Pet Insurance – A Pet Owner's Best Friend

Animal healthcare costs are rising, with $31.4 billion spent on veterinary visits and care in 2020. Because of this, pet owners tend to go into credit card debt and miss a payment on bills to pay for their pet’s care. In fact, a survey of 1,000 pet owners found that 45% of pet owners spend the same amount, or more, on their pet’s healthcare than they do on their own. 

If your employees have pets, chances are they consider them to be well-loved and beloved family members. Pet insurance may be a benefit you want to offer to your employees.

What is pet insurance, and what does it cover?

Pet insurance pays—in part or total—for veterinary treatment of a person’s ill or injured pet. It covers things like:

  • General wellness exams
  • Booster shots and vaccinations
  • Flea prevention
  • Medical costs for emergency care
  • Chronic conditions (e.g., arthritis)
  • Acute illnesses (e.g., allergic reactions)
  • Acute injuries (e.g., a bone fracture)

What is the main benefit of pet insurance?

Having pet insurance ensures that cost will be less of a factor when it comes to providing pets the best possible care. With the average veterinary visit being between $50 to $400 on average, and the average emergency vet visit costing between $800 to $1500, employees will not have to choose between paying a bill or going into debt to give their pet the care they need.

What are the other benefits of pet insurance?

1. Delivers peace of mind

Not having pet insurance can make employees who own pets more stressed if they don’t know how to pay for their pet’s care, either preventatively or during an emergency. By offering this benefit, employees may be less stressed by this financial burden—and when employees are less stressed, they are more healthy, focused, and productive. Also, research shows owning a pet helps soothe anxiety and reduce blood pressure.

2.  Encourages employees to own pets

Pets are a significant emotional investment and a significant financial investment as well—pets require not only health care but also:

  • Food and treats
  • Dishes for their meals
  • Collars and leashes (for dogs and/or cats)
  • Grooming and nail trimming
  • Over the counter medications
  • Items for mental stimulation (e.g., toys)

For your employees who don’t have a pet but are considering purchasing or adopting one, a pet insurance benefit makes the choice of buying or adopting a pet easier since employees know their pets’ health needs will be a bit easier to manage.

3. Demonstrates to employees that you care

There are pet-friendly hotels, apartments, and restaurants, and by offering pet insurance, you send the message to your employees that your workplace, in this regard, is pet-friendly. You also demonstrate and support the idea that pets are important family members and deserve to be loved and taken care of. That is a genuine, loving, and caring message, which can also positively impact hiring and retention.

Pet insurance—protection for a pet’s wellbeing

By offering pet insurance, you will create a positive relationship with your employees, and they, in turn, will know that their pets can get the best care possible. If you are interested in providing this supplemental benefit to your employees and want to learn more about how it works, talk to a trusted consultant or advisor.

 

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Disability Insurance: Just the Facts

Insurance protects your employees and their families against any unexpected financial losses. Health insurance protects against unexpected health expenses, and life insurance gives your employees’ families financial security after an unexpected passing. But what about disability insurance? What is it, and why is it important to offer to your employees?

Here’s what you need to know about it.

What is disability insurance?

Disability insurance, also known as disability income insurance or income protection insurance, is a type of coverage that replaces a portion of your employees’ income if an injury or illness prevents them from working. Disability insurance:

  • Provides financial security for your employees and their loved ones
  • Gives funds to your employees to use for whatever they like

Is it the same thing as health insurance?

Not exactly. Disability insurance replaces a portion of an employee’s income lost due to not being able to work because of injuries or illnesses. In contrast, health insurance covers medical expenses that arise due to an injury or illness.

What does disability insurance cover?  

While people may think of major injuries as the only thing disability insurance covers, here are just a few of the things disability insurance might cover:

  • Arthritis
  • Back pain
  • Cancer
  • Depression
  • Diabetes
  • Heart disease

It doesn’t mean injuries like sprains and fractures aren’t disabling. What it does mean is the scope of injuries that can prevent people from earning an income is broad.

Why is disability insurance important?

A massive 68% of non-government workers carry no form of disability insurance. With this in mind, here is why disability insurance is essential to offer—and necessary for employees to have.

  • Injuries are all too common: The chance of missing months or years of work seems remote. But more than one in four 20-year-olds will experience a disability for 90 days or more before they reach 67, according to the Social Security Administration. Disability insurance covers those “what-if” or worst-case scenarios. 
  • Disability insurance covers risk: People tend to shrug off the risk because they think only about worst-case scenarios. But the leading causes of disability claims are:
     
    • Pregnancy
    • Cancer
    • Mental health issues
    • Musculoskeletal disorders affecting knees, back, and hips
    • Digestive disorders such as hernias and gastritis
    • Injuries including fractures, sprains, and muscle/ligament strains

Disability insurance covers the risk involved with being affected by injuries, situations, or illnesses.

  • It prepares employees for long-term challenges: It’s common to plan ahead and think about how far you can go without one or two paychecks. However, not enough people plan for possible long-term or future challenges. A study of consumer bankruptcy filings found that the primary reasons for bankruptcy involved illness or injury of themselves or a family member.

