What are pay-per-use Health Insurance plans?

Level Funding

As health care costs continue to rise, level funding and self-funding are becoming a more and more attractive option for smaller companies. Technically speaking Benefit Administration Group uses level funded health insurance and insurance captives as the funding mechanisms for each pay-per-use health plan. In more simple terms, here is what that means for customers like you:

  1. Each plan has fixed monthly premiums and no change in monthly costs regardless of how many claims are incurred each month.
  2. Instead of your premium rates being determined by community rates set by your employees’ age and zip code, premium rates are determined by proper underwriting and the actual risk (demographics and health history) of your employees. This is accomplished through the use of a simple online health questionnaire and allows many companies to get far lower rates than they would otherwise from regular fully insured products.
  3. At the end of each year, if you incurred fewer claims than expected, your company gets a refund for the unused claims dollars.
  4. You have stop loss insurance fully baked into your plan rates so that if you incur more claims than expected during any given month, or throughout the year, you still never pay more than the fixed monthly premiums.
  5. If at any time you don’t like your plan, or you don’t like your renewal rates you can always leave and go back to your old carrier or a new one.

Human Resources Q & A of the Day

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Question:


Should an employee’s background check, interview notes, and benefit information be kept separate from the personnel file?

Answer:


As a best practice (and in certain instances it is legally required), employers should keep certain employee records and information in a confidential file separate from the personnel or employee file. Below is general best practice guidance regarding personnel and confidential files and recordkeeping you may find useful.

Personnel Files

A personnel file may contain documents that fall into one of the following categories of records (note that a Social Security number should not be accessible via the personnel file and is a good indicator that the document should be filed elsewhere):

  • Basic Information. This category includes personal information such as the employee’s full name, address, and emergency contact information.
  • Hiring Documents. Many employers retain documents related to the hiring process, including signed job descriptions, employment applications, and resumes. (Note that other recruiting documents are typically retained in a recruitment file along with information about other candidates, indicating why one candidate was selected over others as well as other information regarding the hiring process.)
  • Job Performance and Development. This is a broad category that may encompass documents such as performance evaluations and supervisory or management notes regarding performance issues; corrective action or disciplinary letters; awards, nominations, and other commendation letters; promotion records; and records of trainings or education.
  • Employment-Related Agreements. Any aspect of the employment relationship which is governed by an agreement between the parties, such as an employment agreement, union contracts, noncompetition agreement, confidentiality or nondisclosure agreement, should be kept in the personnel file.
  • Compensation. This category includes documents related to compensation and relevant changes to an employee’s pay and position for future reference. (Payroll records should be retained by the payroll department or in a separate file along with Forms W-4, garnishment documentation, time records, absences, etc.).
  • Termination and Post-Employment Information. Information related to an employee’s termination should be kept on file should a dispute later arise. Compile all documents and retain in archive including exit interview forms (if applicable) and any final employee performance appraisal, as well as a record of documents provided to the employee along with the final paycheck (e.g., termination letter, benefits notices, unemployment compensation forms, etc.).

Confidential Files — Keep Separate from the Personnel File

As stated previously, it is a best practice (and in certain instances a legal requirement) to keep certain employee records and information in a confidential file separate from the personnel file, such as the following:

  • Medical benefit records and documents that relate to an injury or disability.
  • Material relating to workers’ compensation claims.
  • Family and medical leave documents.
  • Employment verification information.
  • Wage garnishment documentation.
  • Forms W-4, if not maintained in payroll.
  • Documents pertaining to sensitive matters, such as harassment investigation records or any information pertaining to an employee’s religion (such as a request for Jewish holidays off as a reasonable accommodation).
  • I-9 documents must be maintained in a separate file or binder for all active and inactive employees until appropriate destroy dates are met.

Some employers may also retain aptitude test scores, background check results, and credit reports in the employee’s confidential file, though it is recommended that documents relative to a hiring decision should also be retained in the recruiting file, yet still maintain protection of private information (i.e. date of birth and Social Security number).

