Contraception Mandate Rolled Back for Employers
Interim Final Rules were released and became effective on October 6, 2017, allowing a greater number of employers to opt out of providing contraception to employees at no cost through their employer-sponsored health plan.
Compliance Recap – November 2017
November was a busy month in the employee benefits world.
On-boarding & Off-boarding Techniques
Join us to learn how to effectively get new employees up to speed and productive quickly.
PTO for When the Wind Blows
This year, much of the United States had some form of major natural disaster—hurricanes, wildfires, floods, tornados—and millions of people were either directly affected, or had a family member or close friend who was affected. This life-changing disruption often meant that people couldn’t, or weren’t able to, go to work.


6 Smart Ways to Put a Dent in the Cost of Dental Care

Not only is your smile an important part of how you present yourself to the world, your dental health is strongly connected to your overall health. Oral health problems, especially if gum disease is involved, have been linked to a number of serious health conditions such as heart disease, poorly controlled diabetes, and even preterm birth.

Money is the top reason people avoid going to the dentist. Studies have shown that many adults in the U.S., even those with private insurance, struggle to afford dental care. Some people put off care until a more serious problem develops which, ironically, ends up costing more in the long run. A small cavity that costs very little to fill today can turn into an expensive root canal tomorrow.

So how can you stay up on preventative care, keep your teeth healthy and put a dent in your annual costs?

1. Cancel Your Coverage

Crunch the numbers and see if you’re spending more on dental insurance premiums than the cost of your family’s visits. This depends highly on your individual situation and insurance options. Ask your dentist to provide you with the fees for the services you’ve received and compare. If your teeth are healthy and you don’t need any major work, it might make sense to cancel for a year or set up your own savings fund (or take advantage of pretax plans) to pay for future visits. Don’t forget to include some savings for emergencies.

2. Use pretax dollars

If you have a flexible spending account (FSA) through your workplace or a health savings account (HSA), you can save by using pretax money to pay for both routine maintenance and major services such as root canals, braces or bridges. With an FSA account, it’s lose or it use it, so you’ll need to figure out your annual costs ahead of time. With an HSA account, your money grows tax free and you never lose it. Using pre-tax dollars is an easy way to squeeze a little more value out of your dental care dollars.

3. Double up on coverage

Do you have children who will need wisdom teeth extractions or braces soon? Unlike health insurance, most dental carriers allow you to have multiple plans pay toward your benefits. If you have a lot of dental expenses coming up, it might make sense to put family members on both your policy and your spouse’s policy. Not all policies cover braces, and most max out at $1,000 to $1,500 per lifetime, but every little bit helps.

4. Spread dental work across two benefit years

Major dental work – such as dentures, bridges and crowns – can cost thousands of dollars and is usually only covered at 50% with an annual limit of $1,000 – $1,500. Since most benefits reset on January 1 of each year, you can schedule some of the major work you need in the 4th quarter of this year and the rest of it in the 1st quarter of next year.

5. Make the very most of your dental insurance coverage

Are you getting the maximum value out of your coverage? Sit down at the beginning of your benefit year and schedule all your covered preventative care visits for you and your family. Make sure you’re going to a dentist who is in-network to get the lowest out-of-pocket costs.

6. Receive services at a dental school

Local dental schools can be a significant resource for reduced cost dental care. Dental students provide everything from routine cleanings and x-rays to dental implants, root canals and other major work – all at fraction of the price you would pay a regular dentist. Your procedure may take a little longer, but the work is supervised by licensed dentists who oversee student work.



Employer Premiums Rise Nearly 7% in 2017; Employees Absorb More of the Health Insurance Cost

Alpharetta, GANovember 17, 2017 – Premium renewal rates (the comparison of similar plan rates year over year) for employer sponsored health insurance rose an average of 6.6% – a significant increase from the five-year average increase of 5.6%, according to the 2017 United Benefit Advisors (UBA) Health Plan Survey, released today. Two states saw record premium increases: Connecticut saw a 24% increase in premiums in 2017, up to $655 from $530; New York also saw a large increase of 14%, up to $712 in 2017 over $624 in 2016.

