The Affordability Test for 2022 Health Plans

The Affordability Test for 2022 Health Plans

The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play or pay penalties by offering all full-time employees at least one group health plan option that meets two standards: It provides minimum value and it is affordable.

Minimum value means the plan’s share of total allowed costs is at least 60 percent and the plan provides substantial coverage of physician services and inpatient hospital services.

Affordable means the employee’s required contribution (payroll deduction) for self-only coverage, if elected, does not exceed a certain percentage of the employee’s household income. The affordability percentage changes slightly each year based on the law’s indexing rule. For 2021, the percentage is 9.83 percent. For 2022, however, the percentage decreases to 9.61 percent.

Although the change is minor, it means that employers need to consider whether their plan’s employee-only contribution rate will still meet the affordability standard next year.

Determining Affordability

The first step in determining whether a group health plan option is affordable is to define the employee’s “income.” Employers do not know their workers’ total household income, so the play or pay rules offer employers three optional safe harbor methods to define income using information known to the employer. Employers may use any of the safe harbor methods. They also may use different methods for different classes (such as one method for hourly employees and another method for salaried employees), provided that the chosen method is applied uniformly to all employees in the class.

The three IRS safe harbor methods are:

  1. Federal Poverty Line (FPL)

The FPL method is the easiest of the three methods. Multiply the mainland FPL amount for a single-member household by the affordability percentage, then divide by 12. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2021: ($12,760 x 9.83%)/12 = $104.52 per month
  • 2022 ($12,880 x 9.61%)/12 = $103.15 per month

The FPL chart is updated every year in late January. For 2022 calendar-year health plans, the employer needs to refer to the current FPL amount ($12,880) since the new FPL amount will not be available until after the plan year starts. If the health plan year starts February 1, 2022 or later, however, the employer may refer to the new FPL amount which likely will be a little higher.

2. Rate of Pay

This is the most convenient method to define income when applied to hourly employees. Multiply the employee’s hourly rate of pay times 130 hours per month (regardless of how many hours he or she actually works), then multiply by the affordability percentage. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2021: ($11* x 130) x 9.83% = $140.57 per month
  • 2022: ($11* x 130) x 9.61% = $137.42 per month

* Replace $11 with the hourly employee’s rate of pay.

For salaried employees, the rate of pay method is somewhat complicated so employers generally avoid using this method for non-hourly employees.

3. W-2

The W-2 method requires using current W-2 wages instead of looking back at the prior year. W-2 wages means the amount that will be reported in Box 1 of Form W-2. Pretax contributions, such as § 125 plan contributions and 401(k) or 403(b) plan deferrals, are not included in Box 1, so using the W-2 safe harbor method may understate the employee’s actual income. Coverage will be deemed affordable if, for each month of the plan year, the self-only contribution does not exceed the Box 1 amount multiplied by the affordability percentage.

Summary

Large employers can avoid the risk of potential penalties under the ACA’s play or pay rules by ensuring that they offer full-time employees at least one minimum value plan option that also is affordable. Affordable means the employee’s contribution to elect self-only coverage would not exceed a certain percentage of the employee’s income.

The percentage used to determine affordability changes from year to year is based on the law’s indexing formula. For 2021 plan years, the affordability percentage is 9.83 percent, but it decreases to 9.61 percent for 2022 plan years. Employers and their advisors will want to keep this information in mind as they finalize their group health plan offerings and employee contribution rates for 2022.


By Kathleen A. Berger, CEBS

Originally posted on Mineral

Cyber Security: Think Before You Click

Cyber Security: Think Before You Click

If you are concerned about your cyber security – and you should be – it’s essential to know the biggest threats to you right now.  So, what is cyber security anyway?  And how can you protect yourself?

Cyber security is the practice of defending computers, servers, mobile devices, electronic systems, networks, and data from malicious attacks. Global cyber threat continues to increase at a rapid pace.  Most, but not all, cybercrime is committed by hackers who want to make money.  As the result of the COVID-19 pandemic, Cybercrime, which includes everything from embezzlement to data hacking and destruction, is up 600%.

