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Accountants are great resources for helping small businesses stay viable during COVID-19 Crisis

April 17, 2020

As the coronavirus pandemic continues, many small businesses are not only figuring out how to keep the lights on but starting to contemplate how to be in a position to fully re-open when the time allows.

An often overlooked, but great resource right now is an experienced, clear-eyed accountant who serves as a critical partner to small business owners, and it is important to consider how your accountant may be able to help you weather the storm.

In hard times, paying for elevated services may be the last thing on your mind. However, accountants bring an unmatched level of knowledge, business perspective, and education to driving your business’ success. In addition, they can often help you unlock many sources of government and private financial relief and recommend ways to save money while also protecting your team. Reach out to your accountant today, or if you are looking for a new accountant, find a local accountant here.

Here are a couple areas that they can help elevate your business:

Provide a smart approach to financial relief

Accountants can tell you what relief programs you are eligible for, and prioritize which ones are most important for your business. In the current business environment, there’s a lot to wrap your head around when it comes to relief, including:

Federal SBA Disaster Loans,
Federal Paycheck Protection Program,
Federal Business Coronavirus Relief Options,
State government loan guarantees and municipal grants,

Accountants can cut through all the noise

First, accountants can help define how much financial support your business will need by forecasting your cash flow and providing revenue modeling. This will allow them to tell you what programs you are eligible for, and more importantly which options might make the most sense. For example, some loans have higher interest rates than others, certain loans are forgiven if used to maintain payroll, and other aid is available only for specific businesses (like food manufacturing, healthcare, and logistics). With an accountant, you can make a strategic relief plan tailored to your business goals and the government resources available to your business to keep you moving forward.

Handling the paperwork, so you can focus

Your accountant, once you have a plan, can help you make it happen. Applying for relief typically means presenting financial information and filing the necessary paperwork. There will then be follow up requests, like the ones from the Small Business Association (SBA), about profit-and-loss statements and monthly sales figures. Your accountant can help you gather this information, and ensure it is accurate, and manage the administrative details. This will allow you to focus on business problems that only you can solve.

Managing your resources wisely

After you have received the emergency relief cash in your account, accountants are important business partners for exchanging thoughts and insights in helping your business stay afloat. Ways they do this:

Optimize your cash flow by identifying profitable and unprofitable customers
Help you lower costs and spot growth opportunities by keeping your books up to date
Highlight ways to reduce your inventory costs
Identify contracts (like loans & leases) you might want to renegotiate

Accountants can also help you think about your team of employees. While employees are major cost drivers for many small businesses, they’re also key drivers of value. Hardworking, diligent, resourceful employees keep customers coming back, regardless the state of the economy. Managing this cost-benefit trade-off is something your accountant can help with, suggesting options like trimming certain discretionary spending or reducing hours or furloughs to prevent layoffs.

Everyone needs help in a crisis. Experienced advisors like accountants can help you navigate the quickly-changing landscape of government aid, get the resources you need, and ensure you’re on the right foot when it’s time to rebuild or continue to drive growth.

Conclusion

As an employer, it is important that you have the resources to navigate this unprecedented time during this crisis. Being able to connect with top advisors such as accountants that will create plans to access funds that will ensure your ability to keep your employees paychecks coming over the next couple months will be vital for business success and ultimately reinforce your employees’ decision and confidence that made you their employer of choice. We are positioned to work with you and your accountant to continue to elevate and drive growth in your business both now and in the future by starting a conversation today.

While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor if different, the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it.

This publication is posted on the understanding that the publisher is not engaged in rendering legal, accounting, or other professional advice or services. Readers should always seek professional advice before entering into any commitments.

What is the Paycheck Protection Program?

What is the Paycheck Protection Program?

March 27, 2020

With cash flows fluctuating due to the recently declared public health emergency due to the COVID-19 outbreak, many small businesses have been unable to make payroll in recent weeks. More disconcerting is the number of employers that are already shuttering their doors and furloughing workers, eliminating paychecks for thousands of workers.

A cornerstone of the recently passed CARES Act is the Paycheck Protection Program which attempts to address this problem. The Paycheck Protection Program is designed to keep employees connected to their employers, keeping them paid even if a business is temporarily closed. It is intended to ultimately ensure the survival of small and medium enterprises by making loans and conditional grants quickly available to them.

Here is a snapshot of what is involved in the Paycheck Protection Program as it pertains to a reading of a recent publication by the U.S. Small Business Administration.

1. Funding for up to eight weeks of payroll

The Paycheck Protection Program provides small businesses with funds to pay up to 8 weeks of payroll costs including benefits. Funds can also be used to pay interest on mortgages, rent, and utilities.

