Proposed Allowance of Association Health Plans Benefits Small Employers and the Self-Employed

By Executive Order from President Trump, the Dept. of Labor has been instructed to draft language allowing for Association Health Plans. This will allow small employers and the self-employed to purchase health coverage based on “commonality of interest” as opposed to current regulations which require a common employer relationship. This is potentially good news for the over 5.2 million businesses in the U.S. which employ less than 20 people, and the 10 million who are self-employed. Currently, many small employers and the self-employed feel at a disadvantage in the health insurance market place. They have not had the purchasing power of large employers. Therefore: Those with pre-existing conditions are often forced to pay high premiums based on individual claims experience. Many cost-saving plans and benefit options have often been unavailable for the sole-proprietor, self-employed or small employer group. Yes, there already are a number of “sponsored” plans from various organizations currently on the market, such as local Chamber of Commerce plans. But these do not form one joint plan where all members receive the same rates or renewals based on the total association’s claims experience. Under possible changes, this segment of the workforce would be able to form or belong to associations for the purpose of purchasing group health insurance as a collective unit. The associations could be established on the basis of geography or interests and industry, i.e. national and state-wide groups or SICS classifications. This opens the door for new partially or fully self-funded plans with the purchasing power big employers currently enjoy. But, There is a Hold-Up But while these positive changes are on the horizon,...
How You Can Help MBA in the Fight Against Cancer

How You Can Help MBA in the Fight Against Cancer

In 2018 there will be an estimated 1,735,350 new cancer cases diagnosed in the U.S, and 609,640 deaths. As tragic as those numbers are, what makes it even worse is that they are not just statistics. The word “cancer” isn’t just about the disease. We all are crushed by it; family, friends and maybe even ourselves – who must go through the pain of cancer’s unfairness as patients, survivors or care-givers. For several years the staff at MBA has participated in the American Cancer Society’s “Relay for Life.” This year’s event will be on June 8th and we’ll be walking from 6:00 p.m. to 6:00 a.m. in Murray Park in Salt Lake City. If you can attend, please look for us and cheer us on. Please consider supporting the patients, survivors and caregivers everywhere by donating to this year’s Relay. Our participation is just one small thing we can do and our financial goal may be miniscule compared to what is needed for education, awareness and research, but we will do everything we can to help beat cancer. Please give by joining us on our team page....
The New Year’s Tradition You’d Like to Get Rid Of: Getting Ready for That Annual Health Insurance Renewal

The New Year’s Tradition You’d Like to Get Rid Of: Getting Ready for That Annual Health Insurance Renewal

In September 2017, the Bureau of Labor Statistics released its latest findings regarding the cost of benefits to employers as a percentage of employee pay. At the top of the list? Health insurance.1 It’s ahead of: Paid leave Overtime and bonuses Retirement contributions, and Individual, legally required taxes. At the same time, SHRM expects health insurance premiums to increase 4.3% in 2018, and that’s after wise employers shop carriers and shift health plan benefits to reduce costs.2 It will be the largest average increase since 2011. It’s an Unfortunate New Year’s Tradition As the new year approaches all employers lament the run-away costs of health insurance premiums, and the fact that we must pass those increases on to someone. We wonder how bad the increase will be going into the new year. We hate the fact that we must go to our employees and explain increases in cost-sharing. It’s maddening that we have no control. We can’t control the actuarial increases in healthcare premiums – but we can greatly reduce the overall costs of those premiums – through partially self-funding our health insurance plan. Here is how this works: At present, most employers are paying a “fully insured” health insurance premium. The bill comes – you write a check. You are paying the insurance company to cover claims on your entire workforce. But in this scenario, you’re at a disadvantage: You’re paying a big insurance premium ($18,764 = the U.S. employer annual average for family coverage in 20173) for most of your employees who will rarely, if ever, use the coverage or will have very few claims. Now contrast...
Stay Tuned for ACA updates and proposed changes

Stay Tuned for ACA updates and proposed changes

You may have noted talk of changes to the Affordable Care Act, widely known as Obamacare. This coming week Phyllis Merrill, MBA’s CEO and her team are traveling to Washington D.C. to be briefed on the current bill now in mark-up, and the likely changes. Stay tuned for details coming soon. We are committed to staying on top of breaking news, and ensuring that you have the information about how it will effect your business and...

