Employee benefits

Fall 2022 Issue

Affordability testing

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

The Affordable Care Act (ACA) brought a lot of extra work to employers and insurance companies. Whether you are pro-health care reform or against it, per the Health Affairs article, the ACA has not made insurance more affordable.

Read more…

Don’t forget to call your mom – and your insurance agent

By WisMed Assure Service Team

With the intention of easing administrative burden for WisMed Assure client physicians, several of our Medical Professional Liability carriers have significantly reduced or suspended asking for renewal applications over the past few years. While this does save time, renewal applications were an opportunity to touch base, review and discuss any changes to your practice that could impact your premium or coverage.

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Year-end tax planning for 2022

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

Want to put thousands of dollars back into your pocket? Who doesn’t. Choices you make during your employer’s open enrollment period and for year-end tax planning can really add up.

Read More…

Graded premium disability? Yes, you can!

By Tom Strangstalien, Insurance Advisor

I recently worked with a young physician to set him up with personal disability protection to provide some financial security if life throws him and his family a curve ball. Prompting our planning was that one of his peers in the general surgery specialty sustained a serious hand injury, ending his ability to perform hands-on surgery.

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5 ways to develop inclusive hiring practices

By Society Insurance Human Resources, reposted with permission from Society Insurance

Inclusive hiring practices recognize diversity and embrace a wide range of perspectives that candidates from all walks of life bring to the organization. And according to research from Monster, “Four in five (86%) candidates globally say diversity, equity and inclusion in the workplace is important to them.”

Read more…

Affordability Testing

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

The Affordable Care Act (ACA) brought a lot of extra work to employers and insurance companies. Whether you are pro-health care reform or against it, per the Health Affairs article, the ACA has not made insurance more affordable. Many health insurance carriers have stated the ACA, Summaries of Benefits and Coverage, machine readable files and other changes imposed added costs to insurance companies, which simply passed these costs on to employers and employees in premiums.

Insurance premium affordability is very important because it allows for more money to employers and employees and is a requirement for groups with 50 or more employees. As you may know, health care reform requires employers with 50 or more employees to offer a group health insurance option that is affordable and meets the minimal essential coverages or the employer can face a potential monetary fine (the 2022 fine was $4,120 annually per subsidized employee). Additionally, the employer should be testing to confirm the affordability requirement is being met for their employees’ premium charges. Based on health care reform’s 2023 rules, to be considered affordable in 2023, an employee cannot be charged more than 9.12% of the employee’s household income.

Do you need to test your affordability? Are you offering a plan similar to other health care companies in your areas? WisMed Assure is the only insurance agency in Wisconsin focused on health care clients and we would love to tell you more about what we can do! Please call me at 608.442.3734 or email chris.noffke@wismedassure.org.

Summer 2022 Issue

Do you have the old or the new life insurance?

By Tom Strangstalien, Insurance Advisor

September is Life Insurance Awareness Month and is the time when I urge all our members to take a moment to reflect on the life insurance protection they have in place. Not too long ago, life insurance (especially term life), was generally viewed as a commodity.

Read more…

Build your financial wisdom

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

Join us for online educational sessions presented by WisMed Financial exclusively for Wisconsin Medical Society members. Session topics include retirement planning, social security and tax planning.

Read More…

Open enrollment

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

We’re rapidly approaching autumn and it’s time to start thinking about your open enrollment. Many companies fail to properly do an open enrollment, or maybe it’s your first time.

Read More…

Workers’ Compensation rate changes & good news for health care professionals

By Brian Fowler, WisMed Assure Account Director

Starting October 1, 2022, Workers’ Compensation rates in Wisconsin will drop for the seventh year in a row. Unlike many other states, Work Comp rates in Wisconsin are set by the state and are the same for every insurance carrier. The decrease is 8.47% over all employee classifications.  

Read more…

$111,000 more from Social Security

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

With more than 2,700 rules and 567 separate filing strategies for Social Security, 96% of people fail to make the optimal claiming decision and miss out on $111,000 of benefits for the average household.

$111,000 – that’s a lot of money. Let’s look at some of the rules for Social Security so your decision is better informed.

Read More…

How to prevent floods from damaging your business

photo of cars on a flooded road

By Society Insurance Team, reposted with permission from Society Insurance

The continued impact of extreme weather events isn’t lost on businesses: according to one report, businesses can expect to see roughly $13 billion in flood damage in 2022. Tornados, derechos, and severe thunderstorms all threaten billions in damage, but with spring just ahead, let’s focus on how you can protect your business from the threat of flooding.

Businesses everywhere are susceptible to flood damage—so how can they prepare?

Read more…

Lower Health Insurance Costs with Strategy and Unique Offerings

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

In 1946 the Wisconsin Medical Society established WPS to help physicians and residents pay for the costs of health care. Seventy years later I had the chance to help create another opportunity for health care professionals, the Wisconsin Medical Society Welfare Benefit Trust (WMSWBT) or the Association Health Plan (AHP). This year I was able to negotiate with our carrier partner, WPS, to lower our rates for all new groups. This has shown significant cost reductions for groups by decreasing their premium rates (up to 40% for some areas).

