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R&R Insurance Blog

What You Need to Know About Premium Refund Checks

Posted by Pete Frittitta

Thu, Apr 19, 2018 @ 10:03 AM

erisa advisoryYou have the opportunity to earn a premium refund on your level-funded plan but do you know what to do with it once you get it? Or maybe you’ve already received one - did you know that there are compliance rules to follow to disburse any employee share of that refund within 90 days?

In most simple terms, if employees pay a portion of health care premiums, then they are entitled to a prorated share of the premium refund. Additionally, you must distribute the appropriate funds within 90 days of receiving the refund check.

There are some interpretations being expressed in the consulting community that would suggest a very simple option exists such as “give every employee the same amount.” We strongly discourage this as it relies on comments from the U.S. Department of Labor (DOL) that contradict other guidance by the DOL. It clearly is not supported.

An employer can apply the entire refund check amount toward reducing employee contributions. However, this only eliminates the need to calculate the “split” between the employees and the employer. Unless the employer has paid 100% of the premiums, employers will still need to calculate the appropriate share of the refund for each employee prorated according to the amount they contributed.

There are basically three compliance options available to employers. If you are not familiar with the compliance options that are available to you, contact an R&R Benefits Knowledge Broker to learn more.

Topics: Employee Benefits, Compliance

Generic vs. Brand Name Drugs

Posted by the knowledge brokers

Thu, Apr 05, 2018 @ 12:56 PM

prescriptionChoosing generic drugs over the brand name is generally less expensive. However, many people question whether generic drugs are as good, effective or safe as their brand name counterparts. The perception is that since many generic items found in grocery stores tend to be of lesser quality, the same must be true for medications. Fortunately, in the case of prescription and over-the-counter (OTC) medications, generic substitutes are the equivalent of brand name drugs. The U.S. Food and Drug Administration (FDA) regulates the chemical equivalency of generic drugs to ensure they are just as safe and effective as the brand name drugs they mimic.

Employees who understand their benefit plans make more informed choices about the medical services they receive, and that benefits everyone.

 

Talk to Your Doctor

The best way to ensure that you know all you can about a drug you have been prescribed, and its generic equivalents, is to talk openly with your doctor. Below are some suggested questions that you may want to ask.

  • Is there a generic substitute for this drug available?
  • Are there any drug interactions that I should be aware of?
  • Does this medication cause any side effects?
  • If I forget to take a dose, what should I do?

Also, make sure your doctor knows about any previous reactions you have had to medications. In addition, be sure to call your doctor immediately if you have any problems or adverse side effects from a new prescription. Choosing generic drugs when available, following your doctor’s and pharmacist’s instructions fully, and talking openly with your doctor will help you make the most of our prescription drug plan. These strategies can help you not only save money on the prescription itself, but also avoid future health problems that could be costly.

To know more about generic and brand name drugs, read here.

Source: Zywave

Topics: Employee Benefits

11 Steps to Protect Your Business from Cyber Crime

Posted by the knowledge brokers

Wed, Apr 04, 2018 @ 01:08 PM

RRI_Cyber-530x275-Homepage-CTA_v1aCyber criminals, for the purposes of extortion, can threaten to shut down computer systems or erase data, infect a company with a virus, publish private information or personally identifiable information on customers or employees, institute a denial-of-service attack or take over social media. There are numerous examples of these attacks happening day in and day out, to businesses of all sizes.

Travelers has provided the following checklist to help protect businesses from cyber crime:

1. Know your data. A company cannot fully know how much is at risk until they understand the nature and the amount of data they have.

2. Create file back-ups, data back-ups and back-ups bandwidth abilities. This will help a company to retain its information in the event that extortion occurs.

3. Train employees to recognize spear phishing. All employees should learn the importance of protecting the information they regularly handle to help reduce exposure to the business.

4. Do background checks on employees. Background checking employees can help identify whether they have criminal pasts.

5. Limit administrative capabilities for systems and social footprint. The less employees with access to sensitive information, the better.

6. Ensure systems have appropriate firewall and antivirus technology. After the appropriate software is in place, evaluate the security settings on software, browser and email programs. In doing so, select system options that will meet your business needs without increasing risk.

7. Have data breach prevention tools, including intrusion detection. Ensure employees are actually monitoring the detection tools. It is important to not only try to prevent a breach, but to make sure that if a breach occurs, the company is aware as soon as possible. Time is of the essence.

