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Author: Site Staff

Posted on June 30, 2009August 31, 2018

Dear Workforce Why Are Companies Taking an Interest in Health Audits

Dear We May Be Overpaying:


Eligibility audits are designed to spot inadequate procedures—and lack of enforcement—that contribute to overpayment of health claims. Although employees often resist the idea, most audits provide an amnesty period during which ineligible dependents can be removed with no penalties.

 

Correcting eligibility requires plan sponsors to develop an employee documentation process. This concept is not new, but it does result in decreasing claims exposure.

Specialty audit firms can be helpful in performing eligibility reviews since they have the necessary staff to handle the administrative requirements of the process. These requirements include developing and sending initial notification letters to all employees with dependent coverage; collecting documentation; answering calls from employees wanting clarification or information; and providing updated eligibility information to other plan vendors.

Eligibility audits should be considered, for example, if a health plan:

 

  • Does not require certified dependent documentation.
  • Recently changed administrative service providers.
  • Has recently experienced a merger or acquisition.
  • Has a high turnover rate or collects enrollment information from multiple sources.
  • Does not receive monthly adds/drops from the plan administrator.

Eligibility audits can also help plan sponsors answer such questions as:

  • Are system updates timely?
  • Are overpayments identified and recoveries pursued following retroactive changes?
  • Is there exposure to high-dollar claims for dependents not qualifying for stop-loss coverage?

It’s easy to see why employers are looking at eligibility audits as a way to combat rising benefit costs, but they cannot be the only arrow in the quiver. There is no substitute for a well-thought-out health benefits plan aligned with an employer’s objectives that is diligently administered.

SOURCE: MaryAnne Watson and Don Cardone, the Segal Co., Phoenix, November 28, 2007

LEARN MORE: You can learn how companies are using dependent audits.

The information contained in this article is intended to provide useful information on the topic covered, but should not be construed as legal advice or a legal opinion. Also remember that state laws may differ from the federal law.

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Dear Workforce Newsletter
Posted on June 30, 2009August 31, 2018

Senators Consider Dropping Required Employer Coverage From Health Care Reform Bill

Senators who are trying to craft a bipartisan health care reform proposal are considering dropping a requirement that all employers provide medical coverage to employees.


In its place would be a “free rider” provision requiring employers to pay for employees who get their health care with government assistance, according to an outline of the committee’s policy proposals.


The legislation from the Senate Finance Committee is expected to be released after the July Fourth holiday. Two other drafts of health care legislation, one in the Senate and another in the House, would require employers to provide health insurance to employees.


Retailers and other businesses that have minimum- or low-wage employees, such as Wal-Mart, oppose the free-rider clause, which they are describing as a backdoor mandate, says a source who asked not to be named but who is familiar with Wal-Mart’s health care policy stance. Around 2.5 percent of Wal-Mart employees receive Medicaid, according to the company.


The Center on Budget and Policy Priorities, a policy group whose work focuses on low- and moderate-income individuals and families, said the free-rider clause could discourage companies from hiring low-income workers and employees with disabilities. People who are poor or disabled are eligible for Medicaid.


The policy group said an employer mandate was preferable because most employers would choose to provide adequate coverage. The fine paid by employers that choose not to provide coverage could help the government recover the cost of insuring workers who do not get insurance through an employer.


Last week, Senate Finance Committee Chairman Max Baucus, D-Montana, said his committee had shaved about $600 million off the cost of health care reform. The new price tag, $1 trillion over 10 years, would be achieved by taxing health benefits and replacing an employer mandate with a free-rider provision.


According to the outline that became public last week, the free-rider clause would require employers to pay half the average national cost of Medicaid for every employee who receives Medicaid. An employer would have to pay the full cost of any tax credit an employee uses to purchase health insurance.


An employer would not have to pay into the cost of Medicaid if the company offered health insurance that was considered affordable. The proposal says health insurance is affordable if it costs no more than 12.5 percent of a worker’s income.


That proposal alone would save the government $300 million, according to Sen. Kent Conrad, D-North Dakota and chairman of the Senate Budget Committee.


A proposal to tax health care benefits could generate as much as $418 billion, the bulk of the money needed to pay for health care reform without increasing the federal government’s deficit.


