Group Health Insurance

February 8, 2021
employee health insurance

BAGI Member Jason Gettum Talks About Offering Employee Health Insurance

The Wharton & Power Insurance Team has been partnered with BAGI for over 10 years to help provide members with access to employee health insurance options. With three programs available to small businesses, we work with BAGI members to choose the plan that best suits their situation. Jason Gettum of Gettum Associate Inc offered a reflection on his decision to offer health benefits to his employees and the Wharton process. “We wanted to provide a health insurance plan to our 13+ employees for two reasons: 1) we feel a moral obligation to take care of our employees in any way we can and 2) we know that offering health benefits helps attract and retain good employees. Both reasons support our bottom line by having a positive work environment and happy employees. We launched our employee health insurance plan in 2020 with help from Wharton & Power Insurance, who we knew through BAGI. Our experience with group health plans was that they did not provide the flexibility or affordability our small business needed. The Wharton Team told us about the ICHRA option, which ended up working well for us. The Wharton Team offered up cost comparisons for group health plans and showed us how the budget we had already set to supplement a health insurance plan could be used for our employees. With the money we provide, our employees are able to apply it all to a healthcare plan, use it all for supplemental insurances, or a mixture of both. ICHRA gave us and our employees great flexibility while allowing us to remain a financially viable company.” The ICHRA program was promulgated by the US Departments of Health & Human Services and the Treasury in 2019. It allows businesses to contribute pre-tax dollars toward employee health coverage. This new program offers employees a lot of flexibility on how they use the dollars, places fewer restrictions on which businesses qualify and which employees can participate, and allows employers control of their spending. Click here to read more about the ICHRA program. The ICHRA program is not right for every business, that is why we spend the time to review the three options we provide. Our clients find the path to offering employee health benefits that suit their needs. Jason offered these final words in his reflection: “I found the Wharton Team extremely easy to deal with. They answered all of our questions and provided plenty of information in a clear format. They made it easy for us to understand our options and to choose a plan that worked well for our company.” If you are considering starting an employee health insurance plan, we would appreciate the opportunity to help you through the process. Send us an email or give us a call at 317-663-4138.
November 20, 2020

Managing Employee Open Enrollment During COVID

At Wharton & Power Insurance, open enrollment is usually a time when we meet with our clients’ employees as a group and one-on-one to review the group health plan. The remote nature of work these days is making that essential communication challenging. Our firm is recording the content so it can be delivered digitally by the employers. However, for employees who are new to the plan, have a new medical diagnosis or medication, or have claim questions, this one-size-fits-all communication does not serve their needs. And, it is up to the employer to ensure everyone views and understands the information, rather than having us available at that moment to clarify. It behooves employers to make sure open enrollment efforts achieve their goal – successfully onboarding employees to the group health insurance plan. For employees, it is imperative they understand their coverage. Below we offer some tips to help everyone begin 2021 on the right track. Offer an Easy Conduit Internally for Individual Questions Employees tend to look to their Human Resources representative for employment-related questions, including health coverage. During open enrollment, it might make sense to offer special “office hours” to ensure HR has the time to field an influx of inquiries. Also, if the same general questions are being asked, place the answers on a virtual community board. Anticipate the Unique Questions COVID Brings Beyond upending our normal communication and social options, the pandemic has offered a slew of new medical situations. Do employees know where they can get a COVID test? Do they know if their family members can get tested? Do they understand what COVID-related procedures are covered? Once a vaccine is available, will they know how to receive one? Creating a central spot for current and evolving pandemic-related information will go a long way in helping employees feel more comfortable during this challenging time. Work with a Broker Committed to Customer Service We have all had to flex during these strange times, and our firm has led the charge. Our employees and our partners are creating personalized content for each of our clients’ employee groups per their specifications. We are also offering one-on-one consultations with their employees. We understand that few benefits are as personally, emotionally and financially charged as health coverage. Our team is ready to guide each employee through their options regardless of this virtual world in which we now find ourselves. For most of us in the workforce, we are not accustomed to the lack of social interaction and personalized information. As an employer, you are investing in employee health insurance because you value your employees and they value the coverage! The Wharton & Power Team is committed to doing whatever it takes to ensure our clients have an impactful open enrollment season. Let us know if we can help you too. Send me an email or give me a call at 317.663.4138.
October 29, 2020
employee health insurance

