So, you own a Small Business – Are you ready for an Audit??

It may seem cruel to joke about, but if you’re a small business owner, an audit to make sure that your company is in compliance with the new healthcare reform requirements can actually be beneficial. The intent of this post is to keep you informed on auditing types and requirements, and how you can properly prepare your organization.

Ask yourself this – if you have a broker, do they have your back in this process?

Pure Risk Solutions (PRS) specializes in assisting with performing self-audits, or in preparing for one that may be enforced by our Federal Government. We are a certified broker, and would love to lend a hand as an experienced extension of your Human Resources (HR) department. Please call us at (303)834-1001 with any questions you may have.

To start, here’s a breakdown of what you can do to prepare your business for a DOL audit, as well as what the government would ask to see of you to verify that you are in compliance with the new reform.

Throw an acronym out, you’d better elaborate – what is a DOL Audit?

‘DOL’ stands for the U.S. Government’s Department of Labor. While the DOL has always held the right to request an audit, with the advent of Affordable Care Act (ACA – “Obamacare”) guidelines and restrictions, requirements have been expanded accordingly. A DOL audit will not only require you to provide proof of ACA employee health plan compliance, but additional documentation as well.

This webpage does a great job of expanding upon what documentation would be required for each of your employee’s healthcare plans – grandfathered or not. It’s extensive, and a broker can easily help you to find the right information, to ensure success in the process and make it as quick as possible.

Several types of audits that the DOL could perform are:

• Compliance: Focuses on how well a business is complying with current federal, state, and local laws and regulations.
• Best Practices: Helps the organization maintain or improve a competitive advantage by comparing its practices with those of companies identified as having exceptional HR practices.
• Strategic: Emphasis is placed on strengths and weaknesses of systems and processes to determine whether they align with the HR department’s and the organization’s strategic plan.
• Function-specific: Focuses on a specific area in the HR function – this could be payroll, performance management, records retention, etc.

So what can Small Business Owners do to prepare?

First step – be proactive. Period.

A self-audit for your business will leave you feeling like you did your homework. But here’s the best part. We’ll do your homework for you. How great is that? Think of us as if we’re that nerdy kid in your calculus class (we love nerds, by the way – no disrespect), who is more than willing to crank out a few additional functions in return for a smile from you, the pretty girl, in the hallway during passing periods. Anyway – silly analogy and the fact that we’ve clearly been watching too many John Hughes movies lately aside – there are a number of key steps involved in a self-audit (all of which we specialize in).

A relatively high-level overview of these steps looks like this:

• Review of job descriptions;
• Understanding of the differences between federal and state laws to ensure that the laws are properly applied to your company’s employees;
• Confirmation that Fair Labor Standards Act (FLSA) classifications of employees are correct;
• Review of payroll records to verify that they have been kept accurately;
• Validation that policies have been applied consistently across the organization;
• Verification that all records are complete, and if not, proper methodology to resolve any inconsistencies;
• Determination of how to address any areas of concern identified in the self-audit (aka – closing the loop).

Also – obtain your company’s Summary Plan Description (SPD). SPDs are your group health insurance plan administrator’s description of your legal rights under the Employee Retirement Income Security Act (ERISA). Each SPD for an organization should be inclusive of information on co-pay, coverage of dependents, and includes circumstances under which one of your employee’s could cancel your health insurance. It’s important to remember that SPDs are not provided by your insurance carrier. You should obtain your SPD by request of an attorney or legal adviser.

Questions? Confusion? Again, here at PRS we encourage you to contact us to discuss how we can help prepare your small business for the audit process, since we know exactly what to look for to protect you. Our number again is (303)834-1001. Ask for me, Dave (Godel), or email me at dave@purerisksolutions.com.

Happy Thanksgiving to all on Thursday! Enjoy the family time, food, football, and continuous reruns of ‘Planes, Trains, and Automobiles’ (another John Hughes classic).

Affordable Care Act Coverage: Top Reasons to use a Broker

Ok – before this post really gets going, here at Pure Risk Solutions, we need to make a confession.

