Small employers still need guidance on ACA basics

Advisers still have a critical role to play helping small business owners and their employees understand the workings of the Affordable Care Act.

Four years after the ACA’s enactment, less than one-third (27%) of employers with fewer than 50 employees state that they understand health care reform “very well” or better, according to Aflac’s latest WorkForces Report.

Nearly 2,000 employee benefit decision-makers and five thousand employees participated in the 2014 survey, which attempts to measure whether initial steps employers have made in response to the ACA have achieved hoped-for results.

The picture is mixed. Employers’ goal in managing health care has primarily been cost management. Tactics put into practice to achieve that last year include:

• Raising employee co-pays or premium sharing (56%),
• Hiring independent contractors or consultants (39%),
• Converting full-time employees to part-time status (21%), and
• Eliminating or reducing employee benefits (22%).

The migration to high-deductible health plans with accompanying HSAs has continued, with 19% of the survey base doing so last year. That conversion pace has been level since 2010.
Reluctant health care shoppers

Meanwhile, employees are keenly aware that they are being asked to shoulder a greater and greater share of the health care burden, but don’t appear willing to take steps to optimize their interactions with the health care system. A slim majority (51%) say they “prefer not to have more control over their health care expenses because they don’t have the time or knowledge to effectively manage them,” according to the report.

One reason is because employees lack the medical knowledge “needed to evaluate the quality of health care providers and the appropriateness of proposed treatment or medication needs”  — nor do they have a clear fix on the true cost of those services, the report states.

Employers should work with benefit advisers for guidance on giving employees the information they need and access (including through voluntary products) to coverage “that offers broad health and financial protection.”

The survey has been conducted annually since 2010.

Stolz is a freelance writer based in Rockville, Md.