2013 health care reform survey results

2013 Health Care Reform Survey | 2

IntroductionThe Affordable Care Act has significantly affected employers across the nation. With the Supreme Court ruling the law constitutional last June and President Obama’s re-election, this continues to be the case. As provisions continue to take effect, how are employers reacting to and coping with the changes? For more than three-quarters of respondents to this survey, health care reform has increased, or is expected to increase, their organization’s health benefit costs. Of those respondents, more than 57 percent have passed or plan to pass these costs on to employees, a number that has decreased by nearly 6 percent in the last year.

The 2013 Health Care Reform Survey was conducted in early 2013 and was available to individuals through client portal websites. A total of 4,429 respondents completed the survey.

Table of ContentsDemographics..........................................................................................3

Broker-provided Services ........................................................................4

Health Plans ............................................................................................5

Pay or Play Decision................................................................................6

Election Results .......................................................................................7

Compliance..............................................................................................8

Health Insurance Exchanges...................................................................9

Workplace Wellness ................................................................................10

Cadillac Plans ..........................................................................................11

Health Care Reform Administration .........................................................12

Overall Changes ......................................................................................13


DemographicsThis survey was completed by employers in all 50 states and the District of Columbia. Similar to last year, the overwhelming majority of survey respondents were from organizations employing fewer than 500 employees.

How many employees does your organization employ?

What is your organization's annual revenue?

In which region is your organization based (the most employees)?

In which industry/sector does your organization operate?

12%10%

11%

11%

16%

5%

15%

13%

5%


How important it is that your benefits broker provides your organization the following services with respect to health care reform?

Very Important Important Slightly

ImportantNot

Important

Offer legislative updates to educate on health care reform and its implications 67.6% 26.3% 5.2% 0.9%Offer educational seminars about health care reform and its implications 47.2% 35.4% 13.7% 3.7%

Model the financial impact of health care reform, including possible penalties, on your organization 63.6% 29.5% 5.7% 1.2%

Help educate employees on the reforms and their implications 40.7% 41.9% 14.8% 2.6%Help develop a health benefit strategy and multi-year implementation plan for

active employees 48.7% 35.7% 12.7% 3.0%

Provide decision support tools to help employees evaluate their options 42.4% 40.3% 14.2% 3.1%Help adopt and implement a consumer-driven health plan (CDHP) to drive

down costs 34.0% 37.6% 20.2% 8.2%

Help implement workforce health improvement / wellness initiatives 30.1% 38.9% 24.8% 6.2%Help prepare the Summary of Benefits and Coverage 63.4% 28.0% 6.2% 2.4%

Broker-Provided Services


Health PlansSince last year, the number of respondents who plan to make changes to their organization’s primary health plan funding mechanism has increased over 3 percent. Regardless, nearly 86 percent still do not plan to make any changes.

Do you plan to make any changes to the funding mechanism for your primary health plan in the next year?

86% No

Yes 14%

What types of health plans does your organization currently offer?

How is your largest group health plan funded?

Which active employees are offered coverage under your organization's health plans?


Pay or Play DecisionIn 2014, employers with 50 or more full-time equivalent employees are required to offer minimal essential health coverage to employees or possibly pay a penalty. The number of organizations who definitely will or likely will continue offering health benefit coverage to employees once this requirement takes effect increased over 7 percent from last year’s survey.

In 2014, employers with more than 50 employees are required to offer minimal essential health coverage to employees or be subject to a penalty. How likely is your organization to continue offering health benefit coverage to your employees once this requirement kicks in?

If you plan to keep coverage, what are your reasons for doing so?

If you plan to discontinue coverage, what are your reasons for doing so?


Election ResultsNearly 70 percent of respondents said that the results of the 2012 presidential election did not influence their organization’s health care decisions.

Did the election results influence your organization’s health care benefit decisions?

69% No

Yes 31%


ComplianceNot complying with the provisions of health care reform can be costly, but employers seem confident that they can take on the new requirements. Only 12 percent of survey respondents indicated that they consider their organization unprepared for compliance with future health care reform provisions.

How certain are you that your organization is currently in compliance with health care reform's effective provisions?

How well prepared do you consider your organization for compliance with future health care reform provisions?


Health Insurance ExchangesMost employers are unsure or skeptical about the upcoming state health benefit exchanges. The vast majority of survey respondents indicated that they do not use, and do not plan to or want to use, private exchanges to obtain coverage.

What is your organization's attitude toward the state health benefit exchanges that are set to be effective in 2014?

Do you use (or are you interested in using) a private exchange for obtaining coverage?


Workplace WellnessIn 2014, employers will be permitted to increase employee wellness program rewards or penalties to 30 percent of the cost of coverage (up from the current limit of 20 percent). The number of employers who are either very likely or likely to create or expand their wellness programs as a result of this increased over 3 percent since last year’s survey.

In 2014, employers will be permitted to increase employee wellness programs rewards or penalties to 30 percent of the cost of coverage (up from the current limit of 20 percent). How likely will this prompt your organization to create or expand your workplace wellness program?


Cadillac PlansIn 2018, a 40 percent excise tax will be imposed on the excess benefit on high-cost employer-sponsored health insurance. The annual value limit for purposes of calculating the tax is $10,200 for individuals and $27,500 for anything other than individual coverage.

There was a slight increase between last year and this year in respondents who cited that their organization was either very likely or likely to need to reduce coverage to stay below these levels.

In 2018, a 40 percent excise tax will be imposed on the excess benefit on high cost employer-sponsored health insurance. The annual value limit for purposes of calculating the tax is $10,200 for individuals and $27,500 for other than individual coverage. What is the likelihood that your organization will need to reduce coverage to stay below these levels?


Health Care Reform AdministrationThe top three health care reform provisions employers report being most concerned about implementing and administering remained constant since last year—new reporting, disclosure and notification requirements come in first, followed by offering affordable health coverage to full-time employees and Form W-2 reporting requirements.

Which health care reform provisions are you most concerned about implementing and administering?


Overall ChangesMany employers plan to make some organizational changes as a result of health care reform. From offering wellness-based care to hiring fewer total employees, health care reform is affecting organizations.

Do you plan on any of the following as a result of health care reform?

Are you considering any of the following options for 2014 or beyond?

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2013 health care reform survey results