(303) 369-3200

Displaying items by tag: Group health insurance brokers

Tuesday, 11 February 2014 10:00

Mandate Delays for Large Employers

On February 10, 2014, the Federal government released the final regulations for the Employer Shared responsibility provisions of the Affordable Care Act (ACA).  These final regulations brought some welcome transition relief to large employers in two different size categories. Employers with 50-99 Full Time Equivalents:

  • The Shared Responsibility Mandate does not apply until 2016
  • Employer does not need to comply until the first day of their 2016 plan year, which means employers may wish to change their anniversary date to later in the year
  • In order to qualify for this delay, employers must not reduce their coverage, contribution, or eligibility below specified levels
  • Also, reducing their workforce below 100 employees other than for a “bona fide business reason” may disqualify an employer from using the transition relief

Employers with 100 or more Full Time Equivalents:

  • Now in 2015, employers in this category will not be subject to a shared responsibility penalty, as long as they offer coverage to 70% of their full time employees (the original requirement was 95%)
  • After 2015, coverage must be offered to 95% of employees to avoid the penalty.  The coverage offered in 2015 and beyond must be “affordable” and offer “minimum coverage”

Recall that the calculation of Full Time Equivalents is defined by the law.  This calculation and other details of the new guidance are summarized in the FAQs recently released. This new transition relief offers new opportunities to employers to create strategies for managing the impact of the ACA on their business. For more information, join our webinar on the topic on March 4th, or just This email address is being protected from spambots. You need JavaScript enabled to view it. with questions. 

Published in Healthcare Legislation
Tuesday, 28 January 2014 10:00

Strategies to Manage the Affordable Care Act

 The Affordable Care Act (ACA) will continue to keep business owners and HR and benefits professionals on their toes in 2014. . Employers of all sizes need to game plan their strategies to manage the impact of the ACA on their businesses.  Whether you are a large employer trying to find the best way to cope with the Pay-or-Play mandate next year, or a small employer looking for alternatives to the community rating that may wreak havoc on your 2014 renewal (2016 for groups with 50-99 employees), we can help! . We are conducting a webinar at 10 am on March 4th on behalf of Mountain States Employers Council. Join us and start formulating your strategy now! Click here now to register.

Published in Healthcare Legislation
Tuesday, 07 January 2014 10:00

Do You Know Where Your POP Plan Document Is?

 Providing a Section 125 Premium Only Plan (or POP Plan), is a great tax benefit for both employees and employers.

  • It allows the employee portion of the health, dental, or vision premium to be deducted on a pretax basis, which increases the amount of their take home pay.
  • Since the employee premium contribution is not counted as income, employers also benefit from the reduction of payroll taxes, which saves you 7.65% of those premiums on FICA taxes.
  • These tax savings for employers helps offset the cost associated with an employer sponsored plan.

POP Plans are the easiest of all the cafeteria plans to administer. But, in order for this type of plan to run properly, it must be compliant with IRS rules and regulations. Failure to have a written plan document or to administer the plan in accordance with that document can cause the loss of a tax-favored status, resulting in a tax liability for the employee and employer. . The POP plan is designed to renew year after year and only requires updating if the employer makes changes to the plan that would necessitate an amendment (i.e. changes in eligibility, plan year, benefit changes such as whether HSA contributions are also allowed, etc.). . However, due to the changes being brought upon by healthcare reform, many industry leaders are recommending an amendment or restatement, to keep your POP plan document in compliance. If your POP plan document has not been updated in several years, be sure to contact your Section 125 administrator. . If you do not have a POP Plan document, or an administrator, call Fall River at 303.369.3200 or This email address is being protected from spambots. You need JavaScript enabled to view it., and we will be happy to get you introduced to someone who can help get you compliant.

Published in Best Practices
Saturday, 21 December 2013 20:00

Was the Website Disaster Worth It?

 The rollout of the Federal and State Affordable Care Act (ACA) Exchange websites have been rocky, to say the least.  Colorado has its own state Exchange Marketplace, fortunately, but even we have had some significant troubles enrolling individuals and small groups early on in the weeks right after the October 1 rollout. More recently, though, the technical glitches of both the Colorado site as well as the Federal site have improved significantly. We’ve enrolled quite a few individuals on the CO site, especially in the month of December. While the technology has been frustrating, and the process for determining one’s subsidy grueling, there are also some nice results that hopefully are making it worthwhile.  A few heartwarming examples from the enrollments we’ve completed:

  • Dani*, a middle aged single mom, was able to enroll herself and her two children for $140 a month in a rich plan similar to one she’d had previously.  But for her pre-ACA policy, she’d been paying over $500 a month.
  • Bonnie is 59, is disabled, and has never really used a computer. She and her husband earn only about $30,000 a year in total, and had been paying almost $6,000 a year to insure Bonnie. Despite her intimidation with technology, we enrolled her in 90 minutes start to finish, including her Medicaid and subsidy application.  The tax credits enabled her to choose a plan comparable to her current coverage for just $240 a month, about half of her current bill.
  • My favorite story is about a 42 year-old named Rob, who gave a homeless shelter as his address despite having a full time job. With the help of both the tax credits and Cost Sharing Reduction, Rob was able to purchase a plan with a $100 deductible and a $5 copay for office visits and prescriptions, all for just $54 a month in premium.

