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Mercer

When your boss asks about how the election will affect your benefit program, your response could be as easy as "It all depends." But you might want to provide more of an answer, and if so we'd like to help you out.

 

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The new Mercer Survey on Absence and Disability Management found that employers continue to embrace workplace flexibility, in part demonstrated by a migration from traditional vacation/sick plans to paid time off (PTO plans). PTO plans are now in place in 63% of the organizations surveyed, up from 50% in 2013 and 38% in 2010. PTO plans provide employees more flexibility and reduce the need to determine (and track) what type of day off is being taken.

 

But despite their focus on time off, many employees do not use all of the days available to them: 44% of participants report that their employees take less than 80% of their allotted PTO time. And for the growing number of employees who work remotely, time off may not truly be time away from work. Employers are rethinking time-off program design to take into account all of these dynamics and help employees to achieve a healthier work/life balance.

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The IRS has released draft instructions for 2016 Forms 1094-B and 1095-B, confirming that health insurers and self-insured employers can expect few changes when reporting minimum essential coverage (MEC) provided to individuals in 2016. The Service posted preliminary 2016 versions of these forms in June, but instructions noting what's new became available only last week. The IRS uses data from this reporting to administer assessments under the Affordable Care Act’s individual mandate provisions. Separately, the IRS earlier released draft 2016 employer shared-responsibility forms and instructions that applicable large employers will use to report coverage offered to employees and their dependents.  

 

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There have been lots of stories in the news over the past week about the Department of Justice suit to block Anthem’s purchase of Cigna and the Aetna and Humana deal. As Tom Murphy reports, leadership from both Anthem and Aetna have committed to defend the lawsuits. The final outcome remains uncertain and could entail a prolonged legal process. The two questions we have been hearing from employers are “what does this mean to us?” and “should we go out to bid now or wait and see what happens?” From an employer perspective, nothing changes – you should continue to refresh your benefits strategy and actively manage your health benefits to meet your goals and objectives. This includes aligning with vendor partners that best support your strategy. We recommend that employers not delay a vendor selection due to this potential consolidation. As the legal proceedings unfold, employers will have visibility into any activity that could impact their vendor partner and their member population. The cost trend for employer-sponsored health coverage has hovered around 3% for the past several years – proof we are managing cost while still providing meaningful health benefits. Don’t let this slow you down!

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Mercer’s Washington Resource Group recently released our top 10 compliance priorities for 2017 health benefit planning. There aren’t any surprises on this list. In fact, we’ve recently blogged about many of them. Employee Benefit News created a slide show on our Top 10 and here is a list of related posts and podcasts if you want to take a deeper dive into a topic. 

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The beginning of June serves as a reminder that we’re approaching the halfway point of 2016. Now is a great time to pull out those strategic plans and assess what you've accomplished and what's left to do. And don't forget to do a mid-year compliance check. I know, it's not the most exciting task, but it is a necessary evil. To make it a little easier, I’ve asked Mercer's compliance experts to describe – in just two minutes each – the top 10 compliance issues on their checklists. Here’s what they had to say.

 

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We’ve been tracking employer adoption of, and interest in, private health exchanges through Mercer’s National Survey of Employer-Sponsored Health Plans for the past few years. Currently 6% of large employers either use an exchange now or will implement one this year for 2017. That’s doubled from 3% using an exchange in 2014 – a strong rate of growth, even if the numbers are still small. Perhaps more telling, more than a fourth of large employers say they are considering moving to an exchange within five years.

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To provide the Affordable Care Act's summary of benefits and coverage (SBC), health plans will have an updated final template and related materials to use beginning with open-enrollment periods after March 31, 2017, according to a new triagency FAQ. This means calendar-year group health plans will use the new SBC materials during fall 2017 open enrollment for the 2018 plan year.

 

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The health care market is getting more and more complicated. More than $4 billion has been invested in digital health in each of the past two years and investment activity remains strong in 2016. Just keeping up with all the latest developments is challenging, never mind the work required to evaluate solutions, decide what to implement, and then communicate and manage them. Conversely, we continue to see consolidation in the market -- health plans, PBMs, and health systems are consolidating and developing ACOs. Fewer choices and more choices all at the same time.

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ERISA pre-empts Vermont's all-payer claims database (APCD) reporting law, the US Supreme Court has ruled. The court held the state statute imposes duties that are inconsistent with ERISA's central design of providing a uniform national scheme for plan administration without interference from multiple state laws. Vermont's law requires all health plan payers to report to state regulators an array of claims and other data about their plans. APCD laws have taken effect or are planned in at least 18 states and several other states have considered such a program. The ruling limits state databases' potential to improve health care transparency but relieves ERISA plan sponsors of complying with multiple APCD laws.

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Much of the pressure driving up pharmacy benefit cost comes from specialty drugs. While some new drugs represent important breakthroughs in the treatment of complex diseases, the spike in the specialty drug cost trend rightfully has employers looking for creative strategies to manage cost growth.

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After 37 years leading the Employee Benefit Research Institute (EBRI), Dallas Salisbury has settled into his new role as president emeritus and resident fellow – but not before giving an “exit interview” to Employee Benefit News about what he’s most proud of and where he believes U.S. health care is headed. In this article, Dallas talks about the vastly different health care landscape in 1978, when EBRI was first founded, and the current state of the industry and employer-sponsored health plans in the wake of the Affordable Care Act. Dallas discusses the advantages of the employment-based system – in particular, the facilitation of enrollment, group design, and payroll deduction – and the increased role of technology and data going forward. Says Dallas:  Health insurance “keeps people at the office, it keeps people working. It contributes to productivity. It's the whole, if you will, wellness movement.”  In other words, employers need to invest in their workers’ health to help keep them engaged and productive.

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