HARTFORD – Feb. 6, 2018 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has been named to the thirteenth annual Best Places to Work in Connecticut list for 2018. This program was created by the Hartford Business Journal and Best Companies Group. OneDigital received the honor based on having a workplace culture and work environment that promotes productivity, superior client service and enthusiasm.

“Our team is excited to receive this award. We truly believe that the work we produce starts with the strong internal culture of our office. Our employees are essential to our continued success, and we take great pride in building an environment for them to thrive.”
— George Papagelis, Managing Principal.

The Best Places to Work awards program was designed to identify, recognize, and honor the best employers in Connecticut, benefiting the state's economy, workforce, and businesses. The list is made up of 45 companies split into two categories: 27 small/medium-sized companies (15-199 U.S. employees) and 18 large-sized companies (200 or more U.S. employees). OneDigital has been named one of this year’s Best Places to Work in Connecticut in the small/medium category.

About OneDigital Health and Benefits

OneDigital Health and Benefits, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. OneDigital stands as one with its clients, delivering fresh thinking ahead of the market, strategic consulting and innovative solutions that give clients peace of mind that their health and benefit plan designs are future-proof. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resources capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 950+ employees throughout the country, serves 35,000 companies and manages nearly $4 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

About Hartford Business Journal

Hartford Business Journal is a business information company all about delivering business news to the community. With essential intelligence and profitable connections, Hartford Business Journal works with companies to help them promote their brand and develop thought leadership channels.

The post OneDigital Connecticut Named Best Places To Work In Connecticut appeared first on OneDigital.

There are some issues that always seem to be a pain point for most employer groups. We’ve answered eight of these popular questions below.

For the full Q&A list, join us on Wednesday, February 14, for the webinar Employee Benefits Compliance Greatest Hits: Top 25 Compliance Questions.

1. Can an employer offer different benefits to different classes of employees?

   Maybe. The employer can offer different benefits to different classes of employees if:

   1. those employees are not similarly situated;
   2. the plan design does not discriminate in favor of highly compensated individuals (HCIs); and
   3. the distinction is consistent with the employer’s usual business practice.

    

2. Can an employer contribute different amounts to employees’ Health Savings Account (HSA)s?

   Maybe. If an employer makes contributions to any employee’s HSA, the employer must make comparable contributions to the HSAs of all comparable participating employees. However, the HSA comparable contribution rule does not apply if the HSA is funded through the cafeteria plan. If funded through the cafeteria plan, HSA contributions are subject to the Section 125 nondiscrimination rules, and cannot discriminate in favor of HCI.

3. Can an employee have other non-high deductible health plan (HDHP) coverage with their HSA?

   Maybe. Generally, an employee cannot have any other non-HDHP coverage and remain eligible to contribute to an HSA. However, there are exceptions to this rule such as dental and vision coverage, limited-purpose or post-deductible flexible spending account (FSA)s or health reimbursement arrangement (HRAs), accident, disability, and death insurance, or liabilities and fixed indemnity plans. Employers should exercise caution when paring an HSA with telemedicine or an on-site clinic.

4. Can an employee change from an FSA to an HSA mid-year?

   Maybe. An employee will only be permitted to change from an FSA to an HSA mid-year if the FSA plan year and HSA plan year match. Otherwise, the employee is locked into his/her FSA election for the remainder of the plan year and ineligible to contribute to an HSA.

5. If the employee has a change in status, can he/she make a mid-year change?

   Yes. To make a mid-year election change, the employee must experience one of the events identified under section 125, such as a change in employment, marital, or dependent status. Additionally, the change must be consistent with the event, the employer must include that event in its cafeteria plan document, and the employee must request the change within the time allotted in the cafeteria plan documents (usually 30 or 31 days).

6. Can an employee make a mid-year change with no change in status?

   No. To make a mid-year change the employee must have a change in status. Common examples of impermissible changes are employees that can no longer afford coverage despite no change in the cost of coverage, or employees that missed the open enrollment deadline.

7. My client just went over 50 full-time equivalent employees. Do they need to offer coverage now?

   No. If an employer has fewer than 50 full-time employees, including full-time equivalent employees, on average during the prior calendar year, the employer is not an applicable large employer for the current calendar year.

8. An employee went over 30 hours/week. Should the client offer coverage?

   Maybe. If an applicable large employer uses the monthly measurement method, the employer determines each employee’s status as a full-time employee by counting the employee’s hours of service for each calendar month. If the employer uses the look-back measurement method, the employee’s benefits eligibility status is determined by average hours during the preceding measurement period.

Are you confident that your company is in compliance with the increasingly complex myriad of employee benefit laws and regulations? Register for the Employee Benefits Compliance Greatest Hits: Top 25 Compliance Questions here.

The post Most Frequently Asked Employee Benefits Compliance Questions appeared first on OneDigital.

On January 5, 2018, the Department of Labor (DOL) issued its proposed rule expanding the circumstances under which employer groups may band together to purchase health insurance for their employees. The proposed rules, redefining the criteria to create association health plans (AHPs), anticipates more affordable health plan choices for individuals and employers.

Background

Shortly after taking office, President Trump issued an Executive Order requesting the Departments to review their administrative practices and procedures and look for opportunities to reduce the burden on individuals, employers, insurers and the healthcare industry. In the October 12, 2017 Executive Order, the President confirms the desire to develop a healthcare system that “provides high-quality care at affordable prices for the American people."

Choosing AHPs as one of three distinct areas for improvement, the administration hopes the modification of existing rules will allow more employers to form AHPs, facilitate purchase across State lines, and improve choice and affordability.

Current federal law and regulations do not consider association health plans (groups of individual employers) to be a single employer. They prohibit employers from grouping together solely for the purpose of health insurance by requiring that the association is in existence for five years prior to offering a health plan. When considering which market rules apply, e.g. individual, small group, or large group, to an employer, the Departments look through any association or group of employers to the actual individual or employer themselves and use their individual size to determine which laws and regulations apply.

For example, three separate members of the same association will only have access to the plans in the market that correspond with their size. A host of other laws and regulations also apply in this manner, like Consolidated Omnibus Budget Reconciliation Act (COBRA) or state continuation.

Overview of the Proposed Rule

To allow more employer groups to unify and enjoy the benefits of being a large group, the association must be recognized as a single “employer”. To be a single “employer,” associations must meet specific criteria. The new rule outlines commonality, structure and control of the association, health nondiscrimination protections, and includes working owners as the means to achieve this new single employer AHP.

Commonality of Interest

Employers may band together solely for the purpose of offering health coverage if they are either:

1. In the same trade, industry, line of business, or profession; or
2. Have a principal place of business within a region that does not exceed the boundaries of the same State or the same metropolitan area (even if the metropolitan area includes more than one State) - examples include the Washington Metropolitan Area of the District of Columbia and portions of Maryland and Virginia, the Greater New York Area/Tri-State Region covering portions of New York, New Jersey, and Connecticut, specific cities or counties.

Bona Fide Group or Associations of Employers

A bona fide group or association of employers capable of establishing a group health plan must meet the following requirements:

1. The group or association exists for the purpose, in whole or in part, of sponsoring a group health plan that it offers to its employer members;
2. Each employer member of the group or association participating in the group health plan is a person acting directly as an employer of at least one employee who is a participant covered under the plan;
3. The group or association has a formal organizational structure with a governing body and has by-laws or other similar indications of formality;
4. The functions and activities of the group or association, including the establishment and maintenance of the group health plan, are controlled by its employer members, either directly or indirectly through the regular nomination and election of directors, officers, or other similar representatives that control the group or association and the establishment and maintenance of the plan;
5. The employer members have a commonality of interest as described in paragraph (c) of this section;
6. The group or association does not make health coverage through the association available other than to employees and former employees of employer members and family members or other beneficiaries of those employees and former employees;
7. The group or association and health coverage offered by the group or association complies with the nondiscrimination provisions (see below); and
8. The group or association is not a health insurance issuer or owned or controlled by such a health insurance issuer.

Health Plan Nondiscrimination

Each bona fide group or association, and any offer of health coverage must comply with the following nondiscrimination provisions:

1. The group or association must not condition employer membership in the group or association based on any health factor of an employee or employees or a former employee or former employees of the employer member (or any employee's family members or other beneficiaries)
2. The group health plan sponsored by the group or association must not discriminate based on health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, or disability
3. The group health plan sponsored by the group or association must comply with respect to nondiscrimination in premiums or contributions required by any participant or beneficiary for coverage under the plan
4. In applying the nondiscrimination provisions of paragraphs (2) and (3) of this section, the group or association may not treat different employer members of the group or association as distinct groups of similarly-situated individuals.

Dual Treatment of Working Owners

A working owner may qualify as both an employer and as an employee of a trade or business. A “working owner” is an individual who:

• Has an ownership right of any nature in a trade or business, whether incorporated or unincorporated, including partners and other self-employed individuals;
• Is earning wages or self-employment income from the trade or business for providing personal services to the trade or business;
• Is not eligible to participate in any subsidized group health plan maintained by any other employer of the individual or of the spouse of the individual; and
• Either:
  • (Works at least 30 hours per week or at least 120 hours per month providing personal services to the trade or business, or
  • Has earned income from such trade or business that at least equals the working owner's cost of coverage for participation by the working owner and any covered beneficiaries in the group health plan sponsored by the group or association in which the individual is participating.
• Absent knowledge to the contrary, the group or association sponsoring the group health plan may reasonably rely on written representations from the individual seeking to participate as a working owner as a basis for deciding whether the individual meets the criteria above.

Anticipated Outcomes

The Departments feel that the expansion of the single employer definition and the clarifying guidelines will help:

• create more affordable alternatives for individuals and small employers;
• deliver plan options that do not have to comply with ACA or State coverage mandates thereby lowering the cost and eliminating the requirement to purchase coverage the individual may not need;
• bring affordable alternatives to previously uninsured business owners; and
• provide individuals qualifying as working owners to participate in a group health care option as an alternative to the individual market

Next Steps

The Employee Benefits Security Administration (EBSA) and the Department of Labor are taking comments on the rule and responses to the long list of questions they pose within the rule. The commentary period ends on March 6, 2018.

OneDigital is working on a response to the Departments and welcomes your input. Please contact your OneDigital representative to provide your remarks.

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On November 24, 2017, the Department of Labor (DOL) released regulations finalizing a 90-day delay in the effective date of the final rules governing claims and appeals procedures for plans that provide disability benefits. The 90-day delay was to give stakeholders the opportunity to submit comments on the costs and benefits of the final rule.

On January 5, 2018, the DOL announced that April 1, 2018 will be the applicability date for employee benefit plans to comply with the final rule under ERISA. The DOL received approximately 200 comment letters, with only a few responding substantively to the DOL’s request for quantitative data to support assertions that the final rule would drive up disability benefit plan costs, cause an increase in litigation, and consequently reduce workers’ access to disability insurance protections. The information provided in the comments did not establish that the final rule imposes unnecessary regulatory burdens or significantly impairs workers’ access to disability insurance benefits, according to the DOL.

The new rule provides new procedural protections for workers dealing with plan fiduciaries and insurance providers who have denied their disability benefits claims. Employers will need to update all relevant disability benefit plan documents to comply with the changes.

For notable provisions in the final rule, download the DOL Updated ERISA Disability Benefit Claims and Appeals Procedures InfoBrief.

Download the DOL Updated ERISA Disability Benefit Claims and Appeals Procedures Infobrief

 
Contact your OneDigital representative to find out more about the updated ERISA benefit claims and appeals procedures.

The post Department of Labor Announces April 1 Applicability Date for New Disability Benefits Claims Procedures appeared first on OneDigital.

While many thoughts and dialogues were shared at the recent U.S. News and World Report Healthcare of Tomorrow conference in Washington D.C., an underlying theme of change and progression in our existing healthcare delivery system was evident. We as consumers will help drive those changes as we push for a better healthcare experience, more convenience and reduced costs. During the conference, many healthcare leaders came together to share views on how our healthcare system may be evolving in the near future.

1. The conversion of reimbursement models to value-based payments continues, but not at an accelerated pace.

   The industry continues to move toward increased value-based care, which is paying providers and facilities on a different set of criteria that include patient quality measures, outcomes, and patient satisfaction, among others.

   This has produced an interesting mix of strategic partnerships and alliances, and the lines between traditional healthcare organizations are blurring.

   One example is Amgen, the large biotech company partnering with Humana to conduct an outcomes-based research study. Another new partnership is CVS and Aetna. While some insurance carriers have offered value-based benefit plans which incentivize individuals to seek out high-value care versus low-value care, they have not become widely accepted.

   Another change in the reimbursement model strategy is the proliferation of referenced-based pricing, which limits the payment to a facility for a covered service at the Medicare rate plus some escalator. This has been shown to significantly lower facility costs, if accepted, over the traditional negotiated fee-for-service discounts. The general consensus at the Healthcare of Tomorrow conference was that discussions about value-based care will certainly continue.

2. Patient care will shift away from hospitals.

   Chairman and Chief Executive Officer of Aetna, Mark Bertolini feels a home setting or a close-by retail clinic is often the least expensive and most convenient location for a patient. Bertolini states, “If you have to go to the hospital, we have failed you. What if that were the way the system was designed?”

   Telemedicine is a great example of how Concierge Medicine is emerging. The patient’s home becomes the setting for the delivery of primary care. According to Christopher Northam, the Vice President for Hospital Corporation of America, telehealth is no longer a novelty and the focus is shifting from the technology to the clinical outcomes and is only expected to become more mainstream. Northam predicts this shift will ultimately, “shut down hospitals.”

   Dr. David Tsay, the Associate Chief Innovation Officer at the New York-Presbyterian Innovation Center agrees that change is forthcoming and hospitals will morph into intensive care units and operating rooms with the rest of care being done in the convenience of the patient’s home. Patients as consumers will continue to drive these changes.

3. Social determinants of health need to be paid attention to.

   Emerging evidence has found that factors like security, nutritious food and affordable housing play a fundamental role in creating positive health outcomes. Bertolini noted that a person’s ZIP code is often a bigger indication of life expectancy than their genetic code. He went on to say it makes sense for payers to be thinking about social determinants of health because diseases can be prevented and savings realized.

