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Behavioral economics can increase plan participation.

There is much employers can learn from the three principles of behavioral economics — loss aversion, social norms and hyperbolic discounting (a.k.a. procrastination) — when it comes to employee health care.

That was the message at ignite09, a May 27 symposium sponsored by the American Benefits Council, PBM Express Scripts and Hewitt Associates.

So why should benefits professionals care about these principles? By applying them to benefits package designs and wellness programs, you can overcome common obstacles to compliance and participation.

Example: With a goal of 90% employee participation in their wellness program, Nationwide Insurance Co. offered employees a $35 credit for completing an HRA. When that only got 30% participation, they tried adding $10 to the bi-weekly paycheck of participating employees the next year. That got them 60% participation. There was no money to up the incentive, so Nationwide rethought their carrot-only approach — this time invoking the principles of both hyperbolic discounting and loss aversion.

This year, the company "doubled the financial incentive," Jack Towarnicky, Nationwide's associate VP of benefits planning told attendees, by introducing a $260 added contribution for medical coverage that they then waived for wellness program participants. Consequently, participation rose to 85%.

"A lot of other companies who only use carrots, who only use positive incentives, many of them didn't achieve their participation and utilization goals as well," Towarnicky said. "Because using only positive incentives allows non-participants the option to maintain the status quo."

Have you experienced this situation with your wellness initiatives? Share your thoughts below.

Republicans release health reform proposal

After months of Democrats responding to Republican criticism of their health care proposals with, "So where's your plan?" Republicans finally have an answer.

Sens. Tom Coburn, (R-Okla.) and Richard Burr (R-N.C.) and Reps. Paul Ryan (R-Wis.) and Devin Nunes (R-Calif.) released The Patients' Choice Act of 2009 today.

The legislation proposes to create individual state health insurance exchanges that offer a tax credit to families and individuals to cover costs, with no mandates to carry coverage. It also claims employees will be able to keep their current coverage, and even take it with them to a new job.

Here is an excerpt:

"The Patients' Choice Act would give every American the opportunity to choose the health care plan that best meets their individual needs. It will utilize state-driven exchanges to facilitate real competition between private plans and give Americans — for the first time — a choice of health care plans ... unlike the government-driven change being advertised today, it will truly achieve portability so that workers can take benefits with them when they change jobs. Rather than Washington and company CEOs, the Patients' Choice Act puts patients in control."

Take a look at it here and let us know what you think.

June Issue Preview

Take a first look at the June issue of EBA where we tackle Massachusetts brokers' perspective on national health care reform, what's happening with medical tourism and why executives should take another look at their benefits.

AHIP on the record

America's Health Insurance Plan's Robert Zirkelbach sat down with EBA to discuss the organization's role in health care reform. Highlights include when we can expect to see legislative proposals from AHIP and what motivated them to join fellow stakeholders in promising the White House they'd reduce the health care spending growth rate.

Is state-level reform a good idea?

Kathryn Wilber of the American Benefits Council isn't so sure. Watch as she shares her thoughts on how such reform efforts would affect employers, and why legislators need to think about what defines a state reform effort before promoting (or opposing) it.

Obama: I want progress by June

In a follow-up letter to the health care stakeholders who offered to cut the health care spending growth rate by 1.5%, President Barack Obama said yesterday he will hold the groups accountable for their promise — and expects progress to be made by June.

Do you think they'll deliver?

A 'watershed event' for health care reform

In a letter to the President that was followed by a White House meeting May 11, health care organizations pledged to do their part to decrease the annual health care spending growth rate by 1.5% over 10 years —a projected savings of $2 trillion or more.

What "doing their part" means in terms concrete, measurable initiatives remains to be seen, but in prepared remarks delivered after meeting with the organizations, President Barack Obama said called it "a historic day, a watershed event in the long and elusive quest for health care reform."

The Advanced Medical Technology Association, American Medical Association, AHIP, PhRMA, American Hospital Association and Service Employees International Union outlined actions such as focusing on administrative transparency, quality and efficiency incentives, encouraging coordinated care and improving delivery models as ways to cut costs, but did not provide specific details.