One Milwaukee-area group enrolled with the rates seen here:

An example of rates for the Marathon County area:

If you haven’t spoken with us about all the services, strategies and benefits available to you through the Wisconsin Medical Society’s insurance agency, reach out today. Even if your current health plan is in the middle of its cycle, we can still find savings for you and your employees (employees can even get deductible credits for health care dollars spent).

Let me give you a no obligation quote today – we can give you a preliminary rate within 2 days of receiving your census. You’ll see that we offer great rates, unique services and are the only agency that exclusively serves the health care community. Let’s schedule a time to talk.

Happy Spring!

Look out! Open Enrollment Is Upon Us!

Never fear… WisMed is here

By Chris Noffke, GBDS – VP of Employee Benefits

November is coming and so too are your updated employee health plan costs… if the carriers are up to speed!

Regardless, it is time to start thinking about and planning for open enrollment. In addition to being prepared so that employees have the time, information, and support they need to select a plan that best fits their needs, here are some important changes you need to know;

  • 2021 affordability percentage is 9.83%, up from 9.78% (This applies to groups of 50 or more employees)
  • Out of Pocket Maximums for 2021: $8,550 for self-only coverage and $17,100 for Family
  • HDHP and HSA Limits for 2021 (see chart)

Compliance, compliance, compliance… talk about fun!

In all seriousness, here is a reminder of when to submit your ACA Disclosures and Notices:

  • Special Enrollment Notice: Initial Eligibility and each Open Enrollment and also must be in SPD (Summary Plan Description).
  • SBCs (Summary of Benefits and Coverage): Required 30 days prior to new plan. Must be provided during each annual enrollment. If an employee must enroll to continue coverage, the SBC must be provided when open enrollment materials are distributed.
  • CHIP Notice: Annually, before beginning of plan year. Recommend to include with Open Enrollment materials and upon initial eligibility.
  • Medicare Part D Creditability: Must be sent before October 15, regardless of your plan year.
  • Women’s Health and Cancer Rights Act (WHCRA): Annually & upon initial enrollment / Usually sent at Open Enrollment.

Market Updates

General opinion on this year’s premium increase range widely between 4 and 10 percent for group benefits.

As to trends in plan design in response to COVID, a survey conducted by Mercer in June found that 37 percent of employers do not anticipate adjusting benefits for 2021. It also found that 48 percent are taking a wait and see approach.

While waiting to see what plans will actually cost, I believe we need to be mindful of what’s almost certain to occur in 2021. Many plans have made gains this year because employees are deferring elective care, but, as COVID releases its grip, it will almost certainly result in a much higher than normal plan usage in 2021.

Some of you may have an opportunity to lower costs if you are willing to change insurance companies. But, look at any “gift horse” very carefully, you could be facing an even larger increase than normal next year if you switch to a company that is trying to grab marketing share.  If you are uncertain what to do, but find yourself in a situation where status quo means accepting a significant increase, we should talk.

And, if you would like to discuss how you can prepare now for what’s ahead, contact me.

Open Enrollment Safety

We will still be hosting town hall meetings but will be doing so with COVID-19 safety in mind. 

Please contact me to discuss arrangements for virtual enrollment meetings for your employees.

Chris Noffke

608.442.3734 direct

Chris.Noffke@wismedassure.org

Navigating Testing in a COVID Environment

By Chris Noffke, GBDS – VP of Employee Benefits

Navigating insurance benefits is complex and confusing for consumers and business owners alike. Today’s insurance landscape requires people seeking benefits to understand insurance terms like deductibles, coinsurance, out of pocket limits, annual out of pocket limits (yes this can be different caps) and many others.

On top of that, you now have to understand the ins and outs of preventative care coverages and COVID related no-cost, shared-cost coverages.

Currently most insurers are covering the COVID tests, antibody testing, and treatment with no cost share. But be aware, these 100% covered costs will eventually become the patient’s responsibility. Some testing may continue to be covered at no cost to the patient but you may be billed if you go outside of your network or don’t have an approved reason for testing.

We can begin to understand why by looking at the cost of one of these tests. A local PPO (preferred provider organization) reported that they have seen the cost of COVID Antibody testing (Codes 86328 and 86769) range from $23 – $1,023.92, which is one of the major issues with understanding your cost shares.

So, while this test may be covered based on current legislation, when will it no longer be covered? As of right now, there is a lot of speculation that once the “state of emergency” ends, you may see no cost end too.

Currently, to get an antibody test done, it needs to be ordered by a healthcare professional in an office visit, urgent care room or emergency room. Although there are some guidelines for how out of network visits will be covered, patients are sure to see costs shifted to them.

What does the future hold?

