Benefits Buzz

Worker Productivity and "Miracle-Gro" for Your Brain...

Dr. John Medina is a developmental molecular biologist and research consultant. He is an affiliate Professor of Bioengineering at the University of Washington School of Medicine. He is also the director of the Brain Center for Applied Learning Research at Seattle Pacific University.

So what does this guy, who knows a lot about brains and not just because his is obviously pretty high powered have to say about how to optimize our brains for work, play and study? Exercise. Yes. Not only does Medina show that exercise is the number one rule for brain health (hint: when our brain was designed regular movement was a fact of life for humans), but he strenuously emphasizes that our modern, sedentary work environment is actually hurting brain performance.

The US's labor landscape continues to undergo dramatic shifts. Manufacturing jobs are fading fast as the rise of the service economy dominates the landscape.  Even in the current downturn, many of the jobs that will grow as a result of the stimulus plan are in clean power, health care and any number of other fields that continue to experience increased modernization and interface with both people and information systems.

"It's good for us to displace low-wage, manual kinds of labor with higher-skill, higher-tech, higher-education-content labor," says Federal Reserve Bank of St. Louis President William Poole, who compares what's happening with the decline in agricultural employment of the early 20th century.

The problem is we are treating service based workers like factory workers. Workers' brain capacity is - at its core - the very product most service based companies sell; however, the sedentary cube land structured like an automotive assembly line is one of the least conducive set-ups for brain function.

Creative, effective ways to mobilize wellness at work will be central to revolutionizing the effectiveness of the knowledge-based worker. Corporate wellness efforts for such companies cannot simply be seen as a small fluff program for the motivated few who thrill at the thought of spandex leggings, step aerobics in the lunch room, or a gym membership on the company dime.

Wellness, when done right, is a strategic, integrated, and systematic approach for improving employee health, but also key to unleashing the very engine of human creativity - the brain.

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

Mommy's Little Angel (Due To Cardiac Arrest)?

Okay, wait, when we said we wanted health care for everyone, we didn't mean that we wanted everyone to desperately need health care. Here are a couple of headlines that scared the bejeesus out of me:

A Rise in Kidney Stones Is Seen in U.S. Children - NYTimes.com
Kidney stones, once considered a disorder of middle age, are now showing up in children as young as 5.

Child Obesity Seen as Warning of Heart Disease - NYTimes.com  A new study finds evidence that children who are obese or have high cholesterol show warning signs of heart disease. 

In the second article the study finds, "artery walls of children and teenagers who are obese or have high cholesterol resembled the thickness of artery walls of an average 45-year-old."   (Silent scream here).  The kids in the study ranged in age from 6-19 years old!

And it isn't as though this is a small portion of the United States we are talking about. The Centers for Disease Control and Prevention estimate that about 16 percent of children ages 2 to 19 are overweight. This tracks well with what we know about the growing prevalence of Type II Diabetes, but now it also appears as though these young people may be at early risk for heart disease as well.

Prevailing data shows that as people age they become medically more costly, but when our 6 year-olds have the arteries and cholesterol levels of 45 year olds, it is anyone's guess how long the middle aged population will maintain its hegemony on medical costs.

• What are you doing to encourage spousal and dependent participation in your wellness program? 
• How many spouses and dependents participate?
• Do you do outreach for parents and kids with high BMI or low activity and high risk for diabetes?
• What about other more common childhood ailments like asthma and coping with allergens?

In many cases, we see that spouses and dependents contribute just as much - if not more - to health care costs and absenteeism as employees themselves.  If we choose to care for the whole person, shouldn't some aspect of that care be targeted at impacting the general well-being of their family milieu as well?

Is Twitter a Viable Tool for Employee Benefits Communication?

Twitter is everywhere. The micro-blogging platform, that asks you “What are you doing?” and only gives you 140 characters to respond, gets more press lately than celebrity mishaps. It is growing crazy fast, CNN loves to integrate it into the newscast and it gives even the biggest celebrities a chance to seem like real people.

Often dismissed as “fluff” in the social media landscape, Twitter is actually an invaluable tool for business, letting you quickly interact with a huge group of industry thought leaders, grab news headlines and even see what your competitors are talking about. The uses of Twitter have surprised even the founders themselves. It took me a little while to really buy in to the power of Twitter, but now I’m officially hooked.

But, can this platform be effective for employee benefits communication? Can it handle the complex needs of communicating to employees and their families about health care, 401(k)s, stock options, wellness programs, EAPs and all the other crazy and complex programs that are out there? 

