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NYS 2022 Final Rates Approved

NYS 2022 Final Rates Approved

Yesterday, NYS has approved 2022 health insurance rate requests yesterday. Small group rates increase 7.6% and  3.7% for individuals.

As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers see original –NYS 2022 Rate Requests.  Despite only 3 months of mature claims data experience for 2021  health insurers’ original requests were noticeably below average.

The 2021 small group rate increase was the third-lowest ever approved at 4.2% vs. 2020s approval at 7.9%. This reflects a lower cost utilization due to COVID-19. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% last year in the individual market nationwide. The state Department of Financial Services said medical claims decreased significantly in 2020 due to the postponement of elective and non-emergency services, but medical claims have increased this year as New Yorkers catch up on medical appointments and postponed services.

Rate Factors

The state noted that the premiums increase main drivers are medications.  “The drug costs account for the largest share of medical expenses, followed by inpatient hospital costs, and outpatient hospital costs.” Drug costs account for the largest share of medical expenses (38.7%), followed by inpatient hospital costs (17.3%), primary care (8.1%), outpatient hospital costs (7.9%), and radiology (5.7%).

Nearly 1 million New Yorkers are enrolled in small group plans, which cover employers with 1 to 100 employees. Insurers requested an average rate increase of  11.4% in the small group market.  DFS cut the weighted average requested rate increases by 63% for 2020, saving small businesses over $565 million. About 264,000 New Yorkers are enrolled in individual plans.

Health Insurance Tax is Back

The HIT (Health Insurance Tax) is back. For Small businesses, this translates to an estimated 2.5%-3% added surcharge. For States like NYS where there is already approx. 16% added surcharge to high premiums, this becomes daunting.  It is no surprise the unpopular HIT was suspended. In 2017, payers escaped making $13.9 billion in payments due to the moratorium, according to a 2018 analysis by Oliver Wyman, commissioned by UnitedHealth Group.  This may have saved consumers billions on their insurance coverage.“The taxes on health insurance are non-deductible for federal tax purposes for health insurers,” the report explained.

Website Stop The Hit calculates $5,000 as the average tax for a 10-man small business for example. Calculates how the HIT affects your State and your business, here. Take action now: tell Congress to repeal the HIT! Join small business owners across the country in stopping the HIT. Sign the petition here.

 

NYS 2020 Final Rates Approved

Summary

Before you consider renewing automatically, you should first find out what is a PEO so that you can know exactly what to expect from it. PEO’s are large-group markets underwritten.  With the right PEO, you will be able to manage your businesses’ demand for growth and your employees as well.

Clients on average save 15-40% off the small group market. If you are looking for a complete insurance solution for your business, go to our website and check out our business insurance solutions. Contact us for more information today.

 

 

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Employee Retention Tax Credits

Employee Retention Tax Credits

Employee Retention Tax Credits under CARES ACT have been available yet there has been confusion surrounding this. Employee Retention Tax Credits (ERTC). Much of this has been covered under Corona Virus Resource Page –What the Coronavirus Means for Your Business.   The ERTC was extended and modified by the Consolidated Appropriations Act of 2021. 

COVID-19 Employee Retention Credit available for Businesses Financially Impacted

The Treasury Department and the Internal Revenue Service today launched the Employee Retention Credit, designed to encourage businesses to keep employees on their payroll. The refundable tax credit is 50% of up to $10,000 in wages paid by an eligible employer whose business has been financially impacted by COVID-19.

FAQ

Does my business qualify to receive the Employee Retention Credit?

The credit is available to all employers regardless of size, including tax-exempt organizations. There are only two exceptions: State and local governments and their instrumentalities and small businesses who take small business loans.

Qualifying employers must fall into one of two categories:

1.The employer’s business is fully or partially suspended by government order due to COVID-19 during the calendar quarter.

2. The employer’s gross receipts are below 50% of the comparable quarter in 2019. Once the employer’s gross receipts go above 80% of a comparable quarter in 2019, they no longer qualify after the end of that quarter.

How is the credit calculated?

