Is Your Healthcare Plan Covering People It Shouldn’t?

healthcare eligibilityIf you provide an employer healthcare plan, it’s vital to ensure only the correct people are covered. Comprehensive healthcare insurance is one of the most important benefits you provide to employees, so keeping premiums down matters to everyone.

One of the main causes of rising premiums and healthcare costs is when ineligible people continue to be covered on a healthcare plan. For employer-provided health insurance, ineligible people are typically:

  • Former employees who have now left your business.
  • Employees whose status has changed, meaning they are no longer eligible under the plan, or should be on a different plan.
  • Dependents of an employee, where the status of the dependent has changed.

Examples of ineligible people for a healthcare plan

The following situations could all cause people to become ineligible.

  • A dependent child who ages beyond the dependent eligibility requirements in the plan.
  • A former spouse who separated from your employee.
  • An employee who leaves your business.
  • An employee whose status has changed, for example through changing the number of hours worked or moving to a different position, and whose new status requires a different healthcare plan.

Creating a healthcare eligibility audit

You need a process to understand and remove people from your employer-provided healthcare plan. Here’s how to put an “Employee and dependent healthcare eligibility audit” together.

Understand the eligibility requirements of your current employer-provided healthcare plans

Go through any existing employer-provided plans and note down:

  • All employees currently covered by the plan.
  • All dependents currently covered by the plan.
  • Eligibility requirements for employees.
  • Eligibility requirements for employee dependents.
  • Benefits and coverage provided.

You may hold this information internally, or you can get the data from your broker or healthcare insurance provider.

Analyze your existing employee data

Match your existing employee data against the healthcare plan eligibility requirements. Check:

  • Any employee listed as being on the plan is still employed by you.
  • Any dependent listed on the plan is still a dependent on the employee.
  • The type of healthcare plan is appropriate for the status of the employee.
  • All eligibility requirements are being met by any active plan participants.

Find gaps in the data

It’s likely that you will find gaps in the information. You may not have the latest details of dependents or employees. Complete a gap analysis to understand the data you need to ensure only appropriate people are covered by the plan.

Carry out a healthcare eligibility audit to close any gaps

Once you know what data you need, you will need to audit the information with your employees. Approach each employee with the details of their health insurance for them and their dependents and ask if all the information is factual and correct. If it is, get them to sign off on the information.

If the data is incorrect, get it updated and see how it affects healthcare eligibility. Communicate this back to the employee.

Careful communication is key

You will need to communicate carefully throughout this process. Employees may see the eligibility audit as a tool for taking away healthcare coverage. It’s important to manage the message carefully — The audit ensures only appropriate, eligible people are covered. That means less cost-leakage and medical expenses on plans, which keeps premiums down and ensures the right people have the right coverage.

You may want to complete the healthcare eligibility audit every year. This will ensure your records are up to date and reduce the premiums you and your employees need to spend.

Jill Goulet
Risk Management Consultant
jgoulet@srfm.com

healthcare eligibility

Trucking Risk Insights: Top 10 Vehicle Violations – 2016

Top 10 Vehicle Violations—2016

A roadside inspection is an examination of individual commercial motor vehicles and drivers by a Motor Carrier Safety Assistance Program (MCSAP) inspector to determine compliance with the Federal Motor Carrier Safety Regulations (FMCSRs) and/or Hazardous Materials Regulations (HMRs). Serious violations result in the issuance of driver or vehicle out of service (OOS) orders. These violations must be corrected before the affected driver or vehicle can return to service.

Trucking ViolationsJonathan Belek
Risk Management Consultant
jbelek@srfm.com

Jon Belek

Trucking P&C Pro-File Newsletter – February 2017

New Study Links Multiple Health Conditions to Preventable Crashes

It can be extremely difficult for commercial truck drivers to stay healthy on the job. Drivers often work long hours without rest, stay seated all day and don’t have access to exercise or nutritious meals. However, a new study conducted by the University of Utah School of Medicine found that drivers with three or more health conditions are much more likely to get into preventable crashes.

The study, which examined the medical records of nearly 50,000 commercial drivers, tracked a number of medical conditions that could have a negative impact on a driver’s performance—such as diabetes, high blood pressure, and anxiety.

Although the study found that drivers who have only one of the conditions

could often control it while on the road, the number of crashes increased significantly when drivers had three or more conditions. The average rate for crashes that result in an injury for all truck drivers is approximately 29 for every 100 million miles traveled, but the rate is 93 for every 100 million miles traveled for drivers who have at least three of the flagged conditions.

Transportation Industry Seeks to Limit New Rule-making

Representatives from the transportation industry have petitioned the Trump administration to slow the rule-making procedures of various federal agencies by adding more steps to the process and including business representatives in future rule-making discussions.

Although agencies such as the Department of Transportation (DOT) and the Federal Motor Carrier Safety Administration (FMCSA) currently go through public steps in their rule-making processes, some business owners believe that the Obama administration bypassed these processes through executive orders and safety advisories. They say this could force businesses to adopt costly new procedures with little evidence of their effectiveness.