Also, workers’ compensation and Social Security do not cover most financial challenges:

Disability insurance gives employees an extra layer of protection to help prepare them and their families for any long-term challenges.

Consider offering disability insurance benefits

Absence of emergency savings and rising medical costs are a concern for many employees. Without added income protection, people may experience severe financial difficulty if they miss work due to injury or illness. Consider adding disability insurance benefits to your employee benefits package and be sure to talk to a trusted advisor to learn more.

 

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Three Financially Focused Benefits Your Employees Will Love

In the last two years, employees across the country have had to adapt and adjust to a lot of challenges, many of which organizations had little to no control over. Employee burnout, stress, and wellbeing took major hits, putting more pressure on organizations to come up with solutions to help them face these challenges. According to the 2021 Employee Benefit Trends Study by Met Life, 86% of employees said finances are a top contributing factor to their stress now and into the future. While this may feel like an insurmountable problem for employers to take on, there are many solutions that can make a big impact for both the wellness of your employees and the health of your business.

1. Student Loan Repayment Programs

Today, 47 million Americans are carrying the burden of student loan debt. This year, student loan debt in America reached a staggering 1.7 trillion dollars. Despite the temporary loan forbearance the Biden Administration placed on federal student loan payments, student loan debt remains a top concern for many Americans in the workforce.

Employers looking for ways to help support employees who are paying off student loans should consider offering employee benefits aimed at just that—helping them pay off this debt. In December, Congress passed the Consolidated Appropriations Act of 2021, enabling employers to contribute up to $5,250 in student loan payments tax-free, making it easier than ever for organizations to help.

Supporting employees burdened with student loan debt can be a strong tool for attracting and retaining top talent.

2. Retirement Planning

A 2019 study by GOBankingRates found that 64% of respondents expected to retire with less than $10,000 in their retirement savings. Employers can help employees prepare for retirement and reduce stress by offering benefits designed to enable employees to begin saving for retirement. Some plan options that provide tax benefits to both employers and employees include:

  • Payroll Deductible IRA – For employers who don’t want to implement a retirement savings plan, this plan offers a way for eligible employees to contribute to an IRA through payroll deductions.
  • 401(k) Plan – This plan offers an opportunity to employees to save through salary deferrals with the option of employer contribution.
  • Money Purchase Plan – This plan allows employers to make contributions to employee savings based on their discretion. There is no fixed amount nor requirement to make a contribution by the employer.

There are many types of retirement plans available to organizations, so do your research and choose the one that fits the needs of your business.

3. Education and stewardship

Understanding the basics of investing, saving, and money management is a challenge for many Americans, leading them to avoid this type of planning altogether. If your organization can’t offer benefits to help them save, consider offering a program to empower them through education.

Platforms like Skillshare and financialgym offer online courses to help anyone learn the basics of investing, planning for retirement and savings, and managing money. Knowledge and understanding can make a more powerful impact, in many ways, than simply offering a plan that no one understands.

Their financial wellness is your reward

Helping employees plan for retirement and effectively manage their savings and debt is a sure-fire way to improve their overall wellbeing by reducing stress and creating stability within their lives and futures. You may see an increase in talent attraction, employee engagement, retention, and satisfaction by offering a hand and enabling employees to create financial stability within their lives. What’s good for them is good for business.

 

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What You Need to Know About Group Life Insurance

A study conducted by LIMRA and Life Happens found that 41 million Americans say they do not have life insurance coverage at all. When it comes to providing benefits for your employees, life insurance ensures they give their families much-needed financial security. All too often, however, life insurance is a misunderstood and confusing topic. We are here to help.

Here is what you need to know about group life insurance plans.

What is life insurance?

Life insurance is a contract between a person and an insurance company. A premium is paid, and after a person’s death, a lump sum, or death benefit, is paid to the beneficiaries the person designates. The beneficiaries can use the money for any purpose they like.

What is group life insurance?

Group life insurance is when an entire life insurance contract covers a whole group of people. The policy owner is the employer or organization, and the policy covers all the employees at the organization.

Are there different types of group life insurance?

Yes, there are two different types of group life insurance: employer-paid or voluntary. These are usually seen as term life insurance, which provides your employees coverage for the term of their employment.

Employer-paid life insurance

Employer-paid life insurance is when the policy is paid by the employer. This offers your employees a convenient way to receive life insurance coverage. This type of coverage, at times, offers them coverage portability or the ability for your employees to continue their life insurance policy when they no longer work for you.

Voluntary life insurance

Voluntary life insurance is an optional benefit offered to employees. This type of life insurance is paid for by the employee directly to the workplace’s insurance company via a monthly premium taken out of their paycheck. Like employer-paid life insurance, voluntary life insurance can also offer coverage portability.

Why is life insurance important?

