IRS Issues Strong Warnings About ACA Compliance: Should HR be worried?

With all the confusion surrounding the ACA over the past few months, employers have been wondering if the IRS was gonna enforce the ACA reporting mandate. The IRS  has just recently released the ACA employers' and individual mandates to make sure everyone is in compliance for the healthcare reporting for 2017. Take a look at this article published by Jared Bilski from HR Morning hightlight eveything you need to know about reporting your healthcare information with the IRS.

Despite lots of warnings, the IRS has yet to impose any non-compliance penalties on employers during the two years the ACA reporting provisions have been mandatory. And with all of the efforts to kill or water down Obamacare, many employers are wondering if they should even make ACA compliance a priority at all.

Now, the agency is reminding folks that the ACA reporting mandate is still in full effect and compliance isn’t optional. It’s also assuring skeptical businesses it’s ready to start issuing penalties.

So should you believe the feds?

It sure sounds like it.

Most recently, the agency released four information letters about the ACA’s employer and individual mandates, and reminding employers exactly what they have to do to stay in compliance.

In addition, IRS sure warned employers it’s primed and ready to collect reporting penalties in a recent government report the folks at FreedomCare called a “game changer.”

Sweeping noncompliance tool

The Treasury Inspector General for Tax Administration (TIGTA) just released a report titled “Assessment of the Efforts to Implement the Employer Mandate under the Affordable Care Act.”

You can view the entire report here.

If you don’t have time to scour a 43-page document, here’s the one key fact: IRS has a new system in place for identifying potentially non-compliant employers, and the system has a very wide reach.

The feds’ ACA Compliance Validation System (ACV) will not only identify potentially non-compliant Applicable Large Employers, it will also calculate the “A” penalty under the Employer Mandate. Plus, the system will allow the feds to mass identify non-compliant employers and send notices to those non-compliant firms for any and all reporting years.

Questions and answers

By this point, you’ve probably got a few questions about the IRS’ new Obamacare compliance weapon, like:

When will the system be in place and ready?

Answer: According to the feds, the ACV should be ready by May 2017. Once it’s up and running, IRS should be able to start issuing large scale penalties.

Hasn’t IRS said it’s ready to start imposing ACA penalties before? Why should we believe them this time?

Answer: Granted, IRS has stated it planned to start penalizing firms before, but this seems different. Initially, the feds have been developing this ACV system since July 2015 and planned to have it ready by January 2017.

But as the report said, “the implementation of the ACV System has been delayed to May 2017.”

With the release of this detailed report, it’s clear the feds are ready to start collecting on all the noncompliance penalties that are long overdue. IRS has stated it expects to pull in $228 billion in ACA penalties.

Plus, with ACA repeal efforts currently on hold, now is a very good time for the agency to come after firms that have been pushing their compliance obligations to the back burner.

Bottom-line: Employers can’t afford to operate as if the delay in IRS reporting penalties is a permanent situation. If you’ve put this task on hold, now is the time to get everything in order.

Key correction steps

So what should employers do if they’ve already missed ACA reporting deadlines? File ASAP.

The sooner you correct an issue, the less likely you’ll wind up in a long, drawn out federal audit. Plus, as employment attorney David M. Pixley points out, IRS has a number of different penalties depending on how late the ACA reporting actually is.

For example, correcting a reporting failure within 30 days of the due date cuts the penalty to $50 per return, with a $532,000 cap.

When firms correct reporting failures after 30 days, but on or before August 1, the penalty is $100 per return, and the cap is $1,596,500.

And of course, late-filing is much safer (i.e., less costly) than not filing at all.

Reason: The standard per return penalty of $260 (max $3,193,000/year) jumps drastically for violations due to “intentional disregard” to a per-return penalty of $530 (no penalty cap).

See the original article Here.

Source:

Bilski J. (2017 August 16). IRS issues strong warning about ACA compliance: should HR be worried? [Web blog post]. Retrieved from address http://www.hrmorning.com/irs-issues-strong-warnings-about-aca-compliance-should-hr-be-worried/


4 Trends Shaping Cybersecurity in 2017

The threat of cyber attacks is increasing every day. Make sure you are stay up-to-date with all the recent news and trends happening in the world of cyber security so you can stay informed on how to protect yourself from cyber threats. Check out this great column by Denny Jacob from Property Casualty 360 and find out about the top 4 trends impacting cybersecurity this year.

No. 4: Growing areas of concern

Organizations with a chief information security officer (CISO) in 2017 increased to 65 percent compared to 50 percent in 2016. Staffing challenges and budgetary distribution, however, reveal where organizations face exposure.

