Insurance News

  • Additional IRS Q&As on American Rescue Plan’s COBRA Subsidy July 27, 2021
    On July 26, 2021, the IRS issued Notice 2021-46, providing additional guidance on the application of the American Rescue Plan Act (ARPA) subsidy for continuation health coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) in the form of 11 questions and answers.
  • Domestic Violence Leave for Missouri Workers Enacted July 23, 2021
    A new statute requires Missouri employers with at least 20 employees to provide unpaid leave when workers or their family members are domestic violence victims. The mandate takes effect August 28, 2021.
  • Hawaii Prohibits Requiring Employees to Download COVID-19 Tracing Apps July 22, 2021
    The Prohibition Applies To Current And Prospective Employees When The Download Is Intended As A Condition Of Employment On July 7, 2021, Hawaii adopted a law that prohibits employers from requiring their employees and applicants to download
  • Colorado Repeals Subminimum Wages for Workers with Disabilities July 21, 2021
    Lower Wages Were Repealed To Encourage Competitive Integrated Employment On June 29, 2021, Colorado repealed a law that permitted employers to pay subminimum wage rates to employees with a disability. This amendment states that the legislature is repealing these provisions
  • California Will Allow Electronic Distribution of Workplace Notices July 21, 2021
    Employers Must Also Continue to Physically Display These Electronic Notices On July 16, 2021, California amended its Labor Code to allow employers to distribute certain workplace notices and posters electronically in addition to displaying the postings required by law. The
  • California Supreme Court Rules Noncompliant Rest Periods Must Be Paid at Regular Rate of Pay July 21, 2021
    The Court's Holding Applies Retroactively  On July 15, 2021, the California Supreme Court ruled in Ferra v. Loews Hollywood Hotel, LLC that employers must use the regular rate of pay rather than the hourly wage rate when paying employees for
  • DOL Proposes Rule to Increase Wages for Federal Contractors July 21, 2021
    This DOL proposed Rule Was Issued To Implement The April 27, 2021 Executive Order On July 21, 2021, The U.S. Department of Labor (DOL) announced a proposed rule that would increase the minimum wage rate for federal contractor employees to
  • Hawaii Repeals Subminimum Wage Rate for Disabled Workers July 20, 2021
    The Amendment Was Necessary Because the Law No Longer Met Its Objective On June 16, 2021, Hawaii repealed the ability of employers in the state to pay lower wage rates to employees with disabilities. As a result, employers in Hawaii
  • Rhode Island Increases Temporary Caregiver Benefits July 20, 2021
    Rhode Island has expanded its temporary caregiver insurance (TCI) benefits to cover five weeks annually starting Jan. 1, 2022, and six weeks annually beginning Jan. 1, 2023.
  • Recalling Service Workers Laid Off Due to COVID-19 in Connecticut July 20, 2021
    Employers in Certain Industries Must Rehire Laid Off Workers Instead of Hiring New Ones When Job Opportunities Arise On July 13, 2021, Connecticut adopted a law that requires employers in the hotel, food service and building service industries to recall

GROUP INSURANCE FAQ’S

  • Optima Health Questions
  • Anthem and Aetna Questions
  • COBRA Questions

 

*OPTIMA FAQ’s

Do members need a referral to see specialists? No, they don’t. All of Optima’s plans (HMO, POS and PPO) are all considered Open Access. By definition, this means that they may go to any provider set within limits of their plan.

Can groups have more than one option? Yes! Optima is now allowing groups to have dual options all the way down to 2 lives.

What is the deadline to get my Small Group (2-50) enrolled with Optima? Optima still allows Small Group enrollment if paperwork is received by the 10th of the month coverage is effective in. Please note that the 10th doesn’t always fall on a business day, so please contact Elizabeth or Terry for the final date. Remind your groups that the paperwork will still require normal processing time so the later the group enrollment is submitted the group numbers, ID cards, etc. could also be delayed.

Do members have to select a PCP? If they are using a Doctor for their primary care, it is best for them to notify Optima who that provider is. If one is not selected, Optima will select one that is closest to their home zip code. Their PCP can be changed by simply making a request to do so.

What is the employer contribution for small group? There is no minimum employer contribution level in small group (2-50). Keep in mind for the small group self-funded (15-50) plans-on a monthly basis, the employer must contribute a minimum of 50 percent of the employee premium. It must be fair, equitable, and non-discriminatory toward any employee class.

*ANTHEM AND AETNA FAQ’s

Can you write a husband and wife group for health insurance with Anthem? No, due to ACA regulations. You have to have a 3rd employee. That 3rd employee can either enroll or have a valid waiver.

How about Aetna? No, due to ACA regulations, but if you have a 3rd employee, they can either enroll or waive.

Can a dual option contain an HMO plan and a PPO with Anthem and Aetna? Yes, it sure can.

Do you need a VEC report to install a new group with Anthem and Aetna? Yes. If you do not have one, please call us to discuss options depending on the carrier.

Can you terminate an employee the beginning of the month? No, they are terminated the end of the month. This is for both Anthem and Aetna.

How do you terminate a group with Anthem and Aetna? Please submit a request in writing on the group’s letterhead, with the group number and date of termination. Signed and dated by the decision maker of the group.

*COBRA FAQ’s

Which employers are subject to COBRA? Generally, the COBRA law applies to private sector employers that employed at least 20 or more employees on more than 50 percent of its typical business days in the previous calendar year. The law does not apply to churches.

How much does COBRA coverage cost the member? Normally the COBRA members will pay 100% of the premium. The group or third-party administrator may also charge an additional 2% administration fee.

When are COBRA premiums due? Plans must provide members at least 45 days after the COBRA election to make the initial premium payment. After that a plan must give at least a 30-day grace period for ongoing payments.

Do COBRA notices need to be sent to employees/spouses when they are first added to a plan? YES! The COBRA General Notice must be provided within the first 90 days of coverage. The purpose of this notice is to describe their COBRA rights.

How much does Glandon Resources charge employers for COBRA Administration service? Our fee is simply an annual fee of $16 per employee listed on the group’s most recent health bill. There are no monthly fees in addition to that.