ATLANTA — There was a lot of scowling during a health reform session at the Society for Human Resource Management's annual conference in Atlanta.
Kay Mooney, head of strategic development and products at Aetna, spoke Monday before a very packed session. The president's health care reform may be headed for extinction, but benefits managers at the expo weren't ready to dismiss it just yet, not when there are penalties still at stake.
While managers still don't know the fate of the Affordable Care Act, they're sure of one thing: it won't be affordable. And it won't be easy to factor in all the variables that come with managing a diverse work force — like employee wages and employment status. Clearly, the biggest groans were over the law's effort to expand coverage even if it's offered through an employer.
Take the full-time employee definition change, for example. Under health reform, FTE's are considered as employees who average 30 or more hours. Furthermore, after a waiting period, every new employee will need to be automatically enrolled in a plan.
On top of these mandates, those employers who offer rich benefits to attract top talent will be hit with an excise tax for high-cost policies. Employers will also have to ensure premiums aren't costing more than 9.5 percent of an employee's income for single coverage.
All of these efforts are likely to drive up benefits expenses for the sake of helping people access affordable and comprehensive coverage. There's a slight problem — employee situations are never the same. Some employers have a population of older workers; some fluctuate working hours; and some have higher turnover rates with relatively low-wage workers. Or maybe their industry in general is risky.
One HR manager I spoke with didn't seem to be concerned about understanding health care reform; If it survives, her health carrier will give her all the information she needs.
That's a good assumption, but if you haven't reached out to a consultant by now, you will before 2014, when things will really get interesting. According to Mooney, that's when the four pillars of change will happen for benefits managers — changed health insurance demographics, evolved affordability considerations, increased regulatory scrutiny and oversight, and a shift from risk selection to risk attraction.
This change will prompt many questions from employers: Should I continue to offer benefits? What do my employees want? Are they eligible for subsidies? Are they better off going to a health insurance exchange?
So many scenarios, so little time to waste.
Despite the uncertainty and frustration, Mooney says she's optimistic. This is the first time in her career with Aetna that she's felt empowered to make a real change in the way we receive health care — an encouraging statement from an actuary who's weighed all the risks of this intrusive law.
Like Mooney, I'm ready to move past the confusion and questions. Come Thursday, optimistic or appalled, at least we'll finally get a decision.