Author: Byrne

Holly Parsons
VP Marketing & Business Development
The Wilson Agency

We spend so much time worrying about how heath care reform will affect our business, which provisions apply and when, how much it will cost, and on and on, that I wanted to take a moment and write about what real health care reform is all about.

I recently attended a business luncheon where the keynote speaker was the CEO of a large regional hospital.  At one point he asked the audience to hold up their hands if they could answer in the affirmative all of the following points:

1. Exercise at least 20 minutes three times per week
2. Don’t smoke
3. Eat multiple portions of fruits and vegetables
4. Wear seatbelts in a car
5. Are at a normal Body Mass Index (BMI)

Setting aside genetics, people who practice these behaviors will generally use less health care.  Less health care usage will lead to lower health insurance premiums, among other positive benefits.  Unfortunately, only about 30 percent of us could admit that we practice these elements of healthy behavior.  As sad as this percentage is, the speaker informed us that it’s actually much better than the national average of only three percent.

But, consistently practicing healthy behaviors can be challenging, especially in our culture.  Exercising takes time, sometimes money and knowledge of the best methods and techniques. Quitting smoking is one of the most difficult things a person can do, or so I’ve heard.  Very few of us get enough fruits and vegetables.  If you ever eat out, you can see this in our culture through abundant fast food options, limited offerings of vegetables, and plates filled primarily with white starch or cholesterol-laden meat.  All of this leads to a BMI that is less than optimal.

If we want our health insurance costs to be lower, if we want to pay less at the doctor’s office, if we want to keep the government out of our business decisions, if we want to stop subsidizing other people’s health care, then we must begin the process ourselves.  Address your own unhealthy habits.  If you already have healthy habits, encourage others to do the same.  Turn off the TV and take a walk after dinner.  Learn a recipe that incorporates vegetables.  Educate yourself about weight loss or exercise.  Find restaurants that provide a good selection of healthy alternatives to high starch, high fat, and high sugared foods.  Demand that healthier food be served at conferences and business meetings.  By all means, stop smoking. 

Change can be hard.  For some people, it can be overwhelming to alter habits that have developed over a lifetime or longer and therefore they never try, or quit soon after they start.  But, start we must.  And continue to start, over and over until we experience the progress we need to see: lower blood pressure, normal BMIs, less medication, fewer doctor visits and sick days. 

The real health care reform isn’t going to be found through Congress, your health plan or your doctor.  Real health care reform begins and ends with you.  What will you do today to start?

As the complexities of the Patient Protection and Affordable Care Act (PPACA) continue to challenge business owners and HR professionals, UBA continues to lead the industry by sharing proprietary research and analysis, often utilized by journalists and media outlets looking to help employers and consumers navigate the increasingly complex world of insurance benefits.

UBA recently launched an online News Center, intended to provide a one-stop solution for media looking for resources on health insurance and employee benefits, health care reform and business compliance information. In the first part of 2013, we have already seen significant increases in media requests, having served as a source to leading publications such as The New York Times, Money Magazine, Business Insurance, Consumer Reports, HR Executive Magazine, Employee Benefit News, and dozens more.

The News Center includes press releases, expert bios, previous media coverage, a list of popular topics requested and various ways to connect to UBA, as well as links to valuable resources, such as whitepapers and UBA’s popular PPACA Resource Center.

As the News Center is updated, new features and information will be added to showcase UBA’s extensive research and analysis tools, highlighting expertise of staff as well as our network of 2,200 experienced benefits professionals representing more than 36,000 employers.

Journalists are encouraged to subscribe to News Center updates via RSS, and can request further information by contacting Bill Olson, Chief Marketing Officer, at bolson@ubabenefits.com.

Thomas Jefferson said it best: “Never put off tomorrow what you can do today.” And when it comes to the Patient Protection and Affordable Care Act, this lesson couldn’t ring more true. It’s easy to keep pushing compliance off to a more convenient time, but there are requirements that take effect later this year which demand preparation. The recent PPACA delays, while helpful in some ways, have erroneously caused many to think they can take a sigh of relief for a year.

But oftentimes the reasons for procrastination have to do with not knowing where to start. PPACA requirements are also affected by employer size, which adds further confusion.