2. $349 billion in total federally backed loans

The CARES Act has authorized commitments to the SBA 7(a) loan program, as modified by the CARES Act, in the amount of $349 billion. The Payroll Protection Program covers the period beginning February 15, 2020 and ending on June 30, 2020 (the Covered Period).

3. Loans forgiven if they are used to keep employees paid

Funds are provided in the form of loans that will be fully forgiven when used for payroll costs, interest on mortgages, rent, and utilities (due to likely high subscription, at least 75% of the forgiven amount must have been used for payroll). Loan payments will also be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge businesses any fees.

4. Firms with 500 or fewer employees, and self-employed can apply

Small businesses with 500 or fewer employees–including non-profits, veterans organizations, tribal concerns, self-employed individuals, sole proprietorships, and independents contractors–are eligible. Businesses with more than 500 employees are eligible in certain industries.

Starting April 3, 2020, small businesses and sole proprietorships can apply
Starting April 10, 2020, independent contractors and self-employed individuals can apply. There is encouragement to apply as quickly as you can because there is a funding cap.

5. Relaxed loan vetting

For eligibility purposes, requires lenders to, instead of determining repayment ability, which is not possible during this crisis, to determine whether a business was operational on February 15, 2020, and had employees for whom it paid salaries and payroll taxes, or a paid independent contractor.

6. Calculating the loan value

During the Covered Period, the maximum loan amount permitted for an eligible Covered Entity is the lessor of $10,000,000 and an amount calculated based on a payroll formula that essentially equals 2.5x the average monthly payroll costs incurred in the one-year period before the loan is made.

The interest rates for loans borrowed by a Covered Entity under the program may not exceed 4%.

Any Paycheck Protection Loan that has a remaining principal balance after any applicable loan forgiveness (as covered below in detail) must have a maturity date no later than 10 years from the date on which the borrower applied for loan forgiveness.

The SBA will direct lenders to defer all payments (principal, interest and fees) due under a Paycheck Protection Loan for a minimum of 6 months and a maximum of 12 months.

7. Loan forgiveness tied to keeping employees on books

During the 8-week period beginning on the date a Paycheck Protection Loan is funded (the Forgiveness Period), a borrower will be eligible for forgiveness and cancellation of indebtedness for up to the full principal amount of such loan. The amount eligible for forgiveness (the Total Eligible Forgiveness Amount) is equal to the total costs incurred and payments made during the Forgiveness Period for 1. payroll 2. mortgage interest 3. rent and 4. utilities.

The loan forgiveness amount available to a borrower is subject to reduction if the borrower terminates employees or reduces employee salary and wages during the Forgiveness Period. There is, however, relief from the forgiveness reduction if the borrower rehires employees or makes up for wage reductions by June 30, 2020.

8. The loan application

A copy of the loan application has been made available through the Treasury Department.

9. How to find an approved lender

The SBA can direct employers to an approved lender here.

Conclusion

As an employer, it is important that you have the resources to navigate this unprecedented time during this crisis. Being able to access funds that will ensure your ability to keep your employees paychecks coming over the next couple months will be vital for business success and ultimately reinforce your employees’ decision and confidence that made you their employer of choice. We are positioned to work with you to access these programs and others both now and in the future by starting a conversation now.

NEW Release – Federal Agencies Provide New Guidance with COVID-19 – Payroll Tax Credit – Easing the Burden for Employers

NEW Release – Federal Agencies Provide New Guidance with COVID-19 – Payroll Tax Credit – Easing the Burden for Employers

March 20, 2020

“…Eligible employers are also entitled to an additional tax credit based on the cost to maintain health insurance coverage for an employee on paid leave…”

The Internal Revenue Service (IRS), U.S. Treasury Department, and the U.S. Department of Labor (DOL) collectively, the agencies issued a press release Friday, March 20 updating employers required to provide paid leave to employees under the Families First Coronavirus Response Act, signed into law by President Trump on March 18, 2020. The update pertained to two new refundable tax credits created by the Act which are designed to reimburse employers for costs associated with the provision of the required paid leave.

