by admin | Oct 11, 2022 | Employee Benefits, Open Enrollment
Choosing the right benefits during open-enrollment season is so important and can help save money. It can also give individuals and families broader support with their health. Benefits like medical coverage are particularly important with high inflation having such a big impact on people’s budgets.
A survey by UnitedHealthcare found that nearly 40% of employees devote less than one hour to the open enrollment process. It is crucial to carefully analyze your benefits during open enrollment as any decisions you make will likely be locked for the year until the next open enrollment period. Don’t rush into open enrollment without carefully considering your options!
Here are some tips to ensure you make the most of your open enrollment:
Be Prepared
Open enrollment typically lasts for a short period (2-4 weeks) so knowing what you need to do ahead of time can be a big stress reliever. A good starting point is to consider how your needs have changed since last year. For example, maybe you got married or received a raise. These changes may require a change in coverage, whether it be for life, health or disability insurance, and it is important to consider how these or any other expected life changes will impact your insurance needs.
Review Any Changes Made by Your Employer
It is common for employers make changes to plans and premiums to keep up with the times. When you receive your open enrollment packet to review plan options, it is important to consider all aspects of coverage and the total cost of coverage. The total cost is impacted by the deductibles, premiums, co-insurance and maximum out-of-pocket expenses.
Take note of whether your employer made any changes in providers. If this happens, your current physician or dentist may be out-of-network which will result in out-of-network costs or denied claims.
Review Your Insurance Options
The largest portion of employer benefits is health insurance so it is important to choose the plan that is best for you and your family. Important questions to ask are: how often do you have medical expenses? Are lower premiums or lower out-of-pocket costs more important to you? Do you take expensive prescription drugs? Can you afford hefty out-of-pocket costs if there is an emergency?
There are 3 main plan types:
- Preferred Provider Organization (PPO)
PPO’s are a popular choice since they allow you to see any doctor or specialist and don’t require a referral from your primary care physician (PCP) to see a specialist. However, PPO premiums are usually much more than other plans. To help reduce costs, remember that using in-network providers and specialists who are part of your PPO network will save you money.
- Health Maintenance Organization (HMO)
HMOs have lower premiums than PPOs but they require you to stay in-network. You will also need a referral from your PCP to see a specialist. The idea is that the PCP coordinates your care.
- High Deductible Health Plan (HDHP)
Another low-cost option is a high-deductible health plan. What sets HDHPs apart from other plans is their low premiums and high deductibles. That means you won’t have to pay as much each month for premiums but you will need to pay more of the healthcare costs when you need services. To help you pay for the bigger deductible, employers usually pair an HDHP with a health savings account (HSA), which allows you to save for medical expenses, including deductibles and copays.
Learn How FSAs, HRAs, and HSAs Differ
Many employers offer accounts that help you save for medical expenses:
- Flexible Spending Account (FSA)
You decide how much pre-tax money to put into the employer owned account through payroll deductions and then you can use that money to pay for out-of-pocket medical expenses. You lose that money if you change jobs or don’t use it by the end of the year.
- Health Savings Account (HSA)
Connected to a HDHP, an HSA lets you set aside money on a pre-tax basis to pay for qualified medical expenses. The account is yours, so you keep it if you change jobs. The money rolls over each year so you don’t have to worry about “using it or losing it.”
- Health Reimbursement Arrangement (HRA)
An HRA is similar to an HSA except that the employer owns the account so you can’t take it with you when you change jobs. You’re able to contribute money for medical expenses just like an HSA or FSA. Money can also be carried over to the next year like an HSA.
Open enrollment is an important time of year and is worth investing some time and energy to decide what is best for you and your family. Health insurance is one of the most important purchases you make. By doing your homework and taking the time to carefully consider your options, you’ll find the plan that is right for you!
by admin | Oct 5, 2022 | Health Insurance, Open Enrollment
For most employers, employee benefits represent a significant portion of their overall budget and a critical part of their employee recruitment and retention strategy. Benefits vary from employer to employer but can range from medical or dental insurance to flexible spending accounts, life and disability insurance, and more. The annual process of renewing those benefits involves a great deal of work, most of which is unseen by employees.