8. Update security software patches in a timely manner. Regularly maintaining security protections on your operating system is vital to them being effective over time.

9. Include DDoS security capabilities. It is important to have the ability to avoid or absorb attacks meant to overwhelm or degrade your systems.

10. Put a plan in place to manage a data breach. If a breach occurs, there should be a clear protocol outlining which employees are part of the incident response team and their roles and responsibilities.

11. Protect your business with insurance coverage designed to address cyber risks. Cyber insurance coverage typically provides protection for costs associated with data breaches and extortion events. The right insurance program will also provide access to skilled professionals to manage the event from start to finish.

Attend our upcoming Cyber Seminar to learn more about protecting your business.

 

Topics: Cyber

Featured Client | Relationship With Financial Planner Leads to Significant Improvements in Coverage

Posted by Tammy Cross

Tue, Mar 20, 2018 @ 01:01 PM

To illustrate the benefits of working with one of the largest independent agencies in the Midwest, the following example presents a recent claim situation for one of our newest valued clients.

young-professionals(small)-1.jpgSteve is a middle-aged profesional with a beautiful home that he’s proudly invested money into to finish the basement, add a mother-in-law suite, fence the yard, and add additional sump pumps. He and his wife of 15 years also own a boat, 2 cars, and a few pieces of valuable jewelry.

Steve has worked with the same insurance company for years – and had what he thought to be decent coverage for his lifestyle. After meeting with his Financial Planner one afternoon, it was brought to Steve’s attention that he should consider getting a second look at his home and auto coverage. In fact, the Financial Planner recommended he reach out to an independent insurance agency (much different than who he was currently working with) for an ‘apples to apples’ quote as well as recommendations on new options to consider.

After a quick phone call with Tammy Cross at R&R Insurance, Steve knew he was in good hands.

Savings Opportunities:

  • Reduced Home Deductible to $1,000 (was $7,000)
  • Eliminated Duplicate Boat Liability Coverage
  • Premium Savings of over $428 - on top of additional coverage endorsements

Program Improvements:

  • Current policy was considerably underinsuring home
  • Single deductible, in the event a claim involves both home and auto(s)
  • Addition of sewer back-up and ID theft coverage
  • Correction of scheduled jewelry and addition of blanket on smaller items
  • $1 million umbrella policy

Find a Private Client Knowledge Broker

 

*Client names have been changed to maintain anonymity.

Topics: Featured Client, Private Client Group

R&R Partners with West Bend Mutual to Create Personal Lines Service Center

Posted by Dan Wolfgram

Tue, Mar 20, 2018 @ 08:53 AM

West Bend Mutual.pngLast year was a pivotal year for our customers and our associates here at R&R Insurance.  In 2017, we partnered with one of our carriers, West Bend Mutual, to utilize their in-house Service Team for all of our West Bend Mutual Personal Lines clients.

This added service comes at no additional cost to our insureds and provides customers with immediate answers to billing questions, making changes to policies, expanded hours of transactional service and reporting of claims. In addition, this change allows R&R more time to take on the role of advisor, counselor and claim advocate on our clients' behalf. Below is just one of the many examples of how the Service Center approach is benefiting our customers. 

Service Center Benefits

Konnie has been a licensed agent in Personal Lines with R&R Insurance since 2002. One of Konnie’s clients added a vehicle to his policy several years ago - something he didn't do frequently.  Konnie reviewed the change after it was processed and called the client to confirm. In doing so, she noticed there was a relatively new and important coverage (Car Damage Replacement Cost) missing from the policy. The endorsement provides insureds a new car (with some limitations) should the car be totaled out without any depreciation. The coverage was added to the policy after Konnie’s review for approximately $6 per month.

Fast forward 4 years and about 68,000 miles, when our client was involved in a pretty serious accident. Fortunately, our client walked away with only minor bumps and bruises.  However, his 2015 Lexus was not so lucky - a total loss. The claim was submitted and his insurance carrier promptly paid the claim for his vehicle. However, because of a human error on their part, they only paid out on the depreciated value of the car.  Konnie, who followed-up to make sure the claim was moving along promptly and fairly, caught this error.  Our insured was happy to find out he would be receiving a supplemental check from his insurance carrier that next day for over $14,000!  While we obviously do our best to insure these errors don't occur in the first place, we are fortunate to have dedicated time for our Service Agents to act as advocates, advisors, and counselors for our customers. 

