Yearly Archives: 2017

  • 2017 UBA Healthplan Survey | CA Benefit Advisors

    December 27, 2017

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    It was recent­ly unveiled the lat­est find­ings from our 2017 Health Plan Sur­vey. With data on 20,099 health plans spon­sored by 11,221 employ­ers, the UBA sur­vey is near­ly three times larg­er than the next two of the nation’s largest health plan bench­mark­ing sur­veys combined.To learn more, watch this short video below.

  • Utilize FSA Monies with Key Year–End Strategies | CA Benefit Advisors

    December 22, 2017

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    ‘Tis the Sea­son’. Like most, you ‘re prob­a­bly in the midst of the “hus­sle and bus­sle” of this hol­i­day sea­son with din­ners, par­ties, and activ­i­ties; Christ­mas shop­ping; and spend­ing those remain­ing FSA dol­lars you have allo­cat­ed this year.

    Wait, what? Yes, you read right. Chances are, if you’ve opt­ed to uti­lize an employ­er-spon­sored FSA account in 2017, you may have remain­ing funds you’ll need to spend. This is espe­cial­ly true if your employ­er opt­ed for the $500 car­ry­over rule in lieu of a grace peri­od. Regard­less of what flex­i­ble spend­ing account you have, here are some strate­gies to get the most out of this ben­e­fit before year end.

    Med­ical Care

    Med­ical FSAs are the most com­mon sup­ple­men­tal flex­i­ble cov­er­age offered under employ­er ben­e­fit plans. If you’ve elect­ed this cov­er­age for 2017, here are a few things to con­sid­er when spend­ing these funds.

    Rou­tine and Elec­tive Med­ical Procedures

    Whether rou­tine or not, now’s the time to get appoint­ments booked. If your employ­er offers a grace peri­od for turn­ing in receipts, you can book appoint­ments into the first cou­ple of months of the New Year and get reim­bursed from this year’s funds with­out affect­ing 2018’s con­tri­bu­tions. This has a two-fold advan­tage, as you can also spread next year’s deductible over the com­ing year.

    Sev­er­al rou­tine and elec­tive pro­ce­dures that are FSA-eli­gi­ble include:

    • Lasik
    • Sleep Apnea/Snoring
    • Her­nia surgery
    • Colonoscopy
    • Smoking/Weight Loss Ces­sa­tion Programs

    Alter­na­tive Therapies

    Under IRS law, cer­tain alter­na­tive ther­a­pies are eli­gi­ble for reim­burse­ment. Acupunc­ture and chi­ro­prac­tic care, alter­na­tive med­i­c­i­nal treat­ments, and herbal sup­ple­ments and reme­dies are a great way to use up your funds for the year and get a lit­tle cash back when you most need it.

    Den­tal

    Den­tal ben­e­fits often work dif­fer­ent­ly than med­ical cov­er­age. Accord­ing to the Amer­i­can Den­tal Asso­ci­a­tion, this ben­e­fit is often capped annu­al­ly – gen­er­al­ly between $1,000 and $3,000.  If you have unused funds remain­ing in your FSA, now may be the time to sched­ule a last-minute appoint­ment with your den­tist, espe­cial­ly if you might need seri­ous work down the road. This way, you can use up the funds remain­ing in your account by year-end, and reduce your out-of-pock­et expense next year by shar­ing the cost of addi­tion­al den­tal ser­vices over a longer peri­od of time.

    Pre­scrip­tion Refills

    Refill­ing your pre­scrip­tion med­ica­tions at year end are a great way to use up your funds in your med­ical FSA. Take inven­to­ry of your pre­scrip­tion drugs, toss out expired ones, and make that call for a refill to your doc­tor or pharmacy.

    Over the Counter Drugs, Med­ical Equip­ment and Supplies

    Many OTC med­ica­tions, med­ical equip­ment and sup­plies are eli­gi­ble for reim­burse­ment under a med­ical FSA. First-aid kits, blood-pres­sure mon­i­tors, ther­mome­ters, and joint braces are just a few.  Please note that some will require a note or pre­scrip­tion from your doctor.

    Mileage and Oth­er Health­care-Relat­ed Extras

    Trav­el­ing to and from any med­ical facil­i­ty for appoint­ments or treat­ment are eli­gi­ble for reim­burse­ment under your FSA. This not only includes trav­el­ing by your own vehi­cle, but also by bus, train, plane, ambu­lance ser­vice; and does include park­ing fees and tolls.

    In addi­tion, you can get reim­bursed for oth­er health-relat­ed expens­es. These include:

    • Lodg­ing and meals dur­ing a med­ical event.
    • Med­ical con­fer­ences con­cern­ing an ill­ness of you or one of your dependents.
    • Advance Pay­ments on a retire­ment home or long-term care.

    Depen­dent Care

    If you have opt­ed to con­tribute to a DCFSA, you can get reim­bursed for day care, preschool, sum­mer camps and non-employ­er spon­sored before and after school pro­grams. In addi­tion, funds con­tributed to this type of FSA can be used for elder­ly day­care if you’re cov­er­ing more than 50% your parent’s main­te­nance costs.

    Adop­tion Assistance 

    If you are con­tribut­ing to an Adop­tion Assis­tance FSA offered by your employ­er, you can get reim­bursed for any expens­es incurred in the process of legal­ly adopt­ing an eli­gi­ble child. Eli­gi­ble expens­es include adop­tion fees, attor­ney fees and court costs, med­ical expens­es for a child pri­or to being placed for adop­tion, and relat­ed trav­el costs in asso­ci­a­tion with the adop­tion process.

    Make the most out of your FSA con­tri­bu­tions by using the above strate­gies to your advan­tage as we close out 2017. As you move into 2018, review the max­i­mum con­tri­bu­tion guide­lines for the com­ing year as set by the IRS, and estab­lish a game plan on expen­di­tures next year. Seek your HR department’s exper­tise for guide­lines and tips they can give you to max­i­mize this valu­able ben­e­fit package.

  • Advance Informational Copies of 2017 Form 5500 Annual Return/Report | CA Benefit Advisors

    December 18, 2017

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    The U.S. Depart­ment of Labor’s Employ­ee Ben­e­fits Secu­ri­ty Admin­is­tra­tion (EBSA), the Inter­nal Rev­enue Ser­vice (IRS), and the Pen­sion Ben­e­fit Guar­an­ty Cor­po­ra­tion (PBGC) released advance infor­ma­tion­al copies of the 2017 Form 5500 annu­al return/report and relat­ed instruc­tions.

    Specif­i­cal­ly, the instruc­tions high­light the fol­low­ing mod­i­fi­ca­tions to the forms, sched­ules, and instructions:

    • IRS-Only Ques­tions. IRS-only ques­tions that fil­ers were not required to com­plete on the 2016 Form 5500 have been removed from the Form 5500 and Schedules.
    • Autho­rized Ser­vice Provider Sig­na­tures. The instruc­tions for autho­rized ser­vice provider sig­na­tures have been updat­ed to reflect the abil­i­ty for ser­vice providers to sign elec­tron­ic fil­ings on the plan spon­sor and Direct Fil­ing Enti­ty (DFE) lines, where applic­a­ble, in addi­tion to sign­ing on behalf of plan admin­is­tra­tors on the plan admin­is­tra­tor line.
    • Admin­is­tra­tive Penal­ties. The instruc­tions have been updat­ed to reflect that the new max­i­mum penal­ty for a plan admin­is­tra­tor who fails or refus­es to file a com­plete or accu­rate Form 5500 report has been increased to up to $2,097 a day for penal­ties assessed after Jan­u­ary 13, 2017, whose asso­ci­at­ed vio­la­tions occurred after Novem­ber 2, 2015. Because the Fed­er­al Civ­il Penal­ties Infla­tion Adjust­ment Improve­ments Act of 2015 requires the penal­ty amount to be adjust­ed annu­al­ly after the Form 5500 and its sched­ules, attach­ments, and instruc­tions are pub­lished for fil­ing, be sure to check for any pos­si­ble required infla­tion adjust­ments of the max­i­mum penal­ty amount that may have been pub­lished in the Fed­er­al Reg­is­ter after the instruc­tions have been posted.
    • Form 5500-Plan Name Change. Line 4 of the Form 5500 has been changed to pro­vide a field for fil­ers to indi­cate that the name of the plan has changed. The instruc­tions for line 4 have been updat­ed to reflect the change. The instruc­tions for line 1a have also been updat­ed to advise fil­ers that if the plan changed its name from the pri­or year fil­ing or fil­ings, com­plete line 4 to indi­cate that the plan was pre­vi­ous­ly iden­ti­fied by a dif­fer­ent name.
    • Fil­ing Exemp­tion for Small Plans. The instruc­tions indi­cate that for a small unfund­ed, insured, or com­bi­na­tion wel­fare plan to qual­i­fy for the fil­ing exemp­tion, the plan must not be sub­ject to the Form M‑1 fil­ing requirements.

    Be aware that the advance copies of the 2017 Form 5500 are for infor­ma­tion­al pur­pos­es only and can­not be used to file a 2017 Form 5500 annu­al return/report.

    By  Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Agencies Provide Relief for Group Plans and Donation Programs Affected by Hurricanes/Wildfires | CA Benefit Advisors

    December 15, 2017

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    Guid­ance for Group Health Plans Impact­ed by Hur­ri­cane Maria and Cal­i­for­nia Wildfires

    The U.S. Depart­ment of Labor (DOL) issued a news release to rec­og­nize that plan par­tic­i­pants and ben­e­fi­cia­ries may encounter prob­lems due to Hur­ri­cane Maria and the Cal­i­for­nia Wild­fires. The DOL advis­es plan fidu­cia­ries to make rea­son­able accom­mo­da­tions to pre­vent work­ers’ loss of ben­e­fits and to take steps to min­i­mize the pos­si­bil­i­ty of indi­vid­u­als los­ing ben­e­fits because of a fail­ure to com­ply with pre-estab­lished time frames.

    The DOL also acknowl­edged that there may be instances when full and time­ly com­pli­ance by group health plans may not be pos­si­ble due to phys­i­cal dis­rup­tion to a plan’s prin­ci­pal place of busi­ness. The DOL’s enforce­ment approach will empha­size com­pli­ance assis­tance, includ­ing grace peri­ods and oth­er relief where appropriate.

    Dead­line Exten­sions for Those Affect­ed by Hur­ri­cane Maria

    The DOL and IRS announced dead­line exten­sions to pro­vide plan par­tic­i­pants, ben­e­fi­cia­ries, and employ­ers affect­ed by Hur­ri­cane Maria with addi­tion­al time to make health cov­er­age and ben­e­fits decisions.

    Under the exten­sion, group health plans have addi­tion­al time to com­ply with cer­tain dead­lines affect­ing COBRA con­tin­u­a­tion cov­er­age, Health Insur­ance Porta­bil­i­ty and Account­abil­i­ty Act of 1996 (HIPAA) spe­cial enroll­ment, claims for ben­e­fits, appeals of denied claims, and exter­nal review of cer­tain claims. Under the exten­sion, par­tic­i­pants and ben­e­fi­cia­ries have addi­tion­al time to make claims for ben­e­fits and appeal denied claims.

    Guid­ance on Leave-Based Dona­tion Pro­grams’ Tax Treatment

    In recent months, the IRS pro­vid­ed guid­ance for employ­ers who adopt leave-based dona­tion pro­grams to pro­vide char­i­ta­ble relief for vic­tims of Hur­ri­cane and Trop­i­cal Storms Irma and Maria. This month, the IRS issued Notice 2017–70, which extends the guid­ance to employ­ers’ pro­grams adopt­ed for the relief of vic­tims of the Cal­i­for­nia wildfires.

    These leave-based dona­tion pro­grams allow employ­ees to for­go vaca­tion, sick, or per­son­al leave in exchange for cash pay­ments that the employ­er will make to char­i­ta­ble orga­ni­za­tions described under Inter­nal Rev­enue Code Sec­tion 170©.

    The employ­er’s cash pay­ments will not con­sti­tute gross income or wages of the employ­ees if paid before Jan­u­ary 1, 2019, to the Sec­tion 170© char­i­ta­ble orga­ni­za­tions for the relief of vic­tims of the Cal­i­for­nia wild­fires. Employ­ers do not need to include these pay­ments in Box 1, 3, or 5 of an employ­ee’s Form W‑2.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • IRS Updates Guidance on Play-or-Pay Penalty Assessments | CA Benefit Advisors

    December 11, 2017

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    Begin­ning in 2015, to com­ply with the Patient Pro­tec­tion and Afford­able Care Act (ACA), “large” employ­ers must offer their full-time employ­ees health cov­er­age, or pay one of two employ­er shared respon­si­bil­i­ty / play-or-pay penal­ties. The Inter­nal Rev­enue Ser­vice (IRS) deter­mines the penal­ty each cal­en­dar year after employ­ees have filed their fed­er­al tax returns.

    In Novem­ber 2017, the IRS indi­cat­ed on its “Ques­tions and Answers on Employ­er Shared Respon­si­bil­i­ty Pro­vi­sions Under the Afford­able Care Act” web­page that, in late 2017, it plans to issue Let­ter 226J to inform large employ­ers of their poten­tial lia­bil­i­ty for an employ­er shared respon­si­bil­i­ty pay­ment for the 2015 cal­en­dar year.

    The IRS’ deter­mi­na­tion of an employer’s lia­bil­i­ty and poten­tial pay­ment is based on infor­ma­tion report­ed to the IRS on Forms 1094‑C and 1095‑C and infor­ma­tion about the employer’s full-time employ­ees that were received the pre­mi­um tax credit.

    The IRS will issue Let­ter 226J if it deter­mines that, for at least one month in the year, one or more of a large employer’s full-time employ­ees was enrolled in a qual­i­fied health plan for which a pre­mi­um tax cred­it was allowed (and the employ­er did not qual­i­fy for an afford­abil­i­ty safe har­bor or oth­er relief for the employee).

    Let­ter 226J will include:

    • A brief expla­na­tion of Sec­tion 4980H, the employ­er shared respon­si­bil­i­ty regulations
    • An employ­er shared respon­si­bil­i­ty pay­ment sum­ma­ry table that includes a month­ly item­iza­tion of the pro­posed pay­ment and whether the lia­bil­i­ty falls under Sec­tion 4980H(a) (the “A” or “No Offer” Penal­ty) or Sec­tion 4980H(b) (the “B” or “Inad­e­quate Cov­er­age” Penal­ty) or nei­ther section
    • A pay­ment sum­ma­ry table explanation
    • An employ­er shared respon­si­bil­i­ty response form (Form 14764 “ESRP Response”)
    • An employ­ee pre­mi­um tax cred­it list (Form 14765 “Employ­ee Pre­mi­um Tax Cred­it (PTC) List”) which lists, by month, the employer’s assess­able full-time employ­ees and the indi­ca­tor codes, if any, the employ­er report­ed on lines 14 and 16 of each assess­able full-time employee’s Form 1095‑C
    • Actions the employ­er should take if it agrees or dis­agrees with Let­ter 226J’s pro­posed employ­er shared respon­si­bil­i­ty payment
    • Actions the IRS will take if the employ­er does not time­ly respond to Let­ter 226J
    • The date by which the employ­er should respond to Let­ter 226J, which will gen­er­al­ly be 30 days from the date of the letter
    • The name and con­tact infor­ma­tion of the IRS employ­ee to con­tact with ques­tions about the letter

    If an employ­er responds to Let­ter 226J, then the IRS will acknowl­edge the response with Let­ter 227 to describe fur­ther actions that the employ­er can take.

    After receiv­ing Let­ter 227, if the employ­er dis­agrees with the pro­posed or revised shared employ­er respon­si­bil­i­ty pay­ment, the employ­er may request a pre-assess­ment con­fer­ence with the IRS Office of Appeals. The employ­er must request the con­fer­ence by the response date list­ed with­in Let­ter 227, which will be gen­er­al­ly 30 days from the date of the letter.

    If the employ­er does not respond to either Let­ter 226J or Let­ter 227, then the IRS will assess the pro­posed employ­er shared respon­si­bil­i­ty pay­ment amount and issue a notice and demand for pay­ment on Notice CP 220J.

    Notice CP 220J will include a sum­ma­ry of the employ­er shared respon­si­bil­i­ty pay­ment, pay­ments made, cred­its applied, and the bal­ance due, if any. If a bal­ance is due, Notice CP 220J will instruct an employ­er how to make pay­ment. For pay­ment options, such as an install­ment agree­ment, employ­ers should refer to Pub­li­ca­tion 594 “The IRS Col­lec­tion Process.”

    Employ­ers are not required to make pay­ment before receiv­ing a notice and demand for payment.

    The ACA pro­hibits employ­ers from mak­ing an adverse employ­ment action against an employ­ee because the employ­ee received a tax cred­it or sub­sidy. To avoid alle­ga­tions of retal­i­a­tion, as a best prac­tice, employ­ers who receive a Let­ter 226J should sep­a­rate their employ­er shared respon­si­bil­i­ty penal­ty assess­ment cor­re­spon­dence from their human resources depart­ment and employ­ees who have author­i­ty to make employ­ment actions.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

     

  • The Perks of Holiday Parties: How They’re Still an Asset to Your Company | CA Benefit Advisors

    December 6, 2017

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    The end of the year is upon us and a major­i­ty of com­pa­nies cel­e­brate with an end-of-year/hol­i­day par­ty.  Although the trend of hol­i­day par­ties has dimin­ished in recent years, it’s still a good idea to com­mem­o­rate the year with an office perk like a fun, fes­tive party.

    BENEFITS OF A YEAR-END CELEBRATION

    • Hol­i­day staff par­ties are a per­fect way to thank your employ­ees for a great year. All employ­ees want to feel appre­ci­at­ed and val­ued. What bet­ter way to serve this pur­pose, than with an end of the year office cel­e­bra­tion. Host­ing a night out to hon­or your employ­ees dur­ing a fes­tive time of year boosts morale. And if done right, your par­ty can jump start the new year with refreshed, pro­duc­tive employees.
    • End-of-year cel­e­bra­tions allow employ­ees to come togeth­er out­side of their own team. The aver­age Amer­i­can will spend 90,000 hours (45 years) of their life at work. Unless you have a very small office, most employ­ees only engage in rela­tion­ships with­in their depart­ment. When employ­ees have a chance to min­gle out­side of their reg­u­lar 9 to 5 day, they’ll build and cul­ti­vate rela­tion­ships across dif­fer­ent teams with­in the orga­ni­za­tion; cre­at­ing a more loy­al, cohe­sive and moti­vat­ed culture.
    • Sea­son­al par­ties can pro­vide employ­ers insight on those who work for them. Spend­ing the evening with your employ­ees in a more casu­al and relaxed atmos­phere may reveal tal­ents and ideas you may not have oth­er­wise seen dur­ing tra­di­tion­al work hours.

    CREATING THE RIGHT FIT

    Regard­less of office size, if planned right, employ­ers can make a hol­i­day par­ty pop, no mat­ter your bud­get. Whether this is your first go at an end-of-year cel­e­bra­tion for your employ­ees, or you host one every year, keep a few things in mind:

    • Plan ear­ly. Estab­lish a steer­ing com­mit­tee to gen­er­ate ideas for your hol­i­day par­ty. Allow the com­mit­tee to involve all employ­ees ear­ly on in the process. Uti­lize vot­ing tools like Sur­vey Mon­key or Out­look to com­pile employ­ee votes. This engages not only your entire work­force, but serves you as well when tai­lor­ing your par­ty to fit your culture.
    • Cre­ate set activ­i­ties. Engag­ing employ­ees in some type of orga­nized activ­i­ty not only eas­es any social anx­i­ety for them and their guests, it cul­ti­vates mem­o­ries and allows col­leagues to get to know each oth­er. Con­sid­er a “Casi­no Night”, a pho­to booth (or two if your com­pa­ny can jus­ti­fy to size), an escape room outing—anything that will kick the night off with ease.
    • Incor­po­rate enter­tain­ment dur­ing the din­ner. Have team leads or man­age­ment mem­bers come up with fun awards that empha­size char­ac­ter traits, strengths, and tal­ents oth­ers may not know of. This is a great way to cre­ate cohe­sive­ness, build rela­tion­ships, and have your employ­ees enjoy a good laugh at dinner.
    • Offer fun door prizes every 15 min­utes or so. Prizes don’t have to be expen­sive to have an impact on employ­ees, just rel­e­vant to them. How­ev­er, with the right plan­ning you may be able to throw in a raf­fle of larg­er gift items as well. Just keep in the spe­cif­ic tax rules when it relates to gift-giv­ing. Gift cards asso­ci­at­ed with a spe­cif­ic dol­lar amount avail­able to use at any estab­lish­ment, and larg­er tick­et items, can be sub­ject to your employ­ees hav­ing to claim income on them and pay the tax.
    • Make the dress code inclu­sive of every­one. Employ­ees should not feel a finan­cial pinch to attend a hol­i­day office par­ty. Estab­lish a dress code that fits your cul­ture, not the oth­er way around.

     TAKE AWAY TIPS FOR A SUCCESSFUL HOLIDAY PARTY

    Accord­ing to the Soci­ety of Human Resource Man­age­ment, sta­tis­tics show in recent years only 65% of employ­ers have offered hol­i­day parties—down from 72% five years ago. Con­sid­er the fol­low­ing tips when host­ing your next year-end celebration.

    • Keep it light. Elim­i­nate itin­er­aries and board-room like struc­ture. Choose to sep­a­rate productivity/award cel­e­bra­tions and upcom­ing year pro­jec­tions from your hol­i­day party.
    • Invite spous­es and sig­nif­i­cant oth­ers to attend the par­ty. Employ­ees spend a major­i­ty of their week with their col­leagues. Giv­ing employ­ees this option is a great way to show you val­ue who they spend their time with out­side of work.
    • Allow employ­ees to leave ear­ly on a work day to give them time to get ready and pick up who is attend­ing the par­ty with them.
    • Show how you val­ue your employ­ees by chat­ting with them and meet­ing their guests.
    • Pro­vide com­fort­able seat­ing areas where employ­ees can rest, eat and talk. Posi­tion these in main action areas so no one feels anti-social for tak­ing a seat somewhere.
    • Con­sid­er tying in employ­ees that work in dif­fer­ent loca­tions. Have a slideshow run­ning through­out the night on what events oth­er office loca­tions have done through­out the year.
    • Cre­ate low-key con­ver­sa­tion starters and get peo­ple to chat it up. This is valu­able espe­cial­ly for those that are new to the com­pa­ny and guests of your employ­ees. Incor­po­rate triv­ia ques­tions into the décor and table set­tings. Get them to engage by tying in a prize.
    • Keep the tastes and com­fort lev­el of your employ­ees in mind. Include a vari­ety of menu items that fit dietary restric­tions. Not all employ­ees drink alco­hol and not all employ­ees eat meat.
    • Lim­it alco­hol to a 2 tick­et sys­tem per guest. Opt for a cash bar after that to reduce liability.
    • Pro­vide access to accom­mo­da­tions or coor­di­nate trans­porta­tion like Uber or Lyft to get your employ­ees some­where safe­ly after the par­ty if they choose to drink.

    Ulti­mate­ly, hol­i­day par­ties can still be a val­ue-add for your employ­ees if done the right way. Feel free to change it up from year to year so these par­ties don’t get stale and con­tin­ue to fit to your company’s cul­ture. Con­tem­plate new venues, ideas and activ­i­ties and change up your steer­ing com­mit­tee to keep these par­ties fresh. Employ­ees are more like­ly to enjoy them­selves at an event that fits with their lifestyle, so don’t be afraid to get creative!

     

     

     

  • The Price ain’t right – resignation comes among allegations, but now who leads the charge?

    December 4, 2017

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    Tom Price came in with much fan­fare as the new Sec­re­tary of Health and Human Ser­vices, com­ing in as the administration’s point man to help upend the Afford­able Care Act.  He had his own plan and prin­ci­ples, out­lined while he was in the House, which would have steered the conversation…had he not found it nec­es­sary to book planes at the tax­pay­ers’ expense.  So now the chair sits emp­ty, and the ACA reform attempts in tat­ters, so now what?

  • Top 3 Frequently Asked Questions about Qualified Small Employer Health Reimbursement Arrangements | CA Benefit Advisors

    December 1, 2017

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    On Decem­ber 13, 2016, Pres­i­dent Oba­ma signed the 21st Cen­tu­ry Cures Act (Cures Act) into law. The Cures Act pro­vides a method for cer­tain small employ­ers to reim­burse indi­vid­ual health cov­er­age pre­mi­ums up to a dol­lar lim­it through HRAs called “Qual­i­fied Small Employ­er Health Reim­burse­ment Arrange­ments” (QSE HRAs). The pro­vi­sion went into effect on Jan­u­ary 1, 2017. On Octo­ber 31, 2017, the IRS released Notice 2017–67, pro­vid­ing guid­ance on the imple­men­ta­tion and admin­is­tra­tion of QSE HRAs.

    Unless an employ­er meets all the require­ments for offer­ing a QSE HRA, pre­vi­ous IRS guid­ance pro­hibit­ing the reim­burse­ment of indi­vid­ual pre­mi­ums direct­ly or indi­rect­ly, after- or pre-tax, through an HRA, a Sec­tion 125 plan, a Sec­tion 105 plan, or any oth­er mech­a­nism, remains in full effect. Reim­burs­ing indi­vid­ual pre­mi­ums in a non-com­pli­ant man­ner will sub­ject an employ­er to a Patient Pro­tec­tion and Afford­able Care Act (ACA) penal­ty of $100 a day per indi­vid­ual it reim­burs­es, with the poten­tial for oth­er penal­ties based on the mech­a­nism of the non-com­pli­ant reimbursement.

    If an employ­er fails to meet the require­ments of pro­vid­ing a QSE HRA, it will be sub­ject to a penal­ty of $100 per day per affect­ed per­son for being a non-com­pli­ant group health plan. An arrange­ment will be a group health plan that is not a QSE HRA if it:

    • Is not pro­vid­ed by an eli­gi­ble employ­er (such as an employ­er that offers anoth­er group health plan to its employees).
    • Is not pro­vid­ed on the same terms to all eli­gi­ble employees.
    • Reim­burs­es med­ical expens­es with­out first requir­ing proof of min­i­mum essen­tial cov­er­age (MEC).
    • Pro­vides a per­mit­ted ben­e­fit in excess of the statu­to­ry dol­lar limits.

    An arrange­men­t’s fail­ure to be a QSE HRA will not cause any reim­burse­ment of a prop­er­ly sub­stan­ti­at­ed med­ical expense that is oth­er­wise exclud­able from income to be includ­ed in the employ­ee’s income or wages. Fur­ther­more, an arrange­ment designed to reim­burse expens­es oth­er than med­ical expens­es (whether or not also reim­burs­ing med­ical expens­es) is nei­ther a QSE HRA nor a group health plan. Accord­ing­ly, all pay­ments under such an arrange­ment are includi­ble in the employ­ee’s gross income and wages. An employ­er’s fail­ure to time­ly pro­vide a com­pli­ant writ­ten notice does not cause an arrange­ment to fail to be a QSE HRA, but instead results in the penal­ty of $50 per employ­ee, not to exceed $2,500.

    Answers to Top Three FAQs about QSE HRAs 

    1, Which employ­ers may offer a QSE HRA?

    Employ­ers with few­er than 50 full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules) that do not offer a group health plan. Employ­ers that do not offer a group health plan, but offer a retiree-only plan to for­mer employ­ees may offer a QSE HRA.

    2. Which employ­ers may not offer a QSE HRA?

    • Employ­ers with 50 or more full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules).
    • Employ­ers of any size that offer a group health plan, includ­ing plans that only pro­vide except­ed ben­e­fits, such as vision or den­tal benefits.
    • Employ­ers that pro­vide cur­rent employ­ees with access to mon­ey from health reim­burse­ment arrange­ments (HRAs) offered in pri­or years (through a carry-over).
    • Employ­ers that offer employ­ees access to car­ry­over amounts in a flex­i­ble spend­ing account (FSA).

    3. What are the rules for employ­ers in a con­trolled group?

    • Employ­ers with less than 50 full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules) may offer QSE HRAs, with the head­count includ­ing all employ­ees across an entire con­trolled group.
    • If one employ­er with­in a con­trolled group offers a QSE HRA, it must be offered to all employ­ees with­in the entire con­trolled group (or each employ­er must offer an iden­ti­cal QSE HRA).

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Latest IRS ACA Round Up (Including 2018 Cost-of-Living Adjustments) | CA Benefit Advisors

    November 24, 2017

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    Recent­ly, the Inter­nal Rev­enue Ser­vice (IRS) issued the instruc­tions for Forms 1094/1095 for the 2017 tax year, announced PCORI fees for 2017–18, and announced cost-of-liv­ing adjust­ments for 2018. The IRS pro­vid­ed addi­tion­al guid­ance on leave-based dona­tion pro­grams’ tax treat­ment and released an infor­ma­tion let­ter on COBRA and Medicare. Here’s a recap of these actions for your reference.

    IRS Announces Cost-of-Liv­ing Adjust­ments for 2018

    The IRS released Rev­enue Pro­ce­dures 2017–58 and Notice 2017–64 to announce cost-of-liv­ing adjust­ments for 2018. For exam­ple, the dol­lar lim­it on vol­un­tary employ­ee salary reduc­tions for con­tri­bu­tions to health flex­i­ble spend­ing accounts (FSAs) is $2,650, for tax­able years begin­ning with 2018.

    Request UBA’s 2018 desk ref­er­ence card with an at‑a glance sum­ma­ry of the var­i­ous limits.

    IRS Announces PCORI Fee for 2017–18

    The IRS announced the Patient-Cen­tered Out­comes Research Insti­tute (PCORI) fee for 2017–18. The fee is $1.00 per cov­ered life in the first year the fee is in effect. The fee is $2.00 per cov­ered life in the sec­ond year. In the third through sev­enth years, the fee is $2.00, adjust­ed for med­ical infla­tion, per cov­ered life.

    For plan years that end on or after Octo­ber 1, 2016, and before Octo­ber 1, 2017, the indexed fee is $2.26. For plan years that end on or after Octo­ber 1, 2017, and before Octo­ber 1, 2018, the indexed fee is $2.39.

    For more infor­ma­tion, view UBA’s FAQ on the PCORI Fee.

    IRS Pro­vides Addi­tion­al Guid­ance on Leave-Based Dona­tion Pro­grams’ Tax Treatment

    Last month, the IRS pro­vid­ed guid­ance for employ­ers who adopt leave-based dona­tion pro­grams to pro­vide char­i­ta­ble relief for vic­tims of Hur­ri­cane and Trop­i­cal Storm Irma. This month, the IRS issued Notice 2017–62 which extends the guid­ance to employ­ers’ pro­grams adopt­ed for the relief of vic­tims of Hur­ri­cane and Trop­i­cal Storm Maria.

    These leave-based dona­tion pro­grams allow employ­ees to for­go vaca­tion, sick, or per­son­al leave in exchange for cash pay­ments that the employ­er will make to char­i­ta­ble orga­ni­za­tions described under Inter­nal Rev­enue Code Sec­tion 170©.

    The employ­er’s cash pay­ments will not con­sti­tute gross income or wages of the employ­ees if paid before Jan­u­ary 1, 2019, to the Sec­tion 170© char­i­ta­ble orga­ni­za­tions for the relief of vic­tims of Hur­ri­cane or Trop­i­cal Storm Maria. Employ­ers do not need to include these pay­ments in Box 1, 3, or 5 of an employ­ee’s Form W‑2.

    IRS Releas­es Infor­ma­tion Let­ter on COBRA and Medicare

    The IRS released Infor­ma­tion Let­ter 2017–0022 that explains that a cov­ered employ­ee’s spouse can receive COBRA con­tin­u­a­tion cov­er­age for up to 36 months if the employ­ee became enti­tled to Medicare ben­e­fits before employ­ment ter­mi­na­tion. In this case, the spouse’s max­i­mum COBRA con­tin­u­a­tion peri­od ends the lat­er of: 36 months after the employ­ee’s Medicare enti­tle­ment, or 18 months (or 29 months if there is a dis­abil­i­ty exten­sion) after the employ­ment termination.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Agencies Issue Proposed Rules and Plans | CA Benefit Advisors

    November 20, 2017

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    Octo­ber was a busy month in the employ­ee ben­e­fits world. Pres­i­dent Trump announced a new Act­ing Sec­re­tary for the U.S. Depart­ment of Health and Human Ser­vices (HHS). Eric Har­gan fills the posi­tion vacat­ed by Tom Price, who resigned in late Sep­tem­ber 2017. The U.S. Depart­ment of Labor (DOL) issued a pro­posed rule to delay a dis­abil­i­ty claims pro­ce­dure reg­u­la­tion’s applic­a­bil­i­ty date and HHS released its pro­posed rule on ben­e­fits and pay­ment para­me­ters for 2019. The U.S. Depart­ment of the Trea­sury (Trea­sury) issued its Pri­or­i­ty Guid­ance Plan for projects it intends to com­plete dur­ing the first half of 2018.

    DOL Pro­pos­es Delay to Final Dis­abil­i­ty Claims Pro­ce­dures Reg­u­la­tions’ Applic­a­bil­i­ty Date

    The DOL issued a pro­posed rule to delay the applic­a­bil­i­ty date of its final rule that amends the claims pro­ce­dure require­ments applic­a­ble to ERISA-cov­ered employ­ee ben­e­fit plans that pro­vide dis­abil­i­ty ben­e­fits. The DOL’s Fact Sheet con­tains a sum­ma­ry of the final rule’s requirements.

    The DOL is delay­ing the applic­a­bil­i­ty date from Jan­u­ary 1, 2018, to April 1, 2018, to con­sid­er whether to rescind, mod­i­fy, or retain the reg­u­la­tions and to give the pub­lic an addi­tion­al oppor­tu­ni­ty to sub­mit com­ments and data con­cern­ing the final rule’s poten­tial impact.

    CMS Releas­es 2019 Ben­e­fits Pay­ment and Para­me­ters Pro­posed Rule

    The Cen­ters for Medicare & Med­ic­aid Ser­vices (CMS) released a pro­posed rule and fact sheet for the 2019 Ben­e­fit Pay­ment and Para­me­ters. The pro­posed rule is intend­ed to increase indi­vid­ual mar­ket flex­i­bil­i­ty, improve pro­gram integri­ty, and reduce reg­u­la­to­ry bur­dens asso­ci­at­ed with the Patient Pro­tec­tion and Afford­able Care Act (ACA) in many ways, includ­ing updates and annu­al pro­vi­sions to:

    • Essen­tial health benefits
    • Small Busi­ness Health Options Pro­gram (SHOP)
    • Spe­cial enroll­ment peri­ods (SEPs)
    • Exemp­tions
    • Ter­mi­na­tion effec­tive dates
    • Med­ical loss ratio (MLR)

    CMS usu­al­ly final­izes the Ben­e­fit Pay­ment and Para­me­ters rule in the first quar­ter of the year fol­low­ing the pro­posed rule’s release. Novem­ber 27, 2017, is the due date for pub­lic com­ments on the pro­posed rule.

    Almost all the top­ics addressed in the pro­posed rule would affect the indi­vid­ual mar­ket and the Exchanges, par­tic­u­lar­ly the Small Busi­ness Health Options Pro­gram (SHOP) Exchanges.

    Of inter­est to small group health plans, CMS pro­pos­es to change how states will select essen­tial health ben­e­fits bench­mark plans. If CMS keeps this change in its final rule, then it will affect non-grand­fa­thered small group health plans for ben­e­fit years 2019 and beyond.

    Trea­sury Issues its Pri­or­i­ty Guid­ance Plan

    The Trea­sury issued its 2017–2018 Pri­or­i­ty Guid­ance Plan that lists projects that it intends to com­plete by June 30, 2018, including:

    • Guid­ance on issues relat­ed to the employ­er shared respon­si­bil­i­ty provisions
    • Reg­u­la­tions regard­ing the excise tax on high cost employ­er-pro­vid­ed cov­er­age (“Cadil­lac tax”)
    • Guid­ance on Qual­i­fied Small Employ­er Health Reim­burse­ment Arrange­ments (QSE HRAs)

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • How to Make the Most Out of Your FSA at Year-End | CA Benefit Advisors

    November 13, 2017

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    As 2017 comes to a close, it’s time to act on the mon­ey sit­ting in your Flex­i­ble Spending/Savings Account (FSA). Unlike a Health Sav­ings Account or HSA, pre-taxed funds con­tributed to an FSA are lost at the end of the year if an employ­ee doesn’t use them, and an employ­er doesn’t adopt a car­ry­over pol­i­cy.  It’s to your advan­tage to review the var­i­ous ways you can make the most out of your FSA by year-end.

    Book Those Appointments

    One of the first things you should do is get those remain­ing appoint­ments booked for the year. Most medical/dental/vision facil­i­ties book out a cou­ple of months in advance, so it’s key to get in now to use up those funds.

    Look for FSA-Approved Every­day Health Care Products

    Many drug­stores will often adver­tise FSA-approved prod­ucts in their phar­ma­cy area, with­in a fly­er, or on their web­site. These prod­ucts are usu­al­ly tagged as “FSA approved”. Many of these prod­ucts include items that mon­i­tor health and well­ness – like blood pres­sure and dia­bet­ic mon­i­tors – to every­day health­care prod­ucts like children’s OTC meds, ban­dages, con­tact solu­tion, and cer­tain per­son­al care items. If you need to use the funds up before the end of the year, it’s time to take a trip to your local drug­store and stock up on these items.

    Know What’s Con­sid­ered FSA-Eligible

    Over the last sev­er­al years, the IRS has loos­ened the guide­lines on what is con­sid­ered eli­gi­ble under a FSA as more peo­ple became con­cerned about los­ing the mon­ey they put into these plans. There are many items that are con­sid­ered FSA-eli­gi­ble as long as a pre­scrip­tion or a doctor’s note is pro­vid­ed or kept on file. Here are a few to consider:

    • Acupunc­ture. Those who suf­fer from chron­ic neck or back pain, infer­til­i­ty, depression/anxiety, migraines or any oth­er chron­ic ill­ness or con­di­tion, East­ern med­i­cine may be the way to go. Not only are treat­ments rel­a­tive­ly inex­pen­sive, but this 3,000 year old prac­tice is rec­og­nized by the U.S. Nation­al Insti­tute of Health and is an eli­gi­ble FSA expense.
    • Dental/Vision Pro­ce­dures. Den­tal treat­ment can be expensive—think ortho­don­tia and implants. While many employ­ers may offer some cov­er­age, it’s a giv­en there will be out-of-pock­et costs you’ll incur. And, eye care plans won’t cov­er the cost of LASIK, but your FSA will. So, if you’ve been want­i­ng to cor­rect your vision with­out the aid of glass­es or con­tacts, or your need­ing to get that child braces, using those FSA funds is the way to go.
    • Health-boost­ing Sup­ple­ments. While you can­not just walk into any health shop and pick up per­for­mance-enhanc­ing pow­der or sup­ple­ments and pay with your FSA card, your doc­tor may approve cer­tain sup­ple­ments and alter­na­tive options if they deem it to ben­e­fit your health and well-being. A signed doctor’s note will make these an FSA-eli­gi­ble expense.
    • Smok­ing-ces­sa­tion and Weight-Loss Pro­grams. If your doc­tor approves you for one of these pro­grams with a doctor’s note deem­ing it’s med­ical­ly nec­es­sary to main­tain your health, cer­tain pro­gram costs can be reim­bursed under an FSA.

    Talk to Your HR Department

    When the IRS loos­ened guide­lines a few years ago, they also made it pos­si­ble for par­tic­i­pants to car­ry over $500 to the next year. Ask Human Resources if your employ­er offers this, or if they pro­vide a grace peri­od (March 15 of the fol­low­ing year) to turn in receipts and use up funds. Employ­ers can only adopt one of these two poli­cies though.

    Plan for the Com­ing Year

    Ana­lyze the out-of-pock­et expens­es you incurred this year and make the nec­es­sary adjust­ments to allo­cate what you believe you’ll need for the com­ing year. Take advan­tage of the slight­ly high­er con­tri­bu­tion lim­it for 2018.  If your com­pa­ny offers a FSA that cov­ers depen­dent care, famil­iar­ize your­self with those eli­gi­ble expens­es and research whether it would be to your advan­tage to con­tribute to as well.

    Flex­i­ble Spending/Saving Accounts can be a great employ­ee ben­e­fit offer­ing tax advan­tages for employ­ees that have a high-deductible plan or use a lot of med­ical. As a par­tic­i­pant, using the strate­gies list­ed above will help you make the most out of your FSA.

  • We had to make the pun – Donald Trumps expectations and upends the ACA

    November 10, 2017

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    We have known this since the begin­ning.  If Con­gress failed to act, the Pres­i­dent still had the pow­er to change the ACA by either with­hold­ing pay­ments, chang­ing juris­dic­tions or sim­ply, as the Pres­i­dent has become so fond of doing, issu­ing an Exec­u­tive Order that just does what he wants.  So here we are, in the midst of an Exec­u­tive Order, that does the following:

    Directs the Depart­ment of Labor to con­sid­er expand­ing Asso­ci­a­tion Health Plans.  The idea here is that by let­ting car­ri­ers com­pete and expand beyond state bor­ders, they will be able to low­er costs and offer more options to poten­tial pol­i­cy­hold­ers in a giv­en state.  Sounds good…except that car­ri­ers already have sub­stan­tial pools they insure, may not have the where­with­al to expand, and many of the major car­ri­ers in the health care mar­ket­place are already nation­al – and already in Cal­i­for­nia (e.g. CIGNA, Anthem, Aet­na and Unit­ed Health Care).  By the way, how did the mul­ti state Co ops work under the ACA?  That’s right, they no longer exist.  Nice try, though.

    Directs Health and Human Ser­vices to expand cov­er­age through low cost short term dura­tion plans.  Which already exist.  Which are already inex­pen­sive.  This sim­ply relieves them of some of the respon­si­bil­i­ty to act like ACA plans.  Any­way, it’s short term, so whatever…

    Directs HHS and Trea­sury to con­sid­er changes to Health Reim­burse­ment Accon­ts.  Now we’re talk­ing – these help com­pa­nies do par­tial self fund­ing, allow expens­es that are not nor­mal­ly tax free to be so, and so, and so.

  • PPOs Dominate Despite Savings with HMOs and CDHPs | CA Benefit Advisors

    November 10, 2017

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    The find­ings of our 2017 Health Plan Sur­vey show a con­tin­u­a­tion of steady trends and some sur­pris­es. It’s no sur­prise, how­ev­er, that costs con­tin­ue to rise. The aver­age annu­al health plan cost per employ­ee for all plan types is $9,934, an increase from 2016, when the aver­age cost was $9,727. There are sig­nif­i­cant cost dif­fer­ences when you look at the data by plan type.

    Cost Detail by Plan Type

    Health Plan Cost Detail by Plan Type

    PPOs con­tin­ue to cost more than the aver­age plan, but despite this, PPOs still dom­i­nate the mar­ket in terms of plan dis­tri­b­u­tion and employ­ee enroll­ment. PPOs have seen an increase in total pre­mi­ums for sin­gle cov­er­age of 4.5% and for fam­i­ly cov­er­age of 2.2% in 2017 alone.

    HMOs have the low­est total annu­al cost at $8,877, as com­pared to the total cost of a PPO of $10,311. Con­verse­ly, CDHP plan costs have risen 2.2% from last year. How­ev­er, CDHP preva­lence and enroll­ment con­tin­ues to grow in most regions, indi­cat­ing inter­est among both employ­ers and employees.

    Across all plan types, employ­ees’ share of total costs rose 5% while employ­ers’ share stayed near­ly the same. Employ­ers are also fur­ther mit­i­gat­ing their costs by reduc­ing pre­scrip­tion drug cov­er­age, and rais­ing out-of-net­work deductibles and out-of-pock­et maximums.

    More than half (54.8%) of all employ­ers offer one health plan to employ­ees, while 28.2% offer two plan options, and 17.1% offer three or more options. The per­cent­age of employ­ers now offer­ing three or more plans decreased slight­ly in 2017, but still main­tains an over­all increase in the last five years as employ­ers are work­ing to offer expand­ed choic­es to employ­ees either through pri­vate exchange solu­tions or by sim­ply adding high, medium‑, and low-cost options; a trend UBA Part­ners believe will con­tin­ue. Not only do employ­ees get more options, but employ­ers also can intro­duce low­er-cost plans that may attract enroll­ment, low­er their costs, and meet ACA afford­abil­i­ty requirements.

    By Bill Olson

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • 2017 Health Plan Survey Shows Sharp Rise in Group Healthcare Premiums | CA Benefit Advisors

    November 6, 2017

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    I’m hap­py to report that this year’s UBA Health Plan sur­vey achieved a mile­stone. For the first time, we sur­passed 20,000 health plans entered—20,099 health plans to be exact, which were spon­sored by 11,221 employ­ers. What we were able to deter­mine from all this data was that a tumul­tuous Pres­i­den­tial elec­tion like­ly encour­aged many employ­ers to stay the course and make only minor increas­es and decreas­es across the board while the future of the Patient Pro­tec­tion and Afford­able Care Act (ACA) became clearer.

    There were, how­ev­er, a few note­wor­thy changes in 2017. Pre­mi­um renew­al rates (the com­par­i­son of sim­i­lar plan rates year over year) rose near­ly 7%, rep­re­sent­ing a depar­ture from the trend the last five years. To con­trol these costs, employ­ers shift­ed more pre­mi­um to employ­ees, offered more low­er-cost CDHP and HMO plans, increased out-of-net­work deductibles and out-of-pock­et max­i­mums, and sig­nif­i­cant­ly reduced pre­scrip­tion drug cov­er­age as six-tier pre­scrip­tion drug plans explod­ed on the mar­ket­place. Self-fund­ing, par­tic­u­lar­ly among small groups, is also on the rise.

    Percent Premium Increase Over Time

    UBA has con­duct­ed its Health Plan Sur­vey since 2005. This longevi­ty, cou­pled with its size
 and scope, allows UBA to main­tain its supe­ri­or accu­ra­cy over any oth­er bench­mark­ing sur­vey in the U.S. In fact, our unpar­al­leled num­ber of report­ed plans is near­ly three times larg­er than the next two of the nation’s largest health plan bench­mark­ing sur­veys com­bined. The result­ing vol­ume of data pro­vides employ­ers of all sizes more detailed—and there­fore more meaningful—benchmarks and trends than any oth­er source.

    By Peter Weber

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • It’s Open Enrollment Time! | CA Benefit Advisors

    October 23, 2017

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    Fall.  With it comes cool­er tem­per­a­tures’, falling leaves, warm sea­son­al scents like turkey and pump­kin pie, and Open Enroll­ment.  It goes with­out say­ing; employ­ees who under­stand the effec­tive­ness of their ben­e­fits are much more pleased with those pack­ages, hap­pi­er with their employ­ers, and more engaged in their work. So, as your com­pa­ny gears up for a new year of nav­i­gat­ing Open Enroll­ment, here are a few points to keep in mind to make the process smoother for both employ­ees and your ben­e­fits depart­ment. Bonus: it will light­en the load for both par­ties alike dur­ing an already stress-induced season.

    Com­mu­ni­cate Open Enroll­ment Using a Vari­ety of Mediums 

    Adver­tise 2018 ben­e­fit changes to employ­ees by using a vari­ety of medi­ums. The more reminders and expla­na­tion of ben­e­fits staff mem­bers have using more than one mode of media, the more like­ly employ­ees will go into Open Enroll­ment with more knowl­edge of your company’s ben­e­fit options and when they need to have these options com­plet­ed for the new year.

