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Q&A: Sibyl Bogardus, Hub International Ltd.

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Q&A: Sibyl Bogardus, Hub International Ltd.

Sibyl Bogardus is Hub International Ltd.'s Salt Lake City-based chief compliance officer for the Western region, and is a nationally recognized expert in employee benefits regulation. Recently, she spoke with Business Insurance Associate Editor Matt Dunning about key compliance issues facing benefit managers in the coming months. Edited excerpts follow.

Q: How would you characterize employers' readiness to meet the new requirements taking effect in 2015 under the health care reform law's employer mandate?

A: I would characterize employers' readiness for the (Patient Protection and Affordable Care Act) coverage mandate as very high. We still do run into groups that have had more of an ostrich mentality and haven't really paid attention, or because of all the delays they thought that it was simply going to go away. But it's very rare that I run into companies taking that approach. The reporting requirements are a different issue. A lot of employers are barely passing or even failing (to meet the requirements), largely because there's no certainty about the requirements. While we do know what information employers need to capture starting in January, it's unclear where exactly that information needs to reside within a system in order to populate the Internal Revenue Service forms. We're working at a bit of a disadvantage in terms of getting employers ready for the reporting. So much of it depends on the technology end of it, some of which is not ready, and what is ready is not as complete as we would like.

Q: Which active court cases do you see having the biggest potential effect on employers' group health benefit strategies from a compliance perspective?

A: It's the cases challenging whether federally run health insurance exchanges can offer premium subsidies to individuals. The effect of not having the federal subsidies available through those exchanges would be that entire populations of people (in states with a federally run exchange) would lose access to those subsidies, which are directly tied to the employer's responsibility and liability for penalty payments under the reform law. That creates an uneven platform across the country, since some employers would escape those penalties because they're in a state in which the subsidies aren't available, and that's something that I think could pull the whole law apart. But it's going to take a while for those cases to work through the courts.

Q: What key regulatory issues should employers bear in mind if they are considering offering health benefits through a private insurance exchange?

A: The key issue with using a private exchange is setting up the plans and the contribution structures so that it's affordable for the employee. For that, you need to have a strategic plan, where you're not just looking at the immediate expense and how much you as the employer would like to contribute. Planning for the Cadillac tax is still going to be a big issue, and employers should now know that it's going to apply even if a policy is offered through a private exchange. Beyond all of the ACA implications, I think the No. 1 practical issue with using a private exchange is to make sure you don't lose control with whatever platform or model you select. We're seeing a lot of exchange models that have prepopulated coverage products offered to every employer group, and that's not necessarily in every employer's best interest. Employers also need to remember that they still have the fiduciary liability for both the selection and the communication of the benefits.

Q: What are some of the most common compliance-related mistakes you've observed employers making in incentivizing workplace wellness?

A: I've seen employers be too harsh on their employees in trying to encourage employees to improve their health, and I've seen employers try to go down the wellness path, but ultimately be too lenient with their employees. We've been given mixed messaging by the U.S. Equal Employment Opportunity Commission.

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