Benefits Communication

Help employees choose the right benefits to manage health care costs in retirement

High health care costs during working years and in retirement can easily derail a financial plan. Employees need a long-term strategy. Fortunately, more and more employers are bolstering their benefits programs to help their employees build a stable financial future.

Increasingly, employers are offering products such as voluntary insurance benefits and health savings accounts (HSAs) that employees can combine to create comprehensive plans that meet their unique needs and goals. With the right plan in place, employees are better able to save consistently, cover unexpected expenses, protect and grow their savings and prepare for health care costs later in life.

The trend toward prioritizing employee wellness is only expected to grow. In a 2018 report by Willis Towers Watson, 92 percent of employers said voluntary benefits and services “will be at the forefront of their strategic thinking and important to their employee value proposition over the next three to five years.” That’s up from just 59 percent in 2013.

Here are four strategies employers can consider as they help employees navigate the benefits and planning landscape for the long term:

1. Encourage employees to look ahead, not just live in the moment

Many people, particularly younger employees, tend to focus on the present. They may not understand that an accident or injury can bring unexpected out-of-pocket costs, from lost wages to high deductibles to paying for help with their daily tasks as they heal. Further, they probably don’t have all the facts about the health care costs they are likely to face in retirement. The percentage of household budgets spent on health expenses is nearly three times as high for retirees on Medicare as it is for working households, rising to 14 percent from 5 percent, according to a Kaiser Family Foundation study.

Even before they get to retirement, more than 25 percent of people have withdrawn money meant for retirement, according to PWC’s 2018 Employee Financial Wellness Survey. More than four out of 10 people believe they’ll need an early withdrawal at some point, with 31 percent of boomers and 30 percent of millennials saying they anticipate needing the money to pay medical bills. That percentage drops somewhat—to 21 percent—for Gen Xers.

The point to emphasize is that the most dependable short- and long-term strategy for employees is to have a plan that covers all the bases with voluntary benefits and a tax-advantaged HSA, as well as a retirement savings plan

2. From saving to spending: The lifetime benefits of HSAs

The HSAs that go along with high-deductible health care plans were designed to offer maximum tax benefits. The money goes into employees’ accounts pre-tax, meaning there’s less of an impact on net pay and FICA withholding is lower. Once in the account, the money grows tax-free and can be withdrawn tax-free to cover qualified medical expenses, even for covering deductibles. Non-qualified expenses currently incur a 20 percent tax penalty.

After age 65 or when a person is Medicare-eligible, withdrawals for nonmedical expenses are no longer subject to the 20 percent penalty, although they are subject to income taxes.

What’s more, HSAs aren’t subject to “use-it-or-lose-it” like a flexible savings accounts where the employee has to spend their contributions by year-end. The money in your HSA can roll over year-to-year and continue to earn until you’re ready to use it.

3. Explain how voluntary benefits fill the “coverage gap” at every life stage

Employers should make sure their health insurance plan descriptions make it loud and clear that they won’t cover every expense that results from an illness or injury. Many people are shocked to learn of out-of-pocket expenses they never considered. A range of products, such as accident, critical illness/specified disease and hospital confinement indemnity insurances, are designed to help fill the “gaps.”

Be sure employees understand these voluntary benefits are flexible and can be used for more than out-of-pocket medical expenses, like for mortgage or rent, utility payments, travel, meal prep, dog walking, child care and any other needs that arise. By covering some of the daily living expenses, these benefits also help mitigate stress so employees can focus on getting well and returning to work, a win-win for employees and their employers.

Employers should work with their providers to demonstrate the relevance of voluntary benefits. The idea is to help employees consider their individual needs and the needs of their family.

Segmenting employees by career or life stage can be useful. Here are a few examples.

Protecting “adulting” independence

A person who is “adulting”—getting settled in a career or an apartment—may have financial limitations, from an entry-level salary to student loans. If they are injured in an accident or develop a serious illness, they can quickly be overwhelmed financially. They may not have saved enough to meet a big deductible or continue paying rent if they miss work.

While any of the voluntary benefits would be helpful, young adults might want to consider accident insurance and look for coverage that pays an additional benefit if they’re injured playing in a friendly pick-up game or an organized sport, like sliding into home during the company softball league championship.

“Balancing” between two worlds

For those in the “balancing” stage of life, between “adulting” and “planning” for retirement, family may be their biggest priority. They need to protect themselves, their spouse and children, and maybe even an aging parent. Whether they are a “weekend warrior” family or one with a history of diseases with a genetic component, there’s a lot to protect against. Employees at this stage might want to consider accident, critical illness or specified disease benefits. Any serious injury or illness puts the whole family under significant financial strain.

“Planning” for what comes next

Employees in the “planning” stage are often more receptive to voluntary benefits than their younger colleagues. They have likely seen family and friends struggle with the costs of a serious illness. They are also acutely aware they have less time to save for retirement and less time to make up for unexpected costs or premature withdrawals from their retirement accounts. Appropriate benefits might include critical illness/specified disease, hospital confinement indemnity and accident insurances, and, depending on the plan, might even cover the entire family.

In all of these cases, having to interrupt saving or dip into a retirement savings account could undermine the ability to meet the high cost of health care in retirement. Balances will be smaller, there will be less of an opportunity for the money to grow, and one emergency could be followed by another, making it more difficult to catch up.

4. The power is in the combination

Employers are making it a top priority to help their employees be more financially resilient now and future ready. To help employees protect themselves and their families, employers need to stress that the best strategy is to not just rely on one savings or financial protection option, but to have a financial plan with the right combination of voluntary benefits in conjunction with an HSA.

With many of the tools employees need at their fingertips at work, it’s easier than ever to include the tools to enroll in and manage their HSA and benefits plans through the workplace. Employees can be confident their employer has the information to research and choose the best products at favorable rates. Employees benefit further from employer contributions to retirement plans, and investment options for HSAs.

An unexpected illness and injury can impact the present and the future, particularly when it comes to saving for retirement and amassing the resources to pay for high health care costs during working years and in retirement. Good employers help their employees stay financially fit while they’re working and give them the tools to prepare for retirement and its high health care costs.

by Rob Grubka
Originally posted on BenefitsPro.com

CMS Disclosure Requirement for Employer Health Plans

Do you offer health coverage to your employees? Does your group health plan cover outpatient prescription drugs? If so, federal law requires you to complete an online disclosure form every year with information about your plan’s drug coverage. You have 60 days from the start of your health plan year to complete the form. For instance, for a calendar-year health plan, this year’s deadline is March 1, 2019.

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Background

The Centers for Medicare and Medicaid Services (CMS) is a federal agency that collects data and administers various federal programs. The agency utilizes the CMS online tool to collect information from employers about whether their group health plan’s prescription drug coverage is creditable or noncreditable. Creditable coverage means the group health plan’s prescription drug coverage is actuarially equivalent to Medicare’s Part D drug plans. In other words, the group plan is considered creditable if its drug benefits are as good as or better than Medicare’s benefits.

To confirm whether your plan provides creditable or noncreditable coverage, check with the plan’s carrier or HMO (if insured) or the plan’s actuary (if self-funded). CMS provides guidance to help plan sponsors, carriers, and actuaries determine the plan’s status.