    • Con­sid­er explain­er videos to sim­pli­fy the amount of emails and paper­work indi­vid­u­als need to review come Open Enroll­ment time. These videos can increase the bot­tom line as well, elim­i­nat­ing the high cost of print material.
    • Opt for plac­ards placed through­out your high-traf­fic areas. Com­mu­ni­cate ben­e­fit options and remind employ­ees of Open Enroll­ment dates for the new year by post­ing in such areas as the lob­by, break room and bath­room stalls.
    • Choose SMS tex­ting. Today, over 97% of indi­vid­u­als use text. Nine­ty-eight per­cent of those that use text open mes­sages with­in the first three min­utes of receiv­ing them; 6–8 times high­er than the engage­ment rate for email. Deliv­er­ing a con­cise mes­sage to employ­ees’ mobile devices cre­ates more touch points along the Open Enroll­ment jour­ney. The key, how­ev­er, is mak­ing it quick so as to entice your employ­ees to take action.
    • Pro­mote apps and in-app tools. Push noti­fi­ca­tions and apps like Remind 101 can help dri­ve employ­ee engage­ment dur­ing Open Enroll­ment sea­son sim­ply by pro­vid­ing short mes­sages remind­ing them to enroll. Noti­fi­ca­tions like these can also be tai­lored to unique employ­ee groups based on loca­tion, job lev­el, eli­gi­bil­i­ty sta­tus and more.

    Uti­lize Mobile Apps and Web Por­tals for Open Enrollment 

    Now that your com­pa­ny has com­mu­ni­ca­tion down pat for Open Enroll­ment, sim­pli­fy the ardu­ous task employ­ees have of enrolling for the com­ing year by going paper­less. Uti­lize web por­tals through ben­e­fit bro­kers and com­pa­nies like ADP to elim­i­nate the has­sle of employ­ees hav­ing to fill out paper­work both at renew­al, and at the time of hire.  With near­ly three quar­ters of indi­vid­u­als in the Unit­ed States check­ing their phone once an hour and 90% per­cent of this time is spent using one app or anoth­er as a main source of com­mu­ni­ca­tion, mobile apps can make ben­e­fits engage­ment much eas­i­er due to the anywhere/anytime acces­si­bil­i­ty they offer.

    The per­son­al perks are for employ­ees are great too! Staff mem­bers with a major lifestyle event can make ben­e­fit adjust­ments quick­ly with the ease of mobile apps.  Employ­ees rec­og­nize this valu­able and time-sav­ing trend and enjoy hav­ing this infor­ma­tion at their fingertips.

    Open Enroll­ment sea­son can be a stress­ful time but hope­ful­ly these tips will help for a smoother tran­si­tion into the next year for your busi­ness. Sim­ple things like using explain­er videos, plac­ing reminders in high traf­fic areas and uti­liz­ing mobile apps and text mes­sag­ing can save time and stress in the long run for your employ­ees and ben­e­fit department.

  • President Trump Ends ACA Cost Sharing Reductions | CA Benefit Advisors

    October 20, 2017

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    On the evening of Octo­ber 12, 2017, Pres­i­dent Trump announced that cost shar­ing reduc­tions for low income Amer­i­cans in rela­tion to the Patient Pro­tec­tion and Afford­able Care Act (ACA) would be stopped. The Depart­ment of Health and Human Ser­vices (HHS) has con­firmed that pay­ments will be stopped imme­di­ate­ly. While there is no direct impact to employ­ers at this time, UBA will con­tin­ue to edu­cate employ­ers about changes in the law and its Health Plan Sur­vey will con­tin­ue to track group health plan rates over time as insur­ance com­pa­nies poten­tial­ly seek to recoup lost rev­enue. It is antic­i­pat­ed at least some state attor­neys gen­er­al will file law­suits to block the end­ing of the sub­sidy pay­ments, with Cal­i­for­nia Attor­ney Gen­er­al Xavier Becer­ra stat­ing he is pre­pared to file a law­suit to pro­tect the subsidies.

    Back­ground

    Indi­vid­u­als with house­hold mod­i­fied adjust­ed gross incomes (AGI) in excess of 100 per­cent but not exceed­ing 400 per­cent of the fed­er­al pover­ty lev­el (FPL) may be eli­gi­ble for cost-shar­ing reduc­tions for cov­er­age pur­chased through health insur­ance exchanges if they meet a vari­ety of cri­te­ria. Cost-shar­ing reduc­tions are lim­it­ed to cov­er­age months for which the indi­vid­ual is allowed a pre­mi­um tax cred­it. Eli­gi­bil­i­ty for cost-shar­ing reduc­tions is based on the tax year for which advanced eli­gi­bil­i­ty deter­mi­na­tions are made by HHS, rather than the tax year for which pre­mi­um cred­its are allowed. In 2015, cost-shar­ing sub­sides reduced out-of-pock­et (OOP) limits:

    • Less than 100 per­cent but not exceed­ing 200 per­cent of FPL: OOP lim­its reduced by two-thirds
    • Greater than 200 per­cent but not exceed­ing 300 per­cent of FPL: OOP lim­its reduced by one-half
    • Greater than 300 per­cent but not exceed­ing 400 per­cent of FPL: OOP lim­its reduced by one-third

    After 2015, the base per­cent­ages were shift­ed based on a per­cent­age of aver­age per capi­ta health insur­ance pre­mi­um increas­es. The cost-shar­ing reduc­tion is paid direct­ly to the insur­er, and is auto­mat­i­cal­ly applied when eli­gi­ble indi­vid­u­als enroll in a sil­ver plan on the Mar­ket­place or Exchange.

    The cost-shar­ing reduc­tion is not the same as the “advance pre­mi­um tax cred­it” which is also avail­able to indi­vid­u­als with house­hold mod­i­fied AGIs of at least 100 per­cent and not exceed­ing 400 per­cent of the FPL.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • 3 Ways Life Insurance Can Help Maximize Your Retirement | CA Benefit Advisors

    October 16, 2017

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    If you’re one of the mil­lions of Amer­i­cans who owns a perma­nent life insur­ance pol­i­cy (or are think­ing about get­ting one!) you’ve prob­a­bly done it pri­mar­i­ly to pro­tect your loved ones. But over time, many of your finan­cial oblig­a­tions may have end­ed. That’s when your pol­i­cy can take on a new life—as a pow­er­ful tool to make your retire­ment more secure and enjoyable.

    Per­ma­nent life insur­ance can open up options for you in retire­ment in three unique ways:

    1. It can help pro­tect you against the risk of out­liv­ing your assets. Struc­tured cor­rect­ly, your pol­i­cy can pro­vide sup­ple­men­tal retire­ment income via pol­i­cy loans and with­drawals. Hav­ing a pol­i­cy to draw from can take the pres­sure off invest­ment accounts if the mar­ket is slug­gish, giv­ing them time to rebound. Some poli­cies may also pro­vide options for long-term care ben­e­fits. At any time, you may also decide to annu­itize the pol­i­cy, con­vert­ing it into a guar­an­teed life­long income stream.

    2. It can max­i­mize a pen­sion. While a tra­di­tion­al pen­sion is fad­ing fast in Amer­i­ca, those who can still count on this ben­e­fit are often faced with a choice between tak­ing a high­er sin­gle life dis­tri­b­u­tion, or a low­er amount that cov­ers a sur­viv­ing spouse as well. Life insur­ance can sup­ple­ment a sur­viv­ing spouse’s income, enabling cou­ples to enjoy the high­er, sin­gle-life pension—together.

    3. It can make leav­ing a lega­cy easy. Accord­ing to The Wall Street Jour­nal, per­ma­nent life insur­ance is “a fan­tas­ti­cal­ly use­ful and flex­i­ble estate-plan­ning tool,” com­mon­ly used to pass on assets to loved ones. Pol­i­cy pro­ceeds are gen­er­al­ly income-tax free and paid direct­ly to your ben­e­fi­cia­ries in a cash lump sum—avoiding pro­bate and Uncle Sam in one pass. Your pol­i­cy can also be used to pay estate tax­es, ensure the con­ti­nu­ity of a fam­i­ly busi­ness, or per­haps leave a lega­cy for a favorite char­i­ty or institution.

    “Hav­ing a pol­i­cy to draw from can take the pres­sure off invest­ment accounts if the mar­ket is slug­gish, giv­ing them time to rebound.”

    If you do expect your estate to be taxed, you can even estab­lish a life insur­ance trust, which allows wealth to pass to your heirs out­side of your estate, gen­er­al­ly free of both estate and income taxes.

    Where to start? A pol­i­cy review
    If you’ve had a life insur­ance pol­i­cy for awhile, sched­ule a pol­i­cy review with your life insur­ance agent or finan­cial advi­sor. By the time you reach mid-life, you may have a mix of cov­er­age—term, per­ma­nent, group or even an exec­u­tive com­pen­sa­tion package.

    Your licensed insur­ance agent or finan­cial advi­sor can help you assess your sit­u­a­tion and adjust a cur­rent pol­i­cy or struc­ture a new pol­i­cy to help you achieve your retire­ment plan­ning goals.

    If you have no cov­er­age at all, there’s no bet­ter time than today to get start­ed. Life insur­ance is a long-term finan­cial tool. It can take decades to build per­ma­nent pol­i­cy val­ues to a place where you can use them toward your retire­ment goals. And, health pro­files can change at any time. If you’re healthy, you can lock in that insur­a­bil­i­ty now and look for­ward to years of tax-deferred (yes!) pol­i­cy growth.

    Retired already? The best thing you can do is meet annu­al­ly with your per­son­al advi­sors to ensure your plans stay on track. Mar­ket con­di­tions and fam­i­ly cir­cum­stances change, so that even the best-laid plans require course adjust­ments over time.

    By  Eri­ca Oh Nataren

    Orig­i­nal­ly post­ed by www.LifeHappens.org

  • Arrow highlighted in UBA In the News — CA Benefit Advisors

    October 13, 2017

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    UBA in the News

    Post­ed by: Geoff Mukhtar    Oct 9, 2017

    This week’s sec­tion show­cas­es UBA Part­ner Firm Arrow Ben­e­fits Group in Petaluma, Cal­i­for­nia, for launch­ing a Span­ish lan­guage divi­sion. They were fea­tured on KFMB-CBS and KUAM-NBC.

    To read the sto­ry about “Arrow Ben­e­fits Group launch­ing a Span­ish lan­guage divi­sion” on KFMB-CBS, click here and to read it on KUAM-NBC, click here.

  • PCORI Fee Increase for Health Plans | CA Benefit Advisors

    October 9, 2017

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    On Octo­ber 6, 2017, the Inter­nal Rev­enue Ser­vice (IRS) released Notice 2017–61 to announce that the health plan Patient-Cen­tered Out­comes Research Insti­tute (PCORI) fee for plan years end­ing between Octo­ber 1, 2017 and Sep­tem­ber 30, 2018 will be $2.39 per plan par­tic­i­pant. This is an increase from the pri­or year’s fee of $2.26 due to an infla­tion adjustment.

    Back­ground

    The Afford­able Care Act cre­at­ed the PCORI to study clin­i­cal effec­tive­ness and health out­comes. To finance the non­prof­it institute’s work, a small annu­al fee — com­mon­ly called the PCORI fee — is charged on group health plans.

    The fee is an annu­al amount mul­ti­plied by the num­ber of plan par­tic­i­pants. The dol­lar amount of the fee is based on the end­ing date of the plan year. For instance:

    • For plan year end­ing between Octo­ber 1, 2016 and Sep­tem­ber 30, 2017: $2.26.
    • For plan year end­ing between Octo­ber 1, 2017 and Sep­tem­ber 30, 2018: $2.39.

    The fee amount is adjust­ed each year for infla­tion. The pro­gram sun­sets in 2019, so no fee will apply for plan years end­ing after Sep­tem­ber 30, 2019.

    Insur­ers are respon­si­ble for cal­cu­lat­ing and pay­ing the fee for insured plans. For self-fund­ed health plans, how­ev­er, the employ­er spon­sor is respon­si­ble for cal­cu­lat­ing and pay­ing the fee. Pay­ment is due by fil­ing Form 720 by July 31 fol­low­ing the end of the cal­en­dar year in which the health plan year ends. For exam­ple, if the group health plan year ends Decem­ber 31, 2017, Form 720 must be filed along with pay­ment no lat­er than July 31, 2018.

    Cer­tain types of health plans are exempt from the fee, such as:

    • Stand-alone den­tal and/or vision plans;
    • Employ­ee assis­tance, dis­ease man­age­ment, and well­ness pro­grams that do not pro­vide sig­nif­i­cant med­ical care benefits;
    • Stop-loss insur­ance poli­cies; and
    • Health sav­ings accounts (HSAs).

    A health reim­burse­ment arrange­ment (HRA) also is exempt from the fee pro­vid­ed that it is inte­grat­ed with anoth­er self-fund­ed health plan spon­sored by the same employ­er. In that case, the employ­er pays the PCORI fee with respect to its self-fund­ed plan, but does not pay again just for the HRA com­po­nent. If, how­ev­er, the HRA is inte­grat­ed with a group insur­ance health plan, the insur­er will pay the PCORI fee with respect to the insured cov­er­age and the employ­er pays the fee for the HRA component.

    Resources

    The IRS pro­vides the fol­low­ing guid­ance to help plan spon­sors cal­cu­late, report, and pay the PCORI fee:

    Orig­i­nal­ly post­ed by www.ThinkHR.com

  • Arrow Benefits Group Launches Spanish Language Division | CA Benefit Advisors

    October 4, 2017

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    In a ground­break­ing effort to ser­vice and pro­vide clear and under­stand­able health ben­e­fits infor­ma­tion to Span­ish speak­ing employ­ees, Arrow Ben­e­fits Group has launched their Span­ish Lan­guage Divi­sion to counter the lack of sup­port, resources, and edu­ca­tion in the Span­ish speak­ing com­mu­ni­ty. “We want to break the lan­guage and cul­ture bar­ri­ers. With a divi­sion specif­i­cal­ly designed to edu­cate, answer ques­tions, and give guid­ance and resources regard­ing not only health insur­ance but employ­er ben­e­fits, we can break down the com­plex­i­ty and make insur­ance a more usable and valu­able ben­e­fit,” says SLD Lead Rosario Avi­la. The employ­ee ben­e­fits world can be con­fus­ing, and the added obsta­cle of infor­ma­tion being pro­vid­ed in an unfa­mil­iar lan­guage makes it much hard­er to under­stand and uti­lize. Even with lit­er­a­ture pro­vid­ed in Span­ish, the ter­mi­nol­o­gy is a lan­guage all its own. With their diverse under­stand­ing of the indus­try, and a ded­i­cat­ed team con­sist­ing of 6 ben­e­fit spe­cial­ists and 2 HR sup­port mem­bers that are not only flu­ent in Span­ish and expe­ri­enced in the ben­e­fits indus­try, but are also under­stand­ing of the cul­ture, Arrow will bridge the gap in edu­ca­tion and ser­vices to this large, high­ly valu­able, and yet his­tor­i­cal­ly under­served demographic.

    For more infor­ma­tion on Arrow Ben­e­fits Group’s Span­ish Lan­guage Divi­sion, con­tact Rosario Avi­la at [email protected] by call­ing (707)992‑3795.

    Most ben­e­fit car­ri­ers under­stand the impor­tance of hav­ing ben­e­fits explained in one’s own lan­guage, but straight trans­la­tions are sim­ply not enough. When it comes to edu­ca­tion, it is not only impor­tant to speak the lan­guage, but to explain the ter­mi­nol­o­gy. The issue here is if an employ­ee does not under­stand the pro­gram that they are eli­gi­ble for, it will be under­uti­lized and unap­pre­ci­at­ed. By being avail­able by phone, email and text, the Arrow Span­ish Lan­guage team will ensure that employ­ees and their fam­i­lies will under­stand what ben­e­fits they have and how their plan works. This also improves cor­po­rate cul­ture, boosts employ­ee morale, and saves HR depart­ments and employ­ers valu­able time and resources.

    In many cas­es, when an employ­ee and their fam­i­lies have ques­tions, they either ask the busi­ness own­er or the HR man­ag­er. If the ques­tion is com­plex, the com­pa­ny rep­re­sen­ta­tive may have to spend hours research­ing the answer, which takes them away from their reg­u­lar tasks. Con­fi­den­tial­i­ty is also a con­sid­er­a­tion. Espe­cial­ly in a small busi­ness, an employ­ee may not feel com­fort­able going to the busi­ness own­er or HR man­ag­er to dis­cuss per­son­al health mat­ters. In many cas­es, if there are ques­tions and no resources for the employ­ee to go to, the ques­tions go unan­swered. Arrow’s Span­ish Lan­guage Divi­sion will be that resource for Span­ish speak­ing employ­ees to be able to talk to when it comes to the per­son­al sub­jects they would not feel com­fort­able dis­clos­ing to their employ­er. Senior Part­ner and bilin­gual advi­sor at New Aspect Finan­cial Ser­vices, Karin Alvara­do, CFS, CPFA says, “In my expe­ri­ence, employ­ers with a large Span­ish speak­ing pop­u­la­tion who hire a native Span­ish speak­ing advi­sor to help edu­cate their employ­ees see a large increase in par­tic­i­pa­tion, uti­liza­tion and appreciation.”

    Arrow’s Span­ish Lan­guage Divi­sion is engag­ing and encour­ag­ing par­tic­i­pa­tion and com­mu­ni­ca­tion, as well as devel­op­ing part­ner­ships in the Span­ish speak­ing com­mu­ni­ty, cre­at­ing con­scious­ness of the health­care indus­try and com­pli­ance issues, as well as build­ing inter­per­son­al rela­tion­ships with Span­ish speak­ing employ­ees and their fam­i­lies. Accord­ing to Rosario Avi­la, “The goal of the Span­ish Lan­guage Divi­sion is to pro­vide hands on, high touch sup­port to the Span­ish speak­ing pop­u­la­tion of our clients. Those that speak Span­ish as their pri­ma­ry lan­guage have been large­ly under­served by the ben­e­fits com­mu­ni­ty and it is our goal to change that.”

    About Arrow Ben­e­fits Group
    Arrow Ben­e­fits Group, the third largest ben­e­fits firm in the North Bay, is a proud part­ner of Unit­ed Ben­e­fit Advi­sors (UBA), one of the largest ben­e­fits con­sult­ing and bro­ker­age firms in the coun­try. Arrow Ben­e­fits Group is the sin­gle-source solu­tion for man­ag­ing the com­plex­i­ties of ben­e­fits with expert advice, cus­tomized pro­grams, and per­son­al­ized solu­tions. Arrow’s inno­v­a­tive pro­grams con­trol costs and give employ­ees a greater sense of finan­cial and emo­tion­al security.

    For straight answers to employ­ee ben­e­fits call 707–992- 3780 or vis­it https://www.arrowbenefitsgroup.com

  • IRS Roundup: What Employers Need to Know about the Latest ACA Notices | CA Benefit Advisors

    October 2, 2017

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    In spite of the recent efforts by Con­gress to change or repeal the ACA, its pro­vi­sions are still in effect. The IRS has issued con­tin­u­ing guid­ance on the afford­abil­i­ty rate for cov­er­age, the employ­er shared respon­si­bil­i­ty pro­vi­sions and report­ing, and the indi­vid­ual man­date provision.

    IRS Released the 2018 Afford­abil­i­ty Rate

    The Inter­nal Rev­enue Ser­vice released its Rev­enue Pro­ce­dure 2017–36, which sets the afford­abil­i­ty per­cent­age at 9.56 per­cent for 2018. Under the Patient Pro­tec­tion and Afford­able Care Act (ACA), an applic­a­ble large employ­er may be liable for a penal­ty if a full-time employ­ee’s share of pre­mi­um for the low­est cost self-only option offered by the employ­er is not afford­able (for 2018, if it’s more than 9.56 per­cent of the employ­ee’s house­hold income) and the employ­ee gets a pre­mi­um tax cred­it for Mar­ket­place coverage.

    Because the 2018 afford­abil­i­ty rate is low­er than the 2017 afford­abil­i­ty rate, applic­a­ble large employ­ers may need to reduce their employ­ees’ share of pre­mi­um con­tri­bu­tions to main­tain afford­able cov­er­age. Employ­ers should dou­ble check their antic­i­pat­ed 2018 pre­mi­ums now to pre­vent the need for mid-year changes.

    IRS Releas­es Infor­ma­tion Letters

    The IRS issued Infor­ma­tion Let­ters 2017–0010, 2017–0011, 2017–0013, and 2017–0017 on the ACA’s employ­er shared respon­si­bil­i­ty pro­vi­sions and indi­vid­ual mandate.

    IRS Infor­ma­tion Let­ters 2017–0010 and 2017–0013 explain that the ACA’s employ­er shared respon­si­bil­i­ty pro­vi­sions con­tin­ue to apply. The let­ters state, “The [Pres­i­den­t’s Jan­u­ary 20, 2017] Exec­u­tive Order does not change the law; the leg­isla­tive pro­vi­sions of the ACA are still in force until changed by the Con­gress, and tax­pay­ers remain required to fol­low the law and pay what they may owe.” Fur­ther, the let­ters indi­cate that there are no waivers from poten­tial penal­ties for fail­ing to offer health cov­er­age to full-time employ­ees and their dependents.

    IRS Infor­ma­tion Let­ters 2017–0011 and 2017–0017 address the con­tin­ued appli­ca­tion of the ACA’s indi­vid­ual shared respon­si­bil­i­ty pro­vi­sions. Let­ter 2017–0017 states, “The Exec­u­tive Order does not change the law; the leg­isla­tive pro­vi­sions of the ACA are still in force until changed by the Con­gress, and tax­pay­ers remain required to fol­low the law, includ­ing the require­ment to have min­i­mum essen­tial cov­er­age for each month, qual­i­fy for a cov­er­age exemp­tion for the month, or make a shared respon­si­bil­i­ty payment.”

    IRS Issues Draft Forms 1094/1095

    The IRS issued draft Forms 1094‑B, 1095‑B, 1094‑C, and 1095‑C for the 2017 tax year. Cov­er­age providers use Forms 1094‑B and 1095‑B to report health plan enroll­ment. Applic­a­ble large employ­ers use Forms 1094‑C and 1095‑C to report infor­ma­tion relat­ed to their employ­er shared respon­si­bil­i­ty pro­vi­sions under the ACA.

    There are no changes to the face of draft Forms 1094‑B, 1095‑B, or 1095‑C. The IRS made one sub­stan­tive change to draft Form 1094‑C. The IRS removed the line 22 box “Sec­tion 4980H Tran­si­tion Relief” which was applic­a­ble to the 2015 plan year only.

    By Danielle Capilla

    Orig­i­nal­ly post­ed  by www.UBABenefits.com

  • Emergency vs. Urgent – What’s the Difference in Walk-In Care? | CA Benefit Advisors

    September 29, 2017

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    We’ve all been there – once or twice (or more)—when a child, spouse or fam­i­ly mem­ber has had to gain access to health­care quick­ly. Whether a fall that requires stitch­es; a sprained or bro­ken bone; or some­thing more seri­ous, it can be dif­fi­cult to iden­ti­fy which avenue to take when it comes to walk-in care. With the recent boom in stand-alone ERs (Emer­gency Care Clin­ics or ECCs), as well as, Urgent Care Clin­ics (UCCs) it’s easy to see why almost 50% of diag­noses could have been treat­ed for less mon­ey and time with the latter.

    It’s key to edu­cate your­self and your employ­ees on the dif­fer­ence between the two so as not to get pum­meled by high med­ical costs.

    • Most Emer­gency Care facil­i­ties are open 24 hours a day; where­as Urgent Care may be open a max­i­mum of 12 hours, extend­ing into late evening. Both are staffed with a physi­cian, nurse prac­ti­tion­ers, and physi­cian assis­tants, how­ev­er, stand alone ECCs spe­cial­ize in life-threat­en­ing con­di­tions and injuries that require more advanced tech­nol­o­gy and high­ly trained med­ical per­son­nel to diag­nose and treat than a tra­di­tion­al Urgent Care clinic.

    • Most indi­vid­ual ERs charge a high­er price for the vis­it – gen­er­al­ly 3–5 times high­er than a nor­mal Urgent Care vis­it would cost. The Amer­i­can Board of Emer­gency Med­i­cine (ABEM) physi­cians’ bill at a high­er rate than typ­i­cal Fam­i­ly-Med­i­cine trained Urgent Care physi­cians do (Amer­i­can Board of Fam­i­ly Med­i­cine (ABFM). These bill rates are based on insur­ance CPT codes. For exam­ple, a trip to the neigh­bor­hood ER for strep throat may cost you more than a vis­it to a UC facil­i­ty. Your co-insur­ance fee for a sprain or strain at the same loca­tion may cost you $150 in lieu of $40 at a tra­di­tion­al Urgent Care facility.

    • Stand alone ER facil­i­ties may often be cov­ered under your plan, but some of the “ancil­lary” ser­vices (just like vis­it rates) may be billed high­er than Urgent Care facil­i­ties. At times, this has caused many “finan­cial stick­er shock” when they first see those med­ical bills. The New Eng­land Jour­nal of Med­i­cine indi­cates 1 of every 5 patients expe­ri­ence this stick­er shock. In fact, 22% of the patients who went to an ECC cov­ered by their insur­ance plan lat­er found cer­tain ancil­lary ser­vices were not cov­ered, or cov­ered for less. These ser­vices were out-of-net­work, there­fore charged a high­er fee for the same ser­vices offered in both facilities.

    So, what can you and your employ­ees do to make sure you don’t get duped into addi­tion­al costs?

    Iden­ti­fy the dif­fer­ence between when you need urgent or emer­gency care.

    • Know your insur­ance pol­i­cy. Review the def­i­n­i­tion of terms and what por­tion your pol­i­cy cov­ers with regard to deductibles and co-pays for each of these facilities.

    • Pay atten­tion to detail. Under­stand key terms that define the dif­fer­ence between these two walk-in clin­ics. Most Emer­gency Care facil­i­ties oper­ate as stand-alone ERs, which can fur­ther con­fuse patients when they need imme­di­ate care. If these cen­ters, or their paper­work, has the word “emer­gency”, “emer­gency” or any­thing relat­ed to it, they’ll oper­ate and bill like an ER with their ser­vices. Watch for clin­ics that offer both ser­vices in one place. Often, it’s very easy to dis­guise their prac­tices as an Urgent Care facil­i­ty, but again due to CPT codes and the med­ical boards they have the right to charge more. Read the fine print.

    It’s ben­e­fi­cial as an employ­er to edu­cate your employ­ees on this dif­fer­ence, as the more they know – the low­er the cost will be for the employ­er and employ­ee come renew­al time.

  • 6 Reasons People Don’t Buy Life Insurance (and Why They’re Wrong) | CA Benefit Advisors

    September 25, 2017

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    Let’s face it. Most peo­ple put off buy­ing life insur­ance for any num­ber of reasons—if they even under­stand it Take a look at this list—do any of them sound like you?

    1. It’s too expen­sive. In the ever-bur­geon­ing bud­get of a young fam­i­ly, things like day care and car pay­ments and pos­si­bly stu­dent loans eat up a good chunk of the mon­ey each month, and a lot of peo­ple think that life insur­ance is just out­side those “neces­si­ties” when money’s tight. But two things: life insur­ance is often not near­ly as expen­sive as you might think, espe­cial­ly when you can get a good pol­i­cy for less than the cost of a dai­ly cup of cof­fee at the local café, and well, if money’s tight now, what if some­thing hap­pens to you?

    2. That’s that stuff for babies and old peo­ple, right? Peo­ple of a cer­tain age remem­ber Ed McMa­hon telling them their grand­par­ents couldn’t be turned down for any rea­son and fig­ure that’s the tar­get demo­graph­ic for life insur­ance. Or, you might have been offered a small per­ma­nent insur­ance pol­i­cy for your new­born, attrac­tive­ly pre­sent­ed with a cheru­bic infant on the enve­lope. The truth of the mat­ter is that these are very spe­cif­ic insur­ance products—just as there are many insur­ance prod­ucts for adults in their work­ing years.

    3. I’m strong and healthy! You eat right, you stay active, and every­one admires how ground­ed and cen­tered you are. You passed your last phys­i­cal with fly­ing col­ors! That’s GREAT! But you’re nei­ther immor­tal nor inde­struc­tible. It’s not even that some­thing could hap­pen to you – though it could – so much as when you’re at your strongest and health­i­est, there’s no bet­ter time to get a pol­i­cy to pro­tect your loved ones. If you fall seri­ous­ly ill or suf­fer sig­nif­i­cant injury lat­er, it will make it tougher to get that kind of pol­i­cy, if any at all.

    4. I have life insur­ance through my job. Many peo­ple are offered life insur­ance as part of their employ­ee ben­e­fit cov­er­age –and often, it’s the first time they encounter life insur­ance and have no idea that a $50,000 pol­i­cy, or one or two times their salary, isn’t as much as they think it is. It sounds like a lot of mon­ey, until you fig­ure that it has to cov­er some or all the expens­es for your loved ones in your absence. Plus, if you leave the job, it’s typ­i­cal­ly the type of insur­ance that doesn’t “move on” with you.

    5. I don’t have kids. Sure, kids are a big rea­son why some peo­ple get life insur­ance. But that’s not the only lit­mus for need­ing pro­tec­tion. If there is any­one in your life who would suf­fer finan­cial­ly from your loss—your spouse or live-in part­ner, a sib­ling, even your parents—a life insur­ance pol­i­cy goes a long way in mak­ing sure everyone’s still OK even if some­thing hap­pens to you.

    6. Life insurance—it’s on my list … even­tu­al­ly. There’s no dead­line on life insur­ance, no man­date from the gov­ern­ment on pur­chas­ing it. Your par­ents may have nev­er talked to you about its impor­tance, and it’s cer­tain­ly not the most invig­o­rat­ing top­ic for con­ver­sa­tion. But don’t let your “even­tu­al­ly” turn into your loved ones’ “if only.”

    If any of this sounds daunt­ing, just know that you can talk to an agent—at no cost. They will help you fig­ure out how much you may need, and also find a pol­i­cy that fits into your bud­get. If you don’t have an agent, you can use this Agent Loca­tor to find one in your area.

    By Helen Mosher

    Orig­i­nal­ly post­ed by www.LifeHappens.org

  • Court Remands Wellness Regulations to EEOC for Reconsideration | CA Benefit Advisors

    September 22, 2017

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    On August 22, 2017, the Unit­ed States Dis­trict Court for the Dis­trict of Colum­bia held that the U.S. Equal Employ­ment Oppor­tu­ni­ty Com­mis­sion (EEOC) failed to pro­vide a rea­soned expla­na­tion for its deci­sion to adopt 30 per­cent incen­tive lev­els for employ­er-spon­sored well­ness pro­grams under both the Amer­i­cans with Dis­abil­i­ties Act (ADA) rules and Genet­ic Infor­ma­tion Nondis­crim­i­na­tion Act (GINA) rules.

    The court declined to vacate the EEOC’s rules because of the sig­nif­i­cant dis­rup­tive effect it would have. How­ev­er, the court remand­ed the rules to the EEOC for reconsideration.

    Based on the recent court deci­sion to require the EEOC to recon­sid­er its well­ness pro­gram rules, does this mean that the EEOC rules no longer apply to employ­er well­ness pro­grams? No. For now, the cur­rent EEOC rules apply to employ­er well­ness pro­grams. How­ev­er, employ­ers should stay informed on the sta­tus of the EEOC’s recon­sid­er­a­tion of the well­ness pro­gram rules so that employ­ers can change their well­ness pro­grams’ design, if nec­es­sary, to com­ply with new EEOC rules.

    Accord­ing to UBA’s free spe­cial report, “How Employ­ers Use Well­ness Pro­grams,” 67.7 per­cent of employ­ers who offer well­ness pro­grams have incen­tives built into the pro­gram, an increase of 8.5 per­cent from four years ago. Incen­tives are the most preva­lent in the Cen­tral U.S. (76.1 per­cent), among employ­ers with 500 to 999 employ­ees (83.2 per­cent), and in the finance, insur­ance, and real estate indus­tries (74.7 per­cent). The West offers the fewest incen­tives, with only 48.3 per­cent of their plans hav­ing rewards.

    Across all employ­ers, slight­ly more (45.4 per­cent) pre­fer well­ness incen­tives in the form of cash toward pre­mi­ums, 401(k)s, flex­i­ble spend­ing accounts (FSAs), etc., ver­sus health club dues and gift cards (40 per­cent). But among larg­er employ­ers (500 to 1,000+ employ­ees) cash incen­tives are more heav­i­ly pre­ferred (63.2 per­cent) over gift cer­tifi­cates and health club dues (33.7 per­cent). Con­verse­ly, small­er employ­ers (1 to 99 employ­ees) pre­fer health club-relat­ed incen­tives (near­ly 40 per­cent) ver­sus cash (25 percent).

    Down­load our free (no form!) spe­cial report, “How Employ­ers Use Well­ness Pro­grams,” for more infor­ma­tion on region­al, indus­try and group size based trends sur­round­ing preva­lence of well­ness pro­grams, car­ri­er vs. inde­pen­dent providers, and well­ness pro­gram components.

    For com­pre­hen­sive infor­ma­tion on design­ing well­ness pro­grams that cre­ate last­ing change, down­load UBA’s whitepa­per: “Well­ness Pro­grams — Good for You & Good for Your Orga­ni­za­tion”.

    To under­stand legal require­ments for well­ness pro­grams, request UBA’s ACA Advi­sor, “Under­stand­ing Well­ness Pro­grams and Their Legal Require­ments,” which reviews the five most crit­i­cal ques­tions that well­ness pro­gram spon­sors should ask and work through to deter­mine the oblig­a­tions of their well­ness pro­gram under the ACA, HIPAA, ADA, GINA, and ERISA, as well as con­sid­er­a­tions for well­ness pro­grams that involve tobac­co use in any way.

    By Danielle Capella

    Orig­i­nal­ly post­ed by www.UBABenefits.com

     

  • Employer Medicare Part D Notices Are Due Before October 15 | CA Benefit Advisors

    September 20, 2017

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    Are you an employ­er that offers or pro­vides group health cov­er­age to your work­ers? Does your health plan cov­er out­pa­tient pre­scrip­tion drugs—either as a med­ical claim or through a card sys­tem? If so, be sure to dis­trib­ute your plan’s Medicare Part D notice before Octo­ber 15.

    Pur­pose
    Medicare began offer­ing “Part D” plans—optional pre­scrip­tion drug ben­e­fit plans sold by pri­vate insur­ance com­pa­nies and HMOs—to Medicare ben­e­fi­cia­ries many years ago. Per­sons may enroll in a Part D plan when they first become eli­gi­ble for Medicare. If they wait too long, a “late enroll­ment” penal­ty amount is per­ma­nent­ly added to the Part D plan pre­mi­um cost when they do enroll. There is an excep­tion, though, for indi­vid­u­als who are cov­ered under an employer’s group health plan that pro­vides “cred­itable” cov­er­age. (“Cred­itable” means that group plan’s drug ben­e­fits are actu­ar­i­al­ly equiv­a­lent or bet­ter than the ben­e­fits required in a Part D plan.) In that case, the indi­vid­ual can delay enrolling for a Part D plan while he or she remains cov­ered under the employer’s cred­itable plan. Medicare will waive the late enroll­ment pre­mi­um penal­ty for indi­vid­u­als who enroll in a Part D plan after their ini­tial eli­gi­bil­i­ty date if they were cov­ered by an employer’s cred­itable plan. To avoid the late enroll­ment penal­ty, there can­not be a gap longer than 62 days between the group plan and the Part D plan.

    To help Medicare-eli­gi­ble per­sons make informed deci­sions about whether and when to enroll in a Part D drug plan, they need to know if their employer’s group health plan pro­vides cred­itable or non­cred­itable pre­scrip­tion drug cov­er­age. That is the pur­pose of the fed­er­al require­ment for employ­ers to pro­vide an annu­al notice (Employer’s Medicare Part D Notice) to all Medicare-eli­gi­ble employ­ees and spouses.

    Employ­er Requirements

    Fed­er­al law requires all employ­ers that offer group health cov­er­age includ­ing any out­pa­tient pre­scrip­tion drug ben­e­fits to pro­vide an annu­al notice to plan par­tic­i­pants. The notice require­ment applies regard­less of the employer’s size or whether the group plan is insured or self-funded:

    • Deter­mine whether your group health plan’s pre­scrip­tion drug cov­er­age is “cred­itable” or “non­cred­itable” for the upcom­ing year (2018). If your plan is insured, the carrier/HMO will con­firm “cred­itable” or “non­cred­itable” sta­tus. Keep a copy of the writ­ten con­fir­ma­tion for your records. For self-fund­ed plans, the plan actu­ary will deter­mine the plan’s sta­tus using guid­ance pro­vid­ed by the Cen­ters for Medicare and Med­ic­aid Ser­vices (CMS).
    • Dis­trib­ute a Notice of Cred­itable Cov­er­age or a Notice of Non­cred­itable Cov­er­age, as applic­a­ble, to all group health plan par­tic­i­pants who are or may become eli­gi­ble for Medicare in the next year. “Par­tic­i­pants” include cov­ered employ­ees and retirees (and spous­es) and COBRA enrollees. Employ­ers often do not know whether a par­tic­u­lar par­tic­i­pant may be eli­gi­ble for Medicare due to age or dis­abil­i­ty. For con­ve­nience, many employ­ers decide to dis­trib­ute their notice to all par­tic­i­pants regard­less of Medicare status.
    • Notices must be dis­trib­uted at least annu­al­ly before Octo­ber 15. Medicare holds its Part D enroll­ment peri­od each year from Octo­ber 15 to Decem­ber 7, which is why it is impor­tant for group health plan par­tic­i­pants to receive their employer’s notice before Octo­ber 15.
    • Notices also may be required after Octo­ber 15 for new enrollees and/or if the plan’s cred­itable ver­sus non­cred­itable sta­tus changes.

    Prepar­ing the Notice(s)
    Mod­el notices are avail­able on the CMS web­site. Start with the mod­el notice and then fill in the blanks and vari­able items as need­ed for each group health plan. There are two ver­sions: Notice of Cred­itable Cov­er­age or Notice of Non­cred­itable Cov­er­age and each is avail­able in Eng­lish and Spanish:

    Employ­ers who offer mul­ti­ple group health plans options, such as PPOs, HDH­Ps, and HMOs, may use one notice if all options are cred­itable (or all are non­cred­itable). In this case, it is advis­able to list the names of the var­i­ous plan options so it is clear for the read­er. Con­verse­ly, employ­ers that offer a cred­itable plan and a non­cred­itable plan, such as a cred­itable HMO and a non­cred­itable HDHP, will need to pre­pare sep­a­rate notices for the dif­fer­ent plan participants.

    Dis­trib­ut­ing the Notice(s)
    You may dis­trib­ute the notice by first-class mail to the employee’s home or work address. A sep­a­rate notice for the employee’s spouse or fam­i­ly mem­bers is not required unless the employ­er has infor­ma­tion that they live at dif­fer­ent addresses.

    The notice is intend­ed to be a stand-alone doc­u­ment. It may be dis­trib­uted at the same time as oth­er plan mate­ri­als, but it should be a sep­a­rate doc­u­ment. If the notice is incor­po­rat­ed with oth­er mate­r­i­al (such as sta­pled items or in a book­let for­mat), the notice must appear in 14-point font, be bold­ed, off­set, or boxed, and placed on the first page. Alter­na­tive­ly, in this case, you can put a ref­er­ence (in 14-point font, either bold­ed, off­set, or boxed) on the first page telling the read­er where to find the notice with­in the mate­r­i­al. Here is sug­gest­ed text from the CMS for the first page:

    “If you (and/or your depen­dents) have Medicare or will become eli­gi­ble for Medicare in the next 12 months, a fed­er­al law gives you more choic­es about your pre­scrip­tion drug cov­er­age. Please see page XX for more details.”

    Email dis­tri­b­u­tion is allowed but only for employ­ees who have reg­u­lar access to email as an inte­gral part of their job duties. Employ­ees also must have access to a print­er, be noti­fied that a hard copy of the notice is avail­able at no cost upon request, and be informed that they are respon­si­ble for shar­ing the notice with any Medicare-eli­gi­ble fam­i­ly mem­bers who are enrolled in the employer’s group plan.

    CMS Dis­clo­sure Requirement
    Sep­a­rate from the par­tic­i­pant notice require­ment, employ­ers also must dis­close to the CMS whether their group health plan pro­vides cred­itable or non­cred­itable cov­er­age. The plan spon­sor (employ­er) must sub­mit its annu­al dis­clo­sure to CMS with­in 60 days of the start of the plan year. For instance, for cal­en­dar-year group health plans, the employ­er must com­ply with this dis­clo­sure require­ment by March 1.

    Dis­clo­sure to CMS also is required with­in 30 days of ter­mi­na­tion of the pre­scrip­tion drug cov­er­age or with­in 30 days of a change in the plan’s sta­tus as cred­itable cov­er­age or non­cred­itable coverage.

    The CMS online tool is the only method allowed for com­plet­ing the required dis­clo­sure. From this link, fol­low the prompts to respond to a series of ques­tions regard­ing the plan. The link is the same regard­less of whether the employer’s plan pro­vides cred­itable or non­cred­itable cov­er­age. The entire process usu­al­ly takes only 5 or 10 min­utes to complete.

    Orig­i­nal­ly pub­lished by www.ThinkHR.com

  • Small Businesses Healthcare Competitive, But Faces Two Big Challenges | CA Benefit Advisors

    September 15, 2017

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    We recent­ly revealed how com­pet­i­tive small busi­ness health plans are when com­pared to nation­al averages—and even how they are doing a bet­ter job of con­tain­ing costs. But the UBA Health Plan Sur­vey also uncov­ers two chal­lenges these groups face in its new spe­cial report: “Small Busi­ness­es Keep­ing Pace with Nation­wide Health Trends”.

    1. Small busi­ness­es are pass­ing near­ly 6.6 per­cent more of the costs for sin­gle cov­er­age and near­ly 10 per­cent more of the costs of fam­i­ly cov­er­age on to employees—and that num­ber increas­es to 17.8 per­cent and over 50 per­cent more respec­tive­ly when you com­pare small employ­ers to their largest counterparts.

    2. Small busi­ness­es also have high­er out-of-pock­et max­i­mums, par­tic­u­lar­ly for families.

    To help attract and retain employ­ees, Peter Weber, Pres­i­dent of UBA, rec­om­mends small busi­ness­es should “bench­mark their plans against their same-size peers and com­mu­ni­cate how com­pet­i­tive their plans are rel­a­tive to aver­age nation­al costs, deductibles, copays, and more.”

    By Bill Olsen

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • The Killjoy of Office Culture | CA Benefit Advisors

    September 14, 2017

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    One of the lat­est things trend­ing right now in busi­ness is the impor­tance of office cul­ture. When every­one in the office is work­ing well togeth­er, pro­duc­tiv­i­ty ris­es and effi­cien­cy increas­es. Nat­u­ral­ly, the oppo­site is true when employ­ees do not work well togeth­er and the cor­po­rate cul­ture suf­fers. So, what are these bar­ri­ers and what can you do to avoid them?

    Accord­ing to an arti­cle titled, “8 ways to ruin an office cul­ture,” in Employ­ee Ben­e­fit News, the ways to kill cor­po­rate cul­ture may seem intu­itive, but that doesn’t mean they still don’t hap­pen. Here’s what orga­ni­za­tions should do to improve their cor­po­rate culture.

    Pro­vide pos­i­tive employ­ee feed­back. While it’s easy to crit­i­cize, and point­ing out employ­ees’ mis­takes can often help them learn to not repeat them, it’s just as impor­tant to rec­og­nize suc­cess and praise an employ­ee for a job well done. An “attaboy/attagirl” can real­ly boost someone’s spir­its and let them know their work is appreciated.

    Give cred­it where cred­it is due. If an assis­tant had the bright idea, if a sub­or­di­nate did all the work, or if a con­sul­tant dis­cov­ered the solu­tion to a prob­lem, then he or she should be pub­licly acknowl­edged for it. It doesn’t mat­ter who super­vised these peo­ple, to the vic­tor go the spoils. If some­one had the guts to speak up, then he or she should get the glo­ry. Theft is wrong, and it’s just as wrong when you take someone’s idea, or hard work, and claim it as your own.

    Sim­i­lar­ly, lis­ten to all ideas from all lev­els with­in the com­pa­ny. Every employ­ee, regard­less of their posi­tion on the cor­po­rate lad­der, likes to feel that their con­tri­bu­tions mat­ter. From the C‑suite, all the way down to the interns, a gen­uine­ly good idea is always worth inves­ti­gat­ing regard­less of whether the per­son who sub­mit­ted the idea has an Ivy League degree or not. Fur­ther­more, some­times it takes a dif­fer­ent per­spec­tive – like one from an employ­ee on a dif­fer­ent management/subordinate lev­el – to see the best way to resolve an issue.

    Fos­ter team­work because many hands make light work. Or, as I like to say, com­pe­ti­tion breeds con­tempt. You com­pete to get your job, you com­pete exter­nal­ly against oth­er com­pa­nies, and you may even com­pete against your peers for an award. You shouldn’t have to com­pete with your own co-work­ers. The win­ner of that com­pe­ti­tion may not nec­es­sar­i­ly be the best per­son and it will often have neg­a­tive con­se­quences in terms of trust.

    Get rid of unpro­duc­tive employ­ees. One way to sti­fle inno­va­tion and hurt morale is by hav­ing an employ­ee who doesn’t do any work while every­one else is either pick­ing up the slack, or cov­er­ing for that person’s duties. Some­times it’s nec­es­sary to prune the branches.

    Let employ­ees have their pri­va­cy – espe­cial­ly on social media. As long as an employ­ee isn’t con­duct­ing per­son­al busi­ness on com­pa­ny time, there shouldn’t be any­thing wrong with an employ­ee updat­ing their social media accounts when they’re “off the clock.” In addi­tion, as long as employ­ees aren’t divulging com­pa­ny secrets, or pro­vid­ing oth­er cor­po­rate com­men­tary that runs afoul of local, state, or fed­er­al laws, then there’s no rea­son to mon­i­tor what they post.

    Pro­mote a healthy work-life bal­ance. Yes, employ­ees have fam­i­lies, they get sick, or they just need time away from the work­place to de-stress. And while there will always be times when extra hours are need­ed to fin­ish a project, it shouldn’t be stan­dard oper­at­ing pro­ce­dure at a com­pa­ny to insist that employ­ees sac­ri­fice their time.

    By Geoff Mukhtar

    Orig­i­nal­ly post­ed by UBABenefits.com

  • Understanding EAP Confidentiality | CA Benefit Advisors

    September 8, 2017

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    When it comes to Employ­ee Assis­tance Pro­grams, con­fi­den­tial­i­ty is a con­cern for both employ­ers and employ­ees. As an employ­er, it is help­ful to under­stand the terms and process­es your EAP uses to keep infor­ma­tion con­fi­den­tial and ensure that your employ­ees and your work­place are safe.

    The Health Insur­ance Porta­bil­i­ty and Account­abil­i­ty Act (HIPAA) rules apply to EAPs and their affil­i­ate providers. All infor­ma­tion that is obtained dur­ing an EAP ses­sion is main­tained in con­fi­den­tial files. The infor­ma­tion remains con­fi­den­tial except in the fol­low­ing circumstances:

    1. An employee/client pro­vides writ­ten permission/consent for the release of spe­cif­ic infor­ma­tion. This can be done using a Con­sent to Inform or Release of Infor­ma­tion form.
    2. The life or safe­ty of the client or oth­ers is seri­ous­ly threatened.
    3. Child abuse has occurred.
    4. EAP records are the sub­ject of a court order (sub­poe­na).
    5. Oth­er dis­clo­sures required by applic­a­ble law.

    Depend­ing on the sit­u­a­tion, an employ­ee may use EAP ser­vices through a self-refer­ral, guid­ed-refer­ral or mandated-referral

    Vol­un­tary or self-refer­rals are the most com­mon. When an employ­ee seeks EAP ser­vices vol­un­tar­i­ly, all of the employee’s infor­ma­tion, includ­ing whether he or she con­tact­ed the EAP or not, is con­fi­den­tial and can­not be released with­out writ­ten permission.

