AssuredPartners’ Webinar – HRCI & SHRM Pre-Approved | Personal Change Resistance & Resilience – Preparing to Control Change Within Your Organization

Posted February 19, 2019 by Megan DiMartino

Change is always hard. It’s not just that most people fear change, though we undoubtedly do. It’s also that we genuinely believe (often on an unconscious level) that when we’ve been doing something a particular way for some time, it must be a good way to do things. And the longer you’ve been doing it that way, the better it is. This is true in both your personal and professional life.

So, change isn’t simply about embracing something unknown – it’s about giving up something old (and therefore good) for something new (and therefore not good). Before you can lead others, including your peers, coworkers and company leadership, through changes, you must prepare yourself and also be able to anticipate some of the predictable ways that people resist change.

Please join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Kip Soteres, Founder/President of Soteres Consulting, focuses on personal resilience and provides practical ways for you to better manage change in your own life and within your company. At the same time, it will indirectly prepare you to be better prepared to deal with change resistance when you observe it in others and in your workplace.

Webinar details:

  • Wednesday, February 27, 2019
  • 2:00pm – 3:00 pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.

**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

High Claims and Prevention – the Mystical ROI of Population Health Management

Posted February 11, 2019 by Megan DiMartino

Author: Scott Mayer, Director of Data Analytics at AP Benefit Advisors

In my conversations with self-insured employer groups, I always drive home the significance of managing high dollar claimants; before, during and even after their event or ongoing treatment. As it stands today, in our book of business, the top one percent of users now account for nearly one third of all medical and pharmacy claims. Let that sink in for a moment. In a population of 1,000 people, a mere 10 of them will consume a full third of all healthcare dollars.

Moving down the continuum, we are now at a point where the next four percent of members are now accounting for another third of all healthcare spending. We used to live by the 80-20 rule, but those days are long past us. Now we live by the Five – Two Thirds rule. Five percent of our population consumes two thirds of all healthcare dollars. In that population of 1,000 people, that means that 50 of them are eating up two thirds of our healthcare budget.

What is just as shocking is what we now see on the inverse. Seventy percent of the population, or 700 people in our fictional group, now account for roughly five percent of all claims. Think of it; in a population of 1,000 people, 700 of them account for what is essentially a rounding error of healthcare consumption, while just 50 people are creating a vast majority of the healthcare claims.

One has to wonder; why do we spend so much time focusing on that 70%? What is our goal within our population health programs as it pertains to that 70%? The “wellness” industry will tell us that our people will “graduate” from that 70% into our top 5% if left unchecked. Clearly, some will. After all, less than half our top claimants from this year will be our top claimants next year. But are they really going to go from spending virtually nothing on healthcare to costing over $100,000 a year just because they are not engaged in the wellness program?

The short answer is, “no.” What’s more, I decided that data would be a good tool to back up my assumption.

I took our sizable book of business and broke it down into 4 groups. Our top 1%, the next 4%, the 6th through 30th percent and our wonderful bottom 70% of all claimants. I utilized DxCG predictive modeling to identify what portion of the total claims dollars in each group was attributable to diabetes, cardio-pulmonary conditions, and cardiovascular conditions. The results are pretty staggering. I’ll spare you the numbers, but suffice it to say, it doesn’t seem to the naked eye that these popular targets for traditional wellness programs are such a big deal. In fact, in our entire population, Diabetes accounts for 5.2% of spend, while Heart Health accounts for 6% of spend.

Don’t get me wrong; 11.2% of plan spend is a good chunk, but how much of that can we expect to eliminate? Are we eliminating diabetes and heart disease entirely? Doubtful. I think even a great program could, at best, cut that number by a third. We’re talking maybe a 4% savings, and that’s under the best of circumstances.

I know what you will say…Diabetes and Heart Disease lead to other comorbidities and it is all part of a continuum. I agree. Diabetes and Heart Disease create higher risk, and higher risk means higher spend. But to what degree?

When I looked at the top 1% and parsed out the 88% of claims that were not heart disease or diabetes, I found some very interesting things: all types of cancer, chronic back/neck issues, congenital diseases, renal failure, shock trauma, childbirth complications, and substance abuse. Just as interesting, most of the largest claims would not be considered “preventable.” Certainly not by “wellness” standards. How do you prevent Lymphoma? How do you prevent a premature childbirth? How do you prevent Hemophilia, Rheumatoid Arthritis, Crohn’s, Muscular Dystrophy, Multiple Sclerosis or Cystic Fibrosis?

Certainly with some of these large items, such as cancer, promoting appropriate screenings and early detection is key. And yes, things like renal failure and osteoarthritis can be the result of lifestyle behaviors, but we are talking about decades of behaviors that cannot be changed in a three-year period because of biometric screenings and a walking challenge.

I am not saying that wellness programs are a waste of time. And I am not saying not to focus on diabetes or heart conditions as part of a population health management program.

What I am saying, is that you should fully understand what parts of your population and risk profile are really driving the bus when it comes to your largest claimants, both now and down the road. If you can manage that top 5% more efficiently, regardless of what they have going on, that’s where you are going to make a dent in your spend. And a one-size-fits-all solution will not get to the heart of the issues affecting your specific group.

Source: Scott Mayer | High Claims and Prevention, the Mystical ROI of Population Health Management


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

AssuredPartners HRCI & SHRM Pre-Approved Webinar | HSAs, HRAs, and HFSAs: What Employers and Employees Need to Know to Ensure Compliance

Posted January 21, 2019 by Megan DiMartino

Health plan deductibles, premiums and other out-of-pocket healthcare expenses are continuously on the rise. In the face of these rising costs, many companies are offering arrangements such as Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and/or Health Flexible Spending Accounts (HFSAs) to supplement their group health plans and help employees pay for healthcare costs. These accounts can be very beneficial to both employers and employees; however, companies and individual account holders/participants must ensure these accounts are implemented and managed correctly to ensure both the company and individuals are compliant with applicable laws.

  • Do you know what kind of account(s) you have and what the legal rules and requirements are?
  • Do your funds roll over or do you lose them at year end?
  • Do you know how much you can contribute and on what items the funds can be spent?
  • Does your spouse have one type of account while you have another? What does this mean for you?
  • Are you certain you are eligible for the type of account you have?
  • Can you change your contributions to the these accounts mid-year?

Please join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Caroline Smith, Esq., VP of Compliance for AssuredPartners, Inc., answers all of these questions and much more as we look at the rules and intricacies surrounding HSAs, HRAs and HFSAs to ensure that both your company, and individual participants, are compliant with the requirements surrounding these accounts.

Webinar details:

  • Wednesday, January 30, 2019
  • 2:00pm – 3:00 pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.

**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

Happy Holidays, from our team to yours!

Posted December 21, 2018 by Megan DiMartino

 

 

4th Quarter Compliance Newsletter

Posted December 20, 2018 by Megan DiMartino

Topics include:

  • 2016 Proposed ACA Penalties
  • 2018 ACA Reporting
  • Final PCORI Fee Adjustment
  • Agencies Release 2018 Form 5500, Schedules, and Instructions
  • 2019 Benefit Limits
  • HSA Eligibility Requirements

Read Now


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

Paid Leave Can Contribute to an Employer’s Bottom Line

Posted December 12, 2018 by Megan DiMartino

The Tax Cuts and Jobs Act (TCJA), P.L. 115-97, signed into law at the end of December 2017 created a Federal Tax Credit for employers that provide paid family and medical leave to their employees in 2018 and 2019. On September 24, 2018, the IRS issued updated guidance in Notice 2018-71 (the Notice) on Internal Revenue Code section 45S, the business tax credit for employers that provide paid family and medical leave (the Credit). Under the Credit, which is in effect for calendar years 2018 and 2019 only, an employer that provides paid family and medical leave may claim a credit based on an employee’s qualifying wages. The Credit applies to employers that grant employees earnings less than $72,000, in 2017, at least two weeks of annual paid family and medical leave for full-time employees, and a proportionate amount for part-time employees where the paid leave rate equals at least 50% of the employee’s qualifying wages. The Credit for employers may total between 12.5% and 25% of the qualifying wages. These rules are explained in prior IRS guidance found in the FAQs section of the IRS website.

