Did you know that some repair facilities, including Midas and Pep Boys, share your vehicle data with Carfax? Did you also know that Carfax sells this data to some insurance companies? This data exchange is not a one-way street – Carfax also receives vehicle claims data from insurance companies.
The Plexus Groupe is not only proud to offer Work Shield as an innovative workplace harassment protection plan to our clients, but we use the confidential reporting platform in our own company as well.
9 ACA Employer Mandate FAQs for Employers and their Brokers
The Affordable Care Act (ACA) is still in effect, despite efforts to dismantle it. This means its employer mandate is still in effect, and something employers and brokers can’t ignore. Plexus Technology Services, which delivers innovative technology reporting solutions to companies needing to report ACA information to the government, provides 9 ACA FAQs (frequently asked questions) about the employer mandate for employers and their brokers.
What is the ACA employer mandate?
Employers with 50 of more full-time employees must offer those workers and dependents the chance to enroll in minimum essential coverage under an employer-sponsored plan.
What is “full-time” under health care reform?
Working at least 30 hours per week or 130 hours in a calendar month. A special rule covers “seasonal workers” and others not continuously employed.
What is the look-back method for counting full-time employees?
Count the number of full-time employees during each calendar month and divide by 12.
What is an offer of health coverage?
Employees with 50 or more employees must offer coverage during a plan year. Employees must pay their share within 30 days of due date.
When is employer coverage considered unaffordable?
If the employee’s required contribution for self-only coverage exceeds 9.69 percent of their household income for the taxable year.
How are wellness programs treated?
If a wellness program provides medical benefits, it will likely be treated as a group health plan, subject to non-discrimination requirements.
How are stand-alone wellness programs treated?
If they don’t pay for medical benefits, they are not treated as group health plans.
Who handles the Summary of Benefits and Coverage?
The insurer prepares the SBC, and the plan sponsor distributes it. A self-funded plan prepares its own SBC.
What are the two employer mandate penalties?
No Minimum Essential Coverage: $2,260 per full-time employee.
Inadequate Health Plan: $3,390 per full-time employee.
Have questions regarding these ACA mandates and filing? Contact a Plexus Technology Services associate in Deer Park, Illinois at 847-307-6100, Chicago at 312-606-4800, Dallas at 972-770-5010 or Oklahoma City at 405-840-3033. We’re here to help and we’re happy to help.
Content provided by New Equipment Digest.
The Plexus Groupe’s Property and Casualty November Newsletter shares the Top 10 OSHA violations in 2018:
10. Personal Protective and Lifesaving Equipment – Eye and Face Protection
This is the first appearance of this construction standard on the list.
Number of Violations: 1, 536
9. Machine Guarding
Inspectors cited machine shops and manufacturers for point of operation and for guards that were not attached to machines.
Number of Violations: 1,972
8. Fall Protection – Training Requirements
Employers lacked competent persons to provide training as well as no written certifications that the training occurred.
Number of Violations: 1,982
7. Powered Industrial Trucks part 2
OSHA inspectors found forklift drivers who were not certified. In addition, employers failed to recertify drivers every three years.
Number of Violations: 2,294
Ladder use continues to be a problem in the construction industry. Inspectors found broken steps, use of top steps and ladders not being used as intended.
Number of Violations: 2,812
A general industry standard, employers did not implement an energy control program or training.
Number of Violations: 2,944
4. Respiratory Protection
Fit testing, medical evaluations and respiratory programs were non-existent for employers who received this violation.
Number of Violations: 3,118
3. Scaffolds – General Requirements
Scaffolds were not properly decked, leaving holes where a worker potentially could fall through.
Number of Violations: 3,336
2. Hazard Communication
Failure to train and not maintaining data sheets led to this violation for many auto repair shops as well as hotels.
Number of Violations: 4,552
1. Fall Protection – General Requirements
Topping the list once again is fall protection. Roofing contractors failed to provide PPE.
Number of Violations: 7,270
If you have questions about this newsletter or any of the OSHA safety violations identified, contact an insurance expert at The Plexus Groupe at 847-307-6100.
A new study from Deloitte Health Solutions describes the U.S. health system as a kind of “Wild West,” and says benefits users and consumers fit into four general categories in that framing.
This Employee Benefits Newsletter from The Plexus Groupe delves into a recent study that surveyed 4,530 U.S. benefits users and consumers to assess their attitudes, behaviors, and preferences when making decisions about health care and health insurance. In their frontier scenario, the Deloitte researchers said consumers can be placed in the following categories:
· Trailblazers—tech savvy, self-directed, engaged in wellness, willing to share data.
