Under the new American Rescue Plan Act (ARPA), among other significant items, imposed new obligations for employers pursuant to COBRA (Consolidated Omnibus Budget Reconciliation Act). COBRA allows group coverage to continue after specific events. ARPA requires employers to provide COBRA premium subsidies to certain employees from April 1, 2021 through Sept. 30, 2021. It’s important to know if your insurance plan will be affected by this law. That is why Hafetz and Associates is here to guide you through it.
The Subsidy applies to specific groups and events. For more details, view our HR Compliance Bulletin COBRA Subsidy Provisions of the American Rescue Plan Act, which highlights eligibility, funding, and switching coverage.
Employers that do NOT have a third-party COBRA administrator and those that are under 20 employees and subject to New Jersey Continuation (mini-COBRA) rules are required to notify their employees about the COBRA subsidies and the change in benefits under ARPA. If you need assistance notifying your employees of these changes, our Legal Update FAQs for COBRA Subsidy in the ARPA provides more information.
As always, Hafetz is here to help. Give us a call or complete our online form and one of our knowledgeable brokers will contact you promptly.
October 1, 2020
An increasing number of businesses are being approached by Professional Employer Organizations (PEOs) to assist in handling their employee health insurance needs. While PEO’s make attractive sales pitches about their services, we believe that we at Hafetz and Associates offer the clearly better choice.
Our commitment is to use our experience and knowledge to provide the highest quality, personalized and accessible service at an excellent value. As we strive to be our industry’s best on a daily basis, we remain devoted to our family, our colleagues and our communities.
We continually invest vast resources in updating our technology with advanced industry applications that not only improve our ability to service our clients with the latest tools in the industry, but also allows us to provide solutions to keep our clients businesses in the forefront of technology and on the cutting edge of their industries.
At Hafetz, our online benefits enrollment platform is powered by your broker and integrated with your other HR technology solutions. This means we can
offer your company a singular integrated system of records for benefits and HR, and a platform where employees can enroll in benefits entirely online.
Our platform also enables you to work with the best in breed for each aspect of HR: payroll, consumer-driven benefits, voluntary benefits, and more. Our payroll connections allow you to sync your benefits and payroll, making it easier to add new employees, manage changes, and keep employee records, PTO and vacation tracking up to date.
With PEOs, your employees do receive access to a system and can enroll in benefits completely online, but the PEO administers the entire solution. And, because PEOs manage their services entirely through one system including payroll, you’ll have to switch your entire solution to work with a new provider in the event you have issues with the payroll feature.
Highly Personalize Service and Expertise
Only at Hafetz and Associates will you experience the personalized, one-on-one assistance and expertise that allows us to customize a health plan for your specific needs. We listen to what works and what does not; explore new carriers or plan types you can offer your employees; and customize a benefits offering based on the traits of your staff’s average age, company size, and location.
PEO’s, on the other hand, typically lack personalized service. Although many PEOs offer customer support, it’s not in-person. Employees have to rely on chat services and phone calls if they have questions.
Additionally, with a deep understanding of the local healthcare market, we can assist your employees during open enrollment, and as experts on plan design and claims management, we are well-positioned to advise you on reducing cost helping employees pick the best plan for their family.
With PEOs, co-employment may enable competitive rates, but it also means that plans and costs are based on all of the groups they employ, not just yours. Therefore, the lower premiums and deductibles may not be aligned with your business’s unique needs. Additionally, PEOs charge an unemployment tax based on all of their employers. Therefore, a small local business may be charged the same as a big corporation.
At Hafetz and Associates our mission is to be the most successful provider of employee health products and services by offering our clients innovative, cutting-edge ideas tailored to meet their specific needs. Through personal attention and customer service, our goal is not only to be a consultant to our clients, but a trusted advisor.
We know how it is. Once a year you get an email or see a flyer from management that the benefits consultants are coming out for an enrollment or renewal meeting – discussing your current health insurance plan, addressing what plan you will have the following year, and answering any questions you may have. You sit through their meeting as they go over the main benefits of your latest health insurance policy and you think, “Yeah, yeah, this all sounds fine. I don’t really use the insurance anyway.” You understand the gist of how your plan works and that is all well and good. You only go to the doctor once a year anyway for your physical or if you can’t shake that stingy flu. All of those examples that the benefits consultants discussed don’t really matter to you.
Flash forward a few months
later to yourself in the Emergency Room with a crazy pain in your side and doctors
telling you that you’ll have to have your gallbladder removed. The only thing
you are concerned with in that moment is how are the doctors going to get the
pain to stop. No thoughts about deductibles, or what your coinsurance or max
out of pocket is – you just want the hospital staff to do whatever it takes to
get you well.
You have emergency surgery,
spend a few nights in the hospital and then you go home to recover before returning
back to work. About a month later, bills from providers begin to clutter your
mailbox! Physician bills, anesthesia bill, facility bill, etc. – each one seeking
different sums of money. Why do you have so many bills? How is it that they are
asking for so much money? I thought insurance was supposed to take care of all of
Now. Hit the pause button
and do not panic. Do you remember a few months back that the benefits
consultants told you they have a dedicated team of Medical Billing Advocates that
are there to help you with current medical bills? Time to reach out to a
Medical Billing Advocate!
To reach the claims
department, please send us your most recent related provider bill to firstname.lastname@example.org. Once we have the claim(s), we’ll research
it to make sure everything has processed properly according to your plan. If we
find an issue, we’ll get it resolved and go over the details with you. We
believe in not only making sure the claim is processed correctly, but that you
understand why they processed as they did. Sometimes if everything has
processed correctly, but it is still a lot of money that the provider is asking
for, we can offer some tips to get that amount possibly lowered or see if it
can be broken down to monthly payments. After our review of your claims, you
may not necessarily owe any less, but you will know why you owe what you owe
and have the peace of mind that your insurance worked the way it was supposed
to and you will be confident in paying these bills.
Hafetz & Associates is
here for you. Our claims department will make the calls and emails, establishing
communication with the providers and insurance carriers for you – saving you countless hours on the phone. At
Hafetz & Associates, our Medical Billing Advocates are there to ensure that
you do not pay one penny more than you should.
We know understanding your
health insurance plan can be tough and our team is there to relieve you of the
burden after you’ve been recently sick or injured. If you or loved ones
have medical bills that need to be reviewed, please call our team today at 609-872-0001.
Our Hafetz team is here for you!
Hafetz & Associates Medical Billing Advocate Supervisor
The IRS Office of Chief Counsel recently released an information letter regarding the employer shared responsibility (pay or play) penalties under the ACA. This information letter confirms that the pay or play penalties continue to apply for ALEs that fail to offer acceptable health coverage to their full-time employees (and dependents). This ACA Compliance Bulletin provides an overview of the IRS information letter.
Read the details here.