The Affordable Care Act (ACA) is here to stay, commentators all agree. There might be some adjustments at the margin – possibly Congress will eliminate the medical device tax; maybe Congress will permit Flexible Spending Accounts and Health Savings Accounts to be used for over the counter drugs. But the essentials of the ACA will remain, including the individual and employer mandates.
The purpose of this post is not to detail the many compliance issues that employers must satisfy under the ACA. Suffice it to say that employers of all sizes need to be aware of their obligations in 2013, and the even greater obligations facing them in 2014, when the major provisions of the act become effective. Employers should consult their legal counsel, brokers, and other benefit plan experts to determine what they must do to comply with the ACA.
Instead, this post is intended to provoke employers to think strategically about how they want to structure their health insurance plans for employees. I recently participated in an Aon Hewitt conference call in which their healthcare experts advised that compliance and corporate strategy are two different things, and employers need to focus on both.
Many corporate leaders deplore the need to be experts in health insurance and plan design issues, because it detracts from their focus on their companies’ products and services to customers. Nevertheless, most executives recognize how important the health and engagement of their workforce is. As they implement the ACA, companies will become more involved in healthcare decisions, not less. Wise employers will deal with the problem strategically.
HR, Finance, and other executives at companies of all sizes should discuss:
- Do we want to build unique health insurance plans designed specifically for our workforce? What are the major healthcare needs of our employees? What employee behaviors are driving our healthcare costs, and how can we incent healthier behavior?
- Do we want to build or join a private healthcare exchange to provide our employees with more choices? Would we rather push employees into state or federal healthcare exchanges to reduce our involvement in structuring healthcare plans?
- Should we structure our jobs to maximize the number of part-time employees for whom we do not need to provide health insurance? What will the implications be for employee satisfaction and for our operational efficiency?
- How do we segment our health insurance offerings and our communications for various groups within our workforce?
Now that the ACA has survived the Supreme Court and the electoral process, employers must focus on their roles in its implementation. But they shouldn’t ignore their companies’ strategic needs as they do.
Complying with the ACA is one thing. Making the right strategic decisions for your workforce is another. Be sure you do both.