§ The Biden Administration has officially reversed the Justice Department’s position on the ACA in California v. Texas, stating that the law is in fact constitutional.
I said in my previous blog the Biden administration is doubling down on the ACA and a push toward "Universal Coverage." This does not mean "Single Payer" Which we do not believe he has enough support nor will the budget handle such a thing after the Pandemic bailouts.
Our new model of helping employers move toward self-funding, when it makes sense, is a sound move. It helps them control costs in so many ways. Instead of the ACA one size fits all model we look at the actual health of the company and price accordingly. We will see this grow and grow in the coming years.
Please let us know if you any of your clients are looking for solutions to the high costs of the ACA plans.
Thank you so much.
Gregory S. Sailer RHU, REBC
SAILER BENEFIT SERVICES, INC.
UNIQUE EXECUTIVE & EMPLOYEE BENEFIT STRATEGIES FOR TODAY’S BUSINESS
8623 Eagle Point Blvd. | Lake Elmo, MN 55042
Office: (651) 702-5626 | Fax: (651) 702-0126 | Cell: (651) 503-4068
“Thank you so much for the referrals”
Ranked 2020 Top 25 Insurance Brokers to work with by Minneapolis/St Paul Business Journal.
Before we tackle how to reduce health insurance costs, we must understand why they are so high in the first place. There are five big - but relatively unknown – contributors to higher healthcare costs. Thankfully, there are also actionable solutions to most of these causes. Below are some both the biggest contributors to our current healthcare costs, and some solutions that could be implemented to reduce these costs over time.
Referenced Base Pricing
Many people may not realize that there is a hidden health care tax. There is an 87% discrepancy between what a commercial plan pays for hospital care and what a government plan pays for hospital care.
For instance, Medicare may allow $1,000 for a procedure that private insurance would allow $2,040 for at the same hospital. The hospital is receiving over $1,000 more for the private insurance patient because they are attempting to cover the costs of the reduced Medicare patient.
The solution to this problem is two-fold. First, we require hospitals to disclose the Medicare allowed amount on the hospital bill. Secondly, employers switch to a referenced based pricing system. That would mean that the employer would pay for the medical services of their employees based on the published Medicare rate.
Hospitals Become Responsible for Mistakes
Hospitals can be a dangerous place. While they are necessary to help you get well, it is not uncommon for them to make mistakes. And when they do make mistakes, the patient is the one who has to pay.
Let’s say a patient gets an infection after surgery. If they have Medicare, the cost to treat that infection would be absorbed by the hospital. If they have private insurance, then it wouldn’t be absorbed by the hospital, and the patient would essentially be paying twice (once for the procedure, and once for the infection).
This is serious money. According to the National Institute of Health, the annual cost of hospital infections is $9.8 billion. The solution is simple. Require hospitals to pay when they have made a mistake. The laws here should be the same for private insurance as they are for government programs. Ultimately, not only would this lower premiums, but the financial incentive would most likely reduce the rate of mistakes.
Require Disclosure and Choice
Many hospitals are padding their bills - and you may not even realize the extra cost you are paying. You may be under the impression that you are going in for an appointment with your normal doctor, but when you get the bill you see a “facility charge.” These charges aren’t unusual for hospitals, who use them for overhead costs, but why are you being charged extra just to see your normal doctor?
The reality is that many clinics are getting bought out by hospital systems, and they are adding facility fees when you visit them at a hospital facility. Sometimes, they’re even adding a facility fee when your doctor is not located at the actual hospital building.
The best solution for preventing this hidden cost would be to require disclosure and offer choice. The hospital would have to disclose how much the facility fee would cost, and offer patients the option of seeing their doctor at the normal office as opposed to the hospital.
Health Services Agreements
Usually, when we sign a contract, we look at the fine print. So why aren’t we doing that at the doctor’s office? We regularly sign provider paperwork without realizing it includes an open-ended contract. This contract indicates that you will be on the hook to pay whatever they charge, even though you won’t know that number until after they bill you.
To prevent this, providers should be required to have you sign a disclosure whenever they charge more than the Medicare allowance, and if they do not obtain the disclosure, then they must only charge you or your insurance for the Medicare allowable amount.
