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.


Survey: Small Businesses Keeping Pace with Health Benefits Offered by Employers Nationwide

Small employers, those with less than 100 employees, have a reputation for not offering health insurance benefits that are competitive with larger employers, but new survey data from United Benefit Advisors reveals they are keeping pace with the average employer and, in fact, doing a better job of containing costs. According to UBA's new special report: "Small Businesses Keeping Pace with Nationwide Health Trends," based on the most recent UBA Health Plan Survey, employees across all plan types pay an average of $3,378 toward annual health insurance benefits, with their employer picking up the rest of the total cost of $9,727.  Among small groups, employees pay $3,557, with their employer picking up the balance of $9,474—only a 5.3 percent difference, finds UBA.

"While employers with 500 to 1,000 or more employees may indeed offer better coverage (lower copays, deductibles, in-network out-of-pocket maximums, and monthly premiums), small employers have a lot to offer employees when it comes to wages, purpose, flexibility, etc.," says Peter Weber, President of UBA. "Small employers would do well to benchmark their plans against their same-size peers and communicate how competitive their plans are relative to average national costs, deductibles, copays, and more."

When looking at average annual cost per employee, UBA's data shows that small businesses actually cut a better deal even when compared to their largest counterparts—their costs are generally below average. For example, the average annual cost per employee (all plans) is $9,727, but for small groups with 25 to 49 employees, the average cost per employee is only $9,165.

"Keep in mind that relief such as grandmothering and the PACE Act helped many of these small groups stay in pre-ACA plans at better rates, unlike their larger counterparts," says Weber. "Generally speaking, however, small businesses are not cutting corners with their coverage. Copays, deductibles, and HSA funding (when offered) are generally in line with average employers."

For more detailed information, including a chart of detailed plan costs comparing small to large businesses nationwide, download a free copy of UBA's Special Report: "Small Businesses Keeping Pace with Nationwide Health Trends". 

Contact us for a customized benchmark survey based on industry, region, and business size.

About United Benefit Advisors
United Benefit Advisors® (UBA) is the nation's leading independent employee benefits advisory organization with more than 200 offices throughout the United StatesCanada, and the United Kingdom. UBA empowers more than 2,000 Partners to both maintain their individuality and pool their expertise, insight, and market presence to provide best-in-class services and solutions. Employers, advisors and industry-related organizations interested in obtaining powerful results from the shared wisdom of our Partners should visit www.UBAbenefits.com.


How to Explain HSAs to Employees Who Don’t Understand Them

HSAs can be a very effective tool for employees looking to save for their healthcare and retirement. But many employees are not knowledgeable enough to fully utilize their HSAs. Here is an interesting column by Eric Brewer from Employee Benefit News on what you can do to help educate your employees on the impartance of HSAs.

High-deductible health plans with health savings accounts are becoming more popular as benefits consumerism increases throughout the country. Enrolling your employees in HDHPs is one way to educate them on the true cost of healthcare. And if they use an HSA correctly, it can help them better manage their healthcare costs, and yours.

But understanding how an HDHP works and ensuring your employees will get the most out of an HSA can be tricky. In fact, a recent survey by employee communication software company Jellyvision found that half of employees don’t understand their insurance benefits. And choosing a benefits plan is stressful for employees because it’s a decision that will impact them for a long time. This is further complicated by the trend toward rising employee contributions and the issue of escalating healthcare costs. Employees are taking on more cost share — and that means plan sponsors have a greater responsibility to do a better job of educating them to make the best decision at open enrollment.

HSAs benefit the employee in a number of ways:
· Just like a retirement plan, HSAs can be funded with pre-tax money.
· Employees can choose how much they want to contribute each pay period and it’s automatically deducted.
· Employers can contribute funds to an HSA until the limit is met.

These are important facts to tell employees. But there’s more to it than that. Here are some tips on how to best explain HSAs to your workforce.

The devil is in the details: discuss tax-time changes

Employees using HSAs will see an extra number or two on their W-2s and receive additional tax forms. Here’s what to know:

· The amount deposited into the HSA will appear in Box 12 of the W-2.
· Employees may also receive form 5498-SA if they deposited funds in addition to what has been deducted via payroll.
· Employees must submit form 8889 before deducting contributions to an HSA. On the form they’ll have to include their deductible contributions, calculate the deduction, note what you’ve spend on medical expenses, and figure the tax on non-medical expenses you may have also paid for using the HSA.
· Employees will receive a 1099SA that includes distributions from the HSA.

Importantly, most tax software walks employees through these steps.

Dispel myths

A lot of confusion surrounds HSAs because they’re yet another acronym that employees have to remember when dealing with their insurance (more on that later). Here are a few myths you should work to dispel.

· Funds are “use it or lose it.” Unlike a flexible spending account, funds in an HSA never go away. In fact, they belong to an employee. So even if they go to another job, they can still use the HSA to pay for medical expenses tax-free.

· HDHPs with HSAs are risky. There are benefits to choosing an HDHP with an HSA for both healthy people and those with chronic illnesses. Healthy people benefit from low HDHP premiums and can contribute to an HSA at a level they’re comfortable with. On the other hand, people with chronic illnesses will likely hit their deductible each year; after that time, medical expenses are covered in most cases.

Help employees understand they’re in control

High-deductible plans with an HSA might seem intimidating, but they put employees firmly in control of their healthcare. This is increasingly important in today’s insurance landscape. When employees choose an HSA, healthcare becomes more transparent. They can shop around for services and find the best deal for services before they make a decision.

HSAs also give you control and flexibility over how and when employees spend the funds. Users can cover medical costs as they happen or collect receipts and get reimbursed later. Finally, employees don’t have to worry about sending in receipts to be reviewed. This means they must be responsible for using the funds the right way, or face tax penalties.

Resist ‘insurance speak’

As an HR professional, you may not realize how much benefits jargon you use every day. After all, you deal with benefits all the time, so using industry terms is second nature. But jargon, especially the alphabet soup of insurance acronyms that I mentioned earlier, is confusing to employees.

One tip is to spell out acronyms on the first reference. Second, simplify the explanation by shortening sentences so that anyone can understand it.

