R&R Insurance Blog

There are two main reasons for a huge upsurge in individual health insurance inquiries. One is that thousands of baby boomers are retiring daily, and those that aren't lucky enough to have a health insurance option in their retirement plan, have to purchase health insurance/supplemental insurance elsewhere. Secondly, reform is well underway, which means that more individuals are forced to search for, and purchase, their own health insurance - depending of course the decision that their employer makes.

7+ Tips on How to Pick The Best Individual Health Insurance Coverage

1. Identify the “must-haves.” You can’t foresee a sudden injury or illness, but some medical needs can be anticipated. Maternity coverage, for example, is an obvious must-have if you’re starting a family, and not all policies offer it. If you have a family history of heart disease, you may want to make sure your coverage includes the cost of cardiac screening tests and cholesterol-lowering drugs. Under the Affordable Care Act, individual insurance plans must cover the full cost of more than two dozen preventive services for men, women, and children, including vaccinations and tests for high blood pressure, cholesterol, colon cancer, and diabetes, as long as they’re provided by a practitioner in the plan’s network.
2. The right plan for your age/health. If you’re relatively young and healthy, consider choosing a policy with a high deductible, the amount you must pay out of pocket before certain benefits kick in. A plan with a deductible of $1,000 or more is likely to cost you considerably less per month, and could save you money in the long run. If you middle aged or older, and things just don't work the way they used to, consider a plan that would address those issues, with a slightly lower deductible - because you know you are for certain going to use it. Do the math. Add your deductible out-of-pocket cost to the monthly cost of the plan - are you ahead at the end of the year if you use your coverage consistently?
3. Make sure your drugs are covered. You’ll want to make certain that the plan’s list of covered medications, includes those you take regularly, especially if they are expensive.
4. Check the network. If you have a primary care physician and specialists you like, be sure they’re in the network of any plan you consider buying. Policies generally cover a lower share of the cost of out-of-network care—or none at all. R&R Insurance can supply you with links to the plan's network of physicians to help you in your decision making.
5. Know your share of the costs. Plans are required to state how much you’ll pay out-of-pocket, through flat fees called co-pays and through coinsurance, a form of “cost-sharing” in which you pay a percentage of a medical service. Find out whether the out-of-pocket includes the deductible - or is it "in addition to" the deductible?
6. Coverage for a spouse or dependents? An "individual" plan, again means that it isn't connected to your employer, but it can cover multiple people. Make sure you factor in the needs of your spouse, their age, affordable deductible etc. If you have children under age 26 without health insurance coverage through an employer, the law permits them to be on your insurance. Policies also can no longer exclude kids under age 19 from coverage because of pre-existing conditions.
7. Walk through several plans. It only takes a few minutes to review the main benefits associated with each plan, and some plans that look appealing at first glance may turn out to have cost-sharing features that could burden you with heavy medical costs.

BONUS SUGGESTION: If you are retiring, always check with your employer to see if it is part of your retirement package, or if your employer offers the option to purchase their health insurance plan to retirees. This a lot of times can be a more affordable option as you settle into retirement. COBRA coverage can also be helpful during your transition phase.

At R&R Insurance, we value your time and your privacy. We will take your call, collect the minimum amount of information necessary to submit a quote, and then review those quotes with you to make sure you fully understand the coverage and the costs. Avoid the hassle of filling out multiple forms online to then be bombarded with email blasts you don't want. We will trust your privacy, get you the right information in a quick and professional manner, and make sure you are covered in the end.

Wisconsin residents contact Donna Wahl, Individual Health Insurance agent for R&R Insurance, or call 1-800-566-7007 to get started on a quote.

Voluntary benefits enable employers to offer their employees the ability to choose from a menu of benefits that meet the employee’s needs, even if the employees pay the full cost of those benefits. Offering voluntary benefits for your employees through a group purchase platform can be better for both you and the employee.

