How to facilitate effective benefits plan communication

The way that employers communicate benefits information to employees has a tremendous impact on how well the programs are understood, utilized and perceived.

“Managers and supervisors can be effective in sharing important benefits information, especially if it is not scripted or canned. Since they are most likely to know what their employees understand, they might be better able to present benefits information in a way that makes sense. As an employee’s main point of contact, managers and supervisors also tend to be more approachable with questions,” says Judy Griffith, compliance officer at JRG Advisors.

Opportunities to ask questions, express dissatisfaction and discuss problems with supervisors and managers should be encouraged. However, when managers and supervisors share benefits information, it needs to be done with caution.

Smart Business spoke with Griffith about effective benefit plan communication, via managers and supervisors.

How can an employer avoid verbal communication problems?

Communicating inaccurate information to employees is always a major concern when using managers and supervisors to relate benefits information. Employers should be mindful that misinformation not only causes an employee relation problem, it has the possibility of leading to litigation, as well.

Follow these tips to avoid problems.

  • Consider allowing only specific HR personnel to discuss benefits information.
  • Remind supervisors and managers, who may be asked benefits questions, to review their plan documents carefully. They should refer any question they’re unsure how to address to the HR department.
  • Whether formal or informal, don’t make promises regarding any aspect of the plan that the company won’t be able to keep.
  • State in the documents that amendments are to be made only in writing and approved by the corporate representative or plan administrator, if applicable.

What are some written communications cautions to be considered?

Even if written material about benefits information isn’t an official plan document, informal written promises can still prevail in court. So, make sure informal written communication about the plan is consistent with official documents before distributing.

Employees often rely on summary plan descriptions to determine their rights under a specific plan. In the event of an issue due to discrepancies between plan documents and the summary plan document, the summary plan document can hold up in court. Therefore, it’s crucial to ensure the summary plan document is correct, current, clear and in agreement with the plan documents, handbooks and other benefits information.

As a safety measure, be sure that the summary plan description, handbooks and other benefits communications state clearly that the plan document has absolute authority over them. This should appear in a separate paragraph in a prominent position. Consider using larger, italic or boldfaced type, or a distinct border, to make the information readily apparent.

Other general helpful tips include:

  • Keep a copy of each communication or disclosure sent to employees, however informal.
  • Grant discretion to fiduciaries in the plan document.
  • Make sure all documents relating to the plan don’t include misleading information before distributing. Request additional information from the plan administrator, if necessary.
  • Reserve the right to amend the plan at any time for any reason.

In addition, health insurance issuers and group health plans are required to provide a Summary of Benefits and Coverage (SBC), an easy-to-understand summary about health plans benefits and coverage. These simplistic health plan summaries can help an employer explain benefits to employees.

How can selecting the right broker help?

Employers should partner with an experienced benefits professional who can provide an effective benefits communications solution and strategy. This strategy should include engaging communications that reflect the needs, wants and motivations of your employees, and also comply with the legal requirements surrounding the benefits plan.

Insights Employee Benefits is brought to you by JRG Advisors

Designing a successful employee benefits program

Let’s face it, one of the most important and costly issues for employers today is implementing and managing a successful employee benefits program.

“When it comes to retaining and recruiting quality employees, your benefits program is a critical component, and in most cases, it can account for 40 percent or more of total compensation costs,” says Ron Smuch, Insurance and Benefits Analyst at JRG Advisors. “Employers should take the time to implement a strategic, well-thought-out benefits program that meets the employee needs and the business objectives.

Smart Business spoke with Smuch about what employers need to consider to achieve a successful benefits program.

How do the objectives and budget shape these programs?

A successful employee benefits program has clearly identified objectives. If you’re offering benefits just so you can say that ‘we offer benefits,’ you’re missing the mark.

Identifying clear objectives will lay the groundwork and guidance to establish the selection and design of your benefits program. Keep in mind, the objectives should reflect both the employer and employee needs. Additional factors also to be considered include employer size, location and industry. Unless you have an open checkbook, budget is an equally important factor. If you already have a benefits plan in place, current benefits costs and projected costs should be analyzed.

Why are the employees’ needs important?

