R&R Insurance Blog

With the onset of Obamacare and the need for individuals to make decisions about their own health insurance purchases, I thought it appropriate to share the information we received from the Wisconsin Office of the Commisstioner of Insurance, (OCI).

Taken directly from the press release dated September 3, 2013:
The Wisconsin Office of Commissioner of Insurance (OCI) has completed its initial analysis of rate filings in the individual market.

View Percent Increase Chart published by the OCI.

"While the exchange in Wisconsin will be run by the federal government, insurers wanting to offer coverage in the exchange had to file their rates with OCI. With our review of the exchange rate filings completed, we have attempted to compare what Wisconsin consumers are paying today to what plans will cost post 2014 under the new federal health law," stated Commissioner Nickel. "The truth is that comparisons are difficult because rates are going to vary based on age and where you live."

"With that said, from our analysis, it appears premiums will increase for most consumers. And, while there is no question that some consumers will have subsidies and may not pay these higher rates," Commissioner Nickel continued, "someone will pay for the increased premiums whether it is the consumer or the federal government."

Wisconsin Health Exchanges Offer Slim Pickins

How to Get, or Keep, Health Insurance if You Are Self Employed

5 Mistakes to Avoid When Buying Individual Health Insurance

7 Tips on How To Pick The Best Individual Health Insurance Coverage

Wisconsin residents: for more information about Obamacare, PPACA or individual health insurance, please contact knowledgebroker Jane Shevey.

Join our group on LinkedIn: Obamacare: Strategies for Business to Survive. We welcome you to join in the conversation with our LinkedIn group dedicated to discussions for business owners on Obamacare: Strategies for Business To Survive. Read articles, download documents, join the conversation, and add your expertise!

82% of mid-to-large size employers surveyed in a recent Towers Watson survey will continue to view health care benefits as a key element of their employee’s compensation in 2014. Despite the impending Obamacare mandates and ACA excise tax - known as the Cadillac Tax - employers continue to value health insurance benefits.

As employers move forward they will be looking to keep their plans affordable and viable - maintaining a sustainable plan amidst cost increases (5.2% increase projected for 2014). Full article on Towers Watson survey results.

Wisconsin based employers are considering a self-funding approach or adding additional voluntary benefits such as dental, vision, life insurance and disability insurance to offset any changes they may be implementing.

We've always known that offering quality health insurance coverage is a critical part of remaining competitive in today's talent marketplace. This news is just a reiteration of what I am seeing on the street when I talk to my customers and prospects. Smart, educated decisions moving forward will help curtail any pain PPACA might inflict.

For Wisconsin employers interested in self funding options or voluntary benefits for their plans, please contact me.

Can you ensure your response to an employee’s request for Family Medical Leave Act (FMLA) is appropriate, consistent, and includes the appropriate certifications? Have you educated and informed your managers about their role and personal responsibilities in following FMLA guidelines?

Here are key elements of the Family Medical Leave Act that you and your managers should know:

• The 3 Critical Areas Affected by the New FMLA Regulations
• New Obligations for Military Leave Amendments
  1. Military Caregiver Leave: Clarifications to the Existing Leave
  2. Qualifying Exigency Leave: Understand the New Leave Provisions
  3. Non-Military Family and Medical Leave Issues Eligible Employees
• Definition of a 'Serious Health Condition' under the New Provisions
• Medical Certification Dos and Don'ts
• Intermittent FMLA Compliance:
  • Who is Eligible?
  • What Employers Can Require?
  • Employer Rights
  • Recognizing FMLA-related Leave Requests
  • Lessons Learned from Court Cases
• Handling the 'Bermuda Triangle' - the Interplay Between the ADA, FMLA, and Worker's Compensation
• Curbing FMLA Abuse
  • What You Can - and Cannot Do - When Investigating Potential Abuses
  • Strategies to Minimize Abuse

Get the practical advice and compliance guidance you need to avoid mistakes and protect your company from FMLA lawsuits. Wisconsin companies looking for more information on the FMLA, please contact knowledgebroker Jane Shevey.

In a time when employers are more budget conscious than ever, an HRA seems like a viable option. Given that HRAs come with few requirements, they provide a great deal more flexibility to employers than HSAs.

Because HRA funds do not belong to an employee, the employer retains any remaining HRA funds when an employee leaves the organization. Companies with high turnover find this to be a very favorable option.

Many employers find an HRA easier to manage. Because the employer is putting money in to the HRA, they are able to determine rules for the benefit plan. An employer has the flexibility to design a plan with a deductible that is not as high as you might see with an HSA-compatible plan. For example, if an employer wants to encourage employees to utilize high-value health care centers or have particular types of care covered at 100%, HRAs allow them to do so.

Wisconsin employers, contact a knowledgebroker to see if an HRA is right for your company.

The Secretary of Labor shall have the power, in order to determine whether any person has violated or is about to violate any provision of this title or any regulation or order thereunder...to make an investigation, and in connection therewith to require the submission of reports, books, and records, and the filing of data in support of any information required to be file with the Secretary under this title...

The above is a small part to the DOL's "Intent to Audit' letter employers have or will be receiving. There is an extensive push from the DOL to police ERISA and PPACA compliance to the extent that their 2013 budget included the hiring of more than 1000 auditors! However, the biggest issue is that most employers don't know that they are out of compliance or how to become compliant.

The DOL's audit letters are looking for information and documentation concerning particular aspects of the PPACA, such as the plan's grandfather status, coverage for adult children, lifetime and annual limits, and claims and appeals procedures

Employers should consider taking a serious look at their group health plans, not only for compliance with the PPACA, but also with the long standing mandates for group health plans - ERISA, HIPAA, COBRA and others laws.

