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Give and Take

With five generations in today’s workforce, employee benefits are no one-size-fits-all proposition — yet, they remain a key issue for employers looking to attract and retain a skilled workforce. Striking a balance between what employees want and what the business can afford is certainly a challenge — but the flexibility and options available to employers these days makes the task a little easier to navigate.

By Mark Morris

Between demographic changes in the workforce and the impact of the pandemic, employers face multiple challenges these days in offering health insurance and other benefits to their workers.

In the U.S., 49% of people receive health-insurance coverage through their employer. According to the Kaiser Family Foundation, that percentage represents approximately 156 million Americans. Many of those workers also receive coverage for dental care and disability, as well as access to a retirement plan as part of a complete benefits package.

And, despite the increasing costs of health insurance, employers are not cutting back on this essential coverage, said Peter Miller, partner with Millbrook Benefits and Insurance Services in Springfield.

“They are trying to strike a balance between offering a benefits package that is attractive to new hires, while also trying to control costs and keep the business running,” he noted.

Traditional benefits, such as healthcare coverage and retirement plans, have always been important to employees. According to Patrick Leary, vice president of Work Benefits Research at LIMRA in Windsor, Conn., traditional benefits make up the core of an employer’s value proposition to employees.

In putting together a benefits package, an employer decides whether a particular offering will be paid 100% by the employer, or use a cost-sharing approach in which employees contribute as well. A third option, known as a voluntary benefit, is completely paid for by the employee.

LIMRA provides research for the insurance and financial-services industry. One significant trend Leary has studied is the expanding demographics of the workplace.

“There are now five generations in the labor force,” he said. “The oldest workers are staying longer, while Gen Z is just beginning to enter the workforce.”

Each generation has different benefit needs, and they are all looking to their employer to address them. Voluntary benefits are one way for an employer to accommodate different needs among a diverse employee population.

Peter Miller

Peter Miller

“They are trying to strike a balance between offering a benefits package that is attractive to new hires, while also trying to control costs and keep the business running.”

“A company can offer a broad-based plan where some benefits appeal to younger workers and some to older,” Leary said. “Because they are voluntary benefits, the employer can address the various needs of their employees without increasing their costs.”

He emphasized the importance of employers working with a benefits consultant to find the right mix. “Part of the process involves the employer understanding their current employees and the types of workers they plan to recruit for the future.”

Employers typically add benefits to make their companies more attractive to the specific types of workers they seek. For example, Miller has been discussing benefit packages with a tech company looking to attract engineering graduates from prominent colleges. While traditional benefits are important, flexible work arrangements and college debt-repayment programs also have a strong appeal to this group.

“It’s important for employers to think outside the box to make themselves more attractive to the people they’re trying to hire,” he said.

College debt repayment offered as a formal benefit is relatively new, but it’s quickly becoming a popular benefit as more graduates enter the workforce saddled with large debt obligations.

Meredith Wise, president of the Employers Assoc. of the NorthEast, said employers are using different tactics to help new employees manage their student-loan debt. Some employers offer a hiring bonus so new employees can pay off a chunk of their student loan.

Another approach allows employees to pay down their debt and contribute to their retirement savings at the same time. Based on his conversations with employers, Leary said the 401(k)/student-loan payment approach strongly resonates with young employees.

“The amount the employee pays each month toward their debt is matched up to 5% by the employer in a 401(k) plan,” Wise said. “This is helpful to young workers who would not normally be thinking about their retirement savings because they are saddled with debt.”

 

What COVID Wrought

There’s nothing quite like a worldwide pandemic to remind everyone of the importance of having healthcare coverage. After 14 months of operating during the pandemic, the benefits professionals BusinessWest spoke with cited two notable trends: an increase in telehealth offerings and usage, as well as an increased demand for mental-health services.

“There’s definitely been an increase in utilization for traditional medicine and mental health,” Miller said.

Wise agreed. “Employers are looking at the mental-health benefits covered under their policies and, in many cases, are augmenting those benefits with employee-assistance programs,” she noted.

A survey released in March by America’s Health Insurance Plans reported that 56% of employees said their telehealth and mental-health services are more valuable now than they were a year ago, before COVID-19.”

Offering wellness programs as a benefit is another trend that has gained popularity in the last several years. “Employers are adding or increasing benefits around wellness, nutrition, stress management, and other areas,” Wise said.

In addition to health wellness, Leary said employers are increasingly offering financial wellness programs as a benefit.

Patrick Leary

Patrick Leary

“Some older employees might be sandwiched between taking care of their children and their parents at the same time, while others are looking at their planning needs for retirement.”

“If an employee is stressed out about their personal finances, it affects their productivity at work,” he said, pointing out that financial wellness is a benefit that can help employees at every stage of their careers by providing guidance tailored to their individual needs.

“It’s a chance to help younger employees get off to a good start and to check in with older Millennials, now approaching their 40s, about retirement planning and the telehealth benefit they can access,” Leary explained. “Some older employees might be sandwiched between taking care of their children and their parents at the same time, while others are looking at their planning needs for retirement.”

