CareMount Medical Joins Empire Blue Access + Connection Networks

CareMount Medical Joins Empire Blue Access + Connection Networks

by | Aug 3, 2022 | NY News, Small Business Group Health

On September 1, 2022, Empire BlueCross BlueShield will begin partnering with CareMount Medical, the largest independent, multi-specialty group in New York State, to provide access to affordable care throughout New York City, Westchester, Putnam, Dutchess, Columbia, and Ulster counties.

CareMount will now be part of Empire’s Blue Access and Connection Networks for all Large Group and Small Group members. This will mean greater access to more affordable care throughout Westchester and surrounding markets.

Contact us to learn how Empire can fit your employee’s needs.  

https://www.medicalsolutionscorp.com/empire-strikes-back-2022-health-plans/

Learn more about how we are successfully helping navigate SMB for 25+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@360peo.com.

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Study: Employer Sponsored Health Plans Generate 47% ROI

Study: Employer Sponsored Health Plans Generate 47% ROI

by | Jul 6, 2022 | group health insurance, Small Business Group Health, Wellness

Health insurance is expensive, and we’ve all asked ourselves, “Is it really worth what I am paying?”. For employer-sponsored health insurance, the answer is a resounding YES it is. For every dollar employers spent on health insurance-related costs, they get back $1.47 according to a new study from Avalere Health. This figure in fact is expected to grow to 52% by 2026 from 47%.

The U.S. Chamber of Commerce commissioned the Avalere Health employer study that used publicly available data from the Bureau of Labor Statistics and the Congressional Budget Office to estimate the return on investment employer-sponsored health insurance provides employers with 100 or more employees.  Improved employee productivity, reduced direct medical costs, and tax benefits were the primary aspects that generated benefits for employer-sponsored health plans. Employers who offered employer-sponsored health coverage and wellness programs had healthier employees and spent less on direct medical costs, Avalare found.

The Numbers

Share of Benefits by Component as % of ROI for ESI

Employee productivity reflects the reductions in absenteeism and lost productivity after receiving employer-sponsored coverage. These productivity increases contributed an estimated $275.6 billion in employer benefits in 2022, or 53.3% of all benefits. By 2026, this is expected to rise to $346.6 billion or 55.9 percent of total ROI.

ROI of some of these key components includes $275.6 billion from improved productivity in 2022 and $346.6 billion in 2026, $101 billion from a reduction in direct medical costs in 2022 and $108 billion in 2026, and $119.2 billion or a 23% ROI from tax benefits in 2022 and $139.7 billion in 2026.

Employer-Sponsored Insurance(ESI) offerings can positively influence prospective employees’ decisions to join firms, reducing employer recruitment and vacancy costs. The study’s model assumes that 9% of individuals decide to accept a certain position based on ESI. The analysis estimates that firms with 100 or more employees derived $141M in employer benefits in 2022, growing to $167M in 2026.

Similarly, ESI positively affects the retention of employees. Avalere’s analysis estimates $20.3B in employer benefits from improved retention in 2022 and $24.3B in 2026.

Conclusion

The study finds that industries where firms generally made greater investments in ESI tended to result in larger ROI. Also, since costs associated with turnover and recruitment are positively associated with wages, Avalere estimates higher ROI in higher-wage industries. On the flip side of that same coin, lower ROI was associated with industries that typically have a lower investment in ESI and wellness programs, lower wages, and lower employee participation in ESI and wellness programs.

The full report including the methodology can be found here.

For more information on how Employer-Sponsored Insurance and a PEO can make difference for your small business please contact us at info@360peo.com or 855-667-4621.

 

Study: Employer-Sponsored Health Insurance Produces +47% ROI

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FEDERAL JAN 1st SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

FEDERAL JAN 1st SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

by | Oct 12, 2021 | group health insurance, NY News, Small Business Group Health

A little-known requirement but most important under Affordable Care Act (ACA) is for Health Insurers must waive their minimum employer-contribution and employee-participation rules once a year. ACA requires a one-month Special Open Enrollment Window for January 1st coverage.

The special open enrollment period occurs November 15th through December 15th of each year, allowing eligible small group employers to enroll for coverage effective January 1st of the following year.

Background

The ACA has a section in it called the “guaranteed issuance of coverage in the individual and group market.” It stipulates that “each health insurer that offers health insurance coverage in the individual or group market in the state must accept every employer and individual in the state that applies for such coverage.” The section also states that this guaranteed issuance of coverage can only be offered during (special) open enrollment periods, and that plans can only be offered to applicants that live in, work in, or reside in the plans’ service area(s).

Participation and Contribution Requirements

In many states (including California and Nevada), carriers can decline to issue group health coverage if fewer than 70% of employees elect to enroll in coverage. Some carriers may have even tighter participation requirements.

Generally speaking, employees with other coverage (Medicare, other group coverage, individual coverage through the Exchange, etc.) are removed from the participation requirement calculation – though it varies by insurance carrier.

Furthermore, employer contribution rules require employers to contribute a certain percentage of premium costs for all employees in order to attain group health coverage. Some businesses struggle to meet these contribution requirements for a variety of financial reasons.

