Preexisting conditions. While it’s no doubt this term has been a hot topic in recent months—and notably misconstrued—one thing has not changed; insurers cannot deny coverage to anyone with a preexisting condition. Now that House Resolution 1628 has moved to the Senate floor, what can employers and individuals alike expect? If passed by the Senate as is and signed into law; some provisions will take place as early as 2019—possibly 2018 for special enrollment cases. It’s instrumental for companies to gear up now with a plan on how to tackle open enrollment; regardless of whether your company offers medical coverage or not.
Under the current proposed American Health Care Act (AHCA) insurance companies can:
Price premiums based on health care status/age. The AHCA will provide “continuous coverage” protections to guarantee those insured are not charged more than the standard rate as long as they do not have a break in coverage. However, insurers will be allowed to underwrite certain policies for those that do lapse—hence charging up to 30% more for a preexisting condition if coverage lapses for more than 63 days. This is more common than not, especially for those who are on a leave of absence for illness or need extensive treatment. In addition, under current law, insurers are only allowed to charge individuals 50 and older 3 times as much than those under this age threshold. This ratio will increase 5:1 under AHCA.
Under the ACA’s current law employers must provide coverage for 10 essential health care benefits. Under AHCA, beginning as early as 2020, insurers will allow states to mandate what they consider essential benefit requirements. This could limit coverage offered to individuals and within group plans by eliminating high cost care like mental health and substance abuse. Not that it’s likely, but large employers could eventually opt out whether they want to provide insurance and/or choose the types of coverage they will provide to their employees.
It’s important to note that states must apply for waivers to increase the ratio on insurance premiums due to age, and determine what they will cover for essential health benefits. In order to have these waivers granted, they would need to provide extensive details on how doing so will help their state and the marketplace. So what can employers do moving forward? It’s not too soon to think about changing up your benefits package as open enrollment approaches, and educating yourself and your staff on AHCA and what resources are out there if you don’t offer health coverage.
Make a variety of supplemental tools available to your employees. Anticipate the coming changes by offering or adding more supplemental insurance and tools to your benefits package come open enrollment. Voluntary worksite benefits, such as Cancer, Critical Illness, and Accident Insurance handle a variety of services at no out-of-pocket cost to the employer. HSA’s FSA’s and HRA’s are also valuable supplemental tools to provide your employees if you’re able to do so. Along with the changes listed above, the AHCA has proposed to also increase the contribution amounts in these plans and will allow these plans to cover Over-the-Counter (OTC) medications.
Continue to customize wellness programs. Most companies offer wellness programs for their employees. Employers that provide this option should continue advancing in this area. Addressing the specific needs of your employees and providing wellness through various platforms will result in the greatest return on investment; and healthier employees to boot. Couple this with frequent evaluations from your staff on your current program to determine effectiveness and keep your wellness programs on point.
Educate, educate, educate—through technology. Regardless if you employ 10 or 10,000, understanding benefit options is vital for your employees; what you have to offer them and what they may need to know on their own. Digital platforms allow individuals to manage their healthcare benefits and stay in the know with valuable resources at their fingertips. There’s no limit on the mediums available to educate your employees on upcoming changes. Partnering with a strong benefit agency to maximize these resources and keep your employees “in the know” during a constantly changing insurance market is a great way to start.
Over the past few years, we’ve seen tremendous growth in Financial Wellness Programs. Actually, as indicated in a recent report by Aon Hewitt, 77% of mid- to large-size companies will provide at least one financial wellness service in 2017; with 52% of employers providing services in more than 3 financial categories. So what are the advantages of these programs and how can the current workforce make the most out of them? Program Advantages
They educate employees on financial management. It’s no doubt, poor income management and cash-flow decisions increase financial stress. This stress has a direct impact on an employee’s physical, mental and emotional state—all which can lead to productivity issues, increased absenteeism, and rising healthcare costs. Financial wellness tools in the workplace can not only support employees in various areas of their finances by expanding income capacity, but can create long-lasting changes in their financial habits as well.
They give a foothold to the employer. As more employers are recognizing the effect financial stress has on their employees in the workplace, they’re jumping on board with these programs. As people are extending the length of their careers, benefits like these are an attractive feature to the workforce and new job seekers alike. In fact, according to a recent survey by TIAA, respondents were more likely to consider employment with companies who provide free financial advice as part of their benefit package.
Program Credentials
While financial wellness benefits may differ among companies, one thing is certain—there are key factors employers should consider when establishing a successful program. They should:
Give sound, unbiased advice. Financial wellness benefits should be free to the employee—no strings attached. Employees should not be solicited by financial institutions or financial companies that only want to seek a profit for services. Employers should research companies when shopping these programs to determine the right fit for their culture.