If you have any questions regarding your ERISA, HIPAA, or PPACA compliance or any issues regarding your health insurance or benefits packages, please contact knowledgebroker Jane Shevey.

Most employers - and you may be one of them - don't completely understand Employee Retirement Income Securtity Act (ERISA), how it impacts business and employees, and the possible risks it presents. Ask yourself the following questions:

1. If you have over 100 enrolled participants in any benefit, have you ever filed a Form 5500 with applicable schedules?
   ERISA imposes an $1100 day penalty for each day this filing is late up to amximum penalty for large employer (over 100) of $30,000 annually.
2. If yes, have you ever completed and distributed a SAR (Summary Annual Report)?
3. Have you ever been subject to a DOL audit?
   Audits can be triggered through a DOL investigation reproted through other agencies (IRS), through review of form 5500 filings and most often through Employee reporting or lawsuits.
4. Do you have other ERISA plans such as a 125 plan with FSAs (flexible spending accounts) or HRAs (helaht reimbursement accounts)?
   Health FSAs and HRAs are also ERISA plans and must meet the same documentation and filing requirements.

Did you answer No to questions 1 or 2? Did you answer yes to questions 3 or 4? If so, you may be in violation of Title I of ERISA that governs health and Welfare Benefit plans.

If you have any questions regarding your ERISA compliance, obligations or anything regarding your health insurance or benefits packages; R&R knowledge broker Jane Shevey can help!

April 30^th was the deadline for the Wisconsin health insurers to motion if they will join the exchange. While Gov. Scott Walker rejected a state run exchange, insurers still needed to file their plan designs for the federally run exchange. However, information on their plan designs and rates will not be released by the Office of Commissioner of Insurance until July. With enrollment for the exchange scheduled to start in October for January 1, 2014 renewals; this information is essential to companies considering whether to continue offering medical benefits or to send their employees to the exchange.

Companies with 50+ employees are those mainly looking toward the exchange. The penalty for not providing health insurance is $2000-$3000 per employee per year; much less than paying for health insurance with double-digit increases on the horizon.

Reasons for the high premiums may be because of the following inclusions:

• High risk profiles for those in the exchange that other insurers won't cover.
  • Pre-existing conditions
  • Members in the Wisconsin Health Insurance Risk-Sharing Plan (HIRSP)
• New limit on ratings based on age.
  • Instant hike rates for people younger than 50

Wisconsin Business; for more information regarding R&R’s Play or Pay calculator; contact Jane Shevey.

ERISA is one of those areas of HR administration that is probably not high on the list of most HR practitioners' favorite things to do. And, honestly, many simply don't have enough people to spend sufficient time on plan issues. The Department of Labor has recently hired more than 1,000 new employees to - you guessed it - make sure you are in compliance!

An increased chance of an audit means that HR departments need to confirm these things:

• The people running the plan know the plan document inside and out
• Plan operations must be in compliance with the plan document
• The plan document must be in compliance with laws and regulations -- all required amendments must be made.

Ask yourself these questions:

1. Do you know if you offer ERISA health and welfare benefits to your employees?
2. Do you have an ERISA plan document?
3. Do you know what needs to be included in your ERISA plan document (known also as an ERISA wrap-document)?

Here's a link to the full article found in HREOnline.com. Should you have any questions regarding your ERISA compliance or anything regarding your health insurance or benefits packages, please contact knowledgebroker Jane Shevey.

For millions of Americans, celebrating an 80th, 90th and even a 100th birthday is increasingly likely. When you live a long life, there is a very high probability that you will need the type of care that's referred to as long term care. 72% of women and 44% of men will need some form of long term care after reaching age 65. (A woman's risk is higher because she has a longer life expectancy.)

Needing long-term care places an enormous emotional and physical strain on loved ones and family members. That's why having a plan is so important. Incorporating long term care (LTC) insurance into your financial plan can help you protect your assets. It can reduce the burden of care that would otherwise fall on family members and enable you to receive care in the setting you most prefer, including your home.

What's the most important question to ask?

Start with the ones like, "Where do I ultimately want to receive care?"  (at home, in an assisted living community) and "What does care cost where I live now?" - or wherever you plan to reside.

When looking into long term care insurance, ask what discounts you qualify for. If you or a spouse have some health conditions or take prescription medications, ask which conditions are acceptable as they can vary from one insurer to another.

For more questions on long term care insurance, contact our Certified Long Term Care Specialist Jane Shevey at jane.shevey@rrins.com or call 262-953-7123.

Information taken from American Association for Long Term Care insurance.

People find it hard to envision themselves needing hands-on assistance with basic living activities like bathing, getting dressed, and eating so they avoid thinking about it altogether.  Statistics show that over 70% of people who reach age 65 will require long term care services at some point. The unknown factor is how long you will need to receive the care services. More long term care facts.

Waiting to address your long term care needs until the point at which you actually need care could have severe financial ramifications.

Consider the costs:

• 1 year of care today: $75,000
• 1 year of care in 30 years: $250,000
• 3 years of care in 30 years: $750,000

Perhaps the greatest benefit of Long Term Care Insurance is allowing your loved ones to care about you, instead of having to care for you. No one wants to be a burden to their family...hear more from Jane Shevey, Long Term care Specialist at R&R Insurance.

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Wisconsin residents, if you would like more information on Long Term Care Insurance (LTC), please contact us.