Here’s an example of a way to introduce an HSA:

A health savings account, also called an HSA, is a tax-free savings account. An HSA helps you cover healthcare expenses. You can use the money in your HSA to pay medical, dental and vision costs for yourself, spouse and dependents who are covered by your health plan. You can use HSA funds to pay for non-medical expenses, but you will have to pay taxes on them…

You get the idea.

As responsibility continues to shift to employees, they may need more education in small chunks over time to reinforce their knowledge. As the employer, it’s in your best interest to help employees choose the best plan and use it the right way.

See the original article Here.

Source:

Brewer E. (2017 August 4). How to explain HSAs to employees who don't understand them [Web blog post]. Retrieved from address https://www.benefitnews.com/opinion/how-to-explain-hsas-to-employees-who-dont-understand-them?feed=00000152-18a5-d58e-ad5a-99fd665c0000


How to Meet Growing Demands for Bigger, Better Voluntary Plans

Has there been an increase in demand from your employees to offer more voluntary benefits? Check out this great article by Whitney Ehret from Employee Benefits Adviser on what you can do to meet your employees' demand for more voluntary benefits.

Over the years, voluntary benefits or worksite products have unfortunately earned a negative reputation in the marketplace. This is largely due to overzealous carriers with aggressive sales tactics and brokers purely seeking higher commissions.

With the introduction of the Affordable Care Act in 2010, employers began to shift more of the benefits cost to employees via high-deductible health plans, increased coinsurance costs and copays. The majority of today’s workforce is comprised of millennials, coupled with Generation Z quickly entering the workforce. There’s no question: traditional employer benefit offerings are about to undergo some major changes.

With a new administration in place and increasing generational challenges, employers are becoming more open to creative ideas to improve their total benefits offering. Today’s voluntary benefits market isn’t shy of options, which in turn makes things quite confusing. Companies will need to shift focus from traditional offerings and begin to get more resourceful — not only with the products they offer, but also with their entire strategy. Communications, enrollment and marketing will all become especially critical in retaining and attracting top talent in the coming months and years.

For the most part, the majority of brokers and employers are somewhat familiar with the top voluntary products in the market: dental, vision, accident, critical illness, cancer, hospital indemnity, disability and life insurance. Those are traditionally the products that spark initial voluntary benefit conversations, although there are many more — including legal, identity theft, auto/home, pet, employee purchasing programs, unemployment gap, tuition and loan assistance programs.

For the remainder of 2017, the conversation is predicted to still involve the top voluntary products, but shift to a new focus. Nearly two thirds of employers are looking to voluntary benefits to reduce overall financial stress on employees, the 2016 Xerox HR Services Financial Wellbeing & Voluntary Benefits Survey found. Integrating voluntary benefits with core benefits may reduce financial stress that ultimately leads to health issues and higher overall benefit costs.

The main goal of these products is to provide employees with cash resources, paid directly to the insured, should they experience an unexpected life event. Insureds can use these payments for anything they choose: mortgage, rent, groceries, deductibles, coinsurance payments, copays and more. Compared to state disability programs, these payments are generally made more quickly and offer a simpler claim filing process. If an employee is faced with a difficult situation, these conveniences can greatly reduce stress during a highly sensitive and vulnerable time.

Financial wellbeing is the focus
A recent Employee Benefit News article found 89% of millennials are interested in receiving financial advice, yet only 58% have been offered this type of assistance. With the majority of the workforce now comprised of millennials, employers will need to offer more diverse benefit options that are tailored to this population.

Millennials aren’t the only ones who are concerned about their financial wellbeing. The MetLife’s U.S. Employee Benefit Trends Study found 49% of employees are concerned, anxious, or fearful about their current financial situation, 72% said that a customized benefits package increases loyalty and only 27% are satisfied with their progress toward paying down student loans. These statistics demonstrate the immediate need for a comprehensive voluntary benefit offering.

Student loan debt is an issue for all generations in the workforce. Whether the individual is a millennial trying to get established and create wealth, a Gen X employee who is struggling with existing student loan debt family debt and saving for retirement, or a baby boomer who is trying to help support the family’s educational needs — namely children and grandchildren — everyone, at some level, has a need for student loan assistance.

Additionally, most voluntary products offer wellness benefits, which is a direct payment to the individual for completing an annual wellness exam. With amounts ranging between $50-$200 (employer selected), this is pure profit to the individual, since ACA requires preventative exams to be covered 100% by insurance carriers.

In addition, this benefit helps to subsidize the actual cost of the product annually. There are carriers in the market that will pay this benefit multiple times in a single year for a single insured.

Increasingly, companies are getting involved with wellness specific initiatives and incentives for their employees to hopefully drive healthy habits that will, in turn, lower healthcare costs and increase workplace satisfaction. To promote these wellness programs, employers offer reduced pricing on their medical plans or make contributions into a medical savings account if employees complete their annual exams or participate in various wellness activities. Offering voluntary products with a wellness benefit is another way to enhance a company’s total health portfolio at no cost to the employer.

Carrier selection Is key
Like many other industries, this business is all about relationships. Brokers and employers need to be able to trust and rely on their voluntary benefits carriers. As HR staffing has shrunk and brokers are required to provide more services with the same resources, it’s imperative that the appropriate carrier is selected for each unique case.

Voluntary benefits, as “cookie-cutter” as we may perceive them to be, are just not that. Since their onset, voluntary benefits have come with administrative obstacles that have historically taken up too much of HR’s time.

Unfortunately, while these products do provide a valuable benefit to employees, they are not the priority for most employers. Employers don’t often care about how many products they are offering as long as the plans aren’t administrative-heavy, the 2016 Employee Benefit News annual survey found. Carriers recognize this issue, and have steadily made improvements to these processes over recent years.

There are carriers in the marketplace today that allow clients to self-bill and self-pay, which is essentially what employers are already used to doing on their basic and supplemental group life and AD&D plans. For claims issues, they have also made this process easier by making it electronic and not requiring extensive information from the employees in the claims-filing process.

Core carriers (traditional medical carriers) are also beginning to get into the worksite market and are further simplifying the claims process by linking their medical system with their voluntary system. This allows the carrier to proactively initiate claims and file complete claims for the insured since the majority of the claims information is already within the single carrier system.

The other benefit to offering voluntary plans with the core medical carrier is that often some products may provide additional benefits if employees have a certain medical condition. For example, voluntary dental plans will provide more cleaning exams per year if an insured is pregnant. Most insureds would not realize they have this benefit, but by linking these systems with a core carrier, the insured makes sure to get the most out of their plan.