Under the Act, eligible employers (generally businesses and tax-exempt organizations with fewer than 500 employees) are required to provide paid leave to employees in a variety of circumstances, including:

Two weeks (up to 80 hours) of paid sick leave to employees who are unable to work because the employee is quarantined, and/or experiencing COVID-19 symptoms, and seeking a medical diagnosis-during such leave the employee will receive 100% of the employee’s pay.
Two weeks (up to 80 hours) of paid sick leave to employees who are unable to work because of a need to care for an individual subject to quarantine or to care for a child whose school is closed ( or whose child care provider is unavailable) for reasons related to COVID-19. During this such leave, the employee will receive two-thirds of the employee’s pay.
In certain circumstances, employees who are unable to work because of a need to care for a child whose school is closed or whose child care provider is unavailable may receive up to an additional 10 weeks of paid leave at two-thirds of the employee’s pay.

The Act, however, exempts businesses with fewer than 50 employees from providing paid leave to employees who are unable to work because of a need to care for a child whose school has closed or whose child care provider is unavailable, if providing such paid leave would jeopardize the ability of the business to continue. In Friday’s press release, the agencies announced that DOL will provide emergency guidance articulating the conditions under which this exemption is available to small employers.

In order to help eligible employers cover the cost of providing paid leave between April 2, 2020, and December 31, 2020, the Act creates two new refundable tax credits: 1. the paid sick leave credit and 2. the paid child care leave credit.

1. Paid Sick Leave Credit

The press release states that with respect to an employee who is receiving paid sick leave because the employee is quarantined or experiencing COVID-19 symptoms and seeking a diagnosis, and eligible employer may receive a refundable paid sick leave credit at the employee’s regular rate of pay, up to $511 per day, for a maximum of 10 days (the total credit is capped at $5,110 per employee).

For employees on paid leave because the employee is caring for an individual who is quarantined or caring for a child whose school is closed (or whose child care providers is unavailable), the eligible employer may claim a credit for two-thirds of the employee’s regular pay, up to $200 per day for a maximum of 10 days ( this total tax credit is capped at $2,000 per employee). Eligible employers are also entitled to an additional tax credit based on the cost to maintain health insurance coverage for an employee on paid leave. The press release does not state if the amount of this tax credit is capped.

2. Paid Child Care Leave Credit

In addition to the paid sick leave credit, eligible employers may receive a refundable paid child care leave credit with respect to an employee who is unable to work because of a need to care for a child whose school is closed or whose child care provider is unavailable due to COVID-19. This credit is equal to two-thirds of the employee’s regular pay, up to $200 per day, for a maximum of 10 weeks (this total tax credit is capped at $10,000 per employee). Eligible employers are also entitled to an additional tax credit based on the cost to maintain health insurance coverage for an employee on paid leave.

Claiming the Tax Credits

Eligible employers may claim the paid sick leave credit and the paid child care leave credit by offsetting the amount of the tax credit to which the employer is entitled against its federal payroll tax liabilities. For example, if an eligible employer is entitled to $5,000 worth of paid leave tax credits and is otherwise required to deposit $8,000 of payroll taxes with the IRS, the employer may retain the $5,000 worth of tax credits and only deposit the remaining $3,000 of payroll taxes on its next regular deposit date.

In circumstances where the amount of an eligible employer’s tax credit exceeds the employer’s payroll tax deposits, the employer will be able to file an accelerated payment of the refundable tax credit from the IRS. The IRS stated in the press release that it expects to process requests for an accelerated payment in less than two weeks. Additional guidance on this point will be released in the near future.

The press release states that the payroll taxes from which an eligible employer may retain paid sick leave or paid child care leave tax credits include withheld federal income taxes, the employee share of Social Security and Medicare taxes, and the employer share of Social Security and Medicare taxes with respect to all employees. Further guidance on retention of tax credits from these amounts are forthcoming and will be released hopefully in the near future.

Non-Enforcement Period

DOL announced in the press release that it will be issuing a temporary non-enforcement policy that provides eligible employers with time to come into compliance with the Act. During the 30-day period covered by the non-enforcement policy, DOL will not bring an enforcement action against any employer for a violation of the Act so long as the employer has made a good faith effort to comply with the Act. Instead of enforcement actions, DOL will be focused on compliance assistance during the 30-day period.

The IRS and DOL recommend that employers check with their legal tax adviser and/or payroll service provider for assistance on checking on their payroll tax credit eligibility.

The importance of utilizing your Telehealth benefit in fighting COVID-19.

The importance of utilizing your Telehealth benefit in fighting COVID-19.

March 13, 2020

For the last couple of years, we’ve seen the rapid growth of telehealth as a valuable health plan offering in the healthcare industry. It has been made readily available in both fully-insured plans as well as self-funded healthcare programs. Unfortunately, many recent studies have shown that this growth has been accompanied by very low utilization of this benefit with studies showing approximately 9% of eligible employees having access to telehealth actually using the benefit.