A survey or needs assessment should be conducted to identify the coverage, cost and network that reflect the needs of your employees. Benefits are by no means one-size-fits-all in today’s diverse workforce. Gaining feedback from your employees will increase motivation and satisfaction with the benefits program. Employee feedback can also help to prioritize which benefits would be most helpful in achieving satisfaction with the plan.

How can employers use survey data?

After analyzing the employee feedback, employers should prioritize the survey findings. For example, the cost of providing the prioritized benefits can then be evaluated and compared to the overall budget and cost sharing methodology.

This process can involve many factors. For instance, should changes be made to the current benefits plan design to promote cost savings? Can underutilized benefits not important to employees be eliminated? What cost containment features can be implemented? These are all important points to evaluate when considering the design of the benefits program.

Where does communication come into play?

Developing effective communication channels should be at the forefront of the planning and management of any employee benefits program. The only way to get employees on board is to ensure that they fully understand their benefits and coverage. Without employee support and satisfaction, an employer’s efforts could prove futile. If employee feedback was used as a determining factor in the benefits program design, employers should make employees aware of how their feedback influenced the design.

Additionally, communications with employees about benefits should extend beyond legal requirements. A good communications strategy and dialogue create awareness and appreciation, provide a heightened understanding of the benefits and promote wise use of the coverages.

What about ongoing evaluation?

Review and assessment of the plan throughout the year will ensure you are meeting employer and employee objectives. Many factors can impact the benefits program, such as the economy, regulatory environment and workforce demographics.

Set the measurements on your goals in order to assess the benefits program and quantify adjustments. The use of benchmarking data and periodic employee surveys further assist employers in evaluating the effectiveness of the employee benefits program.

Insights Employee Benefits is brought to you by JRG Advisors

New ways to approach employee performance reviews

What does the term “performance review” mean to you? To many people, it means sitting down at the end of the year with a manager to discuss work performance over the past 12 months. To others, it could mean a quarterly meeting to report on the status of specific tasks and performance goals. And some may relate to it as a weekly conversation.

“Not all employers approach performance reviews the same way,” says Rob Higginbotham, finance and HR director at JRG Advisors. “Whatever method your company reviews take, it should be formulated from a basis of employee feedback and company culture.”

Smart Business spoke with Higginbotham about trending performance review practices.

How are companies accomplishing ongoing, periodic reviews?

Some employers are replacing the annual performance review with more frequent manager-employee check-ins, which occur monthly or weekly. These check-ins do not need to be lengthy and can be as simple as taking a short walk or coffee break.

For example, instead of waiting until the end of the year to review a year’s worth of projects, managers can give immediate feedback throughout the progress of a project. And when projects are completed, managers can discuss what was done well and areas for improvement. This format makes it easy for employees to ask questions or share ideas.

Frequent dialogue between managers and employees helps to promote continuous growth. And, it gives managers the chance to identify and resolve performance issues in a timely manner. As a result, feedback can seem less confrontational and managers can seem more supportive.

What are wellness checks? How do they affect employees?

Like a performance review, checking in on employee wellness can be critical for their success. Research indicates that people are more stressed than ever. Prolonged stress can lead to serious mental health issues and negatively impact the workplace and employee performance.

Employers can combat stress issues by weaving wellness into performance conversations. Managers who meet with employees more frequently have greater opportunity to talk about stress levels and the importance of personal well-being. In fact, regular conversations about these issues can maximize positive impact for the overall workplace.

How do artificial intelligence (AI) and people analytics play a role?

People analytics is a way of tracking things like employee engagement data, training program effectiveness and productivity. The practice examines human data and crunches the numbers so you have a better idea of the return on investment. Do you need to know if your employees feel appreciated? Do you want managers to have real-time coaching feedback? These are just two examples of how people analytics can make a difference.

Notably, these analytical tools are used to improve performance. If you have the data, you can find a system to be most effective. And with more advanced AI being created, systems will gauge an employee’s productivity based on whatever criteria you like — eliminating the guesswork.

Why is identifying strengths for upskilling important?

If you have a new task that requires new skills, should you hire a new employee for the job? The current trend says no, and to instead upskill current workers.

This process trains current employees in new skills and responsibilities that better suit their talents. If an employee is performing poorly in one area, that doesn’t necessarily mean he or she will not perform well in other areas.

