For employers sponsoring a medical plan, managing the cost of prescription drugs is becoming a complicated task.
Posted: July 20, 2017, 4:00 am
An executive with more than 20 years of leadership experience, Peter Weber joins UBA as President and is based in the company’s Chicago office.
Posted: July 17, 2017, 4:00 am
If a plan is self-funded and uses a trust, it is required to file Form 5500, no matter how many participants it has.
Posted: July 17, 2017, 4:00 am
There are seven steps that attract what's desired and repel what's not desired in your organization.
Posted: July 10, 2017, 4:00 am
The length of the COBRA coverage period depends on the qualifying event and is usually 18 or 36 months.
Posted: July 10, 2017, 4:00 am
Successfully blending personalized benefits communication strategies with benefits administration technology can help increase employee engagement.
Posted: July 3, 2017, 4:00 am
Here are the top seven reasons why LTCi should be a bigger part of the employee benefits conversation.
Posted: July 3, 2017, 4:00 am
The Department of Labor has issued an informational FAQ relating to the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act.
Posted: June 27, 2017, 4:00 am
Employers with group health plans should continue to monitor the progress of health care legislation, but should not stop adhering to any provisions of the ACA.
Posted: June 26, 2017, 4:00 am
When everyone in the office is working well together, productivity rises and efficiency increases.
Posted: June 22, 2017, 4:00 am
There are seven triggering events that are qualifying events for COBRA coverage if they result in loss of coverage for the qualified beneficiaries.
Posted: June 20, 2017, 4:00 am
Employers with 25 to 49 employees are the most generous in contributing to health savings accounts.
Posted: June 15, 2017, 4:00 am
The Section 125 cafeteria plan regulations and the ACA require employers to take certain actions when an employee reduces hours.
Posted: June 13, 2017, 4:00 am
The IRS has released dollar limits for HSAs and HDHPs for 2018, and information about how retroactive Medicare coverage affects HSA contributions.
Posted: June 8, 2017, 4:00 am
Nondiscrimination testing encourages employers to provide benefits to their employees in a way that does not discriminate in favor of highly-paid employees.
Posted: June 6, 2017, 4:00 am
Small employers that plan to offer QSE HRAs should be cautious before presuming that ERISA would not apply to a reimbursement arrangement.
Posted: June 1, 2017, 4:00 am
Well-being strategies should not be a one-size-fits-all approach.
Posted: May 30, 2017, 4:00 am
As wellness programs come to be part of the traditional benefits package, the key differentiator is a culture that supports overall health and well-being.
Posted: May 19, 2017, 4:00 am
Health savings accounts have been gaining momentum as a way to deal with increasing health care costs.
Posted: May 19, 2017, 4:00 am
Offering a high-deductible plan with an HRA is a way for small employers to save over offering a low-deductible health plan.
Posted: May 16, 2017, 4:00 am
Voluntary insurance products have evolved to complement your overall benefit plan design
Posted: May 15, 2017, 4:00 am
Both HSAs and HRAs can be of tremendous value to employers and employees, and and both offer tax benefits.
Posted: May 12, 2017, 4:00 am
A workplace that does wellness the right way focuses on the employee's intrinsic motivation to be the best they can be.
Posted: May 9, 2017, 4:00 am
The AHCA makes numerous changes to current law, much of which impact the individual market, Medicare, and Medicaid.
Posted: May 5, 2017, 4:00 am
It's important to properly manage protected health information to keep it secure from internet attacks
Posted: May 4, 2017, 4:00 am
In this virtual communication age, you can't take the “human” out of Human Resources, or the confusion out of insurance benefits just because you wrap it in a nice website.
Posted: May 1, 2017, 4:00 am
The private exchange model growth may be delayed, or coming to a halt.
Posted: April 26, 2017, 4:00 am
The summary of benefits and coverage must contain specific information, in a specific format, about a group health benefit's coverage and limitations.
Posted: April 20, 2017, 4:00 am
Regardless of who prepares the filing, it remains the sole responsibility of the employer, or Plan Sponsor, when it comes to Form 5500 transmissions or failures to file.
Posted: April 17, 2017, 4:00 am
The broker’s role should be to take as much of the burden off the employer to enable them to reach compliance in the most expedient manner possible.
Posted: April 12, 2017, 4:00 am
We need brave and open-minded companies to embark on the journey of optimal wellness and well-being for their employees.
Posted: April 10, 2017, 4:00 am
The key to getting the most out of an EAP is to make it easily accessible to employees, safe to use, and visible enough they remember to use it.
Posted: April 6, 2017, 4:00 am
Six of the most frequent areas that can cause issues or gaps in coverage when using a stop loss carrier.
Posted: April 3, 2017, 4:00 am
One of the most effective and least disruptive cost-saving strategies available to employers with 150 or more covered employees is self-funding your dental plan.
Posted: March 30, 2017, 4:00 am
A defined contribution plan provides an excellent way for employees to seamlessly save money for retirement.
Posted: March 28, 2017, 4:00 am
Knowing your audience and leveraging the power of personalization will help you achieve success in strategic benefits communication.
Posted: March 23, 2017, 4:00 am
Practically speaking, grandmothering provides some small employers the option to maintain a pre-ACA health plan.
Posted: March 21, 2017, 4:00 am
It's important to look beyond price to ensure that your stop loss policy will give you peace of mind and avoid gaps in coverage.
Posted: March 16, 2017, 4:00 am
As we become more and more connected to the Internet, we leave ourselves and the companies where we work more accessible to cyber threats.
Posted: March 14, 2017, 4:00 am
An IRS memorandum examines whether payments to an employee under an employer-provided fixed indemnity health plan can be excluded from the employee's income.
Posted: March 9, 2017, 4:00 am
It's important for employers to realize that a culture of being always on can be harmful to employees.
Posted: March 8, 2017, 4:00 am
At least once a year, health plans must notify individuals eligible for Medicare Part D if their prescription drug coverage is creditable coverage.
Posted: March 7, 2017, 4:00 am
HUPAC supports candidates who believe in private sector solutions for the health and financial security of all Americans.
Posted: March 2, 2017, 4:00 am
Preventive screenings are a crucial piece of overall health and wellness, and eye exams often detect early signs of health conditions.
Posted: March 2, 2017, 4:00 am
Many employers find the Certifications of Eligibility section of Form 1095-C confusing and are unsure which boxes they should select.
Posted: March 1, 2017, 4:00 am
Your vigilance and a precise and proactive navigation system can be the difference between success and failure.
Posted: February 28, 2017, 4:00 am
The IRS has updated its Q&A that describes when and how an employer reports its offers of coverage to employees.
Posted: February 22, 2017, 4:00 am
While good participation can reflect employee acceptance of voluntary benefits, employee engagement has become more important.
Posted: February 21, 2017, 4:00 am
Compliance assessments can help employers avoid potential penalties for not providing required notices to employees.
Posted: February 20, 2017, 4:00 am
Employer-sponsored health insurance is greatly affected by geographic region, industry, and employer size.
Posted: February 15, 2017, 4:00 am
Opioid abuse has significant effects on health care cost, public safety, and well-being and productivity of employees.
Posted: February 13, 2017, 4:00 am
If not for the PACE Act, mid-size employers would have become subject to the ACA provisions that impact small employers.
Posted: February 13, 2017, 4:00 am
You may have the most affordable plan, but if you are passing most of that cost on to your employees, you may not be a competitive employer.
Posted: February 9, 2017, 4:00 am
The FAQ covers a new HIPAA special enrollment period, women's preventive services, and qualifying small employer health reimbursement arrangements.
Posted: February 8, 2017, 4:00 am
Cafeteria plans, or plans governed by IRS Code Section 125, allow employers to help employees pay for expenses such as health insurance with pre-tax dollars.
Posted: February 7, 2017, 4:00 am
The 1094-C and 1095-C forms are used by applicable large employers to report information about their offers of health coverage to employees as required under the ACA.
Posted: February 2, 2017, 4:00 am
The Cures Act provides a method for certain small employers to reimburse individual health coverage premiums up to a specific dollar limit.
Posted: February 1, 2017, 4:00 am
On the heels of an acrimonious election that has frequently placed national origin in the spotlight, employers should revisit workplace practices.
Posted: January 31, 2017, 4:00 am
The main components to protect an employee’s financial future are managing a nest egg, growing investments, and safeguarding against uncertainty.
Posted: January 25, 2017, 4:00 am
Determining how an employer develops the most effective formulary, while protecting the financial stability of the plan, is certainly the challenge of this decade.
Posted: January 24, 2017, 4:00 am
On Friday, January 20, 2017, President Trump signed his first Executive Order, titled "Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal."
Posted: January 23, 2017, 4:00 am
Today’s buyers tend to judge the capabilities of a benefits system by the “prettiness” of its user interface: The Magpie Effect.
Posted: January 19, 2017, 4:00 am
This quick reference shows the 2017 cost of living adjustments for group health plans.
Posted: January 18, 2017, 4:00 am
Form 5500 filing requirements could cost small employers more in fees and data-gathering time.
Posted: January 17, 2017, 4:00 am
In a few weeks, a second season of ACA shared responsibility reporting will begin. This is a look at the reporting forms and how they are used.
Posted: January 12, 2017, 4:00 am
OSHA provides protection for employees who report potential violations of the ACA's consumer protections.
Posted: January 10, 2017, 4:00 am
Wellness programs can have an impact on a population culture, health, and cost of care if appropriately managed.
Posted: January 5, 2017, 4:00 am
Consumerism in health care is the concept of empowering employees, families and individuals to direct consumption of care.
Posted: January 4, 2017, 4:00 am
The Department of Health and Human Services has adjusted the maximum civil monetary penalties that fall under its jurisdiction.
Posted: December 29, 2016, 4:00 am
Short-term, limited-duration insurance is designed to fill temporary gaps in coverage when an individual is transitioning from one plan or coverage to another.
Posted: December 27, 2016, 4:00 am
U.S. government agencies recently issued FAQs on tobacco cessation coverage and mental health / substance use disorder parity.
Posted: December 20, 2016, 4:00 am
Is this increase in wearable distribution a fad, or are these products truly impacting employee wellness program engagement and health care spending?
Posted: December 19, 2016, 4:00 am
Employers may submit an appeal if they feel an employee should not be receiving a subsidy because the employer offers minimum value, affordable coverage.
Posted: December 15, 2016, 4:00 am
A recent study suggests that wearable fitness devices may not be impacting health as expected.
Posted: December 9, 2016, 4:00 am
Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.
Posted: December 8, 2016, 4:00 am
Strategic Partner solutions are tailored to help benefits advisors reduce operating costs and generate additional revenues while enhancing client satisfaction.
Posted: December 7, 2016, 4:00 am
Employers with a culture of wellness realize many benefits beyond those calculated through claims costs and health care expenditure.
Posted: December 6, 2016, 4:00 am
More than any other benefit, long-term care insurance calls for well-thought-out employee education.
Posted: December 1, 2016, 4:00 am
Recently, there has been a shift away from employer use of health risk assessments to evaluate overall health risk.
Posted: November 29, 2016, 4:00 am
COBRA is a federal requirement of group health plans to provide continuation coverage to people who lose coverage due to a qualifying event.
Posted: November 22, 2016, 4:00 am
The cost of health care is steadily increasing, a trend supported by the latest data from the 2016 UBA Health Plan Survey.
Posted: November 21, 2016, 4:00 am
Employers are eager to offer incentives as a way to both encourage wellness and also lower health care costs.
Posted: November 18, 2016, 4:00 am
The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016 to help stabilize premiums.
Posted: November 16, 2016, 4:00 am
Recently, the IRS issued final regulations that define terms describing the marital status of taxpayers for federal tax purposes.
