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Healthcare Compliance

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.


THE SKYLINE DIFFERENCE

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."
 
 
 

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.

Affordable Care Act Marketplace Competition Getting Slim

Affordable Care Act Marketplace Competition Getting Slim

Those who are taking advantage of the Affordable Care Act may find themselves with fewer choices in carriers. Three major insurance companies are pulling out of the marketplace, and this can leave some counties with only one carrier and others with only two.

Why Are Insurance Companies Pulling Out of the Marketplace?

This lack of competition as far as insurance companies goes is largely due to a lawsuit that the Obama administration is part of in trying to prevent two major insurance companies from coming together into a merger. The administration contends that it would harm the competition. One of the companies, Aetna, had previously said that they were going to expand the plans that they were going to offer in the marketplace. However, after the lawsuit was filed, they decided to exit the marketplace in most areas of the United States.

The other company involved in the lawsuit, Anthem, has not said that they are pulling out of the state marketplaces. However, it has hinted that it may leave in the future, simply because of the money lost on its Obamacare claims last year.

Completely separate from the above legal battle, the largest insurance company in the country, United Healthcare, reduced its offerings in the marketplace to just five states. This comes after seeing hundreds of millions of dollars in losses in plans and claims over the last few years.

Some Areas Worse Than Others

Some areas of the country are seeing a lack of competition more than others. This is especially true in the South. In fact, South Carolina and Alabama are finding that none of their counties have more than one carrier option; North Carolina, Georgia, Florida, and Mississippi are seeing this in the majority of their counties as well. The only state not seeing this trend in the South is Arkansas. Every county in this state has at least three different carriers to choose from in the marketplace.

Research Finds Some Good New About ACA

A study released recently by the University of Miami School of Business had some good news about the Affordable Care Act (ACA). Based on over 100 other studies of the ACA, it was found that approximately 20 million Americans had received coverage through the ACA. It broke down to 11.7 million receiving coverage through the marketplace, almost 11 million receiving coverage through Medicaid, and 3 million young adults being able to stay on their parent’s insurance.

On the other side of the coin, this research study found that there were not enough providers that accept ACA plans. Almost 40 percent of Americans still say that they have an issue getting health care access, and this is especially true for those who are impoverished or people of color.

More Work Still to Do

The Affordable Care Act is a mix of good and bad, but it has given many Americans access to health care for the first time ever. Unfortunately, however, it sounds like it is time for some attention to be given to the plan to ensure that it continues to work for Americans now and in the future. 

Are you an employer or employee struggling to adapt to Obamacare? Contact Skyline Risk Management, Inc. at (718) 267-6600 to voice your concerns. 

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.