ELAP has a new dedicated Spanish line

In the economic atmosphere of rising premiums and decreasing benefits, at MBA Benefit Administrators, we are transforming the healthcare landscape nationally, in part due to our partnership with ELAP, a medical bill audit and repricing company which provides fiduciary protection to our clients. This week ELAP is happy to announce that a Spanish speaking que specifically for our Spanish speaking member population is available. You can click here for a Spanish flyer to disseminate to your members.   Click here for the Spanish...
ACA Reporting Delay

ACA Reporting Delay

We received this email alert from the SPBA on November 18, 2016: ACA Reporting Delay IRS just released Notice 2016-70, extending the due date for furnishing to individuals 1095-C, Employer-Provided Health Insurance Offer and Coverage, as well as 1095-B from January 31, 2017 to March 2, 2017. The Notice also extends good-faith transition relief from penalties to the 2016 information reporting requirements. According to the Notice, Treasury has determined that there is no similar need for additional time for employers, insurers, and other providers of minimum essential coverage to file with the Service the 2016 Forms 1094-B, 1095-B, 1094-C, and 1095-C. The dues dates for these Forms remains February 28, 2017, if not electronically, or March 31, 2017, if filing electronically. The Notice extends transition relief from penalties under sections 6721 and 6722 to reporting entities that can show that they have made good-faith efforts to comply with the information-reporting requirements under sections 6055 and 6056 (both for furnishing to individuals and for filing with the Service) for incorrect or incomplete information reported on the return or statement. This relief applies to missing and inaccurate taxpayer identification numbers and date of birth, as well as other information required on the return or statement. No relief is provided in the case of reporting entities that do not make a good-faith effort to comply with the regulations or that fail to file an information return or furnish a statement by the due...
In Honor of our Veterans

In Honor of our Veterans

MBA would like to express its gratitude to the veterans that work for MBA and all those who have given and risked so much serve and allow us to have the freedoms and rights that we enjoy as a nation today. Veterans currently with MBA include: Vice President, Vince Klingler, who served in the Utah Army National Guard and its Chief Security Officer. Keith Klingler who also served in the Utah Army National Guard, which included his participation in Operations Desert Shield and Desert Storm stations in Saudi Arabia. A sincere thanks to all the selfless veterans that have served and continue to give to our...
October Conference Report

October Conference Report

October 17-19th – Representatives from MBA Benefit Administrators attended a national conference in Minneapolis presented by the Society of Professional Benefit Administrators (SPBA). The aim of the conference is to inform members of recent industry trends and to encourage a forum where other Third Party Administrators and other industry related companies may address current concerns and solutions. This year the conference discussed a large amount of information which dealt with cybersecurity. There were both general sessions on cybersecurity as well as several break-out sessions which dealt with the more technical aspects of the subject. MBA was pleased to have one of its own, Keith Klingler (MBA’s Chief Security Officer), requested to help head a forum on what companies are doing to prepare for the upcoming Phase 2 of the OCR audits. The product was, by the accounts of the host as well as several attendees, a success. Bringing the problems associated with the upcoming Office of Civil Rights (OCR) audits into a more manageable and down to earth approach. The efforts of Klingler and his team were successful in bringing about a new forum on the SPBA website dedicated to the security and compliance needs of its members. MBA, a member of the Society of Professional Benefit Administrators, keeps abreast of the constantly changing climate of the Self-Funded Insurance world. Using the information from these and other conferences allows MBA to stay up-to-date with upcoming rules and regulations. It also allows MBA the opportunity to voice opinions to the regulators as to the potential impact that the regulations may have on our clients. This has been proven to be...
ACA Reporting Requirements

ACA Reporting Requirements

Staying in the know is a crucial component to running a successful business. Last week the U.S. Treasury and the IRS announced an ACA reporting requirements extension for distributing information to employees. While the IRS is prepared to receive documentation of health coverage by employers, because of feedback from businesses, the required deadlines to report this information to both employees and the IRS has been pushed back.  According to a press release, Assistant Secretary for the Tax Policy, Mark Mazur commented, “ As part of our efforts to implement the ACA in a careful and thoughtful way, the Treasury Department and the IRS are responding to feedback from private sector businesses and insurers and providing additional time for employer and insurer reporting under the ACA for the first year,” We have made a commitment at MBA to keeping you informed about regulation milestones, and updates to the ACA that impact your business. If you are unsure how this information impacts your business, please contact our office today.   Employers and Issuers: By March 31, 2016
 Employers must fill out, address and mail employees with the 1095-C  forms reporting on offers of health coverage and coverage provided. By May 31, 2016 (if filing by paper) Employers must fill out 1094-C  and 1095-C form and submit them to the IRS. June 30, 2016 (if filing electronically) Employers must fill out 1094-C  and 1095-C form and submit them to the IRS. To receive a one month extension for IRS transmission fill out Form 8809.  Requirements remain the same for employee form delivery date. Press...
MBA Benefit Administrators shines new light on solutions to the runaway healthcare costs crisis.

MBA Benefit Administrators shines new light on solutions to the runaway healthcare costs crisis.

