As an employer, you know that healthy employees feel more satisfied with their jobs, are more productive, and miss fewer days of work. That’s why you provide them with a quality healthcare plan, and possibly even supplemental policies for dental and vision care.
But those plans don’t exist solely to “fix” health problems. They are designed to provide routine preventive care, so that many problems can be avoided. The problem is, many people never bother to become familiar with their healthcare plans until they’re sick, and therefore aren’t aware of how to best harness the power of these preventive care benefits.
It’s easy to see that taking one day off of work for routine preventive care is far better than a week due to illness or medical treatment! But because most people view healthcare in terms of “fixing” instead of “preventing” it’s important to familiarize your workers with their healthcare benefits, and encourage them to use those perks wisely.
Routine physical. All medical plans offer an annual physical to enrollees, at no charge. Remind your employees to schedule their physicals, so that chronic medical problems can be detected and treated early (or prevented altogether).
Dental exams and cleanings. If you subscribe to a dental health plan, it probably offers free bi-annual exams and cleanings. Not only does routine dental care prevent serious dental problems, an exam can detect other health issues like:
- oral cancer
- pancreatic cancer
- heart disease
- kidney disease
- bone loss
Vision care. Obviously, an annual eye exam can detect changes in vision, which might impair workers on the job, increase the likelihood of accidents, and cause frequent headaches. But you might be surprised to know that an eye exam can often the first time that problems such as brain tumors and developing diabetes are detected!
What you should do… In meetings, newsletters, or other forms of communication with employees, regularly remind them of their preventive care benefits. You’re paying for a quality plan, to help them stay healthy, so you might as well reap the maximum benefits! If you’re unsure of your plan’s coverage of preventive care, give us a call and we’ll help you sort it out.
Last month, Republican efforts to revise parts of the Affordable Care Act seemed to fail, as the American Health Care Act was withdrawn due to lack of sufficient support. Now that President Trump’s long-promised healthcare reform policy has faltered, you might be wondering what is coming next.
The ACA stands for now. Without reform or replacement, all parts of the Affordable Care Act remain law. At the moment your health insurance plan is expected to remain unchanged.
The debate is far from over. Even though the AHCA failed as a whole, Republican lawmakers still express concern over various aspects of the nation’s healthcare. It is likely they will continue to pursue action in some, or all, of the following areas:
- Regulatory relief – to help stabilize the individual marketplace
- Regulatory non-enforcement – certain aspects of the ACA, which are heavily criticized (such as the Individual Mandate), might not be enforced by the current Administration
- Tax Reform – President Trump and other Republican lawmakers have stated that tax reform is their next high-priority issue. It is possible that some of the tax regulations associated with the ACA could be changed or repealed
- Piecemeal legislation – the AHCA failed primarily because a majority of Congressional representatives could not agree on its various components. But we could see individual reforms pass through the House and Senate one at a time
- Increased power to the states – the Administration might defer certain reform issues to the states, to be decided individually as they see fit
Also keep an eye on these issues. At this time of year, insurers begin to submit their healthcare plans for review, to determine whether they will participate in the healthcare Marketplace in 2018. With the ACA standing for now, insurers will be required to comply with current regulations, as they have for the past several years.
We’ll keep you updated on any changes to healthcare on a nationwide or statewide level. For now, we anticipate the possibility for small changes throughout the year, but for now your healthcare plan is expected to remain mostly the same for 2018.
Perhaps for one reason or another, you can’t provide your employees with a group health insurance plan. Luckily, they can purchase a plan on their own or through the Covered California exchange. But… maybe they have trouble covering the premiums. Maybe they need a prescription medication, device, or service not covered by the insurance plan. Now what?
Whatever the situation, these problems can frustrate your employees. They might also have trouble staying healthy, and that’s a problem that can carry over to the workplace. You want to help your employees, and ensure that they can access benefits they need. But how?
A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) might be the answer to your quandary. Due to federal regulations passed in December, small businesses can access this provision to help care for their employees, if you meet the following requirements:
- You employ fewer than 50 full-time workers
- You do not offer a group health insurance plan
- You will offer the HRA to all full-time employees, on the same terms
How an QSEHRA works. A Health Reimbursement Arrangement allows you to make contributions to a tax-advantaged account. That money is used to reimburse the worker for eligible healthcare-related expenses, like their premiums.
How an HRA benefits you. You can offer this valuable benefit to employees, without having to pay payroll taxes on your contributions to the account. They don’t pay taxes on the contributions, either. And of course, happy, healthy employees are always a benefit!
