Improved Communication and Adoption of GAP Coverages Critical to Long-Term HDHP Success

High deductible health plans continue to demonstrate broad appeal even as Congress attempts to pass alternative healthcare legislation. While HDHPs have proven quite effective for some of their insured, many fail to get the specific care they need. High-end health plans that offer more coverage cost dramatically more as services are expanded in every direction. But healthcare isn’t a universal issue with a universal solution.

Surprisingly, both employer and employee adoption of GAP coverages remains low. Some of the most significant voluntary benefits such as critical illness, hospital indemnity, and accident insurance are still not regularly offered alongside HDHPs, creating alarming gaps in coverage – especially for those with health issues that require periodic visits to the doctor and/or pharmacy.

Even when they are offered, employee enrollment rates are modest – a challenge for employer and employee alike. Companies that fail to offer gap coverages and leverage their adaptability as a strong employee benefit will fail to remain competitive in the long term – whether legislation changes or remains as it is today. To learn more about HDHPs, gap coverage, and employee benefits communication, contact us.

Changes to Expect to the Affordable Care Act

There is no doubt changes are coming to the Affordable Care Act (ACA). However, many are wondering when those changes will occur and what they will look like. Like most acts of government, there will be no major modifications anytime soon. It is easy for GOP leaders to say they plan to repeal the Affordable Care Act, but this process is harder than it looks. It is also unlikely that congress will repeal the entire law, so the focus will be more on what aspects are changing and how does it affect individuals and businesses.

Changes to the ACA for 2017

So far, President Trump has not changed much of the ACA. He issued an executive order stating that federal agencies should use any means possible to delay the requirements of the ACA should it impose a fiscal burden on individuals, the health industry, or states as a whole. Due to the vague nature of the order, the only federal response from the IRS is they do not plan to enforce the requirement that most individuals must possess health insurance as strictly as they have in the past. However, it is still law.

What Happens to Those Insured via the ACA?

The biggest concern for individuals and businesses alike is what happens when congress replaces the ACA. Individuals want to know if they will be without insurance. Businesses want to know how these changes affect compliance and if they will suddenly be in violation of new regulations.

Thankfully, both President Trump and congressional leaders spearheading the initiative agree that a smooth transition is vital. They have no desire to leave individuals without insurance or cause major interruptions to businesses. Their current plan is to repeal and replace the law simultaneously.

Looking Forward

While many are concerning themselves with the coming year, 2018 holds fewer answers and more uncertainty. Because of this, more and more insurers are pulling out of the individual market. This is an issue as it is how individuals purchase insurance outside of their employer. Employers need to prepare themselves for an influx of individuals requiring insurance.

Until health care reform is complete, the best solution for employers is to invest in a Bronze level high deductible health plan (HDHP) alongside Group Supplement Health (GAP) plans. GAP insurance can provide coverage where HDHPs prove inadequate. This allows employers to offer compliant health insurance that their employees can afford. To stay up to date with the changing face of ACA as well as learn more about GAP solutions, contact Chelten Consulting.

Overcoming the Boring Benefits Communication Barrier

There is a lot of information new hires need to know. Onboarding processes are notorious for being dull and resulting in many glazed eyes, lack of attention, and failure to absorb the necessary information. Reducing the duration of this process as well as improving the efficacy has two primary benefits. First, Human Resources (HR) is able to disseminate important information without wasting time. Second, companies can start seeing a faster return on investment from their new hire.

Revamping Orientation Programs

HR has the important but tedious task of communicating a vast amount of information to new hires: performance review procedures, the employee handbook, and so on. HR departments often send out newsletters or create PowerPoints to address this information. Even so, many employees fail to absorb it or cannot find what they are looking for later. To overcome this communication hurdle, HR should make their onboarding process:

  • Death by PowerPoint is alive and well among many HR new hire orientation programs. It is also ineffective. Visual presentations that are not-text-heavy are much more likely to capture an audience’s attention than slides overloaded with dense sentences.
  • Taking a holistic approach can show new hires how all of the information they are seeing relates. This type of approach can connect the dots to elucidate the larger picture.
  • Cross platform. Much of the advice for HR professionals recommends communicating information in small pieces so as not to overwhelm employees. While this may be true, HR departments should also take steps to house all of the information in an easy to access and search location. Employees should also be able to access the information from any device.

Chelten Consulting understands your company needs effective information distribution strategies. Making these changes can accelerate and improve new hire benefits communication. Contact us to ensure your business is using the most effective methods of communication.

Employers Becoming PPACA Compliance Officers

With the ever-changing healthcare landscape, employers have had to take on a greater role when it comes to Patient Protection and Affordable Care Act (PPACA) compliance. Various government departments including the Department of Labor, Health and Human Services, and the Internal Revenue Service are actively tracking small and mid-sized businesses for numerous compliance issues. These include PPACA reporting, wage and hour miscalculations, and more. Human Resource (HR) managers have a full-time job on their hands ensuring their company is PPACA compliant.

Many employers are familiar with PPACA’s requirements, but they do not understand their function. For employers, these requirements are boxes that need checking. What concerns business owners more is finding good health insurance that does not break the bank. They also want their plan to be PPACA compliant to avoid fines for implementing their health care offerings incorrectly. Meanwhile, employees need insurance to avoid penalties come tax season as well as for their own health.

These fines and penalties are a serious matter, especially since the IRS increased them in 2016. The increase for employees is:

  • $695 or 2.5% of income per uninsured adult, whichever is more

While the increases for employers include:

  • $2160 per employee if the employer fails to provide insurance or provides a non-compliant plan
  • $3240 per staff member using a subsidy through the marketplace
  • $1100 per day if the employer is late filing tax forms and documents

Now more than ever, employers need knowledgeable counsel to ensure PPACA compliance. Otherwise, they could be facing thousands of dollars in fees. To learn more about PPACA compliance, contact the experts at Chelten Consulting.