Performance reviews offer a great opportunity for evaluating and identifying the skill sets of your employees. Since you’re discussing workplace performance anyway, floating the upskilling opportunities is a way to retain employees who are already familiar with your organization.

Like most trends, employee reviews will continue to develop. This means it is time to prioritize your approach.

Insights Employee Benefits is brought to you by JRG Advisors

In the struggle with health care costs, diligence and ingenuity count

Organizations continue to grapple with providing health care access while limiting cost hikes.

A 2018 Gallagher survey of employers found that 74 percent consider health benefits cost management a top priority, yet 44 percent don’t have an effective strategy. These respondents also cited the high costs of medical services, prescription drugs and specialty drugs as their top three health care cost-management challenges.

Smart Business spoke with Joe Roberts, area vice president at Gallagher, about health care cost-management tactics.

Why should cost shifting be avoided?

The goal of effective cost management is to repurpose health care spend without disrupting premiums, coinsurance rates and deductibles. Cost shifting should be avoided because employees and their families suffer the financial pressure of higher expenses.

Some tactics that employers take to contain health care spend can actually weaken their ability to manage important health outcomes, like physical and emotional well-being. An example is an employee who responds to cost shifting by avoiding the expense of medical care. At worst, the employee could end up in the hospital for an untreated condition. At best, the employee may have escaped that outcome or the employer would have paid less for the hospital stay — if the plan incentivized regular care. Cost-management tactics may also affect morale, workplace culture and oher intangibles.

Employers should explore less common tactics that are gaining traction.

  • Provide employees with cost transparency tools.
  • Offer health care decision support.
  • Use a specialty pharmacy benefit manager.
  • Carve out pharmacy benefits.
  • Use reference-based pricing for health care services.

They also should closely review the language in vendor contracts.

How can data-driven insights help identify needed benefits changes?

Employers walk a thin line between providing access to medical and pharmacy coverage and containing health care costs. Data analysis helps them negotiate that narrow passage, but the trick is obtaining rich data and quality analyses. When a data analysis skims the surface, employers may fall short of their health care cost-containment goals. A comprehensive, strategic analysis can assist in several ways.

  • Identification of cost drivers: A standard analysis identifies how certain types of care affect cost; a deeper look detects what causes treatment trends. For example, an employer attributed an eight-year cost decrease to a well-being initiative, until a more complete analysis assigned greater impact to workers retiring.
  • Informed purchasing: Benefits trends sometimes entice employers to jump on board, like disease management programs focused on high-cost conditions like asthma. Targeted data analytics help employers understand not only the condition’s prevalence, but also whether costs are high enough to warrant a more robust disease management program.
  • Benefits design guidance: Specialty medications are expensive, but rebates help offset the costs. When making decisions about design, employers should analyze the implications of favoring one type of medication over another. Direct costs may be lower in the near term, but the loss of rebate could mean paying more over time.
  • Empowered decisions: Data help take the fear out of making decisions. Employers often shy away from choices that disrupt employee expectations and cause pushback, but this hinders innovative thinking. Data analysis can model the impact of benefit designs and pave the way for changes with lasting value.
  • Transparency: Employers purchase health care at a discount that may obscure the true costs. A larger discount looks good, but analysis can identify the unit price on which it’s based. A greater discount may not mean paying the lowest cost.

Too often, employers turn to familiar tactics and a standard-level analysis that doesn’t keep health care costs in check. When employers routinely dig into data and explore the value of newer tactics, they can curb perpetual financial challenges. By cost-effectively getting the right treatments to the right people at the right time, they also increase employee well-being.

Insights Employee Benefits is brought to you by Gallagher

Voluntary benefits cover the needs specific to your employees

Voluntary benefits are in high demand as employers recognize that a robust benefits portfolio helps them meet the diverse coverage needs within today’s workforce. The demand is also driven by the popularity of employee choice and low cost.

“There is no one-size-fits-all when it comes to meeting the needs of a multiple-generational workforce. Competition is fierce when recruiting and retaining the best talent. This makes voluntary benefits a must-have in today’s employee benefits packages,” says Michael Orangis, sales executive at JRG Advisors. “By offering a spectrum of coverage options, employers send the message, ‘We listen, we care and our company is worth working for.’”

