Category: Employee Benefits


Hidden Opportunities: Mental Health Parity…A Lucid Approach

Mental Health Parity…A Lucid Approach

Join us on Thursday, April 21 from 12:00 to 12:30 CST for the fourth webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, to learn why mental health issues, costs, and administration continue to increase despite Mental Health Parity efforts and how to effectively respond.

Presenters

  • Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
  • Wes Rogers, Humaculturist® and strategy consultant
  • Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant

Objective

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act and Transparency in Coverage to create a competitive advantage for both the employer and employees. In this session we will include a focus on how investing in the organizational soil is “A Lucid Approach” and an example of a strategic action to build organizational resilience and mental fitness by leveraging the purpose, alignment, and health of the organization.

Mental Health Parity Key Takeaways

During this session, participants will learn:

  • Mental Health Parity in health benefits has not reduced mental health issues
  • In fact, mental health issues continue to increase despite efforts to equalize benefits
  • Mere CAA compliance will increase costs and administration
  • How investing in the soil is “A Lucid Approach” and an example of a strategic action to:
    • Avoid what can be avoided
    • Leverage the purpose, alignment, and health of the organization
    • Build organizational resilience and mental fitness
    • Communicate all negatives as the result of compliance
    • Leverage behavioral design to achieve meaningful impact

Webinar Replay: A “Dope” Response to Pharmacy Transparency

A "Dope" Response to Pharmacy Transparency

Watch a replay of the third webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on why the new pharmacy transparency law will not increase transparency; will increase costs, administration, and litigation risk; and how to effectively respond.

Presenters

Objective

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on leveraging Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as an example of a strategic action organizations can take to optimize this compliance opportunity.

Pharmacy Transparency Key Takeaways

During this session, participants will learn:

  • Transparency is a misnomer – New rules don’t provide transparency
  • Pharmacy is likely to continue to be rather “opaque”
  • The conundrum – mere compliance will likely increase costs, administration, and litigation risk
  • How to use Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as examples of strategic actions to:
    • Avoid what can be avoided
    • Provide true transparency with pharmacy benefits
    • Empower consumers to make better, more clinically appropriate decisions
    • Communicate all negatives as the result of compliance
    • Inform/educate consumers (before they become patients)

Available Support

We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us: [email protected].

Watch

Watch the Hidden Opportunities: Preserving the Harvest…Leveraging HSAs Webinar Replay below, or via Rumble or YouTube.

Hidden Opportunities, A Strategic Compliance Series: A “Dope” Response to Pharmacy Transparency

A "Dope" Response to Pharmacy Transparency

You can now access a replay of this webinar here.

Join us on Thursday, March 17 from 12:00 to 12:30 CST for the third webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, to learn why the new pharmacy transparency law will not increase transparency; will increase costs, administration, and litigation risk; and how to effectively respond.

Presenters

Objective

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act and Transparency in Coverage to create a competitive advantage for both the employer and employees. In this session we will include a focus on leveraging Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as an example of a strategic action organizations can take to optimize this compliance opportunity.

Pharmacy Transparency Key Takeaways

During this session, participants will learn:

  • Transparency is a misnomer – New rules don’t provide transparency
  • Pharmacy is likely to continue to be rather “opaque”
  • The conundrum – mere compliance will likely increase costs, administration, and litigation risk
  • How to use Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as examples of strategic actions to:
    • Avoid what can be avoided
    • Provide true transparency with pharmacy benefits
    • Empower consumers to make better, more clinically appropriate decisions
    • Communicate all negatives as the result of compliance
    • Inform/educate consumers (before they become patients)

Webinar Replay: Preserving the Harvest…Leveraging HSAs

Hidden Opportunities: Preserving the Harvest...Leveraging HSAs

Watch a replay of the second webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on Surpassing Mere Compliance and includes an example of leveraging Health Savings Accounts (HSAs) to use tax preferences to finance what can’t/shouldn’t be avoided, promote financial well-being, and make benefits more distinctive in talent attraction and retention.

