Retaliation claims & what you need to be aware of to prevent them

rectangle-hr-compliance4For six years, reports of retaliation have been more common than any other type of discrimination in the workplace. In 2014, retaliation claims made up a record 42.8 percent of all charges reported to the Equal Employment Opportunity Commission. That percentage represents 37,955 charges nationwide (double the number filed in 1998) – 3,708 filed in Texas alone!

With employees increasingly willing to exercise their rights and recent Supreme Court cases broadening what misconduct can be considered retaliation and who can sue for discrimination, it’s more important than ever for businesses to understand and prevent retaliation claims. Without awareness and an effective strategy, even employers with the best intentions can end up with a retaliation charge on their hands.

What Is Retaliation?

Retaliation is punishment for complaining about or resisting discriminatory practices in the workplace. If an employee, job applicant, close associate, or someone participating in a discrimination proceeding is treated adversely in what seems like an effort to discourage him or her from opposing a discriminatory practice, he or she may file a retaliation claim against the employer, employment agency, or labor organization involved.

Employers may not punish anyone acting in a “reasonable” manner on a “reasonable, good-faith belief” that anti-discrimination laws are being broken. It doesn’t matter whether the employee’s initial claim of discrimination holds up; retaliation charges can stick after the associated discrimination charges fade away. Protected activities include complaining about the alleged discrimination, threatening to file a discrimination charge, refusing to obey a discriminatory order, and requesting a (reasonable) accommodation based on religion or disability. Terminating an employee is not the only way to trigger a retaliation claim; “adverse action” ranges from refusal to hire to unjustified negative evaluations. (For more information, see EEOC’s Compliance Manual Section 8, Chapter II, Part D, Chapter II, Part B – Opposition and Part C – Participation.)

What Retaliation Is Not

Retaliation is not the same thing as discipline. Giving an employee negative comments or reviews justified by poor work performance is not retaliatory, even if that employee is filing a discrimination claim. Employees who believe they are being discriminated against may not respond with unlawful activities like acts of violence, or even with poor work performance or tardiness. Refusing to follow a discriminatory rule does not exempt them from following legitimate ones.

Accidental Retaliation

Retaliation should be a concern for even well-intentioned employers. If you try to remedy a discrimination complaint in the wrong way, it could have harmful effects for the employee. Changing an employee’s shift or transferring them to a new location to remove them from a discriminatory environment does not address the unlawful behavior of the coworkers or supervisors, however sufficient it may seem. If the employee is at all negatively affected, you may end up with a retaliation claim on your hands.

How To Avoid Retaliation Charges

Apart from not punishing employees who complain of discrimination, the best way to avoid retaliation charges is to implement a preventative strategy. Establish a strong anti-retaliation policy; communicate with managers and employees; and, in case prevention fails, document everything and consider insurance protection.

Establish a clear policy. Work with your legal counsel to draft a good policy against retaliation. Let your employees know what retaliation is, that you will not tolerate it from anyone, and what steps an employee who feels retaliated against should take.

Train your managers. Policies without training or implementation are notoriously ineffective and may leave you liable for your manager’s actions. Provide annual training on preventing and identifying retaliation in the workplace, as well as how to resist taking allegations personally, be careful what they say in the workplace, and seek help in tricky situations.

Communicate with employees. Make sure to sit down with any employees complaining of discrimination or retaliation and explain your antiretaliation policy. Express that you are taking their complaints seriously and are taking steps to remedy the situation.

Document everything. Keep a record of your conversations with managers and employees; send them notes confirming your policies and interactions. Make sure to document the reasons for disciplinary actions, especially against employees who has filed a discrimination charge.

Get insurance. There is no guarantee that an employee won’t file a retaliation claim, which could can lead to long, expensive legal battles. Purchasing employment practices liability insurance can help with the cost of damages, settlements, and legal counsel.

By implementing good preventative strategies and knowing how to handle retaliation claims when they come up, you can minimize the risk of getting charged with retaliation and create a safer, more productive workplace at the same time.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com


Sources:

“EEOC Releases Fiscal Year 2014 Enforcement and Litigation Data. U.S. Equal Employment Opportunity Commission.”http://www1.eeoc.gov/eeoc/newsroom/release/2-4-15.cfm

“FY 2009 – 2014 EEOC Charge Receipts by State (includes U.S. Territories) and Basis.” U.S. Equal Employment Opportunity Commission. http://www1.eeoc.gov/eeoc/statistics/enforcement/charges_by_state.cfm#centercol

Ho, Catherine. “Rise in retaliation claims reflect changing laws, attitudes about workplace bias.” Washington Post, Nov 2, 2014. http://www.washingtonpost.com/business/capitalbusiness/rise-in-retaliation-claims-reflect-changing-lawsattitudes-about-workplace-bias/2014/10/31/978628d6-5ee9-11e4-91f7-5d89b5e8c251_story.html

“Preventing Retaliation Claims by Employees.” Nolo. http://www.nolo.com/legal-encyclopedia/preventing-retaliation-claims-by-employees-29599.html

“Retaliation Claims: The High Cost of Getting Even.” United Educators. https://www.ue.org/the-ue-difference/preventable-claims/retaliation-the-cost-of-getting-even/

“Retaliation.” U.S. Equal Employment Opportunity Commission. http://www.eeoc.gov/laws/types/retaliation.cfm

Schraer, Mike. “How to Handle the Cost of Retaliation.” Talent Management, Sept 10, 2013. http://www.talentmgt.com/articles/how-to-handle-the-cost-of-retaliation

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015

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The Transition from Employer-Sponsored to Individual Coverage Under ObamaCare

linkedin-df-bannerMaintaining minimum essential coverage under the new ObamaCare law can be difficult for those experiencing certain changes in their job status. It’s not easy for employees experiencing a reduction in hours or termination of employment to transition from employer-sponsored group health plans to Individual coverage. Terminated employees may find that their best option leaves a gap in coverage of up to several weeks. Part-time employees may be stuck paying premiums on coverage they cannot use or change.