PPACA Compliance Concerns for 2017

shutterstock_251707783 smEmployers know they need to remain compliant with the Patient Protection and Affordable Care Act (PPACA) when designing their health benefits, vendor selection, and more. However, it can be hard to manage as compliance regulations change. As businesses begin finalizing their 2017 health plans, they should consider the following compliance issues:

  • FSLA and overtime: The finalized Fair labor Standards Acts (FLSA) altered the parameters for employees who have the right to overtime payment. Employers will need to take this added cost into consideration. This new expense may require employers to revise their benefit plans to account for these changes.
  • Wellness and equal opportunity: Employers should evaluate whether their wellness program meets the new regulations created by the Equal Employment Opportunity Commission (EEOC). Wellness programs that require health risk assessments, for example, may no longer be compliant with the EEOC’s Americans with Disabilities Act.
  • Mental health parity: Coverage for mental health and substance use disorders has changed. Employers should make sure their plan aligns with the most up to date parity guidelines. When selecting vendors, employers should contract with those that handle both mental health and substance use disorder benefits.
  • Preventative care: Employers with non-grandfathered group health plans should verify their plans are PPACA compliant for cost-free preventative care. Employers should update their plans to include the most up to date guidelines for preventative care.

Navigating PPACA compliance can be difficult and employers who aren’t compliant can face steep fines. To learn more about managing these and other compliance issues for 2017, contact us.

New Benefit Micro-Webinar: Private Exchanges and GAP Coverage

new private exchange model video tileGroup Supplemental Health plans – called “GAP” plans – are used to fill in holes in high deductible health plans (HDHPs) offered to workers today.  They’re similar to the “Medigap” supplemental insurance plans millions of Seniors purchase each year to fill in holes in Medicare parts A&B.

These plans are considered “excepted benefits” under ACA meaning that they operate outside many of the rules of Obamacare.  They are offered only as supplements to existing major medical plans and only cover certain inpatient and outpatient deductibles and coinsurance costs.

Most GAP plans cover neither the professional fees in a doctor’s office nor the costs of outpatient prescription drugs.  Because of this, Advisors generally recommend Employers purchase at least a Bronze major medical plan with doctors office and prescription copays to complement any GAP plan.

Learn more about how GAP coverages and basic private exchange plans combine to provide employees with newer and better solutions:

Empty American Savings Accounts Call for Shifts in Healthcare Coverage

shutterstock_92934382 - CopyA recent poll conducted by The Associated Press-NORC Center for Public Affairs Research indicates that approximately two-thirds of Americans would have difficulty covering the costs of an emergency requiring $1,000 in liquid capital. This along with other metrics from the study, strongly suggests that the state of finances for the average American remains painfully precarious.

Financial instability, however, isn’t solely the province of lower-income families. Approximately two-thirds of households earning between $50,000 and $100,000 would struggle with the $1,000 emergency, just 8 percentage points below households making less than $50,000. And the ratio remains above one in three when considering households grossing more than $100,000 a year — a staggeringly high percentage.

Despite the shockingly slim savings, the majority of poll participants indicated that they feel positively about their finances. While this suggests that everyday expenses are well in hand, the vast majority of Americans seem poised for financial crises. Among the most likely culprits of such events are healthcare-related bills. Few Americans carry coverage appropriate to their savings. The underutilization of GAP policies and consumer-driven health plans leave most Americans over-burdened and underprotected.

Regulatory compliance can cause significant challenges for employers attempting to strike a balance between affordability and suitable coverage options, but there are now a wealth of policy alternatives to suit the silent and suffering majority. Contact Chelten Consulting to learn more.


3 Strategies for Revolutionizing Your Benefits Offerings

2016-05-03 (8) - CopyBenefits agencies are all starting to sound alike. With a standard array of PPACA-compliant plans to fit various budgets to the best of their ability. But these plans are representative of an old, stale paradigm that underdelivers for those most in need and overcharges for those who need the least.

One-size-fits-all has never been a sound strategy. So we’re here to share three new strategies that should benefits agencies, employers, and employees. How can everyone win? When plans are designed to provide both flexibility and transparency. Read on to learn more:

  1. “Return of Premium” Health Insurance.  View our 2 minute animated video – Business owners have heard about ROP with disability or life plans. How about a plan that returns money to you if your firm doesn’t use all its claims dollars?  Pay level premiums just like before. Nothing to lose, everything to gain.
  2. “Medigap for the rest of us”. Use the same strategy millions of seniors do each year when they purchase Medigap plans to fill in holes in Medicare A&B. Suggest that your clients purchase a Return of Premium Bronze plan with Doctor Office Visit and RX copays and then give your employees several “Group Medical GAP Plan” options for them to “pick and purchase” however much deductible and coinsurance protection they desire.  ACA minimum rules are met, and employees get the plan they desire.  Use Return of Premium plans and your clients can potentially save even more.
    Watch another 2 minute animated video here. All videos can be branded for specific organizations. we can brand to your organization.
  3. Customized Video Benefits Smartphone “App”. Give employees 60 second video clips of every benefit your clients offer their employees. How to use your plans 24/7 – anytime, anywhere. Claim forms, handbooks, vacation schedules, it’s all there for existing employees and their annual benefits meeting non-attending family members. Here’s a sample of what we create for our Brokers.

To learn more, contact us!