Deadline for Disclosure

All group health plans that include any outpatient prescription drug benefits, regardless of whether the plan is insured, self-funded, grandfathered, or nongrandfathered, must complete the CMS disclosure requirement. There is no exception for small employers.

Complete the CMS online disclosure form every year within 60 days of the start of the plan year. For instance, for calendar-year plans, this year’s deadline is March 1, 2019.

Additionally, if your plan terminates or its status changes between creditable and noncreditable coverage, you must disclose the updated information to CMS within 30 days of the change.

Completing the Disclosure Form

The CMS online tool is the only method allowed for completing the required disclosure. From this link, follow the prompts to respond to a series of questions regarding the plan. The link is the same regardless of whether the employer’s plan provides creditable or noncreditable coverage.

The entire process usually takes only 5 or 10 minutes to complete. To save time, have the following information handy before you start filling in the form:

  • Information about the plan sponsor (employer): Name, address, phone number, and federal Employer Identification Number (EIN).

  • Number of prescription drug options offered (e.g., if employer offers two plan options with different benefit levels, the number is “2”).

  • Creditable/Noncreditable Offer: Indicate whether all options are creditable or noncreditable or whether some are creditable and others are noncreditable.

  • Plan year beginning and ending dates.

  • Estimated number of plan participants eligible for Medicare (and how many are participants in the employer’s retiree health plan, if any).

  • Date that the plan’s Notice of Creditable (or Noncreditable) Coverage was provided to participants.

  • Name, title, and email address of the employer’s authorized individual completing the disclosure.

We suggest you print a copy of the completed disclosure to keep for your records.

Note: Employers that receive the Retiree Drug Subsidy (RDS), or sponsor health plans that contract directly with one or more Medicare Part D plans, should seek the advice of legal counsel regarding the applicable disclosure requirements.

Additional Disclosure Requirement

Separate from the CMS online disclosure requirement, employers also must distribute a disclosure notice to Medicare-eligible group health plan participants. The deadline for distributing the participant notice is October 14 of the preceding year. It often is difficult for employers to identify which employees and spouses may be Medicare-eligible, so most employers simply distribute the notice to all participants regardless of age or status.

Click here to download more information.

This post originally appreared on ThinkHR.com.

Cybersecurity: Employees Are the First Line of Defense

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Cybercriminals are becoming more focused on users of company networks as a weak link in the security infrastructure chain. Secure web gateways, anti-virus tools, malware scanners, spam quarantines, and other technologies help filter out malicious content and defend against a growing variety of threats, but technology alone cannot stop humans from clicking on the wrong links.

Gone are the days when cybersecurity was the sole responsibility of the corporate IT department. Cyber safety programs are a best human resources practice and should be included in new employee onboarding and ongoing training awareness programs. HR might even consider incentive plans for helping keep networks safe.

Why? Employees are vulnerable to malware through their use of company email, the web, social media, instant messaging, and other communication and network software. Employees must be able to spot the types of attacks that may compromise company networks and be ready to use best practices against data breaches and malware infiltration as part of the organization’s overall risk prevention program.

How Pervasive is the Threat?

According to Michael Osterman of Osterman Research, Inc., there is more than a one-in-four chance that a user will mistakenly click on a phishing email and infect a corporate network. Costs to affected companies are steep. A recent example is the city of Atlanta, where a single ransomware infection cost the city more than $2.6 million. Trend Micro predicts worldwide losses from business email compromise (BEC) attacks at more than $9 billion in 2018.

Osterman Research conducted a study of organizations that had been victims of security incidents between March 2017 and March 2018 and found:

  • 9% were victims of phishing attacks that successfully infected systems with malware.

  • 25% had targeted email attacks launched from a compromised account that infected a network endpoint with malware.

  • 25% had sensitive/confidential information accidentally leaked through email.

  • 1% suffered targeted email attacks launched from a compromised account that successfully stole a user’s account credentials.

  • 1% had files encrypted because of a successful ransomware attack.

  • 2% saw malware infiltrate internal systems without being able to pinpoint the source of attack.

  • 2% had one or more systems successfully infiltrated through a “drive-by” malware attack from employee web surfing.

  • 3% had a CEO fraud/BEC email attack that successfully tricked one or more employees in the organization.

  • 7% had sensitive/confidential information accidentally or maliciously leaked through a cloud-based file sharing tool like Dropbox.

  • 8% were victims of sensitive/confidential information accidentally or maliciously leaked through a social media or cloud application.

One reason we are seeing increased vulnerability to cyberattacks stems from a growing attack “surface,” or possible entry points for malware and other malicious attacks. Most employees use multiple company-provided hardware and software products that widen that attack surface. These represent ingress points for various types of threats and often are a more serious problem because their use is not as well controlled by IT, if they’re controlled at all.

Cyberthreats Aimed at Employees

What types of threats should your employees be trained to spot so that they think before they click? Here are the most common ones:

Phishing emails. These are relatively unfocused email messages designed to collect sensitive information, such as login credentials, credit card information, Social Security numbers, and other valuable data. Phishing emails pretend to come from trustworthy sources like banks, credit card companies, shippers, and other sources with which potential victims have established relationships. More sophisticated phishing attempts use corporate logos and other identifiers to fool potential victims into believing the emails are genuine.

Spearphishing emails. These are targeted phishing attacks typically focused on one company or affinity group (such as an industry organization), reflecting the fact that a cybercriminal has studied the target and crafted a message designed to have a high degree of believability and a potentially high open rate.

Consumer file sync and share tools. Productivity tools like Dropbox, Microsoft OneDrive, and Google Drive, which let users make files available on all desktop, laptop, and mobile platforms, generally are safe but can be targeted by sophisticated criminals as an entry point. For example, when an employee accesses corporate files on a home computer that doesn’t have current anti-virus software, the employee can inadvertently infect these files with malware. When files are synced back to the employee’s work computer, malware can infect the network because it may have bypassed corporate email, web gateway, and other defenses.

Watering holes. In these social engineering attacks, cybercriminals identify websites they would like to infiltrate and that employees might visit on a regular basis. They infect these sites with malware.

Malicious Internet advertising (malvertising). This is designed to distribute malware through advertising impressions on websites.

User errors. Users sometimes inadvertently install malware or compromised code on their computers. This can occur if they install ActiveX controls, download a codec, install various applications intended to address some perceived need (such as a capability that IT does not support), or respond to scareware attempts that prey on users who are trying to protect their platforms from viruses and other malware.

Mobile malware. The growing use of smartphones and tablets is increasingly being exploited by cybercriminals. Most infections impact Android devices.

Compromised search engine queries. Valid queries can be hijacked by cybercriminals to distribute malware when employees perform web searches. This type of attack relies on poisoning results, leading to the display of malware-laden sites during these searches. This is particularly effective for popular search terms, such as information on celebrities, airline crashes, natural disasters, and other “newsy” items.

Mobile copycat apps. Some mobile applications are distributed through vendor-based and third-party stores that offer varying levels of security. If the store lacks stringent standards, serious security risks like distribution of copycat apps and malware that can cause infections when downloaded can occur.