If you feel like you see a pattern forming, you would be correct. At the end of the day, many of the health care costs could be lowered if there was more transparency on the part of the provider.
Thankfully, lawmakers are starting to take notice of this trend and are implementing some changes. Effective right now, providers and your insurance company must give you a good faith estimate of their prices (but only if you ask). The law also requires primary care doctors to post prices in their office and on their website.
This includes their billed rate, average payments from commercial plans, and the Medicare allowable price. This is a great start, but right now there is no penalty for doctors who do not comply with the law. Our penalty recommendation would be to require them to limit what they are charging to the Medicare allowable rate if they fail to comply.
The rising cost of healthcare is a serious issue, but hopefully, if we continue on the path of requiring providers to be more transparent about their prices, we will be able to significantly reduce costs to the American people.
According to the National Restaurant Association, there are 15.3 million restaurant employees in the United States. The majority of these employees are paid hourly, and often times don’t work full time. Beyond that, the restaurant industry has a historically high turnover rate. In fact, in 2018, the restaurant industry turnover rate hit a high of 75%.
Unfortunately, these factors create a vicious cycle. Employees often don’t stay long at jobs without benefits, and restaurant owners don’t provide benefits because employee turnover is so high. This poses a unique problem for restaurant owners who want to supply their hard-working employees with benefits, and is the main reason why our team started working with restaurant groups. We knew that there was a solution that would benefit both the employees who needed benefits, and the owners who wanted their staff to be well taken care of and to stick around.
Employee Benefits in an Atypical Industry
A unique problem requires a custom solution, which is why our team dug deep to develop custom benefits plans for restaurant groups. Ultimately, many of our restaurant clients choose to provide benefit options for two separate employee groups within their business.
The full time, salaried employees receive a typical benefits package. Hourly employees receive a reimbursement every month for their healthcare coverage. This is paid for by adding a surcharge of 1% to every customer bill. The reimbursement is available to all employees who work over 20 hours a week, and allows them to purchase a health insurance plan that makes the most sense for their lifestyle.
Why Employee Benefits are Important for Restaurant Owners
It takes time to train restaurant employees, and they are valued members of a team. Providing an option for employee benefits doesn’t just help them lead healthier lives, it shows them that you care – which ultimately leads to better retention and stronger employee loyalty long-term. Our unique strategy is also cost-effective – it is designed to prevent additional budgeting problems for restaurant owners.
Implementing Employee Benefits within a Restaurant Business
As with all of our clients, we’ve simplified the enrollment process and plan administration for smoother plan management. In this case, our client’s employees simply need to fill out the necessary paperwork in order to receive the reimbursement.
To answer employee questions, we send a representative to each restaurant location for educational employee meetings, helping them to take advantage of their benefits package. Lack of knowledge should never be the reason someone isn’t accessing their benefits.
Our team also works with the owners on a 1 on 1 basis, providing consistency, simplicity, and clarity throughout the planning phase, during enrollment, and with follow-up administrative needs. It is our job to handle the complexities, so that your company can reap the benefits of happy, healthy employees.
Take the next step
If you’re in the restaurant industry and want to learn more about how our unique approach to employee benefits in the industry can help you improve employee relations, decrease turnover, and retain the best talent, let’s chat! Reach out to Joel Starke today to set up a complimentary consultation.
Healthcare is a hot button issue across the U.S., especially since many politicians have made it an integral part of their platforms. In particular, many have begun touting that a single-payer system is the answer to the healthcare problem in the United States, instead of private insurance.
A single-payer system would mean that a single public agency would take control of providing healthcare for all of the residents of the United States. Everyone would share the same health insurance plan; though they ultimately would not be able to choose which providers they visited. While this may seem like the answer to healthcare inequality, there are a few fundamental issues with this plan, and its implementation would ultimately create more problems than it solves.
Barriers to Care
The United States is a leader in innovative medicine, providing some of the most novel treatments and quick access to life-saving treatments. If a single-payer healthcare system is adopted, there may be more barriers to this life-saving care.
In countries like Canada and the UK, places with a single-payer system, there are extremely long wait times for specialized (and much needed) treatments. For instance, if you need surgery, you may be put on a waitlist and the surgery may be delayed for as long as 8 months. According to a study conducted by the Fraser Institute, in Canada there is an average 21.2 week wait time between a general practitioner referral and the time a patient actually is seen by a specialist. This wait time could be deadly.
