1. SHRM Poll: Organizations’ Response to Health
Care Reform—Organizations’ Short-Term
Decisions
September 17, 2010

2. 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 its implications for employers and employees. This presentation covers
the findings from the second poll in this series, which was conducted in July 2010.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 2

3. Key Findings
• What is the impact of the “grandfathered” status on organizations? 30% of HR professionals
say they are attempting to maintain their organization’s grandfathered status, whereas 11%
have decided not to maintain their organization’s grandfathered status.
• Are organizations planning to implement wellness programs in light of the health care
reform law? Almost two-thirds (64%) of organizations already implemented wellness
programs, and 18% are planning to implement them.
• What provisions in the new law are organizations planning to implement before they
become required by law? About one-third of organizations reported that their plan already
meets legal requirement in the following areas: 1) removing all preexisting condition
exclusions for children under age 19, 2) removing annual maximums, and 3) re-evaluating
current retiree medical plan.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 3

4. Based on the new health care reform law’s “grandfathered” status, which one of
the following statements best describes your organization’s position?
We are or will be conducting analyses and exploring different health care
options to decide whether to keep the grandfathered status 21%
^We will attempt to maintain grandfathered status to avoid additional costs to
the organization and/or employees 21%
We have not yet begun to consider the issues around grandfathered status 17%
Not sure what grandfathered status means 10%
^We will attempt to maintain grandfathered status to avoid having to comply
with specific elements of the new law 9%
We do not qualify for grandfathered status 6%
*We have already decided not to maintain our grandfathered status as it will
cost more to keep it than to change health care plans 6%
*We have already decided not to maintain our grandfathered status because
we want to modify benefits to provide the additional benefits mandated under 5%
non-grandfathereded plans
Other 6%
0% 10% 20% 30%
• 30% of organizations are attempting to maintain their grandfathered status.^
• 11% of organizations have decided not to maintain their grandfathered status.*
Note: n = 826. Percentages do not total 100% due to rounding.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 4

5. Based on the new health care reform law’s “grandfathered“ status, which one of
the following statements best describes your organization’s position?
Comparison by Organization’s Operations Location, Union Status and Medical Benefit Funding
• We are or will be conducting analyses and exploring different health care options to decide whether to keep the grandfathered
status (by union status): Organizations with no employees under a collective bargaining agreement (23%) were more likely than
unionized organizations (14%) to report that they are or will be conducting analyses and exploring different health care options to decide
whether to keep the grandfathered status.
• We have not yet begun to consider the issues around grandfathered status (by medical benefit funding): Self-insured organizations
(24%) were more likely than insured organizations (11%) to report that they have not yet begun to consider the issues around grandfathered
status.
• Not sure what grandfathered status means (by operations location): Organizations with multinational operations (13%) were more likely
than U.S.-based (8%) organizations to report that they are not sure what grandfathered status means.
• We will attempt to maintain grandfathered status to avoid additional costs to the organization and/or employees (by medical
benefit funding): Self-insured organizations (24%) were more likely than insured organizations (17%) to report they will attempt to maintain
grandfathered status to avoid additional costs to the organization and/or employees.
• We will attempt to maintain grandfathered status to avoid having to comply with specific elements of the new law (by operations
location): Organizations with multinational operations (13%) were more likely than U.S.-based organizations (8%) to report they will attempt
to maintain grandfathered status to avoid having to comply with specific elements of the new law.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 5

6. Are there provisions in the new health care reform law that your
organization is planning to implement before they become required by law?
Currently Implementing Not
Offering and Before Implementing
Plan Already Required by Until Required
Meets Legal Law by Law
Requirement
Removing all preexisting condition exclusions for children under age 19 36% 11% 53%
Removing annual maximums 30% 9% 61%
Re-evaluating current retiree medical plan 27% 14% 58%
Removing lifetime maximums 24% 11% 66%
Extending coverage to adult children up to age 26 regardless of status
22% 21% 57%
(student/married)
Extending coverage to adult children up to age 26 regardless of the
20% 19% 61%
availability of other coverage
Reducing the maximum health care flexible spending account (FSA)
8% 8% 83%
employee contributions prior to 2013
Note: n = 209-705. Percentages do not total 100% due to rounding. “Not sure/not applicable” responses were excluded from this analysis.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 6

