Why self-fund?

With the health benefits market changing so much, the costs of different plans can be all over the place. How would you like better, more cost-effective solutions for your clients to choose from?

Every year, most employers dread shopping around for their plan for the next year but they go to their broker and get several quotes, most employers decide on the most inexpensive plan, then the next year the rates raise with renewals and they are back in this vicious cycle repeating it every couple of years. As the employer or broker, it’s hard to feel like you have any control.

“Insurance can cost close to $10,000 per employee per year, so employees cost as much as $1 million a year. Self-Insurance can save 12 percent, or $120,000, which can be used to hire more employees or grow the business.” – Michael Turpin, Insurance executive.

The potential to save money increases from year to year. For employers, self-funding is a no brainer.  With FreedomCare’s unique structure, our plans protect the employer by collecting a monthly rate to cover claims and build a reserve. Over the years, the employer can build up their reserve utilizing our FreedomCaptive. Learn more and increase your control, give FreedomCare a call today.

4 tips when determining how many full-time employee’s under the ACA

  1. First add up the low-hanging fruit.4 Tips FT employees

If an employee is expected to work 30 or more hours per week, he/she is classified as a full-time employee. You can immediately put all of these people in one category.

  1. Decide how you’ll track hours for variable-hour or seasonal employees

An employee is a variable-hour employee if his/her weekly schedule fluctuates above and below 30 hours.

The IRS has proposed a safe harbor method for employers to determine each employee’s full-time status by counting employee hours using a look-back/stability period. There are two types of measurement periods:

  • The initial measurement period for new employees and;
  • The standard measurement period for ongoing employees. The measurement must be between 3 and 12 consecutive calendar months.

If the variable-hour employee averages at least 30 hours per week during the measurement period, then the employee will be considered full-time during the following stability period (which needs to stay consistent with the measurement period). The employee’s status is “locked in,” regardless of the average hours worked during the stability period.

The stability period always begins immediately after the end of the measurement period and must be at least six consecutive months or the duration of the measurement period, whichever is greater. For example, if the employer used a 12-month look-back period, the duration of the subsequent stability period must be 12 months.

  1. Review your company’s eligibility definition 

The ACA full-time employee definition differs from the 40-hour per week full-time eligibility requirement that many companies currently use. Adjust accordingly to make things less confusing for you.

  1. Don’t forget about ERISA while trying to become ACA compliant.

In a class action suit filed by Dave & Buster’s employee, Maria De Lourdes Parra Marin, claims her employer announced that compliance with the ACA would require a cut in hours to reduce the number of full-time employees from 100 to 40 for the purpose of avoiding $2 million in additional health insurance costs. After the employer mandate took effect, she alleges her hours were in fact cut, she lost full-time status, and her insurance was cancelled.

While an employer who reduces employee hours would not violate any specific provision of the ACA, Dave & Buster’s employees are pursuing their claim under ERISA.

“Under Section 510 of ERISA, an employer cannot intentionally interfere with an employee’s right to benefits,” says Lorie Maring an attorney with the Atlanta office of Fisher & Phillips LLP. “What plantiffs are claiming is that by reducing their hours, the company was intentionally interfering with their right to receive health insurance.

How can your clients stay out of trouble and protect themselves? Self-funding health care benefits with FreedomCare can give them peace of mind and control over their health benefits. We have guaranteed ACA compliant solutions available at different rates to meet the needs of most employers. Reach out today.

Disclaimer:

This article is not to be offered as legal or tax advice. Neither Freedomcare nor the publisher are engaged in legal or tax advisory services. For advice on specific tax or legal questions, contact an attorney, CPA or other professional advisor. IRS CIRCULAR 230 DISCLOSURE: Pursuant to requirements imposed by the Internal Revenue Service, any tax advice contained in this communication is not intended to be used, and cannot be used, for purposes of avoiding penalties imposed under the United States Internal Revenue Code or promoting, marketing or recommending to another person any tax-related matter.

Beyond the ACA, the top 5 reasons to offer employee’s health benefits

Beyond the ACA, top 5 reasons to offerThe Affordable Care Act has been around for several years now, the employer mandated penalties regulated by the IRS are in full effect. Most employers are offering at least Minimum Essential Coverage plans to their employees. If we look past the law, beyond the $2,000 and $3,000 penalties, why should employers offer health benefits to their employees?

It’s simple, one of the most vital components of running a successful business is attracting and keeping great employees. While there are different ways to accomplish this, offering your employees benefits tends to be one of the most cost-effective ways.

