AEIS Advisors

How to Integrate Benefits Education into Onboarding: A Practical Guide for HR Leaders

Tue, 07 Apr 2026 13:00:33 GMT

The first few weeks of employment shape how new hires view their employer, their role, and the benefits available to them. Yet many organizations underestimate the importance of a structured benefits communication strategy during onboarding. When employees receive complex benefits information without a clear explanation, confusion can lead to missed enrollment opportunities, poor plan choices, or underutilized coverage.

Effectively communicating benefits to employees begins during onboarding. When benefits education is integrated into the onboarding experience, employees gain confidence in their options and are more likely to engage with their health, financial, and wellness programs.

For HR teams, the goal is not simply to present benefits information; it is to ensure employees understand how their coverage works and how to make informed decisions. A well-designed benefits onboarding process creates clarity, improves participation, and strengthens the value employees perceive in their benefits package.

Why Benefits Education is Critical in Onboarding

Benefits are often the second-largest investment an organization makes after payroll. However, employees frequently struggle to understand plan differences, provider networks, deductibles, and contribution structures.

Without strong employee benefits education , new hires may feel overwhelmed by enrollment deadlines and unfamiliar terminology. As a result, they may delay enrollment, select plans that do not fit their needs, or overlook valuable voluntary benefits.

Integrating benefits education into new hire benefits onboarding offers several advantages:

Employees understand their coverage options from the start
HR teams reduce confusion and repeated administrative questions
Participation rates improve across benefits programs
Employees perceive greater value in their total compensation package

When organizations implement a thoughtful benefits communication strategy early in the employee lifecycle, it sets the stage for long-term engagement with available programs.

Key Strategies for Communicating Benefits Effectively

A successful benefits onboarding experience requires more than distributing plan documents or hosting a brief orientation session. Employers must take a structured approach to communicating benefits to employees in ways that are clear, accessible, and easy to understand.

The most effective strategies combine simplified messaging, visual explanations, and consistent communication across multiple channels. These methods ensure employees can absorb information at a comfortable pace while gaining confidence in their enrollment decisions.

Integrate Benefits Education into the Onboarding Timeline

Benefits education should be introduced gradually throughout the onboarding process rather than delivered in a single information-heavy session.

A well-designed timeline might include:

A pre-start overview introducing new hire benefits and enrollment deadlines
Benefits orientation during the first week of employment
Follow-up educational resources before enrollment deadlines
Reminders and support for employees finalizing their selections

Spreading information across multiple touchpoints helps reinforce understanding and prevents employees from feeling overwhelmed by complex details.

Keep Messaging Clear, Simple, and Free of Complex Jargon

Employee benefits often include terminology that can be confusing for individuals who are unfamiliar with insurance concepts.

To improve employee benefits education, organizations should avoid overly technical language and instead explain concepts in simple, relatable terms. For example:

Explain deductibles using real-world examples
Clarify differences between plan types in plain language
Use short explanations instead of lengthy policy descriptions

A clear benefits communication strategy prioritizes understanding over technical accuracy alone. When employees grasp the basics quickly, they are more likely to make informed enrollment decisions.

Personalize Benefits Education for Different Employee Groups

Not every employee has the same benefits’ priorities. Early-career employees may focus on affordability, while families may prioritize broader provider networks or dependent coverage.

Tailoring benefits onboarding materials to different employee groups can improve engagement and comprehension. Employers can personalize education by providing:

Examples relevant to employees at different life stages
Guidance for families, individuals, and remote workers
Plan comparisons that highlight common decision scenarios

When employees see how benefits apply directly to their situation, they become more confident in their choices.

Break Down Information into Manageable, Actionable Chunks

Presenting all the benefits information at once can overwhelm new hires. Instead, HR teams should structure communicating benefits to employees in smaller, digestible segments.

For example:

Separate medical, dental , and vision education
Provide step-by-step enrollment instructions
Highlight key deadlines and required actions

Breaking content into manageable pieces makes the onboarding experience more approachable while helping employees focus on what matters most.

Use Visual Aids to Simplify Complex Benefits

Benefits information becomes easier to understand when supported by visual explanations. Charts, comparison tables, and infographics can simplify complicated plan structures.

Visual aids can help employees understand:

Differences between HMO, PPO , and HDHP plans
Cost comparisons between coverage options
Enrollment timelines and steps

When visual tools are incorporated into employee benefits education, employees can quickly grasp key differences between plans and make confident selections.

Leverage Multiple Channels for Communication

Employees absorb information in different ways. Some prefer written guides , while others benefit from live discussions or interactive resources.

An effective benefits communication strategy uses a variety of channels, including:

Live onboarding sessions or webinars
Recorded benefits presentations
Digital benefits guides
HR support for one-on-one questions

Using multiple communication channels ensures that employees can revisit information whenever they need clarification.

Reinforce Messages Consistently and Push Updates Regularly

Benefits education should not end after the onboarding period. Regular reinforcement helps employees remain aware of their options and use their coverage effectively.

Employers can maintain engagement by:

Sending reminders about wellness programs
Highlighting preventive care benefits
Providing updates before open enrollment

Ongoing communication ensures employees continue to understand and utilize their benefits throughout the year.

Common Pitfalls in Benefits Education for New Hires

Even organizations with strong benefits programs can struggle with communication challenges. Common pitfalls include:

Providing too much information in a single onboarding session
Relying solely on complex plan documents
Failing to explain how benefits apply to real-life situations
Not offering follow-up resources after orientation

These issues often result in confusion, missed deadlines, and reduced participation in available programs.

Best Practices to Improve Benefits Communication Strategy

Organizations looking to improve communicating benefits to employees can benefit from implementing several proven best practices:

Develop a structured onboarding timeline for benefits education
Use simple language and real-world examples
Offer visual plan comparisons and educational resources
Provide multiple communication channels for learning
Reinforce benefits messaging throughout the year

When these strategies are implemented effectively, benefits education becomes a valuable part of the employee experience rather than an administrative task.

How AEIS Advisors Can Simplify Benefits Onboarding

Creating an effective benefits communication strategy requires time, expertise, and thoughtful planning. Many organizations rely on experienced advisors to help simplify the process and improve employee engagement with their benefits programs.

AEIS works with organizations to enhance benefits onboarding, providing strategic guidance on employee education, communication planning, and benefits program optimization. Our team helps employers deliver clear, engaging employee benefits education so new hires understand their options and feel confident in their coverage decisions.

By partnering with AEIS, businesses gain access to expert support that helps streamline benefits administration while improving the employee experience during onboarding and beyond.

If your organization is looking to improve how new hire benefits are introduced and explained, AEIS can help you build a benefits education strategy that supports both employees and HR teams.

Disclaimer : Any information related to compliance, laws and regulations, or other subject matters in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this blog is based on the most up-to-date information that was available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Employee Benefits Compliance: Tips for Avoiding Fees & Fines

Mon, 30 Mar 2026 20:57:22 GMT

At AEIS, we understand that remaining compliant with all of your health insurance and benefits-related obligations can often feel like an uphill battle. That's why we offer risk assessment services to help remove as much guesswork from the equation as possible. If you're a small business owner, HR professional or other individual who is responsible for maintaining compliance with all ever-changing state and federal laws regarding employee benefits , don't worry - we can help.

We’ve also compiled a wide array of tips that you can use to avoid fees and fines pertaining to the Affordable Care Act, ERISA, and more that you should be aware of moving forward into 2026.

ACA Compliance

Also commonly referred to as the Affordable Care Act, the ACA was designed to help make sure that affordable health insurance is available to as many people in the United States as possible. As a result, it directly impacts organizations offering group health coverage that have 50 (or more) full-time equivalent employees.

Because of that, to avoid potential penalties and other fines as an Applicable Large Employer (ALE), you must meet the following requirements:

You must offer coverage to 95% of your full-time employees and their dependents that meets the standards of minimum essential coverage. Plans that don't apply are ones that only offer vision or dental, workers' compensation, or coverage for only a specific disease or condition. Likewise, plans that only offer discounts on services and not actual health coverage do not apply.
You must offer affordable coverage. To be deemed affordable in 2026, any employee's required contribution for "self-only coverage" (meaning not additional costs for their dependents) must be no more than 9.96% of their annual household income. To be deemed a plan that provides "minimum value," it needs to pay for at least 60% of all covered benefits.
You need to provide adequate reporting on the coverage that you offer. To do this, you will need to file Forms 1094-C and 1095-C with the IRS every year. A copy of that 1095-C must also be provided to all relevant employees by the March 2, 2026 deadline.

ERISA Compliance

ERISA, otherwise known as the Employee Retirement Income Security Act of 1974, was put into place to offer protection for those in health and welfare and retirement plans. It requires administrators to offer participants detailed data about the plan itself. In addition to applying directly to group health insurance, it also impacts voluntary programs like life and disability insurance policies.

To avoid fees and other penalties, you must meet the following requirements:

You need to provide a Summary Plan Description (or SPD for short) to all participants. This makes every aspect of the plan clear, from eligibility requirements to benefits, claims, how to appeal a denied claim, enrollment rights, and their rights under the act itself. This must be provided within 90 days of an individual becoming covered (or within 120 days for a brand-new plan). It also must be provided every 5 years if any material changes are made, or every 10 years if the plan remains the same.
You need to create a formal Plan Document that your plan is then maintained by. There are no formatting requirements, but it needs to clearly outline all rights of plan participants as well as go into detail about how the plan is operated and administered. This doesn't have to be provided to employees necessarily, but they will need to receive a copy within 30 days if they request it in writing.
If you have 100 or more participants for any given health or welfare plan the employer offers (including dental, disability, vision, life insurance, etc.) you must file Form 5500 with the Department of Labor. You will need to do this every year. You must do this by the final day of the 7th month after the stated plan year ends.

Note that if you fail (or outright refuse) to file Form 5500 unless you are otherwise exempt, you can be fined up to $2,739 per day. Additionally, failing to provide plan documents upon a written request within 30 days can trigger a penalty of $110 per day per request. Willful ERISA violations can also potentially carry additional criminal penalties of imprisonment and fines.

COBRA Compliance

The Consolidated Omnibus Budget Reconciliation Act, otherwise known as COBRA , applies to companies that have 20 or more employees that sponsor group health plans. To remain in compliance and avoid fees or penalties , you must do the following:

Distribute proper notices. As soon as an employee experiences what is deemed as a " qualifying event ," you must provide them certain notices outlining their rights. That includes an Election Notice, which must go out within 14 days after learning of the event. There is also a General Notice, which must be given to the employee or their spouse no more than 90 days after coverage begins.
You must charge the proper premium. Even though you're not required to contribute to COBRA premiums, if your employees are responsible for the entire thing, it cannot cost more than the full cost of coverage plus a 2% administrative fee.
You must make coverage available for the longest allowable period. This means you need to offer continuation coverage for 18 or 36 months, depending on the event that triggered the coverage in the first place. If you fire an employee, for example, they are eligible for 18 months of coverage - except in situations where they became eligible for Medicare fewer than 18 months before you terminated them. To continue with this example, their spouse and any dependents would be eligible for up to 36 months.

HIPAA Compliance

HIPAA was put into place in 1996 as a way to protect the sensitive health information of employees. It applies to all employer-sponsored health plans, except self-funded health plans and those with fewer than 50 people participating. If you hold onto health information like the payments people are making for healthcare services, or identifying records that you've received from a health insurance company, you must follow the rules. Those include:

You need to give notice of your privacy practices. This Notice of Privacy Practices will give people a clear explanation of what their rights are with regard to their health data, as well as the steps you're taking to keep it private.
As of February 16, 2026, all covered entities must update their NPP to include new language regarding the confidentiality of Substance Use Disorder (SUD) records and heightened protections against their use in legal proceedings.
You must establish safeguards to protect employee health information.
You need to provide notice of any breach of unsecured personal health information no later than 60 days after you have discovered that it occurred.

Benefits Notices

In addition to everything outlined above, there are also notices that you will need to send out on a yearly basis for group health plans . These provide essential information about someone's coverage, the rights of their beneficiaries, yours and their responsibilities, and more. These include ones like:

Affordable Care Act Notices.
Genetic Information Nondiscrimination Act (GINA) Disclosures.
Children's Health Insurance Program Reauthorization Act (CHIPRA) Notices.
Michelle's Law Notices.
Mental Health Parity and Addiction Equity Act Disclosures.
Women's Health and Cancer Rights Act Notices.
Newborns' and Mothers' Health Protect Act Notices.
Medicare Part D Notice of Creditable Coverage.
Grandfathered Plan Notices (if offering Grandfathered health plans).
Summary of Benefits and Coverage documents for health and dental plans.

In January 2026, the United States Department of Labor announced a series of updates to their penalty structure. They are as follows:

If you have a multiple employer welfare arrangement (MEWA) and you don't file Form M-1 with the Department of Labor, you can be fined up to $1,992 per day.
If you fail to offer plan-related information requested by the Department of Labor, you can be fined up to $195 per day not to exceed $1,956 per request.
If you don't provide the required annual notice regarding the Children's Health Insurance Program (CHIP) coverage opportunities, you could get fined up to $145.00 per day per employee.
If you don't disclose information to the state regarding group health plan coverage for one of your employees who is covered under a Medicaid or CHIP plan, you can be fined up to $145.00 per day per employee.
If you don't comply with the requirements of the Genetic Information Nondiscrimination Act (GINA) for health plans, you could get fined up to $145.00 per day per plan participant or beneficiary during the period in which you were noncompliant. This is to be a minimum of $3,642.00 per participant or their beneficiaries if the issue is not corrected prior to receiving notice from the Department of Labor. There is also a minimum of $21,864.00 per participant or beneficiary for any issues that are not corrected prior to receiving a notification from the Department of Labor that are not de minimis. There is a maximum of $728,764.00 penalty for all unintentional failures.
If you don't provide the required Summary of Benefits and Coverage, you could be fined $1,443.00 per employee.

If you'd like to find out more information about ensuring benefits compliance and avoiding the types of fees and fines that could potentially cost you significantly, or if you just have any additional questions about employee benefits compliance that you'd like to discuss in more detail, please don't hesitate to contact the team at AEIS today.

Employee Assistance Programs (EAPs) for California Businesses

Mon, 30 Mar 2026 15:49:35 GMT

Supporting employee well-being has become a core priority for organizations across California. From mental health concerns to financial stress and workplace challenges, employees face a wide range of pressures that can affect productivity, engagement, and retention.

Employee Assistance Programs (EAPs) give California employers a way to support their workforce with confidential, professional resources. These programs connect employees to counseling, financial guidance, legal support, and other services that help address both personal and work-related challenges, improving overall well-being and workplace stability.

For employers, understanding the advantages of employee assistance programs is essential when building a comprehensive benefits strategy. With the right structure and support, an EAP can improve employee satisfaction, reduce absenteeism, and reinforce a culture that prioritizes health and balance.

Why EAPs Are Important for California Businesses

California employers operate in a fast-paced, high-pressure environment where employees often juggle demanding workloads alongside personal responsibilities. Stress, burnout, and mental health challenges have become increasingly common across industries.

The advantages of employee assistance programs extend beyond individual support. When employees have access to professional guidance, organizations often experience:

Reduced absenteeism and workplace disruptions
Higher employee engagement and morale
Improved productivity and job satisfaction
Stronger employee retention

By integrating an EAP into a benefits package, employers demonstrate a commitment to employee well-being while strengthening their overall workplace culture.

How Does an EAP Benefit Your Workplace?

Many employers initially view EAPs primarily as mental health resources. While counseling is an important component, the advantages of employee assistance programs reach far beyond therapy.

An effective employee assistance program California organizations offer provides employees with tools to manage life challenges that may affect their ability to focus at work. This can include stress management resources, family support services, financial planning assistance, and legal guidance.

Workplaces that implement EAPs often experience measurable benefits such as:

Improved employee focus and productivity
Reduced workplace conflict and stress
Increased awareness of mental health resources
Greater trust between employees and leadership

When employees know confidential support is available, they are more likely to seek help early and maintain stability in both their personal and professional lives.

Core Components of an Employee Assistance Program

While specific services may vary depending on the provider, most employee assistance programs that California businesses adopt include several core components designed to support a wide range of employee needs.

Mental Health Counseling & Support

Mental health counseling is one of the most widely used EAP services . Employees can access confidential sessions with licensed professionals who provide guidance on issues such as anxiety, depression, grief, and personal challenges.

These services help employees address concerns before they escalate into larger problems that affect both their well-being and their work performance.

Work-Related Stressor Counseling

Workplace stress is a common concern across industries. EAPs often provide counseling resources to help employees manage challenges such as workplace conflict, burnout, workload pressures, and career transitions.

Providing support in this area reinforces the advantages of employee assistance programs by promoting healthier communication and stronger workplace relationships.

Substance Abuse & Recovery Support

Substance misuse can affect both personal health and workplace safety. Many employee assistance programs California providers offer confidential resources to help employees address substance abuse concerns and connect with treatment options.

Early intervention and support can make a meaningful difference in helping employees recover and return to stable work environments.

Financial Counseling & Planning

Financial stress is one of the leading causes of employee anxiety. EAPs frequently offer financial counseling services that help employees develop budgets, manage debt, and plan for long-term financial goals.

This resource supports employee stability and can significantly reduce stress that may otherwise impact workplace productivity.

Legal Guidance & Resources

Some EAP programs provide employees with access to legal consultations or referrals for common concerns such as estate planning, landlord disputes, or family legal matters.

Access to basic legal guidance allows employees to better navigate complex situations without added financial pressure.

How AEIS Supports Your Business Through EAPs

Implementing an employee assistance program that California businesses can rely on requires careful planning and the right provider relationships. AEIS works with organizations to evaluate their workforce needs and identify EAP solutions that align with their broader benefits strategy.

Our team supports employers by:

Assessing workforce needs and identifying appropriate EAP services
Connecting organizations with trusted benefits providers
Integrating EAPs into existing employee benefits programs
Supporting employee communication and education

By helping organizations understand the advantages of employee assistance programs, AEIS ensures businesses implement solutions that deliver real value to both employees and leadership teams.

How to Implement EAP in the Workplace

Introducing an EAP requires more than selecting a provider. Employers should take a thoughtful approach to ensure employees understand and utilize available services.

Steps for implementing an effective employee assistance program California employers can follow include:

Evaluate employee needs and workplace challenges
Identify a reputable EAP provider that aligns with organizational goals
Integrate the program into the existing benefits package
Communicate the availability of services to employees
Reinforce awareness through ongoing benefits education

A strong communication strategy ensures employees know how to access EAP services and feel comfortable using them when needed.

EAP Frequently Asked Questions (FAQ)

Work with AEIS to Implement Your EAP

For organizations exploring an employee assistance program that California businesses can rely on, AEIS provides expert guidance throughout the process. From evaluating providers to integrating services into your benefits package, our team helps employers implement programs that support both employees and business goals.

If your company is considering adding an EAP or optimizing an existing program, AEIS can help you build a strategy that highlights the advantages of employee assistance programs while strengthening employee well-being and workplace performance.

New Federal Paid Leave Tax Credit: What California Employers Need to Know for 2026

Fri, 13 Feb 2026 19:00:08 GMT

Paid family and medical leave continues to be a key focus in today’s competitive benefits landscape. While California already mandates paid leave through its State Disability Insurance (SDI) program, federal incentives are expanding, and they could benefit employers in all states, including California. A significant update to the IRC §45S Paid Family and Medical Leave Tax Credit takes effect in 2026, offering new opportunities for eligible businesses to offset the cost of providing paid leave.

Here’s what California employers need to know, and how this evolving credit can support their retention strategy, compliance efforts, and bottom line.

What Is the IRC §45S Paid Leave Tax Credit?

The IRC §45S Paid Family and Medical Leave Tax Credit, introduced as part of the 2017 Tax Cuts and Jobs Act, was designed to incentivize employers to voluntarily provide paid family and medical leave to their employees.

The credit allows eligible employers to claim up to 25% of wages paid to qualifying employees while they are on leave for FMLA-qualified reasons. Initially authorized on a temporary basis, it has since been extended multiple times. Upcoming changes aim to make it more accessible and permanent.

Original Requirements Included:

Employees must have worked at least one year
Employers must provide at least two weeks of leave at 50% or more of regular pay
Leave must meet Family and Medical Leave Act (FMLA) criteria
Credit was available only on direct wage payments, not premiums for insurance products

What’s Changing in 2026? Key Updates to KnowWhat’s Changing in 2026? Key Updates to Know

Recent legislation will expand and simplify access to the §45S credit beginning in 2026. These updates are particularly relevant to California employers who previously assumed the state program made them ineligible.

1. Permanency of the Credit

Starting in 2026, the §45S tax credit hasbecome permanent, giving employers a longer planning horizon and more incentive to integrate paid leave into their long-term benefits strategy.

2. Shortened Employment Requirement

The length of employment required for an employee to qualify has been reduced from 12 months to 6 months. This change aligns better with the modern workforce, especially for companies with high turnover or seasonal labor.

3. Applies in All States

The revised credit is applicable nationwide, including in states like California that already have mandated Paid Family Leave (PFL). Employers operating across multiple states can now more easily implement a cohesive, federally supported leave strategy.

4. Premiums Now Qualify

One of the most impactful updates is that employers can now claim the credit not only for wages paid directly to employees on leave but also for premiums paid for an eligible private Paid Family Leave insurance policy. This provides greater flexibility for businesses that use insured plans to cover their leave obligations.

Qualifying for the Credit: Eligibility Criteria for Employers

To claim the paid leave tax credit, employers must meet specific criteria . It is not automatic, and documentation matters. Here are the foundational requirements:

Written Policy : Employers must have a formal, written paid family and medical leave policy that meets IRS standards
Duration and Pay : Policy must provide at least two weeks of leave (annually) for full-time employees, at 50% or more of their normal earnings
Income Threshold : The credit only applies to employees earning below a specified income limit (this adjusts annually, so employers should confirm current IRS thresholds)
FMLA-Qualified Leave : Leave must be for a reason covered under the Family and Medical Leave Act, including bonding with a new child, caring for a family member with a serious health condition, or the employee’s own medical needs

Employers must be prepared to demonstrate compliance with these requirements to claim the credit.

Premiums vs. Wages: Two Paths to Claim the Credit

One of the most notable improvements to the paid family and medical leave tax credit is the expanded eligibility to include insurance premiums.

Employers can now claim the credit based on either:

Wages paid directly to qualifying employees on leave
Premiums paid to a qualifying private paid family leave insurance provider

This opens the door for businesses to use insured products, often already in place through disability insurance plans, to help meet compliance and claim credits. The maximum credit remains up to 25% of wages or qualifying premium amounts, depending on the method used.

For businesses with limited HR capacity, using an insured plan to handle claims can reduce administrative burden while still allowing for credit eligibility.

What This Means for California Employers

California has long required participation in its Paid Family Leave program, which provides partial wage replacement through the SDI system. However, California’s state program does not disqualify employers from claiming the §45S credit under the revised rules.

Here is why it still matters for California businesses:

Employers can supplement the state-mandated benefits with private insured plans that meet or exceed state requirements and may be eligible for the federal tax credit
Multi-state employers can use the federal credit to create consistency across locations while still complying with California’s rules
Remote and hybrid teams are more common than ever. Businesses headquartered in California but employing staff in other states may benefit from building a federally aligned leave program eligible for the credit
Wage replacement through private plans may offer higher benefit levels than the state program alone, boosting employee satisfaction and retention

The key is strategic coordination, designing a policy that meets both state and federal requirements while maximizing financial benefits .

How AEIS Helps Employers Navigate Leave Strategy and Tax Credits

At AEIS , we understand the nuances of state and federal paid leave compliance, and how they intersect with benefits strategy, tax planning, and employee satisfaction.

We help California employers:

Evaluate private insured paid family leave plans that meet IRS and California guidelines
Coordinate across states, helping businesses support their remote or multi-state workforces
Partner with legal and tax advisors to ensure that credit eligibility, documentation, and filings are handled correctly
Communicate benefit value to employees to boost awareness and retention

For businesses that already offer leave benefits, this credit represents a meaningful way to recapture costs. For those considering how to enhance their leave offerings, it is an opportunity to do so strategically, with federal support.

Disclaimer: Any information related to compliance, laws and regulations, or other subject matters in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this blog is based on the most up-to-date information that was available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

San Francisco HCSO, OB3, And What Employers Need To Know For 2026

Tue, 10 Feb 2026 21:38:42 GMT

When it comes to employee benefits, the insurance plan itself is only the beginning. For employers with employees in San Francisco, and for those trying to understand new federal rules under the One Big Beautiful Bill Act (OB3), the compliance side can feel overwhelming.

In a recent educational session, AEIS, Inc. President Ron Bland and Senior Advisor Dillon Castro sat down with our Compliance and Technology Officer, Elizabeth Kay, to walk through two big topics in plain English:

The San Francisco Health Care Security Ordinance (HCSO)
Key health and benefit changes under One Big Beautiful Bill Act (OB3)

Who The San Francisco HCSO Actually Applies To

The San Francisco Health Care Security Ordinance has been in place since 2008, but many employers still misunderstand when it applies.

The HCSO applies if:

You are a for-profit employer with 20 or more employees, or
You are a nonprofit with 50 or more employees, and
You have at least one employee working within the geographic boundaries of the City and County of San Francisco.

A few important nuances Elizabeth highlighted:

Employee count is global. If you have 20+ employees worldwide and even one person working in San Francisco, HCSO applies to that covered employee.
Remote and home-based workers count . If a San Francisco based employee works from home, that still counts as work within the city.
Control groups are combined. Companies with shared ownership, husband and wife owned businesses, and certain affiliated groups may have to aggregate their headcounts to determine if they cross the 20 / 50 / 100 employee thresholds.

Required Health Care Expenditures Under HCSO

For covered employers, HCSO requires a minimum hourly health care expenditure for covered employees working in San Francisco:

Employers with 20-99 employees (for-profit) or 50-99 (nonprofit) must contribute at least:
$2.74 per hour in 2026

Employers with 100+ employees must contribute at least:
$4.11 per hour in 2026

This applies only to hours worked within San Francisco, but the employer size test looks at the entire group, including affiliated or commonly owned companies.

Who Counts As A Covered Employee

Under HCSO, an employee is generally “covered” if they:

Are entitled to minimum wage,
Have worked at least 90 calendar days for the employer, and
Regularly work at least 8 hours per week within San Francisco in a given quarter.

Job title or classification does not change eligibility. Seasonal, part-time, full-time, commissioned, union, non-union, exempt or non-exempt, salaried or hourly – if they meet the basic criteria and are working in San Francisco enough hours, they are typically covered.

There are some exemptions, including:

Employees who voluntarily waive HCSO rights each year using the city’s waiver form and have other qualifying coverage (through a spouse, Medi-Cal, Medicare, another employer, etc.).
Certain managers, supervisors, and confidential employees who meet both a salary threshold and a duties test for 2026.

What Counts As An Acceptable Contribution

Employers can meet their HCSO obligation in a few ways:

Premium Contributions

Contributions toward medical, dental, or vision premiums, whether fully insured or self-funded.
Employer dependent premium contributions can count as well.
For age-rated plans with percentage contributions, employers may calculate an average employer contribution per employee to test against the HCSO hourly minimums.

2. M edical Reimbursement Accounts (MRAs)

For employees who are not on the group health plan but are still HCSO-eligible, employers can fund a city approved medical reimbursement account.
Contributions are made quarterly via file upload and ACH, and employees can use those funds for qualified medical expenses like copays, prescriptions, dental work, and eyeglasses.

Practical Scenarios Elizabeth Clarified

Elizabeth walked through real-world examples that often cause confusion:

Delivery drivers who spend more than eight hours per week delivering within San Francisco can become covered employees under HCSO, even if the company has no physical office in the city.

Transit through the city (for example an airport shuttle driving through San Francisco without picking up or dropping off) generally does not trigger HCSO, as long as the driver is not stopping to perform work there.

Seasonal workers can qualify in their second season very quickly, since prior calendar days count toward the 90-day threshold if they return within 12 months.

Annual Reporting And Notices

Employers subject to HCSO must also:

File an annual HCSO expenditure report with the City of San Francisco (reporting prior year premiums and MRA contributions), and

Comply with notice requirements, including posting the official HCSO poster and providin g notice to remote employees who work in San Francisco.

OB3: The One Big Beautiful Bill Act

The second half of Elizabeth’s presentation focused on OB3, signed into law on July 4, 2025. Not all changes take effect immediately, and many roll out in 2026, 2027, and beyond, so it is important for CFOs and HR teams to understand the timeline.

Some of the key changes she highlighted:

1. Telehealth And HSA Eligibility

The temporary pandemic relief rules for telehealth on HSA-qualified plans are now made permanent, retroactive to December 31, 2024.
Employees enrolled in an HSA-qualified high deductible health plan (HDHP) can access telehealth with low or no copays without losing HSA eligibility.

2. Direct Primary Care And HSAs

Direct primary care (concierge) fees can now be paid without impacting your HSA eligibility:
$150 per month for an individual, or
$300 per month for more than one person.
Having a direct primary care arrangement will no longer disqualify an otherwise HSA-eligible individual, starting for plan years beginning after December 31, 2025.

3. Dependent Care FSA Limit Increases

The long-standing $5,000 annual limit for dependent care FSAs is finally increasing.
New limits:
$7,500 per year for joint filers,
$3,750 for a single parent or per parent when filing separately.
Applies to plan years beginning after December 31, 2025.

4. ACA Premium Tax Credits Reverting

The enhanced ACA premium tax credit formula that capped costs at around 8 percent of household income is set to sunset at the end of 2025.
Beginning in January 2026, the original ACA credit formula returns, which may:
Reduce subsidies for many enrollees, especially older individuals.
Encourage dependents who had migrated to the individual marketplace to return to employer sponsored plans for more affordable coverage.
States may choose to offer their own state-funded tax credits for some income ranges, but these will not be federally funded.

5. Stricter Exchange Verification And Clawbacks

Starting in 2026, with full implementation by 2028:

Pre-enrollment verification of income and immigration status will become stricter and faster.
Individuals will be fully liable for any excess advance premium tax credits after January 1, 2026, meaning 100 percent of overpaid subsidies can be clawed back if income is misstated or not updated.

6. HSA Eligibility For Certain Exchange Plans

Bronze and catastrophic individual marketplace plans become HSA-eligible, even if they have first dollar benefits like office visit copays.
This applies only to individual exchange plans, not employer sponsored plans.

7. Other Notable Changes

Elizabeth also covered additional provisions, including:

Student loan repayment: Employers may continue to make up to $5,250 per year in tax free student loan payments.
Transportation benefits: Salary reduction benefits for bicycle commuting will no longer be tax free for plan years beginning after December 31, 2025.
Premium tax credits and special enrollment events: Premium tax credits will no longer be available for people who enroll midyear solely due to a change in household income. In many cases, they will need to wait until open enrollment.
Medicaid / Medi-Cal work requirements: Some individuals may be required to work at least 80 hours per month to maintain eligibility, phased in through 2028, with more guidance to come.
Paid family and medical leave tax credit: Permanently extended.
Employer provided childcare credit: Increased from $150,000 to $500,000, starting after December 31, 2025.

Open Enrollment: A Quick Compliance Checklist

Because these changes are arriving during a busy open enrollment season, Elizabeth closed with a reminder list of items employers should review annually:

Plan documents and SPDs (including Section 125 / Premium Only Plan documents)
Annual required notices , including Marketplace Exchange Notices to new hires
COBRA initial notice and ongoing administration
Summary of Benefits and Coverage (SBC) for medical plans, and in California, dental SBCs
Medicare Creditable Coverage reporting to CMS within 60 days of the plan year start
Pharmacy reporting (confirm whether the carrier or TPA is handling this)
Broker compensation disclosure from your benefits advisor, as part of your fiduciary duty and DOL audit readiness

Need Help Applying This To Your Organization?

Every employer’s situation is a bit different. Factors like multi-state operations, fractional or part-time staff, control groups, and remote employees layered on top of local mandates and OB3 can make compliance feel like a puzzle.

That is where we come in.

AEIS, Inc. helps employers:

Understand when laws like HCSO and OB3 apply to them,
Design cost effective, compliant benefit strategies, and
Stay audit-ready, not scrambling.

If you would like to talk through your specific scenario, or schedule a deeper dive for your leadership team, you can reach us anytime.

Paid Family Leave Benefits for California Businesses

Tue, 10 Feb 2026 06:00:04 GMT

Paid family leave is often viewed through the lens of employee benefits, but its advantages for employers are equally compelling. Especially in California, where public paid leave programs have matured significantly, the question for businesses is no longer if they should support leave, but how to make the most of it. From lowering turnover to boosting morale and long-term profitability, the benefits of maternity leave for employers are real, measurable, and worth understanding.

The Business Case for Paid Family Leave

Offering paid family leave isn’t just about complying with state laws. It's a strategic decision that directly supports business performance. Studies consistently show that one of the most effective maternity programs for reducing turnover is a well-structured leave policy that ensures employees can take the time they need without financial hardship.

Paid leave policies help businesses:

Attract skilled candidates, especially working parents
Retain experienced employees, reducing the costs of hiring and training
Strengthen workplace morale and loyalty
Reduce absenteeism and unplanned time off

In competitive labor markets like California’s, small and mid-sized employers who offer thoughtful leave policies are often more appealing to top talent than larger firms that provide limited flexibility or support .

How Paid Leave Drives Retention and Reduces Turnover Costs

Turnover is one of the most expensive challenges for any business. Replacing an employee can cost anywhere from 20% to 200% of their annual salary, depending on their role. For small employers, this impact is magnified.

Paid maternity and family leave programs significantly improve retention, especially among women, who are statistically more likely to exit the workforce following childbirth if no paid leave is offered. A 2023 study from the U.S. Department of Labor found that access to paid leave was associated with a 20% increase in return-to-work rates for new mothers within 12 months.

Beyond return rates, paid leave also helps preserve institutional knowledge and employee relationships, which are critical assets for small businesses that rely on close-knit teams. Simply put, one of the clearest advantages of paid maternity leave is that it keeps valuable employees from leaving in the first place.

Productivity and Profitability: The ROI of Employee Leave

A common concern among employers is that offering paid leave may strain budgets or slow productivity. But when designed effectively, leave programs tend to do the opposite.

According to the California Budget & Policy Center , employers participating in the state’s Paid Family Leave (PFL) program report neutral or positive effects on productivity, profitability, and performance. This is largely because:

Paid leave reduces burnout and supports long-term productivity
Employees return more engaged and loyal
Cross-training team members during leave improves workforce agility

When employees know they have a safety net, they are more likely to plan their leave in advance, coordinate transitions, and return with greater focus and commitment. These benefits often outweigh the temporary disruptions associated with their absence.

What Small Businesses Are Saying About Paid Leave Programs

California’s Paid Family Leave program, administered through the State Disability Insurance (SDI) system, offers partial wage replacement to eligible workers taking time off to care for a family member or bond with a new child. While some small employers were initially hesitant, many now recognize the practical and cultural benefits of the program.

Research on the impact of Paid Family Leave in California has consistently shown that:

Most employers report no negative effects on productivity or profitability
Many businesses see improvements in employee morale, retention, and loyalty
Small employers, once concerned about disruptions, have found that with clear communication and planning, leave can be managed effectively
Temporary staffing or cross-training during leave periods can improve workforce flexibility
Paid leave programs help level the playing field for small businesses that want to compete with larger employers on benefit offerings

These trends reinforce the growing understanding that public leave programs, when integrated into company operations and culture, can support business objectives rather than hinder them. Employers who proactively plan for employee absences and communicate clearly with their teams are better positioned to experience the long-term benefits .

What California Employers Should Expect from Public Leave Programs

California employers are not required to pay for employees’ benefits directly under the state’s Paid Family Leave program. Instead, employees fund it through a payroll deduction into the SDI system. However, employers still play a role in managing claims, coordinating return-to-work plans, and complying with related regulations like the California Family Rights Act (CFRA) and the federal Family and Medical Leave Act (FMLA).

Key considerations for California employers:

Eligibility and Coordination : Understand how state programs coordinate with federal leave and your internal policies
Job Protection : While PFL provides wage replacement, job protection comes from laws like CFRA and FMLA. Employers must track which laws apply
Communication : Employees may not fully understand their leave rights. Proactive communication and education reduce confusion and errors
Supplemental Benefits : Many employers choose to supplement state benefits or provide additional paid time off to stay competitive

Navigating these requirements can be complex, especially for businesses without dedicated HR departments . That’s where having a trusted benefits advisor becomes invaluable.

Where AEIS Can Help: Navigating Public Programs and Private Options

At AEIS , we work closely with California businesses to ensure their leave policies are both compliant and competitive. Our services include:

Policy Review and Design : We help employers align their internal leave policies with public programs and evolving regulations
Supplemental Leave Benefits : Want to offer more than the state minimum? We help you evaluate private disability or paid leave options to bridge gaps
Compliance Support : Our team helps you stay up to date on laws like CFRA, FMLA, and the Equal Pay Act, ensuring your leave policies are legally sound
Employee Communication : We provide support materials and education tools so your team understands how and when to use their leave benefits

Building a new maternity leave policy or reviewing your current offerings? AEIS can guide you toward solutions that benefit both your business and your team. By combining public program integration with private insurance strategies, we help employers offer the most effective maternity programs for reducing turnover and supporting employee well-being .

Employee Benefits Trends You Need to Know in 2026

Thu, 05 Feb 2026 16:50:55 GMT

Are You Prepared for These Employee Benefits Trends?

As we step into 2026, California employers are facing a seismic shift in the employee benefits landscape. Between rising healthcare costs, evolving workforce expectations, and a new wave of compliance mandates, HR leaders and business owners must act strategically to stay competitive and compliant.

This year, several key California laws take effect, introducing new compliance responsibilities and financial considerations for employers of all sizes. Add in rapidly emerging trends in benefits personalization, mental health, and work-life integration, and it is clear: 2026 is not the year to take a "wait and see" approach.

At AEIS , we believe knowledge is the first step to preparation. Here is what you need to know and what to do next.

Top Employee Benefits Trends Expected in 2026

Employers who want to attract and retain top talent must be proactive. In 2026, we anticipate the following trends will dominate the conversation:

Cost containment through alternative funding models

Personalized benefit plan designs using AI and data analytics

Heightened compliance enforcement , especially in California

Stronger demand for holistic wellness (mental, financial, and physical)

Increased emphasis on flexible work benefits

These are not future projections; they are already reshaping how employers think about total compensation. Let us break down the most urgent regulatory shifts and how they affect your bottom line.

Federal Regulatory Shifts: The Impact of the One Big Beautiful Bill Act (OBBBA)

The One Big Beautiful Bill Act (OBBBA) is expected to influence benefits strategies in 2026. IOBBBA will:

Standardize reporting requirements for employer-sponsored health plans
Create new cost transparency mandates for TPAs and providers
Require mental health parity audits for employers with 50+ employees

For California employers, this could mean enhanced scrutiny on mental health offerings and increased administrative work . Preparing now can prevent noncompliance penalties later.

Key California Compliance Mandates Effective in 2026

IVF Mandate (SB 729)

Effective January 1, 2026, SB 729 requires California health plans to cover in vitro fertilization (IVF) procedures, classifying infertility as a medical condition rather than a lifestyle choice. Employers offering fully insured plans must:

Ensure IVF coverage is included in all eligible plans
Prepare for potential premium increases
Update plan documents and employee communications

Self-funded plans are not required to comply but may face pressure from employees seeking parity. This mandate can significantly impact budgets, particularly for mid-sized businesses.

The "Stay-or-Pay" Ban (AB 692)

AB 692 prohibits California employers from using clawback provisions that penalize employees for leaving before a certain tenure, effective January 1, 2026. This includes repayment of sign-on bonuses, relocation costs, or tuition reimbursement.

What this means for employers:

Review offer letters and employment agreements
Adjust benefit-related incentives to avoid potential legal exposure
Reframe retention strategies around benefit quality rather than penalty

Workplace Know Your Rights Act (SB 294)

SB 294 requires employers to provide annual notices summarizing all employee rights under California and federal employment law. The first notice must be distributed by February 1, 2026.

This includes rights related to:

Leave policies
Pay transparency
Harassment and discrimination protections

Noncompliance can result in fines and employee claims. Now is the time to work with a trusted partner to ensure compliance-ready documentation.

Pay Transparency 2.0 (SB 642)

Building on existing legislation, SB 642 expands pay transparency rules starting July 1, 2026. Employers must:

Provide pay range data in all job postings
Report annual compensation bands by job title and location
Document internal promotion decisions

This law aims to close gender and racial pay gaps but also introduces new compliance layers for HR teams.

Managing Rising Costs for Mid-Market Firms with Strategic Funding

In 2026, California mid-sized firms (50 to 250 employees) face a familiar challenge: rising premiums. But with smart funding strategies, these increases do not have to derail your benefits budget.

Consider these approaches:

Health Reimbursement Arrangements: Combine predictable, fixed monthly costs with claims-based savings
Level Funded plans: Gain more control over plan design and get refunds or credits for plan premiums in years with ideal claims
Professional Employment Organizations (PEO’s): Enterprise level, large-group-like benefits with additional HR and administrative resources

AEIS works with employers to model cost scenarios and implement funding structures that balance risk with predictability.

AI-Driven Insights Moving Beyond "One-Size-Fits-All"

Today’s small group employers (under 100 employees in CA) get little to no data about employee claims, making it difficult for employers to tailor their benefits programs to the need of their employees. AI-powered tools now enable:

Predictive analytics for plan utilization based on actual claims data
Insights into real cost trends of Rx drugs and chronic conditions within the member population
Benchmarking of unique member-level data to into aggregated demographic and morbidity scores

Implementing these tools gives employers a massive leg up in negotiating costs with insurance carriers and empowers employers to take a proactive approach to health plan design in a way that simply wasn’t possible in the past.

Holistic Wellness Revolution: Mental, Physical, and Financial

The definition of wellness has evolved. Employees now evaluate benefits through a holistic lens that includes:

Mental health access (therapy, coaching, EAPs)
Physical wellness (fitness stipends, chronic disease support)
Financial wellbeing (student loan assistance, HSAs, retirement education)

In 2026, employers who ignore holistic wellness will likely see higher turnover and lower engagement.

Flexibility & The Modern Work-Life Integration

Flexibility is no longer a perk; it is an expectation. Employers are expanding beyond remote work to offer:

Customizable hours
Compressed workweeks
Unlimited or flexible PTO
Caregiver and parental support

These benefits directly impact talent attraction and retention. Building flexibility into your benefits strategy is essential in 2026.

Preparing Your 2026 Benefits Strategy

With deadlines approaching and employee expectations rising, your 2026 strategy must align compliance, cost control, and culture. Here is how to get started:

Conduct a compliance review focused on SB 729, AB 692, SB 294, and SB 642
Analyze current plan performance and funding structure
Engage employees to understand their evolving needs
Benchmark against competitors to stay ahead in recruitment
Partner with a benefits expert who understands California regulations and mid-market challenges

At AEIS, we specialize in translating complex mandates into clear strategies that protect your business and support your people. Let us build a plan that turns change into opportunity.

Beyond Enrollment: The Hidden ROI of Employee Benefits Education

Tue, 25 Nov 2025 18:32:20 GMT

Open enrollment may be the most visible moment in an employee benefits program, but it is only the beginning. When employees understand how to use their benefits, not just what they are offered, they are more likely to make smarter, cost-effective choices that benefit both themselves and their employers. In today’s competitive labor market, small and mid-sized businesses cannot afford to overlook the long-term value of employee benefits education. This is not just an HR initiative; it is a business strategy with a measurable return on investment (ROI).

When Employees Miss the Value of Benefits, Your Business Pays the Price

Increased Healthcare Expenses for Both Employers and Employees

Employees who are uninformed about their benefits tend to default to higher-cost options, such as unnecessary ER visits or out-of-network providers. These choices directly affect employer costs, especially under self-funded or shared-cost plans. On the employee side, confusion leads to missed opportunities for lower-cost care, resulting in unexpected bills and financial stress.

Missed Opportunities for Preventive Care and Savings

Without clear guidance , employees often skip preventive services like annual checkups, screenings, and vaccinations, all of which are typically covered at no cost under many plans. Preventive care can catch health issues early, avoiding expensive treatments later. Skipping these services not only impacts employee well-being but also increases long-term healthcare expenses.

Rising Frustration, Burnout, and Turnover Tied to Confusion

When employees don't understand their benefits , frustration builds. They may delay care, experience billing surprises, or feel unsupported by HR. Over time, this confusion erodes trust in the organization, increasing turnover and disengagement. In a market where retaining talent is critical, clarity in benefits communication is more than a nice-to-have; it is essential.

The ROI of Investing in Benefits Education

Smarter Healthcare Decisions Lead to Lower Overall Costs

Well-informed employees are more likely to choose in-network providers, use urgent care instead of the ER, and take advantage of telehealth or preventive services. These decisions reduce claims costs and help maintain more stable premiums year over year.

Improved Employee Satisfaction and Retention

Employees who understand their benefits feel more secure, supported, and valued. This leads to higher job satisfaction, which in turn reduces turnover. Replacing employees is costly, especially when factoring in recruitment, training, and lost productivity. Benefits education is a cost-effective way to strengthen employee loyalty.

Measurable Impact on Productivity and Absenteeism

Healthier employees are more productive and less likely to miss work. When workers use preventive services and manage chronic conditions effectively, absenteeism declines. A proactive benefits education strategy contributes to a healthier, more present workforce.

Stronger Perception of Company Culture and Value

A company that invests in employee understanding sends a clear message: we care. Transparent, ongoing communication about benefits fosters a sense of trust and inclusivity. This strengthens organizational culture and positions your business as an employer of choice.

Enhanced Compliance and Reduced Administrative Risk

Effective benefits education can reduce errors in enrollment and help employees stay in compliance with regulatory requirements, such as required documentation or timely reporting. This decreases the likelihood of costly penalties and reduces the burden on HR teams managing corrections or disputes.

Key Components of an Effective Benefits Education Program & Communication Strategy

Clear Communication and Accessible Language

Avoid jargon. Use plain language to explain options, deadlines, and processes. Visual aids, FAQs, and real-life scenarios can help make complex topics easier to understand.

Personalized Learning Opportunities in Multiple Formats

Different employees learn in different ways. Offer live webinars, recorded videos, printed guides, interactive tools, and one-on-one support. Tailor communications to address the needs of different age groups, family situations, and coverage levels.

Continuous Process Driving Feedback and Improvements

Benefits education should not be limited to open enrollment. Implement regular touchpoints throughout the year to reinforce key concepts, address common questions, and gather feedback. Use surveys or digital analytics to refine the approach based on engagement levels.

Clear Accessible Channels to Reach Easy Support

Employees should know exactly where to go with questions and receive timely, helpful responses. Whether it is a dedicated benefits email address, a chat tool, or scheduled office hours with an HR specialist, support must be consistent and accessible.

Leveraging Technology for Benefits Education

Digital platforms can streamline and personalize benefits education. Interactive decision-support tools, benefits portals, and mobile apps empower employees to explore their options on their own time. Businesses are also beginning to experiment with AI and large language models (LLMs) to create chat-based support tools or customize learning paths for different users. These innovations make benefits education scalable and more responsive to individual needs.

Best Practices for Small and Mid-Sized Businesses

Start early: Begin educating employees weeks before open enrollment, not days.

Partner with your broker: Leverage their resources for presentations, materials, and Q&A support.

Designate internal champions: Identify team members who can answer questions and reinforce key messages.

Track engagement: Use digital tools to measure who is engaging with materials and follow up accordingly.

Encourage questions: Create a culture where asking about benefits is welcomed and supported .

Ready to Improve Employee Understanding and Reduce Costs?

A robust employee benefits education strategy pays dividends long after open enrollment ends. From cost savings to improved morale and compliance, the advantages are clear. For small and mid-sized businesses, investing in benefits education is not an added expense; it is a strategic imperative.

If you are ready to strengthen your benefits communication, improve employee engagement, and reduce healthcare-related costs, AEIS is here to help. Our team works with you to develop tailored strategies that fit your business goals and your team’s needs.

Open Enrollment Tips to Maximize Your Benefits Program

Tue, 04 Nov 2025 17:36:02 GMT

Understanding Annual Benefits Open Enrollment (What/When/Why)

Open enrollment is a critical window for employers and employees alike. It's the designated period prior to your renewal when employees can enroll in or make changes to their benefits for the coming plan year. For California employers, especially those with 2–500 employees, this time presents an opportunity to reassess benefit offerings, enhance employee engagement, and ensure compliance with ever-evolving regulations.

Strategic planning before and during open enrollment helps businesses not only control costs but also attract and retain top talent. A thoughtful, proactive approach positions your benefits program as a competitive advantage rather than a compliance hurdle.

15 Open Enrollment Tips for Employers to Stay Ahead

Building a Strong Open Enrollment Strategy

Start Early and Plan Strategically

Don’t wait until the last minute. Begin planning your open enrollment strategy as soon as you receive your benefits renewals. Early preparation allows time to assess plan performance, identify gaps, and collaborate with your benefits broker to explore competitive alternatives. Our Method at AEIS ensures your planning process is thorough and effective.

Review Current Plans and Utilization

For small group insurance, it can be difficult to obtain direct claims data to see how employees are utilizing the plans. Reviewing the current enrollment, surveying employees and working with your broker can go a long way towards providing insights into how the plan is working for employees. In some cases, your broker may even be able to use AI analytics to review overall risk scores for your group to determine if alternate funding methods are a viable option. Understanding utilization helps you refine offerings and focus on what your employees truly value.

Evaluate New Plan Options and Carriers

Each year brings new opportunities. Consider emerging plan designs, provider network shifts, and alternative funding models. AEIS offers access to a wide range of competitive providers for group health, vision , and dental insurance. For some employers, PEO’s can be another avenue to explore for better benefits outcomes.

Communicating and Engaging Employees Effectively

Communicate Early and Often

One of the most overlooked open enrollment tips for employers is consistent communication. Begin outreach at least a month in advance and maintain momentum. Use multiple channels to ensure messages reach employees.

Highlight What’s Changing and Why

Be transparent. If there are changes to premiums, provider networks, or plan designs, clearly explain the reasons behind them. Context builds trust and reduces confusion. Work with your broker to ensure your employees have the educational resources they need.

Offer Multiple Ways to Get Support (Virtual/In-Person)

Support shouldn’t be one-size-fits-all. Provide help through live webinars, in-person Q&A sessions, and one-on-one consultations. Consider digital tools and resources that enable self-service. Leverage your broker to help provide informational presentations and meetings for employees.

Educate and Empower Employees

Your employees make better decisions when they understand their options. Provide plain-language guides, decision-support tools, and benefits education sessions. This is especially valuable for first-time enrollees or employees facing life changes.

Using Technology and Personalization to Simplify Enrollment

Leverage Digital Enrollment Tools

Digital platforms streamline the enrollment process, reduce errors, and increase participation. Learn how to optimize online benefits enrollment and explore AEIS-supported technology that simplifies administration .

Offer Personalized Guidance

Employees have different needs based on age, family status, and health conditions. Tailor communications and decision support to reflect these differences for a more meaningful enrollment experience.

Encourage Active (Not Passive) Enrollment

Avoid default renewals, particularly if you are a mid-to-large sized organization. Active enrollment ensures employees review their options and make intentional choices. This can improve plan alignment and reduce unnecessary costs.

Ensuring Compliance and Long-Term Program Success

Stay on Top of Compliance Requirements

California employers must stay informed about state-specific mandates, ACA requirements, and ERISA regulations. Use this 2025 Open Enrollment Compliance Checklist to ensure you're meeting all obligations. Your broker should assist you in making sure you have the information you need to maintain compliance, so lean on them.

Confirm Plan Details Before Launch

Double-check plan documents, summaries, premiums, and eligibility rules before releasing information to employees. A single error can lead to confusion and compliance issues.

Monitor Results and Solicit Feedback

Once enrollment ends, track participation rates, identify questions that surfaced frequently, and collect employee feedback. This data is invaluable for refining future strategies. Digital enrollment tools can provide reports which can help easily generate and organize all the information.

Maximizing Value Through Strategic Partnerships

Leverage Your Broker’s Market Access for Competitive Advantage

Your benefits broker should do more than renew plans. At AEIS, we offer employee benefits consulting to help you assess trends, negotiate competitive rates, and identify opportunities for enhanced value. We also provide insights through our United Benefits Advisors partnership, giving you national benchmarking data and strategies.

Explore PEO Partnerships for Added Savings and Support

For some small to mid-sized employers , a [PEO](https://www.aeisadvisors.com/technology) model can provide cost-effective access to large-group plans, HR technology, and administrative support. AEIS can help you easily evaluate if this model is a fit for your business.

Partner with AEIS for Smarter, Simpler Open Enrollment

Open enrollment doesn’t have to be overwhelming. With the right strategy and support, it becomes a powerful tool to strengthen your workforce, boost satisfaction, and manage costs. AEIS helps California businesses navigate each step of the process—from plan design and compliance to technology and employee communication.

Ready to simplify your next open enrollment season? Schedule a consultation or learn more about how we can support your benefits program.

Important Things to Know When Entering or Exiting a PEO

Thu, 02 Oct 2025 00:20:20 GMT

For many businesses, a Professional Employer Organization (PEO) can be a game-changer, offering a way to streamline HR, benefits, payroll, and compliance. But deciding whether to join a PEO, stay with your current one, or transition away can be overwhelming. In a recent discussion, AEIS’s Ron Bland sat down with Chad Todora from CRC Benefits and Dillon Castro, AEIS’s in-house PEO expert, to talk about what business leaders should know before entering or exiting a PEO.

What Exactly Is a PEO?

A PEO is a co-employment partnership that helps businesses by handling HR administration, payroll, employee benefits, and compliance. This allows companies to focus on growth while leaving back-office complexities to specialists. However, every PEO has its own strengths, pricing structure, and limitations, which makes selecting the right one crucial.

Key Considerations When Joining a PEO

Evaluate Fit, Not Just Cost: A PEO should align with your business’s size, industry, and growth goals. Some are designed for startups, others for established companies with hundreds of employees.
Understand the Service Model: Look at what HR, compliance, and technology support is included. Ask whether you’ll have a dedicated account manager or call-center support.
Compare Multiple PEOs: Each PEO is different so by comparing several options side-by-side helps you find the best mix of cost, benefits, and technology.

What to Watch for When Exiting a PEO

Timing Matters: The best time to evaluate a PEO transition is usually before your annual renewal date. This minimizes disruption for your employees.
Data & Payroll Transition: Make sure you have a clear plan for payroll records, benefits data, and compliance reporting so nothing is lost in the switch.
Employee Communication: Plan ahead to explain changes to your team so they understand what is (and isn’t) changing.

Why Expertise Matters

The panel emphasized that navigating PEO entry or exit isn’t just a matter of signing forms, it requires careful analysis to avoid costly mistakes. Many businesses don’t realize that they can get independent, unbiased help comparing multiple PEOs at once instead of going to each provider individually.

If you’re considering joining or leaving a PEO, don’t go it alone. AEIS, Inc. works with all major PEOs and can provide side-by-side comparisons tailored to your business’s needs. Helping you save time, reduce costs, and choose the right solution.

�� Ready to explore your options? Schedule a 15-minute consultation with Dillon Castro, AEIS’s in-house PEO expert, to see how we can simplify your PEO decision-making process.

Employee Benefits Surveys: Matching Offerings to What Employees Really Need

Thu, 11 Sep 2025 15:22:15 GMT

You Don’t Have to Guess What Employees Want

Many employers offer robust benefits packages but still hear that employees are unaware of what is available or that the benefits do not meet their needs. When that happens, it is not always a matter of the benefits themselves, but how they are communicated, prioritized, or understood.

Business owners, CEOs, and HR leaders are often tasked with designing plans that balance cost with value. But how do you know if your current offerings truly support your team? Without direct input, it is easy to misallocate resources or overlook what matters most to employees.

An employee benefits survey creates a clear, structured way to find out what your employees need, what they understand, and where there may be confusion. With thoughtful employee benefits survey questions, you can uncover what employees are actually using, what they value, and how well they grasp the benefits available to them.

The goal is not to survey for the sake of surveying, but to use the results to guide better decisions for your team and for your bottom line.

You Don’t Have to Guess What Employees Want

A well-designed survey helps eliminate assumptions. It gives you f acts about your workforce's preferences , awareness, and satisfaction levels. Most importantly, it tells you what is working and what is not.

By understanding what your employees value, you can:

Improve utilization of benefits
Reduce confusion and frustration
Ensure your investments are supporting recruitment and retention goals

Why Conduct an Employee Benefits Survey?

Every workforce is different. What your competitors are offering may not align with your company culture or employee demographics.

A survey helps you:

Understand which benefits employees value most
Discover which offerings are underused or misunderstood
Identify communication gaps or educational needs
Make informed, data-backed decisions

It provides a baseline to improve your offerings and engage employees more effectively.

Designing Your Employee Benefits Survey

Start by identifying your objective.

Are you trying to:

Gauge employee satisfaction with current benefits?
Prioritize future offerings?
Improve how benefits are communicated?

Keep the survey short and focused. Aim for completion in 10 to 15 minutes and design it to be anonymous. This encourages participation and honest feedback.

Download the Employee Benefits Survey Template

To make this process easier, we have created a downloadable Employee Benefits Survey Template that includes key question categories and sample formats you can customize to your team.

The printable version is designed to help you gather the insights you need, whether you are assessing awareness, understanding, or preferences. It includes multiple-choice, ranking, scaled, and open-ended questions across topics such as benefit satisfaction, usage barriers, communication preferences, and more.

You can use this survey as-is or tailor it to reflect your company’s goals, industry, or workforce demographics.

How to Conduct the Survey

Once your survey is finalized, you will need to choose how you will distribute it.

Here are a few options to consider:

Digital Surveys : Tools like Google Forms, Microsoft Forms, SurveyMonkey, or Typeform are easy to use and can automatically compile results. They are ideal for remote or hybrid teams.

Printed Surveys : If your employees do not work at desks or have limited access to technology during the workday, a printable form may be more effective. These can be handed out at team meetings or placed in common areas.

Anonymous Submission : Encourage honesty by using a format that protects identity. Online tools typically offer this option, and paper surveys can be returned in a sealed envelope or secure collection box.

Clear Instructions : Provide employees with a brief introduction explaining the purpose of the survey, how long it will take, and the deadline for completion. Reinforce that participation is voluntary but valuable.

Once responses begin to come in, track response rates and send out gentle reminders to increase participation.

Interpreting the Results

High-priority benefits
Benefits with low awareness or usage
Preferences for communication formats
Common questions or confusion points

If possible, analyze results by employee segment, such as tenure or department, to identify patterns that may not be obvious across the organization as a whole.

Applying the Survey Results

After collecting responses, the next step is to translate the feedback into practical improvements. Here is how you can move from data to action:

Review the Feedback Thoroughly

Look for consistent themes in what employees are saying. Are certain benefits mentioned frequently in the open comments? Is there a common barrier such as lack of awareness or confusion?

Segment the Responses Where Possible

If you are able to collect responses by department, tenure, or location (without compromising anonymity), you may find trends unique to specific groups. This helps you tailor communication or plan design more effectively.

Create an Action Plan Based on the Data

Decide what adjustments make sense in the short and long term. Some changes may be as simple as providing a one-page explainer on a benefit, while others may involve provider changes or plan redesign at renewal.

Communicate Back to Your Team

Employees appreciate knowing that their feedback is heard. Share a summary of what you learned and what actions you plan to take. Even if you cannot act on every suggestion, transparency builds trust.

Integrate Changes Into Ongoing Communication

Use the feedback to shape your benefits messaging year-round. Focus on clarity, repetition, and relevance, especially for underused or high-impact benefits .

A Simple 3-Step Plan to Improve Engagement

Download the Employee Benefits Survey
Collect and review employee feedback
Work with AEIS to apply the insights and adjust your strategy

With these steps , you are not just gathering information. You are creating a more informed, responsive benefits strategy.

The Cost of Inaction

When benefits are not aligned with employee needs, several issues can arise:

Missed opportunities to support employee well-being
Underused or misunderstood offerings
Wasted budget on benefits that go unnoticed
Higher turnover and weaker recruitment appeal

By staying in tune with your team, you can proactively address these challenges and strengthen your overall HR strategy.

Partner with AEIS for Strategic Benefits Planning

At AEIS , we work with California-based small to mid-size businesses to help them build employee benefits programs that reflect their workforce and support their goals.

Whether you are developing a survey, reviewing results, or planning for your next renewal, we are here to support you with expertise, strategy, and compliance insight.

The Hidden Costs of Going Direct to a PEO vs an Insurance Broker

Tue, 12 Aug 2025 16:18:49 GMT

When small and mid-sized businesses look to streamline HR and provide robust employee benefits, a Professional Employer Organization (PEO) can be a great solution for employers to consider, but with so many options available it can be difficult to understand the key differences between them all. While PEO’s offer potential advantages, there can be disadvantages and even significant hidden costs, especially when choosing to go directly to a PEO without someone to guide you. Understanding these implications is crucial when determining the best fit for your company, and just as important is how you choose your PEO.

Exploring Your Options for Shopping the PEO Market

What is a Professional Employer Organization (PEO)?

A PEO provides bundled services that typically include payroll, HR, and access to benefits plans through a co-employment model. PEOs offer convenience, especially for lean teams, and often appear attractive due to promises of administrative relief and buying power. However, engaging directly with a PEO locks your business into their systems and pricing, without the benefit of independent oversight. How you choose a PEO matters just as much as which one you choose.

Working with a PEO Broker

PEO brokers offer flexible and tailored employee benefits solutions. A broker works on your behalf, helping you compare multiple providers, negotiate rates, and ensure compliance with California's complex regulations . Unlike working directly with representatives of any given PEO, a broker is not tied to a single provider or platform, allowing for a more objective and strategic benefits design. Most importantly, the right broker can also help you shop among multiple PEOs, helping you avoid costly mistakes and hidden fees.

Direct to a PEO vs Working with a PEO Broker:

What You Need to Know

Each PEO has their own sales teams that will look for potential employer clients for their services. They are hard working and know their product in and out, but because they only work for one PEO they are inherently less able to provide you a full 360 degree view of the entire marketplace. Brokers, on the other hand, serve as advocates who are only accountable to you and your organization. We help you assess all available options, including PEOs, and build a strategy that supports your goals.

Without a broker, many employers unknowingly pay more, are locked into systems that don't serve them long term, or miss out on opportunities to tailor a benefits strategy to their workforce. AEIS brings the expertise to help you compare both traditional and PEO options objectively.

The Hidden Costs of Going Direct to a PEO

Huge Time Savings

When you go direct to a PEO , you're personally responsible for managing the intake process with each one individually. That means providing financials, employee census data, and answering a battery of operational questions for each and every provider you're evaluating. In contrast, working with AEIS streamlines this process immensely through a single intake process. We then source proposals from multiple PEOs and compile a clear comparison spreadsheet and summary to help you evaluate them all side by side.

Higher Admin Fees and Benefits Cost

PEOs typically include administrative costs and markups on benefits within their bundled fees. These costs are often opaque, and without comparison to traditional brokered plans or other PEOs, it's easy to pay more than necessary. Without an advocate to help benchmark pricing, companies may unknowingly accept inflated costs with limited recourse.

Brokers like AEIS provide transparency and leverage across multiple PEOs. We identify hidden line items, spot inefficiencies, and help employers secure more cost-effective solutions. Our clients routinely save both time and money by avoiding overpriced or misaligned PEO proposals.

The Risk of Choosing the Wrong Model Without Objective Expert Guidance

Every business is different. A model that works for a tech startup may not be suitable for a manufacturing firm. Going directly to a PEO means making that decision without independent advice from people who know the marketplace. That puts your business at risk of choosing a model that may lead to higher long term costs, limited flexibility, or administrative headaches.

AEIS serves as an additional layer of protection, advocacy, and insight. We highlight pros and cons of each PEO relative to your goals and help ensure the model you choose today continues to work for you tomorrow

How to Choose the Right Benefits Strategy for Your Business

Choosing between a broker and a PEO shouldn’t be a guess. Ask yourself:

Do you want to compare multiple providers objectively?
Is it important to have long term flexibility?
Do you need support understanding compliance in California?
Are you looking to avoid time-consuming intake processes?
Do you want to ensure you're not overpaying or locked into the wrong model?

If the answer is yes to any of the above, working with a broker who can present both PEO and traditional plan options is likely the best path.

Partner with AEIS to Simplify, Compare, and Save

At AEIS , we help clients explore all their employee benefits options, whether that means quoting with a traditional insurance provider, shopping the PEO market, or a hybrid approach. Because we maintain relationships with all major PEOs and group health insurance providers in California, we deliver a comprehensive view of your options.

One intake form gets you access to potentially dozens of PEO proposals, professionally summarized and benchmarked. More importantly, you get a trusted advocate who helps explain trade-offs, flag potential risks, and ensure your strategy aligns with your unique business needs.

Let us save you time , cut through the noise, and deliver a strategy that makes sense for your people and your bottom line.

Common Employee Benefits Confusion and How HR Can Clear It Up

Wed, 02 Jul 2025 15:05:49 GMT

Why Employees Don’t Understand Their Benefits

Employee benefits packages are often layered with jargon, multiple plan options and confusion for which plans they and their dependents are enrolled in that can be difficult for employees to navigate. Even with open enrollment meetings and benefit summaries, many employees remain unclear on what their plans actually cover or how to use them effectively. These challenges are common and reflect the inherent complexity of benefits—not shortcomings in HR teams.

Common Misconceptions Employees Have

Census data is essential for securing accurate bids from providers. Whether you're considering a level-funded plan, joining a PEO, or managing a large group policy, detailed census data can make or break your benefits strategy.

Deductibles vs. Out-of-Pocket Maximum :

Many employees assume that once they meet their deductible, they won't have to pay anything else. In reality, the out-of-pocket maximum includes the deductible, plus any copays and coinsurance, up to a certain limit. Misunderstanding this distinction can lead to unexpected costs.

In-Network vs. Out-of-Network :

Employees often believe they can see any provider and receive the same coverage. However, using out-of-network providers usually results in higher costs and limited coverage. Additionally, sometimes employees will ask if a provider accepts their coverage, instead of if they are in-network. A provider might accept their insurance, but be out of network. Clarifying this early can prevent costly surprises.

Copays versus Coinsurance :

These two cost-sharing mechanisms are frequently confused. Copays are fixed amounts for specific services, while coinsurance is a percentage of the service cost. Not knowing the difference can affect how employees budget for healthcare expenses.

Plan Types ( HMO, PPO , HDHP) :

Understanding the limitations and benefits of each plan type is critical. HMOs typically require referrals and network restrictions (such as no out-of-network), PPOs offer more flexibility, and HDHPs have higher deductibles but allow HSA contributions. Employees often select plans without fully grasping how they align with their needs.

Common types of plans include:

Health Maintenance Organization (HMO) : Requires members to use a network of doctors and get referrals from a primary care physician.

Preferred Provider Organization (PPO) : Offers more flexibility in choosing providers and does not require referrals.

High Deductible Health Plan (HDHP) : Comes with higher deductibles and eligibility for a Health Savings Account (HSA) and can be paired with a PPO or HMO plan.

Exclusive Provider Organization (EPO) : Similar to an HMO but does not require referrals, while still restricting care to in-network providers only.

Point of Service (POS) : Combines features of HMO and PPO plans, requiring referrals for specialists but allowing some out-of-network coverage.

AEIS assists HR teams by evaluating plan designs, educating employees on the trade-offs between options, and aligning offerings with the unique demographics of each workforce. We support a broad range of coverage areas including medical, dental, vision, life, and disability insurance . Our support includes custom comparisons, one-on-one consultations, and guidance to help ensure employees make informed choices that fit their healthcare needs and financial situations.

Lack of Clarity in Communications

Overwhelming Information

Benefits communications frequently include dense legal language, numerous acronyms, and overly technical explanations. Without proper context or simplification, employees may skim through materials without fully understanding them.

Infrequent Communication :

Benefits are typically discussed during onboarding or open enrollment, and then seldom revisited. This leaves employees with limited opportunities to revisit information or ask questions as their life circumstances change

Lack of Personalization :

Benefits communications often adopt a one-size-fits-all approach. Employees with different needs, such as a single young adult versus a parent with dependents may find it hard to determine which options suit them best without personalized guidance.

The Hidden Costs of Benefits Confusion

When employees don’t fully understand their benefits, the impact extends beyond individual frustration. Employers can face a range of hidden costs that affect the organization as a whole.

1. Underutilization of Benefits : If employees don’t know how to access or maximize their benefits, they may delay medical care, miss out on preventive services, or skip financial wellness tools—all of which can lead to higher claims costs or increased absenteeism.

2. Increased Administrative Burden : Confused employees are more likely to reach out to HR with repetitive questions or require extra time during enrollment periods. This adds strain to already busy HR teams.

3. Reduced Employee Satisfaction and Retention : Benefits play a significant role in job satisfaction. If employees feel uncertain or misinformed about what they’re offered, it can diminish trust in the employer and increase turnover rates. Studies have shown employees are more likely to value their benefits when they understand them, even if the benefits are modest, than when generous benefits are poorly understood.

4. Compliance Risks : Miscommunication or lack of clarity around required notices, eligibility windows, or coverage details can inadvertently lead to non-compliance with state or federal regulations, particularly in California where rules frequently evolve. Fines from these kinds of oversights can be incredibly costly to employers.

Effective Strategies for HR to Improve Communication

Click here to download the Effective Strategies for HR graphic.

Use Clear, Simple Language in Benefit Communications

Avoid jargon and use straightforward language to explain benefits concepts. Define terms plainly and offer real-world examples. Consider rewriting summaries with employee-friendly terminology and using consistent formatting across materials. AEIS supports HR teams with clear, customized content that helps make benefits communication more accessible and effective.

Offer Regular Training and Benefit Walkthroughs

Don’t wait for open enrollment . Provide ongoing education through workshops, lunch-and-learns, or virtual Q&A sessions. Interactive sessions allow employees to ask questions and gain clarity, especially as their needs evolve. AEIS can support these efforts by conducting webinars and personalized sessions that address common concerns.

Leverage Digital Tools or Benefit Platforms for Easy Access

Invest in user-friendly benefits platforms where employees can easily access plan documents, provider directories, and cost estimators. Mobile access and 24/7 availability empower employees to get the answers they need when they need them. As your partner, AEIS can help identify and integrate digital solutions that align with your team's goals.

Provide Visual Aids like Charts or Comparison Tables

Help employees compare plan features, costs, and coverage levels with visuals that break down complex data. Simple comparison tables and infographics can dramatically enhance understanding and reduce reliance on HR for explanations. AEIS provides tailored visuals and communication aids that reinforce employee comprehension.

Create a Year-Round Communication Plan

Move beyond a once-a-year push. Develop a calendar of touchpoints to regularly share reminders, seasonal tips, and educational content. This ongoing approach reinforces understanding and helps employees feel supported throughout the year.

An essential part of this strategy is leveraging your benefits broker. A broker can assist in developing a structured communication calendar, provide ready-to-use materials, and lead educational sessions. At AEIS , we work alongside HR teams to bridge the benefits communication gap, helping to ensure that employees not only understand their options but feel empowered to use them. Our collaborative approach lightens HR's administrative load while strengthening employee engagement.

Clarity around employee benefits is not a one-time task. It is an ongoing responsibility that directly affects organizational health, employee morale, and compliance.

Navigating San Francisco Health Care Security Ordinance (HCSO) Compliance

Tue, 27 May 2025 16:29:24 GMT

Regardless of where your headquarters are located, the shift to remote and hybrid work has expanded many companies’ reach, often unintentionally. When an employee responds to emails from a kitchen table in their San Francisco home during a work-from-home day, your company may be operating in a new or different legal environment without even realizing it. Across the Bay Area, several cities enforce their own labor rules related to health care expenditures and paid sick leave . These rules apply based on where work is performed, not where the company is based. If someone on your payroll regularly works from a home office in San Francisco , your responsibilities change.

Under the San Francisco Health Care Security Ordinance (HCSO), employers with 20 or more workers worldwide must spend a set dollar amount on health care for each hour an employee works within city boundaries. This applies even to part-time employees , provided they meet the required threshold.

Understanding who is subject to the HCSO and what it requires is the first step toward staying aligned.

What Is the San Francisco Health Care Security Ordinance (HCSO)?

The San Francisco Health Care Security Ordinance (HCSO) is a city law that requires qualifying employers to make health care expenditures on behalf of employees working in San Francisco. Designed to improve access to medical care, the ordinance applies to for-profit businesses with 20 or more employees worldwide, and nonprofit organizations with 50 or more , when even one employee performs work inside the city for at least 8 hours per week.

This applies to any employee working within San Francisco city limits, whether on-site or from home. It’s the employee’s location that matters, not where the company is based. Employers must calculate expenditures based on hours worked, provide acceptable health care benefits or contributions, and maintain proper documentation. Failing to meet these standards can lead to back payments and financial penalties.

Who Is Required to Comply with HCSO?

As previously stated, the San Francisco Health Care Security Ordinance (HCSO) applies to for-profit businesses with 20 or more employees worldwide and nonprofit organizations with 50 or more. If even one of those employees performs work within the geographic boundaries of San Francisco for at least 8 hours per week, the employer is required to make health care expenditures on their behalf.

This includes remote, part-time, and temporary staff who meet the hourly criteria. Employers must also meet several ongoing requirements: posting HCSO notices, tracking health care expenditures, maintaining detailed records, and ensuring that spending meets or exceeds the city’s minimum contribution rate.

Covered Employers must also post HCSO notices, maintain detailed records, and ensure that health care spending meets the city’s hourly minimum requirement. Failing to comply can trigger audits, penalties, and repayment obligations.

HCSO Compliance Requirements for Employers

Employers covered under the San Francisco Health Care Security Ordinance must follow several ongoing requirements to remain in compliance.

Employer Health Care Expenditures: Minimum Contribution Rates

Employers must make health care expenditures for each covered employee based on hours worked in San Francisco. The required hourly rate is adjusted annually. These contributions can be made through insurance premiums, payments to the SF City option, contributions to a reimbursement program (subject to limitations), or other approved methods .

Recordkeeping and Reporting Obligations

Businesses must track all health care expenditures and retain documentation for at least four years. Employers are also required to submit the Annual Reporting Form to the San Francisco Office of Labor Standards Enforcement (OLSE).

Notice and Posting Requirements

A current HCSO notice must be posted at each worksite where covered employees perform duties. For remote workers, digital distribution may be required.

Waivers

Employees may voluntarily waive employer health care contributions if they have other group coverage. Valid waivers must be renewed annually and kept on file.

Common HCSO Compliance Mistakes and How to Avoid Them

Some employers overlook how easily HCSO requirements can be triggered. It doesn’t take a full office in San Francisco; just one employee working a regular schedule from home is enough. If that work happens inside city limits, the rules apply. Too often, businesses focus on where they’re based instead of where the work is happening.

Another oversight is failing to track hours accurately, especially for employees with irregular schedules. Without precise records, calculating the required expenditures becomes difficult—and noncompliance more likely.

Some employers also miss the annual reporting deadline or neglect to post required notices, both of which can lead to fines. Others rely on outdated contribution rates, unaware that the city adjusts them each year.

Avoiding these mistakes starts with understanding your workforce location, updating procedures regularly, and working with a knowledgeable benefits partner who stays current on HCSO rules. Consistent review helps reduce risk and keep your business on the right track.

What Are the Penalties for HCSO Non-Compliance?

Non-compliance with the San Francisco Health Care Security Ordinance can lead to significant financial consequences. The Office of Labor Standards Enforcement (OLSE) may impose different penalties depending on the violation. These fines can add up quickly, especially if multiple requirements, like insufficient health care spending, failure to post notices, or missing records, are involved. The OLSE also reserves the right to conduct audits, which can extend across several years of employment history.

Frequently Asked Questions About HCSO Compliance

Simplify HCSO Compliance with AEIS

Managing compliance across multiple jurisdictions can feel overwhelming, especially when local rules shift under the surface of a remote workforce. The San Francisco Health Care Security Ordinance is just one of many regulations that can impact your business without warning. Staying ahead requires more than awareness; it demands structure, accuracy, and the right partner.

At AEIS , we help businesses like yours navigate complex benefit regulations, reduce compliance risk , and build benefit strategies that support both your team and your bottom line. From HCSO requirements to broader workforce compliance concerns, our team is here to provide clarity and confidence.

Connect with us today , and we’ll help make sure your business stays compliant (and competitive) in every ZIP code where work gets done.

Disclaimer: Any information related to compliance, laws and regulations, or other subject matters in this content is intended to be informational and does not constitute legal advice regarding any specific situation. The content is based on the most up-to-date information available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Choosing Insurance Plans Based on Employee Demographics

Fri, 16 May 2025 16:24:52 GMT

Why Employee Demographics Should Guide Your Insurance Strategy

When selecting insurance plans for your team, it's important to ask: are you meeting the needs of your actual employees, or are you offering a generic plan hoping it fits everyone? Insurance isn't one-size-fits-all . A workforce made up of young tech professionals will likely have very different needs than one composed of experienced tradespeople or a hybrid team across multiple states. Tailoring your benefits strategy based on employee demographics is more than smart—it's strategic. It allows you to allocate your budget effectively, improve employee satisfaction , and ensure you're offering value where it counts most.

Understanding Employee Census Data for a Benefits Bid

What Information Is Included in Full Employee Census Data?

A complete employee census typically includes:

Date of birth or age
Gender
Residential zip code
Employment type or classification (if applicable)
Dependent information
Sometimes salary or job title

How Census Data Impacts Insurance Bids and Plan Design

Insurance providers use census data to determine pricing and coverage availability. For instance, a census showing a large number of employees over 55 may trigger different underwriting assumptions than one showing a primarily under-30 workforce. These assumptions directly affect the types of plans you're offered and their cost.

What Small Businesses Need for Group Insurance Pricing

In California, small group pricing is based on two key pieces of information: the zip code of the business and the ages of the enrolled employees and dependents. That's it. However, if you're considering a PEO, level-funded, or large group arrangement, a complete census is required. Even small employers can benefit from understanding this process if they're planning to grow or shift strategies.

5 Key Demographic Factors That Influence Insurance Choices

Age: How Younger vs. Older Employees View Health Insurance

Younger employees often seek flexibility and affordability. High-deductible health plans (HDHPs) paired with HSAs are attractive for their lower premiums and tax advantages. Older employees, on the other hand, may place a premium on access to specialists, low out-of-pocket costs, and predictable expenses due to existing health conditions.

Family Status: Single Employees vs. Employees with Dependents

Employees without dependents may prefer low-cost individual coverage, while those with children or spouses are more likely to need PPO plans with wider networks and robust family benefits. Offering a choice of tiers ensures each employee can find the right fit.

Income Levels: Balancing Cost and Coverage

Cost-sharing can be a barrier for employees with lower incomes. These individuals may forgo essential coverage if premiums or deductibles are too high. Consider offering a base plan with 100% employer-paid premiums and optional buy-ups for those who want additional benefits.

Health History and Risk Profiles: Tailoring Coverage Options

Although health status isn’t used in small group rating in California, knowing your team has a high prevalence of certain conditions can help you prioritize coverage areas and invest in wellness programs. For example, if back pain or diabetes is common, a plan with physical therapy or chronic disease management may provide meaningful value.

Employment Location: Local, Remote, and Out-of-State Workers

Where your employees live impacts which networks they can access. A team in one city can often share a regional HMO , but remote or multistate teams need PPOs or national networks. Employers with remote staff may also want to explore virtual-first plans, telehealth integration, or PEOs to maintain consistency across locations.

Matching Insurance Options to Different Employee Demographics

Scenario 1 : Tech Startup with a Young Workforce - This San Francisco-based company employs mostly younger professionals. They offer an HDHP with HSA, mental health support, and a telemedicine-first approach. Premiums stay low, and the team appreciates digital access to care.

Scenario 2 : Construction Firm with Mixed-Age Employees - With field workers and office staff, this firm offers a dual-tier plan: an HMO base and a PPO buy-up. This meets the cost needs of younger employees while accommodating older workers who require broader access.

Scenario 3 : Multistate Law Firm - The firm employs remote legal professionals across six states. They use a national PPO to ensure access across regions and are exploring a PEO to streamline administration and compliance.

Scenario 4 : Non-Profit with Modest Budgets - This organization offers an employer-paid HMO for core coverage and voluntary dental/vision. Defined contributions give employees flexibility to enhance their benefits based on personal needs.

How AEIS, Inc. Helps You Optimize Benefits Based on Demographics

At AEIS, we help businesses move beyond guesswork. By leveraging census data and demographic insight, we guide you through creating a strategic benefits package that makes sense for your team. Our consultative approach ensures that each plan aligns with your goals and your workforce's needs.

What we offer:

Expert interpretation of employee demographic data
Strategic plan design tailored to your workforce
Support for multistate and remote employee coverage
Access to competitive pricing through robust market analysis

Need help interpreting your census data or evaluating your current benefits approach? Contact AEIS today to get started with a personalized consultation.

When Life Changes, So Can Your Coverage: Qualifying Life Event Health Insurance Explained

Wed, 07 May 2025 16:28:56 GMT

Throughout our lives, many things happen to us that are out of our control. This is why we have insurance; to protect us from the risks of life, both planned and unpredictable. Although we may not be able to predict the future, we can keep ourselves informed so we can feel prepared and confident to tackle what may come.

New Hire Enrollment

When you start a new job that offers a benefit package, assuming you are eligible, you will be given the option to enroll or waive coverage. This is often referred to as the “new hire window.” During your new hire window, you will have a limited amount of time to submit your enrollment. If you do not provide your enrollment elections within this time period, you will not be enrolled in the optional benefits (some benefits may not be waived or declined). Please make note of how long you have to make your elections to ensure a smooth and timely submission.

