10 Creative Employee Benefit Strategies: Part 1

I grew up in the Lehigh Valley, lived and worked here my whole life.  I can remember a time when Blue Cross Blue Shield was the only option for health insurance and it was great coverage.  The best part about the plan, back then, was the employer typically picked up the entire premium cost and the employee deductible was very small or none at all.  Well, fast forward, the coverage is still great, the deductibles are still fairly low but the cost is just unsustainable. So much so that companies are faced with the possibility of dropping coverage all together.  Well, it's not just the Blue's that has this challenge.  It's really any insurance provider that offers very low-deductible plans.  Companies just cannot afford these extremely benefit rich plans anymore.  Employees love these plans because they have minimum, if any, out-of-pocket exposure.

If you're one of these Lehigh Valley businesses desperately trying to hold on to this type of plan structure - you simply have to consider increasing the deductible on the plan.  There's no other component that will get you where you need to be.  You can entertain increasing co-pays and co-insurance to the existing plan but none of those options will make a significant financial impact.

Now that you've made the tough decision to raise the deductible - now what?  There are some very practical things that you can do in conjunction with raising your deductibles that will lessen the impact on employee morale, as well as, cultivate more employee engagement with your companies employer-sponsored health plans.  Over the next several months, of this 10 part series, we will look at some creative ways to accomplish these goals.  Look for part 2, The Value of a High Deductible Health Plan, next month.

In the meantime, email me questions or concerns at bknauss@employeemployersolutions.com, visit my website at www.employeemployersolutions.com or just call our office at 484-892-3314.

Small Business Health Insurance Credit

The Internal Revenue Service has come out with guidelines for small commercial and nonprofit employers that want to take advantage of a new health insurance tax break.  PPACA and a companion act, the Health Care and Education Reconciliation Act, are part of what federal agencies have dubbed the Affordable Care Act(ACA).  This year, the new ACA small business tax break will offer small employers a tax credit equal to at least half the cost of single coverage, if the employees earn average wages of less than $50,000 per year.  The tax credit is not available to ordinary government employers, but it is available to small businesses, small tax-exempt employers, and government-affiliated tax-exempt employers that can be described as section 501(c) organizations.  Here are some of the highlights of this provision:

• Tax years 2010 to 2013, the maximum credit is 35% of premiums paid by eligible small business employers and 25% of premiums paid by eligible employers that are tax-exempt organizations.  
• Employers with 10 or fewer FTE employees that pay annual average wages of $25,000 or less can qualify for the maximum credit.  
• Employers with 10 to 25 FTE employees that pay annual wages of $50,000 or less can qualify for a smaller tax credit.

For the full review of this new IRS Section 45R and to see whether or not you qualify for this new tax credit CLICK HERE.  I highly recommend that you speak with your employee benefits broker/consultant for expert advise on what you're entitled to or if you're not currently working with a broker email me at bknauss@employeemployersolutions.com or visit me on the web at www.employeemployersolutions.com

Health Reform Timeline

The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020. 

Below is a high-level overview of the time line.  It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels – which could alter the intended timing of implementation.

2010

New Programs:
 * Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the ”doughnut hole”

Insurance Reforms: 
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescission's/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created

2011

Insurance Reforms:
* Uniform coverage documents and standard definitions are developed
* Minimum medical loss ratios are mandated

Medicare Reforms:
* Medicare Advantage cost sharing limits effective
* Medicare beneficiaries who reach the doughnut hole will receive a 50% discount on brand name drugs
* A 10% Medicare bonus will be provided to primary care physicians and general surgeons practicing in under-served areas, such as inner cities and rural communities.
* Medicare Advantage plans would begin to have their payments frozen.

Other: 
* Employers are required to report the value of health care benefits on employees' W2 tax statements.
* Annual industry fee for pharmaceutical manufacturers of brand name drugs.
* Voluntary long term care insurance program would be made available to provide cash benefit for assisting disabled individuals to stay in their homes or cover nursing home costs. Benefits would start five years after people begin paying a fee for coverage.
* Funding for community health centers would be increased to provide care for many low income and uninsured people.

2012

* Hospitals, physicians, and payers would be encouraged to band together in "accountable care organizations."
* Hospitals with high rates of preventable re-admissions would face reduced Medicare payments.