Types of Cyber Threats:

Malware, short for “malicious software”, refers to any intrusive software developed by cybercriminals or hackers to steal data and damage computers and computer systems.  Malware is often activated when a user clicks on a malicious link or attachment, which leads to installing dangerous software.  There are several types of malware:

  • Virus: A self-replicating program that attaches itself to clean files and spreads throughout a computer system, infecting files with malicious code.
  • Trojans: A type of malware that conceals its true content to fool a user into thinking it’s a harmless file. Cybercriminals trick users into uploading Trojans onto their computer where they can collect data or cause damage.
  • Worms: Malicious software that spreads copies of itself from computer to computer within a network. Worms exploit vulnerabilities in your security software to steal sensitive information and corrupt files. A worm is different from a virus, however, because a worm can operate on its own while a virus needs a host computer.
  • Spyware: A program that secretly records what a user does, so that cybercriminals can make use of this information. Spyware is often used to steal personal or financial information.
  • Ransomware: Malicious software which locks down a user’s files and data with the threat of erasing it unless a ransom is paid.
  • Adware: Unwanted software that displays advertisements on your screen. Adware collects personal information from you to serve you with personalized ads. While adware is not always dangerous, it can redirect your browser to unsafe sites and can even contain Trojans and spyware.
  • Rootkits: Malicious software that is extremely difficult to spot and also very hard to remove. A rootkit allows someone to maintain control over a computer without the computer owner knowing about it.  Once a rootkit has been installed, nothing on your computer is secure.

Where does malware come from?

The most common sources of malware are malicious websites, email attachments, and shared networks.

  • Phishing: E-mails that appear to be from a legitimate company asking for sensitive information. Phishing attacks are often used to trick people into handing over personal information or credit card data.
  • Shared Networks: A malware infected computer on your shared network can spread malware onto all devices on the network.
  • Malicious Websites: Some websites may install malware onto your computer – usually through advertisements on popular sites (malvertising) or malicious links.

How to Prevent Malware – 7 Things You Should Start Doing Now:

  1. Install Anti-virus Software: Anti-virus software will scan your computer to detect and clean the malware and provide enhanced protection against newly created viruses.
  2. Regularly Update Software: Keep your software updated to stop attackers gaining access to your computer through vulnerabilities in outdated systems.
  3. Install a Firewall: A firewall blocks all unauthorized access to or from a private computer network.
  4. Use Secure Authentication Methods: Use strong passwords with at least 8 characters, including an uppercase letter, a lowercase letter, and a number or symbol. You should also enable multi-factor authentication, such as a security question in addition to a password.
  5. Don’t Open Emails From Unknown Sources: Hackers often send emails with links that are sure to send malware your way and hack into your important information. It is better to delete the email than to suffer the consequences of opening it.
  6. Avoid Using Unsecure WiFi Networks in Public Places: On an unsecure network, a cybercriminal can intercept communication between two individuals to steal data.
  7. Maintain Regular Backups of Your Data: Backups do not secure your network from attacks but they help when you face a malware attack.

Jeh Johnson, former U.S. Secretary of Homeland Security, stated “Cyberattacks of all manner and from multiple sources are going to get worse before they get better.  In this realm and at this moment, those on offense have the upper hand.  Whether it’s cyber-criminals, hacktivists, or nation-state actors, those on offense are ingenious, tenacious, agile, and getting better all the time.  Those on defense struggle to keep up.”

It is imperative that you protect yourself and your family from cybercriminals.  With technology increasing, criminals don’t have to rob stores or banks, nor do they have to be outside to commit a crime – they have everything they need on their lap.  Their weapons are no longer guns, they attack with a computer mouse and passwords.

Spam and Phishing

Spam and Phishing

Malicious Email

A malicious email can look just like it comes from a financial institution, an e-commerce site, a government agency or any other service or business.

It often urges you to act quickly, because your account has been compromised, your order cannot be fulfilled or there is another urgent matter to address.

If you are unsure whether an email request is legitimate, try to verify it with these steps:

  • Contact the company directly – using information provided on an account statement, on the company’s official website or on the back of a credit card.
  • Search for the company online – but not with information provided in the email.

Spam

Spam is the electronic equivalent of junk mail. The term refers to unsolicited, bulk – and often unwanted – email. Here are ways to reduce spam:

  • Enable filters on your email programs: Most internet service providers (ISPs) and email providers offer spam filters; however, depending on the level you set, you may end up blocking emails you want. It’s a good idea to occasionally check your junk folder to ensure the filters are working properly.
  • Report spam: Most email clients offer ways to mark an email as spam or report instances of spam. Reporting spam will also help to prevent the messages from being directly delivered to your inbox.
  • Own your online presence: Consider hiding your email address from online profiles and social networking sites or only allowing certain people to view your personal information. 

Phishing

Phishing attacks use email or malicious websites (clicking on a link) to collect personal and financial information or infect your machine with malware and viruses.

Spear Phishing

Spear phishing involves highly specialized attacks against specific targets or small groups of targets to collect information or gain access to systems. For example, a cybercriminal may launch a spear phishing attack against a business to gain credentials to access a list of customers. From that attack, they may launch a phishing attack against the customers of the business. Since they have gained access to the network, the email they send may look even more authentic and because the recipient is already customer of the business, the email may more easily make it through filters and the recipient maybe more likely to open the email.