We are an insurance broker.

*Temporary pause for those who have fallen off their chair to pick themselves back up*

Obviously that’s not groundbreaking information. And therefore, a post entitled ‘Affordable Care Act Coverage: Top Reasons to use a Broker’ may seem a bit like shameless promotion. Of course, it is to an extent – but there really are numerous benefits to using a licensed health insurance agent to obtain Affordable Care Act coverage as opposed to forging your way alone.

Navigator or Broker – What’s the Difference?

Fundamentally, as a broker, we are actually licensed to sell insurance. This is obvious fact number two of this blog post, for those who are keeping track. If you choose to use one of the Affordable Care Act (ACA) Exchanges, you will be provided the option of using a navigator for assistance. Not to downplay the function the people who fill these positions, but it’s basically customer service. Navigators can guide you through the Exchange websites, but cannot answer coverage-related questions or advise you about your specific needs or plan selection. Further to that, it’s worth reemphasizing that they cannot sell you insurance.

So what are the Benefits of using a Broker, then?

Less Hassle

1)      Time is a precious commodity. If you've heard anything about the Exchanges to this point, it’s likely that there have been a litany of glitches, creating for what was already apparent to be a tedious and lengthy process to be even more so for users. While the options are there on the websites, a broker has the ability to purchase coverage in or out of the Exchange, depending on what’s best for you and your family.

Flexibility based on your Schedule

2)      To sum it up, at Pure Risk Solutions, we’re here when you need us – be that during evenings or over the weekend. While the Connect for Health Colorado exchange has a customer service center, calls are only taken 7 am to 8 pm, Monday through Friday. If you contact us, you get to speak with one of us, right away.

Knowledge, Understanding, and Peace of Mind

3)      As a broker, knowing the details of the marketplace and what your options are is our job. It’s one we love doing. We take a great deal of pride in actually getting to know our clients and their needs, so they are fully satisfied that they've found the best coverage possible. You will be assured that your doctor and prescription drug list are covered within the plan you select, and rest assured with the peace of mind you desire.

Avoidance of Pitfalls

4)      If you receive a subsidy in 2014 based on your coverage and income level, there’s a chance you could owe money back at the end of the year. We’ll assist you in providing all of the required information to the federal government, to mitigate this chance.

So there you have it. Though we in no way want to deter you from taking a look at the Exchanges yourself, just know that we are here to help you from start to finish in finding the right healthcare coverage as a licensed broker. Please give our resident expert, Dave Godel, a call at (303)834-1001 to get started, and visit the Pure Risk Solutions website at www.purerisksolutions.com for additional information. 

Healthcare Reform: Answers to your Burning Questions (as a Small Business Owner)

Alright, so in the previous blog post, I addressed a few questions for individuals seeking out coverage through the Affordable Care Act (ACA) – again, “Obamacare” for those who are inclined. But what about small businesses? If you’re an owner, you likely have a TON of questions. That’s absolutely reasonable. Let’s get to it.

With restrictions and deadlines shifting constantly, why should I hurry to meet them?

To be frank – do it for your employees. They have concerns over the changes, just as you do running a business having to make accommodations for the reform. The fact is that many employees (and people in general) are under informed of how it will affect them:

• Will my health care coverage be improved, or diminished?
• Will the medical costs I’m currently responsible for increase? (According to the 2013 Aflac WorkForces Report, 83% of workers actually believe the answer to that question is yes)

Your workforce drives your business. Putting to rest any fears or concerns they have will only benefit you.

How do I get started?

Initially, it’s a good idea to look into the Small Business Health Operations Program (SHOP), set up to assist businesses with 50 or fewer employees select the best health insurance for their employees. At Pure Risk Solutions, we can guide you through this process and remove the hassle.

What are some other key guidelines?

•  $2,500 Flexible Spending Account (FSA) limit on employee annual salary reduction contributions by employee-sponsored cafeteria plans
• 90 day maximum waiting period, beginning January 1, 2014
• Increased reward capacity for Employer Wellness Incentives
• All self-insured employers must report their employer’s health insurance coverage information to the IRS each calendar year

Will my business be eligible for a tax credit?