Botnets. These are the source of many successful hacking and phishing attacks against high-profile targets. A CenturyLink Threat Research Labs study for a 2018 threat report tracked an average of 195,000 threats per day from botnets impacting an average of 104 million unique targets, from large servers to handheld devices, that steal sensitive data and launch network attacks impacting businesses worldwide.

Ransomware. In this particularly malicious form of attack, a cybercriminal can encrypt all files on a hard disk and then demand ransom for access to a decryption key. Victims who choose not to pay the ransom quickly will have their files remain encrypted permanently. Cryptolocker, a common variant of ransomware, typically extorts a few hundred dollars per incident and normally is delivered through email with a PDF or .zip file disguised as a shipping invoice or some other business document.

Hacking. With this form of cyberattack, cybercriminals use many techniques to breach corporate defenses.

Think Before You Click

Train employees to become the first line of defense in the network security risk prevention infrastructure. First, remind them to physically protect devices by not leaving them unattended or in unsecure areas, including locked cars. Focus training on identifying the types of malware they may encounter and how to escalate attempts to the IT professionals for resolution. Use a catchy slogan, like “think before you click,” to create engagement and promote awareness.

Here are some simple training tips:

  • Be skeptical of any email, web page, or social media post that appears to be even remotely suspicious, makes an offer that is too good to be true, or contains strange information.

  • Ask questions. Michael Osterman recommends asking these questions when viewing emails:

    • Do you recognize the sender’s email address?

    • Do you recognize anyone else copied on the email?

    • Are others in the email seemingly from a random group of people or do their last names all begin with the same letter?

    • Is the domain in the email address spelled correctly or is it simply close to the actual URL (e.g., bankofamerica.com vs. bankofarnerica.com).

    • Would you normally receive an email from this individual or organization?

    • Does the subject line make sense?

    • Is the email a “response” to an email you never sent (e.g., does it begin with “re:”)?

    • Does the email contain an attachment that does not make sense in the context of the email or sender?

    • Does the attachment end in “.exe,” “.zip,” or some other possibly dangerous attachment type?

    • Did you receive an email at an unusual time, such as 3 a.m. on a Sunday?

    • Is the sender asking you to keep the contents of this email or requests within it a secret?

    • Does the email contain spelling or grammatical errors?

    • Is there even a hint of extortion in the email, such as a request to look at compromising or embarrassing photos of you or someone else?

  • Review quarantined messages carefully before bringing them out of quarantine. Most anti-spam solutions capture phishing emails correctly.

  • Don’t click on a link in an email or open an attachment until you are certain it is valid.

  • Never use USB flash drives from unknown sources.

  • Set strong passwords. Change passwords regularly.

  • Use password protection on every electronic and mobile device.

  • Intentionally use wrong information for security questions.

  • Keep security software up to date on personal devices.

  • For mobile devices:

    • Disable auto usernames and passwords. This reduces the risk of having personal data accessed if the device is lost or stolen.

    • Know how to wipe your data if your device is lost or stolen.

    • Be careful when using public Wi-Fi networks, especially with insecure networks that do not require a password.

    • Use safe stores for downloading mobile applications.

  • For social media:

    • Don’t overshare personal information on social media.

    • Turn off location services.

    • Be careful clicking on links, liking, and sharing them.

Cyber Risk Prevention is Everyone’s Job

Don’t put it off — take the time to implement or enhance security awareness training for employees, contractors, and others who interact with corporate systems and data sources. Create a stronger line of defense against increasingly sophisticated cyber threats now. Preventing even one employee from making an honest mistake and clicking on the wrong link could save the business from reputational and financial losses. Clients will appreciate having the information to protect their home computers and personal devices, too!

This article was originally posted on ThinkHR.com.

8 Tips for Handling Tough Employee Conversations | North Carolina Employee Benefits

We all get cold feet when it comes to addressing difficult issues with colleagues in the workplace. It’s stressful, and you just can’t help but think of all of the ways that a well-meaning conversation could go sideways. You worry about the longer-lasting effects of a damaged work relationship but know that you must correct problematic work performance or behaviors before they get out of control.

Uncomfortable conversations about personal behaviors and poor performance are tough, and putting them off just allows the problems to worsen. Use your knowledge of the situation and put together the right combination of management skills to tackle the talk now.

Imagine these all-too-familiar employee situations that you know you need to address but don’t think you have the wisdom (or can’t muster up the courage) to handle:

  • The “No Good Deed Goes Unpunished” situation. For the past several months, one of your team members has been underperforming, and it has dragged down your business unit’s productivity. The underperforming employee has shared that she has a number of family and financial issues and is trying her hardest to stay ocused on work because she needs this job and loves the company. She lives your company values and is well-liked by her co-workers. Everyone feels bad for her situation and has been picking up the slack, but they are growing resentful of the extra work with no end in sight. You’ve been trying to be kind by avoiding the issues as her performance has slid from bad to worse. It is now impacting your company’s overall performance and degrading the employee relations climate.

  • The “Bad Behavior, Great Performer” situation. One of your employees consistently exceeds his production goals at the expense of the company culture. He is highly critical of others, issues demands from other work teams without regard for their other priorities, and employees grudgingly drop everything to deliver on impossible deadlines because they believe that they cannot push back. It’s all about him and his performance. He is regularly recognized by the company leadership for being the top producer, and employee complaints to management about his behavior have not been addressed. While production goals are good, your company culture is sinking and you’re starting to see increased absenteeism and turnover among your staff.

Don’t Overlook the Signals

In addition to employee resentment and lost productivity, there’s a bottom-line impact for not tackling these tough talks at the right time and in the right manner. The key is to pay attention to the signals and not feed the problem with neglect.

In the first scenario, trying to be a kind and sensitive boss worked in the beginning but is now backfiring. At first the team worked together to help their struggling colleague, but without a plan to fix the problem in the longer term, it created three serious issues for you to fix: employee morale, lack of confidence in your leadership for missing the signals of “team fatigue,” and not having a plan to keep the team on track — all resulting in lost productivity.

The best thing you can do in situations like these is to work with the struggling employee to develop a plan that puts her back on track or helps her consider alternatives if necessary. This type of conversation requires sensitivity along with some firmness because you need to steer the conversation from the personal issues back to actionable work deliverables.

In my experience dealing with circumstances like the second scenario, typically management allows the top performer’s behavior to go unchecked for fear that if the employee is corrected his performance will suffer or he will quit the company. While there may be an element of truth to those concerns if the individual is unwilling to accept constructive feedback, the bigger fear should be for the company’s culture, employee erosion of trust and confidence in the leadership team, and the motivation, performance, and retention of the other company employees if the behavior is not changed.

Often the top performer continues to use the same work patterns that have been successful and isn’t even aware of the impact on others. Addressing the issues sensitively so that he can make personal changes has the potential to create even higher levels of team unity and performance.

What Signals are You Looking For?

For starters, watch your team’s interactions with each other, be sure that each team member understands their key performance objectives, and take the time to “check in” regularly and solicit feedback about the job, work team, and overall company with each employee.

