Got Strategy?  

Do you own a small business in Washington state? You do huh? Then chances are your company's health plan is about to get it's annual medical plan renewal. Before rushing right into things, stop, breathe and review your employee benefits strategy first. These are some questions to consider prior to renewal:

Cost Management
What is your plan doing to manage benefits costs and achieve sustainable results so you can attract and retain the talent you need?
Compliance Consulting
Have you built a solid foundation for your overall compliance strategy and are you prepared for legislative and regulatory changes that impact your business?
HR Technology Solutions
Do you need to find the right solution that lightens your workload and enables you to achieve your objectives?
Health and Performance
What steps are you taking to enhance the health and productivity of your workforce?
Benefits Communication 
Where can you elevate year-round benefits communication so your employees understand and use their benefits?
Voluntary Benefits
What other benefit options are you offering that your employees will embrace?

Taking a strategic approach before renewal will save time and money.  If your strategy is old or non-existent, we can help.

PNW Insurance Solutions (425) 314-0988

www.pnwisol.com 

Workplace Bullying: More Common Than You'd Think

National Bullying Prevention Month is recognized every October. What many people don’t realize is that workplace bullying affects more than 35 percent of adult Americans.

What is Workplace Bullying?
Generally, workplace bullying is defined as the use of intimidation through power, influence, tone, or language to affect a person negatively. Often, bullying is intentional, but sometimes the bully is not aware of their hurtful actions or words. Workplace bullying affects safety, productivity, trust, and the workplace culture.

What are the Signs of Workplace Bullying?
Some common signs of workplace bullying include:

• Ignoring, isolating, or excluding an employee
• Reprimanding or humiliating an employee publicly
• Name-calling or insulting an employee

Take steps today using your HR Library for specific forms and warnings.  Don't have an HR Library? Contact Wendee Allen (425) 314-0988

Back in early 2017, President Trump signed an executive order intending to provide alternatives to the Affordable Care Act (ACA). One of the rules included in this executive order modifies how the government can regulate association health plans (AHPs). 

What are association health plans?
Association health plans allow small groups to band together and act as one large group. AHPs are actually not plans themselves, but rather an overarching term describing small business and sole proprietors coming together to negotiate better prices with health insurance companies.

Essentially, the larger a group, the less risk there is for an insurance company.  If the group is determined to be less risky, the price is lower. So, by allowing several small groups to act as one large one, the risk (potential cost for the insurance company) gets spread out amongst the large pool of enrollees, and when one person gets sick, there are more than enough monthly payments going to the insurance company to cover those costs.

This concept isn't really new, so what is changing about association health plans?
The big change with these plans is that they will now be regulated the same as large employer policies. Most importantly, this means that association health plans (AHPs) do not need to adhere to ACA rules, such as the requirement to offer plans with the ten essential benefits.

According to Labor Secretary Alexander Acosta, “AHPs are about more choice, more access, and more coverage.” These plans will probably benefit enrollees by having lower premiums, and might even mean the difference between offering coverage or not for some small employers who struggle to afford Obamacare prices. The devil will be in the details.

At what cost does access to more choice and cheaper premiums come at?
Although being part of a larger group does often come with price reduction due to a larger risk pool, there are more reasons why these plans will likely be a lot cheaper.

As stated before, these plans do not have to offer the ten essential benefits. If you’re a young woman looking for maternity benefits, or someone with a chronic illness, you might not be getting everything you need by getting coverage from an association health plan.

Also differing from ACA policy—gender, age, and industry could affect prices of individuals being covered under association health plans. Health status is not included in this list though, so just as with the ACA, pre-existing conditions will not affect prices for those covered under association health plans.

How does the new regulation on association health plans affect the ACA as a whole?
A major selling point of the ACA was that all people would be treated the same, and there was a baseline of benefits that had to be offered.

With the new rules regarding association health plans, this facet of the health insurance industry would no longer be true for small businesses participating in the AHPs.

AHPs could also make our Washington State Health Insurance exchange (Obamacare) more volatile. In theory, young healthy workers could all choose to be covered by the less comprehensive, but cheaper AHP plans. This could leave older and sicker Americans as the only enrollees in Obamacare plans, which could mean prices skyrocket, since the insurance companies are only covering sicker individuals. The death spiral.

We should all remain skeptical until more details and bonfide products are released.

Should you have any questions, please contact me.  Wendee Allen, PNW Insurance Solutions wendee@pnwisol.com.  

This is article is for general information and may not be updated after publication.

Effective for disability claims filed after April 1, 2018, employee benefit plans subject to the Employee Retirement Income Security Act (ERISA) must comply with new requirements.

Background
In 2016, the U.S. Department of Labor (DOL) released a final rule to strengthen the claims and appeals requirements for plans that provide disability benefits and are subject to ERISA. According to the DOL, the information it received during the delay period did not justify modifying or rescinding the final rule. Thus, the final rule will take effect without change.

Final Rule Applies to "Disability Benefits"
A benefit is considered a "disability benefit" if the claimant has to be disabled in order to obtain the benefit. It does not matter how the benefit is characterized or whether the plan as a whole is a retirement plan or a welfare plan. If the claims adjudicator must make a determination of disability in order to decide a claim, the claim must be treated as a disability claim for purposes of the DOL's claims procedures.

Specific Changes Made By The Final Rule
Specifically, the final rule requires that plans, plan fiduciaries and insurance providers comply with additional procedural protections when dealing with disability benefit. 
Employer Action Steps
The final rule applies to ERISA plans that include disability benefits. These plans must comply with the new procedural protections, effective for claims that are submitted after April 1, 2018. Entities that administer disability benefit claims, including issuers and third-party administrators, will need to revise their claims procedures to comply with the final rule. This includes sponsors of defined benefit pension plans, 401(k) plans, 403(b) plans covered by ERISA, and top hat plans, in addition to disability benefit plans.