Small Businesses Have A New Affordable Option for Employee Health Insurance

A ruling by the US Departments of Health & Human Services and the Treasury in mid-2019 changed the game for small businesses looking to compete with large organizations when hiring high-quality employees. The ICHRA program allows employers to contribute pre-tax dollars for employee health insurance which employees can use to purchase a plan. This affordable avenue toward offering sought-after benefits gives small businesses a real chance at attracting and retaining a talented workforce. How We Helped a Local Business Offer Employee Health Insurance We recently worked with a full-service salon located in Downtown Indianapolis. Pre-pandemic they had a large client base, even working with the Colts Cheerleaders. When COVID hit and the Downtown offices shut down, the salon had to shift. The owners decided to purchase a spa located on the northwest side of Indy. They were able to secure PPP loans for the few employees that stayed on, however once the economy began opening up again, the salon was having a difficult time attracting employees back. COVID has brought employee health insurance plans front and center in the minds of workers, and many will not lend their talents to a place that does not offer one. For some people, going back to work in itself is a risk, going back without health insurance is more of a risk, and working for an industry that is struggling is an even greater risk. The salon owners knew they had to provide some form of access to health insurance to ensure the longevity of their business. A traditional group plan was not viable for the salon, so we suggested the ICHRA program. It allows more coverage flexibility for employees, fewer restrictions for employers, wider availability to varying employee classifications, and no limits on contribution or participation levels. Unlike traditional health insurance plans, ICHRA allowed our client to offer pre-tax funds toward employee health insurance for those who wanted it without having to worry about the percentage of participation. And, they were able to set a budget that worked for them and their employees, rather than have the amount mandated. It was a win/win for both the employer and the employees. Click here to read more about the benefits of the ICHRA program. When the ICHRA program was first introduced last year, our Team thought it would create even more complexity in the employee benefits world. However, as we studied the details, we found that it is a viable option for many of our clients. The ruling pushed the insurance brokerage industry out of its comfort zone – and we are one of the few organizations who have taken the challenge head on. ICHRA is now a solid part of our bevy of employee health insurance solutions for our clients. If you are facing challenges in offering health coverage to your valued employees, reach out to me. The Wharton & Power Insurance Team will review your options and find a fit that works for you and your workforce. Send me an email or […]
September 17, 2020

Promote Employee Wellness Through a Telemedicine Plan

Sometimes it takes a world-wide crisis for people to embrace a new way of doing things. Since COVID-19 disrupted our nation’s healthcare system, the use of telemedicine has seen a dramatic rise. Although the technology has been around for a while, patients and providers alike have more fully embraced it in 2020. Now employers are recognizing the benefits of offering a telemedicine plan within their employee health plans. And soon employees will begin to expect it. Benefits of a Telemedicine Plan 24/7 unlimited access to healthcare Less time wasted waiting at the doctor’s office Fewer child care worries Reduced chance of contracting another illness from the waiting room Through the group health insurance plans we offer, you can elect to offer telemedicine services via the HealthiestYou app. Your employees will have access to doctors and therapists by phone, video or directly through the app. HealthiestYou offers intuitive, patient-centered online tools including: High-quality general health, dermatology, back care and mental well-being services Alert and reminder tools to keep appointments and paperwork on schedule Assistance in finding a provider Prescription price search engine to keep medical costs down Employer portal for easy access to monthly use reports and enrollment updates However, the largest benefit of offering access to telemedicine to your employees is that you are promoting better health. The Wharton & Power Team is ready to help you provide telemedicine services as part of your employee group health plan. Send us an email, or give us a call at 317-663-4138.
January 29, 2020
Outsourcing Human resources