Problem Solved: Special Open Enrollment Period

Many employers want to offer coverage to their employees, but are denied because they struggle to meet participation and/or contribution requirements. Employers cannot force employees to enroll in coverage unless the employer pays for 100% of the employees’ premiums, which many employers cannot afford. Even with moderate to generous employer contributions, many employers still find young and lower-income employees waiving coverage. This was even more evident in 2019 with the ACA’s federal Individual Mandate non-compliance penalty reduced to $0.00.

The U.S. Department of Health & Human Services provides final guidance on this in regulation 147.104(b)(1): “In the case of health insurance coverage offered in the small group market, a health insurance issuer may limit the availability of coverage to an annual enrollment period that begins November 15 and extends through December 15 of each year in the case of a plan sponsor that is unable to comply with a material plan provision relating to employer contribution or group participation rules.”

If your employer groups are struggling with participation and/or contribution, the Special Open Enrollment Window is the time to enroll them in coverage.

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PEO Pros and Cons

PEO Pros and Cons

by | Nov 16, 2020 | PEO, Small Business Group Health

When choosing the right PEO, especially when it comes to human resource management, you should ensure that they offer basic HR services like benefits, payroll, and compliance.

Pros of PEO

1. Flexible, scalable:

Bundled HR solution covers you as you grow.  i.e. Compliance changes based on # of employees. The HR Platform can handle 10 as well as 200 employees. The benefits scale up as you do. You are able to include value-added services as you grow.

2. Access to “Big-Company” infrastructure and benefits

  • More health care benefit options for employees and their families mean:
    • Attract high caliber talent in your industry
    • Retain your best employees
  • 401(k) and retirement planning 
  • Top-rated voluntary benefits and discount programs
  • HR technology platform for administering benefit plans

3.  Access to HR expertise

  • Support for payroll and employee needs.
  • HR and Human Capital consultants.
    • Benefits administration
    • Employee issues
    • Strategic HR planning:  Interview Traning and Permanence Management Reviews, etc. 
  • Ensure HR compliance with local, state and federal laws.

4. Shifting and sharing of liability

  • Workplace safety
  • Sexual Harassment
  • Employer Practices Liability Insurance
  • Affordable Care Act compliance
  • COVID and New regulations

5. Value

  • Time Saver:  You get back valuable time from doing redundancies. The average PEO client saves 10 hrs/month. 
  • Benefits Savings:  The average client saves 15-40% on medical benefits alone.   The national networks and robust benefits are also value-added. 
  • Savings on Workmans Comp. 
    • PEO’s are pay as you go WC. This means if you downsized in light of COVID you receive an adjusted lower rate the following month and not end of the year. 
    • PEO’s may be able to place hard to write Workmans Comp. Ex: Construction Industry
  • State Unemployment:  Since you are sharing in a larger company’s SUTA rate the rates are generally lower with lower fluctuations. If during COVID a company had high turnover their SUTA rate can jump much higher than a PEO. 

 PEO Cons

1. Wrong PEO Selecting a PEO for the wrong reason(s): should be considered a long-term strategy, not a short-term fix.  Some PEOs may charge a percentage of salary instead of a clear per employee per month cost.  

2. Employers fear the loss of control Even though you will still be running your small business and making day to day decisions, the PEO will become the co-employer of your staff.  PEOs do NOT have control over your salary. You control who you hire/fire.  You decide on benefits eligibility waiting periods, plan selections, and employer contributions. The PEOs deal with HR responsibilities and risks, saving you countless hours and many headaches, but do not take away your independence.

3  System limitations   Because the PEO is a business as well, and has to meet it’s own deadlines, they may request certain payments upfront. This may mean a fundamental shift in your cash flow because there will be consequences for being a week late with your payroll taxes.

4. It is NOT for every small business depending on your industry and demographics you may or may not be the right for a PEO. While the vast majority of clients are indeed enjoying benefits savings for some groups the costs may be even higher than small group health insurance. Addiotnaly, some companies can develop above-average very high risk and become too much of a liability burden for the PEO and the client can be moved to a higher risk category. The very advantage of a PEO can make it a disadvantage – they can underwrite.  

Summary

Before you consider hiring a Professional Employment Organization, you should first find out what is a PEO so that you can know exactly what to expect from it. With the right PEO, you will be able to manage your businesses’ demand for growth and your employees as well. 

If you are looking for an insurance solution for your business, go to our website and check out our business insurance solutions. Do not hesitate to contact us for more information.

 

 

 

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JAN 1 SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

JAN 1 SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

by | Nov 2, 2020 | group health insurance, Obamacare, PPACA, Small Business Group Health

A little-known requirement but most important under Affordable Care Act (ACA) is for Health Insurers must waive their minimum employer-contribution and employee-participation rules once a year. ACA requires a one-month Special Open Enrollment Window for January 1st coverage.

The special open enrollment period occurs November 15th through December 15th of each year, allowing eligible small group employers to enroll for coverage effective January 1st of the following year.

