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P R E S E N T E D B Y C O T T I N G H A M & B U T L E R

EMPLOYEE BENEFITS:STRATEGIES & ALTERNATIVES FOR YOUR EMPLOYEE BENEFIT PROGRAMJUNE 23, 2016

10:00AM - 1:00PMThe J-Bar Restaurant 4215 Elmore Ave | Davenport, IA 52807

• Established in 1887• Privately owned and operated with headquarters in Dubuque, IA• More than 700 employees • $350 million in commercial insurance premium placement• Over $900 million in bene�t claims administered• Ranked 35th largest broker in the United States• Organic growth more than triple the industry average

National Provider of Risk

Management and Employee

Bene�t Solutions

Risk Management Consulting - placement of property & casualty insurance

Transportation Group - full range of insurance and risk management solutions for the trucking industry

Employee Bene�ts Consulting - works with employers to maximize bene�t programs

Personal Lines - individual insurance

SISCO Bene�ts - third party claims processor

HealthCorp- medical management

HealthCheck360- performance based wellness program

Casualty Claim Services - managed WC, general liability and product liability

Safety Management Services - safety programs to manage risk

Captive & Program Management - alternative market mechanisims

Services include:

Cottingham & Butler | USA | 800.793.5235www.cottinghambutler.com

Firm History1887 Dixon Cottingham, founded Cottingham Insurance Agency.

1938 Ellis Butler took over the family business. The business specialized in poultry insurance.

1957 John Butler, today’s Chairman and CEO, joined his father at Cottingham & Butler.

1980 Self Insured Services Company (SISCO), a third party claim administration company, was founded.

1992 HealthCorp was established to provide health coordination services for self funded health plan recipients.

1993 Cottingham & Butler formed its �rst member owned group captive, Tra�c Insurance Ltd.

1993 Safety Management Services Company was created to provide loss control and essential safety services.

1997 Transportation Insurance Formed (small �eet division)

2001 Truck Insurance Ltd. Founded

2002 Security Insurance Ltd. Founded

2004 Blackhawk, Truck-Pak launched, Cal-Truck Insurance Ltd. Founded

2005 Remote O�ces added: Chattanooga, TN | Naperville, IL

2007 HealthCheck360º was created to provide Health Risk Assessments

2008 Remote O�ces added: Columbus, OH | Orlando, FL

2008 Construction Specialty Founded

2009 Wisconsin Bene�ts Consulting Practice acquired

2013 Butler Insurance Service, Inc. & Butler Bene�t Service, Inc. acquired

2014 Bene�t Coordinators Corporation (BCC) acquired

Cottingham & Butler | USA | 800.793.5235www.cottinghambutler.com

LINDA PERRY Sr. Account Manager, Compliance & HR SpecialistCottingham & Butler’s Employee Benefits Services 563-587-5149 | [email protected]

Linda Perry is the Senior Benefits Executive for Cottingham & Butler’s Employee Benefit Services. As the Senior Benefits Executive, Linda’s highest priority is to provide superior services. Keeping each client’s particular needs in mind, she provides the most up-to-date advice regarding employee benefit trends, issues and compliance. Linda has over 30 years combined experience in Human Resource Management, Employee Benefit Compliance, Compensation and Benefits Consulting. She has completed the Health Insurance Association of America Group Life and Health Insurance Program.

SPECIFIC EXPERIENCE • Specializes in Customer Service• Prior Experience in Human Resources Management and Benefits Consulting

SARA DICKINSON Employee Benefits & Wellness Executive Cottingham & Butler’s Employee Benefits Services 563-581-9695 | [email protected]

Sara Dickinson is a Sales Executive in Cottingham & Butler’s Employee Benefit Services. As a Sales Executive, Sara’s focus is providing the best consultative services and risk management needs for her clients. Sara joined Cottingham & Butler in 2009 with extensive experience in Sales and Marketing. Prior to joining the company, Sara worked for Performics, a Public Groupe Company, as a Senior Account Executive, and for Google – DoubleClick Performics as an inside Sales Representative. She also has experience working on political campaigns and event planning.