Smart Business spoke with Orangis about how voluntary coverage options can enhance your overall benefits program.

What do companies need to know about voluntary benefits?

Voluntary benefits have proven to be a popular, cost-effective method for an employer to offer a broad palette of benefits that provide employees choice. These types of benefits feature guaranteed issue and simple enrollment. And because premiums are paid through employee payroll deduction, there are no checks to write, making these benefits easy to administer.

Further, difficult economic times in the wake of rising health care costs mean tough health plan design choices for business owners. For many, adding voluntary benefits to compensate for benefits cutbacks elsewhere or to enrich a health plan with a high deductible makes good sense.

How do these benefits work?

With a voluntary benefits portfolio, employees are encouraged to focus on their coverage and affordability needs. Instead of employer-sponsored group accident, critical illness, disability, life, vision and dental insurance, business owners see the wisdom of providing these benefits on a voluntary, a-la-carte basis for employees to choose.

Not only will offering voluntary benefits cost employers virtually nothing, it will also help to level the playing field with competing employers. And, employees gain access to unique types of insurance coverage at group rates that are lower in cost than buying on their own.

What should an employer consider when offering voluntary benefits?

First, employers must show their support for the benefits program if they want the employees to see the value of voluntary benefits for themselves and their families.

An employer should talk to employees to help determine what offerings would be most useful. Employers need to carefully examine their current benefits package to determine which benefits are popular and those that are not. Most importantly, employers need to determine the type(s) of voluntary benefits that offer the most value for the lowest cost. This is crucial to the success of the voluntary benefits program.

As the program is implemented, education is key. Employers should educate employees on what voluntary plans are available and the benefits of enrolling. Employers also should follow up with employees on a regular basis throughout the plan year to ensure they are satisfied, there are no problems and that no changes need to be made with the plans offered.

In the end, voluntary benefits are special because they meet the specific needs of the valued workforce. Employers can easily offer these benefits and keep costs down, while enhancing the complete package of benefits and coverages. Employees are able to make informed selections of benefits that meet their unique needs, ultimately increasing their engagement and satisfaction with the benefits program.

Insights Employee Benefits is brought to you by JRG Advisors

Is your insurance investment maximized?

Benefits costs and employee expectations continue to rise. So, the expertise offered from your benefits broker is a critical consideration.

“Most employers struggle to maintain insurance coverage and a healthy financial bottom line. Historically brokers earned your business by representing the lowest price. But in today’s employee benefits landscape, you need experienced representation that delivers beyond the lowest price insurance plans. Premium and fee pricing differentiation represented by agents and brokers is largely marginal.

“Today, the balance between coverage and cost is achieved by differentiation in consultative services, supplemental benefits and complementary products and services,” says Dennis Spingola, vice president of operations at JRG Advisors.

Smart Business spoke with Spingola about getting the most from the employee benefits broker relationship.

What can a consultative broker offer?

A consultative broker can do much more than just place your coverage. A consultative broker is a partner who learns about your challenges and needs, and supports you with a variety of resources and services.

Serving in an advisory role, a consultative broker develops the customized multiyear strategic plan to achieve your objectives now and into the future. The plan may include streamlining HR operations, implementing wellness platforms, and accessing data to support plan designs and funding alternatives. Above all, a consultative broker is your partner, educational resource and champion of your initiatives and requirements.

What is an example of a results-driven strategy?

An alternative premium funding arrangement is a popular strategy that supports health risk management and wellness initiatives. A consultative broker will carefully consider the many options of funding to ensure there is a plan to meet long-term goals for the business, while minimizing disruption to the workforce.

The inclusive funding approach can lead to informed, engaged and healthier employees and family members. Not only does this curb the costs of health care, it can lead to less absenteeism due to illness, more productive employees and improved morale. The consultative broker can combine the funding arrangement that works for you with a wellness program that includes everything you need to implement, monitor and measure outcomes.

How might a consultative broker handle risk management and HR support?

Proper management of Employee Retirement Income Security Act (ERISA) and Affordable Care Act compliance requirements is of significant importance. The consultative broker will remove the burden of complicated mandates and mitigate the risk of costly fines associated with a Department of Labor audit. Education is paramount in this area, so timely bulletins explaining new and changing rules and regulations are key. Working with a consultative broker who makes available an ERISA attorney is another differentiator for peace of mind and reduced overall costs.