Encompass all facets. A successful program should cover all aspects of financial planning, and target all demographics. These programs should run the gamut, providing resources for those with serious debt issues to those who seek advanced estate planning and asset protection. Services should include both short-term to long-term options that fit with the company’s size and culture. Popular programs implement a variety of tools. Employers should integrate these tools with other benefits to make it as seamless as possible for their employees to use.
Detail financial wellness as a process, not an event. Strengthening financial prosperity is a process. When determining the right fit for your company, continued coaching and support is a must. This may require evaluating the program and services offered every year. Employees need to know that while they have the initial benefit of making a one-time change, additional tools are at their disposal to shift their financial mindset; strengthening their financial habits and behaviors down the road.
Employees must understand the value Financial Wellness Programs can provide to them as well. If your company offers these benefits, keep a few things in mind:
Maximize the program’s services. Utilize your financial workplace benefits to tackle life’s financial challenges. Most programs offer financial mentoring through various mediums. Seek advice on your financial issues and allow a coach/mentor to provide you with practical strategies, alternatives and actionable steps to reduce your financial stress.
Evaluate your progress. Strengthening your financial well-being is a process. If your employer’s financial wellness program provides various tools to monitor your finances, use them. Weigh your progress yearly and take advantage of any support groups, webinars, or individual one-on-one counseling sessions offered by these programs.
As the workforce continues to evolve, managing these programs and resources effectively is an important aspect for both parties. Providing and utilizing a strong, effective Financial Wellness Benefits Program will set the foundation for a lifetime of financial well-being.
It’s not surprising that 2017 stands to be the year many will have an experience to share using a Telemedicine or a Virtual Doctor service. With current market trends, government regulations, and changing economic demands, it’s fast becoming a more popular alternative to traditional healthcare visits. And, as healthcare costs continue to rise and there are more strategic pricing options and digital models available to users, the appeal for consumers, self-funded employers, health systems and health plans to jump on board is significant.
Check out this short video and contact us to learn more!
Many employers have invested in benefits administration systems to streamline their processes and connectivity with payroll systems as well as external vendors. From an efficiency and reporting perspective, this works wonderfully. However, when it comes to leveraging that technology for open enrollment and benefits communication, there can be gaps that limit effectiveness.
Our recent survey found that while technology plays a big role (47 percent of surveyed employees used a platform to enroll in their benefits), only 15 percent used an online tool to learn about their options. The good news is that of those who sought information, 90 percent found that interactive digital experience to be helpful.
The question then is, how do we encourage employees to seek information about the benefits available to them?
In a previous blog post, we talked about the power of personalization. Employees want the ability to customize their benefits package to meet their needs. This can seem challenging if your enrollment experience is limited to a simple (or overly complex) menu of benefits, only accompanied by the ability to elect participate, or waive (some may include links to product information). From a data perspective, this can be a seamless HR experience—but is it a great experience for employees?
There are several ways to create a better employee experience and your UBA advisors and vendor partners can help.
When you are planning your next open enrollment, ask your benefits administration partner what, if any, benefits communication tools they may have. Some platforms have started to incorporate dynamic video and animated presentations that help personalize the enrollment experience. Highlight these tools to your employees as part of the pre-enrollment communication package.
Insurance providers and other vendors are also great resources. Insurers may have product calculators to help employees determine coverage amounts that make sense for them. They may also have videos as well as single sign-on links that provide employees additional information. The same types of tools may be available from other vendors, such as health savings account (HSA) administrators.
Consider one-to-one employee meetings with a benefits counselor. Eighty-six percent of surveyed employees said they want a clearer explanation of benefits choices, and 80 percent want one-on-one time. Remember, your employees learn differently, and many could benefit from having a personal conversation about their needs. In many cases, it is possible to work with a carrier, or vendor, that can actually conduct the meetings and enroll employees on the benefits administration platform. The one-on-one meetings help employees learn about options specific to their circumstances, and the on-site representative can help guide them on how to use the system. This can also be an opportunity to update employee information such as dependents, beneficiaries, and contact information. Successfully blending personalized benefits communication strategies with benefits administration technology can help increase employee engagement and streamline your processes.
By Kevin D. Seeker
Originally Posted By www.ubabenefits.com
In conversations with HR professionals and benefit brokers, we find that the topic of long-term care insurance (LTCi) is often covered in less than two minutes during renewal meetings. When I ask why the topic of conversation is so short, they tell me, “Employees just aren’t asking about it, so they must not be interested.”
If employees aren’t asking about LTCi, does it mean they aren’t interested? They just may be unaware of the value of LTCi and that it can be offered by their employer with concessions not available in the open market. Here are the top seven reasons why LTCi should be a bigger part of the employee benefits conversation.
