Category Archives: benefits

A Downside for Health Apps?

appsThis year’s Health & Benefits Leadership Conference saw a host of vendors and experts touting the benefits of the smartphone in promoting employee health. Checking in with apps such as MyFitnessPal (an app for tracking calories and diet) or the FitBit activity tracker will “engage” (that crucial word!) employees in their health like nothing else, they say.

Not so fast, cautions a new article in BMJ, a British medical journal. The BMJ piece features opposing viewpoints from two doctors: Dr. Iltifat Husain, who oversees a review site for medical professionals, writes that apps can help doctors hold patients accountable for their behavior. In a counterpoint, Dr. Des Spence, a Scottish general practitioner, argues that health apps encourage healthy people to unnecessarily record their normal activities and vital signs, ultimately turning them into “continuously self-monitoring neurotics.”

Health apps, Spence writes, are untested and unscientific and should be viewed with skepticism. “Make no mistake,” he writes. “Diagnostic uncertainty ignites extreme anxiety in people.”

This caution is warranted: The New York Times notes that federal regulators have been cracking down on health-apps vendors who’ve falsely claimed, among other things, that their products could accurately analyze skin moles for potential melanoma.

“If an app claims to treat, diagnose or prevent a disease or health condition, it needs to have serious evidence to back up those claims,” the Federal Trade Commission’s Mary K. Engle told the paper. In other words, although health apps clearly have the potential to get employees more focused on improving their health, they should also be wary of apps that claim to diagnose or treat a health condition.

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Payment Reform Urgently Needed

The way in which healthcare is paid for in the United States is a perverse mess — it rewards unnecessary procedures and is lacking in transparency while failing to reward providers for doing things that are actually needed.

“We know the way we pay for healthcare today is inherently inflationary and often does not lead to the outcomes we want,” said Suzanne F. Delbanco, executive director of Catalyst for Payment Reform, a coalition of employers and healthcare purchasers. She spoke at a general session on payment reform on Day 2 of the Health & Benefits Leadership Conference in Las Vegas.

The CPR is working to create a “critical mass” of employers that would push for changes needed to rectify serious problems — such as those uncovered by a report 15 years ago that found healthcare providers throughout the United States charging wildly varying prices for the same medical procedures that bore no relation to quality or outcomes. A decade and a half later, Delbanco said, little progress has been made.

That’s not to say there aren’t bright spots: New innovations such as accountable care organizations and patient-centered medical homes have proven to be viable alternatives to the traditional fee-for-service model and have resulted in lower prices and better outcomes, she said. The CPR is also encouraging employers to experiment with new approaches such as shared savings and non-payment for botched or unnecessary procedures.

One hurdle has been the fact that many employers are more comfortable making changes to benefit-plan designs that shift more of the cost to employees than in challenging the traditional way in which healthcare is paid for, said Delbanco. “Ideally, employers should be doing both,” she said, adding that employees have generally become more receptive to the need to control costs.

Delbanco was joined on stage by Anna Fallieras, G.E.’s program leader for healthcare initiatives and policy, who described her company’s journey to consumerism.

“Our message to employees is, ‘Be an active consumer: Think about managing costs and getting quality care,’ ” she said, adding that GE spends $2 billion per year on employee healthcare.

GE, which rolled out consumer-driven health plans to its employee population in 2013, also created new tools and services to help them make better healthcare decisions. These include a telephonic health-coach service designed to help employees get access to top-performing healthcare providers, and a treatment cost calculator that offers price and quality information on providers.

The cost calculator has helped employees save between 5 percent and 30 percent on their healthcare bills, said Fallieras. GE also offers a telemedicine service that’s garnered a 90-percent satisfaction rate from employees, she said.

Fallieras called on other employers to join GE in fighting for payment reform. “We can’t do it all ourselves,” she said. “We as employers have a central role.”

 

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Work/Life ‘Innovation’ in the Valley

As a session titled “Unlimited Time Off and the Leading Work/Life Benefits of Silicon Valley” reminded those attending this year’s Health & Benefits Leadership Conference, high-tech employers are innovating in areas well beyond technology.

ThinkstockPhotos-78521845Indeed, representatives from Adobe, Yahoo! and CA Technologies each detailed a wide range of work/life programs aimed at providing employees with greater flexibility and making their organizations more attractive places to work.

