(303) 369-3200

Kristen Russell

Kristen Russell

Kristen founded Fall River Employee Benefits as the culmination of her insurance industry career as an actuary, underwriting executive & consultant. As an Assistant Vice President at Great-West Healthcare (now part of CIGNA), she managed a $1 Billion block of health insurance. She also worked as a Senior Consultant at Reden & Anders, consulting to insurance companies and large employers throughout the country. Ms. Russell received a Bachelor of Science, Business Administration in Actuarial Science, is a member of the American Academy of Actuaries and achieved Fellowship in the Society of Actuaries through a rigorous nine-year series of exams.

Kristen grew up in Iowa but has lived in Colorado since 1993, currently living near our office in the Lower Highlands neighborhood near downtown Denver.  She enjoys bicycling, hiking, traveling and has a special passion for non-profit volunteering. She is married to an incredibly talented photojournalist, has two adult stepdaughters and an adorable Border Collie/Lab mix named Chaco.

Wednesday, 23 September 2015 18:00

Fall River celebrates its 10th Anniversary!

This September 16th marked the 10 Years since the founding of Fall River Employee Benefits, and we celebrated by hosting an Open House attended by dozens of clients and partner organizations. We are so thankful for the support of all of the wonderful people who have contributed to our success over this decade.

In the ten years we have been business, we have tried to give back to our community through:

  • Publishing over 300 educational articles via our monthly newsletter, the Fall River Journal
  • Delivering almost 100 free educational seminars and webinars on healthcare cost containment strategies and compliance issues
  • Donating tens of thousands of dollars to the United Way and other important charities in our communities, including many of our own non-profit clients
  • Awarding thousands of dollars in direct scholarships through the Fall River Inspiration Scholarship (http://fallriverbenefits.com/meet-fall-river/inspiration-scholarship)
  • A number of service projects allowing us to directly volunteer  in the community

We are so grateful for our many blessings, which include fabulous clients, an amazing team, and a brand new office building we purchased and into which Fall River recently moved.  Thank you again to all of you who have been a part of us living our dream of being the most proactive and innovative healthcare benefits broker on the Colorado Front Range.

In June, the U.S. Supreme Court ruled that same-sex marriage must be allowed in all 50 states.  This has several implications for employee benefit plans, including solving much of the administrative complexity that had resulted from different tax treatment and marriage laws in different states.

Here are the key takeaways:

  • Fully insured plans are now REQUIRED to offer coverage to same-sex spouses if they offer coverage to opposite-sex spouses. This is effective now, not at the next renewal.
  • The ruling creates a qualifying event for any same-sex spouses previously denied coverage to join the plan within 31 days of the date of the decision, which was June 26th. Some carriers are allowing adds through July 31st.
  • All legally married couples, whether opposite sex or same-sex, will be allowed to cover their spouses and children on employee benefit plans on a pre-tax basis.
  • Same-sex spouses are now universally eligible for Medicaid and subsidies on the exchanges if they don’t qualify for your coverage.
  • Self-funded plans are still not required under ERISA to offer coverage for same-sex spouses.  Many legal scholars, however, warn that employers opting out of this coverage may now face discrimination claims under Title VII of the Civil Rights Act.

Please This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions about how this ruling impacts the administration of your plan.

Tuesday, 23 June 2015 18:00

Have you Explored Partial Self-Funding?

Join Kristen as she presents to the Mountain States Employers Council's Benefit Update Conference!

Many employers have benefitted enormously from having a partially self-funded arrangement, where they participate in the actual claims experience of their employees with protection from any catastrophic claims.  If you haven’t evaluated this for your company, we strongly encourage you to do so.  

Nationwide, 81% of workers in large firms (200+ employees) are covered by a self-funded plan, but only 15% of workers in smaller companies (less than 200 employees) are covered by this type of plan. While the rates of self-funding are even higher among Colorado employers, many employers may still be missing out on significant potential savings available with partial self-funding.  

Those employers who are already self-funded will benefit from reviewing leading practices on how to optimize your plan and strategically control healthcare costs. For those employers who are currently fully insured, we’ll show how to determine if you are a good fit for a partially self-funded plan, and how to make the business case if you feel a switch is in order.