WHAT IS TELEHEALTH

Telehealth is a healthcare benefit offered that gives your employees 24/7/365 access to U.S. board-certified doctors through the convenience of phone or video consults. It an affordable, more convenient alternative to costly doctors office, urgent care, and ER visits for common medical conditions like cold & flu symptoms, allergies, bronchitis, sinus problems, urinary tract infections, and minor respiratory infections.

ADVANTAGES OF TELEHEALTH with the COVID-19 outbreak

Telehealth does not in any way replace your primary care physician or family doctor. However, it can play a potentially crucial role as the coronavirus (COVID-19) outbreak continues to expand in the U.S. and other countries. It does this by providing an alternative option for accessing care for non-epidemic issues so employees avoid unnecessary care and exposure to hospitals, doctor’s offices and other healthcare facilities. Per the CDC (Centers for Disease Control and Prevention), telehealth platforms can prevent patients who can be cared for at home from potentially exposing themselves or others to germs. In addition, accessing the on-line virtual care of telehealth for simple health issues, and some maintenance health issues like diabetes, rather than see a doctor face to face means shorter wait times with expedited treatment. Finally, with the current COVID-19 crisis, many insurers are waiving the co-pays and costs of accessing the telehealth benefit in their healthcare plans making it an affordable viable option.

EDUCATE YOUR EMPLOYEES ABOUT TELEHEALTH

With this in mind, there is a valuable opportunity here to educate employees about existing telehealth solutions that are currently in place, or for employers not offering it, to make immediate plans to add the benefit. You may find that the reason utilization has been low in the past was due to lack of awareness and lack of perceived need. With clear, simple education, employees may actually be far more willing to use telehealth solutions than the current low utilization averages would suggest.

If you have telehealth solutions, we strongly encourage you to consider promoting it to your workforce. Be sure to check first to confirm that your healthcare vendor providing telehealth has the proper protocol in place for handling a virus like this. Diligence and employee communication can help ensure that the telehealth vendor doesn’t over-promise and under-deliver. But in the current environment, the need for using telehealth as an alternative to accessing healthcare has certainly materialized, so now is the time to make sure employees know that telehealth is available and has an important-potentially critical-role to play in keeping them, their families, and their communities safe and healthy.

CONCLUSION

Having your employees understand their health plan is important so that they truly value the benefit and can feel confident they are getting the most out of their employee benefit plans you offer. The experienced team at MY-Employee Benefits Plus is here to help. We work with our clients to put in place not only valuable solutions but also effective and reinforced employee benefit plan education to reinforce their decision and confidence that made you their employer of choice. Let’s start a conversation that will lead your employees to know, like, understand and ultimately have valued, positive experiences while using their employee benefits.

Tax time-Important employees are educated on the new W-4

Tax time – It’s important employees are educated on the new W-4

March 6, 2020

With all the rushing around to complete their taxes, employees may not be aware of the new W-4 form which could affect their taxes, if not this year, potentially next year.

Employees becoming more educated on the new W-4 form will provide another way to help ensure that they get the most out of their taxes. The new form eliminates the “personal exemption” component of calculating taxes for the employee and instead, calculates taxes based on answers to a few personal questions. Only new employees in 2020 will be required to fill out the redesigned form, which was released in early December 2019. Even though current employees are not required to fill out the new form, the new tax calculations could change whether or not they owe taxes when they file in 2021, depending on whether their withholding status changes.

IRS has pointed out that because of the tax reform law in 2018, last year there were people who owed money and weren’t expecting that – not completing the new W-4 could potentially create the same situation for these employees again during the next tax season. Even though the IRS has stated that the new W-4 form is more streamlined, many employees and their employer are not sure how to interpret the changes. Employees are encouraged to consult their legal tax adviser to check on how it affects their individual tax situation.

Essentially, the IRS has said that the new form will make it easier for employees to adjust their wages and claim qualifying tax credits to get a more accurate determination of their income tax withholding. With some tax experts, the jury is still out on if this will actually be the case. Payroll industry experts were consulted by the IRS when designing the new W-4 to make it as easy to understand as possible. There are a few things employers should know about the new form in order to better communicate its benefits to their employees.

First, the whole idea of personal exemptions was suspended which potentially increases the child tax credit and makes it available for more people. In addition, the standard deduction was greatly increased for everybody, which could mean that more people are going to take it instead of itemizing.

Every taxpayer who claims a child dependent will receive a maximum tax credit of $2,000 per child under the new form. The previous W-4 form calculated taxes based on the number of allowances claimed, so employees who don’t file a new W-4 may not receive the full benefit of the updated tax credit if they qualify. The IRS recommends that employees check with their legal tax adviser for assistance on checking on their withholdings every year.