—Jeremy Smerd


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Posted on June 29, 2009August 31, 2018

Some Attendees and Vendors Optimistic About SHRM 2009 Despite Low Attendance


While it may have seemed like the thin gathering that this year left vendors at SHRM’s 61st Annual Conference & Exposition in New Orleans with little to do, one attendee wished the folks in the booths would have done a little more than stand around with their hands in their pockets.


“I wish they’d be more aggressive and come out to talk to me,” said Tameka Flowers, operations recruiting manager for the University of Phoenix. “I want them to reach out and engage me.”


According to numbers released Monday, June 29, there were 6,853 attendees at the Society for Human Resource Management’s 2009 conference as of Sunday night.


That’s less than half the final tallies from the organization’s two previous gatherings, according to figures provided by SHRM officials that were included in stories published by Workforce Management. In 2008, 13,435 people attended the 2007 show in Las Vegas.


Despite the sparse crowds, traffic was good for the Employment Guide, said creative director Michael Godina.


The Norfolk, Virginia-based firm has 20 employees working the 30-by-30 booth, Godina said.


“Sure, the smaller crowds are a function of the economy,” said Godina, who is attending his fourth SHRM conference. “The networking with other companies has been extremely beneficial. But we got over 200 leads in just three hours Sunday night. Traffic has been great for us.”


—Rick Bell


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Posted on June 29, 2009August 31, 2018

Supreme Court Rules for White Firefighters on Job-Test Case

A narrow majority of the Supreme Court ruled on Monday, June 29, that New Haven, Connecticut, could not justify throwing out the results of employment tests that would have promoted only white firefighters to the rank of lieutenant or captain.


The 5-4 majority said that the city had to show a “strong basis in evidence” that the exams were not job related or that another, less discriminatory test existed.


The decision is sure to have an impact on the private sector, where employment tests are increasingly popular. Experts are urging companies to be careful when using them in the wake of the Supreme Court’s ruling.


After administering the promotion tests in November and December of 2003, the city decided not to certify the results because of concerns that it was not fair to African-American candidates and could leave the city open to a lawsuit.


Based on the tests, all the top 10 candidates for lieutenant were white and seven of the top nine for captain were white, along with two Hispanics.


The white firefighters, led by Frank Ricci, sued New Haven, arguing that they were unfairly denied promotions. A district court granted summary judgment in favor of New Haven, and the ruling was upheld by the 2nd Circuit Court of Appeals, where Supreme Court nominee Judge Sonia Sotomayor participated in the decision.


The Supreme Court majority overruled the 2nd Circuit, holding that New Haven effectively discriminated against the white firefighters in order to prevent discrimination against the African-American applicants. The former, “disparate treatment,” and the latter, “disparate impact,” are both prohibited by federal discrimination laws.


But the court ruled that in order to protect minorities against disparate impact, the city had to demonstrate that there was something wrong with the test, which it failed to do.


“[T]here is no evidence—let alone the required strong basis in evidence—that the tests were flawed because they were not job-related or because other, equally valid and less discriminatory tests were available to the city,” wrote Justice Anthony Kennedy for the majority that included Chief Justice John Roberts Jr. and Justices Antonin Scalia, Clarence Thomas and Samuel Alito Jr.


“Fear of litigation alone cannot justify an employer’s reliance on race to the detriment of individuals who passed the examinations and qualified for promotions,” Kennedy wrote.


In a dissent, Justice Ruth Bader Ginsburg said that the majority ignored evidence of flaws in the New Haven tests.


Ginsburg also noted that the court’s decision would prevent New Haven from achieving a diverse workforce. Despite having a population that is nearly 60 percent African-American and Hispanic, the city “must today be served … by a fire department in which members of racial and ethnic minorities are rarely seen.”


Writing for Justices David Souter, John Paul Stevens and Stephen Breyer, Ginsburg argued that an employer that scotches a test that disadvantages a minority group does not commit disparate treatment. In fact, the employer could only use such a test if it is a “business necessity.”


The majority’s position will make it harder for companies to stay within discrimination laws, according to Ginsburg.


“The strong-basis-in-evidence standard, however, as barely described in general, and cavalierly applied in this case, makes voluntary compliance a hazardous venture,” Ginsburg wrote.


Employment lawyers cautioned companies to proceed warily now that the Supreme Court has made it more likely that they must live with the results rather than change the test.


