Employer Outlook | Employers With Union Workers Face More Complex Employee Administration and Compliance Obligations

Employer Outlook | Employers With Union Workers Face More Complex Employee Administration and Compliance Obligations

For more than 30 years, Employer Advantage has comprehensively managed clients’ government employment and labor law responsibilities, including the added complexity of employees that are also union workers. We take on the burden of our clients’ employee administration and compliance responsibilities. Please contact us if you would like assistance: 417-782-3909

In addition to the overwhelming employee administration and compliance responsibilities employers face, meeting the requirements of the bargaining agreement between a business and its union workers makes things even more complicated.

Labor unions have existed in one form or another in the United States since the birth of the country. They were created to protect the working population from abuses such as sweatshops and unsafe working conditions. Today, they represent workers in many industries recognized under US labor law. The most prominent unions are within the public sector, serving city employees, government workers, teachers, and law enforcement.

Most workers’ union activity centers on collective bargaining over wages, benefits, and working conditions for their membership, as well as representing their members in disputes with management over violations of contract provisions. (For example, union workers average 10-30% higher pay than non-union workers.) Employees exercise their right to organize, or choose to refrain from taking part in, union activities.

For our clients, serving union workers over the years has become a valued part of our process. Unions recognize that Professional Employer Organization(s) (PEO) like Employer Advantage have become the entity which pays the employees, collects union dues, provides data, administers benefits and maintains a safe working environment in accordance with the bargaining agreement they have with the original business. If a business operates within the framework of the negotiated agreement, all is well.

Employer Advantage also guides employers, ensuring they meet the obligations placed upon them. Our service includes an HR Department to help administer the HR policies, along with the hiring and firing process. Our safety department experts make sure the safety of workers is a number one priority, and that working conditions are as agreed upon. Benefit plans that are agreed upon are individualized to a specific client, which we manage and can also administer. We also assign a service team with up to four specialists to oversee compliance.

It can be very difficult, demanding of resources, and time-consuming for a business owner to try to independently meet their workforce obligations. Many potential clients ask if we can really manage all of it. The short answer is “YES!”  Employer Advantage has been effectively served clients with union employees since 1990.

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: 417-782-3909

 Click here to see our other helpful “Blog for All Employers”

 About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.

EMPLOYER GUIDANCE | Surviving the Great Resignation and Great Return Will Require That Employers Get Back to HR Basics

EMPLOYER GUIDANCE | Surviving the Great Resignation and Great Return Will Require That Employers Get Back to HR Basics

As part of Employer Advantage’s comprehensive suite of HR management and outsourcing services (HR, Payroll, Health & Benefits, Safety, and more), we take on the burden of our clients’ employee administration and compliance responsibilities. Please contact us if you would like assistance: 417-782-3909

 

The 2022 labor market has been driven by multiple factors that could not be foreseen nor controlled. The kickoff to the country’s labor woes might have begun with the COVID-19 pandemic, but it was the subsequent domino effect of economic and labor-market issues that have left employers with substantial labor shortages.

With some workers having been stuck at home providing childcare or just burned out and quitting, and many taking early retirement, employers felt compelled to create remote or hybrid positions to try to quickly fill the gaps. This has now inadvertently created a rollercoaster ride for both employers and employees. According to a Bloomberg article sighting several polls and surveys, millions of Americans regret quitting their jobs. Many employers are also expressing regret with new hires made in haste to get their workforce back up and running. With so much uncertainty for everyone, there really is only one dependable solution employers can rely upon.

Solution: Get Back to the Human Resources Basics   

When it comes to employment, the basics revolve around efficient and effective management of Human Resources. HR plays a critical role in finding and keeping valuable employees, while protecting your company. Human Resources can ensure your company is poised to offer a safe and enjoyable working environment. Keeping your current staff happy will also enable you to be more selective about the candidates you recruit to join your workforce.

 

Here’s a Back-to-Basics HR Checklist Employers Can Follow: 

 

Make sure employee handbooks are up to date.

If you haven’t had time to update your employee handbook this year, you should consider doing so now. Review your policies for compliance with the latest employment law developments at the federal, state, and local level; you may want to pay particular attention to paid sick leave, remote work, and other policies that may have changed during the COVID-19 pandemic. States and localities have been particularly active in implementing new workplace requirements.

 

Remind employees of your company policies and practices.

Ensure employees receive a copy of the handbook and sign any applicable acknowledgements.

 

Provide a safe and respectful environment for all workers.

You must let workers know that unlawful harassment and discrimination will not be tolerated. Moreover, policies can go beyond what is legally required to curb bullying and other disrespectful behaviors.

