resources

Advocacy in Action | Negotiating Unexpected Claims

Provider Balance Bill Our Patient Advocates are serious about service. As an independent resource, they are available to our members to help them resolve any concerns about their benefit program.  They can assist with concerns about claims, patient referrals, balance bills, enrollment delays, ...

Happier Holidays, the HR Way

Most people, according to a new survey featured in HR Dive, have the greatest sense of belonging in their own homes. That may not be surprising news, but what is interesting is that one third of respondents felt the greatest sense of belonging in their workplace. A significant percentage, 40 ...

Nondiscrimination Rules for Cafeteria Plans

A cafeteria plan is an employer-provided written plan that offers employees the opportunity to choose between at least one permitted taxable benefit and at least one qualified employee benefit. There is no federal law that requires employers to establish cafeteria plans; however, some states ...

It’s Flu Season…Again

When flu season hits, absenteeism skyrockets and productivity drops. In a recent article, Employee Benefit News points out that the first step is the “ounce of prevention,” the flu vaccine. Providing for vaccination can be a smart benefit to offer employees, and it requires navigating ...

Giving Thanks in the Office

While our personal lives may offer plenty of opportunities to give thanks, it’s also important to make a habit of it in our professional lives, according to an article in the Cobb Business Journal. Few people in a study cited expressed gratitude for their work, and that might be because a ...

An Employer’s Guide to Annual Group Health Plan Notices

Employers that sponsor group health plans are required to give eligible employees a number of notices each year. Some notices must be given by a particular date, and some must be given as part of the enrollment packet. (This means that non-calendar year plans may need to provide Medicare Part D ...

Compliance Recap | October 2018

October was a busy month in the employee benefits world. The Internal Revenue Service (IRS) released final forms and instructions for 2018 ACA reporting. The Department of Health and Human Services (HHS) released inflation-adjusted civil monetary penalty amounts. The Treasury, the Department of ...

Advocacy in Action | Auditing Claims and Facilitating Refunds

A member contacted her Patient Advocate, Janel, to request an audit of her eye surgery claims. She felt she might have paid the doctors too much. Janel reviewed the bills and EOB’s and discovered that the member had definitely overpaid the surgeon by over $800. Janel contacted the provider’s ...

How to Handle Benefits When an Employee is on Leave

Employers often have questions about what benefits they must maintain for employees who go on leave. Whether an employer must maintain a particular benefit will depend on a variety of factors, including the type of leave, the employer’s written policy, and federal and state laws. This chart ...

IRS Releases Final Forms & Instructions for 2018 ACA Reporting

Background Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full‑time employees. Reporting is required by employers with 50 or more full-time (or ...