by John Harman, CEO and Founder, Integra Insurance Solutions
When deciding whether to switch from a client-sponsored plan (CSP) to a master medical plan, there are many factors a PEO should consider. First, why do it? Most switch for administrative ease—one renewal instead of many. A second reason is to streamline plan design offerings versus countless options in the open market. Large group pricing is typically more favorable than Affordable Care Act (ACA) coverage, with average savings of 6 to 8 percent and the ability to evaluate or review. These are all good reasons to make the move, but unfortunately getting a master medical plan isn’t always easy. This leaves many PEOs to ask, “How do we best position ourselves for success?”
Sins of the Past
In “The Seven Habits of Highly Effective People,” Stephen Covey writes, “Seek first to understand and then to be understood.” To understand why carriers are reluctant to write master plans for PEOs, let’s look at industry history. In the early to mid-1990s, PEO health plans were more prevalent and had little structure. Many PEOs had little or no risk management and offered only a single set of composite rates. For these PEOs, risk grew and rates increased over time. Eventually, many PEOs were only attracting or retaining high-risk groups. Consequently, plans went into a death spiral of increasing rates and higher risk groups, many times leaving the carrier with large claims. In response, carriers shied away from writing new risk and began carefully managing the risk they already had on their books. By the early 2000s, many PEOs moved to a tiered composite set of rates and began using models that improved performance. Still, carriers were wary of the past and cautious with new business opportunities. To address this, many carriers established dedicated PEO teams and criteria to measure risk for those seeking master medical plans. So, what are those criteria and how do you make your PEO stand out?
When the ACA passed in 2010, many speculated how it would affect group medical insurance for the small groups PEOs serve. [Please click "Read More" to continue reading]
On March 6, 2017, Republican leadership in the U.S. House of Representatives issued two bills to repeal and replace the Affordable Care Act (ACA) through the budget reconciliation process. These bills, which were issued by the Ways and Means Committee and the Energy and Commerce Committee, are collectively known as the American Health Care Act.
To become law, these bills must go through the legislative process, although a budget reconciliation bill can be passed with a simple majority vote. Debate on the legislation is scheduled to begin on March 8, 2017.
If enacted, the new law would not repeal the ACA entirely, although it would make significant changes to key provisions.
The ACA’s employer and individual mandates would be repealed retroactively beginning in 2016. Key consumer protections, like the ACA’s prohibition on pre-existing condition exclusions and dependent coverage to age 26, would remain intact.
Click the link below to download a PDF with more information, including a summary of the bills’ important provisions.
Here's a great article outlining some key points about life insurance from Forbes. Life insurance should be an essential piece of your comprehensive financial plan.
If you have questions or would like to discuss further, please feel free to give me a call.
In 2016, the Equal Employment Opportunity Commission (EEOC) resolved more than 97,443 workplace discrimination claims—securing more than $482 million from employers in the private and public sectors as a result of these claims. Discrimination lawsuits can be very time-consuming and expensive for employers, and can result in a loss of employee morale or reputation within the community.
Top Causes of Decimation Claims
According to the EEOC, the following are the top 10 reasons for workplace discrimination claims in fiscal year 2016:
1. Retaliation—42,018 (45.9 percent of all charges filed)
2. Race—32,309 (35.3 percent)
3. Disability—28,073 (30.7 percent)
4. Sex—26,934 (29.4 percent)
5. Age—20,857 (22.8 percent)
6. National origin—9,840 (10.8 percent)
7. Religion—3,825 (4.2 percent)
8. Color—3,102 (3.4 percent)
9. Equal Pay Act—1,075 (1.2 percent)
10. Genetic Information Nondiscrimination Act (GINA)—238 (0.3 percent)
These percentages add up to more than 100 percent because some lawsuits were filed alleging multiple reasons for discrimination.
Retaliation lawsuits are brought after an employee alleges an employer has fired, demoted, harassed or otherwise retaliated against him or her for filing a charge of discrimination or assisted with a job discrimination investigation or lawsuit. Retaliation claims are the most frequently filed charge of discrimination.
The number of retaliation lawsuits may continue to rise in the future due to new regulations proposed by the EEOC. On Aug. 29, 2016, the EEOC released a subregulatory document that provides guidance on its view of what constitutes actionable retaliation.
For instance, the document broadens what constitutes a “causal connection” between protected activity and adverse action. It says “protected activity” can occur explicitly or implicitly, and expands the definition of an “adverse action” to include anything that could reasonably deter protected activity, even if the action does not have a tangible effect on an individual’s employment.
What Employers Should Do
Employers should take the following steps to protect themselves from retaliation and other discrimination claims:
For more information on discrimination claims and for tips on how to protect your business, contact us today.
This HR Insights blog post is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice.
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