Shrm poll health_care2_actionsbarriers

SHRM Poll: Organizations’ Response to Health
Care Reform – Challenges and Actions

September 27, 2010

Health Care Reform Series: Poll 2
Introduction

Landmark legislation that brought about major reforms in health care coverage in the
United States was enacted in March 2010. The law affects employers and HR
professionals in a variety of ways. SHRM will be conducting a series of polls on health
care reform and the implications for employers and employees. The findings from the
second poll in this series, which was conducted in July 2010, are included in this
presentation.

Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 2

Key Findings

• How Well Do Organizations Understand the Specific Aspects of the Health Care Reform Law? 50% of
organizations have taken some type of action in response to the passing of the health care reform bill. Due
to a lack of clarity on the specifics of the law, another 50% have not taken action or are unsure of if action
has been taken. Sixty-four percent of HR professionals are having difficulty understanding the gray areas
and details of the law, 52% are not comfortable with what they know about the law and 54% see lack of
understanding as the main implementation barrier. Clearly, HR professionals are waiting on additional
information to make informed decisions.
• Where are Organizations Turning To Learn About the Health Care Reform Law? Nearly 75% of
organizations report using an insurance broker to inform them on the new law. Organizations that have not
yet taken action are likely relying on information from their insurance broker on how to proceed.
• What are the implementation barriers of the health care reform law? Lack of overall understanding of the
details of the law, implementation costs and employee out-of-pocket costs were reported as the main
barriers to implementing the new law.
• What actions are organizations taking in response to the new health care reform law? The top five actions
are: 1) working with legal and/or benefits counsel to understand the implications of the law for the
organization, 2) sending HR staff to training to learn the details of the law, 3) partnering with current health
care benefits providers to design the 2011 health care plan, 4) developing health care cost analysis for
organizational leadership, and 5) analyzing the short-term financial impact of the law and the feasibility of
offering health care.


Since April 1, 2010, has your organization taken any action in response
to the passing the new health care reform law?

50% 50%

40% 39%

30%

20%
11%
10%

0%
Yes No Not sure

• Although 39% of respondents report having taken no action, this is fully consistent with the data in the
next three slides. Specifically, 64% of HR professionals are having difficulty understanding the gray areas
and details of the law (see Slide 6). 52% are not comfortable with what they know about the law (see Slide
8) and 54% see lack of understanding as the main implementation barrier (see Slide 9). Clearly, HR
professionals are waiting on additional information to make informed decisions.
• Respondents reporting having taken no action or are not sure if action has been taken, are likely relying on
their insurance broker to take action, as nearly three-quarters of HR professionals report using an
insurance broker to inform them on the new law (see Slide 10).

Note: n = 1095 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 4

Since April 1, 2010, has your organization taken any action in response
to the passing of the new health care reform law?

Comparison by Organization’s Sector and Medical Benefit Funding
• Publicly owned for-profits (62%) were more likely than privately owned for-profits (47%) to report that they have taken action in response to
the passing of the new health care reform law.

• Organizations whose primary medical benefit is currently self insured (61%) were more likely than organizations with insured (44%) primary
medical benefit to report that they have taken action in response to the passing of the new health care reform law.


In your opinion as an HR professional, what would you say is the
biggest problem for HR caused by the new health care reform law?

The grey areas of the new health care reform law 33%

Understanding the details of the new law 31%

Keeping up with the various regulations and relating them to
the appropriate provisions
13%

Determining impact on future total compensation strategy 11%

Keeping track of when various parts of the law take effect 7%

The short compliance deadlines 2%

Keeping employees informed about the implications of the new
law
2%

I don’t see anything problematic about the new law for HR 1%

Keeping the C-suite informed about the implications of the new
law
0%

0% 10% 20% 30% 40%

• 64% of HR professionals are having difficulty understanding the gray areas and details of the law.

Note: n = 774. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 6

In your opinion as an HR professional, what would you say is the
biggest problem for HR caused by the new health care reform law?

Comparison by Organization’s Operations Location and Medical Benefit Funding
• The grey areas of the new health care reform law (by medical benefit funding): Self insured organizations (37%) were more likely than
insured organizations (28%) to report the grey areas of the new health care reform law as a problem for HR caused by the new health care
law.