Some important elements of the Act are outlined below:

  • Who is an eligible employer? – An employer who is eligible for the Credit is one who has a written policy in place that requires the employer to provide at least 2 weeks of paid family and medical leave annually to qualifying employees other than part-time employees. The 2 week requirement is pro-rated for part-time employees (those employees working less than 30 hours per week) by the ratio of the weekly hours they are expected to work to those of an “equivalent” full-time employee.
  • Who is a qualifying employee? – A qualifying employee is any employee under the Fair Labor Standards Act who has been employed by the employer for one year or more and who, for the preceding year, had compensation of not more than a certain amount. For an employer claiming a credit for wages paid to an employee in 2018, the employee must not have earned more than $72,000 in 2017.
  • What constitutes family and medical leave? – For the purposes of the TCJA, family and medical leave has the same definition as the FMLA Sections 102(a)(1)(A)-€ and (3)(Sec. 45S€(1)). Leave can be claimed for any of the following reasons (also see IRS Tax Reform Tax Tip 2018-69, May 4, 2018, available at www.irs.gov, and Notice 2018-71, Q&A 8):
    • The birth and care of a newborn child of the employee;
    • The placement of a child with the employee for adoption or foster care;
    • To care for the employee’s spouse, child, or parent who has a serious health condition;
    • The employee’s inability to perform the functions of his or her position due to a serious health condition;
    • A qualifying “exigency” arising from the fact that the employee’s spouse, child, or parent is on “covered active duty” or “has been notified of an impending call or order to covered active duty” in the armed forces; or
    • For a qualifying employee who is the spouse, child, parent, or next of kin of a covered servicemember, to care for the servicemember.If an employer provides paid vacation leave, personal leave, or medical or sick leave (other than leave specifically for one or more of the purposes stated above), that paid leave is not considered family and medical leave. In addition, any leave paid by a state or local government or required by state or local law will not be considered in determining the amount of employer-provided paid family and medical eave.
  • What are the minimum paid leave policy requirements? – In their written policy, an eligible employer must allow at least two weeks of paid family and medical leave (pro-rated for part-time employees) for all qualifying employees at a rate of at least 50% of the wages normally paid to them. And, for any qualifying employees not covered by Title I of the FMLA, the employer needs to make sure the employer will not interfere with, restrain, or deny any right under the policy. They also need to make sure they will not discharge or discriminate against any individual for opposing any practice prohibited by the policy. Q&A 3 of Notice 2018-71 has sample language to satisfy this “noninterference” requirement. Employers must make the leave available to all qualifying employees, which means all employees who’ve been employed for at least one year and had compensation from the employer for the preceding year that didn’t exceed a certain dollar amount (for 2017 or 2018, this amount is $72,000). The law allows an employer to prorate the two-week leave period for part-time employees (those customarily employed for fewer than 30 hours per week).
  • How to calculate and claim the credit? – The credit is a percentage of the amount of wages paid to a qualifying employee while on family and medical leave for up to 12 weeks per taxable year. The minimum percentage is 12.5% and is increased by 0.25% for each percentage point by which the amount paid to a qualifying employee exceeds 50% of the employee’s wages, with a minimum of 25%. In certain cases, an additional limit may apply.
  • What is the effective date? – The credit is generally effective for wages paid in taxable years of the employer beginning after December 31, 2017, and it is not available for wages paid in taxable years beginning after December 31, 2019.
  • What must an employer’s written leave policy include? – An eligible employer must include in their policy an allowance of at least two weeks of paid family and medical leave (pro-rated for part-time employees) for all qualifying employees at a rate of at least 50% of the wages normally paid to them. And, for any qualifying employees not covered by Title I of the FMLA, the employer needs to make sure the employer will not interfere with, restrain, or deny any right under the policy. They also need to make sure they will not discharge or discriminate against any individual for opposing any practice prohibited by the policy. Q&A 3 of Notice 2018-71 has sample language to satisfy this “noninterference” requirement. Employers must make the leave available to all qualifying employees, which means all employees who’ve been employed for at least one year and had compensation from the employer for the preceding year that didn’t exceed a certain amount (For 2017 or 2018, this amount is $72,000). The law allows an employer to pro-rate the two-week leave period for part-time employees (those customarily employed for fewer than 30 hours per week).
  • When must an employer’s policy be in place? – Except for the first taxable year of an employer beginning after December 31, 2017, an employer can claim the credit only for leave taken after the written leave policy is in place.

Weighing the Potential Benefits for Employers:

The family and medical leave credit is potentially beneficial to employers that already provide paid family and medical leave, with some additional administrative requirements. The requirements and significant costs associated with maintaining benefits and positions for employees out on leave may outweigh any potential tax benefit offered by the new credit for those employers not currently offering paid family and medical leave.

The adoption of a new policy may serve as an employee morale booster. Companies without family and medical leave policy may now want to consider implementing one as employees not currently covered by the FMLA will appreciate the opportunity to have job-protected leave time like other workers. Those workers with those for whom unpaid family and medical leave is already available may also appreciate receiving at least half of their normal salary while they care for a newborn child or take time off from work for other qualified reasons.

For more information see: www.irs.gov

Source: New Tax Credit for Paid Family and Medical Leave | Journal of Accountancy – by: Matthew Geiszler, PH.D., and John McKinley, CPA, CGMA, J.D., LL.M.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

HRCI & SHRM Pre-Approved Webinar | Improve Your 2019 Compliance Outlook – Tips, Tricks & the Dirty Dozen

Posted December 10, 2018 by Megan DiMartino

Join AP Benefit Advisors’ General Counsel and VP of Compliance, Patrick Haynes, Esq., for this HRCI* & SHRM** pre-approved, complimentary, one-hour webinar as he reviews this upcoming year’s compliance tips, tricks and tools of the trade.

Topics include:

  • ACA Limits – Changes to Out-of-Pocket Maximums, HDHP/HSA Interaction, Affordability Increases, etc.
  • Review the EEOC’s and Courts’ ongoing litigation over wellness plans, smoking cessation efforts, etc.
  • Association Health Plans
  • Changes coming to HRAs in 2020
  • IRS Notices
  • Cafeteria Plan Changes
  • And much, much more!

Webinar details:

  • Thursday, December 13, 2018
  • 12:00pm – 1:00 pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.
**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AssuredPartners HRCI & SHRM Pre-Approved Webinar | Let’s Wrap This Up! Understanding the Basics of Health & Welfare Plan Document Requirements

Posted November 19, 2018 by Megan DiMartino

Does your company’s health and welfare plans each have their own plan document and SPD, or are all of your benefits wrapped together under one plan? Do your benefit plan documents and SPDs include the required language under ERISA and other federal laws, or are you relying on the certificates, policies and benefit summaries provided to you by your carriers and/or TPAs to keep you compliant?

If you answered “yes” to the latter questions or if you just don’t know where your company falls, this webinar will help you break down the document requirements and start your company down a path to compliance.

Please join Caroline Smith, Esq., VP of Compliance for AssuredPartners, for this HRCI* and SRHM** pre-approved, complimentary, one-hour webinar as she provides an overview of ERISA and other federal law requirements as they relate to the plan documents, SPDs and the like, and helps you better understand the risks and penalties associated with noncompliance. This webinar will also include a look at the requirements under the Internal Revenue Code and corresponding regulations related to Cafeteria Plans and what those requirements mean to your company. Our goal is to provide tangible takeaways to help employers assess their company’s current risk and learn what to do to get into compliance.

Webinar details:

  • Thursday, November 29, 2018
  • 2:00pm – 3:00 pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.
**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

IRS Announces 2019 Contribution Limits for Health Care FSAs and Qualified Transportation Plans

Posted November 15, 2018 by Patrick Haynes

Today, the Internal Revenue Service announced the tax year 2019 annual inflation adjustments for more than 60 tax provisions, including the tax rate schedules and other tax changes (generally referred to as cost-of-living increases).  Revenue Procedure 2018-57 provides details about these annual adjustments.

The 2019 tax items of greatest interest to our clients that are employers and plans sponsors include:

  • Annual Healthcare Flexible Spending Account (FSA) contribution limits will increase $50 from the current amount of $2,650 to $2,700.
  • Monthly limit for transit and parking will increase $5 from the current amount of $260 to $265.
  • Annual maximum reimbursement for a qualified small employer health reimbursement arrangement (QSEHRA) will increase $100 for individual coverage from the current amount of $5,050 to $5,150, and the maximum reimbursement amount will increase $200 for family coverage from the current amount of $10,250 to $10,450.

Please contact your Account Manager or Sales Executive for more information.

Links: 

 

Small & Large Employer Health Reform Checklists

Posted November 13, 2018 by Megan DiMartino

Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless of the employer’s size, but some changes apply only to small employers and other changes apply only to large employers. Even employers that do not offer any coverage need to comply with certain requirements to distribute notices to workers or submit reports to federal agencies.

Linked below are two, different, Health Reform Checklists. One applies to Small Employers and the other to Large Employers.

For more information about which employers are subject to the Employer Shared Responsibility provisions and other ACA-related questions, please contact your Account Manager or Sales Executive.

Links:
Small Employer Checklist
Large Employer Checklist


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.