2013

* Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income —up from the current 1.45%. A new tax of 3.8% on unearned income, such as dividends and interest, is also added.
* Medical expense contributions to flexible spending accounts (FSAs) limited to $2,500 a year—indexed for inflation. In addition, the thresholds for claiming itemized tax deduction for medical expenses rise from 7.5% to 10% of income.
* Medical device manufacturers would have a 2.9% sales tax on medical devices; devices such as eyeglasses, contact lenses, and hearing aids would be exempt.
* Eliminates deduction for expenses allocatable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D eligible retirees. 

2014

Coverage Mandates and Subsidies:
* Individual and employer coverage responsibilities are effective. 
* Individual affordability tax credits are created and small business tax credits are expanded.

Health Insurance Exchange & Insurance Reforms:
* State individual and small group health insurance exchanges operational.
* Guaranteed issue, guaranteed renew-ability, modified community rating and minimum benefit standards (“essential benefits” plan) effective. 
* Lifetime and annual dollar limits are prohibited for essential benefits.
* Pre-existing condition exclusions are prohibited.

Taxes and  Fees: 
* Addition of new taxes on health insurers

Medicaid and Medicare Reform: 
* Medicaid expanded to cover low income individuals under age 65 up to 133% of the federal poverty level—about $28,300 for a family of four.
* Minimum medical loss ratio of 85% required for Medicare Advantage plans

2018

Taxes and Fees:
 * Tax (“Cadillac tax”) imposed on employer sponsored health insurance plans that offer policies with generous levels of coverage. 

2020

Medicare Reform: 
* Doughnut hole coverage gap in Medicare prescription benefit is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage.

Creating a Culture of Health and Wellness

I deal mainly with small-to-medium sized employer groups and every time I broach the subject of creating a company culture that promotes the health and wellness of their employees - I usually get the same response.  It goes something like this; "Are you kidding?  It's not good enough that I provide a good paying job with a great employee benefits program, now you want me to promote healthy lifestyles for my employees?  Forget it!"  Coincidentally, my response is always the same.  "As long as you [the employer] have a fiduciary responsibility for your companies health plan, meaning, it's your name on the plan and you're the one they ultimately look to for payment - then you have an incumbent responsibility to shield your company finance's against premium increases.  Think about it for a moment.  If the majority of your employees are living unhealthy lifestyles (ie. they're over-weight, they smoke, live sedentary lives) then you'll be bearing that burden in the form of higher health insurance premiums year after year.

It's not just higher premiums that become the negative outcome.  It's also the fact that unhealthy employees tend to be more unproductive than their healthy counterpart employees.  They have a higher absenteeism rate and they have a tendency to be less productive even when they're at work.  Ignoring a robust health and wellness component to complement your employer-sponsored health plan just doesn't make good business sense.

Here are some chilling facts:  

A recent analysis of data from the National Health and Nutrition Survey (NHANES), which is conducted regularly by the National Center for Health Statistics, warns that middle-aged individuals may be at greater health risk than anyone anticipated. In comparing the results of two large-scale studies of the U.S. population in 1988 to 1994 and in 2001 to 2006, the report shows that the number of people aged 40 to 74 adhering to healthy lifestyle habits has seriously declined.

• The percentage of surveyed adults with a body mass index greater than 30 has increased from 28 percent to 36 percent *

• Physical activity 12 times a month or more has decreased from 53 percent to 43 percent *

• Eating five or more fruits and vegetables a day has decreased from 42 percent to 26 percent *

• Moderate alcohol use has increased from 40 percent to 51 percent *

• Smoking rates have not changed (26.9 percent to 26.1 percent) *  

*The Vitality Group " CREATING A NEXT-GENERATION HEALTH AND WELLNESS PROGRAM: Why employers should take the lead, and how to do it

While it's true that Americans are living longer today (life expectancy for males is 75 years and for females it's 80 years), it's also true that more Americans suffer from chronic and debilitating diseases such as diabetes, hyper-tension, acid reflux, heart disease, mostly stemming from too many Americans being obese.  In fact, it's estimated that obesity alone accounts for 147 billion dollars a year in health care related costs.  Now, I'm not an economist by any means but I can figure out that if we created a culture of health and wellness in this country that seeks to stem the negative affects of obesity, we wouldn't need the government to get involved with health care at all.