Here are 7 great reasons to add voluntary products to your benefits strategy:

1. Voluntary benefits are not just for large accounts.
   Today carriers are much more eager to offer opportunities to smaller or medium sized businesses, and third party administrators can be used to relieve any burden on the employer’s human resources department. (Historically, carriers were only interested in selling these plans to large employers, and only big employers had the resources to administer multiple benefit streams.)
2. Voluntary benefits work well for both fully funded and self-insured clients.
   In either scenario, voluntary benefits are a way to fill in the coverage gaps for employees who want supplemental benefits that are not provided within the plan. Voluntary benefits can also help in the negotiation process utilizing the voluntary products that reinsurers offer. Sometimes bundling can help seal the deal or sweeten the offer for your plan negotiations.
3. Voluntary benefits are ideal for clients moving to defined contribution plans.
   In a defined contribution model, employees receive a set amount of funding to purchase the benefits that best fit their needs. For this approach to succeed, employers need to offer a wide variety of voluntary benefits that extend beyond the primary health care coverage. These could include dental plans, vision coverage, life insurance, accident insurance, critical illness insurance and even lifestyle products such as pet insurance, gym membership, ID theft protection or legal advice. These options will make the transition from full health care coverage to defined contribution benefits much easier for employees.
4. Voluntary Benefits can offer higher guarantee issue limits.
   A guaranteed issue limit is the maximum amount for which an insurance company will insure an individual without receiving information concerning their insurability, i.e. a medical exam. Any time you can get higher limits without proving insurability - that's a good thing!
5. Voluntary benefits offer fewer underwriting hassles.
   Guaranteed issue limits which don't require proof of insurability reduces the paperwork and underwriting headaches associated with processing applications that require underwriting scrutiny. Therefore - faster enrollment and quicker turn-around for HR administration. With everything else on the HR plate - less is certainly more!
6. Voluntary benefits usually offer lower premiums than can be obtained through individual policies.
   Voluntary benefits purchased in bulk - or in group packages will offer group discounts or often times better products from which employees can choose. If employees where to purchase, for instance, dental coverage on their own, the pricing for an individual policy would be prohibitive. Offering affordable voluntary benefits for employees that won't break their budget, but yet give them the coverage they need, is a terrific benefit for employers to consider.
7. BONUS: many of these benefits can be paid with pre-tax dollars, which is a plus for both the employee and the employer.

Change always brings opportunities, and smart companies are adapting by using different strategies to continue to improve their benefit plans, and attract and retain the talent they need to succeed. Voluntary benefits are one more tool that can help them succeed.

Related articles:

Voluntary Benefits to the Rescue

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.

There is no doubt that voluntary benefits have moved into the benefits mainstream. Today, voluntary benefits are rightly regarded as a high value benefit strategy by both employers and their employees. Voluntary benefits satisfy employee preference for more benefits choice without adding to a company’s benefits budget.

The biggest challenge with voluntary benefits is choosing the right products that will drive employee participation and satisfaction during this time of extreme workforce diversity – one that is multigenerational, at different life stages and experiencing different economic circumstances, and at a time of immense changes in benefits offerings. There are now four generations in the workforce with a variety of personal needs, as well as fundamental differences in attitudes and expectations that will shape the future of voluntary benefits.

How should voluntary benefits be mixed and matched to provide a flexible product suite with broad appeal? What features will drive positive participation? Psychological, emotional and economic issues come into play in any purchase decision and the decision to open one’s wallet to buy a voluntary benefit is no exception.

A voluntary benefit must offer a solution to a real-life problem that could be experienced by the employee. It is important to offer a broad and rich portfolio of voluntary benefit products to enable individuals to identify “benefits that work for me” in the available mix. Voluntary benefit options that seem more personally relevant can contribute to an employee feeling more valued by the employer and more loyal to the organization.

Insurance needs change with life transitions – a new baby, a teen driver, or divorce. Help employees navigate this by connecting their new needs with a suggested suite of relevant benefit solutions to consider as changes occur - a generational approach.

Examples of generationally appropriate features could include guaranteed issue with no eligibility restrictions for pre-existing conditions, which might be more important for an older workforce. Whereas portability of the benefits may appeal more to younger workers who expect to change jobs more often.

In the end, designing the optimal voluntary benefit strategy is not only good for your employees; it also has advantages for the business. It contributes to a robust and competitive benefits program to attract and retain talent without adding to benefit costs. And it generates goodwill towards the company which can translate into increased employee loyalty and productivity.

