Monthly Archives: February 2009

COBRA Implications of the American Recovery & Reinvestment Act

The American Recovery and Reinvestment Act (the Act) was signed into law by President Obama on February 17, 2009. The Act has wide-reaching ramifications, and we want to make sure you’re aware of the latest developments affecting health insurance.

The Act includes a subsidy for COBRA premiums for a period up to nine months for certain employees that were involuntarily relieved from their job from September 1, 2008, through December 31, 2009.

The COBRA subsidy covers 65 percent of the applicable COBRA premium, initially covered by the employer or the insurer and recouped through payroll tax credits. The remaining 35 percent will be the responsibility of the qualified beneficiary.

The COBRA subsidy becomes effective March 1, 2009. It imposes new COBRA administration and notice requirements on plan sponsors, in addition to those involved with the reimbursement process.

Download this PDF developed by one of our partners for more detailed information. The PDF is intended to provide initial guidance to plan sponsors. It is for informational purposes only and is not intended to interpret laws or regulations or to address specific client situations. The document will be revised as additional information becomes available from insurance carriers and government entities.

There are still many questions surrounding the Act and just how many of the elements will work. For those using Stephenson Welsh Insurance Services, we will continue to stay on top of all the latest developments associated with insurance coverages. We will keep you informed about any changes that might affect you and proactively bring to you any opportunities we see emerging.

The next update will likely come sometime after the U.S. Department of Labor report on this topic on March 19.

If you have any questions or need immediate attention, please call us toll-free (1-866-514-0144) or send us an e-mail.

To the best of our knowledge, based on available resources, the attached piece has been prepared with the intention of providing initial guidance to plan sponsors via the broker. It is for informational purposes only and is not intended to interpret laws or regulations or to address specific client situations. The information contained within may also change or be added to with new issuances by government agencies and/or insurance carriers. By redistributing this piece, Stephenson Welsh Insurance Services is released from all liability.

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How to Trim Ancillary Benefits While Protecting Employee Morale

In tough economic times, sometimes annual reviews reveal a pressing need for benefit cuts. When companies are forced to scale back the benefits employees enjoy, ancillary products are always the first to be affected. It’s in dental or disability or life insurance that employers first look to make reductions. And in just about every case, there’s a deep concern that “taking anything away” from employees will be perceived as a harsh negative that can have widespread ramifications.

Our job as brokers is to help groups figure out where they save money—while still keeping employees satisfied.

Sometimes it’s as simple as doing a review and switching carriers to get a better rate. Sometimes, it’s changing contribution amounts to be able to keep the benefit. The reality is there are a number of things a broker can do to help a company not lose an ancillary benefit entirely even when facing severe budget restrictions.

A lot of it just comes down to strategy.

It comes down to having a good relationship with your broker where you can sit down and truly be honest about the situation. That can be a tough conversation for people to have—to admit it’s a tight time where they need to save money. But those are the conversations you need to be able to have with your broker. That’s because there’s not just one or two options a broker can give you. There are a whole slew of things that can be looked at to improve the situation without eliminating benefits. If the benefit can be saved, it will continue to be an employee retention tool.

A great example is with dental benefits. As a broker, we can run usage model analyses for groups. With the information we obtain, we can find alternatives that don’t disrupt employee benefits while still saving the employer money.

Perhaps a group has a $2,000 annual maximum on its dental plan, but nobody is using more than a thousand dollars. So, we reduce that down and there’s a cost savings. But that reduction has zero negative impact on employees because no one was using that second thousand anyway.

It’s rare to find a scenario without multiple solutions. The unfortunate truth is many brokers just don’t have the incentive to find those answers, while others haven’t adapted to the times and aren’t aware of them. It takes a lot of effort to really talk with a client, do a thorough review and research other carriers. Many brokers would rather keep things status quo rather than look out for a client’s best interests by being more aggressive and forthcoming.

The problem in the small group space is clients are not getting the attention from their broker that they should, in most cases. They’re just a file in the drawer. When renewal comes up, they get their token letter or e-mail, but there’s no outreach. There’s no push for something else—something better or more appropriate—because either the broker hasn’t stayed up with current trends or is only reactive (instead of proactive). Often it’s in the client’s best interest to make changes, but regrettably in the small group space often that client isn’t aware of what the options are.