As you finalize your benefits lineup for the next year and hold your first open enrollment meeting, we’re sharing five tips related to common issues we hear from Mineral customers each year.
There are different ways to handle benefit elections. They range from affirmative or “active” elections that require everyone to select options, to evergreen “rolling” elections that only require employees to take action if they want to make changes. There are also many other options in between. Which option an employer chooses depends on their strategy for participation, the types of benefits they offer, state wage deduction rules, and other factors. Before you get started with benefits elections:
- Double check to confirm that any election rules you are using during open enrollment match what was discussed with your insurance carrier or third-party administrator (TPA), as well as matching what you say to employees in plan materials and open enrollment communications.
- Decide what happens if an employee who is enrolled in coverage takes no action during open enrollment. Will their coverage be dropped? Will some or all of their elections carry over to the next plan year? Clearly communicate the consequences of inaction, if any.
Don’t Forget About COBRA!
Federal COBRA applies to most employers that offer group health coverage and that have 20 or more employees. COBRA allows employees (and certain dependents) who experience qualifying events during the plan year to continue coverage for a period of time, at their own cost. Many states have similar laws for employers with fewer than 20 employees, often called “mini-COBRA” laws. Individuals who have elected federal COBRA have many of the same rights as active participants and must be provided the option to waive or elect coverage or add or remove dependents as well. To notify employees of their COBRA rights:
- Clarify who is responsible for sending open enrollment information to COBRA qualified beneficiaries. If you administer COBRA in-house, ensure the person responsible knows open enrollment communications should include COBRA qualified beneficiaries.
- If you are using a third-party vendor for COBRA administration, make sure they send any required communications or paperwork to eligible employees. If the vendor doesn’t do this, the responsibility generally falls on the plan sponsor (the employer).
Leverage Attention
The open enrollment period happens when employees are paying closer attention to benefit-related topics. Open enrollment meetings and communications can present additional opportunities to gather data and insight into the needs and experiences of participants in your benefit programs. Use this time to:
- Consider including an employee survey or otherwise collecting feedback, even anecdotally, on areas of interest or concern. This might include asking for feedback on the open enrollment process and communications. If you hear grumbling about a specific process or hear people express confusion about a particular option, that can be a great way to identify opportunities for education or change. For example, if several people mention in an open enrollment meeting that drug prices are too high, you might decide to send a follow-up communication to remind employees about bulk mail order prescriptions and the additional value that can provide.
- Consider a dependent audit. Dependent audits ensure only eligible individuals are on the plan, which keeps employers in compliance with their plans as written and reduces any unnecessary costs for ineligible dependents. Timing an audit to occur just before or during open enrollment can reduce compliance complications if a dependent is deemed ineligible.
Carefully Review Salary Deduction Agreements
Benefit costs typically change from year to year and most state wage and hour laws require employees to authorize payroll deductions for benefit contributions. Use this time to review your existing deduction agreements and ensure they cover the most current options. Then gather updated deduction agreements from employees. As you review these agreements, consider the following questions:
- Do they clearly indicate the approved amounts to be deducted from pay and the frequency?
- What rights do employees have to choose whether or not their cost share is taken pre-tax or after-tax? If you have a § 125 cafeteria plan in place, confirm the options available so your deduction agreements accurately reflect the choices available to employees.
- Do they address deductions from final pay (e.g., double deductions)? Caution: Cafeteria plan rules do not allow for double deductions from final pay in most cases, and state wage and hour laws can heavily restrict this as well.
Align Processes
Carefully review your electronic or online benefits enrollment systems to confirm the options and language align with the plan rules, and consider the following:
- If you use a universal enrollment form or electronic system, confirm they contain any insurance carrier or TPA required arbitration or enrollment language, so the election is considered valid.
- Put an audit process in place so that, after open enrollment, you can confirm the elections made by employees are transmitted to the carrier/TPA accurately and payroll entries are aligned.
- Provide employees with a confirmation statement that outlines their final election choices and deduction agreements. Also, consider reminding employees to confirm this statement against their first payroll of the new plan year to make sure it reflects their choices. Both steps can go a long way to catching mistakes early, when they are easiest to compliantly correct.