As Bertolini points out, “paying for an Uber ride, food, or fuel assistance is cheaper than one ER visit.”

It’s clear that changes in the healthcare industry are on the horizon but consumers will only help to dictate the type of reform we see. Unfortunately, with the current state in Washington, we cannot legislate the types of change that will create positive modifications to our existing healthcare system. We need to continue to bring healthcare innovations and new ideas to the table and implement them.

To learn more about how these delivery systems and emerging trends impact your organization, reach out to your OneDigital representative today.

The post The Healthcare Delivery System of Tomorrow – the End of Hospitals? appeared first on OneDigital.

For Human Resource professionals and leaders of tomorrow, the roles and responsibilities show no signs of slowing down in 2018. With the rising demand for immediacy, efficiency, and overall consistency from HR organizations across the globe, it's no surprise that HR groups are racing to revamp their practices to keep pace with the latest business requirements and expectations.

The trends garnering the most interest on the radar for 2018 are expected to ultimately affect the bottom line, disrupting the HR landscape as we know it.

Here are 4 trends to expect in the coming year:

1. Brand and Culture

   If we learned nothing else in 2017, it’s that having a healthy work environment that supports a strong company culture is crucial to securing a reputable brand.

   This became blatantly evident last year as we witnessed big-name companies crash and burn at the hands of sexual harassment allegations, resulting in tarnished brands that failed to withstand their loss in value.

   This year, HR leaders and their teams, are forecasted to ramp up organizational culture efforts.

   This means partnering with senior-level management to reexamine what culture should look like (compared with how it currently functions) and develop a strategic plan to reinforce company values that are critical to your organization’s success.

   Teams can anticipate making changes to how they provide and ensure the following:

   • Ongoing learning and training
   • Empowerment and utilization of teams
   • Clear definition of roles, responsibilities and accountabilities
   • Company ethics, beliefs and values are defined, understood and practiced

 

2. Artificial Intelligence (AI)

   Robots haven’t quite taken over the workplace. However, companies are jumping at the opportunity to invest in adaptive-learning programming to tackle complex practices that would otherwise take an unthinkable amount of time and manpower to complete.
   You can expect AI to take on major roles in 2018, revolutionizing key dimensions of HR, like talent acquisition, onboarding, retention and training.

   With the assistance of AI, employees can look forward to the following:

   • Programs that read and evaluate applicants in record time—making the pool of highly qualified candidates smaller and easier to analyze
   • Differentiated onboarding procedures for all new-hires based on their positions
   • Self-analyzing software that determines employee satisfaction, engagement and answers FAQs in real time
   • Smart systems that plan and coordinate training programs to fit the preferences of the individual employee

 

3. Investing in People

   Today, companies are focusing on the overall employee experience more than ever before. This is largely due to the competitive job market and the fight for top talent. And it doesn’t stop at the recruitment of qualified talent, but also means developing a plan to retain the talent once onboarded.

   Deloitte suggests HR leaders consider the following augmentations to their strategies:

   • Reskill existing employees and build a new generation of leadership
   • Engage the more senior ‘tenured’ professionals in the company
   • Modernize performance management, rewards, well-being, and engagement programs

 

4. Digital Ecosystems

   We hinted earlier about a technological takeover with AI. However, the inclusion of technology in HR delves deeper than AI alone. HR teams are doing away with much of its out-of-date, paper-based systems and turning to a digital, mobile-based system.

   Going forward, most HR teams are going to see an increase in the use of automated services that remove the heavy workload from administrators and offers employees’ ease of access to almost any piece of information from anywhere in the world as long as there is access to the internet.

   These systems will automatically sync themselves, completely eliminating the need to manually update employee benefits information across platforms.
   That includes access to employee data, updates to address, benefits, payroll, time off request, and more.

 
Staying afloat in 2018 will require HR professionals to embrace the change ahead and learn to leverage these new systems. The best strategy is going to be organizing teams to establish a closer relationship with senior management to anticipate development needs.

To find out more about how additional HR trends or how to best incorporate any of these into your benefits design strategy, contact your OneDigital representative today.

The post Top 4 Human Resources Trends Tipping the Scale in 2018 appeared first on OneDigital.

At the core of OneDigital’s disruptive competitive advantage is a unique focus on employee benefits and human capital management that emphasizes corporate culture, meaning we attract like-minded firms that add to our rapid growth and sustained momentum. Recently ranked 13 in Employee Benefit Adviser’s list of Top 50 Benefit Brokerages in the Large-Group Market, OneDigital was interviewed alongside four other large group benefits brokers for a follow-up piece.

OneDigital Chief Growth Officer, Mike Sullivan, discusses how embracing technology and forming strategic partnerships were key factors in the firm’s significant expansion over a four year period, as described in the article, Top 50 Brokerages Eye Mid-Market Sweet Spot.

We’re trying to build a different kind of employee benefits company with fresh thinking.”
 
— Mike Sullivan, OneDigital Chief Growth Officer

Click here to read the full article.

The post OneDigital Chief Growth Officer Discusses Significant Growth with Employee Benefit Adviser appeared first on OneDigital.

ALISO VIEJO, CA – January 25, 2018 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company today welcomed Alexandra Dix, Senior Benefits Consultant, to OneDigital Southern California. Dix will be responsible for developing the client services strategy and managing and expanding her book of business.

Working closely with the client services and consulting team, Dix will focus on strengthening the client services function and expanding client and carrier relationships. She will play a consulting role and provide strategic guidance for the OneDigital Southern California team.

Our exceptional client retention numbers can largely be credited to the incredible talent and culture we have at OneDigital. By welcoming Alexandra to the team, we’re able to strengthen our commitment to responsive customer service. Her extensive knowledge of the employee benefits industry and thoughtful, personal approach to working with clients and carrier partners means she’ll have an immediate impact.”
— Chris Thurin, Managing Principal at OneDigital Southern California.

"I’m thrilled to be teaming up with Russ Gramstad and the entire OneDigital family," said Dix. "This move means I will have the ability to offer more in terms of technology, support and resources working alongside such talented people. I look forward to contributing to the team's continued success."

The Southern California office, led by Managing Principal, Chris Thurin, has been recognized as a “Best Place to Work” by the Orange County Business Journal for the last seven years. Poised to accelerate the deployment of its industry-leading platform, the firm has established its presence in the market by reshaping the way employers manage their human capital.

About OneDigital Health and Benefits

OneDigital, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. By contributing fresh-thinking ahead of the market, innovative approaches and market-leading solutions OneDigital provides clients with peace of mind. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resource capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1,000 employees throughout the country, serves 37,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

The post OneDigital Southern California Welcomes Senior Benefits Consultant Alexandra Dix appeared first on OneDigital.

ATLANTA, GA – Jan. 16, 2018 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has been ranked 13th on Employee Benefit Adviser’s (EBA) list of Top 50 Benefit Brokerages of 2017 in the large-group category. This ranking highlights the organization’s rapid expansion over a four-year period, and underlines OneDigital’s increasing growth—specifically amongst brokers providing strategic benefits consultation to employers with 100 employees or more.

Ranked 28th on EBA’s list of top 50 benefit brokerages in 2014, EBA reports that the firm is experiencing an 86% year-over-year growth. In a review of the top 15 largest benefit brokers on EBA’s 2017 ranking, OneDigital has the overall highest growth. EBA was not the only source to take notice of the company’s accelerated progress. In August 2017, OneDigital was named on the list of top 10 insurance broker buyers of 2017 by Business Insurance, and named for the eleventh consecutive time to Inc. 5000’s distinguished listing of America’s fastest-growing private companies.

Only a small fraction of the nation's companies have demonstrated such remarkably consistent high growth,” says Adam Bruckman, President and CEO of OneDigital. “While our growth is explosive, it's carefully planned. This ranking validates our operational alignment and relentless commitment to drive results for our clients.”

EBA, in partnership with business intelligence data analytics firm miEdge, recognizes leading firms, ranked exclusively on health and welfare revenue. Revealed in descending order, the listing is based on Form 5500 reporting data as of Dec 11, 2017.

About OneDigital Health and Benefits

OneDigital Health and Benefits, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. OneDigital stands as one with its clients, delivering fresh thinking ahead of the market, strategic consulting and innovative solutions that give clients peace of mind that their health and benefit plan designs are future-proof. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resources capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1000+ employees throughout the country, serves 35,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

About Employee Benefit Adviser

Employee Benefit Adviser (EBA) is the information resource for employee benefit advisers, brokers, agents and consultants. Serving over 146,000 brokers, advisers, agents, financial planners, investment advisers and consultants across all platforms, benefits broker community relies on EBA to stay connected, through its website comment forums, its social media communities, and live events. EBA covers a broad range of critical content, including comparative market data, legal and regulatory updates, the latest products and services, and best practices in benefits delivery — including health insurance, vision and dental insurance, voluntary products and services, and retirement benefits.

# # #

The post OneDigital Health and Benefits Ranks 13th on Employee Benefit Adviser List of Top 50 Benefit Brokerages of 2017 in Large Group Market appeared first on OneDigital.

Watch this webinar for our first quarter update on recent legislative and regulatory proposals and changes.

During this session, attendees learned:

• Latest Developments in Healthcare Reform
• Proposed Federal Legislation Impacting Your Employee Benefits
• Newly Issued Federal Employee Benefits Regulations
• Emerging Legal Cases and Agency Guidance
• Preeminent State Law Issues

To learn more about the latest employee benefits legislation and how this might impact your organization, connect with a OneDigital representative today.

The post Webinar Playback: Quarterly Employee Benefits Legislative and Regulatory Compliance Update appeared first on OneDigital.

Both the Senate (81-18) and House (266-150) approved HR 195 (115), the stop-gap bill granting additional government funding through February 8, 2018. This short-term funding fix is known as a continuing resolution (CR). With the President’s signature and the bill now signed into law, many government workers—out of work since Friday, January 19—are breathing a sigh of relief as they will now be able to report to work today.

Effect on the Affordable Care Act (ACA) and Other Benefits

This new law contains modifications to three ACA tax provisions and the Children’s Health Insurance Plan (CHIP). Each of these has been of great concern, as our previous blog explains. Here are the latest developments:

• CHIP funding authorization for an additional six years—through September 30, 2023
• Delay of the excise (“Cadillac”) December 31, 2021 (was 2020)
• Moratorium on the health insurance tax (HIT) for the 2019 calendar year
• Two-year delay (calendar years 2018 and 2019) of the medical device tax

Next Steps

Since the CR expires February 8, Congress will either need to finalize their trillion-dollar omnibus bill or we will face another dance to pass another short-term bill to provide additional government funding. While these delays do not fix these provisions long-term, they do provide some relief and peace of mind to employers and give us additional time to continue advocacy efforts on behalf of our clients.

Join us tomorrow, Wednesday, January 24, for our Quarterly Legislative and Regulatory Update webinar where you’ll hear about the legislative and regulatory developments affecting your benefits program. Click here to register.

The post ACA Watch 2018: Congress Comes Through Delaying ACA Taxes appeared first on OneDigital.

 
In February, as we observe American Heart Health month, there are many ways to engage employees while boosting awareness of heart-healthy behaviors. For example, the American Heart Association’s annual Go Red for Women campaign advocates for more research and swifter action for women’s heart health. The American Heart Association created the infographic below showing 7 practical steps to a healthier heart.

 
An organization may want to focus on heart-healthy eating by promoting DASH (Dietary Approaches to Stop Hypertension) diet foods in its cafeteria. A University of Michigan Clinical Research Unit study found the DASH diet, aimed at lowering blood pressure, can also improve heart function.

Challenges that incorporate physical activity can motivate employees to increase their daily steps and can promote cardiovascular health and an active corporate culture as well.

While these traditional workplace initiatives are critical to improving the heart health of your population, I encourage employers to think about the heart a little differently this February. Employees are your human capital, and your most valuable resource. Therefore, your employee well-being program supporting the overall health of each employee is truly the heart of human capital.

Your well-being program has the potential to impact productivity, resilience, stress, health status and many other areas that are affecting your employees during their time at work. There are few other business components that can positively affect such a wide scope of employee concerns.

Maya Angelou said “every journey begins with a single step.”

Help your employees take a few heart-healthy steps this month, by expanding your focus on the workplace well-being program. To explore options that will excite and engage your workforce contact your OneDigital representative.

The post Workplace Well-Being: the Heart of Human Capital appeared first on OneDigital.

OneDigital's annual growth summit brought together over 275 employees from across the country for a week of inspiration, innovation, and professional development to help our sales teams establish themselves as market leaders in integrating employee benefits and enhancing the brand across all segments of the market.

To get a feel for the energy and enthusiasm our team brings to employee benefits, check out the video above and contact your local OneDigital representative to get connected.

The post OneDigital Growth Summit 2018: Carry the Torch! appeared first on OneDigital.

However, employers are finding that even if they offer premium vision benefits, it doesn't mean their employees are taking advantage—and this can have adverse effects. Lily Lam, Principal at OneDigital Southern California, dives into why this scenario is so common and how to remedy in the article, New Year, New Benefits: Five Strategies for Effectively Communicating the Value of Premium Vision Plans to Employees, published by California Broker Magazine.

But while employees want access to premium vision benefits, research has also shown that many who do have access may not be taking full advantage of all they have to offer—putting them, and their employers, at risk for increased medical costs and decreased employee productivity."

Click here to read the full article.

The post Lily Lam, Principal of OneDigital Southern California, Featured in California Broker Magazine appeared first on OneDigital.

This CFO, like many, has seen his health plan costs go up every year, and like many, his first instinct was to blame the insurance company.

We discussed how the lion’s share of his costs is actually his plans’ claims, and because of the way we pay providers, costs increase every year with no end in sight. Our current fee-for-service model pays providers for every service they perform, meaning the more they do the more they get paid. And since there are no regulations around what a provider can charge, the fees get higher every year. There is no other product or service we pay for in quite this way. “We have to change the way we pay providers,” I said to the CFO. “What other way is there?” he asked.

Enter value-based medicine.

