Q&A on Group Benefits

Q&A on Group Benefits

Q&A with MaryLynn Murray, VP of Commercial Lines and Benefits, & Shemeka Browne-Pohlman, ACA Compliance Specialist

With a new year fast approaching, nearly every business owner is dealing with some level of end-of-year craziness. At ICNE, we understand that making sure your employee benefits program is prepped for year-end is just one of many areas you and your staff are trying to be on top of. As your knowledgeable and experienced group benefits insurance professionals, we think we can make at least this part of the year-end process easier for you! We sat down with two of our Group Benefits team members to get some of your most important questions answered before the ball drops this New Year.

Q: Please tell the reader a little bit about yourself.

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MaryLynn Murray
VP of Commercial Lines and Benefits

MaryLynn: When I came to ICNE in 2012, I already had about a decade of experience in the insurance industry. Our owner, Bill Trudeau, put me in charge of ICNE’s sales team and then, in 2014, he asked me to take over the benefits and commercial insurance divisions as well. As VP, I am responsible for all commercial lines and employee group benefits business and for cultivating and maintaining strong relationships with insurance carriers, which number close to 90 partnerships currently. I feel very lucky to work with the most incredible people here at ICNE. Each person on my staff is truly a team player, has such an incredible work ethic, and is highly knowledgeable. But most of all, my team members have such empathy for our clients. Especially when a business owner, HR manager, or employee is struggling with an issue – whether it be a claim, an increasing workers’ compensation modification factor, or rising costs of employee benefits programs – my staff is going to do everything they can to help you.

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Shemeka Browne-Pohlman
ACA Compliance Specialist

Shemeka: I have worked at ICNE for almost nine years in Group Benefits. Over time, and based on the needs of the marketplace, our team’s responsibilities have grown from sales, to account management and servicing, to HR and ACA compliance support, to now starting to branch into overall benefits compliance. I was asked to take on the ACA – or Affordable Care Act – Compliance Specialist role in 2014. This is a relatively new position for health care professionals, so I wouldn’t be surprised if some people are not familiar with the job role, which is to help organizations conform to ACA regulations. To prepare for such a critical task, I participated in extensive training, including the NAHU PPACA certification, which is a high-level 10 module course aimed at teaching students the key technical components of the Patient Protection & Affordable Care Act (PPACA) and how to counsel clients on upcoming required healthcare changes and new options and requirements for health plans. This certification is not required by most companies in order to hold this role, but it was important to both myself and ICNE’s senior leadership that I be as thoroughly educated as possible on the PPACA. By far the most rewarding part of my job is my one-on-one work with ICNE clients. I have a heart for serving others and so I get the most satisfaction from being able to give knowledgeable advice to businesses and their employees on compliance, benefits, and claims.

Q: With just a few weeks left to 2017, it’s clear to all of us that not only is winter coming, but also that end-of-year cometh as well! What words of wisdom would you like to give a business owner or a benefits manager who is preparing for year-end and the beginning of 2018?

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Shemeka Browne-Pohlman
ACA Compliance Specialist

Shemeka: Right now, it is a particularly busy time for companies that are considered an ALE – or applicable large employer – under the ACA. Businesses that are ALEs are most likely in the midst of trying to prep all the forms that need to be distributed to their employees by January 31st. These include, but are not limited to, your 1095s, which are forms that are similar to a W-2, but rather than reporting an employee’s annual earnings, they show each employee’s health care coverage throughout the year. In addition, if you are an ALE, you want to make sure you have your 1094 ready to file, which is a cover sheet for all those 1095s.

Most of ICNE’s clients that are ALEs have made the wise decision to work with their payroll vendor to do the majority of form prep for them. However, I cannot stress enough that, even if a company is working with a payroll service, it’s essential for the business owner and/or benefits manager to stay actively involved in the process. Keep your eye out for critical reminders from your payroll vendor, like when it’s time to purchase the appropriate modules for year-end reporting and when you need to finalize any updates so that your vendor can get forms ready and printed. You should also know exactly what’s on these forms and what differences there are in forms from year-to-year because your employees are going to come to you with questions and you need to be able to answer them knowledgeably. Also, make sure to review all forms with your payroll vendor before they are processed and handed out to employees.

