Hot Topics in Total Rewards

  • 25 Mar 2021 1:52 PM | Bill Brewer (Administrator)

    letter blocks with H S A and coins stacked on top

    One subset of employee benefits that doesn’t always get the spotlight are tax-advantaged benefits.

    By Christa Day | March 25, 2021 at 10:32 AM

    In a year filled with uncertainty, one thing became quite certain in 2020. Employee benefits are an essential part of the American workforce. Just how essential?

    Quite essential, it turns out. According to a recent Prudential report, a majority of workers believe COVID-19 has made benefits much more important. In the survey, 77% of employees said benefits programs were a large part of their compensation with 73% saying benefits are a large reason why they would stay at their company or organization. Because of the pandemic, three-quarters of workers said having benefits through their employer are “now more important than ever before.”

    Like the ability to work remotely, which once was considered a nice option but not a necessity, workplace benefits are clearly viewed as essential by employees. And we’re not just talking health care, which is obviously at the top of the list. One subset of employee benefits that doesn’t always get the spotlight are tax-advantaged benefits.

    What are tax-advantaged benefits?

    Yay for HSAs: Health savings accounts (HSAs) are accounts designed to help employees with high-deductible health plans save for medical expenses. How do we know? A whopping 28.3 million Americans had an HSA last year, a number that has steadily grown over the past decade. Ninety-five percent of employers are now providing account-based plans with HSAs. HSAs are attractive because they allow an employee to set aside pre-tax dollars to get a better handle on unexpected health care costs.

    FSA – can we say, flexible? 32 million Americans have a flexible spending account, or FSA. Similar to an HSA, an FSA allows users to set aside pre-tax dollars. With an FSA, you have access to the entire amount you want to set aside on day 1 of the plan year.

    Enter the HRA: Health reimbursement arrangements (HRAs), which are self-insured arrangements that are established and completely funded by employers, help reduce insurance premiums, provide employees with greater control over their health care expenses and reimbursements to employees are not taxable. Approximately 14 million people have an HRA.

    What did we learn about these flexible benefits in 2020? Let’s take a deeper dive into these tax-advantaged benefits and see what’s working and what’s not.

    What’s working with tax-advantaged benefits

    HSAs stay even if job lost: HSAs are definitely helping working Americans as we move through the pandemic. In a year where many people lost their jobs, they did not lose their HSAs, allowing them to continue to spend existing funds on qualified expenses.

    Female products get eligible: In a move that many consider a bit late (but better than never), the CARES Act made feminine care products HSA and FSA eligible for the first time. That means people can spend their tax-free dollars on tampons, pads, liners, and cups. We’ll take it as a win.

    FSAs changing with the times: With 2020 being a year of unprecedented changes, FSAs have been trying to go with the flow. First, employers last year could choose to allow employees with FSAs to change their contribution amount or even open or close an account without having a life-changing personal event. Second, furloughed employees could still be considering full-time employees for purposes of maintaining an FSA, depending on your employer.

    No prescription paperwork for OTC meds: The CARES Act ushered in another win for HSA and FSA eligible expenses with over-the-counter (OTC) medicines. Individuals no longer need to obtain prescriptions for OTC medicine in order to use their FSA or HSA dollars to buy them. This paperwork prescription requirement was keeping a lot of people from saving money using tax-free dollars on OTC medicines, and now we’re all free to do so (permanently) without the paperwork trail.

    Yay to new HRA type: In the midst of COVID-19, HRAs have proved resilient and flexible, helping employers maintain benefits. At the start of 2020, HRAs changed considerably with the government allowing employers to provide a new type of HRA called individual coverage HRAs, better known as ICHRAs.

    What’s not working with tax-advantaged benefits

    Let’s ensure PPE/sanitizers are considered qualified medical expenses: Section 213(d) of the Internal Revenue Code defines what expenses are considered “qualified medical expenses” for purpose of the deduction for medical expenses on an individual’s tax return and as a tax-free payment or reimbursement from an employer-provided health plan or HSA. Medical professionals have recommended the use of face masks, hand sanitizers and disinfectants as a means of preventing the spread of COVID-19. Under the current provisions of the tax law, it is unclear whether such items are considered to be qualified medical expenses in all cases.

    Representing over 33 million employees through our member companies, my organization ECFC has asked the Department of the Treasury and the Internal Revenue Service to provide guidance that would state that face masks and hand sanitizers and disinfectants are qualified medical expenses under Code section 213(d).

    The “care” in “dependent care” needs work: Dependent care FSAs, which lets individuals set aside pre-tax dollars to offset work-related dependent care costs such as preschool, summer day camps and before and after school programs, have traditionally been an effective and simple way to save money while taking care of your loved ones so you can continue to work.

    Unfortunately, the effectiveness of dependent care FSAs has been lessened by the fact that statutory $5,000 limited was set more than 20 years ago and has never been adjusted for inflation. The amount falls far below dependent care costs in most parts of the country.