Obama was also pleased that the initiative will help him keep a campaign promise to save families an average of $2,500 on their upcoming health care costs. "The steps that are being announced today are significant," he said. "But the only way these steps will have an enduring impact is if they are taken not in isolation, but as part of a broader effort to reform our entire health care system."

Although she has no delusions that this offering will put an end to public plan talks, Janet Trautwein, EVP and CEO of NAHU, believes the stakeholders' proposal "will go a long way towards preventing [a public plan] from becoming a reality."

Carriers hope more regulatory pain will protect them from a public plan

Listen in as Groom Law Group's Bill Sweetnam takes a look back at the week that was in health care reform. Specter's defection, employer divisions, and the carrier community's public relations problem are just some of what we cover. Check it out.

Senator says let the states have a go at health care reform

Right up there with his opposition to a public plan option (unfair playing field, cost shifting, etc.), Senator Orrin Hatch (R-UT) made clear to reporters May 7 his hope that federal health care reform will be flexible to individual state needs.

"There is an enormous reservoir of expertise, experience and field-tested reform," he says. "We should take advantage of that by placing states at the center of efforts tailored to meet coverage and affordability goals so that we can use approaches that best reflect their unique needs and demographic."

While he says "some of the larger states are disasters," others have made strong advances in their own health care reform initiatives. (Not surprisingly, Utah is high on that list.) He'd like to see 50 state laboratories "where we can pick and choose among the best programs."

But what about ERISA? Hatch contends that it's a tricky issue. Even so, "we’ve got to find ways in the states to help us with efficiencies, with quality, with deliverability, with interoperability, with all of those things, and I think that can be done. Now, will some of those states mess it up? Yeah … but most states would run a system a lot better than it could be done here in Washington."

Do you agree? Would you like to see reform happen on a state-by-state basis, or are broad federal regulations in order? Share your thoughts below.

Single pay protesters disrupt Senate health care coverage talk

Before the Senate Finance Committee could get a word in at their health care coverage round table May 5, protesters let the Senators know they wanted a single pay supporter at the table. After the crowd calmed down, Senator Ron Wyden said individual choice is central to reform — and that’s just what employers are lacking.

Wyden referenced testimony by from NFIB's Dan Danner saying small business employees are best served by choosing their own health insurance plans with employer contribution dollars. He then asked big business rep Business Roundtable's John Castellani if there was a way to unify small and big business by following Danner's suggestion, but 1) also allow workers to use their health care dollars on their employer's plan 2) tread softly on ERISA, and 3) continue prevention incentives.

"The answer is in part yes, but in part no," says Castellani. Listen to his reasoning and share your thoughts below.

16 senators back public plan option

In a letter to health care head honchos Senators Max Baucus and Edward Kennedy April 29, 16 democratic Senators urged the chairmen of the Finance and HELP committees, respectively, to include a public plan option in reform legislation.

"There is no reason to believe that private insurers alone will meet the public purpose of ensuring coverage for all Americans at an affordable price for taxpayers," reads the letter.

The Senators cite Medicare Part D's lack of a public plan alternative to private drug plans as an example of "a privately run program that has hiked up drug prices at the expense of patients and taxpayers ..."

The letter goes on to say that "history suggests that the insurance industry will build a model at least in part around pushing government subsidies upward. A public plan option that sets the standard for quality, efficiency and costs will create incentives for healthy competition that will serve the interests of all Americans."

Senators who signed the letter include:
*Sherrod Brown (OH) *Bob Casey (PA) *Dick Durbin (IL) *Kirsten Gillibrand (NY) *Tom Harkin (IA) *Daniel Inouye (HI) *Ted Kaufman (DE) *Carl Levin (MI) *Jeff Merkley (OR) *Jack Reed (RI) *Jay Rockefeller (WV) *Bernie Sanders (VT) *Charles Schumer (NY)*Debbie Stabenow (MI) *Jim Webb (VA) *Sheldon Whitehouse (RI)

Do you agree with these sentiments? Share your thoughts below.

'I don't sense any appetite whatsoever to invoke reconciliation.'