Lauren Vela, a senior director of member services at the Pacific Business Group on Health and the moderator of session, pointed out that bringing work/life balance to a high stressed, high-achieving population isn’t always an easy feat.

But that said, it’s clearly something companies such as Adobe, Yahoo! and CA Technologies take very seriously.

“In looking at our population,” explained Luz Garcia, senior Americas benefits specialist for San Jose, Calif.-based Adobe Systems, “people were not taking time-off. They were adding huge balances to their PTO accounts,” something that wasn’t in the spirit of Abode’s time-off program.

“We wanted people to take the time-off for rest and relaxation,” she said.

In response, Garcia said, Adobe revisited its program and implemented an unlimited time-off program.

Adobe’s policy states 

“… exempt U.S. employees will be paid their regular base salary at all times while they are actively employed by Adobe (including while on Adobe holidays and during Company break periods); the only time they will not receive their base salary will be during periods when they are on a leave of absence or are taking Sick Time Off, at which time they will be subject to the compensation and benefits provisions of the applicable Adobe leave of absence policy or the Sick Time Off provision below.”

Adobe, Garcia said, also enhanced its sabbatical program in 2009 with a tiered approach— so that after five years of service employees were entitled to four fully paid weeks off; after four weeks, five fully paid weeks off; and after 15 years, six fully paid weeks off.

Garcia noted that the changes helped reinforce the fact that “we value people taking time-off to decompress.”

Adobe also has instituted summer breaks. “We always had a winter break, where we shut down the last week of December. But now, with the summer break, we shut down the week of July 4,” she said.

CA Technologies’ Vice President of Global Benefits Lisa Mars, meanwhile, shared CA’s efforts in onsite day-care.

CA, with facilities in Silicon Valley, launched its first onsite Children’s Center in 1992 at its corporate headquarters in New York, Mars said. Since then, it rolled out centers in all of its large offices. “These sites have programs for children from six weeks of age to six years [and] teachers who we train … who are very highly skilled,” she said.

“It’s emerged as a wonderful influence on our culture,” Mars told attendees. “We have a very family friendly culture.”

CA also regularly holds onsite events, such as a “spring fling” (one was being held as Mars was speaking), where all of the families with children in the center, as well as other employees with children, are able to participate. (The events includes ponies, a petting zoo, kites and games.)

“It just nice to see people step back from all of that stress,” Mars said.

Mars noted she’s been required to do a lot of CEO education over the years, as new CEOs have joined CA and want to know “why we’re spending money” on these programs. “I have to explain to them [that it’s not just about] dollars and sense,” she said. “We have to look at it as something you can’t really apply a dollar value to, but it still brings the organization value.

“We’ve done studies that show that the retention levels of people who bring children to our programs are really much higher than those who don’t,” she added.

At Yahoo!, meanwhile, the goal of its various work/life programs is to not only make the firm a great place to work, but also to draw in “the best of the best.”

One of the areas the Sunnyvale, Calif.-based Yahoo! has focused on is extending paid leave of new mothers and fathers, explained Joe Gracy, director of global benefits for Yahoo! “If you had a baby, adopt a child, provide foster care placement, you get eight [fully paid] weeks off. Birth mothers get an additional eight weeks [fully paid] as a part of their disability leave.”

Management, Gracy said, also wanted to make the experience fun for those new parents by introducing new-child gift baskets that included a diaper bag, toys and more.

All of the initiatives are aimed at “making the employee feel valued and engaged,” Gracy said.

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Starbucks Doubles Down on College

Starbucks, the Seattle-based coffee giant, announced yesterday it was doubling its free college tuition plan for employees to cover a full four years of college instead of two. Starbucks will offer employees faster tuition reimbursement–after every semester instead of after completing 21 class credits.

The program, in partnership with Arizona State University, offers all eligible full-time and part-time employees full tuition coverage for a four-year bachelor’s degree though ASU’s online degree program. Starbucks says it will invest up to $250 million or more to help at least 25,000 employees graduate by 2025.

Nearly 2,000 Starbucks employees have already enrolled in the program, which offers 49 undergraduate degree programs through ASU Online.

“By giving our partners access to four years of full tuition coverage, we provide them with a critical tool for a lifelong opportunity,” says Starbucks CEO Howard Schultz, in a statement. “We’re stronger as a nation when everyone is afforded a pathway to success.”

