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Vince Murdica, chief revenue officer at ThinkHR, discusses what it takes to become scalable and sustainably staff companies through bursts of rapid growth.

I’ve seen it in my own career: When companies go through rapid growth — quickly moving from 50 to 100+ employees — things start to get shaky. This period of acceleration can be compared to when a jet breaks through the sound barrier. The flight is smooth until that moment, then the plane rattles violently and feels like it’s going to break apart. But when it gets through to the other side, it’s smooth skies again and you’re now flying even faster and higher.

There is a loss of control as a company gets bigger, and not all leaders can handle it. Some career entrepreneurs prefer to start companies, grow them to around 50 people, then sell them because they are uncomfortable with the growing pains that inevitably happen beyond this point. They will do it again and again.

Other leaders are better at growth and mastering scalability. They have what it takes to grow their companies over the 100-person mark. I believe these leaders consistently do three key things when growing their staff:

#1 Hire People You Trust

When you scale up, the ability of senior management to be involved in every detail — to be in all the meetings, involved with every decision, leading all the major initiatives — breaks down. There is a human limit to how many one-on-one relationships you can manage, so your ability to manage as you gain more direct reports goes down. When growing from 50 to 100 employees, new layers of management must get formed.

At this point, delegation becomes critical, or productivity will come to a screeching halt. That’s why it’s crucial to hire managers and other people you can trust. This takes time and effort, but I believe the key to establishing this environment of trust is “hiring slow and firing fast.”

#2 Delegate Responsibility and Authority

Once you’ve hired great, trustworthy people, don’t ever delegate responsibility without also delegating authority. Your staff needs to keep everything moving while you are doing other things for the organization. They can’t wait around for you to make decisions. Hand them the power to innovate, solve problems, and reach the goals you’ve set out for them.

A mantra I borrowed from a mentor is, “I don’t mind giving speeding tickets, but if I need to give too many parking tickets, we have a problem.”

I would rather an employee charge ahead and make an informed, strategic decision that turns out to be a mistake instead of hold back and move too cautiously. Everyone on my team feels empowered. We get it done and we don’t wait. (Wait is a four-letter word.) The burden on leadership is to be sure that goals and strategy are clear, so people can move quickly, with confidence and creativity.

#3 Learn from Mistakes

To me, business is like a sport. It’s a competition. There is a winner and a loser and it’s a real-world game. Approaching it that way enforces a specific mindset around it. To use football as an example: On Monday you review the film from Sunday’s game and see how you can improve. You practice all week to make tweaks, try new plays, and fix what’s broken. Then your next game is a fresh opportunity to be a new team with a new opponent.

In business, like in any sport, we are going to make mistakes. That’s how we learn, but what’s important is that we don’t make those same mistakes again. We get into the mindset of always improving. Failing isn’t necessarily bad — it means your people aren’t afraid to innovate and achieve.

Smooth Skies Ahead

Do these three things — trust, delegate, and learn — which are so core to building a scalable team, and soon your company will be breaking through the sound barrier and once again flying smooth skies.

In the end, growth can be fun, and winning is really fun. Your team will be fulfilled and feel like they are making an impact. So to mix metaphors: Go let your team get some speeding tickets!

 

Originally published by www.thinkhr.com

Friday, April 27, the Internal Revenue Service (IRS) announced that the 2018 annual contribution limit to Health Savings Accounts (HSAs) for persons with family coverage under a qualifying High Deductible Health Plan (HDHP) is restored to $6,900. The single-coverage limit of $3,450 is not affected.

This is the final word on what has been an unusual back-and-forth saga. The 2018 family limit of $6,900 had been announced in May 2017. Following passage of the Tax Cuts and Jobs Act in December 2017, however, the IRS was required to modify the methodology used in determining annual inflation-adjusted benefit limits. On March 5, 2018, the IRS announced the 2018 family limit was reduced by $50, retroactively, from $6,900 to $6,850. Since the 2018 tax year was already in progress, this small change was going to require HSA trustees and recordkeepers to implement not-so-small fixes to their systems. The IRS has listened to appeals from the industry, and now is providing relief by reinstating the original 2018 family limit of $6,900.