Presenters

  • Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
  • Wes Rogers, Humaculturist® and strategy consultant
  • Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
  • Kelley C. Long, CPA/PFS, CFP®, accountant, financial well-being planner, coach, and consultant

Objectives

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on Surpassing Mere Compliance and includes Reference Based Pricing as an example of a strategic response to use tax preferences to “preserve the harvest” by financing tax effectively what can’t/shouldn’t be avoided with the No Surprises Act.

Leveraging HSAs Key Takeaways

During this session, participants will learn:

  • Why the No Surprises Act is likely to be inflationary – increasing employer and employee costs
  • How employees are financially fragile and aren’t prepared for out-of-pocket expenses
  • Why Transparency Rules present opportunities to help employees become better consumers
  • How to communicate all negatives as necessary due to compliance
  • How HSA-eligible coverage with an HSA is one strategic action you can take to:
    • Use tax preferences to finance what can’t/shouldn’t be avoided
    • Use design levers to reduce plan and participant cost
    • Create a distinctive design to attract and retain talent (self-selection)

Available Support

We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us: [email protected].

Watch

Watch the Hidden Opportunities: Preserving the Harvest… Leveraging HSAs Webinar Replay below, or via Rumble or YouTube.

Hidden Opportunities, A Strategic Compliance Series: Preserving the Harvest…Leveraging HSAs

Hidden Opportunities: Preserving the Harvest...Leveraging HSAs

This webinar can now be accessed from Here.

Join us on Thursday, February 17 from 12:00 to 12:30 CST for the second webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which will focus on Surpassing Mere Compliance and include an example of leveraging Health Savings Accounts (HSAs) to use tax preferences to finance what can’t/shouldn’t be avoided, promote financial well-being, and make benefits more distinctive in talent attraction and retention.

Presenters

  • Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
  • Wes Rogers, Humaculturist® and strategy consultant
  • Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
  • Kelley C. Long, CPA/PFS, CFP®, accountant, financial well-being planner, coach, and consultant

Objective

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act and Transparency in Coverage to create a competitive advantage for both the employer and employees. In this session we will include a focus on leveraging HSAs as an example of a strategic response to use tax preferences to finance what can’t/shouldn’t be avoided with the No Surprises Act.

Leveraging HSAs Key Takeaways

During this session, participants will learn:

  • Why the No Surprises Act is likely to be inflationary – increasing employer and employee costs
  • How employees are financially fragile and aren’t prepared for out-of-pocket expenses
  • Why Transparency Rules present opportunities to help employees become better consumers
  • How to communicate all negatives as necessary due to compliance
  • How HSA-eligible coverage with an HSA is one strategic action you can take to:
    • Use tax preferences to finance what can’t/shouldn’t be avoided
    • Use design levers to reduce plan and participant cost
    • Create a distinctive design to attract and retain talent (self-selection)

Webinar Replay: Surpassing Mere Compliance – Including Reference Based Pricing

Hidden Opportunities, A Strategic Compliance Series: Surpassing Mere Compliance - Including Reference Based Pricing

Watch a replay of the first webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on Surpassing Mere Compliance and includes an example of using Reference Based Pricing.

Presenters

  • Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
  • Wes Rogers, Humaculturist® and strategy consultant
  • Jack Towarnicky, LLM, JD, MBA, CEBS, strategy and compliance consultant

Objectives

Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on Surpassing Mere Compliance and includes Reference Based Pricing as an example of a strategic response to avoid compliance with many aspects of the No Surprises Act.

Surpassing Mere Compliance Takeaways

During this session, participants will learn:

  • The No Surprises Act doesn’t eliminate all “surprises”
  • The No Surprises Act is likely to be inflationary
  • Mere compliance won’t reign in costs, will increase administration, and may increase litigation risk
  • Using Reference Based Pricing as one example of strategic actions you can take to:
    • Avoid what can be avoided
    • Use tax preferences to finance what can’t/shouldn’t be avoided
    • Communicate all negatives as the result of compliance
    • Inform/educate consumers (before they become patients)

Available Support

We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please Contact us.