Posted: November 15, 2016, 4:00 am
Employers should be aware of the main tenets of President-elect Trump's proposals for healthcare, as well as the policies outlined in Speaker Ryan's white paper.
Posted: November 14, 2016, 4:00 am
Grandmothering refers to March 2014 transition relief that allows small employers to keep their pre-ACA health plan through the end of 2017.
Posted: November 10, 2016, 4:00 am
Though employers are not required to educate employees about their individual responsibilities under the ACA, it is helpful to know about the individual mandate.
Posted: November 9, 2016, 4:00 am
The area covered in the following is that of the intersection of COBRA and the Family and Medical Leave Act of 1993 (FMLA).
Posted: November 8, 2016, 4:00 am
An employer subject to the ACA and either the SCA or DBRA must comply with each law. Each of the laws is separate and independent.
Posted: November 3, 2016, 4:00 am
The UBA Health Plan Survey reflects the experiences of 99 percent of U.S. businesses, not just the largest employers.
Posted: November 1, 2016, 4:00 am
Employers who offer group health plans use opt-out payments to share the savings they receive when an employee chooses not to enroll in the benefits offered.
Posted: October 27, 2016, 4:00 am
One thing rings true when it comes to the Affordable Care Act (ACA): “expect the unexpected.”
Posted: October 25, 2016, 4:00 am
Consumer-directed health plans continue to increase in popularity even though they are offering less savings than a year ago.
Posted: October 20, 2016, 4:00 am
Consumer-directed health plans grow in popularity even though they are offering less savings than a year ago, according to the 2016 UBA Health Plan Survey.
Posted: October 19, 2016, 4:00 am
The employees of a business with common owners or that perform services for each other may need to be combined when determining if the employer is “large.”
Posted: October 18, 2016, 4:00 am
To comply with the Internal Revenue Code, a cafeteria plan must satisfy a set of structural requirements and a set of nondiscrimination rules.
Posted: October 13, 2016, 4:00 am
Employers have an obligation to resolve questions about worker identity and eligibility to work.
Posted: October 11, 2016, 4:00 am
Recently, the IRS released proposed regulations for reporting minimum essential coverage under the ACA.
Posted: October 6, 2016, 4:00 am
Phase 2 audits focus on the policies and procedures adopted by both covered entities and business associates to ensure they meet HIPAA Rules.
Posted: October 4, 2016, 4:00 am
Using the appropriate resources to control diabetes is critical because, as risk increases, cost also jumps.
Posted: September 27, 2016, 4:00 am
There are seven key components that tend to drive the most successful and effective programs.
Posted: September 22, 2016, 4:00 am
Educating employees on wellness program options is crucial to a program’s success.
Posted: September 20, 2016, 4:00 am
Small business owners do not have to break the bank to offer their employees great wellness programs.
Posted: September 15, 2016, 4:00 am
Here we conclude with steps four through six for setting up a successful program.
Posted: September 13, 2016, 4:00 am
These are the key factors that I believe contribute most to the success of a wellness program.
Posted: September 9, 2016, 4:00 am
Employers with self-insured health plans are facing new Section 6055 regulations regarding the reporting of minimum essential coverage.
Posted: September 6, 2016, 4:00 am
By deploying private exchanges, employers have been able to achieve exceptional cost and performance outcomes while gaining a strategic advantage over their competitors.
Posted: September 1, 2016, 4:00 am
In order to study the overall cost of medical care, identify trends, and discover ways to curb inflating costs, data is needed, and selecting a primary care physician for plan participants is the first step.
Posted: August 30, 2016, 4:00 am
HIPAA audits ensure that covered entities comply with the HIPAA privacy, security, and breach notification rules.
Posted: August 26, 2016, 4:00 am
The UBA 2016 shows that employees continue to take on more cost for coverage.
Posted: August 24, 2016, 4:00 am
Overall, employer costs remained consistent because they are passing more and more of their increases on to employees.
Posted: August 23, 2016, 4:00 am
On December 1, 2016, the Department of Labor will implement changes raising the minimum compensation for exempt employees.
Posted: August 18, 2016, 4:00 am
UBA’s Special Report, Trends in Prescription Drug Benefits, explores trends in prescription drug plan design among different group sizes, regions and industries.
Posted: August 16, 2016, 4:00 am
There is a growing recognition of the need to insert non-tech wisdom, sound processes and actual live human beings into the private exchange concept.
Posted: August 11, 2016, 4:00 am
It is important to ensure that the job description reflects the actual functions and outcomes needed and the conditions that impact those processes.
Posted: August 8, 2016, 4:00 am
While most employers aren’t completely penalizing those who choose brand-name drugs, more and more plans are requiring employees to pay higher copays when they elect brand-name drugs.
Posted: August 4, 2016, 4:00 am
Evaluating employee benefits options is tough work, but the right employee benefits advisor can make it seem simple.
Posted: August 2, 2016, 4:00 am
With improvements in retail pharmacy pricing, mail-order pharmacies have diminished in prominence.
Posted: July 29, 2016, 4:00 am
Employers are required to complete the IRS/SSA/CMS Data Match report within 30 days of receipt of the Data Match Personal Identification Number.
Posted: July 26, 2016, 4:00 am
The Latest UBA Survey data shows employers are flocking to two strategies to control rising prescription drug costs.
Posted: July 21, 2016, 4:00 am
Form 5500 is the annual report that group benefit plans use to report required information about the plan’s financial condition and operations.
Posted: July 19, 2016, 4:00 am
What does the future hold for employees when it comes to their expectations of a traditional benefits package?
Posted: July 14, 2016, 4:00 am
How does an applicable large employer determine whether or not a newly hired variable hour employee should be offered benefits?
Posted: July 12, 2016, 4:00 am
Mail order has always been a convenient way to fill maintenance drug prescriptions. Are there other advantages to using mail order other than convenience?
Posted: July 8, 2016, 4:00 am
Employers need to revisit their ACA affordability calculations and safe harbors now, in view of the new overtime exemption rules.
Posted: July 5, 2016, 4:00 am
Employers are using self-funding as a cost-containment strategy for their prescription drug benefits.
Posted: June 30, 2016, 4:00 am
In the early 2000s, prescription costs were around 20 percent of total medical claim spend. Recently, this number has been increasing at an alarming rate.
Posted: June 28, 2016, 4:00 am
United Benefit Advisors Releases New Special Report, “Trends in Prescription Drug Benefits”
Posted: June 27, 2016, 4:00 am
Now that the first set of IRS forms has been completed, many employers are wondering what the next steps are.
Posted: June 24, 2016, 4:00 am
UBA's checklist will help review employee communications, policies, handbooks, and incentives for OSHA compliance.
Posted: June 21, 2016, 4:00 am
Beginning in 2017, certain employers with as few as 20 employees at a single site will be required to electronically file information about employee injuries and accidents that occurred in the prior year.
Posted: June 16, 2016, 4:00 am
Beginning in early 2016, many employers received letters from the IRS-SSA-CMS Data Match program.
Posted: June 14, 2016, 4:00 am
The ACA has many tax provisions written within its pages. This is a brief overview of the taxes, with good news sprinkled among some not-so-good news.
Posted: June 10, 2016, 4:00 am
The passage of the ACA has shined a light on many other prior pieces of legislation, and the enforcement searchlight is starting to shine brighter.
Posted: June 7, 2016, 4:00 am
White collar workers are not eligible for time-and-a-half pay for hours worked over 40 hours per week.
Posted: May 31, 2016, 4:00 am
ACA Section 1557 prohibits discrimination under any health program or activity receiving federal financial assistance on the basis of race, color, national origin, sex, age, or disability.
Posted: May 31, 2016, 4:00 am
Vision benefits have moved into a tie with dental as the second most popular benefit election behind medical.
Posted: May 26, 2016, 4:00 am
The Supreme Court has ruled in Obergefell v. Hodges that states are required to license a marriage between two people of the same sex.
Posted: May 24, 2016, 4:00 am
People who interact with a certified financial planner during the year have a much better grasp on their finances.
Posted: May 19, 2016, 4:00 am
The U.S. Department of Labor has issued a new FAQ on the implementation of the Affordable Care Act.
Posted: May 17, 2016, 4:00 am
Terrorism can happen anywhere and at any time, so companies should be just as vigilant in having a plan in place to communicate with all their employees.
Posted: May 12, 2016, 4:00 am
Strategic Services Group (SSG) is a locally owned business that has been serving that state with a combined 55 years of experience from its agency leaders.
Posted: May 10, 2016, 4:00 am
The IRS has issued extensive guidance prohibiting employers from reimbursing health insurance policies on an individual basis.
Posted: May 10, 2016, 4:00 am
The government was busy recently, issuing the massive Benefit Payment and Parameters rule in addition to numerous other updates.
Posted: May 5, 2016, 4:00 am
COBRA is not necessarily difficult to understand, but the intricacies, and ways in which it interacts with other laws can have expensive outcomes.
Posted: May 3, 2016, 4:00 am
The terms “wellness” and “well-being” are often used interchangeably; however, they mean very different things when applied to workplace health promotion.
Posted: April 28, 2016, 4:00 am
Questions were posed to the IRS concerning the taxability of identity protection services provided at no cost to individuals whose personal information may have been compromised in a data breach.
Posted: April 26, 2016, 4:00 am
No two DOL audits are the same, yet there are typical questions asked and documents requested.
Posted: April 21, 2016, 4:00 am
What can trigger a DOL audit? Usually it’s one of two things — either a complaint, which leads to an investigation, or it’s totally random.
Posted: April 19, 2016, 4:00 am
Established processes and procedures become especially important to help avoid confusion and errors.
Posted: April 14, 2016, 4:00 am
UBA has updated its white paper, "Don't Roll the Dice on Department of Labor Audits."
Posted: April 13, 2016, 4:00 am
Health insurance premium renewal rates increased an average of 6.2 percent for all plans in 2015, up from the previous year’s 5.6 percent increase.
Posted: April 8, 2016, 4:00 am
New survey data reveals health plan costs, options by state and industry.
Posted: April 7, 2016, 4:00 am
Correctly recruiting and retaining the best performers could be the key difference in a company’s success.
Posted: April 5, 2016, 4:00 am
In a series of articles, we will address COBRA in general and also delve into other related issues, such as mini-COBRA, COBRA and account-based plans, and the interaction of COBRA and Medicare.
Posted: March 29, 2016, 4:00 am
Form 1094-C is used in combination with Form 1095-C to determine employer shared responsibility penalties.
Posted: March 29, 2016, 4:00 am
The 2017 Benefit and Payment Parameters rule, an annual rule that sets policies relating to the ACA, has been released.
Posted: March 24, 2016, 4:00 am
The 2015 UBA Health Plan Survey data reveals who will not escape the 40% excise tax to take effect in 2020.
Posted: March 22, 2016, 4:00 am
If you want to attract top talent, then you must utilize mobile recruiting.
Posted: March 17, 2016, 4:00 am
Companies understand that they need to leverage a variety of solutions to provide meaningful healthcare coverage, promote wellbeing and mitigate cost.
Posted: March 15, 2016, 4:00 am
The UBA Health Plan Survey reveals variations by industry in HSA use and contributions.
Posted: March 11, 2016, 4:00 am
If an employee of an applicable large employer takes an unpaid leave of absence (not FMLA), what happens to their benefit eligibility during that time?
Posted: March 8, 2016, 4:00 am
The Department of Labor has issued proposed revisions to the template and related materials.
Posted: March 3, 2016, 4:00 am
Which is faring better in the industry, health reimbursement arrangements or health savings accounts?