No employer wants to go back to its employees and say, “We’re cutting benefits.” It’s hard to do. But when it’s essential to make cuts to important programs, your broker should be engaged and helpful in keeping benefits as rich as possible.

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Nothing to Fear Here: ‘High-Deductible’ Plans Reduce Costs, Please Clients

A lot of people worry that if they switch to a high-deductible health plan to save some money, they’ll end up with lousy insurance. It doesn’t have to be that way. Today’s HSA-compatible (high-deductible) plans aren’t the least bit scary; they’re just different … and cash-strapped employers can save up to 60 percent in reduced premium costs.

High-deductible, HSA-compatible health care plans are normal PPO plans. There’s no gatekeeper, and it’s not an HMO where you’re locked into certain doctors or services of the carrier’s choosing. In fact, these plans are actually relatively rich in benefits.

High-deductible health plans are typically thought of as catastrophic prevention plans that won’t help much in the day-to-day. But the current high-deductible health care plans include a wealth of free preventative services that are covered at 100 percent (regardless of your deductible status). You’re also covered at 100 percent after you hit your deductible. Services of such quality are designed to incentivize people to switch. But what’s nice is the model becomes a win-win (for you and the carrier): With more preventative services, carriers are banking on fewer claims and healthier people. Meanwhile, employers get dramatic cost reductions while retaining benefits—and their employees.

Regardless of whether you use your medical insurance a lot or a little, high-deductible health plans can be a great option because your exposure is capped. You know exactly how much your worst-case scenario is going to be on an annual basis.

People pay huge premiums for rich, low-copay plans. But if you’re not going to the doctor, you’re giving the carrier all your money up front for the coziness of having $10 or $20 copays for purely theoretical doctor visits. The truth is that when expenses are broken down, often these low-copay plans end up having a higher out-of-pocket cost to you than the higher-deductible health plans (because of an inefficient usage model).

Your bill might be a little higher up front if you use your high-deductible health plan. But the nice thing is you know where you stand going into every year. You know you have a maximum exposure that is usually lower than a rich copay plan’s potential exposure. And the cost savings are so dramatically different that I would rather save up front than pay through the nose for a low copay that I don’t ever use.

I’m not just saying that. My wife and I switched our family to a high-deductible, HSA-compatible plan. We chose the lowest of these higher-deductible options and we’re still saving $600 a month in premiums. We also know we have a certain maximum exposure and that we’re 100 percent covered after hitting our individual and/or family deductible. I personally love the plan. And in Stephenson Welsh Insurance Services’ most dramatic case, we saved a small business (eight employees) $52,000 initially in premiums. The business then fully funded each employee’s deductible amount (put that money into their individual HSA accounts), so the employees effectively had a zero deductible and 100 percent coverage. After all that, the business still saw a $34,000 savings by switching to a high-deductible plan.

For those totally unfamiliar with HSA plans, it’s a health savings account, which is a portable medical IRA in your name (and tied to your normal health insurance). You can use it to pay for your medically eligible expenses in a manner that’s not subject to federal income taxes. It’s not “use it or lose it.” Funds roll over and accumulate if not spent during the year. In fact, you have a lot of flexibility, including leveraging it to pay for services such as acupuncture, chiropractic, dental and vision.

If any of this is beginning to sound overwhelming (or simply intriguing and worthwhile), we’re here to help. As an insurance broker, we’ll do a free benefits review and free cost analysis to find the right health plan with the right strategy. High deductibles may not be for everybody. And some others want the most-possible savings by going with a high-deductible plan at $4,000 or $5,000 (as opposed to $1,500).

In all honesty, not all brokers are pushing high-deductible plans. That’s because if you lower your premiums, it lowers the broker’s commissions. But it’s the right thing to do by the client. And ultimately if the client is happy, they’ll refer us to others. By having a delighted client, it benefits us in the long run, too.

For more information or a free consultation, please call us at (925) 256-7800 or send us an e-mail.

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