Another area that ALEs need to be mindful of as related to year-end benefits assessments is making sure that their plans are considered affordable under the ACA. Specifically, you need to ensure that the cost of the health benefits plan for single coverage does not exceed 9.69% of the employee’s household income. It’s critical to work with your payroll partner to solve any affordability issues.

As an ICNE client, you would receive regular communications from me related to this benefits process, including when forms are available. I am also very happy to sit with any client to go over questions and challenges, and can offer guidance on what to do if an employee’s plan is not showing up as “affordable”. In addition, we regularly work with employer groups that are just now coming under ACA requirements due to an increased number of hires. It is my job to make sure that employers and employees are as comfortable as possible with what they need to do to stay on track with ACA regulations.

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MaryLynn Murray
VP of Commercial Lines and Benefits

MaryLynn: It’s also a hectic time of year for any business that might have an employee benefits program renewing on January 1, 2018. On top of all the other demands of year-end, now this employer is working through open enrollment period, distributing medical cards to all employees, getting staff set up with HSAs, and much, much more.

As your renewal date approaches, you will want to plan to gather your employees for open enrollment meetings. At ICNE, we suggest scheduling this session about a month out. So, for a January 1st renewal date, early December – basically right now – is a great time for these informational get-togethers. This is an important face-to-face with your employees as it is your opportunity to go over the plan options, benefits, and any changes taking effect in the coming year as well as to field questions from your workers. Be prepared to address some of the most common employee concerns like changes to the deductible and increases in prescription co-pays or specialist’s fees, just to name a few. Also, these meetings give you a platform to introduce your employees to any new benefits offerings for 2018.

Even if your company is staying with the same insurer in the coming year, and there will be no changes to your employee benefits plan, ICNE believes it is still a smart idea to take advantage of the renewal period to pull together your staff and review their benefits with them again.

If you are an ICNE client, our Group Benefits team can provide a significant amount of support during open enrollment, whether you’re in the process now or planning for it in the coming year. We are happy to review all aspects of your benefits program with your employees and provide guidance for any questions that arise. It is our goal to educate employees on not only what their benefits provide, but also why health insurance premiums might be going up for them, which is a tough conversation to have if you are the employer. During our conversations with employees, we stress how much of the burden the employer takes on when it comes to health care costs et al. The reality is that there is often not much you, the employer, can do to limit rising premiums, especially if they are a result of an increase in claims. However, there are some key steps employees, themselves, can take to keep healthcare costs affordable. We believe that this straightforward dialogue about rising premiums is one of the things that really sets ICNE apart in the industry.

Q: That’s a lot of great information for employers of all sizes to consider this time of year. What about employees? What could they be doing right now to be a more informed participant in their company’s employee benefits program?

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Shemeka Browne-Pohlman
ACA Compliance Specialist

Shemeka: As MaryLynn was saying, some companies may be in the middle of open enrollment period right now if their benefits program is renewing January 1, 2018. For me, the biggest takeaway for an employee going through this process is that they should be as involved as possible. This is your opportunity to thoroughly review the benefits package that is being offered to you by your employer. It’s also important to know that this is the only time of year you can come onto the plan or change your plan without a qualifying event, like marriage, birth of a child, or a death. In addition, open enrollment is when you will find out if your employer is making any type of change to the benefits plans and how it will impact you.

Even if you aren’t enrolled in your employer’s plan right now, my recommendation is still the same – be informed of what your employer offers. Understanding all your options, and knowing what changes are coming in 2018, might help you make better choices for you, your spouse or your family in the future.

One other thing I’d like to mention is that, in addition to open enrollment period at some companies, employees should know that the health insurance marketplace in your state is now open as well. So, this is your chance to compare what’s available through your employer to what is available on the marketplace and decide if you want to stay put with your employer’s plan or make a switch. If you do take advantage of the marketplace, your coverage would be effective January 1, 2018.

If your employer is an ICNE client, you can expect our group benefits department and our account managers to be there in person at any open enrollment meetings. We are committed to informing you of your benefits options and helping you understand how they work. We are also at these sessions to answer questions and concerns. However, we understand that additional questions may arise after these meetings and/or you may have things you’re not comfortable discussing in front of your coworkers. That’s why our team will provide you with our contact information so you can call us anytime to talk about your benefits. We strive to help all employees have a really good handle on their company’s benefits package and how it can work best for them.