SPECIFIC EXPERIENCE • Specializes in Risk Management Programs• Prior Experience in Politics and Event Planning

EDUCATION • Bachelor’s Degree in Business Administration and Marketing from Clarke

University

Benefits Seminar:Ongoing Compliance Management

Presented by: Linda PerryJune 23rd, 2016

Presenter

Linda Perr y Sr. Account Manager, Compliance HR Specialist

[email protected] 563-587-5149

Agenda

• ACA New Guidance—Dec. 2015

• FLSA—Changes 12-1-16• EEO-1—Reporting Changes

• ERISA—ERISA Compliance (What is an ERISA Plan?)

• COBRA—Avoid Common Mistakes

• Other Requirement Notices

• EEOC Wellness—ADA & GINA Add Wellness Program Rules

• Penalties

IRS Notice 2015-87

• Issued Dec. 16, 2015

• Addresses how ACA provisions affectemployer health coverage

• Covers ACA market reforms and employer coverage rules

Determining ALE Status

• ALE status determined by looking at FT and FTE employee count from prior year

• For 2016, ALE status based on entire 2015 calendar year

– 2015 transition relief no longer applies

• Aggregation rules and seasonal worker exception still apply

Pay or Play Rules Overview

Employer Shared Responsibility Rules

Penalties may apply:

• Employer does not offer coverage to all FT employees (and children) OR

• Employer offers coverage to all FT employees (and children) but coverage is unaffordable or does not provide minimum value

Penalties triggered when:

• Any FT employee gets a subsidy for coverage through an Exchange

Affordability Requirement

• Affordability based on lowest-cost self-only coverage offered

• Family coverage does not have to be affordable

• Employer can also offer more expensive coverage options

Employee Cost of Coverage

• “Household income” = modified AGI of the employee and any family members

Employee’s Income

• Form W-2 safe harbor

• Rate of pay safe harbor

• Federal poverty level (FPL) safe harbor

Three optional safe harbors

Employer Shared Responsibility: Affordability Threshold Adjustments

• Affordability safe harbors

• Reference to offer of coverage

• Multiemployer plan interim relief

• Definition of a qualifying offer under § 6056

Adjustments apply for:

• 2014: 9.5% $11,670 $92.38

• 2015: 9.56% $11,770 $93.76

• 2016: 9.66% $11,880 $95.63

Threshold amounts:

The IRS has clarified that the employer shared responsibility affordability standard will be adjusted for inflation

Affordability Safe Harbors

W-2 Income

• Compare employee cost of coverage to W-2 wages (as reported in Box 1)

• Coverage is affordable if cost is 9.5 percent* or less of W-2 income

Rate of Pay

• Compare employee cost to employee’s rate of pay x 130 hours

• Use monthly salary for non-hourly employees

• Monthly contribution for single coverage is affordable if 9.5 percent* or less of monthly wages

Federal Poverty Level

• Compare employee cost to FPL for single individual in effect 6 months prior to the beginning of the plan year

• Coverage is affordable if employee contribution for single coverage is 9.5 percent* or less of that FPL

Affordability and Opt-out Payments

Employers

• Opt-out incentives are not required to be included in employee’s contribution until regulations are issued/effective

• Exception: arrangements adopted after Dec. 16, 2015

Individuals• Individuals may include opt-out payments in cost of

coverage for subsidy eligibility

Methods for Determining Minimum Value

Minimum value calculator

• Provided by HHS

• Employers enter plan information to determine value

Safe harbor checklists

• Three design-based safe harbors

• Additional safe harbor plan designs to be described in future guidance

Actuarial certification

• May be required if the plan contains nonstandard features

• Actuary can make adjustments to calculator value

Metal Level

• Any plan in the small group market that meets any of the “metal levels” of coverage (bronze, silver, gold or platinum) provides MV

Minimum Value Calculator

Employer Shared Responsibility: Hours of Service Definition

Each hour for which an employee is paid, or entitled to payment, for the performance of duties for the employer

Each hour for which an employee is paid, or entitled to payment by the employer for a period of time during which no duties are performed due to:

• Vacation• Holiday• Illness• Incapacity (including disability)

• Layoff• Jury duty• Military duty • Leave of absence

• (as defined in 29 CFR 2530.200b–2(a))

Specific Types of Employees

Final regulations provide examples for:

Adjunct facultyAirline industry

employees (layover hours)On-call hours

Until further guidance is issued, employers must use reasonable method of crediting hours consistent with 4980H

Difficult to apply hours of service definition to certain groups of employees

Clarifications in Notice 2015-87

Hours of Service

• Do not have to be credited if employment relationship terminated

• Do not include hours if payment made to comply with workers’ compensation, unemployment or state mandated disability insurance laws

• No 501-hour limit on hours credited while no duties are performed

• Payment is due from employer whether paid directly or indirectly (such as STD or LTD policy)

IRS clarified how existing DOL regulations apply to “hour of service” definition

4980H(a) Penalty

Employers that do not offer coverage to “substantially all” full-time employees (and children)

“Substantially All” Percentage

• 2015: 70% of full-time employees

• 2016 and beyond: 95% of FT employees

Penalty Amounts

• $2,000* x (all FT employees – 30) x 1/12

• 2015: Employers with 100+ EEs subtract 80

4980H(b) Penalty

Applies to employers that offer coverage to substantially all FT employees but:

• Do not offer coverage to ALL FT employees

• Offer coverage that is unaffordable or does not provide minimum value

Penalty amount

• $3,000* x each employee who gets subsidized coverage x 1/12

• Penalty is capped at the amount the employer would have had to pay under section 4980H(a) IF it applied

Adjusted Penalty Amounts

• 4980H(a) = $2,000

• 4980H(b) = $3,0002014

• 4980H(a) = $2,080

• 4980H(b) = $3,1202015

• 4980H(a) = $2,160

• 4980H(b) = $3,2402016

• Adjustments to be posted on IRS.govFuture Years

Employer Penalties

Penalty is triggered if one or more FT employees receives an Exchange subsidy

Exchange will send a certification to the ALE when an employee is determined eligible for a subsidy

IRS will send a notification of penalties owed and request payment

Exchange Certification—Purpose

The certification will notify the ALE that:

An employee was determined eligible for an Exchange subsidy (and identify the employee)

The ALE may be subject to a pay or play penalty

The ALE has the right to appeal the eligibility determination within 90 days of notice

The notification does not trigger pay or play penalties for the ALE – these are assessed by the IRS

Exchange Certification—Notification Process

FFEs will begin sending notifications in Spring 2016– Notification process is phased-in, starting by only notifying ALEs for whom the employee

provided a complete mailing address

Sending the notification– May be sent on an employee-by-employee basis, or in batches– May use email notifications (or other means) in the future

Exchange Certification—Employer Appeals

Appeals process• FFEs use a federal appeals process

• State Exchanges may create their own process or use the federal process

Appeal request• An employer appeal request form is available on

Healthcare.gov

Pay or play appeals

• Exchange appeal does not foreclose any future rights to appeal a pay or play penalty assessment

IRS Penalties—Employer Notification

• IRS will provide notice of potential liability for shared responsibility penalties

• Employers will have an opportunity to respond to notice

IRS will contact ALEs

• Notification will occur after individual tax returns and Section 6056 reporting are due

Timing of notification

Fair Labor Standards Act

FLSA

Minimum Wage

Overtime Pay

Youth

Employment

Record-keeping

FLSA rules apply to the employer-employee relationship

The FLSA is enforced by the DOL’s Wage & Hour Division

Only Changes

• $455 a week ($23,660 a year) to $913 a week ($47,476 a year)

• Automatic increase every 3 years beginning January 1, 2020

• Highly compensated executive $100,000 a year to $134,004 a year

• Define employees as exempt and pay them at least $47,476 a year or

• Define employees as non-exempt and keep them at or below 40 hours a week

• Employers will be able to use nondiscretionary bonuses & incentive payments (including commissions) to satisfy up to 10% of the standard salary level.

