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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

How Does the FFCRA Affect My Employee’s Coverage?

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The Families First Coronavirus Response Act is an Act of Congress meant to respond to the economic impacts of the ongoing 2019–20 coronavirus pandemic. The act will provide funding for free coronavirus testing, 14-day paid leave for American workers affected by the pandemic, and increased funding for food stamps. So, how does the FFCRA affect my employee’s coverage?

As the effects of Coronavirus continue to unfold, we have seen many changes to how companies have to adjust their benefits. Here are some strategies that employers can utilize to prepare for the changes:

Employer-provided health coverage: The Families First Coronavirus Response Act ensures that group health plans cover COVID-19 screenings without cost-sharing. The law, however,  does not require coverage for treatment without cost-sharing; treatment costs will be based on the terms of the benefits plan.

The IRS states that employees who have coverage with a high-deductible health plan are able to get COVID-19 testing and treatment without additional expenses. 

Paid leave and short-term/ long-term disability coverage: Employees with less than 500 employees must provide up to 12 weeks of leave related to child care with the expansion of the Family and Medical Leave Act, and up to 80 hours of emergency paid sick leave to employees who are full-time. 

Families first does not address employees who were on disability or leave before the outbreak. 

Employer tax credits for paid leave: The FFRCA has provided multiple tax credits to aid employers as they attempt to meet the new requirements. These tax credits are equivalent to 100% of the qualifying leave wages against the employer’s portion of Social Security tax. 

Continuing health coverage during furloughs and mandated leaves of absence. During unpaid leaves of absences that are extended, like a temporary layoff of furlough, health benefits are typically halted. 

Review your insurance contracts and stop-loss policies to determine how to regard employees who lose eligibility due to an extended leave of absence.Group health brokers can help you navigate extended leave coverage for W-2 employees. 

(COBRA), where furloughed employees can choose to remain on the group health coverage the employer must collect the amount of the employees premium. If an employee is receiving payments from accrued time-off, it is possible to collect premiums from those payments. 

Employer inquiries, screenings, and disclosures for infected employees: Asking employees about their health condition is  not a HIPAA violation. Other laws, like the ADA, don’t allow confidential information to be disclosed that concerns employees. If employers screen employees onsite, test results are not associated with a health plan.

Telemedicine programs: The use of virtual medicine gives employees the ability to remain home while being cared for medically, which helps halt the spread of COVID-19.  

Employer expenses with a quarantine employee: Some expenses incurred while an employee is quarantined can be considered deductible. 

As we continue to navigate through COVID-19 we will likely see more changes to benefits that are being offered to employees. Check back for updates

Worksite Benefits Benefit Everyone

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The high cost of health care and the evolution of insurance plans with high deductibles has created a market for voluntary benefits. 

Employees can choose from a number of insurance products to complement their coverage and to help achieve a greater degree of stability. Worksite Benefits (voluntary coverage) plans may be 100% paid for by employees or cost-shared with the employer. Here’s why worksite benefits benefit everyone.

Creating a more comprehensive and competitive benefits package is good for the employer as they attract better talent, good for the employee as they get improved coverage and good for the broker who is providing cost-effective solutions. In 2017 nearly half of large employers offered at least one of the three major voluntary benefits: accident, critical illness, and hospital indemnity.

Enrollment in voluntary benefits can be streamlined by offering these benefits at the time of enrollment in a MEC or other benefits plan, by ensuring ease of use in a portal or enrollment documents and by informing employees of the benefits of Worksite Benefits. .

Voluntary benefits generate commissions that can be used to fund overall benefits administration costs and project work done by TPAs that would otherwise be paid by the employer. 

SUPPORT FOR PHYSICAL AND MENTAL HEALTH AND WELLNESS

On the employer side, there has been a national push for physical and financial wellness initiatives. Employers are recognizing the increased stress their employees deal with on a day-to-day basis and are offering solutions. Stress costs American businesses more than $300 billion a year. 

PERSONAL PREFERENCE DRIVES DEMAND

Employees want to have more control when it comes to deciding which options are useful for them.

When employers offer a wide range of benefits that address physical and mental health and wellness issues, employees can adapt the package to fit their lifestyle needs. 

Employees want a benefits package that feels personalized to them, so that they feel like they An Aflac survey found that employees who were offered voluntary benefits were 19 percent more likely to be satisfied with their job – and 14 percent less likely to be job searching.