While this is what Sen. Christopher Dodd (D-CT) said this morning in response to the news that Democrats will include health care reform in a reconciliation bill if a consensus hasn't been reached by Oct. 15, the HELP committee member also stated that "there's even less of an appetite to lose the health care debate at the end because a handful of people decided they were going to oppose this and make it impossible to get to the conclusion of all of this."

When invoked, reconciliation allows the majority party in Congress to push tax or spending measures through without being blocked by filibuster, which means a bill can pass with 51 votes instead of the usual 60.

Dodd told reporters at a Kaiser Family Foundation breakfast that he hopes health care reform legislation will pass with 70 to 75 Senators' approval. "That's not only important in terms of passing something, I think it's critically important to developing the kind of support that we'll have to sustain with the American public if we're going to deal with the issue," he said.

What do you think are the odds of a 75% approval of health care legislation? Share your thoughts below.

April 29: Mark Your Calendars

That's the day the Senate Finance Committee will hold a closed-door session to hash out the details of a health care reform proposal. The foundation for the proposal will be a white paper released by Chairman Max Baucus (D-MT) in November 2008, he told reporters at a breakfast this morning.

Baucus said a public option plan still remains on the table, but "it might be a bit on the side of the table."

Media reports show that Baucus also said the health insurance system should be more nationally uniform, much like the connector system that has been instituted in Massachusetts with a minimum level of benefits. "You can't have benefits one level in one state and another level in other states," he said.

Baucus's bill will later be combined on the Senate floor with a separate bill written by Health, Education, Labor and Pension Committee Chairman Senator Edward Kennedy (D-MA). Stay tuned.

Health agents find the hot seat yet again.

Last week it was DeParle, this week it's House Education and Labor Subcommittee Chairman Robert Andrews (D-NJ) getting rough with the universe of benefit advisers.

NAHU's EVP and CEO Janet Trautwein tried to stand her ground, but Andrews wasn't going to let her dodge the question: How is America going to pay for health care reform? Specifically, he was looking for her to praise or diss two proposals: 1) higher taxes on top-earners, and 2) ending subsidies for private medicare plans.

Not really what Trautwein came to talk about, but she did offer the idea of further hiking the tax on cigarettes. Not going to happen, according to Andrews.

We caught up with Trautwein afterward. Check it out and share your thoughts.

Health Legislation Ready In Six Weeks, Say Senate Leaders

Health care reform legislation will be ready for mark-up in early June, say Senators Max Baucus (D-MT) and Edward Kennedy (D-MA), chairmen of the Senate Finance Committee and Senate HELP Committee, respectively, in a joint letter sent to the President. Highlights of the letter, sent April 20, include:

Both committees plan to mark-up legislation in early June. Our intention is for that legislation to be very similar, and to reflect a shared approach to reform, so that the measures that our two committees report can be quickly merged into a single bill for consideration on the Senate floor.

We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure that we are getting our money’s worth. With your continued leadership and commitment, and working together, we remain certain that our goal of enacting comprehensive health care reform can be accomplished with the urgency that the American people rightly demand.

What do you think about this promise? Will the legislation be ready by June? Share your thoughts below.

May Issue Preview

Watch as we give a sneak peak at some of the top stories in EBA's May issue. Then, share your thoughts with us, here or through e-mail:
robert.whiddon@sourcemedia.com or elizabeth.galentine@sourcemedia.com.
We want to know what's on your mind.

William Gallagher's Chris Nadeau takes issue with DeParle's public plan reasoning

It didn't quite resound throughout the country, but some benefit advisers did take notice of, and objection to aspects of the White House reform czar's recent comments. Listen in as Chris Nadeau, EB practice leader for William Gallagher Associates and chairperson of CIAB's Council of Employee Benefit Executives, offers his take on what was said and what it means for benefit brokers and advisers.

Called out: Obama's health reform czar draws attention broker-less option

With all the talk of a public plan option swirling around health care reform initiatives, Nancy-Ann DeParle, director of the White House's new Office of Health Reform was asked for her own definition of a public plan during a Q&A with reporters this morning:

“A public plan is something that’s sponsored by the government and therefore has very low or almost non-existent administrative costs compared to others — doesn’t have the need to have brokers out selling, it wouldn’t have the need to have a lot of cost and profits the way private plans would, so it has that advantage ... ” she said.

