August 2013

The Mouth-Body Connection

Open wide! – Your mouth can tell a lot about your body’s health. It is a window into many health issues throughout the body.

More than 3 out of 4 American adults suffer from various forms of periodontal (gum) disease and many don’t know it. This is concerning because infections can be caused by periodontal bacteria entering the bloodstream and travel to major organs.

Some of the risks include:

  • Heart disease, the nation’s leading cause of death. Studies have shown links between cardiovascular disease and key bacteria in periodontal disease.
  • A 4.3 times greater chance of stroke than those with mild or no periodontal disease.
  • Diabetes, approximately 95% of Americans with diabetes also have periodontal disease.
  • A sevenfold increase in the risk of pregnant woman delivering preterm, low birth weight babies.

A significant percentage of people will not visit a physician for medical care during the year. However, many will see a dentist.

What if by visiting the dentist employees are made aware of potential health risks? How might catching these potential health problems early affect absenteeism, employee overall health, and employee satisfaction with their benefit package?

Payroll Vendors Play Critical Role In ACA Analysis

Payroll vendors and PEO providers have all the information needed to run the critical analyses need to comply with the complexities of PPACA.  Your companies partnership with your payroll or PEO vendor should equip you with tools to help consult and support you through the many phases of the PPACA. While some providers offer insight into only the parts of the law their system can interpret, best-in-class vendor’s offer a comprehensive solution providing the flexibility and functionality to ensure you are covered in all aspects of the law. Support needs to include:

  • ACA eligibility analysis with
    • Comprehensive employee demographic detail consistent with allowable groupings for measurement periods under Shared Responsibility
    • Optional employee age information (effective as of a user-defined date) assists in determining eligibility for parental dependent coverage or Medicare
    • Statistical detail over user-defined date range includes optional per-month detail of subject hours and average hours per week and month over the user defined date range along with variances from Shared Responsibility full-time standards
  • ACA Affordability Analysis including
    • Ability to calculate the percentage of federal poverty level earned by the employee over the user defined date range to estimate Medicaid eligibility
    • View results of all proposed affordability safe harbor methods on a single report Including a count of how many employees exceed the affordability threshold. Individual employees will be highlighted on this report as well as having potentially unaffordable coverage
  • ACA FTE Determination Report
    • This report will calculate the number of FTEs for an entire organization or subset of employees within a group as allowed within safe harbor Determination Report

PPACA introduces numerous laws, safe harbor provisions and reporting requirements, some of which must be addressed now and some that will affect processes in the future. To make the complexities of this act easier to understand and to effectively manage your companies needs through PPACA, be sure your payroll or PEO vendor can help you and your broker navigate across all these areas.

Useful Apps – iTriage

tri·age (n) –  the practice of sorting medical conditions to determine priority for treatment.

Founded by two emergency medicine physicians, iTriage® is a free mobile app and website that helps answer the two most common medical questions: “What could be wrong?” and “Where can I go?”. It does not replace a doctor, but it can help you research your condition decide the level of urgency and direct you toward the proper care.

Know of a useful app in the health care, LTC, Rx or related industry? Send it to us, we may blog about it.


Employee Benefit Advisors provides employee benefits. We are a broker helping companies with their Health & Welfare Benefits. We also help companies revaluate PEO Services, deciding if a PEO is a good choice and if so selecting and implementing the PEO.

Delay in ACA Employer Mandate: Opportunity to Regroup

Not All ACA 2013 Tasks Postponed

Don’t be fooled!

Not all aspects of healthcare reform are postponed. Employers face other compliance requirements during or by the end of 2013. Examples:

  • Reducing waiting times for plan eligibility to no more than 90 days;
  • Complying with the rules for the Patient-Centered Outcomes Research Institute (PCORI) fee; and
  • Notifying employees about the availability of state exchanges.

Opportunity for Course Reversal

This delay creates an opportunity for employers to test their compliance strategy for the Shared Responsibility provisions of the Affordable Care Act and to ensure they have the systems and procedures in place to fully comply when required in 2015.

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