Watch

Watch the Hidden Opportunities: Surpassing Mere Compliance – Including Reference Based Pricing Webinar Replay below, or via Rumble or YouTube.

Hidden Opportunities, A Strategic Compliance Series: Surpassing Mere Compliance – Including Reference Based Pricing

Hidden Opportunities, A Strategic Compliance Series: Surpassing Mere Compliance - Including Reference Based Pricing

This webinar can now be accessed from Here.

Join us on Thursday, January 20 from 12:00 to 12:30 CST for the first webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which will focus on Surpassing Mere Compliance and include an example of using Reference Based Pricing.

Presenters

  • Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
  • Wes Rogers, Humaculturist® and strategy consultant
  • Jack Towarnicky, LLM, JD, MBA, CEBS, strategy and compliance consultant 

Objective

Beyond basic compliance, this series will address how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. In this session we will include a focus on Surpassing Mere Compliance and include Reference Based Pricing as an example of a strategic response to avoid compliance with many aspects of the No Surprises Act.

Surpassing Mere Compliance Takeaways

During this session, participants will learn:

  • The No Surprises Act doesn’t eliminate all “surprises”
  • The No Surprises Act is likely to be inflationary
  • Mere compliance won’t reign in costs, will increase administration, and may increase litigation risk
  • Using Reference Based Pricing as one example of strategic actions you can take to:
    • Avoid what can be avoided
    • Use tax preferences to finance what can’t/shouldn’t be avoided
    • Communicate all negatives as the result of compliance
    • Inform/educate consumers (before they become patients)

Hidden Opportunities, A Strategic Compliance Series

Hidden Opportunities, Strategic Compliance Series

Please join us on the third Thursday of the month over the next five months for our upcoming strategic compliance series. This series will focus on harnessing Hidden Opportunities in the No Surprises Act and Transparency in Coverage regulations.

In this webinar series we explore ways organizations can go beyond basic compliance and improve their “organizational soil” through a strategic response to the No Surprises Act and the Transparency in Coverage regulations. Our goal is to help organizations create a competitive advantage. Does it make sense to expend limited resources to merely comply with the law and regulations, or is there a way to strategically “design the compliance away” while strategically differentiating the employee value proposition?

For example, a knowledgeable horticulturist may use the high temperatures of the summer season, which are a normal part of the environment just as law and regulation are a normal part of the business environment, to solarize the soil. This is a low cost and simple process of spreading a plastic sheet over an area of soil to trap and intensify the sun’s energy. It is a process that works well to destroy weed seeds and pathogens. Similarly, a knowledgeable Humaculturist® can employ techniques to leverage laws and regulations to strategically improve the organization. This webinar series seeks to identify some of these techniques.

The topics for the upcoming series will include:

Hidden Opportunities: No Surprises Act 
January 20, 2022 12:00-12:30 CSTSurpassing Mere Compliance – Including Reference Based Pricing
February 17, 2022 12:00-12:30 CSTPreserving the Harvest…Leveraging HSAs
Hidden Opportunities: Transparency 
March 17, 2022 12:00-12:30 CSTA “Dope” Response to Pharmacy Transparency
April 21, 2022 12:00-12:30 CSTMental Health Parity…A Lucid Approach
May 19, 2022 12:00-12:30 CSTPest Management, Minimizing Plan Losses through Fee Disclosure

To view a video on the Humaculture, Inc. Compliance Toolkit that can help support your basic compliance efforts, click here.

Available Support

We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us.

Steve Cyboran Brings Humaculture® Perspective on Data Driven Results

Steve Cyboran on a Panel to Discuss Data Driven Results

Steve Cyboran brings the Humaculture® Perspective to a panel discussion on Data Driven Results for HR Professionals. Join Steve on October 21, 2021 at the Junior League for the Houston Compensation & Benefits Luncheon.

