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te's World –
benefits to Aid DEI
and Support a
Workplace Culture
With Cory Jorbin - Chief Compliance Officer, West
Region with Hub International
WEBINAR EXCLUSIVE
APRIL 6, 2023
11:00 AM PT
2:00 PM ET
7:00 PM GMT
2
Sponsored by:
03
Lark Health is a digital health technology company aimed at delivering infinitely scalable,
accessible digital chronic condition prevention and management coaching. To date, Lark has
provided 2 million people with real-time, 24/7 personalized care coaching that is delivered
through an easy-to-use, text message-like interface. Through the use of conversational AI,
connected devices, remote patient monitoring, and Cognitive Behavioral
Therapy techniques, Lark is poised to help millions of patients improve their health to manage
and reduce their risk of chronic disease.
Lark's scalable platform seamlessly integrates with health plans' and employers' existing
healthcare infrastructure to support their chronic care prevention and management programs.
Lark currently works with many of the largest health plans across five programs: Prevention,
Heart Health, Diabetes Prevention, Diabetes Management, and Hypertension Management.
Lark's Diabetes Prevention Program (DPP), which is the fastest-growing and lowest-cost DPP,
has received Full Recognition from the Centers for Disease Control and Prevention (CDC).
The company has received numerous accolades, includin having been named as one of CB
Insights Digital Health 150 (2019), a finalist for the UCSF Digital Health Awards (2022), one of
Fast Company's Most Innovative Companies (multiple years), and one of Fierce Healthcare's
Fierce15 (2020).
To learn more visit
www.lark.com
3
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and call in using the numbers below.
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Access Code: 699-978-222
Audio PIN: Shown after joining the webinar
4
A Candidate's World –
Employee benefits to Aid DEI
Initiatives and Support a
Positive Workplace Culture
With Cory Jorbin - Chief Compliance Officer, West
Region with Hub International
WEBINAR EXCLUSIVE
5
5
Agenda
Diversity, Equity & Inclusion
1
2 Benefits Protections
3 Supporting DEI with Benefits
6
6
1
Diversity, Equity
& Inclusion
7
Definitions
Definitions sourced from City of Portland Office of Equity and Human Rights, The Independent Sector, and UC Berkeley
https://www.gensler.com/blog/inclusion-by-design-insights-from-design-week-portland
Di●ver●si●ty
All the ways in which
people differ.
Eq●ui●ty
Fair treatment, access,
opportunity, and advancement
for all people. One’s identity
cannot predict the outcome.
In●clu●sion
A variety of people
have power, a voice,
and decision-
making authority.
8
Diversity
9
Equity v. Equality
10
Inclusion
11
Stats…
67% of job seekers consider workplace diversity
an important factor when considering employment
opportunities, and more than 50% of current
employees want their workplace to do more
to increase diversity.
https://www.glassdoor.com/employers/blog/diversity/
45% of American workers experienced
discrimination and / or harassment in the past year.
https://www.gallup.com/workplace/215939/invest-diversity-inclusion.aspx?utm_source=link_wwwv9&utm_campaign=item_236264&utm_medium=copy
78% of employees who responded to a Harvard Business Review (HBR) study said they work at organizations that
lack diversity in leadership positions.
https://hbr.org/2013/12/how-diversity-can-drive-innovation
Organizations with above-average gender diversity
and levels of employee engagement outperform companies with below-average diversity and engagement by 46% to
58%.
https://www.fastcompany.com/3067346/how-these-top-companies-are-getting-inclusion-right
48% of employees believe that respect is the most essential factor for a culture of inclusion.
61% of employees believe diversity and inclusion strategies are beneficial and essential.
75% of employees think more diversity is needed https://www.quantumworkplace.com/diversity-and-inclusion-in-the-workplace
https://www.indeed.com/career-advice/finding-a-job/diversity-inclusion-and-belonging
-jobs-rise#:~:text=According%20to%20Indeed%20data%2C%20demand,jobs%20per
%20million%20to%20219
12
An Integrated Approach
Goal:
Deliver Quality Employee experiences
By Coauthoring Quality Employer experiences
o Recognize that every dimension of an
individual’s performance and health is
interconnected.
o Identify the key success metrics that
influence a person’s ability to thrive -
both at work and at home.
o Develop a comprehensive strategy to
solve issues and prioritize needs.
13
The Employee Lifecycle: The Game of Life™
Family
Leave
Serious
Accident
Lost Job
Drug/Alcohol
Treatment
Overcrowding
At Home
Death of
Close Friend
Are your Benefits a Parachute or the
Thrill of the Sky Dive?
• Is Human Resources positioned as primary
destination?
• Is Technology Platform adept at providing solutions?
• Can we use data to predict needs/noise?