And in a LinkedIn piece announcing the move, CEO Schultz talks in a video interview about the importance of education and his company’s role in making the American workforce a more robust and agile one within the next 10 years.

“We have a long history of under-promising and over-delivering,” he says. “We think we’ll do the same there.”

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Hitting the Road to Promote Paid Leave

X-7Last week, Secretary of Labor Thomas Perez told the Washington Post that “so much of what becomes law in Washington starts out as an experiment in different states.”

For the next month or so, Perez will be conducting his own state-to-state experiment of sorts; one that he hopes will result in workers nationwide being afforded greater flexibility in their jobs, including the right to paid leave.

As part of the Lead on Leave—Empowering Working Families Across America tour, Perez will meet with workers, state officials and employers in a handful of cities in an effort to “promote best practices and discuss how paid leave and other flexible workplace policies can help support working families and businesses,” according to a Department of Labor statement.

Perez will have company on the coast-to-coast jaunt, which kicks off today with a stop in Seattle. Valerie Jarrett, a senior advisor to the White House, and Tina Tchsen, assistant to President Barack Obama, will join him on the tour, which also includes scheduled visits to Minnesota, California, Oregon, Georgia, Colorado and Pennsylvania.

Currently, just three states—California, New Jersey and Rhode Island—offer paid family and medical leave, while only California and Massachusetts require private employers to provide paid sick leave. Meanwhile, Illinois, Ohio and Virginia provide paid parental leave to state employees, while cities such as Chicago, Austin, Texas and San Francisco do the same for municipal workers.

We may be a ways off, however, from federal legislation that obliges employers to provide paid sick leave. As a recent New York Times article points out, President Obama has urged Congress to pass a bill giving U.S. workers seven days of paid sick leave. But, garnering the necessary support in that same Congress to approve such a bill would be “a tough obstacle” to surmount, the Times article notes.

Some organizations, however, aren’t waiting on government action.

The aforementioned Times piece details Microsoft’s “unusual” method of overcoming the absence of a federal policy, noting the company’s March 26 announcement that it would require many of its 2,000 contractors and vendors to offer their employees who perform work for Microsoft 15 paid days off for sick days and vacation time.

“In some ways, it’s a uniquely American solution,” the article continues. “ … The biggest and wealthiest companies are performing the role of setting workplace policy for other businesses.”

While applauding Microsoft’s approach to providing paid leave, Ruth Milkman told the Times she doesn’t foresee other corporate heavyweights following its lead.

“It’s a moral model, but I don’t think there’s a high probability it’s going to become universal through business initiatives,” said Milkman, a professor and sociologist of labor at the City University of New York Graduate Center. “The public wants this. The resistance is all from employers. The only way is through public policy.”

We’ll see if the Lead on Leave tour takes us any closer to such policy becoming reality.

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Being a Disruptive Force in Healthcare

As snow began to fall on the nation’s capital yesterday morning, attendees at the National Business Group on Health’s Business Health Agenda 2015 conference were inside the J.W. Marriott (Washington) intently listening to NBGH President and CEO Brian Marcotte lay out the challenges and opportunities that lie ahead for healthcare in 2015—and beyond.

452031437During his talk, Marcotte touched on the “disruption” occurring in healthcare today and praised employers for the role they’re playing in “driving innovation.” He described those employers that are leading the way with such innovations as “disrupters.”

“Disruption” is certainly as good a word as any to describe what’s taking place in healthcare today.

No surprise that Marcotte — who was vice president of compensation and benefits at Honeywell for roughly 12 years before replacing Helen Darling as NBGH president and CEO last May — pointed to the Affordable Care Act as healthcare’s biggest disruptive force.

Six years ago, Marcotte said, “[w]hen the CEO would ask the question, ‘Why don’t we just get out of healthcare?’ the answer was simple [because] there was no place for people to go to purchase affordable, high-quality healthcare. Well, the answer is not as simple today.”

Nowadays, he explained, there are several options, including staying the course, private exchanges and public exchanges. As things stand today, he said, “staying the course” continues to be the most efficient way to deliver to employees affordable healthcare. As he explained it,  “[w]e haven’t seen good and consistent data” to suggest otherwise.

At the end of the day, Marcotte added, it all comes down to value and whether or not private exchanges can deliver greater value than today’s self-insured model.