We’ll walk through topics such as:

  • Advantages and potential downsides of self-funding;
  • The types of employers who are usually a good fit for self-funding;
  • The mechanics of five different levels of implementing self funding, from the smallest of baby steps to the more complex plans utilized by Fortune 500 companies;
  • How to optimize your self-funded plans using data-driven leading practices; and 
  • The additional responsibilities (which vary by level of self-funding) employers may encounter in these type of plans.

Join us for a fast-paced and high energy session! Visit www.msec.org to register!

Mile High SHRM PDG featuring Kristen Russell and Dean Heizer
Thursday, June 25th, 3-5 pm
CSU Downtown, 475 17th Street Suite 300, Denver, CO 80203

There are so many laws driving your practices regarding HR and Benefits, that it's getting tougher and tougher to keep track of them all. Yet with the threat of significant fines and even jail time for violations, you’ve got to stay on top of the most important ones.

Join us for a high energy and entertaining pick-me-up to the end of your day as we review the most common mistakes that land an HR person in trouble, especially regarding your employee benefits.  We'll cover what you thought you knew, but might be surprised about, on the following topics:

  • ERISA – it’s not just for retirement plans, as the DOL is auditing more and more health plans.  We’ll cover some classic retirement plan blunders, but also what you need to do on your health plan – and why so many employers are out of compliance!
  • HIPAA Discrimination Rules and how to keep your wellness program legal based on all the latest guidance (click here for more topics and to register)
  • The ADA as it impacts wellness and workers comp and wellness programs;
  • COBRA goofs you might just have made at one time or another; and 
  • Tricky situations under disability leave and the FMLA.

Towards the end we'll have time for sharing best practices among peers, and networking, accompanied by some adult refreshments. Who knew Happy Hour could be so fun AND educational??  This program is free for Mile High SHRM members, and very affordable for others.  Register here.

 

We often talk to small and mid-sized employers about the advantages of a Partially Self Funded plan, which most large employers already use.  These include the avoidance of most premium tax, more control over plan design, and access to data that you can use to lower future renewals.

But two forces are coming together to bring more focus on partial self funding.  First, for groups under 50 employees, the end of transition relief that had allowed some smaller plans to avoid the new community rating rules means the four impacts below are hitting those groups this fall. Second, for groups with 51-99 employees, all four of these factors go into effect with your first renewal in 2016:

  • Limited Age Rating: Rates for younger groups may go up once they switch to the new rating. Insurance companies today typically charge 5 to 7 times as much for the oldest enrollees compared to the youngest. Under the ACA, they’re limited to 3 times as much.  This is good news for groups with an older population, but if most of your employees are younger than age 40, this may result in higher rates at the point you switch to a community-rated plan (this Fall for many groups under 50)
  • No Industry Rating: Employers who are in industries generally considered to be healthy get lower rates today to reflect this. Since January of 2014, the ACA no longer allows industry rating for groups under 50, and it’s disallowed in 2016 for groups 51-99, so many smaller plans who may see a bump at their next renewal when they move to an ACA-compliant plan
  • No Rating for Health Status: Groups under 50 employees in Colorado haven’t been rated by health status in a number of years, but small groups in most other states were. Discounts for healthy groups went away in all states for groups under 50 in 2014, and they disappear for all groups up to 100 employees in 2016
  • Age-Rating:  Most employers with 10 or more employees are accustomed to composite rates, where there is a single set of 4 tier rates for all employees.  This structure changes on ACA-compliant small group plans to having a different rate for every single age, as well as separate rates for each dependent.  This requires much more administration work, especially if you don’t have an online enrollment system, which we would highly recommend

Small groups under 50 employees who had used transition relief to put off joining an ACA-compliant plan will have some planning to do to avoid potential unpleasant surprises at their next renewal.  Similarly, groups between 50 and 100 employees will face a major rating change, and partially self funding can be a great way to avoid those changes permanently.  There is some talk of a delay of this rating change for groups of 51-99, but until we see something more concrete we’re encouraging groups to prepare as if it were going into effect on schedule in 2016.

