Presented by: Charlie Isaacs, Sr. Client Consultant/Practice Leader

Presented by:
Charlie Isaacs, Sr. Client Consultant/Practice Leader
Arthur J. Gallagher & Co.
2016 Annual Conference
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Technology and the Benefits Spend
HR Technology and Outsourcing Overview
ACA Compliance and Technology
Intro to Private Exchanges
Engagement and Communication Technology
2016 Annual Conference
2016 Annual Conference
Ownership Structure
* Due to rounding, percentages do not total 100%.
3,047
Organizations
Participated
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2016 Annual Conference
Future Benefits Spend
Unsure,
25%
Increasing,
45%
Neutral,
22%
Decreasing,
8%
2016 Annual Conference
Survey Participants Who Offer These Solutions (2015 vs. 2014)
50%
43%
45%
40%
38%
35%
30%
25%
20%
16%
15%
10%
5%
12%
12%
11%
9%
12%
9%
7%
4%
3%
0%
Telemedicine
('Online Visits' in
2014)
Mandatory
specialty
pharmacy
program
Reduced provider Online enrollment
Social media
network
benefits
accessibility
communications
(limited network)
2015
2014
2016 Annual Conference
Mobile-enable
benefits
communications
Telemedicine
The average estimated cost of a telehealth visit
saves about $100 or more compared to the
estimated cost for in-person care
(Red Quill Consulting, Inc., 2014)
2016 Annual Conference
Source: The 2015 Aflac WorkForces Report Open Enrollment Survey
2016 Annual Conference
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
Total technology and outsourcing in North America grew at a steady
rate of 6.4% to reach $9.1 billion in 2014* growing 6.9% CAAGR
and will be at 11.9b in 2018.

North America H&W Administration & Exchanges grew at an 8%
rate – Exchange growth accounted for more than half of that.*

Driven by Health Care Reform in the US.

