Beginning January 1, 2014, individuals and employees of small businesses will have access to affordable coverage through a new competitive private health insurance market – the Health Insurance Marketplace. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. Open enrollment for health insurance coverage through the Marketplace begins October 1, 2013. Section 1512 of the Affordable Care Act creates a new Fair Labor Standards Act (FLSA) section 18B requiring a notice to employees of coverage options available through the Marketplace.⁽¹⁾

Timing and Delivery of Notice

On January 24, 2013, the Department of Labor issued guidance stating that the notice requirement will not take effect on March 1, 2013. On May 8, 2013, the Department issued that employers are required to provide the notice to each new employee and each current employee at the time of hiring beginning October 1, 2013. For 2014, the notice must be provided within 14 days of an employee’s start date.

Each employee must be provided with a notice, regardless of plan enrollment status or of part-time or full-time status. Employers are not required to provide a separate notice to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees.

The notice is required to be provided automatically, free of charge. It may be provided by first-class mail. It may also be provided electronically if the Department’s electronic safe harbor rules are met.

Form and Content of Notice 

The notice to inform employees of coverage options must include information regarding the existence of a new Marketplace as well as contact information and description of the services provided by a Marketplace.

The notice must also inform the employee that the employee may be eligible for a premium tax credit under section 36B of the Code if the employee purchases a qualified health plan through the Marketplace; and a statement informing the employee that if the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

Model Notice

Model language is available on the Department’s website www.dol.gov/ebsa/healthreform. There is one model for employers who do not offer a health plan and another model for employers who offer a health plan to some or all employees.

Model Notice for employers who do not offer a health plan

Model Notice for employers who offer a health plan to some or all employees

The Patient Protection and Affordable Care Act (PPACA) requires large employers – those with 50 or more full-time employees and full-time equivalents – to offer their employees the opportunity to enroll in coverage that is both affordable and provides minimum value. While determining whether an employer is subject to this employer mandate is complicated in its own right, this determination can get even more complex when several employers are commonly owned.

Bundling Multiple Employers

All employees of companies within the same controlled group must be aggregated to determine whether the commonly owned employers are subject to the employer mandate. For purposes of determining common ownership, PPACA adopts the controlled group rules set forth in sections 414(b) and 414(c) of the Internal Revenue Code. The controlled group rules are quite complex and fact-specific. Under those provisions, there are three types of controlled group relationships: (1) parent-subsidiary; (2) brother-sister; and (3) a combination of the two.

What is a Parent-Subsidiary Group?

A parent-subsidiary group exists when:

• One or more chains of corporations are connected through stock ownership with a common parent corporation;
• 80% of the stock of each corporation (except the common parent) is owned by one or more corporations in the group; and
• The parent corporation owns 80% of at least one other corporation.

What is a Brother-Sister Group?

A brother-sister controlled group is a group of two or more corporations in which five or fewer common owners own a controlling interest of each group and have effective control. Two terms are key here – controlling interest and effective control. A controlling interest generally means 80% or more of the stock of each corporation. Effective control is defined as more than 50% of the stock of each corporation, but only to the extent that such stock ownership is identical with respect to such corporations.

What is a Combined Group?

A combined group consists of three or more organizations where (1) each organization is a member of either a parent-subsidiary or brother-sister group, and (2) at least one corporation is the common parent of a parent-subsidiary, and is also a member of a brother-sister group.

Employer Mandate Applicability

When calculating penalties under the employer mandate, the first 30 full-time employees are excluded. Therefore, if a single employer does not offer coverage or offers coverage to less than 95 percent of its full-time employees, and an employee receives a premium tax credit, the employer must pay a penalty of $2,000 for each full-time employee minus the first 30.

For employers that offer coverage for some months but not others during a calendar year, the penalty will be computed separately for each month in which the employer did not offer coverage and at least one full-time employee received a premium tax credit. In such a case, the employer would be liable for a penalty of 1/12^th of $2,000 for each full-time employee employed for the month minus the first 30.

