Yearly Archives: 2015

  • Industry Differences Among Health Savings Accounts | CA Benefits Broker

    April 24, 2015

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    By Bill Olson
    Chief Marketing Officer at United Benefit Advisors

    While recent survey data shows that, on average, employers are decreasing the amount they’re willing to contribute to employee Health Savings Accounts (HSAs), there are some industries that have not seen such trends.

    On average, employees saw a 10 percent decrease in their average single HSA employer contribution from the previous year, from $574 in 2013 to $515 in 2014. Employees in the public and government sectors, however, continued to have the most generous HSA contributions, at $791 for singles and $1,431 for families. Conversely, workers in the following industries see the lowest average single employer contributions toward HSAs: food services ($279), retail ($323), wholesale ($398), construction ($434), health care/social assistance ($472), and mining/oil and gas extraction ($831).

    Some may see these trends as counterintuitive. However, upon further examination, it becomes clear how employers are using HSAs to supplement plans and drive employees where they ultimately want them, which is toward cost-saving consumer driven health plans (CDHPs). The link between CDHPs and HSAs helps explain industry differences in health plan costs, but demographic differences are also a part of the story.

    “Construction companies typically hire young men who demographically don’t place a lot of value in benefits. Government, on the other hand, has traditionally substituted salary for benefits; one way to move those employees off an expensive plan is to fully fund their deductible,” says Brian M. Goff, President & CEO of Insurance Solutions, a UBA Partner Firm. “But carrier motivations can also be at play. Some carriers give a certain premium discount to go to the high deductible plan. So if you have a low premium, i.e., construction because of a young male demographic, the premium may only come down $800 a year to add a $1,500 deductible. On the other hand, take a nursing home that has expensive premiums, the savings may be $1,700 to add a $1,500 deductible, making it a no-brainer to switch to an HSA plan.”

    The strategy of attracting employees to CDHP plans with generous HSA contributions has worked in the finance and insurance industry as well, where 32.3 percent of plans are CDHPs (the highest of any industry) and enrollment is 32.1 percent (also the highest enrollment of any industry). HSA contributions in the finance and insurance industry are at $634 for singles and $1,074 for families, 20.7 percent and 18.7 percent above average, respectively.

    The opposite trend can be seen in the mining/oil and gas extraction industry, however, where only 16.7 percent of plans offered are CDHPs, and employer HSA contributions are also among the lowest. Correspondingly, CDHP enrollment in this industry is a mere 8.5 percent.


    For the latest health plan cost trends, download the UBA Health Plan Survey Executive Summary. To benchmark your plan to others in your region, industry or size bracket, contact a UBA Partner near you to run a custom benchmarking report.

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  • Health Checklist for Men Over 40 | California Employee Benefits

    April 21, 2015

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    By Stacey Anderson

    ripe red apple with green leaf isolated on whiteCompared to women, men tend to drink more, suffer more from stress and seek medical advice less often. However, men are also living longer and their lifespan is catching up to women. Make sure that your later years are as healthy as possible. As you age past 40, following health recommendations from organizations like the National Institutes of Health is a good way to take control of your health.


    Vaccinations are not just for the young, according to MedlinePlus. Consider a one-time vaccination for herpes zoster, which can cause shingles, after age 60. Your doctor might suggest a yearly flu vaccine over the age of 50 and a one-time pneumococcal vaccine after age 65. This latter vaccine protects against the most common cause of pneumonia in older individuals. Health officials recommend booster shots for tetanus-diptheria-pertussis every 10 years.

    Abdominal Aortic Aneurysm

    If you have smoked more than 100 cigarettes in your lifetime, schedule an abdominal ultrasound at age 65 to screen for an abdominal aortic aneurysm. Using high-frequency sound waves, the ultrasound can look for bulges in the main artery in your abdomen. This bulge can indicate an aneurysm. Treatment varies from watchful monitoring of the aneurysm to emergency surgery, depending on its size.

    Heart Health

    High blood pressure and high cholesterol raise your risk for heart disease and strokes. Normal blood pressure is less than 120 systolic and 80 diastolic, or 120/80. Have your blood pressure checked at least every two years if it is in this range. If your blood pressure is higher than 140/90, see your doctor as often as he recommends. Your doctor will likely recommend a blood test for cholesterol after age 40, especially if you have a family history of high cholesterol or heart disease. Your doctor may also include a measurement of your triglyceride levels. Repeat your cholesterol tests every 5 years, according to MedlinePlus.

