A Healthcare Communications Game Plan
HR leadership must make informed decisions about when and how to communicate with employees about the law's impact on their group-health-plan coverage. But staying silent on the issue should not be an option.
By Jackie Cuthbert and Amy Bergner
So vast in scope is the Patient Protection and Affordable Care Act -- the law runs to more than 2,400 pages -- that it inevitably raises more questions than can possibly be answered in the short term.
When President Barack Obama signed the healthcare-reform bill into law on March 23, the political debate that had enveloped the issue of healthcare reform gave way to a new reality. Organizations and their employees across the United States now face the immediate and long-term impact of the law's many changes to the employer-based healthcare system.
And HR executives and other business leaders are tasked with responding to a new era in healthcare -- with some provisions of the law effective immediately and an array of others that will be in force by 2014 or later.
In the meantime, one of the key challenges is to manage communications effectively so that employees can reasonably know how healthcare reform will impact their employer-based coverage -- and when.
Unfortunately, many of the details are still unclear, so many employers await guidance from the federal government on issues such as restricted annual dollar limits on essential health benefits, and definitions of "reduced limits" and "essential health benefits."
As a result, it's not just employees who have concerns. Employers have a growing list of questions for Washington, health-insurance providers and benefits consultants.
Some employers may be reluctant, therefore, to communicate at all about healthcare reform to their employees until more is clarified; others may want to proactively communicate in order to answer some of the most basic questions, explain the most immediate changes and prepare their employees for the changes to come.
The extent of this communication may vary, certainly. At the most basic level, companies can consider a message to all employees that assures them that management is currently working with health and benefits experts to assess the potential implications of the new legislation on benefits offerings, emphasizing that some of these implications will only become clear over time as the provisions in the new law become effective and regulations are issued.
HR may also encourage employees to use the company's intranet or other means to submit questions and comments related to the legislation -- with the understanding that management will answer as many questions as possible in subsequent communications.
A more detailed communication strategy might involve providing employees with access to some "Healthcare Reform FAQs," offering a sequence of questions and answers designed to address the impact of law's immediate changes. For example:
"Q: What's going to change with my healthcare coverage and when?
A: The new law outlines the following requirements, to be implemented over the next couple of years.[Detail specific employer-plan changes] Additional provisions will be rolled out through 2018; however, things will continue to evolve over time, so we're focusing only on the immediate, short-term changes right now."
Indeed, what is already clear about the many aspects of the law is certainly enough on which to base a reasonably informative communications effort -- and that begins with the relevant timeframes.
For most employer-based healthcare plans, the initial set of health-plan standards will take effect for plan years beginning six months after March 23, 2010. This means most insured and self-insured health plans must comply with the first standards for plan years starting on or after Sept. 23, 2010 (for example, calendar-year plans starting Jan. 1, 2011).
While most of the major reforms will take effect over the next several years, some provisions require all insured and self-insured group health plans to comply as early as 2010, and these are the changes that can serve as a relevant focus of HR communications.
The first round of coverage and cost-sharing standards apply for plan years beginning six months after March 23, 2010 -- that is, Jan. 1, 2011, for calendar-year plans. Employers and their vendors clearly need to focus first on these standards, which set the following coverage and cost-sharing terms:
* Require extending dependent coverage to age 26 for children ineligible for other employer coverage;
* Ban lifetime dollar limits;
* Restrict annual dollar limits for essential health services;
* Prohibit pre-existing condition exclusions for children younger than 19; and
* Bar rescinding coverage, except in specific circumstances.
The law's long-term implementation horizon, its complexity and the continued uncertainty that many employers will experience as they await clarifications and regulations may prove daunting when it comes to formulating an HR game plan for communicating to employees.
But the fact remains that the healthcare-reform law will affect most employers and their employees. Good communication begins with a solid grounding in the facts, and so there are a number of immediate actions that employers should take to prepare for change, utilizing the informational resources and expertise available from their third-party providers, whose services extend to communication strategies as well as to broader guidance about the impact of the law.
Thus, a successful strategy to implement and communicate the relevant provisions of the law would proceed from the following immediate actions:
* Gain an understanding of the new law's many and varied provisions.
* Assess the impact of the law's earliest requirements on plan design and cost.
* Analyze the financial impact of the law's employer-related penalties and requirements, such as the shared-responsibility, free-choice voucher and high-cost-plan excise-tax provisions.
* Identify plans that may require special analysis or treatment, such as multi-employer, collectively bargained or retiree-medical plans.
* Create and begin to implement administrative and compliance strategies.
With such a strategy underway, employers can make the most of their growing understanding of the healthcare-reform bill and HR leadership can make the most informed decisions about when and how to communicate with employees about the law's impact on their group-health-plan coverage.
Moving beyond the initial phase of messaging, FAQs and the like, plans can evolve toward more extensive and definitive communication, including group information sessions for management, employees and even healthcare-reform "clinics" and hotlines, depending on organizational style and size.
There's no question that the new law poses an HR challenge like few, if any, that have come before, but a proactive approach to understanding the law is the key to success in communicating it.
Jackie Cuthbert is a principal in Mercer's Workforce Communication and Change business in Atlanta. Amy Bergner leads the Health and Benefits team in Mercer's Washington Resource Group. The WRG is a national legal resource for Mercer consultants and clients on legislative and regulatory developments, tax, ERISA, HIPAA, employment law, and other federal and state law issues. The organization's
website
offers employer resources regarding healthcare reform, including information about monthly Webcasts.
May 10, 2010 Copyright 2010© LRP Publications
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