The cybercriminal can use even more devious social engineering efforts such as indicating there is an important technical update or new lower pricing to lure people.

Spam & Phishing on Social Networks

Spam, phishing and other scams aren’t limited to just email. They’re also prevalent on social networking sites. The same rules apply on social networks: When in doubt, throw it out. This rule applies to links in online ads, status updates, tweets and other posts. Here are ways to report spam and phishing on major social networks:

Tips for Avoiding Being a Victim

  • Don’t reveal personal or financial information in an email, and do not respond to email solicitations for this information. This includes following links sent in email.
  • Before sending or entering sensitive information online, check the security of the website.
  • Pay attention to the website’s URL. Malicious websites may look identical to a legitimate site, but the URL may use a variation in spelling or a different domain (e.g., .com versus .net).
  • If you are unsure whether an email request is legitimate, try to verify it by contacting the company directly. Contact the company using information provided on an account statement, not information provided in an email. Check out the Anti-Phishing Working Group (APWG) to learn about known phishing attacks and/or report phishing.
  • Keep a clean machine. Keep all software on internet-connected devices – including PCs, smartphones and tablets – up to date to reduce risk of infection from malware.

What to Do if You Are a Victim

  • Report it to the appropriate people within the organization, including network administrators. They can be alert for any suspicious or unusual activity.
  • If you believe your financial accounts may be compromised, contact your financial institution immediately and close the account(s).
  • Watch for any unauthorized charges to your account.
  • Consider reporting the attack to your local police department, and file a report with the Federal Trade Commission or the Internet Crime Complaint Center.

Protect Yourself With These STOP. THINK. CONNECT.™ Tips

  • When in doubt, throw it out: Links in email, tweets, posts and online advertising are often how cybercriminals try to compromise your information. If it looks suspicious, even if you know the source, it’s best to delete or – if appropriate – mark it as junk.
  • Think before you act: Be wary of communications that implores you to act immediately, offers something that sounds too good to be true or asks for personal information.
  • Make your passphrase a sentence: A strong passphrase is a sentence that is at least 12 characters long. Focus on positive sentences or phrases that you like to think about and are easy to remember (for example, “I love country music.”). On many sites, you can even use spaces!
  • Unique account, unique passphrase: Having separate passphrases for every account helps to thwart cybercriminals. At a minimum, separate your work and personal accounts and make sure that your critical accounts have the strongest passphrases.
  • Lock down your login: Fortify your online accounts by enabling the strongest authentication tools available, such as biometrics, security keys or a unique one-time code through an app on your mobile device. Your usernames and passphrases are not enough to protect key accounts like email, banking and social media.

Additional Resources

Originally posted on Stay Safe Online

The ABC’s of Medicare

The ABC’s of Medicare

Trying to figure out Medicare can be one of the most frustrating aspects of retirement.  Even the savviest of retirees struggle with figuring out when to enroll and which parts to enroll in – there’s Part A, Part B, Part C, Part D, Medigap plans and so on. And, what in the world is a donut hole, anyway?

What is Medicare?

Medicare is the government health care program for people 65 and over as well as some younger people with disabilities.  Medicare’s coverage plays an important role in containing medical costs as you age. Medicare is a different program than Medicaid, which offers health and other services to eligible low-income people of all ages.

Types of Medicare

  • Part A covers inpatient hospital stays, skilled nursing facility stays, some home health visits, and hospice care. Generally, you don’t have to pay premiums if you or your spouse paid Medicare taxes for at least 10 years.
  • Part B covers doctor visits and other medically necessary services and supplies. That includes preventive services or health care to prevent illness, as well as ambulance services, durable medical equipment and mental health coverage. Part B comes with a monthly price tag – the standard premium was $148.50 in 2021.
  • Part C or Medicare Advantage is a type of health plan offered by private insurance companies that provides the benefits of Part A and Part B and often Part D as well. These bundles plans may have additional coverage such as vision, hearing, dental care and may even include perks such as gym memberships or transportation to doctor’s appointments. Medicare Advantage plans have an annual limit on out-of-pocket costs.  Medicare Advantage plans are typically HMOs or PPOs.
  • Part D is the prescription drug benefit that covers most outpatient prescription drugs. It is a separate plan provided by private Medicare approved companies, and you must pay a monthly premium.  Unless you have creditable drug coverage and will have a Special Enrollment Period, you should enroll in Part D when you first get Medicare. If you delay enrollment, you may face gaps in coverage and enrollment penalties.  Most plans with Medicare prescription drug coverage (Part D) have a coverage gap (called a “donut hole”).  That means that after you and your drug plan have spent a certain  amount of money for covered drugs, you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit.  Once you have spent up to the yearly limit, your coverage gap ends and your drug plan helps pay for covered drugs again.
  • Medigap or Medicare Supplement Insurance is an additional health insurance policy you can buy from a private insurer to help pay some of the costs not covered by Medicare Part A and Part B, including deductibles, coinsurance and health care if you travel outside the U.S. Medigap policies do not cover prescription drugs, dental, vision, hearing aids, private nursing care or long-term care. There are 10 types of Medigap plans available in most states.