When I think about our healthcare future and how COVID-19 will impact the cost of care, it causes a significant sense of concern. With so many people avoiding seeing a physician during social distancing, we should anticipate a surge of chronic illnesses with higher than average claims costs. Staying home means those with anxiety, depression and obesity may be spending even more of their time on couches and this means less physical activities and socialization.

A recent report by Milliman – the highly respected risk management consulting firm – states, “We expect an increase in costs after the Pandemic due to deferred care and pent-up demand… The estimate of services deferred to 2021 is beyond the scope of this paper, but those costs are likely to be very significant.” The report says that ‘very significant’ is an understatement, as it speculates there will be at least $75 billion and as much as $575 billion in deferred care.

And that’s for non-COVID care! Another analysis, commissioned by America’s Health Insurance Plans, estimates that total costs of COVID-19 for commercially insured individuals could range from $44.6 billion to $438 billion over the next two years.

Arriving at a clear conclusion is impossible given the volatility of our times. But, what we can do is work together to protect each other while aggressively looking for ways we can collaborate to protect our healthcare future.

For a comprehensive look at COVID-19 related insurance coverage, check out this Health Affairs article by Katie Keith and take a look at Wismed Assure’s Covid-19 Updates page for added tools and resources.

It’s Time to Jump Start Your 2020 Employee Benefits Process

Open enrollment season is upon us. Here is a list you can use to ensure your employee benefit program for 2020 is implemented without a hitch.

Has your advisor: 

  1. Requested a census?
  2. Reviewed alternative carrier market options?
  3. Presented a plan level review of your benefits (i.e. deductibles)?
  4. Discussed Open Enrollment and your employee forms?
  5. Provided a Benefit Booklet for your employees?
  6. Updated your Summary Plan Description (SPD)?
  7. Reviewed the legally required group health plan notices for employees? *

If any item on this list causes you concern, or you have any questions about how to make your 2020 employee benefits plan the best ever, we can help.

Contact our director of group benefits, Chris Noffke, GBDS.

608.442.3734 direct

Chris.Noffke@wismedassure.org

*2020 Required Group Health Plan Notices for EmployeesDownload
2020 Employee Benefits Annual LimitsDownload

Want more value from your 2020 medical benefit spend? Think ahead. Act soon.

Do you ever notice how the days seem to slip by faster and faster with each passing year?

Here we are approaching the final couple months of 2019 and it’s a shock to realize we’ll be entering a new decade. I can’t seem to adjust to typing 2020 on the applications. Before the rest of the year slips away completely, it is time to do some serious thinking about your medical benefit policies for next year.

Quoting and Timing

We see it every year— there is always a time crunch when quoting medical benefits mostly because the insurance companies do not make rates available to groups and agents until they absolutely need to. I believe insurance companies offer limited information on rates because it makes it difficult for clients to switch providers.

If you take action early… perhaps even right away, together we can put the pressure on the insurance companies. Additionally, we can reduce the time crunch by taking care of ancillary benefits like Dental, Disability, Life and Vision sooner because all quoting can be done months in advance of renewal. This will allow for more time to be spent toward working on medical benefits when the rates are available.

As a side note, I think it is unfortunate these benefits are called ancillary. Even though they might be seen as a luxury when rising premiums force people to make hard choices, they can be just as important as medical benefits… just ask the employee who needs dental work or has vision problems.

Notices and Enrollment Periods

Other important, time-sensitive things to think about now are your notices and enrollment periods. Open enrollment is the annual period of time when employees are able to make changes to their benefit selections. The only other time they can make changes is when they experience a Qualifying Life Event (QLE). Typically, groups need to provide a special notice to their employees to establish the time period for the upcoming open enrollment.

I am often asked to clarify which employees are eligible for open enrollment. The answer is simple for groups where all employees are working full time – 30 hours or more per week. However, for groups with employees who are working a variety of hours per week, it is a little more difficult. If you are concerned about getting it right, call me, I can help.

If you want to protect yourself, I recommend you consider setting up what is known as a Look Back Period. A Look Back Period helps you and your insurance advisor verify which employees qualify to have been part of the open enrollment process.

WisMed Assure Exclusive Programs – AHP, Delta Dental, MGIS

Most agencies only quote and spreadsheet for their clients which is why they are happy to work with any type of group or company. We’re the opposite. We are focused solely on health care companies which has helped us develop innovate and exclusive products that only WisMed Assure can offer. Some examples are the Association Health Plan, Delta Dental and income protection solutions from MGIS. If you shop for these elsewhere, you won’t get the discounts we offer.

A Little Faith Means Less Frustration

If, as the end of the year comes closer, you find yourself scratching your head with insurance questions, and feel frustrated due to not having access to the systems and services you need, think of us… have faith in us.  We are here to help you move the health care of Wisconsin forward and to be your financial partner for life.

Chris Noffke, GBDS

chris.noffke@wismedassure.org

608-442-3734