Business owners, maybe it's time to make some radical changes in your workplace like, don't just ban smoking in the building but eliminate the 35 smoke breaks that take place throughout the day.  After all, if I came to you with a request to go into the break room to eat something every 30 minutes you would probably
suggest that maybe this jobs not for me - and you would have every right to suggest that!  Studies have shown that it's well worth the investment with ROI's sometimes being $3.27 reduction in medical costs for every dollar spent on health and wellness, as well as, reducing absenteeism costs by $2.73 for every dollar spent. Just some healthy food for thought.

If you would like to learn more about how to cultivate a culture of health and wellness at your company; email me bknauss@employeemployersolutions.com or visit my website at www.employeemployersolutions.com  Don't forget to subscribe to my blog and follow me on twitter at: http://mployebenefits.com

President Obama: Acme Health Plans

In the recent health care summit that the President presided over, he made mention several times to "Acme Health Plans' when referring to High Deductible Health Plans (HDHP). This is just further evidence of Washington's elitist attitude toward health care options that don't conform to their view of the way the world should operate. Furthermore, his plan would all but do away with the incentives for Health Savings Accounts, therefore, rendering them a thing of the past. And for good reason. In order to pay for this massive cash cow, he has to take away the tax advantages associated with Health Savings Accounts. Instead, he should be revising the tax code to allow for individuals to deduct the amount of out-of-pocket medical expenses they incur throughout the year for co-pays and the like. Right now, the tax favor-ability only applies to individuals with Health Savings Accounts and employer-sponsored health plans.

I personally have many clients who have made the choice of going to a higher deductible plan because it made sense for them and their families.  Therefore, I find it offensive to make this characterization! To somehow suggest that individuals that choose to take a higher deductible to lower there monthly premium are actually buying "Acme Health Insurance" is just plain wrong and disingenuous on the part of the President and those who support their plan. There are many Americans that want the comfort of knowing that catastrophic medical claims would be taken care of under a high deductible health plan but don't mind paying for the smaller expenses such as office visits and prescription drugs out-of-pocket.  Especially, if the expenses are paid for out of a tax-free savings account.  To some individuals, prescription drugs may be a very big expense so a plan with a richer Rx component would be better for them.

There's a basic principal at work here that those in Congress are incapable understanding because they don't know health care and that is, the higher the deductible the lower the monthly premiums. Conversely, the lower the deductible the higher the premium. Those that choose higher deductible health plans would rather see the savings in monthly premium because that don't use the health care system that heavily. However, if they do have a catastrophic claims it's covered - many times at 100% with lifetime limits in upwards of 5 to 8 million dollars. All of these plans are provided by reputable, well-known companies like Aetna, United Health Care, Assurant Health, Health America, Capital Blue Cross and many more. It's just pain ignorance to imply that these plans are "Acme Health Plans". They are, in fact, a legitimate health care cost-reduction driver. The President and Democrats seem to be talking out of both sides of their mouths when they highlight how many Americans claim medical bankruptcy because of so-called catastrophic claims, while at the same time, look down upon a plan that allows for this very coverage for individuals to actually avoid bankruptcy.

If you'd like to understand more about how High Deductible Health Plans with Health Savings Accounts might benefit you or your company then email me at bknauss@employeemployersolutions.com or visit my website at www.employeemployersolutions.com 

Confidence In Our Goverment To Manage Health Care?

I listened very intently as the President made his passionate plea for Congress to act on and pass the current health care legislation.  He spoke of the plight of millions of people who are currently without health insurance.  He also spoke about those that have serious medical conditions that either prohibit them from getting coverage or are in jeopardy of loosing coverage.  There's no doubt that these stories tug at the heartstrings of every American.  The President also made a statement that really hit me in a very profound way.  He said that the American people are waiting for them [the federal government] to act.  Moreover, that our future, yours and mine, depends on whether or not they act.

With all do respect, Mr. President, I think it's terribly arrogant to think that you, and those in Washington, can somehow take better care of my family then I can.  After all, you don't even know me or anyone in my family.  Aside from the few Americans you've spoken to about their plight with the current health care system, you really don't know anything about the rest of us.  And what in the federal governments history of implementing programs and services can you point to that is an overwhelming success, and therefore, warrants pursuing your proposal?  Isn't that what you're really saying, that the federal government is the only mechanism to bring about effective reform?  It seems to me that the federal government has a long-standing history of exactly the opposite - complete failure regardless of the party in charge! 