The concept has been around for years, but very few health plans actually do it. The idea is that the provider is reimbursed not for every service performed, but based on the outcome of the treatment. This method focuses on the health of the patient, and pays the doctor based on the patient’s health improvement.

Suddenly the incentive is on keeping the patient healthy. Sounds great, right? So why aren’t we doing it?

The fee-for-service model has been the way we have paid for healthcare for a very long time. Value-based medicine would completely revolutionize the way we pay for health services. To add to the difficulty, this model would require some general agreement on the definition of ‘value’ in medicine, as well as some consensus on measuring health improvement. Much of our healthcare payment system is currently automated, meaning a computer makes 90% of the payments without a human looking at the claim. If we decrease this automation by introducing a subjective ‘value’ element into the claim process, administrative costs could rise. So, establishing some standardized measures of value would need to come first—no easy task.

By far the biggest barrier to implementing value-based medicine is that currently, most healthcare providers are opposed to it. It would mean providers—especially hospitals—would no longer control what gets charged and how much the charge is.

The healthcare lobby is incredibly powerful in this country, and so far they have managed to keep this concept largely under wraps.

But there is hope. Pilot projects across the country are testing the viability of a value-based medicine system. Here in Vermont, we are in the middle of a pilot with 30,000 Medicaid recipients, where their providers are being reimbursed according to the health outcomes of their patients. The providers volunteered to participate in the pilot and hopes are high that this will contain costs for this Medicaid population. Centers for Medicare & Medicaid Services (CMS) is conducting similar pilots with select programs and populations in other states.

Results to come … stay tuned to learn whether this model could spell a new era in paying for healthcare.

To learn more about value-based medicine and how this might impact your organization, connect with a OneDigital representative today.

The post Revolutionizing Healthcare: Value-Based Medicine appeared first on OneDigital.

ATLANTA, GA – Jan. 11, 2018 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has acquired Insight Performance, Inc. and Insight Insurance LLC, a national industry leader in benefits services, human resources and cost-effective HR solutions. Managing Principals, Michael Ward and Nancy Mobley, along with their team will provide expertise and HR consulting services to the Human Capital Solutions division for OneDigital Boston. The acquisition supports OneDigital’s strategy of expanding the company’s national platform to include complementary lines of businesses.

Insight Performance specializes in delivering high quality, cost-effective HR consulting services and benefits brokerage to small and mid-sized employers. In partnering with OneDigital, Insight Performance will be able to leverage OneDigital’s technology and resources while advancing the benefits expertise adding further value to Insight clients.

OneDigital is committed to providing industry leading and integrated solutions to help clients attract, retain and motivate their teams,” says Brian Driscoll, Regional Managing Principal, OneDigital New England, “which is why we are thrilled to welcome Insight Performance onboard. Mike and Nancy’s team of experts will allow us to expand our regional presence in both benefits consulting and premier HR consulting."

The expansion of the Human Capital Solutions division further compliments OneDigital’s comprehensive advisory services and market-leading solutions that are offered in over 55 offices throughout the country. Since the beginning, OneDigital has focused on building a disruptive competitive advantage by partnering with like-minded leaders and teams, who fit our culture, love the benefits business and embrace the latest advances in the industry.

We felt OneDigital provided us with the opportunity to continue to grow and build our HR consulting practice while also providing us with tools and resources that would benefit both our HR and Benefit Brokerage businesses,” says Michael Ward, Managing Principal of OneDigital Boston. “In the New England region, Insight will be able to provide robust HR services to OneDigital's employee benefit clients, which expands OneDigital's ability to serve clients. As a Best Place to Work in our region, we were attracted to OneDigital's culture and commitment to employees."

About OneDigital Health and Benefits

OneDigital Health and Benefits, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. OneDigital stands as one with its clients, delivering fresh thinking ahead of the market, strategic consulting and innovative solutions that give clients peace of mind that their health and benefit plan designs are future-proof. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resources capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1000+ employees throughout the country, serves 35,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

About Insight Performance

Insight offers full-service Human Resources and Benefits solutions for small to mid-size companies, bringing a creative approach to managing human resources, gleaned from our involvement with existing clients and combined professional experience. Insight also supports organizations that are pursuing seamlessly integrated employee benefits and compliance solutions. Delivering out-of-the-box concepts on plan design, combined with thoughtful and creative options for employees. Founded in 1995, Insight Performance, Inc. is recognized as a national industry leader in human resources, providing proven and cost-effective HR solutions and Employee Benefits. Insight’s mission is to deliver high quality, cost-effective HR consulting services and Benefits brokerage to small to mid-sized employers, ranging from 1 to 1000 employees.

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The post OneDigital Health and Benefits Acquires Insight Performance appeared first on OneDigital.

CUPERTINO, CA – January 9, 2018 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company today announced the appointment of Ken Juricic as Vice President, Senior Client Executive at OneDigital Northern California. Juricic will be responsible for new business development in our up-market consulting group.

Juricic will work closely with both the sales and consulting teams, broadening the team’s capabilities and strengthening the services of OneDigital Northern California, located in Cupertino. He will play a consulting role and provide strategic guidance for the block of large group (100+ employees) Zenefits accounts transferred to OneDigital as a result of the recent Zenefits-OneDigital partnership. Poised to accelerate the deployment of its industry-leading platform, OneDigital is reshaping the way small and mid-sized employers manage their human capital.

I have known Ken Juricic for almost 15 years and have always been impressed with his deep and extensive knowledge of the employee benefits industry and his approach to working with clients and carrier partners,” says Jeff Fallick, Managing Principal at OneDigital Northern California. “He will also provide an immediate impact to both the sales and consulting teams from a mentorship perspective. Simply put, Ken is a true professional and we’re lucky to have him on the team.

Juricic, a seasoned insurance executive who has spent his entire career in the employee benefits arena has spent the last 17 years with ABD Insurance & Financial Services and Wells Fargo Insurance Services. Juricic provides strategic guidance to mid-size and large employers for the design and financing of their employee benefit programs.

I am thrilled to be teaming up with Jeff Fallick and the entire OneDigital family," said Juricic. "I have been impressed for years with the talented people, technology, and culture of OneDigital and look forward to contributing to the team's continued success.

About OneDigital Health and Benefits

OneDigital, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. By contributing fresh-thinking ahead of the market, innovative approaches and market-leading solutions OneDigital provides clients with peace of mind. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resource capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1,000 employees throughout the country, serves 37,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

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The post OneDigital Northern California Announces Ken Juricic as Vice President Senior Client Executive appeared first on OneDigital.

It may be a parent or a famous idol but some of us don’t give enough consideration to the healthcare professionals acting as heroes and that are a part of our lives every day.

I recently had the opportunity to attend the Healthcare Heroes Awards Finalists ceremony, where two of our clients were recognized for their hard work and leadership in the healthcare community.

The event was sponsored by the Hartford Business Journal and brought to light all the ways we, as professionals, contribute to the improvement of our healthcare system as a whole. Whether you are working as an emergency room nurse in areas of disaster relief, a phlebotomist helping to calm a pediatric patient before a procedure, a customer support specialist in a hospital billing department, or an insurance broker helping to mitigate the rising healthcare costs and resulting burden on employees, there is one underlying theme: we are all working to provide access to quality care in times of need.

I have been volunteering at Connecticut Children’s Medical Center (CCMC) once a week for almost a year and upon each visit have witnessed these healthcare heroes in action. While some patients only spend a day or two at CCMC, there are several who are there on a long-term basis.

The staff dedicates their time and energy to provide a positive experience for both patients and families facing some of the most difficult times that they may ever experience.

They schedule various events like pajama parties, art projects, and even a superhero dress up day. The Child Life Department hosts a Bingo night on each of the surgery floors for patients, family members and visitors alike to get together, have some fun, and by way of the generous contributions, provide a little something special for each one of the patients.

During the season of giving, OneDigital emphasizes the concept of generosity. Together, our team donated gift certificates to distribute to patients participating in Bingo night, exercising great generosity for those less fortunate and helping to provide light in times of great darkness. On behalf of OneDigital, I’d like to thank our entire community of healthcare heroes, for your tremendous work, wish you the best holiday season and a happy new year.

The post Celebrating Our Local Healthcare Heroes appeared first on OneDigital.

As Congress wrapped up for the year, they left Washington successfully using a budget reconciliation action to affect change. Although the original intent was exclusively for healthcare reform, this sweeping new tax bill impacts specific Affordable Care Act (ACA) provisions along with other benefits and employer-related items. Additionally, legislators and regulators continue to work on other bills and rules that may change the delivery and compliance of healthcare plan offerings.

Benefits-Related Tax Reform Changes

On December 22, 2017, President Trump signed the new tax reform bill, Tax Cuts and Jobs Act (P.L. 115-97), into law. There were differences in provisions between the House’s version of the bill and the Senate’s. Representatives from both chambers worked to reconcile the differences and bring a final version to the President for his signature.

The main Affordable Care Act change comes in the form of negating the individual mandate. In review, a budget reconciliation bill may only modify those items that affect the budget, e.g. revenue, expenses, or the debt limit.

Therefore, the individual mandate of the ACA still remains, but the new tax law reduces the amount of the penalty for those who go without health coverage to $0.

Here are some of the final components of the new tax law that will affect benefits and medical expenses:

Other Affordable Care Act Changes

Although the tax reform law does not repeal or suspend penalties for the employer mandate of the ACA, the IRS, in a separate regulatory action, announced a reporting delay

Applicable large employers (ALEs) who must provide employees with statements regarding their benefit plan offers for 2017 must now furnish those statements to affected employees by March 2, 2018, rather than January 31, 2018. Click here to learn more about the extended deadline.

The other areas of concern to employers are the two taxes that currently, or will have, the greatest impact on the cost of benefits. These are the health insurance tax (HIT) and the excise “Cadillac” tax. Neither was addressed in the tax reform law.

• HIT is the annual tax levied on all health insurers that insurance carriers pass through to employers and employees in their premium rates. There was a moratorium placed on this tax for 2017 but it returns in 2018. In anticipation, carriers have raised premiums in 2018 to account for the return of the tax. Many states allowed carriers to file dual rates–ones that anticipate the inclusion of the tax and ones that assume there is no tax. In this way, some carriers are prepared to react quickly should there be a new delay issued.
• The Cadillac tax assesses a fee on high-cost health insurance plans. It effectively caps the cost of plans by assessing a 40% tax penalty on plan costs that exceed a certain dollar amount. Although delayed in 2015, the new implementation date for this tax is 2020.

As active members of the National Association of Health Underwriters (NAHU) and the Council of Insurance Agents and Brokers (CIAB), we actively work on these issues with leaders of Congress and regulators. Both groups are part of the Alliance to Fight the Forty, a coalition of public and private organizations banding together to support employer-sponsored coverage.

Children’s Health Insurance Program Funding

One of the items we’ve been watching closely is the funding for the Children's Health Insurance Program (CHIP). Planned funding expired September 30, 2017, and the federal government has been assisting some states in meeting payment obligations for participants. Contained within the recently passed Continuing Resolution (CR), granting government funding through January 19, 2018, is authorization for CHIP funding. The new funding lasts through the end of March 2018. Employers are encouraged to continue to provide CHIP notices annually to their employees at the time of open enrollment or upon initial health plan enrollment.

Staying Alert Through 2018

Since the Continuing Resolution (CR) expires mid-January, there will be new talks beginning in an effort, once again, to avoid the next impending government shutdown. Efforts are being made to try to include a delay to both the HIT and Cadillac taxes in the next CR.

With the impending repeal of the individual mandate penalty, there is concern that the individual marketplace will continue to erode.

With no mandate in the Affordable Care Act to spur individuals to purchase coverage, it is likely that the healthiest individuals may forgo the high cost of health coverage by choosing to self-insure. The loss of these individuals will leave only those using the highest amount of services in the healthcare pool resulting in a continuing escalation of premium costs.

In response, many are saying there will be new legislative and regulatory activity to address this problem. The months following the September 2017 deadline to pass any sweeping healthcare reform, resulted in a flurry of legislative activity, including new bills introduced, members of Congress signing on and supporting existing bills, and renewed interest in the Alexander–Murray market stability bill. We will continue to work on your behalf with lawmakers and regulators to bring about the changes needed to support employers and individuals.

For 2018, we will be offering a new opportunity to receive up-to-date information on the changing landscape. In addition to our monthly blog articles, compliance webinars and newsletters, we are adding a new Quarterly Legislative and Regulatory Update webinar.

We look forward to working with you on the next part of the healthcare journey and if you have any questions do not hesitate to reach out to your OneDigital representative. Here’s to an exciting and productive 2018.

The post An Overview of the Affordable Care Act in Early 2018 appeared first on OneDigital.

The HIPAA nondiscrimination rule states that an employer cannot, “refuse to provide benefits because an individual is not actively at work on the day that individual would become eligible for benefits.” Yet, actively-at-work clauses, which require an individual to be actively at work on the day their benefits become effective, remain a standard practice in many medical and group life insurance policies. For life insurance policies, this issue is easily reconciled by the fact that life insurance policies are not subject to HIPAA.

For medical and other group health plan policies subject to the HIPAA nondiscrimination rules, however, a more careful analysis is necessary.

Under HIPAA, an employer is prohibited from denying eligibility for benefits or otherwise treating an individual differently with respect to their benefits based on a health factor. A health factor includes physical and mental medical conditions, claims experience, receipt of healthcare, medical history, genetic information and disability.

The prohibition of actively-at-work clauses is part of the HIPAA nondiscrimination rule’s effort to protect employees from discrimination based on a health factor.

Impermissible Actively-at-Work Clause

If the actively-at-work clause denies entry into the plan because the employee is not actively at work due to a health factor on the day he or she would otherwise enter the plan, the clause is prohibited under HIPAA.

Example: Employer Z hires Employee A on March 15 as a regular, full-time employee. Employer Z has a waiting period of first of the month following 60 days of service, which Employee A satisfies on June 1. Due to a recent back injury, however, Employee A is on sick leave and not actively at work on June 1. Despite Employee A’s absence being based on a health factor, Employer Z denies enrollment to Employee A until Employee A returns from sick leave.