Communication style and strategy are imperative 
Not only is it important to consider the products and carriers that are offered, but also how they are enrolled and communicated. From the voluntary benefits perspective, these products have typically been enrolled face to face with employees. While this may be the best way to fully educate employees on their benefit options, that is no longer the future of employee benefits enrollment.

ACA has also helped enrollment move to the electronic platform because of the requirements made on employers for reporting. Millennials are the technology generation, making them naturally comfortable using technology to enroll and learn about benefits and even be treated by a virtual doctor.

Employers are trending toward a more self-service enrollment environment, which brings its own challenges. Most of these systems are built with decision tools that allow for the enrollment experience to be customized to the employee. These tools will make plan recommendations for the employees based on the answers to health and financial questions. Often, videos within the enrollment site are used to further enhance the educational experience.

Some of the main problems with electronic enrollments include keeping employees engaged, offering voluntary benefit products and carriers that work with the system, keeping costs low or free for the employer and ensuring data accuracy and security.

A company’s overall benefits package is becoming increasingly important in the decision-making process for prospective employees, as well as to retain top industry talent. Employers, rightfully so, are concerned about cost and maintaining this delicate balance while still attempting to manage the complex administration of these plans.

More and more, employers are looking for voluntary benefits to solve this need by offering “free” technology and enrollment solutions to their groups. There is no doubt that if employers want to retain and attract top talent, they are going to have to adapt with the market and offer their employees a wide array of benefit options and new technology that is tailored to their employee needs.

See the original article Here.

Source:

Ehret W. (2017 July 24). How to meet growing demands for bigger, better voluntary plans [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/how-to-meet-growing-demands-for-bigger-better-voluntary-plans


Government and Education Employers Offer Richest HSA Plans

Great article from our partner, United Benefit Advisors (UBA) by Bill Olson

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.

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.

 

See the original article Here.

Source:

Olson B. (2017 July 27). Government and education employers offer richest HSA plans [Web blog post]. Retrieved from address http://blog.ubabenefits.com/government-and-education-employers-offer-richest-hsa-plans


Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

With the Senate's plan for the repeal and replacement of the ACA failing more Americans are hoping for Congress to move on to more pressing matters. Find out how Americans really feel about the ACA and healthcare reform in this great study conducted by the Kaiser Family Foundation.

KEY FINDINGS:
  • The August Kaiser Health Tracking Poll finds that the majority of the public (60 percent) say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. Since then, President Trump has suggested Congress not take on other issues, like tax reform, until it passes a replacement plan for the ACA, but six in ten Americans (62 percent) disagree with this approach, while one-third (34 percent) agree with it.
  • A majority of the public (57 percent) want to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law, while smaller shares say they want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). However, about half of Republicans and Trump supporters would like to see Republicans in Congress keep working on a plan to repeal the ACA.
  • A large share of Americans (78 percent) think President Trump and his administration should do what they can to make the current health care law work while few (17 percent) say they should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively). Moving forward, a majority of the public (60 percent) says President Trump and Republicans in Congress are responsible for any problems with the ACA.
  • Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces. The majority of the public are unaware that health insurance companies choosing not to sell insurance plans in certain marketplaces or health insurance companies charging higher premiums in certain marketplaces only affect those who purchase their own insurance on these marketplaces (67 percent and 80 percent, respectively). In fact, the majority of Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.
  • A majority of the public disapprove of stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and disapprove of the Trump administration no longer enforcing the individual mandate (65 percent). While most Republicans and Trump supporters disapprove of stopping outreach efforts, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.
  • The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support using whatever tactics necessary to encourage Democrats to start negotiating on a replacement plan. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support these negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).
  • This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability of nine percentage points since the 2016 presidential election as well as an increase of favorability among Democrats, independents, and Republicans.

Attitudes Towards Recent “Repeal and Replace” Efforts

In the early morning hours of July 28, 2017, the U.S. Senate voted on their latest version of a plan to repeal and replace the 2010 Affordable Care Act (ACA). Known as “skinny repeal,” this plan was unable to garner majority support– thus temporarily halting Congress’ ACA repeal efforts. The August Kaiser Health Tracking Poll, fielded the week following the failed Senate vote, finds that a majority of the public (60 percent) say it is a “good thing” that the U.S. Senate did not pass a bill aimed at repealing and replacing the ACA, while about one-third (35 percent) say this is a “bad thing.” However, views vary considerably by partisanship with a majority of Democrats (85 percent), independents (62 percent), and individuals who say they disapprove of President Trump (81 percent) saying it is a “good thing” that the Senate did not pass a bill compared to a majority of Republicans (64 percent) and individuals who say they approve of President Trump (65 percent) saying it is a “bad thing” that the Senate did not pass a bill.

The majority of those who view the Senate not passing an ACA replacement bill as a “good thing” say they feel this way because they do not want the 2010 health care law repealed (34 percent of the public overall) while a smaller share (23 percent of the public overall) say they feel this way because, while they support efforts to repeal and replace the ACA, they had specific concerns about the particular bill the Senate was debating.

And while most Republicans and supporters of President Trump say it is a “bad thing” that the Senate did not pass ACA repeal legislation, for those that say it is a “good thing” more Republicans say they had concerns about the Senate’s particular legislation (21 percent) than say they do not want the ACA repealed (6 percent). This is also true among supporters of President Trump (19 percent vs. 6 percent).

WHO DO PEOPLE BLAME OR CREDIT FOR THE SENATE BILL FAILING TO PASS?

Among those who say it is a “good thing” that the Senate was unable to pass ACA repeal and replace legislation, similar shares say the general public who voiced concerns about the bill (40 percent) and the Republicans in Congress who voted against the bill (35 percent) deserve most of the credit for the bill failing to pass. This is followed by a smaller share (14 percent) who say Democrats in Congress deserve the most credit.

On the other hand, among those who say it is a “bad thing” that the Senate did not pass a bill to repeal the ACA, over a third place the blame on Democrats in Congress (37 percent). About three in ten (29 percent) place the blame on Republicans in Congress while fewer (15 percent) say President Trump deserves most of the blame for the bill failing to pass.