More activity than ever due to PPACA and private exchanges
*Source: Nelson Hall, 2015
2016 Annual Conference
Enterprise Resource
Planning (ERP)
• Integrates info across entire organization
• Installed onsite, IT resource intensive
• Enterprise functions—Job Costing, Inventory Management, General Ledger, Payables,
Receivables, HR/Benefits/Payroll/Other
• SAP, Oracle, Peoplesoft, Lawson, Workday, NetSuite, Microsoft Dynamics
Human Capital
Management (HCM)
•Focused on end to end recruitment to retire HR solutions
•HRIS/Time/Payroll/Benefits/Talent Mgmt./Recruiting/Learning/Performance/Other
•ADP, Ceridian, Epicor, UltiPro
HCM “Point” Solutions
Benefit “Point” Solutions
Exchange Platforms
•Specific HCM solutions focusing on single HCM process
•Litmos, Spark Hire, Equifax, Bloomfire
•Specific solutions focusing on management of benefits process-enrollment and
administration
•In general—can support an exchange environment
•Selerix, Spotlite, Benefitfocus, Bswift, Plansource, Businessolver
•Platforms built specifically for exchange activity
•Varying degrees of benefit administration capabilities
•Strong decision support capabilities
•Liazon, Bloom, Connected Health
2016 Annual Conference
ERP
Human Capital
Management
Benefit/Exchange
“Point” Solutions
Other HR “Point”
Solutions
*This graphic depicts Gruppo Marcucci’s representation of the market applying internal market research and knowledge. Such depiction should not be relied on as , or construed to be,
business or legal advice and is presented for demonstrative purposes only.
2016 Annual Conference
Communication/
Decision Support
Enrollment
Administration/
Exchange
Plan Optimization
Tools
*This graphic depicts Gruppo Marcucci’s representation of the market applying internal market research and knowledge. Such depiction should not be relied on as , or construed to be, business or legal advice
and is presented for demonstrative purposes only.
2016 Annual Conference
Traditional Ben Admin
Carrier Automation
Exchange Tech.
*This graphic depicts Gruppo Marcucci’s representation of the market applying internal market research and knowledge. Such depiction should not be relied on as , or construed to be, business or legal advice
and is presented for demonstrative purposes only.
2016 Annual Conference
2016 Annual Conference
1. How does ACA affect
benefits administration?
2. Options for administration
compliance
3. Working with potential
vendors
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ACA basics – Law overview
◦ Measurement, stability and
administration periods
◦ Penalties
◦ Affordability
◦ Definitions
◦ Numbers and percentages
◦ Employer Mandate Final Rules
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1.
2.
3.
4.
Need to track hours and eligibility on a
frequent basis (monthly) from potentially
multiple data sources
◦ Manage scheduling to prevent undesired
eligibility (in some cases)
Need to enroll and de-enroll employees on
a timely basis
New notification requirements
New IRS reporting
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1.
2.
Where are hours consolidated and maintained?
◦ Payroll, T&A, Benefits, HRIS?
◦ Hour adjustments?
◦ Hours that need to be counted but unpaid?
How do you…
◦ Ensure timely employee enrollment (and record
you did)?
◦ Determine when de-enrollment has to happen?
◦ Provide employees legally required notices?
◦ Determine if you are out-of-compliance?
◦ Calculate penalties?
◦ Create monthly reporting necessary for IRS
forms/reports?
2016 Annual Conference
FMLA
Record
Keeper
HRIS/HRMS
Benefit
Administrator
Payroll
Time and
attendance
system
Work number
– Equifax
2016 Annual Conference
HRIS/HRMS
FMLA
Record
Keeper
Benefit
Administrator
Payroll
Time and
attendance
system
ACA
Support
Tool
2016 Annual Conference
Work number
– Equifax
Compliance Education & Communication Resources
1.
◦ SBC distribution, Notices, Definitions of terms
2.
◦
◦
◦
◦
◦
◦
◦
◦
3.
Shared Responsibility
Number of FT and FT equivalent employees
Hours for individual eligibility
Notification and management of eligibility
Hours overage alerts
Government filings
Cost optimization scenario modeling
Potential penalties
Affordability
Other Calculations
◦ W2 reporting, PCORI fees, Nondiscrimination testing
Not all service providers offer all of the above
2016 Annual Conference
1.
2.
3.
4.
5.
Current capabilities; do they meet functionality
needs?
What is their product roadmap?
Fee structure?
Ongoing vs. upfront costs?
Ability to keep up with ever changing ACA
requirements
2016 Annual Conference
•
Be sure you understand EXACTLY what the Vendor will do for you and EXACTLY what
the Vendor expects you to do.
Define what data the Vendor has and where the remaining data is. Does the Vendor
expect you to chase down the remaining data? Or, will it?
Critical question: How will the Vendor handle Lines 14 and 16 of Form 1095-C? These
questions require a code for every month for almost every employee. Will the Vendor
require you to assign these codes and complete these questions, or will it?* Will the
Vendor create an automated process? How much involvement will be required from you
in subsequent years?
Will the Vendor send the forms to individuals and the IRS? How? Electronically, or, by
paper via mail? Or, will you send?
Will the Vendor maintain your data and keep good records of the data and forms?
*
Since you are ultimately liable, you should review the Vendor’s work, but the question is – who completes the first draft?
•
•
•
•
2016 Annual Conference
2016 Annual Conference
Health Insurance
Exchanges (Marketplace)
Public
Individual
Federal or
State
FederallyFacilitated
Small Business
Health Options
Program
(FF-SHOP)
Private
Single
Carrier
MultiCarrier
2016 Annual Conference
2016 Annual Conference
• Educational
• Side-by-side comparisons
• Interactive Q&A
• Predictive cost modeling;
financial risk tolerance
2016 Annual Conference
2016 Annual Conference
2016 Annual Conference
30%
11-15 Benefits
21%
Health
Wealth
Personal
Accident
Critical illness
Hospital
indemnity
Dental
Vision
Short-term
disability
Long-term
disability
Term life
Permanent life
Long term care
Identity theft
Legal
Discount
programs
Auto and home
Student
assurance
card
Loans
*MetLife’s
<5 Benefits
18%
32%
Intend to Stay
Do Not Intend to Stay
Offering fewer than 5 benefits is not
a retention strategy.*
13th Annual U.S. Employee Benefit Trends Study, 2015
2016 Annual Conference
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•
•
•
•
•
Employer Sponsored benefits marketplace
Defined Contribution
Expanded benefits offerings
Employee engaged online shopping experience
Decision Support for member
Fully or self-insured option
2016 Annual Conference
•
•
Benefits administration is designed to help efficiently process
benefits enrollments, life event changes and terminations.
– Typically no carrier inventory.
– Often no/limited decision support.
Exchange platforms:
– More seamless DC approach
– Carrier inventory
– Decision support
– Benefits administration support
2016 Annual Conference
2016 Annual Conference
(From 2014 NBS)
 One of the biggest trends seen in the industry is a simple equation:
resources + communication = satisfied, engaged employees.
 Creating new methods and opportunities to communicate with diverse
workforce segments helps to capture employee’s interests and motivate
their involvement in benefits.
 Organizations that continuously connect in the most relevant way with
their employees can strengthen the employee value proposition without
increasing costs.
 Technology tools can be an invaluable resource in engagement and
consumerism.
2016 Annual Conference
2016 Annual Conference
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2016 Annual Conference
2016 Annual Conference
Cost transparency
• Benchmarked costs
• Empowered employees make smart decisions
• View claims by category of care
• Free tools from nonprofit & gov. entities
• Multiple sources; source is important
Quality transparency
• Providers and facilities
• Evolving; no national database
Two types: Yelp-like or clinical outcomes
Rewards programs
Cost/Quality intersection
Encourages good decision-making (right
care at right price)
2016 Annual Conference
• On-line wellness resources and information
• Full spectrum wellness programs and service providers
• Direct employee engagement
• Mobile Applications
2016 Annual Conference
Charlie Isaacs, Sr. Client Consultant/Practice Leader
Arthur J. Gallagher & Co.
[email protected]
2016 Annual Conference