Know the Basics of Company Wellness and Healthcare

Many human resources information systems (HRISs) exist on the market today. These software programs offer small to mid-size companies a range of solutions for managing payroll, employee benefits, training, recruiting, and compliance processes. Depending on the size of your company, the scope of services can range from simple payroll and tax processing to a full suite of comprehensive services that includes recruitment, benefits administration, performance review, etc. The software programs allow you to generate metrics reporting as well, which is useful for strategic planning. The goal is to make processing and reporting as accurate and efficient as possible. Management will analyze the metrics (eg, turnover rates, headcount, terminations, etc) to assist in making strategic decisions for succession planning and budgeting. It is therefore critical to align the size of your company against the needs of the organization when selecting which HRIS system to use. Generally for a small company, basic payroll processing with annual tax processing is an appropriate fit. If you require a more comprehensive suite of services, you can explore a self-service portal with a file feed that transmits directly to the carriers/vendors. This tends to increase the costs, so depending on the size of the company and budget, it may not be suitable for every business.

For most laboratory owners, providing healthcare plans to employees has become a costly and sometimes confusing challenge. The healthcare landscape has evolved over the past several years with the Affordable Care Act (ACA). The ACA introduced new laws as well as challenges that have emphasized consumerism in the marketplace. One of the key laws was to permit patients who have pre-existing conditions to be enrolled into medical plans without providing evidence of insurability and to include preventive care at no cost to the patient. The rising cost of healthcare is one of the biggest challenges that most companies face.

Healthcare has always been a cost-sharing responsibility between the employer and employee. The consumerism aspect now shifts more of the responsibility to the employee, because the deductibles for most plans have doubled over the last few years. This applies to both Preferred Provider Organization/Exclusive Provider Organization (PPO/EPO) and Health Savings Account (HSA) medical plans. Today’s benefit plans are structured around the population of the company and industry with budgetary concerns a key factor in deciding how to effectively design a comprehensive and affordable medical plan. PPO plans allow employees to visit doctors in- and out-of-network at different benefit levels. A PPO plan is ideal for those who want a more predictable cost but don’t mind paying slightly more in contributions each paycheck. The EPO plans are in-network-only health plans with no out-of-network option. Fewer health care professionals are available in the network to utilize if you offer this option. EPO plans tend to be more cost effective than PPO plans because of the lack of out-of-network options. The deductibles and out-of-pocket maximums will vary depending on plan design.

HSA plans are similar to PPO plans, with the major difference being that coinsurance is used for most services. Instead of requiring copays, coinsurance applies along with the deductible. The HSA plans are very good for both low and high utilizers, but more out-of-pocket money may be required for services. Patients are required to meet an annual deductible before the medical plan begins to cover their health care expenses.

Many factors should be considered when selecting a health care plan. The deductibles and out-of-pocket maximums are only two considerations. For businesses that have employees who have high-frequency visit rates to the doctor’s office or utilize retail Rx coverage, considerations such as these will also play a role when looking at different plan designs and structuring what makes the most sense from an employer’s perspective and the employees’ usage.

For a small to medium-size company, healthcare costs are a major part of their overhead expenses. Most companies partner with a broker to assist in designing and navigating the healthcare landscape because it is the second largest expense after payroll. It is important to align your budget against the headcount when first designing the medical plan. It is also important to forecast what the increase to the headcount will be year over year, so you can accurately calculate what the company’s health care expenses will be. There will always be attrition in any company, but the total headcount of people eligible to enroll for the health plan is most important.

Wellness programs are a great way to introduce preventive healthcare. A good start is to take the pulse of the staff by doing a health risk assessment. This is a good way to actually gauge your employees’ overall health and offer ways to improve it. Discounts on gym memberships, lifestyle coaching, and biometric screenings are a few options to consider. Some companies have raffles to entice employees to participate in the health risk assessment. It is not a mandatory exercise, but it has been a useful motivational tool. Flu shot programs are another great way to promote a healthy lifestyle because people often work in close quarters.

The HR world has changed quite a bit over the last several years. Strategic planning is an essential part of a company’s future. Many decisions must be made, especially when you need to remain competitive within your industry and attract and retain talent. Recruitment, financial, and system upgrades must be considered, just to name a few. There is no “one size fits all” when it comes to human resources because every industry is unique. The key to success is to have the right mix of talent in an organization so you have strengths in every part of the business.

Brian Forman is a Human Resources Benefits Specialist for Worldwide Flight Services in Jamaica, New York.