Employers: Improve Employee Loyalty in the Post ACA World

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

As the Affordable Care Act was coming on line last year, I spoke to a number of employers who suggested that the health benefit plans they offered to their employees were really instruments of competitive advantage. These employers felt that their employees selected to work for their respective company’s, in part, based upon the quality of the health care plan. I thought that was extremely interesting. In my experience, the only employees that actually compare benefits prior to applying to or accepting a job, are those employees that had to address a ‘special-needs’ situation in their immediate family. By far this is a much smaller subset of employees.

Well with the running implementation of the Affordable Care Act, employers might consider another benefit that will provide real value to the majority of their employees. This one has application to a broader employee base and can provide comparative competitive advantage versus other companies that might be competing for great employees.

Addressing the Primary Needs of Working Caregivers

Managing both work life and family life has become a major issue for a large and growing number of family caregivers and their employers. With the aging of the Baby Boom generation will come a dramatic increase in the long-term care needs of our population. As policy-makers consider our options for meeting these needs, supporting working caregivers takes on national importance.” – Margaret Neal and Donna Wagner

There are four areas of need that have implications for structuring workplace settings and providing support for caregivers:Exhausted Business Woman_PM2

  1. Flexibility
  2. Information and assistance
  3. Emotional Support and
  4. Tangible assistance

Employed caregivers routinely note the importance of both flexible work hours and being able to take unscheduled time off to handle caregiving responsibilities when needed. A recent study of working “sandwich generation” couples (e.g. those raising depending children and caring for aged parents) found that couples who felt they had work schedule flexibility experienced less work-family conflict. Work schedule flexibility and other work-based supports offered by employers to their employed caregivers have generally been perceived positively on the part of the caregivers. This, in turn, has led to increased loyalty and satisfaction with those employers.

The needs of employed caregivers vary according to the care situation and the needs of the care recipient. Regardless, however, just as do their non-employed counterparts, employed caregivers need information on the community services that are available to support the needs of elders. Most caregivers of elders have had little or no previous experience either with providing care to an elder or with negotiating the aging services system. Thus, information about caregiving, health conditions, and where to turn for help is a critical need for employed caregivers. Because of the complexity of many elders’ health care situations, employed caregivers, like other caregivers, can find it difficult to know even what is needed, let alone decide which service approach is best for their elder. Professional expertise can be invaluable for assessing the elder’s needs, providing referrals and advice, determining eligibility and payment options, and packaging the needed services.

Emotional support for employed caregivers can come in the form of support from co-workers and supervisors at the workplace, support from other family members, and support from friends. A recent study found that, not surprisingly, lower levels of family related supervisor support were associated with higher levels of work-family conflict. Similarly, a less supportive workplace culture was also associated with work-family

Employed caregivers need help with legal, financial, and health insurance matters and the paperwork associated with these. Helping an elder manage the paperwork associated with his or her medical care is a daunting task. Similarly, securing and completing the legal forms for durable power of attorney, wills, reverse mortgages, and the like can be frustrating and time-consuming.

Adding assistance with eldercare benefits that apply to most of your employee base can provide real competitive advantage versus other companies that are competing for great employees; including employees that are currently on your staff. In the process you can differentiate your company from your competition in a way that is really important to your workforce. Caring Concierge can help you create an affordable, elder care benefit program that makes sense for your company.

Referral: University of Wisconsin


Defined Contribution Benefits Model — Don’t Forget Advance Care Planning!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

With the introduction of health insurance exchanges and full implementation of the Affordable Care Act by 2015, ‘change’ is the operative word in employer-provided benefits. Many employers are moving to a tool called a “Defined Contribution (DC) Benefit Plan”. From Wikipedia, a defined contribution benefits plan is a type of retirement plan in which the employer, employee or both make contributions on a regular basis. Individual accounts are set up for participants and benefits are based on the amounts credited to these accounts (through employer contributions and, if applicable, employee contributions) plus any investment earnings on the money in the account. Only employer contributions to the account are guaranteed, not the future benefits. In defined contribution plans, future benefits fluctuate on the basis of investment earnings. The most common type of defined contribution plan is a savings and thrift plan. Under this type of plan, the employee contributes a predetermined portion of his or her earnings (usually pretax) to an individual account, all or part of which is matched by the employer. In the United States, Internal Revenue Code specifies a defined contribution plan as a plan which provides for an individual account for each participant and for benefits based solely on the amount contributed to the participant’s account, and any income, expenses, gains and losses, and any forfeitures of accounts of other participants which may be allocated to such participant’s account.