Long wait times won’t be the only area that your medical care will suffer, you may also receive less quality care. Without competition, innovative medical treatment will most likely take a nosedive. Currently, medical professionals are driven to possess the latest and greatest in scientific and technological advancements. If being the best in the field, and providing the most innovative treatment no longer impacts a medical professional’s bottom line, chances are there will be less access to innovative treatment. Not to mention, the government may decide that certain treatments are not cost-effective, which could essentially eliminate access to potentially useful treatment options.
You May Pay More
The truth is that the money for a single-payer system will have to come from somewhere. That somewhere is taxes. Single residents and families can expect a large increase in taxes. The shift would also massively increase government spending. The Urban Institute estimated this cost to be $32 trillion over the next ten years. This kind of increase would mean less funding would be geared towards other important government-funded programs, such as education and infrastructure.
Beyond this, if you or your family had special medical concerns, and wished to opt-out so you could receive better care, you would still be required to contribute to the single-payer system. Meaning you would be paying twice for your health insurance. And that’s only if opting out would even be an option. It is possible that substitute insurance would be prohibited.
Medical Professional Shortage
Already in the United States, there is a shortage of medical professionals. The aging population is growing rapidly. A study by AAMC forecasts that today's physician deficit of 20,000 will expand to a deficit of as many as 122,000 by 2032. This increase in needed physicians is without a single-payer system. Now, imagine if we implemented a single-payer system where physician salaries are controlled by the government. This will likely result in fewer talented people seeking to join the medical profession, instead seeking a more lucrative career. This spells bad news for our aging population, who will not have access to the quality care they need. There should be efforts to encourage new talent into medicine, not efforts to discourage people from entering into the field.
While the idea of a single payer system seems to have benefits, ultimately the cons outweigh these benefits. Quality medical care that is available when people need it should not be sacrificed in order to provide government healthcare. Changes to American healthcare may be needed, but single-payer healthcare most likely is not the answer to the problems within the system.
The leadership landscape is changing, and as a result the collective culture of the workplace is evolving as well. Leaders across the country have discovered that coaching, conversation, encouragement, and promoting work life balance are the keys to having happy and productive employees. As more and more upper management, HR professionals, and business owners begin implementing these improved management styles, employees are also beginning to expect bosses who instill this type of company culture. So, if you want to be able gain and retain quality employees, you should consider initiating these management techniques.
No matter the position of an employee, everyone wants to feel respected and heard. That is why it is quintessential for managers to have regular conversations with their employees. Check in and see how they are handling their workload, ask if they have questions, and supply regular feedback about their performance. You can even just ask about their day. Not only does this establish a rapport and show you care, but it also allows you to correct misunderstandings and problems before they become an issue. The days of an unreachable boss closed up in their office are long past, and communication is in.
People, especially millennials, really value working for companies that have a greater purpose. It is up to you as management to establish what sort of purpose-driven opportunities your company provides. If your company doesn’t have a directly positive impact on the world with your product, figure out how you can add community service as part of your business model. Working for a company that helps people within your community will inspire your employees and create a deeper sense of purpose and camaraderie throughout the company as a whole.
Be a Coach
Take the time to develop your employees. Learn about your employees’ strengths and weaknesses, and discover how to utilize those strengths to their maximum potential. Be a mentor who encourages learning, shadowing, and improvement. Employees who feel like management takes the time to help them improve also feel appreciated and develop a strong sense of loyalty to the company.
Nowadays the line between work and personal life often become a blur. It is up to the management of the company to establish a balance that is healthy. Create a safe work environment that people are happy to be a part of and spend a lot of time in, but also encourage time spent with family, and time off for vacations.
Being in upper management is no longer about ruling with an iron fist, instead it is about creating a culture that inspires employees and promotes engagement and purpose. A leader who chooses to use the above management techniques is one who will easily attract employees who are excited about working for their company.
Most businesses today understand the importance of having employees who feel engaged at work, and appreciated by their bosses. Yet, not everyone has a strategy in place to make sure that occurs.
The U.S. Labor market is doing well, and unemployment is down, which means that top talent is harder to come by, and easier to lose. That makes it quintessential that companies implement an employee engagement strategy to ensure that they retain their most valuable employees.