    Guid­ed refer­rals are an oppor­tu­ni­ty for the employ­er to encour­age the employ­ee to use EAP ser­vices when the employ­er sens­es there is a prob­lem that needs to be addressed. This may occur when the employ­er iden­ti­fies an employ­ee who may be hav­ing per­son­al or work-relat­ed dif­fi­cul­ties but it is not to the point of man­dat­ing that the employ­ee use an EAP. In the case of guid­ed refer­rals, infor­ma­tion dis­closed by the employ­ee is still kept confidential.

    Manda­to­ry or for­mal refer­rals usu­al­ly occur when sub­stance abuse or oth­er behav­iors are impact­ing pro­duc­tiv­i­ty or safe­ty. An employer’s pol­i­cy may allow for putting the employ­ee on a per­for­mance improve­ment plan and may even include a “last chance” agree­ment that states what an employ­ee must do in order to keep their job. In these cas­es, employ­ees are man­dat­ed by the employ­er to con­tact the EAP and a Release of Infor­ma­tion is signed so the EAP can exchange infor­ma­tion with the employ­er about employ­ee atten­dance, com­pli­ance and recommendations.

    In some cas­es, it may be advised to send the employ­ee for a Fit­ness for Duty Eval­u­a­tion or sim­i­lar assess­ment to deter­mine the employee’s abil­i­ty to phys­i­cal­ly or men­tal­ly per­form essen­tial job duties, or assess for a poten­tial threat of vio­lence. These eval­u­a­tions are per­formed by spe­cial­ly trained pro­fes­sion­als and will come with an addi­tion­al cost. If the employ­ee has pro­vid­ed writ­ten con­sent, lim­it­ed infor­ma­tion may be released to the employ­er regard­ing the results of these evaluations.

    As an employ­er, if you believe someone’s life or the safe­ty of oth­ers is poten­tial­ly at risk, con­sult with your EAP if time allows. If it is an emer­gency, your local law enforce­ment or emer­gency per­son­nel should be con­tact­ed first. Then con­tact your EAP for fur­ther assis­tance, sup­port and guidance.

    If you ever have ques­tions or con­cerns about EAP con­fi­den­tial­i­ty, refer­rals, process­es or legal reg­u­la­tions, don’t hes­i­tate to con­tact your EAP. Con­sul­ta­tion and col­lab­o­ra­tion are key ele­ments in get­ting the most out of your EAP ser­vices and keep­ing your employ­ees both safe and productive.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • North Bay employers urged to get heart-saving devices | CA Benefit Advisors

    September 6, 2017

    The No. 1 health-cri­sis death in the work­place is by heart attack.  But hav­ing an auto­mat­ed exter­nal defib­ril­la­tor (AED) on hand can improve the chances for sur­vival of a heart attack vic­tim by about 70 percent.

    So why don’t all work­places have one?

    Read full arti­cle here.

  • What You Need to Know about Health Flexible Spending Accounts | CA Benefit Advisors

    September 6, 2017

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    A health flex­i­ble spend­ing account (FSA) is a pre-tax account used to pay for out-of-pock­et health care costs for a par­tic­i­pant as well as a par­tic­i­pan­t’s spouse and eli­gi­ble depen­dents. Health FSAs are employ­er-estab­lished ben­e­fit plans and may be offered with oth­er employ­er-pro­vid­ed ben­e­fits as part of a cafe­te­ria plan. Self-employed indi­vid­u­als are not eli­gi­ble for FSAs.

    Even though a health FSA may be extend­ed to any employ­ee, employ­ers should design their health FSAs so that par­tic­i­pa­tion is offered only to employ­ees who are eli­gi­ble to par­tic­i­pate in the employ­er’s major med­ical plan. Gen­er­al­ly, health FSAs must qual­i­fy as except­ed ben­e­fits, which means oth­er nonex­cept­ed group health plan cov­er­age must be avail­able to the health FSA’s par­tic­i­pants for the year through their employ­ment. If a health FSA fails to qual­i­fy as an except­ed ben­e­fit, then this could result in excise tax­es of $100 per par­tic­i­pant per day or oth­er penalties.

    Con­tribut­ing to an FSA

    Mon­ey is set aside from the employ­ee’s pay­check before tax­es are tak­en out and the employ­ee may use the mon­ey to pay for eli­gi­ble health care expens­es dur­ing the plan year. The employ­er owns the account, but the employ­ee con­tributes to the account and decides which med­ical expens­es to pay with it.

    At the begin­ning of the plan year, a par­tic­i­pant must des­ig­nate how much to con­tribute so the employ­er can deduct an amount every pay day in accor­dance with the annu­al elec­tion. A par­tic­i­pant may con­tribute with a salary reduc­tion agree­ment, which is a par­tic­i­pant elec­tion to have an amount vol­un­tar­i­ly with­held by the employ­er. A par­tic­i­pant may change or revoke an elec­tion only if there is a change in employ­ment or fam­i­ly sta­tus that is spec­i­fied by the plan.

    Per the Patient Pro­tec­tion and Afford­able Care Act (ACA), FSAs are capped at $2,600 per year per employ­ee. How­ev­er, since a plan may have a low­er annu­al lim­it thresh­old, employ­ees are encour­aged to review their Sum­ma­ry Plan Descrip­tion (SPD) to find out the annu­al lim­it of their plan. A par­tic­i­pan­t’s spouse can put $2,600 in an FSA with the spouse’s own employ­er. This applies even if both spous­es par­tic­i­pate in the same health FSA plan spon­sored by the same employer.

    Gen­er­al­ly, employ­ees must use the mon­ey in an FSA with­in the plan year or they lose the mon­ey left in the FSA account. How­ev­er, employ­ers may offer either a grace peri­od of up to two and a half months fol­low­ing the plan year to use the mon­ey in the FSA account or allow a car­ry­over of up to $500 per year to use in the fol­low­ing year.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

     

  • DOL Guidance for Benefit Plans Impacted by Hurricane Harvey | CA Benefit Advisors

    August 31, 2017

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    The U.S. Depart­ment of Labor has issued com­pli­ance guid­ance for ben­e­fit plans, employ­ers and employ­ees, and ser­vice providers who are impact­ed by Hur­ri­cane Har­vey. The guid­ance gen­er­al­ly pro­vides relief from var­i­ous ERISA require­ments and time lim­its for enti­ties in the dis­as­ter area. This fol­lows the Inter­nal Rev­enue Ser­vice (IRS) announce­ment extend­ing cer­tain fil­ing dates, includ­ing Form 5500.

    Key excerpts from the DOL guid­ance include:

    “The Depart­ment rec­og­nizes that some employ­ers and ser­vice providers act­ing on employ­ers’ behalf, such as pay­roll pro­cess­ing ser­vices, locat­ed in iden­ti­fied cov­ered dis­as­ter areas will not be able to for­ward par­tic­i­pant pay­ments and with­hold­ings to employ­ee pen­sion ben­e­fit plans with­in the pre­scribed time­frame. In such instances, the Depart­ment will not–solely on the basis of a fail­ure attrib­ut­able to Hur­ri­cane Harvey–seek to enforce the pro­vi­sions of Title I with respect to a tem­po­rary delay in the for­ward­ing of such pay­ments or con­tri­bu­tions to an employ­ee pen­sion ben­e­fit plan to the extent that affect­ed employ­ers, and ser­vice providers, act rea­son­ably, pru­dent­ly and in the inter­est of employ­ees to com­ply as soon as prac­ti­cal under the circumstances….

    “With respect to black­out peri­ods relat­ed to Hur­ri­cane Har­vey, the Depart­ment will not allege a vio­la­tion of the black­out notice require­ments sole­ly on the basis that a fidu­cia­ry did not make the required writ­ten determination….

    “The Depart­ment rec­og­nizes that plan par­tic­i­pants and ben­e­fi­cia­ries may encounter an array of prob­lems due to the hur­ri­cane, such as dif­fi­cul­ties meet­ing cer­tain dead­lines for fil­ing ben­e­fit claims and COBRA elec­tions. The guid­ing prin­ci­ple for plans must be to act rea­son­ably, pru­dent­ly and in the inter­est of the work­ers and their fam­i­lies who rely on their health plans for their phys­i­cal and eco­nom­ic well-being. Plan fidu­cia­ries should make rea­son­able accom­mo­da­tions to pre­vent the loss of ben­e­fits in such cas­es and should take steps to min­i­mize the pos­si­bil­i­ty of indi­vid­u­als los­ing ben­e­fits because of a fail­ure to com­ply with pre-estab­lished timeframes.”

    The DOL also released FAQs for Par­tic­i­pants and Ben­e­fi­cia­ries Fol­low­ing Hur­ri­cane Har­vey. The eight-page FAQ cov­ers issues regard­ing health plan claims, COBRA con­tin­u­a­tion cov­er­age, and col­lect­ing retire­ment plan benefits.

    ThinkHR will con­tin­ue to mon­i­tor issues affect­ing employ­ers impact­ed by Hur­ri­cane Harvey.

    Orig­i­nal­ly pub­lished by www.thinkhr.com

  • The COBRA Payment Process | CA Benefit Advisors

    August 28, 2017

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    The Con­sol­i­dat­ed Omnibus Bud­get Rec­on­cil­i­a­tion Act of 1985 (COBRA) allows qual­i­fied ben­e­fi­cia­ries who lose health ben­e­fits due to a qual­i­fy­ing event to con­tin­ue group health ben­e­fits. The COBRA pay­ment process is sub­ject to var­i­ous rules in terms of grace peri­ods, noti­fi­ca­tion, pre­mi­um pay­ment meth­ods, and treat­ment of insignif­i­cant shortfalls.

    Grace Peri­ods

    The ini­tial pre­mi­um pay­ment is due 45 days after the qual­i­fied ben­e­fi­cia­ry elects COBRA. Pre­mi­um pay­ments must be made on time; oth­er­wise, a plan may ter­mi­nate COBRA cov­er­age. Gen­er­al­ly, sub­se­quent pre­mi­um pay­ments are due on the first day of the month. How­ev­er, under the COBRA grace peri­od rules, pre­mi­ums will still be con­sid­ered time­ly if made with­in 30 days after the due date. The statu­to­ry grace peri­od is a min­i­mum 30-day peri­od, but plans may allow qual­i­fied ben­e­fi­cia­ries a longer grace period.

    A COBRA pre­mi­um pay­ment is made when it is sent to the plan. Thus, if the qual­i­fied ben­e­fi­cia­ry mails a check, then the pay­ment is made on the date the check was mailed. The plan admin­is­tra­tors should look at the post­mark date on the enve­lope to deter­mine whether the pay­ment was made on time. Qual­i­fied ben­e­fi­cia­ries may use cer­ti­fied mail as evi­dence that the pay­ment was made on time.

    The 30-day grace peri­od applies to sub­se­quent pre­mi­um pay­ments and not to the ini­tial pre­mi­um pay­ment. After the ini­tial pay­ment is made, the first 30-day grace peri­od runs from the pay­ment due date and not from the last day of the 45-day ini­tial pay­ment period.

    If a COBRA pay­ment has not been paid on its due date and a fol­low-up billing state­ment is sent with a new due date, then the plan risks estab­lish­ing a new 30-day grace peri­od that would begin from the new due date.

    Noti­fi­ca­tion

    The plan admin­is­tra­tor must noti­fy the qual­i­fied ben­e­fi­cia­ry of the COBRA pre­mi­um pay­ment oblig­a­tions in terms of how much to pay and when pay­ments are due; how­ev­er, the plan does not have to reno­ti­fy the qual­i­fied ben­e­fi­cia­ry to make time­ly pay­ments. Even though plans are not required to send billing state­ments each month, many plans send reminder state­ments to the qual­i­fied beneficiaries.

    While the only require­ment for plan admin­is­tra­tors is to send an elec­tion notice detail­ing the plan’s pre­mi­um dead­lines, there are three cir­cum­stances under which writ­ten notices about COBRA pre­mi­ums are nec­es­sary. First, if the COBRA pre­mi­um changes, the plan admin­is­tra­tor must noti­fy the qual­i­fied ben­e­fi­cia­ry of the change. Sec­ond, if the qual­i­fied ben­e­fi­cia­ry made an insignif­i­cant short­fall pre­mi­um pay­ment, the plan admin­is­tra­tor must pro­vide notice of the insignif­i­cant short­fall unless the plan admin­is­tra­tor choos­es to ignore it. Last, if a plan admin­is­tra­tor ter­mi­nates a qual­i­fied ben­e­fi­cia­ry’s COBRA cov­er­age for non­pay­ment or late pay­ment, the plan admin­is­tra­tor must pro­vide a ter­mi­na­tion notice to the qual­i­fied beneficiary.

    The plan admin­is­tra­tor is not required to inform the qual­i­fied ben­e­fi­cia­ry when the pre­mi­um pay­ment is late. Thus, if a plan admin­is­tra­tor does not receive a pre­mi­um pay­ment by the end of the grace peri­od, then COBRA cov­er­age may be ter­mi­nat­ed. The plan admin­is­tra­tor is not required to send a notice of ter­mi­na­tion in that case because the COBRA cov­er­age was not in effect. On the oth­er hand, if the qual­i­fied ben­e­fi­cia­ry makes the ini­tial COBRA pre­mi­um pay­ment and cov­er­age is lost for fail­ure to pay with­in the 30-day grace peri­od, then the plan admin­is­tra­tor must pro­vide a notice of ter­mi­na­tion due to ear­ly ter­mi­na­tion of COBRA coverage.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Strategic benefits communication: Five key steps to success this open enrollment season | CA Benefit Advisors

    August 23, 2017

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    In pre­vi­ous posts, I have talked about sev­er­al aspects of strate­gic ben­e­fits com­mu­ni­ca­tion. Now it’s time to put those strate­gies into action. As we approach enroll­ment sea­son, let’s look at five key steps to ensur­ing this year’s open enroll­ment is suc­cess­ful for you and your employees.

    1. Deter­mine your key objectives

    What do employ­ees need to know this enroll­ment sea­son? As you review your ben­e­fit plan designs, think once again about your key objec­tives, and for each, how you will make employ­ees aware and keep them engaged. What are the chal­lenges employ­ees face when mak­ing their ben­e­fits decisions?

    • Are you rolling out new med­ical plan options? Does this include HDHP options? An HSA? Are there changes in pre­mi­ums and con­tri­bu­tion levels?
    • Are there any changes to oth­er lines of cov­er­age such as den­tal, life insur­ance, dis­abil­i­ty insurance?
    • Are you adding new vol­un­tary plans this year? How do they inte­grate with your med­ical plans? Do they plug gaps in high deductibles and out-of-pock­et expens­es? Are there exist­ing vol­un­tary plans with low participation?
    • Are there oth­er impor­tant top­ics to share with employ­ees, like new well­ness pro­grams, or health-dri­ven employ­ee events?

    Once you’ve gath­ered this infor­ma­tion, you can devel­op a com­mu­ni­ca­tion strat­e­gy that will bet­ter engage employ­ees in the ben­e­fits deci­sion-mak­ing process.

    2. Per­fect your script

    What do you know about your employ­ee demo­graph­ics? Diver­si­ty doesn’t refer only to age or gen­der. It could mean fam­i­ly size, dif­fer­ences in phys­i­cal demands of the job, income lev­els, or sim­ply lifestyle. It isn’t a one-size-fits-all world any­more. As you edu­cate employ­ees on ben­e­fits, you will want to give exam­ples that fit their lives.

    You will also want to keep the expla­na­tions as sim­ple as pos­si­ble. Use as much plain lan­guage as you can, as opposed to “insur­ance speak” and acronyms. Ben­e­fit plans are already an over­whelm­ing deci­sion, and as we have seen in our research, employ­ees still don’t ful­ly under­stand their options.

    3. Use a mul­ti-faceted com­mu­ni­ca­tions strategy

    Sun Life research and expe­ri­ence has shown that the most appre­ci­at­ed and effec­tive strate­gies incor­po­rate mul­ti­ple method­olo­gies. One help­ful tac­tic is to get a jump-start on enroll­ment com­mu­ni­ca­tion. As enroll­ment sea­son approach­es, try dynam­ic pre-enroll­ment emails to all employ­ees, using videos or brochures. Once on-site enroll­ment begins, set up group meet­ings based on employ­ee demo­graph­ics. This will arm employ­ees with bet­ter knowl­edge and pre­pared ques­tions for their one-to-one meet­ing with a ben­e­fits counselor.

    Con­sid­er hard-to-reach employ­ees as well, and keep your web­sites updat­ed with help­ful links and pro­vide con­tacts who are avail­able by phone for addi­tion­al support.

    Also, look to open enroll­ment as a good time to fill any employ­ee data gaps you may have, like ben­e­fi­cia­ries, depen­dents, or emer­gency contacts.

    4. Check your tech!

    We have talked in pre­vi­ous posts about lever­ag­ing ben­e­fits admin­is­tra­tion tech­nol­o­gy for effec­tive com­mu­ni­ca­tions. For open enroll­ment, espe­cial­ly when you may be intro­duc­ing new vol­un­tary insur­ance plans, it is impor­tant to check your tech­nol­o­gy. I rec­om­mend this eval­u­a­tion take place at least 6 to 8 weeks before open enroll­ment if possible.

    Work­ing with your UBA advi­sor, plat­form ven­dor and insur­ance car­ri­ers, some key considerations:

    • Pro­vide vol­un­tary prod­uct spec­i­fi­ca­tions from your car­ri­er to your plat­form ven­dor. It is impor­tant to check up front that the plat­form can han­dle prod­uct rules such as issue age and age band pric­ing, age reduc­tion, benefit/tier changes and guar­an­tee issue rules. Also, con­firm how the sys­tem will han­dle evi­dence of insur­a­bil­i­ty pro­cess­ing, if needed.
    • Elec­tron­ic Data Inter­face (EDI). Con­firm with your plat­form part­ner as well as insur­ance car­ri­ers that there is an EDI set-up process that includes test­ing of file feeds. This is a vital step to ensure seam­less inte­gra­tion between your ben­e­fits admin­is­tra­tion plat­form, pay­roll and the insur­ance carriers.
    • User Expe­ri­ence. Often ben­e­fits admin­is­tra­tion plat­forms are very effec­tive at mov­ing data and help­ing you man­age your company’s ben­e­fits. As we have dis­cussed, when it comes to your employee’s open enroll­ment user expe­ri­ence, there can be some chal­lenges. Espe­cial­ly when you are offer­ing vol­un­tary ben­e­fits. Con­firm with your ven­dor what, if any, deci­sion sup­port tools are avail­able. Also, check with your vol­un­tary car­ri­ers. These could range from ben­e­fit cal­cu­la­tors, prod­uct videos, and even log­ic-dri­ven presentations.

    5. Keep it going

    Even when enroll­ment sea­son is over, ongo­ing ben­e­fits com­mu­ni­ca­tions are a cen­tral tool to keep­ing employ­ees informed, edu­cat­ed, and engaged. The small win­dow of enroll­ment sea­son may not be long enough for peo­ple to get a full grasp of their ben­e­fits needs, and often their deci­sions are dri­ven by what is eas­i­ly under­stood or what they think they need based on oth­er people’s choic­es. Ongo­ing com­mu­ni­ca­tions can be about spe­cif­ic ben­e­fits, well­ness pro­grams, or oth­er health and ben­e­fit relat­ed items. This prac­tice will also help new hires who need to make ben­e­fits deci­sions rather quickly.

    In sum­ma­ry, work with your UBA con­sul­tant to cus­tomize ben­e­fits and enroll­ment com­mu­ni­ca­tions. Lever­age resources from your provider, who may, as Sun Life does, offer turnkey ser­vices that sup­port com­mu­ni­ca­tion, engage­ment, and enroll­ment. Explore third-par­ty ven­dors that offer plat­forms to sup­port the process. The whole thing can seem daunt­ing, but fol­low­ing these steps and con­sid­er­a­tions will not only make the process eas­i­er for you, it will make a world of dif­fer­ence to your employees.

    To help employ­ers com­mu­ni­cate their plan’s advan­tages, UBA Part­ners can bench­mark your plan against oth­ers in your indus­try, region and groups size. Request your free bench­mark­ing report.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Biting the Hand that Pays Them | CA Benefit Advisors

    August 21, 2017

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    I was recent­ly asked to speak to a gath­er­ing of hos­pi­tal-spon­sored health plans and providers of health care ser­vices about our health care sys­tem, and trends I see devel­op­ing which threat­en it. I’d planned to talk about how the Patient Pro­tec­tion and Afford­able Care Act (ACA or Oba­macare) only tar­gets one-third of the health care sys­tem – that being pay­ers (insur­ance), while most­ly ignor­ing the oth­er two-thirds: providers and patients. Call it a scape­goat, or some­thing else, but of the three play­ers in health care, insur­ance is the vil­lain. It’s easy, then, to say that what’s wrong with health care is what’s wrong with insur­ance, and vice ver­sa. As such, fix­ing health care then becomes fix­ing health insur­ance. Rather than assign blame to all three – providers, patients, and pay­ers – it’s polit­i­cal­ly expe­di­ent to point a fin­ger sole­ly at the least pop­u­lar of the three: the pay­er. And so, health care reform became health insur­ance reform; but as I’ve said many times before, insur­ance isn’t health care – it’s a way to pay for health care. This idea that insur­ance is to blame for the over­all cost of health care, that it can strong-arm providers into tak­ing what­ev­er they want to pay, and thus, the ris­ing cost of insur­ance is based sole­ly on greed and not at all on the actu­al cost of the care, is a lie. There is anoth­er atti­tude that it’s eas­i­er for insur­ance to raise pre­mi­ums than push back on the cost of care, because push­ing back on providers is tough, and – for the insured – not hav­ing insur­ance means cer­tain death (and thus they will pay any pre­mi­um). This holds a lit­tle more water; how­ev­er, it wrong­ful­ly assumes that with­out insur­ance there is no health care. Yet, the truth is that health care would exist with or with­out insur­ance; we’d just need to find a dif­fer­ent way to pay for it. Peo­ple “need” insur­ance – not for its own sake – but to pay for health care, because health care itself is too expensive.

    Imag­ine the fol­low­ing sce­nario: Oil changes for your car jump to $1,000 per oil change. Rather than be out­raged with the price, we turn around and demand that auto insur­ance start pay­ing for it. We then get out­raged when auto insur­ance rates increase. Insur­ance isn’t with­out blame. Indeed, I believe that some forms of insur­ance are too prof­it dri­ven, and/or force insureds to pay the cost when they make mis­takes or act inef­fi­cient­ly. Yet, with that said, blam­ing those actors (even the bad ones) for all the prob­lems fac­ing health care is a huge mis­take. Health insur­ance is not a behe­moth, stomp­ing around, forc­ing its will on insureds and providers. In fact, the oppo­site is true. Prob­lems with the sta­tus quo arise not from the strength of the insur­ance mar­ket, but rather, its weakness.

    This brings us to the top­ic I opt­ed to speak about, and the top­ic about which I write today. That this issue would be abol­ished by a sin­gle-pay­er sys­tem – at the expense of med­ical ser­vice providers, and thus, providers need to take action now to aid our employ­ment based ben­e­fit plans, before they cut off their own nose to spite their own face.

    Present­ly, insur­ers (try to) nego­ti­ate with hos­pi­tals and drug com­pa­nies on their own. To do this, many rely upon pre­ferred provider orga­ni­za­tion (PPO) net­works or oth­er such pro­grams. In exchange for agree­ing to the net­work terms, providers are promised prompt pay­ment, and reduc­tions in (or elim­i­na­tion of) audits and oth­er activ­i­ties pay­ers oth­er­wise engage in when deal­ing with med­ical bills sub­mit­ted by out-of-net­work providers. Indeed, ben­e­fit plans uni­lat­er­al­ly cal­cu­late what the cov­ered amount is when pay­ing an out-of-net­work provider (usu­al­ly result­ing in the “bal­ance” being “billed” to the patient). When pay­ing an in-net­work provider, how­ev­er, ben­e­fit plans are required to pay the net­work rate (the billed charge minus an agreed upon dis­count), regard­less of what pric­ing para­me­ters they’d usu­al­ly apply to out-of-net­work bills. This is agree­able to the pay­er, mean­while, because it means they get a dis­count (albeit off of inflat­ed rates), and, more impor­tant­ly, the pay­ment is pay­ment in full – mean­ing patients aren’t bal­ance billed.

    Due to the payer’s lack of size and num­ber of pay­ers present, com­pe­ti­tion between pay­ers and net­works, and oth­er ele­ments present in our mar­ket, pay­ers can­not “strong arm” providers. Com­pare this to mar­kets where there is a sin­gle pay­er; when providers must agree to terms con­trolled by the pay­er, since it’s their way or no way. In oth­er words, in a pure sin­gle-pay­er sys­tem, there is only one pay­er avail­able – and you play by their rules, or you don’t play at all. Cur­rent­ly, in the Unit­ed States, Medicare and Med­ic­aid are the two “biggest” pay­ers, and thus, it should come as no sur­prise that they rou­tine­ly secure the best rates.

    A 2011 study found that reim­burse­ments to some U.S. providers from pub­lic pay­ers, such as Medicare and Med­ic­aid, were 27 per­cent high­er than in coun­tries with uni­ver­sal cov­er­age, and reim­burse­ments from pri­vate pay­ers were 70 per­cent high­er than the Medicare pay­ment. This tells you two things – pri­vate plans pay way more than Medicare, and Medicare pays way more than “sin­gle-pay­er systems.”

    What does this mean? If providers fail to offer pri­vate pay­ers bet­ter rates soon, they will bank­rupt the sys­tem. If that hap­pens, Medicare will go from being the “biggest” pay­er to the “only” pay­er, and the rates they pay will drop accordingly.

    Why is this a prob­lem? Because, like it or not, providers are busi­ness­es too; and if they sud­den­ly see pay­ments plum­met to “sin­gle-pay­er” rates, they will take action to remain prof­itable. Months to have a lump exam­ined? Hours upon hours sit­ting in a wait­ing room? Death pan­els? The “hor­ror” sto­ries we hear from oth­er nations with sin­gle-pay­er sys­tems are not shock­ing – they are expect­ed. Yet, those who sup­port a sin­gle-pay­er sys­tem do so because the cur­rent sys­tem is too expen­sive. Thus, to avoid a sin­gle-pay­er sys­tem, we need to make health care less expen­sive. How do we do that? Reduce the cost of health care, and reduce the cost of health insur­ance accordingly.

    Ideas for the Future

    First, many have argued (and I tend to agree) that health insur­ance pays for too many med­ical ser­vices. Rou­tine, fore­see­able ser­vices should not be “insured” events. Insur­ance is meant to shift risk, asso­ci­at­ed with unfore­seen cat­a­stroph­ic events. A flu shot doesn’t fall into that cat­e­go­ry. If peo­ple paid for such costs out of their own pock­et, hope­ful­ly the cost of insur­ance would decrease (adding cash to the individual’s assets with which they can pay for said expens­es). Like­wise, hope­ful­ly providers would rec­og­nize that peo­ple are pay­ing for these ser­vices out of their own pock­ets, and reduce their fees accord­ing­ly. If an insur­ance car­ri­er want­ed to reim­burse insureds for these expens­es (pro­mot­ing a healthy lifestyle and avoid­ing some cat­a­stroph­ic costs insur­ance would oth­er­wise pay) or employ­ers want to cov­er these costs as a sep­a­rate and inde­pen­dent ben­e­fit of employ­ment (dis­tinct from health insur­ance) so be it; (cough*self-funding*cough).

    Next, we need to refo­cus on pri­ma­ry care as the gate­keep­er. I’ve seen a move­ment toward “physi­cian only” net­works, direct pri­ma­ry care, and oth­er inno­v­a­tive meth­ods by which ben­e­fit plans and employ­ers pro­mote the use of pri­ma­ry care physi­cians, and I applaud the effort. They pro­vide low-cost ser­vices, iden­ti­fy poten­tial high-cost issues before they mul­ti­ply, and steer patients to the high­est qual­i­ty, yet low­est cost, facil­i­ties and spe­cial­ists when needed.

    Last­ly, I’ve seen ben­e­fit plans attempt to remove them­selves from tra­di­tion­al “bind­ing” net­work arrange­ments across the board, instead using net­works in a much more nar­row func­tion (con­tract­ing direct­ly with one or two facil­i­ties in a giv­en geo­graph­ic area). By engag­ing with spe­cif­ic facil­i­ties direct­ly, they can find com­mon ground, and iden­ti­fy valu­able con­sid­er­a­tion not pre­vi­ous­ly con­sid­ered. Between increased steer­age, true exclu­siv­i­ty, elec­tron­ic pay­ment, prompt pay­ment, ded­i­cat­ed concierge, and oth­er ser­vices pay­ers can offer hos­pi­tals when they lim­it the scope of who is includ­ed – above and beyond dol­lars and cents – some facil­i­ties are able to reduce their ask­ing price to a rate that will allow the plan to sur­vive and thrive.

    From Account­able Care Orga­ni­za­tions (ACOs) to val­ue-based pric­ing, from direct pri­ma­ry care to carv­ing out the high­est cost (yet rarest) types of care, to be nego­ti­at­ed case-by-case, many inno­v­a­tive pay­ers are try­ing to cut costs and ensure their sur­vival. The next step is get­ting providers to agree that such sur­vival is good for the provider as well. Com­pared to the alter­na­tive, I hope they will not choose to con­tin­ue bit­ing the hands that pay them.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Local Benefits Group Distributes First $100,000 of AED Machine Donations to Community | CA Benefit Advisors

    August 17, 2017

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    As part of the Arrow Well­ness Ini­tia­tive to donate and dis­trib­ute $100,000 in AED (Auto­mat­ed Exter­nal Defib­ril­la­tor) machines to their local busi­ness com­mu­ni­ty, River­front Fit­ness is the first of many recip­i­ents vying to receive an AED device from Arrow Ben­e­fits Group. AED machines are an inte­gral part of treat­ing those suf­fer­ing from sud­den car­diac arrest in the few vital min­utes before emer­gency med­ical crews arrive, dra­mat­i­cal­ly increas­ing the sur­vival rates of the vic­tims of sud­den car­diac arrest. With­out these machines on hand, the sur­vival rate is under 10%; imme­di­ate response with the use of CPR and AED increas­es sud­den car­diac arrest sur­vival rates by as much as 70%. “Hav­ing the AED gives both our clients and our­selves the reas­sur­ance and com­fort of know­ing that if a heart attack occurs while using the facil­i­ty we have the prop­er equip­ment avail­able to use until the Fire Depart­ment arrives. It brings us a sense of secu­ri­ty and assur­ance that we are pro­vid­ing a life­sav­ing machine at our fit­ness facil­i­ty. It means the val­ue of a life,” says Amy Pon­tius, Man­ag­er at River­front Fit­ness. The AED device dona­tions build on Arrow’s pop­u­lar Well­ness Ini­tia­tive which pro­vides free CPR and First Aid class­es to clients and the com­mu­ni­ty. If you would like to learn more and par­tic­i­pate with your com­pa­ny in the pro­cure­ment of one of the AED machines please con­tact Andrew McNeil at 707–992-3789 or [email protected]

    In a life-threat­en­ing sit­u­a­tion where every sec­ond counts, access to these devices can mean the dif­fer­ence between life and death. Accord­ing to the Amer­i­can Heart Asso­ci­a­tion, for every minute that pass­es with­out CPR and defib­ril­la­tion, the chances of sur­vival decrease by 7–10%. Hav­ing an AED on hand makes it pos­si­ble to respond imme­di­ate­ly in emer­gency sit­u­a­tions, and yet the devices remain cost-pro­hib­i­tive for many small busi­ness­es. For River­front Fit­ness and their 45 mem­bers, the high price-tag means hav­ing an AED device at their facil­i­ty would be unat­tain­able with­out the sup­port of the Arrow Well­ness Initiative.

    “I can’t thank Arrow enough for their gen­eros­i­ty in pro­vid­ing us with an AED. Being a small busi­ness, find­ing the extra fund­ing to pur­chase such an expen­sive piece of equip­ment is dif­fi­cult. The cost is almost a deter­rent. I hope that changes in the future. This piece of equip­ment saves lives and there should be no price tag on that. We thank Arrow for rec­og­niz­ing our need and bring­ing the AED to River­front Fit­ness. Of course, we hope to nev­er have to use it, but we are pre­pared just in case!” The dona­tion is part of Arrow’s ongo­ing mis­sion to sup­port client health and well-being needs. “We are ded­i­cat­ed to help­ing our clients take proac­tive actions to keep their employ­ees healthy and safe,” said Arrow Ben­e­fits Group Prin­ci­pal Andrew McNeil.

    About Arrow Ben­e­fits Group

    Arrow Ben­e­fits Group, the third largest ben­e­fits firm in the North Bay, is a proud part­ner of Unit­ed Ben­e­fit Advi­sors (UBA), one of the largest ben­e­fits con­sult­ing and bro­ker­age firms in the country.

    Arrow Ben­e­fits Group is the sin­gle-source solu­tion for man­ag­ing the com­plex­i­ties of ben­e­fits with expert advice, cus­tomized pro­grams, and per­son­al­ized solu­tions. Arrow’s inno­v­a­tive pro­grams con­trol costs and give employ­ees a greater sense of finan­cial and emo­tion­al security.

    For straight answers to employ­ee ben­e­fits call 707–992-3780 or vis­it https://www.arrowbenefitsgroup.com

  • Wellness Programs – Getting Started and Remaining Compliant | CA Benefit Advisors

    August 15, 2017

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    Where to Start?

    First, expand the usu­al scope of well­ness activ­i­ty to well-BEING. Include ini­tia­tives that sup­port more than just phys­i­cal fit­ness, such as career growth, social needs, finan­cial health, and com­mu­ni­ty involve­ment. By doing this you increase your chances of see­ing a return on invest­ment (ROI) and a return on val­ue (ROV). Qual­i­ta­tive results of a suc­cess­ful pro­gram are just as valu­able as see­ing a finan­cial impact of a health­i­er population.

    Wellness program ROI and ROV

    Source: Kather­ine Baick­er, David Cut­ler, and Zirui Song, “Work­place Well­ness Pro­grams Can Gen­er­ate Sav­ings,” Health Affairs, Feb­ru­ary 2010, 29(2): pp 304–311

    To cre­ate a cor­po­rate cul­ture of well-being and ensure the suc­cess of your pro­gram, there are a few impor­tant steps.

    1. Lead­er­ship Sup­port: Pro­grams with lead­er­ship sup­port have the high­est lev­el of par­tic­i­pa­tion. Gain lead­er­ship sup­port by hav­ing them par­tic­i­pate in the pro­grams, give recog­ni­tion to involved employ­ees, sup­port employ­ee com­mu­ni­ca­tion, allow use of on-site space, approve of employ­ees spend­ing time on coor­di­nat­ing and facil­i­tat­ing ini­tia­tives, and define the bud­get. Even though you do not need a bud­get to be successful.
    2. Cre­ate a Com­mit­tee or Des­ig­nate a Cham­pi­on: Do not take this on by your­self. Cre­ate a well-being com­mit­tee, or iden­ti­fy a cham­pi­on, to share the respon­si­bil­i­ty and nec­es­sary actions of coor­di­nat­ing a program.
    3. Strate­gic Plan: Cre­ate a three-year strate­gic plan with a mis­sion state­ment, bud­get, real­is­tic goals, and mea­sure­ment tools. Cre­at­ing a plan like this takes some work and coor­di­na­tion, but the ben­e­fits are sig­nif­i­cant. You can cre­ate a suc­cess­ful well-being pro­gram with lit­tle to no bud­get, but you need to know what your real­is­tic goals are and have a plan to make them a reality.
    4. Tools and Resources: Gath­er and take advan­tage of avail­able resources. Tools and resources from your bro­ker and/or car­ri­er can help make man­ag­ing a pro­gram much eas­i­er. Addi­tion­al­ly, an employ­ee sur­vey will help you focus your efforts and accom­mo­date your employ­ees’ imme­di­ate needs.

    How to Remain Compliant?

    As always, remain­ing com­pli­ant can be an unplanned bur­den on employ­ers. Whether you have a well­ness or well-being pro­gram, each has their own com­pli­ance con­sid­er­a­tions and require­ments to be aware of. How­ev­er, don’t let that stop your orga­ni­za­tion from tak­ing action.

    There are two types of pro­grams – Group Health Plans (GHP) and Non-Group Health Plans (Non-GHP). The well­ness reg­u­la­tions vary depend­ing on the type of employ­er and whether the pro­gram is con­sid­ered a GHP or Non-GHP.

    Group health plan compliance table

    Employ­ers look­ing to avoid some of the com­pli­ance bur­den should design their well-being pro­gram to be a Non-GHP. Gen­er­al­ly, a well-being pro­gram is Non-GHP if it is offered to all employ­ees regard­less of their enroll­ment in the employer’s health plan and does not pro­vide or pay for “med­ical care.” For exam­ple, employ­ees receive $100 for attend­ing a class on nutri­tion. Here are some oth­er tips to keep your well-being pro­gram Non-GHP:

    • Finan­cial: Do not pay for med­ical ser­vices (e.g., flu shots, bio­met­ric screen­ings, etc.) or pro­vide med­ical care. Finan­cial incen­tives or rewards must be taxed. Do not pro­vide pre­mi­um dis­counts or surcharges.
    • Vol­un­tary Par­tic­i­pa­tion: Include all employ­ees, but do not man­date par­tic­i­pa­tion. Make activ­i­ties eas­i­ly acces­si­ble to those with dis­abil­i­ties or pro­vide a rea­son­able alter­na­tive. Make the pro­gram par­tic­i­pa­to­ry (i.e., edu­ca­tion­al, sem­i­nars, newslet­ters) rather than health-con­tin­gent (i.e., require par­tic­i­pants to get BMI below 30 or keep cho­les­terol below 200). Do not penal­ize indi­vid­u­als for not participating.
    • Health Infor­ma­tion: Do not col­lect genet­ic data, includ­ing fam­i­ly med­ical his­to­ry. Any med­ical records, or infor­ma­tion obtained, must be kept con­fi­den­tial. Avoid Health Risk Assess­ments (i.e. health sur­veys) that pro­vide advice and analy­sis with per­son­al­ized coach­ing or ask ques­tions about genetics/family med­ical history.

    By Hope DeRocha
    Orig­i­nal­ly Post­ed By www.ubabenefits.com

  • When Grief Comes to Work | CA Benefit Advisors

    August 10, 2017

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    Death and loss touch all of us, usu­al­ly many times through­out our lives. Yet we may feel unpre­pared and uncom­fort­able when grief intrudes into our dai­ly rou­tines. As a man­ag­er, when grief impacts your employ­ees it’s help­ful to have a basic under­stand­ing of what they are going through as well as ways you can help.

    Expe­ri­enc­ing Grief

    Although we all expe­ri­ence grief in our own way, there are behav­iors, emo­tions and phys­i­cal sen­sa­tions that are a com­mon part of the mourn­ing process. J. William Worden’s “Four Tasks of Mourn­ing” will be expe­ri­enced in some form by any­one who is griev­ing. These tasks include accept­ing the real­i­ty of the loss, expe­ri­enc­ing and accept­ing our emo­tions, adjust­ing to life with­out the loved one, and invest­ing emo­tion­al ener­gy into a new and dif­fer­ent life.

    Com­mon­ly expe­ri­enced emo­tions are sad­ness, anger, frus­tra­tion, guilt, shock and numb­ness. Phys­i­cal sen­sa­tions include fatigue or weak­ness, short­ness of breath, tight­ness in the chest and dry mouth.

    Manager’s Role

    When employ­ees are mourn­ing, it’s impor­tant to cre­ate a car­ing, sup­port­ive and pro­fes­sion­al work envi­ron­ment. In most cas­es, employ­ees will ben­e­fit from return­ing to work. It allows them to resume a reg­u­lar rou­tine, focus on some­thing besides their loss and boost their con­fi­dence by com­plet­ing work tasks.

    At the same time, bereaved employ­ees may expe­ri­ence many chal­lenges when return­ing to work. They may have poor con­cen­tra­tion, be extreme­ly tired, feel depressed or have a short tem­per and uncon­trol­lable emotions.

    As a man­ag­er, the best thing you can do is acknowl­edge the loss and main­tain strong lines of com­mu­ni­ca­tion. Even if you believe some­one else is check­ing in with them, make sure you stay in touch and see if there is any­thing you can do.

    Devel­op­ing a Return to Work Plan

    In order to help your employ­ees have a smooth tran­si­tion back to work you must lis­ten and under­stand their needs. Some addi­tion­al ques­tions you’ll want to answer are:

    • What are your company’s poli­cies and pro­ce­dures for med­ical and bereave­ment leave?
    • What infor­ma­tion do your employ­ees want their co-work­ers to have and would they rather share this infor­ma­tion themselves?
    • Do they want to talk about their expe­ri­ence or would they rather focus on work?
    • Do they need pri­vate time while at work?
    • Does their work­load and sched­ule need to be adjusted?
    • Do they need help at home – child care, meals, house work, etc.?
    • Are there oth­ers at work that may be expe­ri­enc­ing grief of their own?

    Help­ful Respons­es for Managers

    • Offer spe­cif­ic help – make meals, wash their car, walk their pet, or any­thing else that will make their life easier.
    • Say some­thing – it can be as sim­ple as, “I’m so sor­ry for your loss.”
    • Lis­ten – be kind but honest.
    • Respect pri­va­cy – hon­or closed doors and pri­vate moments.
    • Expect tears – emo­tions can hit unexpectedly.
    • Thank your staff – for every­thing they are doing to help.

    Griev­ing is a neces­si­ty, not a weak­ness. It is how we heal and move for­ward. As a man­ag­er, being there for your employ­ees dur­ing this time is impor­tant in help­ing them through the griev­ing process.

    An Employ­ee Assis­tance Pro­gram is a great resource for both you and your employ­ees when grief comes to work.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Employer Strategies for Managing Prescription Drug Costs | CA Benefit Advisors

    August 8, 2017

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    Mod­ern med­i­cines have result­ed in longer, more pro­duc­tive lives for many of us. Pre­scrip­tion drugs soothe sore mus­cles after a stren­u­ous work­out or man­age the con­di­tions of a chron­ic dis­ease. Unfor­tu­nate­ly, this use of pre­scrip­tions drugs can come with a hefty price tag.

    Amer­i­cans are spend­ing more mon­ey on pre­scrip­tion drugs than ever before and the Unit­ed States as a nation spends more per capi­ta on pre­scrip­tion drugs than any oth­er coun­try. With the cost of some drugs exceed­ing thou­sands of dol­lars for a 30-day sup­ply, this can trans­late into finan­cial hard­ship for many Americans.

    For employ­ers spon­sor­ing a med­ical plan, man­ag­ing the cost of these pre­scrip­tion drugs is also becom­ing a task. Insur­ance com­pa­nies and employ­ers strug­gle with the abil­i­ty to pro­vide afford­able med­ical plans, and the ever-increas­ing pre­scrip­tion drug costs are a pri­ma­ry dri­ver of this dif­fi­cul­ty. As a result, pre­scrip­tion drug plan designs are chang­ing shape – mov­ing to a mod­el that helps push more of the cost of these drugs to the mem­ber along with increas­ing aware­ness of the true cost of the prescriptions.

    Flat dol­lar copay plans have become an expect­ed norm in med­ical plans for almost a decade. How­ev­er, insur­ance com­pa­nies under­writ­ing ful­ly insured med­ical plans and employ­ers spon­sor­ing self-fund­ed med­ical pro­grams now need to make mod­i­fi­ca­tions to these plan designs to man­age the ever-increas­ing pre­scrip­tion drug costs. As a result, we are see­ing more pre­scrip­tion drug plans com­bin­ing some aspect of coin­sur­ance along with or in place of the flat dol­lar copayments.

    Accord­ing to the 2016 UBA Health Plan Sur­vey, copay mod­els are still the most pop­u­lar, with a three-tier copay struc­ture the most preva­lent. Medi­an retail copay­ments for these three-tier plans are $10 for gener­ic drugs, $35 for pre­ferred brand drugs (drugs on the carrier’s pre­scrip­tion drug list) and $60 for non-pre­ferred brand drugs (drugs not on the carrier’s pre­scrip­tions drug list). While 54.5 per­cent of all pre­scrip­tion plans are copay only, approx­i­mate­ly 40 per­cent of all pre­scrip­tion drug plans have co-insur­ance along with (or in lieu of) copays–a plan design that is par­tic­u­lar­ly com­mon among four-tier plans.

    Coin­sur­ance mod­els have many unique designs. Some plans are a straight per­cent­age of the cost of the drug; some may involve a max­i­mum or min­i­mum dol­lar copay­ment com­bined with the coin­sur­ance. For exam­ple, a plan may require 40 per­cent coin­sur­ance for a pre­ferred brand drug, but there is a min­i­mum copay­ment of $30 and a max­i­mum copay­ment of $50. Typ­i­cal­ly, we see a high­er coin­sur­ance per­cent­age for non-pre­ferred brand drugs and spe­cial­ty drugs. The mem­ber cost of the drug is cal­cu­lat­ed after any nego­ti­at­ed dis­counts, so mem­bers cov­ered by a coin­sur­ance plan are reap­ing the ben­e­fits of any dis­counts nego­ti­at­ed with the phar­ma­cy by the phar­ma­cy ben­e­fit man­ag­er (PBM).

    Coin­sur­ance plans do pro­vide sev­er­al advan­tages to man­ag­ing pre­scrip­tion drug costs. Under a flat dol­lar copay plan design, mem­bers may not tru­ly under­stand the full cost of the drug they are pur­chas­ing. Phar­ma­cies are now dis­clos­ing the full cost of drugs on the pur­chase receipts. Yet, most con­sumers do not take note of this dis­clo­sure, focus­ing only on the copay­ment amount. When a mem­ber pays a per­cent­age of the cost of the drug as in a coin­sur­ance mod­el, the true cost of the drug becomes much more apparent.

    Anoth­er advan­tage of the coin­sur­ance mod­el is that it auto­mat­i­cal­ly increas­es the mem­ber share of the cost as the price of the drug increas­es. Under the flat dol­lar copay­ment mod­el, as the true cost of the drug increas­es, the mem­ber pays a small­er por­tion of the total cost. When the member’s por­tion is deter­mined by a coin­sur­ance per­cent­age, the mem­ber pays more as the cost of the drug increases.

    As the costs of health care over­all con­tin­ue to increase, we all need to become bet­ter con­sumers of our health­care. Mem­bers cov­ered by a pre­scrip­tion drug plan with a coin­sur­ance mod­el will have a bet­ter under­stand­ing of the true cost of their pre­scrip­tions. As mem­bers become more aware of the true costs of their care, they make bet­ter health care deci­sions, man­ag­ing the over­all cost of care.

    We expect to see pre­scrip­tion drug ben­e­fit plans change even more as the cost of health care – espe­cial­ly pre­scrip­tion drugs – esca­lates. These changes will like­ly result in more of the cost being pushed to the patient. There are resources avail­able to patients for assis­tance with some of these out-of-pock­et costs. It is vital for the patient to under­stand their costs and know how to max­i­mize their ben­e­fits. In a few weeks, the UBA blog will high­light some of these resources and pro­vide infor­ma­tion on how to edu­cate employ­ees on max­i­miz­ing their ben­e­fits and the indus­try resources avail­able to them.

    For all the cost and design trends relat­ed to health and pre­scrip­tion drug plan costs by group size, indus­try and region, down­load UBA’s Health Plan Sur­vey Exec­u­tive Sum­ma­ry.

    By Mary Drueke-Collins
    Orig­i­nal­ly Post­ed By www.ubabenefits.com

  • Government and Education Employers Offer Richest HSA Plans | CA Benefit Advisors

    August 4, 2017

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    Across most indus­tries, HSA con­tri­bu­tions are, for the most part, down or unchanged from three years ago, accord­ing to UBA’s Health Plan Sur­vey. The aver­age employ­er con­tri­bu­tion to an HSA is $474 for a sin­gle employ­ee (down 3.5 per­cent from 2015 and 17.6 per­cent from five years ago) and $801 for a fam­i­ly (down 9.2 per­cent from last year and 13.7 per­cent from five years ago). Gov­ern­ment and edu­ca­tion employ­ers are the only indus­tries with aver­age sin­gle con­tri­bu­tions well above aver­age and on the rise.