Loss of
Family Pet
Promotion/
Transfer
Change in
Citizenship/
Naturalization
Status
Child moving
out of home
Downshifting
Job Responsibilities
Change in
Retirement Horizon
A New
Puppy
Change in
Childcare
Status
Divorce
A
long-planned
trip
Strategic Execution
Specialty Offerings
Insights from Employees
Modernizing the employer/
employee experience through data
analysis
Multi-year
Strategic
Plan
Employee Experience
Specialty Offerings
Strategic
Execution
• Strategy
• Cost Optimization
• Employee Engagement
• Plan & Contribution Design
• Communication
• Wellness
• Leaves of Absence
• Voluntary Benefits
• Pharmacy
• Technology
• Compliance
• Retirement
• Lack of Choice
• Population Targeting
• Suboptimization of Spend
• More Relevant Benefits
The Workforce Experience
15
15
2
Benefits Protections
16
What Employees Need, Want, and Expect
o No discrimination in plan design and administration
o Consistency in plan administration
o Understandable, accessible, and expedient claims
processes
o Plain language explanations of employee and Plan
Sponsor rights and obligations
o Affordable health insurance premiums and limited financial
exposure for health events
o Ability to plan ahead and make informed decisions
o Certainty of costs
o Clear explanations of federal and state employee rights
o Proper use of Plan Assets
17
Benefits Protections
HIPAA
Prohibits group health plans and health insurance issuers offering group health insurance coverage
from discriminating with regard to eligibility, premiums, or contributions on the basis of specified health
status-related factors.
Affordable Care Act
o Prohibits exclusions from plan eligibility based on pre-existing conditions –
goes beyond HIPAA protections
o Section 1557 provides protections on the basis of sex, including sex stereotyping
and gender identity
Mental Health Parity
Requires plans to treat mental health / substance abuse disorder benefits in parity
with medical / surgical benefits
Title VII
EEOC requires coverage under employer sponsored health plans be provided “without regard
to the race, color, sex, national origin, or religion of the insured.”
18
HIPAA
Health status related factors – health status, medical condition, claims experience, receipt of healthcare,
genetic condition, disability, medical history
Eligibility – enrollment, waiting periods, special enrollment, benefits
Plans may not have:
o EOI requirements
o Actively at work provisions
o Exclusions based on past claims history
o Exclusions based on participating in dangerous activities
o Exclusions directed at specific participants
Pre-existing condition protections
19
Affordable Care Act
Expands on HIPAA protections against exclusions based on pre-existing conditions
Previous HIPAA protections only allowed for minimum gaps in coverage
Prohibits excessive waiting periods
o Maximum waiting periods capped at 90 days for full-time employees & up to 12 months
for variable hour employees who qualify
Prohibitions on recissions of coverage
o Aimed at retroactive cancellations
o Only allowed due to fraud, or intentional misrepresentation of material facts
o Exception for cancellation due to non-payment of premiums
20
Section 1557 - Background
ACA provision that prevents plans issued by Covered Entities from discriminating on the basis
of gender identity and sexual stereotyping
Covered Entities are those who receive funding from HHS…all fully-insured plans since carriers
receive HHS funding, and self-insured plans that receive HHS funding
Who receives HHS funding? It depends…medical practices, hospitals, home health agencies,
assisted living facilities and also possibly schools, municipalities, and other organizations –
question for accounting team
Legislative rollercoaster since 2016, with new “final” rules expected in 2023
21
Mental Health Parity
Health plans not required to cover mental health, but if they do, they need to treat mental health /
substance abuse (“MH / SUD”) benefits in parity with medical / surgical (“Med / Sur”) benefits
under the plan
Quantitative limitations
o Limits tied to numbers, such as a limit on the number of visits, or annual dollar limits
o Limits prohibited for MH / SUD without also having them on the Med / Sur side
Non-Quantitative Treatment Limitations
o Limits other than those tied to numbers – step-therapy, medical necessity, prerequisites
o Standards can be no greater on MH / SUD benefits than Med / Sur benefits
o Comparative analysis requirement added for plans in 2021
22
Overview of Title VII
Sexual harassment is a form of sex discrimination that violates
Title VII of the Civil Rights Act of 1964 (Title VII)
Title VII prohibits discrimination
on the basis of:
o Sex
(including pregnancy
and gender nonconformity)
o Race
o Color
o Religion
o National origin
Title VII prohibits adverse employment
actions against protected classes,
including:
o Termination
o Failure to hire
o Demotion
23
Forms of Discrimination
Intentional Discrimination
against an employee or applicant because
of their membership in a protected class
or classes.
Disparate Impact Discrimination
occurs when a neutral-appearing practice
or policy actually has a discriminatory effect
on a protected class or classes.
24
What is Discrimination
Treatment or consideration based on class or category rather than individual merit.
