WHY DO YOU NEED AN EMPLOYEE BENEFITS ADVISOR/AGENT/BROKER?

An employee benefits agent or broker is a great resource for both employers and employees.  An advisor, agent or broker manages a number of different areas of employee benefits, including:   • Advocating for the employer and employee with insurance carriers, vendors, and providers.   • Subject matter expertise related to employee benefits, from plan design, trends, financing and compliance.   • Educating employees on how to use their benefits, tips and tricks, etc.   • Providing employee claims assistance between the carriers and providers.   • Assisting in enrollments, changes and terminations with carriers.   • Providing online benefits administration assistance (i.e. a Ben Admin system).  In some cases, like Rose Street Advisors, an      advisor will also actively build, manage and integrate, the benefits administration system internally on behalf of their clients.   • Being a strategic partner in achieving each organization’s goals and objectives and driving recruitment and retention efforts      through employee benefits.

Ben Cohen

CEBS | EMPLOYEE BENEFITS RELATIONSHIP MANAGER

Ben Cohen, CEBS, is one of our large group Employee Benefits Relationship Managers.  Following graduation from Central Michigan University (Fire Up Chips!) with a degree in Human Resources, Ben began his career in 1997 as a benefits consultant with Kushner & Company.  After 18 years in that role Ben joined Rose Street Advisors in 2014.  Ben’s daily focus is working with clients to offer benefit options that help recruit and retain a productive workforce in a compliant and cost-effective manner designed specifically for each employer.  He also enjoys educating employees about their benefits in a fun and informative manner.  Outside of work, Ben is passionate about community involvement and volunteering.  He currently donates his time as a board member with the Portage Community Center, volunteers with Hospice Care of Southwest Michigan, and participates with volunteer opportunities through Rose Street Advisors’ SWEET committee.  In the past, his involvement has included the American Red Cross, United Way, Volunteer Kalamazoo, Optimist Club, Jaycees, KHRMA, and the Michigan Maritime Museum.  Ben loves spending time at home and at their cottage in South Haven with his wife, Jen, and their dogs.  He loves travel, cars, golf, sailing, and recently started a group with friends rowing vintage wood shells (42 N’ Rowing).

Interested in more?

Let's Talk

With a slight adjustment to the Janet Jackson classic… “what has your broker done for you lately?” How might you rate your most recent benefits open enrollment on a scale of 1-10? What could be improved upon? There’s a laundry list of moving parts and details when it comes to open enrollment.  At Rose Street Advisors, we feel that no individual part of the process should be deemed lesser in value than another. It’s the bigger picture and the conversations from the leadership team down to the employees and their families that really make an impact.

Many of the conversations we’re having include stories or instances in which employees and employers alike don’t feel as if they have an advocate within their partnership. The most common feedback we've heard over the past year from employers as to what they’re seeking includes employee education, strategic conversations – those which include managing/reducing costs, staying within compliance, overall HR assistance and technology options and guidance.

So, if we could slightly adjust the previous question; could you share what you love about your existing broker partnership? Would it surprise you if I shared that 62%, compared to 44% two years ago, plan to make changes in their health care broker relationships in the next 12–18 months? It’s true. So why is that?

Personally, client stories have always felt like they have the most substance. Below is just one example that was shared by a member of our employee benefits team regarding a client that recently began a partnership with Rose Street Advisors: 

“One story that pulls at the heart strings includes a client’s employee who has a child with a disability. The child has had the diagnosis for a few years now. Upon diagnosis, the employee’s family took a proactive approach and reached out to their medical carrier to run down answers to their questions, assistance with coverage and ultimately inquire on somewhat of a roadmap of what to expect. Unfortunately, there was no response, no assistance. For months that turned into years, their family seemed to run into a brick wall when it came to getting answers on why claims were denied, why what seemed to be logical treatment for her child, was like fighting tooth and nail. Fast forward to this organization making a move to Rose Street Advisors. Within a month of a denied claim, our RSA team had connected with multiple team members of the client's medical carrier. A case manager reached out and the individual began to receive what they were looking for all along… answers. They finally felt like they had someone's ear that would be an advocate for their child and their situation.”

 

We received a note from this client soon after stating, “Have I mentioned lately how grateful I am to be with RSA?!?” We’re grateful that we have the opportunity to make an impact on organizations, employees and their families.

At Rose Street Advisors, we don't discriminate based on the size of your organization. We provide all of our clients with the same customer service, care, education and dedication It is our mission to be your advocate while providing your employees with the tools and resources to maximize their healthcare in the best way possible.

As you enter a new year, think about what you truly want to get out of your existing partnership(s). If you’re interested in hearing more about how Rose Street Advisors serves our clients, let’s have a conversation!