An HRA might be subject to limits. Under Small Business HRA rules, you can contribute up to $4,950 for a single employee and $10,000 for those with families. These limits may be adjusted in the future to account for inflation.
Even if you can’t afford to fully fund a group health insurance plan, you can help your employees pay for their own plans (and keep them happy and healthy at the same time). As with any other health insurance related issue, QSEHRAs can be complex and often require some explaining. Give us a call if you have questions, and we can help you decide if this type of benefit is right for your company.
Visiting another country is an exciting, hands-on way to learn about another culture. Of course, if an illness or accident happens, you will also receive a demonstration of their healthcare system. And that’s not so exciting!
If you’re planning a foreign vacation, you’re probably quite busy researching the different aspects of your trip. Don’t forget to consider healthcare. In the event that something happens along the way, will your health insurance policy still protect you?
The answer to that question is… It depends. The first thing you should do is find out about how your plan will work.
Will my plan cover overseas healthcare? In some cases the answer is yes, but coverage might be limited to emergency situations only. Seek to fully understand those limitations. Ask if any countries are excluded from this coverage. If you’re planning any special activities, such as mountain climbing, ask if accidents related to “risky activities” will be covered.
Ask about coverage for emergency evacuations. Find out if your insurance policy will pay for you to be transported back to the US, in the event of a very serious illness or injury. These emergency evacuations can cost upwards of $100,000 in some cases!
How do I file a claim? Your health insurance provider has an established system for filing overseas healthcare claims. Knowing this information upfront can help you make the right decisions along the way.
In many cases, after asking these questions you might determine that your health insurance does not adequately protect you in all possible scenarios. A travel insurance plan can help fill in the gaps, ensuring that you receive the care you need in an emergency.
If you have Medicare… consider Medigap insurance. If you’re over age 65 and receive Medicare benefits, know that Medicare will not cover medical care that you seek in foreign countries. A Medigap supplemental policy can help, but there is a lifetime $50,000 cap on overseas services.
If you’re considering a trip to another country, it can be easy to get caught up in the “fun” parts of vacation planning. But your health goes with you wherever you go! And in the event of an emergency, you don’t want to return home to a mountain of bills. Give us a call and we can help you evaluate your health insurance plan, and decide upon a strategy to address this risk.
As an employer, you know that happy employees are the foundation of a successful company. There are many factors that can influence job satisfaction, and your benefits plan plays a big role. How much are you spending each year on employee benefits? Do your employees understand the value of their benefits plan?
Often, an employer rolls out the plan or only addresses benefits during open enrollment. Then, there isn’t much discussion about these topics throughout the rest of the year. As a result, employees don’t fully understand their benefits, and they aren’t utilizing all of the options that are offered.
Here are three things that you can do to maintain great communication regarding employee benefits:
Schedule Employee Meetings
Most new hires hear about the benefits during the onboarding process, but there isn’t much communication after that point. Schedule meetings to update your staff about the benefits and offer suggestions about ways to leverage the options that are offered. You might consider a mid-year meeting as well as a meeting during open enrollment.
Use Other Forms of Communication
Do you feel like your schedule is already overbooked with meetings? If you don’t want to setup another time to gather the group in the conference room, then you might look at other forms of communication. Emails can be a powerful way to disseminate information to everyone in the company. Another option is to put together a whitepaper that outlines the benefits that are offered. These pages can be printed and distributed with paychecks, in employee mailboxes, or in the breakroom. We live in a digital world, so a printed piece of paper can be an effective way to capture the attention of your workforce in a unique way.
List the Value of Benefits
Regardless of the communication platform that you choose, make sure that you provide details about the benefits that are offered. Employees don’t often understand the money that is invested to provide a great benefits package. Outline the extras that they are receiving on top of their base salary: insurance premiums, workers compensation, taxes, vacation pay and time off, and more.
Ensure that Your Benefits Plan is Being Used
We’ve found that the best way to ensure that your benefits plan works is by helping employees understand how to use it. By sharing this information, you can boost employee satisfaction and help them to see the ways their employer is providing for their family.
Are you interested in learning more about how you can provide the best benefits for your employees? Contact us today for more information.
Open Enrollment for health insurance ended on January 31. If you missed the deadline, you might be wondering what will happen now. The answer depends largely upon your income, and also upon events that could unfold later this year. So when we talk about the consequences of failing to purchase health insurance, keep in mind that each individual situation varies. In general, though, you’re looking at three possible outcomes.