HR responsibilities and benefits administration can be daunting. HR professionals are asked to do more than ever before. A consultative broker provides access to employee newsletters and benefits announcements, as well as sample documents and expert advice for crafting policies, forms, benefits summary statements, handbooks and more. Providing technology for online 24/7 access to an array of resources, coupled with an employee self-serve benefits portal, is a game changer.

Employers are faced with a variety of issues when it comes to running a successful enterprise. Choose a benefits professional who is consultative and equipped to provide the range of solutions and creative strategy that solves your challenges and supports your business objectives.

Insights Employee Benefits is brought to you by JRG Advisors

Taking your benefits plan for a ‘test drive’

Considering changes to your employee benefits plan can be a perplexing process. And the risk associated with making any plan modification is heightened when the supporting data are not available.

In today’s health care environment, however, plan design adjustments need to be considered far more frequently due to the pressures of managing costs.

“Providing a comprehensive benefits package is a vital component to attracting and retaining employees. Employers need to carefully consider how changes to the benefits plan design can affect their current and future workforce,” says Aaron Ochs, managing consultant at JRG Advisors. “When considering plan changes, partner with an experienced benefits professional who can utilize plan modeling to determine your best benefits strategy.”

Smart Business spoke with Ochs about how plan modeling helps employers to identify the best use of resources and to engage in experimentation without taking on risks.

What is plan modeling?

Plan modeling makes it possible to create scenarios that consider how medical claims would be paid given various plan design modifications. The analysis also identifies problem areas within the plan. With the results of the professional analysis, employers can consider the realistic solutions that are aligned with their coverage and cost objectives.

For instance, if emergency room costs were disproportionately high, an employer could consider raising the emergency room co-pay, while educating employees about 24/7 telemedicine and urgent care facilities. This would create a lower out-of-pocket cost for these more convenient options to the expensive ER visit.

Even if an employer is just thinking about making plan design adjustments because it suspects it would drive better claims results, the use of modeling can help the employer test-drive those changes before implementing them. The results of the modeling will help an employer see the outcome of suggested changes to its current benefit structure, before actual implementation.

How specifically might the plan benefit from modeling?

Plan modeling gives employers the ability to see the likely impact of plan changes beforehand.

With access to the data provided by plan modeling, employers can identify the strategies that fit the employee population coverage needs and the company goals. Employers mitigate the risk of a benefits design misstep like implementing drastic changes to popular — and necessary — benefits offerings.

With these data points, an employer can make educated, strategic decisions that balance the financial benefit with employees’ coverage and access needs. Some models even illustrate how many employees will be affected by each change, allowing employers to truly balance value and cost.

What are the popular plan changes?

Some of the more popular plan modifications include adjustments to deductibles and co-insurance, office visit versus specialist co-pay, urgent care versus emergency room co-pay, tiered rates for prescription drugs and Health Savings Account plans.

Identifying and managing even just a fraction of costs can generate significant savings year-over-year. That is because the smallest percentages of identified high-spending areas represent the most promising potential for savings. And, the more models employers run, the more likely they will find hidden ways to curb benefits costs.

In a burgeoning area where employers are trying to manage expenses, plan modeling is essential. With this approach, employers can consider changes without having to wait until after implementation to measure success.

Insights Employee Benefits is brought to you by JRG Advisors

Bridging the gap of time, distance and affordability in health care

As technology develops, so too have the improvements and capabilities with the delivery of health care.

“Telehealth innovations in the health care industry are a significant step forward in mitigating rising health care costs,” says Ron Carmassi, client advisor at JRG Advisors.

He added that technology can lead to better outcomes and lower costs, thus saving time and money for the patient, provider and insurance company.

Smart Business spoke with Carmassi about how telehealth can be a supplement or temporary substitute for traditional medical care.

What is telehealth?

Telehealth utilizes technology to facilitate communication, whether real-time or delayed, between a doctor and patient.

One advantage is that medical evaluation, diagnosis and treatment can be accomplished without the doctor and patient being in the same location. In other words, telehealth accomplishes the virtual doctor vist. It also facilitates the exchange of medical information from one location to another so that the evaluated patient can seek treatment in a convenient clinical setting.