– Has to bew paid on a quarterly or more frequent basis

FLSA Coverage

FLSA coverage is very broad: many employers and most employees are covered by the FLSA

Covered Enterprise Covered Employees

• At least two employees engaged in interstatecommerce with at least $500,000 in gross annual business

• Hospital, residential care facility or school

• Public agencies

• Involved in interstatecommerce (including the production of goods for commerce)

• Domestic service workersmay be covered (housekeepers, full-time babysitters, cooks)

• Covered even if employer is not a covered enterprise

Joint Employment

Vertical JointEmployment

Horizontal Joint Employment

All employers in a joint employment situation are

jointly and severally liable for compliance with the

FLSA

Horizontal joint employment: when an employee works

for two or more sufficiently related or associated

employers

Vertical joint employment: when an employee is

economically dependent on two or more employers

that have a contractual labor arrangement

Minimum Wage Rate

Current federal minimum wage rate - $7.25

Federal vs. State rates

Special Minimum Wage Issues

Special compensation problems

Board, lodging & facilities Other deductions

Minimum wage for tipped employees

Minimum wage is $2.13 per hour

Must receive at least $30 per month in tips

Employer must subsidize wages

Some employees can be paid wages below the minimum wage rate

Learners, apprentices and messengers

Students Disabled workers

Overtime Compensation

• Must be paid for all hours over 40 in a workweek

• No limit on number of hours an employee may work in a workweek

• Each workweek stands alone

One and a half times the regular wage“time and a half”

Common Overtime Mistakes

• Classifying non-exempt employees as exempt

• Classifying employees as independent contractorsClassification

• Not recognizing all compensable time

• Allowing “off the clock” work

• Automatically deducting meal and rest periods from hours worked

Employee Hours

• Miscalculating total compensation

• Offering compensatory time off in lieu of overtime

• Refusal to pay unapproved overtime

• Paying “straight time” rates

• Allowing employees to waive their right to overtime

Compensation

Exemptions

The most common FLSA minimum Wage and overtime exemption

often called the ―white collar‖ exemption – applies to certain• Executive Employees – Primary duty managing enterprise authority to hire / fire

• Administrative Employees – performance of office or non-manual work independent judgment

• Professional Employees – advanced knowledge in field of science or learning

• Outside Sales Employees – primary duty sales and be away from employer office

• Computer Employees – Analyst, programmer, software engineer

• Highly compensated - $100,000 – at least $455 as weekly salary basis – duties above

Salary Basis Test – fixed not subject to variation

Salary Level Test - $ threshold the basis for this change the proposed increase

Duties Test - primarily involve executive, administrative, or professional duties

Professional Exemption Duties--Exceptions

Teachers—exempt if primary duty is teaching, tutoring, instructing or lecturing

Practice of Law or Medicine—exempt if they hold a valid license or certificate. The salary and salary basis requirements do not apply to bona fide practitioners of law or medicine.

Motor Carrier Exemption—applies to employees who are employed by a motor carrier or motor private carrier includes drivers, driver’s helpers, loaders, or mechanics whose duties affect the safety of operation of motor vehicles in transportation on public highways in interstate or foreign commerce.

Small Vehicle Exception—the motor carrier exemption does not apply to an employee of a motor carrier in any work week that: the vehicles weigh 10,000 pounds or less except vehicles designed/used to transport 8 or more passengers for compensation; or 15 or more passengers not for compensation; or used in transporting hazardous material.

Next Steps

• Conduct an Audit

• Determine which exempt positions that are currently paid between $23,660 and $47,476 annually

• Determine hours worked per week

• Change management for employees who may have to start tracking hours

• Examine policies for employees using electronic devices outside of schedule work hours

• Potentially look at job duties for executive exemptions

• Be aware of state OT and exemption laws

Potential Strategies

• Consider making employees salaried, non-exempt

• Move employees to non-exempt (hourly) and track hours

• Increase employees’ salary to $47,476 or $134,004

• Consider hiring more employees to cover OT hours

• Decrease salary (same net salary)

• Manage hours worked in workweek to avoid OT

EEO-1 Changes

New Salary Reporting Requirements

• EEOC proposes to collect pay data by sex, race, and ethnicity by job category from private employers, including federal contractors, with 100 or more employees through the EEO-1 report

• EEOC has published proposed new rules stating that it require employers to report salary data on the EEO-1 report beginning in 2017 as a way to catch employers with discriminatory pay practices

• The Form EEO-1 is required to be completed annually by large employers (100 or more employees) and federal contractors

EEO-1 Changes

Who:

• Private employers with more than 100 employees and federal contractors Employers, including federal contractors, with 100 or more employees would submit data about pay

• Federal contractors with 50-99 employees would not report pay data but would continue to report ethnicity, race, and sex by job category

• Consistent with current practice, non-contractor employers with 1-99 employees and federal contractors with 1-49 employees would not be required to file the EEO-1 report

Penalties:

• Any employer failing or refusing to file Report EEO-1 when required to do so may be compelled to file by order of a U.S. District Court, upon application of the commission. In other words, the EEOC will sue you

• Government contractors that do not file a report could be subject to debarment from their contracts

What is ERISA?

