All posts tagged health insurance exchanges

While the health care affordability crisis has become so significant, questions still linger—will private exchanges become a viable solution for employers and payers, and will they will continue to grow? Back in 2015, Accenture estimated that 40 million people would be enrolled in private exchange programs by 2018; the way we see this model’s growth today doesn’t speak to that. So, what is preventing them from taking off as they were initially predicted? We rounded up a few reasons why the private exchange model’s growth may be delayed, or coming to a halt.

They Are Not Easy to Deploy

There is a reason why customized benefits technology was the talk of the town over the last two years; it takes very little work up-front to customize your onboarding process. Alternatively, private exchange programs don’t hold the same reputation. The online platform selection, build, and test alone can get you three to six months into the weeds. Underwriting, which includes an analysis of the population’s demographics, family content, claims history, industry, and geographic location, will need to take place before obtaining plan pricing if you are a company of a certain size. Moreover, employee education can make up a significant time cost, as a lack of understanding and too many options can lead to an inevitable resistance to changing health plans. Using a broker, or an advisor, for this transition will prove a valuable asset should you choose to go this route.

A Lack of Education and a Relative Unfamiliarity Revolves Around Private Exchanges

Employers would rather spend their time running their businesses than understanding the distinctions between defined contribution and defined benefits models, let alone the true value proposition of private exchanges. With the ever-changing political landscape, employers are met with an additional challenge and are understandably concerned about the tax and legal implications of making these potential changes. They also worry that, because private exchanges are so new, they haven’t undergone proper testing to determine their ability to succeed, and early adoption of this model has yet to secure a favorable cost-benefit analysis that would encourage employers to convert to this new program.

They May Not Be Addressing All Key Employer and Payer Concerns

We see four key concerns stemming from employers and payers:

  • Maintaining competitive benefits: Exceptional benefits have become a popular way for employers to differentiate themselves in recruiting and retaining top talent. What’s the irony? More options to choose from across providers and plans means employees lose access to group rates and can ultimately pay more, making certain benefits less. As millennials make up more of today’s workforce and continue to redefine the value they put behind benefits, many employers fear they’ll lose their competitive advantage with private exchanges when looking to recruit and retain new team members.
  • Inexperienced private exchange administrators: Because many organizations have limited experience with private exchanges, they need an expert who can provide expertise and customer support for both them and their employees. Some administrators may not be up to snuff with what their employees need and expect.
  • Margin compression: In the eyes of informed payers, multi-carrier exchanges not only commoditize health coverage, but perpetuate a concern that they could lead to higher fees. Furthermore, payers may have to go as far as pitching in for an individual brokerage commission on what was formerly a group sale.
  • Disintermediation: Private exchanges essentially remove payer influence over employers. Bargaining power shifts from payers to employers and transfers a majority of the financial burden from these decisions back onto the payer.

It Potentially Serves as Only a Temporary Solution to Rising Health Care Costs

Although private exchanges help employers limit what they pay for health benefits, they have yet to be linked to controlling health care costs. Some experts argue that the increased bargaining power of employers forces insurers to be more competitive with their pricing, but there is a reduced incentive for employers to ask for those lower prices when providing multiple plans to payers. Instead, payers are left with the decision to educate themselves on the value of each plan. With premiums for family coverage continuing to rise year-over-year—faster than inflation, according to Forbes back in 2015—it seems private exchanges may only be a band-aid to an increasingly worrisome health care landscape.

Thus, at the end of it all, change is hard. Shifting payers’, employers’, and ultimately the market’s perspective on the projected long-term success of private exchanges will be difficult. But, if the market is essentially rejecting the model, shouldn’t we be paying attention?

