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7 Important Differences Between FMLA and the Paid Family Leave Act

7 Important Differences Between FMLA and the Paid Family Leave Act

For those of you who do not know, starting in 2018, New York state is introducing the Paid Family Leave Act (PFL). New York’s Paid Family Leave program provides wage replacement to employees to help them bond with a child, care for a close relative with a serious health condition, or help relieve family pressures when someone is called to active military service. Employees are also guaranteed to be able to return to their job and continue their health insurance. If you contribute to the cost of employee health insurance, you must continue to pay your portion of the premium while they are out on Paid Family Leave.

FMLA, or The Family Medical Leave Act, has been in effect since 1993 when it was enacted to provide 12 weeks of unpaid job protections for eligible employees at covered employers.

While both PFL and FMLA are designed to protect the family members of an employee, they do have key differences:  

1. Federal vs. State:

FMLA is a federal program where PFL is a state program. All businesses with 50 more employees across the United States must abide by the laws of FMLA. PFL however is a state mandated program and although it has been implemented in other states, it will begin in New York starting in January of 2018.

2. Benefits Comparison:

FMLA is an unpaid benefit, which means no monetary benefit is provided to employees who participate. PFL is a paid benefit, which will start out by providing 50% of an employee’s income capped at New York’s average weekly wage which is currently $1,305.92. By 2021 PF will cover up to 67% of an employee’s income. Payment for PFL comes from employee payroll deductions.

3. Job Protection:

Both FMLA and PFL provide job protection for eligible employees.

4. Time off:

FMLA provides employees with a maximum of 12 weeks off in increments of as little as 15 minutes. This means an employee can miss 15 minutes of work at a time for an FMLA-related event.

PFL will initially be capped at 8 weeks of time off and will increase to a maximum of 12 weeks by 2021. Time off with PFL may be used in 1-day increments.

5. Eligibility:

FMLA applies to employees who work for a company employing 50 or more employees. In order to be eligible for FMLA, an employee must work for the same employer for a minimum of 12 uninterrupted months, or 1,250 hours in the months prior to FMLA event.

PFL applies to all business in New York and other states where PFL has been applied. Any and all New York State companies employing 1 or more employees are required to participate in the PFL. To be eligible an employee must work a minimum of 20+ hours per week for a minimum of 26 consecutive weeks. If an employee is working less than 20 hours per week, they must have been working for their employer for 175 days or more to be eligible.

*Note: If an employee is eligible for both FMLA and PFL the benefits they receive will run concurrently. This means an employee cannot combine FMLA and PFL time to extend the duration of the leave.

6. Qualifying Events:


For the most part, FMLA and PFL cover the same life events. These events include bonding and caring for a newborn child, caring for a sick family member, and adjusting for a family member’s military deployment.

One major difference between FMLA and PFL is that PFL will not cover an employee who is absent from work because they need to care for themselves and a personal injury or illness they endure. FMLA will cover an employee if they personally become sick or injured.

7. Vacation & Sick Days:

Vacation and sick time benefits are left at the employer’s discretion, however all employees must be treated equally under the governing decisions of the employer. Under FMLA, an employer can force an employee to use their sick or vacation days while they are on leave. Under PFL, an employer cannot require an employee to use their sick or vacation days during leave.


Other brokerages take a cookie cutter approach to insurance and outfit their customers with generic coverage.  Skyline is different.  We believe insurance should be built on innovation and experience. We appreciate the fact that every engagement is unique and understand proper coverage requires a deep understanding of the underlying business and individual.

"The opportunity to safeguard your concerns is a privilege we never take for granted."

Multiple-Employer Welfare Arrangements (MEWA) a Healthcare Alternative

Multiple-Employer Welfare Arrangements (MEWA) a Healthcare Alternative

Multiple-Employer Welfare Arrangements, or MEWAs, are growing in popularity as another alternative to traditional health insurance policies. The Affordable Care Act’s mandate requires a broader range of employers to cover their employees’ healthcare costs. MEWAs are an alternative healthcare option to the federal health insurance exchanges.

MEWAs are a kind of self-funded insurance plan. MEWAs are put together by a group of employers who don’t want to work within the governmental healthcare system. A self-funded MEWA allows a group to get together to pool their health care resources, rather than strike out on their own to fund their health insurance needs individually.

Benefits of MEWAs

MEWAs are beneficial to employers because they allow for risk to be spread to a number of entities, rather than be shouldered by one small business. MEWAs can be used to offer health care incentives to employees or members of a professional association. If a small business doesn’t want to use the existing federal health insurance marketplace in order to provide health insurance for their employees, this can be a viable alternative.

MEWAs are member-owned, meaning the benefits flow around to all the people who are involved in the program. Employers who offer a MEWA health insurance plan are able to keep deductibles and premiums stable while still offering full healthcare coverage to their employees. Profits from the MEWA stay within the group that started the MEWA, so the savings and the risks are spread around.

Many MEWAs are set up like a board of trustees. This means that there is no artificial inflating of health insurance costs and that your payments don’t have to change year to year. If an employer is offering up incentives for their employees in the form of a wellness program, that positive action comes back around in the form of healthier employees and even lower insurance costs. If employees sign on to the MEWA program but don’t use it very often, costs are decreased for everyone.

A board of trustees is usually set up to manage the MEWA, which allows changes and alterations to be made to the program to account for the specific needs of the group that is being insured. This ensures a stability that doesn’t always exist in traditional insurance plans, because people are in control of the costs and not the insurance market.

Although small businesses can benefit from MEWAs, other organizations large and small can create a MEWA, too. Individuals, large groups, and professional associations are also eligible for this kind of insurance program.

What to know about MEWAs

There are some states in the US that allow MEWAs, while others do not. Other states may regulate MEWAs strictly. Although too many restrictions can harm the functioning of a MEWA, a level of regulation isn’t a bad thing. This keeps MEWAs for the people, businesses, and organizations that can benefit from them the most and use them properly.

When determining your eligibility for a MEWA, your state’s laws regarding this kind of insurance plan will need to be checked. If your state does allow MEWAs, this can be an incredibly helpful opportunity for you and your employees.

MEWAs are member-owned, so the rewards and the risk are contained in that particular group of employers or associated organizations. This allows for a dissemination of pressure if there are a lot of claims one year and not the next. A MEWA is set up to be regulated, but also to give employers the ability to control their own health insurance options and not be vulnerable to the changes in the government-run health insurance exchange.