    Colon Cancer Screening

    Unless you have a family history of colon cancer or personal risk factors like polyps or inflammatory bowel disease, screening for colon or rectal cancer typically begins at age 50. A number of screening tests are available to look for cancer or for treatable precancerous changes. This includes testing a stool sample looking for blood, the fecal occult blood test, or for DNA mutations, also known as a stool DNA test. Using a colonoscopy or sigmoidoscopy your doctor views the colon to look for suspicious areas and take samples for biopsy.

    Prostate Exam

    Enlargement of the prostate can cause urinary problems as one of the first symptoms. This enlargement can be benign, or a sign of prostate cancer. After age 40, your doctor will recommend a yearly digital rectal exam to feel the prostate gland and check for abnormalities. The prostate-specific antigen, or PSA, test is another screening method. This blood test measures levels of PSA, with high levels possibly indicating cancer.


    As you age your risk for Type II diabetes increases. Screening for diabetes, using a fasting blood glucose test or blood A1C test, should begin at age 45. Generally, repeat screening is every 3 years although your doctor might recommend a more frequent screening schedule depending on your risk factors.

    Other Screening Tests

    Get your hearing tested every 10 years after age 40 and every 3 years after age 50. Mental health screening for dementia and Alzheimer’s disease is available if you or your family is concerned about your decision-making ability or possible memory loss. Over the age of 40, you might find yourself divorced and newly dating. Discuss sexually transmitted disease screening, including an HIV test, with your doctor. This is especially important if you are going to begin a new sexual relationship.

    Eye Health

    Treatable eye diseases can cause blindness if you ignore symptoms for too long. In addition to checking your visual acuity, your eye specialist will examine your eyes for signs of glaucoma, macular degeneration and cataracts. Your risk for these eye conditions increases after age 40. The recommendations for eye checkups are every 2 years after age 40, according to MedlinePlus.

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  • Arrow Benefits Group Wellness Series Makes the News

    April 17, 2015

    Andrew McNeilArrow Benefits Group principal Andrew McNeil was interviewed in an article for The North Bay Business Journal about a collaboration with St. Joseph Health, Petaluma Health Care District, and Whole Foods to offer free wellness programs.






  • Congress Taking (Small) Steps for Employee Wellness Programs | CA Benefits Broker

    April 9, 2015

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    By Jennifer Kupper

    The Patient Protection and Affordable Care Act (PPACA) specifically encourages and promotes the expansion of wellness programs in both the individual and group markets. In the individual market, the secretaries of the Capitol Building, Washington DCdepartments of Health and Human Services (HHS), Treasury, and Labor are directed to establish a pilot program to test the impact of providing at-risk populations who utilize community health centers an individualized wellness plan that is designed to reduce risk factors for preventable conditions as identified by a comprehensive risk-factor assessment. Results will be compared against a controlled group.

    In the group market, the secretaries are directed to establish a multi-state, employer-sponsored, health-contingent wellness program demonstration project. The objectives are to determine the effectiveness of employer-sponsored, health-contingent wellness programs, the impact of wellness programs on the affordability and access to care for participants versus non-participants, the impact of cost-sharing and incentives on participant behavior, and the effectiveness of other types of rewards.

    There is, however, a huge disconnect within the administration. This is exemplified by the Equal Employment Opportunity Commission’s (EEOC) revived attacks and recent litigation against employers who sponsor presumably PPACA-compliant wellness programs. Employers are waking up to the sad facts that the risk in sponsoring health-contingent wellness programs is mounting, the EEOC remains silent in providing guidance*, and the corporate wellness industry is in quandary.

    In response to the recent litigation, two parallel bills were introduced the first week of March (S. 620/H.R. 1189). With less than a 2% chance of being enacted, Mr. Lamar Alexander (R-Tenn.) of the Senate and Mr. Jon Kline (R-Minn.) of the House introduced the Preserving Employee Wellness Programs Act (the legislation). The purpose of the legislation is “[t]o clarify rules relating to nondiscriminatory employer wellness programs as such programs relate to premium discounts, rebates, or modifications to otherwise applicable cost sharing under group health plans.”

    The legislation would allow employers to implement workplace wellness programs or employer-sponsored, health-contingent programs without the fear of running afoul of the Americans with Disabilities Act (ADA) and its amendments (ADAAA) or Genetic Information Nondiscrimination Act (GINA), so long as the wellness programs operated pursuant to the Health Insurance Portability and Accountability Act (HIPAA) nondiscrimination and wellness regulations.