Background

The ACA has a section in it called the “guaranteed issuance of coverage in the individual and group market.” It stipulates that “each health insurer that offers health insurance coverage in the individual or group market in the state must accept every employer and individual in the state that applies for such coverage.” The section also states that this guaranteed issuance of coverage can only be offered during (special) open enrollment periods, and that plans can only be offered to applicants that live in, work in, or reside in the plans’ service area(s).

Participation and Contribution Requirements

In many states (including California and Nevada), carriers can decline to issue group health coverage if fewer than 70% of employees elect to enroll in coverage. Some carriers may have even tighter participation requirements.

Generally speaking, employees with other coverage (Medicare, other group coverage, individual coverage through the Exchange, etc.) are removed from the participation requirement calculation – though it varies by insurance carrier.

Furthermore, employer contribution rules require employers to contribute a certain percentage of premium costs for all employees in order to attain group health coverage. Some businesses struggle to meet these contribution requirements for a variety of financial reasons.

Problem Solved: Special Open Enrollment Period

Many employers want to offer coverage to their employees, but are denied because they struggle to meet participation and/or contribution requirements. Employers cannot force employees to enroll in coverage unless the employer pays for 100% of the employees’ premiums, which many employers cannot afford. Even with moderate to generous employer contributions, many employers still find young and lower-income employees waiving coverage. This was even more evident in 2019 with the ACA’s federal Individual Mandate non-compliance penalty reduced to $0.00.

The U.S. Department of Health & Human Services provides final guidance on this in regulation 147.104(b)(1): “In the case of health insurance coverage offered in the small group market, a health insurance issuer may limit the availability of coverage to an annual enrollment period that begins November 15 and extends through December 15 of each year in the case of a plan sponsor that is unable to comply with a material plan provision relating to employer contribution or group participation rules.”

If your employer groups are struggling with participation and/or contribution, the Special Open Enrollment Window is the time to enroll them in coverage.

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For more help with the Special Open Enrollment Window contact us at info@360peo.com or (855)667-4621.

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

6 Advantages of a PEO during COVID-19

6 Advantages of a PEO during COVID-19

by | May 3, 2020 | COVID-19, group health insurance, PEO, Small Business Group Health

6 Advantages of a PEO during COVID-19

As COVID-19 unfolds, the importance of a PEO for a Small Business becomes evident. How can you protect your employees while also managing costs?  Here are examples of how our PEO clients have benefited.

 1. Rapid Law Changes

With recent CARES Act and FFCRA(Families First Coronavirus Response Act) to help struggling businesses, overwhelming info and regulations have mounted for the small business owner. Who is eligible for benefits? Tax credits? Furloughs and COBRA? Is their business Essential? Paid Sick Leave eligibility and additional tax credit entitlement?

PEOs provide a full team of experts who anxiously awaited the legislation, final rulings, and updates on all the Acts. They spend countless hours diving into legal jargon to answer business owners’ questions. Then, PEOs work alongside organizations to implement processes that assist in keeping the business compliant. They also help employees through the difficult time, with the livelihood of the business always in mind.

2. PEOs help with Paycheck Protection Program (PPP) loans through the CARES Act

Lenders are asking for historical payroll data and tax reports quickly produced by a PEO’s HRIS System. Many small businesses without HR help find these systems financially draining. Example: Needed 940/941 reporting is issued which can be sent to SBA Lender.  Also, several leading  PEO’s have supported clients with NYS Shared Loans Program.

Working with clients to understand options.

 3. Payroll Burden

Payroll administration is now a nightmare. Tracking the FFCRA emergency sick leave and expanded FMLA separately from regular sick and FMLA leave has thrown a wrench in many payroll processors’ systems. Add on any furloughed or terminated employee reporting and tracking, and now the job has doubled.

Instead, our PEO Clientsy are spending their time on mission-critical work that could make or break the business. Additionally, their payroll is processed by professionals who have the time and expertise to know the nuances of payroll and payroll tax laws with back up teams of professionals in place.

 4. Staffing Needs – On-Boarding and Terminations 

A minimum 75% of PPP loans must be spent on staffing costs.  Companies that had previously furloughed or terminated employees find they need to hire employees back. This comes with additional paperwork and many employee questions, such as whether benefits wait periods start over. 

Conversely, when businesses do need to furlough or terminate employees, the PEO is a great guide for compliance. The layoff process, COBRA,  paperwork including givernement reporting are supported. 

5. HR Excellence

Partnering with a PEO is much like gaining access to a full-service HR division, with a team of HR experts who are up-to-date with new and changing employment laws and able to identify ways to streamline your HR.

According to a report conducted by the National Association of Professional Employer Organizations (NAPEO), PEOs provide access to more HR services at a cost that is close to $450 lower per employee, compared to companies that manage their HR services in-house. 

 Studies show that businesses in a PEO arrangement grow 7-9 percent faster, have 10-14 percent lower turnover, and are 50 percent less likely to go out of business.

 6. Affordable and Better Benefits

By joining a large group risk-pool a a PEO can help employers gain access to high quality employee benefits, such as health insurance options with stable and affordable rates. Due to costs, small businesses often find high-quality employee benefits out of reach.  The savings on health insurance alone can pay for the PEO itself.  

If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

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Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.