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Mercer

While it’s far from clear where the incoming administration and Congress will land on the “replace” part of “repeal and replace” with regard to the Affordable Care Act, they are signaling interest in promoting the use of health savings accounts by expanding eligibility and allowing funds to be used for more purposes. High-deductible HSA-eligible plans already feature in many employer health benefit programs. In 2016, 21% of all covered employees were enrolled in an HSA-eligible plan. Enrollment has been rising over the past decade as employers -- especially large employers (500+ employees) -- have added HSA-eligible plan choices to their health programs. The threat of the excise tax was a big motivator for employers to move employees into lower-cost plans; while the excise tax may go by the wayside, there is now discussion of capping the individual tax exclusion for employer-provided health coverage, which could still drive cost pressure on employer-sponsored health plans.

 

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Offerings of HSA-eligible high-deductible health plans have more than doubled in the past five years. Our 2016 National Survey of Employer-Sponsored Health Plans found that more than half of large employers (53%) now provide this type of plan to their employees, and nearly a quarter of employees (24%) are enrolled. At the same time, there has also been steady growth in offerings of onsite and near-site medical clinics, especially among the largest employers: About a third of employers with 5,000 or more employees provide a clinic for primary care services. An onsite clinic offers the maximum opportunity for control over quality, and more than half of the clinic sponsors in another Mercer survey said that their clinic is integrated with their population health efforts.

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A plethora of Federal, state and local leave laws and regulations has made employer compliance and leave administration increasingly complex. It’s not surprising, then, that improving FML administration is the top priority for employers’ absence and disability programs. Employers are increasingly relying on outside vendors or licensing software to administer and manage these leaves and attempt to keep up with the ever-changing leave landscape. We’re seeing the fastest growth in outsourcing leave administration among small and mid-sized employers.

 

FMLA OUTSOURCING

EMPLOYER SIZE

2007

2010

2013

2015*

All respondents

14%

25%

38%

40%

100 – 999 employees

5%

13%

13%

19%

1,000 – 4,999 employees

11%

29%

37%

48%

5,000 or more employees

25%

37%

57%

60%

 

*Co-sourcing was included as an option in the 2015 survey and results for both co-sourcing and outsourcing are included in the overall outsourcing figures

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Click here to see the full infographic

 

We’ve been tracking the growth of consumer-directed health plans in our national survey for years.  Now policymakers in Washington are signaling interest in liberalizing health savings account rules, intensifying the focus on high-deductible plans that would be eligible for an HSA. While the majority of large employers already offer CDHPs – among the largest they are nearly ubiquitous – most often they are offered as a choice, not as the only medical plan. Building enrollment in a CDHP offered as a choice has proven to be challenging, but it can be done. In this infographic, we present survey findings that should be of interest both to employers thinking about a full replacement strategy and to those committed to offering a CDHP as a choice but looking to encourage more employees who could benefit to make the move. 

 

 

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While working women continue to earn less money than their male counterparts, the gap is narrowing when it comes to health benefits. Three years ago, we used data from Mercer’s National Survey of Employer-Sponsored Health Plans to examine the difference in benefits between large employers with workforces that are 65% female or more to those with workforces that are 65% male or more. Just under half of the mostly female companies are in health care and a quarter are in the services sector, while mostly male companies are found predominately in the manufacturing industry (52%). The percentage of employees in collective bargaining agreements has remained about the same for the two groups (13% for companies with mostly female employees and 15% for companies with mostly male employees). One workforce statistic has seen some movement since 2013, when the average salary for mostly female companies was about $10,000 less than when the workforce is mostly male; data from our 2016 survey shows the difference is now over $15,000. That’s right – the gap in the average salaries of companies with mostly female vs. mostly male workers has only gotten wider.

 

The health benefits at organizations with predominantly female workforces continue to be less generous than in those with predominantly male workforces. In addition, the employee contributions for these less generous plans are higher than those for the richer benefits offered to employees at mostly male companies. For coverage in a PPO, the most common type of medical plan, the monthly contribution for family coverage is 17% higher ($484 for mostly female companies and $415 for mostly male companies), which is down from a 31% difference in 2013.

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We were saddened today to hear about the loss of Carrie Fisher, best known for her role as Princess Leia in the Star Wars film franchise. As a tribute to the joy she brought us over the years, we’ve prepared a Star Wars themed challenge for our readers. Try to find all 17 Star Wars references below -- ask a fan if you need help! Then be sure to check back later this week -- the answers will be posted on Friday.

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Earlier this week, we posted a challenge to our readers to find the 17 Star Wars references in the blog post below. You may have noticed the first reference ("There Is Another...") in the headline. Check out the others below.

 

As the winter weather is finally upon us (can someone say brrr!) cold and flu season also strikes back this time of year, causing many employees to take time off to seek care.  Some employees may want to rush to their nearest doctor to make sure they’ve gotten their flu shot, while others may try to be a trooper and just hope to avoid any illness this season. Holiday travel in crowded airports increases your odds of getting sick, especially if you make your return on the redeye and don’t get enough rest to boot! Getting an end of year appointment can be a menace, but employees have a new hope with retail health clinics. A long time ago, these may have been met with luke-warm reception, but now the retail health market is stronger than you could possibly imagine; many CVS and Walgreens stores operate these clinics, so they’re probably not far, far away from your home or office. Most clinics have a computer kiosk where you can enter your insurance information upfront and get an appointment time; some locations will even send you a text letting you know you’re next patient - advances in e-health sure has made access to care seem like an e-walk in the park! However, if your retail health clinic can’t provide the services you were looking for, don’t feel you have to go it solo in finding appropriate care.  Employees don’t need to go rogue to find the right doctor; they can utilize health advocacy services, to laser in on specific providers to get the specific care they need.  Employers – be sure to communicate these options to employees, so they can maintain their health and productivity during this season and you can ensure your workforce is with you.

 

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More employees moving into lower-cost medical plans contributed to one of the smallest increases in total health benefit cost per employee in decades: 2016’s average increase of 2.4% is the lowest since 2013 and, before that, since 1997. According to Mercer’s survey, total health benefits cost averaged $11,920 per employee in 2016. This cost includes both employer and employee contributions for medical, dental and other health coverage, for all covered employees and dependents. Small employers (10-499 employees) again reported lower cost -- $11,271 -- compared to $12,288 for large employers with 500 employees or more. 

 

While many factors contributed to the low cost increase, including general inflation hovering around 1%, one that is drawing attention is the accelerating movement of employees into high-deductible consumer-directed health plans (see this article in the New York Times). CDHP enrollment has been rising for a decade and in 2016 jumped to 29% of all covered workers, up from 25% in 2015.

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