WHEN
EMPLOYEES PAY FOR HEALTH CARE, THE BOSS PAYS TOO
QUESTIONS
BESIEGE MR. BOND AS WORKERS TRY TO SCRIMP IN HIGH-DEDUCTIBLE
PLAN MR. MILLER'S
CHEAPER PILLS
Last year Russ Moore
Transmission Inc. adopted a health-insurance plan
in tune with the "consumer driven" philosophy
President Bush has been touting. The plan requires
employees to pay as much as $5,250 a year in medical
costs out of their own money before insurance
kicks in, with the goal of turning them into savvy
shoppers for doctors and drugs.
The new strategy
has motivated some workers to research what they
are paying for medical care. One found an over-the-counter
replacement for a more expensive brand-name heartburn
drug. That is good news for Nick Bond, who runs
the business and had suspected some employees
were overusing medical care because they didn't
have to pay for much of it themselves.
The bad news: The
employees'
research often consists of going to Mr. Bond and
asking for his help, even after they have had
19 months to get familiar with the plan. At one
point, he and his office manager had to hole themselves
up in their offices for about two weeks developing
a spreadsheet with price information on 32 drugs.
Mr. Bond's
experience suggests that although information
about the price and quality of health care remains
sketchy, the president's push to make the health-care market
more like the market for other services can change
consumers'
behavior. However, some managers have to turn
themselves into instant experts both on health
care and on the law. Mr. Bond knows about a transmission
rebuilder's heartburn, a technician's
blood-pressure medication and a visit to the emergency
room by a mechanic's
daughter. If he uses health information in firing
or demoting an employee -- or is perceived to
do so -- he might be in for a lawsuit.
"There are things
I'm
not supposed to know -- but I know," says Mr.
Bond, who is part-owner and general manager of
the company previously run by his father-in-law.
Under most health-insurance
plans, once employees pay their share of monthly
premiums, their upfront out-of-pocket costs are
at a relatively manageable level. Those with family
coverage pay on average the first $700 or so of
costs themselves -- what is called a deductible
-- and modest co-payments for visiting a doctor
or buying drugs.
Consumer-driven
plans usually have a much higher deductible. Many
of these plans also come with a sweetener: some
kind of account to use for medical expenses. A
popular option is the tax-advantaged "health savings
account," a Republican initiative that was passed
by Congress in 2003. As of January, nearly 3.2
million people were enrolled in insurance plans
that enable them to open HSAs, according to the
trade group America's Health Insurance Plans.
Sarah Rubenstein September 25, 2006
TAKING
A FRESH LOOK AT YOUR BENEFITS
If you haven't
already, you'll
soon be getting materials from your employer for
your company's
open enrollment season – the time when employees
look at their benefit choices and determine whether
to make any change for 2007.
More than ever,
this is an annual fall ritual that you should
take seriously because more of the responsibility
is being put on employees to fund their health
care as companies seek to cut costs in every way
they can.
"In this age of
'consumerism,' open enrollment is often the one
time of year when employees have the chance to
act like true consumers by evaluating their benefits
coverage and ensuring that they don't
have gaps or costly overlaps in coverage," said
physician Ronald Leopold, vice president of MetLife's institutional business.
The good news is
that MetLife's
2006 Study of Open Enrollment Benefits Trends
found that most workers look forward to their
employer's open enrollment period.
"The MetLife study
suggests that individuals increasingly recognize
that it's
their responsibility to fund their own benefits,
and they are willing to pay the price for peace-of-mind
protection," Dr. Leopold said.
To make the best
decisions about your benefits, go through this
checklist:
- Review the benefits
you used last year and evaluate the money you
allocated to those various benefits. "Understanding
all of your options will help you better estimate
your future needs, and enable you to make more
efficient trade-offs about which benefits are
most important to you," according to Hewitt
Associates, a human resources consulting firm.
·
Take
into account any major life event, such as marriage,
divorce or childbirth. Those events affect your
needs.
- Make a list of
the major preventive and diagnostic procedures
you're
likely to need, and make sure your health and
dental plans cover those services.
- Consider any benefits
your spouse may have so you don't pay for double coverage if you
don't
need it. Compare coverage levels and cost to
get the best plans.
Employers are becoming
pickier when it comes to covering dependents and
spouses.
"Human resource
professionals and CFOs [chief financial officers]
are getting tremendous pressure to reduce the
cost of their employer's
health-benefit cost," said Marva DeVault, senior
vice president of Willis of Texas in Dallas, a risk-management and
employee-benefits consulting firm. "Self-insured
plans have a fiduciary responsibility to ensure
plan assets are not used to pay claims for ineligible
participants." Monday, September 25, 2006
HEALTH-CARE
PREMIUMS RISE 7.7%, OUTPACING WAGES AND INFLATION
The health-care
premiums of employers and their workers have climbed
twice as fast as wages and inflation in 2006 --
to nearly double their cost in 2000 -- and look
to rise at a similar clip next year, two nationwide
surveys show.
The average family
premium rose 7.7% in 2006, marking the third year
employer health-care cost increases have slowed
since soaring nearly 14% in 2003, according to
a 2,122-employer survey by the Kaiser Family Foundation
and Health Research and Educational Trust. (See the survey's findings1.)