If an employer offers coverage to 95 percent or more of its full-time employees, but a full-time employee nonetheless receives a premium tax credit on the basis of the coverage not being affordable or not providing minimum value, the employer must pay a penalty equal to 1/12^th of $3,000 for each full-time employee who received a premium tax credit for the month. The amount paid under this scenario cannot exceed the amount the employer would have had to pay if it did not offer coverage – that is, 1/12^th of $2,000 for each full-time employee minus the first 30.

However, when multiple employers fall under the same controlled group, this 30 full-time employee exclusion must be proportionally allocated based on each employer’s number of full-time employees. Therefore, it will be important for entities to carefully analyze application of these controlled group rules, both to figure out whether they are subject to the employer mandate and if so, their potential liability.

Final Thoughts

The take away from the “Control Group” protocol is that many small employers might be bundled into a large group for purposes of PPACA’s employer mandate. Brokers are encouraged to work with their clients to make sure that they are proactively determining whether or not the obligation to offer affordable and provides minimum value coverage or pay a penalty extends to any grouping of companies with related ownership.

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of Shirazi Benefits. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.

Beginning on January 1, 2014, employers with 50 or more full-time employees (including full-time equivalent employees) will be subject to the Patient Protection and Affordable Care Act’s (PPACA) “employer mandate.” Under the employer mandate, such “applicable large employers” must offer the vast majority of their full-time employees (and their dependents) the opportunity to enroll in coverage or face the possibility of a tax penalty.

Under PPACA, a full-time employee, with respect to any month, is an employee who provides an average of 30 hours of service per week. However, enrolling and disenrolling employees on a monthly basis would raise significant administrative issues for employers and regulators. To address these issues, the Internal Revenue Service has promulgated regulations which allow employers to use a “look-back measurement method” to determine an employee’s full-time status under the law. This Legislative Alert provides key information related to this look-back measurement method of determining full-time employees.

Learn more:

Q. What is the “look-back” period as defined by PPACA?

A. In general, the look-back measurement method allows the employer to select a look-back period of time to measure whether the employee worked an average of 30 hours per week. If the employee worked an average of 30 hours per week during the look-back period, the employer must consider the employee a full-time employee during the subsequent “stability” period, regardless of the number of hours the employee works during the stability period.

Q. How do I calculate the look-back period?

A. Calculation of the look-back period depends on whether the employee is (1) an ongoing employee, or (2) a new variable hour employee or seasonal employee.

Ongoing employees: For an ongoing employee, an employer may determine full-time status by using a look-back period of between three and 12 months. Under the rules, the employer is given discretion to choose the length of the look-back measurement period provided it conforms with the length of time rules discussed above and that the determination is made on a uniform and consistent basis for all employees in the same category.

New variable hour employees and seasonal employees:An applicable large employer may also use a look-back measurement period for new variable hour employees and for seasonal employees in certain circumstances. A new employee is a variable hour employee if, based on the circumstances at the employee’s start date, it cannot be determined that the employee is reasonably expected to work on average at least 30 hours per week. Through at least 2014, employers may use a reasonable, good faith interpretation of the term “seasonal employee.” For new variable hour and seasonal employees, an employer may use a look-back period of between three and 12 months that begins on any date between the employee’s start date and the first day of the first month following the start date.

Q. Do I have to use a consecutive period of time?

A. Yes. The look-back period must use a consecutive period of time.

Q. What is the “stability period” as defined by PPACA?

A. The stability period begins immediately after the look-back period and any administrative period. Calculation of the stability period depends on the type of employee and whether he or she is determined to be a full-time employee during the look-back period.

Q. How do I calculate the stability period?

A. Ongoing employees: If an employer determines that an ongoing employee worked full-time during the look-back period, then the stability period must be at least the greater of six consecutive calendar months or the length of the look-back period. If the employer determines that the ongoing employee was not a full-time employee during the look-back period, then the stability period must be no longer than the look-back period.

