Health care is changing, and with each passing month it's clear: job-based benefits will never be the same. Employers of all sizes agree that health care reform is confusing, but that doesn't mean companies should be stuck in the “wait and see” mode. There are several important steps your business can take to prepare for changes to health care in 2015. Three key benefits decisions can give you a fresh perspective and key advantage in the year ahead.

1. Choose a benefits strategy – not just a benefits package

Since health care costs continue to rise at rates faster than inflation,1,2 it's important for businesses to look beyond a specific benefits plan and set their eyes on a benefits strategy to carry their company into the future. A successful plan will help your company answer a host of important questions:

  • What role will benefits play in your business?
  • How will your company's benefits keep pace with competitors?
  • Will your benefits meet health care reform standards to avoid triggering penalties or the Cadillac tax?
  • How will your company handle health care reform reporting and communications requirements?

It's a safe bet to look for partners who can help you navigate the sometimes murky waters of post-reform health care. Lean on trusted benefits brokers and advisors to help determine answers to these questions. And remember, your company can adjust or change its strategy as you learn what works best for your business. Learn more about strategies that may help your company at

2. Leverage employee demographics and preferences as a guide.

In the past, job-based benefits could usually pass as one-size-fits-all, but today the size of your workforce and their hours worked, their individual household incomes, dependents and even lifestyle can play a vital role in the cost-benefit analysis. Don't let changes to health care steer you off course. Instead, use your understanding of employee demographics and preferences to help chart the way to the best benefits options and practices for your organization.

Employee demographics and preferences shape how health care reform affects your business

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Number and hours worked

Several health care reform rules are based on a company's size:

  • Shared-responsibility requirement and penalties
  • Small-business health care tax credits
  • IRS reporting of employer-sponsored coverage
  • W-2 of health care reporting
  • Communications requirements
Household incomes

The income of your employees can determine if they're eligible for tax credits or subsidies through the government-facilitated exchange and whether your company is penalized for not offering affordable, minimum value coverage. It will also play a role in your employees' ability to cover out-of-pocket medical expenses.


Family plans can be important to employees who rely on family health plans to cover their entire household. Health care reform requires all health plans to cover dependent children up to age 26. It doesn't require employers to offer spouse coverage.


The law allows companies to charge different insurance rates (up to 30 percent) based on employee participation in wellness programs, and companies can charge higher rates for individuals who use tobacco (1.5:1), as long as the program is reasonably designed. All outcome-based programs provide a reasonable, alternative standard to qualify for the reward for all individuals who do not meet the initial standard that is related to their health factor.3


Understanding your employees' benefits preferences is crucial to building an efficient benefits model. In fact, more than 9 in 10 employees (93 percent) say they'd be more likely to take advantage of a benefits package tailored to their personal situation.4

3. Prepare employees for what's ahead.

Whether your company offers benefits options or not, your employees are most likely facing rising health care costs and feeling the burden of these increases. Preliminary predictions by Pricewaterhouse Cooper's Health Research Institute estimate average premiums will increase by roughly 6 percent in 2015.5 However, salary increases are only expected to reach 3 percent.6 And while out-of-pocket limits for individuals are set at $6,450 for individual coverage and $12,900 for family coverage, these limits can be misrepresentative of the true out-of-pocket costs an employee encounters for expenses not included in the covered benefits of their plan.

It's a matter of good business. Though your company cannot protect employees from all of the changes coming their way, you can help prepare them to make the best decisions possible. Clearly communicating your company's benefits options, explaining how workers can apply for adequate coverage and providing employees with access to resources so they can make informed decisions can go a long way with helping employees build a strong financial safety net.

Tips for getting workers ready for changes to their benefits:4

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Rely on your benefits provider or consultant to meet with workers one-on-one to determine the best benefits for them. These partners might also offer important benefits education and support tools.

80 percent of employees say they'd be more informed about health insurance choices if they sat with an insurance consultant during enrollment.

Offer workers out-of-pocket support such as voluntary accident or disability insurance options. These policies help employees cope with daily living expenses and out-of-pocket costs associated with accidents or illnesses — helping to protect their well-being and financial assets.

88 percent of employees at least somewhat agree they consider voluntary benefits to be part of a comprehensive benefits program.

Effectively communicate your company's benefits offerings, along with workforce health and wellness, three or more times throughout the year to help employees understand their benefits.

80 percent of employees at least somewhat agree a well-communicated benefits program would make them less likely to leave their jobs.

Prepare to succeed in 2015.

Though health care and job-based benefits are changing, these three decisions can help your business lay the foundation for a benefits program that fits your company's unique needs. Focusing on a benefits strategy, leveraging employee demographics and preferences and preparing employees for what's in store can help your business attract and retain talent, maintain a healthy and prepared workforce and achieve your business objectives both for today and the future.

This material is intended to provide general information about an evolving topic and does not constitute legal, tax or accounting advice regarding any specific situation. Aflac cannot anticipate all the facts that a particular employer or individual will have to consider in their benefits decision-making process. We strongly encourage readers to discuss their HCR situations with their advisors to determine the actions they need to take or to visit (which may also be contacted at 800.318.2596) for additional information.