As an employer, you may wonder why life insurance is important to provide to your employees, and there are several reasons:

  • It provides for lost income: Providing a group life insurance policy helps ensure that your employees’ loved ones will have some financial replacement for the lost paycheck in the case of their death. This allows the family time to get a footing in their new reality.
  • It reduces stress: Losing a loved one is already a difficult and emotional experience without the added financial burden of losing a partner or parent. Life insurance will help protect the family from the difficulty that awaits. For example, finding help for childcare after the loss of a parent is a huge stress for the surviving parent. Knowing they have financial support to afford it can ease the pressure.
  • It helps cover bills and debts: Life insurance will help cover bills or debts your employees leave behind, so they are not passed to your employees’ loved ones.

It doesn’t have to be confusing

Life insurance can be, admittedly, confusing. But it is a smart move for employers who want to add family-focused benefits into their employee benefits plan. Talk to a trusted advisor who will help you decide on the best group life insurance plan for your employees.

 

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3 Ways to Set Yourself Up For Open Enrollment Success

Regardless of when your benefits package renews, there’s a lot to be said for employers who plan ahead. Undoubtedly, many changes caused by the pandemic have shifted the needs of employees and altered the ‘normal’ approach to open enrollment. However, planning has always (and will always) be a good idea—especially when it comes to group health plans.

Giving your organization time to plan and prepare will help you improve the absolutely critical process of implementing your benefits package, which has *major* repercussions on your return on investment (ROI). Start by following these three steps.

1. Consider changes to your benefits offering

Pandemic or no, employee needs are constantly changing. They have changed significantly over the past year and will continue to change as our country adjusts how we approach work. Since employee benefits are such a significant investment for employers, it only makes sense to meticulously review what benefits are most popular and what benefits don’t hold as much value.

Survey your employees and do your research. Since the start of the pandemic, some benefits have risen in popularity as employee needs have changed.

These include:

  • Virtual healthcare
  • Flex work, childcare, and elderly care
  • Financial wellness
  • Mental healthcare

Talk to your broker about your options and create a strategy that fits the needs of your employee population, as needs and wants can vary broadly. One size does not fit all for an attractive benefits package.

2. Open enrollment planning

Depending on the shifts your organization made since the pandemic, it’s important to consider how you will proceed with open enrollment this fall. Organizing a supportive and education-based strategy to guide your employees through enrollment can make a real impact on the employee experience during the process and increase plan utilization by employees.

  • Consider how to create a system that works for your employees wherever they are (on-site or remote).
  • Provide resources and support to employees as they make their decisions. These can include educational resources (such as this glossary of standard benefit terms), in-person or virtual support, and clear communication around deadlines and qualifications.
  • Get feedback from your employees before open enrollment about their experience last year and their concerns and needs for the upcoming season. Find common trends to help you fill in gaps that you may have missed in years past.

3. Preparing for implementation

Spend time reviewing and improving your plan of execution. This plan should include a detailed communication strategy, employee education, and year-round support. If you want to see significant participation from your employees, you need to engage with consistent support and education strategies. Ask your employees if:

  • They understand the benefits available to them. Do you offer an HSA or self-insured plan? If so, make sure your employees have a proper understanding of how these different plans work and what to expect when they participate.
  • They know where to go to ask for help. Do they have access to a support line? Are there online resources you are providing them?

Consistent and clear communication is a critical part of ensuring your employees participate in and get the most out of the benefit plan you’re offering. Consider which channels you will be relying upon (email, meetings, one-on-one support, a web page, etc.) to get the word out and offer support. Get clear on how and when you’ll use these channels and stay consistent in using them.

Preparation = success

The more you plan, the better you can guide your employees and your organization through the process of open enrollment. This isn’t the sort of thing you want to put off until the last minute or until your broker comes to talk to you.

Employee benefits are a crucial part of your employee engagement, retention, attraction, and ultimately, the business’s success. And as such, they require and deserve careful planning. By starting with these three steps, you’ll set your organization, and your employees, up for success.

 

 

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A Crash Course in Group Health Insurance Plans

When it comes to health insurance, people want the right amount of coverage. They also want coverage for what they see as high value (doctor’s visits, medical procedures, etc.). There are many insurance plans out there—the traditional fully insured plan, the level-funded plan, the self-funded plan…and you may be wondering what the difference is between them, and where to even begin.

Welcome to our crash course in group health insurance plans.

Where it all began—fully insured plans

Fully insured plans are probably what come to mind when you think of group health insurance plans. Employers get the plan from an insurance company (carrier) and pay a premium to the insurance company. The yearly premium rates depend on how many employees are enrolled in the plan. When employees make a claim, the insurance company writes a check to the healthcare provider (hospital, doctor, etc.). Employees are responsible for paying the deductibles and co-pays defined in the plan.

A fully insured plan usually includes coverage for medical procedures, prescriptions, and doctor’s visits. Employers tend to go the route of fully insured for their business if they want to give their employees predictable benefits that remain consistent over time and provide the business with a regular monthly fee to manage cash flow.

New paths and steppingstones—level-funded plans

Level-funded plans are the go-betweens, the bridge between a fully insured plan and a self-funded plan (which we will discuss in a minute).

