Colonial Life Survey Reveals Seven Top Benefits Plan Enrollment Mistakes Made By Employees

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Colonial Life Employee Healthcare Survey

A new Colonial Life survey shows countless employees making benefits plan enrollment mistakes because they lack the willingness to educate themselves. They simply do not know or have a basic understanding of what is available to them. Colonial Life & Accident Insurance Company recently questioned nearly 400 employee benefits counselors about the top mistakes they see employees making during enrollment. As experts in benefits program administration and employee benefit plans, the principals at Pontrelli, Timour & Associates are not surprised by the results of the survey.

The number one mistake was how employees tend to assume they do not need certain benefits being offered without even discussing such options with a benefits professional. This all-too-common mistake was cited by 81 percent of survey respondents.

Benefits Plan Enrollment Mistakes

What PT Benefits find fascinating is how little the expertise of insurance brokers is taken advantage of by employees. It’s almost as if there is a fear that asking questions will have repercussions. From our perspective, there are no foolish questions if they are asked in a honest quest for understanding and knowledge.

Benefits Plan Enrollment Mistakes 2 to 5 were closely grouped in the rankings and all related to lack of information:

  1. Not reading the benefits information prior to enrollment — 69 percent.
  2. Not knowing what benefits they currently have and what they cost — 69  percent
  3. Forgetting to talk with their spouse about their family’s needs before the enrollment — 67 percent
  4. Assuming the cost of a new benefit is unaffordable without seeing any prices — 66 percent

A survey respondent describe his frustration with this lack of planning and foresight by employees when he said: “This is the one time you have to take control of how you want to provide for your family and yourself. Take time to talk with your spouse and understand how the benefits can really help your family.”

Benefits Plan Enrollment Mistakes 6 & 7 directly pertain to a failure to take advantage of educational resources available:

  1. Not attending group informational meetings — 58 percent
  2. Not taking time to understand the upcoming changes in their benefits plan — 50 percent

Personal knowledge can be translated into power, but so few employees seem willing to access such power to help themselves. Many employers give workers the opportunity to meet one-to-one with a benefits expert for a personalized counseling session.

Post-enrollment surveys by Colonial Life show 98 percent of employees who participated in a one-to-one session said it was important, and 97 percent said the session improved their understanding of the benefits being offered.

With the complexities presented by the Affordable Care Act, such past benefits enrollment mistakes are even more dangerous today. PT Benefits recommend that every small to mid-sized employer sit down with their employees and emphasize the importance of education and knowledge.

With ACA affecting everyone and the higher costs coming down the line, it is time for employees to take hold of the reins when it comes to benefits enrollment. If you have questions from the perspective of an employer or an employee about benefits enrollment, please call 866-782-9899 or fill out our handy contact form.

 

8 Affordable Care Act Predictions For 2014

When it comes to making expert predictions about the wide range effects of the Affordable Care Act in 2014, Pontrelli, Timour & Associates have the expertise needed to be right on target. As an employee benefits and insurance agency working with small to mid-sized businesses for over a decade in Pasadena, the principals at the agency have the knowledge to provide quality prognostications. The following 8 predictions are based on a balance of factual data combined with the insight of long-term experience.

8 Affordable Care Act Predictions For 2014

  1. Since the majority of carriers shifted the renewal dates of their clients to December 1, most business owners don’t have to take any direct action until then. As a result, the true brunt of the Affordable Care Act’s business fallout will hit hardest in the 4th quarter.
  2.  The biggest initial problems will be with individual solo policies as rates go up the benefits are reduced. The result is going to be a lot of angry people shaking their fists at healthcare reform and wondering why they ever wanted it in the first place.
  3.  Many uninformed business owners without an actual understanding of the laws will try to avoid the 50 employee mark of the Employer Mandate by shifting full-time employees to part-time. Such a shift is illegal, doesn’t work as an avoidance strategy because part-time employees are included in the Employer Mandate equation, and will result in many stories about the IRS and other government agencies cracking down on small business owners across the country for this violation.
  4. On account of the customercentric approach of PT Benefits, almost 100% of our clients early renewed and moved to December. In contrast, how many small to mid-sized companies with the huge corporate providers fell through the cracks of poor customer service. The immediate result when they have to renew early will be the tough initial options on account of a lack of concrete rate information. Anger over this outcome will result in a bevy of local negative ACA news stories in the first to second quarter of the year.
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    Affordable Care Act Predictions

    Any employee or group that had a high deductible catastrophic PPO plan will most likely be paying double come their renewal in 2014. An example is a small restaurant owned by an older lady with such a plan. Her rate will double in terms of the costs because of the minimal coverage and deductible thresholds. In addition, the new extensive requirements for pediatric dental and vision, maternity, expanded non-institutional mental health benefits, contraceptives, breast pumps, lactate consultants, and the list goes on and on. Each state threw in their benefit requirements on top of the federal requirements, resulting in plans that simply cover so much more than is truly needed. Both the business owners and the employee are being hurt because the rates are skyrocketing. As a result, this woman’s rate at her restaurant will more than double because of these new requirements, perhaps even causing her to go out of business after years of serving food to her community.