Sure, a broker may not be as necessary with a public plan than a private one, but considering this White House representative brought up brokers of her own volition (no one had asked a question raising the issue) and specifically called their absence out as a top-of-the-mind advantage to a public plan, does this make you nervous about the White House's perception of a broker's role in the future of health care?

Share your thoughts below, or e-mail elizabeth.galentine@sourcemedia.com

An Employer's Perspective On Cost Saving, Wellness

After a Blue Cross and Blue Shield press conference announcing the expanded use of generic drugs, Diane Mohorter, senior benefits manager for Birds Eye Foods, took a moment to share how the "Generics are Real" program, as well as other wellness initiatives, has helped Birds Eye's bottom line while keeping employees happy.

Defining Involuntary

The DoL has added to the Q&A section of it's Web site explaining the COBRA subsidies. This includes a link to the IRS's further explanation of what it means to be "involuntarily" terminated.

So, involuntary or not? Here's a simplified sample. Be sure to visit the Web site directly for full details.

YES: the employer doesn't renew a contract when it expires.

NO: divorce or a dependent child becoming independent.

NO: the death of an employee or absence from work due to illness or disability.

YES: reduction to zero hours (lay-off, furlough, etc.) that results in lost coverage.

YES: voluntarily quitting in response to an employer imposing reduced hours.

Public Plan Option Would Reduce Private Plan Participation By The Millions

A public health insurance option as proposed by the President (limited to small employers, individuals and the self-employed) that assumes Medicare payment levels, would lead to a 32 million-person decline in private plan participants, according to a study released yesterday by The Lewin Group. If private payer reimbursement levels are used, 10.4 million people are estimated to switch.

If the public plan is open to all employers at Medicare payment levels, Lewin estimates a two-thirds reduction in private insurance enrollment. Participation would decrease from 170 million people to 119.1 million. Using private payer levels, enrollment in private plans would decline by 12.5 million.

What do you think of these results, are they what you would expect from a public plan? Share your thoughts below.

NAHU Members Want Their Voice Heard

Congress needs to know the pivotal role benefits professionals play in keeping health care costs down, says Dave Petno of Ohio's Accelerated Benefits. In town for NAHU's annual Capitol Conference, Dave took a few minutes to speak with EBA before heading to Capitol Hill to meet with his Congressmen. Watch as he shares his thoughts on the value of being a "cost-control broker" and how aspects of the American Recovery and Reinvestment Act would have benefited from a benefits professional's perspective.

OMB Director Talks Budget Numbers ... Sort of.

President Barack Obama began his address to the nation last night by stating fours areas that are important to him — health care, energy, education and cutting down the deficit.

In a phone conference with reporters today, OMB Director Peter Orszag talked about the money in the President's FY 2010 budget proposal required to accomplish those initiatives. Here are some of his comments relating to financing health care:

"With regard to health care, exactly as under our budget submission, both the House and Senate include deficit-neutral reserve funds to kick-start the health reform process ... The way the budget resolution implements the proposals that the President put forward and the concept that the President put forward is through a deficit-neutral reserve fund."

One reporter asked Orszag to address criticism that when President Clinton made tough choices it was to raise taxes in order to reduce the deficit, while President Obama is making choices to expand the role of government in energy and health care:

"We are, in terms of health care, approaching this in a somewhat different way than was the case in the early 1990s. But I don't think it's accurate to say,just pursuant to what we were just discussing with regard to the deficit-neutral health reserve fund, it's not accurate to say it's a massive expansion of government.

And then the final point I would make is ... if you've asked corporate leaders over the past decade or two what the key to our long-term productivity is ... they have answered consistently: a more efficient health care system; a more efficient energy base and reduced dependence on foreign oil; and improved education, along with ... raising national savings, which involves reducing the deficit."

Do you follow Orszag's logic? Share your thoughts below.