It is illegal to discriminate in any aspect of employment, including:
o Hiring and firing
o Pay, retirement plans,
and disability leave
o Employee benefits
o Fringe benefits
o Compensation, assignment,
or classification of employees
o Transfer, promotion, layoff,
or recall
o Job advertisements
o Recruitment
o Use of company facilities
o Training and apprenticeship
programs
o Other terms and conditions
of employment
25
Summary of Protected Classes
o Race
o Color
o Religion
o Age
o Gender
o Transgender
o Sexual Orientation
o Disability
o Whistleblower
o Worker’s
Compensation
o Pregnancy
26
26
3
Supporting DEI with
Benefits
27
The Big Picture
Evaluate the full suite of benefits offered to employees…think beyond medical, dental and vision coverage
Limited offerings means employees’ needs are not being met
Understand the benefits employees actually utilize
Look to enhance benefits to improve morale and become the employer of choice
Consider bolt-on programs to supplement core offerings
28
Benefits Solutions
Family Formation + Childcare
Domestic Partners
Supporting Gender Identity
Mental Health
Student Loan Repayment + Voluntary Benefits
Leaves of Absence
Lifestyle Accounts
29
51.7% of the U.S. workforce is female **
*2022 Harvard Business Review
**Bureau of Labor Statistics 2021
***2022 Maven _The State of Family Health Benefits
****US Census Bureau 2021
The median age of first-time births in the U.S. is 30 –
trending upwards since the 1990s ****
1 in 8 U.S. couples face infertility – more than
diabetes or breast cancer*
57% of employees are expanding or planning to expand their families ***
DID YOU KNOW...
30
77% would stay at a company if it offered fertility benefits.*
*2022 Carrot & Resolve.org Survey
** 2022 Maven _The State of Family Health Benefits
***CSource: Cleo, Making Families That Work
63% of LGBTQ+ people are planning to build families using assisted reproductive
technologies, foster care, or adoption. *
89% said that fertility and family forming has negatively affected their mental health.*
31
Cost of Inaction
left their jobs because they
wanted to find a better fit on
their path to and through
parenthood.*
17
%
88
%
of people said they would
change jobs because of fertility
benefits. **
*2022 Maven _The State of Family Health Benefits
**2022 Carrot _ Market Landscape & Stats
***2021 Mercer survey on Fertility Benefits
When employees don’t feel supported, it impacts their ability to start and
raise families—and their loyalty to their job.
of employers said they have
NOT experienced a significant
increase in medical plan cost,
when asked about the impact of
offering infertility coverage. ***
97
%
32
Fertility Benefits Trending: (2020 vs. 2016)
International Foundation of Employer Benefits Plans
The percentage of
organizations that
are covering fertility
benefits has grown
significantly.
33
Domestic Partner Coverage
o Originally offered by employers when same-sex couples were not allowed to marry
o Frequently driven by younger employees delaying marriage, and older employees not wishing to remarry
o Often includes both registered and non-registered domestic partners, same and opposite-sex
o Don’t forget about dependent children of the domestic partner who are not the employee’s children
o Can apply to all lines of coverage that spouses/children are eligible for
34
Supporting Gender Identity
o Specifically included as covered under the health plan rather than merely not excluded
o Gender affirmation surgery
o Hormone replacement therapy
o Mental health
o Related laboratory services & cosmetic surgery
Applicable to spouses, domestic partners and dependents
No annual or lifetime maximums
Out of network coverage when in network care is unavailable + travel benefits
35
26% of Americans suffer from a
diagnosable mental disorder in a given
year.. *
60% of working parents reported being “very” to “extremely concerned” about
their child’s emotional health and development or behavior in the past 2 years. **
DID YOU KNOW...
* Hopkins Medicine _ Mental Health Disorder Statistics
** Nationwide Children’s _ The Great Collide 2022 Report
*** CDC _Facts About Suicide 2020
:**** American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association
.
Suicide is the 2nd
leading cause of death among people ages 10-14 and 25-34.
***
Declaration of a National Emergency in Child and Adolescent Mental Health ****
36
7 in 10 employees found it difficult to concentrate at work (2022). *
*Mental Health America _ 2022 Mind the Workplace Study
**NIH_ National Library of Medicine_ Ten modifiable health risk factors are linked to more than 1/5 employer health care spending
*** 2020 IBM Study
Employees at high risk of depression remained most strongly associated with
increase (48% higher) per capita medical spending up to 3 years after.**
When asked if companies were supporting the physical
and emotional health of employees, 80% of executives
agreed or strongly agreed.
Yet when the same question was posed to employees,
the figure was a glaringly low 46%. ***
- - -
37
A Concerning Mental Health Gap
Hartford 2022
More employers feel they have offered workers mental health resources than in previous years and that
their Company culture around mental health has significantly improved. However, workers disagreed.
