Top 10 Employee Questions on Private Exchange Enrollment

Top 10 Employee Questions on Private Exchange EnrollmentHEALTHCARE
Top 10 Employee Questions on Private Exchange Enrollment
Towers Watson compiled these top 10 questions that full-time employees ask when enrolling in the company private exchange:

  1. Which plan has the lowest cost? Using premium cost as the most important criterion for making health plan choices could be a mistake because the least expensive plan is not always the best one. Employees should also consider their health status, the doctors and hospitals they use, and the prescription medications they take.
  2. What are the copays for the medical plans being offered? Historically, employees have gravitated toward the predictability of PPOs with copays, but these plans may cost more out-of-pocket and may not be the best choice for them. Some employees may be surprised to learn their employer doesn’t offer any copay plans. In these situations, it’s important to explain that there may be plans of similar value even if they have different coverage features.
  3. Why do my health plan options have high deductibles? Employees need tools to help them understand the workings of high deductible plans that are connected to HRAs or HSAs and why they may actually be the better choice for them. Employees also need help understanding how accounts work and the tax advantages of HSAs. Some employers enhance this transition by jump-starting the balance with a cash contribution.
  4. What are the differences among gold, silver, bronze, and safety net plans? The metal tiers mandated by the Affordable Care Act (ACA) for public exchanges (and adopted by many private exchanges) are designed to make it easier for people to compare plans but employees should delve deeper into the details beyond the metal hierarchy. Coverage, premiums and out-of-pocket costs vary by plan and insurer within the metal plans. Employees should make decisions based on a thorough comparison of plan details; they often need the help of decision support tools and live, personalized advice from an expert to do that.
  5. What do I need to do to earn my wellness dollars? Over 50% of enrollees say they will engage in wellness activities. They have many questions on how to earn wellness dollars, when they’ll have the money in their account, and what they can spend it on. This is good news for employers that have struggled to engage employees in wellness programs.
  6. How do I know if my doctors are part of the plan I choose? Being able to continue seeing their current medical providers is top of mind for employees when evaluating new health plans. However, answering this question can be a moving target as contracts among doctors, hospitals, and insurance companies can change from year to year. Exchange providers can make this complicated task easier by integrating doctor and facility lookup tools into the exchange enrollment experience. Many physicians are part of multiple plans, giving employees the choice of carriers and price points while still keeping their family physician.
  7. What are the difference among an HRA, HSA, and FSA? Health insurance is a complex topic with confusing jargon and acronyms. HRA, HSA and FSAs refer to the options employers have for funding health benefits through accounts that offer tax advantages to employees and employers for offsetting health care costs. These types of accounts have been available for some time, but are increasing in popularity as employers seek new ways to fund health benefits and encourage employees to save for health expenses.
  8. What does the prescription drug plan cover? Employees are confused by the array of pharmacy provisions, copays, coinsurance minimums and maximums, formularies, and more. They want to know what their drugs will cost for each plan and insurer option. In addition to using the decision support tools available, many employees want to discuss their circumstances with an informed service center representative.
  9. What are the differences between insurers? Confronted with different price points from different insurers for similar plan designs, employees want to know what added value they might be getting from a higher-cost insurer. While most insurers believe they do a good job of marketing and differentiating themselves from the competition, the prevalence of this question suggests there is more work to be done.
  10. If I want to keep the same plan I had last year, do I need to do anything? Historically, plans have had default rules that place employees in a predetermined safe plan choice if they don’t take action during open enrollment. In an exchange offering, some employers want to encourage an active enrollment choice each year so employees get to know the available options through a shopping experience. As employers offer more voluntary and ancillary benefits, employees should evaluate annually which of these to keep or change, as well.

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CMS Finalizes 2016 Payment and Policy Updates for Medicare Health and Drug Plans
The Centers for Medicare & Medicaid Services (CMS) released final Medicare Advantage (MA) and Part D Prescription Drug program changes for 2016 that provide fair and accurate payments to plans and encourage the delivery of high-quality care for all populations. The Rate Announcement finalizes changes in payments that will affect plans differently depending on their characteristics. On average, the expected revenue change is 1.25% without accounting for the expected growth in coding acuity that has typically added another 2%. The final revenue increase is larger than the February advance notice largely because the Medicare actuaries recently updated Medicare per capita spending estimates for 2014 and 2015. Medicare per capita spending in 2014, 2015 and 2016 is still expected to be below historical standards.
According to CMS, the changes include important improvements to the star rating system and accuracy and transparency of provider networks. To view a fact sheet on the 2016 Rate Announcement and final Call Letter, visit:

Americans Ignore Cost in Care Decisions
Americans value their employee benefits, but lack the initiative to ask doctors how much it will cost. That question could mean the difference in thousands of dollars for consumers and millions for U.S. companies. These are among the findings from a national survey of more than 2,000 employees by Benz Communications, and Quantum Workplace.

