There are strict deadlines for open enrollment each year. It opens nationally on November 1st, and closes on January 15th. Some states, such as New York and California, have extended deadlines through January 31st. Click here to see your state’s open enrollment period.

During this period, people have the opportunity to enroll in healthcare coverage, or change their plans. Failing to take action during this time can pose serious consequences because open enrollment is the time employers can take advantage of having health, dental, vision, life and other voluntary benefit insurance plans.

Enrolling after the deadline means that there is no way to make changes to your plan or enroll again until it opens back up a year later.

What Happens if Your Employee Misses Open Enrollment?

Employees who miss the deadline to sign up for health insurance during open enrollment could face a year without health insurance. In turn, those without coverage may have to pay an individual mandate penalty on their next tax return. However, there are a few options available to employees depending on their circumstances.

What Other Options Can You Provide to Your Employees?

Depending on the employee’s circumstances, they may be eligible to register for alternative coverage options.

Medicaid

Enrollment for Medicaid is open year-round to those seeing to apply. Eligibility is based on federal requirements that differ depending on the state. It extends coverage for:

  • Low-income adults
  • Children
  • Pregnant women
  • Elderly adults

Short-Term Health Insurance

Private insurance companies offer short-term health insurance policies. Most do not cover pre-existing conditions nor do they guarantee coverage because they are not required to fit ACA minimum essential coverage (MEC) benefits.

Young Adult Benefit Plan

Those under 26 years old are eligible to join their parent’s plan if that plan offers dependent coverage. This plan does not require the child to be employed, a student, or have a child. A caveat may include that registration for the child may need to occur during open registration. Rules and regulations for this may vary depending on plan type and state location.

Qualifying Events

If a qualifying event occurs, employees have the opportunity to change their plans.

Qualifying events are the only exception for employees to add or change health insurance after open enrollment deadlines. If any of the following occur, your employee is able to adjust or enroll in health insurance:

  • Marriage
  • Divorce if the divorce is counted as a qualifying event by the insurer, or the divorce causes a loss of health coverage
  • Death in the family
  • Birth of a child
  • Adopting a child
  • Loss of health coverage
  • Turning 26 and losing eligibility as a dependant
  • Becoming a United States citizen
  • Increased pay that moves the employee out of the Medicaid coverage gap
  • Change in income changing eligibility requirements
  • Grandfather or grandmother plan renewal
  • Moving to an area where there are different health plans
  • Changing jobs

Learn More

Employers who invest in their employees, and encourage them to take full advantage of their benefits increase productivity, and attract top talent. Learn more about why you should invest in healthcare for your employees here. 

A study found that 70% of people don’t feel valued by their workplace. In that same study, 25% of people believed that their productivity at work would improve if they received employee benefits. When you show your employees you value their hard work, they will be more likely to strive to perform better. It’s part of why investing in health insurance for your employees is so important. 

 

Investing in health insurance is essential to ensuring a happy and healthy workforce. Navigating employee benefits that your employees actually want, can be a challenge. Not to mention the various requirements necessary for employers with 50 or more employees. So, why should you invest in health insurance for employees?

 

Learn more about Affordable Benefits, talk with one of our team members!

 

Employee Benefits Increase Employee Productivity

According to the CDC, employees who prioritize preventative care, such as annual check-ups, are more productive in the workplace. This may be attributed to a few different reasons. Whether they’re taking less sick time, or they’re less stressed about their health, improving focus on their work, whatever the outcome, is beneficial to you. 

 

As an employer, you want your employees to remain focused on their work to ensure ongoing success. Having to worry about their personal healthcare and that of their dependents drains their time and energy. While it can be time-consuming to set up proper health insurance, partnering with the right company can simplify the complexities involved.

 

Almost anyone in a management role knows the importance of employee morale in the workplace. A positive workforce yields positive results. One way to ensure your workforce remains positive is to provide benefits that match their needs. After all, employers who provide great benefits gain a better reputation for their business, while also increasing productivity, and decreasing turnover. 

 

When you partner with a broker who can guide you through the process seamlessly, health insurance doesn’t have to be complicated. They can help select plans that are right for your employees, help set up your virtual benefits, and serve as a go-to resource to answer questions that your employees may have. 