Employers that offer HSAs to their workers will receive information from their HSA administrator or trustee regarding any updates needed in their payroll files, systems, and employee communications. Note that some administrators had held off making changes after the IRS announcement in March, with the hopes that the IRS would change its position and restore the original limit. So employers will need to consider their specific case with their administrator to determine what steps are needed now.

HSA Summary

An HSA is a tax-exempt savings account employees can use to pay for qualified health expenses. To be eligible to contribute to an HSA, an employee:

  • Must be covered by a qualified high deductible health plan (HDHP);
  • Must not have any disqualifying health coverage (called “impermissible non-HDHP coverage”);
  • Must not be enrolled in Medicare; and
  • May not be claimed as a dependent on someone else’s tax return.

HSA 2018 Limits

Limits apply to HSAs based on whether an individual has self-only or family coverage under the qualifying HDHP.

2018 HSA contribution limit:

  • Single: $3,450
  • Family: $6,900
  • Catch-up contributions for those age 55 and older remains at $1,000

2018 HDHP minimum deductible (not applicable to preventive services):

  • Single: $1,350
  • Family: $2,700

2018 HDHP maximum out-of-pocket limit:

  • Single: $6,650
  • Family: $13,300*

*If the HDHP is a nongrandfathered plan, a per-person limit of $7,350 also will apply due to the ACA’s cost-sharing provision for essential health benefits.

 

Originally posted on thinkHR.com

As the first month of 2018 wraps up, companies have already begun the arduous task of submitting budgets and finding ways to cut costs for the new year. One of the most effective ways to combat increasing health care costs for companies is to move to a Self-Funded insurance plan. By paying for claims out-of-pocket instead of paying a premium to an insurance carrier, companies can save around 20% in administration costs and state taxes. That’s quite a cost savings!

The topic of Self-Funding is huge and so we want to break it down into smaller bites for you to digest. This month we want to tackle a basic introduction to Self-Funding and in the coming months, we will cover the benefits, risks, and the stop-loss associated with this type of plan.

THE BASICS

  • When the employer assumes the financial risk for providing health care benefits to its employees, this is called Self-Funding.
  • Self-Funded plans allow the employer to tailor the benefits plan design to best suit their employees. Employers can look at the demographics of their workforce and decide which benefits would be most utilized as well as cut benefits that are forecasted to be underutilized.
  • While previously most used by large companies, small and mid-sized companies, even with as few as 25 employees, are seeing cost benefits to moving to Self-Funded insurance plans.
  • Companies pay no state premium taxes on self-funded expenditures. This savings is around 5% – 3/5% depending on in which state the company operates.
  • Since employers are paying for claims, they have access to claims data. While keeping within HIPAA privacy guidelines, the employer can identify and reach out to employees with certain at-risk conditions (diabetes, heart disease, stroke) and offer assistance with combating these health concerns. This also allows greater population-wide health intervention like weight loss programs and smoking cessation assistance.
  • Companies typically hire third-party administrators (TPA) to help design and administer the insurance plans. This allows greater control of the plan benefits and claims payments for the company.

As you can see, Self-Funding has many facets. It’s important to gather as much information as you can and weigh the benefits and risks of moving from a Fully-Funded plan for your company to a Self-Funded one. Doing your research and making the move to a Self-Funded plan could help you gain greater control over your healthcare costs and allow you to design an original plan that best fits your employees.

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

Researchers have shown us that there is a close-knit relationship between oral health and overall wellness. With over 500 types of bacteria in your mouth, it’s no surprise that when even one of those types of bacteria enter your bloodstream that a problem can arise in your body. Oral bacteria can contribute to:

  1. Endocarditis—This infection of the inner lining of the heart can be caused by bacteria that started in your mouth.
  2. Cardiovascular Disease—Heart disease as well as clogged arteries and even stroke can be traced back to oral bacteria.
  3. Low birth weight—Poor oral health has been linked to premature birth and low birth weight of newborns.

The healthcare costs for the diseases and conditions, like the ones listed above, can be in the tens of thousands of dollars. Untreated oral diseases can result in the need for costly emergency room visits, hospital stays, and medications, not to mention loss of work time. The pain and discomfort from infected teeth and gums can lead to poor productivity in the workplace, and even loss of income. Children with poor oral health miss school, are more prone to illness, and may require a parent to stay home from work to care for them and take them to costly dental appointments.