How One Company Saved Time and Money by Outsourcing HR Services

In recent years regulations for the workplace have increased rapidly, making the job of administrating human resources complex and time-consuming. Organizations can become bogged down in the ocean of employment rules and policies, losing time and money in the effort to keep up with compliance. And, the consequences for falling behind have become steeper with the increase in fines. In search of a cost-effective solution, some companies have turned to outsourcing HR services from Professional Employer Organizations or PEOs. PEOs bypass the knowledge gap for employers who don’t have that expertise. I’d like to share a story about an Indiana-based company who was looking for an efficient way to handle their human resources tasks. The organization manages fitness centers in more than a dozen states. Trying to handle the plethora of regulations specific to each state, along with the wave of regulations legislated by the Affordable Care Act, was consuming too much of their time and bottom line. Seeking an alternative to hiring a $50,000 specialized HR employee, the company found that Worksmart Systems worked best for their situation. Without an in-house HR expert, the company relied on a combination of insurance brokers and expensive law firms for advice on internal benefits and workplace-related legal guidance. According to the company president, “As much as anything, it felt like we were spending more time making sure we didn’t step on a crack. Focusing on the legal aspects of employment law took time away from running the business. Now we have Worksmart to do that and it reduces our administrative time.” Worksmart Systems is an Indiana-based PEO that offers businesses payroll services, employee benefits, HR and compliance services, and a human resources information system. Another benefit of working with Worksmart is access to their expertise in employment policy and regulations. Each client has the ability to contact Worksmart for answers to employment questions and advice. Having experts just a phone call away at no additional expense offers business owners an invaluable peace of mind about their benefits and policies. Through Worksmart’s comprehensive offerings, the fitness company has seen improvement across the board, from staying compliant to revamping their employee medical package and retirement plans. The new retirement plan cuts administrative fees in half, and the health package includes better medical options and a health savings account for employees.  “It’s a much better plan,” said the company president. “I would have never offered a health savings account because I would have had to figure out all the rules on it. It’s too complicated.” “Worksmart has made things simple,” added the company president. “They uncomplicated the questions. In the past when someone asked us about insurance plans, we’d have to call the broker and get back to the employee. Worksmart knows the answer. We can take care of our customers and take care of our employees and run the business.” From providing peace of mind and efficiency, to offering robust medical and retirement benefits, PEOs act as a crucial spotter for companies who want […]
January 16, 2020
employee group health benefits

ICHRAs Offer a New Landscape for Small Business Employee Health Benefits

In mid-June 2019, the US Departments of Health & Human Services and the Treasury issued a rule allowing employers to contribute pre-tax dollars for employee health care coverage through a new health reimbursement arrangement named ICHRA. Like previous HRAs, employees can use employer funds to purchase health coverage from the public exchange or other insurance plans. However, this ruling lifted many restrictions on how companies could use HRAs or even qualify for group health plans, such as employee participation rates and affordability. This news changes the game for small business employee health benefits. The flexibility and options offered by this new ruling are not well known, but Wharton & Power Insurance has already assisted many local employers in taking advantage of this opportunity. For example, we helped three small business clients offer ICHRAs to their employees: a remodeler with 12 employees, a homebuilder with 12 employees and a restaurant with 70 employees. Benefits of ICHRAs in Offering Small Businesses Employee Health Benefit 1) Flexibility in Coverage By allowing employers to provide funds for employees to choose their own coverage, ICHRAs provide the flexibility for employees to determine their budget and coverage, rather than the employer. 2) Fewer Restrictions Small businesses had a difficult time meeting the requirements for group health plans, such as the number of W-2 employees, participation rate and premium contribution levels. ICHRA removes those restrictions while placing more control in the hands of the employer and the employees. 3) Wider Employee Definitions ICHRA allows contractors, 1099, W-2, seasonal and temporary employees to participate, though they must be of similar employment class, such as hourly or salary. Employers may vary their contribution levels per employee. 4) No Set Contribution and Participation Levels The employer sets the amount of money they want to provide to employees to supplement health care premiums. And, not every employee has to participate, making no real downside to the employer to offer the program.   How ICHRAs Work Once a budget has been set and the paperwork has been filed, an insurance broker like our Wharton & Power Insurance Team will work with employees to choose a health insurance plan that works for them. Considerations include the amount of money coming from their employer, their personal budget for health insurance premiums and the coverage they need. W&P then explores the options offered through the public exchange and private insurers. We also test for federal subsidy opportunities which can further reduce the employee’s cost of coverage. Rather than a company-wide group meeting about coverage options, the employee experience is more personal and has the potential to provide more beneficial coverage. With W&P, there is no cost for this service. Partnering this program with Wharton & Power Insurance can make taking advantage of this new option easy for your business. We have been working with employers and employees on both group and individual policies for over 30 years. We can help guide you through your budgeting decisions, set up your program and then work with your […]
November 20, 2019
group health benefits