When:

October 21, 2021
11:30 AM CDT – 1:15 PM CDT
Add to Calendar

Where:

Junior League of Houston
1811 Briar Oaks Lane
Houston, TX 77027

Register: Here

Employee Benefits – The Humaculture® Perspective

Photos above: Just as different plants thrive in different soils, different people also thrive in different organizations. Aloe vera thrives in thin, rocky, dry soil. Similarly, there are also certain organizations that employ people who may primarily have access to benefits through a spouse or parent and don’t require rich benefits. Other organizations may need moderate benefits (like drip irrigation on grapes) designed and structured to nurture them to thrive properly. Still other organizations may require benefits designed to protect and nourish employees, much like lettuce requires mulch and abundant moisture.

Did any person, or any organization, ever become great by striving to be average? Many business leaders instinctively look at what every other organization in their particular industry is doing, then defensively adopt benefits that make their organization “competitive” with their peers. But, does this approach really make an organization distinctive and magnetic to talented people who will lead to success? Is it really a good idea to attract employees who are concerned primarily about benefits?

Understanding the Nature of the Organization – Vision, Mission, and Strategy

The horticulturist understands that different plants, different production goals, and different climates require soils to be built in specific and intentional ways. Each planting bed is designed with climate, soil texture and drainage, fertility, pH, and other factors in mind based on the types of plants and crops desired. So, the successful horticulturist begins with a vision and mission, then develops a strategy based on the vision and mission while considering climate and available resources. While other inputs may be required (irrigation, support, row covers or other protection), the soil is the key. Without well designed soil one can typically expect mediocre results at best. The most successful gardens “feed the soil, not the plant.” A well-chosen plant in well-designed and prepared soil will naturally thrive and produce the desired fruit.

To be successful and highly effective, organizational leaders must take a similar approach. Each organization has different goals, different purposes, and operates in different business, social and legal environments. All of these factors will have tremendous impact on how the organization is able to attract, engage, grow, retain, sustain, and transition employees or other people who will in some way be a part of, and grow, in the organizational “soil.” Many leaders have at least some idea of their organization’s vision and mission, even if only informally. They also know they need the “right” employees to carry out the strategy to accomplish the vision and mission, so much so that the focus becomes “feeding the plant, not the soil.” But failing to understand the importance of building a good organizational “soil” substantially reduces the effectiveness of recruiting, compensation, benefits, well-being initiatives, engagement, safety, and any other perk or program directed at employees.

Pitfalls of the “We Offer Excellent Benefits” Approach

One large health system sought to have only the “very best” benefits, desiring to be viewed as cutting edge to potential employees and to motivate current employees, which is popular among progressive and innovative organizations. The health system combined the Paid Time Off (PTO) benefits for 7 recently integrated entities by adopting a richest benefit approach. This put the new, larger system above the 75th percentile of its peers. However, the workforce plan and job designs did not allow employees to effectively use those benefits, which led to a lot of frustration and inequitable use. It’s a little like over fertilizing plants, they may be “burned” by the excessive fertilizer. The intent of PTO is to recharge and re-energize people so they can better perform in their job. In this case, the employees felt resentment over a benefit they couldn’t readily access and still meet the patient and business needs of their jobs. There must be an appropriate balance between no time off and full time off. It is important that the PTO be designed for optimal performance. The strategic workforce plan and jobs should then be designed for the level of time off provided (e.g., preparing organizational “soil” to allow the employees to use the PTO benefit to help them thrive).

Similar scenarios are repeated in many organizations, especially as organizations look to benefits and other benchmark surveys to guide their benefit choices. So often, organizations implement or modify benefits programs based on benchmark studies, then struggle with high benefits costs and look for the latest “cost containment” measures, programs, or services. For example, a large utility maintained a traditional sick leave program to remain “competitive” with its industry peers. The 100% pay replacement led to over-utilization, excessive costs, scheduling challenges, and increased time to manage employee relations issues related to absence. It simply became much harder to manage and was not attracting and retaining the employees who would best thrive and contribute to continue to build the organizational “soil.” Yes, “everyone else” was doing it but the choice to be average led to high costs and failed to make this organization distinctive and magnetic to the employees who could best produce the intended “fruit” and nourish the “soil”.