7. Are there provisions in the new health care reform law that your organization is
planning to implement before they become required by law?
Comparison of Provisions Organizations Are Currently Offering by Organization’s Staff Size
• Removing all preexisting condition exclusions for children under age 19 (by staff size): Larger organizations (those with 2,500 to
24,999 employees) were more likely than organizations with 500 to 2,499 employees to report that removing all preexisting condition
exclusions for children under age 19 is one of the provisions in the new law that their organizations already offer.
Smaller Organizations Larger Organizations Differences Based on
Organization Staff Size
•500 to 2,499 employees (29%) •2,500 to 24,999 employees Larger organizations > smaller
(50%) organizations
• Extending coverage to adult children up to age 26 regardless of status (student/married) (by staff size): Smaller organizations (those
with less than 500 employees) were more likely than organizations with 500 to 2,499 employees to report that extending coverage to adult
children up to age 26 regardless of status is one of the provisions in the new law that their organizations already offer.
Smaller Organizations Larger Organizations Differences Based on
Organization Staff Size
•100 to 499 employees (30%) •500 to 2,499 employees (15%) Smaller organizations > larger
organizations
• Extending coverage to adult children up to age 26 regardless of the availability of other coverage (by staff size): Smaller
organizations (those with less than 500 employees) were more likely than organizations with 500 to 2,499 employees to report that
extending coverage to adult children up to age 26 regardless of the availability of other coverage is one of the provisions in the new law that
their organizations already offer.
Smaller Organizations Larger Organizations Differences Based on
Organization Staff Size
•100 to 499 employees (29%) •500 to 2,499 employees (13%) Smaller organizations > larger
organizations
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 7

8. Are there provisions in the new health care reform law that your organization is
planning to implement before they become required by law?
Comparison of Provisions Organizations Are Currently Offering by Selected Organizational Demographics
Differences Based Differences Based Differences Based
on Organization’s on Medical Benefit on Union Status
Operations Funding
Location
Insured (37%) > self-
Removing annual maximums
insured (26%)
Insured (34%) > self- Unionized (31%) > non-
Removing lifetime maximums
insured (18%) unionized (22%)
U.S.-based only
Extending coverage to adult children up to age 26 regardless of organizations (24%) Insured (39%) > self-
status (student/married) > Multinational insured (10%)
operations (15%)
Extending coverage to adult children up to age 26 regardless of the Insured (35%) > self-
availability of other coverage insured (8%)
Note: Blank cell indicates that there were no significant differences in this category.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 8

9. Are you planning to implement wellness programs in light of the new health
care reform law?
Not planning to
implement yet, 18%
Planning to
implement, 18%
Implemented, 64%
• Comparison by Organization’s Medical Benefit Funding: Self-insured organizations (69%)
were more likely than insured organizations (57%) to report implementing wellness
programs in light of the new health care law.
Note: n = 598. “Not sure/not applicable” responses were excluded from this analysis.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 9

10. How is your organization’s primary medical benefit currently funded?
Insured, 44%
Self-insured, 56%
Note: n = 749 Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 10

11. How is your organization’s primary medical benefit currently funded?
Comparison by Organization’s Staff Size, Operations Location, Sector and Union Status
• 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 (39%) •500 to 2,499 employees (69%) Larger organizations > smaller
•2,500 to 24,999 employees organizations
(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 organization’s primary medical benefit is self-insured.
• By sector: Publicly owned for-profits (72%) were more likely than privately owned for-profits (50%) and nonprofits (49%) to report that their
organization’s primary medical benefit is self-insured.
• By union status: Unionized organizations (64%) were more likely than non-unionized (54%) organizations to report that their organization’s
primary medical benefit is self-insured.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 11

12. 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 7%
Educational services/education 6%
Government/public administration—federal, state/local, tribal 5%
5%
Retail/wholesale trade
Construction, mining, oil and gas 4%
4%
Insurance
Note: n = 754. Percentages do not total 100% due to rounding.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 12

13. Demographics: Organization Industry (continued)
Industry
Other services (e.g., other nonprofit, church/religious organizations) 4%
Transportation, warehousing (e.g., distribution) 3%
High-tech 3%
Services—accommodation, food and 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%
Note: n = 754. Percentages do not total 100% due to rounding.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 13

14. 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%
Note: n = 756 Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 14

15. 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
Note: n = 497. Percentages do not total 100% due to rounding.
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 15

16. Demographics: Other
Does the 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: A 29%
company in which the
U.S.-based operations 75% location and the company
are one and the same
Multinational operations 25% Multi-unit company: A 71%
company that has more than
Note: n = 750 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
Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 16

17. SHRM Poll: Organizations’ Response to Health Care Reform – Poll 2
Methodology
• Response rate = 21%
• Sample comprised of 1,095 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
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Organizations’ Response to Health Care Reform – Pending Short Term Decisions | ©SHRM 2010 17