Open Enrollment: Stay in the Know

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America’s Affordable Care Act allows individuals and families to apply for major medical insurance each year without the need to answer any health questions and includes coverage for pre-existing conditions. The Annual Open Enrollment Period to apply for coverage is November 1st through December 15th 2018 and with that in mind, we are happy to provide you with an update on the program and important information related to applying for coverage.

Medical costs can cripple one’s finances and carrying health insurance offers you many benefits including the peace of mind that you and your family are protected in the event of an accident or illness. Peace of mind is priceless. Click here to read more on the benefits of having health insurance.

What you need to know


Open Enrollment is from November 1st to December 15th, 2018. Plans are elected during this time frame with a coverage inception date of January 1st, 2019. You must act by December 15th, 2018 in order to obtain coverage. This is typically for individual policies; group policies may have a different inception date based on renewal.

Here is a great article that offers Open Enrollment tips and some things to consider before choosing a plan that’s right for you.

A great resource guide for up-to-date information is Healthcare.gov. Not only do they publish informative articles about open enrollment, they also offer information regarding wellness. Articles are published frequently that will help keep you up to date with the ever changing healthcare system. Be sure to subscribe to their newsletter to receive information on updates.

Click here for a quick reference guide on terminology often used in insurance quotes and proposals. Getting familiar with these terms will help you to better understand your proposals.

How to Apply


Contact us, your local agent regarding a quote. One of our experienced professionals will be happy to provide you with pricing and the plans available to you.

Our agent will need the following information:

  • Name
  • Date of Birth
  • Smoker/Non-Smoker
  • Zip code

Choosing a Plan


There are 4 categories that the plans are placed into: Bronze, Silver, Gold and Platinum

  • Each of these compare costs that are shared between you and the provider.
  • Each plan will list highlights about what the plan entails.

There are 4 policy types that you should be familiar with:

  • Health Management Organization (HMO) – coverage is typically limited and you can only see physicians within your network. These types of policies refer to “preventive care”. Preventive care is referred to wellness checkups, etc. in order to prevent any health issues.
  • Preferred Provider Organization (PPO) – this plan type is a network of providers such as hospitals and doctors. Cost will typically be less when you see a doctor within your plan’s network. Referrals are not required when you need to see a specialist.
  • Point of Service (POS) – Cost is less if you use providers within your network. POS plans do require a referral from your primary care physician to see anyone out of network. Keep in mind that some plans are open access and do not require a referral from a primary physician.
  • Exclusive Provider Organization (EPO) – A plan where coverage is only covered if you go to see a doctor, a specialist or hospitals within the plan’s network (except in the event of an emergency).

We hope that you have found this information helpful when it comes to deciding the right policy for you and your family. As always we are happy to help you choose said policy and thank you for allowing us the opportunity to serve you.

 

 

 

 

 

 

Internship Programs under the FLSA

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Many organizations use internship programs, and these programs can have many advantages for the employer and the intern. However, employers that hire interns must be aware of the rules that apply to interns under the Fair Labor Standards Act (FLSA).

The FLSA requires most employees of for-profit employers—including interns—to be compensated for their services. Unpaid internships are generally permissible in the public sector and for nonprofit charitable organizations. However, interns of for-profit private sector companies generally must be paid at least the minimum wage and receive overtime compensation. There is a very limited exception to this rule for trainees who participate in an internship program for their own educational benefit.

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Supreme Court Ruling Allows Employers to Require Arbitration and Bar Class-Action Lawsuits

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OVERVIEW

On May 21, 2018, the U.S. Supreme Court ruled that employers can use arbitration clauses in employment contracts to bar employees from filing class-action lawsuits related to wage and overtime claims. In a 5-4 split decision, the court determined that employment agreements can require arbitration, waiving the employee’s right to participate in a class-action lawsuit, to settle these disputes.

This ruling is a departure from the position taken by the Obama administration and the National Labor Relations Board (NLRB). Instead, the decision favors employers and follows President Donald Trump’s position on federal employment law that employers are entitled to waive their employees’ right to file class-action lawsuits under the Federal Arbitration Act (FAA).

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Affordability Percentages Will Increase For 2019

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OVERVIEW

On May 21, 2018, the Internal Revenue Service (IRS) issued Revenue Procedure 2018-34 to index the contribution percentages in 2019 for purposes of determining affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2019, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed:

  • 9.86 percent of the employee’s household income for the year, for purposes of both the pay or play rules and premium tax credit eligibility; and
  • 8.3 percent of the employee’s household income for the year, for purposes of an individual mandate exemption (adjusted under separate guidance).

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Covered Establishments in All States Must Now Submit OSHA Electronic Reports

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OVERVIEW

On April 30, 2018, the Occupational Safety and Health Administration (OSHA) announced it will require all establishments affected by the electronic reporting rule to submit their 2017 data to OSHA by July 1, 2018.

This announcement clarifies the requirement for establishments in states with an OSHA-approved plan. These establishments must submit electronic reports, regardless of whether the state has ratified or incorporated the electronic reporting rule into its OSHA state plan.

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