These individuals and many others have certainly experienced confusion and technology challenges as a result of the new law, but are receiving better coverage at a far lower cost that makes a world of difference for these hard working people.  Stories like these keep me going as we work hard to ensure all of our clients have the best possible strategy around the ACA. *All names changed to protect privacy.

Published in Healthcare Legislation
Wednesday, 13 November 2013 17:00

What’s your 2014 Exchange Strategy?


Despite a few glitches, October 1 marked the launch of the Colorado Individual and Small Group Exchanges, now called Marketplaces.  These have the potential to permanently change the way Americans purchase insurance.  Are you ready for the questions your employees and leadership team may already be asking?
Back by popular demand, we are repeating the Exchange webinar we did in October.  On Tuesday the 19th, at 11:30, Tonya and Amy on the Fall River team will be walking you through how the Exchange Marketplaces can benefit your company and your employees.
The webinar is right around the corner, so click here to register now!
Published in Healthcare Legislation
Sunday, 10 November 2013 10:00

Clarification on the Individual Mandate Penalty

 Many are confused about when the individual mandate is actually effective.  It DOES still go into effect in 2014, unlike the employer mandate which has been delayed in its entirety to 2015. Initially, the mandate would be considered to be satisfied if you had a gap of no more than two months of coverage, which would require individuals to enroll in coverage by March 1st.  However, there has been some new guidance issued just this month clarifying that individuals who enroll through the marketplace have until March 31st to select their coverage. Enrolling this late, however, means coverage would not be effective until  April or May, due to the rule requiring individuals to be enrolled by the 15th of the month prior to starting coverage. Because the enrollment period in the marketplace goes until March 31 this first year, the Department of Health and Human Services (HHS) has clarified that individuals who enroll by March 31, 2014 in the marketplace WILL qualify for a hardship exemption from the mandate, even if their coverage does not start until April 1 or even May 1. Drop us a line or read more here if you have any further questions about this!

Published in Healthcare Legislation


On October 31, the US Treasury released guidance indicating that employers may now offer the option of rolling over up to $500 of unused Flexible Spending Account dollars to a future plan year.  This is big news because it takes away one of the biggest fears employees have about using an FSA.  There’s really no reason now for an eligible employee to NOT enroll in the FSA for at least $500, now that it can roll over indefinitely.
Note that if an employee rolls over $500, he or she may still elect the entire amount allowed under your FSA plan for the following year (up to an IRS max of $2,500). If they don’t use it all, however, they can only roll over the same $500 next year.
Employers now have three choices when it comes to designing an FSA:
  1. Continue to enforce the “Use-it-or-Lose-it” Rule that means any unused dollars at the end of the plan year revert to the employer.
  2. Take advantage of a 2 ½ month grace period which allows your employees to have extra time to INCUR claims, not just submit receipts.  This allows UNLIMITED rollover in terms of dollar amounts, but a LIMIT in terms of time to use it. This grace period cannot be used in conjunction with the new $500 rollover.
  3. Jump on this newly available third option, of allowing a $500 rollover.  This works the opposite of option 2, giving the employee only a LIMITED dollar amount, but UNLIMITED time to use that $500.
You may amend your plan document right now for the plan year that is already in progress (IF you don’t already offer the 2 ½ month grace period), to allow employees to rollover up to $500 of the dollar amounts already elected.  Or, you can wait until the following plan year to put in place ANY of the three options above.
We recommend choosing the new option of the $500 rollover as the most employee-friendly option, to encourage the highest FSA participation possible. Give us a call or This email address is being protected from spambots. You need JavaScript enabled to view it. with any questions.
Published in Best Practices
Monday, 09 September 2013 21:40

Educating Employees About the Exchanges

You have just issued your employees the Model Exchange Notice, so now what?

Published in Best Practices
Wednesday, 21 August 2013 20:28

Avoiding the Renewal Rush

Do you or your employees feel rushed during the busy benefits renewal and open enrollment season? 

Published in Best Practices
Thursday, 15 August 2013 15:22

Top Five HIPAA Mistakes

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a provision for protecting the privacy of individual health information and the security of electronic protected health information.

Published in Best Practices
Page 13 of 17