Yearly Archives: 2015

  • Employers Procrastinating? | CA Benefits Broker

    June 22, 2015

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    By Peter Freska
    Benefits Advisor at The LBL Group
    A UBA Partner Firm

    Employee Benefit News published an article titled, “Employers procrastinating on ACA recordkeeping compliance.” It is an interesting read, as it refers to a recent survey by PricewaterhouseCoopers in which “Only 10% of some 480 employers in 36 industries responding to a recent poll have implemented an in-house or outsourced solution to comply with Affordable Care Act reporting requirements.” This is an alarming number, as employers may be subject to significant penalties for non-compliance.

    To address these concerns, United Benefit Advisor (UBA) Partner Firms, such as The LBL Group, are working with our strategic partners to provide employers with solutions. Employers will need to address the following reporting requirements:

    Our solutions include both stand-alone and integrated tracking, measurement and filing systems so that employers affiliated with UBA Partner Firms can choose the solution that best fits their needs, rather than the needs of the service provider. In addition, our national compliance team continues to monitor and educate our partners on the latest developments, as they happen. These PPACA updates are available to the more than 17,000 plan sponsors working with trusted advisors from UBA.

    In essence, employers are working with multiple data sources, systems, and people. For large and small employers this can be a daunting task. Education, understanding, services and systems, are all great, but having an advisor from a UBA Partner Firm on your team can make all the difference in how employers choose to move forward in complying with the laws of the land.

    For comprehensive information on PPACA reporting requirements including coverage requirements, due dates, special circumstances, controlled groups and how to complete the forms – including sample situations – request UBA’s PPACA Advisor, “IRS Issues Final Forms and Instructions for Employer and Individual Shared Responsibility Reporting Forms”.

    Read More …

  • What can we exchange for an exchange that cannot make change for federal dollars?

    June 17, 2015

    Nearly half of the 17 insurance marketplaces set up by the states and the District under the ACA are struggling financially, which creates even more pressure on the upcoming Supreme Court decision over the federal exchanges. Oregon is already out but Connecticut is succeeding, and there are a lot in between, but mostly leaning toward failure. Signups for the state marketplaces rose a disappointing 12% while those in the federal exchange rose 61%. In Minnesota and Vermont officials are so fed up with costly technical problems that they are considering handing over some or all of their functions to the state or federal governments. In Rhode Island, the legislature is considering a fee on health plans that would rise or fall depending on how costs go, and in Hawaii they already need another $28 million to fund operations until 2022.

  • CPR & AED Training and certification | Arrow Benefits Group

    June 15, 2015

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    We’re proud to offer the latest information in health and wellness in our ongoing training series donated to community. We’re partnering with numerous healthcare industry leaders to offer lectures & classes.  Our goal is to offer a variety of tools and techniques that will vastly improve the lives of each of the attendees. The idea for the series was sparked by inquiries from clients looking for support for health related issues.

    Training saves lives

    Are You Prepared?

    When an individual is not breathing or is only occasionally gasping, they are likely experiencing cardiac arrest.

    Sudden Cardiac Arrest (SCA) occurs when the heart stops beating, abruptly and without warning. When this occurs, blood stops flowing to the brain and other vital organs. If a heartbeat is not restored, death follows within minutes.

    SCA is a leading cause of death in the U.S., killing 325,000 adults in the U.S. each year. In fact, SCA claims one life every 90 seconds, taking more lives each year than breast cancer, lung cancer or AIDS. SCA is responsible for half of all heart disease related deaths.

    SCA is the greatest cause of workplace death, killing 10,000 workers every year.

    What: CPR & AED Training and certification
    When: Saturday, June 27th at 9:00 am
    Where: Petaluma Valley Hospital

    For more information or to reserve seats, please call Andrew McNeil at 707-992-3789 or email Andrew at

  • Economic Trends and Human Resources | Petaluma Employee Benefits

    June 11, 2015

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    By Robin J. Anderson
    Senior Economist, Principal Global Investors

    globaltrendGlobal economic trends have a profound impact on human resource management with effects on everything from talent management, hiring, outsourcing, investment strategies, wages, asset management and business development. As globalization continues to shrink the world, human resource departments are transforming themselves into strategic business partners with senior leaders in order to effectively lead their organizations. A look at current economic trends through the perspective of human resources paints a picture of what matters most to U.S. markets.