By Paul Rooney
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Small Businesses No Longer Going for the Gold in Medical Insurance | Ohio Employee Health Benefits

Categories: General News
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By Carol Taylor, Benefits Advisor at D & S Agency

Small employers are feeling the squeeze from increasing costs of medical care and increasing premiums for the medical insurance they offer their employees. Recently released findings from the 2015 UBA Health Plan Survey show that 54 percent of small employers are currently offering gold or platinum plans to their employees. However, with the pressure from rising medical care costs, the introduction of community rating in setting insurance rates, and the end of grandmothering, it is highly unlikely that this trend will continue.Medals

The community rating model that was launched with the Patient Protection and Affordable Care Act (ACA) allows insurers to set premiums based only on age, geographic area, tobacco use, and individual vs. family enrollment, spreading the risk more evenly. However, that also means that employers whose employees have lower risk factors will no longer be able to take advantage of lower insurance rates. As grandmothering of plans comes to an end in 2016, small employers can no longer delay the effects of community rating and will have no choice but to reduce benefit levels to maintain coverage.

While the majority of small employers are offering higher level benefits, the survey also shows that employers continue to shift a greater share of expenses to employees through out-of-pocket cost increases. Over a five-year period, median in-network single deductibles have doubled, going from $1,000 in 2010, to $1,500 in 2014, to $2,000 in 2015.

Taking a look at small employer benefit options in Virginia, one of a handful of states that did not allow grandmothered plans, platinum level plans currently have no deductible, but the in-network out-of-pocket maximums range from $1,600 to $6,000, depending upon the insurance carrier. The plans are mainly driven by copays assessed at the place where care is received, versus a coinsurance percentage. Given that in-network deductibles, copays and coinsurance amounts all roll up into the out-of-pocket maximum, as consumers become more savvy they will look for ways to save on insurance premiums. This will also prompt employers to reduce metal levels.

Another major factor in determining medical insurance premiums is the cost of medical care. With many prescription drug prices skyrocketing, this will drive premiums ever higher. As hospitals, particularly those in areas with large uninsured populations as well as large populations on Medicare and Medicaid, increase reimbursement rates to private insurance carriers to offset the losses they incur with government-set payment levels, premiums will increase. Until pricing transparency for medical procedures and prescriptions becomes reality, we will continue to see deductibles, coinsurance and copays rise, along with out of pocket maximums and premium amounts.

Very few platinum level plans are offered and, they will continue to decline in number as employers can no longer afford them. Gold level plans have also decreased in number, so employers have fewer options. As employers shift to silver and bronze plans to reduce costs, insurance carriers will offer even fewer gold and platinum plans.

While employers are faced with a paradox of offering benefits to attract and retain talented employees, the cost at some point will be too much to bear and many will be forced to reduce the metal level in the future.

Even the lowest quality “bronze-level” health insurance plans on the ACA exchanges are at risk of triggering the Cadillac tax. Read our latest press release, which details the findings, potentially affecting 74 percent of employers by 2022.

Download the free 2015 Health Plan Survey Executive Summary for additional information on health plan cost trends across the U.S., including employer contributions and costs for employees.

To benchmark your plan against others in your region, industry or size bracket, contact a UBA Partner near you to run a custom benchmarking report.

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2016 Annual Limits Card Back by Popular Demand | OH Employee Benefits

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By Bill Olson, Chief Marketing Officer at United Benefit Advisors

Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an “indexed” limit). UBA offers a quick reference chart showing the 2016 cost of living adjustments for health and Section 125 plans, qualified plans, Social Security/Medicare withholding, compensation amounts and more. This at-a-glance resource is a valuable desk tool for employers and HR practitioners.

Here’s a snapshot of the 2016 health plan limits; be sure to request the complete chart from a UBA Partner.

2016 Annual Benefit Limits

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By Bill Olson, Chief Marketing Officer at United Benefit Advisors

Someone in the C-Suite of a company gets sick. I’m not talking about a cold or flu; I’m talking about a major, possibly even terminal, illness. Depending on the level of severity, what can the human resources department do to help When the C-Suite Gets Seriously Sickcommunicate this information properly to the company’s employees?

There will always be privacy concerns, but there are also requirements with the Securities and Exchange Commission (SEC) that mandate publicly traded companies to disclose information that may impact an investor’s decision to buy or sell stock. A serious illness could be interpreted as something that needs to be reported to the SEC. Other than that, how much information should a C-Suite executive share with HR, when should he or she share it, and should they discuss any plans for a successor – either temporary or permanent? On the HR side, how much of this should they release to the rest of the company?