• Understanding the details of the new law (by medical benefit funding): Insured organizations (36%) were more likely than self insured
organizations (28%) to report understanding the details of the new health care reform law as a problem for HR.

• Determining impact on future total compensation strategy (by operations location): Organizations with multinational operations (15%)
were more likely than U.S. based only (10%) organizations to report determining impact on future total compensation strategy as a problem
for HR caused by the new health care law.


What is your level of agreement with the following statement?
"I am comfortable with what I know about the new health care reform law."

50%
45%
41%
40%

30%

20%

11%
10%

3%

0%
Strongly disagree Disagree Agree Strongly agree

• 52% of HR professionals are not comfortable with what they know about the law.


In general, what do you think is the main implementation barrier of the
new health care reform law for your organization?

Lack of overall understanding of details of the new law and its
impact on my organization
54%

Cost of implementing 37%

Employee out-of-pocket cost 16%

Not applicable, there is no implementation barrier for my
organization
15%

Lack of support by senior management 5%

Lack of support by employees 3%

Lack of support by unions 1%

Other 6%

0% 10% 20% 30% 40% 50% 60%

Note: n = 759. Percentages do not total 100% as multiple responses were allowed. Respondents were allowed to select their top two options.


What are the resources your organization is currently using in regard to
the new health care reform law?

Insurance broker 73%

SHRM’s resources on the new health care reform law 54%

Legal counsel (internal or external) 42%

Consultants 30%

Internal experts 17%

Other 12%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Note: n = 759. Percentages do not total 100% as multiple responses were allowed. Respondents were allowed to select their top two options.



Comparison by Organization’s Staff Size
• Insurance broker (by staff size): Smaller organizations (those with fewer than 2,500 employees) were more likely than organizations with
2,500 employees to 24,999 to report that they are currently using insurance broker 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 (97%) •2,500 to 24,999 employees Smaller organizations > larger
•100 to 499 employees (85%) (55%) organizations
•500 to 2,499 employees (75%)

• SHRM’s resources on the new 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 resources as one of their resources in regard to the new law.

•100 to 499 employees (68%) •2,500 to 24,999 employees Smaller organizations > larger
(40%) organizations

• Legal counsel (internal or external) (by staff size): Larger organizations (those with 500 or more employees) were more likely than
smaller organizations (100 to499 employees) to report that they are currently using legal counsel as one of their resources in regard to the
new law.
•100 to 499 employees (28%) •500 to 2,499 employees (49%) Larger organizations > smaller
•2,500 to 24,999 employees organizations
(57%)
•25,000 or more employees
(57%)



Comparison by Organization’s Staff Size (continued)
• Consultants (by staff size): Larger organizations (those with 500 to 24,999 employees) were more likely than organizations with 100 to 499
employees to report that they are currently using consultants as one of their resources in regard to the new law.

(57%)

• Internal experts (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations
(500 to 2,499 employees) to report that they are currently using internal experts as one of their resources in regard to the new law.

•500 to 2,499 employees (18%) •2,500 to 24,999 employees Larger organizations > smaller
(32%) organizations



Comparison by Organization’s Selected Demographics

Differences based on Differences Differences Differences
organization sector based on based on medical based on union
organization’s benefit funding status
operations
location

U.S. based only
Privately owned for-profits
organizations (76%)
(80%) & nonprofit (81%) > Insured (83%) > self Non-unionized (75%)
Insurance broker > Multinational
publicly owned for-profits insured (66%) > Unionized (65%)
operations (66%)
(60%) & government (59%)

Privately owned for-profits U.S. based only
(59%) & government (66%) organizations (56%) Insured (59%) > self
SHRM’s resources on the new health care reform law
> publicly owned for-profits > Multinational insured (51%)
(43%) operations (43%)
Multinational
Publicly owned for-profits
operations (50%) > Self insured (52%) > Unionized (51%) >
Legal counsel (internal or external) (56%) > privately owned
U.S. based only insured (29%) non-unionized (40%)
for-profits (37%)
organizations (39%)
Publicly owned for-profits Multinational
(44%) > privately owned operations (42%) > Self insured (43%) > Unionized (41%) >
Consultants
for-profits (25%) & U.S. based only insured (15%) non-unionized (28%)
nonprofit (27%) organizations (27%)
Multinational
Publicly owned for-profits
operations (22%) > Self insured (20%) >
Internal experts (28%) > privately owned
U.S. based only insured (14%)
for-profits (15%)
organizations (16%)

Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010
Note: Blank cell indicates that there were no significant differences in this category. 13

What actions has your organization taken in response to the passage of
the new health care reform bill?
Already Planning Currently NOT
doing/done to do doing and have
NO plans to do
Working with legal and/or benefits counsel to help the organization understand the
80% 15% 5%
implications of the new law
Sending HR staff in organization to classes (i.e., attending seminars, participating in
78% 14% 8%
webcasts on this topic, etc.) to learn details of the new law and impact to organization
Partnering with current health benefits provider to design 2011 health care plan that will
75% 24% 1%
include areas affected by the new law
Developing health care cost analysis for organization’s leaders 59% 35% 7%
Analyzing short-term financial impact of the new law and the feasibility of offering
57% 33% 10%
health care
Developing a new health care strategy plan for our organization 48% 39% 13%

Developing an employee communication strategy related to the new law 45% 46% 9%
Developing employee communication on the impact of the new law on the
41% 54% 6%
organization’s health care plan and the employees
Analyzing long-term financial impact of the new law and the feasibility of offer health
38% 54% 9%
care

Communicating impact of the new law to employees 37% 57% 7%

Communicating impact of the new law to retirees 12% 40% 48%

• HR professionals appear to be focused first on understanding the law and its implications for the organization
and employees before communicating with employees/retirees.
Note: n = 395-427. Percentages do not total 100% due to rounding. Only respondents whose organizations have taken action(s) in response to the
passing of the new health care reform law were included in this analysis. “Not sure/not applicable” responses were excluded from this analysis.

What actions has your organization taken in response to the passing of
the new health care reform law since April 1, 2010?

Comparison of Actions Organizations Have Taken by Organization’s Staff Size
• Partnering with current health benefits provider to design 2011 health care plan which will include areas affected by the new
health care reform law (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations
with fewer than 500 employees to report that they are partnering with current health benefits provider to design 2011 health care plan which
will include areas affected by the new law.
•100 to 499 employees (58%) •2,500 to 24,999 employees Larger organizations > smaller
(84%) organizations

• Developing health care cost analysis for organization’s leaders (by staff size): Larger organizations (those with 2,500 to 24,999
employees) were more likely than organizations with fewer than 500 employees to report that they are developing health care cost analysis
for organization’s leaders.
(76%) organizations

• Analyzing short-term financial impact of the new law and the feasibility of offer health care (by staff size): Larger organizations
(those with 2,500 to 24,999 employees) were more likely than smaller organizations (2,499 employees or less) to report they are currently
analyzing short-term financial impact of the new law and the feasibility of offer health care.

•500 to 2,499 employees (59%) (80%) organizations



Comparison of Actions Organizations Have Taken by Organization’s Staff Size (continued)
• Developing a new health care strategy plan for our organization (by staff size): Larger organizations (those with 2,500 to 24,999
employees) were more likely than organizations with fewer than 500 employees to report that they are developing a new health care strategy
plan for their organization.
(62%) organizations

• Developing an employee communication strategy related to the new law (by staff size): Larger organizations (those with 2,500 to
24,999 employees) were more likely than organizations with fewer than 2,499 employees to report that they are developing an employee
communication strategy related to the new law.

•500 to 2,499 employees (38%) (61%) organizations

• Developing employee communication on the impact of the new law on organization’s health care plan and the employees (by staff
size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees) to
report they are currently developing employee communication on the impact of the new law on organization’s health care plan and the
employees.

(58%) organizations



Comparison of Actions Organizations Have Taken by Organization’s Staff Size (continued)
• Analyzing long-term financial impact of the new law and feasibility of offering health care (by staff size): Larger organizations (those
with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees) to report they are currently analyzing
long-term financial impact of the new law and their ability to offer health care.