· Prospectors—who rely on recommendations from friends/family, use providers as trusted advisors, willing to use technology.
· Homesteaders—reserved, cautious traditionalists.
· Bystanders—complacent, tech-reluctant, resistant to change, unengaged.
According to the report, Trailblazers make up 16 percent of consumers. These tend to be younger, higher-income consumers. They tend to be in excellent health, and the group contained more men than women. These are consumers who are most likely to look up report cards or scorecards on doctors, hospitals, and health insurance companies. They are also the most likely to change doctors if they are dissatisfied with their communication style.
The Prospectors is the second-youngest group and made up 30 percent of respondents. This group is also the second-highest income group and consisted of equal percentages of men and women. They are more open to technology such as wearable devices and virtual office visits. They are the second-most likely group to look up quality ratings for providers and plans, and rely on word of mouth or recommendations of former providers when choosing a new provider.
The Bystanders make up 14 percent of respondents, and are the oldest and poorest segment in the survey. This group is made up of more women than men, and are the most likely to be in poor health. The Bystander group is least likely to share health information with a doctor, least likely to follow a healthy diet or exercise according to recommendations, and most likely to choose a doctor based on out-of-pocket costs and convenience.
The largest group in the survey was Homesteaders, at 40 percent of respondents. This is the second-oldest group, second-lowest income group, and consists of more women than men. This group is less open to technology and close to average when it comes to following recommendations about health diet and exercise. This group is also more interested in convenience than out-of-pocket costs when choosing a provider, and less likely to change providers, even if they are dissatisfied with the provider’s communication style.
The Deloitte report suggested a range of strategies for reaching consumers, based on where they fell in these categories. For example, they recommend offering virtual office visits and encouraging the use of wearable devices or phone apps for the Trailblazer and Prospector groups. On the other hand, the report recommends a less-high tech, more high-touch approach for the Homesteaders and Bystanders. Using case managers, wellness coaches, or engaging caregivers and family members will yield better results with these groups, the report says.
“Every consumer makes decisions differently—whether deciding on which movie to watch, what type of car to buy, or where to stay or eat during a vacation. Consumers also have different approaches to determining which health plan offers the most appropriate coverage, when and where to seek care at a hospital, how to choose a doctor, and whether a pharmaceutical product or medical device offers value,” the report says. “Organizations can use data beyond just demographics to identify which segment their population or consumers fall into—and thus better target, attract, and retain consumers.”
If you have concerns about how best to approach your employee base, contact a client service team representative from The Plexus Groupe in Deer Park, Illinois at 847-307-6100, Chicago at 312-606-4800, Dallas at 972-770-5010 or Oklahoma City at 405-840-3033.
We’re here to help and we’re happy to help.
Content provided by BenefitsPro.
Insurance For Mass Shootings On The Rise
With the rise in mass shootings at schools, churches, concert venues, movie theaters, and even yoga studios, the need for insurance for mass shootings increases.
A terror attack or mass shooting can plunge organizations into a disorienting world of trauma, grief, media scrutiny and litigation threats. This newsletter from The Plexus Groupe’s Property & Casualty practice delves into how to protect your assets when an attack occurs to allow healing to begin.
When an attack occurs, the leaders of private companies and government entities alike feel driven to deliver a caring, supportive response to the victims and survivors. At the same time, they are staring down expenses that can spiral into millions of dollars.
A specialized kind of named-perils insurance is helping risk managers deliver the response organizations need. Indeed, select insurers are seeing strong demand for active shooter policies, which came to the marketplace within the past few years amid rising anxieties from a seemingly endless stream of violent attacks.
These policies represent more than an extra budget line item—they provide resources that help people recover from trauma. Understanding the basics of violence-response policies can help risk managers better serve their companies and stakeholders.
The Rise of Active Shooter Policies
Organizations such as the FBI and the Gun Violence Archive have documented a rise in mass shootings in the United States in recent years. In the immediate aftermath of these attacks, employers, school districts and other targets faced a similar challenge. While enduring the painful process of recovery, they were also scanning their existing insurance policies and discovering that they lacked the appropriate coverage. As a result, they often had to bear the full brunt of the recovery-related expenses on their own.
This gap between available coverage and marketplace demand provided an opportunity for insurance program developers who applied traditional named-perils coverage to new categories of risk. Over the years, named-perils policies had emerged to protect against storm risk, employment practices liability, cyber events and sexual misconduct. Today, named-perils policies help organizations manage the risks of mass shootings, terror attacks, kidnapping/ransom, and workplace violence.
