Employers Need To Start Communicating Now About Health Exchanges: Benz Communications

The Patient Protection and Affordable Care Act (ACA) created health insurance exchanges. Exchanges will be starting enrollment for the 2014 plan year in October. The ACA requires that employers send out notices to employees about the health insurance exchanges, and EBSA Technical Release 2013-02 specified that this notice must be sent to employees by Oct. 1, 2013. “Communicating with employees about health care reform—and insurance exchanges in particular—is no longer an option for employers,” said Jennifer Benz, founder and chief executive officer of Benz Communications.

“According to focus groups conducted with clients from Utah to New Hampshire—and data from the recent Aflac WorkForces Report and Kaiser Tracking Poll—one theme is clear: People don’t get it. ‘It’ being their health care benefits, health care costs, and health care reform. It doesn’t matter if we speak with highly paid PhDs or individuals working two minimum-wage jobs. Everyone has similar questions, misunderstandings and a sense of being overwhelmed about health care. At a minimum, this confusion is going to create more work for HR staffs. Plus, it can negatively affect how employees perceive their benefits offerings and result in them making poor benefits decisions that cost them—and their employers—precious time and money. To preempt the added confusion that’s sure to result from consumer marketing and state-led exchange education, employers need to start communicating about health care reform and the exchanges now,” said Benz.

Benz provided the following guidance on how to communicate health care reform:

Focus only on what matters now. Don’t overwhelm employees with what happens four years from now or random “What if?” scenarios.

Plan for ongoing communication. Don’t pile it all on at once. And don’t think that a single communication is going to fix everything. Use all the channels available and make sure you are giving people many ways to interact with the information.

Do the work to make this simple for your employees. This is a complicated issue, confusing and full of nuance. You need to be the source of clear, simple, unbiased information.

Use social media, videos, tools, examples, and real-life stories to make this come to life. Health care topics will always be emotional. A less formal tone and some interactivity work to bring your employees closer to your message. A blog is perfect for a series of posts on health care and health care reform.

Here is what Benz suggests regarding what to communicate:

Tell employees ACA is now the law. All aspects of health care are going through major, desperately needed change—driven both by health care reform and by all that’s broken in our current system. Employers that have not communicated along the way need to explain the changes already in place as a result of health care reform. Employers can and should be transparent with employees about the additional costs of the new requirements and how they have implemented new requirements so far.

Tell employees that health insurance will soon be a new ball game. Explain that, starting Jan. 1, 2014:

o Insurance companies must accept everyone who applies for coverage, regardless of health status.

o The “individual mandate” requires that everyone must be covered by health insurance or pay a fine; those who can not afford insurance will be eligible for assistance.

o There are many new requirements that place more burden and costs on employers. Overwhelming employees with details is not important; clearly explaining the impact to the company is. If real cost figures can be used, even better.

Focus on the exchanges. Any health care reform information provided to employees must include a simple-to-understand explanation of public health exchanges. Although employers are not required to communicate about health insurance exchanges until October 1 (when the official notice must be sent), waiting until then will create a headache for employers, their HR team and their employees.

Explain that the exchanges are marketplaces where people can easily buy health insurance. Direct employees to sources for additional information and guidance, such as http://www.healthcare.gov. There will likely be additional sources as state exchanges come online. For example, Covered California is already online with a simple cost modeler.

• Explain the government subsidies and what makes someone eligible or—in the case of most employees—ineligible for a subsidy.

• Give clear direction to employees about what they should do. This direction and guidance really depends on the individual employer’s employee population and benefit strategy. Here are the most common situations:

o 2014 is business as usual with regard to eligibility and coverage. Many employers offer good coverage that meets all the requirements. In this situation, employees are not eligible for a subsidy and the main message is easy: The benefits provided by the employer are still the best deal available. If this is the case, there is no need for employers to do anything beyond the usual open enrollment. Still, some employees will want to compare their employer’s plan to what is available. According to Benz, “Employers should make this easy—employees may finally understand the value of their plans!” Employers that skim over this risk two things: 1) employees wrongly enrolling in benefits through an exchange (and returning angry when they realize they are not eligible for the subsidy) and/or 2) losing young and healthy participants, and having the plan’s costs increase.

o Exchanges may be a good thing for a segment of employees. This is true for employers with a part-time workforce, seasonal employees, summer interns, pre-65 retirees or temporary workers who do not qualify for the company-provided health plan but whose engagement is important. Employers with these types of employees will want to direct them to the exchanges and show them how the subsidy works. “Even employees who stay on the company health plan may have friends or family who would benefit from the exchanges. Although it is not an employer’s duty to educate them about these scenarios, the value for caregivers will be tremendous—and educating employees about the exchanges will help illustrate the value of the coverage provided,” Benz says.
o Families could benefit from the exchanges. Employers incurring a spousal surcharge or those that minimally subsidize family coverage or simply do not offer it, have faced tough questions in the past. They will face more if they do not proactively suggest that the exchanges are a viable alternative for many of their employees’ families. Benz said, “It’s a delicate dance, no doubt. Likely, these employers still meet the legal requirements of offering affordable care, but some employees may feel the pinch. Why not help them through the application process with some thoughtful context and advice?”
o Employees are eligible for a subsidy. For those with employees whose income levels would qualify them for tax subsidies, employers want to provide targeted communications that emphasize the importance and availability of public health care exchanges. “Employers in this category want to work with their actuarial team to identify who may qualify for the subsidy, get their demographic profile and target them,” said Benz.

“Creating health care behavior change requires getting people motivated and feeling capable of making changes for themselves and their families. Communication is the key to keeping them focused on changes one step at a time. This minimizes confusion and reinforces that change is the new normal,” Benz concluded.

For more information, visit http://www.benzcommunications.com.

Visit our News Library to read more news stories.