Finding qualified personnel to fill cybersecurity positions is as ongoing challenge. For example, one-third of study respondents note that their enterprises receive more than 10 applicants for an open position. More than half of those applicants, however, are unqualified. Even skilled applicants require time and training before their job performance is up to par with others who are already working on the company's cybersecurity operation.

Half of the study respondents reported security budgets will increase in 2017, which is down from 65 percent of respondents who reported an increase in 2016. This, along with staffing challenges, has many enterprises reliant on both automation and external resources to offset missing skills on the cybersecurity team.

Another challenge: Relying on third-party vendors means there must be funds available to offset any personnel shortage.

If the skills gap continues unabated and the funding for automation and external third-party support is reduced, businesses will struggle to fill their cybersecurity needs.

No. 3: More complicated cyber threats

Faced with declining budgets, businesses will have less funding available on a per-attack basis. Meanwhile, the number of attacks is growing, and they are becoming more sophisticated.

More than half (53 percent) of respondents noted an increase in the overall number of attacks compared previous years. Only half (roughly 50 percent) said their companies executed a cybersecurity incident response plan in 2016.

Here are some additional findings regarding the recent uptick in cyber breaches:

• 10 percent of respondents reported experiencing a hijacking of corporate assets for botnet use;• 18 percent reported experiencing an advanced persistent threat (APT) attack; and

• 14 percent reported stolen credentials.

• Last year’s results for the three types of attacks were:

• 15 percent for botnet use;

• 25 percent for APT attacks; and

•15 percent involving stolen credentials.

Phishing (40 percent), malware (37 percent) and social engineering (29 percent) continue to top the charts in terms of the specific types of attacks, although their overall frequency of occurrence decreased: Although attacks are up overall, the number of attacks in these three categories is down.

No. 2: Mobile takes a backseat to IoT

Businesses are now more sophisticated in the mobile arena. The proof: Cyber breaches resulting from mobile devices are down. Only 13 percent of respondents cite lost mobile devices as an exploitation vector in 2016, compared to 34 percent in 2015. Encryption factors into the decrease; only 9 percent indicated that lost or stolen mobile devices were unencrypted.

IoT continues to rise as an area of concern. Three out of five (59 percent) of the 2016 respondents cite some level of concern relative to IoT, while an additional 30 percent are either "extremely concerned" or "very concerned" about this exposure.

IoT is an increasingly important element in governance, risk and cybersecurity activities. This is a challenging area for many, because traditional security efforts may not already cover the functions and devices feeding this digital trend.

No. 1: Ransomware is the new normal

The number of code attacks, including ransomware attacks, remains high: 62 percent of respondents reported their enterprises experienced a ransomware attackspecifically.

Half of the respondents believe financial gain is the biggest motivator for criminals, followed by disruption of service (45 percent) and theft of personally identifiable information (37 percent). Despite this trend, only 53 percent of respondents' companies have a formal process in place to deal with ransomware attacks.

What does that look like?

Businesses can conduct "tabletop" exercises that stage a ransomware event or discuss in advance decisions about payment vs. non-payment. Payment may seem like the easiest solution, but law enforcement agencies warn it can have an encouraging effect on those criminals as some cases lead to repeated attacks of the same business.

Many cybersecurity specialists argue that the best way to fight a ransomware attack is to avoid one in the first place. Advance planning that might include the implementation of a governing corporate policy or other operating parameters, can help to ensure that the best cybersecurity decisions are made when the time comes to battle a breach.

See the original article Here.

Source:

Jacob D. (2017 August 25). 4 trends shaping cybersecurity in 2017 [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/08/25/4-trends-shaping-cybersecurity-in-2017?ref=hp-in-depth&page_all=1


ACA Revamp Odds Slip as Senate Gets New Expiration Date

Timeframe to repeal and replace has just shortened. Find out how this new timeline for the repeal of ACA will impact Senate and their plan for healthcare in this informative column by Laura Litvan from Think Advisor.

The Senate parliamentarian told lawmakers that Republicans’ ability to pass an Affordable Care Act change bill with just 51 votes expires at the end of this month, Sen. Bernie Sanders said Friday.

The preliminary finding complicates any further efforts by Republican leaders in Congress to pass a comprehensive GOP-only overhaul of the health care law.

Sanders, a Vermont independent, in a statement called the determination a "major victory" for those who oppose Affordable Care Act de-funding.

Senate Republicans, who control the chamber 52-48, failed to win enough support for their ACA de-funding and change bill in July as three GOP lawmakers joined Democrats to oppose the measure. Republican leaders haven’t ruled out reviving their effort, and some party members — including Lindsey Graham of South Carolina, Bill Cassidy of Louisiana and Ted Cruz of Texas — say they’re talking to colleagues about a possible broad-based bill.