    The legislation also provides that a sponsoring employer can establish a deadline of up to 180 days for employees to request and complete a reasonable alternative standard (or waiver of the otherwise applicable standard). Further, the legislation affirms that the employees’ spouse and family members can participate and would have the same protections afforded as an employee-participant. In other words, medical history and biometric information of participating family members would not be an unlawful acquisition under GINA.

    * On March 20, 2015, the EEOC voted to send a Notice of Proposed Rulemaking (NPRM) on the interplay of the ADA and PPACA with respect to wellness programs to the White House Office of Management and Budget (OMB) for clearance.

    For more data on wellness program features employers are using, download the 2014 Health Plan Executive Summary. This survey – which has been conducted every year since 2005 – is the nation’s largest health plan survey and provides more accurate benchmarking data than any other source in the industry. You can also contact a UBA Partner Firm for a customized benchmark report based on industry, region and business size.

    Topics: wellness, employee benefits, wellness programs, PPACA Affordable Care Act, 2014 Health Plan Survey

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  • Keith McNeil Quoted in Business Journal

    April 6, 2015

    Published today in The North Bay Business Journal, Arrow Benefits Group Partner Keith McNeil is quoted in an article about the rising trend of workplace wellness programs.


    Providing wellness programs for employees is also a way for larger companies to lower their insurance rates.

    “Once you get over 50 employees, the insurance company will look at the claims and lower the rate,” said Andrew McNeil, principal with Arrow Benefits Group in Petaluma. “It takes between three and five years of offering the programs to see any return on investment, however, and that can be an eternity for small employers.”

    The majority of larger companies Arrow works with have wellness programs in place, McNeil said. Many small businesses (under 50 employees) don’t implement wellness programs as the program itself cannot directly affect the monthly health insurance premium. That’s because the premiums are a pooled risk, and filed by the health plans with the State of California. (The under 50 employees definition changes to under 100 employees in 2016.)

    Still, while small employers that offer a wellness program can’t impact the cost of their group health insurance, a well-designed wellness program has the potential for reducing absenteeism as well as increasing employee morale. Larger employers that offer a wellness program may see over time a reduction in their medical rates (assuming the wellness program is implemented correctly) as the medical rates are tied to the overall health risk of the employees and their covered dependents, especially if the wellness program is targeted to specific medical problems such as obesity.


  • Supreme Court Hears Oral Argument in Subsidy Eligibility Battle | CA Health Insurance

    April 6, 2015

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    By Danielle Capilla, Chief Compliance Officer at United Benefit Advisors

    On March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA). At question in the case is or not the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through health Exchanges established by the federal government via the Department of Health and Human Services (HHS) under Section 1321 of PPACA.

    The ruling from the court is expected in late May or June of 2015. The case involves challenges to the IRS ruling that individuals are eligible for the premium subsidy regardless of whether their state has a state-run or federally-run Marketplace or Exchange. In King, a lower court held that the current IRS interpretation of Section 36B, which provides for premium tax credits to anyone who purchases insurance on any Exchange, is reasonable. Conversely, another court, in a case called Halbig v. Burwell, held that, based on the way the law is written, the subsidies should only be available to people living in a state with a state-run exchange. As we await the decision, employees will still receive premium subsidies and employers should continue preparations to meet the employer-shared responsibility/”play or pay” requirements.

    For more information on this case, download UBA’s free PPACA Advisor, “Supreme Court Hears Oral Argument in Subsidy Eligibility Battle“.

    For upcoming analysis on this case by UBA Partners, subscribe to the UBA blog.

    Topics: health insurance exchanges, PPACA Affordable Care Act, Play or Pay, health care subsidies, employer shared responsibility, tax-credit subsidy

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  • We’re in the Top 500!

    April 2, 2015


    We’re really proud to be included in this year’s NorthBay biz’s “The Top 500 Annual Listing of Top Ranking Businesses” in Napa, Marin, and Sonoma Counties.

    Here’s the link to the complete list The Top 500.

  • Republicans feel that the Democrats hatched a conspiracy and lost too much on the ACA | California Employee Benefits

    April 1, 2015

    Orrin Hatch, the chairman of the Senate Finance Committee, says they have found at least $5.7 billion inn wasted ACA related spending over the last five years. The analysis includes an estimated $2 billion it took to repair, $1.3 billion spent on now defunct state exchanges and a $2.4 billion co op program, which included 24 plans but saw little success with sign ups.

