美国人力资源管理—福利管理-教学课件11.ppt

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1、Chapter 11Managing the Employee Benefits System McGraw-Hill/IrwinCopyright 2011 The McGraw-Hill Companies,Inc.All rights reserved.LEARNING OBJECTIVESMethods for managing benefits costsDifferences between the traditional and flexible approaches to benefits designsEssentials for communicating the bene

2、fits programOutsourcing employee benefitsIssues for the future of employee benefitsThe Market Demands Flexibility in BenefitsEmployees may represent different demographics and value different benefits.Employers are providing choices in individual choices in plan benefits to meet diverse employee nee

3、ds.Traditional Benefits ModelPredetermined set and level of benefitsBased largely on cost considerationsDifferences in employee needs and preferences strongly influence the adequacy of this company-sponsored benefitCAFETERIA PLANSSection 125 of IRC allows for employee choice while preserving employe

4、r tax benefitFlexible(cafeteria)benefits enable employees to choose between type and level of benefitsWith a“qualified benefit”an employee may exclude the cost from their federal income tax calculationExhibit 11.3 identifies allowable and prohibited benefitsCAFETERIA PLAN GUIDELINESMust Be In Writin

5、gChoice of Taxable&Non-TaxableFor Current&Former EmployeesEmployees Yearly ChoiceMust Meet Non-Discretionary RulesMay not defer compensation from year to yearNONDISCRIMINATION RULES VIOLATIONSfor Highly Compensated&Key EmployeesEligibilityHCEs with Shorter Waiting PeriodsBenefitsHCEs with Higher Con

6、tributions and More OptionsConcentrationKey Employees with Higher Contributions and More OptionsFLEXIBLE BENEFIT PLANSVary by Flexibility&CostsPretax Salary Reduction PlansModular PlansCore-Plus Option PlansMix and Match PlansPretax Salary Reduction PlansEmployees set aside a portion of their wages

7、for allowable benefits on a pretax basis.Two common reduction plans are flexible spending accounts which permit employees to pay for certain benefit expenses,typically those that exceed regular benefit limits.The second,premium-only plans,enable employees to pay a share of their health,dental or oth

8、er company-sponsored insurance.MODULAR PLANSPlans offered to different employee demographic groups.Costs vary depending upon which benefits are chosen.Employers typically chose the fixed cost of the lowest possible modular plan and employees who choose higher cost benefits pay the difference.Meeting

9、 employee life cycle needsCORE-PLUS-OPTION PLANSPre-Established Benefits Plus Employee Choice of OptionsEmployees Offered Option of Cash Over Additional BenefitsMIX AND MATCH PLANSEmployer decides how much it will spend annually per employee.Company awards credits which employees use to make their b

10、enefits choices.The value of each credit and the cost of each benefit is clearly communicated to the employee.COMMUNICATING EMPLOYEE BENEFITS PROGRAMSElementsLegal ConsiderationsSummary Plan DescriptionSummary of Material ModificationGood Business SensePlan Summary Names&Address of Developers and Ad

11、ministrators Plan Benefits Employee Rights under ERISA Eligibility Criteria Disqualification or Suspension Rules Claims Procedures Notification of Insurance Protection(whether insured by PBGC)Employers are obligated to distribute summary plan descriptions to employees and U.S.DOL within 120 days of

12、the plan becoming subject to ERISA.MANAGING COSTSALTERNATIVE METHODSBenefit FeaturesEmployee Contributions Waiting PeriodsHigh Deductible PlansUtilization ReviewsCase ManagementProvider Payment SystemsLifestyle InterventionsTrends in Managing Cost1.Companies may impose waiting periods for specific b

13、enefits.2.High-deductible health care plans shift more of the health care expense to the employee.3.Changes in workers compensation coverage allow the employer to pay lower premiums by agreeing to assume all costs up to an agreed upon cap.Employee EducationEmployees need to understand the changing l

14、andscape of employer-sponsored benefits.They also need to understand the mutual responsibility they share with the employer to keep health care and related benefits costs down.The employee needs to become an active partner in cost containment and receive the information and education necessary to be

15、gin to manage their own health through alternative methods such as diet,exercise,and weight management.UTILIZATION REVIEWSFor Group Health Insurance PlansEvaluates Quality of Services Conducted by Insurance Companies KindsProspective/Precertification ReviewsConcurrent ReviewsRetrospective ReviewsPRO

