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Wellness – Size Seems to Matter

David P. Lind BenchmarkSize really does matter – it appears.

For many years, we have asked thousands of Iowa employers whether they offer some type of wellness initiative, and if so, what components do they include in their program. From our 2011 Study, we do know that Iowa employers offer the following wellness initiatives:

  • 44 percent offer Medical Information to their employees through a website, newsletter, etc.
  • 26 percent of Health Screening Programs
  • 23 percent offer Smoking Cessation Programs
  • 22 percent offer Chronic Disease Management Programs
  • 21 percent offer Health Risk Assessment Programs
  • 21 percent offer Health Club discount/reimbursement Programs
  • 18 percent offer Weight Control Programs

When we look a bit closer at these numbers, we see a very consistent theme (found in all past studies) – smaller employers are clearly less likely to embrace wellness initiatives (see below).

 David P. Lind Benchmark

A few primary reasons that smaller employers do not offer wellness initiatives relates to cost and time. Smaller employers have fewer resources than their larger counterparts, and therefore desire to spend their time and money on keeping their business, well, in business! For the typical small Iowa employer, focusing on the basics of their business is paramount to surviving in these harsh economic times.

Due to sheer cost, offering health insurance might be considered a ‘necessary evil’. But offering health coverage allows the employer to compete with other employers for qualified workforce talent. From our studies, we know that smaller employers are less likely to offer health insurance to their employees. Compared to larger Iowa employers, small employers tend to receive higher rate adjustments to their health plans, year after year. From this, small employers are forced to drastically change plan designs that shift additional costs to employees through higher deductibles and copayments. When employees have to pay more through higher cost shifting, many may forgo (or delay) seeking health care services altogether. This unintended consequence can be detrimental to the long term interests of small employers.

It may be time for smaller employers to reconsider offering sensible wellness initiatives – perhaps not to expect immediate relief in health insurance premiums, but to promote a healthier, more productive workforce. Size should not really matter when it comes to having a healthy workforce.

 

Waiting for 2014 and Beyond

David P. Lind BenchmarkUncertainty remains…we continue to wait.

A Deloitte study was released on July 24 indicating that 9 percent of employers in the U.S. said they may stop offering health insurance in the next three years. Based on numerous study results from last year, this number is not at all surprising. In fact, we surveyed Iowa employers last summer and found that less than 6 percent of employers reported the possibility of dropping health coverage when 2014 arrives (see below).

2011 Iowa Employer Benefits Study 

So what gives? Why do employers feel that they may no longer offer coverage? For one, in 2014 employers with over 50 employees who fail to offer minimum essential coverage will incur a penalty of up to $2,000 annually per employee. In addition, if employees are required to pay more than 9.5 percent of their income for self-only coverage, the employer would be penalized $3,000 per year, per full-time employee who enrolls in the exchange and is eligible for government subsidies…a non-deductible expense to the employer.

Perhaps another more plausible approach employers might take would be to pursue a “defined contribution” strategy whereby the employer provides a defined amount of money to each employee who will then purchase coverage through the exchange. Keep in mind that by 2014, individuals will not have to worry about pre-existing conditions when applying for individual coverage. Employers may find this approach more palatable than offering their own health plan, which takes time and resources to keep the plan in compliance (and remain competitive).

When we asked Iowa employers whether they would terminate their current group medical plan, pay the $2,000 penalty per employee, and increase employee compensation with the money saved from dropping health coverage, less than 1 percent said they were “very likely” to pursue this approach (see below).

 2011 Iowa Employer Benefits Study

There are many studies to draw from when attempting to understand what employers will do in 2014 and beyond. Needless to say, there is still much confusion from the employer community about how the health reform law will impact their health coverage.

Playing a “wait and see” approach may be the most logical strategy for the time being.

New Beginnings for Benchmarking Benefits in Iowa

David P. Lind BenchmarkSince 1999, my firm has surveyed Iowa employers to learn about the benefits they offer to their employees. The “Iowa Employer Benefits Study” has revealed many key facts that allow employers, regardless of size and industry, to determine annually how competitive their benefits are when attempting to attract and retain employees. After all, to be successful, employers MUST have the right employees when competing locally, nationally and globally. This is a fact of business life!

Prior to 2012, our surveys have randomly-selected Iowa employers once a year. Annual surveys are really a “snap-shot” in time, allowing us to sample a particular population for that time period and compare the results to previous years’ results.  Doing this has provided a wealth of data on employee benefit trends that provides meaningful information for employers, policy-makers, the media, etc. This work also allows us to compare different industries within Iowa to one another. All industries, by the way, are NOT created equal! There are inherent issues within each industry that impacts the type of benefits offered to employees…and the costs can be considerably different when comparing industries.

Beginning in 2012, we have updated our survey process to make it even more fresh, relevant, local and customized for the Iowa employer. Instead of surveying all industries at the same time each year, we are staggering the survey process to allow a greater likelihood of observing trends sooner, rather than later.

Here’s how it will work:

Every two months, beginning in January and February of 2012, we will survey just one major Iowa industry. For example, we just finished surveying the Manufacturing industry in Jan/Feb, and we are now “interviewing” the Retail sector for March and April. The other survey periods for 2012 include:

  • May/June – Finance and Insurance
  • July/August – Healthcare & Social Services
  • September/October – All Other Sectors not interviewed in the other five periods
  • November/December – All State & Local Governments

In 2013 and beyond, the process will be repeated as mentioned above. During any given survey period, new questions can be added once new trends and developments have been identified, including new questions about health reform issues, wellness initiatives, and employer attitudes on various subject matter, to name a few.

In addition to having on-going “fresh” data, we will seek a higher number of respondents for each industry than we have in the past, making our already credible survey even more robust! Our studies have consistently interviewed over 900 employers in each of the last several years…and we will now add to this number under the new survey process.

If your organization is randomly selected to participate in this new and improved study, I highly encourage you to participate (if you already have, we thank you!). By participating in this important research, you will receive an overall summary of the survey results that will help your organization compare itself to other Iowa employers. If your organization has not been randomly selected to be surveyed, don’t despair, you still have access to this information. Should you wish to have an easily customized benchmark analysis with other Iowa employers both within and outside your industry, you can perform this anytime here. New and improved benchmark programs will also be developed within the near future! Many changes are being made to this landmark study, but its’ integrity remains unchanged. You have my word on that!

Here’s to a new beginning – for all of us!