The government has taken steps to address such issues in the past. Congress’ 1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions were created to let employees and other qualified beneficiaries (spouses, former spouses, and dependents) enjoy group health coverage up to 18 months after job termination. COBRA coverage generally covers individuals retroactively to the date previous coverage was lost, making it an attractive choice for retirees and former employees.

Expiring COBRA coverage and loss of a job qualify individuals for a special enrollment period, which allows them to choose an individual coverage plan. (Those who do not qualify for a special enrollment period must wait until the next open enrollment period, which in 2015 starts November 1.) There are some benefits to securing Individual coverage. Not only is Individual coverage usually cheaper than COBRA coverage the employee has a broad choice of options.

Individual coverage, however, usually takes effect on the first day of the next month after enrolling. This could create a gap in coverage of up to several weeks if the employee forgoes Cobra. Because individuals can elect Individual coverage 60 days before or after termination, those who know about the termination beforehand can cover the potential gap. Individuals who lose their jobs suddenly and do not have the time to plan for change in coverage are at a disadvantage. They have to choose between the more expensive but retroactively effective COBRA plan and an individual or marketplace plan, which may leave a gap of several weeks in coverage.

One category of employees are at particular disadvantage: individuals covered under an applicable large employer’s health plan whose hours are reduced during a stability period (according to the look-back measurement method). Such individuals do not lose their minimum essential coverage and have, therefore, no special enrollment or COBRA rights. They must continue to pay the employee portion of their group health premiums in accordance with a cafeteria plan election and cannot enroll in Marketplace coverage until the next open enrollment period.

COBRA coverage can help former employees transition from an employer group health plan to Individual or Marketplace coverage, but it isn’t a cure-all. There are some sticky situations which oversights in the law don’t address, leaving some part-time and former employees with unsatisfactory options for transitioning to Individual plans outside of open enrollment.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com 


References:


Bianchi, Alden J. “The Affordable Care Act—Countdown to Compliance for Employers, Week 27: COBRA, Marketplace Coverage, Stability Periods, and Cafeteria Plan Elections.” ACA Countdown to Compliance, p 78-79. June 23, 2014. 
http://www.employmentmattersblog.com/files/2015/02/ACA-complete-v5.pdf

U.S. Centers for Medicare & Medicaid Services. “COBRA coverage and the Marketplace.” healthcare.gov/unemployed/cobra-coverage

U.S. Department of Labor. “COBRA Continuation Coverage.” dol.gov/ebsa/cobra

U.S. Department of Labor. “FAQs about Affordable Care Act Implementation (Part XIX).” dol.gov/ebsa/faqs/faq-aca19

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015

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Providing For Those You Love When You’re Gone

Part 1 of a 3 Part Overview on Providing For your Families Financial Needs

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No one likes to think about their own mortality, but if providing for the financial well-being of loved ones when you aren’t there anymore is important to you, it may be a good idea to start. Like paying taxes, death of course is an absolute certainty. According to the US Census Bureau, about 2.5 million people die every year in the United States. Heart disease, cancer, & chronic respiratory disease are the three leading causes according to the CDCOne common denominator in many deaths is the failure to prepare financial provisions for loved ones before the Grim Reaper shows up. Ed Hineman of the Hineman Group did some number crunching and determined that “out of the 6,850 people that die every day, 3,292 die without any life insurance at all. Another 1,445 die without adequate life insurance. So, 48% of people who die every day leave no life insurance benefits behind and another 21% don’t leave enough.”

Life Insurance Is A Sensible Way to Transfer The Risk Of Family Impoverishment, But It’s Not The Only Way

Life insurance, although a sensible tool to resource your loved ones’ financial security, shouldn’t be your first choice. Your own savings should. Why pay money to an insurance company if you don’t have to? Self-insure instead, if you can. For example, if you have a million or two tucked away in a bank or brokerage account and believe that amount is sufficient to maintain the pre-determined standard of living you have set for your family, then you’re golden. If you have about the same value in real property, like real-estate, or a business that could be easily liquidated or converted into cash at your death, then great, you’re there; go solve another problem. But, if you don’t have those kinds of financial resources just hanging around, life insurance may be a viable option. Life insurance essentially transfers the financial risk associated with premature death from your loved ones to an insurance company, evening out the burden on them after the main breadwinner’s death. The first step is to determine your loved ones financial need, that is your family’s desired standard of living minus your income including the need to satisfy any obligations to employers and creditors from arrangements put in place before death. If you find you don’t have enough savings or liquid assets, life insurance coverage may be the ticket. So, the next step would be to decide on what type of life insurance to secure. You have essentially two options: Term Life Insurance, and Cash-Value Life Insurance.