When to Sign Up for Medicare

For most people, signing up for Medicare occurs during a 7 month initial enrollment period(IEP).   The IEP starts 3 months before you turn age 65 and continues for 3 months after your birthday. You may be eligible sooner if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).

During the IEP, you can sign up for Medicare Part A.  Even if you are still working after you turn 65, you should consider signing up for Part A now.  If you’ve worked and paid Medicare taxes, it comes at no cost to you and covers hospital services.

You can join, switch, or drop a Medicare Health Plan or a Medicare Advantage Plan (Part C) with or without drug coverage during these times:

  • Initial Enrollment Period – When you first become eligible for Medicare, you can join a plan.
  • Open Enrollment Period – From October 15 – December 7 each year, you can join, switch, or drop a plan.
  • Medicare Advantage Open Enrollment Period – From January 1 – March 31 each year, if you’re enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time.

Let’s be honest, no one gets too excited about enrolling in Medicare, but the more you know, the easier it is.  Being prepared for life’s unexpected twist and turns and keeping up with your health care is more important than ever.  By understanding the ABC’s of Medicare, you are empowering yourself for your future!

Other Helpful Resources Include:

Understanding Medicare’s Options: Parts A, B, C and D

What is Medicare?

An Overview of Medicare

Johnson & Dugan Named Mployer Advisor Top Employee Benefits Consultant

Johnson & Dugan Named Mployer Advisor Top Employee Benefits Consultant

 

Johnson & Dugan recognized as a 2021 Top Employee Benefits Consultant for the San Francisco Bay Area by Mployer Advisor

Redwood City, CA September 30, 2021 – Johnson & Dugan Insurance Services, an independent employee benefits consultant, is recognized by Mployer Advisor, an independent platform for employers to research, review and evaluate insurance brokers, as a Top Employee Benefits Consultant Award for 2021 for San Jose, California. Mployer Advisor’s Top Employee Benefits Consultant Award recognizes brokers for demonstrating market-leading competencies in several areas.

“Who an employer chooses as their insurance advisor has significantly more impact on the quality and cost of a benefit plan than who they chose as the carrier. We are proud to honor these firms who have demonstrated a wide range of experience in combination with positive employer feedback on service and quality,” said Brian Freeman, CEO of Mployer Advisor.

“I am personally very proud of this industry recognition. We have always strived to provide strategic benefit plans, tailored to each employer partner, with the highest customer satisfaction,” comments Michael Johnson, CEO. “Our team serves over 180 organizations in the Northern California region.  We have seen a significant need for our services as organizations continue to reemerge after the pandemic”, Michael Johnson continued.

To determine award winners, Mployer Advisor analyzes each brokerage based on historical data to gauge the range of business experience across employer sizes, industry experience and products, combined with employer ratings and reviews of insurance brokerages across several platforms. Results are a snapshot of Mployer Advisor’s matrices and proprietary M Score on May 31, 2021.

About Johnson & Dugan:

Since 1983, Johnson & Dugan’s highest priority has been to make it easy for any company to expertly plan and administer their employee benefits plans.

Unlike other employee benefits consulting firms, J&D does not deliver one-size-fits-all solutions — our team works with each client to deliver the right mix of expertise, products, services and support based on the scope of their needs — with the flexibility necessary to adapt to organizational changes.

Contact: info@johnsondugan.com

About Mployer Advisor:

Mployer Advisor is changing the way employers search, evaluate and select insurance advisors. Our goal is to connect employers and employees to great benefits and insurance. We do this by providing employers with actionable data to easily evaluate and select the best advisor for a company’s unique needs. Mployer Advisor provides independent ratings of insurance advisors to support employers. The rating is our opinion and should be one of many factors, including when selecting a consultant. An insurance brokerage cannot pay to influence their Mployer Advisor rating. Most brokerages have a profile on Mployer Advisor. Only highly rated brokerages are allowed to advertise on the platform. To learn more about Mployer Advisor visit https://mployeradvisor.com.