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Shrm poll health_care3final

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  • 1. SHRM Poll:Health Care Reform: Where Are Organizationsin the Decision-Making Process? February 7, 2011
  • 2. Health Care Reform Series: Poll 3 IntroductionLandmark legislation that brought about major reforms in health care coverage in theUnited States was enacted in March 2010. The law affects employers and HRprofessionals in a variety of ways. SHRM will be conducting a series of polls on healthcare reform and its implications for employers and employees. This presentation coversthe findings from the third poll in this series, which was conducted in December 2010. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 2
  • 3. Key Findings• Will Organizations Drop Health Care Coverage? One-half of organizations (51%) have decided not to drop health care coverage for employees as a result of the health care reform law. Of these organizations, 24% made this decision without conducting an analysis to determine whether to continue offering health care coverage or to drop coverage and pay opt-out fines. Twenty-seven percent did conduct such analysis and decided not to drop coverage. Nearly one-third of organizations (27%) are still conducting or plan to conduct an analysis on the impact of health care reform.• Many Organizations Waiting on Regulatory Guidance. Nearly one-half of organizations (48%) indicated that they are waiting on regulatory guidance or information on specific provisions in the health care reform law to make some health care decisions for their organizations.• What Are the Implementation Barriers? For a number of provisions in the health care law that will take effect between 2011 and 2018, 27% to 65% of organizations reported that there are no implementation barriers for their organizations. Of the organizations that reported implementation barriers, 54% reported the cost of including benefits for adult children up to age 26 (2011) as an implementation barrier. In addition, one-third (34%) of organizations reported employee out-of- pocket expenses as an implementation barrier to their organization putting into action the exclusion on purchasing over-the counter medications using flexible spending account (2011).• HR Knowledge About Law’s Specifics Steadily Increasing. The percentage of HR professionals who are comfortable with their level of familiarity with the health care reform law increased from 48% in July 2010 to 62% in January 2011. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 3
  • 4. Is your organization engaging in an analysis to determine the impact of the health care reform law on your health care plan? Will not conduct an analysis and already decided we will 24% not drop health care coverage 34% Already conducted an analysis and decided not to drop 27% health care coverage 12% Plan to conduct such an analysis 17% 15% Currently conducting analysis 10% 22% Already conducted an analysis and decided to drop health <1% care coverage <1% Will not conduct an analysis and already decided to drop <1% health care coverage <1% Unsure at this time 22% 16% 0% 10% 20% 30% 40% January 2011, n = 677 June 2010, n = 813 • One-half of organizations (51%) have decided not to drop health care coverage for employees as a result of the health care reform law compared with 46% in June 2010.Note: Percentages do not total 100% due to rounding. June 2010 data are from SHRM Poll: Organizations’ Response to Health Care Reform. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 4
  • 5. Is your organization engaging in an analysis to determine the impact ofthe new health care reform law on your health care plan?Comparison by Medical Benefit Funding Differences Based on Medical Benefit Funding Self-insured (33%) > insured Already conducted an analysis and decided not to drop health care coverage (20%) Will not conduct an analysis and already decided we will not drop health care coverage Insured (31%) > self-insured (18%) Unsure at this time Insured (26%) > self-insured (18%) Organizations with self-insured plans were more likely to have already conducted analysis and decided NOT to drop health care coverage. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 5
  • 6. Is your organization waiting to make any health care plan decisions based on any of the following factors? Yes No Don’t know Regulatory guidance or information on specific provisions in the health care reform law 48% 42% 10% Changes to specific provisions in the health care reform law 32% 57% 11% Repeal of specific provisions of the health care reform law 24% 64% 12% Repeal of the entire health care reform law 13% 75% 12% Other factors 13% 53% 35%Note: n = 617-674. Percentages do not total 100% due to rounding. Data sorted by “Yes” column. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 6