 

Human Resources Q & A of the Day

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Question:
We recently made some changes to our handbook policies regarding benefits offered to employees and have a disclaimer stating, “The Company reserves the exclusive right to change or terminate any benefits or related policy at any time in accordance with applicable law.” Are we required to have employees sign a new acknowledgment of the handbook because of these recent changes?

Answer:
Yes, employees should be required to sign an acknowledgment noting that they are aware of any new policies or changes to existing policies.

Any new or changed policy should be provided to employees through the distribution of a new handbook accompanied by a brief memo directing the employees to the locations of the changes and requesting an updated acknowledgment signature. Without distributing and getting proof of receipt, the changed policies may be difficult to point to when correcting, disciplining, or terminating an employee. Most employers update their handbooks every one to two years. If there is a major change to an integral policy, that may be distributed separately and added to the handbook as an addendum until the next revision.

While not required, handbooks are a best practice in order to minimize risk. Clearly articulated and distributed handbooks can supplement a defense against many compliance issues such as, but not limited to, claims of sexual harassment, wrongful termination, and discrimination.

Handbooks are a general overview of policies and procedures. Key handbook policies include:

Definitions of commonly used terms.
Explanation of to whom the Handbook and its policies apply.
At-will employment policy.
Disclaimer that handbook is not a contract and the right to change policies without notice.
Antiharassment Policy.
Equal employment opportunity/discrimination/accommodation policies.
Leave of absence and family and medical leave policy (if applicable).
Maternity leave policy.
Drug-free workplace policy.
Standards of conduct.
Timekeeping and overtime.
Paid time off/vacation/sick leave policies.
Lastly, because a handbook is not legally mandatory, it may contain whatever information an employer wishes to impart to its employees. In addition, handbooks are traditionally separate from benefits summaries and other health and welfare plan materials, although the handbook may discuss employee status (full time, part-time, etc.) and may refer employees to benefit plan materials. Further, handbooks do not need to outline company job positions or titles; this can be maintained separately in the job descriptions.

As a best practice, we recommend reviewing new or modified policies with counsel prior to implementation.

Top Questions on Dependent Care Spending Accounts

School’s out! Summer is here, and it’s the time of year when working parents have questions about using their Dependent Care Spending Accounts (DCSAs). Are summer camp expenses eligible? What about day versus overnight camps? Employers and benefit advisors want to be ready with answers about this valuable benefit program.

The following are the top summertime questions about DCSAs and reimbursable expenses:

1. What are the basic rules for reimbursable expenses?

Dependent care expenses, such as babysitting and daycare center costs, must be work-related to qualify for reimbursement. Work-related means the expenses are for the care of the employee’s child under age 13 to allow the employee to work. If the employee is married and filing jointly, the employee’s spouse also must be gainfully employed or looking for work (unless disabled or a full-time student).

In some cases, expenses to care for a disabled dependent, regardless of age, may be reimbursable. This article focuses on expenses for children under 13 since those are by far the most common type of DCSA reimbursement.

2. One of our employees and his family are taking a two-week vacation this summer, but his children’s daycare center will charge its regular fee. Are the expenses reimbursable even if the employee and spouse are off work?

Yes. In most cases, expenses are not eligible unless the dependent care services are necessary for the parents to work, but some exceptions apply. The IRS rules for DCSAs provide that expenses during short, temporary absences are eligible if the employee has to pay the child’s care provider. Absences of up to two weeks are automatically considered short, temporary absences. Depending on the circumstances, longer absences also may qualify.

3. During the school year, our employee uses her DCSA for her 10-year old’s after-school daycare center expenses. This summer, the child’s daycare will be provided by her 20-year old sister. If the older daughter bills for her services, are the costs eligible for reimbursement?

The answer depends on whether the employee or spouse can claim the older daughter as a tax dependent. If the older daughter can be claimed as a dependent, whether or not the employee actually claims her, she is not a qualifying dependent care provider under the DCSA rules.