This action, without provisions, would violate HIPAA nondiscrimination rules.

Permissible Actively-at-Work Clause

An employer may have an actively-at-work provision that does not violate the HIPAA nondiscrimination rules if:

1. The plan treats the absent employee as if they were actively at work for purposes of health coverage;

   Example: Employer Z hires Employee A on March 15 as a regular, full-time employee. Employer Z has a waiting period of first of the month following 60 days of service, which Employee A satisfies on June 1. Due to a recent back injury, however, Employee A is on sick leave and not actively at work on June 1. Because Employee A’s absence is based on a health factor, Employer Z enrolls Employee A on June 1 as if Employee A was actively at work that day.

2. The clause only requires that the employee report for their first day of work before coverage becomes effective; or

   Example: Employer Y hires Employee B as a regular, full-time employee with a March 15 start date. Employer Y has no waiting period, which Employee B will satisfy on the first day of work. Due to physical injuries from a car accident the day before, however, Employee B is unable to start work until March 18. Because Employee B did not report for the first day of work until March 18, Employer Y denies enrollment to Employee B until March 18.

3. The clause is only applied to absences not related to a health factor.

   Example: Employer X hires Employee C on April 15 as a regular, full-time employee. Employer X has a waiting period of first of the month following 30 days of service, which Employee C satisfies on June 1. June 1, however, is a Saturday and Employer X is not open on Saturdays. Because Employee C’s absence on June 1 was not based on a health factor, Employer X denies enrollment until June 3 when Employee C is actively at work the following Monday.

If you’re interested in learning more about the actively-at-work provisions of the HIPAA nondiscrimination rule or have specific questions regarding the permissibility of the clause, reach out to your OneDigital consultant.

The post How to Correctly Administer an Actively-At-Work Clause appeared first on OneDigital.

I hate getting sick, and I am pitiful when ill. But getting sick with the flu is the worst. Although your employees may feel as though their job is critical, or they’ve used up their sick leave, remind them to consider others before coming to work sick. If they have the flu or flu-like symptoms, caution them to limit their contact with others and connect with their doctor.

Do you know what’s better than treating flu symptoms? Staying flu-free.

Here are a few ways you can help your employees stay healthy this cold and flu season.

Set Up a Flu Shot Clinic in Your Workplace

The Center for Disease Control (CDC) recommends that everyone aged six-months and older get a flu shot. Create an environment where your employees are encouraged to be proactive about preventive healthcare. You can schedule on-site flu clinics, as well as promote and educate your employees about flu shots. Contact your OneDigital service team for more information about setting up employee vaccinations.

Remind Employees to Wash Their Hands Frequently

Make sure soap and water are available and even consider distributing alcohol-based hand sanitizers throughout the workplace. Employees can also use alcohol-based wipes to disinfect door knobs, phones and keyboards especially if there are shared workspaces.

Educate Workers About Influenza Signs and Symptoms

Post educational materials in your office break room. The CDC provides free materials that you can easily display and distribute in your office. To view the full list of flu symptoms, visit the CDC’s website. Caution your employees that the only way to truly know if they have the flu is to visit a doctor who can run the necessary laboratory tests.

Allow Workplace Flexibility

Technology makes it easier than ever for employees to work remotely, depending on their job function and remote capabilities. If an employee is sick, consider allowing them to work from home instead of using a sick day. You might also consider offering personal days for your employees to use for doctor’s appointments, checkups, attending kids’ activities, etc. Some employers are able to offer their employees “use as you need PTO” also known as unlimited paid time off. Ultimately, making your workplace flexible can help keep your employees happy and healthy (and also has a positive impact on your organization’s bottom line).

Foster a Culture that Values Employee Well-Being

We all know that employees are more productive when they are healthy and happy. By creating an office culture where your employees feel comfortable staying home if they are sick, you’re showing them that personal health comes first. If your employees are feeling burnt-out, offer a “mental health” day to provide a chance to recharge and return to work refreshed. Encourage employees to leave early if they are sick. Allowing this flexibility can often result in a quicker recovery and keeps the rest of your employees from getting sick.

We want to help you and your employees stay healthy and productive this cold and flu season. Contact your OneDigital benefits consultant to discuss best practices and programs you can incorporate into your benefits plan design now.

The post 5 Tips For A Healthy Workplace During Cold And Flu Season appeared first on OneDigital.

When an individual is eligible for an employer’s group health plan and Medicare, employers must be mindful of issues arising under the Medicare Secondary Payer (MSP) rules.

Download the Medicare Secondary Payer Requirements for Employers Infobrief

 
Contact your OneDigital representative to find out more about Medicare secondary payer requirements for employers. It is that simple.

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Now that most of your employees have reviewed their plan documents, carefully weighed coverage options and have made all the necessary changes, as a plan administrator it’s safe to celebrate the completion of yet another successful open enrollment period, right? Not just yet.

Before you start throwing confetti, it wouldn’t hurt to consider a few tips to ensure your employees have a smooth post-open enrollment experience that will carry them through 2018.

Share the following list with your employees to make sure they are fully equipped to benefit from their plan elections:

1. Be on the Lookout for New ID Cards

   If your employer changed insurance providers or if you made changes to your plan elections, you can expect insurance carriers to issue new ID cards a few weeks after all required documents are received and processed. Most employees report receiving their new cards a few weeks after the effective date of their new plan.

   If your employees need proof of insurance sooner, they can usually download a temporary ID card online and can easily store it on most mobile devices.

2. Set up Your User Account

   With all the technology available, registering through each carrier’s website might be the best thing you can do with your laptop, tablet or smartphone. It can save you time when looking for specific information about your coverage and can even take the hassle out of finding in-network providers. Most carriers have smartphone apps with all the resources you could possibly need right in the palm of your hand.

And while you’re on your medical insurer’s website, research the cost of care for any procedures you may need in the upcoming year. Most websites include generic information about the costs of MRIs, knee surgeries, lab work, prescription drugs and more.

3. Schedule Your Annual Exams

   Just about every healthcare plan covers specific annual preventive care services without imposing cost-sharing requirements—meaning no pesky out-of-pocket expenses. So, as you peruse the insurer’s website, look for what is covered and set up your appointments today. Annual physicals, well-woman checkups, cancer screenings, dental cleanings and vision check-ups are what most tend to check off the list first. Remember, taking care of yourself, and encouraging your family members who are covered under the plan to do the same, is a top priority.

4. Double-Check Your First Paystub

   After your effective date, check the amount deducted from your paycheck, specifically for your insurance coverage.

   Be sure the amounts correctly match the total for you and your family members currently enrolled in the plans you selected. If there are any discrepancies, now is the time to check with your human resources team to resolve the issue.

   The last thing you want is to be halfway into 2018 and having to pay back hundreds of dollars for deduction shortage.

5. Lastly, Track All Health-Related Expenses

   Pay attention to how much you spend on health-related expenses over the course of the year. That way, you’ll be prepared for next year’s open enrollment period ahead of time and will be ready to make an educated choice on plan changes, perhaps looking into an FSA or HSA to put money back in your pocket.

Open Enrollment can be a stressful time of year for many of us. Figuring out what to do next can be even more of a headache, but it doesn’t have to be. Putting aside extra time to organize next steps is all that it takes. If you aren’t sure, have questions or just need clarity, it is never too late to reach out to your benefits manager or plan administrator for answers. Contact your OneDigital representative to find out more about implementing a flexible workplace environment. It is that simple.

The post 5 Things To Do After Open Enrollment Is Over appeared first on OneDigital.

 
“Shouldn’t Aetna be the one buying CVS?”

“They’re not even competitors, what’s the point?”

If it weren’t for the Senate’s passage of a sweeping tax reform bill a day earlier, the CVS-Aetna deal would be getting even more attention as it is the largest healthcare deal in history.

Yet, ever since the deal became official, it’s left consumers wondering, why?

Here are three reasons why CVS and Aetna decided to combine:

Scale

The Aetna/Humana deal earlier this year was halted by antitrust concerns causing Aetna to look outside of the direct competition to achieve the scale necessary to succeed in today’s political and economic climate.

Defense

CVS and Aetna see the writing on the wall. UHCOptum are already a force to be reckoned with, Walmart and Humana are rumored to be talking about merging, and it appears inevitable that Amazon too will try to disrupt the pharmacy industry in a big way.

Change

Aetna no longer wants to be seen as an insurance company. It hasn’t been subtle in communicating the new direction charted for the nearly 160-year-old company either. Last October, Aetna’s CEO Mark Bertolini, said, “Insurance is a nasty word. We may not even call it that when we’re done with it.”

Aetna is posturing itself as a health improvement company with a core competency in the collection and use of data. If Bertolini’s words aren’t indicative of Aetna’s changing view of itself, the company recently offloaded its most “insurance-y” products—life and disability insurance—to its neighbor, The Hartford, and moved headquarters to Manhattan, right across the street from Google’s NYC operations. Rumor has it there will even be a ping pong table in Aetna’s new HQ.

By joining CVS, not only will Aetna gain pharmacy pricing leverage by having an in-house pharmacy benefit manager, it will also obtain a vast array of retail locations to pilot and deploy new health improvement products and services to members and competitors’ members.

CVS will gain insight into healthcare consumer behavior and use the treasure trove of Aetna’s data, provider network relations, and care coordination systems to give consumers even more reasons to visit CVS stores.

The merger also cements CVS’ relationship as Aetna’s pharmacy benefit manager, a partnership that has been in place since 2010.

On the surface it may seem like a strange marriage, but Aetna and CVS believe they have increasingly complementary business models that are better off together. The combined company stands to become a major force in the future of healthcare, not only in the United States, but across the globe. In the words of Larry Merlo, CEO of CVS, the combined company aims to be the “front door to healthcare.”

For questions on how the CVS-Aetna merger might impact your organization, reach out to your OneDigital representative today.

The post CVS-Aetna Merger: A New Front Door To Healthcare? appeared first on OneDigital.

Note: Due to the extension, some individuals may not receive form 1095-B or 1095-C prior to filing their individual income tax return. However, while helpful in completing the individual income tax return, the forms are not required to complete the return, so individuals should not wait for the forms.

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Unless offered through their employer, most adults have little, if any, disability insurance coverage. Find out more about how you can help keep your employees financially supported if they experience a debilitating injury, giving them the peace of mind they deserve.

Click To Download The Short-Term Disability Infographic:

 
Contact your OneDigital representative to find out more about short-term disability. It is that simple.

The post Short-Term Disability Infographic: What You Should Know Before An Accident Happens appeared first on OneDigital.

The New Year is a great opportunity to re-imagine your employee wellness approach with renewed energy. As your employees develop personal wellness resolutions, seize the opportunity to breathe new life into your organization’s wellness strategy.

Simply said, worksite wellness programs and regulations have become increasingly complicated and frustrating for many employers. We’re here to make it easier for you.

Below, you’ll find a list of fresh approaches that can expand the scope of your employee well-being program, while simultaneously simplifying your offerings. Creative wellness strategies can engage and excite employees, enhancing the overall health and productivity of your employee population and have an impact on your bottom line. Genius!

1. Be Courageous

“We’ve never done it that way,” has been the downfall of many new wellness initiatives. Tradition and fear can be the reason that new ideas never come to fruition. Don’t be afraid to try a new program such as mindfulness, financial well-being or hosting a healthy cooking demo. New technology involving existing platforms such as fitness trackers, apps and web-based education can add genuine excitement to “old” (but essential) topics for your employees.

2. Leverage Resources

Well-being programs for your employees don’t have to be costly. On the contrary, consider the return on well-being (ROW) versus return on investment (ROI) or bottom line. Increased productivity from engaged, healthier, less stressed employees can result in more bang for your buck than many other budget line items. A membership to WELCOA, carrier based health education seminars, broker and benefit vendor resources, and even your own employee talent pool can yield inexpensive and impactful programming.

3. Simplify

Behavior and cultural changes take time. Consider quarterly well-being initiatives instead of monthly topics. Trying to do too much too soon can add stress and often doesn’t provide the lead time necessary to produce quality, well-communicated initiatives. Develop a calendar of the quarterly programs and share them well in advance so that employees can plan to participate.

4. Back to Basics

Having a goal to build awareness and provide education by route of the employee well-being program, may be more effective than many of the complicated wellness initiatives out there. Awareness is the supportive foundation that can initiate and motivate both organizations and individuals to change. If your wellness “team” is a few (or just one) members strong, this tactic can help you remain focused on quality over quantity.

5. Commit

Commitment from senior leadership is the most critical and effective tool in any worksite well-being program. Middle management will respond to and support cultural changes and initiatives only if the baton is passed down from the top.

6. Personalize

Allow individuals to participate where they live (this is typically where most people are comfortable starting) and design worksite initiatives to support this. There’s a behavioral framework called the Occupational Profile of Health which focuses on “doing, being, belonging, and becoming” as measurements of healthy engagement. Use these as guiding principles, allowing employees to set their own health goals. Ask yourself the following questions:

• Are we helping employees to “do” differently?
• Can we “be” healthier?
• How do we encourage support and “belonging”?
• What do we do to assist employees in “becoming” confident in their ability to change?

When you have a game plan, you’re more likely to pull off a successful employee wellness program and your company and its employees will reap the benefits. Reach out to our team at OneDigital to start building a key narrative surrounding the business case for employee health and well-being initiatives.

The post 6 Ways To Improve Your Wellness Plan For 2018 appeared first on OneDigital.

HARTFORD – Dec. 13, 2017– OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has been named to the “Best of Business Awards” list in the Best Employee Benefits category by Hartford Business Journal. Led by Managing Principal George Papagelis, the employee benefits company received the prestigious honor based on votes cast by the publication's readers. Winners in each category were chosen based on their high level of customer service and commitment to excellence.

“It is an honor to receive this award, especially knowing it was voted on by Hartford Business Journal readers and members of our community,” says George Papagelis, who heads up the employee benefits team of 45 located in Farmington, CT.

“We love what we do, and I think that shows. Our team focuses on delivering the best quality product in a manner that puts our clients at ease in what can often be a stressful process. This award is a testimonial to our team and the wonderful clients we serve.” adds Papagelis.