Term Life Insurance

Term Life Insurance, the simplest of all life insurance contracts available in the market-place today offers pure protection in exchange for a fixed relatively low premium. These policies provide beneficiaries a certain amount of money at the insured’s death, simple as that. Term insurance gives the newly insured the best bang for their buck. It’s designed to last for 5 to 40 years, your premium is fixed for the entire period, and you can terminate the contract at any time without penalty. With Term Life Insurance, you’re essentially renting coverage for a certain period of time. A word of caution however, if you stop paying premiums and the policy cancels, you walk away with nothing.

Cash-Value Life Insurance

Cash Value Life Insurance is a little different, it includes a savings & investment component in addition to a death benefit. Your premiums are usually higher than term. Cash-value life insurance addresses the complex desires of people looking for more than “payoff at death” protection from their policies, such as lifelong coverage, more flexible premiums, or the ability to borrow or withdraw money from the insurance fund. In order to make any of these feasible, insurance companies that offer cash-value plans take higher premiums than term and invest the excess money in investments meant to grow over time.¹

There are basically three types of cash-value plans. Whole-Life, Guarantee Universal Life, and Variable Life.

1. Whole-life Insurance

Also called “permanent” insurance, whole-life insurance is the original lifetime policy. It uses a level premium throughout the insured’s life. Whole-life Insurance is a life insurance policy which is guaranteed to remain in force for the insured’s entire lifetime, provided required premiums are paid in full. Premiums are fixed and usually do not increase with age.²

2. Guarantee Universal Life

Guarantee Universal life (GUL) insurance policies provide a death benefit as well as the opportunity to build policy cash value. This coverage is different from whole life insurance in that within policy limits, you can vary the amount and timing of your premiums. Some contracts even allow you to increase or decrease your death benefit. As a policy owner, you have more flexibility with GUL than with whole life, but you assume additional risk. GUL policies usually have fewer guarantees than whole life coverage, so you must carefully manage premium payments and any distributions taken to help ensure your policy will stay in-force. This type of life insurance policy usually offers a built-in no lapse guarantee that can last for the lifetime of the insureds life or for a shorter period selected by the policy owner.” ³ We are not big fans of this contract. It seems it’s a better deal for the carrier than the client in many cases for a whole host of reasons.

3. Variable Life Insurance

Created to make up for inflation’s effect on your purchasing power, variable Life Insurance has been somewhat popular in the last two decades or so. In these policy contracts, the insured gets to decide where to invest the policy’s cash value from a menu of investment options offered by the carrier. We would not recommend these type policies either as the fees are inordinately high. If they are a good deal at all, they are better for very high tax bracket individuals that do not have time to attend to their investments.  

Summary

Term insurance allows those insured to afford more death benefit because the premiums are much lower than cash value insurance plans. It’s also far simpler and much more affordable than cash-value policies.
 Cash-value policies get favorable tax treatment, are relatively flexible, and can benefit the insured while still alive. They are more suitable for those who need permanent coverage and the ability to borrow against their policy. Cash-value policies also are an option for those who need the discipline of forced savings, don’t have a solid plan for retirement, and want lifetime coverage that does not expire.

We favor term because it’s just a better deal for the policy holder in most cases.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com 


Sources:

1.Vaughan, Therese M. (2013-10-28). Fundamentals of Risk and Insurance, 11th Edition. Wiley. Kindle Edition. (224-239).

2.Wikipedia.org – Whole Life Insurance

3.Geneworth.com – Life Insurance Types and Options

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015
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Skinny Plans: Minimum Value or Not?

 The IRS Weighs in on Skinny Plans

linkedin-df-bannerSkinny Plans have been told to beef up by the IRS. Until recently, employers have been able to enjoy ambiguities and loopholes in ACA regulations that made offering low-cost “skinny plans” a viable option. Regulations proposed in November 2014 definitively declared that plans that do not cover in-patient hospitalization or physician services do not meet “minimum value” requirements. Employers relying on skinny plans must be ready to beef up their offerings to comply.

How Did Skinny Plans Come About?

Under healthcare reform regulations, large employers must offer minimum essential coverage that satisfies minimum value and affordability requirements (but need not cover Essential Health Benefits). “Bare-bones” or “skinny” plans are creatively designed group health plans that offer preventative services and meet other requirements, but may not offer minimum value. They have been popular among employers with low-wage workers or have used the now outlawed “mini-med” policies in the past.

Not offering minimum essential coverage results in “the big penalty” for large employers: hefty fees of $2,000 per employee (minus the first 30 workers). Skinny plans have been considered minimum essential coverage under the current, somewhat vague definition. They adhere to other laws as well. They don’t cut off benefits at a certain dollar amount; instead, they exclude whole categories of care to keep down costs. They avoid rules limiting out-of-pocket expenses for consumers because these caps only apply to covered care. Thanks to exceptions to the rule for high-turnover workers and the fact that hourly workers need only to be offered rich-benefit plans, not to purchase them, skinny plans avoid breaking nondiscrimination laws as well.

It has never been clear whether skinny plans offer “minimum value.” However, the penalty for failing this requirement—$3,000 for each worker enrolling in subsidized exchange coverage—may be worth the savings in healthcare costs for employers. They also benefit employees who wanted to avoid individual mandate penalties, especially healthy low-income workers who are loath to pay for extra benefits.

Recent Clarification of “Minimum Value”

There has been a lot of debate on whether the ambiguity in the new healthcare laws about what counts as “minimum value” coverage was intentional or accidental. Did regulators intend to give relief to employers that had traditionally been unable to afford health care, such as those in the hospitality, food service, retail, and temp staffing industries? Or was it simply an oversight?