“Undertaking employment tests should be well thought out before [they] are utilized,” said Linda Cavanna-Wilk, of counsel to Ford & Harrison in New York. “The decision significantly increases the legal risk associated with the use of selection devices or employment tests. An employer’s back is somewhat against the wall.”


Companies must be prepared to show that exams are relevant in the hiring process.


“Employers really need to be careful to the way they design these tests to ensure that the questions in fact relate to the duties of the position,” said Peter Mina, an associate at Tully Rinckey in Washington.


In a pre-emptive strike against opponents of Sotomayor, Sen. Charles Schumer, D-New York and a member of the Senate Judiciary Committee, downplayed the fact that her position on the case was overturned by colleagues she may soon join if the Senate confirms her to replace the retiring Souter.


The Supreme Court majority “merely chose to look at the record in a different way,” Schumer said.


—Mark Schoeff Jr.


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Posted on June 29, 2009August 31, 2018

Health Care Reform Legislation Priced at Under $1 Trillion, Officials Say

The Congressional Budget Office said a slate of legislative options shaped in the Senate Finance Committee could be priced under $1 trillion and expand coverage to 97 percent of Americans even while some Republicans expressed doubts.


“We are much closer on scores from CBO,” said Senate Finance Committee Chairman Max Baucus, D-Montana. “In fact, CBO now tells us we have options that would enable us to write a $1 trillion bill fully paid for.”


While a bill has yet to emerge from the committee, Baucus nevertheless said the number-crunching from CBO moves them closer toward a bipartisan agreement. Still, Sen. Orrin Hatch of Utah, a senior Republican on the Finance Committee, cautioned that the numbers could be premature and would likely change.


“You can’t really make decisions until you’ve seen the language and seen the scoring,” he said, referring to the CBO cost assessment.


The announcement follows a frantic couple of days in which key lawmakers have met behind closed doors in an effort to trim about $600 billion from a set of proposals that would be used to frame a broad bill to overhaul the U.S. health care system.


It also comes as President Barack Obama continued to seek public support for reform, an effort that included a televised town hall meeting at the White House on Wednesday, June 24.


Lawmakers from both parties declined to comment on specifics of how the bill would be paid for or which options were tweaked in order to lower the overall cost.


Senate Budget Committee Chairman Kent Conrad, R-North Dakota, however, said the committee had been able to reduce costs by lowering the amount of money the federal government would pay to help subsidize some Americans as they transition from one payer group to another.


“By altering those subsidy levels, you get the more favorable scoring that shows the bill can be paid for,” he said.



Filed by Matthew DoBias of Modern Healthcare, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.


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Posted on June 28, 2009August 31, 2018

SHRM Conference Attendance Lower in New Orleans; Association to Create Social Network for Members

With preliminary attendance figures off by about 4,000 attendees from 2008, the opening day of the Society for Human Resource Management’s annual conference gave the general membership its first introduction to its new leader, as well as a fresh look at employee benefits.


During Sunday’s press conference following former GE chief Jack Welch’s keynote address at the 61st annual SHRM conference in New Orleans, the organization released its 2009 Employee Benefits Survey. Sixty percent of HR professionals say the recession has caused their organization to cut back or maintain benefits offerings, according to the June 28 release.


“Six of 10 employers say the recession has affected benefits,” said SHRM director of research Steve Williams. “Companies are scaling back on some benefits, including executive bonuses and relocation.”


A companion survey noted that the recession has not affected overall job satisfaction. Employees ranked job security as key to job satisfaction, followed by benefits, compensation, opportunities to use skills and abilities, and feeling safe at work, the survey noted.


New SHRM president and CEO Laurence “Lon” O’Neil opened the day’s events, offering the general assembly a glimpse into what SHRM will offer its membership in the future.


“We are adapting to meet your needs; how can we help members during these tough times?” said O’Neil, who was absent from the later press conference because of scheduling conflicts. “SHRM’s mission is more needed now than ever. These are the most challenging times in history.”


O’Neil, who said a social networking site soon will be rolled out for members, also praised those in attendance and reassured them by adding, “You’re not alone when you’re a member of SHRM.”


Preliminary attendance figures noted that as of Saturday, there were 6,808 attendees, compared with the roughly 11,000 members who attended the SHRM conference last year in Chicago and 13,000 attendees in 2007 in Las Vegas. Figures also showed there are 594 exhibitors this year in New Orleans.