I asked that on Twitter, and here are just a few of the replies:

So, it is a resounding YES. And, I agree completely. Here's why.

Four Reasons Why Twitter Works for Benefits Communication

Short and sweet. Twitter forces you to keep things to 140 characters, or about 20 words. That means you have to get to the point fast and entice your audience to link for more information. This is precisely the way effective communication should be structured, especially in our media-saturated world. And, this works really well for benefits information, where each individual needs to quickly find the information that is relevant for them and go. Too often, benefits communication is delivered in a one-size-fits-all package that has so much technical information and detail that the actual message is lost completely. There is a place for that (in your Summary Plan Description, for example) but the majority of benefits communication should be about engaging employees and families so they take action and make good decisions. Twitters’ quick to-the-point format would be great for delivering those action items in clear and simple terms.

On the Internet, for everyone to see. There’s nothing private about Twitter, as some have learned the hard way, but that is a good thing for your benefits communication. You want to get information into the hands of your employees (and new hires!) and their spouses and families as easily as possible. Unnecessary passwords are just an opportunity for your audience to get distracted by YouTube or Facebook and never return to your site or the important task they meant to do. There are Twitter-esque tools for the enterprise, like Yammer, that can live behind a firewall, but sequestering your benefits info behind all that security keeps it out of the hands of the spouses and families who are driving the largest portion of your costs. Not convinced? Here’s a full article on this topic alone.

Interactive. The @ feature on Twitter makes it easy to send a quick question or direct a reply at an individual. This makes the platform incredibly interactive—and efficient. The vast majority of benefits questions that are handled either by self-service websites and costly call centers are simple, simple, simple. “What’s the phone number for our health plan?” “Where do I submit claims for the FSA?” “What’s the deadline for the stock plan enrollment?” “Can I get reimbursed for salsa dance lessons as part of our fitness incentive?” All of these are simple less-than-10-word answers that could be handled by a benefits team member or a call center rep with minimal effort. I’d love to see a company roll out Twitter help as an adjunct to their call center. (Yes, obviously, there must be some common sense training that goes along with this but call center reps and benefits pros who are sophisticated enough to handle HIPAA regulations and FMLA rules are also smart enough to know when to say “we can’t answer that in a public forum—call us at this number.”)

Twitter can come to you. I know someone is thinking “but our employees aren’t on Twitter yet, why would we use that?” and that is a valid point. You have to go where your employees and families already are. And, you can do that with Twitter. All of the applications and widgets and add-ons that make putting a Twitter feed into another website easy are part of the reason the platform has grown so quickly. So, yes, you have to go where your people already are—is that your Intranet, your benefits website, Facebook, LinkedIn? Or, is it their mobile phones? Twitter can work anywhere and I think the mobile applications are going to become even more interesting and useful.

BUT, (there has to be a “but” right?), I do have a few cautions before you drop all your current communication channels and hire someone to man Twitter 24/7.

Some Cautions

If you use Twitter for benefits communication, it MUST be part of an integrated campaign. Twitter is just one tool and you have to give employees and families comprehensive resources and frequent updates in other media, of course. The ideal communication strategy is going to have a mix of online, print, interactive and hopefully face-to-face communication. And, just like any website, you can’t have an “If we build it, they will come” mindset—you have to consistently remind employees about the resources out there and why they should bother taking a look. (And, no, I don’t think good old-fashioned print communication mailed to homes is going away anytime soon—especially among companies who do not have completely wired workforces.)

Jargon alert. Benefits has enough jargon and silly acronyms already without throwing a new language of “Twitter” and “Tweeting” in the mix. If you use Twitter for your benefits communication, you must be very cautious not to further confuse employees or forget to define acronyms. It is no fun to spell out "high deductible health plan" when you’ve only got 140 characters to work within, but chances are pretty good your employees are not going to know HDHP, at least not the first time around. 

Understand the time commitment. An investment in any social media takes time and you need to accurately understand the commitment required, which could be significant. If you have someone on your benefits team monitoring Twitter and answering questions in real time, it might make sense to say “We respond between 10am and 2pm PT Monday-Friday. We’ll get back to you as soon as we can” so that you set appropriate expectations with employees—and so that individual can actually get some work done outside of those hours. 

I'm convinced Twitter holds tremendous promise to help engage employees and their families and get them taking action with their benefits. What do you think? Please comment below or let me know on Twitter.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. She helps companies, large and small, connect with their people so that those people (and their families!) understand all the confusing, but oh-so-important, benefits programs that are out there. She's located in San Francisco.