Other brokerages take a cookie cutter approach to insurance and outfit their customers with generic coverage.  Skyline is different.  We believe insurance should be built on innovation and experience. We appreciate the fact that every engagement is unique and understand proper coverage requires a deep understanding of the underlying business and individual.

"The opportunity to safeguard your concerns is a privilege we never take for granted."

Health Insurance Relief for NY Business

Health Insurance Relief for NY Business

Finally some good news for New York business owners actively insured in the small group commercial health insurance market. Effective April 1, 2017, businesses with 1-99 employees will now have 7 health insurance carriers to choose from, which is almost double what the market offered in 2016. In January of 2017, New York welcomed Empire Blue Cross Blue Shield, which was the first of three new carriers to enter New York’s commercial health insurance market. Just recently, both Healthfirst and Oscar health insurance companies also announced that they will be participating in New York’s commercial health insurance market beginning on April 1, 2017. Here is what you’ll need to know about these two new carriers: 


Healthfirst is a not-for-profit managed care organization sponsored by several prestigious and nationally recognized hospitals and medical centers in New York. Currently, Healthfirst is a major player in the New York individual market offering Medicaid, Medicare Advantage, Child Health Plus, and Managed Long Term care plans for more than 1.2 million members in downstate New York.
Healthfirst’s history in New York indicates a strong track record and has analysts optimistic regarding the carrier’s decision to join the New York commercial health insurance market.
Fun Fact: Healthfirst plans are the only plans in the NY small group market offering dental insurance as additional insurance for no extra cost. When you buy your health plan it comes with a complimentary dental plan at no cost.


Similar to Healthfirst, Oscar has made their reputation in New York’s individual health insurance market. Know for its cutting edge technology, Oscar appeals mainly to a millennial business demographic, keen on simplicity and innovation. Oscar has made an emphasis on enhancing the member’s experience and has created a mobile application allowing users to:

  • Search for symptoms, providers, and drugs
  • Use Doctors on Call to talk with a doctor over the phone at anytime
  • View you Oscar health history
  • Send questions to Oscar’s customer care team
  • Access your digital ID card

The Oscar mobile application also rewards members:

  • Track your steps and earn rewards for just hitting daily goals and staying active.
  • By connection to Apple’s Health App, you can see all your steps tracked by your phone and compatible step tracking devices, and get rewarded for your hard work.

Customer Reviews: “Tracks my steps to earn Amazon rewards, links to my watch’s app and account for the steps my watch records.”

Both of these carriers will be available effective April 1st, 2017. It is okay to switch carriers during your plan year. If you are currently insured you do not have to wait until your renewal to change carriers. If you have questions and/or would like to see if these rates and plan designs work for your business please contact Skyline Risk Management, Inc. at (718) 267-6600 for consultation.  

If you have questions and/or would like to see if these rates and plan designs work for your business please contact Skyline Risk Management, Inc. at (718) 267-6600 for consultation.  

Diving into the Dynamic Behind Self-Funding and Voluntary Benefits

Diving into the Dynamic Behind Self-Funding and Voluntary Benefits

Employers have changed how they view health care plans. With all the reforms and high costs, companies struggle to cope with the ever-changing landscape. Employers create benefit plans with employee retention and cost control on their minds. However, many forget about a little helper called voluntary benefits.

Nearly every employer looks to achieve these goals with health care. Offer great benefits to employees without breaking the bank. Many companies achieve this noble goal by using a self funding approach that features a high-deductible. Often, these companies are larger. Recently, smaller companies have taken this approach, too.

The Self-Funding and Voluntary Benefits Dynamic

When paired with voluntary benefits, employers reduce costs greatly while still giving their employees the type of insurance they need. Plus, employees can tailor their coverage with a variety of options.

So why have employers started going the self-funded route? That's simple. Health care costs are rising. By using self-funded services, a company can keep medical expenses down.

What Does Self-Funding Offer?

Self-funding may sound nice in theory, but it's important to understand what self-funding allows employers to do. Overall, an employer can:

1. Control Costs: Self-funding allows employers to control costs, with funding amounts that are pre-determined. This ensures the profit margin of the insurance company is cut down.

2. Protect the Plan: Using stop-loss insurance as an employer can ensure no catastrophic claims exceed the pre-determined amount in their self-funded plan.

3. Only Pay Actual Claims: Instead of paying the margin created by an underwriter, a self-funded plan allows the company only to pay medical claims that actually happen.

4. Keep Track: A self-funded plan ensures an employer can keep track of the plan and accounts. By keeping statistics year after year, an employer can plan for the future management of their self-funded program.

5. Further Savings: Certain self-funded plans save even more money by utilizing a predictive analysis to determine health and wellness. A third-party administrator usually administers this.

Lastly, many companies prefer self-funded plans because they may not be subjected to Obamacare regulations. Since they do not have to follow all the regulations of the Affordable Care Act, the company can tailor plans to the needs of specific employees and groups.

Adding Voluntary Benefits to Self-Funding

Once an employer has a self-funded benefits plan, they can begin to allow voluntary benefits. Voluntary benefits complement the plan and allow employees to meet their every need – without adding unnecessary costs to the plan.

By combining these two options, employers allow their employee the ability to customize the benefits to their unique needs. The benefits of this methodology are vast and allow companies and employees to account for expenses in a detailed manner.

Always Be Communicating

No matter how a company offers health insurance, communication is key. The majority of employees are tired of spending so much money on health care. As well, most have concerns about how the changing health insurance market and reform will impact their families and pocketbooks.

Studies have shown that 95% of employees need an individual to talk to them about benefits information. This means your employees need to speak with an administrator. They want to keep communication lines open when they have questions and want access to resources.

Communication is especially needed when a company offers a self-funded plan with voluntary benefits. The variety of options and costs can be confusing – so being able to communicate with an administrator is key.

A Winning Combination

Employees want great benefits and lower costs. Most companies want similar things in regards to health insurance. As such, many have found self-funded plans combined with a myriad of voluntary benefits options to be a dynamic insurance duo.

For more information about self-funding contact Skyline Risk Management, Inc. at (718) 267-6600. 