EMPLOYERS WORKERS
Feel workers have the flexibility in their schedule to
get the mental health they need
80% 53%
Have more access to mental health resources than
previous years
82% 50%
Has an open and inclusive environment that
encourages a dialogue about mental health
82% 48%
Mental health has improved thanks to resources
provided by the company
79% 35%
38
Cost of Inaction
of workers reported the
workplace itself affects their
mental health and wellbeing.***
85
%
91
%
of HBR respondents believe that a
company’s culture should support
mental health (up from 86% in
2019).**
*Mental Health America _ 2022 Mind the Workplace Study
**HBR_ October 2021 _It’s a New Era for Mental Health at work
***National Safety Council
For every
$1 SPENT
on mental health
care, there is a
$4 RETURN
in improved health
and productivity. *
39
Voluntary Benefits: Diversity, Equity and Inclusion
Student Loan Debt Profile
o 58% of all Student Loan Debt Belongs to Women
o 48% of Black Students owe an average of 12.5% more than
they borrowed today
o 30% of Black College Graduates with student loans default in
the first 12 years of repayment
o 50% of Black Student Borrowers report their net worth is less
than they owe in student loan debt / At 52%, Asian student
borrowers are the most likely to have a net worth that exceeds
their student loan debt
o Hispanic and Latino borrowers were the most likely to delay
getting married and having children due to student loan debt
o Borrowers who identify as LGBTQ have an average of $16,000
more in student loan debt
1. Educationdata.org
Impact of Diversity on Student Loan Debt
40
Voluntary Benefits: Inclusion, Equity & Belonging
Legal
Coverage
Assists members with Legal
issues including:
o Change Gender Identifier /
Name
o Immigration
o Adoption
o Bullying/Discrimination
o Domestic Partnership
Agreement
o Hospital Visitation Authorization
o Family Matters (Ex. Divorce,
Abuse, Custody, Juvenile Court)
o Financial Issues
(Ex.Wills/Trusts, Eviction, Credit
Defaults, Bankruptcy, Wage
Garnishment)
Critical
Illness
Insurance
Pays a benefit to the member if
they are diagnosed with a
covered condition
o Including: Cancer,
Cardiovascular Conditions, and
Autoimmune Conditions (2 to 1
diagnosis rate for females vs
males)1
o Racial and ethnic minority
groups throughout the US,
experience higher rates of
illness and death across a wide
range of health conditions,
including: diabetes,
hypertension, obesity, asthma,
and heart disease2
Hospital
Indemnity
Insurance
Pays the member a benefit if they
are hospitalized
o Black adults are ~80%,
American Indian or Alaska
Native adults are ~30%, and
Hispanic Adults are ~20% more
likely to be hospitalized due to
the flu than White adults3
o Top 10 Inpatient Stay
Diagnosis: Maternity,
Septicemia, Heart Failure,
Osteoarthritis, Complications
During Childbirth, Pneumonia,
Diabetes, Heart Attack, Cardiac
Dysrhythmias, Chronic
Obstructive Pulmonary Disease
(now – COVID)4
Life
Insurance
Life insurance is used to: cover
burial/final expenses, help replace
lost wages, help pay living
expenses for dependents, and
more.
o 32% of women do not have any
life insurance and feel they
need it5
o Only 38% of the estimated 19
million US adults who identify
LGBTQ, are life insurance
owners6
1. https://www.sciencedirect.com/science/article/abs/pii/S1568997212000225?via%3Dihub
2. https://www.cdc.gov/minorityhealth/racism-disparities/index.html
3. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb277-Top-Reasons-Hospital-Stays-2018.pdf
4. CUP Fast Stats. Healthcare Cost and Utilization Project (HCUP). April 2021. Agency for Healthcare Research and Quality, Rockville, MD
5. “Key Challenges and Solutions to the Life Insurance Need-Gap Among Women, LIMRA
6. “U.S. Insurance Market Briefing: LGBTQ Americans”, LIMRA
41
Leaves of Absence
Sick, Vacation and PTO just begin to scratch the surface of available leaves
Growth in paid family/parental leave, both statutory and employer driven
Volunteer time to support employees in volunteering
Bereavement leave available for a wide range of losses (including miscarriage), and additional time for certain
losses
PAWternity leave for those who become new pet parents
Sabbatical leave available for long tenured employees
42
Lifestyle Spending Accounts
Taxable, employer provided funds that can be used towards a variety of non-medical expenses
Employers often have flexibility to specify how funds must be used
Can be designed to meet employer budgets, amounts typically range from $200 - $2,000
Wellness related expenses – gym memberships, fitness classes, exercise equipment, fitness trackers
Financial expenses – financial advising and education, identity theft coverage
General expenses – travel, childcare, pet walking/care, entertainment, meditation/relaxation apps
43
MODERATOR:
STEPHANIE BRASWELL
WEBINAR COORDINATOR
Q&A
With Cory Jorbin - Chief Compliance Officer,
West Region with Hub International