On the other side, some states saw decreases in premiums, such as Arizona and Washington which saw 2% and 10% decreases, respectively.

Average employee premiums for all employer-sponsored plans rose from $509 in 2016 for single coverage to $532 in 2017 and from $1,236 to $1,272 for family coverage (a 4.5% and 3% increase respectively). Average annual total costs per employee increased from $9,727 to $9,935. However, the employee share of total costs rose 5% from $3,378 to $3,550, while the employer’s share rose less than 1%, from $6,350 to $6,401.

“Premiums have been holding relatively steady the last few years. And while this year’s increases are not astronomical, their departure from the trend does warrant attention. To mitigate these rising costs, employers are shifting more premium onto employees, offering more lower-cost consumer directed health plans (CDHPs) and health maintenance organization (HMO) plans, increasing out-of-network deductibles and out-of-pocket maximums, and leveraging continued extensions on the ability to “grandmother,” says Peter Weber, President of UBA. “We’ve also seen reductions in prescription drug coverage to defray increasing costs even further.”

Prescription Drug Plans  For a second year, prescription drug plans with four or more tiers are exceeding the number of plans with one to three tiers. Almost three-quarters (72.6%) of prescription drug plans have four or more tiers, while 27.4% have three or fewer tiers. Even more surprising is that the number of six-tier plans has surged, accounting for 32% of all plans, when only 2% of plans were using this design only a year ago.

“While employers chose to hold contributions, copays and in-network benefits steady, they dramatically shifted prescription drug costs to employees. By increasing tiering and adding coinsurance (vs. copays), employers were able to contain costs,” says Weber.

Out-of-Pocket Costs   Median in-network deductibles for singles and families across all plans remain steady at $2,000 and $4,000, respectively. Single out-of-network median deductibles saw a 13% increase in 2016, and a 17.6% increase in 2017, from $3,400 to $4,000. Both singles and families are facing continued increases in median in-network out-of-pocket maximums (up by $560 and $1,000, respectively, to $5,000 and $10,000).

Self-Funding – The number of employers using self-funding grew 48% for employers with 25 to 49 employees in 2017 (5.8% of plans), and 13.4% for employers with 50 to 99 employees (9.3% of plans).

Overall, 12.8% of all plans are self-funded, up from 12.5% in 2016, while almost two-thirds (60.9%) of all large employer (1,000+ employees) plans are self-funded.

“Self-funding has always been an attractive option for large groups, but we see self-funding becoming increasingly desirable to all employers as a way to avoid various cost and compliance aspects of health care reform,” says Weber. “For small employers with healthy populations, self-funding may be particularly attractive since fully insured community-rated plans under the ACA don’t give them any credit for a healthy group.”

Contact us at 678-533-6040 or for a customized benchmark survey based on industry, region and business size

About the 2017 UBA Health Plan Survey

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2018 Annual Tax Benefit Levels

We are pleased to release to you the new 2018 Annual Tax Benefit levels. Please contact ARISTA team if we can be of assistance in leveraging any of these tax efficient tools and strategies to your organization’s benefit.

This information is brought to you by your Partner Firm of United Benefit Advisors, the nation’s leading employee benefits advisory organization with more than 200 offices throughout the United States, Canada and the United Kingdom.




What Employers Need to Know about IRS Reporting in 2018
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Stop Handing Out Your SSN Like Candy
Social Security numbers (or SSNs) used to be tied just to your Social Security benefits. Now, that number is tied to just about everything used to identify you.
Get Moving… To Live!
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7 Genius Ways to Save on Prescription Drugs. Small steps that can add up to big savings.

Prescription drug costs are growing faster than any other health care expenditure in the U.S. For most of us, these medications are not optional. Nearly 60% of adults take a daily prescription to help manage their health. The good news is that you can make a dent in your monthly out-of-pocket costs with a just a little research and action on your part. Check out these six steps you can take to help lower your costs.