    Gov­ern­ment employ­ees had the most gen­er­ous con­tri­bu­tions for sin­gles at $850, on aver­age, up from $834 in 2015. This indus­try also has the high­est employ­er con­tri­bu­tions for fam­i­lies, on aver­age, at $1,595 (though that is down from 1,636 in 2015). Edu­ca­tion­al employ­ers are the next most gen­er­ous, con­tribut­ing $636, on aver­age, for sin­gles and $1,131 for families.

    Sin­gles in the accommodation/food ser­vices indus­tries received vir­tu­al­ly no sup­port from employ­ers, with aver­age HSA con­tri­bu­tions at $166. The same is true for fam­i­lies with HSA plans in the accommodation/food ser­vices indus­tries with aver­age fam­i­ly con­tri­bu­tions of $174.

    Retail employ­ers also remain among the least gen­er­ous con­trib­u­tors to sin­gle and fam­i­ly HSA plans, con­tribut­ing $305 and $470, respec­tive­ly. This may be why they have low enroll­ment in these plans.

    HSA Plans by Industry

    The edu­ca­tion ser­vices indus­try has seen a 109 per­cent increase in HSA enroll­ment since 2013 (aid­ed by employ­ers’ gen­er­ous con­tri­bu­tions), cat­a­pult­ing the indus­try to the lead in HSA enroll­ment at 23.8 per­cent. The professional/scientific/tech and finance/insurance indus­tries fol­low close­ly at 23.3 per­cent and 22.1 per­cent, respectively.

    The mining/oil/gas indus­try sees the low­est enroll­ment at 3.8 per­cent. The retail, hotel, and food indus­tries con­tin­ue to have some of the low­est enroll­ment rates despite the preva­lence of these plans, indi­cat­ing that these indus­tries, in par­tic­u­lar, may want to increase employ­ee edu­ca­tion efforts about these plans and how they work.

    For a detailed look at the preva­lence and enroll­ment rates among HSA and HRA plans by group size and region, view UBA’s “Spe­cial Report: How Health Sav­ings Accounts Mea­sure Up”.

    Bench­mark­ing your health plan with peers of a sim­i­lar size, indus­try or geog­ra­phy makes a big dif­fer­ence in deter­min­ing if your plan is com­pet­i­tive. To com­pare your exact plan with your peers, request a cus­tom bench­mark­ing report.

    For fast facts about HSA and HRA plans, includ­ing the best and worst plans, aver­age con­tri­bu­tions made by employ­ers, and indus­try trends, down­load (no form!) “Fast Facts: HSAs vs. HRAs”.

    For a com­pre­hen­sive chart that com­pares eli­gi­bil­i­ty cri­te­ria, con­tri­bu­tion rules, reim­burse­ment rules, report­ing require­ments, pri­va­cy require­ments, applic­a­ble fees, non-dis­crim­i­na­tion rules and oth­er char­ac­ter­is­tics of account-based plans, request UBA’s Com­pli­ance Advi­sor, “HRAs, HSAs, and Health FSAs – What’s the Dif­fer­ence?”.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Best Practices for Initial COBRA Notices | CA Benefit Advisors

    August 2, 2017

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    The Con­sol­i­dat­ed Omnibus Bud­get Rec­on­cil­i­a­tion Act of 1985 (COBRA) requires group health plans to pro­vide notices to cov­ered employ­ees and their fam­i­lies explain­ing their COBRA rights when cer­tain events occur. The ini­tial notice, also referred to as the gen­er­al notice, com­mu­ni­cates gen­er­al COBRA rights and oblig­a­tions to each cov­ered employ­ee (and his or her spouse) who becomes cov­ered under the group health plan. This notice is issued by the plan admin­is­tra­tor with­in the first 90 days when cov­er­age begins under the group health plan and informs the cov­ered employ­ee (and his or her spouse) of the respon­si­bil­i­ty to noti­fy the employ­er with­in 60 days if cer­tain qual­i­fy­ing events occur in the future.

    The ini­tial notice must include the fol­low­ing information:

    • The plan administrator’s con­tact information
    • A gen­er­al descrip­tion of the con­tin­u­a­tion cov­er­age under the plan
    • An expla­na­tion of the cov­ered employee’s notice oblig­a­tions, includ­ing notice of 
      • The qual­i­fy­ing events of divorce, legal sep­a­ra­tion, or a dependent’s ceas­ing to be a dependent
      • The occur­rence of a sec­ond qual­i­fy­ing event
      • A qual­i­fied beneficiary’s dis­abil­i­ty (or ces­sa­tion of dis­abil­i­ty) for pur­pos­es of the dis­abil­i­ty extension)
    • How to noti­fy the plan admin­is­tra­tor about a qual­i­fy­ing event
    • A state­ment that that the notice does not ful­ly describe con­tin­u­a­tion cov­er­age or oth­er rights under the plan, and that more com­plete infor­ma­tion regard­ing such rights is avail­able from the plan admin­is­tra­tor and in the plan’s sum­ma­ry plan descrip­tion (SPD)

    As a best prac­tice, the ini­tial notice should also:

    • Direct qual­i­fied ben­e­fi­cia­ries to the plan’s most recent SPD for cur­rent infor­ma­tion regard­ing the plan administrator’s con­tact information.
    • For plans that include health flex­i­ble spend­ing arrange­ments (FSAs), dis­close the lim­it­ed nature of the health FSA’s COBRA oblig­a­tions (because cer­tain health FSAs are only oblig­at­ed to offer COBRA through the end of the year to qual­i­fied ben­e­fi­cia­ries who have under­spent accounts).
    • Explain that the spouse may noti­fy the plan admin­is­tra­tor with­in 60 days after the entry of divorce or legal sep­a­ra­tion (even if an employ­ee reduced or elim­i­nat­ed the spouse’s cov­er­age in antic­i­pa­tion of the divorce or legal sep­a­ra­tion) to elect up to 36 months of COBRA cov­er­age from the date of the divorce or legal separation.
    • Define qual­i­fied ben­e­fi­cia­ry to include a child born to or placed for adop­tion with the cov­ered employ­ee dur­ing a peri­od of COBRA con­tin­u­a­tion coverage.
    • Describe that a cov­ered child enrolled in the plan pur­suant to a qual­i­fied med­ical child sup­port order dur­ing the employee’s employ­ment is enti­tled to the same COBRA rights as if the child were the employee’s depen­dent child.
    • Clar­i­fy the con­se­quences of fail­ing to sub­mit a time­ly qual­i­fy­ing event notice, time­ly sec­ond qual­i­fy­ing event notice, or time­ly dis­abil­i­ty deter­mi­na­tion notice.

    Prac­ti­cal­ly speak­ing, the ini­tial notice require­ment can be sat­is­fied by includ­ing the gen­er­al notice in the group health plan’s SPD and then issu­ing the SPD to the employ­ee and his or her spouse with­in 90 days of their group health plan cov­er­age start date.

    If the plan doesn’t rely on the SPD for fur­nish­ing the ini­tial COBRA notice, then the plan admin­is­tra­tor would fol­low the U.S. Depart­ment of Labor (DOL) rules for deliv­ery of ERISA-required items. A sin­gle notice addressed to the cov­ered employ­ee and his or her spouse is allowed if the spouse lives at the same address as the cov­ered employ­ee and cov­er­age for both the cov­ered employ­ee and spouse start­ed at the time that notice was pro­vid­ed. The plan admin­is­tra­tor is not required to pro­vide an ini­tial notice for dependents.

    By Danielle Capilla
    Orig­i­nal­ly Post­ed By www.ubabenefits.com

     

  • 5 Things Millennials Need to Know About Life Insurance | CA Benefit Advisors

    July 28, 2017

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    Being cat­a­pult­ed into the adult world is a shock to the sys­tem, regard­less of how pre­pared you think you are. And these days, it’s more com­pli­cat­ed than ever, with inter­net access and mobile devices being must-have util­i­ties and nav­i­gat­ing tax forms when they aren’t as “EZ” as they used to be.

    Maybe you’re still liv­ing with your folks while you get estab­lished. Or maybe you’re look­ing for­ward to mov­ing out of a rental and into a house or to tie the knot. Life insur­ance might be the last thing on your list of things to deal with or even think about. (You’re not alone.) But here are five things you might not know about life insurance—that you prob­a­bly should.

    1. Life insur­ance is a form of pro­tec­tion. If you Google “life insur­ance” you’ll get a slew of ads telling you how cheap life insur­ance can be, with­out near­ly enough infor­ma­tion about what you need it for. That’s prob­a­bly because it’s not ter­ri­bly pleas­ant to think about: this idea that we could die and some­one we care about might suf­fer finan­cial­ly as a result. Life insur­ance pro­vides a finan­cial buffer for the peo­ple you care about in the event some­thing hap­pens to you. Think just because you’re sin­gle, nobody would be left in the lurch? Read the next point.

    2. Col­lege debt may not go away. Did someone—like your parents—co-sign your stu­dent loans through the bank? If so, the bank won’t dis­charge that debt upon your death the way that the fed­er­al gov­ern­ment would with fed­er­al stu­dent loans. That means your par­ents, or oth­ers who signed the paper­work, would be respon­si­ble for pay­ing the full balance—sometimes imme­di­ate­ly. Don’t sad­dle them with the bill!

    3. If you don’t know any­thing about life insur­ance, it’s prob­a­bly bet­ter if you don’t buy it off the inter­net. It’s what we’re used to: You find the thing you need or love on Ama­zon or Ebay or Etsy, click a few but­tons, and POOF. It arrives at your door. But life insur­ance is a finan­cial plan­ning prod­uct, and while it can be as sim­ple as a 20-year term pol­i­cy for less than a cup of cof­fee each day (for real!), going through your options with an insur­ance pro­fes­sion­al can ensure that you get the right amount for the right amount of time and at a price that fits into your bud­get. And many peo­ple don’t know that an agent will sit down and help you out at no cost.

    4. Social fundrais­ing only goes so far. This rel­a­tive­ly recent phe­nom­e­non has every­one think­ing that they’ll just turn to GoFundMe if things go awry in their lives. But does any griev­ing per­son want to spend time admin­is­ter­ing a social fundrais­ing site? The chances of going viral are marked­ly slim, and social fundrais­ing sites will take their cut, as will the IRS. And there is absolute­ly no guar­an­tee about how much—if any—money will be raised.

    5. The best time is now. You’ll def­i­nite­ly nev­er be younger than you are today, and for most of us, the younger we are the health­i­er we are. Those are two of the most impor­tant fac­tors for get­ting afford­able life insur­ance cov­er­age. So don’t delay.

    By Helen Mosher
    Orig­i­nal­ly Post­ed By www.lifehappens.org

  • So everyone is talking about it – what’s in it? Not much except a lot | CA Benefit Advisors

    July 26, 2017

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    Cal­i­for­nia Sen­ate Bill 562 would cre­ate the Healthy Cal­i­for­nia pro­gram “to pro­vide uni­ver­sal sin­gle pay­er health care cov­er­age and a health care cost con­trol sys­tem for the ben­e­fit of all res­i­dents of the state” with the catch that “this bill would pro­hib­it this act from becom­ing oper­a­tive until the Sec­re­tary of Cal­i­for­nia (HHS) gives writ­ten notice…that the Healthy Cal­i­for­nia Trust Fund has the rev­enues to fund the costs of imple­ment­ing the act.”  Which means they need Fed­er­al waivers to run their own Medi-Cal and relat­ed pro­gram reim­burse­ment and also receive fed­er­al funds direct­ly for those ser­vices, as well as tax rev­enue, since there will be no pre­mi­ums charged, copay­ments, or deductibles to recip­i­ents of care under the act.  Essen­tial­ly “it is fur­ther the intent of the Leg­is­la­ture to estab­lish the Healthy Cal­i­for­nia pro­gram to pro­vide uni­ver­sal health cov­er­age for every Cal­i­forn­ian based on his or her abil­i­ty to pay and fund­ed by broad based revenue”

    What is surprising?

    • That they intend to pay providers on a “cap­i­tat­ed” (fixed fee) basis and that they will some­how be able to nego­ti­ate not just with all hos­pi­tal sys­tems but doc­tors as well. In a lat­er sec­tion it dis­cuss­es pay­ment by fee for ser­vice (which by itself has no means of cost con­trol) “until anoth­er pay­ment method­ol­o­gy is estab­lished by the board”
    • That this includes cov­er­age for Long Term Care – though that is relat­ed to tak­ing over Medi-Cal, demands will be made for improve­ments and thus increased costs
    • “This title does not pre­empt any city or coun­ty from adopt­ing addi­tion­al health care cov­er­age for res­i­dents in that city or coun­ty that pro­vides more pro­tec­tions and ben­e­fits to Cal­i­for­nia res­i­dents than this title”
    • Car­ri­ers seem to dis­ap­pear unless they want to offer cov­er­age that sup­ple­ments what is offered here. The “good news” how­ev­er, is that “the board shall pro­vide funds from the Healthy Cal­i­for­nia Trust Fund (or oth­er funds as appro­pri­at­ed) for a pro­gram of retrain­ing and assist­ing job tran­si­tion for indi­vid­u­als employed or pre­vi­ous­ly employed in the fields of health insur­ance, health care ser­vice plan and oth­er third par­ty pay­ments for health care or those indi­vid­u­als pro­vid­ing ser­vices to health care providers to deal with third par­ty pay­ers for health care, whose jobs may be or have been end­ed as a result of the imple­men­ta­tion of the pro­gram.”  So…everyone in health insur­ance – agents, car­ri­er employ­ees, third par­ty admin­is­tra­tors – will be giv­en train­ing for new jobs, paid for by tax­pay­ers, while an entire­ly new bureau­cra­cy is cre­at­ed, again with tax­pay­er dol­lars, to admin­is­ter the new plan?
    • The pro­gram is allowed to pay for cap­i­tal expen­di­tures incurred by any non prof­it health facilities

    The main line – “every res­i­dent of the state shall be eli­gi­ble and enti­tled to enroll as a mem­ber under the pro­gram” and “res­i­dent” is defined as “an indi­vid­ual whose pri­ma­ry place of abode is in the state, with­out regard to the individual’s immi­gra­tion status”

    Most of the bill is giv­en over the fun­da­men­tals of gov­er­nance, which include appoint­ment of a gen­er­al board of 9 and then a pub­lic advi­so­ry com­mit­tee with 22 assort­ed members.

    That’s it.  Twen­ty pages.  The pro­jec­tion of a $400 bil­lion cost to enact and imple­ment.  Details to follow…but when, how and what will they show?  And isn’t it a polit­i­cal tru­ism that any pro­ject­ed cost will almost always dou­ble when it is a gov­ern­ment project?  Mon­ey which, by the way, Cal­i­for­nia does not have.

  • Small Employers Ask about Form 5500 | CA Benefit Advisors

    July 21, 2017

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    UBA’s com­pli­ance team lever­ages the col­lec­tive exper­tise of its inde­pen­dent part­ner firms to advise 36,000 employ­ers and their 5 mil­lion employ­ees. Late­ly, a com­mon ques­tion from employ­ers is: If a health and wel­fare ben­e­fit plan has few­er than 100 par­tic­i­pants, then does it need to file a Form 5500?

    If a plan is self-fund­ed and uses a trust, then it is required to file a Form 5500, no mat­ter how many par­tic­i­pants it has.

    Whether the plan must file a Form 5500 depends on whether or not the plan is “unfund­ed” (where the mon­ey comes from to pay for the self-fund­ed claims).

    Cur­rent­ly, group wel­fare plans gen­er­al­ly must file Form 5500 if:

    • The plan is ful­ly insured and had 100 or more par­tic­i­pants on the first day of the plan year (depen­dents are not con­sid­ered “par­tic­i­pants” for this pur­pose unless they are cov­ered because of a qual­i­fied med­ical child sup­port order).
    • The plan is self-fund­ed and it uses a trust, no mat­ter how many par­tic­i­pants it has.
    • The plan is self-fund­ed and it relies on the Sec­tion 125 plan exemp­tion, if it had 100 or more par­tic­i­pants on the first day of the plan year.

    There are sev­er­al exemp­tions to Form 5500 fil­ing. The most notable are:

    • Church plans defined under ERISA Sec­tion 3(33)
    • Gov­ern­men­tal plans, includ­ing trib­al gov­ern­men­tal plans
    • Top hat plans which are unfund­ed or insured and ben­e­fit only a select group of man­age­ment or high­ly com­pen­sat­ed employees
    • Small insured or unfund­ed wel­fare plans. A wel­fare plan with few­er than 100 par­tic­i­pants at the begin­ning of the plan year is not required to file an annu­al report if the plan is ful­ly insured, entire­ly unfund­ed, or a com­bi­na­tion of both.

    A plan is con­sid­ered unfund­ed if the employ­er pays the entire cost of the plan from its gen­er­al accounts. A plan with a trust is con­sid­ered funded.

    For small­er groups that are self-fund­ed or par­tial­ly self-fund­ed, you’d need to ask them whether the plan is fund­ed or unfunded.

    If the employ­er pays the cost of the plan from gen­er­al assets, then it is con­sid­ered unfund­ed and essen­tial­ly there is no trust.

    If the employ­er pays the cost of the plan from a spe­cif­ic account (in which plan par­tic­i­pant con­tri­bu­tions are seg­re­gat­ed from gen­er­al assets), then the plan is con­sid­ered fund­ed. For exam­ple, under ERISA, pre-tax salary reduc­tions under a cafe­te­ria plan are par­tic­i­pant con­tri­bu­tions and are con­sid­ered plan assets which must gen­er­al­ly be held in trust based on ERISA’s exclu­sive ben­e­fit rule and oth­er fidu­cia­ry duty rules.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Extension of Maximum COBRA Coverage Period | CA Benefit Advisors

    July 19, 2017

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    The Con­sol­i­dat­ed Omnibus Bud­get Rec­on­cil­i­a­tion Act of 1985 (COBRA) requires employ­ers to offer cov­ered employ­ees who lose their health ben­e­fits due to a qual­i­fy­ing event to con­tin­ue group health ben­e­fits for a lim­it­ed time at the employee’s own cost. The length of the COBRA cov­er­age peri­od depends on the qual­i­fy­ing event and is usu­al­ly 18 or 36 months. How­ev­er, the COBRA cov­er­age peri­od may be extend­ed under the fol­low­ing five circumstances:

    1. Mul­ti­ple Qual­i­fy­ing Events
    2. Dis­abil­i­ty
    3. Extend­ed Notice Rule
    4. Pre-Ter­mi­na­tion or Pre-Reduc­tion Medicare Entitlement
    5. Employ­er Exten­sion; Employ­er Bankruptcy

    In this blog, we’ll exam­ine the first cir­cum­stance above. For a detailed dis­cus­sion of all the cir­cum­stances, request UBA’s Com­pli­ance Advi­sor, “Exten­sion of Max­i­mum COBRA Cov­er­age Peri­od”.

    When deter­min­ing the cov­er­age peri­od under mul­ti­ple qual­i­fy­ing events, the max­i­mum cov­er­age peri­od for a loss of cov­er­age due to a ter­mi­na­tion of employ­ment and reduc­tion of hours is 18 months. The max­i­mum cov­er­age peri­od may be extend­ed to 36 months if a sec­ond qual­i­fy­ing event or mul­ti­ple qual­i­fy­ing events occur with­in the ini­tial 18 months of COBRA cov­er­age from the first qual­i­fy­ing event. The cov­er­age peri­od runs from the start of the orig­i­nal 18-month cov­er­age period.

    The first qual­i­fy­ing event must be ter­mi­na­tion of employ­ment or reduc­tion of hours, but the sec­ond qual­i­fy­ing can­not be ter­mi­na­tion of employ­ment, reduc­tion of hours, or bank­rupt­cy. In order to qual­i­fy for the exten­sion, the sec­ond qual­i­fy­ing event must be the cov­ered employee’s death, divorce, or child ceas­ing to be a depen­dent. In addi­tion, the exten­sion is only avail­able if the sec­ond qual­i­fy­ing event would have caused a loss of cov­er­age for the qual­i­fied ben­e­fi­cia­ry if it occurred first.

    The extend­ed 36-month peri­od is only for spous­es and depen­dent chil­dren. In order to qual­i­fy for extend­ed cov­er­age, a qual­i­fied ben­e­fi­cia­ry must have elect­ed COBRA dur­ing the first qual­i­fy­ing event and must have been receiv­ing COBRA cov­er­age at the time of the sec­ond event. The qual­i­fied ben­e­fi­cia­ry must noti­fy the plan admin­is­tra­tor of the sec­ond qual­i­fy­ing event with­in 60 days after the event.

    Exam­ple: Jim was ter­mi­nat­ed on June 3, 2017. Then, he got divorced on July 6, 2017. Jim was eli­gi­ble for COBRA con­tin­u­a­tion cov­er­age for 18 months after his ter­mi­na­tion of employ­ment (the first qual­i­fy­ing event). How­ev­er, his divorce (the sec­ond qual­i­fy­ing event) extend­ed his COBRA con­tin­u­a­tion cov­er­age to 36 months because it occurred with­in the ini­tial 18 months of COBRA cov­er­age from his ter­mi­na­tion (the first qual­i­fy­ing event).

    The health plan should indi­cate when the cov­er­age peri­od begins. The plan may pro­vide that that the plan admin­is­tra­tor be noti­fied when plan cov­er­age is lost as opposed to when the qual­i­fy­ing event occurs. In that case, the 36-month cov­er­age peri­od would begin on the date cov­er­age was lost.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Why you can never trust the numbers – they’re in, they’re out, follow the bouncing results | CA Benefit Advisors

    July 14, 2017

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    Almost two mil­lion peo­ple who signed up for health plans on the ACA Exchange dur­ing the 2016/17 open enroll­ment dropped their cov­er­age from Jan­u­ary 31 through March 15.

  • How to Be a Magnetic Organization | CA Benefit Advisors

    July 13, 2017

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    When we hear something’s mag­net­ic, it’s like­ly the first thought that comes to mind is attrac­tion. By def­i­n­i­tion, a mag­net­ic force is the attrac­tion or repul­sion that aris­es between elec­tri­cal­ly charged par­ti­cles because of their motion. What per­fect fram­ing for an orga­ni­za­tion – the desire to attract (or repel) peo­ple to help advance your orga­ni­za­tion. With this fram­ing comes the assump­tion that there’s motion, which is, hope­ful­ly, a result of inten­tion­al action.

    If we fol­low the thought of inten­tion­al action, there are sev­en steps (and many more details for each step that would be too lengthy to include here) that attract what’s desired and repel what’s not desired.

    Sev­en Steps to Being a Mag­net­ic Organization

    1.  Decide what you want for the company

    Sim­ple, right? Yes. How­ev­er, often an assump­tion is made that every­body knows what’s want­ed. The best way to deter­mine if you know what’s want­ed is to ask the ques­tion, “Can I paint a clear, col­or­ful and com­pelling sto­ry of the future?” This is one of the most impor­tant roles of lead­er­ship in an orga­ni­za­tion. Cre­ate, and tell a com­pelling sto­ry wor­thy of the effort it will take to get there.

    2.  Get 100 per­cent buy-in from top leadership

    It’s not enough for the CEO or own­er to own the future sto­ry, every top leader who’s respon­si­ble for the per­for­mance and expe­ri­ence of employ­ees and cus­tomers needs to be 100 per­cent com­mit­ted to the future. This is per­haps the most telling test of how quick­ly and assured­ly you will achieve the goals to sup­port the future state. It’s crit­i­cal to check for this buy-in up front as well as at key mile­stone points along the way.

    3.  Com­mu­ni­cate

    As impor­tant as the first two steps are, a pin­na­cle point in the process is shar­ing with your employ­ees, cus­tomers, and oth­er stake­hold­ers what you intend to do.

    This is a step that is often over­looked and under­val­ued. If you ascribe to the rule of sev­en for mar­ket­ing, it takes at least sev­en expo­sures for a per­son to hear some­thing with the like­li­hood of remem­ber­ing the mes­sage. Com­mu­ni­cate often and keep your mes­sage clear and con­sis­tent. Also, keep in mind that peo­ple absorb infor­ma­tion dif­fer­ent­ly. This absorp­tion is rel­a­tive to learn­ing styles. Pre­sent­ing infor­ma­tion will be accept­ed dif­fer­ent­ly if some­one is visu­al, aur­al, ver­bal, phys­i­cal, log­i­cal, social, or soli­tary in their learn­ing style.

    As you design your com­mu­ni­ca­tion plan, explore not only what you’ll share, but how you’ll pro­mote the messages.

    4.  Build Your Culture

    This speaks to the actions nec­es­sary to achieve desired out­comes. It’s inten­tion­al­ly ordered after com­mu­ni­ca­tion. Rein­force the mis­sion of the com­pa­ny, or roll it out if it’s new­ly cre­at­ed. To move for­ward, you need every employ­ee to be aware of the direc­tion and expec­ta­tions for the orga­ni­za­tion. Share orga­ni­za­tion­al goals and keep lead­ers account­able to cre­ate align­ment for their teams, includ­ing work­ing with each per­son on their team to under­stand how his or her unique role fits into the over­all pic­ture. This will dri­ve inter­ac­tions that con­tribute to, or detract from, success.

    Involve employ­ees in the ear­ly phas­es of cul­ture change and share quick wins. Con­sid­er includ­ing sto­ries and tes­ti­mo­ni­als from employ­ees that show how the com­pa­ny is already mak­ing strides to get to the future vision.

    Assure the right fit of employ­ees. Clear­ly iden­ti­fy the top three expec­ta­tions for each role and then find peo­ple who will be on fire to do these things well.

    David Pink, in his book Dri­ve, explores exact­ly what moti­vates peo­ple and claims that true moti­va­tion con­sists of: 1) auton­o­my, the desire to direct our own lives; 2) mas­tery, the desire to con­tin­u­al­ly improve at some­thing that mat­ters; and 3) pur­pose, the desire to do things in ser­vice of some­thing larg­er than ourselves.

    In addi­tion, make a habit of catch­ing peo­ple doing the right things right. Recog­ni­tion of work well done con­tin­u­ous­ly rein­forced will add fuel to build­ing a pos­i­tive cul­ture. Final­ly, allow peo­ple to be who they are and find ways to insert moments of fun.

    5.  Eval­u­ate

    There are many eval­u­a­tion tools to help iden­ti­fy what’s hap­pen­ing. Ask­ing for feed­back from employ­ees and cus­tomers can be a high­ly effec­tive way to help under­stand where the best prac­tices exist and where improve­ments are need­ed. Mea­sur­ing what’s hap­pen­ing on a reg­u­lar basis offers iden­ti­fi­ca­tion of val­ue in process­es and with products.

    Accord­ing to the Pre­dic­tions for 2017 Bersin by Deloitte report, “Dri­ven by the need to under­stand and improve engage­ment, and the con­tin­u­ous need to mea­sure and improve employ­ee pro­duc­tiv­i­ty, real time feed­back and ana­lyt­ics will explode.”

    6.  Assess

    The inten­tion of assess­ment is to deter­mine how things are going and then focus on improve­ment. The peo­ple who know the oper­a­tions the best are the ones work­ing the busi­ness. Trust your employ­ees. As you under­stand the frus­tra­tions and bar­ri­ers employ­ees encounter, there’s an oppor­tu­ni­ty to reengi­neer how to tai­lor process­es, deliv­er ser­vices, and pro­vide prod­ucts to sup­port the chang­ing needs of the customer.

    7.  Adjust

    When you iden­ti­fy what’s work­ing and what needs to be changed – act with a sense of urgency to make the nec­es­sary changes. The orga­ni­za­tions who adapt are the ones who have the great­est longevi­ty. Mar­ket changes are con­stant and the abil­i­ty to under­stand what’s hap­pen­ing and move toward what will occur in the future is not only admirable, but nec­es­sary for sustainability.

    It’s obvi­ous how these steps attract peo­ple with desired tal­ents and atti­tudes to help advance your orga­ni­za­tion, but how will these same actions repel those who don’t align? When there’s con­sis­tent rein­force­ment of the cul­ture, those who don’t fit will have a sense that your com­pa­ny just isn’t the right place for them, like try­ing to fit into a jack­et that is too small or too large. This will be true for cur­rent employ­ees and poten­tial employees.

    Not get­ting the results you want? Con­sid­er revis­it­ing these actions – one step at a time.

    How to Be a Magnetic Organization

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Are they serious about Single Payer? It appears to be the case… | CA Benefit Advisors

    July 12, 2017

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    It’s not just Cal­i­for­nia, but a num­ber of states are look­ing to find a solu­tion to the “prob­lem” sup­pos­ed­ly caused by The Afford­able Care Act.  The ACA didn’t cause the prob­lems – it mere­ly rode the coat­tails of prob­lems that have always exist­ed.  Some blame the insur­ance com­pa­nies, but in fact while they don’t real­ly help they also are not the cause – costs are up, thus rates are up, and car­ri­ers have no appar­ent han­dle on any of this.  Will the gov­ern­ment?  At least car­ri­ers are dri­ven by a prof­it motive (even the non­prof­its) while the gov­ern­ment is dri­ven more by social motives which, of them­selves, aren’t bad, but they can be so inclu­sive as to dri­ve costs up even more as they accom­mo­date all the claims and demands made on the sys­tem.  The alter­na­tive, of course, is that the gov­ern­ment is less accom­mo­dat­ing, in which case you have a sit­u­a­tion with cost con­trols that can’t be appealed and no option if you don’t like them.

    OK, here are the basics in Cal­i­for­nia – the Sen­ate has have passed a bill but now they have to fig­ure how to pay for it (that means replac­ing pre­mi­ums with tax­es).  Ini­tial esti­mates are a sys­tem cost of $400 bil­lion, which we ain’t got.  There are pro­po­nents who counter, how­ev­er, that the amount of mon­ey that will be saved from installing a Sin­gle Pay­er sys­tem will coun­ter­act these costs – but how?  Thus cost is the ulti­mate conundrum…and will deter­mine how, if or how well a Sin­gle Pay­er sys­tem may work here.

    Oh, and the bill is only twen­ty pages…the Afford­able Care Act was 2,000 (to start).  So…

  • TeleMedicine | CA Benefit Advisors

    July 7, 2017

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    It’s not sur­pris­ing that 2017 stands to be the year many will have an expe­ri­ence to share using a Telemed­i­cine or a Vir­tu­al Doc­tor ser­vice. With cur­rent mar­ket trends, gov­ern­ment reg­u­la­tions, and chang­ing eco­nom­ic demands, it’s fast becom­ing a more pop­u­lar alter­na­tive to tra­di­tion­al health­care vis­its.  And, as health­care costs con­tin­ue to rise and there are more strate­gic pric­ing options and dig­i­tal mod­els avail­able to users, the appeal for con­sumers, self-insured employ­ers, health sys­tems and health plans to jump on board is significant.

    Watch this short video to learn more.

     

  • A Country Polarized? Make Sure Your Office Isn’t | CA Benefit Advisors

    July 6, 2017

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    One of the lat­est things trend­ing right now in busi­ness is the impor­tance of office cul­ture. When every­one in the office is work­ing well togeth­er, pro­duc­tiv­i­ty ris­es and effi­cien­cy increas­es. Nat­u­ral­ly, the oppo­site is true when employ­ees do not work well togeth­er and the cor­po­rate cul­ture suf­fers. So, what are these bar­ri­ers and what can you do to avoid them?

    Accord­ing to an arti­cle titled, “8 ways to ruin an office cul­ture,” in Employ­ee Ben­e­fit News, the ways to kill cor­po­rate cul­ture may seem intu­itive, but that doesn’t mean they still don’t hap­pen. Here’s what orga­ni­za­tions SHOULD do to improve their cor­po­rate culture.

    Pro­vide pos­i­tive employ­ee feed­back. While it’s easy to crit­i­cize, and point­ing out employ­ees’ mis­takes can often help them learn to not repeat them, it’s just as impor­tant to rec­og­nize suc­cess and praise an employ­ee for a job well done. An “attaboy/attagirl” can real­ly boost someone’s spir­its and let them know their work is appreciated.

    Give cred­it where cred­it is due. If an assis­tant had the bright idea, if a sub­or­di­nate did all the work, or if a con­sul­tant dis­cov­ered the solu­tion to a prob­lem, then he or she should be pub­licly acknowl­edged for it. It doesn’t mat­ter who super­vised these peo­ple, to the vic­tor go the spoils. If some­one had the guts to speak up, then he or she should get the glo­ry. Theft is wrong, and it’s just as wrong when you take someone’s idea, or hard work, and claim it as your own.

    Sim­i­lar­ly, lis­ten to all ideas from all lev­els with­in the com­pa­ny. Every employ­ee, regard­less of their posi­tion on the cor­po­rate lad­der, likes to feel that their con­tri­bu­tions mat­ter. From the C‑suite, all the way down to the interns, a gen­uine­ly good idea is always worth inves­ti­gat­ing regard­less of whether the per­son who sub­mit­ted the idea has an Ivy League degree or not. Fur­ther­more, some­times it takes a dif­fer­ent per­spec­tive – like one from an employ­ee on a dif­fer­ent management/subordinate lev­el – to see the best way to resolve an issue.

    Fos­ter team­work because many hands make light work. Or, as I like to say, com­pe­ti­tion breeds con­tempt. You com­pete to get your job, you com­pete exter­nal­ly against oth­er com­pa­nies, and you may even com­pete against your peers for an award. You shouldn’t have to com­pete with your own co-work­ers. The win­ner of that com­pe­ti­tion may not nec­es­sar­i­ly be the best per­son and it will often have neg­a­tive con­se­quences in terms of trust.

    Get rid of unpro­duc­tive employ­ees. One way to sti­fle inno­va­tion and hurt morale is by hav­ing an employ­ee who doesn’t do any work while every­one else is either pick­ing up the slack, or cov­er­ing for that person’s duties. Some­times it’s nec­es­sary to prune the branches.

    Let employ­ees have their pri­va­cy – espe­cial­ly on social media. As long as an employ­ee isn’t con­duct­ing per­son­al busi­ness on com­pa­ny time, there shouldn’t be any­thing wrong with an employ­ee updat­ing their social media accounts when they’re “off the clock.” In addi­tion, as long as employ­ees aren’t divulging com­pa­ny secrets, or pro­vid­ing oth­er cor­po­rate com­men­tary that runs afoul of local, state, or fed­er­al laws, then there’s no rea­son to mon­i­tor what they post.

    Pro­mote a healthy work-life bal­ance. Yes, employ­ees have fam­i­lies, they get sick, or they just need time away from the work­place to de-stress. And while there will always be times when extra hours are need­ed to fin­ish a project, it shouldn’t be stan­dard oper­at­ing pro­ce­dure at a com­pa­ny to insist that employ­ees sac­ri­fice their time.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • The CBO and the JCT weigh in – acronyms determine fate of the American Health Care Act | CA Benefit Advisors

    July 5, 2017

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    Tweets began ear­ly after the CBO and JCT pub­lished their joint find­ings about the long term effects of the AHCA as pro­posed by the House (the Sen­ate has yet to con­jure up a vision).  They do say that there will be sav­ings (most­ly due to changes in sub­si­dies) of $32 bil­lion net.  The tax cred­its will off­set some of the “loss­es” expect­ed in cov­er­age but over­all they are deal­ing with some huge num­bers — $1.11 tril­lion in reduced direct spend­ing (tax sav­ings and a change in Med­ic­aid) vs. a rev­enue reduc­tion (tax cuts) of $992 bil­lion.  What if their cal­cu­la­tions are off just a few per­cent­age points?

    The non­group mar­ket is expect­ed to remain sta­ble, even in those states that request waivers from mar­ket regulations…until 2020, after which they expect some insta­bil­i­ty in that mar­ket.  There are still a lot of assump­tions, includ­ing the idea that younger peo­ple will buy insurance

    more often (with­out a man­date?) and that many states would make mod­er­ate changes to mar­ket reg­u­la­tions.  The biggest poten­tial prob­lem, and again sub­ject to a lot of math with which many already dis­agree, is that 23 mil­lion more Amer­i­cans would be unin­sured under the AHCA.

  • What Qualifying Events Trigger COBRA? | CA Benefit Advisors

    June 30, 2017

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    The Con­sol­i­dat­ed Omnibus Bud­get Rec­on­cil­i­a­tion Act of 1985 (COBRA) requires employ­ers to offer cov­ered employ­ees who lose their health ben­e­fits due to a qual­i­fy­ing event to con­tin­ue group health ben­e­fits for a lim­it­ed time at the employee’s own cost. Per reg­u­la­tion, qual­i­fy­ing events are spe­cif­ic events that cause or trig­ger an indi­vid­ual to lose health cov­er­age. The type of qual­i­fy­ing event deter­mines who the qual­i­fied ben­e­fi­cia­ries are and the max­i­mum length of time a plan must offer con­tin­u­a­tion cov­er­age. A group health plan may pro­vide longer peri­ods of con­tin­u­a­tion cov­er­age beyond the max­i­mum 18 or 36 months required by law.

    There are sev­en trig­ger­ing events that are qual­i­fy­ing events for COBRA cov­er­age if they result in loss of cov­er­age for the qual­i­fied ben­e­fi­cia­ries, which may include the cov­ered employ­ee, the employee’s spouse, and depen­dent children.

    Triggering event plus loss of coverage equals COBRA coverage

    The fol­low­ing quick ref­er­ence chart indi­cates the qual­i­fy­ing event, the indi­vid­ual who is enti­tled to elect COBRA, and the max­i­mum length of COBRA con­tin­u­a­tion coverage.

    COBRA qualifying events

    For an exten­sive dis­cus­sion of each qual­i­fy­ing event and the con­di­tions when it is not a trig­ger­ing event (includ­ing exam­ples), request UBA’s Com­pli­ance Advi­sor, “What Qual­i­fy­ing Events Trig­ger COBRA?’.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

     

  • Just when you thought things weren’t complicated enough – let’s do Single Payer | CA Benefit Advisors

    June 30, 2017

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    Everyone’s favorite solu­tion.  Elim­i­nate the insur­ance car­ri­ers and health care reform, the lega­cy of Pres­i­dent Oba­ma and the idea of free mar­ket enter­prise being able to work with health cov­er­age and you have the stage set for…a gov­ern­ment run pro­gram.  Bernie Sanders pro­posed it, and he wasn’t the first, but it’s not ready for prime time.  Region­al­ly, how­ev­er, Cal­i­for­nia has always want­ed to pro­mote it, even if they were the only one who would have it.  Stephen Short­ell of the UC School of Pub­lic Health says “sin­gle pay­er has its pros and cons, but if it’s built on the foun­da­tion of fee for ser­vice (doc­tors paid as they pro­vide care) it will be a dis­as­ter.  It would be a huge step back­wards in deliv­er­ing health care”  Of course, the oth­er chal­lenge is that the esti­mat­ed cost of the bill would be $400 bil­lion – a new study refutes this, of course, with fund­ing pro­vid­ed by the side favor­ing sin­gle pay­er, so in the end…who knows?  Except are you sure you want the gov­ern­ment run­ning this thing?

  • Meanwhile, as the Federal government was doing nothing…California passed some laws | CA Benefit Advisors

    June 27, 2017

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    Employ­ment Pro­tec­tions for Vic­tims of Domes­tic Vio­lence, Sex­u­al Assault or Stalking

    July 1, 2017 – groups of 25 or more employ­ees – must pro­vide spe­cif­ic infor­ma­tion in writ­ing to new employ­ees upon hire and to oth­ers upon request of their rights to take leave with regard to being a vic­tim of domes­tic vio­lence, sex­u­al assault or stalk­ing.  The Labor Com­mis­sion­er is to devel­op a form for mak­ing this request

    Pro­tec­tion for Patients from Sur­prise Med­ical Bills

    July 1, 2017 – patients who receive care in “in net­work” facil­i­ties will have to pay only in net­work cost shar­ing.  The law also says that health plans pay non con­tract­ing health care providers the plan’s aver­age con­tract­ed rate or 125% of the Medicare rate, whichev­er is greater.

    Com­ment – not much effect here as the aver­age con­tract­ed rate is high­er than 125% of Medicare – it is still a major mis­take to see some­one not on the provider list due to the severe cut­backs in pay­ment allowance (the patient always pays the dif­fer­ence between the billed charges and the allowed amount) and, as with many con­tracts, the sep­a­rate deductible and co insur­ance tracking.

    San Fran­cis­co – Employ­er Paid Parental Leave

    July 1, 2017 – groups of 35 or more employ­ees – must pro­vide six weeks of paid parental leave Must pay eli­gi­ble employ­ees 45% of week­ly gross wages up to a max­i­mum of $924 per week Cap based on the Cal­i­for­nia Paid Fam­i­ly Leave Act which shows 55% and $1,129 per week For part time and tem­po­rary as well as full time – must be employed at least 180 days To deter­mine eli­gi­bil­i­ty, employ­ers use a three month “look back” peri­od Employ­er can require employ­ees to use up to 2 weeks of unused accrued vaca­tion first This vaca­tion time can be count­ed toward the six week paid parental leave period

    Eli­gi­ble employ­ees must also work at least 8 hours per week in San Fran­cis­co, with at least 40% of their week­ly hours in San Fran­cis­co and be eli­gi­ble for Cal­i­for­nia Paid Leave

  • It May not be a law, but Trump is still getting his way | CA Benefit Advisors

    June 26, 2017

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    The rise of the Trump Ryan express may have slowed, as the Sen­ate sorts its issues, but that doesn’t mean the Pres­i­dent doesn’t have an oppor­tu­ni­ty to change the law.  The Admin­is­tra­tion has now pro­posed that, begin­ning in 2018, small busi­ness­es would no longer be able to enroll work­ers in health insur­ance plans through the fed­er­al exchange.  Not too sur­pris­ing, since it has not been a big win­ner since its incep­tion, but still…

  • AHCA and the Preexisting Conditions Debate—What Employers Can Do During Uncertainty | CA Benefit Advisors

    June 22, 2017

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    Pre­ex­ist­ing con­di­tions. While it’s no doubt this term has been a hot top­ic in recent months—and notably misconstrued—one thing has not changed; insur­ers can­not deny cov­er­age to any­one with a pre­ex­ist­ing con­di­tion.  Now that House Res­o­lu­tion 1628 has moved to the Sen­ate floor, what can employ­ers and indi­vid­u­als alike expect? If passed by the Sen­ate as is and signed into law; some pro­vi­sions will take place as ear­ly as 2019—possibly 2018 for spe­cial enroll­ment cas­es. It’s instru­men­tal for com­pa­nies to gear up now with a plan on how to tack­le open enroll­ment; regard­less of whether your com­pa­ny offers med­ical cov­er­age or not.

    Under the cur­rent pro­posed Amer­i­can Health Care Act (AHCA) insur­ance com­pa­nies can:

    • Price pre­mi­ums based on health care status/age. The AHCA will pro­vide “con­tin­u­ous cov­er­age” pro­tec­tions to guar­an­tee those insured are not charged more than the stan­dard rate as long as they do not have a break in cov­er­age. How­ev­er, insur­ers will be allowed to under­write cer­tain poli­cies for those that do lapse—hence charg­ing up to 30% more for a pre­ex­ist­ing con­di­tion if cov­er­age laps­es for more than 63 days. This is more com­mon than not, espe­cial­ly for those who are on a leave of absence for ill­ness or need exten­sive treat­ment. In addi­tion, under cur­rent law, insur­ers are only allowed to charge indi­vid­u­als 50 and old­er 3 times as much than those under this age thresh­old. This ratio will increase 5:1 under AHCA.
    • Under the ACA’s cur­rent law employ­ers must pro­vide cov­er­age for 10 essen­tial health care ben­e­fits. Under AHCA, begin­ning as ear­ly as 2020, insur­ers will allow states to man­date what they con­sid­er essen­tial ben­e­fit require­ments. This could lim­it cov­er­age offered to indi­vid­u­als and with­in group plans by elim­i­nat­ing high cost care like men­tal health and sub­stance abuse. Not that it’s like­ly, but large employ­ers could even­tu­al­ly opt out whether they want to pro­vide insur­ance and/or choose the types of cov­er­age they will pro­vide to their employees.

    It’s impor­tant to note that states must apply for waivers to increase the ratio on insur­ance pre­mi­ums due to age, and deter­mine what they will cov­er for essen­tial health ben­e­fits. In order to have these waivers grant­ed, they would need to pro­vide exten­sive details on how doing so will help their state and the marketplace.

    So what can employ­ers do mov­ing for­ward? It’s not too soon to think about chang­ing up your ben­e­fits pack­age as open enroll­ment approach­es, and edu­cat­ing your­self and your staff on AHCA and what resources are out there if you don’t offer health coverage.

    • Make a vari­ety of sup­ple­men­tal tools avail­able to your employ­ees. Antic­i­pate the com­ing changes by offer­ing or adding more sup­ple­men­tal insur­ance and tools to your ben­e­fits pack­age come open enroll­ment. Vol­un­tary work­site ben­e­fits, such as Can­cer, Crit­i­cal Ill­ness, and Acci­dent Insur­ance han­dle a vari­ety of ser­vices at no out-of-pock­et cost to the employ­er. HSA’s FSA’s and HRA’s are also valu­able sup­ple­men­tal tools to pro­vide your employ­ees if you’re able to do so. Along with the changes list­ed above, the AHCA has pro­posed to also increase the con­tri­bu­tion amounts in these plans and will allow these plans to cov­er Over-the-Counter (OTC) medications.
    • Con­tin­ue to cus­tomize well­ness pro­grams. Most com­pa­nies offer well­ness pro­grams for their employ­ees. Employ­ers that pro­vide this option should con­tin­ue advanc­ing in this area. Address­ing the spe­cif­ic needs of your employ­ees and pro­vid­ing well­ness through var­i­ous plat­forms will result in the great­est return on invest­ment; and health­i­er employ­ees to boot. Cou­ple this with fre­quent eval­u­a­tions from your staff on your cur­rent pro­gram to deter­mine effec­tive­ness and keep your well­ness pro­grams on point.
    • Edu­cate, edu­cate, educate—through tech­nol­o­gy. Regard­less if you employ 10 or 10,000, under­stand­ing ben­e­fit options is vital for your employ­ees; what you have to offer them and what they may need to know on their own. Dig­i­tal plat­forms allow indi­vid­u­als to man­age their health­care ben­e­fits and stay in the know with valu­able resources at their fin­ger­tips. There’s no lim­it on the medi­ums avail­able to edu­cate your employ­ees on upcom­ing changes. Part­ner­ing with a strong ben­e­fit agency to max­i­mize these resources and keep your employ­ees “in the know” dur­ing a con­stant­ly chang­ing insur­ance mar­ket is a great way to start.

  • How much are we really paying for medications? Is there a prescription for this mess? | CA Benefit Advisors

    June 19, 2017

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    Anthem Blue Cross, the biggest cus­tomer of Express Scripts, has changed their sup­pli­er. What is inter­est­ing is that Express Scripts offered Anthem $1 bil­lion in price con­ces­sions. Does this mean they were over­charg­ing by at least $1 bil­lion in the first place?  And that Anthem, which mere­ly pass­es this on to its cus­tomers, approved of this?  Why did it take so long for Anthem to make a change to a less expen­sive provider?  And why is there such a gap between the new provider and Express Scripts?  Are we deal­ing with qual­i­ty issues? So many ques­tions, and so much money…

  • Arrow Benefits Group gives $100K for North Bay businesses’ AEDs

    June 14, 2017

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    The lat­est effort to reduce Sono­ma Coun­ty deaths from car­diac arrest comes from a Petaluma com­pa­ny that recent­ly pledged $100,000 to pur­chase auto­mat­ed exter­nal defib­ril­la­tors for North Bay busi­ness­es.  Sta­cy Gib­bons, exec­u­tive direc­tor of Amer­i­can Heart Asso­ci­a­tion North Bay, called the move by Arrow Ben­e­fits Group “unprece­dent­ed.”