In November 2014, the HHS and Treasury addressed the issue by proposing new regulations. In Notice 2014-69, the IRS declared “that plans that fail to provide substantial coverage for in-patient hospitalization services or for physician services (or for both)[…] do not provide the minimum value intended by the minimum value requirement.” No MV Calculator or actuarial certification can be used to prove that plans without coverage for in-patient hospitalization or doctor visits provide minimum value.

Consequences of the Updated Rules

Companies that have been looking to skinny plans to offer coverage to their employees that all can afford have a few options.

They can continue to offer skinny plans beefed up with hospitalization and physician services. By placing a high deductible on these services, such plans can control costs while meeting new regulations.

They can accept the penalty. Large employers can still help employees avoid the individual mandate penalty by offering a plan with minimum essential coverage that does not offer minimum value. It’s important for these companies to inform employees of this choice.

They can reduce employee hours to less than 30 per week, effectively reducing the number of full-time employees who need to be offered coverage. This is a risky move in terms of company culture and employee morale, but some employers are pursuing it as a last option.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com


Sources:

1.Hancock, Jay. “Why Health Law’s ‘Essential’ Coverage Might Mean ‘Bare Bones’.” Kaiser Health  News . August 25, 2013.

2.Jacobs, Bruce. “‘Skinny Plans’ Gain Traction Among Employers.” Benefits Pro, March 05, 2014.

3.”Notice 2014–69: Group Health Plans that Fail to Cover In-Patient Hospitalization Services.” Internal Revenue Bulletin:  2014-48, November 24, 2014.

4. Turner, John. “Why Skinny Plans Are Getting Fatter. Employee Benefits News, March 10, 2015.”

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & ones advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015
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Home Fire Fatalities and Simple Steps to Prevent Them

Between 2007 and 2011, the NFPA reported a yearly average of 366,600 home structure fires resulting in 2,570 civilian deaths, 13,210 civilian injuries, and over $7 billion dollars in damage.¹ That’s an average of seven deaths per day. In 2013, a home structure fire was reported every 85 seconds in the United States.

house fireOne home fire fatality occurs for approximately every 142 incidences. But where, how, and when a fire starts affects that proportion. Christmas tree-related fires, for example, result in one death per 40 incidents. (Christmas tree fires cause about six deaths, 22 injuries, and $18.3 million in property damage every year.²) Fires starting in bedrooms and living rooms also result in disproportionate fatality rates. Upholstered furniture is often the first household item to catch flame. While home fires tend to peak between 5:00-8:00 pm, half of all home fire fatalities result from fires beginning between 11:00 pm and 7:00 am.

Which month a fire occurs affects its danger potential, too. June through September account for the lowest incidence and fatality rates of any time of year, though home fires caused by child play and grills tend to peak. January is by far the deadliest month for home fire victims. While the monthly average is 8%, the months between December and March each represent between 11-14% of the year’s home fire deaths, and each has higher proportions of fatalities than incidences.

Why are winter’s home fires deadlier than at any other time of the year? The combination of space heaters, decorations, parties, and lots of time indoors that comes with the holidays makes for a particularly hazardous atmosphere. But it’s not until April that the number of fires caused by Christmas trees, electrical distribution/lighting, candles, and heating come down from their annual highs.

Top 5 causes of preventable home fire fatalities

Together, the following five causes account for 74% of all home fire fatalities  between 2007 and 2011. Three of the five causes have fatality rates that peak in winter; smoking deaths, on the other hand, rise in April and May, while cooking deaths remain steady throughout the year. Following the relevant safety recommendations when smoking, using heat, cooking, and setting up electrical arrangements and candles will cut your chances of having a fire in your home substantially. Nobody wants a home fire, but few people know how to avoid the common mistakes that can cause them.

1. Smoking Materials

Lit tobacco products but not lighting tools such as matches and lighters are “smoking materials”. Accounting for only 5% of home fires but causing 22% of all home fire fatalities, tobacco-related fires tend to be the deadliest, year-round. Usually trash, mattresses, bedding, and upholstered furniture are the first to ignite in these fires. One in four fatal victims is not actually the one whose smoking material started the fire. The elderly population is most at risk: Though adults over 65 are less likely to smoke and make up 13% of the population, they are the victims of nearly half of all tobacco-related fire deaths.³

The NFPA has some valuable recommendations for reducing smoking fires: Smokers should avoid smoking indoors.

Make sure your ashtray can’t tip over and, if it does, that whatever it’s on is sturdy and not flammable. Balancing a saucer on an armchair is not ideal.

  • Douse ashes in sand or water before tossing them out.
  • If you have smokers in your house, check regularly for hidden cigarette butts.
  • Never smoke near medical oxygen.
  • To prevent a deadly cigarette fire, you have to be alert. You won’t be if you are sleepy, have been drinking, or have taken medicine or other drugs.
  • Opt for fire-safe cigarettes.
  • Put matches and lighters far out of the reach of curious children.

2. Heating Equipment

Heating equipment  is responsible for 8,800 fires and 19% of deaths by home fire annually. Naturally, home heating fires peak between December and January (half of the year’s heating-related fires occur between December and February) and don’t drop significantly until April.

