United Benefit Advisors Insight and Analysis Blog

Growing Pains: Why Adolescence Is About To Get That Much Harder

Posted by: Elizabeth Kay    Mar 19, 2015 12:00:00 PM

Employers that are growing up, and are in the awkward teenage years, are about to get a big surprise, and not the good kind.

When a company first opens, they are excited when they first implement their benefit plans for their handful of employees. They offer one or two medical plans, perhaps some dental and vision, and a small life insurance policy. The company knows that the small group rates will be high, but not much can be done, so they live with it. The rates are based on the employee’s age and where the company is located. They rely on their broker to show them the different options and help them offer plans with the best value to their employees.

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Topics: ACA, employee benefits, COBRA, community rating, composite rating

EEOC Files Suit Over Wellness Program

Posted by: Linda Rowings    Sep 9, 2014 1:32:00 PM

The Equal Employment Opportunity Commission (EEOC) has sued an employer because the penalty it applied for not participating in its wellness program was, in the eyes of the EEOC, so high that participation was not, as a practical matter, “voluntary.” Under EEOC rules, an employer may conduct medical examinations, which includes obtaining medical histories and blood draws, only in limited situations. One of those permitted situations is a voluntary wellness program. Because the program did not qualify as “voluntary,” the questions employees were asked about their health on a health risk assessment, a blood draw, and a range of motion assessment violated the Americans with Disabilities Act (ADA), according to the EEOC’s Complaint.

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Topics: employee engagement, wellness, ancillary benefits, health care costs, ACA, disability management, voluntary benefits, employee satisfaction, UBA Partner Firm, employee benefits, hr consulting, health care reform, health care, wellness programs, absence management, absenteeism, disability insurance, health risk assessment, PPACA Affordable Care Act, employee health, insurance solutions, medical plan, self funded health plans, HRA

Overcoming Employee Disengagement

Posted by: Bill Olson    Aug 27, 2014 2:31:00 PM

By Peter Freska, CEBS, Advisor
The LBL Group 
A United Benefit Advisors Partner Firm 

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Topics: employee engagement, wellness, ancillary benefits, health care costs, ACA, disability management, voluntary benefits, employee satisfaction, UBA Partner Firm, employee benefits, hr consulting, health care reform, health care, wellness programs, absence management, absenteeism, disability insurance, health risk assessment, employee health, insurance solutions, medical plan, self funded health plans, HRA

The Road to Better Absence Management

Posted by: Bill Olson    Aug 11, 2014 4:14:00 PM

By Stephen Coffman, Group Practice Leader
The Guardian Life Insurance Company of America  

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Topics: employee engagement, wellness, ancillary benefits, health care costs, ACA, disability management, voluntary benefits, employee satisfaction, UBA Partner Firm, employee benefits, hr consulting, health care reform, health care, wellness programs, absence management, absenteeism, disability insurance, employee health, insurance solutions, medical plan, self funded health plans

How Long Commutes Impact Workplace Productivity

Posted by: Geoff Mukhtar    May 19, 2014 12:44:00 PM

What do all employees have in common? They all have a burning dislike for their morning commute! Let’s face it, it’s not the actual commute that most people dislike, it’s the hassle of dealing with traffic, long lines, and rude people that make the trip so despised.

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Topics: employee engagement, wellness, ancillary benefits, health care costs, ACA, voluntary benefits, employee satisfaction, employee benefits, health care reform, health care, wellness programs, absenteeism, employee health, insurance solutions, medical plan, self funded health plans

Summary of Eligibility Waiting Period Requirements

Posted by: Bill Olson    Feb 28, 2014 12:33:00 PM

On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements. The Patient Protection and Affordable Care Act (PPACA) provides that plans may not require an employee who is eligible for coverage to complete a waiting period of more than 90 days before coverage is available. This requirement is effective on the first day of the 2014 plan year. This requirement applies to all plans, including grandfathered plans, fully insured and self-funded plans, and plans offered by small employers. It applies to both full-time and part-time employees if the employer has chosen to cover part-time employees. These final regulations are effective as of the beginning of the 2015 plan year, but they largely mirror the rules that are already in place for 2014. They do not in any way delay the requirement that plans meet the eligibility waiting period requirement by the start of the 2014 plan year.

The regulations state that an eligibility waiting period cannot be more than 90 days. This, literally, is 90 calendar days – a plan that begins coverage as of the first of the month after 90 days of employment, or after three months of employment, will be out of compliance. If the 91st day falls on a weekend or holiday, the plan may not wait to begin coverage until the following work day. In that situation, the plan will need to begin coverage as of the Friday before the end of the allowed waiting period.