New variable hour and seasonal employees: If a new variable hour or seasonal employee is determined to be a full-time employee, then the stability period must be the same as that for ongoing employees – either six consecutive calendar months or the length of the look-back period, whichever is longer. If a new variable hour or seasonal employee is determined not to be a full-time employee during the look-back period, then the stability period may be, at a maximum, one month longer than the look-back period. However, the stability period may not exceed the remainder of the employer’s look-back period for ongoing employees (plus any associated administrative period).

Q. What is the “administrative period” as defined by PPACA?

A. Employers may impose an administrative period that begins immediately after the end of the look-back period and ends immediately before the stability period. The purpose of this administrative period, which may last up to 90 days, is to give employers time to determine employee eligibility for coverage, notify them of their eligibility, and enroll them in the plan.

Q. How do I calculate the administrative period?

A. The administrative period may last up to 90 days. However, this administrative period cannot create a gap in coverage for ongoing employees who are enrolled in coverage because of full-time employee status. For new variable hour employees and seasonal employees, the look-back period and administrative period combined may not extend past the last day of the first calendar month beginning on or after the one-year anniversary of the employee’s start date.

Q. Can I use different look-back periods, stability periods, or administrative periods for different categories of employees?

A. Yes. According to the proposed rule on the employer mandate, an employer may select different look-back periods, administrative periods, and stability periods for certain categories of employees. For example, the proposed rule states that an employer may select different periods for:

·         Each group of collectively bargained employees covered by a separate collective bargaining agreement,

·         Collectively bargained and non-collectively bargained employees,

·         Salaried employees and hourly employees, and

·         Employees whose primary places of employment are in different states.

Q. Can I select a look-back period where I have the fewest number of employees?

For example, I am a seasonal employer with 50 full-time employees for six months. For my look-back period, can I select the six months where those seasonal employees are not working for me?

A. No. For new variable hour and seasonal employees, the look-back period must begin on a date between the employee’s start date and the first day of the first calendar month following the employee’s start date. Therefore, a seasonal employer would not be able to use, as the look-back period, the six months where those seasonal employees are not working.

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of Shirazi Benefits. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.

Even though the employer shared responsibility provisions of the Patient Protection and Affordable Care Act (PPACA) will not take effect until January 1, 2014, employers should start preparing for their compliance strategies this year.

For example, business owners and payroll personnel will want to determine if the employer mandate will apply to their company sooner rather than later. If PPACA’s ‘shared responsibility’ provisions do apply, employers need to prepare in 2013 to ensure a smooth transition next year. Several issues need to be addressed to mitigate any potential challenges, covering issues such as how the baseline measurement period is calculated and the adequacy of coverage requirements are met.

Here are some of the most common questions employers have:

• Will my company have to comply with employer-shared responsibility provisions?
• What kind of insurance will my company have to provide?
• To whom will I have to provide insurance?
• What about seasonal, per diem, or part-time employees?

Utilize the below guidelines and our FTE Worksheet to help your business determine these answers.

1. Count the number of “full-time” employees (including seasonal employees) who work on average 30 hours or more per week per month
2. Calculate the number of full-time equivalent employees by aggregating the number of hours worked by all non-full-time employees (including seasonal employees) and dividing by 120
3. Add the number of “full-time” employees and full-time equivalents calculated in steps (1) and (2) for each of the 12 months in the preceding calendar year, and
4. Add the monthly totals and divide by 12. If the average exceeds 50 full-time equivalents, the employer must also determine whether the seasonal employee exception applies

1. Each hour for which an employee is paid, or entitled to payment, for the performance of duties for the employer;
2. Each hour for which an employee is paid, or entitled to payment, by the employer for a period of time during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty or leave of absence.

• Count actual hours of service from records using the same methodology as hourly employees;
• Use a days-worked equivalency method that credits the employee with eight hours of service for each day that the employee would be required to be credited with at least one hour of service; or
• Use a weeks-worked equivalency of 40 hours of service per week for each week that the employee is credited with at least one hour of service.

• The “rate of pay” safe harbor provides that coverage meets the affordability standard if the employee premium share does not exceed the total of the hourly rate of pay multiplied by 130 hours per month.
• Employers may also use the “federal poverty line” approach, where coverage meets the affordability standard if employee premium share does not exceed 9.5% of the federal poverty line for one person. The calculation can be done using the most recently published federal poverty guidelines as of the first day of the plan year.