When you receive your enrollment packet, also take note of the new hire waiting period. To ensure you have no lapse in coverage, you will want to consider enrolling on a plan through the individual insurance marketplace, or continuing your previous employer plan coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA was established to allow terminated employees to continue coverage for a limited period of time. You will want to be covered in case of an accident or other unforeseen event, and some states have penalties if you are not insured. Click Here for more information on COBRA , or reach out to our team if you have additional questions or would like assistance enrolling in the individual insurance market.

Qualifying Life Event (QLE)

Once you have made your decision, you are “locked in” until your employer’s Open Enrollment Period, unless you experience a Qualifying Life Event (QLE). QLE’s allow you to make a change outside of Open Enrollment. Open Enrollment is the time in which you can enroll yourself or dependents if previously waived or switch plans, without having to provide proof of QLE. To make changes outside of Open Enrollment, you will need to provide proof of the QLE to your employer. You will have only 30 days to report your event, so please act quickly to ensure a smooth process.

Following a QLE, you may make mid-year changes to your benefits—such as enrolling in coverage if previously waived, adding eligible dependents, or switching to a different plan (if multiple plans are available through the employer). Voluntarily dropping coverage—for example, deciding mid-year that you no longer want or cannot afford the coverage—is not considered nor does it trigger a QLE. While some insurance carriers may allow coverage to be canceled mid-year, Section 125 rules prohibit changing or revoking pre-tax premium elections without a qualifying event. In addition, if you were to cancel your employer sponsored plan without a QLE, you would not be able to enroll in other coverage such as an individual plan without said QLE and would not be covered.

Qualifying Life Event Examples:

Marriage/divorce/separation/registration of domestic partnership
Gaining or becoming a dependent through birth or adoption
Involuntary loss of prior coverage through spouse, parents, Medi-Cal, etc.
Excludes terminations due to nonpayment of premium
Spouse enrolling in Medicare
Return to the United States after being abroad for more than30 days
Employer cessation of contribution towards employee or dependent coverage
Dependent turns 26 (and is not deemed permanently/totally disabled)
Death of covered person (self or dependent)
Court order
No longer living or working within the covered service area
Return from active military duty
Release from incarceration

Again, you will only have 30 days to report your QLE and request a change, so reach out to your HR representative as soon as possible so they have enough time to give you the materials needed for the update and submit the request timely to the carriers.

The carrier will request documentation to prove your QLE. Your HR representative will advise exactly what they need for the specific event, but commonly accepted items are:

COBRA offer letter (must list names of dependents if they are to be enrolled)
Letter from prior insurance carrier (must list names of dependents if they are to be enrolled)
Marriage certificate
Court order document
Adoption papers

Do not submit the termination letter from your prior employer. Employer letters may mention COBRA but may not be the COBRA offer letter itself. Depending on the employer, the termination letter and COBRA offer may be bundled together, otherwise the termination letter will simply advise you will be receiving the COBRA offer in the mail soon. Carriers do not see employer letters alone as credible proof of QLE. If you are not sure, reach out to HR and they will advise. If you don’t receive a COBRA offer letter in the mail or a termination letter from the carriers, call the carriers directly and ask for a “statement of coverage” letter or simply let them know you need proof of termination.

Open Enrollment

Even if you are covered by your spouse or parent’s plan, it is important to review your company’s policies and know when Open Enrollment occurs. Open Enrollment is commonly held at the end of the calendar year, with changes effective January 1st. However, not every employer operates on a calendar year cycle. Check your employee handbook or ask HR when the Open Enrollment window is, and mark it on your calendar. Even if you are not expecting to make any changes, it’s imperative that you are informed.

Understanding the Rules Through Fictional Scenarios

Here are some examples you can review to provide additional context to how these rules can play out in real life situations. Please note these are fictional examples and any similarities to yourself or others is coincidental and entirely unintentional.

Peter was 25 years old when he started work at ABC Firm. He preferred the insurance he had through his parents, so he waived coverage during his new hire window. Peter’s 26th birthday is July 8th– as a result he will no longer be eligible to be enrolled on their plan and his coverage will be terminated July 31st. Peter has the option to elect COBRA and join during ABC Firm’s next Open Enrollment, or he can use the QLE of aging off his parent’s plan to join ABC Firm’s offerings effective August 1st. Peter decides to join ABC Firm’s plans, and provides the COBRA offer letter that was sent to his parents notifying them of his termination.
Arthur was enrolled on the health plan with his son, Greg. Greg is not disabled, but has many medical needs, so Arthur bought up to the Platinum tier plan to ensure his needs were covered. When Greg turned 26, he decided to continue the Platinum plan via COBRA until he found sufficient coverage elsewhere. However, Arthur uses the QLE of Greg aging off to switch to the Silver plan, as that is more cost effective for Arthur’s personal needs.
Rose was enrolled with her spouse Jimmothy on ABC Firm’s medical plan. Rose turned 65 and enrolled in Medicare, however Jimmothy was still only 64 and was not yet eligible for Medicare. Rose cancelled their insurance through ABC Firm, and Jimmothy decided to elect COBRA to cover himself until he became eligible for Medicare.
Tyler waived coverage during his new hire window, because he was on COBRA. He elected COBRA because his prior employer agreed to subsidize six months of premium. When the subsidy ended and he saw how much it would cost to continue without it, he reached out to HR to inquire about enrolling on ABC Firm’s plans. HR informs him that the end of the subsidy is not a qualifying event, and that he will need to wait an additional three months until Open Enrollment to enroll effective July 1st. Tyler asks if canceling his COBRA will trigger a QLE, and he is informed nonpayment of premium is also not a QLE for enrollment. Tyler decides to pay for COBRA until he can enroll during Open Enrollment.
Betty and Joe have coverage through the Individual Insurance Marketplace. Betty has a job that offers coverage, but she waived due to personal preference towards her existing plan. Joe decides he doesn’t like the plan anymore, and stops paying for the insurance premium, hoping to trigger a qualifying event that will allow them to join the plan offered by Betty’s employer. The carrier cancels their insurance due to nonpayment. Betty attempts to enroll herself and her spouse, but is informed by her HR department that she and Joe will have to wait until Open Enrollment, because termination due to nonpayment of premium is not a qualifying event.
Jenny waived ABC Firm’s benefit package during her new hire window, because she was covered by her spouse Steve’s employer. Steve received an offer at another firm, so he quit that job, resulting in their insurance terminating at the end of November. However, the new job has a 60 day waiting period for benefits. Since COBRA was too expensive for their budget, and Jenny’s package at ABC Firm is sufficient, Jenny takes the COBRA offer letter from Steve's employer to her HR department as proof of QLE and requests enrollment effective December 1st.
Quinn and his wife Ella are expecting their first child. They utilize open enrollment to switch to a plan that will be more beneficial to them through Ella’s pregnancy. Ella has a healthy baby boy, and notifies HR of the birth. Ella and Quinn review the quote, and when submitting the enrollment for their newborn, they also request to move from the Platinum plan to the Gold plan, as it still provides sufficient coverage for their family but is more cost effective for them. Since most carriers don’t request proof of birth, they simply provide the insurance change forms.
Cody waived coverage when first hired, and again during open enrollment in December. Cody does not have insurance, but thinks that he doesn’t need it as he is “perfectly healthy.” In May, Cody gets into a car accident, and needs ongoing physical therapy. The costs are quickly adding up, so he reaches out to HR because he thinks he can enroll at his discretion. HR informs him that albeit unfortunate, he cannot enroll until the next open enrollment. Cody then continues to pay for all medical expenses out of pocket.

Contact Us For More Insurance Needs

Thank you for taking the time to inform yourself of these rules and requirements. Knowledge is one of the best tools at your disposal. If you have any additional questions or concerns, please reach out to your HR department, or our team here at AEIS . We are happy to help provide you with any additional guidance.

Why Tax Treatment of Employee Benefits Matters

Mon, 24 Mar 2025 15:00:04 GMT

A well-structured employee benefits package is a key factor in attracting and retaining top talent. Part of the reason why businesses offer benefits to employees in the first place is to give them some incentive to work there that goes above and beyond their base salary.

You might not be able to offer more money per hour than your biggest competitor... but if your benefits package is more valuable, you're still able to remain competitive.

That is where the discussion of pre-tax vs post-tax benefits begins. The classification of benefits as pre-tax or post-tax impacts both employee take-home pay and employer payroll costs. Understanding the tax implications of pre-tax and post-tax benefits is essential for designing a package that maximizes financial advantages for both businesses and employees.

What Are Pre-Tax Benefits?

As the term implies, pre-tax benefits are those that are deducted from an employee's paycheck before any income taxes are applied. This reduces the amount of taxable income that an employee makes per year.

Common Pre-Tax Benefits

Section 125 Cafeteria Plans (POP Plans) and Pre-Tax Premiums: These are employer-sponsored benefits that let employees pay for medical, dental , and vision insurance with pre-tax dollars under Section 125 plans.
Flexible Spending Accounts (FSAs): Allow employees to set aside pre-tax funds for eligible medical and dependent care expenses. Employers should be aware of rollover provisions or grace periods to help employees maximize unused funds.
Health Savings Accounts (HSAs): Available to employees enrolled in high-deductible health plans (HDHPs), HSAs allow tax-free contributions, earnings, and withdrawals for qualified medical expenses. While HSAs offer federal tax benefits, California taxes contributions and interest earnings at the state level.
Commuter Benefits: Pre-tax deductions for transit passes, vanpooling, and qualified parking can provide tax savings for employees who commute to work.

Advantages of Pre-Tax Benefits

Obviously, the biggest advantage to pre-tax benefits is that employees pay fewer taxes on their income. They have a lower taxable income, which means they're actually taking home more money when all things are considered. This also helps to reduce the payroll taxes that are paid by both employers and employees, meaning the employer benefits from employees leveraging pre-tax benefits too.

This also helps to increase benefit participation. Meaning that an employer is actually getting the most value from their investment .

For employers, offering pre-tax benefits is one of the many ways that they can reduce payroll taxes. This can create a potentially enormous amount of savings for the company depending on the size of the workforce.

HSAs, FSAs, and Other Pre-Tax Benefits: What You Need to Know

When it comes to something like an HSA, where an employee will contribute pre-tax money to cover qualifying medical expenses, or an FSA, where employees can use pre-tax money for medical or dependent care, there are a number of key things to keep in mind.

Take an FSA, for example. An FSA is a "use it or lose it" kind of account - meaning that if you don't actually use the money you're putting in, it will "expire" at the end of the term. With an HSA, on the other hand, funds still must be spent on qualifying expenses but that money can grow tax-free over time.

What Are Post-Tax Benefits?

Post-tax benefits are those that are paid out after taxes have been deducted from an employee's paycheck. While they do not reduce taxable income, they can provide flexibility and long-term financial advantages to employees.

Examples of Common Post-Tax Benefits

Life Insurance: Employer-paid group life insurance exceeding $50,000 in coverage is subject to imputed income taxation.
Long-Term Disability Insurance: If employees pay premiums with post-tax dollars, any benefits received will not be taxed. However, if premiums are paid pre-tax, benefits will be taxable upon payout.
Employee Assistance Programs (EAPs): While many EAP services are tax-free, expanded benefits such as financial counseling or wellness reimbursements may be taxable.

Advantages of Post-Tax Benefits

Post-tax benefits tend to be slightly more flexible in how they can be used, and they pose no impact on taxable impact at all - meaning that employees can still qualify for other benefits at the end of the year.

Considerations for Employers

While post-tax benefits do not provide immediate tax savings, they can be valuable for long-term financial protection. Employers should communicate the trade-offs between pre-tax and post-tax benefit structures to help employees make informed decisions.

Additionally, pre-tax benefits introduce compliance considerations as they need to pass non-discrimination testing to ensure the plan is not unfairly favoring highly compensated employees.

California-Specific Considerations

Paid Family and Medical Leave: California’s Paid Family Leave (PFL) program provides wage replacement benefits to employees who take time off to care for a seriously ill family member or bond with a new child. Additionally, California's Family and Medical Leave protections require certain employers to provide job-protected leave, which can affect workforce planning and benefit offerings. Employers operating in California must account for state-specific tax treatment when structuring benefits:
HSAs Are Taxed at the State Level in California: Unlike federal tax rules, California taxes both contributions and earnings on HSAs .
Pay Data Reporting Requirements: Under SB 1162, employers with 100+ employees must report compensation data, which may include taxable benefits .
CalSavers Retirement Program: California mandates that businesses with five or more employees offer a retirement plan or enroll in the state-run CalSavers program, which has tax implications for employer contributions.
State Disability Insurance (SDI) Impact: SDI is calculated based on gross wages , meaning pre-tax deductions affect employee contributions differently than in other states.

Key Differences Between Pre-Tax and Post-Tax Benefits

The major difference between pre-tax and post-tax benefits has to do with the tax impact itself. Post-tax benefits do not affect income tax calculations, while pre-tax benefits do. The types of benefits that are available pre-tax are also different than post-tax.

Choosing the Right Approach for Your Workforce

The decision between pre-tax and post-tax benefits should align with business objectives and employee needs. Employers should:

Evaluate Workforce Priorities: Gather employee feedback on preferred benefits to enhance participation and satisfaction.
Analyze Tax Implications: Work with a benefits advisor to assess payroll tax savings and long-term financial impacts.
Maintain Compliance: Keep up with state and federal regulations affecting benefits taxation, especially in states like California with unique tax rules.

Optimizing Benefits Strategies with Expert Guidance

A well-balanced benefits package provides financial advantages for both employers and employees. Understanding how tax treatment affects benefits allows businesses to design cost-effective, competitive offerings.

AEIS specializes in helping businesses navigate the complexities of benefits taxation and compliance. If you want to review your current benefits strategy or explore ways to maximize tax advantages, contact AEIS today .

Disclaimer: Any information related to compliance, laws and regulations, or other subject matters in this content is intended to be informational and does not constitute legal advice regarding any specific situation. The content is based on the most up-to-date information available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Why Staying Ahead in Employee Benefits Matters in 2025

Fri, 21 Mar 2025 15:00:02 GMT

Written by: AEIS

Employee benefits never stay the same for long. New regulations, shifting workforce expectations, and economic pressures keep employers on their toes. Offering the right benefits helps businesses attract talent, keep employees engaged, and stay competitive in a changing market. Companies that pay attention to these trends put themselves in a stronger position for long-term success.

Younger workers in particular look to benefits with the same level of importance that they do base salary, if not more. Even if you can't offer a salary that is higher than that of your competitors, you might be able to offer a better benefits package and still attract the same quality of people. Never underestimate the difference that something even as seemingly straightforward as group health insurance might make on a candidate.

In California, where labor laws and compliance requirements are among the strictest in the country, businesses must be proactive in aligning benefits strategies with regulatory mandates and workforce expectations.

Top 10 Employee Benefits Trends for 2025

To remain competitive and compliant, businesses should be aware of the following employee benefits trends shaping the market in 2025.

1. Personalized Benefit Packages

Employees no longer want "one size fits all" benefits packages, especially at mid-size or even large organizations. Employees now expect customized benefits , tailored to their individual needs, lifestyle, and financial circumstances.

And employers who solicit feedback from their workforce and offer flexible options—such as voluntary benefits, expanded healthcare choices, or tiered coverage levels—are more likely to see increased employee satisfaction and retention.

2. Holistic Wellbeing Initiatives

Well-being benefits go beyond traditional health insurance to encompass mental, physical, and financial wellness. Employers are offering Lifestyle Spending Accounts (LSAs), which provide funds that employees can use for gym memberships, wellness apps, childcare, and even home office equipment. These programs demonstrate a company’s commitment to supporting employees’ overall well-being.

3. Financial Wellness Support

With student loan debt, inflation, and economic uncertainty weighing on employees, financial wellness benefits have become a priority. More companies are offering student loan repayment assistance, access to financial advisors, and employer-matching contributions for emergency savings accounts. Additionally, in 2025, tax-free employer student loan contributions of up to $5,250 per year (under the extended CARES Act) remain an attractive benefit.

4. Rising Healthcare Costs and Affordability Strategies

Healthcare costs continue to rise, making affordability a top concern for employers and employees alike. Businesses are exploring cost-containment strategies such as:

Level-funded health plans as an alternative to traditional fully insured plans
Health Savings Accounts (HSAs) paired with High Deductible Health Plans (HDHPs), offering tax-advantaged savings for medical expenses
Telehealth services to reduce in-person visit costs while maintaining healthcare accessibility
Health Reimbursement Arrangements (HRAs) allow employers to reimburse employees tax-free for medical expenses
Flexible Spending Accounts (FSAs) let employees set aside pre-tax dollars for healthcare costs

5. Flexibility and Hybrid Work Models

Flexible work options, including hybrid and remote work, remain highly desirable. Many employees consider flexibility a core component of their benefits package. Employers who adapt policies to accommodate hybrid work can improve retention and attract a wider talent pool.

6. Diversity, Equity, and Inclusion (DEI) in Benefits

Companies are expanding DEI-related benefits to create more inclusive workplaces. This includes:

Pay transparency compliance, as required by California’s SB 1162, mandating detailed reporting on compensation equity
Expanded parental leave policies that include adoption assistance, surrogacy benefits, and paid leave options beyond legal minimums
Gender-affirming healthcare coverage, which has gained prominence as part of inclusive benefits offerings

7. Technology Integration in Benefits Administration

New tools are making it easier for employees to understand and access their benefits. Employers are integrating:

Mobile-friendly benefits portals
AI-powered benefits navigation tools
Virtual book shelves or libraries with information about benefits, insurance carrier value added services, and enrollment platform instructions

8. Expanded Family-Building Benefits

Parental benefits are evolving to include adoption support, fertility treatments, surrogacy assistance, and childcare subsidies. California’s Paid Family Leave (PFL) program provides up to eight weeks of paid leave, and businesses are supplementing this with additional employer-funded leave to attract and retain top talent.

9. Professional Development and Career Growth

Upskilling and professional development benefits are becoming a key focus for retaining employees. Companies are offering tuition reimbursement, online course stipends, mentorship programs, and leadership training to enhance employee career trajectories and internal mobility.

10. Proactive Mental Health and Burnout Prevention

Employers are taking a more proactive stance on mental health by offering benefits such as:

Expanded Employee Assistance Programs (EAPs) with enhanced mental health services
Stress management workshops and resilience training
Paid mental health days separate from traditional sick leave

California-Specific Benefits Trends and Compliance Considerations

How to Stay Competitive in 2025

If you want to stay competitive in a crowded market when it comes to employee benefits trends, you need to take the most proactive approach possible.

Conducting a Benefits Audit: Identifying Gaps and Opportunities

Review the benefits you currently offer to identify compliance risks, bridge any gaps that may exist, and to highlight anything that is now considered to be outdated. Do this on a regular basis to make sure you're aligned with all current trends.

Engaging Employees in Benefits Planning

If you want to take full advantage of the future of employee benefits , you need to speak to the employees themselves for feedback. Open communication about benefits offerings also helps employees make informed decisions about their plans.

Partnering with a Benefits Expert to Optimize Offerings

Finally, you'll want to collaborate with a team of benefits brokers like AEIS to help navigate not only how complicated this process can be, but how easy it can be to get it wrong, too. This will help make sure that you're not only making the most out of your budget but that you're able to meet employee needs and exceed their expectations whenever possible.

Preparing Your Business for the Future

More than anything, you need to understand that preparing your business for the future of employee benefits is not something that you "do once and forget about." You always need to be looking ahead to upcoming changes in not only your industry, but in the benefits landscape in general.

When you make strategic investments today, make sure you're doing so in adaptable solutions . You want to not only support your employees right now, but you also want to be prepared to do so for years to come. Not only will this allow you to remain competitive as an employer, but it will also go a long way toward making sure that you're ready for whatever life happens to throw at you as well.

If you'd like to find out more information about the employee benefit trends you should be paying attention to, or if you have any additional questions that you'd like to go over with a team of experts in a bit more detail, please don't hesitate to contact the AEIS team today .

Challenges for California's Mid-Sized Businesses in Today's Market

Thu, 20 Mar 2025 15:00:02 GMT

Written by: AEIS

Running a mid-sized business in California comes with a unique set of obstacles. From talent acquisition tactics to benefits packages, companies must find creative ways to compete against the rest of the hiring pool.

For example, large corporations can often outspend smaller competitors, offering higher salaries and extensive perks. Startups, on the other hand, may attract talent through stock options and flexibility. Rising healthcare and insurance expenses, evolving labor laws , and shifting employee expectations make it increasingly difficult to remain competitive.

While these challenges can seem overwhelming, the right benefits package can help mid-sized businesses attract and retain top talent. Offering a combination of healthcare options, supplemental benefits, and work-life balance incentives can provide a competitive edge.

Key Components of a Competitive Mid-Size Business Benefits Plan Package

A well-designed benefits package can make a business stand out in the job market. Below are essential elements that help attract and retain employees:

Health Insurance Plans: Finding the Right Fit

Employees often prioritize healthcare coverage when evaluating job offers. Offering multiple plan options, such as HMOs, PPOs, and High Deductible Health Plans (HDHPs), allows employees to select the coverage that suits them best.

Employers can also provide Health Savings Accounts (HSAs) for employees enrolled in HDHPs, enabling tax-advantaged savings for medical expenses. However, California taxes HSA contributions and earnings at the state level, which differs from federal regulations.

Supplemental Benefits to Meet Diverse Needs

Some of the supplemental benefits you'll want to offer to meet the most diverse needs possible include ones like:

Dental Insurance: This gives an employee access to routine dental care , which can reduce overall healthcare costs.
Vision Insurance: This allows employees to address their eye health and can prevent larger health issues in the long run.
Life Insurance: This is a great way to give peace of mind and can be a valuable benefit, especially for those with dependents.
Disability Insurance: This makes sure that employees can maintain their income if they are unable to work due to illness or injury .
Voluntary Plans : These types of plans are typically employee-paid, but they allow businesses to offer options like critical illness, accident, or hospital indemnity insurance without incurring large costs.

Lifestyle and Work-Life Balance Benefits: Meeting Modern Employee Expectations

Modern employees expect more than just traditional benefits. Companies that offer flexibility and lifestyle perks can improve employee satisfaction and retention. Examples include:

Paid Time Off (PTO) and Vacation Policies: Demonstrates a commitment to work-life balance.
Remote and Flexible Work Options: Reduces commuting stress, especially in urban areas.
Paid Family and Medical Leave: California law requires Paid Family Leave (PFL), providing wage replacement for employees caring for family members or bonding with a new child.
Parental Leave Enhancements: Some companies extend paid leave beyond legal requirements to support new parents.

Additional Benefits to Enhance Your Offerings

Businesses looking to enhance their benefits package can consider:

Wellness Programs: Includes gym memberships, mental health resources, and wellness initiatives.
Retirement Plans: A required benefit in CA for employers with 5 or more employees.
Student Loan Assistance: Helps attract Millennial and Gen Z employees by reducing financial burdens.

Key Considerations for Businesses When Designing Benefits Plans

One of the most important things to understand about all this is that there is no "one size fits all" approach to putting together a benefits plan for your employees. Every business is a bit different, so you need to start within and with the goals you're trying to accomplish.

Only after that level of reflection will you be able to work your way to the benefits plan that will help.

Understanding Employee Needs Based on Demographics

A benefits package should reflect the needs of the workforce. Younger employees may seek student loan assistance, while older staff members often prioritize retirement contributions. Gathering feedback helps shape offerings that provide meaningful value.

Balancing Cost and Value in Benefit Plans

Mid-size California businesses must strike a balance between offering competitive benefits and managing costs. At a certain point, paying for an ineffective benefits strategy may not provide better value than simply allocating those funds towards increased salaries would have.

Look for cost-efficient options, like group plans. You should also focus on education-related materials to increase utilization and help employees perceive the real value of what you offer.

Staying Competitive in Your Industry and Local Market

All throughout this time, you'll want to make sure you're keeping up to date with industry trends and best practices. Look at the benefits packages that your competitors are offering to make sure yours is at least equal, if not better . Your broker should be able to help you with benchmarking your benefits against those of your peers.

Clearly Communicating Options to Employees

Employees need to understand their benefits options and how to access them. If they don't, they're not going to take advantage of them.

Regularly hosting informational sessions, providing benefit summaries, and offering support through HR professionals can help employees navigate their options and make informed decisions.

Navigating California-Specific Compliance Requirements

Finally, you'll want to make sure that you're following the strict labor and health laws in California regarding what you need to offer and how it must be made available to your employees.

Key regulations include:

Health Insurance Mandates: Employers with 50+ employees must provide coverage that meets state and federal ACA standards .
Paid Family Leave (PFL): Requires wage replacement for employees on family or medical leave.
Paid Sick Leave: State law mandates at least three paid sick days annually , though some local ordinances require more.
Retirement Plan Requirements: Businesses with five or more employees must offer a retirement plan or enroll in CalSavers , the state’s mandatory program.
Wage and Hour Laws: Minimum wage, overtime, and break period rules must be carefully followed to avoid penalties.

Partnering with the Right Benefits Provider for Your Business

Developing a competitive benefits strategy requires expertise in compliance, cost management, and employee satisfaction. AEIS helps mid-sized California businesses build benefits packages that align with business goals and employee needs.

If you're looking to refine your benefits offerings and stay competitive, contact AEIS today .

Guide to Legally Required Employee Benefits in California

Wed, 19 Mar 2025 15:46:19 GMT

Employer Benefit Laws in California

California employers must comply with both federal and state laws regarding employee benefits. While federal laws like the Affordable Care Act (ACA) set nationwide requirements, California has additional mandates that expand employee protections. These laws apply to various aspects of employment, including health insurance, paid leave, retirement plans, and workplace safety.

Employers with at least one employee must follow California's strict labor and benefits regulations. Some requirements, such as workers’ compensation insurance and payroll tax contributions for Social Security and Medicare, apply to all employers. Others, like CalSavers (the state-mandated retirement program), apply to businesses with five or more employees—soon to include those with just one employee by December 31, 2025.

California Employee Benefits Requirements

California’s employee benefits laws build upon federal requirements, often expanding protections for workers. Employers must provide certain benefits to employees, including health and welfare programs, paid leave, and payroll-based contributions. Unlike optional perks such as bonuses or voluntary benefits, these legally required benefits are non-negotiable.

Some benefits, like workers’ compensation insurance and payroll taxes for Social Security and Medicare, apply to all employers, regardless of size. Others, such as CalSavers, currently apply to businesses with five or more employees but will extend to those with just one employee by the end of 2025. Additionally, California mandates paid sick leave and offers programs like Paid Family Leave (PFL) and State Disability Insurance (SDI) to support workers facing health or family-related needs.

Health and Welfare Benefits Required by Law in California

California employers must comply with several mandatory health and welfare benefit laws, many of which expand upon federal requirements. These regulations allow employees to have access to essential protections, from health insurance to retirement plans. Below, we break down key benefit requirements that all California employers need to understand.

Health Insurance Requirements

Under the federal Affordable Care Act (ACA), employers with 50 or more full-time equivalent employees (FTEs) must offer affordable health insurance that meets minimum essential coverage requirements. While smaller businesses are not required to provide health insurance, California’s individual mandate imposes penalties on residents without coverage, which can increase employee demand for employer-sponsored plans.

Employers who offer group health insurance must verify their plans comply with both federal and state laws, including coverage mandates such as mental health services, maternity care, and preventive care. Additionally, California requires employers to offer coverage to registered domestic partners if they provide benefits to spouses.

While the ACA defines full-time employees as those working 30 or more hours per week, part-time employees do not automatically qualify for employer-sponsored coverage. However, some California employers voluntarily extend benefits to part-time workers to enhance recruitment and retention, and certain city-specific ordinances, such as San Francisco’s Health Care Security Ordinance (HCSO), impose additional health care spending requirements on part-time employees.

Workers’ Compensation Insurance

Workers’ compensation insurance is legally required for all California employers, regardless of size or industry. This coverage provides medical benefits and wage replacement for employees who suffer work-related injuries or illnesses. Even businesses with only one employee must carry a policy, and failing to do so can result in significant penalties.

While not a traditional employee benefit, workers’ compensation is crucial because insurers will not issue a group health insurance policy without proof of coverage. Many employers overlook this requirement, leading to compliance issues and potential liability.

California COBRA and Cal-COBRA Requirements

Federal COBRA law allows employees at companies with 20 or more employees to continue their group health insurance for a limited time after leaving their job, provided they pay the full premium. California extends this coverage further through Cal-COBRA, which applies to businesses with 2–19 employees. This ensures that employees and staff at smaller companies still have access to continuation coverage.

Employers must provide timely COBRA or Cal-COBRA notices to departing employees, ensuring they understand their rights and options for maintaining health insurance coverage. Failure to comply with these notice requirements can result in fines.

Retirement Plan Requirements

California employers with five or more employees must either offer a qualified retirement plan, such as a 401(k), or register with CalSavers, the state-run retirement program. This requirement will expand to businesses with just one employee by December 31, 2025.

Employers do not contribute to the plan but must facilitate enrollment and remain compliant with reporting requirements. Businesses that fail to register may face penalties.

Social Security and Medicare Contributions

All California employers must contribute to Social Security and Medicare (FICA) taxes on behalf of their employees. The current rates are:

Social Security: 6.2% of an employee’s wages, up to an annual wage cap
Medicare: 1.45% of all wages, with an additional 0.9% Medicare surtax for high earners (income above $200,000 for individuals)

Employers must match these contributions, ensuring employees receive these essential federal benefits upon retirement or disability.

Health Care Security Ordinance (HCSO) – San Francisco

Employers operating in San Francisco with 20 or more employees (50 or more for nonprofits) must comply with the Health Care Security Ordinance (HCSO). This ordinance requires businesses to spend a minimum amount on health care for employees working at least 8 hours per week in San Francisco.

Covered employers can meet this requirement through health insurance premiums, health reimbursement accounts (HRAs), or contributions to the city’s Healthy San Francisco program. Employers must track and report their spending to remain compliant.

Section 125 Plans and Compliance Considerations

California law sets strict requirements on employee benefits, but businesses can still offer tax-advantaged options like Section 125 plans, also known as cafeteria plans. These plans let employees use pre-tax dollars to pay for things like health insurance premiums, Flexible Spending Accounts (FSAs), and commuter benefits. Lower taxable income means savings for both employees and employers.

That said, compliance comes with a few key rules:

Non-Discrimination Testing (NDT): Section 125 plans can’t favor highly compensated or key employees. Businesses need to run annual tests to confirm fairness. Failing could mean losing the plan’s tax benefits.
Plan Documents: Every cafeteria plan needs a formal written document. This outlines benefits, eligibility, and participation guidelines.
Election and Changes: Employees typically make benefit choices during open enrollment. After that, changes only happen after major life events like marriage or having a child.

Section 125 plans can be a great way to add flexibility while keeping costs manageable. However, nnavigating the details takes careful planning. This is where a knowledgeable benefits advisor can help keep everything on track and compliant.

We're here to help.

Contact us today.

Required Leave Benefits in California

California employers must provide various leave benefits that go beyond federal requirements. These laws guarantee employees can take time off for health, family, and personal needs without jeopardizing their employment. Below are the key leave benefits required under California law:

Paid Sick Leave

Under the Healthy Workplaces, Healthy Families Act, California requires all employers, regardless of size, to provide paid sick leave to employees who work at least 30 days in a year. Employees accrue a minimum of one hour of sick leave for every 30 hours worked, with a yearly usage cap of at least 40 hours or five days, depending on the employer’s policy. Some cities, like San Francisco and Los Angeles, have even stricter sick leave requirements.

Employers must track accruals, allow employees to carry over unused sick leave, and include balances on pay stubs. Violations can result in fines and back pay.

Family and Medical Leave

California’s Family and Medical Leave laws expand upon the federal Family and Medical Leave Act (FMLA). Under the California Family Rights Act (CFRA), employers with five or more employees must provide up to 12 weeks of unpaid, job-protected leave in a 12-month period for:

A serious health condition (employee or a family member)
Bonding with a new child (birth, adoption, or foster care)
A qualifying military family need

Unlike FMLA, CFRA covers more family members, including adult children, siblings, and grandparents. Employers must continue health insurance benefits during leave and restore employees to their original or equivalent position upon return.

Paid Family Leave (PFL)

California’s Paid Family Leave (PFL) program provides partial wage replacement for employees taking leave to care for a seriously ill family member or bond with a new child. All private-sector employers must facilitate PFL through State Disability Insurance (SDI) payroll deductions.

Employees can receive up to 70% of their wages (capped at state-mandated limits) for up to eight weeks. Unlike CFRA, PFL is a wage replacement benefit rather than job-protected leave. However, employers cannot retaliate against employees for taking PFL.

Additional Legally Required Benefits in California

Beyond health and leave benefits, California mandates several additional protections for employees. These benefits secure financial stability in cases of illness, job loss, or other life events.

State Disability Insurance (SDI)

California requires employees to contribute to State Disability Insurance (SDI) through payroll deductions. SDI provides partial wage replacement for employees who cannot work due to a non-work-related injury, illness, or pregnancy.

Employers must withhold the required SDI percentage from employee wages and remit contributions to the state. Unlike workers’ compensation, SDI does not require employer funding, but businesses must facilitate employee participation.

Unemployment Insurance (UI)

California employers must pay into the state’s Unemployment Insurance (UI) program, which provides financial assistance to employees who lose their jobs through no fault of their own. Eligibility for UI benefits depends on factors like prior earnings, job separation circumstances, and availability for work.

Employers are responsible for paying UI taxes based on employee wages. The Employment Development Department (EDD) oversees the program and determines employer contribution rates annually.

Employment Training Tax (ETT)

The Employment Training Tax (ETT) is a California-specific payroll tax that funds workforce training programs for employees in eligible industries. Employers subject to UI tax must also pay ETT, which helps subsidize retraining programs for workers to develop new skills and remain employable.

Employers must maintain accurate payroll reporting to comply with ETT regulations. While the tax is relatively small, failure to pay can result in penalties.

Paid Time Off for Voting

California requires employers to provide employees with up to two hours of paid time off to vote in statewide elections if they do not have sufficient time outside of working hours. Employees must request voting leave at least two working days in advance, and employers must post a Voting Rights Notice at least 10 days before an election.

Final Wage Payment

When an employee leaves a job, California law mandates strict final paycheck timelines:

Voluntary resignation: Wages must be paid within 72 hours
Termination or layoff: Wages must be paid immediately upon dismissal

Final wages must include all earned wages, unused vacation time (if applicable), and commissions. Employers who delay payment may face penalties equal to the employee’s daily wages for each late day, up to 30 days.

Notice and Reporting Requirements for California Employers

California employers must comply with various notice and reporting obligations to inform employees of their rights and maintain compliance with state and federal laws. These requirements include workplace postings, employee notifications, and documentation retention.

Employers must display mandatory posters covering wage laws, discrimination protections, and leave entitlements. Notices about Paid Family Leave (PFL), State Disability Insurance (SDI), workers’ compensation, and COBRA/Cal-COBRA must be provided at the time of hire or when an employee becomes eligible.

Additionally, employers must furnish detailed wage statements with each paycheck, including hours worked, deductions, and accrued paid sick leave. Compliance also requires proper documentation of leave requests, final wage payments, and employee benefit elections.

Failing to meet notice and reporting obligations can result in penalties. Keeping accurate records, staying updated on legal changes, and regularly reviewing required postings help businesses maintain compliance and avoid legal risks.

How to Stay Compliant with California Employee Benefits Laws

Staying compliant with California’s employee benefits laws requires proactive management and ongoing awareness of state and federal regulations. Employers should regularly review their benefit offerings, update workplace policies, and ensure all required notices are properly displayed. Maintaining accurate payroll records and meeting reporting deadlines for taxes, leave benefits, and retirement plans is also essential.

Given California’s frequently changing employment laws, businesses should stay informed about updates to paid leave, retirement plan requirements, and local ordinances. Partnering with a knowledgeable employee benefits advisor can help ensure compliance and prevent costly penalties.

At AEIS , we specialize in guiding businesses through California’s complex benefits landscape. Whether you need help structuring a compliant benefits package, navigating new regulations, or streamlining your administrative processes, we’re here to assist. Contact us today to discuss how we can support your business and keep you compliant.

Disclaimer: Any information related to compliance, laws and regulations, or other subject matters in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this blog is based on the most up-to-date information that was available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Types of Employee Benefits: A Comprehensive Breakdown

Mon, 10 Feb 2025 16:00:07 GMT

Importance of Employee Benefits

A strong employee benefits package is essential for attracting and retaining top talent. Competitive benefits improve job satisfaction, boost productivity, and reduce turnover. They also demonstrate an employer’s commitment to workforce well-being, fostering a positive workplace culture.

Beyond employee retention, benefits can provide tax advantages and help ensure compliance with labor laws. Understanding the available options allows businesses to build a package that supports both their employees and long-term success.

Main Types of Employee Benefits Offered

Employee benefits typically fall into several key categories:

Health Benefits – Medical, dental, and vision coverage to support employees’ well-being.
Financial Protection – Life and disability insurance to provide income security.
Work-Life Balance – Paid time off, remote work options, and flexible schedules.
Supplemental & Voluntary Benefits – Additional coverage like accident insurance and critical illness plans.
Other Perks – Options such as FSAs, HSAs, fertility benefits, discount programs, and pet insurance.

Offering a well-rounded benefits package helps businesses attract talent and enhance employee satisfaction.

Health Benefits

Health benefits are a cornerstone of any employee benefits package, helping employees access essential medical care while managing costs. Providing quality health coverage can improve employee retention, reduce absenteeism, and boost overall well-being.

Group Health Insurance

Group health insurance allows employers to offer comprehensive medical coverage at a better value than most individual plans and usually with more participating providers. These plans typically cover preventive care, doctor visits, hospital stays, and prescriptions, with premium costs usually shared between employers and employees.

Overview of Major Carriers

California businesses have access to several leading health insurance carriers, including but not limited to, Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente, and UnitedHealthcare. Each carrier offers different plan structures, networks, and pricing, allowing employers to select coverage that best fits their workforce’s needs.

Types of Medical Plans: HMO, PPO, HDHP

Employers can select from different health plan types:

Health Maintenance Organization (HMO) – Requires employees to use a specific network of doctors and obtain referrals for specialists. Typically lower-cost but with less flexibility. No Out-Of-Network Coverage.
Preferred Provider Organization (PPO) – Offers greater flexibility to see both in-network and out-of-network providers, usually with higher premiums than other plan types.
High Deductible Health Plan (HDHP) – Features lower premiums and higher deductibles with the ability to be paired with a Health Savings Account (HSA) for tax-advantaged medical savings.

Alternate Funding Options

For businesses seeking cost control beyond traditional fully insured plans, alternative funding strategies include:

Health Reimbursement Arrangements (HRAs) – Employer-funded accounts that reimburse employees for qualified medical expenses.
Level Funding – A hybrid approach offering predictable monthly costs with potential savings based on claims.
Self-Funding – Employers assume the financial risk of healthcare costs but gain flexibility in plan design and cost management. Typically a strategy reserved for large organizations.

Each funding model has unique advantages, and AEIS can help businesses explore the best fit for their needs.

We're here to help.

Contact us today.

Dental Insurance

Offering dental insurance helps employees maintain their oral health, which is closely linked to overall well-being. Plans typically cover preventive care like cleanings and exams, as well as basic and major procedures such as fillings, crowns, and root canals. Some plans include coverage for orthodontia as well.

Employers can choose from:

Fully Insured Plans – Fixed premiums with coverage managed by an insurance carrier.
Self-Funded Plans – Employers take on the financial risk but gain cost control. This is not typically seen with small to midsize businesses.
Discount Plans – Employees receive reduced rates from in-network providers without traditional insurance coverage.

Providing dental benefits enhances employee satisfaction and can reduce long-term healthcare costs by preventing more serious health issues.

Vision Insurance

Vision insurance helps employees access affordable eye care, including routine exams, prescription glasses, and contact lenses. Many plans also offer discounts on corrective surgery, such as LASIK.

Coverage typically includes:

Annual eye exams – Detecting vision changes and underlying health conditions.
Prescription eyewear – Frames, lenses, and contact lenses with cost-sharing.
Discounts on procedures – Savings on laser vision correction and other treatments.

Since eye health is linked to overall well-being, offering vision insurance can improve both employee health and productivity.

Life and Disability Insurance

Life and disability insurance provides financial security for employees and their families in case of unexpected events . These benefits help protect income and ensure financial stability during difficult times.

Life Insurance

Employers can offer:

Basic Group Life Insurance – Employer-paid coverage providing a set benefit amount.
Voluntary Life Insurance – Employees can purchase additional coverage at group rates for themselves and their spouses.

Disability Insurance

Disability insurance replaces a portion of an employee’s income if they are unable to work due to illness or injury. Options include:

Short-Term Disability (STD) – Covers temporary disabilities, typically lasting a few weeks to months.
Long-Term Disability (LTD) – Provides extended income protection for serious conditions.

Supplemental Voluntary Benefits

Supplemental voluntary benefits give employees additional financial protection beyond standard health, life, and disability insurance. These benefits are often employee-paid but offered at group rates for affordability.

Voluntary Life Insurance

Allows employees to purchase extra life insurance coverage to supplement their employer-provided plan.

Critical Illness Coverage

Provides a lump-sum payout if an employee is diagnosed with a serious illness such as cancer, heart attack, or stroke.

Accident Insurance

Covers expenses related to accidental injuries, including emergency treatment, hospital stays, and rehabilitation.

Hospital Indemnity Plans

Pays a fixed amount for hospital stays, helping employees manage out-of-pocket expenses not covered by health insurance.

Paid Time Off

Paid time off (PTO) is a key benefit that supports employee well-being and work-life balance. Employers may offer different types of PTO, including:

Vacation Days – Time off for personal travel, relaxation, or leisure.
Sick Leave – Paid time off for illness or medical appointments.
Paid Holidays – Company-designated holidays when employees receive paid leave.
Personal Days – Flexible days off for personal needs or emergencies.

In California, certain paid leave policies, such as sick leave, have legal requirements. Providing a competitive PTO policy helps attract and retain employees while promoting productivity and job satisfaction.

Remote Work

Remote work has become a highly valued benefit, offering employees flexibility while helping businesses attract and retain talent. Employers may implement different remote work models, such as:

Fully Remote – Employees work entirely from home or another location.
Hybrid Model – A mix of in-office and remote workdays.
Flexible Work Arrangements – Employees can choose where and when they work within set guidelines.

Additional Benefits to Consider

Beyond traditional benefits, many employers are expanding their offerings to meet evolving employee needs. These additional perks can enhance job satisfaction and set businesses apart in a competitive job market.

Flexible Spending Accounts (FSAs)

FSAs allow employees to set aside pre-tax dollars for qualified expenses. Options include:

Health FSAs – Cover medical, dental, and vision expenses.
Dependent Care FSAs – Help pay for childcare or elder care.
Commuter FSAs – Reduce costs for public transit and parking.

Health Savings Accounts (HSAs)

Available to employees enrolled in a high-deductible health plan (HDHP), HSAs offer tax advantages and long-term savings for medical expenses.

Pet Insurance

Covers veterinary costs, helping employees manage expenses related to pet care.

Lifestyle HRAs

Employers can offer stipends for wellness-related expenses such as gym memberships, fitness classes, and mental health programs.

Fertility Benefits

Assists employees with fertility treatments, egg freezing, and adoption support—an increasingly valued benefit in today’s workforce.

Technology Solutions for Benefit Management

Platforms that integrate all benefits into a single system make it easier for employees to access and manage their plans, improving overall benefits utilization.

Professional Development Options

Supporting employees’ career growth fosters loyalty and strengthens workplace culture. Employers can offer:

Tuition Reimbursement – Financial assistance for job-related education.
Certification & Training Programs – Sponsorship for industry credentials and skill-building.
Mentorship & Coaching – Guidance from experienced professionals.
Career Development Stipends – Funding for conferences, courses, and leadership programs.

What Benefits Are Required to Offer to Employees in CA

California has specific laws mandating certain employee benefits . Employers must comply with these requirements to avoid penalties and ensure legal compliance. Key mandated benefits include:

Health Insurance (for Applicable Large Employers) – Under the Affordable Care Act (ACA), employers with 50 or more full-time employees must provide health insurance that meets minimum coverage and affordability standards.
Paid Sick Leave – California law requires employers to provide at least 24 hours (or three days) of paid sick leave per year.
Family and Medical Leave – Eligible employees may take unpaid, job-protected leave under the California Family Rights Act (CFRA) and the federal Family and Medical Leave Act (FMLA).
Paid Family Leave (PFL) & State Disability Insurance (SDI) – Funded through employee payroll deductions, these programs provide partial wage replacement for family caregiving and medical leave.
Workers’ Compensation Insurance – Employers must provide coverage for work-related injuries and illnesses.
COBRA & Cal-COBRA – Employers must offer continuation of health coverage for eligible employees after job loss or other qualifying events.

Understanding these requirements helps businesses remain compliant while supporting their employees' well-being.

Customize the Right Benefits Offerings with AEIS

Building the right benefits package requires balancing employee needs, compliance, and costs. With so many options available, expert guidance is key to making informed decisions.

AEIS helps businesses design competitive, cost-effective benefits plans tailored to their workforce. Whether you need traditional coverage, alternative funding strategies, or emerging perks like fertility benefits and lifestyle HRAs, we provide customized solutions .

Contact AEIS today to create a benefits package that supports your employees and strengthens your business.

Ways to Reduce The Cost of Employee Benefits

Fri, 07 Feb 2025 17:20:52 GMT

Written by: AEIS

Are Employee Benefits Costs Rising?

Employee benefits costs continue to rise, creating challenges for employers striving to offer competitive packages while maintaining financial sustainability. According to a recent study, total employer compensation costs for private industry workers—including employee benefits—averaged $43.94 per hour worked in June 2024. This upward trend shows no signs of slowing, driven primarily by increasing healthcare costs and regulatory changes that make cost control difficult.

Despite these challenges, businesses can take strategic steps to manage and reduce employee benefits costs while maintaining an attractive benefits package.

Why Offering Competitive Employee Benefits Still Matters

Before exploring cost-saving strategies, it is essential to understand why investing in employee benefits remains crucial.'

A strong benefits package helps attract and retain top talent. In many cases, employees prioritize benefits over salary when choosing an employer. Competitive benefits not only position your company as a desirable workplace but also improve job satisfaction and productivity. Additionally, satisfied employees are less likely to leave, reducing costly turnover and hiring expenses.

How to Reduce the Costs of Competitive Employee Benefits

There are several effective strategies to reduce employee benefits costs without compromising quality:

Assess Employee Utilization of Current Benefits

One of the most important things to do when attempting to reduce the costs of competitive employee benefits involves taking a closer look at what your current offerings are working and which parts, more crucially, aren't.

Remember that you pay for benefits whether your employees are utilizing them or not. If there are aspects of your current policies that employees have no interest in, get rid of them and replace them with something else. You can likely save a bit of money and even if you don't, it could still improve the quality of your benefits to the point where you're getting more for every dollar you're spending.

Educate Employees About Offered Benefits

If your evaluation reveals low benefits utilization, the issue may be a lack of awareness rather than a lack of interest. Effective communication ensures employees understand and take full advantage of their benefits, maximizing the value of your investment.

Consider distributing a detailed employee benefits guide, hosting informational webinars, or offering one-on-one consultations. When employees make informed decisions about their benefits, they can select cost-effective options that still meet their needs.

Choose Cost-Effective Health Plans

At a bare minimum, you should be comparing different health insurance plans and carriers to find the one that makes the most sense for both your business and your employees.

Conduct surveys to understand their healthcare priorities and explore plan designs that optimize affordability and coverage, such as:

High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs)
Health Reimbursement Arrangements (HRAs)
Tiered or narrow network plans

Offer Flexible and Supplemental Benefits

Providing flexible benefits allows employees to customize their coverage based on individual needs, often at a lower cost to employers. Examples include:

Flexible Spending Accounts (FSAs): Employees set aside pre-tax funds for qualified medical expenses.
Cafeteria Plans: Employees select from a menu of pre-tax benefit options.
Supplemental Benefits: Offering voluntary benefits such as dental, vision, disability, and life insurance gives employees more choices without significantly increasing employer costs.

Double-check that these are the types of things people actually want before you offer something nobody will take advantage of.

HRAs

Short for Health Reimbursement Arrangement, an HRA is an employer-funded account that reimburses employees for out-of-pocket medical expenses. It is usually paired with lower premium plans that have a higher deductible; the employer then covers part of the deductible through the HRA, creating a net savings compared to traditional plans. Since only the employer funds an HRA and any unused funds the employer keeps.

HSAs

Short for Health Savings Accounts, HSAs are tax-advantaged accounts funded by both employees and employers. Employers may choose to match employee contributions or make a defined contribution for each enrolled employee. HSAs are paired with High Deductible Health Plans (HDHPs), which typically feature lower monthly premiums. Employees benefit from HSAs by making pre-tax contributions that grow tax-free, with tax-free withdrawals available for qualified medical expenses . These accounts also roll over annually, allowing employees to accumulate savings over time.

Alternative Funding Solutions

For employers seeking additional cost-saving opportunities , alternative funding methods provide flexibility and potential savings:

Level Funding

Level Funding is a hybrid approach between fully insured and self-funded plans, where employers pay a fixed monthly amount for claims, administrative fees, and stop-loss insurance. If claims are lower than expected, employers may receive a refund or credit.

Self-Funding

With self-funding, employers directly pay employee healthcare costs instead of purchasing traditional insurance. While riskier, self-funding can be cost-effective for businesses with a young or healthy workforce. Self-funding is usually geared towards larger businesses.

Meeting With an Employee Benefits Consultant

For the best results , you'll always want to meet with an employee benefits consultant like the team at AEIS. We'll take the time to get to know your business and your people so that we can find out how to meet your needs and save as much money as possible at the same time.

We'll be able to conduct a thorough benefits analysis, giving you all the actionable information you need to select the right plan. We can also help with cost management strategies moving forward.

How an Employee Benefits Consultant Can Reduce Your Employee Benefits Costs

An employee benefits consultant can help reduce your employee benefits costs through various organization-specific cost-saving measures that are built with you in mind. Using our expertise to your advantage, we can optimize plan structures in a way that makes perfect sense for exactly the type of business you're running. We can run a market analysis to confirm you are not overpaying, and can even recommend alternative funding solutions that make sense given your specific company.

Reach Out to AEIS for Your Employee Benefits Needs

If you're interested in finding out more information about how to save money on employee benefits, or if you have any additional questions that you'd like to go over with someone in a bit more detail, please don't delay - contact the team at AEIS today .

Employee Benefits and Its Effect on Productivity & Performance

Fri, 07 Feb 2025 16:59:57 GMT

Written by: AEIS

The ROI of Investing in Employee Benefits

For business owners and HR leaders, employee benefits are more than just a line item in the budget. They represent a strategic investment in workforce satisfaction and productivity. Numerous studies highlight that comprehensive benefits packages not only help attract top talent but also reduce turnover, foster loyalty, and enhance performance. Companies that prioritize robust employee benefits often experience measurable returns in the form of higher productivity, improved morale, and better organizational outcomes.

Investing in benefits can also lead to financial savings in unexpected ways. Businesses that offer strong health and wellness programs often experience reduced absenteeism, lower healthcare claims, and increased employee productivity. According to the Society for Human Resource Management (SHRM) , employers may see an average return of $3 to $6 for every dollar spent on wellness initiatives. These savings typically come in the form of lower long-term healthcare costs, fewer sick days, and improved employee retention—particularly for self-funded employers who directly manage claims expenses. With these advantages, organizations of all sizes are reevaluating their benefits strategies to maximize their return on investment.

The Link Between Employee Benefits and Their Effect on Productivity and Performance

Employee benefits directly influence productivity and performance by meeting key needs—physical, emotional, and financial. When employees feel valued and supported, their engagement and efficiency naturally improve. Conversely, insufficient benefits can lead to burnout, dissatisfaction, and higher turnover rates.

For example, offering comprehensive health insurance can provide employees with the peace of mind that they and their families are covered in the event of illness. Similarly, professional development opportunities demonstrate an employer’s commitment to growth, empowering employees to advance their skills and contribute more effectively to the organization’s goals.

The connection is clear: benefits that address the diverse needs of employees lead to a more motivated and productive workforce . When businesses focus on meeting those needs, they position themselves to achieve both immediate and long-term success.

Key Employee Benefits That Boost Productivity

Mental Health Benefits

Mental health support is one of the most impactful benefits an organization can offer. Programs such as Employee Assistance Programs (EAPs), access to therapists, or reimbursement for mental health services help employees manage stress, anxiety, and other challenges. Employees who feel mentally supported are more likely to remain engaged and productive in their roles.

Lifestyle HRAs

Health Reimbursement Arrangements (HRAs) tailored to lifestyle needs offer employees financial support for health-related expenses, such as gym memberships or wellness classes. This flexibility promotes healthier habits and overall well-being, reducing absenteeism and increasing energy levels at work.

Comprehensive Health Insurance

Health insurance remains a cornerstone of employee benefits. Employers offering competitive health plans—including options for vision, dental, and preventive care—can significantly reduce stress for employees, allowing them to focus more fully on their work. Offering plans that include benefits like telehealth services or maternity support can also be a game-changer for many workers.

Work-Life Balance

Flexible Work Arrangements and Work-Life Balance

Flexibility in scheduling can dramatically improve employee satisfaction. Whether through remote work, hybrid arrangements, or flexible hours, allowing employees to tailor their schedules fosters better work-life balance. Employees with flexibility are often more focused and efficient during working hours.

Remote Work and Flexible Scheduling

The shift toward remote work has shown that employees are often more productive when given the autonomy to work in environments that suit their needs. For businesses, this can also mean lower overhead costs and access to a broader talent pool.

Generous Leave Policies

Paid time off (PTO), parental leave, and sick days contribute to better performance by allowing employees to recharge and return to work energized. Businesses offering generous leave options often see higher levels of retention and employee satisfaction.

Volunteer Time Off

Providing employees with opportunities to volunteer—with paid time off to do so—can enhance job satisfaction. Employees appreciate companies that support their personal values and give back to the community, further fostering loyalty.

Career and Development

Professional Development Opportunities

Investing in your employees’ growth creates a more skilled and dedicated workforce. Whether it’s funding for certifications, on-the-job training, or tuition reimbursement, professional development opportunities show employees that they have a future within the company. This can significantly reduce turnover and elevate overall performance.

Recognition and Engagement

Recognition and Reward Programs

Acknowledging employee achievements through bonuses, awards, or even simple recognition in team meetings can have a profound impact. Employees who feel recognized are more motivated and committed to their work. Implementing structured reward programs can also drive productivity by setting clear goals and incentivizing high performance.

Community Engagement Opportunities

Encouraging employees to engage in their communities not only boosts morale but also enhances the company’s reputation. Sponsoring team participation in local events or charitable causes strengthens team bonds and fosters a sense of pride in the workplace.

Unconventional Benefits

Unconventional Benefits to Boost Work Motivation

Creative perks like pet care stipends, gym memberships, or fertility benefits can set an organization apart in a competitive hiring market. These benefits address unique employee needs and demonstrate that the company is committed to supporting their lives beyond work. For example, offering fertility support or childcare benefits can significantly improve retention among employees starting families.

How to Customize Benefits for Maximum Impact

Assessing Employee Needs and Preferences

The first step to building an impactful benefits program is understanding your workforce. Conduct surveys or focus groups to gather input on which benefits employees value most. This data-driven approach ensures that your investment aligns with their expectations.

Tailoring Benefits to Business Goals and Workforce Demands

Aligning your benefits program with your company’s strategic objectives is equally important. For example, businesses focused on attracting younger talent might prioritize student loan repayment programs or tuition reimbursement. Conversely, organizations with a more senior workforce might focus on retirement planning and comprehensive health coverage.

How AEIS Can Help You Optimize Employee Benefits

At AEIS , we specialize in designing benefits programs that meet the unique needs of your organization. From assessing employee preferences to negotiating with providers, our team takes the complexity out of benefits management. By working closely with you, we develop comprehensive, cost-effective solutions that boost productivity, attract talent, and promote employee well-being.

Ready to take your benefits strategy to the next level? Contact us today.

Disclaimer: Any information related to compliance, laws and regulations, or other subject matters in this piece is intended to be informational and does not constitute legal advice regarding any specific situation. The content is based on the most up-to-date information available at the time of publication and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Unlocking the Power of PEOs for Your Small to Mid-Size Business

Fri, 07 Feb 2025 16:00:01 GMT

Small to mid-sized companies are constantly seeking innovative solutions to streamline operations, enhance employee benefits, and stay compliant and “audit-ready” with ever-changing regulations. One powerful solution that is gaining traction is the Professional Employer Organization (PEO). In our latest video, our Employee Benefits Consultant, Dillon Castro, hosts an insightful discussion with experts Ari Wind, Rob Schlossberg, and Chad Todora from BenefitMall’s PEO Division, shedding light on the myriad benefits PEOs can offer.

What is a PEO?

A Professional Employer Organization (PEO) is a firm that provides comprehensive human resources (HR) services to businesses. By entering into a co-employment arrangement, the PEO handles various services including payroll processing, tax administration, risk management, benefits administration, and regulatory compliance. By partnering with a PEO, companies can offload the administrative burdens of HR tasks, allowing them to focus on core business activities and growth.

Key Benefits of Partnering with a PEO

In our video, our panelists outlined several key benefits that businesses can expect when partnering with a PEO:

Streamlining HR Functions : By consolidating HR tasks under one umbrella, PEOs provide a seamless and efficient way to manage payroll, benefits, and compliance. This integration saves time and resources, enhancing overall productivity.
Access to Advanced Technology Platforms: PEOs offer integrated technology solutions that streamline payroll, benefits administration, and HR tasks. These platforms often include features like online enrollment, time tracking, and robust reporting capabilities, which enhance efficiency and accuracy.
Compliance and Risk Management: PEOs ensure that businesses stay compliant with federal, state, and local regulations. They manage various compliance aspects, such as tax filings, workers' compensation, and unemployment insurance, reducing the risk of penalties and legal issues.
Focus on Core Business Activities : By handling the administrative burdens of HR tasks, PEOs allow business owners and managers to focus on strategic initiatives, business development, and overall growth. This can lead to improved productivity and profitability.

Evaluating the Fit for Your Business

Not all businesses are the same, and neither are all PEOs. Our experts emphasize the importance of evaluating your company’s specific needs and expectations before selecting a PEO. Key factors to consider include:

Service: The level of service provided by a PEO is crucial. As Ari Wind mentioned, it’s important to have a PEO with a strong technology platform and excellent service teams. The PEO should offer proactive HR support, enabling HR personnel to focus on strategic initiatives rather than getting bogged down by administrative tasks.
Industry Type : Certain industries, such as technology firms, startups, and nonprofits, can particularly benefit from the robust services offered by PEOs.
Compliance Needs : Companies with employees across multiple states can greatly benefit from a PEO’s expertise in managing diverse regulatory requirements.
Financial Considerations : While cost savings are a significant factor, the true value of a PEO lies in the comprehensive services and long-term benefits they provide.
Benefits Package : Evaluating the benefits package offered by a PEO is essential. Ari Wind highlighted that PEOs can provide significantly richer benefits, including medical, dental, vision, pet insurance, and critical illness coverage. The quality and range of these benefits can be a major driver for partnering with a PEO, especially for companies looking to offer competitive employee benefits.

Certification and Accreditation

Certification and accreditation are crucial when selecting a PEO. Our experts discuss the importance of certifications like CPEO by the IRS and ESEC accreditation, which ensure that the PEO is financially sound and compliant with industry standards. These certifications provide peace of mind and protection for businesses entrusting their HR functions to a PEO.

Understanding the Pricing of a PEO

When considering a PEO, pricing is an important factor but should not be the sole determinant. As Ari Wind and Chad Todora discussed, the cost of a PEO includes more than just savings on health insurance, since future renewal increases can diminish those savings. PEO pricing encompasses the entire scope of services provided, including payroll, workers’ compensation, state unemployment insurance, and HR administration. The goal is to provide a comprehensive package that delivers value beyond immediate cost savings. It’s essential to evaluate how the PEO’s pricing structure aligns with the company’s long-term strategic goals and the efficiencies gained through streamlined HR processes.

Conclusion

Partnering with a PEO can be a game-changer for small to mid-sized companies, offering numerous benefits that streamline HR operations, ensure compliance, and enhance talent acquisition efforts.. Transitioning to a PEO is all about education and finding the right fit for your specific needs. If you’re considering the PEO model for your business, reach out to us here at AEIS for a personalized evaluation and let our team of experts guide you toward the best solution for your company.

For more detailed insights and to hear directly from our panel of experts, watch the full video here .

2025 Open Enrollment Compliance Checklist for California Employers

Wed, 18 Dec 2024 16:00:04 GMT

Written by: AEIS

Open enrollment season allows employers to fine-tune their benefits offerings while meeting important legal and regulatory obligations. For California businesses, it’s a period that requires careful attention to both state and federal requirements, ensuring employees have the information they need while your organization stays compliant.

This checklist is your guide to navigating 2025 open enrollment with clarity and purpose. By staying proactive and organized, you can avoid common pitfalls, support your employees effectively, and maintain compliance every step of the way.

The Importance of Compliance During Open Enrollment

Open enrollment isn’t just about offering benefits—it’s about doing so legally and ethically. For employees, open enrollment is a great chance to make any changes to their benefits to better serve the needs of themselves and their family. Employers during this time, get the chance to support their staff, while keeping their business compliant and positioned for success.

By maintaining compliance:

You mitigate the risk of legal penalties.
You avoid administrative issues such as incorrect billing or misclassification of employees.
You reinforce a positive company culture by ensuring fairness and clarity.

2025 Open Enrollment Requirements

For 2025 , employers that have more than 50 full-time employees (or full-time equivalents) are required to offer affordable, minimum-value health coverage under the ACA to avoid penalties. Additionally, employers of all sizes must issue notices informing eligible employees about available health insurance coverage.

Timeline Guidelines for 2025 Open Enrollment in Group Benefits

For group benefits, it’s essential to plan for key dates well in advance, though specific timelines can vary. If your small group has a 1/1/2025 renewal, expect to receive a pre-renewal survey from your broker roughly 90 days before the renewal date. Around 60 days prior, your broker will provide the renewal details and alternative options for review. Make sure to coordinate with your broker to discuss any changes or to schedule an open enrollment meeting, allowing employees sufficient time to understand their choices.

Typically, employees are given a 1-2 week period to make decisions on benefits selections just ahead of the effective date. For larger groups or organizations using alternate funding arrangements, the timeline may differ, so consult with your broker to establish a schedule that aligns with your unique needs.

Open Enrollment Checklist for California Employers

During the open enrollment period , one of the most important things for California employers to do involves reviewing and updating their benefits plan. Use this as a yearly opportunity to verify that all health plans and other benefits comply with both state and federal laws.

Based on any changes that you make , you'll also want to update your employee benefits portal to keep everyone on the same page at all times. Then, distribute all the required notices (including the California Healthy Workplaces notice, the sick leave notice, etc.) and make sure that you comply with all Affordable Care Act and California-specific health coverage mandates.

While it's true that this can all take a great deal of time and effort to get right , it's easy if you enlist the help of a team of professionals like those at AEIS. We can take care of these things on your behalf so that you can focus less on mitigating risk during open enrollment and more on running the most successful business that you can.

California-Specific Laws to Know

A few of the California-specific laws that you'll definitely want to be aware of include but are not limited to those like:

San Francisco HCSO

Also called the Health Care Security Ordinance, this requires employers with 20 employees company-wide (50+ for nonprofits) to make healthcare contributions on behalf of their employees who work in the city of San Francisco for a certain number of hours per week, with a higher contribution required for businesses with more than 100 employees.

California Paid Family Leave

This is a law in the state of California that mandates paid family leave for a wide range of different caregiving-related circumstances.

SDI

This is a requirement that all employers need to make certain that eligible employees are enrolled in California's State Disability Insurance program.

Required Notices for Employers

Some of the notices that you'll need to distribute during the open enrollment period include ones like the HIPAA Notice of Privacy Practices, COBRA-related Notices, Patient Protection Disclosure, Medicare Part D Notice of Creditable Coverage, the Your Rights and Protections Against Surprise Medical Bills, and more. You'll want to guarantee that all these notices have been distributed to the appropriate parties as quickly as possible so that they can make the most informed decisions possible when it comes to open enrollment. If you have an online benefits enrollment system you may be able to post the required notices on the system as required reading in the enrollment process in lieu of physically handing out copies to employees.

Ensure Non-Discrimination Testing is Conducted

During this time, you'll also want to confirm that how you offer benefits plans does not discriminate against any employees. Employees who make more money can't be treated more favorably , for example.

Proper Classification of Employees

Take great care to ensure that you are properly categorizing full-time, part-time, and 1099 workers during the open enrollment period or you could face hefty fines and other violations as a result.

Document and Audit Everything

At a bare minimum, you need to keep a record of all communications with employees pertaining to open enrollment. You'll also want to document and track all employee contributions and periodically audit this all throughout the year to make sure that everything is as it should be. This includes collecting signed waivers for any employees who choose not to participate in any of the plans you offer.

HIPAA Compliance and Protecting Employee Information

When it comes to HIPAA, you'll need to make sure that certain types of employee information are fully protected during open enrollment. All employee data, including the type of health insurance they have and date of births and more, should be kept confidential. If yours is a business with a human resources department, they need to be fully trained and up-to-date on the proper handling of Personal Health Information (PHI). You'll also need to take great care to make sure that any information stored electronically is safeguarded as well.

Common Mistakes During Open Enrollment

There are a wide range of different mistakes that businesses often fall into during open enrollment, especially when they try to do things themselves without the guidance of an experienced broker.

Verifying Invoices Post-Enrollment

After enrollment changes have been fully processed, confirm that all billing is accurate, that proper contributions have been made, and that employees who opted out of coverage are not charged.

Coordinating with Brokers and COBRA Administrators

Always work with brokers to ensure that plan information is accurate. Do what you can to make the transition for employees who may qualify for COBRA as seamless as possible.

Communicating Benefit Changes and Enrollment Dates Clearly

Whenever benefits or open enrollment dates change, you need to provide clear instructions to employees and let them know what they can expect. Set your expectations ahead of time and offer assistance whenever necessary. Doing so will go a long way towards preserving your relationship with your employees.

Ensuring Compliance with California & Federal Laws for 2025

It’s important to remember that open enrollment compliance goes beyond California-specific regulations. Federal laws, including the Affordable Care Act (ACA) requirements, play a key role in maintaining a compliant benefits offering.

ACA Reporting Requirements for 2025

For ACA reporting requirements for 2025, Applicable Large Employers (ALE’s) need to provide form 1095-C to employees so that they can then file with the IRS to prove that they have offered the required coverage. Confirm that all information on that form is accurate to avoid confusion moving forward.

How AEIS Can Help

Navigating compliance for 2025 open enrollment doesn’t have to be overwhelming. At AEIS, our team of experts offers tailored solutions to help California employers meet all federal and state requirements. Whether you need assistance with benefits planning, ACA reporting, or employee communication, we’re here to streamline the process and ensure compliance.

Contact us today to learn how we can help your organization navigate the complexities of open enrollment with confidence.

Disclaimer

Any information related to compliance, laws, and regulations in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. The content is based on the most up-to-date information available on the date it was published and is subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Guide to HMO vs. PPO for California Employers

Tue, 17 Dec 2024 15:34:38 GMT

Last Updated: May 23, 2025

What’s the Difference Between an HMO and a PPO Plan?

Understanding the differences between HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans is crucial for employers when selecting the right health insurance for their teams. Both plans offer distinct benefits , different networks, and cost structures, making them suitable for different types of businesses and employee needs.

Understanding HMO Plans

HMO plans are structured to provide comprehensive care within a network of doctors, hospitals, and other healthcare providers. One of the defining aspects of an HMO is its emphasis on coordinated care. Employees are required to select a primary care physician (PCP) who manages their healthcare and provides referrals to specialists when necessary.

Key Features of HMO Plans

In-network care only: Employees must use providers within the HMO’s network; there are no benefits for out-of-network care, except in emergencies where there is risk of loss of life or limb.
Referral system: Employees must obtain a referral from their PCP before seeing a specialist.
Lower premiums: HMOs typically have lower premiums and out-of-pocket costs compared to PPOs, but the trade-off is less flexibility.

Understanding PPO Plans

PPO plans offer more opportunities for choice by allowing employees to see any healthcare provider, in or out of network. This makes PPOs an attractive option for those who prefer to have control over their healthcare choices.

Key Features of PPO Plans

No referrals needed: Employees can see specialists directly without needing a referral from a PCP.
Out-of-network coverage: PPOs offer coverage for both in-network and out-of-network providers, though out-of-network care comes with higher out-of-pocket costs.
Higher premiums: The ability to access a broader range of providers with PPO plans typically results in higher premiums and out-of-pocket costs.

Whether it’s the affordability and structure of an HMO or the freedom offered by a PPO, understanding these options ensures your employees have access to the right care while feeling confident in their coverage.

Pros and Cons of

HMO vs. PPO Plans

When choosing between HMO and PPO plans for your business, it’s important to consider both the benefits and trade-offs of each option.

HMO Plans

Because HMO plans typically come with lower premiums and more affordable cost-sharing, it makes them an attractive choice for businesses focused on controlling healthcare expenses. However, this cost-effectiveness comes with limitations. Employees are restricted to a narrower network of providers and won’t have coverage for out-of-network care, except in true emergencies. Additionally, HMOs may not be a good fit if your business has employees who live or work out of the area or state, as HMO networks are usually regionally based and don’t offer national coverage.

PPO Plans

On the other hand, PPO plans provide employees with broader access to a variety of doctors and medical groups, including the ability to see out-of-network providers. While PPOs offer more choices when it comes to healthcare, they come at a higher cost—both in premiums and out-of-pocket expenses. One key advantage of PPOs is the partial coverage for out-of-network services, though in-network care is still more affordable. PPOs can also be a better option for companies with employees located out of state, as national networks may be available, ensuring continuity of care across regions.

HMO vs. PPO Insurance: Which Plan is Right for Your Business?

The key differences between an HMO and a PPO come down to what matters most for your business and employees. If you're looking to keep costs manageable while still offering solid, in-network care, an HMO might be the way to go. It’s budget-friendly, but employees need to stick to the network and get referrals for specialists.

On the other hand, if your team values flexibility and the ability to see any doctor they choose, a PPO could be the better fit—though it comes with higher premiums. The right choice is about finding that sweet spot between affordability and giving your team the care options they need.

Many companies offer both PPO and HMO plans to their employees, so that their employees can choose the best plan for them and their families.

HMO vs. PPO California: State-Specific Trends and Insights

When selecting a healthcare plan, it helps to know how preferences and costs vary by region. These differences can play a big role in finding the right fit for your business and employees.

Prevalence of HMO and PPO Plans in California

In California, there are distinct regional trends when it comes to HMO and PPO plan preferences. Southern California tends to favor HMO plans, which offer lower costs and tightly managed care. These plans have strong networks in densely populated areas, making them a popular choice. Conversely, the Greater Bay Area leans more toward PPO plans, where the demand for access to a broader range of providers is higher.

Cost Comparisons:

What You Need to Know

In addition to premiums, consider differences in deductibles and out-of-pocket maximums. PPOs generally have higher deductibles and allow for more freedom with out-of-network care, but at a cost. HMOs, while more affordable, offer fewer options for provider access. Additionally, prescription drug costs can vary, with PPOs often having higher copays but broader access, while HMOs typically offer lower costs through more restrictive formularies.

Employer Contributions

California employers also contribute a higher percentage toward premiums than their national counterparts. For PPO plans, California businesses typically cover about 80% of premiums for singles and 45% for family coverage. In contrast, employers offering HMO plans contribute around 83% for single employees and 57% for families, giving employees substantial support in covering healthcare costs.

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HMO or PPO: Factors to Consider When Choosing the Right Plan

When deciding between HMO and PPO plans for your business, several key factors can guide your choice. Balancing employee needs, company size, and location is key to finding the right fit .

Evaluating Employee Preferences and Needs

Every workforce is different, and offering a mix of HMO and PPO plans can help address the diverse needs of your employees. Some may prefer the cost savings and simplicity of an HMO, while others might value the broader provider access that a PPO offers. By providing options, you can meet a wider variety of healthcare preferences and help your employees feel supported.

The Impact of Company Size

Mid-Size to larger companies may have the ability to offer both HMO and PPO plans more easily, while smaller businesses often lean toward HMOs for their lower premiums. However, as your company grows, incorporating a PPO may become essential to accommodate employees with varying needs and healthcare preferences. Also, smaller companies with a distributed workforce will need to offer a PPO option.

Location

Your company’s location plays a significant role in choosing between HMO and PPO plans. Multi-state employers often require PPO plans to guarantee employees outside of California have coverage through a national network. Additionally, in more rural areas, HMOs may not be as viable due to the limited availability of in-network providers, making PPO plans a more practical choice for these regions.

Actionable Insights: Making the Best Choice

Selecting the right health plan for your business requires careful consideration of multiple factors. Here are some actionable steps to guide your decision.

Assess Employee Needs

Start by evaluating your employees’ healthcare preferences and needs. Do they prioritize lower premiums and predictable costs, or do they value more freedom in choosing providers? Gathering the data on these preferences can help you offer a plan that aligns with what matters most to your team.

Analyze Current Plan Satisfaction

Take the time to review your employees' satisfaction with their current health plan. Gathering feedback can highlight what’s working and identify any gaps in coverage, helping you make a more informed decision moving forward.

Consider Financial Impact

Balancing affordability with comprehensive coverage is key. Compare the premium costs, out-of-pocket expenses, and network coverage of both HMO and PPO plans to find the right fit for your budget and long-term financial goals.

Seek Expert Insight

Choosing the right health insurance plan is critical for your business, but navigating the complexities of HMO and PPO options, balancing employee needs, and managing costs can be overwhelming. That’s where AEIS comes in . As an experienced employee benefits broker, we go beyond just offering insurance options—we tailor benefit solutions to meet the unique needs of your business. For example, we recently helped a mid-sized company lower their healthcare costs by 15% while enhancing employee satisfaction by introducing a mix of HMO and PPO plans. Our personalized approach ensures that your benefits not only attract top talent but also align with your financial goals.

Let AEIS guide you through the complexities of employee benefits. Get in touch with us today for a free consultation and discover how we can optimize your benefits package, reduce costs, and improve employee satisfaction. Don’t wait— take the first step toward a tailored benefits solution that supports both your business and your team’s well-being.'

The Pros and Cons of PEO for Small Businesses

Thu, 14 Nov 2024 17:42:46 GMT

Written by: Ron Bland, GBDS

What is a PEO and How Does PEO HR Outsourcing Work?

Also commonly referred to as a Professional Employer Organization (PEO), a PEO is a type of third-party organization that partners with a business to handle all of its various human resource-related functions through a co-employment relationship.

HR is an essential part of any business, regardless of the industry you're operating in. Still, some companies may be new to the point where they just don't have the resources needed to handle everything properly on their own. In that scenario, a PEO would come in and assume all responsibilities related to things like payroll, benefits administration, compliance with employment laws and more - all so that organizational leaders can get back to their core competencies of actually running the business in question.

Benefits of Using a PEO: How HR Outsourcing Can Boost Your Business

For business owners, open enrollment is a perfect opportunity to reassess their current offerings in a way they may not have had the chance to do for quite some time.

Work with your broker to look at your current plan's benefits and make sure they still align with the overall goals of your workers. If you identify any gaps, compare them with other plans to see if you can fill them. Do the same in terms of premiums and even out-of-pocket costs.

Essentially, you need to make sure you still understand the needs of your workers and that your healthcare offerings are still meeting them. If they're not, open enrollment preparation becomes comparing plans until you find the right one to accomplish your goals within the context of this year.

Supporting Your Employees in the Open Enrollment Period

Streamlined HR Processes and Administration

By far, the biggest benefit of using a PEO is one of streamlined HR processes and administration. It's an important point to make within the context of pros and cons of a PEO. Think about the sheer volume of time that goes with recruiting new employees, onboarding them, managing employee records, etc. A PEO can streamline all of these tasks from your current in-house HR employee's plate, freeing up their valuable time to focus on more important matters.

PEO Payroll Services: Simplifying Employee Payments

A PEO can step in and handle not only the processing of employee paychecks but also deductions and tax withholding for employees, and tax filing and tax payments for the employer, and more. PEOs also help employers with payroll reporting and payroll record-keeping. Not only does this make things dramatically more straightforward, it also eliminates the risk that the business will run into any compliance or regulatory issues, too. It’s highly recommended to work with a PEO that has IRS/CPEO (Certified Professional Employer Organizations) certification and ESAC (Employer Services Assurance Corporation) accreditation to significantly lower the financial risk and liability of the business.

Access to Competitive Benefits: PEO Benefits Administration

These days, benefits are a huge factor that someone looks at when deciding where to work - almost more so than even salary. Just because an organization is small doesn't mean a company shouldn't work to offer a top tier benefits package and PEO benefits administration can make that possible.

Partnering with a PEO gives businesses access to a wider range of high-quality, competitive benefits that they might not be able to offer on their own. Since PEOs pool employees from multiple companies, they can negotiate better rates for health insurance, dental and vision coverage, and other employee perks.

Risk Management and Compliance: A PEO's Role

The world of compliance is ever-changing, and it's up to leaders and HR professionals at an organization to keep up. The issue is that their attention is being constantly pulled in different directions, to the point where it's easy to miss something. That doesn't make the consequences of doing so any less severe.

A PEO can make sure that not only are all risks that a business might be exposed to adequately addressed, but all compliance matters are handled as well. You're getting access to a team of people with expertise in this particular area, all so that you can spend less time worrying about accidentally violating compliance and focus more of your attention on those daily tasks that actually need you and generate a profit for your business.

Cost Savings: How a PEO Can Save Your Business Money

Because PEOs tend to work with many organizations at once , they have a lot of pull when it comes to pricing. They can leverage that large pool of clients to the benefit of each of them - giving smaller organizations access to the type of large group pricing and benefits that a smaller business would be unable to achieve on its own.

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Disadvantages of Using a PEO: What to Consider Before Outsourcing HR

Balancing Control with PEO Support

When considering the pros and cons of PEO relationships, it's always important to pay just as much attention to the cons. The operative word in the business/PEO relationship is "support." A PEO is supposed to step in and offer assistance with all your human resources-related needs - because of that, you'll always be giving up a certain level of control to the company you've chosen to work with. Exactly how much control will depend on your partner, as well as your own tolerance for that sort of thing.

Evaluating the Cost-Effectiveness of a PEO

Using a PEO isn't free - you'll pay for their services based on the amount of value they provide. Because of that, you need to make sure that you're always aware of just how much value that truly is. You may approach a situation where it legitimately "costs more" on paper to use a PEO than it does to simply handle all these needs yourself. Additionally, sometimes the admin costs may outweigh the benefit savings costs, so you need to look at the PEO as a whole.

Ensuring a Good Fit with Your Business Needs

One of the most important things about all this to keep in mind is that not all PEOs are created equally . All PEOs won't offer the same set of services, so you can't just pick one at random and assume that they'll be able to accomplish what you're looking for.

Make sure that you put in the time to find a credible PEO that has industry-specific experience and that understands your company culture. Only then will you be able to choose a partner that is a good fit for what you're trying to accomplish.

Addressing Employee Concerns During the Transition

Changing over to a PEO will bring about a certain level of disruption to your employees, particularly when it comes to benefits, payroll, and who they can turn to when they need HR support. Throughout this time, communication is key. Keep everyone in the loop and address any concerns that people may have as thoroughly as you can.

Is a PEO the Right HR Outsourcing Solution for Your Business?

Again - not every organization has the same set of needs. For smaller organizations in particular, streamlining HR and getting access to a more competitive (and competitively priced) array of benefits could be a game-changer. For others that are larger and have staff whose roles are dedicated solely to the functions the PEO is meant to address, the benefits may be more negligible.

Make a list of the things that you can't do right now that you need to be able to do. Then, see how many of them working with a PEO can help with. Only then will you be able to act confidently, knowing that you're making the best decision possible for you and your people.

Is a PEO the Right HR Outsourcing Solution for Your Business?

At AEIS , we have a unique process in which we can simultaneously evaluate numerous PEO’s for your organization and can show you the benefits and differences between the various options. We take the time to learn as much about your business, your employees, and your culture as possible - all so that we can help you accomplish your goals in the most efficient ways.

To find out more information about PEO pros and cons, or to get answers to any other specific questions you might have, please don't delay - contact the AEIS team today .

About The Author:

Ronald L. Bland

President

Ron, a top insurance professional in the Bay Area since 1985, excels in creating cost-effective, comprehensive plans for business owners. His achievements include top-of-the-table status in the Million Dollar Round Table and speaking at the 2021 Top of the Table Conference. A Bay Area native, Ron graduated with honors from San Francisco State University and lives in San Mateo with his wife, Elaina, and their two children.

Post Open Enrollment Checklist

Tue, 09 Jul 2024 16:45:58 GMT

Written by: AEIS

What is Open Enrollment & Why Does It Matter?

If you had to make a list of some of the topics that are crucially important to both employees and employers alike, healthcare would undoubtedly be right at the top.

For workers, it's a major factor that they consider when deciding where to work. For business owners, it's how they attract and retain top talent. Regardless, it's not something to be taken lightly - especially as open enrollment approaches.

Open enrollment is the annual period when employers can update their employee benefit offerings and employees can make changes to their elections for the upcoming year. During this time, employees can adjust their plan, waive coverage, add dependents, and make other changes without needing a qualifying life event.

How to Prepare for Open Enrollment

For business owners, open enrollment is a perfect opportunity to reassess their current offerings in a way they may not have had the chance to do for quite some time.

Supporting Your Employees in the Open Enrollment Period

By far, the best thing to do to support your employees in the open enrollment period involves opening a channel of open and direct communication as soon as possible.

