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  • Self-improvement is a constant thought in most consumer’s minds and the advertising industry knows this all too well. “The weight loss industry is a 60-billion-dollar business” oversaturated with fitness gurus and companies advocating various fad diets and weight-loss products. However, these media-marketed solutions don’t stick and people end up feeling confused and frustrated.

    Aside from the quick-fix mentality from the media, people are also growing tired of the “just eat less and move more” advice they may receive from their physicians and peers. However, professional wellness coaches, who are trained in behavior modification techniques, can help individuals bridge the gap between medical recommendations and the behaviors required to implement them.

    Wellness educators use behavior modification techniques to help individuals identify personal barriers and set realistic goals 

    Often a visit to a medical professional will encompass a diagnosis and basic advice that leaves many feeling lost in how to take action. This type of care does not help individuals, with their own unique needs or personal barriers, make the necessary adjustments. It also does not allow for the person to create their own solution to the existing problem.  

    Working directly with a personal wellness coach creates long-term successes in establishing healthier lifestyles

    “Researchers at the University of California at Los Angeles analyzed 31 long-term diet studies and found that about two-thirds of dieters regained more weight within four or five years than they initially lost.”

    However, health professionals know that the solution isn’t about following a specific diet or the use of a particular weight-loss product, but instead it’s the level of self-confidence and ability to consistently make small changes that lead to long-term better health.

    Aside from developing new positive habits, “The New England Journal of Medicine found that participants who were coached via telephone spent less money on medical care and drugs and were 10 percent less likely to be admitted to the hospital than those who were not coached.”

    A wellness coach provides the additional support when working directly with clients to:

    • Educate individuals on researched-based theories 
    • Recognize and understand how and when it’s appropriate to adjust a client’s health plan based on current progress of the client 
    • Create a motivating and fun atmosphere where a client can develop confidence and self-efficacy 

    Small Business Guide to Health & Welness

    Meet your GMS Wellness Coordinator Team serving all of Ohio

    Corrinne Ward, RD, LD  

    Corrinne services the greater Columbus/Cincinnati areas. She’s a registered dietitian with professional experience in nutritional counseling for those dealing with diabetes, weight management, high cholesterol, digestive issues, and food allergies. Additional past experience includes leading group and individual fitness classes. 

    For fun, Corrinne is a competitive marathon runner and is married to Mike Ward, who is a manager for the Columbus Running Company. They currently reside in Gahanna, Ohio with their four cats.

     

    Siobhan Hein 

    Siobhan services the greater Cleveland Area, where she is responsible for developing and coordinating client wellness programs. She directs and oversees program activities designed to benefit the health and well-being of client employees, including physical fitness, weight reduction, stress management, and smoking cessation.

    Siobhan received her B.S in Exercise Physiology from Kent State University.  She is passionate about motivating, educating, and inspiring people to make healthier lifestyle choices both at home and at work.

     

    Julie James A.T.C. 

    Julie James has a B.S. of Science with a dual concentration in Sports Medicine and Exercise Physiology. She services the greater Cleveland/Columbus/Cincinnati areas. Julie is a Certified Athletic Trainer with 25 years of experience in several different settings. Her passion has helped expand her knowledge in many areas of wellness. She has spent time as an A.T.C. at the high school, college, and professional athlete level. Her desire to help people of all ages reach their wellness potential led her to the corporate world. Julie designs, implements, and oversees comprehensive wellness programs for companies as well as the internal program at GMS.

    Julie resides in Hartville, Ohio with her husband Sean, daughter Kenzie, and son Sean-Michael. The whole family is immersed in many different sports and outside activities that keep them a very active bunch!

  • Did you know that 75 percent of all healthcare costs are attributed to preventable conditions? Imagine the burden this places on employers and their healthcare costs. Here is what the numbers are saying:

    • 45 percent of Americans suffer from at least one chronic disease.
    • More than two-thirds of all deaths are caused by these five chronic diseases: heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes.
    • Treatment for chronic disease constitutes roughly 96 cents per dollar for Medicare and 83 cents per dollar for Medicaid.
    • More than one in four Americans have multiple chronic conditions (MCC), and this number is continuing to grow.

    Chronic disease, by definition, is a disease that typically lasts three months or longer. In most cases, chronic conditions can be controlled but not cured. In fact, it affects 1.7 million lives each year, being the leading cause of death and disability in the United States. Many people assume this is only affecting the elderly, but in the past 10 years, working aged adults being diagnosed with chronic diseases increased by 25 percent. This epidemic is having a strong effect on the cost of healthcare. A study performed at Milken Institute examined the relationship between chronic disease and absenteeism among full time workers. The study focused on seven different diseases and found that the indirect costs of chronic diseases (such as missed days away from work) are higher than the direct cost to treat them.

