Group Health Insurance strategies for Small Businesses

If you have Group Benefits in place now at your company, or if you are thinking of putting together Group Health Insurance for your employees, there is a lot to think about.  Health Insurance is all over the news.  Group Health Insurance is expensive, confusing, and most business owners don’t know where to start.  That’s where having an expert on your side can make all the difference in the world.  Most people don’t realize it, but having a Group Benefits expert is free.  They are paid by the commission that is “built” into the monthly premium, set by the State of CA.

Would you ever consider doing your own corporate taxes?  Most business owners rely on people with the expertise to help them through the process and create a strategy for them.  Those tax experts know the system, and know how to keep people in compliance.  The same concept applies for Group Health Insurance.  There is a strategy to Group Benefits, specifically Group Health Insurance.  Being in the wrong health insurance network, overpriced premiums, and being out of compliance with the IRS and Dept of Labor is kind of a big deal.

Choosing an Employee Benefits Adviser

Choosing a Group Health Insurance Advisor is also important.  There are tons of us running around, claiming to be experts.  It pays to do your homework and due diligence on Group Health Agencies.  Check their ratings, and their reviews.  Are you dealing with the owner of the agency, or just an account manager for a big firm?  Who has a vested interest in YOUR company and making sure you are set with the right products.  Basically, who has your back? Compliance is a big issue now, especially for groups over 20 or 50 employees.  If that fits your company and your broker has not spoken to you about all of the compliance mandates surrounding the ACA (ObamaCare), that may be an issue.

Compliance mandates for small business

If you are a business owner with 20+ employees, there are steps you have to take to be compliant with the IRS and the DOL (Dept of Labor).  If you’ve ever been in front of the Labor Board or had to deal with the IRS, its never fun.  Getting compliant is not really that hard, if you specialize in Group Health Insurance.  Too many of the business owners I speak with, are completely unaware of the Employer Mandates set up by ObamaCare in 2010.  Since Trump has taken office, the mandates, and enforcement has changed with Group Insurance.  In 2018, the IRS is now auditing companies, from their 2015 filings, that appear to be out of compliance.  Again….if you have a true expert on your side, this is a non-issue.

At Brauer Insurance, we specialize in Group Health Benefits for companies under 100 employees.  Call us anytime for a free evaluation.  (408) 421-5555

 

 

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New laws require managers to change their behaviors in three ways in 2018. Overall, these are not onerous requirements. What a welcome change from previous years!

1. Hiring managers cannot inquire about an applicant’s current pay. In the past, managers could find out a recruit’s current pay and then offer just a slight increase. These bumps did not have to be at market rate—and often weren’t. Effective January 2018, these salary questions are no longer allowed. Companies should change their applications if salary inquiries questions appear on the application.

2. While updating their applications, companies with 5 or more employees need to “Ban-the-Box” and stop asking about convictions at all stages prior to an offer being issued.

3. Managers need to be trained to be more sensitive to LGBTQ issues. Avoidance of discrimination to this protected class has been added to the mandatory Sexual Harassment and Anti-Abusive prevention classes for companies with 50 or more employees. Smaller companies should be looking at these issues too because the legislature’s action indicates that this kind of discrimination may be labeled a high enforcement priority in the near future.

 

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If you are a business owner that is looking for affordable Group Benefits and Health Insurance, you have a lot of options.  There are many strategies that HR Directors and company owners can use to keep the same level of Health Insurance benefits for their employees.  Not all health insurance policies are created equal.  Affordable Group Benefits are out there, but affordable is a debated word.  In these times, all insurance is expensive.  Most times, you can adjust your benefit offering, save some money and actually bring in Affordable Group Benefits for your employees.  Health insurance for companies is a complicated product.  Do yourself a favor and find a Benefits Broker that knows what they are doing.  Affordable Group Benefits are important, but the compliance piece of Health Insurance for companies is even more important.

Affordable Group Benefits and the compliance with the ACA

It’s important that you find Affordable Group Benefits and Health Insurance, but you need to address all of the compliance issues associated with the ACA, Affordable Care Act.  If your broker does not have you dialed in to the necessary paperwork, you need to be careful.  If you’re ever unfortunate enough to be audited or contacted by the DOL, Dept of Labor, there is some paperwork that they will immediately be asking for.  If you don’t have that paperwork set up ahead of time and distributed to employees, you’ll have a problem.