    Arrow Ben­e­fits Group’s first for­ay into reduc­ing car­diac arrest deaths was in late 2014, when the com­pa­ny asked the Petaluma Health Care Dis­trict to teach its employ­ees hands-only CPR.

    Read entire arti­cle here.

  • New HSA Limits – unless the Trump administration decides to raise and make you flush | CA Benefit Advisors

    June 14, 2017

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    New lim­its for these accounts in 2018 will be $3,450 for a sin­gle cov­ered employ­ee and $6,900 for an employ­ee cov­ered with depen­dents.  There is con­sid­er­a­tion of oth­er lim­its in the Amer­i­can Health Care Act, recent­ly passed by the House of Rep­re­sen­ta­tives, but it is not much dif­fer­ent.  There are some expand­ed pro­vi­sions there, as well, but it is not clear whether the Sen­ate will come up with a dif­fer­ent ver­sion and if the joint com­mit­tee will come up with an accept­able com­pro­mise, and if Pres­i­dent Trump will sign it, etc. etc.

  • Answers to the Top 4 Questions about Section 105(h) Nondiscrimination Testing | CA Benefit Advisors

    June 12, 2017

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    Under Inter­nal Rev­enue Code Sec­tion 105(h), a self-insured med­ical reim­burse­ment plan must pass two nondis­crim­i­na­tion tests. Fail­ure to pass either test means that the favor­able tax treat­ment for high­ly com­pen­sat­ed indi­vid­u­als who par­tic­i­pate in the plan will be lost. The Sec­tion 105(h) rules only affect whether reim­burse­ment (includ­ing pay­ments to health care providers) under a self-insured plan is taxable.

    When Sec­tion 105(h) was enact­ed, its nondis­crim­i­na­tion test­ing applied sole­ly to self-insured plans. Under the Patient Pro­tec­tion and Afford­able Care Act (ACA), Sec­tion 105(h) also applies to ful­ly-insured, non-grand­fa­thered plans. How­ev­er, in late 2010, the gov­ern­ment delayed enforce­ment of Sec­tion 105(h) against ful­ly-insured, non-grand­fa­thered plans until the first plan year begin­ning after reg­u­la­tions are issued. To date, no reg­u­la­tions have been issued so there is cur­rent­ly no penal­ty for noncompliance.

    Prac­ti­cal­ly speak­ing, if a plan treats all employ­ees the same, then it is unlike­ly that the plan will fail Sec­tion 105(h) nondis­crim­i­na­tion testing.

    What Is a Self-Insured Med­ical Reim­burse­ment Plan?

    Sec­tion 105(h) applies to a “self-insured med­ical reim­burse­ment plan,” which is an employ­er plan to reim­burse employ­ees for med­ical care expens­es list­ed under Code Sec­tion 213(d) for which reim­burse­ment is not pro­vid­ed under a pol­i­cy of acci­dent or health insurance.

    Com­mon self-insured med­ical reim­burse­ment plans are self-fund­ed major med­ical plans, health reim­burse­ment arrange­ments (HRAs), and med­ical expense reim­burse­ment plans (MERPs). Many employ­ers who spon­sor an insured plan may also have a self-insured plan; that self-insured plan is sub­ject to the Sec­tion 105 non-dis­crim­i­na­tion rules. For exam­ple, many employ­ers offer a ful­ly insured major med­ical plan that is inte­grat­ed with an HRA to reim­burse expens­es incurred before a par­tic­i­pant meets the plan deductible.

    What If the Self-Insured Med­ical Reim­burse­ment Plan Is Offered Under a Cafe­te­ria Plan?

    A self-insured med­ical reim­burse­ment plan (self-insured plan) can be offered out­side of a cafe­te­ria plan or under a cafe­te­ria plan. Sec­tion 105(h) nondis­crim­i­na­tion test­ing applies in both cases.

    Regard­less of grand­fa­thered sta­tus, if the self-insured plan is offered under a cafe­te­ria plan and allows employ­ees to pay pre­mi­ums on a pre-tax basis, then the plan is still sub­ject to the Sec­tion 125 nondis­crim­i­na­tion rules. The cafe­te­ria plan rules affect whether con­tri­bu­tions are tax­able; if con­tri­bu­tions are tax­able, then the Sec­tion 105(h) rules do not apply.

    What Is the Pur­pose of Nondis­crim­i­na­tion Testing?

    Con­gress per­mits self-insured med­ical reim­burse­ment plans to pro­vide tax-free ben­e­fits. How­ev­er, Con­gress want­ed employ­ers to pro­vide these tax-free ben­e­fits to their reg­u­lar employ­ees, not just to their exec­u­tives. Nondis­crim­i­na­tion test­ing is designed to encour­age employ­ers to pro­vide ben­e­fits to their employ­ees in a way that does not dis­crim­i­nate in favor of employ­ees who are high­ly paid or high ranking.

    If a plan fails the nondis­crim­i­na­tion test­ing, the reg­u­lar employ­ees will not lose the tax ben­e­fits of the self-insured med­ical reim­burse­ment plan and the plan will not be inval­i­dat­ed. How­ev­er, high­ly paid or high rank­ing employ­ees may be adverse­ly affect­ed if the plan fails testing.

    What Are the Two Nondis­crim­i­na­tion Tests?

    The two nondis­crim­i­na­tion tests are the Eli­gi­bil­i­ty Test and Ben­e­fits Test.

    The Eli­gi­bil­i­ty Test answers the basic ques­tion of whether there are enough reg­u­lar employ­ees ben­e­fit­ting from the plan. Sec­tion 105(h) pro­vides three ways of pass­ing the Eli­gi­bil­i­ty Test:

    1. The 70% Test – 70 per­cent or more of all employ­ees ben­e­fit under the plan.
    2. The 70% / 80% Test – At least 70 per­cent of employ­ees are eli­gi­ble under the plan and at least 80 per­cent or more of those eli­gi­ble employ­ees par­tic­i­pate in the plan.
    3. The Nondis­crim­i­na­to­ry Clas­si­fi­ca­tion Test – Employ­ees qual­i­fy for the plan under a clas­si­fi­ca­tion set up by the employ­er that is found by the IRS not to be dis­crim­i­na­to­ry in favor of high­ly com­pen­sat­ed individuals.

    The Ben­e­fits Test answers the basic ques­tion of whether all par­tic­i­pants are eli­gi­ble for the same benefits.

    For infor­ma­tion on who is a high­ly com­pen­sat­ed indi­vid­ual, how the tests are applied, when to test, and what to do if you fail the test (includ­ing excess reim­burse­ment exam­ples), request UBA’s Com­pli­ance Advi­sor, “Sec­tion 105(h) Nondis­crim­i­na­tion Test­ing”.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Speaking of which…yes, you heard the news about the American Health Care Act | CA Benefit Advisors

    June 9, 2017

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    The first vote was almost in and then was not in and then there was anoth­er vote and then and then…they sent it to the Sen­ate, where the process will start again.  So don’t change your plans at this point – Con­gress hasn’t and it may not do so for a while.  Until then, the Afford­able Care Act remains the law of the land and will through 2017.

  • HSAs and Employer Responsibilities | CA Benefit Advisors

    June 2, 2017

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    It’s no secret that one of the pri­ma­ry agen­da items of the new Repub­li­can admin­is­tra­tion is to repeal the Patient Pro­tec­tion and Afford­able Care Act (ACA) and to sign into law a plan that they feel will be more effec­tive in man­ag­ing health care costs. Their ini­tial attempt at a new plan, called the Amer­i­can Health Care Act (AHCA), includ­ed an increased focus on lever­ag­ing health sav­ings accounts (HSAs) to accom­plish this goal. As the plan gets debat­ed and mod­i­fied in Con­gress, we do not know whether the role of HSAs will be expand­ed or not, but they will con­tin­ue to be a part of the land­scape in some shape or form.

    HSAs first came into exis­tence in 2003 and they have been gain­ing momen­tum as a way to deal with increas­ing health care costs ever since. If you, as a plan spon­sor, do not already offer a health plan com­pat­i­ble with an HSA, chances are you’ve at least dis­cussed them dur­ing your annu­al plan reviews. So, what exact­ly is an HSA and what is an employer’s respon­si­bil­i­ty relat­ing to one?

    An HSA is a tax-favored account estab­lished by an indi­vid­ual to pay for cer­tain med­ical expens­es incurred by account hold­ers and their spous­es and tax depen­dents. Any­one can make a con­tri­bu­tion to an eli­gi­ble Individual’s HSA. This includes the individual’s employ­er. How­ev­er, if employ­ers con­tribute to par­tic­i­pant HSAs, employ­ers must:

    1. Ensure their health plan meets high-deductible health plan (HDHP) requirements,
    2. Deter­mine eligibility,
    3. Estab­lish con­tri­bu­tion method,
    4. Pro­vide W‑2 report­ing, and
    5. Con­firm employ­er involve­ment in the HSA does not cre­ate an ERISA plan, or cause a pro­hib­it­ed transaction.

    High-Deductible Health Plan Requirements

    Plan spon­sors should make sure their plan meets cer­tain HDHP require­ments before mak­ing con­tri­bu­tions to par­tic­i­pants’ HSAs.

    Char­ac­ter­is­tics of an HDHP

    An HDHP is a health plan that has statu­to­ri­ly pre­scribed min­i­mum deductible and max­i­mum out-of-pock­et lim­its. The lim­its are adjust­ed annu­al­ly for inflation.

    For exam­ple, for 2017, the lim­its for self-only cov­er­age are:

    • Min­i­mum Deductible: $1,300
    • Max­i­mum Out-of-Pock­et: $6,550

    The lim­its for fam­i­ly cov­er­age (i.e., any cov­er­age oth­er than self-only cov­er­age) are twice the applic­a­ble amounts for self-only cov­er­age. The lim­its are adjust­ed annu­al­ly for infla­tion and, for a giv­en year, are pub­lished by the IRS no lat­er than June 1 of the pre­ced­ing year. In addi­tion, an HDHP can­not pay any ben­e­fits until the deductible is met. The only excep­tion to this rule is ben­e­fits for pre­ven­tive care.

    Eligibility

    Eli­gi­ble Indi­vid­u­als can make or receive con­tri­bu­tions to their HSAs. A per­son is an eli­gi­ble indi­vid­ual if he or she is cov­ered by an HDHP and is not cov­ered by any oth­er plan that pays med­ical ben­e­fits, sub­ject to cer­tain exceptions.

    Employer Contribution Methods

    Employ­ers that con­tribute to the HSAs of their employ­ees may do so inside or out­side of a cafe­te­ria (Sec­tion 125) plan. The con­tri­bu­tion rules are dif­fer­ent for each option.

    Con­tri­bu­tions Out­side of a Cafe­te­ria Plan

    When con­tribut­ing to any employee’s HSA out­side of a cafe­te­ria plan, an employ­er must make com­pa­ra­ble con­tri­bu­tions to the HSAs of all com­pa­ra­ble par­tic­i­pat­ing employees.

    Con­tri­bu­tions Made Through a Cafe­te­ria Plan

    HSA con­tri­bu­tions made through a cafe­te­ria plan do not have to sat­is­fy the com­pa­ra­bil­i­ty rules, but are sub­ject to the Sec­tion 125 non-dis­crim­i­na­tion rules for cafe­te­ria plans. HSA employ­er con­tri­bu­tions will be treat­ed as being made through a cafe­te­ria plan if the cafe­te­ria plan per­mits employ­ees to make pre-tax salary reduc­tion contributions.

    Employer HSA Contribution Amounts

    Con­tri­bu­tions from all sources can­not exceed cer­tain annu­al lim­its pre­scribed by the IRS. Although employ­er con­tri­bu­tions can­not exceed the applic­a­ble lim­its, employ­ers are only respon­si­ble for deter­min­ing the fol­low­ing with respect to an employee’s eli­gi­bil­i­ty and max­i­mum annu­al con­tri­bu­tion lim­it on HSA contributions:

    • Whether the employ­ee is cov­ered under an HDHP or low-deductible health plan, or plans (includ­ing health flex­i­ble spend­ing accounts (FSAs) and health reim­burse­ment arrange­ments (HRAs) spon­sored by that employ­er; and
    • The employee’s age (for catch-up con­tri­bu­tions). The employ­er may rely on the employee’s rep­re­sen­ta­tion as to his or her date of birth.

    When employ­ers con­tribute to the HSAs of their employ­ees and retirees, the amount of the con­tri­bu­tion is exclud­able from the eli­gi­ble individual’s income and is deductible by the employ­er pro­vid­ed they do not exceed the applic­a­ble lim­it. With­hold­ing for income tax, FICA, FUTA, or RRTA tax­es is not required if, at the time of the con­tri­bu­tion, the employ­er rea­son­ably believes that con­tri­bu­tion will be exclud­able from the employee’s income.

    Employer Reporting Requirements

    An employ­er must report the amount of its con­tri­bu­tion to an employee’s HSA in Box 12 of the employee’s W‑2 using code W.

    Design and Operational Considerations

    Employ­ers should make sure that their involve­ment in the HSA does not cre­ate an ERISA plan, or cause them to become involved in a pro­hib­it­ed trans­ac­tion. To ensure that con­tri­bu­tions will not cause the health plan to become sub­ject to ERISA, cer­tain restric­tions exist that employ­ers should be aware of and fol­low. Employ­er con­tri­bu­tions to an HSA will not cause the employ­er to have estab­lished a health plan sub­ject to ERISA provided:

    • The estab­lish­ment of the HSA is com­plete­ly vol­un­tary on the part of the employ­ees; and
    • The employ­er does not: 
      • lim­it the abil­i­ty of eli­gi­ble indi­vid­u­als to move their funds to anoth­er HSA or impose con­di­tions on uti­liza­tion of HSA funds beyond those per­mit­ted under the code;
      • make or influ­ence the invest­ment deci­sions with respect to funds con­tributed to an HSA;
      • rep­re­sent that the HSA is an employ­ee wel­fare ben­e­fit plan estab­lished or main­tained by the employer;
      • or receive any pay­ment or com­pen­sa­tion in con­nec­tion with an HSA.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Factor Emerging Trends, Generational Needs Into Wellness Programs | CA Benefit Advisors

    May 30, 2017

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    Your well­ness pro­gram seems to have it all – bio­met­ric screen­ings, lunch and learns, and weight loss chal­lenges. So, why do you strug­gle with engage­ment, or to see any real results? While tra­di­tion­al well­ness com­po­nents are still a large part of plans today, emerg­ing trends, cou­pled with gen­er­a­tional dif­fer­ences, make for chal­lenges when design­ing an impact­ful program.

    As well­ness pro­grams begin to be viewed as a part of the tra­di­tion­al ben­e­fits pack­age, the key dif­fer­en­tia­tor is cre­at­ing a cul­ture and envi­ron­ment that sup­ports over­all health and well-being. Vis­i­ble engage­ment and sup­port from front-line and senior lead­er­ship dri­ves cul­ture change. By pri­or­i­tiz­ing health through con­sis­tent com­mu­ni­ca­tion, resource allo­ca­tion, per­son­nel del­e­ga­tion, and role modeling/personal health pro­mo­tion prac­tices, employ­ers gain the trust of their employ­ees and devel­op an envi­ron­ment sit­u­at­ed around well­ness. When employ­ees rec­og­nize the impor­tance of well­ness in the over­all com­pa­ny strat­e­gy and cul­ture, and feel sup­port­ed in their per­son­al goals, healthy work­ing envi­ron­ments begin to devel­op, result­ing in health­i­er employees.

    Look­ing beyond tra­di­tion­al well­ness top­ics and offer­ing pro­grams that meet the goals of your employ­ees also leads to high­er engage­ment. The Amer­i­can Heart Asso­ci­a­tion CEO Round­table Employ­ee Health Sur­vey 2016 showed improv­ing finan­cial health, get­ting more sleep, and reduc­ing stress lev­els are key focus areas for employ­ees as part of over­all well­ness. More so, employ­ees see the ben­e­fits of unplug­ging and men­tor­ing, two new top­ics  in the area of over­all well-being. While most employ­ers feel their employ­ees are over sur­veyed, com­plet­ing an employ­ee needs or pref­er­ence sur­vey will ensure your pro­grams align with your employ­ees’ health and well­ness goals – ulti­mate­ly lead­ing to bet­ter engagement.

    Well­ness pro­grams are not immune to gen­er­a­tional dif­fer­ences, like most oth­er facets of busi­ness. While mil­len­ni­als are most like­ly to par­tic­i­pate and report that pro­grams had an over­all impact, they pre­fer the use of apps and track­ers along with social strate­gies and team chal­lenges. Con­ve­nience and senior lev­el sup­port are also impor­tant with­in this group. Gen­er­a­tion X and baby boomers show more skep­ti­cism toward well­ness pro­grams, but are more like­ly to par­tic­i­pate when the pro­grams align with their per­son­al goals. Their over­all top health goal is weight loss. Ulti­mate­ly, address­ing the spe­cif­ic needs of your mem­ber pop­u­la­tion and pro­vid­ing well­ness through var­i­ous modal­i­ties will result in the great­est reward of investment.

    Eval­u­a­tion and data are the lynch­pins that hold a suc­cess­ful pro­gram togeth­er. Con­sis­tent eval­u­a­tion of the effec­tive­ness of pro­grams to increase par­tic­i­pa­tion, sat­is­fac­tion, phys­i­cal activ­i­ty, and pro­duc­tiv­i­ty – all while reduc­ing risk fac­tors – allow us to know if our pro­grams are hit­ting the mark and allow for addi­tion­al tai­lor­ing as needed.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

     

     

  • Why some companies offer an HRA | CA Benefit Advisors

    May 26, 2017

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    In a world of insur­ance and acronyms, the term “HRA” is thrown around a lot, but it has a vari­ety of meanings.

    HRA can mean health reim­burse­ment account, heath reim­burse­ment arrange­ment, or health risk assess­ment, and all of those mean some­thing dif­fer­ent. I want to be clear that in the fol­low­ing arti­cle I am going to be dis­cussing the use of health reim­burse­ment accounts with ful­ly-insured health plans. We can leave the oth­er mean­ings of HRA for anoth­er time.

    An HRA can be “wrapped” with a high-deductible, ful­ly-insured health plan and this can lead to sav­ings for an employ­er over offer­ing a tra­di­tion­al health plan with a low­er deductible.

    Offer­ing a high-deductible health plan and self-fund­ing, the first $2,000, or $3,000, in claims on behalf of the employ­ees can trans­late to sig­nif­i­cant sav­ings because the employ­er is tak­ing on that ini­tial risk instead of the insur­ance car­ri­er. Unlike a con­sumer-dri­ven health plan (CDHP) that has a high deductible and can be paired with a health sav­ings account (HSA) where an employ­er can con­tribute funds to an employee’s HSA account that can be used to pay for qual­i­fied med­ical expens­es, an employ­er only has to pay out of the HRA if there is a claim.

    With an HSA that is fund­ed by the employ­er, the mon­ey goes into the HSA for their employ­ees and then those funds are “owned” by the employ­ee. The employ­er nev­er sees it again. Under an HRA, if there are no claims, or not a high num­ber of claims, the employ­er keeps those unused dol­lars in their pocket.

    An HRA com­po­nent to a health plan is sub­ject to ERISA and non-dis­crim­i­na­tion rules, mean­ing every­one that is eli­gi­ble should be offered the plan, and the ben­e­fits under the HRA should be the same for every­one enrolled. It is advis­able that an HRA be admin­is­tered by a third-par­ty that pays the claims to the providers, or reim­burse plan enrollees under the terms of the plan, in order to keep employ­ees’ and their depen­dents’ med­ical infor­ma­tion pri­vate from the employ­er as to avoid poten­tial discrimination.

    The HRA com­po­nent of a health plan is essen­tial­ly self-fund­ed by the employ­er, which gives the employ­er a lot of flex­i­bil­i­ty and can be tai­lored to their spe­cif­ic needs or desired out­comes. The employ­er can choose to fund claims after the employ­ee pays the first few hun­dred dol­lars of their deductible instead of the employ­er pay­ing the claims that are ini­tial­ly sub­ject to the high deductible. An employ­er can have a step arrange­ment, for exam­ple, the employ­er pays the first $500, the employ­ee the sec­ond $500, the employ­er pays the next $500, and the employ­ee pays the final $500 of a $2,000 deductible.

    If an employ­er has a young pop­u­la­tion that is healthy, they may want to use the HRA to pay for emer­gency room vis­its and hos­pi­tal in-patient stays, but not office vis­its so they can help pro­tect their employ­ees from hav­ing to pay those “large tick­et items,” but not blow their bud­get. While an employ­er with a more sea­soned staff, or diverse pop­u­la­tion, may want to include pre­scrip­tion drugs as a cov­ered ben­e­fit under the HRA, as well as office vis­its, hos­pi­tal in-patient stays, out­pa­tient surgery, etc. Or, if an employ­er needs to look at cost-sav­ing mea­sures, they may want to exclude pre­scrip­tions from being eli­gi­ble under the HRA.

    Keep in mind, all of these ser­vices are essen­tial health ben­e­fits and would be cov­ered by the insur­ance car­ri­er under the terms of the con­tract, but an employ­er can choose not to allow the HRA to be used to pay for such ser­vices, leav­ing the enrollee to pay their por­tion of the claims. In any case, the para­me­ters of what is eli­gi­ble for reim­burse­ment from the HRA is decid­ed and out­lined at the begin­ning of the plan year and can­not be changed pri­or to the end of the plan year.

    If you are think­ing about imple­ment­ing a high-deductible health plan with an HRA for your employ­ees, be sure you are doing it as a long-term strat­e­gy. As is the case with self-fund­ing, you are going to have good years and bad years. On aver­age, a com­pa­ny will expe­ri­ence a bad, or high claims, year out of every four to five years. So, if you imple­ment your new plan and you have a bad year on the first go-round, don’t give up. Chances are the next year will be bet­ter, and you will see sav­ings over your tra­di­tion­al low-deductible plan options.

    With an HRA, you cap the amount you are going to poten­tial­ly spend for each enrollee, per year. So, you know your worst-case sce­nario. While it is extreme­ly unlike­ly that every one of your employ­ees will use the entire amount allot­ted to them, it is rec­om­mend­ed that you can absorb or han­dle the worst case sce­nario. Don’t bite off more than you can chew!

    HRA admin­is­tra­tors usu­al­ly charge a month­ly rate per enrollee for their ser­vices, and this should be account­ed for in the bud­get­ing process. Dif­fer­ent HRA third-par­ty admin­is­tra­tors have dif­fer­ent claims process­es, online plat­forms, deb­it cards, and busi­ness hours. Be sure to use one that offers the ser­vices that you want and are on budget.

    Anoth­er aspect of offer­ing a high-deductible plan with an HRA that is often over­looked is com­mu­ni­ca­tion. If an employ­ee does not know how to uti­lize their plan, it can cre­ate con­fu­sion and anger, which can hurt the over­all com­pa­ny morale. The plan has to be laid out and explained in a way that is clear, con­cise, and easy to understand.

    In some cas­es, the HRA is admin­is­tered by some­one oth­er than the insur­ance car­ri­er, and the plan admin­is­tra­tor has to make sure they enroll all plan enrollees with the car­ri­er and the third-par­ty administrator.

    The COBRA admin­is­tra­tor also has to offer the HRA as part of the COBRA pack­age, and the third-par­ty admin­is­tra­tor must com­mu­ni­cate the appro­pri­ate pre­mi­um for the HRA under COBRA. Most COBRA enrollees will not choose to enroll in the HRA with their med­ical plan, as they are essen­tial­ly self-fund­ing their deductible and plan costs through the HRA instead of pay­ing them out of their pock­et, but many plan admin­is­tra­tors make the mis­take of not offer­ing the HRA under COBRA, as it is man­dat­ed by law.

    Offer­ing a high-deductible plan with an HRA is a way for small employ­ers to save over offer­ing a low-deductible health plan, and can be a way for an employ­er to “test the waters” to see if they may want to move to a self-fund­ed plan, or lev­el-fund­ed plan, in the future.

    To any employ­er look­ing to imple­ment an HRA with a med­ical plan, you want a sea­soned advi­sor, or con­sul­tant, on your side to walk you through the costs, pros, and cons, poten­tial sav­ings, and risks. Your local UBA Part­ner Firm is a great place to start.

    For a com­pre­hen­sive chart that com­pares eli­gi­bil­i­ty cri­te­ria, con­tri­bu­tion rules, reim­burse­ment rules, report­ing require­ments, pri­va­cy require­ments, applic­a­ble fees, non-dis­crim­i­na­tion rules and oth­er char­ac­ter­is­tics of account-based plans, request UBA’s Com­pli­ance Advi­sor, “HRAs, HSAs, and Health FSAs – What’s the Dif­fer­ence?”.

    For infor­ma­tion on mod­est con­tri­bu­tion strate­gies that are still dri­ving enroll­ment in HSA and HRA plans, read our break­ing news release.

    For a detailed look at the preva­lence and enroll­ment rates among HSA and HRA plans by indus­try, region and group size, view UBA’s “Spe­cial Report: How Health Sav­ings Accounts Mea­sure Up”, to under­stand which aspects of these accounts are most suc­cess­ful, and least successful.

    For fast facts about HSA and HRA plans, includ­ing the best and worst plans, aver­age con­tri­bu­tions made by employ­ers, and indus­try trends, down­load (no form!) “Fast Facts: HSAs vs. HRAs”.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • HSAs vs. HRAs: Things Employers Should Consider | CA Benefit Advisors

    May 24, 2017

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    With health care costs and insur­ance pre­mi­ums con­tin­u­ing to rise, employ­ers are look­ing for ways to reduce their insur­ance expens­es. That usu­al­ly means increas­ing med­ical plan deductibles. Accord­ing to the lat­est UBA Health Plan Sur­vey, the aver­age in-net­work sin­gle med­ical plan deductible increased from $2,031 in 2015 to $2,127 in 2016. But shift­ing costs to employ­ees can be detri­men­tal to an employer’s efforts to attract and retain top tal­ent. Employ­ers are look­ing for solu­tions that reduce their costs while min­i­miz­ing the impact on employees.

    One way employ­ers can mit­i­gate increas­ing deductibles is by pack­ag­ing a high-deductible health plan with either a health sav­ings account (HSA) con­tri­bu­tion or a health reim­burse­ment arrange­ment (HRA). Either can be used to bridge some or all of the gap between a low­er deductible and a high­er deductible while reduc­ing insur­ance pre­mi­ums, and both offer tax ben­e­fits for employ­ers and employ­ees. How­ev­er, there are advan­tages and dis­ad­van­tages to each approach that employ­ers need to consider.

    Health Sav­ings Account (HSA) Gen­er­al Attributes

    • The employ­ee owns the account and can take it when chang­ing jobs.
    • HSA con­tri­bu­tions can be made by the employ­er or employ­ee, sub­ject to a max­i­mum con­tri­bu­tion estab­lished by the government.
    • Triple tax advan­tage – funds go in tax-free, accounts grow tax-free, and with­drawals are tax-free as long as they are for qual­i­fied expens­es (see IRS pub­li­ca­tion 502).
    • Funds may accu­mu­late for years and be used dur­ing retirement.
    • The HSA must be paired with an IRS qual­i­fied high-deductible health plan (QHDHP); not just any plan with a deductible of $1,300 or more will qualify.

    HSA Advan­tages

    • Costs are more pre­dictable as they are not relat­ed to actu­al expens­es, which can vary from year to year; con­tri­bu­tions may also be spread out through the year to improve cash flow.
    • Employ­ees become bet­ter con­sumers since there is an incen­tive to not spend the mon­ey and let it accu­mu­late. This can result in an imme­di­ate reduc­tion in claims costs for a self-fund­ed plan.
    • HSAs can be set up with few­er admin­is­tra­tion costs; usu­al­ly no admin­is­tra­tor is need­ed, and no ERISA sum­ma­ry plan descrip­tion (SPD) is needed.
    • The employ­er is not held respon­si­ble by the IRS for ensur­ing that the employ­ee is eli­gi­ble and that the con­tri­bu­tion max­i­mums are not exceeded.

    HSA Dis­ad­van­tages

    • Employ­ees can­not par­tic­i­pate if they’re also cov­ered under a non-qual­i­fied health plan, which includes Tri­care, Medicare, or even a spouse’s flex­i­ble spend­ing account (FSA).
    • Employ­ees accus­tomed to copays for office vis­its or pre­scrip­tions may be unhap­py with the ben­e­fits of the QHDHP.
    • IRS rules can be con­fus­ing; IRS penal­ties may apply if the employ­ee is inel­i­gi­ble for a con­tri­bu­tion or oth­er mis­takes are made, which might intim­i­date employees.
    • Employ­ees may for­go treat­ment to avoid spend­ing their HSA bal­ance or if they have no HSA funds available.

    Health Reim­burse­ment Arrange­ment (HRA) Gen­er­al Attributes

    • Only an employ­er can con­tribute to an HRA; employ­ees cannot.
    • The employ­er con­trols the cash until a claim is filed by the employ­ee for reimbursement.
    • HRA con­tri­bu­tions are tax deductible to the employ­er and tax-free to the employee.
    • To com­ply with the Patient Pro­tec­tion and Afford­able Care Act (ACA), an HRA must be com­bined with a group med­ical insur­ance plan that meets ACA requirements.

    HRA Advan­tages

    • HRAs offer more employ­er con­trol and flex­i­bil­i­ty on the design of the HRA and the health plan does not need to be HSA qualified.
    • The employ­er can set it up as “use it or lose it” each year, thus reduc­ing fund­ing costs.
    • An HRA is com­pat­i­ble with an FSA (not just lim­it­ed-pur­pose FSA).
    • Depend­ing on the employ­er group, HRAs can some­times be less con­fus­ing for employ­ees, par­tic­u­lar­ly if the plan design is simple.
    • HRA funds revert to the employ­er when an employ­ee leaves – which might increase employ­ee retention.

    HRA Dis­ad­van­tages

    • Self-employed indi­vid­u­als can­not par­tic­i­pate in HRA funding.
    • There is lit­tle or no incen­tive for employ­ees to con­trol uti­liza­tion since funds may not accu­mu­late from year to year.
    • More admin­is­tra­tion may be nec­es­sary – HRAs are sub­ject to ERISA and COBRA laws.
    • HRAs could raise HIPAA pri­va­cy con­cerns and cre­ate the need for poli­cies and testing.

    Both HSAs and HRAs can be of tremen­dous val­ue to employ­ers and employ­ees. As shown, there are, how­ev­er, a num­ber of con­sid­er­a­tions to deter­mine the best pro­gram and design for each sit­u­a­tion. In some cas­es, employ­ers may con­sid­er offer­ing both, allow­ing employ­ees to choose between an HSA con­tri­bu­tion and a com­pa­ra­ble HRA con­tri­bu­tion, accord­ing to their indi­vid­ual circumstances.

    For a com­pre­hen­sive chart that com­pares eli­gi­bil­i­ty cri­te­ria, con­tri­bu­tion rules, reim­burse­ment rules, report­ing require­ments, pri­va­cy require­ments, applic­a­ble fees, non-dis­crim­i­na­tion rules and oth­er char­ac­ter­is­tics of account-based plans, request UBA’s Com­pli­ance Advi­sor,  “HRAs, HSAs, and Health FSAs – What’s the Dif­fer­ence?”.

    For infor­ma­tion on mod­est con­tri­bu­tion strate­gies that are still dri­ving enroll­ment in HSA and HRA plans, read our break­ing news release.

    For a detailed look at the preva­lence and enroll­ment rates among HSA and HRA plans by indus­try, region and group size, view UBA’s “Spe­cial Report: How Health Sav­ings Accounts Mea­sure Up”, to under­stand which aspects of these accounts are most suc­cess­ful, and least successful.

    For fast facts about HSA and HRA plans, includ­ing the best and worst plans, aver­age con­tri­bu­tions made by employ­ers, and indus­try trends, down­load (no form!) “Fast Facts: HSAs vs. HRAs”.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Is Your Wellness Program Compliant with the ACA, GINA and EEOC? | CA Benefit Advisors

    May 20, 2017

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    Work­place well­ness pro­grams have increased pop­u­lar­i­ty through the years. Accord­ing to the most recent UBA Health Plan Sur­vey, 49 per­cent of firms with 200+ employ­ees offer­ing health ben­e­fits in 2016 offered well­ness pro­grams. Work­place well­ness pro­grams’ pop­u­lar­i­ty also brought con­tro­ver­sy and hefty dis­cus­sions about what works to improve pop­u­la­tion health and which pro­grams com­ply with the com­plex legal stan­dards of mul­ti­ple insti­tu­tions that have not real­ly “talked” to each oth­er in the past. To “add wood to the fire,” the Equal Employ­ment Oppor­tu­ni­ty Com­mis­sion (EEOC) made pub­lic some legal actions that shook the core of the well­ness indus­try, such as EEOC vs. Hon­ey­well Inter­na­tion­al, and EEOC vs. Ori­on Ener­gy Systems. 

    To ensure a well­ness pro­gram is com­pli­ant with the ACA, GINA and the EEOC, let’s first under­stand what each one of these insti­tu­tions are.

    The Afford­able Care Act (ACA) is a com­pre­hen­sive health­care reform law enact­ed in March 2010 dur­ing the Oba­ma pres­i­den­cy. It has three pri­ma­ry goals: to make health insur­ance avail­able to more peo­ple, to expand the Med­ic­aid pro­gram, and to sup­port inno­v­a­tive med­ical care deliv­ery meth­ods to low­er the cost of health­care over­all.1 The ACA car­ries pro­vi­sions that sup­port the devel­op­ment of well­ness pro­grams and deter­mines all rules around them.

    The Genet­ic Infor­ma­tion Nondis­crim­i­na­tion Act of 2008 (GINA) is a fed­er­al law that pro­tects indi­vid­u­als from genet­ic dis­crim­i­na­tion in health insur­ance and employ­ment. GINA relates to well­ness pro­grams in dif­fer­ent ways, but it par­tic­u­lar­ly relates to the gath­er­ing of genet­ic infor­ma­tion via a health risk assessment.

    The U.S. Equal Employ­ment Oppor­tu­ni­ty Com­mis­sion (EEOC) is a fed­er­al agency that admin­is­ters and enforces civ­il rights laws against work­place dis­crim­i­na­tion. In 2017, the EEOC issued a final rule to amend the reg­u­la­tions imple­ment­ing Title II of GINA as they relate to employ­er-spon­sored well­ness pro­gram. This rule address­es the extent to which an employ­er may offer incen­tives to employ­ees and spouses.

    Here is some advice to ensure your well­ness pro­gram is com­pli­ant with mul­ti­ple guidelines.

    1. Make sure your well­ness pro­gram is “rea­son­ably designed” and vol­un­tary – This means that your program’s main goal should be to pro­mote health and pre­vent dis­ease for all equal­ly. Addi­tion­al­ly, it should not be bur­den­some for indi­vid­u­als to par­tic­i­pate or receive the incen­tive. This means you must offer rea­son­able alter­na­tives for qual­i­fy­ing for the incen­tive, espe­cial­ly for indi­vid­u­als whose med­ical con­di­tions make it unrea­son­ably dif­fi­cult to meet spe­cif­ic health-relat­ed stan­dards. I always rec­om­mend well­ness pro­grams be as sim­ple as pos­si­ble, and before mak­ing a change or deci­sion in the well­ness pro­gram, iden­ti­fy all dif­fi­cult or unfair sit­u­a­tions that might arise from this change, and then run them by your company’s legal coun­sel and mod­i­fy the pro­gram accord­ing­ly before imple­ment­ing it. An exam­ple of a well­ness pro­gram that is NOT rea­son­ably designed is a pro­gram offer­ing a health risk assess­ment and bio­met­ric screen­ing with­out pro­vid­ing results or fol­low-up infor­ma­tion and advice. A well­ness pro­gram is also NOT rea­son­ably designed if exists mere­ly to shift costs from an employ­er to employ­ees based on their health.
    2. Do the math! – Recent rules imple­ment­ed changes in the ACA that increased the max­i­mum per­mis­si­ble well­ness pro­gram reward from 20 per­cent to 30 per­cent of the cost of self-only health cov­er­age (50 per­cent if the pro­gram includes tobac­co ces­sa­tion). Although the final rules are not clear on incen­tives for spous­es, it is expect­ed that, for well­ness pro­grams that apply to employ­ees and their spous­es, the max­i­mum incen­tive for either the employ­ee or spouse will be 30 per­cent of the total cost of self-only cov­er­age. In case an employ­er offers more than one group health plan but par­tic­i­pa­tion in a well­ness pro­gram is open to all employ­ees regard­less of whether they are enrolled in a plan, the employ­er may offer a max­i­mum incen­tive of 30 per­cent of the low­est cost major med­ical self-only plan it offers. As an exam­ple, if a sin­gle plan costs $4,000, the max­i­mum incen­tive would be $1,200.
    3. Pro­vide a notice to all eli­gi­ble to par­tic­i­pate in your well­ness pro­gram – The EEOC made it easy for every­one and post­ed a sam­ple notice online at https://www.eeoc.gov/laws/regulations/ada-wellness-notice.cfm. Your notice should include infor­ma­tion on the incen­tive amount you are offer­ing for dif­fer­ent pro­grams, how you main­tain pri­va­cy and secu­ri­ty of all pro­tect­ed health infor­ma­tion (PHI) as well as who to con­tact if par­tic­i­pants have ques­tion or concerns.
    4. If using a HRA (health risk assess­ment), do not include fam­i­ly med­ical his­to­ry ques­tions – The EEOC final rule, which expands on GINA’s rules, makes it clear that “an employ­er is per­mit­ted to request infor­ma­tion about the cur­rent or past health sta­tus of an employ­ee’s spouse who is com­plet­ing a HRA on a vol­un­tary basis, as long as the employ­er fol­lows GINA rules about request­ing genet­ic infor­ma­tion when offer­ing health or genet­ic ser­vices. These rules include require­ments that the spouse pro­vide pri­or, know­ing, writ­ten, and vol­un­tary autho­riza­tion for the employ­er to col­lect genet­ic infor­ma­tion, just as the employ­ee must do, and that induce­ments in exchange for this infor­ma­tion are lim­it­ed.”2 Due to the com­plex­i­ty and “gray areas” this item can reach, my rec­om­men­da­tion is to keep it sim­ple and to leave genet­ic ser­vices and genet­ic coun­sel­ing out of a com­pre­hen­sive well­ness program.

    Well­Steps, a nation­wide well­ness provider, has a use­ful tool that every­one can use. Their “well­ness com­pli­ance check­er” should not sub­sti­tut­ed for qual­i­fied legal advice, but can be use­ful for a high lev­el check on how com­pli­ant your well­ness pro­gram is. You can access it at https://www.wellsteps.com/resources/tools.

    I often stress the need for all well­ness pro­grams to build a strong foun­da­tion, which starts with the company’s and lead­ers’ mes­sages. Your com­pa­ny should launch a well­ness pro­gram because you val­ue and care about your employ­ees’ (and their fam­i­lies’) health and well-being. Every­thing you do and say should reflect this phi­los­o­phy. While I always rec­om­mend com­pa­nies to care­ful­ly review all reg­u­la­tions around well­ness, I do believe that if your well­ness pro­gram has a strong foun­da­tion based on your cor­po­rate social respon­si­bil­i­ty and your pas­sion for build­ing a healthy work­place, you most like­ly will be with­in the walls of all these rules. At the end, a work­place that does well­ness the right way has employ­ees who are not moti­vat­ed by finan­cial incen­tives, but by their intrin­sic moti­va­tion to be the best they can be as well as their accep­tance that we all must be respon­si­ble for our own health, and that all cor­po­ra­tions should be respon­si­ble for pro­vid­ing the best envi­ron­ment and oppor­tu­ni­ties for employ­ees to do so.

    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Financial Wellness Benefits — Adapting Them In The New Workforce | CA Benefit Advisors

    May 17, 2017

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    Over the past few years, we’ve seen tremen­dous growth in Finan­cial Well­ness Pro­grams. Actu­al­ly, as indi­cat­ed in a recent report by Aon Hewitt, 77% of mid- to large-size com­pa­nies will pro­vide at least one finan­cial well­ness ser­vice in 2017; with 52% of employ­ers pro­vid­ing ser­vices in more than 3 finan­cial cat­e­gories. So what are the advan­tages of these pro­grams and how can the cur­rent work­force make the most out of them?

    Pro­gram Advantages

    • They edu­cate employ­ees on finan­cial man­age­ment. It’s no doubt, poor income man­age­ment and cash-flow deci­sions increase finan­cial stress. This stress has a direct impact on an employee’s phys­i­cal, men­tal and emo­tion­al state—all which can lead to pro­duc­tiv­i­ty issues, increased absen­teeism, and ris­ing health­care costs. Finan­cial well­ness tools in the work­place can not only sup­port employ­ees in var­i­ous areas of their finances by expand­ing income capac­i­ty, but can cre­ate long-last­ing changes in their finan­cial habits as well.
    • They give a foothold to the employ­er. As more employ­ers are rec­og­niz­ing the effect finan­cial stress has on their employ­ees in the work­place, they’re jump­ing on board with these pro­grams. As peo­ple are extend­ing the length of their careers, ben­e­fits like these are an attrac­tive fea­ture to the work­force and new job seek­ers alike. In fact, accord­ing to a recent sur­vey by TIAA, respon­dents were more like­ly to con­sid­er employ­ment with com­pa­nies who pro­vide free finan­cial advice as part of their ben­e­fit package.

    Pro­gram Credentials

    While finan­cial well­ness ben­e­fits may dif­fer among com­pa­nies, one thing is certain—there are key fac­tors employ­ers should con­sid­er when estab­lish­ing a suc­cess­ful pro­gram. They should:

    • Give sound, unbi­ased advice. Finan­cial well­ness ben­e­fits should be free to the employee—no strings attached. Employ­ees should not be solicit­ed by finan­cial insti­tu­tions or finan­cial com­pa­nies that only want to seek a prof­it for ser­vices. Employ­ers should research com­pa­nies when shop­ping these pro­grams to deter­mine the right fit for their culture.
    • Encom­pass all facets. A suc­cess­ful pro­gram should cov­er all aspects of finan­cial plan­ning, and tar­get all demo­graph­ics. These pro­grams should run the gamut, pro­vid­ing resources for those with seri­ous debt issues to those who seek advanced estate plan­ning and asset pro­tec­tion. Ser­vices should include both short-term to long-term options that fit with the company’s size and cul­ture. Pop­u­lar pro­grams imple­ment a vari­ety of tools. Employ­ers should inte­grate these tools with oth­er ben­e­fits to make it as seam­less as pos­si­ble for their employ­ees to use.
    • Detail finan­cial well­ness as a process, not an event. Strength­en­ing finan­cial pros­per­i­ty is a process. When deter­min­ing the right fit for your com­pa­ny, con­tin­ued coach­ing and sup­port is a must. This may require eval­u­at­ing the pro­gram and ser­vices offered every year. Employ­ees need to know that while they have the ini­tial ben­e­fit of mak­ing a one-time change, addi­tion­al tools are at their dis­pos­al to shift their finan­cial mind­set; strength­en­ing their finan­cial habits and behav­iors down the road.

    Employ­ees must under­stand the val­ue Finan­cial Well­ness Pro­grams can pro­vide to them as well. If your com­pa­ny offers these ben­e­fits, keep a few things in mind:

    • Max­i­mize the program’s ser­vices. Uti­lize your finan­cial work­place ben­e­fits to tack­le life’s finan­cial chal­lenges. Most pro­grams offer finan­cial men­tor­ing through var­i­ous medi­ums. Seek advice on your finan­cial issues and allow a coach/mentor to pro­vide you with prac­ti­cal strate­gies, alter­na­tives and action­able steps to reduce your finan­cial stress.
    • Take advan­tage of oth­er employ­ee ben­e­fits. Incor­po­rate oth­er ben­e­fits into your finan­cial well­ness pro­gram. Use finan­cial resources to help you run pro­jec­tions and mon­i­tor your 401k. Bud­get your health­care costs with these tools. Research indi­cates those who tap into these finan­cial well­ness pro­grams often are more like­ly to stay on track than those who don’t.
    • Eval­u­ate your progress. Strength­en­ing your finan­cial well-being is a process. If your employer’s finan­cial well­ness pro­gram pro­vides var­i­ous tools to mon­i­tor your finances, use them. Weigh your progress year­ly and take advan­tage of any sup­port groups, webi­na­rs, or indi­vid­ual one-on-one coun­sel­ing ses­sions offered by these programs.

    As the work­force con­tin­ues to evolve, man­ag­ing these pro­grams and resources effec­tive­ly is an impor­tant aspect for both par­ties. Pro­vid­ing and uti­liz­ing a strong, effec­tive Finan­cial Well­ness Ben­e­fits Pro­gram will set the foun­da­tion for a life­time of finan­cial well-being.

     

  • Is company culture the new frontier of benefits?

    May 11, 2017

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    Once Our Cul­ture Insights Pro­gram Launched our Indus­try Lead­ing Mag­a­zine Inter­viewed Andrew McNeil for an in-depth piece on the program!

    With the increas­ing com­modi­ti­za­tion of employ­ee ben­e­fits, how can com­pa­nies in tight labor mar­kets win the war on tal­ent?  At least one bro­ker­age known for push­ing the enve­lope believes it has the answer.

    Arrow Ben­e­fits Group’s HR divi­sion is rolling out Cul­ture Insights, which devel­ops a per­son­al­ized plan for employ­ers to oper­ate at their high­est poten­tial from six key angles. They include cor­po­rate pur­pose, mis­sion, val­ues, cul­ture, HR and employ­ee ben­e­fits. The pro­gram, which doesn’t have any paid cus­tomers yet, was inspired by a 2016 tour of Zappos.com by Andrew McNeil, an advis­er with Arrow Ben­e­fits Group. Anoth­er source of moti­va­tion was a sur­vey the firm did of mil­len­ni­als, Gen-Xers and baby boomers.

    “Peo­ple want to work for a place where they feel val­ued and are aligned with the mis­sion and pur­pose of that orga­ni­za­tion,” he explains, regard­less of their age or indus­try. “They don’t just want a pay­check.” …There’s also a larg­er pur­pose behind the Cul­ture Insights pro­gram. In all his email cor­re­spon­dence, McNeil now includes the fol­low­ing philo­soph­i­cal state­ment: “We believe we can build a stronger com­mu­ni­ty by build­ing stronger employ­ers. Stronger employ­ers trans­late into a stronger local econ­o­my and hap­pi­er, more pro­duc­tive citizens.”

    Read entire arti­cle here.

     

    By Bruce Shel­ton
    Pub­lished April 28, 2017

     

  • Arrow is a proud supporter of Social Advocates For Youth (SAY) | CA Benefit Advisors

    May 9, 2017

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    We are so proud to sup­port the SAY team San­ta Rosa and had a blast at the fundrais­er tonight.  Every­one worked so hard and raised aware­ness and big mon­ey to sup­port home­less chil­dren in Sono­ma Coun­ty!!!! Here’s our Mari­ah Shields with the love­ly Sarah Scud­der, anoth­er great SAY sup­port­er!  If you’d like to sup­port too, please vis­it: https://www.saysc.org/

  • House Passes AHCA Bill in First Step to Repeal and Replace the ACA | CA Benefit Advisors

    May 6, 2017

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    On May 4, 2017, the U.S. House of Rep­re­sen­ta­tives passed House Res­o­lu­tion 1628, a rec­on­cil­i­a­tion bill aimed at “repeal­ing and replac­ing” the Patient Pro­tec­tion and Afford­able Care Act (ACA). The bill, titled the “Amer­i­can Health Care Act of 2017” or “AHCA,” will now be sent to the Sen­ate for debate, where amend­ments can be made, pri­or to the Sen­ate vot­ing on the bill.

    It is wide­ly antic­i­pat­ed that in its cur­rent state the AHCA is unlike­ly to pass the Sen­ate. Employ­ers should con­tin­ue to mon­i­tor the text of the bill and should refrain from imple­ment­ing any changes to group health plans in response to the cur­rent ver­sion of the AHCA.