Let people know that they can come to their HR Department (or an employee benefits partner) with any specific questions they might have. Make sure you provide educational resources, host an open enrollment meeting in person or virtual, and share other materials so that people understand what is being offered to them and why it is in their best interest to consider it all.

Send regular emails and other messages to let people know when open enrollment dates are coming up and when certain deadlines are happening. People lead busy lives and they may forget on their own. They'll appreciate the reminders, especially considering that it is all so important. It can be a good practice to have open enrollment education meetings recorded if they are on a video conferencing service, that way any employees who weren’t able to attend can still get the information.

A good benefits broker can offer individual assistance. Part of what makes a successful healthcare plan involves personalization and an employee may not be able to get to that point on their own. So long as you provide them with what they need to help to that end, they'll be able to take full advantage of everything that you have to offer.

Steps During Post-Open Enrollment

Never make the mistake of assuming that post-open enrollment is somehow less important than the actual enrollment period. Just because most of the deadlines have passed doesn't mean that there still isn't work to be done.

The post-open enrollment period is a great time to solicit even more feedback from your employees so that you can find out what worked, what didn't, and what you can do better next year.

Just a few of the important steps you or your broker will want to take during this time include but are not limited to:

Double-check all employee enrollment forms to make sure that the provided data is accurate.
Submit all enrollment forms to the carrier by the associated deadlines.
Confirm changes have been made with the carrier.
Administer all employee health plan notices as per the rules and regulations stipulated by the Affordable Care Act, COBRA, and others.
Confirm with employees that they have received all necessary documentation, like their health insurance ID cards.
Proactively monitor employee engagement to make sure that people are taking advantage of the health plan that you've already invested so heavily in.
If employee engagement is suffering, solicit feedback to see if you can determine why and what to do about it next year.
Sit down for an advisory session with your benefits broker to discuss how things went.
Continue to provide employees with resources relating to education and awareness in terms of their benefits in an effort to increase engagement even more.

Key Takeaways for Successful Open Enrollment Periods

Healthcare and benefits in general are a massive expense for any employer - but they're also an important one. Happy, healthy workers are more engaged on average, which makes them more productive as well .

But you don't want to offer people access to health insurance that won't help them. You need it to be a plan that meets their needs and that they'll end up using. Selecting plans with that in mind, and keeping an open line of communication with your employees so that they can always vocalize their opinions, is a bit part of how you accomplish precisely that. The same is true of your ability to acknowledge that this is something you have to "get right" year after year. It never stops being important.

AEIS is Here to Help With Your Open Enrollment

At AEIS , we understand just how important open enrollment is to your ongoing success as a business. One of the major things that a robust benefits package is supposed to do is prevent employee churn. If the process is long, frustrating, and convoluted, employees won't forget that - and it may be one of those things that causes them to disengage from the workplace.

We don't want to see that happen to you, which is why we're proud to step in and assist with open enrollment and all other benefits-related needs you may have. We can leverage our decades of combined experience to your advantage, allowing you to enjoy all the advantages of this process with as few of the potential downsides as possible.

If you'd like to find out more information about how to create the perfect post-open enrollment checklist to meet your business needs, or if you have any additional questions that you'd like to go over with someone in a bit more detail, please feel free to contact the team at AEIS today .

When and How to Leave a PEO: Your PEO Transition Checklist

Tue, 09 Jul 2024 16:19:24 GMT

Written by: Ron Bland, GBDS

Navigating the decision to transition out of a Professional Employer Organization (PEO) can be a pivotal moment for any business. Whether you're experiencing growth that necessitates more direct control over your HR functions or seeking to reduce costs, knowing when and how to make this transition smoothly is crucial.

Why Consider a PEO Transition?

Headcount Growth and Changing Needs

Historically, one of the most common reasons for a PEO transition has to do with an organization that is outgrowing its original needs. Generally speaking, a PEO is really best for organizations with between five and 50 employees. As you get bigger than that, your needs begin to change and what was once a necessity might not make sense anymore.

Adverse Medical Benefits Renewals

A significant draw to PEOs is their ability to pool together many small-group clients in order to provide cost-effective medical benefits. Another common reason for a PEO transition can be when the costs for your own group trend much higher than the rest of the “pool”. Be it because of several high-dollar medical claims or a drastic change in company demographics, your PEO benefits costs have the potential to increase shockingly fast year over year in ways that the standard small group insurance market does not.

Internal HR Team Expansion

If yours is a business in the process of expanding your internal human resources team, a PEO transition may be in order . Remember that the whole point of a PEO is to act as your outsourced HR department. If you start handling things like payroll, compliance, and benefits in-house, you don't need that PEO any longer .

Financial Considerations

Finally, for many organizations, one of the biggest reasons to transition away from a PEO has to do with the high costs that they're known for. Typically, you can expect to pay between $100 and $200 per employee per month for a PEO. After you grow past a certain point, this simply won't make much sense any longer.

Planning Your Transition Out of a PEO

Evaluating Cost-Benefit Analysis

One of the most important things to do is to get clarity about how much you're spending with your PEO by taking a closer look at all the expenses you have as they relate to your workforce. Include service fees, administrative charges, and the cost of benefits.

Compare the amount of money you're currently spending versus the amount you'll need to spend to take care of all these essential tasks in-house. At a certain point, the latter will be far more cost-effective than the former and, at that point, the time is right for a PEO transition. This becomes compounded if the cost for benefits under the PEO, which are initially low in order to help offset the administrative fees, also increase significantly.

Coordinating Transition Timing and Communication

Successfully transitioning away from a PEO will likely take several months of work, at a bare minimum. During this time, you need to have a strategy in place and a timeline to follow that makes sense for your business. This is the only way that you'll be able to gauge success in actionable terms and mitigate risk as much as possible.

You'll also want to stay in constant communication with employees during this time - especially since, at some point, you essentially have to re-hire them. Be prepared to answer any questions and address any concerns. Let people know what is happening when it's happening, and most importantly why.

Addressing Tax & Regulatory Compliance

Finally, you'll need to take care of your PEO transition from a tax and regulatory compliance perspective. Not only do you need to re-establish SUTA IDs, but you also need to re-establish local withholding accounts as well. Don't worry - the vendor that you've chosen to work with will likely be able to walk you through this process to avoid any potential issues that may arise.

You'll also need to build compliant LOA and PTO policies, create employee handbooks for each state, and take care of similar tasks.

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Executing the Transition: Your PEO Transition Checklist

Implementing New Services and Tools

To help make sure that your PEO transition goes as smoothly as possible from the perspective of your employees, you'll need to implement new services and tools to help make things as straightforward as you can for them. Case in point: an employee benefits management portal. This will be a way that employees can see what their current status is, all while making any changes as necessary moving forward.

Upgrading IT Systems and Infrastructure

Once your PEO transition has been completed, your business (and more specifically, your HR department) will be responsible for meeting certain obligations that it may not have been in the past. This means that you need the base technology to support not only core functionality like payroll but also benefits and benefits administration as well.

Evaluating HRIS & Payroll Requirements

Executing your PEO transition will also involve hiring a new HRIS and payroll provider. After determining what your system requirements are, think about what your vendor partner needs to provide in terms of integrations, value, support, and other important factors.

Managing Benefits & Insurance Changes

Naturally, this period will be filled with changes in terms of what you can offer to your employees. You need to get this right, as again, this is a major part of what makes your company competitive in the first place.

Not only do you need to determine and address your needs in terms of things like traditional health insurance benefits, HSAs, FSAs, 401ks, and more, but you'll also have to account for elements like workers' compensation and COBRA administration (if necessary).

How a Benefits Advisor Can Help

When you partner with a benefits advisor like the team at AEIS, you get access to a wealth of experience that can help you enjoy all the advantages of a PEO transition with as few of the potential downsides as possible.

Not only can they help confirm that leaving your PEO makes financial sense for your business in the first place, but they also offer assistance in terms of addressing any operational gaps that exist once the PEO is gone, as well as putting together a timeline that makes sense for exiting your PEO and beginning this new chapter in your organization's life.

Look for Assistance in Your PEO Transition

If you'd like to find out more information about how to make the most of your PEO transition, or if you have any additional questions you'd like to go over with someone in a bit more detail, please don't delay - contact the team at AEIS today .

About The Author:

Ronald L. Bland

President

Health Insurance Requirements For Part Time Employees In California

Wed, 05 Jun 2024 21:09:37 GMT

Written by: Ron Bland, GBDS

Table of Contents

Health Insurance for Part-Time Employees in California
Health Insurance Requirements for California Employers
What Constitutes Part Time Employment In California?
Do Employers Have to Offer Health Insurance to Part-Time Employees?
Do Part-Time Employees Get Health Insurance in California?
How Many Hours Do You Have to Work to Get Benefits in California?
What are the Mandatory Employee Benefits in California?
Family and Medical Leave
Paid Sick Leave
Additional Time Off Entitlements
Day of Rest Requirements
California Continuation of Benefits Replacement Act (Cal-COBRA)
Workers' Compensation Insurance
Employee Expense Reimbursement
Retirement Plans through CalSavers
Benefits of Offering Health Insurance to Part-Time Employees
Additional Benefits for Part-Time Employees in California
Compliance and Strategic Recommendations
Offering Health Insurance May Be Easier Than You Think

If you have any involvement in the employee benefits program at your California company, you may be aware of regulations regarding full-time and part-time employees and health care benefits . Depending on the status of the company and its part-time employees, these changes may be significant. Do part-time employees get benefits? What is considered a part-time employee, and what strategies may best benefit companies impacted by the changes?

Health Insurance for Part-Time Employees in California

The Affordable Care Act (ACA) requires that all Americans have health insurance or pay a tax penalty, but does this mandate extend to part-time employees?

Currently, California state law does not require employers to provide health insurance for their employees . However, federal law states that companies with 50 full time employees or more must provide health benefits to a standard of minimum essential coverage.

Health Insurance Requirements for California Employers

The first part of the regulations requires Californians to obtain health care coverage at minimum standards. Coverage must be secured for individuals, spouses and partners, and children residing in California. Those not complying could face additional state taxes. Additional subsidies are available to help cover the cost of health care when purchased from CoveredCA.com.

Regulations also mandate that employers with 50 or more employees working full-time (30 or more hours weekly) are required to provide at least minimal levels of healthcare insurance . Employers with 50 or more employees are referred to as "Applicable Large Employers", ALE.

Employers with fewer than 50 full-time employees are not required to provide healthcare coverage. While small employers with 50 or fewer employees are not required to offer coverage, if they decide to offer it, coverage must meet ACA minimum standards.

For companies who may see this 50 employee mark as being avoidable by simply converting more full-time employees to part-time employees, there is the issue of equivalents. Now, hours worked by part-time employees have to be counted as a portion of a full-time employee. For example, all part-time hours are added up and divided by 120 to determine the number of “equivalent” full-time employees. These are added to the number of full-time employees already on staff. This is designed so employers will not just slash full-time staff to avoid health care benefits compliance. It is important to note that employees in each classification, full or part-time, be treated equally when benefits are offered.

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What Constitutes Part Time Employment In California?

A part-time employee is defined as someone who works less than 30 hours per week. When it comes to regulations, however, few things ever seem to occur at their simplest. There may be lower-end minimums for part-time workers, like 15 hours weekly. Generally speaking, small group insurance carriers only consider those working 20 hours or more per week. Below that, employees may be considered below the threshold to be considered for benefits.

How far back do they look when calculating part-time hours? While individual carriers may have their own guidelines, frequently it is one-half of the previous quarter's hours for part-timers. It is also important to note that part-time workers are W2 employees and not contract workers or 1099 workers. Contract workers are not counted as full or part-time employees. Some employers may attempt to take advantage of this by referring to some employees as contract workers. This can lead to significant issues for employers who misclassify workers.

Do Employers Have to Offer Health Insurance to Part-Time Employees?

Under the ACA, employers with 50 or more full-time employees (including full-time equivalents) are required to provide health insurance or face penalties. This calculation includes part-time employees when determining full-time equivalents. However, the ACA does not mandate that health insurance be offered to part-time employees specifically. Many employers, nonetheless, choose to offer these benefits to attract and retain talent.

Do Part-Time Employees Get Health Insurance in California?

Yes, part-time employees can receive health insurance in California, but this largely depends on the employer's offerings and the employee's eligibility. While federal law under the ACA does not mandate coverage for part-time employees, many employers choose to offer it as a benefit to attract and retain a talented workforce.

How Many Hours Do You Have to Work to Get Benefits in California?

To qualify for health benefits, part-time employees generally need to work a certain number of hours per week. This threshold can vary by employer but often includes employees working at least 20 to 30 hours per week. Employers should set clear policies regarding eligibility for part-time employees to avoid misunderstandings.

What are the Mandatory Employee Benefits in California?

While health benefits are not mandated for companies of less than 50 full time employees, there are other benefits related to time off, work expenses, family, and injury that are required.

Family and Medical Leave

Companies employing a minimum of five individuals are obligated to offer up to 12 weeks of job-protected leave annually. This leave accommodates medical reasons, childbirth, adoption, or needs tied to active military service and their kin. Additionally, organizations must extend up to eight weeks of paid family leave for employees who must tend to a family member, establish a bond with a newborn, or manage needs related to military service.

Paid Sick Leave

Employers are required to allocate paid sick leave to employees for the diagnosis, care, or treatment of their own or a family member’s medical conditions. This provision also covers preventive care and instances of domestic violence, sexual assault, or stalking. A minimum of 24 hours (equivalent to three workdays) per annum is mandated.

Additional Time Off Entitlements

Pregnancy Disability Leave : Coverage for disabilities due to pregnancy.
Kin Care Leave : Utilization of sick leave to care for a family member.
Family Military Leave : Leave for family members of active-duty military personnel.
Bone Marrow and Organ Donor Leave : Leave for individuals donating bone marrow or organs.
School Activities Leave : Time off to participate in children's school activities.
School Discipline Leave : Leave for addressing issues related to school discipline.
Jury Duty Leave : Mandatory leave for serving on a jury.
Judicial Leave : Leave for court appearances.
Voting Leave : Time off to cast a ballot.
Election Official Leave : Leave for serving as an election official.
Military Leave : Leave for military service obligations.
Civil Air Patrol Leave : Leave for Civil Air Patrol service.
Literacy Leave : Leave for participating in literacy programs.
Drug and Alcohol Rehabilitation Leave : Leave for rehabilitation purposes.

Day of Rest Requirements

Employers must ensure that employees receive adequate days of rest in accordance with state regulations. California Labor Code Section 551, states all California employees are entitled to at least one day of rest out of every seven days. Section 552 prohibits employers from forcing and employee to work more than six days in a seven day period.

California Continuation of Benefits Replacement Act (Cal-COBRA)

This act mandates that businesses with two to 19 employees enrolled in a group health plan provide continuation coverage under Cal-COBRA. The notification requirements and premium structures differ from those stipulated under federal COBRA.

Workers' Compensation Insurance

Employers are mandated to carry workers' compensation insurance to cover employees in case of work-related injuries or illnesses.

Employee Expense Reimbursement

Organizations are required to reimburse employees for all necessary expenses incurred in the course of their duties, including costs associated with remote work.

Retirement Plans through CalSavers

Employers must facilitate access to retirement savings plans for employees via the CalSavers program. By adhering to these requirements, California employers ensure compliance with the state's intricate labor laws while fostering a supportive and equitable work environment for their employees.

Benefits of Offering Health Insurance to Part-Time Employees

1. Improves Employee Retention

Health care benefits encourage employees to stay with an employer and make it a bit more challenging to change employers. When companies offer health care benefits, it places more weight on their side of the scale.

2. Attracts New Talent

A company that offers health care benefits has an advantage when recruiting new employees. This is particularly true if their current employer doesn't offer such benefits.

3. Improves Employee Satisfaction

Helping employees maintain their health can improve attitudes, overall health, and even productivity.

4. Creates Sense of Community and Belonging

For many employees, especially Millennials and younger, they seek more than a paycheck from their jobs. They want to be a part of something bigger, and working for a caring, responsible employer is critical. Offering group health benefits can help to fill that need.

5. Contributions Are Tax Deductible

Employer contributions to a health care benefits package are tax deductible. This can reduce taxes for employers offering benefits, helping to offset costs.

Additional Benefits for Part-Time Employees in California

In addition to health insurance, part-time employees may be eligible for other benefits, which can include:

Dental and Vision Insurance : Coverage for dental and vision care , which can be crucial for overall employee health.
Retirement Plans : Access to retirement savings plans such as 401(k)s.
Paid Time Off : Some employers offer vacation, sick leave, or paid time off to part-time employees.

Compliance and Strategic Recommendations

Employers should ensure compliance with both federal and state regulations regarding health insurance for part-time employees. Offering health insurance can help retain employees and avoid potential penalties. Consulting with a benefits advisor can provide clarity and help navigate these regulations effectively.

Offering Health Insurance May Be Easier Than You Think

Offering a health care benefits program at your company may be easier and more affordable than you believe. Rather than attempting to manipulate employee full-time and part-time rosters to avoid offering it, many companies are finding it easier to embrace providing health care for employees.

This is particularly true when you have the assistance of an employee benefits specialist like AEIS. We are a California-based company with experience in helping small and mid-sized companies not only get into and stay within government mandates, but also help them maximize their ROI.

Getting the maximum value from your company's health care and employee benefits programs does not always have to just be about compliance or even about spending as little as possible. Your benefits program should always add value. At AEIS, we can help you with this.

While compliance issues are critical in managing your health care and employee benefits programs, there is more at stake; you need to make your company as attractive as possible so that you can recruit and retain talented workers. Now may be just the perfect time to do just that.

The ever changing health care laws can be hard to keep up with. Don't wait to discuss your company, your options, and how health care benefits can help take your company to the next level, contact AEIS today . At AEIS , insurance is just the beginning. While health care insurance can be complex, we make it simple for you.

If you have questions about your status under the recent changes in the California health care laws, we encourage you to contact us .

About The Author:

Ronald L. Bland

President

What to Keep in Employee Personnel Files?

Mon, 13 May 2024 16:28:46 GMT

Written by: AEIS

Most small business owners (and certainly HR professionals ) are familiar with the larger concept of a personnel file. However, many assume it's a file that contains every document or other item related to an employee that has ever been created. In reality, taking this approach would turn a valuable asset into something that is essentially worthless fairly quickly.

What exactly is a personnel file, what is included in one, and how do you keep them all organized for maximum efficiency? The answers to those questions require you to keep a few key things in mind.

What are Personnel Files?

As the term implies, a personnel file is used to store any "necessary documentation" that is directly tied to every employee within a business. If your company employs 100 people, you'll have 100 personnel files. They help organizational leaders keep track of not only someone's current status and position, but also their larger employment history as well.

Note that despite the all-encompassing name, a personnel file is not the only type of file that will be associated with each worker. Payroll files, for example, are where you would store documents relating to someone's pay (think: tax forms). Benefits files would be used to keep track of the benefits elections someone has made, as well as information about their beneficiaries. Medical files would be used to store data pertaining to medical leave they've taken, emergencies they've been through, and more.

All this is so that if a human resources employee needs to quickly refer to documents pertaining to a specific worker, they know exactly where to go to find them.

What to Keep in a Personnel File

For personnel files to be as useful as possible, they cannot be used to store anything and everything relating to each worker. Their value comes from the fact that they make it easy to quickly find certain types of documents. That becomes irrelevant if personnel files become what is essentially the equivalent of filing cabinets with someone's name on them.

When setting up personnel files, you'll want to start by noting the date a person was hired. Then, you'll want to compile documents pertaining to their employment, including things like:

A precise description of the job they applied and were hired for.
The job application they submitted, along with their resume (if one was provided).
A copy of any formal offer of employment you made the employee they accepted.
Their copy of the IRS Form W-4 that they had to fill out when you hired them.
Verification that they received an employee handbook.
Copies of any performance evaluations that they receive over time.
Any complaints that have been lodged against them from customers, clients, or even their coworkers.
Any notes that have been made about their attendance, or any warnings that they have received as a type of disciplinary action.

Anything that falls under this type of umbrella would be useful to put in a personnel file.

What to Not Keep in a Personnel File

Personnel files should contain relevant information about an employee's job performance and qualifications. However, there are certain types of documents that should not be kept in personnel files for legal compliance and privacy protection. These include:

Medical Information: This should be kept in a separate, confidential file to comply with legal requirements and protect employee privacy.
Reference/Background Check Results: These are sensitive documents and should be kept separately from personnel files.
Drug Test Results: These should be kept confidential and not included in personnel files.
Equal Employment Opportunity (EEO) Self-Identification: Information regarding an employee's gender and race/ethnicity should be kept separate to avoid discrimination and protect employee privacy.
Legal and Financial Matters: Files of this type include child support, garnishments, and litigation documents. These are personal and legal matters that should be kept out of personnel files.

Other examples of documents that you would not want to keep in personnel files include Form I-9s and other unnecessary materials. Form I-9s relate to an individual's citizenship and must be retained as required by law. However, since certain government agencies may need to inspect them, these forms should be stored separately but kept easily accessible when needed.

Entries that do not directly pertain to an employee's job performance and qualifications—such as references to their private life or unsupported criticisms—should also not be kept in personnel files. Keeping these types of documents out of personnel files helps maintain organization, legal compliance, and employee privacy.

Organizing and Managing Personnel Files

As documents and other forms are created across an employee's history with your company, that information will go into their personnel file. Note, however, that this isn't a process that stops as soon as they leave.

If a day comes when an employee gets fired, their personnel file will need to be properly "closed." This means you'll want to go into detail about why the person was fired, you'll want to include copies of any relevant unemployment documents, etc. If they choose to leave to pursue a better opportunity, you'll want to note all that as well.

As part of the ongoing organizational process, personnel files will need to be periodically reviewed for accuracy and timeliness. Certain elements of their employment will naturally change over time. They will get raises, promotions, or commendations, for example. All of this should ideally be noted in the file as it is happening. If your business issues a new copy of the handbook, they'll need to once again acknowledge the receipt.

To stay as organized as possible, go through personnel files at least once per year and make sure they include everything they should. Again, personnel files are ultimately only as useful as they are updated.

At AEIS , we fully understand how challenging it can be to effectively handle the human resource-related needs of your organization in a way that addresses everyone's needs. That's part of the reason why we regularly help our clients partner directly with HR consultants who can help develop the custom plans they need to thrive.

AEIS also offers a complimentary HR Learning Management system that many come to find invaluable. It includes a handbook generator, safety and government-mandated virtual training resources, and more.

As is true with all the services we offer, we do this because we want to free up as much of your valuable time as possible so that you can focus on that which really matters.

If you'd like to find out more information about how to create and maintain personnel files, or if you'd like to discuss your business' larger benefits-related needs with a professional in a bit more detail, please feel free to contact the team at AEIS today .

What's Included within an Employee Benefits Package

Wed, 17 Apr 2024 16:30:09 GMT

Last Updated: May 27, 2025

What is an Employee Benefits Package?

As the term implies, an employee benefits package is a set of "bonuses" that employees get for working with a company that is outside of their salary or wage. This can include things like insurance, access to retirement plans, and more

Why Do Employee Benefits Matter?

The number one reason why employee benefits matter has to do with how they help businesses attract and retain top talent. Not only do they enhance employee satisfaction, but they go a long way towards increasing productivity as well.

If you can't necessarily outspend your competitors, you might be able to offer better benefits - allowing you to stay competitive in the job market, too.

Choosing the Right Benefits Package Based on Business Size

Smaller businesses may want to just focus on the essentials and offer things like health insurance and retirement plans. Larger businesses can offer things like stock options, or even specialized health plans that employees might not have access to anywhere else.

Types of Employee Benefits

Health & Wellness

Health and wellness benefits tend to include things like not only health insurance and vision insurance, but also assistance with prescription drugs, employee assistance programs, wellness programs, and more. Even retirement-related benefits can be a big part of this category, which includes but are not limited to things like 401(k) plans, pension plans, and employee stock ownership programs.

Work-Life Balance

Maintaining a proper work/life balance is a dream of many people, regardless of the employer they have or even the industry that they're operating in. People want to devote their passion, their creativity, and their energy to their job - such a big part of their lives needs to be fulfilling. It's just that they don't want it to come at the expense of their personal life. That is, after all, the thing they're working so hard to support.

That's why work/life balance benefits are often crucial, especially among a younger generation of people looking to broaden their careers. These can include things like flexible working arrangements, the ability to telecommute, assistance with any child care-related needs they may have, and even eldercare assistance.

Time-Off

Even in a world where a lot of people are operating on a hybrid model, time-off benefits are still a crucial part of any employee benefits package. As an employer, you always want to do whatever you can to prevent your employees from burning out. The happier they are, the more productive they tend to be on average. Time-off isn't about allowing employees to work as little as possible - it's about making sure that they can strategically refresh themselves so that they can come back to work firing on all cylinders.

Employee Benefit Package Options

Group Health Insurance

PPOs, HMOs, and HDHPs are all examples of viable group health insurance offerings. With a PPO (also called a Preferred Provider Organization), employees can go to any doctor or specialist they want without a referral. With a Health Maintenance Organization plan, however, employees need to go through their primary care to get a referral. The main difference among the various types of group health insurance plans has to do with the deductibles and copay that are required, as well as the monthly premiums that are charged to employers and employees.

Vision Insurance

Vision insurance is a (relatively) inexpensive addition to an employee benefits package that can make a big difference in terms of the value that you're providing to your workers. Anyone who has suddenly had to deal with getting glasses, regular contact refills, or sudden vision-related emergencies can tell you how expensive it is - and how appreciated a quality vision insurance plan is, as well.

Dental Insurance

Many people make the mistake of assuming that dental insurance isn't an attractive employee benefit because of how much less expensive dental care is relative to healthcare its "bland" reputation. When you consider the sheer cost of even routine dental procedures like root canals, however, the savings begin to add up fast. This is especially certain if someone is suddenly taking a proactive approach to their oral health, possibly for the first time in their lives.

Disability Insurance

This is a type of insurance coverage that protects employees who are unable to work because they fall ill or get injured. This comes in two variations - short-term and long-term disability. The former pays out for 3-12 months up to 26 weeks. Long-term disability would be considered anything after that point. Note that there are five states including California and New York with state disability insurance that actually require disability insurance from employers. This is also not quite the same thing as worker's compensation insurance as disability insurance policies cover employees for disabilities that occur outside of work.

Life Insurance

This common benefit is often paid for in entirety by the employer but can also be done on a voluntary basis usually provided at no additional charge to the employee. They do, however, have the option to increase the amount of coverage they have for a fee. If nothing else, life insurance gives employees the confidence that only comes with knowing that even in the event that they unfortunately pass away, their loved ones will still be protected from a financial point-of-view.

Time-Off

Paid time-off is one of the best, easiest ways to not only attract top employees, but retain them as well. Note that while sick days are a big part of this, there are other types of days that qualify. Employees can use paid time-off to take a much-needed vacation for themselves, as personal days, or for any other purpose that they like. This is again a viable way tofor maintain the work/life balance that is so precious to them.

Flexible Schedule

In some industries, it doesn't actually matter when work gets done - so long as important tasks are completed. Technology has evolved to the point where it doesn't necessarily make sense to force everyone into the office to follow a rigid "9-to-5" structure. In those situations, businesses can turn this into an asset by offering flexible hours, telecommuting, remote work, and other possibilities to employees.

This is great for employees who may be trying to balance raising a family , for example, or taking care of loved ones. So long as their obligations are being met, they can work on whatever schedule they'd like.

Additional Employee Benefit Options

Just a few of the additional employee benefits options you might want to explore include:

Professional Development & Educational Assistance. You might offer to pay for certifications, workshops, and more.
Metal Health & Well-Being Programs. This can include things like stress management workshops or even counseling services.
Emerging & Unique Benefits. Examples of this might include loan repayment assistance, or even something as seemingly straightforward as pet insurance.

To find out more information about what is included in benefits package offerings, or to get answers to any other questions about employee benefits packages you might have, please don't hesitate to contact AEIS today .

Best Practices for Your Employee Benefits Package

The number one thing you can do when putting together your employee benefits package is talk to your workers to see what their unique needs are. Don't just assume you know what is best for them. Let them tell you directly. Make an effort to understand what their concerns are and what you can do to address them.

Beyond that, it's always important to enlist the help of seasoned professionals like those at AEIS , as opposed to trying to put together an employee benefit package on your own. We can leverage our pre-existing relationships with vendors to your advantage, allowing you to put together the most competitive package you can in the most efficient and cost-effective way.

If you'd like to find out more information about what is included within a high quality employee benefit package, or if you'd just like to discuss your workforce's own unique needs with a team of professionals in a bit more detail, please don't hesitate to contact AEIS today .

Employee Benefits Package FAQs

What is The Purpose of Key Person Life Insurance for Businesses?

Wed, 20 Mar 2024 16:50:50 GMT

Written by: AEIS

What is Key Person Insurance?

It doesn't matter what type of business you're running or even the industry that you're operating in - every employee is important. They all come together to form something more powerful as a unit than they could be as individuals. Having said that, there are certain people that a business absolutely cannot afford to lose.

If a charismatic, visionary CEO or a high-earning salesperson should pass away, it wouldn't just suddenly harm the organization's financial viability–it would likely cause a permanent alteration to its reputation at the same time.

That's exactly what key person insurance , also commonly referred to as key person life insurance, is designed to prevent.

What is the Purpose of Key Person Insurance?

Key person insurance aims to safeguard an organization in the event of the death of crucial employees. For instance, not only the CEO but also vital contributors like a top salesperson are covered. Losing such a key individual unexpectedly could severely disrupt the business, making it challenging to sustain its current course and potentially leading to the business's demise if their specialized skills cannot be replaced. Key person insurance serves as a protective measure to mitigate these risks.

When Should a Business Get Key Person Insurance Policy?

When an organization heavily depends on specific, indispensable individuals, it makes sense for businesses to explore key-person insurance. In situations where your company is essentially incapacitated without specific roles being fulfilled, and the sudden absence of one or more of these key figures could jeopardize operations, having a key-person insurance policy becomes crucial for protection.

How Much Key Person Insurance Coverage to Buy

As is true with most types of business insurance, there is no "one size fits all" answer to this question. As a rule of thumb, consider both the immediate and long-term financial impact should a key individual suddenly pass away. How much financial damage would occur, or how much would you need to stay afloat? You can then work your way backward to the amount of coverage you need. Another option is to purchase 5 to 10 times the key employee’s salary.

Note that included in your coverage should also be enough money to recruit and replace the key person’s position.

Policy Types to Consider

Not unlike other types of insurance, there are a few different key-person policy types that you'll want to consider. Each has its own unique advantages, which is why knowing as much about them as possible is the key to making the best decision for your company.

Term Life Insurance

As the name implies, term life insurance offers temporary coverage that lasts for a specific period of time. If you have a key employee who also happens to be relatively young and healthy, this would be the more cost-effective route to go. Terms tend to last between ten and 30 years. Although you will likely be able to get another policy when that term ends, you'll have to pay more because the key employee will be significantly older.

Permanent Life Insurance

Permanent life insurance would be appropriate in a situation where the key person you are trying to cover is one of the founders of the company, for example. Whereas a top salesperson might eventually leave to go work for someone else, the chances are high that the founder is there for the duration. In that case, this type of policy would make sense.

Whole Life Insurance. This is a type of key person life insurance policy that has a guaranteed premium that stays flat for the duration of the policy. Whole-life policies also accumulate cash value in a tax-advantaged way with a predictable, fixed interest rate.
Universal Life Insurance. This is another type of tax-advantaged policy, but it offers more flexibility in that payments can vary within a specific range. Depending on who you choose to go with, you may even be able to invest your policy - although this does expose you to market volatility in a way that other types of policies do not.

Is Key Person Insurance Tax Deductible?

Unfortunately, no. According to the IRS , unlike other types of insurance premiums that you may pay that you can deduct on your taxes, premiums for key person insurance are not a deductible expense on federal income taxes.

However, there are still certain tax implications to be aware of. The cash value in a permanent policy is tax-deferred. This means that the policy can compound more interest. A small business can borrow against the value of a permanent policy without it being considered a "taxable event." Talk to a financial professional before you do so.

AEIS Support for Your Insurance Needs

At AEIS , key person insurance is just one example of the solutions we offer to help your business thrive. We understand that especially when it comes to things like health insurance, the landscape is getting more complicated all the time. Making sure that you have the right policies in place to protect everything you've worked so hard to build can often feel like an uphill battle - largely because it is.

That's why we want to step in and take care of everything on your behalf.

Through our business administration solutions , we'll learn everything we need to know about your organization in intimate detail. That way, we can make sure you always have the right coverage for you and your people - allowing you to rest easy knowing that complicated topics like key person life insurance are not things you have to spend time worrying about again.

If you'd like to find out more information about the purpose of key person life insurance, or if you have additional questions about protecting your business that you'd like to go over with someone in more detail, please don't delay - contact the AEIS team today .

Current Employee Benefits Trends in 2024

Mon, 04 Mar 2024 19:43:09 GMT

Written by: Ron Bland, GBDS

When it comes to employee benefits , one of the most important things to understand is that your workforce is constantly changing - as are their needs. If you asked someone in 2010 what their ideal employee benefits package looked like, they'd probably give a wildly different answer than someone in 2020. The same is true if you polled a group of 30-year-olds versus 50-year-olds. You need to make an effort to fully understand both your current and prospective employees to get a sense of what they're looking for and what you can do to give it to them.

Keeping up-to-date with all the employee benefit trends to watch in 2024 is a big part of how you do it. Not only can this help give you an indication of where things are today, but they can also provide clues as to where the field itself may be headed. That can help you get there before any of your competitors, turning benefits into yet another opportunity to attract the best people into your organization.

Telemedicine

Telemedicine exploded in popularity due to the COVID-19 pandemic, but it's something that has absolutely not gone away even though things are more or less returning to normal. Thanks to telemedicine, employees don't need to travel as much for routine health visits or to consult with their doctor. They're more likely to be proactive about their health, which makes them healthier over all. This means fewer sick days and a more productive workforce .

To that end, supporting telemedicine is a good idea and offering this type of flexibility can be a great way to attract the right type of attention.

Mental Health Focus

Especially given everything going on in the world over the last several years, it should come as no surprise that mental health has become an increasingly large focus for organizations of all types and in all industries. Employee burnout rates are on-the-rise, in part due to people becoming disengaged with their working environments and in part because people are just more stressed out than ever before.

Because of that, people are taking a more proactive look at their own mental health, and they're increasingly attracted to employers who are willing to do the same. Note that this doesn't just mean offering benefits packages that include mental health coverage. It means creating the type of work environment that people want to participate in and that they don't find toxic. It's about helping them maintain a positive work/life balance. All these things make a great deal of impact, especially when it comes to separating yourself from your competitors.

We're here to help.

Contact us today.

Pay Transparency

Another major trend to be aware of in employee benefits for 2024 has to do with pay transparency. For the last year, there have been a number of states that are considering legislation that will require businesses to "regularly communicate to their employees what the pay range is and where they fall in that range" for a position. While Hawaii is the only such state that has a law passed at the moment, that could easily change moving forward.

Because of that, this is the type of thing that employees will begin to expect, and you'll want to do whatever you can to get ahead of that. The more transparent you are about this and related topics, the more employees will trust you. That can only help retention.

Diversity, Equity and Inclusion

While it's true that making an organization-wide effort to be more diverse isn't necessarily an "employee benefit" in the strictest sense of the term, it's still something worth paying attention to. Studies have shown that Millennials and Gen Zers in particular are not only attracted to companies that are making an open effort to focus on diversity, but that are also meaningfully tackling issues like pay equality as well.

The more willing you are to speak about what you're doing to address diversity, equity, and inclusion concerns, the more likely you are to attract the attention of a younger generation of workers that you'll need moving forward.

Personalized Benefits

Another critical employee benefit trend to be aware of takes the form of personalized benefits . Workers are no longer swayed by "one-size-fits-all" packages. Businesses are finding a great deal of success with giving their employees as much choice as possible in terms of how a customized benefits package is constructed. It encourages participation and long-term engagement as well.

Employer Takeaways

In the end, remember that while these employee benefit trends to watch in 2024 may be relevant today, that isn't a guarantee even a year from now. The needs of your workers will always reflect where they are in their lives. Their priorities will naturally change. Therefore, while it's important to be aware of the trends that are making a big impact, you must acknowledge that they're also just one small part of a much larger story.

Don't chase trends and hope they bring you the results you're after. Start with your workers and find out what they want and need, along with what they like and dislike. At that point, you'll have the insight you need to work your way back to the trends that you should be embracing that make the most sense given your situation.

At AEIS, we understand that trying to keep up with the ever-changing world of employee benefits trends can quickly become a full-time job - which is problematic, since you already have one of those monopolizing a lot of your time. On the one hand, offering the highest quality benefits package you can is your opportunity to both attract and retain the top talent you need to remain competitive. On the other hand, things move quickly, and you're already (correctly) focusing the majority of your attention on running the most successful business possible.

That's why our team of trusted, trained, passionate professionals will come in and learn as much about your organization and its goals as possible. We'll stay abreast of all the latest employee benefit trends to watch in 2024 and beyond so that you don't have to. All this so you can rest easy knowing that things are being taken care of by those who are every bit as invested in your success as you are.

If you'd like to find out more information about the top employee benefit trends to watch in 2024, or if you'd just like to talk to someone about your business' own needs in a bit more detail, please don't delay - contact AEIS today .

About The Author:

Ronald L. Bland

President

What Is A Buy-Sell Agreement, And Why You Need One?

Tue, 13 Feb 2024 21:41:22 GMT

Written By: AEIS

What is a Buy-Sell Agreement?

A buy-sell agreement is one that creates a clear path for the transition of ownership of a business. This typically occurs if a business partner passes away, or if they simply choose to leave the company for whatever reason.

The agreement dictates that what is left of the business is sold either to the company as its own entity, or to specific remaining members of the business. If a business partner should pass away, their estate is required by law to sell that interest.

A buy-sell agreement like this is traditionally used for sole proprietorship, partnerships, and closed corporations.

A buy-sell agreement is typically created by the business owners or partners themselves, often with the assistance of legal professionals such as business attorneys or corporate lawyers. Consulting with legal and financial professionals experienced in business succession planning and then brokers experienced in buy-sell insurance can help tailor the strategy to meet the specific needs and goals of the business owners.

Who Needs a Buy-Sell Agreement?

Anyone who owns a business with one or more additional people needs a buy-sell agreement.

For example, let's say your only other business partner suddenly passes away. Without a buy-sell agreement, their spouse could suddenly become your co-owner and have a say in the day-to-day operations of the organization. Do you want that to happen to everything you've worked so hard to build?

Or, your business partner could suddenly find themselves in financial or even legal trouble. Before you know it, a bank or other debtor is suddenly your co-owner. This is a less-than-ideal scenario to say the least.

Buy-sell agreements help prevent these types of things from happening. Even if your business partner isn't thinking about leaving right now, they one day will be. Even if you or your partner are in perfect health right now, it may not be that way forever. A buy-sell agreement can help specify exactly what needs to happen should one of you want to leave so that everything you've already worked so hard to build can be preserved in the exact way you want.

How Can a Buy-Sell Agreement Help Business Owners?

Maybe the number one way in which a buy-sell agreement helps business owners has to do with how it helps to establish a fair market value for shares.

If one partner wants to be "bought out" of the company, they want to be able to command the highest price possible for their share. If you have a fair market value that has already been established, there is no negotiation (or arguing) that needs to take place. Without a fair market value, what that share is actually worth is up for interpretation and it could lead to a more stressful situation than you would want to deal with.

In a logistical sense, a buy-sell agreement also helps to develop a clear exit plan for any and all business partners at any time. Not only does it specify how a person will leave, but it also indicates exactly what has to happen next. You could make it so that a business partner can not legally disparage the company they left behind, for example. There are all sorts of things you could stipulate depending on your needs. Simply having this type of plan in place can help mitigate financial risk, not to mention eliminate headaches, moving forward.

Finally, a buy-sell agreement benefits business owners by creating a clear continuity plan so that the company can continue to grow and strive. If one of your business partners unexpectedly dies and nobody knows what to do, at a bare minimum you're dealing with a disruption in your normal operations. At worst, the balance of power is suddenly shifted and you have no idea when or even if things will be able to return to "normal."

A buy-sell agreement helps to establish a much-needed sense of business continuity. If someone should suddenly leave or unexpectedly pass away, the role that everyone has to play is crystal clear. You know what steps must be followed to avoid disruption and how certain risks need to be addressed immediately. No matter what, this will help avoid the type of disruption that could cause significant reputational damage to those left behind.

How to Fund a Buy-Sell Agreement

One of the ways to fund your buy-sell agreement is through life insurance policies. This is only applicable when one of the owners has passed away since the death benefit for life insurance is only triggered by a death. Funding a buy-sell agreement with life insurance can be a smart strategy for businesses to ensure a smooth transition of ownership in the event of a partner's death.

The process involves several key steps. Firstly, as mentioned above, the partners must determine the value of the business and establish a buy-sell agreement outlining the terms of the arrangement. Next, each partner purchases a life insurance policy on the life of the other partner(s). These policies are typically either term or permanent life insurance policies. The ownership structure depends on various factors such as tax implications and the specific needs of the business.

In the event of a partner's death, the surviving partner(s) can use the insurance proceeds to buy out the deceased partner's share of the business at the predetermined value, ensuring continuity and stability for the company. It's crucial to review and update the buy-sell agreement and insurance policies regularly to reflect changes in the business's value and ownership structure. Overall, funding a buy-sell agreement with life insurance provides a cost-effective and efficient way to safeguard the future of the business and protect the interests of all parties involved.

Key Person vs Buy-Sell Agreement

Key person is actually a form of buy-sell agreement insurance , making it different from a buy-sell agreement from the start. Key person insurance is a type of policy designed to protect your business from the sudden loss of a valuable person, like a business partner. It helps to make sure that routine business operations are able to continue should someone suddenly pass away, for example.

A buy-sell agreement, however, is a legally binding document that addresses what happens next. So from that point of view, a good way to look at it might be that key person insurance helps cover you in the short term, whereas a buy-sell agreement is all about making sure the long-term story of your business plays out as smoothly as possible.

Fund Your Buy-Sell Agreement with AEIS

At AEIS, we offer employee benefits consulting and other services to help make sure that your business is always functioning exactly as it should be. We always take the time to get to learn our clients individually, all so that we can put together the customized plan they need to thrive. In a best-case scenario, your business itself - meaning its people, policies, and how it runs - should be your competitive advantage in the marketplace. We want nothing more than to help you accomplish precisely that.

If you'd like to find out more information about funding your buy-sell agreements with life insurance, or if you are ready to fund your buy-sell agreement through life insurance, please don't hesitate to contact the team at AEIS today.

Can an HSA Be Used For Dental Expenses?

Tue, 06 Feb 2024 20:23:15 GMT

Written by: Ron Bland, GBDS

Table of Contents

Can an HSA Be Used For Dental?
Qualifying Dental Expenses
Orthodontics and an HSA
Non-Qualifying Expenses
Dental Implants and an HSA
What to Know About Using An HSA For Dental
How To Pay Your Dental Bills with an HSA
How AEIS Can Help

Health Savings Accounts (HSA) are proving invaluable for helping cover employee medical expenses while offering tax advantages to both the employer and employee. An HSA is particularly valuable in covering expenses that may not be covered by a company's healthcare program . These could include deductibles, copayments, prescriptions, and more.

While most understand the value of these types of accounts in covering out of pocket expenses associated with healthcare, there are questions many have in regard to HSA and dental expenses. Can an HSA, for example, be used for dental expenses? What procedures qualify for payment? Are orthodontics and implants covered? What should you know about HSA and dental expenses and how do you get dental expenses paid through an HSA?

Can an HSA Be Used For Dental?

You will probably be glad to know that, yes, an HSA can be used to pay eligible dental expenses. Of course, the key words here are "eligible” and “qualifying expenses.” What are these “qualifying” dental expenses, and which procedures are non-qualifying? In many cases, the deciding factor is what is determined as corrective or preventive and what is considered "cosmetic".

Qualifying Dental Expenses

Generally speaking, qualifying dental expenses are determined by the IRS . An HSA can cover these expenses not only for you but for your spouse and dependents as well.

Qualifying dental expenses eligible for payment under an HSA include:

Extractions
Teeth Cleanings
X-rays
Crowns and fillings
Non-cosmetic dentures and implants
Braces
Flouride treatments
Sealants
Root Canal
Some over-the-counter dental products

This is quite a generous list of services that can be paid for through an HSA, although not totally complete.

Orthodontics and an HSA

Many wonder if they can use their HSA account to pay for orthodontics like braces. The short answer is that yes, expenses related to braces could be picked up under an HSA. This is particularly true if braces are used as a preventive or corrective measure. Clear or “invisible" aligners are often approved for coverage through an HSA. Your dentist will need to convey that the need for orthodontics is more than cosmetic.

Non-Qualifying Expenses

While the list of eligible dental procedures covered under an HSA is extensive, the list of non-qualifying expenses is minimal. These include teeth whitening and what may be considered cosmetic dental procedures. Also, daily care products like toothpaste, mouthwash, and dental floss do not qualify under an HSA. Such items are considered “general use” products and do not address a specific healthcare issue.

There may be circumstances, however, when a healthcare professional or dentist may determine a general-use tool is critical in the treatment of a specific problem. In such circumstances, these general daily tools may be covered by your HSA. These are considered “dual purpose” tools.

Dental Implants and an HSA

While basic dental insurance may not cover dental implants, an HSA might pay expenses. As long as procedures are not deemed purely cosmetic, dental implants should be covered. This can range from a few teeth to an entire mouthful of implants.

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Contact us today.

What to Know About Using An HSA For Dental

Perhaps the best piece of advice about using an HSA for dental surgery is to become as familiar as possible with your plan before planning a procedure. This can prevent being surprised by unknown costs. Your provider should be able to provide a complete listing of covered dental and other medical expenses that can be used as a guideline. They may make this available either online or through their benefits booklet. You can also always ask for a pre-treatment estimate or a predetermination of benefits to review what your out of pocket costs for any given procedure will be.

Be aware that if you use HSA funds for a non-qualifying expense, you may be subject to taxes on any funds used for the non-qualifying expense. Those under 65 may face a significant 20% penalty in such circumstances, so due diligence is key. That 20% penalty is no longer in effect after age 65.

One of the key issues that can cause confusion is whether or not a dental procedure is “cosmetic." Of course, for the patient, appearance is critical. However, if the procedure is not considered a medical necessity, it may not be considered a qualified expense with which you can apply your HSA. That being said, HSA has proven to be very flexible in the types of procedures that are qualified expenses.

While a Health Savings Account is not a healthcare plan, it can be vital in ensuring that out-of-pocket costs are being taken care of. In many cases, these out-of-pocket costs can be significant.

How To Pay Your Dental Bills with an HSA

Paying your dental bills through an HSA can depend on your healthcare specialist and provider. In some cases, the dental office will assist in filing your claim. Many providers also offer online systems for filing claims. Once you are comfortable that your bills are covered, you should initiate the claim filing with your dentist or provider.

This is one reason working with a professional benefits team like those at AEIS can help. Providing coverage is one thing. Making sure employees can take the full value of those benefits is another. We work hand in hand with our clients and their employees in making sure programs like an HSA are administered efficiently and effectively.

How AEIS Can Help

AEIS (Advanced Estate and Insurance Services, Inc.) specializes in serving as an advocate, advisor, and strategist for small to medium businesses with 2 to 500 employees. If you are in search of expertise in selecting, optimizing, executing, and maintaining a benefits package for your company, we invite you to connect with us.

About The Author:

Ronald L. Bland

President

How Technology Is Revolutionizing Employee Benefits

Fri, 02 Feb 2024 15:28:34 GMT

Written by: AEIS

Benefits of Technology for Employers

For employers , employee benefits technology brings with it a myriad of different advantages that simply cannot be ignored. Chief among these is a newfound sense of efficiency.

The integration of technology in benefits administration provides employers with powerful tools to simply organize data that may be needed to help maintain compliance or for cost/benefit analysis and comparison. Unlike the manual processes of the past, benefits administration technology streamlines these tasks, making it remarkably simple to generate and pull reports, as well as censuses. This efficiency not only saves time and resources for employers but also ensures accuracy and compliance with regulatory requirements.

Any administrative or human resources professional can tell you just how time-consuming employee benefits management can be. Even once the package itself has been put together, you have to spend countless hours fielding questions, addressing problems, and more.

With modern technology, this changes dramatically. Employees are now in the driver's seat of their own healthcare and larger benefits experiences. Not only is this more efficient, but it also frees up valuable time for admin and HR professionals to focus on more important parts of their day like finding top-tier talent, employee retention, and more.

This integration of technology typically is seen in an employee benefits platform, which is a centralized digital solution designed to streamline and manage various employee benefits offered by an organization. This tool serves as a hub where employees can access, understand, and make choices related to their workplace benefits. The platform typically encompasses a wide range of benefits, including health insurance, dental and vision coverage, life insurance, and other perks.

Most businesses can also take advantage of the fact that modern technology makes it dramatically easier to maintain compliance in terms of benefits. These days, if an employee goes through a “qualifying life event” and needs to secure access to employee benefits, they can largely do so on their own. They input all relevant information into the benefits system, at which point the employer is notified. Additionally, in many Employee Benefits Platforms, you can make “Required Annual Notices” required readings so employees must review them before making their elections. Maintaining compliance and being "Audit-Ready" becomes more manageable when relying on data provided by employees. This approach assists in addressing potential issues, such as a lapse in coverage.

Benefits of Technology for Your Employees

By far, the number one benefit that technology brings to employees is the remarkable increase in efficiency it affords to employers' administration efforts.

Even as recently as a decade ago, healthcare was a confusing and frustrating experience for workers. Typically, once a year, staff would all be called into a meeting and essentially told what limited options were available to them, with little to no actual discussion to follow.

Now, they have access to many new options in terms of benefits , which allows them to be more proactive about the health of themselves and their loved ones. With the advent of advanced benefits administration technology, it has become significantly easier for employees to access their coverage and benefits details at enrollment and throughout the year, empowering them to make informed decisions about their well-being. This accessibility not only fosters a sense of autonomy but also encourages a proactive approach to healthcare management.

Employees appreciate having the option to choose — many of them for the first time. Online employee benefits portals distill everything down into one simple, easy-to-use platform. It acts as a “single source of truth” for their healthcare. They can see what their current plans do and do not cover, any perks that may be available to them, access to their different types of plans (medical, dental, vision, ancillary), and more.

Furthermore, they're far more likely to take a proactive approach to all of this, as opposed to keeping it all at arm's length as they did in the past.

When someone is confused and frustrated by healthcare, they're less likely to pay close attention to it until it's too late. When they're engaged and invested, they're more willing to go to the doctor early to address small problems before they have a chance to become much bigger ones. Employees who are engaged with their healthcare are proven to find their benefits richer and more substantial than those not engaged. This keeps them happier and more productive overall.

Now, thanks to the ease and convenience of modern employee benefits technology, creating personalized experiences is easier than ever. It helps make important decisions easier and less overwhelming. People can get a better sense of what they're paying for, about important plan details like deductibles and co-pays, easily see premium rates for different plans or dependents, and more. They're more aware of their circumstances and are more engaged with the program, thus increasing participation at the same time.

Ways Technology is Changing Employee Benefits

With just a few quick clicks of a mouse, employers can now analyze real-time and historical data regarding what benefits they're offering, how those benefits are being selected, and more.

Thanks to technology, business owners no longer have to rely solely on guesswork when it comes to understanding their employees' needs. While seeking employee feedback remains a crucial part of the process, technology-enabled surveys and data analysis streamline this aspect.

The technology itself provides insights into employee preferences and requirements, allowing employers to make more informed choices about the types of plans they offer. This not only saves time but also ensures that businesses stay competitive in a crowded market by aligning their benefits with actual employee preferences.

Let AEIS Help You Find The Best Technology

At AEIS, we've always believed that comprehensive benefits advisory experience is a requirement, not a recommendation . This means that our team will always work with you to create the customized group benefits package you need. We want to help improve things for your employees so that they in turn can help improve things for your business, exactly as it should be.

If you'd like to find out more information about how technology is revolutionizing employee benefits, or if you have any additional questions you'd like to go over in a bit more detail, please contact the team at AEIS today .

What is a Benefits Administration Platform?

Tue, 09 Jan 2024 15:12:58 GMT

Written by: Ron Bland, GBDS

Table of Contents

Benefits Administration Technology for Businesses
Key Features of a Benefits Administration Platform
Why Use a Benefits Administration Software?
Steps to Finding the Right Benefits Administration Platform

Benefits Administration Technology for Businesses

In the modern era, employee benefits have truly never been more important to a business. Not only do people tend to look at benefits packages even more than salary when it comes to deciding where to work, but it also goes a long way towards cutting down on employee churn by keeping existing workers satisfied, too.

But as is true with most human resources and administrative processes, benefits administration can take a great deal of time. Not only do you have to think about healthcare coverage but also life insurance, dental, vision, disability insurance, and more. Anything you can do to streamline these processes frees up the valuable time of HR professionals to focus on more important matters — which is where benefits administration technology for businesses comes into play.

Key Features of a Benefits Administration Platform

A business administration platform is, in part, designed to automate and streamline as much of the traditional employee benefits management and selection process as possible. Rather than having people fill out reams of paperwork just to sign up for the benefits your company offers, everything is handled by a convenient and easy-to-use digital system.

Depending on the type of platform you choose, there may be integration with your medical and ancillary carriers so that enrollments, terminations, and changes are automatically sent over via EDI feeds — thus saving an organization's human resources department quite a bit of time and money as well.

There are two types of Benefits Administration Platforms, one that is not integrated with your Payroll but may share information through EDI feeds or by downloading/uploading Excel spreadsheets, and one that is fully integrated and part of your payroll platform. Examples of non-integrated Benefits Administration Platforms are Ease or Employee Navigator. Examples of fully integrated Benefits Administration Platforms are Rippling or Gusto.

While every platform will be different, some of the key features that any business administration platform should offer at a bare minimum include ones like:

Online Benefits Enrollment, including signing the forms digitally
Ability to customize various contribution modeling
Employee communication tools to send information to employees about critical dates and deadlines
Document Management to store important and required benefit plan documents, including the Summary of Benefits Coverage and Annual Required ERISA Notices
Support for managing life events that trigger a Qualified Life Event so employees can make changes
Ability to generate reports on benefit utilization, enrollment trends, and other relevant metrics

Why Use a Benefits Administration Software?

By far, the number one reason to use a benefits administration software platform has to do with the amount of time a business can save. Some estimates say that it could take up to an hour per employee for an HR professional to complete basic tasks like checking for duplicate data, answering questions that employees might have, preparing benefits packages, and more.

Even if yours is a very small business with only 10 employees, that's still roughly a full workday that is devoted to these routine tasks. If they could be automated, think about what more productive work that person could accomplish in a day.

As is true with most types of automation, benefits administration software also goes a long way towards reducing errors at the same time. The more manual paperwork you're dealing with, the more likely that mistakes can be made. If information isn't being entered flat out incorrectly, you may have duplicate data entries that you're not even aware of until it's too late.

Automating data entry reduces not only the amount of work that someone has to do but also the number of potential mistakes they can make. As a bonus, a lot of these platforms also directly integrate with organizations like insurance carriers, which further reduces the possibility of error.

A few of the other reasons why you would want to use benefits administration software include but are not limited to:

Greater transparency than ever. Employees can see real-time cost calculations to help them instantly understand what their benefits will cost with each paycheck that they receive.
Benefits analysis. Employers can take a look at which employees are utilizing benefits and which ones aren't, allowing them to meaningfully improve what they're offering in order to remain competitive in the marketplace.
Superior satisfaction. Because benefits administration platforms are so easy to use, employees, employers, and all others can access critical information anytime, anywhere, and on virtually any device. This can help with the decision-making process, creating a system that is as easy to use as it is effective for everyone involved.

Steps to Finding the Right Benefits Administration Platform

Having said all of that, it's important to note that not all benefits administration platforms are created equally. If you want to guarantee that you find the right solution that meets the unique needs of your organization, there are several key steps to follow.

Conduct research into what features you need and which solutions offer them. This will take a significant amount of time to get right, and if you can't afford to do so yourself, don't be afraid to delegate the responsibility to someone who can .
Understand what you need. Where do your priorities rest when it comes to benefits? Why are these things so significant? Only by understanding your needs will you be able to find a solution that meets them.
Know your options. At a bare minimum, make a list of three or four potential options that meet all the requirements you've just laid out.

5. Compare your options. Dive deep into each product offering and find out what makes each one unique. Look at things like not only features but customer support and training options as well.

6. Embrace product demonstrations. If a free demo is available of the software to help make your choice easier, request one, so you can see it in action.

7. Narrow down your options. Try to get your list down to one or even two options as the best candidate starts to rise to the top.

8. Compare your options one final time. If necessary, write a list of the advantages and disadvantages of each one to help illustrate the difference.

At that point, your ideal benefits administration platform should be clear, and you can begin the process of entering into a contract with the vendor you have selected.

If you'd like to find out more information about the major benefits of a benefits administration platform, or if you'd just like to discuss your organization's own needs with a team of professionals in a bit more detail, please don't hesitate to contact AEIS today .

About The Author:

Ronald L. Bland

President

Benefits of Using a Disability Insurance Broker

Thu, 04 Jan 2024 18:03:31 GMT

Written by: Ron Bland, GBDS

What is a Disability Insurance Broker?

As the name implies, a disability insurance broker is a professional who helps obtain the insurance coverage they need to live comfortably in the event they have a disability that keeps them from working. A broker will work with their clients and learn as much about their situation as possible. They will then work directly with insurance companies on behalf of their clients to help put together the policy to meet those needs.

Benefits of Using a Disability Insurance Broker

One of the major benefits of using a disability insurance broker comes by way of the education that they provide. Insurance is a complicated topic on a good day — to say nothing of how difficult things can be when you're wading into something as essential as disability insurance. A broker will help make sure their clients understand the pros and cons of each coverage type, all so that they can make the most informed decisions possible when it comes to their health.

By nature of their professional status, a disability insurance broker will also be able to leverage their career to the benefit of clients everywhere. They're not starting from scratch, so to speak — they come with pre-existing relationships that they can use to get the best possible rate and to secure other types of coverage that a business or individual may be unable to get on their own.

We're here to help.

Contact us today.

What Are the Types of Disability Insurance?

All told, there are different terms for different types of disability insurance coverage that people should be aware of moving forward. Only by understanding what kind of needs each type is designed to meet (and what they aren't) will you be able to make the best decision possible.

Short-term disability coverage. This is designed to provide coverage for someone after an injury or illness when they are expected to recover in between a few weeks and a few months.

Long-term disability insurance . This is coverage for those periods of time when someone will be out of work for more than several months and it can potentially pay out claims on a disability up until one reaches Social Security Normal Retirement Age (SSNRA).

Individual disability insurance. This is the type of coverage that a single person can buy outside of their employer. It can be more difficult to qualify for as these policies generally require proof of good health before a policy can be issued.

Group disability insurance. This is the type of policy that is offered by employers that is designed to cover their employees. In this situation, the benefits being received may be taxable — it depends on how the plan is set up. It is generally easier to obtain group disability insurance compared to individual insurance as there are fewer instances where proof of good health is required in order to enroll.

Employer-sponsored disability insurance. This is a type of disability coverage that is typically paid either mostly or entirely by the employer.

Voluntary Group Disability. Another type of group disability policy is where the employee pays most or all of the premium themselves.

Social Security Disability Insurance , otherwise known as SSDI for short, is a tax-funded federal insurance plan managed by the Social Security Administration and is available to those who have the required minimum number of Social Security credits. It generally has the most stringent requirements to qualify for and takes by far the longest to get a claim processed and approved.

Statutory Disability Insurance. A few states (CA, HI, NJ, NY, and RI as of 2023) also have tax-funded disability insurance administered at the state level. These tend to be limited in their maximum duration. E.g. CA SDI will pay out claims on a qualified disability for up to 52 weeks.

Business overhead expense disability insurance . This provides financial compensation to a business in the event that the owner should fall ill or get injured for an extended period of time.

High-limit/Executive disability insurance. Unlike some of the other types of coverage, this is designed for individuals with high income levels. It is intended to cover a “substantial” portion of their regular income should they get injured or fall ill.

Again, there is no “one size fits all” approach when it comes to selecting the right disability insurance coverage. A policy type that works well for one employer may be woefully inadequate for the next. This is part of the reason it's always recommended to work with a disability insurance broker — they can distill this process down to its bare essentials, making sure employers have the coverage their employees need in the most efficient way possible.

Who Pays the Disability Insurance Broker?

Generally, brokers work on a commission basis, which means that they're paid by the insurance providers they work with when they sell a policy to a client. The broker would receive a specific percentage of the premium as a payment from the carrier in exchange for assisting the client's employer with the administration of the plan. Unless otherwise stated by the broker, there don’t tend to be any additional fees for their services

AEIS Makes Disability Insurance Simple

At AEIS, we understand how convoluted shopping for the right type of insurance can sometimes feel. This is true for individuals who just want to make sure they have the disability coverage they need, as well as for businesses who are trying to put together the most competitive benefits package possible.

That's why we pride ourselves on our ability to make topics like disability insurance as simple as possible . In addition to getting you the coverage you can depend on, we want to free up as much of your valuable time as possible so that you can focus on more important matters — exactly the way it should be.

If you'd like to find out more information about the major benefits that come with using a disability insurance broker, or if you're eager to get started and would like to discuss your needs in more detail, please don't hesitate to contact the team at AEIS today .

About The Author:

Ronald L. Bland

President

A Guide to Hiring an Employee Benefits Broker

Mon, 11 Dec 2023 21:15:00 GMT

Written by: AEIS

What Does a Benefits Broker Do?

According to one recent study , benefits make up an incredible 29.6% of all employee compensation-related costs for your average business. Since getting the most ROI (Return on Investment) for those costs is a top priority, it stands to reason that working with a team of experts like a benefits broker is a step worth taking.

At their core, benefits brokers help create benefits packages for businesses like yours that are selected to fit your exact needs. Not only is this a viable way to help attract top talent in a competitive marketplace, but it can also improve morale and help retain the employees you already have, too.

This is all why working with a benefits broker is so important. They can help save your business money on benefits, can make sure your employees have the quality insurance and coverage they can depend on, and help you stay “audit-ready” in compliance with state and federal regulations. They can even help educate you and your employees on how to take advantage of the benefits you do offer. All this is incredibly time-consuming and difficult to manage on your own. The best part is that, in the vast majority of instances, working with a broker does not add any additional cost to your benefits.

Tips for How to Choose A Benefits Broker

Having said that, it's equally important to acknowledge that not all benefits brokers are created equally. If you truly want to find a partner who will always act with your best interests at heart, there are a number of key things to watch out for.

Know Your Company’s Needs

This is so crucial because you can't expect even an objectively great benefits broker to be much help meeting your needs if you haven't properly defined what those needs are to begin with.

Begin by assessing your employees. What are their concerns? What do they like about your current benefits offerings, and what would they prefer to see more of? These questions can serve as crucial starting points to give you a baseline to work from.

Likewise, don't be afraid to look at some of your closest competitors. What are they offering? What gaps can you fill?

What are they doing that you could be doing even better? If one of the objectives of a benefits package is to help you remain competitive in attracting talent, you need to make sure that whatever it is you're offering is top-notch.

Start Looking Early

There are a lot of moving parts when it comes to putting together a benefits package. It's a very time-consuming process. Therefore, if you wait until it's time to renew your plan to begin looking for a broker to help with new options, there may not be enough time left to accomplish anything meaningful.

Don't delay—start looking for a broker as early as possible, so they can team with your HR team and review items like your budget to put together the best package possible given the circumstances.

Find a Broker with Industry Expertise

Just as every organization is unique unto itself, the same is true of every industry . The needs of a team of people working at an automobile manufacturing plant will likely vary from people working in a pharmaceutical laboratory.

Never work with a benefits broker that tries to cram you and your people into a “one size fits all” box that doesn't exist. Your benefits partner should take the time to learn as much about your workers and your business as possible, all to come up with the customized solution needed to serve them well.

Cost Analysis

In addition to helping you put together a competitive benefits package, a benefits broker should also be in a position to help you save money. Know exactly how much you're currently spending and what you're getting. Then, compare it to what a broker can put together for you and what that package will include.

Value Ads from the Brokers

Finally, it's important to acknowledge the other ways in which a benefits broker can help beyond simply putting together the initial package. They should have technology, tools, and services that support your HR and admin teams and make their lives easier, for example. They should also offer access to educational resources for employees and their covered family members. It’s also not a bad idea to work with a broker that has relationships with various PEO’s (Professional Employer Organizations) as they can also be a great place to find lower cost benefits, for the right companies.

When Should You Find a New Broker?

If you feel like you're paying too much for your current benefits and aren't sure how to save money on your own, or if you have a problem filling vacant positions or are dealing with high instances of employee turnover, these are all signs that you should find a new benefits broker as soon as you can. In small group insurance, the broker’s compensation is typically included in the plan costs, whether you use a broker or not. So make sure you’re getting the most value out of your plans by working with a great broker.

Steps to Selecting a Benefits Broker for Your Business

Start by asking for direct referrals for a new benefits broker from people and organizations that you trust. Talk to your colleagues and peers and ask them who they're currently working with. More importantly, ask them about what their experiences are—both positive and negative. The more you reach out, the more you'll see a few key brokers who have a reputation that always seems to rise above the rest .

Get a Broker That Supports Your Business with AEIS

At AEIS , we regularly advise businesses with anywhere from two to 500 employees on how to meet their needs in terms of employee benefits, insurance, and more. In addition to standard medical insurance we also help take care of factors like vision, dental, disability, group term life, and more.

We also offer value added services like free sexual harassment prevention training, online benefits enrollment through Ease/Rippling/Gusto, and other critical employee training modules through Zywave—all so that you can rest easy knowing that your benefits needs are being taken care of .

If you'd like to find out more information about the steps you should take when hiring an employee benefits broker, or if you'd just like to discuss your own organization's needs with a team of experts in more detail, please don't hesitate to contact AEIS today .

Clever Ways To Spend FSA Money Before the Deadline

Tue, 21 Nov 2023 14:21:05 GMT

Written by: Ron Bland, GBDS

Table of Contents

Two Options for the Extra Cash
Grace Period
Rollover
Can You Transfer FSA to a Bank Account?
What Happens If Your FSA Money is Not Used?
How to Use FSA Money
#1: Eyeglasses & Contact Lenses
#2. Acupuncture
#3. Shoe Support
#4. Acne Medicines
#5. Skincare Treatment
#6. Stockpiling Medical Supplies
#7. Prescription Products
#8. Pain Relievers
#9. Thermometers
#10. Pregnancy and Baby-Related Items
#11. Dental Treatments
#12. Hearing Aids
#13. Eye Surgery
#14. Psychiatric Care
#15. Other Approved IRS Medical Expenses
Other Benefits of FSAs for Your Employees
The AEIS Approach

Short for "Flexible Spending Account," FSA money or funds has to do with funds that are put into a special account that are intended to be used to pay for certain IRS eligible out-of-pocket healthcare and medical-related expenses.

Not only can using an FSA account help give some much-needed financial relief to individuals, but it can also help reduce a person's taxable income - making it a great benefit for employers to both attract and retain top talent for their organization.

Two Options for the Extra Cash

At the same time, it's important for people to understand that any money deposited into their FSA account won't stay there indefinitely. Funds need to be used by the end of the plan year. However, there are two options employers can choose to allow employees more time to spend their funds: grace period or rollover.

Grace Period

If an employer elects a grace period, then the employee has a two and a half month period following the end of the plan year, during which employees can still incur eligible expenses and use any remaining funds in their account to cover those expenses. So for example if their plan year is from January 1st - December 31rd, under a regular FSA employees have to spend it by December 31 of the current calendar year - whereas if their employer elects a grace period then they have until March 15 of the following year.

Rollover

If the employer elects the FSA rollover it gives employees the ability to roll over up to $640 (new limit for the 2024 plan year) of unused funds to the next plan year. Regardless, if the end of the year is coming up, it's understandable to worry about that money going away without being able to derive any benefit from it.

Thankfully, all hope is not lost. If you still have money in an FSA account and are looking for creative ways to spend it before the deadline, there are a number of techniques that you'll want to keep in mind.

Can You Transfer FSA to a Bank Account?

The answer to this question is a straightforward "no." FSA money can only be used for designated healthcare-related purposes . As per the IRS, you cannot transfer that money to another account.

What Happens If Your FSA Money is Not Used?

At the end of the predetermined period, any FSA money that you have not already used for its designated purpose returns to your employer. Employers can choose to apply the forfeited funds to administrative costs from the plan year or they can choose to equally distribute the funds to employees who enroll in an FSA for the next year, as long as Internal Revenue Code Section 125 is not violated.

How to Use FSA Money

When a lot of people think about their FSA money, they think about uses like co-pays for doctor's appointments, hospital bills, and similar events of that nature. Really, they need to be thinking bigger - that money is a great way to cover expenses that they may otherwise overlook.

#1: Eyeglasses & Contact Lenses

Case in point: eyeglasses. If you wear prescription eyeglasses, and even if you've already been to an optometrist and have made sure that your prescription is up-to-date, that doesn't mean you can't still put that FSA money to good use. You can also use those funds to get a pair of prescription sunglasses or even prescription contact lenses to help get you through the year.

Many don't realize that even contact lens solutions are often covered under the terms and conditions of your standard FSA account.

#2. Acupuncture

On the subject of medical procedures, using FSA money can also be a good way to experiment with certain techniques that you may otherwise not think too much about. If you're someone who suffers from joint pain or even arthritis, you should know that FSA money can also be used to pay towards your next visit to an acupuncture professional.

#3. Shoe Support

Regardless of the type of job you have, the chances are high that you spend a lot of time on your feet every day. What you might not realize is that your FSA money can help with that, at least as far as massaging gel shoe inserts are concerned.

These are a great way to relieve some pressure on your feet while you stand for long periods every day, which can also help eliminate stress on other joints like your knees and hips as well. If you have already explored this type of option, don't worry - there are others available. Everything from arch support to callus remover medicine to Orthopedic shoe inserts, can also be paid for, giving you a little physical relief while you enjoy some financial relief as well.

#4. Acne Medicines

Other creative ways to spend FSA money include investing in those products that will help clear up some skin issues that you may be experiencing. Statistically speaking, a lot of people deal with the impacts of acne at some point throughout their lives - not just during their teenage years. Various acne medications can be eligible expenses.

#5. Skincare Treatment

A number of skincare products are also able to be paid for by your FSA money. This can include those products that are used to clear up skin conditions that are not acne-related, like Eczema and others.

#6. Stockpiling Medical Supplies

Don't forget about these potential supplies that you may not necessarily need right now, but that would be good to have around the house in the event of an emergency. You can never have too many bandages, for example, especially if you have a larger family.

Blood pressure monitors, heating pads, medical cold packs, you name it - all of them would be right at home in a First Aid kit. Thankfully, you don't necessarily have to run to the pharmacy and buy all of these things out-of-pocket - you can stock up on each one of them with that FSA money that you have been saving up throughout the year.

#7. Prescription Products

As an aside, it is important to understand that you can't necessarily walk into a store and use your FSA money for all the products outlined above. Some will definitely require a prescription, for example. But that's okay, because the checkup with your medical professional will be covered as well - allowing you to enjoy all the benefits of this process with as few of the potential downsides as possible.

We're here to help.

Contact us today.

#8. Pain Relievers

You can also use your FSA money to stock up on non-prescription items. This can include medicines that are used to treat headaches, general pain relievers, and more that you can buy over the counter at a pharmacy.

#9. Thermometers

Thermometers are always important, but are especially helpful given everything going on in the world right now. Given the rise in COVID-19 cases there is a chance you'll be checking for a fever with you and your family members more frequently than ever and FSA money can help cover those expenses.

#10. Pregnancy and Baby-Related Items

You can use your FSA money to cover the cost of not only pregnancy tests, but also things like fertility monitors, breast pumps, and even baby breathing monitors as well.

#11. Dental Treatments

You can include in medical expenses the payments for preventing and easing dental disease. Preventive treatment covers the services of a dental hygienist or dentist, including procedures like teeth cleaning, applying sealants, and fluoride treatments to prevent tooth decay. Alleviating dental disease involves the services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental treatments, besides teeth whitening.

#12. Hearing Aids

You can include in medical expenses the expenses for a hearing aid and the batteries, repairs, and maintenance necessary for its operation.

#13. Eye Surgery

You can include in medical expenses the payment for eye surgery to address defective vision, such as laser eye surgery or radial keratotomy.

#14. Psychiatric Care

You can include in medical expenses the payments you make for psychiatric care. This encompasses the expenses associated with supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care.

#15. Other Approved IRS Medical Expenses

Finally, you can use your FSA funds on other IRS approved medical expenses , such as legal abortions, ambulances, crutches, therapy and more.

Other Benefits of FSAs for Your Employees

When it comes to employers contemplating the value of introducing a Flexible Spending Account (FSA) for their staff, it becomes crucial to delve into the wider spectrum of advantages it can bring to the organization. While the primary aim of an FSA remains to provide financial relief to individuals for IRS-qualified healthcare expenditures, there's more in it for employers than meets the eye. Notably, one compelling facet is how an FSA can serve as a potent tool for talent acquisition and retention. In today's fiercely competitive job market, benefits such as FSAs can significantly augment a company's appeal to potential hires and fortify its capacity to retain existing talent. Furthermore, FSAs hold the potential to reduce the taxable income of employees, leading to mutual savings in taxes for both employees and employers. Thus, even if an employer harbors initial reservations about FSAs , it is beneficial to explore their potential to elevate employee satisfaction, bolster financial well-being, and concurrently enhance the organization's financial standing.

The AEIS Approach

At AEIS, Inc., we aim to make things as simple as possible - this is true whether you're talking about spending FSA money before the aforementioned deadline, health insurance, employee benefits , or something in between. No matter what, we want to leverage our decades of combined experience to your advantage - making sure that the financial futures of both businesses and employees are taken care of , exactly the way things should be.

If you'd like to find out more information about spending FSA money in creative ways before the deadline, or if you have any additional questions that you'd like to talk to a professional about in a bit more detail, please don't hesitate to contact the team at AEIS today.

About The Author:

Ronald L. Bland

President

HMO vs PPO vs EPO vs POS vs HDHPs: How Are They Different?

Fri, 03 Nov 2023 17:38:16 GMT

Written by: AEIS

How Are They Different?

According to one recent study , a massive 78% of employees said that they're more likely to stay with their current employer because of the quality of the benefits program that they offer. If you're having issues with things like employee engagement or high employee turnover, simply taking a look at your benefits package is likely an opportunity to address them as soon as possible.

One of the most important elements of any benefits package is and will always be healthcare. But with so many different options available, it can be difficult to know where to begin. Only by making an effort to understand the different types of health insurance plans that are available will you be able to make the most informed decision possible given your employees.

What are the Types of Health Insurance Plans?

As stated, there are a number of distinct types of health insurance plans that are available depending on what works best for both your workers and ultimately your business. They include those like the following:

What is HMO: Health Maintenance Organization?

If your health insurance is part of an HMO plan, this means that when you go to your primary care physician (otherwise known as your PCP), it must be someone who is within your specified network. They can then refer you to others within the same network as-needed. HMO’s tend to have narrower networks than PPO’s but lower cost in terms of premiums. Members of an HMO plan must use in network providers unless it is a bona fide emergency.

What is PPO: Preferred Provider Organization?

With a PPO plan, members typically have access to a wide number of different medical groups and providers. Patients have the flexibility to see doctors both in and out of network depending on their preferences (however we always recommend staying in network as often as possible). While they will likely pay more for care when seeing someone out of the network, they still have the option available to them. PPO’s also allow members to seek specialists without a referral from their primary care physician.

What is EPO: Exclusive Provider Organization?

If your health insurance is an EPO plan, it works very similar to a PPO except there is no out of network coverage at all . So long as someone is within your network, you can see them - even without a referral.

What is POS: Point of Service?

It can be helpful to think of these types of insurance plans a bit like a combination between a health maintenance organization and a preferred provider organization. If you want to see a specialist, you'll need a referral from your PPC. However, you will also be able to get some level of care when seeing someone out of your network. It's just that you will likely have a higher co-pay than you would with in-network care.

What is HDHP: High Deductible Health Plans?

This is a type of health insurance plan that allows members to contribute tax-preferred dollars into a health savings account (HSA) which can be used for qualified medical expenses. The caveat however is that the member must pay for all expenses out of pocket until the high deductible has been satisfied, even for things that wouldn’t normally be subject to the deductible such as office visits. An HDHP plan can be within a HMO, PPO, EPO or POS network.

What's the Difference Between HMO, PPO and HDHP?

The major difference between an HMO, and a PPO, comes down to access to providers. HMO’s have narrower networks of providers and members must generally stay within the specific medical group of their primary care physician. PPO’s allow members to see providers in a variety of medical groups and can see specialists in network without a referral. For multi-state employers, your employees will need a PPO in order to be able to get coverage outside of the employer’s primary state.

Likewise, both HMOs and PPOs typically h ave HDHP options available. An HDHP isn't necessarily a unique type of plan; it is moreso a designation for various plans that can be paired with an Health Savings Account. .

How to Choose the Right Plan for My Company

The most important thing to understand about picking the right type of health insurance plan for your company is that you're looking at the needs of the collective, not individuals .

Because of that, you need to sit down with your employees and have them come up with a list of things they "need to have" and "would like to have" in a health insurance plan. If you're ultimately trying to put together a benefits package that satisfies as many people as possible, it stands to reason that you need to know what these people's preferences are. The best way to do that is to come right out and ask them.

You'll also want to consider things like the quality of the doctors who are in-network for a particular plan, and whether things like being able to go outside a network is important to people. For multi-state employers it is critical to make sure your plans have adequate network access for the states they live/reside in.

Really, what you're trying to do is balance the amount of money you'll be paying for healthcare (which is traditionally one of the biggest expenses for any organization) and the amount your employees will be paying, coupled with the quality of the experience you'll be able to offer them. It is often possible to offer a variety of different plan types in order to suit the needs of your diverse team. Because of that, resist the urge to cram your company into a "one size fits all" box and really take the time to come up with a solution that is every bit as unique and specific as your workforce is. It would be a mistake to offer them something generic and say "most other businesses are fine with this so you should be, too."

If you know you need to re-think your business' approach to health insurance coverage but aren't sure where to begin, don't worry - the team at AEIS is here to help . We'll get to know your business and its employees on an intimate level, making sure we understand what everyone's preferences are and what they truly need. We'll help make sure you understand all available options and will ultimately sit down and help you make the best decision possible given your workers.

If you have any additional questions about the differences between concepts l ike an HMO, PPO, EPO, POS, and HDHP when it comes to health insurance, or if you'd just like to talk to someone about your business' own needs in a bit more detail, please don't hesitate to contact the team at AEIS today .

2023 Trends in Employer Sponsored Health Insurance

Fri, 15 Sep 2023 20:45:53 GMT

Regardless of how you look at it, employer-sponsored health insurance remains one of the most important types of coverage available to those in the United States. However, it's also no secret that premiums are higher than ever. According to one recent study , the average annual premium for single coverage is $7,911. Family coverage sees that number climb to $22,463.Additionally, the UBA Employee Benefits Benchmarking trends report finds that average total annual cost per employee across various medical plan types is $12,024 and this reflects both the employer and employee contributions.

This is why it's so important to pay attention to the top trends in employer sponsored health insurance in a given year. It helps make sure that your employees are always getting the coverage they need while saving your business money at the same time.

What is Employee Sponsored Health Insurance?

An employer sponsored health insurance plan is exactly what it sounds like - one that is selected and purchased by an employer and offered to eligible members of the workforce and their family members.

In addition to covering some portion of the premiums with the workers, the employer is the one who typically selects the plan itself. They will do so based on their ability to find a plan that meets the needs of their workers as a collective. Any premium contributions made by the employer are not subject to taxes, which is crucial because from the point of view of those workers, it can help lower their taxable income at the end of the year.

Recent Health Care Trends

There are two main trends in employer sponsored health insurance that help not only contextualize where the topic currently stands, but also give insight into where it might be headed over the next few years.

Shifting Workforce Expectations

These days, top tier talent looks to more than just a base salary when deciding where to work. Especially given everything going on in the world right now, people want a job that they believe in. One that gives their lives purpose and meaning. One that closely aligns with their values in a multitude of ways.

What this means is that if you think you can just "buy" the best people in your field by way of big salaries, the odds are that you'll be mistaken. Employees are increasingly looking to benefits packages and to health insurance in particular when not only making a decision about where to work, but also whether to look for a new job if they quickly become dissatisfied with the one they already have.

Because of that, employers need to see their benefits programs for what they are: an opportunity for real action that creates a meaningful, lasting impact on company culture. With the right approach it can also be one that cements a legitimate competitive advantage for themselves at the same time.

Mental Health Support

Another key thing to understand is that employees are increasingly prioritizing their own well-being, particularly when it comes to mental health. An employer who shows that they are just as concerned about this as their employees are finds themselves in a position to both attract and retain top talent in the field.

In addition to offering insurance with mental health coverage, employers should be prepared to build as much flexibility into the workplace as possible. Allowing employees to work via a hybrid virtual model can benefit both the business and its workers alike.

In large numbers, modern workers are expecting more out of their employers to that end - which is why mental and behavioral health support will only continue to grow in popularity over the course of the next decade.

The Impact of Medical Care and Health Insurance Rises

Another thing to keep in mind has to do with the impact of medical care in general as health insurance costs continue to rise. It has been estimated that in the coming year, businesses in the United States can expect to see a median health care cost increase of 7% - 8.5% for 2024, in some areas and industries the cost increase will be more.

There are a variety of factors that are contributing to these increases including high-cost claims and even higher utilization rates. As more people participate in employer sponsored health insurance and get coverage, the overall costs naturally rise as a result.