• Enacted in 1974

• Sets minimum standards for pension and welfare plans provided by employers to protect employees

Employee Retirement Income Security Act

• Part 1: Reporting and Disclosure

• Part 4: Fiduciary Responsibility

• Part 5: Administration and Enforcement

• Part 6: COBRA Continuation Coverage and Additional Standards for Group Health Plans

• Part 7: Group Health Requirements (HIPAA, NMHPA, MHPA, WHCRA)

Title I: Protection of Employee Benefit Rights

Who Must Comply with ERISA?

Subject to ERISA

• Corporations

• Partnerships

• Sole proprietorships

• Nonprofit organizations

Exempt from ERISA

• Governmental plans

• Church plans

Most private sector employers are subject to ERISA

Employee Welfare Benefit Plans

A plan, fund or program

Established or maintained by an employer

For the purpose of providing welfare benefits to participants and beneficiaries

Voluntary Plans

• Employer allows insurance company to sell voluntary policies to interested employees

• Employees pay full cost of coverage

• Employees pay premiums through payroll deductions

• Employer forwards deductions to the insurer

Exempt arrangements

• Employer may not contribute to cost of coverage

• Insurer may not pay the employer

• Employer may not endorse the program

Restrictions

Certain “voluntary employee-pay-all” arrangements are exempt from ERISA

Plan Document Requirement

• Every ERISA plan must have a written plan document describing the benefits provided

• An ERISA plan may exist without a written plan document but will be out of compliance

– Possible to inadvertently create an ERISA plan

• Wrap document for insured benefits

– Insured benefits controlled by terms of contracts/policies

– Contracts/policies will not contain all provisions required for ERISA plan document

– Wrap document is combined with contract/policy to provide missing terms

SPD Distribution

Deadlines

• Provide within 90 days after participant becomes covered under the plan

• Updated SPD must be provided every 5 years (10 years if no changes)

Approved Distribution

Methods

• First-class mail

• Hand delivery

• Electronic distribution if requirements met

Form 5500 Reporting

Significant penalties

• Up to $1,100/day for missing or incomplete 5500s

• Criminal penalties for willful failures

• Voluntary correction program available

Exemptions

• Full or partial exemption

• Depend on size and funding method

Many ERISA plans must report plan information to the DOL each year using Form 5500

Form 5500 Exemptions

Small welfare plans – full exemption• Fewer than 100 covered participants at the beginning of the plan year

• Must be unfunded (benefits paid from general assets of employer) or insured (benefits paid through an insurance policy that is not stop-loss insurance) or a combination

• Can accept participant contributions if conditions met

Large welfare plans – partial exemption• Exempt from providing some of the required information

• If unfunded, insured or a combination

• Financial information (Schedule H) and accountant’s opinion

ERISA Enforcement

• The U.S. Dept. of Labor (DOL) enforces ERISA Title I

• Primary enforcement responsibility held by Employee Benefits Security Administration (EBSA)

• ERISA violations can be costly for employers

– DOL investigations

– DOL enforcement actions

– DOL penalties

– Employee lawsuits

COBRA

• Requires most group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated due to:

– Termination of employment or reduction in hours

– Death of or divorce/legal separation from the employee

– Loss of dependent status under the plan

• Employers may charge up to 102% of the cost of coverage

Who Must Comply with COBRA?

• COBRA generally applies to:

– All private-sector group health plans maintained by employers that have at least 20 employees on more than 50 percent of its typical business days in the previous calendar year

– Plans sponsored by state and local governments

• COBRA does not apply to plans sponsored by:

– The federal government

– Churches and certain church-related organizations

Other Group Health Plan Requirements

• Newborns’ and Mothers’ Health Protection Act

• Requires minimum hospital stays after childbirth

NMHPA

• Mental Health Parity Act

• Amended by Mental Health Parity and Addiction Equity Act

MHPA

• Women’s Health and Cancer Rights Act

• Requires benefits for reconstructive surgery

WHCRA

EEOC, ADA, GINA Final Wellness Rules

• The rules add complexity to already existing HIPAA Wellness Regulation.

