Health Insurance 2018

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PwC’s Health Research Institute (HRI) annually projects the growth of health insurance and more specifically, medical costs, in the employer insurance market for the coming year.  They also identify the major factors expected to impact the trend.  Moving into 2018, the healthcare industry seems to be settling into a “new trend” which is marked by more moderate fluctuations and single-digit medical cost trends

HRI projects 2018’s medical cost trend to be 6.5%—the first uptick in growth in three years.

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What does this mean for employers still seeking to get the most for their insurance dollars and provide the best benefits for their employee population?  In a labor market that is heating up and becoming more competitive, employers are looking for new cost containment strategies beyond shifting more costs to their employees.

Target Health and Wellness

Many employers are creating wellness programs and enlisting the employees in a partnership arrangement regrading practicing better health habits.  Although hard numbers are difficult to come by, many employers believe they are creating a focus on wellness that will pay off at the bottom line.  Employers are offering smoking cessation programs, health fairs populated by as many as 100 different vendors, offering everything from multi vitamins to massage, and healthy snacks, like fruit and nuts instead of candy, cupcakes and empty snacks.

Investigate provider arrangements

More employers are taking a harder look the health services they are providing and how those health services are being offered.  Some are considering more restrictive arrangements like EPO’s (Exclusive Provider Organizations)  where they can get better discounts by decreasing the size of the provider network.  Other options include offering 2 tier plans where the employer pays a sizable percentage of the lower plan, but gives the employees an opportunity to “buy up” if they want to choose the more expensive plan.

Evaluate the value of drug spending

Employers are banding together to put pressure on drug companies to moderate price increases. Similar pressures were enacted in the early 1990s and significant decreases in the drug price growth rate.

We are already seeing some pharmaceutical companies take action, limiting price increases, offering cheaper generic alternatives and proactively addressing questions of value in the marketplace.

Even though health insurance price increases have slowed over the past three years, they still outpace inflation and employers need to continue to pursue alternatives that will lead to a healthier workforce and, ultimately, to lower health insurance costs for everyone.

 

International HR – Germany

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There are significant differences when it comes to the Human Resources organizations in the US versus companies in Germany, and many other countries in the EU.

 

Managerial Discretion

Anyone who has worked in the US understands that managers and HR have a lot of discretion over who to hire and who and when to terminate.  Sometimes these kinds of decisions can be made in a few days or weeks.  In Germany, specifically, these types of decisions are months if not years long, with serious infractions needing to have taken place.  Germany has a co-determination practice.  Co-determination is a practice whereby the employees have a role in the management of a company. The word is a literal translation from the German word Mitbestimmung.. In some countries, like the USA, the workers have virtually no role in corporate management; and in others, like Germany, their role is more important.

 

Wage differences

In the US, many studies show that white collar workers can make as much as 20 times that of blue collar workers in the same company.  This is drastically different than in Germany. Germany  is known for its balanced remuneration system.  The average white-collar worker’s wage is only 20% over the average blue collar worker`s wage. In addition, companies are not allowed to hire skilled workers from other companies by offering higher salaries.

 

Company Loyalty

Here too, the perception differs.  In the US, workers are generally always in search of something new or better, and there is very little company loyalty.  In Germany, employees feel a much greater sense of loyalty to their companies and, general, will not leave.  They will look for opportunities within their current company or subsidiaries and the company will work hard to provide those. 

 

Management decisions

While the US is typically a very individualistic society, making quick decisions and reversing them if necessary, Germany, in stark contrast, tends to work like a democracy in their companies. It is important the whole team has a say and the whole team is bought into the decision.  While this can seem appealing, the trade off is time.  Decision making will take much longer with a group of employees when everyone needs to be in agreement. 

Both cultures have their pros and cons and neither is necessarily best.  The US, acting as an impulsive, decisive,  all knowing teenager and Germany as the wise parent, moving slowly with certain purpose.

International HR – UK

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Differences between the UK and US

Much like there are slight difference between states in the US, like the timing of final pay for an involuntary or voluntary termination, ranging from day of termination in California to next scheduled pay period in Georgia, there are greater difference amongst countries around the world. Many of these differences relate to working hours and leave.

 

Overtime

In the UK, for instance, employees cannot be required to work more than 48 hours in a work week, while in the US, there are companies that require, legally, far in excess of this amount, especially during peak seasonal times.

 

Vacation Pay

While most workers in the US get 10 paid vacation days per year, their lucky UK counterparts are enjoying more than twice that at 28 days. And, if you are in the UK, you are going on “holiday”, not on “vacation.”

 

Maternity Leave

In the UK you can take a year off for maternity leave without losing your employee rights. No matter how long you’ve worked for a company. Just let the company know 15 weeks before the due date. The official UK maternity leave policy – known as Statutory Maternity Leave (SMP) – means that employees will still earn money for up to 39 weeks. During the first 6 weeks they receive 90% of their average weekly earnings before tax.

Then for the next 33 weeks either £136.78 pounds sterling (about $225 US  per week) or 90% of their average weekly earnings before tax depending which is lower. Their employee rights, including holiday entitlements and pay raises, are safeguarded during the time they take off. Compare that to the 6-8 weeks that most US employees take and only receive 66% of their normal wages IF they have SDI.