Likewise, the increasing cost of even common prescription drugs is also causing stress for both employees and employers alike.

Choose AEIS to Help with Your Employee Benefits

At AEIS, our team of passionate, experienced advisors is prepared to significantly improve your approach to employee benefits. We treat each client as the unique entity that they are - there is no "one size fits all" approach to what we do.

This means that not only do we make sure that your employees are fully covered and aware of all the benefits you offer, but we can also help put together customized group benefits offerings that align with your long-term goals as a business and are up to date on the most recent employer sponsored health insurance trends. This can help you attract higher quality employees than ever, cementing a true competitive advantage for yourself in the marketplace. We also have the technology needed to streamline your costs and improve what you're offering for years to come as well. It's a personalized level of care and attention-to-detail that you won't be able to find anywhere else.

If you'd like to find out about even more 2023 trends in employer sponsored health insurance, or if you'd like to speak to a team of California benefits advisors about your own needs in a bit more detail, please feel free to contact AEIS today .

A Guide to Employee Benefits Benchmarking

Thu, 24 Aug 2023 18:02:00 GMT

What is Benefits Benchmarking?

In order to know whether your efforts are successful, you need to first be able to define what "success" actually looks like. That, in essence, is what employee benefits benchmarking is all about.

Essentially, you're analyzing how your current benefits offerings compare to other organizations - both of the same size that you are and that are operating in the same industry. There are a number of factors that influence what you should be offering. Even the cost of living in the area of the country your employees live in will play a role and benefits benchmarking can help you better understand all of it.

Why Run an Employee Benchmarking Report

The overarching reason why you should run an employee benchmarking report is that it helps you remain competitive . Understand that benefits are hugely important when someone is looking for a new job - even more than base salary in some cases. Likewise, if your benefits are inadequate compared to a similar organization, that's all the more reason for someone who might not be fully satisfied with their current job to start looking for a new one.

It always costs more money to hire a new employee than it does to retain an existing one, which is why this is one element of your operations that you always need to consider.

Employee benchmarking reports are also helpful for other reasons, like:

They help you evaluate the overall return on investment (ROI) of your benefits. If you're paying money for benefits that people aren't actually using, those are funds that could be better used elsewhere. Likewise, if you had specific goals in mind when it came to something like a wellness program, benchmarking utilization rates can help you see whether you hit the mark or missed entirely. Saved money can be put into new offerings that they will use and that will also allow you to remain as competitive as possible in the marketplace.
Helping with education of benefits. Benchmarking can help you understand the true value of the benefits that you offer, allowing you to promote that via your employees, on social media, during hiring, and more.
Uncovering trends and patterns. The accepted best practices of employee benefits change rapidly and without being proactive it can be easy to miss important changes. Regular benchmarking helps you capitalize on new trends quickly , all while allowing you to stay ahead of the competition at the exact same time.

Methods for Employee Benefits Benchmarking

When it comes to successful employee benefits benchmarking, there are a few key methods you'll want to take advantage of.

Organizational Review

You'll want to begin this process by conducting a thorough organizational review to analyze your existing benefits as honestly as possible. Take a look at all basic categories, like:

Your healthcare-related offerings.
Compensation, bonus structure, retirement assistance, and related areas.
The amount of vacation time and/or paid leave you offer.
Insurance programs you offer like life insurance and disability.
Any opportunities you offer like professional development or student loan repayment.

You'll also want to consider things that are particularly important to the younger generations of workers, like family assistance and work flexibility. Make sure you understand exactly what you currently offer and why.

Internal Survey

Another great way to accurately benchmark your employee benefits is to go right to the source - the employees themselves. Send out a survey to people who are actively participating in the current program. Ask them what they like and what they don't like. Inquire as to what their favorite parts are and what they feel is missing. Let them share where they feel like you're coming up short compared to other companies they may have looked at.

Make no mistake: your employees always have opinions. It is up to you to listen to them.

Competitor Data Analysis

Since part of putting together a terrific employee benefits package is all about remaining competitive, it stands to reason that you should also compare what you offer to others in your field, too.

When you do, always use raw data sources like the Bureau of Labor Statistics. Download reports from legitimate industry experts, even if you have to pay for them. Make sure you're comparing yourself accurately so you don't get the wrong impression about where your opportunities for improvement truly rest.

Third Party Audit (AEIS)

Part of improvement in terms of employee benefits has to do with your ability to remain objective. Involving a third party like the team at AEIS to conduct a third party audit can show you exactly where you stand with no "rose colored glasses," so to speak. As a United Benefit Advisor (UBA) firm, AEIS has access to one of the largest data sets around by combining the data of all 140+ UBA partner firms along with the existing industry data of the third party analytics firm, Milliman, Inc.

Because AEIS offers access to experts in terms of employee benefits and general HR needs, they can also pull data from many trustworthy sources to help accurately compare what you offer to those in your field. Not only will you see what can be improved, but you may also uncover what you excel at.

Are There Downsides to Benefits Benchmarking?

For many organizations, the only real downside to benefits benchmarking is how much time and or money the process can sometimes cost. You can try to do things internally, but you're likely only getting one small part of a much larger story. Reports, and especially partnering with a third party to conduct an audit, can add up.

But consider this. If your current employee benefits offerings are causing high employee turnover or are keeping top tier candidates from applying at all, you're likely losing more time and money than the reports would require. So benchmarking becomes an investment in fixing your problem today so that you can create a more prosperous business tomorrow .

Benefits Benchmarking Your California Business with AEIS

In the end, employee benefits benchmarking is something that you don't want to leave to chance. Just because you can't necessarily offer the highest salary for workers in your field doesn't mean you can't still outperform your competitors. To do that, you have to offer the benefits package that they need and want - and employee benefits benchmarking goes a long way towards making that happen.

If you'd like to find out more information about the major advantages of California employee benefits benchmarking , or if you'd just like to speak to a team of trusted professionals who understand your workforce and your industry, please contact the team at AEIS today .

Trending Fringe Employee Benefits – Employers Guide

Wed, 09 Aug 2023 19:47:00 GMT

Fringe benefits are those that a business gives to its employees in addition to the financial compensation they're already earning. Essentially, anything that goes above and beyond a person's base salary would fall under this category.

Some types of fringe benefits are given out to all employees. Others are only available once someone has achieved a certain position, like becoming an executive. Regardless, the goal is clear - they significantly help increase employee satisfaction, which also goes a long way toward improving engagement as well. Many organizations use fringe benefits to not only motivate existing employees but to attract and retain top talent in increasingly competitive industries, too.

Types of Fringe Benefits

All told, there are a few different types of fringe benefits to be aware of when putting together such a program for your organization. Some are essentially required as employees - especially those top-tier candidates who are looking for a new position - have come to expect them. While others are optional, it is still a good idea to offer for several different reasons.

Required Benefits

One prime example of a required fringe benefit has to do with health insurance. Under the Affordable Care Act, a business does not have to provide health insurance to employees if they have fewer than 50 full-time equivalent workers. Having said that, many employees and job seekers have come to expect it and if you don't offer it, they will likely go somewhere.

Paid Sick Leave (PSL) is another example of a required fringe benefit in the state of California. PSL requires employers to provide at least 24 hours (3 days) off each year to most workers who meet a set of qualifications.

Finally, family and medical leave would be another perfect example of a required fringe benefit. If you employ more than 50 people within a 75-mile radius of your primary location, you must offer this under the Family and Medical Leave Act. However, even if you don't, it's another in a long line of ways in which you can remain competitive when hunting for high-quality candidates to fill available positions.

Optional Benefits

There are a number of other fringe benefits that, while not explicitly required by law, would still be a good idea for any business to offer.

Paid vacation leave or Paid Time Off, also commonly referred to as PTO, is an example. Whether someone has a health situation on their hands and needs to be away from work, or if they just want to go on a much-needed vacation, offering PTO is a perfect way to support them and show that you care about their health and well-being.

Other organizations have taken to offering things like gym memberships or commute benefits as well. Gym memberships are a great way to encourage your employees to stay healthy. Those who are active tend to get sick far less than average, which helps with their productivity and quality of work. Commuter benefits are transportation benefits that people can use for things like public transportation, bicycling, and even parking to get to and from work.

Here are some examples of optional Fringe benefits that more and more employers are offering:

Dental
Vision
Group Term Life
Disability Insurance
PTO
Gym Memberships
Employee Discounts
Commuter Benefits
Additional Mental Health Services
Identity Protection
Financial Wellness Education
Legal Services
Pet Insurance
And More!

Advantages of Offering Fringe Benefits

As stated, perhaps the biggest advantage of offering fringe benefits is that it helps you attract and retain top talent . Even if you can't offer what is objectively the highest salary in your industry, that doesn't mean you can't remain competitive. If you offer a lower salary than another business but offer fringe benefits that they do not, like healthcare or PTO, jobseekers will still take that very seriously.

Other advantages of fringe benefits include the fact that it keeps your employees invested in your business, which ultimately keeps them motivated to do their best work on a regular basis. All of this helps to boost employee satisfaction, which also increases loyalty. The happier someone is, the less likely they are to look elsewhere for employment - never underestimate how important satisfaction in the workplace really is.

Are Fringe Benefits Taxable?

Yes. All fringe employee benefits that you offer are taxable by the Internal Revenue Service unless they are expressly stated. The "fair price value" of the benefit in question will count as taxable income for a given year.

What Fringe Benefits are Non-Taxable?

As per the Internal Revenue Service , just a few examples of the types of fringe employee benefits that are exempt from Income Tax Withholding include but are not limited to:

Accident and health-related benefits.
Adoption assistance.
Dependent care assistance (up to a certain limit).
Educational assistance.
Employee discounts.
Group-term life insurance (up to a certain limit).
Health savings accounts.
Transportation benefits (up to a certain limit).
Tuition reduction.
Working conditions-related benefits.

Why Should an Employer Offer Fringe Benefits?

Overall, employees should offer fringe benefits because, in the fast-paced modern era that we're living in, a business will live and die based on the strength of its workforce. Especially when many industries are facing increasing skills gaps that are only going to get worse over the next decade, fringe employee benefits are the best way to both attract the attention of the best possible workers and keep them in the fold for as long as possible.

How Can AEIS Help with Fringe Benefits?

At AEIS, we pride ourselves on our ability to offer the comprehensive benefits advisory experience that business leaders need, regardless of the industry that they're operating in. In addition to helping with fringe benefits, we also offer access to your own personal account manager to assist you with ongoing services, an HR and employee learning management system, the assistance of a marketing and renewal specialist, and more - all so that you can rest easy knowing that your benefits needs are being taken care of.

If you'd like to find out more information about why fringe employee benefits are an avenue that you should be exploring, or if you'd just like to discuss your own needs with someone in a bit more detail, please contact the team at AEIS today .

Paid Family and Medical Leave California Employers Guide

Wed, 24 May 2023 18:35:01 GMT

California Paid Family Leave (PFL) Overview

California was the first state in the country to develop a Paid Family Leave program, otherwise known as the PFL for short. It was created in 2002 and became available in 2004. Since then, 11 other states have followed suit. If you're an employer operating in California (or if you live in a surrounding state), there are several important things to keep in mind.

Long-Term Impacts of the PFL Program

Research suggests that, in this context, higher benefits do tend to lead to A) longer leave duration, and B) higher earnings one year after the claim has been filed. There has also been no evidence to suggest that those organizations with employees who take PFL at a higher rate in turn have to deal with higher wage costs or high employee turnover.

How Does PFL Support Working Women?

Just because some working women want to prioritize their careers, it doesn't mean they don't have the right to start a relationship with their child if they have recently given birth. Thanks to the PFL, they are able to welcome that new child into their family without worrying about how they're going to pay for it and without losing momentum in their job while they're gone.

How Does PFL Support Caregivers?

A lot of people don't realize that caring for a seriously ill family member can quickly become a full-time job. Not only does this person likely need assistance to perform basic functions (like going to the bathroom) 24 hours a day, but they'll also have a litany of doctor's visits and other appointments to keep. Illness does not adhere to any set schedule and things can take a turn in minutes. The PFL allows caregivers to turn their full attention over to the loved one without making them choose between their family and their employment.

How Does PFL Support Fathers?

By design, the PFL supports fathers across the state in a few different ways. For starters, it gives them an invaluable opportunity to put their family first - they can spend some much-needed bonding time with their new child soon after it has entered this world, allowing them to establish a quality relationship as early as possible. It also allows them to provide daily support to care for both their child and their spouse.

Naturally, the program also supports both parties by giving them access to financial assistance that they may otherwise miss out on.

Paid Family Leave Checklist

To get the most out of Paid Family Leave benefits as an employer (and to help your employees do the same), be sure to complete the following items:

Actively encourage all employees to get an idea of how much they can receive in PFL benefit payments. This will encourage them to actively participate. They can do so on the http://edd.ca.gov website.
Make sure employees understand their schedule by helping them determine how much time they plan on taking, whether that time will be in increments or all at once, and other important factors.
Assist your employees as they develop a transition plan to support their colleagues during their leave.
Help your employees make sure they have all the important documents to file their PFL claim.
Educate the employees about what documents they'll need during this process, including their W-2 form or paystub, Proof of Relationship for bonding claims, and more.
Encourage your employees to file a PFL claim over the Internet using the SDI Online tool. Conversely, they can submit the form titled "Claim for Paid Family Leave (PFL) Benefits (DE 2501F) by mail if they prefer.
Make sure that your employees understand the ways in which they can receive these funds. Some prefer to do so via a debit card for the speed and convenience alone, for example.
If your employees are on intermittent leave, make sure they understand that if they do not properly return form DE 2580GF, their benefits will cease.

Employer FAQs

Is my business required to contribute to the paid family leave fund?

While it is true that all employers in the state of California must participate in the Paid Family Leave program, they do not necessarily "contribute" in the strictest sense of the term. The entirety of the program is employee-funded.

As is true in other states surrounding California, you are however responsible for withholding the proper amount for ongoing PFL contributions from each worker paycheck you issue. Most other states that offer PFL are also at least partially employee funded programs, but the employer is still responsible for the ongoing PFL contributions from each worker paycheck that is issued. Be sure you are familiar with leave laws in all of the states that you have employees.

How are paid family leave benefits funded?

Employees are considered covered for Paid Family leave when they are unable to perform their regular duties and when they have lost wages specifically because they need to care for a family member that is ill, want to take time out to bond with a new child, or are participating in a qualified family event (like if their military spouse is getting deployed to a foreign country).

They will also need to have contributed at least $300 to California State Disability Insurance during their employment. Naturally, they also have to be considered employees with a business when their family leave period begins. So long as they can also provide all supporting documentation, they are considered covered employees.

Which employees are considered covered employees for paid family leave?

How do employers register for the PFL program?

Employers do not need to "register" for the PFL program because in California it is mandatory. Any business operating within the state needs to collect the appropriate amount of contributions from each paycheck and send them to the EDD in a timely manner .

If you'd like to find out more information about paid family and medical leave factors that you need to account for in the state of California, or if you just have any additional questions about things like business administration and benefits consulting that you'd like to go over in a bit more detail, please don't delay - contact the team at AEIS Advisors today .

Your Guide to Employee Benefits for Nonprofit Organizations

Thu, 20 Apr 2023 20:48:21 GMT

Written by: Ron Bland, GBDS

At AEIS, we fully understand that all organizations are unique unto themselves - which means that there is truly no "one size fits all" approach when it comes to putting together an employee benefits package. You need to carefully consider the needs and preferences of your employees when coming up with options that have their best interests at heart. What people are concerned about in a manufacturing environment can vary wildly from what workers in a retail or even corporate environment might desire, and vice versa - which is why you always need to start with the employees and work your way back to the benefits packages that meet their needs and exceed their expectations. Case in point: nonprofit employee benefits .

The main thing that our team of professionals has observed over the years is that, while a nonprofit may not be able to offer the highest salary to those that they employ, they do tend to offer more competitive benefits plans than their for-profit counterparts. It is more common than not to see small group nonprofits offering Platinum or Gold tiers as the base plans whereas many similarly sized corporations and LLCs are more likely to have their base plan set at the Silver or, occasionally, Gold tier. This is because employee benefits for nonprofits are not only a way to address the needs of workers - they are also a way to remain competitive as well. Workers with lower salaries, which can be customary for nonprofits, are comforted when they have better health coverage that keeps their out-of-pocket costs lower.

All in all, employee benefits for nonprofits are an important topic that requires you to keep a few key things in mind.

Are Employee Benefits Different For Nonprofits?

One of the biggest mistakes that a lot of people make involves assuming that nonprofits do not offer benefits at all. Many believe that these organizations instead rely exclusively on volunteers to help with their larger mission - people who are not getting anything in the way of compensation and who are instead only acting out of the kindness of their hearts.

Oftentimes, this is not the case, even though it may be true for some types of nonprofits. Instead, most have legitimate employees who receive not only traditional compensation but a full nonprofit employee benefits package as well.

The key difference between a nonprofit and a "traditional" business is that many that fall into the former category operate on an incredibly tight budget. Having said that, this does not mean that it is impossible for them to offer employee benefits - but rather, they often have to go about it in a slightly different way. Not only do a lot of nonprofits offer many of the same benefits that for-profit organizations do, but they are also often subject to the same types of rules and regulations governing them as well.

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Affordable Care Act (ACA) Compliance for Nonprofits

Concerning the Affordable Care Act (known as the ACA for short), understand that this legislation does not mandate that nonprofit organizations offer medical coverage to their employees provided that they employ fewer than 50 Full Time Equivalent (FTE) employees. If an employer does have 50 or more full-time equivalent employees , then they are known as an Applicable Large Employer (ALE), and they must offer medical coverage - nonprofit organizations are not an exception to this.

Of course, there are a few distinct advantages that nonprofits can unlock by going above and beyond when it comes to benefits. For example, say that a nonprofit organization has 25 or fewer full-time equivalent employees (with the average employee salary being about $56,000 per year or less), and is paying for at least 50% of the health insurance premiums of those individuals. In that case, the organization itself may qualify for a special type of small business healthcare tax credit if they get benefits through the state’s health benefits exchange (e.g. Covered CA for Small Business in the state of CA).

Non-profits must otherwise still adhere to many of the same healthcare compliance rules and regulations as their for-profit counterparts such as Federal COBRA administration, providing required ERISA notices and disclosures, Section 125 non-discrimination testing, and many others. Since non-profits do not always have the resources to hire someone solely to manage and administer benefits, it makes it even more important for them to work with a broker who can streamline administration and take a lot of this off their plate.

Employee Benefits for Nonprofit Organizations

By far, one of the most common types of employee benefits for nonprofit organizations takes the form of group health insurance . This can offer high-quality health insurance to employees at a far lower cost compared to if those employees went out and purchased their own individual plans.

Another common employee benefit that nonprofit organizations often embrace has to do with paid time off. Also referred to as PTO for short, paid time off gives someone compensation for not only personal time like vacations but sick days as well.

While it is true that PTO is not required under the Fair Labor Standards Act, it is still a good idea to help employees maintain their much-needed work/life balance.

As stated, these types of benefits are often a way for nonprofit organizations to remain competitive that go above and beyond simple base salary. If someone has a choice on their hands of working for a nonprofit that they passionately believe in versus a for-profit business that offers a very high salary, this in and of itself is a battle that the nonprofit is likely not going to win. But thankfully, people are willing to look beyond a straightforward salary and nonprofit leaders need to as well.

In addition to offering Platinum small group health plans , we at AEIS have also observed nonprofits offer a full complement of additional, quality benefits such as dental , vision , STD, LTD, and life plans as well.

If you would like to find out more information about the importance of nonprofit employee benefits and how they can help achieve success for your non-profit organization, or if you would just like to start the process of putting together your own benefits plans but do not know where to begin, please do not delay - contact the team at AEIS today.

About The Author:

Ronald L. Bland

President

What is Open Enrollment: Tips for Employers

Fri, 24 Mar 2023 16:05:00 GMT

For an employer, few things are as important as properly handling the open enrollment process when it comes to employee benefits and healthcare. But what is open enrollment, why is it important, and how do you make sure that everything goes off without a hitch? Thankfully, this isn't necessarily difficult, but it will require you to keep a number of important things in mind along the way.

What is Open Enrollment?

As the name suggests, open enrollment is the period of the year - typically during the fall - when employees enroll in health and ancillary insurance plans that will carry them through the next employer’s plan year or calendar year.

How Does Open Enrollment Work?

During the open enrollment period, a few key things will happen.

First, when offering group health insurance plans for your employees, as the employer you will work with your employee benefits broker to determine if any changes or modifications should be made to your company’s employee benefits plan to either make it more robust or to enact cost savings. Such as changing carriers , adding or removing medical plans, or adding or changing ancillary carriers or plans, such as dental, vision, group life, short or long term disability.

Once you have decided on your employee benefits package for the upcoming year, it is time to inform your employees about any changes they should be aware of for the coming year. There will likely be some kind of "all hands on deck" meeting communicating any changes in policies, at which point employees can enroll for the first time, waive coverage, change between plans, and add or remove eligible dependents.

How to Hold a Good Open Enrollment When Your Employees are in Different States

If employees are spread out across multiple states (as is getting increasingly common these days with hybrid working situations), all the best practices of open enrollment still apply - albeit on a much larger scale.

There should still be some type of "kickoff" event that will let people know what is happening and what their options are, only it should be held virtually, so everyone can attend. A benefit of virtual online enrollment meetings, whether the workforce is distributed or not, is that some video conferencing services allow you to record meetings so that the open enrollment presentation can be saved and reviewed by employees with their spouses at home or for future new hires to learn about the company's benefits. All ongoing communication needs to happen via multiple channels like email, text messaging, and even social media to keep everyone informed at all times. If you stick with print communication you run the risk of alienating anyone who isn't in the home office.

How Do I Make Open Enrollment Easier?

By far, one of the most important steps that you can take to make the open enrollment process easier involves embracing open communication as early as you can.

For many employees, one of the major hurdles of open enrollment has to do with the fact that it is A) too short, and often B) too late in the year. In an effort to help them make the most out of this period, be sure to communicate information as often as you can.

Make sure they know when open enrollment is. Make sure you're using not just printed materials to communicate but also email and even text messages as well. Another way to make communication of benefits easy for employees can be to have an online benefits enrollment platform like Ease or Rippling. Benefits enrollment applications themselves can be rather intimidating or exhausting to review, but having employees enroll into benefits using an online enrollment platform tends to be more straightforward and less daunting. In addition, most online enrollment platforms also house key information such as benefit plan details as well as required documents like "Summaries of Benefits and Coverage" (SBC's) or ERISA notices, all of which is then at the employee's fingertips as they make their benefits elections.

All of this will go a long way towards keeping people in the loop during open enrollment, which in turn will help them make the best decisions possible given their situation.

Along the same lines, another way to make the open enrollment process easier is to take a proactive approach to it in terms of education. Another major pain point that a lot of people have comes down to the fact that open enrollment (and often healthcare in general) are too confusing. Between HMOs, PPOs, and EPOs, and various tiered plans, a lot of people aren't sure what the differences are and which would best fit their own needs.

Therefore, make sure that your human resources department (or someone else within your organization) and benefit advisors are available to act as a trusted resource to answer any questions or address any concerns that people might have. The more they understand open enrollment, the more likely they are to embrace the entire process.

Again, this level of education and support must be extended to special circumstances, too. Many people assume that once the open enrollment window closes, they're unable to make any change to their healthcare-related decisions they've made for another year. That isn't necessarily the case. Special situations, known as a Qualifying Life Event (QLE), like the birth of a child, a spouse who has lost their healthcare, starting a new job, marriage or divorce, and more all allow people to make changes throughout the year within 30 days of that QLE. You need to make sure that employees are aware of this and that you help them make the most out of these special circumstances if they do occur.

Finally, many people feel that the open enrollment process is just too impersonal. Fixing this issue is another way that you can help things go as smoothly as possible. You should encourage people to reflect on their own situation on a case-by-case basis because everyone is different. If your employees have questions or concerns about what plans to pick based on health history or chronic conditions of them or their dependents, have them speak with your benefits advisor/broker team so they can assist the employees without exposing you or anyone in your organization to protected health information of fellow employees and their family. There is no "one size fits all" approach to the open enrollment process and treating things like there is only leads to potentially significant issues down the road.

In the end, open enrollment is one of the most important periods in any business' year - both in terms of leveraging an opportunity to increase employee engagement and with regard to making sure those employees are taken care of. Another way to help make sure things go as smoothly as possible involves contacting the team at AEIS at your convenience.

At AEIS, we have years of experience helping organizations all across California (including the San Francisco Bay Area) with employees nationwide address these and other benefits-related needs. We're prepared to support you through the entire open enrollment process, making sure that you're able to enjoy all the benefits of it with as few of the potential downsides as possible.

If you'd like to find out more information about open enrollment tips for employers, or if you know that this is something you need to address in the near future but aren't sure where to begin, please don't delay - contact the team at AEIS today .

What is a Distributed Workforce & How To Create Compelling Benefits

Fri, 10 Mar 2023 20:35:43 GMT

At AEIS, we understand that the way we think about work is changing significantly and distributed workforces are a big part of that. Guaranteeing the success of your own remote/distributed work program often requires you to prioritize compelling benefits and to keep a few key things in mind along the way.

What is a Distributed Workforce?

A distributed workforce, as the term suggests, involves a team of employees who don't operate within the traditional office environment of a business. This type of remote working situation became very popular at the onset of the COVID-19 pandemic, but many organizations continue to embrace it because of the wide range of different benefits it brings with it.

What’s the Value of a Distributed Workforce?

When employees have the freedom and flexibility to work ow they want, where they want, on their own schedule, the most immediate impact has to do with an improvement of their own sense of satisfaction. People who get to enjoy these benefits tend to be more productive than others, which goes a long way towards improving the quality of work that they're able to do as well.

This also tends to have a major, positive impact on a business' ability to retain top employees , too. When people are already satisfied with their existing job, they're less likely to look elsewhere in the first place. Likewise, they may not be able to find a new job that offers the same level of flexibility as their current one - even if it does offer a higher salary - allowing this f reedom to become a major competitive advantage for employers, too.

A distributed workforce is also significantly more cost-effective to maintain for organizational leaders. Some businesses have chosen to forgo a physical location at all to go 100% remote. Others do have a physical space, but it is far smaller than it otherwise would be if countless employees were coming into the office five days a week. The money saved on things like rent and energy bills alone can then be funneled back into other areas of the organization where it can do the most good. It could even be used to purchase laptop computers and other tech-driven resources that employees need to thrive.

Embracing a distributed workforce also allows a business to potentially hire top tier candidates for available positions from nearly anywhere. They aren't limited to a specific geographic region, and they don't need to then pay for costs associated with relocation and more. If the right person for the job is halfway across the state (or even the country), it doesn't matter - they can easily be brought into the fold and can still meaningfully contribute to the greater good.

In general, the major benefit of creating a distributed workforce can be summed up by way of the increased work/life balance that employees can enjoy. It is for reasons like these that a significant number of workers still say that they're functioning remotely for at least one day a week despite the fact that the COVID-19 pandemic seems to be winding down, and most restrictions have long since been lifted.

Everyone always knew that this type of remote work and the idea of a distributed workforce was on the horizon, it’s just that the horizon turned out to look significantly closer than most thought in the wake of the pandemic. Still, most people have gotten a taste of just what a distributed workforce can do, and it is very likely that anyone will be able to go back to the way things were - not that they would want to.

Tips for Creating Benefits for a Distributed Workforce

All told, a distributed workforce can and should become an essential part of the overall benefits package that you offer to employees. While you do so, you’ll have to make a number of important considerations like how you must not forget that employees who live out of state will now need PPO plans for medical insurance, along with any dental and vision coverage that you offer. HMO plans (with Kaiser being one of the prime examples) will usually only be viable for in-state employees. Even for statewide HMOs like Kaiser, there may even be remote areas in a state (like California, for example) that are outside of their service areas. Some HMOs may even only consist of just a few counties.

It is always critical to make sure that any PPO plan you select has a solid national network of providers so that remote employees in other states have access to quality coverage. These are a few of the benefits items that you should consider, which is why it is also always important to talk to professionals like the team at AEIS to make sure that all of your bases are covered.

In a larger sense, the major factor to account for when creating a distributed workforce has to do with the creation of rules regarding flexible working hours. Since people are no longer commuting into the office, they actually likely do have more hours in a day to get important work done. They also want to hold onto that well-earned freedom, so try to strike a balance.

Along the same lines, a distributed workforce will require various communications channels to be employed so that managers can keep in touch with the remote employees. Regular meetings to check in on progress should be encouraged at least a few times a week, for example, as should the use of various tools like Slack and Discord. Just because employees are fully or even mostly remote doesn't mean that some type of oversight still isn't necessary.

Another one of the benefits that you might consider for a distributed workforce has to do with remote work allowances. Obviously, the remote employees will be relying heavily on their own computers and Internet connections, which they pay for. After figuring out just how much money you're saving because you no longer need to pay for a larger office, consider funneling some of that money back towards the employees themselves to help get the ideal remote work setup off the ground.

Many organizations also prioritize health and wellness programs as a benefit for their distributed workforce. This makes sense from a few different angles. For starters, healthier employees tend to be more productive on average and do higher quality work. Secondly, when an employer goes out of their way to communicate that they value an employee's health, people tend to notice that. This again helps create a much-needed sense of community and culture even though people are spread out over a larger area.

Finally, it's important to prioritize things like employee development opportunities within the context of a distributed workforce. Remember that in addition to being able to hire people from virtually anywhere, employees can advance within the company with no geographic restrictions as well. This dramatically increases the number of opportunities for their own career advancement within the company, provided that those opportunities exist in the first place.

If you'd like to find out more information about how to create compelling benefits for a distributed workforce, or if you'd just like to talk about your own benefits needs in more detail, p lease contact AEIS today .

Mental Health Benefits for Employees

Mon, 16 Jan 2023 20:01:02 GMT

Protecting Your Workforce, Protecting Your Business

One of the most important things to understand about your employees is that they are ultimately an investment - one that will help secure the future success of your organization. That investment needs to be protected and when it comes to employee benefits like healthcare , you need to go beyond the idea that physical health is the beginning and end of the story.

Especially given everything going on in the world right now, mental health benefits are equally important. This is true for a wide range of different reasons, all of which are worth exploring.

The Importance of Mental Healthcare in the Workplace

Most people find their jobs to be stressful by their very nature. Having said that, with the onset of the COVID-19 pandemic in 2020, there was a significant increase in the number of employees who suffered from depression on average.

People who suffer from mental health-related issues like depression tend to be more distracted than others. The quality of their work goes down and they become less productive in general. They take more sick days, which ends up costing a business money - not to mention the potential reputational damage that can be caused if work output for clients declines.

This is why a focus on mental health benefits for your employees is so critical. Even going beyond the fact that treating people with care and showing them that you value their mental health is the right thing to do ethically, offering these types of comprehensive services can go a long way towards making sure that they're able to function at their best at the exact same time. If you are a small group employer, not all health plans offer comprehensive services or include the services below, and some standalone options are only available for large groups. This is why having a benefits broker, like AEIS, that has already done research on this topic is so important. They can help guide your company and find the solutions that fit the needs of your specific employees the best.

Types of Mental Healthcare Benefits

Overall, there are a few different types of mental healthcare benefits that businesses can choose to offer to their workers depending on the situation. Many of them are focused on not only helping people to deal with the existing issues that they may have, but to also develop the types of coping skills necessary to prevent new ones from developing and moving forward. These types of mental healthcare benefits include, but are certainly not limited to, the following.

Counseling Services

Counseling services, as the term implies, are very similar to traditional therapy. It's a collaborative form of mental health treatment where an employee has the chance to sit down with a trained professional who is equal parts caring and neutral. Not only will they have the time to work out any issues that develop in the workplace, but also those that impact their productivity as well - like issues stemming from their relationships or other areas in their personal lives. Employers can sometimes work with a third party to offer limited counseling services to employees after a communal event that affects their employees’ mental health, such as layoffs or a coworker’s passing.

Stress Management Services

Again, most employees consider their jobs to be a fairly consistent source of stress. The more they're able to deal with these stressors, the less likely they are to develop issues like anxiety that will ultimately negatively impact the quality of their work and their overall wellbeing.

Stress Management Services can include things like the following:

Acupuncture, which can relieve both physical and mental stress depending on the context
Mindfulness-based stress reduction techniques that people can use to relieve stress in the moment
Problem-solving therapy, which can be useful both on the job and in their personal lives.
Cognitive Behavioral Therapy
Psychotherapy, which many people also refer to by terms like talk therapy
Meditation Apps
And more

These are just a few examples of the types of Stress Management Services that are available. Offering a wide variety of different Stress Management Services to employees allows people to choose the ones that work best for them and that can help address whatever it is they are trying to deal with in their lives.

Virtual Services

With Covid-19, we have seen an increase in the number of people using telehealth for mental health issues, including depression or anxiety. According to KFF , before Covid-19, telehealth represented less than 1% of therapy visits, now it represents 36% of outpatient visits for mental health and substance abuse treatment. Virtual services can be embedded in an employee’s medical insurance or employers can add standalone options for their employees. Additionally, virtual services can be more cost effective for employees and they can usually set an appointment within weeks, versus in-person service, which can have a waitlist of months.

Employee Assistance Programs (EAPs)

EAPs, otherwise known as Employee Assistance Programs, can be a great way to help employees deal with the issues they may be facing at little or not cost to them. It's very similar to the types of Stress Management Services outlined above, but it provides a comprehensive array of treatment options that people can embrace should they believe that this will help them in both their personal and professional lives.

However, it's pivotal to communicate the fact that these types of programs are available at all. Many employees may not even be aware that EAPs exist or that they have access to them, thus causing them to fail to take advantage of what could be a legitimate resource to help them improve their lives moving forward. Should you choose to offer EAPs for your business, make sure that all employees know why they're important, what they offer, and how they can best take advantage of them.

Benefits for Employers and Employees Alike

By far, the biggest reason why employers should offer these types of mental health benefits to employees comes down to the fact that it's the right thing to do. Whenever possible, we should all do our part to help our colleagues. Having said that, happier and healthier employees tend to be far more productive on average - which increases the quality of the work they're able to accomplish and ultimately improves the core foundation of the business at the same time.

Not only that, but when employees understand that their employers value their mental health every bit as much as they do, they tend to be more invested in the environment. Company culture improves in a way that motivates everyone to "give their all" to the proceedings. The more work you put into your employees, the more work they're willing to put back into the business and accomplishing your goals - which in and of itself is the most important benefit of all.

So if you'd like to learn more about the major advantages of mental health services and what they can potentially bring to your business, or if you're interested in talking to a professional about these and related matters in a bit more detail, please don't hesitate to contact the team at AEIS today .

Employee Benefits Trends To Pay Attention To

Thu, 22 Dec 2022 19:39:48 GMT

At AEIS, Inc., we believe that offering a comprehensive, high quality benefits package to your employees is not always a requirement but is highly recommended and has become an industry standard. Yet at the same time, what employees value in such a package is changing all the time. It's not up to you to offer a "one size fits all" package that you hope they will embrace. You need to work to understand what they want and what they need, doing what you can to provide them a benefits package in the most effective way possible.

With that in mind , there are a number of important employee benefits trends taking place as we speak that you need to be aware of moving forward, all so that you can make the best decisions possible when it comes to what you're offering to your workforce.

Increasing Healthcare Costs

One of the biggest trends that deserves to be paid attention to involves the rising cost of healthcare . Thanks in large part to the onset of the still-ongoing COVID-19 pandemic, people are paying more attention to their health than ever before. Healthcare costs have risen greatly in the last couple of years due to a mix of inflation, population growth and aging, increased utilization and many more factors. This means employees are looking more and more at their employer to help pick up some of the expenses.

It's true - one recent study indicated that over 60% of people say that their health is far more important to them today than it was prior to the pandemic. If employees are placing a bigger emphasis on their health, that means that you should, too. If they're concerned about how they're going to pay for the healthcare they need, the benefits package that you offer should be able to provide as much assistance as possible to guarantee that they're able to do precisely that.

Employee Mental Health Considerations

At the same time, it is important to not underestimate the importance that mental health coverage has on the overall quality of a benefits package.

This, too, is inspired in large part by the COVID-19 pandemic. Seemingly overnight, many employees found themselves working from home with absolutely no idea when they'd be able to return to the office. They're feeling alone and isolated and collectively, their mental health is suffering as a result. This is especially true among the younger generations of workers, among whom roughly 50% sought support for mental health struggles at some point in the last year.

In virtually every industry that you can name, employees are feeling overwhelmed. They're depressed. They're burned out. The list goes on and on. That's why offering mental health support as part of a benefits package is key - it helps to combat a lot of these issues head-on.

The happier and healthier your employees are, the better positioned they'll be to do excellent work on behalf of your business. Caring about your employee’s mental health as much as they do is the right thing to do, but it is also an investment that will have an almost instant positive impact on your business as a whole.

Increasing Employee Voluntary Benefits

Just how important are employee voluntary benefits to the ongoing success of a business? In a word, "very."

According to another recent study , approximately three out of every four employees say that they carefully consider voluntary benefits when deciding not just to work for a new employer, but to stay with the one that they're already with.

So not only can the right employee voluntary benefits significantly help your efforts to attract top talent, but it can also help retain your existing talent as well. But at the same time, it's true that not all workforces are created equally - meaning that it's always recommended to have an advisor by your side who can create a package that is custom-built for your organization and its employees from the ground up and recommend the voluntary benefits that your workforce might be the most likely to elect.

Expanding Paid Leave Policies

Finally, one of the biggest employee benefits trends that you need to pay attention to has to do with an overarching expansion of paid leave policies.

As previously mentioned, over the last few years people have placed a higher priority on their health than ever before. They want to go to the doctor to make sure they're okay. They want to seek mental health treatment should it be deemed necessary. They want to have the flexibility in their schedule to take a day off if it means they'll be able to recharge and come back all the better for it.

Employee benefits packages need to adapt in order to provide this. Currently, it is estimated that half of workers in the United States do not have access to paid leave time at all. Those who do find their options woefully inadequate. By offering compensation for these needs, you can do a large part to help provide your workers with the care they deserve - all while differentiating yourself from your competitors at the exact same time.

At AEIS, Inc., we've been in the business of helping organizations like yours handle all of their employee benefits needs for many years - all with the name of allowing you to use that benefits package as a way to both attract and retain top talent.

Studies have shown that even more so than pay, potential employees look to benefit packages to decide who they want to work for. With the right benefits advisor by your side, you can make sure that yours is the most attractive package out there - all to guarantee that you have the right people to fill the right positions at exactly the right time, all while reducing employee churn along the way.

If you'd like to find out more information about the employee benefits trends that you should be paying attention to, or if you just want to discuss your own business and your vision for how it operates with someone in a bit more specificity, please don't hesitate to contact the team at AEIS today.

Reasons to Switch Group Health Insurance Plans

Mon, 05 Dec 2022 21:51:16 GMT

At AEIS, we believe that group health insurance plans are one of the best ways to not only attract higher quality applicants to available positions for your business, but to retain them for the long-term as well. This is true for a variety of different reasons, all of which are certainly worth a closer look.

What is a Group Health Insurance Plan?

At their core, group health insurance plans are exactly what they sound like - plans that are offered to a collective of employees on behalf of a business . This is a single plan that provides coverage to all of (or at least most) employees in an equal manner. The major perk is that employees don't have to worry about finding their own individual plans because their employer is providing them one that they are (in theory) satisfied with.

These types of plans are typically paid for every month. The total amount that you and your employees will pay in premiums will depend on a range of different factors, including but not limited to the number of people who are involved in the group, their respective ages, the area of the country that you live in, and the amount of coverage the plan(s) provides.

Note that while an employer is not legally obligated to pay 100% of the premiums for any group health insurance plans that are offered to employees(there is a minimum amount employers must contribute though), everything that employees pay is fully tax-deductible as per the Internal Revenue Service as long as your company has a Section 125 Premium Only Pop (POP) plan in place.

Are You Legally Required to Provide Health Insurance for Employees?

While not all types of businesses are legally required to offer health insurance for employees, many of them are. This is true if you have more than 50 Full Time Equivalent (FTE) employees, known as an Applicable Large Employer (ALE). If this is true in your situation, you will need to make sure that affordable coverage is being offered to at least 95% of your full-time workers.

For the purposes of this discussion, understand that a "full-time employee" is currently defined as someone who works more than 30 hours per week and is W2 Employee, not a 1099.

In the event that you do not meet this threshold, it's still a good idea to offer benefits to employees . A happier and healthier workforce is a more engaged workforce - which will only improve the quality of the work they're able to do, which in turn improves the reputation of your business as well.

5 Things To Do Before Changing Health Insurance Plans

By far, the most important step to take before changing health insurance plans involves opening an ongoing communication channel with employees that will be utilized moving forward. Don't forget that this is a potentially significant change in your employee's lives. You need to let them know what is happening, why you're considering this type of change, and how they can stay involved in the process moving forward.

Similarly, another thing to do before changing plans involves soliciting the feedback of as many employees as you can. Group health insurance plans need to adequately cater to as many people as possible and to get to that point, you need to know what their needs actually are. In addition to asking for this feedback yourself, you can also enlist the help of a benefits broker like the team at AEIS to take care of this step on your behalf.

Next, you'll want to make sure that you understand the various types of group health insurance plans that are available and how each one might fit in with your larger benefits strategy. A PPO or Preferred Provider Organization, for example, is seen as a "lenient" type of plan because referrals are not mandatory and the plan itself often pays for at least a portion of any out-of-network service. An HMO or Health Maintenance Organization has lower monthly premiums, but referrals for any special services are required and there is no out-of-network coverage. Each type of plan has its own pros and cons, so you need to consider them carefully before making a decision one way or the other. Depending on the size of your company, employers can opt to offer both types of plans for their employees to choose from. Also, which carrier(s) you chose for your employee benefits plan depend on many factors. Health insurance carriers share many similarities between them all, but each have their own pros and cons and specialties, and different hidden benefits.

Another important factor to consider when changing health insurance plans, is which states do your employees currently reside in? During Covid-19, many employers moved to a work from home model and now have a distributed workforce throughout the US. Do you have employees that live in a state that has specific compliance laws and regulations employers need to follow, such as paid disability leave, also known as PDL, and/or paid family medical leave, also known as PFML. Additionally, certain carriers have better out-of-state networks than others, so where your employees reside can be an important factor in which insurance carrier you choose.

It's equally important to consider what you will pay when it comes to offering these types of group health insurance plans so that you can make more informed decisions in the future. According to one recent study, employers pay about $5,700 on average per employee for single coverage plans. For plans that cover an employee's entire family, that number is increased to an average of $14,000 per year. You need to know how much this will ultimately cost, so you know how much to attempt to share with your employees.

Finally, you need to consider the income tax implications. Again, monthly premiums for these types of plans will be fully deductible at both the state and federal levels. Likewise, if you have a group health plan through a Small Business Health Options Program (SHOP) plan such as Covered CA for Small Business, then up to 50% of healthcare expenses can be claimed as a credit under the Small Business Healthcare Tax Credit if you have A) less than 25 full-time employees, if B) the average employee makes $50,000 or less annually, and if C) your business is covering at least 50% of their monthly premiums. This can certainly help you decide which type of plan to go with.

In the end, it's important to remember that an employer has a certain obligation to take care of its workers. Not only does doing so help create more engaged employees, but it's also an opportunity to stand out in an incredibly crowded marketplace. The quality of your group health insurance plans can be a way to both attract and retain top talent - people are more likely to join your team if they have multiple offers and are less likely to look anywhere else for employment. When you also consider the higher productivity and quality that they are known for, you're looking at a perfect storm of advantages in the best possible way.

If you'd like to find out more information about the myriad of different reasons why your organization should consider switching to a group health insurance plan , or if you just want to discuss this or other essential topics with someone in a more specific way, please don't hesitate to contact the team at AEIS today.

Mployer Advisor Names Advanced Estate & Insurance Services, Inc. a Winner of ‘Top Employee Benefits Consultant Award’ for 2022

Tue, 22 Nov 2022 14:37:32 GMT

We’re thrilled to report that Advanced Estate & Insurance Services, Inc has been named a 2022 “Top Employee Benefits Consultant” by Mployer Advisor! We are honored to have been named a 2022 Top Employee Benefits Consultant , and we are thrilled to share this incredible news with you.

Thank you to each valued client for your continued loyalty and trust; we are grateful for your business and proud to be your partner.

San Mateo, CA – November 2022 – Mployer Advisor , the leading independent platform for employers to research, review, and evaluate insurance advisors has named Advanced Estate & Insurance Services, Inc. a winner of its second annual “Top Employee Benefits Consultant Awards” for 2022. Mployer Advisor’s Top Employee Benefits Consultant Award Program evaluates brokers based on breadth and depth of experience across employer industries, sizes, insurance products, and employer reviews. We recognize esteemed brokers that demonstrate market-leading competencies and a proven track record of success among employers, insurance providers, and peers.

“The team at Mployer Advisor is proud to honor this group of top insurance consultants as part of the 2022 class for our second annual Top Employee Benefits Consultant Awards,” said Brian Freeman, the Founder and CEO of Mployer Advisor. “Employer-sponsored healthcare and benefits cover over 150M+ Americans. Who an employer selects as their benefits advisor has more impact on cost and quality than who they choose as the insurance carrier. We scored these brokerages utilizing sophisticated, industry-first algorithms, and we applaud the winners’ demonstrated commitment to service, quality, and positive employer feedback.”

"I am very honored to receive this industry recognition. We strive to provide customized and strategic benefit plans, personalized to each employer partner, with the highest customer satisfaction," comments Ronald Bland, President at AEIS, Inc.. "Our team serves over 550 organizations in the San Francisco Bay Area and Silicon Valley region.”, Ronald Bland continued.

Mployer Advisor determined the winners of the second annual “Top Employee Benefits Consultant Award” by analyzing each brokerage based on historical data, online reviews, their M Score rating , and demonstrated business experience.

To view a complete list of the 2022 recipients of Mployer Advisor’s “Top Employee Benefits Consult Award,” visit MployerAdvisor.com .

To view Advanced Estate & Insurance Services’ profile on Mployer Advisor, visit https://mployeradvisor.com/insurance-brokers/california/san-mateo/advanced-estate-insurance-services-aeis-inc

Advanced Estate & Insurance Services

Advanced Estate & Insurance Services Inc. (AEIS, Inc.) is an employee benefits brokerage firm. We are located in the San Francisco Bay Area and partner with employers throughout California. We advise businesses with 2 to 500 employees on various types of insurance, which includes Medical, Vision, Dental, Disability, Life / AD&D, and Key Person and Buy-Sell Life Insurance. With over 35 years of expertise, we are prepared for the needs of every industry and ready to support your growth at any stage. Our holistic process is aimed to help your company navigate change. AEIS, Inc. is more than simply an insurance brokerage - it is having an insurance strategist, advocate, and advisor set on helping you and your company thrive.

Contact Details: team@aeisadvisors.com

Disclaimer: Rankings are dynamic, and this report may not reflect the rankings currently listed on Mployer Advisor’s website. Because Mployer Advisor’s research is ongoing, interested companies that want to join next year’s list are encouraged to claim their free profile on Mployer Advisor.

Attention Plan Fiduciaries: Don’t Neglect Your Recordkeeping Responsibilities!

Thu, 08 Sep 2022 14:22:37 GMT

Who is a Fiduciary?

A fiduciary is someone who looks after another person's assets or money. When someone names you as a fiduciary, you are obligated by law to handle their assets for their benefit, not your own.

Offering a robust group health plan is one way in which employers can help to recruit and retain your employees and that is essential in the current climate. While the initial implementation of a group health plan can be straightforward when you have someone like an experienced insurance broker to walk you through the process, there is a lot to maintain on an ongoing basis.

A very important part of the health plan itself is the plan fiduciary. All plans are required to have a fiduciary. The fiduciary acts in the best interest of the plan and the beneficiaries of the plan with the exclusive purpose of providing benefits to them. The responsibilities of the fiduciary may include day to day administration of the plan, following the plan documents (unless inconsistent with ERISA), paying only reasonable plan expenses, recordkeeping, submission of required forms and reporting to government agencies.

The ERISA statute of limitations is 6 years, so it is recommended that employers maintain records for the previous 7 years.

The records should include the following for fully insured plans:

Payroll records showing employee premium deductions
Insurance billing statements showing a detailed summary of the premiums and what they are for
Summary Plan Description
A sample packet of all documents given at open enrollment and to new hires for each plan year
This would include the enrollment /termination/change forms
Summary of Benefits and Coverage (SBCs)
Annual Notices Packet
Marketplace Exchange Notice
Any Summary of Material Modifications (SMM)
Form 5500 and Summary Annual Report (SAR) if applicable
All enrollment and termination forms completed by employees and beneficiaries
Communications with employees with regards to the plan including rate information
Record the dates that materials were given to employees at open enrollment, the dates open enrollment was held
Record the dates that enrollment materials were given to each new hire, and the date the completed forms were returned

If an employer has a grandfathered plan, and wishes to maintain their grandfathered status they will need to maintain these same records stated above from March 23, 2010 moving forward, and also need to include the following:

Premium percentage contribution showing employer and employee contributions for each plan year
Plan summary showing the benefits for each year
SBCs were not used until 2012, so the employer would need a simple benefit summary or Evidence of Coverage for 2010 and 2011.
Enrollment census from March 23, 2010, showing at least one person enrolled in the plan
Show evidence of the grandfathered model notice being distributed to participants and beneficiaries

Primary Responsibilities of the Plan Fiduciary

A key responsibility of the plan fiduciary is making sure that the plan offered is in the best interest of the plan beneficiaries, which includes how it impacts their pocketbooks. A fiduciary is required to do their due diligence and make sure that plan assets are being spent responsibly and that the plan is not paying unreasonable fees.

To show that the fiduciary is completing this part of their responsibilities, records need to show the following:

Plan renewals and marketing of alternate plan options for each plan year
Notes regarding the renewal process and what led to the final plan decisions for each plan year
Signed Broker Compensation Disclosure Agreement
This is required for all new contracts dated after December 27, 2021 when this part of the Consolidated Appropriation Act (CAA) was implemented
Please note that while this comes from your broker, it is actually the fiduciary’s responsibility to have and keep on file as part of the due diligence process. A fiduciary who fails to produce it during a plan audit by the DOL or EBSA could face penalties

While this list of records may seem lengthy, the key to managing it is to do it as you go. Don’t put it off and try to compile it afterwards. Create a system and stick to it. There is nothing worse than getting an audit letter from the Department of Labor, Employee Benefits Securities Administration, or the Internal Revenue Service and having to scramble trying to find documents and records that they are asking for before the submission deadline.

The list of documents included in this article is not exhaustive and this article is not intended to be taken as legal advice.

If you have received an audit letter from one of the Agencies, contact your counsel for guidance.

What Is the Importance of Benefits on Employee Retention and Attraction?

Mon, 29 Aug 2022 19:18:54 GMT

When running a business — whether small, medium, or large — there is always a battle to find and keep the best people in any number of positions. A company is only as strong as its workforce, and with competitive offers, a dynamic economy, and ever-shifting industries, holding onto the best employees is a struggle.

The best way to attract and retain great workers is to find out what they care about the most and provide it. Many employers realize that benefits are tied to these desires, but they often have only a loose grasp of what matters the most and how to reasonably provide it to their workers.

You can overcome all of this by taking a few minutes to learn more about benefits, what employees really think about them, and how to manage them. You might find that this is an easier hurdle to overcome than you originally thought. This can become a source of success for your company instead of an obstacle.

Why Is It Important for Businesses to Offer Benefits?

It’s easy to assume that benefits are important to business leaders and employees alike, but you don’t have to rely on assumptions. Strong empirical data exists, and many experts have taken long, hard looks at benefits. You can learn from their discoveries.

Take this Harvard Business Review analysis. According to their research, 80 percent of workers prefer additional benefits over a flat pay raise.

Now, that preference will depend on current income, but it’s clear that benefits weigh heavily on the minds of employees .

If you want to minimize worker turnover, and the costs associated with that turnover, then a focus on benefits can improve retention. Simultaneously, improved benefits can bolster efforts to attract new team members and keep your company competitive in the hiring market.

Which Benefits Are the Most Attractive?

Of course, it’s one thing to say that benefits are important and another to identify which benefits matter the most . Sticking with Harvard Business Review data, there is a clear winner in this category.

Employees care about healthcare benefits more than anything else. Health insurance , dental, and vision are the top concerns across every benefits survey. Robust health coverage will do wonders for employee retention and attraction.

Outside of health coverage , top benefits include life insurance, disability insurance, flexible hours, additional vacation, work from home, and tuition/student loan assistance.

To put it simply, employees want benefits that clearly impact daily life.

What Are the Best Ways to Explore Benefits?

You’ve established that benefits are important, and you have an idea of which ones matter the most to employees. That’s a great start, but the work only really begins here. How do you actually explore benefits? How do you know which insurance plans are best for your employees? From there, how do you negotiate contracts, build up enrollment, and otherwise execute your plans?

For starters, you can find out what your employees want by asking them. A simple employee survey or questionnaire can see what matters to them most, and you can strategize your benefits packages around those responses.

When it comes to comparing, negotiating, and executing benefits packages, the easiest solution is to get expert help. You can work with a benefits advisor to quickly and deftly browse a number of custom benefits packages. When you select the package, the same advisor can help you deploy the package, push enrollment and educate your employees, and ensure that everything works properly.

What Should I Expect From a Benefits Advisor or Broker?

If you have never worked with a benefits advisor/broker before, then you are essentially walking into the unknown. What should you expect from your advisor? How can you gauge the quality of one broker against another?

The first step is understanding key advisory services. A benefits advisor/broker isn’t just making suggestions. They are providing resources that assist in the entire benefits research and deployment process. Look at this list of services to get an idea:

Advising and negotiation services
Compliance and risk assessments
Administration support
Business administration technology partnerships
HR consulting partnerships
Professional employer organizations (PEOs) partnerships

Some of those services were probably within your expectations, but others likely extend beyond what you thought an advisor role might cover. A benefits broker aids with enrollment, and finding benefit admin tools, vendors, and other technology resources that help you manage your benefits moving forward.

Advisors should offer robust services, and when you gauge them by what they can do, it will help you discern which advisors will best partner with your business.

If you focus on benefits packages that are built around employee requests and a motive of retention and attraction, you will find the right options. Centering your search this way can help you land a great benefits advisor, and together, you can build up this part of your company culture to improve employee satisfaction and make a better workplace overall. Contact AEIS today, and we can show you how it all works.

Employee Benefits Every Startup Should Offer

Tue, 09 Aug 2022 13:50:21 GMT

Written by: AEIS

Startup companies often have to be strategic about the benefits they offer. As a new company, you can choose to make a strong statement early on by flashing an impressive benefits package to attract quality talent.

There's no one-size-fits-all solution to employee benefits for startups, so you should put a lot of thought into what options work best for your business and employees, so you can keep enrollment high and your employees happy.

Many top employees tend to be nervous about leaving a "more secure" job to pursue a startup company. Offering non-traditional benefits and perks like remote working stipends, gym memberships, and stock options may be more affordable and simpler, but trying to pull the brightest stars from top companies will require a robust traditional benefits package. These employees are accustomed to things like premium health care plans, life insurance, dental insurance, vision insurance, and health savings account options.

Benefits can be seen as just another cost of running a business if you want to succeed. This doesn't mean you should overspend and put yourself in a bad position. Starting with these options below will leave you in a great position right out the gate, and we'll tell you more about what you need to know to get there.

When you're running a startup, literally every dollar needs to stretch as far as it can go. That's why startup benefits are so important - they help attract and retain the type of talent that will allow you to do more with less on a daily basis.

Importance of Employee Benefits for Startups

The number one reason why small business benefits are so important is because, as mentioned, they allow you to attract and retain top talent. This is especially key in a competitive market where people might be able to offer a higher salary that you can't match.

Startup employee benefits also help with employee retention by directly addressing employee satisfaction. All of this helps to enhance employee productivity, which is again how you remain as competitive as possible.

Types of Employee Benefits for Startups to Offer

Just a few of the types of small business benefits that startups can offer include ones like the following.

Health Insurance

Offering health insurance is one of the most impactful benefits a startup can provide. Even if you're working with a limited budget, there are flexible options available. Employers can choose different contribution structures and tiers of coverage based on workforce needs.

For cost-conscious startups, High Deductible Health Plans (HDHPs) paired with Health Savings Accounts (HSAs) can be a smart option. HDHPs generally have lower monthly premiums, making them more affordable for both employers and employees. When paired with an HSA, employees can set aside pre-tax dollars for out-of-pocket medical expenses, reducing their taxable income. Employers can also contribute to these accounts, further enhancing the value of the benefit. Unlike Flexible Spending Accounts (FSAs), HSA funds roll over each year and grow tax-free.

Dental and Vision Insurance

Here, group benefits will be particularly important. Most individual dental plans include wait periods and costly exclusions for services your employees need. By providing group coverage you can often mitigate these drawbacks from your plan.

Life and Disability Insurance

Life & Disability benefits help ensure financial security for your employees and their families in the event that they have an untimely death or are unable to work due to an illness or injury. These types of coverage aren’t always available from the get-go, but providing them once you can goes a long way to show employees that you as an employer want to protect their income.

Retirement Plans

California employers with five or more employees must either offer a qualified retirement plan, such as a 401(k) or register with CalSavers, the state-run retirement program. This requirement will expand to businesses with just one employee by December 31, 2025.

Extra Benefits You Can Offer

There are emerging benefits to offer employees that can enhance employee morale while reducing indirect costs. These include:

Remote Work or Flexible Hours
Bonuses
Company Retreats
Mental Health Support
Travel Reimbursement
Childcare Assistance
Student Loan Assistance
Wellness Subscriptions or other Discounts
Recognition and Rewards Programs

Compliance Requirements for Startups in California

In addition to workers' compensation insurance, all employers in California - including startups - need to provide eligible employees with at least five days of paid sick leave per year. They'll also need to provide family and medical leave under the CFRA.

Customizing Benefits to Fit Your Startup's Needs

To customize benefits to fit your startup's needs, you'll first want to understand employee preferences. Don't be afraid to give out polls and solicit feedback regarding what people actually want.

You'll want to set a strict budget for benefits and stick to it. You'll also want to choose scalable solutions that will grow as your business does the same.

Get Help From A Trusted Insurance Broker

To find out more information about small business and startup business benefits to offer, or to get answers to any other important questions that you might have, please don't hesitate to contact the team at AEIS today .

Is Vision Insurance Worth It?

Mon, 01 Aug 2022 11:00:03 GMT

A Guide for Employers

Did you know that more than 6 out of 10 U.S. adults wear either contacts, glasses, or both? It makes sense that employees report that either vision or dental insurance is the third most important benefit to them, and it weighs heavily on their decision about which company to commit to when job-hunting. In fact, vision and dental benefits, when ranked by employees, fall only behind standard health insurance and retirement plans.

Dental insurance can be both a powerful tool to attract top talent and keep your best employees onboard. If your human resources department is considering adding vision insurance to your benefits offerings, read on to learn more.

Reasons Why Employers Struggle Offering Vision:

General medical health insurance will compensate insured parties for costs related to many eye diseases or unexpected accidents. Health insurance will not, however, cover costs associated with general eye care. Maintenance costs that aren’t covered by health insurance include annual eye exams, contacts, or glasses. Comprehensive eye exams are required for all eyeglass or contacts wearers in order to renew or update their prescriptions. And even those who don’t have a current prescription should still periodically have a check-up.

Almost all very large companies (with 1,000 employees or more) offer vision insurance. Many smaller employers, on the other hand, struggle to see a return on investment in offering the benefit, and shy away from providing vision insurance. Even under the Affordable Care Act, employers are not mandated to provide vision (or dental) insurance for adults. But just because firms aren’t legally required the benefit doesn’t mean it doesn’t benefit them to have it available.

Do You Need to Offer Vision Insurance?

Employees Appreciate and Use the Benefit:

According to a study published in 2019 by the Employee Benefit Research Institute, almost three quarters of all companies offered vision insurance to their employees. The study reported that when they were offered, employees utilized the vision benefits substantially. In fact, 73 percent of employees were found to have participated in the vision plan. While it’s less than the participation rate for general medical insurance, these numbers show that employees want and need vision coverage.

Vision Insurance Provides Companies with a Healthy ROI:

If your company wants to save money on its overall claim costs, vision insurance can present an interesting benefit as a preventative measure. Employees with vision coverage are more likely to schedule an eye exam than those without coverage. Routine eye exams are a tool that licensed optometrists and ophthalmologists can use to detect abnormalities within the eye. Eye exams can serve as a tool for early detection and prevention, frequently uncovering signs of many serious health issues, including:

Diabetes
Glaucoma
Cancer
Hypertension
High cholesterol
Brain tumors
And other health problems

For this reason, routine eye exams are important for the long-term health of all employees. Early detection is key in both the holistic health of a patient and in the goal to keep overall health costs down in the long run. By ramping up your ancillary benefits, like vision insurance, your company could both reduce overall coverage costs and lower the amount of paid sick leave spent on employees seeking treatment for a condition that could have been prevented or caught early through an eye exam.

As an added benefit to your organization’s ROI, consider the relation between eye strain and productivity. The Internal Agency for the Prevention of Blindness published a study with an interesting finding on the topic, reporting that vision problems, left uncorrected, may be causing anywhere from a 2.5% to a 21% decrease in productivity (depending on the particular issue). The agency found eye strain will, on average, lower an employee’s productivity by fifteen working minutes each day – amounting to 65 hours of productivity lost over the course of a year.

Costs Can Be Relatively Low for Employers:

Providing general medical insurance can be extremely costly for employers – to the tune of hundreds of dollars monthly per employee. Vision insurance, however, is much less expensive, sometimes costing as little as ten dollars monthly per worker. The cost can also be passed on to the employee themselves, who can elect to opt-in to utilize the benefit. Not all vision insurance plans require employers to pay a portion of the monthly premium; still others only require a few dollars each month from the employer. If your company wants to offer vision insurance but simply can’t make the cost work for their budget, reaching out to an employee benefits consulting expert is a great place to start.

Vision Insurance for Small Business

Many small businesses are not required to offer medical insurance to their employees, and they’re not required to vision insurance either. However, for small businesses who recognize the long-term value of providing the benefit, obtaining coverage is relatively simple.

Health reimbursement arrangements (HRAs) offer an easy and affordable route to providing vision insurance. HRAs are not traditional medical insurance plans, but they can be used to help employees cover the costs of their care. To learn more about your options as a small to mid-sized employer, begin your research with the help of an experienced employee benefits consultant.

Vision Insurance for Large Corporations

All large companies (with fifty or more full time employees) must provide health care benefits under the Affordable Care Act. While dental and vision insurance is not required by federal law, most large companies still recognize the value of providing these benefits as a tool for long term cost control, employee retention and recruitment, and increasing overall employee wellness. Keeping costs low for both employers and employees can be tricky, however, and large corporations should periodically review their vision plans to make sure they’re still working for the company and its employees. To get an expert’s eye on your benefits offerings, reach out to the experienced consultants at AEIS.

AEIS: Your Partner in Employee Benefits

Considering offering vision insurance to your employees, or revamping your current plan? The best first step is reaching out to an expert. AEIS is a strategist, advocate, and advisor for businesses looking to select, optimize, and maintain the perfect employee benefits package. Contact AEIS today.

Partial Self-Funding Explained

Mon, 25 Jul 2022 18:50:07 GMT

Healthcare costs are rising, and organizations across the country are looking to save money where they can. Doing so without hindering your benefit offerings poses a dilemma for many small and mid-sized firms. If your organization is among the thousands taking a careful look at its options for employee health coverage this year, partial self-funding may be a decision to explore. Read on to learn more about partial self-funding from the employee benefits experts at AEIS.

What is Self-Funded Health Insurance?

You’re probably intimately familiar with the design of a traditional health plan – what’s known as fully insured health coverage. Businesses who carry fully insured health coverage for their employees assume no exposure to the financial risk that accompanies fluctuating monthly claim costs. In this set-up, the insurance company foots the bill for the cost of employee claims, and the business itself just pays the monthly premiums. Your premiums will stay the same each month for the contract term (usually 12 months), affording your business some stability on your balance sheet. Costs, however, while stable, are very high. The appeal of fully insured health coverage, rooted in its predictability, may not be enough to keep many small to mid-sized firms hooked.

Enter self-funding: a different kind of health insurance coverage wherein a business allocates a monthly or annual budget for employee claim costs. The budget you set will be based on a careful estimate as to what claim costs might look like, taking into consideration the relative age, health, and past claims of your workforce. For your employees, the experience likely won’t feel any different at all. They’ll still be able to see the same doctors, visit the same pharmacies, and receive the same level of care that they’re familiar with from being a part of a fully insured health plan. The only difference is the payee at the other end of their insurance claims – instead of the insurance company, it’s their employer.

What is Level-Funded Health Insurance?

A level funded health plan is, in its simplest terms, somewhere between self insured and fully insured health insurance coverage. For businesses that are looking for the cost savings that a self funded plan can provide, but are understandably drawn to the measure of predictability guaranteed by a fully insured plan, level funded health insurance is particularly attractive.

With a fully insured health plan, high monthly costs are guaranteed. Annual rates, however, can soar from one year to the next, sometimes seemingly without reason. Self-insured plans can wreak havoc on a small to mid sized firm’s accounting department, who may be left to scrape up tens of thousands of dollars for claims in a high cost month.

Level funded insurance may deliver the best of both worlds. As part of a level funded insurance arrangement, a business pays a predetermined monthly premium to either the insurance carrier or TPA (Third-Party Administrator). The third party administrator or insurance carrier will then transfer the allotted funds into an account. Costs to cover employee claims, administrative expenses, and stop loss coverage for the business will draw from that account.

Businesses who choose level funded insurance obtain the benefit of stop loss insurance. This insurance caps total yearly claim losses, essentially putting a limit on potential cost exposure, so businesses with level funded plans have some peace of mind about their fiscal year. Many different types of level funded plans exist, and some level funded plans even guarantee businesses can receive a refund of their unused monthly budgeted amounts for claims. If you’re interested in level funded insurance, you’re certainly in good company. In fact, according to the Society of Human Resource Management, 16 percent of firms who have between three and ninety-nine employees have opted for level funded health plans.

What is Partially Self-Funded Insurance?

Similar to level funded plans, partially self-funded plans are an attractive option for businesses looking for a compromise between cost stability and low premium prices.

Many businesses opt to partially self-fund through the provisions of an HRA, or health reimbursement arrangement, which is a way in which employers can step into self-funding and start to take some control. An HRA can act as a complement to traditional health insurance coverage. The funds deposited into an HRA account can be used to cover any “qualified expenses,” for employees, such as health insurance premiums, out of pocket expenses, and pharmacy, vision, and dental costs.

The provision of HRA accounts can allow employers to select a traditional health insurance plan that carries higher deductibles, co-pays, and/or co-insurance. HRA funds step in to “cover” the gap in care an employee might feel with a higher deductible plan. This is a unique way for employers to self fund, as they can control their contributions to the HRAs.

The Benefits of Partially Self-Funded Insurance Plans:

Aside from the unique balance between predictability and cost savings described above, partial self funding may be able to offer businesses key advantages. You should speak to an employee benefits expert to check to see which benefits are applicable, but generally, perks of partial self funding may include:

Reimbursements can be made either directly to the participant or their provider;
You may save costs and time associated with administrative work when you provide HRA accounts;
Employers can retain greater control over costs; and
The provision of an HRA may avail the employer to certain tax advantages.

With so many interesting benefits of partial self funding, it’s no wonder that the popularity of this health insurance plan model has increased over the last decade.

Deciding whether Self-Funding is the Right Choice for Your Organization:

After learning about self-funding, you’ll want to weigh the pros and cons of this approach to health coverage for your organization. It always helps to talk to employee benefits and insurance experts , and Advanced Estate & Insurance Services, Inc. (AEIS) is here to help. AEIS is a strategist, advocate, and advisor for businesses looking to select, optimize, and maintain the perfect employee benefits package.

AEIS brings more than 35 years of experience in the industry to your advantage. Looking to simplify your benefits processes? It’s time to reach out. Contact AEIS today .

What Are Ancillary Benefits?

Tue, 10 May 2022 21:51:56 GMT

In today's business environment, retaining and recruiting exceptional talent is critical in keeping companies competitive. While compensation is certainly key, so is ensuring your employees are being taken care of. This is of particular importance to Millennials with a strong desire to be part of an organization that cares about their well-being. While full major health care coverage has always been a challenge, especially for small to mid-sized companies, ancillary benefits are stepping in to level the playing field.

As more and more of these benefits become available, it can serve you well to become aware of their increasing value to your current team and potential recruits. If you are involved in the decisions impacting your company's benefits program, it can be helpful for you, your organization, and its team members to be as familiar as possible with its potential components.

Today, more than ever, there are creative options available to keep your company attractive in maintaining your current staff, and in recruiting top-talent. It doesn't always have to result in budget-busting benefits. There are available programs to make your company more appealing without overspending.

One such area to be aware of is what are known as ancillary benefits. What is the definition of ancillary benefits and when should you be aware of them? What is important to know about ancillary benefits and what are their pros and cons for employers and employees? Most importantly, how can ancillary benefits help your company remain competitive in retaining and recruiting top-notch staff? Ancillary benefits should not be overlooked as a valuable retention and recruiting tool for your business.

Here is a closer look at ancillary benefits and the role they may play in your organization's employee benefits program. You may be surprised at the affordable and attractive options available for your organization.

Ancillary Insurance Definition

Ancillary benefits are defined as a secondary layer of coverage used to supplement group health insurance. It can be used to fill gaps in coverage or reduce the risk of devastating healthcare expenses for employees.

It is most frequently purchased in conjunction with major medical insurance and can include benefits such as vision and dental care that may not be addressed by a company's current major medical program. Policies such as hospital indemnity, critical illness and cancer insurance may also be offered to help employees with out of pocket costs that reimburse the insured for covered illnesses and expenses. Ancillary benefits can even include policies that provide financial protection for employees' families such as life insurance, disability insurance, and identity theft protection.

Ancillary benefits are a powerful trend that is allowing small to medium sized companies to compete with larger or more well-funded competitors. Ancillary benefits, overall, provide an affordable alternative for both employers and employees to increase health care coverage at optimum pricing. It uses the power of "buying in bulk" for groups as opposed to purchasing benefits individually.

When to be Aware of Ancillary Benefits

Employee benefit administrators should always be aware of trends in ancillary benefit programs, but there are several times when awareness should peak. These include when changes are being made to major medical program benefits and when recruiting efforts increase. Ancillary benefits are an excellent way to round out a major medical benefits program as well as increase your company's appeal to new recruits.

It is also valuable in retaining quality employees to maintain your competitive advantage and for recruiting in the current employee marketplace. Of course, it is also important to be aware of ancillary benefits when experiencing a claim that may not be fully covered under your company's major medical program. If employees appear to be disgruntled under your current benefits program, ancillary benefits can provide an appealing solution.

What is Important to Know About Ancillary Benefits

Perhaps the most significant aspect to understand about ancillary benefits is that they fall into two broad categories. Ancillary benefits can fall into three different categories depending on the amount the employer is contributing to the coverage: voluntary, contributory, or non-contributory. In voluntary plans the employer usually contributes zero to 50% of the plan costs. For contributory plans the employer usually pays at least 50%-75% of the premiums (varies from carrier to carrier) while the employees pay the remainder. Noncontributory plans are ones in which the employer pays 100% of the premiums (which means all eligible employees must be enrolled). Just like with health insurance, any portion of premiums that employees are responsible for are usually paid through payroll deductions. This helps assure that administration is easy and straight-forward.

Pros and Cons of Ancillary Benefits to Employers and Employees

There are benefits to both the employer and the employee through ancillary benefits whether the employer contributes or if the employee voluntarily pays for the benefits.

Most benefits are paid through pre-tax dollars, which lowers the taxable income for employees. This both increases their benefits while lowering their tax burden.
Employers can be more attractive to both current employees and to recruits when offering ancillary benefits. It provides another option for potential employees and weighs the scale in favor of employers who offer them.
Ancillary benefits can help round out a major medical program by offering benefits like vision or dental that may not otherwise be included.
When a larger group of people participate, ancillary benefit program payments are usually very affordable.
Ancillary benefits can provide employees’ families with significant financial protection through life and disability insurances.

The fact is, ancillary benefits have become an increasingly vital part of many small to midsize companies. They are appealing to employees because it increases benefit options, which are often paid for with pre-taxed dollars. It is valuable to companies of all sizes because it provides them with an opportunity to offer current and potential employees valuable benefits at little or even no expense to the employer.

Advanced Estate and Insurance Services (AEIS) was created to assist small and medium sized businesses (2 to 500 employees) make the most of their employee benefits programs. We keep our clients competitive in recruiting superior talent with exceptional benefits and programs that are affordable. Our mission is to help you maximize your employee benefits package while staying within your budget. If you are struggling with increasing healthcare and employee benefit expenses, connect with us for a no-obligation review and a look at the innovative options now available. We encourage you to contact AEIS today. We are rooted in the protection and success of your small to medium business.

“My PEO Health Insurance increased by 20%+! What do I do now!?”

Wed, 27 Apr 2022 21:22:07 GMT

Many companies within a Professional Employer Organization, known as a PEO, are accustomed to the usual rigors of the health insurance renewal process: readying employees for annual open enrollment, providing all the notices and documents for employees as required by the government, and figuring out how to mitigate the ever-increasing cost of health insurance.

PEO’s largely help employers handle the first two of those items, but the issue of health insurance cost can have drastically different outcomes for any given employer. Sometimes the renewal rates fall in line with expectations, perhaps an increase of a few percent, but what happens if you receive an increase of 20%, 50%, or more?! At first, those numbers may seem like an extreme exaggeration, but here at AEIS we have personally worked with plenty of clients for whom this was a sudden and stark reality.

PEO Basics

For those who are not familiar with the concept, PEO’s (Professional Employer Organizations) are businesses that help employers by assisting in a variety of administrative functions from Human Resources to payroll. PEO’s can also often help provide employers with insurances, both commercial insurance, such as worker’s compensation and employment practices liability, as well as employee benefits like health, dental, and life insurance.

For the administration portion they typically charge a fixed fee on a “per employee, per month” or “PEPM” basis that tends to become lower as the employee population increases. For the insurance side, the business model is a bit more nuanced.

PEO’s and Health Benefits

The advantages of having insurance through a PEO can be enticing. It is usually priced by the PEO carefully managing the collective risk within the pool of their employer clients. This generally leads to health plans with better coverage for similar or lower cost than what can often be found in the small group health insurance market, but not always.

Inevitably, from time to time employers will have employees who will accumulate very expensive medical claims either for themselves or their dependents. When this happens for employers, PEO’s can choose to channel some of the hit of the high claims onto the employer in the form of exorbitantly large increases.

Over the years we’ve had groups come to us in these instances with renewal increases well above 20%, at times even exceeding 50%! Sometimes they endure multiple of these increases during a period of several years. It can be a tough pill to swallow for an employer who had been relying on the stability the PEO brought to their business functions to then be faced with such a daunting, often unsustainable, increasing cost of benefits. It leaves employers looking at the possibility of having to either drastically reduce the benefits or push more of the cost to employees through lowered employer contributions (which is essentially a pay cut to employees), but employers should not feel as though they have no options.

So… now what?

Employers may feel like they have nowhere to turn in these situations, but we’ve partnered with many businesses to get their benefits back on track to sustainability. There is more than one way to face this challenge, but the two we see have the best outcomes the most often are:

1) Explore the Small Group Insurance Market (less than 100 full time equivalent employees)

While PEO’s can factor in health history when determining their health insurance rates, small group health insurance carriers cannot. Since the enactment of the Affordable Care Act, small group carriers use a modified community rating methodology which in this case means they cannot charge employers or individuals higher costs based on individuals’ preexisting health conditions or a checkered health histories.

Small group rates do consistently trend upward annually because of this, but because the modified community rating does not penalize employers for high claims in the way that PEO’s can, the increases often do not exceed more than 10% in a given year. Going from consistent 20%-50%+% renewals with a PEO to an average increase of less than 10% with small group can have a significant impact on the healthcare cost, especially over the long run.

Moving from PEO brokered benefits to small group health plans can sometimes mean completely leaving the PEO, but some PEO’s will allow clients to move to the small group insurance market while continuing to receive the PEO’s administrative and commercial insurance services.

2) Explore Different PEO’s

We briefly covered how PEO’s generally rate their health insurance plans for their clients based on utilization and claims history, but each PEO can potentially have different processes and methodologies for how they go about doing that.

For example, many PEO’s broker their insurance plans meaning the health insurance is a profit and revenue center for their company, whereas some PEO’s are set up such that they are not even legally allowed to make revenue off the health insurance and it must instead be a pass through cost.

Some PEO’s put aside funds in special reserve accounts to be specifically doled out for high claims in order to mitigate the increase that clients receive when a few catastrophic claims come through in any given year.

You can imagine how these and many other differences in practices might affect what one’s health insurance renewal numbers will look like. All things being equal, each PEO’s personal rating methods are idiosyncratic to one another’s, and while one might give you a massive increase, another might have a more productive way to help you manage and mitigate the risk.

We at AEIS work with a number of different PEO’s and have helped employers successfully transition out of the PEO model entirely or move from one PEO to another. If you want to learn more about whether other PEO’s might be a better fit then your current provider, check out another blog of ours on what is a PEO broker and set up a call to speak with us .

PEO’s can be incredibly helpful for employers looking to outsource a variety of business and administrative functions, but there are times when things such as huge health insurance renewal increases can begin to outweigh the other benefits of the PEO.

If you find yourself in this position and want to consider either looking at small group benefits or perhaps shopping for a different PEO altogether, set up an appointment with our benefits consultants or give us a call to go over your company and what ways you can get your health insurance back on track!

Section 125: What it is and What It Means to Employers

Fri, 15 Apr 2022 16:16:26 GMT

CEO's, managers and human resource professionals may struggle a bit with what exactly is a Section 125 Plan and what it can mean to employers. At AEIS , we make it part of our mission to help small to medium-sized employers understand the employee benefit products and programs available to them, including Section 125 Plans.

Adding to the confusion is the fact that these plans can be known by several names. While Section 125 Plans are named for the applicable IRS code that governs their use, they are also often referred to as a cafeteria plan or flexible benefits plan. In addition, these plans are available in three primary forms, each with its own value and appeal to certain companies and employees.

These plans certainly offer benefits to employees, but how can they positively impact employers? If your company has been sitting on the sidelines when it comes to implementing or even investigating a Section 125 cafeteria-style plan, here is what you should know about them and how AEIS can help.

What is a Section 125 Plan?

A Section 125 Plan is a benefits plan authorized by the IRS Code that bears its name. It is a written plan that allows employees the flexibility to choose compensation in the form of benefits or in cash. The real beauty of a Section 125 Plan is how it provides value for both the employees and the company. Both can enjoy significant tax benefits and companies may discover a new valuable recruiting tool. This is particularly important in a time when valuable employees are difficult to keep and recruit.

How Do Section 125 Plans Work?

While Section 125 Plans are offered by employers, they are approved and accepted in writing by employees. It provides the employees with an opportunity to pay for certain medical, dependent-care and dental expenses with pre-tax dollars. In essence, this reduces the taxable income for employees while also reducing the employers' share of Federal and State taxes, Social Security contributions, and unemployment taxes. These savings benefit both employees and employers. It also provides an opportunity for employers to offer employees a more personalized, appealing, cafeteria-style benefits plan that suits their needs. It is a more efficient, effective and affordable way to provide employee benefits and keep your company attractive to the workforce.

Types of Cafeteria Plans

There are three types of Section 125 Cafeteria Plans.

Premium Only Plan (POP)

This is often considered the foundation of the Section 125 Plan. It allows employees to pay health related insurance premiums (health, vision, dental) with pre-tax (tax-free) dollars.

Flexible Spending Account

An FSA (Flexible Spending Account or Flexible Spending Arrangement) allows employees to put pre-tax dollars into a spending account specifically to cover health care costs. This allows an employee access to funds to help cover medical expenses. It also allows employers to reduce their share of social security, income and unemployment taxes.

Health Savings Account

An HSA also grants employees the ability to make contributions as pre-tax deductions from their salary. The employee must first be enrolled in a high-deductible health plan (HDHP) and unlike an FSA , the election amount in not pre-funded, meaning funds are immediately available for reimbursement use.

Dependent Care Assistance Plan (DCAP)

This employee benefit plan allows employees assistance in paying for care of dependents who qualify under IRS regulations. DCAP contributions are paid with pre-tax funds and can be used for a variety of qualifying care such as elder care, nursery schools, day care, camps and other programs. Employees choose how much in annual contributions they would like to put into a DCAP and funds are deducted each pay period.

What is a Section 125 Deduction?

A Section 125 deduction is the amount of pre-tax funds employees choose to contribute to their Section 125 cafeteria plan. These deductions occur prior to their payroll taxes, so income taxes are reduced. These deductions are at the core of the benefits of a Section 125 Plan for both employees and employers as it reduces taxable income for employees and employers' shares of these taxes for employers.

Who Needs a Section 125 Document?

Any employer who wants to offer their employees the benefits of, and wants to take advantage of the benefits of a Section 125 cafeteria plan themselves will need to have a Section 125 Plan Document. This is a written document that allows employees to choose certain benefits instead of cash payments as part of their salary. Some employers do not realize that this document is required and should be prepared and updated annually by professionals in the benefits administration industry.

A Simple Cafeteria Plan Strategy

Many small to medium sized businesses forgo offering employees the benefits of a cafeteria plan and of taking advantage of the benefits of a Section 125 Plan themselves for a variety of reasons. Perhaps they feel employees may not understand or appreciate the benefits of such a plan. They may not realize the overall impact on their own tax savings. They may not see the value of a Section 125 plan as a recruiting tool. They may just view the process as being too complex.