The survey reveals the following:

  • 69% of workers say they have enough information to get the right health care for themselves and their family, yet only 48% always ask their doctor how much their care will cost. Among employees with household incomes of $125,000 to $149,999, only 31% always ask their doctor how much a procedure will cost.
  • 70% say they depend on their benefit package.
  • 89% say health benefits play a part in staying at their current employer.
  • 73% wouldn’t work for a company with no health plan.
  • 73% of employees who say the Affordable Care Act changed their benefits say the change had a negative effect.
  • 52% say their employers provided an adequate explanation of ACA-related benefit changes.
  • 60% of those who have access to workplace wellness program have been inspired to make healthy choices compared to just 15% who don’t have access to a wellness plan. Communication correlates to more trust.
  • 49% of employees who trust their company leaders say they get frequent health and wellness communication. Only 28% of employees who do not trust company leaders get frequent communications.
  • 83% of those who say their manager supports their efforts to be healthy also say that there is open communication between employees and managers.

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John Hancock Acquires New York Life’s Retirement Plans Business
John Hancock Financial completed its acquisition of New York Life’s Retirement Plan Services business. The business will be combined with John Hancock Retirement Plan Services (JHRPS), significantly increasing its retirement plan assets under administration. With the closure of the transaction, JHRPS’s retirement plan assets under administration have increased by approximately 60% to $135 billion, and the business now serves 55,000 retirement plans and 2.5 million plan participants. “Retirement Plan Services is a significant portion of John Hancock’s wealth business, and having greater scale, added capabilities and talent, positions us as a major plan provider in the U.S. retirement plan business,” said Craig Bromley, president, John Hancock.

Private Healthcare Exchange for the Self-funded Marketplace
CieloStar has partnered with Worksite Benefit Services to extend the private healthcare exchange concept. The “Worksite Benefit Services Private Exchange” will offer an exclusive pricing arrangement that offers carrier connectivity and aggregated carrier billing. Employees will be able to manage all information related to dependents and beneficiaries and access a menu of client-specific links and forms. For more information, visit

State Health Insurance Marketplaces for “Lease”
hCentive is offering state-based health insurance exchange (HIX) marketplaces for “lease.” The lease offers states access to hCentive’s WebInsure State Exchange, the same HIX technology that powers federal and multiple state marketplaces. By leasing the complete solution from hCentive, states can quickly and cost-effectively deploy a federally approved HIX to serve individuals and small businesses in a more fiscally sustainable way without complex technology implementation or dependence on federal funds. The lease option also allows states to maintain federal subsidies and health coverage for the 2016 Plan Year, regardless of the outcome of the ongoing Supreme Court challenge to the Affordable Care Act (ACA). For more information, visit

Free Estate Planning Guidebook
ARAG is offering the estate planning guidebook, “Building Your Legacy” as a free download.
This guidebook will introduce consumers to the kinds of questions they’ll need to ask and explains estate planning documents, what they do, and how they work. For more information, visit

Health Credit Outcome Product
PokitDok introduced its Health Credit Outcome (HCO) product. It’s designed for lending institutions, payment solutions, health systems, and medical practitioners, as they provide new financing options to their customers for non-acute medical services. HCO is a risk model that uses patient health data, claims, and financial history. For more information, email

Affordable HR Hotline and Compliance Platform for Non-Profits
The Unemployment Services Trust (UST) is offering a cloud-based HR platform that shields nonprofit organizations from costly risk and liability by offering reliable, on-demand HR help.
It features an HR hotline every business day, hundreds of online employee training courses, ACA guidelines, and a job description builder and employee handbook template. For more information, visit

Engaged Employees Perceive total rewards More Competitively
A survey by Aon Hewitt reveals a strong relationship between how employees view their total rewards package and their engagement levels. Aon Hewitt surveyed more than 2,500 U.S. employees at mid-size and large U.S. employers about their employment experience including values and culture, work environment, engagement, total rewards and communication.

Ray Baumruk, partner, employee research leader, Aon Hewitt said, “Engaged employees value a more balanced, less oriented toward pay-only, rewards package compared to those who are disengaged.”
“Companies could see improvements in employee engagement by increasing awareness and understanding these programs. Often providing total rewards statements and related web tools can help foster greater understanding. Administering engaging quizzes or quick assessments to employees can also draw attention to rewards that may be undervalued or misunderstood,” said Pam Hein, partner, Communication Consulting, Aon Hewitt. Sixty percent of engaged employees say their total rewards (everything an employer provides to an employee, including pay, benefits, and the work environment) are above or well above what other employers offer. In contrast, only 24% of those who are disengaged say the same. Fifty-one percent of engaged employees view career development/training programs as better than what other employers offer while only 19% of disengaged employees would rate these programs as better.

Paid time off (84%) and base pay (83%) were the most understoodl total rewards programs while bonus (64%), career development/training (61%) and work/life balance (60%) were among the least understood. Baumruk said, “Employees are telling us that nothing about their total rewards package stands out. This lack of differentiation could be damaging to attraction, and many of the least understood programs are also the ones viewed by employees as less competitive.”

Employees rated their current employer’s paid time off programs (42%) and pension plans (41%) as above the competition. Bonus incentives/commissions (30%), base pay (27%), career development/training programs (22%) and work/life balance (20%) were less likely to be viewed as competitive.
For more information on Aon Hewitt, visit

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