 

Set performance expectations.

In response to staffing shortages, supervisors may have overlooked employee attendance and performance problems – but these issues can’t be ignored long term. Consider meeting with workers to remind them of your business objectives, review policies and procedures, and tie company goals to performance metrics. Make sure goals are realistic and measurable and employees understand they will be held accountable.

 

Review and update job descriptions.

Some roles likely changed in response to labor shortages and evolving business dynamics. Ensure job descriptions are updated to accurately describe the job performed.

 

Update hiring procedures.

Have you lessened your hiring standards while scrambling to fill vacancies? If so, you should review your staffing policies and set consistent hiring practices. For example, you may want to develop written interview questions that hiring managers can ask each job applicant. You may also want to review your background screening and drug testing policies.

Set Diversity, Equity, and Inclusion (DEI) goals.

Creating DEI workplace initiatives can increase morale and work output and benefit your bottom line. To recruit and retain the best talent, your policies must be fundamentally fair, and your workplace should be as inclusive and engaging as feasible. Training and awareness programs on diversity and ethics should be targeted to meet your unique business needs.

 

Reward top performers.

In addition to attracting the top talent for your workplace, you’ll also want to focus on retaining your good employees. Don’t forget to recognize and reward employees who meet or exceed performance goals. Your specific recognition program may depend on your business environment and company culture, but even saying “thank you” or recognizing an employee’s accomplishments during a meeting can go a long way. For more formal programs, set clear guidelines, performance indicators, and award types so employees understand the criteria and can set their goals accordingly. Consider asking employees what types of rewards they would like to see the company offer.

 

Discipline consistently.

Once you’ve established performance standards and updated your policies and procedures, you should be sure to apply them consistently. Disciplining and firing employees is difficult for everyone involved, but the burden may be eased by following fair and consistent standards that account for anti-discrimination laws, wage and hour rules, and other applicable employment laws. Discuss performance issues privately with employees and be objective and honest when giving feedback. Be sure to go over the specifics of the performance challenges, identify ways the employee can correct the problem, and communicate the consequences for failing to meet future performance objectives. Document the conversation, as well as your expectations, and set a time to follow up with the employee. Then, be sure managers follow through.

 

Rethink your process for terminations.

Unfortunately, performance issues and misconduct will sometimes lead to termination decisions, even after you have set expectations and plans for improvement. As with disciplinary discussions, you must be prepared to follow fair and consistent practices when firing employees. Be sure to collect company property – such as laptops, phones, and other equipment – and provide departing employees with any applicable benefits paperwork, notices, and final pay as required by federal, state, and local laws.

 

Conduct exit interviews.

Exit interviews when employees resign or are let go can help uncover and fix problems, improve your culture, and reduce further turnover. The exit interview also gives you an opportunity to remind the departing employee of ongoing obligations to your company regarding intellectual property and confidentiality.

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: 417-782-3909

 

Click here to see our other helpful “Blog for All Employers”

 

About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

 

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.

 

EMPLOYER GUIDANCE | Managing COVID-19 in the Workplace Is Far from Over

EMPLOYER GUIDANCE | Managing COVID-19 in the Workplace Is Far from Over

As part of Employer Advantage’s comprehensive suite of HR management and outsourcing services (HR, Payroll, Health & Benefits, Safety, and more), we take on the burden of our clients’ employee administration and compliance responsibilities. Please contact us if you would like assistance: Info@EmployerAdvantage.com | 877.476.9520

Employers are once again finding themselves in the difficult position of implementing effective COVID-19 mitigation strategies while trying to manage the politics surrounding this latest wave of increasing Coronavirus case numbers, hospitalizations, and deaths.

The emerging dominance of the Omicron BA.5 variant, shown to be the most transmissible yet, has not only seen a rapid rise in infections, but a doubling of hospitalizations since May. During the week of July 4-10, more than 5.7 million new cases were reported – a 6% increase compared to the previous week. The latest number of new COVID deaths is reported to be up to more than 9,800 weekly.

Prompted by this development, the White House just issued a new fact sheet outlining its strategy to manage BA.5, including boosters:

  • Free testing
  • Free masks
  • Ventilation and filtration improvements implemented through the Clean Air in Buildings Challenge

Actions employers should take immediately:

Have a Written COVID-19/Infectious Disease Policy.

Even if your business has never adopted a written COVID-19 plan, it’s never too late to document the policies you have in place to keep employees safe from any infectious disease. This is especially important when considering future changes in infection rates in different communities. Work with counsel and/or a safety professional to write down what you are doing to keep employees healthy in response to COVID-19 or any other infectious disease. This will also aid in training employees about your safety programs.