4 Reasons Women Must Have Life Insurance

4 Reasons Women Must Have Life Insurance

Women have been changing their roles in the home and at work for decades now. They have found that more opportunity and options are available to them now than before. These days, we see women with full-time careers and women who take care of the home full-time – and pretty much everything in between.

Women have found a new work-life balance that was never available before. Due to these factors, many females also have found solvency and greater financial independence. However, there seems to be one huge gap in some women's financial plans.

Do Women Need Life Insurance?


Many financially independent women do not have life insurance. While certain insurance policies like health, homeowners, and auto insurance are necessities, many females forget about life insurance; like most men do. LIMRA found that nearly 48% of women do not have any life insurance. This could be problematic.

Here are four reasons why women must have life insurance:

1. Income Replacement

While it may be unpleasant to think and plan for one's death, life insurance is an easy way to ensure your family won't have financial worries when you pass, as they'll already be mourning your loss.

Life insurance covers funeral costs and more. For full-time homemakers, the cost of paying someone to handle the household duties is often covered under a life insurance policy. As hiring a maid or caretaker can be costly, this could be a substantial help to a family.

For women with full-time careers who have an income that supports a family, a policy can cover funeral expenses along with other day-to-day living costs. These type policies could ensure your family doesn't miss a beat if you were to pass.

2. Financial Gains

Life insurance policies tend to gain financial value over time. For women, your employment or marital status rarely matters when talking about life insurance plans. Agents should understand that this is even more important for women making more than their spouses.

3. Protect Her Interests

There can be situations where a woman does not need life insurance. If she is single without children, then life insurance could be put off. However, certain circumstances permit taking out a policy.

For example, a single woman may consider a life insurance policy if she has a lot of debt and someone co-signed for her loan. By doing so, she could protect the co-signer from taking her debt if she passes.

As well, a woman who is taking care of an aging or ill family member may benefit from taking a life insurance policy. Many policies cover those she cares for if she were to pass.

4. Less Expensive For Women

Life insurance policies and premiums are typically priced based on life expectancy for age groups and genders. As such, women typically pay less than men. This is due to the fact that men have shorter life expectancies on average. Women tend to outlive males by nearly five years.

One of the main contributing factors to gender lifespan is cardiovascular problems. Women tend to avoid heart attacks and strokes earlier in life. Men typically find these problems at a younger age than women.

What is the right life insurance plan for me?

There's no exact math when looking at life insurance. Each woman will have different wants and needs. On average, a woman will want to purchase a life insurance policy 5-15X her income at the moment.

For example, if a woman is making $100,000 per year, then she could purchase a life insurance policy from $500,000 to $1,500,000. Her needs, family, and age will contribute to what type of coverage she chooses. A young, single woman may only want 5X her income in coverage, but a married woman could want up to 15X her income. 

For more information on life insurance contact Skyline Risk Management Inc. (718) 267-6600 to voice your concerns. 

Replacing Obamacare Will Be Harder Than Any Republicans Thought

Replacing Obamacare Will Be Harder Than Any Republicans Thought

President-elect Donald Trump has made many promises as he campaigned for the Presidential election. While no one knows which promises he'll keep and if he'll be able to accomplish many of them, repealing the Affordable Care Act will be difficult. Here's why:

The Repeal

It took President Obama several years to create and complete Obamacare. The system is vast and complex. Plus, it took years just to approve the legislation before any implementation could be completed. Repealing the system is not going to happen overnight.

Millions of people utilize Obamacare. And many Republicans agree that instantly repealing the system could cause a shock to the industry – and not in a good way. No matter what happens, most predict change is inevitable.

Trump could sign a repeal of Obamacare in his first days in office. Then ensure it doesn't go into effect for some time. This would allow Republicans to draft complex plans and policy for the replacement of the Affordable Care Act. Everyone in Congress is confident that repealing the act will be much easier than replacing it.

For example, certain provisions will be included in the new health care laws and mandates. Many Republicans, including Trump, like the age provisions that allows young adults to stay on their parent's insurance plan. Other Republicans are found of provisions that offer guaranteed coverage to all.

Health Insurers & ACA

Health insurance companies are essentially playing a waiting game at this point. The Affordable Care Act was a complete and utter shock to the industry. Many insurers struggled to cope with the various regulations and costs. However, now that the act is in place, things seem to be running smoothly.

Repealing and replacing Obamacare will be anything but smooth. Many health insurance companies are crossing their fingers in hopes of a minor disruption. Most people in the industry don't want to see the shock and chaos that implementing Obamacare brought just a few years back – again!

Getting Into the Details

Obamacare, repealing, and new replacement legislation is going to get tricky. For instance, most believe that guaranteeing coverage for pre-existing conditions is an important piece of legislation. However, many argue that the mandate requiring all Americans to have health coverage is unjust.

Alternatives to the mandate have been discussed. However, most agree that the financial penalties found in the mandate ensure more Americans get coverage. Without the financial penalties, there would be many people who wouldn't buy coverage

Many Republicans, like Speaker of the House Paul Ryan, have proposed similar legislation to Obamacare. He'd like certain people to receive tax incentives to help people afford the type of coverage they need. He's also interested in protecting people from rising rates for illness – when they maintain continuous health insurance coverage.

Breaking Records

While Obamacare has taken certain hits here and there, the people of the United States have hit a record low of uninsured. More people have coverage in the United States than nearly ever before. In this way, the Affordable Care Act was a success.

Not every aspect of Obamacare has been successful, though. Major insurance companies like Aetna and UnitedHealth Group both withdrew from the program. Premiums have skyrocketed, too. Plus, many Obamacare plans feature high deductible – ensuring many couldn't afford care if they got ill.  

The Reality of Obamacare

The Affordable Care Act will be repealed. With Trump as the President and a Republican House and Senate, the legislation doesn't stand a chance. The reality of the situation is this:

Once the bill is repealed, Republicans and Democrats will have to work together to replace the parts of Obamacare that everyone agrees on. It will take time, a lot of time – as that's just how things work in Washington. Hopefully, the time and change won't have too negative of an effect on the health insurance industry and the American public. 

For more information about health insurance contact Skyline Risk Management, Inc. - (718) 267-600.

What is Long-term Care Insurance?

What is Long-term Care Insurance?

