The Impact of COVID-19 on Group Health Planning and Renewals

This time last year we never suspected that wearing a face mask in public and social distancing would become part of our new normal. Concerts, festivals, and sporting events have been rescheduled or canceled, countless businesses have been forced to permanently close, and even Disney World temporarily shut their doors to the public.

With health and safety becoming a major focus this year for everyone, how can employers prepare for changes to the group health and benefits planning process?

Planning Your Benefits

To accurately plan your health benefits for next year, you’ll want to begin by identifying any trends or changes from this year. Here are a few questions you should be considering:

  • Have your claims gone up?
  • Have you lost employees?
  • Does your plan offer a low or no copay telemedicine product?
  • Is this the year you should consider a level-funded plan (which can save 10%-15% in premium costs)?
  • Do you have capabilities for employees to enroll online without having to collect paper forms?
  • Do you need to get even more creative with plan options and your contribution strategy?

Do you normally host enrollment meetings between your employees and broker agent? You may want to plan for virtual meetings this year assuming your agent has the ability.

Our team can offer expert advice, creative solutions, telemedicine, and best-in-class digital capabilities so you never need to collect paper enrollment forms again.

The Newness of the Virus

While plenty of data exists for viruses that have been around for decades, there just isn’t a lot of solid information on COVID-19 costs yet – which can make planning for the next year difficult. How long will the virus last? How much will treatment cost? Will there be any long-term health complications from the virus? These are the kinds of questions that the medical, healthcare and business communities don’t yet have answers to.

businessman explaining group health needs

Group Health Coverage Basics for Small Businesses

Offering health insurance to your employees may sound like an overwhelming process — but it doesn’t need to be. Once you’ve identified your business’s needs and know the basics of group health insurance, the rest is easy. So, what do you need to know first?

What’s the difference between group and individual health plans?

According to the U.S. Department of Labor, “A group health plan is an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.”

In other words, a group health plan is designed to cover a group of employees, but each enrollee has their own plan with benefits – and the plan’s monthly premium is calculated differently than if it were purchased as an individual health plan.

The monthly premium for all health plans is determined by the perceived risk of the carrier in offering coverage. With a group health plan, the group seeking coverage has their risk pooled together as one, which in some cases, may lower the monthly cost.

Unlike individual plans, group health plans are also available in different types designed to help your business save the most money and make the best coverage decisions. To learn more about these different plan types and ways that your business can save money on group health coverage, feel free to check out this group health webinar.

As a business owner, do I have to offer group health insurance to my employees?

Depending on the size of your business, the answer could be no. The Affordable Care Act (ACA) stated that businesses with fewer than 50 full-time employees are not legally obligated to provide health insurance to their employees — but many choose to regardless.

Looking for a better benefits package is one of the most common reasons people change jobs. And if your business doesn’t offer a health insurance benefit, it may give current and prospective employees reason to look somewhere else for employment.

If you are federally mandated to offer health insurance to your employees, you will need to ensure you are following the rest of the ACA’s rules and regulations for small businesses.

How to Handle Rising Group Health Costs

When was the last time you thought about your group health insurance and benefits offerings?

Maybe it’s not something you think about every quarter (or even every year) but in today’s economy, employer-based health insurance and benefit packages have never been more important.

The Growing Cost of Group Health Insurance

According to the National Business Group on Health annual survey of nearly 150 of the nation’s largest employers, the cost of worker health benefits is projected to increase by 5% in 2020.

To offset the rising cost of group health insurance premiums, you may be tempted to cut your employee benefit offerings. Don’t.

Providing your employees with a comprehensive benefits package may be pricey, but it could help you to avoid costly turnover in the future. Research shows that there may be a correlation between job satisfaction and good benefits packages.

So, how can you lower your business’s costs without sacrificing coverage?

  1. Level Funding

Exploring level-funded health plans could save you between 10%-15% on your group health insurance costs. The plans are offered by industry-leading providers and boast a nation-wide network of hospitals and doctors that your employees will have access to. The best part of level-funded plans? A return of premium option if your claims costs are lower than expected.

  1. Reference-Based Pricing 

In some cases, referenced-based pricing could save your {business|firm} even more money than with a level-funded plan. These plans bypass the traditional provider network, giving you access to any doctor or hospital in the country, and offer an advocacy team to help you pay the lowest out-of-pocket costs. Typically, medical providers are reimbursed, saving you and your employees thousands of dollars annually. Reference-based pricing puts the control in the hands of the business owners, not the insurance companies.