  6.  The biggest losers in the financial chaos that is being wrought by the Affordable Care Act will be lower middle class to middle class Americans, the vast majority of the country stuck in the center. Healthcare reform really only affects high middle class to wealthy Americans as business owners, and most of them will be able to adapt. The bottom rung of the ladder – the homeless and the destitute – theoretically will be helped. But the middle will be hurt and hurt bad in 2014. And this middle is the heart of America.
  7.  Technology in the industry of benefits administration and insurance brokers traditionally has been very poor. In 2014, this is going to start to shift as a result of ACA and the need for more interactive websites to explain and evaluate the changes for existing clients and potential new clients. Mobile technology will be on the rise as well.
  8. Overall, the Great Panic Debate of 2013 will shift into more realistic discussions about how to be sustainable in 2014. How are insurance brokers going to make the changes work for their clients beyond the initial stage of denial. This is why the insurance brokerage team at Pontrelli, Timour & Associates is focused on finding the best possible ways to optimize the Affordable Care Act options and possibilities for all of our clients.

Help With The Affordable Care Act

If these Affordable Care Act predictions scare you, you are not alone. The perspective of the government on the Affordable Care Act is not the perspective of insurance professionals. If you are worried about how the Affordable Care Act will affect your business and your employees, please contact PT Benefits by calling 626-795-4138 for insurance solutions.

Raphy Timour Of PT Benefits Speaks For Business Owners In Pasadena Now Article On The Affordable Care Act (ACA)

As a co-founder of Pontrelli, Timour & Associates and a respected expert on the Affordable Care Act, Raphy Timour was interviewed by Pasadena Now about how ACA is affecting small to mid-sized business owners and their employees across Pasadena. Since so many business owners are trapped in the maze of the healthcare requirements, mandates and restrictions, Raphy Timour is stepping up to be the voice of the small to mid-sized business owner in trouble. The problem with the Affordable Care Act is that the good man in the middle is being squeezed once again. It is both a honor and an opportunity for Pasadena Now to give Raphy Timour a platform from which to help educate business owners who truly need help and support

A Voice Speaking For The ACA Embattled Business

In the Pasadena Now article, Raphy Timour describes the difficulties faced by one of the clients of PT Benefits:

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ACA Going Off The Rails

“We do the benefits for a small local restaurant and the owner is a woman in her early 60’s. She chose not to early renew. Over the years, to help offset the rising cost of healthcare, she moved to a higher deductible PPO plan. Although the out-of-pocket costs were greater, she chose to pay less each month in premiums. Her group benefits plan renews in March 2014 and her individual rate is going from $532 a month to $925 a month! Yes, her benefits are more extensive, but nowhere near justifying a 74% increase over last year. Why should a woman in her 60’s with adult children be required to have a plan that covers maternity and pediatric dental and vision?”

Why should business owners be penalized who actually have been doing the right thing for years? Why should they be hurt just so others can be helped? Does it seem fair that so many small to mid-sized business owners across not only Pasadena and Southern California, but across the entire country are being slammed so hard or are going to be slammed so hard in their pocketbooks by the Affordable Care Act? Why is Affordable even in the name of the act if the actual results turn out to be the exact opposite of this word – more expensive and more costly?

A Voice Needed Come ACA December Renewals

Since most business clients early renewed, they won’t be facing the real financial challenges of the Affordable Care Act until December. Come December, however, Raphy warns in the Pasadena Now article that “The fourth quarter is going to be a real wake-up call for most employers. There are going to be a lot of shocked and surprised people.” The goal of Pontrelli, Timour & Associates is to help our clients make this tough transition as easily as possible while raising awareness of these challenges in our community in general. To learn more about how ACA might affect your business, please call 626-795-4138 to reach Pontrelli, Timour & Associates and get the help your company truly needs.

Pasadena Now Article And Interview With Raphy Timour About The Affordable Care Act

Reprinted from with permission from Pasadena Now,  this Business Article was titled:

How Is The Affordable Care Act Affecting Small To Mid-Sized Businesses In Pasadena?

