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Professional Service

We do Employee Benefits. For over 30 years we have assisted small businesses with a knowledgeable and caring approach. We free you to do your job. We clarify any confusion with insurance forms, policies and procedures. Give our phone number to your employees. Diamond Certified and Better Business Bureau A+ Ratings

Personal Service

We know your name & your company. We know you and care about your insurance needs. We value your employees. We do not pass the buck or just provide you with the carrier’s 800#. We take the time to listen, find the answer, and then get back to you with a simple and thorough explanation – no snappy answers – we want you to understand.

All Major Carriers

We work with all insurance carriers including Covered California to find the lowest cost and best benefits for you and your employees.

Full Service

We set you up, run employee meetings, process enrollments, and we are  available for employee questions. We are here 12 months a year, not just on the day you  enroll. 

Online HR Support Center

provides easy accessible information and tools to help you manage your day to day HR functions and challenges.

Set-up your POP

we set up your Premium Only Plan to assist you and your employees with important tax savings.

Federal COBRA Administration

Although we do not administer your COBRA  duties for you, we enlist the services of a proven professional, Sterling Administrators. 

Keep You Informed

with our Monthly Newsletters and emails.

Annual Review

We review your benefits and rates with all available carriers. We are watching costs and looking for the most economical plan for your company. We are up to date with new products & explore many options.

What Employers Need to Know About ERISA

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What Employers Need to Know About ERISA

The Employee Retirement Income Security Act, or ERISA, is a federal law that regulates certain group-sponsored benefit plans. The law requires employers to disclose plan information to all eligible employees, subject to strict guidelines. As an employer, here’s what you need to know.

Who is subject to ERISA? Churches and government employers are exempt from ERISA regulation. Most other private-sector corporations, partnerships, and proprietorships must comply with this set of laws. When in doubt, employers should consult a business planning attorney.

Which group benefit plans fall under ERISA regulation? Most employer-sponsored plans, such as medical, dental, and vision plans are subject to ERISA, along with health savings accounts, healthcare FSA, and HRA accounts. Even vacation and scholarship plans fall under the law.

However, ERISA typically does not apply to:

  • Cafeteria Plans
  • Premium-Only Plans
  • Section 125 Plans
  • Premium Conversion Plans
  • Pre-tax Premium Plans
  • Health Savings Accounts when employers have limited involvement
  • Dependent Care FSAs
  • Dependent Care Assistance Plans
  • Transit and parking plans
  • Adoption Assistance
  • Educational Assistance and Tuition Reimbursement
  • Paid time off
  • On-site medical clinics for the purpose of providing first aid

*Even minimal endorsement, such as using the company name on brochures, could make the plan non-exempt from ERISA.

What is the Summary Plan Description and how must employers provide it? The SPD communicates rights and obligations to plan participants and beneficiaries and summarizes the main provisions of the plan. Employers must provide a SPD to beneficiaries within 90 days of coverage, via email, regular mail, or hand delivery. Failure to comply with this requirement can trigger fines from the Department of Labor.

What is an ERISA “wrap”? A wrap document can help small employers in particular meet their ERISA obligations. The Wrap SPD requirement applies to all employer sponsored group health insurance offerings, including a one-person plan. A wrap document “wraps around” all ERISA health and welfare benefits and includes required disclosures that are not typically found in other documents. These include details like the allocation of duties and responsibilities between the employer and the insurer, or the rights participants are entitled to under ERISA

What else do employers need to know about ERISA? ERISA regulations can become complicated. This document outlines 18 things employers need to know about ERISA compliance, in order to avoid violations and potential fines.

We can also help you to understand your employer-sponsored benefits plans. Call us with any questions you might have about plan administration, and we will be happy to help.

Why is Vision Coverage so Important?

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Why is Vision Coverage so Important?

Most of us are now enrolled in either a group health insurance plan or a private plan that we purchased for ourselves. But medical insurance unfortunately does not cover everything that you might need over time. For example, 75 percent of Americans need a form of vision correction at some point in their lives… And health insurance rarely covers this expense.

In addition to detecting vision problems, an eye exam can detect early signs of other health conditions, such as:

  • Diabetes
  • High blood pressure
  • Heart disease
  • High blood cholesterol
  • Brain tumors
  • Some types of cancer
  • Glaucoma
  • Macular Degeneration
  • Cataracts

You probably noticed that some of those conditions are diseases of the eyes, but others are not. However, early signs of some conditions (such as diabetes) can actually show up in the eyes first! And anyone’s vision can change as they age, so regular eye exams are important for all of us.

