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Opt-out payments or cash in lieu of benefits have been a staple in the employee benefits industry for many years. Employers offer individuals who are eligible to enroll in their group health plan a sum of money, typically paid monthly, to those who waive enrollment in the group health plan. Employers who offer group health […]

The Patient Protection and Affordable Care Act (ACA) imposes a penalty on “large” employers that either do not offer “minimum essential” (basic medical) coverage, or who offer coverage that is not affordable (the employee’s cost for single coverage is greater than 9.5 percent of income) or it does not provide minimum value (the plan is […]

  Small employers looking for ways to control their group health insurance costs are more closely examining what it means to be “fully insured.” These days, employers with as few as ten full-time employees are exploring other funding arrangements which can allow them more control—or at least more accountability—over their annual premium increases. Fully Insured “Fully […]

Reports submitted to the U.S. government that include both names and Social Security numbers (SSNs), such as 1095 and W-2 forms, are filtered through U.S. Immigration and Customs Enforcement (ICE), a division of the Department of Homeland Security (DHS). In some cases, employers will receive a No-Match Letter or an Employer Correction Request from the […]

Diabetes is an expensive disease: $322 billon in America! Costs are compounded because diabetes is the leading cause of heart disease, stroke, kidney disease, lower limb amputation, and blindness, and also has connections with some cancers, arthritis, gum disease and Alzheimer’s disease. To add some perspective, consider these facts: Today, 3,835 Americans will be diagnosed with […]

While employee wellness benefits programs and offerings continue to evolve among new trends and regulations, there are seven key components that tend to drive the most successful and effective programs we have seen with our clients.more Biometric Data Collection Whether in the form of a biometric screening event or annual physical exam with a primary […]

Last month, the Internal Revenue Service released the long anticipated 1095 forms required to comply with ACA Reporting requirements under Sections 6055 and 6056. This is significant in that there will be many more companies required to file these forms in 2017 (for filing year 2016) versus the amount that filed in 2016. First off, […]

Many wellness programs start off with good intentions, offer some education and fun, but even after several years, have failed to meet their original goals or produce real culture change. We recently reviewed the first three steps to a successful, sustainable workplace program. Here we conclude with steps four through six for setting up a […]

Employers with self-insured health plans for health coverage are facing new Section 6055 regulations regarding the reporting of minimum essential coverage. The proposed regulation requires self-insured employers to report this information to the IRS on either Form 1095-B or in Part III of Form 1095-C, if the coverage is provided by an applicable large employer. Section 6055 […]

The Affordable Care Act (ACA) has brought about many changes to the health insurance industry. As we are now in the sixth year of implementation of the Act, we are seeing more changes coming just around the corner. Generally speaking, most health plans can be classified into two categories: HMO and PPO. With an HMO […]