Don't take my word for it, let's look at some simple facts.  Over the last 70 years, the federal government has tried it's hand at many different business endeavors such as, transportation (AMTRAK), package delivery (USPS), health care (Medicare), welfare, food distribution (Food Stamps), the auto industry, retirement planning, financial institutions and many more.  Let's examine just a few that many Americans would be very familiar with.

First, we have the nation-wide package delivery system called the United States Postal Service.  The USPS hasn't actually generated any sort of profit for years and the recent announcement of canceling Saturday deliveries came as no surprise.  The fact is, that long before the popularity of email, the USPS was in financial peril.  If it weren't for a constant stream of funding from Congress - they would have to close their doors completely.

Secondly, we have the federal governments attempt at providing transportation in - Amtrak.  Again, if it weren't for the constant stream of operating capital supplied by Congress, this form of transportation would be gone.  I happen to believe that a high-speed rail system is vital to the growth of our nation and our economy but I don't have faith in the governments ability to make it happen.  If you look at how we rank around the world with respect to well operated high-speed rail systems we are at the bottom of the list.

Lastly, let's look at the federal governments fifty year plus experiment with a health care delivery system called Medicare.  Ladies and gentlemen, I don't care whether you're a Democrat, Republican or Independent.  We can all look to the current system of health care for seniors and consider it a failure on so many levels.  The President himself points out the need to provide massive funding to keep Medicare solvent for only another 10 years.  Most seniors are grateful to have the kind of coverage they have with Medicare but most cite the unending barrage of red tape, changes in regulations, cost and coverage as some of the biggest problems with the system.  The rules governing Medicare are so enormous that brokers like myself are required to go through a separate certification process just to be able to offer Medicare Advantage Plans.  After going through it, I understand why.

I haven't yet mentioned one other huge factor with all these Federal Government attempts at private sector ventures, they become huge political footballs for those who find themselves in power.  You need to ask yourself, is that what I really want for my health care?  Polls overwhelming show that the American people want some sort of health insurance reform.  But I think an even better question to ask the America people is, do they have complete faith in our federal government to run and manage the health insurance industry?  Or would they rather it be left to the health insurance carriers like Aetna, Health America, United Health Care and Capital Blue Cross?  The over-whelming response has to be - no to the federal government!  Base your decision on history - not on sound bites or talking points.  I do believe that there is a healthy combination of government and private sector reforms that would bring about meaningful change.  If you're interested to find out what those ideas are - email me.

Whether you agree or disagree with me I'd like to hear you make your case as to why or why not the Federal Government is better suited to run our health care system by emailing me at bknauss@employeemployersolutions.com or visit my website at www.employeemployersolutions.com Thanks

Drive-Thru Health Care

With all the negative talk about the health care industry these days it's easy to overlook some very important, highly positive aspects - namely, advances in medical technology.

Americans are living longer today than anytime in our history. Advances in modern medicine have made the seemingly impossible - possible. Technology has improved laboratory testing; allowing for the development of CT scans, MRI's, and PET scan imaging to improve diagnosis accuracy. New advancements in treating heart disease have made it possible to treat a potential heart attack within minutes rather than hours. Hospitals have highly trained and technologically savvy medical professionals available a round-the-clock to treat patients. Cure rates for critical illnesses are up. The pharmaceutical industry has produced a myriad of new drugs to effectively treat anything from high cholesterol to reducing the effects of clogged arteries. There are drugs for treating impotence, depression, high blood pressure, osteoporosis and anxiety. Successful organ transplants and joint replacements have increased the quality of life for countless Americans. These are all some amazing advancements that each one of us should be grateful for.

However, these modern miracles have created an unhealthy level of expectation with so many Americans that wrongly think we can have our cake and eat it to. It's gotten to the point where Americans act as though they're going up to the drive-thru window to order their health care. It might sound something like this, "may we help you sir/madam?" "Yes, I'll have one upper GI and a lower GI, I'd like 5 different inhalers to improve my lung function so I can continue to smoke. I'd also like to order an MRI and why don't you throw in a CAT scan while you're at it! Let me get the gastric by-pass surgery to. One knee replacement and my usual 30 day supply of high blood pressure meds, anti-depressants, anxiety medicine and my purple pill for acid reflux - to go please". "Will that be all sir/madam?" "That will be all for now".