Additional conference highlights include:
• The establishment of the Susan R. Meisinger Fellowship, a $10,000 annual stipend that will be awarded to a graduate-level student pursuing a master’s degree focused on human resources. The award recognizes Meisinger, who retired in 2008 as SHRM’s president and CEO, for her belief in education furthering the HR profession.


• The announcement that SHRM’s Curriculum Guideline in practical HR theory has been adopted by more than 100 universities globally.


—Rick Bell


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Posted on June 25, 2009June 27, 2018

About the HR Anxiety Survey

Workforce Management surveyed 372 HR professionals who are registered users of the Workforce Management Web site and who work at organizations of 100 or more employees where layoffs have been conducted in the past 18 months. Forty-three percent of the respondents work at organizations of 5,000 or more employees. A third of respondents are at organizations of 1,000 to 4,999 workers. Ten percent are at organizations with 100 to 999 employees. Thirty-seven percent of the respondents have the title of HR manager; 30 percent are HR directors. The balance of respondents have other HR titles, such as vice president of HR, chief human resource officer or HR generalist. The survey responses were collected from May 26 through June 3.

Workforce Management, June 22, 2009, p. 19 — Subscribe Now!

Posted on June 24, 2009June 27, 2018

LinkedIn Connects With New CEO

LinkedIn on Wednesday, June 24, named Internet industry veteran Jeff Weiner as its CEO.


Weiner, who had served as interim president of the professional networking site since January, also was appointed to LinkedIn’s board of directors.


Weiner is taking the helm of one of the pioneers in the social networking field, which is blossoming partly because people are pushing to improve their employment prospects amid the recession.


LinkedIn founder Reid Hoffman, who served as CEO from December of last year until this month, has become executive chairman of the Mountain View, California-based firm.


“LinkedIn was founded to harness the power of the Internet to create a tool that would help individuals become more effective and successful professionals,” Hoffman said in a statement. “Over the past six months, Jeff has done an exceptional job leading the company and I look forward to continuing the work that we have begun together.”


Founded in 2003, LinkedIn allows people to create profiles of themselves, connect with others and communicate with people in their extended networks.


While some other early social and business networking sites such as ZeroDegrees have faded, LinkedIn has grown stronger over the years. It boasts more than 42 million members worldwide, up from 30 million members last October.


The firm has secured more than $100 million in funding from investors including Sequoia Capital, Greylock Partners and SAP Ventures.


LinkedIn says it turned a profit in 2008 and expects to be profitable again this year. A shift in online recruiting practices is goosing those results.


Organizations that once relied on general purpose job boards are turning to alternative strategies, including social networking sites, search engine marketing and niche job sites.


In a May study by research firm AIM Group, nearly 45 percent of recruiters surveyed said they used networking sites such as LinkedIn and Facebook with mixed or great results.


LinkedIn offers services to recruiters including expanded results when searching the LinkedIn network, targeted job postings and direct access to candidates.


In February, LinkedIn said it saw responses to job postings on the professional network double from six months earlier.


Earlier this year, the company also introduced what it called “custom company profiles” with “viewer-aware” information. These profiles are designed to adapt to viewer characteristics such as location and industry.


Recruiting industry analyst Peter Weddle named LinkedIn one of the top 100 job boards this year. He says the site makes networking easier, but notes that networking is a time-consuming method for landing candidates.


LinkedIn “is a site with great potential for recruiters,” Weddle says. “We’re still trying to figure out how to use it efficiently.”


Weiner has more than 14 years of consumer Web experience. Before joining LinkedIn as interim president, Weiner was executive in residence at venture capital firms Accel Partners and Greylock Partners. Greylock helped finance LinkedIn.


He also held leadership roles at Yahoo, most recently serving as executive vice president of Yahoo’s network division with responsibility for Yahoo’s consumer Web product portfolio, including Yahoo’s front page, mail, search and media products.


—Ed Frauenheim


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Posted on June 24, 2009June 27, 2018

House Panel OKs 401(k) Fee Disclosure, Defined-Benefit Plan Funding Relief

Legislation approved Wednesday, June 24, by the House Education and Labor Committee would require improved disclosure of fees and other financial information to 401(k) and other defined-contribution plan participants, as well as provide some modest funding relief for defined-benefit pension plans.