The Best of Business Awards were created as a guide to highlight exemplary companies in the Greater Hartford area to promote locally owned and operated businesses while helping to ease the burden of finding quality service providers amidst a sea of information in today's digital age.

About OneDigital Health and Benefits

OneDigital Health and Benefits, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. OneDigital stands as one with its clients, delivering fresh thinking ahead of the market, strategic consulting and innovative solutions that give clients peace of mind that their health and benefit plan designs are future-proof. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resources capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 950+ employees throughout the country, serves 35,000 companies and manages nearly $4 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

About Hartford Business Journal

Hartford Business Journal is a business information company all about delivering business news to the community. With essential intelligence and profitable connections, Hartford Business Journal works with companies to help them promote their brand and develop thought leadership channels.

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ATLANTA – Dec. 12, 2017 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has acquired The Ruggieri Consulting Group, LLC, in New York, New York. This marks the first step in expanding the OneDigital footprint within the New York market, continuing the company’s explosive national growth. Philip Ruggieri will be joining the company as Managing Principal, Robert Simeone as Vice President, Client Services of OneDigital’s New York City location.

For over 21 years, Ruggieri Consulting has provided their clients with consulting services on health, welfare and retirement plans, as well as advanced administrative capabilities. The former Ruggieri team will continue to offer their full suite of services while expanding their capabilities as part of OneDigital’s advantage.

“We are very proud that Phil and his team have chosen to align with OneDigital as they are the right partner to develop our presence in New York City. The combination of the Ruggieri team’s deep consulting expertise with OneDigital’s suite of employee benefits tools and resources is a powerful combination that will benefit their existing client base and employer’s looking for new solutions to today’s employee benefits challenges.
 
— Brett Rosen, OneDigital’s Executive Vice President, Mergers & Acquisitions (East)

OneDigital’s comprehensive advisory services and market-leading solutions are offered in over 57 offices throughout the country. Responding to the convergence of broker consolidation, digitalization and an increase of millennials in the workplace, the 17-year-old company is staking a claim as “the new generation in health and benefits.”

“OneDigital aligns perfectly with our company culture and our client service philosophy while adding sophisticated technology and deep compliance resources,” says Philip Ruggieri, Managing Principal of OneDigital New York. “The senior leadership and management teams share the client-centric focus that has been the foundation of the success of Ruggieri Consulting and we are looking forward to continuing that service focus with OneDigital.”

About OneDigital Health and Benefits

OneDigital Health and Benefits, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resources capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1,000 employees throughout the country, serves 35,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

About The Ruggieri Consulting Group, LLC

The Ruggieri Consulting Group, LLC specializes in the design, pricing, communication, implementation and administration of all health and welfare benefit programs and defined contribution retirement programs. They work with the major insurance providers to produce creative benefit solutions for their clients and because of their knowledge of the full range of competitive choices available, they have the ability to provide valuable guidance to their clients. Ruggieri Consulting operates exclusively in the benefits area, delivering the highest level of focused expertise and professional service.

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The post OneDigital Health And Benefits Acquires The Ruggieri Consulting Group, LLC appeared first on OneDigital.

Josh Roland, Principal of OneDigital Atlanta, has found that tailoring a benefits package can be an excellent way to meet the challenges of companies looking to enhance or re-imagine their offerings to retain and attract new talent. He's found that many of the ideas and solutions arising from these customized projects can be incorporated into other areas of voluntary products as discussed in the recent Employee Benefit Adviser article, "Adviser Designs Customized Voluntary Benefits to Integrate Well-Being."

In the unified benefit theory, your wellness permeates all of your benefits. And some wellness programs work better than others. Plans with strong personal coaching components tend to generate the best results.
 
– Josh Roland

Click here to read the full article.

The post Josh Roland Featured In Employee Benefit Adviser Discussing Customized Employee Benefits appeared first on OneDigital.

This will allow the employer to reimburse medical expenses including premiums for other health coverage. The introduction of QSEHRAs creates new opportunities for small employers; however they have a number of requirements and we’ve highlighted several below:

Eligible Employer

Only employers who are not applicable large employers (ALEs) can offer QSEHRAs.

On the date an employer becomes an ALE, even if occurring during the QSEHRA’s plan year, the employer is ineligible for the QSEHRA.

Additionally, offering a group health plan can disqualify an employer from offering QSEHRAs. Group health plans include Health Reimbursement Accounts (HRAs), health flexible spending accounts (FSAs), and plans providing only excepted benefits, such as dental or vision. Continued access to accumulated amounts in an HRA from previous years or carryovers in an FSA would also disqualify the employer. However, contributions to an employee’s health savings account (HSA) and employer-sponsored retiree-only plans do not disqualify the employer.

Eligible Employee

The QSEHRA must be provided to all eligible employees, defined as employees of the employer, and participation cannot be waived. Former employees, retirees, and non-employee owners are not eligible employees and cannot be provided a QSEHRA. However, the employer may exclude certain employees, if they meet the following criteria:

• Have not completed 90 days of service;
• are under the age 25;
• are part-time or seasonal employees;
• are covered by collective bargaining agreement with negotiated accident and health benefits;
• and are nonresident aliens with no US-source earned income.

Same Terms Requirement

The employer must operate the QSEHRA on a uniform and consistent basis with respect to all eligible employees. A permitted design includes one offering, the same dollar amount benefit whether self-only or family coverage is elected. A QSEHRA will not fail to meet this requirement because different eligible employees are reimbursed different amounts for different expenses for reimbursement.

However, if different types of medical expenses may be reimbursed for different categories of employees, the arrangement will fail.

Statutory Dollar Limits

The statutory dollar limit for 2018 is $5,050/$10,250 (self-only/family coverage), adjusted annually for inflation. If a QSEHRA allows carryover, the total permitted benefit, including the carryover balance, cannot exceed the applicable dollar limit. The employer must prorate the QSEHRA applicable dollar limit to reflect the actual number of months an eligible employee is provided the QSEHRA, non-calendar years, and short plan years.

Written Notice Requirement

The employer must provide written notice to eligible employees at least 90 days before the beginning of each year and for an employee who is eligible midyear, on the date the employee is first eligible to participate. For QSEHRAs provided during 2017 or 2018, the deadline for providing notice is the latter of February 19, 2018, or 90 days before the first day of the QSEHRA’s plan year. The guidance elaborates on the content of the notice and confirms the notice can be furnished electronically. Failure to provide notice results in a $50 per employee penalty, up to a maximum of $2,500 per calendar year per eligible employer.

Proof of Minimum Essential Coverage (MEC)

A QSEHRA may only provide reimbursements to an eligible employee after the employee provides proof of MEC. This initial proof, which the employee must provide at least annually, must show that the employee and (if different) the individual who incurred the expense, has Minimal Essential Coverage (MEC) for the month in which the expense was incurred. Following this initial proof, each new request for reimbursement requires the employee to attest that the employee and individual whose expense is being reimbursed continue to have MEC. Model attestations for both purposes are provided in the appendix.

Reimbursement

Premiums for coverage under the group health plan of a spouse’s employer are reimbursable but will be taxable to the extent premiums were paid on pre-tax basis. Cash-out of unused permitted benefits is not allowable; however a run-out period is allowable if it is provided on a uniform and consistent basis. Reimbursement of over-the-counter drugs purchased without a prescription is allowable, but also taxable to the eligible employee.

Reporting

Employers must report on Form W-2 the eligible employee’s permitted benefit, without regard to the amount of payments or reimbursements actually received. The notice provides seven Q&A’s explaining how to report, including non-calendar year plans, carryovers, midyear permitted benefit changes, and taxable reimbursements. Eligible employers are not required to provide Forms 1095-B, or Health Coverage, to its eligible employees. Note: QSEHRA benefits may affect eligibility for or reduce the amount of premium tax credits.

HSA Interaction

An eligible employer can contribute to its employees’ HSA and allow employees to make pre-tax HSA contributions through a cafeteria plan. However, employees may lose HSA eligibility if the QSEHRA’s coverage is not HSA-compatible (e.g., reimbursing any medical expenses, including cost sharing).

Click Here To Download The IRS Notice 2017-67 Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) InfoBrief

For questions regarding the Employer Shared Responsibility mandate or any of the information above, please reach out to your OneDigital representative today.

The post IRS Issues Guidance On Qualified Small Employer HRAs appeared first on OneDigital.

It's been quite a year in healthcare. Since President Trump's executive order in January, the future of healthcare in this country has been confusing and uncertain. As the nation watched legislators debate the state of the Affordable Care Act (ACA), tensions ran high.

OneDigital’s compliance team embraced the uncertainty head on—serving as steady, thoughtful and forward-thinking experts for our clients in 2017. The OneDigital ACA Watch page was the epicenter of all things repeal and replace for our clients—housing over 28 posts over the last year translating what’s happening in Congress, and how it could impact your organization.

2017 may be winding down, but there’s still plenty on Congress’s plate as we head into the New Year. The parties and committees will continue to work on specific issues. Working issue-by-issue, however, is a long process. Whether the market can sustain itself as it waits for solutions, is the real question.

Check out our top 7 ACA Watch Posts of 2017:

1. House GOP Passes Bill, AHCA Onto The Senate

05.04.2017
Over the past few weeks, House members and the Administration have been working to identify and introduce modifications to H.R. 1628, the American Health Care Act (AHCA) that will achieve enough votes to pass the bill through the House. Click here to read more…

2. Employer Health Plans Under President Trump

03.01.2017
President Donald Trump has made dismantling the Affordable Care Act (ACA) one of the cornerstones of his administration. Steps have already been taken to begin the process. Click here to read more…

3. Trump Signs Executive Order, Congress Forges Ahead

02.07.2017
As I indicated in my first article of the year, change is imminent. The real questions are “what” will change and “when” will it happen. As the new 45th President of the United States, Donald Trump is not wasting any time jumping in to make good on his campaign promise to repeal and replace the Affordable Care Act (ACA). Click here to read more…

4. The Repeal And Replace Architects: How Two Key Players Could Shape The Future Of The ACA (Part I)

01.18.2017
There is a daily stream of updated predictions regarding the fate of the Affordable Care Act (ACA). In discussions around the ACA there is no shortage of opinions on what can or can’t be done and why it will or will not work. Regardless of the outcome, in addition to President Donald Trump, it seems likely (barring a nomination block) that there will be two main actors on the stage representing what change might look like. Click here to read more…

5. House GOP Releases ACA Replacement Legislation: The American Health Care Act

03.08.2017
On March 6, 2017, Republican House of Representatives leadership finalized the American Health Care Act—a new budget reconciliation bill to repeal and replace the Affordable Care Act (ACA). Committee work on this legislation is set to begin this week where they’ll discuss and mark-up the bill with any changes. Click here to read more…

6. The American Health Care Act: Where Do We Go From Here?

03.24.2017
It’s been a frantic few weeks. The advance of the American Health Care Act (AHCA) to the House Rules Committee, the remaining step before a floor vote, proves to be one of the longest steps on the timeline. The role of the House Rules Committee is to finalize the “rules” of engagement, i.e. how and when the bill will come to the floor for a vote, the time and limitation of debate, and whether they may introduce other amendments. Click here to read more…

7. The Road Trip Is Over: Healthcare Reform Returns Home

07.31.2017
The votes are in—the final Senate bill to repeal and replace the Affordable Care Act (ACA) was defeated 49-51 in a late night vote on Friday, July 28. The idea of breaking with the norm and fast-tracking legislation is over. The healthcare reform road trip has ended, and what a ride it has been. Click here to read more…

As always, we are actively working to advocate on your behalf with the regulatory agencies to help reduce the administrative burdens related to the sponsoring of employee health insurance coverage. Bookmark our Compliance Confidence Blog and get ready to meet your regulatory responsibilities in 2018 with OneDigital by your side.

The post OneDigital’s Top 7 ACA Watch Posts Of 2017 appeared first on OneDigital.

About eight years ago, the ACA made its way into the spotlight promising greater access, choice, and coverage for all. The population primarily needing assistance included those ineligible for employer-sponsored health insurance or either of the entitlement programs Medicare or Medicaid. The individuals with the poorest health had little to no choices for health insurance and the options available were extremely expensive. Although the smallest population, they are most vulnerable.

Today’s healthcare enrollment numbers help us understand the story. In 2010, 50 million people were without health insurance coverage. Seven years later, the number is 11.7 million people. While a great improvement, this change didn’t come without a cost.

http://www.markfarrah.com/healthcare-business-strategy/Health-Insurance-Enrollment-Shifts-and-Market-Segment-Trends.aspx
 
The marketplace faces significantly higher costs in both medical goods and services, and its corresponding health insurance premiums. The trajectory of cost escalations, including administrative expenses, results in a higher deductible and out-of-pocket expense for recipients. Since 2016, there’s been an 11 percent decline in individual market health insurance enrollment. At the end of this year’s open enrollment, we’ll see an even greater number.

The downward market trajectory and unsustainable costs led to the ACA “repeal and replace” platform. OneDigital’s coverage of the year’s events began with the President’s executive order encouraging repeal and replace, and requesting that the departments “ease the regulatory burden” of the law. For the greater part of 2017, our ACA Watch page focused on the legislative developments and the use of a budget reconciliation vehicle to pass ACA repeal and replace legislation. From February through September, we kept pace with Congress in their efforts to make things better. In the end, Congress was unable to affect sweeping change.

Now that Congress is back to regular order, the parties and committees will continue to work on specific issues. Working issue-by-issue, however, is a long process. Whether the market can sustain itself as it waits for solutions, is the real question.

We will see a few things happen before the end of the year. The first focuses on the results of tax reform and the second is the end of year funding package.

1. Results of Tax Reform

Earlier this month, the House passed its tax reform bill. This week, the Senate will begin debates on their version of the bill. While the bill addresses tax reform, it also has consequences for several ACA provisions. Listed below are the components of both the House and Senate bills that would impact employers.

 
From an ACA standpoint, the potential elimination of the individual mandate looms ahead. While the House bill does not address this, the Senate bill will zero out the individual mandate penalty. This could result in a further negative impact on an already unstable marketplace. While the House did not include this provision in their bill, they have indicated that they will back this provision should the Senate pass their bill. We should see final outcomes in the next week or so.

