Choosing A Benefits Broker

Choosing MedCon Benefit Systems Group, Inc. as your benefits broker – we aim to improve your bottom line and save you money – all at the same time.

We understand you need to save money on employee benefits.

With the rising cost of employee benefits, balancing employee needs with your capabilities and bottom line has never been more difficult. Let us help you meet your benefits goals, your employees’ expectations and your bottom line.

MedCon provides not only insurance, but also employee benefits consulting services. We save you money by delivering benefits solutions that meet your needs through strategic planning, professional services and technology-based solutions.

What You Should Expect from Your Insurance Broker

Your broker shouldn’t stop at obtaining competitive quotes for coverage and handling claims issues—you should expect more from your insurance broker.

MedCon goes above and beyond, providing quality service throughout the year. From custom employee communication materials to human resources tools and claims data analysis, we have the tools to make your benefits goals a reality.

The bare minimum doesn’t cut it anymore—get what you really need from your insurance broker.

Officially Obtaining Our Firm’s Services

There is no standard contract to sign to obtain services from an insurance broker. MedCon is an independent agency that works with a wide variety of carriers in order to provide you with the best possible benefits options.

Once you have chosen us as your insurance broker, you need only provide your current carriers with a letter establishing us as your broker of record. We even provide this letter for you—if you would like to see a sample, please let us know.

When we are established as your broker of record, we are able to do a detailed market analysis, getting quotes from more markets, better leveraging our relationships with carriers and taking advantage of a better negotiating position with carriers.

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Increase Value, Not Cost

Providing the best possible value and service to your employees is important—especially because they are paying a portion of the benefits costs and our commission.

While some brokers only provide quotes, we also provide clear and professional enrollment materials, wellness communication materials and other resources to help keep employees healthy and safe.

Saving You Money

The value-added services we offer can save your employees money and protect your bottom line. The educational materials we provide can do everything, from helping employees understand their health care needs to enabling them to make healthy lifestyle changes. Helping employees understand the benefits that are available and make educated decisions about which benefits are right for them allows them more say in their health care, and also saves you money.

Employees educated on the importance of preventive care may be less likely to rack up hospital bills resulting from leaving conditions untreated. Employees with large families and frequent doctor visits may choose a health plan with broader coverage than employees who live alone and visit the doctor infrequently.

Allowing employees to choose the level of coverage that is right for them saves you money in the short and long term.

Contact MedCon Benefit Systems Group, Inc. today to learn more about the value we can bring to your organization – we look forward to partnering with you!

Advantages of Self-Funding

Sharon McReynolds

As mentioned in a prior article, self-funding an employee benefit plan as a long-term strategy to save money works because it does afford an awesome opportunity for an employer to achieve savings plus cost control. Over history, the smaller employers, those traditionally under 250 or even 100 employees, have been hesitant to self-fund their health plan as in the past it was commonly believed that self-funding was only appropriate for “large groups.” Our previously owned third party administrator (TPA), Group Administrators, Inc., survived and flourished on companies with less than 250 employees and several with down to 25 employees. We were able to establish the right plan design, the correct specific deductible amount as well as placement of an aggregate coverage, often paired with a monthly accommodation feature, that allowed our clients to be confident in their determination that self-funding was in fact a formula for success.

The purpose of this article is to allow you to gain some insight into the key determining factors to consider for your company when deciding if self-funding is a viable option for you. The right health plan can and should be an integral part of the proper growth and success of your company, the wrong one can have very negative impacts. We believe you can offer the benefits much larger companies offer, taken down to a proper scale, to benefit you, the small employer.

A self-funded plan affords all groups, regardless of size, the opportunity for savings. You have the opportunity to pay your own claims, while a TPA administers the claims, processing them, issuing ID cards, handling the tasks that the insurance companies typically do. The difference: they hire a “stop-loss” carrier on your behalf to take on a large piece of the risk, leaving you with the risk under the stop-loss amount. Your company pays for the everyday claims, the stop-loss carrier is there to protect you from the run-away claims. If designed properly, you know exactly what your risk is from one year to the next, and oftentimes, from one month to the next. Again, if designed properly, your risk should line up with what you were paying in a fully insured environment.