R&R Insurance will continue to be here for you and will always remember that our job is to make sure that we place you with only the best insurance companies. This change is just one example of how R&R is able to better serve our customers. Thank all of for allowing us to be your insurance agency, your advocate and your advisor.

Buying a New Car?

Posted by Tom Mack

Tue, Mar 20, 2018 @ 08:23 AM

iStock-664521270.jpgBuying a new car doesn't happen all too often, so it's likely your "What to Do Before I Leave the Lot" list isn't top of mind. It's also common to be picking up your new car on a weeknight or weekend - when your insurance agency is closed. Below is a quick reminder of what to keep in mind when buying a new car.

Bring the following items with you:

  • Checkbook
  • Title on the vehicle you may be trading
  • Insurance ID card on a currently insured vehicle

 

Most importantly - are you covered to drive this new vehicle home?

Generally speaking, most auto policies will give you coverage on a newly acquired vehicle to get the vehicle home and contact your agent as soon as possible. 

  • At a minimum, you would have 4 days of comprehensive and collision coverage @ $500 deductible (no physical damage coverage currently on policy) as well as liability coverages.
  • The physical damage coverages are expanded to 14 days if comprehensive and collision coverages are currently on the auto policy. Liability coverages would also follow.

 

If possible, always contact your insurance agency before you visit the dealership.

We won't need much time to get your new vehicle added to the policy and have you safely on the road. Here are the quick items we'll discuss:

  • Vehicle Identification Number (VIN)
  • Lien / Lease – name and address, if applicable
  • We can offer GAP coverage on your loan or lease
  • Car Damage Replacement coverage may be available
  • List of safety features on vehicle for possible discounts

Still have questions? As always, your R&R Insurance Knowledge Broker is here to assist!

Contractor Immunity Denied Before WI Supreme Court

Posted by Brad Stehno

Wed, Feb 28, 2018 @ 03:50 PM

iStock-519890233 (1).jpgWisconsin contractors - budget for pedestrian safety when taking jobs on recreational land.

The courts are not ruling in your favor.

From the standpoint of a business, there is no better take away from the recently decided John Y. Westmas v. Selective Insurance Company of South Carolina. At stake for Wisconsin contractors was their inclusion in Wisconsin Statute § 895.52, known as the recreational immunity statute. By the most recent reasoning of the court, it would be difficult to imagine a scenario when an independent contractor could expect inclusion in this immunity law from the 1980s.

The Situation:

As I’ve written before on this incident, a little caution tape or an extra man on the job could have prevented a tragic pedestrian fatality in 2012.

Circling the 26-mile shoreline of Lake Geneva is a recreational trail open to the public but maintained by the private property owners. One such landowner is the faith-based youth camp Conference Point Center, who in 2012 contracted Creekside Tree Service to trim trees along the highly trafficked shore path.

On the first day of the job, Creekside Tree Service employed two safety “spotters” along the path to divert pedestrian traffic, and two “cutters” to perform the task at hand. On the second day the crew was reduced to three, with only one spotter along the trail.

It was on that second day when Jane Westmas and her adult son were walking along the path. A heavy 17-foot tree branch was cut from 30-feet in the air, falling and killing Jane. While there was an orange road cone on the trail, the pedestrian view was also obscured by the overhang of a nearby building and the spotter was not in their area of the trail.

Creekside admitted another spotter might have prevented the tragedy, but argued that they were immune from prosecution by Wisconsin Statute § 895.52.

The [Failed] Immunity Argument:

Arguing the recreational immunity statute worked in favor of Creekside Tree Service in the first of its three court rulings. Creekside won on the Circuit Court level, and for a moment appeared to be immune.

Wisconsin Statute § 895.52 was passed by the Wisconsin legislature in the 1980’s to encourage private property owners to open their land to the public for recreational purposes. This law grants “owners”, “agents” of the owners, and “occupiers” of the land immunity to injuries and fatalities that occur on the private land open to the public.

Creekside Tree Service argued they were both “agents” of Conference Point Center and “occupiers” of the land engaged in its maintenance for the public good. By a plain reading of the statute, it might appear they are immune from prosecution.

A case used to justify this line of reasoning is the 2007 Held v. Ackerville Snowmobile Club, Inc. In Held, a Snowmobile Club left trail grooming equipment along a path they were maintaining. A snowmobile rider collided with the equipment during a night ride sustaining injuries. The court sided with the snowmobile club finding them the “occupier” of the land and immune under statute § 895.52.

