A Q&A with Scott Schanen, CEO of Dominium.

Recently, I attended the 2015 RIMS Annual Conference & Exhibition, where Integro, a specialty insurance brokerage firm, was an exhibitor. I had the chance to question Scott Schanen, CEO of Dominium, Integro’s national employee benefit consulting practice, about the current state of wellness programs, PPACA, private exchanges and the future of employee benefits.

The following is what transpired:

Q: Federal agencies seem to be really intent on making sure that wellness programs help keep employees not well. What do you think about the new guidelines? 

A: Philosophically, we don’t believe in restricting employers’ ability to incent healthy behaviors. We believe employers should be able to require completion of biometric screenings or health risk questionnaires to participate in the plan. Employers aren’t using this information to discriminate and they don’t know the results on an individual level. Such data is used to make employees aware of their own health risk factors and help provide them with programs to help improve their health. This will lead to lower cost in the long run and allow employers to continue offering health benefits in the future. 

Q: Are they clear enough?  

A: In some ways the recent guidance from the EEOC, while more restrictive than PPACA, is still a relief. Employers now know the boundaries for incenting wellness programs to avoid potential future litigation. Prior to the EEOC’s guidance, their stance wasn’t clear. There is still some question as to how the EEOC guidance impacts incentives for spouses, if it does at all. 

Q: Would they really affect any of Integro’s clients? 

A: Fortunately, there is little to no impact on many of Integro’s clients. Most clients have been very conservative with their incentive programs and are below the 30 percent threshold, even when including participatory programs.

Q: How is employee counting going? Has anything turned out to be harder or easier than expected?  

A: The process is still fairly new to employers and the variable hour reporting can be challenging. Our clients are looking to other third party service companies to provide the measurement and process. We expect this will continue into the foreseeable future.  

Q: Have you seen any change in employer interest in public group exchange coverage? Private exchanges? Dumping regular employer plans and sending workers out to get their coverage from the exchange? 

A: We’ve seen very little migration to public or private exchanges. A recent National Business Group on Health survey showed 2 percent of employers moved their active employees to private exchanges in 2014 and 1 percent planned to move in 2015. Most of our clients desire to maintain control of this benefit, which is highly valued by their employees.

Q: Do you expect the rest of 2015 and 2016 to be about the same? Do you expect to see any major changes in 2017? 

A: The big change on the horizon is the excise tax in 2018. This will force some employers to make benefit cuts to avoid the 40 percent tax on high cost plans. Democrats in Congress just introduced a bill to repeal the “Cadillac Tax,” so it will be interesting to see if the excise tax survives as it has opposition on both sides of the aisle.

Q: What health care initiatives does Integro have on the table right now? 

A: We are helping our clients evaluate everything from private exchanges to high performance networks, to tools that help employees become better consumers, to wellness programs that promote a healthy lifestyle, to programs that help employees manage their chronic conditions. There is no silver bullet. Every company has a unique culture and cost requirements. As such, our clients need solutions tailored to their situations.

See also:

Aetna: What PPACA problem?

These are the regulatory trends to watch for in 2015