May is Melanoma/Skin Cancer Detection and Prevention Month. Melanoma is the deadliest form of skin cancer, and the number of new cases is on the rise. You can lower your risk of developing melanoma and other skin cancers by protecting yourself from ultraviolet (UV) radiation all year long, not just during the summer months. 
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Being exposed to UV radiation is a risk factor for skin cancers, including melanoma. In the United States, the hours between 10 am and 4 pm are the most hazardous for UV exposure. To protect yourself from UV radiation, the Center for Disease Control and Prevention (CDC) recommends staying in the shade, wearing clothing that covers your arms and legs, and using sunscreen with a sun protection factor (SPF) of 15 or higher and both UVA and UVB (broad spectrum) protection. In addition to increased exposure to UV radiation, people with the following risk factors are more likely than others to develop skin cancer:

• A lighter natural skin color
• Family history, or personal history of skin cancer
• Skin that burns, freckles, reddens easily or becomes painful in the sun
• Blue or green eyes
• Blond or red hair
• Certain types and a large number of moles

Skin cancer is the most commonly diagnosed cancer in the United States, but the good news is that it is largely preventable, and can almost always be cured when it’s found and treated early

....for certain individuals.

The Internal Revenue Service (IRS) has announced that the 2018 annual limitation on health savings account (HSA) contributions by individuals with family coverage under a high deductible health plan (HDHP) is now $6,850. This limit was previously announced as $6,900, but has been revised downward due to an inflation adjustment provision in the Tax Cuts and Jobs Act. The 2018 annual limitation on HSA contributions by an individual with self-only coverage under a HDHP remains unchanged at $3,450.

The above change applies to the 2018 calendar year. Employees contributing to an HSA should be informed of the reduced maximum limit, and adjustments in contributions for the remainder of 2018 may be needed. Employees who have already contributed the maximum amount for 2018 will need to receive a refund of the excess contribution.

See page 400 of IRS Bulletin 2018-10 ​

Looking for a way to reduce your workers’ compensation claims?

Voluntary benefits could be the answer. A recent survey of 600 employers* found that nearly half of companies offering accident and disability insurance experience reductions in workers' compensation claims. In addition to asking employers if they could confirm declines in claims, the survey also inquired about the significance of those declines. The results demonstrate that by making voluntary accident and disability insurance available to employees, companies can often decrease the frequency and expense of their workers' compensation claims.

The survey results reveal the following:

Employers who offer voluntary accident insurance noticed declines in their workers’ compensation claims. Specifically:

•  Small employers saw a 34% decline overall
• Medium employers saw a 34% decline overall
•  Large employers saw a 55% decline overall

In examining their volume of workers’ compensation claims and the amount of decline, declines of 50% or more were determined to be significant or very significant:

• Small employers reported a 15% significant/very significant decline
• Medium employers reported a 13%significant/very significant decline
• Large employers reported a 12% significant/very significant decline

Interestingly, large employers also saw a 29% moderate reduction in workers’ compensation claims of between 25 and 49%.

Employers who offer voluntary disability insurance noticed declines in their workers’ compensation claims. Specifically:

• Small employers saw a 43% decline overall
• Medium employers saw a 33% decline overall
•  Large employers saw a 47% decline overal

​In examining the volume reduction in workers’ compensation claims, a reduction of 50% or more was determined to be significant or very significant:

• Small employers reported 18% significant/very significant decline and 17% moderate decline between 25 and 49%
• Medium employers reported 18% significant/very significant and 7% moderate decline between 25 and 49%  
• Large employers reported 11% significant/very significant and 20% moderate decline between 25 and 49%

​Numerous studies indicate an increasing number of employers are offering voluntary benefits as part of their total employee benefits program. However these studies do not review the overall employee/employer satisfaction with the voluntary benefit program. Total satisfaction is based on more than just the product that is offered. Unlimited Benefits' approach to voluntary benefits is customized based upon the needs of each employer and that employer’s team members. 

For more information on how VWB's can positively impact you, the employer, and your employees contact Unlimited Benefits at 888-587-9370

The Affordable Care Act ensures that health plans offered in the individual and small
group markets, both inside and outside of the Exchanges, offer a comprehensive package
of items and services known as essential health benefits. Insurance policies must cover
these benefits in order to be certified and offered in the Exchanges, and all
Medicaid/Medi-Cal state plans must cover these services by 2014.

Essential health benefits must include items and services within at least the following 10
categories:
1. Ambulatory patient services (outpatient services)
2. Emergency services
3. Hospitalization, including medically necessary surgeries and other inpatient
procedures
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health
treatment
6. Prescription drug coverage
7. Rehabilitative and habilitative services and devices*
8. Laboratory tests and services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care

Health plans are allowed to impose cost sharing obligations on plan members for most
essential benefits, but those that qualify under a category of preventive health services
will be made available at no charge to plan members.

The ACA gives states authority to specify details surrounding the essential benefits. The
states must each choose a benchmark plan that will serve as a more detailed definition of
benefits within each of the ten Essential Health Benefit categories.