Based on an article on Human Resource Executive Online titled, “Disclosing Illness in the C-Suite,” when handled correctly, the disclosure of an executive’s illness can do more than satisfy SEC compliance. It can reassure employees and investors that the company has a plan going forward, it can address important questions, and it can stop the almost certain spread of false rumors.

Sharing information today is common and rapid, which makes hiding a major illness next to impossible. Rather than letting the company’s rumor mill disclose the information in a way that could be harmful to the executive and his or her family, detrimental to the company, and potentially completely false, it’s better to have it come directly from a company representative. Current examples include Goldman Sachs CEO and Chairman Lloyd Blankfein, who sent a memo to employees and the SEC just one day after his lymphoma diagnosis. Contrast this with Apple CEO Steve Jobs who withheld his cancer diagnosis for an entire year. The latter example is cited as a textbook case of how not to handle this. The “doom and gloom” speculation of what was happening to Jobs was rampant both internally at Apple and with investors.

This type of speculation almost always leads to decreased employee morale and productivity, which is why HR should communicate information as quickly as possible. That being said, it’s up to the C-Suite executive to determine how much information he or she wants to divulge. The role of HR is to communicate how this is going to impact the company’s daily operations, whether someone will be temporarily assuming those responsibilities, and if the company has a succession plan in place if the executive is not able to return to work.

Because this type of news can disrupt the operations of a company, HR should continually provide updates and put them in a positive light. As it states in the article, you can’t draft this type of plan, especially a plan of succession, after a critical illness diagnosis is announced. This is something that must be thought of ahead of time in order to avoid the turbulent aspect it can produce. Regardless of this, HR also needs to emphasize the seriousness of the issue and that it must be handled with respect, sensitivity, and professionalism.

Hopefully, an HR department will never have to deal with this unfortunate experience. Striking a balance between the C-Suite executive’s privacy and everyone else’s need to know may be one of the most difficult things an HR department can face. This is why planning ahead can often provide that level of confidence during this time of corporate instability.


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Healthcare Cost Reduction: Community Paramedicine as a New Primary Care Delivery Model | Ohio Employee Benefits Broker

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By Peter Freska, Benefits Advisor at The LBL Group A UBA Partner Firm

I recently read an article on what some say is the conventional wisdom of healthcare costs in the United States which, as a percent of gross domestic product, are higher than most other countries. The article works to demonstrate that the reason for the higher than average cost and the lack of “better” health outcomes in light of significantly higher spending is attributable to non-healthcare issues such as lack of access, especially for the poor. With the drive of healthcare reform to make sure the U.S. population is insured and address the shortage of primary care physicians increasing as high as 31,000 (“Physician Supply and Demand Through 2025: Key Findings,” Association of American Medical Colleges, April 1, 2015), where will people receive their primary care, and at what cost? What if there were a more efficient and cost effective way to deliver care to populations that lack access or don’t have the ability to easily access care.

Here are some data points to set the stage:

Enter community paramedicine. According to the California Emergency Medical Services Authority, “Community Paramedicine focuses on providing services, where access to care is limited, or a short term intervention is needed. By targeting locally identified health care needs, and offering a creative solution to fill local health care gaps, [Community Paramedicine] helps to increase access to care, and often reduces health care costs by providing the right level of care based on the individuals medical needs.” (Source: Community Paramedicine Fact Sheet, California Emergency Medical Services Authority)

So what is community paramedicine? Paramedics with this additional training (EMT-P designation) operate under strict standards and procedures with clear medical control by a supervising physician as they respond to emergency situations and provide some medical transportation roles in the communities they serve. Community paramedics are experienced paramedics with additional training in patient assessment and familiarization with healthcare providers and social services that are available to the community they serve. The net result is a more direct, integrated and immediate approach to healthcare delivery in a community.