Do you know LTCi can be offered as an employee benefit? There are multiple employer-sponsored products, including those with pricing discounts, guarantee issue, and payroll deduction.
Do you believe Medicaid and Medicare will provide long-term care for employees? This is a popular misconception. Medicare and Medicaid will restrict your employees’ choices of where and how they receive care. These options will either not offer custodial or home care, or they’ll force employees to spend down their assets for care.
Do you think LTCi is too expensive, or that your employee population is too young to need it? Many plans can be customized to meet personal budgets and potential care needs. It’s also important to know that rates are based on employees’ ages. The younger the employees are, the lower their rates will be.
Are you aware of the variety of LTCi plans? Many policies offer flexible coverage options. Depending on the policy an employer selects, LTCi can cover a wide range of care—in some cases even adult day care and home safety modifications.
Do you believe the market is unstable?
Today’s products are priced based on conservative assumptions, and employers are enrolling very stable LTCi plans for their employees. Each month, we see new plan options and products being introduced along with new carriers entering the market.
Do you already offer an LTCi plan but it’s closed to new hires? Being able to offer a similar LTCi benefit to all employees is crucial for most employers. Find a partner that can assist with the current LTCi plan and can assist with bringing in a new LTCi offering for new hires
Under Internal Revenue Code Section 105(h), a self-funded medical reimbursement plan must pass two nondiscrimination tests. Failure to pass either test means that the favorable tax treatment for highly compensated individuals who participate in the plan will be lost. The Section 105(h) rules only affect whether reimbursement (including payments to health care providers) under a self-funded plan is taxable.
When Section 105(h) was enacted, its nondiscrimination testing applied solely to self-funded plans. Under the Patient Protection and Affordable Care Act (ACA), Section 105(h) also applies to fully insured, non-grandfathered plans. However, in late 2010, the government delayed enforcement of Section 105(h) against fully insured, non-grandfathered plans until the first plan year beginning after regulations are issued. To date, no regulations have been issued so there is currently no penalty for noncompliance.
Practically speaking, if a plan treats all employees the same, then it is unlikely that the plan will fail Section 105(h) nondiscrimination testing. What Is a Self-Insured Medical Reimbursement Plan?
Section 105(h) applies to a “self-funded medical reimbursement plan,” which is an employer plan to reimburse employees for medical care expenses listed under Code Section 213(d) for which reimbursement is not provided under a policy of accident or health insurance.
Common self-funded medical reimbursement plans are self-funded major medical plans, health reimbursement arrangements (HRAs), and medical expense reimbursement plans (MERPs). Many employers who sponsor an insured plan may also have a self-funded plan; that self-funded plan is subject to the Section 105 non-discrimination rules. For example, many employers offer a fully insured major medical plan that is integrated with an HRA to reimburse expenses incurred before a participant meets the plan deductible. What If the Self-Insured Medical Reimbursement Plan Is Offered Under a Cafeteria Plan?
A self-funded medical reimbursement plan (self-funded plan) can be offered outside of a cafeteria plan or under a cafeteria plan. Section 105(h) nondiscrimination testing applies in both cases.
Regardless of grandfathered status, if the self-funded plan is offered under a cafeteria plan and allows employees to pay premiums on a pre-tax basis, then the plan is still subject to the Section 125 nondiscrimination rules. The cafeteria plan rules affect whether contributions are taxable; if contributions are taxable, then the Section 105(h) rules do not apply. What Is the Purpose of Nondiscrimination Testing?
Congress permits self-funded medical reimbursement plans to provide tax-free benefits. However, Congress wanted employers to provide these tax-free benefits to their regular employees, not just to their executives. Nondiscrimination testing is designed to encourage employers to provide benefits to their employees in a way that does not discriminate in favor of employees who are highly paid or high ranking.
If a plan fails the nondiscrimination testing, the regular employees will not lose the tax benefits of the self-funded medical reimbursement plan and the plan will not be invalidated. However, highly paid or high ranking employees may be adversely affected if the plan fails testing. What Are the Two Nondiscrimination Tests?
The two nondiscrimination tests are the Eligibility Test and Benefits Test.
The Eligibility Test answers the basic question of whether there are enough regular employees benefitting from the plan. Section 105(h) provides three ways of passing the Eligibility Test:
The 70% Test – 70 percent or more of all employees benefit under the plan.
The 70% / 80% Test – At least 70 percent of employees are eligible under the plan and at least 80 percent or more of those eligible employees participate in the plan.
The Nondiscriminatory Classification Test – Employees qualify for the plan under a classification set up by the employer that is found by the IRS not to be discriminatory in favor of highly compensated individuals.
The Benefits Test answers the basic question of whether all participants are eligible for the same benefits.
By Danielle Capilla
Originally Posted By www.ubabenefits.com