Engage with Your Employees.

The companies that thrived during the first year of the COVID-19 pandemic are those that communicated with, listened to, and engaged their workforce. Ask non-managers for feedback on company policies. Listen and address concerns through tasks like safety committees, audits, and safety improvement projects. Always provide a transparent workplace where employee concerns are truly considered.

Clean the Workplace.

Employees are happier, feel safer, and are more productive in a clean work area they can take pride in. Having a clean business will also mean OSHA inspectors will feel more confident in your workplace management policies and less likely to spend time looking for safety violations. The COVID-19 pandemic has demonstrated employee interest in a clean workplace, which they will rightfully demand in the future.

Should businesses be mandating masks again?

CDC guidance on masking, quarantining, and isolation remains unchanged from March 2022.

A) Mandate masks in areas of high community spread. Employers in areas of high COVID-19 community levels of transmission should consider keeping mask requirements in place or reinstating mask mandates. For national employers, this may mean different policies in different locations, which can create logistical and communication issues. Recognize that you could open yourself up to an OSHA inspection or a General Duty Clause citation if mask mandates were dropped too quickly or taken away in a high-risk setting.

B) The CDC has somewhat downplayed their concerns in the use of cloth masks, emphasizing instead “fit and filtration” – such as respirators (N95s and KN95s), or using a surgical mask layered with a cloth mask. However, employers should be aware that requiring use of N95s or KN95s in the workplace comes with additional OSHA obligations.

C) The CDC guidance states that a fully vaccinated employee (or one who has had COVID-19 within the last 90 days) who has had close contact with someone with COVID-19 and has no symptoms, they should wear a well-fitting mask for 10 days and get tested five days after the exposure. If symptoms develop or the employee tests positive, they must isolate for at least five days from that positive test result or the onset of symptoms. Employees may end isolation after the fifth day when they are fever-free for 24 hours without the use of fever-reducing medication and their symptoms are improving. Those employees that are not up to date with their vaccines have the additional hurdle of quarantining for five days after close contact, along with the same testing and masking requirements.

Employers are always one of the first places to feel the impacts of every COVID surge, with obligations to follow guidance from the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA), and the Centers for Medicare & Medicaid Services (CMS,) as well as state and local health departments. Businesses should continue to be vigilant in implementing protocols to combat the seemingly endless COVID variant surges.

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: Toll Free 877.476.9520

 

Click here to see our other helpful “Blog for All Employers”

 

About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.

 

Employer Insights | Healthcare Responsibilities and Employee Protections in a Post Roe v. Wade World

Employer Insights | Healthcare Responsibilities and Employee Protections in a Post Roe v. Wade World

Employers face an almost insurmountable task of maintaining a stable workforce while trying to fully understand new prohibitive laws, current legal obligations for healthcare benefits, and existing abortion-rights employment protections.

The United States Supreme Court’s overturning of the landmark 1973 Roe v. Wade decision, which federally protected the ability to choose to have an abortion, did not ban or make illegal abortions. Rather, it lifted the federal protection, giving states the ability to pass new laws or reactivate dormant laws that would restrict or ban the procedure.

This mass confusion for citizens in states working to limit or ban abortions is only compounded for employers who provide healthcare for workforces around the country. For multi-state employers that are fully insured, monitoring of activity of state departments of insurance will be critical as states are free to regulate the insurance industry within their state, including insurance issued in another state that covers individuals within such state.

Employers should understand the workplace protections that their employees have under existing federal anti-discrimination laws, which may protect an employee’s decision to have the procedure.

Some things employers should keep in mind:

  1. Employees in states with strict abortion limitations may end up traveling to other states or countries to receive abortion-related care. What obligations to employees, including travel benefits, will an employer have in this situation?
  2. Will your company’s major medical plan cover this?
  3. Can employees take job-protected leave to obtain such services?
  4. What rights might employees have under federal employment laws? Title VII of the Civil Rights Act of 1964 bans employment discrimination based on color, national origin, race, religion, and sex. Additionally, in 1978, Congress enacted the Pregnancy Discrimination Act (PDA) to clarify that discrimination based on pregnancy, childbirth, and related medical conditions is considered unlawful sex discrimination under Title VII. Under these laws:
  • Employers are prohibited from firing an employee for having or considering having an abortion, according to the Equal Employment Opportunity Commission (EEOC).
  • Equally, employees are protected from adverse employment actions based on their decision not to have an abortion. For example, the EEOC said, a manager can’t pressure an employee to have an abortion in order to keep a job, get promoted, or be assigned better projects.