Wellness Programs Vital To Health Care Reform

After the stimulus package passed with $1 billion allotted to prevention and wellness efforts, there was some chatter on blogs and op-ed pages about the likelihood that these funds will help end the recession. "Disease prevention is important, however, it is uncertain how it will help to stimulate the economy," said National Review's Rich Lowry on the conservative news magazine's blog.

At the Senate HELP committee's hearing on insurance market reform today, it was clear that these efforts remain important to legislators and industry leaders in initiating health care reform.

"We see a tremendous level of enthusiasm among the employer community to implement well thought out, appropriate programs. And I can tell you from our own experience with 36,000 employees, our medical cost went up 3% last year, and the reason it went up only 3% was because our employees engage in wellness and fitness ..."

— Ronald Williams, Aetna CEO

"I've been trying to get my head around how insurance is utilized more effectively in ... prevention and wellness. I saw a picture ... of a sink that was overflowing with water and yet people on the floor were mopping it up ... It seems to me insurance is paying for mopping up the floor, but not paying much to think about shutting off the sink ... What is the role of insurance engaging people in healthful lifestyles, for businesses to be involved?"

— Sen. Tom Harkin (D-IA)

What do you think about the role of wellness and prevention programs in health care reform? Will they help, or just add to our deficit? Share your thoughts below.

Check Out Our April Issue

We've just wrapped the April issue of EBA. Watch as we give a sneak peak on what you'll be seeing in your mailbox soon.

401(k)s Still A Top Retirement Resource

Employers and employees are "still strongly committed" to matching and contributing to 401(k) retirement programs despite the economic hit they've taken, says WorldatWork's Cara Welch. So say the results of a December 2008 survey conducted by the non-profit and the American Benefits Council. Here, Welch, WaW's director of public policy, expands on those results.

Suspending Match Considered Extreme Move

The 401(k) market is standing strong in the face of the economic turmoil, a December 2008 survey from the American Benefits Council and WorldatWork reveals. Nearly three-quarters of respondents reported no change in their matching contributions.

That’s the good news, but for those companies thinking of reducing or dropping 401(k) matching all together (11%), employers should beware of the impression this could send to employees if ABC’s Lynn Dudley’s comments at a press conference today are any indication.

“By and large, employers are consistently making this match. The economic downturn hasn’t caused them to drop off their match,” says Dudley, senior vice president of policy. “Where that has occurred, it has been a response to a particularly devastating circumstance for an industry or company, and maybe some of the challenges that they’re experiencing in the defined benefit/pension area as well.”

Dudley says dropping the match doesn’t mean employers won’t bring it back eventually. In fact, that’s been the experience she’s seen so far.

Still, just because the match comes back doesn't mean employee confidence in the company will.

How do you think employers reducing or dropping the 401(k) match is impacting employee morale? Have you seen your customers experience any consequences from doing so? Share your thoughts below.

We're Looking For A Few Good Blogs!

Know of any good benefits blogs? We're looking for benefits-related blogs for an upcoming article and we'd like to know, where do you go for your benefits news? Have a blog yourself? Send us the link. Our blog wants to meet your blog.

If you'd rather e-mail, send the link to elizabeth.galentine@sourcemedia.com.

Will A Public Plan Lead To Lost Coverage?

During the Senate Finance Committee hearing on FY 2010 health care budget proposals yesterday, ranking member Sen. Chuck Grassley (R-IA) questioned the President's campaign promise that under his reforms, "If you've got a health care plan that you like, you can keep it."

Citing The Lewin Group, Grassley was concerned that a public plan offering government rates competing with private insurers could lead to 118 million people losing their current coverage. Peter Orszag, director of the Office of Management and Budget, offered this response:

"We're trying at this point in the process to keep everything on the table ... There are obviously different ways of designing a public plan that would have different effects, and one of the things that we would look forward to working with you on is, if there is a public plan, how to minimize some of the concerns that you identified."

What's your opinion, are you concerned? Share your thoughts below.

'Now Is Really The Time To Do This'

As one of 150 attendees at yesterday's White House Forum on Health Care, Becky Patton of the American Nurses Association was one of the few to participate first hand in the opening round of health care reform. Here, she shares what was discussed and why "the attitude is significantly different" from past reform attempts.