Posted: March 1, 2016, 4:00 am
California employers offer the most generous employee benefits through account-based plans.
Posted: February 29, 2016, 4:00 am
Do your employees often eat alone? If so, you may be missing an opportunity, according to an article on the SHRM website.
Posted: February 23, 2016, 4:00 am
An employer that offers minimum essential coverage to substantially all of its full-time employees may still owe penalties if the coverage it offers is inadequate because it is not “affordable” and/or it does not provide “minimum value.” It also may owe penalties on the employees it does not offer coverage to who receive a premium subsidy.
Posted: February 16, 2016, 4:00 am
The Internal Revenue Service (IRS) recently issued a final rule that clarifies various topics relating to the Patient Protection and Affordable Care Act (ACA) and premium tax credit eligibility provisions. Mirroring guidance from IRS Notice 2015-87, the final rule clarifies that health reimbursement arrangement (HRA) contributions by an employer that may be used to pay premiums for an eligible employer sponsored plan are counted toward the employee's required contribution, subsequently reducing the amount required for their contribution.
Posted: February 9, 2016, 4:00 am
The long-standing IRS FAQs related to reporting under sections 6055 and 6056 on requirements provided by the Patient Protection and Affordable Care Act (ACA) have been updated to reflect new information.
Posted: February 4, 2016, 4:00 am
As many analysts projected, premiums continue to rise, forcing many employers to manage this expanding price tag by shifting costs to their employees. As UBA reported in its breaking news, this cost shifting took the form of higher deductibles, out-of-pocket maximums, and copays for both singles and families.
Posted: February 2, 2016, 4:00 am
Employers breathed a sign of relief when the looming Cadillac Tax was delayed. But are you subject to other fees and penalties under the ACA? ACA has introduced a multitude of new fees that employers must pay, in addition to penalties for non-compliance with employer shared responsibility rules. These dollar amounts change annually, as does the percentage amount used to calculate affordability in relation to the ACA. UBA’s new ACA Advisor, “Patient Protection and Affordable Care Act Fees, Penalties” gives a quick reference summary of the key 2015 and 2016 fees and penalties associated with the ACA.
Posted: January 28, 2016, 4:00 am
As wellness programs continue to flourish particularly among large employers, a discovery is being made about one of the most important health conditions -- hypertension. Hypertension (also known as high blood pressure) is a medical issue where the pressure of the blood in a person’s cardiovascular system is constantly elevated. According to the Mayo Clinic, a person can have high blood pressure for years without any symptoms. Yet even without symptoms, damage to arteries, blood vessels, and even the heart continues until serious health issues, including a heart attack and stroke, happen.
Posted: January 26, 2016, 4:00 am
According to the 2015 UBA Health Plan Survey, fewer employers are offering bonuses to waive coverage, but for those that do, the bonus amount is on the rise. Only 2.9% of employers offered a bonus to employees to waive medical coverage in 2015, an 17.1% decrease from 3.5% two years ago. The average annual single bonus in 2015 was $1,680, which is a 10% increase from 2013.
Posted: January 21, 2016, 4:00 am
United Benefit Advisors (UBA), the nation’s leading independent employee benefits advisory organization, is pleased to welcome The Health Plan as a new Strategic Partner. They join an already elite group of service providers that offer vetted and approved products to UBA Partner Firms.
Posted: January 19, 2016, 4:00 am
Are you benchmarking your health plan correctly? If you are using data from your carrier or a small study of only large employers, chances are, you are not effectively analyzing your rates. To truly benchmark your plan, you need to compare your plan to others in your state, industry, and size category.
Posted: January 19, 2016, 4:00 am
United Benefit Advisors (UBA), the nation’s leading independent employee benefits advisory organization, is proud to announce Valued Pharmacy Services as a new Strategic Partner.
Posted: January 15, 2016, 4:00 am
Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance, while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. On December 28, 2015, the IRS issued Notice 2016-4, delaying the reporting deadlines.
Posted: January 14, 2016, 4:00 am
UBA offers a comprehensive library of ACA Advisors and white papers to help employers navigate health care cost and compliance. Every year we look at the documents most accessed by employers and remind our audience of these helpful, free resources. Here’s what was most in demand in 2015.
Posted: January 12, 2016, 4:00 am
Top 10 UBA Blogs from 2015 Reveal Hot Button Healthcare Issues for Employers
Posted: January 7, 2016, 4:00 am
The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee's own cost. COBRA provisions are found in the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code (Code), and the Public Health Service Act (PHSA). Employers with 20 or more employees and group health plans are subject to COBRA provisions. Most governmental plans, church plans, and certain plans of Indian tribal governments are exempt from COBRA. Employers should always consult with counsel about state continuation laws that are similar to COBRA and apply to small employers.
Posted: January 5, 2016, 4:00 am
President Obama has signed the omnibus legislation that includes the Consolidated Appropriations Act for 2016 and a tax extenders package. The agreement will keep the federal government running through September 2016. Within the legislation is language that significantly impacts provisions of the Patient Protection and Affordable Care Act (ACA), largely through delays of upcoming taxes.
Posted: December 30, 2015, 4:00 am
Federal agencies recently issued a final rule that essentially combined a variety of interim final rules and non-regulatory guidance on a variety of Patient Protection and Affordable Care Act (ACA) initiatives such as grandfathered health plans, preexisting condition exclusions, internal and external appeals, rescissions of coverage, lifetime and annual limits, emergency care access and dependent coverage. The final rule was very similar to the previous guidance it consolidated. The final rule goes into effect on January 1, 2017. At that time all of the prior interim rules will be superseded.
Posted: December 22, 2015, 4:00 am
Federal agencies have released the proposed rule for the 2017 Benefit Payment and Parameters. Among other items, it provides updates and annual provisions relating to tisk adjustments, reinsurance, and risk corridors programs, cost-sharing parameters and cost-sharing reductions, user fees for Federally-Facilitated Exchanges (FFEs), the standards for open enrollment for the individual market for the 2017 benefit year, updates to the Small Business Health Options Program (SHOP), definitions of large and small employer, guaranteed availability, and the medical loss ratio (MLR) program.
Posted: December 21, 2015, 4:00 am
Small employers are feeling the squeeze from increasing costs of medical care and increasing premiums for the medical insurance they offer their employees. Recently released findings from the 2015 UBA Health Plan Survey show that 54 percent of small employers are currently offering gold or platinum plans to their employees. However, with the pressure from rising medical care costs, the introduction of community rating in setting insurance rates, and the end of grandmothering, it is highly unlikely that this trend will continue.
Posted: December 17, 2015, 4:00 am
Have you ever overheard the new employee in the break room, bragging about how good their health insurance was with their previous employer, and how much less expensive it was than the coverage they are currently being offered? You may think ”If it was so good, then why give it up?” There are always a number of factors that can lead to someone making a job change, but what happens when COBRA becomes a part of the negotiating process when they are working out the terms of employment with the new company?
Posted: December 15, 2015, 4:00 am
Looking at the projected cost increases based on its annual Health Plan Survey of over 18,000 health, plans offered by nearly 11,000 employers nationwide, UBA estimates that nearly three out of four U.S. Employers will be hit with the Cadillac tax by 2022 . With alarm bells sounding, many employers are planning benefit cuts to avoid the tax.
Posted: December 10, 2015, 4:00 am
UBA has created a template letter that employers may use to draft written communication to employees regarding what to expect in relation to IRS Forms 1095-B and 1095-C, and what employees should do with a form or forms they receive. The template is meant to be adjustable for each employer, and further information could be added if it is pertinent to the employer or its workforce.
Posted: December 8, 2015, 4:00 am
UBA offers a quick reference chart showing the 2016 cost of living adjustments for health and Section 125 plans, qualified plans, Social Security/Medicare withholding, compensation amounts and more. This at-a-glance resource is a valuable desk tool for employers and HR practitioners.
Posted: December 3, 2015, 4:00 am
We’ve become a very connected society, but that doesn’t mean we want to share everything with everybody. Take, for example, your social media site (e.g., Facebook, Twitter, LinkedIn, etc.). Typically, you have a select network of individuals with whom you want to connect and share your life, thoughts, and opinions. But what happens when a current or prospective employer wants access to your social media account either as a “friend” or by demanding your login and password information?
Posted: December 1, 2015, 4:00 am
Someone in the C-Suite of a company gets sick. I’m not talking about a cold or flu; I’m talking about a major, possibly even terminal, illness. Depending on the level of severity, what can the human resources department do to help communicate this information properly to the company’s employees?
Posted: November 24, 2015, 4:00 am
The UBA Health Plan Survey looks at over 18,000 health plans sponsored by nearly 11,000 employers nationwide to offer the largest data source on plan costs and design. While headlines talk about issues related to same sex and dependent coverage, the 2015 Health Plan Survey looks at the facts. When it comes to who is being covered, we also look at how many employers are complying with the requirement to cover employees working 30 hours or more. The findings may surprise you.
Posted: November 23, 2015, 4:00 am
The UBA Health Plan Survey tracks plans offered by region as well as enrollment by region. From a prevalence perspective, preferred provider organization (PPO) plans are most prevalent in the Central U.S., though they generally dominate nationwide, except in the Northeast where consumer-directed health plans (CDHPs) are most prevalent.
Posted: November 19, 2015, 4:00 am
With the drive of healthcare reform to make sure the U.S. population is insured and address the shortage of primary care physicians increasing as high as 31,000, where will people receive their primary care, and at what cost? What if there were a more efficient and cost effective way to deliver care to populations that lack access or don’t have the ability to easily access care.
Posted: November 17, 2015, 4:00 am
The Providing Affordable Coverage for Employees (PACE) Act amended the Patient Protection and Affordable Care Act (ACA) and redefined small employers as those with 50 or fewer employees; it also gives states the option to expand the definition to include employers with up to 100 employees (or, practically speaking, those with 51 to 100 employees, also called "mid-size employers"). Prior to the ACA, all states defined small employers as those with 1 to 50 or 2 to 50 employees; however, many have passed legislation redefining the group size up to 100 employees beginning in 2016. States are now in the process of determining what they define as "small employer."
Posted: November 12, 2015, 4:00 am
The Department of Labor (DOL) recently provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and Patient Protection and Affordable Care Act (ACA) market reform provisions. Non-grandfathered group health plans and individual or group market health insurance must cover a variety of preventive services without any cost-sharing requirements. Required preventive services include "breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies," obesity screening and weight management services for certain individuals, colonoscopies for certain age groups, and contraception coverage for women.
Posted: November 10, 2015, 4:00 am
The data are in for the 2015 Health Plan Survey! See our news release with the top cost trends. Download the UBA 2015 Health Plan Survey Executive Summary with more detailed findings. For quick reference, here’s a brief punch list of the top trends.
Posted: November 5, 2015, 4:00 am
The Employee Retirement Income Security Act (ERISA) was signed in 1974. The U.S. Department of Labor (DOL) is the agency responsible for administering and enforcing this law. For many years, most of ERISA’s requirements applied to pension plans. However, in recent years that has changed, and group plans (called “welfare benefit plans” by ERISA and the DOL) now must meet a number of requirements.
Posted: November 3, 2015, 4:00 am
In June 2015, the Supreme Court ruled in Obergefell v Hodges that the 14th Amendment requires a state to license a marriage between two people of the same sex, and to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out of state. The IRS has issued proposed regulations to reflect that holding, which will impact married couples, employers, sponsors, and administrators of employee benefit plans and executors.
Posted: October 28, 2015, 4:00 am
The Patient Protection and Affordable Care Act (ACA) established the Transitional Reinsurance Program to help stabilize premiums in the individual private and public marketplaces. The Transitional Reinsurance Fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016, regardless of the policy or plan year. Insurers of fully insured major medical plans and sponsors of self-funded major medical plans are responsible for filing and submitting contributions for the Transitional Reinsurance Program.