  • 7. Is your organization waiting to make any health care plan decisionsbased on any of the following factors?Comparison by Medical Benefit Funding Differences Based on Medical Benefit Funding Self-insured (54%) > insured Regulatory guidance or information on specific provisions in the health care reform law (42%) Self-insured (36%) > insured Changes to specific provisions in the health care reform law (28%) Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 7
  • 8. For the following provisions of the health care reform law, what do you see as the main implementation barrier in your organization? implementation implementation understanding barrier for my out-of pocket of the details Management organization organization employees, There is no support by Employee of the law provision unions or Lack of Lack of Cost of to the Other cost Limits on deductibles in the small group market (companies with less than 100 employees) to $2,000 for individuals and $4,000 for families 65% 8% 18% 3% 2% 4% (2014) Prohibition on lifetime dollar limits on coverage of essential benefits 52% 8% 32% 4% 1% 4% (2011) Exclusion on purchasing over-the counter medications using flexible 43% 13% 1% 34% 8% 2% spending account (2011) Inclusion of benefits for adult children up to age 26 (2011) 37% 4% 54% 2% 1% 2% Employer mandate to provide coverage or pay a penalty (2014) 37% 17% 37% 1% 4% 4% Excise tax on high-value (so-called "Cadillac") health plans (2018) 34% 19% 28% 7% 8% 4% Requirement to report the value of an employees health benefits on 30% 17% 38% 2% 6% 7% individual employee W-2s (W-2s for 2012 tax year) Tax form 1099 requirement for all vendor transactions above $600 29% 22% 39% 0% 2% 7% (2012) CLASS Act (government-provided long-term care insurance) (2011- 27% 48% 12% 3% 3% 6% 2013)Note: n = 674-698. Percentages do not total 100% due to rounding. Data sorted by first column. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 8
  • 9. What is your level of agreement with the following statement:"I am comfortable with what I know about the new health care reform law." 60% 54% 50% 45% 41% 40% 32% 30% 20% 11% 10% 8% 6% 3% 0% Strongly disagree Disagree Agree Strongly agree July 2010, n = 774 January 2011, n = 679 • The percentage of HR professionals who are comfortable with their level of knowledge about the health care reform law increased from 48% in July 2010 to 62% in December 2010. This shows that more HR professionals are quickly familiarizing themselves with the health care reform law, thereby helping their organizations with the implementation of the law.Note: July 2010 data are from SHRM Poll: Organizations’ Response to Health Care Reform—Challenges and Actions. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 9
  • 10. What is your level of agreement with the following statement:"I am comfortable with my level of knowledge about the CLASS Act provision(government-run long-term care insurance) in the health care reform law." 60% 58% 50% 40% 30% 28% 20% 12% 10% 2% 0% Strongly disagree Disagree Agree Strongly agree • Only 14% of HR professionals are comfortable with what they know about the CLASS Act provision. Nearly half of organizations (48%) indicated that lack of understanding of the details of the CLASS Act provision as an implementation barrier to their organizations.Note: n = 678 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 10
  • 11. What resources is your organization currently using in regard to the health care reform law? Insurance broker 69% 73% SHRM’s resources on the new health care reform law 47% 54% Legal counsel (internal or external) 50% 42% Consultants 45% 30% Internal experts 30% 17% Other 8% 12% 0% 10% 20% 30% 40% 50% 60% 70% 80% January 2011, n = 663 July 2010, n = 759Note: Percentages do not total 100% as multiple responses were allowed. Respondents were allowed to select their top two options. July 2010 dataare from SHRM Poll: Organizations’ Response to Health Care Reform—Challenges and Actions. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 11
  • 12. What resources is your organization currently using in regard to thehealth care reform law? Comparison by Organization Staff Size• Insurance broker (by staff size): Smaller organizations (those with fewer than 2,500 employees) were more likely than organizations with 2,500 to 24,999 employees to report that they are currently using insurance brokers as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •50 to 99 employees (84%) •2,500 to 24,999 employees Smaller organizations > larger •100 to 499 employees (83%) (55%) organizations •500 to 2,499 employees (74%)• SHRM’s resources on the health care reform law (by staff size): Smaller organizations were more likely than organizations with 2,500 to 24,999 employees to report that they are currently using SHRM’s information as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •50 to 99 employees (62%) •2,500 to 24,999 employees Smaller organizations > larger •100 to 499 employees (56%) (36%) organizations •500 to 2,499 employees (52%)• Legal counsel (internal or external) (by staff size): Larger organizations (those with 500 or more employees) were more likely than smaller organizations (100 to 499 employees) to report that they are currently using legal counsel as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (38%) •500 to 2,499 employees (54%) Larger organizations > smaller •2,500 to 24,999 employees organizations (68%) •25,000 or more employees (68%) Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 12