HIPAA/ACA

ADA/EEOC

GINA/EEOC

All Apply Now

Covered Employees or Programs

Reasonable Design

Frequency of Reward

Voluntary

Limit on Incentives

Limit on Incentives (Cont.)

Some More Details

Uniform Availability

Reasonable Accommodation

Notice

Stay the Course

Questions?

Linda Perr y Sr. Account Manager, Compliance HR Specialist

[email protected] 563-587-5149

SOLUTIONS & STRATEGIES FOR

LOWERING EMPLOYEE BENEFIT

PACKAGE COSTSPresented by: Sara Dickinson, Employee Benefits & Wellness ExecutiveJune 23rd, 2016

PRESENTER

SARA DICKINSONEmployee Benef its & Wellness Executive

[email protected]

AGENDA

•Cottingham & Butler Overview

• 3 BIG C’s•Cost

•Compliance

•Creating Efficiencies

•Q&A

EMPLOYEE BENEFITS | PROPOSAL FOR CONSULTING SERVICES

COTTINGHAM & BUTLER

• National provider of employee benefits and risk management solutions

• Fourth Generation Dubuque headquartered business

• Established in 1887 & Privately Held

• 35th Largest Insurance Broker in U.S.

• Approximately 725 employees with 500 in DBQ

• Clients in 47 states

• Over 3,500 customers

• Recognized for excellence

• “Agency of the Year” National Underwriter

• “Agency of the Year” Rough Notes Magazine - THE COTTINGHAM & BUTLER MISSION -

To PARTNER with our clients to PROTECT their most valuable assets and to BUILD an exceptional company of passionate

insurance professionals


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=MNm0jx_RtRkvnM&tbnid=p62303L_hejmaM:&ved=0CAUQjRw&url=http://www.cottinghambutler.com/&ei=I1xpUrf_DZGDkQeHn4HQAQ&bvm=bv.55123115,d.aWc&psig=AFQjCNHvNC7pFHmgEM0j6Ljh4X8hzU-V7w&ust=1382722976027588

• Employee Benefits Brokerage and Consulting

• Health Care Reform Compliance and Human Resource Consulting

• SISCO – Benefit Claims Administration (TPA)

• HealthCorp – Medical Management Services

• HealthCheck 360 - Wellness and Disease Management Solutions

• Property & Casualty Insurance

• Safety and Loss Control Consulting Services

• CBCS - Casualty Claim Administration (TPA)

• Captives & Programs

C&B – CORPORATE RESOURCES

Cottingham & Butler provides a complete 360-degree suite services. While clients may not utilize all available C&B

programs, they will benefit from the broad range of professional services that our consultants are familiar with as well

as our in-house experts from different practices across the company—such as:


SERVICE PHILOSOPHY

Traditional Broker Model “The New Normal”

20% 20%

80% 80%

Shop Rates, Manage Day-to-Day Issues Strategic Planning, Analytics, Regulatory & Compliance, HR Support, and more

What makes C&B different: Most brokers are still in the “Traditional Model”…and many of those aren’t even good at just that.

C&B embraces the model of year round benefits planning, support and preparation.


C&B FOCUS

Lower Costs, Create Efficiencies and Ensure Compliance

• Medical Plan Assessment• Data Analytics • Reporting • Cost Savings Solutions• Self-funding Expertise• Health Improvement Solutions

Cost

• Employee Communications• Online Technology Solutions• Enrollment Solutions

Creating Efficiencies

• ERISA Attorney• Regular Compliance

Communications• ACA Expertise and Tools• HR and Health & Welfare Audit

Compliance


MEDICAL PLAN ASSESSMENT

Coverage

Consumption

Cost Sharing

Cost EMPLOYEE BENEFITS | PROPOSAL FOR CONSULTING SERVICES

METRICS POTENTIAL SOLUTIONS

Metric #1 – Ideas for Reducing Participation• Increase employee/family contributions• Add wellness requirements (condition management/outcomes)• Spousal surcharge or carve-out• Decrease plan benefits• Avoid offering multiple plan offerings or ensure proper pricing • Educate employees on alternatives available to them