With level-funded plans, employers pay a set amount of money each month to the insurance company that funds a reserve account for claims and manages administrative costs and fees. Rates for a level-funded plan is defined by the number of employees and the estimated cost of anticipated claims. If the employer has a surplus of claims funds at the end of the year, they will receive a refund. If the claims are higher than estimated, they will receive a premium increase for any stop-loss coverage an employer has.

Employers usually choose level-funded plans if they anticipate employees not making many insurance claims and want to offer their employees insurance at an affordable cost. It also allows ease of access to utilization trends that show where employees might be overspending and allows employers to use education and wellness programs to improve claims costs.

Rise in popularity—self-funded plans

The popularity of self-funded plans is on the rise. A report published in 2020 found that 60% of workers in companies with three or more employees were on some kind of self-funded plan. But how does it work, exactly?

With self-funded plans, or self-insured plans, an insurance company provides administrative services. Like with level-funded plans, there is a fixed cost for administrative fees. But unlike level-funded plans, employers assume all the costs and financial risks in a self-funded plan. They pay for employee health claims from a bank account or trust fund set up for that purpose.

These plans have the highest amount of risk; however, employers can have stop-loss insurance that reimburses them for claims that exceed a predetermined level. There are two types of stop-loss insurance:

  • Specific stop-loss coverage, or individual stop-loss coverage, provides protection for employers against a high claim for any one employee. For example, if employers want a maximum liability of $150,000 per person, and an employee makes $200,000 in medical claims, specific stop-loss reimburses the employer for the $50,000 in excess claims.
  • Aggregate stop-loss coverage provides a set coverage ceiling on the amount of eligible expenses employers pay during that contract period. In other words, this is the coverage for all the employees total, not just for any one specific employee.

While self-funded plans can be expensive without stop-loss coverage, many employers find self-funded plans attractive. If they don’t need to pay fixed monthly premiums and they want to proactively manage claims costs with a hands-on approach, such as steering employees to high-value, low-cost providers and taking advantage of clinical wellness programs, self-funding may be a good fit.

One size doesn’t fit all

What’s right for one company may not be right for you. There are many different health insurance plans and different plan options, and taking a route doesn’t mean you take the route alone. Many advisors are well-educated in level-funding and self-funding.

Start a conversation with your broker to find out if this is in their area of specialty. Whether it is or not, do your research so you can fully participate in the conversations to determine what is the best for you and your employees.

 

 

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Non-Insurance Solutions That Make a Real Impact

The world of employee benefits experienced significant growing pains since the pandemic hit a little over a year ago. With all the new challenges employees began experiencing (job loss, loss of childcare, financial instability, mental health, and so much more), employers learned, fast, that ensuring the wellbeing of their employees is essential.

Let’s break down some of the factors contributing to employee resilience and wellbeing that employers can effectively take action on.

Employee Wellness

It’s important to understand that while the term ‘wellness’ is singular, it encompasses a variety of factors that contribute to it. While someone may have good physical wellness, if they are experiencing hardship in other areas of their lives, their overall wellness will be affected. In this way, employers need to approach wellness holistically, focusing on more than one contributing factor in an employee’s overall wellbeing.

Financial stability

A 2018 report by the Federal Reserve found 40% of adults would struggle to pay off a $400 unexpected expense. According to the MetLife Employee Benefit Trends Study 2021, financial stress is both the top concern and the leading factor contributing to poor mental health among employees. A staggering 86% of employees reported financial stress was a leading source of anxiety now and going forward.

These numbers vastly differ between demographics, showing a disparity in the experience of white/Caucasian and Black and Latinx respondents. When asked if they had been worried about their financial health, 53% of white respondents and 70% of both Black and Latinx respondents said yes. These numbers are concerning not only because of the disparity they represent but also because they demonstrate the vast number of people suffering from financial stress.

Many employers function under the misconception that their employees are financially stable, but there is no way of knowing what kind of financial burdens employees may carry. They may be a single parent, a caregiver of a family member with medical needs, or struggling to pay off staggering student loan debts. Whatever the case, employers that offer financially focused benefits can help make a significant difference in their employees’ lives.

Consider offering financially focused benefits aimed at developing financial stability for your employees now and into their future:

  • Student loan support
  • 401(k) and other retirement savings
  • Monthly wellness stipends
  • Financial coaching and education
  • Childcare support

Mental health

One of the positive side effects created by the pandemic has been the increased availability of accessible mental health support. Organizations like BetterHelp and Talkspace provide access to qualified therapists that provide therapy services online or over the phone, and these services have taken off over the past year as more Americans have reached out for mental health help. Offering programs designed to overcome cost barriers that may deter employees from accessing mental health services is a great way to help support your employees’ wellbeing.

Flex time

Another way to provide support to employees is to offer flex time. Many organizations have started to use flex time since the pandemic began, along with remote work. According to the same MetLife study, 76% of workers are interested in continuing alternative working arrangements developed during the pandemic such as remote work and flexible schedules, but 90% of employers who said they implemented these alternative solutions are planning to go back to pre-pandemic working arrangements when possible. That is a concerning disparity that may result in employee frustration when they are forced back into the office, expensive commutes, and less flexibility to manage their personal lives.