16、SPECTIVE REVIEWSEvaluate Proposed TreatmentMainly for Managed Care PlansEntailsVerifying a Patients CoverageVerifying Treatment CoverageJudging Treatment AppropriatenessDeciding on Second OpinionPROVIDER PAYMENT SYSTEMCost Savings Options Percentage DiscountsCapped Fee SchedulesPartial CapitationFul

17、l CapitationProvider payment systems refer to payment arrangements between managed care insurers and health care providers.Fee-for-service plans do not include this feature because they seek reimbursement after the date of service.Life Style InterventionLife style intervention refers to an activity

18、that changes how a person lives.In virtually all companies,employees choose whether to participate in wellness programs or other educational programs designed to improve well being.Current litigation will determine whether employers may terminate employee who refuse to make healthful life style chan

19、ges.OUTSOURCINGTwo factors drive the decision to outsource:Reductions in workforce sizeComplexity of benefit plan administrationHR outsourcing on the riseCan be very expensiveFUTURE INFLUENCESChanging Employment ContractsAccountability to ShareholdersRecent and Proposed LegislationDomestic Partner B

20、enefits&Same-Sex Marriage IssuesGenerational Diversity and ConflictCurrent legislation in both houses of CongressChanging the Employment ContractThe World Has ChangedTraditional employer-employee contracts that were considered to be mutual,long term arrangements have been changed by the competitive

21、global economy and the mobility of the workforce.As an example many companies have adopted pension plans that discourage long term employment.New Workforce DemographicsYounger,mobile,talented employees to not expect or desire long term employment.The new workforce may desire flexible health care ben

22、efits,day care assistance,and tuition reimbursement programs.MetricsEmployee benefits should contribute positively to the bottom line of the organization.Employee benefits should be an integral part of the business strategy whose intended result is optimization of human capital.Organizations need a

23、system of metrics(measurement)that collects,analyzes,and distributes relevant data to senior management and shareholders.The organizations benefit plans should be in a constant“360 degree”review to determine their relevance and efficacy.The organization needs to devote the human resources necessary

24、to manage this function.HUMAN RESOURCESRecent and Proposed LegislationEconomic Growth and Tax Relief Reconciliation Act of 2001 created greater ease for individual retirement account contributions.Taxpayer Relief Act of 1997 introduced tax-free,nondeductible IRAs(individual retirement accounts)refer

25、red to as Roth IRAs.HIPPA(health insurance portability act of 1996)allows for the portability of benefits and the exclusion of pre-existing conditions.Domestic partners and same-sex marriage issuesSame-sex marriage in Iowa Tearese Bomar,22,and Shamera Page,27,both of Davenport,hold hands as they sit

26、 waiting at the Scott County Recorders Office in Davenport on Monday April 27,2009.The pair was the first couple in line to get a license.Bomar said they had thought theyd have to go to another state to get married,but stayed in Iowa,hoping for this day to arrive.The Iowa Supreme Court issue the pro

27、cedendo at 7:52 a.m.,allowing its ruling legalizing same-sex marriages to go into effect.(Kevin E.Schmidt/QUAD-CITY TIMES)The legal right to employment benefits for civil unions and same-sex marriage employees continues to considered by state and federal courts.However,more and more companies are of

28、fering benefits to domestic partners.Extending benefits can be seen as a way to attract,retain and motivate workforce talent.Human resource professionals may be challenged to clearly and correctly identify plan offerings for their specific industry,demographic,or business.Generational Diversity and

29、Workplace ConflictA changing workforce demographic requires metrics and systems that accurately assess benefit demand and provide benefits that inspire employee participation and productivity.Increasingly,benefits may mirror the desired expectations of one segment of the workforce and be in direct o

30、pposition to the articulated needs of another segment.28Presidential PoliticsDramatically rising health care costs will require changes in the method of delivery and funding of what has been traditionally defined as“employer-funded benefits”.American citizens,employed or not,also will be required to

31、 adjust their expectations and to be more fully engaged in health care issues that impact their daily lives.Baker 2009Both houses of Congress are currently debating proposals from the Obama Administration and house/senate leaders that call for a public option(government sponsored health care provision)as well as possible changes in private health care systems and revisions to assure the sustainability of such programs Medicare.