Metric #2 – Ideas for Reducing Dependent Ratio• Increase family contributions• Eligibility Audit• Spousal Provisions (Carve-Out/Surcharge)• Expand Family Contribution Tiers• Educate Members of Alternative Coverage Options

Metric #3 – Ideas for Reducing Average Allowed Claims• Wellness & Disease Management Programs• Network/PBM Contract Evaluation• Remove Non-Mandated Coverages• Utilization/Cost Management (ER, Cost Transparency, Telemedicine)• Encourage Generic Utilization/Substitution• Specialty Drug Safeguards• Therapeutic Alternatives/Incentives for Top Drug Users• Alternative RX Solutions For Medical Spend/Case Management

Cost

Metric #4 – Ideas for Reducing Demographic Index• Educate Medicare Eligible Members on Alternative Options• Longevity Based Opt-Out Benefits

Metric #5 – Ideas for Reducing Admin Cost Per Participant• Ideas differ depending on location, network, administrator, etc.

Metric #6 – Ideas for Lowering Plan Cost Share• Introduce telemedicine in exchange of OV copays• Pre-authorization penalties or exclusions• Exclusion of non-mandated services• Exclusion or higher cost share for non-true ER visits• Coinsurance based RX member copays• Separate deductible and OOP max for RX or Medical Copays

Metric #7 – Ideas for Reducing Contribution Percentage• Change EE contribution % to match across all plans• Add wellness incentives (condition management program)• Consider charging premiums based on dependents covered• Avoid multiple plan offerings


EXAMPLE OF DELIVERABLECost

ABC Co. Industry

ABC Co.

Industry

Industry


DEPENDENT ELIGIBILITY AUDITCostEMPLOYEE BENEFITS | PROPOSAL FOR CONSULTING SERVICES

EXAMPLE OF DELIVERABLECost


C&B FOCUS

Lower Costs, Create Efficiencies and Ensure Compliance

• Medical Plan Assessment• Data Analytics • Reporting • Cost Savings Solutions• Self-funding Expertise• Health Improvement Solutions

Cost

• Employee Communications• Online Technology Solutions• Enrollment Solutions

Creating Efficiencies

• ERISA Attorney• Regular Compliance

Communications• ACA Expertise and Tools• HR and Health & Welfare Audit

Compliance


• ThinkHR™: A HR service provided free as a C&B client.This is an 800 number and website where the our clientscan ask licensed HR professionals any Human Resourcequestion. There are free employer webinars and over 400employee training programs.

ONLINE SYSTEMS:THINKHRCompliance

Creating Efficiencies&

Courses that help you mitigate risk, protect employees and ensure compliance include:• Sexual harassment and discrimination•OSHA requirements•Workplace safety•Safety and health•Hazard communications•Employment law•Workers’ compensation•Ethics at work•FMLA•HIPAA•Etc.

Courses that improve performance and help your organization grow:• Effective meetings•Workplace skills•Motivating employees•Performance management•Time management•Customer service skills•Business writing•Effective communication•Balancing work and home•Training the trainer•Performance evaluation•Etc.


https://www.thinkhr.com/

• ThinkHR™: A HR service provided free as a C&B client.This is an 800 number and website where the our clientscan ask licensed HR professionals any Human Resourcequestion. There are free employer webinars and over 400employee training programs.

ONLINE SYSTEMS:THINKHRCompliance

Creating Efficiencies&

Courses that help you mitigate risk, protect employees and ensure compliance include:• Sexual harassment and discrimination•OSHA requirements•Workplace safety•Safety and health•Hazard communications•Employment law•Workers’ compensation•Ethics at work•FMLA•HIPAA•Etc.

Courses that improve performance and help your organization grow:• Effective meetings•Workplace skills•Motivating employees•Performance management•Time management•Customer service skills•Business writing•Effective communication•Balancing work and home•Training the trainer•Performance evaluation•Etc.