  • 13. What resources is your organization currently using in regard to thehealth care reform law? Comparison by Organization Staff Size (continued)• Consultants (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations with 100 to 2,499 employees to report that they are currently using consultants as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (34%) •2,500 to 24,999 employees Larger organizations > smaller •500 to 2,499 employees (42%) (67%) organizations• Internal experts (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (100 to 2,499 employees) to report that they are currently using internal experts as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (23%) •2,500 to 24,999 employees Larger organizations > smaller •500 to 2,499 employees (27%) (44%) organizations Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 13
  • 14. What resources is your organization currently using in regard to the health care reform law? Comparison by Selected Organizational Demographics Differences Based on Differences Differences Differences Organization Sector Based on Based on Based on Union Organization’s Medical Benefit Status Operations Funding Location U.S.-based only Privately owned for-profits organizations (72%) (80%) & nonprofits (74%) > Insured (81%) > self- Non-unionized (72%)Insurance broker > multinational publicly owned for-profits insured (59%) > Unionized (55%) operations (58%) (53%) & government (47%) U.S.-based only Nonprofits (53%) > publicly organizations (52%) Insured (56%) > self- Non-unionized (50%)SHRM’s resources on the new health care reform law owned for-profits (36%) > multinational insured (41%) > Unionized (40%) operations (37%) Multinational Publicly owned for-profits operations (57%) > Self-insured (60%) >Legal counsel (internal or external) (61%) > privately owned U.S.-based only insured (37%) for-profits (45%) organizations (47%) Multinational Publicly owned for-profits operations (54%) > Self-insured (56%) > Unionized (55%) >Consultants (60%) > privately owned U.S.-based only insured (30%) non-unionized (42%) for-profits (33%) organizations (41%) Multinational operations (38%) > Self-insured (34%) >Internal experts U.S.-based only insured (23%) organizations (27%)Note: Blank cell indicates that there were no significant differences in this category. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 14
  • 15. If you use an insurance broker or third-party administrator to help you understand the health care reform law, we would like to understand the primary direction of contacts made between you and the agent. Please select the option below that best characterizes how this process has worked for your organization: The broker or third-party administrator contacts us about as frequently as we contact them. 35% The broker or third-party administrator contacts us; we do reach out to them on occasion, but somewhat less frequently 17% than they do. We have not used an insurance broker or third-party administrator to help us understand the health care reform law. 14% My organization has been contacting the broker or third-party administrator on occasion; they do contact us, but somewhat 13% less frequently than we reach out to them. The broker or third-party administrator proactively and frequently contacts us; rarely do we contact them. 13% My organization has been contacting the broker or third-party administrator proactively and frequently; rarely do they contact 8% us. 0% 10% 20% 30% 40%Note: n = 619 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 15
  • 16. If you use an insurance broker or third-party administrator to help you understand thehealth care reform law, we would like to understand the primary direction of contacts madebetween you and the agent. Please select the option below that best characterizes how thisprocess has worked for your organization: Comparison by Organization’s Staff Size, Sector and Medical Benefit Funding• The broker or third-party administrator contacts us about as frequently as we contact them (by staff size): Smaller organizations (those with 500 to 2,499 employees) were more likely than organizations with 2,500 to 24,999 employees to report that the broker or third- party administrator and the organization have reached out to each other about equal number of times. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •500 to 2,499 employees (49%) •2,500 to 24,999 employees Smaller organizations > larger (29%) organizations• We have not used an insurance broker or third-party administrator help us understand the health care reform law (by sector): Publicly owned for-profits (27%) were more likely than privately owned for-profits (7%) to report that their organizations have not used an insurance broker or third-party administrator to help them understand the health care reform law. Differences Based on Medical Benefit Funding We have not used an insurance broker or third-party administrator to help us understand the Self-insured (18%) > insured (9%) health care reform law The broker or third-party administrator contacts us about as frequently as we contact them Self-insured (39%) > insured (31%) The broker or third-party administrator contacts us; we do reach out to them on occasion, but Insured (22%) > self-insured (13%) somewhat less frequently than they do. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 16
