Agenda: Communications It’s Not Too Late

There’s time to begin educating employees about health care reform.

By Nancy Hatch Woodward August 1, 2013

Health care reform is here, and employers are working to comply with the Patient Protection and Affordable Care Act. Yet 42 percent of Americans are unaware it is the law of the land, according to a Kaiser Health Tracking Poll from April.

New health insurance rules are scheduled to kick in soon, so employee communication about the reform law and any benefits changes should start now.

Do not despair, however, if your communication plan is at the starting line, says Dani McCauley, senior vice president of marketing at Univers Workplace Solutions, a benefits administration and communications provider in Hammonton, N.J. Brokers, consultants and other vendor partners can help.

A Strategic Plan

Employers should have a strategic communication plan in place as early as possible. By Oct. 1, all companies must provide employees with information about state health insurance exchanges, where individuals and small businesses will be able to shop for insurance.

If you know you are making changes to your health plan, you need to figure out what those changes will be before you can communicate them, says R. Pepper Crutcher Jr., a partner in Balch & Bingham’s Jackson, Miss., law office. "This is a very complicated topic, and your communications should not be rushed," he adds.

Careful planning is essential for framing difficult communications, such as telling employees the company will not offer benefits; will not pay as much (or anything) for spouse or dependent coverage; or will reduce the number of hours employees work, making them ineligible for health care coverage.

"Never give people bad news at the last moment," Crutcher says. "Don’t corner employees by springing something like this on them and then saying ‘Merry Christmas.’ "

For organizations that are keeping health care benefits, it is a great time to remind workers how valuable these benefit are and that the employer provides coverage as an investment in employees.

"We have heard from some clients that their employees believe the government is now giving them their health care, and they no longer understand their employer’s role," McCauley says. "If an employer does not stay active in the conversation, it is going to be very easy for that employer to lose the perceived sponsorship." HR professionals have their work cut out for them. The Kaiser poll of 1,203 adults living in the U.S. found that about half of those surveyed said they did not have adequate information about the law, and only 11 percent said they had received any information from their employer. This puts a burden on HR.

Start with the Basics

"HR has been immersed in health care for the last several years, but the public has not," says Heidi tenBroek, a principal at Milliman, a benefits consultancy in Seattle.

Start by telling employees whether the company plans to continue offering coverage in 2014. "There’s been enough speculation out in the news about employers dropping coverage," tenBroek notes.

Jennifer Benz, founder and chief executive officer of Benz Communications in San Francisco, notes additional basic questions that employees will have if their employer is continuing to offer health care coverage:

  • Could I get a better deal on the health insurance exchange?
  • Could someone in my family get a better deal on the exchange?
  • Am I eligible for a subsidy on the exchange?

Answering these questions is critical because employers may face penalties if their employees migrate to public exchanges. HR professionals will want to do all they can to keep employees in their employers’ health plans.

Because the health care reform law is so complex, the best approach is to focus on the most critical information, communicate it simply and try not to get too far ahead of yourself, Benz says.

Deliver bite-size pieces of information, McCauley says, but try to frame the information in the larger context of the ongoing shift that is occurring as a result of the health care reform law.

Try to provide personalized information, says Denise Foster, a principal and practice leader at Milliman. Tailor messages to the appropriate audiences, especially if only some of your employees will be in the employer’s health plan.

Next Up: Leaders

Educate business leaders and get them involved. The HR team at Intrust Bank, based in Wichita, Kan., spent March and April informing senior leaders about the health care reform law, the bank’s health care risks and claims data, and the leaders’ role in the communication process, says Jill Beckman, division director of people services. In May, the president headed to bank locations for all-employee meetings to explain the law’s requirements and that the bank already offers many of those benefits.

HR professionals at Legacy Health System in Portland, Ore., used e-mail and other messages from their CEO to employees that explained the organization’s health plan in the context of health care reform. They met with the organization’s leaders to detail how the leaders could support and explain the changes the hospital group was making to its health plans, says Sonja Steves, SPHR, senior vice president, human resources.

Communicate Key Reform Topics

Depending on its situation, an employer may need to cover the following topics before the new plan year begins:

State exchanges. On Oct. 1, all employers must provide information to employees about the public health insurance exchanges. Explain that if they decline employer coverage, they may not be eligible to buy subsidized coverage through an exchange for the same coverage period.