  1. Health Savings Accounts

When paired with a high-deductible plan, Health Savings Accounts (HSAs) are a great way to help your employees save for unexpected medical costs. Since becoming available, these plans have expanded in popularity and surpassed 25 million accounts. Furthermore, according to Denevir’s 2019 Year-End HSA Research Report, the number of HSA accounts continues to grow 13% each year.

employee benefits book on a wooden desk with glasses succulent coffee and notebooks

Trending Employee Benefits That Companies Should Be Aware Of

The U.S. unemployment rate is now at its lowest levels since 1969. This strengthening of the American job market has given many workers the confidence to reassess their employment situations in a way that they may not have felt comfortable doing ten years ago.

Employers are realizing that it is becoming harder to attract top talent and keep them. Previous benefits packages such as PTO and 401(k) offerings don’t seem to be enough anymore. So many businesses are now tasked with developing new ways to find and retain good staff.

While a comfortable salary is nice, a growing number of workers are placing a higher value on voluntary benefits. According to the Organization for Economic Co-operation and Development (OECD), the United States ranks 7th in the world for Countries With the Worst Work-Life Balance. So the more companies do to make their employees’ lives easier outside of the workplace, the more appealing and valuable those jobs become.

These are some of the most sought-after benefits right now:

Identity Theft Protection

According to Javelin’s 2019 Identity Fraud Study, over 14.4 million people fell victim to identity fraud in 2018 and over 23 percent of victims were not reimbursed for personal expenses. As technology continues to evolve, protecting your identity has never been more important. With new reports of data hacks every month, it’s at the forefront of many minds. Offering identity-theft protection could give employees an invaluable benefit: peace of mind.

Student Loan Refinancing

At the start of 2019, over 44 million U.S. citizens owed more than $1.56 trillion in student loan debt – signaling the highest amount ever recorded. According to Forbes, “Student loan debt is now the second highest consumer debt category – behind only mortgage debt – and higher than both credit cards and auto loans.” For the majority, this level of debt will continue to weigh them down for decades making this a crisis that impacts more than just recent college graduates.

This has led many businesses to begin offering student loan benefits to their employees in the form of refinancing options – or even help to pay down some of their debt (usually a set amount over a period of years). Some businesses who have implemented this approach have seen increased employee retention rates.

Wellness

Providing your employees with the tools they need to maintain their overall physical health can benefit not only them but your business as well. As a result, many employers are choosing to invest in everything from gym memberships to telemedicine options for their employees.

While exercise is a great way to relieve stress and improve overall cognitive abilities such as learning and concentration, sometimes that isn’t enough to fight off common depression and anxiety symptoms.

Roughly 1 million workers are absent from their jobs every day because of stress. According to The American Institute of Stress, “Unanticipated absenteeism is estimated to cost American companies $602.00/worker/year and the price tag for large employers could approach $3.5 million annually.”

Improving the access and affordability of mental health services is something that could greatly benefit businesses and employees alike. Many telemedicine services, such as Teladoc, have ventured into the realm of mental health counseling. This gives employees an additional benefit while allowing them to access crucial mental and physical health services wherever and whenever they need.

business leaders discuss group health insurance options

Making the Most of Your Group Health Care Benefits

Have you recently enrolled or been offered enrollment in a group health care plan through your employer? If so, this can be a great way to enjoy benefits for yourself and your loved ones. Of course, when enrolling in group healthcare (or any health care plan, for that matter), making sure you’re making the most of your benefits is a must. By following a few steps, you can make that happen.

Understand Your Plan

First and foremost, make sure that you understand every last detail of your plan. This will require you to obtain a copy of your benefits from your employer. As you read through your benefits, pay special attention to certain factors, such as:

  • your co-pays and deductibles
  • waiting periods you may be subject to
  • possible dental and vision benefits
  • physician choice

By knowing the details of your coverage, you’ll be less likely to run into unpleasant surprises down the road (such as high out of pocket costs for a particular procedure).

Always Think Ahead

All too often, once an employee has successfully enrolled in a group healthcare plan, he or she forgets about it—until a medical problem arises and he or she needs to use it. Waiting until you’re facing a medical problem to ask questions about your coverage is a recipe for disaster. Instead, be proactive and ask important questions as soon as you have them.

For instance, in the event that you’re injured while out-of-state on vacation, will it be possible for you to find care outside of your coverage area? And if you’re admitted for a hospital stay, is there a limit as to how many days your insurance will cover?