At AEIS, we can assist you in creating a simple cafeteria plan strategy that you and your employees will appreciate. We can help you take that next step in competing in your industry for employees and in building a more attractive bottom line.

If your company has been standing on the sidelines when it comes to a Section 125 Plan, now is the time to move forward. A well-crafted plan can help you lower your company's tax burden while making it more attractive in recruiting talented team members. It can assist you in keeping those MVP employees so critical to your success.

What is a Section 125 plan? We invite and encourage you to contact us and learn more today. Discover how AEIS and a Section 125 Plan can take your company to the next level.

AEIS is a California-based, employee benefits brokerage firm with over 35 years of experience working with small to midsize companies. Insurance is just the beginning and we make it easy for you. We work diligently in keeping our clients competitive, both from a bottom line perspective but in maintaining and recruiting superior talent. We are pleased to help companies in every stage and in every industry. Compete better with the help of AEIS.

Understanding Community Rating Health Insurance

Wed, 06 Apr 2022 14:24:39 GMT

The cost of your company health insurance plan’s premiums has a lot to do with the pricing system your insurance company uses to calculate them. There are three main pricing systems used today by health insurance companies to determine costs for your organization: experience or “risk” rating, community rating, and modified community rating. Which pricing system insurance carriers are permitted to use is typically mandated by federal and state laws and has been affected in recent years by the Affordable Care Act.

Looking to learn the basics regarding different health insurance premium pricing systems, and how they could affect your bottom line? Read on for more from the Employee Benefits Insurance Experts at AEIS .

What is Community Rating in Health Insurance?

According to healthcare.gov , community rating is a rule that prevents health insurers from varying premiums within a geographic area based on age, gender, health status, or other factors. This is known more technically are pure community rating. More specifically, the term “community rating” refers to a pricing system within the health insurance industry. If an insurer uses community rating, they adhere to a policy of refraining from charging higher premiums within a geographic area based on the above mentioned factors.

What is Experience Rating in Health Insurance?

Experience rating and community rating pricing systems are fundamentally opposed. In an experience rating pricing system, an insurance company charges premiums based on individual and group applicants’ health and medical history. The number and costs of claims are taken into consideration when premium costs are figured.

Before the year 2014, most health insurers used the experience rating pricing system. Consumers’ premiums were by and large calculated based on their expected health care costs. This meant those with preexisting conditions (or individuals in the same applicant group) could be doomed to exorbitant health care costs.

Pure Community Rating vs Modified Community Rating

As described above, a pure community rated policy is one in which everyone in a geographic area has the same priced health insurance premium. No variation exists based on insureds’ age, health history, tobacco use, etcetera. This approach is a rare one.

In 2014, the Affordable Care Act enacted extensive market rating reforms requiring that insurers use a modified form of community rating for small group insurance (large group is still usually experience rated). With the new legislation, the Centers for Medicare and Medicaid Services described that premiums could be varied “based on age (within a 3:1 ration for adults), tobacco use (within a 1.5:1 ratio and subject to wellness program requirements in the small group market), family size, and geography.”

The ratios may seem tricky, but they essentially mean that for a health insurance plan to be in compliance with the Affordable Care Act, premiums could only require older insured individuals to pay three times what younger insureds pay and tobacco users to pay one and a half times what non-tobacco users pay. California prohibits Tobacco rating completely, so in California modified community rating is only based on age and geography. While similar, this modified form of community rating differs from pure community rating, where, as described, premiums can’t vary at all based on age or health status.

Under the Affordable Care Act, states are permitted the choice to enact stronger consumer protections than these minimum ratio standards.

What Pricing Systems do Insurance Companies Use?

While most plans use modified community rating systems, the experience rating system is still being used by some large group plans. For example, in California, large group insurance companies (with 101 or more employees in CA, 51+ in certain other states) use experience rating whereas small group uses the modified community rating.

Self-insured plans use experience rating because the cost of employee medical care is covered by both the employer’s own funds and a separate reinsurance policy (for catastrophic claims and claimants), not through the purchase of health coverage through an insurance company.

While many self-insured companies still have contracts with health insurance companies, these contracts are mainly for plan administration services, not for employee claim coverage.

Even if a health plan uses experience rating, the Health Insurance Portability and Accountability Act (HIPAA) mandates that insurance companies cannot single out individual employees within the group health plan and charge higher premiums based on medical history alone. The group, however, can still be charged based on the group’s aggregate claim history data.

Choosing the Right Health Insurance Coverage

There are many positives to pure community rating and modified community rating pricing systems. One of the downsides for small businesses is that they could mean higher premiums than you can reasonably afford to pay. Conversely, while they can be more risky, using experience rated partially or fully self-insured plans for certain groups can provide significantly better value if well designed and maintained. Striking the right balance between finding health coverage within your organization’s budget, and keeping and attracting the best talent, can be tough without an expert on your side.

As your benefits advisor, AEIS will work with you to determine your specific needs and prioritize your goals. We provide you with the solutions needed to streamline costs and improve your overall benefits package for years to come.

For companies looking to take back control of their benefits plans, we offer comprehensive guidance on switching to alternative funded plans for increased flexibility and reduced costs.

Health Insurance is Complex. AEIS Makes it Simple.

Looking for an experienced health broker? Advanced Estate & Insurance Services, Inc. (AEIS) has all the insurance services you need, all in one place. We offer a range of custom employee benefits insurance services, including employee benefits packages, compliance risk assessments, plan administration, and high net worth life insurance.

AEIS brings more than 35 years of experience in the industry to your advantage. AEIS will walk with you through your health insurance questions and beyond for an easier, more complete benefits plan. We’re here to help. Contact us online or schedule a free phone consultation today.

What is Online Onboarding and Enrollment

Wed, 23 Mar 2022 16:48:17 GMT

In the wake of Covid-19, countless industries adjusted to communicating and working virtually. While a love/hate relationship with Zoom and email threads may have emerged over the past two years, technology can positively transform the way companies run and employees interact. Specifically, online platforms, such as Ease, Zywave, and TriNet, are essential in securing a smooth and efficient onboarding and enrollment process. Read on to learn more about the best practices for, and benefits of, online onboarding and enrollment.

Benefits of Online Onboarding

The early days for a new hire are critical. From the moment the employee walks in the door or logs on for the first time, she is evaluating her environment and wondering if her perception of the organization from the interview is correct. Ben Peterson of BambooHR stresses that, “…the worst thing for a new employee is being wooed through the recruiting process and then arriving on the job and the receptionist isn’t even expecting [her] and [her] office isn’t even set up.” It has been found that one in ten employees have left a company prematurely due to a mediocre onboarding experience. While the new hire is building her understanding of the company’s culture, values, and treatment of its employees, it is imperative the organization puts it best foot forward during the onboarding process.

With a traditional paper and pen onboarding process, employees have to tediously fill out countless forms by hand. The HR department has to scan, file, and audit these forms. For both the employee and employer, this process can take hours. By utilizing an online onboarding platform, the HR department can enter employee information and then send the new hire a login for completing forms such as the W-2, W-4, and I-9. HR no longer has to scour file cabinets and new hires do not have to endure hand cramps or paper cuts!

An online portal can enhance the onboarding process by giving the new hire a glimpse into the company culture. Before the employee even begins, she can log on to the portal and read about the company’s policies and review an organizational chart as well as company acronyms. HR can also post a FAQ section so she can also prepare for her first day, such as answers addressing where to go and who to ask for upon arrival. On Day One, an onboarding schedule on the portal can outline her day; it is recommended that the schedule is a balance of meeting peers, learning more about her role, and checking in with her manager. The team can also post welcome messages and photos for the new hire. By structuring and streamlining this process, the employee will feel valued, equipped, and supported; this will also empower the employee to quickly become a productive member of the team.

As an employer, what is the ideal impression a new hire could have of the company by the end of her first day? The onboarding process is directly related to this first impression. As Peterson puts frankly, “You want them back for Day Two, right?”

Benefits of Online Enrollment

In addition to a smooth onboarding process, online platforms can be instrumental during enrollment. Nowadays, HR is tasked with manually determining eligibility, comparing and explaining plan details, and organizing summaries. With an online system, employers and HR can set eligibility conditions so employees can view easily view and compare the insurance plans for which they qualify. During open enrollment, employees and HR no longer have to fill out and comb through piles of paperwork. Rather, an online platform permits HR to electronically submit benefit elections without having to decipher their coworkers’ handwriting. In the event an employee loses his ID card, an online platform allows for easy access to an online version of his medical information during a doctor’s appointment or a trip to the pharmacy.

Talk to our Benefits Consultant , Dillon Castro, to explore insurance options for your organization. You can reach us here . Our team, made up of expert advisors, can also assist you in acquiring a robust and comprehensive benefits package.

Disclaimer: Any information related to compliance or other subject matters in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this blog is based on the most up-to-date information that was available on the date it was published and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

What Employers Should Know About Dental Insurance

Wed, 02 Mar 2022 20:56:58 GMT

Written by: Ron Bland, GBDS

Table of Contents

What is Covered by Dental Insurance?
How Does Dental Insurance Work for Employers?
Dental PPOs vs Dental HMOs
Choosing Between DPPOs and DHMOs
How Carriers Adjudicate Claims that are Out of Network
Dental Plan MAC Fee Structures
Dental Plan UCR Fee Structures
Dental Insurance 101 For Employers – Frequently Asked Questions
How much do Employers Pay for Dental Insurance?
I have a Small Business, how can I Offer Dental Insurance?
Are There any Dental Benefits I can Offer as an Alternative to Traditional Dental Insurance?
Is my Organization Legally Required to Offer Dental Insurance?
Why Should Employers Offer Dental Insurance?
The Power of Dental Benefits in Recruitment and Retention Efforts
Companies who Provide Dental Benefits Have a More Efficient and Productive Workforce
Partnering with an Experienced Health Broker

As an organization with a stellar team of talented employees, you know it’s important to offer great benefits. Doing so has advantages for your business beyond just recruitment and retention. What not all employers realize, however, is that dental benefits are equally important, but they’re usually not wrapped up in your standard health insurance offering. With employees indicating that dental or vision insurance is the third most important benefit in making a job decision, behind only health insurance and a retirement savings plan, dental insurance is a benefit that should be on your human resources department’s radar.

Thinking of offering dental insurance to your employees? You’re off to a great start! Before you make a decision, there are some key basics employers should be aware of when considering which dental plan is right for their team. Read on to learn more from the employee benefits experts at AEIS .

What is Covered by Dental Insurance?

First things first, it’s important to know that there are many different types of dental plans . With that said, a “typical” dental policy will cover preventive care (generally two preventative visits each year), fillings, crowns, root canals, and oral surgery, such as tooth extractions. Of course, more comprehensive plans can be selected to cover items such as orthodontics, periodontics, and prosthodontics, for example, dentures and bridges.

A great deal of dental plans available today adhere to what’s known as a “100-80-50” coverage structure.

A 100-80-50 plan is designed to cover:

100% of the cost to the patient for preventive care, including check-ups, diagnostic care, cleanings, and dental exams
80% of the cost associated with basic dental procedures, like root canals, removal of teeth, and fillings
half of the cost to the patient for major dental procedures, including crowns, bridges, implants, and sometimes sealants

With most dental plans, patients are expected to pay for the remaining, uncovered portion of care in the form of a co-payment. While this is the most common structure, your company can certainly select a plan that works differently and covers more or less of certain items, procedures, or categories of care. If your company employs many young parents, for example, it may be in your best interest to select a health plan that reimburses a portion of orthodontic care for dependents.

The timing of care is an important aspect of what dental insurance will cover for your employees. After you’ve selected a plan, make sure your employees are aware of timing parameters. The average patient will visit the dentist twice annually for checkups and cleanings, and again for the treatment of any identified issues, such as fillings.

Dental policies are designed around this general structure, and typically support only the number of visits they predict to be necessary. For example, it’s very common for dental policies to fund 100% of a semiannual visit, but no more than just two. It’s also normal for policies to only cover services such as X-rays, crowns and bridges, and fillings to treat the same tooth once during a specified number of years (usually 1-3). No matter what type of care is needed, most dental policies have annual maximums that cap the amount of money they will pay toward an employee’s dental care each year.

How Does Dental Insurance Work for Employers?

The way your company’s dental plan will work depends in large part on the type of plan you select. The two most common types of plans are dental PPOs and HMOs.

Dental PPOs vs Dental HMOs:

Dental PPOs, or Dental Preferred Provider Organization plans, are plans with large network of providers. While employees can still see providers out of the plan’s network, if they see an in-network provider, they’ll see lower out of pocket costs and won’t have to submit a claim after receiving care. PPO plans typically have the “100-80-50” coverage structure described.

Dental HMOs, or Dental Health Maintenance Organization plans, are plans that typically trade lower premiums for less patient flexibility. HMOs usually still have a network of dentists under their plan, although their networks tend to be smaller. Employees also must see a provider that’s in-network to ensure any coverage. While dental HMOs may have very low or nonexistent deductibles and maximums, they do require copayments for the majority of non-preventive procedures.

Choosing Between DPPOs and DHMOs:

How can you decide whether a Dental PPO or a Dental HMO is best for your organization? One factor to consider is average premium cost. The average monthly premiums for DHMO plans are $22.75, while the average monthly premiums for DPPOs are much higher, at $62.75. According to Cigna , DPPOs differ on several key factors, including coinsurance, copays, annual maximums, waiting periods, among other things. DHMOs charge coinsurance amounts as a percent of a flat rate for services, while DPPOs charge coinsurance amounts as a percent of the contracted rate per dentist. DHMOs typically don’t have annual maximums, while DPPOs almost always do. DHMOs always assess copayments, while DPPOs may or may not. Finally, with DHMOs, there’s usually no waiting period, but there can be with a DPPO, especially for groups with less than 5 or 10 employees.

How Carriers Adjudicate Claims that are Out of Network:

An employee can usually see a dentist outside of your plan’s network and receive some coverage. How much coverage is provided will depend on whether the dental plan you’ve selected uses an “MAC” or “UCR” fee structure. Here’s the difference between the two:

Dental Plan MAC Fee Structures:

An “MAC,” or a Maximum Allowable Charge fee structure, refers to a fee structure in which a plan sets a maximum amount that they’ll pay for a covered service from a provider.

If an employee sees an in-network provider, the MAC structure works like this: Hypothetically, let’s say the set MAC fee determined by your insurer for a dental bridge is $50, and the insurer has agreed to cover 80% of the MAC fee for tooth bridges. In-network providers are “in-network” because they have agreed to accept your insurer’s MAC fee.

If the employee sees an out-of-network provider, however, the scenario is a bit different. In this instance, the insurer still covers a set percentage of the MAC fee, but the insured is responsible for making up the full outstanding balance, known as a balance billing. This is because an out-of-network provider never agreed to accept the insurer’s MAC fee, and won’t have to reduce prices for its services.

Dental Plan UCR Fee Structures:

A “UCR,” or a Usual, Customary, and Reasonable fee structure, refers to a fee structure in which a plan has been designed to cover the cost of a predetermined percent of the usual, customary, and reasonable fee charged by a provider. Under a UCR fee structure, employees can visit any dentist they choose. The UCR fee will depend in large part on what providers normally charge for various services throughout a given geographic area. These values are calculated by a third party, using claim data from your business’ area, and are expressed as a percentile. If, for example, a 90th percentile UCR amount is determined for a tooth bridge replacement procedure, this means the UCR value for the bridge procedure will be an amount designed to meet the cost that 90% of providers in your area charge for the procedure. The insurer will then pay this predetermined cost as its maximum payout amount for the service.

For more information on types of dental plans, and guidance on choosing the best dental plan for your organization, contact the employee benefits experts at AEIS .

We're here to help.

Contact us today.

Dental Insurance 101 For Employers – Frequently Asked Questions:

1. How much do Employers Pay for Dental Insurance?

Who pays for dental insurance: is it the employer, or the employee? The answer is: whatever you decide is best for your company! KFF found that in 2021, the average health insurance cost for employers was $16,253 annually, or 73% of the premium, to cover a family and $6,440, or 83% of the premium for an individual. These premiums for families and individuals have increased 22% over the last five years and 47% during the previous 10 years.

If you choose a fully insured dental plan, dental insurance monthly premiums can be paid either 1) in full by the employer, 2) in full by the employee, or 3) by the employer in part, and through employee contributions in part. Of course, employees are generally going to be the ones responsible for paying deductibles copayment associated with the plan you choose.

2. I have a Small Business, how can I Offer Dental Insurance?

No matter how large or small your organization is, you can find a dental plan that works great for your employees. While almost all large employers with 200 or more employees offer dental insurance, more than half of small firms offer dental insurance as well, and the percentage is climbing every year.

3. Are There any Dental Benefits I can Offer as an Alternative to Traditional Dental Insurance?

Yes, there are other ways, besides traditional dental insurance, for employers to offer dental coverage to their employees. One of the most common ways to go about providing dental benefits is through a Health Reimbursement Arrangement, or HRAS. This is a particularly attractive option for smaller businesses.

An HRA is a type of health spending account. Funds are deposited into the HRA ahead of time, and those funds can go toward paying for anything that is deemed a “qualified expense.”

HRAs aren’t always just used for dental, though it’s a great way to provide dental benefits, nonetheless. You can choose to allow HRA funds to be used toward medical, pharmacy, or vision care expenses, as well. This type of blanket advantage can be found in what’s called a Qualified Small Employer HRA, or “QSEHRA.”

QSEHRAs are available to any company that does not offer a group health plan and has fewer than fifty employees. If you do offer a health plan, you can still use an HRA for dental benefits (or vision, too, for that matter!) using a dental or vision HRA, as opposed to a QSEHRA.

For more information on alternatives to traditional dental insurance, reach out to the employee benefits experts at AEIS .

4. Is my Organization Legally Required to Offer Dental Insurance?

No federal or state laws require businesses of any size to offer dental insurance to their employees.

Why Should Employers Offer Dental Insurance?

Are you considering offering dental insurance to your employees? A growing body of research points to the conclusion that you really can’t go wrong doing so. Employees want dental insurance and to be able to weigh the provision of dental insurance in their decision to join or stay at a company.

In addition, employers who provide dental benefits will save money long-term on health costs for their employees and perform better on indicators associated with employee productivity. Let’s go over some of the data out there on the topic:

The Power of Dental Benefits in Recruitment and Retention Efforts:

According to research uncovered in the NADP 2019 Dental Benefits Report: Enrollment, 79% of Americans had dental benefits, and the majority of these Americans had plans that were sponsored by their employers. This leaves little room for companies to stand out if they’re not offering dental insurance.

Costs mount for necessary treatment for employees and their children, and when choosing a new job, those costs come to mind. In fact, the 2018 NADP Survey of Employers revealed that 87 percent of employees surveyed believe dental benefits to be either a key differentiator, or absolutely essential.

Companies who Provide Dental Benefits Have a More Efficient and Productive Workforce:

According to research published by the Center for Disease Control and Prevention in 2018, adult employees lose more than 164 million hours of work per year due to dental diseases. Researchers involved in the study indicated that poor oral health is associated with lost hours at work which in turn affect a person’s productivity.

Just like when an individual has a cold, chronic pain, or any other type of ailment, people are not capable of performing at their professional highest standard when they have a dental issue.

Partnering with an Experienced Health Broker

If you’re considering offering dental coverage to your employees, you’ve come to the right place. Advanced Estate & Insurance Services, Inc. (AEIS) brings more than 35 years of experience in the industry to your advantage.

AEIS will walk with you through your dental insurance and employee benefits questions for a seamless, more manageable benefits selection experience. Choosing the right balance of employee benefits is complex. AEIS makes it simple for you.

Give AEIS a call at (650) 348-6234, contact AEIS by email at team@aeisadvisors.com, or fill out a contact form .

About The Author:

Ronald L. Bland

President

Exiting a PEO Relationship - Your PEO Exit Strategy

Thu, 27 Jan 2022 22:44:52 GMT

When your organization entered into a contract with a professional employer organization (PEO), it was likely looking to outsource a variety of human resources functions and save valuable resources. However, many companies will eventually decide it’s time to end their relationship with their PEO. Doing so can be tricky, but the Benefits Experts at AEIS have you covered on your way to forming your PEO exit strategy. Read on for a comprehensive guide to exiting a PEO relationship.

Reasons for Exiting a PEO Relationship:

A need for greater control of your own company: As your organization grows, employers in a PEO also grow to a certain size, it eventually becomes more economical to hire staff to internally handle the HR and admin functions that the PEO provides than to bear the cost of outsourcing to the PEO. If that tradeoff no longer feels valuable to a business, the time may be right for exiting the PEO relationship.
The desire to choose your partners: Often, PEOs have total control over what businesses you’ll partner with for your health benefits and workers’ compensation needs, among other things. Not only can you not be sure you’re being paired with the perfect vendor, but you also lack a complete picture of how those partners are interacting with your business. Having the ability to choose how you work becomes more critical as an organization grows.
You’re not getting enough to justify steep PEO fees. PEO fees can be steep and can easily cost over $1,000 annually per employee. As your organization grows and changes, it may make more sense to hire Human Resources or Finance professionals internally. Hiring your own HR professionals, for example, can ensure new employees receive company-specific onboarding and receive the unique ongoing support they need.
Rising costs of PEO-facilitated health care relationships. The overall costs of health insurance have risen in recent years. PEO’s have to actively manage the collective risk of all the members in their health insurance risk pools (i.e. including your employees), this means that employers in a PEO can see drastic cost increases at their health insurance renewals if their employees experience catastrophic medical claims. It’s not uncommon for some PEO’s to present 50%+ renewal increases to clients on their health insurance when these catastrophic claims happen. These factors mean while PEO’s can help some employers save money on health insurance, there are no shortage of instances in which the costs can exceed what is available by simply going to the small group market.

Items to Consider Before Exiting a PEO Relationship:

Key Items to Consider:

Timing and Tax Consequences. If you’re exiting your PEO relationship mid-year, there are certain tax consequences you should be aware of. The government will count all your employees as “new” employees when you exit the relationship mid-year, for example. This means FICA and FUTA taxes for each worker’s wages for the year will be nontransferable, and the wage base will restart at the time of transfer. This will result in a double-taxation situation. Employees will still be able to reconcile excess payroll taxes on their own tax returns.
COBRA Liability and Administration. You likely know that your PEO charges fees to manage your former employees who receive COBRA benefits. Employees can continue to receive COBRA benefits through your PEO during their maximum coverage period. You could be responsible for ACA reporting after leaving your PEO, including finding a partner to file your Form 1094-Cs and Form 1095-Cs.
Two W-2s at Year End.
Termination Requirements.
PEO Termination Notification.
FSA / Transit Benefit (spend-down period).
1-9s and W-4s.

Services that will Need to be Replaced:

Payroll / HRIS: It’s crucial to have your new payroll system completely in place before you exit your PEO relationship. Doing so will prevent the interruption of paychecks to your employees.
Human resources services: Of course, you’ll need to delegate any services that were performed by your PEO to existing HR professionals within your company or hire and train new employees to cover these tasks. After your exit from the PEO relationship, you may also want to update your policies and procedures, including your employee handbook.
Legal and compliance services, including compliance with FMLA and FLSA.
Technology, i.e., online enrollment and eligibility solutions. Leaving the PEO relationship means losing their integrated technology solutions, but it doesn’t mean you won’t be able to replace and even improve upon their systems with partners that appreciate your unique needs.

Benefits that will Need to be Replaced:

Workers’ compensation / EPL Insurance: Keep in mind that it’s critical that your organization does not experience a lapse in workers’ compensation insurance, so as to avoid government fines and penalties. Coverage must therefore be in place before you exit your PEO relationship.
Medical
Dental
Vision
Life
Disability
EAP
FSA
Transit Plan
401(k)

What to Request from your PEO before Exiting the Relationship:

PEO Invoice / chargeback Invoice
Benefits register
Plan summaries / benefits-at-a-glance
Employee census
Carrier history for the last 5 years
Large claim information in excess of $25,000
Completed questionnaires, if placing with UHC or CalChoice
Current rates and renewal rates
Employer contributions for both employees and dependents

Implementation Requirements:

Most recent chargeback invoice (in lieu of DE9C, when enrolling fewer than 51 employees)
PEO termination letter
Employer application
Employee applications and waivers
Binder check

What to Do if You Have More Questions about Exiting Your PEO Relationship:

At AEIS, our top priority is always to pair you with the best solutions based on your unique and current business needs. Whether you are looking to transition from one PEO to another or leave the PEO model entirely, we are ready to offer assistance and better outcomes. From helping you compare and contrast each of the PEOs you can choose, to walking you through the transition or exit process, to helping you shop the market for your new health insurance and payroll/HRIS systems, AEIS has the resources and experience necessary to facilitate a smooth transition. We can provide you and your business with a tailored list of options and rates to ensure you are making the most informed decisions.

Considering breaking off your contractual obligations to your current PEO? Your company could benefit from a free phone consultation with the Benefits and Compliance Experts at AEIS . Give AEIS a call at (650) 348-6234, contact AEIS by email at team@aeisadvisors.com , or fill out a contact form .

Broker Commission and Service Disclosure Notices

Fri, 21 Jan 2022 17:36:38 GMT

You may have recently received a notification from your broker that they have sent you a Commissions and Services Disclosure Notice. This is because of a new requirement that went into effect as of December 27, 2021, that was included in the Consolidated Appropriations Act (2021). This Act amended ERISA Section 408 (b)(2)(B) to require that brokers and other service providers disclose to welfare plan fiduciaries how much they are paid by the plan and the services that they offer to the client, when the broker or service provider reasonably expects to receive $1,000 or more in total direct or indirect compensation from the plan.

Basically, it is a way of the broker stating, “this is what I do, and this is how much I am paid to do it.” The commission disclosure notice also states where the compensation comes from, if it is direct compensation from the plan itself, indirect compensation from another source, or if there is any compensation that is non-monetary such as perks or additional incentives given to them as a result of placing business with a particular vendor or insurance carrier.

How Are Brokers Typically Compensated?

Brokers are typically compensated by being issued commission from the insurance carriers and providers OR by a flat service fee that they charge the client or business directly in lieu of commissions. The IRS Form 5500 that plans with 100 or more participants are required to submit to the IRS contains information related to the commissions that the broker was paid for the plan year that is being filed, so this is not an entirely new concept for businesses to be informed of how much their broker is being paid by their insurance carriers, but it is new for small businesses who do not have to file a Form 5500.

What New Disclosure Rules Are Included in This Notice?

The new compensation and services disclosure notice is not a bill or invoice, but it is required to be signed or acknowledged by both the broker and the plan fiduciary. The plan fiduciary is required to keep a copy of the disclosure on file with their records as part of their due diligence and they could be required to pay a penalty if the plan were to be audited by the Department of Labor and the disclosure is not produced for review by the auditor.

The compensation and services disclosure notice should be provided to the fiduciary during the renewal or vetting process. The reasoning behind this is that if a broker is promoting or recommending a particular plan over another, a plan fiduciary will be able to see if there is a financial incentive for the broker to be suggesting that specific plan, or if it is simply the best option for the business moving forward. For example, if the renewing plan pays the broker a 5% commission on the premium received, but an alternate carrier that they are recommending would pay them a 10% commission on the premium or a 4% on the premium it can become evident that they may be recommending a plan because it will pay them a higher commission, or they are recommending another alternate plan because it really is in the best interest of the company even if it means a pay cut for them.

Medical, dental, and vision plan commissions are required to be disclosed, but disability and life insurance premiums are not required to be included.

What if I Haven’t Received A Commission and Services Disclosure Yet?

If your current broker has not given you a commission and services disclosure, ask them for it. Keep in mind it is required to be given before a new contract is signed with the carrier or service agreement with the broker, so you may not see it until closer to your renewal. But if you don’t receive it from your broker or prospective broker, be sure to ask for it as the plan fiduciary does have a joint responsibility to have it as part of their records.

Still have Questions about the Broker Commissions and Services Disclosure Notice? You’ll be in good hands with AEIS and their compliance risk assessment services . Give AEIS a call at (650) 348-6234, contact AEIS by email at team@aeisadvisors.com , or fill out a contact form.

How to Make the Most of Online Benefits Enrollment

Fri, 21 Jan 2022 16:09:40 GMT

The open enrollment period: it’s an especially hectic time for most companies. The process is notoriously time-consuming for your benefits team and confusing for the bulk of your employees. With new technology making online benefits enrollment accessible to companies everywhere, the open enrollment period no longer needs to bring your Human Resources department to a screeching halt every year.

Transitioning your enrollment process from a paper-centric, manual method to an online experience can help your HR team save time, money, and resources. Read on for AEIS’ HR Consulting Experts’ guide to how to make the most of online benefits enrollment.

Benefits of Using Online Open Enrollment

The annual open enrollment period is a very demanding time of year for companies. It is vital to have all the right information to help guide your employees in making these important decisions, along with the resources and capacity to address questions from every employee. Implementing open enrollment benefits software offers numerous advantages, benefiting both your organization and its employees. These advantages include:

Efficiency and Convenience : Online benefits enrollment systems automate and streamline the enrollment process, reducing the administrative burden on HR departments. This allows HR professionals to focus on more strategic tasks instead of manually processing paperwork and forms, ultimately improving overall efficiency.

Cost Savings : Online enrollment systems can lead to significant savings for businesses. They eliminate the need for printing and distributing paper forms and help reduce errors, which can be costly. Additionally, the ability to compare and analyze benefit plan costs can aid organizations in making informed decisions about their benefits packages.

Accessibility and Transparency : Online systems provide employees with 24/7 access to their benefit information, allowing them to review plan details, costs, and coverage options at their convenience. This transparency helps employees make informed decisions about their benefits, leading to higher satisfaction and engagement.

Enhance Data Accuracy : Online enrollment systems often include validation checks and data integration with other HR and payroll systems, improving the accuracy and reliability of employee data.

Compliance and Reporting : Online enrollment systems can help businesses stay compliant with legal and regulatory requirements, generating reports and analytics to provide insights into benefits enrollment trends and ensure organizational adherence to necessary laws and regulations.

Online Enrollment: What to Expect

With online benefits enrollment, every step of the benefits selection and management process can be automated and take place online. Not only will you be able to close your filing cabinets again, but your employees will also have the ability to access everything they need.

Using online enrollment, employees can compare the costs and coverage of different plans before ultimately self-enrolling. They’ll also be able to later review their benefits and make changes to their personal information. With online enrollment, you can expect to see a decrease in the overall costs associated with the process and a shortened enrollment cycle. Your Human Resources department will be able to access employee data and compile information on the costs of various benefits and health plans quickly and easily.

Online benefits enrollment sounds like a breeze, and in so many ways, it is. But as with anything, a new change brings new challenges, and AEIS wants you to be aware of what to look out for. Whenever a shift toward a technology-focused process occurs, some employees may be reluctant to use the new service. Dealing with this and other small dilemmas efficiently can help you make the most of online benefits enrollment.

Preparing Your Employees Beforehand

Any education you can provide to your employees on the new change before it takes place will be instrumental for a successful online benefits enrollment implementation. Have your Human Resources team introduce the software system or website your employees will be using to review and compare health plans and self-enroll.

If the online system provides a phone app, have employees who may want to use the app download it beforehand. Showing employees their selected plan in real-time can help eliminate an influx of IT requests and calls to HR during the enrollment period.

Remind your employees of when the enrollment period begins and ends, as well as how to log on to their portals. It never hurts to use multiple forms of communication to get your point across, including email, paper flyers, Slack reminders, and friendly notices around the office.

Take Advantage of Online Benefits Enrollment Technology

New and innovative benefit technology firms are popping up everywhere in recent years, offering features like interactive enrollment and online hubs personalized for your company. Working with an experienced health broker to find the perfect vendor for your business’ online benefits enrollment process will help you take advantage of all available advances while staying within your HR budget.

When choosing a benefits technology vendor, many employers value easy employee communication and engagement as well as accessible employee education tools. New benefits enrollment technology platforms can analyze employee and guide the individual toward picking the best plan for them.

Companies love the availability of certain vendors’ health plan comparison tools, cost calculators, and other employee support functions that can help guide employees to the right decision for their unique circumstances, in many cases without the need for one-on-one personal assistance from a member of the HR staff.

Technology vendors are able to make the online benefits enrollment experience easily digestible for your employees, with mobile apps and single sign-in platforms to view which medical plans, life insurance, FSA, disability plans, and 401k accounts employees are enrolled in. Employees will be able to access their portals and make changes as allowed throughout the year.

Strike the Right Balance Between Autonomy and Availability

While many employees, especially millennials, will be right at home during the online benefits enrollment process, all employees are different. Many employees will prefer a more tangible experience, and others, even those who are comfortable self-enrolling, will have unique circumstances that require additional assistance and advice. Allowing for an avenue to easily and quickly request personal assistance when it’s needed is key. An experienced health broker with a team of HR consultants can provide support services when your team needs them.

Educating employees is crucial to helping them select the right plan for them. It’s important they are aware of new benefit offerings even if they are comfortable with their current plan. Employees should consider the costs associated with their current plan as compared with other offered benefits with lower or higher premiums. Sometimes, it may require a mixture of automated and more personal, perhaps one-on-one support to drive this point home.

Partner with an Experienced Health Broker

If you’re considering switching to an online benefits enrollment process, you’ve come to the right place. Advanced Estate & Insurance Services, Inc. (AEIS) brings more than 35 years of experience in the industry to your advantage. AEIS will walk with you through your online benefits enrollment questions and beyond for a seamless, more manageable enrollment period. Benefits enrollment is complex. AEIS makes it simple for you.

Give AEIS a call at (650) 348-6234, contact AEIS by email at team@aeisadvisors.com, or fill out a contact form .

Looking for more open enrollment tips? Read on - Open Enrollment Tips for Employers

AEIS News: Advanced Estate & Insurance Services, Inc. recognized as a 2021 Top Employee Benefits Consultant for San Mateo, CA by Mployer Advisor

Thu, 30 Dec 2021 17:00:47 GMT

San Mateo, CA – 12/29/2021 – Advanced Estate & Insurance Services, Inc. (AEIS, Inc.), a benefits advisory that has been in the business for over 35 years and helps companies find real solutions for an easier, more complete benefits plan, is recognized by Mployer Advisor, an independent platform for employers to research, review and evaluate insurance brokers, as a Top Employee Benefits Consultant Award for 2021 for San Mateo Mployer Advisor’s Top Employee Benefits Consultant Award recognizes brokers for demonstrating market-leading competencies in several areas.

“Who an employer chooses as their insurance advisor has significantly more impact on the quality and cost of a benefit plan than who they chose as the carrier. We are proud to honor these firms who have demonstrated a wide range of experience in combination with positive employer feedback on service and quality,” said Brian Freeman, CEO of Mployer Advisor .

"I am personally very proud of this industry recognition. We have always strived to provide strategic benefit plans, tailored to each employer partner, with the highest customer satisfaction," comments Ronald Bland, President at AEIS, Inc.. "Our team serves over 500 organizations in the San Francisco Bay Area and Silicon Valley region. We have seen a significant need for our services as organizations continue to reemerge after the pandemic”, Ronald Bland continued.

To determine award winners, Mployer Advisor analyzes each brokerage based on historical data to gauge the range of business experience across employer sizes, industry experience and products, combined with employer ratings and reviews of insurance brokerages across several platforms. Results are a snapshot of Mployer Advisor’s matrices and proprietary M Score on May 31, 2021.

About Advanced Estate & Insurance Services, Inc.

Contact: team@aeisadvisors.com

About Mployer Advisor:

Mployer Advisor is changing the way employers search, evaluate and select insurance advisors. Our goal is to connect employers and employees to great benefits and insurance. We do this by providing employers with actionable data to easily evaluate and select the best advisor for a company’s unique needs. Mployer Advisor provides independent ratings of insurance advisors to support employers. The rating is our opinion and should be one of many factors, including when selecting a consultant. An insurance brokerage cannot pay to influence their Mployer Advisor rating. Most brokerages have a profile on Mployer Advisor. Only highly rated brokerages are allowed to advertise on the platform. To learn more about Mployer Advisor visit https://mployeradvisor.com.

Understanding Expense Reimbursement Law California

Thu, 30 Dec 2021 16:03:45 GMT

Article 2, Section 2802 of the California Labor Code is colloquially known as “California’s Expense Reimbursement Policy”. Subsection (a) of the Reimbursement Policy, entitled “Obligations of Employer,” requires employers to, among other things, “indemnify” or in other words, pay for initially or reimburse, “his or her employee for all necessary expenditures or losses incurred by the employee in direct consequence of the discharge of his or her duties, or of his or her obedience to the directions of the employer.”

That sounds like a mouthful of legalese, and as an employer you may be left wondering exactly what you need to do to stay in compliance with California labor laws. Thankfully, AEIS ’ HR partners are here to help you make sense of California’s expense reimbursement policy.

What Does California’s Expense Reimbursement Law Say?

California’s Labor Code requires employers to reimburse their employees when employees have paid for anything out of their own pocket that is sufficiently work-related. This law was passed by the California Legislature to keep companies from reallocating costs associated with their business to their employees.

What does the law mean when it says: employers must reimburse employee expenditures made by an “employee in direct consequence of the discharge of his or her duties, or of his or her obedience to the directions of the employer”? Let’s break this down.

Tucker v. Cooper, a 1916 case heard by the Supreme Court of California, has helped to shape interpretation of the policy. In its opinion, the Supreme Court of California has explained “It is sufficient to establish liability under this section that the plaintiff was performing services at the request of and for the benefit of the defendant, and that the plaintiff was under the direction and control of the defendant while performing the services.”

So anytime your employee is completing duties within the scope of their employment, or some act that would benefit you as an employer, you’re likely going to be liable for expenses they incur in the process. Most times, this is true whether you’ve directly preauthorized the expense and amount or not.

Even if your company already has a policy of attempting to avoid this dilemma altogether, perhaps by allowing employees authorized to make purchases to carry a company credit card, you should still be aware of this particular section of the California Labor Code. You can never know for sure what will come up, or whether an employee will be without a card and make a payment that should be reimbursed.

What Should Employers do in Order to Stay in Compliance with California’s Expense Reimbursement Policy?

To make life easier for your human resource professionals and your employees alike, one of the best steps you can take is to set out a reimbursement policy and publish it in your employee handbook. It’s a good idea to err on the side of generosity when making reimbursements, and grant reimbursement for all expenses that an employee could reasonably believe was necessary, and that were incurred in direct relation to their job duties.

Your reimbursement policy can set out a reasonable per diem, for example, that permits employees to spend $100 daily on food and other necessities (besides travel and other major costs) when they’re traveling for work. Here are some other things you should consider for clear coverage in your reimbursement policy:

Uniforms and required shoes and other accessories or equipment, such as safety gear
Mileage if using a personal vehicle, gas if using a work vehicle, and tolls along the route in any event (keep in mind the 2022 federal standard for reimbursement is $0.585 per mile)
Personal cell phone bills or at least a percentage of the bill, if the employee uses the phone for work. You may also consider providing a separate work phone to ensure privacy on both ends.
Conference or seminar fees, especially if you recommend or require attendance.
Travel expenses, although you can pay for as much as you are able to beforehand.
Expenses incurred by your employees when they are entertaining current or prospective clients, such as restaurant or theatre bills.
Postage
Chairs, desks, laptops, printers, paper, printer ink, and other office equipment, especially if the employee is working remotely without access to company-provided equipment.
The cost of software or subscriptions needed for the job, such as Adobe Acrobat, Photoshop, Zoom, and WebEx.

When your organization is reimbursing its employees, it’s perfectly fine to add on the reimbursement to their paycheck or salary. As long as the reimbursement is timely and the reimbursement pay is itemized so that it can be separated from the regular wages or salary the employee has earned, the reimbursement is proper.

What Should Employers Avoid in Order to Stay in Compliance with California’s Expense Reimbursement Policy?

This may seem fairly obvious, but employers should not attempt to create an employment or other contract that serves to have employees abandon their right to the legally required reimbursements laid out in the California Labor Code. If an employer has a provision to this effect in any contract, a court will declare that provision null and void. So even if you write one, it will not have effect – you’ll still need to make reimbursements where appropriate.

Employers also can’t terminate or otherwise punish employees who have requested reimbursement for appropriate expenses. As an employer, the best choice is to err on the side of caution and clarify your reimbursement policy unless the incurred expenses from a particular employee have become frequent and obviously flagrant and egregious.

What Happens if an Employer Does Not Reimburse Their Employees Pursuant to California’s Expense Reimbursement Policy?

As a successful business, you know it’s always in your best interest to remain in compliance with state and federal labor laws. Not only does it protect your employees, but it also protects your company from costly lawsuits and all the litigation fees that come with defending your business in court. Employers that find themselves in violation of California’s Labor Code could potentially face lawsuits, and even class action lawsuits if multiple employees allege the same violations.

If violations are found, a court can hold your company liable for the appropriate reimbursement, interest accrued from the date on which the employee(s) incurred the necessary expenditure or loss, attorneys’ fees and court costs from both sides, and citations from the State of California.

What to Do if You Have More Questions about Your Reimbursement Policy:

Need to be sure you’re in compliance with California law? You’ll be in good hands with AEIS’ Human Resources Partners. . Give AEIS a call at (650) 348-6234, contact AEIS by email at team@aeisadvisors.com , or fill out a contact form .

Level Funded vs Fully Insured Health Plans

Wed, 01 Dec 2021 15:37:36 GMT

As an employer, you have a lot of decisions to make when it comes to selecting the right health coverage for your employees. Often, the choice can be difficult, especially as insurance premiums rise from year to year. You’re likely familiar with the concept of a traditional, fully insured health plan, but you may be wondering if there are any less expensive alternatives that make sense for your organization. If so, you’re not alone.

According to a 2020 Employer Health Benefits Survey from the Kaiser Family Foundation, out of a total of 1,765 employers surveyed, 16 percent of small firms with 3 to 199 employees use an alternative to fully insured health plans, specifically, what’s known as a level funded health plan. That number was slightly higher (17 percent) at firms with 50 to 199 employees. The popularity of the level funded health plan has increased over recent years, due in large part to the concept’s flexibility and affordability.

What Exactly is Level Funded Insurance?

A health insurance plan is “level funded” when the employer makes a pre-determined payment each month, and that payment is placed in an account reserved for the payment of costs associated with the plan. Costs deducted from the account can include claims, administrative expenses, and premiums for stop loss insurance coverage. The monthly cost of a level funded plan varies with the number of covered employees and the strength of the selected coverage.

If the amount of employee claims submitted at the end of the policy contract are lower than expected, the employer can receive either a refund or a credit on the next annual policy contract. However, if claims submitted at the end of the policy contract are higher than expected, the level-funded insurance carrier the employer has been paying will, in theory, cover the remaining claim amount, which may affect the rates for the following plan year.

Fully Insured vs Level Funded Plans: What is The Difference?

In general, think of a level funded health plan as a stepping stone between self insured and fully insured health plans. It’s very common for small businesses to be torn between the security of a fully insured health plan and the possible benefits and lower premiums associated with self insured health plans.

A fully insured health plan takes the risk of high claims away from the employer completely, in exchange for a high monthly cost. The variable month to month claim risk is put on the insurance carrier, instead. Rates can rise with little to no explanation from year to year, regardless of the amount of claims the firm’s employees have actually made.

With a self insured plan, what may seem like a cheaper choice at first can turn into a nightmare. For example, if a business decides to become self insured, they might face $3,000 in claims in February and $18,000 in claims in March. Stop loss insurance puts a cap on total annual losses for employers with self insured health plans, but it doesn’t mitigate damages from month to month. The unpredictability can be hard to swallow at best, and devastating at worst for small firms. Level Funding is the best of both plans. Level Funding combines the lower risk of fully insured plans with the customizability and potential savings of self Insured plans.

Is a Level Funded Health Plan the Right Choice for My Organization?

If your organization is drawn toward the benefit of predictability inherent in a fully insured plan’s monthly billing model, but is also interested in moving toward the monetary benefit of self funding, a level funded health plan may be the right choice for you. Of course, choosing a health insurance plan for your company is not just a decision for the Human Resources Department, it’s also a big financial consideration.

If your Finance Department likes the possibility of earning a credit at the end of a plan year, but is still reasonably risk-averse, your organization may be among the 16 to 17 percent of smaller organizations and start-ups that have determined level funded insurance plans make the most sense for them.

From the Human Resources perspective, you know your employees best, and you may be able to use their demographics and prior claim information (in the aggregate) to determine if your organization is taking less of a risk with a level funded plan. In general, healthier, younger workforces are less risky in terms of self or level funded insuring. Your employees, on the other hand, might like the perks associated with some of the level funding carriers, such as larger mental health networks or potential savings on copays and maximum out of pockets compared to fully insured plans.

When it comes to choosing a health insurance plan for your organization, there is a lot to consider. If you’re feeling a bit stuck between going with a traditional, fully insured health plan and seeing exactly what a level funded plan has to offer, it’s time to reach out to employee benefits and insurance experts . Advanced Estate & Insurance Services, Inc. (AEIS) brings more than 35 years of experience in the industry to your advantage. AEIS will walk with you through your health insurance questions and beyond for an easier, more complete benefits plan. Health insurance is complex. AEIS makes it simple for you .

Long Term vs Short Term Disability Insurance

Wed, 24 Nov 2021 16:36:39 GMT

Your company cares about doing the right thing for its employees. After all, they’re what keeps everything running smoothly. When the worst situations arise and an employee is out on disability leave, would you rather send them a get-well card, or a check? With disability insurance, you can do both. Employers who carry disability insurance can ensure that their employees will receive a portion of their income through disability insurance while they are unable to work.

There are two main kinds of disability coverage you should be aware of when considering whether offering this insurance makes sense for your business: short term disability insurance and long term disability insurance. Read on for a guide to the two types, and some considerations to keep in mind when determining whether you will offer this type of insurance as part of your competitive benefits package.

What’s the difference between Short Term and Long Term Disability Insurance?

Disability Insurance Generally:

Disability insurance is essentially “paycheck insurance” for your employees if they are injured or diagnosed with a serious illness. This type of coverage is not intended to cover the wages an employee misses when they are out of work for a couple of days because of strep throat or the flu. When a qualifying event happens, an employee with disability insurance simply files a claim with the insurance company to receive a portion of their paycheck.

Disability insurance is also a separate concept from workers’ compensation benefits, which are regulated by state law and (in brief) determine the amount of money an employee must receive if they are injured at work while performing activities within the scope of their employment. Disability insurance, on the other hand, covers wages in the event of an unrelated illness or injury.

Short Term Disability Insurance:

Short term disability insurance policies pay benefits for less time than long term disability insurance policies will. These types of policies will usually provide an amount of an employee’s income for a period of three months, six months, or a year, depending on the level of coverage. In addition to illness and injury, they also cover some medical conditions you may not think of that would prevent an employee from working for a few months, such as pregnancy or rehabilitation after surgery. Short term disability insurance typically covers forty to seventy percent of an employee’s lost wages, with most common being sixty percent.

Short term disability insurance policies include what’s called an elimination period, or a period of time that an employee must be out of work before benefits under the policy will kick in. Elimination periods are generally anywhere from seven days (one week) to thirty days (one month), but the most common period is fourteen days (two weeks).

Long-Term Disability Insurance:

Long term disability insurance policies pay benefits for a longer time than short term disability insurance policies will. These types of policies will usually provide an amount of employee’s income for a period of two, five, or ten years – and on some policies, an employee can be insured until retirement (say, age sixty-five,). Long term disability insurance typically covers sixty to eighty percent of an employee’s lost wages, with most common being sixty percent

Long term disability insurance policies also include elimination periods, though their waiting times are a bit longer: on average, at least ninety days (three months). However, it is common for insurance companies to offer lower premiums in exchange for even longer elimination periods.

Should Your Company Offer Disability Insurance?

Offering disability insurance to your employees helps them out in obvious ways: it guards them against some of the financial difficulties associated with an already stressful period of time following an injury, illness or diagnosis. Disability insurance also benefits you, the employer, as well.

Think of disability policies as a projection of your sunk cost in your employees. With disability insurance, they’ll remain stable until they can return to work. You won’t lose them and all you’ve invested in their training due to a relatively brief period out of the workforce. And because the insurance company will be paying their benefits, your company will be able to afford to hire a temporary replacement for the displaced worker.

If your company has ten or more employees, it may make sense to offer benefits through group disability plans. Most group disability plans will be able to provide your employees with competitive coverage for lost wages, i.e., up to sixty percent of their regular paycheck. Plans usually have a capped maximum monthly or annually.

What are the Pros of Offering Disability Insurance Through a Group Plan?

When offering disability insurance through a group plan, as the employer, you’ll be able to choose the plan that works with your benefits budget. You will also be able to offer coverage to your employees at a lower rate than they would have to pay if they sought out disability insurance individually.

Offering a group plan doesn’t mean your business necessarily has to pay the entire premium amount, however. You might elect to pay the entire premium, pay some of the premium, or none of the premium. Of course, you should always stay aware of state laws regarding disability insurance, as some states require companies to offer a certain amount of coverage.

There are benefits to paying the premium for your employees: not only will you add a competitive recruitment and retention tool to your benefits package, but you can also consider company-paid premiums as a tax-deductible business expense.

Can We Offer Both Short Term and Long Term Disability Insurance?

Absolutely! Long term disability is frequently paired with short term disability insurance since short term benefits don’t last forever, but long term benefits may last through retirement age. Also, since the elimination, or waiting period, for short term benefits is much shorter than it is for long term benefits, the addition of short term disability insurance to a long term plan can be particularly relieving to an employee waiting through a long elimination period.

Talk to an Expert about the Plan That’s Perfect for Your Employees.

Considering offering disability insurance to your team? Weigh the pros and cons of coverage for your organization with an expert . AEIS is here to help. AEIS is a strategist, advocate, and advisor for businesses looking to select, optimize, and maintain the perfect employee benefits package. Contact AEIS today .

A Guide to Lowering Health Plan Costs Using Section 105

Fri, 12 Nov 2021 20:42:53 GMT

Choosing the right health insurance for your organization’s employees is no easy task. If you’re a small business, you’ve likely considered the viability of leveraging a Section 105 Plan. Read on to learn the basics of Section 105 Plans for employers.

What is a Section 105 Plan?

Section 105 Plans are also commonly referred to as Health Reimbursement Arrangements, or HRAs. The plan gets its name from its origin in the allowance of tax-free reimbursement of medical and insurance expenses under Section 105 of the Internal Revenue Code. A Section 105 Plan is regulated by the IRS. Many small to mid-sized businesses are drawn to Section 105 Plans for premium cost savings.

It’s important to know that a Section 105 plan is not the only type of HRA, however. There are several different types of HRAs, and some work distinctly differently from the HRA “wrap strategy” we will discuss later on in this blog post. Section 105 plans are separate from Individual Coverage HRAs (ICHRAs), Excepted Benefit HRAs, or premium-only reimbursement arrangements.

Section 105 plans / HRAs are a type of self-insured health plan that can be either used alone or coupled with a fully insured health plan. When coupled with a fully-insured plan, the Section 105 plan can be used as a partial self-funding strategy in order to lower fixed premium costs, while still mitigating risk from catastrophic health claims.

How Does a Section 105 Plan Work for Employers?

A Section 105 plan / HRA is not health insurance in and of itself, rather, you can think of it as a vehicle for employers to reimburse their employees for their medical expenses. However, as described above, Section 105 plans can be used in conjunction with the “regular” health insurance plan your company may already be offering.

Employers tend to pair or “wrap” Section 1-5 plans/HRAs with a low cost fully insured health plan such as a high deductible health plan (HDHP), consumer directed health plan (CDHP), or a “bronze plan.” “Bronze” plans, for example, usually have the lowest monthly premiums, but the highest costs for medical care.

These types of fully insured plans can be a great option for individuals who don’t use many medical services but need protection in case of an unexpected event. However, deductibles with these plans are typically very high. These types of plans are commonly coupled with Section 105 plans, as Section 105 plans can serve to reimburse the employee medical expenses where the Bronze plans don’t offer first dollar coverage.

When it is set up well, the effect of pairing a bronze plan, HDHP, or CDHP with a Section 105 plan is the reduction of employees’ deductibles and out-of-pocket costs, while employers can save significantly if the all the covered employees have little to no costly medical claims. Essentially, an HRA / Section 105 plan is a way for employers to turn a Bronze plan into a Gold or Platinum plan, in a manner of speaking, because from the employees’ perspective, the Section 105 plan makes the Bronze plan much more comprehensive.

How Does Reimbursement Work Under a Section 105 Plan?

In order to establish a Section 105 plan, the employer must create a formal, written plan and decide on a periodic allowance amount for employees. Employees submit expenses, which are reviewed for eligibility. If the expense qualifies, it will be reimbursed by the employer from their Section 105 plan fund. Legally, the fund must not be made up of employee deductions. The interesting advantage of this for employers is that the reimbursement they make to employees is 100% tax-free (up to the previously set allowance cap).

What are the Pros of Section 105 Plans?

You can leverage a third party to administer Section 105 / HRA reimbursements. Doing so outsources the administrative burden of reimbursing employees’ expenses; and, perhaps more importantly, it insulates the employer from having to review and process HIPAA sensitive health information of their employees, since the third party administers the reimbursements.
Pairing a Section 105 plan with a fully insured health plan can be more affordable for employees. Section 105 plans / HRAs carry lower premiums than fully insured plans, due in large part to the fact that they are not subject to health insurance tax. Reimbursements received by employees can be excluded from their gross income.

What are the Cons of Section 105 Plans?

Navigating a new benefit administration model: If you’re not already offering a Section 105 plan / HRA, there may be growing pains involved in kickstarting the process. The workaround, of course, is finding a great third-party administrator.
You’ll have new compliance considerations: Section 105 Plans / HRAs are regulated by the IRS, and are subject to regulations under ERISA, HIPAA, and ACA Market Reforms, among others. Again, this is a “con” that can be easily regulated with assistance from the right team of experts.

Choosing the Right Health Plan for Your Organization

After learning about Section 105 Plans, you’ll want to weigh the pros and cons of this type of health plan for your organization. It always helps to talk to an expert , and AEIS is here to help. AEIS is a strategist, advocate, and advisor for businesses looking to select, optimize, and maintain the perfect employee benefits package. Contact AEIS today .

Maximizing Your Dental Insurance Annual Maximum

Wed, 20 Oct 2021 20:57:51 GMT

Fall means many things for many different people. Weather is changing, schools are back in session, everything becomes pumpkin flavored, and your employee benefits open enrollment is likely coming up soon. While there are lots of considerations for your employees to keep in mind when selecting their benefits elections at open enrollment, getting the most of their current benefits before the year ends is also something to prioritize. What does that mean exactly? Many small group benefit plans have calendar year accumulations or maximums, particularly your health and dental plans. Today we’re going to talk about the latter.

What Is A Dental Insurance Annual Maximum?

For your employees with a dental PPO plan, usually there is a finite “Calendar Year Maximum” (CYM), i.e. the maximum dollar amount a dental insurance carrier will reimburse dental providers for services that members receive over a calendar year. This is important to note in the fall as it is not uncommon that people have used little to none of their CYM by that point. Because the CYM resets at the beginning of every calendar year, CYM dollars are “use it or lose it” (unless you have a dental plan with a “Max Rollover”. Contact us here if you have questions about this nifty plan feature).

How Can Employees Take Full Advantage of their Annual Maximums?

This fall, if your employees find themselves in a position where they need any significant dental work done (fillings, periodontics or endodontics, crowns, implants, etc.) and they have dollars remaining on their CYM, it is in their best interest to get some or all of the work done before the plan’s CYM resets at the end of the year. If your employees are unsure of what their needed dental work will cost them and how to plan appropriately, they may benefit from a pre-treatment estimate if they are:

Planning dental work that will likely exceed $300, like a crown, wisdom tooth extraction, bridge, dentures or periodontal surgery
Wondering if a procedure is covered by your plan
Worried a procedure might exceed the annual plan maximum
On a budget and need to plan their payment in advance

AEIS: Helping You Navigate Your Health Insurance

With a little planning and some timely advice from your benefits broker/advisor your employees can ensure that they make the most of their dental plan which in turn raises their value perception of the benefits package that you provide them. For more tips and strategies on how your employees can get the most out of your benefits offerings, schedule a call with us and talk with the experts!

Finding the Best Health Broker for Your Redwood City Company

Wed, 06 Oct 2021 13:34:37 GMT

Redwood City, California is a center of the American technology industry, known for its mild climate and great sense of community. Did you know that Professional, Scientific & Technical Services is the industry with the largest number of employees in Redwood City , followed by the Information industry? At almost 30,000 employees, the number of employees in the combined industries in Redwood City has grown by roughly 6% in recent years.

The most common job titles in Redwood City are “software developer,” and “software programmer,” with more than three times the number of developers and programmers than the next leading profession: secretaries and administrative assistants. It’s no secret that software developers and programmers are in increasingly high demand. The United States Bureau of Labor Statistics estimates that by 2026, the US software engineer shortage will hit 1.2 million.

Therefore, employees can be rightfully picky about which company they choose to work for. This dynamic has driven the IT sector to become one of the most highly compensated industries. Offering great benefits, including excellent healthcare coverage, is a key way to differentiate your company and recruit the best talent in a competitive market. In fact, a 2018 survey revealed that 78% of employees reported being more likely to choose an employer because of their benefits.

Working with an experienced health insurance broker will allow you to provide the best health insurance coverage for your staff without creating extra hassle for you. That way, you can focus on what you do best: taking care of your people and running your business.

When searching for the best health broker in Redwood City to help you, pay specific attention to what the broker can do to help your organization and its employees!

What Will a Health Broker Do for Your Organization?

Using a health insurance broker can save your company precious time and resources. A health broker will evaluate the insurance needs of your staff, identify the coverage best-suited to your unique needs, and put together a comprehensive package for you to offer to your team. Simplifying the process of buying health insurance provides you with peace of mind knowing that 1) your company is compliant with California State employment and benefits laws, 2) your employees are properly covered and appropriately cared for, and 3) your entire team is accessing the best your benefits have to offer.

Let’s break down these key areas of service:

1. Your Broker Assesses and Addresses Your Plans to Help You Stay Compliant with Federal and State Laws.

Remaining compliant with your benefits may feel like trying to hit a moving target. Your health insurance broker knows how to anticipate and manage the safety of your business and the satisfaction of your employees through compliance.

The first hurdle in staying compliant is choosing a partner to help you proactively anticipate and actively manage regulatory issues. Working with an experienced broker reduces your risk for problems in the healthcare compliance arena. Your broker knows the ins-and-outs of the Affordable Care Act, HIPAA, COBRA, ERISA, and—importantly—state and local laws, such as Redwood City Ordinances, and the effect these laws and programs have on your benefits plan. For those reasons, it is crucial to find the best health broker in Redwood City. The end result is a location-specific, tailored compliance review and action plan designed to keep you “audit-ready”.

2. Your Broker Makes Sure Your Employees are Covered and Cared For.

Selecting the perfect health insurance for your team is a daunting task, and you have a lot to juggle. Your company’s budget and your personnel’s health needs are salient in this process. With a health insurance broker, you won’t have to go at it alone; you’ll have experts in your corner. As we touched on before, brokers will begin by explaining the practical and functional details, as well as the pros and cons of different benefits types and packages. They marry their wide range of knowledge with an understanding of your firm’s specific needs in order to offer personalized advice guiding you to make a plan selection. Making sense of healthcare terms—and all their many acronyms—goes a long way in the process of weighing your options.

A health broker will help you make sense of FSAs (flexible spending arrangements, or employer-sponsored and employer-owned benefits allowing for employee reimbursements), HSAs (health savings accounts, which provide certain tax benefits), and HRAs (health reimbursement arrangements), Fully-Insured versus Alternate Funded Plans , as well as the difference between ACA marketplace plans and off-exchange, non-ACA plans.

3. Your Broker Makes Sure Your Team is Accessing the Best Your Benefits Have to Offer.

Once you’ve worked together to select the right health insurance coverage package, you’ll certainly have all the information you need. But your health broker will make sure you understand it. Your health insurance broker brings their expertise to the table, and helps your employees understand how to select the best doctors, file and navigate insurance claims, and provide coverage for their dependents. Your broker provides support and advice throughout the entire process. Beyond just doctor’s appointments for preventative care and routine tests, your health broker will help your team identify all of your health plan’s perks and benefits so you can truly make the most of your healthcare dollars.

Did you know that many health insurance companies offer a range of benefits, including walk-in clinics, telehealth and virtual care, healthy meal and activities savings, chronic illness case managers, discounted gym and fitness club memberships, house calls, 24/7 nurse lines, and even away-from-home coverage? These are some of the undiscovered points in health insurance plans that your broker can help you understand and optimize.

Looking for a health broker in Redwood City? Advanced Estate & Insurance Services, Inc. (AEIS) brings more than 35 years of experience in the industry to your advantage. AEIS will walk with you through your health insurance questions and beyond for an easier, more complete benefits plan. Health insurance is complex. AEIS makes it simple for you .

Local Interest: Bland Selected to Speak at the Top of the Table Annual Meeting

Fri, 24 Sep 2021 19:34:25 GMT

MDRT membership is exclusive to world’s leading financial professionals

AEIS Advisors is happy to share the following press release for the upcoming Million Dollar Round Table's (MDRT) Top of the Table Annual Meeting. AEIS President Ronald Bland will get the chance to host a discussion on the life insurance profession and the power of building strong supportive teams during two separate sessions.

PARK RIDGE, Ill. – Ronald Bland of San Mateo, CA has been chosen to be a speaker at the Top of the Table Annual Meeting in October of 2021 at Amelia Island, Florida. MDRT’s most exclusive event of the year, the 2021 Top of the Table Annual Meeting unites entrepreneurs and top-tier members to discuss innovative and creative business concepts. Ronald Bland will be speaking on the main platform for Top of the Table Speaks on “To benefit or not to benefit? That is the question.” Additionally, he is hosting a discussion for a Member Spotlight Focus Sessions on “Collaboration: He said, she said, we said.”

Ronald Bland is a 30-year MDRT member and 16-year Top of the Table qualifier. Top of the Table is the highest level of membership in MDRT and places Bland among the top professionals in the global life insurance and financial services industry.

“MDRT provides a unique mix of networking and resources to help members broaden their expertise, grow their businesses and educate clients about the importance of financial planning, ” said MDRT President Mark J. Hanna, CLU, ChFC. “MDRT is committed to delivering innovative ideas and connecting members so they can share best practices in order to maintain high professional and ethical standards.”

In addition to recognizing career accomplishments, Top of the Table membership offers Bland the opportunity to further the collective wisdom of the industry by sharing ideas and best practices with other leading professionals at the Top of the Table Annual Meeting and other educational forums.

For more information, contact Ronald Bland at 650-348-6234 x 12 or Ron@AEISadvisors.com.

ABOUT MDRT

Founded in 1927, the Million Dollar Round Table (MDRT), The Premier Association of Financial Professionals®, is a global, independent association of more than 49,500 of the world's leading life insurance and financial services professionals from more than 500 companies in 70 countries. MDRT members demonstrate exceptional professional knowledge, strict ethical conduct and outstanding client service. MDRT membership is recognized internationally as the standard of excellence in the life insurance and financial services business.

For additional information about MDRT, please contact Jennifer Schimka, MDRT Phone: +1 (847) 993-4955 Email: Jschimka@mdrt.org

Finding the Best Health Insurance Broker in the San Francisco Bay Area for Your Company

Wed, 22 Sep 2021 16:26:50 GMT

Written by: Ron Bland, GBDS

You’ve invested years into your company and its success. You’ve watched it grow—possibly from just one great idea—into a business operation that not only provides an invaluable benefit to its clients and customers, but also takes incredible care of its employees. You know your employees are integral to your company’s past and future successes. You care for their wellbeing as if they were your own family members. That’s why you’re searching for the best way to ensure their healthcare needs are met. Working with an experienced health insurance broker will allow you to provide the best health insurance coverage for your staff without creating extra hassle for you. That way, you can focus on what you do best: taking care of your people and running your business.

Health Insurance Brokers versus Agents: What’s the Difference?

When searching for the best health broker in the San Francisco Bay Area to help you, pay specific attention to whether you’re working with a health insurance broker or a health insurance agent. What’s the difference between a health insurance broker and a health insurance agent?

In technical terms, an insurance agent usually represents one or more specific insurance agencies. Agents may be an employee or independent contractor of a specific agency. There are two general types of insurance agents: captive agents and independent agents. A captive insurance agent works for one insurance agency and can typically offer only products from that specific agency. An independent agent may be able to offer a larger range of products. A health insurance broker is not an employee or contractor for an insurance carrier. Brokers work for their clients, not for insurance companies. Brokers operate independently to offer a range of plans from a multitude of companies to best fit the needs of their clients. However, when it comes to health insurance brokers and agents, the industry tends to use the terms agents and broker interchangeable. Here at AEIS, we are independent agents so work with many carriers and have no affinity to one over another, but also our goal and mission is to help our clients find the best plans and rates that fit their needs for their companies.

What Will a Health Broker Do for Your Organization?

Using a health insurance broker can save your company precious time and resources. A health broker will evaluate the insurance needs of your staff, identify the coverage best-suited to your unique needs, and put together a comprehensive package for you to offer to your team. Simplifying the process of buying health insurance provides you with peace of mind knowing that 1) your company is compliant with state employment and benefits laws, 2) your employees are properly covered and appropriately cared for, and 3) your entire team is accessing the best your benefits have to offer.

Let’s break down these key areas of service:

1. Your Broker Assesses and Addresses Your Plans to Help You Stay Compliant with Federal and State Laws.

The first hurdle in staying compliant is choosing a partner to help you proactively anticipate and actively manage regulatory issues. Working with an experienced broker reduces your risk for problems in the healthcare compliance arena. Your broker knows the ins-and-outs of the Affordable Care Act, HIPAA, COBRA, ERISA, and—importantly—state and local laws, such as San Francisco Ordinances, and the effect these laws and programs have on your benefits plan. For those reasons, it is crucial to find the best health broker in the San Francisco Bay Area, if that’s where your company is based. The end result is a location-specific, tailored compliance review and action plan designed to keep you “audit-ready”.

We're here to help.

Contact us today.

2. Your Broker Makes Sure Your Employees are Covered and Cared For.

3. Your Broker Makes Sure Your Team is Accessing the Best Your Benefits Have to Offer.

Advanced Estate & Insurance Services, Inc. (AEIS) brings more than 35 years of experience in the industry to your advantage. AEIS will walk with you through your health insurance questions and beyond for an easier, more complete benefits plan. Health insurance is complex. AEIS makes it simple for you .

About The Author:

Ronald L. Bland

President

Keep Those Receipts Now That Business, And Business Meals, Are Back

Tue, 14 Sep 2021 19:23:44 GMT

By George Paulsen, CPA, Tax and Advisory Partner of Hood & Strong LLP

Two helpful things happened while we were all home working in our sweats and tees. Now that some of us are venturing back to the office and trying to reconnect with our business associates, the government changed our business dining rules, mostly for the good.

First, the Taxpayer Certainty and Disaster Relief Act of 2020, enacted in 2021, temporarily repeals the 50 percent business meal limitation and allows 100 percent deduction of meals purchased for a business purpose in a restaurant for 2021 and 2022. The IRS provided a notice of what qualifies as a restaurant, which is essentially what we all think it is — “a business that prepares and sells food or beverages to retail customers for immediate on-premise and/or off-premise consumption.” It is not a “to-go” meal from a grocery store. If you want to study the definition check out IRS Notice 2021-25.

Second, while we were Zooming the IRS released Final Regulations giving guidance for deducting business meals. Since John F. Kennedy was President, business meals have been considered an area of abuse and several presidents have pushed for management of these business expenses; Jimmy Carter even tried to get rid of the three-martini lunch. Over the years business meal deductions have been heavily regulated, and they remain one of the most litigated expenses in tax court.

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“Over the years business meal deductions have been heavily regulated, and they remain one of the most litigated expenses in tax court.”

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In October 2020 the IRS Final Regulations attempted to clarify what is deductible as a business meal, but first they had to “uncouple” the entertainment portion of the Tax Cuts and Jobs Act (TCJA) as it eliminated entertainment expenses as a deduction. There are now three requirements to qualify as a business meal:

1. The meal isn’t lavish or extravagant under the circumstances.

2. The taxpayer or an employee is present at the furnishing of the food.

3. The food or beverage is provided to a taxpayer or a business associate.

In the case of food and beverages provided during entertainment, the food must be purchased separately. Essentially, you can buy your client a hot dog at a baseball game as long as you keep the receipt!

The rule loosened up a bit by removing the requirement of “active conduct of business” and created the definition of a “business associate.” Like the restaurant definition earlier, a business associate is what you assume them to be: a person with whom the taxpayer could reasonably expect to engage in business.

Substantiate or No Deduction

The problem with these deductions when they come up in audit is that clients generally don’t keep good records, or they misplace receipts. In the current world of cell phone accounting there is often little evidence to prove the business purpose of the expense. We recommend the following best practices to reduce the risk of the IRS adjusting your tax liability:

1. Always keep the meal receipt from the restaurant, as the credit card statement is not enough evidence for an IRS auditor. Simply note on the back of the receipt who you dined with and the business purpose, such as “we shared leads” or “we discussed a new project.” You don’t need much except the who and why, as the receipt has the date, amount, and location of the business meal.

2. Remember that a business meal while traveling is only deductible if you stay overnight. This rule stems from a court case referred to as the “Sleep or Rest Rule.” A hotel statement is required to document any applicable deductible charges, as a line on your credit card statement from Hilton or Marriott is not adequate backup for an audit.

Business meals deducted as business expenses are almost always examined when returns are selected for audit, so keeping contemporaneous records from the time the expenses are incurred are essential for a good audit outcome. Please reach out to your Hood & Strong advisor with any questions, and here’s to many tax-deductible business meals ahead!

Contact AEIS Today

Contact us today and let us know what challenges you need help with or if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP to see how the tax-deductible business meals will impact your business.

This post was originally published in Hood & Strong’s Newsletter.

What the 1095-C Codes Mean & How They Work

Tue, 31 Aug 2021 15:11:04 GMT

Employers that offer an employer-sponsored health insurance plan and who are considered applicable large employers (ALEs have 50 or more full-time and full-time equivalent employees total on average during the prior calendar year. Multi-employers or those with common ownership may be considered a control group by the IRS and may be counted together as one employer) are required to fill out a 1095 C form for each full-time employee, but not everyone knows what this document is or why it's important. IRS Form 1095-C is basically used to meet the Section 6056 large employer play or pay requirement and to help determine if an individual is eligible for a premium tax credit. It is the employer’s responsibility to complete the form for each eligible full-time employee, and they are required to send a copy to the employee and file a copy with the IRS. In addition to sending the 1095-C for each full-time employee to the IRS, an employer is also required to submit them with the 1094-C summation form. To best help you learn more about the process of filling one out, we've created this comprehensive blog post. We'll start by explaining how the 1095 C works, then go through each section in detail so you know exactly what goes where, what it all means, and which codes may be applicable to you. We will visit the completion of the 1094-C in at another time.

Part 1: Employee Lines 1-13

The first portion of the 1095 C form includes information about the employee and employer. This is where you'll fill out the employee’s name, address, social security number, as well as the name and address of your company.

This section doesn't throw much technical terminology at you, but the next part is more complex.

Part 2: Employee Offer of Coverage Lines 14-17

The second section of the 1095 C outlines the coverage offered to each full-time employee, the affordability of that coverage, and/or the reason why they were or were not offered coverage.

This information must be reported each month unless the information remains the same for all 12 months.

Line 14

In line 14, you will see instructions asking you to enter the "required code" in the "Offer of Coverage" section. There are 19 codes to choose from - outlined in depth below.

Code 1A

What It Means: A qualifying offer of affordable healthcare was made to the employee, their spouse, and any applicable dependent(s) to sign up for. Affordability is based upon the federal poverty line.

Code 1B

What it Means: A qualifying offer of healthcare coverage was made to the employee, but not to the spouse or applicable dependent(s).

Code 1C

What it Means: Your employer offered healthcare coverage to the employee and applicable dependent(s), but not to their spouse.

Code 1D

What it Means: A qualifying offer of healthcare coverage to the employee and spouse, but no dependent(s).

Code 1E

What it Means: The employer made a qualifying offer of healthcare coverage to the employee, their spouse, and their dependent(s). However, that offer was either affordable under any of the affordability safe harbors, or unaffordable.

Code 1F

What it Means: The healthcare coverage offered to the employee, their spouse, and dependents does not qualify as providing "minimum value."

Code 1G

What it Means: The employee was enrolled in healthcare coverage but was not a full-time employee.

Code 1H

What it Means: No coverage was offered by the employer, or the offer was not a qualified one.

Code 1I

What it Means: This code is only used in certain years as needed. For example, in 2015 the 1I code was used for transition relief for taxes. In future years, it may have different purposes but does not currently apply.

Code 1J

What it Means: A qualifying offer of healthcare coverage was made to the employee with a conditional offer of coverage to their spouse and no offer to dependent(s).

Code 1K

What it Means: A qualifying offer of healthcare coverage was made to the employee and their dependents, with a conditional offer of coverage made to their spouse.

Code 1L

What it Means: The employer offered you the employee an Individual coverage HRA, the affordability of which will be based on a primary residence location ZIP code.

Code 1M

What it Means: The employee and any dependents but not spouse were offered an Individual coverage HRA; the affordability is determined by the employee’s primary residence location.

Code 1N

What it Means: The employer offered the employee, their dependent(s), and spouse an Individual coverage health reimbursement arrangement (HRA). Affordability was determined based on the ZIP code of the employee’s primary residence.

Code 1O

What it Means: An Individual coverage health reimbursement arrangement (HRA) was offered, and the affordability was determined by using the employee’s primary employment site ZIP code.

Code 1P

What it Means: The employer offered the employee and their dependent(s) (but not spouse) an Individual coverage health reimbursement arrangement (HRA) and the affordability was determined by using the primary employment site ZIP code.

Code 1Q

What it Means: The employer offered the employee, dependent(s), and their spouse an Individual coverage health reimbursement arrangement (HRA). Like Code 1P, the affordability is determined by using the primary employment site ZIP code.

Code 1R

What it Means: The individual coverage HRA offered to the employee and their spouse/dependents is not affordable.

Code 1S

What it Means: The employee was not a full-time employee, but the employer still offered an Individual coverage HRA.

Line 15

Line 15 is used to report the employee’s required premium contribution of the lowest-cost monthly premium for self-only qualifying coverage. The amount reported on line 15 may not always be the amount the employee paid for coverage. For example, if the employee chose to enroll in more expensive coverage for their entire family, they will have paid more than what is reported on line 15.

Line 15 will only show an amount if certain codes are entered on line 14. If the employee was offered coverage but not required to contribute any amount towards the premium, the amount will be "0.00." If the code 1A is used in Line 14, then Line 15 will be left blank.

Line 16

This line explains why the employer did or did not offer coverage. The IRS uses this information to determine whether your employer is satisfying federal mandates and may affect their eligibility for premium tax credits. If an employee is offered coverage that meets both the minimum value and affordability safe harbors, they and their dependent(s) are not eligible for a premium tax credit or subsidy. There are several additional codes that must be entered on line 16 to help deliver this information quickly.

Code 2A

What it Means: The employee had no workdays in the month.

Code 2B

What it Means: The employee was not full-time during the month.

Code 2C

What it Means: The employee was enrolled in coverage for the whole month.

Code 2D

What it Means: The employee was in a waiting period and was not yet eligible for coverage per Affordable Care Act Regulations.

Code 2E

What it Means: The employee was covered under a union plan.

Code 2F

What it Means: The employer offered the employee coverage that was affordable based on the W-2 safe harbor, but they didn't enroll.

Code 2G

What it Means: The employee was offered coverage that is considered affordable based on the federal poverty line, but they did not enroll.

Code 2H

What it Means: The employee was offered coverage that was considered affordable based on the employee’s rate of pay.

No Code

What it Means: An offer of coverage was made to an employee, their spouse, and eligible dependent(s) that met both the minimum value and was affordable using the federal poverty line safe harbor. Line 16 can only be left blank if code 1A is used in Line 14.

Line 17

Line 17 displays the ZIP code used for determining the affordability of coverage when offered an individual coverage HRA. Codes 1L, 1M, or 1N in line 14 means the employer will have to use the employee’s primary residence ZIP code; codes 1O, 1P, or 1Q will require the ZIP code of the primary employment location.

Part 3: Covered Individuals (Lines 18-30)

If the plan offered is partially or fully self-funded, or self-insured, Part III must be completed with the information of those enrolled in the plan. This includes the employee, and anyone they have enrolled under them such as their spouse and/or dependent(s).

Part III requires the full name, social security number or date of birth for each enrollee, and the box for each month will need to be marked with an ‘X’ corresponding with the months they were enrolled.

This part of the form is used to prove coverage for individuals that are required to have health insurance per federal or state regulations. For those who are not enrolled in a self-funded or self-insured plan they will be issued a 1095-B or 1095-A from the carrier issuing the coverage.

1095 C Codes Made Simple by AEIS

We hope you found this brief guide to the 1095 C codes helpful as you begin to fill out the data. With over 35 years of expertise, Advanced Estate & Insurance Services, Inc . (AEIS) is ready to help you find real solutions to all your benefits questions for an easier, more complete employee benefits experience.

Empower your employees to make the most of their benefits with more complete communication and a better understanding of what's available. See how AEIS can help you create a better benefits program.

7 Essentials to Consider Before Choosing a PEO

Wed, 11 Aug 2021 16:24:01 GMT

You have spent years preparing to run your own business, and you are finally operational, quickly finding success. You have a business plan, you have hired employees, you know your overhead, profit, and have anticipated potential losses. You purchased insurance, and you found the perfect location. There is just one thing that keeps you awake at night, and that is the administrative duties which are becoming daunting. The start-up you’ve invested your life into has quickly become a desperate attempt to “keep up.”

Perhaps you are further along than the first scenario, your small to medium sized business has been operational for a few years. You have tightened up your business model, you have expanded your employee base and added staff, you are more familiar with the day-to-day happenings surrounding your business. You love what you do, but from time to time you find yourself worrying about taxes, benefits, payroll – those pesky administrative requirements that keep changing. You worry about compliance more than anything.

If you find yourself in either of these categories, then it’s time for you to take your life back and seriously consider working with PEOs. Below we cover the information business owners should absolutely know and understand when determining the best PEO for their business.

What is a PEO?

A PEO is a Professional Employer Organization. A PEO is a group of experts in a myriad of areas that can help you stay up to date with all your most pressing administrative matters. Examples of benefits a PEO can give you and your business include time management, direct deposits, company accounts, and payroll tax deductions. A PEO can also assist by ensuring you remain compliant and “in-the-know” about the latest strategies and employment laws. Finally, PEOs act as protection against expensive fines and costly penalties.

How do I know which PEO is best for my company?

You have already wrestled through the big question, to PEO or not to PEO ? So now you are tasked with learning how to know which PEO is best for your company.

There are literally hundreds of PEOs, nearly one thousand are operating within the United States. TriNet, ADP, Rippling, Justworks, Oasis, Insperity and Papaya Global – just to name a few. With this many options, how are you supposed to find the PEO that is best for you and your business?

Know what you want to get out of a PEO.

When you begin the process of identifying which PEO is right for you, there are a few items you should be prepared to discuss.

Here are 7 essentials to consider before you choose a PEO.

First and foremost, the area in which you operate your business matters. If you have not yet started to operate your business, then this is a factor you must be prepared to evaluate.
Next, you will need to be prepared to discuss the number of employees you employ. Often, your PEO evaluator will give you a category, 1-4, 5-9, and eventually more than 199. You need to know how many employees you have or hope to have. Be aware, some PEOs will require your business employs a certain number of employees to use their services.
Next, the PEO evaluator will want to know what kind of benefits you would like to provide through your PEO, or if you want to provide any benefits at all. These benefits include health insurance, disability options, flexible spending plans, retirement plans and life insurance.
Additionally, consider your industry, and research the PEOs who specialize in your area of expertise. Consider your business size, specialty, location, and practices to help guide towards the best PEO fit for your business.
Further, you will want to consider the level of involvement you would like your PEO to have. Should your PEO handle Human Resources administration and payroll? Should the PEO handle compliance and legal issues? Do you need the PEO to handle talent management? Once you answer these basic questions, you will be more prepared to review plans.
Review the PEO.

There are a few things you will want to review before you sign with a PEO. Industry leaders suggest you investigate the technology and ensure your employees enjoy the interface. Next, you will want to ask about current and previous user experiences. Ensure the customer support is accessible, helpful and available for your employees. Finally, review accreditations and services history.

7. Pricing Structures. There are two main pricing structures PEOs use for small businesses. These two include: percentages of total monthly payroll and fees per-employee. The costs within these structures varies.

Under the first structure, percentages of total monthly payroll, on average you can expect to effect 3% to 12% of your monthly payroll.

Under the second structure, fees per-employee, you can expect the average will range from $40 to $160 per person.

These numbers will vary depending on your individual factors and may be higher or lower. Always be on alert for additional fees. Before you sign on the dotted line, request an itemized, detailed, list of all pricing, costs, fees and penalties.

Talk to an Expert

You now have all of the basic information you need to take your next step, and that is to speak with one of our experts to learn more about the PEO you need. We know this is a daunting task, and it is very likely you still have questions. We do not expect you to take on this research and make this decision alone. We are here to partner with you.

When you decide to partner with AEIS on your PEO decision, you will have an advocate who holds your best interest in mind. Our job is to help you take the right steps which will have your business thriving like never before. Now that you know a PEO is right for you, we invite you to take advantage of special pricing available only through our exclusive channel partnerships.

PEOs will take on the daunting administrative tasks that steal your joy, so click here to take the first step toward your peace of mind.

How can you know which PEO is best for your company? Let us help!