EMS FunctionsChart source: Beyond 911: State and Community

Strategies for Expanding the Primary Care Role of First Responders, National Conference of State Legislatures, 2012

How does this impact insurance and benefits? Financing of community paramedicine services faces many hurdles, but there are several bright spots across the country and on the federal level. Several states (Minnesota, Maine, and Colorado) have passed legislation to allow reimbursement for these services under insurance plans. On the federal level, Medicaid doesn’t currently recognize community paramedic services for reimbursement, but alignment to value-based medicine and a patient centered medical home model may allow for alignment of these services in the future. If the states and federal government can come into alignment and allow reimbursement for community paramedicine services, insurance companies will align policies to allow this service. If provider organizations adopt community paramedicine as part of a commitment to value-based medicine and patient-centered medical homes, they will be able to provide more direct, local care, in a timely fashion at a lower cost. With 10,000 baby boomers turning 65 every day and millions of previously uninsured joining the insured ranks, primary care is a focus in the provision of health care now and for many years to come. Community paramedicine is a primary care force multiplier that makes sense.

The National Conference of State Legislatures summarizes the need for community paramedicine by stating “Using community paramedics to deliver basic primary care offers unique opportunities to reduce emergency room contact and improve health outcomes for underserved patients.  As policymakers consider their role within this workforce shift, they will benefit from the experiences of community paramedic pilot programs. Emerging data on cost and quality outcomes will help policymakers and payers assess the impact of these interventions on health care costs and individual and community health.  Policymakers can play an important role in ensuring that these coordinate public and private resources, track health care and cost outcomes, and foster innovation while also protecting patient health and safety.”

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UBA Partners Awarded Top Industry Award | Ohio Benefits Broker

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By Bill Olson, Chief Marketing Officer at United Benefit Advisors

Selden Beattie, a UBA Partner Firm in Florida, has two of the Top 25 Most Influential Women in Benefit Advising for 2015, according to industry magazine Employee Benefit Advisor.Selden Beattie

Selden Beattie Founder and CEO, Beverly E. Beattie, and Chief Client Officer, Monica Digon, have been named two of The Most Influential Women in Benefit Advising for two consecutive years.

Selected by Employee Benefit Adviser’s editorial panel, this honor is given to women who excel in categories including significantly increasing a firm’s sales and/or market share, providing strategic consulting to help clients achieve their highest goals, fostering employee benefit innovations, advocating successfully for advisor causes and, in general, elevating the status of all women in the profession.

EBA asked these women: What motivates you most about your job?

“Helping people and driving successful outcomes for our clients,” Beattie stated as the motivation for her job.

“Impacting the overall strategic direction and financial health of the organizations we serve, but more importantly, it is derived from building cultures of health that improve the lives of each employee and dependent,” said Digon.

Beattie and Digon are featured on the cover of Employee Benefit Advisor Magazine’s October Issue.

For more information, visit


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How to Get Employees’ Attention during Open Enrollment | Ohio Employee Health Insurance

Categories: Enrollment
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By Matthew Augustine, GPHR, REBC, CEO of Hanna Global Solutions, a UBA Partner Firm

It’s that time of the year – open enrollment season is here! Insurance carriers are presenting renewals and brokers are presenting ways to alleviate the cost pressure with innovative cost management strategies. HR and benefits professionals are under pressure to think out of the box and come up with new and improved benefit programs to Open enrollmentengage employees. Benefits administration companies are busy getting staffed, trained and ready for long hours and last-minute client decisions. And employees are getting ready for the barrage of benefits-related communications that are coming their way.

Are employees really looking forward to this?

My daughter was recently hired by a global pharmaceutical company and had to complete her benefits enrollment online. She was definitely was not looking forward to this part of her onboarding process. For her, it was one of those necessary ”to do” items that had to be checked off, and the less time it took, with the least bit of engagement or attention required from her, the better. That is, until I intervened and pointed out the possibility of higher costs and money being left on the table if she ignored some of the attractive benefit programs.

Employees comparison shop for other purchases, so why aren’t they curious about the price differences between plans and ways they could save money with the right choices? HR and benefits professionals have been looking for better ways to engage employees in the enrollment process for many years, especially as costs have escalated, and employers have had to scale back their share of costs.