There are roughly 76 million baby boomers in the United States with an approximate average age of 60 years old. It is no secret, as people age, they may require assistance for activities of daily living. Understanding this concept and considering the large population of aging baby boomers, insurance carriers have created a product to help reduce the costs of long-term care. This product is called long-term care insurance (LTCI) and this article well help educate anyone who is considering purchasing this product. 

What is Long-term Care Insurance (LTCI)?

Long-term Care Insurance (LTCI) is an insurance product, which helps to cover the expenses associated with long-term care beyond a predetermined period of time. People who require long-term care are those who have an inability to preform two or more basic activities of daily living.

Activities of Daily Living (ADL):

1. Mobility - ability to "transfer" your body. For example, a persons ability to walk or get out of bed. 

2. Bathing & Showering - the ability to shower yourself

3. Dressing - the ability to dress yourself

4. Feeding - the ability to feed yourself

5. Personal hygiene - the ability to brush your teeth, comb your hair, and other grooming practices. 

6. Bathroom - the ability to use the bathroom independently. This includes being able to get to the toilet and your ability to get up off the toilet. 

If a person is unable to complete two or more of these activities of daily living (ADL) then they are eligible and would certainly benefit from long-term care. 

Who does Long-term care insurance (LTCI) benefit?

Long-term care insurance has many benefits for various people. A common misconception is that long-term care insurance is a benefit only for the person in which the policy is meant to insure.

This is not the case!

Actually, the family members of the insured are the ones who benefit the most. In many cases, long-term care is expensive so when a loved one is no longer able to perform two or more actives of daily living the responsibility of caring for this person often falls to family members. Depending on their financial situation, some families cannot assume this responsibility and cannot afford to hire professional help. 

By purchasing LTCI a person is not only protecting themselves but also the financial well-being of their loved ones.

What does Long-term care insurance (LTCI) cover?

Long-term care insurance covers certain expenses for those who participate in any of the following care facilities:

  • Home Care - this allows a person who requires help with ADL to receive aid right in their own home.
  • Adult Daycare - this is a non-residential facility, which caters to adults who require help with ADL.
  • Hospice care - this services provides care to support people with advanced or terminal illnesses. 
  • Nursing homes - private institutions, which provide aid for elderly people and/or people who require help with ADL.
  • Assisted Living  - provides housing for elderly people and/or people who require help with ADL.
  • Respite Care  - temporary care for a person who requires aid with ADL.

Does my health insurance and/or medicare cover long-term care insurance?

No, traditional health insurance and medicare does not cover you for long-term care. Although under certain financial circumstances medicare may cover a portion of long-term care, an individual will still have to cover the costs of the majority of long-term care expenses themselves.

There is a price associated with everything. The important thing to remember is that if you require long-term care this could really become a financial burden to yourself and your loved ones. Be prepare, be protected and please do not underestimate the impact of long-term care insurance. 

For more information contact Skyline Risk Management, Inc. at (718) 267-6600.

Common Life Insurance Beneficiary Blunders

Common Life Insurance Beneficiary Blunders

It is no fun to think about the day when a life insurance policy will need to go into effect, but it is even less fun to think about a day when a life insurance policy or a day when a life insurance policy goes into effect but does not benefit the beneficiaries that the insured had intended to designate. In listing the beneficiaries on a life insurance policy, the manner in which one lists the intended recipients of the policy can make a big difference in who, if anyone, actually receives the money. In taking a look at some of the most common discrepancies that can arise during a life insurance policy payout, one can avoid making some of the common mistakes.

The first thing to know is that not only does a life insurance policy have the ability to have more than one beneficiary; it really should have more than one beneficiary. In fact, a life insurance policy can have up to three "classes" of beneficiaries whereby if the person, people, or entities named in one class are all deceased, the benefits would then be paid out to the next class of beneficiaries. By listing multiple classes of beneficiaries the insured ensures that they still have some say in who the policy funds go to if those for whom the policy was intended have passed.

Listing a loved one by relationship

The way in which you list a loved one on the insurance policy can be one of the biggest roadblocks to the benefits payout. The wording is crucial when naming a benefits recipient because, depending on the words you choose, the beneficiary may change. You can opt to list a beneficiary by their relationship to the insured or by their name. Each has its benefits and drawbacks. If you choose to list by relationship, then whoever currently holds the role when the insured dies will be the one to receive the policy benefits. If you list “wife” as the beneficiary, for instance, it would consider the spouse at the time of death as the beneficiary but exclude any former spouses. It can be convenient if that is the insured’s intention, but you also run the risk of unintentionally excluding a loved one from coverage due to a relationship change.

Listing a loved one as a group

The clearest and most common example of listing beneficiaries as a group is naming the insured's children as a class. While typical parent-child relationships do not legally change over time, the definition of "child" can create problems. In situations where step-children, adopted children, and children born after the insured's death come into play, the meaning of the word child can become unclear and again the policy may end up excluding someone that the insured did not intend. On the flip side, there are also benefits of listing one's children as a group as it would also include any children that were not currently born when the beneficiaries were listed.

Listing a loved one by name

Listing a loved by their name provides a clear idea of exactly who the insured would like to receive the policy payout. In most cases, this is the best way to make sure that the policy upholds insured's intentions. However, there is still risk in specifically naming beneficiaries as well if the insured forget to update the list when new meaningful relationships develop, such as new children or a new spouse.

Many other issues can arise when listing beneficiaries on a life insurance policy, but one clear solution to mitigating those problems is to make sure you are incredibly specific when designating beneficiaries.  The more specific you are in who exactly is to benefit from the policy, the less likely any discrepancies will arise.

For more information contact: Skyline Risk Management, Inc. at (718) 267-6600

Why The Open Enrollment Process Brings In the Cybercriminals In Droves?

Why The Open Enrollment Process Brings In the Cybercriminals In Droves?

Doing business in the modern marketplace requires small business owners to take on more risk than ever before. With more and more personal data and credit information being collected every day, small businesses take on more legal responsibility than they ever have – in the history of doing business.

More companies continually fall prey to cyber attacks, data breaches, and more each week. Criminals have realized that stealing data is a better business model than stealing cash or product. There seems to be no end in sight for business owners and the hackers who attack their data.

