Blog

Telemedicine | California Corporate Benefits

Telemedicine in ContextAs an employer, you are keenly aware that rising healthcare costs are increasingly chipping away at your bottom line — often forcing you to pass on the extra financial burdens onto your employees. This can result in lowered morale.There is an exciting new alternative, however, to this ever worsening predicament. Telemedicine, which harnesses the power of computers, t…

Oral Health = Overall Health | California Corporate Benefits

Have you heard the saying “the eyes are the window to your soul”? Well, did you know that your mouth is the window into what is going on with the rest of your body? Poor dental health contributes to major systemic health problems. Conversely, good dental hygiene can help improve your overall health.  As a bonus, maintaining good oral health can even REDUCE your healthcare costs!Researchers…

Understanding W-2 Reporting under the ACA | California Corporate Benefits

The ACA requires employers to report the cost of coverage under an employer-sponsored group health plan. Reporting the cost of health care coverage on Form W-2 does not mean that the coverage is taxable.Employers that provide “applicable employer-sponsored coverage” under a group health plan are subject to the reporting requirement. This includes businesses, tax-exempt organizations, and federal,…

2017 UBA Healthplan Survey | California Corporate Benefits

It was recently unveiled the latest findings from our 2017 Health Plan Survey. With data on 20,099 health plans sponsored by 11,221 employers, the UBA survey is nearly three times larger than the next two of the nation’s largest health plan benchmarking surveys combined.Here are the top trends at a glance!  …

Utilize FSA Monies with Key Year–End Strategies | California Corporate Benefits

‘Tis the Season’. Like most, you‘re probably in the midst of the “hustle and bustle” of this holiday season with dinners, parties, and activities; Christmas shopping; and spending those remaining FSA dollars you have allocated this year.  Wait, what? Yes, you read right. Chances are, if you’ve opted to utilize an employer-sponsored FSA account in 2017, you may have remaining funds…

The Perks of Holiday Parties: How They’re Still an Asset to Your Company | CA Benefit Advisors

The end of the year is upon us and a majority of companies celebrate with an end-of-year/holiday party.  Although the trend of holiday parties has diminished in recent years, it’s still a good idea to commemorate the year with an office perk like a fun, festive party. BENEFITS OF A YEAR-END CELEBRATIONHoliday staff parties are a perfect way to thank your employees for a great year. A…

Latest IRS ACA Round Up (Including 2018 Cost-of-Living Adjustments) | CA Benefit Advisors

Recently, the Internal Revenue Service (IRS) issued the instructions for Forms 1094/1095 for the 2017 tax year, announced PCORI fees for 2017-18, and announced cost-of-living adjustments for 2018. The IRS provided additional guidance on leave-based donation programs’ tax treatment and released an information letter on COBRA and Medicare. Here’s a recap of these actions for your reference.IRS…

How to Make the Most Out of Your FSA at Year-End | California Corporate Benefits

As 2017 comes to a close, it’s time to act on the money sitting in your Flexible Spending/Savings Account (FSA). Unlike a Health Savings Account or HSA, pre-taxed funds contributed to an FSA are lost at the end of the year if an employee doesn’t use them, and an employer doesn’t adopt a carryover policy.Losing money is upsetting, but it’s not necessary!  Here are 4 ways you can make t…

Why should you protect your identity? | California Benefit Advisors

On September 7th, the credit reporting agency Equifax reported that it was the victim of a massive cyberattack — one that resulted in the exposure of more than 143 million U.S customers.  Social Security numbers, birth dates, addresses and driver’s licenses were accessible, everything needed to wreck financial havoc.  Worse yet, although the breaches occurred between May and July, Equifax…

It’s Open Enrollment Time! | CA Benefit Advisors

Fall.  With it comes cooler temperatures’, falling leaves, warm seasonal scents like turkey and pumpkin pie, and Open Enrollment.  It goes without saying; employees who understand the effectiveness of their benefits are much more pleased with those packages, happier with their employers, and more engaged in their work. So, as your company gears up for a new year of navigating Open Enrollment,…

President Trump Ends ACA Cost Sharing Reductions | CA Benefit Advisors

On the evening of October 12, 2017, President Trump announced that cost sharing reductions for low income Americans in relation to the Patient Protection and Affordable Care Act (ACA) would be stopped. The Department of Health and Human Services (HHS) has confirmed that payments will be stopped immediately. While there is no direct impact to employers at this time, UBA will continue to educat…

October 2017 Executive Order on Healthcare | CA Corporate Benefits

On October 12, 2017, the White House released an Executive Order, signed by President Trump, titled “Promoting Healthcare Choice and Competition Across the United States.”It is important to note that the Executive Order (EO) does not implement any new laws or regulations, but instead directs various federal agencies to explore options relating to association health plans, short term…