    With the dependent care FSA limits remaining the same and little flexibility built in for COVIDS-19 factors, childcare became a big problem for parents and families. Many parents had to quit their jobs or reduce their working hours because of a lack of childcare. Essential workers did not have that option. They were often left scrambling for childcare. Congress needs to act to make sure dependent care FSAs have a higher limit and more flexibility for funds to help cover skyrocketing prices for childcare. Dependent care FSAs do work but not as effectively while stuck in their current limit.

    COBRA not cutting it: With unemployment still high and COVID-19 not showing signs of abating, many Americans are concerned that they will not be able to play for all their health care needs this year. Many of those who were furloughed or lost their jobs last year ended up in COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act. It is a law that mandates that an employer offer prolonged health coverage if an employee is laid off or quits. COBRA falls into the not working category because it is very expensive as well as confusing for many employees and employers alike.

    COBRA speaks to the larger issue of expanding the portability of health insurance and how it can be used to meet the needs of an ever-changing and transient workforce, particular during this pandemic. COBRA is not cutting it for many Americans. This one requires a more thoughtful and thorough overhaul and is high on the list of overall health care concerns in our COVID-19 economy.

    What’s next?

    The good news is COVID-19 has made benefit offerings a focal point to help workers navigate health care, mental health and family challenges. In 2020, employers had to get creative, stay flexible and apply stop-gap measures. Some of these measures worked, other did not. As this pandemic made frighteningly clear, employee benefits are essential. What’s next? Let’s hope we can improve what’s not working, and close more employee benefit gaps for Americans.

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    Source: Benefits Pro

  • 25 Mar 2021 11:52 AM | Bill Brewer (Administrator)

    AUTHOR: Kate Tornone | PUBLISHED: March 25, 2021

    Dive Brief:

    • Trump-era regulations prohibiting managers from keeping tips and allowing employers to include non-tipped workers in certain tip pools will take effect April 30 as scheduled, the U.S. Department of Labor announced Tuesday.
    • The agency also proposed, however, to delay other portions of that rulemaking a second time, to Dec. 31. Specifically, DOL said it wants to revisit provisions affecting civil money penalties and the application of the Fair Labor Standards Act's tip credit to tipped employees who perform both tipped and non-tipped duties.
    • "The proposals we announced today ensure that we consider all of the circumstances in today's rapidly changing workplace," said Wage and Hour Division Deputy Administrator Jessica Looman in a statement. "These essential workers deserve our careful and thoughtful consideration as we craft and implement rules that affect their well-being."

    Dive Insight:

    Tip rules have been in flux in recent years. Generally, the FLSA requires that employers permit workers to retain gratuities, but allows for some tip pooling.

    In 2011, former President Barack Obama's DOL issued rules prohibiting tip pools that included non-tipped employees, even if employers also paid all workers involved minimum wage. (Employers with tipped employees can take a "tip credit," applying some gratuities toward minimum wage obligations.) Federal circuit courts split on that specific issue, with one declaring the regs invalid.

    Despite the Biden administration's pro-worker stance, the agency said it will allow the Trump-era plan to reverse that rule to take effect in just a few weeks. Employers will soon be cleared to operate tip pools that include both tipped and non-tipped employees as long as all involved are paid minimum wage. In other words, employers may not take a tip credit based on those gratuities.

    It hopes to delay and revisit, however, the Trump administration's attempt to change limits on when employers can take a tip credit for an employee who performs both tipped and untipped work, known as the "dual job" or "80/20" rule.

    Stakeholders may submit comments on both actions.

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    Source: HR Dive

  • 11 Mar 2021 9:25 AM | Bill Brewer (Administrator)

    AUTHOR: Ryan Golden | PUBLISHED: March 10, 2021

    Dive Brief:

    • Employers paid "close to $4 million" to more than 3,500 employees last year to resolve Families First Coronavirus Response Act (FFCRA) violations alleged by the U.S. Department of Labor (DOL), Helen Applewhaite, director of DOL's Division of FMLA and Other Acts, said during the 2021 DMEC Virtual Compliance Conference March 3.
    • In total, Applewhaite said the agency conducted more than 4,200 FFCRA investigations and continues to enforce the law's emergency paid leave requirements for the effective period, which ended Dec. 31, 2020. She added that DOL continues to do virtual presentations on COVID-19 and its impacts on the workforce and will do so "for whatever period of time in order to reach the people we need to reach."
    • Applewhaite said that other department initiatives have continued, including DOL's Request for Information on paid leave programs and the Family Medical and Leave Act. The agency received "about 100" comments from stakeholders on the RFI and "is still looking at those," Applewhaite said.

    Dive Insight:

    Much of Applewhaite's presentation discussed the wide-ranging, sometimes overnight changes DOL made during the initial months of the pandemic. She noted that the agency's website, which typically received 500,000 visitors per week prior to the pandemic, saw more than 6 million visitors in a single week last year.

    She described the process of implementing FFCRA regulations as "intense" and "unprecedented." Staff performed online presentations and outreach, with investigators answering "hundreds of thousands" of phone calls and providing technical assistance. DOL published regs implementing the FFCRA without the opportunity to gather public comments and feedback.

    "To say that we published regulations in two weeks — it still kind of chills me every time I say that," Applewhaite said. "It's just not done."