Is Fast Food Nation Conspiring to Put You Out of Business?

British health experts have issued a health warning pertaining to the "Super Size" phenomenon in hospitality establishments. Yes, it has finally reached the UK. The World Cancer Research Fund (WCRF) states that 'two-for-one' or 'meal deal' offers encourage people to eat too much. Even though this super size trend is "old news" in the US, we have a headache that our buddies across the pond get to ignore - a hamburger today can equal a big fat medical bill for your company tomorrow.

When dining out, eating fast food or in a rush, the pressure to finish everything on the plate can lead to overeating. Most restaurants will serve more food than the body needs. When employees hustle back to their desks, take-out in hand, to tackle their afternoon work, their inattention to what's on their plate could easily lead to regular overeating and significant weight gain. 

Compare the difference in serving size (and calories) of some food and drinks 20 years ago versus today:

It doesn't cost a great deal to provide employees with quick handouts about smart tips for eating out, and most health carriers will offer you such materials for free.  Here's a classic: ask for a box before your food comes out. When your meal comes you can put some of the food in the box before you start eating and set it aside (out of sight, out of mind). When you finish the food on your plate, if you're still hungry, open the box and go for it. If not then you have some delicious leftovers for tomorrow.

Also, employees who haven't eaten breakfast may literally be starving by lunch - at least their body thinks they are in calorie deficit.  In addition, their lowered blood sugar is not exactly enhancing great brain or work performance.  When they do hit the cafeteria or the fast food cart down the street, their body will be crying out for calories, and their brain will undoubtedly give in to satisfy cravings for high sugar, high fat foods that will scratch the itch. 

So let's get creative here, which employees want to be the most well liked?  The dreaded candy bowl types.  What about an unusual perk where the company actually pays a fruit stipend to those employees - leaving little fruit bowls scattered around the office?  Also just plain old providing a bowl of fresh fruit at the front desk or in break rooms will allow employees' brains to stay powered up between breakfast and lunch and will satisfy their cravings in a much healthier fashion. 

Do you currently offer healthy alternatives in your cafeteria at a subsidized rate, or provide fresh and healthy snacks as alternatives to soda pop and high sugar drinks (yes, juice is high sugar)?

 

No?  Why not start now?

Editor's Note - It's hard to be humble when you're bloggin' straight out of Portland, Oregon.  Tanya Barham is the Founder and CEO of Recess Wellness, a company where all the staff works like little elves at Christmastime to transform their client's workplaces into healthy, happy, productive places akin to Santa's workshop at the North Pole.  Seriously.  Of course, Santa's fat, so they still have work to do.

How to Create Vacation Policies That Result in Jaded Employees...

John Hollon has a post up over at Workforce regarding the recent decision of Bob Nardelli to tell all Chrysler workers they would “be required to use two weeks of their vacation time in July, in a company-wide shutdown intended to improve the automaker’s efficiency and boost productivity".

That got me thinking.  Next vacation, I'm going to find a wood-paneled station wagon to rent, like the one pictured to the right...

It also got me thinking about time off.  Vacations, Personal Day, PTO banks - all good things for employees, right?  The answer is a strong "yes", unless companies over-define the way time-off can be used.

With that in mind, here's my top ways that companies can turn a positive (time-off with pay!) into a neutral to negative event:

--Use it OR Lose it with no cultural protection - Some companies like to have a policy mandating employees to use all of their vacation or PTO each year.  That's cool, but if the culture mandates face time or workloads dictate employees can't use their time off, it turns into a negative.

--Take your two weeks together - One of my favorites.  We want you to have some time off, but you have to take it all at one time.  You can't split it up or we'll crumble from the complexities...

--Take it when it's convenient for us - See the Nardelli example listed above...

--Over-defining when sick time can be used - As lame as it sounds, some companies still don't allow employees to use sick time for the care of children or other loved ones.  You're kidding me, right?

Notice that I didn't list scheduling your vacation vs. the needs of the business.  Lots of employees in structured environments get upset about having to schedule their vacation vs. how many other people are scheduled to be off, but that's business (and being a part of a team). 

I'm lucky to be working for a company believes that time off is important.  As a result, our leadership grants a lot of it, and also takes a real world approach to allow the banking of time within reason, thus managing the inherent conflicts between being busy and the use it or lose it camp.

