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Kim Buckey, vice president of client services at DirectPath, helps large employers deal with some of the larger snarls of federal employee benefits red tape.
DirectPath guides its employer clients through the dreaded Affordable Care Act coverage reporting process.
The Birmingham, Alabama-based company also works with employers to produce ACA Summary of Benefits and Coverage notices; traditional Summary Plan Descriptions (SPDs) for all benefit plans governed by the Employee Retirement Income Security Act; and many other types of employee communication materials.
(Related: Benefits Players Say Trump Administration Is Listening)
In January, Buckey was hoping the new Trump administration would reach out more to the benefits community and ease red tape.
Here’s a look at some of what Buckey is seeing in the benefits market now, drawn from a telephone interview conducted Thursday.
1. The Employee Benefits Security Administration (EBSA) and other federal agencies are harder to reach than they were two years ago.
Early on, the Trump administration invited many benefits community players to come to Washington to help brief transition team officials on benefits program details, Buckey said.
Now, Buckey said, reaching administration officials involved with benefits issues, whether to ask a question or resolve technical problems, tends to be more difficult than it was two years ago.
The Trump administration is still filling vacant positions at agencies like EBSA, and that might be affecting the agencies’ ability to respond to questions from the public, Buckey said.
2. DirectPath’s employer clients like the ACA preventive services package coverage requirement.
The Affordable Care Act requires major medical plans, included self-funded plans, to cover the goods and services in a basic package of preventive services without imposing co-payments, deductibles or other out-of-pocket costs on the patient.
In practice, the package includes coverage for annual checkups, vaccinations, and a wide range of screening tests.
“I think that’s an incredibly popular benefit,” Buckey said.
Even if the ACA goes away, “I don’t see that going away,” she said.
3. Buckey has not met any clients who have complained about the birth control benefits mandate.
The drafters of the ACA never mentioned birth control or contraception in the text of the bills that created the ACA. The statute did call for the U.S. Department of Health and Human Services to work with its own Health Resources and Services Administration (HRSA) to come up with preventives services package recommendation for women.
HRSA recommended that the preventive care services package include birth control.
Kathleen Sebelius, President Barack Obama’s first HHS secretary, endorsed the HRSA recommendation.
The recommendation sparked a long-running battle between HHS and employers who object to having even an indirect relationship with any mechanism for paying for birth control.
Buckey said that, in the real world, in spite of the headlines about the birth control coverage mandate dispute, she’s never had a benefits client who complained about having to cover birth control.
“It’s really not that expensive,” Buckey said. “All of our clients cover it. Many were covering it even before the ACA.”
4. Many employer clients would be happy to be rid of the Summary of Benefits and Coverage (SBC).
The SBC is supposed to be alike a standardized milk carton label for health coverage.
In theory, everyone loves the SBC. Surveys have found that people who say they oppose the Affordable Care Act like the idea of giving consumers a tool they can use to do a better job of shopping for health coverage.
In practice, however, many employers see the SBC requirement as another annoying paperwork requirement, and they don’t understand why they have to provide both an SPD for a health plan and an SBC for the same plan, Buckey said.
The purpose of the SBC becomes more clear, however, when employees have a choice between the employer’s plan and some other plan. In those cases, Buckey said, the SBCs do help the employees compare the employer’s plan with any alternatives.
5. Buckey would love for someone to spoil the tax reform story plot.
Some people are eager to know what happens in the new Star Wars movie.
Buckey is more interested in the fate of H.R. 1, the Tax Cuts and Jobs Act bill.
“We’re standing by breathlessly,” Buckey said.
So far, she said, she does not believe the House and Senate versions of the tax bill would have much effect on fully insured group health plans.
But some provisions in the House version of the tax bill could affect non-ERISA employee benefits, such as moving expense benefits, and it’s hard to know for certain what the legislation might or might not affect until the final language is available, Buckey said.
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