 

Why invest in health insurance for your employees?

 

How can Ancillary & Voluntary/Worksite Benefits Attract and Retain Top Talent? 

In today’s job market, employees require more than traditional benefit programs. Benefits like vision, dental, accident, term life, critical illness, and hospital indemnity insurance can provide your employees with additional coverage when they need it most.  These additional benefit options allow your employees to tailor their benefit coverage to their needs.

 

When employees are given the choice in their benefit programs, they are more likely to use them. And when employees use their benefits, as we said above, they are able to remain healthy and ready to work more often. 

 

Employees look for employers who offer voluntary benefits because these benefits give employees choice, they meet various needs of a diverse workforce, and they ensure employees remain financially stable. Offering voluntary benefits adds a level of insurance coverage that many workers have not previously had access to. Benefits beyond the traditional 401(k) and health insurance are vital to attracting the right talent for business. 

 

At Innovative HIA, we offer our clients comprehensive coverage that provides the complete solution for employers who want to provide affordable benefits to their workers. Service is our priority. We pride ourselves on our reliable, fast, and friendly team that makes compliance with ACA easy and affordable. 

 

You Remain Compliant with ACA Requirments – and Avoid Paying Hefty Fines

As an applicable large employer (ALE) you are required by the Affordable Care Act to provide benefits to 95% of your full-time or full-time equivalent employees. If you fail to do so, you will be subject to some pretty significant financial penalties. 

 

The Cost of Pentalty A 

If an employer fails to offer benefits to their full-time employees, they will be subject to a penalty of $2,700 per employee annually. Violations are assessed on a monthly basis. When broken down monthly, each month that an eligible employee is not offered coverage will earn you a $225. A large company with 5,000 employees that fails to provide proper benefits for its employees, could be subject to a $13,500,000 annual fine.

 

The Cost of Pentalty B

Penalty B is calculated for every full-time employee that was not offered minimum value coverage by their employer and went to the Health Insurance Marketplace and qualified for a premium tax credit. The annual penalty per employee in this scenario totals $4,060. Penalty B is also calculated on a monthly basis and when broken down to a monthly rate equates to $338.34 per employee. 

 

If a company failed to offer minimum value coverage to 100 ACA full-time eligible employees, or if the offered coverage was not affordable and they received a premium tax credit or subsidy on the exchange, the employer involved would be liable for an annual fee of $406,000.

 

At Innovative HIA, we have the most competitive affordable benefits available. We ensure the benefit plans you offer your employees are fully ACA compliant.  To achieve this, we process your 1094/1095s on your behalf. If there are ever any errors in your 1095 processing, we refile for you. No hassle to you, just compliant benefits.

 

Read on to learn more about how offering minor medical benefits is more beneficial than not. 

Article originally published on SBMA Benefits.

 

infographic explaining why employers should invest in health insurance for their employees

Businesses that provide health benefits for their employee workforce must submit the right forms proving that they offered the required benefits. Now that 1094/1095 filing is complete, it’s time to prepare for federally mandated annual PCORI fees. Are you prepared? Let’s discuss 1094, 1095, and PCORI compliance. 

How Can Applicable Large Employers Stay Compliant? 

 

Applicable Large Employers (ALEs), employers with 50 or more full time employees, must offer Affordable Care Act (ACA) compliant health benefits to at least 95% of their workforce. Failure to do so can result in hefty fines and penalties from the Internal Revenue Service (IRS). 

The IRS can issue ALEs Penalty A or Penalty B fines for each employee that is not offered correct or compliant benefit plans. Employers can avoid unnecessary fines and penalties by offering ACA Compliant Minimum Essential Coverage (MEC). MEC benefit plans allow employers to provide affordable benefits to their employees without compromising their bottom line. 

In order to verify employers are, in fact, offering ACA compliant benefits, the IRS requires employers to fill out form 1094 and 1095

Employers must complete Form 1094, which is used to determine their liability for payment under the employers’ shared responsiblity provision. Form 1095, however, is used as a summary of healthcare information the ALE offers employees. 