HALF OF THE PUBLIC ARE “RELIEVED” OR “HAPPY” THE SENATE DID NOT REPEAL AND REPLACE THE ACA

More Americans say they are “relieved” (51 percent) or “happy” (47 percent) that the Senate did not pass a bill repealing and replacing the ACA, than say they are “disappointed” (38 percent) or “angry” (19 percent).

Although two-thirds of Republicans and Trump supporters say they feel “disappointed” about the Senate failing to pass a bill to repeal and replace the ACA, smaller shares (30 percent and 37 percent, respectively) report feeling “angry” about the failure to pass the health care bill.

MAJORITY SAY PRESIDENT TRUMP AND REPUBLICANS IN CONGRESS ARE RESPONSIBLE FOR THE ACA MOVING FORWARD

With the future of any other replacement plans uncertain, the majority (60 percent) of the public say that because President Trump and Republicans in Congress are now in control of the government, they are responsible for any problems with the ACA moving forward, compared to about three in ten Americans (28 percent) who say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it. Partisan divisiveness continues with majorities of Republicans and supporters of President Trump who say President Obama and Democrats are responsible for any problems with it moving forward, while large shares of Democrats, independents, and those who do not approve of President Trump say President Trump and Republicans in Congress are responsible for the law moving forward.

Moving Past Repealing The Affordable Care Act

This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability since Congress began debating ACA replacement plans and a nine percentage point shift since the 2016 presidential election.

The shift in attitudes since the 2016 presidential election is found regardless of party identification. For example, the share of Republicans who have a favorable view of the ACA has increased from 12 percent in November 2016 to 21 percent in August 2017. This is similar to the increase in favorability among independents (11 percentage points) and Democrats (7 percentage points) over the same time period.

NEXT STEPS FOR THE ACA

The most recent Kaiser Health Tracking Poll finds that after the U.S. Senate was unable to pass a plan to repeal and replace the ACA, the majority of the public (57 percent) wants to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law but not repeal it. Far fewer want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). About half of Republicans (49 percent) and Trump supporters (46 percent) want Republicans in Congress to continue working on their own plan to repeal and replace the ACA, but about a third of each say they would like to see Republicans work with Democrats on improvements to the ACA.

Six in ten Americans (62 percent) disagree with President Trump’s strategy of Congress not taking on other issues, like tax reform, until it passes a replacement plan for the ACA while one-third (34 percent) of the public agree with this approach. Republicans and Trump supporters are more divided in their opinion on this strategy with similar shares saying they agree and disagree with the approach.

MOST WANT TO SEE PRESIDENT TRUMP AND REPUBLICANS MAKE THE CURRENT HEALTH CARE LAW WORK

Regardless of their opinions of the ACA, the majority of the public want to see the 2010 health care law work. Eight in ten (78 percent) Americans think President Trump and his administration should do what they can to make the current health care law work while fewer (17 percent) say President Trump and his adminstration should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively).

This month’s survey also includes questions about specific actions that the Trump administration can take to make the ACA fail and finds that the majority of the public disapproves of the Trump Administration stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and no longer enforcing the individual mandate, the requirement that all individuals have insurance or pay a fine (65 percent). While most Republicans and Trump supporters disapprove of President Trump stopping outreach efforts so fewer people sign up for insurance, which experts say could weaken the marketplaces, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.

The Future of the ACA Marketplaces

About 10.3 million people have health insurance that they purchased through the ACA exchanges or marketplaces, where people who don’t get insurance through their employer can shop for insurance and compare prices and benefits.1 Seven in ten (69 percent) say it is more important for President Trump and Republicans’ next steps on health care to include fixing the remaining problems with the ACA in order to help the marketplaces work better, compared to three in ten (29 percent) who say it is more important for them to continue plans to repeal and replace the ACA.

The majority of Republicans (61 percent) and Trump supporters (63 percent) say it is more important for President Trump and Republicans to continue plans to repeal and replace the ACA, while the vast majority of Democrats (90 percent) and seven in ten independents (69 percent) want them to fix the ACA’s remaining problems to help the marketplaces work better.

UNCERTAINTY REMAINS ON WHO IS IMPACTED BY ISSUES IN THE ACA MARKETPLACES

Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces which has led some insurance companies to charge higher premiums in certain marketplaces.  Six in ten Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.

There has also been news about insurance companies no longer selling coverage in the individual insurance marketplaces and currently, it’s estimated that 17 counties (9,595 enrollees) are currently at risk to have no insurer on the ACA marketplaces in 2018.2 The majority of the public (54 percent) say health insurance companies choosing not to sell insurance plans in certain marketplaces will have no impact on them and their family. Yet, despite the limited number of counties that may not have an insurer in their marketplaces as well as this not affecting those with employer sponsored insurance where most people obtain health insurance, about four in ten (38 percent) of the public believe that health insurance companies choosing to not sell insurance plans in certain marketplaces will have a negative impact on them and their families.

The majority of the public think both of these ACA marketplace issues will affect everyone who has health insurance and not just those who purchase their insurance on these marketplaces. Six in ten think health insurance companies choosing not to sell insurance plans in certain marketplaces will affect everyone who has health insurance while about one-fourth (26 percent) correctly say it only affects those who buy health insurance on their own. In addition, three-fourths (76 percent) of the public say that health insurance companies charging higher premiums in certain marketplaces will affect everyone who has health insurance while fewer (17 percent) correctly say it will affect only those who buy health insurance on their own.

MAJORITY SAY PRESIDENT TRUMP SHOULD NOT USE COST-SHARING REDUCTION PAYMENTS AS NEGOTIATING STRATEGY

Over the past several months President Trump has threatened to stop the payments to insurance companies that help cover the cost of health insurance for lower-income Americans (known commonly as CSR payments), in order to get Democrats to start working with Republicans on an ACA replacement plan.3 The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support President Trump using whatever tactics necessary to encourage Democrats to start negotiating. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).

See the original article Here.

