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Issue: # 122
May 7, 2015
  
Liam the fist bump kid trailer for ESPN E:60
 

Dear  :     

 


We are currently waiting for 3rd quarter rates to be approved by the Division of Insurance.  SO, if you are a July renewal, we are still on hold.  Renewals look a little different this year alsoas the new 4 tier rate configuration is now in force.  This means from the employer perspective, you will have to look at the group total monthly premium to calculate the rate increase.  For the employees however, the increases are varied.  In many cases single and family premiums increase, but two person, or employee and child rates generate a decrease.
 
Please pay attention to the info below on the new Mass Sick Pay law for July 1.  There was much talk the law was going to be delayed, but now it will go as planned for July 1.  Helpful information is below.   Please note this applies to ALL GROUPS!

To our clients, we would like to thank you for your positive feedback on our newsletters.  If you have any topics you would like us to address please let us know.  Any questions send us an e-mail , and if you think anyone would benefit from this information, please forward the newsletter to them.  




Thanks

Bill Randell CLU ChFC
Vanessa Costa CLU ChFC 
Medicare Part B premiums

We typically tell our clients that both employees and owners may be better enrolling in Medicare as the primary insurance when they turn age 65 for several reasons:
  1. The Premium for Part B is currently only 104.90
  2. Even if you include the premium for Medicare Supplement it is typically less then the individual premium of the group sponsored plan.
  3. The coverage with Medicare (Part A and Part B) with the Medicare Supplement is usually better then the group sponsored plan. No high deductibles)
  4. The premiums for the underlying group sponsored plan will be less without employees age 65 and over participating.

Please note, Part B of Medicare does have a surcharge for higher income earning individuals. The Medicare option is still a viable option, even with the surcharge, so businesses need to take a closer look at this option.  

There may be a couple options to consider.  Depending upon the carrier you have, there may be a group senior plan available.  If not, there are a host of individual medicare supplement plans available. 

 

Here is a a brochure on the subject detailing the premiums as incomes increase for Medicare Part B.

   

WE enjoy sharing stores of all the interesting items we run into.  Today more than ever, we have to be a watchdog over the bills we receive from our doctors, labs, imaging and hospitals.  Countless times, employees go in for annual physicals and then get a bill for the labwork.  It is up to the consumer to challenge these bills, as more often than not they are coded incorrectly.  If we do not question, the problem goes unnoticed.


 

Here's an interesting tale, recently Bill had his 50th birthday, which triggers his Primary Care physician  to order a Colonoscopy. Without any kicking or screaming, Bill agreed to the process and his Blue Cross PCP referred him to a Blue Cross Specialist for the procedure.   

 

Since this is all part of the ACA ROUTINE preventive care, the entire procedure should be  covered 100%.    During the Colonoscopy, a polep was found, tested and determined to be benign.   A month later, however, Bill received a bill for $259.   


Turns out the tests were sent to a non Blue Cross lab??  The only way to figure out what happened was to call Blue Cross.  After review of the situation it looked like the Blue Cross specialist sent the test results to a NON BLUE Cross approved lab/facility.

 

How do we control where our Blue Cross physician send the labwork???  Why should we be penalized for this?


 

Blue Cross agreed and paid the bill.   The lesson here is that no matter how careful you are, things pop up and you need to fight for yourself.   Admittedly it was not thousands of dollars, but still one phone call and the $259 bill was paid.      


 

Nobody is a better advocate for yourself then you!!!   


Massachusetts Sick Pay Plan Update
July 1st looks like the effective date
 

There are efforts to delay the July 1st effective date, stay tuned.  Here are a couple articles to get you up to speed on the latest developments:

If you want to read a great summary of the law, questions and problems, read this:  

 Last week there was a vote in the House to delay  it, but it failed.   It looks like July 1st may in fact be the effective date-stay tuned.   Last week the Attorney General Office issued a press release to answer some of the questions that have arisen, read this column for these answers.   

Paid time off Q & A

1. How much paid sick time is a company required to offer?

Businesses with 11 or more employees will be required to offer up to 40 hours of paid sick time per calendar year. Businesses with fewer than 11 employees will be required to offer up to 40 hours of unpaid time to workers each calendar year.

2. How do I count employees for the purposes of the law?

Any person who performs services for an employer for "wage, remuneration or other compensation," including all full-time, part-time or temporary employees.


3. How and when is mandatory sick time earned?

An eligible employee will earn a minimum of one hour of sick time for every 30 hours worked.  Employees will begin to accrue this earned sick time on their date of hire, or on July 1, 2015, whichever date is later.  Exempt employees will earn paid sick time based upon the assumption of a 40-hour work week, unless their normal work week is less than 40 hours, and in that case their paid time would accrue based upon their normal work week. Employees may begin to use earned sick time on the 90th day after hire.

4. For what reasons may an employee use earned sick pay?

An eligible employee may utilize earned time to care for a physical or mental illness, injury or medical condition, or to attend routine medical appointments for him/herself or one of the following relations: child, spouse, parent, or parent of a spouse. Earned sick time may be taken to address the physical, psychological or legal effects of domestic violence.

5. Can an employer require an employee to work additional hours to make up for missed time?

If an employee misses work for a reason eligible for earned sick time, but agrees with the employer to work the same number of hours or shifts in the same or next pay period, the employee would not have to use earned sick time for the missed time, and the employer would not have to pay for that missed time.  Employers would be prohibited from requiring such an employee to work additional hours to make up for missed time, or to find a replacement employee.

6. Are employees permitted to take earned sick time in less than full work day increments?

An employee will be able to use earned sick time in increments as small as one hour, or the smallest increment or the smallest unit that employer's payroll system allows for taking time off.

7. Will earned sick time carry over from one calendar year to the next?

Employees will be able to carry over up to 40 hours of earned unused sick time to the next calendar year, but may not use more than 40 hours in a calendar year. 

8. Is an employer required to pay earned but unused sick time at the time of an employee's termination? 

An employer will not be required to pay employees for earned unused sick time at the end of their employment.

9. Is documentation required to take sick time?

Employers may require certification of the need for sick time when more than 24 consecutive hours of earned sick time are requested.  But employers may not delay the taking of, or payment for, earned sick time because they haven't received the certification.  The employee does not need to provide documentation for absences of fewer than than 24 consecutive hours. 

10. Does an employee have to provide advance notice of the need to take time off? 

An employee must make a good-faith effort to notify the employer in advance if the need for the earned sick time is foreseeable.

11. What if I have a Paid Time-Off program?

Employers with a Paid Time-Off (PTO) program that combines vacation, holidays, sick time and personal time should determine whether it makes sense to carve out sick time so that the mandatory paid sick time is not applied on top of their employees' PTO bank.

12. Our business has a "good attendance" policy for our employees.  Will our policy be impacted by this legislation?

"Good Attendance" policies must be reviewed since the ballot question makes it unlawful for any employer to prevent an employee from utilizing paid sick days or to penalize an employee for using leave. "Good attendance" policies provide incentives to employees who do not use their earned paid time off.


 

13. Who enforces the law?

The attorney general will enforce the proposed law, using the same enforcement procedures applicable to other state wage laws, and employees could file suits in court to enforce their earned sick time rights. The Attorney General would have to prepare a multilingual notice regarding the right to earned sick time, and employers would be required to post the notice in a conspicuous location and to provide a copy to employees