 

What Can Innovative HIA Do For You?

 

One of the many services we provide at SBMA Benefits is 1094 and 1095 Form processing. We simplify the complexity of providing employee benefits while simultaneously ensuring ACA compliance. 

What’s included in our 1094/1095 processing?

  • Electronic filing of 1094 and 1095 forms annually 
  • PDF soft copies of 1095 for employee distribution 
  • 1095 error corrections refiling (if applicable) 
  • Mail distribution

 

What Happens After I Submit Forms 1094 and 1095?

After submitting Forms 1094 and 1095 by their due date, March 31st, employers must pay fees to the Patient-Centered Research Institute (PCORI) by July 31st. This year, however, the due date has been extended to August 2nd since the previously mentioned due date lands on a Saturday. 

 

What is PCORI and Why Do I Have to Pay Their Fees?

 

PCORI was created to improve the quality, quantity, timeliness, and trustworthiness of health information for patients. 

According to the PCORI, its mission is to “help people make informed healthcare decisions, and improve healthcare delivery and outcomes, by producing and promoting high-integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader healthcare community.”

Employers are responsible for paying PCORI trust fund fees annually. The amount employers owe depends on the number of people enrolled in their offered benefits program. 

The fee is calculated based on the average number of individuals covered in a benefits plan- including spouses, dependents, retirees, and COBRA participants. Currently, PCORI fees are $2.79 per enrollee. In 2021, PCORI fees cost $2.66 per enrollee. 

The fee was slated to end in 2019, but was extended via Trump’s Further Consolidated Appropriations Act of 2020. For now, PCORI fees are extended through 2029. 

For more information read our article on what business owners should know about ACA Benefits in 2022

ALEs submit forms 1094 and 1095 to prove they provided ACA compliant benefits. Furthermore, they must prepare for annual PCORI fees.

Article originally published on SBMA Benefits.

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process, by giving you access to everything you need in one place. Our enrollment portal houses everything you need for:

  • Onboarding 
  • Off boarding 
  • Enrollment 
  • Portal assistance 

Our employee benefits professionals have the knowledge and expertise that can save your company time and money. We aim to offer comprehensive benefit management, not only with our portal, but also as it pertains to ACA compliance, providing low-cost options, and offering fast and reliable service.

The convenience of SBMA’s employee benefits administration support allows your Human Resources department to work on their daily tasks and responsibilities without the headache of a difficult benefits administrator. Our one-stop-shop portal helps reduce the paperwork your HR department has to deal with and therefore, improves your bottom line.

Employer Resources

Our website is equipped with plenty of employer resources that give easy and secure access to your records and the ability to make plan changes at your fingertips (i.e. (enrollment portal, adding dependents, employee termination, and more). Adjusting benefit plans couldn’t be any easier with SBMA. Additionally, every task includes video tutorials, walkthroughs, and instructions. 

 

Watch the videos below to see just how easy navigating our portal is. 

 

Enrollment portal walkthrough

 

Adding Dependents walkthrough 

 

Termination walkthrough 

 

 

Partnering with us takes the burden off of your HR department and places it on us, your benefits administrator. Ready to get started? Reach out to us today

 

Innovative HIA supports HR departments with onboarding, off boarding, and more

Article originally published by SBMA Benefits.

Health insurance is hardly a one size fits all industry. Different people need and want different coverage based on their lifestyle and what they can afford. Based on this and additional personal factors, people choose to enroll in various coverage plans. One policy type that someone might choose to opt into is hospital indemnity coverage. Let’s discuss the details regarding hospital indemnity coverage, who needs it, how much it costs, what it covers, and more.

 

What is Hospital Indemnity Insurance Coverage?

Hospital indemnity insurance is a supplemental coverage option that supports the financial aspect of your health coverage.

It is intended to cover the costs of hospital stays and emergency care that are not otherwise covered under a typical insurance plan. If you do have to take an unexpected trip to the hospital, you pay a fixed cost, instead. 