    The global and U.S. economies operate in the context of secular themes – trends that may last more than one business cycle. Those secular themes include: the credit cycle in emerging markets, the commodity super cycle, and the return of the U.S. consumer.

    I call these themes “The Great Unwindings.” Let’s take a closer look:

    The Chinese Investment Boom: After years of unprecedented investment in U.S. markets from China, we’re now seeing a slowing in Chinese growth with impacts felt around the world. The relationship between the U.S. and China is shifting, which has an enormous effect not only for those two countries, but the wider global economy.

    The Commodity Super Cycle: Since the start of the year, oil prices have bottomed and rallied, the dollar has moved up and down, and interest rates have fallen to near historic lows only to bounce back. With all the news and data at our fingertips, it is important to decipher what matters for markets and what does not.

    The End of the U.S. Middle Class Squeeze: Since the late ’90s, the U.S. lost 6 million manufacturing jobs. However, we’re finally seeing this trend reverse and have gained 866,000 jobs since 2010. A skilled labor force and increasingly competitive wages mean that Chinese companies are even moving operations to the U.S. More broadly, the labor market is looking more “normal” in the U.S. The unemployment rate is declining quickly and that should hopefully lead to stronger wage growth. Coupled with lower gas prices, real incomes should see the benefit.

    The gain in manufacturing jobs is significant, but it’s important to note that these jobs today are much more sophisticated than those a generation ago. Jobs are more likely to be found in industries involving chemicals, machinery, and transportation equipment than in textiles.

    There remains, however, demand for traditional “blue-collar,” workers and high-skill jobs that can’t be shipped overseas, like plumbers, truck drivers, or electricians. Demand for these types of jobs should pick up especially as boomers retire. Going forward, as robotics and advanced analytics continue to develop, I expect more demand for highly-skilled manufacturing jobs and for statisticians and data scientists in the manufacturing sector.

    So how does the end of the middle class squeeze affect employers and human resource professionals?

    As the unemployment rate has declined, the labor market has shifted from a buyer’s (employer’s) to a seller’s (employee’s/prospective hire’s) market. We have seen wage pressures slowly rise nationally as the unemployment rate has dropped, and that trend should continue. Large firms like Wal-Mart and Target have increased wages for their lowest paid workers to reduce turnover. Tight labor markets mean recruiters have to increase initial offers and, more broadly, HR professionals increasingly have to worry about retention.

    These longer-term trends translate into near-term views for the U.S. and global economic growth, interest rates and inflation, and federal and global central bank action. HR policies, practices, benefits and strategies should be fine-tuned according to market factors facing any business.

    Read More …

  • Covered California Losing its Clothes – and much more as expenses are exposed

    June 10, 2015

    There are a number of things being said, being written and being speculated about the future of the Covered California health care exchange, all surrounding its survival…or its swooning

    1) They have now burned through $1.1 billion and there is no more money available
    2) This money was all from federal grants which do not require any scrutiny
    3) The current fee is $13.95 per employee per month – how much need it increase?
    4) To compensate for losses, they are budgeting a 15% reduction in spending
    5) State law prohibits Sacramento from spending or getting any more money
    6) Exec Director Peter Lee said in December that he questions “long term sustainability”
    7) Enrollment in 2015 fell 300,000 short of their goal – growth rate was only 1%
    8) AP reported Covered California took $184 million in no bid contracts related to Peter Lee
    9) Whistleblower Peter Hill was fired after complaining about waste and cover-ups
    10) YELP has 205 reviews on service for Covered California – 185 were only 1 star
    11) 100,000 Covered California customers got wrong or no tax forms
    12) How can anyone complain about service…when they have nowhere else to go?
    13) Churn rate – one third of 2014 enrollees did not re enroll, but were replaced by the same number that was lost

  • It’s Not a Matter of “If,” But “When” You Get Audited By the U.S. Department of Labor | CA Benefits Broker