While they won at the Circuit Court level, the appellate court reversed this decision. Creekside Tree Service’s line of reasoning was thrown out, mostly due to more recent rulings by the Wisconsin Supreme Court.

The appeals court followed a 2016 case Roberts v. T.H.E. Ins. Co ruled on by the Wisconsin Supreme Court. In Roberts, a hot air balloon company was providing rides at a charity event in Beaver Dam (private land open to the public). Due to high winds, one of the tethered lines snapped sending the balloon into a line of spectators seriously injuring one. The Wisconsin Supreme Court ruled against the hot air balloon company declaring they were not “occupiers” of the land since there had to be a “degree of permanence” as oppose to mere use of the land.

Seeing as Creekside’s case is somewhere in-between Held and Roberts the Wisconsin Supreme Court took it up. On February 7, 2018 the WI Supreme Court gave clarity on the issue.

Neither An Agent Nor An Occupier:

The Wisconsin Supreme Court agrees with the appeals court – Creekside Tree Service is neither an agent nor an occupier of the land and thus has no immunity under Wisconsin Statute § 895.52.

Complicating this case is that the words “agent” and “occupier” are not defined in the immunity statute. The Supreme Court reasons it must rely on prior case law to define the terms. They agree that “an agent may be either an employee or an independent contractor” but that “[an] important factor in determining whether a person is an agent is the extent of control retained over the details of the work”. In this case, “Conference Point did not control or attempt to control the physical conduct of Creekside [Tree Service’s] employees” and is thus is not an agent.

In other words, because the owners of the property did not control how Creekside trimmed the trees which resulted in the injury, they are not considered “agents” and thus not included in the recreational immunity statute.

The Wisconsin Supreme Court also ruled Creekside was not an “occupier” of the land. For this the court relied heavily on the aforementioned Roberts v. T.H.E. Ins. Co. Recreational immunity requires “a degree of permanence, as opposed to the mere use of the property in question.”

The Dissenting Opinion Is Insight for Contractors:

In the majority decision for the Wisconsin Supreme Court, it was made clear they did not believe this ruling would “contribute to a landowner’s decision to open the land for public use” and thus is within the spirit of the immunity statute.

The dissenting opinion has a completely different take. The two dissenting Wisconsin Supreme Court justices speak almost from a contractor’s point of view. They reason contractors would become more hesitant to take on jobs in land open to the public:

Refusing to recognize immunity for Creekside may force companies like it to weigh the risk of liability to the public when performing their tasks, dissuading them from working at these sites. This could create a domino effect of discouraging landowners, like Conference Point, from opening their land to the public because of the unsafe conditions arising from neglected maintenance the landowner is unwilling, unable, or unqualified to perform.

The dissent did not understand how it’s practical for contractor to be immune after the majority’s decision. Would the court “require Creekside employees to spend the night on the property to establish ‘a degree of permanence’?”  The dissent reasoned the “plain meaning” of the word “occupies” made it “logically impossible” to reason Creekside was not an “occupier” of the land and would fall under immunity.

 Safety First:

The tragic fatality is over. The court’s ruling has been made. What’s important is the future.

This case represented a legal grey area in-between the aforementioned Held and Roberts cases. What can be reasoned from this decision is that, when in doubt, contractors should not expect immunity when performing maintenance on private land open to the public. With courts relying heavily on prior case law to determine rulings like this, it can only be more difficult to claim immunity under the recreation statue in future cases after this judgement.

For a contractor, it’s best tragedies like this are avoided from the beginning. Imagine if Creekside had draped caution tape along the trail or had a second spotter on the day of the fatality. When taking jobs on recreational land budget for the safety of passing pedestrians.

Recordkeeping Update for Wisconsin Public Employers

Posted by Julie LaRose

Wed, Feb 21, 2018 @ 08:33 AM

Ind_School_sect.jpgStarting in 2018, the DSPS requires information from the Summary of Work-Related Injuries and Illnesses to be entered into the DSPS’ Online Injury and Illness Reporting System.  A user name and password is required to enter information into the online system.  For questions regarding online access, send an email to DspsSbHealthandSafetyTech@wi.gov or contact your local DSPS OSH inspector.