Source:

Kirzinger A., Dijulio B., Wu B., Brodie M. (2017 Aug 11). Kaiser health tracking poll-august 2017: the politics of ACA repeal and replace efforts [Web blog post]. Retrieved from address http://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2017-the-politics-of-aca-repeal-and-replace-efforts/?utm_campaign=KFF-2017-August-Tracking-Poll&utm_medium=email&_hsenc=p2ANqtz-9GaFJKrO9G3bL05k_i4GzC04eMAaSCDlmcsiYsfzAn-SeJdK_JnFvab4GydMfe_9iGiiKy5LR0iKxm6f0gDZGbwqh-bQ&_hsmi=55195408&utm_content=55195408&utm_source=hs_email&hsCtaTracking=4463482c-5ae1-4dfa-b489-f54b5dd97156%7Cd5849489-f587-49ad-ae35-3bd735545b28


What Could Happen If The Administration Stops Cost-Sharing Reduction Payments To Insurers?

Has the President's recent threat to slash Cost-Sharing Reduction Payments for insurers left you worried about your healthcare costs? Find out how the loss of Cost-Sharing Reduction Payments will impact your health insurance in this informative column by Timothy Jost from Health Affairs.

August 4 Update: Voluntary Insurer Reporting Of Catastrophic Coverage Offered Through Exchange Continued

On August 3, 2017, the Internal Revenue Service released Notice 2017-41  informing insurers that for 2017, as for 2015 and 2016, they would be encouraged but not required to report coverage under catastrophic plans in which individuals were enrolled through an exchange. Insurers and employers are generally required to file 1095-B or 1095-C forms with the IRS, and to provide these forms to individuals whom they cover, documenting that the individuals have minimum essential coverage as required by the individual mandate.

Insurers are not, however, required to report qualified health plan coverage provided through the exchanges, because the exchanges themselves file 1095-A forms documenting QHP coverage and provide these forms to enrollees. But catastrophic health plans are not QHPs, so exchanges do not report catastrophic coverage either.

The IRS proposed regulations in 2016 to require insurers to report catastrophic coverage issued through the exchange and thus to fill this gap.  These rules have not yet been finalized however.  In the meantime, the IRS has encouraged insurers to report catastrophic coverage issued through an exchange voluntarily. The guidance extends this policy for another year. Insurers that voluntarily report catastrophic coverage will not be subject to penalties with respect to returns and statements reporting this coverage.

Original Post

Although the decision of the Court of Appeals for the District of Columbia Circuit to allow attorneys general from 17 states and the District of Columbia to join the House v. Price cost-sharing reduction (CSR) litigation as parties complicates President Trump’s ability to simply stop the CSR payments, rumors continue that he is preparing to do so. The CSR payments are made monthly; the next installment is due on August 21, 2017. If the administration intends not to make the August payment, it must announce its decision soon.

Changes to qualified health plan (QHP) applications in the federally facilitated exchange (FFE) are due on August 16, 2017, as are final rates for single risk pool plans including QHPs. Final contracts with insurers for providing QHP coverage through the FFE must be signed by September 27. If the Trump administration is going to defund the CSRs, now is the time it will do it.

The back story on the CSR issue can be found in my post on July 31, while the intervention decision is analyzed in my post on August 1. This post focuses on issues that will need to be resolved going forward if the Trump administration decides to defund the CSRs.

The Choices Insurers Would Face If CSR Payments Were Ended

First, insurers would have to decide whether to continue to participate in the exchanges. Those in the FFE have a contractual right to drop participation for the rest of 2017, but how exactly they would do this would depend on state law, and would probably require 90 days notice. Insurers would also not be able to terminate the policies of individuals covered through the exchange, although once the insurers left the exchange premium tax credits would cease and many policyholders would drop coverage. Insurers that tried to leave immediately would likely suffer reputational damage, and those that could financially would likely try to hold on until the end of the year.

Some insurers might well decide that the government is an unreliable partner and give up on the exchanges for 2018. Indeed, some would conclude that the individual market is too risky to play in at all. The individual market makes up a small part of the business of large insurers; even though it has become more profitable in the recent past, some insurers might conclude that the premium increases that would be needed to make up for the loss of the CSRs would drive healthy enrollees out of the individual market. Rather than deal with a deteriorating risk pool, they might leave the individual market entirely (although they would probably have to give 180 days notice to do so.)

Insurers that decide to stay would have to charge rates that would allow them to survive without the $10 billion dollars the CSR payments would provide. They would need to raise premiums significantly to accomplish this. How they did so would depend on guidance that they got from their state department of insurance or possibly from the Centers for Medicare and Medicaid Services.

The California Experience

On August 1, 2017, Covered California announced its 2018 rates. The California state-based marketplace is an example of how the Affordable Care Act can work in a state that fully supports it and has a big enough market to form a balanced risk pool. For 2018, the average weighted rate increase in California is 12.5 percent, of which 2.8 percent is attributable to the end of the moratorium on the federal health insurance tax. Consumers can switch to plans that will limit their rate change to 3.3 percent in the same metal tier. All 11 health insurers in California are returning to the market for 2018 (although one insurer, Anthem, is leaving 16 of the 19 regions in which it participated for 2017) and 82 percent of consumers will be able to choose between three or more insurers. About 83 percent of hospitals in California participate in at least one plan.

Covered California instructed its insurers to file alternate rates that would go into effect if the Trump administration abandons the CSR payments. The insurers were instructed to load the extra cost onto their silver (70 percent actuarial value) plans, since the CSRs only apply to silver plans. The alternative rates filed by the insurers project that if the CSRs are not funded, they would have to essentially double their premium increases, hiking premiums by an additional 12.4 percent.

Virtually all of this increase would be absorbed by increased federal premium tax credits for those with incomes below 400 percent of the federal poverty level. As the premium of the benchmark second-lowest cost silver plan increased, so would the tax credits. A Covered California study concluded that the premium tax credit subsidy in California would increase by about a third if the CSR subsidies are defunded.

Bronze, gold, and platinum plan premiums would not be affected by the silver plan load. As the premium tax credits increased, many more enrollees might be able to get bronze plans for free, and gold plans would become competitive with silver plans in price. More people would likely be eligible for premium tax credits as people higher up the income scale found that premiums cost a higher percentage of their household income.

Consumers who are not eligible for premium tax credits would have to pay the full premium increase themselves. Covered California has suggested, however, that insurers load the premium increase only onto silver plans in the exchange, since CSRs are only available in the exchange. Insurers would likely encourage their enrollees who are in silver plans in the exchange to move to similar products off the exchange that are much more affordable. Bronze, gold, and platinum plans would cost more or less the same on or off the exchange.