During a session later in the morning, Julie Stone, North America health and group benefits leader for Towers Watson, shared, for the first time, the results of her company’s just-completed 2015 Emerging Trends in Health Care Survey. Among the findings: While 17 percent of 444 employer respondents believe private exchanges provide a viable alternative for employer-sponsored coverage for active full-time employees in 2016, confidence in the approach builds to 37 percent by 2018.

In addition, the Towers Watson study found companies that have done extensive analyses of private exchanges are twice as likely to consider them a viable option in 2016 (29 percent versus 14 percent).

Despite this somewhat promising data, Marcotte said, employers aren’t going to embrace private exchanges until they see more data suggesting it’s the right move to make.

Early on in his remarks, Marcotte emphasized the need for more data, recalling an episode at Honeywell when CEO David Cote put him on the spot at a meeting to back up a statement he made with meaningful data.

CEOs make their decisions based on data, Marcotte said. But with the exception of cost, he continued, the data needed to make the right healthcare decisions aren’t available yet.

In his talk, Marcotte also touched on other disrupters, such as the industry consolidation that’s going on in healthcare. “When will we begin to see the synergies from the consolidation?” he asked.

Another disrupter: emerging delivery models, such as accountable-care organizations. Despite an “explosion” in the number of these organizations, he said, the jury is still out as to “what to make of it.”

“Employers,” he said, “need to know what they’re buying.”

In other words, he said, they need to understand the “value” they’re getting.

As he put it, if you’re going to go to your CEO and say, “We’re going to change the plan design and encourage people to go to ACOs,” that CEO is going to respond, “Why? What’s the value proposition?”

So be ready for that question. And, I would think, be ready with the required data to back your proposal up, because you know you’re going to need it.

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FMLA Update Redefines ‘Spouse’

same sex marriageAnd the reverberations of the United States v. Windsor decision continue to be felt.

The U.S. Department of Labor announced yesterday that workers in legal, same-sex marriages—regardless of where they live—will now have the same rights as those in opposite-sex marriages to federal job-protected leave under the Family and Medical Leave Act to care for a spouse with a serious health condition.

The announcement comes not quite nine months after the DOL issued a proposed rule to change the FMLA’s definition of “spouse” in the wake of the Supreme Court’s Windsor decision.

That June 2013 ruling, of course, struck down the Defense of Marriage Act’s provision interpreting “marriage” and “spouse” to be limited to opposite-sex marriage for the purposes of federal law.

According to the DOL, the rule change updates the FMLA regulatory definition of “spouse” such that an eligible employee in a legal same-sex marriage will be able to take FMLA leave for his or her spouse, regardless of what state the employee calls home. The previous regulatory definition of “spouse” didn’t extend to same-sex spouses if an employee resided in a state that did not recognize the employee’s same-sex marriage.

Under the new rule, eligibility for federal FMLA protections is based on the law of the place where the marriage was entered into, according to the DOL. This “place of celebration” provision allows all legally married couples, whether opposite-sex or same-sex, to have consistent federal family leave rights regardless of whether the state in which they currently reside recognizes such marriages.

We’ll see what this means for employers and HR. But yesterday’s announcement marks a step toward fulfilling the “basic promise of the FMLA,” said U.S. Secretary of Labor Thomas E. Perez in announcing the updated rule.

That guarantee, he said, “is that no one should have to choose between the job and income they need, and caring for a loved one.

“With our action today, we extend that promise so that no matter who you love, you will receive the same rights and protections as everyone else,” added Perez. “All eligible employees in legal same-sex marriages, regardless of where they live, can now deal with a serious medical and family situation like all families—without the threat of job loss.”

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Shaking the Mental Health Stigma

mental healthJust a few short weeks from now, our March issue will see the light of day. In it, you’ll find the second installment of a three-part series on employee health.

This Carol Patton-penned feature looks at how more employers are “recognizing the destructive footprint of depression on their workforce and bottom line, and are taking direct aim at the illness.”

There’s no doubt that many companies have made great strides in identifying the signs and understanding the insidious impact of this illness, and are acting to help employees affected by depression as well as those dealing with other mental health issues.

But, that doesn’t mean there isn’t still a ways to go.

The Disability Management Employer Coalition’s just-released 2014 Behavioral Risk Survey posed 42 online questions to 314 employers of various sizes between July and August of last year. The results suggest the stigma surrounding mental health in the workplace still very much exists, to say the least.

