New Model Exchange Notices — Distribute to Employees No Later Than October 1, 2013

New Model Forms Released: Health   Insurance Exchange Notices and Revised COBRA Election Notice

Employers and group health plan   administrators will want to download new   model notices released by the U.S. Department of Labor (DOL) to   comply with changes as a result of Health Care Reform.

New Model Exchange Notices —   Distribute to Employees No Later Than October 1, 2013
Following a delay in the original effective date, employers need to comply   with the new requirement to provide employees a written notice with   information about a Health Insurance Exchange (Marketplace) beginning this   fall. Two separate notices are available from the DOL:

  • Model Notice for Employers Who Offer a        Health Plan to Some or All Employees
  • Model Notice for Employers Who Do Not        Offer a Health Plan
Employers are required to provide   the written notice to each current employee not later than October 1, 2013,   and to each new employee at the time of hiring beginning October 1, 2013 (a   notice will generally be considered to be provided ‘at the time of hiring’ if   it is furnished within 14 days of an employee’s start date).

Employers must provide the notice   automatically and free of charge to each employee, regardless of plan   enrollment status or of part-time or full-time status. The notice may be   distributed by first-class mail, or electronically if certain requirements   are met. Employers do not need to provide a separate notice to dependents or   other individuals who are or may become eligible for coverage under the plan   but who are not employees.

Updated Model COBRA Election   Notice
A revised Model COBRA Election Notice is now available   for group health plans subject to federal COBRA to inform eligible   employees and dependents of the right to continue coverage and how to make an   election when a qualifying event occurs.

COBRA generally requires plan administrators to provide eligible   individuals (called ‘qualified beneficiaries’) an election notice within 14   days after receiving notice of a qualifying event. The updated model notice   includes additional information for qualified beneficiaries who may want to   consider and compare health coverage alternatives to COBRA that will be   available through the Health Insurance Exchanges (Marketplaces), which are   expected to begin operating in 2014.

Check out our Group Health Plan Notices Calendar for   information on other notice requirements and to download additional model   notices.

New Version of Form I-9

Employers Must Use New Version of Form I-9 Beginning May 7, 2013

Employers needing additional time to switch to the new Form I-9 (released in March) have until May 7th to begin using the revised version. Federal law requires all U.S. employers to verify the identity and employment eligibility of employees hired to work in the United States by completing Form I-9.

Prior versions of the Form I-9 will no longer be accepted effective May 7th, 2013. Employers should not complete a new Form I-9 for current employees if a properly completed Form I-9 is already on file.


(SBC) Summary of Benefits and Coverage for 2014

New Summary of Benefits and   Coverage Template for 2014

Employers responsible for   distributing a summary of benefits and coverage (SBC) to employees in   connection with group health plan coverage will need to include additional   language to satisfy new requirements under Health Care Reform becoming   effective in 2014. An updated SBC template, which includes the new language,   is now available for SBCs provided with respect to coverage beginning on   or after January 1, 2014 and before January 1, 2015.

SBC Notice Requirements
Group health plans are required to provide, without charge, a standard SBC   form explaining plan coverage and costs to employees at specified times   during the enrollment process and upon request. For insured group health   plans, the notice requirement may be satisfied if the issuer furnishes   recipients with a timely and complete SBC.

New Language Required for 2014

The updated SBC template includes   additional language indicating whether the plan provides “minimum   essential coverage” (the type of coverage an individual needs to satisfy   the individual responsibility requirement), and   whether the plan meets the “minimum value” standard under Health   Care Reform (meaning the plan pays for at least 60% of covered health care   expenses).

FAQs issued simultaneously provide some relief for plans   already working on preparing SBCs for 2014, where adding the new information   to the template would present an administrative burden. To the extent a plan   is unable to modify the SBC template for coverage beginning on or after   January 1, 2014 and before January 1, 2015, a plan may use the previously   authorized template, so long as the SBC is furnished with a cover   letter or similar disclosure stating whether the plan does or does not   provide “minimum essential coverage” and “minimum value.”

