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Your Virtual Benefit Administrator Makes a Difference

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Your Virtual Benefit Administrator Makes a Difference

Brokers! Choosing your virtual benefits administrator is vital to the success and care of your clients. In order to give your clients the best health insurance experience, choose an administrator that offers a wide variety of products. Your virtual benefit administrator should give your client the ability to control their healthcare at their fingertips. How can a benefits administrator, like freshbenies, help your clients take control of their healthcare?

As the benefits marketplace continues to shift and evolve, your clients need to be in control of their health care services. 

How can you help your clients gain control of their healthcare?

Help them: 

Control their spending.

A virtual benefit administrator, like freshbenies, helps your clients take control of their spending related to healthcare. freshbenies users receive bottom-line savings. All packages include Member Engagement Systems to drive member experience. The expansion and wide-use of telehealth services give your clients the care they need from the safety of their own homes at an unbeatable price. More employees opt-in when services are bundled and convenient like those from our partner at freshbenies. 

Control the time they spend navigating healthcare.

With SBMA, Transamerica, and freshbenies, multiple vendors are bundled into one invoice, membership, and point of contact. This ensures your and the client’s experience is simple and streamlined. With freshbenies your clients’ employees can forget the hassle of waiting rooms and scheduling appointments.

The included Virtual Benefits Administrator takes away the hassle. You can negotiate medical bills, find local in-network doctors, and book a telehealth appointment all in one place.

Control their peace of mind.

As a broker, you want your clients to receive the best possible benefits packages at the best price. What comes with offering benefits that provide the best care, support, and price for your clients is peace of mind. With streamlined processes, convenient and cost-saving services, and instant access to their portal,  your clients can gain that peace of mind.

Thousands of employers, of varying sizes, trust SBMA and freshbenies. You can be confident that you are receiving the best care. 

At SBMA, our insurance coverage plans offer clients coverage when they need it most, with exemplary customer service. Our employee benefits administrators offer partnerships and health coverage that are ACA compliant, affordable and hassle-free.  To learn more reach out to our team at info@sbmabenefits.com.

Your Virtual Benefit Administrator Makes a Difference

What You Need to Know During Open Enrollment

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what you need to know during open enrollment

The open enrollment period for 2020 is here! It’s time to consider whether or not to enroll in a new health insurance plan or change your health insurance plan. To begin, you need to understand what benefits you can receive with minimum essential coverage. If your employer offers Minimum Essential Coverage and you’ve been hesitant to enroll, let us help you understand how MEC can give you the essential health benefits you need most.

What is MEC?

Minimum essential coverage is an insurance plan that meets the Affordable Care Act requirements for health insurance coverage. Plans under MEC include marketplace, job-based plans, Medicare, and Medicaid.

Before the Affordable Care Act, insurers would not cover people who had preexisting medical conditions. Those who had used too much of their medical coverage in the past were also at risk of not receiving insurance coverage. MEC ensures that insurance is offered to all enrollees regardless of health status, or the plan selected.

What is open enrollment?

Open enrollment is a period where individuals and employees can change or enroll in health insurance. During this period employees can also set up a flex spending account or health savings account. They can also sign up for and adjust the amount of various types of insurance, including

  • life insurance
  • disability insurance
  • vision insurance
  • dental insurance
  • legal insurance
  • supplemental benefits

What coverage uses open enrollment?

Most types of health insurance use open enrollment periods, including Medicare, job-based health insurance, and individual market health insurance. Outside the open enrollment period, individuals must show proof of a “life event” such as marriage, childbirth or new employment to be able to change insurance coverage. However, Medicaid, CHIP, travel insurance, and short-term health insurance do not use an open enrollment period. 

Why should I consider MEC during open enrollment?