The waiting period may be delayed until the employee meets the plan’s eligibility requirements. For example, if the plan does not cover employees who work fewer than 30 hours per week, or employees in certain job categories, and an employee moves from ineligible to eligible status, the waiting period may begin as of the date the employee first moves into the eligible class. Other acceptable eligibility requirements include earnings requirements for salespeople, cumulative service requirements of up to 1,200 hours for part-time employees, or employees covered under a multiemployer plan, and similar arrangements that are not designed to circumvent the waiting period.

Example: Fay begins working 25 hours per week for Acme Co. on January 6, 2014. Acme’s group health plan does not cover part-time employees until the employee has completed a cumulative 1,200 hours of service. Fay satisfies the plan's cumulative hours of service condition on December 15, 2014. Acme must offer Fay coverage by March 15, 2015 (the 91st day after Fay meets the service requirement.).

The regulations recognize that multiemployer plans often have complicated eligibility rules, and that is permitted as long as the eligibility requirements are not designed to avoid the waiting period rules.

Example: A multiemployer plan has an eligibility provision that allows employees to become eligible for coverage by working a specified number of hours of covered employment for multiple contributing employers. The plan aggregates hours in a calendar quarter and then, if enough hours are earned, coverage begins the first day of the next calendar quarter. The plan also permits coverage to extend for the next full calendar quarter, regardless of whether an employee’s employment has terminated. This arrangement satisfies the regulation.

An employer may require that an orientation or probationary period be successfully completed before an employee is considered an eligible employee. However, in a proposed regulation issued with the new final regulation, the agencies state that because of concerns that orientation or probationary periods will be used to improperly delay coverage, they are considering limiting permissible orientation and probationary periods to one month.

The regulation allows a waiting period that is longer than 90 days for new variable hours employees. A variable hours employee is someone whose hours cannot be predicted when the person is hired. An employer may average the time worked by a variable hours employee over his or her initial measurement period to determine if the employee is eligible for coverage. The waiting period may be imposed after the initial measurement period is completed as long as both periods are completed by the first day of the month following completion of 13 months of employment.

Example: Ann is a variable hours employee because she is an on-call nurse. Ann’s employer uses a 12-month initial measurement period for variable hours employees and a 60-day waiting period. Ann is hired May 10, 2014. If Ann averages 30 or more hours per week during the initial measurement period, she must be offered coverage with an effective date of July 1, 2015, or sooner.

Individuals who are part way through a waiting period as of the start of the 2014 plan year must be credited with time prior to 2014, so that their total waiting period as of the start of the 2014 plan year is no more than 90 days.

Example: Ed is hired October 22, 2013. Ed’s employer has a calendar year plan and during 2013 it used a six-month waiting period. Ed must be offered coverage with an effective date on or before January 20, 2014, because that is Ed’s 91st day of employment.

Although not related to eligibility waiting periods, this regulation also confirms that certificates of creditable coverage need to be provided through December 31, 2014, (regardless of plan year). The certificates will not be required after that date because pre-existing condition limitations will not be permitted after the start of the 2014 plan year.
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Topics: ACA, employee benefits, benefit communication, benefit consultants, benefit management, compliance with health care reform, group health insurance, Group health plans

New PPACA Fees Strike Employers

Posted by: Josie Martinez    Feb 26, 2014 10:15:00 AM

By Josie Martinez
Senior Partner and Legal Counsel 

EBS Capstone, A UBA Partner Firm

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Topics: health care costs, ACA, employee benefits, health care reform, PPACA, benefit communication, benefit management, compliance with health care reform, Group health plans

Who’s Walking and Who’s Just Talking?

Posted by: Bill Olson    Feb 24, 2014 9:41:00 AM

There is a lot of talk about the many cost-control and health care reform tactics available to employers, but what are companies actually implementing? The latest UBA Benefit Opinions Survey aims to define just that. While clients and prospects of UBA’s Partner Firms have contributed thousands of responses to the survey, any employer can participate and get a complimentary findings report. This landmark benchmarking resource compiles information from employers representing all major industry classifications, employee size categories and regions of the country, and delineates employers’ opinions in five key areas:

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Topics: employee communication, ACA, employee benefits, PPACA, leadership, UBA Benefit Opinion Survey, benefit communication, benefit consultants, benefit management, compliance with health care reform

More on Skinny Plans: No Minimum Value Plans Continue to Be an Option

Posted by: Josie Martinez    Feb 20, 2014 11:46:00 AM

By Josie Martinez
Senior Partner and Legal Counsel 

EBS Capstone, A UBA Partner Firm

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Topics: ACA, employee benefits, PPACA, benefit communication, benefit consultants, benefit management, compliance with health care reform

IRS Issues Final Regulations on Employer Shared Responsibility (Play or Pay)

Posted by: Linda Rowings    Feb 13, 2014 1:47:00 PM

By Linda Rowings
Chief Compliance Officer
United Benefit Advisors

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Topics: ACA, Linda Rowings, employee benefits, health care reform, PPACA, benefit communication, benefit consultants, benefit management, compliance with health care reform