Posted: October 27, 2015, 4:00 am
Cafeteria plans, or plans governed by IRS Code Section 125, allow employees to pay for expenses such as health insurance with pre-tax dollars. Employees are given a choice between a taxable benefit (cash) and specified pre-tax qualified benefits, for example, health insurance. Employees are given the opportunity to select the benefits they want, just like an individual standing in the cafeteria line at lunch.
Posted: October 20, 2015, 4:00 am
Selden Beattie, a UBA Partner Firm in Florida, has two of the Top 25 Most Influential Women in Benefit Advising for 2015, according to industry magazine Employee Benefit Advisor.
Posted: October 15, 2015, 4:00 am
Minimum essential coverage or "MEC" is the type of coverage that an individual must have under the Patient Protection and Affordable Care Act (ACA). Employers that are subject to the ACA's shared responsibility provisions (often called play or pay) must offer MEC coverage that is affordable and provides minimum value.
Posted: October 8, 2015, 4:00 am
The Patient Protection and Affordable Care Act (ACA) requires applicable large employers (ALEs) to offer full-time employees health coverage, or pay one of two employer shared responsibility penalties. An ALE is an employer with 50 or more full-time or full-time equivalent employees (for 2015, this threshold is 100). A full-time employee is an employee who works 30 hours or more a week.
Posted: October 6, 2015, 4:00 am
It’s that time of the year – open enrollment season is here! Are employees really looking forward to this?
Posted: October 1, 2015, 4:00 am
A Summary of Benefits and Coverage (SBC) is a four-page (double-sided) communication required by the federal government under the Patient Protection and Affordable Care Act (ACA). It must contain specific information, in a specific order and with a minimum size type, about a group health benefit's coverage and limitations.
Posted: September 29, 2015, 4:00 am
Beginning in 2015, under the Patient Protection and Affordable Care Act (ACA), large employers must offer affordable, minimum value coverage to their full-time employees or potentially pay a penalty.
Posted: September 24, 2015, 4:00 am
The Department of Health and Human Services (HHS) has issued the first of the anticipated nondiscrimination rules, which sets forth proposed regulations to implement Section 1557 of the Patient Protection and Affordable Care Act (ACA). Section 1557 provides that individuals shall not be excluded from participation, denied the benefits of, or subjected to discrimination under any health program or activity which receives federal financial assistance, on the basis of race, color, national origin, sex, age, or disability.
Posted: September 22, 2015, 4:00 am
UBA’s annual Health Plan Survey, the largest of its kind, provides data on 10,804 employers sponsoring 18,186 health plans. While the full findings will be released soon, preliminary data on average health plan costs, premiums, and contributions is now available.
Posted: September 18, 2015, 4:00 am
Following the June release of the draft forms, the IRS has issued draft 2015 instructions for Forms 1094-B, 1094-C, 1095-B, and 1095-C, which include a variety of changes from the 2014 instructions.
Posted: September 10, 2015, 4:00 am
As a result of the Patient Protection and Affordable Care Act (ACA) triggering cost increases for fully insured employer-sponsored health insurance plans, more employers are moving to a self-funded model for pharmacy plans, particularly among large employers (1,000+ employees), according to the 2014 United Benefit Advisors (UBA) Health Plan Survey.
Posted: September 8, 2015, 4:00 am
As one might think, employee wellness programs are still top-of-mind for many employers. As companies continue to struggle with the rising costs in today’s health care market, they are constantly looking for that silver bullet to kill trends.
Posted: September 3, 2015, 4:00 am
The Department of Labor (DOL) has issued an “Administrator’s Interpretation” to assist employers in determining if a worker is an employee or an independent contractor. The DOL has determined that many employers are incorrectly classifying employees as independent contractors, which can harm the worker and open the employer up to various liabilities.
Posted: September 1, 2015, 4:00 am
The IRS has issued its second notice regarding the upcoming implementation of the Patient Protection and Affordable Care Act’s (ACA) excise tax on high cost employer-sponsored health coverage, also known as the “Cadillac tax.” Beginning in 2018, plans that provide coverage that exceeds a threshold will owe the tax.
Posted: August 27, 2015, 4:00 am
I’m sure you’ve heard the phrase, “Nothing in life is free,” and nothing is – not even Medicare. In most cases, you won’t have to pay a premium to get Medicare, at least for Part A (here’s a refresher on the different parts of Medicare), but that doesn’t mean it’s free. You’ve just pre-paid in the form of taxes. So you don’t have to worry about a premium for Part A, which covers in-patient hospital expenses, assuming you or your spouse paid Social Security for at least 10 years. However, there are other costs associated with Medicare, which vary depending on the specific insurance.
Posted: August 25, 2015, 4:00 am
Advancements in science and technology can be absolutely amazing. The types of treatments that are available now are light years ahead of where we were even 10 years ago. For example, there are some new anti-viral drugs that have become available. One in particular that is for treating Hepatitis C has been very successful. It can actually cure patients of Hepatitis C, in just weeks for some cases. So why might these drugs not be available to those who could really use them?
Posted: August 18, 2015, 4:00 am
Have you ever heard the quote, “If you take care of your people, they’ll take care of your business”? It’s great advice and goes beyond ensuring that they get a paycheck each month. Does your company show that they care about an employee’s total well-being? They should, especially considering that an employee’s physical and mental well-being can affect productivity and consequently cost the company money. One great way to show employees that you are invested in them, and to help them stay healthy, is through a wellness program.
Posted: August 18, 2015, 4:00 am
Most employers are familiar with the penalties assessed to applicable large employers that fail to offer minimum essential coverage that is minimum value and affordable. In addition to being required to offer coverage, employers (all applicable large employers, and all employers with self-funded plans regardless of size) are required to complete IRS reporting forms under sections 6055 and 6056 of the Patient Protection and Affordable Care Act (ACA).
Posted: August 13, 2015, 4:00 am
UBA recently released new pharmacy data from the 2014 UBA Health Plan Survey which shows a significant increase in the use of 4-tier plans. UBA also released the findings related to pharmacy copay design. Not surprisingly, the majority (67.8 percent) of prescription drug plans utilize copays.
Posted: August 11, 2015, 4:00 am
Federal agencies released final regulations on the preventive services mandate of the Patient Protection and Affordable Care Act (ACA) that requires non-grandfathered group health plans to provide coverage without cost-sharing for specific preventive services, which for women include contraceptive services.
Posted: August 6, 2015, 4:00 am
Most employers have been using multi-tier prescription drug plans for many years, but new data released from the 2014 UBA Health Plan Survey shows a significant increase in the use of 4-tier plans, which typically cover the highest cost drugs, as well as major increases in corresponding median copays – a trend that is expected to continue.
Posted: August 4, 2015, 4:00 am
The IRS released a notice providing further guidance on expatriate health coverage.
Posted: July 30, 2015, 4:00 am
The Affordable Care Act's Employer-Shared Responsibility (ESR), otherwise known as Play or Pay, is here! Not only are employers struggling to apply the once-abstract-but-now-actual complex and convoluted rules and regulations, employers are facing yet another hurdle – Affordable Care Act (ACA) Information Returns (AIR).
Posted: July 28, 2015, 4:00 am
Cafeteria plans, or plans governed by IRS Code Section 125, allow employers to help employees pay for expenses such as health insurance with pre-tax dollars. Employees are given a choice between a taxable benefit (cash) and two or more specified pre-tax qualified benefits, for example, health insurance. Employees are given the opportunity to select the benefits they want, just like an individual standing in the cafeteria line at lunch.
Posted: July 20, 2015, 4:00 am
The Supreme Court has granted the petition in Gobeille v. Liberty Mutual Insurance Company, a case centered on the issue of whether the Employee Retirement Income Security Act of 1974 (ERISA) preempts Vermont's health care database law as it was applied to a third-party administrator for a self-funded ERISA plan.
Posted: July 20, 2015, 4:00 am
Under the Patient Protection and Affordable Care Act, individuals are required to have health insurance while applicable large employers are required to offer health benefits to their full-time employees. Employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer.
Posted: July 16, 2015, 4:00 am
More and more employers—especially mid to large size groups—are considering different types of self-insured financing mechanisms. UBA partners are at the forefront of helping employers understand their options, and as a group of independent advisors bound by a code of conduct to actively cultivate, validate and share wisdom, we offer advisors and employers unparalleled local and national expertise.
Posted: July 14, 2015, 4:00 am
The Supreme Court ruled in Obergefell v Hodges, that the 14th Amendment requires a state to license a marriage between two people of the same sex, and to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out of state.
Posted: July 9, 2015, 4:00 am
The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA).
Posted: July 7, 2015, 4:00 am
The employer shared responsibility (i.e., "play or pay") requirements went into effect in 2015 for large employers only (those with 100 or more full-time or full-time-equivalent employees). Even though they generally will not be liable for penalties until 2016, mid-size employers (employers with 50 to 99 full-time or full-time-equivalent employees) will need to report on the coverage they offered for 2015, so long as they meet the maintenance requirements for transition relief.
Posted: July 2, 2015, 4:00 am
How is your company distributing compliance documents? Do you have a written process? Do you have written consent? It boils down to one simple question: Are you compliant?
Posted: June 30, 2015, 4:00 am
Recently, federal agencies, including the Department of Labor (DOL), issued a short five-question FAQ on two ACA-related issues: limitations on cost-sharing and provider discrimination.
Posted: June 25, 2015, 4:00 am
As the likelihood of an audit from the U.S. Department of Labor increases, every organization should be prepared so that this potential disaster can be handled with confidence. Conducting a mock audit can be key part of your prevention and preparation strategy.
Posted: June 23, 2015, 4:00 am
PPACA created a private non-profit corporation called the Patient-Centered Outcomes Research Institute (PCORI). The Institute's job is to research the comparative effectiveness of different types of treatment for certain diseases, and to share its findings with the public and the medical community. The goal is to improve quality of treatment and reduce unnecessary spending. The PCORI fee is to support this research and applies from 2012 to 2019.
Posted: June 16, 2015, 4:00 am
Regardless of how sound your company’s business practices may be, a DOL audit needs to be dealt with professionally and expediently. Every organization should be prepared so that this potential disaster can be handled with confidence.
Posted: June 11, 2015, 4:00 am
For large and small employers, PPACA reporting requirements can be a daunting task. Work with a United Benefit Advisors Partner Firm to help you navigate these complex requirements.
Posted: June 10, 2015, 4:00 am
Global economic trends have a profound impact on human resource management with effects on everything from talent management, hiring, outsourcing, investment strategies, wages, asset management and business development. As globalization continues to shrink the world, human resource departments are transforming themselves into strategic business partners with senior leaders in order to effectively lead their organizations.
Posted: June 9, 2015, 4:00 am
United Benefit Advisors (UBA) and senior economist Robin Anderson from Principal Global Investors, are hosting a webinar for employers, titled "Credit, Commodities and Consumers: An Economic Update” on Thursday, June 18, 2015, at 2:00 p.m. ET / 11:00 a.m. PT, which will help human resources professionals understand key drivers of the U.S. and global economies so they can better align HR with the market trends facing their companies.
Posted: June 9, 2015, 4:00 am
On May 11, 2015, the Department of Labor (DOL) along with other federal agencies issued an FAQ regarding the implementation of the Patient Protection and Affordable Care Act (PPACA) that focused on coverage of preventive services.
Posted: June 4, 2015, 4:00 am
As the saying goes, an ounce of prevention is worth a pound of cure, and that’s definitely the case when it comes to a health plan audit by the U.S. Department of Labor (DOL).