Crossing the Border: How Far Will You Go with Medical Tourism?

There are not many word combinations more awkward than "medical tourism." But, that's not preventing a whole industry from springing up around the more-and-more common notion that you just might jet off to Bangkok or Buenos Aires for your next knee replacement, face lift or even heart surgery--along with a cozy recovery pool-side and a few days at the spa, of course.

There's lots of talk about medical tourism making a major breakthrough in '09. The stars are aligning not just because the economy is demanding cost-cutting measures that may have seemed extreme before, but because the globalization of health care is making huge strides in terms of quality and accessibility. Over 50 countries are trying to attract patients from the US with JCI-accredited facilities and US-trained doctors and some with outcomes data that would make some of our best hospitals blush. The result: 1.5 million Americans traveled outside the country for health care in 2008, saving 50-80% on the cost of services here. McKinsey expects the number of "medical tourists" to increase 20% annually.

Once just for uninsured or under-insured, medical tourism is now being targeted for the group health insurance market. The reasons for this are pretty obvious--employers represent a huge potential market. And, why market individual-by-individual when one contract can get you thousands of potential patients at once? Several major insurance carriers are writing this into their plans and large employers should not be surprised to see this in renewals this year.

Whether you think this trend is delightful or disturbing, watching this pan out in the group market will be fascinating. We struggle to get employees and their families to do simple things like go to the doctor once a year, get the necessary cancer screenings and actually take their prescription drugs as directed. Even though we have spent years attempting to make employees great "consumers" of health care, most people are overwhelmed and feel unequipped to make important health care decisions--especially when a disease or accident strikes.

How will they react to the option of going to Costa Rica instead of the local hospital for that hip replacement? How will they be able to evaluate the risk and reward? Sure, the employer may save tens of thousands of dollars and be able to pass that along to the employee in terms of a waived deductible (with a family trip to boot!), but how do you help that individual get comfortable with the process? And, how do you serve this up as a real option when there's such big money at stake? (And, those questions just touch the surface of the compliance/liability issues.)

While these are messy messy questions, in the best scenario, medical tourism could actually help push the envelope on consumerism in health care. Clearly, all those millions of people traveling abroad for surgery are already savvy consumers--price shopping, comparing their options, picking facilities and tallying up the costs of the medical procedures and the whole trip (one would argue, you're always a better consumer when it is your own money you're spending, as is the case with uninsured individuals). Subjecting US hospitals to a transparent and open comparison with their foreign counterparts on outcomes data could shed a whole new light on the quality of care we receive here. A surge in Americans traveling outside the US for cutting-edge procedures that the FDA is slow to approve may help adoption of new technology, like stem cell treatments. Getting away from the notion that the best care is always in your backyard may help employees be more receptive to turning to data (not word of mouth) when they pick their next doctor.

But, I'm afraid that is an overly optimistic view. At least in the short term, the option to go abroad is going to add to the overall confusion about how, where and when to get the best care. (This may be less so for companies who have a global workforce already or whose employees travel abroad regularly for work and for fun. But, imagine explaining to an employee who has never left the country that you'd like them to consider going to Bangkok for their next major surgery!) But, with a thoughtful approach, the employers and insurers and facilitators forging through this new frontier may come out winners--if they can keep their costs down while keeping employees happy (and healthy!). Couldn't hurt if they throw in a few more days at the spa, too.

Thanks to Robert Repke at Global Medical Conexions for lots of background material. His presentation in San Francisco sparked this post.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. She helps companies large and small connect with their people so that those people (and their families!) understand all the confusing but oh-so-important benefits programs that are out there. She's located in San Francisco, but her team and clients are all over the place.

Here Comes the Insensitive Question - Is the Stimulus Package Going to Make COBRA Like Unemployment?

Thought I would follow up today with a question that's been on my mind, and was rehashed in Greg Dagley's piece at the Buzz on the COBRA portion of the Stimulus bill.

Here's the question - is the COBRA stimulus package for everyone who has lost a job?  I know it's for the folks who have been laid off between the dates in question, but Greg's piece used the following language, which I think speaks volumes:

"The subsidy only applies to employees who’ve been involuntarily terminated for reasons other than gross misconduct.  Employees who voluntarily leave are not eligible.  So employers will now need to look through their HRIS and determine which termination codes can be used to identify involuntarily terminated employee that should be eligible for the subsidy.  Since there’s some grey area in determining who may have been terminated for “gross misconduct,” this task won’t be as easy as it sounds."