Unfortunately, there is no easy copy and paste strategy that will work for all companies- every culture is unique, and various industry professionals value different offerings. Yet, there are some initial steps your company can take that will jump-start your engagement strategy plan.
One of the easiest ways to figure out what areas of employee engagement your company needs to work on is by simply asking your employees. You can conduct the surveys with a questionnaire, online, or with a consulting firm- the method is less important than the questions.
On this survey you want to make sure you’re asking your employees how they feel about their current career development options, financial rewards, job recognition, job characteristics, and work-life balance. Of course you can also include questions about overall satisfaction, and the general office culture.
Oftentimes, companies see that there is space to improve employee engagement, but they are not organized enough to see these changes through to fruition. It is crucial that when making a strategy for employee engagement that one person or one team takes ownership. This could be a member of the C-suite, a member of the HR team, or it could simply be an employee that is dubbed the “Culture Officer.” It matters less who it is that is chosen, and more that there is a specific person or team that will analyze the problem, implement changes, and track further feedback going forward.
The last step of the process is actually setting up concrete changes in response to the feedback received from employees. Employees don’t just want their grievances heard they want to see the problems fixed.
Fixing the problem could be as small as providing more feedback and communication, or initiating more office wide social events. It could also involve some more heavy lifting like creating a health and wellness program, or changing the telecommuting policy to allow for more work-life balance. Finding a solution that works for your company, and actually putting in the effort to implement real changes will absolutely improve employee engagement, and ultimately improve retention.
The culture of “work” is changing. With more companies than ever before offering exceptional benefits and building experiential office cultures, having great benefits is becoming more of a requirement than a perk.
Employee loyalty is no longer tied to just having a good job – employees expect companies to help them build a great work-life balance, make the workplace fun, and provide benefits that go beyond your standard employee benefits package. And for the companies that don’t do these things? They face higher potential turnover rates and a decreased ability to attract top talent.
Implementing simple strategies to improve employee retention will help you keep high value employees with your company, and support lower turnover costs. A 2018 study published in The International Journal of Advances in Management and Economics found that the factors that most influence employee retention are career development, financial rewards, recognition, job characteristics, and work-life balance. Below are five strategies that can be implemented to improve these work-related retention factors.
We hear a lot about flexible schedules, but less about how to make them work at your business. Flexible scheduling can include small perks, like summer hours or occasional work from home options, or a more comprehensive offering, like allowing employees to set their own schedules, so that they can work when they’re most productive instead of being confined to the typical 9-to-5. New technology has made this a possibility for many companies, and employees highly value the ability to make work work within their life.
The best way to make flexible and work-from-home scheduling a functional offering is to be clear about your expectations, along with any rules or procedures around how your flex scheduling works to ensure your team is on the same page.
Providing your employees with specialized training, and professional development opportunities allows you to have more qualified employees, and makes your staff feel valued. Investing in your people will create a symbiotic relationship. From industry-specific options to soft skills training (a body language training, for example), you can boost attendance by building a creative offering throughout the year.
To help your staff understand all of the opportunities you provide and see the value in the training, plan your professional development opportunities six to twelve months in advance. That will give you enough time to communicate and market your offering so that it’s visible and appreciated amongst your people.
Go Beyond Basic Health Insurance
When coming up with a benefits package, go beyond the basic health and dental insurance options and PTO offerings. Consider gym memberships, childcare support, massages, and mental health options. Even adding expanded telehealth coverage for your employees can make an impact. These types of benefits show that the company cares about the well being of their employees and makes employees feel appreciated, while helping them better care for themselves and their families.
One way to maintain a positive company culture is to host social events. This can be anything from a team or vendor happy hour to company-wide potlucks to off-site celebrations. This allows employees to bond, facilitates good team communication, and instills a bit of fun and excitement into the work atmosphere – all of which builds stronger employee loyalty and boosts retention rates.
Make Employee Retention a Priority
Great employees are the cornerstone of great companies. Keeping your employees happy, engaged, and feeling appreciated will help you build a stronger relationship with your staff, deepen the employee experience and support stronger retention rates. If you want to maintain your fantastic employees give some of these retention strategies a shot.