For more information about voluntary benefits and their increasing role within today's benefits landscape, contact knowledgebroker Stephanie Riesch-Knapp.

Related articles:

Voluntary Benefits to the Rescue!

Forty-four percent of surveyed employees are concerned that their employer may reduce their benefits. As well, two-thirds are very concerned about having access to affordable health insurance as well as having enough money to cover increasing out-of-pocket medical costs.

These concerns have a negative impact on employee productivity. Employees who report being concerned about having access to affordable health insurance are also more likely to report distraction and stress at work and a decrease in their work quality.

Here are 3 ways you can reduce the stress that reform changes are having on your employees, and preserve productivity in the face of health care reform:

1. Offer supplemental Health Options
   Voluntary supplemental health benefits such as accident, critical illness, dental, disability and vision coverages help employees cope with unplanned medical costs.
2. Cultivate Wellness to Promote Productivity
   Healthy employees mean fewer costly medical interventions and absences and more productive employees. Wellness programs can work with proper communication, management buy-in and education.
3. Keep Employees in the Loop
   Health Care Reform is a complex issue, and many employees are in the dark about how it will impact them. An ongoing communication plan to keep employees informed as the company considers its options and makes decisions can reduce concerns and help maintain productivity.

At R&R, we take wellness to a whole new level. Wellness programs will increase the health and longevity of employees and their families –which means that businesses can have a lot of control over their health insurance costs and the productivity of their employees – control that they don’t know they have. At R&R Insurance, we call this program WellCompForLife!

Join the WellCompForLife discussion on LinkedIn!

For more information about WellCompForLife, about self-funding your health insurance plan, health care reform or basic employee benefits questions, contact knowledgebroker Laura Stehno.

The Affordable Health Care Act (PPACA) requirement that employers issue a formal “Notice of Exchange” previously tagged with a deadline of March 1, 2013 and indefinitely delayed, is now back on track.

Employers, whether offering a health plan or not, are required to furnish this notice to their employees before October 1, 2013.

Providing the Notice

Who Must Receive a Notice?

Employers must provide the Exchange notice to each employee, regardless of plan enrollment status or of part-time

or full-time status. Employers are not required to provide a separate notice to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees.

What Is the Deadline for Providing the Notice?

ACA required employers to provide the Exchange notice by March 1, 2013. However, on Jan. 24, 2013, the DOL announced that employers would not be held to the March 1, 2013, deadline and that employers would not have to comply with the Exchange notice requirement until more guidance was issued.

The DOL’s temporary guidance sets a compliance deadline for providing the Exchange notices that matches up with the start of the first open enrollment period under the Exchanges.

Employers must provide the Exchange notice to both new hires and current employees as follows:

• New Hires – Employers must provide the notice to each new employee at the time of hiring beginning Oct. 1, 2013. For 2014, the DOL will consider a notice to be provided at the time of hiring if the notice is provided within 14 days of an employee’s start date.
• Current Employees – With respect to employees who are current employees before Oct. 1, 2013, employers are required to provide the notice no later than Oct. 1, 2013.

Employers that decide to inform their employees about the Exchanges earlier than the Oct. 1, 2013, deadline are permitted to use the model notices and rely on the DOL’s temporary guidance.

More about Model Exchange Notices and compliance deadlines…

Helpful Links:

Model Exchange Notice: for employers who do not offer a health plan

Model Exchange Notice: For emplyers who offer a health plan to some or all employees

Do I have to comply with the Fair Labor Standads Act (FLSA)?

The IRS, EBSA and HHS developed the new group wellness program standards to implement Section 1201 of the Patient Protection and Affordable Care Act (PPACA). PPACA Section 1201 lets group health plans offer wellness programs, but it prohibits plans from using the programs to discriminate against people with health problems.

The federal agencies -- the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) and the U.S. Department of Health and Human Services (HHS) -- said today they will compromise by requiring wellness incentive programs to use a "reasonable design."

"These final regulations state that a wellness program is reasonably designed if it has a reasonable chance of improving the health of, or preventing disease in, participating individuals, and is not overly burdensome, is not a subterfuge for discrimination based on a health factor, and is not highly suspect in the method chosen to promote health or prevent disease," agency officials said in a preamble to the final rule, Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (CMS-9979-F) (RIN 0938-AR48).