But of course, a vision exam plus corrective lenses can quickly run up a bill. That’s what vision insurance was designed to address. A vision insurance plan can allow you to pay one low monthly premium, and then access services such as regular vision exams, a credit toward corrective lenses, and certain screenings that can detect diseases.

Some vision plans even offer a credit toward Lasik or other corrective surgeries! So for those of you who are tired of dealing with glasses or contact lenses, a vision insurance plan can help you do away with them for good.

Vision insurance plans are typically inexpensive options that almost everyone can afford. And if you’re already receiving a subsidy toward your health insurance, vision plans look even more affordable.

Contact us to learn more about adding a vision insurance plan to your main insurance plan, and we will help you compare plans to locate one that best suits your needs.

What is a POP (Premium Only Plan) and How Does it Benefit Employers?

Posted by on 10:23 pm in Blog | 0 comments

What is a POP (Premium Only Plan) and How Does it Benefit Employers?

As an employer, you understand the value that a quality healthcare plan provides to your employees. Healthy employees are happy employees, and access to reliable healthcare helps them to manage their personal expenses. 

However, you also need to balance your own budget. That’s why you evaluate your group benefits plans carefully, to choose the best fit for your company. If you want to pair tax savings with wider employee choice, you might be interested to learn about Premium-Only Plans, or Section 125 plans. 

A Premium-Only Plan allows employees to pay their own health insurance premiums with pre-tax dollars. These plans can be used in conjunction with employer-sponsored group healthcare plans. 

This is how it works: Premiums are paid from pre-tax dollars before FICA or income taxes are withheld. By utilizing this strategy, employees can reduce their federal income taxes by as much as 40 percent. Now you can offer your employees valuable healthcare benefits while also helping them to save a considerable amount on taxes. 

At the same time, employers will not have to pay FICA/FUTA taxes on any wages that employees use toward their healthcare plan premiums. 

As a courtesy, Bay Area Health pays the setup and maintenance fees for our clients’ POP plans. This typically is around $100 per year.

If a Premium-Only Plan sounds like it would suit your needs, call our office to learn more. We can help you calculate the expected savings for both you and your employees and decide if this healthcare option is right for your company. 

When is Open Enrollment and What Do I Need to Do?

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When is Open Enrollment and What Do I Need to Do?

Your healthcare plan is one of the most important decisions you make each year. Not only does your healthcare plan set forth your network of providers; it also deeply impacts your budget. Choosing the right plan helps you access the care you need, while managing your out-of-pocket expenses in the best way for your situation.

That’s why it is so important to pay attention to Open Enrollment each year. Normally, Open Enrollment runs from November 1 to January 31 each year. However, in response to the pandemic and related conditions, Covered California is operating a special Open Enrollment throughout the year in 2021. Here’s what you need to know.

Healthcare plans depend upon where you live. In California, you can choose from two to six healthcare providers, depending upon the offerings in your area. Determine which providers you prefer, and check to see if they are offered under a particular plan’s network.

Plans are offered in tiers. You can choose from plans in four tiers: Bronze, Silver, Gold, or Platinum. To those who qualify, a minimum coverage plan might also be available. Bronze tier plans have the lowest premiums but highest deductibles, whereas Platinum plans have high premiums but the lowest deductibles.

Analyze your budget. The plan you choose should fit the amount of healthcare you typically require, with a premium that suits your monthly budget. If you choose a low-premium, high-deductible plan, consider a health savings account which will help you set aside pre-tax dollars for use toward your deductible or other out–of-pocket expenses.

Apply for financial assistance. Through Covered California, you can apply for government-funded subsidies that help you manage the cost of your premiums. Your subsidy will depend upon the size of your household and your income. If your income falls below certain levels, you might be eligible for Medi-Cal. We can help you find out how much assistance you qualify for.

Life Changes? If you have had any life changes (marriage/ divorce, had a newborn, got a new job or lost a job, moved to a new county ) please let us know so we can make sure your plan fits your health care needs as well as your budget.

Assistance is available. Call our office to discuss your healthcare plan options. Healthcare plans can be complicated, and we will help you understand the ins and outs of each plan, so that you can choose the right plan for your budget and healthcare needs.

