13 Dec Q&A on Group Benefits
Q&A with Shemeka Browne-Pohlman, ACA Compliance Specialist
With a new fiscal year fast approaching, nearly every business owner is dealing with some level of planning. At ICNE, we understand that making sure your employee benefits program is prepped for the new fical year 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 planning process easier for you! We sat down with Shemeka Browne-Pohlman to get some of your most important questions answered.
Q: Please tell the reader a little bit about yourself.
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: What words of wisdom would you like to give a business owner or a benefits manager who is preparing for a new fiscal year?
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. 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.
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?
ACA Compliance Specialist
Shemeka: Some companies may be in the middle of open enrollment period right now. 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, the 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 in the marketplace and decide if you want to stay put with your employer’s plan or make a switch.
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.
Q: Do you anticipate any changes in the employee benefits landscape in the coming year?
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.
Q: With a new fiscal 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?
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.