Open enrollment in the new era of employee health benefits is almost here, and employers may have a problem. Although most indicate they are concerned that health care reform may produce challenges surrounding insurance coverage gaps and costs to their employees, a large number of American workers remain unaware, confused and unprepared for looming changes to their benefits coverage.

These are among the key findings of the 2013 Open Enrollment Survey, an online survey of 2,001 U.S. consumers conducted by Research Now in August and recently released by Aflac.

The Aflac study found that 69 percent of workers say their employer hasn’t communicated changes coming to their benefits package due to health care reform, despite the October 1, 2013, deadline for employers to notify their employees of their coverage options.

Employers’ delay in communication so far about potential employee benefits changes may be in part due to their own lack of preparation for health care reform. In fact, only 9 percent of companies indicate they are very prepared to implement required changes to their businesses based on the health care reform law at this time.2

Although the implications of health care reform are yet to be seen, some employers (41 percent) believe more gaps in coverage will be created and 69 percent believe costs to employees will increase as a result of health care reform.2

“At the heart of this issue is the fact that many workers will be blindsided this open enrollment season because we know they already struggle with understanding their insurance policies today, and in covering the high out-of-pocket costs from gaps in their current coverage,” says Michael Zuna, Aflac’s executive vice president and chief marketing officer.

“Over the next few months, these challenges will be exacerbated as employees may be more confused by changes in their policies and face greater gaps in their health insurance coverage, leaving them at risk. With little notice, education, and coverage options to help guide and support them during this season, employers themselves may be at risk of a highly dissatisfied workforce.”

For example, the 2013 Open Enrollment Survey found that:

• 74 percent of workers sometimes or never understand everything that is covered by their insurance policy today.
• Now, nearly 4-in-10 (37 percent) workers think it will be more difficult to understand everything in their health  are policy with the changes dictated by health care reform.
• Nearly a third (28 percent) of employees are confused, worried or simply unsure about the change their employer is making to their health care coverage or benefits options due to health care reform.
• 60 percent of workers have not begun to educate themselves about coming changes to their benefits package due to health care reform.

“The good news is there is an opportunity for employers who take a proactive role in helping employees effectively maneuver this new benefits landscape to make significant gains in worker satisfaction and retention levels,” says Zuna. “Through aggressive education and communication efforts, as well as leveraging ancillary benefits options to offer workers additional options to close growing gaps in their insurance coverage, employers can help their workforce make the right benefits choices and protect their wellbeing.”

Closing the gap

In addition to encouraging employees to do their own homework, employers should take advantage of available resources to help employees navigate this topic, including on-site visits from an insurance agent or broker, the survey notes.

Information sessions can not only provide an opportunity for employees to ask questions and receive relevant information to guide them to the best decisions for themselves and their families, but can also aid employers in determining the best benefits changes for their business.

In fact, employers named “insurance companies” as the most helpful source of information they have obtained on the health care law.2 One tool available to employers is a Health Care Reform Communications Toolkit ,which provides companies with resources needed to meet the October 1 deadline for informing employees about the Health Insurance Marketplace.

NAIFA launches ACA microsite

NAIFA has also launched a microsite that examines the Patient Protection and Affordable Care Act and subsequent regulations that NAIFA members can share with their clients as the law goes into effect.

“Many NAIFA members and their clients are counting down to the October 1 enrollment date and are facing a completely new healthcare landscape as the administration implements new elements of the law,” says NAIFA President-Elect John F. Nichols, MSM, CLU. “This site is designed to help members and their clients adapt to the changes, with resources that include a practical application guide for agents, brokers, and employers, an implementation timeline, and background materials on several other topics such as the marketplaces, essential health benefits and information about the individual mandate.”

There also is a brief analysis of the major policy issues surrounding the ACA, as well as NAIFA’s positions on these issues and links to external, topical sources. The site will provide the most up-to-date information as the implementation process moves forward to ensure that NAIFA members are the best informed in the industry.

NAIFA members at work

NAIFA members are working hard to reach out to organizations in their communities by offering advice to consumers that goes beyond plan enrollment. For example, one hospital system in Southwest Missouri officially will refer its patients to NAIFA members for advice, and the Tennessee Hospital Association is listing NAIFA Members as a reliable and trusted resource for consumers.

While the thousands of “navigators” hired will help consumers enroll through a state or federally-facilitated marketplace, consumers will require assistance that goes far beyond registering for a plan, Nichols adds.

“Agents and brokers do much more than sell insurance. They explain critical differences in plan options and coverage, which may involve substantial research and fact-finding about the client’s needs. They advocate on behalf of their clients, helping people when they have trouble getting procedures approved or claims processed. They also review coverage on a periodic basis, suggesting changes when appropriate and counseling on ways to reduce costs," Nichols says.

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By Ayo Mseka
Editor-In-Chief
Advisor Today