  • 17. How is your organization’s primary medical benefit currently funded? Insured, 43% Self-insured, 57%Note: n = 660 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 17
  • 18. How is your organization’s primary medical benefit currently funded? Comparison by Organization’s Staff Size, Operations Location, Sector• By staff size: Larger organizations (those with 500 or more employees) were more likely than organizations with fewer than 500 employees to report that their organization’s primary medical benefit is self-insured. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (36%) •500 to 2,499 employees (66%) Larger organizations > smaller •2,500 to 24,999 employees organizations (82%) •25,000 or more employees (86%)• By operations location: Organizations with multinational operations (69%) were more likely than U.S.-based (52%) organizations to report that their organization’s primary medical benefit is self-insured.• By sector: Publicly owned for-profits (70%) were more likely than privately owned for-profits (52%) and nonprofits (49%) to report that their organization’s primary medical benefit is self-insured. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 18
  • 19. Demographics: Organization Industry Industry Manufacturing—other 17% Health care, social assistance (e.g., nursing homes, EAP providers) 14% Government/public administration—federal, state/local, tribal 8% Services—professional, scientific, technical, legal, engineering 8% Financial services (e.g., banking) 6% Educational services/education 6% Retail/wholesale trade 4% Construction, mining, oil and gas 4% Other services (e.g., nonprofit, church/religious organizations) 4% Note: n = 652 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 19
  • 20. Demographics: Organization Industry (continued) Industry Transportation, warehousing (e.g., distribution) 4% Insurance 3% High-tech 3% Utilities 3% Manufacturing—auto/auto-related 3% Services—accommodation, food and drinking places 2% Telecommunications 2% Arts, entertainment, recreation 2% Real estate, rental, leasing 2% Consulting 1% Biotech 1% Publishing, broadcasting, other media 1% Association—professional/trade 1% Pharmaceutical 0% Other 1% Note: n = 652 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 20
  • 21. Demographics: Organization Sector Privately owned for-profit organization 44% Publicly owned for-profit organization 22% Nonprofit organization 19% Government sector 10% Other 5% 0% 10% 20% 30% 40% 50% 60% Note: n = 651 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 21
  • 22. Demographics: Organization Staff Size50%40% 30% 29%30% 27%20% 9%10% 6% 0% 50 to 99 employees 100 to 499 employees 500 to 2499 2500 to 24999 25000 or more employees employees employees Note: n = 580. Percentages do not total 100% due to rounding. Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 22
  • 23. Demographics: Other Does organization have U.S.-based Is your organization a single-unit company or a operations (business units) only or multi-unit company? does it operate multinationally? Single-unit company: A company in 30% U.S.-based operations 72% which the location and the company are one and the same. Multinational operations 28% Multi-unit company: A company that 70% has more than one location. Note: n = 657 Note: n = 665• 20% of organizations indicated that Are HR policies and practices determined byemployees at their work location were the multi-unit corporate headquarters, by eachunionized. work location or both? Note: n = 650 Multi-unit headquarters determines HR 56% policies and practices Each work location determines HR policies 3% and practices A combination of both the work location and 41% the multi-unit headquarters determine HR policies and practices Note: n = 480 Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 23
  • 24. SHRM Poll: Health Care Reform – Poll 3 Methodology • Response rate = 13% • Sample comprises 698 randomly selected HR professionals with the job title of manager and above, as well as HR professionals in the compensation and benefits functional area. All analyses were based on respondents working at organizations with a staff size of 50 employees or more. • Margin of error is +/- 4% • Survey fielded December 3 – December 31, 2010 For more poll findings, visit: www.shrm.org/surveys Follow us on Twitter: http://twitter.com/SHRM_Research Health Care Reform - Where Are Organizations in the Decision-Making Process | ©SHRM 2011 24

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