If you are an employer with a relatively healthy population, you may wish to strongly consider a partially self funded plan with your next renewal.  We are helping some of our clients evaluate this strategy now so they can plan ahead of their anniversary date. Kristen will also be giving a number of seminars on partial self funding this year at the Mountain States Benefit Update Conference and also the CO-SHRM conference in Keystone. 

Please This email address is being protected from spambots. You need JavaScript enabled to view it. or give us a call at (303) 369-3200 if you would like some tips on how to approach this important decision.

Sunday, 22 March 2015 18:00

Healthcare Cost Management Strategies

Are you paying more and more for worse benefits? While some aspects of rising healthcare costs are driven by factors outside our control, there are MANY factors within our control, even for smaller employers.  The problem is that the strategies used by many brokers aren’t sustainable.

Learn how employers of all sizes can manage their health care costs down, by taking an out-of the box approach in multiple areas. Register now for our webinar on Tuesday, May 19th, to start taking charge of the cost factors you CAN control.

 

Thursday, 05 March 2015 11:59

Supreme Court Hears ACA Subsidy Challenge

In a much watched case, the Supreme Court heard arguments yesterday about a provision that could eliminate the Affordable Care Act (ACA) individual market premium assistance, depending on how it is interpreted by the Court.  This would affect the roughly 70% of states who have not established their own exchange; please note that Colorado is NOT one of the states affected. The provision relates to language in the ACA that indicates subsidies for low-income individuals are available on “Exchanges established by the states.”  The debate is between a literal reading of that language, or looking at the larger context of what Congress intended.

 

A ruling is not expected until late June, but expert opinion appears to be leaning slightly in favor of predictions that the Supreme Court will uphold the subsidies as currently implemented.  If it goes the other way, an estimated 7.5 million Americans in those states who did not choose to set up their own Exchange will lose access to subsidized coverage.  If too many of them choose to not purchase coverage as a result, it will likely raise premiums for those remaining, and may destabilize the individual insurance marketplaces in those states.

 

Keep in mind there is NO impact on insurance in Colorado, regardless of the outcome of the case.

 

Guest Article by Brad Cooper, MSPT, MBA, CWC, the  CEO of US Corporate Wellness

 

If you’ve been in the Employee Benefits or Human Resources arena for more than a few minutes, you’ve likely experienced the “Well-less Dilemma.” This is the common situation where a wellness company representative comes into your office, shows off a bunch of fancy flyers and dazzling Powerpoint slides. You’re encouraged, thinking this might actually be “the one!”  So the contract is signed, the program rolled out with great fanfare and 6 months down the road:

  1. You’re spending far too much time (which you were lacking in the first place!) managing, following up, answering questions, etc.
  2. Nobody seems to care (except for the employees who care to regularly remind you why the program stinks)
  3. Beyond a little low hanging fruit, the ROI appears to be non-existent
  4. Oh yes – and that wellness company representative with the fancy slides? She earned a promotion with a different company so you’ve been bounced between a couple of others who are filling in until they fill the role.

Sound familiar? Unfortunately it’s all too common in the growing wellness industry. However, it doesn’t have to be this way.  If you’re armed with some key knowledge, you can turn your wellness strategy into a culture enhancing, time saving, bottom line impacting, solution to all of your problems! (ok – that last one may be going a bit too far, but the first three are more than reasonable).

On March 12th, at the Mile High SHRM Total Rewards Professional Development Group meeting, I’ll have the opportunity to present the information you need to allow you to create the strategy you intended, without biting into your own schedule over the long term. Click here to register for this event.  Some of the key aspects we’ll be covering include these below and other topics:  