Q. How will an employer know if offered coverage provides minimum value?

A. A Final Rule was recently released that provides that an employer-sponsored plan provides minimum value if the percentage of total allowed costs of benefits provided is no less than 60%.

The Final Rule sets forth the following methodologies to determine if the Minimum Value (MV) criteria is satisfied:

1. Click here to view the Minimum Value Calculator
2. Any safe harbor established by HHS and the IRS;
3. Certification by an actuary, which is only available if the plan contains non-standard features that are not suitable for the MV calculator or safe harbor checklists. If this options is used, the determination must be made by a member of the American Academy of Actuaries; or
4. Any plan in the small group market that meets any of the “metal levels” of coverage based on the MV Calculator.

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of Shirazi Benefits. The federal regulations offer some basic guidance on how to calculate the total number of employees for purposes of the employer mandate. However because different elements of PPACA are still being finalized through the regulatory process, all employers and other stakeholders are strongly encouraged to hire locally-licensed legal or benefit experts in their jurisdictions to support and document this process. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.

(Photo by Robin Kanouse via Flickr)

Everyone is talking about the health insurance exchanges and what they will mean to you.  Starting January 1^st, 2014, the Affordable Care Act requires every state to create health insurance exchanges for businesses, employees, and individuals.  If states do not establish an exchange in time, the Federal government will step in and create one.

So, what exactly is a health insurance exchange?

A health insurance exchange is an organized marketplace for individual, families, and small business to shop for and purchase health insurance based on quality and price.   Basically, they are a store specializing in health insurance merchandise.

How is this all going to work?

In Colorado, the Health Benefit Exchange will be an online marketplace; a website where Coloradans can shop for and purchase health plans. Two will be set up: one for individuals, and one for small groups. This website will interface with various government databases to determine a consumer’s eligibility for tax credits and public insurance.

Small employers will also be able to purchase plans for their employees, using tax credits.

Insurance brokers will need to be certified to sell plans through the exchanges; they will be able to help individuals and small groups navigate the exchanges.

Who is eligible to participate?  

An exchange would be available to be used by individual consumers who do not have access to a group plan and small businesses with up to 50 employees when it opens for enrollment beginning October 2013. Large employers may be allowed to participate in 2017.

Will the Colorado Health Benefit Exchange offer every health plan that is currently offered on the market?

No. The exchange will offer health plans that have been determined to offer adequate levels of coverage and comply with new regulations to protect consumers. These plans will have ratings and will fall into four tiers: bronze, silver, gold and platinum. The bronze plans will offer the basic coverage required by law and will be the most affordable. The platinum plans will offer the highest level of coverage and will be the most costly. Silver and gold plans will offer coverage with monthly premiums in the middle of that spectrum.

Are there any tax credits for going through the exchange?

For small group employers, the tax credit that you receive now will only be available if you purchase your plan through the exchange. An enhanced version of the credit will be effective beginning January 1, 2014. In general, on January 1, 2014, the rate will increase to 50 percent and 35 percent, respectively.

Advance tax credits are available to individuals and families with incomes between the federal poverty level and up to 4 times that amount to help reduce the cost of purchasing health insurance. That means an individual making up to $43,320 a year and a family of four making up to $88,200 a year will be eligible for this financial assistance. The amount of assistance will be determined on a sliding scale, which means the higher your income, the lower the amount of aid.

Can you provide an example of how the tax credit will work?

Here are three examples provided by the Internal Revenue Service in August 2011 to explain how the tax credits will work:

1. Family of Four with Income of $50,000, Purchases Benchmark Plan

• Premium Cost for Plan Family Chooses: $9,000
• Tax Credit: $5,430
• What Family Pays: $3,570

2. Family of Four with Income of $50,000, Purchases Less Expensive Plan

• Premium Cost for Plan Family Chooses: $7,500
• Tax Credit: $5,430
• What Family Pays: $2,070

3. Family of Four with Income of $50,000, Parents are between ages 55 and 64,
Purchases Benchmark Plan

• Premium Cost for Plan Family Chooses: $14,000
• Tax Credit: $10,430
• What Family Pays: $3,570

I have a pre-existing condition. Am I eligible to buy insurance in the exchange?