The biggest factor leading to heating home incidences is poor maintenance. Failing to clean creosote, a wood preservative, from chimneys and other solid-fueled heating equipment creates a fire hazard. The leading factor contributing to deaths, on the other hand, is leaving heating equipment too close to furniture, bedding, and other materials that can burn. A vast majority of these fires involve space heaters 

The NFPA recommends the following heating safety tips:

  • Keep a three-foot radius clear of children and any flammable items around equipment like your furnace, fireplace or open fire, wood stove, or space heater.
  • Don’t use an oven as a heater.
  • Employ qualified professionals to set up any type of heating system for your home and inspect heating equipment (and chimneys!) every year.
  • Don’t leave portable heaters on when you’re asleep or leave the room.
  • Fuel-burning space heaters require a certain kind of fuel. Make sure you follow the manufacturer’s instructions carefully.
  • Keep cool ashes in a metal container away from your home, and use a sturdy screen in front of your fireplace.
  • Test all your smoke alarms every month.

3. Cooking Equipment

Causing 156,600 home fires annually—more than twice the incidence rate of its runner-up—cooking equipment resulted in many more home fires (and injuries!) than any other home fire cause. Thankfully, cooking fires are not as lethal as they are common. Only 17% of total home fire fatalities were caused by fires started by cooking equipment. Fires started by ranges or igniting clothes tend to result in a disproportionate number of deaths.

The NFSA has many resources  related to cooking fires, including a section of safety tips for prevention.

  • The leading cause of cooking fires is simply leaving cooking unattended. Don’t use a stove or stove top if you’re sleepy, have consumed alcohol, or are distracted.
  • Don’t leave the kitchen if you are frying, grilling, or broiling. For simmering, baking, roasting, or boiling, stay alert and don’t leave your home. Check in regularly and use a timer.
  • Keep anything flammable a safe distance away from your stove top.

What if you already have a cooking fire?

Over 50% of cooking injuries occur when victims try to fight the fire themselves instead of seeking help. If it’s a small grease fire, slide a lid over the pan to smother it. If it’s an oven fire, turn off the heat and leave the door closed. Then get out of the house, close the door behind you, and call 911. If you do decide to fight the fire, make sure everyone else is on the way out of the house and that you have a clear escape route.

4. Electric and Lighting

Electrical distribution and lighting equipment fires aren’t caused by electrical failures, though electrical failures are often a factor. Instead, they account for any fire ignited by a lighting or electricity-related source, such as a light bulb.

Wiring and related equipment make up a majority of these ignition sources. Such fires are not as common as even intentional fires, but they tend to be deadly. They account for 6% of all home fire incidences and 13% of home fire fatalities. In 2011, they caused an estimated 295 civilian deaths. Fluorescent lights are safer than incandescent lights (which are safer than halogen lights), yet homes had twice as many incandescent lights as fluorescent lights in 2010.

  • Make sure outlets and electrical cords have an appropriate load.
  • Use appropriate cords for indoor and outdoor use.
  • Make sure to turn off Christmas lights, Christmas trees, and halogen lights before you go to bed or leave home.
  • Have a professional check your home’s wiring every year.

5. Candles

While about 14 times less frequent than cooking equipment home fires and less common even than fires caused by clothes dryers and washers, candle-related fires account for 4% of home fire fatalities. Home candle fires peak in December and January. Most December candle fires naturally involve seasonal decorations, which are implicated in three times more candle fires in December as in January or November. Just as smokers should refrain from handling a lit cigarette if tired or intoxicated, candles should be used responsibly, kept far away from upholstered furniture and other flammable materials, and completely extinguished before bedtime—especially during the holidays.

The NFPA’s safety tips for candle-related fires include special instructions for religious candle safety:

  • Keep candles at least 12 inches from anything that can burn. More than half of home candle fires occur when some form of combustible material is too close to a candle.
  • Don’t go to sleep in a place with lit candles, or don’t even light candles in a place you might fall asleep accidentally. Falling asleep was a factor in 11% percent of these fires and 37% of the associated deaths.
  • Don’t walk out on a burning candle; blow them out if you leave a room. Unattended equipment or abandoned materials or products were contributing factors in 18% of home candle fires.
  • Keep candles out of the reach of children, and never leave a child in a room with a candle, even if he or she is sleeping. Four percent of home candle fires were started by people playing with candles—many of these were, of course, children.
  • Make sure to place candles on stable surfaces in strong and secure holders, out of high traffic areas. Two percent of these fires start when the candle was bumped into or knocked over. Improper containers or storage was a factor in another 2% of the fires.
  • For religious candle use, the same safety recommendations apply. In addition, make sure handheld candles do not pass from person to person, dip unlit candles into the flame of a lit candle in lighting services, and make sure continuously burning candles are enclosed in glass and surrounded by a sink, metal tray, or water.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com


References:

¹Ahrens, Marty. “Home Structure Fires.” April 2013: http://www. nfpa.org/research/reports-and-statistics/fires-by-property-type/residential/home-structure-fires

² Hall, John R. “Home Christmas Tree and Holiday Light Fires.” National Fire Protection Association. November 2013: Christmas Tree And Holiday Light Fires.pdf

3 Hall, John R. “The Smoking Material Problem.” National Fire Protection Association, July 2013: http://www.nfpa.org/research/reports-and-statistics/fire-causes/smoking-materials

4 Hall, John R. “Home Fires Involving Heating Equipment .” National Fire Protection Association, October 2013: U.S. Home Heating Fires Fact Sheet.pdf

Sources:

Fire Causes by Month. National Fire Protection Association, June 2014: Fire Causes by Month.pdf

Original link: http://www.propertycasualty360.com/2015/02/23/its-house-fire-season-here-are-the-8-most-common

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & ones advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015
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ACA New Reporting Requirements

The Affordable Care Act requires all applicable large employers to report health coverage information for 2015. These employers need to provide Form 1095-C to employees and file Form 1095-C and Form 1094-C with the IRS in early 2016. Preparing these forms requires tracking monthly information about your employees and the health care coverage offered them, if any.