At R&R, we take wellness to a whole new level. Wellness programs will increase the health and longevity of employees and their families –which means that businesses can have a lot control over their health insurance costs and the productivity of their employees – control that they don’t know they have. At R&R Insurance, we call this program WellCompForLife!

Join the WellCompForLife discussion on LinkedIn!

For more information about WellCompForLife, about self-funding your health insurance plan, health care reform or basic employee benefits questions, contact knowledgebroker Laura Stehno.

“Wellness” is more than just a buzzword. Wellness means having the energy and vitality to be productive, and feel and perform your best. It’s our greatest opportunity to restore Americans and American businesses to better health. Your company’s healthy journey begins now. Step by step, employee by employee, to a new culture of health and a healthier bottom line.

Take a look around. What can you do to make your worksite a healthier environment?

• Have you checked your vending machines lately?
• Got stairs? Anyone using them?
• Are you sending out reminders about how to get healthier and avoid injuries.

Helping your employees improve their health is one of the best long-term strategies for reducing your health care costs. Most people spend 53% of their waking hours at work; you have an incredible opportunity to change the lives of the people you see and work with everyday.

The single issue driving the cost of medical, pharmacy, disability, behavioral health, worker’s compensation, absenteeism and presenteeism (coming to work when you’re sick) is the lifestyle choices people make.

• Chronic conditions such as diabetes and heart disease account for 75% of our nation’s health care costs.
• Obesity costs employers $45 billion annually in medical costs and lost productivity.
• The excess cost to employers of employees who use tobacco, factoring in increased medical cost and loss of productivity increases to approximately $3,400 per year per smoking employee.

When your employees are healthy, there’s a healthy chance that:

• Productivity increases
• Premiums or total medical spending may be reduced

When your employees experience fewer health complications, the result is a healthier, more productive workforce and potentially lower overall health care costs. It’s estimated that over 10 years, cumulative medical cost savings through reduced obesity rates could reach $282.6 billion.

Your Worksite Wellness team will assist you in choosing health screenings, health seminars and other wellness events that will work best for your employees. Help employees identify possible health risks and how they can lower them and start enjoying a healthier life or understand their benefits and treatment options so they’ll be able to make more informed decisions. Once you get a good idea, you can better choose which wellness programs will go over well, so employees will be more likely to participate. Your leaders can be your best wellness champions by sending emails directly to employees encouraging them to participate. Other ideas can include:

• Decide what the focus of your program will be: awareness, education, behavior change, culture enhancement, etc.
• How often will you have an onsite program and how long will it run?
• Who’s the targeted audience: staff only, spouses, dependents, retirees?
• Consider interventions that would impact both the low-risk and high-risk staff.
• Identify incentives that will increase participation such as low cost giveaways for participation or raffle/door prizes like fitness equipment, lunches, gift certificates or even paid time off.

Your wellness team should be a winning combination of management, front line staff and employees from every health status. Lay out a specific plan for your wellness campaign.

What we know for a fact: healthier employees recover more quickly from a work-related injury, and are actually less likely to even be injured. If Healthier Employees = Less Work Comp Injuries and Less Work Comp Claims, then another way of reducing work comp costs is to improve the health of your employees.

How does that culture shift play into the fact that the workforce is aging? How can an employer adjust roles and responsibilities of older workers to continue to make headway on reducing workers compensation costs?

The Aging Workforce Seminar, scheduled for May 23, 2013, held at the MRA Conference Center in Waukesha, WI, will address wellness, workers compensation and the aging workforce. How can employers finesse all three to improve efficiencies and increase profits?

Dr. Andrew Seter with Sensia Wellness will discuss a physician’s perspective on what he looks for in medical evaluations and how he advises employers with return-to-work programs. Proven Cost/Process/Behavior models will be discussed in this two hour seminar.

More seminar details and registration information.

Related Articles:

Preventing Injuries for an Aging Workforce

Obese Workers More Likely to Report Injury

Health-Related Productivity Costs

Employers Growing Role in Chronic Condition Management

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!