Obviously there is now some incentive for the employer and employees to be involved in the delivery of health care: cost savings. Wellness programs, HSA’s, consumer-driven health plans with high deductibles paired with programs allowing employees to participate in their own comparison shopping on their respective providers or hospital charges before they are incurred — all are great ideas to incorporate to save money on the overall health plans that we design.

Self-funding also aids the employer in knowing what and where you are paying for delivery of care. Wouldn’t you like to be able to dig into the amount your company is paying toward emergency room visits, or specific drug costs? How about the overall cost for in- and out-of-network claims, or wellness visits? Self-funding will afford you the opportunity to see exactly where your health plan dollars are spent month-to-month, giving you the chance to make informed decisions moving forward at renewal regarding benefit changes or employee contributions. You can tailor the benefits to meet your specific group’s needs. Employers with self-funded health plans see exactly how the plan performs, thus removing the element of surprise at renewal as it relates to substantial increases or decreases in premium.

With over 30 years of experience in the self-funding arena, we welcome the opportunity to discuss the concept in further detail. Please visit our contact us page to schedule a more in-depth discussion.

Legislative Brief: What is an ERISA Plan?

What is an ERISA Plan in the group health plan environment? ERISA has been amended many times over the years, expanding the protections available to welfare benefit plan participants and beneficiaries. ERISA violations can have serious and costly consequences for employers that sponsor welfare benefit plans, either through DOL enforcement actions and penalty assessments or through participant lawsuits.
ERISA applies to virtually all private-sector employers that maintain welfare benefit plans for their employees, regardless of the size of the employer. This includes corporations, partnerships, limited liability companies, sole proprietorships and nonprofit organizations. They exempt two types, those maintained by Governmental Employers and Church Plans.
ERISA generally applies to the following common employee benefits, regardless of whether they are insured or self funded:

  • Medical
  • Dental
  • Vision
  • RX
  • HRA’s
  • FSA’s
  • Group Life and AD&D Benefits
  • EAP’s
  • Short and Long Term Disability Benefits
  • Disease-specific Coverage (for example, cancer policies)

ALL Group health plans subject to ERISA are required to provide participants with a summary plan description (SPD). An SPD must be written in a manner calculated to be understood by the average plan participant and must be sufficiently comprehensive to inform the participant of his or her rights and obligations under the plan.

For additional information, please feel free to contact us at 214/739-5215.

Self-Funding: Points to Consider

Gaining popularity similar to it’s peak in the early 1980’s, self-funding is making a comeback. Many brokers / advisers are not well versed in this concept, and therefore are less likely to present the approach to clients. One point they will also likely not share with clients: commissions are paid on the stop loss premiums, not the entire premium amount.

There are reasons to consider self-funding that typically outweigh the reasons not to self-fund. Most importantly, you should be working with an experienced adviser. One who works with self-funded clients day-in and day-out. An adviser who has relationships with a number of Stop Loss Carriers, Third Party Administrators (TPAs) and Pharmacy Benefit Managers, just to name a few.

The first point to consider – self-funding is not a “one year” solution. I do not recommend self-funding to any of our clients if they are not willing to commit to an overall 3-5 year plan. Typically the concept is a win for the client on average four out of five years, but you must be prepared for the bad along with the good.

Additionally, the size of the group should not deter your group from exploring self-funding as an option for your plan. I hear many of my peers say a group has to be at least 200 or 100 employees to consider self-funding, and that is just not true. If a client is financially stable and the adviser understands and communicates all risks involved in the contract, self-funding can be offered successfully as an alternative for clients with as few as 20-25 employees. Some of our clients in the range of 25 employees have been self-funded for over ten years, and are very happy with the stability of the rates over that time period.

Many smaller to mid-size clients should consider a closer look at self-funding due to some distinct advantages under the Patient Protection and Affordable Care Act (PPACA).