Health Insurance for companies and the necessary compliance paperwork

Affordable Group Benefits and the compliance associated with those benefits, is a moving target.  Health Insurance for companies is a niche product.  This is a very dysfunctional industry…just pick up a newspaper.  When you use the words Affordable Group Benefits, people will almost laugh because they don’t think that it’s a real concept.  All of this boiled down…do your due diligence on your Group Benefits Broker and their agency.  Unless they are a specialist in Health Insurance for companies, run screaming.

Brauer Insurance does only one thing…Affordable Group Benefits and Health Insurance for companies.  You can’t be an expert at everything, pick one.

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If you own a company that does not have the required participation to enroll into a Group Health Plan or a Group Benefits Plan for your company, there IS an alternative.  Once a year, all the carriers are mandated to allow any company to enroll into a Group Benefits Plan.  Group Benefits are available to all companies through the ACA.  There is no penalty for low participation during this time but you have to enroll between November 15th and December 15th with an effective date of January 1.  We get so many calls from employers that want to offer Group Benefits to their employees but they just can’t meet the typical 70% participation that is required.

Available Group Benefits during this Special Enrollment Period for businesses

All of the typical health insurance products are available for companies that take advantage of this SEP (Special Enrollment Period) for businesses.  The only downside is that, depending on the carrier, they may want to “recertify” your company after 12 months of coverage.  That means that (Anthem in particular) will ask to see your payroll reports and want you to meet the standard participation rules for that time frame, no matter what you originally enrolled into.  If you have a broker that specializes in Group Benefits or Health Insurance for companies, they know which carriers are the ones to avoid when it comes to the SEP enrollment

Having a Group Benefits Broker that is an expert, is definitely an advantage

First of all, the price of the coverage is the same, whether you use someone that doesn’t know what they’re doing, or a specialist that ONLY does Group Benefits.  Its like having a heart issue and seeing a Cardiologist vs. a General Practitioner.  Both are good docs, but one has a specialty.  When we started our agency in 2003, we had no idea that this crazy dysfunctional industry would be such a niche product in 2017.  There are so many mandates now with Group Benefit Plans, that employers “don’t know what they don’t know”.

Brauer Insurance are the experts at Group Benefits.  I”ve taught Group Benefits at UC Santa Cruz Extension, been featured on KPIX on some of their ObamaCare segments and doing Group Benefits since 2003.

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If you are an employer “reimbursing” employees for their health insurance plans they are purchasing on their own….you’d better be careful.  The IRS has outlawed doing that specifically, and they are not friendly to deal with…if you’re caught.  They stopped allowing that as part of the Affordable Care Act a couple of years ago.  The reasoning is that the IRS is trying to stop employers from skirting the employer responsibilities when they elect to offer coverage, or pay for some of it.  The Dept of Labor, the DOL, just like the IRS, is fee driven, which means that they are hunting for employers that have made mistakes.

The IRS and DOL (Dept of Labor) have hired additional agents to collect fees and fine employers

I’ve have made friends with some people within the Dept of Labor, and they’ve confided in me that they have hired many additional agents to hunt for employers making mistakes.  I’ve heard those stories for years, but thought it was just a scare tactic.  My inside person has confirmed this.  Honestly, I don’t really thing they’d go after employers with 10 or 12 employees, but you never know.  Why take the chance.  Besides….routing the insurance through the business, you get a tax deduction.  Reimbursing….not so much.

Having a Group Employer Health Insurance plan insures that you have a great business deduction

Offering a Group Health Plan to employees allows the employer to have a business deduction.  There are MANY more health insurance plans available with Employer Group Plans too.  Another benefit is for the employees….they can pay their portion of the premiums tax free.  That means that anything that employees pay, through an Employer Group Health Plan can be done on a tax free basis.  That includes Dental Insurance, Vision Insurance, and many other Employee Benefits offered by the company.  A HUGE savings for your employees.

Overall, offering a Group Health Plan through the business or employer has many benefits.  Reimbursing employees to purchase their own plans is not allowed.

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I wish there was a way to find Inexpensive Business Health Insurance.  I would be a multi millionaire overnight.  However, there ARE ways to reduce the amount you pay for Business Health Insurance and even products that pay companies back when they don’t have many claims.  I have one company that I insure, that got a refund of almost $100,000 back because their employees did not have any major claims to the insurance.  Its a little complicated to explain, but its a fully insured Inexpensive Business Health Insurance that covers everything that any other plan would cover, and even more.  CFOs, CEOs, HR Directors, and business owners that want to be creative can save big money on premiums, with little risk.

There are creative ways to make Business and Group Health Insurance affordable

Its like anything else….the more creative you are, the more rewards are available.  For many companies, having affordable Group Health Insurance and Business Health Insurance seems out of reach.  The more creative you are, the more you can save, potentially.  There are products that pay employees that experience medical issues, which in turn, helps them pay for their deductibles and medical costs.  Many times the payouts are MORE than the cost of the medical issue.  These are some of the creative solutions available out there that many brokers either don’t know about.  When you specialize in Group Health Insurance and Business Health Insurance, you’re on the cutting edge of what is out there and the solutions that companies use.

Business Group Health Insurance can be affordable if you work with a Specialist

Many times business owners don’t know, what they don’t know.  That means that they are settling for working with a broker that probably doesn’t specialize in Business or Group Health Insurance.  When you work with a specialist, that person knows this dysfunctional industry, and how to help with saving money, compliance issues, etc…When you work with a “Generalist”, you give all of that up.  You are paying really high monthly premiums….why not have someone that knows what they’re doing.  It costs the same.  If you had a heart issue, would you go to a General Practitioner, or a Cardiologist.  Exactly….

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Good & Bad News: Recent Rulings on Abusive Work Environments

searchIf you’ve ever dealt with litigation over workplace stress, you’ll be glad to know that the court doesn’t always side with the employees. Here are a couple of examples:

  • Some times referred to as the “Goldilocks decision”, the first case involves a plaintiff who requested an accommodation of a less stressful job. The transfer was allowed. The employee didn’t find the transfer to be interesting enough so asked for the accommodation of a transfer to a middle-of-the-road stress job. The court held that it was not reasonable to ask for a “just right amount of stress” job.
  • In November of last year, a Florida District Court decided that an employee cannot immunize herself or himself from stress and criticism in general. In this case the employee had requested an accommodation from a supervisor’s “hostile confrontations.” The court commented that the obligation to make a reasonable accommodation does not extend to providing an “aggravation-free” or “peaceful calm” environment.

Yet, it’s not all good news. California employers continue to deal with hostile environment and constructive discharge claims arising out of what is described as “bullying.”

The courts have made it clear that the manner of conducting discipline rises to the statutory definition of abusive conduct when the discipline is “harshly and constantly criticizing” of one individual. Public criticism of an employee often is seen as unprofessional and stress producing.

On the other hand, most states have uniformly found that stress claims arising out of disciplinary action or performance improvement plans are not covered under workers’ compensation law.

A Case in Point: An employer recently allowed an employee who was the vice president of finance to work at home. The VP’s job required her to be available for on the spot determinations regarding cash flow. The employee said that she suffered from an anxiety disability and requested an accommodation that she be given 15 minutes time before responding to telephone requests for cash flow estimates. It would seem that this would not be a reasonable accommodation because it would reduce the company’s ability to compete. Nonetheless the employee filed a lawsuit.

Although this seemed like a frivolous claim, the company narrowly avoided bankruptcy given the huge legal fees they were forced to pay.

Clearly these doctrines are in conflict. How are employers supposed to navigate these murky waters when legal authority is uncertain?

So, what is learned from this? It’s important to train managers to run to the HR department whenever the word “stress” crops up. Additionally, managers should be trained that discipline should always take place in private. In our society, yelling at an employee in front of coworkers is thought to be abusive.

Reduce risk by always engaging in an interactive process when an accommodation is requested. At these sessions, employees can learn what the rules require—and what they don’t­—in terms of reasonableness of requests. Make sure they know that a Goldilocks accommodation is not reasonable.

Finally, in job interviews and in job descriptions it should be clear that some jobs involve pressure. Employees should be aware that the ability to handle pressure and ambiguity is a requirement of the job.

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We get calls constantly from business owners that are frustrated with the high cost of Business Health Insurance and Employee Benefits.  Because Business Health Insurance is so complicated and confusing, HR Directors and CFOs rely on their broker to help them.  Most times the brokers are clueless too.  Unless someone specializes in Employee Benefits or Business Health Insurance, their info is many times either outdated or flat out wrong.  There are only so many hours in the day…you can’t be an expert at everything.

Having an Employee Benefits Broker that specializes is like gold

When you rely on your broker for the correct info, they had better be right.  Just as an example, if a broker miscalculates the business health insurance and they enroll a group of 20 employees,  there could be waste of $1000-$3000 a month, because they’re on the wrong business health insurance plan.  That could be enrolling employees into a plan that is more expensive than they need, or even worse, they enroll them into plans with a limited or skinny network.   That brings up another point to all of this.  The crazy network issues that are happening now will all of the carriers

Business Health Insurance networks are crazy in 2017

Health Insurance networks are the number ONE issue that is causing disruption in the Employee Benefits world, hands down.  Take Anthem for example…for Business Health Insurance plans for companies with under 100 employees there are 6 different networks available….SIX!  Unless your Employee Benefits broker has the experience dealing with all of these…you’re running the risk of enrolling into something you’ll majorly regret.

When you have a minute…Google Anthem Blue Cross network litigation.  Its page after page of issues that consumers and businesses have experienced not knowing the difference between the networks and how to navigate them.  Its a HUGE problem, not only with Anthem, but all of them.  Kaiser excluded of course!

The main theme here is to find a Benefits Broker that knows the industry, what they’re doing and specializes in the crazy industry known as Employee Benefits or Business Health Insurance.

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Most people are not sure what’s going to happen with the ACA, Affordable Care Act, and what a replacement would look like.  Recently there has been much fighting about what the changes are, when it would take effect, and who would pay for it.  The last thing we need is to have it rammed down our throat like the ACA.  TrumpCare, honestly, would probably look a lot like what we have now, but the mechanism of how we buy would change.  Definitely more carriers in the mix would help, but the bottom line issue is the cost of care

Health Insurance is expensive because the cost of care is expensive

Its really as simple as that.  If you can’t drive down the cost of the services, this will never become affordable.  That is the bottom line.  Whether its TrumpCare, ObamaCare, or anything else, insurance rates will continue to rise until we get a handle on the healthcare system we have.  The Affordable Care Act was not Health Reform…it was Insurance Reform.  I was not against the insurance reform, but when you’re talking about pricing, this is an empty conversation.  There are just too many factors that affect the cost of health care.  Its a very complicated problem.

Driving down the cost of health care, no easy answers

There are probably 15 different issues that affect the cost of care, prescription drugs, hospital costs, fraud, end of life procedures, etc…  There are no easy answers to this.  TrumpCare in San Jose or any city will have to address these in the coming years.  For the last few years, employers have been passing on the cost increases to their employees.  I don’t see that changing

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International Companies looking for Health Insurance options

If you are a company that have worldwide employees, there are Global Health Insurance products that may be a good fit.  When you have over 100 employees worldwide with locations inside the US, Global plans are very flexible and a great option.  They can be a bit pricey, but enrollment and flexibility in tailoring the plans is much better than domestic plans like Anthem Blue Cross, Kaiser, Aetna, etc..  Currently we insure companies from Singapore, India, and England using the Global Health Insurance options.  When your company have needs of interchanging employees, the option of insuring overseas employees and dependents, or have an unusual payroll mechanism, International Health Plans are a great fit

International companies struggle with employees with visas and obtaining health insurance

Many times, we help companies that have issues with the typical domestic US Health Plans that don’t fit with their needs.  The Global Plans are super flexible with how companies structure their plans and benefits.  They can tailor the deductible, copays and even the benefits offered.  The pricing is adjusted accordingly.  The pricing structure of International Health Plans use a composite rating, meaning that if you are 18 or  60 years old, you pay the same price for the plan.  This can be good or bad depending on the demographics of your International Company

Comparing Expat Health Plans

When you are considering an Expat Health International Health Plan, the differences can be significant.  Some companies accept a larger US citizen population than others.  Others have a better International network than others.  The International community is relatively small, so many of the International carrier reps have worked for several of the companies.

Variety of insurance carriers that offer Global-International-Expat plans

There are 6International carriers that most employers work with.  Blue Cross Geo, Aetna, Cigna, United HealthCare, Bupa, and GBG.  Any other carriers I’d be suspicious.  Their International networks are vast and far reaching.

 

Brauer Insurance can help you translate the Global and International Health Plans for you.

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