Engaging EAPs

What is the definition of employee assistance? What's the value proposition for employers to provide employee assistance programs? What should these programs look like, and how should EAPs' effectiveness be measured?

These are all questions addressed in the National Business Group on Health's Employer's Guide to Employee Assistance Programs. We spoke with Paul Heck, manager of global employee assistance and worklife services at DuPont, about his role as one of 27 committee members who developed the guidebook.

Senators Unsure About CE

The topic was underinsurance, but during Q&A at last Tuesday's Health, Education, Labor and Pensions committee hearing at least two senators expressed their doubts about funding comparative effectiveness research.

"I agree ... only in terms of looking at clinical effectiveness, and not for making treatment and coverage decisions based on costs. There's too much variability from patient to patient that directly effects the treatment outcomes, and therefore such decisions should be left up to the physician and patient."

—Sen. Orrin Hatch (R-UT)

"The thing that worries me about comparative effectiveness as a physician that's practiced 26 years is the art of medicine is totally ignored. Totally ignored in comparative effectiveness."

—Sen. Tom Coburn (R-OK)

What do you think about CE? Share your thoughts below.

People Or Values, What's Driving Future Health Care?

With 8% of surveyed employers planning to offer only consumer-driven plans in the future, the CHDP market is still open to expand, especially as people start to think about retiree medical coverage, says Mercer's Tracy Watts in our final interview.

Also, getting the chronically ill in compliance with their treatments has potential for a huge ROI, with the future of value-based benefit design likely hinging on the prescription drug component of it. As for wellness-focused benefits, they better produce quantifiable results or they won't stick around in this economy.

Streamlining Health Care

Creating personal health records is large employers' No. 1 goal in the next five years. Since the big guys are interested in it, smaller groups will follow, says Mercer's Tracy Watts. In part four of our interview, Mercer's health care survey also shows that the future is all about convenience for employees.

Tune in tomorrow for part five, when Tracy will address CDHPs. Could they soon be the only health care plan employers will offer?

Staying In Shape For COBRA'S Future

In the last part of our talk with Bill Sweetnam, principal at the Washington, D.C., employee benefits firm Groom Law Group, Bill says in light of the new COBRA regulations, HR departments need to examine the way they handle terminating employees — particularly how they document firings. Those who don't will suffer the DoL consequences.

And don't be counting on that December 31 end date if the economy's still in bad shape. Since it's "politically difficult" for law makers to stop offering aid to the unemployed, Bill thinks the new COBRA could be here to stay.

Taking Advantage Of Increased Competition

In part three of our interview with Tracy Watts, senior consultant with Mercer, Tracy discusses employers' plans to save costs. With increasing competition in the vendor market, 63% of respondents say they're taking a closer look at fees and making plans to address them.

Stay tuned for part four, where Tracy says large employers' future plans could predict where the employer sponsored health care market is going.

Working Out Interactions With COBRA Administrators

While COBRA administrators are there to take care of the paperwork, it's no excuse to slack because the legal liability still falls on employers, says Bill Sweetnam, principal at the Washington, D.C., employee benefits firm Groom Law Group.

Employers need to communicate with COBRA administrators to let them know which ex-employees were involuntarily terminated, while COBRA administrators need to inform the payroll department of the reimbursement amount to apply for payroll tax refunds.

Stay tuned for part three of our workout with Bill. We move on to the leg machine and work on the future of COBRA reform. Could these regulations be here to stay?



(Note: Revised notices need to be sent to all eligible former employees as of September 2008)

Employers React To The Recession

In part two of our talk with Tracy Watts, senior consultant for Mercer, Tracy addresses employers' response to the economic downturn — including why their contingency plans may lead to an action she hasn't seen in 20-plus years in the business.

Stay tuned for part three, where Tracy talks about employers' plans to save costs.

Flexing The COBRA Muscle

The stimulus bill is now a law and employers are going to need to comply fast. Changes to COBRA — starting with a 65% federal subsidy for employees terminated between Sept. 1, 2008 and Dec. 31, 2009 — take effect March 1.