Planning ahead can result in a more effective, streamlined process for the employer and clarity for employees.
By Eeloria Brown
Originally posted on Mineral
by admin | Feb 1, 2022 | Health & Wellness
While the new year feels like a fresh start for most workers, it’s also expected to come with a spike in health insurance premiums. Premiums and deductibles have been steadily increasing for years. The Kaiser Family Foundation (KFF) found that premiums for a family rose 4% in 2021, according to a survey focused on employer-sponsored benefits.
The average family pays $22,221 in premiums, according to KFF. Workers contributed $5,969 toward their coverage, while employers paid the rest. In fact, since 2011 the average family premiums have increased 47%, which KFF found was more than wages (31%) and inflation (19%).
Not only is this a financial hardship for American families, but it’s also draining companies that are struggling to maintain employee coverage. To complicate the matter, several federal programs providing support for healthcare are due to expire in 2022.
What to Expect in Healthcare Coverage
Rising healthcare premiums are only part of the problem. Deductibles are also skyrocketing. This is the amount workers have to pay before insurance kicks in and could make a huge financial difference for families dealing with a serious health issue.
The average single deductible has doubled in the last decade to $1,669. For the more affordable healthcare plans, deductibles can be as high as $8,000. Overall, 85% of the 155 Americans with employer-sponsored coverage have a deductible.
Another survey conducted by the Business Group on Health anticipates healthcare costs increasing by as much as 6% in 2022. Analysts pointed out that 2021 rates actually flattened out slightly because many Americans avoided treatments during the pandemic. That’s expected to end in 2022, which will drive up prices. Of all employers surveyed by BGOH, 94% expected higher medical costs because of delays in treatment.
Expiring Federal Support Programs
Federal legislation is also expiring in January 2022. The Coronavirus Aid, Relief, and Economic Security (CARES) Act was one of the first bills signed in 2020 to help workers. It gave money to businesses, enhanced unemployment programs, and funded hospitals.
One provision known as “safe harbor” allowed high-deductible health plans to cover telehealth and remote care services at little to no cost. The CARES act expired on December 31 and will now impact who is eligible for telehealth services.
Another rule under the American Rescue Plan Act (ARPA) in 2021 allowed for mid-year election changes for Dependent Care Reimbursement Accounts (DCRA). This allowed workers to elect higher limits to help pay for childcare pre-tax. The ARPA also expires on December 31. If the new higher exclusion limit is not extended into 2022, families will have to contend with the previous $5,000 limit.
Around 30 million Americans get their health coverage from the Marketplace, which was established by the Affordable Care Act. With more enrollees and more available plans in 2022, experts anticipate a change in premium subsidies that could increase the total price people have to pay.
Navigating the Future
Regardless of what employers decide to do, HR departments need to be proactive in guiding employees through the process. Healthcare decisions are complex and no company wants disgruntled workers as a result of cutting or switching plans without notice. Clear communication and assistance are necessary to ensure a smooth transition that is beneficial for everyone.
Companies and HR departments should also keep in mind that the benefits they ultimately choose will define future recruiting. Healthcare benefits are a top decision-making factor for most prospects.
By Mckenzie Cassidy
Originally posted on HR Exchange Network
by ckistler | Nov 12, 2020 | Benefit Management, Open Enrollment
As the weather turns cooler and shopping centers get busier, it’s easy to surmise that it’s nearing the end of the year. Are we all ready for 2020 to be over?! Yes, please! Since we are closing in on 2021, it’s time for you to maximize your healthcare plan by taking advantage of end-of-year healthcare benefits.
HAVE YOU MET YOUR DEDUCTIBLE YET?
Before you continue reading, look over your insurance plan details and check your deductible amount. Then, check with your HR advisor and see where you are with your benefits per their records and the insurance company records to ensure you have all the information you need regarding these details. Now that you have all your ducks in a row, let’s look at some ways to make sure you are maximizing your healthcare benefits before year-end.