The amount of the credit is 50% of qualifying wages paid up to $10,000 in total. Wages paid after March 12, 2020, and before Jan. 1, 2021, are eligible for the credit. Wages taken into account are not limited to cash payments, but also include a portion of the cost of employer-provided health care.

How do I know which wages qualify?

Qualifying wages are based on the average number of a business’s employees in 2019.Employers with less than 100 employees: If the employer had 100 or fewer employees on average in 2019, the credit is based on wages paid to all employees, regardless if they worked or not. If the employees worked full time and were paid for full-time work, the employer still receives the credit.

Employers with more than 100 employees: If the employer had more than 100 employees on average in 2019, then the credit is allowed only for wages paid to employees who did not work during the calendar quarter.

I am an eligible employer. How do I receive my credit?

Employers can be immediately reimbursed for the credit by reducing their required deposits of payroll taxes that have been withheld from employees’ wages by the amount of the credit.

Eligible employers will report their total qualified wages and the related health insurance costs for each quarter on their quarterly employment tax returns or Form 941 beginning with the second quarter. If the employer’s employment tax deposits are not sufficient to cover the credit, the employer may receive an advance payment from the IRS by submitting Form 7200, Advance Payment of Employer Credits Due to COVID-19.

Eligible employers can also request an advance of the Employee Retention Credit by submitting Form 7200.

Where can I find more information on the Employer Retention Credit and other COVID-19 economic relief efforts?

Updates on the implementation of this Employee Retention Credit, Frequently Asked Questions on Tax Credits for Required Paid Leave and other information can be found on the Coronavirus page of IRS.gov.

Do you have a Checklist for the Paycheck Protection Loans Documentations?

Start preparing NOW. Gather documents that provide proof of payment for allowable expenses under the Paycheck Protection Program and be ready to make related certifications for the application.

I’m working with a PEO, how do I get these forms to the IRS?

When partnering with a PEO, the PEO may request an attestation from the client or the client‘s CPA  certifying that the client qualifies for the ERTC.  This is because the PEO is unable to verify that the client incurred a reduction in gross receipts or otherwise qualified for the credit.  Furthermore, indemnification may be requestedgiven that incongruities with claiming the credit must be reconciled on the PEOs Form 941.  Finally, in order to prevent multiple filings, it is possible that a PEO may establish deadlines for clients claiming the ERTC and impose an administrative fee associated with processing the ERTC for former clients or clients seeking to claim the credit outside of specified time frames.

For more information about the ERTC, please contact your PEO service provider.

Paycheck Protection Program Document Checklist and Certifications

Resource:

ERTC Video Explainer

Silver Linings Pandemic Playbook  – American Benefits Council

 

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Preparing for a Telehealth Visit

Preparing for a Telehealth Visit

Amid the COVID-19 pandemic, telehealth (or telemedicine)—healthcare via phone, email, video, and other technologies—is moving from a trend to the mainstream.  Virtual doctor’s appointments are nothing new, but they’re certainly becoming more popular. Have you reaped the benefits of your telehealth options? Did you know that virtual visits have nearly tripled to 37% from 10 years ago and that 85% of patients are satisfied?Preparing for Telehealth Visit

Meeting online means you can check in with your provider from the comfort of your home — but you’ll want to make sure you make the most of that face time. 

There are many ways to make telemedicine work for you. Here are five tips to prepare for a virtual appointment.

  • Prepare some talking points. Make a list of your symptoms and concerns. Your appointment will likely last for 15 to 20 minutes, depending on the reason for your visit.
  • Do a practice run. You don’t want a faulty internet or audio connection during your visit. Check that your device is running properly, and set yourself up in a quiet, well-lit area before your appointment begins.
  • Write down your questions. Don’t hesitate to speak up during your visit. Ask your provider for clarification, next steps and anything else you feel you may need.
  • Take your vitals, if necessary. Your doctor might ask you to take your pulse, temperature and blood pressure before your appointment. Double-check if you should do so manually or with an app on your phone.
  • Get a post-visit summary. It can be easy to forget the details of your visit. Before signing off, ask for an overview of what you discussed, including any care and medication instructions.