MEC covers ten essential benefits in order to ensure everyone can receive proper coverage. These benefits include:

  • Laboratory services: preventative screening tests and diagnostic lab tests
  • Emergency services: emergency care at a hospital, even at a hospital out of network.
  • Prescription drugs
  • Mental health and substance abuse: includes counseling, psychotherapy, mental health, inpatient services, and treatment for substance abuse.
  • Maternity and newborn care: services during pregnancy, delivery, and after delivery
  • Pediatric services (including oral and vision): These services keep your children healthy. They include dental checkups, eye exams, vaccinations, and well-child visits.
  • Rehabilitative services and devices: A patient with disabilities, injuries, or chronic conditions receive coverage for physical, occupations, and speech therapy visits.
  • Habilitative services and devices: A patient can receive coverage for services and devices that help them learn and improve daily skills.
  • Ambulance patient services: services in outpatient care
  • Preventative/ wellness services and chronic disease management: including cancer screenings, annual checkups, and more at no cost.
  • Hospital visits: if you are in the hospital for inpatient care, your plan will help you pay your medical bills. However, it may only cover you for a certain period of time.

Minimum essential coverage can be an affordable option to ensure you and your family are covered during times of need. At SBMA we provide affordable coverage for all of our clients, with a variety of options, including telehealth, vision, and dental voluntary benefits.

why should I consider MEC during open enrollment?

What’s the difference between hospital indemnity policies and accident insurance?

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What's the difference between hospital indemnity policies and accident insurance?

Navigating insurance policies can be challenging for anyone. There isn’t a way to predict the future, how can you know what you will need? There are so many options available, how can you decide? Voluntary benefits can help supplement insurance policies that may not cover all of your employee’s needs. There are multiple options when it comes to voluntary benefits with a few differences. What’s the difference between hospital indemnity policies and accident insurance? Here’s a breakdown.

Accident Insurance

Accident insurance is an option to help supplement out-of-pocket expenses for potential expenses incurred when an accident occurs. This insurance is used to cover expenses that your standard health insurance plan cannot cover. Typical medical insurance directly pays the medical provider, and you get the bill later. Accident insurance pays the cash directly to you and you are able to choose the best way to utilize that money.

What exactly does an accident insurance policy cover?

There are quite a few expenses accident insurance covers that your traditional health insurance plan may not. These can include emergency room visits, ambulance rides, helicopter transportation, hospital admission charges, diagnostic exams, follow-up treatments, ICU and rehabilitation unit care, and physical therapy. If you have ever had to be transported in an ambulance, you know how expensive that can be, therefore accident insurance could save you thousands of dollars.

Deductibles for many medical insurance plans can cost thousands of dollars, other insurance simply doesn’t cover hospital stays, ambulance rides, or other non-preventative care. Accident insurance can be a great back up plan.

What is hospital indemnity insurance?

Hospital indemnity insurance is very similar to accident insurance, whether you choose one over the other or, get both, will depend on your lifestyle, expenses, and savings. It is also used to supplement any expenses incurred outside of your health coverage. 

Hospital indemnity insurance provides a set cash payment to use for any bills you need to pay. This is especially helpful for paying housing, bills, and living expenses if you are unable to work.

What does hospital indemnity insurance cover?

Hospital indemnity insurance coverage depends on the plan and coverage options you choose. Some things covered under a typical hospital indemnity plan include: ICU stays, critical care unit stays, outpatient surgery, continuous care, outpatient x-rays and laboratory procedures, outpatient diagnostic imaging procedures, ambulances, emergency rooms, and physician office visits.

Generally, hospital indemnity plans have lower premiums compared to other insurance, but depending on your coverage that can increase.

So, how do you decide which coverage to invest in?

The important distinction between the two types of insurance is how often you frequent the hospital. If you have hospital indemnity insurance and do not go to the hospital, you will not get paid benefits. However, accident insurance applies to both hospital stays and treatment from your primary care doctor. Consider a few things before you make your decisions. 

Consider your lifestyle.

Do you enjoy running, hiking, and other activities that may be more prone to accidents? Accident insurance might be your best choice. Do you have kids who play sports or are constantly playing outside? Accident insurance may be for you. If you lead a relatively healthy, active lifestyle, accident insurance might be a better option for you.