    During the temporary non-enforcement period instituted following the FFCRA's enactment, DOL took a compliance assistance approach, Applewhaite said; "If we had a complaint, we would contact the employer, provide information needed for compliance, and if we gained agreement to comply and the issues were remedied immediately we didn't pursue further." But DOL did take a more "vigorous" approach "if we didn't find a willing employer," she noted.

    As a result of legislation passed in December 2020, employers were not required to provide paid leave via the FFCRA beyond the end of the year, but they may continue to do so on a voluntary basis in exchange for a tax credit through March 31, 2021. In his American Rescue Plan document, President Joe Biden called on Congress to strengthen and extend the FFCRA's mandatory paid leave provisions through Sept. 30, 2021.

    However, that provision does not appear in the version of H.R. 1319 — also known as the American Rescue Plan Act of 2021 — the Senate passed March 6. The bill would instead establish a tax credit for employers that voluntarily provide paid leave between April 1, 2021 and Sept. 30, 2021. In addition to the qualifying reasons for taking such leave described in the FFCRA, the tax credit would also apply to leave taken to receive a COVID-19 vaccination or to recover from any injury, disability, illness or condition related to receiving a COVID-19 vaccine.

    DOL continues to publish FAQ-based guidance on its website as well as field assistance bulletins that allow employers to see how DOL will approach enforcement, Applewhaite said, adding that last year's experience showed how the agency can adapt to the needs of the U.S. workforce; "We can be far more flexible than we ever thought possible."

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    Source: HR Dive

  • 09 Mar 2021 12:00 PM | Bill Brewer (Administrator)

     salary negotiation illustration

    By Roy Maurer | February 24, 2021

    HR is still working toward equity in compensation, total rewards

    The majority of employers are open to negotiating salary for some or all positions once a job offer has been made, but that openness does not extend to bonuses and benefits, according to a new survey.

    Nearly 90 percent of the 324 organizations that responded to XpertHR's Recruiting and Hiring Survey 2021 said they are flexible about negotiating salary with job candidates—at least for certain positions—but only 42 percent are open to negotiating bonuses, and just 32 percent are willing to negotiate benefits.

    "The survey results show that employers are much more likely to negotiate pay with a prospective hire than benefits, something job seekers may want to keep top of mind when presented with a fresh offer of employment," said Andrew Hellwege, XpertHR surveys editor.

    Total rewards experts agreed that the survey results reflect consistent practices that have been in place for years, especially at midsize and large organizations.

    "Salary has traditionally been viewed as more flexible because it is commonly accepted that pay is influenced by a variety of factors, including the organization's compensation philosophy, as well as a candidate's experience level and expectations," said Marta Turba, an expert on total rewards strategy and vice president of content at WorldatWork, the association for total rewards professionals.

    Tom McMullen, a senior client partner in the Chicago office of Korn Ferry and a leader in the firm's North America total rewards expertise group, agreed that "base salary is typically where the negotiation happens. There may be more flexibility in creating a tailored, custom reward package around the specific requests of an employee in a smaller organization, where there may not be as much structure and consistency in the base pay, incentive and benefits programs.

    "In medium to large organizations, typically benefits are not as open to negotiation because the intent of the benefits package is that it applies to all employees in an employee group within an organization. It is a consistent part of the rewards package that all employees receive by virtue of being a member of the organization."

    WorldatWork's Turba added that traditional benefits programs like health care and retirement are highly regulated and based on universal, nondiscriminatory standards that would prevent flexibility in negotiation. "By contrast, ancillary programs like hiring bonuses, flex schedules, paid/unpaid time off and educational assistance are more likely to be negotiated," she said.

    Employers are less likely to negotiate structured short-term incentive plans such as bonuses because they are an integral part of the total cash compensation package, and most employers have a standardized plan design, Turba said. "Targets are set at a rate that appropriately incentivizes performance and connection to business results in a specific role, and deviation from the set plan may create inappropriate incentives, pay inequities, market competitive challenges and administrative burden."

    McMullen added that incentive programs often consist of enterprise or team performance instead of or in addition to individual performance. "However, it can be a reasonably prevalent practice in some organizations to offer either a guaranteed incentive or bonus for the first year of tenure in a new organization as a bargaining chip. Sometimes a signing bonus will serve in this capacity to offset some of the risk in the candidate joining a new organization."

    Addressing Pay Inequity

    A contentious issue generated by the practice of salary negotiation is the high risk of creating or perpetuating pay inequity within an organization, Turba said. She outlined a few common scenarios that often drive pay equity concerns:

    • When the salary offer is extended without a deep understanding of qualifications.
    • When the salary offer is made in consideration of the work group but not the organization.
    • When a higher offer is made to overcome a real or perceived labor market shortage.
    • When the offer is based on pay in a prior position.

    Proponents of the recently reintroduced Paycheck Fairness Act contend that more transparency from employers during salary negotiations would help close the gender wage gap. The bill would ban employers from asking applicants about salary history and prohibit retaliation against workers who discuss wages. The proposal has unanimous support among Democrats in Congress and the support of President Joe Biden.

    Salary-history bans have been enacted for all employers in 19 states and territories, and newly introduced state bills would require employers to provide compensation ranges for open positions.