ONLINE SYSTEMS: MYWAVE

• MyWave™: MyWave provides a wealth of employer andemployee resources like Human Resource administrationtools, communication materials, legislative guides,compliance briefs and much more. Access to this highlyutilized web site is available to Cottingham & Butlerbenefits clients free of charge.

ComplianceCreating

Efficiencies& EMPLOYEE BENEFITS | PROPOSAL FOR CONSULTING SERVICES

https://www.thinkhr.com/



ComplianceCreating




ComplianceCreating




ComplianceCreating


ONLINE SYSTEMS: GOHEALTH

• GoHealth™: GoHealth is a website that C&B clientscan direct newly eligible COBRA participants. TheGoHealth counselor will assist the former employeeswith the decision making process of analyzing thestate marketplace, an individual medical policy andCOBRA coverage.

ComplianceCreating




ComplianceCreating




ComplianceCreating




ComplianceCreating




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EMPLOYEE GUIDESComplianceCreating










ANIMATED EDUCATIONAL VIDEOS

http://www.alexbenefits.com/cottingham-butler-demo/2015

• Employee Benefit Video Library

ComplianceCreating

Efficiencies&






https://vimeopro.com/user17537651/cb-videos

HR, WELLNESS & AFFORDABLE CARE ACTComplianceCreating

Efficiencies&

• HR Compliance Audit

• Handbook Review

• Super Notice Preparation

• Summary Plan Document Review

• New Hire Packet Review

• HIPAA Consulting & Training

• Plan Language Requirements

• EEOC’s Final Regs for Wellness

• Avoidance of Penalties

• Fee Calculations

• Cadillac Tax Calculations

• Employer Reporting

• Regulatory Updates


QUESTIONS

SARA DICKINSONEmployee Benef its & Wellness Executive

[email protected]

Name:Company Name:Phone #:E-mail:

EMPLOYEE BENEFITS SEMINAR

EVALUATION FORM

Presented by:

StronglyDisagree Disagree Indifferent Strongly

AgreeAgree

PRESENTATIONS

1. Please rank today’s presentation from 1-5, with 1 being the least beneficial and 5 being the most beneficial.Employee Benefits: Strategies & Alternatives for your Employee Benefit Program 1 2 3 4 5

FACILITIES

2. Meeting room and hotel facilities met my expectations.3. Parking and travel to the venue was easily accessible.4. Food and beverage selections met my expectations.L

OVERALL

6. I would consider attending future seminars If yes, please suggest topics/discussions you are most interested in: ________________________________________________________

7. I would recommend others to attend a Cottingham & Butler seminar8. I would rank this seminar (1 = Poor, 5 = Excellent) 1 2 3 4 5

FEEDBACK FOR FUTURE SEMINARS

9. Which part of the seminar provided the most value to you? Why? 10. Which part of the seminar provided the least value to you? Why?

11. I would consider attending future Cottingham & Butler events: Yes or No

12. How did you hear about this seminar?

13. I would be interested in attending future seminars on the following topics:

14. Overall comments/suggestion on this event or future events: (topics, presenters, location etc.)

Yes No

Strategies to manage health plan participation and eligibility

Managing employee access to health care (E.R., urgent care, etc.)

Telemedicine solutions

Accountable Care Organizations (ACOs)

Yes No

Email Mail Invitation Wesbite Phone Call

Cutting Edge Medical Management Programs

Enhance Employee Communications (videos, guides and more)

Benefits Technology Solutions (HRIS, enrollment platforms, etc.)

ThinkHR: Team of HR professionals at your disposal to perform research, provide advice and HR training for your organizationC&B Proprietary Metrics to Benchmark the Financial Performance of your health plan

Employee concierge/advocacy services

Benefits Captives

Private Exchanges

HR Policies & Procedures

Rx Strategies / Specialty Drugs

Voluntary Benefits Programs

Financial wellness education

Creating HR efficienciesCompliance Audit of the Health & Welfare Plan

Cyber Security Risks

Affordable Care Act (ACA) Updates

Review of local vendor partners and networks

Wellness Programs: Participation based vs. Outcome based

Cost Plus / Reference Based Pricing models

Documents

presented by EMPLOYEE BENEFITS: STRATEGIES & … · Safety Management Services - safety programs to manage risk Captive & Program Management - alternative market mechanisims ... Account