68% of employees working remotely want their employers to allow them to make the decision for themselves. Over half of workers in their 20s, including Gen Zs and young Millennials, are happier with their working arrangements now than before the pandemic.

Flexible scheduling, remote options, and unlimited PTO programs allow employees to better manage their personal commitments with less stress, enabling them to maintain their overall wellness with greater ease.

Social justice

2020 wasn’t just the Year of the Pandemic, but a year of great social unrest and change. 42% of all employees say that social justice issues are a source of anxiety for them. These issues reach across demographics, location, age, and economic status. All employers must do what they can to provide support in this area.

Consider offering:

  • Paid volunteer hours
  • Paid holidays or time off during election days
  • Inclusivity training for managers and employees

In it for the long haul

Employee wellness was a critical issue long before the pandemic and will continue to be one well into the future. Employers who are serious about developing a company that can drive growth, attract, retain, and engage employees, and leave a positive legacy behind them need to be considering these issues consistently throughout the years.

What’s good for your employees is good for you: employees who identify as mentally and physically healthy are 37% more productive than those that aren’t. And that’s just one statistic that shows how caring for your employees creates a positive ripple effect within your organization, their community, and the world.

It’s a win-win for everyone.

 

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It’s Time to Expect More from Your Broker

For most employers, the story is the same every year. They don’t hear from their benefits broker until renewal starts to appear around the corner, and then it’s spreadsheets, rising premiums, and more spreadsheets. The world of insurance is confusing and frustrating, and for many employers, this leads them to seek out second opinions from multiple brokers. Why wouldn’t you? Even if your goal is just to keep your current broker honest, it’s only common sense to get second opinions on a purchase that large.

But here’s the problem. Almost without fail, the brokers you talk to will get the same numbers from the carriers, bring in the same spreadsheets, and will likely tell you about their services, which are the same as every other broker. Benefits admin support, compliance support, HR services—the list goes on, and it’s almost always the same.

You still have to make that gut-wrenching purchase come renewal time, and you still feel in the dark about your options.

So how do you decide which broker to go with if everything they’re offering is the same? That’s where many brokers and employers alike would point to the “relationship” part of the business. They would say it all comes down to who you like the best.

But we disagree. There is a different kind of broker out there—one that doesn’t look the same as the rest and can offer you something different—something better.

What you really need

While every year you feel the same frustration and anxiety around having to make an extremely (and increasingly) expensive investment in your employees, how much do you really understand about why you’re making that particular purchase?

The reality is most employers simply don’t have enough real experience with the world of insurance other than that dreaded yearly renewal process. This leaves them at the mercy of their broker and relying on others to tell them what’s best for their business.

While this makes sense—the world of insurance is increasingly confusing and constantly changing—it’s simply not sustainable. What employers need is to have the power to make an informed and educated decision when it comes to their benefits plan. They need to have the kind of power only true understanding can bring.

How to differentiate

So it’s time to start looking for something different in your broker. Here’s how to spot it. While the benefits broker you’re used to will:

  • Only get in touch with you when it comes time to renew
  • Offer you the same spreadsheet and the same services every year
  • Assure you their service is the best and that’s what sets them apart
  • Hand you their non-insurance solutions and call it good
  • Completely fall off your radar once you’ve renewed

The benefits broker you want:

  • Shows up well before you have to start thinking about renewals
  • Starts off the conversation by uncovering your goals and challenges
  • Focuses on educating you about your options
  • Isn’t interested in forcing you to buy unless their solution improves your business
  • Continues to provide you with advice and education throughout the year
  • Supports the use of non-insurance solutions via training, communication, and education

The first type of broker wants you to buy from them and pick them out among the rest. While the second type also wants that, their first priority is to help you improve your business and make an impact in the lives of your employees. What you need isn’t a benefits broker—what you need is a benefits advisor.

Why?

So you can make the most informed decision for your business without blindly relying on a handful of brokers at renewal telling you the same thing over and over. So you won’t make the mistake of simply sticking to what you know just because you know it, passing over opportunities to make massive savings because you don’t understand them, and thus don’t trust them (yes, this really happens).

The world of insurance is growing and changing, and employers need to be able to grow and change along with it—and that requires employers to become educated about their situation and their options.

Expect more

The bottom line is you don’t have to settle for the same type of broker. In fact, you shouldn’t. You and the people your business supports deserve the best service and the best benefits available—and you can only get that by having the power to make informed decisions yourself.

Start expecting your broker to teach you. Start asking questions and expecting answers. Look for a broker who focuses on education, year-round communication, and who takes the time to help you fully understand all your options. You deserve more than the same old story. It’s time to expect a new one.

 

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Congress Passes the American Rescue Plan Act

Congress Passes the American Rescue Plan Act

Congress has passed, and President Biden has signed, the American Rescue Plan Act, 2021 (ARPA), the third COVID-19 stimulus bill.  This new $1.9 trillion stimulus package includes several health and welfare benefits-related provisions relevant to employers and plan sponsors, as summarized below.

