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Confronting the growing burden of health care compliance documents
U.S. employers continue to grapple with employee-communication obligations related to health care, including new requirements under the Affordable Care Act (ACA). And while compliance staffs appear to be getting larger, organizations continue to have a vague picture of the total costs of writing, producing and distributing compliance documents, according to data from benefits management firm HighRoads’ Fifth Annual Compliance Trends Survey.
Conducted near the end of 2013 with midsize to large companies representing 5 million plan participants, the survey revealed that:
“We are seeing the continued struggle of employers to comply with ACA requirements," said Kim Buckey, principal for compliance communication services at HighRoads. "It is a challenge that will only increase as new regulations under the ACA take effect, current safe harbors and postponed effective dates expire, and enforcement of the regulations begin in earnest."
For example, she noted that the two-year "best efforts" safe harbor for complying with SBC regulations around format and length is now ending.
Having sufficient resources (budget, time and people) and managing the review process continue to be the biggest hurdles as companies produce their SPDs. For the first time, a quarter of respondents (27 percent) reported that their internal SPD team consists of six or more people, while 55 percent get the job done with two to five team members. In 18 percent of companies, SPDs are handled by one person.
The second year for SBCs was 2013, during which employers also dealt with a new template and required information. Despite the change, twice as many self-insured respondents opted to produce these documents in-house (40 percent, up from 18 percent the prior year), and far fewer planned to have their insurance carriers handle SBC production (36 percent, down from 53 percent).
Who is producing SBCs for your self-insured plans?
Medical carrier or third-party administrator
The 2013 SBC required businesses to determine whether their plan meets minimum-value standards, and federal agencies gave employers multiple options for doing so. While many respondents relied on their actuaries to make this determination, some used their carrier, and a handful used the calculator provided on the Department of Labor (DOL) website.
How are you determining whether your plan meet the minimum-value requirement?
Calculator on DOL website
For the first time, in 2013 employers were required to provide a notice of coverage options. Given the relatively simple nature of the form, more than two-thirds of respondents (68 percent) produced it in-house, 24 percent opted to reach out to consultants, and just 12 percent used their carriers to generate the notice.
Compliance document distribution continues to migrate toward electronic channels, with 33 percent of respondents reporting they used e-mail to alert participants that SPDs and other materials had been posted online, typically at a secure site. Organizations are also broadening online access—specifically, 63 percent allow access from anywhere (not just from work), while 30 percent limit access to active employees.
Who has access to electronically distributed SPDs?
All participants from any location
Employees only, from any location (home, library, other remote site)
Employees only, at work (retirees and other nonactive participants can't access online)
Don’t provide electronic access
Almost half of respondents (45 percent) indicated they are using or plan to use Twitter and/or Facebook, along with e-mail, to direct participants to online notifications about their benefits.
Most organizations, however, still don’t know what percentage of their employees are using smartphones and other mobile devices for work, although 27 percent said they intend to explore their use as a benefits-communication tool within the next two years.
Private Exchanges Considered
“The continued challenge of compliance may be a contributing factor to the decision of some employers to move their employees and/or retirees to a private exchange,” Buckey said. “Almost 88 percent of our respondents indicated that they have considered moving to an exchange within the next five years."
Have you considered moving any of your participants to a private exchange …
within the next year?
within the next five years?
Stephen Miller, CEBS, is an online editor/manager for SHRM.
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