We met with Bill Sweetnam, principal at employee benefits firm Groom Law Group, in his building's gym to discuss how employers need to get their COBRA compliance muscles in shape.

In part one, Bill says the first thing employers need to do is get their different departments working together. Stay tuned for part two, where we move onto the weights and address why the legal liability will always fall on the employer, no matter who's administrating COBRA.

Will Projected Health Care Costs Stand?

This morning, Tracy Watts, senior consultant for Mercer, took time to speak with us on the results of the company's annual health care survey.

In part one of our five-part interview, Tracy shares employers' projection that health care costs will remain around 6%, where they have been for the last several years. But, since the survey was taken last summer before the economic turmoil really started to churn, the real question is will the trend change?

Stay tuned for part two, where Tracy addresses employers' response to the economic downturn.

Check Out Our March Issue

We're back with a preview of EBA's March issue. Watch us explain why:

• You'll want to get to know the Alfred brothers.
• It's a good sign that you're visiting this blog right now.
• Voluntary benefits are no good without education.
• You don't know as much about CDHPs as you think you do.
• You should step up your game.
  
  
  
  

Want your own sneak peak at the March issue? Contact Robert at robert.whiddon@sourcemedia.com

They're Your Representatives, Talk To Them

Congress has health care reform on the mind. In part two of our talk, Tom Mangan says contact your congressional leaders now to share your thoughts while they're ready to listen.

'A Groundswell Like I've Never Seen'

In meetings with congressional leaders on the Hill yesterday, Thom Mangan of Hub International brought the benefits professional's perspective straight to legislators like Sen. Chris Dodd. Watch as he describes the "fundamental movement of change" in the Senate and explains why he says the House's desire to act on health care is "a groundswell like I've never seen."

Tune in tomorrow for part 2 when Thom discusses how he plans to take that groundswell back home with him.

Bracing For The COBRA Bite

As the Senate gets ready to (most likely) pass its version of the stimulus bill today, allow me to share the thoughts of Christopher Nadeau, chair of The Council of Employee Benefits Executives, on the COBRA regulations included in the bill.

Whatever the final regulation is, in a press conference yesterday I asked him about the role of benefits advisers and brokers in its administration:

"If reimbursement comes directly out of a payroll tax then there may not be a lot for the broker intermediary or the COBRA administrator to handle."

He was more concerned from the claims perspective:

"COBRA populations historically have run about 50% higher than an active population employee."

When the stimulus bill passes, what will be your first communication with employers? Share your thoughts below.

The Benefit Of A Retirement Adviser

On Wednesday, the DoL decided to put off implementing changes to ERISA that would expand access to 401 (k) and IRA investment advice thanks to a White House request for more time to review final rules published before the administration change. The Employee Benefits Security Administration has proposed to extend the implementation date from March 23 to May 22.

Recently, I was on Capitol Hill stalking tourists to comment for our blog when I met John Skelton, a retired teacher from Oregon. Here, John explains the benefit of working with a retirement adviser.



The DoL wants to hear what you think about the investment advice final rule, and so do we. Share your thoughts below.

HSA issues

Expanding on yesterday's House hearing "Health Care Reform in a Struggling Economy" (hey, I was there for 3 hours — I deserve two blog posts about it!), Small Business Committee ranking member Rep. Sam Graves of Missouri brought up the issue of health savings accounts. Several panelists gave their real-world perspective on them:

"Virtually zero people want it."

—Dave Ratner, Dave's Soda & Pet City

"I'm not seeing any."

—Dirck Clark, Heartland Regional Medical Center

"As times get tougher, the employee tends to pull back coverage for money for something else."

—Janette Davis, Southeast American Financial Group

"[HSAs] could keep people from going to the doctor when needed."

—Michael Beene, National Association for the Self-Employed

What has been your experience offering health savings accounts to employers? Share your thoughts below.

Mandated Health Insurance?

Today I ventured to the House side of the Hill to attend a Small Business Committee hearing entitled "Health Care Reform in a Struggling Economy: What is on the Horizon for Small Business?"