Think Like a Criminal to Prevent Attacks

Most data attacks center around information that can easily be converted to cash. Criminals pay top dollar for freshly stolen card numbers and more, but once the information is no longer fresh – it quickly loses value. And while data breaches tend to linger on for over six months, the data doesn't have value for that long.

Hackers work hard to get as much data as possible in a quick manner. Then they try to turn that information for profit rapidly. So these hackers try to attack businesses when they're getting a lot of information at once. Businesses are most vulnerable when there is a huge influx of information at once.

The biggest data breaches for all industries tends to occur at two times a year: holiday season and tax time. These times are when many businesses see the most transactions and when the most personal information is available.

A New Issue

Other industries seemingly being hit hard by hackers are health care and insurance. As electronic health care records become more common, one can expect more attacks. So let's look at when the health care industry is the busiest. Let's apply our thinking like a criminal to these industries.

The health care and insurance industries in particular, see the most personal data during one time of the year: the open enrollment period. During these periods, hackers have huge opportunities to steal information from:

  • Call centers
  • Online forms
  • Questionnaires
  • Databases

…And more!

We have seen an increase in attacks during open enrollment periods and expect more in the future. It is important for all business owners to be extra diligent during these periods and focus on protecting information.

What To Do

The easiest way to limit your vulnerability during these times is to stay lean. If you don't absolutely have to have the information, don't store it. Don't store or save information that isn't vital. By doing this, a hacker won't have as many access points into your systems.

You should also focus on minimizing risk when collecting necessary information. For example, if a customer is speaking with a call center representative, you can have the customer enter private information info the keypad of their phone instead of saying it out loud to the representative. This way the information is never on the call center server and is automatically sent to a secure server.  

No matter what, you need to stay diligent about storing your customer’s information and pay attention when your busy season occurs. The more information you store and process, the more likely you'll be hacked. So store only the necessary information and quickly get the info to a secured server.

Worried about your exposure to cyber criminals, or just feel like you need better security protocols for your business? Call Skyline Risk Management, Inc. at (718) 267-6600 to voice your concerns. 

How To be Healthy and Save Money on Health Insurance

How To be Healthy and Save Money on Health Insurance

Have you ever heard of a Gym Reimbursement?

Many health insurance carriers offer a gym reimbursement option, which is an incentive for a healthy lifestyle.

The trade-off is simple!

Health insurance carriers offer to reduce health insurance premiums if the person who is insured consistently goes to the gym. Requirements vary depending on the insurance carrier.

The requirements for United Health Care Oxford in 2016 are:

“1. Visit the gym – You must complete a minimum of 50 visits per six-month period. Reimbursements will not be issued until six months have passed, even if 50 visits are completed sooner than six months.”

(For more information about Oxford Gym Reimbursements Click Here)

To find out how much you can save you should contact your health insurance broker or plan administrator.


Why Should Employers Care?

Employers should care about gym reimbursements for 3 reasons, which include premiums, claims, and culture.

1. Premiums:

Employers have a significant upside for encouraging gym reimbursement participation. Companies electing to pay for employee benefits, including medical will benefit from a premium reduction for all employees who decide to participate. For an employer who pays for the medical benefits of its employees, encouraging gym reimbursement participation is a great way to offer essential benefits while also cutting costs.

2. Claims:

Encouraging healthy habits can be a great way for employers to save money on claims. This is especially important for companies who elect to offer self-funded medical benefits. Self-funded medical benefits are benefits offered by the employer at a lower premium. In a Self-funded plan the employer assumes responsibly if anyone on the plan submits a claim. To offset this risk employers collect a portion of the premiums, which is allocated specifically in the event that a loss occurs. 

For employers who elect self-funded medical insurance reducing claims is essential. Utilizing a gym reimbursement option is a great way for employers to help their employees stay healthy and hopefully reduce claims.

3. Culture:

Culture is a key factor for a prospective employee when deciding to join an organization. Employers can enhance the attractiveness of their organization by establishing a healthy work culture. A prospective employee understands the commitment of joining a new company. There are a lot of unknown factor and risks involves, however having an upbeat and healthy workplace is a great way to reinforce the positive experience of working at your company.

SKYLINE's Bottom-Line

The bottom line is this… Why not encourage employees to utilize the gym reimbursement program offered by your business’s healthcare carrier? The carrier, employer, and employee all benefit! If you are a leader in your organization with the power to reduce premiums, claims and enhance the well-being of your workforce wouldn’t you promote this?

For more information about your business's gym reimbursement program, or for more ways to add benefits to your organization, contact Skyline Risk Management, Inc. at (718) 267-6600.

Making the Most of Benefits Integration

Making the Most of Benefits Integration

Businesses are always concerned with the bottom line. It's a part of being in business. The goal is to generate as much profit as possible. While increasing revenues are essential to this aim, one's bottom line can see a huge bump by keeping employees healthy, free of injuries, and at work as much as possible.

One way to encourage employees to continually come to work stems from benefits integration. By combining absence management programs and disability benefits, many companies can find a cost savings advantage.

If the employer adds a wellness program into this mix, the company may see added benefits. Wellness programs have been proven to rapidly improve the health of employees after implementation.

Integrating Benefits For Good

Cost savings isn't the only reason to combine benefits. Many companies have seen compliance risks eliminated due to integration. When programs are segregated, and administration is not properly aligned, a company puts itself at risk of making compliance errors. And these errors can be costly.

If a company does not integrate their benefits, then numerous claims could all be made at different times for the same injury, including:

  •  Workers' compensation
  • Family and Medical Leave Act time
  • Short-term disability

For an example, let's look at someone who had surgery. The first eight weeks they are out stemming from the surgery could be on a workers' comp claim. Once they come back from that claim, they could use an additional 12 weeks by filing for FMLA time.

Instead, an employer can run both of these claims concurrently – limiting the time away from work for the employee to 12 weeks, not 20. This is one of the easiest ways for employers to lower their lost time rates. Implementing a few return-to-work programs has also shown benefit to some companies.

It's important to remember that benefits integration will work differently for every company. Each employer has a variety of factors to consider before implementing any integration programs.

A Focus On Wellness

While limiting lost time rates is vital to improving profitability, some employers are taking a different route. Many companies have begun to focus on keeping employees productive by keeping them healthy.

Many wellness programs promoted by employers are focusing on helping employees with illnesses become healthier. Standard concentrations of employee health programs include diabetes, heart disease, and more.