If you have a chronic health issue or have dependents with chronic health issues, hospital indemnity insurance may be a better bet for you.

How much money do you need to get by? 

If you live alone, or if you are a relatively young person with fewer financial responsibilities, accident insurance is a great option to ensure you are covered for whatever comes your way. Sometimes, the best solution may be to have both coverage options. If you have children, own a home, own a car, and have other expenses, purchasing both will give you the best coverage.

Lastly, consider how much money you have saved for emergencies.

If you don’t have a large amount of savings, e.g. enough to cover 3 months of expenses, a small monthly premium for accident insurance may sense for you. On the other hand, if you have enough money to cover potential accident expenses and support your lifestyle, but a large hospital bill might drain your savings, hospital indemnity insurance may be the better option. 

There are quite a few things to consider as you decide what coverage may be best for you. At SBMA, we offer multiple voluntary benefit options to ensure you are prepared for whatever comes your way. Contact us to learn more about our employment policies and how you can ensure you are covered in case of an emergency.

How to decide if you need accident insurance or hospital indemnity insurance... or both!

Brokers: Are you offering your ALE clients the most affordable MEC?

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Brokers: are you offering your ALE clients the most affordable MEC?

Attention Brokers: Are you offering your ALE clients the most affordable MEC?

Attention Brokers: Are you offering your ALE clients the most affordable MEC? How can you offer your applicable large employers a one-stop-shop for all their needs? Benefits are no longer about simply meeting Minimum Essential Coverage options.  You need to offer worksite and voluntary benefits, telehealth options, call center availability, and easy portal management. Why should you offer these options to your employers? Because they want them.

In order for employers to attract and retain great talent, they need great benefit options. This means going beyond standard MEC requirements and offering services that provide value and attract the best workers..

Let’s start with voluntary benefits.

Worksite and voluntary benefits include accident insurance, term life insurance, critical illness insurance, and hospital indemnity. 

  • Accident insurance includes aid in payment for medical and out-of-pocket expenses that may occur due to an accident occurring.
  • Term life insurance includes a way to provide financial protection for loved ones while employees are working.
  • Critical illness insurance adds a safety net for those who are under-insured. 
  • Hospital indemnity benefits help to offset high deductibles and out-of-pocket expenses so a hospital stay does not become a financial crisis.

Next, consider offering your employees access to telehealth care.

With 24/7 access to doctors, telehealth, also known as Virtual Health, can help employees get care when they need it with added convenience. At SBMA, we offer telehealth options that include behavioral health and therapy access, to give employees the ability to speak to a therapist whenever they need it*. In addition, it helps employees receive necessary prescriptions without having to go to a doctor’s office.

Employers look for convenience when looking for benefits, as a broker you can provide a one-stop-shop for all your ALEs benefits needs. This means 24/7 call center support and easy access to portal management, single point billing, and US-based customer care. 

At SBMA, we offer portal management access to provide employers with the ability to make plan changes, order ID cards, and have them shipped within a few days, check their claim statuses, and give employees the ability to manage their own profiles. 

With bilingual call center support, you’re getting licenses representatives to help manage enrollment and provide year-round support. All of our representatives are in-house, which means they understand your client’s needs.

SBMA can provide a one-stop-shop for all employers to handle their benefit needs. As a broker, it is your responsibility to provide your employers with the best possible options for their needs. Contact us to learn more!

*3X/year

voluntary benefits ale

What to do if your employee has COVID

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employee benefits

With companies beginning to return to work, there are a few procedures that employers need to put in place to keep their employees and customers safe. One thing employers need to put thought into is how they will handle what happens when an employee displays symptoms of COVID-19. Furthermore, when an employee is suspected or confirmed to have COVID-19, or if employees are exposed to COVID-19 but are not showing symptoms. Here is some guidance on what to do if your employee potentially has COVID-19.

First, what to do if an employee comes to work with COVID-19 symptoms…

According to the CDC, if an employee has symptoms when they arrive to work or become sick when they are at work, they “should immediately be separated from other employees, customers, and visitors, and sent home.” Be sure to communicate the protocol. If they develop symptoms outside of work, they should notify leadership and stay home, away from all employees. 