You don’t have health insurance. This one is obvious. If you don’t have health insurance, unexpected medical expenses throughout this year could become a big problem. You will be held personally responsible for 100 percent of those bills.
You might owe a penalty on your taxes next year. When you file your tax return in spring of 2018, here’s what you could owe for failing to purchase insurance (on top of your regular taxes):
- $695 per uninsured person in the household
- 2.5 percent of your total income
The penalty will be the greater of these two amounts, limited to $13,100 per household. There are exceptions to this rule. For example, those who fall below a certain income range might not be required to purchase insurance (although in that case, you should enroll in Medi-Cal). Various other exemptions exist, such as those for members of Native American tribes, but they are rare.
You might be able to enroll in a health insurance plan at some point this year. The penalty applies if you go more than three months without health insurance during the calendar year, and is calculated on a pro-rated, per-month basis. So for example, if you aren’t covered for four months of the year, your penalty would be smaller than someone who is uncovered for the entire year.
The good news is that you might still be able to obtain health insurance coverage, protect your financial future, and prevent the Individual Mandate penalty on your taxes next year. In certain cases, you might qualify for a Special Enrollment Period. You could be able to select a healthcare plan if:
- Your family size changes (you get married, get divorced, have a child, and so on)
- Your health insurance plan is canceled
- You experience a major change in financial status, which could qualify you for Medi-Cal or subsidies to help with the cost of insurance
- … and several more special situations.
When in doubt, ask! Give us a call, and we can help you determine whether you are eligible for the Special Enrollment period. Even if you missed the Open Enrollment deadline on January 31, you might have opportunities throughout the year to enroll in a health insurance policy.
For businesses that choose to offer group health insurance to employees, a question of cost versus benefit always arises. You hope to offer the best healthcare policy possible to your workers, but you might end up choosing a plan that carries a higher deductible. Don’t despair; by offering health insurance, you are still providing a wonderful benefit. And luckily, we have ways of mitigating the burden of high deductibles.
In these situations, a health savings account (HSA) is often the perfect solution. Your employees no doubt enjoy the low monthly premiums of their healthcare plan, but they might worry about meeting their annual deductibles. An HSA allows them to stash tax-free money (that is, deducted from paychecks before taxes are taken out) in a spending account. Your workers can then use the funds in this account to pay for unexpected medical bills, so that a high deductible is not seen as an obstacle to medical care.
Not everyone is eligible to open an HSA. In 2017, you can pair this type of account with any plan that carries an annual deductible of $1,300 (for individual coverage) or $2,600 (for family coverage). That means quite a few of the group health insurance plans available in California can be paired with an HSA.
Each year, an individual can contribute a certain amount to their health savings account. In 2017, the limit is $3,400, or $6,750 for those with family insurance coverage. Those aged 55 and older can contribute an additional $1,000 to their accounts.
Holders of health savings accounts can contribute money for as long as they are enrolled in a high-deductible health insurance plan. If that plan ends, or they upgrade to a low-deductible insurance policy, they can no longer contribute to the HSA. However, unused money rolls over from one year to the next, and the money is theirs to keep.
In fact, an HSA can serve as an additional retirement planning vehicle. Unused funds, rolled over from one year to the next, can be used on medical expenses in retirement. By helping employees to establish a health savings account, you are providing them with a useful budgeting tool now – and potentially a valuable source of much-needed funds in retirement.
As always, contact us with your questions about group health insurance and other employee benefits. We can help you decide what works for your business, while providing excellent care and coverage to your employees.
Each year, the health insurance marketplace holds its annual Open Enrollment period, beginning in the fall and stretching into January. Many of you early birds have already taken care of this important decision, and your new healthcare plan took effect on January 1. But for those of you who tend to procrastinate, keep in mind that the deadline to enroll in a healthcare plan is rapidly approaching at the end of this month.
If you’re tempted to wait until the last minute to select a health insurance policy, keep one thing in mind: Your enrollment date will affect the effective date of your coverage. This late in the game, you have two options:
- Select a health insurance policy by January 15, and make your binder payment by January 27, for coverage that begins on February 1.
- Enroll in a plan between January 16 and 31, for coverage to begin by March 1.
As you can see, missing the January 15 deadline will mean that your health insurance coverage won’t start until March, rather than February. Since one day of procrastination can cost you an entire month of coverage, it’s best to submit your application right away.
What if you’ve enrolled in a healthcare plan, and you’ve been issued a “pending” status for coverage that begins on February 1, but you change your mind about some aspect of the policy? You can still make changes to your application, but hurry. If you make those changes after January 15, they won’t take effect until March 1.