    Image of a stethoscope. Learn how workplace wellness programs can help business and employees.

    How Businesses Can Improve Employee Health

    Most businesses take an interest in their employee’s health in one way or another. In addition to the employee’s basic health coverage, some businesses provide amenities like healthier food options in their cafeterias, onsite Fitness Centers and ergonomic desks. These are all well-intended options for helping employees, but when it comes to chronic disease, it barely moves the needle.

    The question yet stands: How can an employer impact the prevention of chronic disease in the workplace? Answer: By educating employees on how to modify their current behaviors before they turn into a chronic condition. Adults spend most of their time in the workplace, which is why it makes the most sense to attempt to reach them at their job. All of this sounds expensive and tough to get everyone involved. Fortunately, the GMS Wellness Program has what you need, at a reasonable cost.

    When instituting a Workplace Wellness Program, your employees are not only supported with education on current topics but also with ways to take their health into their own hands and control it. Unhealthy behaviors like smoking, physical inactivity, poor diet, poor standard of care compliance, insufficient sleep, and lack of health screenings can quickly turn into chronic conditions like diabetes, coronary heart disease, back pain, obesity, COPD, and arthritis. A wellness program can help by providing:

    • A custom program that is in compliance with all of the ACA regulations for wellness plans
    • Health risk assessments, which are protected by HIPAA and confidential
    • Health screenings for height, weight, blood pressure, glucose, and total cholesterol, which are all done on site, with HDL, LDL, and Triglyceride screening available upon request
    • Biometric body fat scans by Body Metrix®
    • On-site wellness recommendations
    • Smoking cessation and drug and alcohol abuse prevention
    • One-on-one communication with a Wellness Coordinator
    • Voluntary lunch and learns, classes, and informational meetings
    • A monthly newsletter
    • Healthy challenges

    Contact GMS today to learn more about the services we offer and how we can make your business simpler, safer, and stronger. 

  • The health and fitness industry is growing in the corporate world; yet preventable diseases are still the leading cause of skyrocketing healthcare costs for employers and their workforce.

    Here at Group Management Services, we do our best to design a program that is suited for everyone and every population. Our main priority is to help your employees achieve their personal health goals without interfering with your business. There are many benefits for the employer as well, such as a decrease in medical costs, reduced absenteeism, increased productivity, and business incentives through the ACA for offering a Wellness Program. Here is what GMS promises you:

    • A customized program that is designed to suit your work environment and employee needs. 
    • A team of wellness experts comprised from various health backgrounds to offer personal, hands-on guidance that will create individual motivation and accountability 
    • Privacy for your employees under HIPPA and other federal regulations while working on personal health goals.

    It’s not just about making or saving money; it’s a way to better the lives of the team you work with every day.

    The truth of the matter is, there are strict government regulations to abide by when it comes to a workplace wellness program. As a result, many companies are turning to professional employer organizations to aid in the proper execution of an effective wellness program at their office.

    Image of a health screening through a workplace wellness program.

    What You Get with GMS’ Workplace Wellness Program

    There are several components to a Workplace Wellness Program, including:

    • Designing a custom program that is in compliance with all of the ACA regulations for wellness plans
    • Health risk assessments, which are protected by HIPAA and confidential
    • Health screenings for height, weight, blood pressure, glucose, and total cholesterol, which are all done on site, with HDL, LDL, and Triglyceride screening available upon request
    • Biometric body fat scans by Body Metrix®
    • On-site wellness recommendations
    • Smoking cessation and drug and alcohol abuse prevention
    • One-on-one communication with a Wellness Coordinator
    • Voluntary lunch and learns, classes, and informational meetings
    • A monthly newsletter
    • Fun challenges

    In addition to the components listed above, you’ll also receive a quarterly review of employee claims and your Wellness Program.

    Give us a call today at 330-659-0100 or contact us online to talk to one of our experts about instituting a Workplace Wellness Program for your business.

  • Don’t look now, but Fall is upon us and we are closer to the start of 2017 than we are the start of 2016.

    We have a Presidential election coming up in a few weeks, meaning that there will be a change in the leadership of this country, one way or another. Either way, expectations are running rampant about changes to healthcare plans in 2017 and the compliancy tied to those programs.