Employers say the top two reasons for contemplating a switch to DC benefit models are to lower health care costs and to offer their employees more choice in the allocation of tiStock_RetirementPlanning_PMheir benefit dollars (59% and 40%, respectively). Employees report they would allot 75% of their benefit dollars to health, dental, and vision coverage, leaving 25% for other coverage’s such as voluntary life, disability, accident, and critical illness insurance. Even with this allocation by employees, 42% of brokers feel the shift to DC plans will lead to an uptick in sales for voluntary products.

“While employers struggle to fund increasing health care costs and more look to shift to DC plans, employees will realize a higher level of choice when it comes to benefits selection and aligning their benefit dollars with personal priorities,” said Jim Gemus, senior vice president, Products, Prudential Group Insurance. “Carriers and brokers have an opportunity to ramp up employee awareness and educational efforts in order to help ensure employees fully appreciate the value of the voluntary benefits available to them.”

I am an active participant in National Healthcare Decisions Day (NHDD) which takes place April 16th. The goal is to inspire, educate & empower the public and providers about the importance of advance care planning. As employers pivot to DC Benefits model and the like, it is crucial that advance care planning (Advanced Directives) be included as an element of a sound employee benefit plan portfolio.


All adults can benefit from thinking about and planning for what their healthcare choices would be if they are unable to speak for themselves.  These decisions can be written down in an advance directive so that others know what they are.  Advance directives come in two main forms:

  1. A “healthcare power of attorney” (or “proxy” or “agent” or “surrogate”)  documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself.
  2. A “living will” documents what kinds of medical treatments you would or would not want at the end of life.

The Ohio Durable Power of Attorney for Health Care lets you name someone, called an agent, to make decisions about your medical care—including decisions about life-sustaining treatment—if you can no longer speak for yourself. The durable power of attorney for health care is especially useful because it appoints someone to speak for you any time you are unable to make your own medical decisions, not only at the end of life.  Your durable power of attorney for health care becomes effective when your doctor determines that you have lost the capacity to make informed health care decisions for yourself.

The Ohio Living Will Declaration is your state’s living will. It lets you state your wishes about health care in the event that you become terminally ill or permanently unconscious and can no longer make your own health care decisions. Your Ohio Declaration becomes effective when your doctor determines that you have lost the capacity to make informed health care decisions for yourself and you are terminally ill or you are permanently unconscious.

The Organ Donation Enrollment Form allows you to register your organ donation choices with the registry, so that your organ donation wishes will be followed, even if your declaration cannot be found.

These forms do not expressly address mental illness. If you would like to make advance care plans regarding mental illness, you should talk to your physician and an attorney about a durable power of attorney tailored to your needs.

There are other advanced planning vehicles including ‘trusts’ that should be considered however, the basic elements of the advanced planning portfolio are what I’ve covered above. This is important and I urge every employer, every employee, in fact, every adult, to proactively address advanced planning today for the sake or yourselves and your families!


 Thanks to contributions from Prudential Financial and Employee Benefit News


The “B” Clause…The Additional Healthcare Costs for Employees Who Are Caregivers

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Last month I met with an HR executive at a local business. She was aware that businesses such as hers were ‘likely’ being impacted when their employees needed to address immediate adult caregiving needs. I was able to quantify the lose in productivity across all businesses in the U.S., after which, I provided a method she could use to estimate the amount of loss in productivity being experienced by her company.

adding up figures concept with modern white calculator in officeOne data point of significant lose she had not considered was the secondary or indirect costs of employee adult caregiving being shouldered by her company. I thought I’d provide a detailed explanation of what I reviewed for this HR exec.

Using the average additional cost of a series of major health conditions (such as depression, hypertension, and diabetes) reported by employees with eldercare responsibilities and non-caregiving employees, the estimated average additional health cost to employers is 8% more for those with eldercare responsibilities. Excess medical costs reached almost 11% for blue-collar caregivers and over 18% for male caregivers.