Yes. Beginning in 2014, pre-existing conditions will be a thing of the past. No insurer can deny anyone health insurance based on health status, inside or outside the exchange.

Shirazi Benefits can help you navigate through all of this. 

Resource: Colorado Health Benefit Exchange.

As we get closer to approaching the end of the year, it may be time for you to start thinking about spending any money that still remains in your Flexible Spending Account (FSA). While you won’t lose any money in your Health Savings Account (HSA), you will miss out on funds in your FSA if you don’t use it prior to the end of 2012. So, if you’ve still got money lingering around in your FSA, now is the time to use it!

There is actually a long list of items you can use the funds in your FSA to purchase. The following is a list of common medical, dental and vision related items you can purchase using your FSA:

• Acupuncture: Most health coverage does not cover acupuncture care, so if you have pain, you might consider this.
• Breast Pump: If you’re expecting a child, you can use your FSA dollars to purchase a breast pump.
• Chiropractic services: Perhaps you have reached your maximum visit limit at your Chiropractor’s office this year under your health insurance plan or perhaps your health insurance doesn’t cover Chiropractic care? You can use FSA dollars for this!
• Dental work: Visit a dentist to get orthodontia treatment or other dental work.
• Eye exam: Don’t have vision coverage? Not to worry. You can use your FSA dollars for eye examination fees, as well as prescribed eyeglasses and contact lens solution.
• Flu shot: If you haven’t gotten your flu shot yet, you may want to use your FSA dollars to get one now.
• Over-the-counter items: While you’re no longer allowed to use FSA dollars for over-the-counter medication, there are still plenty of over-the-counter items that are acceptable to use FSA dollars to purchase such as sunscreen with SPF of 30 or higher and hot and cold first-aid wraps.
• Physical exam: If you haven’t had your annual exam this year, get one scheduled!
• Prescriptions: Many insurer mail-order pharmacy plans and pharmacies will fill 90-day prescriptions, so load up now.
• Weight loss: If your doctor agrees your weight is an issue, consider asking for a recommendation to a Nutritionist. Provided you receive a letter from your doctor listing weight loss as a treatment for a specific diagnosed disease, you could use FSA dollars for weight loss over-the-counter drugs and/or weight loss programs and fees.

While the items above are qualified expenses you can purchase using your FSA dollars, be careful on using those dollars on items that are not covered. FSA dollars cannot be used to pay for:

• Baby sitting or childcare
• Cosmetic surgery
• Future medical care
• Health club dues
• Nonprescription drugs and medicines
• Insurance premiums

Remember to submit your claim within your current claim period. You will also need to make sure the expense is incurred during the plan year to be eligible for reimbursement.

Have you reconciled your bill lately?

As time consuming as it can be, reconciling your bill each month is a very necessary part of your employee benefits. You could be paying hundreds of dollars each month for people who should no longer have coverage.

It is very important that changes to eligibility be communicated timely. Due to legislative changes in healthcare, retroactive terminations may no longer be accepted. Often, it is on the monthly invoice from benefit carriers that we find out that an enrollment or termination has not been applied properly.

Invoice reconciliation can take time, but it is time well spent. We recommend setting aside a specific day and time each month to review the billing. For example, the bill is received on or around the 5^th of each month; you can reconcile the bill on the 10^th of every month. Owners and managers may often require the audit be performed prior to signing the corresponding check. This is just final review of the information prior to paying the premiums.

Be sure all new hires have been added, terminated employees have been removed, and changes are reflected.  It is much easier to research and correct discrepancies immediately rather than months later when it may no longer be possible to make the change.