Shannon Thomas

LIC | EMPLOYEE BENEFITS ADVISOR

Shannon values working closely with business leaders to make a positive impact at their organization. With over 6 years of experience at a major HRIS company, her skills include consulting with organizations on their HR processes and creating efficiencies within the employee lifecycle. She understands the importance of clear communication and meeting deadlines. Her outgoing nature and ability to communicate across many levels makes her an important part of our team.

In her spare time, she enjoys traveling, spending time with family and friends and anything outside during the warmer months.

Interested in more?

Let's Talk

Transparency Regulations were issued by the Departments of Labor, Health and Human Services and the Treasury (Departments) in November 2020. A month later, the Consolidated Appropriations Act, 2021 (CAA) was signed into law. Following in August 2021, the Departments released FAQ guidance addressing several CAA requirements. These new requirements are designed to increase health care transparency and protect consumers against surprise billing. Let’s take a summary tour through the deadlines set forth.

Prohibition on Gag Clauses

applies immediately on December 27, 2020

A gag clause could directly or indirectly restrict/prevent insurers from making price or quality information available to patients or other third parties. This also includes preventing a pharmacist from disclosing cost information to patients. Under the CAA, insurers and group health plans cannot enter into agreements with providers that restrict their ability to disclose provider-specific cost or quality of care information. The provision also states that electronic deidentified claims and encounter information or data for enrollees cannot be restricted, with respect to applicable privacy regulations. Beginning in 2022, attestations will begin to be collected, focusing on the enforcement of compliance with the ban on gag clauses.

Broker Compensation Disclosure

generally applies to contracts beginning, extended or renewed on or after December 27, 2021

Section 202 of the CAA requires brokerage and consulting firms to disclose, in writing, the amount of compensation (direct and indirect) we anticipate receiving during your plan year ($1,000 or more). This disclosure applies to medical, dental and vision plans only, however Rose Street Advisors has made the decision to disclose all compensation received related to all benefit plans we service for you. This requirement does not apply to plans not subject to ERISA or plans that have a fee-for-service compensation model.

Ban on Balance Billing

applies to plan years beginning on or after January 1, 2022

Group Health Plans and Health Insurance Insurers are required to provide protection against balance billing and out-of-network cost sharing like emergency services and air ambulance services by non-participating providers. It also protects nonemergency services provided by non-participating providers at participating facilities. Members will find notice of these protections on an Explanation of Benefits (EOB) for an item or service when it applies.

Transparency in ID Cards

applies to plan years beginning on or after January 1, 2022

Health Insurance Insurers were mandated to provide updated physical and/or electronic ID Cards that include applicable out-of-network deductibles, out-of-pocket maximums, and contact information for individuals seeking assistance.

Continuity of Care

applies to plan years beginning on or after January 1, 2022

This new rule states a Health Insurance Issuer must offer an enrollee the opportunity to elect a transitional period of continued care with a provider whose participation in an applicable network ends while the enrollee is in a course of treatment for a medical condition.

Provider Directory Accuracy

applies to plan years beginning on or after January 1, 2022

In recent years, it is not uncommon to have a Physician listed In-Network, only to confirm that the Provider contract has ended and they are no longer a participating Provider. Health Plans and Insurers must now maintain provider directories on their public website. If inaccurate information is found, a covered individual cannot be required to pay more than in-network cost shares.

Machine Readable Files

initially set for January 1, 2022 then delayed until July 1, 2022

Fully Insured Insurers and Self-Funded Employers must disclose detailed service pricing information on their public website through three phases. • Phase One: In-Network provider negotiated rates for covered items and services (In-Network Rate File) • Phase Two: Historical payments to and billed charges from out-of-network providers (Allowed Amount File) • Phase Three: In-network negotiated rates and historical net prices for covered prescription drugs (Prescription Drug File)

Prescription Drug Cost Reporting

initially required by December 27, 2021, and extended until December 27, 2022

Insurers and Group Health Plans must provide data on pharmacy benefits and drug costs to federal regulators an on annual basis. The gathered information will then be used to provide publicly available reports on a bi-annual basis reviewing prescription drug reimbursements, pricing trends, and how much prescription drugs impact premium increases or decreases. By December 27, 2022, Insurers and Group Health Plans must be prepared to submit information for both 2020 and 2021.

Price Comparison Tool

applies to plan years beginning on or after January 1, 2023

Insurers and Group Health Plans are required to provide an internet-based self-service tool to disclose to the public the price comparison information and cost-sharing estimates. This tool cannot require someone to have a subscription, login, or charge fees to access the data. Upon request, information must also be provided in paper form or over the phone. The price comparison tool is being released in two phases. • Phase One: By January 1, 2023 at least 500 specific shoppable items, services and drugs identified by the Departments must be       available on the price comparison tool. • Phase Two: By January 1, 2024 all items, services and drugs must be available on the price comparison tool.