Is my organization an applicable large employer?

Non-profit, for-profit, and governmental organizations (or aggregated groups) qualify as applicable large employers if they employed an average of 50 or more full-time employees during the previous year. A special rule for 2015 allows employers to use any consecutive six-month period of 2014, rather than all 12 months, to determine whether they are considered applicable large employers for ACA purposes.

If special circumstances qualify you for transition relief from employer shared responsibility payments for 2015, reporting requirements still apply to you.

If you are not an applicable large employer, but you are an employer that sponsors self-insured coverage, certain reporting requirements apply to you.

When should I begin preparing for the new reporting requirements?

You should begin immediately; the new IRS forms require you to track data about your full-time employees and the coverage you offer month-by-month.

What information do I need to track each month in 2015 in preparation for filing Form 1095-C and 1094-C?

Employee Information
• How many total employees did you have?
• How many full-time employees did you have?
• Who are your full-time employees for each month? What are their names, addresses, and other identifying information?
• What’s the total number of Forms 1095-C you issued to employees?

Offered Health Coverage Information
• Are you part of an aggregated applicable large employer group?
• Are you eligible for transition relief?
• Did you offer your full-time employees and their dependents health coverage in 2015?

• If so, did you offer coverage to 70% of your full-time employees and their dependents? (After 2015, this threshold will rise to 95%.)
•  Did it qualify as minimum essential coverage? (Minimum essential coverage does not include fixed indemnity coverage, life insurance, dental or vision coverage.)
•  Did the coverage meet minimum value requirements? (In other words, is it designed to pay at least 60% of the total cost of medical services? Download the minimum value calculator for precise calculations. Plans with nonstandard features must obtain actuarial certification.)
•  Was it affordable? (Coverage is affordable if the lowest-cost self-only plan was equal to or lower than = 9.5% of your full-time employee’s household income.)
•  For lowest-cost self-only minimum value coverage, what was the employee’s share of the monthy premium?

Employee-Specific Health Coverage Information
• Which employees were enrolled in the coverage you offered?
• If you offered a self-insured plan, which employees were enrolled?
• For each employee, did you meet an affordability safe harbor, and did other relief apply to the employee?

Why should I track this information?

You could be subject to an employer shared responsibility payment if one of your full-time employees receives a premium tax credit for purchasing individual coverage on one of the Affordable Insurance Exchanges (“Marketplace”).

I have more questions. Where can I find answers?

Visit the Q & A on Employer Shared Responsibility Provisions Under the Affordable Care Act for more answers from the IRS.

View the Final Regulations about Shared Responsibility for Employers Regarding Health Coverage published in February 2014 for a full view of Shared Responsibility rules.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
info@deerfieldadvisors.com

Sources:

Department of the Treasury Internal Revenue Service. Affordable Care Act: Reporting Requirements for Applicable Large Employers [Brochure]. Publication 5196 (2-2015) Catalog Number 67464S.

Department of the Treasury Internal Revenue Service. Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act. Reviewed/updated 18 Feb 2015.

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & ones advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA,Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015

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ACA Implementation & Excepted Benefits

shutterstock_168962594 MEDICAL2-0304On February 13, 2015, the Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) issued  Part XXIII of their FAQs about ACA implementation. ¹  This FAQ addresses the confusion about whether supplemental health insurance products that provide a single benefit qualify as excepted benefits, which are excluded from the ACA’s requirements. While there are four types of excepted benefits, ² the Departments address only one:
Q: Can health insurance coverage that supplements group health coverage by providing additional categories of benefits, be characterized as supplemental excepted benefits?

The Departments’ prior guidance defined supplemental excepted benefits as those:
1.“Provided under a separate policy, certificate, or contract of insurance,” and
2. Provided as supplemental coverage by Medicare (Medigap) or Tricare, or are “similar” supplemental coverage provided to coverage under a group health plan.
The answer to the FAQ’s question—“It depends”—hinges on determining what counts as “similar supplemental coverage”. To be considered similar to Medigap or Tricare, coverage must meet four criteria:

  1. It must be issued by an entity other than the one providing primary coverage under the plan.
  2. It must “be specifically designed to fill gaps in primary coverage, such as coinsurance or deductibles.”
  3. Its cost must not exceed 15% of the primary coverage’s cost.
  4. If sold in the group insurance market, it must not treat individuals or their dependents differently based on health factors.

These criteria were published previous to February 2015. The FAQ Part XXIII adds that the Departments intend to propose a new regulation. This regulation would preclude coverage offering any benefit that is an essential health benefit (EHB) in the State where it is marketed from qualifying as supplemental excepted benefits. Any coverage that includes one or more EHBs is not designed to “fill in the gaps” of primary coverage, according to the proposed regulation. You can read the full FAQ here.

Until the proposed regulations are finalized, “the Departments will not initiate an enforcement action if an issuer of group or individual health insurance coverage fails to comply with the provisions of the PHS Act, ERISA, and the Code, as amended by the Affordable Care Act, with respect to health insurance coverage that (1) provides coverage of additional categories of benefits that are not EHB in the applicable State (as opposed to filling in cost-sharing gaps under the primary plan); (2) complies with the applicable regulatory requirements and meets all of the criteria in the existing guidance on “similar supplemental coverage”; and (3) has been filed and approved with the State (as may be required under State law).”

