benefits communication

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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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.

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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.

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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.

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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.

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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.

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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.

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Originally published by www.thinkhr.com

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Custom Benefits Solutions Expands Services

Custom Benefits Solutions Expands Services

With the desperate need to control healthcare costs, employers are eager to have a solution that allows them the advantage of large numbers but the autonomy to create their own destiny.  The current constraints and opaque pricing models of the provider-payer relationship as well as “secret” PPO contracts have yielded a healthcare system that is confusing, hard to navigate and, in some situations, bankrupting to healthcare consumers. These days it takes an employee benefits consultant who understands how to think around problems before they ever really become problems.

Employers are Calling for Innovative Solutions

Employers are Calling for Innovative Solutions

Perhaps the most notable change in this movement toward self-funding is the number of smaller employers getting in the game. Although most of these are level-funded arrangements, employers see the value in gaining control of their plan with a focus on what’s important to their specific employee base. Plus, the tax advantage isn’t bad either, as state taxes are eliminated on most self-insured plans. 

Employees get "a free expert" with every open enrollment

Employees get "a free expert" with every open enrollment

Technology makes it easier to do just about everything. It simplifies and speeds banking and paying bills. It allows people to stay connected with colleagues, friends and family in numerous ways. It enables collaboration, creativity and research. But relying on technology alone to solve connectivity challenges can be problematic. Connectivity takes a human touch and that goes the same for employee benefits.

Communication is they key...but you have to fundamentally change how you do it.

Communication is they key...but you have to fundamentally change how you do it.

As Bill Gates once said, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next 10. Don't let yourself be lulled into inaction.”

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