Having direct conversations on a regular basis helps you nip problems in the bud and shows your employees that you care about their concerns. You also learn each other’s communication patterns so that when it comes time to have that awkward or difficult conversation, you both are less uncomfortable.

Groups where team members work remotely increase the chances that signals can be missed. When telecommuting is coupled with the use of instant messaging and other forms of communications in place of direct face-to-face or voice communications, the sender’s well-intentioned messages may get lost in translation. Be sure to follow up any electronic communications with a direct phone call or meeting.

Eight Tips for Tackling These Conversations

Strategies to manage conflicts with subordinates are not fully taught in business classes. More common are courses addressing project conflicts, where the focus is on fixing the “what” of the problem, such as resetting priorities, changing business plans, or repairing broken systems or processes. There are fewer tools focusing on how teams communicate and repairing broken business relationships. Preparation and planning are critical to get what you need from these hard conversations while keeping your relationship with the employee intact.

  1. Focus your own viewpoint first. If you start out thinking the conversation will be really hard, you’re going to be more anxious. Chances are the conversation will be harder. Instead, position this discussion as a means to enhance your relationship while helping your employee develop better skills, understand company priorities better, or work more positively on the team. Think about how you can deliver the difficult talking points with honesty, courage and fairness.

  2. Recognize the emotions you will be feeling. Are you disappointed in this employee? Angry about the problems they’ve caused? Scared that your conversation will damage your work relationship? Put your negative feelings aside and consider how you will frame the problem you need to discuss and how your employee may feel. Try to come at the discussion with consideration and compassion for their feelings and frame the conversation with a desire for the employee’s success. “John, we need to have a hard conversation today, and I’m feeling anxious because I want you to win. Please know that I am invested in your success and will work with you to make that happen.”

  3. Be intentional in planning the conversation, but don’t script it out so that your delivery sounds mechanical. Some business consultants suggest drafting a script and considering alternatives based on the employee’s reactions. In my experience, these conversations never go completely according to plan, and scripted conversations feel artificial. Instead, write down key points and plan as if you are just having a simple conversation with a colleague. Be prepared to provide specifics and pace your conversation so that you take time to gauge your employee’s reactions to your comments. Your employee may react defensively if you provide vague statements. Instead of saying, “Sue, people in the company are telling me that you are difficult to work with and have a bad attitude,” frame the issue with examples, such as, “Sue, I am concerned because I’ve noticed in the last four team meetings you arrived late and weren’t prepared with project updates. As a result, both Joe and Sam missed their deliverables, and you didn’t let any of us know in advance that the timeline was slipping.”

  4. Recognize that you own part of the problem, too. Your goal is to have a conversation between adults where each owns some responsibility for the issue and solving the problem. This takes the conversation from finding fault to finding solutions. “Rob, I realize now that you have too many priorities and I didn’t provide you with the resources to deliver on the project. I also realize that I avoided addressing the problem at the beginning of the project and let it go too long without discussing it with you.”

  5. Outline what you want changed. Don’t just discuss the problem; describe the end result you envision. Discuss realistic and achievable outcomes and be willing to offer resources and assistance as appropriate.

  6. Ask the employee for his or her viewpoints. The last thing you want is a one-sided conversation. Slow the pace of the conversation, observe the employee’s reactions to your comments, and ask for feedback and suggestions for solving the problem. You may learn new information about what may have caused the problem, and the employee could offer even better solutions than you thought possible. Throughout the conversation, look for areas of consensus and acknowledge the employee’s feelings and concerns. That shows respect.

  7. End the conversation on a positive note with an action plan. Thank the employee for working with you through the difficult discussion. Acknowledge that it was a tough conversation and express appreciation for the employee’s professionalism as you both work towards a better outcome. Develop a going-forward action plan to solve the problem. “Tom, this was a hard talk, and I know it wasn’t easy for you. You provided some good ideas for fixing the issue, and I appreciate your professionalism. You can do this, and I am here to help you win.”

  8. Close the loop and follow up. Give the employee a little time to reflect on the discussion, but no more than a day or two. Follow up and ask the employee if they would like to have another discussion to cover any additional information or clarification. Put the agreed-upon action plan in writing, schedule regular status meetings, and recognize progress and improved performance. Taking these steps demonstrates your respect for the employee and desire for them to succeed.

Keep the Conversation Going

Great managers keep the conversation going to ensure team members are aligned and supporting each other to create a healthy corporate culture and successful company. When problems arise, they have the tough conversations to get things back on track. Handling these discussions well takes courage as well as empathetic listening and communications skills. Pay attention to the signals, develop your communications plan, and you’ll be more confident in tackling your next tough employee communications challenge.

Originally published by www.thinkhr.com

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Ask the Experts: Mandatory Flu Shots | North Carolina Benefit Advisors

While there is no law that prohibits employers from mandating flu shots, you should carefully determine if the benefits to your business outweigh the risks. Read the article to determine the best course of action, from incentives to suggestions about policy wording.

Ask the Experts: Distributing ERISA Notices Electronically | North Carolina Employee Benefits

Question: Our company is getting ready for open enrollment. Can we distribute ERISA notices electronically instead of printing and delivering hard copies?

Answer: Yes, electronic delivery complies with ERISA’s disclosure rules – but certain conditions must be met.

First, whether delivered in hard copy or electronic media, ERISA requires preparing and furnishing materials “in a manner consistent with applicable style, format, and content requirements.” It is a good idea to test electronic documents to make sure the formatting and style are correct.

Secondly, materials must be furnished using “measures reasonably calculated to ensure actual receipt.” For instance, if using a traditional delivery method, such as first-class mail, be sure to follow up on any undelivered/returned mail.

For electronic delivery, the compliance rules work differently depending on whether the recipients have regular access to the employer’s electronic information system:

  • Regular access means the recipients use the system, such as the employer’s email system or intranet, as an integral part of their regular job duties. This may include employees who work from home or who are traveling. However, simply having access to a kiosk in a workplace common area does not qualify as having regular access.

  • Without regular access means all other recipients. This may include employees on leave as well as non-employees such as COBRA participants, retirees, and alternate payees. For this group, electronic delivery does not comply with ERISA unless the recipient first affirmatively consents to receive the material electronically, provides an electronic address, and reasonably demonstrates their ability to access the material in electronic form. Since the process to secure consent is fairly cumbersome, most employers choose to distribute materials to this group using traditional hard-copy methods instead of electronic delivery.

Both groups of recipients must be notified of their rights to receive paper copies of the documents (at no charge), and reasonable and appropriate steps must be taken to safeguard confidentiality of personal information related to benefits. A best practice is for employers to ensure return-receipt or notice of undelivered mail features are enabled. Employers may conduct periodic reviews or surveys to confirm receipt as well.

Just emailing documents or posting them on the company’s intranet or benefit administration portal is not enough. Each time an electronic document is furnished, a notice (electronic or paper) must be provided to each recipient describing the significance of the document.

Originally published by www.thinkhr.com

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Ask the Experts: FSA Limits | North Carolina Employee Benefits

Question: Our company offers flexible spending accounts (FSAs) for health care and dependent daycare. Our plan limits are the maximum amounts allowed by federal law. Will the IRS increase the limits for 2019? We hold open enrollment in November for employees to make their FSA elections for the following year.