When an employee does need to stay home due to illness, they should follow the CDC-recommended steps to help prevent the spread of the virus. Once they are sent home from work, employees should remain home for at least ten days. 

Next, consider what to do if an employee is suspected or confirmed to have COVID-19…

In most cases, as a business owner, you do not need to shut down your facility. But work to close off any areas that the person who might have had COVID-19 had been in for an extended period. When you have the opportunity, follow CDC cleaning and disinfection recommendations to disinfect your workspace.

Consider how to determine what employees came into contact with the employee who may have COVID-19. Employers should inform their employees that someone they have come into contact with has Coronavirus. Ensure to maintain confidentiality to remain in compliance with ADA regulations. 

What about employees who have been exposed, but are not showing symptoms?

Employees who have been in close contact with someone infected (someone who has been within 6 feet of a person with COVID-19 for a prolonged period) but are not showing symptoms should remain home, or in an isolated area, and practice social distancing for 14 days. 

The CDC explains critical infrastructure employees can continue to work as long as they remain symptom-free and more precautions are put in place to protect the community. Be sure to advise these employees to wear a cloth face covering at all times during the 14 days following exposure. 

As we all continue to understand the implications of returning to the physical workspace, be sure to keep your employees safe and informed as you move forward. Take proper precautions to ensure your workforce and your surrounding community remains safe. For more information regarding COVID-19 resources, check out our COVID-19 page.

What to do if your employee has COVID

How Have Your Employee Benefits Changed Since the Start of COVID?

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How Have Your Employee Benefits Changed Since the Start of COVID?

Before Coronavirus swept the world with high unemployment rates, a strain on healthcare resources, and economic strife, employers were thinking creatively about how to not only retain their existing employees but also attract the best employees with benefits. While some states have been more affected by the health concerns surrounding COVID-19, almost all have felt the effects of the economic downturn. How have your employee benefits changed since the start of COVID? Once you identify the changes, how can you begin to prepare your insurance plan for post-pandemic employee benefits to attract and retain the best employees?

Despite the large unemployment numbers we’ve seen over the last few months, employers should still consider offering employee benefits that align with their employees’ needs. 

Employers had to act fast as stay-at-home orders went into place rather quickly. Therefore, they had to establish work-from-home policies, provide external education opportunities, provide new leave requirements, and anticipate new policies for return to work phases. All of this combined with the fear of potentially contracting COVID-19 can be overwhelming. 

However your employee benefits have changed since the start of COVID, here are a few ways you can look to the future for your employee’s benefits:

  • Get proactive: As an employer, understand the implications of layoffs, furloughs, and other workplace changes. You also need to understand benefits utilization, headcounts, and changes to employment policies. 
  • Rework your employment policies: What does the return to the physical workspace look like? How can you ensure your employees stay safe when they come back? What happens when an employee tests positive for COVID-19? Think creatively about how to run your business effectively outside of your physical space. 
  • Consider your compliance: Have you experienced changes to your workforce? If you are a large employer (with 50 or more full-time employees), and you do not offer benefits to 95% of full-time or full-time equivalent employees you may be opening yourself up to liability. 
  • Include Telemedicine options: Telemedicine use has seen a drastic increase over the last few months. Be sure telemedicine is offered in your employee’s benefit programs. 

As we all continue to understand what the effects of Coronavirus will be, as an employer it’s best to try to get out in front of it. Ensure both your business and your employees stay safe. Contact us to begin crafting your benefit plans today!

Your Guide to Post Pandemic Employee Benefits

How to attract the best employees: Voluntary benefits.

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Attract the best employees with voluntary benefits

Looking for ways to attract the best employees in a market where thousands of employees have been laid off? Offering voluntary benefits adds a level of insurance coverage that many workers have not previously had access to. Benefits beyond the traditional 401(k) and health insurance are vital to attracting the right talent for your business. 