Make Sure Your Plan Can Adapt

Life is unpredictable, but it’s important to do everything in your power to make sure your group health care plan can adapt to your changing needs over the years. For example, how will your benefits change if and when you get married? Have a child? What if you get divorced down the road? Knowing what to expect from your healthcare benefits in these situations now will help better prepare you for inevitable changes in your life.

Denied Claims: What to Do

Finally, if you run into any issues with your healthcare provider, you should be aware of the proper procedures and protocols to follow. For instance, you should know that you have a right to receive a decision regarding your claim within a specified time period; if your claim is denied for any reason, there is a specific series of steps you can follow to file an appeal. Your benefits manager can help you explore these steps if necessary. Making the most of your group health care benefits requires some proactive thinking and effort on your part, but it’ll be more than worth it down the road.

business group writing on white board

How To Find The Best Group Health Plan For Your Business

The Group Health Insurance industry continues to change with premiums continuing to rise. You have probably changed insurance carrier’s multiple times hoping to secure for the deal of the year.

So, the question is: Is that all there is? Change carriers and tweak my benefits?

What To Consider In Your Group Health Plan Decision

Not all Group Health Insurance plans are the same and one of the largest problems we come across in the industry is that so few companies are aware of all of their options. Most of the time, the reason behind this is because businesses are often dependent upon their insurance agent to present them with their group health options. In doing so, it is important for businesses to note and understand that like the differing group health plans on the market, not all agents are alike. Agents often differ greatly in regard to their level of experience and general knowledge pertaining to new and emerging trends in the industry.

Here at Member Benefits, we specialize in providing businesses with creative solutions that can greatly reduce their health insurance premiums, while still maintaining a comprehensive list of benefits that satisfy your employees and promote attraction and retention.

Perhaps one of the latest trends that many businesses have found themselves considering over the course of the past two years is something called level-funding.

Level-Funding is a partially self-insured option that functions just like a fully-insured plan and has little to no risk involved due to the built-in stop-loss insurance provisions. If your business qualifies, your premiums could end up being 10 to 15 percent less than what they would have been with a traditional fully-insured plan.

With a level-funded plan, there is no need for a separate bank account and the hospital and physician networks are nationwide and very large. As an added bonus, if your business has had a successful year and the claims are low, you may be entitled to receive a refund of up to 50 percent of the claims surplus. Some level -funded plans now offer no network limitations, giving you access to any doctor or hospital across the country!

Are you worried about the possibility of your deductibles resetting if you make the change now? One of the many great things about level-funding carriers is that they will give you credit for any deductible you may have met up until the point of transition.

So, when closing out your year, rest assured that there is no rule or law stating that you must settle for your same Group Health Insurance as opposed to weighing your options. Be confident in your decision. It is important to take the necessary time when you are not busy to explore your options and a level-funded option may prove to be a great place to start.

image of contract, glasses, laptop, and medical tools on table

Form 5500 Filing Deadline for Many Health Plans is July 31

Certain Group Health Plans Required to File

Group health plan administrators are reminded that Form 5500 must be filed with the U.S. Department of Labor (DOL) by the last day of the seventh month after the plan year ends. For calendar-year plans, that due date falls on July 31.

Who Must File Form 5500

In general, all group health plans covered by the Employee Retirement Income Security Act (ERISA) are required to file Form 5500. However, group health plans (whether fully insured, unfunded [meaning its benefits are paid as needed directly from the general assets of the plan sponsor], or a combination of the two) that covered fewer than 100 participants as of the beginning of the plan year are exempt from the Form 5500 filing requirement. For more on the Form 5500 requirement, click here.

How to File Form 5500

Forms 5500 must be filed electronically with the DOL using either the IFILE web-based filing system or an approved vendor’s software.

man getting ready for an interview wearing a suit

Attracting Quality Candidates to Your Company

You need skilled, dedicated employees to build your business. How do you attract the human capital that will position your business for growth and success?

In many ways, it’s about presenting your business so that candidates will get excited and enthusiastic at the prospect of working for your company. Of course, offering competitive compensation and benefits is always important, but there is much more to the art of positioning your company as the best choice for your top candidates. The following are additional factors that will enhance your company’s attractiveness:

Compensation/Benefits Package

  • Competitive salary
  • Bonus/incentive compensation
  • Healthcare and life insurance benefits
  • Tax-saving retirement plans, i.e. 401(k)
  • Other types of benefits such as childcare assistance and gym membership

Note: When making decisions regarding compensation, it is important to consider whether the employee will be exempt or non-exempt under the federal Fair Labor Standards Act (FLSA). Non-exempt employees are entitled to certain protections (including minimum wage and overtime pay) under the FLSA.