So, how do you prevent this nightmare of pain, disease, and increased healthcare costs? It’s simple! By following through with your routine yearly dental check ups and daily preventative care you will give your body a big boost in its general health. Check out these tips for a healthy mouth:

  • Maintain a regular brushing/flossing routine—Brush and floss teeth twice daily to remove food and plaque from your teeth, and in between your teeth where bacteria thrive.
  • Use the right toothbrush—When your bristles are mashed and bent, you aren’t using the best instrument for cleaning your teeth. Make sure to buy a new toothbrush every three months. If you have braces, get a toothbrush that can easily clean around the brackets on your teeth.
  • Visit your dentist—Depending on your healthcare plan, visit your dentist for a check-up at least once a year. He/she will be able to look into that window to your body and keep your mouth clear of bacteria. Your dentist will also be able to alert you to problems they see as a possible warning sign to other health issues, like diabetes, that have a major impact on your overall health and healthcare costs.
  • Eat a healthy diet—Staying away from sugary foods and drinks will prevent cavities and tooth decay from the acids produced when bacteria in your mouth comes in contact with sugar. Starches have a similar effect. Eating healthy will reduce your out of pocket costs of fillings, having decayed teeth pulled, and will keep you from the increased health costs of diabetes, obesity-related diseases, and other chronic conditions.

There’s truth in the saying “take care of your teeth and they will take care of you”.  By instilling some of the these tips for a healthier mouth, not only will your gums and teeth be thanking you, but you may just be adding years to your life.

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

Cost-shifting, plan changes, and other protections influenced rates

  • Sustained prevalence of and enrollment in lower-cost consumer-driven health plans (CDHPs) and health maintenance organization (HMO) plans kept rates lower.
  • For yet another year, “grandmothered” employers continue to have the options they need to select cheaper plans (ACA-compliant community-rated plans versus pre-ACA composite/health-rated plans) depending on the health status of their groups.
  • Increased out-of-network deductibles and out-of-pocket maximums, with greater increases for single coverage rather than family coverage, as well as prescription drug cost shifting, are among the plan design changes influencing premiums.
  • UBA Partners leveraged their bargaining power.

Overall costs continue to vary significantly by industry and geography

  • Retail, construction, and hospitality employees cost the least to cover; government employees (the historical cost leader) continue to cost among the most.
  • As in 2016, plans in the Northeast cost the most and plans in the Central U.S. cost the least.
  • Retail and construction employees contribute above average to their plans, so those employers bear even less of the already low costs in these industries, while government employers pass on the least cost to employees despite having the richest plans.

Plan design changes strained employees financially

  • Employee contributions are up, while employer contributions toward total costs remained nearly the same.
  • Although copays are holding steady, out-of-network deductibles and out-of-pocket maximums are rising.
  • Pharmacy benefits have even more tiers and coinsurance, shifting more prescription drug costs to employees.

PPOs, CDHPs have the biggest impact

  • Preferred provider organization (PPO) plans cost more than average, but still dominate the market.
  • Consumer-driven health plans (CDHPs) cost less than average and enrollment is increasing.

Wellness programs are on the rise despite increased regulations and scrutiny

Metal levels drive plan decisions

  • Most plans are at the gold or platinum metal level reflecting employers’ desire to keep coverage high. In the future, we expect this to change since it will be more difficult to meet the ACA metal level requirements and still keep rates in check.

Key trends to watch

  • Slow, but steady: increase in self-funding, particularly for small groups.
  • Cautious trend: increased CDHP prevalence/enrollment.
  • Rapidly emerging: increase of five-tier and six-tier prescription drug plans.

By Bill Olson
Originally Published By United Benefit Advisors

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

According to our new special report: “Small Businesses Keeping Pace with Nationwide Health Trends,” employees across all plan types pay an average of $3,378 toward annual health insurance benefits, with their employer picking up the rest of the total cost of $9,727. Among small groups, employees pay $3,557, with their employer picking up the balance of $9,474 – only a 5.3 percent difference.