Answer: The maximum annual limits for Dependent Care FSAs and Health Care FSAs are set forth under § 129 and § 125, respectively, of the Internal Revenue Code.

The § 129 (Dependent Care) limits do not change from year to year. They are currently $5,000, or $2,500 if married and filing separately, and they apply on a calendar-year basis. To change them would require a change in law, which is unlikely in the current Congress.

On the other hand, the maximum limit for elective contributions to a Health Care FSA (HFSA) may change from year to year depending on inflation. The limit applies on a plan-year basis and the HFSA limit for a 12-month plan year beginning in 2018 is $2,650. The limit is one of over 50 different tax provisions that is subject to annual cost-of-living or inflation adjustments. Each fall, the IRS announces any changes for the following year. The announcement usually is released in mid-October, which should give employers time to prepare 2019 enrollment materials.

Based on estimated inflation, it appears the HFSA limit will increase from $2,650 for plan years beginning in 2018 to $2,700 for plan years beginning in 2019. The increase will not be official, however, until the IRS announcement is released.

Originally published by www.thinkhr.com

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Look Backward to Plan Forward | North Carolina Employee Benefits

We have entered Open Enrollment season and that means you and everyone in your office are probably reading through enrollment guides and trying to decipher it all. As you begin your research into which plan to choose or even how much to contribute to your Health Savings Account (HSA), consider evaluating how you used your health plan last year. Looking backward can actually help you plan forward and make the most of your health care dollars for the coming year.

Check out these four things to look at as you go into Open Enrollment season!

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Is Your Health Plan Affordable for 2019? | North Carolina Benefit Advisors

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 2018, the percentage is 9.56 percent. For 2019, however, the percentage increases to 9.86 percent.

Although the change is minor, it means that employers may increase their plan’s employee-only contribution rate and 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:

  • 2018: ($12,060 x 9.56%)/12 = $96.08 per month

  • 2019: ($12,140 x 9.86%)/12 = $99.75 per month

The FPL chart is updated every year in late January. For 2019 calendar-year health plans, the employer needs to refer to the current FPL amount ($12,140) since the new FPL amount will not be available until after the plan year starts. If the health plan year starts February 1, 2018 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:

  • 2018: ($11* x 130) x 9.56% = $136.70 per month

  • 2019: ($11* x 130) x 9.86% = $140.99 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 2018 plan years, the affordability percentage is 9.56 percent, but it increases to 9.86 percent for 2019 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 2019.

Originally published www.thinkhr.com

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Back to School Time Off Tips | North Carolina Benefit Advisors

The coals from the Labor Day barbecues have cooled, the beach chairs have been returned to their sheds, the ice cream shops have scaled back their hours, and the white shoes have been set aside for the next nine months. Whatever the end of summer means to you, for millions of families, it signals the return to school for children in preschool through college.

This means your employees will likely need to take a few hours out of their workday occasionally to participate in their children’s education. Parents’ fall calendars are often packed with school events, parent-teacher conferences, and/or parent meetings – some of which will inevitably occur during their usual working hours – and any flexibility you give them to attend these events, or even volunteer in the classroom or chaperone a field trip, will be greatly appreciated.

Where it’s the law

Nine states and the District of Columbia have passed laws protecting parents’ rights to take small increments of time away from work to attend to school matters. They vary widely in their specifics regarding eligibility for leave, whether the time is paid or unpaid, and the amount of time available for use. (ThinkHR customers can get details about each state’s provisions by clicking the act titles listed below after logging into to your ThinkHR account.)

Even if it’s not the law

It’s a best practice to offer flexibility to all employees so that they can meet the obligations of daily life while still performing at their peak at work. It goes a long way toward making an employee feel good about where they work when they can see their child perform in a school play, take their dog to the vet, or accept an appliance delivery without worrying about missing a couple hours of work or needing to take a full day off.

The beginning of fall is a great time to review your established time off policies to see how you can accommodate parents and guardians who need to meet school obligations as well as giving all employees the flexibility to attend to the other small necessities of life.

In many cases, your established policies may not need to change. Depending on the needs of your workplace, your state laws, and the employee’s position, this could mean allowing employees to make up a few hours of work, take an extended lunch period, shift their schedule to start earlier or later to still get a full day in, or use personal, vacation, or PTO time in small increments.

Originally published by www.thinkhr.com

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New Federal Contract Compliance Directives | North Carolina Employee Benefits

On August 24, 2018, the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) announced the following three directives:

  • Guidance for Contractor Compensation PracticesDirective 2018-05 clarifies the OFCCP’s approach to conducting compensation evaluations, supports compliance and compensation self-analyses by contractors, and improves compensation analysis consistency and efficiency during compliance evaluations.
  • Contractor Recognition Programs: Directive 2018-06 establishes a contractor recognition program with awards that highlight best practices, a contractor mentoring program, and other initiatives that provide opportunities for contractors to collaborate or provide feedback to OFCCP.
  • Affirmative Action Program Verification Initiative: Federal contractors are legally required to take steps to ensure equal opportunity in their employment processes, including developing a written affirmative action program within 120 days of when the contract begins. Directive 2018-07 establishes a program for verifying compliance with these and other affirmative action obligations.

The OFCCP enforces federal laws that prohibit federal contractors and subcontractors from discriminating on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. In addition, contractors and subcontractors are prohibited from discriminating against applicants or employees because they inquire about, discuss, or disclose their compensation or that of others, subject to certain limitations.

Originally published www.thinkhr.com

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Short-Term Limited-Duration Insurance – In a Nutshell | North Carolina Benefit Advisors

On August 3, 2018, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (the Departments) published a Final Rule to expand the availability of short-term medical policies. Called short-term, limited-duration insurance (STLDI), the policies are marketed to individuals as an alternative to ACA-compliant plans. Currently a short-term policy is limited to less than three months, but the new rule will allow carriers to issue the policies for longer periods.

What is short-term limited-duration insurance (STLDI)?

Short-term, limited-duration insurance is a specific type of health coverage that is exempt from the ACA’s market reform rules. STLDI policies may exclude entire categories of benefits, such as prescription drugs, maternity, or mental health care, may impose coverage caps, and may reject applicants with pre-existing conditions. STLDI policies offer lower premiums than ACA-compliant plans because they provide less coverage and typically only accept healthy applicants.

Note that STLDI is not minimum essential coverage and does not satisfy the ACA’s individual mandate. The individual mandate (i.e., the requirement for individuals to have some form of minimum essential coverage) expires at the end of 2018, after which persons without adequate health coverage will no longer be exposed to potential IRS tax penalties.

What is the purpose of the new federal rule?

The existing rule defines “short term” as less than three months and limits the policy’s duration by prohibiting renewals that would go beyond the three-month period. The new rule, on the other hand, will allow carriers to issue STLDI policies for an initial term of up to 364 days, and allows extensions or renewals for up a total of 36 months. This is a significant change that is intended to expand access to low-cost limited-coverage options for individuals.