While Telehealth appointments can be a great way to see a doctor without leaving your home, there are some cases where an in-person visit is necessary. Therefore, don’t be surprised if the provider directs you to make a follow-up appointment with your local doctor or, if urgent, to go to the local emergency room or urgent care center.

Do you have questions about your health care? Or do you need more guidance about your telemedicine options? Get in touch today. 

 

See: Top 7 Health Trends for 2021

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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Update: Oxford/United and Montefiore Health Systems Still Split

Update: Oxford/United and Montefiore Health Systems Still Split

Recently, UHC/Oxford and Montefiore Health System had split effective January 1, 2021.  Since that time there have been state-required cooling-off period and ongoing talks on resolution but that has not yielded a positive outcome yet. 

According to Oxford, Montefiore patient claims are deemed as out-of-network. 

  • Montefiore’s physicians will be out-of-network for all employer-sponsored and individual plans, including Oxford, as well as our Medicaid plan, effective January 1, 2021.

  • Montefiore’s hospitals will be out-of-network for all self-insured commercial plans, effective January 1, 2021.

  • Our members enrolled in fully insured commercial plans as well as our Medicaid plan will continue to have in-network access to Montefiore’s hospitals until March 1, 2021.

Montefiore Hospitals & Health System

Facility Name County
Montefiore Hospital (Moses Campus) Bronx
Children’s Hospital at Montefiore Bronx
Garnet Health MedJack D. Weiler Hospital (Einstein Campus)ical Center Bronx
Montefiore Wakefield Hospital (Wakefield Campus) Bronx
Burke Rehabilitation Hospital Westchester
Montefiore Mount Vernon Hospital Westchester
Montefiore New Rochelle Hospital Westchester
Montefiore Nyack Hospital Rockland
Montefiore St Luke’s Cornwall Hospital Orange
White Plains Hospital Bronx
Montefiore Hutchinson Campus Bronx
Montefiore Medical Group Westchester
Montefiore Medical Specialists of Westchester Westchester

 

Neighboring Hospitals

Facility Name County
Bon Secours Community Hospital
BronxCare Hospital Center
Garnet Health Medical Center
Good Samaritan Hospital of Suffern
New York Presbyterian Hudson Valley Hospital
New York Presbyterian Lawrence Hospital
NYC Health + Hospitals Jacobi
NYC Health + Hospitals Lincoln
NYC Health + Hospitals North Central Bronx
St. Anthony Community Hospital
St. Barnabas Hospital
St. John’s Riverside Hospital
Westchester Medical Center
Orange
Bronx
Orange
Rockland
Westchester
Westchester
Bronx
Bronx
Bronx
Orange
Bronx
Westchester
Westchester

Leading Health Insurers 

2021 Empire Blue Cross Blue Shield
2021 EmblemHealth 
2021 Healthfirst Plans
2021 New Oscar Circle Plus

Both sides need each other as both are market leaders in their fields. It is our hope and most of our clients that they get this resolved soon. In the meantime, please bookmark our site for the latest updates.  And do reach out to us and learn the steps that you can take to smoothen this temporary roadblock.

Resources:

KeepMontefiore.Org

https://www.uhc.com/montefiore

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

HSA 2022 Dollar Limits

HSA 2022 Dollar Limits

The IRS has released the 2022  Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

New HSA 2022 limits are as follows:

 

2022

2021

HSA Annual Contribution Limit
$3,650;  $7,300
$3,600 – Single; $7,200 – Family
HDHP Minimum Annual Deductible
$1,400;  $2,800
$1,400 – Single; $2,800 – Family
HDHP Out-of-Pocket Maximum
$7,050;  $14,100
$7,000 – Single; $14,000 – Family
Age 55+ Catch-Up Provision
$1,000;  $2,000
$1,000- Single; $2,000 – Husband/Wife

 

Age 55 Catch Up Contribution

As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of the year, you can contribute an additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute an additional $1,000. A savvy strategy for high-income earners is to invest the money in your HSA for the long haul. Once you’re 65, you can take out tax-free distributions to cover Medicare premiums. If you withdraw money at that point for non-medical uses, you pay the same tax as you would on withdrawals from a pretax 401(k). But you can also take money out tax-free to reimburse yourself for prior years’ out-of-pocket medical expenses if you have the old receipts.