After several years
of steady steep rises, the cost for family coverage
under an employer health plan is now $11,480,
well over the annual wage of a full-time minimum
wage worker and beyond what many companies, mostly
smaller businesses, and their workers can afford.
While 98% of firms with more than 200 workers
still provide some sort of employee health benefits,
only 60% of smaller companies do. That's little changed from last year
but down from 68% in 2000.
"A modest reduction
in an already high rate of increase hardly looks
like salvation for employers and workers who've been getting hammered by high
health-care costs year after year," said Drew
Altman, president of the Kaiser Family Foundation,
a nonprofit health-policy research group based
in Menlo Park, Calif.
Even when employers
do offer health insurance, not all workers get
it or can afford it. On average, only 78% of employees
are eligible at these companies, either because
they don't work full-time or fail to meet
other eligibility requirements. And given that
employers require workers to pay and average 27%
of the total premium -- or $2,973 for family coverage
-- many employees can't
afford to accept the coverage. Indeed, the share
of workers covered by health insurance through
their own employer has fallen to 59%, down from
60% last year and 63% in 2000, according to the
Kaiser survey. Vanessa Fuhrmans September
26, 2006
EEOC
FINALLY DEFINES 'RACE' AND 'COLOR' IN CONNECTION WITH DISCRIMINATION
SUITS
RACE
& COLOR DISCRIMINATION
With the enactment
of the Civil Rights Act of 1964, Congress sought
to eliminate the problems of segregation and discrimination
in the United
States. The impetus
for the Act was the civil rights movement of the
1950s and 1960s, which challenged the denial of
the right of Blacks to participate equally in
society.
The employment title
of the Act — Title VII — covers employment discrimination
based on race, color, religion, sex, national
origin, or protected activity. Title VII’s prohibitions
against race and color discrimination were aimed
at ending a system in which Blacks were “largely
relegated to unskilled and semi-skilled jobs.”
(1) However, Congress
drafted the statute broadly to cover race or color
discrimination against anyone – Whites, Blacks,
Asians, Latinos, Arabs, American Indians and Alaska
Natives, Native Hawaiians and Pacific Islanders,
persons of more than one race, and all other persons.(2)
Today, the national
policy of nondiscrimination is firmly rooted in
the law.(3) In addition,
it generally is agreed that equal opportunity
has increased dramatically in America, including
in employment. Blacks and other people of color
now work in virtually every field, and opportunities
are increasing at every level.
Yet significant
work remains to be done. Charges alleging race
discrimination in employment accounted for 35.5
percent of the Commission’s 2005 charge receipts,
making race still the most-alleged basis of employment
discrimination under federal law.(4) In addition,
several private studies conducted in the early
2000s provide telling evidence that race discrimination
in employment persists. A 2003 study in Milwaukee found that Whites
with a criminal record received job call-backs
at a rate more than three times that of Blacks
with the same criminal record, and even at a rate
higher than Blacks without a
criminal record.(5) A 2003 study
in California found that temporary
agencies preferred White applicants three to one
over African American applicants.(6) And, a 2002
study in Boston
and Chicago
found that résumés of persons with names common
among Whites were 50 percent more likely to generate
a request for an interview than equally impressive
résumés of persons with names common among Blacks.(7) EEOC.gov
September 26, 2006
U.S.
COURT
APPROVES EMPLOYERS RIGHT UNDER FMLA TO PRORATE
BONUS
A U.S. court has ruled
that employers may prorate employee production-based
bonuses for employees who take leave under the
Family and Medical Leave Act (FMLA). The decision
was reached by the Third U.S. Circuit Court of
Appeals in the case of Sommer versus The Vanguard
Group.
The court was faced
with the decision as to whether or not Vanguard
illegally interfered with Sommer’s FMLA rights
when, upon his return from approximately eight
weeks of short-term disability FMLA leave, it
did not award him a full annual bonus payment
under its Partnership Plan. Instead the company
awarded him a payment prorated on the basis of
the time he was absent. Central to this question
for the court was a determination of what the
bonus program rewards.
Previously, in a
summary judgment dated August 10, 2005, the District
Court for the Eastern District of Pennsylvania
determined that the Vanguard Partnership Plan
is a production bonus and that the company had
not unlawfully interfered with Sommer’s FMLA rights
by prorating his bonus.
“In conclusion,
we hold that the hours-based Vanguard Partnership
Plan is a bonus program designed to reward employee
production, which may be prorated to account for
the hours not worked by those employees who take
FMLA leave. Accordingly, Vanguard’s proration
of Sommer’s Partnership Plan bonus for the time
he spent on short-term disability FMLA leave did
not interfere with his FMLA rights,” the court
opinion said. September 21, 2006
WorldatWork Staff {www.ca3.uscourts.gov]
THOMPSON
V. BI-STATE DEV. AGENCY
In an employment
discrimination action brought by bus driver-employee
who took a disability pension after an accident,
summary judgment for employer is affirmed where
defendant was not constructively discharged from
his position and was unable to make out a prima
facie case of discrimination under the Americans
with Disabilities Act (ADA), and he also failed
to present evidence of a causal connection between
prior lawsuits and his employer's
decision to take disciplinary for purposes of
a retaliation claim. September 25, 2006 FindLaw.com
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