Advanced EOBs

delayed until further notice

Group Health Plans and Insurers must provide an advanced EOB to covered individuals highlighting details of the estimate of expected cost of services. This comes after receiving a good faith estimate of charges for those services from a health care provider or facility. For more information, please contact your Relationship Manager or our office at infor@rosestreetadvisors.com or 269.552.3200.

Several of these requirements are currently using a good faith, reasonable interpretation of the law until the Departments issue further regulations.

Justine Dickens

EMPLOYEE BENEFITS ADVISOR

Justine is a devoted and meticulous team member with a passion to educate and support business partners and their employees. Since 2013, Justine’s commitment to her clients has allowed her to instill confidence and stability in the benefits packages offered to their employees. Her strengths allow her to communicate efficiently, focus on customization and understand the complexities of an ever changing industry. She is a Dale Carnegie Graduate and has her NAHU Self-Funded Certification. When she is not working, Justine is busy running her son and daughter to their practices and games and volunteering in the community. She enjoys playing golf, hiking and spending time with her family and friends.

Interested in more?

Let's Talk

Save The Trees!

Why Using Employee Benefits Technology Matters...

Throughout the day. I easily open my phone hundreds of times to buy something, read an article, respond to a message, watch a video for a good laugh or look up the passwords I forgot for the 17^th time that day.

I did not always depend on that technology so frequently. I remember paper. LOTS of it. An overwhelming amount of it most of the time. I remember a time when getting a giant stack of paper when I started a new job was the norm. And all too often, it is still how many organizations onboard new employees. I am sure you have recently onboarded an employee or ten and when you hand them their onboarding packet they look at you with that deer in the headlights look wondering what they are supposed to do with all of it.

The availability of technology to efficiently onboard employees from I-9’s to life insurance evidence of insurability forms has come a long way. That technology is now easier to use, more cost effective, more integrated than ever before and, most importantly, it is an expected part of the experience for employees starting a new job.

Not all technology is the same though. There are a few key components to consider when reviewing a technology system for onboarding and benefits enrollment to consider –

1

Is it easy for your employees to use on whatever device they prefer (phone, tablet, computer, etc.)? Do not make it worse than paper.

2

Does the system compliment or hinder your processes? Do not make more work for yourself either.

3

Is there ample support that comes with the technology to ensure if something goes wrong, it is fixed quickly and accurately?

4

Are you excited about it? Do not pick a technology system just to check the box. You should be excited to have it and use it!

5

Can it connect? Ensuring that your technology systems can talk to one another is important. Do not pick a system that will still require you to use the same paper you were using before.

Here at Rose Street Advisors, we understand how important technology is. We have recently made a change to partner with a new technology partner- Employee Navigator. It is important to us to ensure we are bringing technology to our clients as a value add and not just another task to complete. We are excited for this new partnership and what it means for our clients!

If you would like to learn more about Employee Navigator, please feel free to reach out to any of the team members at Rose Street Advisors.

Alicia Ball

STRATEGIC OPERATIONS ADVISOR

As Strategic Operations Advisor, Alicia has the opportunity to lead the Employee Benefits Department every day. The focus of her role is to ensure the Department is operating at maximum efficiency, which allows us to ensure that our client’s needs and expectations are consistently exceeded. She accomplishes this efficiency through her strong communication, ability to maximize resources and staying true to Rose Street’s core values. Alicia’s tenure with Rose Street began in 2016 as our Maxwell Health Champion. She then spent time as a Employee Benefit Advisor where she built long lasting relationships with her clients that remain in place today even with her role change.

In her spare time, Alicia tries to keep up with her very busy son, volunteers as a Big Sister for the Big Brother, Big Sister organization, and makes sure to spend as much time outside as she possibly can.

aball@rosestreetadvisors.com

Interested in more?

Let's Talk

What’s an SPD?!

Space Patrol Delta?  Super Perfect Day?  Special Person Driver?  Spinning Pile Driver?! Summary Plan Description?  Oh yeah, that’s it, at least in the context of benefit plans!

So, what is a Summary Plan Description, or SPD, who needs one and why?