Posted: June 2, 2015, 4:00 am
This week we will go over another important aspect of stop-loss: contract periods. Stop-loss contract periods are perhaps the most complicated aspect of understanding how stop-loss insurance works.
Posted: May 28, 2015, 4:00 am
With the rising cost of health insurance and the need to provide coverage to employees, we have noticed many employers taking advantage of becoming self-insured. While being self-insured isn’t for everyone, there are definite advantages, such as the possibility of saving money – especially if you have a healthy staff.
Posted: May 26, 2015, 4:00 am
Self-funding is a very hot topic these days for a number of reasons. For small group employers offering a self-funded plan this means they can charge a composite premium rate based on the employee population versus the community rates that are based on each individual enrollee’s age. For all employer sizes this also means that they are not subject to all of the taxes under the Patient Protection and Affordable Care Act (PPACA), which alone can translate into a savings of 3% to 4% of their premiums.
Posted: May 20, 2015, 4:00 am
The above title of a Harvard Business Review (HBR) article caught my eye. The author was commenting on a number of recent books that addressed the issue of technologies putting people out of work. The article began with an 1867 quote from Karl Marx that went like this: “History discloses no tragedy more horrible than the gradual extinction of the English handloom weavers by the rapid and persistent progress of machinery.” Referring to this situation with the 19th century weavers, James Bessen, in his book Learning by Doing, noted that as humans work with new technologies over the long term, they improve them and boost their own fortunes in the process. Wages of weavers remained flat for a decade, but from 1860 to 1890, weavers’ pay more than doubled.
Posted: May 14, 2015, 4:00 am
Section 9010 of the Patient Protection and Affordable Care Act (PPACA) imposes a fee on each covered entity engaged in the business of providing health insurance for United States health risks. This is known as the Health Insurance Providers (HIP) fee or the Health Insurers Tax (HIT) tax. The first filings were due from covered entities by April 15, 2014, and the first fees were due September 30, 2014.
Posted: May 12, 2015, 4:00 am
Employers that do not meet the requirements of the Patient Protection and Affordable Care Act (PPACA) need to be concerned about several potential penalties. Two significant penalties include the excise tax, which can be as much as $100 per affected individual per day, and the penalties that larger employers must pay if they do not meet their employer-shared responsibility/play or pay obligations.
Posted: May 7, 2015, 4:00 am
Federal agencies recently released a Proposed Rule to amend regulations and provide guidance on implementing Title I of the Americans with Disabilities Act (ADA) as it relates to employer wellness programs.
Posted: May 5, 2015, 4:00 am
We’ve already discussed Health Savings Account (HSA) activity at length, looking first at the correlation between generous HSA contributions and increased enrollment in consumer-driven health plans (CDHPs). Second, we looked at how HSAs have performed in recent years across different industries. Now, we’ll look closer at HSA activity across different regions of the country, based on the results of the 2014 UBA Health Plan Survey.
Posted: April 29, 2015, 4:00 am
While recent survey data shows that, on average, employers are decreasing the amount they’re willing to contribute to employee Health Savings Accounts (HSAs), there are some industries that have not seen such trends.
Posted: April 16, 2015, 4:00 am
The Patient Protection and Affordable Care Act (PPACA), commonly referred to as “Obamacare,” was signed into law with the intention of decreasing the number of uninsured Americans and reducing the overall costs of health care in the United States.
Posted: April 14, 2015, 4:00 am
The Patient Protection and Affordable Care Act (PPACA) specifically encourages and promotes the expansion of wellness programs in both the individual and group markets. In the individual market, the secretaries of the departments of Health and Human Services (HHS), Treasury, and Labor are directed to establish a pilot program to test the impact of providing at-risk populations who utilize community health centers an individualized wellness plan that is designed to reduce risk factors for preventable conditions as identified by a comprehensive risk-factor assessment. Results will be compared against a controlled group.
Posted: April 9, 2015, 4:00 am
In the Benefit and Payment Parameters for 2016 Final Rule issued in February 2015, federal agencies included a clarification that annual cost-sharing limitations for self-only coverage apply to all individuals, regardless of whether the individual is covered by a self-only plan or is covered by another kind of plan.
Posted: April 7, 2015, 4:00 am
On March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA).
Posted: April 2, 2015, 4:00 am
Employer health savings account (HSA) funding strategies have changed in recent years in response to the Patient Protection and Affordable Care Act (PPACA) and its impact on employer-sponsored health insurance plans.
Posted: March 31, 2015, 4:00 am
The Department of Labor has issued an updated definition for “spouse” under the Family and Medical Leave Act (FMLA) to make compliance with FMLA easier for both employers and employees.
Posted: March 26, 2015, 4:00 am
Recently, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services issued a Final Rule with standards for insurers and Marketplaces in 2016, covering topics such as transparency in health insurance rate increases, formulary drug lists, drug mail order opt out provisions, determination of minimum value, and benefits discrimination.
Posted: March 24, 2015, 4:00 am
Employers that are growing up, and are in the awkward teenage years, are about to get a big surprise, and not the good kind.
Posted: March 19, 2015, 4:00 am
On February 18, 2015, the Internal Revenue Service (IRS) issued Notice 2015-17. This Notice addresses employer payment or reimbursement of individual premiums in light of the requirements of the Patient Protection and Affordable Care Act (PPACA).
Posted: March 17, 2015, 4:00 am
On February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits.
Posted: March 12, 2015, 4:00 am
Beginning in 2018, plans that provide coverage that exceeds a threshold will owe an excise tax that is frequently referred to as the “Cadillac tax.”
Posted: March 10, 2015, 4:00 am
Our recent blog reviewed the highlights of the new employer and insurer reporting requirements. UBA has created this quick reference chart to help you sort out who should use which form, and when:
Posted: March 5, 2015, 4:00 am
The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption.
Posted: March 3, 2015, 4:00 am
Many employers look at employee benefits as a commodity, bidding out their plans annually -- and who can blame them? Rising health care costs coupled with a challenging economic environment have forced many human resources decision-makers to focus heavily on cost.
Posted: February 26, 2015, 4:00 am
Employers have a lot of choices when it comes to buying group health insurance, including going directly to a carrier (or one of its agents), buying online, or going through a broker.
Posted: February 24, 2015, 4:00 am
Just because the holidays are long over does not mean that the giving season has ended. Charitable giving can be incorporated into your company culture so that the joy is spread year-round and busted out of the “season.” Here are three things to consider when developing your corporate charitable giving strategy.
Posted: February 19, 2015, 4:00 am
With health care expenditures in the United States fast approaching 17.7% of gross domestic product (GDP), the cost of health care is a valid concern.
Posted: February 17, 2015, 4:00 am
The federal poverty level guidelines (FPL) are used for many purposes, including assessing eligibility for a premium tax credit for coverage purchased through the health Marketplace.
Posted: February 12, 2015, 4:00 am
With the passage of the Patient Protection and Affordable Care Act (PPACA), we saw a number of hospitals and provider groups being bought and merged with larger provider groups. This was done for two reasons.
Posted: February 10, 2015, 4:00 am
Although employers are not required to offer coverage during 2014, individuals are generally required to have health coverage during 2014 and must report on that coverage through their 2014 federal income tax return.
Posted: February 5, 2015, 4:00 am
On December 10, 2014 the IRS released the optional standard mileage rates for 2015. Beginning on January 1, 2015, the standard rates for the use of a car, van, pickup or panel truck are:
Posted: February 3, 2015, 4:00 am
The excise tax on high cost plans (also referred to as the Cadillac tax and the 4980I tax) is scheduled to take effect in 2018. To date, regulations have not been issued, so many of the details about how the tax will operate are unclear.
Posted: February 2, 2015, 4:00 am
The Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have issued proposed regulations that would update the summary of benefits and coverage (SBC) requirement, including the SBC template, instructions, example calculator, and uniform glossary.
Posted: January 28, 2015, 4:00 am
The 2014 UBA Health Plan survey of nearly 10,000 employers finds that employers are shifting more responsibility and cost to workers through increases in out-of-pocket costs and cutbacks in family benefits.
Posted: January 26, 2015, 4:00 am
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 …
Posted: January 21, 2015, 4:00 am
The New York Times recently stirred up a media firestorm when it reported about Harvard University professors who were lambasting the health care increases they were facing this year.
Posted: January 20, 2015, 4:00 am
We’ve rounded up the most popular UBA blogs of 2014, which have garnered thousands of views.
Posted: January 16, 2015, 4:00 am
The last few months have seen as many complaints filed by the U.S. Equal Employment Opportunity Commission (EEOC) against wellness programs. On August 20, 2014, the EEOC brought its first direct challenge of a wellness program under Title I of the Americans with Disabilities Act (ADA) against Orion Energy Systems, Inc. (The Orion Suit).
Posted: January 13, 2015, 4:00 am
UBA publishes many white papers, an executive summary of its annual Health Plan Survey, and other custom reports. Below are the publications that garnered the most interest and requests from employers in 2014.
Posted: January 9, 2015, 4:00 am
Many employers benchmark their health plans against other employers with the same carrier or using nationally available data. But the benchmarking best practice is to compare your plan with others based on plan type, region, employee size, and industry.
Posted: January 8, 2015, 4:00 am
As mentioned in the first posting, wellness programs must be analyzed under a myriad of laws and regulations.
Posted: January 5, 2015, 4:00 am
The Department of Health and Human Services (HHS) has issued its proposed Benefit and Payment Parameters for 2016. While these amounts and dates are not yet final, they may be of help for planning purposes.
Posted: December 30, 2014, 4:00 am
The IRS has released final regulations that address how wellness incentives or penalties, contributions to a health reimbursement arrangement, and employer contributions to a Section 125 plan are applied to determine affordability.
Posted: December 26, 2014, 4:00 am
While wellness programs have increased in popularity, according to the 2014 UBA Health Plan Survey, actual wellness program adoption has been in a holding pattern. As one might expect, the highest percentage (58.8%) of plans offering wellness benefits came from employers with 1,000 or more employees and the lowest percentage (8%) of plans offering wellness benefits came from employers with fewer than 25 employees.
Posted: December 22, 2014, 4:00 am
Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an "indexed" limit). The Internal Revenue Service and the Social Security Administration have released a number of indexed figures for 2015.
Posted: December 17, 2014, 4:00 am
Data in the 2014 UBA Health Plan Survey is based on responses from 9,950 employers sponsoring 16,967 health plans nationwide.
Posted: December 15, 2014, 4:00 am
Premium tax credits are only available to individuals who obtain health coverage through a Marketplace. A dispute has arisen as to whether the IRS has the ability to interpret PPACA to allow the subsidy to individuals who obtain coverage through any Marketplace, or whether the language of PPACA limits eligibility to those who have obtained coverage through a state Marketplace.
Posted: December 10, 2014, 4:00 am
The employer-shared responsibility (“play or pay”) requirements do not apply to small employers and have been delayed until 2016 for most mid-sized employers.
Posted: December 8, 2014, 4:00 am
Since 2005, United Benefit Advisors® (UBA) has surveyed thousands of employers across the nation regarding their health plan offerings, their ongoing plan decisions in the face of significant legislative and marketplace changes, and the impact of these changes on their employees and businesses.
Posted: December 2, 2014, 4:00 am
Beginning in 2015, large employers must offer affordable, minimum value coverage to their full-time employees or potentially pay a penalty.
Posted: December 1, 2014, 4:00 am
The Centers for Medicare and Medicaid Services (CMS) extended the deadline for group health plans to provide their 2014 transitional reinsurance fee (TRF) submission. Filing is now due by 11:59 p.m. on December 5, 2014.
