Category Archives: Insurance / Employee Benefits

By Jason Bowman

If you are like most people who find choosing a health plan confusing and stressful, rest assured that a little homework can help make the decision process easier.

When it comes to insurance, unfamiliarity can lead to choices that may not suit you best. But the good news is you get a “do-over” annually during open enrollment.

A good place to start is understanding common health insurance-related terms, such as the “metal” levels of bronze, silver, gold and platinum. It kind of sounds like the Olympics, minus all the excitement.

The idea behind these descriptions is to give you, as the prospective insured, an idea of how costs will be shared between you and your insurer. You will receive the same standard health services regardless of the level, but your cost-share will vary depending on which level you select.

Bronze level means 60 percent is the insurance carrier’s share, 40 percent is your share. Silver level is 70 percent/30 percent; gold level, 80 percent/20 percent; and platinum, 90 percent/10 percent.

To keep it simple, a bronze plan, in most cases will have the same exact network of healthcare providers and prescription drug coverage as that of a platinum plan. The noticeable difference among all levels will be the premiums and the cost of services at time of usage. Simply stated, pay less in premiums and you’ll pay more out-of-pocket at the time of service.

Cory O’Brien opened his own agency, CORE Insurance Consultants.

©2016 Saratoga Photographer.com

By Jill Nagy

After 11 years in the insurance business, Cory O’Brien has opened his own agency at 1539 Crescent Road in Clifton Park.

The company, CORE Insurance Consultants, sells property and casualty insurance, provides home, auto and business coverage, and can also provide a life or health insurance policy if necessary.

O’Brien represent three insurance companies. His main supplier is Erie Insurance Group. He also sells policies from Travelers and Progressive insurance companies.

Rose Miller is president of Pinnacle Human Resources LLC.

Courtesy Pinnacle Human Resources LLC

By Rose Miller

Benefits are a very important issue for current and potential employees. In past years, surveys show employees place a higher importance in health insurance than even wages.

The representative of management needs to be knowledgeable about all the organization’s policies and benefits programs. Although administering benefits and explaining all the details is usually the job of human resources, employers need to know basic information about employee benefits for a variety of important reasons.

First, a small employer may not have an HR department and employees will look to the person who handed them the large packet of information to answer complex questions. Even some HR departments are not a part of the benefits purchasing resulting in large gaps of knowledge regarding plan documents.

Job candidates, during a job interview, are likely to inquire about benefits, and the hiring manager will want to be able to provide decent answers (or the correct answers). Benefits are a selling point when interviewing job applicants.

Amelia M. Klein is an attorney with Bond, Schoeneck & King PLLC.

Courtesy Bond, Schoeneck & King PLLC

By Amelia M. Klein

Health insurance premiums are expected to increase by double-digit percentages for 2017. What are you going to do about it?

Many employers will choose to increase deductibles, co-payments and/or coinsurance amounts in order to reduce the premium cost. This shifts some of the cost of health coverage to employees without violating the “affordability” requirement of the Affordable Care Act.

Under the ACA, an employer health plan is considered to be affordable if the employee’s share of the 2017 premium for individual coverage under the lowest-cost option does not exceed 9.69 percent of the employee’s 2017 W-2 wages, 9.69 percent of the 2017 individual federal poverty line, or 9.69 percent of the employee’s rate of pay multiplied by a 30 hour “full-time” work week.

But employees don’t like cost shifting. To ease their concerns, an employer might offer to reimburse all or a portion of the actual amount of the out-of-pocket costs that the employee is required to pay. However, you can’t just reimburse the expenses on an ad hoc basis as employees come in with their receipts – you must follow one of the three IRS-approved methodologies or there will be some serious tax penalties to pay.

The Health Flexible Spending Account (HSFA) is the least flexible of the options available to reimburse the additional out-of-pocket costs. In addition to the employee’s pre-tax contribution of up to $2,550, the maximum amount that the employer may contribute on behalf of the employee is $500. Contribute more than that, and the FSA will not be exempt from the ACA’s requirements for a full-fledged health plan. Unspent amounts are forfeited after the end of the year, subject to either a $500 maximum carryover or a 2.5-month grace period.