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
 info@deerfieldadvisors.com 

¹ United States Department of Labor. FAQs about Affordable Care Act Implementation (Part XXIII). http://www.dol.gov/ebsa/faqs/faq-aca23.html.

² United States Department of Labor. Elaws Glossary: “Excepted Benefits”. http://www.dol.gov/elaws/ebsa/health/glossary.htm?wd=Excepted_Benefits

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & ones advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015

 

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Open Enrollment & ACA Penalty Tax

ENROLL BEFORE FEBRUARY 15

clipboard2Health care enrollment ends in February! Are you covered for 2015? You only get three months to decide. November 15, 2014, marked the beginning of open enrollment to secure a health insurance policy for 2015. If you haven’t purchased one yet, you may want to start thinking about it. After February 15, 2015, it will be too late unless you experience what’s called a qualifying life event. This is a change in your life that can make you eligible for a Special Enrollment Period. Qualifying life events are things like moving to a new state, certain changes in your income, and changes in your family size (for example, if you marry, divorce, or have a baby) and gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder. ¹

There are other exceptions as well. Enrollment in Medicaid, the Children’s Health Insurance Program, and some small business-based plans are open year-round. Special Enrollment Periods define those times you are allowed to purchase regular health insurance coverage under the new ObamaCare law.

Coverage normally starts the first day of the month after you purchase it—if you enroll between the 1st and 15th. If you enroll on January 15, your coverage starts February 1. But if you enroll on January 16, you’ll have to wait until March 1 for your plan to go into effect.

If you have questions, call us, or if you want to see what a health plan might costs, just Click here for a do it yourself quote. After you get your quote, you will still need to call us to have it processed.

WHAT IF I DON’T PURCHASE A PLAN BY FEBRUARY 15?

Memory lapse, procrastination, indecision, whatever the reason, if February 15th comes & goes and you still don’t have health insurance, there are consequences because you wouldn’t be in compliance with the “Individual Mandate.” That’s, the term of art used by the government to indicate the obligation that most of us have to purchase health insurance or pay a penalty tax.

 

HOW MUCH IS THE PENALTY TAX?

 The ObamaCare penalty tax first went into effect January 1, 2014. “If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts when you file your 2014 federal tax return.

The IRS says direct from their website Healthcare.gov that “If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts when you file your 2014 federal tax return:

  • 1% of your yearly household income.  (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
  • $95 per person for the year ($47.50 per child under 18).  The maximum penalty per family using this method is $285.”

“If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:

  • 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
  • $325 per person for the year ($162.50 per child under 18).The maximum penalty per family using this method is $975.” ²

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team
800.233.6428
 info@deerfieldadvisors.com

Sources:

  1. HealthCare.Gov Glossary
  2. “2015 Open Enrollment”  &  “Fees & exemptions” on HealthCare.gov, a federal government website managed by the U.S. Centers for Medicare & Medicaid Services. Last accessed December 19, 2014.

 

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & ones advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2015
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Employer Shared Responsibility requirements for 2015 and beyond – Information on safe harbors

March 28, 2014

On Feb. 10, the final regulations for the Employer Shared Responsibility provisions (also referred to as the “employer mandate”) under the Affordable Care Act were released by the Internal Revenue Service and Department of the Treasury.

These final regulations provide different types of safe harbors to employers in 2015, depending on the type of employer or plan offered. The triggers for the tax penalties also vary depending on the type and timing of the safe harbor option an employer may qualify for and choose to implement.

Applicable large employers with 50 to 99 full-time equivalent employees may not be subject to the employer mandate requirements until the first day of their 2016 plan year.

An applicable large employer is not subject to tax penalties for any calendar month in 2015 (and for the portion of the 2015 plan year that falls in 2016 if it has a non-calendar plan year) if it meets all three major requirements and certifies that it qualifies for this safe harbor:

1.  An applicable large employer has at least 50 and no more than 99 full-time equivalent employees during 2014 so that it meets the workforce size  requirements.

2.  There are no reductions to an employer’s workforce size or overall hours of service between Feb. 9, 2014 and Dec. 31, 2014.

However, reductions made due to “bona fide” business reasons are allowed. The regulations provide examples of “bona fide” reasons that include changes in the economic marketplace, sales of business divisions or other similar reasons.

3.  An applicable large employer must maintain the health coverage it previously offered between February 9, 2014 through Dec. 31, 2015 (or on the last day of the 2015 plan year).

An employer will certify its eligibility requirements on designated IRS forms (1095-C for self-funded large employers and 1094-C for fully insured large employers) by Jan. 31, 2016.

Percentage threshold to offer coverage is 70 percent for all applicable large employers

For all applicable large employers in 2015, including employers with 50 to 99 full-time equivalent employees that do not qualify for the safe harbor described earlier, the employer will be liable for tax penalties only if:

  1. The applicable large employer does not offer coverage to at least 70 percent of full-time employees and their, and at least one of the full-time employees receives a premium tax credit to help pay for coverage on a Marketplace (Exchange); or
  2. The applicable large employer offers coverage to at least 70 percent of full-time employees and their dependents, but at least one full-time employee still receives a premium tax credit to help pay for coverage on a marketplace because the employer did not offer coverage to that employee or because the coverage that was offered to that employee was either unaffordable to the employee or did not provide minimum value.

