What Everyone Should Know about the ACA and Grandfathering Provisions

 

While the Patient Protection and Affordable Care Act requires certain benefits be made available by health plans, there are some grandfather provisions that protect employer-sponsored plans. If these plans were made before March 23, 2010, sponsors will not have to make significant changes. Due to this provision, there are many Americans who are covered by large employers who will not see major changes after the new law takes effect.

What is a Grandfathered Plan?
A grandfathered plan is one that has existed since the date mentioned in the last paragraph, and it must have at least one person who is covered at all times. In addition to this, it cannot be changed except as permitted. These types of plans are not exempt from all health reform rules, but they are exempt from many of them as long as they maintain their grandfather status. Insured group plans, self-insured group plans and individual coverage may be grandfathered. These plans may also allow workers to enroll their family members. Although new employees may be able to join the plans, there are restrictions that apply to employers transferring plans without endangering their grandfather status.

How to Determine if a Plan is Grandfathered
As mentioned before, a plan must qualify by its active date. If some individuals cease to be covered after the active date, that does not automatically take away a plan’s grandfather status. However, one or more people must continuously be covered. Plans that change from self insured to fully insured can keep their grandfather status. Plans that eliminate all or most of the benefits to treat and diagnose certain conditions do not qualify. If a plan increases the percentage cost sharing, it will not qualify. Plans that increase cost-sharing amounts that are otherwise fixed other than copay amounts to make the total percentage increase will not qualify. If a plan increases a copay amount that is otherwise fixed, it might not qualify. This is true if it exceeds the greater of an amount equal to inflation plus $5 or the maximum percentage increase. If the employer’s contribution rate decreased toward any tier of coverage for any class of individuals at a rate of more than five percentage points below the contribution rate, it will not qualify.

If a group plan changes from self insured to fully insured, it must properly notify all members to keep its grandfather status. In addition to this, any plan claiming grandfather status must include a statement that it believes it is grandfathered, and this must be distributed to plan participants. The plan must maintain records showing the terms and connections with coverage effective after the cutoff date. These records must be available to participants upon request. Some plans that switched companies after the effective date may still qualify for grandfathering. Self-insured plans can change third-party administrators without losing their status, and they can also change stop-loss coverage without losing status. Some enhancements and additions can be made to a grandfather plan also.

New hires, family members and some enrollees can be added to health plans without them losing their status. However, only family members of people who were enrolled at the time of the effective date qualify for this provision. If employees are not enrolled in a grandfathered plan, they may move into it during the open enrollment period. In addition to this, employees can transfer from one grandfathered plan to another. To learn more about grandfather status for plans, how to keep it or for further information about applicable dates, call ACBI at 203-259-7580 or visit our website by clicking here.

Why Workers are Placing More Importance on Retirement Plans

 

Recent research shows that since the economic recession ended, a larger percentage of people are working for companies that provide better retirement plans. In addition to this, a much larger number of people are participating in these plans. In 2012, more than 60 percent of all employees who were 16 years of age or older were employed by a company or union sponsoring a retirement plan or pension for all employees. That number was up from less than 60 percent in 2009. The amount of workers using retirement plans increased to more than 45 percent in 2012, which was a slight increase from the percentage documented in 2009. However, it was almost three percent lower than the number recorded in 2003.

The amount of workers who said they were entitled to lump-sum distributions or pensions after leaving their jobs were at more than 40 percent in 2012, and this was an increase from about 25 percent in 1979. The larger number of participants now is due to more workers using defined contribution plans where their money is quickly vested. Almost 80 percent of respondents said that defined contribution plans were considered the primary plan among workers. Slightly more than 20 percent said that defined benefit or pension plans were the primary ones for workers.

Although worker participation rates have been increasing for salary reduction plans, most employee contributions to these plans dropped in 2012 from the numbers recorded in 2009 by a total of slightly more than one percent. This was partly due to the total number of 401(k) plans continuing to grow, and these types of plans are known to bring in more low-income participants who are new to retirement plans. However, the workers who enroll in these plans as a form of a first retirement plan usually start with a lower contribution rate.

With additional research showing that many Americans are not fully prepared for retirement, it is important for all working people to start considering their employers’ retirement benefits. Employers must also think about their benefits packages for optimizing their chances of attracting and maintaining good talent. As more workers learn the importance of searching for employers offering good retirement benefits when looking for jobs, employers can expect to see a greater demand for reasonable options. To learn more about these types of plans or for answers to any specific questions, call ACBI at 203-259-7580 or visit our website by clicking here.

What Time Is It? It’s High Noon!

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In the bygone days of the Wild West, if you offended someone or were accused of such an offense, the solution to settle the dispute was pretty simple – pace off 20 steps, hands by your side, and the first one to draw their six-shooter and aim accurately was deemed to have won the dispute, public sentiment aside.

Today, as a Business Owner or Property Owner, if someone has decided you have offended or otherwise injured them, there is a lawyer ready to file suit on their behalf, whether that someone is an employee, customer, vendor, supplier or visitor.  Wrongful acts include harassment and all forms of discrimination based on age, race, religion, national origin, disability, pregnancy, or sexual orientation.  And if that’s not enough add allegations of mental anguish, emotional distress and humiliation.  Instead of reaching for you six-shooter to defend yourself, grab you Employment Practices Liability policy, with beefed-up firepower of Third Party coverage, which, if you are deemed negligent, will pay up to the policy limits, with defense cost either inside or outside those policy limits.  Never heard of this coverage?  Not anymore!  Consider yourself informed.  Now you can ride in to the sunset, knowing the bad guys won’t have the drop on you.

For more information, visit our website or call John Czel at ACBI, 203-254-4587.

New Ladder Safety App Helps Construction Workers Avoid Falls

The National Institute for Occupational Safety and Health promoted a new ladder safety phone application recently. The app is available for all smartphone users, and it uses audio and visual signals to aid workers who must use extension ladders. The app checks the ladder’s angle when it is positioned and also provides several helpful tips for proper ladder use. It is free to download for Android and iPhone devices.

Every year, there are many injuries resulting from ladders falling on construction sites. Whether a person is on the ladder or standing under it when it is knocked over, injuries are usually severe enough they require emergency medical attention. Falls are one of the biggest concerns, and many people fall while they are on an extension ladder if safety precautions are not followed. One major risk is misjudging the angle of the ladder. It may look secure from one point, but it may actually be far from a safe angle for climbing. When it is set too steep, it often falls backward. However, ladders where the bottoms are set too shallow may fall out from below.

Experts say that the new phone app is a good way to keep workers safer in two useful ways. They also believe it will help prevent injuries if construction workers are encouraged to download it. They point out that the app is proof of how experts are constantly looking for easier ways for workers to protect themselves. This app provides feedback for setting up ladders at certain angles. In addition to this, there are references users will find helpful. There is also a guide for inspecting, using, accessorizing and selecting extension ladders.

In addition to downloading this app, it is helpful for construction workers to brush up on their extension ladder safety basics frequently.

The following are some useful points to remember:

– Never stand above the ladder’s highest safe standing level, which is outlined by the manufacturer and is usually above three rungs.

– Always keep three or more points of contact during a project.

– Avoid extending the center of the body beyond the sides of the ladder.

– Do not carry tools while using a ladder. Instead, wear a window cleaner’s belt or similar product designed to meet the purpose.

– Always face the ladder when descending or ascending.

– Do not leave an erected ladder unattended for any length of time.

– Always wear non-slip footwear when climbing a ladder.

If you have any questions about insurance for your Construction Business or Workers Compensation, please contact ACBI at 203-259-7580 or visit our website by clicking here.