Individual Coverage

Penalty & Exemptions

The End is Near…for 2015 Open Enrollment.

Another update from the HR jungle….
image017Walter owns a restaurant and catering business with 25 employees, most of them part-time. The hours can be brutal and the pay is low. Walter wishes he could pay more but in the competitive market he faces that’s not an option.

He can’t afford a group health plan for even his handful of full-time employees. Instead, he has encouraged his employees to sign up for coverage through the Exchange, also called the Marketplace. He thought some of his employees would qualify for a subsidy to help pay their premiums. Last year many of the employees decided not to buy individual health policies for a variety of reasons, including needing the money to pay bills. Now these employees will be assessed the penalty because they also didn’t try to qualify for an individual exemption.

Walter knows that he has no legal obligation to help his employees with health insurance. But he wants to help his employees because it’s the right thing to do. Walter is thinking about how to make one last effort to encourage his employees to sign up for coverage before open enrollment closes on February 15th.

What options are available to Walter?

  1. Walter can remind his employees that open enrollment closes in about 2 weeks. He can encourage them to go on-line to healthcare.gov or see an insurance agent.
  2. Walter can invite a health insurance agent to his restaurant to meet with his employees before or after their work shifts to sign up for coverage.
  3. Walter can remind his employees that they may be able to qualify for an exemption from the penalty, such as a hardship exemption due to low income.

Need help with HR issues? Corporate Compliance Risk Advisor can help you create HR policies that are appropriate for your company’s size and then serve as a resource to your staff when the policies are implemented.

Join the HR Compliance Jungle today. Click here!

Follow us on Facebook & Twitter!

Visit us: http://www.complianceriskadvisor.com/

Advertisements

Time & Money

Another update from the HR jungle….

image007

Back in December, Sue, the HR director, decided she needed to review the employee handbook to ensure that all the information is still accurate. Now that her rum hangover from her cruise is gone, she’s focusing on this project.

Sue revised individual sections of the employee handbook over the past two years as the laws changed. For example, she changed the definition of employees eligible for health insurance. Under the old criteria, employees had to work at least 32 hours a week to be eligible. But under the Affordable Care Act (ACA), employees who average 30 hours per week are eligible for health coverage.

Of course, this piecemeal approach means that she may have missed something. She also knows that her company added employees since the handbook was last updated and she thinks that the increased number of employees means that additional employment laws now apply to the company. As she surveys the scope of the project, Sue worries about how she’ll manage to review and update the handbook while still keeping up with her regular duties.

What are Sue’s options?

  1. She can research federal and state government websites to collect information about employment laws and regulations that apply to employers with the number of employees that her company has.
  2. She can attend a seminar for HR professionals to learn about recent changes to federal and state employment laws, although the update won’t include existing laws that haven’t been revised and that may apply to her company.
  3. She can convince her employer that it is a better use of her time and their money to outsource this project to a subject matter expert.

Need help with HR issues? Corporate Compliance Risk Advisor can help you create HR policies that are appropriate for your company’s size and then serve as a resource to your staff when the policies are implemented.

Join the HR Compliance Jungle today. Click here!

Follow us on Facebook & Twitter!

Visit us: http://www.complianceriskadvisor.com/

 

Be Kind, Not Nice.

Another update from the HR jungle….

image012

“Be kind, not nice” is a favorite saying of one of my friends. Consider what that means for employers and their employees.

Leslie’s company has less than 50 employees, so the Family Medical Leave Act (FMLA) does not apply to her company. This fact became important yesterday when Beth revealed that she has breast cancer and needs extended leave while she undergoes treatment. Beth also says that she wants to return to work full-time after completing her initial treatment.

Leslie counts Beth as a personal friend as well as an employee and wants to help. Beth was one of the first employees she hired and has always been a stellar performer. But Leslie knows that if Beth is granted extended leave, other employees will demand the same treatment later. She also worries that her staff is too small to cover for an employee who is absent for an extended period of time.

Leslie considers her situation and how she can be kind, but not nice to Beth. What options are available to Leslie?