The defined-benefit plan funding relief may be only the first of additional changes, with committee Chairman George Miller, D-California, describing the funding relief provisions as a “work in progress.”


Under the measure, H.R. 2989, approved on a 29-17 vote, service providers would have to disclose to employers all fees assessed against a participant’s account, with those fees broken down into four categories: administrative, investment management, transaction and other fees.


That would change the practice of some service providers, especially mutual funds, that include fees, such as record keeping, in the expense ratio of the investment funds they provide.


The proposal also would mandate quarterly statements be provided to participants that detail contributions, earnings, account balances and all fees taken out of their accounts.


In addition, the measure includes a provision that would effectively require defined-contribution plans to include at least one market index fund as an investment option.


The measure also would delay the effective date of regulations mandated under a 2006 law that toughened funding requirements. Under current law, the rules can be effective as soon as July 1. The amendments to be added to the bill would delay the effective date until January 1, 2010, at the earliest.


Until then, employers could make a good-faith interpretation of the law’s funding requirements.


In addition, employers would be given more flexibility in choosing an interest-rate methodology to value pension plan liabilities in 2009 and 2010.


An amendment proposed by Rep. Brett Guthrie, R-Kentucky, and approved by the committee on a voice vote would require employers to only pay interest on 2008 losses in 2009 and 2010, but the seven-year amortization of losses—set under the 2006 funding reform law—would not begin until 2011.


The funding relief provisions are “good positive changes,” with a possibility that legislators will consider additional relief proposals, said Kyle Brown, an attorney with Watson Wyatt Worldwide in Arlington, Virginia.


On the other hand, more employers would be required to report plan actuarial and financial information to the Pension Benefit Guaranty Corp. Under current law, only plans that are less than 80 percent funded have to report this information to the PBGC.


The legislation would change that requirement so reporting such information would be triggered if plan underfunding exceeded $50 million.


Such a change is needed, according to a committee summary, “since large plans that are more than 80 percent funded can still be underfunded by hundreds of millions of dollars, the PBGC is not getting information on many underfunded plans.”


It isn’t clear yet if the measure will now go straight to the full House or whether the Ways and Means Committee, which also has jurisdiction on pension issues, will take up the bill.



Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.


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Posted on June 24, 2009June 27, 2018

HR Outsourcing Providers Eye Buying ExcellerateHRO

A number of HR outsourcing providers are interested in buying ExcellerateHRO from Hewlett-Packard if the firm is in fact up for sale, insiders say.



“We know a number of people are interested, but we don’t know if any of them have gotten discussions going with HP,” said Lowell Williams, executive director of EquaTerra, a Houston-based information technology and business process transformation consulting firm.


Earlier this month, Hewlett-Packard bought Towers Perrin’s shares of ExcellerateHRO, causing industry experts to speculate that the Palo Alto, California-based company is preparing to sell the HRO provider. HP bought EDS in May but hasn’t shown any interest in ramping up its HRO business.


“Our assumption has been that ExcellerateHRO is dead since no attention has been paid to it since the EDS acquisition,” said Stan Lepeak, managing director of global research at EquaTerra. “They hadn’t been getting much traction in the market anyhow, and reviving it would require a significant investment.”


In the four years since ExcellerateHRO was established, it has made only two end-to-end HR business process outsourcing deals and a number of benefits administration deals, experts say.


Still, the company could be a great addition to an HRO provider that is strong in benefits administration, Williams said.


“ExcellerateHRO had about 10 to 15 benefits deals, so they would be a good fit for companies that are big into benefits like Hewitt Associates, Affiliated Computer Services or Fidelity Investments,” he said.


Calls to a spokeswoman at Hewitt were not immediately returned. A Fidelity spokesman and an ACS spokeswoman declined to comment. An HP spokeswoman declined to comment.


ACS, in particular, could be a likely candidate to purchase ExcellerateHRO because it has been ramping up its HRO business in the past several months, said Phil Fersht, an analyst at AMR Research.


In May, the Dallas-based company launched SynchHRO, a self-service standardized HRO service targeting the midmarket as well as larger employers.


“ACS does seem to be doubling down on HRO,” Fersht said.


Other possible buyers could be the Indian HRO providers, such as Infosys, which are looking to gain market share in the U.S., Lepeak said.


“This could be a way for them to gain a local presence in terms of HR acumen and connections,” he said.


—Jessica Marquez


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