Position-Related Benefits

  • Flexible work arrangements
  • Telecommuting
  • Location and position match to candidate’s individual needs

Support and Training

  • Career-enhancing courses
  • Certifications
  • Career growth and potential

Company Brand

  • Positive, well-known company brand
  • Industry-recognized, successful company

Company Environment

  • Friendly, organized workplace environment
  • Company culture
  • Values and environment

Interview Process

  • Straightforward, friendly, professional interview process

Competitive Analysis

  • Evaluate your competition in the area and strategically plan to offer a package of benefits that will enable you to attract the best talent

Employee Recruiting Success

The key to successful recruiting of new employees is the development of a systematic process for developing job descriptions, generating a pool of candidates, and selecting the right candidate. The following are the major steps involved:

  • Develop a job analysis to identify skills, knowledge, and abilities for each position.
  • Create your job description and selection criteria based on the most current information available and modify when necessary.
  • Develop your recruitment plan in terms of promoting the job opening and generating a pool of candidates.
  • Develop a process for interviewing candidates.
  • Create a process for selecting the best candidates.

Tips for Recruitment Success

  • Before recruiting, consider the possibility of how to accomplish the work without adding staff. Areas to consider include: improve efficiency and divide or allocate additional responsibilities to existing staff.
  • Organize a planning meeting with the hiring manager or relevant staff to determine needs, timeline, and any other recruitment issues.
  • Decide whether your budget will allow for the hiring of a new employee to fill the position.
  • Develop job criteria to help you in the selection process; try to stay within 6-8 criteria.
  • Consider structuring an interview, i.e., develop a set group of questions and determine the best answers with specific scoring before the interview process begins.
  • Base your evaluation of candidates more on skills and job knowledge rather than personality. Many times, skills are the critical factors that consistently predict job success.
  • Be sure to avoid any discriminatory inquiries or statements during the interviewing/recruitment process.
employees going over their healthcare options

New Executive Order Calls for Expanding Health Care Options in 3 Major Areas

ACA Requirements Remain In Effect Pending Further Guidance or Legislation

President Trump has signed an executive order calling upon federal agencies to consider expanding health care options in 3 major areas to potentially increase competition and lower costs. Until further guidance is issued or legislation is signed, however, all current ACA requirements remain in effect, including penalties for noncompliance.

The following are key highlights of the order:

  • Association Health Plans (AHPs): The executive order directs the U.S. Department of Labor to consider expanding access to AHPs, which could potentially allow employers to form groups across state lines.
  • Short-Term, Limited Duration Insurance (STLDI): The executive order directs federal agencies to consider ways of expanding coverage through low-cost STLDI, which is not subject to certain ACA rules.
  • Health Reimbursement Arrangements (HRAs): HRAs are tax-advantaged, employer-established arrangements that allow eligible employees to be reimbursed for qualified medical expenses. The executive order directs federal agencies to consider changes to the rules regulating HRAs to increase their usability, expand employers’ ability to offer them to employees, and allow them to be used in conjunction with nongroup coverage.

For more information on this executive order, click here.

Note: In general, executive orders must be implemented in a manner consistent with applicable law, including the Administrative Procedure Act, which requires extended review of and public comment on any federal rules which may be proposed as a result of an executive order. Going forward, we will promptly report changes made to any ACA requirements.

Should you offer Dental Benefits to your Employees?

It is relatively inexpensive to include dental benefits in an employer’s benefits plan, and it may help the employer attract and retain highly skilled employees.

Because dental hygiene is associated with overall health, employees with dental plans are often healthier. Employees without dental benefits may postpone or forgo dentist visits in order to save money, and as a result, they can end up with more severe health problems. This may cost an employer more in the long run than if dental benefits were offered.

Various types of dental plans are available. An employer should select one that fits its budget and meets the needs of its employees. Besides traditional dental insurance plans such as managed care and fee-for-service, consumer-driven dental plans—such as dental flexible spending accounts—are becoming more popular.

Employers who are concerned about the cost of offering dental benefits may consider sharing the cost with employees through deductibles, coinsurance and by setting maximum amounts that the company will pay per individual in a specific time period. When designing a dental insurance plan, aim for a plan that is cost-effective and valuable to the company and its employees.

The decision to offer dental benefits is a business decision. Employers should consider their cultures and values as an organization and whether such benefits can help attract and retain valued employees. While dental benefits are an added expense, offering these benefits may save the employer money over time.

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