Online enrollment systems with attractive presentations of benefit programs and ”engaging” user experiences in enrollment are one method. Forcing employees to select from a portfolio of plans using a combination of their own and employer money is another way. Add to all this a big dose of communications, both in print and online, that attempt to educate employees on their benefit options.

Within a couple of months of her starting her job, my daughter received an award for her contribution to work on a project. The reward was in the form of points that she could redeem for items offered on a rewards website. She was much more interested in browsing the ”stuff” that she could get with her rewards, or with rewards she could earn in future, than in browsing for something as important as insurance coverage.

Maybe a creative blend of shopping for rewards and shopping for insurance and other traditional employee benefits is what we need to get employees engaged in benefits enrollment. Many employers already offer enrollment rewards – gift cards for attending an open enrollment meeting, credits for completing a health risk assessment, and other such ideas. The next step is to integrate the benefits enrollment process with the employee reward program in a seamless experience, using one portal for comparing and enrolling in benefit plans, and offering payroll deduction options for purchases made with reward points.

With added reward products and programs on the shelves, employee benefits enrollment systems will become online marketplaces that attract employees to shop there.

Learn more about UBA’s online private insurance exchange platforms.

For information on how your health plan stacks up against other employers, pre-order the 2015 Health Plan Executive Summary, which highlights the latest findings of the UBA survey, the largest health plan cost survey in the industry.


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IRS Releases Draft 2015 Instructions for 6055/6056 Reporting | Team Kaminsky

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By Danielle Capilla, Chief Compliance Officer at United Benefit Advisors

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) IRS Filingindividuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015. All reporting will be for the calendar year, even for non-calendar year plans. Mid-size employers (those with 50 to 99 employees) will report in 2016, despite being in a period of transition relief in regard to having to offer coverage. The reporting requirements are in Sections 6055 and 6056 of the ACA. Draft instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in August 2015.

Draft 2015 Instructions

Following the June release of the draft forms, the IRS has issued draft 2015 instructions, which include a variety of changes from the 2014 instructions. For the 1094-C and 1095-C forms, the following important clarifications were provided: (1) who must file, (2) information on extensions and waivers, (3) how to correct returns, (4) an example and further information on the 98% offer method, (5) information on the new plan start month box, (6) multiemployer plan reporting, (7) offers of COBRA coverage, (8) reporting on employee premiums, and (9) break in service information. For the 1094-B and 1095-B forms there were fewer updates, with information regarding penalties for not reporting and how to file for an extension.

There is no target date for the final versions of either the forms or instructions, however it is generally anticipated they will be released in the fall of 2015.

Who Must File

The draft instructions clarify that all ALEs (employers with 50 or more employees) must file one more 1094-C forms (including the designated authoritative transmittal) and a 1095-C for each employee who was a full-time employee for any month of the year.

Extensions and Waivers

The draft instructions provide information on requesting extensions and waivers. Automatic 30-day extensions will be given to entities filing Form 8809, and no signature or explanation is needed. Form 8809 must be filed by the due date of returns in order to be granted the 30-day extension. Waivers may be requested with Form 8508, and are due at least 45 days before the due date of the information returns.

Corrections to Forms 1094-C and 1095-C

The draft instructions provided detailed instructions on correcting returns. Separate instructions are given for correcting authoritative 1094-C and 1095-C forms. Steps are given for a variety of mistakes, including incorrect full time employee counts, premium amounts, and covered individual information.

Extensions to Furnish Statements to Employees

Employers may request an extension of time to furnish statements to recipients by mailing a letter to the IRS with information including the reason for the delay. If the request is granted, the maximum extension that will be given is 30 days.


The draft instructions incorporate the new penalties for failing to file information returns, which are now $250 for each return that an employer fails to file. The IRS again noted that, for 2015 reporting, penalties will not be imposed for filing incorrect or incomplete information so long as the employer can show it made a good faith effort to comply with the requirements. The “grace period” does not apply to employers who fail to file or who file late.

