule, Prescription Drug and Health Care Spending, released Nov. 17 and to be published in the Federal Register on Nov. 23, is the latest in a series of regulations implementing price transparency provisions in the Consolidated Appropriations Act, 2021, which was signed at the end of 2020. The law includes the No Surprises Act and other measures to curtail unscheduled “surprise” out-of-network health care charges and improve the transparency of health care costs.

“The No Surprises Act has helped to end surprise billing. This rule monitors pricing trends and builds on that work so we can find other barriers to affordable care,” said Ali Khawar, the DOL’s acting assistant secretary for employee benefits.

A fact sheet from the Centers for Medicare & Medicaid Services provides additional details on reporting requirements, including data collection and analysis.

Earlier this year, federal agencies issued No Surprises Act interim final rules on limiting surprise medical bills and implementing surprise billing arbitration,as well as a proposed rule on requirements for plans and issuers to report on the cost of air ambulance services.

Applicability Dates

The Consolidated Appropriations Act, 2021, requires plans and issuers to begin submitting the required information to federal agencies by Dec. 27, 2021, and to submit this information by June 1 of each year thereafter. However, under the interim final rule, regulators will not initiate enforcement action against a plan or issuer that submits the required information for 2020 and 2021 by Dec. 27, 2022.

The deferred enforcement of reporting requirements will “give health plans and insurance issuers time to come into compliance,” wrote Ayla Ellison, editor-in-chief of Becker’s Hospital Review.

Taking Advantage of Delayed Enforcement

“Although HHS said they will not enforce the rule until December 2022, employers should certainly be having conversations now with their carriers and third-party administrators [TPAs] to confirm who will be handling this reporting and when they expect to be able to comply,” Kim Buckey, vice president of client services at DirectPath, a benefits advocacy and education firm, said in an e-mail.

“Unfortunately, it’s reasonable to expect that TPAs and carriers will pass on the added costs of this required reporting to employers/plan sponsors and then, ultimately, to plan participants,” she noted.

Denise Stefanoff, interim executive director of Benefit Advisors Network (BAN), a consortium of health and welfare benefit brokers, advised that “despite the delays, employers should use  this time to prepare by reviewing their contracts with carriers and other administrators to determine if they are in compliance with the regulations. In the meantime, employers should continue to track any updates to the provisions and work with their advisors, if applicable, to get educated on what this means to them and the employees.”

Reporting Requirements

Reportable cost-sharing information includes average monthly premiums and drug spending by plan enrollees in comparison with spending by their employers or health insurance issuers.

Plans and issuers will also need to report total health care spending by the type of care patients receive. This includes spending on hospital care, primary care and specialty care, as well as on prescription drugs and wellness programs.

Because prescription drugs account for a significant portion of health care spending, the interim final rule includes requirements to identify specific cost drivers. Plans and issuers must now provide federal agencies with an annual overview of their top 50 drugs across key areas of concern, including:

• The brand-name prescription drugs dispensed most frequently.
• The prescription drugs generating the highest total annual spending.
• The drugs that resulted in the greatest increase in total annual spending over the previous year.

Additional information on drug rebates paid by drug manufacturers to plans, issuers and pharmacy benefit managers, including details on the top 25 drugs generating the highest rebate amounts, is intended to give regulators a better picture of prescription drug costs and fluctuations in their costs.

To reduce administrative burden while ensuring data is as valuable as possible for experts and consumers, the rule allows for data collection at an aggregate level and on a calendar-year basis. Plans and issuers will be able to provide information based on all their offerings collectively, rather than the more difficult details associated with plan-specific data.

Educating Employees About Costs

Although HHS intends to release aggregate reports every two years and use them to identify pricing trends and barriers to care, “given how quickly things move in the health care space, I’m not sure what value these reports will have, other than to confirm what the industry already knows,” Buckey said. “It remains to be seen just how this data will promote competition and curb the rising cost of drugs.”

However, employers on their own, she added, can “educate employees about the value of generics and the importance of shopping for the best prescription pricing—sharing plan data such as the 50 most frequently dispensed brand drugs, the 50 costliest drugs and the 50 drugs with the greatest cost increase over the previous year—and how individual choices can lead to big savings on the cost of their medications.”

Comments Requested

Federal agencies are accepting comments on the interim rule through Jan. 24, 2022. Written comments may be submitted electronically at https://www.regulations.gov.