Are you addressing your employee’s financial health? | CA Benefit Advisors

The importance of health and wellness in the workplace is more apparent than ever. It’s obvious why healthy individuals make better employees and the positive impact this has on your bottom line. When thinking about building a program to improve the well-being of your employees, don’t forget about the importance of their financial health.In recent years, studies show that employees have a…

IRS Releases Draft Forms and Instructions for 2017 ACA Reporting | CA Benefit Advisors

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.Reporting is required by employers with 50 or more full-time (or full-time equivalent) employees, insurers, or sponsors of self-funded health plans, on health coverage that is…

IRS Roundup: What Employers Need to Know about the Latest ACA Notices | CA Corporate Benefits

In spite of the recent efforts by Congress to change or repeal the ACA, its provisions are still in effect. The IRS has issued continuing guidance on the affordability rate for coverage, the employer shared responsibility provisions and reporting, and the individual mandate provision.IRS Released the 2018 Affordability RateThe Internal Revenue Service released its Revenue Procedure 2017-36, whic…

Court Remands Wellness Regulations to EEOC for Reconsideration | CA Benefit Advisors

On August 22, 2017, the United States District Court for the District of Columbia held that the U.S. Equal Employment Opportunity Commission (EEOC) failed to provide a reasoned explanation for its decision to adopt 30 percent incentive levels for employer-sponsored wellness programs under both the Americans with Disabilities Act (ADA) rules and Genetic Information Nondiscrimination Act (GINA)…

IRS Releases Drafts of 2017 Forms 1094 and 1095 | CA Benefit Advisors

The IRS has released drafts of the forms and instructions that employers will use for 2017 reporting under the Affordable Care Act (ACA). It is expected that when the IRS releases final versions, the material will be virtually identical to the drafts.Applicable large employers (ALEs) will use the following:Draft 2017 Form 1094-C (transmittal to IRS).Draft 2017 Form 1095-C (statement to…

Emergency vs. Urgent – What’s the Difference in Walk-In Care? | CA Benefit Advisors

We’ve all been there – once or twice (or more)—when a child, spouse or family member has had to gain access to healthcare quickly. Whether a fall that requires stitches; a sprained or broken bone; or something more serious, it can be difficult to identify which avenue to take when it comes to walk-in care. With the recent boom in stand-alone ERs  (Emergency Care Clinics or ECCs), as w…

What You Need to Know about Dependent Care Flexible Spending Accounts | CA Benefit Advisors

A dependent care flexible spending account (DCFSA) is a pre-tax benefit account used to pay for eligible dependent care services. The IRS determines which expenses are eligible for reimbursement and these expenses are defined by Internal Revenue Code §129 and the employer’s plan. Eligible DCFSA expenses include: adult day care center, before/after school programs, child care, nanny, preschool,…

Understanding EAP Confidentiality | CA Benefit Advisors

When it comes to Employee Assistance Programs, confidentiality is a concern for both employers and employees. As an employer, it is helpful to understand the terms and processes your EAP uses to keep information confidential and ensure that your employees and your workplace are safe.The Health Insurance Portability and Accountability Act (HIPAA) rules apply to EAPs and their affiliate providers.

Employer Medicare Part D Notices Are Due Before October 15 | CA Benefit Advisors

Are you an employer that offers or provides group health coverage to your workers? Does your health plan cover outpatient prescription drugs—either as a medical claim or through a card system? If so, be sure to distribute your plan’s Medicare Part D notice before October 15.Purpose Medicare began offering “Part D” plans—optional prescription drug benefit plans sold by private insuranc…

Small Businesses Healthcare Competitive, But Faces Two Big Challenges | CA Benefit Advisors

We recently revealed how competitive small business health plans are when compared to national averages—and even how they are doing a better job of containing costs. But the UBA Health Plan Survey also uncovers two challenges these groups face in its new special report: “Small Businesses Keeping Pace with Nationwide Health Trends”.Small businesses are passing nearly 6.6 percent more of t…

What You Need to Know about Health Flexible Spending Accounts | CA Benefit Advisors

A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket health care costs for a participant as well as a participant’s spouse and eligible dependents. Health FSAs are employer-established benefit plans and may be offered with other employer-provided benefits as part of a cafeteria plan. Self-employed individuals are not eligible for FSAs.Even though a healt…

How to Be a Magnetic Organization | CA Benefit Advisors

When we hear something’s magnetic, it’s likely the first thought that comes to mind is attraction. By definition, a magnetic force is the attraction or repulsion that arises between electrically charged particles because of their motion. What perfect framing for an organization – the desire to attract (or repel) people to help advance your organization. With this framing comes t…

Survey: Small Businesses Keeping Pace with Health Benefits Offered by Employers Nationwide | CA Benefit Advisors