What is a PEO Broker and How PEO Brokerage Can Benefit Your Company

Wed, 11 Aug 2021 16:23:59 GMT

Written by: Ron Bland, GBDS

Table of Contents

You started your business because you have a gift, skill set, idea, or passion. You are excited to serve your community by using this resource, but you are not as excited about the legal hurdles you have to jump over to remain compliant with ever-changing laws.

Other small and medium-sized business owners keep referring to a “ PEO ” that helps them with administrative duties and legal compliance. You have a small or medium sized business, you love your staff and employees, and you believe they deserve the best you can give them, but you feel overwhelmed by paperwork. Not to mention, you started this business because you are passionate about the work you do, not these administrative tasks: payroll, benefits packages, insurance, Human Resources requirements – among other things – and you do not feel confident in your ability to manage them.

You know these things are important, and of course you want to provide your employees with the best benefits you can, but these complex administrative requirements keep you from focusing on what originally inspired you to start a business in the first place. If there is a resource out there to help manage payroll and benefits, and it will free your mind and help your employees, you know you need guidance navigating if and which PEO brokerage is the right fit for you and your company!

So, what is a PEO Broker?

A Professional Employer Organization, or “PEO” is an entity which operates in harmony with corporations, organizations and businesses to assist in the management of employee benefits packages, payroll, and other administrative and Human Resources responsibilities. Because of the nature of a PEO, it is sometimes referred to as a co-employer. There are more than 900 PEO companies in the United States, and this number does not include international contenders.

A PEO brokerage or broker is an individual or firm which represents and manages many different PEOs and brokers for several different businesses or companies, such as our team here at AEIS. In short, these PEO brokers help their clients determine if they are a good fit for a PEO and then match their clients with a PEO. The client is you, the hardworking small or medium size business owner. These firms exist to garner a thorough understanding of the several hundred types of PEOs available, as well as learning your business needs. In fact, these firms operate by maintaining a focus on the specific needs of their individual clients. They will help you decide if you want to go directly with carriers and payroll companies or bundle everything under a PEO. Ultimately, these PEO brokers create a market amongst the PEO companies to drive competition and keep prices low for their clients.

This is a huge benefit for business owners that do not have hours to invest in research for the 900+ United States PEO companies.

Is a PEO a person?

A PEO is a conglomeration of individuals, often individuals who are educated and experienced in accounting, customer service, Human Resources, law, and taxation. PEOs “pool” various types of insurance with some of the top carriers in the United States, and the PEO will add clients, like yourself, to these plans, this creates a group who can then receive lower rates than you could as an individual business on your own.

Further, as your business continues to grow, PEOs can assist you with time management, direct deposits, company accounts, and payroll tax deductions. A PEO is essential in ensuring you remain compliant and “in-the-know” about recent and ongoing strategies and employment laws, PEOs serve as protection against wasted time, potential fines, and penalties.

Why would my business need a PEO Brokerage?

There are many reasons it benefits a business to partner with a PEO brokerage, namely: reducing costs, streamlining operations, hiring internationally, legal compliance and even employee termination all while reducing risk liability. Additionally, PEOs help by mitigating benefits costs and health insurance to relieve the business of some expenses. A PEO can be a great administrative assistant for the right company. There are some important considerations to keep in mind such as commitment because co-employment is harder to break than a typical vendor. Another one is renewals can be subject to higher rate increases than the fully insured health insurance market.

We're here to help.

Contact us today.

How Does a PEO work?

A PEO places a business’ employees on the PEO’s payroll. In this capacity, the PEO brokerage is the “employer of record” for the employees. These employees will still work for the business, they receive duties, tasks, responsibilities and assignments from the business, but the PEO administers benefits and paychecks.

In other words, you get to run your business while the PEO handles the administrative tasks. The PEO broker oversees this entire relationship with your business’ best interest in mind.

If you do not have a PEO, talk to a PEO broker today!

Moments ago you were asking, “ what is a PEO broker ?” Now you know, so the next question is “ to PEO or Not to PEO ?” PEOs are experts in deciphering which legal requirements apply to your business, and determining which paperwork is required to ensure your business complies with the law. As your business grows, PEOs can assist you so you can focus on your business and doing what you love.

Again, there are many PEO companies you may consider: Insperity, Rippling, Justworks, Oasis, Extensis Group – the list goes on. We know this is a daunting task, and that is why we are here to guide you every step of the way.

If you are still unsure whether or not working with a PEO brokerage is the best choice for you and your business, we understand, and that is why we are here. We encourage you to consider the time you could save by working with a PEO broker and utilizing a PEO for the benefit of you and your employees. We provide an opportunity for you to inquire about what all of this could mean for your business.

Follow the link below to begin a conversation with one of our experts, at no risk to you, to see just how helpful a PEO could be for you, your business, and your employees.

About The Author:

Ronald L. Bland

President

The Cost of Estate Planning Failures

Wed, 04 Aug 2021 17:32:55 GMT

Prince (57) was a singer-songwriter known for hits like “Little Red Corvette,” “Purple Rain,” and “When Doves Cry.” He died in April 2016 after an accidental fentanyl overdose. At the time of his death, there were no legal instructions for his $300 million estate. Based on Minnesota law, his estate was left to his child and then to any surviving siblings. This situation was quite complex since Prince’s estate consisted of copyrights and recordings as opposed to dollars and cents.

Kobe Bryant (41) was a basketball player known for playing for the Los Angeles Lakers for twenty seasons, winning five championships in the process. He, along with his 13-year-old daughter and eight passengers, died in a helicopter crash in January 2020. At the time of his death, it is estimated that Kobe had earned over $500 million throughout his career. As his surviving spouse, Vanessa Bryant will receive at least half of the money that came in since their marriage in 2001. As Wealth Advisor points out, a fair amount of forty-year-olds do not think to update their beneficiaries when they get married. As a result, there is a chance that Kobe’s parents may be listed as the heirs of record as opposed to his wife. When this occurs, money bypasses the surviving spouse and moves back up a generation .

Chadwick Boseman (43) was an actor known for his roles in Black Panther, 42, and Ma Rainey’s Black Bottom. After a four-year battle with colon cancer, Chadwick died in August 2020. For reasons that have remained private, he died without a will. As a California resident, his surviving spouse, Taylor Simone Ledward, would be his legal heir under the state’s intestacy law. The future of part of his estate will require court intervention during probate – the legal process of administering someone’s estate after death.

Importance of Estate Planning

Whether the individual is famous or not, whether the death is sudden or foreseeable – people tend to procrastinate getting their estate in order and preparing their will. While death is inevitable for everyone, Steve Parrish, co-director of the Center for Retirement Income at The American College of Financial Services, laments that, “…no wants to admit their own mortality.” It is estimated that 62% of people residing in the United States do not have a will.

People mistakenly believe they do not have enough assets to justify having a will or engaging in estate planning. Shann Chaudry, an estate-planning attorney, stresses that, “It doesn’t matter how many assets you have, an estate plan will ensure that your medical and financial decisions can be made by someone that you trust.” A last will and testament is a document that identifies to whom an individual gives their assets after death while a durable power of attorney is an individual who is legally empowered to make financial decisions on behalf of a sick spouse, family member, or friend. Michael Arden, president of Arden Trust, warns that “A lot of folks say, ‘I don’t have an estate plan,” but you do – the state has one for you.” These decisions, which will impact the financial and emotional future of one’s loved ones, are too important to be made by a total stranger.

Importance of Life Insurance

It can be harrowing to think about the lingering costs of an estate after one’s death. Whether the death is foreseeable or not, life insurance in an irrevocable insurance trust (ILIT) can be instrumental in this process. This trust is designed to receive the proceeds of the death benefit without inflating the value of the insured’s estate. The death benefit can be utilized to repay debts, cover funeral expenses, and finance administrative costs, such as lawyers, accountants, and appraisal fees.

Rather than leave your future up to the state, take power into your own hands and take steps to secure your own will and estate. Let this article be the catalyst to get your estate in order!

Talk to our Principal Ron Bland to further discuss life insurance options. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12. The team, made up of expert advisors, can also assist you in acquiring a robust and comprehensive benefits package.

Is A Flexible Spending Account (FSA) Worth It?

Thu, 29 Jul 2021 18:25:28 GMT

Flexible Spending Accounts, or FSAs can have many benefits for employees who choose to utilize them, but mistakes can be made, and it is important to avoid them. In order to do that, you need to know what kind of an FSA you have, and what specific terms mean. Below, we explore four important FSA aspects you should be aware of before choosing to implement them into your own business. Read on to get started!

#1) There Are Different Types of FSAs

There are three types of FSAs, Health or Medical, Excepted Benefits, and Dependent Care. A health FSA can be used to pay for any qualified medical expense as outlined in the IRS Tax Code, Section 213(d). An excepted benefit FSA can be used solely for medical expenses related to dental and vision care. Generally, Dependent Care FSA funds can be used to pay for day care provided for a dependent child under the age of 13.

#2) Employee FSA Contribution Limits Exist

While the amount an employee is allowed to fund any of these types of accounts can vary based on overall participation by other employees in their company, health and excepted benefit FSAs have a maximum contribution of $2,700/year, and dependent care maximum contributions are $5,000/year.

The FSA is funded by employee payroll deductions with the full contribution amount elected by the employee divided evenly throughout the plan year. An employee can use the full amount of the FSA elected at the beginning of the plan year and ‘pay it back’ over the course of the plan year. Dependent care FSA funds can only be paid out to the employee or day care provider up to the amount that has been funded to date.

#3) FSAs Can Have Special Plan Features

FSAs can come with some plan features, making it important to know the differences between them. We discuss a few of the most common and important features below.

Runout Periods

The first is Runout Period. The Runout Period is a window of time at the end of the plan year that a plan participant is able to submit for reimbursement of claims that occurred prior to the end of the plan year. For example, a plan year runs from October 1 – September 30 ^th , and an employee had a dentist appointment on September 18 ^th . If the plan has a runout period of 30 days, the employee can submit their claim for that dentist appointment as late as October 30 ^th to be reimbursed.

Grace Periods

A Grace Period is different than a Runout Period. The Grace Period is a window of time that cannot exceed 60 days following the end of the plan year where plan participants can make new claims to use up any unused balance in their FSA after the end of the plan year. For example, the plan year runs from October 1 – September 30 and has a 60 day grace period. The fore mentioned employee could have postponed their dentist appointment from September 18 ^th to November 9 ^th and it would still be eligible for reimbursement.

Rollover Provisions

For those employers who do not offer a grace period, they do have the option of offering a Rollover provision. A rollover provision allows employees to rollover an unused balance in their FSA from one plan year to the next. The maximum amount eligible for rollover is decided by the employer and cannot exceed $500. In order for an employee to be eligible for the rollover provision, they have to participate in the next plan year, even if they only contribute $1 for the year.

#4) The Impact of COVID-19

COVID-19 legislation temporarily changed many of the rules for FSA plans including the maximum amounts allowed for contribution, roll over amounts, and run out periods. Be sure to check with your plan administrator if you want to implement any of these changes and to be sure your plan continues to be in compliance with Federal requirements.

AEIS – Your Trusted Benefits Advisor

Contact our team for expert guidance to implement an FSA for your company and your employees.

If you’re looking for assistance with your employee health benefits plans, AEIS is here as a trusted advisor, advocate, and strategist. With over 35 years of expertise, we are ready to help you answer the "is a flexible spending account worth it" questions and find real solutions to your most pressing benefits questions for an easier, more complete, always compliant plan.

Cash in Lieu of Benefits: Not So Fast…

Mon, 14 Jun 2021 20:55:45 GMT

Employers have often offered their employees cash in lieu of enrolling in the employer-sponsored benefit plans. Some employers want to offer something to those employees who choose not to take advantage of the health benefits they make available; so, they can have similar compensation as those employees that choose to participate. Others do it to incentivize employees to make use of other plans they have available to them, such as through a spouse or parent’s plan. The cash compensation is often less than what the employer would otherwise spend for them to enroll in the benefit plan. Some simply see it as a job perk and a helpful way to recruit and retain employees.

However, what seems simple on the surface is far more complicated. Dive in as we explore some of the difficulties of offering cash in lieu of benefits before deciding on this course of action.

The Legality of Cash in Lieu of Benefits

The first thing to remember with any kind of employee benefit is that it must be offered on an equal basis to all similarly situated employees (e.g. all full-time employees, all employees working in one particular state, or management employees). Keep in mind that whatever classification is used, that classification must exist for a bona fide business reason besides benefit eligibility.

During the Reagan administration, Medicare was in dire trouble. As a result the Medicare Secondary Payer rules were enacted to relieve some of the financial strain. One of the things these rules state is that any employer with 20 or more employees cannot incentivize employees who are eligible for Medicare to dis-enroll from their employer sponsored plan and enroll in Medicare. Offering employees cash instead of enrolling in the offered benefit plan can be seen as an incentive to enroll in Medicare. If the employer only offers cash in lieu of benefits to those under the age of 65, the policy can be seen as discriminatory. Be sure to consult with counsel to carefully craft the plan documents to ensure the policy is not discriminatory and not violating the Medicare Secondary Payer rules.

How to Report Cash in Lieu of Benefits to the IRS & Potential Pitfalls

If an employer is considered an Applicable Large Employer, or ALE, under the Affordable Care Act, they are required to offer health insurance that meets the minimum value and affordability standards set forth in the law to their full time employees; if they do not offer this, they could potentially face a penalty. Generally, an ALE is an employer with 50 or more full-time and/or full-time equivalent employees. An ALE is also required to report to the IRS regarding their employees and whether the required offer of affordable coverage was made. This reporting is conveyed through the IRS 1094-C and 1095-C forms. The 1095-C form requires that the employer disclose the monthly premium cost to the employee for enrollment in the lowest plan offered that meets the minimum value standard.

If an employer offers cash in lieu of benefits the IRS considers that amount to be a cost to the employee who chooses to enroll in the employer sponsored coverage. For example, if the base plan costs an employee $200/month to enroll and the employer offers employees $300/month if they choose not to enroll in the employer sponsored plan, the employer must report $500/month as the cost to enroll in coverage. The reason being the employee who enrolls in coverage and pays the monthly premium is also losing the $300 they would otherwise be receiving. This could cause the plan to be deemed unaffordable under the standards set in the Affordable Care Act, potentially resulting in a penalty to the employer.

Lastly, Flores v. City of San Gabriel, 824 F.3d 890 (9 ^th Cir. 2016) under statutory interpretation of the Fair Labor Standards Act found that cash in lieu of benefits payments was considered compensation for work, regardless of whether the payments were attributable to specific hours that were worked. This ruling means that any employer who offers cash in lieu of benefits must include the cash benefit amount when calculating overtime compensation rates for non-exempt employees.

Any cash an employee receives for not enrolling in the benefit plans offered is considered taxable compensation, something both the employer and employee should keep in mind as it increases the cost for both parties above the simple cash amount.

AEIS – Your Benefits Guide

In short, when an employer wants to offer cash in lieu of benefits because it seems like a simple way to beef up their benefits package, they should think twice as it is not nearly as simple as it sounds.

If you’re looking for assistance with your employee health benefits plans, AEIS is here as a trusted advisor, advocate, and strategist. With over 35 years of expertise, we are ready to help you find real solutions to your most pressing benefits questions for an easier, more complete, always compliant plan.

Contact our team today and let us know how we can help you!

Mental Health Benefits for Employees | CA Benefits Group

Mon, 17 May 2021 15:50:47 GMT

The overall well-being of an employee has never been more of a priority for employers as it is right now. From health care to vision care to mental health care, the entirety of the employee’s health is important to the health of the organization.

Importance of Mental Health Benefits for Employees

Mental health and the cost of not treating its issues has far-reaching effects from the individual to the global world. Let's name a few:

If left untreated, an employee’s poor mental health could lead to work related accidents, absenteeism, poor workplace productivity, and even workplace violence.
Mental health costs make up about 8% of the US’s total healthcare spending.
The National Institute on Mental Health estimates that major mental illness costs the US at least $193 billion per year in lost earnings.
Globally, depression and anxiety issues cost about $1 trillion a year .

Types of Mental Health Benefits

Mental health benefits can look different for each organization. Universally, businesses offer some sort of Employee Assistance Program (EAP) to its members. EAPs include services that are typically delivered online or by telephone. Services may include alcohol and substance abuse counseling, legal aid, and health and wellness counseling. These services are offered to the employee free of charge and are done anonymously.

As an extension of basic health care benefits, mental health benefits can also include one-on-one counseling with a licensed counselor for a certain number of sessions. Mental health benefits for employees may also incorporate wellness programs like relaxation and meditation classes, sleep techniques, and stress management lessons. Check your health insurance benefits package details as you may find mental health insurance coverage included under the behavioral health section.

During open enrollment, when employers present the employees with the upcoming year’s health insurance plans, the employee should also ask about mental healthcare options. Just as you assess the different healthcare plans and what fits best for you and your family, you can also assess the costs and coverage of mental health plans. Also, find out if your company offers a Flexible Spending Account as you can use that pre-tax money to pay for out-of-pocket mental health service costs.

Now, more than ever, people are more aware of the benefits to good mental health and how it affects their overall health and work performance. Utilize the company sponsored EAP offerings and investigate the details of your health insurance plan to find out what mental health services are covered. Your overall health and well-being are important and so are you!

State Compliance Laws

Wed, 28 Apr 2021 13:55:29 GMT

Do you have remote employees that work in any of the following states?

If you have even one employee working in any one of these states, be aware that there are specific laws that you must comply with!

Colorado – Law: Paid Family and Medical Leave (PFML)

Implementation: 1/1/2023 – 1/1/2024
Paid Via: EE and ER
Duration: 80 hours (maximum)
Reasons:
Birth and care of a child (to be completed within one (1) year of the birth).
Placement and care of an adopted or foster child (to be completed within one (1) year of the placement).
Serious health condition of an employee’s parent, child under the age of eighteen (18), an adult child who is disabled at the time of leave, spouse, partner in a civil union, or registered domestic partner for physical care or psychological comfort.
Employee’s own serious health condition. An illness, injury, impairment, physical or mental condition that requires inpatient care in a hospital, hospice, or residential medical care facility or continuing treatment by a health care provider. Continuing treatment is a period of incapacity of more than three (3) calendar days, pregnancy, a chronic serious health condition, or permanent long-term condition for which there is no treatment but the patient is under supervision, or multiple treatments without which a period of incapacity would result.
Active duty military leave when a parent, child, or spouse experiences a qualifying event directly related to being deployed to a foreign country.
Military caregiver leave for a parent, child, spouse, or next of kin who suffered a serious injury or illness in the line of duty while on active duty. Military caregiver leave includes time for veterans who are receiving treatment within five (5) years of the beginning of that treatment.
More Information: https://dpa.colorado.gov/about-us/faqs/paid-family-medical-leave-faq

Connecticut – Law: Paid Family and Medical Leave Act (PFMLA)

Implementation: 1/1/2021 – 1/1/2022
Description: Deduct 0.5% of employee’s wages beginning 1/1/2021. Benefits available beginning 1/1/2022. Applies to all employers, and sole proprietors and is 100% Employee funded. Notice requirement must be fulfilled by Employer by 7/1/2022.
Paid Via: EE payroll deduction of 0.5% of income. No ER contribution required.
Duration: 12 weeks (maximum)
Reasons:
Care for a seriously ill family member.
Bond with a new baby or foster/adopted child.
Due to serious medical issue.
Deal with family violence.
Deal with military deployment of a family member.
Donate bone marrow, tissue, or organ donation.
More Information: https://ctpaidleave.org/

Washington D.C. –Law: The Paid Leave Act

Implementation: 7/1/2020
Paid Via: ER payment of 0.62% of employee wages
Duration: 2 – 8 weeks (depending on the reason)
Reasons:
Deal with serious medical condition (2 weeks).
Deal with an ill family member (6 weeks).
Bond with new baby or child (8 weeks).
More Information: https://dcpaidfamilyleave.dc.gov/

Massachusetts – Law: Paid Family and Medical Leave (PFML)

Implementation: 7/1/2019 – 1/1/2021
Description: Requires specific policies and plans to be offered. State option premiums began to be collected through payroll on 7/1/2019. First quarterly filings due 10/1/2019.
Paid Via: ER and EE payments – 0.75% of EE salary.
Duration: 12 – 26 weeks (depending on the reason).
Reasons:
Bond with a new baby or child.
Deal with a serious illness.
Care for an ill family member.
Deal with military deployment or a family member who is actively deployed.
More Information: https://www.mass.gov/orgs/department-of-family-and-medical-leave
More Information: https://www.sunlife.com/us/For+businesses/Paid+family+medical+leave/Massachusetts

New Jersey – Law: Family Leave Insurance

Implementation: 7/1/2020
Paid Via: EE payroll deduction of 0.16% of salary (2020). EE payroll deduction of 0.28% of salary (2021).
Duration: 12 weeks (maximum).
Reasons:
Bond with a new child.
Care for a seriously ill or injured family member.
Link: https://www.myleavebenefits.nj.gov/worker/fli/

New York – Law: Paid Family Leave

Implementation: 2018
Description: Requires specific policies and plans to be offered. Both state run and private insured options are available.
Paid Via: EE or ER contribution. Maximum EE payroll contribution is 0.153% of salary without ER contribution.
Duration: 12 weeks (maximum).
Reasons:
Bond with a new child.
Care for a seriously ill close family member.
Assist with a military deployment or assist while someone is deployed.
More Information: https://paidfamilyleave.ny.gov/

New York – Law: Harassment Prevention Training (Local Law 96 of 2018)

Implementation: 4/1/2019
Description: Employers with 15 or more employees are required to conduct annual sexual harassment prevention training for all employees.
More Information: https://www1.nyc.gov/site/cchr/law/sexual-harassment-training-main.page

Oregon – Law: Paid Family and Medical Leave Insurance (PFMLI)

Implementation: 1/1/2022 – 1/1/2023
Paid Via: EE and ER contribution.
Duration: 12 weeks (maximum).
Reasons:
Bond with a new child.
Care for a family member while they recover from a serious illness.
Deal with issues related to domestic violence, sexual assault, harassment, or stalking.
More Information: https://www.oregon.gov/employ/PFMLI/Pages/PFMLI-General-Information.aspx

Rhode Island –Laws: Temporary Disability Insurance (TDI) and Temporary Caregiver Insurance (TCI)

Implementation: 1942 (TDI) and 2013 (TCI)
Paid Via: EE payroll deduction of 1.1% of salary.
Duration: 4 weeks (maximum)
Reasons:
Bond with a new child.
Care for a seriously ill family member.
Deal with a disability or an illness.
More Information: https://dlt.ri.gov/tdi/

Washington – Law: Paid Family and Medical Leave

Implementation: 1/1/2019 – 1/1/2020
Description: Requires specific polices and plans to be offered. State option premiums begin to be collected through payroll on 1/1/2019. First filing deadline was 7/1/2019.
Paid Via: EE payroll deduction 0.4% of salary. If ER has 50 or more EE’s, the ER must contribute 37% of the 0.4% of EE wages.
Duration: 12 weeks (maximum)
Reasons:
Bond with a new child.
Care for an ill family member.
Recover from off-the-job serious illness or injury.
More Information: https://paidleave.wa.gov/

Washington – Law: Long Term Services and Supports Trust Act

Implementation: 1/1/2022
Description: This is a tax that will cost $0.58/$100 of income. If you make $100,000 per year, the tax will start at $580. The more you make, the more you will pay. Once you are on this system you are not able to leave it as long as you live in Washington State. Bi annually the state legislature can vote to increase the tax being charged. If you leave the state you will not receive the benefit you have been paying for, it will be lost. Furthermore, to qualify to receive the $100/day for 365 days (maximum benefit of $36,500) you must lose 3 activities of daily living (eating, bathing, dressing, transferring, walking, & continence).
Pay Via: Washington workers will pay $0.58 per $100 of earnings. Every EE contributes – No ER contribution.
Benefit: up to $36,500 over their lifetime
Types of services that can be paid for via benefit.
Professional care in your home, a licensed residential facility, or a nursing facility.
Adaptive equipment and technology, such as wheelchair ramps and medication reminder devices.
Home safety evaluations.
Training, pay, and support for family members who provide care.
Home-delivered meals.
Care transition coordination.
Memory care.
Education and consultation.
More Information: https://www.dshs.wa.gov/altsa/stakeholders/long-term-services-and-supports-ltss

Out-of-State Compliance Laws Alert by State Chart: Click HERE to download

Remote Onboarding

Mon, 26 Apr 2021 13:46:21 GMT

Remote Onboarding Success Plan

Remote workplaces have become very commonplace in our world today. In fact, a PwC survey of 669 CEOs, 78% agree that remote work is here for the long-term. As a result, remote onboarding has become part of the normal Human Resources operation in companies. Let’s dive into what remote onboarding looks like and some benefits and challenges of this new way of welcoming employees to the team.

What is onboarding?

Onboarding is the process of welcoming new employees to the company and introducing them to the company culture of their new employer. Onboarding is different from training in that training focuses on the policies and procedures of the job while onboarding is more focused on integrating the new hire to the team and helping them develop relationships within the workplace. Remote onboarding has the same focus but everything is done online through Zoom or other virtual meeting platforms. Onboarding is also not a one-time event. It’s a process that takes multiple days and an ongoing commitment to truly acclimate the new employee to the department.

Challenges of remote onboarding

Connecting virtually with others can have its challenges. Coordinating the entire team’s schedule to welcome new hires as they arrive on the team can be hard. This same challenge happens as the team attempts to continue to build camaraderie with some in-person team members and other remote team members. As many of us have come to understand, working remotely can be very isolating. Throw in joining a new team, and your new hire can feel extremely unengaged. Another challenge is technology set up in a remote environment. When onboarding in person, the IT department can physically be there to issue company technology. Remote onboarding relies on the new employee setting up their own technology or walking through set-up with an IT representative online.

Tips for remote onboarding success

Despite the challenges, remote onboarding can be a successful experience. Here are some tips to overcome some of these obstacles and make your new hire feel engaged and part of the team by the end of their remote onboarding process.

Set up a kick-off video call with your entire team to welcome the new member. By having a video call, you make it easier for names and faces to connect. Video welcome calls also allow the new hire to see the enthusiasm in the faces of their new team and begin to build an emotional connection.
Provide an organizational chart so that the remote employee understands the reporting lines in the company. Additionally, consider including pictures of those included on the chart so they can put faces to names. Another great way to go to the next level to connect with the new hire would be to pre-record quick welcome videos by the high-level execs and send them via email.
Introduce the new employee to the company via email or social media. Do a simple “Getting to Know You” interview with them so you can share some interesting facts about this new team member.
Regularly check-in via quick chat messages or video call with your remote new hire to find out if they have any questions or concerns in their first week(s). By having scheduled times where you connect with your new employee, they will have less of a chance to feel alone and will begin to learn your management style.

According to ServiceNow , “enthusiasm for a job peaks at the start of the job and wanes by 22% shortly thereafter.” Now is the time to capture your new hire’s enthusiasm and encourage its growth. While remote onboarding can be a challenge, it is possible to overcome the obstacles it presents with some careful planning and dedication to its success.

Vision Insurance: How Does it Work? | AEIS Advisors

Fri, 23 Apr 2021 16:10:04 GMT

According to WebMD , the eyes are the most highly developed sensory organs in your body. They report that more of your brain is dedicated to the sense of sight than to all of the other senses combined. So, it makes sense that you would do all that you can to protect and care for these important organs. Vision insurance can be a great asset as you work keep your eyes healthy.

How does vision insurance work?

Vision insurance is an insurance product used to reduce the costs of eye-related care, eye products, and eye surgeries. Group vision plans are typically purchased through employers, associations, or government programs like Medicare or Medicaid. Sometimes, vision plans are part of a value-added benefit that is linked to the subscriber’s health insurance. Plan subscribers usually receive free eye care, like annual eye exams, and a fixed discount on eye wear in exchange for a monthly premium. This type of coverage is recommended for people who need vision correction devices, who have a family history of eye issues, or for those who have a higher risk of eye disease, like diabetics.

What is a vision discount program?

Different from vision insurance, a vision discount program gives users discounts on eye exam services and products. The monthly premium is lower for discount programs but does not generally include free annual eye exams like vision insurance does. When the user buys into the discount program, they become a member of a large group for whom the program administrators have negotiated lower costs. Discount programs are most useful for those without pre-existing eye conditions.

What are the benefits of having vision coverage?

As mentioned before, your eyes are the most complex sensory organ in your body. Because of this, they are important to keep healthy and in good working condition. Vision coverage allows the user to have annual eye exams. At these exams, the optometrist determines if you need corrective lenses to improve your eyesight by means of glasses or contact lenses. The doctor will also check for eye diseases. Exams can even detect hidden medical conditions like brain tumors, rheumatoid arthritis, high blood pressure, or thyroid disease. If a medical condition is detected, the optometrist will refer the patient to a medical doctor for further tests and treatment.

Vision insurance and discount programs play a huge part in keeping your eyes healthy. Through regular eye exams, not only are your eyes evaluated, but the health of the rest of your body is, too. By scheduling eye exams, you are also able to obtain corrective eye wear that allow you to see clearer and without eye strain. Healthy vision is a benefit you don’t want to lose!

The Power of Praise | CA Benefits Agency

Fri, 09 Apr 2021 01:13:00 GMT

Think for a minute about all you have done today. Now, from that list of tasks, how many would you say you have done well? Again, from the list of tasks you feel you’ve done a good job on, how many were you praised for by your manager or even a co-worker? We all crave approval and praise from others in our life. The workplace is no exception. Praise motivates us to do well and to improve. Praise is necessary and praise is powerful. Follow these easy steps to build an effective habit of praise in your organization.

The WHY of Praise

Before we can get into the HOW of praise, let’s touch on the WHY. According to Gallup.com, “Recognition for good work releases dopamine in the brain, which creates feelings of pride and pleasure.” People want to feel like others see them and appreciate them. The praise-giver also receives benefits from this exchange. By giving praise, you get the same sense of satisfaction as you get when making a charitable gift or helping others. An environment of praise-giving is one where individuals work, not just to complete a task and be done, but they work to do a good job and to please their manager with hard work that is done well. Also, in terms of employee engagement, a manager who regularly praises their team, is one who is

The HOW of Praise

Giving praise is easy and, if you follow these simple tips, it is also an effective tool to motivate and encourage those in your workplace.

Make it QUICK

When you notice something that should be recognized with praise, do it immediately. The more time that passes between the event and the recognition, the less powerful the praise becomes. Make it a habit that when you see good work or good behavior, you stop what you are doing and give praise.

Make it SPECIFIC

Now that you have recognized the behavior or project that deserves praise, you’ll want to make the praise specific. Offering a vague compliment like, “You did good” doesn’t truly speak to the specific action that is praise-worthy. Instead, make your words of affirmation ones that point to a specific instance like, “The logo you created for the Milestone marketing project was clean and really inventive.”

Make it GENUINE

You may be tempted to adopt this new praise policy and start doling out compliments left and right like a praise shotgun, but, don’t. Disingenuous praise is almost as bad, if not worse, than no praise at all. You can tell if someone is making a forced comment or one that has no thought behind it. Instead, make sure the praise is given with a genuine heart and tone.

Create a CULTURE of praise

As you fine-tune the act of giving praise in your workplace, your final task is to create a culture of praise-giving. When you build this culture, and everyone is actively involved in recognizing their peers, you will find the morale and engagement in your office are lifted higher. Increased morale and engagement also increases productivity, lowers absenteeism, and lowers turnover.

Praise is incredibly powerful. Praise has the power to motivate, encourage, and build. By following the simple tips outlined here, you can unleash the power of praise in your organization and in your life and reap the benefits to both the giver and receiver.

Estate Tax Planning May Become More Important

Thu, 08 Apr 2021 15:14:00 GMT

By George Paulsen, CPA, Tax and Advisory Partner of Hood & Strong LLP

There is a lot of pending legislation in Congress right now. Of note, Senator Bernie Sanders is proposing a far-reaching estate tax that would apply to the top 0.5 percent of American taxpayers, which he is calling the “For the 99.5% Act.” According to the Joint Committee on Taxation, this estate tax could potentially raise $430 billion over the next 10 years. But this is misleading, as to get to the projected revenue, the estate tax exemption we have now – $11.7 million per individual – would be lowered to $3.5 million per individual.

The bill has several revenue-raising features. Currently, the tax rate on an estate over $11.7 million is 40 percent. Under Sanders’ proposal, the tax rate would start at 45 percent on amounts over $3.5 million, go to 50 percent on estates over $10 million, and scale up to 65 percent on estates over $1 billion.

Estate planners use several tools to reduce estate taxes and this bill would remove them from our tool chest. One commonly used instrument is valuation discounts on assets at death. As an example, if a father and mother own 49 percent of a rental property and their two children own 51 percent in a family limited partnership, upon one parent’s death we may be able to discount that parent’s share of the appraised value by up to 40 percent, depending on factors such as lack of control or marketability. This act would remove that option.

We often suggest that parents or grandparents make gifts to children and grandchildren to slow accumulation of wealth and move it down one or two generations. This proposal would also sharply limit the annual gift tax exclusion.

As our clients live longer and see grandchildren and even great grandchildren grow up, we use generation-skipping trusts and gifting to avoid estate taxes by providing for later generations. There is also a limit in this proposed law to restrict the use of trusts to accomplish this.

There are other tools that will be affected as well, including grantor-retained annuity trusts and other grantor trusts that would now have to pay gift taxes.

The Sanders bill is only a proposal, but it will go into the mix as Congress works on new infrastructure legislation and other spending laws to support those most affected by the COVID-19 pandemic. As we always do, our tax professionals are monitoring this and other proposals as they move through the House and Senate. Because this proposal has the potential to raise significant funding, it could well be made law and become effective later this year or next. We will keep you informed.

Contact AEIS Today

As one of the leading employee benefits firms in the Bay Area, AEIS, Inc. has a wide network of experts and partners to help you with your business and high-net-worth individual needs, from taxes to HR to payroll. If you need tax help, reach out to us at AEIS, Inc. at Alyssa@AEISAdvisors.com if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP .

This post was originally published in Hood & Strong’s Newsletter.

Exploring Year-Round Benefits Engagement

Fri, 26 Mar 2021 13:17:00 GMT

Just as with any good, healthy relationship, communication with employees is key. Only communicating with employees regarding their benefits package during open enrollment will most definitely result in them not taking full advantage of all it has to offer. In an effort to assist employees in understanding and maximizing their benefits, companies should use a year-round benefits engagement strategy. Let’s explore some simple ways to set up your annual communication plan.

START WITH THE END IN MIND

As you begin crafting your engagement plan, think of the overall goal you want to accomplish. Perhaps you simply want your employees to be better educated on their plan offerings. Maybe you’d like to reduce the number of questions that employees ask during open enrollment meetings. Or, maybe you want your employees to utilize a certain plan benefit that has been historically underused resulting in higher costs to the employee or the company. Whatever the case, first set your goal for the communication plan.

CREATE A CALENDAR

Now that you have an end-goal in mind, start thinking of how frequently you want to communicate. Schedule your communication moments to post consistently. Maybe you start a “Benefits Minute” that hits the first Monday of the month. Or, start a “Benefits Blog” that posts every other Friday. Whatever the case, make the communication happen on a schedule so that employees know when to expect it and know what it’s called.

KEEP IT SIMPLE

Wordy emails, drawn-out meetings, and forever long phone messages will quickly get ignored and deleted. Instead, follow this simple formula when crafting your communication:

Give a quick overview of the benefit you are focusing on for this particular communication.

In a few short sentences, explain how this benefit benefits the employee whether it be a cost savings, time savings, or simply a great help to them.

3. Here’s what you need to do to find out more.

Provide a way to find out more information on this benefit by giving a link, an email address, or a phone number.

MIX UP YOUR COMMUNICATION STYLE

Communication isn’t one-size-fits-all. People learn in different ways—some may be visual learners while others may be oral learners. Make sure you mix up the way you communicate to cover both types. Also, change up the method of communication. Try emails, explainer videos, printed flyers, and quick, stand-up meetings. By using a variety of methods, you are able to engage a broader audience since your company is comprised of a range of ages, genders, learners, and tech users.

Engaging in a regular, year-round communication strategy for explaining employee benefits will support both the company as well as the employee. Set your strategy in motion by following the simple tips shared here. And, when you do this, you will see that your employees will reap the benefits of a healthy understanding of their benefit plan.

AEIS News: The MDRT Foundation Presents Grant to the One Hit Away Foundation

Wed, 24 Mar 2021 19:33:00 GMT

In 2020, the MDRT Foundation awarded a USD $5,000 grant to the One Hit Away Foundation , a local Bay Area 501(c)(3) non-profit that provides resources for education and advocacy for brain health from sports-related brain injuries.

Through its global grants programs, the MDRT Foundation is committed to building stronger families and communities around the globe.

Representing the MDRT Foundation, Ron Bland, President of AEIS, Inc., presented the grant to the One Hit Away Foundation at their virtual 2020 annual gala. We were honored to be able to submit the One Hit Away Foundation for this grant. Ron has reached a Gold Knight donor level of the MDRT Foundation, and is a proud partner of both the MDRT Foundation and MDRT.

Congratulations to the One Hit Away Foundation and special thanks to the MDRT Foundation for their vital grants and resources for communities across the globe.

About the MDRT Foundation:

The MDRT Foundation was created in 1959 to provide MDRT members with a means to give back to their communities. Since its inception, the Foundation has donated more than $36 million in more than 72 countries throughout the world and in all 50 U.S. states. These funds were raised by MDRT members and industry partners. For more information, visit www.mdrtfoundation.org .

About MDRT:

Founded in 1927, Million Dollar Round Table (MDRT) , The Premier Association of Financial Professionals®, is a global, independent association of more than 72,000 of the world’s leading life insurance and financial services professionals from more than 500 companies in 70 nations and territories. MDRT members demonstrate exceptional professional knowledge, strict ethical conduct and outstanding client service. MDRT membership is recognized internationally as the standard of excellence in the life insurance and financial services business. For more information, please visit www.mdrt.org and follow them on Twitter @MDRtweet.

How Your Employees May Be Facing Burnout and 5 Ways to Address It

Wed, 24 Mar 2021 15:17:00 GMT

Introduction

After a year of isolation, grief, and adversity, mental health has been at the forefront of national conversations. How do you take care of yourself, your family, and your colleagues during an unprecedented global pandemic? As people cope with new or amplified feelings of anxiety and depression, employers may also notice employees exhibiting symptoms of burnout. It is a common and valid experience that can have drastic impacts on the workplace. Read on how to learn more about burnout and how to be a leader who can take concrete steps to prevent burnout as well as assess and respond to its effects.

What is Burnout?

The World Health Organization defines burnout as an occupational phenomenon. Mayo Clinic expands on this by explaining that burnout is a state of physical or emotional exhaustion . Burnout can encompass feelings of cynicism, frustration, and emptiness in the context of work. According to an estimate by Korn Ferry, a leading executive search firm, 7 in 10 employees experience burnout . It is important to underscore that anyone is susceptible to burnout , even those who feel fulfilled in their career.

Signs of Burnout

Take a moment to read over the possible signs of burnout.

Do you recognize any of these feelings or actions in your employees? If so, the employee may be experiencing burnout. It is important to note these signs may be related to other health conditions, such as depression.

Causes of Burnout

What exactly evokes feelings of burnout in the workplace?

Lack of Control. During this past year, people had to reckon with the amount of control they do and do not have in their own lives. More often than not, a lack of control can exist in the workplace as well, which can be difficult to face. Having little to no influence over projects, doing monotonous work, and enduring unclear job expectations are examples of an absence of control.

Lack of Support. Burnout occurs when people are over-whelmed and under-supported. Unfortunately, mental health continues to be a taboo subject in the workplace. If employees are feeling frustrated and depleted at work, and there are no existing resources or supportive figures in the organization, those feelings may continue and strengthen over time.

Work-Life Imbalance. As people transitioned to working from home, the lines between one’s professional and personal life blurred. Many people had to figure out how to be an employee, a caretaker, and a partner in the same space, and often at the same time. Wearing numerous hats for an extended period can contribute to feelings of exhaustion and irritability.

Consequences of Burnout

There are valid and significant consequences of burnout in the workplace. People who are exposed to burnout have reported experiences of insomnia, excessive stress, and fatigue. Burnout is also correlated with heart disease, diabetes, and chronic substance use. Employees may feel that a job or career change can alleviate feelings of burnout. In order to effectively support and retain their employees, employers must take steps to tackle the phenomenon of workplace burnout.

Remedies for Burnout

Employee Assistance Programs. An Employee Assistance Program (EAP) is a company-sponsored program whose purpose is to support employees as they navigate challenges that adversely impact their work performance. The common services of an EAP are legal aid, health and wellness counseling, child or elder care resources, marital and family counseling, and substance use counseling. Employees turn to EAPs when experiencing personal issues, such as grief, anger, stress, coworker conflict, and life changes. EAPs are voluntary, free, and typically offered through third-party administrators. Through the confidential and holistic services of an EAP, employees can receive aid and remain focused on their work. Employers who offer EAPs send convey they care about their employees and strive for a safe and understanding environment.

Communication. In addition to an EAP, employers should encourage open and honest conversations throughout the company. It is encouraged that employers hold regular staff meetings, both with the whole team and with individual team members. Meetings allow employers to check-in with the team as well as for employees to discuss projects, obstacles, successes, and career goals. Additionally, employers can utilize meetings to provide sincere praise and recognition regarding the employee’s work. As mentioned previously, unclear job expectations can heighten feelings of burnout. It is imperative that employers clearly define the duties and requirements of each and every employee.

Balance. As employees continue to work from home, balance is key in preventing and mitigating feelings of burnout. Encourage employees to practice boundary-setting. When they sign off for the day, support them in truly disconnecting from work emails and phone calls. Ensure employees are being adequately compensated for their work so they do not have to continually work over-time to make ends meet. Balance applies to those who are under-stimulated at work as well as to those who are over-stimulated. If an employee’s workload is low or monotonous, they may benefit from a new task or project. Explore virtual trainings that will help employees develop new skills.

Self-Care. Activities that promote self-care should consistently be incorporated and valued throughout the organization. Invite employees to take a walk or get fresh air during the workday. Permit employees to listen to music as they work independently. Designate time on the meeting agenda for meditation, mindfulness, or sharing healthy tips. Urge employees to prioritize sleep, healthy eating, and exercise every day.

Another way to ensure your employees are cared for is to provide them with a robust and comprehensive benefits package. Full benefits offering and expert advisors by your side can save your company time, resources, and money so you can focus on supporting your team. Talk to our Principal Ron Bland on what plans are best to offer your employees. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12.

Top 8 Health Plan Trends of California Businesses

Tue, 09 Mar 2021 15:01:00 GMT

As a business owner, selecting a health plan can be difficult. How much should the in-network deductible be? In California and across the country, what plans are businesses in my industry choosing for their employee benefits? How much are other businesses spending per employee? Luckily, United Benefit Advisors (UBA) has gone to great lengths to provide answers to those questions to ensure businesses are making informed health care decisions.

UBA is one of the two largest employee benefit organizations in the United States. Their survey, which is nearly three times larger than the next two largest health plan benchmarking surveys combined, reaches a broad range of employers across the nation. In 2020, UBA surveyed 11,778 employers regarding their health plans; 659 of those employers, encompassing nearly 30,000 employees, are based in California. Below are some of the most significant findings from this survey.

#1 – The top plan in California is an HMO/EPO plan.

Employers and employees are shown to prefer health maintenance organization (HMO)/exclusive provider organization (EPO) plans. In the Golden State, HMO/EPO plans comprise 52.4% of health plans. Preferred provider organization (PPO)/point of service (POS) plans account for 41.74% of plans while health savings accounts (HSAs) cover 5.8% of plans.

#2 – Both small and large groups tend to favor HMO/EPO plans.

51.6% of small groups (1 – 99 employees) choose HMO/EPO plans while 43.6% select PPO/POS plans and 4.8% opt for HSAs. Similarly, 55.8% of large groups (100+ employees) choose HMO/EPO plans while 33.0% select PPO/POS plans and 11.2% opt for HSAs.

#3 – There is a notable difference in plan preferences between Northern and Southern California.

Northern California is mostly PPO territory for non-Kaiser groups while Southern California is largely HMO focused.

#4 – The top four industries in California are Professional/Scientific/Technology Services, Manufacturing, Health Care/Social Assistance, and Wholesale/Retail.

Of these industries, HMO/EPO plans are quite popular amongst manufacturing businesses; they comprise of 60.8% of health plans within that field. In regards to the other top three industries, they tend to more equally favor HMO/EPO and PPO/POS plans.

#5 – The Manufacturing Industry has the highest total average cost per employee across all plan types.

Manufacturing, on average, spends between $10,343 (HMO/EPO) and $16,338 (PPO/POS) per employee. Professional/Scientific/Technology Services spends between $10,370 (HMO/EPO) and $15,200 (HSA). Wholesale/Retail spends between $8,721 (HMO/EPO) and $14,157 (PPO/POS). Health Care/Social Assistance spends between $7,822 (HSA) and $11,612 (PPO/POS). Besides Health Care/Social Assistance, the other three industries fall above or within the state average. Across all California employers, businesses tend to spend an average of $9,345 (HMO/EPO), $12,220 (HSA), or $14,532 (PPO/POS) per employee.

#6 – California business owners make a larger employer contribution than the national average.

Employers in California tend to pay for 71% of the cost of the health plan with the employee paying for the remaining 29%. In the United States, the average employer pays for 68% and the employee pays for 32% of the plan.

#7 – While PPO/POS plans and HSA plans are on the expensive side in California, HMO/EPO plans are below the national average.

For PPO/POS plans, the average cost per employee per year is $11,249 nationally and $14,532 in California. For HSA plans, the average cost per employee per year is $10,089 nationally and $12,220 in California. For HMO/EPO plans, the average cost per employee per year is $10,040 nationally and $9,345 in California.

#8 – In California, the median in-network deductible for H.S.A. plans was the most expensive while the median in-network deductible for PPO/POS plans was the most inexpensive.

The median in-network HSA deductible was $3,000 for singles and $6,000 for families. The median in-network HMO/EPO deductible was $1,650 for singles and $3,300 for families. The median in-network PPO/POS deductible was $750 for singles and $2,000 for families.

While the UBA Survey can be tremendously helpful in understanding trends in California and across the United States, at the end of the day, your business has unique needs regarding health insurance. Talk to our Principal Ron Bland to understand which insurance plan fits best with your company. Our team, made of expert advisors, can also assist you in acquiring a robust and comprehensive benefits package. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12.

What to Do and Know as an Employer If You Have Remote Out-of-State Employees

Fri, 05 Mar 2021 13:55:00 GMT

The pandemic has fundamentally changed our personal and professional lives over these past eleven months. One notable change is that a greater number of employees are working from home, some for the foreseeable future. As a result, many employees do not necessarily have to reside in the same city, county, or state as the company for which they work. Employers are also not confined by geographic limits when seeking to hire new employees during this time. While having out-of-state employees can yield positive benefits, employers should be mindful about the implications. Read on to learn how to ensure your business is prepared to have an efficient and compliant workforce with in- and out-of-state employees.

Residency

There is a high likelihood that one of your employees will relocate during this time. When an employee leaves the state, do you need to inform your health insurance carrier about the employee’s “new” address? The answer is – it depends. We recommend asking more questions to find out.

Does the employee have a set return date? If the answer is yes, you may not have to change their address. However – every state has different standards regarding the amount of time (weeks, months, etc.) that an employee can be out-of-state before they are required to submit a change of address form. Work with your HR team to learn more about each state’s requirements.

Is the employee planning to work at this new address? If the employee intends to answer a few work emails during a weekend getaway, it is acceptable to keep their address as is. However, if the employee intends to “set up shop” and work from this new address, it is highly advised that their address is updated.

When in doubt, the insurance carrier should have the employee’s most up-to-date address. A temporary living situation can quickly become more permanent – better to be proactive than reactive.

Taxes

At this point, you may be asking yourself why you need to update the employee’s address at all. Simply put, it boils down to tax liability. Each state wants to get its fair share of taxes. If an employee moves, loses their job, and then attempts to apply for unemployment benefits, it is imperative that there is a previous record of them residing in that state.

As an employer, you must be sure to understand the various state-level differences on how they define employee residence and taxation for your business. If you have an employee working out-of-state, you and your payroll company need to make sure that you formally register for tax purposes with that state. These registrations can include, but are not limited to, business tax registration, corporate income tax registration, employer withholdings registration, unemployment insurance employer registration, among others. Please confirm with your payroll company that they are filing your out-of-state employees’ taxes properly according to that state.

Work Culture

If an employee is no longer in the same zip code as your business, it is important to consider how distance can impact the work. An 8:00 am morning in California means a 5:00 am meeting in Hawaii. If you are calling an employee based in New York at 5:00 pm PST, they are answering a work call at 8:00 pm EST.

An out-of-state employee also may not have access to certain office essentials, such as a printer, scanner, or fax machine. Luckily, there are phone apps that can provide scanning and faxing services. Additionally, out-of-state employees may find themselves paying out-of-pocket for office supplies, such as paper, pens, and notepads – it is recommended that employees are reimbursed for, or provided with a budget toward, these items and phone applications.

Employee Benefits

Additionally, each state has different requirements in regards to benefits and policies such as paid leave, sick leave, employee and managerial training, disability insurance, and workers compensation, to name a few examples.

Be aware of the peculiarities and ordinances of where your out-of-state employees work. There may even be local ordinances that now apply to your employees that are working-from-home in a different local city. Your remote employees could fall under local ordinances such as HCSO in San Francisco as well as state-by-state variations in required PTO, paid family leave, vacation time policy, sick days, and more.

For example, most companies in California don’t have short-term disability because the State of California already covers short-term disability. However, some states don’t offer short-term disability insurance, such as Texas. We had a client in that exact situation with an out-of-state employee moving from California to Texas. Luckily, the employer asked us to review their case and we established a short-term disability plan for them to ensure that the employee is covered. If you have an employee working in a state that offers less government benefits, you have to find out what you now must cover as the employer.

Meanwhile, when it comes to health insurance for your out-of-state employees you need to ask, what is the network of health providers like out-of-state? Some national insurance carriers don’t have the same type of network in every state. Even those that do, you should ask what are the most cost-efficient and broadest networks of healthcare providers and hospitals for out-of-state employees, particularly for PPO plans. In other words, are you spending your dollars wisely for your out-of-state employees’ health insurance plans?

So how do you navigate the waters of managing your employee benefits and HR administration for your out-of-state employees? You need to partner with the right team of experts who can help make sure your out-of-state employees are well taken care of.

What is an Employee Assistance Program (EAP)?

Mon, 22 Feb 2021 14:18:00 GMT

Written by: AEIS

Understanding What an Employee Assistance Program (EAP) Is

At its core, an employee assistance program (otherwise known as an EAP for short) is a type of "work-based intervention program" that helps employees resolve some of the problems they may be dealing with in their personal lives.

In essence, an employee's personal problems will eventually impact their work performance. Likewise, offering a benefit like an EAP is a great way for employers to attract and retain top talent. Therefore, offering an employee assistance program becomes a way to accomplish a number of important goals, all at the same time.

What is Covered By an EAP?

Mental Health Resources

One of the major elements covered by an EAP has to do with psychological disorders that an employee may be experiencing. They don't necessarily have to disable an employee's life with the proper care and management. Employees may not have the resources needed to accomplish this on their own, so an EAP can help them.

Work-Related Stressor Counseling

Apart from financial matters, work-related issues are one of the major things that contribute to the stress an employee may be feeling. An EAP can provide them with the unique steps and tools they need to properly cope with whatever it is that they're dealing with.

Substance Abuse Resources

When treated with care, substance abuse issues like alcohol or drug use can get employees the qualified help they need to retake control over their lives. If nothing else, it can be a way to help stop a progressive disease like alcoholism from getting worse.

Financial Counseling

If an employee feels like they're overworked and are still struggling to make ends meet and provide for their family, it will ultimately lead to them being spread too thin. Their performance in the workplace will suffer, which will only exacerbate their issues. The right EAP can go a long way towards preventing this from happening.

Legal Aid

If an employee is going through a complicated legal matter like a messy divorce, an EAP can help give them access to the legal resources they need to see things through to the most satisfying conclusion possible.

Key Benefits of EAPs

Improves Employee Mental Health

Mental health issues are not uncommon, and the more access people have to the resources needed to manage them, the less likely they are to make mistakes, do poor-quality work, or even take unnecessary sick days.

Improvers Employee Retention

It's no secret that access to high-quality benefits like an employee assistance program helps to make workers more engaged. When they feel like their employer genuinely cares about them, that feeling is reciprocated. The more engaged someone is with their job, the less likely they are to go looking for another one - thus helping significantly with any retention problems you've been experiencing.

Attracts Talented Workers

Even more so than salary, many top-tier employees consider benefits packages when deciding who to work for. If you offer a high-quality employee assistance program and a lot of your direct competitors don't, this can give you a major advantage when it comes to finding new candidates to fill available positions.

Improves Employee Productivity

Finally, one of the major benefits that come with offering an employee assistance program has to do with the major improvement that it can make to employee productivity. The better someone is at managing the various issues going on in their lives, the more time and attention they'll have to do the best work possible. They'll also be far more engaged with their workplace, which makes them more productive on average.

Types of Employee Assistance Programs (EAPs)

There are two types of EAP options that we offer:

Embedded EAP : This type of EAP is connected to your ancillary lines carrier. Typically, if you have three or more ancillary lines, such as dental, vision, and life, with a single carrier, they will offer you an embedded EAP at no additional cost.
Standalone EAP : This option allows you to shop the market and select the best EAP for your employees at an additional cost.

Is an EAP Right for Your Business?

To determine the best Employee Assistance Program (EAP) for your business, consider the unique needs of your workforce and your goals for offering such a program. Evaluate what your employees are experiencing and what you aim to achieve. This will help you select the most suitable EAP for your situation.

Tips for Implementing an EAP

The number one thing you need to do after implementing an employee assistance program is to let your employees know that it is available. People won't participate if they're unaware that it exists in the first place.

You should also offer a wide range of services in an effort to help the highest number of employees possible, not just a select few. Likewise, make it clear that everything that takes place within the employee assistance program is strictly confidential. Nobody has to worry about their personal matters being exposed to the entire business for all to see.

Reach Out to AEIS for a Free Consultation

At AEIS , we're prepared to leverage our decades of combined experience in employee benefits and related matters to your advantage. We know that you want to do whatever it takes to help your workers and offering a high-quality EAP is a big part of that.

To find out more information about what an employee assistance program is and what it entails, or to get answers to any other questions that you might have, please don't delay - contact the team at AEIS today and schedule your free consultation so that you can take the next steps.

State Laws, Taxes, and Employees Working Remotely During COVID: What You Should Know as an Employer

Tue, 16 Feb 2021 19:41:00 GMT

Throughout California and across the country, many of us are working almost exclusively from home during the COVID-19 pandemic. We must all be careful of the definition of home – young employees could have moved back home with their parents, while others might have chosen to get away to their vacation home to work.

Federal law, and many state laws, look at residence differently. The federal government has a residency test for people who enter or leave the country. California and many other states have domicile laws based on where you sleep, and other factors such as where you vote and keep property. Six months usually prevails as proving domicile.

As an example, a San Francisco employee at the end of March gives up their lease and moves in with Mom and Dad in Montana but continues to work with their employer in San Francisco using phones, email and Zoom. If the employee expects to come back, he may be working in Montana and must file a Montana return while there. He would also file a California return as a resident and pay tax there as well and get a tax credit for tax paid to Montana. The taxpayer may end up with a considerable underpayment in one state.

For that same person, if they change their domicile to Montana and are out of California more than six months, change their voting address and vehicle license, and cut off ties with California, they will file a part-year return for the time in California, a part-year return in Montana, and split the income between the states. One of the Franchise Tax Board’s (FTB) biggest audit groups audits final California returns for people moving out of state so understanding the law is crucial. The employer should be directed by the employee as to where they are domiciled so proper withholding can be provided on the paychecks.

To keep talent or hire talent not available locally we, like our clients, have employees in other states. This can bring up several issues that have to be managed. What state gets to tax the wage, and could the employee have to apportion their income to several states? Companies can get trapped by economic nexus and pay tax in a state they may have little or no revenue from. A new wrinkle regarding COVID-19 is if your employee lives in Oregon and the employer is in California, which state laws direct COVID coverage for the employee?

The FTB has clarified taxable nexus to California will not be established for an out-of-state corporation whose only connection is the presence of an employee who is working here due to the governor’s “stay at home” directive. It is not clear if another state’s shelter-in-place order will prevent California nexus and the business may have to file and report apportioned income to California. Also, the employee while working in California, must report their income earned while here and file a return. As an example, a Washington-based employee that is living in California during the pandemic will have to pay California income tax on the money they made while living in California, even though Washington has no income tax.

As you can see, the new economic nexus laws coupled with COVID-19-induced changes to our normal way of life have created a new tax normal for employees and employers.

Contact AEIS Today

Reach out to us at AEIS, Inc. at Alyssa@AEISAdvisors.com if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP who can help you navigate the various state and federal tax laws for your remote employees.

This post was originally published in Hood & Strong’s Newsletter.

Inforce Illustration and Life Insurance: What You Need to Know

Thu, 28 Jan 2021 16:23:00 GMT

Life insurance is complicated. Even if you already have a life insurance policy, you may need to have a trusted advisor review it to make sure that it is still “in force”. A major part of reviewing policies involves inforce illustrations. Here we outline the who, what, when, where, why (and how) surrounding inforce illustrations and the best time for you to get one.

Who needs life insurance?

If an individual’s death would financially impact the people in their life, such as a key person partner, business, employees, child, parent, sibling, or spouse, it is highly recommended that they look into life insurance. A life insurance policy provides financial protection to dependents after one’s death. The death benefit can be used to cover expenses such as childcare, household payments, or debts.

Who should request an inforce illustration?

Not all life insurance policies require inforce illustrations. Term life policies have premiums that are set for a specified amount of years. In other words, if an individual purchases a 20 year life policy, the premium and death benefit will typically remain the same for those twenty years.

People who have purchased permanent insurance policies (e.g. whole life, Guaranteed Universal Life, Indexed Universal Life, etc.) should request inforce illustrations to ensure their policy is performing as expected. The performance of a permanent insurance policy varies based on components such as earnings and interest, overhead expenses, and the cost of insurance for the insured.

What is an illustration?

Upon purchase of a life insurance policy, the insured will receive an illustration. An illustration is a projection of how the policy will perform in the future. It is crucial to emphasize the illustration is only a projection and it based on the notion that earnings, expenses, and the cost of insurance will remain constant throughout the years.

The aspects of a permanent life insurance policy (e.g. death benefit, premium, lapse age) fluctuate based on economic factors, such as interest rates and overhead expenses. These aspects need to be monitored to avoid problems with the policy. If left unchecked, the policy may underperform or even lapse in the coming years.

An inforce illustration is a significant tool to help the insured understand the potential, more realistic performance of a permanent life insurance policy. Based on current earnings, overhead expenses, and the cost of insurance, an in-force illustration can detect any problems that have risen or may arise. Possible problems with a life insurance policy include the policy terminating earlier than expected or the insured needing to pay premiums for longer than planned to keep the policy alive.

It is recommended that the insured individual compare their original illustration to the most recent inforce illustration to ensure that the policy is performing as anticipated. If it is underperforming, action may need to be taken to address the problem(s). According to Forbes, an in-force illustration is paramount in helping the insured to avoid unpleasant, and unnecessary, surprises .

What are the different types of inforce illustrations?

There are various types of inforce illustrations that answer distinct questions.

When should an inforce illustration be ordered?

It is recommended that the insured individual requests an inforce illustration every two to three years. A policy owner is permitted to request an inforce illustration annually.

Where does the insured individual request an inforce illustration?

There are numerous ways to request an inforce illustration. The insured can request it from their insurance agent or from their insurance company through phone, in writing, or via a customer portal. The insured should receive their inforce illustration within 30 days of request.

Why does the insured need to order and inforce illustration?

In a Proformex Case Study, it was found that 31% of life insurance policies would lapse before the desired coverage date. Additionally, 53% of policy owners had a 25% chance of outliving their life insurance coverage. Proformex also uncovered that 69% of life insurance policies have not been reviewed in the past five years and 20% of these policies are likely to lapse during the next three to seven years. Josh Resnick, an author and lawyer focused on estate and business planning, spent nearly a decade reviewing hundreds of life insurance policies. Of these policies, Resnick concluded that, “…easily 90% or more were in trouble or soon to be in trouble.”

An inforce illustration is a proactive way to verify that one’s life insurance policy is performing as expected. If the insured has a chance of outliving their coverage or if the policy experiences a decrease in cash value, an inforce illustration is key in the process of identifying the problem and acting swiftly to resolve it.

How to know which policy is the best fit?

At this point, the answers to the five W’s of in-force illustrations may have spurred some “How” questions. How do people know which life insurance policy is the best fit? How does the insured understand the information on their in-force illustration? How does the insured know if they need to make adjustments to their policy? Talk to our Principal Ron Bland to learn more about the ins and outs of life insurance policies and inforce illustration whole life. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12.

Exploring Disability Insurance | CA Employee Benefits Agency

Mon, 25 Jan 2021 13:15:00 GMT

Disability insurance is a type of insurance coverage that replaces a portion of your monthly income in the event you are unable to perform your work functions due to illness or injury. This insurance gives both yourself, and those who are dependent on you and your paycheck, a sense of financial security while you are out of work. Let’s explore disability insurance.

Who Qualifies for Disability Insurance and Why?

According to the Social Security Administration , about 1 in 4 adults, who are currently in their 20’s, will have some sort of disabling event in their life that will cause them to be out of work for at least 3 months before they hit retirement age. And, while most people think that disability insurance is most used by those with an injury due to an accident, the majority of claims (90%) come from medical illnesses. In fact, the most common claims are related to cancer, back pain, cardiovascular disease, injury, pregnancy, and digestive disorders.

Types of Disability Insurance

There are two types of disability insurance than an individual can enroll in and one that is administrated by the government through the Social Security Administration. First, there is short-term disability insurance. This type pays paycheck benefits for, as the name suggests, a short-term disability due to injury or illness. The time frame for these benefits is between 3-6 months and can cover between 40-60% of the participant’s income. Purchasing this type of insurance tends to be expensive and benefits usually begin about 14 days after the qualifying incident.

Long-term disability insurance pays between 60-80% of the participant’s income and typically lasts until they recover from the injury or illness or until a pre-determined number of years, for instance, until they are 65. Benefits for long-term disability insurance usually begin after a 90-day waiting time.

Social Security Disability Insurance (SSDI) is administered by the Social Security Administration (SSA). To be eligible for these benefits, the person must be approved through a strict list of qualifications from the SSA, which can be found here . It is difficult to qualify for SSDI benefits and the average monthly benefit in 2019 was $1,234.

How to Enroll in Disability Insurance

When looking to buy disability insurance, first, look to see if your employer offers employer-sponsored coverage at work. Many times, employers pay for all or a portion of the premiums. Some employers offer disability insurance for employees to buy at a discounted rate as a voluntary benefit as part of their benefits package. If you are part of a professional organization like a labor union or one for a specific profession, they may offer the ability to purchase disability insurance at a group rate. Also, you may purchase insurance through an insurance broker or directly from an insurance company.

COVID-19 and Disability Insurance

In some instances, disability insurance may cover the participant who is affected by the COVID-19 pandemic. Some benefits will cover if you are medically quarantined because of a positive COVID test or exposure to the coronavirus and you cannot complete your work function. This does not include state mandated “work from home orders.” Also, some COVID-19 survivors have lingering symptoms such as fatigue, headaches, and pain and these symptoms prevent them from being able to work. In these cases, short-term disability insurance may kick in. Check with your HR team or insurance broker to verify your coverage and eligibility.

Disability insurance provides the financial security needed by yourself and those who depend on you. In these uncertain times, having a backup plan in place will give you the confidence that an unforeseen illness or injury will not deplete your bank accounts while you get back on your feet. Check into disability insurance plans at your workplace, professional organization, or through a local broker. You and your family will be glad you did.

The information and content provided herein is for educational purposes only, and should not be considered legal, tax, investment, or financial advice, recommendation, or endorsement.

What is IRS Code Section 139 and How It Could Provide Relief for Your Employees During COVID-19

Fri, 22 Jan 2021 16:30:00 GMT

IRS Code Section 139, written for 9/11 victims in 2001, may help small businesses assist employees with unforeseen costs due to COVID-19 and other recent disasters. A business can write a disaster relief program to give employees nontaxable help. The program must describe the type of expenses eligible, a maximum amount of reimbursement, and an application deadline for a specific disaster. The disaster must be an event that the IRS determines to be catastrophic in nature – COVID-19 is one such disaster. While the provisions are fairly narrow, they are designed to help a business and its employees.

Expenses that qualify in general for reimbursement include:

There are other items that can qualify for the current COVID-19 disaster, such as:

Generally, these payments are excludible from income by the employee, but still deductible by the employer. The employer is not required to get documentation as long as the amounts are reasonable, necessary, and related to the disaster. Paying an employee’s salary does not qualify. COVID-19 provisions do allow emergency paid sick leave and expanded family leave to qualify for payroll tax credits. But those provisions sunset on Dec 31, 2020, unless an employer chooses to offer them through Q1 of 2021. There are also employee retention credits.

Employers can set up a program to help their employees pay for these costs, but they have to qualify as a disaster relief program under Code Section 139.

Contact AEIS Today

Reach out to us at AEIS, Inc. at Alyssa@AEISAdvisors.com if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP who can help you set up a disaster relief program for your employees.

This post was originally published in Hood & Strong’s Newsletter.

HRA vs HSA vs FSA: The Difference Between Each

Fri, 08 Jan 2021 16:42:00 GMT

Your business has just hired a new group of recruits, and as any caring employer would, you want to help your employees thrive by making sure your staff has the best benefit packages. You have decided on the retirement and investment plans you will offer, so now you turn your attention to the foundation of all benefits, the health plan. As you wade through the myriad of health care options, you find yourself wondering “What is the difference between HRA vs HSA vs FSA? What is going to be best for my employees and my business?”

These plans are quite different, but they are all avenues to help your employees cover inevitable health expenses. We know this can be a confusing, overwhelming and daunting decision for employers. We want you to have confidence that you have chosen the right employee benefits , so we have outlined the most important similarities and differences between these three types to help you make the best decision for your employees and your business.

Note: Throughout this article we will reference “pre-tax dollars.” This means the funds are pulled from the employees’ paycheck before it has been taxed.

What is an HSA (Health Savings Account)?

An HSA is a Health Savings Account . An HSA is an employee-owned account that can be utilized to pay for qualified health care expenses with pre-tax dollars. However, California and some other states still tax the funds. Any employee who is enrolled in a High Deductible Health Plan (HDHP) is eligible for an HSA.

Answers to Common HSA Questions

Who owns the account?

The employee owns the HSA account.

Who is contributing funds to the HSA?

Both the employer and employee can contribute funds.

Who sets contribution limits for an HSA?

The Federal Government decides the annual contribution limits. In 2021, the annual maximum contribution amount for an HSA is $3,600 for individuals and $7,200 for families. The employee can decide how much they want to contribute from payroll deductions, but the amount they deposit and any amount the employer may deposit cannot exceed the Federal limits.

Do funds in the HSA rollover?

Yes, HSA funds are never forfeited, and they always belong to the employee.

What insurance plans can you have with an HSA?

The employee needs to have a High-Deductible Health Plan (HDHP) to be eligible to contribute to an HSA account.

What can be reimbursed with an HSA?

Any eligible medical expenses as outlined in the IRS tax code section 213(d) are eligible for reimbursement with an HSA. Premiums are typically ineligible for reimbursement with an HSA, except for COBRA and Medicare B & D premiums.

What are the pros of an HSA?

There is a triple Federal tax advantage, so long as the funds are used for qualified medical expenses (contributions are pre-tax or tax deductible, interest earned is tax-free, and withdrawals are not taxed).

Another pro of the HSA is the fact that the employee owns the HSA themselves. Accordingly, if that employee moves to a new job, makes changes to their medical coverage, moves to a new state, or becomes unemployed, they will still keep their HSA.

Finally, the employee can decide how much they want to deduct from their pre-taxed paycheck to their HSA each year, up to the maximum contribution amount.

What are the cons of an HSA?

The employee cannot make contributions to an HSA account if they have dual health insurance coverage from a secondary insurance plan. They also cannot contribute to a health FSA (discussed below) unless the FSA is for excepted benefits only (dental and vision expenses).

The HSA is a great tool and provides a lot of autonomy for the employee, however, the HSA does have some limitations, so it may not

be the best option for everyone.

What is a Traditional HRA (Health Reimbursement Arrangement)?

A Traditional HRA is a Health Reimbursement Arrangement. Sometimes erroneously referred to as a Health Reimbursement Account. Please note, this is different from a health risk assessment.

Rather, an HRA for the purposes of this post is an employer-owned and funded account which can reimburse employees for out-of-pocket health care expenses. Any employee who is enrolled on a health plan through their employer, where the health plan offers an HRA, is eligible for an HRA.

Answers to Common HRA Questions

Who owns the arrangement?

The employer owns the arrangement.

Who is contributing funds to the arrangement?

Only the employer can contribute funds.

Who sets contribution limits?

The employer decides how much can be contributed annually to an HRA.

Do funds in the arrangement rollover?

The employer decides if the funds rollover or not. The arrangement is not portable – in other words, if the employee moves to a different state or becomes unemployed, they will lose access to the funds, unless they want to fund the HRA themselves through COBRA.

What insurance plans can you have with an HRA?

Different carriers have different rules, and you should always check with your insurance carrier before making an assumption.

What can be reimbursed with an HRA?

The employer, at the beginning of the year, decides what is eligible and ineligible for reimbursement, which are limited to medical expenses.

What are the pros of an HRA?

The HRA is regarded as one of the most flexible types of benefit plans and can be bundled with a lower fixed premium fully-insured health plan. This provides noticeable savings for the employer.

One notable difference between an HRA and the above-mentioned HSA: in an HRA, an employer only has to pay out of the arrangement if there is a claim. This differs from the consumer-driven health plan (CDHP) that has a high deductible and can be paired with a health savings account (HSA) in which an employer contributes funds to an employee’s HSA account with or without a claim.

What are the cons of an HRA?

There is more third-party administration involved in administering the HRA. Additionally, Section 105 non-discrimination testing is required.

The HRA provides some financial protections for the employer, however, the HRA also has some limitations, so it may not be the best option for everyone.

What is an FSA (Flexible Spending Account/Arrangement)?

A Flexible Spending Account or Flexible Spending Arrangement (FSA) is an employer-owned account that covers health care expenses with pre-tax dollars. The general purpose of an FSA is to fund predictable healthcare expenses, or qualified expenses, such as medical and dental services.

Answers to Common FSA Questions

Who owns the account?

The employer owns the account.

Who is contributing funds to the account?

The employees contribute some of their regular compensation, and these funds are not taxed. The employer can only match what the employee contributes, up to the maximum annual allowable amount.

Who sets contribution limits?

The employee decides how much they want to deduct from their paycheck to contribute to the FSA. In 2021, the annual maximum contribution amount for an FSA is $2,750. These amounts may be less depending on how many employees participate in the plan in order to pass non-discrimination testing.

Do funds in the account rollover?

The money an employee and employer have contributed to an FSA is expected to be used annually, but the employer can offer temporary extensions. Depending on the health plan, the employee can carry up to $550 into the next year. The new COVID relief bill extends this amount for 2021 into 2022.

What insurance plans can you have with an FSA?

The employee can pair any health plan with an FSA.

What can be reimbursed with an FSA?

Any qualified medical expense as listed in the IRS tax code section 213(d) is eligible for reimbursement with an FSA. Premiums are ineligible for reimbursement with an FSA.

What are the pros of an FSA?

An FSA is a pre-tax account. The money is taken out of the employee’s paycheck before taxes are paid; the funds can be used to pay for eligible health expenses.

Qualified medical expenses for employees and their spouses and children are covered.

What are the cons of an FSA?

Self-employed workers are ineligible for FSAs. FSAs are also limited to medical care, so general health items or cosmetic surgeries are not eligible for reimbursement.

Which of These Three Plans Is Right For Me and My Employees?

Now that we've address what is the difference between HSA and FSA and HRA, you have a general idea what the key differences are. There are pros and cons to all three plans, and each has its own perks and limitations.

For your next step, we encourage you to talk to our Principal Ron Bland to explore whether a HSA, HRA, or FSA is right for you and your employees. We know you care about your employees, and we know you want them to thrive. Our team, made of expert advisors, can assist you in acquiring a robust and comprehensive benefits package to meet the needs of your business and staff.

You can reach Ron Bland at Ron@AEISAdvisors.com or 650.348.6234 x12.

How to Save and Spend with an HSA

Mon, 21 Dec 2020 14:30:00 GMT

According to Fidelity , this year the average couple needs $295,000 for medical expenses after the age of 65. As that number sinks in, people tend to respond with, “Well, Medicare will cover that, right?”

While Medicare covers many health care expenses, it does not cover everything. Even on Medicare, people still have to pay deductibles, copays, and excluded benefits, all of which will likely come out of pocket.

Thankfully, there is an option that as an employer you can offer your employees – a Health Savings Account (HSA). An HSA is often utilized to save for medical expenses. While the “S” in HSA stands for savings, the HSA can also be a great tool for spending.

How Does an HSA Work?

The account owner of an HSA is your employees. If they change their job, adjust their medical coverage, move to a different state, or become unemployed, they will keep their HSA. Every year, they decide how much they want to deduct from their paycheck (on a pre-tax basis) to contribute to their HSA.

In 2021, the annual maximum contribution amount for an HSA is $3,600 for self-only and $7,200 for families. When an individual is faced with qualified medical expenses, such as a deductible, money can be withdrawn from the HSA to pay for those costs.

With an HSA, the tax advantages are three-fold . First, contributions to a health savings account are either pre-tax or tax-deductible. Second, as the account grows, the interest earned is tax-free. Third, if and when you make withdrawals for eligible expenses, you do not pay taxes on those withdrawals. It should be noted that you can only contribute to a health savings account if you have a High Deductible Health Plan (HDHP).

In addition, you cannot make contributions to an HSA plan if you have dual health insurance coverage from a secondary insurance plan.

Saving and Spending

The significant tax advantages that an HSA yields can help an individual or family save tens of thousands of dollars over the years. The more you keep in your HSA, the more it will grow. As the years go on, the funds in a health savings account will always belong to the employee. Additionally, the money in the account will roll over from year to year, so they never have to worry about losing their savings.

Money from an HSA can be also utilized for spending purposes. With an HDHP, you typically have a lower premium since the deductible is higher. As a result, your employees have more money at their disposal. If they are faced with unemployment or need to pay for COBRA, an individual can use their HSA money to cover those finances.

HSA and AEIS

While an HSA can be a great tool, it may not be the right fit for everyone as they consider current and future medical expenses. Talk to our Principal Ron Bland to explore if your company should offer a HDHP to open an HSA. Our team, made of expert advisors, can also assist you in acquiring a robust and comprehensive benefits package. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12.

San Francisco Voters Approve Increases in Gross Receipt Taxes | Bay Area Insurance Experts

Wed, 16 Dec 2020 14:40:00 GMT

Two measures passed last week increasing business taxes in San Francisco. Propositions F and L were passed by voters aimed at businesses with over 2 million dollars in gross receipts.

What is Proposition F?

Proposition F, now law, repeals the payroll tax and raises the gross receipt tax on businesses with gross receipts over two million dollars a year. The law is scheduled to increase the tax between 15 to 20% over the old rates.

A tax based on gross receipts affects businesses differently. A business like a grocery store that sells goods at low margins and high volume with high payroll will have the same tax as a high margin retailer like a mattress store with less overhead and payroll. It is also a burden on startup companies that are just ramping up revenues while spending their money on product development and operating at a loss.

What is Proposition L?

Proposition L is looking to tax large global corporations by taxing these businesses based on the highest-paid employee globally comparing that person’s pay to the median pay of the company’s San Francisco-based employees. The way this would work is with a 100:1 ratio.

Say the CEO of a company makes $25,000,000 compensation per year and is headquartered in another country. If the San Francisco location’s business has an average compensation of $100,000 per employee, it is multiplied by 100 to compare $10,000,000 to the officer’s pay of $25,000,000 creating a $15,000,000 amount that will be used to calculate the increase in the gross receipts tax.

At this time, it is unclear how the Propositions will be integrated but local businesses need to understand that the gross receipts payroll tax in San Francisco has changed and many local businesses will be affected. It remains to be seen how or if the local business landscape will change.

The San Francisco Chamber of Commerce opposed both laws with concerns of businesses leaving the city and taxing struggling small businesses now that are trying to recover from the pandemic.

Contact AEIS Today

Reach out to us at AEIS, Inc. at Alyssa@AEISAdvisors.com if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP to see how the new San Francisco laws will impact your business.

This post was originally published in Hood & Strong’s Newsletter.

Prop 19: What Does It Mean for Your California Properties and Homes?

Tue, 08 Dec 2020 15:19:00 GMT

Is it time to give your children your vacation home or a rental property you own in California? Proposition 19 that just passed suggests it might be the right time.

In the last election Proposition 19 was voted into law. This new law, effective February 15 ^th 2021, makes significant changes to the old Prop 13 and Proposition 58 that Californians have enjoyed for years. The new law adds some flexibility but pays for it with fewer benefits.

Today the law allows an individual to give their primary residence to children or grandchildren and retain the parents’ tax basis. So if the parents owned a home in California and the assessed value is $200,000 and its value today is $2,000,000 then they give it to their child, she can move in or rent it and retain the parents tax base of $200,000. Thereby continuing to pay the same property taxes that her parents paid.

In addition, if mom and dad had a rental property with an assessed value of $1,000,000 or less but it is worth $10,000,000, they can give that property to their children or grandchildren and they can still retain that low tax base. Therefore, they can avoid reassessment where the property tax could go up to over $110,000 annually.

What Happens Now That Prop 19 Passed?

On February 15 ^th of next year all that changes. After that date only a principal residence qualifies for a reduced property tax rate with caveats. The child or grandchild must use the home as their principal residence and the benefit is limited to the extent that the fair market value does not exceed the assessed value by more than $1,000,000.

The old law that allowed once in a lifetime transfer of property tax from an old home to a less expensive new home in a qualifying county has been expanded and effective after April 1,2021. This law was not used often because many counties would not allow the transfer. To get this one time transfer you had to be over 55, disabled, or a victim of a natural disaster.

The new law adds flexibility to the Proposition 58 law. Now those qualifying individuals can move up to three times taking their tax base with them and they can transfer it anywhere in the state. This will be very helpful for wildfire victims and retiring people wanting to downsize and move to a smaller community or closer to family.

With these coming changes families have a little time to help their future generations benefit.

Let’s say that grandma has the home she and her husband bought when their children were little with a tax base of $75,000. The family loves the place, and everyone now uses it. Grandma can gift the cabin to her qualifying grandchild or children that is now worth $1,000,000. If done before the new law goes into effect, the property tax bill of say $850 a year will not go up to over $10,000 per year.

Transferring now would allow the family to continue to enjoy the property at a low family cost for years to come. The same would be true for any other property owned in California with low assessed values compared with the current market value today. If the children or qualifying grandchildren intend to retain the property for a long time after the owners passing, the family should consider transferring now.

What Steps Can You Take?

Reach out to us at AEIS, Inc. at Alyssa@AEISAdvisors.com if you would like to be connected with George Paulsen and his team of tax advisors and CPAs at Hood & Strong, LLP to get advice on your situation.

This post was originally published in Hood & Strong’s Newsletter.

Open Enrollment FAQs for Employers

Tue, 24 Nov 2020 15:36:00 GMT

This year open enrollment may be as busy ever. In the face of COVID-19 throughout the Bay Area and California, businesses are just trying to keep up. With smart solutions in hand, employers can avoid various problems that arise during open enrollment. But you may still have lingering questions regarding open enrollment and how to communicate with your employees.

At AEIS, we have seen it all. This year we are revealing 10 of the most asked open enrollment questions – and the answers to give you peace of mind.

4. If my spouse loses their job outside of open enrollment, can I add them to my health care coverage?

5. What is the difference between HMOs, PPOs, EPOs and HDHPs with HSAs?

6. How do deductibles and out-of-pocket maximums work?

7. How do I make sure my preventive care visit is 100% covered?

8. How do I get approval for a service or drug?

9. Can I have other health coverage?

10. Is there anything I can do if I have a doctor I like, but they’re out-of-network?

How AEIS Can Help You with Open Enrollment

With your most important questions answered you may still be uncertain what to do next. If you need help with your company’s open enrollment then reach out to Advanced Estate & Insurance Services, Inc. ! We are located in the San Francisco Bay Area and partner with employers throughout California. We advise businesses with 2 to 500 employees on various types of insurance , including Medical, Vision, Dental, Disability, Life/AD&D, and Key Person and Buy-Sell Life Insurance. At AEIS, we value communication and we will support you through the entire open enrollment process. Our partnership will ensure that your company has all of its questions answered and taken care of. With over 30 years of experience, we take a holistic approach as we help you navigate the entire open enrollment process and beyond.

Give us a call today at 650.348.6234 x12 or email us at Ron@AEISAdvisors.com .

How to Support Your Employees While Working-from-Home During COVID-19

Tue, 17 Nov 2020 14:55:00 GMT

As millions of people transitioned to working from home, the needs of employees, as well as the obstacles they face, drastically shifted . Many employers now find themselves navigating being a manager with limited, if any, face-to-face interactions with their team members.

How do you effectively supervise your team during a global pandemic as well as ensure productivity does not suffer ? We’ve outlined five key challenges employees may face during this unprecedented time – and how employers can address them.

Back in March, coworkers may have been used to their private offices or cubicles. Now in October, the bedroom is the new cubicle and the kitchen is the new water cooler. Being at home means makeshift office spaces and increased distractions.