(61%) organizations

• Communicating impact of the new law to employees (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were
more likely than smaller organizations (500 to 2,499 employees ) to indicate that they are communicating impact of the new law to
employees.

(53%) organizations



Comparison of Actions Organizations Have Taken by Organization’s Selected Demographics

Differences Differences Differences Differences
based on based on based on medical based on union
organization organization’s benefit funding status
sector operations
location

Working with legal and/or benefits counsel to help Self insured (83%) >
organization understand the implications of the new law insured (73%)

Sending HR staff in our organization to classes (i.e., Privately owned for-
attending seminars, participating in webcasts on this topic, profits (86%) >
etc.) to learn details of the new law and its impact on the publicly owned for-
organization profits (70%)

Partnering with current health benefits provider to design
Self insured (81%) >
2011 health care plan which will include areas affected by the
insured (64%)
new health care reform law
Developing health care cost analysis for organization’s Self insured (71%) > Unionized (73%) >
leaders insured (44%) non-unionized (58%)
Publicly owned for- Multinational
Analyzing short-term financial impact of the new law and the profits (73%) > operations (73%) > Self insured (69%) > Unionized (72%) >
feasibility to offer health care privately owned for- U.S. based only insured (43%) non-unionized (57%)
profits (55%) organizations (55%)
Developing a new health care strategy plan for our Self insured (57%) >
organization insured (34%)

Note: Blank cell indicates that there were no significant differences in this category.


Comparison of Actions Organizations Have Taken by Organization’s Demographics Selected (continued)

Differences Differences Differences Differences
based on based on based on medical based on union
organization organization’s benefit funding status
sector operations
location

Developing an employee communication strategy related to Self insured (51%) >
the new law insured (34%)
Multinational
Developing employee communication on the impact of the
new law on organization’s health care plan and the
employees
organizations (37%)
Publicly owned for-
Analyzing long-term financial impact of the new law and the profits (55%) > Self insured (45%) >
feasibility to offer health care privately owned for- insured (28%)
profits (35%)
Multinational
Communicating impact of the new law to employees
organizations (32%)

Note: Blank cell indicates that there were no significant differences in this category.


Has there been an increase, decrease or about the same contact by your organization’s plan
participants (e.g., employees, spouses, retirees), since the enactment of the new health care
reform law, with your HR/benefits staff or Third-Party Administrator (TPA)?

1%
From active employee participants 80% 19%

1%
From non-employee plan participants (e.g., spouse) 91% 8%

1%
From retirees 90% 10%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Decrease About the same Increase

Note: n = 291-715. Percentages do not total 100% due to rounding. “Not sure/not applicable” responses were excluded from this analysis.


Has there been an increase, decrease or about the same contact by your organization’s plan
participants (e.g., employees, spouses, retirees), since the enactment of the new health care
reform law, with your HR/benefits staff or Third-Party Administrator (TPA)?

Comparison by Organization’s Sector and Medical Benefit Funding
• Increase contact with your HR/benefits staff or Third-Party Administrator (TPA) by active employee participants (by medical
benefit funding): Self insured organizations (25%) were more likely than insured organizations (12%) to report that there has been increase
contact with HR/benefits staff or Third-Party Administrator (TPA) by active employee participants.

• Increase contact with your HR/benefits staff or Third-Party Administrator (TPA) by active employee participants (by sector):
Publicly owned for-profits (27%) were more likely than privately owned for-profits (14%) to report that there has been increase contact with
HR/benefits staff or Third-Party Administrator (TPA) by active employee participants.


How is your organization’s primary medical benefit currently funded?

Insured, 44%

Self insured, 56%


How is your organization’s primary medical benefit currently funded?

Comparison by Organization’s Staff Size, Sector, Operations Location, Sector and Union Status
• Funding of organization’s primary medical benefit (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 organizations’ primary medical benefit is self insured.

(84%)
•25,000 or more employees
(84%)

• By operations location: Organizations with multinational operations (71%) were more likely than U.S. based only (51%) organizations to
report that their organizations’ primary medical benefit is self insured.