    The AHCA makes numer­ous changes to cur­rent law, much of which impact the indi­vid­ual mar­ket, Medicare, and Med­ic­aid. Some pro­vi­sions in the AHCA also impact employ­er group health plans. For exam­ple, the AHCA removes both the indi­vid­ual and the employ­er shared respon­si­bil­i­ty penal­ties. The AHCA also push­es imple­men­ta­tion of the Cadil­lac tax to 2025 and per­mits states to waive essen­tial health ben­e­fit (EHB) requirements.

    The AHCA removes the $2,500 con­tri­bu­tion lim­it to flex­i­ble health spend­ing accounts (FSAs) for tax­able years begin­ning after Decem­ber 31, 2017. It also changes the max­i­mum con­tri­bu­tion lim­its to health sav­ings accounts (HSAs) to the amount of the accom­pa­ny­ing high deductible health plan’s deductible and out-of-pock­et lim­i­ta­tion. The AHCA also pro­vides for both spous­es to make catch-up con­tri­bu­tions to HSAs.

    The AHCA pro­vides for a “con­tin­u­ous health insur­ance cov­er­age incen­tive,” which will allow health insur­ers to charge pol­i­cy­hold­ers an amount equal to 30 per­cent of the month­ly pre­mi­um in the indi­vid­ual and small group mar­ket, if the indi­vid­ual failed to have cred­itable cov­er­age for 63 or more days dur­ing an applic­a­ble 12-month look-back peri­od. This pro­vi­sion is slat­ed to begin in 2019, or in the case of a spe­cial enroll­ment peri­od, begin­ning in plan year 2018. The AHCA also allows states to obtain a waiv­er and under­write poli­cies for indi­vid­u­als who do not main­tain con­tin­u­ous coverage.

    The AHCA would also return per­mis­si­ble age band rat­ing (for pur­pos­es of cal­cu­lat­ing health plan pre­mi­ums) to the pre-ACA ratio of 5:1, rather than the ACA’s 3:1. This allows old­er indi­vid­u­als to be charged up to five times more than what younger indi­vid­u­als pay for the same pol­i­cy, rather than up to the ACA lim­it of three times more.

    It is unknown at this time if the AHCA can pass the Sen­ate, or what might be changed in the text of the bill in order to earn votes in an attempt to pass the bill.

    By Danielle Capilla
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • We have no value – there is no need – everyone for themselves – in the individual market | CA Benefit Advisors

    May 2, 2017

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    Indi­vid­ual health insur­ance cov­er­age is now read­i­ly avail­able, on a guar­an­teed basis and with­out any penal­ties for cov­er­ing pre-exist­ing med­ical con­di­tions.  That makes things eas­i­er, along with the fact that the avail­able plan designs fall into neat­ly con­fig­ured cat­e­gories.  So who needs agents?  The car­ri­ers have cut com­mis­sions, and now many are not pay­ing com­mis­sions at all.  The assump­tion, of course, is that agents in the indi­vid­ual mar­ket are not required – peo­ple can make deci­sions on their own with what is made avail­able on line.  Funny…the time we spend in coun­sel­ing cur­rent and poten­tial clients about their indi­vid­ual options and some of the nuances of cov­er­age and provider net­works seems to take us just as much time as before, with fol­low-up ser­vice calls and needs, keep­ing clients cur­rent, argu­ing with car­ri­ers and providers.  So real­ly, there is no val­ue here?  And still, over 50% of those who enroll through the Exchanges are enrolled through agents…guess they don’t know any better…

  • Department of Labor Delays Enforcement of the Fiduciary Duty Rule | CA Benefit Advisor

    April 28, 2017

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    On April 4, 2017, the Depart­ment of Labor (DOL) announced that the applic­a­bil­i­ty date for the final fidu­cia­ry rule will be extend­ed, and pub­lished its final rule extend­ing the applic­a­bil­i­ty date in the Fed­er­al Reg­is­ter on April 7. This exten­sion is pur­suant to Pres­i­dent Trump’s Feb­ru­ary 3, 2017 pres­i­den­tial mem­o­ran­dum direct­ing the DOL to fur­ther exam­ine the rule and the DOL’s pro­posed rule to extend the dead­line released on March 2, 2017.

    The length of the exten­sion dif­fers between cer­tain require­ments and/or com­po­nents of the rule.  Below are the com­po­nents and when and how applic­a­bil­i­ty applies:

    • Final rule defin­ing who is a “fidu­cia­ry”: Under the final rule, advi­sors who are com­pen­sat­ed for pro­vid­ing invest­ment advice to retire­ment plan par­tic­i­pants and indi­vid­ual account own­ers, includ­ing plan spon­sors, are fidu­cia­ries. The applic­a­bil­i­ty date for the final rule is extend­ed 60 days, from April 10 until June 9, 2017. Fidu­cia­ries will be required to com­ply with the impar­tial con­duct or “best inter­est” stan­dards on the June 9 applic­a­bil­i­ty date.
    • Best Inter­est Con­tract Exemp­tion: Except for the impar­tial con­duct stan­dards (applic­a­ble June 9 per above), all oth­er con­di­tions of this exemp­tion for cov­ered trans­ac­tions are applic­a­ble Jan­u­ary 1, 2018. There­fore, fidu­cia­ries intend­ing to use this exemp­tion must com­ply with the impar­tial con­duct stan­dard between June 9, 2017 and Jan­u­ary 1, 2018.
    • Class Exemp­tion for Prin­ci­pal Trans­ac­tions: Except for the impar­tial con­duct stan­dards (applic­a­ble June 9 per above), all oth­er con­di­tions of this exemp­tion for cov­ered trans­ac­tions are applic­a­ble Jan­u­ary 1, 2018. There­fore, fidu­cia­ries intend­ing to use this exemp­tion must com­ply with the impar­tial con­duct stan­dard between June 9, 2017 and Jan­u­ary 1, 2018 and thereafter.
    • Pro­hib­it­ed Trans­ac­tion Exemp­tion 84–24 (relat­ing to annu­ities): Except for the impar­tial con­duct stan­dard (applic­a­ble June 9 per above), the amend­ments to this exemp­tion are applic­a­ble Jan­u­ary 1, 2018.
    • Oth­er pre­vi­ous­ly grant­ed exemp­tions: All amend­ments to oth­er pre­vi­ous­ly grant­ed exemp­tions are applic­a­ble on June 9, 2017.

    By Nicole Quinn-Gato, JD
    Orig­i­nal­ly Pub­lished By www.thinkhr.com

  • Getting the Most Out of an Employee Assistance Program (EAP) | CA Benefit Consultants

    April 25, 2017

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    Many employ­ers under­stand the val­ue of hav­ing an Employ­ee Assis­tance Pro­gram (EAP) since the heart and soul of orga­ni­za­tions are employ­ees. Employ­ees who are phys­i­cal­ly and men­tal­ly healthy, high­ly pro­duc­tive, engaged in their work, and loy­al to their employ­er con­tribute pos­i­tive­ly to their employer’s bot­tom line. For­tu­nate­ly, most employ­ees are pos­i­tive con­trib­u­tors, yet even the best of employ­ees can occa­sion­al­ly have issues or cir­cum­stances arise that may inad­ver­tent­ly impact their jobs in a neg­a­tive way. Hav­ing an EAP in place that can address these issues ear­ly may mit­i­gate any neg­a­tive impact to the work­place. This is a win-win for both employ­ees and employers.

    A key com­po­nent of EAP ser­vices lies in “catch­ing things ear­ly” by assist­ing employ­ees and help­ing them address and resolve issues before they impact the work­place. Most employ­ees will use EAP ser­vices on a vol­un­tary, self-referred basis that is com­plete­ly con­fi­den­tial. Some employ­ers may won­der if ser­vices are even being used by employ­ees because it won’t be all that appar­ent, but most EAPs pro­vide a uti­liza­tion or usage report that will show the num­ber of peo­ple served, and pos­si­bly the types of rea­sons ser­vices were requested.

    If employ­ee issues do begin to appear in the workplace—related to per­for­mance, atten­dance, behav­ior, or safety—it is impor­tant for man­agers, super­vi­sors, and human resources to also have access to EAP ser­vices. They may wish to con­sult with an employ­ee assis­tance pro­fes­sion­al that can pro­vide guid­ance and direc­tion lead­ing to prob­lem iden­ti­fi­ca­tion and res­o­lu­tion. These issues have the poten­tial to become very cost­ly for the organization—and again, the ear­li­er they can be addressed, the greater chance of suc­cess for both employ­ee and employ­er, with min­i­mal neg­a­tive impact to the company’s bot­tom line.

    The key to get­ting the most out of an EAP is to make it eas­i­ly acces­si­ble to employ­ees, safe to use, and vis­i­ble enough they remem­ber to use it. It is impor­tant that employ­ees under­stand using the EAP is con­fi­den­tial and their iden­ti­ty will not be dis­closed to any­one in their orga­ni­za­tion. Pro­mot­ing the EAP ser­vices with mate­ri­als such as fly­ers, posters, or web­site infor­ma­tion with EAP con­tact infor­ma­tion will also increase the like­li­hood of employ­ees access­ing services.

    By Nan­cy Cannon
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Arrow’s Wellness Initiative CPR/First ‑aid community classes in the News!

    April 21, 2017

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    As bro­ker­ages con­tin­ue to look for ways to stand out from the com­pe­ti­tion, two agen­cies are giv­ing back to their com­mu­ni­ties and help­ing those areas become health­i­er in the process. Arrow Ben­e­fits Group in Petaluma, Calif., cre­at­ed the Arrow Com­mu­ni­ty Well­ness Ini­tia­tive. The ini­tia­tive each month offers CPR and auto­mat­ed defib­ril­la­tor (AED) train­ing and cer­ti­fi­ca­tion with first ‑aid, instruct­ed by the Petaluma Health Care Dis­trict, free to the com­mu­ni­ty. Read entire arti­cle here.

  • Flex Work: Advantages in the New Workforce | CA Benefit Advisors

    April 19, 2017

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    Flex Work. No doubt you’ve heard this term (or some vari­a­tion) float­ing around the last decade or so, but what exact­ly does it mean? Flex­i­ble work can vary by def­i­n­i­tion depend­ing on who you ask, but one thing is for sure, it’s here to stay and chang­ing the way we view the work­force. Accord­ing to a recent study by Rand­stad, employ­er com­mit­ment to increase the amount of flex work­ers in their com­pa­nies has increased 155% over the last four years. If fact, 68% of employ­ers agree that the major­i­ty of the work­force will be work­ing some sort of flex­i­ble arrange­ment by 2025.

    So then, since the land­scape of a tra­di­tion­al office set­ting is chang­ing, what exact­ly is Flex Work? Sim­ply stat­ed, it’s a prac­tice employ­ers use to allow their staff some dis­cre­tion and free­dom in how to han­dle their work, while mak­ing sure their sched­ules coor­di­nate with col­leagues. Para­me­ters are set by the employ­er on how to get the work accom­plished.  These guide­lines may include employ­ees work­ing a set num­ber of hours per day/week, and spec­i­fy­ing core times when they need to be onsite. No mat­ter how it’s defined, with a new gen­er­a­tion enter­ing the work­force and tech­nol­o­gy con­tin­u­ing to advance, employ­ers will need to explore this trend to stay competitive.

    Let’s take a look at how this two-fold ben­e­fit has sev­er­al advan­tages for employ­ers and employ­ees alike.

    Increas­es Productivity

    When employ­ees work a more flex­i­ble sched­ule, they are more pro­duc­tive. Many will get more done in less time, have less dis­trac­tions, take less breaks, and use less sick time/PTO than office coun­ter­parts. In sev­er­al recent stud­ies, employ­ees have stat­ed they’re more pro­duc­tive when not in a tra­di­tion­al office set­ting. In a recent arti­cle pub­lished by Entrepreneur.com, Sara Sut­ton, CEO and Founder of FlexJobs wrote that 54% of 1500 employ­ees polled in one of their sur­veys would choose to under­take impor­tant job-relat­ed assign­ments from home rather than the office. And 18% said that while they would pre­fer to com­plete assign­ments at the office, they would only do so before or after reg­u­lar hours. A mere 19% said they’d go to the office dur­ing reg­u­lar hours to get impor­tant assign­ments done.

    Flex­i­ble work­places allow employ­ees to have less inter­rup­tions from impromp­tu meet­ings and col­leagues, while min­i­miz­ing the stress of office chat­ter and politics—all of which can drain pro­duc­tiv­i­ty both at work and at home. What’s more, an agile set­ting allows your employ­ees to work when their ener­gy lev­el is at peak and their focus is best. So, an ear­ly-ris­er might ben­e­fit from work­ing between the hours of 4:30 and 10 a.m., while oth­er staff mem­bers excel in the evening; once chil­dren are in bed.

    Reduces Cost Across the Board

    Think about it, every­thing we do costs us some­thing. Whether we’re sac­ri­fic­ing time, mon­ey, or health due to stress, cost mat­ters. With a flex­i­ble work envi­ron­ment, employ­ees can tai­lor their hours around fam­i­ly needs, per­son­al oblig­a­tions and life respon­si­bil­i­ties with­out tak­ing valu­able time away from their work. They’re able to tap into work remote­ly while at the doc­tor, car­ing for a sick child, wait­ing on the repair­man, or any oth­er num­ber of issues.

    What about the cost asso­ci­at­ed with com­mut­ing? Besides the obvi­ous of fuel and wear and tear on a vehi­cle, an aver­age work­er com­mutes between 1–2 hours a day to the office. Tack on the stress involved in that com­mute and an 8 hour work­day, and you’ve got one tired, stressed out employ­ee with no bal­ance. Telecom­mut­ing reduces these stres­sors, while adding val­ue to the com­pa­ny by elim­i­nat­ing wast­ed time in traf­fic. And, less stress has a direct effect – health­i­er and hap­pi­er employees.

    Pro­vid­ing a flex­i­ble prac­tice in a tra­di­tion­al office envi­ron­ment can reduce over­head costs as well. When employ­ees are work­ing remote­ly, busi­ness own­ers can save by allow­ing employ­ees to desk or space share. Too, an agile envi­ron­ment makes it eas­i­er for busi­ness­es to move away from tra­di­tion­al brick and mor­tar if they deem necessary.

    Boosts Loy­al­ty, Tal­ent and the Bot­tom Line

    We all know employ­ees are the num­ber one asset in any com­pa­ny. When employ­ees have more con­trol over their sched­ule dur­ing the busi­ness day, it breeds trust and reduces stress. In fact, in a recent sur­vey of 1300 employ­ees polled by FlexJobs, 83% respond­ed they would be more loy­al to their com­pa­ny if they offered this ben­e­fit. Hav­ing a more agile work sched­ule not only reduces stress, but helps your employ­ees main­tain a good work/life balance.

    Offer­ing this incen­tive to prospec­tive and exist­ing employ­ees also allows you to acquire top tal­ent because you aren’t lim­it­ed by geog­ra­phy. Your tal­ent can work from any­where, at any time of the day, reduc­ing oper­a­tional costs and boost­ing that bot­tom line—a very valu­able asset to any small busi­ness own­er or new start-up.

    So, what can employ­ers do?   While there are still com­pa­nies who view flex­i­ble work as a perk rather than the norm, for­ward-think­ing busi­ness own­ers know how this will affect them in the next few years as they recruit and retain new tal­ent. With 39% of per­ma­nent employ­ees think­ing to make the move to an agile envi­ron­ment over the next three years, it’s impor­tant to con­sid­er what a flex­i­ble envi­ron­ment could mean for your com­pa­ny.  Keep in mind there are many types that can be mold­ed to fit your company’s and employ­ees’ needs. Flex­i­ble work prac­tices don’t have to be a one-size-fits-all approach. As the old­est of Gen­er­a­tion Z is enter­ing the work­force, and mil­len­ni­als are set­tling into their careers, com­pa­nies are wise to fig­ure out their own cus­tomized poli­cies. The desire for a more flex­i­ble sched­ule is key for the chang­ing workforce—often times over health­care, pay and oth­er ben­e­fits. Pro­vid­ing a flex­i­ble arrange­ment will keep your com­pa­ny competitive.

  • The Trump Effect: Potential Changes on the Employee Benefits Horizon

    April 17, 2017

    Exclu­sive Webi­nar Invi­ta­tion from Arrow!

    Wednes­day, May 3, 2017
    11:00 a.m. PT

    As Pres­i­dent Trump chal­lenges the sta­tus quo in Wash­ing­ton, D.C., CEOs, CFOs and HR deci­sion-mak­ers are prepar­ing for how his admin­is­tra­tion could impact the employ­ee ben­e­fits indus­try. James Slot­nick, AVP, Gov­ern­ment Rela­tions, for Sun Life Finan­cial will pro­vide insight into what changes are most like­ly to make it through Con­gress. His dis­cus­sion will focus on the cur­rent state of repeal­ing and replac­ing the Patient Pro­tec­tion and Afford­able Care Act (ACA), the like­li­hood of cor­po­rate and indi­vid­ual tax reform, how fed­er­al paid fam­i­ly leave could become a real­i­ty, and oth­er impor­tant issues.

    Sim­ply fill out the online form by click­ing here, and enter Dis­count Code “UBA465″ to waive the asso­ci­at­ed fee.

     

  • Petaluma teen saves a life with CPR | CA Benefit Advisors

    April 12, 2017

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    We’re proud to be in part­ner­ship with the Heart­Safe Com­mu­ni­ty, an ini­tia­tive of the Petaluma Health Care Dis­trict, and will con­tin­ue to offer free CPR/­First-Aid class­es to the open pub­lic. What an incred­i­bly impact­ful pro­gram for our com­mu­ni­ty – this is the third report­ed inci­dent where some­one who learned the CPR pro­ce­dure saved a life!

    Click here for more information.

     

  • What is “the Republican way” – who knows, as they’ve lost their say regarding ACA | CA Benefit Advisors

    April 10, 2017

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    There are now sev­er­al pieces of draft leg­is­la­tion float­ing through Capi­tol Hill that pro­pose a repeal and replace­ment of the Afford­able Care Act.  The lat­est is being writ­ten by Dar­rell Issa of Cal­i­for­nia who sits on the House Ways and Means Com­mit­tee.  What they have in common:

    No man­dates
    No subsidies
    A new tax strat­e­gy to make cov­er­age more affordable
    More focus on strength­en­ing the val­ue of Health Sav­ings Accounts
    The pos­si­bil­i­ty of a tax on the val­ue of cov­er­age over a cer­tain threshold

  • Employee Benefit Trends of 2017 | CA Benefit Advisors

    April 7, 2017

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    Cus­tomiza­tion of ben­e­fits is becom­ing more pop­u­lar.  The process of per­son­al­iz­ing employ­ee ben­e­fits allows for indi­vid­u­als to choose from an array of options, and increas­es employ­ee satisfaction.

  • Self-Funding Dental: Leave No Stone Unturned | CA Benefit Advisors

    April 4, 2017

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    With all of the focus that is put into man­ag­ing and con­trol­ling health care costs today, it amazes me how many orga­ni­za­tions still look past one of the most effec­tive and least dis­rup­tive cost-sav­ing strate­gies avail­able to employ­ers with 150 or more cov­ered employ­ees – self-fund­ing your den­tal plan. There is a rea­son why den­tal insur­ers are not quick to sug­gest mak­ing a switch to a self-fund­ed arrange­ment … it is called profit!

    Why self-fund dental?

    We know that the notion of self-fund­ing still makes some employ­ers ner­vous. Don’t be ner­vous; here are the fun­da­men­tal rea­sons why this requires lit­tle risk:

    1. When self-fund­ing den­tal, your expo­sure as an employ­er is lim­it­ed on any one plan mem­ber. Ben­e­fit max­i­mums are typ­i­cal­ly between $1,000 and $2,000 per year.
    2. Den­tal claims are what we refer to as high fre­quen­cy, low sever­i­ty (mean­ing many claims, low­er dol­lars per claim), which means that they are far less volatile and much more pre­dictable from year to year.
    3. You pay for only what you use, an admin­is­tra­tive fee paid to the third-par­ty admin­is­tra­tor (TPA) and the actu­al claims that are paid in any giv­en month. That’s it!

    Where do you save when you self-fund your dental?

    Trend: In our ongo­ing analy­sis over the years, den­tal claims do not trend at any­where near the rate that the actu­ar­ies from any giv­en insur­ance com­pa­ny project (keep in mind these are very bright peo­ple that are paid to make sure that insur­ance com­pa­nies are prof­itable). There­fore, insured rates are typ­i­cal­ly overstated.

    Claims mar­gin: This is mon­ey that insur­ance com­pa­nies set aside for “claims fluc­tu­a­tion” (i.e., prof­it).  For exam­ple, ABC Insur­er (we’ll keep this anony­mous) does not use paid claims in your renew­al pro­jec­tion. They use incurred claims that are always some­where between three and six per­cent high­er than your actu­al paid claims. They then apply “trend,” a risk charge and reten­tion to the over­stat­ed fig­ures. This fac­tor alone will result in insured rates that are over­stat­ed by five to eight per­cent on insured plans with ABC Insur­er, when com­pared to self-fund­ed ABC Insur­er plans.

    Risk charges: You do not pay them when you self-fund! This com­po­nent of an insured rate can be any­where from three to six per­cent of the premium.

    Reserves: Mon­ey that an insur­er sets aside for incurred, but unpaid, claim lia­bil­i­ty. This is an area where insur­ance com­pa­nies prof­it. They over­state the reserves that they build into your pre­mi­ums and then they earn invest­ment income on the reserves. When you self-fund, you pay only for what you use.

    Below is a recent case study

    We received a bro­ker of record let­ter from a grow­ing com­pa­ny head­quar­tered in Mass­a­chu­setts. They were hov­er­ing at about 200 employ­ees enrolled in their ful­ly-insured den­tal plan. After ana­lyz­ing their his­tor­i­cal den­tal claims expe­ri­ence, we saw an oppor­tu­ni­ty. After pre­sent­ing the analy­sis and edu­cat­ing the employ­er on the lim­it­ed amount of risk involved in switch­ing to a self-fund­ed pro­gram, the client decid­ed to make the change.

    After we had received 12 months of mature claims, we did a look back into the finan­cial impact of the change. Had the client accept­ed what was his­tor­i­cal­ly a well-received “no change” ful­ly-insured den­tal renew­al, they would have missed out on more than $90,000 added to their bot­tom line. Their employ­ee con­tri­bu­tions were com­pet­i­tive to begin with, so the employ­er held employ­ee con­tri­bu­tions flat and was able to reap the full finan­cial reward.

    This is just one exam­ple. I would not sug­gest that this is the norm, but sav­ings of 10 per­cent are. If you are a mid-size employ­er with a ful­ly-insured den­tal plan, self-fund­ing den­tal is a cost-sav­ings oppor­tu­ni­ty you and your con­sul­tant should be mon­i­tor­ing at every renewal.

    By Gary R. Goodhile
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • TeleMedicine – The NextGen Benefit of Minor Healthcare | CA Benefit Advisors

    March 31, 2017

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    It’s not sur­pris­ing that 2017 stands to be the year many will have an expe­ri­ence to share using a Telemed­i­cine or a Vir­tu­al Doc­tor ser­vice. With cur­rent mar­ket trends, gov­ern­ment reg­u­la­tions, and chang­ing eco­nom­ic demands, it’s fast becom­ing a more pop­u­lar alter­na­tive to tra­di­tion­al health­care vis­its.  And, as health­care costs con­tin­ue to rise and there are more strate­gic pric­ing options and dig­i­tal mod­els avail­able to users, the appeal for con­sumers, self-insured employ­ers, health sys­tems and health plans to jump on board is significant.

    In a recent study con­duct­ed by the Aloft Group on the state of Telemed­i­cine, 47.7% of respon­dents weren’t sure about what Telemed­i­cine meant, but it’s pos­si­ble they may have expe­ri­enced it, as 52.4% have had inter­ac­tion with a physi­cian or clin­i­cian via email or text. Fur­ther, 78.5% of respon­dents indi­cat­ed they would be com­fort­able talk­ing with a physi­cian using an online method.

    Dr. Tony Yuan, an expe­ri­enced ER doc­tor in San Diego, who also con­sults for Doc­tor on Demand, pro­vides insight into this increas­ing trend dur­ing a recent Q and A ses­sion. Cur­rent­ly, over half of the patients he sees in his ER could uti­lize a dig­i­tal health­care mod­el. In fact, 90% of patients who head to the ER for minor ill­ness­es can be treat­ed through this ser­vice. So, the next sinus, ear infec­tion, or oth­er minor health issue just may pro­vide you and your fam­i­ly the chance to try what will become the new stan­dard in minor healthcare.

    Here are few ben­e­fits TeleMed­i­cine has to offer:

    It’s Fast and Simple

    There’s no ques­tion apps are avail­able for every­thing to make our lives easier—and TeleMed is no excep­tion. With­in min­utes, stan­dard first time users can set up an account, com­plete a few med­ical pro­file ques­tions, then cre­ate and save a ses­sion. Hav­ing the abil­i­ty to log on with a board-cer­ti­fied physi­cian or clin­i­cian 24/7/365, using any PC, smart device, and even phone in some cas­es, saves time and mon­ey. Many ser­vices, like Tele­doc and MDLive, will con­nect you with a licensed doc­tor or clin­i­cian online in just a few min­utes – no sched­ul­ing or wait required. Once on, you can dis­cuss your health­care needs con­fi­den­tial­ly. After the vis­it, the doc­tor will update his/her records, noti­fy your pri­ma­ry care physi­cian of the call, and send an elec­tron­ic pre­scrip­tion to the phar­ma­cy of your choice, if necessary—all in the time it takes for a lunch break.

    It’s Flex­i­ble

    The abil­i­ty to con­nect with a pro­fes­sion­al whether you are at home, work, or trav­el­ing makes get­ting the care you need invalu­able. How often have you expe­ri­enced the symptoms—or the full blown-effect—of get­ting sick while trav­el­ing? Many, no doubt, have had to adjust flight/travel plans to get the help need­ed from their PCP, in order to avoid get­ting worse.  By using an app or online ser­vice from your smart phone or lap­top, you’re able to get the antibi­otics you need quick­er with­out cut­ting trips short or miss­ing work to do so.

    In addi­tion, patients in small­er com­mu­ni­ties with­out the resources avail­able of clas­si­cal­ly- trained, emer­gency-med physi­cians, see the ben­e­fit and flex­i­bil­i­ty of tap­ping into these online doc­tor ser­vices. Not only is it a plus for the patient to access more advanced care if need­ed, doc­tors in these rur­al areas val­ue this as well. These dig­i­tal health­care mod­els pro­vide imme­di­ate, life-sav­ing tools for both doc­tors and their patients who may not have access to high­er, acute facilities.

    It’s Afford­able

    Many TeleMed­i­cine ser­vices now accept insur­ance, mak­ing a patient’s vis­it free, or at min­i­mum the same as most deductible or co-insur­ance amounts for office vis­its; around $40. For those on a high-deductible plan, pay­ing $40 for an online doc­tor ser­vice is a much cheap­er alter­na­tive than pay­ing $150 or more for an Urgent Care vis­it, or over $1200 for a trip to the ER. For employ­ers, group options are low cost and can be a clear asset when cre­at­ing solu­tions EEs will value.

    It’s Ben­e­fi­cial to Employers

    Today, 3 of 5 cor­po­ra­tions, or 59% of employ­ers pro­vide dig­i­tal health­care ben­e­fits to their employ­ees. As an employ­er, the ben­e­fits are straight­for­ward. First, employ­ees can par­tic­i­pate in pro­fes­sion­al con­sul­ta­tions for their fam­i­ly mem­bers or them­selves with­out tak­ing away from pro­duc­tiv­i­ty. Sec­ond, when employ­ers incor­po­rate these ser­vices into their ben­e­fit plans, non-emer­gency care is redi­rect­ed from expen­sive ER vis­its, ulti­mate­ly sav­ing thou­sands of dol­lars or more to the bot­tom line. Addi­tion­al­ly, Tele­Health ser­vices offer fre­quent mon­i­tor­ing from clin­i­cians for those employ­ees who may need reg­u­lar sup­port due to more chron­ic issues, reduc­ing trips to the hos­pi­tal. Reduc­ing these costs have a direct ROI for the employ­er and relieves the stress on the employee’s pock­et­book. Third, many com­pa­nies are now adding this dig­i­tal ben­e­fit to their pack­ages as a way to recruit new talent.

    There’s no doubt 2017 will see a greater oppor­tu­ni­ty for all to expe­ri­ence the increas­ing trend of Telemed. Cre­at­ing a clear com­mu­ni­ca­tion strat­e­gy to make sure employ­ees know how to find, access and uti­lize this ser­vice to the high­est poten­tial is key.

  • North Bay’s Forty Under 40 remarkable young professionals of 2017 | CA Benefit Advisors

    March 29, 2017

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    We’re so proud of our man­ag­ing part­ner Stephen McNeil for win­ning the 40 under 40 acco­lade from the North Bay Busi­ness Journal! 

     Stephen tru­ly exudes pro­fes­sion­al growth and tremen­dous lead­er­ship abil­i­ties at such a young age. He is lead­ing our team into the future with his indus­try exper­tise, inno­va­tion, and abil­i­ty to com­mu­ni­cate across all dividers.  Stay tuned for more on his work and the award when the Jour­nal inter­views him in April.   For now you can see him and his 40 under 40 col­leagues here…  

     

  • Indecision and delay, it’s becoming the American way…as the ACA is hung out to dry | CA Benefit Advisors

    March 24, 2017

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    OK, the Trump cam­paign said the first act in office would be the repeal of the Afford­able Care Act.  The Repub­li­cans, which have since day one asked for its removal, lined up behind this.

    Then real­i­ty set in and they decid­ed to deter­mine what a replace­ment would look like…and they don’t know.  And they still don’t know.  And they’re still dis­cussing it.  In the mean­time, there is a lot of jock­ey­ing for posi­tion.  What the admin­is­tra­tion did do was issue an Exec­u­tive Order that sus­pend­ed enforce­ment activ­i­ty (the man­dates) and now the debate is over the sub­si­dies.  The most recent notice is from new HHS Sec­re­tary Tom Price who said this will require an addi­tion­al “three months to come to a resolution”.

  • The Overtime Rule Saga Continues… CA Benefit Consultants

    March 21, 2017

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    All the hul­la­baloo about the poten­tial new Depart­ment of Labor over­time rules was for naught as the imple­men­ta­tion of the law has been delayed again. Pres­i­dent Trump’s Depart­ment of Jus­tice (DOJ) request­ed exten­sions to the appeal process to deter­mine its strat­e­gy and final­ize its stand­point on the pro­posed reg­u­la­tions. Some polit­i­cal experts the­o­rize that the need for an exten­sion is the result of delays in Pres­i­dent Trump’s appoint­ment of a Sec­re­tary of Labor. The President’s first nom­i­nee, Andrew Puzder, with­drew and con­fir­ma­tion hear­ings for his sec­ond nom­i­nee, Alexan­der Acos­ta, have not been scheduled.

    Here’s where we are so far:

    • Decem­ber 2016 was the effec­tive date, but it was delayed by court order in Novem­ber 2016.
    • Obama’s DOJ request­ed expe­dit­ed review to get the law pushed through but Trump’s DOJ request­ed an exten­sion; exten­sion granted.
    • Trump’s DOJ request­ed anoth­er exten­sion, unop­posed, and it was granted.

    In the legal world the result of these delays is that the appeal will not be ful­ly briefed until May 1, 2017. This means the law is to enact­ment as War­ren Beat­ty is to envelopes — no one knows what’s going on (at least until May) and the con­fu­sion may con­tin­ue to go unre­solved with no clear date of resolution.

    What to Do Now

    In the mean­time, employ­ers should be informed about how the rule, if imple­ment­ed, would impact their work­place. You can read our blog post to learn more. As always, ensure that your com­pa­ny main­tains com­pli­ance with cur­rent over­time rules and reg­u­la­tions, and use this time of legal inde­ci­sion as an oppor­tu­ni­ty to review your prac­tices and poli­cies in accor­dance with state and fed­er­al wage pay­ment laws.

    By Saman­tha Yur­man, JD
    Orig­i­nal­ly pub­lished by www.thinkhr.com

  • Long-Awaited Repeal and Replacement Plan for ACA Unveiled | CA Benefit Consultants

    March 17, 2017

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    On March 6, 2017, the U.S. House of Rep­re­sen­ta­tives Ways and Means Com­mit­tee released a pro­posed bud­get rec­on­cil­i­a­tion bill, enti­tled the Amer­i­can Health Care Act, to replace por­tions of the Afford­able Care Act (ACA). If enact­ed, the Amer­i­can Health Care Act would pro­vide some relief from pro­vi­sions of the ACA for employ­ers and make oth­er sig­nif­i­cant changes to employ­ee ben­e­fits. While the pro­pos­al is 53 pages long and cov­ers a range of tax and ben­e­fit changes, below is a sum­ma­ry of key pro­vi­sions impact­ing employ­ers and employ­ee benefits.

    Employer and Individual Mandates

    The pro­pos­al effec­tive­ly elim­i­nates the employ­er and indi­vid­ual man­date by zero­ing out penal­ties for an employer’s fail­ure to offer, and an individual’s fail­ure to obtain, min­i­mum essen­tial cov­er­age retroac­tive to Jan­u­ary 1, 2016.

    Health Care Related Taxes

    The pro­pos­al extends the applic­a­ble date for the “Cadil­lac tax” from 2020 to 2025 and repeals the med­ical device tax, over the counter med­ica­tion tax, indoor tan­ning sales tax, and Medicare hos­pi­tal insur­ance sur­tax begin­ning in 2018.

    Reporting Requirements

    Because the pro­pos­al is through a bud­get rec­on­cil­i­a­tion process, employ­er report­ing require­ments for report­ing offers of cov­er­age on employ­ees’ W‑2s can­not be repealed; how­ev­er, the pro­pos­al cre­ates a sim­pli­fied process for employ­ers to report this infor­ma­tion that, accord­ing to the House Ways and Means Committee’s sec­tion-by-sec­tion sum­ma­ry, makes the cur­rent report­ing redun­dant and allows the  Sec­re­tary of the Trea­sury to cease enforc­ing report­ing that is not need­ed for tax­able purposes.

    Contribution Limits

    Addi­tion­al­ly, the pro­pos­al elim­i­nates the cap on con­tri­bu­tions to flex­i­ble spend­ing accounts (FSAs) and almost dou­bles the max­i­mum allow­able con­tri­bu­tions to health sav­ings accounts (HSAs) by allow­ing con­tri­bu­tions of $6,550 for indi­vid­u­als and $13,100 for fam­i­lies begin­ning in 2018. This aligns the HSA con­tri­bu­tion amount with the sum of the annu­al deductible and out-of-pock­et cost expens­es per­mit­ted under a high deductible health plan. The pro­pos­al also allows both spous­es to make catch-up con­tri­bu­tions to one HSA begin­ning in 2018.

    Patient Protection Provisions

    Final­ly, the pro­pos­al retains some key patient pro­tec­tion pro­vi­sions of the ACA by con­tin­u­ing to pro­hib­it insur­ers from exclud­ing indi­vid­u­als with pre-exist­ing con­di­tions from obtain­ing or pay­ing more for cov­er­age and con­tin­u­ing to allow chil­dren to stay on their parent’s plan to age 26.

    What Employers Should Know Now

    We are still in the first round of the new government’s strat­e­gy to repeal and replace the ACA. The Con­gres­sion­al Bud­get Office will next review and score the plan before it goes back to the House and the Sen­ate for full votes before mak­ing it to Pres­i­dent Trump’s desk for approval. This will take time.

    In the inter­im, the pro­vi­sions of the ACA still apply. While applic­a­ble large employ­ers may not be assessed penal­ties for fail­ing to offer min­i­mum essen­tial cov­er­age to employ­ees if the pro­pos­al is even­tu­al­ly enact­ed, please note that employ­ers are still oblig­at­ed to report offers of cov­er­age and should final­ize their ACA report­ing for the 2016 tax year if they have not com­plet­ed their e‑filing with the IRS (due March 31, 2017).

    By Nicole Quinn-Gato, JD
    Orig­i­nal­ly pub­lished by www.thinkhr.com

  • The “Line 22” Question: Which Box(es) Do I Check? | CA Benefit Consultants

    March 14, 2017

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    Under the Patient Pro­tec­tion and Afford­able Care Act (ACA), indi­vid­u­als are required to have health insur­ance while applic­a­ble large employ­ers (ALEs) are required to offer health ben­e­fits to their full-time employees.

    In order for the Inter­nal Rev­enue Ser­vice (IRS) to ver­i­fy that (1) indi­vid­u­als have the required min­i­mum essen­tial cov­er­age, (2) indi­vid­u­als who request pre­mi­um tax cred­its are enti­tled to them, and (3) ALEs are meet­ing their shared respon­si­bil­i­ty (play or pay) oblig­a­tions, employ­ers with 50 or more full-time or full-time equiv­a­lent employ­ees and insur­ers will be required to report on the health cov­er­age they offer. Sim­i­lar­ly, insur­ers and employ­ers with less than 50 full time employ­ees but that have a self-fund­ed plan also have report­ing oblig­a­tions. All of this report­ing is done on IRS Forms 1094‑B, 1095‑B, 1094‑C and 1095‑C.

    Final instruc­tions for both the 1094‑B and 1095‑B and the 1094‑C and 1095‑C were released in Sep­tem­ber 2015, as were the final forms for 1094‑B, 1095‑B, 1094‑C, and 1095‑C.

    Form 1094‑C is used in com­bi­na­tion with Form 1095‑C to deter­mine employ­er shared respon­si­bil­i­ty penal­ties. It is often referred to as the “trans­mit­tal form” or “cov­er sheet.” IRS Form 1095‑C will pri­mar­i­ly be used to meet the Sec­tion 6056 report­ing require­ment, which relates to the employ­er shared responsibility/play or pay require­ment. Infor­ma­tion from Form 1095‑C will also be used in deter­min­ing whether an indi­vid­ual is eli­gi­ble for a pre­mi­um tax credit.

    Form 1094‑C con­tains infor­ma­tion about the ALE, and is how an employ­er iden­ti­fies as being part of a con­trolled group. It also has a sec­tion labeled “Cer­ti­fi­ca­tions of Eli­gi­bil­i­ty” and instructs employ­ers to “select all that apply” with four box­es that can be checked. The sec­tion is often referred to as the “Line 22” ques­tion or box­es. Many employ­ers find this sec­tion con­fus­ing and are unsure what, if any, box­es they should select. The box­es are labeled:

    1. Qual­i­fy­ing Offer Method
    2. Reserved
    3. Sec­tion 4980H Tran­si­tion Relief
    4. 98% Offer Method

    Dif­fer­ent real world sit­u­a­tions will lead an employ­er to select any com­bi­na­tion of box­es on Line 22, includ­ing leav­ing all four box­es blank. Prac­ti­cal­ly speak­ing, only employ­ers who met the require­ments of using code 1A on the 1095‑C, offered cov­er­age to vir­tu­al­ly all employ­ees, or qual­i­fied for tran­si­tion relief in 2015 and had a non-cal­en­dar year plan will check any of the box­es on Line 22. Notably, employ­ers who do not use the fed­er­al pover­ty lev­el safe har­bor for afford­abil­i­ty will nev­er select Box A, and cor­re­spond­ing with that, will nev­er use codes 1A or 1I on Line 14 of a 1095‑C form.

    By Danielle Capilla
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Arrow Wins North Bay Business Journal Philanthropy Award 2017! | CA Benefit Consultants

    March 10, 2017

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    Arrow Ben­e­fits Prin­ci­pal Mari­ah Shields found­ed her local chap­ter of 100 Sono­ma Coun­ty Peo­ple Who Care – She and Arrow won the North Bay Busi­ness Jour­nal Phil­an­thropy award for this and all their good char­i­ta­ble work. Mari­ah is shown here pre­sent­ing one of the checks for funds raised by the orga­ni­za­tion in sup­port of local non-prof­its that sup­port the com­mu­ni­ty. Read the entire arti­cle here.

  • Gig Economy 101 | CA Benefit Advisors

    March 7, 2017

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    What is a Gig Economy?

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    By Nicole Fed­eri­co, eTekhnos Ben­e­fits Technology

  • Top Five Compliance Assessment Surprises | CA Benefit Advisors

    March 1, 2017

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    Our Firm is mak­ing a big push to pro­vide com­pli­ance assess­ments for our clients and using them as a mar­ket­ing tool with prospects. Since the U.S. Depart­ment of Labor (DOL) began its Health Ben­e­fits Secu­ri­ty Project in Octo­ber 2012, there has been increased scruti­ny. While none of our clients have been audit­ed yet, we expect it is only a mat­ter of time and we want to make sure they are prepared.

    We knew most ful­ly-insured groups did not have a Sum­ma­ry Plan Descrip­tion (SPD) for their health and wel­fare plans, but we have been sur­prised by some of the oth­er things that were miss­ing. Here are the top five com­pli­ance sur­pris­es we found.

    1. COBRA Ini­tial Notice. The ini­tial notice is a core piece of com­pli­ance with the Con­sol­i­dat­ed Omnibus Bud­get and Rec­on­cil­i­a­tion Act (COBRA) and we have been very sur­prised by how many clients are not dis­trib­ut­ing this notice. Our clients using a third-par­ty admin­is­tra­tor (TPA), or self-admin­is­ter­ing COBRA, are doing a good job of send­ing out the required let­ters after qual­i­fy­ing events. How­ev­er, we have found that many clients are not dis­trib­ut­ing the required COBRA ini­tial notice to new enrollees. The DOL has recent­ly updat­ed the COBRA mod­el notices with expi­ra­tion dates of Decem­ber 31, 2019. We are try­ing to get our clients to update their notices and, if they haven’t con­sis­tent­ly dis­trib­uted the ini­tial notice to all par­tic­i­pants, to send it out to every­one now and doc­u­ment how it was sent and to whom.
    2. Pre­scrip­tion Drug Plan Report­ing to CMS. To com­ply with the Medicare Pre­scrip­tion Drug Improve­ment and Mod­ern­iza­tion Act, passed in 2003, employ­er groups offer­ing pre­scrip­tion ben­e­fits to Medicare-eli­gi­ble indi­vid­u­als need to take two actions each year. The first is an annu­al report on the Cen­ters for Medicare & Med­ic­aid Ser­vices (CMS) web­site regard­ing whether the pre­scrip­tion drug plan offered by the group is cred­itable or non-cred­itable. The sec­ond is dis­trib­ut­ing a notice annu­al­ly to Medicare-eli­gi­ble plan mem­bers pri­or to the Octo­ber 15 begin­ning of Medicare open enroll­ment, dis­clos­ing whether the pre­scrip­tion cov­er­age is cred­itable or non-cred­itable. We have found that the vast major­i­ty (but not 100 per­cent) of our clients are com­ply­ing with the sec­ond require­ment by annu­al­ly dis­trib­ut­ing notices to employ­ees. Many clients are not com­ply­ing with the first require­ment and do not go to the CMS web­site annu­al­ly to update their infor­ma­tion. The annu­al notice on the CMS web­site must be made within:
    • 60 days after the begin­ning of the plan year,
    • 30 days after the ter­mi­na­tion of the pre­scrip­tion drug plan, or
    • 30 days after any change in the cred­itabil­i­ty sta­tus of the pre­scrip­tion drug plan.
    1. ACA Notice of Exchange Rights. The Patient Pro­tec­tion and Afford­able Care Act (ACA) required that, start­ing in Sep­tem­ber 2013, all employ­ers sub­ject to the Fair Labor Stan­dards Act (FLSA) dis­trib­ute writ­ten notices to all employ­ees regard­ing the state exchanges, eli­gi­bil­i­ty for cov­er­age through the employ­er, and whether the cov­er­age was qual­i­fy­ing cov­er­age. This notice was to be giv­en to all employ­ees at that time and to all new hires with­in 14 days of their date of hire. We have found many groups have not includ­ed this notice in the infor­ma­tion they rou­tine­ly give to new hires. The DOL has acknowl­edged that there are no penal­ties for not dis­trib­ut­ing the notice, but since it is so easy to com­ply, why take the chance in case of an audit?
    2. USERRA Notices. The Uni­formed Ser­vices Employ­ment and Reem­ploy­ment Rights Act (USERRA) pro­tects the job rights of indi­vid­u­als who vol­un­tar­i­ly or invol­un­tar­i­ly leave employ­ment for mil­i­tary ser­vice or ser­vice in the Nation­al Dis­as­ter Med­ical Sys­tem. USERRA also pro­hibits employ­ers from dis­crim­i­nat­ing against past and present mem­bers of the uni­formed ser­vices. Employ­ers are required to pro­vide a notice of the rights, ben­e­fits and oblig­a­tions under USERRA. Many employ­ers meet the oblig­a­tion by post­ing the DOL’s “Your Rights Under USERRA” poster, or includ­ing text in their employ­ee hand­book. How­ev­er, even though USERRA has been around since 1994, we are find­ing many employ­ers are not pro­vid­ing this information.
    3. Sec­tion 79. Inter­nal Rev­enue Code Sec­tion 79 pro­vides reg­u­la­tions for the tax­a­tion of employ­er-pro­vid­ed life insur­ance. This code has been around since 1964, and while there have been some changes, the basics have been in place for many years. Despite the length of time it has been in place, we have found a num­ber of groups that are not cal­cu­lat­ing the imput­ed income. In essence, if an employ­er pro­vides more than $50,000 in life insur­ance, then the employ­ee should be pay­ing tax on the excess cov­er­age based on the IRS’s age rat­ed table 2–2. With many employ­ers out­sourc­ing their pay­roll or using soft­ware pro­grams for pay­roll, cal­cu­lat­ing the imput­ed income usu­al­ly only takes a cou­ple of mouse clicks. How­ev­er, we have been sur­prised by how many employ­ers are not com­ply­ing with this part of the Inter­nal Rev­enue Code, and are there­fore putting their employ­ees’ ben­e­fi­cia­ries at risk.

    There have been oth­er sur­pris­es through this process, but these are a few of the more strik­ing exam­ples. The feed­back we received from our com­pli­ance assess­ments has been over­whelm­ing­ly pos­i­tive. Groups don’t always like to change their process­es, but they do appre­ci­ate know­ing what needs to be done.

    Audit-proof your com­pa­ny with UBA’s lat­est white paper: Don’t Roll the Dice on Depart­ment of Labor Audits. This free resource offers valu­able infor­ma­tion about how to pre­pare for an audit, the best way to accli­mate staff to the audit process, and the most impor­tant ele­ments of com­ply­ing with requests.

    By Bob Bentley
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Keeping Pace with the Protecting Affordable Coverage for Employees Act | CA Benefit Advisors

    February 25, 2017

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    Last fall, Pres­i­dent Barack Oba­ma signed the Pro­tect­ing Afford­able Cov­er­age for Employ­ees Act (PACE), which pre­served the his­tor­i­cal def­i­n­i­tion of small employ­er to mean an employ­er that employs 1 to 50 employ­ees. Pri­or to this new­ly signed leg­is­la­tion, the Patient Pro­tec­tion and Afford­able Care Act (ACA) was set to expand the def­i­n­i­tion of a small employ­er to include com­pa­nies with 51 to 100 employ­ees (mid-size seg­ment) begin­ning Jan­u­ary 1, 2016.

    If not for PACE, the mid-size seg­ment would have become sub­ject to the ACA pro­vi­sions that impact small employ­ers. Includ­ed in these pro­vi­sions is a man­date that requires cov­er­age for essen­tial health ben­e­fits (not to be con­fused with min­i­mum essen­tial cov­er­age, which the ACA requires of applic­a­ble large employ­ers) and a require­ment that small group plans pro­vide cov­er­age lev­els that equate to spe­cif­ic actu­ar­i­al val­ues. The orig­i­nal intent of expand­ing the def­i­n­i­tion of small group plans was to low­er pre­mi­um costs and to increase man­dat­ed ben­e­fits to a larg­er por­tion of the population.