Sometimes history provides the best perspective and subsequently solutions to life’s most challenging problems, for example runaway healthcare costs. Read on to learn a history lesson on the beginning of PPO networks and how the disconnect between medical services and the cost of service were born. The future is best planned for by looking in the past. Phyllis Merrill, CEO of MBA Benefit Administrators and the creator of The Open Solution describes in her book, “UnCommon,” co authored by Brian Tracy, the history of medical insurance and how that impacts how we have reacted to and inflated the cost of medical care today.  “The first medical insurance was an Indemnity Plan that paid a set mount for a specific type of medical event. Then came Major Medical, which at the time seemed revolutionary, and gave people a way to cover the cost of catastrophic care for the price of a monthly premium. It was up to the insurance company to pay for medical care and being an informed and responsible consumer was now not possible.” In most cases you cannot even find out the cost of a service at a hospital before it is provided. There are no price comparisons, or shopping around. Because everyone is entitled to have medical insurance, there is a sense of entitlement for the payment of medical bills regardless of the cost. Merrill goes on to say, “This created a disconnect between the billing and the payment of the bills. The disconnect is even greater now that it has become a right to have all major medical expenses paid no matter the cost.” The...

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The Open Solution Founder Phyllis Merrill

 

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We're neighbors you can talk to...
Where else can you get a direct line to a claims adjudicator, plan manager or even the President of the company? Only at MBA Benefit Administrators. We’re the big third party administrator for health plans with personal service that you can only wish others would provide. Like talking to a friend over a fence, we have that neighborly feel…but we provide world class advantages.
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…and we prove real solutions do exist for escalating healthcare costs.
We’ve received national kudos for our multiple, proven strategies which reduce claims and plan costs without harmful benefit reductions for our clients’ employees. Proof of MBA’s effectiveness in this is in the numbers. Our clients see:

  • An immediate average reduction of up to 25% in maximum health plan costs the first year,
  • Flat renewals after that, and because of this and our commitment to impeccable service…
  • Our clients remain with us an average of 12 years…an unheard of accomplishment in the health insurance industry.
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With “outside the box” flexibility in health plan administration…
Since 1987 MBA Benefit Administrators has successfully served large and small employers, public entities, associations, tribal nations, school districts, non-profit organizations and insurers. We have the capability to administer anything from single-plan 25-life groups to complex employee organizations with multiple medical, dental and vision benefits or employees in multiple states. We also provide a wide array of ancillary services such as COBRA and HIPAA administration and HSAs. When you discover:

  • The depth of our experience
  • The flexibility we offer in benefit design
  • Our commitment to technology to make your life easier
  • Our can-do attitude toward service

 

…we’re confident you too will see why MBA is a national leader in third party administrative healthcare benefits.

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…and state-of-the-art technology for painless administration and integration of services, we make your life easier.
No one thinks about making your life easier and more efficient than MBA Benefit Administrators. Our technological investments are totally integrated across services so that employees and employers – with HIPAA-compliant and appropriate need-to-know safeguards – can view at a glance their standing for benefits, claims, plan reporting and other services. These advancements provide:

A Comprehensive On-Line Enrollment Wizard: Employee self-enrollment or HR department enrollment methods, including ancillary program enrollments and billings.

HR On-line Capabilities: View, adjust and approve on-line employee eligibilities; check claims status, print reports and plan documents all from one place.

Multiple Employee Access Channels: Employees can view on-line their claims status, eligibility and account balances of reimbursement plans such as HRA, HSA, Flex and Executive Reimbursement plans. In addition, we offer all employees our MBA App, where they can:

  • Carry a virtual ID card,
  • Check on the status of a claim,
  • Submit secure documentation to MBA,
  • Contact our support team,
  • …and more!

On-line Document Management: In one place view specific documents such as:

  • Plan Documents
  • Temporary ID Cards, and
  • Employee Communications and Forms

HSA Services Integration: MBA seamlessly integrates HSA plans with HealthEquity Services. Claims information is electronically transferred from MBA’s claims system to HealthEquity employee accounts. There is no need for paper claim filing or second-guessing the eligibility of expenses. Even employee eligibility is updated through MBA data feeds.

HRA Reimbursement Plans: MBA’s administration processes allow clients and their participants to rely on accurate and timely processing of reimbursements. Eligibility, billing and remittance of claims, integrated scanning and storage allow for real-time remote access.

Section 125 Flexible Spending Plans: MBA Benefit Administrators coordinates with employers to offer Section 125 Flexible Spending administration and help employees save money on medical expenses. Providing this benefit for your employees is like getting a 30% discount on Medical Premiums, uncovered medical expenses and dependent care.

COBRA Administration: MBA Benefit Administrators can handle all of your COBRA requirements. We will mail and track notifications, coordinate COBRA payments, receipts and reporting and ensure claims match “paid through” dates, plus give you on-line access to all activities.