The new federal rule takes effect for STLDI policies issued October 2, 2018, or later. There is a catch, however. Insurance is subject to state insurance laws, and many states appear reluctant to adopt the new rule for policies issued in their state. Some states even prohibit short-term policies under the current federal rule. At last weekend’s National Association of Insurance Commissioners (NAIC) meeting, several state regulators expressed concerns about “junk insurance” or deceptive marketing practices that may lure consumers into purchasing substandard coverage.

Are employers affected by STLDI policies or the new rule?

No.

Employers are not directly affected by STLDI policies. The policies are marketed to individuals, where permitted by state insurance law; they are not group plans.

Some workers may consider STLDI options, or ACA-compliant individual insurance options, as an alternative to their employer’s group plan. In most cases, though, persons who buy individual insurance do so because they do not have access to an employer’s plan. Workers whose employment ends may also consider individual options as an alternative to COBRA.

What’s Next?

Over the coming weeks and months, state insurance regulators and state legislatures are expected to review their existing laws and regulations on short-term, limited-duration insurance and consider whether to adopt changes. Some states likely will choose to implement rules to support the new federal rule, while other states certainly will impose restrictions or continue to prohibit the sale of insurance products they consider to be substandard.

Originally published by www.thinkhr.com

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DOL Updates the Employer CHIP Notice | North Carolina Employee Benefits

The U.S. Department of Labor (DOL) has updated the model notice for employers to use to inform employees about the Children’s Health Insurance Program (CHIP). All employers with group health plans are required to distribute a CHIP notice at least once a year to employees living in certain states. There is no need to send another notice to workers who received the prior version in the past year, but employers should use the updated notice going forward. This also is a good time for employers to review their procedures for distributing CHIP notices.

The following are the most frequently asked questions we receive from employers about CHIP notices.

Frequently Asked Questions

What is the purpose of the CHIP notice?
The CHIP notice informs benefits-eligible employees that their state’s CHIP or Medicaid program may offer premium assistance to help them pay for group health coverage at work. Many states offer some form of premium assistance to residents based on their family income. The updated notice includes contact information for each participating state (currently 37 states) and explains that persons approved for premium assistance have a special 60-day enrollment period to join their employer’s group plan without having to wait for the employer’s next annual enrollment period.

Does the CHIP notice requirement affect all employers?
All employers that offer a group health plan providing medical benefits, whether insured or self-funded, must consider the CHIP notice requirement. Each employer then will determine if it must distribute the notice depending on whether any of its employees live in one of the states listed in the notice.

Further, all group health (medical) plans must offer a special 60-day enrollment period when an employee becomes eligible for premium assistance (for the employee or a family member) from a state’s CHIP or Medicaid program.

Is the notice required for all employees or just for those enrolled in our group health plan?
The notice must be given to all employees living in any one of the listed states and eligible for the employer’s group health plan, whether or not currently enrolled. That is the minimum requirement. Many employers, however, choose to distribute the notice to all employees, regardless of benefits eligibility or location, to avoid the need for separate distributions when an employee’s status or location changes.

How do we prepare and distribute the notice? How often?
The DOL provides a model notice that employers can copy and distribute. Although employers have the option of creating their own notice to list only the states where their employees are located, most employers simply use the DOL model notice as it is. The model notice also is available in Spanish.

The notice must be distributed when employees initially become eligible for the employer’s health plan and then at least once a year thereafter. For convenience, most employers provide the notice at the same time as they distribute new hire materials and annual enrollment materials.

When combined with other materials, the CHIP notice must appear “separately and in a manner which ensures that an employee who may be eligible for premium assistance could reasonably be expected to appreciate its significance.” For instance, the notice may be a loose item in the same envelope with other material. If the notice is stapled inside other material, however, there should be a note on the top page or cover alerting the reader to the placement of the CHIP notice and its importance.

Do we have to mail out paper copies or can we distribute the notice electronically?
The notice may be sent by first-class mail. Alternatively, it can be distributed electronically if the employer follows the DOL’s guidelines for electronic delivery of group health plan materials. That means that the employer first must determine whether the intended recipient has regular access to the electronic media system (e.g., email) as an integral part of his or her job. If so, the notice can be sent electronically provided the employer takes steps to ensure actual receipt, along with notifying the employee of the material’s significance and that a paper copy is available at no cost.

For persons who do not have regular access to the electronic media system, the notice cannot be sent electronically unless the intended recipient provides affirmative consent in advance. The guidelines for obtaining advance consent are fairly cumbersome, so employers are advised to distribute paper copies in these cases.

Summary

Employers offering group health plans are encouraged to review their procedures for distributing CHIP notices. At a minimum, the notice must be given annually to all employees eligible for the employer’s health plan who live in any of the states listed in the notice. Many employers choose to distribute the notice to all workers in an abundance of caution. The DOL provides model notices in English and Spanish that do not need any customization, so employers can simply copy and distribute one or both versions as needed.

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Wearable Technology | North Carolina Employee Benefits

Don’t lie--we ALL love gadgets. From the obscure (but hilariously reviewed on Amazon) Hutzler 571 Banana Slicer to the latest iteration of the Apple empire. Gadgets and technology can make our lives easier, make processes faster, and even help us get healthier. Businesses are now using the popularity of wearable technology to encourage employee wellness and increase productivity and morale.

According to a survey cited on Huffington Post, “82% of wearable technology users in American said it enhanced their lives in one way or another.” How so? Well, in the instance of health and wellness, tech wearers are much more aware of how much, or how little, they are moving throughout the day. We know that our sedentary lifestyles aren’t healthy and can lead to bigger health risks long term. Obesity, heart disease, high blood pressure, and Type 2 Diabetes are all side effects of this non-active lifestyle. But, these are all side effects that can be reversed with physically getting moving. Being aware of the cause of these problems helps us get motivated to work towards a solution.

Fitbit, Apple Watch, Pebble, and Jawbone UP all have activity tracking devices.  Many companies are offering incentives for employees who work on staying fit and healthy by using this wearable technology. For example, BP Oil gave employees a free Fitbit in exchange for them tracking their annual steps. Those BP employees who logged 1 million steps in a year were given lower insurance premiums. These benefits for the employee are monetary but there are other pros to consider as well. The data collected with wearable technology is very accurate and can help the user when she goes to her physician for an ailment. The doctor can look at this data and it can help connect the dots with symptoms and then assist the provider with a diagnosis.

So, what are the advantages to the company who creates wellness programs utilizing wearable technology?

·      Job seekers have said that employee wellness programs like this are very attractive to them when looking for a job.

·      Millennials are already wearing these devices and say that employers who invest in their well-being increases employee morale.

·      Employee healthcare costs are reduced.

·     Improved productivity including fewer disruptions from sick days.

The overall health and fitness of the company can be the driving force behind introducing wearable technology in a business but the benefits are so much more than that. Morale and productivity are intangible benefits but very important ones to consider. All in all, wearable technology is a great incentive for adopting healthy lifestyles and that benefits everyone—employee AND employer. 

 

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10 Stories That Caught Our Eye in June 2018 | North Carolina Benefit Advisors

Just Don’t Ask

Job candidates are covered by the Civil Rights Act prohibiting discrimination, and most interviewers know what kinds of direct questions to avoid. But what seems like a friendly conversation-starter could be an unwitting violation of the act. Read five questions you should never ask.

