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Early renewals help businesses delay PPACA effects

BY JOYCE M. ROSENBERG

SEPTEMBER 20, 2013 

NEW YORK (AP) — Many small businesses hope to temporarily sidestep Patient Protection and Affordable Care Act (PPACA) by renewing their coverage early.

One of those businesses is Huber Capital Management. The asset management firm is renewing its health insurance policy this year, instead of next year. The early renewal will help the company avoid buying insurance that conforms to PPACA requirements, and also help it avoid any surge in rates resulting from PPACA.

“We can just push this whole thing off and defer it for essentially one year,” says Gary Thomas, chief operating officer of El Segundo, Calif.-based Huber Capital, which has nine employees covered by insurance.

The Obama administration says it won’t force employers with at least 50 workers to comply with the PPACA coverage reporting rules or the PPACA “play or pay” coverage mandate until 2015, but the law will still affect businesses.

Any company that offers health insurance, including very small businesses, will still have to contend with many other PPACA provisions starting Jan. 1.

Many insurance companies are raising their premiums sharply because they don’t know yet how many people will be covered by insurance. No one knows how quick young, healthy uninsured people will be to sign up. Supporters of PPACA are hoping a larger pool of insured people will bring down the average cost of claims per enrollee. If people forgo coverage, that may not happen.

Thomas got the idea to renew early from Huber Capital’s health insurance broker, who said the firm would likely have an 8 percent increase in premiums if it did renew in 2013, compared to an estimated 30 percent under a policy that complies with PPACA. The idea is also appealing to many companies because they can put off dealing with the law’s complex requirements. For example, companies with 50 or more workers must do calculations to determine whether they’re providing adequate insurance coverage. If they have employees who work less than 40 hours, owners need to determine whether those workers must be covered. By renewing in 2013, owners will get more time to educate themselves about the law.

“Some of the things that might be guesswork or estimates will be more of a known quantity than they are today,” Thomas says.

Quantum Networks, an online seller of high-tech items, is also renewing on Dec. 1. Its broker says its premiums may be unchanged from this year under a renewed policy.

“We want to drag this on as long as possible,” says Bita Goldman, vice president for operations. “For a small company like ours, every little bit helps.”

Quantum Networks, based in New York, has 24 staffers. Health insurance accounts for about 15 percent of its expenses. CEO Ari Zoldan wants extra time to understand the impact of the law on his company.

“With the health ecosystem as complicated as it is, even the brightest of the brightest don’t understand this,” he says. “Over the next year, we’re going to educate ourselves, we’re going to shop around, we’re going to speak to other business owners and ask, ‘what are you guys going to do?'”

Anthony Lopez, a small business specialist at online broker eHealthInsurance, says half the clients he’s spoken with are renewing early. He expects more after Oct. 1, when rates for 2014 are published.

But Lopez warns that insurance companies have different expiration dates for the option to renew their policies this year. While some allow small businesses to decide as late as December, others have earlier cutoff dates. But businesses that miss the deadline might still get insurance at 2013 rates if they switch to another carrier.

Higher Logic, a social media and mobile software company based in Arlington, Va., faced the specter of increasing insurance costs although it doesn’t have 50 workers yet. The company is growing rapidly, having hired 15 people this year. And its 45 staffers are scattered across 15 states, which makes buying health insurance complicated because states have different rules. President Andy Steggles has moved up the renewal date for the company’s insurance from Feb. 1.

“If we lock in now, we’ll know we have a 14 percent increase. If we hold off a renewal till Feb. 1, who knows what it’s going to be?” Steggles says. His broker said she can’t estimate the increase in his premiums under PPACA, but she gave him a range of 20 percent to 40 percent.

PURR-fect Solution’s insurance policy doesn’t expire until next May, but general manager Chett Boxley is renewing five months early, in December, because the premiums will stay the same. He hopes to set aside money to pay for future rate hikes for the four employees of his Salt Lake City-based company, which manufactures cat litter.

Boxley faced a 20 percent to 25 percent rate increase under the ACA.

“When I heard ‘no increase,’ I was pretty stoked to hear that. It was a no-brainer — we said OK.”

 

Exchanges eye the unbanked

Managers of Covered California may require individual exchange plan issuers to accept cash payments through neighborhood utility offices or other brick-and-mortar offices.

The managers discuss payment options in a premium payment report in a packet for an upcoming board meeting.

All of the 12 sellers of individual “qualified health plans” (QHPs) will be taking personal checks, cashier’s checks, money orders, Visa, MasterCard, debit cards and electronic fund transfers.

Capture

 

Five issuers will take the Discover card, and two will take American Express payments.

Half will take cash.

In the dental plan market, all six carriers have agreed to take personal checks, cashier’s checks, money orders, Visa, MasterCard, debit card payments and electronic fund transfers, but only half will take Discover or American Express cards. None will take cash.

California exchange officials estimate that about 1 million state residents have no bank accounts.

Officials fear letting QHP issuers choose whether to take cash could lead to antiselection problems.

Eventually, “Covered California and the plans want to implement common payment processes that will foster the enrollment and retention of all individuals, with particular attention to those who are unbanked,” officials said.