    Image of a sick employee. Contact GMS about healtchare compliance for businesses.

    Potential Healthcare Changes to Consider

    What are these changes that are coming up? According to benefitsnews.com, the following are the top 10 compliance issues to consider when doing your benefits planning for 2017:

    1. Wellness
    2. Essential health benefits and ACA nondiscrimination rules
    3. Mental health parity
    4. Employer shared-responsibility strategy and reporting
    5. Preventive Care
    6. SBC model documents
    7. FLSA’s final overtime rules’ impact on employee benefit plans
    8. Expatriate group health plans
    9. HIPAA privacy, security and electronic transactions
    10. DOL fiduciary rule

    And as an added bonus:

         11. There is a push to make companies with fewer than 100 employees file a 5500 for not only their 401k offering, but also their healthcare benefits. 

    What Business Owners Can Do to Prepare

    For years, business owners would turn to Professional Employer Organizations (PEOs) to help reduce their premium costs in healthcare, risk management, and other HR concerns. In recent years, more and more companies are now looking to PEOs to not only help control their short-term healthcare costs, but also to help put together a game plan for controlling those costs in the future. One healthcare cost that is often overlooked is the cost of compliancy.

    If the list above has you worried about your benefits plans or at a minimum, wondering if you’re compliant, you might want to consider talking with an attorney or a PEO like GMS.  Not only does a PEO provide you the buying power necessary in today’s healthcare environment, they relieve small business owners of the regulatory liability that keep them awake at night.

    If you want to learn more about a PEO and if it’s right for you, contact us today and find out how we can help your business.  

  • In addition to an upcoming national election, we are now quickly approaching open enrollment season for the Affordable Care Act. This is the time of year when people can  apply for healthcare coverage through the exchanges and look for income-based subsidies to help them offset some of their insurance costs.

    It’s also the time when employees who don’t feel they have an adequate or affordable employer-sponsored health plan may  seek out coverage and subsidies through the exchanges. While an employer may be tempted to find relief in one less person to cover (and pay for), there may be some repercussions.

    Image of an ACA notice for an applicable large employer.

    ACA Notices

    According to a recent article in the National Law Review, employers are starting to receive notices that:

    • An employee has been determined to be eligible for premium tax credits or cost-sharing reductions to help pay for Marketplace coverage and has enrolled in Marketplace coverage
    • The employer may have to pay an employer shared responsibility payment (i.e., a penalty) to the Internal Revenue Service (IRS)
    • The employer has the right to appeal the determination

    These notices are typically addressed to the “Benefits Manager” and require action on their part. An employer may appeal by completing and submitting the Employer Appeal Request Form available at www.healthcare.gov or by sending a letter that includes the information requested on the form. The employer can then designate a secondary contact (i.e. an attorney) as the employer’s representative when dealing with the appeal.

    In 2016, only employers that fall into the 50-plus employee range (Applicable Large Employer or ALE) are subject to the penalties.

    Partner with a PEO to Avoid ACA Ramifications

    If you have received one of these and are confused and concerned about the ramifications, it appears you have reason to be. Employer shared responsibility penalties can be substantial if it is determined that an employee is eligible under the ACA. If you are an ALE or on the threshold of becoming one, you should consult with your attorney or explore other options.  

    One of those other options would be to consider working with a Professional Employer Organization like GMS. Contact us today and let our HR experts help you clear your ACA anxiety, by assuring you are compliant with all guidelines.  

  • Are you a business owner looking for additional ways to compensate and retain your key employees? There are several options that are mutually beneficial for employees and businesses.

    I’m going to preface this blog with the fact that I was born and raised in Ohio and am therefore an Ohio State fan. I was on ESPN’s website the other day and came across a story about the “school up north” and their Head Coach Jim Harbaugh getting additional compensation in the form of a life insurance loan.

    The story caught my attention because you don’t see articles like this too often, especially when you are looking to read about sports. The fact is, it is commonplace in the corporate world for businesses to offer additional benefits to key executives and/or employees. The agreement that the University of Michigan and Jim Harbaugh have entered into is called a split-dollar life insurance arrangement. These types of arrangements can be a win-win for the employer and employee.

    Image of Jim Harbaugh. Contact GMS about unique benefits plans for employees.

    Photo by Eric Upchurch via Wikimedia Commons.

    A Win-Win Situation 

    Michigan is able to offer Harbaugh a phenomenal benefit at virtually no long-term cost. The university is loaning him money to pay the insurance premiums, but they will eventually recoup their investment. It will happen either through the death of Jim Harbaugh or the surrender of the policy. There is an opportunity cost to all of this, but at some point in time, Michigan will get their loan payments back. In the process, they get to establish good will with this key employee of theirs.