Other States Would Likely Make Different Choices Than California’s

It is likely that not all states would follow California’s lead. If state departments of insurance do not allow insurers to increase their premiums, more insurers would leave the individual market. If state departments require insurers to load the CSR surcharge onto all metal-level plans, both on and off the exchange, bronze, gold, and platinum plans would be more expensive and individual insurance would become much more costly for all consumers who are not eligible for premium tax credits. If insurers leave the market or consumers drop coverage, more consumers would end up using care they cannot afford, increasing medical debt and the uncompensated care burden of providers, and of hospitals in particular.

Some insurers in other states have likely already loaded a substantial surcharge onto their 2018 premiums in anticipation of CSR defunding and of other problems, such as uncertainty about the Trump administration enforcing the individual mandate. If insurers in fact profit from excessive rates, consumers might eventually receive medical loss ratio rebates, but 2018 rebates would not be paid out until late in 2019, if the requirement is still on the books by then.

Other Ramifications Of Ending CSR Payments To Insurers

CSR defunding could have other effects as well. Insurers have been reimbursed each month for CSRs based on an estimation of what they are paying out to actually reduce cost sharing. Each year the insurers must reconcile the payments they have received with those they were actually due. Insurers were supposed to have filed their reconciliation data for 2016 by June 2, 2017, and were supposed to be paid any funds due them, or to refund overpayments, in August. Reconciliation payments may also be due in some situations for 2015. If the administration cuts off CSR payments, it could conceivably cut off reconciliation payments as well.

Finally, defunding of CSRs would likely have an effect on risk adjustment payments as well. The risk adjustment methodology has been set for 2018 in the 2018 payment rule. It would likely not be amended for 2018 in light of the CSR defunding. Defunding would increase the statewide average premium on which risk adjustment payments are based. This would generally exaggerate the effects that risk adjustment would otherwise have. In particular, insurers with heavy bronze plan enrollment would end up paying more in, while insurers with more gold or platinum plans might receive higher payments.

Looking Forward

President Trump claims to see the CSR payments as a “bailout” to insurers, which surely they are not. They are a payment for services rendered, much like a Medicare payment to a Medicare Advantage plan. The effects of defunding would reverberate throughout out health care system, likely causing problems far beyond those identified in this post.

Fortunately, Senators Alexander (R-TN) and Murray (D-WA), the chair and ranking member of the Health, Education, Labor, and Pensions Committee, have announced that they will begin hearings on a bipartisan approach to health reform when the Senate returns in September, and funding of the CSR payments for at least a year seems to be at the top of their list. A bipartisan group of House members has also called for funding the CSRs. And pressure to fund the CSRs continues from the outside, with the National Association of Insurance Commissioners calling for it again last week. It is to be hoped that President Trump will not take steps that would sabotage the individual market and that a solution can quickly be found to the CSR issue that will bring stability to the market going forward.

See the original article Here.

Source:

Jost T. (2017 August 2). What could happen if the administration stops cost-sharing reduction payments to insurers? [Web blog post]. Retrieved from address http://healthaffairs.org/blog/2017/08/02/what-could-happen-if-the-administration-stops-cost-sharing-reduction-payments-to-insurers/


Compliance Recap July 2017

July was a relatively quiet month in the employee benefits world, despite the U.S. Senate's release of two bills in its attempt to repeal the Patient Protection and Affordable Care Act (ACA).

First, the U.S. Senate revised its Better Care Reconciliation Act and declined to vote on its revision. Then the U.S. Senate released its Health Care Freedom Act and voted on it. The Health Care Freedom Act failed to pass the U.S. Senate.

The Occupational Health and Safety Administration (OSHA) launched an electronic form 300A that employers use to report work-related injuries and accidents. Two courts issued decisions regarding ACA accommodation and website accessibility. The U.S. Citizenship and Immigration Services (USCIS) released a revised version of Form I-9, Employment Eligibility Verification, opened the H-2B Temporary Nonagricultural Worker program to an additional 15,000 workers for 2017, and began issuing redesigned Green Cards and EADs as part of the Next Generation Secure Identification Document Project.

The U.S. District Court, which issued a nationwide preliminary injunction against the U.S. Department of Health and Human Services (HHS) to prohibit HHS from enforcing portions of the ACA's Section 1557, remanded the case in part to HHS for reconsideration of the regulation.

UBA Updates

UBA released three new advisors in July:

·         COBRA Notices

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

·         ERISA's "Church Plan" Exception

UBA updated existing guidance:

·         OSHA's Final Rule on Electronic Tracking of Workplace Injuries and Illnesses

U.S. Senate Releases Revision of Better Care Reconciliation Act

On July 13, 2017, the U.S. Senate released a revised draft of its Better Care Reconciliation Act (BCRA) bill. The U.S. Senate released the original draft of the BCRA on June 22, 2017, which would substitute the House's House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The House bill was titled the "American Health Care Act of 2017" (AHCA).

The revised draft BCRA proposes to affect employer-sponsored plans in a few ways:

·         Allow health savings account (HSA) funds to be used to pay for the medical expenses of children under age 27 and to pay for high-deductible health plans' (HDHPs) premiums that are not otherwise covered by tax credits, deductibles, or exclusions.

·         Make HDHPs ineligible for HSAs if the HDHPs cover abortions except where necessary to save the mother's life or in cases of rape or incest.

·         Allow professional employer organizations to sponsor association plans.

On July 18, 2017, the U.S. Senate declined to vote on the revised BCRA after it determined that it didn't have enough votes to pass the bill.

On July 28, 2017, the U.S. Senate voted on the Health Care Freedom Act to repeal the ACA's individual and employer mandates and temporarily repeal the medical device tax. The bill failed to pass.

Employers with group health plans should continue to monitor progress in Washington, D.C., and should not stop adhering to any provisions of the ACA in the interim, or begin planning to comply with provisions in either the AHCA or revised BCRA.

OSHA Launches Electronic Form 300A

In 2016, the Occupational Safety and Health Administration (OSHA) published a rule entitled "Tracking of Workplace Injuries and Illnesses" which issued sweeping changes to the way certain employers were required to report work-related injuries and accidents. Employers with at least 10 employees at a single site have always been required to maintain and annually post a Form 300A log. Among the changes were that "high risk" employers with at least 20 employees (see the complete list atwww.osha.gov/recordkeeping/NAICScodesforelectronicsubmission.pdf) and all employers with 250 or more employees in a single physical location were required to file their report electronically. The original due date for filing 2016 data was July 1, 2017.

