2010 - InsureYourCompany

As an employee of a company that has a group health insurance plan, you are only allowed to enroll during specified times. You are initially allowed to enroll when you are first hired. If your company has a waiting period for new hires, then you may have to wait 30 days or more to enroll in your New Jersey group health insurance plan.

Each year a special period called “open enrollment” occurs on the anniversary of the date that you policy has started. During this period any employee of the company that have previously waived coverage are allowed to enroll in the plan. In addition, if you do participate in the policy, you’ll be able to update or change your coverage during the open enrollment period.

I am frequently asked if you go on vacation, are you are allowed to cancel your coverage and restart it in a few months after you return? Insurance carriers do not allow employees to do this. You are only allowed to leave a plan and come back on in open enrollment, otherwise you are allowed to come back on the plan if a qualifying event occurs. An example of this is, if you waived coverage for existing coverage during open enrollment. Then you lost your coverage, you would be allowed to enroll in the health plan from the date your coverage terminated.

Please be aware that pre-existing conditions of 12-18 months may apply if you have a break of coverage of over 63 days. While employee benefits programs change based on the employer, these types of changes to your health insurance policy are fairly standard.

I have been selling New Jersey Employee Benefits and group health insurance to small and medium sized businesses since 1997. Each year I see the plan design change slightly; there was higher co-pay, a split co-pay, higher drug card, two tier drug card, three tier drug card, and Hospital deductibles, in network deductibles. During this period the rates were rising. It was a challenge to bring a plan to the employer that was a slight increase over last year. Well things have changed, there are very few insurance carriers now offering the plans. The ones that do have raised the rates so much that a thirty percent increase over last year’s is the norm. I sit at my desk wondering what is happening, I have no options for the employer any longer, the rates go up, the plans keep offering less and less benefits. I do not see people utilizing the services less, what I see are companies forgoing the benefits all together. Is this what the insurance carriers want? Do they want to make it so the only people that take the insurance are the very ill and wealthy? What are employers supposed to do? Their employees think it is the employer that is reducing the coverage or lowering their contribution to raise the rates. I have no answers, all I have are questions. The most important one I have is what is Washington going to do to address these issues? The bickering between the Democrats and the Republicans and an ineffective President only delays and stalls the issue. Seems to me the Insurance and Drug companies are in control. In the end it is the American worker that is bearing the brunt of this problem and the final resolution is not even flicker of light at the end of a very dark and long tunnel.

One question I am often asked by my clients and friends, is why do I need life insurance? The answer can be complicated, but it comes down to the following purposes of life insurance:

Pay off a home mortgage if you were to pass away
Fund a business transfer
Create an estate
Create a charitable gift
Provide income to beneficiary
Provide an equal inheritance.

Life insurance is a very unique product it can be used to solve many of life’s financial problems. Many people see advertisements online for life insurance and simply purchase the cheapest term life insurance. It is a disservice to yourself and your family if you do not have a licensed life insurance professional evaluate your needs and accurately determine the correct type and amount of life insurance that you need. It’s important to figure out how much life insurance you need so you don’t buy too much (or too little). Many New Jersey businesses offer supplemental life insurance as part of their benefits package. Check with your New Jersey employee benefits administrator or your Human Resources Manager to find out how much life insurance your employer offers and how you can purchase.

I wanted to share a story about one of my clients. He was expanding his IT staffing business and hired a female recruiter /salesperson. This salesperson was emailing and interacting with the client’s operations staff at their offshore operations center. The emails started to turn more and more inappropriate, in a sexual way. The client is not sure who initiated the inappropriate emails but he now sees himself on the other side of a sexual harassment lawsuit. Needless to say the legal costs are great and he is scared to let any of these employee go. There is an insurance product that can protect your company from this type of exposure, Employment Practices Liability Insurance (ELPI). EPLI covers a business against claims by workers of the company, that their legal rights have been violated. Protection is provided against many types of employee lawsuits, including claims of: Sexual Harassment, Discrimination, Wrongful Termination, Breach of Employment Contract, and many others. The policies will reimburse your company against the costs of defending a lawsuit in court and for judgments and settlements. The policy covers legal costs if you win or lose the suit.

To prevent employee lawsuits, educate your managers and employees so that you minimize the problems in the first place. Create effective hiring and screening programs to avoid discrimination in hiring. Post corporate policies throughout the workplace and place them in employee so policies are clear to everyone. Show employees what steps to take if they are the object of sexual harassment or discrimination by a supervisor. Make sure Supervisors know where the company stands on what behaviors are not permissible. Document everything that occurs and the steps your company is taking to prevent and solve employee disputes. Contact us if you would like to learn more about employment practices liability insurance.