Employers should encourage employees to seek a designated space in which to work. A separate, private space, such as a basement, shed, guest room, walk-in closet, or attic, helps to decrease distractions and increase a semblance of work-life balance.

If possible, employers should assist employees in creating an ergonomic workspace through the purchase of accessories such as a standing desk, monitor stand, or wrist support. Not only will this help employees feel more comfortable, it is more health conscious, both in the short and long term.

Many people are facing increased loneliness as they work from home and remain largely isolated from friends, family, and coworkers. Additionally, employees report that working from home contributes to feeling disconnected from the organization. If an employee does not feel as though they belong, this could contribute to thoughts of leaving the company.

In order to remedy this problem, employers should be mindful of creating opportunities for connection amongst the team. During a virtual meeting, employers could ask employees about their weekend or to share a funny thing that happened in the past week. Even though people are working from home, employers can continue to incorporate team building activities through video conferencing. Hold a virtual pizza party, host a trivia night, play Jackbox games, or lead a Bingo game with fun prizes!

When employees are unable to see their supervisor every day, they may feel as though they are not getting as much support. Furthermore, employees may perceive their employer as not being understanding of their current needs. It is essential that employers check in with their employees. Check-ins, which can be one-on-one or in a group setting, should be predictable and regular. Employees will be reassured they have a consistent format in which to voice their questions or concerns.

Employers should seek to understand every employee’s situation. While working from home, some employees may now find themselves being a parent, caretaker, and employee all at one time. Asking open-ended questions (“How is working from home going for you thus far?”) allows employees to share the trials and tribulations of their experience.

Communication between team members looks very different nowadays. In response to this change, employers should set expectations for how often and through what means employees should communicate. If it is an emergency, what is the fastest way to get a hold of someone? Are people still available from 9:00 to 5:00 or have their hours shifted as a result of other responsibilities? Will meetings be held on a group call or through Zoom? Take steps to eliminate uncertainty by addressing these questions. Video-conferencing apps (Zoom, Google Hangouts) and messaging apps (Slack, Microsoft Teams) offer alternative ways for team members to communicate and ensure everyone is on the same page.

These are stressful, uncertain, and overwhelming times. People are experiencing new or amplified feelings of anxiety and depression. Remember that during crises, people look to their leaders for insight on how to react and handle the situation.

Assure your team that yes – times are tough, but together, we can get through this. Encourage your employees to incorporate yoga and meditation into their routine. Pass along information about Zoom exercise classes. Support employees if they may need to make adjustments in their schedule to incorporate therapy or counseling services. Be adamant about employees not forgoing basic needs, such as sleeping, showering, or eating.

Never Forget the Benefits

Surprise! There is one more way to support your employees during this time – provide them with a robust and comprehensive benefits package. Full benefits offering and expert advisors by your side can save your company time, resources, and money so you can focus on supporting your team. Talk to our Principal Ron Bland on what plans are best to offer your employees. You can reach us at Ron@AEISAdvisors.com or 650.348.6234 x12.

Disclaimer: Any compliance related information in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. Should you require further compliance assistance or legal advice, please consult a licensed attorney.

AEIS News: Congratulations to Our Award-Winning Team

Thu, 05 Nov 2020 16:03:00 GMT

Our Award-Winning Team

Here at AEIS, Inc., we pride ourselves on our astounding team who have brought devotion and expertise to our clients and partners throughout California. We are thrilled to announce a recent slate of recognition for our wonderful staff and their efforts.

Awardee: Dillon Castro, Benefits Consultant

Award: Employee Benefit Adviser’s 2020 Rising Star in Advising Award

The 2020 Rising Stars in Advising encompasses the next generation of leaders from across the nation who are tackling issues related to healthcare, wellness and employee benefits with new perspectives. Our Benefits Consultant Dillon Castro joins a total of 20 selected leaders this year who are active industry and community mentors taking the field of benefits advising to new levels.

Awardee: Alyssa Bland, Business Development Strategist

Award: Silicon Valley Business Journal’s 2020 Top 100 Women of Influence Award

Women of Influence are established business leaders who have a proven record of innovation in their fields, superb business performance, and a history of involvement in the community. Our Business Development Strategist Alyssa Bland is one of the recognized women this year who have made a difference in their communities, blazed a trail for the rest of us, and are leaving a mark in Silicon Valley.

Awardee: AEIS, Inc.

Award: San Francisco Business Times Book of Lists 2020 Ranked #23 Among Bay Area Benefits Consulting Firms

AEIS, Inc. is ranked #23 among benefits consulting firms within the San Francisco Bay Area in the San Francisco Business Times Book of Lists. We are one of the last independently owned family firms to make the list.

We are incredibly proud of these honors and our team’s hard work. Congratulations Dillon, Alyssa, and the entire AEIS Team!

And most importantly a big thank you to all of our clients. It is wonderful working and partnering with you across our community for so many years. You make this all possible!

Check out more on all of our amazing team members and their stories.

AEIS News: Introducing Our PEO Partners to Provide Clients with HR Solutions

Tue, 27 Oct 2020 02:01:00 GMT

At AEIS we offer our clients the tools, resources, and partnerships to help save you time so you can focus on growing your business. At this time of year, in addition to shopping for benefits, you may be looking around to join a Professional Employer Organization, also known as a “PEO”.

Y ou may be hesitant to join a PEO as you may want to switch up your HR operations but not your current partnership with your benefits broker. However, nowadays you have the option of working with a PEO while having an expert employee benefits advisor by your side like AEIS. We have built trusted partnerships with leading PEOs such as Insperity , TriNet , Justworks , and ADP .

But how do you know if a PEO is right for your business?

What Is a PEO?

PEOs offer a range of organizational services for their clients, which may include human resources consulting, payroll processing, tax filing, workers compensation filing, among others. PEOs enter into a co-employment agreement with their clients, meaning that you would fall under their company umbrella for tax identification purposes.

When evaluating whether a PEO is the best thing for your company, you must consider the various benefits, drawbacks, and risks that may be involved in your outcomes.

Why Consider a PEO?

A big reason why companies join a PEO is to help them with their Human Resources responsibilities. A PEO can help support your HR needs and administration with a technologically forward platform that helps you and your business thrive.

On the other hand, it is important to consider that there are some limitations when choosing a PEO model for your business. Recall that you now fall under a PEO’s tax ID when you join so depending on your situation you may lose important tax benefits your company currently relies on. A PEO could also limit your choice and options such as when selecting workers’ compensation programs.

The Best of Both Worlds: A PEO with an Expert Benefits Agency

By partnering with us, you can trust that we will advise you on making the best decision for your business.

Whether you are just starting to evaluate PEOs or if you are ready to switch, AEIS, Inc. is there to guide you in the process. As a client, your relationship with us lets you take advantage of special pricing offered through our channel partnerships.

Contact us at Ron@AEISAdvisors.com or 650-348-6234 x12 if you’re interested in learning more about our PEO partners and what they have to offer.

How to Hire and Interview Employees During COVID-19

Fri, 16 Oct 2020 16:46:00 GMT

As companies recover and continue to march forward during these unprecedented times, many are looking to fill empty positions or expand their team. During a health pandemic, businesses are taking steps to limit in-person meetings and conversations. With this in mind, many businesses are seeking to transition into a virtual hiring and interviewing process .

Though conducting an interview via Zoom or Skype can be a new and daunting experience, it can also bring about advantages for the employer and interviewee . Virtual interviewing permits the employer to accommodate a variety of schedules. Additionally, employers can conduct interviews with people from another city, state, or country than the one in which their business is physically located. This flexibility allows employers to seek qualified candidates from around the world. Virtual interviewing allows interviewees to move forward with the job search without having to put their health, or the health of people in their homes, at risk.

Despite these benefits, there are some challenges. Below are some tips and tricks on how to thrive in the virtual process of hiring and interviewing.

Before the Interview

During the Interview

After the Interview

Once you’ve decided to go through with a certain candidate, make sure to offer them a robust package including employee benefits. After investing all this time in the interview process, you want to make sure to offer your potential employees a competitive employee benefits package. Talk to our Principal Ron Bland on how to communicate employee benefits during the interview stage and on what plans are best to offer your employees. You can reach us at or 650.348.6234 x12.

Employee Time Off for Voting in California: What to Know as an Employer

Thu, 08 Oct 2020 15:27:00 GMT

Election Day is almost here! In the state of California, county elections officials will begin to send vote-by-mail ballots to all active, registered voters by October 5, 2020.

While voting by mail is a viable option for the general election, some people may still prefer to vote in person on November 3rd . Even though people are working from home, employers still have an obligation to follow California mandates regarding granting time off for voting.

Are you an employer-based in California with questions about the upcoming election? Read on to make sure you are prepared for November 3 ^rd .

Election Notices

According to state law, employers are required to prominently display a post regarding paid leave for voting purposes in statewide elections. Notices are available in languages such as, but not limited to, English, Spanish, Chinese, Hindi, and Tagalog. You can also call the Elections Division at (916) 657 – 2166 to receive posters of the notice. You can also download the notice in English here .

Employers are required to post this notice ten days before a statewide election. The notice must be posted in the workplace or in a location where it can be seen as employees enter and exit the workplace. Since many employees are working from home, it is essential that employers take steps to guarantee their employees have access to this information. Set a reminder for yourself: by October 20 ^th (just to be safe) – make sure the notice is posted in your workplace AND sent to employees via mail, email, or fax.

Employee Eligibility

If employees do not have sufficient time outside of work hours to visit their polling center, they are eligible for paid leave for the purpose of voting. Polls are open in California from 7:00 am to 8:00 pm Pacific Time. While employees can have as much time as they need to go through the voting process, it is important to note that a maximum of two hours is paid.

Rights of Employer

If employees are eligible for paid time off for voting, as an employer, you have the right to require that time be taken off only at the beginning or end of the shift. However, it is encouraged to work with your employees and make arrangements if this is not feasible. Additionally, employers can require that employees give notice if they need additional time off to vote. While an employee must do this at least two working days prior to the general election, it is recommended that employers encourage employees to give as much notice as possible.

As November 3rd approaches and questions emerge, employers are encouraged to contact the Secretary of State’s Voter Hotline at (800) 345-VOTE. Go forth and vote!

Interested in learning more about compliance? Curious about how to get the best workplace and benefits for your employees? Reach out to our President Ron Bland at ron@aeisadvisors.com and 650-348-6234 x12 for further information.

Tips to Maximize Your HSA Benefits | CA Employee Benefits Agency

Thu, 01 Oct 2020 17:06:00 GMT

Health Savings Accounts (HSA) are great ways to save tax-free money for medical expenses both in the current term, and for your retirement years. By making wise choices, you can maximize the benefit of these fantastic savings accounts. Let’s take a quick look at the basics and then explore some tips on how to make your HSA money grow.

What is an HSA?

According to the website HealthCare.gov , a Health Savings Account is a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. By using untaxed dollars in an HSA to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your overall health care costs. HSA funds generally may not be used to pay premiums.

In order to contribute to an HSA, you must be enrolled in a High Deductible Health Plan (HDHP). A HDHP is defined as a plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible). A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes.

HSA vs Traditional Insurance

As mentioned, you are able to open a Health Savings Account when you enroll in your employer’s High Deductible Health Plan. A HDHP is different from traditional insurance in that with traditional insurance, you and your employer both contribute to the cost of your health insurance each month—otherwise known as the premium. You then have a fixed cost—a “co-pay”—that you pay when you visit a doctor, pay for prescriptions, or have a health procedure. With a HDHP, the patient is incentivized to shop around for lower cost doctor visits and procedures since they are paying for those costs out of their pocket at the full amount from the beginning until the high deductible amount is met.

Now, when used in tandem, the two components of the HDHP and the HSA have the potential to save the insured party money on their health care expenses. Here’s how it works:

Each year, the government puts a cap on the amount of money that an individual and a family can contribute to their HSA. For 2020, an individual can contribute up to $3550 and a family can add in $7100 to their account. In 2021, the amounts both increase: individuals will be $3600 and families will be able to deposit $7200.

When you contribute to your HSA, your money gets a triple tax benefit. There is a 0% tax on deposited money, your money grows tax-free while in the account, and, when used for qualified medical expenses, you can withdraw the money tax-free.

The money that you deposit into your HSA is yours to keep–forever. If you change jobs, the money follows you. If you don’t use the money you’ve contributed by the end of the year, it rolls over to the next year with no penalty.

Tips to Maximize the Benefits of Your HSA This Year

Don’t be complacent to let your tax-free hard-earned money simply sit in your HSA all year! You can by making some wise choices. Here’s some tips on how to do this:

Finding ways to save money is always a good idea. Finding ways to maximize the benefit of your already saved money is even better!

Is Your Business in Compliance with San Francisco and Oakland City Ordinances During Work-From-Home?

Mon, 14 Sep 2020 16:01:00 GMT

Complying with City Requirements While Working-From-Home

Here in the Bay Area, many cities have their own ordinances and laws surrounding health benefit offerings and paid sick leave. What many employers don’t realize is that they are subject to complying with these rules even if the business is not headquartered in these areas. Simply having employees working-from-home within the boundaries of these cities makes them subject to complying with the city laws and ordinances for those employees currently working there.

For example, the San Francisco Health Care Security Ordinance or HCSO requires that an employer with 20 or more employees globally pay a flat dollar amount towards health care expenditures to any employee per hour worked within the geographic boundaries of the City of San Francisco. So for an employer based in Union City, if they have employees who are now working from their home in San Francisco due to the COVID-19 pandemic, they are obligated to comply with the HCSO for these specific employees. This ordinance applies even for part-time employees so long as they meet the minimum hour threshold.

The City of Oakland has a more generous paid sick leave than the State of California mandated 3 days per year minimum. For any employees working from their homes in Oakland, the employer is obligated to comply with the additional required sick day accrual amounts.

Double Check That You Are in Compliance

Be sure you are in compliance with local laws and regulations for the cities and areas that your employees are working in, even when conducting work-from-home. Check with local government websites and agencies for information and requirements such as the HCSO informational page and the City of Oakland .

At AEIS, we take compliance seriously and help you to mitigate risks for your business. Reach out to us if you are interested in learning more about compliance. As always, for compliance related questions you can contact our Compliance Officer, Elizabeth Kay .

Disclaimer: Any information related to compliance or other subject matters in this email, including any attachments, is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this blog is based on the most up-to-date information that was available on the date it was sent and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

9 Books Every HR Pro Should Read in 2020 | Bay Area Consultants

Wed, 02 Sep 2020 17:58:00 GMT

Quarantine leaves us with a healthy chunk of time to reassess and spend time with the ones we love. But as quarantine goes on, the work must go on as well and for HR professionals, that means developing professionally as much as everyone else within the organization.

With all this time on your hands, a nice relaxing read is not only good for your development, but also your health. To help you develop a reading list that can fuel your own growth, we’ve provided a quarantine reading list of the best HR focused books to read in 2020.

Enjoy.

A well-known thought leader in HR, Brown spends a great deal of time facilitating conversations about the possibilities in HR. In this book, he looks to challenge assumptions and preconceived notions about what HR should be and instead challenges the reader to think of the possibilities and tap into their passion for HR.

A cast of HR veterans has put together a handbook of competencies that sets the modern HR professional up for a more strategic role within the business . The put forward the argument that one of the most important roles of an HR practitioner is to be a credible activist, both for the employee and for the business as a whole.

When Millennials (Gen Y) hit the workforce it created a shift in expectations of employers, workplace cultures and the way employers think about processes and employee relationships. Now, a new generation is entering the workforce and their lifestyles, expectations and world view are once again different.

To manage the Gen Z demographic effectively, HR leaders need to look at how the way this generation manages money, pursues education, values their relationships and what they want for their careers. This book explores these topics in a way that will help HR teams manage the generational diversity of their teams.

As cultures collide and the nature of work becomes more global, there are differences which could divide teams if we can’t develop a common language and a culture that highlights our common struggles. In this book, the author unveils a step-by-step program for communicating across cultural lines to develop a culture of trust that facilitates greater diversity within the organization and the construction of global teams.

Talent planning is changing and requires a new way of doing things. This book uses examples from some of the world’s largest companies all the way down to Silicon Valley startups to show how HR can become the partner the business needs to acquire, develop and manage talent that can meet the technological and analytical demands of the modern workplace.

Good, honest feedback can be difficult to take, but as HR leaders, collecting feedback and being able to package it into constructive conversations that fuel employee growth is an art. In this book, the authors take a deeper look at where negative reactions to feedback come from and how to limit negative physical and emotional responses to it. It introduces the three F’s of feedback, (focused, fair and frequent) to help ease the tension that sometimes accompanies these discussions.

Advanced HR metrics can be difficult, but are becoming a necessary part of the modern HR professionals work as employee engagement and experience take center stage. Being able to predict turnover, analyze and forecast diversity and fine tune employee interventions are all key skills discussed in this book. The authors focus on statistical techniques and predictive analytics models that can help improve the HR practitioner’s ability to do those things in an ethical manner.

Through six case studies, the authors of this book reveal how organizations can develop and implement employee engagement plans that use tactics which have shown proven results. Starting from the time a new hire walks through the door to years into their development, this systemic approach will help HR leaders create a culture that retains and nurtures employees to grow within the organization.

Culture is everything, but there are misconceptions and lies that pervade the workplace and cause dysfunction. That is the central tenet behind this book which seeks to identify those lies and highlight freethinking leaders are able to see through the fog to see the unique nature of their teams and reveal truths about the workplace or what the authors call the real world of work.

Originally posted on hrexchangenetwork.com

Family Caregivers: 5 Tools to Avoid Burnout | California Employee Benefits Advisors

Wed, 26 Aug 2020 16:11:00 GMT

According to the National Center on Caregiving , a family caregiver (or informal caregiver) is “an unpaid individual (for example, a spouse, partner, family member, friend, or neighbor) involved in assisting others with activities of daily living and/or medical tasks.” In the US, 85% of caregivers care for a relative or loved one with 42% of those caregivers supporting an aging parent. Since early 2020, we have seen this vulnerable aging population fall prey to the COVID-19 pandemic. As a result, those providing care for this group have also begun to fall prey to this virus’s demise in the form of care-fatigue. We’ve compiled a toolkit of some simple resources to help the caregivers that are on the frontline of care for their loved ones avoid burnout.

5 Tools to Avoid Burnout

When taking your loved one to any sort of appointment, plan out what you hope to accomplish while you are there. Make a checklist of what items you want to discuss with the provider. Ask your loved one what they would like to talk about as well. In addition, keep your other family members informed about the care you are providing by establishing a weekly check-in whether through email or Facetime or phone call.

Providing daily care can be immensely rewarding but can also be a physically and emotionally exhausting job. When the job seems bigger than you can handle alone, do some research into community resources for assistance. There are networks of caregiving agencies that can help with everything from personal care to behavioral issues. Determine what you can afford to pay for services and prioritize those that are most needed for you to maintain your own health.

Have you heard the saying “you cannot fill someone else’s cup if your own cup is empty”? In order for you to continue providing care for your loved ones, you must tend to your own care. This involves taking regular breaks throughout the day—maybe for a quick walk or some exercise—to clear your head and refocus your energy. This can also include seeking out respite care so that your immediate family can go out for dinner or even away for a few days. Self-care is a chance to recharge your batteries so you are fully able to care for others.

This may seem like a daunting task, but teaching your aging loved one some easy technology tips can free up some time in your daily schedule for other pressing tasks. Help them use Amazon’s Alexa and Google Home to check the weather or call a friend or even to set alarms and reminders. Another handy tech tool is introducing them to the convenience and safety of telemedicine. Many elderly folks are unsure of transitioning to this kind of care, but with your support, this can be a great resource for their physical health appointments.

Frustration and fatigue are easy traps to find yourself in when providing care for others. The way to best combat this is through finding ways to reframe your thoughts. The author of the Blue Zone series, Dan Buettner, traveled the world to study the happiness of people in different parts of the world and found that if you find a balance of pleasure, purpose, and pride in life, you can achieve happiness even in tough, challenging times. You can change the way you approach the caregiving tasks in your day by seeking this balance of the 3 P’s.

As the “new normal” begins in our world, you can also begin a new approach to your role as a family caregiver. Commit to using these trusty tools for avoiding burnout. They are time-tested and will help you achieve the correct, and happiness-inspiring balance that best serves both you and your loved ones.

Resources:

American Association of Retired Persons (AARP) “Caregiver Burnout: Steps for Coping with Stress”

U.S. Administration on Aging— Eldercare Locator

Family Caregiver Alliance

Caring.com— Family Caregiver Basics

Caregiver Action Network— 10 Tips for Family Caregivers

How to Search Online for a Loved One’s Life Insurance Policy or Annuity

Fri, 21 Aug 2020 17:11:00 GMT

What is the Life Insurance Policy Locator Service?

If you’re faced with the tragedy of the loss of a loved one, dealing with their life insurance situation is one of the last things you want to deal with while you’re grieving. If you don’t have a life insurance advisor by your side, you may not be certain if your loved one had life insurance. Even if you know that they had life insurance coverage, you may not be aware of who the life insurance carrier is that sponsored the plan.

For a long time, individuals had little avenues to turn to when they didn’t know the details of their spouse or loved one’s policies. Today there is a tool called the Life Insurance Policy Locator Service offered by the National Association of Insurance Commissioners (NAIC) that assists you in locating life insurance policies and annuity contracts from a deceased relative or someone with whom you had a close relationship.

The online tool helps you find a loved one’s life insurance policy for free by searching across participating life insurance companies to help you find out if your recently deceased loved one had a life insurance policy or annuity. You may submit a request if you are a beneficiary, executor or legal representative of a deceased person.

As Business Insider reported , this search program is a voluntary service. In other words, insurance companies don’t have to participate. So always make sure to exhaust other avenues of searching for the deceased’s life insurance policy or annuity before using the NAIC feature.

According to the NAIC, you should look into the deceased’s bank statements, safety deposit boxes, and personal files for information that may contain their life policies or annuities so you can contact the insurance company directly to pull their information. If this task is unfruitful, then go on and use the online feature for another way to check.

Make sure to have a certified death certificate on hand, as that will provide crucial information in filling out your request. While not every data field is mandatory to submit your request, remember that the more information you provide, the better your search results will be.

After you submit your request, the NAIC notifies participating companies to search their records for an individual life insurance policy or annuity contract under the deceased’s name. It could take up to 90 days to hear back, depending also on if the insurance company needs further information from you.

Partnering with a Trusted Advisor Prevents Issues Before They Happen

Even with this feature that has been long needed, dealing with life insurance in this manner feels haphazard and overly complex. At AEIS, we work hand-in-hand with our life insurance clients dealing with high-net-worth estates to ensure that they and their loved ones have plans in place to meet their goals and overcome their obstacles.

As part of our process, we assess our clients’ situation with in-depth interviews and historical and financial reviews. We then bring in all stakeholders of policies to make sure that everyone’s goals are being addressed and that everyone understands the plan ahead. At AEIS, you can have comfort in knowing that your loved ones will not have to fend for themselves or go digging for your life policy information.

Call us today for a free consultation at 650-348-6234 x12 or email us at Ron@AEISAdvisors.com.

Disclaimer: Any compliance-related information in this blog is intended to be informational and does not constitute legal advice regarding any specific situation. Should you require further compliance assistance or legal advice, please consult a licensed attorney.

By Wyatt Bland, August 2020

Compliance – Why You Still Need to Be Audit Ready | California Benefits Agency

Wed, 12 Aug 2020 16:18:00 GMT

Every few years there is a change in administration at the Federal level, and with each change often comes a change in policy, change in areas of focus, and sometimes a change in revenue streams. For example, under the Obama Administration the Department of Labor and IRS were looking to increase revenue by performing audits on businesses of all sizes for compliance with Federal Law such as Employee Retirement Income Securities Act (ERISA) and the Affordable Care Act (ACA).

Under the current administration we have not seen as much activity on behalf of the DOL, but we have continued to see collection letters from the IRS for Applicable Large Employers who are being asked to pay a penalty for not offering health coverage to their employees as required under the ACA.

Since the current administration is showing less interest in overseeing businesses and how they administer their health and welfare plans, you may be asking why you still need to be audit ready. Why do you still need to dedicate time and resources to documenting your plan benefits and notices that have been distributed to participants, if no one is going to care?

Well the answer is two-fold really. One you need to do it because it is the right thing to do for your employees and plan participants. Second, you need to do it because the next administration may care and may come knocking on your door looking to make sure you are doing what the law says you should be doing. The statute of limitation for ERISA compliance is 6 years. This means that the Department of Labor can look back in your records to a time of a previous administration and require you pay penalties for non-compliance.

In addition, if you make it policy to maintain the proper records and administration habits now, then you spend less time trying to make up for it later on when someone finally cares again about what you are doing (or not doing).

Our dedicated Compliance Officer, Elizabeth Kay conducts mock audits for our clients for DOL and IRS compliance as they relate to health and welfare plans to uncover any areas where they may be lacking or missing information so they can shore up the problem areas in case of a future audit. If you are not sure you are ‘audit ready’, give us a call today at 650.348.6234 or email at ElizabethKay@AEISAdvisors.com

Employee Engagement in a Post-COVID Workplace | CA Employee Benefits Firm

Tue, 28 Jul 2020 19:44:00 GMT

“When people are financially invested, they want a return. When people are emotionally invested, they want to contribute.” – Simon Sinek

The COVID-19 pandemic has taught us many things. First, it has taught us that empathy and kindness goes a long way. We’ve learned that as individuals, communities, and as a nation, that we can do hard things when we work together. Finally, this pandemic has taught us that the relationship between employer and employee is a valuable one. How much the employee feels valued by their employer is called “engagement.” And this feeling of value is one that more and more companies are investing in in a post-COVID environment.

Employee engagement is when an employee feels “high levels of involvement (passion and absorption) in the work and the organization (pride and identity) as well as affective energy (enthusiasm and alertness) and a sense of self-presence.” Let’s dive in and look at some fast facts on this subject and how to increase engagement in this new workspace we have found our world occupying.

BY THE NUMBERS

BOTTOM LINE

HOMESCHOOL

RESOURCES

There are numerous blogs and articles and creative educational interaction sites to keep employees engaged and learning while remote. Below are some fun and creative sites to help you create your own engagement campaign for your organization.

Introduction to Exit Planning: 8 Key Options to Consider | Bay Area Consultants

Tue, 28 Jul 2020 17:03:00 GMT

Did you know Baby Boomers will transfer ownership of over TEN TRILLION DOLLARS in closely held businesses throughout the next decade? Are you one of them?

Whether you want to fund a retirement lifestyle, maintain a community presence, or simply create more spare time for yourself, you can achieve your personal goals while maintaining the business legacy you have built. Consider rewarding loyal employees, benefiting charitable interest, or even staying involved in your business at a level you determine. Clarifying your timing, financial expectations, and identifying ownership succession are three very basic goals that need to be established when planning your business exit strategy.

8 Exit Options to Consider

1) Keep Ownership “In the Family”

2) Sell to Other Shareholders

3) Sell to Management (MBO or Mgmt Buyout)

4) Employee Stock Ownership Plan (ESOP)

5) Sell to a Third Party

6) Recapitalize (Refinanace)

7) Go Public

8) Liquidate

As business owners you already know the key role which timing plays in the future success of your business. Now is the time to determine how your legacy will live on through the success of your business, even after you leave it. Starting the planning process 3-4 years before the transition is important to ensure all necessary financial information is not only compiled but consistent. Waiting until the last minute could leave money on the table, as buyers may sense urgency and could attempt to take advantage of this during negotiation periods.

SR Allison, Ltd. works with AEIS, Inc. by providing business owners solutions which are tailored to their specific exit planning needs.

Photo Credit: Photo by Dustin Tramel on Unsplash

When Administering COBRA Can Be Costly | Bay Area Benefits Consultants

Wed, 08 Jul 2020 16:56:00 GMT

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) was enacted to give employees the ability to continue their employer-sponsored health benefits if they were laid off or lost their job. Therefore employees who were terminated could continue their eligibility to be enrolled in their group health plan.

While the intention was good, it is almost obsolete now that the individual marketplace allows for individuals to purchase a health plan without having to be concerned with denials of their application due to health concerns or pre-existing conditions. However, some terminated employees want to maintain their current health plans for various reasons: access to their current physicians, the ability to maintain any amounts they have already paid towards their deductible and out of pocket maximums for the year, etc.

COBRA is a Federal law and all employer-sponsored health plans offered by a company with 20 or more employees must make COBRA available to anyone who has been terminated from their health plan. Termination from the health plan can be due to a change in eligibility status such as a reduction in hours, layoff, or job termination. In addition, enrolled dependents that lose their eligibility must also be offered COBRA either at the same time the employee loses eligibility or due to their own circumstances. An example of this could be in the event of divorce from the employee, death of the employee, or aging off the plan such as a child turning 26 years of age.

COBRA requires administration and can be handled by the employer or by a third party administrator. Some employers may want to save some costs by handling it in-house themselves, but COBRA requires multiple notifications to be sent to the COBRA eligible individuals based on a specific timeline, payments need to be submitted and tracked, and information about payment status can trigger changes with enrollment or termination of benefits with the insurance carrier(s).

Most companies do not have the ability to designate one department solely to COBRA administration. It will almost always fall to HR or Finance to handle and they inevitably have a multitude of other responsibilities . This is where mistakes can be made, and they can be costly.

We have recently seen an uptick in litigation against employers for failing to issue COBRA election notices to those eligible at the appropriate time, and failure to make it clear who to contact in case of questions about their eligibility or payments. These fines can be very high, typically in the thousands of dollars.

In order to avoid these costly penalties and the cost of defending these cases, we strongly recommend using a third-party administrator to handle the administration of COBRA. Most contracts put the responsibility on the COBRA Administrator, absolving the employer of responsibility in case of error and also putting some distance between the employer and terminated employees with the added benefit of reducing potentially uncomfortable interactions.

When employing a third party administrator for COBRA there are three key things to remember:

Here at AEIS, we help you to determine if you are required to comply with Federal COBRA and if so, we help you complete setup of your COBRA operations with one of our many trusted COBRA administrators so you can focus on your business. For further information contact your Personal Account Manager or one of our producers Ron Bland and Dillon Castro .

Which Startup Health Insurance Plan Level is Best?

Wed, 24 Jun 2020 13:55:00 GMT

Throughout the Bay Area and Silicon Valley, COVID-19 has made many startups reevaluate their choice of health plans . Not to mention that investors may be looking for ways to tighten spending with an economic crisis still looming large. Even before the COVID-19 pandemic, selecting which health insurance plan for your business has been a tough balancing act between trying to cater to your employees, recruit top talent, and adhere to your funding situation.

Your first step in trying to navigate how to successfully choose your group health insurance is to understand which tiers you want to offer. After the Affordable Care Act (ACA), health care plans were categorized into different level tiers by insurance companies.

You can think of the different metal tier categories like the Olympics. Small group ACA Plans are split into Bronze, Silver, Gold, and Platinum levels.

The higher the tier, the more coverage is paid for by the insurance company in terms of lower deductibles, copays, and out-of-pocket expenses. But at the same time, the higher the metal tier, the more you would pay for in monthly pre-tax premiums.

The plans reflect what percentage of coverage insurance companies pay for out-of-pocket expenses versus what an insured employee enrolled in the health plan would pay. As a general approximation, the plans cover out-of-pocket expenses at the following rates:

But a lot more goes into understanding the metal tiers than their percentage of coverage. Let’s break down the plan levels further to see which one would be best for your startup health insurance offerings.

Bronze Plans

Bronze plans are the lowest tier of health plans. If you are low on cash flow then a Bronze plan will be the least cost for your startup. These plans have the lowest monthly premium out of most major plan options yet they have the highest price point for when you access your care.

You could even have a deductible as high as $6,000, which may only be waived for the first three doctor’s visits of the year.

As an employee, Bronze plans are a good option if you’re looking for coverage in case of an emergency and if you want some form of health coverage without paying a lot each month.

Startups that offer Bronze plans usually do so to offer a Health Savings Account, also known as an HSA . You can create an HSA for High Deductible Health Plans (HDHPs), which are typically only Bronze level plans. But a major caveat is that most companies no longer fund HSAs due to HDHPs providing less and less savings over the years.

Based on my clients’ experiences, Bronze plans are often cheap to buy but expensive to use. In other words, you may be able to cut down on pre-tax monthly costs when it comes to your premiums but you and your employees will be paying for it after-tax when it comes to actually using medical services.

Silver Plans

Silver plans usually have a moderate monthly premium but the enrolled employee will have less out-of-pocket expenses to pay than a Bronze plan.

A typical deductible for a Silver plan is around $1,800 to $2,200 and may be waived for office and specialist visits with only a copay to pay. Some Silver plans even waive the deductible for certain lab tests, x-rays, and outpatient surgeries.

Silver plans are ideal if you are looking to control costs but you still would like to have an increased amount of coverage for care and services.

Silver plans are a smart compromise if your startup doesn’t have limitless resources but you still would like to offer your employees more robust coverage.

Gold Plans

Gold plans typically have high monthly premiums but low costs for when the insured employee receives care.

Startups that want to retain and even recruit talent gravitate towards Gold plans. With a Gold plan offering, employees can be more at ease knowing that the costs of their appointments and procedures will cost less when they use them. For what you receive, Gold plans can be a cost-effective option even with the higher premium.

Employees who utilize large amounts of care would select a Gold option when available since they are willing to pay more in pre-tax premiums so that they could have more coverage for expensive appointments and services.

Platinum Plans

Platinum level plans are the highest tier and offer the most coverage for the insured employee’s medical costs out of all the tiers.

On the other hand, Platinum plans tend to have the highest monthly premiums. If you rarely use health care services then Platinum plans may be a poor option. Typically, Platinum plans are favored by those who have chronic health conditions or diseases, disabilities, or want to pay more on the front end than the back end for using services.

However, there may be tax incentives to a Platinum plan. As an employee, I would want to pay more pretax for higher premiums taken out of my payroll than pay more for services after tax when I try to use them.

Some of the top tech companies offer Platinum benefits. For startups, you may need proper funding in order to provide lucrative Platinum plans. Even with the right funding, startups face difficulty in sustaining Platinum plans because of the high cost and burn rate.

Just remember selecting a Platinum option depends entirely on who you’re recruiting from, if you’re targeting talent who may be accustomed to Platinum level coverage, as well as if you’re sufficiently funded.

Offering More Than One Tier

The wisest solution for a startup would be to offer your employees different options of plan tiers. With the right contribution model of how much your startup pays and how much your employee pays for premiums, you can offer a variety of solutions for your employees that would fit their individual health needs.

Employees can truly reap the benefits of having a diversity of options. Say you’re an employee and become pregnant or are expecting to become pregnant. If your startup offers a variety of plan options, you can sign-up for a Platinum plan to take advantage of the lower out-of-pocket costs for the tests, appointments, and delivery. Even with higher monthly premiums you can save a lot more with having high level coverage for services.

You can then downgrade to a lower tier with less of a monthly premium after you have your baby since having a baby is a qualifying event that allows you to change your health plan. Since all carriers are different, please make sure to check with your carrier and get it in writing before you do this.

A variety of plans will also cater to the diversity of your employees. Someone who is young, healthy, and doesn’t want to pay a lot in premiums may opt for a Bronze or Silver plan. Meanwhile if you are an employee and are going to have a major surgery this year, you may want to think about upgrading to a higher plan so you pay less out-of-pocket.

In the end offering different solutions will be the best way to go.

How Am I Supposed to Decide Between All These Plan Tiers?

All in all, the numbers make the decision for you. If cashflow is not an issue for your startup, then offering high-level plans may make sense for offering a comprehensive benefits package.

Don’t be afraid to start with lower-tiered benefits and work your way up. Employees will always appreciate if you upgrade their tiers as your startup grows, although downgrading plans may hurt morale when funding slows or during economic crises. Remember to exercise caution when selecting a plan tier.

We understand that even if you know the differences between all the various health insurance tiers, it may be difficult to decide which level, let alone which exact plans, will offer you and your employees the best coverage, care, and value.

At AEIS, we are your trusted partner that will help you make the best decision for your startup when it comes to employee benefits. We believe a robust, well organized, and well communicated employee benefits package is essential for incentivizing and retaining top talent.

Setup a complimentary consultation today with myself, Ron Bland, at ron@aeisadvisors.com and 650-348-6234 x12 for a review of your current plans and how we can work together.

By Ron Bland

June 2020

Mental Health Exercises for a Strong Mind | California Benefits Agents

Wed, 17 Jun 2020 18:06:00 GMT

Anxiety disorders are the highest reported mental health issue in the US with 42.5 million Americans claiming to suffer from this illness. We can only assume that now, due to the state of the world in the middle of a global pandemic, those numbers will be increasing. It’s natural to feel stress, anxiety, grief, and worry during a crisis. But, rather than camp out in those feelings, it’s a better choice to work out of those feelings.

Let’s get to work and train our brains to be healthy.

As you bulk up your mind with healthy thoughts, you will find your body follows suit. Mental health requires the same dedication to good habits and choices that physical health does. And, when you make daily decisions to think about those things that are good and noble and uplifting, your strong mental health will carry you through the rough patches of life without letting you down.

How Does a Level Funded Plan Work Part 1: Level Funding Health Insurance

Tue, 09 Jun 2020 23:02:00 GMT

The New Normal

During the time of consistent economic growth and low unemployment that we’ve experienced for most of the last decade, businesses have experienced unprecedented success. Unfortunately, rapid growth and prosperity in business can often cause inefficiencies to go unchecked. When times are good these issues may seem trivial or benign… until the economy unexpectedly tightens. That is what we are experiencing right now in the Bay Area and throughout the country.

The COVID-19 pandemic has decimated businesses , and while the government is doing what it can to prevent a complete downturn by creating economic stimulus and aid packages, it’s likely that the US, and perhaps the world, will feel the economic ripple effect for quite some time after we get through the worst of this. Businesses will need to take a hard look at how they allocate their financial resources.

Health Insurance As a Capital Expense

After payroll, benefits (particularly health insurance) are usually at or near the top of every employer’s list of biggest expenses, yet in the midst of a pandemic, continuing to offer health insurance will be necessary to recruit and retain employees.

To control costs many small businesses will believe that they have little choice but the “easy” route of reducing the benefits offered or increasing the employees’ share of costs, either of which may aggravate employees more than actually help the bottom line.

What are employers to do?

One business solution for employers to consider is a type of health insurance arrangement called “Level Funding”.

Level Funding Health Insurance

Since the passing of the Affordable Care Act (ACA), employers with less than 100 employees typically purchase small group health insurance plans that have non-negotiable, fixed costs. There is little to no financial incentive for employers to educate employees on best practices for healthcare consumption. Additionally, the premium costs continue to rise year after year regardless of an employer’s individual utilization.

A level-funded health plan allows employers to still pay a fixed premium, but the insurance company takes the health of the employees and their dependents into consideration when determining the premium. Rather than the premiums going on a one way trip to the insurer, employers can qualify to get a refund on the premiums if the utilization of the plan is lower than expected. If the utilization is higher than expected the carrier can increase the premium rates at the renewal, but the employer is often not required to stay with the plan.

We work with carriers who offer level-funded plans and for most small businesses it is one of the best tools out there to help employers to continue offering the level of benefits that their employees have come to expect while also saving on the bottom line.

The Way Forward

If you believe you are paying too much for health insurance, but don’t want to risk watering down your benefits offering, schedule a call with us today for business solutions to help eliminate inefficiencies to be ready for the post-COVID business environment.

Webinar May 14th, 2020: Reopening the Workplace after COVID-19

Fri, 15 May 2020 15:48:00 GMT

Webinar Thursday, May 14th, 11:00 AM PDT: Reopening the Workplace after COVID-19

AEIS and Zywave: Return to Work Plans Following COVID-19 Pandemic [PDF]

Webinar Thursday, May 14th, 11:00 AM PDT: Reopening the Workplace after COVID-19

Advanced Estate & Insurance Services, Inc. (AEIS, Inc.) is excited to introduce Employment and Labor Lawyer Karin Cogbill from Hopkins & Carley as our third speaker in our COVID-19 webinar series.

For more information on our speaker, Karin Cogbill, please click here .

Please join us while Karin discusses key considerations for reopening the workplace. Topics will include:

Additional Resources:

Mental Health Support for Employees | California Benefits Team

Tue, 05 May 2020 16:10:00 GMT

The COVID-19 pandemic has taken a toll on everyone’s mental health . People have experienced financial hardship, additional challenges with childcare and school cancellations, job loss, reduced hours, sickness, and grief. The future is uncertain, and the present is extra stressful. And to make matters worse, many of the networks and practices that people use to support their mental health are currently unavailable due to social distancing.

In this environment, where people are increasingly anxious and may be socially isolated, it’s even more important that managers support the mental health of their team members — both those who are coming into the workplace and those working from home.

High stress can quickly destroy trust, inhibit empathy, and break down teams — each of which makes it more difficult for people to do their jobs. Fortunately, employers can provide some support. Here are some things employers can do to help employees manage stress and tend to their mental health:

When possible, give employees a little extra time to slow down and rest

Employees may need a moment to breathe or a day to regain their peace of mind, and they shouldn’t be afraid to ask for time to take care of themselves. The ability to occasionally function at a medium (or even slow) pace should be built into performance expectations so that employees can avoid burnout or breakdown.

Offer PTO, mental health benefits, and flexible schedules if appropriate

In some cases, employees who want to get the mental health care they need can’t afford it. Losing pay from a missed work shift might be too great a hardship, and effective treatments might be financially out of reach. These financial hindrances can exacerbate conditions like anxiety and depression. In other cases, employees can afford the time off and the treatments, but they can’t make regular appointments work with their schedules. If you can offer paid time off, health insurance benefits, or flexible schedules, these can help employees get the care they need.

Offer an Employee Assistance Program (EAP)

An EAP gives employees access to expert, confidential assistance for substance abuse issues, relationship troubles, financial problems, and mental health conditions. These services are offered through an outside provider that connects employees with the appropriate resources and professionals. These programs enable you to provide professional assistance to employees while allowing them confidentiality at work. EAPs are also inexpensive, costing between just 75 cents and 2 dollars per employee per month.

Make reasonable accommodations when possible

If an employee informs you that they have anxiety, depression, or another mental health condition, and they request an accommodation, you should begin the interactive process to determine what reasonable accommodation(s) you can provide in accordance with the Americans with Disabilities Act (ADA). The ADA applies when an employer has 15 or more employees, but many states have similar laws that require employers to make accommodations at an even lower employee count. You can learn more about the ADA on the HR Support Center.

Create digital spaces for friendships to grow

Loneliness in the workplace can be a serious issue, with significant negative effects on both employees and the workplace. Right now, with many employees working from home, it’s harder to spot signs of it. Employers can facilitate friendships and connections between employees by setting up virtual chat programs and video conferencing apps.

Mental health support for employees looks like reassuring them it’s fine for to take a little time during the workday to reach out to others about non-work matters and participate in virtual games and other fun group activities. Managers can set the tone by participating in fun chats and activities and encouraging employees to join in. Helping employees foster friendships is not only the right thing to do, it can also reduce turnover and increase engagement.

Promote good mental (and physical) health in the workplace

Healthy habits are important for everyone to practice. Consider setting time aside during the week or month for employees to participate in activities like yoga, meditation, and mindfulness that develop and strengthen these habits. If you aren’t familiar with these practices, solicit the help of your employees. One or more of them may know a lot about these activities and be able to assist you in setting up a workplace program or modifying a program for employees currently working from home.

Make use of additional resources

During this time, employees might benefit from this three-page list of several virtual recovery resources from the federal Substance Abuse and Mental Health Services Administration and this COVID-19 resource and information guide from the National Alliance on Mental Illness.

5 Tips for Building Trust When Employees Return to Work | CA Employee Benefits Firm

Thu, 30 Apr 2020 19:31:00 GMT

The day where people return to normal routines around work doesn’t seem as far off today as it did just a few weeks ago. As politicians itching to “re-open” the world look at ways to revive normalcy, companies now have to do the same as they consider operational needs and employee safety.

As the work environment shifts back toward what it was, what HR teams will find is that a new normal must now exist. Procedures that were once an afterthought, such as how the break room was cleaned, are now top of mind for everyone from entry level employees to the C-suite. Having the trust of your employees that the workplace is safe for them to return to is paramount to productivity.

And it isn’t just during a period of time when the virus subsides temporarily. The lasting impact of the coronavirus pandemic is that even after a vaccine is developed, it will alter the way people view the cleanliness of public spaces and the amenities at their disposal for things such as washing their hands or cleansing shared surfaces, be it a meeting room table or door handles.

There is a lot more to consider than simply reassuring everyone that the facilities are clean and that the company is doing the best it can to assure everyone’s health. There are cultural aspects of day-to-day business to address as well as implications for the organization’s reputation to consider. As an article from the Society for Human Resource Management notes, job candidates interviewed in the future will ask how the company handled this situation and “about the organization’s business continuity plans, pandemic-specific plans and other coronavirus-oriented practices.”

HR departments have a significant challenge ahead, but not one they should shy away from or feel overwhelmed by.

“I think this is the beginning of the most exciting period we’ve ever been part of,” Eric Torigian, Vice President and Assistant General Manager of Global HR for Akebono Brake Corporation USA told us on a recent episode of the HR Exchange Network podcast . “People are going to figure out how to pour their passion into it. The world has been getting ready for this for a while. We’ve been moving to an online world, a gig economy, toward remote work groups. In the next 20 or 30 years, this world is going to change a lot and people are going to come back to this time and ask ‘who were the people that made the difference?’ I think they’re going to look at HR people and say they’re the ones who led us through this.”

Leadership Considerations

To help you manage current and future employee expectations, here are 5 tips for managing your teams’ return to the workplace.

The government telling everyone to get back to work isn’t likely to inspire faith in a lot of people given how things have been handled so far and the fact that social distancing has been as effective as it has. There are many people who would hesitate to return to a normal working environment in the near future and rushing them back early will likely undermine any good will accrued in facilitating remote work and establishing improved engagement practices during this period.

The first thing to consider is the situation in your local area. The number of new cases in the city and state will drive perception among your employees. Even if numbers are on the decline, a return may be seen as jumping the gun, particularly for large companies with bigger personnel footprints.

Once you decide to put things in motion, spend time discussing team needs with managers to determine which teams can remain remote and which ones are required to return. Then, assemble your operations staff and develop a plan to create safer physical spaces.

Finally, engage with your employees to find out how they’re feeling about a possible return to the office through surveys and town halls. Doing so and incorporating their concerns into your strategy will go a long way toward building the type of trust necessary to maintain a good reputation with your employees.

Social distancing isn’t going anywhere any time soon. This means restaurants will likely have to re-think seating arrangements, cleanliness practices and personal protective equipment and testing for staff before they can re-open. That may mean limiting the scale of business and changing the way people flow through the every part of the building.

Offices will have to consider whether desks spaces are separated enough to comply with social distancing standards and retail operations will need to continue limiting the flow of people into their stores for the time being.

How companies react and commit to this new normal is going to determine how well they maintain morale and what the reaction of returning workers to physical locations will be. For new hires, seeing a commitment to social distancing will reassure them that they’ve joined an organization which has their health and wellbeing top of mind.

There is always a lot of talk about culture in HR, and in the wake of this pandemic, that is likely going to have to change as well. But as Torigian noted in our discussion, teaching people how to be responsible around each other and avoid the spread of the virus is a challenge for both organizations and society as a whole.

“That’s not just something that’s good for business, it’s something that is going to be required in the new world,” Torigian said. “We’ll learn how to do it and we’ll get really good at it.”

This means changing social norms. For example, banning handshakes in favor of greeting techniques that respect personal space and safety.

Beyond that, HR teams have to consider what mechanisms are in place to ensure cleanliness, such as hand-washing stations and requirements for different roles. Which employees require personal protective equipment, for example, is a key consideration.

Additionally, using company resources to ensure safety will help employees feel the organization is doing everything in its power to prioritize their health and therefore, will be more dedicated to doing their part. Care packages with cleansing wipes, hand sanitizer, gloves, tissues and other items they can use to stay safe is one small act that could go a long way toward inspiring confidence.

Businesses are bound to operate differently from here on out and with that comes some new realities. People who have traditionally been in office may no longer be required to be there and some, unfortunately, will not be required at all. That, however, does not mean those people must be cut loose.

Now is an ideal time for companies to engage in career mapping exercises to better understand the capabilities and interests of their employees. There is already talk of mass efforts by some in government to retrain much of the workforce for positions that can be done remotely and for careers that offer different prospects going forward than what they’ve experienced in the past, but that is something that may be better led by HR professionals than government programs.

It may seem an invasion of privacy at first, but given the implications for your staff as a whole, monitoring on-site employees’ health and wellness is a matter of public safety. Some public health experts say that office buildings and public spaces such as bars and restaurants cannot be re-opened until there are testing methods that can be done quickly and accurately to determine if someone is carrying the virus.

We’re likely a ways off from that being a possibility for many businesses, but others are already putting measures in place to conduct temperature checks at entrances and getting creative as they find solutions for social distancing buzzers and one way routes through shared spaces so that people don’t cross paths or come face-to-face with one another.

As an article from Bloomberg noted recently: “The way we work, shop, travel and eat in 2020 – and probably beyond – is being plotted out in boardrooms around the world.”

Meanwhile, office spaces may have to be redesigned, moving away from the open floor plans that have been trending for several years and toward cubicles with high walls so that employees have more isolated spaces.

To get ahead of these issues, now is the time for organizations to begin discussing what their path forward is and consider how much risk they are willing to take on in bringing employees back to work. What improvements need to be made to sanitation procedures, ventilation systems and the structure of the workplace are all things that need to be evaluated.

By HR Exchange Network Editorial Team

Originally posted on hrexchangenetwork.com

What is Telemedicine and How Do I Use It?

Thu, 23 Apr 2020 21:01:00 GMT

In the San Francisco Bay Area and around the world, the COVID-19 pandemic has made going out in public a risky activity. Even routine doctor’s appointments have become difficult because you may be afraid of exposing yourself or your loved ones to germ-filled waiting rooms and doctor’s offices. If you are looking for a safer way to visit a doctor, then you should look into telemedicine.

Telemedicine , also known as virtual care and telehealth , is a fast, convenient, and affordable way to check-in with a doctor about your symptoms for non-emergency conditions. With telemedicine, there is no need to leave your home.

After you find a program that is covered by your insurance plan, you can call or video chat via phone, website, or app with a certified physician. A telemedicine doctor can even order tests or prescriptions for you. If the physician is unable to help you via virtual care, she can point you in the right direction for further treatment.

You may even be able to schedule a phone or video call with your current general practitioner or specialist. Be sure to call your doctor’s office and insurance company to see if your physician is offering covered telemedicine services. But in the case of an emergency or life-threatening illness, always seek immediate medical attention at an emergency room.

Telemedicine programs and services may vary depending on your health insurance carrier and plan. Access to telemedicine could even be a part of your hidden benefits in your health insurance plan . Below you can find California telemedicine services by various insurance companies. (Please note that this list may vary by state, is subject to change, and that you should always confirm with your broker and health insurance carrier that you are covered under your specific plan before booking an appointment.)

This list is by no means exhaustive so make sure to find out with your broker what telemedicine and telehealth options you may have under your plan.

In order to use many of these services, you have to create an account and log in with your health insurance carrier. You can find member registration links here .

Being sick is hard enough as it is, especially when you want to minimize further exposure to COVID-19. Telemedicine is another great option at your disposal to stay safe and to have your questions answered in a quick and convenient fashion.

We encourage you to call us today to make sure that you and your employees are covered in a plan. For more information on telemedicine services, email Dillon Castro at Dillon@aeisadvisors.com or call us at 650-348-6234.

Disclaimer: Any compliance or medical-related information in this blog is intended to be informational and does not constitute legal or medical advice regarding any specific situation. Should you require further compliance assistance or legal advice, please consult a licensed attorney. Should you require medical treatment, please contact a licensed medical physician. You should familiarize yourself with your available health insurance benefits before you may need them. In case of an emergency seek immediate medical attention and call 911.

By Wyatt Bland

Helpful Information for Employers and Employees

Wed, 15 Apr 2020 15:49:00 GMT

With so many people working from home or not being able to access their office spaces, the carriers are working to be able to assist their policy holders with ways to continue administering their plans with as little disruption as possible. For your convenience, we have included the links to the various carriers pages below.

Employer Registration

Many of the carriers have the ability to provide billing statements online, receive payments online and enroll or terminate employees via their online platforms. Be sure to take advantage of this access by registering for their employer service portals, if you have not done so already.

Member Resources

Your employees can also have access to their health information via many carrier online sites once they register. Many medical carriers offer virtual visits, options to email physicians, and the ability to get answers to frequently asked questions, all through their member portals. We have included the registration links below as well as links to mobile apps that many of the carriers provide. Please share this information with your employees. Keeping social distance is especially important in healthcare facilities and these features allow members to receive care without having to go out into the spaces where they could be most at risk for transmission of COVID-19.

Member Registration Links

Mobile Apps for Members’ Smart Phones

Please contact your AEIS Personal Account Manager if you have any questions. We are here to support both you and your employees during this critical time.

Disclaimer: Any information related to compliance or other subject matters in this email, including any attachments, is intended to be informational and does not constitute legal advice regarding any specific situation. The content of this email is based on the most up-to-date information that was available on the date it was sent and could be subject to change. Should you require further assistance or legal advice, please consult a licensed attorney.

Important Information Regarding Paid Sick Leave and EFMLA | California Employee Benefits Agency

Wed, 08 Apr 2020 15:12:00 GMT

Both forms collect key information that will need to be kept for 4 to 6 years from the date the leave is taken. In addition to the request and approval forms, employers are also required to keep additional records including how the benefit amount is calculated for each eligible employee that requests Paid Sick Leave or EFMLA under the FFCRA. Please refer to this article from Kutak Rock regarding those requirements.

As a reminder, be sure to print and post the required posters or direct mail or email them to your employees who are working remotely or who may not be working their regularly scheduled hours but are still active employees.

The Department of Labor’s Wage and Hour Division released the required notification posters for the Families First Coronavirus Response Act (FFCRA) that will soon need to be posted in many workplaces and distributed to remote workers. Copies of the posters are available here:

Employee Rights: Paid Sick Leave and Expanded Family and Medical Leave under The Families First Coronavirus Response Act (FFCRA)

Federal Employee Rights: Paid Sick Leave and Expanded Family and Medical Leave under The Families First Coronavirus Response Act (FFCRA)

Each covered employer must post a notice of the FFCRA requirements in a conspicuous place on its premises. An employer may satisfy this requirement by emailing or direct mailing this notice to employees, or posting this notice on an employee information internal or external website.

The DOL also posted a Frequently Asked Questions page regarding the new notices.

Ask the Advisor: What’s the Difference Between Layoff and Furlough?

Fri, 27 Mar 2020 21:11:00 GMT

Question:

What’s the difference between a furlough and a layoff?

Answer:

First, you should note that the language used when sending employees home for a period of time is less important than communicating your actual intent. Since temporary layoffs and furloughs are only used regularly in certain industries (usually seasonal), you should not assume that employees will know what they mean. Be sure to communicate your plans for the future, even if they feel quite uncertain or are only short-term.

Furlough

A furlough continues employment, but reduces scheduled hours or requires a period of unpaid leave. The thought process is that having all employees incur a bit of hardship is better than some losing their jobs completely. For example, a company may reduce hours to 20 per week for a period of time as a cost-saving measure, or they may place everyone on a two-week unpaid leave. This is typically not considered termination; however, you may still need to provide certain notices to employees about the change in the relationship, and they would likely still be eligible for unemployment.

If the entire company won’t be furloughed, but only certain employees, it is important to be able to show that staff selection is not being done for a discriminatory reason. You’ll want to document the non-discriminatory business reasons that support the decision to furlough certain employees and not others, such as those that perform essential services.

Layoff

A layoff involves terminating employment during a period when no work is available. This may be temporary or permanent. If you close down completely, but you intend to reopen in the relatively near future or have an expected reopening date—at which time you will rehire an employee, or all employees—this would be considered a temporary layoff. Temporary layoffs are appropriate for relatively short-term slowdowns or closures. A layoff is generally considered permanent if there are no plans to rehire the employee or employees because the slowdown or closure is expected to be lengthy or permanent.

Pay for Exempt Employees (those not entitled to overtime)

Exempt employees do not have to be paid if they do no work at all for an entire workweek. However, if work is not available for a partial week for an exempt employee, they must be paid their full salary for that week, regardless of the fact that they have done less work. If the point is to save money (and it usually is), it’s best to ensure that the layoff covers the company’s established 7-day workweek for exempt employees. Make it very clear to exempt employees that they should do absolutely no work during any week you’re shut down. If exempt employees do any work during that time, they will need to be paid their normal weekly salary.

Pay for Non-Exempt Employees (those entitled to overtime)

Non-exempt employees only need to be paid for actual hours worked, so single day or partial-week furloughs can be applied to them without worrying about pay implications.

We recommend that you engage in open communication with the affected employees before and during the furlough or temporary layoff period.

Originally posted on ThinkHR.com

Kaiser HRA Plan

Thu, 20 Feb 2020 16:18:00 GMT

Since the Affordable Care Act (ACA) began to truly take affect (and in some cases well before) small to mid-size employers here throughout the San Francisco Bay Area and California at large have had challenges trying to control one of their biggest expenses outside of payroll: their health plan costs. Seemingly every year costs increase at a rate that many would argue is not sustainable in the long term.

Thankfully for employers, Kaiser Permanente has made a major change to their rules around small group health plans (<100 employees). This change represents a huge opportunity for employers to either lower their fixed cost, improve their plan, or both. The following is information about the change and how it can affect employers moving forward.

The Change – Small Group Deductible Funding

Kaiser had a rule against employers funding medical expenses on behalf of employees through an HRA unless the employees were specifically enrolled in an “HRA”-designated plan. But Kaiser has recently rescinded this policy for small groups (<100 employees) meaning that small group employers can now fund an HRA with any Kaiser small group health plan. For the purposes of this article think of an HRA as a strategy to potentially lower costs for employer sponsored health plans . If you want to know more about the specifics of what an HRA is, check out our blog about them here .

Why Does This Matter?

For many small group employers here in the Bay Area, the only way of lowering health insurance cost has simply been choosing a lower cost health plan or carrier. The lower cost usually comes with employees taking on more risk and cost, higher deductibles, narrower provider networks, etc.

Though the ACA has made changes to health insurance, insurance at its very core is a form of risk management. By allowing more liberal use of HRA’s for small group plans, Kaiser has empowered employers to manage risk to control cost rather than forcing companies to make the difficult decision between passing increased cost and risk on to employees or having the company absorb the entire increase.

This can allow a company to either lower cost or to increase benefits, or both if managed properly with the right broker.

How Does This Work?

In brief, an HRA allows an employer to take a very low cost health plan to serve as a sort of “base” or “foundation” and use company dollars to fund some or all of the employees’ accumulated medical claims. While the “base” plan that the employer purchases might be a Bronze level with a very high deductible, the employer can fund the plan so that as far as the employees are concerned, the plan’s benefits mirrors closer to a higher metal tier with lower deductible costs. We often informally refer to this as “turning Bronze into Gold or Platinum”.

As previously mentioned, this HRA setup allows employers to manage risk because the amount of savings realized by the plan sponsor (aka the employer) directly correlates to the amount of medical expenses the employees accumulate. If employees accumulate few and lower cost expenses, then the employer saves more. Lots of bigger expenses result in that savings shrinking.

With this new flexibility to manage risk, small group employers would be wise to leverage strategies that aim to reduce the frequency and severity of medical claims/expenses. Promoting Kaiser’s FREE telehealth programs , educating employees on topics such as preventive care and when to use urgent care instead of the ER , and utilizing second opinion services, etc. can all have a major impact on the ultimate savings for the company.

The employer has flexibility to determine how the HRA will be funded. For a company that wants to offer better benefits but doesn’t want to pay the fixed premium of a Platinum plan, they might fund the plan so that it looks and feels like a Platinum plan to the employees, but has the monthly fixed cost of a Bronze plan.

A company that wants to keep the level of benefits the same but lower the fixed cost can fund the HRA to look like their current plan but have the fixed premium of a Bronze plan.

Moving Ahead

In conclusion, this Kaiser small group policy change represents a major paradigm shift. Employers offering Kaiser HRA Plan will now be able to more actively manage healthcare risk for their employees. This can allow them to achieve lower fixed cost, offer a more competitive healthcare benefit to attract employees and further protect them from financial hardship over healthcare expenses. At the end of the day, aren’t those the reasons employers invest so much into benefits?

Give us a call at AEIS at 650-348-6234 to learn whether this major Kaiser Policy change can yield positive outcomes for you and your company.

Healthy Snack Alternatives: Eat Your Way to a Healthy Heart

Wed, 12 Feb 2020 15:32:00 GMT

Each February we focus on ways to improve our heart health in honor of American Heart Month. This year we help you eat your way to a healthy heart by turning your attention to the foods you eat and how to make smart choices with our “This or That” challenge!

Below you will see two foods to choose between. Your goal is to choose the healthier option from the healthy snack alternatives. Answers can be found at the end of the challenge.

Diet Soda vs Carbonated Water

Skip the drink with the high levels of artificial sweeteners and choose carbonated water! Diet drinks have been linked to symptoms of metabolic syndrome . Some symptoms of this include high blood pressure, high blood sugar, and lower than normal HDL cholesterol levels. Pour yourself a glass of carbonated water and put a slice of fruit in your glass instead!

Butter vs Olive Oil

Pour on the olive oil to maintain good heart health. Butter is full of high amounts of saturated fat. Butter is also known to raise the bad cholesterol levels in your blood. Olive oil and even canola and sunflower oils contain heart healthy mono- and polyunsaturated fats.

Sweet Potato Fries vs French Fries

Warm up your new Air Fryer and start cooking sweet potato fries with a little olive oil. French fries are full of fat and salt and a study linked eating 2-3 servings of fries a week to a higher chance of an early death.

1 oz Salted Nuts vs 1 oz Potato Chips

Pass the pecans, please! When you choose nuts over chips, you are also choosing your health. Regular nut snackers are 14% less likely to develop cardiovascular disease and 20% less likely to develop coronary heart disease.

1.5 oz Dark Chocolate vs 2 Chocolate Chip Cookies

No matter how much you love Grandma’s cookie recipe, your heart needs you to choose the dark chocolate. A study has found that those people who eat dark chocolate 3 times a week reduce their risk of a heart attack or stroke by 11%.

T-bone Steak vs Grilled Salmon Fillet

Just keep swimming! Just keep swimming! Salmon is chock full of omega 3 fatty acids which reduce fat in your blood and reduces clogged arteries. Steak is famous for high levels of saturated fat and LDL cholesterol.

Coca-Cola vs Red Wine

Pop the cork, not the soda tab. Carbonated sodas are full of artificial ingredients and sugar. Red wine has been shown to increase your good cholesterol levels and has many antioxidants that can help protect the lining of the blood vessels in your heart.

You are now a “This or That” Food Challenge winner! Go celebrate with a grilled salmon dinner, a glass of red wine, and a handful of dark chocolate!

Sources:

https://www.webmd.com/heart-disease/ss/slideshow-foods-bad-heart

https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-hearthealthy-food-swaps

https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/red-wine/art-20048281

The California Individual Mandate is Here – What It Means For You

Wed, 05 Feb 2020 21:54:00 GMT

In 2017, a federal bill passed that repealed the Affordable Care Act’s individual mandate, a tax penalty for individuals who are not enrolled in a health insurance plan. The repeal of the Federal Individual Mandate penalty fee took effect in 2019 but if you live in California a new mandate may be coming your way. Last year in 2019 the California legislature passed a budget bill that included a state-level individual mandate for those without health insurance

According to the California Franchise Tax Board , the California mandate took effect on January 1, 2020, and requires all Californians to be enrolled in a qualifying health insurance plan or possibly face a tax penalty.

The penalty amount depends on your state income and the number of people in your household. Depending on your situation, when you file your 2020 state income tax return in 2021 your penalty could range from $695 to thousands of dollars.

How to Avoid Paying the Mandate

The mandate only applies to you if you pay taxes in California.

If you already have health insurance, whether through your employer, the individual marketplace, or a government-sponsored or subsidized plan then you don’t have to worry. The penalty only applies to people who don’t have health insurance.

If you don’t have health insurance, you could still qualify for an exemption from the penalty. The exemption reasons vary from excessive cost of obtaining insurance (exceeding 8.24% of household income in the 2020 taxable year) to have a short coverage gap of 3 consecutive months or less to many more exemption qualifications.

If you and your dependents don’t qualify for an exemption then you, your spouse or domestic partner, and your dependents all need to enroll in a health insurance plan for every month beginning on January 1, 2020. Otherwise, you may have to pay a fee under your 2020 tax returns when you file in spring 2021.

We encourage you to call us today to make sure that you and your employees are covered in a plan. For more information on the California individual mandate and how to get the best coverage for your business group, call us today at 650-348-6234.

How AEIS Can Help You and Your Business

Advanced Estate and Insurance Services, Inc. (AEIS) is a family-owned business with over 30 years of experience in the San Francisco Bay Area. As your broker, our goal is to maximize the ROI from your benefits and to free up your time and bandwidth. Our role is to advise and advocate on behalf of your company and your employees on all benefits-related items. We are not just a broker, but your trusted partner. We serve as an extension of your team to help grow your business.

How to Get Your HR Department Back on Track (Without Really Trying) by Wyatt Bland

Thu, 05 Dec 2019 20:09:00 GMT

What do you think of when you think of HR? Whether you are in the field or work alongside them at your office, you may think of human resources as simply the department that handles all the paperwork. In too many corporate offices today, HR is viewed at its best as the ones who handle the dirty work of a company’s operations and at its worst an unnecessary entity.

This view of HR is not only inaccurate but dangerous to the health and potential of your company’s success and ability to grow. HR ought to be looking after personnel changes, not administration. As business executive Jack Welch states in his blog article , “What could possibly be more important than who gets hired, developed, promoted, or moved out the door?” So then why would you bog down that department with administrative work?

Jack and Suzy Welch explain further in their book The Real-Life MBA that “HR isn’t optional—not in any industry” and that HR “gets a bad rap because most organizations lump administrative HR and real HR together.” They go on to explain how “administrative” HR consists of payroll, benefits, and so on. Meanwhile “real” HR is the one that is in charge of people development and “finding, training, motivating, and retaining great talent.” But if HR is too busy dealing with administrative day-to-day tasks then it cannot focus enough attention on the long term strategies of real HR.

So if you’re a business owner or if you work in HR, how do you bring your HR department back to where it needs to be in order to hire and develop your team and company?

We recommend investing in a Human Resources Information System (HRIS). A HRIS is able to streamline the administrative functions that we normally associate with HR departments. This digital software is not here to necessarily replace HR. Instead, HRIS allows HR departments to focus less on the administration of a company and more on the growth of your business.

We work side by side with many great HRIS programs and PEOs. Call us at 650-348-6234 to see if you can take advantage of our special channel partnership pricing and get started on streamlining your HR administration today.

Pet Insurance Benefits

Tue, 19 Nov 2019 15:46:00 GMT

We’ve all heard the saying “A dog is a man’s best friend” and we know it’s true! Pets give us unconditional love, companionship, and joy. But, are we willing to pay the price when a hefty vet bill comes along? Pet insurance may help you stomach that unexpected emergency room charge due to Fluffy’s uncanny ability to eat anything within reach—even if it’s rotten!

In 2017, over $16.62B were spent on veterinarian bills in the United States. In that same year, Americans also spent over $1B on pet insurance. This begs the question “is pet insurance worth buying?” While this market continues to grow, 99% of pet owners report NOT having pet insurance. The number one reason? Cost. Premiums are at their lowest when you own a puppy or kitten and increase as the pet gets older. This results in the insured only keeping pet insurance for an average of 3 years. The cost of insurance can increase 5-fold between the puppy and adult years.

Pet insurance is one of the fastest growing markets in the US. This insurance can be purchased with increased levels of coverage. The most basic level may cover treatments for some common illnesses or accidental injury. The mid-range coverage could cover preventative care as well as immunizations. An example of premium coverage is surgical cost and liability for if the pet injured someone. Prices for these levels range from $15/ month to $45/month.

What is Pet Insurance?

Pet insurance is now becoming a more commonplace employee benefit. Contingencies.org says that 6500 employers in the US and Canada offer pet insurance to its employees. A report by SHRM says that of those offered pet insurance as an employee perk, only 6% of pet owners utilized that benefit in 2012. By 2017, that number rose to 9%. Employees say this is an important benefit because, for many, pets are considered part of a family and if you insure a human member of a family, why wouldn’t you also insure your pet?

If your company does not offer pet insurance, here are some tips on what you should look for when considering purchasing pet insurance:

With our pets being a vital part of our family, having pet insurance can give you peace of mind that you don’t have to shoulder the entire cost of an injury or illness of a pet. Not having to make decisions for their care based on money is a blessing to their families. For over 6,000 companies and their 80,000 employees this perk is worth every penny.

Diabetes Education and Prevention | California Benefits Experts

Tue, 05 Nov 2019 18:46:00 GMT

Diabetes patients are unable to make enough of the hormone called insulin or cannot use the insulin that is made in their body efficiently. When this happens, your body can respond in some serious ways that include liver damage, heart disease, vision loss, and kidney disease.

There are two types of diabetes. Type 1 diabetes is an autoimmune disease where the body just stops making insulin. These patients are usually diagnosed as children, teens, or early adults. Type 2 diabetes is a result of your body not using the insulin produced in an efficient manner. About 90% of all diabetic patients are type 2 cases. But, through education and prevention, the effects of diabetes on a person’s body can be lessened.

How is food converted to energy?

When you eat food, most of it is converted to sugar (glucose) and released into your bloodstream to provide you with the energy you need to do daily tasks. When your blood sugar levels increase, your pancreas is then activated to release insulin into your body’s cells and use it for energy. Insulin not only helps convert glucose to energy, but it also helps our body store glucose for future energy use.

Diabetes = Broken Process

In some people, the conversion process is interrupted and the message to the pancreas to release insulin into the cells to use for energy is done ineffectively. These patients have trouble balancing the correct amount of insulin in their cells and so therefore have a harder time maintaining energy levels. Diabetic patients try to get rid of extra sugar (blood sugar level of 180 +) through the kidneys and therefore have the need to urinate more often. When releasing large amounts of sugar through urine, it means that there is less available to convert to energy and leads to lethargy, loss of appetite, and excess burning of body fat.

Education & Prevention is Key

For people with either type 1 or type 2 diabetes, understanding how your body processes sugar and maintains healthy blood sugar levels is paramount. Those with type 1 diabetes require daily insulin shots to keep blood sugar levels even. These patients are unable to reverse this autoimmune disease and solely rely on insulin shots to level out glucose levels. Those with type 2 diabetes can control the progression of this disease by making healthy diet choices and exercising regularly. In some cases, type 2 diabetics also have to include insulin shots or diabetes pills.

November is National Diabetes Month and is a great opportunity to adopt healthy lifestyle habits. Maintaining blood sugar levels through diet and exercise as well as becoming aware of the effects of the eating choices you make is key to understanding this disease. For more information on diabetes and how to make good choices, visit the American Diabetes Association website.

Hidden Benefits of Health Insurance: 8 Commonly Missed Benefits

Mon, 28 Oct 2019 19:43:00 GMT

You probably already know the standard benefits and coverage options that your health insurance carrier is offering you, from doctor’s appointments to preventative care to routine tests. But do you use or even know about your hidden benefits and perks? To incentivize healthy lifestyles and compete with other plans, carriers will often include benefits and discounts for enrollees. Although this list is by no means exhaustive and benefits vary greatly from insurance company to insurance company and plan to plan, these may be some of your hidden benefits that you should inquire about from your broker, HR department, or health insurance carrier:

Walk-in clinics are available around the country and may be located at your local pharmacy. Walk-in clinics are perfect options when you are travelling or can’t get an appointment with your regular physician. Places such as CVS , Walgreens , and Target offer walk-in clinic services as easy, quick, and simple as shopping. Under a physician or registered nurse practitioner, you can seek treatment for a wide array of ailments, have a prescription filled, and even have tests run.

Telehealth is a bit of a catch-all term with a wide assortment of definitions. Many insurance companies refer to telehealth as a system of accessing care remotely through the comfort of your computer or phone. With services like Teladoc , you can video chat with a certified physician while benefiting from low wait times and on-demand service at the touch of a screen.

Although not as common as other hidden benefits of health insurance, insurance companies are beginning to explore subsidizing and offering discounts on healthier food and groceries. These benefits could also include discounts on registered dieticians and popular weight loss programs such as Jenny Craig®. Your insurance may even offer you their in-house weight loss programs and services.

If you have a qualifying illness you may be able to participate in your carrier’s chronic illness management program. Qualifying diseases could include, but are not limited to, heart conditions, diabetes, asthma and other chronic respiratory conditions, among others. In addition to online access and support, you could receive a case manager that helps to teach you how to navigate your symptoms and manage your illness.

Some insurance carriers partner up with fitness centers and gyms to offer discounts and savings on memberships to enrollees like you. You could also save further health costs down the road by staying fit and active. Not to mention that some insurance companies offer reward programs in which you are rewarded just for going to the gym or walking a certain amount of steps each day.

See if you can access one of the many companies that offer house calls like Heal . A house call is when a doctor comes to your home for a personal appointment, rather than you having to go to the doctor’s office. Many insurance companies cover house calls so they are an affordable and convenient option for when you are feeling sick. Ultimately you can avoid germ-filled waiting rooms and enjoy the privacy and comfort of your home.

When you are feeling a minor illness or have a medical question, you could call up a 24/7 nurse line. These phone lines may be covered by your insurance through a partner organization or directly sponsored by your carrier. Typically the nurse line involves a registered nurse available 24/7 to answer questions and offer advice on symptoms, care, and minor illnesses. But a 24/7 nurse line is not a substitute for emergency services so as with any case if you are experiencing a medical emergency call 911.

We have all had that moment when we took the family for a vacation and someone gets sick. While it depends on the carrier and your plan, realize that your insurance may reach across the country. Call your insurance company and the doctor’s office before setting up an appointment to see if a physician is contracted with your insurance. But don’t assume that just because you’re away from home means you won’t be covered.

There are numerous benefits that you may be underutilizing. These benefits include discounts, savings, and special programs and resources that you might be missing out on. Take advantage of your options and find out which hidden benefits of health insurance you may qualify for.

For more information on some of the hidden benefits of health insurance for specific carriers please call your broker or insurance company. Call us today at AEIS, Inc. to help you explore hidden benefits at 650-348-6234.

Disclaimer: You should familiarize yourself with your available insurance benefits before you may need them and in case of an emergency seek immediate medical attention and call 911.

How to be an Open Enrollment Rockstar | Employee Benefits Team

Wed, 23 Oct 2019 15:07:00 GMT

It’s the most wonderful time of the year.

No, it’s not Christmas—it’s Open Enrollment!!

When the autumn leaves fall and the weather turns cooler, we know it’s time to start thinking of open enrollment hype and meetings and meetings and meetings. So how do you change normal and ordinary communication about employee benefits and change them into rockstar communication? We have some tips that may help!

COMMUNICATE EARLY

People need time to process all the information you share about their employee benefits. Once they have received the info, they typically need to ask questions, compare/contrast plans, and weigh decisions. By communicating with your employees early, you give them plenty of time to make their choices without feeling rushed by a short deadline.

COMMUNICATE CLEARLY

HSA, FSA, PPO, HMO, LTD? What? You can see how your employees can get confused with all the terms and plan names that get presented to them during open enrollment. The Society for Human Resources Management (SHRM) suggests creating a glossary of common terms for enrollment meetings. Another way to clearly communicate benefits is to think ahead to the common questions asked each year and make a FAQ sheet with the answers.

COMMUNICATE FREQUENTLY

Did you know that it takes 8 times to read something before you retain that information? Think of all the material that gets shared at open enrollment meetings. There is no way that an employee would be able to retain that info in one sitting. So, communicate about your benefit plans all year long. Do trivia contests with prizes in your company newsletter about different benefits topics. Use multiple channels to frequently communicate such as print, digital, and animated videos!

COMMUNICATE PERSONALLY

Share “real life” examples of a sample employee with specific health issues and how they can utilize their benefits. This helps your audience think of additional situations in which they could see themselves needing some of the insurance products offered in your meetings. Host small Q & A sessions after larger meetings to allow for more personalized attention. When you communicate personally, you are able to explain the value of the benefits to your employees better.

By focusing on these communication techniques, you will reap the rewards of a well-informed and connected employee when they are choosing benefits. Plan ahead, speak with a clear message, personalize example situations, and repeat, repeat, repeat. Here’s to a great open enrollment season!

Deadline Extended for California Harassment Prevention Training | Employee Benefits Consultants

Fri, 20 Sep 2019 15:20:00 GMT

California has passed an emergency bill to extend the deadline for the first round of sexual harassment prevention training by one year. Previously, employers with five or more employees were required to provide interactive sexual harassment prevention training to all employees in California by January 1, 2020. The deadline is now January 1, 2021. The […]

Volunteering Time Off, Part Two | California Employee Benefits

Thu, 12 Sep 2019 14:04:00 GMT

In survey after survey, employees state that they want to work for companies who care for others. In fact, “71% of employees surveyed say it’s very important to work where culture supports volunteering,” according to America’s Charities Snapshot . There are different types of volunteer options when looking to begin a volunteer program at a company. For example, entire companies can come together for a big “Day of Service” event. Or perhaps there is an ongoing need in the community, like Meals on Wheels, and employees sign up to help when needed by the charity. Offering pro bono services to non-profit community groups or donating skills for specific projects are other ways to assist charities in your area.

The issue of time worked and pay typically comes up when talking about employer sponsored/encouraged volunteering. There are a couple different ways that companies structure this. One way is to simply pay employees for their usual time at the workplace even though they are not actually working on company business at the time of the volunteer project. This is typical of big “Day of Service” campaigns during the workweek. Another way is to encourage employees to donate their break or lunch time to complete volunteer service projects. Finally, and this is the emerging trend in employee benefits, is to give each employee Volunteer Time Off (VTO) hours as part of their benefits package.

The benefits of VTO are numerous. One of the biggest values of VTO is that of employee recruitment and retention. PricewaterhouseCoopers conducted a survey and the results were that “59% of Millennials gravitated towards companies with pronounced Corporate Social Responsibility programs.” For retention, the value is even higher, “ 74% of employees say their job is more fulfilling when given the opportunity to make a positive impact at work.” Companies also see a benefit in camaraderie across departments and company hierarchy. Working together towards a common goal builds these interdepartmental relationships. Also, by playing towards strengths unseen in a regular office setting, employers have a chance to discover untapped leadership skills and completely unknown skill sets of employees. Finally, your company’s brand image is boosted by the view of its involvement in the community.

Whatever the benefit that your company assigns to a healthy VTO program, be it retention, image, or team building, the fact remains that there WILL BE a benefit. If you are looking to begin the search for the right fitting program, there are great resources available for you. Check out this quick read on Charities.org and also the great tips on SalesForce.com . Start the conversation today with your leadership and start making an impact in your community!

Urgent Care vs. Emergency Room | CA Benefits Partners

Tue, 03 Sep 2019 16:54:00 GMT

Urgent care centers and emergency rooms are both great options for times when you are unable to see your primary care physician (PCP). The reasons for choosing these facilities can be because the injury or sickness has occurred outside normal office hours for your doctor or that you are out of town when an emergency hits. As you know, the first choice for non-life or limb-threatening conditions should be your regular doctor—they will have your medical history on file and your medication list at the ready. When this is not an option, you will need to make the choice on what level of care you need.

Urgent Care Centers

Urgent care centers fill the gap between when you are sick or minorly injured but cannot see your PCP and when you are in need of hospital emergency care. Most urgent care locations are staffed by doctors or physician’s assistants. These centers can get you in and out quickly and some even take appointments. Since you will not see your PCP at these clinics, it’s always best to bring a copy of all the medications and dosages of meds you take. If you have a special condition, like epilepsy, make sure you disclose that to the urgent care provider you see. In the case of your avocado hand, your urgent care physician may be able to do minor stitches and bandaging at the facility. Most have access to x-ray machines and basic diagnostic tests. The typical range of costs for care at these centers is between $50-$150.

Here are some conditions that typically can be seen at urgent care centers:

Emergency Room Care

Hospital emergency rooms provide care for life and limb-threatening situations ranging from heart attack and stroke to car accident injuries. Staffed by physicians, nurses, and specialists, emergency rooms have access to highly knowledgeable and diverse medical teams. In emergency rooms, care is given to the most serious injury/illness first—not on a first-come, first-served basis. Because of this, wait times in emergency rooms are widely varied and may be into a several hours-long wait. Again, it is wise to bring a list of any medications, both prescribed and over-the-counter, with you when seeking care since the ER will not have this information from your PCP. Costs for emergency services can be anywhere from $50 to more than $10,000 depending on the severity of the injury or illness.

Symptoms that are best evaluated in an emergency room include:

When faced with the decision to visit an urgent care center or emergency room, you have to first evaluate your symptoms. Once you have done this, ask yourself this question, “Does this condition have the possibility of permanently impairing or endangering your life?” If the answer is “yes,” then you have an emergency and should proceed to the nearest hospital ER. If the answer is “no,” then take your towel-wrapped avocado hand to your local urgent care center for stitches or whatever care they recommend. You will save yourself time and money by making a good choice on your care.

What is an EOB and why should I use it? | California Benefits Advisors

Mon, 19 Aug 2019 14:31:00 GMT

As the insurer Cigna states, an EOB is “a statement from your health insurance plan describing what costs it will cover for medical care or products you’ve received.” While they may look different depending on the insurance company, EOBs help to explain how much the cost of your care for a visit was, how much your insurance carrier paid for it, and how much your provider may bill you for. Your insurance negotiates prices with your provider so there will be an “allowed amount” section on your EOB of how much a doctor could charge your insurance. An EOB could also include information on the claim, member details, deductibles, and copays.