Cory Jorbin
/in/coryjorbin/
hubinternational.com/
/in/stephanie-braswell-664364248/

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A Candidate's World - Employee benefits to Aid DEI Initiatives and Support a Positive Workplace Culture.pptx

  • 1. 1 te's World – benefits to Aid DEI and Support a Workplace Culture With Cory Jorbin - Chief Compliance Officer, West Region with Hub International WEBINAR EXCLUSIVE APRIL 6, 2023 11:00 AM PT 2:00 PM ET 7:00 PM GMT
  • 2. 2 Sponsored by: 03 Lark Health is a digital health technology company aimed at delivering infinitely scalable, accessible digital chronic condition prevention and management coaching. To date, Lark has provided 2 million people with real-time, 24/7 personalized care coaching that is delivered through an easy-to-use, text message-like interface. Through the use of conversational AI, connected devices, remote patient monitoring, and Cognitive Behavioral Therapy techniques, Lark is poised to help millions of patients improve their health to manage and reduce their risk of chronic disease. Lark's scalable platform seamlessly integrates with health plans' and employers' existing healthcare infrastructure to support their chronic care prevention and management programs. Lark currently works with many of the largest health plans across five programs: Prevention, Heart Health, Diabetes Prevention, Diabetes Management, and Hypertension Management. Lark's Diabetes Prevention Program (DPP), which is the fastest-growing and lowest-cost DPP, has received Full Recognition from the Centers for Disease Control and Prevention (CDC). The company has received numerous accolades, includin having been named as one of CB Insights Digital Health 150 (2019), a finalist for the UCSF Digital Health Awards (2022), one of Fast Company's Most Innovative Companies (multiple years), and one of Fierce Healthcare's Fierce15 (2020). To learn more visit www.lark.com
  • 3. 3 Have questions about todays presentation? Click on the Questions panel to interact with the presenters Having issues with todays presentation? Try Dialing in! TO USE YOUR TELEPHONE: You must select "Use Telephone" after joining and call in using the numbers below. United States: +1 (415) 655-0052 Access Code: 699-978-222 Audio PIN: Shown after joining the webinar
  • 4. 4 A Candidate's World – Employee benefits to Aid DEI Initiatives and Support a Positive Workplace Culture With Cory Jorbin - Chief Compliance Officer, West Region with Hub International WEBINAR EXCLUSIVE
  • 5. 5 5 Agenda Diversity, Equity & Inclusion 1 2 Benefits Protections 3 Supporting DEI with Benefits
  • 7. 7 Definitions Definitions sourced from City of Portland Office of Equity and Human Rights, The Independent Sector, and UC Berkeley https://www.gensler.com/blog/inclusion-by-design-insights-from-design-week-portland Di●ver●si●ty All the ways in which people differ. Eq●ui●ty Fair treatment, access, opportunity, and advancement for all people. One’s identity cannot predict the outcome. In●clu●sion A variety of people have power, a voice, and decision- making authority.
  • 11. 11 Stats… 67% of job seekers consider workplace diversity an important factor when considering employment opportunities, and more than 50% of current employees want their workplace to do more to increase diversity. https://www.glassdoor.com/employers/blog/diversity/ 45% of American workers experienced discrimination and / or harassment in the past year. https://www.gallup.com/workplace/215939/invest-diversity-inclusion.aspx?utm_source=link_wwwv9&utm_campaign=item_236264&utm_medium=copy 78% of employees who responded to a Harvard Business Review (HBR) study said they work at organizations that lack diversity in leadership positions. https://hbr.org/2013/12/how-diversity-can-drive-innovation Organizations with above-average gender diversity and levels of employee engagement outperform companies with below-average diversity and engagement by 46% to 58%. https://www.fastcompany.com/3067346/how-these-top-companies-are-getting-inclusion-right 48% of employees believe that respect is the most essential factor for a culture of inclusion. 61% of employees believe diversity and inclusion strategies are beneficial and essential. 75% of employees think more diversity is needed https://www.quantumworkplace.com/diversity-and-inclusion-in-the-workplace https://www.indeed.com/career-advice/finding-a-job/diversity-inclusion-and-belonging -jobs-rise#:~:text=According%20to%20Indeed%20data%2C%20demand,jobs%20per %20million%20to%20219
  • 12. 12 An Integrated Approach Goal: Deliver Quality Employee experiences By Coauthoring Quality Employer experiences o Recognize that every dimension of an individual’s performance and health is interconnected. o Identify the key success metrics that influence a person’s ability to thrive - both at work and at home. o Develop a comprehensive strategy to solve issues and prioritize needs.