    Turba recommended ways employers can do their part to address pay inequity:

    • Establish strong foundational structures, such as consistent job-evaluation processes, salary structures and pay determination guidelines. 
    • Establish firm pay rates and ranges to provide more transparency.
    • Cultivate strong interview techniques that get at the value of knowledge, skills, abilities and past accomplishments.
    • Document negotiations during the offer process. "This data is invaluable later when your organization conducts pay equity analyses to validate that pay outcomes are in line with intentions," she said.

    Negotiating Benefits

    Turba explained that U.S. regulations ensure consistency and nondiscrimination in benefits offerings, but there is no guarantee that consistent offerings translate to equal value in the workforce. "It is likely this perceived disparity in value that's sparking the interest or need to negotiate benefits," she said.

    "We are seeing that employers are actively working to address this by infusing more personalization and flexibility in benefit offerings, knowing that their offerings must work to attract and retain workforce segments with very different needs and expectations. Social determinants of health are not uniform for all employees in an organization, and it is unrealistic to expect a one-size-fits-all benefits package to be effective."

    Flexibility in benefits is the critical element to achieve fairness, she said. "This flexibility is much more likely to surface in areas related to work exchange, flexible working hours, location, extra vacation time and child care needs versus traditional areas of regulated benefits, like health or retirement planning. We've seen an acceleration of this in the past year with COVID-19."

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    Source: Society for Human Resource Management (SHRM)

  • 09 Mar 2021 11:54 AM | Bill Brewer (Administrator)

    Costco to increase its minimum wage to $16 per hour, but CEO says the average pay for hourly workers is $24

    Kelly Tyco | Published 1:47 p.m. ET Feb. 25, 2021 Updated 10:56 a.m. ET Mar. 1, 2021

    Costco is raising its minimum wage to $16 an hour, leapfrogging competitors including Target, Best Buy and Amazon.

    Costco CEO Craig Jelinek announced the increase Thursday at a U.S. Senate Budget Committee hearing on worker wages at large companies. Democrat lawmakers and President Joe Biden are pushing to raise the federal minimum wage to $15 from $7.25.

    "Since Costco's inception, the company has been committed to paying the employees very competitive retail wages and providing them broad and affordable health care benefits," Jelinek said. "Two years ago, we moved our starting hourly wage to $15 everywhere in the U.S. Effective next week, the starting wage will go to $16."

    But the membership-based wholesale chain already is paying many of its 180,000 U.S. workers a much higher rate. Jelinek said the average wage for hourly workers is around $24 per hour.

    Costco has 558 clubs in 45 states, Washington D.C., and Puerto Rico.

    "We try to take care of our employees because they play such a significant role in our success," Jelinek said, who noted the longevity of employees and that Costco pays regular bonuses and offers vacation time. 

    Sen. Bernie Sanders, I-Vt., convened Thursday's hearing titled "Should Taxpayers Subsidize Poverty Wages at Large Profitable Corporations?" to discuss proposals to change the minimum wage.

    The Vermont independent railed against corporations like Walmart and McDonald's, saying hundreds of thousands of workers were being left behind.

    Target raised the minimum wage for all of its U.S. hourly employees to $15 an hour in July 2020 and Best Buy raised its minimum to $15 in August. Amazon also increased the starting wage in 2018 to $15.

    "While Costco, Amazon, Target, Best Buy, and other large corporations have all raised their minimum wage in recent years to at least $15 an hour, the minimum wage at Walmart has remained stuck at $11 an hour for three years," he said. "The result: 760,000 workers at Walmart, about half of their U.S. workforce, are paid less than $15 an hour."

    Walmart announced last week it was raising pay for 425,000 employees starting March 13. The nation’s largest employer said the raise for store workers in its digital and stocking workgroups and would bring their average pay above $15 an hour. Starting pay rates for these employees move from $13 to $19 per hour based on the store location and market, Walmart said.

    Walmart CEO Doug McMillon said the company has increased starting wages by more than 50% since 2015 and that the average wage in the U.S. will be at least $15.25 per hour. The retailer has about 1.5 million employees in the U.S. at more than 5,000 stores and Sam's Club locations.

    Hobby Lobby's rate is even higher than Costco's at $17 an hour, an increase that went into effect in October. In 2014, the chain raised its full-time minimum wage to $15 and says that was "well before it became fashionable with other retailers."

    A recent report released by the nonpartisan Congressional Budget Office said boosting the minimum wage to $15 per hour would raise income for millions of Americans and lift 900,000 people out of poverty.

    But by 2025, when the hourly rate would hit $15 under a proposal before Congress, some 1.4 million fewer Americans would be working, the report concluded. That is because higher wages would increase the cost of producing goods and services and, in response, many employers would reduce their workforce or hire fewer employees, the report said.

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    Source: USA Today

  • 17 Feb 2021 9:37 AM | Bill Brewer (Administrator)

    Reported by LEE BARNEY | February 17, 2021

    Equity compensation has not traditionally been used for retirement savings, but there are ways to incorporate it into employees’ long-term financial plans.