At the same time, some senators are discussing a scaled-back, bipartisan health measure. It takes 60 votes to overcome a Democratic filibuster, and Democrats are united against de-funding of the Affordable Care Act, or the kinds of Affordable Care Act program changes proposed in the bills that have reached the House or Senate floor.

The Senate Health, Education, Labor and Pensions Committee has scheduled four hearings this month to examine bolstering the Affordable Care Act public health insurance exchange system.

Committee Chairman Lamar Alexander, a Tennessee Republican, and the panel’s top Democrat, Patty Murray of Washington, have pledged a bipartisan effort to shore up the exchanges, which provide consumers a place to purchase individual coverage with help from Affordable Care Act subsidies.

Earlier guidance from Senate Parliamentarian Elizabeth MacDonough dogged Republicans in their Affordable Care Act change effort throughout the summer. In late July, she issued a preliminary finding that key parts of a proposal drafted by Senate Majority Leader Mitch McConnell didn’t qualify for consideration under the budget reconciliation rules, dramatically complicating the already slimming prospects of passing a bill.

Republicans can still try to use the budget reconciliation process to get an Affordable Care Act change bill through the Senate with just a 51-vote majority, rather than a 60-vote majority, during the fiscal year that starts Oct. 1.

The House Budget Committee has drafted a fiscal 2018 budget that could be used for both de-funding the Affordable Care Act and tax reform. That budget may come to the floor in mid-September, and the Senate Budget Committee hopes to release its version of the budget in the coming weeks. Still, putting a tax overhaul and Affordable Care Act de-funding in the same legislation would be time-consuming and unlikely.

See the original article Here.

Source:

Litvan L. (2017 September 1). ACA revamp odds slip as senate gets new expiration date [Web blog post]. Retrieved from address http://www.thinkadvisor.com/2017/09/01/aca-revamp-odds-slip-as-senate-gets-new-expiration?t=health-insurance?ref=channel-top-news


Wellness Programs – Getting Started and Remaining Compliant

Are you looking to set up a wellness program at your company. Here is a great article from our partner, United Benefit Advisors (UBA) by Hope DeRocha on what you need to know when setting up your wellness program.

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.

See the original article Here.

Source:

DeRocha H. (2017 Aug 15). Wellness programs-getting started and remaining compliant ik[Web blog post]. Retrieved from address http://blog.ubabenefits.com/wellness-programs-getting-started-and-remaining-compliant


How Voluntary Benefits Options are Changing

The market for voluntary benefits has seen substantial growth over the last few years with the rise of health care cost. Find out how you can prepare for the changes coming to the voluntary benefits market thanks to this great article by Keith Franklin from Benefits Pro.

As health care insurance deductibles continue to rise, interest in voluntary benefits are growing. This trend supports another growth area that we’re seeing: companies are looking for innovative, cost-effective ways to enhance their compensation packages and are finding that voluntary health benefits are the solution. We’ve seen a significant rise in sales for dental discount plans that offer additional benefits over the past six months.

The most popular dental plans that we offer to groups and individuals now include telemedicine, medical bill negotiation and health advocacy services — along with our more typical dental care, vision, hearing, and prescription savings plans.

But, no matter how popular they are, these plans still do not sell themselves. The key to success in the group voluntary benefits marketplace is clearly communicating the business return on investment that can be expected from offering voluntary benefits to employees.

Voluntary benefits refresher

Of course, you know employers use voluntary programs to offer ancillary benefits, or supplementary benefits, that help fill in the holes in major medical coverage.

If you have not had much direct involvement in voluntary benefits, you may be surprised by how much the menus have grown.

Many of the newest voluntary benefits provide discounted or free access to services that were not typically associated with health care plans. These offerings tend to address concerns related to security, financial management, health care that may not covered by primary insurance (such as dental) and personal improvement.

Today, voluntary benefits may include:

  • Automobile, homeowners, or pet insurance
  • Concierge services
  • Critical illness
  • Cybersecurity/Identify theft protection
  • Dental
  • Education
  • Financial counseling
  • Financial planning
  • Fitness
  • Healthcare advocacy
  • Life insurance
  • Medical bill negotiation
  • Telemedicine/Telehealth
  • Vision

Voluntary benefits are typically offered to employees as an optional add-on to their benefits package. While the benefits may be paid for in part by the employer, these are more typically payroll-deducted benefits.