But an EOB is NOT a bill. It is simply the explanation of charges, allowed charges, and insurance payments for a service to your medical provider. You will receive a bill separately from your physician or hospital.

While you look over your EOB, make sure to look at the section that states how much you owe your hospital or physician. This section could be worded as “total patient cost,” “total provider may bill you,” or something along those lines. When you receive your actual bill, check the charged amount with your EOB information because sometimes hospitals or physicians could make a mistake when billing you.

In addition be sure that your EOB shows any copays or amounts you have already paid to the provider at the time of your visit. If your copay that you already paid does not appear on your EOB or bill, contact your provider and insurance carrier to make sure that it is corrected.

If you have a PPO plan, you also want to make sure on your EOB that the insurance carrier has correctly coded your provider as “in-network,” if they are an in-network provider. A PPO plan gives you the option to see providers that are in or out of your network. Your insurance carrier has negotiated lower costs with in-network providers so you will almost always pay less out of your pocket if you stay with providers in your network as opposed to out of network providers.

Essentially EOBs are there to show transparency and to catch billing errors. Michelle*, a graphic designer from Northern California, quickly learned this lesson. Recently Michelle opened up her bill from her dermatologist and found that she was charged hundreds of dollars for a visit. She had an exam and a couple of procedures but was skeptical of the high price so she checked her EOB online. She realized that her doctor had charged her for a service that her insurance did not allow for her physician to charge. She called her doctor and explained what her EOB said. In a few weeks, her doctor’s office worked with her insurance and fixed their billing mistake. Because of her diligence, she saved nearly $300.

A few months later her husband, Jack, was charged thousands of dollars for procedures from his doctor. But Jack checked his EOB and quickly saw that all the charges were for preventative procedures, which Jack was not responsible for paying under his health plan. He called his doctor and explained what the EOB said. His doctor’s office realized that they had made a mistake and told him not to pay the bill. How much did he save by checking his EOB? Around $2,000. If Michelle and Jack hadn’t read over their EOBs, they may have ended up paying for these unnecessary charges.

EOBs will either be mailed to you or available for access online. If you have a digital account with your insurance, sign in and check under EOBs to download your latest ones. If you are not sure how to access your EOBs, contact your broker or insurance company for assistance.

While billing mistakes are rare and it may be extra work to check your EOB, it never hurts and you could avoid paying fees that should not be there. When in doubt, check your EOB.
*All identifying information has been changed and permission was granted to be included in this post.

Disclaimer: This blog is intended to be informational and does not constitute legal advice regarding any specific situation. Should you require further compliance assistance or legal advice, please consult a licensed attorney.

Source: https://www.cigna.com/individuals-families/understanding-insurance/explanation-of-benefits

By Wyatt Bland

Volunteering Time Off, Part 1 | California Employee Benefits

Thu, 08 Aug 2019 16:17:00 GMT

Volunteering Time Off, or VTO, has become a buzz topic for many companies as of late. It involves encouraging employees to take time off from their job to plug in to their community and the nonprofits that support it. Let’s delve in deeper to understand what VTO looks like. Typical VTO policies allot for 8 […]

ASK THE EXPERTS: OVERTIME AND PAID TIME OFF | CA Benefits Agency

Tue, 30 Jul 2019 13:43:00 GMT

Answer: No. Because holiday, PTO, and vacation hours are not actually hours worked they do not count towards overtime pay.

Under the Fair Labor Standards Act (FLSA), an employer who requires or permits an employee to work overtime is generally required to pay the employee premium pay for such overtime work. Unless specifically exempted, employees covered by the FLSA must receive overtime pay for hours worked in excess of 40 in a workweek at a rate not less than time and one-half their regular rates of pay. The key consideration for premium pay under the FLSA is whether or not the employee actually works more than 40 hours in the workweek, not just that he or she is paid for more than 40 hours in the workweek.

For example, an employee is off work for one day for a company-paid holiday and takes the next day as a paid vacation day. He then works 10 hours for the next three days of the workweek. Under the FLSA, he would be paid straight time at his regular rate for the 46 hours recorded for that week as follows: 8 hours of holiday pay + 8 hours of vacation pay + 30 hours of regular pay for time worked = 46 hours at his regular pay rate.

Employers should also check state laws for overtime requirements regarding holiday and vacation time.

Originally posted on thinkhr.com

We Have the Technology – AEIS’s Newest Partnership

Fri, 19 Jul 2019 20:18:00 GMT

Being a little over halfway through 2019, this is the time of year we check in with all our contacts to learn what is going on in their world and to give them insight into what is happening in ours. Here’s what we’ve been working on:

This year we are excited to announce that we have begun a new partnership with Rippling!

Among the many changes we’ve seen over the years in our industry, none have been as nuanced or as rapid as the ever-expanding capabilities of technology. It wasn’t long ago that cloud based payroll, benefits and HR platforms were new and novel concepts. As important a breakthrough as these innovations have been for the way employers now operate, there is a problem we’ve seen many employers experience.

Even employers who adopted these technological innovations often faced the issue of having multiple separate platforms that operate completely independent of each other. Double entry of data and potential for errors in transcribing and reconciling data can almost cause more headaches than not using technology at all.

Another layer to the problem has been that the technology exists, but a gap has existed in the relationship between the companies developing it and benefit advisors, meaning employers are often forced to choose whether they wanted the tech or the advisor.

For years we’ve heard employers explain these issues and we’ve been determined to find a solution. After vetting numerous potential partners over several years, we’ve finally found the perfect fit that allows our clients to have the best technology without having to sacrifice having licensed, experienced benefits advisors.

Rippling is a fully integrated Payroll, HR, IT and Benefits administration system that integrates with hundreds of apps like salesforce, zoom and slack. It allows everything to be in one place making it easy for employees and employers/administrators. Schedule a Demo .

To learn more about Rippling and our partnership, you can see our blog post on our website or click this link see what Rippling has to say and schedule a demo. http://aeisadvisors.com/aeis-rippling-forge-alliance/

Compliance Updates

We have always placed tremendous value and focus on keeping our clients in the good graces of “The Departments” (IRS, DOL, etc.), but we also know that just the words “Healthcare Compliance” often inspire one of two emotions from employers and plan administrators: apathy or anxiety. As if there wasn’t enough to keep track of for employers in CA, the PPACA has given employers even more to juggle in recent years. While it may not be fun to hear about compliance, we’ve created new tools to make it easier to understand.

Check out our new infographic that briefly explains what regulations to look out for and how to determine if your organization is subject to them. For employers with employees in San Francisco we even created a separate graphic that addresses the many regulations that are particular to the city.

Once you have figured out what to be aware of, refer to our Compliance checklist to be sure you’ve got everything you need.

If you have any questions about any of these regulations or want to speak with us about a specific situation, please feel free to reach out to us at (650) 348-6234

Hotel Via Event to celebrate our partnerships!

We’re hosting an event on Monday 8/19 at the Hotel Via rooftop lounge (across from the Giants ballpark on King St. in SF) with a couple of our channel partners and we wanted to invite you to go. The cost for the event to the public would normally be $50-$75 per person (there will be drinks and appetizers) but this link will let you register for no cost.

Our goal is to have Technology & SaaS, Human Resources, Real Estate, Social Media, Finance, Marketing and other businesses come together for drinks, appetizers and networking.

Our cohosts will be Rippling and Keating Consulting. You may have read about them above, but Rippling is a new technology partner of ours that provides integrated administrative processes like payroll, HR and benefits. Keating Consulting is an accounting firm and consultancy providing interim financial leadership and back office support to startups and early-stage companies.

If you have any other colleagues or contemporaries you think would get value out of this event, please feel free to share the link with them so they can register for no cost: https://business-buzz-aeis-82019.eventbrite.com?discount=AEIS

We hope you’re able to make it!

Ask Our Experts: Vacation Time in California | California Benefits Partners

Wed, 10 Jul 2019 21:36:00 GMT

As an employer in California, what are my options in how I man age my employee’s vacation days?

First off, in California there is no legal requirement to provide paid or unpaid vacation time. But most companies do in order to recruit and retain employees. (Please note: While employers don’t have to offer vacation or PTO plans, they must comply with a number of paid leave related laws in California and various instrumentalities. This article solely addresses vacation policies.)

If you do chose to offer such a policy as the employer, earned vacation time is then considered wages and it is earned by employees as they work. In other words, vacation pay is considered a form of wages, which is given as it is earned. Please note, this also applies to Paid Time Off (PTO) earned days.

So in short, if your employee is not using vacation days, you could A) pay them off each year or B) set a cap in order to incentivize the employee to spend them. However, as the employer you CANNOT put in a “use it or lose it” policy.

A “use it or lose it” policy is when a company installs a forfeiture of vacation pay when it is not taken by a certain date, which is an illegal policy in California.

As opposed to a “use it or lose it” policy, a vacation policy that puts a “cap” or “ceiling” on the amount of vacation pay an employee can accrue is allowed. An illegal “use it or lose it” policy leads to a loss of accrued vacation pay for the employee. Meanwhile a “cap” puts a limit on how many vacation days can build up. That is to say, as soon as a set number of accrued vacation days is earned but not used, no additional vacation days accrue until the amount lowers back down below the set cap.

For example, if you set the cap at four weeks, or 160 hours, that an employee can accrue, then they will not be able to start accruing more vacation time until they have used some of their vacation hours and their hours fall below the maximum.

Even though “cap” policies are allowed, the employee must be able to take a vacation within a reasonable time frame. If a “cap” policy actually serves as a means to deny employees vacation pay or benefits, the policy would not be permissible in California. For example, a work policy of vacation days having to be taken in the year that it is earned or in a very constrained time period following when the vacation days were accrued is deemed unfair.

The employer can decide vacation pay responsibilities, such as managing when the employee can take a vacation and how long of a vacation they may take at a time. The employer can also pay the employee off at the end of the year for vacation that the employee earned and accrued that year, but ultimately did not take.

Summary:

In California, you cannot institute a “use or lose it” policy in which the employee has to use the vacation within a narrow timeframe or the same year or face loss of vacation days. You also must pay terminated employees their unused vacation days.

Employers can institute policies of cap/ceiling where there is a limit to the amount of vacation days they can accrue and must fall below that cap to get more; pay off unused vacation days for ones not used that year; and decide when and the amount of vacation days at a certain time.

For more information, please visit the California Department of Industrial Relations.

Source: https://www.dir.ca.gov/dlse/faq_vacation.htm

By W. Bland
AEIS Advisors

AEIS & Rippling Forge Alliance!

Thu, 20 Jun 2019 17:00:00 GMT

At AEIS, our tagline is “Insurance is just the beginning” because we know as benefits advisors that attracting and retaining employees doesn’t stop at offering great benefits–it extends to employers having the tools to be successful so they can have an “edge” in acquiring talent. Enter the alliance of Rippling and AEIS!

Rippling is a comprehensive Payroll, HR, IT and Benefits A dministration system that integrates with hundreds of apps like Salesforce, Zoom, and Slack . It allows everything to be in one place making it easy for employees and employers. Having cutting edge technology OR having an experienced benefits advisor no longer has to be a choice.

Save Time : No more having to house employee data in multiple separate systems or manually double enter information. Manage everything within one platform. Onboard new hires in less than 90 seconds.

Save I.T. Headaches : Buy or lease equipment through Rippling for employees preloaded with all the apps and programs applicable to their role with a single sign-on and real-time threat detection software. If the equipment is lost or stolen, remotely deactivate and wipe it clean .

Save on BenAdmin : Get Rippling’s benefits administration included for no additional cost when working with both AEIS and Rippling.

Save Face : When new hires join your team, fair or not , the onboarding process is one of their first impressions of what it will be like to be an employee at your organization. Give them confidence and remove any doubt from their mind by providing an easy and seamless experience as they begin their journey with you.

Call us at 650-348-6162 , email Dillon@aeisadvisors.com or click here to learn more about how our collaboration can benefit your organization!

Ask the Experts: Taxability of Reimbursements for Mileage | California Employee Benefits Partners

Thu, 13 Jun 2019 20:05:00 GMT

Answer: They may be; the type of reimbursement plan will dictate whether reimbursement for business travel is or is not taxable. Both accountable plans and non-accountable plans allow an employer to reimburse employees for their business expenses.

With an accountable plan , the reimbursement is not taxable to your employee. Amounts paid under an accountable plan are not wages and are not subject to income tax withholding and payment of Social Security, Medicare, and Federal Unemployment Tax Act (FUTA) taxes. Your reimbursement or allowance arrangement must meet all of the following conditions in order to quality as an accountable plan:

A non-accountable plan does not meet the three requirements for accountable plans and is subject to all employment taxes and withholding. Payments under a non-accountable plan occur if: (1) the employee is not required to substantiate expenses with receipts or other documentation in a timely manner; and (2) the employer advances an amount to the employee for business expenses and the employee is not required to, and does not, return any amount he or she does not use for business expenses in a timely manner.

Employers should also check with their state department of taxation to understand any state tax rules applicable to them.

For more detailed information on federal mileage reimbursement, see the IRS page containing Publication 463, Travel, Entertainment, Gift, and Car Expenses, and updates to this publication since its publication date.

Originally posted on ThinkHR.com

IRS Announces HSA Limits for 2020 | California Benefits Advisors

Tue, 04 Jun 2019 19:56:00 GMT

To be eligible for an HSA, an employee:

The limits vary based on whether an individual has self-only or family coverage under an HDHP. The limits are as follows:

*If the HDHP is a nongrandfathered plan, a per-person limit of $8,150 also will apply due to the Affordable Care Act’s cost-sharing provision for essential health benefits.

Originally posted on ThinkHR.com

Who Can I Name as a Beneficiary on My Life Insurance Policy? | CA Benefits Partners

Wed, 08 May 2019 16:51:00 GMT

Every life insurance policy requires you to name a beneficiary. A life insurance beneficiary is typically the person or people who get the payout on your life insurance policy after you die; it may also be a trust, charity or your estate.

You can also name more than one beneficiary, as well as the percentage of the payout you want to go to each one—for instance, you could designate 50% to a spouse and 50% to an adult child.

You’ll typically be asked to pick two kinds of beneficiaries: a primary and a secondary. The secondary beneficiary (also called a “contingent beneficiary”) receives the payout if the primary beneficiary is deceased.

Providing for Kids
A big reason why people buy life insurance is to provide for children left behind. Usually this is done by making the surviving spouse or partner who cares for and is raising the kids the beneficiary. But what if you’re widowed or—God forbid—-both you and your partner pass away at the same time?

First, know that it’s not a good idea to name a minor as a beneficiary. That’s because the law forbids life insurance payouts to anyone who has not reached the age of majority, which is 18 to 21 depending on your state. If a child were to be named, then it would be turned over to probate court. The court will name a guardian who has oversight of the money/estate until the child comes of age.

Fortunately, there are two options. The first is to name an adult custodian. The custodian should be someone you can trust to use the money for things like housing, health care, and education until the child reaches the age of majority. At that point, any remaining money gets turned over the child and they can spend it any way they want.

The second option is to work with an attorney to set up a trust. In this scenario, the trust is the beneficiary and a trustee is named to manage and distribute the funds. The main advantage of a trust over naming a custodian is having more control.

A trust lets you specify how you want the money distributed—and it lets you do so even when your kids are adults. (One quick word of caution: Definitely consult with an attorney if you’re setting up a trust for a special needs child . They can help you create one that doesn’t impact your child’s eligibility for government assistance like Medicaid or Supplemental Security Income.)

Naming a Charity
Do you have a cause that’s near and dear to your heart? If so, you might consider naming a charitable organization as the beneficiary of your life insurance .

There are several ways to do this. They include naming the charity as a beneficiary on a new or existing life insurance policy, making the charity both the owner and the beneficiary of a life insurance policy, adding a charitable-giving rider to a life insurance policy, or working with a community foundation to figure out the best way to distribute a payout.

Final Tips
Think carefully about naming your estate as a beneficiary. This can trigger a long and costly legal process known as probate. A faster and more efficient solution is to name specific individuals or organizations as beneficiaries.

1. Get specific. Instead of naming “my spouse” or “my children” as beneficiaries, list their names along with their addresses and Social Security numbers. This saves a lot of time since the insurance company doesn’t have to track down information.

2. Always name a contingent beneficiary. Passing away and leaving behind life insurance without a living beneficiary could mean the payout goes to someone you never wanted your policy to benefit. It could also require a court-appointed administrator to sort things out.

3. Pick trustworthy custodians and trustees. Really consider who’d you trust your child’s financial well-being with if you weren’t in the picture. Your kids may love their uncle or aunt, but is he or she mature and responsible with money? If not, pick someone else who is.

4. Regularly review your beneficiaries. It’s a good idea to review your beneficiaries about once a year and after major life events like a marriage, divorce, the birth of a child, or a death in the family.

5. Communicate your wishes. Let your beneficiaries know your intentions and how to find the policy.

6. Be aware of special situations. There are some situations that could trigger a tax on the life insurance benefit—for instance, when the policyholder and the insured aren’t the same person. Likewise, things can get sticky if you live in a community property state and don’t name your spouse as a beneficiary. An insurance agent can give you life insurance advice on this and much more.

By Amanda Austin

Originally posted on lifehappens.org

5 Ways to Express Gratitude | CA Insurance Agents

Wed, 09 Jan 2019 21:57:00 GMT

As we begin our new year of 2019, we have also closed 2018 with lots of celebrations, gift-giving, and family time. Showing appreciation for others during this generous season comes second nature for some but for others, it doesn’t. You may be looking for ways to express gratitude effectively to those around you and so we’ve compiled a list of five unique ways to say “thank you” to someone.

#1 - WRITE IT OUT

Receiving a handwritten note is a rare occurrence in this day. Speaking or emailing a thank you is more common and does effectively communicate the gratitude of the sender. However, the spirit of gratefulness that is communicated by sitting down and taking pen to paper to express your thankfulness for the act or gift received, is a bonus to the note receiver. Take the extra time to write out that thank you.

#2 - PHONE A FRIEND

In a day and age of emails and texts and social media, we rarely get phone calls from people who aren’t asking for something—billing issues, appointment reminders, robo-calls. Even if the person on the other end of the call doesn’t pick up, leave that voicemail telling them thank you for their thoughtfulness for the gift you received. Be specific and mention the gift by name and what it meant to receive it. That phone call may be the brightest part of their day!

#3 - SAY IT ON SOCIAL MEDIA

We spend more time scrolling through social media than we do having face-to-face contact with people. Instead of getting caught up in a heated debate on NextDoor, take a few minutes to write on a friend’s wall to tell them thank you. It’s refreshing to see gratitude on display instead of incivility. And it’s always nice to see your friends get noticed for kindness!

#4 - FLASH A SMILE

The look of surprise on someone’s face is sometimes the greatest thank you that you can receive! The age old saying of “your face says it all” is true. When you open that gift and you can tell that the giver spent time thinking of the perfect thing to give you, look up and give them the thank you of a smile!

#5 - PAY IT FORWARD

Were you bowled over by the thoughtfulness of a gift or act? A beautiful way to show your gratefulness is to pay it forward. Buy the coffee of the person behind you in line. Say three nice things to strangers on the way in to your office. Tell your child a character quality you see in them that is fabulous. While this act of gratitude may mean that the original giver never knows about the ripple effect of their gift, you will, and hopefully that ripple is carried on and on and on.

These acts of gratitude are simple, effective, and most of all, meaningful. Take the time to say thank you!

Attention Small Group Employers in California! Sexual Harassment Training is required, even for you… | California Benefits Agency

Fri, 30 Nov 2018 17:58:00 GMT

Employers have until January 1, 2020, to comply with the new requirements.

In short, employees are required to complete this training within 6 months of starting a position. Employees in supervisory roles will be required to complete a 2-hour course; employees in non-supervisory roles will be required to complete a 1-hour course. All employees will be required to complete the training once every two years.

The training can be completed online or in a classroom setting. It can be integrated with other training sessions that you may require for new employees so long as the curriculum meets the requirements for time and content.

Remember that your required posters and fact sheets will need to be updated. These posters can be requested directly from the California Department of Fair Employment and Housing.

Per the regulations, the Department will be providing two online training courses: a 2-hour course for supervisors and a 1-hour course for employees in non-supervisory roles. These interactive courses will include questions that must be answered before a participant can continue the course. After the course is completed, the Department will provide an option for the participant to save a certificate of completion electronically or print it.

For employees placed with a company through a temporary staffing agency, the responsibility of sexual harassment training falls to the temporary staffing agency.

For seasonal or temporary workers who are to be employed less than 6 months, training must be completed within the first 30 calendar days of being hired or within the first 100 hours of service, whichever occurs first .

Keep in mind that there are additional requirements for sexual harassment and record keeping per Labor Code section 1684 for migrant or agricultural workers and AB 1978 for employees that provide property services such as janitorial services.

We will provide an update when more information becomes available regarding the training courses provided by the State. If you have further questions, or would like alternate solutions besides the State provided ones, please contact us.

By Elizabeth Kay, Compliance and Retention Analyst at AEIS

Important Update for 1099 Contractors | California Employee Benefits

Thu, 04 Oct 2018 03:05:00 GMT

Previously there was a lengthy multi-factor test that an employer would use to determine if they had classified all of their 1099 contractors correctly or if they needed to re-classify them as W-2 employees. Now the California Supreme Court is stating that employers need to use the ABC test.

The test established by the Court in California reads as follows:

“The [new] ABC test presumptively considers all workers to be employees, and permits workers to be classified as independent contractors only if the hiring business demonstrates that the worker in question satisfies each of three conditions: (a) that the worker is free from the control and direction of the hirer in connection with the performance of the work, both under the contract for the performance of the work and in fact; and (b) that the worker performs work that is outside the usual course of the hiring entity’s business; and (c) that the worker is customarily engaged in an independently established trade, occupation, or business of the same nature as that involved in the work performed.” – Dynamex Operations West, Inc. v. Superior Court of Los Angeles , No. S222732 (Cal. Sup. Ct. Apr. 30, 2018)

This new standard makes California’s policy regarding independent contractors one of the most restrictive in the United States.

Employers who traditionally hire employees for short periods to help them get through their busy season but pay them as 1099 contractors will no longer be able to do so. If you hire someone to perform the same work that your company already performs, even if it is for a shorter period of time, they will need to be hired and paid as any other W-2 employee.

This will mean increased costs for employers in many areas including, but not limited to, increased taxes through FICA, workers comp premiums, and in some cases health benefit premiums if the employees meet the eligibility criteria. However, even with the potential increase in costs, the penalty for non-compliance with the new 1099 employee test could be much higher.

By Elizabeth Kay

California Compliance: Is my company over 50 employees? | California Employee Benefits Firm

Fri, 21 Sep 2018 04:44:00 GMT

As your company grows and you hire more employees, there are milestones that you will hit. Some of these milestones come with additional responsibilities that you need to attend to, such as Cobra, HCSO, FMLA, Sexual Harassment Prevention Training and the Affordability Care Act’s Large Employer Mandate.

For example, if you are a company based in California and offer an employee benefits plan that includes medical insurance, you are obligated to allow former or terminated employees and their enrolled dependents to enroll in Cal-COBRA if they are no longer eligible to be enrolled in your plan. Once you reach 20 employees or more for an average of 50% or more of the previous calendar year, then you are obligated to start offering enrollment in Federal COBRA for those plan participants and enrolled dependents if they are no longer eligible to be enrolled in your plan.

Additionally, if you have any employees working in the City of San Francisco, you would also need to comply with the Health Care Security Ordinance (HCSO). However, these two things would not happen at the same time because while they both require you have 20 or more employees before you have to comply, they count those employees differently, and over a different length of time.

Federal COBRA counts employees by their classification. A full-time employee is counted as 1, and part-time employees are counted in fractions. So you may have 15 full-time employees, and 5 part time employees and you would NOT be subject to Federal COBRA because your part time employees work an average of 20 hours per week, meaning all together they only count as 2.5 full-time equivalents which when combined with your full-time employees puts your count at 17.5.

The HCSO counts employees by head count, and they do it per quarter. So if you have 19 employees during one quarter of the year, you don’t need to comply. But if you have 20 employees for at least 13 weeks of the following quarter, you would need to comply.

Is your head spinning yet?

As you move further along and you reach 50 employees, there are more regulations that may now be applied to your company. They are the Family Medical Leave Act (FMLA), Sexual Harassment Prevention Training for California businesses, and the Pay or Play provision of the Affordable Care Act. As one might expect, each regulation counts employees in a different way.

When you have had 50 or more employees over 20 weeks during the current or previous calendar year, you are subject to FMLA. The weeks do not have to be consecutive weeks. Additionally, FMLA counts the employees on your payroll register even if they are not being paid. If they are on your payroll register, they are counted. Each person is counted as 1, regardless of the number of hours worked.

For sexual harassment prevention training in California, once you have 50 or more employees (regardless of full-time or part time status) for 20 or more consecutive weeks, you have to begin offering training for your management staff every 2 years, and within 6 months of promoting an employee to a managerial position.

The Applicable Large Employer or ALE classification under the Affordable Care Act counts employees in yet a different way. With regards to determining ALE status, you generally count each full-time employee as 1, and for part-time, seasonal, and variable-hour employees you count the number of hours they all worked collectively during a month (do not include more than 120 hours for any employee), then divide the total hours by 120 hours to get how many Full-Time Equivalent Employees (FTEs) you have. You then add the number of full-time employees, to your FTE’s to get your total employee count. If you average 50 or more employees during the calendar year, you are considered an ALE the following tax year. For example, if you average 50 or more employees during the 2018 calendar year, you would be subject to the Pay or Play Mandate and the reporting requirements associated with it for the year 2019.

If your employee count stays at 50 or above in 2019, you would continue to be an ALE with all associated requirements in 2020. If your employee count dips below 50 in 2019, then you would not be considered an ALE in the year 2020.

The Pay or Play Mandate (Employer shared responsibility) means that as an ALE you are required to offer minimum value, affordable coverage to your full-time employees and their dependent children, or potentially face a penalty from the IRS.

No one is an expert in all things, which is likely why your business is doing well and thriving: because you fulfill a need or expertise in the area that you specialize in. As a successful business owner you know it is advantageous to have strong partners in your corner to help lend their strengths to your areas of weakness.

Having a strong benefits advisor to assist you in navigating these hurdles, speed bumps, and curves in the road is essential. Whether you have the resources to handle these regulations in-house, or if you need someone to recommend a trustworthy third party vendor to handle it for you, we are pleased to be able to fulfill that need for you.

by Elizabeth Kay

ACA Tax Repeal & What It Means For You | California Benefits Firm

Wed, 05 Sep 2018 02:29:00 GMT

First, as an individual, if you do not carry health insurance, you are currently paying a penalty of $695/adult not covered and $347.50/uninsured child with penalties going even as high as $2085/household. These penalties have been the deciding factor for most uninsured Americans—go broke buying insurance but they have insurance or go broke paying a fine and still be uninsured. With the repeal signed in December 2017, these penalties are zeroed out starting January 1, 2019. While it seems that the repeal of the tax penalty should be good news all around, it does have some ramifications. Without reform in the healthcare arena for balanced pricing, when individuals make a mass exodus in 2019, we can expect higher premiums to account for the loss of insured customers.

As a business, you are still under the Employer Mandate of the ACA. There have been no changes to the coverage guidelines and reporting requirements of this Act. However, with healthy people opt-ing out of health insurance coverage, the employer premiums can expect to be raised to cover the increased expenses of the sick. Some do predict the possibility of the repeal of some parts of the Employer Mandate —specifically PCORI fees and employment reporting. The Individual and Employer Mandates were created to compliment each other and so changes to one tend to mean changes to the other.

So, why should you pay attention to this change? Because the balance the ACA Individual Mandate was designed to help make in the health insurance marketplace is now unbalanced.

Taking one item from the scale results in instability. Both employers and employees will be affected by this tax repeal in one way or another.

Ask the Experts: Marijuana and the ADA | California Benefit Partners

Thu, 16 Aug 2018 23:46:00 GMT

Answer: You are not required to accommodate medical marijuana use under the Americans with Disabilities Act (ADA). Even though medical marijuana is legal in many states, under the federal Controlled Substances Act (CSA), marijuana is still illegal. The ADA expressly excludes people who use illegal drugs from its definition of “qualified individual with a disability.”

However, as a best practice, you should still engage in the ADA interactive process if a request for a reasonable accommodation for medical marijuana use is made. Under the ADA, employers are required to provide reasonable accommodation to qualified individuals with disabilities unless doing so would cause an undue hardship on the employer. Any request for a reasonable accommodation triggers an interactive process with the employee to determine:

If the employee’s physician has determined that medical marijuana is the most effective treatment, a possible reasonable accommodation would be a waiver of your anti-drug policy. However, if the employee is in a safety-sensitive position, it may pose an undue hardship to make that accommodation and you should consider any other possible accommodations before denying the request.

There are no reasonable accommodations that would work in every circumstance. You will need to review the essential functions and safety requirements of the job with the employee to determine what types of reasonable accommodations may be acceptable while not imposing an undue hardship.

The Courts May Not Concur

While medical marijuana use is not protected by the ADA, this is being challenged at the state level. For example, in July 2017, the Massachusetts Supreme Judicial Court held in Barbuto v. Advantage Sales and Marketing that an employee who was fired after testing positive for marijuana could proceed with a “handicap discrimination” claim under the Massachusetts Fair Employment Practices Act.

In allowing the employee’s discrimination claim to go forward, the Court expressly rejected the employer’s argument that, because marijuana is illegal under federal law, requiring an employer to accommodate medical marijuana use is per se unreasonable.

Instead, the Court held that, at a minimum, the employer was obligated to engage in an interactive dialogue concerning the employee’s ongoing medicinal marijuana use before terminating her employment. The Court did not rule out the possibility that accommodating medicinal marijuana use could pose an undue hardship, leaving that issue open for the employer to address at a later date.

Originally posted on thinkhr.com

Summer Survival Guide | California Employee Benefits

Fri, 03 Aug 2018 00:19:00 GMT

Kids thrive with schedules. The idea of just lazing around all summer sounds great at the beginning, but it feeds the “I’m bored” monster. Having no routine or daily schedule leaves kids with no expectations of what needs to be accomplished for the day. I cannot count the number of times I’ve texted my children from work at 1pm, “Have you gotten dressed and brushed your teeth?” Set up a daily routine and post it in a well-traveled location in your home. Set up expectations for the day—make your bed, get dressed, feed the dogs, brush your teeth, put away laundry. Simple tasks give familiarity to the day and help guide them to productivity.

Teach your kids to always ask before heading out to the pool—whether it’s in your backyard, a friend’s house, or the neighborhood splash park. When they are in the water, make sure someone is watching. Among preventable injuries, drowning is the leading cause of death for children 1 – 4 years old. Drowning happens quickly and quietly —not like it’s portrayed in movies and on TV with lots of splashing and yelling. Keep kids in your sight at all times. Likewise, pay attention to applying sunscreen consistently. The sun’s UV rays can damage your skin in as little as 15 minutes . Apply sunscreen every hour and if possible, have your children wear UV protected clothing and hats.

Make your “Top 5 Summer Activities” list as a family and schedule them! Maybe it’s to try the new snow cone shop around the corner or go to a special concert series in the park. Your community is bustling with things to do during the summer. Research what special speakers are coming to your local library, break out your list of favorite movies from when you were a kid and introduce them to your children (Space Camp, Neverending Story, Flight of the Navigator!), make slime! Making a list of these fun activities gives your children something to look forward to and work towards achieving.

This summer’s skill in my house is learning how to type! I found a website that has free lessons and skills tests and my kiddos are completing modules of learning online during the day. Our hope is by the end of the summer, our teenagers can type using all 10 fingers! Figure out a skill that your children could benefit from learning and find a way to teach them this skill. It doesn’t mean you are now instructing them on how to play a violin, but if they want to learn, can you find a local music store that has some summer lessons? Or what about your friend’s artistic teenager who could teach your child how to draw anime or how to sing?

You knew that one was coming. We’ve all heard of the “summer slide” where kids slide backwards in learning during their summer break. Reading not only prevents this slide but can propel your child into success for the coming school year. Get to your local library and talk with your librarians about the latest book series that are on fire for your school-aged children. Read along with your kid so you can discuss the twists and turns in the books. Have your student draw pictures of their favorite scenes in their book. Get your noses in some books! Readers are leaders!!

With these survival tips you will be blazing the trails to a successful summer. Parents—you got this!

Wearable Technology | California Benefit Brokers

Tue, 17 Jul 2018 22:50:00 GMT

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?

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.

The News about Association Health Plans | California Benefit Brokers

Thu, 28 Jun 2018 02:42:00 GMT

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:

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:

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.

ThinkHR will continue to monitor developments in this area.

by Kathleen A. Berger
Originally posted on thinkhr.com

Disability Insurance | CA Benefit Consultants

Thu, 14 Jun 2018 00:53:00 GMT

No one foresees needing disability benefits. But, should a problem arise, the educated and informed employee can plan for the future by purchasing disability insurance to help cover expenses when needed.
Watch this short video to learn more!

Annual Physical Exam Preparation | California Benefit Advisors

Sat, 19 May 2018 01:32:00 GMT

Have you ever heard the proverb “Knowledge is power?” It means that knowledge is more powerful than just physical strength and with knowledge people can produce powerful results. This applies to your annual medical physical as well! The #1 goal of your annual exam is to GAIN KNOWLEDGE . Annual exams offer you and your doctor a baseline for your health as well as being key to detecting early signs of diseases and conditions.
View the video below for more information.

It’s Intern Season | California Employee Benefits

Fri, 04 May 2018 02:46:00 GMT

However, there are some potential legal and administrative pitfalls that many employers overlook. One of the largest issues is determining what interns should be paid – or not paid.

The Department of Labor issued new guidance on January 5, 2018, that gives employers more flexibility in deciding whether to pay interns. A seven-criteria test is now used to determine if an internship may be unpaid, but the biggest change is that not all factors need to be met – no single factor is decisive, and the determination is made on the unique circumstances of each case.

If the job training program primarily provides professional experience that furthers a student’s educational goals, a student may not be considered an employee entitled to compensation. However, if students are doing work usually done by employees and are not receiving training and close mentoring, they should be paid wages. If there is any doubt, the best approach is to pay the student.

4 Reasons to Pay Interns

However, while it’s now legally permissible to classify more interns as unpaid, there are still compelling reasons to pay interns even when the internship does meet the criteria for unpaid status.

Unpaid internships tend to exclude students from lower- and middle-income backgrounds, who cannot afford not to work at paid jobs during the summer. In addition, they may need to pay up to several thousand dollars for course credit, in addition to coming up with funds for housing, clothing, and transportation related to the internship. This can put internships out of reach for some of the students who can benefit from them the most.

Unpaid internships may devalue the work paid employees are doing. After all, interns are working alongside regular employees — often doing some of the same tasks — and not being compensated for that work. This may send the message to employees that their work, or time, is not valued.

Unpaid internships can create a negative impression of your company. Customers or the community may see you as taking advantage of these students, which is not the message you want to portray. It’s a good community relations move to offer youth paid opportunities.

The work the unpaid intern is doing may actually be work that should be compensable. Improperly classifying an internship and not paying the student could result in wage claims that include back pay, penalties, and fines. To mitigate those risks, once again, the best approach is to pay the student.

Hiring summer students is a great way to help youth learn what it takes to be successful in business while helping employers get special projects completed. Plan ahead and structure your program so that your summer internship program is a great experience for everyone.

by Rachel Sobel
Originally posted on thinkHR.com

Electronic Delivery of ERISA Notices | California Benefit Consultants

Fri, 06 Apr 2018 00:24:00 GMT

A. Yes. However, just sending them is not enough to meet ERISA requirements; you must ensure the intended recipients are actually getting them.

Specifically, ERISA requires SPDs to be furnished using “measures reasonably calculated to ensure actual receipt of the material” via “methods likely to result in full distribution.” Electronic delivery is one way to meet this requirement.

Any electronically delivered documents must be “prepared and furnished in a manner consistent with applicable style, format, and content requirements.” Therefore, it is a good idea to test the electronic document and make sure formatting and style are correct.

Unlike first class mail or hand-delivery options, electronic delivery does not work the same for all recipients. Instead compliance differs depending on whether the recipients:

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 accounts and 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 the 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

An Introduction to Self-Funding | California Benefits Advisors

Wed, 31 Jan 2018 01:01:00 GMT

If your organization is looking to save money on health coverage while maintaining a reliable standard of care for your employees, self-funding could be right for you. As an alternative to a traditional fully insured health plan, self-funding is a particularly attractive option for firms whose employees are generally young and healthy. If you’re considering self-funding as an approach to healthcare for your organization, you’ve come to the right place. Read on for our employee benefits and insurance experts ’ introductory guide to self-funding.

What is self-funding?

You’re likely already familiar with the concept of a fully insured health plan. This is the type of insurance coverage where the employer does not assume any exposure to the financial risk of varying claims made by their employees. Rather, an insurance company agrees to pay employee claims in exchange for a high monthly cost, known as a premium. If you have a fully insured health plan, the premium you’ll pay as an employer will remain the same from month to month, regardless of the actual cost of claims made by your employees.

Self-funding is a slightly different animal. When an employer chooses a self-funded health plan, they’ll put aside a set amount of money based on what they expect their employees’ claims will total each month. They’ll also set aside money for administrative fees and stop-loss insurance.

Employees will have an experience similar to if they were covered under a fully insured health plan. They’ll go see doctors and pharmacies within a network. But when it comes time to pay claims, the employer will pay the claim bill from the money they set aside at the beginning of the month.

Benefits of self-funding:

If your workforce is younger or healthier than the average American worker, you could save money through self-funding. Instead of paying a high premium and letting your claim costs come out of a larger pool, you're paying solely for your employee's (and their dependents') claim costs.
With self-funding, you have the ability to customize your coverage to fit your employees’ unique needs.
In a self-funded plan, the money set aside to pay for expected costs generates interest for your business. As the employer, you keep the money accrued, rather than seeing that interest turn over to the insurance company.
When your company doesn’t have to pre-pay for health coverage, you’re able to free up your cash flow, using the money how you see fit.
If you choose to self-fund, your company will not be subject to state health insurance premium taxes.
Self-funding allows employers to avoid the high premiums and significant fixed costs associated with fully insured health plans.
Self-funding allows employers to mitigate the premium fluctuations you’re likely to experience (sometimes without explanation) from fully insured health plans.

Disadvantages of self-funding:

Self-funding comes with inherently more risk than using a fully insured health plan. With a fully insured health plan, an insurance company assumes the risk of all medical claims. This stability can be attractive to some organizations.
While stop loss insurance usually caps the total amount of losses for self-insured employers annually, it may not mitigate damages from month to month.
Variable costs can be overwhelming for some smaller firms.

How to take care of administrative tasks if your business chooses to self-fund:

In deciding whether to self-fund, a common concern for employers is how they'll be able to take care of all the administrative tasks that come with managing claims and payments. As a self-insured company, you have a couple of options. Sometimes, the insurance company will be able to take on administrative tasks such as management of payments, though the employer will actually pay the claims.

Oftentimes, however, an employer will hire a third-party administrator or a "TPA." A TPA handles claim processing for the employer and can even take on tasks like the collection of premiums and claim review. Delegating these tasks to a TPA is generally recommended but is not technically required and companies can always decide to handle administration in-house by expanding their human resource or finance departments' capabilities. Deciding to handle it in-house, even with a certified HIPAA Officer, can open an employer up to potential HIPAA violations, so it is usually not recommended.

How to handle the risks involved with self-funding:

The most important hurdle to jump in consideration of self-funding as an option is the financial risk associated with claim variability. Companies can and do insure against annual overwhelming damage amounts. This type of insurance is called "stop-loss insurance." Stop-loss coverage protects an employer annually, but not monthly, beyond a predetermined point.

You should be aware of two types of stop-loss insurance: specific, or individual stop-loss, and aggregate stop-loss insurance. Specific stop-loss coverage protects employers from excess risk stemming from a single high claim made by an individual employee. Employers would benefit from specific stop-loss coverage in the event of a severe illness or accident. On the other hand, Aggregate stop-loss insurance protects employers through an entire predetermined period. This type of coverage places a ceiling on the monetary amount of claims in the aggregate across all employees and dependents.

Deciding whether self-funding is the right choice for your organization:

AEIS brings more than 35 years of experience in the industry to your advantage. Looking to simplify your benefits processes? It’s time to reach out. Contact AEIS today .

It’s Open Enrollment Time! | California Benefit Advisors

Wed, 01 Nov 2017 22:46:00 GMT

Communicate Open Enrollment Using a Variety of Mediums

Advertise 2018 benefit changes to employees by using a variety of mediums. The more reminders and explanation of benefits staff members have using more than one mode of media, the more likely employees will go into Open Enrollment with more knowledge of your company’s benefit options and when they need to have these options completed for the new year.

Utilize Mobile Apps and Web Portals for Open Enrollment

Now that your company has communication down pat for Open Enrollment, simplify the arduous task employees have of enrolling for the coming year by going paperless. Utilize web portals through benefit brokers and companies like ADP to eliminate the hassle of employees having to fill out paperwork both at renewal, and at the time of hire. With nearly three quarters of individuals in the United States checking their phone once an hour and 90% percent of this time is spent using one app or another as a main source of communication, mobile apps can make benefits engagement much easier due to the anywhere/anytime accessibility they offer.

The personal perks for employees are great too! Staff members with a major lifestyle event can make benefit adjustments quickly with the ease of mobile apps. Employees recognize this valuable and time-saving trend and enjoy having this information at their fingertips.

Open Enrollment season can be a stressful time but hopefully these tips will help for a smoother transition into the next year for your business. Simple things like using explainer videos, placing reminders in high traffic areas and utilizing mobile apps and text messaging can save time and stress in the long run for your employees and benefit department.

Elizabeth Kay discussed the ACA at recent luncheon | California Benefit Advisors

Thu, 26 Oct 2017 21:56:00 GMT

What an informative luncheon (on Wednesday 10/25) with our very own Elizabeth Kay discussing the most recent updates of the Affordable Care Act! She discussed the most recent executive order and how if it takes effect, it will more likely impact the individual market, not the group market. Thank you to the San Mateo County EAC and the Employment Development Department for putting it all together!

AEIS attends the MyOHR Annual Seminar in Palo Alto, California | California Benefit Advisors

Mon, 23 Oct 2017 22:27:00 GMT

Thursday, October 19, 2017 our team attended the MyOHR Annual Seminar in Palo Alto. We learned about new labor laws that were passed October 12 ^th , discussed the past and present of the Affordable Care Act, and delved into worker’s comps claims and what employers can do to make the process smoother for themselves and the employee. A shout to our great speakers Trina Clayton at Ad Astra, Owen Fennern at Armstrong Law Firm and Elizabeth Kay from our very own AEIS (not pictured). Thank you to all the guests who were able to make it during this busy time of year! We hope to see you at next year’s Annual Seminar!

Compliance Officer, Elizabeth Kay to speak at the upcoming ACA Seminar.

Tue, 03 Oct 2017 01:22:00 GMT

click here

Employer Medicare Part D Notices Are Due Before October 15 | California Benefit Advisors

Tue, 26 Sep 2017 06:38:00 GMT

Purpose
Medicare began offering “Part D” plans—optional prescription drug benefit plans sold by private insurance companies and HMOs—to Medicare beneficiaries many years ago. Persons may enroll in a Part D plan when they first become eligible for Medicare. If they wait too long, a “late enrollment” penalty amount is permanently added to the Part D plan premium cost when they do enroll. There is an exception, though, for individuals who are covered under an employer’s group health plan that provides “creditable” coverage. (“Creditable” means that group plan’s drug benefits are actuarially equivalent or better than the benefits required in a Part D plan.) In that case, the individual can delay enrolling for a Part D plan while he or she remains covered under the employer’s creditable plan. Medicare will waive the late enrollment premium penalty for individuals who enroll in a Part D plan after their initial eligibility date if they were covered by an employer’s creditable plan. To avoid the late enrollment penalty, there cannot be a gap longer than 62 days between the group plan and the Part D plan.

To help Medicare-eligible persons make informed decisions about whether and when to enroll in a Part D drug plan, they need to know if their employer’s group health plan provides creditable or noncreditable prescription drug coverage. That is the purpose of the federal requirement for employers to provide an annual notice (Employer’s Medicare Part D Notice) to all Medicare-eligible employees and spouses.

Employer Requirements

Federal law requires all employers that offer group health coverage including any outpatient prescription drug benefits to provide an annual notice to plan participants. The notice requirement applies regardless of the employer’s size or whether the group plan is insured or self-funded:

Preparing the Notice(s)
Model notices are available on the CMS website. Start with the model notice and then fill in the blanks and variable items as needed for each group health plan. There are two versions: Notice of Creditable Coverage or Notice of Noncreditable Coverage and each is available in English and Spanish:

Employers who offer multiple group health plans options, such as PPOs, HDHPs, and HMOs, may use one notice if all options are creditable (or all are noncreditable). In this case, it is advisable to list the names of the various plan options so it is clear for the reader. Conversely, employers that offer a creditable plan and a noncreditable plan, such as a creditable HMO and a noncreditable HDHP, will need to prepare separate notices for the different plan participants.

Distributing the Notice(s)
You may distribute the notice by first-class mail to the employee’s home or work address. A separate notice for the employee’s spouse or family members is not required unless the employer has information that they live at different addresses.

The notice is intended to be a stand-alone document. It may be distributed at the same time as other plan materials, but it should be a separate document. If the notice is incorporated with other material (such as stapled items or in a booklet format), the notice must appear in 14-point font, be bolded, offset, or boxed, and placed on the first page. Alternatively, in this case, you can put a reference (in 14-point font, either bolded, offset, or boxed) on the first page telling the reader where to find the notice within the material. Here is suggested text from the CMS for the first page:

“If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see page XX for more details.”

Email distribution is allowed but only for employees who have regular access to email as an integral part of their job duties. Employees also must have access to a printer, be notified that a hard copy of the notice is available at no cost upon request, and be informed that they are responsible for sharing the notice with any Medicare-eligible family members who are enrolled in the employer’s group plan.

CMS Disclosure Requirement
Separate from the participant notice requirement, employers also must disclose to the CMS whether their group health plan provides creditable or noncreditable coverage. The plan sponsor (employer) must submit its annual disclosure to CMS within 60 days of the start of the plan year. For instance, for calendar-year group health plans, the employer must comply with this disclosure requirement by March 1.

Disclosure to CMS also is required within 30 days of termination of the prescription drug coverage or within 30 days of a change in the plan’s status as creditable coverage or noncreditable coverage.

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.

Originally Published By ThinkHR.com

What Is the Importance of OSHA in the Workplace? | California Benefit Advisors

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Ron has been appointed to the Board of Directors for United American Bank | California Benefit Advisors

Thu, 15 Jun 2017 06:40:00 GMT

Ron has been elected to join the Board of Directors at United American Bank. He is honored to be selected for this position and looks forward to bringing his 30+ years of small business and insurance knowledge to the community of United American Bank.

Click here for the press release on Ron being elected.

Health Plan PCORI Fees Are Due July 31 | California Benefit Advisors

Sat, 10 Jun 2017 08:12:00 GMT

What is the PCORI fee?

The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute to study clinical effectiveness and health outcomes. To finance the nonprofit institute’s work, a small annual fee is charged on health plans.

Most employers do not have to take any action, because most employer-sponsored health plans are provided through group insurance contracts. For insured plans, the carrier is responsible for the PCORI fee and the employer has no duties. If, however, you are an employer that self-insures a health plan or an HRA, it is your responsibility to determine whether PCORI applies and, if so, to calculate, report, and pay the fee.

The annual PCORI fee is equal to the average number of lives covered during the health plan year, multiplied by the applicable dollar amount:

Payment is due by July 31 following the end of the calendar year in which the plan year ended. Therefore, for plan years ending in 2016, payment is due no later than July 31, 2017.

Does the PCORI fee apply to all health plans?

The fee applies to all health plans and HRAs, excluding the following:

The IRS provides a helpful chart indicating the types of health plans that are, or are not, subject to the PCORI fee.

If I have multiple self-insured plans, does the fee apply to each one?

Yes. For instance, if you self-insure one medical plan for active employees and another medical plan for retirees, you will need to calculate, report, and pay the fee for each plan. There is an exception, though, for “multiple self-insured arrangements” that are sponsored by the same employer, cover the same participants, and have the same plan year. For example, if you self-insure a medical plan with a self-insured prescription drug plan, you would pay the PCORI fee only once with respect to the combined plan.

Does the fee apply to HRAs?

Yes, the PCORI fee applies to HRAs, which are self-insured health plans, although the fee is waived in some cases. If you self-insure another plan, such as a major medical or high deductible plan, and the HRA is merely a component of that plan, you do not have to pay the PCORI fee separately for the HRA. In other words, when the HRA is integrated with another self-insured plan, you only pay the fee once for the combined plan.

On the other hand, if the HRA stands alone, or if the HRA is integrated with an insured plan, you are responsible for paying the fee for the HRA.

Can I use ERISA plan assets or employee contribution to pay the fee?

No. The PCORI fee is an employer expense and not a plan expense, so you cannot use ERISA plan assets or employee contributions to pay the fee. (An exception is allowed for certain multi-employer plans (e.g., union trusts) subject to collective bargaining.) Since the fee is paid by the employer as a business expense, it is tax deductible.

How do I calculate the fee?

Multiply $2.17 or $2.26 (depending on the date the plan year ended in 2016) times the average number of lives covered during the plan year. “Covered lives” are all participants, including employees, dependents, retirees, and COBRA enrollees. You may use any one of the following counting methods to determine the average number of lives:

For an HRA, count only the number of primary participants (employees) and disregard any dependents.

How do I report and pay the fee?

Use Form 720 , Quarterly Excise Tax Return , to report and pay the annual PCORI fee. Report all information for self-insured plan(s) with plan year ending dates in 2016 on the same Form 720. Do not submit more than one Form 720 for the same period with the same Employer Identification Number (EIN), unless you are filing an amended return.

The IRS provides Instructions for Form 720 . Here is a quick summary of the items for PCORI:

Caution! Before taking any action, confirm with your tax department or controller whether your organization files Form 720 for any purposes other than the PCORI fee. For instance, some employers use Form 720 to make quarterly payments for environmental taxes, fuel taxes, or other excise taxes. In that case, do not prepare Form 720 (or the payment voucher), but instead give the PCORI fee information to your organization’s tax preparer to include with its second quarterly filing.

Summary

If you self-insure one or more health plans or sponsor an HRA, you may be responsible for calculating, reporting, and paying annual PCORI fees. The fee is based on the average number of lives covered during the health plan year. The IRS offers a choice of three different counting methods to calculate the plan’s average covered lives. Once you have determined the count, the process for reporting and paying the fee using Form 720 is fairly simple. For plan years ending in 2016, the deadline to file Form 720 and make your payment is July 31, 2017.

Originally published by www.thinkhr.com

Critical Illness Insurance —What You Need to Know

Sat, 27 May 2017 04:55:00 GMT

When we hear the word insurance, most of us tend to think of things like car or health insurance. Critical illness insurance most likely isn’t one of the types of insurance that comes to mind.

It makes sense—we often don’t want to think about the scarier health-related risks in life—especially not critical illness. Unfortunately this inclination to turn away also often leaves us vulnerable and unprotected should we be diagnosed with a critical illness.

The reality is by the time we reach retirement age, one out of every four of us will be out of work due to illness or injury for longer than our accrued paid time off allows .

What is Critical Illness Insurance?

Illnesses can happen to any of us, at any time. They might be simple like a cold, or one of the several critical illnesses that affect Americans. The three major critical illnesses are:

Other critical illnesses can include:

According to The American Association for Critical Illness Insurance , statistics show annually:

These numbers are alarming and that’s why protecting your income with disability and/or critical illness insurance is so important. Naturally, when we’re unfamiliar with certain types of insurance, many questions come to mind:

• Why do I need critical insurance?
• If I already have disability insurance should I get critical illness insurance as well?
• Which one is the best option?

Differences Between Critical Illness Insurance and Disability Insurance

Critical illness insurance pays you a lump-sum cash amount if you are diagnosed with any one of the critical illnesses covered by your policy, even if you make a full recovery. Disability insurance on the other hand pays you a regular payout when you’re ill or hurt and can’t work. It protects your income from the very real possibility you’ll become disabled for a period of time during your career, whether due to injury or illness.

There are several differences between critical illness and disability insurance:

Income protection: Critical illness insurance is meant to provide you a source of income to pay for your health costs if you are diagnosed with a critical illness, while disability insurance is meant to pay a portion of your income in the event that you cannot work.

Frequency of payment: Critical illness insurance generally provides you a lump sum payment as specified in the policy while disability insurance pays you a monthly benefit, usually a percentage of what you earned before becoming disabled.

Qualification of benefits: Critical illness benefits depend on the diagnosis of one of the policy-listed illnesses, while disability insurance benefits rely on your inability to work.

Tax implications: Critical illness gives you a lump sum tax-free cash payout, while disability coverage is calculated as a percentage of your after-tax income and is paid for a certain amount of time.

Requirement of proof of loss: Critical illness insurance generally doesn’t require any ongoing proof of loss of income, and is not affected by any other income you make, while disability insurance requires ongoing proof of loss of income. Disability insurance payments can stop when you go back to work and start earning income.

Which Critical Illness Policy Is Right For You?

Each critical illness policy has specific terms and conditions, which must be reviewed very carefully. Make sure you understand which types of illnesses are considered critical and will qualify for payment.

If your diagnosed illness is not included on the policy list, your claim may be denied by the insurance company. Also, be aware of the survival period of your policy. Critical illness policies typically have a survival period or waiting period, This is a period of time which specifies how long you must wait after you’ve received your medical diagnosis to collect the lump sum benefit from the insurance company. This period can vary from one policy to another.

Be sure to ask all your questions before buying a critical illness policy. This is where an insurance agent can be a valuable resource. They can help you understand the language in your policy, explain the specific terms and conditions, and guide your decision around which critical insurance policy is right for you.

By Sean Hanson
Originally Published By ThinkHr.org

What is a Health Reimbursement Account?

Fri, 19 May 2017 20:03:00 GMT

HRA can mean health reimbursement account, heath reimbursement arrangement, or health risk assessment, and all of those mean something different. I want to be clear that in the following article I am going to be discussing the use of health reimbursement accounts with fully-insured health plans. We can leave the other meanings of HRA for another time.

The importance of HRA programs cannot be stressed enough. An HRA can be “wrapped” with a high-deductible, fully-insured health plan and this can lead to savings for an employer over offering a traditional health plan with a lower deductible.

Offering a high-deductible health plan and self-funding, the first $2,000, or $3,000, in claims on behalf of the employees can translate to significant savings because the employer is taking on that initial risk instead of the insurance carrier. Unlike a consumer-driven health plan (CDHP) that has a high deductible and can be paired with a health savings account (HSA) where an employer can contribute funds to an employee’s HSA account that can be used to pay for qualified medical expenses, an employer only has to pay out of the HRA if there is a claim.

With an HSA that is funded by the employer, the money goes into the HSA for their employees and then those funds are “owned” by the employee. The employer never sees it again. Under an HRA, if there are no claims, or not a high number of claims, the employer keeps those unused dollars in their pocket.

An HRA component to a health plan is subject to ERISA and non-discrimination rules, meaning everyone that is eligible should be offered the plan, and the benefits under the HRA should be the same for everyone enrolled. It is advisable that an HRA be administered by a third-party that pays the claims to the providers, or reimburse plan enrollees under the terms of the plan, in order to keep employees’ and their dependents’ medical information private from the employer as to avoid potential discrimination.

The HRA component of a health plan is essentially self-funded by the employer, which gives the employer a lot of flexibility and can be tailored to their specific needs or desired outcomes. The employer can choose to fund claims after the employee pays the first few hundred dollars of their deductible instead of the employer paying the claims that are initially subject to the high deductible. An employer can have a step arrangement, for example, the employer pays the first $500, the employee the second $500, the employer pays the next $500, and the employee pays the final $500 of a $2,000 deductible.

If an employer has a young population that is healthy, they may want to use the HRA to pay for emergency room visits and hospital in-patient stays, but not office visits so they can help protect their employees from having to pay those “large ticket items,” but not blow their budget. While an employer with a more seasoned staff, or diverse population, may want to include prescription drugs as a covered benefit under the HRA, as well as office visits, hospital in-patient stays, outpatient surgery, etc. Or, if an employer needs to look at cost-saving measures, they may want to exclude prescriptions from being eligible under the HRA.

Keep in mind, all of these services are essential HRA benefits for employers would be covered by the insurance carrier under the terms of the contract, but an employer can choose not to allow the HRA to be used to pay for such services, leaving the enrollee to pay their portion of the claims. In any case, the parameters of what is eligible for reimbursement from the HRA is decided and outlined at the beginning of the plan year and cannot be changed prior to the end of the plan year.

If you are thinking about implementing a high-deductible health plan with an HRA for your employees, be sure you are doing it as a long-term strategy. As is the case with self-funding, you are going to have good years and bad years. On average, a company will experience a bad, or high claims, year out of every four to five years. So, if you implement your new plan and you have a bad year on the first go-round, don’t give up. Chances are the next year will be better, and you will see savings over your traditional low-deductible plan options.

With an HRA, you cap the amount you are going to potentially spend for each enrollee, per year. So, you know your worst-case scenario. While it is extremely unlikely that every one of your employees will use the entire amount allotted to them, it is recommended that you can absorb or handle the worst case scenario. Don’t bite off more than you can chew!

HRA administrators usually charge a monthly rate per enrollee for their services, and this should be accounted for in the budgeting process. Different HRA third-party administrators have different claims processes, online platforms, debit cards, and business hours. Be sure to use one that offers the services that you want and are on budget.

Another aspect of offering a high-deductible plan with an HRA that is often overlooked is communication. If an employee does not know how to utilize their plan, it can create confusion and anger, which can hurt the overall company morale. The plan has to be laid out and explained in a way that is clear, concise, and easy to understand.

In some cases, the HRA is administered by someone other than the insurance carrier, and the plan administrator has to make sure they enroll all plan enrollees with the carrier and the third-party administrator.

The COBRA administrator also has to offer the HRA as part of the COBRA package, and the third-party administrator must communicate the appropriate premium for the HRA under COBRA. Most COBRA enrollees will not choose to enroll in the HRA with their medical plan, as they are essentially self-funding their deductible and plan costs through the HRA instead of paying them out of their pocket, but many plan administrators make the mistake of not offering the HRA under COBRA, as it is mandated by law.

Offering a high-deductible plan with an HRA is a way for small employers to save over offering a low-deductible health plan, and can be a way for an employer to “test the waters” to see if they may want to move to a self-funded plan, or level-funded plan, in the future.

By Elizabeth Kay
Originally Published By United Benefit Advisors

What You Need To Know About Voluntary Benefits | California Benefit Advisors

Wed, 10 May 2017 21:15:45 GMT

Voluntary Benefits are Supplementary Benefits in addition to the core benefits package that the employee can choose to add.

TeleMedicine – The NextGen Benefit of Minor Healthcare | California Benefit Advisors

Wed, 29 Mar 2017 02:46:00 GMT

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.

In a recent study conducted by the Aloft Group on the state of Telemedicine, 47.7% of respondents weren’t sure about what Telemedicine meant, but it’s possible they may have experienced it, as 52.4% have had interaction with a physician or clinician via email or text. Further, 78.5% of respondents indicated they would be comfortable talking with a physician using an online method.

Dr. Tony Yuan, an experienced ER doctor in San Diego, who also consults for Doctor on Demand, provides insight into this increasing trend during a recent Q and A session. Currently, over half of the patients he sees in his ER could utilize a digital healthcare model. In fact, 90% of patients who head to the ER for minor illnesses can be treated through this service. So, the next sinus, ear infection, or other minor health issue just may provide you and your family the chance to try what will become the new standard in minor healthcare.

Here are few benefits TeleMedicine has to offer:

It’s Fast and Simple

There’s no question apps are available for everything to make our lives easier—and TeleMed is no exception. Within minutes, standard first time users can set up an account, complete a few medical profile questions, then create and save a session. Having the ability to log on with a board-certified physician or clinician 24/7/365, using any PC, smart device, and even phone in some cases, saves time and money. Many services, like Teledoc and MDLive , will connect you with a licensed doctor or clinician online in just a few minutes – no scheduling or wait required. Once on, you can discuss your healthcare needs confidentially. After the visit, the doctor will update his/her records, notify your primary care physician of the call, and send an electronic prescription to the pharmacy of your choice, if necessary—all in the time it takes for a lunch break.

It’s Flexible

The ability to connect with a professional whether you are at home, work, or traveling makes getting the care you need invaluable. How often have you experienced the symptoms—or the full blown-effect—of getting sick while traveling? Many, no doubt, have had to adjust flight/travel plans to get the help needed from their PCP, in order to avoid getting worse. By using an app or online service from your smart phone or laptop, you’re able to get the antibiotics you need quicker without cutting trips short or missing work to do so.

In addition, patients in smaller communities without the resources available of classically- trained, emergency-med physicians, see the benefit and flexibility of tapping into these online doctor services. Not only is it a plus for the patient to access more advanced care if needed, doctors in these rural areas value this as well. These digital healthcare models provide immediate, life-saving tools for both doctors and their patients who may not have access to higher, acute facilities.

It’s Affordable

Many TeleMedicine services now accept insurance, making a patient’s visit free, or at minimum the same as most deductible or co-insurance amounts for office visits; around $40. For those on a high-deductible plan, paying $40 for an online doctor service is a much cheaper alternative than paying $150 or more for an Urgent Care visit, or over $1200 for a trip to the ER. For employers, group options are low cost and can be a clear asset when creating solutions EEs will value.

It’s Beneficial to Employers

Today, 3 of 5 corporations, or 59% of employers provide digital healthcare benefits to their employees. As an employer, the benefits are straightforward. First, employees can participate in professional consultations for their family members or themselves without taking away from productivity. Second, when employers incorporate these services into their benefit plans, non-emergency care is redirected from expensive ER visits, ultimately saving thousands of dollars or more to the bottom line. Additionally, TeleHealth services offer frequent monitoring from clinicians for those employees who may need regular support due to more chronic issues, reducing trips to the hospital. Reducing these costs have a direct ROI for the employer and relieves the stress on the employee’s pocketbook. Third, many companies are now adding this digital benefit to their packages as a way to recruit new talent.

There’s no doubt 2017 will see a greater opportunity for all to experience the increasing trend of Telemed. Creating a clear communication strategy to make sure employees know how to find, access and utilize this service to the highest potential is key.

Are Supplemental Accident Insurance Payouts Taxable? | California Benefit Advisors

Wed, 22 Mar 2017 21:14:00 GMT

Most health insurance plans cover emergency treatment, hospital stays and medical exams. If you are injured in an accident, your health insurance plan might not pay for all the incurred medical expenses. Supplemental accident insurance coverage pays cash benefits for illnesses or injuries caused by an accident, including fractures and physical therapy. The coverage is designed to help alleviate the burden of unexpected costs. Depending on how the policy is paid, the payouts may be classified as taxable income.

Self-Paid Plans

According to the IRS, if you paid the premiums on an accident or health insurance policy, the benefits are not taxable. Payouts from an insurance policy taken out through the employer are not taxed if you paid the premiums with after-tax dollars. If you pay the premiums of an accident insurance plan through a cafeteria plan, the premium was not included as taxable income and is considered paid by the employer and therefore the benefits are taxable.

Gig Economy 101 | California Benefit Advisors

Wed, 08 Mar 2017 05:23:00 GMT

What is a Gig Economy?

By Nicole Federico, eTekhnos Benefits Technology

What Is Employer Paid Term Life Insurance? | CA Benefit Advisors

Wed, 11 Jan 2017 03:10:00 GMT

Employer-paid life insurance can be an important part of protecting your family in the event that you die prematurely. Companies offer the program on top of other benefits, such as health insurance. The coverage is generally term insurance, meaning there is no investment or cash-value component. If you pass on unexpectedly, depriving your family not […]

Why Technology Plays an Important Role as Workplace Demographics Shift | CA Benefit Advisors

Tue, 22 Nov 2016 23:55:00 GMT

Millennials are technology-driven.

75% of millennials believe that technology helps them operate more efficiently in the workplace. Millennials are the first generation to truly incorporate technology as an imperative tool for maximum efficiency. Millennials look for efficiency, digital communication, and mobility founded in technology in the workplace, and use of technology helps facilitate innovation, engagement and clarity. Baby Boomers in management who are getting ready to hand over the reins to their younger counterparts can facilitate a smooth operational transition by embracing new systems and processes led by technology.

Efficiency is key.

Millennials have grown up in a fast-paced culture where new technologies are constantly being developed , and because of this they find it natural to lean on technology to efficiently tackle daily work tasks. As opposed to previous generations, millennials are used to instant gratification and desire work to be completed in the most practical and timely manner. One example of state-of-the-art technology is automated task management systems which allow you to complete work ahead of time. For example, social media scheduling platforms like Hootsuite allow you to schedule posts ahead of time and select when you want them to post automatically. The automation process creates a more efficient way to complete time-consuming, yet simple tasks . Another task management tool is Asana . Asana provides a single outlet for companies to manage projects, assign tasks and track progress, all through one system. Asana ensures a safe and organized portal for your company to complete tasks in the most practical manner. Invest time in researching technological tools your millennial employees find helpful in their day-to-day work, and start implementing them now.

Digital communication is here to stay.

Communication is vital to facilitating an engaged company culture. Being able to communicate well with not only clients, but with employees, is crucial. Millennials have grown up utilizing technology as a main form of communication , and they have mastered the art of making it work for them in the office as well. The mass amount of information that must be learned when implementing a new technology company-wide can be overwhelming, and keeping track of relevant news within your company can be difficult. To create an organized and effective internal communication strategy many companies are turning to social intranet software. This type of software creates a portal that keeps all of the company’s internal information in one place making mass communications easier to streamline. Digital communication fosters more efficient and timely transfer of information and problem solving. The impact of incorporating digital technology reaches beyond the office and can even help you prepare your employees to be social media advocates for your brand in their off time.

Mobility is the new norm.

One of the most attractive assets of technology is mobility. Technology has completely disrupted the workplace by allowing employees to work anywhere at any time. Employees no longer have to complete their typical workday in the office. Working from home or remote locations provides room for great work/life balance and creative inspiration. A prime example of an effective technology when it comes to remote work and flexible hours is video conferencing through apps like Skype or FaceTime. By incorporating video conferencing, companies can easily expand their client base country wide and even internationally, at a much more cost effective price.

As millennials continue to take over the workforce and we see more innovations and improvements made to current technology, be sure your company stays up to date on the latest trends. Ensuring your employees are engaged with and fluent in technologies that are being globally implemented is vital to your company’s success in this digital age.

What You Need to Know About Student Loan Repayment and the Millennial Workforce | Benefits Specialist Bay Area

Fri, 05 Aug 2016 01:49:00 GMT

A promising solution to this change in the playing field is to offer a student loan repayment program as part of an employee benefit package. In a study done by the American Payroll Association , it was found that two-thirds of Americans live paycheck to paycheck. As college tuition costs rise, millennials who graduate and enter the workforce are finding themselves with large amounts of debt while simultaneously facing job scarcity.

In fact, not only are millennials inhibited from saving due to student loans ( Paylocity ), they have the lowest retirement savings rate of any demographic at 7.5% ( EBRI ). Because there is evidence that millennials also are not as responsive to the traditional employee benefit package and instead seek jobs where they are more likely to have work/life balance as well as travel and vacation opportunities, offering a student loan benefit gives employers hope that innovations can be made to attract top young talent.

Prudential Retirement is partnering with Student Loan Genius to develop a creative solution to the one barrier to this otherwise highly inventive idea: the fact that no current tax breaks exist for loan repayment programs, thus employees could end up being heavily taxed if they receive a loan repayment benefit ( Paylocity ).

Prudential Retirement and Student Loan Genius are working to offer a pre-tax 401k contribution whenever an employee makes a payment on their loan ( Society for Human Resource Management ). This type of contribution would help an employee avoid heavy taxing and simultaneously save for retirement.

According to the Employee Benefit Research Institute , millennials have lower employee benefit participation rates than Gen Xers or Baby Boomers. Seventy-six percent of respondents to the American Student Assistance’s recent survey indicated that their choice to take a job would be positively impacted if a student loan repayment program was offered. As employers continue to search for new ways to engage their workforce in these programs and hire new talent, some form of loan repayment program may be the answer.

How to Calculate Cobra Insurance | Benefits Specialist San Francisco

Fri, 04 Mar 2016 01:35:00 GMT

Step 1

Read the COBRA election notice you receive from your former employer. This notice contains information necessary to calculate and pay COBRA insurance. COBRA regulations allow employers to charge you up to 102 percent of the cost of coverage. Cost of coverage includes the amount you contribute, the cost to the employer and an additional 2 percent as an administrative fee. Look for this percentage in the election notice.

Step 2

Calculate the total monthly cost of your health coverage. Locate the amount you contribute on your pay stub. Locate the amount your employer pays in the insurance enrollment paperwork or call the employer’s human resources department. Add the amount you contribute each month to the amount paid by your employer.

Multiply the total monthly cost by the percentage you will pay. For example, assume the total monthly cost of your insurance is $450 and you must pay 102 percent as a monthly premium. Multiply $450 by 1.02 percent to arrive at a monthly premium of $459.

Things You’ll Need

Pay stub
Insurance enrollment paperwork
COBRA election notice

Americans Prefer Cleaning Toilets Over Researching Health Benefits | California Benefits Broker

Wed, 21 Oct 2015 05:33:00 GMT

In fact, many workers would rather be doing almost anything other than researching their health benefits. The survey found that more than a third (38 percent) would rather clean out their email inboxes, 23 percent would rather clean their toilets and 18 percent would rather do their taxes.

Despite the shift to more consumer-directed health care, U.S. workers are in denial about the financial consequences resulting from their health insurance choices. This is concerning, given that an Aflac study found more than half (52 percent) of workers have less than $1,000 on hand to pay out-of-pocket medical costs associated with unexpected serious illness or injury. And 42 percent waste up to $750 annually with mistakes made during open enrollment with insurance benefits.

Employees need to weigh not only the monthly cost of insurance plans, but also the amount of the total cost of their health care that they will be responsible for.

Here are four tips to help employees choose the right benefits and protect their wallets:

1. Review and compare benefits information. Be aware of annual insurance policy changes to avoid costly mistakes.

2. Understand the financial implications your choices have on your budget. Calculate yearly medical expenses, like deductible costs and monthly premiums.

3. Consider adding voluntary insurance for more financial protection. Accident, critical illness and hospital policies help cover what major medical insurance doesn’t, such as out-of-pocket costs and other expenses that continue to roll in even if you’re too ill or injured to work.

4. Seek advice from HR or insurance consultants to help understand your benefits coverage.

EAP and COBRA explained | Bay Area Employee Benefits

Tue, 26 May 2015 23:16:00 GMT

Answer:
Employee assistance programs (EAPs) that offer medical benefits such as direct counseling and treatment, rather than just referrals for counseling and treatment, are regulated under the Employee Retirement Income Security Act (ERISA) and therefore subject to reporting and notice requirements under the act. Additionally, if the EAP provides direct counseling or other “medical benefits” to its participants, the plan is subject to the Consolidated Omnibus Budget Reconciliation Act (COBRA). If the EAP does not provide services directly, but provides only referrals and facilitation of obtaining these services, then it is not considered a group health plan and is not subject to COBRA regulations. If the plan is subject, the applicable COBRA premium will be based on cost to provide service and employers may rely on the actuarial method. The applicable premium can include an additional administrative fee of 2 percent allowable under the act.

Are Supplemental Accident Insurance Payouts Taxable? | California Benefits Broker

Tue, 27 Jan 2015 01:08:00 GMT

How it Works

Accident insurance coverage generally covers death or injuries caused by accidents on or off the job. There are a variety of coverage options available. Some employers offer the accidental coverage as a voluntary supplemental plan. You can also purchase private accident insurance to protect yourself if the coverage is not offered through your employer.

Self-Paid Plans

Employer-Paid Plans

Accidental insurance payouts are taxable if the employer paid for the insurance plan. If you paid for an accidental insurance plan through the employer using pre-tax dollars, your benefits are taxable income. Any benefits received from your employer while injured are considered salary or wages and taxable as ordinary income. Additional taxable disability benefits include income from a welfare fund, state sickness or disability fund and association of employers or employees.

Withholding and Reporting

Report any taxable insurance payouts as wages, salaries, tips, etc., on your taxes. If you are suffering a long-term disability and receive taxable benefits, avoid a hefty tax bill by submitting a Form W-4S, Request for Federal Income Tax Withholding From Sick Pay, to the insurance company.
Read More …

The Impact of PPACA – Changing Times | California Employee Benefits

Thu, 22 Jan 2015 20:03:00 GMT

There is still a divided public: “The public remains deeply divided. As of last month, more Americans viewed the law unfavorably (46%) than favorably (37%)—a shift from four years earlier, when respondents favored it 42% to 40%, according to a Kaiser Family Foundation poll … ’The fundamental impetus for the law was to lower the number of uninsured, and it has clearly done that,’ said Larry Levitt, a senior vice president at the Kaiser Family Foundation. ’But simply getting people insured doesn’t mean health care is afforda ble.’” Source

Where will all these things take us in the coming years?

Kaiser Permanente has been viewed as an example of how things could look in the future, but there are others that are making a discernable impact on health care management, delivery and cost. For Example, Anthem Blue Cross along with MemorialCare Health System, Cedars-Sinai, Good Samaritan Hospital, Huntington Memorial Hospital, PIH Health, Torrance Memorial Medical Center and UCLA Health announced Vivity. This is the first national partnership between an insurer and competing health systems, and it includes enhanced alignment in health delivery as well as a full risk/gain share among all the partners. Additionally, according to Anthem Blue Cross West Region President Pam Kehaly, premiums will be “lower than what exists on the market today.” If we work our way to the middle of the country, a bright spot will be found at The Surgery Center of Oklahoma ( http://www.surgerycenterok.com/ ). Here, all surgeries performed are at one low price, without any hidden fees. They use a simple, three-step process to make it easy.

On the other side of the country is another prominent health system making a stand on health care delivery and the cost of insurance. North Shore LIJ formed a new health plan called CareConnect ( http://www.nslijcareconnect.com/ ) with the motto “Changing what to expect from health insurance.” To validate their motto, in their second year of operations they have been able to reduce the premium paid by their employer groups.

These are just three examples from across the country. There are many more and even more in the works for sure. Health care and health insurance are in changing times, and nobody knows what the future holds. In the meantime, if you are a U.S. citizen or legal resident who is required to maintain health insurance, work to be informed. If you are an employer, or other purchaser of group health benefits, make sure that you are working with a trusted advisor like the Partners of United Benefit Advisors. Lastly, check to see if your advisor or advisory firm works with a National Association of Health Underwriters (NAHU)-certified PPACA expert.

Nondiscrimination Rules for Benefits Plans | CA Benefits Broker

Tue, 02 Dec 2014 05:18:00 GMT

Answer:
Under the Health Insurance Portability and Accountability Act (HIPAA, which is governed by ERISA) and I.R.C. § 125 plan rules, employers are allowed to offer different contribution levels or benefit coverage levels based upon legitimate nondiscriminatory business classifications.

For example, part-time and full-time employees, employees working in different geographic locations, and employees with different dates of hire or lengths of service can be treated as different groups (benefit classes) of similarly situated individuals. Plans that favor highly compensated employees may violate the nondiscrimination provisions that § 125 cafeteria plans are subject to or I.R.C. § 105(h) if the plans are self-funded. Additionally, employers must keep in mind whether any carve-outs they are considering could create an unintended discriminatory impact. The onset of the Affordable Care Act has added new regulations for insured plans, mirroring those currently found in § 105(h) regarding nondiscrimination in health and welfare plans but these regulations are on hold pending additional guidance from the Internal Revenue Service.

Due to the complexity of testing plans for compliance with the nondiscrimination rules of I.R.C. § 105(h), any employer considering offering health benefits to only certain classes of employees should carefully review all of the provisions of that section and its accompanying regulations, work closely with the benefits broker to structure the plan design and seek the advice of a knowledgeable benefits law attorney for specific guidance on its particular plan.

Community Rating vs Experience Rating

Mon, 22 Sep 2014 22:20:00 GMT

By Anna Cocke

Health insurance arose as a way of shielding people from catastrophic financial loss due to medical expenses and to ensure that people had access to care. By distributing costs equally throughout a community, each member is protected against the financial risks of a serious illness or accident. Critics argue that this principle has been undermined by underwriting, in which insurance companies determine an individual or group’s share of costs based on their perceived risk as opposed to that of the larger community.

Community Rating vs Experience Rating

There are two ways in which insurance companies determine the percent of cost sharing for members of a group health insurance plan. With a community rating, the overall medical expenses of the group are estimated based on the profile of a geographic region and each member pays the same amount. With an experience rating, insurance companies take into consideration the medical history and expected future medical costs of an individual or group to determine their percentage of costs. Members who are expected to have greater medical expenses, pay more in the form of premiums–payments made in advance of medical costs.

History

In the 1930s, a group of Texas teachers banded together to form a group health plan called Blue Cross. Each member paid a premium which guaranteed them hospital services. This group plan was based on a “community rating”–each member paid the same amount. Blue Cross plans proliferated throughout the country. With the rise of major medical insurance companies in the 1950s, community ratings gave way to experience ratings. In a competitive marketplace, this allowed insurance companies to vie for the healthiest and least expensive members by offering cheaper plans with more generous benefits. However, for the elderly and sick, this had a negative effect on the their ability to receive coverage and their ability to pay for it.

Trends

Avram Yedidia, a health care economist, argues that Medicaid and Medicare were passed in 1965, in part due to the rise of experience ratings by health insurance companies. The elderly and poor, who tend to have poorer health and higher medical expenses, could not obtain or afford coverage, leading the government to intervene and provide them with health care. Since the 1960s, the majority of PPO plans invoke an experience rating system. HMOs were required in 1973 to use a community rating system, but beginning in 1988 Congress has revised legislation to permit experience ratings.

Effects

Experience ratings underlie the common practices of insurance companies of denying applicants insurance based on preexisting conditions, having a waiting period before preexisting conditions are covered and dropping members when they suffer an accident or get sick. The rating system has also caused hardship for employers in the small-group market as the cost of a member incurring medical expenses can result in widely fluctuating premiums for members. A number of states require insurance companies to use community ratings in the small-group market for employer coverage.

Reform

President Barack Obama’s health care reform legislation tries to counteract some of the effects of experience ratings. Individuals with preexisting conditions who have been uninsured for at least six months are allowed to join high-risk pools with capped premiums to safeguard against exorbitant out-of-pocket expenses. Insurance companies are also banned from denying children insurance based on preexisting conditions and dropping someone from a policy who gets sick, according to the Commonwealth Fund, a health policy and research foundation.

California COBRA Length and Termination | Bay Area Benefits Broker

Mon, 08 Sep 2014 23:41:00 GMT

Question:

How long can a terminated employee remain on COBRA in California?

Answer:

The answer depends upon the employer size, and the maximum amount of time for a terminated employee in California is 36 months.

California’s Continuation Benefits Replacement Act (Cal-COBRA) applies to employers and group health plans that cover from 2 – 19 employees. To be covered by Cal-COBRA, an employer’s policy must be in force with 2 – 19 employees covered on at least 50 percent of the business days during the preceding calendar year (or the preceding calendar quarter if the employer was not in business during any part of the preceding calendar year). Cal-COBRA also applies to an employer with more than 20 employees when an employee has exhausted his or her 18 months of federal COBRA benefits (more on that below).

Cal-COBRA allows individuals to continue their group health coverage for up to 36 months. For individuals covered under federal COBRA, Cal-COBRA may be used to extend health coverage for a combined period of up to 36 months. For example, if an individual has used up 18 months of federal COBRA, Cal-COBRA then allows the individual to maintain coverage for up to 18 more months for a combined period of 36 months.

For larger employers, the health benefits continuation coverage under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to group health plans for employers with 20 or more employees on more than 50 percent of its typical business days in the previous calendar year. Both full- and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of an employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be considered full-time. The law does not apply, however, to plans sponsored by the federal government or by churches and certain church-related organizations.

The length of coverage under federal COBRA is determined by the type of qualifying event. Depending on the reason for COBRA coverage, the employee or dependent will have access to coverage for 18, 29, or 36 months.

Eighteen-Month Events

Eighteen-month events apply to employees and may be characterized by the following:

* Any voluntary or involuntary termination other than for gross misconduct.
* Reduction in hours to below the minimum required to participate in the employer’s plan.
* Labor strike.
* Leave of absence.
* Military leave.

Twenty-Nine-Month Events

Twenty-nine-month events apply to disabled employees, covered spouses, and dependents and may be characterized by the following:

* Any qualified beneficiary who is considered disabled according to Social Security guidelines.
* Individuals must be considered disabled by Social Security at the time of the event, not when COBRA is initiated. However, employers may make exceptions to this rule, as applications for Social Security disability insurance are often initiated after the qualifying event to be retroactive to the qualifying event.

Thirty-Six-Month Events

Thirty-six-month events apply to covered spouses and dependents and may be characterized by the following:

* Employee’s death.
* Employee’s entitlement to or activation of Medicare, resulting in the family’s exclusion from the employer’s plan.
* Divorce or legal separation from a covered employee.
* Family member no longer considered a dependent under the employer’s plan (for example, a covered dependent child attaining age 26).

If a 36-month event occurs during an 18-month event, COBRA benefits may be extended to the 36th month from the original event date for dependents and spouses only.

The state of California has created a useful chart outlining the differences and similarities between federal COBRA and Cal-COBRA to help California employers, found at http://www.dmhc.ca.gov/HealthPlansCoverage/WhatisCOBRA(FederalCOBRAandCal-COBRA.aspx#.U_UlePldV7E.