Remember that if you miss the January 31 deadline to apply for health insurance coverage, you won’t be able to enroll in a plan unless you experience a Qualifying Life Event at some point during the year. Otherwise, you will have to wait until Open Enrollment begins this November.
NOTE: Dental applications can be made any time during the year and are not subject to the Open Enrollment timelines.
As always, give us a call if you have questions about health insurance coverage, or need help with your application. We specialize in helping our clients identify all of their options and choose a healthcare plan that fits their needs.
You probably think of vision benefits as something only people with known eyesight problems really need. However, according to the National Association of Vision Plans, Americans with vision care insurance exhibit healthier eye care habits overall. And since we can all develop health issues with our eyes (even if we don’t have a history of vision problems), regular checkups are important for everyone. These checkups can keep your employees healthy, help them manage overall healthcare costs, and even prevent time lost from work due to events ranging from severe headaches to eye surgery.
According to the study, 62 percent of people with vision benefits had an eye exam within the last year. A whopping 90 percent planned to see the eye doctor at some point next year. Meanwhile, only 40 percent of people without a vision care plan had visited an eye care professional in the preceding 12 months, and only 67 percent said they would probably make an appointment within the next year.
In other words, people with vision benefits tend to visit eye care professionals much more often than those who do not have this type of insurance. That information probably does not surprise you. However, what might surprise you is the fact that eye care providers tend to be the first line of defense against many diseases and chronic conditions. And since early detection of some problems can lead to a faster and easier resolution, vision care benefits can actually lower overall long-term health care costs.
In fact, 5.6 percent of all chronic conditions are first identified by a comprehensive eye exam. Imagine how long those conditions might have gone untreated! Many chronic conditions must progress much farther before they are noticed by the patient or his primary care physician, at which point the condition could be much more difficult and expensive to treat.
Regular vision care also helps those with vision problems to receive up-to-date prescriptions for eyeglasses and contact lenses. Using outdated corrective lenses can result in chronic headaches, and advancements in technology can help to ward off problems that would otherwise develop from wearing old contact lenses. Vision problems can also develop as we age, so even those who have never experienced difficulties should visit an eye care professional regularly for early detection of nearsightedness and other conditions.
For more information on vision care benefits, give us a call. We can help you determine if adding vision care to your roster of employee benefits would be a useful and cost-saving measure for your employees.
We’re currently right in the middle of the annual Open Enrollment period for health insurance, which opened on November 1 and will end January 31. You still have plenty of time to enroll in a health insurance plan, but what happens if you get busy and forget? There are two main consequences of procrastination, and neither of them are easy to get around.
First, if you don’t enroll in a health insurance plan as required by the Affordable Care Act, you will most likely be subject to a penalty on your income taxes. When you file your income tax return in the spring of 2018, you could be fined up to $2,085 if your family did not have health insurance coverage in 2017. There are exceptions to this rule, but they fall under pretty strict requirements and it’s difficult to qualify for them.
Second, going without health insurance can quite simply be dangerous. Even if you’re in excellent health, one accident or illness could set you back by tens or even hundreds of thousands of dollars. With quality health insurance plans so readily available – and most Californians qualifying for subsidies to help cover their premiums – neglecting to enroll in a plan simply doesn’t make sense.
But for various reasons, people still sometimes miss the Open Enrollment window. Luckily, regulations take into account changing needs during the course of the year. If one of these following conditions apply to you at any point, you can still enroll in a health insurance policy during a Special Enrollment Period:
- You lose Medi-Cal coverage, employer-sponsored coverage, or COBRA
- You turn 26 years old and must exit your parent’s plan
- You turn 19 and are no longer eligible for a child-only plan
- You move and gain access to at least one new Covered California health insurance plan
- You have a baby, adopt a child, or receive a child into foster care
- You get married, enter into a domestic partnership, or get divorced
- You lose health insurance coverage after leaving military service
- Your citizenship status changes
- You are a member of a federally recognized American Indian tribe
- You discover that you were subject to incorrect eligibility determination during the Open Enrollment period
- There was an error processing your application during Open Enrollment
- Your health plan violates its contract
- … and many more life-changing events
If you think you might be eligible for a Special Enrollment period during the year, contact us so that we can discuss your situation. But if you’re reading this, then we want to remind you that Open Enrollment is happening right now, and everyone should investigate their health insurance options. Don’t put it off until later, when you’re likely to forget. Give us a call and let’s get started today.