Women make up more than half of the country’s workforce. Decisions made by the employer today may impact the success of the business for years to come.

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: Toll Free 877.476.9520

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: Toll Free 877.476.9520

 

Click here to see our other helpful “Blog for All Employers”

 

About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

 

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.

 

EMPLOYER INSIGHTS | PEOs Bring the Power of Economies of Scale to Small and Mid-Size Businesses

EMPLOYER INSIGHTS | PEOs Bring the Power of Economies of Scale to Small and Mid-Size Businesses

Professional Employer Organizations (PEOs) combine the buying power of many businesses by pooling employers and their employees together to provide an economy of scale previously only achievable by very large employers.

 

Businesses that turn to a PEO to manage their employee administration and compliance responsibilities experience the buying power, benefits, and specialty assistance of a large corporation…for a fraction of the cost of attaining these things independently. Especially for small and mid-size business owners, this kind of economy of scale provides huge advantages.

 

PEOs Help Businesses Survive

For the past several years, the challenges and expenses facing employers have proved too much for many businesses to survive. Companies across the country have been experiencing the impacts of not having the Human Resources necessary to mitigate and manage the depth of responsibilities placed upon employers. Many companies are using a PEO to save money while offloading and streamlining the HR-outsourcing services such as payroll, benefits, and workers’ compensation.

 

PEOs can also play an important role in helping businesses recruit and retain talented employees. Bringing all the advantages of this economy of scale, PEOs provide a company’s workforce with more robust and affordable benefits packages.

 

Not All PEOs Are Alike

Of the thousands of businesses in the US that have trusted a PEO to handle their employee administration and compliance responsibilities, many are unaware that only 11.5% are IRS-certified.

 

PEO IRS certification matters because it requires annual renewal to ensure that a PEO is financially sound by, among other things, requiring evidence of business experience and audited financial statements and quarterly reports prepared in accordance with generally accepted accounting principles (GAAP) that reflect positive working capital.

 

More than anything, businesses should be able to trust that their management of Human ResourcesPayrollHealth and Benefits, and Workplace Safety is being handled by an experienced PEO operating under the highest standards, certifications, licenses, and accreditations.

 

The Best Time to Begin Working With a PEO

There really isn’t a “bad time” to start working with a PEO, especially if your company has an urgent need for Human Resources management.

 

When just considering an annual business cycle, there are timeframes that make sense to begin HR management services with us:      

 

1) Filing Federal and State Employment Tax Returns

Each quarter, businesses are required to file reports on employee wages, federal and state taxes, and unemployment insurance. To avoid splitting quarters, January 1st, April 1st, July 1st, and October 1st would be great times to begin service with us.

 

2) Major Medical Plan Renewals

Changing medical plans can be a major task. Since many new clients qualify for Employer Advantage’s Major Medical Health Plan, another ideal time to begin service would be just before your existing medical plan is set to renew. We take care of all the underwriting and will complete employee enrollments before your plan ends. If you choose to keep your existing medical plan, we can also assist with open enrollment and administer the monthly billing.

 

3) Workers’ Compensation Insurance Policy Renewal

Each workers’ compensation policy has an annual renewal and payment schedule in which all the premiums are paid at the beginning of the policy term, or by making a large down payment along with monthly payments. Since many businesses qualify to be included on Employer Advantage’s Master Workers’ Compensation Policy, a good time to start with Employer Advantage would be at the end of your current WC policy. This would avoid the early termination fees the other insurance companies charge.

 

4) Internal Personnel Changes

If you have an HR manager retiring or a payroll specialist getting a promotion, you may be ready to look at outsourcing. Employer Advantage will assume those duties (and many more) so you won’t have to hire or train any replacements. Just as with any profession, the skill set required to perform the “business of employment” is beyond the capabilities of just one person.

Although we have seen an influx of clients needing our assistance in navigating their workplace through the COVID-19 pandemic, for more than 30 years, hundreds of businesses have left the perceived comfort of self-service HR to join the ever-growing advantages of Human Resources outsourcing and management provided by Employer Advantage.

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: Toll Free 877.476.9520

 

Click here to see our other helpful “Blog for All Employers”

 

About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

 

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.

EMPLOYER GUIDANCE | New Transparency Requirements Effective July 1 for Businesses Offering Medical and Group Health Plans

EMPLOYER GUIDANCE | New Transparency Requirements Effective July 1 for Businesses Offering Medical and Group Health Plans

As part of Employer Advantage’s comprehensive suite of HR management and outsourcing services (HR, Payroll, Health & Benefits, Safety, and more), we take on the burden of our clients’ employee administration and compliance responsibilities. Please contact us if you would like assistance: Info@EmployerAdvantage.com | 877.476.9520

With an increasingly tight labor market, offering employee medical and group health plans has become a necessity for any employer wanting to attract and retain employees. These already costly benefits are accompanied by complicated government regulations that require employer compliance.

