Blog

• Think Before You Click

  October 6, 2021

  Tags: Cyber Attacks, Cyber Crime, Cyber Security

  

  If you are concerned about your cyber security – and you should be – it’s essential to know the biggest threats to you right now.  So, what is cyber security anyway?  And how can you protect yourself?

  Cyber security is the practice of defending computers, servers, mobile devices, electronic systems, networks, and data from malicious attacks. Global cyber threat continues to increase at a rapid pace.  Most, but not all, cybercrime is committed by hackers who want to make money.  As the result of the COVID-19 pandemic, Cybercrime, which includes everything from embezzlement to data hacking and destruction, is up 600%.

  Types of Cyber Threats:

  Malware, short for “malicious software”, refers to any intrusive software developed by cybercriminals or hackers to steal data and damage computers and computer systems.  Malware is often activated when a user clicks on a malicious link or attachment, which leads to installing dangerous software.  There are several types of malware:

  • Virus: A self-replicating program that attaches itself to clean files and spreads throughout a computer system, infecting files with malicious code.
  • Trojans: A type of malware that conceals its true content to fool a user into thinking it’s a harmless file. Cybercriminals trick users into uploading Trojans onto their computer where they can collect data or cause damage.
  • Worms: Malicious software that spreads copies of itself from computer to computer within a network. Worms exploit vulnerabilities in your security software to steal sensitive information and corrupt files. A worm is different from a virus, however, because a worm can operate on its own while a virus needs a host computer.
  • Spyware: A program that secretly records what a user does, so that cybercriminals can make use of this information. Spyware is often used to steal personal or financial information.
  • Ransomware: Malicious software which locks down a user’s files and data with the threat of erasing it unless a ransom is paid.
  • Adware: Unwanted software that displays advertisements on your screen. Adware collects personal information from you to serve you with personalized ads. While adware is not always dangerous, it can redirect your browser to unsafe sites and can even contain Trojans and spyware.
  • Rootkits: Malicious software that is extremely difficult to spot and also very hard to remove. A rootkit allows someone to maintain control over a computer without the computer owner knowing about it.  Once a rootkit has been installed, nothing on your computer is secure.

  Where does malware come from?

  The most common sources of malware are malicious websites, email attachments, and shared networks.

  • Phishing: E-mails that appear to be from a legitimate company asking for sensitive information. Phishing attacks are often used to trick people into handing over personal information or credit card data.
  • Shared Networks: A malware infected computer on your shared network can spread malware onto all devices on the network.
  • Malicious Websites: Some websites may install malware onto your computer – usually through advertisements on popular sites (malvertising) or malicious links.

  How to Prevent Malware – 7 Things You Should Start Doing Now:

  1. Install Anti-virus Software: Anti-virus software will scan your computer to detect and clean the malware and provide enhanced protection against newly created viruses.
  2. Regularly Update Software: Keep your software updated to stop attackers gaining access to your computer through vulnerabilities in outdated systems.
  3. Install a Firewall: A firewall blocks all unauthorized access to or from a private computer network.
  4. Use Secure Authentication Methods: Use strong passwords with at least 8 characters, including an uppercase letter, a lowercase letter, and a number or symbol. You should also enable multi-factor authentication, such as a security question in addition to a password.
  5. Don’t Open Emails From Unknown Sources: Hackers often send emails with links that are sure to send malware your way and hack into your important information. It is better to delete the email than to suffer the consequences of opening it.
  6. Avoid Using Unsecure WiFi Networks in Public Places: On an unsecure network, a cybercriminal can intercept communication between two individuals to steal data.
  7. Maintain Regular Backups of Your Data: Backups do not secure your network from attacks but they help when you face a malware attack.

  Jeh Johnson, former U.S. Secretary of Homeland Security, stated “Cyberattacks of all manner and from multiple sources are going to get worse before they get better.  In this realm and at this moment, those on offense have the upper hand.  Whether it’s cyber-criminals, hacktivists, or nation-state actors, those on offense are ingenious, tenacious, agile, and getting better all the time.  Those on defense struggle to keep up.”

  It is imperative that you protect yourself and your family from cybercriminals.  With technology increasing, criminals don’t have to rob stores or banks, nor do they have to be outside to commit a crime – they have everything they need on their lap.  Their weapons are no longer guns, they attack with a computer mouse and passwords.

• Big News! Arrow Benefits Group Announces New Partnership with Aita and Associates, Inc. Expanding Local Ties with Community.

  September 29, 2021

  Tags: Aita, Arrow, Partnership

  Aita continues to serve clients united with Arrow.

  Arrow Benefits Group announces its partnership with Aita and Associates, Inc., a highly respected insurance firm headquartered in Sebastopol, Ca. for over 35 years. This consolidation allows the Aita team to build on its reputation of commitment to local community, personal attention to clients, and advocacy excellence in the benefits insurance industry. The union serves to further strengthen ABG’s assets and ties to the local community.  Says company co-owner Bob Aita, “We have always been intensely client focused, and this partnership — and the culture and autonomous leadership at Arrow Benefits — will allow our team to continue their efforts in that same manner. For us, it also means we’ll have access to additional exceptional top resources to serve our clients. ABG’s level of integrity, respect for team members and how and where they perform their responsibilities, along with a real understanding and acceptance of how Aita does business, allows our legacy of excellence to be continued as part of Arrow.”

  The Aita team of experts each bring to the accord a wide breadth of experience and dedication to highly hands-on personalized service, guidance for benefits, and an intimate knowledge of the Benefits, HR, and Compliance worlds. They will continue this high level of service and consultation. The combination of these two long-term industry leaders and both their shared connections with well-respected agencies and long-term relationships with carriers is a winning combination. With ABG’s developed resources, the Aita team will continue to deliver the same level of service to existing clients while also freeing up time to prospect for and market to prospective clients.

  The talented Aita team continues to include:

  • Bob Aita, Co-owner/Senior Benefits Consultant – Contact: BobA@arrowbenefitsgroup.com & 707-981-5414 x 251
  • Jessica Dominik, Senior Account Manager – Contact: JDominik@arrowbenefitsgroup.com & 707-981-5415 x 252
  • Linda Rivera, Senior Account Manager, Compliance Officer and H.R. Consultant – Contact: LindaR@arrowbenefitsgroup.com & 707-981-5417 x 254
  • Stephanie Pavlos, Account Manager – Contact: StephanieP@arrowbenefitsgroup.com & 707-981-5416 x 253

  “We are excited about bringing the Aita team into Arrow Benefits Group,” says Joe Genovese, CEO & Managing Principal. “Their long-standing reputation for exceptional service, high level of expertise, and a personal touch that goes well beyond simply serving the client is a great compliment to the increasing capabilities at ABG. We are extremely proud to welcome the A&A team.”

  Arrow & Aita Continuing to Support Local Including:

  

   

   

• Employer Medicare Part D Notices Are Due Before October 15, 2021

  September 29, 2021

  Tags: medicare, Prescription Drug Coverage

  

  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. People 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 the 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 creditable group plan and the Part D plan.

  To help Medicare-eligible plan participants 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 (2022). 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:

  • Model Notice for Group Plan that is Creditable Coverage (English)
  • Model Notice for Group Plan that is Noncreditable Coverage (English)
  • Model Notice for Group Plan that is Creditable Coverage (Spanish)
  • Model Notice for Group Plan that is Noncreditable Coverage (Spanish)

  Employers who offer multiple group health plan 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. To submit your plan’s disclosure, use the CMS online tool and follow the prompts. The process usually takes only 5 or 10 minutes to complete. It is due with 60 days after the start of the plan year; for instance, for calendar year plans that will be March 1, 2022. If the plan’s prescription drug coverage ends or its status as creditable or noncreditable changes, submit a new disclosure within 30 days of the change.

  By Kathleen A. Berger

  Originally posted on Mineral

• They had it all figured out – until they didn’t | by Jordan Shields, Partner

  September 24, 2021

  Tags: Health care

  

  First the combination of Berkshire Hathaway, Amazon and Citibank – we can’t even remember the name it came and went so fast.  Then Google Health was formed, supporting over 500 employees to transform the way health care is delivered.  Apple followed suit.  And now…the first guys are gone, Google just announced it was pulling the plug, and Apple said it has scaled back a specific health team focused on its internal health app.

  So wait, is it really that hard, and why is it that the great tech companies couldn’t solve the problem of administrative waste, health care delivery efficiency and all the other items the federal government said they can solve just by expanding Medicare?  Huh?

• Life Insurance: Putting a Price on Peace of Mind

  September 22, 2021

  Tags: Permanent Life Insurance, Term Life Insurance

  

  Life insurance provides financial protection for your loved ones when you die.  Essentially, in exchange for your premium payments, the insurance company will pay a lump sum known as a death benefit to your beneficiaries after your death. While this money can never replace you, it can help your loved one(s) live the kind of life you hoped to provide.

  Life insurance coverage offers affordable financial protection and invaluable peace of mind.  You can choose a legal entity, organization or anyone to be your life insurance beneficiary.  You can name multiple beneficiaries and decide what percentage they each will receive when you die.  Common choices include:

  • Your spouse
  • Family members
  • Friends
  • A trust
  • Charitable organizations

  You can customize your policy to fit your family’s needs by choosing the type of policy you buy, the number of years you want it to last and your coverage amount.  If you die while your life insurance policy is active, your beneficiaries can file a claim and the death benefit will be paid out to them.

  There are two primary types of life insurance: term and permanent life. Permanent life insurance such as whole life insurance or universal life insurance can provide lifetime coverage, while term life insurance provides basic protection for a set period of time.

  Term life Insurance:

  • Term life insurance guarantees payment of a stated death benefit to the insured’s beneficiaries if the insured person dies during a specified term.
  • These policies have no value other than the guaranteed death benefit and feature no savings component as found in a whole life insurance product.
  • Term life premiums are based on a person’s age, health, and life expectancy.
  • Simplest and most affordable type of life insurance.

  Whole Life Insurance:

  • Whole life insurance lasts for a policyholder’s lifetime, as opposed to term life insurance, which is for a specific number of years.
  • Whole life insurance is paid out to a beneficiary or beneficiaries upon the policyholder’s death, provided that the premium payments were maintained.
  • Whole life insurance pays a death benefit, but also has a savings component in which cash can build up.
  • The savings component can be invested; additionally, the policyholder can access the cash while alive, by either withdrawing or borrowing against it, when needed.

  Universal Life Insurance:

  • Universal life (UL) insurance is a form of permanent life insurance with an investment savings element plus low premiums.
  • The price tag on universal life (UL) insurance is the minimum amount of a premium payment required to keep the policy.
  • Beneficiaries only receive the death benefit.
  • Unlike term life insurance, a UL insurance policy can accumulate cash value.

  How Do I Choose What is Right for Me?

  It can be confusing to choose the right type of life insurance.  When you compare some of the biggest differences in life insurance, it is easier to choose.

  The biggest difference in term life vs. whole life or universal life insurance is coverage length.  Term life insurance is good for people who want a financial safety net for a specific number of working years, such as the years of paying off a mortgage.  Different term lengths are available such as 10, 15, 20 or 30 years.  Term life insurance is much cheaper than whole life but if you outlive your term, there won’t be a life insurance payout. Term life is a simple, inexpensive way for you to proactively take care of your loved ones so they don’t have to worry when you’re gone.

  Whole and universal life insurance give you coverage for the duration of your life. It also includes a cash value component. The biggest difference between whole life insurance and universal life insurance is the cost. Whole life insurance is generally the most expensive way to buy permanent life insurance because of the guarantees within the policy: premiums are guaranteed not to change, the death benefit is guaranteed and cash value has a minimum guaranteed rate of return. Whole life insurance is good for people who like predictability and want lifelong coverage to build cash value.  Your beneficiary will get a guaranteed life insurance payout as long as you’ve paid the premiums to keep the policy current. This type of policy tends to cost more in the early years to support the guarantees it provides.  But, as the cost of living goes up in the years ahead, your whole life insurance premium will remain identical every month and will never cost more.

  Universal life insurance often offers more flexibility than a whole life insurance policy.  These policies offer lifelong coverage, provide flexibility when it comes to paying premiums and choices for how the policy’s cash value is invested. A standard universal life insurance policy’s cash value grows according to the performance of the insurer’s portfolio and can be used to pay premiums.  With a universal life insurance policy, the cash value will build depending on the policy type.  If you want to build tax-deferred savings and don’t expect to tap into the funds for a long time, universal life may be a suitable option for you.

  No one wants to talk about it, but we have to. You need life insurance. When you’re gone, those you love will be grieving. This is unavoidable. Leaving them to struggle financially, however, is avoidable.  Talking to a professional when you choose your life insurance plan can help you to find ways to afford the right kind of coverage.

  Check out these great resources to better educate yourself on choosing life insurance:

  Term vs. Whole Life Insurance: How to Choose

  Life Insurance Basics

  8 Smart Steps for Buying Life Insurance

• The Great Resignation: How Companies Can Cope With The Mass Exodus

  September 13, 2021

  Tags: Employee Morale, Great Resignation

  

  American companies are at a serious crossroads right now because of an unexpected consequence of COVID-19 known as the “Great Resignation.”

  CNBC reported earlier this summer that four million people had quit their jobs. This would be shocking under normal circumstances, yet these people quit stable jobs in the middle of a global pandemic.

  The majority of these resignations occurred in retail, professional services, transportation, warehousing, and utilities. And in terms of geography, workers were more likely to quit in the Southern, Midwestern, or Western regions of the United States.

  What caused this to happen? Analysts say it’s been in the works for years, and COVID-19 simply gave dissatisfied workers a moment to reflect on their situations.

  People have reprioritized their lives as a result of COVID-19, putting more of their time and effort into personal experiences and family time.

  Other employees took advantage of the quarantine to leave low-wage jobs or companies they believed were taking advantage of them. Remote work has also flourished over the past two years.

  Employers are now panicking about how to bring these people back, or at the very least, find suitable replacements. This blog will cover some of the changes companies should make to survive the “Great Resignation.”

  Change How You Treat Employees

  Data from a 2019 survey of 11 million workers narrowed down three reasons for the “Great Resignation,” each related to how companies treated their employees and their work environment.

  A lack of workplace communication frustrated enough employees to consider leaving their position. They seek more transparency in a new job, as well as a sense of belonging.

  Other respondents said they were concerned about the manager-employee relationship. Specifically, they said managers needed to acknowledge their work more and serve as reliable intermediaries between them and the organization.

  Many frustrated employees also said they were leaving toxic environments that held them and the company back from reaching its full potential. They wanted company leadership to address the issues and offer more flexibility with remote or hybrid options.

  Morale Does Matter— And It’s Your Responsibility

  A large share of resignations this year came from workers on edge in their toxic workplaces or continually feeling burnt out without any relief. Working from home during the quarantine gave them time to think about what they really wanted in their career.

  What is a toxic workplace exactly? It’s a company that puts money or success over the needs of its employees. Profits are important in business but nothing is sustainable if employees aren’t in a healthy mind frame.

  Here are some common signs of a toxic workplace:

  ● Employees are overworked and underpaid
  ● Management rules with fear and they aren’t concerned with staff well-being
  ● Verbal abuse or sexual harassment in the office
  ● Employees aren’t recognized for good work and made to feel guilty for not taking on new projects
  ● Zero accountability companywide

  Healthy work environments and employee morale start at the top. It’s important for company leadership to establish and maintain a positive culture for everyone.

  Otherwise, employees will be miserable, productivity will plummet, and there will be high turnover rates.

  Stay Competitive With Salaries & Benefits

  Although money isn’t the primary factor behind the “Great Resignation,” enhancing salary and benefits could entice some employees back.

  Workers now have more options and power in their job searches than ever before. There is a surplus of talent. If you want to recruit the best, you’ll need to be willing to pay for them.

  In fact, a labor market survey discovered the lowest wage workers without a college degree are willing to accept in 2021 is $61,483. That’s a $10,000 increase from the year before.

  Prospective employees are also thinking more about their health benefits after living nearly two years with COVID-19. They want better preventative care, enhanced relationships with primary care providers, and mental health coverage.

  Their focus is on preventing disease and ensuring that insurance plans will cover any serious illnesses that do emerge.

  Mental health services are at the center of this trend. Around 60% of employees reported feeling more stress and anxiety during the pandemic, and therapy appointments have skyrocketed in 2021.

  Rethinking Business As Usual

  The “Great Resignation” is not hitting every industry or business the same, but those who want to weather the storm will need to evaluate how they treat employees and what kind of work culture they want to promote.

  They can start by taking an “employee-centric” approach to decision-making and taking full responsibility for employee morale.

  And while salary shouldn’t be the only reason someone takes a job, there is a growing expectation among younger workers for higher salaries and better healthcare benefits.

  By Mckenzie Cassidy

  Originally posted on HR Exchange Network

• Vaccine or Not – But Now it Might Cost You – Delta Air Lines, Ironically, Pushes the First Variant | by Jordan Shields, Partner

  September 10, 2021

  Tags: COVID-19, Delta Variant

  

  Companies have been cajoling and compensating employees to get the COVID vaccine, but now Delta is fighting the Delta with a new delta – if employees do not get the vaccine, they will now pay $200 per month for their health insurance.  This is to offset the additional costs to the Delta medical plan due to COVID cases.  While Delta does have 75% of their employees vaccinated, their goals, as with other companies looking for full compliance, are for 100%.

• Open Enrollment: Looking Backward to Plan Forward

  September 7, 2021

  Tags: benefits, health benefits, Open Enrollment

  

  When the autumn leaves fall and the weather turns cooler, we know it’s time to start thinking of open enrollment. Open enrollment season can be a confusing time. As you begin your research into which plan to choose or even how much to contribute to your Health Savings Account (HSA), consider evaluating how you used your health plan last year. Looking backward can help you plan forward to make the most of your health care dollars for the coming year.  Here’s what you need to know about your workplace benefits to maximize them:

  1).  Know the Open Enrollment Dates

  It is up to you to make sure you take advantage of the open enrollment period. Be sure you know when your company has open enrollment because it can be your only time to adjust benefits for the coming year.

  2).  Evaluate Your Current Benefits

  Before open enrollment starts, review the benefits you currently are receiving. Your pay stub can be an excellent resource to find this information; you should be able to find the benefits you are paying for under the deductions or withdrawals section.  Standard deductions might include medical insurance, dental insurance, 401(k) contributions, life insurance, vision insurance, long- term disability insurance, health savings account or flexible spending account contributions, and accidental death and dismemberment insurance.  Review those deductions to make sure you know what you’re paying for and whether you actually used the benefits.

  3).  Ask These Questions to Decide What Benefits You Need

  Everyone’s situation is different, but most employees should have at least medical, dental and vision insurance and make contributions to a 401(k) or similar workplace retirement savings account.

  When evaluating your benefits package, consider what your needs will be or what life changes you can expect for the coming year:

  • Do you have a medical condition that requires ongoing care such as diabetes or heart disease?
  • Are you trying to get pregnant or are expecting a baby?
  • Are you getting married (or divorced)?
  • Is your child turning 26 and can no longer be covered under your health insurance?
  • Does your significant other have coverage, or will you need to include your partner in your health coverage?
  • Are you on track for retirement, or do you need to save more? Don’t forget to take advantage of your company match in your retirement account. This is free money for the future.

  All of these are essential questions to ask yourself during the open enrollment season because they can make a difference in what benefits you choose to elect.  As you browse the different options, analyze the type of treatment and the amount of treatment you have received in the past. You cannot foresee every expense but focusing on the trends will help you make a sound decision.

  4). Compare Out-of-Pocket Cost

  Much like health networks, out-of-pocket costs are crucial when choosing the right plan for you and your family. Most health benefits summaries should highlight the amount you will pay in out-of-pocket expenses, including the pocket limit.

  Your goal in comparing out-of-pocket costs is to narrow down the plans that pay a higher percentage of your medical expenses and offer higher monthly premiums. These types of plans are suitable for you if:

  • You need emergency care frequently
  • You are planning to have surgery soon
  • You often see a primary care physician
  • You have a pre-existing condition or have been diagnosed with a chronic disease like cancer or diabetes
  • Your household income is sufficient to cover the monthly premiums

  5).  Do the Math

  People focus on the monthly premium, but you also need to look at the deductible. For instance, if you have a choice between a lower silver plan premium of $345 a month for a plan with a $5,500 deductible, and a higher gold plan premium at $465 a month with a $1,750 deductible, you’re better off with the second plan if you anticipate needing more than $1,500 in medical care. With the second plan, your total annual cost for the premium and deductible comes to $7,330, a $2,310 savings over the lower premium plan.

  6).  Look at Out-of-Pocket Costs

  The deductible is just one out-of-pocket expense; you also have copayments and coinsurance. The three together are your maximum out-of-pocket costs. Under the Affordable Care Act, the maximum out-of-pocket limit is $8,550 for a single person and $17,100 for a family policy.