    June 9, 2015

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    By Bill Olson, Chief Marketing Officer at United Benefit Advisors

    As the saying goes, an ounce of prevention is worth a pound of cure, and that’s definitely the case when it comes to a health plan audit by the U.S. Department of Labor (DOL). And prevention is certainly warranted, according to Jeff Hadden, Partner at LHD Benefit Advisors (a UBA Partner Firm), because it’s not a matter of “if” you’re getting auditaudited, but “when” you get a letter from the DOL that your company is being audited. Hadden said that 12 of their clients received DOL audits of their group health plans in the past 20 years. However, out of those 12 audits, nine of those clients went through the audit process in just the previous two years. That’s a significant increase and a harbinger that more audits are likely to come from the DOL.

    So what exactly is a DOL audit? According to the DOL, the purpose of an audit is not to rehash past mistakes but to look at past events with a view toward improving future performance. Findings from an audit can be used as a basis for adjusting policies, priorities, structure or procedures in order to make operations as efficient, economical and effective as possible.

    What can trigger a DOL audit? Usually it’s one of two things — either a complaint, which leads to an investigation, or it’s totally random. Regarding the former, any audit is not limited in scope to the area of the complaint. The audit may cover all aspects of plan administration, often going back several years. Michael J. Cramer, JD, Compliance Officer at Beneflex Insurance Services (a UBA Partner Firm) emphasizes that you should try to audit-proof your company as best as possible in order to minimize any issues when and if an audit does happen.

    Whenever you do get that letter from the DOL informing you that you’ve been selected to be audited, the following steps should be taken:

    1. Call the DOL phone number. Call the DOL phone number listed on the letter and request an extension. If granted, this additional time is vital and should be used to your advantage to help prepare.
    2. Get specific information about the audit. Contact the auditor to ascertain specific information about the audit 
he or she is going to perform. An important question to ask is what the focus of the investigation will be.
    3. Call your attorney and your broker.

    As the likelihood of an audit from the U.S. Department of Labor increases, UBA is offering new white paper that can help employers prepare:

    • Learn how to audit-proof your company
    • Avoid the worst mistake you can make
    • Conduct a mock audit
    • Get an auditor out of your office as quickly as possible

    Download “Don’t Roll the Dice on Department of Labor Audits” today.

    Topics: DOL, Department of Labor, white papers, Jeff Hadden, Michael Cramer, Audit

    Read More …

  • Preventive Service Requirement FAQ | CA Employee Benefits

    June 5, 2015

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    By: Danielle Capilla
    Chief Compliance Officer at United Benefit Advisors

    PreventiveCareOn May 11, 2015, the Department of Labor (DOL) along with other federal agencies issued an FAQ regarding the implementation of the Patient Protection and Affordable Care Act (PPACA) that focused on coverage of preventive services. Non-grandfathered group health plans and health insurance offered in the individual or group markets must provide certain listed benefits with no cost-sharing to the beneficiary. The FAQ provided information on some commonly confusing or ambiguous requirements.

    BRCA Testing

    PPACA requires health plans to offer evidence-based services with a rating of A or B in the current recommendations provided by the United States Preventive Services Task Force (USPSTF), as well any additional coverage for women provided in guidelines supported by the Health Resources and Services Administration (HRSA). A 2013 FAQ left confusion as to whether the recommendation to provide BRCA screening applies to women who have had a prior non-BRCA-related breast cancer or ovarian cancer diagnosis, even if they are asymptomatic and cancer-free. The DOL clarified that a plan or issuer must cover (without cost-sharing) genetic counseling and BRCA genetic testing for women who have not been diagnosed with a BRCA-related cancer but previously had breast cancer, ovarian cancer, or other specific cancers.


    The FAQ provided information relating to contraception coverage that is applicable to plan years or policies beginning on or after July 10, 2015 (60 days from issuance of the FAQ). It made clear that if a plan or issuer covers some forms of contraception without cost-sharing, but completely excludes other forms of contraception, it will not be in compliance with regulations. Plans and issuers must cover the full range of FDA-identified methods and must cover without cost-sharing at least one form of contraception in each method identified by the FDA. There are 18 FDA-identified methods of contraception for women. The coverage must include clinical services, including patient education and counseling that is needed for the provision of the contraception method.