I recently had the extreme pleasure of reading a well thought out opinion column in the Wall Street Journal by the Republican Governor of Indiana, Mitch Daniels. Mr. Daniels shared his experience with Indiana state employee’s usage of Health Savings Accounts.

In review of the usage and cost savings, Indiana will stand to save $20 Million Dollars due to high enrollment in the HSA. An HSA is an outstanding addition to a company’s benefit plan and in the case of Indiana State workers in my opinion is successful due to high contribution rates provided by the government.

For example, the whole deductible of $2,750 is put into the HSA for the employee to use for any qualified medical necessity. For employees, “about 6 percent last year, who use their entire account balance, the state shares further health costs up to the maximum-out-of-pocket of $8000, after which the employee is completely protected.”
This generous level of contribution by the state is seldom seen in the private sector. Our New Jersey Employee Benefits Specialists have implemented many HSA plans and usually the deductible is funded by the employer, but beyond that it is the employees responsibility to pay out of pocket for expenses or contribute themselves to the HSA plan.

I would like to see a wider adoption of HSA plans in the public and private sector. I hope the current administration in Washington makes consumer directed healthcare a bigger priority and looses the mentality that regular workers can not afford HSA plans due to the high deductibles present. The focus should be on providing incentives for employers to at least contribute to the HSA in the amount of the deductible since the savings on the premiums are so significant.

We have had a few issues recently with regard to employees trying to figure out how to apply for NJ Short Term Disability. New Jersey, New York and Rhode Island are the only states that require employers to have this coverage. The NJ form (WDS-1) is available from the NJ State website. This form has all the detailed instructions for the EMPLOYEE to file a claim. The 3 part form needs to be filled out by the employee, employer and doctor. Submission is required within 30 days of the disability. We will make the form available on our website you can also contact my office for the form. As with most forms that deal with claim issues timely filing is most important.

One of our goals at CG Benefits Group is to help employees understand their benefits. Many employees are often confused about how various components of their health care work such as deductibles, co-insurance, and co-pays.

In the first of our series aimed at helping you understand your benefits, we will discuss what a co-pay is in health insurance plans and how to find out what your co-pays are.

A co-pay is a defined amount of money that is used by the insurance company to charge you for utilizing a service. Commonly you are charged a co-pay for doctor, specialist, and hospital visits. Typical co-pays can range from fifteen Dollars for a doctor visit to one hundred and fifty Dollars per day for a hospital visit.

If you are unsure about how much you co-pays are, then look on your insurance ID card. Most insurance carriers print the co-pays for your primary care physician and specialist visits on the ID card for convenience. If you insurance carrier does not list the co-pay, or if you would like to find out how much your co-pay is for other services, then you can call CG Benefits Group and speak to your assigned customer service representative at 888-242-4675.

I am asked this question thousands of times annually by small businessmen. Here are the rules, they apply if you own or operate a business in New Jersey. If you have an employee and pay wages you are required to obtain Workers Compensation. All Corporations operating in New Jersey must obtain workers compensation regardless if you have employees. Partnerships or LLC must obtain workers compensation if you have employees, owners for those entities can exclude themselves. If you cannot obtain coverage from an insurance carrier, the State will assign one to insure you. Rates are set by the State based on the employee’s duties. All rates will be the same regardless of the carrier. These are the basic rules, I would be glad to any question you might have about your business. Drop me a line alan@cgbins.com.

As a business owner you must remember why you have a group benefits plan. Yes, it provides coverage for you and your family and of course your employees, but it is a great tool for recruiting and retaining GREAT talent. What you have to remember to do is let your employees know exactly what the cost is. I am amazed when I speak to employees of companies where the employer pays the ENTIRE cost of the health insurance, that they do not know what the cost is. If the employee fails to understand the value of the benefit, it is a worthless benefit. You can send them a notice at the end of each year letting them know how much you spent for their share of the benefits. They will start to think twice about moving to another job where the benefits are not as rich or the employer does not pay a greater share.

I wanted to make all employers that have workers in New York State aware that they need a separate policy for Disability. Unlike New Jersey where Workers Compensation and Disability in incorporated in the same policy Disability in New York is written on separate paper. This issue has caused many employers to incur huge penalties and fines. The policy is quite inexpensive and is based on the number of male and female employees one has working in New York. Minimum premium is around $45.00 annually. New York is very harsh on employers that are unaware of this policy and $1000 for every 10 days of non compliance is charged. I have seen fines and penalties as large as $99,000. A call to your insurance agent can get you in compliance in a few minutes. Technology Insurance Associates offers this policy , give us a call or fill out the inquiry form on our website. We are glad to help.

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