THE IMPORTANCE OF TECHNOLOGY

The wide array of technology providers offering more streamlined technology also makes voluntary benefits easier to implement for employers and brokers. Online enrollment, automated processing of administrative tasks and the ability for employees to “self-serve” all make the voluntary benefits enrollment process more attractive to employees and employers.

Voluntary benefits are only going to increase in popularity for employers and brokers of all sizes as they become more essential in the lives of employees. Isn’t it time to take a look at your benefits offerings and make sure they are competitive? Call SBMA today.

What is the Families First Coronavirus Response Act?

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In March 2020, President Trump signed into law the Families First Coronavirus Response Act, the initial coronavirus relief bill aimed at assisting families living in the United States. The new law requires small employers—those with fewer than 500 employees—to provide limited paid-leave benefits to employees who are affected by the coronavirus emergency. Small employers receive new tax credits and federal payroll-tax relief to pay for the new mandatory benefits.

Mandatory employee paid leave.

The Act requires emergency paid sick leave. It is limited to $511 per day for up to 10 days (up to $5,110 in total) for an eligible employee in coronavirus quarantine or seeking a coronavirus diagnosis. An employee can also receive emergency paid sick leave of up to $200 per day for up to 10 days (up to $2,000 in total) to care for a quarantined family member or a child whose school or child-care location has been closed due to the pandemic.

The Act also requires that small-business employees obtain the right to take up to 12 weeks of job-protected family leave if the employee or a family member is in coronavirus quarantine or if the school or child-care location of the employee’s child is closed due to the coronavirus. The employer must pay at least two-thirds of the employee’s usual pay, up to a maximum of $200 per day, subject to an overall per-employee maximum of $10,000 in total family-leave payments.

Small-employer tax credits

The Act grants a new tax credit to small employers to cover the now-required payments to employees who take time off under the new law’s emergency sick-leave and family-leave provisions.

Specifically, a small employer can collect a tax credit equal to 100% of qualified emergency sick-leave and family-leave payments made by the employer according to the Act. However, the credit only covers leave payments made during the period beginning on a date specified by the Secretary of the Treasury and ending December 31, 2020. The beginning date will be within 15 days of March 18, 2020, when the Act became law.

The credit increases to cover a portion of an employer’s qualified health-plan expenses that are allocable to emergency sick-leave and family-leave wages.

The new credit offsets the Social Security tax component of the employer’s federal payroll-tax bill. Any excess credit is refundable, meaning the government will issue a payment to the employer for the excess.

Warning: The credit is not available to employers that are already receiving the pre-existing credit for paid family and medical leave under Internal Revenue Code Section 45S.

Small-employer FICA tax relief

Sick-leave and family-leave payments mandated by the Act are exempt from the 6.2% Social Security tax component of the employer’s federal payroll tax that generally applies to wages. Employers must pay the 1.45% Medicare tax component of the federal payroll tax, but they can claim a credit for that outlay.

The Families First Coronavirus Act is just the first step of many that are sure to be taken by the U.S. government as they continue to face the COVID-19 outbreak. You can read answers to common questions, apply for aid, and more on the Department of Labor’s Q&A page here.

For a list of COVID-19 resources, click here.

What Employers Need to Know About FFRCA and Benefits

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The Coronavirus pandemic has had a massive impact on the financial health of thousands of companies in the United States. These employers have seen the enormous reduction in business and the effect it has on their employee benefit programs, and adjust them to meet the needs of both their employees and their business. These adjustments still carry certain obligations the employer must meet under federal legislation. So what do employers need to know about FFRCA and benefits?

Employers have had to reduce or terminate a portion of their workforce, put furloughs in place, and reduce hours and compensation for their employees in response to the crisis. All of these changes impact the employee’s benefit plans and policies, so an employer must review said plans and policies and make adjustments accordingly. Here’s what to consider while doing so:

Service provider contracts for employee benefit plans

Review the terms for existing contracts with multiple service providers, as the fees related to administrative contracts can be determined by the number of participants on your plan. Any reduction in workforce or hours for your employees would affect the total number of eligible employees, which could result in additional fees within the contract. The stay-at-home order may affect a service providers ability to meet their obligations within the contract, as well. Many of these contracts will contain a “Force Majeure” clause that excuses a party for nonperformance due to extraordinary events. Each of these provisions is contract-specific — be sure to review yours. A service provider’s nonperformance in regard to ERISA plans could pose a problem for employers. Employers should seek legal advice in terms of navigating their service providers contracts during this unprecedented time.