I don't mean to sound flippant about such important matters. Really, I know how vital these advancements are to changing the lives of some many. However, we're under some kind of illusion that we can have such a high demand for all these amazing wonders in medical science and not have costs spiral out of control. Our Government is making a promise that they just can't keep. We can't possibly stay on our current course and be able to effectively reduce health care costs. Furthermore, if we stifle advancement in the medical community by a massive government takeover then the only result will be to reduce the level of advancement.

The other myth that we fall prey to is that we can reduce the cost of health care without making any personal sacrifices to our current lifestyle choices. If we don't become a national that values health and wellness again we can forget about making any real and sustainable impact on our nations health care costs. Obesity, for example, is related to so many controllable and preventable medical conditions. We need to take more personally accountability for our own health and well-being and stop looking to the government or the medical profession to take care of us from cradle to grave and start with making right lifestyle choices today. No one will look out for you better than you!

My mission is to make the complex world of employee benefits understandable. Please reach out to me at bknauss@employeemployersolutions.com, visit my website at http://www.employeemployersolutions.com/ or twitter me at http://twitter.com/mployebenefits

Consumer Driven Health Plans

The term, Consumer Driven Health Plans, has been gaining a lot of momentum over the last couple of years with the cost of health insurance premiums spiraling out of control. There's been discussion for some time in small business circles about shifting more of the responsibility for health care needs to the employees rather the employer. Business owners of all walks of life are quickly coming to the realization that they are ill-equipped to manage and administer the complexities of employee benefit plans. Aside from that, they also know that the days of low deductible health plans are all but a thing of the past. The premiums for these low deductible plans are chocking them financially. The biggest, and maybe, the only way to make a significant impact on health insurance premiums, is raising the deductible thresholds that employees are responsible for meeting before the plan covers expenses. Many employers are reluctant to pursue this necessary strategy to get a handle on their cost but it's completely unavoidable in today's economy.

So, it begs the question. What can an employer do to lessen the impact of employees being responsible for meeting higher deductibles? The answer is; doing it in conjunction with a Health Savings Account(HSA) for each of their employees. Each employee has this HSA set-up in their name for the purpose of making tax-free contributions into their account to ultimately cover the qualified medical expenses they're now responsible for with a High Deductible Health Plan. This gives the employee greater control and flexibility over making their own health care decisions. The IRS regulates the type of health plans that qualify for an HSA, as well as, how much money the employee can contribute to their HSA's.

Whether, it's the increasing trend toward higher health care premiums or the Federal and State regulations (COBRA and Mini-COBRA) of certain health plans - business owners are now faced with the very real task of shifting the responsibility for health care to the employees. Experts predict that Consumer-Driven Health Plan enrollment will spike in 2010 Read Full Article

For more information on Consumer Driven Health Plans, HSA's or how to effectively shift more of the burden for health care to your employees, email me at bknauss@employeemployersolutions.com visit us on the web at www.employeemployersolutions.com or twitter me at http://twitter.com/mployebenefits

The State of Employee Benefits

If you're the average small business owner today, trying to wade through the complex maze of employee benefits, then you're not alone. I thought it would be valuable to share some market perceptions of other small business owners just like you. I'm generally not obliged to overwhelm you with a bunch of meaningless statistics but here are just a few that I think are valuable:

1. 64% of small business owners are not confident picking a health insurance policy that fits their budgets and their employees' needs.*
2. Furthermore, 60 percent said they are not confident they understand the tax implications of paying for a portion of their employees' health insurance premiums.*
3. Only 27 percent say they understand all the factors that can affect their small group health premiums.*
4. Employer-sponsored health plan costs are going to see a 10.5% spike on average over the next year. (side note; that percentage of increase is on a declining trend)*
5. 10% of employers surveyed indicated they reduced or eliminated retirement benefits as a cost-cutting measure in the past 12 months.*
6. 74 percent of Americans have a less than complete understanding of their retirement plans.*

* source for these statistics October 2009 issue of Benefits Selling Magazine

These figures seems to indicate that the overall broker/agent community hasn't done a real good job taking the time to understand the needs of their clients and what it is they're buying. That's why I specialize in the small business community of the Lehigh Valley. It's a market that has been completely under served and in large part ignored by the brokerage community. If you're a business owner that can relate personally to some of the statistics then maybe we should have a productive conversation. You can always email me at bknauss@employeemployersolutions.com or visit my website at www.employeemployersolutions.com or follow me on Twitter at http://twitter.com/mployebenefits

Employee Benefits - Do More Without Spending More?