The institution of the Affordable Care Act and its effects on business owners and their employees is one of the biggest national stories of 2014. Pasadena Now wanted to break down the implications of this national story by understanding what is happening on a local level. To illuminate how the ACA changes are affecting small to mid-sized businesses in Pasadena, Pasadena Now spoke with Raphy Timour of Pontrelli, Timour & Associates, Inc.

Like most insurance brokers that handle employee benefits, Raphy Timour recommended that most his clients take the early renewal option. As a result, their current plans will stay in place until December of 2014. Most companies will not experience major changes until the end of the year. When those changes come, however, Raphy Timour told Pasadena Now what will happen:

affordable care act, pasadena now

Raphy Timour on ACA

“The fourth quarter is going to be a real wake-up call for most employers. There are going to be a lot of shocked and surprised people. Most plans had to bulk up to meet the minimum essential coverage requirements of the ACA. These new comprehensive plans are both less flexible and more expensive. I believe the middle class in Pasadena are going to be hit the hardest. They won’t qualify for the low-income subsidies and employers will pass off most of the new expenses onto their employees. They will have higher premiums, and higher out of pocket costs when they go to seek services. Healthcare reform will make life harder for a lot of people.”

What exactly is meant by the new coverage requirements? Won’t healthcare reform be beneficial for most people? Aren’t the new essential health benefits a positive thing? When asked this question, Raphy Timour shook his head in frustration:

“You would think that would be the case, but it actually is the opposite. If you currently offer your employees a small group health plan in California that was established or renews in 2014, your plan is mandated to include 10 categories of essential health insurance benefits. Some of these essential benefits make perfect sense like the preventative services that include both annual screenings and wellness visits, inpatient hospital services, emergency services, and prescription drug coverage.  On the other hand, so-called essential benefits now also include the following: acupuncture, pediatric dental and vision services, and a host of other specialized items. These specialized services increase the costs for everyone.  People should have more choices; one size does not fit all.”

Wanting to know more, Pasadena Now asked for a concrete example of how a small business could be affected by these rate increases. Raphy Timour responded by telling us a story about one of his Pasadena-based clients:

“We do the benefits for a small local restaurant and the owner is a woman in her early 60’s. She chose not to early renew. Over the years, to help offset the rising cost of healthcare, she moved to  a higher deductible PPO plan. Although the out-of-pocket costs were greater, she chose to pay less each month in premiums. Her group benefits plan renews in March 2014 and her individual rate is going from $532 a month to $925 a month!  Yes, her benefits are more extensive, but nowhere near justifying a 74% increase over last year. Why should a woman in her 60’s with adult children be required to have a plan that covers maternity and pediatric dental and vision?”

By removing the ability to choose what should be covered, ACA is adding significant costs. Moving forward, what is the best choice for small to mid-sized businesses to make in regards to health insurance? Should they go on the Covered California exchange? Raphy Timour answered these questions with a resigned honesty:

“Healthcare reform is a very complex issue with many perspectives and market forces. Right now, the group insurance market is still the best choice as opposed to the exchanges and the individual policies. There are significantly more options and carriers available with the off-exchange group insurance market, including the largest network of hospitals and medical providers. What is frustrating is that all of the options under the Affordable Care Act seem to be more expensive and less helpful. They tried to squeeze everyone into the same little box. When it comes to healthcare, one size simply is not enough.”

IRS Modifies “Use It Or Lose It” Rule For Health Flexible Spending Arrangements Under The Affordable Care Act

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Pressures of Use It Or Lose It

On October 31, 2013, the Internal Revenue Service issued Notice 2013-71 about the “Use It Or Lose It” Rule for health flexible spending arrangements under the Affordable Care Act.

The notice instituted significant changes that will affect the administration of cafeteria plans under section 125 of the Internal Revenue Code. Pontrelli, Timour & Associates offers a brief outline of these changes as a public service. If you need to know how the specific details affect your healthcare plans, please contact PT Benefits for help.

Use It Or Lose It Update

The main change is a modification of the regulations proposed under section 125 to add a limited exception to the “use it or lose it” rule for health flexible spending arrangements. Employers are permitted to amend plans that provide health flexible spending arrangements to permit up to $500 of unused credits to be carried over and applied towards the following plan year.

It is important to realize that the “use it or lose it” rule is not  completely eliminated. Any unused credit in excess of $500 will still be forfeited.

This new carryover is an alternative to the current “grace period” rule. As a result, a health FSA may not provide for both the new carryover and the current grace period. From a pragmatic perspective, if a carryover is to be provided at all, the choice is between (a) permitting a carryover of a limited amount (up to $500) that can be applied during the entire following year, or (b) permitting a potentially larger carryover that can only be applied against expenses incurred during a specific period of time (one month, two months, three months) that is designated as the grace period.