FFCRA Paid Leave Extended and Enhanced

While COVID-19 vaccines are starting to become more readily available, the pandemic continues. In recognition, Congress extended through September 30, 2021, the refundable payroll tax credits for emergency paid sick leave (EPSL) and extended family and medical leave (E-FMLA), which were enacted pursuant to the Families First Coronavirus Response Act.  As with the extension through March 31, 2021 under the second stimulus package (the Consolidated Appropriations Act, 2021), only the tax credits are extended, which means compliance with the EPSL or E-FMLA requirements is voluntary for employers after December 31, 2020.

The ARPA expands FFCRA leave in several ways for employers who choose to offer it from April 1, 2021 through September 30, 2021:

  • The 10-day limit for EPSL resets as of April 1, 2021. Employees were previously limited to 80 hours from April 1, 2020 through March 31, 2021.
    • Paid leave continues to be limited to $511 per day ($5,110 total) for an employee’s own illness or quarantine (paid at the employee’s regular rate), and $200 per day ($2,000 total) for leave to care for others (paid at two-thirds of the employee’s regular rate).
  • A new “trigger” is added under both the EPSL and E-FMLA provisions. Employees qualify for leave if they are:
    • seeking or awaiting the results of a diagnostic test for, or a medical diagnosis of, COVID-19, and the employee has been exposed to COVID–19 or the employee’s employer has requested such test or diagnosis;
    • obtaining immunization related to COVID–19; or
    • recovering from any injury, disability, illness, or condition related to such immunization.
    • MBWL Note: The ability of an employer to receive a tax credit for providing paid time off for an employee to receive the vaccine is a clear indication of the federal government’s desire to facilitate employees receiving a vaccine.
  • Leave under the E-FMLA provision is increased from $10,000 to $12,000, with $12,000 being the maximum an employer may claim for an employee in 2021.
  • Leave under the E-FMLA provision is expanded to be available for any EPSL-qualifying reason, which is when an employee is unable to work or telework because the employee:
    • is subject to a federal, state, or local quarantine or isolation order related to COVID-19;
    • has been advised by a health care provider to self-quarantine due to concerns related to COVID-19;
    • has COVID-19 symptoms and is seeking medical diagnosis;
    • is caring for an individual who is subject to a quarantine or isolation order;
    • is caring for a child if the school or day care center has been closed, or the child-care provider is unavailable, due to COVID-19 precautions; or
    • is experiencing any other substantially similar condition specified by the regulatory agencies.
  • E-FMLA leave taken on or after April 1, 2021 is not subject to the 10-day elimination period that applied previously under FFCRA.
    • An employee’s eligibility for E-FMLA may depend on when they used E-FMLA previously and how the employer establishes its 12-month FMLA period (e.g., calendar year, fixed period, measure-forward, or “rolling” 12 months).
  • For leave taken on or after April 1, 2021, the employers may take a credit against Medicare payroll tax only (1.45%); however, the credit continues to be refundable.
    • ESPL and E-FMLA credits are available for qualified health plan expenses and for the employer’s share of Medicare and Social Security taxes.
  • ARPA clarifies that refundable credits may be received by state and local governments that are tax exempt under Code 501(a).
  • ARPA adds a new nondiscrimination requirement that eliminates the credit for any employer that discriminates in favor of highly compensated employees, full-time employees, or employees based on tenure.

Dependent Care Assistance Program Limit Increase

In February, the IRS released Notice 2021-15, which provides guidance related to the relief for health FSAs and dependent care assistance programs (DCAPs) contained in the second stimulus bill. Unfortunately, the Notice failed to clarify with any certainty whether an employee may be taxed on any DCAP reimbursements in excess of $5,000 for the calendar year.  That issue is now settled by the ARPA, which increases the DCAP exclusion from $5,000 to $10,500 (from $2,500 to $5,250 in the case of a separate return filed by a married individual) for 2021. This relief is only available for calendar year 2021; however, it also implies that an employee could elect to increase their DCAP election to the newly available $10,500 limit for 2021 (based on the relief in Notice 2021-15).  A DCAP must be amended by the end of the 2021 plan year to take advantage of the increased exclusion limit.

Temporary Premium Tax Credit Enhancements

The Affordable Care Act’s premium tax credit program is significantly enhanced for 2021 and 2022. The existing income limit of 400% of the federal poverty level, after which individuals will no longer qualify for a premium tax credit, is lifted for 2021 and 2022. In addition, the applicable percentage of household income that individuals must pay for Marketplace coverage has been reduced at all income levels.  Special rules also apply to those individuals receiving unemployment compensation during 2021.

MBWL Note: The increased eligibility for premium tax credits makes it ever more important for applicable large employers (ALEs) to offer affordable, minimum value coverage to their full-time employees to avoid potential penalty exposure.