Small employers, those with fewer than 100 employees, have a reputation for not offering health insurance benefits that are competitive with larger employers, but new survey data from UBA’s Health Plan Survey reveals they are keeping pace with the average employer and, in fact, doing a better job of containing costs.According to our new special report: “Small Businesses Keeping Pace wit…

The COBRA Payment Process | California Corporate Benefits

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.Grace PeriodsThe initial premium payment is due 45…

The Affordable Care Act Rate Reforms and what can small employers do about it

Background:

One purpose of enacting the Affordable Care Act (ACA) was to increase access to health insurance.  It does so by guaranteeing every U.S. citizen the ability to purchase the health plan of their choosing with no pre-existing conditions provisions.  Although this provision enjoyed broad support, it comes at a high cost and it was never clear to most people who would pay for it and…

U.S. Supreme Court Upholds ACA Subsidy Eligibility on Federal Exchanges

The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA). The six-to-three opinion was authored by Chief Justice John Roberts, who was joined by Justices…

All About the Cadillac Tax

The Cadillac Tax is a new annual tax beginning in 2018.  It is imposed on employers that provide high-cost employer-sponsored group health plans.  It is expected to generate $80 billion over 10 years to help finance the expansion of health coverage under the Affordable Care Act (ACA).

The following Q&A format will help you understand what is known about the tax.  The IRS is presently…

IRS Issues Drafts of Instructions for Employer and Individual Responsibility Reporting Forms

The Internal Revenue Service (IRS) must verify whether or not individuals have purchased and paid for required minimum essential coverage, whether or not individuals who request premium tax credits are entitled to them, and whether or not large employers are meeting their shared responsibility (play or pay) obligations.  In order for the IRS to do this job, employers and insurers are required to…

IRS Issues Drafts of Individual and Employer Responsibility Reporting Forms

The IRS must verify that individuals and employers are meeting their shared responsibility obligations under the ACA and that individuals who request premium tax credits are entitled to them.  Employers and insurers must report on the health coverage they offer. The first reporting will be due early in 2016, based on coverage in effect in 2015.

On July 24, 2014, the IRS published drafts of…

Counting Variable Hour Employees in California

Employers all across America are preparing for the new “Play or Pay” rules coming next year.  Under these rules, employers must count their employees, first to determine if the Play or Pay rules apply to them, and second, to know which employees might be subject to a penalty if they are not eligible for medical benefits.

Assuming an employer has at least 50 employees, the employer must…

Medical Loss Ratio Rebates Update

As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders.  The MLR threshold for large groups is 85%, and the threshold for small group and individual policies is 80%.  The MLR ratio is based on the insurer’s block of business in the state, and not on the specific policy’s claims…

Grandfathered Health Plans

It’s time to revisit Grandfathered Health Plans.  Few Grandfathered Health Plans remain but for employers who have them it’s time to decide again whether Grandfathered status is the best option.  To help, we will answer many of the important questions in a Q&A format.

Q1: May plans maintain grandfathered status after 2014?

A1:  Yes, they may. There is no specific end date for…

COBRA Under Health Reform

COBRA has changed.  Regulators recently issued guidance that affect both an employer’s COBRA obligations and COBRA beneficiaries’ opportunities.

New Special Enrollment for COBRA Beneficiaries

Under the Exchange (Marketplace) special enrollment rules, a person who has a COBRA qualifying event may enroll in an Exchange policy as a special enrollee when the person first becomes eligib…

Defined Contribution – The Benefits and Limitations

What is defined contribution and how does it work?

With defined contribution, employers determine a fixed dollar amount that the firm will contribute toward a menu of employee benefits.  Usually, the plan is coupled with a Section 125 Plan.  This allows employees to pay their share of premiums pre-tax and to receive unused employer contribution amounts in cash.  The employer knows its cost…

New Out-of-Pocket Maximum Rules Explained

The Out-of-Pocket maximum plan feature is meant to limit a participant’s exposure to high expenses that are not covered by the plan.  Beginning with the 2014 plan year, plans may not have an out-of-pocket maximum greater than $6,350 for single coverage and $12,700 for family coverage.  In addition, the out-of-pocket maximum must now include copays, coinsurance, prescription coverage and any…

Summary of Eligibility Waiting Period Requirements

On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements.  The Patient Protection and Affordable Care Act (PPACA) provides that plans may not require an employee who is eligible for coverage to complete a waiting period of more than 90…

New Survey To Provide Essential Benchmarks For Employers Coping With Health Care Reform Compliance And Cost Management Decisions

Employers Who Complete the Survey by March 4, 2014 Receive an Exclusive Complimentary Report

Indianapolis, Indiana – [February 18, 2014] – United Benefit Advisors (UBA), the nation’s leading independent employee benefits organization, today announced the opening of the 2014 UBA Benefit Opinions Survey. The survey results compile information from employers representing all major industry…

Businesses Still Unprepared for “Play or Pay”