When we start working with a new client, one of the first things we hear about are the challenges they experienced in managing their previous benefits program. From coordinating open enrollment for their staff to explaining plans to onboarding new employees, there’s a lot of paperwork and timelines to manage – which oftentimes goes far beyond their main job duties.
After the same client spends a season with us, we start hearing about how much easier their job has become. That’s because our job is to do more than just sell you the right benefits package for your company and your employees. We strive to deliver amazing tools and customer service that simplifies the administrative side of your employee benefits plan. Wondering what that could look like for your company? Below, we outline a few of the tools and services that make work easier for each of our clients.
Our online enrollment tool, Ease Central, is the first step in our approach to uncomplicating benefits for your team. This is the portal that houses all of your documents, and helps your staff enroll in the right programs. You send us a list of employee names and contact information, we get each one set up in the system with an individual login, and they review their options to elect all of their benefits in one simple platform.
Questions from your team are directed to our experienced staff, so we act as an expert resource to help walk your employees through their plans. This takes the headaches out of open enrollment, and simplifies your onboarding system for new employees.
Downright Thorough Information
Within Ease Central, we add a customized employee packet that outlines everything available to them in a snapshot. We also create a customized video for your staff that outlines all the documents they’ll find in the portal, what each plan includes, and some FAQ’s about the options they have. This is a critical piece of our process, as it helps your employees feel empowered to make the right choices for themselves and their families as they’re reviewing their options.
Painless Deductions and Reporting
Once your company wraps up the open enrollment period, or your new employee finishes their paperwork, we get everything set up with the insurance companies and pull a summary that’s shared with you. This helps you understand which benefits your staff opts into most – and finds the most useful. It also makes setting up payroll deductions effortless.
A Managed Timeline
When we set your company up in our system for open enrollment, we set up a clear timeline with e-reminders so that your employees have ample time to elect their benefits, without you constantly needing to remind them to do so. It’s virtually a hands-off process for your HR folks – we manage the paperwork, we manage the timeline, and we even get in touch with staffers who haven’t filled out their details.
A Scalable, Scrupulous Approach to Employee Benefits
If our approach to helping you find and manage your employee benefits sounds different from what you’ve experienced in the past, that’s because it probably is. Our vision is to help you find what fits your company and takes care of your employees, while providing you with an elite level of customer service, with no additional fees or charges for leveraging our expertise. Basically, we treat you how we like to be treated – and once you experience the difference of having a real benefits partner by your side, you won’t want to work with anyone else.
The labor market is big news right now. Unemployment is under 4%, and local companies are on the lookout for new, innovative ways to not just attract the best talent to their team – but retain the people they’ve already invested in.
One way to make your company stand out is to strengthen the connection between your corporate culture and the entirety of your employee benefits package. The emotional connection – and therefore, loyalty – employees feel towards your company starts and ends with whether they enjoy their job and the people they work with, along with how your company promotes a strong work-life balance. And by nature, you can deepen what your company has to offer in these channels through a more well-rounded benefits package.
Grow your wellness program
Today’s best employees want jobs that work for their lives – not the other way around. One way you can build this mentality into the way your company operates is through an innovative wellness program. Not only will this help reduce stress, build stronger relationships among your staff and promote a healthy lifestyle for the people who work for you, it will help drive stronger productivity and employee engagement. There are many ways to do this – but here are a few ideas to get you started:
Offer more expansive food and beverage options
Today’s modern employee naturally expects more from their employer, down to the snacks they offer in the breakroom. Gone are the days of a pot of coffee and a water cooler – your coffee bar and vending machines speak to the type of experience potential employees anticipate at your business across the board.
To start, offer a variety of coffee, tea and water options in your break room and at interviews. Stock your kitchen with simple, healthy snacks like fruit and nut bars. And if you offer vending, consider adding a healthy vending machine that stocks fruits and vegetables.
You could also consider a partnership with a local healthy restaurant, like Panera, to offer convenient group delivery options for lunch meetings. By making healthier options more accessible within your office, you’ll show both existing and potential employees that you value them, and that you’re adapting to their generational culture, not just expecting them to adapt to your company culture.
