Six Years After The ACA, Employers Turn To Benefit Consultants For Strategies And Compliance Advice

Since it became law in October, 2010 the Affordable Care Act has challenged employers with regulatory compliance and administrative responsibilities that can overwhelm even the seasoned HR veteran. More employers are now looking to their broker-consultants to develop strategies that increase efficiencies and save money.

Six years after the Affordable Care Act (ACA) became law, compliance and regulatory guidelines continue to perplex employers as they work to fund and deliver employee benefits programs that balance the needs of their businesses and help them attract and retain the best employees.

Employers face a range of challenges that have escalated with the ACA regulations, including increased compliance and administration responsibilities, the pressure to offer wider benefit choices, the burden of controlling the costs of their benefits programs and additional reporting requirements.

According to the most recent Guardian Workplace Benefits Study (July 2015), 60 percent of employers report that they need help managing their ACA responsibilities, and many are seeking outside consultants for advice in response to confusion over health care reform. Most of these are small and mid-sized employers.

In addition to these challenges, employers are also dealing with mounting pressure to balance employee well-being with containing company costs for benefits-related administration. According to the Guardian study, fewer employers are asking employees to pay for more benefits as a part of their cost-curbing strategies. Instead, they are turning to broker consultants to reduce their benefits administration burden and find increased efficiencies and savings.

Employers believe the ACA’s impact on their businesses will extend beyond insurance premiums. Forecasting the time required to address compliance and administration drives their costs up, a growing number of business owners either already have enlisted or plan to enlist third-party administrators, carriers and brokers to help them navigate ACA-related changes and identify strategies that can meet both company and employee needs.

James Consedine, President of Tulsa, Oklahoma-based Benefit Plan Strategies is an employee benefits broker and consultant who is called upon by companies employing anywhere from two to 2,000 employees to help design their benefits plan, address compliance issues, and broker and market the actual insurance policies that the employers will use for that plan. In addition, Consedine handles ancillary services such as plan administration, telemedicine services, and other types of health services administrative responsibilities needed.

“Companies are drowning in regulation and need help,” Consedine says. “In addition, the Department of Labor (DOL) has stepped up their audit process and frequency regarding employee benefits and compliance. We are needed to pick up slack because employers are lost, and cannot fund the additional staff and few companies have in-house administrators who specialize in this area.” While the future of the ACA is unsure given the recent election of Donald Trump, who vowed to repeal it during his campaign, complete repeal is doubtful. More likely are modifications such as an end to the Cadillac tax and changes in the subsidy program for individuals. Consedine stresses that concrete changes will take a while, so it’s important to understand the system as it stands.

At a time when the workplace is a foundation of financial security for many American households, employees confirm the importance of their workplace benefits and the role those benefits play in their overall financial security. Reliance on benefits, according to the Guardian study, is leading many employees to believe employers have a responsibility to provide core benefits. Employers, however, don’t always view benefits in the same light, and may be underestimating employees’ positive opinion of the ACA.

According to Consedine, the insurance industry is currently in a heavy regulatory season, which means employers have a lot of regulations on their hands in order to comply with the Affordable Care Act. To compound the problem, the major insurers are losing hundreds of millions of dollars on ACA sponsored plans. This makes for a stressed relationship between employers and the insurance carriers.

“Right now our focus is consumerism and value of the benefits,” Consedine remarks. “Many employers are moving to this approach for health plan management in response to the financial impact of the ACA. The goal is to help motivate plan participants to become healthier and more prudent purchasers of healthcare services.” This consumerist approach may include providing educational tools to participants like wellness programs to encourage better health, and establishing plan designs that offers rewards for sound usage.

In contrast, Physician Focused Consumerism (PFC) is a set of initiatives designed to align physician decision making with high-quality health care outcomes provided in a cost-efficient manner. PFC can include the redesign of financial incentives, greater access to patient data, decision support tools, on-going education about treatment alternatives, and an understanding of the financial impact of alternatives on patients. It can be the basis for collaborative efforts between employer health plan sponsors, provider systems, and physicians to help achieve high-quality care cost-effectively.

As a member of the Board of Directors of United Benefits Advisors (UBA)— a partnership of more than 140 established independent employee benefits advisory firms in North America and Europe— Consedine has access to, and expertise in a host of state-of-the-art tools and solutions that can boost employer benefits and shore up costs.

“It’s important to make sure that our organizations’ partners are equipped to handle anything the government brings along regarding regulation,” he says. “Wellness programs, various spending accounts, telemedicine—there are a lot of tools that go along as ancillaries to a medical plan, and these are the core of participant-focused consumerism strategies.”

Custom-fit benefits and communications better address employee needs at different work stages. In the process of finding solutions that suit everyone, employers are looking at innovative ways to tailor their enrollment processes and ongoing communication to align with the individual needs of each employee. In particular, employees starting their careers and those approaching retirement have very different financial needs and require benefits and communications relevant to their individual situations.

“Employers are realizing that advancements in outsourced expertise and technology are reshaping the benefits landscape,” says Consedine. “To control costs, improve efficiency and keep up with legal and regulatory changes impacting their benefits programs outsourcing elements of administration, enrollment, and absence management is becoming a more and more attractive option.”

Contact Info:
Name: James Consedine
Email: Send Email
Organization: Benefit Plan Strategies
Phone: 918-398-2600

Release ID: 169244