California has selected the "Kaiser Foundation Health Plan, Inc. - Kaiser Foundation Health Plan Small Group HMO 30 ID 40513CA035"as its state benchmark plan.

Colorado selected the "Kaiser Foundation Health Plan of Colorado - Ded HMO 1200D" as its state benchmark plan. Following are sample Evidences of Coverage and Plan Summaries for the benchmark plans.

The Affordable Care Act changed the definition of Small Groups to be those with 1-100 full-time (FTE) employees.  Groups with 51-100 FTEs were required to transition from Large to Small Group on January 1st, 2016. Some groups chose an "Early Renewal" option in order to bypass this requirement for one more year. However, in 2017 there will be no escape.

Small Group guidelines and regulations differ from Large Group.  It’s important to be aware of the changes.  We've collected our considerable resources into one toolkit to help your transition..

These tools include but are not limited to:

• Interactive Plan Comparison Tools
• Multi-Plan Calculators
• Health Care Reform Calculators
• Transition Documents
• Medical Network Comparisons
• Summary Benefit Comparisons
• And many more exclusive tools

Call Unlimited Benefits today to help transition your group as easily as possible. 

888-587-9370

Download your "At-A-Glance Transition Guide."

On September 9, 2013, the IRS released proposed regulations on the Affordable Care Act (ACA)'s annual information reporting requirements under Internal Revenue Code (IRC) sections 6055 and 6056.  Employers and medical benefits providers have been eagerly awaiting these new proposed regulations.

Who is responsible for the reporting?  

IRC section 6056:  Large employers (as defined by the Employer Shared Responsibility Provisions) with both fully-insured and self-insured plans are subject to the reporting.  This means that employers subject to the 2015 penalties must comply with this reporting requirement. 

IRC section 6055:  Employers who sponsor self-insured health plans

How does an employer report the information?

IRC section 6056:  Forms 1094-C and 1095-C (or a substitute form if certain requirements are met)

IRC section 6055:  Form 1095-B (or a substitute form if certain requirements are met)

When will reporting begin?

IRC sections 6065 & 6055:  February 28, 2016 (or March 31, 2016 if filed electronically). The report must cover information for the 2015 calendar year.  Employers must continue to report annually. 

The IRS encourages employers to voluntarily comply with the information reporting provisions in 2014 in order to test reporting systems and plan designs prior to full implementation in 2015.

What information must be reported to the IRS? 

IRC section 6056:  For each person enrolled in coverage, the employer must report to the IRS the following:

• Name, address and Employer Identification Number of the employer;
• Certification as to whether the employer offers its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer sponsored plan;
• The number of full-time employees for each month during the calendar year;
• For each full-time employee, the months during the calendar year for which coverage under the plan was available;
• For each full-time employee, the employee's share of the lowest cost monthly premium (self-only) for coverage, providing minimum value offered to that full-time employee under an eligible employer-sponsored plan.  This information must be provided for each calendar month;
• Name, address, and Taxpayer Identification Number of each full-time employee during the calendar year and the months, if any, during which that employee was covered under an eligible employer-sponsored plan; and
• Any other such information as the IRS may require.

IRC section 6055:  For each person enrolled in coverage, employers sponsoring self-insured plans must report to the IRS the following:

• Name of each individual enrolled;
• Name and address of the primary insured or responsible individual who submits the application for coverage (such as a parent or spouse);
• Taxpayer Identification Number for each covered individual;
• Months of coverage for each covered individual;
• Any other information specified by the forms instruction and published guidance provided for by sections 601.601(d) and 601.602;
• Name, address and Employer Identification Number of the employer maintaining the plan; and
• Whether coverage was enrolled through the Small Business Health Insurance Options Program (or "SHOP").

What must employers provide to covered individuals?

IRC sections 6056 & 6055:  Employers must provide written notice to covered individuals of the following:

• Name, address and contact number of the reporting entity; and
• The information (listed above) required to be reported to the IRS concerning the covered individual (pursuant to either IRC section 6055 or 6056 as applicable).

Other information that employers may need to report:

The proposed regulations state that simplified reporting methods are under consideration, and the IRS may request additional information from employers, including:

• Information as to whether the coverage offered meets minimum value,
• Total number of employees by calendar month,
• Whether coverage was affected by a waiting period, and
• Whether an employer was not conducting business during any particular month or does not expect to be an "applicable large employer" the following year.

Where can employers obtain more information?  The proposed regulations are available at https://www.federalregister.gov/articles/2013/09/09/2013-21783/information-reporting-of-minimum-essential-coverage and https://www.federalregister.gov/articles/2013/09/09/2013-21791/information-reporting-by-applicable-large-employers-on-health-insurance-coverage-offered-under.

Simply put, according to ACA guidelines, you're new company can not obtain group benefits until there is at least one person on payroll for 50% of the previous quarter. 

For example, you've incorporated in December of the previous year but you have no W2 employees until March of the new year. Your company would be ineligible to start a benefit program until June 1. This would be the beginning of the 3rd Quarter. 

Other guidelines and Underwriting requirements for carriers in California can be found in this fantastic spreadsheet below. 

 #unlimitedbenefits, #groupbenefits, #businessinsurance, #bluecross