Tag Archives: Health

How Do You Hire Your First Employee? Seven Suggestions

Situation:  The CEO of an early stage company has identified a person to help her as an assistant. This will be her first real employee. Prior hires have been contractors who have been paid on revenue generated. This individual’s salary will be an expense without clear association to revenue. What guidelines do you suggest as she makes this hire? How do you hire your first employee?

Advice from the CEOs:

  • Create a cash flow projection to make sure that you have the cash to afford an employee.
  • If you consistently expect 40+ hours of work from this individual, consider a salaried position which will give both of you more flexibility.
  • Paychex currently handles your payroll and benefits. Work with them to make sure that all labor law compliance issues are covered. Also, consider hiring a labor law consultant to help you avoid minefields.
  • Do a background check even if you have known this individual for a long time.
  • Consider working with a professional employment organization that can provide back-office HR support for you.
  • An employee handbook is unnecessary at this point. However, think through how you will want to handle issues that may come up including vacation, benefits and paid/unpaid leave like bereavement leave. Document these for inclusion in a future employee handbook.
  • Under the current health care law employers with less than fifty employees are not required to provide health benefits without paying a penalty. This may change as the law continues to evolve.

How Do You Make Time for Priorities? Eleven Recommendations

Situation: A CEO is building a new company. She has a small, highly qualified team, and much of the work is hands-on. In addition, there is fund raising to support the venture. The CEO also makes time for exercise and keeping in shape. With all of this on her plate she is getting overwhelmed. How do you focus on priorities in an early stage company? How do you make time for priorities?

Advice from the CEOs:

  • Maintain your exercise and health – this makes everything else easier.
  • Decide on your strategic platform. This creates a larger conceptual framework and helps to clarify priorities.
  • Identify the gating items. Focus effort here and spend scarce resources strategically to push your goal.
  • Within your gating items, identify the factors that make you scalable. Focus most of your effort here.
  • Create a weekly focus.
  • Lay out your to-do list in a Covey quadrant – most and least important vs. urgent and not urgent. Review this weekly to eliminate or delegate less important priorities.
  • Operational issues are usually symptoms – identify the causes and fix them.
  • Daily, list what you’ve done. Look back every 1-2 weeks and assess how you spent your time. Eliminate time wasters.
  • Don’t let you passion be undermined by the drudgery.
  • As an early stage company, you have to react – understand and appreciate that some aspects of early stage company life will not be very strategic.
  • Fix things rather than adding people and complexity. This compliments Fisher’s Stages of Growth recommendations for a company of under 11 people.

What Changes in Benefits Do You See for 2015? Five Points

Situation: A CEO is doing benefit planning for next year. The company is small, with just under 100 full-time employees. They are growing, and anticipate reaching over 100 FTEs in the next 12 months, unless they consider either contract or less-than-full-time employees. The CEO is curious about what other companies are planning for employee benefits. What changes in benefits do you see for 2015?

Advice from the CEOs:

  • Including employer-paid social security and Medicare matches, CEOs in the group are seeing a range of from 12.5% to 30% in benefits. This does not include 401K matches or bonuses.
  • Over the last five years, there has been a big shift in benefits, in particular a move from traditional health coverage to high deductible HSA plans.
  • ACA requirements for businesses kick in during 2015/2016. In 2015 employers with more than 100 FTEs will need to provide coverage to at least 70% of full-time employees. Starting in 2016 employers with 50 or more FTEs will need to provide coverage to 95% of their full-time workforce.
  • Much depends upon your annual cost per employee is for health coverage as well as your philosophy on employee benefits.
    • Starting in 2015, if a business is supposed to insure its full-time workers but does not, they will have to make a $2,000 per uninsured employee payment on their year-end federal income taxes.
    • The fee is $3,000 if the employee gets health insurance subsidies through the Health Insurance Marketplace.
    • Some companies who currently pay more than this in annual premiums per-employee are considering boosting employee pay and having their employees self-insure through the Marketplace, or by purchasing the same policies available in the Marketplace directly from health insurers. The policy cost is no different, assuming that the employees will not qualify for subsidies, but policies purchased directly from insurers may provide a better network of physician providers.
  • Before you make any decisions, it is best to consult an outside HR professional who is knowledgeable in both health care alternatives and the ACA.