Why Employers Continue to Offer Employee Health Benefits

It’s renewal season for most companies that offer employee health benefits. As the costs of offering health care have continued to rise, this time of year can come with hard choices. With the passage and gradual implementation of the Affordable Care Act, some businesses have considered abandoning offering health benefits, but continue to hang on regardless of their bottom line. Others have chosen to eliminate their plans, increasing employee pay instead to help them afford their own insurance. However, those employers are now returning to their previous ways. Why do employers continue to offer employee health benefits? For a few reasons: 1) To retain employees – Even though the increased income and ACA plan choices gave employees more flexibility with their health benefits, losing that employer benefit also brought complexity and fear. Workers are accustomed to this “perk” and can feel less valued by an organization that does not invest in their well-being. Wading through the ACA-approved insurance plans each year is frustrating and time-consuming. Businesses run the risk of good people leaving for organizations that offer employer-based coverage. There is a high value placed on peace of mind, not just by the employee, but by the employer as well. Offering quality employee benefits tends to be a common trait of companies committed to creating a desirable place to work. 2) To attract employees – One of the most common complaints among business owners is the challenge of finding quality employees to hire. Once that rare gem is found, employers must have an attractive package to offer, which for most workers includes more than salary and PTO. Health benefits can be an important value-add to attract a stellar workforce. 3) There are cost-effective alternatives available – Organizations facing large rate increases in their group health insurance premiums are looking for more affordable alternatives. One of those options is to contract with a Professional Employment Organization, or PEO. For a business with a healthy workforce, the unique role PEOs play in the health insurance world can be particularly beneficial. PEOs are designated as MEWAs, Multiple Employer Welfare Arrangements, which are exempt from the ACA’s community-rated requirement placed on most health insurance providers. This allows PEOs like Indiana-based WorkSmart Systems to offer private group health insurance plans, allowing employers to take advantage of the power behind economies of scale. A co-employment PEO, WorkSmart medically underwrites its plan for its 9,000 co-employees, with multiple benefit options. Employers are able to offer the quality coverage of a Fortune 500 company while managing their costs. WorkSmart also offers other HR services to help businesses be more efficient with their time and money, such as payroll, HR administration, and an HRIS platform. Continued change is on the horizon in the health insurance landscape. Regardless, businesses still want to attract and maintain a quality workforce while managing their bottom line. Reach out to us for more information on WorkSmart, as well as other opportunities to help you achieve this goal.
July 17, 2019