Use It Or Lose It Modifications

PT Benefits understands if all of these new rules and regulations sound like a sputtering of ancient Greek to you. As a businessman, you are focused on growing your business and not getting lost in a maze of such technical particulars.

If you contact Pontrelli, Timour & Associates with questions, we can provide you the support you need to make sure the “Use It Or Lose It” modifications are effectively applied to your business. To learn more about how PT Benefits can deliver premium health coverage and benefits packages to your employees and guide you as an employer through the maze of the Affordable Care Act, please call 866-782-9899 or fill out our handy contact form.

4 Healthcare Changes And Affordable Care Act Challenges In 2014

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Healthcare Changes In 2014

With the Affordable Care Act now in full force, the overall societal goal is for millions of uninsured Americans to either now have health coverage or to be able to obtain it within the coming calendar year. As a Southern California provider of employee benefits programs and solutions for small to mid-sized companies, Pontrelli, Timour & Associates, Inc. make it a point to keep our clients updated about the ongoing evolution of upcoming healthcare changes and Affordable Care Act challenges in 2014.

Healthcare Changes & ACA

As the new year begins, more than 1.1 million people have gained coverage through the offerings of the Affordable Care Act.  Through the combination of HealthCare.gov with the federal and state exchanges, millions more will be enrolled before the cut-off date at the end of March. By looking ahead at what is to come, the goal of PT Benefits is to make the process of adapting to the changes as smooth and easy as possible for both the employers and the employees at our client companies.

Here Are 4 Healthcare Changes Coming In 2014:

The Shadow Of The Employer Mandate:

Employers need to prepare for the Employer Mandate requirement that companies with more than 50 employees provide health insurance for their employees. Although this requirement was delayed a year by the Obama administration, employers will be surprised by how quickly the deadline approaches. Given the choices that need to be made like wellness discounts and health incentive strategies for employees, decisions need to be made well in advance.

The Requirement Of Pricing Transparency:

A major part of the Affordable Care Act is the emphasis on clarity in relation to health insurance costs. Transparency means an understanding of what exactly needs to be paid by both employers and employees and why.  PT Benefits believes that such price transparency will allow both employers and employees to make better educated choices with less surprises.

The Inevitability Of Shrinking Networks:

In order to save money, insurers will continue to shrink their networks of health care providers, going with the best deals that might not always be the best options for consumers. By relying on providers offering the best rates, insurance companies will limit the options in many plans. Such a shrinking of networks will have a greater effect on ongoing consumers with histories with certain providers. The loss of those providers will prove challenging. In contrast, first-time insurance purchasers won’t miss what they never had in the first place.

The Need For Electronic Records & HIPAA Compliance

With the institution of the PPACA in 2014, the need for electronic records will increase. Electronic records will provide better tracking and analytics while helping to ensure higher standards of record keeping and maintenance. The challenge of more electronic records will be a greater need for HIPAA compliance.

For Pontrelli, Timour & Associates emphasize the above updates are only short capsule descriptions of the bevy of healthcare changes to come in 2014. Luckily, the client companies of PT Benefits do not need to be healthcare experts. We handle such challenges and questions for you, providing a customer-centric approach that focuses on the specific needs of your organization. To learn more about how we can help you, please call 866-782-9899 or fill out our handy contact form.

Kaiser Family Foundation Study Shows Health Insurance Costs Rising For Both Employers And Employees

A Kaiser Family Foundation study revealed that health insurance costs rose in 2013 for employees in the United States. During the same period, American employers experienced a parallel rise in health insurance premiums. Overall, the total cost of employer-provided health benefits increased 4% for family plans and 5% for individual plans.

Increases In Health Insurance Costs

As a provider of premium benefits programs, Pontrelli, Timour & Associates knows from experience that such increases in health insurance costs usually can be mitigated with effective health insurance solutions. Even with the bevy of new challenges resulting from problems raised by the Affordable Care Act, PT Benefits knows how to provide legitimate savings for both the employers and the employees of our client companies.

health insurance costs, kaiser family foundation

Rising Health Insurance Costs

According to the study by the nonprofit Kaiser Family Foundation in conjunction with the Health Benefit & Educational Trust., 57% of firms with at least three employees offered health benefits in 2013. The authors of the study noted the figure reveals a slight change from 2012, when 61% of employers offered health benefits. The 61% of 2012 actually was a slight increase from the 60% of employers offering health benefits in 2011.

