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Who was John Henry?

6/9/2015

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Well, it depends on who you talk to and how you ask.  The tale goes that he challenged a machine to dig a tunnel and lay railroad track ... he won but died from a heart attack.  How much of it is true will remain part of what makes it a tall tale.

It has a LOT to do with us in the benefit and HR industry. Candles replaced light bulbs, cell phones replace land lines, and the Luddites lost.  Yes the Luddites.

We are driving ourselves crazy trying to keep up with the PPACA and companies like Zenefits seem to be flying past us.  The market is changing and brokers and landlines and HR managers and candles seem to be headed into the same history.

Being part of the past is not our collective desire for the future ... because it is NOT a future at all.  So, what are we to do.  What John Henry did in the tale is a short road to death.  The Luddites lost and many died with a mysterious leader who sought to stop the industrial revolution.

First, we need to recognize that this is a cycle and we cannot stop it.  The Luddites would have been far better off in so many ways had they learned that lesson first.  Next, consider finding a niche and get there first.  With an average of 65,000 brokers in each state on the east coast, many are going to be changing jobs.  There is not room for that many brokers in the new world of the PPACA.  Not quite to the level of being a candle maker or a Luddite or a John Henry but probably half way there ... because of the new rules and increased automation and integration.

The truth remains, that the trusted relationship between a broker and an HR professional is facing changing dynamics.  Benefits are certainly headed to being a commodity and just a "checkoff" on the list of things to do with enrollments and plan designs moving to clicks for employees to make.  Notifications and compliance still matter but that too will be put on the auto pilot of "clicks"  for all but the newest smallest employers.

That is another trend to remember.  The cycle includes a trickle down of abilities for administration and benefits.  Remember when only the large companies had multiple plan choices and 401(k) plans.  Now PayChex (whose average client is 5 employees) has more 401(k) plans in place than just about all the others administrators put together and it is rare for a company of 20 or so employees not to have at least two or three medical plans, two dental plans and vision coverage as well.  The cycle we need to see is simple ... what big companies have today, small companies will have soon.

Next ... more change.  If the Supreme Court throws out the subsidies in 36 states, something will plug that hole quickly and could even be worse for the current market situation.  If the subsidies are upheld, the markets should settle down for a season ... but not for long.  Premiums are far too high without a reduction of participation.  We moved from indemnity to PPO to HMO to High Deductible to Marketplace to ... (what ever is next)

The ONLY thing we have in our control are the two things that make all successful people successful.  These two things measure every successful person I have met and in a USA Today study 20 years ago it was true and remains true today.  Successful people are Life Long Learners and Effective Collaborators. 

Think about it ... that is what it takes to succeed.  We don't need some new law or plan or industry protection.  We need to be committed to learning and work well with others that make 1+1=3 or 5 or 10.

Instagram had 16 employees when it was sold in 2012 for $1 billion.  Wait.  2012 was a bad year right?  Not for Instagram.  Life Long Learning and Effective Collaboration ... $1 billion.  Now, there is a formula!


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DOL Audits Abound ... and the fines are costly!

6/1/2015

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We are asked frequently about a list of DOL (Department of Labor) Audit items.  Following is a current list of items examined from actual DOL audits in most circumstances.  They can go deeper.  But if you have this list, you are far enough down the road to have little to worry about.

  • Plan documents for each plan along with any amendments. (Content in all plan documents must comply with ERISA regulations.)
  • Trust agreement (if any) and all amendments.
  • Current SPDs.
  • Form 5500 and accompanying schedules for most recent plan year and previous three years.  (IF the plan has 100 or more participants.)
  • Listing of all current service providers and those from the past three years.
  • All current contracts with administrative service providers on the plan and most current fee schedules.
  • All insurance contracts between plan and service providers.
  • Name, address and telephone number of plan administrator.
  • Sample HIPAA certificate of creditable coverage and proof of compliance with on-time issuance of COBRA notices.
  • Notice of special enrollment rights and record of dates when notice was distributed to employees.
  • Written eligibility criteria for plan enrollment.
  • Documentation regarding all mandatory employee notices, i.e., ERISA Statement of rights, Women’s Health and Cancer Rights Act notice, etc.
  • Copy of most recent monthly bill for premiums (if any) from insurance carrier(s).
  • Copy of check, wire transfer or other method of payment for insurance premium (if any).
  • Enrollment form(s) for the plan.
  • Employee handbook (if any).
  • All documentation of claim adjudication and payment procedures.
  • Fidelity bond (if any).


Costly Fines

ERISA’s reporting and disclosure requirements can result in fines of $110 per day, per person, per violation for every plan participant who was covered under a single contract. That fine jumps to $200 for plan participants covered by a family contract. ERISA fines represent just one flag from the DOL auditor and can cost the plan sponsor dearly. Most fines for noncompliance under the ACA are not tax-deductible, either.

Since Brokers are  licensed, clients often do not see the lines between ERISA and being the broker of record.  Those lines are quickly disappearing.  So, getting tuned up should be important to all benefit brokers.

Taking some time to catch up on the compliance rules and with your groups is a good idea ... now.  Because, the fear of audits will push them into talking to someone with answers.

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    Frank Surface

    MoneyWise Solutions, Inc.
    Principal

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