98 Percent Offer Method

The draft instructions provided clarification of the 98 percent offer method. This method requires employers to certify that they offered affordable health coverage providing minimum value to at least 98 percent of their employees. The instructions clarify how to report on an employee in a limited non-assessment period. The instructions make clear that an individual in a limited non-assessment period does not count against the employer’s 98 percent calculation.

Plan Start Month Box

The draft instructions provide information on the new “plan start month” box, which is optional for 2015. This box is intended to provide the IRS with information used to calculate an individual’s eligibility for premium tax credits, which is based on the employer plan’s affordability, calculated by plan year.

Multiemployer (Union) Plan Relief

The 2014 instructions had told ALEs not to enter a code in Part II, Line 14 of Form 1095-C for coverage that is not actually offered, as the information must reflect the coverage offered to the employee. In 2015 ALEs with multiemployer plans are instructed to enter code 1H on line 14 for any month in which an employer enters code 2E on line 16. Code 2E indicates an employer is required to contribute to a multiemployer plan on behalf of the employee for that month, and is eligible for multiemployer interim relief. This is intended to assist with reporting challenges for multiemployer plans.

COBRA Coverage

The draft instructions provide information on how to handle offers of COBRA coverage. If COBRA is offered to a former employee upon termination, it is only reported as an offer of coverage if the employee enrolls in coverage. If the former employee does not enroll (even if his or her spouse or dependents enroll), employers should use code 1H (no offer of coverage) for any month in which the COBRA offer applies. If an employee is offered COBRA (due to loss of eligibility), that coverage is reported in the same way and with the same code as an offer of coverage to any other active employee.

Line 15 Calculations

The draft instructions clarify how to calculate employee contributions: by dividing the total employee share of the premium for the plan year by the number of months in the plan year to determine the monthly premium.

Break in Service

The draft instructions note that in certain circumstances an employee may have a break in service (which may be due to termination) during which he or she does not earn hours of service, but upon beginning service, is treated as a continuing employee rather than a new hire. The instructions clarify that the individual should only be treated as an employee during the break in service for reporting purposes if the individual remained an employee (was not terminated). An employee on unpaid leave would be treated as an employee for reporting purposes.

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How to Motivate Employee Participation in Your Wellness Program | OH Benefits Broker

Categories: Employee Wellness
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By Sara Saidi, Marketing Coordinator at The Wilson Agency
A UBA Partner Firm

Have you ever heard the quote, “If you take care of your people, they’ll take care of your business?” It’s great advice and goes beyond ensuring that they get a paycheck each month. Does your company show that they care about an employee’s total well-being? You should, especially considering that an employee’s physical and mental well-being Wellness rewardscan affect productivity and consequently cost the company money. One great way to show employees that you are invested in them, and to help them stay healthy, is through a wellness program.

Once you decide to start a wellness program, there are many things that must be considered, but one of the most important is figuring out how you are going to motivate employees to participate and invest in living a healthy lifestyle.

Let’s take a look at the psychology behind motivation. Behavior can be regulated externally (e.g., gift rewards and punishment) or intrinsically (e.g., internal goals). To motivate your staff, the goal should be to leverage both of these methods to help employees develop healthy behaviors that will last a lifetime so that it essentially becomes second nature to them. That lasting change will be felt throughout your organization for a long time to come. Those that haven’t already incorporated healthy behaviors into their lifestyle will need the extra push, and that’s where an organized wellness program comes in.

Here are different types of incentives that wellness programs typically use to give employees that extra push:

  • Financial (gift card or decreased premium)
  • Social recognition (awards)
  • Surprise incentives (every once in a while, surprise employees with an additional award – the element of fun will help keep employees motivated)

To really create a well-designed wellness program, we suggest incorporating these other tips.


If you want employees to be engaged and motivated, make the wellness program personalized so that it’s fair for all participants. Understand that not all employees are at the same level. It can often be easy to marginalize those who are already doing everything right. Try to find a way to recognize these employees as well. If employees can participate at their own fitness or readiness level, they will be more likely to participate.