When looking at total average annual cost per employees for PPO plans, small businesses actually cut a better deal even compared to their largest counterparts—their costs are generally below average—and the same holds true for small businesses offering HMO and CDHP plans. (Keep in mind that relief such as grandmothering and the PACE Act helped many of these small groups stay in pre-ACA plans at better rates, unlike their larger counterparts.)

PPO Plan Average Annual Cost per Employee

Think small businesses are cutting coverage to drive these bargains? Compared to the nations very largest groups, that may be true, but compared to average employers, small groups are highly competitive.

By Bill Olson
Originally Published By United Benefit Advisors

It’s not surprising that 2017 stands to be the year many will have an experience to share using a Telemedicine or a Virtual Doctor service. With current market trends, government regulations, and changing economic demands, it’s fast becoming a more popular alternative to traditional healthcare visits.  And, as healthcare costs continue to rise and there are more strategic pricing options and digital models available to users, the appeal for consumers, self-insured employers, health systems and health plans to jump on board is significant.

Check out this short video and contact us to learn more!

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.

In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. Similarly, insurers and employers with less than 50 full time employees but that have a self-funded plan also have reporting obligations. All of this reporting is done on IRS Forms 1094-B, 1095-B, 1094-C and 1095-C.

Final instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in September 2015, as were the final forms for 1094-B, 1095-B, 1094-C, and 1095-C.

Form 1094-C is used in combination with Form 1095-C to determine employer shared responsibility penalties. It is often referred to as the “transmittal form” or “cover sheet.” IRS Form 1095-C will primarily be used to meet the Section 6056 reporting requirement, which relates to the employer shared responsibility/play or pay requirement. Information from Form 1095-C will also be used in determining whether an individual is eligible for a premium tax credit.

Form 1094-C contains information about the ALE, and is how an employer identifies as being part of a controlled group. It also has a section labeled “Certifications of Eligibility” and instructs employers to “select all that apply” with four boxes that can be checked. The section is often referred to as the “Line 22” question or boxes. Many employers find this section confusing and are unsure what, if any, boxes they should select. The boxes are labeled:

  1. Qualifying Offer Method
  2. Reserved
  3. Section 4980H Transition Relief
  4. 98% Offer Method

Different real world situations will lead an employer to select any combination of boxes on Line 22, including leaving all four boxes blank. Practically speaking, only employers who met the requirements of using code 1A on the 1095-C, offered coverage to virtually all employees, or qualified for transition relief in 2015 and had a non-calendar year plan will check any of the boxes on Line 22. Notably, employers who do not use the federal poverty level safe harbor for affordability will never select Box A, and corresponding with that, will never use codes 1A or 1I on Line 14 of a 1095-C form.

By Danielle Capilla, Originally Published By United Benefit Advisors

Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.

We knew most fully-insured groups did not have a Summary Plan Description (SPD) for their health and welfare plans, but we have been surprised by some of the other things that were missing. Here are the top five compliance surprises we found.