For example, respondents were asked what level of, or change in, stigma associated with “having a psychological/psychiatric problem” they have witnessed in the last two years. (DMEC conducts its Behavioral Risk Survey on a biennial basis.)

Overall, 41.4 percent of respondents said the stigma remained the same, with 25.1 percent indicating that the stigma has actually decreased in that time.

Another 24.2 percent, however, said the stigma has increased since 2012. And, consider that just 7.6 percent reported feeling the same way two years ago.

Troubling as some of these figures are, the survey does show signs that management awareness and acceptance of behavioral health issues is growing, though. When asked how their upper management’s opinion regarding the need to review behavioral health issues has changed over the past two years, for instance, 36.8 percent of respondents replied, “yes, it has become more open” in that time. In 2012, 25 percent of respondents said the same.

In addition, 32.8 percent of survey participants said their organizations screen for underlying psychological or psychosocial issues, marking a slight, 3.2 percent increase from 2012.

In a statement detailing some of the survey’s findings, DMEC Executive Director Terri L. Rhodes described employers’ increased adoption of screening and other tools to identify and address mental health conditions as “heartening.”

But, she adds, “there is much more to be done to reduce the stigma still attached to these illnesses and create a consistently collaborative approach to treating them.”

(A full report on the 2014 Behavioral Risk Survey is available by contacting John Jordan at jjordan@principor.com or 202.595.9008.)

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Shoring Up Pension Plans

About two-thirds of companies that sponsor defined-benefit plans plan to take steps this year to protect their bottom lines from expected rises in premiums from the Pension Benefit Guaranty Corp.

That’s according to a new survey from Aon Hewitt, which queried 183 DB plan sponsors about their current and future plans. Twenty-two percent said they’re “very likely” to offer terminated vested participants a lump-sum window this year, while 19 percent plan to increase cash contributions to their plans to reduce PBGC premiums in the year ahead and 21 percent will consider purchasing annuities for some of their plan participants.

“A growing number of plan sponsors anticipate increasing pension plan costs due to recent changes to the Society of Actuaries longevity models and rising PBGC premiums,” said Aon Hewitt’s Ari Jacobs, its global retirement solutions leader.

President Obama has once again proposed giving the PBGC the power to raise premiums on single and multiemployer DB plans, a strategy that would raise a projected $19 billion over the next decade (Congress rejected the President’s previous proposal). This move is staunchly opposed by many in the business community, however — including the ERISA Industry Committee –  who say it would “create a direct conflict of interest.”

“This proposal continues to resurface each year, and policymakers appropriately have rejected it as an inappropriate and impractical expansion of government authority that would hurt plan participants and plan sponsors,” ERIC CEO Annette Guarisco Fildes said in a statement.

Although the PBGC is now on sturdier financial footing than in previous years — thanks in part to an improving economy — the agency still faces considerable deficits in its single-plan and multiemployer insurance plans. The annual report estimates that the multiemployer plan has a 90-percent chance of running out of money by 2025.

Late last year Congress passed the Multiemployer Pension Reform Act, which makes it easier for sponsors of plans that are at serious financial risk to reduce payments to retirees, with the intent of reducing the risk that the PBGC will need to take over the plan.

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Another City Tackles Paid Sick Days

The Philadelphia City Council today is debating a hot-button topic with potential HR ramifications that may reach far beyond the city’s limits: whether to enact a paid sick days bill into law.

If passed, the City of Brotherly Love will join San Francisco, Washington, D.C., Seattle, Portland, Ore., New York City, Jersey City, Newark and the state of Connecticut as municipalities with such laws on the books.

While the debate around such laws has been growing over the years, momentum for its passage increased after President Obama’s recent State of the Union Address, which called for cities to ensure paid sick days for millions of Americans. The president is also urging Congress to require companies to give workers up to seven days of paid sick leave a year.

According to the National Partnership for Women & Families, San Francisco became the first locality in the nation to guarantee access to earned paid sick days in 2006.

In 2008, the District of Columbia and Milwaukee passed paid sick days standards that included paid “safe” days for victims of domestic violence, sexual assault and stalking. In 2011, the Connecticut legislature became the first in the nation to pass a statewide paid sick days law, and Seattle became the fourth city, with Portland, Ore., and New York City joining their ranks in 2013.

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