    WHILE EMPLOYER STOCK OPTIONS, stock purchase plans and equity compensation have not traditionally been thought of as retirement savings tools, benefits executives and attorneys say companies can help their workers think of these options for long-term goals, including retirement.

    “I don’t know of many employees, or employers, who view those vehicles as necessarily meant for retirement savings, because they are generally tied to a set vesting period—unless it is a publicly traded company,” says David Joffe, chairman of the employee benefits and executive compensation practice group at Bradley. “There are usually limits to how long an employee can hold those types of stock options, and it may not be possible for them to own it through the time when they retire. They may leave the company or face an event that causes them to sell the stock.”

    However, Joffe notes that employee stock ownership plans (ESOPs) are used to save for retirement and are becoming more and more popular, particularly if the company wants to help its employees have greater retirement savings. “A lot of the companies I work with not only have a 401(k) but profit sharing and ESOPs, which provide substantial additional retirement savings,” he says.

    Sheila Frierson, president, plan managers, North America, at global employee share plan provider Computershare, agrees that “historically, equity has never really been looked at from a retirement-related perspective. However, as more plan sponsors become more concerned about the financial health and well-being of their employees, they might begin to view how such a compensation plan could be used for their employees’ future goals. For now, however, a survey we did jointly with WorldatWork found that only 34% of companies said they might make their restricted stock program retirement related.”

    Jon Barber, vice president of compensation and policy research at Ayco, says his company makes sure advisers discuss stock options with clients when it’s applicable to their personal retirement savings strategy.

    Barber says the firm seeks to help executives understand that value “comes down to goal setting.”

    “We can help participants do cash flow analysis on when the best time is to exercise their stock,” he says. “When it comes to retirement, it might be wise to reign the executive in and help them see the wisdom of not holding the stock up until their retirement.”

    Barber says it is important for benefits firms and advisers to communicate the terms of their stock options to executives, especially when it comes to termination events, which might accelerate the vesting of those holdings.

    Barber says companies that want to help their employees view their stock options through the prism of retirement can do so by equipping them with tools that can perform retirement cash flow and risk analyses and aggregate all their stock holdings so they can see when the various units are vested and when they can exercise them. “That will enable them to inventory what they have and fully understand when they can monetize those units for their retirement,” he says.

    Barber also says companies are giving stock options and restricted stock units to more of their employees these days, not just highly paid executives.

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  • 17 Feb 2021 9:34 AM | Bill Brewer (Administrator)

    AUTHOR - Ryan Golden | PUBLISHED - Feb. 11, 2021

    Organizations have the opportunity to re-examine several aspects of their plans and educate employees about their health, sources told HR Dive.

    Employers have long sought programs and practices that can help workers be proactive in managing their health. But a pandemic disrupted that work in many ways.

    COVID-19's spread — a health risk by itself — coincided with a decline in healthcare participation. In one study conducted by healthcare navigation company Castlight Health, researchers found "dramatic reductions" in the use of healthcare during the first two months of the pandemic. Musculoskeletal surgery, for example, declined about 47% compared to the same time frame in 2019, while MRIs declined 45%.

    Some of the biggest plummets came at the expense of preventative care, a broad category that can include check-ups, immunizations, screenings and other procedures undertaken for disease prevention purposes. According to data from the nonprofit Health Care Cost Institute (HCCI), submitted health claims for mammograms and pap smears were down nearly 80% in April 2020 year-over-year, and those for colonoscopies were down "almost 90%" in mid-April 2020 year-over-year.

    Percentage change of selected preventative care procedures during COVID-19 pandemic
    Preventative care type YOY trend (as of April 14, 2020) YOY trend (as of Oct 1. 2020)
    Colonoscopies -88% -13%
    Childhood vaccinations (aggregate) -57% -8%
    Mammograms -76% -11%
    Pap Smears -77% +19%

    SOURCE: Health Care Cost Institute

    Those declines reversed by fall, HCCI data show, but preventative care procedures generally have not returned to pre-pandemic levels, said Daniel Kurowski, senior researcher at HCCI. While Kurowski noted that there are limitations to the type of claim-based analysis used by HCCI in its study, he confirmed that the organization's data suggest the U.S. healthcare system has not made up for the loss of services that occurred since the pandemic's onset.

    What can employers derive from these findings? Healthcare industry sources who spoke to HR Dive expressed some concern that deferred care could have an impact on disease prevention down the line, but the complete picture is far from clear. What's more, the scramble to respond to such challenges could yield some positive lessons.

    'Everything stopped'

    Dr. Mark Cunningham-Hill remembers the initial months of the pandemic well. As the medical director for the Northeast Business Group on Health, a regional coalition of employers and healthcare stakeholders, Cunningham-Hill observed closures on a wide scale. "Everything stopped for a month or two," he told HR Dive, "and gradually, telemedicine started coming online."

    An executive at insurer Aetna shared a similar view. "We have seen declines in every aspect of care within our populations, specifically within preventative services," said Julie Bietsch, the company's senior vice president, clinical operations. But by August, Aetna began to see preventative care utilization trends rebound to the point that, by October 2020, those trends were close to 2019 levels, Bietsch noted.