  • Why a “Check the Box” solution can box you into negative outcomes. We all like lists, and we understand the importance of accountability. So when a wellness program includes a checklist of items each employee must accomplish, it sounds perfect! Unfortunately, the best laid plans often fall short if we’re not extremely careful about insuring these “Point-based” approaches don’t eliminate meaningful engagement. It’s critical to remember that One Size Fits… ONE.  Point systems can be built into your wellness program, but great care must be taken to insure they are individualized. At the same time, swinging the pendulum too far can result in providing credit to anyone for anything, which then just produces carpal tunnel from all the boxes that must be checked. 
  • Hope makes for a fantastic noun but an awful verb when it comes to wellness programs, security, HIPAA compliance and more. Hope (as a noun) can be the basis behind our actions, for the pursuit of opportunities, and the reason we continue in the face of long odds. However, when it’s the basis of our strategy (verb), it will consistently fall short. If you’re looking to save time, enhance engagement and drive ROI, a specific strategy must come into play.
  • Robots ‘R Us might make for a futuristic sci-fi movie, but it can destroy the chances of an engaging wellness program strategy. If information resulted in application, we would all be eating healthy, exercising, sleeping soundly…  Unfortunately that’s clearly not the case.  An effective wellness program requires we go beyond simply information and incorporate strategies that actually help bring these into reality for our employees. By effectively combining extrinsic and intrinsic motivators, this can be done and done consistently.

Your time, budget and opportunity to enhance the lives of your team members are all limited. However, if we implement the right steps as part of our wellness program strategy, the opportunity for real change with a high return on both your time and money is not only possible – it’s expected.

 

Brad Cooper, MSPT, MBA, CWC is CEO of US Corporate Wellness (USCW), one of only 9 national firms to earn Full Accreditation through URAC as a Comprehensive Wellness Provider. But don’t let that scare you – as the core values of USCW is all about relationships.  If you’d like to learn more, please join us on March 12th.  If that doesn’t work with your schedule, Brad is happy to discuss your situation with you – personally.  Contact him at your convenience at This email address is being protected from spambots. You need JavaScript enabled to view it..

 

Tuesday, 11 November 2014 17:00

Make Your 2015 Compliance Game Plan

It's almost 2015.  Is your benefit compliance game plan ready? 

We'll help you create the plan you need to ensure you are ready for the coming year:

  • What you need to do in 2015 to meet ACA requirements and deadlines;
  • An overview of what all private employers MUST do to comply with ERISA; and 
  • The most common mistakes employers make on Section 125 plans.

Join us on Wednesday, December 17th, from 10-11 am to learn the latest up-to-date information. Register now to get your game plan in place!

 

Employers who have non-calendar year plans have had challenges in the past when employees wanted to enroll in the Exchange Marketplace, but have already made a pre-tax election to take the employer’s health plan which binds them for the entire plan year.  This problem has been eliminated with a recent joint guidance, Notice 2014-55, issued by the Treasury and the IRS September 18, 2014.

Employers may now allow an employee to drop coverage in the middle of the plan year if it coincides with the annual open enrollment period of the Exchange Marketplace, and if the employee replaces their employer coverage with a Marketplace policy beginning the day after the employer coverage ends.

For example, an employer with a July 1 anniversary generally requires all employees to be enrolled until June 30 under their pre-tax election, barring a qualifying event.  Because the new rule expands the list of qualifying events, employees may be permitted to drop their employer coverage enroll in the marketplace coverage anytime during the open enrollment period of November 15 to February 15.  This employee could be allowed to have an effective date anywhere from January 1 to March 1, and can drop their employer coverage effective the day before their Marketplace policy begins.

The notice indicates that “A cafeteria plan may rely on the reasonable representation of an employee who has an enrollment opportunity for a Qualified Health Plan through a Marketplace that the employee and related individuals have enrolled or intend to enroll in a Qualified Health Plan for new coverage that is effective beginning no later than the day immediately following the last day of the original coverage that is revoked.” This means you don’t have to personally verify the enrollment but can simply accept a statement (we suggest this be in writing) from your employee.

The cafeteria plan must be amended to allow for these types of election changes, no later than the last day of the plan year during which these new elections are to be allowed.  This will allow Marketplace elections retroactively back to the first day of that same plan year as long as all participants are notified of the amendment. If you plan to allow employees to move to the Marketplace during the 2015 open enrollment period, be sure to amend your Section 125 plan prior to the last day of your plan year in 2015.

If you aren’t sure whether you have a Section 125 plan document at all, please This email address is being protected from spambots. You need JavaScript enabled to view it. so we can help you get in compliance! 

 

Page 3 of 4