When sold directly to individuals, voluntary benefit offerings are often described as “discount,” or “additional benefit” plans. Target markets in the business-to-consumer space would include self-employed people and owners of very small businesses. Typically, businesses can qualify as a “group” for voluntary benefits purposes if the business employs three to five people.

When sold to groups, these plans offer savings by tapping into discounts for group rates, and discounts pre-negotiated by the plans’ providers. The savings are passed on to plan members, giving the cost-savings of group coverage to individuals. Brokers and agents can tap into this market effectively by working with trade groups, chambers of commerce, and other associations that serve small businesses, contactors and the self-employed.

It is important to note that many voluntary benefits offerings are not insurance. They are intended to complement existing insurance coverage, make health care such as dental and vision more affordable, or provide discounted access to a broad variety of supplementary services.

There are exceptions, of course. Some voluntary plans offer supplementary health coverage, or other types of insurance.

How to communicate advantages

Financial benefits are the most obvious advantage to businesses. Adding desirable benefits at no additional (or low) cost to the company is obviously an appealing proposition. But that’s not the whole picture.

Businesses considering offering voluntary benefits plans to their employees will also want to ensure that any solution that they buy into fully delivers on its promises and doesn’t add new complications.

Provider reliability: Who is offering the benefit, who is the provider or underwriter? Voluntary benefits can be backed by a provider, such as a health insurance company that offers both dental insurance and dental discount plans. The benefit may be offered directly by the providing company or by another company that they have partnered with. Look for a proven track record of trustworthiness and experience within the voluntary benefits space by all companies involved in providing the benefit.

Easy deployment and administration: What is involved in offering the benefit to employees? What information will be required, how long will it take to on-board people? Will proprietary software need to be installed, or are benefits managed through a platform-generic, online portal? Is there an automatic payroll deduction feature? Obviously, the easier a solution is to set up and use, the more attractive it is. Know the back-end as well as you know the benefits.

Data security: Securing information is an ever-growing concern. Not all companies will ask about data security when evaluating a benefits plan, but an increasing number are vitally concerned about protecting personnel information – both as a service to employees and as a way of warding off digital crime. Cyber criminals can use information about employees to impersonate them and gain access to company networks and data. It is best to be prepared with answers to these questions: How is sensitive information on employees kept secure and private when it is captured, in use, and in storage? If data is stored in the cloud, does the storage solution used meet the organization’s compliance and regulatory obligations?

Education/engagement: Well-designed, informative, and customizable materials that help employees get excited, understand, and use their voluntary benefits are a highly valuable add-on to any offering. Companies expect to see quantifiable results from their benefits packages, and limited adoption reduces return on investment. Keeping employees engaged is central to a company’s happiness with their voluntary benefits plan. Get samples of the employee training material from providers.

Metrics: While many companies will rely on their own data-led decision making tools to measure a program’s success, it’s helpful to point out the ROI voluntary benefits can deliver. Overall, the data points that can be used to gauge the success of a voluntary benefits offering will include an ability to attract and retain top talent, reduced medical absenteeism/presenteeism, increased productivity, and employee interest and usage of the benefits.

Customer care: If employees have problems using their benefits, who provides support? The provider or service partner should offer a single-point-of-contact tasked with solving problems, and a dedicated customer support team that employees can access with questions or concerns.

Interest in voluntary growing

Voluntary benefits aren’t new, but the interest in these offerings is strong – particularly for money-and-time saving services such as telemedicine. As the marketplace grows, businesses and brokers need to understand how to evaluate these offerings and select the best options.

There are advantages to offering a tightly curated bundle of benefits, or providing a broad variety of options that businesses can mix and match. When offering the latter, it’s important to ensure that administration and access are streamlined as much as possible. What seems simple in isolation – you manage and access your benefits though this app or portal – can quickly become wildly complex when the burden grows to a dozen or more apps and portals. Partnering with service providers who focus on delivering a quality experience end-to-end provides significant advantages to brokers and businesses.

See the original article Here.

Source:

Franklin K. (2017 July 13). How voluntary benefits options are changing [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/07/13/how-voluntary-benefits-options-are-changing?t=innovation&page_all=1


Employers Broadening Health Programs

Employers are starting to change their approach on how they look at their employee benefits program. Take a look at this great article by Nick Otto from Employee Benefit Adviser and find out how employers are reclassifying their employee benefits program in order to expand their employees' well-being.

The siloed approach to retirement, healthcare and wellness is a thing of the past as employers are increasingly taking a holistic approach to addressing their employees’ health and wealth.

Employers are expanding their view of employee overall well-being, according to a new report from Optum, a technology-enabled health services company. That means that, while employers are still offering traditional wellness programs, there has been a significant shift in the last three years to those programs addressing workers’ financial, behavioral and social health.

