Tom Weatherman’s Article in the Nashville Business Journal — Health Care Reform and Employee Benefits

Health Care Reform and Employee Benefits — Putting Your Broker to Work

By Tom Weatherman

Director of Insurance Services

Employers of all types are now grappling with health care reform that can impact a company’s operations on a number of administrative and operational levels.

Health reform is also referred to as the Patient Protection and Affordability Care Act (PPACA), Affordable Care Act (ACA), and Obamacare.  It includes terms such as minimum value requirements, essential health benefits, cost sharing, play or pay and market place exchanges. Common reform questions include:

  • Am I covering employees who work an average of 30 hours per week?

  • Do employee premium contributions exceed 9.5% of their household income?

  • Do our group benefits meet the 60% minimum value requirement?
  • What are my tax and fee obligations?

Business professionals need to understand that this is truly a new dawn when it comes to employee benefits, and never before has the importance of informed expertise in the field been more relevant.

An employer’s relationship with his or her benefits broker needs to be openly communicative, proactive and consistent. Your broker is the conduit between your company, the government regulators and the insurance companies. And any communication on behalf of your company should result from strategic planning between your internal team and your benefits professional.

The first step in putting your broker to work is to have them educate you on the challenges ahead. As an employer, you have a responsibility to understand your options and your obligations. If your broker can not help you understand why and how things have changed, find another one. But be informed. Ignorance is not an excuse.

Step two is to build a plan of attack. Address how your medical plan will conform to PPACA regulations while also meeting regulatory changes, educating employees, and managing health care cost. Once this is built, identify the holes and possible solutions.

Step three is to engage your broker in an on-going dialog. Insist on being ahead of change, and addressing issues before they become problems. Waiting around and hoping that you are in compliance or assuming that your broker has everything covered is not a safe assumption. Like your accountant or your attorney, your benefits broker needs to be on speed dial.

Finally, use your broker to inform your employees about their plan. Make sure they understand their coverage and any necessary logistics. As the employer, you should be part of that conversation, but your broker should manage the heavy lifting.

In summary, employee benefits are no longer an easily categorized element of American business. Build a relationship with a broker you trust, and lean on that relationship whenever necessary.

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