  • 13. 13 The Employee Lifecycle: The Game of Life™ Family Leave Serious Accident Lost Job Drug/Alcohol Treatment Overcrowding At Home Death of Close Friend Are your Benefits a Parachute or the Thrill of the Sky Dive? • Is Human Resources positioned as primary destination? • Is Technology Platform adept at providing solutions? • Can we use data to predict needs/noise? Loss of Family Pet Promotion/ Transfer Change in Citizenship/ Naturalization Status Child moving out of home Downshifting Job Responsibilities Change in Retirement Horizon A New Puppy Change in Childcare Status Divorce A long-planned trip
  • 14. Strategic Execution Specialty Offerings Insights from Employees Modernizing the employer/ employee experience through data analysis Multi-year Strategic Plan Employee Experience Specialty Offerings Strategic Execution • Strategy • Cost Optimization • Employee Engagement • Plan & Contribution Design • Communication • Wellness • Leaves of Absence • Voluntary Benefits • Pharmacy • Technology • Compliance • Retirement • Lack of Choice • Population Targeting • Suboptimization of Spend • More Relevant Benefits The Workforce Experience
  • 16. 16 What Employees Need, Want, and Expect o No discrimination in plan design and administration o Consistency in plan administration o Understandable, accessible, and expedient claims processes o Plain language explanations of employee and Plan Sponsor rights and obligations o Affordable health insurance premiums and limited financial exposure for health events o Ability to plan ahead and make informed decisions o Certainty of costs o Clear explanations of federal and state employee rights o Proper use of Plan Assets
  • 17. 17 Benefits Protections HIPAA Prohibits group health plans and health insurance issuers offering group health insurance coverage from discriminating with regard to eligibility, premiums, or contributions on the basis of specified health status-related factors. Affordable Care Act o Prohibits exclusions from plan eligibility based on pre-existing conditions – goes beyond HIPAA protections o Section 1557 provides protections on the basis of sex, including sex stereotyping and gender identity Mental Health Parity Requires plans to treat mental health / substance abuse disorder benefits in parity with medical / surgical benefits Title VII EEOC requires coverage under employer sponsored health plans be provided “without regard to the race, color, sex, national origin, or religion of the insured.”
  • 18. 18 HIPAA Health status related factors – health status, medical condition, claims experience, receipt of healthcare, genetic condition, disability, medical history Eligibility – enrollment, waiting periods, special enrollment, benefits Plans may not have: o EOI requirements o Actively at work provisions o Exclusions based on past claims history o Exclusions based on participating in dangerous activities o Exclusions directed at specific participants Pre-existing condition protections
  • 19. 19 Affordable Care Act Expands on HIPAA protections against exclusions based on pre-existing conditions Previous HIPAA protections only allowed for minimum gaps in coverage Prohibits excessive waiting periods o Maximum waiting periods capped at 90 days for full-time employees & up to 12 months for variable hour employees who qualify Prohibitions on recissions of coverage o Aimed at retroactive cancellations o Only allowed due to fraud, or intentional misrepresentation of material facts o Exception for cancellation due to non-payment of premiums
  • 20. 20 Section 1557 - Background ACA provision that prevents plans issued by Covered Entities from discriminating on the basis of gender identity and sexual stereotyping Covered Entities are those who receive funding from HHS…all fully-insured plans since carriers receive HHS funding, and self-insured plans that receive HHS funding Who receives HHS funding? It depends…medical practices, hospitals, home health agencies, assisted living facilities and also possibly schools, municipalities, and other organizations – question for accounting team Legislative rollercoaster since 2016, with new “final” rules expected in 2023
  • 21. 21 Mental Health Parity Health plans not required to cover mental health, but if they do, they need to treat mental health / substance abuse (“MH / SUD”) benefits in parity with medical / surgical (“Med / Sur”) benefits under the plan Quantitative limitations o Limits tied to numbers, such as a limit on the number of visits, or annual dollar limits o Limits prohibited for MH / SUD without also having them on the Med / Sur side Non-Quantitative Treatment Limitations o Limits other than those tied to numbers – step-therapy, medical necessity, prerequisites o Standards can be no greater on MH / SUD benefits than Med / Sur benefits o Comparative analysis requirement added for plans in 2021
  • 22. 22 Overview of Title VII Sexual harassment is a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964 (Title VII) Title VII prohibits discrimination on the basis of: o Sex (including pregnancy and gender nonconformity) o Race o Color o Religion o National origin Title VII prohibits adverse employment actions against protected classes, including: o Termination o Failure to hire o Demotion
  • 23. 23 Forms of Discrimination Intentional Discrimination against an employee or applicant because of their membership in a protected class or classes. Disparate Impact Discrimination occurs when a neutral-appearing practice or policy actually has a discriminatory effect on a protected class or classes.