Bill aims to change meaning of full-time under PPACA

Gina Binole
benefitspro

Two U.S. senators have introduced a bill to redefine what it means to be a full-time employee under the Patient Protection and Affordable Act.

The measure, if enacted, would protect a greater number of employers from fiscal penalties imposed by the law as now written.

The legislation, the Forty Hours is Full Time Act of 2013, was introduced by Sens. Joe Donnelly, D-Ind., and Susan Collins, R-Maine, and would change the PPACA’s definition of full-time employees to those working an average of 40 hours per week, or 174 hours per month.

As outlined in the PPACA, employers are required effective in 2014 to offer qualified coverage to full-time employees — defined as those working an average of 30 hours per week — or be liable for a $2,000 penalty per employee.

“Most Hoosiers I know think 40 hours is full time. We need to change the definition of a ‘full-time employee’ in the Affordable Care Act to bring it in line with what most Americans have traditionally recognized as full time,” Donnelly said in a statement introducing Senate Bill 1188. “We also need to provide clarity to employers so they have the information they need to run their businesses and plan for the future.

“Many employers have to make decisions because of this definition, and some have chosen to cut current part-time employees’ hours.”

Donnelly and Collins said they worry, though, that full-time as now defined will end up hurting workers because they’ll end up earning less.

“The new health care law creates a perverse incentive for businesses to cut their employees’ hours so they are no longer considered ‘full time,’” Collins said. “If its definition of a full-time worker as someone who works only 30 hours a week is allowed to go into effect, millions of American workers could find their hours, and their earnings, reduced. This simply doesn’t make sense.”

Sens. Collins and Donnelly urged President Obama to provide transition relief for employers. They co-authored a letter to the president urging the administration to work with the employer community to provide transition flexibility beyond Jan. 1, free from the threat of penalty.

6 ways to prep for FMLA cases

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By Dan Cook
BenefitsPro

6 ways to prep FMLAResearch indicates that employees who invoke the Family Medical Leave Act are much more likely to request short-term disability within a year. Rather than just sit with that sound bite, Integrated Benefits Institute advises companies to do something about it.

“A worker’s request for leave under the FMLA may be a precursor to other, more costly leaves. Rather than view the FMLA as strictly a legal compliance requirement, employers should consider using FMLA as an early-warning system to detect potential costly health issues among their employees and their families,” said Thomas Parry, IBI president.

A panel of IBI experts has come out with six practical steps employers can take to address the impact on their business of such absences.

1. Connect employees with resources: When employers become aware of employees’ challenging personal situations through FMLA requests, they have the opportunity to direct workers to resources that can help minimize the risks of subsequent claims. Employers should take steps to connect employees requesting FMLA leaves with resources such as employee assistance programs, ergonomic interventions and disease management programs.

2. Explore work continuity options: Discussions with employees about job accommodation and stay-at-work options should commence at the earliest opportunity. Job accommodation and stay-at-work programs involve making changes to the duties of affected employees to enable them to continue working at a reduced level.

3. Expand training for supervisors: Employers and their benefits partners should expand FMLA training for supervisors on early warning signs and potential interventions. They should also conduct periodic “roundtables” with supervisors and human resources staff to review ongoing cases and provide appropriate coaching and support for supervisors.

4. Stay in touch with workers: Supervisors should remain in contact with employees during FMLA and STD leaves to keep them engaged and connected to work.

5. Better educate employees about FMLA: Training for employees about their FMLA rights and responsibilities should be improved and consistent. Employees generally receive information about FMLA from their human resource departments, but typically only at the time of requests. This increases the workload of personnel who must verify requests with no chance of approval. Workers should also be educated on the types of leaves FMLA does and does not cover.

6. Synchronize HR duties related to leaves: Employers should coordinate FMLA-related activities of human resources, benefits and occupational health departments so cases can more actively be monitored and managed.

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What the employer mandate delay means to you

July 3, 2013

On July 2, 2013, the Department of Treasury announced that the employer mandate and its associated penalties have been delayed until 2015. The delay, according to the Department of Treasury, allows employers to prepare for the reporting requirements necessitated by federal health reform. In summary, the announcement states that employers with 50 or more full-time and full-time equivalent employees will not be penalized until 2015:

  • For failing to offer coverage to 95% of eligible employees
  • For failing to provide a health plan to employees that covers at least 60% of services
  • For failing to provide a health plan that is affordable for eligible employees (defined as having an employee contribution of less than 9.5% of an employee’s wages)

This announcement allows large employers additional time to determine their full-time equivalent (FTE) calculations and the best coverage for their employees. No additional delays have been announced. At this time, the employer responsibility delay does not affect:

  • Rules for small business and individual plans including the essential health benefits, rating requirements and plan design (metal tiers).
  • The individual mandate, which requires most Americans to carry health insurance or pay a penalty for failing to do so.
  • Taxes and fees on health plans, including the Patient-Centered Outcomes Research Institute fee, which some groups must pay by July 31, 2014 as well as four other taxes/fees effective January 1, 2014