Understanding CalSavers and Your Alternatives

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Retirement poses a considerable challenge to most workers today. That’s why the state of California started the CalSavers program, to help businesses in the state offer a retirement plan to their employees. In fact, the law requires California businesses with five or more employees to offer either the CalSavers program or another retirement plan to their workers, by June 30, 2021 (for businesses with more than 50 employees) or June 30, 2022 (for those with more than five employees). Here’s what you need to know, if you’re comparing your options.

CalSavers is an IRA program that is funded by payroll deductions. Since it was established by the state government, and administered by a private sector financial services firm, many consider CalSavers to be a simple and straightforward option. However, there are a few drawbacks to CalSavers, such as:

  • It is a Roth IRA and subject to income limits. This means higher-income employees won’t be able to participate
  • It is not subject to worker protections under ERISA
  • Contributions are made on an after-tax basis, so employees won’t receive tax advantages in the year that they make contributions
  • Contribution limits are low; $6,000 annually or $7,000 for those age 50 and older
  • There are no employer matching or profit sharing contribution options
  • The plan carries a relatively limited range of investment options
  • Employee fees can run higher than some other retirement plans, impacting overall employee savings over time

While nearly all California businesses are now required to provide a retirement plan for employees, CalSavers is simply one option and it may not be the best fit for your group. So, we are encouraging our clients to review their plan objectives and the pros/cons of CalSavers vs 401(k)’s, etc.

BAHIMI now has a retirement plan team of specialists ready to assist. We are here to run this review on your behalf and help you make the best decision for your team.

Give us a call to discuss your retirement plan options, and we can help you locate a plan that best suits you and your employees.

Understanding the Difference Between Voluntary and Involuntary Termination of Employment

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Understanding the Difference Between Voluntary and Involuntary Termination of Employment

The American Rescue Plan Act brought some good news to those who lost their healthcare coverage due to job loss in the past eighteen months. While COBRA benefits were already available to these individuals, many did not enroll due to the high cost of premiums. The new law provides for 100 percent coverage of COBRA premiums, provided those former employees, or those who lost their plans due a reduction in hours, meet certain qualifications.

However, those qualifications seem a bit murky to many, so let’s clear up the confusion.

First, anyone who lost their healthcare coverage due to a reduction in work hours is eligible to enroll in the subsidized COBRA program. It does not matter if the reduction in work hours was voluntary or involuntary.

As for those who lost their healthcare coverage because they became unemployed, the termination in employment must have been involuntary in order to qualify for subsidized COBRA.

Herein lies the confusion: What types of situations fall under “involuntary termination of employment”? The following conditions were outlined in 2009, and are likely to be adopted by the IRS at this time:

  • There was a separation of employment
  • The separation was due to the independent exercise of the unilateral authority of the employer to terminate the employment
  • And not due to implicit or explicit request by the employee
  • And the employee was willing and able to continue performing services

Under the 2009 law, layoffs, buyouts, seasonal work, failure to renew contracts, and military callups all qualified as involuntary terminations. And under certain circumstances, some retirements and “good reason quits” qualified as well.

The IRS is still undertaking the process of interpreting the new COBRA laws. But because it looks likely that they will adopt some form of previous interpretations, keep the above rules in mind as guidance is issued to former employees.

We also recommend that you contact your COBRA Administrator or insurance carrier if you are subject to Cal COBRA regulations.

COBRA Deadline for Employers is Coming Soon

Posted by on 7:23 pm in Blog | 0 comments

As you might already know, the May 31 deadline for submitting notices of COBRA and CAL-COBRA eligibility (as outlined by the American Rescue Plan Act) is rapidly approaching.

The ARPA extended “free” COBRA coverage to all employees who would have otherwise been eligible during the past 18 months. You, as the employer, are responsible for providing that coverage and will be reimbursed by a tax credit later on.

But first, you must submit information on these employees to your health insurance provider. Some insurance companies have already communicated with covered small businesses, while others are still working through the process. Either way, you will be required to follow through with your side of the responsibilities by the deadline.

Please note that this information applies to both COBRA and CAL-COBRA groups.

COBRA Administrators should already be in contact with you. Watch for their notifications.