    Jordan Shields

  • Growing Pains: Why Adolescence Is About To Get That Much Harder | Arrow Benefits Group

    March 24, 2015

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    By Elizabeth Kay, Compliance & Retention Analyst, AEIS Advisors

    Employers that are growing up, and are in the awkward teenage years, are about to get a big surprise, and not the good kind.

    When a company first opens, they are excited when they first implement their benefit plans for their handful of employees. They offer one or two medical plans, perhaps some dental and vision, and a small life insurance policy. thinking manThe company knows that the small group rates will be high, but not much can be done, so they live with it. The rates are based on the employee’s age and where the company is located. They rely on their broker to show them the different options and help them offer plans with the best value to their employees.

    Then the company starts to grow. They hire a few more employees, they have to look at making their benefit offerings richer so they can be leveraged to recruit new talent and retain the talent they have, and they have to begin concerning themselves with additional requirements such as the Consolidated Omnibus Budget Reconciliation Act (COBRA). The rates are still the rates; still high, but manageable. They may experience some discomfort that comes with growing up, but nothing that they are not able to overcome.

    As the company ages and continues to grow, they may come to the awkward teenage years; when they are almost up to 50 employees, or slightly more than 50 employees. Not really a “young” company, but not yet a well-established “adult,” and the growing pains become more noticeable. Now they have to be concerned with the Family and Medical Leave Act (FMLA), sexual harassment prevention training, and whether or not to move to an online human resource information system (HRIS) and benefits enrollment system to make onboarding of employees easier.

    In addition, once they exceed 50 employees, they can move away from small group medical insurance to mid-market or large group medical insurance plans. These plans are composite rated instead of rated on the employee’s age. And once a group is that size the carrier can collect more claims data and rate their plans based on that data, instead of the larger pool of clients/members that are used to rate small groups, which may lead to lower rates.

    The Patient Protection and Affordable Care Act (PPACA) has changed the rules slightly and it will mean the growing pains of adolescence for these companies are going to last even longer and require some strategic planning for 2015 and 2016. The PPACA is changing the classification of small group from 2 to 50 employees to 2 to 99 employees beginning in 2016. Employers of 50 or more employees still have to comply with the employer-shared mandate (“play or pay”), even though they will be considered to be a small group. But that is not the biggest growing pain.

    For those companies that currently have more than 50 employees, and have a medical plan with composite rates, they will be moved back to rates based on the employee’s age and location of the company at their plan’s renewal in 2016. Now, why is this such a big deal? They have experienced age banded rates before, right?

    Well, for companies with a diverse workforce, with some younger employees, and others that are more seasoned, they are now going to be paying very different premiums for each demographic where they used to pay the same rate, no matter their age. In addition, community rating under PPACA is different from the age banded rating they had before. Previously, employee rates were determined by the age band the employee fell into. For example, 30 to 39, 40 to 49, 50 to 54, etc. Then, if the employee enrolled any dependents, there was a rate for their dependents that was generated based on the age bracket the employee fell into, and an employee with their spouse and one child had the same rate as an employee with their spouse and three children if the employees were in the same age bracket.

    But community rating means that every employee is rated based on their actual age, not on a range of years, and each dependent in a family has their own rate, based on their individual age as well. There is one rate for ages 0 to 18, an individual rate for ages 19 to 64, and one rate for ages 65 and older. Please see the examples of John Doe and Jane Smith below comparing pre-PPACA age banded rating to PPACA community rating.

    Name / Age Pre-PPACA
    Employee +
    Family Age
    40 to 49
    Name / Age Pre-PPACA
    Employee +
    Family Age
    40 to 49
    John / 43    $900      $356 Jane / 45    $900      $365
    Spouse / 40     N/A      $349 Spouse / 49     N/A      $400
    Child #1 / 12     N/A      $250 Child #1 / 20     N/A      $275
    Child #2 / 10     N/A      $250 Child #2 / 17     N/A      $250
    Child #3 / 15     N/A      $250
       $900    $1,205 Total
       $900    $1,540


    As you can see, under the old age banded rating, both John and Jane were paying the same rate, as they both had families, and each were in the 40 to 49 age bracket.

    Under the PPACA community rating for small groups, their rates become very different because they are rated not only on their individual ages, but are also paying a separate rate for each dependent based on their ages.

    Now, let’s look at it from another angle. Michael and Jennifer worked for a company that moved from age banded rates in 2014, to a composite rated plan in 2015, when they grew to have more than 50 employees. Jennifer was happy, but Michael was not. Let’s see why in the example below.

