health plan

I’m Not Crazy!

Mental Health1Andrea is a lawyer in the corporate legal department of a major company.  She’s never quite fit in with the rest of the department and tends to work alone rather than as part of a team.  She gets the assignments the other lawyers don’t want.

Over time, feeling isolated and unwanted, Andrea’s confidence drops and the quality of her work slides.  She thinks about calling the employee assistance program (EAP) but she’s paranoid that her boss will find out and it will be a mark against her.  So she slogs along feeling unwanted and unappreciated.

Her lowest point comes when an executive chews her out in front of the whole department accusing her of misreading a paragraph in a contract that he wants to cancel.  When Andrea protests that she wasn’t asked about how to cancel the contract, the executive says she’s incompetent and ought to be fired.

On the way home that day, Andrea buys supplies at a local craft store to build a piñata. That evening she creates the piñata and writes the executive’s name on it. Then she beats the piñata to a pulp with her tennis racket.  After that, she has a glass of wine and some dark chocolate.

Mental Health3But wine and chocolate can’t solve every problem. Andrea’s morale continues to disintegrate and she becomes deeply depressed. She begins seeing a psychologist for mental health counseling. The counseling sessions help her with personal problems even as her work situation deteriorates.

Eventually, she is fired from her job and she sues the company. The company argues that she was fired for incompetence due to emotional and mental instability. To prove it, they demand details of her sessions with the psychologist. The company argues that it has a right to this information because it paid the insurance premiums for the health plan that covered the psychologist’s sessions.

What should Andrea do next?

  1. She should make a bigger piñata of the executive and buy more wine and chocolate.
  2. She should accept that she’s not crazy; the company was the wrong employer.
  3. She should write an advice book about dealing with egotistical managers and start a new career as a business consultant.

Mental Health4The above scenario is loosely based on a California lawsuit about ten years ago where the company argued unsuccessfully that paying health insurance premiums meant it had a right to know the details of an employee’s mental health treatment. Unfortunately, arguments like the one raised by the California case make it difficult to convince employees to seek mental health treatment from an EAP or their health insurance plan.

If your company is struggling 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 as the policies are implemented.

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It’s Back Again!

Another update from the Jungle….

unnamed (11)Michelle owns a small business of 35 employees that is slowly expanding. She’s ignored the Affordable Care Act (ACA) ever since she realized that her company was too small to be subject to the employer penalty. Besides, she has other concerns, such as finding new markets for her company so that it can continue to grow.

However, her employees like having benefits, including health coverage. Last year, Michelle encouraged her employees to obtain individual health policies because she couldn’t afford a group health plan. Now the issue has arisen again as the annual open enrollment period for the Exchange approaches on November 1st.

Michelle would like to offer a group health plan because she thinks it would be a nice perk for employees. But she’s heard other small business owners complain about increased premium costs.
image038She’s afraid she can’t afford a group plan this year either.

She does a quick survey of her employees. She learns that 15 of them have coverage through their spouses. One employee is an early retiree covered under a former employer’s plan. Another employee is eligible for Medicare. Part-time workers wouldn’t be eligible for coverage in an employer’s group health plan under the ACA rules.

That leaves a grand total of 12 employees who are interested in a group health plan. Of the 12 employees, several could qualify for a subsidy from the Exchange based on their income and family size.

What should Michelle do next?

  1. She can ignore the issue completely since her company is not subject to the employer penalty.
  2. She can ask her insurance agent to give her information on a group health plan option for the 12 employees who are interested in coverage.
  3. She can arrange for an insurance agent to come to her work place to help employees choose individual health policies, through the Exchange or outside the Exchange.

There are no easy solutions for small employers regarding health coverage. Small employers may find that not offering a group health plan actually helps their lower income employees to qualify for a subsidy through the Exchange. On the other hand, any employer offering a group health plan may use a business tax deduction to offset part of the cost of the plan. An experienced insurance agent or producer can help small employers assess their options.

If your company is struggling 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 as the policies are implemented.

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Pay Now or Pay Later.

Another update from the HR jungle….

9098832-a-set-of-tools-for-repairs-vector-illustrationBarb owns a small home repair business with six employees. She pays them wages higher than the industry average so that they won’t defect to larger competitors who can offer more benefits. She’d like to add a group health plan as another incentive to remain loyal to her company.

But, once again, the health insurance quotes Barb received gives her sticker shock. There’s no way she can pay the employer’s portion of the premium for a group health plan. She’s already paying a fortune for her worker compensation premiums.

She knows her employees can’t afford the employee’s portion of the premium on a group health plan. Don Juan Smith’s paycheck is subject to the maximum allowed payroll deductions due to the court-ordered child support he owes to two girlfriends. High Risk Randy’s wages are being garnished for old debts and he’s never paid voluntarily for any employee benefit.

What options are available to Barb?

  1. She can remind her employees that annual open enrollment for the Exchange (a/k/a Marketplace) began on November 15th. They can apply for individual health policies or apply for an individual exemption to the requirement of having health insurance.
  2. She can tell her employees to talk to a health insurance agent about coverage options for the employee or for the employee’s family.

Is your business struggling to understand the Affordable Care Act and how it affects your company and employees? Corporate Compliance Risk Advisor can provide an overview of how the ACA affects employers and employees and answer specific questions you may have.

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