Posted: November 26, 2014, 4:00 am
As a business professional who is trying to classify a worker, it is important to remain compliant with the IRS regulations that determine whether an individual providing services to your organization should be classified as an independent contractor or an employee.
Posted: November 24, 2014, 4:00 am
On November 6, 2014, the collective Departments of Health and Human Services (HHS), Labor (DOL) and the Treasury released three Frequently Asked Questions (FAQs) directed at employer payment plans for the purchase of individual insurance.
Posted: November 20, 2014, 4:00 am
The Department of Labor (DOL), the IRS, and the Department of Health and Human Services (HHS) have jointly issued a FAQ that addresses how "reference-based pricing" works with the Patient Protection and Affordable Care Act's (PPACA) restrictions on out-of-pocket maximums.
Posted: November 17, 2014, 4:00 am
With Ebola being declared an international health emergency, and the first U.S. cases of the disease having been confirmed, some employers are asking what preparations and actions they should be takin
Posted: November 11, 2014, 4:00 am
On Friday, October 31, 2014, the Department of Health and Human Services (HHS) quietly updated its Health Plan Identifier information page to delay the requirement that insurance carriers and self-funded health plans obtain a health plan identifier (HPID). T
Posted: November 6, 2014, 4:00 am
The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016.
Posted: November 4, 2014, 4:00 am
We field many calls to review, speak, and comment on a variety of topics. Of course, these generally pertain to health care. In preparing for a coming presentation, I came across a recent article in Becker’s Hospital Review titled “100 Healthcare Statistics to Know”.
Posted: October 30, 2014, 4:00 am
The United Benefit Advisors (UBA) annual Health Plan Survey for 2014, which contains validated data on 16,467 plans for 9,950 employers, shows minor average change for plans in the last year. The survey contains information on plans that renewed predominantly between June 2013 and June 2014.
Posted: October 27, 2014, 4:00 am
We field a lot of questions from employers about wellness programs and how they comply with PPACA. Here are two of the most common ones from UBA’s “Frequently Asked Questions (FAQ) About Wellness Programs’ Legal Requirements”:
Posted: October 24, 2014, 4:00 am
To meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts.
Posted: October 22, 2014, 4:00 am
The U.S. Department of Health and Human Services (HHS), the Internal Revenue Service (IRS), and the Department of Labor (DOL) released final regulations that explain when dental and vision plans and employee assistance plans (EAPs) will be considered “excepted benefits.” Excepted benefits are health benefits that are limited enough in scope to be exempt from many of the requirements of the Patient Protection and Affordable Care Act (PPACA), such as annual dollar limits, reporting on W-2s and various fees.
Posted: October 21, 2014, 4:00 am
Health care reform has brought about many changes and growing pains. One of the changes we have seen recently in 2014 is the increased use of focused or ”narrow” provider networks.
Posted: October 16, 2014, 4:00 am
There is a lot of buzz in the market right now as employers are implementing their plans for the upcoming year. Many employers are looking at ways to keep their costs for medical coverage low, but still meet the requirements of the Patient Protection and Affordable Care Act (PPACA).
Posted: October 15, 2014, 4:00 am
Below are some to-dos for sponsors of self-funded group health plans. The information is limited generally to the “what” and the “when.”
Posted: October 10, 2014, 4:00 am
On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55 which allows employers to amend their Section 125 plans to recognize several new change in status events.
Posted: October 8, 2014, 4:00 am
The Patient Protection and Affordable Care Act (PPACA) is driving companies to look at many aspects of their organization more strategically.
Posted: September 30, 2014, 4:00 am
Focused provider networks (aka skinny or narrow) are nothing new to the health insurance marketplace. Insurance carriers have been using different sized provider networks in their HMO and PPO portfolios for many years now.
Posted: September 25, 2014, 4:00 am
It is back to school time! Universities and colleges across the nation have dedicated time and resources to course planning and curriculum evaluation, but have they prepared for the Patient Protection and Affordable Care Act (PPACA)? Have they run the numbers, solved for unknown variables, and double-checked their answers?
Posted: September 18, 2014, 4:00 am
Communicating the value of benefits is an age-old dilemma further complicated now that many employers are making big plan changes to comply with the Patient Protection and Affordable Care Act (PPACA). As more and more employers move to high deductible health plans, making employees aware of how to use their benefits and take control of their health care consumption will be the key to cost savings.
Posted: September 16, 2014, 4:00 am
A Summary of Benefits and Coverage (SBC) must contain:
Posted: September 11, 2014, 4:00 am
The Equal Employment Opportunity Commission (EEOC) has sued an employer because the penalty it applied for not participating in its wellness program was, in the eyes of the EEOC, so high that participation was not, as a practical matter, “voluntary.” Under EEOC rules, an employer may conduct medical examinations, which includes obtaining medical histories and blood draws, only in limited situations.
Posted: September 9, 2014, 4:00 am
On August 22, 2014, the Departments of Health and Human Services (HHS), Labor, and Treasury released an interim final rule and a proposed rule that provide some new accommodations to employers that have religious objections to covering contraception under their group health plans. The agencies also released a fact sheet on the rules and an alternate form that religious organizations (like religious hospitals, universities and charities) may use.
Posted: September 5, 2014, 4:00 am
The advent of state insurance exchanges last year has promoted a paradigm shift in the distribution and sales of insurance programs as part of employee benefit programs. Individuals using their ‘own’ funds to pick from virtual ‘store shelves’ of a wide range of insurance products is not an experience limited to employees of large corporations supported by big technology and service operations anymore.
Posted: September 3, 2014, 4:00 am
With Fall open enrollment around the corner, most employers will need to provide a Summary of Benefits and Coverage (SBC) to eligible individuals. Here are some highlights of the requirement (as of August 2014):
Posted: September 1, 2014, 4:00 am
I have sat with hundreds of employers that want to make a difference. They want to make a difference in how their teams work, how productive the employees are, and better yet…in how they, as an employer, can attract, retain and engage the best and brightest people for long-term sustainable (profitable) growth of the organization.
Posted: August 28, 2014, 4:00 am
Recently, UBA Partner Mike Humphrey, Senior Benefits Advisor at The Wilson Agency, shared some great insights for those who are considering doing a dependent audit. He points out three reasons why you shouldn’t do these audits and offers a much better approach to reining in costs associated with covering dependents that should no longer be on your plan.
Posted: August 26, 2014, 4:00 am
No matter who you are, no matter where, the Affordable Care Act, one of the largest pieces of legislation in recent history, will affect you...and not always in ways you can foresee, and not always in ways that give credence to what the ACA is meant to do.
Posted: August 15, 2014, 4:00 am
In order for the IRS to verify that individuals and employers are meeting their shared responsibility obligations, and that individuals who request premium tax credits are entitled to them, employers and insurers will be required to provide reporting on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015.
Posted: August 13, 2014, 4:00 am
A more meaningful attempt to manage absences can go a long way toward helping ease the staffing and morale challenges of small and midsize businesses that often feel the impact of absences more acutely than larger firms.
Posted: August 11, 2014, 4:00 am
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured small group plans (50 or fewer employees) provided inside and outside the SHOP exchange.
Posted: August 7, 2014, 4:00 am
A little over a month ago, the Department of Health and Human Services (HHS) released several Q&As regarding the Federally Facilitated Small Business Health Options Program (FF-SHOP). At the time, they stated the FF-SHOP would not support COBRA transactions (see blog and Q&A here).
Posted: August 5, 2014, 4:00 am
As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. The MLR threshold for large groups is 85%, and the threshold for small group and individual policies is 80%. The MLR ratio is based on the insurer’s block of business in the state, and not on the specific policy’s claims experience and administrative costs.
Posted: July 31, 2014, 4:00 am
As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option. Following are some frequently asked questions, and answers, about grandfathering a group health plan.
Posted: July 29, 2014, 4:00 am
On July 22, 2014 two Courts of Appeals issued decisions that address whether only people who live in states that have state-run Marketplaces (which are also called exchanges) are eligible to receive premium tax credits or subsidies under the Patient Protection and Affordable Care Act (PPACA).
Posted: July 24, 2014, 4:00 am
By Elizabeth Kay
Compliance and Retention Analyst for AEIS, UBA Partner Firm in San Mateo, CA
482462399According to new information from United Benefit Advisors (UBA), health savings accounts (HSAs) are outpacing health reimbursement arrangements (HRAs) in both adoption and participation rates. And now that metal tier health plans [e.g., platinum, gold, silver, etc.] are allowed higher deductibles, employers are increasingly looking at HSA qualified plans for their upcoming plan year. Here’s a look at why this trend is unfolding.
Posted: July 21, 2014, 4:00 am
Generally, plans that must comply with ERISA must file a Form 5500 by the last day of the seventh month after the close of their plan year. For calendar year plans this means the due date for the Form 5500 is July 31. Government plans (which includes most public schools) generally do not need to comply with ERISA and therefore do not need to file a Form 5500. Many church plans also are exempt from this requirement.
Posted: July 16, 2014, 4:00 am
The Family and Medical Leave Act (FMLA) regulations that became effective in 2009 provide employers with mechanisms by which we can better curb FMLA abuse. However, there are also some traps employers can fall into if they do not review the regulations carefully and administer leave requests appropriately.
Posted: July 7, 2014, 4:00 am
On June 30, 2014 the U.S. Supreme Court issued a decision in a case generally referred to as the Hobby Lobby case. Hobby Lobby is a family-owned for-profit corporation. The family that owns Hobby Lobby strongly believes that it would violate their deeply held religious values and obligations to provide coverage for four of the types of contraception that non-grandfathered plans must cover as preventive care.
Posted: July 2, 2014, 4:00 am
The Patient-Centered Outcomes Research Institute (PCORI) fee is due July 31, 2014, for virtually all group medical plans.
Posted: June 26, 2014, 4:00 am
By Josie Martinez, Senior Partner and General Counsel
As of January 1, 2014, the Patient Protection and Affordable Care Act (PPACA) requires pediatric dental benefits to be one of the 10 essential health benefits (EHB) that must be included in individual and small group medical coverage, as well as coverage offered through the Exchanges.
Posted: June 24, 2014, 4:00 am
Beginning in 2015, if you average enough full-time employees or full-time employee equivalents during a calendar year to be considered an “applicable large employer,” to avoid the shared-responsibility penalty you must provide medical coverage...
Posted: June 20, 2014, 4:00 am
Understanding the penalties for not offering adequate coverage under the Patient Protection and Affordable Care Act (PPACA) is tricky for many employers. Use UBA’s chart below to see if your company will have to pay a penalty.
Posted: June 17, 2014, 4:00 am
There’s no denying it. The vast majority of workers won’t be ready financially for retirement. Seventy percent are behind schedule in saving for retirement and half of all Americans have less than $10,000 in savings. Of immediate importance is the fact that nearly half of the oldest boomers are at risk of not having sufficient retirement resources to pay for basic retirement and healthcare costs!
Posted: June 13, 2014, 4:00 am
For employers and their employees, past and present, there may be a few issues that you need to consider before enrolling through products sold in the Federally-Facilitated Small Business Health Options Program (FF-SHOP).
Posted: June 12, 2014, 4:00 am
As the cost of employer-sponsored health insurance continues to rapidly outpace wages and inflation, now more than ever employers are looking for ways to keep costs down. One way to do so (that requires very modest investment) is by improving benefits communication, a critical component of employee engagement.
Posted: June 5, 2014, 4:00 am
The regulatory agencies have recently issued two sets of guidance that affect an employer’s Consolidated Omnibus Budget Reconciliation Act (COBRA) obligations and opportunities under the Patient Protection and Affordable Care Act (PPACA).