In early 2020, the IRS launched its upgraded Tax Withholding Estimator , a calculator to help employees determine how much to withhold from their taxes. The tool addresses issues like changes in income, withholding status and multiple jobs. The calculator provides information to help employees fill out the new W-4. Employers are encouraged to share this information regarding the new W-4 form and the tax calculator tool above with their employees.

Having your employees understand the forms they are required to fill out & making it easy to fill them out & make changes periodically is important not only during the on-boarding stage but throughout their employment. It will ultimately reinforce their decision and confidence that made you their employer of choice. We work with our clients to incorporate this. Let’s start a conversation today to solidify this type of confidence with your employees.

Tip #3 Employees Ask – What is a Nurse Practitioner? Doctors vs. Nurse Practitioners?

Tip #3 Employees Ask – What is a Nurse Practitioner? Doctors vs. Nurse Practitioners?

February 28, 2020

Enrolling in a medical plan is one thing. Understanding your plan is another. Educating your employees to become better smarter consumers about their healthcare can translate into healthier employees and cost savings. Another common area of confusion involves employees being confronted with seeing a nurse practitioner when calling to see a doctor.

Determining whether you need a traditional doctor or if seeing a nurse practitioner will handle your current healthcare needs can be difficult, especially if you are not sure how they differ. Hopefully we can shed some light here as to the general differences between general practicing doctors (MDs) and nurse practitioners (NPs) to assist you in making that decision.

WHAT IS A NURSE PRACTITIONER?

According to the American Association of Nurse Practitioners (AANP), nurse practitioners, or NPs as they are sometimes referred, are trained, licensed and independent healthcare clinicians concentrated on managing patient’s health conditions including treating injuries and illnesses, as well as supporting prevention. Licensed as advanced practice registered nurses (APRNs), nurse practitioners usually specialize, or even sub-specialize, in a specific medical specialty. Common specialty areas include family practice, pediatrics and women’s health, whereas sub-specialties may be in dermatology, cardiology, oncology, or behavioral health and psychiatry. NPs generally are required to have master’s degree in nursing to practice, while a doctoral degree in nursing practice (DNP) is becoming a more preferred degree track for this profession.

NURSE PRACTIONER VS. MEDICAL DOCTOR

An MD is a doctor of medicine. Doctors are able to diagnose conditions, treat patients for all ailments, and write prescriptions. While a doctor may refer a patient for specialized care, such as a neurologist, the physician has a well-rounded education that overlaps with all specialties. An NP is a nurse practitioner. This is sometimes confused with an RN, which is a registered nurse. Whereas the RN can’t prescribe medications, the nurse practitioner is licensed to do so, as well as diagnose conditions. Some states and cities have differing laws and regulations that require physicians to oversee NPs, but other areas allow NPs to work without oversight. NPs are sometimes called the bridge that connects RNs and MDs; they have two-years more education than registered nurses, but they have less training than MDs. Also, it is key to remember that an NP is licensed by the Nursing Board, while doctors are licensed by the Medical Doctor’s Board.

THE DIFFERENCE IN ACCESSIBILITY

The United States is facing shortages of doctors all over the country, particularly in primary care. Because of this, many hospitals, private clinics, and urgent care locations are relying upon nurse practitioners to fill the excess need. Patients who demand to see traditional physicians may experience longer waiting periods before appointments, whereas patients who accept NPs could receive care more expediently. Because of this, many urgent care centers and walk-in and retail clinics are staffing nurse practitioners instead of physicians. For the services offered by the majority of urgent cares, NPs are fully licensed and capable of treating all illnesses and injuries. That said, if you have a desire to be seen by a doctor at an urgent care, do some research on your local clinic to make sure they staff physicians.

HOW HEALTHCARE IS CHANGING

While the growing number of nurse practitioners could fill the need for more doctors in the US, many doctors are fighting not to let NPs care for patients without supervision. According to Bloomberg Business Week the United States is facing a shortage of 13,000 doctors, which could grow to more than 130,000 within 12 years. Meanwhile, there are 155,000 NPs willing to fill that need. In the future, that could spell more freedom for Nps to practice without supervision, particularly in urgent care settings and with roll-out of healthcare reform whereby creating the need for greater accessibility and care team accountability. Understanding the difference between nurse practitioners and traditional physicians can be difficult, because in many cases, the job descriptions overlap. The key differences are that many states require NPs to have physician supervision, and the medical doctors have much more extensive and comprehensive training.

