Our Benefits Blog

So what is a large employer?

Unfortunately the health care reform law doesn't have a consistent answer, it changes based on what part of the legislation we are talking about.

Here are some examples:

• W2 reporting it's 250 or more employees during the course of the year.
• Automatic Enrollment 200 employees is our number.
• SBC's, 60 Day Notice, $2,500 FSA Limit, Excessive Waiting Periods all groups.
• Pay or Play Penalties it's 50 full-time employees, including full-time equivalents (FTE's)

Today Our Focus Is On Determining Employer Size Related To Pay Or Play Penalties.

To qualify as a large employer for "Pay or Play", an employer must employ on average at least 50 full-time employees, including full-time equivalents (FTEs) on business days during the preceding calendar year. Full-time means 30 or more hours of service each week. Hours worked by employees with fewer than 30 hours per week must be counted—and then divided by 120 per month—to determine the number of FTEs. The number of FTEs is then added to the actual full-time employee count.

Employers will determine each year, based on their current number of employees, whether they will be considered a large employer for the next year. For example, if an employer has at least 50 full-time employees, including FTEs, for 2013, it will be considered a large employer for 2014.

All employers that employ at least 50 full-time employees, including FTEs, are subject to ACA’s pay or play rules, including for-profit, nonprofit and government employers. Seasonal employees and employees working abroad can be excluded under certain circumstances.  Also there are rules for common ownership that can take a company that might otherwise be a small employer and move them to large employer status.

The employee size calculation will be used later in the series when we discuss affordability and penalties.  In fact we have a calculator/spreadsheet that looks at all of the variables in the "Pay or Play" equation and will tell you what if any fines your company might have.  My main goal today is to make sure you understand the concept so we can dig deeper later.

Action Items:

• Calculate your total employees taking into account FTE's.
• Understand the Transition Rule for 2014 and determine what periods you will use.
• Review the common ownership rules if applicable.

Recommended Legislative Briefs:

• Large Employers Subject to "Pay or Play" Penalties
• "Pay or Play" Penalty - Identifying Full-time Employees
• "Pay or Play" Penalty - Common Ownership Aggregation Rules

In light of the Supreme Court’s June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect. Employers must also prepare to comply with ACA changes that will go into effect in the future. To prepare for upcoming changes, employers need to be aware of the ACA mandates that will go into effect in 2013.  

This Talon Benefits Legislative Brief provides a compliance checklist for employers for 2013. Please contact your Talon Benefits representative for assistance or if you have questions about changes that were required in previous years.

What is the Fiscal Cliff and how does it affect me?

On Jan. 1, 2013 when the terms of the Budget Control Act of 2011 take effect, the United States will face what has been referred to as the “fiscal cliff.” In general, this refers to widespread tax increases and spending cuts that will occur if the tax cuts put in place by former President George W. Bush expire as scheduled.

Congress is working to negotiate a deal to avoid the fiscal cliff but faces significant challenges in reach a compromise. If a deal cannot be reached, the economy could be significantly impacted:  the U.S. could face another recession, unemployment rates could skyrocket and many individuals and businesses could suffer the effects. However, reaching the fiscal cliff would cut the federal deficit and some sources say negative effects would be gradual and could be addressed after Jan. 1.  

This Talon Benefits Legislative Brief provides an overview of the fiscal cliff and how it could affect you and your organization.

What's on Your Plate? 

Maybe a better question is What Should be on Your Plate and in what quantities?

Forget about using the Food Pyramid we were all told growing up to use as a guideline. The most recent guidelines now suggest emphasizing lean proteins like turkey, fish and beans, lots of veggies, some fruit and whole grains with some dairy (or calcium rich foods) and healthy fats to complete the meal in the following recommended proportions.

For more detailed information and some great resources, check out:

ChooseMyPlate.gov

November is National Diabetes Month. 

Are you Diabetic?

If so, do you know your Current Levels AND your Target Goals for these parameters:

Fasting Blood Sugar?

A1C?

Blood Pressure?

Cholesterol Levels?

BMI?