COVId-19 Update: 

You can even use an HSA to save on a typical trip to the CVS. Thanks to a tax relief provision tucked in the last Covid-19 stimulus package, you can use the money you stash in an HSA or FSA (more on those later) for over-the-counter medications like Tylenol or Flonase as well as menstrual products like tampons and pads. That reverses Obamacare restrictions on OTC meds requiring a doctor’s prescription for them to be eligible for reimbursement.

HSA/HDHP Market Growth

HSA holders own the assets in the accounts and can build up substantial sums over time.  Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.

FSA Store

HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.

  • The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
  • 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
  •  14% of all workers in the private sector have access to a Health Savings Account acc. to the Bureau of Labor Statistics.
  • States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois, and Minnesota.

HSA Advantages:

  • Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
  • Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
  • Tax-Free Money allowed for non-traditional Medical coverage– As per IRS Publication 502, unused money can be used for dental, vision, Lasik eye surgery, acupuncture, yoga, infertility, etc.  Popular Examples
  • Portability – The funds belong to you, so you keep the funds if you change jobs or retire.

Our overall experience with HSAs has been positive when employer funding is at a minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money).  Traditional plans trend of higher copays and new in-network deductibles has also led to the popularity of an HSA.

Next Steps

Plan sponsors should update payroll and plan administration systems for the 2022 cost-of-living adjustments and should incorporate the new limits in relevant participant communications, such as open enrollment and communication materials, plan documents, and summary plan descriptions.

RESOURCE:

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for the latest news updates.

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Economic Analysis: The PEO Industry Footprint in 2021

Economic Analysis: The PEO Industry Footprint in 2021

The PEO Industry Footprint in 2021 Laurie Bassi and Dan McMurrer, McBassi & Company May 2021

Professional employer organizations (PEOs) provide comprehensive HR solutions for small and mid-sized businesses by supplying them with a broad array of cost-effective HR offerings and expertise. This enables PEO clients to concentrate on growing their businesses while offering superior benefits and HR practices to their employees. Research in our previous white papers has shown multiple positive effects from these services: PEO clients enjoy a better chance of survival, higher growth rates, lower employee turnover, higher employee satisfaction, and they fared better during the COVID-19 pandemic. 

KEY FINDINGS: 

NAPEO’s White Paper series aims to help the general public and small business owners better understand the economic impact and value of the PEO industry and the ways working with a PEO can help businesses grow and thrive.

Our white papers have shown that:

  • Businesses in a PEO arrangement grow 7-9 percent faster, have 10-14 percent lower turnover, and are 50 percent less likely to go out of business.
  • PEOs are able to offer a broad array of HR services at a lower cost and offer access to retirement plans to small businesses that may not otherwise sponsor them.
  • PEOs provide services to 175,000 small and mid-sized businesses, employing 3.7 million people.
  • There are 907 PEOs in the United States.
  • The total employment represented by the PEO industry is roughly the same as the combined number of employees for Walmart (United States only), Amazon, IBM, FedEx, Starbucks, AT&T, Wells Fargo, Apple, and Google.
  • The PEO industry’s 175,000 clients represent 15 percent of all employers with 10 to 99 employees.
  • Administrative costs are around $450 lower per employee for businesses that use a PEO.