Posted: June 3, 2014, 4:00 am
Beginning in 2014, small employers may choose to provide health coverage to their employees through a Small Business Health Options Program (SHOP) Marketplace. Here are the top 5 questions we hear about SHOP:
Posted: May 29, 2014, 4:00 am
To meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health plans don't have receipts, insured plans should look at premiums for the prior plan year and self-funded plans should look at claims paid for the prior plan year.
Posted: May 26, 2014, 4:00 am
What do all employees have in common? They all have a burning dislike for their morning commute! Let’s face it, it’s not the actual commute that most people dislike, it’s the hassle of dealing with traffic, long lines, and rude people that make the trip so despised.
Posted: May 13, 2014, 4:00 am
As more and more Americans face high deductible health plans (HDHPs) and increased up-front out-of-pocket costs, it is more important than ever to closely monitor medical bills for errors. According to the Medical Billing Advocates of America, more than 80% of medical bills contain errors, which can cost patients thousands of dollars. Those errors may be simple mistakes, double billings, or in some cases, abusive charging practices.
Posted: May 8, 2014, 4:00 am
On February 10, 2014, the IRS issued final regulations on the employer shared responsibility requirements, often known as “play or pay.” The play or pay requirements originally were to take effect in 2014, but on July 2, 2013, the White House announced that compliance would be delayed until 2015.
Posted: April 30, 2014, 4:00 am
The IRS has released the 2015 minimums and maximums that apply to health savings accounts (HSAs) and related high-deductible health plans (HDHPs). These increases occur annually based on a cost-of-living formula. Because the inflation rate is fairly low, the amounts have not increased very much from last year.
Posted: April 29, 2014, 4:00 am
The Department of Labor (DOL) collected more than $1.6 billion in fines in fiscal year 2013 and has hired 700 new agents to enhance its enforcement and plan audit efforts. As a result of an uptick in DOL audits, those employers that might not have been targeted before are now being targeted, regardless of size, industry, or location.
Posted: April 21, 2014, 4:00 am
Many group health plans will need to be amended to reflect the required changes to benefits and waiting periods that take effect in 2014. Employers also should consider whether eligibility language will need to be updated to reduce the number of hours the employee must work to be eligible, to address look-back periods, and/or to base eligibility on actual hours worked instead of the “regularly scheduled to work” standard that is common now.
Posted: April 18, 2014, 4:00 am
More than 75 cents of every health care dollar spent in the United States goes toward treating chronic diseases such as arthritis, asthma, cancer, cardiovascular disease, and diabetes, according to the Centers for Disease Control and Prevention. Because these conditions are the No. 1 cause of death and disability, and consequently the primary factor in rising health care costs, moving toward prevention-based care will be the key that helps both employers and employees pull health care costs back from the edge of crisis over the long term.
Posted: April 15, 2014, 4:00 am
Tacked into the Medicare provider payment fix bill was a repeal provision that removed the $2,000 single deductible maximum. The bill passed the U.S. House of Representatives in late March, passed the U.S. Senate on March 31 and was signed into law on April 1.
Posted: April 10, 2014, 4:00 am
In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer. The reporting requirements are in two separate sections of the Patient Protection and Affordable Care Act (PPACA) -- sections 6055 and 6056. Reporting will first be due early in 2016, based on coverage in 2015.
Posted: April 9, 2014, 4:00 am
With every day that goes by, the nation’s employers move a step closer to having to make “play or pay” decisions. Many employers have less than a year to prepare for the arrival of this core provision of the Patient Protection and Affordable Care Act (PPACA). Their decisions are far from easy... the ensuing financial, legal, and competitive implications are profound... and the clock is ticking.
Posted: April 7, 2014, 4:00 am
Q: I know there are new out-of-pocket maximum rules beginning in 2014. Can you explain them?
A: Beginning with the 2014 plan year, plans may not have an out-of-pocket maximum greater than $6,350 for single coverage and $12,700 for family coverage. READ MORE...
Posted: April 2, 2014, 4:00 am
Posted: March 31, 2014, 4:00 am
The Employer-Shared Responsibility (“Play or Pay”) final regulations released February 2014 provide a little relief for Applicable Large Employers (ALEs) and their obligations surrounding dependent coverage. The final regulations provide, in part, that in order to avoid a potential penalty, ALEs must offer coverage to the full-time employees’ dependents. This article will address the Final Regulations’ definition of dependent, possible implications, and allowable transitional relief.
Posted: March 27, 2014, 4:00 am
Another delay for non-compliant plans was released recently, to renew the plan into 2017. However, the process to remain on these plans relies on several items. First, the State Insurance Commissioner must allow or approve non-compliant plans to renew. Second, the insurance carrier decides to file the non-compliant plan rates, get approval from the respective State Insurance Commissioner in a timely manner, and send out all the required notices to the affected policyholders. Many in the industry are now calling these ‘grandmothered’ plans.
Posted: March 25, 2014, 4:00 am
On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury/IRS issued Frequently Asked Questions - Part XVIII that provides additional information about requirements in several areas. In this third of a three-part series, we will address some clarifications related to wellness programs.
Posted: March 20, 2014, 4:00 am
Several years ago, I went to the doctor for a sinus infection. While waiting for the doctor to return with a prescription, I happened to look over and notice that every jar, pen, notepad, etc. on the counter had the name of a recently released brand name antibiotic.
Posted: March 19, 2014, 4:00 am
On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury/IRS issued Frequently Asked Questions - Part XVIII.
Posted: March 13, 2014, 4:00 am
Remember when you used to pay a $15 copay for prescription drugs and that was the end of the story? Those days are quickly disappearing and in their place is a complex four-tiered prescription drug plan, with copays becoming less of an option for many.
Posted: March 11, 2014, 4:00 am
If you are a mid-size employer (50-5,000 employees), you are likely considering a private exchange to affordably handle your benefits complexity (eligibility management, payroll deduction, billing and reconciliation, enrollment and claims issues, defined contribution automation, etc.) while reaping the benefits of cost certainty from a defined contribution model.
Posted: March 10, 2014, 4:00 am
On March 5, 2014, the Department of the Treasury and the Internal Revenue Service released the final employer-shared responsibility ("play or pay") reporting rules. The Patient Protection and Affordable Care Act (PPACA) requires reporting in support of the individual and employer-shared responsibility requirements and premium tax credit/subsidy eligibility, under Sections 6055 and 6056 of the Internal Revenue Code.
Posted: March 7, 2014, 4:00 am
On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury/IRS issued Frequently Asked Questions - Part XVIII. This document provides additional information about requirements in several areas. In the first of a three-part series, we will break down the details related to preventive care, out-of-pocket limits, and wellness programs.
Posted: March 6, 2014, 4:00 am
We’re asking some really interesting questions on the UBA Benefit Opinions Survey. Some of the answers (being compiled from what is shaping up to be the most comprehensive set of employers across all sizes, industries, and geography) are likely to surprise us all.
Posted: March 4, 2014, 4:00 am
On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements.
Posted: February 28, 2014, 4:00 am
There is a lot of talk about the many cost-control and health care reform tactics available to employers, but what are companies actually implementing?
Posted: February 24, 2014, 4:00 am
As the implications of health care reform become more apparent, large employers are increasingly grappling with coverage options to avoid the penalties.
Posted: February 20, 2014, 4:00 am
The Federal Poverty Level (FPL) is used to determine eligibility for many government programs, including Medicaid and the premium tax credit/subsidy available through the health marketplace/exchange. The Department of Health and Human Services (HHS) has released the following 2014 Federal Poverty Level figures. They reflect a 1.5% cost of living increase over 2013.
Posted: February 19, 2014, 4:00 am
On February 10, 2014, the IRS issued final regulations on the employer-shared responsibility requirements, often known as “play or pay.” The final regulations follow the proposed regulations in many respects, but also contain some transition rule surprises.
Posted: February 13, 2014, 4:00 am
With open enrollment for the Marketplace close to 60% complete, one would like to think what they were told about the subsidy they will be receiving is accurate. How can you be sure that you were given correct information? Let’s take a look at the 2014 Federal Poverty Level (FPL) tables and see if the information given is accurate.
Posted: February 12, 2014, 4:00 am
Lately, it seems we have been getting the same compliance questions over and over again from our clients. Below are some of our most frequently asked questions.
Posted: February 5, 2014, 4:00 am
Most of us have heard of "concierge medicine" and it's gaining popularity, especially among executives. As more people enroll, more questions are popping up that we haven't heard before. One of the most frequent questions we've heard is, "Can I fund the cost of the concierge with my health savings account (HSA) or flexible spending account (FSA)?"
Posted: February 3, 2014, 4:00 am
The 90-day maximum for eligibility waiting periods is effective as of the start of the 2014 plan year. As employers are beginning to implement this new requirement, many have questions. For instance, what should employers do if they hired an employee under the prior rules?
Posted: January 29, 2014, 4:00 am
For most employers, looking at the health insurance plan every year is a tradition. The numbers are reviewed, a bid is suggested (or not), and an analysis of the performance and incoming numbers is performed. Unfortunately, other ancillary lines are often overlooked, renewed as-is because they aren't used as much or there's a rate hold. This can lead to dire consequences, especially for an employer's group disability insurance.
Posted: January 27, 2014, 4:00 am
As we inch closer to full implementation of the Patient Protection and Affordable Care Act (PPACA), the nation's employers are facing a deadline about whether or not they will "play or pay," with regard to offering employee benefits. Unfortunately, many still do not fully understand the options and various implications of their PPACA-related decisions.
Posted: January 23, 2014, 4:00 am
In the face of the Patient Protection and Affordable Care Act (PPACA), the most substantial change in decades to the U.S. health care system, many employers are struggling to stay on top of health plan compliance while focusing on attracting and retaining employees, especially as the economy improves. Employee benefits packages that include vision insurance can help employers reach strategic goals, attract and retain employees, control health care costs, and increase productivity.
Posted: January 21, 2014, 4:00 am
To alleviate PPACA compliance anxiety, employers need resources that clearly explain which provisions affect them so they can make the best decisions. The following four guides will help you get started:
Posted: January 17, 2014, 4:00 am
Group health plans must meet many requirements under the Patient Protection and Affordable Care Act (PPACA), the Health Insurance Portability and Accountability Act (HIPAA), the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code, etc.
Posted: January 13, 2014, 4:00 am
By all accounts, California is leading the country when it comes to On-Exchange sales (Covered California). With a total 2013-2014 marketing budget of $286,519,301, Covered California is definitely working to get the word out about their options. Also interesting to note is that reports show Covered California costs 56 times more than Facebook (more than $910 million spent on Covered California). So for all this hype and cost, Covered California has 71,188 applications completed.
Posted: January 8, 2014, 4:00 am
"The Only Thing That Is Constant Is Change." ? Heraclitus.
When it comes to health plan compliance, this statement couldn't be truer. The IRS and the Department of Health and Human Services (HHS) are constantly developing, revising and amending regulations related to the Patient Protection and Affordable Care Act (PPACA).
Posted: January 3, 2014, 4:00 am
Delay, delay, delay ... Error, delay, repeal. That seems to be the trend with health care reform, but it doesn't mean employers are exempt from compliance in 2015 or the requirements that remain in effect for 2014 under the Patient Protection and Affordable Care Act (PPACA).
Posted: December 4, 2013, 4:00 am
In the words of Yogi Berra, it's like déjà vu all over again: Here we are, again almost at the end of the calendar year, and we still do not know where things stand with transit benefit parity.
Posted: December 3, 2013, 4:00 am
On Nov. 14, 2013 the White House announced that insurers will not be required to meet most of the provisions of the Patient Protection and Affordable Care Act (PPACA) if they renew individual or small group policies that were in effect on Oct. 1, 2013.