    Plans and issuers may utilize reasonable medical management techniques. The plan may discourage the use of brand name pharmacy items over generic pharmacy items, or use cost sharing to encourage the use of one of several FDA-approved intrauterine devices (IUDs) with progestin. When utilizing reasonable medical management techniques the plans and issuers must have an easily accessible, transparent, and sufficiently expedient exceptions process that is not unduly burdensome on either the patient or the provider. If an individual’s attending provider recommends a particular service or FDA-approved item based on medical necessity, the item must be covered without cost-sharing and the plan or issuer must defer to the medical provider.

    Sex-Specific Recommended Preventive Services

    The FAQ made clear that plans or issuers may not limit sex-specific recommended preventive services based on an individual’s sex assigned at birth, gender identity, or recorded gender. The decision regarding the medical appropriateness of a preventive service is to be determined by the individual’s attending provider.

    Well-Woman Preventive Care for Dependents

    Plans or issuers that cover dependent children must cover recommended preventive services related to pregnancy, such as preconception and prenatal care for dependent children, without cost-sharing.

    Colonoscopies and Anesthesia Charges

    Colonoscopies that are scheduled and performed as a preventive screening procedure for colorectal cancer pursuant to USPSTF recommendations may not charge the patient for anesthesia services performed in connection with the colonoscopy.

    For this and other free publications related to PPACA compliance, visit UBA’s Compliance Solutions resource center.

    Read More …

  • We saw it coming…emergency room visits are rising under the Affordable Care Act

    June 3, 2015

    With greater access to health care coming due to guarantees under the ACA, it was expected, and now it has come to fruition, that emergency room visits are up. In a survey of 2,000 emergency room physicians, it is claimed that visits have increased markedly. A spokesman said “there was a grand theory the law would reduce ER visits. Well, guess what, it hasn’t happened. Visits are going up despite the ACA, and in a lot of cases because of it”

  • Question of the Month: How is PPACA’s “IRS Form W-2 safe harbor” regarding affordability calculated? | California Benefits Broker

    June 1, 2015

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    By Danielle Capilla
    Chief Compliance Officer at United Benefit Advisors


    How is PPACA’s “IRS Form W-2 safe harbor” regarding affordability calculated?


    Under PPACA, coverage is considered affordable if it costs less than 9.5 percent of an employee’s household income. Because employers are often unaware of an employee’s household income, there are three safe harbors that an employer can use to determine affordability. One is the “IRS Form W-2 safe harbor,” and under it coverage is affordable if the employee’s contribution for self-only coverage is less than 9.5 percent of his W-2 (Box 1) income for the current year. Box 1 reports taxable income and might be artificially low for an individual with high 401(k), 403(b) or Section 125 deferrals, or who takes unpaid leave. There are no adjustments to account for this.

    Employers using the W-2 safe harbor may not change an employee’s contribution level (dollar amount or percentage) during the calendar year, or the plan year for non-calendar year plans.

    If the employee is only offered coverage for part of a year, an adjustment to W-2 income is made by multiplying the IRS Form W-2 wages by a fraction equal to the number of calendar months for which coverage was offered over the number of calendar months in the employee’s period of employment during the calendar year. (If coverage is offered for at least one day during the calendar month, or the employee is employed for at least one day during the calendar month, the entire calendar month is counted in determining the applicable fraction.)

    The W-2 safe harbor is considered the most flexible, but it is calculated at the end of the year, which does not give an employer the ability to make necessary adjustments. It has shortcomings for employees with significant pre-tax deductions or who take unpaid leave.
    Employers may use different safe harbors for different employee groups, so long as the employee groups are based on reasonable classifications such as hourly or salaried employees, geographic location, and job category.

    Read More …

  • Allowed and Disallowed – Grumbles about Health Insurance Costs Breed New Solutions

    May 29, 2015

    Despite the promises made by politicians, health care and insurance industry prices continue to rise in the aftermath of the Affordable Care Act’s passage. So how can employers cope with rising prices yet take care of employees and provide the best access and coverage for them? Read entire article here.

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