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At MBA employers are cared for too…
MBA goes the extra mile to ensure that as an employer your health plan does not complicate your life. We give you things like:

  • Business intelligence for advanced reporting and critical analysis of your plan’s performance, costs, payouts, claims analysis and large claims submitted for insurance.
  • Billing and Funding services integrated with enrollment, customized to your specifications and handled electronically.
  • Account balancing systems produce cost accounting reports and perform bank reconciliation activities, available for review at any time.
  • And the ability to review multiple reports regarding your plan; check registers, active employee reports, YTD recaps, claims reviews and lots more.
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...with powerful health care and claims management systems to save them money.
We believe your investment in a health plan should be treated like any other aspect of your business, with upfront knowledge of the costs and all attempts to weed out waste. MBA saves employers more than nickels and dimes with many methods of management, including:

Metrics Based Pricing: Why rejoice over a 30% discount on a claim that is 1000% too high? Metrics Based Pricing reduces claims to a “cost of service + reasonable margin” level by auditing claims for unfair markups and inaccurate or fraudulent billing. This results in an average $1500 per employee savings – AND WE DO IT WITHOUT RESTRICTIVE NETWORKS!

Medical Management Services: Proven to reduce hospital admissions and the average length of stay.

HealthSteps™: Wellness plans and initiatives that do make a difference in the overall health of your workforce and drive down health claims.

Prescription Benefit Management: With an average reduction of 9.4%.

Internet Prescription Bidding: Allowing employees to save up to 87%.

Actuarial Projecting: The projection of benefit costs and savings is one of our underwriting core competencies. Go ahead – suggest benefit changes, add or drop a plan component, change eligibility: MBA will accurately determine the financial impact on the plan and offer suggestions to tweak the benefits to suit your objectives. We offer the facts then you call the shots.

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1. It’s an “easy in”.
Almost every larger employer (50+ employees) annually shops their company’s health insurance. Rapidly rising rates and diminishing benefits have traditionally caused them to shop this aspect of company insurances more than any other.

With very little work this easily opens a lot of doors you wouldn’t otherwise get through. Furthermore, local employers like local expertise. They welcome the neighborhood broker who can answer service questions or help with the employee enrollment process. All you have to do is be ready with competitive products at the appropriate time.

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2. Group health opens the door to other profitable sales.
There are a lot of needs that are begging for solutions within the corporate world, whether that world employs 50 or 5,000. CEOs and business owners want to retain key employees or prepare themselves for the future. Employees need guidance during life changes, such as an impending retirement, the buying of a new house or the birth of a child.

If you wander the halls of your group clients under the guise of service, you’ll be surprised what you uncover and how much more you can sell – just because you’re accessible.

With very little work this easily opens a lot of doors you wouldn’t otherwise get through. Furthermore, local employers like local expertise. They welcome the neighborhood broker who can answer service questions or help with the employee enrollment process. All you have to do is present your own insurance lines and solutions – the same products you currently sell – when the need arises…and it will!

• Key Person Insurance
• Buy/Sell Agreements
• Deferred Compensation
• Disability
• Estate Planning
• Retirement Plans
• P&C Products – Both Business and Personal

…the list could go on and on. MBA doesn’t provide these products, but with the group health business already captured you’ll be in a position to favorably present your own policies and services.

Each easy cross-sell has the potential to be very profitable as now you, the group health broker, are a trusted resource. Make one sale and it won’t be long before everyone wants to talk to you just because you are the tacit face of insurance within a group client’s company.

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3. The larger group health market offers long term financial stability.
It is a proven fact that the more products you have in place within a group the less likely it is that some other broker will be stealing your business. With a competitive group health plan, a passion for service and additional products in place, employers think twice about switching brokers. MBA, for example, has an average client retention rate of 12 years.

Group health is rarely a stand-alone product. With today’s tax codes a group health plan almost always immediately calls for HSAs, COBRA administration and the like. In addition you’ll be finding a lot of ancillary sales.

That’s a good, stable building block for a broker’s income. Year after year the same commission is paid the broker and year after year the deep well for cross-sells keeps on giving.

In the meantime, adding new groups just keeps the broker’s income growing to the upside.

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4. Commissions are recurring and high, perhaps higher than any other product line.
To put things into perspective:

• What’s the average commission on a home owner’s or auto policy?
• How often do you dig up on your own a million dollar life policy or high 6-figure annuity?
• How easy is it to scrape up new business?

Contrast that with the group health broker. MBA, for example, pays brokers handsomely (on average $25 per employee per month) for every group they sign up. On top of this are your multiple cross-sells for several product lines. With a good base group health income and constant cross-sells, a commission from one group can rack up quickly.

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