How We Design Benefits from a Humaculture™ Perspective

Humaculture™ recognizes that the organization itself is the key to a thriving, engaged, and contributing workforce that leads to success. Benchmarks are good against which to test designs and cost levels to assure they are distinctive and magnetic, but the designs should first support the vision and mission of the organization. While many advisors may suggest, for example, a healthcare organization should provide rich health care benefits, the Humaculture™ approach would view it a little differently. Humaculture™ would focus on the vision to model healthier behaviors, understand the consumer choices their patients are making, and differentiate the type of talent that may choose their organization (e.g., make the benefits less rich for those who aren’t willing to engage in healthier behaviors).

Such a design would support the organization’s effort to attract, engage, grow, retain, sustain, and transition employees who will buy-in to the vision and mission, be fruitful, and contribute to the tilth of the organizational “soil.” Well-designed soil requires fewer inputs of fertilizer, pesticides, water, etc. to successfully produce a crop. Likewise, well-designed organizations, including benefits and compensation that are aligned to support the vision and mission of the organization, will have much lower costs and achieve greater results than those organizations who “burn” the employees with rich or misaligned benefits. For example, one health plan had a copay for emergency room (ER) visit but applied the deductible and coinsurance for office visits. After switching the design to copays for office visits and increasing the ER copay, ER utilization dropped by 20% and non-emergent ER costs dropped by 99%. Overall, the broader behavioral redesign rolled back the cost levels 3 years of double digit increases without increasing plan participant costs.

So, what steps should be taken to design and implement benefits that support the organizational vision and mission, as well as reduce costs and support employees who thrive? How should you begin to develop an effective Humaculture™?

  1. Either develop or formalize and articulate the Organization’s vision, mission, and strategic priorities.
  2. Consider and design benefits that support the vision, mission, and strategic priorities.
  3. Optimize benefit design by applying principles of behavioral economics and choice architecture.
  4. Develop metrics that will provide actionable insights into the performance of the benefit designs.
  5. Evaluate benefit effectiveness relative to vision, mission, and strategic priorities and performance.
  6. Modify designs accordingly and continue to measure and evaluate.

Applying these Humaculture™ principles will move your organization toward providing fertile “soil” for employees, reduce benefit costs (even before “cost management” techniques or services are used), and contribute to a much more productive and profitable organization. Please see our real world applications of this approach and the outcomes achieved with time off, health care, and financial well-being benefits. Take the Humaculture™ Benefits Assessment to conduct a high level analysis of how you are doing.

About Humaculture, Inc.
Humaculture, Inc. transforms organizations—the way organizational leaders understand the organization and the relationships among the people in it, and the way people think about their position and role in the organization. Humaculture™ is a philosophy and systematic approach for creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. Humaculture™ helps organizations create the right culture in order to naturally attract, engage, retain, sustain, grow, and transition people who enable the business—and each other—to thrive. More information can be found at: Humaculture.co. Learn more about our team at https://humaculture.co/who-are-we/.

Authors:
Wes Rogers, Chief Guidance Officer for Humaculture, Inc. Wes has almost 35 years’ experience in consulting and senior management positions with a variety of organizations, facilitating groups of people with diverse perspectives and objectives to coalesce around a singular vision and marshal resources to achieve the vision. This experience provides exceptional insights into how organizations operate and succeed.  Contact Wes at [email protected].

Steve Cyboran, ASA, MAAA, FCA, CEBS, Chief Behavioral Officer, Consulting Actuary for Humaculture, Inc. Over the past 30 years, Steve has worked extensively with leading corporations, higher education institutions, and health systems across the country to articulate a vision for a healthy and effective workplace culture, develop a total rewards strategy to support that vision and brings deep benefits expertise with a behavioral approach and sound analytics to achieve and measure the desired outcomes. Contact Steve at [email protected].


 

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