  7).  Utilize Tax-Free Benefits

  Flexible spending accounts (FSAs), health savings accounts (HSAs), and dependent care spending accounts provide wonderful tax advantages because contributions are made with before-tax income.  They can be used to pay for deductibles, prescriptions and health-related costs that are not covered by your insurance (braces, eyeglasses, etc.). At the end of the year, you lose any money left over in your FSA so it’s important to plan carefully and not put more money in your FSA that you think you’ll spend.  However, with an HSA, funds roll over from year to year which makes it a great way to save for future medical costs.

  8).  Review the Provider List

  Most health plans today have “in-network” providers. If you see those doctors and visit those hospitals, you pay less out of pocket than if you go outside the network. So, if you want to keep your own doctor and go to a certain hospital, make sure they’re on the provider list.

  When it comes to choosing the best workplace benefits plan for you, education is your most significant defense against making substantial financial mistakes, including not taking full advantage of your employer’s benefits.  If you have questions about any of the benefits offered, ask your HR department for help or clarification.  And remember, looking backward on your past habits and expenses can be an important tool to help you plan forward for next year.

• What’s in Store for Wal Mart – They Want More of Your Money Through Health Care| by Jordan Shields, Partner

  September 3, 2021

  Tags: Health Centers, Walmart

  Walmart unveiled its first health center in 2019, offering a variety of services that include primary care, lab, X-Ray, EKG, counseling, dental, optical, hearing and community health.  All pricing is low (naturally) and transparent (unnaturally).  Walmart is now expanding their model across several sites, with a lot more to go (given that they have 5,000 stores nationwide).

  Walmart is not limiting its efforts to in store services.  They also just announced their acquisition of MeMD, a leader in telehealth (also known as virtual health).

  Finally, don’t forget that Walmart, as with a few other major pharmacy retailers, provide a large list of $4 drugs.

• Does Enrolling in Medicare Trigger an Offer of COBRA?

  September 1, 2021

  Tags: cobra, medicare

  

  Enrolling in Medicare does not cause COBRA to start. Under the federal rules, COBRA must be offered to persons enrolled in the employer’s health plan only if they lose coverage because of certain specific events. Termination of employment is an example of a COBRA qualifying event. Becoming eligible for Medicare, or enrolling in Medicare, is not a COBRA qualifying event.

  On the other hand, if someone is already on COBRA due to a prior event, and then they enroll in Medicare, COBRA will end. Early termination of COBRA due to Medicare enrollment only affects that person. If other family members also are on COBRA, they may continue for the remainder of the COBRA period assuming their premiums are paid when due and they do not enroll in Medicare or another group health plan.

  Let’s look at another scenario: An employee enrolls in Medicare while continuing as an active employee covered under the employer’s health plan. Then the employee leaves the company. This will trigger a COBRA offer since loss of coverage due to termination of employment is a COBRA qualifying event. Can the former employee elect COBRA despite being enrolled in Medicare? Yes, because they were already enrolled in Medicare before they elected COBRA. They probably will choose not to elect COBRA due to the cost, and since Medicare will be the primary claims payer, but they have the choice.

  There is one other rule about COBRA and Medicare that can be confusing. As we said, the employee who enrolled in Medicare while still working and covered under the employer’s plan later had a COBRA event. When loss of coverage is due to termination of employment, the COBRA continuation period is 18 months. Due to a special provision in the COBRA rules, the maximum COBRA period for the spouse or child (if also enrolled in the employer’s health plan when the COBRA event occurred) might be longer than 18 months. If the employee had first enrolled in Medicare no more than 18 months before the COBRA event, the maximum period for the spouse and children is 36 months counting from the employee’s Medicare enrollment.

  For instance, let’s call the active employee Mary and say she enrolled in Medicare in January 2021 and then lost her group coverage when she terminated employment in May 2021. So, she enrolled in Medicare fewer than 18 months before her COBRA event. Her maximum COBRA period will be 18 months counting from May 2021, but COBRA for her spouse and children (if enrolled) could run for up to 36 months counting from January 2021.

  Lastly, employers sometimes ask whether they can automatically terminate an employee’s (or spouse’s) group health coverage at age 65. Due to the federal Medicare as Secondary Payer (MSP) rules, employers with 20 or more workers cannot take into account anyone’s potential Medicare status in administering the group health plan. An employer with fewer than 20 workers also may be prohibited from basing health plan eligibility on the employee’s age due to the federal Age Discrimination in Employment Act (ADEA). We recommend employers review these matters with legal counsel.

  By Kathleen A. Berger, CEBS

  Originally posted on Mineral