    Harbaugh benefits by receiving great life insurance policy at a fraction of the cost he would pay outside of this agreement. He will eventually have to report an economic value on the money Michigan is loaning him come tax time. He will have to pay taxes on this value, but that is less expensive than him funding the policy out of his own pocket. 

    As mentioned in the article, Harbaugh has the ability to borrow from the policy while he is still living. The money he borrows is tax-free income; however, he cannot borrow more than 150 percent of the value of the premiums. The reason for this is Michigan wants to make sure they get their investment back. If Harbaugh borrowed too much and passed away, they wouldn’t recoup all of the premiums they loaned him. For Harbaugh, the real benefit is that this protects his family while he is coaching in the event that he passes away and there is a stoppage of income. At the same time, the policy offers the potential to act as a supplemental retirement income stream of money in the likely event that he is living into his retirement. 

    Unique Benefits Plans for Businesses

    This type of arrangement does not work for every business, but there are multiple options for how these types of products can be designed and funded. Benefits like this exist to attract and retain great employees. GMS has partnered with insurance consultants in order to offer these same types of executive benefit plans for their employees. Contact GMS today if you are interested in learning more!

  • Recently, I watched a documentary on Tony Robbins. Tony was telling his audience to write down all the things that were getting in the way from becoming the person they wanted to be and then talked about “looking in the mirror.” This talk made me think of my business and how we conduct exit interviews.

    Whether it’s a voluntary resignation or termination, we always ask the employee to complete an exit interview. It’s a very simple interview asking the former employee about his or her experience working for Group Management Services. In many of the exit interviews the employee talks about enjoying their time here, but their circumstances changed: they received a better offer, had a baby, a spouse is getting transferred, etc. Many have offered useful suggestions that we have acted upon such as “the sales manual needs to be updated, not enough holidays are recognized, need to have a more flexible schedule,” to name but a few.

    These recommendations have all helped GMS become a better company, but they are definitely not the fun ones. The comments I really look forward to are from failing Sales Reps. You see, we have a very thorough sales process. We know how many calls you have to make every day. We know how many people you have to see every week. We know how many people you have to propose to every month. We know who is cheating by looking at the numbers. Thus, their suggestions are the ones I love.

    Image of a man looking in the mirror.

    Looking in the Mirror

    There is almost always a consistent tone to these exit interviews. Here are some examples:

    • “I really liked it in the beginning, but when I didn’t sell anything in the first six months my manager started to micro manage me.”
    • “The training was great in the beginning, but after the first six months, Tim hardly ever came here for additional training.”
    • “Other offices receive more visits and training.”
    • “I don’t feel like our office is as important or as part of the GMS family.”
    • “Don can do whatever he wants. Debbie would call on him to spy on the rest of us, but he wasn’t ever on time.”

    These are all real quotes from real exit interviews.  

    You want more training? Try reading some books. Try Googling a topic. Try calling an expert.  These people have taken zero ownership of their careers. Somebody is getting treated differently? Guess what? It happens in life. Feel like a red-headed step child? Guess what. I was an actual red headed step child. No picnic! Deal with it. You don’t feel part of the family? Do something about it. If you make an excuse every time you don’t experience success, you will be a loser.

    Remember the scene from Good Will Hunting where Robin Williams keeps telling Matt Damon, “It’s not your fault”? That was for being abused as a child. Truly, it was not his fault.  If you are a healthy adult, you should be looking in the mirror every day and saying to yourself, it is your fault. The truth is just about everything in your life is your fault, good or bad.

    This translates to your personal life as well. Your kids are pigs and leave the house dirty? Your fault. Punish them. They will get tired of not having a phone or a gaming system. 

    Your significant other doesn’t want to spend time with you? Your fault. Try doing something special for him or her.

    Your kids don’t call you often enough? Your fault. Make that call the highlight of their day. Your boyfriend is a loser who smokes pot and can’t keep a job? Your fault. Get rid of him. You’ll find another.

    Work to Get Better

    Excuses are crutches that we use to keep our spirits up, but we’re actually fooling ourselves.  Burn the boats. Focus on the basics: 

    • Are you eating right?
    • Are you reading books?
    • Are you associating with successful people?
    • Do you have a mentor? 
    • Are you mentoring anyone?
    • Are you getting enough sleep?
    • Are you getting better every day?

