How to choose a PEO – Part 2 (Health Insurance)
Get a clear understanding of the health insurance. How is it rated? Ask about tier placement and get a guarantee you can only be moved down a few tiers in any one year. Ask for claims/utilization records supporting the decision. Key points for Health Insurance Renewals What rate increases have your clients experienced in the […]
How to choose a PEO – Part 1 (Transparency)
Many variables exist when choosing a PEO. – The first step is deciding IF a PEO is the right decision. It’s never always yes or no. You may have the goal of being in a PEO for the short term or long term. If short term you may be trying to correct WC, health insurance […]
Memorial Day – Short History Lesson
Memorial Day was formerly known as Decoration Day and originated after the American Civil War to commemorate the Union and Confederate soldiers who died in the war. By the 20th century, Memorial Day had been extended to honor all Americans who have died while in the military service. (Memorial Day is not to be confused […]
Rx Impact – Bid Rx – Prescriptions for Less (Part 2 of 2)
BidRx (www.bidrx.com) is a website built by pharmacists that links consumers with pharmacies and pharmaceutical companies, so consumers can make better decisions when purchasing prescription drugs. BidRx provides the information needed to identify the best value drug; then pharmacies compete for filling prescriptions. Consumers can See cost of prescriptions (original plus alternatives) and services. See list of […]
Rx Impact – Specialty Drugs (Part 1 of 2)
Specialty Drugs – generally referring to drugs costing over $600 per month – are estimated to account for 30% of total drug costs and expected to reach 50% by 2018. These drugs are expensive to develop and pose challenges manufacturing. However they target life altering illnesses making them an absolute must if needed. These patients […]
ACA Recap – Employer Checklist (Part 5 of 5): Exchanges
Types of Exchanges 1. State Exchanges – Individual Consumer – Federal or State Run Carrier participation will be voluntary State determines plan designs: Bronze (low cost), Silver, Gold, Platinum (high cost); Catastrophic Plan – young invincibles (18 -30) 2. SHOP Exchange – Small Employers Open in 2015 Limited to 50 FTE’s Employer picks plan for […]
ACA Recap – Employer Checklist (Part 4 of 5): Underwriting
Under ACA beginning with all new groups and for groups renewing in the 2014 calendar year the following criteria will be used to underwrite group. (In Florida, group size is determined by ATNE, Average Total Number of Employees. ATNE is calculated by averaging the total number all employees, full & part time, seasonal, temporary, etc… for […]
ACA Recap – Employer Checklist (Part 3 of 5): Compliant Plans
What is a Minimum Value Plan? Coverage that has an actuarial value (AV) of at least 60%. AV is the plan’s share of the total allowed cost of benefits provided to an enrolled individual Example, if a plan has an AV of 60% then the individual is theoretically responsible for 40% of the costs for all […]
ACA Recap – Employer Checklist (Part 2 of 5): Affordability
ACA Employer Responsibility Affordable Coverage Requirement Companies are only required to offer at least one medical plan that meets the “affordability” requirement (at the employee-only coverage level). Regulatory guidance allows companies to calculate affordability based on the employee’s income, using one of three IRS safe harbors. The Safe Harbors are: 9.5% of W-2 wages from […]
ACA Recap – Employer Checklist (Part 1 of 5): Accessibility
ACA Employer Responsibility: “Pay or Play” (Delay Announced) Large Employer Subject to “Pay” if they do not “Play” – Starting in 2015, applies to employers with 100 or more FTEs (Full Time Equivalents) Offer Minimum Essential Health Care to 70% of employees effective on the start of the plan year beginning on or after January […]