Employees with diabetes, cost employers 2.3 times more on medical coverage. This hurts profitability. So wellness programs aim to limit the impact of such illness by incorporating recreation centers, trainers, desk exercises, health assessments, and more.

Many employers also offer employees with diabetes free testing supplies, monitoring, and more. Some companies even provide a reduction in employee health care premiums – if the employee takes part in the wellness program.  

How Your Business Can Make the Most Of Integration

When increasing profitability is in the cards, companies will pull out all the stops. From wellness programs to benefits integration, employers have many ways to bump the bottom line without increasing revenues.

From an insurance standpoint, wellness programs offer great benefits to employers and employees alike. Combining benefits like workers' comp and short-term disability eliminates employees taking advantage of the system. Employers also benefit from wellness programs as it covers their compliance when integrating.

Health Insurance 101: Lowering Premiums

Health Insurance 101: Lowering Premiums

Obamacare Tax Penalties

Obamacare Tax Penalties

We’ve all been there, "My health insurance premium is too high and I am sick of paying every month for coverage I never use!" I have heard it a million times and when clients tell me that their health insurance it too high I don’t argue with them because THEY ARE RIGHT! Unfortunately since the emergence of Obamacare healthcare premiums increased.

ATTENTION: Did you know that since 2014 all Americans are required by law to have health insurance, and if they don’t have health insurance they have to pay an Obamacare tax penalty? It may not seem fair but the Affordable Care Act was implemented to make healthcare more affordable and accessible by obligating all Americans to purchase health insurance.

In response to these laws this article has been created to help Americans learn more about purchasing health insurance.

First off, what is a premium?

A premium is the cost a person pays to obtain insurance. Dependent on the type of insurance, premiums may be paid in a variety of ways including monthly or annual payments. Typically health insurance in New York is paid on a monthly basis.

Premiums should have an impact on a person’s decision to buy health insurance, however it should not be the primary factor dictating what plan you choose. In order to fully appreciate higher or lower premiums a potential health insurance purchaser needs to understand the premium, deductible and co-pay relationship.

A good health insurance broker will present three options when offering a health insurance plan. These plans include a high, medium, and low option, which are commonly referred to as Platinum and Gold for the high option plans, Silver for the medium option plan, and Bronze for the low option plan. A broker may not offer all plan tiers to a potential purchaser if the broker feels that the purchaser has no desire to purchase a certain plan, in which case they may elect to exclude it from the proposal. Regardless at the time of proposal three plan options are usually presented. 

What is a deductible?

A deductible is the specified amount of money that a person must pay before an insurance company will pay a claim. For example, I have health insurance with a $5000 deductible and I have a procedure, which costs $10,000. I am responsible for paying the $5000 deductible before my insurance kicks in and pays the difference.

A higher deductible means that in the event of medical necessity, a person must pay more money out of pocket than they would if they had a lower deductible.

What is a co-pay?

A co-pay is the cost associated with a health insurance policy, which a person must pay if they visit a doctor or specialist. For example, I have a health insurance plan which has a $20 co-pay for both my general physician and specialist. If I go to my physician or specialist I have to pay $20 because my copay is $20.

How the Premium, Deducible, and Copay Relate:

This diagram represents an example of some of the features presented on a health insurance proposal.

This diagram represents an example of some of the features presented on a health insurance proposal.

High Option:

  1. Deductible - $1,000
  2. Primary Care (Co-pay) - $25
  3. Specialist (Co-pay) - $40
  4. Premium - $750.40

This option has the lowest deductible at $1000 and has co-pays of $25 and $40 dollars. The reason that this option is the high option is because it has the highest premium, which is dictated by the plan's low deductible and low co-pays. This plan is good for someone who plans on visiting their doctor or specialist regularly throughout the year. Examples of medical specialists induce:

  • Addiction psychiatrists
  • Allergists
  • Cardiologists
  • Dermatologists
  • And more...

Medium Option:

  1. Deductible - $1,250
  2. Primary Care (Co-pay) - $30
  3. Specialist (Co-pay) - $60
  4. Premium - $747.27

The medium option has a deductible of $1,250 and co-pays of $30 and $60 dollars. This option is a good choice for someone who doesn’t visit the doctor’s office regularly but wishes to have a lower deductible in the event of a medical emergency.

Low Option:

  1. Deductible - $2,000
  2. Primary Care (Co-pay) - $40
  3. Specialist (Co-pay) - $70
  4. Premium - $654.16

The low option has a deductible of $2000 and co-pays of $40 and $70 dollars. This plan is good for a person who wishes to have health insurance instead of paying the Obamacare tax penalty and who doesn’t feel the need to visit their doctor or specialist regularly. This option has the lowest premium and has a higher deductible and higher co-pays. 

Wrap Up

                People are always complaining about the premiums of their health insurance plans. What they often fail to understand is that the premium reflects the deductibles and co-pays they elected in their coverage. BE SMART and ask your insurance broker about ways to strategically alter your health insurance to customize a plan with deductibles and co-pays that fit your budget.

If you have questions about health insurance and ways to lower your premium for yourself, or your business, contact Skyline Risk Management, Inc. today at (718) 267-6600 to voice your concerns. 

Americans Still Underestimate the Risk of Disability

Americans Still Underestimate the Risk of Disability

Most people lock their doors when they leave the house and when sleeping. You probably brush your teeth on a daily basis to prevent cavities and gum disease. Wearing sunscreen is commonplace when enjoying the great outdoors. Going to the gym ensures one becomes healthier and happier. The risks of not going to the gym outweigh the pain of the gains for many.

While Americans are relatively cautious in certain ways, some fail to realize the actual risk of disability. Research has shown only 40% of Americans hold some form sort of income protection stemming from in the form of disability insurance. This means three out of every five people you work with won't receive an income if they become disabled in the future.

Statistics Meant to Scare

Think about this: the risk of having your home broken into is one in 36, but the risk that a 20-year-old today will find themselves disabled before they retire is one in four. You're nines times more likely to become disabled than your to have your home broken into,. yet, everyone has insurance against robberies. Meanwhile, Only only 40% of individuals are protected against disabilities.