New Interstate Passenger Resource

The FMCSA recently released an online

resource to help businesses that transport passengers across state lines. The resource includes a list of requirements that have changed over the years as a result of litigation, legislation, and rule-making. Additionally, passenger carriers can determine their registration requirements, minimum levels of financial responsibility and any applicable safety and commercial regulations.

For more information on keeping your business compliant with FMCSA regulations, contact us at 203-265-0996 today.

Jonathan Belek
Risk Management Consultant
jbelek@srfm.com

Jon Belek

Construction P&C Pro-File Newsletter – February 2017

New OSHA Beryllium Standards

On Jan. 9, 2017, the Occupational Safety and Health Administration (OSHA) issued a final rule to amend its beryllium standards for the construction, shipyard and general industries.

The final rule will reduce the eight-hour, permissible beryllium exposure limit from 2.0 micrograms per cubic meter to 0.2 micrograms per cubic meter. It also establishes a short-term exposure limit of 2.0 micrograms per cubic meter over a 15-minute sampling period.

The rule will require additional protections that include personal protective equipment, medical exams, medical surveillance, and training.

The final rule becomes effective on March 21, 2017. Affected employers must provide newly required showers and changing rooms within two years after the effective date and implement new engineering controls within three years after the effective date.

OSHA estimates that the new rule will prevent 46 new cases of beryllium-related disease and save the lives of 94 workers annually.

Employers should become familiar with the new standards and evaluate their current workplace practices to ensure compliance with the final rule.

DOL Sues Contractor for Firing Safety Manager

According to a lawsuit filed on Dec. 28, 2016, a Tampa roofing contractor discriminated against its safety manager after he cooperated with an OSHA investigation. The Department of Labor (DOL) lawsuit was a result of an investigation by OSHA’s Whistleblower Protection Program.

Under the program, employers are prohibited from retaliating against employees who raise protected concerns or provide protected information to the employer or government. The lawsuit seeks back wages, interest, and injunctive relief as well as compensatory and punitive damages.

Construction Workers at Highest Risk for WMSDs

According to a recent Occupational and Environmental Medicine report, U.S. construction workers are at a higher risk of work-related musculoskeletal disorders (WMSDs) than all other industries combined. The back is the primary body part affected, with overexertion named as the major cause of WMSDs.

Employers should adopt ergonomic solutions at construction sites, such as training employees on safe lifting practices, in order to reduce the number of WMSDs and prevent lost wages.

Jonathan Belek
Risk Management Consultant
jbelek@srfm.com

Jon Belek

How to choose the perfect appraiser for your property, art, antiques, jewelry, and other valuables

appraiserIf you have highly valuable, treasured property or possessions, you may need to get them appraised for insurance purposes. Many insurance carriers will insist on accurate valuation of property, art, antiques, jewelry, and other items so they can ensure the correct level of coverage and premium payment.

When you’re seeking out a good appraiser, here are some areas to consider:

Talk to your friends and colleagues

If you know other people who need to insure high-value items, talk to them about their experiences. Get recommendations on good appraisers and create a shortlist.

Look at professional qualifications

There are a variety of professional accreditations and qualifications depending on the fields an appraiser trains in. These include:

  • International Society of Appraiser’s credentials for fine art, antiques, and personal property.
  • A diploma in gemology for jewelry appraisal.
  • Uniform Standards of Professional Appraisal Practice exam for members of the American Society of Appraisers.
  • Principles of Valuation courses for members of the American Society of Appraisers.
  • Property appraisers should have one of the following designations from the Appraisal Institute — MAI Designation, SRPA Designation, SRA Designation, AI-GRS Designation, AI-RRS Designation.

There are various other exams and certifications available. Always check an appraiser’s qualifications to ensure they’re qualified to provide expert advice.

Check if they’re members of professional appraiser organizations

There are several industry bodies for appraisers. They include:

Many of these websites have membership directories for their appraisers.

Professional appraisers are required to uphold a strong code of ethics, including:

  • Providing truly independent valuation services, with no external influences.
  • Have no outside interest in the valued item, other than as providing a professional service.
  • Only carry out appraisal work in their area of expertise.
  • Consider all relevant factors when arriving at a valuation.
  • Treat and document property with the right level of care and respect.
  • Ensure personal remuneration and pay is independent of the value of property being appraised.

Interview your shortlist

When you have a shortlist of appraisers, call each one and ask questions about their area of expertise, qualifications, professional standards, and membership of industry bodies. Get a feel for what each appraiser is like and use that to decide which one would be right for your needs.

Remember that valuations change with time, many carriers will require updated valuations on a regular basis.

As always, if you have any questions about your scheduled property or how to get your property appraised, we are a phone call away!

Mary McGrath
Personal Lines Manager
mmcgrath@srfm.com

Appraiser