Initially, coverage for active shooter and other mass violence incidents came in response to requests from larger school systems, health care companies, and the organizers of high-profile events like parades and festivals. Now, small-business owners, daycare centers, churches, car dealerships, and other local organizations have started seeing the value of these policies as well.
What Policies Can Cover
While general liability coverage applies to an expansive range of risks, it also has its limitations. By contrast, named-perils policies for mass violence explicitly state what they do cover. Of course, coverages have limits, but they address common expenses and scenarios that many general liability policies do not. Active shooter coverages can include:
Crisis management. Insurers can partner with expert teams trained to help insureds deal with media, reassure families, confer with top executives, and help the organization show the public it is handling the crisis with competence and compassion. Without expert guidance, it is possible that an organization’s suboptimal response to a crisis can create an entirely new crisis in its own right. The branding and public perception of an institution after an active shooter event can be difficult to recover from.
Victim counseling, medical, disability, funeral expenses and death benefits. Policies help organization leaders answer the question of who will help the victims by providing a supportive response to the trauma their employees and patrons experience.
Off-site/international terror attacks. Coverages can apply to workers traveling worldwide.
Loss of revenue/extra expenses. Policy provisions help commercial businesses recover income lost when police investigations bring commerce to a halt.
Loss of attraction. When a mass attack stigmatizes a neighborhood or business district, insurance can help companies fill some of the revenue gaps. This applies even if the incident did not occur at the insured’s own business.
Property cost. Many organizations have experienced millions of dollars’ worth of property expenses from an attack due to the cost of structural security upgrades along with building closure, relocation or teardown.
Litigation. Policies can cover an expansive range of legal costs related to “duty of care” that might not be available under general liability insurance. According to Dr. Christina Marinakis, director of jury research at Litigation Insights, this is important because organizations today are being held to a higher standard of accountability than in the past when it comes to providing public safety measures.
Prevention. Insurers can work with policyholders to figure out how to identify troubled individuals and intervene before it is too late.
Examining the Exclusions
Many active shooter/workplace violence policies contain exclusions that could prove costly in the aftermath of an incident. The following are some of the most common exclusions:
Employees. Coverage may only include guests or visitors and not employees of the insured. Due to the nature of these events, insured persons should include employees, volunteers, students, guests and patrons.
Casualty thresholds. Some policies have a body deductible and coverage applies only after a certain number of people (usually three or four) have been injured or killed. Most active shooter/ workplace violence events involve less than three individuals, however, so it is important to ensure that your policy covers these incidents as well.
Vehicles. Vehicle attacks are becoming more common. Certain policies might rule out damage caused by a vehicle, such as an incident involving a vehicle ramming into a crowd of people.
Weapons. Coverage can be confined to firearms or bladed weapons and might not cover improvised explosives or ordinary items used for violent purposes, which, as the Boston Marathon bombing demonstrated, can be just as harmful.
While these exclusions are rare, with the evolution of coverage forms, policies still need to be reviewed carefully. More robust policies are available that cover all these risk scenarios to provide the proper coverage.
The Cost of Recovery
Lone-wolf violent attacks have garnered a significant amount of private and government attention and resources to provide vital attack analysis. For example, earlier this year, the U.S. Secret Service’s National Threat Assessment Center released its analysis of various mass attacks that occurred in 2017 in an effort to uncover clues that could assist in developing effective prevention measures.
These incidents are among the most significant financial exposures an organization can face. For example, the actions of the single assailant in the 2007 Virginia Tech shooting produced an estimated $48.2 million in litigation and recovery costs. And it cost $50 million to build a new Sandy Hook Elementary School in response to the 2012 attack.
In Florida, Broward County spent $1.2 million after a 2017 lone-wolf shooting at Fort Lauderdale-Hollywood International Airport. The Sun Sentinel reported the county’s spending included $562,000 to reunite travelers with their luggage, $270,000 to replace carpets and tiles at the shooting site and $314,700 for an assessment of the county’s handling of the crisis.
The combination of litigation costs and direct recovery expenses can financially devastate smaller organizations. Larger entities like corporations and universities may have more resources, but they still must reallocate funds toward recovery and away from other critical needs.
Thus, risk managers need to carefully assess their organization’s ability to withstand a violent attack and help the victims heal from the damage in order to determine if active shooter and workplace violence insurance is worth exploring in order to help mitigate these risks.
If you have questions about this newsletter or mass shooting insurance, contact an insurance expert at The Plexus Groupe at 847-307-6100.
Content provided by Risk Management Magazine.