Understanding Insurance in the United States

Americans protect their families and assets with a variety of insurance policies. With the variety of policies and plans available, you can cover nearly every one of your bases these days. Nearly 87% of Americans have health insurance. Over 71% of us have rental or homeowner's policies. Even 61% of the people in the United States have dental coverage.

However, only 40% of people have disability insurance. It's hard for to come to grips with this statistic. , especially when Dental dental plans are not more important that than disability coverage.

For the Family

Americans value family. You value your family – just like everyone else values their loved ones.  And no one doubts that income is a vital aspect of a family's overall well-being. One in four people knows they could not cover their bills and family expenses for even a one month if they didn't have income,.  yet, most people refuse to protect their income against disability. That's a significant risk many take, and one that could easily be avoided with proper disability coverage.

Employers Have a Role

Dental coverage can be cheap, especially when it's tacked on to the end of a health plan filled with benefits. Thus, many employers offer dental coverage, and many Americans keep their teeth clean. However, Disability disability coverage is different. Many find disability insurance a bit pricier than other complimentary complementary policies.

For this reason, many employers skimp on the disability component of insurance coverage or do not encourage employees to sign up. Don't let this happen! Individuals cannot protect themselves against threats they aren't planning on, a. And most people don't expect to become disabled.

Take Things Into Your Hands

It's imperative to inform employers of the importance of disability coverage for their employees. Make sure you employers understand the grave financial disaster one's that can befall a family can incur if disability strikes you.

Employers can benefit by integrating medical benefits and disability insurance. In doing so, many employers find employees getting back to work sooner after injuries and illnesses. If your company is looking to control absenteeism, this could be the perfect solution.

Ultimately, disability insurance offers Americans an important step to fully protecting their income against disaster, illnesses, and injuries. Disability policies have helped many avoid bankruptcy and offer great peace. 



" 1 in 4 people currently at 20 years of age will become disabled before they retire"


If you have questions about critical illness policies contact Skyline Risk Management, Inc., (718) 267-6600 to voice your concerns. 


6 Factors Driving Critical Illness Insurance

6 Factors Driving Critical Illness Insurance

In recent years Americans have expressed a growing interest in critical illness insurance policies. Now more than ever, Americans desire coverage for critical illness due to the increase likelihood of critical illness and the devastating affects it has on families and friends. 

So, what's driving the surge in critical illness insurance?

1. Living Longer

The average lifespan for both men and women has been steadily increasing over the years. Currently, the Center for Disease Control lists the average life span of an individual in the United States at nearly 79 years. That's a long time! For men, the average life expectancy is around 76. American women live to be 81 years on average. Compared to 1950, when the average life expectancy was around 71 years, that's a significant improvement.

2. Living With Diseases

While we are living longer as a society, we are not living without disease. Many individuals suffer through their final years battling medical conditions like cancer, heart disease, dementia, and more. Luckily, modern medicine extends these people's lives, but there is still pain and suffering.

3. Cancer Is Rampant

Speaking of suffering, cancer rates have never been higher. While we are living longer, more people are suffering from cancer than ever before. Roughly 41% of men will face cancer at least one time in their lifetime. Around 38% of women will suffer similar bouts with the nasty disease.

4. Medical Expenses Sky-High

The continuous battle that many people suffering from cancer face does not come cheap. In fact, medical treatments when fighting illnesses like cancer, heart disease, or a stroke can wreak havoc on bank accounts and savings. An individual and their family can go bankrupt trying to afford the treatments that come with battling cancer, even if they have great health insurance.

5. Employer Provided

Due to the nature of these critical illnesses, many businesses have been providing their employees with critical illness insurance. The insurance product has gained steam as a protection policy against cancer, and many employees view the plan as an excellent perk in the benefits package. Around 45% of large companies have started to offer the policy – compared to just 34% a few years ago.

6. Financial Security

Ultimately, individuals and families find great value in critical illness insurance due to the financial security it provides them. Many people have been saved from bankruptcy due to their critical policy. The lump-sum payouts make a huge difference when paying for chemotherapy and for when other treatments become a necessity.

Critical Illness Policies for Your Clients

Ultimately, insurers should be offering critical illness policy to all customers of a certain age. The policies have helped many avoid bankruptcy and offer great peace of mind if an illness disaster strikes. If you have questions about critical illness policies contact Skyline Risk Management, Inc., (718) 267-6600 to voice your concerns. 

Directors & Officers are Targets for Lawsuits

Directors & Officers are Targets for Lawsuits

Any board member or company officer serving at a for-profit or non-profit company is at risk of being accused of wrongful misconduct when they are acting on behalf of the organization they represent. Directors & Officers Insurance (D&O) is the vehicle used to transfer this risk to an insurance company.

Most of these policies cover alleged wrongful acts that have taken place either before or during the policy period. Many policies that are purchased may or may not include coverage for "past acts", and for that reason, the applicant must pay close attention to the "retroactive date" listed on the policy. Since coverage is provided on a "claims made" basis rather than "occurrence" basis like other liability policies, a claim may be filed based on an alleged wrongful act that may have occurred several years before the current policy was purchased.

Policy Expansion

While historically only directors and officers were covered under the D&O policy, today many policies are expanded to include upper-level managers and non-executive employees. Also, the company itself can be offered coverage. Claims can be brought by stakeholders, customers, consumer groups, competitors, suppliers and government regulatory groups.

Typical exclusions include fraud, illegal compensation, intentional acts, pending and prior litigation, accounting profits and ERISA claims. The D&O policy will always exclude coverage that should be provided by another type of policy such as General Liability and Fiduciary Liability. Insurers may also exclude other items based on the claims history of the applicant.


The exact definition of a claim can vary among policies and insurers. In fact, some companies and policies do not define it at all. In most cases, a claim includes any type of written demand that accuses an alleged wrongful act by a director or officer acting in their capacity of such and seeks monetary or non-monetary damages.

Fortunately, the D&O policy will reimburse the company for costs associated with legal defense, investigation, and negotiating a settlement of a covered claim. The reimbursement will include attorney's fees, court costs and fees for expert testimony provided for depositions or during a trial. There will always be wording in the policy for "reasonable defense costs" to protect the insurer from paying for excessive expense costs. The carrier will also require advance notice of expense costs and demand that consent is given in advance.