For example, without this supplemental insurance, if you have to take an unexpected trip to the hospital, you instead pay a fixed cost

Depending on the type of plan you have, hospital indemnity insurance benefits can go toward:

  • Deductibles
  • Coinsurance 
  • Transportation
  • Medication 
  • Rehabilitation  
  • Home care costs 
  • Various recovery expenses 

This coverage can be sponsored by your employer, a government plan, or by a private insurer. 

 

What Does Hospital Indemnity Insurance Cover?

Hospital indemnity coverage may vary slightly from one plan to another. However, it most commonly covers the following: 

  • ICU stays
  • Critical care unit stays 
  • Outpatient surgery
  • Continuous care 
  • Outpatient x-rays and laboratory procedures 
  • Outpatient diagnostic imaging procedures 
  • Ambulance transport fees
  • Emergency room visits
  • Physician office visits

Generally, plans have lower premiums compared to other insurance, but depending on your coverage, can increase.

 

Who Needs Hospital Indemnity Insurance Coverage?

The age-old adage, “accidents happen,” is around for a reason.

Accidents can’t be predicted or prevented, hence why they’re accidents. In some cases, however, certain people may be more inclined to need consistent hospital health services.

A hospital indemnity policy is a worthwhile benefit to have for someone who frequents the hospital or if you can afford the security that it provides.

Oftentimes patients may be surprised and overwhelmed by the bills and financial responsibility that follow a hospital stay. At SBMA, we believe it’s better to protect your finances with additional coverage.

Consider this policy for individuals with the following:

  • Chronic conditions that can lead to hospitalization (i.e. heart disease)
  • Upcoming surgery that could lead to extended hospital stays or care 
  • Women who are pregnant or expect to become pregnant (the supplemental coverage can cover additional days spent in the hospital after childbirth)
  • Peace of mind knowing there is coverage in case of an accident 

Although emergency services can create a financial burden, patients can have peace of mind now with the No Surprises Act protecting from surprise medical billing. Read on to learn more about The No Surprises Act.

How Much is Hospital Indemnity Insurance? 

There isn’t a fixed cost to this insurance policy. The cost, however, depends on a few factors:

  • The insurance company  
  • Your age 
  • Your sex
  • Your geographic location
  • Deductible amounts

Forbes found that on average, hospital indemnity insurance premiums can range from about $50 to $400 a month. Additional research found that the average 3-day hospital stay costs about $30,000.

Is Hospital Indemnity Insurance Worth It?

It depends on who you’re asking.

Investing in hospital indemnity insurance can be worth it—depending on your health, lifestyle, and future plans.

Ask yourself the following when deciding whether or not to add the supplemental insurance to your existing coverage:

  • How healthy are you? Consider the likelihood that you or a loved one will become hospitalized.
  • What does your current health plan cover? Look at your current healthcare plan to identify what it does and does not cover.
  • Can you afford the medical costs if an accident occurs? Forbes found that “over 36 million people in the U.S. are admitted to a hospital every year, many of whom may not be prepared for the cost.”

Answering these questions will help you decide if this additional policy is worth it for you.

 

Why Should Employers Offer Hospital Indemnity Insurance to Employees? 

Employers who offer hospital indemnity insurance to their employees add value beyond salary—without affecting their bottom line.

As employees consider the widening job market available to them, offering a competitive job opportunity that includes healthcare benefits and hospital indemnity can make you an ideal employer that attracts and retains the best employees. After all, 60% of employees rated benefits as very important in contributing to job satisfaction. 

Other benefits of offering this supplemental coverage to employees include: 

  • Increasing employee retention 
  • Increasing employee productivity
  • Increasing teamwork and organization
  • Improving overall financial savings for employers and employees

Want to learn more? Read our article “The Difference Between Hospital Indemnity and Accident Insurance” for more information.

Here at Innovative HIA, we offer various comprehensive health care plan options in addition to supplemental coverage options—such as hospital indemnity coverage. For details about our plans or to enroll today, contact us directly or speak with one of our experienced brokers.

 

understand if you nees hospital indemnity

Article originally published on SBMA Benefits.

Sitting is now one of the most common daily activities. Increased desk jobs and a bigger than ever stay-at-home workforce have contributed to more sedentary lives.