Possibly. A Small Business Health Care Tax Credit will be available to small business with 25 or fewer employees, with average income of less than $50,000.

Next steps?

Again, let Pure Risk Solutions be your advocate! To learn more, please call me or my colleague and resident healthcare reform expert, Dave Godel, for more information at (866)738-2180 or send him an email at dave@purerisksolutions.com.

Questions? Comments? Frustrations? Success stories? Connect with us on Facebook and tell us about your experiences in looking into health insurance coverage for your small business, or your thoughts from an employee point of view. Please also feel free to leave a comment below.

Healthcare Reform: Answers to your Burning Questions (as an Individual)

Like many Coloradans, at this point you’re probably aware that the Affordable Care Act (ACA) - aka “Obamacare” - state exchanges are now live. It’s a historic milestone for the U.S., but just the same, you may be thinking that finding the right coverage will be a daunting task. So, let’s make it less daunting.

How does this apply to me?

If you already have health insurance through your employer, you are covered. But in order to really answer that, it’s fundamental to understand who stands to benefit the most through the reform. The simple answer would be those who suffer in the system today:

·         People currently uninsured, who will get coverage; and

·         The under-insured, who will be provided with superior benefits.

Further, the ACA holds a check on health insurance companies so that they cannot discriminate against individuals with pre-existing conditions by charging more or denying coverage.

So when do I sign up?

Now! There are a few dates you need to keep in mind to ensure that you ring in the new year with the best possible coverage.

·         December 15, 2013: Enrollment deadline to be covered on January 1, 2014

·         March 31, 2014: Marketplace open enrollment ends

At this point, time is still on your side. But take the initiative now, and ensure health and happiness for you and your family in 2014 and beyond.

Well... what if I don’t sign up?

The simple answer? You will owe Uncle Sam part of your paycheck. Because the primary objective of the ACA is for all Americans to have health care coverage meeting the basic minimum standards, naturally, the government will enforce penalties for those who are not proactive in the enrollment phase. To what extent? After the March 31^st date passes, those uninsured will be required to pay the following:

·         1% of their yearly income or $95 per adult in 2014 (whichever is higher)

·         $47.50 per child in a family household

It’s also important to keep in mind that if you don’t sign up by the start of April 2014, you will be unable to obtain coverage until the next annual enrollment period opens (not to mention penalties will go up!). But c’mon, that’s obviously not something you – the diligent and responsible individual you are – will need to worry about!

How can I benefit?

Begin by thinking about the individual health care needs of you and your family, as well as your budget. And then remember that professional help is available! As a certified healthcare broker, Pure Risk Solutions can take that information and weigh your options to see if certain benefits of the system apply to you, such as:

·         Lower Monthly Premiums

Household income and size determine who will qualify for lower monthly premiums as well as eligiblity for lower out-of-pocket costs for things like copayments, coinsurance, and deductibles.

·         Tax Credits

Tax credits are available to those who qualify, to partially or fully offset the price of the insurance. Find out if you’re eligible for premium tax credits here.

·         ACA Insurance versus Current Employer Plans

The ACA is designed to keep existing employer-based insurance in place, but it is possible to opt out and obtain coverage through Connect for Health Colorado if an employer offers an underwhelming plan.

Next steps?

Let Pure Risk Solutions be your advocate. If you’d like to learn more, please call me or my colleague and resident healthcare reform expert, Dave Godel, for more information at (866)738-2180 or send him an email at dave@purerisksolutions.com.

Questions? Comments? Frustrations? Success stories? Connect with us on Facebook and tell us about your tips for buying individual health insurance. Please also feel free to leave a comment below.

Pure Risk Solutions Insurance Agency celebrated grand opening and ribbon cutting for their new offices in Erie, Colorado on May 9th, 2012.  The new office provides a central location and great atmosphere for our clients and a wonderful work environment for our staff.  We are proud to be a part of Erie's growth and look forward to the future here.