2. End of Year Funding Package

The second areas that may change are in the health insurance tax (HIT), the annual tax levied on all health insurers that pass through to consumers, and the "Cadillac Tax". There is a significant push to include delays for both of these taxes. Last year’s moratorium on the HIT tax will end and the amount has been incorporated in the 2018 rates to individuals and groups. There is support on both sides of the aisle for this delay.

For 2019 plan years, employers will also have to prepare for the “Cadillac” tax. The tax will be assessed in 2020, for the 2019 plan year. Our OneDigital Compliance Team, along with many others, is pushing for a delay. Employers will need to start planning for this and, as we explain to regulators and lawmakers, we will see employers decrease health insurance coverage so as not to pay this additional tax. This is contrary to the entire healthcare reform initiative and will have devastating effects on the greatest number of individuals.

We are actively working to advocate on your behalf for these delays and with the regulatory agencies to help reduce the administrative burdens related to the sponsoring of employee health insurance coverage. Look for more information in the coming weeks as the year winds down and contact your local OneDigital representative if you have additional questions.

The post Healthcare Reform And The ACA: Where Do We Stand And What’s Next? appeared first on OneDigital.

During this session, attendees learned:

• How to Determine ALE Status
• Compliance Obligations for ALEs
• How to Determine Full-Time Employee Status
• Special Considerations with Temporary Employees, Interns, and Employees Experiencing a Change in Status or Break in Service
• Legislative Changes and Outlook

The post Webinar Playback: Healthcare Reform - Determining Applicable Large Employer Status And Employer Shared Responsibility For Full-Time Employees appeared first on OneDigital.

When most people think of November, they think of Thanksgiving or maybe even political elections–ugh. However, both pale in comparison to the decision made this month to either drop the razor or continue dragging it across the face (or for some, legs) each and every morning. Before we make this choice, let’s first understand what No-Shave November is all about.

The initial goal of No-Shave November was to change the face of men’s health by embracing facial hair in honor of cancer patients who lose hair during their battle.

However, it has since evolved into a campaign to raise awareness for both genders in support of overall cancer prevention, research, and education while also raising funds for this cause.

An estimated 2 million people will be diagnosed with cancer this year. Early detection and diagnosis can only help to make an impact on the number of preventable deaths. Going for your annual checkup, and being aware of your family’s history of cancer are important aspects of preventative care. Personally, I have a history of cancer in my family, and yes, I’m getting a bit older–not OLD–just older, so preventive care is essential!

Each November, the OneDigital Connecticut office holds a No-Shave November challenge where the team is given the opportunity to let facial hair flow or keep it tight.

We start the challenge off on November 1, completely clean-shaven and end up looking like grizzly bears toward the end of the month.

Even if you didn’t want to grow hair, you had the ability to sponsor a colleague, significant other or family member. If you chose to grow facial hair, you were encouraged to up the ante with a donation each week to stay in the race. At the end of the month, we gathered to enjoy great food and vote for three different hair growing categories: Best Baby-Face (A for Effort), Best Growth, and Best Transformation. Besides bragging rights, the winners received a fantastically carved log in the shaped of a face, complete with a beard made of bark. This year, all proceeds collected were donated to the Prevent Cancer Foundation, Fight Colorectal Cancer, and St. Jude Children’s Research Hospital.

Embracing our hair and letting it grow wild and free–something many cancer patients lose the ability to do–was the least our team could do to raise awareness and funds. Not only did we accomplish these goals for a great cause, but we did it as a team.

The post Let It Grow: No-Shave November appeared first on OneDigital.

Effective since 2014, the Employer Shared Responsibility rules require an applicable large employer (ALE) to offer minimum essential coverage that is affordable and provides minimum value to substantially all of its full-time employees, or face a potential tax penalty. Prior to its most recent announcement, the IRS had not yet penalized employers for any failures to comply with the rules during the 2015 or 2016 calendar year.

Download The Employer Shared Responsibility Penalty Assessment – Letter 226J

In the updated Employer Shared Responsibility Questions and Answers, the IRS introduced Letter 226J which is the IRS letter issued to employers to propose and assess the Employer Shared Responsibility Penalty Payment.

An ALE receives Letter 226J if the IRS, determines that, for at least one month in the year, one or more of the ALE’s full-time employees was enrolled in a qualified health plan for which a premium tax credit was allowed (and the ALE did not qualify for an affordability safe harbor or other relief for the employee).

What is the process for an Employer Shared Responsibility Penalty Assessment?

When will the IRS start issuing Letter 226J to ALE’s?

The IRS began issuing Letter 226J to applicable large employers in November 2017.

What information does Letter 226J include?

Letter 226J includes:

• A payment summary table itemizing the proposed payment by month and an explanation of the table;
• Indication of whether the liability is under section 4980H(a) or 4980H(b);
• A response form, Form 14764;
• An Employee Premium Tax Credit List, Form 14765, identifying full-time employees allowed a premium tax credit who the employer did not offer affordable coverage;
• A description of actions the ALE should take if it agrees or disagrees with the proposed payment; and
• A description of the actions the IRS will take if the ALE does not submit a timely response.

Is Letter 226J an IRS bill?

Letter 226J is not a bill. The letter is the initial proposal of the Employer Shared Responsibility Payment. Notice CP 220J is the IRS notice and demand for payment.

Where did the IRS get the information used to determine the Employer Shared Responsibility Payment?

The IRS used the information you submit to it via Forms 1094-C and 1095-C and the individual’s income tax returns to determine your liability for a payment.

What should I do if I receive Letter 226J?

You should review Letter 226J and its attachments carefully. Compare the information shown in Letter 226J to the information you reported on Forms 1094-C and 1095-C to ensure the accuracy of the information you filed and the information in Letter 226J. You should complete the response form with information on your agreement or disagreement with the letter. If you agree with the proposed Employer Shared Responsibility Payment in Letter 226J, complete, sign and return the response form with your full payment in the envelope provided. Keep a copy of the letter and any documents you submit in response to the letter.

What if I do not agree with the information included in Letter 226J?

Letter 226J includes detailed instructions for appealing the proposal. If you disagree with the proposed Employer Shared Responsibility Payment, complete, sign, and return the response form no later than the response date shown on your letter (generally within 30 days of Letter 226J). In your response, you should include a signed statement explaining why you disagree with all or part of the proposal and include any supporting documentation.

How will I know if the IRS received my response?

When an ALE responds to Letter 226J, the IRS will provide the ALE with an acknowledgement via Letter 227. There are five different versions of Letter 227 but each acknowledges receipt of the response and outlines any additional action the ALE must take. If, after Letter 227, the ALE still disagrees with the payment, the ALE can request a pre-assessment conference with the IRS Office of Appeals. For more information on this process, see IRS Publication 5.

What happens if I do not respond to Letter 226J?

If you do not respond to the letter by the response date, the IRS will send a Notice and Demand – Notice CP 220J for the Employer Shared Responsibility Payment amount proposed and assessed in Letter 226J. The payment is subject to interest, as well as IRS lien and levy enforcement actions.

Where can I find more information about paying my Employer Shared Responsibility Payment?

The notice will instruct you on how to make a payment. However, you are not required to include the payment on any tax return or make a payment before receiving the Notice CP 220J. The IRS provides options for employers that want to pay in full, are unable to pay in full, or unable to pay at all at this time. For additional information on the collection process and payment options, see IRS Publication 594.

Download The Employer Shared Responsibility Penalty Assessment – Letter 226J

For questions regarding the Employer Shared Responsibility mandate or any of the information above, please reach out to your OneDigital representative today.

The post Holiday Gifts From The IRS: ACA Employer Mandate Penalty Assessment Letters appeared first on OneDigital.

On December 3, CVS announced its plans to acquire health insurance giant Aetna in a $69 billion deal. While the deal still needs to be approved by antitrust regulators, the acquisition will change the healthcare industry as we know it. Click here to see the full press release.

CVS-Aetna Merger Has Potential To Change Consumer Experience and Healthcare Industry

In the near future, will your employees receive health insurance by the same company that sells packs of gum?

The landscape for how and where health and prescription drug coverage is delivered is poised for radical change.

Let's consider a few trends. We have close to 20 percent of expenditures in the U.S. economy tied to a very inefficient healthcare ecosystem, an aging population that will swell the ranks of Medicare by 30 percent over the next 10 years, and a very divisive policy-making environment on Capitol Hill and in the White House, trying to reshape the way healthcare coverage is provided and financed. The innovators and disrupters smell opportunity.

In October, CVS, one of the largest U.S. Pharmacy Benefits Managers (PBM) and drugstore chains, announced their intention to buy Aetna--one of the largest and oldest health insurance companies in the country. The irony here is that Aetna went from being the hunter two years ago, with an attempted acquisition of health insurance company, Humana that was eventually overturned for anti-trust reasons, to being the hunted. CVS, best known for their retail stores on virtually every other street corner, may not seem a likely contender, so why would they get into the business of being a health insurer?

Presumably, CVS sees a world where their existing MinuteClinics would become an outlet for receiving basic, lower cost healthcare services for Aetna customers. It would include getting healthcare coverage through their employer, Medicare or Medicaid. CVS is already one of the largest Pharmacy Benefit Managers that provides prescription coverage through their Caremark PBM business.

Another theory that’s been circulating regarding this merger is that the two healthcare companies are partnering out of fear: Amazon has stated its intention of getting into the business of dispensing prescription drugs, either through a mail order service and/or inside of its Whole Foods stores. The sheer size of Amazon along with its consumer brand recognition makes it a compelling disruptor to a fractured healthcare industry. Will Amazon build something from the ground up or make a big bet, following CVS's playbook and buying a large Pharmacy Benefit Manager or even a health insurer. Might they target an acquisition like Humana?

A vertical merger between CVS and Aetna would probably not raise the same anti-trust concerns or additional scrutiny by the Department of Justice that we saw during the attempted partnerships of Aetna/Humana and Anthem/Cigna.

It appears we are on a path to shake-up the healthcare industry.

We will continue to monitor these developments and keep you informed on what this CVS-Aetna partnership could mean regarding healthcare costs for both consumers and employers.

The post Are We On The Brink Of Disruption To The Health Insurer And Pharmacy Benefit Manager Industries? appeared first on OneDigital.

As the year winds down and open enrollment season comes to a close, it’s time to examine how the employee benefits landscape may look in 2018 and beyond. Rather than offer an exhaustive list of every conceivable option available to employers, we'll focus on a handful of the progressive employee benefit products and strategies we can expect to see in the coming year(s). Here are six benefits industry market trends to watch for.

1. Narrow Networks

   As more health insurance carriers develop and evolve their Accountable Care Organizations (ACO) models, they are offering products that guide members toward high-performing doctors and facilities. Broad provider networks have become crucial over the last twenty years but recently have proven to be ineffective at controlling cost. Though employees prefer having access to a wide network, employers are concluding they simply can’t afford it. Narrow networks, built around accountable care and pay-for-performance reimbursement models, will influence the trend slope by steering plan participants away from inefficient and wasteful providers and facilities. Some employers may even abandon the network approach entirely. At this point, you may wonder, what’s a healthcare program without a network? Read on to find out…

2. Value-Based Payments (Reference-Based Pricing)

   Employers have reached a healthcare cost tipping point and are willing to try a radical approach to cost-control. While a narrow network might initially drive medical claims down 3-7%, a value-based payment (VBP) program could easily yield a reduction of 10% during year one, and even offer reductions as high as 20% in some cases.

   Focusing on facility claims by using a national Preferred Provider Organization (PPO) network for physician services, VBP plans pay hospitals and other facilities based on the actual value (cost) of the delivered service, typically established based on Medicare-reported costs.

   This is a stark contrast to traditional carrier reimbursements that discount an arbitrary billed amount. Carriers celebrate 50% or more discounts off of billed charges, but the resulting payment can be upwards of 300% of Medicare. VBP plans might pay as low as 130% of Medicare, and plan participants can go to any hospital or facility without network restrictions. The savings are significant and grow each year as VBP trends with Medicare in the 1-3% range.

3. Stop-Loss Captives

   Smaller employers will assume ownership—or co-ownership—of their health insurance stop-loss risk. Multi-employer stop-loss captives will gain momentum in 2018 for a number of reasons:

   • Allow smaller employers a softer landing into a self-funded environment by creating a larger risk pool
   • Owners create the rules of entry and manage risk by requiring a robust wellness program, an aggressive pharmacy management strategy, narrow networks or VBP’s
   • Larger risk pool with effective risk management programs tend to generate better pricing

    
   Participating in a captive allows employer groups to benefit from favorable claims experience, as the owners share the assets of the captive plan.

4. Pharmacy Benefits Manager (PBM) Carve-Outs

   As trends in prescription drug expenditures remain in the double-digits, even small to midmarket employers will demand more transparency in prescription drug pricing. Insurance carriers tout the virtues of bundling, but withhold information regarding prescription pricing deals and savings to the customer or plan sponsor, especially downmarket. Meanwhile, third-party pharmacy benefit managers are usually:

   • Eager to increase market share
   • Able to offer aggressive guarantees on average wholesale price discounts, dispensing fees and rebate performance
   • Flexible on formulary management and clinical programs like pre-authorization, step therapy, quantity limits and manufacturer payment assistance

    

   A 1,000-employee company can cut net pharmacy costs by $150,000 to $500,000 per year by un-bundling their prescription plan from the medical carrier and engaging directly with a pharmacy benefit manager.

5. Health Navigators

   The healthcare delivery system is fragmented and overwhelming. Complicated employer benefit designs and insurance rules only confuse participants further. All too often, patients feel lost and alone when dealing with illness or an injury and carrier service centers don’t offer the depth of assistance consumers need. In 2018—and beyond—midmarket employers will adopt upmarket strategies to fill this void, investing in third-party vendors to provide this resource for participants.

   Call it a concierge service, health navigation or care-coordination, these programs, independent of the carrier, third party administrator (TPA) and/or network, will actually advocate on behalf of the plan participant.