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MaryLynn Murray
VP of Commercial Lines and Benefits

MaryLynn: I just want to emphasize a key point Shemeka has made – the importance of taking the time to learn what your company has to offer you in terms of health plans and group benefits. In particular, if you work for a company that will be changing to a new insurance carrier for any reason, then it’s essential that you understand how this transition will affect you and your health plan. Your new insurer will provide you with several plan options to select from and it’s critical for you to weigh the pros and cons of each. You should ask yourself how much you want to put towards health insurance on a monthly basis, how much deductible feels comfortable, and how much you think you can afford to pay out of pocket for things like prescriptions, medical visits, and emergency care. I encourage employees to take advantage of any and all information sessions their company holds because these workshops should help them sort through the different plan options being offered. Also, by understanding what your employer is offering for health insurance and group benefits, you will be much better prepared for – and not surprised by – any expenses you have to cover in the case of an emergency or unexpected health-related situation.

Q: Do you anticipate any changes in the employee benefits landscape in the coming year?

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Shemeka Browne-Pohlman
ACA Compliance Specialist

Shemeka: Looking ahead to 2018, we encourage employers to remain flexible and open-minded in regard to cost containment and new options to aid you in managing the premiums for health care and other group benefits.

We continue to keep our eyes on consumer-driven health care options such as Health Savings Accounts (or HSAs), which are tax-advantaged medical savings accounts. Currently, HSA funds may be used to pay for qualified medical expenses at any time without federal tax liability or penalty. However, in order to contribute to an HSA, the employee must also be enrolled in a qualified high-deductible health plan (QHDHP), which has its deductible limits determined by the IRS.

Another type of health insurance account that we are closely watching for 2018 is the Health Reimbursement Arrangements (or HRAs). Unlike HSAs, which are owned by both the individual employee and the employer, HRAs are solely company-owned and can be paired with either QHDHPs or standard health plans. Currently, you can use HRA account funds to pay your health plan deductible and/or qualified medical expenses. Right now, these accounts are a hot topic because President Trump’s administration is assessing the way the funds in HRAs are used. While we can’t give any definitive information at this time on what will happen with HRAs, you can count on ICNE to alert you to significant changes that might affect your business. In fact, if you are an ICNE client, you already received a compliance bulletin from me stating the facts about Trump’s HRA-related executive order.

Our Group Benefits team also understands that an email blast is not always the best way to address a major change in health care and group benefits that we see coming down the pike. So, at least a couple of times a year, we host an educational breakfast or lunch on a specific topic that is of interest to our clients. Whether it’s the impact of the legalization of marijuana on the workplace or the financial effect of the Employer Medical Assistance Contribution Supplement (EMAC), the ICNE group benefits team stays up to date on the most relevant issues and holds events to inform, educate, and field your questions. Our mission in holding these meetings and sending out regular communications is to provide our clients with the help they need in order to have a game plan in place for whatever might be coming in the future.

At the end of the day, there is a lot still up in the air as far as what will happen in 2018. We do our best to be proactive by monitoring possible changes and filtering out those things that are really important for our clients to know about.

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MaryLynn Murray
VP of Commercial Lines and Benefits

MaryLynn: The biggest question on every business owners’ minds I’m sure is, “What can I do about increasing healthcare premiums?” We meet with current and prospective clients who tell us that one of their top concerns is how to contain the double-digit increases in their group health benefits program costs. Unfortunately, even if you have a workforce that is in tiptop health, you can still experience rising insurance costs. The average percentage increase is 9% and anything less than this is an outstanding achievement in this day and age.

Implementing HSAs and HRAs are other ways that businesses can contain health care costs while at the same time supporting their employees’ health and wellness needs. For instance, many employers are having to choose a qualified high-deductible health plan in order to manage the rising cost of their insurance premiums, but by setting up an HSA option for employees, they feel they can make up for the increased deductible. With an HSA, the employee owns the account but they can both put money into it. As an employer, you could decide to contribute money to each employee’s HSA to offset the higher deductible and yet still save the company money in the long run. HRAs are another health account option that can assist with deductible and qualified medical expenses; however, only the employer can contribute. Again, many of our clients are using these accounts to offset a higher deductible and expenses that might fall on employees, but are simultaneously reducing costs for the company.