The average total cost for a family health plan hit $16,351 this year. In most cases, such costs are split between employer and employee. The typical employee’s share of that premium hit $4,565, up about 6% from 2012. In addition to rising employee premiums, the survey revealed that employees are getting hit with larger deductibles and higher out of pocket costs as well. For example, the average deductible for a health plan that covers only the employee reached $1,135, up from $1,097 in 2012.

Employees of small businesses have been hit particularly hard. It historically has been the case that employees of small businesses pay more for their health coverage than employees at larger companies. Nearly a third of workers at companies with fewer than 200 employees have deductibles of at least $2,000. Does it seem fair that an employee should be penalized for choosing to work for a small business as opposed to the alternative?

Health Insurance Costs Higher In 2014?

Looking forward to 2014, and with the implementation of the PPACA’s Minimum Essential Coverage plans, this trend will continue.  Premium rates will somewhat stabilize, but employees will be faced with significantly higher out of pocket costs and out of pocket maximums.  Another significant consideration for next year will be doctor and hospital networks.  Each insurance carrier will have multiple networks and it will be critical to determine which network of providers will work best for you.

Since PT Benefits understands how challenging benefits program administration can be for small to mid-sized business owners, we do our best to provide the best in services and solutions. As benefits administration experts, we offer the guidance our clients need to avoid the pitfalls of high costs and premiums. To learn more about how we can help you, please call 866-782-9899 or fill out our handy contact form.

 

Affordable Care Act Delays and Deadlines: A PT Benefits Guide To Recent PPACA Changes And Upcoming Healthcare Reform Benchmarks

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Affordable Care Act Guidelines

As the U.S. Labor Department, Department of Health and Human Services and the Treasury Department figure out Affordable Care Act guidelines and specify the deadlines for PPACA, PT Benefits offers a guide to recent changes and upcoming benchmarks related to the new healthcare reform laws and regulations. The goal is to help our clients and potential clients navigate the complex maze of healthcare reform and the Affordable Care Act. As a full service benefits agency, PT Benefits provides the guidance and the support needed to find success for your company when it come to benefits administration.

Recent PPACA Changes & Upcoming PPACA Benchmarks

One Major Affordable Care Act Delay —

1) The Employer Mandate

The mandate of the Employer Mandate of PPACA is that employers with 50 or more full-time workers or equivalents will have to pay a tax penalty of $2,000 to $3,000 per employee. The penalties will kick in if the employers fail to offer health insurance plans to their employees or if the plans they do offer do not meet ACA minimum standards. Delayed until 2015, to learn more, please check out this, check out this link to the Internal Revenue Service website.

Two Major Affordable Care Act  Deadlines —

1) Notification of Marketplace Coverage

If an employer is subject to the Fair Labor Standards Act, they are required to notify all their employees of the health care options available by October 1, 2013. At the time of hiring, each employee must be provided with a written notice. The written notice must inform the employee of the existence of the Marketplace, including a description of the services provided. Under the regulations of the Affordable Care Act, the employee must also be made aware of how to contact the Marketplace to request assistance.

In practice, this requirement affects the majority of employers. FLSA applies to employers with at least two employees and $500,000 in annual revenue or sales. What is intriguing is the requirements also applies to hospitals, nonprofits, schools and government agencies. Notices in the workplace must tell employees whether their employer-sponsored plan meets the minimum value standard.

In addition, within the parameters defined by PPACA, employees must be informed of whether or not the employer’s plan is considered affordable. Employees also need to know whether or not they can qualify for a premium tax credit if the insurance offered by the employee fails to meet these benchmarks. It is the employer’s responsibility to inform their employees across the board. With the Oct. 1, 2013 deadline already passed, to learn more, check out this link to the website of the U.S. Labor Department.

2) Employee Status

The delay of the employer mandate  of  the Affordable Care Act does not delay the necessity of employers to start collecting information needed to manage the potential penalty they will have to pay if they violate the Employer Mandate of 2015. If an employer wants to minimize their tax exposure, a 12-month period will have to be chosen to measure employee job status. Such a period can only be chosen if the proper records have been kept and the reporting requirements have been met. Without question, any employees determined to be working full time will need to be offered coverage in 2015. If they are not offered insurance, the employers will be liable for the penalty. With the deadline being in the fall of 2013, to learn more, check out this link to a PDF from the Internal Revenue Service website.

Since PT Benefits understands how intimidating and overwhelming healthcare reform and the Affordable Care Act can be for small to mid-sized business owners, we hope this guide has been helpful. As benefits administration experts, we provide the guidance our clients need to navigate through the maze of potential fines and trouble. To learn more about how we can help you, please call 866-782-9899 or fill out our handy contact form.