    Virtual care has helped to fill in some of the gaps caused by COVID-19 and may even have helped to offset some declines in care utilization, said Magda Rusinowski, vice president of Business Group on Health. While such care was initially delivered via providers that specifically focus on virtual care, the format "has emerged as a way to see your brick-and-mortar provider" as well, Rusinowski said.

    Cunningham-Hill said telehealth and similar technologies can allow care providers to review patients' health and direct them to book appointments for in-person procedures, such as a mammogram, when available. For other specialties, such as mental healthcare, telehealth "possibly works better" than it did even before the pandemic, he added.

    Even for procedures such as colonoscopies that typically require an in-person visit, alternatives are available. The pandemic has caused providers and other members of the healthcare system to "think outside the box" when it comes to preventative care, Bietsch said. Examples include HbA1c test kits that can evaluate blood glucose levels and Cologuard, a Food and Drug Administration-approved, at-home testing kit that helps screen for colon cancer.

    'A matter of enormous concern'

    Still, the impact of deferred care may be a puzzling development for employers, one with potentially devastating consequences for some patients.

    Early detection of serious conditions is a primary concern. In a June 2020 article published in Science Magazine, Norman E. Sharpless, director of the U.S. National Cancer Institute, described a statistical model for excess deaths from colorectal and breast cancers between 2020 to 2030. Due to delayed diagnosis and care issues caused by COVID-19, Sharpless said the model suggests almost 10,000 excess deaths from both types of cancer over the next decade, or about a 1% increase.

    "This analysis is conservative," Sharpless wrote, "as it does not consider other cancer types, it does not account for the additional nonlethal morbidity from upstaging, and it assumes a moderate disruption in care that completely resolves after 6 months. It also does not account for regional variations in the response to the pandemic, and these effects may be less severe in parts of the country with shorter or less severe lockdowns."

    And while declines for procedures such as colonoscopies and mammograms pose a challenge for health plans, another item — childhood vaccinations — can be just as worrisome, multiple sources told HR Dive. HCCI found that childhood immunization rates varied by type. Meningococcal and HPV vaccines saw year-over-year declines of 75% in mid-April 2020, while those for Rotavirus saw a 33% decline.

    This area is "a matter of enormous concern" for employers, said Jeff Levin-Scherz, national co-leader of Willis Towers Watson's health management practice, because vaccinations save lives and prevent families from incurring substantial medical costs.

    Childhood vaccinations have not only been impacted by closure of care centers, in which such vaccines are often given, but also by the closure of school systems, which often provide reminders to families about receiving vaccines, Bietsch said. Lack of access in certain geographic areas can also play a role in vaccine disparities, she added.

    There also are concerns about the management of chronic conditions such as diabetes and asthma. Bietsch said Aetna has messaged plan members after, for example, a trend of diabetic patients who would receive a lab test but not a foot or eye exam.

    What employers can do

    Providing coverage is the most important thing employers can do to encourage employees to use preventative care, Levin-Scherz said; "No one should miss preventative care because they didn't think it was covered." Employers have several opportunities to improve their healthcare offerings as a result of the pandemic, including the chance to work closely with health plans that are proactive about reminding employees about the importance of such care, he added.

    COVID-19 also may prompt healthcare providers, payers and even employers to re-examine what constitutes high-value or low-value care, Cunningham-Hill said. He referred specifically to procedures such as colonoscopies that are performed on patients over the age of 75, as well as false positives that lead to lengthy investigations that do not turn up problems. But there are also items proven to be valuable, such as asthma medications and diabetes management tools. "How do we come out of this doing more of the high-value stuff?," Cunningham-Hill said.

    That points to another actionable item for employers: access. It is one thing to provide coverage for a given form of preventative care, but associated copays may discourage workers from actually taking part in that care. Even if the plan provides 80% coverage for a procedure with a $25 copay for the worker, "that copay is a fortune for someone earning $25,000 a year," Cunningham-Hill said. Such examples point to the need for greater healthcare equity, he added.

    Employees may have alternatives when it comes to things like ensuring their children have access to important vaccinations. "It doesn't have to be a physician's office," Bietsch said, adding that pharmacies and other qualified health centers can provide such vaccines.

    Communication also emerged as a common theme in conversations with sources. Kurowski said his takeaway for employers is to encourage employees to take control of their health and remind them of the access that employers provide to chronic care management, preventative care and even fringe wellness programs, like fitness benefits.

    This can be particularly important for workers with chronic conditions. "You can't tell people enough about looking at their diabetes in different ways," Bietsch said. Plans and employers might decide to mix up communications around preventative health by sharing stories about how a plan member managed their diabetes successfully, she noted. Rusinowski said organizational leaders, especially those whom employees trust, can also play a part in communications strategy.

    Healthcare industry observers have noted for months that COVID-19 spurred the growth of the virtual healthcare space, but that growth also could yield positive results for preventative care. Telehealth can allow care providers to monitor patient health, recommend follow-ups and help patients manage their chronic conditions. "Many of the telemedicine companies have been doing substantially more primary care," Levin-Scherz said. "As they do that, they become educated on preventative care and they become advocates of preventative care."