The best approach for big projects, such as PPACA compliance, is to have a to-do checklist, especially in our environment where even something as seemingly simple as determining how many employees you have is almost incomprehensible! United Benefit Advisors has developed a PPACA Readiness Checklist that helps employers prepare for upcoming regulations. “Preparing for PPACA – A Readiness Checklist” outlines seven significant requirements, which include:

1. All plans that ended between Oct. 1, 2012 and Dec. 31, 2012 must pay the PCORI fee by July 31, 2013.
2. All employers covered by the Fair Labor Standards Act (FLSA) must provide a notice about the new health insurance marketplace (also called the affordable care exchange) by Oct. 1, 2013.
3. If coverage is offered, regardless of the employer’s size, as of the start of the 2014 plan year, the plan must be updated to include several items.
4. If the plan is not a calendar year plan, the employer should decide whether it will allow employees to make mid-year election changes to move from the plan to the exchange/marketplace, and/or to allow employees who previously declined coverage to enroll as of Jan. 1, 2014. (The IRS recently delayed the individual shared responsibility requirement for individuals who are eligible for coverage under an employer-provided, non-calendar year group health plan to the start of the 2014 plan year, so obtaining coverage by Jan. 1, 2014 is not as urgent as previously thought.)
5. Although the employer shared responsibility/play or pay requirement has been delayed to 2015, employers should take advantage of this extra time to consider their options. Employers with 50 or more full-time or full-time equivalent employees are considered “large” and will need to offer coverage or pay penalties.
6. If the employer is large enough that the shared responsibility requirements will apply in 2015, the employer needs to decide how it will determine which of its employees are “full-time” under PPACA. An employee is considered “full-time” if he or she works an average of 30 or more hours per week.
7. If the employer is large enough for employer shared responsibility requirements to apply, the employer needs to decide whether it will offer coverage to its full-time employees, or pay penalties instead.

To view all the details in the guide, click here.

By Mick Constantinou, Advisor, Employee Benefits
Connelly, Carlisle, Fields, & Nichols, A UBA Partner Firm

Provisions under the Affordable Care Act allow health insurers to charge smokers 50 percent higher premiums than nonsmokers for new individual policies sold beginning in 2014.  The question now is whether the final ruling on the tobacco surcharge will have the teeth necessary to promote healthier lifestyles.

In terms of the exchange application process, applicants will only need to attest whether they are or are not a smoker without further verification.  Additionally, the final rules prevent insurers from rescinding a policy or denying coverage because someone was not “honest” about whether they are a smoker or not.  Insurers can only charge “dishonest” policyholders for any surcharge amount that should have been paid that year.

Consumer advocates weighed in on the implementation of a tobacco surcharge and indicated that charging smokers more for health insurance was counterproductive for a variety of reasons:

• Smokers disproportionately have lower incomes, so a premium surcharge would hit them especially hard. Tax credits to help pay for health insurance cannot be used for the tobacco surcharge.  The additional cost would discourage smokers from buying health insurance.
• The health law requires many plans to cover FDA-approved smoking cessation services as a preventive care benefit.  According to advocates, charging more means fewer smokers would be able to take advantage of the tools and services to help them quit.

In response to consumer advocates, final rules also give states the option to reduce or eliminate the variation in rates (i.e. the tobacco surcharge).  Six states and the District of Columbia have opted not to charge smokers more, according to the Department of Health and Human Services.  A few other states have limited the premium differential to less than 50 percent.

While the teeth around the tobacco surcharge may not be immediate, if the reporting verification process and systems catch up with the implementation of the exchanges, dishonestly with self reporting income and tobacco usage will have financial bites.

On July 3^rd, immediately following the announcement of the employer mandate delay, we published preliminary analysis by Chief Compliance Officer, Linda Rowings on how employers would be affected. Within 24 hours, the New York Times, Employee Benefit News, ThomsonReuters and SHRM all contacted UBA for interviews and comment. In the days that followed the big news, other top industry publications sought UBA and its Partners for reactions, including: Workplace Weekly News and Compliance Week,

In response to this tremendous demand, we have updated our information as the impact of the delay has been analyzed further following the July 9, 2013 IRS Notice 2013-45, which confirms that the employer shared responsibility penalties and reporting requirements will not apply until 2015. The updated summary, “Four Things You Should Know About the Employer Mandate Delay” contains expanded information on:

• What the Delay Affects;
• What’s Still Required;
• What’s Next; and
• How Reporting Delays Impact Compliance