CONCLUSION

Having your employees understand their health plan is important so that they truly value the benefit and can feel confident they are getting the most out of their plan. The experienced team at MY-Employee Benefits Plus is here to help. We work with our clients to put in place effective and reinforced employee benefit plan education to ultimately reinforce their decision and confidence that made you their employer of choice. Let’s start a conversation that will lead your employees to know, like, understand and ultimately have positive, valued experience with their employee benefits.

Tip #2 Employees Ask – How do I choose between the ER and Urgent Care?

Tip #2 Employees Ask – How do I choose between the ER and Urgent Care?

February 21, 2020

Enrolling in a medical plan is one thing. Understanding your plan is another. Educating your employees to become smarter about their healthcare can translate into healthier employees and cost savings.

Another common area of confusion involves employees choosing between the Emergency Room (ER) and the local Urgent Care. Here is a common employee scenario:

From wobbly ladders, dull kitchen knives, to our kids sports teams, most of us will find ourselves in a mishap that creates a medical emergency requiring instant help and care. When the unexpected happens, it’s important to know whether to choose the ER or an urgent care center. If your are wondering what the differences are between the two, you are not alone.

Both will allow you to walk in without an appointment. Both can address health problems within hours, or even minutes. However, going to the ER versus going to urgent care can make a big difference when it comes to getting the most out of your insurance plan. After all, even though emergency rooms and urgent care centers have some similarities, they do not have the same pricing schedules or wait times. To understand why, let’s start off with some basic definitions.

TERMS TO KNOW

Emergency Room: Usually an attached department of a hospital, the emergency room is designed to treat walk-in visitors with life-threatening conditions, trauma, severe injuries, and sudden serious illnesses.
Urgent Care: An urgent care center also takes walk-in visitors and can treat many of the same illnesses, injuries, and health problems as an ER. However, it has a limited ability to treat certain conditions and is better for minor health issues – not life-threatening healthcare situations or conditions that may require an operation or more complex diagnostic tests like an MRI or CAT scan.
Walk-In Clinics: Often found within or near local retailers and pharmacies, these clinics are best suited for handling minor conditions such as colds, flu, minor cuts, immunizations, or health screenings.

WHAT TO CONSIDER

Knowing the difference between each of these terms can have a real impact on your wallet and your experience of receiving care. While an ER could treat any of the urgent care issues, it is must be noted that emergency rooms are busier and more expensive. The average ER costs $1,500 to $1,900 per visit while the average urgent care visit costs patients $50-$125 for basic care, with additional costs added for things like shots, x-rays (if available) and labs.

On the flip side, it is important to note that urgent care centers may not be able to treat the serious illnesses or conditions reserved for emergency rooms. That said, of the top diagnosis at both urgent care centers and ER’s, nearly 50% of them are the same. Both emergency rooms and urgent care centers are staffed with compassionate health care providers and in most cases both facilities will have doctors and nurses available. Both ER and urgent care centers are able to give patients shots, medications, IV’s and even treatment plans. Also, many urgent care centers offer x-rays, just like emergency rooms.

UNDERSTAND YOUR BEST OPTION

In the end, save ER visits for critical health trauma or accidents, such as heart attacks or chest pain, strokes, difficulty breathing, uncontrollable bleeding, severe pain or fever, loss of consciousness, and other dangerous life-threatening illnesses. Emergency rooms are prepared to respond to almost any serious emergency and have the needed equipment, for instance, radiology labs, CAT scanners, MRI’s and operating rooms. While urgent care centers have some medical equipment, they simply are not equipped like an emergency room for severe medical needs.

If you need minor health services, opt for the urgent care. Not only will you reduce your bill, you will usually spend much less time. Urgent care centers are ideal for non-critical stitches, non-life threatening x-rays, allergy, cold, and flu treatment and preventive care.

BE PREPARED UPFRONT

The first step toward saving is preparing. Proactively research the best in-network urgent care centers and ER’s for your local area by calling your health plan’s customer service center upfront before the need for healthcare, whether serious or minor, arises. For urgent care centers, pay attention to the stated hours. While some urgent care centers are open 24/7, others close at night or have limited “after-hour” times. If you are travelling, find a list of medical centers, ER or urgent care centers, along your route that accept your insurance.

CONCLUSION

Having your employees understand their health plan is important so that they truly value the benefit and can feel confident they are getting the most out of their plan. The experienced team at MY-Employee Benefits Plus is here to help. We work with our clients to put in place effective and repeatable employee benefit plan education. Let’s start a conversation that will lead your employees to know, like, understand and ultimately have positive, valued experience with their employee benefits.