Read more on Namely.

Trust in Design

Office design is known to have an impact on employee productivity and satisfaction. At the heart of this is trust – trust that staff will choose to use the facility in the most effective way rather than be chained to their desks. And when trust rises, engagement follows.

Read more on Entrepreneur.

Pride Without Pandering

June was Pride Month, and corporations everywhere joined in the celebration. Some, although well-meaning, missed the mark. Seven LGBTQ executives explain how employers can embrace inclusion and celebrate diversity without coming across as pandering.

Read more on Fast Company.

Dad Days

Reddit cofounder Alexis Ohanian was a proponent of paternity leave and planned to lead by example by using his company’s benefit. However, he didn’t fully appreciate its importance until his daughter was born and he used the time off to slow down and take stock of his priorities.

Read more on CNN.

Culture Still Eats Strategy

Strategy is essential, but if a company doesn’t have a good culture, it won’t matter. Once you understand what culture is and isn’t, you can work toward developing a strong one, starting with defining the qualities you value in your employees.

Read more on Forbes.

Buy in Bulk

A rule released by the U.S. Department of Labor on June 19 loosens restrictions on association health plans, paving the way for more small businesses to band together to buy health coverage. That is, if it stands up to legal challenges, state laws, and the realities of the insurance marketplace.

Read more on Kaiser Health News.

The Family Friendly Workplace

Work-life balance can be especially challenging for parents. Both mothers and fathers lament not having enough time for their children. Get 10 creative ways you can make your workplace better for working parents.

Read more on Employee Benefit News.

Remote Control

The remote workforce continues to grow, but 57 percent of companies still lack a remote work policy. These companies may be missing out on attracting and retaining top talent. There’s no one-size-fits-all solution, with numerous factors to consider in crafting one.

Read more on HR Dive.

What Makes a Great Workplace

Inc. magazine surveyed thousands of employees to measure what employer qualities lead to high levels of employee engagement and sentiment, taking into account elements of corporate culture. See which of 45 perks and benefits employees value most.

Read more on Inc.

Run, Hide, Fight

Law enforcement officials stress the need for employers to conduct active shooter training to protect their employees and customers in the event of a violent incident. In addition to training, find out other ways to mitigate the risk a shooter or potential shooter holds.

Read more on Business Insurance.

Originally published by www.thinkhr.com

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The News about Association Health Plans | North Carolina Employee Benefit Advisors

On June 19, 2018, the U.S. Department of Labor released its Final Rule regarding Association Health Plans (AHPs). AHPs are not new, but they have not been widely available in the past and, in some cases, they have not been successful. The Final Rule is designed to make AHPs available to a greater number of small businesses as an alternative to standard ACA-compliant small group insurance policies.

This article answers common questions about AHPs under the current rules (which groups can continue to use) and the new rules.

Is group medical insurance the same for small and large employers?

Yes and no. Federal law imposes certain basic requirements on all group medical plans, regardless of the employer’s size. For instance, plans cannot exclude pre-existing conditions nor impose annual or lifetime dollar limits on basic benefits. If the plan is insured, it also is subject to the insurance laws of the state in which the policy is issued.

Small group policies, which are sold to employers with up to 50 or 100 employees, depending on the state, are subject to additional requirements. These policies must cover 10 categories of essential health benefits (EHBs), including hospitalization, maternity care, mental health and substance abuse treatment, and prescription drugs. (Some states allow certain grandfathered or grandmothered policy exceptions.) For most small employers, their options for group medical insurance are limited to small group policies that comply with the full scope of ACA requirements. On the other hand, the policies are subject to guaranteed issue and adjusted community rating rules, so carriers cannot refuse to insure a small employer nor use any past claims experience in setting rates.

Large group policies, which can only be sold to groups with at least 50 or 100 employees, depending on the state, are not required to cover all EHBs. Carriers have more flexibility in designing coverage options and developing premium rates in the large group market. This means larger employers have more options to choose from and may be able to purchase coverage at a lower cost than would apply to a small group policy. Note, however, that there is no guaranteed issue protection, so carriers can accept or reject each employer’s application or use the employer’s past claims experience in setting rates.

Lastly, self-funded plans are subject to the ACA and other federal laws, but generally are exempt from state laws. They typically are not feasible for small employers, however, due to the financial risk of uninsured programs.

What is an Association Health Plan (AHP)?

Group insurance covers the employees of an employer (or an employee organization such as a labor union). An AHP, as the name implies, covers the members of an association. Unrelated employers can obtain coverage for their employees through an AHP provided the employers form a bona fide association. Traditionally, this has meant that the employers had to have a “commonality of interest” and their primary interest had to be something other than an interest in providing benefits. For this reason, AHPs generally have been limited to associations formed by employers in the same trade, industry, or profession.

The Final Rule makes AHPs available to a wider range of businesses by expanding the meaning of “commonality of interest.” Once the Final Rule takes effect, an association may be formed by employers that are:

  • In the same trade, industry, or profession, regardless of location; or
  • In the same principal place of business; i.e., in the same state or in the same multi-state metropolitan area.

Under the new rules, the employer’s primary interest in associating may be benefits coverage, although they still will need to have at least one other substantial business purpose other than benefits. This is a key difference from the current rules.

When does the new Final Rule take effect?

The Final Rule expanding the definition of an association for purposes of an AHP will take effect on staggered dates:

  • For fully insured AHPs: September 1, 2018
  • For self-funded AHPs:
    • If in existence on or before June 19, 2018: January 1, 2019
    • If created after June 19, 2018: April 1, 2019

As noted, the new rules do not replace existing rules. Employers and associations may continue to follow the existing rules (which generally limit AHPs to employers in the same trade, industry, or profession). The new rules merely expand the opportunities for AHPs, such as making them available to employers in the same state or metropolitan area even if they are in different industries.

Are AHPs limited to employers with employees? What about sole proprietors?

Currently, sole proprietors, such as mom-and-pop shops without any W-2 employees, purchase medical insurance in the individual market. Individual policies often cost more than group policies or AHPs. The new rules will expand the availability of AHPs to include sole proprietors who work a minimum number of hours (so-called working owners).

What about state laws? Will AHPs be available nationwide?

Insurance products, including AHPs, are regulated by state law. Under both the existing and new rules, AHPs are multiple employer welfare arrangements (MEWAs). State laws on MEWAs are quite complicated. In some states, MEWAs are prohibited. In others, insured MEWAs are allowed but self-funded plans are prohibited. The laws vary from state to state, so different carriers will make different decisions about whether they want to design and market AHPs in various jurisdictions around the country.

A number of states are very concerned about AHPs and may prohibit them in their states or impose strict requirements to ensure they will provide reliable and effective coverage. Other states will view AHPs as cost-effective alternatives to ACA-compliant policies for small employers and look to encourage their expansion.

What’s next?

There is no clear answer to what’s next. Over the coming months, carriers across the country likely will review the reasons they have or have not offered AHPs in the past, and whether they want to consider new approaches in the future. Along with economic and market issues to consider, carriers also must consider the state insurance laws in different jurisdictions. At the same time, many state legislatures and insurance commissioners will be reviewing their existing rules and whether they want to promote or expand the availability of AHPs in their area.