    The low­er cost the­o­ry was based on the premise that broad­en­ing the risk pool of cov­ered indi­vid­u­als with­in the small group mar­ket would spread the costs over a larg­er pop­u­la­tion, there­by reduc­ing pre­mi­ums to all. How­ev­er, after fur­ther scruti­ny and com­ments, there was con­cern that the expand­ed def­i­n­i­tion would actu­al­ly increase pre­mi­um costs to the mid-size seg­ment because they would now be sub­ject to com­mu­ni­ty rat­ing insur­ance stan­dards. This shift to small group plans might also encour­age mid-size groups to leave the ful­ly-insured mar­ket by self-insur­ing – a move that could actu­al­ly negate the intend­ed ben­e­fits of the expand­ed definition.

    Anoth­er issue with the ACA’s expand­ed def­i­n­i­tion of small group plans was that it would have result­ed in a dou­ble stan­dard for the mid-size seg­ment. Not only would they be sub­ject to the small group cov­er­age require­ments, but they would also be sub­ject to the large employ­er man­date because they would meet the ACA’s def­i­n­i­tion of an applic­a­ble large employer.

    Note: Although this bill pre­serves the tra­di­tion­al def­i­n­i­tion of a small employ­er, it does allow states to expand the def­i­n­i­tion to include orga­ni­za­tions with 51 to 100 employ­ees, if so desired.

    By Vic­ki Randall
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • Top 3 Questions to Make the Most out of your Dental Plan – by Jennifer Wardell & Stephen McNeil

    February 21, 2017

    For many den­tal patients, den­tal insur­ance annu­al max­i­mums replen­ish on Jan­u­ary 1.  To make sure you get the most bang for your buck on your den­tal plan, we rec­om­mend you ask these three vital ques­tions before hav­ing any upcom­ing pro­ce­dures.  Read entire arti­cle here…

    North­Bay­Biz Mag­a­zine – Feb­ru­ary 2017

    Stephen McNeil

     

     

     

     

     

     

     

     

     

     

     

    Jen­nifer Wardell

  • The IRS Clarifies Tax Treatment of Fixed-Indemnity Health Plans | CA Benefit Advisors

    February 16, 2017

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    While many Amer­i­cans will remem­ber Jan­u­ary 20, 2017 as the day the 45th Pres­i­dent of the Unit­ed States was sworn into office, employ­ee ben­e­fits experts will also remem­ber it as the day the IRS Office of Chief Coun­sel (OCC) released this mem­o­ran­dum that clar­i­fies, among oth­er things, the tax treat­ment of ben­e­fits paid by fixed-indem­ni­ty plans.

    Fixed indem­ni­ty plans are gen­er­al­ly vol­un­tary ben­e­fits employ­ers offer to com­ple­ment or sup­ple­ment group health insur­ance, such as a hos­pi­tal indem­ni­ty plan that pays a fixed dol­lar amount for days in the hos­pi­tal. The plans do not meet min­i­mum essen­tial cov­er­age stan­dards and are exempt from the Afford­able Care Act.

    In the mem­o­ran­dum, the IRS clar­i­fied that if an employ­er pays the fixed-indem­ni­ty pre­mi­ums on behalf of employ­ees and the val­ue is exclud­ed from employ­ees’ gross income and wages or allows employ­ees to pay pre­mi­ums pre-tax through the employer’s cafe­te­ria plan, the amount of any ben­e­fits paid to an employ­ee under the plan will be includ­ed in the employee’s gross income and wages. On the oth­er hand, if employ­ees pay the pre­mi­ums with after-tax dol­lars, then the ben­e­fits are not includ­ed in the employ­ees’ gross income and wages.

    While this cre­ates a tax bur­den for the employ­ee, it also cre­ates a bur­den for employ­ers, as they are tasked with deter­min­ing whether an employ­ee has received a ben­e­fit and the amount of the ben­e­fit to deter­mine wages and applic­a­ble employ­ment taxes.

    Employ­ers that offer employ­er-paid fixed indem­ni­ty plans or allow employ­ees to pay for plans pre-tax are encour­aged to work with their coun­sel, bro­ker, car­ri­er, or oth­er trust­ed advi­sor to address their cur­rent prac­tices and deter­mine if any changes should be made.

    By Nicole Quinn-Gato, JD
    Orig­i­nal­ly pub­lished by www.thinkhr.com

  • Good Sense Guide to Minimum Essential Coverage Forms 1094‑C and 1095‑C | CA Benefit Advisors

    February 14, 2017

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    If you are an Applic­a­ble Large Employ­er (ALE), you may still be catch­ing your breath from 2015 Patient Pro­tec­tion and Afford­able Care Act (ACA) report­ing. How­ev­er, in a cou­ple of weeks the process starts all over again as you pre­pare for the 2016 report­ing cycle. As with all new require­ments, the first fil­ing cycle had some bumps as there was lit­tle guid­ance for some of the ques­tions and issues that arose. In prepa­ra­tion for 2017, let’s take a look at the “C” forms and dis­cuss areas of the forms that may have been confusing.

    To refresh, the C forms are used by ALEs to report infor­ma­tion about their offers of health cov­er­age as required under Sec­tion 6056. For self-insured ALEs, the C forms are also used to report cov­er­age infor­ma­tion for indi­vid­u­als enrolled in the ALE’s health plan as required under Sec­tion 6055. All ALEs are required to file 1094/1095‑C forms regard­less of what kind of cov­er­age, if any, they offer. ALEs with self-insured plans or ful­ly-insured plans, as well as, ALEs that offer no plan are sub­ject to Sec­tion 6056 report­ing. See my blog “Mak­ing Sense of Form 1095 Min­i­mum Essen­tial Cov­er­age Report­ing.”

    The 1094‑C is the trans­mit­tal form that goes along with all of your 1095‑C forms when you sub­mit them to the IRS. It has four parts and in gen­er­al, the 1094‑C is pret­ty straight­for­ward. How­ev­er, Line 22, locat­ed in Part II of the form, deserves some dis­cus­sion. Line 22 is used to indi­cate when an ALE is eli­gi­ble for one or more types of report­ing relief. A response is not manda­to­ry and is only nec­es­sary if an ALE wish­es to take advan­tage of one of the relief options.

    It prob­a­bly seems obvi­ous, and this will sound a bit like a tongue twister, but it may be help­ful to review the relief that is pro­vid­ed pri­or to going to the effort of deter­min­ing whether you meet the require­ments of the relief. Said dif­fer­ent­ly, if the relief for meet­ing cer­tain require­ments isn’t of val­ue to you, there is lit­tle val­ue in tak­ing the time to deter­mine if you qual­i­fy for the relief. The table below pro­vides a sum­ma­ry of the relief options avail­able for selec­tion on Line 22.

    Summary of line 22 reporting relief

    The 1095‑C is employee/participant spe­cif­ic and one is gen­er­at­ed for all full-time employ­ees. In addi­tion, if it is a self-insured plan, a 1095‑C is also gen­er­at­ed for any non-full-time indi­vid­ual who enrolled in the plan.

    An area of con­fu­sion on the 1095‑C is Part II. This area requires that you under­stand the dif­fer­ent codes used to report the var­i­ous “offer” sit­u­a­tions that might exist. Deci­pher­ing these dif­fer­ent sit­u­a­tions can be some­what like play­ing a game of Twister as mul­ti­ple codes may be applicable

    Line 14 – Offer of Cov­er­age Code

    This line cap­tures the code that reflects the offer an ALE made to the employ­ee on a month-by-month basis. For some employ­ees, this may be straight­for­ward. For exam­ple, the employ­ee may have been employed for the entire year and may have received an offer at the begin­ning of the year, which cov­ered all 12 months and no changes occurred with regard to that employee’s offer through­out the year. There­fore, one code can be used for all 12 months. How­ev­er, when an employ­ee is hired or ter­mi­nat­ed, the code will not be the same for the entire year. Throw in sit­u­a­tions where employ­ees go from part-time to full-time, or per­haps you have a rehire sit­u­a­tion, and it can become quite complicated.

    In 2016, there were 11 dif­fer­ent offer codes. How­ev­er, one of these codes (1I) is not to be used, so essen­tial­ly there are 10 options available.

    Offer codes for line 14

    Line 14 is manda­to­ry and should always have a code entered.

    *If used on Line 14, then line 15 must be completed.

    Line 15 – Employ­ee Required Contribution

    This line cap­tures the amount the employ­ee would be required to con­tribute for the low­est cost min­i­mum val­ue cov­er­age that was offered by the ALE. Note: This is not nec­es­sar­i­ly what the employ­ee enrolled in. Line 15 is used by the IRS to deter­mine if the min­i­mum val­ue cov­er­age that was offered meets the afford­abil­i­ty require­ment. NOTE: Line 15 is only to be com­plet­ed when the code on Line 14 is 1B, C, D, E, J or K. When any of the oth­er codes are used on Line 14, line 15 is to be left blank because the IRS does not need to ascer­tain affordability.

    Line 16 – Sec­tion 4980H Safe Har­bor and Oth­er Relief Codes

    This line is used to pro­vide a rea­son why an ALE mem­ber should not be liable for a 4980H(b) penal­ty. Line 16 pro­vides addi­tion­al infor­ma­tion to sub­stan­ti­ate why a penal­ty should not apply to that par­tic­u­lar employee’s offer, or lack of an offer. Line 16 is not manda­to­ry, so depend­ing on the code used on Line 14, you may, or may not, need to pro­vide a code on this line. Exam­ples where you may wish to pro­vide a code include:

    • Codes 2A, B, D, or E could be used to explain why an offer was not required for an employ­ee. For exam­ple, Code 2A is used for months in which a ter­mi­nat­ed employ­ee has COBRA.
    • Codes 2F, G, or H might be used in sit­u­a­tions where afford­abil­i­ty of the offer is ques­tion­able based on the fig­ure on line 15.
    • Code 2C is applic­a­ble if the employ­ee enrolled in the cov­er­age for each day of the month and was full-time for at least one month dur­ing the year.

    Section 4980H Safe Harbor and Other Relief Codes for Line 16

    Those are the areas of the 1094‑C and 1095‑C that seemed to be the most con­fus­ing for many ALEs. Although the infor­ma­tion pre­sent­ed here by no means extin­guish­es this con­fu­sion, our intent was to help explain the pur­pose of the more con­fus­ing parts and how cer­tain respons­es can prove ben­e­fi­cial so that deter­min­ing those respons­es is less frustrating.

    By Vic­ki Randall
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

  • National Rising Star Award

    February 10, 2017

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    The entire team at Arrow Ben­e­fits Group con­grat­u­lates our Andrew McNeil, Prin­ci­pal for win­ning the Employ­ee Ben­e­fits Advis­er Nation­al Ris­ing Star Award! The award is well deserved and Andrew is some­one tru­ly con­cerned with the growth and well-being of all his clients and com­mu­ni­ty at large. His con­tin­u­ous inno­va­tions in the indus­try are being well-rec­og­nized and we agree!

  • UBA Health Plan Survey — 2016 | CA Benefit Advisors

    February 9, 2017

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    Employ­er-spon­sored health insur­ance is great­ly affect­ed by geo­graph­ic region, indus­try, and employ­er size. While some cost trends have been fair­ly con­sis­tent since the Patient Pro­tec­tion and Afford­able Care Act (ACA) was put in place, Unit­ed Ben­e­fit Advi­sors (UBA) finds sev­er­al sur­pris­es in their 2016 Health Plan Survey.

    Based on respons­es from more than 11,000 employ­ers, UBA announces the top five best and worst states for group health care costs.

    Check out this short video and con­tact us with how this Sur­vey impacts you and your business!

  • Here’s What You Need to Know About a Long-Term Care Insurance Policy | CA Benefit Advisors

    February 6, 2017

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    So you’ve made the deci­sion to learn more about long-term care insur­ance. That’s smart, as nei­ther health insur­ance nor Medicare would pay for extend­ed long-term care ser­vices in the event that you need­ed them in the future. Plus, there’s about a 70% chance you’ll need some type of long-term care after age 65, accord­ing to gov­ern­ment stats. And giv­en that the cost of long-term care can quick­ly deplete your life’s sav­ings, it just makes sense to add it your finan­cial plan.

    When you pre­pare for any upcom­ing invest­ment or pur­chase, you prob­a­bly run into some unfa­mil­iar lan­guage or ter­mi­nol­o­gy in your research, which can be frus­trat­ing and down­right confusing.

    Search­ing for a long-term care insur­ance pol­i­cy is no dif­fer­ent. A long-term care insur­ance pol­i­cy describes cov­er­age under the pol­i­cy, exclu­sions and limitations—and can be laden with indus­try jar­gon. Here’s a break­down of the fundamentals:

    There are four pri­ma­ry com­po­nents that deter­mine your long-term care ben­e­fits and influ­ence your month­ly cost.

    1. How much. This is the total max­i­mum ben­e­fit avail­able under any pol­i­cy. There are many max­i­mums to choose from, rang­ing from $100,000 to $250,000, $500,000 or more. Ben­e­fits are avail­able until you have received your max­i­mum ben­e­fit in total.

    2. How fast. This is the month­ly lim­it you can access from your total max­i­mum ben­e­fit. Insur­ance com­pa­nies do not pay out your “how much” in a sin­gle lump sum. Rather, you access your ben­e­fits in small­er amounts on a month­ly basis up to a pre­de­ter­mined month­ly maximum.

    Depend­ing on the car­ri­er you choose, your month­ly max­i­mum could range from $1,500 to $10,000 a month. The “how much” and “how fast” com­po­nents work togeth­er to deter­mine how long your cov­er­age will last. If your month­ly max­i­mum (“how fast”) is $5,000 and your total pol­i­cy max­i­mum (“how much”) is $250,000, it would take 50 months (four years, two months) before your exhaust your pol­i­cy ben­e­fits. If you need­ed $2,000 a month to pay for home care, as an exam­ple, it could take more than 10 years to exhaust a $250,000 pol­i­cy. The greater your “how much” and “how fast,” are the high­er your pre­mi­um will be.

    3. Growth rate. This deter­mines how your ben­e­fit grows over time. The most com­mon growth rate today is 3%. If your pol­i­cy start­ed with $176,000 in your “how much” and $4,500 in your “how fast,” a 3% annu­al growth rate would dou­ble your ben­e­fits in 24 years to $352,000 total max­i­mum ben­e­fit and $9,000 month­ly max­i­mum respectively.
    You also have the option of choos­ing a growth rate oth­er than 3% or to increase your max­i­mums upfront and for­go a growth rate all togeth­er. A spe­cial­ist can help you iden­ti­fy the growth rate that best suits your goals and budget.

    4. Deductible. Long-term care insur­ance has an elim­i­na­tion peri­od that, like a deductible, deter­mines how much you may have to pay out of your pock­et before ben­e­fits are paid. One dis­tinc­tion to note is that an elim­i­na­tion peri­od is stat­ed in days, not dol­lars. The most com­mon­ly select­ed elim­i­na­tion peri­od is 90 days. This typ­i­cal­ly means that you must receive 90 days of care that you pay for out of your pock­et before ben­e­fits are available.

    Not that dif­fi­cult when put sim­ply, right? I hope you feel bet­ter pre­pared in your search for the right pol­i­cy and that I have also remove some of the con­fu­sion. Long-term care insur­ance is here to help you live the lifestyle you want 10, 20, even 30 years down the road.

    By Matt Dean
    Orig­i­nal­ly pub­lished by www.lifehappens.org

  • President Trump Makes First Moves Towards ACA Repeal — What Employers and Plan Sponsors Should Know Now | CA Benefit Advisors

    February 2, 2017

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    One of Pres­i­dent Don­ald Trump’s first actions in office was to make good on a cam­paign promise to move quick­ly to repeal the Afford­able Care Act (ACA). He issued Exec­u­tive Order 13765, Min­i­miz­ing the Eco­nom­ic Bur­den of the Patient Pro­tec­tion and Afford­able Care Act Pend­ing Repeal. The one-page exec­u­tive order (EO) is effec­tive imme­di­ate­ly and very light on details, with the goal to min­i­mize the finan­cial and reg­u­la­to­ry bur­dens of the ACA while its repeal is pend­ing. The EO directs the Exec­u­tive Branch agency heads (those in the depart­ments of Labor, Health and Human Ser­vices, and the Trea­sury) in charge of enforc­ing the ACA to “exer­cise all author­i­ty and dis­cre­tion avail­able to them to waive, defer, grant exemp­tions from, or delay the imple­men­ta­tion of any pro­vi­sion or require­ment of the Act that would impose a fis­cal bur­den on any State or a cost, fee, tax, penal­ty, or reg­u­la­to­ry bur­den on indi­vid­u­als, fam­i­lies, health­care providers, health insur­ers, patients, recip­i­ents of health­care ser­vices, pur­chasers of health insur­ance, or mak­ers of med­ical devices, prod­ucts, or medications.”

    While Con­gress works on the ACA repeal through bud­get rec­on­cil­i­a­tion, which allows for quick con­sid­er­a­tion of tax, spend­ing, and debt lim­it leg­is­la­tion, Pres­i­dent Trump is tack­ling the reg­u­la­to­ry enforce­ment actions of the law. The prac­ti­cal impact of the EO is lim­it­ed to agency enforce­ment dis­cre­tion and requires agen­cies to imple­ment the EO in a man­ner con­sis­tent with cur­rent law, includ­ing assur­ing that any required changes to applic­a­ble reg­u­la­tions will fol­low all admin­is­tra­tive require­ments for notice and com­ment periods.

    The bot­tom line is that until the agency heads in Labor, Health and Human Ser­vices, and the Trea­sury are con­firmed and take charge of their depart­ments, there will prob­a­bly be lit­tle change in agency enforce­ment action right away. The broad­er changes to amend or repeal the ACA will take even more time to implement.

    What Employers and Plan Sponsors Should Know Now

    While the EO does not specif­i­cal­ly refer to the ACA com­pli­ance bur­dens on employ­ers or plan spon­sors, such as the employ­er or indi­vid­ual man­dates, required health ben­e­fits cov­er­age, report­ing or employ­ee noti­fi­ca­tion require­ments, the lan­guage address­es the actions that the fed­er­al agen­cies can take to soft­en enforce­ment until the repeal is accom­plished. It does direct the gov­ern­ment to address the tax­es and penal­ties asso­ci­at­ed with the ACA. So what does that mean for employ­ers and plan spon­sors now?

    IRS employ­er report­ing delay? Not yet. The top con­cern of employ­ers is whether or not those sub­ject to the shared respon­si­bil­i­ty pro­vi­sions of the law would need to sub­mit their 1094/1095 reports of cov­er­age to the IRS by Feb­ru­ary 28 (or March 31, if fil­ing elec­tron­i­cal­ly) and pro­vide their employ­ees with indi­vid­ual 1095‑C state­ments by March 2. These reports are essen­tial for the IRS to assess penal­ties under the law, and this report­ing has been a bur­den for employ­ers. Unfor­tu­nate­ly for employ­ers, the order did not men­tion delay­ing or elim­i­nat­ing this report­ing requirement.

    What employ­ers should do now:

    • Applic­a­ble large employ­ers (ALEs) sub­ject to the employ­er man­date should plan to com­ply with their 1094/1095 report­ing oblig­a­tions this year.
    • All employ­ers should con­tin­ue to com­ply with all cur­rent ACA require­ments until there is fur­ther guid­ance from the lawmakers.

    We’ve Got You Covered

    We’ll be mon­i­tor­ing Pres­i­dent Trump’s actions to reduce reg­u­la­to­ry bur­dens on Amer­i­can busi­ness­es along with Con­gres­sion­al leg­isla­tive actions that can impact your busi­ness oper­a­tions. Look for ThinkHR’s prac­ti­cal updates where we’ll ana­lyze these devel­op­ments and break them down into action­able infor­ma­tion you need to com­ply with the chang­ing laws and regulations.

    By Lau­ra Kerekes, SPHR, SHRM-SCP
    Orig­i­nal­ly pub­lished by www.thinkhr.com

  • Who Are You Benchmarking Your Health Plan Against? | CA Benefit Advisors

    January 31, 2017

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    Many employ­ers bench­mark their health plan against car­ri­er pro­vid­ed nation­al data. While that is a good place to start, region­al cost aver­ages vary, mak­ing it essen­tial to bench­mark both nation­al­ly and region­al­ly—as well as state by state. For exam­ple, a sig­nif­i­cant dif­fer­ence exists between the cost to insure an employ­ee in the North­east ver­sus the Cen­tral U.S.—plans in the North­east con­tin­ue to cost the most since they typ­i­cal­ly have low­er deductibles, con­tain more state-man­dat­ed ben­e­fits, and fea­ture high­er in-net­work coin­sur­ance, among oth­er factors.

    UBA Health Plan Survey Costs by Region

    Drilling down even more, com­par­ing your­self to your indus­try peers can tell a very dif­fer­ent story.

    UBA Health Plan Survey Costs by Industry

    Con­sid­er a man­u­fac­tur­ing plant in Geor­gia that offers a PPO. Its pre­mi­um cost for sin­gle cov­er­age is $507 per month. Com­pare this with the bench­marks for all plans and you can see that it is $2 per month less than the nation­al aver­age. When com­pared with oth­er PPOs in the South­east region, this employer’s cost is actu­al­ly $2 more than the aver­age. This employer’s cost appears to be high­er or low­er com­pared with nation­al and region­al bench­marks, depend­ing on which bench­mark is used. Yet this employer’s cost is actu­al­ly high­er than its clos­est peers’ costs when using the state-spe­cif­ic bench­mark, which in Geor­gia is $468. Bot­tom line, this employer’s month­ly sin­gle pre­mi­um is actu­al­ly $39 more than its com­peti­tors in the state.UBA Health Plan Survey Plan Comparison

    As our CEO, Les McP­hear­son, recent­ly stat­ed, “Bench­mark­ing by state, region, indus­try, and group size is crit­i­cal. We see it time and time again, espe­cial­ly with new clients. An employ­er bench­marks their rates nation­al­ly and they seem at or below aver­age, but once we look at their rates by plan type across mul­ti­ple car­ri­ers and among their neigh­bor­ing com­peti­tors or like-size groups, we find many employ­ers leave a lot on the bar­gain­ing table.”

    By RJ Nelson|
    Orig­i­nal­ly pub­lished by www.ubabenefits.com

     

  • DOL Increases Penalty Amounts to Adjust for Inflation | California Benefit Advisors

    January 25, 2017

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    For the sec­ond time in less than a year the Depart­ment of Labor (DOL) has increased the civ­il mon­e­tary penal­ties assessed or enforced by the DOL. The increas­es were announced in a final rule issued by the DOL on Jan­u­ary 18, 2017. The increas­es were made pur­suant to the Fed­er­al Civ­il Penal­ties Infla­tion Adjust­ment Act Improve­ments Act of 2015, which requires fed­er­al agen­cies to annu­al­ly adjust their civ­il mon­ey penal­ties for infla­tion, based on the Con­sumer Price Index for All Urban Con­sumers (CPI‑U), no lat­er than Jan­u­ary 15 of each year. The infla­tion adjust­ment for 2017 was based on the per­cent­age change between the Octo­ber 2016 CPI‑U and the Octo­ber 2015 CPI‑U. The penal­ties were last increased on August 1, 2016.

    The increased penal­ties apply to a broad range of laws enforced by the DOL including:

    • The Black Lung Ben­e­fits Act.
    • The Con­tract Work Hours and Safe­ty Stan­dards (CWHSSA).
    • The Employ­ee Poly­graph Pro­tec­tion Act (EPPA).
    • The Employ­ee Retire­ment Income Secu­ri­ty Act (ERISA).
    • The Fair Labor Stan­dards Act (FLSA).
    • The Fam­i­ly and Med­ical Leave Act (FMLA).
    • The Fed­er­al Mine and Safe­ty Health Act.
    • The Immi­gra­tion and Nation­al­i­ty Act.
    • The Long­shore and Har­bor Work­ers’ Com­pen­sa­tion Act.
    • The Migrant and Sea­son­al Agri­cul­tur­al Work­er Pro­tec­tion Act (MSPA).
    • The Occu­pa­tion­al Safe­ty and Health Act (OSH Act).
    • The Walsh-Healey Pub­lic Con­tracts Act (PCA).

    The new penal­ties apply to vio­la­tions that occurred after Novem­ber 2, 2015, and for which penal­ties were assessed after Jan­u­ary 13, 2017. View the updat­ed penal­ties for vio­la­tions of laws enforced by the Wage and Hour Divi­sion of the DOL.

     

    By Rick Mont­gomery, JD — Orig­i­nal­ly pub­lished by ThinkHR — Read More

  • 2017 Annual Limits Card Back by Popular Demand | CA Benefit Advisors

    January 23, 2017

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    Many employ­ee ben­e­fit lim­its are auto­mat­i­cal­ly adjust­ed each year for infla­tion (this is often referred to as an “indexed” lim­it). UBA offers a quick ref­er­ence chart show­ing the 2017 cost of liv­ing adjust­ments for health and Sec­tion 125 plans, qual­i­fied plans, Social Security/Medicare with­hold­ing, com­pen­sa­tion amounts and more. This at-a-glance resource is a valu­able desk tool for employ­ers and HR practitioners.

    Here’s a snap­shot of a sec­tion of the 2017 health plan lim­its; be sure to request the com­plete chart from a UBA Partner.

    2017 health plan limits

     

    By Danielle Capil­la, Orig­i­nal­ly pub­lished by Unit­ed Ben­e­fit Advi­sors — Read More

  • Department of Labor Form 5500’s Time-Intensive and Expensive Reporting Requirements Painful for Small Employers | CA Benefit Advisors

    January 20, 2017

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    Pro­posed reg­u­la­tions for revis­ing and great­ly expand­ing the Depart­ment of Labor (DOL) Form 5500 report­ing are set to take effect in 2019. Cur­rent­ly, the non-retire­ment plan report­ing is lim­it­ed to those employ­ers that have more than 100 employ­ees enrolled on their ben­e­fit plans, or those in a self-fund­ed trust. The fil­ings must be com­plet­ed on the DOL EFAST2 sys­tem with­in 210 days fol­low­ing the end of the plan year.

    What does this expand­ed num­ber of busi­ness­es required to report look like? Accord­ing to the 2016 Unit­ed Ben­e­fit Advi­sors (UBA) Health Plan Sur­vey, less than 18 per­cent of employ­ers offer­ing med­ical plans are required to report right now. With the expand­ed require­ments of 5500 report­ing, this would require the just over 82 per­cent of employ­ers not report­ing now to com­ply with the new mandate.

    While the infor­ma­tion report­ed is not typ­i­cal­ly dif­fi­cult to gath­er, it is a time-inten­sive task. In addi­tion to the usu­al infor­ma­tion about the carrier’s name, address, total pre­mi­um, and pay­ments to an agent or bro­ker, employ­ers will now be required to pro­vide detailed ben­e­fit plan infor­ma­tion such as deductibles, out-of-pock­et max­i­mums, coin­sur­ance and copay amounts, among oth­er items. Cur­rent­ly, insur­ance car­ri­ers and third par­ty admin­is­tra­tors must pro­duce infor­ma­tion need­ed on sched­uled forms. How­ev­er, an employer’s plan year as filed in their ERISA Sum­ma­ry Plan Descrip­tion, might not match up to the renew­al year with the insur­ance car­ri­er. There are times when these sched­ule forms must be request­ed repeat­ed­ly in order to receive the cor­rect dates of the plan year for filing.

    In the ear­ly 1990s small employ­ers offer­ing a Sec­tion 125 plan were required to fill out a 5500 form with a very sim­ple 5500 sched­ule form. Most small employ­ers did not know about the fil­ing, so non­com­pli­ance ran very high. The small employ­er fil­ings were stopped main­ly because the DOL did not have ade­quate resources to review or tab­u­late the information.

    While elec­tron­ic fil­ing makes the process eas­i­er to tab­u­late the infor­ma­tion received from com­pa­nies, is it real­ly need­ed? Like­ly not, giv­en the expense it will require in addi­tion­al com­pli­ance costs for small employ­ers. With the cur­rent infor­ma­tion gath­ered on the forms, the least expen­sive ser­vice is typ­i­cal­ly $500 annu­al­ly for one fil­ing. Employ­ers with­out an ERISA required sum­ma­ry plan descrip­tion (SPD) in a wrap-style doc­u­ment, would be required to do a sep­a­rate fil­ing based on each line of cov­er­age. If an employ­er offers med­ical, den­tal, vision and life insur­ance, it would need to com­plete four sep­a­rate fil­ings. Of course, with the expand­ed infor­ma­tion required if the pro­posed reg­u­la­tions hold, it is antic­i­pat­ed that those offer­ing Form 5500 fil­ing ser­vices would need to increase with the addi­tion­al amount of infor­ma­tion to be entered. In order to com­pen­sate for the addi­tion­al infor­ma­tion, those fees could more than dou­ble. Of course, that also doesn’t account for the time required to gath­er all the data and make sure it is cor­rect. It is at the very least, an expen­sive endeav­or for a small busi­ness to undertake.

    Even though small employ­ers will like­ly have few­er items required for their fil­ings, it is an espe­cial­ly undue hard­ship on many already strug­gling small busi­ness­es that have been hit with ris­ing health insur­ance pre­mi­ums and oth­er increas­ing costs. For those employ­ers in the 50–99 cat­e­go­ry, they have like­ly paid out high fees to com­plete the ACA required 1094 and 1095 forms and now will be sad­dled with yet anoth­er report­ing cost and time inten­sive gath­er­ing of data.

    Giv­en the non­com­pli­ance of the 1990s in the small group are­na, this is just one area that a new admin­is­tra­tion could very sim­ply and eas­i­ly remove this unwel­come bur­den from small employers.

     

    By Car­ol Tay­lor, Orig­i­nal­ly pub­lished by Unit­ed Ben­e­fit Advi­sors — Read More

  • 2017: What HR Can Do to Prepare for a Big Year of Change | California Employee Benefits

    January 18, 2017

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    Employ­ers saw unprece­dent­ed changes to human resources man­age­ment in 2016, includ­ing Afford­able Care Act (ACA) com­pli­ance, new Fair Labor Stan­dards Act (FLSA) reg­u­la­tions, parental leave laws and a push for equal pay. With a new year and a new pres­i­dent tak­ing office, 2017 is sure to ush­er in some major changes and HR chal­lenges that could have sig­nif­i­cant impact on busi­ness­es large and small. Here are a few of the hot but­ton issues to keep on your radar and how to pre­pare for them:

    Keep cur­rent on ACA changes
    With Pres­i­dent-elect Trump tak­ing office, the ACA finds itself once again in the nation­al spot­light, this time stand­ing on more uncer­tain ground than ever before. Whether the ACA will be repealed ful­ly, par­tial­ly, or left as is, it’s impor­tant for employ­ers to stay cur­rent on com­pli­ance to avoid penal­ties and fees. For more infor­ma­tion, seek out the help­ful ques­tions and answers on the ACA report­ing require­ments that the IRS pro­vides here.

    Don’t assume the law is barred
    In Novem­ber 2016, a fed­er­al judge in Texas issued an injunc­tion block­ing the new over­time reg­u­la­tions slat­ed to go into effect the first of Decem­ber. This would have dou­bled the FLSA’s salary thresh­old for exemp­tion from over­time pay. Despite the injunc­tion, many employ­ers have already adjust­ed work­ers’ salaries or reclas­si­fied their employ­ees. While we wait to see what comes from the Depart­ment of Labor’s appeal, it is a safe bet for employ­ers to leave their deci­sions in place, and not assume the law will be per­ma­nent­ly barred.

    Make a good (and fair) recruit­ment process a priority
    Find­ing the best employ­ees is one of the most crit­i­cal aspects to your busi­ness. 2016 saw big push­es with diver­si­ty ini­tia­tives and blind hir­ing, a prac­tice which means being hired with­out dis­clos­ing your name, edu­ca­tion­al back­ground or work expe­ri­ence to your future employ­er. While we expect these trends to car­ry over in 2017, we also pre­dict a renewed focus on improv­ing the over­all job can­di­date expe­ri­ence. A recent study found that 60 per­cent of job seek­ers have had at least one bad recruit­ment expe­ri­ence, and 72 per­cent of those report hav­ing shared their expe­ri­ence with a recruiter or career web­sites. In order to ensure that it’s a pro­duc­tive expe­ri­ence for all, employ­ers should main­tain con­sis­tent com­mu­ni­ca­tions dur­ing the hir­ing process and be pre­pared to share tai­lored feed­back should the can­di­date request it.

    Con­sid­er updat­ing your per­for­mance review process
    We’ve all done them, and it’s like­ly we’ve all dread­ed them at least once. One study found that a quar­ter of employ­ees sur­veyed found their annu­al per­for­mance reviews were inef­fec­tive and didn’t actu­al­ly help their per­for­mance. 2016 saw plen­ty of con­ver­sa­tions about how to improve the out­dat­ed process and we expect this to con­tin­ue in 2017. One strat­e­gy that we see gain­ing pop­u­lar­i­ty in 2017 is build­ing out the review process to include bian­nu­al or even quar­ter­ly reviews. More fre­quent reviews may help build rap­port between man­agers and their employ­ees and encour­age all par­ties to stay on track with their goals and objec­tives for the year.

    Focus on com­pa­ny cul­ture and brand
    In line with recruit­ing and employ­ee feed­back strate­gies, employ­ee engage­ment con­tin­ues to be a hot but­ton issue. Retain­ing employ­ees is crit­i­cal to a busi­ness’ suc­cess and the last year brought this to light—85% of exec­u­tives sur­veyed in the 2016 Deloitte Human Cap­i­tal Trends report ranked employ­ee engage­ment as a top pri­or­i­ty. We expect to see this trend car­ry over into 2017 with an added empha­sis on well­ness pro­grams and work-life bal­ance. As a company’s brand and cul­ture becomes more crit­i­cal than ever, it’s impor­tant to make con­cert­ed efforts to keep employ­ees hap­py, healthy, and engaged.

    One of the many keys to a company’s suc­cess is being aware of the con­stant­ly chang­ing work land­scape. As you enter 2017, keep these pre­dic­tions and actions in mind and we’ll do our best to keep you up to date on the latest.

     

    Orig­i­nal­ly pub­lished by ThinkHR — Read More

  • How Paid Parental Leave is Changing the Benefits Landscape | California Employee Benefits

    January 13, 2017

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    When you hear the term “paid parental leave”, what do you think of? Here in the U.S., paid leave ben­e­fits are some­what of a lux­u­ry. Although the Fam­i­ly and Med­ical Leave Act (FMLA) has made it pos­si­ble for par­ents work­ing at com­pa­nies with 50 or more employ­ees to secure 12 weeks of unpaid leave, the U.S. is one of only three coun­tries on a list of 185 that does not man­date a peri­od of paid parental leave. This leaves the coun­try ranked below Iran and Mex­i­co, who both offer 12 weeks of paid parental leave. On the oth­er end of the spec­trum, employ­ees in the UK ben­e­fit from up to 40 weeks of paid leave.

    As a result of hav­ing no man­dat­ed paid parental leave pol­i­cy, approx­i­mate­ly a quar­ter of U.S. women who become preg­nant while employed quit their jobs upon giv­ing birth, one third of women are forced to bor­row mon­ey or with­draw from sav­ings to cov­er time off from work, and 15% uti­lize pub­lic assis­tance. The June 2015 Enforce­ment Guid­ance on Preg­nan­cy Dis­crim­i­na­tion from the Equal Employ­ment Oppor­tu­ni­ty Com­mis­sion (EEOC) was the first leg­is­la­tion to make a case for offer­ing equal parental leave to moth­ers and fathers, set­ting a new prece­dent for the evo­lu­tion of the paid leave benefit.

    Why Should You Offer Paid Parental Leave to Employees?

    The EY & Peter­son Insti­tute for Inter­na­tion­al Eco­nom­ics recent­ly released a study reveal­ing that 38% of mil­len­ni­als would move to a new coun­try if they would be afford­ed bet­ter paid parental leave ben­e­fits. Mil­len­ni­als now make up the largest demo­graph­ic in the Amer­i­can work­force, and com­pa­nies will need to increas­ing­ly take sta­tis­tics like this into account when build­ing ben­e­fit plans that will attract and retain top talent.

    Aside from tal­ent acqui­si­tion, the study goes on to show the pos­i­tive impacts a paid parental leave ben­e­fit can have on keep­ing women in the C‑Suite, as men who would usu­al­ly be con­sid­ered sec­ondary care­givers take advan­tage of the time off and allow women to get back to work more quick­ly. In addi­tion, change.org, who has imple­ment­ed a gen­er­ous paid parental leave pol­i­cy, observed that dads who took leave in their com­pa­ny encour­aged oth­er new fathers to take advan­tage of the ben­e­fits as well, cre­at­ing a cul­ture of safe­ty in which to uti­lize leave and invest more ful­ly in their fam­i­ly life.

    Ulti­mate­ly, employ­ees are hap­pi­er and are empow­ered to do bet­ter work when they are allowed to hon­or their pri­or­i­ties. Whether this means a new moth­er is allowed to take stress-free, paid time off to bond with her child, or a father takes advan­tage of leave to be with his fam­i­ly or allow his part­ner to return to work, the abil­i­ty to bal­ance work and life is of the utmost impor­tance to younger generations.

    Case Stud­ies – Top Com­pa­nies Doing it Right

    Amer­i­can Express

    Amer­i­can Express recent­ly announced that they were chang­ing their paid parental leave pol­i­cy from three months for pri­ma­ry care­givers and two weeks for sec­ondary care­givers to five months of paid parental leave for all full-time and part-time employees.

    All gen­ders are eli­gi­ble for the ben­e­fit, and employ­ees may become par­ents via birth, adop­tion or sur­ro­ga­cy. In addi­tion, Amer­i­can Express offers up to $35,000 for adop­tion or sur­ro­ga­cy fees with a lim­it of two events.  A life­time max­i­mum of $35,000 is also allot­ted for fer­til­i­ty treatments.

    The com­pa­ny also announced a unique sup­ple­men­tal ben­e­fit of 24-hour lac­ta­tion con­sul­tants avail­able to nurs­ing moth­ers, and a breast milk ship­ment pro­gram avail­able to moth­ers trav­el­ing for busi­ness who need to send milk home.

    Bank of America

    Bank of Amer­i­ca offers 16 weeks of paid leave for bio­log­i­cal and adop­tive par­ents. A unique fea­ture of their pol­i­cy allows par­ents to take leave any time dur­ing the first year of the child’s life, enabling part­ners to take over­lap­ping or sub­se­quent time off, whichev­er best fits their family’s needs. The com­pa­ny val­ues pro­vid­ing this option, as they see almost half of par­ents in today’s soci­ety rais­ing their kids togeth­er at home while both hold­ing jobs.

    The bank­ing giant also tries to make life after baby eas­i­er for work­ing par­ents by offer­ing a more flex­i­ble work-from-home pro­gram and pro­vid­ing $240 in month­ly child­care reim­burse­ment for employ­ees whose house­hold income comes in under $100,000 annually.

    Net­flix

    Net­flix took the spot­light when it comes to paid parental leave ben­e­fits when they announced that the com­pa­ny would offer unlim­it­ed paid leave with no loss of ben­e­fits dur­ing the first year after a child’s arrival. Leave can be tak­en at any time dur­ing the year, and employ­ees may choose to work part-time, or come back to work and then leave again if desired.

    Net­flix chief tal­ent offi­cer, Tawni Cranz, said of the mon­u­men­tal deci­sion, “Expe­ri­ence shows peo­ple per­form bet­ter at work when they’re not wor­ry­ing about home.”

    Twit­ter

    While Twit­ter offers 20 weeks of paid leave for moth­ers and 10 for fathers and adop­tive par­ents, the most inno­v­a­tive ben­e­fits this com­pa­ny offers come through its pre and post-natal pro­grams for par­ents. Twit­ter offers quar­ter­ly “New Moms and Moms-To-Be” round­ta­bles, a Mom­my Men­tor Pro­gram, Work­ing Mom lunch­es and most late­ly, “Dads on Leave” round­ta­bles. In-house sup­port for employ­ees when it comes to fam­i­ly life pro­vides a safe place to embrace new roles as par­ents while still pro­gress­ing in their careers.

    How Can You Adopt This Benefit?

    Job par­tic­i­pa­tion by women in peak years is declin­ing, and paid parental leave is a way to help remove bar­ri­ers in the work­place that leave women in only 5% of CEO posi­tions at For­tune 500 com­pa­nies. Karyn Twa­ronite, EY glob­al diver­si­ty and inclu­sive­ness offi­cer, said, “Com­pa­nies that view parental leave as some­thing sole­ly for moth­ers are becom­ing extinct, as more mod­ern and enlight­ened com­pa­nies are real­iz­ing that many peo­ple, espe­cial­ly mil­len­ni­als, are even more inter­est­ed in co-par­ent­ing giv­en most are part of dual career couples.”

    If your com­pa­ny is unable to keep up with the gen­er­ous paid leave pack­ages larg­er busi­ness­es can afford, con­sid­er tak­ing a page out of Twitter’s book and offer­ing men­tor­ing pro­grams and sup­port groups for new par­ents. Bud­get for child­care reim­burse­ment costs like Bank of Amer­i­ca. Even small­er changes that are made thought­ful­ly, with the employ­ee in mind, will increase the appeal of your ben­e­fits package.

    As the ben­e­fits land­scape changes with shift­ing demo­graph­ics, con­sid­er care­ful­ly how offer­ing paid parental leave could pos­i­tive­ly impact your employ­ees, and ulti­mate­ly, your bot­tom line as work­ers are moti­vat­ed to work hard­er and smarter, know­ing things are tak­en care of at home.

     

    By Kate McGaugh­ey, eTekhnos

  • Identify and Evaluate the Impact of Your Wellness Program | California Benefit Advisors

    January 11, 2017

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    Mea­sur­ing pro­gram val­ue, or return on invest­ment, is crit­i­cal and imper­a­tive in man­ag­ing a healthy well­ness pro­gram. Fur­ther, clear­ly iden­ti­fy­ing and objec­tive­ly eval­u­at­ing the impact helps keep the ven­dor focused on what is crit­i­cal for the employ­er. If these pro­grams are not hav­ing the impact intend­ed, then the cost of those ser­vices is only adding to med­ical spend­ing waste.

    When adding well­ness ser­vices to any employ­er ben­e­fits pack­age, it is imper­a­tive to clear­ly iden­ti­fy the intend­ed impact and out­come. Out­comes fall into three gen­er­al categories:

    1. Employ­ee sat­is­fac­tion with the employ­er, which adds to recruit­ment and retention
    2. Reduc­ing bio­met­ric risk and improv­ing the health of the population
    3. Reduc­ing med­ical spending

    Employ­ee Satisfaction

    In the book, Shared Val­ues, Shared Results by Dee W. Edding­ton, Ph.D., and Jen­nifer S. Pitts, Ph.D., the val­ue of employ­ees appre­ci­at­ing the ben­e­fits an employ­er offers is clear­ly out­lined as a win-win strat­e­gy. If an employer’s intent in pro­vid­ing well­ness ser­vices is to improve the sup­port for its employ­ees, then mea­sur­ing the sat­is­fac­tion relat­ed to those out­comes is crit­i­cal. Employ­ee sur­veys are typ­i­cal­ly the best approach to gath­er out­comes relat­ed to these intend­ed pro­grams. Some key ques­tions to ask may include:

    • Is work­ing at this orga­ni­za­tion ben­e­fi­cial for my health? (“Strong­ly Agree” to “Dis­agree” responses)
    • Do I trust that my orga­ni­za­tion cares about me? (“Strong­ly Agree” to “Dis­agree” responses)
    • Which of the fol­low­ing well­ness pro­gram ini­tia­tives do you find to be valu­able? (list all pro­grams offered)

    Col­lect­ing employ­ee, or spouse, feed­back on these pro­grams will pro­vide insight to allow an employer/ con­sul­tant to know if pro­grams are appre­ci­at­ed, or if mod­i­fi­ca­tions are required in order to achieve the desired outcomes.

    Reduc­ing Bio­met­ric Risk and Con­trol­ling Disease

    If the intent of a well­ness pro­gram is to help improve the health of indi­vid­u­als so that future med­ical spend­ing will be reduced, then it is crit­i­cal to deter­mine if the pro­gram is engag­ing the cor­rect mem­bers and then mea­sure the impact on their risk. At Vital Incite, we uti­lize Johns Hop­kins’ risk index­ing along with bio­met­ric risk migra­tion to pro­vide feed­back to ven­dors and employ­ers of the impact of their pro­grams. Some sug­gest­ed goals may include:

    • Engag­ing 80 per­cent of per­sons with high risk biometrics
    • Reduc­tion in weight of per­sons over­weight or obese by greater than 5 per­cent in 30 per­cent of the engaged population
    • Of dia­bet­ics with an A1c greater than 7 per­cent, 80 per­cent will reduce their A1c by 1 per­cent in one year
    • Of per­sons with blood pres­sure in the high-risk range, 40 per­cent will have achieved con­trolled blood pres­sure with­out adding med­ica­tions in one year
    • Of per­sons who take few­er than 10,000 steps per day, 70 per­cent will increase their aver­age step count by 20 per­cent or more

    These goals need to be very spe­cif­ic and tar­get­ed to address the exact needs of your pop­u­la­tion, mea­sur­ing what is most like­ly to have an impact on a person’s long-term health. This pro­vides spe­cif­ic direc­tion for your well­ness providers, but allows an employer/consultant to mon­i­tor the impact through­out the year to con­tin­ue to redi­rect com­mu­ni­ca­tion and ser­vices to help pro­vide the best outcomes.

    The first step in any pro­gram is to engage the intend­ed audi­ence. UBA’s Health Plan Sur­vey finds that 54.6 per­cent of employ­ers with well­ness pro­grams use com­po­nents such as on-site or tele­phone coach­ing for high-risk employ­ees, an increase of 7.5 per­cent from last year. Once you tar­get the intend­ed audi­ence, engage­ment of those at risk is crit­i­cal. Mon­i­tor­ing this sub­set of data can make sure the ven­dor resources are direct­ed appro­pri­ate­ly and, many times, iden­ti­fy areas where the employ­er may be able to help.

    Engagement of High Risk Individuals in CoachingOf course, engage­ment is only the first step and the intend­ed out­come is to reduce risk or slow down the pro­gres­sion of risk increas­ing, that is real­ly the final out­come desired. The fol­low­ing illus­tra­tion allows employ­ers and the ven­dor solu­tion to mon­i­tor the true impact of the pro­gram by review­ing the risk con­trol, or improve­ment based on pro­gram participation.

    Participant vs non-participant results

    Reduc­ing Med­ical Spending

    Although many employ­ers are inter­est­ed in help­ing their employ­ees become health­i­er, the real­i­ty is these efforts have to help reduce med­ical costs or increase pro­duc­tiv­i­ty so these efforts are sus­tain­able. Since, to date, few employ­ers have data on pro­duc­tiv­i­ty, the analy­sis then is focused on reduc­ing med­ical spend­ing. The cor­rect analy­sis depends on the size of your pop­u­la­tion and the tar­get­ed audi­ence, but a gen­er­al analy­sis to deter­mine if those engaged are cost­ing less than per­sons who have sim­i­lar risk on your plan would look some­thing like the analy­sis below.

    participant engagement chart

    If your pro­gram is tar­get­ed specif­i­cal­ly on a dis­ease state, then the impact on the cost to care for that dis­ease state may be more appro­pri­ate. In the exam­ple below, the employ­er insti­tut­ed a pro­gram to help asth­mat­ics, and there­fore, the analy­sis is relat­ed to the total cost to care for asth­ma com­par­ing the year pri­or to the pro­gram to the year of the pro­gram. In this analy­sis, the impact is very clear.

    Impact of Program on Cost for all ID-Asthma

    The employ­er antic­i­pat­ed first year sav­ings due to high emer­gency room (ER) uti­liza­tion for per­sons with asth­ma and the report proved that along with ER uti­liza­tion declin­ing, the total cost of care for asth­ma sig­nif­i­cant­ly declined.