Posted: November 22, 2013, 4:00 am
The IRS does not consider the availability of the health exchanges/marketplaces a change in status event that would allow an employee to make a mid-year change under a Section 125 plan. However...
Posted: November 13, 2013, 4:00 am
Most of us are scratching our heads on a daily basis as the rules of health care reform seem to shift continually. Particularly for employers in the under 50 employee market, identifying marketplace health care coverage options has been a moving target.
Posted: November 8, 2013, 4:00 am
On Sept. 13, 2013, the IRS issued details on permissible health reimbursement arrangements(HRAs), providing some clarification on minimum essential, minimum value and affordable coverage, and addressing payment of individual premiums through an employer-provided plan.
Posted: November 4, 2013, 4:00 am
It is finally here. The Patient Protection and Affordable Care Act (PPACA), along with all the “stuff” that has been following it is really happening. Of course, with any major change there are bumps along the way.
Posted: October 30, 2013, 4:00 am
UBA Health Plan Survey benchmarking data reveal national, regional and local cost differences.
Posted: October 28, 2013, 4:00 am
The Affordable Care Act (ACA) has so many provisions to be aware of that it can be downright overwhelming.
Posted: October 24, 2013, 4:00 am
Results from the United Benefit Advisors (UBA) 2013 Health Plan Survey, the nation's largest health plan benchmarking survey, show drastic differences in employee health benefits cost and plan design across multiple regions of the United States.
Posted: October 18, 2013, 4:00 am
States have two major decisions to make with respect to the Patient Protection and Affordable Care Act (PPACA) - whether they will run the health exchange themselves, and whether they will expand Medicaid to cover most individuals whose income is below 133 percent of the federal poverty level.
Posted: October 16, 2013, 4:00 am
With the advent of the health marketplaces, why do we still have COBRA?
Posted: October 11, 2013, 4:00 am
It is becoming more and more common for employers to offer wellness incentives to their employees as motivation for employees to improve their overall health and well-being. Management has started to buy in to the fact that there is a correlation between healthier employees, lower medical claims and lower medical premiums, but this only works with employee participation.
Posted: October 8, 2013, 4:00 am
The IRS has issued the long-awaited rules on required reporting of minimum essential coverage (under Code Section 6055) and affordable, minimum value coverage (under Code Section 6056).
Posted: October 4, 2013, 4:00 am
The health marketplaces are starting to accept applications, and with that, interest in the premium subsidy process is increasing.
Posted: October 4, 2013, 4:00 am
The countdown has begun to what some consider a soft launch of the public insurance exchanges established under the landmark health law known as the Patient Protection and Affordable Care Act (PPACA), yet many employers remain unprepared.
Posted: September 27, 2013, 4:00 am
Many employers are uncomfortable foregoing the marketplace/exchange notice, even with the highly unusual DOL release stating that penalties would not be applied to employers that fail to provide the notice. If you fall in this category, we encourage you to provide the notice anyway and have developed a new FAQ document to help you.
Posted: September 26, 2013, 4:00 am
Many U.S. employers offer self-funded insurance plans, with most of them purchasing stop-loss coverage from insurance providers. Historically, most of these companies have been large employers. However, given the fact that self-funded companies could avoid many PPACA regulations, more companies, particularly those will less than 100 employees, are considering this alternative strategy.
Posted: September 20, 2013, 4:00 am
I am constantly amazed when I hear that large employers (those with 100-plus employees, and especially those with 1,000-plus) do not know how they are going to handle health care reform yet.
Posted: September 19, 2013, 4:00 am
PPACA requires employers covered by the Fair Labor Standards Act to provide a notice about the upcoming health marketplaces (also called exchanges) to their employees. The notice is due Oct. 1, 2013. On Sept. 11, 2013 the Department of Labor (DOL) announced that it will not penalize employers that do not provide this notice.
Posted: September 16, 2013, 4:00 am
Add another item to the growing list of provisions of Health Care Reform (aka "Obamacare") that will be delayed for an additional year: caps on out-of-pocket health care expenses ("OOP"). According to the law, health plans are required to cap the total amount consumers can be charged through deductibles, co-payments and co-insurance.
Posted: September 11, 2013, 4:00 am
Whatever your view of the massive law that is The Affordable Care Act, there is no denying that it is having a big impact on the market. As we sifted through the enormous amounts of data that comprise the 2013 UBA Health Plan Survey, the reality of the law's impact became clearer. In short, if you are a single employee without dependents who is mostly healthy, you likely saw your health care costs decrease. If you're anyone else, you probably felt a punch below the belt.
Posted: September 4, 2013, 4:00 am
As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option. Following are some frequently asked questions, and answers, about grandfathering a group health plan.
Posted: September 3, 2013, 4:00 am
Last week several media outlets picked up a FAQ that the Department of Labor issued in February of this year. Some of the reports have created confusion about the requirement, and the scope of what has been delayed; here is a summary of the rules:
Posted: August 21, 2013, 4:00 am
"To be, or not to be," is the famous opening phrase of the soliloquy in William Shakespeare's tragic play Hamlet (Act 3, Scene 1). Early in the scene, Hamlet questions the meaning of life, and whether or not it is worthwhile to stay alive when life contains so many hardships.
Posted: June 12, 2013, 4:00 am
As the implications of health care reform become more and more apparent, large employers are increasingly grappling with coverage options in order to avoid the penalties. Over the past few months, there has been considerably more attention paid to the problems faced by the staffing industry and similar employers since the temporary employees and variable hour employees are generally common law employees of the organization, and ultimately such companies are on the hook as it relates to offering health coverage.
Posted: May 31, 2013, 4:00 am
The Wall Street Journal recently reported, and we in the industry have seen, that companies across America are penalizing workers for a range of health conditions, including high blood pressure and thick waistlines, as a way to fight rising health care costs.
Posted: May 10, 2013, 4:00 am
As the complexities of the Patient Protection and Affordable Care Act (PPACA) continue to unfold, UBA will be offering employers free tools, materials, and analysis to help with your decision-making.
Posted: April 8, 2013, 4:00 am
Employers have a new opportunity to offer increased value through ancillary benefits -- an area expected to grow substantially in the coming years.
Posted: March 29, 2013, 4:00 am
Public-sector employers face incredible pressure to contain their employees’ health care costs. Private-sector employees can learn some of their secrets in a webinar on April 3.
Posted: March 27, 2013, 4:00 am
Need help wading through all those provisions and decisions related to the health care reform law? We have the top four resources that can put you on the right track and help you stay compliant.
Posted: March 15, 2013, 4:00 am
In the new era of PPACA, some companies will realize the inherent inefficiencies and costs associated with their internal silos and the risks these silos present in terms of quantify and qualify the impacts of PPACA.
Posted: March 12, 2013, 4:00 am
Matthew Kistler has joined UBA in a new role as Director of Partner Relations.
Posted: March 7, 2013, 4:00 am
Consumer-driven health plans (CDHPs) have benefited many employers since they were first introduced in 2002.
Posted: March 5, 2013, 4:00 am
The goal of health care reform is health care for all... but at what cost?
Posted: March 1, 2013, 4:00 am
For many businesses, the bottom line is that self-insuring a group medical plan might be a way to avoid additional costs and constraints of PPACA.
Posted: February 21, 2013, 4:00 am
Leaders of organizations large and small are getting pulled in many different directions. It is easy to see how a leader can focus on shareholder returns or profitability instead of what really matters - the people.
Posted: February 19, 2013, 4:00 am
What will happen to the burgeoning population of retirees in future decades who find not only their retirement underfunded but also their health care?
Posted: February 15, 2013, 4:00 am
If the insurance you provide for your employees has become so expensive that you have had to minimize the benefits, it's time to start figuring out a way to get involved in "their business."
Posted: February 7, 2013, 4:00 am
Mishandling or delaying the question of health benefits now can carry a big price tag in dollars, reputation, competitiveness, retention, employee engagement or a combination of all of the above.
Posted: February 7, 2013, 4:00 am
In a time when health care costs are at an all-time high, it's essential to maximize employee benefit investments
Posted: February 6, 2013, 4:00 am
PPACA is prompting many small and midsize employers to talk even more seriously about taking the plunge to self-funded health care plans.
Posted: February 4, 2013, 4:00 am
UBA has posted an evaluation toolkit that can help you choose the right benefits advisor for you.
Posted: January 28, 2013, 4:00 am
Posted: January 24, 2013, 4:00 am
You never want to assume value -- especially when it comes to how your employees perceive the employee benefit program being offered.
Posted: January 18, 2013, 4:00 am
Unfortunately, there is not a harbor big enough to house those lost in the sea of health care reform, and many employers are still feeling like they have a new "cliff" to set their sights on.
Posted: January 16, 2013, 4:00 am
The advent of the New Year is always full of resolutions. Although we may recognize certain personal areas that need our commitment and growth, don't forget areas for professional growth.
Posted: January 9, 2013, 4:00 am
As economic, industry and regulatory factors continue to challenge the marketplace, finding the best "wheat" in a field of "chaff" is the most important decision a business can make.
Posted: January 4, 2013, 4:00 am
Learn to excel by discovering how to make the best professional and personal decisions in this special webinar at 2 p.m. EST on Jan. 14.
Posted: January 3, 2013, 4:00 am
Need help with PPACA? Check out some quick summaries of the latest proposed rules.
Posted: December 27, 2012, 4:00 am
On the surface, private exchanges seem right in line with American consumerism, but the jury's out on which ones will actually work.
Posted: December 19, 2012, 4:00 am
With 2013 just weeks away, payroll professionals are getting extremely anxious about various favorable payroll tax provisions affecting individuals and businesses that have yet to be determined relating to 2013 withholdings.
Posted: December 14, 2012, 4:00 am
Posted: December 12, 2012, 4:00 am
With the major regulations of health care reform legislation scheduled to kick in on Jan. 1, 2014, many employers are trying to get an idea of the financial impact on medical premiums due to these new rules
Posted: December 6, 2012, 4:00 am
In light of the recently released proposed rules on wellness programs under health care reform, now's a good time to review your program (or consider starting one if you haven't already).
Posted: December 4, 2012, 4:00 am
The federal government has issued a proposed rule that addresses some of the questions surrounding essential health benefits and determining actuarial and minimum value.
Posted: November 30, 2012, 4:00 am
As benefit advisors, Members of United Benefit Advisors (UBA) have been preparing themselves and their clients as information has become available over the last 18 months about the role that they will play in their state exchange and to what extent their employer clients will have to become educated in the purpose and functionality of their exchange.
Posted: November 28, 2012, 4:00 am
Posted: November 20, 2012, 4:00 am
Employers may or may not be looking to attract new employees in today's economy, but they certainly need to retain the good ones they have. Benchmarking play a key role in that effort.
Posted: November 16, 2012, 4:00 am
A close look at new health plan data shows that of all health plans in the Northeast, 33.6 percent have no single deductible, compared with just 8.4 percent and 4.1 percent in the Southeast and Central regions, respectively.
Posted: November 13, 2012, 4:00 am
Maintenance of the health care reform status quo in Washington, D.C. (the re-election of President Barack Obama, with a split congress) means that implementation of the Patient Protection and Affordable Care Act (PPACA) likely will move forward largely as the law was passed in 2010.
Posted: November 8, 2012, 4:00 am
No matter the results of today's election, the stakes are high and the changes will be intense.
Posted: November 6, 2012, 4:00 am
Through our affiliation with United Benefit Advisors, we can provide unique guides and tools to help employers clear any PPACA hurdles.
Posted: November 1, 2012, 4:00 am