The percentage of employees that must be offered coverage to limit employer mandate liability increases from 70 to 95 percent in 2016.

Change in 2015 tax penalty calculation for employers with 100 or more full-time equivalent employees

An employer with 100 or more full time equivalent employees during 2015 is subject to the tax penalty in 2016 for not offering health coverage to at least 70 percent (will increase to 95 percent in 2016) of its full-time employees and their dependents. This means a tax penalty will be assessed if the employer (a) does not provide health coverage at all, or (b) the employer does not offer coverage to at least 70 percent of its full-time employees and at least one full-time employee receives a premium tax credit on the Marketplace.

For 2015, this tax penalty calculation is different. The tax penalty will be calculated by subtracting 80 full-time employees instead of 30:

  • 2015: Annual penalty calculation is $2,000 x (number of full-time employees minus 80)
  • 2016: Annual penalty calculation is $2,000 x (number of full-time employees minus 30)

Applicable large employers with non-calendar year plans

An applicable large employer may receive relief from tax penalties for any month prior to the first day of the 2015 plan year if it meets the following requirements:

  1. Maintained a non-calendar plan year as of Dec. 27, 2012 and not changed its plan year after this date to begin later.
  2. Meets one of the following three tests:
  3. Offers affordable coverage meeting minimum value requirements to its eligible employees (under the terms of the non-calendar plan as of Feb. 9, 2014) by the first day of the 2015 plan year
  4. Covered at least 25 percent of all employees on any date between Feb. 10, 2013 through Feb. 9, 2014, or offered coverage to at least 33 percent of all employees during the most recent open enrollment period ending before Feb. 9, 2014
  5. Covered at least 33 percent of its full-time employees as of any date between Feb. 10, 2013 through Feb. 9, 2014, or offered coverage to at least 50 percent of full-time employees during the most recent open enrollment period ending before Feb. 9, 2014
  6. Offers coverage to at least at least 70 percent of full-time employees and their dependents (unless the employer qualifies for the 2015 safe harbor for dependent coverage) as of the first day of the 2015 plan year.

Note that the relief does not apply to employees also eligible for or covered under a calendar year plan offered by the applicable large employer.

The Deerfield Team

 

 

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2014.

 

 

 

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Time is Running Out to Secure Health Insurance This Year

2014 open enrollment is ending

Open enrollment, that period when a person is allowed to sign up for health insurance under the new health care law otherwise known as Obamacare, ends March 31, 2014. If you enroll by then you could have coverage in force for an effective date of April 1, 2014.  If you haven’t enrolled in coverage by then, you are probably out of HourGlass_v3luck in regards to obtaining health coverage the rest of this year, unless there is another rule change. The next open enrollment period begins November 15, 2014 for a policy effective date of January 1, 2015. Meaning, your health insurance coverage wouldn’t start until January 1, 2015.

Obtaining coverage outside of open enrollment is possible but limited. You may buy insurance outside open enrollment if you qualify for a special enrollment period due to a qualifying life event such as marriage, divorce, birth or adoption of a child, or loss of a job, but that’s the only way.

Important health insurance marketplace dates & rules you need to know

  • March 31, 2014: Open enrollment for this year ends.
  • November 15, 2014: Proposed date for 2015 open enrollment to start for a possible effective policy coverage date of January 1, 2015.
  • January 15, 2015: Proposed date for 2015 open enrollment to end.
  • Rule: If you enroll between the 1st and 15th days of the month, your coverage starts the first day of the next month in most cases except for this month.
  • Rule: If you enroll between the 16th and the last day of the month, your coverage starts the first day of the second following month in most cases. So for example, if you enroll on February 19, your coverage starts on April 1.

Monetary fines & penalties for non-compliance

There are now, courtesy of the new healthcare law, monetary Penalties or fines for those who go without health insurance.  Violators of the new so called “Individual Mandate,” the term used for the requirement we all have to sign up for health insurance or pay a fine, will be enforced by the IRS.

The size of the penalty is phased-in over three years:

  • In 2014, the penalty will be $95 per person up to a maximum of three times that amount for a family ($285) or 1% of household income if greater
  • In 2015, the penalty will be $325 per person up to a maximum of three times that amount for a family ($975) or 2% of household income if greater
  • In 2016, the penalty will be $695 per person per year up to a maximum of three times that amount for a family ($2,085) or 2.5% of household income if greater

Financial fines & penalties, irksome as they are, pale in comparison to the potential unpleasantness of facing surgery, disease, or a long-term illness  with no health insurance, especially when you find out the cost.

Here are some average costs to put things into perspective ¹

√  Spinal Fusion,  typically used to treat conditions such as a slipped vertebra, fractured vertebra or other spinal  instability, typically costs $80,000 to $150,000

√  Mastectomy, typically costs more than $15,000-$55,000 not including breast reconstruction.

√  Heart Bypass surgery, typically costs about $70,000-$200,000 or more.

√  Broken Leg that requires surgery, $17,000-$35,000 plus.

√  Brain Surgery can costs upwards of $750,000, not  including drug medications.²

 Deerfield can help

Deerfield can help you get Health insurance in place. If you want to check prices & coverage from the top carriers click here  for access to our private exchange.   Then call us & we can finish the process for you. Our best advice, don’t play “Russian Roulette” with your savings, get health insurance now!

The Deerfield Team
800.233.6428
j@deerfieldadvisors.com

1 – Average price source: CostHelperHealth

2 – Wiki Anwsers

DISCLAIMER

This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2014.