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Displaying items by tag: health insurance broker

Thursday, 25 September 2014 08:13

What is your Healthcare Strategy Score?

The Affordable Care Act aside, employers everywhere are struggling with the rising cost of healthcare.  Even though annual trend levels have tapered off, the costs were already so high that adding even one extra dime to healthcare costs can feel like the straw that broke the camel’s back.

There are some factors affecting your healthcare costs that you don’t control.  But what about those you CAN control?  Are you taking advantage of all of the potential ways you can engage your employees as consumers, help them get healthy, and then use creative funding strategies to capture the resulting savings? 

First of all, you’ll want to check out our Tackling Healthcare Costs webinar next Tuesday, October 7th, at 10 am.  But also, you’ll want to take advantage of Fall River’s new Healthcare Strategy Score system, where we meet with you to benchmark how proactive and creative your current strategies are on a scale of zero to 100%, then lay out a game plan of how you can up your score and save on your costs as a result.


Request your Healthcare Strategy Score now!

Published in Best Practices
Wednesday, 13 August 2014 16:53

Exchange Options For Your Employees

During open enrollment, employees tend to ask a lot of questions about the benefits and their options. Now that the exchange plans are available in the Individual Marketplace, employees will naturally have questions about the plans available and if they can move their coverage or their dependents’ coverage to save money. 

There are a few things to be aware of when providing the employee with information about the marketplace. 

  • The open enrollment period for Connect for Health Colorado is November 15, 2014 to February 15, 2015 for coverage that begins January 1, 2015. 
  • Since coverage is now guaranteed issue, enrollment is ONLY allowed during this open enrollment period OR when an individual has a qualifying event (QE).
  • QEs create a 60 day Special Enrollment Period (SEP) when individuals and families have the right to sign up for coverage. 

What constitutes a Qualifying Event (QE) on the exchange? 

  • Birth, adoption or placement for adoption of a child
  • Change in Marital Status due to marriage, death of spouse, divorce, legal separation or annulment
  • Moving to Colorado
  • Change in citizenship or incarceration status
  • Involuntary loss of health coverage (loss of job-based coverage, COBRA expiration, aging of parent’s plan, loss of student coverage, losing eligibility for Medicaid or CHIP)
  • Voluntarily ending of employer coverage if and only if that coverage qualifies as a minimum essential coverage, AND the ending of coverage is at the employer’s open enrollment effective date. Note that if the employee is opting out of “affordable” coverage, they will not be eligible for a tax credit on the exchange.

These rules can be complex and employees may have questions beyond what you can answer.  This email address is being protected from spambots. You need JavaScript enabled to view it.

Published in Healthcare Legislation

As a company grows and wants to attract the best workforce, their benefits strategy needs to change with them.  While a smaller start-up company may offer the bare-bones benefits, a larger company may need to offer a very comprehensive benefits package to suit the needs of all employees, along with a creative strategy to make it affordable. We thought we’d share a case study to demonstrate how active the evolution of benefits needs to be.


Fall River has worked with a rapidly-growing Denver software consulting firm for about eight years.  They started with us with just three employees on the benefits, and offered a fully-insured traditional medical plan, as well as dental, vision, and basic life insurance.  


Within just a few years they had grown to have dozens of employees all over the country, and discovered that they needed a richer benefits package to attract the specialized talent they were looking for.  They also found themselves at the mercy of their small group renewals, even though their demographics were better than average.


We started by implementing a creative plan design strategy, allowing the company to offer richer benefits at a lower cost.  Since they had almost as many locations as employees, we helped them conduct all their enrollment meetings via Web Conference. At this point we suggested adding more extensive Life insurance coverage and Disability policies that fit the needs of their high-end, growing workforce. We also helped them identify global benefit resources for their employees outside the United States.


By moving the group to a partially self-funded plan a few years later, we were able to take advantage of their good demographics and save them even more money.  Under this strategy, they also received claims data that they never had before, allowing us to help them to target their employee education and wellness incentives.  This laser-sharp focus enabled them to keep their renewals under control, thus allowing for the continuation of their extremely rich benefit plan.  As this company continues to grow and is now approximately 100 employees, their robust benefits package continues to be a significant part of their recruiting success.


This year, this dynamic firm has successfully completed a sale to a private equity firm that will enable them to make significant equity payouts to the employee owners of the company, and to enter into a new phase of growth.  We’re in the strange position of being both humbled by the amazing accomplishments of these leaders, who have become our friends, yet also feeling like proud parents sending their kids off to college as we wish this fabulous client success in the next stage of their journey!


There are many other considerations for companies that are growing quickly.  If this is your situation, we’d be happy to provide additional guidance as you navigate the rapids of change. This email address is being protected from spambots. You need JavaScript enabled to view it.


Published in Best Practices
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