How does telehealth help both doctors and patients?

Telehealth offers numerous benefits for doctors and patients. Here are a few of the advantages.

Remote accessibility — The primary functions of telehealth are efficiency and convenience of the communication between the patient and doctor. With this technology, doctors can reach patients in remote, rural and underserved areas where there might not be an available doctor or hospital.

Additionally through telehealth, patients can access doctors for routine visits, emergency care or diagnostics from a specialist from the comfort of their home or the convenience of their workplace.

Specialist availability — Telehealth also provides increased access to specialists. Even when patients live in urban areas with numerous doctors and hospitals, specialists for some health conditions may not practice in the area. This technology enables patients in both rural and urban areas to easily connect with specialists who may be hundreds of miles away.

Cost savings — Patients save money for routine and specialist care because they do not have to pay travel expenses for distant doctors or take excessive time off from work. Additionally, many health plans offer telehealth visits at lower copayments than a primary care physician or specialist visit.

Doctors participating with telehealth also can serve more patients in a day, which can reduce overhead and related costs. With remote monitoring through telehealth services, the larger costs associated with hospitalization, in-home nursing and chronic conditions management can be significantly lessened. For example, remote monitoring provides proper supervision of a patient following discharge from the hospital, which reduces hospital readmissions.

Convenience of care — For some patients, the comfort and convenience of consulting with a doctor from their homes is a tremendous advantage. The convenience also can improve care. For example, whereas patients often forget to bring medications with them to a traditional office visit, when patients are at home they have ready access to the information necessary for the doctor to diagnose and prescribe.

Also, because the patient is at home, it is often easier to take notes or even include a family member who can help retain important information from the doctor.

Fueled by technological advances and answering the demand for consumer-convenient care, telehealth is widely offered through all insurance companies and delivers many advantages. Although not the same as sitting in an actual doctor’s office, a telehealth visit with a doctor can prove beneficial by warding off further illness or disease, stabilizing a condition until a patient is able to reach a hospital or monitoring a patient at home.

Telehealth is not a complete replacement for face-to-face health care, but it can be a helpful supplement and even a temporary substitute for traditional medical care.

Insights Employee Benefits is brought to you by JRG Advisors

How workplace culture props up wellbeing initiatives, and vice versa

More employers recognize that employees’ physical and emotional wellbeing affects job performance. That’s one reason why 41 percent offer a wellness program and an additional 29 percent expect to adopt this benefit by 2019, according to a 2017 Gallagher survey.

What employers may not realize is how significantly their culture and work environment can influence wellbeing outcomes — for better or worse.

Workplace-induced stress has been linked to depression, diabetes, absenteeism, disability and employee turnover. Medical research also shows a relationship between chronic stress and opioid misuse. These findings help explain why it’s important for employers to have both effective wellbeing initiatives and a workplace culture that doesn’t inadvertently undermine these initiatives or employers’ larger objectives.

Smart Business spoke with Joe Roberts, area vice president, Benefits & HR Consulting, Gallagher, about how to empower a healthy workforce.

Realistically, what can employers do to help employees better manage stress?

It’s not possible to eliminate stress entirely, but employers can equip employees to manage stress and the challenges that cause it in wiser, more agile ways. Helping them develop resilience is one key opportunity.

How does improved resilience translate to healthier employees?

Resilience in a work-life integration context means the ability to withstand, grow and adapt, while weathering personal, professional and societal stressors.

Research from the American Heart Association shows that resilience among employees is associated with reduced stress, greater job satisfaction, work happiness, organizational commitment and employee engagement. The benefits of resilience, however, extend beyond the individual. Individual resilience helps build organizational resilience, making it easier to withstand the inevitable ups and downs of striving to achieve organizational goals.

What role do managers play in this equation?

Managers can make or break workplace culture. Equipping them to help build a better employee experience is one of the biggest challenges employers encounter. Many managers have technical expertise but aren’t experienced in guiding and supporting others’ performance. Yet, creating proficient people managers is critical.

Managers impact whether employees perceive their work environment as positive, and how those employees experience that environment can affect their physical health. For instance, research has found stressful working conditions may contribute to injuries. At least one study suggests a negative work environment can also contribute to poor health outcomes because of increased stress.