If not, you should find out. Why? Because it's extremely important to your long-term health to keep these numbers at optimal levels. If they're not at optimal levels, you are doing serious damage to your body and organs and the longer you wait to get them under control, the more irreversible damage is occuring. There's no way to get your levels under control unless you know what your current levels are. There are increasingly more convenient, alternative ways to assess your current levels, other than going to your physicians office.

More and more Clinics and Pharmacy Care Centers are getting into the Screening business and they can give you an accurate assessment of your current levels of these important parameters.

There is also an increase in availability of Diabetes Education Programs. If you are diabetic and you don't know why it's important to control your blood sugar or how to control your blood sugar, you are a prime candidate for this type of education. If you need a resource of where to go for these services, please contact me at 720-458-8191. I will be happy to hook you up with a Pharmacy Care Center that can provide Screening and Diabetes Educational Services. There can be a minimal charge for this service, but it is very minimal for the vast amount, yet easily understandable information you receive, and can be literally life-saving!

Here are the Target Goals for Diagnosed Diabetics (non-diabetic goals can vary):

Fasting Blood Sugar?  70 to 130mg/dl

A1C?  less than or equal to 6.5% to 7.0%

Blood Pressure?  less than 130/80 mm Hg 

Cholesterol Levels?   

LDL less than 100mg/dl, HDL greater than 40mg/dl (men) and greater than 50mg/dl (women), Triglycerides less than 150mg/dl

BMI?  18.5 to 24.9

GET EDUCATED!

Here's to taking personal responsibility of your own healthcare and becoming educated about it!

Terrie Stonebraker, RPh

 We're smack in the middle of summer.

Are you taking the proper skin care sun precautions?

Even if you think you know all there is to know about skin care and the sun, read on.

I even learned a few new skin sun care facts... 

While on vacation on the East Coast this summer, I came across the above brochure, in a local beach shop, from a sunscreen company called Sun Bum. I took a brochure and bought some of their sunscreen. I like the sunscreen and thought their brochure was very informative and more complete than any other brochure I've seen. Their website has even more information regarding sun care protection facts and information. Above is information from the brochure's Sun Care Facts, reprinted with permission. Read it and check out their website for more information:

http://www.trustthebum.com/us/ 

http://www.trustthebum.com/us/sun-care-facts/

http://www.trustthebum.com/us/faq/

Sun Bum also supports some very worthy causes:

http://www.trustthebum.com/good/

To a Skin Happy Summer!

Terrie Stonebraker, RPh

Patient Protection and Affordable Care Act (PPACA) was upheld by the Supreme Court.  What does that mean...

BenefitMall one of the vendors I work with has created a great report that goes over what the individual mandates look like.

The some of the questions they answer are:

To whom does the Individual Mandate provision apply?

Who is exempted from the Individual Mandate?

What is "Minimum Essential Coverage"?

How much is the flat tax for individuals?

How will income impact the tax rate?

They give us plenty of informtation without overdoing it and there are links to dive deeper into the law.

To download the report click here: Individual Mandates Explained

National Drug Take Back Initiative

Saturday, April 28th 10am to 2pm

Here's a Reminder to clean out your cabinets and drawers and dispose of any unused or expired medication. This program, set up by the DEA, will accept ANY type of drug...OTC, Prescription, Injectable, Controlled or Illicit. No questions asked. This is your chance to get rid of all of it.

This is only a Bi-Annual event, at this point in time, and won't take place again until the fall. So, take advantage of this opportunity to dispose of your drugs properly.

Saturday, April 28th 10am to 2pm

Drop off sites are numerous and there's bound to be one close to where you live. To find out where a close drop off location is, click on this link:

Collection Sites

For more information on this event, click here:

National Drug Take Back Initiative

Saturday, April 28th 10am to 2pm

To a Healthy Environment!

Terrie Stonebraker, RPh

Today was the second day of oral arguments for Healthcare Reform.  There will be a lot of opinions expressed about the arguments but I wanted to provide the actual testimony. 

For a transcript Tuesday 3-27 Oral Arguments PDF.

To play the audio hit play below.

Today was the first day of oral arguments for Healthcare Reform.  Today's arguments are in relation to Department of Health and Human Services. v. Florida.  There will be a lot of opinions expressed about the arguments but I wanted to provide the actual testimony. 

For a transcript Monday 3-26 Oral Arguments PDF.

To play the audio hit play below.