Here's the scoop from my perspective.  That language is straight out of the unemployment office handbook, and if you're an HR pro who has ever termed anyone and then fought an unemployment claim because you didn't feel your company should pay unemployment for someone who didn't try to make it work, you know the following reality:

You can't fight an unemployment claim for an employee who was termed for performance reasons in most states. 

Doesn't matter how many chances the employee was given, and how attainable the performance levels were.  You can't win that type of claim.  In order for an involuntarily termed employee to be denied unemployment, they have to steal something and be caught redhanded or simply refuse to come to work without notice multiple times.  That's pretty much it.  Want to talk about performance and how the employee didn't even try?  Most administrators in the unemployment office will listen, then rule in the employee's favor.

I'm all for a net to help those who need it, both from an unemployment and a health care perspective.  But guess what?  The way unemployment has migrated to "applying to employees who’ve been involuntarily terminated for reasons other than gross misconduct", it's easy to see the COBRA bill going the same way.

And, of course, it's easy to see the COBRA stimulus bill being extended indefinitely while the Obama administration figures out what to do with health care.  Which means that employers bear the cost, at least until they get the "benefit" of a tax break.

If employers are going to bear the upfront cost, they deserve some dialog about how folks who refuse to work hard are treated under the system.  I know it's a thousand shades of gray, but we don't need another government system administered like the unemployment office.

Bariatric Surgery - Does it Really Pay for Itself in 2-4 Years?

Weight reduction surgery has long been controversial for employers, with healthcare insurers putting up multiple behavioral goals and other gates before providing access to extreme solutions like bariatric surgery to covered individuals.

Is that the right or wrong approach?  I've never had enough information to really have an opinion.

Here's the first research I've ever seen as a HR pro that talks about expected payback to the extreme weight loss procedures.  Follow me after the snippet from the article to talk about what it means for you and me as advocates of healthcare and retention.

From information provided in the Wall Street Journal:

"Health insurers can offset the cost of laparoscopic or traditional bariatric surgery as a weight-loss treatment for obese patients within two to four years as a result of savings on other medical costs, according to a study published this month in the American Journal of Managed Care, the Wall Street Journal reports.

For the study, Pierre-Yves Crémieux, a health economist and principal at Analysis Group, and colleagues analyzed health insurance claims data for 2003 through 2005 for 3,651 severely obese patients who underwent either laparoscopic or traditional bariatric surgery. The patients in large part were female, with an average age of 44; more than one-third of the patients had high blood pressure, and many of them had high cholesterol, diabetes and other health problems.

Researchers matched each patient based on age, gender, geography, health status and baseline costs with a patient who did not undergo either of the surgeries. Researchers tracked claims data for the patients who underwent either of the surgeries for six months of pre-surgical examination and care, the procedures themselves, and about 18 months of post-surgical care; tracked claims data for post-surgical care for some patients for as long as five years; and tracked claims data for the matched patients over the same period.

According to the study, health insurers that covered patients who underwent laparoscopic surgery, which has an average cost of $17,000, offset the cost in about 25 months. Health insurers that covered patients who underwent traditional bariatric surgery, which has an average cost of $26,000, offset the cost in about 49 months. Crémieux said, "The most cost-effective treatment for obesity is bariatric surgery," adding, "If you do that, within two to four years, you will get your money back." In addition, he said, "We have identified the break-even point for insurers."

The 2-4 year break even point is important to me, because it allows me to get my head around payback.  The thing that's confusing to me is that there's a lot of other research that talks about the failure rate of the surgery - meaning employees can have the surgery or procedure, then not do the things they need to do to keep the weight off.  I haven't read the study in full, so I also wonder if the cost of the medical complications so often written about is reflected here.

Still, the concept of payback is good to have.  We're talking about an investment in an employee to help them improve their life, much like tuition aid.  Many tuition aid programs mandate a payback agreement that an employee stay with the company for a year or two once the company has made the investment.

Now that we have payback numbers and companies have to bear the cost of this surgery, I wish companies could short circuit the red tape by allowing the employee to say, "I want to be at this company long term, and I'm willing to sign a payback agreement making that pledge as a part of this optional proceedure".

I know there are a million legal reasons why you can't do this, and I'm not looking to tie payback to other big ticket items. Medical necessity still rules the day on that end, but it seems like the big question with this one is medical necessity and payback.  That said, my take is that a lot of employees who want the optional surgery would be willing to fast track the process and would accept a payback agreement of 2 years for improved access.