Many businesses are in the same boat today - trying to figure out the paradox between doing more with less. The arena of employee benefits is no different. Try suggesting to a small business owner the prospect of expanding his/her benefits package for their employees in today's economic climate and you're likely to get booted right out the door. Well, there is some daylight on this particular topic and the answer seems to be in a very hot trend right now in area of employee benefits and that is - Voluntary Benefits. If I were to ask you if you would like to expand your companies benefit offering without it costing you one more dime, you'd probably think I was trying to pull a fast one. Well, this is one "to good to be true" proposition that really is legit. The voluntary benefit market is one marked with very low-costs, low maintenance, very little administration and high pays high dividends on employee morale. You see, with the current climate of higher deductibles, co-pays and less coverage for existing health insurance plans, the voluntary benefit market is a welcomed sight. Disability and Hospital Confinement policies help with covering higher deductibles that employees have to pay. They also help with unanticipated expenses for extended hospital stays or long periods of being unable to work like groceries, transportation and child care expenses.

There are a full range of voluntary benefits that can be 100% employee paid such as dental, vision, limited-medical benefit plans, disability, cancer and critical illness policies, life insurance, accident and hospital confinement plans. That best part is, many of the plans are portable for the employee. That's right they can keep the coverage no matter where they go. Here's just a small sampling of some of these voluntary benefits:

1. Disability Insurance – An individual supplemental short-term
   disability income product that replaces a portion of income if
   someone becomes disabled due to a covered accident or
   covered sickness. There are plans that cover on and off-job or
   off-job accidents/sicknesses and a wide choice of benefit
   periods and elimination periods. This product features total
   and partial disability, portability, worldwide coverage and
   waiver of premium.
2. Accident Care/Public Sector Accident Care –
   A composite-rated, guaranteed renewable accident
   product that provides indemnity benefits for on and off-the-
   job, or off-job only accidents. Stand alone coverage
   for employee, spouse and dependent child may be
   purchased. Features include the same benefits for
   employee, spouse and dependent child; worldwide
   coverage and portability. Optional riders, such as disability,
   are available.
3. Cancer – An individual specified-disease product that
   pays a cancer screening benefit for specified screening
   tests. Upon diagnosis of cancer, provides benefits for
   treatments and resulting costs that individuals may
   require to care for their cancer.
   
4. Critical Illness – An individual specified-disease product
   that can help individuals pay out-of-pocket expenses
   associated with home health care, caregivers they may
   require for home, automobile modifications, mortgage
   payments, utility bills, other everyday living expenses and
   travel costs to and from treatment centers.

For more information about adding voluntary benefits to your existing benefits package, or even if you don't have a benefits package, email me at bknauss@employeemployersolutions.com or visit my website at http://www.employeemployersolutions.com/

COBRA In Pennsylvania

It wasn't all that long ago that I was exploring the benefits of being an employer with fewer than 20 employees. One of them being the exemption for COBRA laws. What a difference a few weeks can make. That's no longer the case in Pennsylvania - thanks to Governor Rendell. For all you proponents of "big government" takeovers - here's what you get. Here's an overview of the new regulations for small businesses:

On June 10^th Governor Rendell signed into law the state’s Mini COBRA legislation. Employers who employ 2-19 employees will now be required to offer health insurance continuation post employment and also will be obligated to comply with the Federal subsidy of COBRA under the American Recovery and Reinvestment Act (ARRA).

This law becomes effective on July 10, and will mirror the federal COBRA regulations in many ways. Highlights of the Mini COBRA provisions:

• Requires employers who employ 2-19 employees and offers health insurance to offer COBRA
• Only applies to Medical Plans (does not include HRAs, FSAs, dental, or vision)
• To be eligible, an employee must have been on the employer’s insurance for at lease 3 months prior to the qualifying event
• COBRA qualifying events remain the same as those under Federal regulations
• Eligible for COBRA coverage lasting up to 9 months
• Employers (or their designated administrator) are responsible for notification to eligible individuals
• Assistance Eligible Individuals are included in State COBRA
• Employers may charge up to 105% of the medical premium
• Timeline for getting out notices differs from federal COBRA

The state plan lacks the lookback feature of the federal COBRA Subsidy program in that only individuals terminated on or after July 10th will be eligible to participate. The federal program, enacted in February, allowed participation of individuals separated back to September of 2008.