Oh … and the lawsuits. Yes, that also is what’s next. As of this writing, attorneys general in different states are planning to join together in challenging the federal government’s Final Rule on AHPs. Their stated concern is that effective regulation is required to ensure that plans provide adequate coverage.

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6 Questions on Dependent Care Spending Accounts | North Carolina Employee Benefits

School’s out! Summer is here, and it’s the time of year when working parents have questions about using their Dependent Care Spending Accounts (DCSAs). Are summer camp expenses eligible? What about day versus overnight camps? Employers and benefit advisors want to be ready with answers about this valuable benefit program.

The following are the top summertime questions about DCSAs and reimbursable expenses:

1. What are the basic rules for reimbursable expenses?

Dependent care expenses, such as babysitting and daycare center costs, must be work-related to qualify for reimbursement. Work-related means the expenses are for the care of the employee’s child under age 13 to allow the employee to work. If the employee is married and filing jointly, the employee’s spouse also must be gainfully employed or looking for work (unless disabled or a full-time student).

In some cases, expenses to care for a disabled dependent, regardless of age, may be reimbursable. This article focuses on expenses for children under 13 since those are by far the most common type of DCSA reimbursement.

2. One of our employees and his family are taking a two-week vacation this summer, but his children’s daycare center will charge its regular fee. Are the expenses reimbursable even if the employee and spouse are off work?

Yes. In most cases, expenses are not eligible unless the dependent care services are necessary for the parents to work, but some exceptions apply. The IRS rules for DCSAs provide that expenses during short, temporary absences are eligible if the employee has to pay the child’s care provider. Absences of up to two weeks are automatically considered short, temporary absences. Depending on the circumstances, longer absences also may qualify.

3. During the school year, our employee uses her DCSA for her 10-year old’s after-school daycare center expenses. This summer, the child’s daycare will be provided by her 20-year old sister. If the older daughter bills for her services, are the costs eligible for reimbursement?

The answer depends on whether the employee or spouse can claim the older daughter as a tax dependent. If the older daughter can be claimed as a dependent, whether or not the employee actually claims her, she is not a qualifying dependent care provider under the DCSA rules.

If the older daughter cannot be claimed as a tax dependent, her charges for providing care are eligible expenses. The specific rule is that a child of the employee, whom the employee cannot claim as a dependent, may be a qualifying provider if the child is age 19 or older by the end of the year.

Note that the employee’s spouse or the child’s parent is never a qualifying provider.

4. One of our employees has to pay an application fee and deposit before her child starts attending a daycare center this summer. Are those expenses eligible for reimbursement?

Prepaid expenses are eligible for DCSA reimbursement, provided the costs are required in order for the child to receive care. In this case, after the daycare center begins providing care, the employee can be reimbursed for the application fee and deposit she paid. On the other hand, if the employee cancels and her child does not attend, then the application fee and deposit are not eligible expenses.

5. An employee will pay day camp expenses for his 8-year-old son and overnight camp expenses for his 12-year-old daughter this summer. Are both types of expenses eligible for reimbursement?

The day camp expenses generally are reimbursable. Expenses for overnight camp, however, are not eligible since overnight care is not work-related.

Under the IRS rules for DCSAs, expenses for food, lodging, clothing, education, and entertainment are not reimbursable. If, however, such expenses are small, incidental expenses that cannot be separated from the cost of caring for the child, they may be included for reimbursement. For instance, the day camp may include lunch, snacks, and some sports activities in its basic fee, which would be eligible for reimbursement.

6. An employee’s children go to private year-round schools. He pays tuition for one child’s grade school and fees for the other child’s nursery school. Are both types of expenses eligible for reimbursement?

Educational expenses are not reimbursable, unless the educational services are merely incidental as part of a child care service. Expenses to attend kindergarten or a higher grade are educational, so the older child’s school fees are not eligible for DCSA reimbursement. (Expenses for before- or after-school care, however, may qualify as reimbursable expenses.)

On the other hand, expenses for a child in nursery school, preschool, or a similar program for children below the level of kindergarten are expenses for care. Such expenses are not considered educational even though the nursery school may include some educational activities.

Originally published by www.thinkhr.com

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Price Shopping Health Care | North Carolina Benefit Advisors

As the costs of health care soar, many consumers are looking for ways to control their medical spending. Also, with the rise of enrollment in high deductible health plans, consumers are paying for more health care out-of-pocket. From medical savings accounts to discount plans for prescriptions, patients are growing increasingly conscious of prices for their healthcare needs. Price shopping procedures and providers allows you to compare prices so that you are getting the best value for your care.

Check out this short video to learn more!

Opioids in America | North Carolina Benefit Advisors

Lately, there’s been a big focus on America’s opioid addiction in the news. Whether it’s news on the abuse of the drug or it’s information sharing on how the drug works, Americans are talking about this subject regularly. We want to help educate you on this hot topic.

Opioids are made from the opium poppy plant.  Opium has been around since 3,400 BC and it was first referenced as being cultivated in Southwest Asia. The drug traveled the Silk Road from the Mediterranean to Asia to China. Since then, the drug has gained popularity for pain relief but it also has gained notoriety as an abused drug. Morphine, Codeine, and Heroin are all derived from the opium poppy and are all highly addictive drugs that are abused all around the world. As the demand for these drugs has increased, so has the production.  From 2016 to 2017, the area under opium poppy cultivation in Afghanistan increased by 63 percent. In 2016, it killed some 64,000 Americans, more than double the number in 2005.

We can see that the danger from this drug is growing rapidly. What can we do to recognize potential abuse problems and to get help? Here are some facts about opioid addiction:

·       How do they work? Opioids attach to pain receptors in your brain, spinal cord, and other areas that recognize pain signals. As they attach to the receptors, it reduces the sending of pain messages to the brain and therefore reduces the feelings of pain in your body.

·       Short-acting opiates are typically prescribed for injuries and only for a few days. They take 15-30 minutes for pain relief to begin and this relief lasts for 3-4 hours. Long-acting opiates are prescribed for moderate to severe pain and are used over a long period of time. Relief typically lasts for 8-12 hours and can be used alongside a short-acting drug for breakthrough pain.

·       Dependence is common with long-term use of an opiate. This means that the patient needs to take more of and higher doses of the medicine to get the same pain relieving effect. This does not necessarily mean the patient is addicted. Addiction is the abuse of the drug by taking it in an unprescribed way—like crushing tablets or using intravenously.

·       Americans account for less than 5% of the world’s population, but take 80% of the world’s opioid medications. About 5% of the people who take opiates become addicted to the drug.

·       Help is available through many channels from private recovery centers to insurance providers. The Substance Abuse and Mental Health Services Administration helpline is 1-800-662-HELP. This line is confidential, free, and available 24-hours a day and 7 days a week. Family and friends may also call this number for resources for help. Additional resources can be found at www.drugabuse.com.

Make sure you are educated about the dangers of opioid abuse. But, don’t be discouraged and think that the abuse is incurable! There are many resources that can be used to break the addiction cycle and can make real change in the lives of its victims. Ask for help and offer help.

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