    Name / Age Pre-PPACA
    Employee +
    Family Age
    30 to 39
    Name / Age Pre-PPACA
    Employee +
    Family Age
    50 to 54
    Michael / 31     $950    $1,150 Jennifer / 53    $1,450   $1,150


    As a result of the averaged rating under composite rates, Michael had a rate increase and Jennifer had a rate decrease.

    Now, imagine being Michael or Jennifer, working for a company that is still in its “adolescence.” The company is still growing, but not yet to a size of 100 employees going into 2016. So they moved from age banded rates in 2014 to composite in 2015, only to have to move back to community rating in 2016. Talk about feeling like a yo-yo!

    Then to add insult to injury, they will most likely have to pay even more in premiums as they will be rated on each individual of their family that they enroll in the plan.

    It is because of these changes in the insurance industry that make having a trusted advisor to walk companies through these significant changes, and to help strategize and prepare for them, is so important. Many businesses are being blindsided by the significant increase in premiums the community rating structure is causing and employees who are required to pay a portion of their premiums are being blindsided as well.

    For companies who are still in those awkward teenage years in 2015, where they have more than 50 employees, but fewer than 100, they will need to determine if they want to risk moving to a composite rated plan for 2015. Will they be at 100 employees or more at their renewal in 2016? If it is not clear they will be that large, they may want to stay on an age rated, mid-market plan for another year, or risk major disruption for their employees in 2016.

    For those companies in a state where composite rates are the norm, even for small group, they will need to plan ahead. The employer contribution strategy will most likely need to change from a flat contribution to a percentage so that older employees are not hit with a higher rate increase than the younger employees. The employees of companies with 2 to 100 employees should be educated by their employer about what is coming down the line so that they can have time to prepare themselves and their families.

    As an advisor to our clients, we may not always deliver the news that our clients want to hear, but knowledge is power, and it is our duty to give them the information they need to make the necessary decisions, and to plan ahead for the sustainability and growth of their companies so they can mature into adulthood.

    For information to help you determine if you are a small or large employer under PPACA, request UBA’s PPACA Advisor: “Counting Employees Under PPACA

    Topics: ACA, employee benefits, PPACA, COBRA, The Patient Protection and Affordable Care Act, community rating, composite rating, small group insurance

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  • From Keith’s Keyboard | Taking Part in the Healthcare Solution March 2015

    March 13, 2015

    Washington, D.C.—I recently attended the National Association of Health Underwriters (NAHU) annual “fly in” event, where employee benefits specialists meet for two days and then see the offices of their respective Senators and members of Congress. In reality, it is rather rare to actually meet the member, but instead, the meeting is usually with one of the administrative aides. That can actually be a good thing, since the aides often have more expertise on the subject at hand.

    The preliminary NAHU meetings often have high-level members of Congress and the Administration in attendance, and it is thus possible to get a closer look at the employee benefits laws as they are considered and debated in Washington.

    Keynote speaker, Senator Tim Scott (R-SC), a former insurance broker, gave an excellent talk on the role of the agent in healthcare reform. There were a number of excellent breakout talks including one by Dr. Tim Church, Chief Medical Officer of ACAP Health Consulting. His expertise on the importance of structured weight loss in any wellness plan was well presented. The potential medical costs due to the obesity epidemic are frightening, and his company specializes in that phase of overall employee wellness.

    “How We Can Offer More Transparency in Medical Costs” was a key conference topic. Suzanne Delbanco of Catalyst for Payment Reform spoke about what is being done nationally and how far we have to go. We are still at the beginning stages of this national debate, but progress is being made. As more and more Americans purchase high deductible health plans with Health Savings Accounts (HSAs), the need for accurate, comparative health cost data is more important than ever.

    After the meetings, we headed off to Capitol Hill. I met with one of the legislative aides for Congressman Jared Huffman. It is a small world, because the legislative aide is the nephew of an Arrow client. Beyond discussing legislative issues of the day, we offered our services to their constituents who may need help navigating the maze of healthcare reform today. In the past, I have also met with the legislative aides of Congressman Mike Thompson. But, the timing did not work to see them this trip, so I left the information for them.

    Walking the halls of Congress is really an eye-opening experience; the offices are actually fairly small, situated in buildings with names such as Longworth, Cannon, Russell, and Rayburn. Once past security, it is possible to travel underground to other buildings through tunnels. Nearby is the Supreme Court, the Library of Congress, and of course, the United States Capitol building.

    Back home we deal with healthcare issues every day but it is helpful, I believe, to annually visit Washington, D.C., to try to be part of the solution at the political level as well.

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