Tip#1 Employees ask – How do I read my Explanation of Benefits?

Tip#1 Employees ask – How do I read my Explanation of Benefits?

February 14, 2020

One area of confusion involves employees being able to read their Explanation of Benefits (EOB). Here is a common employee scenario:

You recently went to a surgical center for outpatient surgery. You know there is a lot of paperwork involved, but you’re a bit surprised when you receive a letter titled “Explanation of Benefits” that looks like a billing statement. Before you decide to write a check, you should know that an Explanation of Benefits (EOB) is actually not a bill. Instead, its a document that helps you understand how your benefits apply to and pay for your latest medical expense.

Think of an EOB as a way to quickly see:

The actual cost of your medical bill that is based on the retail or list price of the procedure(s).
Your insurance company’s negotiated discounted price for that procedure; how much your insurance provider will cover based on this negotiated discounted price.
What part of this negotiated discounted price you are responsible for.

To better understand your EOB, here are some essential terms to know:

TERMS TO KNOW

Allowable Amounts: Next to the actual cost of your bill, you should notice something called “allowable amount.” This is the negotiated discounted amount your insurance will allow for a healthcare provider to charge you for a medical service. If the cost of the service charged is higher than the allowable amount, you are not responsible for the difference and this amount is written off by the provider as a contractual agreement, if the provider is in-network.
Cost-Sharing: Simply put, cost-sharing is your share of the “allowable amount” that you are responsible for. You will likely share these costs in three ways which are defined below here (remember that these all are included in your EOB).
- Deductible: A deductible is the amount you’ll have to pay before your policy will help cover your bill. It is often an annual amount or an amount based on a 12 month period that you are responsible for. For example, if the allowable amount for your minor surgery above is $1,400, but you have not paid any of your $1,500 deductible, you would pay the full $1,400 and still have another $100 to pay before you have met your policy’s deductible. If you have paid the amount of your deductible, then your coinsurance would kick in.
- Coinsurance: Once you have paid your deductible, you will need to think about coinsurance. Coinsurance is a percentage of your bill that you will need to pay of the allowable amount (for instance, 20% or 30%).
- Co-payment (Copay): Unlike deductibles and coinsurance, a co-payment is a fixed amount that you must pay for a healthcare service determined by your insurance plan. For example, a health insurance company may set a $40 copay for a regular office visit.

Out of Pocket: These expenses are what you, not the insurance company, pays for healthcare services in total for an annual or plan year period. You will find how much you’ve paid out of pocket on your insurance policy on your EOB. More importantly, you do have a safety net called an “out-of-pocket maximum. Once you’ve hit this maximum amount in a benefit or calendar year, there is no more for you to pay and the insurance company pays for all covered services going forward until a new benefit or calendar year begins. However, be aware that your out-of-pocket maximum sometimes do not apply to co-payments paid by you. The good news is, if co-payments don’t apply, for most services, they fall under $100 for standard health needs and will not break the bank.

Just because EOB’s aren’t bills doesn’t mean they don’t belong in your filing cabinet. In fact, we strongly recommend that you file your EOBs with the corresponding bills for the matching dates of service that the healthcare services were provided to help confirm that you were billed the correct amount and to prove your medical expenses.

CONCLUSION

Having your employees understand their health plan is important so that they truly value the benefit and can feel confident they are getting the most out of their plan. The experienced team at MY-Employee Benefits Plus is here to help. We work with our clients to put in place effective and repeatable employee benefit plan education. Let’s start a conversation that will lead your employees to know, like, understand and ultimately have positive, valued experience with their employee benefits.

Open Enrollment Finished? Now the challenge to keep employee benefits visible, understood, & valued throughout the year!

February 7, 2020

You have spent a great deal of time implementing your company’s employee benefits program, and been successful with an excellent communication plan of open enrollment options. Now 2-3 months into the plan year, you are getting lots of questions. What’s happening?

During open enrollment, employees often focus to much on completing the enrollment process timely, making the once a year “right plan choice” and weighing the financial impact to their paycheck. Only when they start utilizing the plan do the real questions regarding understanding how to use the plan surface. Out of pocket limits, which benefits do not apply to the deductible, how to access that new virtual office consult benefit by phone or video, what is that EOB that comes in the mail, and how your broker offers individualized help to explain plan details or look into benefit claims issues has been forgotten or never fully understood by your employees.