What exactly are voluntary benefits?

Voluntary benefit plans are offered through the employer, but are paid, either partially or solely, by the employees. These benefits are typically paid through payroll deductions. Some of these plans offer group rates that employees cannot typically get on their own.

Why do employees look for employers who offer voluntary benefits?

  • It gives employees the choice: Allowing employees to choose the voluntary benefits they need gives your employees higher satisfaction and engagement with your business.
  • It meets the needs of various types of employees: Voluntary benefits cater to various generational, cultural, and economic differences among employees. It can be a challenge to meet the needs of a diverse workforce with a benefits plan that has only one option.
  • It ensures employees are financially stable: Voluntary benefit plans can protect employees financial wellbeing, and give them a sense of security in case something goes wrong. This makes them better, more engaged employees.

Not only do voluntary benefits help your existing employees, but also your future employees. When you offer competitive voluntary benefit packages to your workforce, great talent will be more likely to join your team. 

At SBMA, our benefit plan offers voluntary benefits that most employees will need. Your employees are the backbone of your business, so treat them right! Our plans can be modified to include dental, vision, life, hospital indemnity, accident, and critical illness coverage. Contact us today to see how voluntary benefits packages can improve your company’s ability to attract and retain the best employees.

how can voluntary benefits help you attract and retain employees

Are You Liable for Shared Responsibility Payments?

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are you liable for shared responsibility payments?

With all the recent changes to employment due to the global pandemic, navigating ACA compliance can be challenging. ACA noncompliance may lead to shared responsibility payments. Businesses with 50 or more full-time employees must offer affordable, minimum essential health coverage. 

How can your business avoid tax penalties from the IRS? 

The first step to avoid potential shared responsibility payments is to make sure your business stays compliant with the ACA shared responsibility requirement. While this may seem simple, there are few distinctions to be aware of, including determining full-time employment status and full-time equivalents, and identifying the minimum value requirements. 

If employers do not cover at least 95% of full-time employees and their dependents, the employer will be subject to a shared responsibility payment. 

If a full-time employee receives a premium tax credit because they were not offered coverage, the coverage was not affordable, or the minimum value was not provided, the employer may also be subject to a shared responsibility payment. 

Once you have identified how to stay compliant with the ACA shared responsibility requirements, ensure your reporting is accurate and timely. 

Applicable Large Employers (employers with 50 or more employees) are required to file information returns with the IRS, Forms 1094-C and 1095-C. These forms will inform the IRS of the employers that owe shared responsibility payments.

To mitigate the risk of receiving a letter from the IRS for shared responsibility payments, employers should carefully review and complete the forms above. 

If you do receive a shared responsibility payment letter from the IRS, the employer has 30 days to respond. If you do need more time to gather your information, the IRS may be able to extend the 30 days deadline. Either way be sure to respond or ask for an extension as quickly as possible.

If you are required to pay a shared responsibility payment be sure to consult a lawyer to ensure your reporting is accurate. At SBMA, we want to ensure you remain compliant with all ACA requirements. If you receive a letter from the IRS in 1094/1095 filing that we completed, we will refile your forms, free of charge. 

Contact us today to learn more.

shared responsbility payments

Employee Retention is More than Just Health Care

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Keeping employees engaged and excited about work can be a difficult task for some employers. There are a few things you can do as a leader within your organization to foster employee happiness. One of the main ways is to offer voluntary benefits. Employees are looking for insurance when they are looking for a company that will serve them, but they also require additional benefits, and other creative approaches to benefits. In the article below, you will see the best ways to keep employees engaged and excited about work, and how important it is to offer more than just health insurance. At SBMA, we have insurance options that include vision, dental, and other voluntary benefits. Check out our plan options here!

The Best Ways to Keep Employees Engaged and Excited About Work

The Best Ways to Keep Employees Engaged and Excited About Work

Attract ENGAGE Retain. 

An engaged workforce is a productive workforce. 

But you can’t force someone to be engaged. 