Specific employer action items include the following:

Identify all ERISA covered plans that provide for a disability benefit. This includes most long-term disability plans and some short-term disability plans, as well as retirement plans that provide for a disability benefit;
Review current plan documents and summary plan descriptions, and update claims procedure descriptions to include the additional requirements of the final rule; and
If applicable, review any contractual agreements with third parties responsible for making disability determinations to confirm appropriate processes are in place on their end and they have responsibility for complying with the new requirements.

For additional information, please contact your PNW Insurance Solutions Benefits Consultant or Wendee Allen at 425-314-0988 or wendee@pnwisol.com.

The Internal Revenue Service (IRS) has announced that the 2018 annual limitation on health savings account (HSA) contributions by individuals with family coverage under a high deductible health plan (HDHP) is now $6,850. This limit was previously announced as $6,900, but has been revised downward due to an inflation adjustment provision in the Tax Cuts and Jobs Act. The 2018 annual limitation on HSA contributions by an individual with self-only coverage under a HDHP remains unchanged at $3,450.

Click here to read the IRS announcement and contact us with any questions.

PNW Insurance Solutions

(425) 314-0988

www.pnwisol.com

Hello,

I wanted to share with you a very informative webinar, Sexual Harassment Prevention Guidelines. I have included a copy of the slide presentation and a recording of the webinar below.

Download Webinar Slide Presentation
View the Webinar Recording

This webinar covers important topics, including:

• Recognizing Sexual Harassment
• Establishing a Sexual Harassment Policy
• Investigating Sexual Harassment Claims
• Taking Corrective Actions

I hope you find this webinar helpful.

Best,

Wendee Allen
PNW Insurance Solutions
(425) 314-0988

If you've got teenagers covered on either your individual or small group medical insurance plan, be prepared to pay higher rates for them because insurance companies must comply with new Member-Level Rating (MLR) requirements starting in 2018. This change is to help lessen future increases when a member turns age 21.  

Q: What is Member-Level Rating (MLR)? 
A:  Each member gets an assigned rate and these are then added together to determine the premiums charged to the subscriber and any dependents. 

Q:  What are the new regulations about age and rates? 
A:  The Final Rule directs all health plan issuers of small group and individual plan coverage (on and off the  Exchanges) to revise the member level rating age bands used for individuals 0–20 years of age from using 1 age band to now create 7 age bands. The first age band cover ages 0–14, then single year age bands cover 15, 16, 17, 18, 19, and 20. This change will align with utilization of  services while smoothing rate increases over time. 

Q: How does this impact rates? 
A:  Every year members get 1 year older and in most cases move to a new age band. The introduction of the new age bands changes how rates are calculated for members under 21. By 2019, having more age bands will allow a more gradual  increase as experienced today when turning age 21.  2018 is a transition year where all members age 0 to 20 will experience significant increases. 

Want to learn more about this change and how it will impact you? Call PNW Insurance Solutions at (425) 314-0988 and ask to speak with Wendee Allen
 

King County & Snohomish County Health Insurance Open Enrollment begins in 1 week! Are you ready? Need help? We're not called PNW Insurance Solutions for nothing. Contact us today. 
 

The Trump administration announced yesterday that it will no longer make cost-sharing reduction (CSR) payments to insurance companies under the Affordable Care Act (ACA). According to a statement issued by the U.S. Department of Health and Human Services (HHS), the agency's decision to discontinue these payments immediately follows a legal review by HHS, the Department of Treasury, the Office of Management and Budget, and an opinion from the U.S. Attorney General. 

Background
The ACA requires insurers to offer plans with reduced deductibles, copayments, and other means of cost sharing to eligible individuals who purchase plans through the Health Insurance Marketplace. In turn, insurers receive CSR payments arranged by the Secretary of HHS to cover the costs they incur because of this requirement. Whether CSR payments were properly appropriated by Congress has been the subject of litigation since 2014.
To read the HHS statement, click here. 

Call us today for more information about ACA requirements and changes to the Individual & Family marketplace. We're here to help. PNW Insurance Solutions - (425) 314-0988.  Ask for Wendee Allen

New Executive Order Calls for Expanding Access to Association Health Plans

President Trump has signed an executive order calling upon the U.S. Department of Labor (DOL) to consider, among other things, expanding access to Association Health Plans, which could potentially allow employers to form groups across state lines. Until further guidance is issued or legislation is signed, however, all current ACA requirements remain in effect, including penalties for noncompliance.

Key Highlights

The following are key highlights of the order:

Association Health Plans (AHPs): The executive order directs the DOL to consider adopting a broader interpretation of the Employee Retirement Income Security Act (ERISA), which could potentially allow employers in the same line of business anywhere in the country to join together to offer health insurance coverage to their employees.

Short-Term, Limited Duration Insurance (STLDI): The executive order directs federal agencies to consider ways of expanding coverage through low-cost STLDI, which is not subject to certain ACA rules.

Health Reimbursement Arrangements (HRAs): The executive order directs federal agencies to consider changes to the rules regulating HRAs so that employers can make better use of these arrangements for their employees.

Note: In general, executive orders must be implemented in a manner consistent with applicable law, including the Administrative Procedure Act, which requires extended review of and public comment on any federal rules which may be proposed as a result of an executive order. Going forward, we will promptly report changes made to any ACA requirements.

To access your HR library, please visit www.pnwisol.com/hr360. Call with questions (425) 314-0988.