 

In fact, over a quarter of Americans sit for more than eight hours a day, and most sit for six to eight hours a day according to a report by TIME.

 

They call the results of sitting “the new smoking” because of the negative impacts it can have on your body. Do you sit all day? Are you tired of tight hamstrings or back pain?

 

Let’s dive into what sitting does to your body and how you can combat those negative effects daily.

What Does Sitting Do to Your Body? 

Sitting doesn’t seem like it should or would be such a dangerous activity for your body. After all, you aren’t doing much—but that could be the point.

 

There are both long and short-term effects that sitting for long periods of time can have on your body. After all, they don’t call it the “new smoking” for no reason. Below are some details.

 

  1. Sitting can lead to weight gain because you spend less time moving/ exercising.
  2. Use it or lose it! You start to lose muscle in your legs and glutes because they don’t have to work to hold you up, which can cause muscle atrophy.
  3. Sitting is linked to increased lung, uterine, and colon cancer.
  4. Those who sit for longer periods of time are more likely to suffer from anxiety and depression.
  5. Sitting can lead to tight muscles, especially tightness in your hamstrings.
  6. Your body can experience back pain from poor posture (i.e. hunching over a computer screen for prolonged periods of time).
  7. You can also experience stiff shoulders and neck pain from bad posture.
  8. There is a higher risk for heart diseases like strokes and heart attacks. 
  9. Sitting for long periods of time is linked to an increased risk of diabetes and can also lead to varicose veins. 
  10. Sitting can cause deep vein thrombosis (DVT).

 

There are many negative effects of sitting that can be detrimental to your health. But how do you combat them when you have to work a desk job?

Combatting the Effects of Sitting 

Just because you’re sitting all day doesn’t mean that you can’t combat its negative effects —you can. (After all, this article was written while standing!)

 

Here’s our guide on how you can combat the negative effects of sitting all day.

1. Stand While You Work

As mentioned before, you can stand while you work. Take advantage of standing desks so you can alternate from a seated to a standing position throughout the day. This will help get blood flowing through and also build muscle.

2. Walk During Meetings 

If you can, walk or stand during your scheduled meetings or calls if you don’t have to be at your desk. Plug in earbuds to move while the call takes place.

3. Take Movement Breaks 

Use your breaks to walk around and help avoid staying sedentary. It’s okay to start small and work your way up to longer breaks. This might look like walking up and down your stairs, around your office, or going for a quick stroll outside. Use your best judgment to find out what type of movement you like the most.

4. Stretch During the Day 

Plug in a quick and easy stretch when you wake up, take your lunch break, or take a few minutes in the middle of your day. Here’s a link from healthline for an easy five minute stretch.

 

Stretching can help you recenter and refocus, boosting your productivity during the day. 

5. Take Walks

Working straight throughout the day without breaks isn’t healthy or productive. Schedule time to take a quick walk.

6. Keep Yourself Hydrated 

While you’re reading this, drink a glass of water. Staying hydrated is great for your health and refilling your water bottle forces you to get up and move. 

7. Set Timers to Stand and Move  

Yes, it’s easy to start on a project and then look up only to realize a few hours have flown by. During that time, you were probably sitting hunched over your laptop or workspace.

 

So, consider setting a timer on your computer, phone, or watch to remind yourself to get up and move!

A Final Note

Adding walking as a healthy habit can take time and practice. It’s okay that it may not come naturally or immediately. As you slowly integrate it into your life, have patience if it doesn’t happen immediately. Little movements daily will benefit your health in the long run.

 

Did you know that people who use their health insurance are healthier than those who don’t? Read the different minimum essential coverage options available to you to continue making health habit choices. 

 

Sitting has been dubbed the “new smoking.” Add walks throughout your day to combat the negative effects of a sedentary life.

Original article published on SBMA Benefits. 

Applicable Large Employers (ALEs) are businesses that have at least 50 full-time, or full-time equivalent employees in one calendar year. Under federal law, they must provide at least 95% of their employees and their children up to age 26 with Affordable Care Act (ACA) compliant coverage. 

 

Why? Because the ACA was designed to make healthcare services affordable to more people. 