   They’ll help participants navigate the healthcare delivery and insurance systems and carefully guide them to the most appropriate site of service for care. By reducing inefficient and ineffective care, third-party health navigators and care coordinators can reduce aggregate medical and drug spending by as much as 15% in year one and significantly lower thereafter.

6. Expansion of Voluntary Benefits

   Realizing that high deductibles and out-of-pocket maximums are the norm in health insurance, employers will offer robust voluntary benefit programs to their employees. Voluntary benefits add no cost to the employer; instead grant additional protection for employees from financial hardship in the event of injury, illness and other potentially costly life events. Critical illness, accident, and long term care insurance, voluntary vision plans, legal assistance, identity theft protection, and even pet insurance will be growth markets in 2018.

While some healthcare markets have evolved to adopt the six trends, most employers would benefit from embracing as they gain momentum in 2018. Employers may be willing to—if not forced to—take a fresh approach to employee benefits cost management in the coming year.

To learn more about benefit trends to watch for in 2018, or how to successfully incorporate them into to your employee benefit plan design, contact your OneDigital representative.

The post 6 Employee Benefits Trends To Watch In 2018 appeared first on OneDigital.

Fresh thinking is the fabric of OneDigital, and as the benefits landscape continues to evolve, it pays to have an insider perspective from our experts across the country. For us, it is invaluable to learn what resonated with our audiences as we continue working to provide peace of mind heading into 2018.

Here are the Top 7 Most Popular Blog Posts of 2017:

1. Employers #1 Concern In 2017

As I watched the state-by-state results of the 2016 Presidential Election roll in, I realized that this, like all elections, was history in the making. Americans passionately turned out in record-breaking numbers and stood in long lines to cast their vote in one of the most emotionally-charged and closest races in history. Whether you were a proponent of either, or neither, of the Presidential candidates it is clear that America has spoken. Click here to read more…

2. Zenefits Selects OneDigital As First Benefits Brokerage Partner

Atlanta, GA and San Francisco, CA, September 21, 2017 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, and Zenefits today announced a groundbreaking partnership that will give Zenefits and OneDigital customers access to the unique combination of the industry’s best technology platform and more than 1,000 experienced benefits advisors across the country. Click here to read more…

3. Open Enrollment 101: How To Improve Your Employee Experience

It’s that time of year again—Open Enrollment (OE) season is upon us. This can be a stressful time for both employees and employers. In fact, the 2017 ALEX Benefits Communication Survey showed that 36% of the employees polled say the open enrollment process at their company is extremely confusing and 49% of employees whose companies offer health insurance, say making health insurance decisions is always very stressful for them. Click here to read more…

4. Health Insurance Requirements For Employers With Interns & Temporary Workers

Businesses that employ interns or other temporary workers may question whether they are obligated to offer health insurance to these employees. The answer to this question may depend on a number of factors, including whether the intern or temporary worker is paid or unpaid, full-time or part-time, and whether the employer is an applicable large employer under the Affordable Care Act (ACA). Click here to read more…

5. First Quarter Compliance Checklist

Regardless of the impact 2017 will have on the future of healthcare, there are still a number of areas employers will need to ensure they are remaining compliant this first quarter. Click here to read more…

6. 6 Ways To Kick-Start Global Employee Health And Fitness Month

This May, we will once again celebrate Global Employee Health and Fitness Month, promoting the benefits of a healthy lifestyle to employers and their employees. In supporting this initiative, companies will be recognizing the importance of physical activity as an important driver of employee health, satisfaction and overall business performance. Click here to read more…

7. Can An Employer Offer Different Benefits To Different Groups Of Employees?

The Health Insurance Portability and Accountability Act (HIPAA) prohibits group health plans and group health insurance issuers from discriminating against individuals with regard to eligibility, premiums, or coverage based upon a health status-related factor. Click here to read more…

The post OneDigital's Top 7 Employee Benefits Topics of 2017 appeared first on OneDigital.

At our annual Retention and Growth Summit, we asked Debbie to explain her "why." Here is what she has to say about OneDigital's culture and the reason she's energized and motivated to provide quality service to her clients.

The following video is a success story, and an example of OneDigital’s culture and fresh thinking. My clients think of me as part of their team. I am invested. When challenges arise we are relentless in finding solutions. Being trustworthy and always doing the right thing is just simply our culture—I have your back!

The post What's Your Why: Debbie Werst, OneDigital Atlanta appeared first on OneDigital.

Many struggle to find balance, peace and meaning during this hectic time of year. Often, the year-end business needs collide with the demands of the holiday season, creating a pressure filled environment that leaves little time for “peace.”

As employers, we have an opportunity to impact employee health behaviors during the busy holiday season and beyond, setting our team up for a strong start to the year.

This year, consider a new tradition to help employees practice peaceful habits, find meaning in the season and reflect on the opportunities of the approaching New Year. We’ve compiled 3 recommendations from Forbes Magazine to transform workplace holiday stress.

Download the "3 Tips To Transform Workplace Holiday Stress From The Inside-Out" infographic:

For more tips on how to alleviate holiday related stress at work, check out these statistics from a SHRM study of popular ways employers have provided support this time of year.

• 51 percent schedule holiday events during normal business hours.
• 39 percent remind employees of their Employee Assistance Program.
• 32 percent encourage casual dress for holiday parties.
• 23 percent give the quarterly or annual bonus early for holiday shopping.
• 20 percent provide floating days for holidays worked.
• 13 percent allow time for volunteer opportunities during work hours.

For more ideas or for help implementing any of these strategies into your workplace, contact your OneDigital Health and Benefits representative.

The post Make Peace A Priority For Your Employees This Season appeared first on OneDigital.

With this in mind, it is important for employers to understand the unique compliance concerns presented by this group of employees. When an individual is eligible for an employer’s group health plan and Medicare, employers must be mindful of issues arising under the Medicare Secondary Payer (MSP) rules.

During this session, attendees learned:

• To Which Employers MSP Rules Apply
• How to Determine When the Group Health Plan or Medicare is Primary
• Prohibited Incentives
• Discrimination Based on Medicare Entitlement

The post Webinar Playback: Medicare Secondary Payer - Beware Of Compliance Pitfalls With Your Medicare-Eligible Population appeared first on OneDigital.

Then we will slip away with our bellies full to catch the Giants play the Redskins. If we are lucky, we may even snag a few Black Friday deals before the department stores are completely ransacked. These traditions truly make the holidays worth celebrating. If you are looking to switch up your routine, giving back to your local community is the perfect change of pace. Here are just a few ways you and your family can make “giving back” a part of your Thanksgiving tradition:

Volunteer At Your Nearest Soup Kitchen

During the holiday season, soup kitchens across the country experience an overwhelming increase in the number of hungry individuals seeking nourishment and shelter. Having more hands on deck to combat the holiday rush means less time waiting in lines and more time enjoying a warm meal. Finding a soup kitchen can be pretty simple; a quick Google search typically does the trick. www.homelessshelterdirectory.org is a great resource to find volunteer opportunities at an emergency food center near you.

Donate To A Food Bank

Food banks are without a doubt one of the top emergency food sources for those seeking nourishment, providing over four million meals each year. Thriving primarily off of donations, contributions are critical to their mission to fight hunger, especially now with federal cuts targeting food assistance programs. However, before running to home to load up your box of goodies, contact your local food bank to ask if there is a shortage of any items in particular. This way, food banks are better equipped to provide everyone with a nutritiously balanced meal.

Invite A New Guest(s) Over

Extending a seat at the table this Thanksgiving could be a great way to share holiday traditions you hold so dear with someone who does not have a place to go. If you’re not comfortableinviting a stranger into your home, you can reach out to your local church. Most churches are involved in their communities, and many, to the extent that they could connect you with someone who would appreciate a quality family meal. Perhaps there is a lonely neighbor or a student away at college that could use the company. Either way, the kind gesture goes a long way this time of year.

Feast With Your Furry Friends

Maybe you are not big on letting outsiders into your home but would be more comfortable spending quality time with an adorable pet without a home. Families are now turning to animal shelters to spend their holidays with animals in need. While many shelters are closed during major holidays, some offer the option to foster an animal for a few days. You have the opportunity to care of a pet for a couple days, giving them the chance to experience the joys of being around a loving family in a nice home. Studies show that having a pet around creates a more calming and peaceful atmosphere—and we can all appreciate a bit more peace these days.

Make A Charitable Donation… ONLINE

Thanks to the internet, it is easier than ever to give back without even leaving your couch. There are countless charities looking to make a difference in the life of a family in need and your support could be the push they need. Be warned, online charities have gained widespread popularity so it is important to do your research. Not everyone online has good intentions, which is why sites like www.charitynavigator.org and www.guidestar.org come in handy when verifying the legitimacy of a cause. It is easy to be swept up in the hustle and bustle of the holiday season. But as we enjoy the time spent with our friends and family, let us not forget about those who regularly go without. Use this Thanksgiving to start a new tradition and make a difference in the life of someone in need.

The post 5 Ways To Give Back This Thanksgiving appeared first on OneDigital.

ATLANTA, GA – November 8, 2017 – OneDigital Health and Benefits, the nation’s largest employee benefits-only company, has named John Ollis, Senior Vice President of Strategic Partnerships. With over 25 years of industry experience, Ollis will leverage his expansive industry perspective gained while holding leadership roles at IBX, American Medical & Life Insurance Company and UNUM. OneDigital is poised to accelerate the deployment of its industry-leading platform with the goal of reshaping the way small and mid-sized employers manage their human capital.

From the moment John and I began to discuss the potential for expanding our partnership business, I knew his experience, operational acumen and thirst for innovation was a perfect fit for OneDigital,” said Mike Sullivan, Co-Founder & Chief Growth Officer. “Our platform is built for the industry, not just our own firm and John is poised to take this division of the company to the next level

"It’s an incredibly exciting time to be in the employee benefits industry, and I’m thrilled to be joining a team that understands the value of strategic alignments,” says Ollis. “Human Capital Management and brokerage advisory services continue to merge, and the recent Zenefits partnership brings a new best-in-class offering for our partnership clients. We see no signs of slowing, and a vast opportunity to grow the strategic partnership business.”

As OneDigital emerges as a frontrunner in the benefits space, Ollis will spearhead the company's continued partner alignments, advancing its growth and success.

About OneDigital Health and Benefits
OneDigital, the nation’s largest company focused exclusively on employee benefits, combines people and technology to deliver the new generation of health and benefits. By contributing fresh-thinking ahead of the market, innovative approaches and market-leading solutions OneDigital provides clients with peace of mind. Serving companies of all sizes, OneDigital offers employers a sophisticated combination of strategic advisory services, analytics, compliance support, human resource capital management tools and comprehensive insurance offerings. Headquartered in Atlanta, OneDigital has more than 1,000 employees throughout the country, serves 37,000 companies and manages nearly $4.5 billion in premiums. Formerly known as Digital Insurance and Digital Benefit Advisors, the company has been named to the Inc. 5000 List of America’s fastest-growing companies every year since the honor’s inception in 2007.

The post OneDigital Health And Benefits Appoints John Ollis Senior Vice President Strategic Partnerships appeared first on OneDigital.

1. Final Transitional Reinsurance Fee Payment Due November 15

The Affordable Care Act (ACA) established the transitional reinsurance program to help stabilize premiums in the individual market by collecting contributions from certain entities, such as health insurance issuers and self-insured group health plans, for the 2014, 2015, and 2016 benefit years. Contributing entities that elected to make two installment contribution payments for the 2016 benefit year must use pay.gov to submit its final payment of $5.40 per covered life no later than November 15, 2017. Learn more about the Transitional Reinsurance Fee.

2. IRS Increases Health FSA Limit for 2018

The IRS issued Revenue Procedure 2017-58 which increased the Health Flexible Spending Arrangement (FSA) employee contribution limit for 2018 to $2,650. This represents a $50 increase from the 2017 limit of $2,600. Learn more about Health FSAs.

3. Additional Mandated Preventive Health Services for 2018

The ACA requires most health plans to cover certain preventive health care services at no cost-sharing to the participant. The U.S. Preventive Services Task Force (USPSTF) added the following preventive services recommendations for implementation under the ACA:

4. Individuals Must Report Health Coverage on Taxes

In a shift from prior years’ requirement, the IRS recently announced that for the upcoming 2018 tax filing season, it will not accept electronic returns and may suspend paper returns until the taxpayer indicates whether or not they had health coverage, were eligible for an exemption, or will make an individual shared responsibility payment. The 2018 filing season is the first year the IRS will not accept returns missing this information. While taxpayers are required to report their health coverage status, the IRS is not requiring taxpayers to attach a copy of the 1095-A, 1095-B, or 1095-C.

5. IRS Announces New PCORI Fee Amount

The Patient-Centered Outcomes Research Fund fee is a fee on health insurance issuers and self-insured group health plans that helps fund the Patient-Centered Outcomes Research Institute (PCORI). The IRS issued Notice 2017-61 which increases the applicable dollar amount for the PCORI fee from $2.26 to $2.39 for policy years and plan years ending on or after October 1, 2017, and before October 1, 2018. Learn more about methods of calculating the PCORI fee.

The post Top 5 End-of-Year ACA Compliance Updates appeared first on OneDigital.

The final regulations, published on December 16, 2016, amend the rules governing claims and appeals procedures for plans that provide disability benefits, such as short-term and long-term disability plans, as well as other plans that condition the availability of benefits upon the plan’s determination that the participant is disabled (e.g., 401(k) and pension plans). Under the proposal, the regulations would apply to disability claims filed after April 1, 2018, rather than the initial January 1, 2018, effective date.

The final regulations require plans, plan fiduciaries, and insurance providers to comply with certain requirements when dealing with disability benefit claimants. These requirements follow similar rules to health care reform’s enhanced requirements for group health plans. In general, the final regulations include the following:

• require more detail in benefit denial notices;
• impose additional criteria to ensure claims and appeals are adjudicated in a manner of independence and impartiality;
• allow claimants to go directly to court for review if a plan’s procedures failed to comply with the requirements;
• treat most rescissions of coverage as adverse benefit determinations; and
• require disability claims notices written in a “culturally and linguistically appropriate manner.”