  • 24. 24 What is Discrimination Treatment or consideration based on class or category rather than individual merit. It is illegal to discriminate in any aspect of employment, including: o Hiring and firing o Pay, retirement plans, and disability leave o Employee benefits o Fringe benefits o Compensation, assignment, or classification of employees o Transfer, promotion, layoff, or recall o Job advertisements o Recruitment o Use of company facilities o Training and apprenticeship programs o Other terms and conditions of employment
  • 25. 25 Summary of Protected Classes o Race o Color o Religion o Age o Gender o Transgender o Sexual Orientation o Disability o Whistleblower o Worker’s Compensation o Pregnancy
  • 27. 27 The Big Picture Evaluate the full suite of benefits offered to employees…think beyond medical, dental and vision coverage Limited offerings means employees’ needs are not being met Understand the benefits employees actually utilize Look to enhance benefits to improve morale and become the employer of choice Consider bolt-on programs to supplement core offerings
  • 28. 28 Benefits Solutions Family Formation + Childcare Domestic Partners Supporting Gender Identity Mental Health Student Loan Repayment + Voluntary Benefits Leaves of Absence Lifestyle Accounts
  • 29. 29 51.7% of the U.S. workforce is female ** *2022 Harvard Business Review **Bureau of Labor Statistics 2021 ***2022 Maven _The State of Family Health Benefits ****US Census Bureau 2021 The median age of first-time births in the U.S. is 30 – trending upwards since the 1990s **** 1 in 8 U.S. couples face infertility – more than diabetes or breast cancer* 57% of employees are expanding or planning to expand their families *** DID YOU KNOW...
  • 30. 30 77% would stay at a company if it offered fertility benefits.* *2022 Carrot & Resolve.org Survey ** 2022 Maven _The State of Family Health Benefits ***CSource: Cleo, Making Families That Work 63% of LGBTQ+ people are planning to build families using assisted reproductive technologies, foster care, or adoption. * 89% said that fertility and family forming has negatively affected their mental health.*
  • 31. 31 Cost of Inaction left their jobs because they wanted to find a better fit on their path to and through parenthood.* 17 % 88 % of people said they would change jobs because of fertility benefits. ** *2022 Maven _The State of Family Health Benefits **2022 Carrot _ Market Landscape & Stats ***2021 Mercer survey on Fertility Benefits When employees don’t feel supported, it impacts their ability to start and raise families—and their loyalty to their job. of employers said they have NOT experienced a significant increase in medical plan cost, when asked about the impact of offering infertility coverage. *** 97 %
  • 32. 32 Fertility Benefits Trending: (2020 vs. 2016) International Foundation of Employer Benefits Plans The percentage of organizations that are covering fertility benefits has grown significantly.
  • 33. 33 Domestic Partner Coverage o Originally offered by employers when same-sex couples were not allowed to marry o Frequently driven by younger employees delaying marriage, and older employees not wishing to remarry o Often includes both registered and non-registered domestic partners, same and opposite-sex o Don’t forget about dependent children of the domestic partner who are not the employee’s children o Can apply to all lines of coverage that spouses/children are eligible for
  • 34. 34 Supporting Gender Identity o Specifically included as covered under the health plan rather than merely not excluded o Gender affirmation surgery o Hormone replacement therapy o Mental health o Related laboratory services & cosmetic surgery Applicable to spouses, domestic partners and dependents No annual or lifetime maximums Out of network coverage when in network care is unavailable + travel benefits
  • 35. 35 26% of Americans suffer from a diagnosable mental disorder in a given year.. * 60% of working parents reported being “very” to “extremely concerned” about their child’s emotional health and development or behavior in the past 2 years. ** DID YOU KNOW... * Hopkins Medicine _ Mental Health Disorder Statistics ** Nationwide Children’s _ The Great Collide 2022 Report *** CDC _Facts About Suicide 2020 :**** American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association . Suicide is the 2nd leading cause of death among people ages 10-14 and 25-34. *** Declaration of a National Emergency in Child and Adolescent Mental Health ****
  • 36. 36 7 in 10 employees found it difficult to concentrate at work (2022). * *Mental Health America _ 2022 Mind the Workplace Study **NIH_ National Library of Medicine_ Ten modifiable health risk factors are linked to more than 1/5 employer health care spending *** 2020 IBM Study Employees at high risk of depression remained most strongly associated with increase (48% higher) per capita medical spending up to 3 years after.** When asked if companies were supporting the physical and emotional health of employees, 80% of executives agreed or strongly agreed. Yet when the same question was posed to employees, the figure was a glaringly low 46%. *** - - -