Because employees have so many different needs, communication around benefit offerings becomes essential. As COVID disrupted so many other norms, it also caused significant changes in benefit communications. But in this particular case, Miller said, the change was an improvement.

For years, the model for enrolling employees into a company’s benefit plan involved on-site meetings and speaking directly with as many employees as possible to make sure all their questions and concerns were addressed. Miller said the strong in-person presence continued even after the actual enrollments were done online.

“We’re doing many of our open-enrollment meetings now on Zoom,” he said. “One advantage is that you can gather employees no matter where they are for the live presentation, and they can ask questions, either by shouting them out or using the chat box.”

For employees who may be on vacation or traveling, the Zoom meeting is recorded and uploaded to a video-sharing platform like YouTube.

“Lots of people want to discuss their benefit options with their spouse,” Miller said. “Now they can, because everyone can access the presentation whenever they want.”

Miller said the video gives employers a tool they can use for the entire plan year. “When a new hire comes in, they can be directed to the link and listen in on the entire employee-benefit presentation. The video approach was one of the few positive developments that resulted from adjusting to COVID concerns.”

Sometimes, a new employee benefit can emerge from a catastrophe. At the onset of COVID, Leary said, employers were frantically setting people up at home just to keep their businesses in operation.

“Several months later, they began seeing the benefits of having people work from home,” Leary said. “While many are discussing a hybrid approach, where employees split their time between the office and home, working from home to some degree is now undeniable.”

Because his business lends itself to working remotely, Miller said his employees definitely perceive it as a benefit.

“If you asked me last February if working from home would be feasible, I would have said ‘no way,’” he noted. “But it not only works, it works very well.”

 

Help Wanted

These days, employers need every benefit they can offer when recruiting new employees. Despite businesses itching to expand, Miller said, employers face new challenges in doing so. “I’ve been doing this nearly 30 years, and I don’t ever remember so many different employers saying they can’t get good people.”

Local employers he’s speaking with are increasingly hiring workers from other states to meet their needs.

“My clients are looking for health plans that are more robust and have a national presence,” Miller said. “I’m hearing that from employers right here in Western Mass.”

For many, traditional benefits remain important, but they make up only a part of the employment experience. Leary said the move to remote work means employers and benefit consultants need to think in new ways to communicate benefits and enroll employees in a new hybrid environment.

“You can make the argument that flexible work schedules and the ability to work autonomously without having a manager look over your shoulder are also benefits that go beyond traditional health, dental, and disability plans,” Miller said.

It’s a trend to keep an eye on — one of many employers need to consider as they determine which benefits will attract and retain employees in a changing economy — while making sense for the company’s bottom line.

Senior Planning

Many Options Are Available for Seniors and Their Families

From the NATIONAL INSTITUTE ON AGING

Many older adults and caregivers worry about the cost of medical care. These expenses can use up a significant part of monthly income, even for families who thought they had saved enough.

How people pay for long-term care — whether delivered at home or in a hospital, assisted-living facility, or skilled-nursing facility — depends on their financial situation and the kinds of services they use. Often, they rely on a variety of payment sources, including personal funds, government programs, and private financing options.

Out of Pocket

At first, many older adults pay for care in part with their own money. They may use personal savings, a pension or other retirement fund, income from stocks and bonds, or proceeds from the sale of a home.

“How people pay for long-term care — whether delivered at home or in a hospital, assisted-living facility, or skilled-nursing facility — depends on their financial situation and the kinds of services they use.”

Professional care given in assisted-living facilities and continuing-care retirement communities is almost always paid for out of pocket, though Medicaid may pay some costs for people who meet financial and health requirements.

Medicare

Medicare is a federal government health-insurance program that pays some medical costs for people age 65 and older, and for all people with late-stage kidney failure. It also pays some medical costs for those who have gotten Social Security Disability Income (discussed later) for 24 months. It does not cover ongoing personal care at home, assisted living, or long-term care.

Medicaid

Some people may qualify for Medicaid, a combined federal and state program for low-income people and families. This program covers the costs of medical care and some types of long-term care for people who have limited income and meet other eligibility requirements.

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a Medicare program that provides care and services to people who otherwise would need care in a nursing home. PACE covers medical, social-service, and long-term-care costs for frail people. It may pay for some or all of the long-term-care needs of a person with Alzheimer’s disease. PACE permits most people who qualify to continue living at home instead of moving to a long-term care facility. There may be a monthly charge.

State Health Insurance Assistance Program (SHIP)

SHIP, the State Health Insurance Assistance Program, is a national program offered in each state that provides counseling and assistance to people and their families on Medicare, Medicaid, and Medicare supplemental insurance (Medigap) matters.

Department of Veterans Affairs

The U.S. Department of Veterans Affairs (VA) may provide long-term care or at-home care for some veterans. If your family member or relative is eligible for veterans’ benefits, check with the VA or get in touch with the VA medical center nearest you. There could be a waiting list for VA nursing homes.

