As Employers look ahead to 2011 plan years, they're raising questions to understand the affect health-care reform will have on current and future employee benefits plans. What changes, if any, apply to our group plan? Do I have to may all changes now? Is our plan Grandfathered; if so, does that mean I can disregard the September 23, 2010 changes?
To answer the first question Patient Protection and Affordable Care Act (PPACA) applies to 'group health plans'. But that does not mean 'every' group health plan. PPACA applies to:
Major Medical plans, Mini-Med plans, Executive Medical Expense Reimbursement Plans, Government Medical Plans, and some Health Flexible Spending Arrangements.
Changes that become effective September 23, 2010 are as follows:
- Coverage of older children (Grandfathered plans prior to 2014 do not have to offer coverage to older children if child is eligible to enroll in an employer-sponsored plan).
- New Appeals Process / External Review (does not apply to Grandfathered plans).
- Any Available Primary Care Provider / Pediatrician (does not apply to Grandfathered plans).
- Coverage of Emergency Services (does not apply to Grandfathered plans).
- Access to Ob/GYN Care (does not apply to Grandfathered plans).
- Limits on Pre-existing Conditions Exclusions (under age 19).
- No Lifetime Limits on Essential Health Benefits.
- Restricted Annual Limits on Essential Health Benefits.
- No Rescission.
- Preventive Health Coverage (does not apply to Grandfathered plans).
implement. The topics range from discipline, to employee medical benefits, to how long they should retain employee records. Developing these policies can be a time consuming, difficult task, especially for small employers who are busy running their business. Without these policies, however, employers can face problems such as poor productivity, low employee morale, and even costly legal issues. 
In addition to helping our clients deal with specific employee relations matters, Management 2000 provides a broad range of services related to day-to-day operations. Just a few of these services include:
With health costs skyrocketing and recession revenues contracting, certain employers have had no choice but to eliminate group health coverage all together. There are still options, however, for small employers to put together some sort of benefit package for their remaining employees. For one, group life still remains a bargain, so I recommend having a separate group life policy paid by the employer for all employees. $15k - $25k can ofter be had for less than $15 a month. Next, voluntary benefits are not suffering nearly the rate increases of health plans, so those things like FLEX, AFLAC, dental, vision, legal plans can still be offered without any additional cost to the employer. But what about medical coverage? For folks with a fairly healthy group of employees, a list bill option for individual health plans may be an option. With our PEO, Management 2000, we have an in-house insurance agency names RMIA Inc. This allows us to offer groups unable to afford group coverage through the PEO an option of offering payroll deducted individual plans. The only downside to this strategy is that employees with ongoing health concerns will not qualify for this coverage and will have to seek other options. In Indiana, we help guide those employees through the state pool process. It is actually illegal for employers to contribute toward these health plans when a group plan could be available, so it doesn't look so bad when the employer couldn't afford to do it anyway. If a client wishes to 
, introduced by the IRS back in the mid '80's, are a terrific benefit tool to help contain out of pocket medical and dependent care expenses. The advantage of utilizing this benefit over deducting these expenses on a personal tax return is that in most states, you save on five (5) different taxes. You reduce your Federal Income, State Income, Local Income, Social Security and Medicare taxes. As great as these two programs are for an employee and employer, it has a disturbing "catch" that invariably encourages smaller employers to limit or eliminate the amount of $$ that may be put aside each year. The problem provision allows whatever level an employee enrolls in to have access to the full amount on 1/1 of the calendar year. If they use the entire amount on 1/2, that is their prerogative and they may pay the employer back each pay period the rest of the calendar year. If that same employee quits or leaves the company on 1/3, there is no obligation for that employee to repay this money and there is no legal remedy for the employer to recoup this cash outlay from the employee. The only recourse is to hope other participants either quit with positive balances or they leave a balance under the "use it or lose it" rule at the end of the calendar year. For small employers, this just does not happen. As a result, this benefit was often only available to employees of large companies that could spread the risk. Enter the PEO. Professional Employer Organizations allow many small employers to assemble under one organization for benefits purposes. This allows the inherent risk described earlier to be spread out over a much larger group of participants. Now, when a employee who has maxed out his claim leaves a small 5 man group, the Benefits Administration Team of the PEO takes on the risk of recouping the lost money through the other many small employers participating in the FLEX plan. In addition, this reduction in risk allows the PEO to offer higher annual limits employees may set aside. At Management 2000, we allow individuals to set aside up to $5,000 for medical and/or dependent care expenses in a calendar year. Ultimately, it is the PEO who assumes all the risk for this plan. The employee and employer participants in the PEO get all the benefits of the FLEX plans with none of this risk described above. This is just another example of the Human Resource Administration advantage that a PEO can offer small to medium sized companies. 
For most of the past century, life insurance was a product that was marketed by agents who went door to door. They reviewed folks needs across the kitchen table and often came by each month to collect the premiums. Well, thanks to the internet, price of shoe leather and what not, this practice has pretty much gone the wayside. Now, most people get life insurance through their work. Many employees make the mistake of believing that the $10-$50k worth of life insurance provided under a medical plan is adequate. Larger employers often offer higher options that can be purchased to protect their employees and their families. Smaller firms barely have the resources to offer a health plan much less worry about life insurance optoins. Enter the PEO and their Employee Benefits Management Team. These folks can enable small employers to offer similar programs as their larger competitors. Not only does this give better options to the employee, it helps the small guy retain valuable employees with stelllar benefits. Life insurance is an important, often overlooked need that your PEO benefits department will help fill for you and your employees. 
At Management 2000, we ROCK Benefits Plan Administration! 
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