On June 28, 2017, OSHA proposed delaying the compliance date until December 1, 2017, "to provide the new administration an opportunity to review the new electronic reporting requirements prior to their implementation and allow affected entities sufficient time to familiarize themselves with the electronic reporting system, which will not be available until August 1."

OSHA will release the electronic Injury Tracking Application (ITA). Three options have been made available for submission:

1.     Users may manually enter data into a web form.

2.     Users may upload a CSV file to process single or multiple establishments at the same time.

3.     Users of automated recordkeeping systems will have the ability to transmit data electronically via an API (application programming interface).

OSHA estimates that it will take employers 10 minutes to create an account. Establishments may no longer submit paper reports. Future plans include an interface for entering data from a mobile device.

Technology is the New Frontier with ADA Accommodation

Website accessibility has become a hot topic in the world of ADA accommodation. Recently, a Florida federal judge handed down a trial verdict finding that grocery chain Winn-Dixie had violated Title III of the Americans with Disabilities Act (ADA) by having a website that was inaccessible to a blind plaintiff. Shortly thereafter, a federal judge in the Central District of California allowed another blind plaintiff to continue a case against Hobby Lobby for failing to "provide full and equal enjoyment of goods and services offered by its physical stores by not maintaining a fully accessible website."

Title III relates to public accommodation (private and non-profit business) and could impact any business offering goods and services through a website, which, in this era of e-commerce is far-reaching. Further, Title I of the ADA relates to employment, so would impact online application processes and career web pages.

In the Winn-Dixie case, the court recognized Web Content Accessibility Guidelines (WCAG) 2.0 as the website standard. WCAG are guidelines developed by a private group of accessibility experts that have been used to support accommodation initiatives. Until this case, WCAG had not been referenced by the court as the de facto legal standard.

Regarding Title I employment accommodation, the U.S. Department of Labor recently identified the Partnership on Employment & Accessible Technology (PEAT) as the source for employers who want to ensure that their workplace technology is accessible to all employees and job applicants. In particular, the "Accessible Technology Action Steps: A Guide for Employers" was recommended as a resource.

Definitive guidelines have traditionally been elusive in the amorphous arena of public accommodations within the requirements of the ADA. Businesses would be well advised to review their accessibility through these validated resources.

Immigration Updates: I-9, H-2B Visas, Green Cards

I-9 Updates

U.S. Citizenship and Immigration Services (USCIS) released a revised version of Form I-9, Employment Eligibility Verification, on July 17, 2017. Employers can use this revised version or continue using Form I-9 with a revision date of 11/14/16 through September 17, 2017. On September 18, 2017, employers must use the revised form with a revision date of 07/17/17. Revisions include changes to the instructions and revisions to the List of Acceptable Documents, including:

·         All the certifications of report of birth issued by the Department of State (Form FS-545, Form DS-1350, and Form FS-240) were combined into List C, number 2.

·         All List C documents were renumbered, except the Social Security card. For example, the employment authorization document issued by the Department of Homeland Security on List C changed from number 8 to number 7.

·         Consular Report of Birth Abroad (Form FS-240) was added to List C. Employers completing Form I-9 on a computer will be able to select Form FS-240 from the drop-down menus available in List C of Sections 2 and 3. E-Verify users will also be able to select Form FS-240 when creating a case for an employee who has presented this document for Form I-9.

Increase in H-2B Visas

USCIS has opened the H-2B Temporary Nonagricultural Worker program to anadditional 15,000 workers for 2017. The H-2B Temporary Nonagricultural Worker program was designed to serve U.S. businesses unable to find a sufficient number of qualified U.S. workers to perform nonagricultural work of a temporary nature. To qualify for the additional visas, petitioners must attest, under penalty of perjury, that their business is likely to suffer irreparable harm if it cannot employ H-2B nonimmigrant workers during fiscal year (FY) 2017.

New Green Cards Issued

USCIS has begun issuing redesigned Green Cards and Employment Authorization Documents (EADs) as part of the Next Generation Secure Identification Document Project. The new cards feature enhanced graphics and fraud-resistant features. Enhancements include:

·         The card holder's photo on both sides of the card

·         Unique graphic images and color palette

·         Holographic images

Cards will no longer display the individual's signature, nor will they have an optical stripe on the back.

Court Remands ACA Section 1557 Case to HHS

ACA Section 1557 provides that individuals shall not be excluded from participation, denied the benefits of, or be subjected to discrimination under any health program or activity which receives federal financial assistance from the U.S. Department of Health and Human Services (HHS), on the basis of race, color, national origin, sex, age, or disability.

In May 2016, HHS issued a final rule implementing Section 1557, which took effect on July 18, 2016.

Eight states and three faith-based private health care providers filed a lawsuit to challenge HHS' authority under the ACA to issue regulations that interpret sex discrimination as forbidding discrimination based on gender identity and termination of pregnancy. The lawsuit also asserted that the regulations violate the Religious Freedom Restoration Act as applied to them.

On December 31, 2016, the U.S. District Court for the Northern District of Texas issued a nationwide preliminary injunction prohibiting enforcement of the rule as it prohibits discrimination on the basis of gender identity or pregnancy termination.

On July 10, 2017, the District Court stayed the case and remanded it in part to HHS for reconsideration of the rule. The injunction remains in place.

Question of the Month

Q. Who must be counted under Form 5500's 100-participant rule?

A. Generally, small unfunded, insured, and combination unfunded/insured welfare plans are exempt from the Form 5500 filing requirement. To qualify for the exemption, a plan must cover "fewer than 100 participants at the beginning of the plan year."

Employees who are covered participants are counted. All former employees who are COBRA qualified beneficiaries are counted. Non-employees (covered spouses and dependent children) are not counted.

Only covered participants are counted. To determine when a participant is covered, the plan sponsor would look to the earlier of:

·         The date that the plan document states that participation begins.

·         The date when the individual becomes eligible to receive a benefit.

·         The date when the individual makes a voluntary or mandatory plan contribution.

To download the full recap click here.