Social Security Disability Income (SSDI)

This type of Social Security is for people younger than age 65 who are disabled according to the Social Security Administration’s definition. For a person to qualify for Social Security Disability Income, he or she must be able to show that the person is unable to work, the condition will last at least a year, and the condition is expected to result in death. Social Security has ‘compassionate allowances’ to help people with Alzheimer’s disease, other dementias, and certain other serious medical conditions get disability benefits more quickly.

Private Financing Options for Long-term Care

In addition to personal and government funds, there are several private payment options, including long-term-care insurance (see story on this page), reverse mortgages, certain life-insurance policies, annuities, and trusts. Which option is best for a person depends on many factors, including the person’s age, health status, personal finances, and risk of needing care.

Reverse Mortgages for Seniors

A reverse mortgage is a special type of home loan that lets a homeowner convert part of the ownership value in his or her home into cash. Unlike a traditional home loan, no repayment is required until the borrower sells the home, no longer uses it as a main residence, or dies.

There are no income or medical requirements to get a reverse mortgage, but you must be age 62 or older. The loan amount is tax-free and can be used for any expense, including long-term care. However, if you have an existing mortgage or other debt against your home, you must use the funds to pay off those debts first.

Trusts

A trust is a legal entity that allows a person to transfer assets to another person, called the trustee. Once the trust is established, the trustee manages and controls the assets for the person or another beneficiary. You may choose to use a trust to provide flexible control of assets for an older adult or a person with a disability, which could include yourself or your spouse. Two types of trusts can help pay for long-term-care services: charitable remainder trusts and Medicaid disability trusts.

Life-Insurance Policies for Long-term Care

Some life insurance policies can help pay for long-term care. Some policies offer a combination product of both life insurance and long-term-care insurance.

Policies with an ‘accelerated death benefit’ provide tax-free cash advances while you are still alive. The advance is subtracted from the amount your beneficiaries will receive when you die.

You can get an accelerated death benefit if you live permanently in a nursing home, need long-term care for an extended time, are terminally ill, or have a life-threatening diagnosis such as AIDS. Check your life-insurance policy to see exactly what it covers.

You may be able to raise cash by selling your life-insurance policy for its current value. This option, known as a ‘life settlement,’ is usually available only to people age 70 and older. The proceeds are taxable and can be used for any reason, including paying for long-term care.

A similar arrangement, called a ‘viatical settlement,’ allows a terminally ill person to sell his or her life-insurance policy to an insurance company for a percentage of the death benefit on the policy. This option is typically used by people who are expected to live two years or less. A viatical settlement provides immediate cash, but it can be hard to get.

Using Annuities to Pay for Long-term Care

You may choose to enter into an annuity contract with an insurance company to help pay for long-term-care services. In exchange for a single payment or a series of payments, the insurance company will send you an annuity, which is a series of regular payments over a specified period of time. There are two types of annuities: immediate annuities and deferred long-term-care annuities.

Senior Planning

What Options Are Available?

Many seniors are not aware of the options available for affordable housing and care as they age. In Massachusetts, there are a few financial-assistance programs that can assist low- to moderate-income seniors pay for both housing and care options. Residential care homes in Massachusetts offer seniors and disabled adults affordable housing options that include services such as homemade meals, snacks, scheduled activities, housekeeping, laundry, and clinical oversight with medication management.

“Many homes, like the Lathrop Home, offer private rooms, with shared common areas and daily activities to enrich the lives of the residents we serve,” said Crystal Cote-Stosz, executive director of the Northampton facility. “For many individuals, the offerings of a residential care home can bridge the care gap by providing assistance that is customized and affordable. Finances are a major consideration with life’s transitions, and for those of us needing support services such as meals, medication management, and assistance with personal care, making these choices can be difficult. Luckily for Massachusetts residents, subsidized care options are available in many residential care homes and assisted-living facilities.”

Paying for care is a significant stressor for families, especially for those who have not planned ahead or saved enough. According to a TD Bank study, one in five Millennials helps to financially support their aging parents, to the tune of $18,250 per year on average, and nearly three-quarters of the financial aid goes towards general living expenses like food and housing.

Both the state and federal government offer subsidy programs for residential care facilities, like the Lathrop Home, Cote-Stosz noted. The federal subsidy that assists individuals pay for residential care is through the Supplemental Security Income (SSI) program combined with the state Supplemental Security Program. Both programs work together to supplement an individual’s income to pay for the care provided by a residential care home.

The state program that assists residents in Massachusetts pay for residential care is called EAEDC (Emergency Aid to Elderly and Disabled Children). Residential care facilities like the Lathrop Home can have residents with monthly incomes up to $3,450 qualify for assistance paying for care. Many Massachusetts residential care facilities offer nursing on staff to triage residents’ clinical care needs, which allows individuals to remain independent from long-term care.

Residential care facilities provide application assistance for the financial-assistance programs available to those residents that spend down or require a subsidy application from point of admission. Individuals interested in residential care should visit the Massachusetts Assoc. of Residential Care Homes website at maresidentialcarehomes.org.

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