PEOs: The Difference Between Full Co-Employment and ASO Models

As business leaders review the PEO marketplace for human resource services like payroll, employee benefits and HR administration, two options emerge: a full co-employment model and an ASO model. What are the differences? Why choose one over the other? A co-employment PEO is a Professional Employer Organization that provides small to medium-sized businesses with HR services through a co-employment model. An ASO PEO is an Administrative Services Organization that also serves as a source for HR services but without a co-employment agreement. Both models aim to streamline the behind-the-scenes administration requirements associated with having employees. It is important to note that co-employment does not mean the PEO delves into the day-to-day operations of a business. They are there to add efficiency, structure, and accountability to the backend of an organization. The Benefits of a Co-Employment PEO: The Power of Pooling: A co-employment PEO combines all of their clients’ employees into one group, creating one large pool to cover under a group health plan. This pooling allows the PEO to offer the bargaining power of large businesses to small and medium-sized businesses, which can lead to better coverage and lower premiums. The ASO model is based on outsourcing services separately for each employer that contracts with them. While ASOs also alleviate their clients from the responsibility of finding and implementing a group health plan, they are not able to offer smaller employers the preferred rates and benefits available to large companies. Full Suite of HR Services: With co-employment comes a full array of human resource services: health insurance, payroll functions, HR admin, HRIS, reporting and compliance. The PEO essentially takes on responsibility for their client’s employees like they are their own. The organization enrolls those employees in a timely manner into a group health coverage plan, provides payroll and payroll reporting, and manages COBRA and COBRA compliance as well as other human resource functions. An ASO is based on a cafeteria plan model, where an employer can pick and choose which services they would like to outsource. This type of PEO may not be able to reap the benefits of the bargaining weight of larger organizations, as it may not have enough participants in each service line. The co-employment PEO model includes many benefits to a small or medium-sized employer. Case in point, Worksmart Systems is an Indiana-based PEO that has been offering HR outsourcing services for 21 years. They provide a group health insurance plan. By pooling health risk-rating groups over many employees, Worksmart can offer small to medium-sized businesses competitive rates that larger businesses enjoy. Questions about PEO services? Send me an email, or give me a call at 317-663-4138.
June 11, 2019

The Value Proposition of a PEO

How we work has changed quite a bit over the last decade. We’ve seen growth in the gig economy, and in the complexity of employment regulations. Even if your organization is fortunate enough to still have human resources professionals on staff, it can be difficult for them to stay up-to-date in this quickly changing world. A Professional Employer Organization, or PEO, offers your small to medium sized business the opportunity to efficiently manage these employee-based business operations. When you partner with a PEO, you are getting the benefit of economies of scale, shared liability and expertise. As a co-employer, the PEO streamlines your business operations, and provides a safety net for your decisions. They are not there to make day-to-day decisions about how you run your company – that’s your area of expertise. A PEO adds efficiency, structure, and accountability to the backend of your organization. PEO Services: Payroll: Once you have entered the co-employment status with a PEO, services begin with payroll. As the financial management center for employment, how you pay your employees is the key to the tracking and reporting requirements for your business. Quality PEOs go above and beyond the typical payroll service company by offering you access to other services, such as streamlined ACA reporting requirements and a pooled cost structure for areas like employee benefits and worker’s compensation. Employee Benefits: With the increasing cost of providing employee benefit plans, as a business owner you may be feeling squeezed. You want to take care of your employees, but the bottom line has to come first. A PEO is a great solution to this problem. Your business joins one large group plan, taking advantage of the economies of scale enjoyed by much larger organizations. For example, Worksmart Systems, an Indiana-based PEO, offers a self-funded plan offering four options, with 8,000 participants. They partner with Anthem, whose expansive network in Indiana offers greater discounts leading to more cost savings for you and your employees. Worksmart allows you to offer your employees a menu of benefits like a Fortune 500 company! Human Resources: During the economic downturn, many businesses downsized their non-revenue generating staff like human resource managers. However, that skill set is still needed. PEOs can serve as your human resources department, providing a wide range of services from employee training, hiring and termination assistance, and downsizing plans to EEOC claims, mandatory postings and employee handbooks. If you already have an HR department in place, PEOs can create an infrastructure to manage your day-to-day operations more efficiently. By offering a system that streamlines the multiple vendors that come with medical and dental benefits, 401k plans, payroll, worker’s comp, etc., PEOs allow your HR professionals to focus on the human aspect of their job. Benefits and HR Compliance: Businesses are finding it more difficult to stay in compliance in this constantly evolving world of employment law. The Affordable Care Act reporting requirements alone have placed a greater burden on business owners. Employers also must follow strict procedures within […]
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