Three Ways For Employers To Help Employees Understand Healthcare Policy In The 21st Century

With the onset of the Affordable Care Act changing the landscape of healthcare benefits and plans, employers need to help employees understand their company’s healthcare policy and the new options provided by the Affordable Care Act. From implementing any of the new changes to communicating new information about both regulations and options to employees, Pontrelli, Timour & Associates can help employers feel comfortable about taking such steps.

healthcare policy

Healthcare Policy in the 21st Century

Once you understand what needs to be communicated, you can come up with a workable and proactive plan of how to communicate this bevy of new information about your healthcare policy.  PT Benefits offers 3 ideas on how to help your employees with a dual goal of covering the informational bases of your new healthcare policy and creating common ground that raises morale.

3 Ways To Help Employees Understand Your Healthcare Policy:

1) An employer should make sure to share the “what” and “why” of their company’s healthcare strategy. If you’re changing your organization’s health benefits approach for 2014, communicate both the “what” and the “why” to employees. Such shifts in strategy and plans are very common among small to mid-sized companies, particularly nonprofits. You should help employees understand what impact the Affordable Care Act has on the plans you offer, including who is eligible for coverage. In addition to raising awareness, all employers are required to provide a notice about new coverage options with the health insurance exchanges.

2) Employers should develop a new plan for distributing resources about basic healthcare information. PT benefits can help you with such a plan based on our experience with other clients. Many employers are shifting how they offer benefits because of the Affordable Care Act. In many cases, this means is a shift toward consumer-driven health care or defined contribution. Both of these models require employees to take more control. Employees need access to resources and education about basic health care terms, and basic healthcare reform information. A good start is by answering the following questions:

Healthcare Policy Questions

  • Who can your employees call with questions?
  • How can healthcare experts like PT Benefits help? 
  • What resources should be provided to employees? 

3) In order to strengthen their bond with employees, employers need to reinforce the value of their health plans and the overall value of working for the company. Regardless of the type of health benefits you are providing, you obviously care about the health of your employees, but do your employees know this to be the case? If not, you should use communication about health reform as an opportunity to reinforce this principle in order to improve retention rates and create a sense of goodwill by raising company morale.

PT Benefits can support your efforts to help your employees understand your company’s healthcare policy. To learn about how we can make the Affordable Care Act easier for your company to navigate, please contact the professionals at Pontrelli, Timour & Associates by calling 626-795-4138 or fill out our handy contact form.

 

 

 

 

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.”

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

affordable care act, obamacare, healthcare reform, ppaca, employer mandate

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.