Play or pay. Employers need to announce whether they will continue to offer health care coverage or whether they will elect to pay applicable taxes and give employees the option to buy coverage, which might be subsidized, through an exchange.

Plan-design changes. Some employers may offer plans and features that are unfamiliar to employees and that need to be explained—for example, a high-deductible health plan paired with a health savings account, a “skinny med” plan that provides limited benefits, or wellness program incentives.

Coverage changes. Employers must offer coverage to full-time employees and their dependents; however, because spouses are not defined as “dependents,” coverage for them is optional.

Cost-sharing changes. The employee’s coverage must be “affordable,” but there is no such requirement for dependent coverage.

Medicaid expansion. In states that have signed up to expand Medicaid coverage, employees with household incomes up to 133 percent of the federal poverty level may be eligible for Medicaid.

Reduction in regularly scheduled hours. Some employers, especially in retail, hospitality and other service industries that employ hourly workers, have begun to convert full-time jobs to part-time jobs to minimize their play-or-pay expenses.

Use Your Entire Arsenal

Use a variety of tools in your education campaign, experts advise. "Try a little bit of everything, and do not rely on just one method," Steves says. Legacy Health’s HR professionals have used home mailings and articles in newsletters to educate the organization’s 9,700 employees. They recently launched "The Future," a bimonthly e-mail on health care reform. "At first, it was a little mysterious to employees because no one knew who wrote it," she says, "but they have come to rely on it."

At Intrust, managers encourage the bank’s 880 employees to read mailings and articles and come to meetings. HR developed Q&As and, in May, began putting out a series of newsletter articles that focus on topics such as the health care reform law’s impact on the employer, public health insurance exchanges or possible future health care benefits.

The HR department at Darden Restaurants Inc., headquartered in Orlando, Fla., started employee communication early. In 2012, employees had the opportunity to sign up for their 2013 health insurance through a private exchange offered by Aon Hewitt.

Darden moved from one health plan with one provider to five medical plans and up to five carriers on the exchange, depending on the location. Danielle Kirgan, senior vice president of total rewards and HR shared services, says the company prepared for this "change on steroids" by approaching its communication and change process in three stages:

Build awareness. Last August, Darden’s HR team started educating leaders and reaching employees through videos, home mailings and text messages about some "new and interesting" benefits that would soon be rolled out.

Educate employees. In October, the team held employee training sessions facilitated by their benefits professionals and provided on-demand videos employees could watch at their desks. The videos detailed the company’s new high-deductible health plans and other plan changes. Employees also had access to video testimonials from colleagues who had experience with different plan options before joining Darden and from actors portraying fictional employees who explained why they chose a specific plan option.

Encourage decision-making. Open enrollment in October included electronic tools that were popular with employees and that helped them model their medical needs and choose the plan best suited for them.

Handling Questions

Considering the complexity of the health care reform law, HR professionals should expect to be peppered with questions from employees.

Last year at Darden, HR received many calls from employees regarding the reform law. In response, the company’s benefits professionals created talking points for managers, set up a call center, and created a website where employees could submit questions and have live chats with an HR representative to get answers, Kirgan says. During open enrollment, the company provided live sessions to walk employees through the process of signing up.

Intrust set up a team of four HR professionals who were prepared for a barrage of questions. HR developed a two-page document listing all the main points about the health insurance exchanges, the waiting periods, the affordability requirement and more. The information was also made available to senior leaders so they could provide support as well.

When it comes to health care reform, Glassdoor Inc.’s HR director, Amanda Lachapelle, PHR, strives to communicate one-on-one with 160 employees of the jobs-and-career network based in Sausalito, Calif. Because that’s not always possible, Glassdoor has a dedicated intranet site on the topic, and the professional employer organization that manages the company’s health insurance benefits provides employees with information about health care reform.

HR professionals would be well-advised to keep the outreach and education coming. When companies launch something new, they tend to put a lot of energy into the launch and think their communications role is over, Steves says, but not every employee is listening. "If I’m personally impacted by the change, then you have my attention," she says. "If I’m not, I probably won’t pay attention." Employers need to keep a steady drumbeat of communication all the time; then, as the need arises, people know where to go for information.

Nancy Hatch Woodward is a freelance writer based in Georgia.

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