At times, lack of participation cannot solely be attributed to an unwilling employee. It’s possible that employees are unaware of, or do not fully understand, the wellness program and the benefits of participation. To ensure a greater level of participation, make sure that you are properly communicating with your employees. According to a recent article in Plan Sponsor, Robert Kennedy, Health and Welfare practice leader with Fidelity’s Benefits Consulting business in Boston, says “incentives will get some employees engaged in the programs, but beyond that, communications play a strong role. Communications should set the context for employees—explaining why the employer is offering the programs and what it hopes to accomplish.” The article goes on to suggest, “frequent, short reminders about how to take advantage of incentives, using a variety of channels—emails, the employer’s intranet site or employee meetings. Short messages should contain a click-through for more detail for those employees who want it.”

Peer pressure

No one wants to be known as the only employee who doesn’t participate. Be careful not to call out any employee, but do get employees talking about the wellness program. In March, one of the ways in which our employees could obtain points toward a wellness credit (which decreased premium costs for those on the health plan) was to motivate other employees to participate. This works out great because most people want to demonstrate that they are a positive influence in the company and participating in activities with coworkers is a great way to do that.

Spread incentives out over time

To assist employees in developing a pattern of healthy behaviors, spread incentives out over time. This way they will be less likely to just take the money and run. Some employees will participate for the incentive, but over time the healthy behaviors will become habit. Some may even realize that they enjoy living a healthy lifestyle more than an unhealthy one as they experience the benefits of living well.

Keep in mind that a wellness program is not one size fits all and, while turnkey programs should be easy to implement, companies should carefully think about their culture and what they want to achieve. People are motivated by different things, so what works for one person in your company may not work for another and what works for your company may not work for other companies.


For information on wellness plan trends from the UBA’s Health Plan Survey, download our Executive Summary.

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IRS Provides Expatriate Plan Guidance | Ohio Employee Benefits

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By Danielle Capilla, Chief Compliance Officer at United Benefit Advisors

The IRS released a notice providing further guidance on expatriate health coverage. The guidance generally provided for:

  • Temporary relief allowing taxpayers to apply the requirements of the Expatriate Health Coverage Clarification Act (EHCCA) using a reasonable and good faith interpretation of the EHCCA while issuers, employers, and Expatriate health careplan sponsors modify their current arrangements to comply with the EHCCA.
  • Clarification that the EHCCA exemption from Affordable Care Act (ACA) provisions does not apply to requirements of sections 6055 and 6056 (play or pay reporting). However, statements to individuals reporting an offer of minimum essential coverage may be furnished electronically (unless the recipient refuses consent).
  • PCORI fee calculations may exclude lives covered under a specified health insurance policy that is issued or renewed on or after July 1, 2015, or under an applicable self-insured health plan for plan years starting on or after July 1, 2015, if the facts and circumstances demonstrate that the policy or plan
    1. was designed and issued specifically to cover primarily employees
      (a)   who are working and residing outside the United States, or
      (b)   who are not citizens or residents of the United States but who are assigned to work in the United States for a specific and temporary purpose or who work in the United States for no more than six months of the policy year or plan year; or
    2. was designed to cover individuals who are members of a group of similarly situated individuals for purposes of § 3(d)(3)(C) of the EHCCA under the explained special rule for groups of similarly situated individuals.

The IRS will consider an individual to be a member of a group of similarly situated individuals if

  • the group of individuals satisfies the standards under §§ 3(d)(3)(C)(i) and (ii) of the EHCCA;
  • in the case of a group organized to travel outside the United States, each member of the group is expected to travel or reside outside the United States for at least six months of the policy year (or, in the case of a policy year that is less than 12 months, for at least half of the policy year), and in the case of a group organized to travel within the United States, each member of the group is expected to travel or reside in the United States for not more than 12 months; and
  • the group of individuals meets the test for having associational ties under § 2791(d)(3)(B) through (F) of the PHS Act (42 U.S.C. 300gg-91(d)(3)(B) through (F)).


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