The departments of Health and Human Services, Labor, and Treasury have released new Transparency in Coverage (TIC) rules that put several additional compliance burdens on group health plan sponsors. Employers must make public disclosures of in-network and out-of-network rates by July 1, 2022.

To meet that deadline, plan sponsors should have already received from their carriers and third-party administrators (TPA) the necessary information in the proper format to comply with the new rules.

Additionally, employers are required to provide “machine readable files” (MRF) that reveal in-network rates, out-of-network charges, and information relating to prescription drug coverage. The first MRF must disclose a plan’s negotiated rates for covered items and services for all in-network providers. The second MRF must show the historical payments and billed charges from out-of-network providers. This file should include at least 20 historical entries to help protect individual participant privacy.

Although most medical insurance companies should be prepared to help businesses meet these requirements, it is still important for an employer who sponsors health plans to make sure the TIC and MRF are in total compliance.

The MRF must include:

  1. Each group medical plan must include the insurer Health Insurance Oversight (HIOS) identifier or, if none, the employer identification number (EIN).
  2. A billing code (e.g., Current Procedural Terminology (CPT) code, Healthcare Common Procedure Coding System (HCPCS) code, Diagnosis-Related Group (DRG) code, National Drug Code (NDC), or any other common payer identifier, as well as a plain-language description for each billing code.
  3. The In-Network Rate MRF must show:
  • In-network rates for each item or service provided by in-network providers.
  • Negotiated rates, fee-schedule rates used to determine cost-sharing, or derived amounts-whichever rate is applicable to the plan.
  • The TIC rules allow plan sponsors to contract with a carrier, TPA, or other third party to produce and house the information for a plan.

Be aware it is the employer that will remain responsible for any failures.

 

The Allowed Amount MRF must show:

  1. Out-of-network allowed amounts and billed charges with respect to covered items or services, furnished by out-of-network providers during the 90-day period starting 180 days prior to the MRF publication date.
  2. The plan must omit data for a particular item or service and provider when the plan or insurer would be reporting on payment of out-of-network allowed amounts for fewer than 20 different claims for payment under a single plan or coverage. These amounts must be expressed as dollar amounts and associated with the NPI, Taxpayer Identification Number, and Place of Service Code for each network provider.
  3. Plan sponsors must update the MRFs at least monthly. So, they should establish processes to coordinate regularly with the carrier.
  4. The appropriate departments require the files be posted to a public website that consumers can use without providing individually identifiable information. The website cannot require passwords, account setup, login credentials, or any other barriers to accessing the required information.

In this instance, the insurance carrier will be responsible for any MRF failure required in writing to ensure a plan’s compliance. Employers and insurance carriers should carefully review indemnification provisions in all relevant vendor service agreements.

 

Not currently an Employer Advantage client?

WE’D BE HONORED TO PROVIDE YOU WITH A NEW PATH TO HR BLISS.

We don’t just give quotes—We provide strategic business proposals.

-Free strategic assessment of your business needs

-Quick and easy account setup and seamless transitions

-Urgent requests | Please Call: Toll Free 877.476.9520

 

Click here to see our other helpful “Blog for All Employers”

 

About Employer Advantage

A New Path to HR Bliss – Trusted for more than 30 years, Employer Advantage frees you from the administrative and compliance burdens of having employees so you can focus on your business success. Versatile enough for companies of all sizes, our unique service combines comprehensive management of your employee administration and compliance with the latest software solutions, tailored to meet your individual needs and company culture. Our full-service management of Human Resourcespayrollhealth and benefits, workplace safety, and more enhances your profitability while reducing the costs and risks associated with employment law compliance. We provide your employees with top-notch assistance and benefits that help you increase productivity, save time and money, and attract and retain a talented workforce. And for small and mid-sized businesses, we bring you economy of scale with access to Fortune 500-level benefits, specialty assistance, and savings that would not be possible to attain on your own. Headquartered in the Midwest and serving more than 500 companies and 10,000 worksite employees throughout the country, Employer Advantage is an IRS-Certified Professional Employer Organization (PEO) (CPEO). Experienced, certified, and trusted. www.EmployerAdvantage.com

Employer Advantage has joined the G&A Partners family. Combining forces with this team of trusted and seasoned advisors will help business owners on a much larger scale and with more resources.