  1. COBRA Initial Notice. The initial notice is a core piece of compliance with the Consolidated Omnibus Budget and Reconciliation Act (COBRA) and we have been very surprised by how many clients are not distributing this notice. Our clients using a third-party administrator (TPA), or self-administering COBRA, are doing a good job of sending out the required letters after qualifying events. However, we have found that many clients are not distributing the required COBRA initial notice to new enrollees. The DOL has recently updated the COBRA model notices with expiration dates of December 31, 2019. We are trying to get our clients to update their notices and, if they haven’t consistently distributed the initial notice to all participants, to send it out to everyone now and document how it was sent and to whom.
  2. Prescription Drug Plan Reporting to CMS. To comply with the Medicare Prescription Drug Improvement and Modernization Act, passed in 2003, employer groups offering prescription benefits to Medicare-eligible individuals need to take two actions each year. The first is an annual report on the Centers for Medicare & Medicaid Services (CMS) website regarding whether the prescription drug plan offered by the group is creditable or non-creditable. The second is distributing a notice annually to Medicare-eligible plan members prior to the October 15 beginning of Medicare open enrollment, disclosing whether the prescription coverage is creditable or non-creditable. We have found that the vast majority (but not 100 percent) of our clients are complying with the second requirement by annually distributing notices to employees. Many clients are not complying with the first requirement and do not go to the CMS website annually to update their information. The annual notice on the CMS website must be made within:
  • 60 days after the beginning of the plan year,
  • 30 days after the termination of the prescription drug plan, or
  • 30 days after any change in the creditability status of the prescription drug plan.
  1. ACA Notice of Exchange Rights. The Patient Protection and Affordable Care Act (ACA) required that, starting in September 2013, all employers subject to the Fair Labor Standards Act (FLSA) distribute written notices to all employees regarding the state exchanges, eligibility for coverage through the employer, and whether the coverage was qualifying coverage. This notice was to be given to all employees at that time and to all new hires within 14 days of their date of hire. We have found many groups have not included this notice in the information they routinely give to new hires. The DOL has acknowledged that there are no penalties for not distributing the notice, but since it is so easy to comply, why take the chance in case of an audit?
  2. USERRA Notices. The Uniformed Services Employment and Reemployment Rights Act (USERRA) protects the job rights of individuals who voluntarily or involuntarily leave employment for military service or service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services. Employers are required to provide a notice of the rights, benefits and obligations under USERRA. Many employers meet the obligation by posting the DOL’s “Your Rights Under USERRA” poster, or including text in their employee handbook. However, even though USERRA has been around since 1994, we are finding many employers are not providing this information.
  3. Section 79. Internal Revenue Code Section 79 provides regulations for the taxation of employer-provided life insurance. This code has been around since 1964, and while there have been some changes, the basics have been in place for many years. Despite the length of time it has been in place, we have found a number of groups that are not calculating the imputed income. In essence, if an employer provides more than $50,000 in life insurance, then the employee should be paying tax on the excess coverage based on the IRS’s age rated table 2-2. With many employers outsourcing their payroll or using software programs for payroll, calculating the imputed income usually only takes a couple of mouse clicks. However, we have been surprised by how many employers are not complying with this part of the Internal Revenue Code, and are therefore putting their employees’ beneficiaries at risk.

There have been other surprises through this process, but these are a few of the more striking examples. The feedback we received from our compliance assessments has been overwhelmingly positive. Groups don’t always like to change their processes, but they do appreciate knowing what needs to be done.

 

By Bob Bentley, Originally Published By United Benefit Advisors

Many employers benchmark their health plan against carrier provided national data. While that is a good place to start, regional cost averages vary, making it essential to benchmark both nationally and regionally—as well as state by state. For example, a significant difference exists between the cost to insure an employee in the Northeast versus the Central U.S.—plans in the Northeast continue to cost the most since they typically have lower deductibles, contain more state-mandated benefits, and feature higher in-network coinsurance, among other factors.

UBA Health Plan Survey Costs by Region

Drilling down even more, comparing yourself to your industry peers can tell a very different story.

UBA Health Plan Survey Costs by Industry

Consider a manufacturing plant in Georgia that offers a PPO. Its premium cost for single coverage is $507 per month. Compare this with the benchmarks for all plans and you can see that it is $2 per month less than the national average. When compared with other PPOs in the Southeast region, this employer’s cost is actually $2 more than the average. This employer’s cost appears to be higher or lower compared with national and regional benchmarks, depending on which benchmark is used. Yet this employer’s cost is actually higher than its closest peers’ costs when using the state-specific benchmark, which in Georgia is $468. Bottom line, this employer’s monthly single premium is actually $39 more than its competitors in the state.UBA Health Plan Survey Plan Comparison

As our CEO, Les McPhearson, recently stated, “Benchmarking by state, region, industry, and group size is critical. We see it time and time again, especially with new clients. An employer benchmarks their rates nationally and they seem at or below average, but once we look at their rates by plan type across multiple carriers and among their neighboring competitors or like-size groups, we find many employers leave a lot on the bargaining table.”

By RJ Nelson
Originally published by www.ubabenefits.com

 

Switching over to AEIS Advisors was the best decision we’ve made this year. Ronald and his team were able to identify discrepancies on our billing statements which got missed by our last broker, and they saved us over $8,000 in credits! AEIS has proven to be an attentive and caring company, looking out for the best needs of their clients."

- Director of Operations

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