As flu season nears, questions are sure to arise about how the flu shot will be covered under your health insurance plan, where you can get a flu shot, when you should get a flu shot and many others. Knowing that all our clients are not covered by the same insurance carrier, we have compiled all the information you will need about flu shots in one place. Whether you have health insurance through CIGNA, Anthem, UnitedHealthcare or Rocky Mountain Health Plans, this is your readily available guide to use when you need to start making decisions on a flu shot.

Flu Shot 101

First and foremost, you should know the basics about the flu shot:

• Why get the flu shot?
• Who should get the flu shot and when?
• Who should not get the flu shot?
• What are the risks of getting the flu shot?

The Center for Disease Control (CDC) has developed a clear and concise to help you answer all the above questions, all in one place. Please read that document here.

The Flu Shot and Your Health Care Coverage

So you read the CDC information on flu shots and you have decided to get a flu shot. Now what?

If you do not have health insurance, the answer is pretty easy. Call your doctor or go to your local pharmacy. The cost of a flu shot is fairly inexpensive and if it saves you from getting the flu, taking a sick day at work or missing out on a paid day of work all together, then the cost is worth it.

And if you do have health insurance, the answer is almost just as easy. To make it really easy, we have broken down the information below about how each insurance carrier we work with will cover the flu shot. Find the insurance company you have your health insurance with and read on to find out how the flu shot will be covered under your health insurance plan. And as always, if you have further questions, please call us.

Anthem

Anthem will cover the flu shot based on a couple of factors: whether or not your health insurance plan is “grandfathered” or not and where you go to receive the flu shot. Basically, if your group health insurance plan with Anthem is considered “non-grandfathered”, the flu shot is covered at 100%, provided the flu shot is given in either an in-network physician’s office or in-network pharmacy. As the terms “grandfathered” and “non-grandfathered” are relatively new terms that came out of health care reform implementation, many of you likely do not know whether your plan is grandfathered or not. In that case, please call our office and we will be happy to help you find out how the flu shot will be covered under your plan.

If you receive a flu shot at a clinic that is out of the Anthem network, Anthem will reimburse you up to $25. To be reimbursed, you will need to complete a flu shot claim form. You can view the flu shot claim form here and submit to our office once complete.

For a comprehensive list of preventive health services covered by Anthem, view the PDF here. Anthem has added several new screening tests, counseling intervention services and has added services associated with previously covered screenings and vaccines.

CIGNA

Starting October 1st, 2011, CIGNA has partnered with several pharmacies and retail locations to administer the flu shot. Locations include Albertson’s Pharmacy, CVS, King Soopers, Rite Aid, Safeway, Target and Walgreens. You can also use their online provider directory to find other participating providers, such as physicians or other locations where you can get the flu shot. The flu shot will then be billed to CIGNA in accordance with your health plan.

UnitedHealthcare

Flu shots are covered at 100% if received during a physician office visit that is an in-network provider.

Also, flu shots are covered at 100% at the following retail pharmacies: The Little Clinic, RediClinic, Walgreens, CVS and Target. If a flu shot is received at the pharmacy counter at King Soopers, Safeway or Wal-Mart, members may incur added costs. However, if the flu shot is received through a convenience care clinic at the above mentioned locations (King Soopers, Safeway or Wal-Mart), the flu shot will be covered at 100%.

UnitedHealthcare has developed a nice flyer on locating flu shot providers in your area and even compiled information on work site clinics. Take a look at that PDF here.

Rocky Mountain Health Plans

Flu shots are covered at 100% if received during a physician office visit that is an in-network provider.

Visit one of the following pharmacies and the flu shot will also be covered at 100%: Albertsons, City Market, Colorado Flu Clinics (CIPAC), King Soopers, Rite Aid, Safeway, Target or Walgreens.

We realize making the best choices when it comes to your health care dollars is important to you, so we hope the above guide is helpful to you. But the bottom line is: don’t be one of the 5-20% of the U.S. population that develops the flu each year or one of more than 200,000 hospitalizations from flu-related complications. As most insurance companies either cover the flu shot at 100% or with minimal cost to you, we urge you to take advantage of this benefit.

Yes, it’s true! We’re giving away a brand-new bike. Again!

