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  • 1. Presented by Jenny Sardi
  • 2.
    • The Objective
    • To exam the “Five W’s” of employee
    • benefits, and explore the purposes and
    • philosophies used by Employers as they
    • determine their benefit offerings
  • 3.
    • Who is covered by the benefit?
    • What is being protected by the benefit?
    • Why are employee benefits offered?
    • Where employee benefits are offered, (a look at the State and other regulatory considerations)?
    • When are employee benefits offered?
  • 4.
    • Wise spending of resources;
    • the Cost of providing
    • or not providing an employee benefit .
  • 5.
    • All forms of financial and tangible services and benefits employees receive as a part of an employment relationship.
  • 6.
    • Any form of compensation other than direct wages paid to an employee and may include:
      • Employers share of legally required payments, (Statutory Benefits)
      • Payment for time not worked (paid vacation, paid holidays, parental leave, etc.)
      • Employers share of medical and medically related payments
      • Employers share of retirement and savings plan payments
      • Others - employee discounts, tuition assistance, childcare
  • 7.
    • Employee Benefits are intertwined
    • with every aspect of an
    • Individual’s financial
    • and economic security.
  • 8.
  • 9.
    • Active Employees
      • Full-time and Part-time employees
      • Dependents of employees
    • Former employees
    • Retirees
      • Dependents of retirees
    • Others...
  • 10.
    • There is more diversity in the workplace - one size fits all benefits may no longer work.
      • Married or cohabitating couples,
      • Single head of households,
      • Caretakers for parents/children,
      • Employees that are still students, continuing education
      • And more
  • 11.
  • 12.
    • Employees are concerned with job security, family time, paying bills during times of income loss, adequate health insurance, making ends meet, saving for college, adequate childcare, and adequate elder care.
  • 13.
    • Medical Expense
      • Health Insurance
      • Dental Insurance
      • Vision Insurance
      • Flexible Spending Account
  • 14.
    • Losses due to disability
      • Workers Compensation
      • Statutory Disability
      • Long term disability
      • Social Security
    • Losses due to employee’s death
      • Life Insurance for Employee
      • Life Insurance for Dependents of employee
      • Key Man Policies
  • 15.
    • Retirement needs of Employee and Dependent
      • Saving Plans
      • Defined Contribution Plans
    • Loses due to unemployment
      • Unemployment Insurance
      • Reimburser for Unemployment
    • Others
  • 16.
  • 17.
    • Business reasons:
    • To attract and hold capable employees
    • To improve corporate efficiencies and productivity
    • Tax advantages offered to employers
    • A cost effective and administratively efficient distribution channel
  • 18.
    • Social reasons
    • A social objective
    • Because of “ Moral Suasion ” – to prevent further government programs
    • To improve employee morale
  • 19.
  • 20.
    • In one of the most heavily regulated States for Insurance
      • Community Rating
      • Statutory Benefits
      • Complex Workers Compensation requirements
    • Mostly in the small group market
    • Need to be aware of
      • Mandatory Benefits,
      • Regulatory Issues like COBRA and HIPAA, TEFRA and DEFRA
  • 21.
    • An example:
    • Statutory Disability – covers 50% up to a maximum weekly allowance of $170 a week.
      • There are very feasible options for enhancing this disability coverage
      • Offering additional voluntary disability protection to your employees may pay off for the employees as well.
  • 22.
  • 23.
    • Certain Benefits require a set number of hours
      • Community rating Health Insurance require employees to work 20 hours per week
      • Most Group Life or Dental programs require employees to work 30 hours a week.
    • Certain Benefits must be provided to all employees regardless of hours worked.
  • 24.
    • There are two types of benefits:
    • Protection Benefits
      • Protect employees against the risk of serious loss exposure.
      • Consist of medial expense benefits, life insurance, short and long term disability benefits.
      • The need for immediate protection is great and the reasons for a probationary period no longer make sense.
  • 25.
    • Accumulation Benefits
      • Consist of pension plans, bonuses, profit sharing, tuition assistance programs.
      • These benefits are used as rewards for service length and loyalty.
    • Determining when to apply a waiting period should be consistent with the overall employer objective and benefits philosophy.
  • 26.
    • There may be financial or social reasons to apply a waiting period with both the Protection Benefits and Accumulation Benefits,
  • 27.
  • 28.
    • Cost Shifting to Employees through premium contribution or through increased co-pays and deductibles.
      • PRO of Cost Shifting – allows the continued offering of coverage.
      • CON of Cost Shifting – is not a solution to the high increases experienced each year.
  • 29.
    • Alternative Health Plans and Funding Arrangements such as HSA Plans and HRA’S.
      • Pro of HSA – the employee has more control over health care options, can allow unused dollars to build.
      • Con of HSA/HRA – upfront deductible is not always feasible for the employee , especially in the first year.
  • 30.
    • Look at your benefit priorities through the Five W’s process.
    • Review all of your benefits and services to see where gaps and overlaps exist.
    • Explore alternatives for each coverage
      • Committing to a worksite wellness program
      • Implementing an HSA,
      • Unemployment options,
      • Making some benefits voluntary instead of eliminating them altogether.
    • Share a Total Compensation summary with your employees