CAL-COBRA groups need to be prepared to take the action as directed by their insurance carrier. Not all carriers are handling this situation the same way and it could require you to take prompt action as we are approaching the deadline. Please pay attention and be ready for any correspondence that might come from your insurance carrier.

Prepare this information now, so that it is ready to go once your notice arrives. Eligible employees include:

  • Those who have been insured during the last 18 months, but were terminated or laid off. (Those who quit voluntarily are not eligible.)
  • Those who were insured but are no longer eligible for health benefits due to a reduction in hours
  • Dependents of the above past or present employees

Additionally, you will be responsible for providing the same information to your insurance company for any COBRA-eligible employees in the future. As of now, the ARPA offers this subsidized COBRA coverage through September 30.

Notices must be sent to all ex-employees who Involuntarily lost benefits, and Assistance Eligible Individuals (AEIs) by May 31. Get ahead of this deadline now, so that you aren’t forced to rush at the last minute. Contact our office if you need further assistance to understand this process.

The American Rescue Plan Act and COBRA Subsidies: What Employers Need to Know

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A pandemic is probably the last event during which anyone wants to lose their health insurance. But unfortunately, due to major shake-ups in employment over the past year, that’s exactly what happened to many Americans. If you lost health insurance due to job loss, or other reasons, you have the option to continue your coverage under COBRA provisions.

In the past, COBRA coverage was theoretically possible, but not always practical. That’s because the premiums can run fairly high, especially for those who lose their healthcare plans due to job loss. But due to the challenges posed by the pandemic, the American Rescue Plan Act includes provisions to help the uninsured continue their healthcare coverage through COBRA.

As of April 1, and continuing through September 30, group health plans that provide COBRA coverage must also offer a 100 percent COBRA subsidy for “assistance eligible individuals” and their qualified beneficiaries.

This subsidy applies to major medical plans, along with dental and vision plans, but does not apply to health flexible spending accounts.

Who is “assistance eligible”?

Individuals who qualify for COBRA due to involuntary termination or a reduction in hours should be eligible for the 100 percent subsidy.

Those employees who voluntarily terminated employment, or are eligible for COBRA for some other reason, will not be able to claim the subsidy.

Those who would have been eligible for the COBRA subsidy in the past 18 months, but did not elect the coverage, might also be eligible to enroll and get help with premiums.

Premiums are advanced by the employer or the insurer and are reimbursed by the federal government via a payroll tax credit. This should save the insured individual some time and hassle, allowing easy enrollment for those who qualify and wish to do so. However, employers must be aware of and prepared for being responsible for these premiums. Since federal reimbursement comes in the form of a payroll tax credit, there will be a waiting period before employers will recoup the premiums.

If you have questions about this new legislation or your responsibilities as an employer, contact us right away. The program began on April 1 and will last through September if it is not renewed.

What is an Employee Assistance Program?

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What is an Employee Assistance Program?

Most business owners know that hiring experienced and educated workers is just the first step to ensuring workplace efficiency and effectiveness. Those workers must also be supported, and their needs or concerns addressed, in order to help them continue to perform to their full potential.

That’s why a comprehensive group benefits program can be so helpful in attracting and retaining the best employees. But did you know that many Group Life or Group Disability plans also include something called Employee Assistance Programs (EAPs)? These programs can address a wide variety of employee needs and help to solve problems that could interfere with their work performance.

Over the past year in particular, we’ve all seen that anything going on outside of work (like a pandemic and the associated stress, for example) can affect happenings inside the workplace as well. Employee Assistance Programs are designed to provide assistance to employees and cover a wide range of personal and legal issues that can add stress to their lives or require time away from work for treatment.

What types of situations fall under the umbrella of an Employee Assistance Program? You might be surprised at the wide range of topics that your program could address, such as:

  • Alcohol or other substance abuse treatment
  • Child or elder care complications
  • Financial and legal problems
  • Marital or relationship discord
  • Traumatic events
  • Wellness matters
  • Adoption assistance
  • …and more

These services can be available via a variety of formats, such as email, phone, video chatting, or face-to-face meetings, as the situation warrants. They are delivered at no charge via EAP vendors or providers within the employee’s healthcare plan network.

Services are usually available to the employee as well as their spouse or domestic partner and children.

Many employers actually have Employee Assistance Programs available within their group benefits plans, and don’t even know it! For more information on EAPs and your group benefits plan, give us a call and we’ll be happy to explain your benefits.