A couple of small business owners testified, including David Ratner, owner of Dave's Soda & Pet City in Agawam, Mass., who has this to say about the state of health care in America: "My customers know more about the pet products on my shelves than they do about the doctors they use."

The topic of states mandating that employers provide their employees with health care coverage came up repeatedly, with most witnesses firmly against mandates ("It will kill jobs," said Ratner) unless there is a tax credit involved to offset costs.

During a Q&A session with the representatives, Alissa Fox, senior vice president of policy and representation for Blue Cross and Blue Shield Association, expressed her support for a mandate on the individual level. I asked her to further explain her position as the hearing adjourned:



(Hear highlights of the testimony yourself)

Daschle Is Done

Today Tom Daschle withdrew from the confirmation process to become Secretary of Health and Human Services. Since news first broke of the former Senator's $120,000 tax lapse Daschle had been facing a growing battle to be confirmed.

In a statement, Daschle called being chosen for the post an honor, adding, "But if 30 years of exposure to the challenges inherent in our system has taught me anything, it has taught me that this work will require a leader who can operate with the full faith of Congress and the American people, and without distraction. Right now, I am not that leader."

What do you think about Daschle's choice to withdraw? Vote in our poll to the right of this post. Any thoughts on who Obama should choose to replace him? Comment below.

More Time With Jim Klein

As promised, here is the second part of our interview with Jim Klein, president of the American Benefits Council. Jim discusses comparative effectiveness research (also in the House bill), how turning the focus from sickness to wellness can lead to savings and what the future holds for the council.

Stim-u-lus: something that incites to action or exertion or quickens action, feeling, thought, etc.

Today we met with American Benefits Council President Jim Klein to discuss a few of the health care issues included in President Obama's economic stimulus package currently making its way through Congress.

In part one of the interview, EIC Robert Whiddon asks Jim to address COBRA reform initiatives included in the package, as well as whether or not money allocated for health information technology resources will indeed create jobs.

Be sure to come back Monday for part two when Jim will discuss comparative effectiveness research (also in the House bill), how turning the focus from sickness to wellness can lead to savings and what the future holds for the council.

'There's No Money In Wellness'

Today I got myself acquainted with Capitol Hill by attending the Senate Committee on Health, Education, Labor and Pensions hearing entitled "Crossing the Quality Chasm in Health Reform."

The hearing was a follow-up to a 2001 Institute of Medicine report that defined six goals to improve health care: safety, effectiveness, timeliness, efficiency, patient-centered and equitability that should be part of any health care reform passed by Congress.

Perhaps the most thought-provoking piece of information came as I arrived at the Dirksen Senate Office Building to wait in line for the hearing.

I met a man who was sitting in line as a place holder for a lobbyist (only 60 visitors are allowed in). The man commented that health-related hearings often have long lines of lobbyists waiting to get into them, but ones such as today's that are focused on wellness rather than sickness are usually not popular, “because there’s no money in wellness,” he said.

Sure enough, the panel of three doctors, a professor and the president of The Commonwealth Fund highlighted several ways to improve health care on the front end of the health cycle. Among their recommendations:

• Create teams of doctors, nurses and other health professionals working across disciplines to more fully serve patients’ needs.


• Report not only the results of new health initiatives, but also the outcome of those initiatives. For example, hospitals may be successful in instituting a new treatment for a disease, but how many patients actually benefited from it?


• Focus more on behavioral health issues, as they can be a precursor to other medical issues later on. According to panelist Dr. Rhonda Robinson Beale, chief medical officer of OptumHealth Behavioral Solutions, as many as 40% of patients have both behavioral and other health issues.


• Improve health information technology by investing in research into technologies such as a hand-held device for doctors to access patients' records and diagnose potential conflicts between medicines before they occur, among other capabilities.

For more information, including full audio of the hearing, visit HELP's Web site.

-Elizabeth Galentine

A Benefits Blog is Born

Welcome to Benefits Explained, Employee Benefit Adviser's blog bringing you news and opinions on current developments, trends and best practices in the benefits industry from experts to average employees.

Check out our first video previewing the February issue of EBA and come back often for new posts, more videos and ways you can get involved with upcoming issues of the magazine.