    Sum­ma­ry

    In sum­ma­ry, hav­ing a clear under­stand­ing of the expec­ta­tion and desired out­comes and mon­i­tor­ing that impact through­out the year, we believe, dri­ves bet­ter out­comes. When we first start­ed ana­lyz­ing out­comes of pro­grams, the impact of many pro­grams were far less impres­sive than ven­dor reports would allow us to believe. That false sense of secu­ri­ty is not because they were try­ing to fal­si­fy infor­ma­tion, but the reports did not pro­vide enough detail to ful­ly illus­trate the impact. Most ven­dor part­ners don’t have access to all of the data to pro­vide a full analy­sis and oth­ers will only show what makes them look good. But, if you iden­ti­fy the impact you need in order to achieve suc­cess, all par­ties involved focus on that pri­or­i­ty and con­tin­u­al­ly work to improve that impact. We believe that well­ness pro­grams can have an impact on a pop­u­la­tion cul­ture, health and cost of care if appro­pri­ate­ly managed.

     

    By Mary Delaney, Orig­i­nal­ly pub­lished by Unit­ed Ben­e­fit Advi­sors — Read More

  • No On-Call Paid Rest Periods in California | California Benefit Advisors

    January 5, 2017

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    On Decem­ber 22, 2016, the Cal­i­for­nia Supreme Court, in Augus­tus v. ABM Secu­ri­ty Ser­vices, Inc., held that employ­ers can­not require employ­ees to remain on call dur­ing paid rest peri­ods. The court reit­er­at­ed the stan­dard estab­lished in Brinker Restau­rant Corp. v. Supe­ri­or Court, 53 Cal. 4th 1004 (2012), which clar­i­fied that dur­ing rest peri­ods employ­ees must be relieved of all duties and be free from employ­er con­trol as to how they spend their time. How­ev­er, Augus­tus went even fur­ther by hold­ing that if employ­ees are required to remain on call and avail­able for pos­si­ble inter­rup­tion dur­ing the break, then it is not a true rest peri­od nor is such a pol­i­cy com­pli­ant with Cal­i­for­nia law. Accord­ing to the court, the mere require­ment of an employ­ee to remain avail­able for inter­rup­tion inval­i­dates the rest peri­od, regard­less of the employ­ee being com­pen­sat­ed for his or her time. As a result, employ­ers must review their cur­rent work­place poli­cies deal­ing with paid rest peri­ods and ensure employ­ees are not required to remain on call or on duty dur­ing paid rest periods.

    Real­is­ti­cal­ly, rest peri­ods may get inter­rupt­ed and this inter­rup­tion neces­si­tates an employer’s reme­di­al action. For instance, after an inter­rup­tion an employ­er may allow the employ­ee to restart his or her unin­ter­rupt­ed paid rest peri­od. Or if the rest peri­od is missed then, as required by law, an employ­er must make sure to pay the employ­ee one hour of pay in his or her next pay­check for each work­day that the rest peri­od was not pro­vid­ed. The key to the Augus­tus deci­sion is that employ­ees can­not be required to remain on call. Of note, the deci­sion does not pre­vent employ­ers from requir­ing employ­ees to remain on premis­es dur­ing paid rest peri­ods, but rather that employ­ees can­not be on call.

     

    Orig­i­nal­ly pub­lished by ThinkHR — Read More

  • Officials Provide New ACA Guidance in FAQ #35 | California Benefit Advisors

    January 3, 2017

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    On Decem­ber 20, 2016, fed­er­al offi­cials released FAQs About Afford­able Care Act Imple­men­ta­tion Part 35 (FAQ #35) in an ongo­ing series of infor­mal guid­ance regard­ing the Afford­able Care Act (ACA). This FAQ address­es sev­er­al topics:

    • Spe­cial enroll­ment rules.
    • Pre­ven­tive services.
    • Qual­i­fied small employ­er health reim­burse­ment arrangements.

    A sum­ma­ry of the key points from FAQ #35 follows.

    Special Enrollment Rules

    Group health plans are sub­ject to rules under the Health Insur­ance Porta­bil­i­ty and Account­abil­i­ty Act (HIPAA) requir­ing plans to offer a spe­cial enroll­ment (mid-year enroll­ment) oppor­tu­ni­ty for per­sons who are not enrolled when first eli­gi­ble but then expe­ri­ence cer­tain events. Exam­ples of qual­i­fy­ing events include acquir­ing a new depen­dent through mar­riage, birth or adop­tion (includ­ing place­ment for adop­tion) of a child, or los­ing cov­er­age under anoth­er plan. The require­ments are referred to as the HIPAA spe­cial enroll­ment rules.

    One of the events trig­ger­ing a spe­cial enroll­ment oppor­tu­ni­ty is the invol­un­tary loss of oth­er cov­er­age, such as los­ing cov­er­age under the spouse’s plan, unless the loss is for cause or due to fail­ure to pay premiums.

    UPDATE: FAQ #35 con­firms that per­sons are enti­tled to a spe­cial enroll­ment if they are oth­er­wise eli­gi­ble for the group plan, had oth­er cov­er­age (includ­ing indi­vid­ual insur­ance obtained inside or out­side of a Mar­ket­place) when the group plan cov­er­age was pre­vi­ous­ly offered, and now have lost eli­gi­bil­i­ty for that oth­er cov­er­age. Fur­ther, the spe­cial enroll­ment rule applies whether or not the indi­vid­ual is eli­gi­ble for oth­er indi­vid­ual mar­ket cov­er­age, though or out­side of a Marketplace.

    Coverage of Preventive Services

    The Afford­able Care Act (ACA) requires that non­grand­fa­thered health plans pro­vide 100 per­cent cov­er­age with­out deductibles or co-pays for cer­tain pre­ven­tive ser­vices. Some excep­tions are allowed regard­ing ser­vices received out­side the net­work when they are avail­able from in-net­work providers and for brand-name drugs when equiv­a­lent gener­ics are avail­able (unless the physi­cian deter­mines a med­ical neces­si­ty). See the fol­low­ing cur­rent lists of required pre­ven­tive services:

    For women’s health ser­vices, the cur­rent list of required pre­ven­tive ser­vices includes pre­scribed con­tra­cep­tives (includ­ing ster­il­iza­tion pro­ce­dures, and patient edu­ca­tion and coun­sel­ing). At this time, there are 18 FDA-approved con­tra­cep­tive meth­ods and the plan must cov­er at least one item in each method at 100 per­cent. Plans also must have an “excep­tions process” to ensure 100 per­cent cov­er­age of any item with­in the method based on med­ical neces­si­ty as deter­mined by the physician.

    The pre­ven­tive ser­vices require­ments are devel­oped based on rec­om­men­da­tions from the U.S. Pre­ven­tive Ser­vices Task Force (USPSTF), the Cen­ters for Dis­ease Con­trol (CDC), the Health Resources and Ser­vices Admin­is­tra­tion (HRSA), and oth­ers, and are sub­ject to change from time to time.

    UPDATE: FAQ #35 explains that updat­ed HRSA rec­om­men­da­tions for women’s pre­ven­tive ser­vices will apply for plan years begin­ning on or after Decem­ber 20, 2017 (e.g., Jan­u­ary 1, 2018 for cal­en­dar-year plans). Plans may adopt the new guide­lines ear­li­er if they choose. The updat­ed guide­lines address sev­er­al women’s health ser­vices, includ­ing breast can­cer screen­ing, cer­vi­cal can­cer screen­ing, ges­ta­tion­al dia­betes, breast­feed­ing ser­vices and sup­plies, and well-woman pre­ven­tive visits.

    The new guide­lines also will require plans to cov­er all 18 of the FDA-approved con­tra­cep­tive meth­ods. Plans may con­tin­ue to impose cost-shar­ing require­ments on brand­ed drugs for which gener­ic equiv­a­lents are avail­able. Note that the ACA pro­vides cer­tain excep­tions regard­ing con­tra­cep­tives with respect to plans spon­sored by reli­gious employ­ers and non­prof­it reli­gious-affil­i­at­ed employ­ers; those excep­tions will continue.

    See the HRSA’s Women’s Pre­ven­tive Ser­vices Guide­lines for more information.

    Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs)

    Sec­tion 18001 of the recent­ly-enact­ed 21st Cen­tu­ry Cures Act cre­ates an oppor­tu­ni­ty for small employ­ers to offer a new type of health reim­burse­ment arrange­ment for their employ­ees’ health­care expens­es, includ­ing indi­vid­ual insur­ance premiums.

    Employ­ers of all sizes cur­rent­ly are pro­hib­it­ed from mak­ing or offer­ing any form of pay­ment to employ­ees for indi­vid­ual health insur­ance, whether through pre­mi­um reim­burse­ment or direct pay­ment. Employ­ers also are pro­hib­it­ed from pro­vid­ing cash or com­pen­sa­tion to employ­ees if the mon­ey is con­di­tioned on the pur­chase of indi­vid­ual health insur­ance. (Some excep­tions apply; e.g., retiree-only plans, dental/vision insur­ance.) Vio­la­tions can result in excise tax­es of $100 per day per affect­ed employee.

    The new law does not repeal the exist­ing pro­hi­bi­tion, but rather it pro­vides an excep­tion for a new type of tax-free ben­e­fit called a Qual­i­fied Small Employ­er Health Reim­burse­ment Arrange­ment (QSEHRA). Small employ­ers meet­ing cer­tain con­di­tions may begin offer­ing QSEHRAs in 2017. Our Decem­ber 9, 2016 blog post, New Law Allows Small Employ­ers to Pay Pre­mi­ums for Indi­vid­ual Poli­cies, sum­ma­rized the require­ments for small employ­ers to offer QSEHRAs.

    Sep­a­rate­ly, the 21st Cen­tu­ry Cures Act offers small employ­ers cer­tain relief from excise tax­es for vio­lat­ing the exist­ing pro­hi­bi­tion against employ­er pay­ment of indi­vid­ual health insur­ance. The relief applies retroac­tive­ly and con­tin­ues through the 2016 plan year (whether or not the employ­er offers QSEHRAs in 2017), but cer­tain con­di­tions must be met. FAQ #35 clar­i­fies the con­di­tions for tax relief, as follows:

    • The relief applies only to plan years begin­ning on or before Decem­ber 31, 2016;
    • The relief applies only to employ­ers that employed on aver­age few­er than 50 full-time and full-time-equiv­a­lent employ­ees. In oth­er words, for the rel­e­vant peri­od, the employ­er must not have been an applic­a­ble large employ­er (ALE) as defined under the ACA; and
    • The relief is lim­it­ed to employ­er arrange­ments that pay or reim­burse only indi­vid­ual health insur­ance pre­mi­ums (or Medicare Part B or D pre­mi­ums, in some cas­es). The relief does not extend to stand-alone health reim­burse­ment arrange­ments that pay or reim­burse med­ical expens­es oth­er than indi­vid­ual health insur­ance premiums.

    Last­ly, note that an employ­er arrange­ment that qual­i­fies for relief from excise tax­es gen­er­al­ly will be con­sid­ered min­i­mum essen­tial cov­er­age and pre­clude cov­ered per­sons from qual­i­fy­ing for pre­mi­um tax cred­its (sub­si­dies) at a Mar­ket­place (Exchange).

    More Information

    Employ­ers and their advi­sors are encour­aged to review the com­plete FAQ #35 to ensure their group health plans con­tin­ue to com­ply with the ACA’s require­ments. The spe­cial enroll­ment rule mere­ly con­firms exist­ing HIPAA require­ments. For pre­ven­tive ser­vices, the update regard­ing women’s health ser­vices applies for plan years begin­ning on or after Decem­ber 20, 2017 (e.g., Jan­u­ary 1, 2018 for cal­en­dar-year plans). Last­ly, small employ­ers may want to con­sid­er the new option for QSEHRAs start­ing in 2017.

     

    By Lau­ra Kerekes, Orig­i­nal­ly pub­lished by ThinkHR — Read More

  • 2017 UBA Healthplan Survey | CA Benefit Advisors

    December 27, 2017

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    It was recent­ly unveiled the lat­est find­ings from our 2017 Health Plan Sur­vey. With data on 20,099 health plans spon­sored by 11,221 employ­ers, the UBA sur­vey is near­ly three times larg­er than the next two of the nation’s largest health plan bench­mark­ing sur­veys combined.To learn more, watch this short video below.

  • Utilize FSA Monies with Key Year–End Strategies | CA Benefit Advisors

    December 22, 2017

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    ‘Tis the Sea­son’. Like most, you ‘re prob­a­bly in the midst of the “hus­sle and bus­sle” of this hol­i­day sea­son with din­ners, par­ties, and activ­i­ties; Christ­mas shop­ping; and spend­ing those remain­ing FSA dol­lars you have allo­cat­ed this year.

    Wait, what? Yes, you read right. Chances are, if you’ve opt­ed to uti­lize an employ­er-spon­sored FSA account in 2017, you may have remain­ing funds you’ll need to spend. This is espe­cial­ly true if your employ­er opt­ed for the $500 car­ry­over rule in lieu of a grace peri­od. Regard­less of what flex­i­ble spend­ing account you have, here are some strate­gies to get the most out of this ben­e­fit before year end.

    Med­ical Care

    Med­ical FSAs are the most com­mon sup­ple­men­tal flex­i­ble cov­er­age offered under employ­er ben­e­fit plans. If you’ve elect­ed this cov­er­age for 2017, here are a few things to con­sid­er when spend­ing these funds.

    Rou­tine and Elec­tive Med­ical Procedures

    Whether rou­tine or not, now’s the time to get appoint­ments booked. If your employ­er offers a grace peri­od for turn­ing in receipts, you can book appoint­ments into the first cou­ple of months of the New Year and get reim­bursed from this year’s funds with­out affect­ing 2018’s con­tri­bu­tions. This has a two-fold advan­tage, as you can also spread next year’s deductible over the com­ing year.

    Sev­er­al rou­tine and elec­tive pro­ce­dures that are FSA-eli­gi­ble include:

    • Lasik
    • Sleep Apnea/Snoring
    • Her­nia surgery
    • Colonoscopy
    • Smoking/Weight Loss Ces­sa­tion Programs

    Alter­na­tive Therapies

    Under IRS law, cer­tain alter­na­tive ther­a­pies are eli­gi­ble for reim­burse­ment. Acupunc­ture and chi­ro­prac­tic care, alter­na­tive med­i­c­i­nal treat­ments, and herbal sup­ple­ments and reme­dies are a great way to use up your funds for the year and get a lit­tle cash back when you most need it.

    Den­tal

    Den­tal ben­e­fits often work dif­fer­ent­ly than med­ical cov­er­age. Accord­ing to the Amer­i­can Den­tal Asso­ci­a­tion, this ben­e­fit is often capped annu­al­ly – gen­er­al­ly between $1,000 and $3,000.  If you have unused funds remain­ing in your FSA, now may be the time to sched­ule a last-minute appoint­ment with your den­tist, espe­cial­ly if you might need seri­ous work down the road. This way, you can use up the funds remain­ing in your account by year-end, and reduce your out-of-pock­et expense next year by shar­ing the cost of addi­tion­al den­tal ser­vices over a longer peri­od of time.

    Pre­scrip­tion Refills

    Refill­ing your pre­scrip­tion med­ica­tions at year end are a great way to use up your funds in your med­ical FSA. Take inven­to­ry of your pre­scrip­tion drugs, toss out expired ones, and make that call for a refill to your doc­tor or pharmacy.

    Over the Counter Drugs, Med­ical Equip­ment and Supplies

    Many OTC med­ica­tions, med­ical equip­ment and sup­plies are eli­gi­ble for reim­burse­ment under a med­ical FSA. First-aid kits, blood-pres­sure mon­i­tors, ther­mome­ters, and joint braces are just a few.  Please note that some will require a note or pre­scrip­tion from your doctor.

    Mileage and Oth­er Health­care-Relat­ed Extras

    Trav­el­ing to and from any med­ical facil­i­ty for appoint­ments or treat­ment are eli­gi­ble for reim­burse­ment under your FSA. This not only includes trav­el­ing by your own vehi­cle, but also by bus, train, plane, ambu­lance ser­vice; and does include park­ing fees and tolls.

    In addi­tion, you can get reim­bursed for oth­er health-relat­ed expens­es. These include:

    • Lodg­ing and meals dur­ing a med­ical event.
    • Med­ical con­fer­ences con­cern­ing an ill­ness of you or one of your dependents.
    • Advance Pay­ments on a retire­ment home or long-term care.

    Depen­dent Care

    If you have opt­ed to con­tribute to a DCFSA, you can get reim­bursed for day care, preschool, sum­mer camps and non-employ­er spon­sored before and after school pro­grams. In addi­tion, funds con­tributed to this type of FSA can be used for elder­ly day­care if you’re cov­er­ing more than 50% your parent’s main­te­nance costs.

    Adop­tion Assistance 

    If you are con­tribut­ing to an Adop­tion Assis­tance FSA offered by your employ­er, you can get reim­bursed for any expens­es incurred in the process of legal­ly adopt­ing an eli­gi­ble child. Eli­gi­ble expens­es include adop­tion fees, attor­ney fees and court costs, med­ical expens­es for a child pri­or to being placed for adop­tion, and relat­ed trav­el costs in asso­ci­a­tion with the adop­tion process.

    Make the most out of your FSA con­tri­bu­tions by using the above strate­gies to your advan­tage as we close out 2017. As you move into 2018, review the max­i­mum con­tri­bu­tion guide­lines for the com­ing year as set by the IRS, and estab­lish a game plan on expen­di­tures next year. Seek your HR department’s exper­tise for guide­lines and tips they can give you to max­i­mize this valu­able ben­e­fit package.

  • Advance Informational Copies of 2017 Form 5500 Annual Return/Report | CA Benefit Advisors

    December 18, 2017

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    The U.S. Depart­ment of Labor’s Employ­ee Ben­e­fits Secu­ri­ty Admin­is­tra­tion (EBSA), the Inter­nal Rev­enue Ser­vice (IRS), and the Pen­sion Ben­e­fit Guar­an­ty Cor­po­ra­tion (PBGC) released advance infor­ma­tion­al copies of the 2017 Form 5500 annu­al return/report and relat­ed instruc­tions.

    Specif­i­cal­ly, the instruc­tions high­light the fol­low­ing mod­i­fi­ca­tions to the forms, sched­ules, and instructions:

    • IRS-Only Ques­tions. IRS-only ques­tions that fil­ers were not required to com­plete on the 2016 Form 5500 have been removed from the Form 5500 and Schedules.
    • Autho­rized Ser­vice Provider Sig­na­tures. The instruc­tions for autho­rized ser­vice provider sig­na­tures have been updat­ed to reflect the abil­i­ty for ser­vice providers to sign elec­tron­ic fil­ings on the plan spon­sor and Direct Fil­ing Enti­ty (DFE) lines, where applic­a­ble, in addi­tion to sign­ing on behalf of plan admin­is­tra­tors on the plan admin­is­tra­tor line.
    • Admin­is­tra­tive Penal­ties. The instruc­tions have been updat­ed to reflect that the new max­i­mum penal­ty for a plan admin­is­tra­tor who fails or refus­es to file a com­plete or accu­rate Form 5500 report has been increased to up to $2,097 a day for penal­ties assessed after Jan­u­ary 13, 2017, whose asso­ci­at­ed vio­la­tions occurred after Novem­ber 2, 2015. Because the Fed­er­al Civ­il Penal­ties Infla­tion Adjust­ment Improve­ments Act of 2015 requires the penal­ty amount to be adjust­ed annu­al­ly after the Form 5500 and its sched­ules, attach­ments, and instruc­tions are pub­lished for fil­ing, be sure to check for any pos­si­ble required infla­tion adjust­ments of the max­i­mum penal­ty amount that may have been pub­lished in the Fed­er­al Reg­is­ter after the instruc­tions have been posted.
    • Form 5500-Plan Name Change. Line 4 of the Form 5500 has been changed to pro­vide a field for fil­ers to indi­cate that the name of the plan has changed. The instruc­tions for line 4 have been updat­ed to reflect the change. The instruc­tions for line 1a have also been updat­ed to advise fil­ers that if the plan changed its name from the pri­or year fil­ing or fil­ings, com­plete line 4 to indi­cate that the plan was pre­vi­ous­ly iden­ti­fied by a dif­fer­ent name.
    • Fil­ing Exemp­tion for Small Plans. The instruc­tions indi­cate that for a small unfund­ed, insured, or com­bi­na­tion wel­fare plan to qual­i­fy for the fil­ing exemp­tion, the plan must not be sub­ject to the Form M‑1 fil­ing requirements.

    Be aware that the advance copies of the 2017 Form 5500 are for infor­ma­tion­al pur­pos­es only and can­not be used to file a 2017 Form 5500 annu­al return/report.

    By  Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Agencies Provide Relief for Group Plans and Donation Programs Affected by Hurricanes/Wildfires | CA Benefit Advisors

    December 15, 2017

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    Guid­ance for Group Health Plans Impact­ed by Hur­ri­cane Maria and Cal­i­for­nia Wildfires

    The U.S. Depart­ment of Labor (DOL) issued a news release to rec­og­nize that plan par­tic­i­pants and ben­e­fi­cia­ries may encounter prob­lems due to Hur­ri­cane Maria and the Cal­i­for­nia Wild­fires. The DOL advis­es plan fidu­cia­ries to make rea­son­able accom­mo­da­tions to pre­vent work­ers’ loss of ben­e­fits and to take steps to min­i­mize the pos­si­bil­i­ty of indi­vid­u­als los­ing ben­e­fits because of a fail­ure to com­ply with pre-estab­lished time frames.

    The DOL also acknowl­edged that there may be instances when full and time­ly com­pli­ance by group health plans may not be pos­si­ble due to phys­i­cal dis­rup­tion to a plan’s prin­ci­pal place of busi­ness. The DOL’s enforce­ment approach will empha­size com­pli­ance assis­tance, includ­ing grace peri­ods and oth­er relief where appropriate.

    Dead­line Exten­sions for Those Affect­ed by Hur­ri­cane Maria

    The DOL and IRS announced dead­line exten­sions to pro­vide plan par­tic­i­pants, ben­e­fi­cia­ries, and employ­ers affect­ed by Hur­ri­cane Maria with addi­tion­al time to make health cov­er­age and ben­e­fits decisions.

    Under the exten­sion, group health plans have addi­tion­al time to com­ply with cer­tain dead­lines affect­ing COBRA con­tin­u­a­tion cov­er­age, Health Insur­ance Porta­bil­i­ty and Account­abil­i­ty Act of 1996 (HIPAA) spe­cial enroll­ment, claims for ben­e­fits, appeals of denied claims, and exter­nal review of cer­tain claims. Under the exten­sion, par­tic­i­pants and ben­e­fi­cia­ries have addi­tion­al time to make claims for ben­e­fits and appeal denied claims.

    Guid­ance on Leave-Based Dona­tion Pro­grams’ Tax Treatment

    In recent months, the IRS pro­vid­ed guid­ance for employ­ers who adopt leave-based dona­tion pro­grams to pro­vide char­i­ta­ble relief for vic­tims of Hur­ri­cane and Trop­i­cal Storms Irma and Maria. This month, the IRS issued Notice 2017–70, which extends the guid­ance to employ­ers’ pro­grams adopt­ed for the relief of vic­tims of the Cal­i­for­nia wildfires.

    These leave-based dona­tion pro­grams allow employ­ees to for­go vaca­tion, sick, or per­son­al leave in exchange for cash pay­ments that the employ­er will make to char­i­ta­ble orga­ni­za­tions described under Inter­nal Rev­enue Code Sec­tion 170©.

    The employ­er’s cash pay­ments will not con­sti­tute gross income or wages of the employ­ees if paid before Jan­u­ary 1, 2019, to the Sec­tion 170© char­i­ta­ble orga­ni­za­tions for the relief of vic­tims of the Cal­i­for­nia wild­fires. Employ­ers do not need to include these pay­ments in Box 1, 3, or 5 of an employ­ee’s Form W‑2.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • IRS Updates Guidance on Play-or-Pay Penalty Assessments | CA Benefit Advisors

    December 11, 2017

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    Begin­ning in 2015, to com­ply with the Patient Pro­tec­tion and Afford­able Care Act (ACA), “large” employ­ers must offer their full-time employ­ees health cov­er­age, or pay one of two employ­er shared respon­si­bil­i­ty / play-or-pay penal­ties. The Inter­nal Rev­enue Ser­vice (IRS) deter­mines the penal­ty each cal­en­dar year after employ­ees have filed their fed­er­al tax returns.

    In Novem­ber 2017, the IRS indi­cat­ed on its “Ques­tions and Answers on Employ­er Shared Respon­si­bil­i­ty Pro­vi­sions Under the Afford­able Care Act” web­page that, in late 2017, it plans to issue Let­ter 226J to inform large employ­ers of their poten­tial lia­bil­i­ty for an employ­er shared respon­si­bil­i­ty pay­ment for the 2015 cal­en­dar year.

    The IRS’ deter­mi­na­tion of an employer’s lia­bil­i­ty and poten­tial pay­ment is based on infor­ma­tion report­ed to the IRS on Forms 1094‑C and 1095‑C and infor­ma­tion about the employer’s full-time employ­ees that were received the pre­mi­um tax credit.

    The IRS will issue Let­ter 226J if it deter­mines that, for at least one month in the year, one or more of a large employer’s full-time employ­ees was enrolled in a qual­i­fied health plan for which a pre­mi­um tax cred­it was allowed (and the employ­er did not qual­i­fy for an afford­abil­i­ty safe har­bor or oth­er relief for the employee).

    Let­ter 226J will include:

    • A brief expla­na­tion of Sec­tion 4980H, the employ­er shared respon­si­bil­i­ty regulations
    • An employ­er shared respon­si­bil­i­ty pay­ment sum­ma­ry table that includes a month­ly item­iza­tion of the pro­posed pay­ment and whether the lia­bil­i­ty falls under Sec­tion 4980H(a) (the “A” or “No Offer” Penal­ty) or Sec­tion 4980H(b) (the “B” or “Inad­e­quate Cov­er­age” Penal­ty) or nei­ther section
    • A pay­ment sum­ma­ry table explanation
    • An employ­er shared respon­si­bil­i­ty response form (Form 14764 “ESRP Response”)
    • An employ­ee pre­mi­um tax cred­it list (Form 14765 “Employ­ee Pre­mi­um Tax Cred­it (PTC) List”) which lists, by month, the employer’s assess­able full-time employ­ees and the indi­ca­tor codes, if any, the employ­er report­ed on lines 14 and 16 of each assess­able full-time employee’s Form 1095‑C
    • Actions the employ­er should take if it agrees or dis­agrees with Let­ter 226J’s pro­posed employ­er shared respon­si­bil­i­ty payment
    • Actions the IRS will take if the employ­er does not time­ly respond to Let­ter 226J
    • The date by which the employ­er should respond to Let­ter 226J, which will gen­er­al­ly be 30 days from the date of the letter
    • The name and con­tact infor­ma­tion of the IRS employ­ee to con­tact with ques­tions about the letter

    If an employ­er responds to Let­ter 226J, then the IRS will acknowl­edge the response with Let­ter 227 to describe fur­ther actions that the employ­er can take.

    After receiv­ing Let­ter 227, if the employ­er dis­agrees with the pro­posed or revised shared employ­er respon­si­bil­i­ty pay­ment, the employ­er may request a pre-assess­ment con­fer­ence with the IRS Office of Appeals. The employ­er must request the con­fer­ence by the response date list­ed with­in Let­ter 227, which will be gen­er­al­ly 30 days from the date of the letter.

    If the employ­er does not respond to either Let­ter 226J or Let­ter 227, then the IRS will assess the pro­posed employ­er shared respon­si­bil­i­ty pay­ment amount and issue a notice and demand for pay­ment on Notice CP 220J.

    Notice CP 220J will include a sum­ma­ry of the employ­er shared respon­si­bil­i­ty pay­ment, pay­ments made, cred­its applied, and the bal­ance due, if any. If a bal­ance is due, Notice CP 220J will instruct an employ­er how to make pay­ment. For pay­ment options, such as an install­ment agree­ment, employ­ers should refer to Pub­li­ca­tion 594 “The IRS Col­lec­tion Process.”

    Employ­ers are not required to make pay­ment before receiv­ing a notice and demand for payment.

    The ACA pro­hibits employ­ers from mak­ing an adverse employ­ment action against an employ­ee because the employ­ee received a tax cred­it or sub­sidy. To avoid alle­ga­tions of retal­i­a­tion, as a best prac­tice, employ­ers who receive a Let­ter 226J should sep­a­rate their employ­er shared respon­si­bil­i­ty penal­ty assess­ment cor­re­spon­dence from their human resources depart­ment and employ­ees who have author­i­ty to make employ­ment actions.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

     

  • The Perks of Holiday Parties: How They’re Still an Asset to Your Company | CA Benefit Advisors

    December 6, 2017

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    The end of the year is upon us and a major­i­ty of com­pa­nies cel­e­brate with an end-of-year/hol­i­day par­ty.  Although the trend of hol­i­day par­ties has dimin­ished in recent years, it’s still a good idea to com­mem­o­rate the year with an office perk like a fun, fes­tive party.

    BENEFITS OF A YEAR-END CELEBRATION

    • Hol­i­day staff par­ties are a per­fect way to thank your employ­ees for a great year. All employ­ees want to feel appre­ci­at­ed and val­ued. What bet­ter way to serve this pur­pose, than with an end of the year office cel­e­bra­tion. Host­ing a night out to hon­or your employ­ees dur­ing a fes­tive time of year boosts morale. And if done right, your par­ty can jump start the new year with refreshed, pro­duc­tive employees.
    • End-of-year cel­e­bra­tions allow employ­ees to come togeth­er out­side of their own team. The aver­age Amer­i­can will spend 90,000 hours (45 years) of their life at work. Unless you have a very small office, most employ­ees only engage in rela­tion­ships with­in their depart­ment. When employ­ees have a chance to min­gle out­side of their reg­u­lar 9 to 5 day, they’ll build and cul­ti­vate rela­tion­ships across dif­fer­ent teams with­in the orga­ni­za­tion; cre­at­ing a more loy­al, cohe­sive and moti­vat­ed culture.
    • Sea­son­al par­ties can pro­vide employ­ers insight on those who work for them. Spend­ing the evening with your employ­ees in a more casu­al and relaxed atmos­phere may reveal tal­ents and ideas you may not have oth­er­wise seen dur­ing tra­di­tion­al work hours.

    CREATING THE RIGHT FIT

    Regard­less of office size, if planned right, employ­ers can make a hol­i­day par­ty pop, no mat­ter your bud­get. Whether this is your first go at an end-of-year cel­e­bra­tion for your employ­ees, or you host one every year, keep a few things in mind:

    • Plan ear­ly. Estab­lish a steer­ing com­mit­tee to gen­er­ate ideas for your hol­i­day par­ty. Allow the com­mit­tee to involve all employ­ees ear­ly on in the process. Uti­lize vot­ing tools like Sur­vey Mon­key or Out­look to com­pile employ­ee votes. This engages not only your entire work­force, but serves you as well when tai­lor­ing your par­ty to fit your culture.
    • Cre­ate set activ­i­ties. Engag­ing employ­ees in some type of orga­nized activ­i­ty not only eas­es any social anx­i­ety for them and their guests, it cul­ti­vates mem­o­ries and allows col­leagues to get to know each oth­er. Con­sid­er a “Casi­no Night”, a pho­to booth (or two if your com­pa­ny can jus­ti­fy to size), an escape room outing—anything that will kick the night off with ease.
    • Incor­po­rate enter­tain­ment dur­ing the din­ner. Have team leads or man­age­ment mem­bers come up with fun awards that empha­size char­ac­ter traits, strengths, and tal­ents oth­ers may not know of. This is a great way to cre­ate cohe­sive­ness, build rela­tion­ships, and have your employ­ees enjoy a good laugh at dinner.
    • Offer fun door prizes every 15 min­utes or so. Prizes don’t have to be expen­sive to have an impact on employ­ees, just rel­e­vant to them. How­ev­er, with the right plan­ning you may be able to throw in a raf­fle of larg­er gift items as well. Just keep in the spe­cif­ic tax rules when it relates to gift-giv­ing. Gift cards asso­ci­at­ed with a spe­cif­ic dol­lar amount avail­able to use at any estab­lish­ment, and larg­er tick­et items, can be sub­ject to your employ­ees hav­ing to claim income on them and pay the tax.
    • Make the dress code inclu­sive of every­one. Employ­ees should not feel a finan­cial pinch to attend a hol­i­day office par­ty. Estab­lish a dress code that fits your cul­ture, not the oth­er way around.

     TAKE AWAY TIPS FOR A SUCCESSFUL HOLIDAY PARTY

    Accord­ing to the Soci­ety of Human Resource Man­age­ment, sta­tis­tics show in recent years only 65% of employ­ers have offered hol­i­day parties—down from 72% five years ago. Con­sid­er the fol­low­ing tips when host­ing your next year-end celebration.

    • Keep it light. Elim­i­nate itin­er­aries and board-room like struc­ture. Choose to sep­a­rate productivity/award cel­e­bra­tions and upcom­ing year pro­jec­tions from your hol­i­day party.
    • Invite spous­es and sig­nif­i­cant oth­ers to attend the par­ty. Employ­ees spend a major­i­ty of their week with their col­leagues. Giv­ing employ­ees this option is a great way to show you val­ue who they spend their time with out­side of work.
    • Allow employ­ees to leave ear­ly on a work day to give them time to get ready and pick up who is attend­ing the par­ty with them.
    • Show how you val­ue your employ­ees by chat­ting with them and meet­ing their guests.
    • Pro­vide com­fort­able seat­ing areas where employ­ees can rest, eat and talk. Posi­tion these in main action areas so no one feels anti-social for tak­ing a seat somewhere.
    • Con­sid­er tying in employ­ees that work in dif­fer­ent loca­tions. Have a slideshow run­ning through­out the night on what events oth­er office loca­tions have done through­out the year.
    • Cre­ate low-key con­ver­sa­tion starters and get peo­ple to chat it up. This is valu­able espe­cial­ly for those that are new to the com­pa­ny and guests of your employ­ees. Incor­po­rate triv­ia ques­tions into the décor and table set­tings. Get them to engage by tying in a prize.
    • Keep the tastes and com­fort lev­el of your employ­ees in mind. Include a vari­ety of menu items that fit dietary restric­tions. Not all employ­ees drink alco­hol and not all employ­ees eat meat.
    • Lim­it alco­hol to a 2 tick­et sys­tem per guest. Opt for a cash bar after that to reduce liability.
    • Pro­vide access to accom­mo­da­tions or coor­di­nate trans­porta­tion like Uber or Lyft to get your employ­ees some­where safe­ly after the par­ty if they choose to drink.

    Ulti­mate­ly, hol­i­day par­ties can still be a val­ue-add for your employ­ees if done the right way. Feel free to change it up from year to year so these par­ties don’t get stale and con­tin­ue to fit to your company’s cul­ture. Con­tem­plate new venues, ideas and activ­i­ties and change up your steer­ing com­mit­tee to keep these par­ties fresh. Employ­ees are more like­ly to enjoy them­selves at an event that fits with their lifestyle, so don’t be afraid to get creative!

     

     

     

  • The Price ain’t right – resignation comes among allegations, but now who leads the charge?

    December 4, 2017

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    Tom Price came in with much fan­fare as the new Sec­re­tary of Health and Human Ser­vices, com­ing in as the administration’s point man to help upend the Afford­able Care Act.  He had his own plan and prin­ci­ples, out­lined while he was in the House, which would have steered the conversation…had he not found it nec­es­sary to book planes at the tax­pay­ers’ expense.  So now the chair sits emp­ty, and the ACA reform attempts in tat­ters, so now what?

  • Top 3 Frequently Asked Questions about Qualified Small Employer Health Reimbursement Arrangements | CA Benefit Advisors

    December 1, 2017

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    On Decem­ber 13, 2016, Pres­i­dent Oba­ma signed the 21st Cen­tu­ry Cures Act (Cures Act) into law. The Cures Act pro­vides a method for cer­tain small employ­ers to reim­burse indi­vid­ual health cov­er­age pre­mi­ums up to a dol­lar lim­it through HRAs called “Qual­i­fied Small Employ­er Health Reim­burse­ment Arrange­ments” (QSE HRAs). The pro­vi­sion went into effect on Jan­u­ary 1, 2017. On Octo­ber 31, 2017, the IRS released Notice 2017–67, pro­vid­ing guid­ance on the imple­men­ta­tion and admin­is­tra­tion of QSE HRAs.

    Unless an employ­er meets all the require­ments for offer­ing a QSE HRA, pre­vi­ous IRS guid­ance pro­hibit­ing the reim­burse­ment of indi­vid­ual pre­mi­ums direct­ly or indi­rect­ly, after- or pre-tax, through an HRA, a Sec­tion 125 plan, a Sec­tion 105 plan, or any oth­er mech­a­nism, remains in full effect. Reim­burs­ing indi­vid­ual pre­mi­ums in a non-com­pli­ant man­ner will sub­ject an employ­er to a Patient Pro­tec­tion and Afford­able Care Act (ACA) penal­ty of $100 a day per indi­vid­ual it reim­burs­es, with the poten­tial for oth­er penal­ties based on the mech­a­nism of the non-com­pli­ant reimbursement.

    If an employ­er fails to meet the require­ments of pro­vid­ing a QSE HRA, it will be sub­ject to a penal­ty of $100 per day per affect­ed per­son for being a non-com­pli­ant group health plan. An arrange­ment will be a group health plan that is not a QSE HRA if it:

    • Is not pro­vid­ed by an eli­gi­ble employ­er (such as an employ­er that offers anoth­er group health plan to its employees).
    • Is not pro­vid­ed on the same terms to all eli­gi­ble employees.
    • Reim­burs­es med­ical expens­es with­out first requir­ing proof of min­i­mum essen­tial cov­er­age (MEC).
    • Pro­vides a per­mit­ted ben­e­fit in excess of the statu­to­ry dol­lar limits.

    An arrange­men­t’s fail­ure to be a QSE HRA will not cause any reim­burse­ment of a prop­er­ly sub­stan­ti­at­ed med­ical expense that is oth­er­wise exclud­able from income to be includ­ed in the employ­ee’s income or wages. Fur­ther­more, an arrange­ment designed to reim­burse expens­es oth­er than med­ical expens­es (whether or not also reim­burs­ing med­ical expens­es) is nei­ther a QSE HRA nor a group health plan. Accord­ing­ly, all pay­ments under such an arrange­ment are includi­ble in the employ­ee’s gross income and wages. An employ­er’s fail­ure to time­ly pro­vide a com­pli­ant writ­ten notice does not cause an arrange­ment to fail to be a QSE HRA, but instead results in the penal­ty of $50 per employ­ee, not to exceed $2,500.

    Answers to Top Three FAQs about QSE HRAs 

    1, Which employ­ers may offer a QSE HRA?

    Employ­ers with few­er than 50 full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules) that do not offer a group health plan. Employ­ers that do not offer a group health plan, but offer a retiree-only plan to for­mer employ­ees may offer a QSE HRA.

    2. Which employ­ers may not offer a QSE HRA?

    • Employ­ers with 50 or more full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules).
    • Employ­ers of any size that offer a group health plan, includ­ing plans that only pro­vide except­ed ben­e­fits, such as vision or den­tal benefits.
    • Employ­ers that pro­vide cur­rent employ­ees with access to mon­ey from health reim­burse­ment arrange­ments (HRAs) offered in pri­or years (through a carry-over).
    • Employ­ers that offer employ­ees access to car­ry­over amounts in a flex­i­ble spend­ing account (FSA).

    3. What are the rules for employ­ers in a con­trolled group?

    • Employ­ers with less than 50 full-time and full-time equiv­a­lent employ­ees (under ACA count­ing rules) may offer QSE HRAs, with the head­count includ­ing all employ­ees across an entire con­trolled group.
    • If one employ­er with­in a con­trolled group offers a QSE HRA, it must be offered to all employ­ees with­in the entire con­trolled group (or each employ­er must offer an iden­ti­cal QSE HRA).

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Latest IRS ACA Round Up (Including 2018 Cost-of-Living Adjustments) | CA Benefit Advisors

    November 24, 2017

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    Recent­ly, the Inter­nal Rev­enue Ser­vice (IRS) issued the instruc­tions for Forms 1094/1095 for the 2017 tax year, announced PCORI fees for 2017–18, and announced cost-of-liv­ing adjust­ments for 2018. The IRS pro­vid­ed addi­tion­al guid­ance on leave-based dona­tion pro­grams’ tax treat­ment and released an infor­ma­tion let­ter on COBRA and Medicare. Here’s a recap of these actions for your reference.

    IRS Announces Cost-of-Liv­ing Adjust­ments for 2018

    The IRS released Rev­enue Pro­ce­dures 2017–58 and Notice 2017–64 to announce cost-of-liv­ing adjust­ments for 2018. For exam­ple, the dol­lar lim­it on vol­un­tary employ­ee salary reduc­tions for con­tri­bu­tions to health flex­i­ble spend­ing accounts (FSAs) is $2,650, for tax­able years begin­ning with 2018.

    Request UBA’s 2018 desk ref­er­ence card with an at‑a glance sum­ma­ry of the var­i­ous limits.

    IRS Announces PCORI Fee for 2017–18

    The IRS announced the Patient-Cen­tered Out­comes Research Insti­tute (PCORI) fee for 2017–18. The fee is $1.00 per cov­ered life in the first year the fee is in effect. The fee is $2.00 per cov­ered life in the sec­ond year. In the third through sev­enth years, the fee is $2.00, adjust­ed for med­ical infla­tion, per cov­ered life.

    For plan years that end on or after Octo­ber 1, 2016, and before Octo­ber 1, 2017, the indexed fee is $2.26. For plan years that end on or after Octo­ber 1, 2017, and before Octo­ber 1, 2018, the indexed fee is $2.39.

    For more infor­ma­tion, view UBA’s FAQ on the PCORI Fee.

    IRS Pro­vides Addi­tion­al Guid­ance on Leave-Based Dona­tion Pro­grams’ Tax Treatment

    Last month, the IRS pro­vid­ed guid­ance for employ­ers who adopt leave-based dona­tion pro­grams to pro­vide char­i­ta­ble relief for vic­tims of Hur­ri­cane and Trop­i­cal Storm Irma. This month, the IRS issued Notice 2017–62 which extends the guid­ance to employ­ers’ pro­grams adopt­ed for the relief of vic­tims of Hur­ri­cane and Trop­i­cal Storm Maria.

    These leave-based dona­tion pro­grams allow employ­ees to for­go vaca­tion, sick, or per­son­al leave in exchange for cash pay­ments that the employ­er will make to char­i­ta­ble orga­ni­za­tions described under Inter­nal Rev­enue Code Sec­tion 170©.

    The employ­er’s cash pay­ments will not con­sti­tute gross income or wages of the employ­ees if paid before Jan­u­ary 1, 2019, to the Sec­tion 170© char­i­ta­ble orga­ni­za­tions for the relief of vic­tims of Hur­ri­cane or Trop­i­cal Storm Maria. Employ­ers do not need to include these pay­ments in Box 1, 3, or 5 of an employ­ee’s Form W‑2.

    IRS Releas­es Infor­ma­tion Let­ter on COBRA and Medicare

    The IRS released Infor­ma­tion Let­ter 2017–0022 that explains that a cov­ered employ­ee’s spouse can receive COBRA con­tin­u­a­tion cov­er­age for up to 36 months if the employ­ee became enti­tled to Medicare ben­e­fits before employ­ment ter­mi­na­tion. In this case, the spouse’s max­i­mum COBRA con­tin­u­a­tion peri­od ends the lat­er of: 36 months after the employ­ee’s Medicare enti­tle­ment, or 18 months (or 29 months if there is a dis­abil­i­ty exten­sion) after the employ­ment termination.

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

  • Agencies Issue Proposed Rules and Plans | CA Benefit Advisors

    November 20, 2017

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    Octo­ber was a busy month in the employ­ee ben­e­fits world. Pres­i­dent Trump announced a new Act­ing Sec­re­tary for the U.S. Depart­ment of Health and Human Ser­vices (HHS). Eric Har­gan fills the posi­tion vacat­ed by Tom Price, who resigned in late Sep­tem­ber 2017. The U.S. Depart­ment of Labor (DOL) issued a pro­posed rule to delay a dis­abil­i­ty claims pro­ce­dure reg­u­la­tion’s applic­a­bil­i­ty date and HHS released its pro­posed rule on ben­e­fits and pay­ment para­me­ters for 2019. The U.S. Depart­ment of the Trea­sury (Trea­sury) issued its Pri­or­i­ty Guid­ance Plan for projects it intends to com­plete dur­ing the first half of 2018.

    DOL Pro­pos­es Delay to Final Dis­abil­i­ty Claims Pro­ce­dures Reg­u­la­tions’ Applic­a­bil­i­ty Date

    The DOL issued a pro­posed rule to delay the applic­a­bil­i­ty date of its final rule that amends the claims pro­ce­dure require­ments applic­a­ble to ERISA-cov­ered employ­ee ben­e­fit plans that pro­vide dis­abil­i­ty ben­e­fits. The DOL’s Fact Sheet con­tains a sum­ma­ry of the final rule’s requirements.

    The DOL is delay­ing the applic­a­bil­i­ty date from Jan­u­ary 1, 2018, to April 1, 2018, to con­sid­er whether to rescind, mod­i­fy, or retain the reg­u­la­tions and to give the pub­lic an addi­tion­al oppor­tu­ni­ty to sub­mit com­ments and data con­cern­ing the final rule’s poten­tial impact.

    CMS Releas­es 2019 Ben­e­fits Pay­ment and Para­me­ters Pro­posed Rule

    The Cen­ters for Medicare & Med­ic­aid Ser­vices (CMS) released a pro­posed rule and fact sheet for the 2019 Ben­e­fit Pay­ment and Para­me­ters. The pro­posed rule is intend­ed to increase indi­vid­ual mar­ket flex­i­bil­i­ty, improve pro­gram integri­ty, and reduce reg­u­la­to­ry bur­dens asso­ci­at­ed with the Patient Pro­tec­tion and Afford­able Care Act (ACA) in many ways, includ­ing updates and annu­al pro­vi­sions to:

    • Essen­tial health benefits
    • Small Busi­ness Health Options Pro­gram (SHOP)
    • Spe­cial enroll­ment peri­ods (SEPs)
    • Exemp­tions
    • Ter­mi­na­tion effec­tive dates
    • Med­ical loss ratio (MLR)

    CMS usu­al­ly final­izes the Ben­e­fit Pay­ment and Para­me­ters rule in the first quar­ter of the year fol­low­ing the pro­posed rule’s release. Novem­ber 27, 2017, is the due date for pub­lic com­ments on the pro­posed rule.

    Almost all the top­ics addressed in the pro­posed rule would affect the indi­vid­ual mar­ket and the Exchanges, par­tic­u­lar­ly the Small Busi­ness Health Options Pro­gram (SHOP) Exchanges.

    Of inter­est to small group health plans, CMS pro­pos­es to change how states will select essen­tial health ben­e­fits bench­mark plans. If CMS keeps this change in its final rule, then it will affect non-grand­fa­thered small group health plans for ben­e­fit years 2019 and beyond.

    Trea­sury Issues its Pri­or­i­ty Guid­ance Plan

    The Trea­sury issued its 2017–2018 Pri­or­i­ty Guid­ance Plan that lists projects that it intends to com­plete by June 30, 2018, including:

    • Guid­ance on issues relat­ed to the employ­er shared respon­si­bil­i­ty provisions
    • Reg­u­la­tions regard­ing the excise tax on high cost employ­er-pro­vid­ed cov­er­age (“Cadil­lac tax”)
    • Guid­ance on Qual­i­fied Small Employ­er Health Reim­burse­ment Arrange­ments (QSE HRAs)

    By Danielle Capilla

    Orig­i­nal­ly post­ed by www.UBABenefits.com

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