Fortunately, there are easy to implement strategies employers can put in place to help guide employees to truly and consistently value their benefits throughout the year by ensuring that your benefits are simple to use, easy to understand, and provide a positive plan experience for them and their family members. Here are several tips to engage your employees and improve valued proper utilization of your benefits program:

1.Employee Education throughout the year

Tailor several forms of communication tailored to how your workforce is uniquely & currently using benefits, including a multi-generational approach. It should also provide consistent company-wide benefit updates, as well as convenient opportunities for one-on-one questions.

2.Provide easy to access Examples

75-80 percent of employees typically enroll in a health plan that is not appropriate for their needs. Did you know that by providing examples of different benefit scenarios that apply to your specific workforce helps to paint a clearer picture of the benefits plan that might work best for them. Offer multiple plans with a ranges of different benefits, providing a comparison of the total maximum out of pocket costs and sample claim examples illustrating the impact to the member out of pocket costs with each plan.

3.Provide an easy to understand Glossary

Yes, insurance is often like rocket science with a complicated language that some of your workforce may struggle to understand. Providing an easy to access glossary of terms written in plain English, available through an online benefits portal, company website, or handout will help your employees better understand the offerings of your benefits.

4.Utilize Carrier Tools

Most insurance carriers have online tools that provide an excellent source of information-help your employees identify, get access to, and leverage this existing information. In today’s workplace, many employees prefer to utilize online technology when accessing their healthcare, so encouraging and reminding the use of existing online tools improves the overall engagement they have with their healthcare benefits.

5.Provide consistent Benefit Reminders

Providing reminders throughout the year on your employee benefits’ coverage and incentives is a great way to keep benefits valued and in front of your employees. Simple reminders such as preventive care that is covered at 100% or the cost-savings of urgent care versus an emergency room visit are excellent examples. In addition, even if you don’t offer a formal wellness plan, consistent flow of useful benefit info empowers employees to fully utilize a healthcare plan, increasing its value and actually encouraging employee Wellbeing.

With unemployment rates at an all-time low, attracting, engaging and retaining the right employees remains a top priority for employers. To learn more about providing strategic employee benefits guidance throughout the year that will position your company as a top employer of choice, contact us here today.

Help Employees Minimize Health Costs – Starting from $0 with a new annual plan deductible

January 31, 2020

For many people, January is a fresh new beginning. In the health insurance world, it is the well-known “reset button” on meeting your health plan’s annual deductible. Given that the majority of Americans live paycheck to paycheck, and a growing number are enrolled in high-deductible plans, the stress of meeting deductibles is very real. So we thought it would be a good time to share some helpful ideas that could help employees better manage out-of-pocket expenses.

Provide and overview of the health care services that are available at no cost or a lower cost than an office visit. For example, suggest that employees:

Try telemedicine. This cost-efficient benefit is often offered as a value add to their existing health plan. The cost of a telemedicine visit is usually around $40-$50, and can be scheduled at your convenience via phone or video chat.
Consult with a nurse for free by calling the nurse-line of your health plan for consultation before scheduling an appointment with a physician; it could save you the cost of an office visit.
Take advantage of preventive services covered at 100%. For example, get a flu shot so you are less likely to get sick.
Consider a “convenience care” clinic located in stores like CVS, Target, or Walgreens. They offer a limited number of services at a lower cost that urgent care or a physician office visit.
Use in-network providers for the lowest possible out-of-pocket costs. If you need to see a specialist, ask for an in-network referral.

2. Offer tips to manage prescriptions drug costs:

When your doctor recommends a prescription drug, take the informed consumer approach and asks how much it costs and if there is an over-the-counter or generic option. Use prescriptions tools that are no cost to you like GoodRx that offers coupons and checks the nearest pharmacies to your location for the best price.
If a newly prescribed drug is very expensive and does not have a generic option available, ask whether you could have a smaller number of pills at first to be sure it works. Also, ask the pharmacy if there are patient assistance programs to help defray the cost.

3. Promote the use of transparency tools

A variety of tools exist to encourage healthcare consumers to shop around for services and tests. Check with your insurance company if you are not familiar with their transparency tool or need a refresher.
This is the perfect time to remind employees about tools that help them find out the cost of services. Promote the tools by providing examples and training opportunities.

4. A few new ideas. If you don’t have these financial management tools in place today, it would be worth investigating them for next year to help with the January out-of-pocket medical expense panic:

Some HSA vendors will advance reimbursement for medical bills based on amount committed from paycheck for the year.
Some EOB (Explanation of Benefits) aggregators will pay the amount due to the provider and assist the employee with a payment plan interest free.

Given that financial issues is a top stressor for individuals, anything you can do to help alleviate the burden of health care costs will contribute to a more productive employee and that is a real plus for your company. Contact us to discuss how we can pro-actively address this for your employees !