THINGS TO DO LIST
- Refill prescriptions—maybe get 90-day supplies so they last beyond the start of the new year
- Schedule lab work
- Schedule imaging
- Visit the dermatologist
- Visit the optometrist—get new glasses or contact lenses
- Schedule preventive screenings like:
- Endoscopy
- Colonoscopy
- Prostate cancer
- Lung cancer
- Schedule elective surgeries like:
- Hysterectomy
- Gallbladder
- Joint replacement
- Weight loss
- Thyroid
- Eye
- Back
- Go to physical therapy for an injury
- Visit your PCP for preventive care
- Visit the dentist
THINGS TO CONSIDER
Before you go whole-hog on scheduling these appointments, you need to consider some things first.
- Think about the additional costs associated with procedures like physical therapy post-surgery. You should calculate the cost of having the surgery this calendar year and starting PT after the new year begins and your deductible resets versus doing everything next year.
- Many dental plans have yearly maximums so it may be better to split up some dental procedures between this year and next.
- Make sure you stay in your network when you schedule these appointments or else your insurance coverage won’t be as robust as you thought.
- Use your FSA money before the end of the year because these funds are “use it or lose it.”
- The IRS does give you a grace period of 2 ½ months to spend your money
BONUS TIPS
As a couple bonus tips:
- Check your plan’s terms about coinsurance so you know if this will come into play even after meeting your deductible.
- Increase your HSA contributions to max out your account before the end of the year. The IRS, again, gives you some extra time in the following year to keep contributing to the prior year’s account. But, not maxing out your contribution amount means that you aren’t reaping the benefits of this tax-free money.
Making sure you are fully utilizing your healthcare plan at the end of the year is a smart move for every healthcare consumer. Begin crossing things off this “To Do List” today!
by admin | Nov 12, 2020 | Benefit Management, Open Enrollment
As the weather turns cooler and shopping centers get busier, it’s easy to surmise that it’s nearing the end of the year. Are we all ready for 2020 to be over?! Yes, please! Since we are closing in on 2021, it’s time for you to maximize your healthcare plan by taking advantage of end-of-year healthcare benefits.
HAVE YOU MET YOUR DEDUCTIBLE YET?
Before you continue reading, look over your insurance plan details and check your deductible amount. Then, check with your HR advisor and see where you are with your benefits per their records and the insurance company records to ensure you have all the information you need regarding these details. Now that you have all your ducks in a row, let’s look at some ways to make sure you are maximizing your healthcare benefits before year-end.
THINGS TO DO LIST
- Refill prescriptions—maybe get 90-day supplies so they last beyond the start of the new year
- Schedule lab work
- Schedule imaging
- Visit the dermatologist
- Visit the optometrist—get new glasses or contact lenses
- Schedule preventive screenings like:
- Endoscopy
- Colonoscopy
- Prostate cancer
- Lung cancer
- Schedule elective surgeries like:
- Hysterectomy
- Gallbladder
- Joint replacement
- Weight loss
- Thyroid
- Eye
- Back
- Go to physical therapy for an injury
- Visit your PCP for preventive care
- Visit the dentist
THINGS TO CONSIDER
Before you go whole-hog on scheduling these appointments, you need to consider some things first.
- Think about the additional costs associated with procedures like physical therapy post-surgery. You should calculate the cost of having the surgery this calendar year and starting PT after the new year begins and your deductible resets versus doing everything next year.
- Many dental plans have yearly maximums so it may be better to split up some dental procedures between this year and next.
- Make sure you stay in your network when you schedule these appointments or else your insurance coverage won’t be as robust as you thought.
- Use your FSA money before the end of the year because these funds are “use it or lose it.”
- The IRS does give you a grace period of 2 ½ months to spend your money
BONUS TIPS
As a couple bonus tips:
- Check your plan’s terms about coinsurance so you know if this will come into play even after meeting your deductible.
- Increase your HSA contributions to max out your account before the end of the year. The IRS, again, gives you some extra time in the following year to keep contributing to the prior year’s account. But, not maxing out your contribution amount means that you aren’t reaping the benefits of this tax-free money.
Making sure you are fully utilizing your healthcare plan at the end of the year is a smart move for every healthcare consumer. Begin crossing things off this “To Do List” today!