    There are still hurdles to the adoption of telehealth and similar services and, importantly, not all visits can be replaced by virtual care. But Rusinowski sees the space "not as a replacement, but as a way to enhance" care specialties and improve the overall patient experience.

    As employers seek to communicate to employees the importance of continuing their care routines and seeking preventative care, businesses should not focus solely on costs. "I just want to make sure that when we talk about it, we emphasize the well-being component and the desire to create an environment where employees can have the best health outcomes possible," Rusinowski said. "The pandemic has shown us more than anything else that you can't have a productive workforce where health is an issue, but this is not anything new for [employers]."

    Correction: An earlier version of this story misspelled Rusinowski's name. HR Dive regrets the error.

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    Source: HR Dive

  • 12 Feb 2021 9:36 AM | Bill Brewer (Administrator)

    Image result for Thinking Through COVID Vaccine Incentives


    There’s a segment of the population that doesn’t believe in the medical advantages of vaccinations.

    2019 Gallup survey, for instance, found that 11% of 1,025 American adults actually consider vaccines to be more dangerous than the diseases they’re intended to prevent.

    Given the distaste that some have for vaccines in general, it stands to reason that a fair number of individuals have no intention of receiving one of the vaccines now available to help fend off COVID-19. One recent poll sees more than a quarter of U.S. respondents saying they definitely or probably won’t get vaccinated against the coronavirus.

    Many of the American employees who do receive COVID vaccinations will do so via their employer-sponsored insurance plans. And, while companies can — with some exceptions — require employees to receive a coronavirus vaccination, most won’t.

    That’s according to an ongoing Mercer survey, which finds 78% of more than 350 employers saying their organization has no plans to mandate the vaccine for employees. (Just 13% said their company is considering mandatory vaccinations at this point.)

    Still, employee skepticism toward the coronavirus vaccine creates a challenge for employers with designs on providing vaccines for their workforce. The Mercer poll also looks at the likelihood of companies creating rewards to encourage COVID vaccine uptake among employees who are hesitant about being vaccinated.

    Many companies remain unsure as to whether they will provide incentives in hopes of motivating this group of workers to get the vaccine, according to Mercer’s data. Roughly 44% of respondents have already decided against it, but a nearly identical number (46%) said their organization is still thinking and talking it through.

    Most of these discussions center around the possibility of offering incentives like cash, gift cards and/or paid time off, Mercer finds, with the still-open survey finding nearly half of employers (47%) indicating they will provide employees with additional paid time off to go get the vaccine. 

    Companies that do opt to proceed with such vaccination incentives will have a host of factors to weigh, said Wade Symons, leader of Mercer’s regulatory resource group.

    “There are different considerations, depending on whether the employer will be involved in the vaccine administration or simply encouraging employees to seek vaccinations in their communities,” said Symons.

    Symons points out that the EEOC’s updated guidance clarifies that the administration of a vaccine alone does not constitute a medical examination, but the questions an employee must answer before receiving the vaccine “will almost certainly qualify as a disability-related inquiry under the Americans with Disabilities Act (ADA).”

    As such, ADA restrictions would apply, even if the employer has contracted with a third party to deliver the vaccine.

    “In connection with an incentive program, that means the incentive likely must be limited in order for it to be considered a ‘voluntary’ program.”

    That said, simply encouraging employees to get vaccinated through, say, a pharmacy chain or county health department would not carry ADA implications, said Symons.

    “Limits should not apply, since the pre-vaccination medical questions do not tie back to the employer. And, per the EEOC, requiring proof of vaccination is not a medical inquiry under the ADA. Thus, the employer would be free to ask for such proof in order to provide the applicable incentive.”

    Companies providing vaccination incentives should also be careful to provide accommodations due to disability or religious objections, he added.

    “The obligation to accommodate would only be implicated in situations where an employee is unable to get the vaccine due to a disability or an objection based on a sincere religious belief, and then, only absent undue hardship to the employer.”

    When an accommodation is required, the employer would need to consider alternatives to getting the vaccine, such as periodic COVID testing or remote work options, so the employee with the religious- or disability-related objection can still earn the incentive, said Symons.

    “As far as ADA limitations on vaccines, we don’t currently have guidance as to what amount of incentive would exceed the threshold to make vaccination ‘involuntary’ for those employers involved with vaccine administration,” he continued.

    “Rules which permitted incentives of up to 30% of the employee-only medical plan premium amount were struck down by the courts several years ago and regulations to replace them have yet to be formally proposed.”

    For employees without strong feelings one way or the other, incentives might ultimately be “the nudge they need to make the effort to get vaccinated,” said David Zieg, MD, clinical services leader at Mercer.

    On the other hand, such rewards could lead some workers to feel the organization is “coercing them into accepting the vaccine, especially if they are experiencing financial challenges and view the money being offered as substantial,” he added.

    “The good news is that the majority of the population is willing to get vaccinated, which means that incentives are not targeted to these people and will not change their behavior.”

    Then there are employees for whom no amount of encouragement, financial or otherwise, will likely make much difference, said Zeig.

    “Widespread disinformation about COVID-19 vaccines has fostered confusion and distrust. It seems unlikely that incentives will affect the behavior of people who are strongly opposed to taking the vaccine.