If the older daughter cannot be claimed as a tax dependent, her charges for providing care are eligible expenses. The specific rule is that a child of the employee, whom the employee cannot claim as a dependent, may be a qualifying provider if the child is age 19 or older by the end of the year.

Note that the employee’s spouse or the child’s parent is never a qualifying provider.

4. One of our employees has to pay an application fee and deposit before her child starts attending a daycare center this summer. Are those expenses eligible for reimbursement?

Prepaid expenses are eligible for DCSA reimbursement, provided the costs are required in order for the child to receive care. In this case, after the daycare center begins providing care, the employee can be reimbursed for the application fee and deposit she paid. On the other hand, if the employee cancels and her child does not attend, then the application fee and deposit are not eligible expenses.

5. An employee will pay day camp expenses for his 8-year old son and overnight camp expenses for his 12-year old daughter this summer. Are both types of expenses eligible for reimbursement?

The day camp expenses generally are reimbursable. Expenses for overnight camp, however, are not eligible since overnight care is not work-related.

Under the IRS rules for DCSAs, expenses for food, lodging, clothing, education and entertainment are not reimbursable. If, however, such expenses are small, incidental expenses that cannot be separated from the cost of caring for the child, they may be included for reimbursement. For instance, the day camp may include lunch, snacks, and some sports activities in its basic fee which would be eligible for reimbursement.

6.  An employee’s children go to private year-round schools. He pays tuition for one child’s grade school and fees for the other child’s nursery school. Are both types of expenses eligible for reimbursement?

Educational expenses are not reimbursable, unless the educational services are merely incidental as part of a child care service. Expenses to attend kindergarten or a higher grade are educational, so the older child’s school fees are not eligible for DCSA reimbursement. (Expenses for before- or after-school care, however, may qualify as reimbursable expenses.)

On the other hand, expenses for a child in nursery school, preschool, or a similar program for children below the level of kindergarten are expenses for care. Such expenses are not considered educational even though the nursery school may include some educational activities.

For detailed information about expenses eligible for DCSA reimbursement, the IRS provides a helpful guide: Publication 503 “Child and Dependent Care Expenses.” Have a fun summer!

Retaining Employees

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Retaining skilled employees is a significant issue for any business. A high rate of employee turnover can result in a loss of knowledge and skills, as well as have a direct impact on a company’s bottom line. The cost of losing an employee includes not only lost productivity, but also the expense of recruiting, selecting and training a new employee. Consider the ideas presented below to help reduce turnover and increase satisfaction among your company’s valued employees.

Why Employees Stay

Some of the factors affecting retention include:

  • Compensation
  • Good leadership
  • Challenging and fulfilling job
  • Relationships with immediate supervisors and staff
  • Recognition

Ways to Increase Retention

The following are a number of ways to help increase retention:

  • Acknowledge and reward your employees’ contributions and provide regular, constructive feedback
  • Make sure your compensation package is fair and competitive
  • Provide a forum to encourage new ideas and open communication
  • Provide training programs and mentoring to enhance skills development, learning and career growth
  • Provide employee assistance, wellness and health programs
  • Support work-life balance
  • Offer flexible work arrangements, such as varied hours and the possibility of telecommuting
  • Provide leadership opportunities

Employee Attitude Surveys

Employee attitude surveys allow your staffers to give confidential feedback on their opinions of your company in terms of satisfaction with the job and how their jobs and work environment might be improved. To help build a relationship of integrity and trust among company employees, the results of your survey should be communicated effectively and acted upon by your company.

There are a number of different ways to conduct an employee attitude or satisfaction survey– from simply filling out a paper survey to taking an online survey or hiring a consulting firm to do all the surveying and analysis work for you. If you work with a consultant to administer an employee satisfaction survey, make sure you have access to the data. By personally reviewing the data and analysis, you’ll be able to make a better assessment of employee satisfaction. The survey results can provide you with key information on how to improve workplace processes, policies and morale to retain existing staff and attract new employees.