    If you make a habit of getting better every day, you’ll look back after a year and think, “Hmm… that really added up.” After 10 you’ll think, “That was pretty cool.” After 20 you’ll think, “That was badass.”

    “To let life happen to you is irresponsible.  To create your day is divine right.” – Ramtha

  • The cost of prescription drugs in the United states continues to rise which has become a source of concern for everyone from patients to policymakers.  According to a study published in the Journal of the American Medical Association (JAMA), “Prescription medications now comprise an estimated 17% of overall personal health care services in the U.S.”  

    We don’t want to think that we overpay for any goods or services. Taking time to do some research can help you save substantially on your prescriptions. Here are some tips to help save on costs.

    Image of costly prescription drugs. Learn tips to save on prescription drug prices.

    Take Advantage of Generic Drug Options

    Learn your prescription drug copays or co-insurance. Talk to your doctor about prescribing drugs that have generic equivalents. According to the U.S. Food and Drug Administration website, “When a generic drug product is approved, it has met rigorous standards established by the FDA with respect to identity, strength, quality, purity, and potency.” If your medication doesn’t have a generic form, or if it may not be covered under your prescription drug plan, ask your doctor for a generic alternative.   

    Consider Pill Splitting

    Many medications can be split, so talk to your doctor about doubling the strength (40mg instead of 20mg for example) and cutting the pills in half. You would then be charged for 15 tablets instead of 30. 

    According to Kevin Schulman, MD, Professor of Medicine and business administration at the Duke University Medical Center in Durham, N.C., “Sometimes it makes a lot of financial sense to split pills, but if you try to split the wrong sort of medications, that could be potentially dangerous.” So, this is a good option for some people, but as always, check first with your doctor to make sure if it can work for you. 

    Do Your Homework

    Shop around. Prescription drug prices vary from pharmacy to pharmacy, so if you have the time, take your prescription to more than one pharmacy to find the best price. This will help you if you have a high deductible plan with your out-of-pocket costs. 

    Try and Find Discount Cards

    Prescription discount cards sometimes provide even better discounts than what insurance can provide, especially on generic drugs. Websites such as www.goodrx.com and www.blinkhealth.com also provide drug discount information in your area. Pharmacies also have discount cards available.  

    If prescription drug prices are a problem area in your company, contact Group Management Services today. We can help you learn more about the coverage options we can provide for your employees along with our other outsourced HR services.

  • Over the years while working in the field of Workplace Wellness we have seen many programs succeed… and fail.

    Throughout these successes and failures, we have come to realize there are a few key components that make or break a Workplace Wellness Program.

    Image of a woman engaged with her compnay’s workplace wellness program.

    Communication – in All Directions

    Employers need to express, in a clear cut way, that the wellness program is being put into place to benefit all sides. 

    Showing true concern for employees and their personal health goes a long way. Expressing how claims and misuse of their healthcare coverage, along with unhealthy lifestyles, affect both the workplace and their personal life is beneficial in engaging employees in a wellness plan.

    Small Business Guide to Health & Welness

    Use of Incentives & Healthy Challenge Activities

    One of the most effective ways to engage employees to participate in a workplace wellness program is with the use of incentives. The long-term goal of using incentives is to get employees to initially engage in healthy challenges and encourage them to adopt new healthy habits. 

    Money talks. This incentive seems to be single most effective method to engage employees. Examples are:

    • Cash in all forms
      • Discount off monthly premium for every health marker they hit
      • HSA credits for participating in a specified number of wellness activities each quarter
    • Cash prizes or gift cards for individual or team challenges
    • PTO for meeting certain health standard criteria
      • Lunch & Learns – Health topics
        • Attend so many per quarter
      • Walking Challenges
        • Walk and Record 10,000 steps for four out of seven days a week/month
      • Chug-a-Jug Water Challenge
        • Drink and Record eight 8-oz. servings of water four out of seven days a week/month
      • Healthy Lunch Challenge – Eat a healthy lunch three out of five days during the work week
        • Take a screenshot of your lunch and share with co-workers
        • Take a co-worker to a healthy lunch place
          • Divide into groups and each bring a healthy lunch for all on specified days.
      • Team Challenges
        • Divide co-workers into teams and enter into a fun, eight-week challenge
          • Have a point system 
          • Team exercise and nutrition demos
          • Weight loss percentage
          • Attendance points awarded
        • Offer prizes for 1st, 2nd, and 3rd place finishes

    Accessibility to the Workplace Wellness Program

    This is a very important component. The use of a data-driven web-based programs is the No. 1 wellness solution being implemented at this time. While these are a great asset to any program, they do not make people well! A recent Gallup poll shows that web-based wellness programs only have a 27% usage rate among employees after the initial 90 days. 