    That said, it remains unclear whether incentives “will meaningfully improve uptake among those who are hesitant rather than opposed,” said Zeig. “Many will wait to be vaccinated until they feel comfortable, which will take time and experience, not money.”

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    Source; WorldatWork

  • 11 Feb 2021 2:59 PM | Bill Brewer (Administrator)

    Industry sources have recommended that participants adopt a savings hierarchy for retirement plan and health savings account contributions.

    Reported by REBECCA MOORE

    More than half (56%) of 401(k) participants reduced their retirement plan contributions in the first year that they made health savings account (HSA) contributions, according to a study conducted by the Employee Benefit Research Institute (EBRI).

    In general, as income increases, the percentage of participants reducing their deferrals to their 401(k) increases in the first year that they made HSA contributions. There was also a spike among low-income workers in the percentage making a reduction.

    EBRI found that the “crowding out” of HSA savings on retirement savings was modest at the median: The median dollar reduction in participant 401(k) contributions in the first year of HSA contributions was $34. However, deferral rates decreased by $5,127 at the 10th percentile.

    Higher HSA contributions were associated with lower 401(k) contributions. While at the median, 401(k) contributions fell $315 among HSA participants allocating more than $4,350, among HSA participants committing $1,000 or less, median 401(k) contributions fell only $8.

    “Not only does the amount of 401(k) contributions decrease as HSA contribution levels increase, the higher the 401(k) contribution, the greater the reduction in 401(k) contribution among those who contributed to their HSA for the first time,” says Paul Fronstin, director of the health research and education program at EBRI and coauthor of the report.

    Specifically, 401(k) contributions fell $482 in the year following initial HSA deferrals among those allocating more than 10% of their income in the year prior to the HSA contribution. They fell $49 among those contributing 6% to 10% of their income. At the median, 401(k) deferrals were essentially unaffected among participants contributing 6% or less of their income.

    The results of the EBRI survey highlight the need for retirement plan participants to establish a savings hierarchy. During the 2018 PLANSPONSOR HSA Conference, Jack Towarnicky, executive director of the Plan Sponsor Council of America (PSCA), advocated for saving enough to get the employer match in both the retirement plan and the HSA, if the HSA offers an employer match and if the participant can afford it. Otherwise, Towarnicky said the common-sense approach is to contribute an initial amount to fund the HSA and contribute up to the full match in the 401(k). Participants can then alternate contributions between the two vehicles.

    More recently, Brian Hanna, a partner and executive vice president at Everhart Advisors, told PLANSPONSOR, “What’s becoming more accepted as a best practice is that you should save into your qualified employer plan up to the match level first. Then you should save into your HSA up to the maximum annual contribution—and not spend your HSA on an annualized basis but use it as a retirement savings vehicle. Then, if you have any money available for savings, you can go back to the 401(k) and make a higher contribution.”

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  • 09 Feb 2021 11:53 AM | Bill Brewer (Administrator)

    Image result for Google to pay $3.8 million over alleged discrimination against women, Asians

    ByCatherine Thorbecke | February 2, 2021

    Google to pay $3.8 million over alleged discrimination against women, Asians

    As part of the resolution, the tech giant denies wrongdoing.

    Google has agreed to pay more than $3.8 million, including nearly $2.6 million in back pay, to settle allegations of "systemic" pay and hiring discrimination that disadvantaged women and Asian workers.

    The payments will go to more than 5,500 current employees and job applicants from the company's California and Washington state offices, the Department of Labor announced in a statement Monday evening.

    As part of the resolution, Google denies any violations or noncompliance with any laws or regulations.

    Of that sum, more than $1.3 million will go toward back pay, with interest, to 2,565 female employees in engineering positions who were allegedly subjected to pay discrimination, while over $1.2 million will be set aside for 1,757 women and 1,219 Asian applicants for software engineering positions who weren't hired.

    The Department of Labor said its Office of Federal Contract Compliance Programs identified pay disparities affecting female employees in software engineering positions at Google offices in Mountain View, California, as well as in Seattle and Kirkland, Washington, during a routine compliance evaluation.

    "Pay discrimination remains a systemic problem," Jenny Yang, programs director at the OFCCP, said in a statement. "Employers must conduct regular pay equity audits to ensure that their compensation systems promote equal opportunity."

    The agency said it also found hiring rate differences that disadvantaged women and Asian applicants for software engineering positions at Google outposts in San Francisco and Sunnyvale, California, as well as in Kirkland.

    In addition to the back pay, the tech company will also allocate a reserve of $1.25 million for pay-equity adjustments over the next five years for employees in engineering positions in Mountain View, Kirkland and New York City -- where approximately 50% of Google's engineers work.

    A Google spokesperson told ABC News in a statement the company is pleased to have resolved the matter and that the company has conducted an internal analysis of pay equity for the last eight years.

    "We believe everyone should be paid based upon the work they do, not who they are, and invest heavily to make our hiring and compensation processes fair and unbiased," the spokesperson said. "We're pleased to have resolved this matter related to allegations from the 2014-2017 audits and remain committed to diversity and equity and to supporting our people in a way that allows them to do their best work."

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    Source: ABC News

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