After the DOL initially published the final rules, various stakeholders and lawmakers asserted that the new rules would cause an increase in litigation, impose greater administrative costs, drive up disability benefit premium rates, and ultimately impair a participant’s access to disability insurance benefits. Pursuant to Executive Order 13777, a directive by President Trump to reduce the amount and cost of regulations, the DOL concluded that it is appropriate to give the public an additional opportunity to submit comments and data concerning the potential impacts on the final regulations. Based on these responses, the DOL may allow the final regulations to take effect as written, propose further extension, amend the regulations, or withdraw the regulations entirely.

The uncertain status of these final regulations may present some administrative challenges.

As a plan sponsor, you may need to decide whether to amend your plan to comply with the final regulations as initially issued or wait and see if the DOL will issue any new guidance or further delay of the effective date of the regulations.

OneDigital will be closely monitoring any further developments and provide additional guidance as it becomes available.

The post DOL Proposes 90-Day Delay For Disability Claims Procedure Regulations appeared first on OneDigital.

To fulfill this requirement, a compliant ACA plan offering must meet minimum value and affordability criteria. A complex method of employer reporting began in 2015 to help track compliance with the law. It additionally aids in identifying employees who are ineligible recipients of premium tax subsidies.

ALEs are those employers who average 50 or more full-time and full-time equivalent employees for the prior calendar year.

An ALE member is a company that is part of a controlled group of companies, as defined under the Internal Revenue Code, whose total employees across all related entities meet the ALE definition.

Curious if you are or are not an Applicable Large Employer (ALE) under the ACA and to which employees you are required to offer coverage? Register for our webinar on December 6th to determine ALE status.

We’ve spoken to a few of our members who’ve already received inquiries and notices from the IRS regarding potential penalties. Employers should prepare for potential tax assessment notices by making sure their 2016 reporting and supporting plan offering information is readily available.

Here is a quick recap of the employer shared responsibility, its associated rules, and potential penalties.

Employer Shared Responsibility

(Employer Mandate) – ALEs offer affordable, minimum value coverage to substantially all full-time employees and their dependents.

• Affordability – an offer is affordable if the employee’s contribution— toward the employee only rate—does not exceed a certain percent of their compensation. Employers may use one of the three allowable safe harbor compensation methods to determine affordability, e.g. W-2, rate of pay, or federal poverty line (FPL).

 
Example: John works for A&B Company and is a full-time employee with 2016 W-2 earnings of $3,500 per month.

John’s employer plan is affordable if John’s contribution toward employee-only coverage does not exceed $338.10 per month ($3,500 x 9.66%).

Plan years	2018	2017	2016	2015	2014
Affordability Safe Harbor	9.56%	9.69%	9.66%	9.56%	9.50%
Percentages

 

• Minimum Value - a plan that reimburses at least 60% of the cost of essential health benefits
• Full-time Employees – those who average 30 hours or more of service per week

Penalties

Failure to comply with the Employer Shared Responsibility provision

• Part A/Tier 1 - §4980H(a) - Failure to offer minimum essential coverage to substantially all full-time employees, i.e. 95%, AND at least one full-time employee purchases coverage from the Exchange Marketplace and receives a subsidy.
• The penalty for 2016 is $180 per full-time employee (less the first 30 employees) for each month they had no offer of minimum essential coverage.
• If no coverage offered for any month in 2016, the penalty is $2,160 x the total number of full-time employees less the first 30 employees.
• Part B/Tier 2 - §4980H(b) – Failure to offer specific full-time employees coverage that is affordable or meets minimum value AND that individual purchases coverage from the Exchange Marketplace and receives a subsidy.
• The penalty for 2016 is $270 per full-time employee for each month they had no offer of minimum essential coverage.
• If no coverage offered for any month in 2016 and the employee purchased Marketplace coverage and received a premium tax subsidy, the penalty is $3,240 ($270 x 12 months).

Employer Mandate Penalties—Calendar Year	2018	2017	2016	2015	2014
Tier One—Failure to offer coverage or to offer to 95% of employees (70% for 2015)	$2,320*	$2,260	$2,160	$2,080	$2,000
Tier Two—Failure to offer coverage that is affordable and meets minimum value	$3,480*	$3,390	$3,240	$3,120	$3,000

*Projected amounts

 
Example: C&D Company averaged 89 full-time and full-time equivalent employees for the 2015 calendar year. Of the 89, 78 are full-time employees. Although an ALE, ABC did not offer minimum essential coverage to their employees for any month in 2015.
Penalty: $168,480.00 [$180/month x 12 months x 78 full-time employees]
 
Example: E&F Company, an ALE, offered minimum value coverage to all full-time employees for 2016. While minimum value coverage was offered to all full-time employees for all 12 months, the required contributions for 14 employees exceeded the affordability limits, i.e. greater than 9.66% of their compensation. Of the 14, 9 purchased coverage from the Exchange Marketplace and received a tax subsidy for 12 months.
Penalty: $29,160.00 [$3,240 x 9 employees]

Click here to download our Infobrief
Employer Shared Responsibility: Offering An Affordable Plan

The post Employer Shared Responsibility Recap: IRS To Enforce Rules And Penalties appeared first on OneDigital.

Thanks to HR software and tools, HR teams are now able to harness technology to collect relevant HR information and streamline tedious services like payroll and benefits administration. And increasingly, HR teams are now able to offer valuable contributions to an organization’s profitability.

Want an in-depth look at what’s changed—and how you can implement these new HR practices into your overall HR strategy? Read on.

1. Data-Driven HR

Gone are the days when human resources practices were developed by academics or top leadership devoid of input from managers and workers. Today, big data and people analytics help make sense of important HR data points.

This means that HR departments everywhere have the power to inform day-to-day decision making within companies, plus create new processes and initiatives using valuable information gleaned from people analytics. This includes information on compensation, diversity, turnover, and more.

And this type of data will only become more critical for businesses. In fact, Deloitte’s 2017 Global Human Capital Trends Report found that 71 percent of companies identify people analytics as a company priority.

By analyzing relevant people data, HR leaders can develop best practices and processes for typical HR activities such as recruiting, hiring, performance management, measuring productivity.

Ready to use people analytics to drive business strategy? Click here to learn how Zenefits can help.

2. Fast, Easy, and Automated HR

Technology has also introduced HR departments to the digitalization of traditional paper-based (and human-driven) HR tools and services.

Today’s modern HR platform help streamline tasks such as hiring, onboarding, and employee records management—activities that typically require many man-hours to complete.

The automation of HR has been identified as a current issue that is top of mind for HR leaders worldwide. A full 74 percent of executives surveyed in the Deloitte 2016 Human Capital Trends report said that digitizing HR is a top priority for their organizations.

3. Ongoing Performance Evaluations

In a recent Harvard Business Review article, executive coach and author, Jeff Gothelf, argues that “HR needs to provide the same services it’s always provided—hiring, professional development, performance management—but in ways that are responsive to the ongoing changes in the culture and work style of the organization.”

And one of those services is performance management.

Foram Sheth, co-founder of career coaching organization, Ama La Vida, says traditional performance management is an outdated practice that has simply become a formality because “HR said so.”

“The idea of it is great—it’s meant to help individuals assess where they are and identify areas of opportunity and growth,” she says. “But doing a performance management review once a year and being evaluated against goals made a year ago when so much has changed isn’t relevant nor helpful.”

Instead, Sheth says the trend in modern HR is to offer frequent feedback set to purpose-driven goals (instead of tactical goals).

This means employees should receive continuous feedback on how well they’re meeting expectations, and more importantly—how to improve. This method aligns with today’s agile business, which must respond to technological and market changes more quickly than ever before.

“This is where day-to-day coaching comes into play as there must be proactive management from leaders,” she says. “Set milestones and evaluate progress frequently.”

4. Strong Focus on Company Culture and Values

Company culture and values has also emerged as a key HR initiative. This—in large part—is in response to the growing wave of millennial workers who value intangible benefits.

In fact, a 2016 Fidelity study found that millennial workers are willing to forego an average $7,600 in salary in exchange for a better work/life balance, a company culture they’re comfortable with, and the opportunity to engage in “purposeful work.”

And data shows that company leadership is listening. The Deloitte Capital Trends Report found that 86 percent of respondents rated “challenges with company culture” as important or very important.

5. Human Resources Departments As Strategic Business Partners

Perhaps one of the most important changes to HR is the repositioning of the human resources field from a traditionally non-profit department (not generating sales for a business) to a strategic business partner.

“The modern HR leader needs to increasingly show how their work ties to the company’s bottom line,” advises Stan Kimer, President of Total Engagement Consultancy, a diversity and career development consultancy firm. “And by tying HR work to the bottom line, it will be more likely for the modern HR leader to be looked at as part of the strategic leadership team, and invited to participate in C-Suite deliberations.”

One way they’re doing this is by analyzing trends in retention, engagement, and productivity—three important factors that tie to business profitability.

“Increasing employee retention can save on recruiting and onboarding costs, productive empowered employees who are engaged can increase sales, and so on,” says Kimer.

The Bottom Line

As modern business practices change, so do HR practices.

HR departments have traditionally supported the human capital of their organizations. In today’s technology-driven world, HR departments have the potential to make actionable and measurable contributions across all aspects of business and this is one of the reasons we are bringing the Zenefits platform to you. Ready to impress your employees, eliminate administrative headaches and get true peace of mind? Click here to experience the platform.

This article was written in partnership with Zenefits, OneDigital's newest technology partner.

The post 5 Ways HR Teams Are Changing (For The Better) appeared first on OneDigital.

It takes a toll on HR and it can be a confusing process for workers. Think about all the benefit policies you have in place and how many different iterations of those policies there can be—various tiers, classes, life amounts, DI amounts, deductions, eligibility stipulations, etc. Now think about using a technology-based enrollment platform. You can save time and money, make the process more efficient and user-friendly for HR and your employees. Remember, your changing workforce wants an online experience. Let’s look at the pros, cons and some recommendations of adopting this type of platform.

Benefits of Technology-based Enrollment

Embracing technology can simplify many of your processes related to benefits technology. Learn more about the advantages of incorporating a platform to your plan design.

With technology based open enrollment, every step of the benefits management process is automated, eliminating the need for paper-based processes and improving efficiency and accuracy. Online enrollment lowers the overall cost of providing services to your employees by eliminating the costs of distributing and collecting paper enrollment packets, shortens the enrollment cycle and enables employees to self-enroll in benefit programs, review their benefit data and report life event changes. Employees can also choose plans based on eligibility criteria and can compare costs and coverage of previous elections against new offerings. Some additional advantages include the following:

• Elections can be automatically applied to employee records.
• Employees receive written confirmations detailing their elections.
• Employees can easily view and update their records and plans.
• HR can check the status of enrollment in real time and may be able to generate detailed reports regarding the cost of employee benefits.

Disadvantages of Technology-based Enrollment

Implementing new procedures will typically come with drawbacks, but with preparation, these hindrances can be avoided.

• Employees may be intimidated by the software and may also desire interpersonal assistance, rather than making their selections via a computer.
• Employees may not make informed benefit decisions if they are only advised via the computer and are not provided personalized recommendations.

Recommendations

Knowing what you can do to properly implement changes to the accepted way of doing things can save you headaches in the long term. Here are a few suggestions for addressing any obstacles you may encounter.

Introducing the new enrollment software and training employees before open enrollment begins to make sure all employees are comfortable with the software. It's helpful to make sure someone is available to answer additional questions and provide further help. You can also incorporate the following to address any obstacles to the process:

• Use various communication mediums for initial alerts concerning open enrollment to prepare employees for the process.
• Use existing resources to promote technology-based enrollment such as your company’s intranet, bulletin board postings or your newsletter.
• Encourage management to promote the use of technology-based enrollment to increase employee buy-in.

Another helpful method to combating any confusion is to establish online communities or blogs where employees can discuss successes and problems they are having while enrolling. That way, they can assist one another with the process and HR can address any problems that employees may be having.

Let us know if these tips worked for you and find out more about OneDigital's open enrollment technology to seamlessly integrate your HR benefit functions.

The post Technology-Based Enrollment Could Be Your Employee Benefits Solution appeared first on OneDigital.

Lost productivity due to employees becoming disabled is an issue of great cost for employers. Economic, demographic and societal trends have led to an increasingly mobile, diverse and older workforce. In addition, increased stress in the workplace and the home are taking a toll on overall employee health, productivity and safety. The result is higher health care and disability costs that have a measurable impact on employers and the employee benefits packages that they offer. These trends and costs are expected to continue to interact with and influence the marketplace, so making appropriate benefit choices remains important for employers.

Studies show that working-age adults are more likely to suffer from lengthy disabilities in any given year than they are to die. Unless it is offered through their employer, most adults have little, if any, disability insurance coverage.

What is group disability insurance?

Group disability insurance provides income protection for employees as well as cost-saving management strategies for employers. For employers, lost time on the job due to a disability can significantly impact workplace productivity and profitability. However, disability insurance provides partial replacement of lost income for employees while also covering overtime and costs of hiring replacements. Most employers offer salary continuation plans. Many states also mandate temporary disability insurance that requires employers to provide benefits equivalent those working in non-statutory states.

Is group disability insurance really necessary?

Lost time and medical costs are on the rise, and the risk of disability is greater than most employers and employees realize. Consider these statistics:

• Over 36 million Americans are classified as disabled.
• Three in ten workers entering the workforce today will become disabled before retiring
• An illness or accident will keep one in five workers from working for at least a year sometime during his or her career
• Americans have a 50 percent chance of becoming disabled for 90 days or more between the ages of 35 and 65
• Disabilities affect one-fifth of Americans (over 60 million people).
• A disabling injury occurs every eight seconds at work.

The possibility of becoming disabled very real for working Americans, and so are the financial consequences and costs associated with employee absence. The population is aging, which also translates to rising benefit utilization and cost. Beyond that, unscheduled absences disrupt workflow and increase cost, while human resource pressures are impacting the ability to dedicate adequate time and attention to situations where working time is lost.

Contact your benefits consultant to discuss group disability insurance and determine if it is the right choice for your organization.

The post Short-Term Disability Benefits: What You Should Know Before An Accident Happens appeared first on OneDigital.