Where Do You Currently Stand on Benefits? Three Comments

Situation: A small company (fewer than 50 employees) is reviewing their employee benefit package and wants to get a sense of what others are currently covering in their benefit packages. Where does your company currently stand on employee benefits, and what does your company cover in its benefit package?

Advice from the CEOs:

  • A recent small (unscientific) poll of entrepreneurial Silicon Valley SMB Companies on benefits offered found:
    • Health: 100%, Dental: 83%, Vision: 67%, Disability: 17%
    • 401K: 100%, 401K Match: 33% (most companies eliminated the match to reduce costs)
    • Reduced benefits in the last 6 months: 67%
    • Employee complaints or recruiting challenges following cuts: 0%
  • One company commented that when a key customer cut their payments they had to cut benefits. They reduced the company payment from 100% to 50% of benefit cost. Their employees make choices among options available, with a company dollar payment cap. Management explained the situation when they made the cuts, and there were no objections.
  • Several companies have shifted to consumer directed health care options.
  • A comment of caution was offered by one CEO – employees are unlikely to object to their company needing to reduce benefits to get through a difficult market. However, as conditions improve, employees are likely to expect some level of return to prior benefit levels. If not, the company at risk of increased turnover. It is best to stay ahead of the curve to assure that your benefits packages are competitive.

How Can You Use Web and Mobile Tech to Bridge Different Worlds?

Interview with Jason Langheier, MD, MPH, Founder and CEO, Zipongo

Situation: The Internet and social media provide opportunities to bridge seemingly distinct worlds through common interests. For example, grocery chains that sell healthy foods and health insurance companies might be brought together through a common interest in healthy eating habits. How can you use web and mobile technology to bridge these two worlds?

Advice from Jason Langheier:

  • Interests and industries which are at first glance distinct can be brought together using the power of the Internet and social media. For example, Let’s Move and the Partnership for a Healthy America have nudged national food retailers and grocers to improve the health of their offerings in an effort to fight childhood obesity. Success here can benefit health insurers because obesity leads to increased healthcare costs through its link to diabetes and other complications. The potential of subsidies from health insurers to promote and generate healthy food choices is interesting to food retailers, but requires new incentive and recommendation systems.
  • We want to help people harness their motivation to build lasting new eating and activity routines. We do this through rewards based commerce, supported by social networks and gamification to help reach one’s health goals. We focus on choices that people make in daily living like grocery and restaurant choices and physical activities. We highlight alternatives, create simple recommendations, and make it easy to act on those recommendations. We encourage repetition of positive choices through a feedback loop which is tailored to the individual.
  • Commitments made within a social network are more likely to stick than promises to self. We leverage existing social media networks and offer incentives for referring friends. Friends help friends make better choices by encouraging them to read labels and buy healthier foods at the moment of purchase.
  • It is important to keep the user interface simple, especially at first. Many of the most successful applications initially present simple yes-no choices. From a tracking standpoint, this also minimizes variables and improves data measurement. Featuring high contrast action buttons on our site also helps prompt decisions.  There is a sweet spot on a commerce site between presenting an overwhelming array of options, and too few choices – which we assess through A-B testing.  By starting simply and building complexity slowly we build a baseline control scenario, then vary choices simply off the baseline to improve results.
  • The entrepreneur seeking to truly achieve a social mission must plan for both the short and long-term. In the short-term, it is critical to build milestones which will demonstrate financial feasibility and sustainability for potential investors. However a long-term perspective is also essential, particularly when one is interested in long term behavioral and economic impact.

You can contact Jason Langheier at j@zipongo.com

Key Words: Internet, Social Media, Food, Insurance, Health, Common, Interest, Software, Bridge, Entrepreneur, Partnership for a Healthy America, Incentive, Tracking, Reward, Commitment, Behavior, Change, Friend, Simple

How Will You Care for Aging Parents? Four Considerations

Interview with Barbara Smith, CEO, Ask Barbara

Situation: Many executives in their 50s and 60s have parents in their 80s and 90s. When parents can no longer take care of themselves, there are important decisions to make regarding long-term care. What considerations are important to these decisions?