Finally, no company should overlook the benefits of implementing wellness programs in the workplace. Whether you simply leave out a bowl of fresh fruit or start a walking club during lunch, or do something a little more extravagant like give everyone a Fitbit and have team challenges, or maybe even schedule a Weight Watchers coach to come in and hold monthly meetings, all these actions will encourage people to be healthier. This wellness culture can lead to better results at annual physicals and fewer claims, which, ultimately, will keep the costs of your health insurance premiums lower.

Q: With the new year approaching, some business owners and benefits managers may be thinking about making a change in who they work with on their group benefits programs. Why should they consider working with ICNE?

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Shemeka Browne-Pohlman
ACA Compliance Specialist

Shemeka: The entire ICNE Benefits Group is always committed to going the extra mile for our clients. We all strive to make sure that we are doing everything within our power to stretch our clients’ benefit dollars, assemble the best employee package that we possibly can, and, subsequently, help them improve employee retention and their employees’ health and happiness. It’s never a bother when our customers contact us – any and all questions are always welcomed and treated as important, because they are important. While health care plans and employee benefits programs, on the surface, may seem like a dollars and sense issue, it’s much more emotional than that. We understand that we are helping employers and employees find the best way to protect their own health or their spouse’s health or their child’s health. So, we take our responsibility as your insurance professional very seriously. If an employer really wants to get to know us and what sets us apart, I really encourage them to contact us for an in-person meeting.

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MaryLynn Murray
VP of Commercial Lines and Benefits

MaryLynn: One of the reasons clients choose to work with us is that we are always thinking ahead and helping you strategize your group benefits plan. For example, when it comes to renewals, we are sitting down with you in advance, looking at what the increase in premiums might be, and combing through your plan to figure out how we can limit your costs. Our team will spend a significant amount of time on customizing your plan, arguably more than most others in the industry would do, and invest even more effort in educating your employees on their options.

Another benefit of partnering with ICNE is that we take a lot of things off your plate, whether you’re the business owner or benefits manager. When you have a new hire, we are here to help you get the new hire up and running. Or when an employee has a life change – a baby, a wedding, or a death in the family – we’ll assist them in choosing the right benefits plan for their new situation. You can also use us as a resource for any questions that arise about ACA, COBRA, or forms like the 5500, or anything else you need.

As the Vice President of Benefits, I take great pride in the excellent communication our team has with each and every client, not only during your renewal period, but throughout the year. Our doors are always open to Human Resource managers, executive directors of not-for-profits, business owners who have questions for us, prospective clients. We also offer HR consulting for free, so if you are a smaller group that doesn’t have an HR manager, or you have one that is understandably overwhelmed, we are glad to meet face-to-face or hop on the phone to lend our support and guidance.

I would also like to mention that in the industry, ICNE is uniquely positioned to help not-for-profit and human services businesses. Over the years our clientele in this area has grown substantially, and many of these employer groups have joined us after working with our competitors and finding that they just weren’t getting attention because they were under 100 employees. At ICNE, we give these companies – just like all of our clients – the TLC they deserve.

Lastly, as Shemeka spoke of, it’s the people on our Group Benefits team that really distinguish ICNE from the competition. They are all extremely knowledgeable and, honestly, I believe they are the best in their field. We also take a truly unique team approach to our work. You will always have a lead person – what we like to call the “quarterback” – assigned to your account. This will be the primary workhorse getting things done for you and making sure nothing falls through the cracks. However, Shemeka, Steve, and Val work together as a team and have adopted a “next man up” mentality. If one of them is not available, then there will be someone else who can step up and answer your question and be here to support you. When you partner with ICNE, you will get to know everyone in Group Benefits and they will get to know you.

We hope this Q & A with members of the ICNE Group Benefits team has been helpful to you and we’d love to hear from you with your comments or questions. Feel free to call us at (800) 243-8134 for more information about year-end benefits planning or to set up a meeting to discuss ICNE’s group benefits insurance offerings.

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