  1. She can be kind to Beth by offering support as a friend and accommodating Beth’s treatment schedule as much as reasonably possible without disrupting the company’s work flow.
  2. She can protect her company by documenting the business reasons for making an exception to the leave policy for Beth. For example, Beth’s work performance and length of service could justify making an exception to the leave policy.

Distinguishing kind from nice may not be easy particularly when creating HR policies. Corporate Compliance Risk Advisor can help you separate kind from nice in your employee practices with HR policies that are appropriate for your company.

Join the HR Compliance Jungle today. Click here!

Follow us on Facebook & Twitter!

Visit us: http://www.complianceriskadvisor.com/

 

Doing the Right Thing under the ACA.

Another update from the HR jungle….

Cindy owns a small business that has 6 employees. She would love to offer health insurance to her employees but has found it too expensive in the past. Instead, she raised wages slightly and encouraged her employees to buy individual coverage.

When Cindy first heard about the Affordable Care Act (ACA or Obamacare) she was excited about the possibilities. Early reports were that small employers like her company might finally be able to afford a group health plan. The Small Business Health Option Program (SHOP) would have standardized plans, making it easier to compare coverage. The SHOP was also supposed to allow small employers to offer more than one health plan option to employees.

Alas, the SHOP is part of the Healthcare Exchange or Marketplace. The roll out of the Individual Exchange was such a mess that all the most attractive features of the SHOP were delayed. Another year has gone by and open enrollment in (and outside) the Exchange will soon start. Cindy is pondering her choices.

What options are available to Cindy?

1. She could work with her insurance agent to apply for a group health plan via the SHOP, even though the coverage options are limited.
2. She could work with her insurance agent to apply for a group health plan outside the SHOP where there are more coverage options available from more insurers.
3. She could continue doing what she currently does, which is to increase her employees’ pay and encourage them to obtain individual coverage.

Is your company struggling to understand how the ACA will affect the employee group health plan? Corporate Compliance Risk Advisor can help you grasp the basics of the ACA and how it affects an employer of your company’s size.

Join the HR Compliance Jungle today. Click here!

Follow us on Facebook & Twitter!

Visit us: http://www.complianceriskadvisor.com/

Pay Raises v. Health Insurance

Another update from the HR jungle….

Pete has a small company with 12 employees, many of whom are also related to him. Running a business with lots of family is not easy. (Who knew that Aunt Martha’s feud with Uncle Les would still be an issue after 50 years?) Pete figures the best way to keep everyone happy is to offer good pay and benefits.

One of the benefits he’s always wanted to offer is a group health plan. Pete gave up on a group plan for employees after his nephew had surgery and the rates on the group plan shot through the roof. Back when employees were risk-rated based on health factors, his nephew and a couple of other less healthy employees guaranteed that the premium increased dramatically each year.

Pete knows that under the Affordable Care Act (ACA or Obamacare) small group plans with less than 50 employees are no longer risk-rated. Instead, the premium is based on the age of each participant, geographic location, family size (number of individuals covered), and tobacco use. So Pete decides to ask his insurance agent for a quote on a group health plan for his employees.

Pete gets sticker shock again when he sees the amount of the premium. He knows that he simply can’t afford to offer a group health plan. Still, he wants to do something for his employees.

What options are available to Pete?

1. He can tell employees that no pay raises will be given this year so that he can offer a group health plan.
2. He can go ahead with his plan to give pay raises and let his employees buy individual health policies. He hopes some will qualify for the subsidies offered by the Healthcare Exchange (a/k/a Marketplace).
3. He can give each employee a set amount of money, in lieu of a pay raise, that would cover employee-only health insurance on a low cost bronze plan (bought via the Exchange or directly from the insurer).

Is your company struggling to understand how the ACA will affect the employee group health plan? Corporate Compliance Risk Advisor can help you grasp the basics of the ACA and how it affects an employer of your company’s size.

Join the HR Compliance Jungle today. Click here!

Follow us on Facebook & Twitter!

Visit us: http://www.complianceriskadvisor.com/