 

Businesses that are considered ALEs that fail to meet ACA requirements will end up paying fines and penalties by the Internal Revenue Service (IRS). These fines can range from $300 – $4000 per employee who is not offered ACA compliant benefits.

 

Minimum Essential Coverage (MEC) is one of the most comprehensive and affordable ACA-compliant plans employers can provide to their workforce. Basic benefit plans meet the minimum ACA requirements while simultaneously supporting a healthy workforce

 

As we look to the next year, it’s important to understand how changes in insurance and federal law may affect their ACA compliance. What does a business owner need to look out for in 2022 to remain ACA compliant?

Look out for Increased Insurance Premium Costs 

First and foremost, health insurance premium costs are increasing for business owners this year. The baseline for affordability percentage, or the maximum percentage of an employee’s income they can contribute to their employer-sponsored self-only coverage, has lowered, therefore there is a greater cost to the business owner. 

 

In 2021, the affordability percentage was 9.83%, however, the threshold for 2022 is decreased to 9.61%. 

What does this mean for business owners? 

Business owners who provide ACA-compliant benefits to their employees will now have to cover the difference between last year’s and this year’s affordability threshold. 

 

If an employee makes $40,000 a year, they could only contribute a maximum of $3,932 towards health coverage plans in 2021. That same employee can now only contribute $3,844 per year in 2022. The employer is now responsible for the $88 difference. 

 

The lowered affordability threshold makes healthcare more affordable for employees but will be an additional financial responsibility for employers. 

Understand the American Rescue Plan (ARP)

The American Rescue Plan (ARP), created by the Biden Administration, was built to lower insurance premiums for lower and middle-income families. It temporarily reduced the affordability threshold to 8.5%. 

 

These lowered premiums contributed largely to this enrollment season’s record-breaking number of people enrolling in health insurance. 

Evaluate Grandfathered Group Health Plans 

Health plans are considered grandfathered plans if they existed and have covered at least one person as of March 23, 2010. These plans do not have to comply with certain ACA rules. Some plans may lose their grandfathered status if specific changes are made to reduce benefits or increase costs to employees or dependents. 

 

As a business owner, it’s important to look for those grandfathered plans that may have lost their grandfathered status. Ensure all elements of the plan design remain ACA-compliant. One specific area that grandfathered plans may not include in the latest ACA requirements is preventative services without cost-sharing.

 

It’s also important to keep records that document the plan’s terms that were in effect on March 23, 2010. This helps to verify existing grandfathered plans. 

Review Plan Documents for Changes 

Plans undergo changes over time. Review any changes to make sure your plan documents are aligned with any changes– new and old. 

 

All group health plans must:

Ensure waiting periods are met

The waiting period is a period of time that must pass before coverage is effective for an employee or their dependents. This waiting period must not exceed 90 days.

Confirm annual dollar limits are not covering essential health benefits 

The essential health benefits are the services that must be covered under the Affordable Care Act. If the plan you’re using limits the number of visits to health providers or limits the days of treatment, you must verify that the visit/day limit does not amount to a dollar limit.

Verify there are not any pre-existing condition exclusions 

Exclusions for pre-existing conditions cannot be imposed on any individual, regardless of their age. 

 

Unless there are certain HRAs, make sure there is not an employer payment plan in place.  

Lastly, as an employer offering ACA-compliant benefits, it’s important to ensure that there are not any employer payment plans in place. These payment plans are used by an employer to reimburse employees for some or all of the premium expenses for their health insurance policy. 

 

Non grandfathered group health plans must: 

Make sure out-of-pocket costs for essential health benefits don’t go over $8,700 for individuals and $17,400 for family coverage.

Give Employees and Dependents Required Notices 

Be aware of the required notices employees and their dependents might receive so you are prepared to submit these notices appropriately. 

 

Employees and their dependents must receive the proper notices such as: 

 

  • Health insurance exchange notice: written notice related to the Health Insurance Marketplace for all new employees within 14 days of their start date.
  • Summary of benefits and coverage: Confirm the contractual arrangement with your carrier to a third-party administrator and any notice of plan changes no later than 60 days prior to the effective date of the change.