Temporary PTC Percentages Under ARPA
In the case of household income (expressed as a % of poverty line) within the following income tier: The initial premium percentage is— The final premium percentage is—
Up to 150.0% 0% 0%
150% to 200% 0% 2%
200% to 250% 2% 4%
250% to 300% 4% 6%
300% to 400% 6% 8.5%
400% and up 8.5% 8.5%

 

2021 PTC Percentages (Pre-ARPA)
In the case of household income (expressed as a % of poverty line) within the following income tier: The initial premium percentage is— The final premium percentage is—
Up to 133.0% 2.07% 2.07%
133% to 150% 3.10% 4.14%
150% to 200% 4.14% 6.52%
200% to 250% 6.52% 8.33%
250% to 300% 8.33% 9.83%
300% to 400% 9.83% 9.83%
400% and up Ineligible for PTC

COBRA Subsidy

The ARPA provides significant assistance to employees and their families who are eligible for COBRA (or state mini-COBRA) due to an involuntary termination of employment or reduction in hours.  The law provides a 100% subsidy for COBRA premiums from April 1, 2021 through September 30, 2021. The subsidy applies to group health plans other than health FSAs.

Employers who are subject to COBRA under ERISA (private employers) or the PHS Act (state and local governmental employers) are responsible for complying with the COBRA subsidy provisions.  Insurance companies are responsible for complying with the COBRA subsidy provisions for insured group health plans that are not subject to federal COBRA (e.g., when state “mini-COBRA” requirements apply to small plans that are not subject to federal COBRA, or to large group plans after federal COBRA is exhausted).  Additional highlights include:

  • The subsidy applies to an “assistance eligible individual” (AEI) who is any COBRA qualified beneficiary who is eligible for, and elects, COBRA during the period of April 1, 2021 through September 30, 2021, due to an involuntary termination of employment or reduction in hours. (The reduction in hours is not required to be involuntary.)
  • AEIs must be offered at least a 60-day window within which to elect COBRA coverage.
    • The 60-day period begins April 1, 2021 and ends 60 days after the date the notice is provided to the individual.
    • AEIs include individuals in their COBRA election period, and individuals who would be AEIs but whose COBRA coverage lapsed due to non-payment prior to April 1, 2021.
    • MBWL Note: Many AEIs will still be within their COBRA election period as a result of the Department of Labor’s disaster relief (Notice 2021-01).
  • COBRA coverage elected during the subsidy period will be effective April 1, 2021; employees are not required to elect retroactive to the date of their qualifying event or any other date prior to April 1, 2021, nor are they required to pay outstanding premiums for prior periods of coverage in order to secure subsidized coverage.
  • Employers will be entitled to an advanceable, refundable tax credit against Medicare payroll taxes (1.45%) to pay for coverage during the subsidy period. The DOL will provide forms and instructions for employers to apply for the credit.
    • Additional guidance is expected for multiemployer (union) plans and professional employer organizations (PEOs).
  • The subsidy is available until the first to occur of:
    • the qualified beneficiary becoming eligible for other group health plan coverage (other than coverage consisting only of excepted benefits, such as dental or vision, coverage under a health FSA, or coverage under a qualified small employer health reimbursement arrangement (QSEHRA));
    • the qualified beneficiary becoming eligible for Medicare;
    • the end of the qualified beneficiary’s maximum COBRA duration; or
    • September 30, 2021.
  • Qualified beneficiaries who fail to notify the plan that they are no longer assistance-eligible can be liable for a $250 penalty, which may be waived if the failure was due to reasonable cause and not willful neglect. An intentional failure can result in a penalty of $250 or 110% of the amount of premium assistance received, if greater.
  • Employers may allow currently enrolled AEIs to select new plans. An individual has 90 days from the date they are notified of the enrollment option to elect a different plan.  This option is available only if:
    • the premium for such different coverage does not exceed the premium for coverage in which such individual was enrolled at the time such qualifying event occurred;
    • the different coverage in which the individual elects to enroll is coverage that is also offered to similarly situated active employees; and
    • the different coverage is not coverage consisting only of excepted benefits, such as dental or vision, coverage under a health FSA, or coverage under a QSEHRA.
  • Required Notices to Individuals
    • General Notice / Notice of Subsidy Availability. Individuals who become eligible to elect COBRA during the subsidy period (April 1, 2021 – September 30, 2021) must be provided a notice that describes the availability of the premium assistance. The notice requirement may be satisfied by amending existing notices or by including a separate attachment. The notice must include:
      • the forms necessary for establishing eligibility for premium assistance;
      • the name, address, and telephone number to contact the plan administrator and any other person maintaining relevant information in connection with such premium assistance;
      • a description of the extended election period;
      • a description of the obligation of the qualified beneficiary to notify the plan when they are no longer eligible for a subsidy and the associated penalty for failure to do so;
      • a description, displayed in a prominent manner, of the right to a subsidized premium and any conditions thereon; and
      • a description of the option to enroll in different coverage if the employer so permits.
    • Notice of Extended Election Period. AEIs must be offered at least a 60-day window within which to elect COBRA coverage.
      • The 60-day period begins April 1, 2021 and ends 60 days after the date the notice is provided to the individual.
      • This includes:
        • individuals terminated on or after April 1, 2021;
        • individuals in their COBRA election period on April 1, 2021 (including any COVID-19-related extensions); and
        • individuals who would be AEIs but whose COBRA coverage lapsed due to non-payment prior to April 1, 2021.
      • Notice of Subsidy Expiration. Informs AEIs that the subsidy period is ending.
      • The notice must disclose that:
        • premium assistance for the individual will expire soon and the date of such expiration;
        • the individual may be eligible for coverage without any premium assistance through COBRA or coverage under a group health plan.
      • The subsidy expiration notice is not required if the subsidy is ending due to the individual becoming eligible for another group health plan or Medicare.
      • This notice must be provided not more than 45 days but no less than 15 days before the premium assistance ends.
      • Model Notices. The DOL must issue model notices of subsidy availability and extended election period within 30 days of enactment, and a model notice of subsidy expiration within 45 days of the law’s enactment.

