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BHCG employers share 2015 plan changes

A significant component of the BHCG value proposition is the opportunity for employers to share their health plan information and strategies in an open forum. Employer members find this type of sharing invaluable to compare notes and learn about what has worked and not worked for other employers. Indeed, our annual BHCG Benefits Subcommittee open forum meeting is one of the most well attended events for employer members.

In the 2015 open forum meeting held in February, members shared information around their 2015 plan changes and short-term/long-term strategies for their health and wellness programs.

Representatives from member employers Robert W. Baird, BMO Harris, City of West Allis, Charter Manufacturing, Journal Communications, MillerCoors, Northwestern Mutual, Briggs & Stratton, Johnsonville, Western States Envelope, Maysteel and Rockwell Automation reported on their 2015 plan and program changes. The following general trends were noted among the meeting employer participants.

Plan costs/rate increases

  • Employers reported minimal to moderate rate increases at or below market trend – with a couple of employers reporting no increase.
  • Most report raising employee contributions and/or deductibles (one employer for the first time in eight years) and out-of-pocket maximums to mitigate increases and engage employees.
  • High costs related to musculoskeletal services and specialty drugs were also identified.

2015 health plan changes and activities

High Deductible Health Plans

  • Several employers had already gone to a full replacement, account-based high deductible health plan (HDHP) before the 2015 plan year.
  • In anticipation of a full replacement plan in 2016, one employer introduced an HDHP/HSA plan with incentives, modified the HRA plan and decreased the employer contribution (resulting in 45 percent of employees moving to the HDHP/HSA plan, 25 percent enrolling in the HRA plan and the remaining in the PPO plan).


  • Many reported employer HSA/HRA contributions as part of a wellness reward program and one employer kept employee premium contributions flat for those participating in the wellness program and a modest increase for those that don’t.
  • Several employers use outside wellness programs vendors and some plan to go out to bid for a wellness vendor this year.
  • One employer reported using incentives in three areas: biometric screening/health risk assessment, health coaching and physical activity (recently increased incentive to boost activity).
  • Several employers have gone to or will go to an outcomes-based wellness incentive program vs. a participation-based program, one moving to an outcomes-based program tied to employer contributions.
  • A couple of employers reported using BMI reduction as an outcomes measure for wellness.
  • One employer reported a positive ROI for their wellness program.

Administrator change

  • Two employers changed administrators from Humana to UnitedHealthcare (UHC) for 2015, with one in the process of heavily promoting premium designated (Tier 1) health care providers and stand alone facilities to maximize savings. Both employers are looking to increase employee registration on the UHC consumer tools site.

Other plan changes and activities

  • The addition of transgender benefits
  • Changing eligibility for new hires from day one until the first of the month following 30 days of employment
  • Moving to stand-alone HSA administration
  • Subsidizing dental premiums to reflect medical plan cost sharing
  • Conducting a dependent audit through the open enrollment process resulting in an unusually high number of members being dropped

Affordable Care Act (ACA)/future strategy

  • Several employers report struggling with the ACA’s 1094/1095 IRS reporting requirement – citing problems with eligibility determination for interns and temporary workers, etc.
  • Some employers have outsourced ACA reporting or are considering outsourcing; others have built internal resources to accommodate reporting.
  • Most employers are predominantly concerned with preparing to avoid the excise tax in 2018; some reporting a consumer-focused strategy and one determining trigger points for 2018 to determine if they should eliminate their self-funded plan.
  • A couple of employers have moved their Medicare population to private exchanges and one is planning to move pre-65 retirees to the Marketplace in 2018.
  • One employer reported they are managing trend in anticipation of the excise tax and communicating to employees that they are also responsible for helping the company prepare.

Onsite/near-site clinics (four employers utilize an onsite/near-site clinic)

  • One employer set up a fee schedule for onsite clinic services and has seen participation drop;
  • Two employers report unions are not supportive of onsite clinics because of confidentiality issues.
  • Another employer reports their onsite clinic continues to grow with the addition of physical therapy that does not require pre-authorization. Current providers include three physicians and three mid-level practitioners and they are expecting to increase providers annually.
  • Two employers outsource their onsite clinic administration; one is conducting an analysis to evaluate offering onsite clinics at all their locations.

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