“For example, we see increased interest among companies in developing new programs around mindfulness, positivity and creativity, which can reduce stress, improve eating and sleeping habits, and stimulate innovative thinking,” says Seth Serxner, Optum’s chief health officer.

While physical health still remains a significant focus for employee wellness programs, other dimensions are tracking with higher importance among large employers:

· 51% of such programs now address financial health, up from 38% in 2015;
· 47% address employees’ social health by using strategies like team-based activities to increase feelings of connectedness and a sense of belonging, compared to 37% in 2015; and
· 68% address behavioral health, up from 65% in 2015

And technology is helping employers to better engage these programs to workers. Since 2014, there has been a significant increase in the use of a variety of innovations, including online competitions, activity tracking devices, social networks, mobile apps and mobile messaging to help engage employees, the study notes.

Additionally, incentive strategies are helping to get workers in the wellness game.

Use of incentives is at an all-time high, Optum notes, with 95% of employer respondents offering incentives to their employees. Recognizing that workers can be highly influenced by their family members, 74% of employers also are offering incentives to family members. According to Optum, average incentives per participant per year equate to $532.

See the original article Here.

Source:

Otto N. (2017 August 15). Employers broadening health programs [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/employers-broadening-health-programs


New House Healthcare Proposal a Mixed Bag for Employers

The House of Representatives has just introduced their new bipartiasn plan for healthcare reform. Find out how this new healthcare legislation will impact your employers' healthcare in this great article by Victoria Finkle from Employee Benefit News.

A new bipartisan healthcare plan in the House contains potential positives and negatives alike for employers.

The plan could provide much-sought relief to small and medium-sized businesses with respect to the employer mandate, but it could also institutionalize the mandate for larger firms and does little to reduce employer-reporting headaches. Critics say it also fails to endorse other employer-friendly reforms to the Affordable Care Act.

The Problem Solvers Caucus, a group of more than 40 Republicans and Democrats led by Reps. Tom Reed, R-N.Y., and Josh Gottheimer, D-N.J., unveiled their new plan last week to stabilize the individual markets, following the collapse of Senate talks that were focused on efforts to repeal and replace the Affordable Care Act last month. The proposal would be separate from an earlier bill that passed the House to overhaul large swaths of the ACA. Congress is now on recess until after Labor Day, but talks around efforts to shore up the individual markets are likely to resume when lawmakers return to Washington this fall.

PaulThe House lawmakers introduced a broad set of bipartisan principles that they hope will guide future legislation, including several key tweaks to the employer mandate. This plan includes raising the threshold for when the mandate kicks in from firms with 50 or more employees to those with at least 500 workers. It also would up the definition of full-time work from those putting in 30 hours to those working 40 hours per week. Among changes focused on the individual markets, the proposal would bring cost-sharing reduction payments under the congressional appropriations process and ensure they have mandatory funding as well as establish a stability fund that states could tap to reduce premiums and other costs for some patients with expensive health needs.

Legislative talks focused on maintaining the Obamacare markets remain in early stages and it’s unclear whether the provisions targeting the employer mandate will gain long-term traction, though lawmakers in support of the plan said that their proposed measure would help unburden smaller companies.

“The current employer mandate places a regulatory burden on smaller employers and acts as a disincentive for many small businesses to grow past 50 employees,” the Problem Solvers Caucus said in their July 31 release.

Observers note that raising the mandate’s threshold would likely have few dramatic effects on coverage rates. But critics argued that while the plan would eliminate coverage requirements for mid-size employers — a boon for smaller companies — it could ultimately make it more difficult to restructure or remove the mandate altogether.

“It would provide relief to some people — however, it will enshrine the employer mandate forever,” says James Gelfand, senior vice president of health policy at the ERISA Industry Committee. “You are exempting the most sympathetic characters and ensuring that large businesses will forever be subject to the mandate and its obscene reporting.”

The real-world impact of the change would likely be limited when it comes to coverage rates, as mid-sized and larger employers tend to use health benefits to help attract and retain their workforce. Nearly all firms with 50 or more full-time employees — about 96% — offered at least one plan that would meet the ACA’s minimum value and affordability requirements, according to the Kaiser Family Foundation/Health Research & Education Trust employer health benefits survey for 2016. Participation was even higher — 99% — among firms with at least 200 workers.

“At the 500 bar, realistically, virtually every employer is offering coverage to at least some employees,” says Matthew Rae, a senior policy analyst with Kaiser Family Foundation.