Stress at Work Solutions

5 Tips for Keeping Stress at Work in Check

Stress in the workplace, whether triggered by significant workloads or pressing deadlines, can sidetrack employees and prevent them from doing their best. The following simple steps for managers and employees can help reduce the pressure and increase team performance and productivity:

  • Avoid Setting Unrealistic Goals. Setting achievable goals with reasonable timelines helps your sense of accomplishment grow while your stress level declines.
  • Step-Out Complicated Projects. Dividing a complex project into phases provides specific direction, helps maintain a calm environment, and motivates the team. Daily or weekly to-do lists can also help prioritize tasks.
  • Make Time for Meetings and Completing Tasks. Blocking out the time necessary to complete a task on your calendar is just as important as scheduling time for meetings.
  • Communicate Regularly. Recognizing employee achievements can increase confidence, as well as reduce stress related to workloads. Employees may also be able to help identify new ways that they can contribute.
  • Schedule Time for Exercise. A regular exercise routine can help lower stress and recharge your batteries for the challenges ahead.

Does Your Health Plan Pass Section 105(h) Nondiscrimination rules?

Plan sponsors are required to do annual discrimination testing to remain qualified. The testing is two part; “The Benefits Test” and “The Eligibility Test”. Failure to properly preform and report these annual test can result in a failing plan. Penalties can include benefits becoming taxable as income! If you are not sure if your plan is in compliance gives us a call we can help!

Wellness! Wellness! Wellness!

“Well designed health promotion and disease prevention interventions work only if people participate. The higher the level of participation, the greater the potential savings to a health plan. These savings are not only from direct health care cost, but also from improved productivity at work and fewer absences. But the battle is how does a health plan engage members in participating in wellness and health promotion programming?”

Ask us; we will tell you how to engage your employees!

Do you qualify for the 2010 Small Business Health Care Tax Credit?

The Small Business Health Care Tax Credit is designed to help small businesses who have no more than 25 fulltime employees, not counting owners or their family members, and the average annual wages of employees must be less than $50,000 per fulltime employee. This health care tax credit also mandates that the owner of the small business must pay a least 50% of the single coverage for their employee’s to qualify for this credit. This credit is targeted at small business with the express intent to encourage organizations to offer health insurance coverage for their employees. We recommend that you discuss this credit with your tax consultant to determine your eligibility and potential credit amount should your company qualify.

New Testing Available for Diabetes!

A new test is available called the NMR LipoProfile. This test can predict the development of type 2 diabetes in women as early as 13 years before blood glucose test put them in the category of diabetic. Study’s done at Harvard University linked women with the greatest concentration of small LDL and HDL particles four times as likely to develop type 2 diabetes. The test suggests this occurs because the tiny particles are more densely packed with cholesterol and triglycerides. To learn more visit

My company’s group insurance policy renews January 1, 2011. When should I hear from my agent to start the renewal quoting process?

The short answer is now. The truth is, with this complex time in major group medical, agents should be in regular contact with their customers. The new federal legislation on health insurance is complex and changing. It is our top priority to make sure that our customers are informed about changes to the health care laws. Our goal is to make sure your company is well informed and compliant with all the new laws. Please feel free to call or email us for a quote today.

If I’m on Medicare will my benefits change?

Those individuals who are Medicare age now or will be in the near future will see benefits expand slightly under a basic package of Medicare benefits. Let’s start with prescription drugs, or what is known as Part D. At the end of August nearly 1 million Medicare beneficiaries received a $250 check to help bridge the coverage gap, or what is better known as the “doughnut hole”. This is the gap in Part D coverage where beneficiaries must pay the full cost of their prescriptions until the catastrophic coverage kicks in. Starting in 2011, beneficiaries will receive 50 percent discounts on brand name drugs and 7 percent discounts on generic drugs while they’re in the coverage gap. The new health law is scheduled to close the gap entirely by 2020. Beginning in 2011 the new changes to health care also state that Medicare beneficiaries won’t have to pay co-payments or deductibles on many preventive health care services, including diabetes and cervical cancer screenings. Medicare will also pay for your annual wellness visit to the doctor. If you are looking for sound advice when it comes to Medicare, call or email me I am happy to help. ~ Bryan Valentine.