• By sector: Publicly owned for-profits (72%) organizations were more likely than privately owned for-profits (50%) and nonprofit (49%)
organizations to report that their organizations’ primary medical benefit is self insured.

• By union status: Unionized organizations (64%) were more likely than non unionized (54%) organizations to report that their organizations’
primary medical benefit is self insured.


Demographics: Organization Industry

Industry
Manufacturing - other 18%

Health Care, Social Assistance (e.g., hospitals, clinics, 13%

Financial Services (e.g., banking) 8%

Services - Professional, Scientific, Technical, Legal, Eng 7%

Educational Services/Education (e.g., universities, school 6%

Government/Public Administration - Federal, State/Local, T 5%
5%
Retail/Wholesale Trade

Construction, Mining, Oil & Gas 4%

4%
Insurance

Note: n = 754. Percentages do not total 100% due to rounding.


Demographics: Organization Industry (continued)

Industry
Other Services (e.g., other non-profit, church/religious o 4%
Transportation, Warehousing (e.g., distribution) 3%
High-Tech 3%
Services - Accommodation, Food & Drinking Places 3%
Utilities 2%
Real Estate, Rental, Leasing 2%
Publishing, Broadcasting, Other Media 2%
Manufacturing - auto/auto related 2%
Arts, Entertainment, Recreation 1%
Consulting 1%
Telecommunications 1%
Association - Professional/Trade 0%
Pharmaceutical 0%
Biotech 0%
Other 5%



Demographics: Organization Industry

Industry
Manufacturing - other 18%
Health Care, Social Assistance (e.g., hospitals, clinics, doctor's offices, in-home care, 13%
nursing homes, EAP providers, hospice, etc.)
Financial Services (e.g., banking) 8%

Services - Professional, Scientific, Technical, Legal, Engineering 7%

Educational Services/Education (e.g., universities, schools, etc.) 6%

Government/Public Administration - Federal, State/Local, Tribal 5%
5%
Retail/Wholesale Trade

Construction, Mining, Oil & Gas 4%

4%
Insurance



Demographics: Organization Industry (continued)

Industry
Other Services (e.g., other non-profit, church/religious organizations, etc.) 4%
Transportation, Warehousing (e.g., distribution) 3%
High-Tech 3%
Services - Accommodation, Food & Drinking Places 3%
Utilities 2%
Real Estate, Rental, Leasing 2%
Publishing, Broadcasting, Other Media 2%
Manufacturing - auto/auto related 2%
Arts, Entertainment, Recreation 1%
Consulting 1%
Telecommunications 1%
Association - Professional/Trade 0%
Pharmaceutical 0%
Biotech 0%
Other 5%



Demographics: Organization Sector

Privately owned for-profit organization 47%

Publicly owned for-profit organization 21%

Nonprofit organization 20%

Government sector 8%

Other 4%

0% 10% 20% 30% 40% 50% 60%


Demographics: Organization Staff Size

50%

40%
35%

30% 27% 26%

20%

10%
6% 5%

0%
50 to 99 employees 100 to 499 employees 500 to 2499 employees 2500 to 24999 25000 or more
employees employees



Demographics: Other

Does organization have U.S.-based Is organization a single-unit company or a multi-
operations (business units) only or unit company?
does it operate multinationally?
Single-unit company: 29%
Companies in which the
U.S.-based operations 75% location and the company
are one and the same.
Multinational operations 25% Multi-unit company: 71%
Companies that have more
Note: n = 750 than one location.

Note: n = 763

• 19% of organizations indicated that Are HR policies and practices determined by
employees at their work location were the multi-unit corporate headquarters, by each
unionized. work location or both?
Note: n = 755
Multi-unit headquarters determines 64%
HR policies and practices

Each work location determines HR 1%
policies and practices

A combination of both the work 35%
location and the multi-unit
headquarters determine HR policies
and practices

Note: n = 556

SHRM Poll: Organizations’ Response to Health Care Reform – Poll 2

Methodology

• Response rate = 21%
• Sample comprised of 1095 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 +/- 3%
• Survey fielded July 22–August 3, 2010

For more poll findings, visit:
www.shrm.org/surveys
Follow us on Twitter:
http://twitter.com/SHRM_Research


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