Who Should Evaluate the Ensuing Financial, Legal, and Competitive Implications Facing Business of the Patient Protection and Affordable Care Act (ACA)

With every day that passes, the nation’s employers move a step closer to having to make decisions about whether or not they will “play or pay” with regard to the ACA.  Although results from United Benefit Advisor’s 2013 Health Plan…

Regulatory Agencies Propose Expansion of “Excepted Benefits”

By Linda Rowings
Chief Compliance Officer
United Benefit Advisors

Group health plans must meet many requirements under the Patient Protection and Affordable Care Act (PPACA), the Health Insurance Portability and Accountability Act (HIPAA), the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code, etc.  The regulatory agencies have long recognized that it doesn’t mak…

Evaluating Private Exchanges

Private Exchanges are here to stay and likely will increase in importance.  There are many new private exchanges cropping up and some have the potential to provide more choice and administrative simplicity.  There may also be improved financial control, budgetary certainty, cost reduction and risk reduction.  However, not all private exchanges deliver on their claims and there are risks. …

Insurers Given Permission to Renew Policies That Don’t Meet PPACA Requirements

On Nov. 14, 2013 the White House announced that insurers will not be required to meet most of the provisions of the Patient Protection and Affordable Care Act (PPACA) if they renew individual or small group policies that were in effect on Oct. 1, 2013.  The Department of Health and Human Services (HHS) concurrently sent a Letter to all Insurance Commissioners that provides additional details on…

United Benefit Advisors Launches Private Exchange Marketplace for Large Group Employers

Indianapolis, Ind., [Oct. 31, 2013] – United Benefit Advisors® (UBA), the nation’s leading independent employee benefits advisory organization, today announces the launch of Benefits Passport, a private insurance exchange marketplace exclusive to UBA Partner Firms. Based on a defined contribution model, Benefits Passport will serve large group employers (more than 50 employees) and provide a…

Explaining Health Care Reform to Your Employees

It is finally here. The Patient Protection and Affordable Care Act (PPACA) in all its complication is really happening. 

The latest tracking polls from the Kaiser Family Foundation (source: http://kff.org/health-reform/) indicate that the public’s top two questions about health care reform are:

How much will the law cost me and how is it paid for?
What does the law do and how does it…

IRS Liberalizes the Health Flexible Spending Account

On Oct. 30, 2013, the Internal Revenue Service issued a notice that liberalizes the “use it or lose it” rule that applies to health flexible spending accounts (HFSAs) and clarifies that employers of all sizes may choose to amend their Section 125 plan to essentially treat the availability of the health marketplaces/ exchanges as a one-time change in status event.

Use It or Lose It

Under…

How Health Benefits Differ Across the Country

By Thomas Mangan
CEO, United Benefit Advisors 

Paul, who owns a mid-size design firm in Atlanta, Ga., wanted to recruit some new talent and had some questions about how best to highlight the health benefits his firm could offer. In his research, he looked up national averages for single employee health plan cost: the amount the employee contributed to monthly premiums.

When compared…

Boiling Down the Affordable Care Act

We’ve had a lot of employers request a simple, at-a-glance way to see all the PPACA requirements that apply to their business.  This is no easy task since requirements vary by group size, markets, such as private markets or SHOP exchanges and self-funding variables! Let’s just look at a few provisions that are effective for the plan year beginning on or after 1/1/2014:

Here’s what…

Early Renewal – Keeping it Legal

Beginning January 1, 2014 the ACA (Healthcare Reform) will dramatically change the types of small group health insurance plans offered and how their premiums are calculated.  Some employers may, as a result, face breathtaking increases in both rates and complexity in 2014 compared with their present plans.  In particular, employers in the following situations will face the greatest negativ…

Health Reform – What You Must Know About MLR Rebates

MLR REBATE CONSIDERATIONS – PRIVATE PLANS
As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders.  Insurers must pay rebates owed on calendar year 2012 experience by Aug. 1, 2013. The rules for calculating and distributing these rebates are largely the same this year as they wer…

Why You Should Voluntarily Comply with the “Play or Pay” Reporting Rules in 2014

Posted by Bob Recchia:

Employers should make good-faith efforts to voluntarily report their affordable minimum value coverage in 2014 even though it is not required.  Voluntary reporting will reduce an employer’s adverse-selection risk from the Marketplaces, lowering costs in future years.  Also, efforts will help employees from being exposed to significant penalties for inappropriately…

Five Things You Should Know About the Employer Mandate Delay

Posted by Bob Recchia:

On July 2, 2013 the Department of the Treasury and the White House used their blogs to announce that the employer reporting requirements, and the employer shared responsibility/play or pay penalty, are being delayed until 2015.  The Treasury said that it will provide a formal announcement and additional details next week. In the meantime, UBA’s experts are preparing to…

Copyright ©2013. All Rights Reserved.