What to Tell Employees About Health Care Reform: Must-Do’s This Summer

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Second of three parts

Yes, you need to get your health care reform communication out this summer.

That will get you ahead of the consumer marketing and state-led exchange education.

Plus, it will give you time to tell your employees what is important in small bits — not all at once.

This is what you want to cover:

1. Tell employees ACA is the law of the land

The Affordable Care Act is part of massive changes that our whole health care system is going through. All aspects of health care are going through major change — driven in part by health care reform, and in part by all of the things that are broken about our current system. And, our system is in desperate need of change.

If you haven’t communicated along the way, explain what health care reform law already has done. From expanding coverage to removing limits, ACA has already done a lot. If you need a short overview, we really like this summary from BCBS of Michigan.

And yes, the new requirements cost you, the employer, money. You can and should be transparent with employees about what those additional costs are and how you have implemented new requirements so far.

2. Tell employees what’s coming next

Health insurance will soon be a new ball game. Explain that starting January 1, 2014:

  • Sick people can get insurance. Insurance companies will accept everyone who applies for coverage, regardless of health status.
  • Employers must offer insurance. Employers with at least 50 employees must provide health care benefits or pay a penalty. Lots of rules are in place to make that health insurance valuable and affordable — or employers pay penalties.
  • Everyone must have insurance. This is the “individual mandate.” Everyone will have to be covered by health insurance or pay a fine; those who can’t afford insurance will be eligible for assistance. There are lots of other new requirements that place more burden and costs on employers. You can bore your employees with the communications requirements, reporting requirements and new fees. But, chances are, this is more detail than they want or need. You can also explain the penalties, if they will have a big impact on your company. Overwhelming employees with details is not important; clearly explaining the impact to your company is. If you can use real cost figures, even better.

3. Tell them a lot about the exchanges

Any health care reform information you share over the summer must include a simple-to-understand explanation about public health care exchanges. Although you aren’t required to do this until October 1 (when you must get the official notice out), waiting that long is going to create a headache for you, your HR team and your employees.

  • First, explain what the health exchanges are — a marketplace where people can easily buy health insurance. Be sure to tell employees where they can get additional information and guidance. For now, that is healthcare.gov, but we’re sure that will change as the state exchanges come online. For example, Covered California is already up with a simple cost modeler.
  • Second, explain the government subsidies and what makes someone eligible or — in the case of most of your employees — ineligible for a subsidy.
  • Then, give clear direction to employees about what they should do. This direction and guidance really depends on your employee population and your benefit strategy. Here are the most common examples:

Is 2014 business as usual as far as eligibility and coverage?

This is the case for most of our clients and chances are you offer good coverage that meets all the requirements.

That means your employees aren’t eligible for a subsidy and, the main message is easy: Your benefits are the best deal in town, you don’t need to do anything outside the usual enrollment period. Still, some of your employees are going to be curious to compare your plans to what’s out there.

Make this easy — they may finally understand the value of their plans!

Skim over this, and you risk two things: Employees wrongly enrolling through an exchange (and arriving at your door mad when they realize they weren’t eligible for the subsidy after all!), or losing your young and healthy participants and driving up your costs.

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Will the exchanges be a good thing for your employees?

You may have a part-time workforce, seasonal employees, summer interns, pre-65 retirees, or temporary workers who don’t qualify for your health plan but whose engagement is important to you. If that’s the case, you’ll want to direct them to the exchanges and show them how the subsidy works.

Even employees who stay on your health plans may have friends or family who would benefit from the exchanges. Although it’s not your duty to educate them about these scenarios, the value for caregivers will be tremendous. It also helps illustrate value of your coverage.

Could families benefit from the exchanges?

If you have a spousal surcharge, minimally subsidize family coverage or simply don’t offer it, you’ve faced tough questions in the past. You’ll face more if you don’t proactively suggest that the exchanges are a viable alternative for many of your employees’ families.

It’s a careful dance, no doubt. Likely, you’ll still meet the legal requirements of offering affordable care but some employees may feel the pinch. Why not help them through the application process with some thoughtful context and advice?

Will some of your employees be eligible for a subsidy?

If your workforce includes employees whose income levels would qualify them for tax subsidies, you’ll want to arrange targeted communications that emphasize the importance and availability of public health care exchanges.

Work with your actuarial team to find out who may qualify for the subsidy, get their demographic profile and target them.

Tomorrow: Tips for Open Enrollment. See Part 1 of this series here. 

Common sense caveat that keeps our lawyers happy: This article is from Benz Communications, an employee benefits communication consulting firm. We know benefits. We know what your employees care about. We know how to help you bridge the two. We are not attorneys, and nothing in this constitutes legal advice or anything coming close to it. In addition, as we all know, the legislation and regulations are in flux. This information is accurate at the time it was published, but you should consult the HHS website or other sources for the most up-to-date information at the time you communicate to employees.

Jennifer Benz is Chief Strategist and Founder of Benz Communications, a San Francisco-based consultancy that focuses on custom, comprehensive benefits and HR communications services. Jen is an active member of the Council for Communication Management, the International Association of Business Communicators, the Northern California Human Resources Association and Women in Consulting. Contact her at jen@benzcommunications.com.

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