  • 37. 37 A Concerning Mental Health Gap Hartford 2022 More employers feel they have offered workers mental health resources than in previous years and that their Company culture around mental health has significantly improved. However, workers disagreed. EMPLOYERS WORKERS Feel workers have the flexibility in their schedule to get the mental health they need 80% 53% Have more access to mental health resources than previous years 82% 50% Has an open and inclusive environment that encourages a dialogue about mental health 82% 48% Mental health has improved thanks to resources provided by the company 79% 35%
  • 38. 38 Cost of Inaction of workers reported the workplace itself affects their mental health and wellbeing.*** 85 % 91 % of HBR respondents believe that a company’s culture should support mental health (up from 86% in 2019).** *Mental Health America _ 2022 Mind the Workplace Study **HBR_ October 2021 _It’s a New Era for Mental Health at work ***National Safety Council For every $1 SPENT on mental health care, there is a $4 RETURN in improved health and productivity. *
  • 39. 39 Voluntary Benefits: Diversity, Equity and Inclusion Student Loan Debt Profile o 58% of all Student Loan Debt Belongs to Women o 48% of Black Students owe an average of 12.5% more than they borrowed today o 30% of Black College Graduates with student loans default in the first 12 years of repayment o 50% of Black Student Borrowers report their net worth is less than they owe in student loan debt / At 52%, Asian student borrowers are the most likely to have a net worth that exceeds their student loan debt o Hispanic and Latino borrowers were the most likely to delay getting married and having children due to student loan debt o Borrowers who identify as LGBTQ have an average of $16,000 more in student loan debt 1. Educationdata.org Impact of Diversity on Student Loan Debt
  • 40. 40 Voluntary Benefits: Inclusion, Equity & Belonging Legal Coverage Assists members with Legal issues including: o Change Gender Identifier / Name o Immigration o Adoption o Bullying/Discrimination o Domestic Partnership Agreement o Hospital Visitation Authorization o Family Matters (Ex. Divorce, Abuse, Custody, Juvenile Court) o Financial Issues (Ex.Wills/Trusts, Eviction, Credit Defaults, Bankruptcy, Wage Garnishment) Critical Illness Insurance Pays a benefit to the member if they are diagnosed with a covered condition o Including: Cancer, Cardiovascular Conditions, and Autoimmune Conditions (2 to 1 diagnosis rate for females vs males)1 o Racial and ethnic minority groups throughout the US, experience higher rates of illness and death across a wide range of health conditions, including: diabetes, hypertension, obesity, asthma, and heart disease2 Hospital Indemnity Insurance Pays the member a benefit if they are hospitalized o Black adults are ~80%, American Indian or Alaska Native adults are ~30%, and Hispanic Adults are ~20% more likely to be hospitalized due to the flu than White adults3 o Top 10 Inpatient Stay Diagnosis: Maternity, Septicemia, Heart Failure, Osteoarthritis, Complications During Childbirth, Pneumonia, Diabetes, Heart Attack, Cardiac Dysrhythmias, Chronic Obstructive Pulmonary Disease (now – COVID)4 Life Insurance Life insurance is used to: cover burial/final expenses, help replace lost wages, help pay living expenses for dependents, and more. o 32% of women do not have any life insurance and feel they need it5 o Only 38% of the estimated 19 million US adults who identify LGBTQ, are life insurance owners6 1. https://www.sciencedirect.com/science/article/abs/pii/S1568997212000225?via%3Dihub 2. https://www.cdc.gov/minorityhealth/racism-disparities/index.html 3. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb277-Top-Reasons-Hospital-Stays-2018.pdf 4. CUP Fast Stats. Healthcare Cost and Utilization Project (HCUP). April 2021. Agency for Healthcare Research and Quality, Rockville, MD 5. “Key Challenges and Solutions to the Life Insurance Need-Gap Among Women, LIMRA 6. “U.S. Insurance Market Briefing: LGBTQ Americans”, LIMRA
  • 41. 41 Leaves of Absence Sick, Vacation and PTO just begin to scratch the surface of available leaves Growth in paid family/parental leave, both statutory and employer driven Volunteer time to support employees in volunteering Bereavement leave available for a wide range of losses (including miscarriage), and additional time for certain losses PAWternity leave for those who become new pet parents Sabbatical leave available for long tenured employees
  • 42. 42 Lifestyle Spending Accounts Taxable, employer provided funds that can be used towards a variety of non-medical expenses Employers often have flexibility to specify how funds must be used Can be designed to meet employer budgets, amounts typically range from $200 - $2,000 Wellness related expenses – gym memberships, fitness classes, exercise equipment, fitness trackers Financial expenses – financial advising and education, identity theft coverage General expenses – travel, childcare, pet walking/care, entertainment, meditation/relaxation apps
  • 43. 43 MODERATOR: STEPHANIE BRASWELL WEBINAR COORDINATOR Q&A With Cory Jorbin - Chief Compliance Officer, West Region with Hub International Cory Jorbin /in/coryjorbin/ hubinternational.com/ /in/stephanie-braswell-664364248/