Emergency Paid Sick Leave and FMLA Expansion

On March 18, 2020, The Families First Coronavirus Relief Act was enacted. It requires employers with fewer than 500 employees to provide paid sick leave and additional FMLA benefits to their employees. Because of the added cost to employers, the FFRCA provides a quarterly payroll tax credit which is equivalent to 100% of qualified sick and leave wages paid to employees as emergency paid sick leave and emergency family and medical leave.

Health and Welfare Plans

  • COVID-19 Specific Coverage: The FFCRA requires group health plans to cover COVID-19 diagnostic testing related costs, healthcare provider services, and facility costs without the participant’s deductibles, copay, or coinsurance. The FFCRA also ensures that prior authorization and other medical management requirements be waived regarding COVID-19 services. In addition to the FFCRA, the CARES Act requires group health plans to cover preventive services and vaccines related to COVID-19.
  • Reduction in hours (or furloughing): Specific plan or policy terms determine whether furloughed employees or employees with a reduction of hours can keep their health coverage. Many plans require employees to uphold a minimum amount of hours to maintain coverage. Employers might be able to amend their plan or alter the policy to expand coverage or modify procedures for employee premium payments, but must seek approval from their insurance provider before any changes take place. 
  • COBRA Continuation Coverage: COBRA continuation coverage is offered to employees who have been terminated or have reduced hours. Employers can provide a subsidy to help their employees cover the COBRA continuation costs. Be sure to consider any discrimination issues that may arise if the subsidy is not offered throughout your company. 
  • ACA Employer Mandate: ACA requires employers with 50 or more full-time employees (who average 30 hours a week or more) provide minimum essential coverage to their employees.
  • HIPAA: employers who are covered under HIPAA and their associates must remember that HIPAA applies during the COVID-19 pandemic. With changing work conditions, ensure that you review and update HIPAA privacy practices to ensure your safeguards are in place.
  • Cafeteria Plan Elections: There cannot be any change in mid-year election choices based on employment status change. 
  • Premium adjustments: The potential reduction or change in your workforce could affect the employee eligibility for health insurance policies, which could bring about premium adjustments. 
  • Value of welfare benefits: Welfare benefits and their value is tied to employee compensation, reducing their compensation can reduce the value of these benefits for those employees. 

Retirement Plans

  • There are fiduciary responsibilities under ERISA in a market similar to the one COVID-19 has caused. ERISA plans should pay specific attention to fiduciary duties, like acting prudently, diversifying plan assets, and complying with plan provisions. 
  • Participant Access to Retirement Plan Accounts: 
    • The CARES Act permits multiple situations for employees. Employers can expand participant access to specific retirement accounts for “coronavirus-related distribution,” without subjection to 10% early withdrawal penalties and must be repaid over a 3-year period. 
    • The CARES Act also allows employers to increase the maximum loan amount for qualifying individuals if their 401k plan allows participant loans. 
    • Hardship Withdrawals: Most plans allow for hardship withdrawals in areas that are federally declared disaster areas. These withdrawals are still subject to the 10% withdrawal penalty who have not reached the age of 59 ½ and are taxable in the year they are withdrawn. 
    • In-Service Distributions: If the employee has reached the age of 59 ½, many plans allow their participants to receive in-service distributions without a withdrawal penalty. In light of the crisis, employers should consider a plan amendment to expand or add in-service distribution to defined contribution plans or benefit plans.
  • Reducing or Freezing Benefits and Contributions: Employers may be looking to reduce operating costs by reducing or freezing benefits or suspend employer matching or nonelective contributions. This requires at least a 45-day notice before the reduction is put into effect. Discretionary employer matching and nonelective contributions may be suspended or reduced prospectively and may or may not require a plan amendment. Consider the IRS rules that prevent cutbacks in benefits.
  • Funding Relief for Single-Employer Defined Benefit Plans: The CARES Act gives single-employer benefit plans more time to meet funding obligations by delaying the due date until January 1, 2021, with interest on the delayed payment. CARES Act also allows a single-employer defined benefit plan sponsor can elect to treat the plan’s different funding target attainment percentage to the last plan ending before January 1, 2020.
  • Voluntary Termination of Qualified Retirement Plans: Due to the change in economic circumstances some employers may feel they need to terminate their qualified plans. All participants must be fully vested in their accounts under the plan during termination. However, there is a rule that employers who terminate a 401k plan may not establish a new plan within 12 months of the termination. Participants and beneficiaries must receive a special notice at least 45 days prior to the effective date of termination.
  • Partial Termination of Qualified Retirement Plans: Reducing your workforce by 20% or more of qualified retirement plan participants in a plan year that is not considered routine turnover could end up in partial termination of the plan. All participants who have been affected must be fully vested in their accounts. 
  • Deadlines for 403(b) Plans and Pre-Approved Defined Benefit Plans Extended: The IRS is extending the last day of the initial remedial amendment period for 403(b) plans from March 31, 2020, to June 30, 2020. They also are extending both the April 30, 2020 deadlines for an employer to adopt a pre-approved defined benefit plan and submit a determination letter application under the second 6-year remedial amendment cycle and the April 30, 2020 end of the second 6-year remedial amendment cycle for pre-approved defined benefit plans deadline until July 31, 2020.