Make sure your parental leave policies are up-to-date
There’s a huge focus on family leave as a whole, and it can be a deal breaker for your staff. From traditional maternity leave to caring for sick family to taking care of family when a spouse or parent is called to active duty in the military, companies that offer broad, inclusive leave options are thriving.
To make sure your employee leave policies match your staff expectations, consider hosting a small employee group review of existing policies and ask for feedback on what they’d like to see added in the future. Then work with your HR team and your employment attorney to choose what will be included in your new leave standards, and craft an updated policy for your handbook.
Offer workplace flexibility – but be clear on what that means
Today’s employee is looking for a more flexible workplace. That said, you need to be up front about what that means and includes at your business, as “flexibility” often means different things for different people.
For example, you could offer a 4 day in-office work week, with the option of working from home on Fridays. You could create extreme flexibility with a completely virtual work environment. You could look at adding additional PTO or flex-time as a retention or hiring incentive. You may even offer different versions of flexibility for different staff levels.
No matter the format, you need be clear about your expectations for when and how employees work, along with what you expect them to accomplish if you want your flexible workplace to truly benefit your company.
A changing employee means a changing workplace
Just as digital media has changed how our business operates, it’s changed the expectations of today’s best workers. As the way we work continues to evolve, our health and benefits offerings will change as well. If you’re looking build a more comprehensive offering that attracts the right talent, builds employee loyalty and sparks employee engagement for your business, we’d love to chat. Reach out and let’s get some time on the calendar.
Did you know that cost is the number one reason why Americans don’t take their medications as prescribed? That doesn’t just impact their health and wellbeing – it impacts their ability to do good work for your company.
Here’s part of the problem: prices for prescription drugs can vary widely between pharmacies. The main pharmacy you – or your employees – visit may charge $150 for your prescription, while the exact same prescription carries no cost at another pharmacy down the road. But without the right tools and knowledge, you’d never know.
For many of our clients, finding the right tools to help their employees control and manage the rising cost of healthcare is now an essential component of their benefits packages. One of the tools we are recommending our clients share with their employees is GoodRx, which helps your staff choose a pharmacy based on prescription price, and offers prescription coupons to further discount the cost.
The truth about prescription prices
Whether your employees opt-in to your health plan or not, they could be spending less on their prescriptions. Even a $10 co-pay could be more than the true cost of a generic prescription, and over time, all those additional costs can add up. With GoodRx, your employees can find many of those generic prescriptions for just $4, if they’re choosing the right pharmacy.
Brand-name medications can cost significantly more. Having access to the coupons provided through a powerful app like GoodRx could save them upwards of $500 a year, depending on the medications they need and the frequency of their refills.
How can an app like GoodRx save my employees so much money?
The GoodRx app is linked to a huge database that tracks prescription prices across pharmacies around the nation, and is a coupon conglomerate for nearly every prescription drug on the market. By simply checking the app for the prescription they need, your employees are shown the best ways to save money before their doctor even sends the prescription to their pharmacy of choice.
All that said, it’s important to note that GoodRx is something used in place of insurance. Purchases made via GoodRx cannot be submitted to insurance or Medicare, nor will purchases apply towards a deductible, although the use of HSA dollars to pay for the prescriptions is allowed if the medication qualifies.
What that means is that GoodRx is an excellent app to have on hand for most of your employees, but it’s not for everyone. In some situations – such as when there are a lot of anticipated medical expenses and/or expensive prescriptions that an employee or their family will need throughout the year – it may make more sense to satisfy a deductible and skip the GoodRx coupons.
How will GoodRx impact my bottom line?
The best part of an app like GoodRx? There’s no cost to you to share it with your employees, or for your employees to use the app and coupons. Sharing education about the platform, and encouraging your staff to take charge of their out-of-pocket healthcare costs is one way that you can empower your employees to create significant healthcare savings in their budget, and is a great way to show your staff that you care.
It doesn’t make you any money – why are you sharing this with me?
At Sailer Benefit, we believe in helping our clients get more out of their employee benefits packages. That means more than just understanding all the ways your staff can better use their benefits. It means helping you identify what will supplement the tools and programs you already have in place to build more ROI and savings for both the company and the employees. GoodRx is just one tool that we recommend to our clients as a way that they can help their employees maximize their healthcare spend.
Have questions? We’re happy to help! Reach out to schedule a quick consultation with us today.