Plan Documents and SPDs are required for most benefit plans covered by ERISA, including Health (and “Welfare”) plans – i.e. medical, dental, vision, life, STD and LTD, etc., pre-tax plans like a Section 125 plan (typically as standalone documents), and Qualified Retirement Plans like a 401(k) or 403(b). The Plan Document outlines all the possible parameters that could be adopted by a plan and defines and includes all the legal components. The Summary Plan Description (SPD) adopts the applicable provisions from the Plan Document, puts them in a more employee friendly, readable format, and is then distributed to each plan participant. The structure of these documents is generally similar, but the contents vary quite a bit between different benefit types and applicable laws.  For example, with Health and Welfare benefits, employers often adopt a wrap SPD that pulls all medical, dental, vision, life and disability benefits under one single Plan Document and SPD.  In each case, the requirements surrounding Plan Documents and SPDs are governed by ERISA through the Employee Benefits Security Administration (EBSA), a division of the Department of Labor (DOL). With regard to pre-tax plans like a Section 105, 125 or 129, or 132 that allow pre-tax benefits for things like HRAs, employee premium contributions, Flexible Spending Accounts, Health Savings Accounts and parking and transit, Plan Documents and SPDs are required regardless of ERISA status (those IRS sections dictate these requirements, not ERISA). In other words, even if you're a governmental entity or church plan not otherwise subject to ERISA, you do need Plan Documents and SPDs for these pre-tax benefits. This is meant as a very high level description of Plan Documents and SPDs. If you are a current client of Rose Street Advisors, please contact your Relationship Manager to discuss your needs in greater detail.   If you are not a current client of Rose Street Advisors, please feel free to contact us at 269-552-3200 or contact@rosestreetadvisors.com to speak to someone.

Ben Cohen

CEBS | EMPLOYEE BENEFITS RELATIONSHIP MANAGER

Ben Cohen, CEBS, is one of our large group Employee Benefits Relationship Managers.  Following graduation from Central Michigan University (Fire Up Chips!) with a degree in Human Resources, Ben began his career in 1997 as a benefits consultant with Kushner & Company.  After 18 years in that role Ben joined Rose Street Advisors in 2014.  Ben’s daily focus is working with clients to offer benefit options that help recruit and retain a productive workforce in a compliant and cost-effective manner designed specifically for each employer.  He also enjoys educating employees about their benefits in a fun and informative manner.  Outside of work, Ben is passionate about community involvement and volunteering.  He currently donates his time as a board member with the Portage Community Center, volunteers with Hospice Care of Southwest Michigan, and participates with volunteer opportunities through Rose Street Advisors’ SWEET committee.  In the past, his involvement has included the American Red Cross, United Way, Volunteer Kalamazoo, Optimist Club, Jaycees, KHRMA, and the Michigan Maritime Museum.  Ben loves spending time at home and at their cottage in South Haven with his wife, Jen, and their dogs.  He loves travel, cars, golf, sailing, and recently started a group with friends rowing vintage wood shells (42 N’ Rowing). bcohen@rosestreetadvisors.com

Interested in more?

Let's Talk

Employee Retention Credit (ERC)

On December 27, 2020, the Consolidated Appropriations Act of 2021 was signed. This provided updates and extensions to Employee Retention Credits (ERC). Employers that received Paycheck Protection Program (PPP) loans can also qualify for the ERC for wages that are not paid for with forgiven PPP loans. Prior rules only allowed employees to claim up to $5,000 per employee per year. With these updates employers can now claim a credit up to $7,000 per employee per quarter. In this post, life insurance professionals from Rose Street Advisors discuss the changes to ERC further. 

Is your organization eligible? If so, how much credit will you receive?

ERCs allow you to offset your payroll taxes and receive cash back for credits above your payroll tax liability. This credits serve as a refund. Example: If you qualify for $50,000 in credits and only owe $8,000 in payroll taxes, you receive a $42,000 refund.  Previously, the tax credit was equal to 50% of wages and compensation, up to $10,000 in wages for the year (2020). With the ERC updates, it made Q1-Q2 2021 equal to 70% of wages and compensation, up to $10,000 in wages for each quarter. This equals a max potential credit of $14,000 per qualified employee for Q1-Q2 2021 in addition to the 2020 credits. No limits exist on how you can spend your refund. •  Employers are eligible if their business operations have been fully or partially suspended as a result of a government order

OR

• For 2020, if the business experienced a 50% reduction in quarterly receipts compared to a base period

OR

• For 2021, if the business experiences a 20% reduction in quarterly receipts compared to a base period Previously, businesses with 100 or less full-time employees, could take the tax credit for all employees. That number has changed to 500 full-time employees. Under 500 full-time employees: The tax credit is for wages paid to all employees.  • For example, if you have 490 full-time employees and 200 additional part-time employees the entire payroll is eligible up to the maximum credit per employee. Over 500 full-time employees: The tax credit is for wages paid to employees not working. There is no limit on the number of employees or the size of your company that prevents you from taking your credit.

Shannon Thomas

EMPLOYEE BENEFITS ADVISOR

Shannon values working closely with business leaders to make a positive impact at their organization. With over 6 years of experience at a major HRIS company, her skills include consulting with organizations on their HR processes and creating efficiencies within the employee lifecycle. She understands the importance of clear communication and meeting deadlines. Her outgoing nature and ability to communicate across many levels makes her an important part of our team. In her spare time, she enjoys traveling, spending time with family and friends and anything outside during the warmer months. sthomas@rosestreetadvisors.com

Interested in more?

Let's Talk