Gelfand notes that under the proposed measure, big businesses would still have to comply with time-consuming and costly reporting requirements under the ACA and would continue to face restrictions in plan design, because of requirements in place that, for example, mandate plans have an actuarial value of at least 60%.

“Prior to the ACA, big business already offered benefits — and they were good benefits that people liked and that were designed to keep people healthy and to make them productive workers,” he says. “[The ACA] forces us to waste a boatload of time and money proving that we offer the benefits that we offer and it constrains our ability to be flexible in designing those benefits.”

Susan Combs, founder of insurance brokerage Combs & Co., says that changing the definition of full-time employment from 30 to 40 hours per week could have a bigger impact than raising the mandate threshold, because it would free up resources for employers who had laid off workers or cut back their hours when they began having to cover benefits for people working 30 or more hours.

“Some employers had to lay off employees or had they to cut back on different things, because they had to now cover benefits for people that were in essence really part-time people, not full-time people,” she says. “If you shifted from 30 to 40 hours, that might give employers additional remedies so they can expand their companies and employ more people eventually.”

Two percent of firms with 50-plus full-time workers surveyed by Kaiser in 2016 said that they changed or planned to change the job classifications of some employees from full-time to part-time so that the workers would not be eligible for health benefits under the mandate. Another 4% said that they reduced the number of full-time employees they intended to hire because of the cost of providing health benefits.

Gelfand calls the provision to raise the definition from 30 to 40 hours per week “an improvement,” though he said a better solution would be to remove the employer mandate entirely.

He added that he would like to see any market stabilization plan include more items employers had backed as part of the earlier repeal and replace debate. While the House plan would remove a tax on medical devices, it does not address the Cadillac tax on high-cost plans, one of the highest priority items that employer groups have been working to delay or repeal. It also doesn’t include language expanding the use of tax-advantaged health savings accounts detailed in earlier House and Senate proposals.

“There’s not likely to be another healthcare vehicle that’s focused on ACA reform, so if you have a reform vehicle that goes through and it doesn’t do anything to give us tax relief and it doesn’t do anything to improve consumer-driven health options, like HSAs, and it doesn’t do anything to improve healthcare costs — wow, what a missed opportunity,” he says.

See the original article Here.

Source:

Finkle V. (2017 August 10). New house healthcare proposal a mixed bag for employers [Web blog post]. Retrieved from address https://www.benefitnews.com/news/new-house-healthcare-proposal-a-mixed-bag-for-employers


How Health Coaching can Revitalize a Workforce

Do you need help revitalizing your workforce? Check out this great column by Paul Turner from Employee Benefit Advisor and see how health coaching can be a great way to increase engagement and productivity among your employees.

Nearly 50% of Americans live with at least one chronic illness, and millions more have lifestyle habits that increase their risk of health problems in the future, according to the Centers for Disease Control and Prevention. Type 2 diabetes, cardiovascular disease, cancer, pulmonary disease and other conditions account for more than 75% of the $2 trillion spent annually on medical care in the U.S.

Employers have a stake in improving on these discouraging statistics. People spend a good portion of their lives at work, where good health habits can be cultivated and then integrated into their personal lives. While chronic diseases often can’t be cured, many risk factors can be mitigated with good health behaviors, positive and consistent lifestyle habits and adherence to medication and treatment plans. Moreover, healthy behaviors — like smoking cessation, weight management, and exercise — can help prevent people from developing a chronic disease in the first place.

Companies that sponsor well-being programs realize the benefits of a healthier and more vital employee population, with lower rates of absenteeism and improved productivity. Investing in such programs can yield a significant return — particularly from condition management programs for costly chronic diseases.

Digitally-based well-being programs in particular are powerful motivators to adopt healthy behaviors. Yet for many employees, dealing with difficult health challenges can be daunting and digital wellness tools may not offer them sufficient support. Combining these health technologies with the skill and support of a health coach, however, can be a winning approach for greater workplace well-being. The benefits of coaching can also extend to employees that are currently healthy. People without a known condition may still struggle with stress, sleep issues, and lack of exercise, and the guidance of a coach can address risk factors and help prevent future health problems.

Choosing a health coach

Coaching is an investment, and the more rigor that employers put into the selection of a coaching team, the better the results. Coaches should be a credentialed Certified Health Education Specialist or a healthcare professional, such as a registered nurse or dietician, who is extensively trained in motivational interviewing. It also helps when a coach has a specialty accreditation in an area such as nutrition, exercise physiology, mental health or diabetes management. Such training allows the coach to respond effectively to highly individualized needs.