This is the first in a series of posts that will focus on the concept of self-funding. With 30+ years experience in all things self-funded, we have a lot to share. We welcome questions and hope those who read will learn something. Continue to follow us for more information coming soon.

What Should You Look for When Searching for an Employee Benefits Advisor?

When evaluating, expanding and maintaining your benefits, including self-funding, fully insured or voluntary benefits, look for these qualities in a broker:

1. Comfort and trust level: Do you feel comfortable working with your broker? Do you feel they have your best interests in mind? Do you trust their intentions – are they assisting you with meaningful benefits or merely “selling” benefits?

2. Resources: Does your broker have resources to evaluate how your plans are working? Can they compare them to other plans in the marketplace; do they have benchmarking tools? Are they providing any level of HR services or tools?

3. Experience: Has your broker implemented both self-funded and fully insured plans? Have they worked with large groups, small groups? Do they have experience in traditional and voluntary plans? Short- and long-term disability? Long-term care? Do they have a working relationship with various carriers? Enough to know who requires what and who provides exceptional service?

4. Strategy: Is your broker experienced enough to actually think out of the box and provide innovative solutions? Do they have a long-term strategy for your future over a three- to five-year plan, or do they just bring you a spreadsheet with a “pick a rate” strategy for the year?

5. Compliance and Regulation: Is your broker well-versed in all things ACA (Affordable Care Act) as well as the DOL, ERISA, HIPAA and Plan Document requirements, just to name a few?

6. Compensation Disclosure: Do you know each and every year exactly how much your advisor is compensated on each product?

All of these questions should be answered with confidence in your relationship with your benefits partner. You know up front exactly what to expect from your CPA and your lawyer. They are strategic business partners and have responsibilities in the success of your firm. We submit that your benefits is every bit as important, should not your partner be chosen just as carefully?

NAPEO White Paper Released: “PEO’s – Keeping Turnover Low and Survival High”

The National Association of Professional Employer Organizations (NAPEO) has released its second white paper entitled “Professional Employer Organizations: Keeping Turnover Low and Survival High.” MedCon’s sister company, Employee Resource Administration (ERA) – a Professional Employer Organization, has been serving clients of all sizes throughout the country with the significant issues addressed in the white paper.

 

Key findings highlight the lower employee turnover rate for small businesses in PEO arrangements, faster growth and significantly decreased failure rate.

 

As small businesses continue to struggle in a professional world of ever-changing compliance issues, MedCon and ERA strive to provide greater professional services tailored to meet specific needs of our clients. MedCon aims to provide provide custom employee benefit solutions specific to each client’s needs. ERA provides services to give relief from administrative functions that inhibit clients from doing what they do best – promoting, managing and expanding business. With 4 principals who have all spent their careers working in the insurance and administrative fields, the experience level provided to clients of all industries is unmatched.

 

If you have considered partnering with professional consultants, now is a crucial time to do so. With many changes imposed by the Affordable Care Act, small employers must have a resource to assist with various legislation and compliance matters. Instead of taking time away from the business you have built, consider partnering with the experienced team at MedCon and ERA to provide your professional solution.

 

 

The National Association of Professional Employer Organizations (NAPEO) is the largest trade association for professional employer organizations (PEOs) nationwide.  NAPEO advocates for the interests of its PEO members at all levels of government.

HSA Limits and Out Of Pocket Maximums Released for 2015

The IRS has released HSA contribution limits as well as maximum out of pocket amounts for 2015.

The maximum HSA contribution will be $3,350 for individuals with self-only coverage, up from $3,300 for 2014. For those with family coverage, the maximum contribution will be $6,650, up from $6,550.

The maximum out of pocket expense will increase to $6,450 for single coverage from $6,350 and to $12,900, from $12,700, for family coverage. These changes will take effect in 2015, and will impact group health plans in both the small and large group markets.

Please reach out to your MedCon Benefit Systems representative with any questions.