Some of the topics that can be covered in a survey include:

  • Satisfaction
  • Senior Management
  • Functional Expertise
  • Compensation
  • Customer Service
  • Communication
  • Mentoring
  • Leadership
  • Teamwork
  • Staff Development

Benefits of Employee Attitude Surveys

  • Facilitate company’s development and change.
  • Focus the company on specific needs or gaps in service or training.
  • Provide management with employee feedback on company morale.
  • Provide feedback on the impact of company policies and procedures.
  • Results can be used to motivate employees and improve job satisfaction.

Developing a Health and Wellness Program

A company health and wellness program refers to activities or initiatives undertaken within the workplace that are designed to support your employees’ general health and well-being. Programs will often differ from business to business in terms of the range of initiatives offered.

Health and Wellness Initiatives

Some simple initiatives to consider include:

  • Providing filtered water.
  • Having your air-conditioning and heating systems checked and maintained on a regular basis.
  • Increasing the nutritional quality of food available in the workplace.
  • Providing desk chairs that are ergonomically designed to support the back.
  • Empowering employees to include physical activity into their working day, such as encouraging walking at lunch.
  • Providing incentives such as such subsidized memberships to local health clubs. Be sure to check with your local health clubs to see if they offer corporate rates.
  • Providing more flexible work hours.

Summer Interns Could Be Subject to Minimum Wage and Overtime Requirements

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Internships Most Often Considered “Employment” by DOL

Employers planning to hire interns this summer should keep in mind that the U.S. Department of Labor (DOL) has stated that private sector internships are most often considered “employment” subject to the federal Fair Labor Standards Act’s (FLSA) minimum wage and overtime rules.

The Test for Unpaid Interns
There are some circumstances under which individuals who participate in for-profit private sector internships or training programs may do so without compensation. The determination of whether an internship or training program meets this exclusion depends upon all of the facts and circumstances. The DOL uses the following six criteria which must be applied when making this determination:

  1. The internship, even though it includes actual operation of the facilities of the employer, is similar to training which would be given in an educational environment;
  2. The internship experience is for the benefit of the intern;
  3. The intern does not displace regular employees, but works under close supervision of existing staff;
  4. The employer that provides the training derives no immediate advantage from the activities of the intern, and on occasion its operations may actually be impeded;
  5. The intern is not necessarily entitled to a job at the conclusion of the internship; and
  6. The employer and the intern understand that the intern is not entitled to wages for the time spent in the internship.

If all of the factors listed above are met, an employment relationship likely does not exist under federal law, and the FLSA’s minimum wage and overtime provisions do not apply to the intern. This exclusion is narrow, because the FLSA’s definition of “employ” is very broad.

Note: Be sure to check your state wage and hour laws for applicable requirements. When both the FLSA and a state law apply, the employee is entitled to the most favorable provisions of each law.

How to Keep Your Employees Motivated This Summer

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The warm weather and eagerly anticipated outdoor activities of summer may take a toll on your workers’ concentration. If you’re noticing a lack of focus among your employees during this time of year, consider the following ideas to help keep them motivated:

  1. Encourage your employees to step outside for at least 15 minutes each day. Exposure to natural sunlight can prevent workers from feeling confined to the office during the warm summer months. Holding business meetings outside may also help to boost workers’ morale.
  2. Change things up! Employees may become more motivated when their jobs are more challenging and interesting. Consider lateral moves to build your workers’ skill levels and knowledge base.
  3. Create opportunities for casual interaction. A company sports team, a family day or an outdoor after-hours social event can keep your employees engaged and interested in each other and in their workplace.
  4. Consider flexible working arrangements. Arrangements such as flextime or staggered work hours may allow employees to enjoy summer activities and attend to family obligations, while coming to work refreshed. It’s a good idea for employers to work with a knowledgeable employment law attorney when creating policies on flexible working arrangements, to ensure policies and practices are in compliance with the law and do not unlawfully discriminate against certain employees.