  • When extrapolated to the business sector generally, this 8% differential in health care for caregiving employees is estimated conservatively as costing U.S. employers $13.4 billion per year.
  • Employees providing eldercare were more likely to report fair or poor health in general. For example, among female employees ages 50 and older, 17% of caregivers reported fair or poor health compared to 9% of non-caregivers. Among men ages 18 to 39 and women ages 40 to 49, caregivers were also marginally more likely than non-caregivers to report lower health ratings.
  • Employees providing eldercare were significantly more likely to report depression, diabetes, hypertension, or pulmonary disease regardless of age, gender, and work type.
  • Female employees with eldercare responsibilities reported more stress at home than non-caregivers in every age group. Stress at home appears to affect younger female caregivers most frequently. Caregivers were more likely to  report negative influences of personal life on their work.
  • Eldercare demands were associated with greater health risk behaviors. Smoking is higher among male caregivers, especially among younger male caregivers and white-collar caregivers relative to non-caregivers. Alcohol use is higher among blue-collar caregivers.
  • Employed caregivers find it more difficult than non-caregivers to take care of their own health or participate in preventive health screenings. For example, women caregivers were less likely to report annual mammograms than non-caregivers. Employed caregivers of all ages and gender defer preventive health screenings as well.
  • Employees with eldercare responsibilities were more likely to report missed days of work. This was driven by the much higher absenteeism among younger caregiving employees, ages 18 to 39. Overall, 9% of non-caregivers missed at least one day of work over the past two weeks because of health issues compared to 10% of caregivers.
  • Excess employee medical care costs associated with eldercare were highest among younger employees, males, and blue-collar workers.
  • Younger caregivers (ages 18 to 39) demonstrated significantly higher rates of cholesterol, hypertension, chronic obstructive pulmonary disease (COPD), depression, kidney disease, and heart disease in comparison to non-caregivers of the same age.

Remember, when quantifying the approximate cost of lost employee productivity due to adult caregiving for your company, don’t forget to include the increased healthcare costs that this group of employees experience over and above non-adult caregiving employees.

Source: The MetLife Study of Working Caregivers and Employer Healthcare Costs

Trends in the Workplace — Fewer People have Employment-Based Health Coverage

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Recently I speaking with an executive of a prominent large employer regarding trends in workplace. Specifically we were discussing the decrease in employment-based health coverage that has taken place over the past decade. As you likely know, traditionally, employers have been the provider of the majority of health care in the United States. However, due to the tremendous cost of managing these programs and the ever-increasing cost of health insurance from providers, more-and-more companies have been quietly moving away from providing services to their employees.

The following report in the April 25, 2012 edition of Employee Benefit News (EBRI)documents the trends.

“Since 2002, the percentage of American workers with health coverage has fallen, mostly because fewer workers have access to coverage through their jobs,” says Paul Fronstin, author of the report and director of EBRI’s health and education program. “Fewer employers are offering the benefit, fewer workers are eligible for it and fewer workers are taking advantage of the benefit when it is offered, largely due to cost.”

The report notes that the percentage of the population with employment-based health benefits is lower, most recently due to the recession, but also as part of a longer-term trend that has seen fewer workers with access to health coverage.

Among the key reasons:

  • Fewer employers are offering health coverage to their workers. Between 1997 and 2010, the percentage of workers offered health benefits from their employers moved from 70.1% to 67.5%.
  • A growing percentage of workers are part-time and typically do not qualify for their employers’ health benefits. Two-thirds of workers not eligible for their employers’ health plans reported that they worked part-time in 2010, up from one-half in 1997.
  • When health coverage is offered, workers increasingly are turning it down because they say it’s too expensive.  Between 1997 and 2010, the percentage of workers who declined coverage because of cost increased from 23.2% to 29.1%. By contrast, fewer workers are declining coverage because they get it from somewhere else.

Overall in 2010, 46.7% of wage and salary workers ages 18 – 64 reported that they worked for employers that did not offer health benefits. Another 14.7% worked for employers that provided health benefits but were not eligible for those benefits. One-quarter of workers reported that they were offered health benefits but chose not to participate.

The rate of uninsured workers is going up, EBRI found. In 2010, one-half of workers whose employers did not offer health benefits were uninsured compared with 44.1% in 1997.

When I was a manager in corporate America, I remember the shared employer/employee disdain over health care benefits. Employers were shopping and  constantly making an annual change in health care providers. This was followed by the annual meetings with employees to explain the new health care plans and the reduced benefit offerings. The overall cost to employers, factored in as a cost-of-doing-business was exorbitant.

I told the executive I was speaking with that this was a major factor in our decision to introduce Caring Concierge in 2006 in a new model, separate from health care providers. Our ability to help employers significantly reduce their portion of the over $30 billion per year in lost employee productivity resulting from adult caregiving is unimpeded; we don’t charge our clients to offer our services as a benefit to their employees.

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