What Does This Mean For Employers?

Employers and plan sponsors should consider whether they will adopt the extended FFCRA leave provisions and/or use them to incentivize employees to receive a COVID-19 vaccine. They should also ensure their COBRA vendors are prepared to assist in identifying and notifying assistance eligible individuals within 60 days of April 1, 2021.  The DOL also plans to provide outreach consisting of public education and enrollment assistance relating to premium assistance. Their outreach will target employers, group health plan administrators, public assistance programs, States, insurers, and other entities as the DOL deems appropriate. The outreach will include an initial focus on those individuals eligible for an extended election period. We also expect the DOL and other agencies to issue guidance on various issues related to the subsidy in the coming weeks.


About the Author.  This alert was prepared for Employee Benefit Consultants, Inc. by Marathas Barrow Weatherhead Lent LLP, a national law firm with recognized experts on ERISA-governed and non-ERISA-governed retirement and welfare plans, executive compensation and employment law.

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers or our clients.  This is not legal advice.  No client-lawyer relationship between you and our lawyers is or may be created by your use of this information.  Rather, the content is intended as a general overview of the subject matter covered.  This agency and Marathas Barrow Weatherhead Lent LLP are not obligated to provide updates on the information presented herein.  Those reading this alert are encouraged to seek direct counsel on legal questions.

© 2021 Marathas Barrow Weatherhead Lent LLP.  All Rights Reserved.

 

Wellness Plans: Q&A

Are you thinking of implementing a wellness program? If so, check out answers to these common questions.

Q: What kind of wellness plans are there?

A: As employee wellness has increasingly gained attention and a spot on most employers’ priority lists, the variety of wellness plans has increased. Your wellness plan will change depending on several things: where your priorities are, what your budget is, and the demographic you want to reach. Some examples of standard plans are:

  • Wellness programs to help stop bad habits such as smoking
  • Paramedical plans that offer massages, chiropractic work, or acupuncture
  • Employee assistance plans and teletherapy to provide mental health support
  • Physical activity challenges such as community races or a team steps contest
  • Coaching services for leading a healthy lifestyle (cooking, physical activity, mental wellness)

Q: How do I choose a wellness plan for my business?

A: Not every wellness program will work for your business. First, ask yourself, “What is my primary goal for implementing an employee wellness program?” Your plan may look different if your goal is to reduce healthcare costs for your business than if your goal is to create more loyal employees by developing a positive culture.

In either case, the main thing you want is for people to participate. If you choose a plan that doesn’t interest your employees, they’ll be much less likely to participate, resulting in a low ROI. Send out a survey, taking the temperature of your employees’ feelings about a wellness program. Ask what interests them, what challenges they have and would like help with, and how they see themselves participating. Use what they tell you to inform your wellness plan choice.

Q: Do wellness plans work?

A: There’s been some back and forth about whether or not wellness programs work. Critics point to studies showing a lack of clear improvement or healthcare savings for employers who offer wellness programs. There have also been studies showing that while people who participated in the programs cited feeling happier and healthier, their participation didn’t result in decreased healthcare costs for employers. Other studies show that programs aimed at increasing physical health are most often used by those already in good health and can possibly alienate those who aren’t.

However, the conversation of employee wellness has become a top concern for employers and employees alike. Employees expect more from their organization and value jobs that support their overall wellness. Proponents of wellness programs point to studies linking them to increased employee retention, satisfaction, engagement, and much more.

Q: How do I keep my wellness plan in compliance?

A: In the past few years, regulations for ADA-covered wellness programs that include employee participation incentives have come under some scrutiny. Critics say wellness programs that require employees to pay higher premium costs for not participating or not meeting specific health-related goals are immoral and violate the Americans with Disabilities Act (ADA).

This year, the EEOC has proposed new regulations, requiring only “de minimis” incentives for employee participation. Under the new rules, health-contingent wellness programs would still be allowed to offer incentives of up to 30% of the total cost of insurance, but no more. So far, the new regulations haven’t been published yet and will likely be challenged. To stay in compliance, be sure to know what kind of wellness program you’re offering and how it may be affected.

 

Photo by Vasyl Yakobchuk

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