Per Safety and Professional Services (SPS) Chapter 332.10 – public sector employers must record information about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid.  Significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional must be recorded.  Public sector employers must also be familiar with recording criteria listed in 29 CFR 1904.8 through 1904.12 and follow this recording criteria as well.  Injuries and illnesses must be recorded on DSPS Form SBD10710A Log of Work-Related Injuries and Illnesses or the equivalent OSHA 300 log.

If there is uncertainty whether a case is recordable, refer to the Department of Public Safety (DSPS) – Frequently Asked Questions document.  This resource answers the following questions:

  • When in an injury or illness considered work-related?
  • What are the additional criteria?
  • What is medical treatment?
  • What is first aid?
  • How do you decide if the case involved restricted work?
  • How do you count the number of days of restricted work activity or the number of days away from work?
  • What if the outcome changes after you record the case?
  • How do you classify injuries?
  • How do you classify illnesses?

Per SPS 332.205, all Wisconsin public employers must complete and submit DSPS Form SBD10710 Summary of Work-Related Injuries and Illnesses, or the equivalent OSHA 300A form by March 1st.  It is required to submit this form even if there are no work-related injuries or illnesses that occurred during the previous calendar year. This Summary must be posted from February 1st through April 30th in an area where the employer posts other important notices.

If the DSPS does not receive the SBD10710 Summary form by the March 1st deadline, orders may be issued. In addition to orders, a SPS 332 safety inspection may be conducted.

For more information about DSPS reporting, recordkeeping and posting requirements, click here to download a copy of R&R's Public Employer Recordkeeping Flowchart.

 

Prescription Drug Trends: Making Sense of Your Plan

Posted by the knowledge brokers

Thu, Feb 01, 2018 @ 07:08 AM

Prescription Drugs.jpgAs prescription drug costs continue to increase, it is important for employers to understand the trends behind cost of prescription drugs and what they can do to better manage their health care expenses. By taking the time to understand prescription drug trends and how the ACA is impacting the pharmaceutical industry, employers may be able to identify ways to reduce health care expenditures.

In 2014, prescription drug spending in the United States increased 13.1 percent—the largest increase since 2003. This jump was due to a number of factors—a major one being a 30.9 percent increase in spending on specialty medications, which are high-cost drugs used to treat complicated conditions like hepatitis C, cancer and rheumatoid arthritis. The growth in prescription spending was also due to more people being insured and gaining prescription drug coverage as a result of the Affordable Cart Act (ACA).

You can get more insight about the reasons behind prescription drug trends by viewing this comprehensive list.

Spending Resolution Affects ACA Taxes

Posted by Terry Frett

Wed, Jan 31, 2018 @ 07:03 AM

Gavel with cash.jpgOn Monday January 22, 2018, Congress passed HR195 to extend funding for the government through February 8, 2018.  President Trump signed the legislation into law Monday night.  Although this new law was crafted to continue funding the government, it did contain 3 specific items impacting employer sponsored health insurance plans:

  • Health Insurance Tax
    • Presently, insured health plans include a premium tax that adds over 2% to the premium rate. This tax is part of the Affordable Care Act.  With the passage of HR195, the Health Insurance Tax will be suspended for 2019.
  • Cadillac Tax
    • The Affordable Care Act contained what is often referred to as the “Cadillac Tax”. The tax was originally scheduled to be implemented in 2018.  It would result in a 40% excise tax for health insurance plans with annual costs in excess of $10,200 for single coverage and $27,500 for family coverage.  The tax would be paid by the plan sponsor.  This tax was delayed to 2020 and now, as a result of HR195, it is delayed until 2022.
  • Medical Device Tax
    • Manufacturers of medical devices were set to be subjected to a 2.3% tax on their products. Again, this tax was part of the Affordable Care Act.  The passage of HR195 delays the start of this tax for 2 more years.

The new tax law (signed on December 22, 2017) eliminated the individual health insurance mandate penalty starting in 2019.  The employer mandate for Applicable Large Employers (generally companies with 50 or more full-time equivalent employees) and the 1095 reporting continues unchanged.

Employers should be aware of the evolving applicability of existing ACA taxes and fees so that they know how the ACA affects their bottom lines. R&R Insurance Services will continue to keep you informed of changes.

Read here for a more comprehensive list of these current updates. If you have any questions, feel free to contact a Knowledge Broker at 800.566.7007.

Topics: Compliance, ACA