It seems to be a common theme around here. We love the thought of giving away something that promotes health and wellness, and what better way to do that than by giving away a bike?

So why are we giving away another bike?

Here’s why:

Shirazi Benefits is going to have a booth (#28) at the 7th Annual Northern Colorado Business Report’s Bixpo. If you aren’t familiar with Bixpo, it just so happens to be the largest regional business and industry event in Northern Colorado. This year, Bixpo will take place on Thursday, September 15 from 10am-5:30pm at the Embassy Suites in Loveland, CO.

Along with Bixpo ties-in the 2011 BizFit Challenge, also put on by the Northern Colorado Business Report, in which Shirazi Benefits participated in. The BizFit Challenge was a way for businesses to get involved in challenging themselves and other northern Colorado businesses to healthier lifestyles and better health. An awards luncheon will be held on the same day as Bixpo to honor those company teams that participated.

This is where the bike comes into play. What better way to send the message during Bixpo that Shirazi Benefits is not only just a leader in group employee benefits, but we are also a company that cares about the health and well-being of our employees AND our clients!

Starting Thursday, September 1st at 12:01am MST and running through Thursday, September 15 (the day of Bixpo) at 11:59pm MST, you will have two ways to get your name entered into the drawing for a brand-new 2011 GT Transeo 4.0 Hybrid Bike.

Receive one entry each for doing the following (max of two entries per person):

• Like our facebook page. This literally will only take seconds of your time!
• Stop by our booth (#28) at Bixpo, and drop your business card into the drawing bowl.
  • Not only will you get to see many of our smiling faces, but you will also get to see the bike in person and be guaranteed to walk away with one of many numerous smaller giveaways!

Now, don’t be shy. We want YOU to win! So like our facebook page and stop by our booth at Bixpo. And tell your friends and co-workers. Hey, if someone you refer wins the bike, they may just let you take the bike for a spin.

Additional giveaway details:
Contest will end at 11:59pm MST on Thursday, September 15, 2011. Winner will be chosen at random on Friday, September 16, 2011 and be notified with further instructions.

Child-only policies are now available for purchase! For those unfamiliar, a child-only policy means there is no adult on the individual policy. This is great news for parents in many different situations, including those that simply cannot afford to put their child(ren) on the group health insurance plan.

Under the new health care reform law, insurance carriers in the individual (non-employer) market can no longer deny coverage to a child with a pre-existing condition. However, in the 2011 legislative session, the Colorado Legislature passed and signed into law that takes an additional step by requiring any insurance company that sells individual policies to adults and families, to also sell child-only policies.

Like many employer plans, there will now be “open enrollment” periods when child-only policies can be purchased. The open enrollment period began on August 1^st, 2011 and ends on August 31^st, 2011. Coverage will be effective on October 1^st, 2011.

If you are interested in applying your child for a child-only policy, applications will need to be completed and returned to our office by the August 31^st deadline. After this deadline passes, there will not be another open enrollment period until 2012, in which insurance carriers will then be required to hold an open enrollment period each January and July for the entire month.

Outside of open enrollment, the only other time you may apply for child-only coverage is if a parent experiences a qualifying event (ie birth, adoption, marriage, divorce, loss of employer-sponsored coverage, loss of eligibility for Medicaid or CHP+, entry of a valid court or administrative order mandating the child have coverage, or involuntary loss of existing coverage).

All child-only policies are guarantee-issue, meaning the insurance carrier cannot deny coverage unless the child has access to other creditable coverage such as a parent’s plan through an employer. Although these policies are guarantee-issue, an insurance carrier can still charge a higher premium if a child has a pre-existing condition.

Both CIGNA and Anthem are only offering (1) child-only policy each. Below is a side-by-side comparison of their benefits. Rocky Mountain Health Plans is another carrier that will also be offering child-only policies, but they have several policy options available. Please call our office if you would like more information on a Rocky Mountain Health Plan child-only policy or would like to see complete benefit summaries of the CIGNA or Anthem child-only plans.

If you are interested in applying for coverage, would like to obtain rate information or have any other questions, please call our office.