How can employers give managers the skills to better support the people under them?

Several methods can help managers grow in their roles and actively contribute to a positive, supportive work environment.

On a large, collaborative scale, focus groups, engagement surveys and similar opportunities for direct and indirect dialogue allow employees to have a voice in decisions that affect them. Management that solicits feedback — and takes it into account when making decisions — shows respect for the wants and needs of the workforce. Employers also gain an outlet for ideas.

Tactics that center on the individual employee include defining clear performance goals, giving timely and constructive feedback, communicating in a way that fosters trust and confidence, and supporting employees in developing and pursuing a career path.

A 2017 Gallagher benchmarking survey of mid-sized and large employers shows that top-performing employers use these tactics more often than their same-size peers.

Certainly, many factors affect the ability of employers — and their workforce managers — to build a sustainably engaging culture and productive work environment that drives the business results they’d like. But a reliable, guiding principle for developing a resilient workforce empowered by that culture is: Do whatever is possible to take care of the employees that take care of the business. It’s a no-lose proposition, because the culture that helps employees thrive helps the business thrive, too.

Insights Employee Benefits is brought to you by Gallagher

Are you an applicable large employer?

The Affordable Care Act (ACA) doesn’t require all employers to offer coverage to their employees. Only those employers defined by federal law as applicable large employers (ALEs) must make health insurance available.

“Accurately calculating and knowing your company’s ALE status is crucial to ACA compliance and helping your company avoid a costly penalty,” says Judy Griffith, compliance officer at JRG Advisors.

Smart Business spoke with Griffith about how to determine your ALE status to see if you must offer health insurance.

What exactly is ALE status?

An employer that had an average of at least 50 full-time employees on staff per month during the prior calendar year is an ALE.

ALE status must be determined each year. This determination is vitally important to a business or organization’s ACA compliance. ALEs are subject to the employer shared responsibility and information reporting provisions for offers of minimum essential coverage to employees.

How do employers determine if they are an ALE or not?

You must consider many items to determine whether an organization employs 50 full-time employees and is therefore an ALE. The first question to think about is how are full-time employees defined under the ACA? Full-time employees include an employee who works 30 hours or more per week or employees working 130 or more hours in a calendar month.

Full-time equivalent employees are also included in the count of full-time employees. Full-time equivalent employees are not full-time employees. Instead, the number of full-time equivalent employees is determined by combining the number of hours of service for all part-time and variable hours employees working 120 hours or less during the month and dividing that total by 120.

This number only counts toward the total number employees per month for determining if the employer is an ALE. It won’t change an individual employee’s status from part time to full time, which affects whether an offer of coverage must be made.

How are seasonal workers reflected?

Employers who exceed 50 full-time employees (including full-time equivalent employees) are not considered ALEs where the business employs seasonal workers if certain conditions apply. First, the company’s total workforce must only exceed 50 full-time employees for 120 or fewer days during the year. Second, the employees who exceed 50 full-time employees during those 120 or fewer days must be seasonal workers. Seasonal workers are generally defined as employees who work on a temporary or seasonal basis, such as retail employees who work during the holiday season or summer staff at a swimming pool.

What happens if a company is part of a larger ownership group?

Companies with common ownership may be part of a controlled group, which requires employers to aggregate the total number of employees across the group to determine if the included companies are ALEs. In other words, the employees of every company within a controlled group determine if any company within the controlled group is an ALE.

Also, for a calendar year in which an employer is an ALE, the regulations applicable to ALEs apply to each company within the controlled group regardless of whether the individual company has 50 or more full-time employees or full-time equivalent employees.

What else do employers need to know?

The final item to consider is the definition of a common law employee. Common law employees are generally defined as workers whose work schedule is controlled by the employer (rather than by the worker himself or another employer).

Employers should closely review the job duties and expectations for workers from temporary staffing agencies and those classified as independent contractors because their employment status can be easily confused. These workers may be considered employees who count toward a company’s full-time employee or full-time equivalent employee number. Failure to correctly account for these employees can result in a false conclusion as to whether an employer is an ALE.

Insights Employee Benefits is brought to you by JRG Advisors