Incentive Compensation/ Non-Qualified Deferred Compensation Plans

There are strict rules that Code Section 409A adheres to regarding the time and type of payment incentive compensation and other non-qualified deferred compensation a company puts in place. This could include penalties for both the employer and the employees. As you work to navigate potential liquidity issues through the COVID-19, ensure that you navigate Code Section 409 A properly by addressing these issues:

  • Paying Annual Bonuses by March 15th: If you missed the March 15th deadline due to COVID-19 related issues with administrative duties or if the payment jeopardized the employer’s ability to continue, the payment may be made as soon as possible after the unforeseen circumstances are alleviated.
  • Cancellation of Deferrals/ Unscheduled Distributions: In the event of an unforeseeable event, an employee’s deferral election may be canceled, if the plan allows. Employers can also allow a participant to receive distributions if their plan contains these distributions. The employee still must show that emergency expenses cannot be covered by insurance, liquidation of assets, or ceasing deferrals under their plan. The distribution will also be limited to the amount needed to satisfy the participant’s financial needs. 
  • Scheduled Distributions/Distributions Payable Upon Separation From Service: Most non-qualified deferred compensation plans provide payment upon an employee’s separation from service. Separation of service includes termination or a reduction in hours, and the employee would be entitled to a distribution from their plan.
  • Equity Award Considerations: Employers should consider if they should update their stock option valuation that considers the COVID-19 pandemic. This could affect the issuance of equity compensation.
  • Termination of Non-qualified Deferred Compensation Plans: Section 409A does allow a voluntary plan termination and distribution of benefits under specific circumstances, but these rules do not allow termination in connection with a downturn of employers’ financial status. This would require similar non-qualified deferred compensation arrangements to be terminated, and payments would be delayed 12 months after the plan is terminated. Once this is done, the employer cannot adopt a new non-qualified deferred compensation arrangement of the same type for 3 years.

As an employer, there are many things to consider with the changing economic times. For more information visit our site.

How to Offer Remote Workers Benefits

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Due to changes caused by the Coronavirus outbreak, many people have made the transition to working from home. This new reality has changed the way most people do business — from holding meetings over Zoom to dealing with distractions at home, this new reality has been an adjustment for just about everyone involved. For employers, this has meant adjusting where they allocate resources and how they operate on a day-to-day basis. As companies continue to keep their employees working remotely, it’s important to understand the effects this change will have on employee insurance benefits.

Most Americans rely on their workplace to offer their health insurance options. As we adjust to a new way of working, it’s important as an employer to ask: Should I make adjustments to the benefits I offer my employees?

The answer to this question is almost always: Keep offering benefits! 

In order to retain employees and save company time and money, offering insurance is imperative. Health insurance is an important consideration most people take when deciding whether or not to take a job. Offering competitive health insurance options gives you a competitive advantage. 

When employees feel their best and know they are protected if anything happens, they are more likely to work harder for the company. Employees with insurance are more likely to go to the doctor for annual check-ups to ensure their health. If you give your employees insurance, they will likely take less time off for illness, which will benefit your company in the long run. 

Especially during these uncertain times, offering insurance and peace of mind to your employees allows them to focus on things other than their well-being. Virtual healthcare is also a great option for most employers, as the effects of COVID-19 drive many people to stay home as often as possible. If that is not included in your program now, consider adding it. Most people will want to be able to contact a doctor while adhering to the social distancing measures still in place.

