Insurance News

  • Florida New Hire Reporting Now Includes Independent Contractors October 15, 2021
    Reporting Requirement Applies to Contractors That Render At Least $600 In Services Effective Oct. 1, 2021,  a new law in Florida requires employers and service recipients to report to the State Directory of New Hires (the Directory) information
  • District of Columbia Expands Paid Employee Leave October 13, 2021
    The District of Columbia has amended its Universal Paid Leave Act (UPLA) and Family and Medical Leave Act (DCFMLA). The amendments took effect Oct. 1, 2021, via emergency legislation and expire Nov. 21, 2021. An identical, permanent law is under Congressional review.
  • Allegheny County, Pennsylvania, Passes Paid Sick Leave Ordinance October 8, 2021
    Employers in Allegheny County, Pennsylvania must provide employees with paid sick time under a new ordinance passed Sept. 14, 2021.
  • Clarifying Guidance on COBRA Deadline Extension Relief October 7, 2021
    IRS Notice 2021-58 clarifies the application of certain COBRA deadline extensions for electing COBRA coverage and paying COBRA premiums under prior relief that was issued as a result of the COVID-19 outbreak (“Emergency Relief”).
  • Ohio Minimum Wage to Increase in 2022 October 7, 2021
    The New Rate Becomes Effective Jan. 1, 2022 On Jan. 1, 2022, Ohio’s minimum wage rate will increase to $9.30 per hour for nonexempt employees.  The state minimum wage in Ohio applies to employers that gross at least
  • Washington Announces 2022 Minimum Wage Rate October 7, 2021
    The New Rate Becomes Effective Jan. 1, 2022 Washington state has announced that its minimum wage rate will increase to $14.49 per hour on Jan. 1, 2022. Employers may continue to pay employees who are 14 or 15 years of
  • California Family Rights Act to Cover Care for Parents-in-Law October 6, 2021
    Effective Jan. 1, 2022, California employers subject to the California Family Rights Act must allow eligible employees to take leave under the act to care for a parent-in-law with a serious medical condition.
  • California Repeals Subminimum Wage Rates for Disabled Workers October 6, 2021
    A Multi year Plan Will Be Developed To Phase Out All Subminimum Wages For Employees With Disabilities By Jan. 1, 2025 On Sept. 27, 2021, California repealed a provision that enabled employers to pay wages below the state’s minimum wage
  • South Dakota Announces 2022 State Minimum Wage Rate October 6, 2021
    New Rates Become Effective Jan. 1, 2022 South Dakota has announced a $9.95 per hour minimum wage rate for nonexempt employees. The new minimum wage rate becomes effective Jan. 1, 2022.  State Minimum Wage Rate South
  • New York Announces Minimum Wage Rates for 2022 October 6, 2021
    New Rates Become Effective On Dec. 31, 2021 On Sept. 22, 2021, the New York Department of Labor (NYDOL) announced the state’s two minimum wage rates will increase on Dec. 31, 2021.  The rate for Nassau, Suffolk and

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.