1. Get your prescriptions free

The proliferation of online discount eyeglass providers has made it easier than ever to get your frames for less. You’ll typically pay 50-75% less with online sellers versus traditional retailers. Sites like Zenni Optical, Warby Parker and other online retailers have perfected the art of buying online by offering generous home try-on and return programs.

Stores like Giant Eagle, Meijer and Publix offer some common generic prescriptions for allergies, diabetes infections and high blood pressure at no cost.

2. See if it’s cheaper to pay out of pocket

Believe it or not, many chain and big-box stores such as Kroger, Publix and Walmart offer common generic drugs for less than your co-pay from your insurance company. For instance, Walmart offers a list of common generic prescriptions for $4 for a 30-day supply and $10 for a 90-day supply.

In other cases, “clawbacks” from Pharmacy Benefit Managers (PBMs) such as Caremark, Express Scripts and Optum have contracts that allow pharmacies to charge patients with insurance more than the retail cost of the prescription. An investigation in New Orleans exposed an example of this swindle. A pharmacy patient was charged her full $50 co-pay for a drug that had a retail cost of $11.65, meaning it would have been much cheaper to purchase outside the patient’s prescription drug plan.

3. Request a 90-day prescription

For prescription drugs you’ll be taking long term, ordering 90-day supplies in not only more convenient, it can save you a third of your copays – which will help lower your annual costs.

4. Compare prices

Use apps like GoodRX and OneRx to compare prices and see where you can get your prescription for the lowest price. For instance, researching Lipitor on GoodRX showed local prices ranging from $18-$144 and listed additional options to lower costs further with links to coupons.

5. Maximize your benefits

Always see if you are eligible for refills at the end of the calendar year. If you’ve already satisfied your out of pocket maximum, your refills will be free.

6. Use generics whenever possible

Generic drugs contain the same active ingredients and produce the same effects as their brand-name equivalents, but at a lower cost. According to the U.S. Food and Drug Administration, the cost of a generic drug can be as much as 85% lower on average.

7. Take advantage of special programs

Check with your pharmacist, GoodRx and OneRx about special programs, coupons or discount cards. If you use an expensive drug, see if the pharmaceutical manufacturer has a patient assistance program to help lower costs for people who have trouble affording treatment.


Qualified Sick Pay Plans 

A Qualified Sick Pay Plan (QSPP) is an agreement for employers to continue to pay an employee’s salary during a period of disability resulting in an absence from work. The employer is responsible for determining what employees qualify for QSPP and how long they will qualify for QSPP. These factors may change depending on the employee and the employee’s rank within the company.

Administration and Design 

When creating a QSPP, you should consider the following:

• Which employees are covered
• How long these employees will be paid
• When the benefits will begin
• How the benefits will be determined, if a covered employee becomes disabled
• Which company representative will approve claims and administer benefits on behalf of the plan
• How the benefits will be funded under the plan

Insured Plans 

By purchasing insurance on a QSPP, the insurance company determines the validity of a disability claim as well as when the employee has recovered. The insurance company also holds financial liability for benefit payments and takes care of tax reporting and claims service.

Self Funded Plans 

If you choose to self-fund the plan, you either pay the employee directly with current profits or set up a trust for payments. Under this option, your company determines the validity of claims and proper Federal Insurance and Compensation Act (FICA) and Federal Unemployment Tax Act (FUTA) tax withholdings and reporting requirements. Your company must also shoulder the benefit liability on financial statements under the Financial Accounting Standard (FAS) 112.

Communication to Employees 

Once the plan is in place, covered employees will be notified of this option in the event that they become disabled and cannot work. The ultimate benefit of QSPPs is that they eliminate the risk of unnecessary tax consequences for the company and covered employees when the company chooses to financially support employees while they are disabled.

To learn more about these plans, contact Arista Consulting Group today.