 

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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PPE Expenses May Be Reimbursable Under HSA

PPE Expenses May Be Reimbursable Under HSA

PPE Expenses May Be Reimbursable Under Health Spending Accounts – Video

During the COVID-19 pandemic, you may have purchased masks or PPE for the purpose of preventing the spread of the COVID-19. Now, according to a recent announcement from the IRS, those purchases may be deductible from your income for tax purposes and eligible to be paid or reimbursed under certain savings accounts. This video explains further:

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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New  COBRA Guidance and Subsidies Released By DOL

New COBRA Guidance and Subsidies Released By DOL

New COBRA Guidance and Subsidies Released By DOL

Today, the IRS released the following:
Model Notices
  • Model General Notice and COBRA Continuation Coverage Election Notice: MS Word | PDF
  • Model Notice in Connection with Extended Election Period: MS Word | PDF
  • Model Alternative Notice: MS Word | PDF
  • Model Notice of Expiration of Premium Assistance: MS Word | PDF
  • Summary of COBRA Premium Assistance Provisions under the American Rescue Plan Act of 2021: MS Word | PDF

For more details and customized help with your HR, Compliance, HCM Payroll needs please contact World Insurance Payroll at 855-667-4621. 

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Get Covered NJ and American Rescue Plan Act

Get Covered NJ and American Rescue Plan Act

Get Covered NJ and American Rescue Plan Act and the Extension of COVID-19 Special Enrollment Period

Governor Murphy announced an extension of the COVID-19 Special Enrollment Period for Get Covered New Jersey to May 1, 2021.

Special Enrollment Period Effective Dates:

  • Enroll by March 31, coverage effective April 1
  • Enroll by April 30, coverage effective May 1
  • Enroll by May 15, coverage effective June 1

The American Rescue Plan – Additional Financial Relief 

The new COVID-19 relief bill, the American Rescue Plan Act of 2021, will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. These changes will make coverage more affordable at many income levels:

  • Increases in financial help (Advance Premium Tax Credits or APTC) for all eligible consumers. The amount of financial help is based on household income just like before, but has increased at every income level. Families making less than 150% of the Federal Poverty Level (FPL) – or $19,140 a year for an individual or $39,300 for a family of four – will be eligible for near zero-dollar premiums under the new law.
  • New financial help for higher incomes. Previously, financial help was not available for households making more than $51,040 for an individual or $104,800 for a family of four. The new law ensures that no family spends more than 8.5% of their income on health insurance premiums. This means many individuals who previously did not qualify for financial help from the federal government may now see more affordable premiums.
  • Financial help for unemployed. Additional financial help may be available for anyone who has received unemployment benefits in 2021

For more details visit the Get Covered New Jersey COVID-19 webpage at:

https://nj.gov/getcoverednj/findanswers/covid19/

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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American Rescue Plan Act

American Rescue Plan Act

American Rescue Plan Act – Extension of EPSL and EFMLA and New COBRA Subsidies

The American Rescue Plan Act (ARPA), which is the latest bill to address the ongoing economic impacts of COVID-19, has been signed into law. We’ve outlined the key provisions of this new legislation that directly affect employers and employees – the optional extension of sick and family leave and the establishment of COBRA subsidies. 

Click here for a complete overview of these new provisions and how they affect employers and employees. 

Pertaining to the COBRA premium subsidy it is important to note:

  • ARPA provides a 100% COBRA subsidy if the employee’s work reduction or termination was involuntary. The subsidy applies for up to six months of coverage from April 2021 through September 2021 (unless the individual’s maximum COBRA period expires earlier).
  • For group plans subject to the federal COBRA rules, the employer will be required to pay the COBRA premium but then will be reimbursed through a refundable payroll tax credit.
  • Employers with fewer than 20 workers usually are exempt from the federal COBRA rules, but their group medical insurance plans may be subject to a state’s mini-COBRA law. In that case, it appears the subsidy will be administered by the carrier. The carrier will pay the premium and then be reimbursed by the government.
    Note: the premium subsidy will apply to NY continuation.
  • Although it takes effect April 1, 2021, employees who were terminated earlier but are still in their COBRA election window also are included.
  • Federal guidance is expected to be released by April 10, including model notices that
    plans can tailor for their use.

As this legislation is very new and vague in certain areas, we will keep you updated as more information and additional clarification becomes available. 

For more details visit  Understanding the $1.9 Trillion American Rescue Plan 

 

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP.