Displaying items by tag: Group health insurance brokers
Update on ACA Repeal and Replace Strategy
It was no secret before President Trump signed the executive order that he wanted the Affordable Care Act (ACA) repealed, and now he has made his intentions clear. His first signed executive order requires federal agencies to ease the economic burden of the ACA “to the maximum extent permitted by law” until it is repealed. Although the executive order doesn’t grant the administration any powers that it didn’t already have, it does signal to the public that change is coming.
On Wellness, One Size Fits ONE
Guest Article by Brad Cooper, CEO of US Corporate Wellness
The research is in, and it warrants an exclamation point! An effective employee wellness program will provide a 125-600% ROI or more through decreased health care, sick time and disability costs, as well as improved recruitment, retention and employee engagement (and that doesn’t take into account the personal enhancements participants experience in their own lives!). The result of this research has been a two-fold increase in the number of organizations that have launched wellness programs for their employees in recent years. Only one problem – the first word in the phrase “Effective Employee Wellness Program.”
There are many approaches to employee wellness. Common entry level approaches include holding an internal “biggest loser”-like contest or providing paid memberships at the local health club.
21st Century Cures Act and Small Employer HRAs
The 21st Century Cures Act was signed into law on December 13, 2016 by then President Obama. The bulk of the Cures Act covers areas such as medical research and drug and device approvals. This new law also revokes a ban in effect since 2014 on small employer pre-tax funding of individual health insurance premiums. Beginning in 2017, this new act will allow small employers to create “Qualified Small Employer Health Reimbursement Arrangements” or “QSEHRAs.”
Annual Study Shows Trends Stay Low with Help from HDHPs
The annual Kaiser Family Foundation/Health Research & Education Trust Employer Survey is always a great source of information about the trends in employer-sponsored health coverage. This year’s big conclusion is that while final premium increases were not that high, the average was markedly reduced by even more movement to cost-saving High Deductible Health Plans (HDHPs), which means employees likely have less rich benefits than before.
Fall River Inspiration Scholars Announced
Final Colorado Exchange Enrollment
Are You ERISA Compliant? Try This Checklist!
- Written Plan Document – insurer certificates are not sufficient; a wrap document is often required
- Summary Plan Descriptions (SPDs)
- Summary of Material Modification (SMM) for off-anniversary changes
- Form 5500 and Summary Annual Report (SAR), for those with 100+ participants
- Numerous required notices throughout the year – note that these changed recently
- COBRA compliance
- HIPAA and HITECH compliance – including the latest privacy regulations effective 9/23/13
- Medicare Part D notifications to members and CMS if any beneficiaries could be Medicare eligible; note that even some non-ERISA plans such as churches and governments are also subject to this requirement
- Collect and review all benefit plan documents
- Identify plan changes and initiate corrections
- Mark calendar for the dates required forms are due and deadlines for reporting
- Review and update required notices for employee distribution
- Group Medical (PPO, HDHP, HMO, POS, etc.)
- Dental
- Vision
- Group Life & AD&D
- Disability
- Prescription Drug Plans
- FSA
- HRA
- Wellness programs (if medical care is offered)
- Employee Assistance Programs (if counseling is provided)
- Government Plans (federal, state, city, county, public school districts)
- Church
- Health Savings Accounts themselves (though the underlying HDHP plans are)
- Section 125 - Premium Only Plans
- Payroll Practices
- Voluntary Plans
Colorado Opts Out of Latest ACA-Compliance Delay
Create Great Healthcare Consumers
- Prepare for doctor visits by bringing a list of questions and taking notes during the appointment
- Bring someone else with you to take notes, especially when discussing complex conditions or treatment plans with your doctor
- Research your condition or surgery prior your appointment so you come informed
- Take prescription medications as directed and don’t stop without the instructions of your physician
- Ask for generic prescriptions whenever possible and use the prescription mail order program for maintenance medications you take every day
- Use your insurer’s online cost and quality data to determine where the best outcomes happen for the surgery or procedure you need
- Avoid hospital or other high cost settings by asking your doctor for alternative locations where you could have a procedure or complex imaging performed
- Call the 24/7 Nurse line if one is provided by your carrier
- Make a doctor’s visit for the next day if it’s not serious
- Visit your nearest covered Urgent Care facility (research ahead of time the nearest one to your home and your workplace)
- Use the Emergency Room as a last resort for treatment
Rounding Out Your Benefits Offerings with Voluntary Benefits
A great way to enhance an employee benefit package is with voluntary products. Examples of voluntary products that could be added benefits with no cost to the employer include:
- Additional Life Insurance
- Dental plans to replace or enhance your group plan
- Accident Policies
- Disability Insurance
- Vision Insurance
- Critical Illness
- Legal Services
- Financial Counseling
- Credit Union Membership
- Pet insurance
- Discount programs
- Conduct an employee survey or a focus group – determine your employee demographics and which products would interest your employee population to help ensure the success of the benefits offered
- Educate employees about the coverage offered –explain in both group and 1-on-1 meetings (all conducted by the carrier or broker) the value of the added layer of protection that voluntary products can provide for employees and their families
- Distribute communication pieces year round – don’t wait until the annual open enrollment to discuss benefit options available (i.e. web based enrollment, use of onsite enrollment counselors, payroll deductions for the premiums). Use email, employee portals or company specific social media sites to raise employee awareness and encourage participation.