Four years after the enactment of the Affordable Care Act, the health law’s ever-evolving requirements remain a hot topic during open enrollment meetings. Sophisticated enrollment technology can go only so far in giving employees all the information they seek and need, so many benefit brokers and advisers are gearing up for another round of old-fashioned, in-person enrollment meetings.

“Having an online enrollment system doesn’t mean that enrollment meetings are not still useful,” says Kris Allison, CEO of Burnham Benefits in Irvine, Calif. Also, brokers are not expecting all of their clients to abandon the use of paper enrollment forms and booklets quite yet. “We have some hold-outs still using paper,” Allison says.

Meeting employers and employees “where they are” is the name of the game in sustaining business relationships, brokers say.

At the same time, most employers urgently seek operational efficiency in the face of increased ACA-mandated data collection for 2015 plan years. That includes, for companies with at least 250 employees, putting the value of health benefits on employees’ W2 forms. And that’s the tip of the data requirement ice berg, making harnessing sophisticated enrollment systems critical — even when employees themselves still fill out paper forms, leaving the data input to others.

Pressing questions

One of the hottest topics among employees at enrollment meetings lately is whether they would be better off buying coverage through a public exchange, so advisers need to be prepared with answers.

“We’ve had enrollment meetings where employees thought they were going to get free coverage thanks to the Affordable Care Act,” says Keith Kiser, senior VP at BB&T Insurance Services in North Carolina.

Because the employer mandate for companies with at least 100 employees didn’t take effect this year as originally planned, some employees were better off going the exchange route.

Jordan Prosceno, account executive with The Bailey Group in St. Augustine, Fla., had a client that faced a large rate increase this year. Instead of absorbing it, the client opted to let employees pick up the increase. Had the employer mandate been in effect, the client would have flunked the value or affordability test, incurring a penalty. However, most employers that consider offering health benefits an important element of their human capital strategy met the ACA affordability and value standards this year even without the mandate.

“A lot of basic education about the ACA is still needed,” Prosceno says.

That includes the fact that employees will penalized if they opt out of coverage altogether. At one enrollment meeting Prosceno conducted this year, she says an employee became incensed upon learning that his employer, which formerly paid 100% of individual coverage, was now requiring employees to shoulder a modest 10% of the cost.

“He was ready to drop his coverage, until I explained about the individual mandate,” Prosceno recalls. The penalty, the greater of $95 or 1% of income this year, will really begin to bite next year when the formula becomes the greater of $325 or 2% of income.

Knowing one’s audience prior to enrollment meetings is, of course, essential to brokers’ success. Allison and her team take their cue from their clients in devising an enrollment plan suited to employee demographics. “Do they need materials in Spanish? Video? Animation?” she asks.

These factors fall under what Allison terms “the human bucket.” The “technology bucket” is no less important. Burnham Benefits works with more than 20 enrollment vendors. Assuring that enrollment systems vendors can pull together all of the pieces, including voluntary benefits, and gather the additional ACA-mandated employee data (including for employees who don’t use the health plan) is no small task.

“When you add in consumer-driven plans, it’s so much more complicated than it used to be,” Allison says.

The complexity confronts employees as much as those organizing and running the enrollment process. Allison’s team encourages clients enable employees to take advantage of decision-support tools that help them assess the cost of plan alternatives under various coverage scenarios.

She also believes decision-support tools should not be limited to helping employees choose health plans during enrollment. Resources such as Castlight Health that allow employees to compare medical outcomes at various institutions and providers, as well as performing pricing comparisons, are valuable components of the “technology bucket.”

How to reach them

So too are capabilities that some providers offer through health plans in Allison’s Southern California market allowing employees to have virtual, online doctor’s office visits. 

Getting employees to exploit such opportunities requires getting them motivated around the whole process of picking health plan options in the first place, instead of merely defaulting into the same choices year after year. That means attending enrollment meetings, particularly with an expectation that it won’t be dull.

“You need to prepare employees for enrollment by educating them all along the way before the enrollment period,” says Nooshin George, vice president of Burhnam Benefits. The firm conducts webinars for clients’ employees on different ways to get the most out of the health plan. “We record them so employees can let their spouses see them,” George adds.

While there is no substitute for clear, printed material, visual media is far more compelling for many employees, she notes. Similarly, systems that send periodic pithy enrollment-related text messages to employees (with their advance permission) can keep employees focused on and prepared for open enrollment, according to George.

Stolz is a freelance writer based in Rockville, Md.

Register or login for access to this item and much more

All Employee Benefit Adviser content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access