This sort of personalization is essential. A good coach will recognize that each wellness program participant is motivated by a different set of desires and rewards and is undermined by their own unique combination of doubts, fears and temptations. They build trust and confidence by helping employees identify the emotional triggers that may lead them to overeat, smoke or fail to stick with their treatment plans and healthy lifestyle behaviors.

What works for one employee, does not work for another. A 50-year-old trying to quit smoking may need the personal touch of a meeting or phone conversation to connect with her coach; a 30-year-old focused on stress management might prefer email or texting. It’s important for the coaching team to accommodate these preferences.

Working with our employer clients, WebMD has seen what rigorous coaching can achieve:
· A 54% quit rate for participants in a 12-week smoking-cessation program
· Successful weight loss for 68% of those who joined a weight-management program
· A nearly 33% reduction in known health risks for relatively healthy employees in a lifestyle coaching program
· A corresponding 28% health risk reduction for employees with a known condition who received condition management coaching.

Coaching is more likely to succeed when it is part of a comprehensive wellness program carried out in an environment where employee well-being is clearly emphasized by the employer and its managers. WebMD popularizes the saying that ‘When the coach is in, everybody wins.’ Qualified health coaching may be the missing ingredient that helps an employer achieve its well-being goals and energize its workforce.

See the original article Here.

Source:

Turner P. (2017 July 27). How health coaching can revitalize a workforce [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/how-health-coaching-can-revitalize-a-workforce?feed=00000152-1387-d1cc-a5fa-7fffaf8f0000


Determining COBRA Premiums for Fully Insured and Self-Funded Health Plans

Here is a great article from our partner, United Benefit Advisors (UBA) on what you need to know about COBRA when dealing with fully insured and self-funded health plans by Danielle Capilla.

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. While some group health plans may provide COBRA continuation coverage at a reduced rate or at no cost, most qualified beneficiaries must pay the full COBRA premium. The COBRA election notice should include information about COBRA premiums.

For fully insured health plans, the premium is the cost to maintain the plan for similarly situated employees. For self-insured plans, the premium is the cost to maintain the plan for similarly situated employees as determined by an actuary or the past cost from the preceding determination period. The applicable premium calculation for both fully- and self-insured plans includes the cost of providing coverage to both active employees and COBRA qualified beneficiaries. All COBRA premiums must be calculated in good faith compliance with a reasonable interpretation of COBRA requirements.

Generally, COBRA payments are made on an after-tax basis. Qualified beneficiaries have 45 days after the election date to make an initial premium payment. The plan may terminate the qualified beneficiary's COBRA rights if no initial premium payment is made before the end of the 45-day period. In addition, plans must allow monthly premium payments and cannot require payment on a quarterly basis. As established under COBRA, premiums are due on the first day of each month with a minimum 30-day grace period. A plan may terminate COBRA coverage for nonpayment or insufficient payment of premiums after the grace period.

If a qualified beneficiary makes an insignificant underpayment, then the premium payment will still satisfy the payment obligation. An underpayment is deemed insignificant if the shortfall is no greater than the lesser of $50 or 10 percent of the required amount. However, if the plan notifies the qualified beneficiary of the shortfall and grants a reasonable amount of time to correct the underpayment (usually 30 days after the notice is provided), then the qualified beneficiary is required to make the payment; otherwise, COBRA coverage may be canceled.

Fully Insured Health Plans

Generally, the applicable COBRA premium amount for fully insured plans is the insurance premium charged by the insurer. The applicable premium is based on the total cost of coverage, which includes both the employer and employee portions. The premium amount is based on the cost of coverage for similarly situated individuals who have not incurred a qualifying event.

A group health plan may charge at most 102 percent of the premium during the standard COBRA coverage period for similarly situated plan participants (100 percent of the total cost of coverage plus an additional 2 percent for administrative costs). However, the plan may increase the premium for a disabled qualified beneficiary and charge 150 percent of the applicable premium during the 11-month disability extension period (months 19 through 29). In addition, COBRA regulations permit a plan to charge a 150 percent premium to nondisabled qualified beneficiaries as long as the disabled qualified beneficiary is covered under the plan. If the disabled qualified beneficiary is no longer covered under the plan, then the remaining qualified beneficiaries may continue coverage up to 29 months at 102 percent of the cost of the plan.

If an employer maintains more than one plan, then a separate applicable premium is calculated for each plan. Also, the applicable premium for a single plan may vary due to factors such as the coverage level, the benefit package, and the region in which covered employee resides. For instance, single employees may pay a different applicable premium than employees who include their spouse on the plan. Thus, the plan may charge different premiums based on the varying coverage levels.