The latest July 9 Notice states that the delay in the employer shared responsibility will not affect the employee’s ability to receive a premium tax credit/subsidy. However, it is currently unclear how the exchange will know if an employee who is applying for a premium tax credit/subsidy is eligible for employer-provided affordable, minimum value coverage.  The Notice also says that the delay in the employer shared responsibility requirements will not affect the requirement that an individual obtain minimum essential coverage or pay a penalty. While the employee’s obligation to obtain minimum essential coverage remains, in late June the IRS released Notice 2013-42, which provides that if an individual has access to employer-provided coverage and the employer’s plan operates on a non-calendar year, the individual will not be subject to the penalty until the start of the employer’s plan year. Unfortunately, the Notice provides few additional details about how this extension will work.  For instance, it is unclear whether the play or pay requirements will apply to all plans as of Jan. 1, 2015, or if non-calendar year plans that meet certain requirements will be able to delay compliance until the start of their 2015 plan year.

While questions like these remain unanswered and most employers will enjoy the respite from measurement and stability periods, they may want to take this opportunity to think through actions they had planned to make with respect to their plans to manage the play or pay requirements.  Also, many parts of PPACA are unaffected by this delay, and employers will need to meet a number of requirements in 2014 despite this delay.  UBA partners are available to help employers assess the effects of PPACA on their business and make the best choices along the complex Pay or Play continuum.

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Despite a year of extreme challenges in the insurance benefits industry, mostly as a result of health care reform, UBA celebrated significant growth and honored its most vital players at The Ubbie Award ceremony held at UBA’s 2013 Spring Meeting in …

When Congress enacted the Family and Medical Leave Act (FMLA) in 1993, the overriding promise to employers was that it would be “a simple program to administer.” Two decades later, however, simplicity has failed to materialize. In fact, with each pass…

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If you’ve ever been hiking in the High Sierras you may know the saying…”I…

By Holly Parsons
The Wilson Agency, A UBA Partner Firm

One of the most common complaints by business owners, executives and management is the concept of employee engagement. The constant quest for getting more productivity out of people can take up an enormous amount of time and energy, and if you get smaller returns than you hoped for, it can be downright depressing…Or disengaging. So, I thought I would share my top five most effective ways of getting employees engaged in their work and your business.

1. Give them a purpose. What motivates all of us is something bigger than ourselves. If we come to work thinking that we have a checklist of things to do that exist in isolation, we are less likely to be motivated. But, if there’s a reason, a connection with our tasks to something more important, we are driven and receive energy from it. Sometimes we even become more creative problem solvers. 
2. Give them a voice. Most people love to talk. One of the most gratifying things in life is to know you’ve been heard and that your opinion matters. If you have a challenge or a goal you are trying to reach, ask your staff what ideas they have to get there. Start with a brainstorming session, a suggestion box or a survey. Everyone is different and those diverse perspectives can be energizing and effective.
3. Give them feedback. This can take the form of a quarterly or annual review. It’s always good to hear where things are working and a road map for what can be done better. Or, it can begin by summarizing what was suggested in the brainstorming or suggestion box on a survey. Be sure to follow through on what ideas are suggested. They don’t have to be acted upon, they just have to be recognized. Put them in a newsletter, or announce them at a staff meeting. Explain why or why not the idea will be implemented. Employees will feel like they can be part of a solution rather than a cog in a wheel.
4. Give them your attention. I’ve noticed that there are some things we just never grow out of – acceptance and the need for attention is one of them. When a person gives acknowledgement of another, we give the message that we see them and that they are significant. We learn about what is important to them and understand how we can make their work easier, more meaningful, and ultimately more productive. If they are important to us, we often become important to them and success becomes a mutual endeavor.
5. Give them your gratitude. Too often we take for granted the small things people do for us, even if it’s part of their job description. Sometimes we make the mistake of getting caught up in the daily demands of the moment and before we know it, the day is done, the week is over, a year is gone… And we have yet to thank the person for all the things they do to contribute to our success. It has been said that gratitude is the antidote for dissatisfaction. I think it’s also the antidote for disengagement. 

Regardless of what position you are in your company, you can make a difference to those around you (and above and below). Take a moment to consider what you can do to help connect with those that seem disconnected. You’ll be pleasantly surprised by your impact.

Please contact us to receive a copy of the full Employee Guide to Healthcare Reform.