As companies adjust to the “new normal,” they must consider how this could change their benefit programs for their employees. Ensure that you are giving the best options possible to all your employees, and giving them a piece of mind during this uncertain time. Contact us for more information on how you can best serve your employees with the best possible benefits.

Navigating Individual and Voluntary Benefits

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How to Understand the Differences Between Voluntary and Individual Benefits

Navigating the similarities and differences between individual and voluntary benefits can seem challenging. Which ones do your employees want? What can employees get from individual benefits that they can’t from voluntary? How can benefits attract and retain great talent? Here is a list of the major similarities and differences between the two to help you navigate what benefits you want to provide.

Some similarities include:

  • Customizable options: Both benefit options have multiple coverage options available. These customizations give people the ability to change their options to cater to their needs, their family size, and their budget.
  • Dependent coverage: You have the ability to add eligible dependents, like your spouse and children, for an additional charge.
  • There are various areas that are covered: Both types of insurance cover dental, vision, disability, and life insurance.

Some differences include:

  • Voluntary benefits are sponsored by your employer: Voluntary benefits are only offered through employer-sponsored healthcare plans. Those who are not employed do not have access to voluntary benefit options. The employer also chooses what options are offered and what the coverage levels are. As an employer, this can be a great way to differentiate your company.
  • Individual insurance is completely paid for by an employee: Some business owners pass the cost of voluntary benefits on to their employees, though it is not required. Some employers will also cover a portion of voluntary benefit elections for their employees. With individual coverage, the employees take the entire cost.

At SBMA, we understand how important your employees are to your organization. Offer your employees the most options for coverage. When you offer your employees more options when it comes to benefits, they will likely have higher engagement levels as they feel you care for their wellbeing. Contact us to learn more about the voluntary benefits you can offer your employees.

ACA Compliance and COVID-19

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How to Prevent ACA Penalties due to COVID-19

Due to COVID-19, ACA compliance has become a bit more complicated. As an employer, you must ensure that all your paperwork and practices are ACA compliant. If individuals wrongly receive a PTC, the employer is responsible for proving to the IRS that the individual did not qualify. It is now more important than ever to have your information in order, in case of future issues. In the ACA times article below, you will see why ACA penalties may increase this year, and how you can prevent potential penalties for your business.

A new data analysis report from the Kaiser Family Foundation (KFF) finds the vast majority of Americans who lost their job amid COVID-19will be eligible for government-subsidized health coverage.

The KFF report, issued May 13, identifies 79% of Americans that lost their job due to COVID-19 related factors “are likely eligible for subsidized coverage, either through Medicaid (12.7 million) or through the ACA’s marketplaces (8.4 million).”

Of the nearly 13 million potentially eligible for Medicaid, individuals will have a more affordable option if their home state was one of the 37 to have expanded Medicaid.

The remaining eight million and counting will apply for a Premium Tax Credit through either a state or federal health exchange. Some of these individuals may wrongfully receive the government subsidy, as a recent TIGTA report finds. Whether they correctly receive the subsidy or not, the onus will be on employers to maintain accurate records as they gear up to file their 1094-C and employee 1095-C’s with the IRS next year. Without detailed record-keeping and an accurate ACA filing, employers could potentially expose themselves to significant ACA penalties.

As a reminder, PTCs are the trigger for the IRS issuing Letter 226J penalty notices to employers identified as having failed to comply with the ACA’s Employer Mandate for a specific tax year.

Under the ACA’s Employer Mandate, Applicable Large Employers (ALEs) organizations with 50 or more full-time employees and full-time equivalent employees) are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is Affordable for the employee or be subject to Internal Revenue Code (IRC) Section 4980H penalties.

If individuals wrongfully received a PTC, the burden falls on the employer to not only have their ACA practices and filing tight-nit, but to also prove to the IRS that the individual did not qualify. For those who correctly received the PTC, it is important that employers code the employee’s 1095-C correctly to prove why the PTC should not result in a corresponding penalty.

And with states passing special enrollment periods allowing individuals to enroll in their health exchanges indefinitely, employers may see a significant uptick in the number of IRS penalty assessments in the mail due to more PTCS being issued.

This could prove problematic for employees, currently facing financial challenges from COVID-19, among other issues including furloughs, layoffs, changes in employee classification and so on.

Employers should explore ACA Complete as a solution to ACA compliance and have peace of mind knowing their workforce changes are being documented and handled by a third-party expert who specializes in data consolidation, analysis and regulations.

To learn more about ACA compliance in 2020, click here.