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Health Insurance Recap  and Update – 2015-2016

10/19/2015

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For the first time on record, more than 90% of Americans have health insurance…and I can still hear some of the complaints…about costs, about types of doctors, about the government forcing us to purchase a ‘product’….I wish I would hear the ultimate complaint, which in my estimation should be….’only 90%’…and that 10% remaining would be covered if we had a single payer health care program….
 
I am still waiting to see an alternative to the Affordable Care Act that would be acceptable to conservatives as well as liberals…or even something that would only be acceptable to the conservatives that would not cost any more than the ACA costs individuals at this point in time and would cover just as many, if not more, Americans.
 
Important dates for enrollment are November 1, 2015 through January 31, 2016.  The first day you are eligible for enrollment in a 2016 Health Plan is January 1, 2016.  New or continuation of  existing plans and prices will be available by the end of October 2015.  The last day you can enroll in new or existing plans to begin on January 1, 2016 is December 15, 2015.  If you enroll in a new or existing plan after December 15, 2015, you will not be eligible for coverage until February 1, 2016.  If you enroll after January 15, 2016 in a new or changed plan, it will begin on March 1, 2016. Please remember that the last day to enroll for any coverage in the 2016 calendar year (unless you qualify for a Special Enrollment Period), is January 31, 2016. 
 
Another thing to remember….a little late but as they say, ‘better late than never’…if you qualified for tax credits in 2015, you must file an income tax return for the 2014 calendar year no later than October 15, 2015….which has already passed.  If you haven’t already done so, please do so for it may affect your ability to obtain tax credits for the 2016 calendar year…and we want to maintain that, at the least, 90% of insured Americans.
 
As of this writing complete data is not available for the change of pricing of health insurance plans across the country.  A few states have come through with marked increases showing up in Minnesota at a 28.7% increase, however, in Washington state, there is a marked decrease of 10.4%.  As of today’s date, only 14 states have reported the changes in the pricing of health care plans.  The Kaiser Family Foundation, www.kff.org, is the premiere analyzer of all health care plans and programs in the country (there is another link on this website for the Kaiser Family Foundation), and the types of plans that have been analyzed in the 14 states are the Silver and the Bronze plans.  The costs are also broken down by smokers and non-smokers, which, as we all know, is a major distinction when it comes to determining Health Insurance rates.
 
I will have a few more BLOGs out at the beginning of the open enrollment so I I will am hoping that those of you that are in need for information, will contact me via email at info@scbhrserv.com or via phone at 484-798-1236 at your earliest convenience If I am unable to help anyone, I will direct those of you in need to the correct agency. 
 
I will update information for employers and the Affordable Care Act in my BLOG on November 3rd and  I will be back to posting at least twice per week, if not more often from that point forward.
 
In the next month I will be recapping the HEDIS situation again this year and  I am anxious to see if I receive any additional, nasty or threatening emails from former ‘employers’ …it is tough attempting to provide a service (recommendations of good HEDIS contract agencies) when one knows how certain ‘service providers’ actually manage their business.  As of January 1, 2016, SCB Services, LLC will be offering both Medical Record Review (MRR) and HEDIS services.  Watch for website changes and more information.....
 
 
 
 
 


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Update - Independent Workers - Still Doing Well...

10/7/2015

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​Back in August of 2014, I wrote a BLOG on Independent Workers as a result of a New York Times article re the same.  In that BLOG, I casually mentioned ‘Uber’ as a new avenue for independent workers….I decided to follow through and research how well Uber and Lyft are doing here in the US and around the world as well as the other avenues ‘independent workers’ choose to pursue….
 
Please note that no matter what the DOL states as a definition of an employee/independent contractor, the main thing to remember is that we have more ways for more individuals to earn money (legally) here in this country, than ever before… there is a method of earning money that can suit each and every person as long as all of the conditions are researched ahead of time.  For the time being, a growing number of lawsuits allege companies should be classifying individuals as employees and not independent workers (free agents). 
 
In June, a California commission ruled that an Uber driver is really an employee and not a contractor.  Hillary Clinton (the Democratic Presidential frontrunner) recently promised to ‘crack down on bosses who exploit employees by misclassifying them as contractors.’  With the new directive, the Department of Labor pretty much considers most workers to be employees under the Fair Labor Standards Act and the agency will apply a very broad definition when investigating a company’s practices.  In light of the DOL announcement in July and the final ruling on the overtime wages, employers should be much more cautious at this time because it appears that the DOL has declared war on the independent contractor relationship. 
 
Put simply, Uber would not be making the money that it is making if their ‘contractors’ were ‘employees’.  Independent contractors are cheaper for companies to hire.  Employers don’t have to pay them benefits or offer 401(k) plans, pay them overtime or give them paid days off….and they certainly don’t have to pay unemployment insurance or worker’s compensation funds on the contractors’ behalf (the contractors have to pay their own workers’ compensation premiums)….and the best for the employers (of which I have mounds of personal experience), the employer does not have to cover the employer share of their payroll taxes or withhold income taxes (the responsibility is for the independent contractor)….however, we know that there are those employers who don’t care what the DOL states or has stated….they only pay their portion of the payroll taxes or income taxes after accountants/attorneys/IRS/State Departments of Revenue, etc. require them….
 
Now, in return for the limited obligations that are thrown the way of the employer, the independent contractor should have autonomy deciding when, where and how to do the work assigned.  They’re free to take on projects with other companies.  They essentially run their own business, and may even have their own employees, office space and equipment.  That is how it is suppose to be.  However, the lines seem to blur when a company hires someone to do work that might be considered integral to the core of the business….that a full time employee normally does…or when it dictates where, when or how the work should be done…..or when it restricts the worker’s ability to work for other clients.
 
If a company has found to have misclassified workers as independent contractors, it may be required to pay legal fees, back wages, back taxes, penalties and damages.  The DOL, together with the IRS and  22 states cracked down on misclassification, resulting in employers having to pay $79 million in back wages for more than 100,000 workers in various industries in 2014 alone.  The Labor Department’s missions is to be vigilant in protecting workers whose rights are being violated….which it has done in industries as varied as construction, meat processing, landscaping and personnel/staffing services. 
 
What if someone really wants to work for Uber or Lyft as an independent contractor?  In the ‘guidance’ or 'directive' that the DOL published in July of 2015, the Labor Department explicitly said that the ‘economic realities’ of the working relationship determine whether a worker is an employee, and those would override any agreement that may have been made between the employer and the worker.  This may pose a problem for some individuals….


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    Rosanne is a Senior and Global Professional in Human Resources as well as a Certified Personnel Consultant and has over 30 years of experience in human resources, recruitment and staffing. 

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