美国人力资源管理—福利管理-教学课件11.ppt

1、,Chapter 11,Managing the Employee Benefits System,McGraw-Hill/Irwin,Copyright 2011 The McGraw-Hill Companies, Inc. All rights reserved.,Noelle Baker, Contributing Editor,11-2,LEARNING OBJECTIVES,Methods for managing benefits costs Differences between the traditional and flexible approaches to benefi

2、ts designs Essentials for communicating the benefits program Outsourcing employee benefits Issues for the future of employee benefits,Noelle Baker, Contributing Editor,11-3,The Market Demands Flexibility in Benefits,Employees may represent different demographics and value different benefits. Employe

3、rs are providing choices in individual choices in plan benefits to meet diverse employee needs.,Noelle Baker, Contributing Editor,11-4,Traditional Benefits Model,Predetermined set and level of benefits Based largely on cost considerations Differences in employee needs and preferences strongly influe

4、nce the adequacy of this company-sponsored benefit,Noelle Baker, Contributing Editor,11-5,CAFETERIA PLANS,Section 125 of IRC allows for employee choice while preserving employer tax benefit Flexible (cafeteria) benefits enable employees to choose between type and level of benefits With a “qualified

5、benefit” an employee may exclude the cost from their federal income tax calculation Exhibit 11.3 identifies allowable and prohibited benefits,Noelle Baker, Contributing Editor,11-6,CAFETERIA PLAN GUIDELINES,Must Be In Writing Choice of Taxable & Non - Taxable For Current & Former Employees Employees

6、 Yearly Choice Must Meet Non - Discretionary Rules May not defer compensation from year to year,Noelle Baker, Contributing Editor,11-7,NONDISCRIMINATION RULES VIOLATIONS for Highly Compensated & Key Employees,Eligibility HCEs with Shorter Waiting Periods Benefits HCEs with Higher Contributions and M

7、ore Options Concentration Key Employees with Higher Contributions and More Options,Noelle Baker, Contributing Editor,11-8,FLEXIBLE BENEFIT PLANS,Vary by Flexibility & Costs Pretax Salary Reduction Plans Modular Plans Core - Plus Option Plans Mix and Match Plans,Noelle Baker, Contributing Editor,11-9

8、,Pretax Salary Reduction Plans,Employees set aside a portion of their wages 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,

9、premium-only plans, enable employees to pay a share of their health, dental or other company-sponsored insurance.,Noelle Baker, Contributing Editor,11-10,MODULAR PLANS,Plans offered to different employee demographic groups. Costs vary depending upon which benefits are chosen. Employers typically cho

10、se the fixed cost of the lowest possible modular plan and employees who choose higher cost benefits pay the difference.,Meeting employee life cycle needs,Noelle Baker, Contributing Editor,11-11,CORE-PLUS-OPTION PLANS,Pre-Established Benefits Plus Employee Choice of Options Employees Offered Option o

11、f Cash Over Additional Benefits,Noelle Baker, Contributing Editor,11-12,MIX AND MATCH PLANS,Employer decides how much it will spend annually per employee. Company awards credits which employees use to make their benefits choices.,The value of each credit and the cost of each benefit is clearly commu

12、nicated to the employee.,Noelle Baker, Contributing Editor,11-13,COMMUNICATING EMPLOYEE BENEFITS PROGRAMS,Elements Legal Considerations Summary Plan Description Summary of Material Modification Good Business Sense,Noelle Baker, Contributing Editor,11-14,Plan Summary,Names & Address of Developers and

13、 Administrators 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 da

14、ys of the plan becoming subject to ERISA.,Noelle Baker, Contributing Editor,11-15,MANAGING COSTSALTERNATIVE METHODS,Benefit Features Employee Contributions Waiting Periods High Deductible Plans Utilization Reviews Case Management Provider Payment Systems Lifestyle Interventions,Noelle Baker, Contrib

15、uting Editor,11-16,Trends in Managing Cost,Companies may impose waiting periods for specific benefits. High-deductible health care plans shift more of the health care expense to the employee. Changes in workers compensation coverage allow the employer to pay lower premiums by agreeing to assume all

16、costs up to an agreed upon cap.,Noelle Baker, Contributing Editor,11-17,Employee Education,Employees need to understand the changing landscape of employer-sponsored benefits. They also need to understand the mutual responsibility they share with the employer to keep health care and related benefits

17、costs down. The employee needs to become an active partner in cost containment and receive the information and education necessary to begin to manage their own health through alternative methods such as diet, exercise, and weight management.,Noelle Baker, Contributing Editor,11-18,UTILIZATION REVIEW

18、S,For Group Health Insurance Plans Evaluates Quality of Services Conducted by Insurance Companies Kinds Prospective/Precertification Reviews Concurrent Reviews Retrospective Reviews,Noelle Baker, Contributing Editor,11-19,PROSPECTIVE REVIEWS,Evaluate Proposed Treatment Mainly for Managed Care Plans

19、Entails Verifying a Patients Coverage Verifying Treatment Coverage Judging Treatment Appropriateness Deciding on Second Opinion,Noelle Baker, Contributing Editor,11-20,PROVIDER PAYMENT SYSTEM,Cost Savings Options Percentage Discounts Capped Fee Schedules Partial Capitation Full Capitation,Provider p

20、ayment 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.,Noelle Baker, Contributing Editor,11-21,Life Style Intervention,Life style intervention r

21、efers to an activity 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 h

22、ealthful life style changes.,Noelle Baker, Contributing Editor,11-22,OUTSOURCING,Two factors drive the decision to outsource: Reductions in workforce size Complexity of benefit plan administration HR outsourcing on the rise Can be very expensive,Noelle Baker, Contributing Editor,11-23,FUTURE INFLUEN

23、CES,Changing Employment Contracts Accountability to Shareholders Recent and Proposed Legislation Domestic Partner Benefits & Same-Sex Marriage Issues Generational Diversity and Conflict Current legislation in both houses of Congress,Noelle Baker, Contributing Editor,11-24,Changing the Employment Con

24、tract,The World Has Changed,Traditional employer-employee contracts that were considered to be mutual, long term arrangements have been changed by the competitive global economy and the mobility of the workforce. As an example many companies have adopted pension plans that discourage long term emplo

25、yment.,New Workforce Demographics,Younger, mobile, talented employees to not expect or desire long term employment. The new workforce may desire flexible health care benefits, day care assistance, and tuition reimbursement programs.,Noelle Baker, Contributing Editor,11-25,Metrics,Employee benefits s

26、hould 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 system of metrics (measurement) that collects, analyzes, and distributes relevant dat

27、a 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 to manage this function.,HUMAN RESOURCES,Noelle Baker, Contributing Editor,11

28、-26,Recent and Proposed Legislation,Economic 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) referred to as Roth IRAs. HIPPA (he

29、alth insurance portability act of 1996) allows for the portability of benefits and the exclusion of pre-existing conditions.,Noelle Baker, Contributing Editor,11-27,Domestic partners and same-sex marriage issues,Same-sex marriage in Iowa Tearese Bomar, 22, and Shamera Page, 27, both of Davenport, ho

30、ld hands as they sit 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 S

31、upreme Court issue the procedendo 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

32、, more and more companies are offering 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.,Noelle Baker, Contributing Editor,11-28,Generational Diversity and Workplace