Be Aware of “Pay or Play” Responsibilities 

ALEs, as mentioned before, are responsible for providing employees with healthcare benefit coverage options. Make sure you know your business’s status as an ALE, and that you are complying with the rules and regulations. 

 

If you know your status as an ALE, revisit the type of group health plan coverage you’ll offer your full-time or full-time equivalent employees

Prepare forms 1094 and 1095

Each year, the IRS requires ALEs to send their employers 1094 and 1095 documents to fill out to make sure their employers are complying with ACA requirements. It also helps the IRS ensure ALEs are offering coverage, and verify the type of coverage they are offering. 

 

The forms for the 2021 calendar year are due in early 2022. Fill them out early and accurately to avoid missing any information. 

 

Learn more about forms 1094 and 1095 here. 

Other Updates to Review

Depending on the employer and the health plan, other action item updates might need to be reviewed. The list below outlines certain actions employers might need to take to continue being compliant with ACA regulations in 2022. 

 

  • Medicare Tax for High Earners should be withheld (0.9%) from employees who make $200,000 or more in a calendar year
  • Monitor the coverage of preventative services guidelines 
  • Distribute the medical loss ratio rebate as appropriate 
  • Employers who have certain self-insured health plans must report and pay Patient-Centered Outcomes Research Institute (PCORI) fees by July 31st, 2022
  • Report health coverage costs on W-2 forms 
  • Confirm compliance with Section 1557 Nondiscrimination requirements if applicable. 

 

For more information about ACA compliance, and how to avoid the fines and penalties associated with being uncompliant, read our article, here.

business owners need to be aware of ACA updates this year

 

Article originally published on SBMA Benefits

Preventative care is the measure you take to prevent illness or disease before it grows into a more difficult problem. It can include:

  • Physical exams
  • Immunizations
  • Screenings

Preventative Care 

Encouraging preventative care benefits your company short and long term. When employees have access to resources to support their wellbeing, they are able to utilize them to continue on a healthier trajectory to be more present and engaging during day-to-day tasks.

If an employee uses the benefits and goes to their annual physical exam, they have a baseline of health. This results in employees becoming aware of chronic issues that need to be monitored. Physical exam visits are opportunities for your employee to ask their healthcare provider questions about their health, along with gaining tips on how to live a healthier lifestyle.

If said employee is diagnosed with high blood pressure at this office visit, their healthcare team will take preventative measures to ensure they stay healthy. If this same employee did not attend the preventative visit, the undiagnosed high blood pressure will continue to go unnoticed and could lead to a heart attack or stroke.

If your employee attends the visit and receives proper care, you have an employee who takes less sick leave down the line. On the other hand, if your employee was not encouraged to take preventative healthcare measures, they could end up suffering from a heart attack or stroke. This case ends up requiring your employee to take time off to heal and recover and less time at work. Preventative care increases overall productivity in the workplace.

Preventative care also covers immunizations and vaccinations like:

  • Influenza
  • COVID-19
  • Tdap

This promotes overall wellness for employees because they will be less susceptible to diseases and illnesses. This allows them to spend more time continuing the success of your business.

Around 50% of people without health insurance plans went to an annual physical. Without insurance, physicals can cost up to $300. Imagine half of your employees falling ill and needing to take leave due to worsening unseen underlying conditions.

Benefits for You 

Providing affordable healthcare for employees reduces the stress associated with healthcare, like expensive medical bills. Additionally, when employees and their families are healthy, they miss fewer workdays to tend to their medical conditions, resulting in overall increased productivity for your business.

Employees who are supported through covered preventative care gain access to resources that combat preventable illness and are more likely to be positive, engaged, and determined to do their best at their place of work.

Investing in your employees is a critical entity in the ongoing success of most businesses. Offering a comprehensive health plan to employees not only helps attract and retain talent but supports their general well-being.

Employees that are taken care of are more likely to invest themselves in your business. If you’re looking for a great health care benefits plan to offer your employees, look no further.

At Innovative HIA, our goal is to provide affordable health coverage to help keep your employees healthy and promote their overall well-being. If you’re interested in offering our benefits to your team, call or contact us today.