Advice:

  • The most important challenge is that we often don’t want to think about these decisions.
  • There are three legs of the stool when it comes to later life planning.
    • Regular life insurance for family and final arrangements.
    • Financial planning to assure that you will have the assets to provide for yourself in later life.
    • Long-term care insurance can expand alternatives and help defer the cost of later life care.
    • Also, an estate planning attorney can shield assets if Medicaid will cover the expense of later life care.
  • The aging population is rapidly changing the demographics of later life care provision.
    • In Santa Clara County, California 16% of the population is currently 60+. This will go up to 25% by 2040.
    • Baby Boomers who waited longer to have children may have small children and aging parents at the same time. If a family member currently cares for elders, what will happen if they return to the workforce?
    • Medicare and Medicaid cover hospital and skilled nursing, but not assisted living. Long-term care insurance is important for those in their 50s and 60s and is less expensive if purchased earlier.
  • Needs and alternatives are changing as the generations change.
    • In contrast to their parents, Baby Boomers are more open to late stage options. They look for amenities and social environments that will enable them to stay active.
    • The village concept is gaining momentum – communities of like-minded seniors who will move into a community, often at a younger age than earlier generations.
    • Current elders are healthier than Boomers, and even more so than younger generations due to better diet and exercise habits. This has implications for both the care needs and options available to the younger generations as they age.
    • Technology will come into play in new ways. Current products assist in tracking and dispensing medications. There are also fall-alert devices and nanny cams to monitor parents in case of emergencies. Many more will be developed.

You can contact Barbara Smith at askbarbarasmith@gmail.com

Key Words: Long-term care, Generations, Planning, Urgent, Insurance, Financial Planning, Long-term Care Insurance, Estate Planning, Demographics, Baby Boomer, Depression, Family Care, Assisted Living, Village, Health

How Do You Take a Guilt-Free Vacation? Seven Suggestions

Situation: A CEO has not taken a vacation for years due to focus on the company. He knows that he needs a vacation and wants to take one. However, he feels guilty taking time off. How do you take a guilt-free vacation?

Advice from the CEOs:

  • For your general health, you need to take time off to refresh and recharge!
  • Think of the vacation as your CEO Test – have you created a team that can perform in your absence?
    • You may be amazed at the initiative that some will take given the freedom to do so. As a corollary, initiative is accompanied by risk and your employees may make some bad choices. Be patient. Congratulate them for taking initiative and coach to improve choices.
    • Stay out of touch. Don’t call in daily and see what happens. If and when you do call in, don’t solve challenges that come up – let your people solve the challenges. Keep a few notes. On your return see where you need to adjust procedures to allow employees to make independent decisions.
    • More than one CEO has found that taking 3-4 week vacations each year has had very positive results. The company actually performs more efficiently and with more energy upon their return than it did when they left!
  • To ensure that you take a vacation, schedule it in advance. Let everyone know that you are going to take it and Just Do It!
  • If you can’t take the time to plan a vacation, have your spouse or a loved one plan the vacation.
  • If you need to feel in touch during your vacation, take your laptop. You may never even use it, but it will be there as a security blanket. Once you are on vacation, let family and personal priorities rightly take precedence over your need to stay in touch.

Key Words: Vacation, Company, Focus, Guilt, Health, Refresh, Recharge, Initiative, Patience, Coach, Problems, Valuation, Performance, Planning, Priorities, Family, Stress, Support

Living for Work or Working for a Living? Six Solutions

Situation: The CEO typically works long hours and frequent weekends. This taxes family life and has resulted in neglect of activities that were previously enjoyed. How do other CEOs maintain a healthy work-life balance?

Advice from the CEOs:

  • Life is more than work. Just the fact of your asking this question indicates that you already know that too much focus on work is not good for you.
  • Develop and devote time to your hobbies. The CEO and engineers in one company developed a company robotics club, and even participate in robotic competitions. This has a number of benefits:
    • It provides fun away from work while keeping their creative engineering skills sharp;
    • In the process of competing, they meet and form relationships with potential business partners and customers;
    • It builds camaraderie and cohesiveness within the team;
    • They have the opportunity to involve their kids in this activity, and
    • They translate this into a public service by assisting local schools who have their own robotics clubs.
  • Regular exercise, particularly with a group, helps you to be more effective at work. This is supported by substantial objective research.
  • Involve other people – friends and family – in your hobby or exercise activity – it will help to both strengthen relationships and resist distractions.
  • To assure that this becomes part of your life, put it on the calendar and don’t let other priorities displace it.
  • Learn to say “no” to things that would displace this activity.

Key Words: Work-Life Balance, Hobbies, Family, Exercise, Health, Priorities