We’ve gathered the top 5 reasons for employers to offer coverage below.

  1. Attract top talent.

    • A survey by McKinsey Quarterly showed that attracting and retaining talent was the biggest reason that companies offered employee benefits. 46% of employees say their company’s health care program was an important reason they chose to work for their current employer. It helps to attract top talent by having tangible benefits that differentiate your business from your competitors.
  2. Minimize your turnover rate.

    1. It’s difficult for a business to make serious progress when employees are constantly coming and going. 55% of employees say their company’s health care program is an important reason they stay with their current employer. By investing in your employees and offering benefits, it shows that you have their best interest in mind and value their job performance. This also helps to improve your stability as a company.
  3. Better morale.

  4. Healthier employees.

    • When your employees have health coverage, there is a higher likelihood that they will have regular checkups and take preventative medical steps, which will lead to fewer unexpected sick days.
  5. Better job performance.

    • By offering benefits, you give employees more of a reason to care about your company and remain loyal. According to a survey done by the Society of Human Resource Management, 71% of employees who are satisfied with their benefits reported that they are more loyal to their employer. As a result, they will be motivated to work harder, which can lead to greater productivity and a higher quality of work.

These all sound like no brainers but what if my client’s company is barely scraping by and can’t afford health benefits from traditional carriers? Check out our article about self-insuring your health benefits, you might be surprised what a small business can afford with the help of FreedomCare.

How to control your “out of control” insurance premium increases.

Insurance premiums expected to riseAmerica is sicker than we thought. The nation’s leading health insurers are seeking rate increases of 20 to 40 percent for the 2016 open enrollment season citing sicker than expected customers who purchased health benefit policies under the Affordable Care Act.

The rate requests, from some of the most popular health plans, suggest that the insurance market is still adjusting to the shock waves set off by the Affordable Care Act. Experts believe the root cause of this problem is the failure of several marketplaces to attract enough young, healthy applicants.

With increasing expenses already hurting your bottom line, how are you going to keep your business alive while facing inflated insurance premiums or massive penalties from the IRS?

  • Self-Insure your health benefits.

This isn’t a new concept, large companies have been self-insuring their health benefits and workers comp for years. We’ve now made it available to any size employer; so why would you pay a large insurance carrier for something you can do yourself?

  • Stop-loss or reinsurance to limit your liability.

When you self-insure, you need to have reinsurance to protect your business.

  • Claims funding is returned to you.Control your insurance premiums

When you self-insure, you are contributing monthly to a fund that claims are paid out of. Any money that goes unused will be returned to you on a quarterly basis. In a nutshell, you only pay for what you use and that unused money ends up back in your pocket.

  • Implement Health and Wellness Programs to keep your costs low

It’s no secret that America is unhealthy. Bringing health and wellness programs to your employees and encouraging yearly checkups can cut down on illnesses and increase the possibility of claims funding coming back to you.

Simple enough, right? Give FreedomCare a call to learn more about self-insuring and avoiding these premium increases.

4 Major ACA Reporting Myths Debunked

With so many oACA Reporting Myths Debunkedf the ACA reporting requirements are difficult to interpret, business owners and brokers are struggling to see right from wrong. We did some of the leg work for you and here are 4 major ACA reporting myths you may have fallen for.

"I don't have to offer any employees medical benefits even though I have employed more than 50 full-time equivalent employees during 2014."

ALL applicable large employers are subject to the ACA Employer Shared Responsibility requirements and must report, even if the employer chooses not to offer benefits or offers benefits that don't meet minimum value and affordable requirements. In other words, you can't just avoid the law hoping to fly under the radar. You have to report it whether you comply or not.

"I don't have to report for 2015 because I had less than 100 full-time equivalent employees during 2014."

ALL applicable large employers must report, even if the employer qualifies for transition relief. What is transition relief? Not sure if you qualify? Check out ACA expert, Kaya Bromley's webinar here.

"I can wait and decide later this year how I'm going to meet the reporting requirements."

Data MUST be reported each month of the 2015 calendar year. Be prepared to hire a professional to sort it all out for you if you don't have accurate historical records of all changes made.

"There aren't going to be any fines until next year."

They've given you plenty of time. You can't claim you forgot your homework. There may be some relief from fines for employers submitting incomplete forms or forms with minor inaccuracies, however, the IRS has made it clear that there is no relief for employers that cannot show a good faith effort to comply. If you don't have something in place, you need to act now.

Are you still confused? Give us a call at FreedomCare and we can walk you through what you need to know.