Once you’ve got a candidate through the hiring, onboarding and training process, you really want to retain them.  But what about two years in, five years in.  What do you do as a company to re-engage and thereby retain your staff?

People are engaged when they feel they make a difference.  People are engaged when they feel appreciated.  People are engaged when they feel a sense of purpose.  People are engaged when they feel aligned with the company’s values.

So, here are 6 ways to align yourself as a company for the best possible chance of engaging, inspiring, and thereby retaining your workers. 

  1. Benefits aren’t just a 401K: While health insurance is the #1 benefit employees look for, there are many other ways to keep employees feeling valued that are outside the traditional, raise, increase in benefits routes. Flexibility around work-life balance rates more highly among millennials than even health insurance in a study conducted in 2017 by Forbes magazine.  Bringing yoga into the workplace is another way to engage your teams in physical and emotional self-care right there on the job.  Don’t think of it as losing an hour of productivity, you’re not!  You’re donating an unproductive hour to the cause of engagement. Stress is the #1 reason people leave jobs.  So OHHHMMMMMM.
  2. Share your passion: If you’re passionate about running, donate 5% of your profits to a charity that uses running programs to get homeless people back on their feet.  If your passion is the environment, commit to a 100% plastic waste-free catering service… Whatever drives you will inspire others.  Sharing your passion with the team makes everyone clear that the CEO and owner cares deeply just like them.
  3. Get goofy: Not the dog that owns a dog… Get silly, be willing to be wrong.  Allow the company to see your human side. If that means outtakes and blooper reels go out on social media, do that.  If it means sharing that your dog died and you’re feeling really low… that’s vulnerability and as goofy as it may sound.  There’s tremendous strength in vulnerability (Brene Brown)
  4. Raise the bar: Raise up the mid-level managers in your company by bringing in training for them.  There are grants companies can apply for that pay for training effectively making that training free on the front end and so very profitable when your managers become leaders.
  5. Bang a gong: Employee of the month? Employee Spotlight, an actual gong for sales that close? There are so many ways to praise publicly (and reprimand in private).  These principles set out years ago by the likes of Ken Blanchard hold true to this day.  People want to be recognized for what they do well.  So give ‘em a hand.
  6. Ensure role alignment: Identify your company culture.  Hone in on it like a laser and protect it like it’s a crystal figurine your granny asked you to hold.  When you’re certain about your culture you can hire to align with it.  When you hire people who are aligned with the culture and get them in the right role, you’ll retain those people throughout their job lifecycle.

Intentional culture takes time and effort to build and only a small amount of neglect to destroy.  On that happy note, we’ll say, Happy retaining!

Encouraging and engaging employees can make a huge impact on your company’s culture. If you feel your company could use some adjustments to your current company culture, Culture Works can help!

Vision and Dental Add Value for Employees

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How Can Vision and Dental Add Value for Your Employees?

Voluntary benefit plans are an important part of employee insurance opportunities. Among these voluntary benefits, vision and dental insurance are an important part of employees voluntary benefit plans. How can vision and dental plans add value to your employees’ wellbeing? Here are a few ways:

Vision:

  • Vision exams identify future problems: They can detect things like eyestrain, diabetes, and even high blood pressure. They can also identify common eye issues and diseases.
  • Cost savings: According to the National Alliance for Eye and Vision Research eye disease, vision loss, and eye disorders cost the U.S Economy $68 billion per year.
  • Increase productivity: The vision council reported that eye care delivers $7,800 in more productivity per employee.

Dental:

  • Dentists can identify disease: Dentists have the ability to identify over 120 diseases. This can help your employee long-term health with potential early detection
  • Young employees likely don’t have dental coverage: The American Dental Association states that millennials have untreated tooth decay. The main reasons for this issue are cost convenience and confusion surrounding dental care.
  • Those with dental coverage are more likely to use it: As more people offer dental insurance the number of adults who miss work for oral health-related issues dropped 7%.

At SBMA, we provide voluntary benefits that employees love. To learn more about our voluntary benefit programs, contact us today!

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