Voluntary Benefits Key to Helping Employees with Rising Health Costs

With the cost of healthcare rising day by day, many employees are struggling to pay for their healthcare expenses. Take a look at this interesting article by Nick Otto from Employee Benefit Adviser and see how employers are leveraging their voluntary benefits to help employees offset some of their healthcare costs.

As workers continue to struggle with out-of-pocket medical bills, there’s a growing opportunity for benefits managers to hold more conversations with employees on voluntary benefits that can help offset costs.

“The rising cost of healthcare has driven many employers to offer supplemental group insurance products, often in conjunction with a health savings account,” says Elias Vogen, director of group insurance client relationships for financial services firm Securian. “This combination can be cost-effective for both employer and employee … and when employees are aware that these benefits are available to them through work they opt in at a high rate.”

According to a recent survey from Securian, 28% of employees with health insurance through work facing an out-of-pocket expense of $5,000 or more would use their personal savings to pay rather than other means, including an HSA (8%) or supplemental group insurance (7%).

Further, a majority of respondents said they do not know how they would pay for an out-of-pocket expense (21%), or that they would need to rely on credit cards (12%), a loan from their 401(k) (7%) or family/friends (4%), their tax return (5%) or by selling/pawning a personal possession (2%).

“Healthcare costs continue to rise and that almost certainly will not change anytime soon,” Vogen says. “As a result, employers and employees will continue to look for options to help ease the cost crunch. The popularity of benefits like accident, critical illness and hospital indemnity insurance will continue to rise. These benefits are here to stay.”

A multi-touch strategy is the best way for employers to communicate with employees about voluntary benefits, according to Vogen.

“We recently conducted accident and critical illness insurance enrollment campaigns with a large employer that involved six points of contact: direct mail, e-mail, videos, digital materials, an interactive benefits guide and webinars,” he says. “By using a variety of channels, we were able to educate employees on the value of these voluntary benefits in ways that were convenient and comfortable to them.”

Voluntary benefits relieve a key concern for employees: While the survey revealed that paying for out-of-pocket medical expenses would be the top financial concern for a plurality (42%) of workers facing a debilitating injury, a critical illness diagnosis or a hospitalization, 58% say their top concern would be lost wages from work, the ability to pay for regular monthly expenses such as groceries, or the need to take on additional expenses such as lawn care or cleaning.

“If you break your leg, or your critically ill spouse needs specialized medical care out of state, these benefits can be used to help pay for expenses like hiring out your household chores, paying for travel costs, extra child care and more,” says Vogen. “You don’t have to turn in your receipts; you’re able to use the funds as you wish. The flexible nature of these benefits can be instrumental in warding off financial troubles from an unexpected health event.”

According to the survey, employees were asked if they are offered six different voluntary benefits by their employer:

· Life insurance (54% said yes)
· Disability insurance (38%)
· Health savings account (36%)
· Accident insurance (24%)
· Critical illness insurance (15%), and
· Hospital indemnity insurance (9%).

Further, 12% of employees said they are offered none of these benefits, and 18% said they are not sure if these benefits are offered by their employer.

Of these six benefits, life insurance is the most popular, with 75% of employees who have access to life insurance through their employer saying they are enrolled. “Accident insurance ranked second, with 64% of employees offered this insurance enrolled. Hospital indemnity insurance came in third at 59%, followed by disability insurance at 54%, health savings account at 52% and critical illness insurance at 47%,” says Vogen.

Employers recognize that healthcare costs have become burdensome to their workers and their families, and it’s important to remember that these cost increases have impacted employers’ bottom lines as well, according to Terry Holloway, an employee benefits adviser and executive vice president with insurance broker Cobbs Allen.

“Supplemental group insurance benefits are a cost-effective solution for both employers and employees,” Holloway says. “We have seen a significant increase in employer interest in these and other voluntary benefit platforms in the past five years, along with innovative enrollment solutions from insurance carriers.”

See the original article Here.

Source:

Otto N. (2017 July 20). Voluntary benefits key to helping employees with rising health costs [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/voluntary-benefits-key-to-helping-employees-with-rising-health-costs?feed=00000152-a2fb-d118-ab57-b3ff6e310000


Top Misconceptions about Long Term Care Insurance

What do you know about long-term care insurance? Here is a great article from our partner, United Benefit Advisors (UBA) by Christine McCullugh on the top misconceptions people have about long-term care insurance.

In conversations with HR professionals and benefit brokers, we find that the topic of long-term care insurance (LTCi) is often covered in less than two minutes during renewal meetings. When I ask why the topic of conversation is so short, they tell me, “Employees just aren’t asking about it, so they must not be interested.”

If employees aren’t asking about LTCi, does it mean they aren’t interested? They just may be unaware of the value of LTCi and that it can be offered by their employer with concessions not available in the open market. Here are the top seven reasons why LTCi should be a bigger part of the employee benefits conversation.

  1. Do you know LTCi can be offered as an employee benefit?
    There are multiple employer-sponsored products, including those with pricing discounts, guarantee issue, and payroll deduction.
  2. Do you believe Medicaid and Medicare will provide long-term care for employees?
    This is a popular misconception. Medicare and Medicaid will restrict your employees’ choices of where and how they receive care. These options will either not offer custodial or home care, or they’ll force employees to spend down their assets for care.
  3. Do you think LTCi is too expensive, or that your employee population is too young to need it?
    Many plans can be customized to meet personal budgets and potential care needs. It’s also important to know that rates are based on employees’ ages. The younger the employees are, the lower their rates will be.
  4. Are you aware of the variety of LTCi plans?
    Many policies offer flexible coverage options. Depending on the policy an employer selects, LTCi can cover a wide range of care—in some cases even adult day care and home safety modifications.
  5. Do you believe the market is unstable?
    Today’s products are priced based on conservative assumptions, and employers are enrolling very stable LTCi plans for their employees. Each month, we see new plan options and products being introduced along with new carriers entering the market.
  6. Do you already offer an LTCi plan but it’s closed to new hires?
    Being able to offer a similar LTCi benefit to all employees is crucial for most employers. Find a partner that can assist with the current LTCi plan and can assist with bringing in a new LTCi offering for new hires.

See the original article Here.

Source:

McCullugh C. (2017 July 6). Top misconceptions about long term care insurance [Web blog post]. Retrieved from address http://blog.ubabenefits.com/top-misconceptions-about-long-term-care-insurance