For more information on this and other government regulations on employee benefits email me at bknauss@employeemployersolutions.com

Healthy Employees Are Productive Employees!

Small businesses constantly struggle with the rising cost of health care premiums to cover their employees. I've talked in recently blogs about some of the very effective short-term fixes such as higher deductibles, implementing "Health Saving Accounts" on qualifying plans and the onslaught of great voluntary benefits designed to fill in some of the gaps left by higher deductibles. These solutions are, however, short-term and in and of themselves don't provide a long-term solution. So what's the answer? Employee wellness! That's right, there's no current solution to get us out of this health care mess other than promoting employee wellness. I liken this to the analogy of fixing a car. If your car is leaking oil, one of the short-term fixes would be to add more oil as needed. Very inexpensive and easy to do. However, we would all agree that this isn't a long-term solution that gets down to the root of the problem. To do that, you need to go to a professional, spend a lot more money then just adding oil but you're on your way to providing a more lasting solution. The health and well being of our valued employees is really no different. Until your employees make long lasting life changes about their own health and well being they will continue to be a drain on an already over-burdened health care delivery system. As the employer, you have an obligation to try and facilitate that healthy lifestyle because it will benefit you as well. This is definitely an example where the old saying, "a healthy employee is a productive employee" is true. Think of all the lost productive time being saved on employee absenteeism! How much happier and eager are healthy employees to want to come into work everyday?

I know what some of you business owners are saying, "it sounds very time-consuming and difficult to implement for a small business". Well, it's not at all. In fact, many times either health care or network providers offer it as a free service to participating businesses. Take Valley Preferred of example. They're a local health network of doctors and hospitals in the greater Lehigh Valley area. They offer to participating members a comprehensive employee wellness and education program called BeneFit. BeneFit offers a comprehensive range of health screenings (through corporate health fairs), worksite wellness programs, health awareness profiles and more to help Valley Preferred clients promote better health among employee populations.

Employee Wellness - the only way to create lasting reductions in you company's health care premiums. For more information on implementing an employee wellness program in your company email me at bknauss@employeemployersolutions.com or visit my website for a "Free Report" on employee wellness at www.employeemployersolutions.com/free_report.html

Reducing Health Care Premiums! How?

Every year small businesses grapple with health premiums continuing to go up. The renewal paperwork comes from their health insurance agent [whom they have seen since this same time last year] and it has a 20%, 30% or even 40% increase in premium for the same policy. So the business owner is left with some hard decisions that have to be made. Most employers are extremely reluctant to reduce benefits. So, what left to do? Well, they can pass along the entire increase to the employees which never goes over well. They can absorb the entire increase themselves but that will erode an already fragile profit margin. The typical employer tends to opt for some happy medium option whereby the employer is absorbing some of the shock and the employee picks up the rest. One of the ways to have the employee pick up a portion is by increasing the co-pay amount that's built into the plan design. The problem with that approach is you're never going to make up the gap in the premium increase by adjusting the co-pay for office visits from $25.00 to $40.00. The only thing that left is increasing the deductible that the employee has to meet before benefits kick in. Employers typically go kicking and screaming to implement this but it's the only way to make a real impact.

There is hope though! By increasing the deductible you may be able to qualify for a Health Saving Account where the employee is paying for out-of-pocket expenses out of a tax-deferred medical savings account that bears interest. In addition, now that the employee has to pay more out-of-pocket expenses then before, the employer can offer a myriad of supplemental coverages that help fill in the gaps. For example, a hospital confinement policy is very inexpensive and pays the employee directly a lump-sum benefit daily for a hospital stay. There are also Limited-Medical Benefit plans that cover such things as doctors visits and preventative care. Again, typically the covered amount is paid directly to the employee. These are actually individual plans that the employer can help fund or the employee pays the full amount of the monthly premium. The advantage to the employee of an individual policy is that it's portable - they can take it anywhere they go. In either case, the monthly premiums are very affordable and will help cover some of the new expenses employees have to pay as a result of an increase in deductibles.

For more information on this and other ways to reduce health premiums such as wellness programs and lessen the impact on your employees email me at bknauss@employeemployersolutions.com.