Who Should Be Covered

Anytime an individual is asked to serve as a board member or officer of any organization, whether a major corporation, a church, or the town’s Little League, the risk of being accused of a wrongful act presents itself and should be dealt with by requiring the organization to purchase the proper D&O policy to protect you from the costs of possible litigation.

For more information about Directors and Officers Liability Insurance, contact an insurance professional at Skyline Risk Management, Inc. (718) 267-6600 to address your concerns. 

What Is EPLI and Why Should I Buy It?

What Is EPLI and Why Should I Buy It?

Every business that has at least one employee has an employment practices liability risk. Claims can be brought for many reasons and may typically include charges of wrongful termination, discrimination, sexual harassment and retaliation. In many cases the claims are based on “he said – she said” information but must be defended nonetheless. Even though most claims are filed against large corporations, every employer is at risk.

EPLI Provides Coverage against Employee Lawsuits Including Claims Of:

  • Sexual harassment

  • Discrimination

  • Wrongful termination

  • Negligent evaluation

  • Failure to employ or promote

  • Breach of contract

  • Wrongful discipline

  • Deprivation of opportunity

  • Infliction of emotional distress

  • Mismanagement of benefit plans

Typically, policies are rated based on your industry, the number of employees and claims history. The insurance policy is designed to reimburse for defense costs, settlement costs, and court judgments although they will not pay for punitive damages or civil and criminal fines.

Your Insurer Will Help Your Business

Most insurance carriers that offer EPLI will provide resources to the business in order to mitigate claims. If implemented properly, these mitigation resources will assist the business with reducing claims and can result in discounted premiums by:

  • Creating effective screening and hiring programs

  • Posting corporate policies in conspicuous areas throughout the workplace and placing them in employee handbooks

  • Offering a systematic process to file a grievance if the employee believes they have been subjected to sexual harassment or discrimination

  • Documenting everything that occurs and the process your company is taking to solve and prevent employee disputes

Many business owners make the mistake of purchasing EPLI after an action has been filed and then discover that coverage will not be available while the action is pending. When they are able to purchase coverage after an action has been resolved they will more than likely be surcharged for the previous action whether they were forced to settle or not. Knowing this, it is incumbent on every business owner to make this coverage a part of their insurance portfolio. Most Business Owner Policies offer an endorsement for EPLI; however as an endorsement, the coverage may not be as broad as in a stand-alone policy.

There are many reasons every employer should carry Employment Practices Liability Insurance, particularly in the litigious environment we are living and working in. Although many EPLI cases never make it inside a courtroom, there are, very often, settlements offered by the insurer. Even actions that appear without merit on their face must be responded to by a skilled attorney, which can become very expensive. Your EPLI policy will respond by paying your defense costs so that the company's bottom line doesn't take a hit every time a disgruntled employee claims they were harassed at the workplace or fired for no reason.

Who Should Carry Employment Practices Liability Insurance?

Any employer that answers yes to at least one of the following questions:

  1. Have you ever terminated an employee?

  2. Have you ever interviewed a prospective employee and didn't make a job offer?

  3. Do you currently have at least one employee?

EPLI is a very important coverage for any business with employees. Contact an insurance professional at Skyline Risk Management, Inc. (718) 267-6600 to learn more about protecting your business from your everyday risks. 

Why Break the Bank When You Can Borrow from Your Life Insurance Policy?

Why Break the Bank When You Can Borrow from Your Life Insurance Policy?

For most people, financial emergencies happen. Your water heater blows up; your transmission dies, or your roof leaks when it rains. We all know that we're supposed to have that "emergency fund" in our savings account, but sometimes everything comes at us at once.

Then you remember that insurance guy was telling you that you can borrow against your life insurance. Oh yeah! Yes, you can borrow against your life insurance because it's YOUR money.

There are, however, a few things to take into consideration.

Your Type of Policy

If you've been paying into your life insurance for at least a few years, the chances are good that there is some cash available to you, depending on the type of policy you purchased.

  • Whole Life - If you purchased a whole life policy then you will definitely have some cash available if you've owned the policy for three or more years. The key word here is "own". You must be the owner of the policy to access the cash value. If your Mom owns it and you are the insured, you'll have to get her to do it for you.
  • Universal Life (UL) - With UL or a similar version of UL, the rules are pretty much the same. If you are making minimum payments into the policy, it may take five or more years before your cash builds up to anything worth borrowing.
  • Term - If you opted for the cheap stuff, you're out of luck. Term insurance does not build cash value. Sorry.

The Next Step

Visit or call a life insurance agent and ask what your available cash value is. It's okay to let them know you want to take out a loan; it's your money, and they'll give you the advice you'll need. Your agent can check your cash value balance and also answer any questions you have about interest, repaying the loan, and how it might affect your policy. Typically, you'll be required to sign an authorization form for the insurance carrier, and your check will arrive in about seven to ten days.

The process for borrowing against your life insurance is pretty simple, as it should be. Your agent told you about this benefit, and now you're just exercising your right to borrow. There are, however, some pros and cons when borrowing against your life insurance.


·         No credit check. You're borrowing your money. No credit needed!

·         Favorable Interest - In most cases the interest on a life insurance loan is lower than the interest charged for a personal loan or a cash advance against your credit card.

·         Payback on Your Terms - Since you are lending money to yourself, you decide when and how you'll repay it, if you repay it at all. Typically, the insurance carrier will add unpaid interest to the loan balance each year. This will be shown on your annual report.

·         Your Choice Where You Spend - There are no limitations on where you spend the borrowed funds. You can buy a new water heater for your home or go to Vegas. It's completely up to you.


·         The death benefit of your life insurance will be reduced by the amount of any outstanding loans until the loan and interest are repaid.

·         If you elect not to pay the interest when due, the amount will be added to the balance of your outstanding loan.

·         For policies that pay dividends, your dividend amount will be reduced because of the outstanding balance of your loan.

·         Policy Lapse - If your policy is a Universal Life Policy, the interest that is credited to your account is based on the cash value of the policy. The lower the cash value in your policy, the lower amount of interest will be credited. Since Universal Life Policies rely on interest to keep them in-force in the later years, it is possible that your policy may lapse if the interest credits are significantly reduced.

When you purchased your life insurance, your agent probably told you about cash value and how you can access it during your lifetime. If that time has come, contact Skyline Risk Management, Inc. by calling (718) 267-6600 to get the information you need to make an informed decision.