FAQs

How to choose the right benefits broker?

 

Make sure there's a good service model behind your broker. All too often a licensed broker sells you on his agency and then non licensed individuals try to service your account. Human Resources should be able to call your broker with employee questions and receive accurate answers.  Otherwise the results can have a very detrimental impact on your employees and ultimately your business. 

Are only large groups required to have employer sponsored health insurance?

In January of 2018 Massachusetts passed a law to encourage more small businesses to offer employee health insurance.  Since January employers with 6 or more employees will pay a new penalty of up to $750 for each non-disabled worker, who receives health insurance coverage through MassHealth (or other subsidized coverage) instead of through an employer-sponsored health plan.  

How are benefit brokers compensated?

Generally, you don't pay your broker directly.  Regardless your broker should be providing support to your organization throughout the entire year.  Most brokers are compensated a small percentage of your insurance premium.  As we know insurance premium is costly so you should be receiving exceptional service.  

When is the best time to switch brokers?

You can choose a new broker at any time as long as it is not too so close to your annual renewal date.  Changing brokers is a simple as signing a letter.  The new broker will receive everything they need from your insurance carrier(s) to effectively manage your benefits.

Do brokers advise on reporting requirements for benefit programs?

Absolutely. Good brokers will make you aware of employee benefit required reporting well before their due dates and even offer guidance as to how to correctly complete formal documents. 

How do I find a great workplace wellness program?

It is essential to start with someone who is highly qualified.  There are a lot of "experts" in the field.  However, we suggest choosing someone with at least a bachelor's degree in nutrition. Additionally, since the most successful workplace wellness programs ultimately need to drive culture change, we also recommend finding someone that inspires employees. 

Does Massachusetts require employers with 25 or more full-time employees to have paid family and medical leave?

Yes on June 28, 2018, Governor Charlie Baker signed a Bill that establishes a mandatory statewide paid family and medical leave program for all employers, which will be administered by the new Department of Family and Medical Leave. The leave program will be financed through employer and employee contributions for groups with 25 or more full-time employees.

Was the Affordable Care Act (ACA) ruled invalid?

Yes on December 14, 2018, a federal judge rules that the entire Affordable Care Act is invalid due to the elimination of the individual mandate penalty in 2019.  However, the White announced the ACA will remain in place pending appeal.  Additionally, the Department of Health and Human Services confirmed that it will continue administering and enforcing all aspects of ACA. 

What is the Pay or Play rules?

The Affordable Care Act requires applicable large employers (ALEs) to offer affordable, minimum value health coverage to their full-time employees or pay a penalty.  The IRS clarified that ALEs can use an affordability safe harbor to adjusted affordability contributions percentages.  Employer-sponsored coverage will generally be considered affordable under the employer shared responsibility rules if the employee's required contribution for self-only  coverage does not exceed 9.86% of the employee's household income for 2019 plan year.

Generation Z will be entering the workforce. Is your company ready to attract & retain this group?

Generation Z have never known a life without technology. This means if your business still touts outdated tech, generations Zers likely won't give you a second thought. For this generation it is not as important who they connect with across the hall, but rather who they connect with across the screen. The company that developed WordPress employs more than 430 people distributed across forty countries does not have an office. This company  powers more approximately 24% of the internet today and is valued at more than a $1.16 billion dollars.  Employees are valued on the help they provide to their co-workers. 

What are the employer shared responsibility rules?

  

The employer shared responsibility rules were added under Code Section 4980H by the ACA. Under these rules, certain employers (called applicable large employers, or ALEs) must either:

· Offer health coverage that is “affordable” and that provides “minimum value” to their full-time employees (and offer coverage to the full-time employees’ dependents); or

· Potentially pay an employer shared responsibility penalty to the IRS, if at least one of their full-time employees receives a premium tax credit for purchasing individual coverage through a Health Insurance Marketplace (Marketplace), also called the Exchange.

Whether an employer is an ALE, and is therefore subject to the employer shared responsibility rules, depends on the size of its workforce. In general, employers employing at least a certain threshold number of employees (generally, 50 full-time employees, including full-time equivalent employees, which means a combination of part-time employees that count as one or more full-time employees) are ALEs. The vast majority of employers fall below the ALE size threshold, and therefore are not subject to the employer shared responsibility rules.

Are all employees of an employer taken into account in determining whether the employer is an ALE?

  

Generally, all employees are counted (either as full-time employees or FTEs) when an employer is determining whether it is an ALE, but there are some exceptions.

· Seasonal workers: An employer is not an ALE if both of the following apply:

o The employer’s workforce exceeds 50 full-time employees (including FTEs) for 120 days or fewer during the preceding calendar year; and

o All of the employees in excess of 50 employed during that period of no more than 120 days are seasonal workers.

  

“Seasonal workers” are   workers who perform labor or services on a seasonal basis (as defined by the   DOL) and retail workers employed exclusively during holiday seasons. For this   purpose, employers may apply a reasonable, good faith interpretation of the   term “seasonal worker” and a reasonable, good faith interpretation of the   DOL’s definition of seasonal worker.

· TRICARE/Department of Veterans Affairs (VA) Coverage: Employees who have coverage under TRICARE or a VA health program are not taken into account in determining if an employer is an ALE.

These exceptions apply solely for purposes of determining whether an employer is an ALE. For additional information, see Section 4980H(c)(2)(F) and Section 54.4980H-2(b) of the regulations.

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