Careful -- This Snake Might Bite... (The New COBRA Bill)

If you’re a benefits professional and you haven’t started thinking about how the stimulus package that the President signed into law on February 17 will affect you, you ought to start now.  Chances are you’re impacted.  Part of the bill includes the subsidization of COBRA at 65% for 9 months for employees who are involuntarily terminated between September 1, 2008 and December 31, 2009.  Of course the federal government will fork over the 65% subsidy -- to the tune of $25 billion -- but not directly to participants.  Instead, employers and benefits administrators will need to adjust their COBRA billing accordingly and then deduct the 65% subsidy from the portion of payroll taxes that employers pay.  Rest assured, employers will not be reimbursed for the administrative costs incurred for setting this up.  And since the provision is short lived, the money spent setting up the administration will be lost once it expires.

The subsidy only applies to employees who’ve been involuntarily terminated for reasons other than gross misconduct.  Employees who voluntarily leave are not eligible.  So employers will now need to look through their HRIS and determine which termination codes can be used to identify involuntarily terminated employee that should be eligible for the subsidy.  Since there’s some grey area in determining who may have been terminated for “gross misconduct,” this task won’t be as easy as it sounds.

The subsidy applies to anyone who is involuntarily terminated between September 1, 2008 and December 31, 2009.  Employees terminated between September 1, 2008 and February 17, 2009 -- when the President signed the law -- must be given a special enrollment period during which they can enroll in COBRA coverage prospectively to take advantage of the subsidy.

Employers will need to work with their COBRA administrators and their payroll departments to figure out how to reduce their payroll tax to account for the COBRA subsidy.  Additionally, since there are income limitations on who can take advantage of the subsidy, employers are on the hook to generate W-2s for terminated employees taking advantage of the program showing how much subsidy they take.  Depending on the complexity of your organization and payroll system, this may be no small task. 

Not everyone is a fan of this legislation.  Generally speaking, COBRA participants are higher utilizers of medical coverage than active participants.  It’s estimated that, for every $1 in medical premium paid by a COBRA participant, the plan pays out $1.50.  For employers with self-insured plans, that means that the 65% subsidy may result in worse experience in their medical program, since more ex-employees are likely to pick up coverage.

There are some who believe that the 65% COBRA subsidy may actually increase the number of employees being laid off, especially among smaller employers.  Employers who’ve been willing to cut corners elsewhere to keep people on the payroll just so that those employees can keep their health care benefits may look at this as a way to cut staff without having to live with the guilt of leaving them without affordable health care.  In fact, there are a number of circumstances where an employee may be better off from a coverage premium perspective as a COBRA participant they s/he was as an employee (e.g., unsubsidized dental or vision coverage now subsidized at 65% under COBRA). 

The upside to the final version of the legislation signed into law on February 17 is that it left out a provision that had a lot of employers worried.  That’s the provision that would’ve allowed employees age 55 and older or those who’ve been with an employer for 10+ years to remain on COBRA until they become eligible for Medicare.  It’s not hard to imagine a 35 year old employee with 10 years of service who’s always wanted to start his/her own home business but was hesitant to do so because s/he wasn’t sure s/he could get health insurance on her own.  Under this provision s/he could have stayed enrolled on an employers COBRA plan until either s/he became Medicare eligible or the employer stopped offering health insurance to its employees.

This blog entry does not provide an exhaustive list of everything you’ll need to think about when implementing this change.  In fact, it barely scratches the surface.  If I rambled on about all of what you’ll need to think about 1) I’d miss something and 2) you’d stop reading.  There are a million tiny questions that’ll need to be asked and answered when you implement this for your organization.

By now, you should already be working on this.  If you aren’t, it’s time to start.  Employers are expected to take action to implement this change quickly.  You should be reaching out to stakeholders both inside and outside of your organization who are impacted by this legislation so that you can begin laying the groundwork necessary to implement the change.  Just remember -- it’s temporary.  Whatever you do now will have to be unwound later, so make sure the duct tape you use to rig this process together can be unstuck when the federal subsidy expires.

Disclaimer: I’m not an attorney.  I don’t even pretend to be one.  You should be working with your own internal and/or external counsel to interpret this legislation and what it means for your organization.

Editor's Note - Greg Dagley is a Benefits Consultant for a large multinational employer in Houston, TX. While his company has employees all over the globe, his job keeps him focused on US benefits and spending a lot of his time managing external vendors.  Is there any doubt his excel skills are more advanced than yours?