Blog 2018-04-22T03:00:08+00:00

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Trump institutes new Health Insurance options for Small Business owners, lower prices

By | June 21st, 2018|Categories: Uncategorized|

Yesterday, President Trump finalized the regulations allowing #SmallBusiness to have more options for their Group Health offerings to #employees.  Association Health Plans, or #AHP, are now less restrictive because of Trump legislation.  AHPs allow certain employers to band together to obtain Group Health Insurance through an “association” affiliation.  The employer must be in the same industry to be able to join the AHP, but the potential benefits could be much lower pricing.

Potential benefits to joining an AHP

When an employer joins an AHP and purchases Health Insurance through them, there could be a monthly savings on premium.  The idea is that pooling resources and large group purchasing has more power than our traditional #EmployeeBenefits pricing structure in place now.  The Group Health benefits could be tailored to fit the industry and what the AHP wants to offer to their members.  Something else that you don’t hear much about it that the rating structure can be different than what is currently available now.  When a larger group obtains #GroupHealth from insurance carriers, employee pricing is not based on age.  A single employee price is X, employee plus spouse is Y….etc.  Currently groups under 100 employees pricing is age rated, meaning someone 20 is fairly cheap (nothing is cheap anymore) and someone 60 is stupid expensive.  If you have an older group of employees, this may be a viable solution for cost savings….younger groups, maybe not.

Drawbacks to AHPs and the coverage options

With AHPs, because of the way they’re structured, they can offer #EmployeeBenefit plans that do not include the #ACA mandated essential coverage services like maternity, pediatric dental, even hospitalization.  Some see this as a good thing.  Why would someone 55 years old want to pay for maternity coverage or pediatric dental at their age.  I get more angry calls from people that are seeing double digit increases, complaining about having to “subsidize” others for coverage they don’t need or want.  They have a point.  If someone has kids, let THEM pay for the increase

Employee Benefits and Group Health Insurance may not make sense for some employers

By | June 17th, 2018|Categories: Uncategorized|

Depending on what type of company you run and who you are trying to attract and retain as employees, will determine if you, as an #employer, should be offering #GroupBenefits and Group Health Insurance for your people.  Employee Benefits are usually the second most costly line item for employers, right underneath wages.  Depending on your industry, you may not need to offer Employee Benefits

Employees have to see Employee Benefits as a value, or don’t waste your money

I speak to employers constantly that wrestle with the idea of having to spend tons of money each month on Group Benefits,   In some cases, I recommend against it.  My first question to them is “why are you looking into Employee Benefits?”  Their answers are usually all over the map.  If the employer does not see this as a value for their people, our conversation is usually pretty short.  Without having the right mindset for an Employee Benefits offering, it usually goes horribly wrong.  What I’ve learned is that unless you’re going into this for the right reasons, no one likes the outcome.

Unless both the employER and the EmployEES see value in Group Insurance, we’ve got a problem

Here is a typical scenario: the business owner, begrudgingly puts together an Group Health Insurance plan for the company.  The owner does not see value in the offering and selects the absolute cheapest plan available….and then wants to contribute almost nothing towards the employee’s monthly premium.  The message that the employee hears: they don’t care about me, and they only want to spend the bare minimum and expect me to foot the rest of the bill.  Which translated means: I’m not valued.  So the employer spends lots of money every month, for a Employee Benefits plan that the employees don’t like, and also sends a negative message to the employees who are expected to pay for the bulk of the coverage.

Having employees involved in the Employee Benefits process sends a positive message

In every Group Health Plan I’ve helped put together, when an employer has the employees become part of the process, it always turns out more positive.  Both the business owner and employees can discuss what’s available, what each can afford, and sends a much more positive message.  The outcome is ALWAYS more productive, everyone feels better, and in some cases, they determine, together, that the offering of Group Benefits is not a good fit.  That is totally OK.

Steve Brauer is the Principal for Brauer Insurance Services in the Bay Area.  He is a recognized expert in the translation of ObamaCare and the #ACA.  He and his daughter, own and operate an Independent Employee Benefits agency.  www.brauerinsurance.com   (877) 421-4325

Medicare at 55? What would that look like, who would pay for it? Tens of millions more on Federal System

By | June 8th, 2018|Categories: Uncategorized|

Late in 2017 there was proposed legislation in the Senate to allow people between the ages of 55 and 64 to “buy into” the Medicare program.  This would allow people to access the #Medicare hospital, medical services and prescription drug benefits.  On the surface it sounds interesting, until someone asks how we are going to pay for having tens of millions more on the Federal books.  However you want to phrase it, Socialized medicine, Universal Health Care, it all sounds great, until you break down the numbers.

If you think Health Insurance is expensive now, wait until its free!

No easy answers here.  I always laugh when someone from another country tells me that the healthcare system is so great in their country, “why can’t the US figure it out”, they ask me.  My answer to that….you get what you pay for!  When you break down the cost of all of these great healthcare systems that people crow about in other countries and try to apply it to the US, it ends up being WAY more expensive than the system we have now.  This issue has been examined from all angles and there is no easy way to solve it, and too many problems to point to just one issue to solve.  One thing is certain.  Until we can reign in the COST of #HealthCare, the cost of the insurance will continue to go up.

Feinstein vs. De Leon for Senate and their views on HealthCare

Well…both of them are liberal, De Leon is seen as an ultra liberal and believes a #SinglePayer or Medicare for all, is the only way to solve the health care issues in America.  Feinstein is a bit more tempered.  She supports #ObamaCare and supports a Medicare-based public insurance option for individuals and employers.  She believes this would increase competition and choice in the #employer marketplace and drive down costs.

One thing is certain….if this was an easy problem, we would have solved it a long time ago.

Steve Brauer is the Principal of Brauer Insurance Services, an Independent Insurance Agency that specializes in Employer Based Health Insurance plans.  As a ACA expert and speaker, Steve is one of the go-to people in the Bay Area insurance industry.  www.brauerinsurance.com  (877) 421-4325

Employers finding a way around the ACA, looking at the 2018 Farm Bill for relief

By | June 5th, 2018|Categories: Uncategorized|

OK, maybe we can’t scrap the #ACA altogether, and I’m not sure we should, frankly, but there is a piece of legislation inside the #FarmBill2018 that may provide some relief to the Agriculture Industry.  Inside the Farm Bill is the potential for up to $65 Million in loans for AHPs or Association Health Plans.  An AHP is basically a co-op of employers that share an industry or profession that can band together and purchase Group Health Insurance.  By doing this the AHP may be able to structure plans that don’t meet the current ACA standards.

AHPs can be set up cheaper, less comprehensive Health Insurance Plans, that don’t have certain “essential” services

Under the current proposal, the #AHP would be able to offer plans without things like Maternity, Prescription Drugs, even Hospitalization, some of the biggest cost drivers of the Employee Benefits industry.  By doing this, the AHP would most likely be much less expensive and attractive to employers trying to save money.  The Trump Administration will be finalizing new rules with these AHP plans, so we should be seeing something fairly soon.

Limited Medical Plans or Short Term plans are also being proposed to curb pricing, but not without skeptics

The Trump Administration is proposing Limited Medical Plans and Short Term plans for consumers that don’t want to pay for things like maternity or other benefits they don’t need.  These plans are not Guarantee Issue and people can be rejected, if they have a considerable medical condition.  Critics also say that by allowing these plans to flourish, we would be driving out healthier people from the ACA, who can qualify for these plans.  That would leave a skewed risk pool for the ACA type plans, and pricing would skyrocket.  All of this has yet to be proven, but makes sense.  Opponents also say that people would put themselves in a position to take on way too much risk with a Limited Plan and it could create financial hardship.

No easy answers here, but one thing is certain….we cannot handle the double digit price increases each year, year after year.

Steve Brauer is the Principal of Brauer Insurance Services, an Independent Employee Benefits Agency in the Bay Area, serving employer groups of typically under 100 employees.  www.brauerinsurance.com   (877) 421-4325

What are the main cost drivers behind Health Insurance…who’s making the money??

By | June 1st, 2018|Categories: Uncategorized|

A recent study done by AHIP, America’s Health Insurance Plans, shows that about 50% of the monthly premium costs associated with each of the Health Insurance plans in America, go to Doctors and Prescription Drugs.  22% goes to doctors and physicians, another 23% goes to Prescription Drug costs.  Recently the spotlight by President Trump has been the huge increases in pharmaceutical costs.  Trump is trying to control spending at the insurer and pharmacy benefit manager level.  Recently pharmaceutical companies are being blamed for “blocking” the availability of Generic Drugs

There is a real problem with allowing generics to be distributed….follow the money

The FDA listed more than 50 drug companies that are actively blocking the generic companies to develop cheaper alternatives.  One case in point is the drug Revlimid, a cancer fighting drug.  The manufacturer of Revlimid, Celgene Corp, being blamed for what the FDA called “shenanigans”.  This one drug, is very lucrative for Celgene, and accounts for about 63% of their revenue.  Just to give you an idea of the amount of revenue.  Many of these Brand Name Drugs, can be hundreds of millions of dollars for the manufacturer…almost as much as the health care system itself.  Folks, something is wrong with this system.  What a sham!!

Some of these companies basically have a monopoly on certain drugs

Remember Martin Shkreli, the CEO of the BioTech company Retrophin that jacked up the AIDS drug from $15 a pill to almost $800 and then laughed about it.  Well…he’s on his way to prison, for something else, but he is the poster child for “Big Pharma” and what everyone hates.  According to multiple sources, Shkreli is even more hated than the dentist that killed Cecil the Lion.  This is an extreme example, but you get the picture.  We have to figure out a way for Drug Companies to make money, and people have access to the medications they need.  This goes way deeper than I have time to write about, but this is not an easy fix.  But then, neither is our whole Health Insurance industry we have.

Steve Brauer is the Principal at Brauer Insurance Services, www.brauerinsurance.com   (877) 421-4325

HSAs, Medicare, and employees over 65 still working, can they contribute, draw, what does it all mean

By | May 30th, 2018|Categories: Uncategorized|

I get this question from more and more these days, about #Medicare.  What happens if I have an employee that is over 65, is eligible for Medicare and wants to continue with their HSA.  Lets break this down a couple of ways.  First off, someone can continue to participate in the company’s health plan over 65…even if they have Medicare.  There area a couple of situations to think about.  Since Part A (hospital services) are free to people over 65, many will enroll, even if they are still working, and on the company’s Health Insurance plan.  Most of them will delay the enrollment into Medicare Part B (Physician Services), until they leave employment, and that’s perfectly fine.  This is the typical scenario for people working over 65…except when you have an #HSA or #HDHP (High Deductible Health Plan)

If you have an #HSA plan at work and you enroll into Medicare

When an #employee is enrolled into an HSA compatible Health Insurance plan at work, the #employER can contribute to the HSA savings account, the employEE can contribute, or both.  If the employee is enrolled into ANY part of Medicare, either Part A, Part B, or both, they are not allowed to contribute to the HSA savings account anymore.  The employee is free to use the already banked funds for the allowed services, but they have to stop contributing when they enroll into any parts of #Medicare.  I know its confusing….welcome to the dysfunctional world of #HealthInsurance.

Who pays claims when an employee is enrolled in Medicare and the #GroupHealth plan at work

If the company has 20 or more employees and the employee is enrolled into both Medicare and the employer plan, the company plan is the Primary Payer of claims.  Conversely, if the company has under 20 employees, Medicare is the Primary Payer.

Every situation is different, so having a strategy BEFORE you end up in this situation is the key.  #EmployeeBenefits is an absolute specialty product, and deserves to be recognized as such.  Find an Independent Brokerage that can give you guidance, its well worth it!

Steve Brauer is the Principal at Brauer Insurance Services in San Jose, an Employee Benefits specialist.  He and his daughter are Independent Brokers serving employers all over the state of CA.  www.brauerinsurance.com   (877) 421-4325

Top 5 reasons employers bring Employee Benefits into the company

By | May 26th, 2018|Categories: Uncategorized|

There are several reasons that employers bring in Employee Benefits into the company, for the “benefit” of the employees.  Attract and retain employees is the overall answer, but it goes much deeper.

Networks are much different in Group Health Plans vs. Personal Plans you purchase online

The biggest disruption in the Health Insurance industry has been the carving up of networks.  The smaller the network, the cheaper the health insurance plan…usually.  Group Health Plans usually have a much broader network with the offered plans.  That means that your employees can have their in-network doctors in some of the major medical groups….Stanford, UCSF, Sutter, etc…

Employees can pay for their portion with #PreTax money

When you offer Employee Benefits and Group Health Insurance, employers can set up an IRS Section 125 plan that allows employees to pay for any of THEIR premium costs non-taxable.  That also helps employers by lowering their payroll numbers and FICA payments to the government.

Employees pay less for their Group Health Insurance

When an employer “sponsors” an Employee Benefits, Group Health Plan, they have to contribute to that plan, a minimum of 50% of the employee’s premium.  No employee has ever complained about that.

Group Health Insurance has WAY more choices than Individual-Family plans

There are hundreds of Group Health Plans on the market, available to employer groups.  There are maybe 25 plans or so, available on the internet for individuals and families.  The cost is almost the same between Employee Benefit plans and the ones on the internet.  The plans are not exactly the same, so its not exactly an “apples to apples” comparison, and remember, the networks are super small with the internet plans.

Brokers play a key role with Group Benefits, when it comes to an employee having a claim

Anyone that has ever had a significant medical issue know what I’m talking about.  When you go to use the internet ObamaCare plan, and you have a claim, get ready.  You will probably get a bunch of confusing, expensive, and most times incorrect bills from doctors, hospitals, etc.  With the internet plans, it’s up to YOU to figure it out.  Good luck getting an help from anyone at the insurance company.  With Group Health Plans, the employer has a broker attached to the account.  The Group Benefits broker’s job is to make sure everyone’s happy and there are not issues with claims.  Well….the good ones take care of the claims.  Hey…we earn 5% each month, we better be doing something for that money.  Sadly, many brokers are only around during Open Enrollment, and to collect their commission each month.  That’s why brokers that specialize in Employee Benefits are so needed.  Specialists know how to resolve #EmployeeBenefit issues with the least amount of hassle for the employer and the employees.

Brauer Insurance is one of the leading Employee Benefits only agencies in the Bay Area.  Have questions?  Email us…no strings, and I won’t hound or stalk you.  Promise.

Steve Brauer-Principal, Brauer Insurance Services,  www.brauerinsurance.com  (877) 421-4325

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ACA, ObamaCare compliance for companies offering Employee Benefits, or not

By | May 23rd, 2018|Categories: Uncategorized|

The ACA is very clear about companies with over 50 employees.  You better be offering Group Health Insurance, and it needs to be “affordable” by #ObamaCare standards.  The companies not complying in 2015 are just now feeling the wrath of the #ACA penalties in 2018.  Larger employers are getting hefty penalties for not complying.  I spoke to several larger employers back in 2014 that felt they did not have to comply and that the ACA was going to go away.  That didn’t happen.  Most of them felt that they didn’t want the government to tell them what to do.  All of the ones I spoke to, offered Employee Benefits, including Group Health Insurance.  They were out of compliance with the offering because their employees were made to pay more than 9.5% of their gross income.

ACA Affordability is measured in several ways

Most of our employers use the 9.5% standard.  One of the easier ways to become compliant with the offering of Group Health Insurance to an employee is to use their W-2 gross wages as a guide.  Using their wages, employees cannot be made to spend more than 9.5% of their wages on the Group Health Insurance offered by the company.  The business has to pick up the difference between the 9.5% and the cost of the coverage.  #GroupHealth coverage has to meet the minimum standards as well, with maternity, prescription drugs, and pediatric dental coverage.

The affordability is measured by the lowest cost plan offered to the employee

Because the 9.5% calculation is based on the price of the cheapest Group Health Plan offered to the employee, there was a rush to find the cheapest plan on the #GroupBenefits market that was compliant and available.  Depending on the year, that could be an #Aetna plan, or an #AnthemBlueCross plan.  #Kaiser has an inexpensive plan, but usually the skinny network PPO plans have Kaiser beat on lowest price.

All of the ACA compliance pieces are complicated and require some expertise.  Find yourself a Specialist, not a Generalist, when it comes to #EmployeeBenefits.  You’ll end up paying way less for the insurance and it will fit exactly what you need.  Too many times I run across a larger company that THINKS they are saving money, and they have a broker that does not specialize in Group Health or tries to be a “jack of all trades”.  Do yourself a favor and find an expert.

Brauer Insurance is an Independent Insurance brokerage that specializes in the dysfunctional, ridiculous and super expensive ACA, Group Health Insurance and Employee Benefits.  Call us, even if its for some advice!

Steve Brauer, Principal,  Brauer Insurance Services LLC……www.brauerinsurance.com       To Protect and To Serve

Employee Benefits for companies, offering better benefits to key employees, be careful

By | May 22nd, 2018|Categories: Uncategorized|

We get many calls about employers wanting to offer better Employee Benefits to their key employees, supervisors, etc.  The Affordable Care Act, #ACA, states that employers are not permitted to do that anymore.  Group Health carriers will not let companies offer “carve out” benefits for select employees.  That is the black and white of the law.  Now for the real world.

Offering enhanced or better Employee Benefits to certain employees

This can be tricky.  According to the HR attorneys I’ve consulted with, they say that this particular piece of legislation with the ACA is not being enforced yet, by the Dept of Labor.  What IS a problem is when it is deemed to be discriminatory.  When two employees are in the same position at work and they are not offered the same benefits, that’s a problem.  Some employers have been advised to make it a policy, and put it in their handbook, that if you are in certain employee codes, they can split up what they offer.  If an employee is in position A, they are offered certain benefits, position B, other benefits.  Employers are also making tenure a condition for obtaining certain Employee Benefits and even what the company will contribute towards those benefits.

Tenure and job descriptions are also being used to separate Employee Benefit offerings

Some employers are using tenure with the company as a guide for their Employee Benefits offering.  If someone has been with the company 1-12 months, your Employee Benefits are XXX, 1-3 years your Employee Benefits are YYY, etc….  Other companies are using Job Descriptions.  If you have an employee doing job X, your #benefits are ________, and the company contribution is __________.   Again…I’m not an attorney, so I cannot give you Employment Attorney advice.  I’m commenting on what employers are DOING.  Most business owners I speak with don’t want the government telling them what to do, and frankly I agree with them.

Hey ACA…don’t tell me what to do

Most employers are high performing people and they don’t take kindly to someone telling them what to do, especially the #ACA or the government.  They are very sensitive to the whole “discrimination” issue…but not being able to compensate key employees or supervisors, infuriates them.  As long as their NOT discriminating them because of race, gender, etc…I think they should be able to regulate their #compensation to their employees.

For legal advice, please consult an #HR or #EmploymentAttorney.  These are real life examples of what employers are doing.  www.brauerinsurance.com  (877) 421-4325

HSA Health Insurance plans are likely to change for employers with the Bipartisan HSA Improvement Act

By | May 22nd, 2018|Categories: Uncategorized|

HSA compatible Health Insurance plans are a great tool for employers that want to be creative.  There are currently some drawbacks to HSAs that keep many people from enrolling into them, the biggest one being that HSA plans are designed where employees have to pay for all of the services, up to the deductible amount, at the negotiated rate.  Yearly preventative services are the exception to this.  The #HSA Act would change that to include many other health services BEFORE the deductible, making it much cheaper for the employee.

The HSA Improvement Act includes other benefits

Another part of this Act would be to offer “pre-deductible” coverage for things like services and medication that manage chronic conditions.  Having that in place would definitely help #employees with their medical issues that are ongoing.  Instead of having to pay everything out of pocket for those chronic issues, there might be a smaller copay, encouraging employees to get the help they need for themselves or their families.

#Telemedicine, #TeleHealth, #Ehealth, and other second opinion services may also be offered

The passage of this Act would make it so #employers can offer “excepted benefits” for things like #TeleHealth and #TeleMedicine to employees with an HSA plan, not currently available.  #TeleHealth and Ehealth would also be available for spouses and dependents under this ruling.  Years ago when the telemedicine began, I brought it on for some of our larger groups, thinking that employees would use it.  I had to cancel it after a few years, since our agency was paying for it, and no one was using it.  That was back in pre-ObamaCare days.  Over the last few years, the whole #Ehealth industry has exploded, and the usage is way up.  Many of the major carriers offer some sort of it, with their larger policies.  Many of the #Voluntary carriers like #Aflac and #Colonial also offer a version of it.

The biggest champion of the Bipartisan HSA Improvement Act is Rep. Mike Kelly from Pennsylvania, @MikeKellyPA.

Brauer Insurance is on the cutting edge of any changes in the #HealthInsurance industry.  We champion #SmallBusiness with Employee Benefit strategies.  www.brauerinsurance.com  (877) 421-4325

Having a online platform for Employee Benefit enrollment and management is critical

By | May 20th, 2018|Categories: Uncategorized|

#Employers and even most Group Benefit Brokers, are not sure where to turn to bring their business into the 21st century.  The insurance industry, especially the Group Benefits insurance, has been stuck in the 1990’s, in terms of technology.  There have been very few solutions that are user friendly, with the functionality that Group Health Insurance brokers need.  We have been fortunate enough buy into a system that helps Brauer Insurance and all of our Group Health clients.  When you are working with a CFO or HR Director, most of them want to have an easy way to track employees, find out what Employee Benefits they are offering, and onboard new employees.

Onboarding employees with technology that is user friendly to both the company and its employees

You would think that there would be tons of technology out there to address fairly simple needs of being able to enroll employees, have them pick their plans, compare pricing, and track their progress.  Well, it must be much harder than anyone thinks, because up until now, there really was not a solution.  Once we found the #EaseCentral platform, it has made things much easier.  Luckily I have my millennial daughter that grew up with technology.  She has embraced not only the concept, but this specific platform.  For the groups that see the value, its been fantastic.  We have many more groups, even larger ones, that still prefer the paper applications and interaction, which is fine with us.  Slow integration into technology like this, is a good thing

People and companies, are slow to change, which is not a bad thing

Like I said, we have tons of groups that still prefer to #onboard and manage employee’s #benefits the old fashioned way.  Some even want us to meet with groups of the new employees, explain the benefits and have them enroll directly with us.  Happy to do it.  Technology is not something you can force onto anyone.  They have to see the value and adopt the change gradually.  As a Group Health Benefits Broker, you have to be versatile enough to be able to handle both styles…..even if you know that the technology platform is the most functional and optimum way to conduct business

Brauer Insurance protects and serves Group Health Insurance clients with not only technology, but Employee Benefit strategies to drive down healthcare costs.  www.brauerinsurance.com  (877) 421-4325

Employee Benefits, Group Health Insurance for smaller companies, not as expensive as you might think

By | May 18th, 2018|Categories: Uncategorized|

If you are smaller employer and considering offering #EmployeeBenefits, it may be more affordable than you think, and you can really help your #employees in the process.  Whether you want to be competitive in the marketplace to attract and retain employees, or you are just a benevolent employer that wants to do the right thing for their people, there are tons of options out there.  Offering Employee Benefits can be a win-win for both of you.

Offering the RIGHT benefits is crucial and makes a world of difference

Having the right consultant is key.  It does not have to be Brauer Insurance, there are other fantastic Independent Group Benefits agencies that specialize in Employee Benefits, and the “specialize” should be highlighted.  Brokers that are Generalists cannot know all of the nuances of Health Insurance, there are just not enough hours in the day to become an expert at everything.  Offering the right Employee Benefits and Group Health Insurance is a big deal.  Little tweaks in the offering can make a significant difference in your bottom line.  I’ve seen it all….companies way over insured and way under insured.

Many companies waste money, others go too cheap and employees hate the coverage

When you’re over insured, you’re wasting money.  What if you can get equal, or even better coverage, for the same price or a less.  As an example…why would you pay for a Gold Health Insurance plan, when a Silver plan with some strategy actually covers the person better, for a cheaper price.  Also, when you’re under insured, most times, the employees hate the coverage.  Sure its cheaper, but its cheaper for a reason.  Even if you pay for a majority of the Bronze, cheaper coverage, most employees will not be happy when they go to utilize services.  There are ways around that.  Again…when you ONLY do Group Health Insurance you know that stuff.

Bonnie and I are dedicated to helping employers with their Employee Benefits offering.  We are happy to chat about this over the phone with NO expectation of doing business.  We’re either a good fit for your company or we’re not.  No pressure here.

 

Steve Brauer-Principal, Brauer Insurance Services LLC…..www.brauerinsurance.com   (877) 421-4325

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