The most common tier structures include employee-only, employee-plus-spouse, employee-plus-children, and employee-plus-family. According to Internal Revenue Ruling 96-8, a fully insured plan that pays different premiums for individual versus family coverage must use those same premium tiers for COBRA continuation coverage. Thus, COBRA premiums are divided into multi-rate and single-rate tier structures.

See the original article Here.

Source:

Capilla D. (2017 August 1). Determining COBRA premiums for fully insured and self-funded health plans [Web blog post]. Retrieved from address http://blog.ubabenefits.com/determining-cobra-premiums-for-fully-insured-and-self-funded-health-plans-1


CenterStage...Assure Elite: Could You Better Control Your Healthcare Renewal Costs?

Assure Elite is a partnership between Hierl Insurance, Network Health, and Agnesian Healthcare. It was specifically designed for employers in Fond du Lac, Dodge, and Green Lake counties. Assure Elite is a level-funded product, which means you benefit from the predictable, fixed monthly costs of a fully insured plan, but only pay for the health care your employees actually receive. Rates are underwritten so your premiums are based only on your employee’s (and their dependents) health status rather than being pooled with other employer groups that may not be as healthy. No more paying more due to the unhealthy conditions of others, which drives up the cost.

The Assure Elite plan allows employers to pay a flat rate each month to cover employees. If actual medical expenses are less than what the employer paid in a year, they'll get 50 percent of the difference back. If costs are higher, they won't be required to pay more. Level-funded plans can save eligible groups up to 30 percent versus a fully insured ACA plan. This type of plan design lacks the volatility often associated with self-insured plans that can cripple small businesses. Additionally, level funding is another way small businesses can get around ACA requirements such as state mandated benefits and premium taxes.

So, for small groups, the question is why not explore a level-funded plan?  With savings up to 30 percent, there is very little reason not to consider a quote!

"Every group with 2+ employees should be looking at these plan offerings! We’ve seen premiums reduce significantly with these plans. Companies can’t continue to take the financial burden of year-over-year increases on their medical premiums. We found a way, through Assure Elite, to solve the problem plaguing business owners. Assure Elite offers the same, if not better, coverage options with deep discounts that lower premiums. It’s a win-win."

 - Tonya Bahr, Employee Benefits Advisor at Hierl.

 

UNIQUELY DESIGNED PLANS

Q: While uniquely designed for 2-100 employees, tell me how larger organizations can also benefit from this plan?

A: As groups increase in size, we have more flexibility in how we finance health plans as well as with plan design. The provider discounts available through Assure Elite are also available for groups with 100+ employees.

Q: What are some of the main advantages of gaining access to Agnesian's Know & Go program?

A: For companies that already have a wellness program in place, this is a great added value. There is no additional charge for the Know & Go program. It includes a health risk assessment questionnaire, biometric screenings, one-on-one wellness coaching, and an employee portal with educational materials, food and exercise trackers, online workshops, and more.

Agnesian’s Know & Go program, which provides education and other services aimed at promoting healthy living, serves as a wellness benefit for Assure Elite plans.

“Agnesian HealthCare is excited to partner with Network Health and Hierl Insurance to offer an employer-sponsored health plan that provides cost certainty and improves the well-being of the citizens in the communities we serve,” said Steve Little, Agnesian HealthCare president, and CEO.

AFFORDABLE AND COST EFFECTIVE 

Q: How does this program provide the security of a fully insured plan with the advantages of a self-funded plan?

A: An employer experiences the convenience of predictable, fixed monthly costs just like a fully insured plan, but only pay for the care their employees/dependents receive through claim costs. The result - the elimination of cash flow concerns some businesses have regarding self-funding. If claims are less than the amount funded at the end of the policy year, employers get 50% of the funding surplus back. If claims are over the funded amount, the company is protected by stop loss coverage. Unlike traditional self-funding, an employer will never pay more than the maximum claim cost, which is the premium due each month.

Q: How does Assure Elite help control renewal costs?

A: Assure Elite offers deep discounts at Agnesian Healthcare and within Network Health’s footprint in Fond du Lac, Dodge, and Green Lake counties. These discounts are only available through this product offering and there’s potential for some groups to receive a 2-year rate guarantee.

IMMEDIATE ACCESS

You don’t have to wait until your next renewal to get a quote. There’s no reason to not look at the options and rates available now so you can reap the financial rewards sooner.

Q: How long does it take to get a quote?

A: The turnaround time for an initial/base quote is quick. To secure final rates, members need to go through the underwriting process, which can be done through paper applications or online.

For more information about level funding or the Assure Elite plans, please contact us at 920-921-5921 or hierlquotes@hierl.com.

To download the full article click here.