    What recent studies have shown is that the amount of accessibility an employee has to one-on-one coaching with a designated wellness coach, consistent meetings and demonstrations with an onsite educator, and the ability to earn incentives has increased employee engagement.

    A few ways to increase accessibility are listed below:

    • Offer Lunch & Learns during work hours (20-30 minutes)
    • Allow for employees to schedule a one-on-one session with the wellness coordinator a few times a year during the workday ( 10 minute sessions)
    • Have all educational materials easily accessible, with an online folder and an onsite wellness folder that includes contacts for the wellness coordinator and point person at the workplace

    This is the very foundation of every wellness plans at Group Management Services. We believe that assigning a specific wellness coordinator to each client is the best way possible to reach as many employees as we can. By combining the consistent presence of a wellness professional along with our web-based portal, we can build trust among the employees while still providing verifiable data.  

    Please feel free to contact a Wellness Team Member at GMS with any of your wellness questions!

    Julie James A.T.C., Richfield – jjames@groupmgmt.com 

    Siobhan Hein, Richfield – shein@groupmgmt.com 

    Corrinne Ward RD, LD, Columbus/Cincinnati – cward@groupmgmt.com 

  • The 21st Century Cures Act allows small employers to offer Health Reimbursement Arrangements (HRAs) to their workforce to help cover the cost of medical expenses and health insurance premiums for themselves and their families. Previously, the Affordable Care Act (ACA) prohibited businesses from offering HRAs for individual insurance premiums.

    With the passage of the new law, employers and workers alike have questions about how a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) will affect them. Legal experts are in the process of interpreting the law, below are a few of the QSEHRA FAQs and their answers that are generally agreed upon.

    Image of health legislation. Lerarn more with our 21st Century Cures Act and QSEHRA FAQs.

    Which employers can offer QSEHRAs?

    Small employers with fewer than 50 full-time equivalent (FTE) employees and those who do not offer a group health plan to any of their employees.

    Can employers who have a group insurance plan also offer a QSEHRA?

    No. The Cures Act does not apply to small employers who offer a group health plan.

    What benefits does a QSEHRA cover?

    As defined in Section 213(d) of the Internal Revenue Code, a QSEHRA can cover the cost of any documented healthcare expenses. Additionally, employees can use their QSEHRA to help pay for individual health insurance premiums. All medical expenses, including insurance premiums must be documented and substantiated. 

    Who can contribute to the QSEHRA?

    Like a regular HRA, a QSEHRA is solely funded (100%) by the employer. Therefore, employees cannot contribute and the employer’s contributions are not deducted from the employees’ pay.

    Are there contribution limits?

    Yes. For single employees, the employer may contribute a maximum of $4,950 annually. For employee with family expenses, the employer may contribute a maximum of $10,000 annually.

    What are the health plan requirements for employees?

    Employees must purchase a health plan that has minimum essential coverage (MEC), as stated by the ACA. If an individual purchases health coverage without MEC, then they may be taxed and reimbursements from the QSEHRA may be included in their gross income.

    Can employees be excluded?

    Yes, some employees may be excluded. Employers may exclude the following from receiving a QSEHRA:

    • Seasonal employees
    • Part-time employees
    • Workers who are covered by a collective bargaining agreement in which accident and health benefits were the subject of good faith negotiations
    • Employees with less than 90 days of service
    • Employees who are under the age of 25
    • Certain non-resident aliens

    Are individuals who purchase subsidized health insurance affected by QSEHRA?

    Yes. For employees who obtain health insurance through a public exchange and qualify for subsidized coverage, they must report the amount in the QSEHRA to the exchange. Their federal subsidy amount will be reduced by the amount in the HRA benefit.

    What about employees who currently purchase health coverage on the ACA Marketplace?

    With the implementation of a QSEHRA benefit plan Employees who have been purchasing their individual or family health insurance plans on the ACA Marketplace may continue to do so.

    Does this impact employees who buy health insurance on the independent market?

    Yes. It gives the employee additional funds to pay insurance premiums or to reimburse qualifying medical expenses, if the plan is designed to reimburse IRC Section 213(d) items.

    Is a QSEHRA subject to COBRA or ERISA rules?

    No. Employers are not required to offer COBRA continuation coverage or ERISA since a QSEHRA is not a group insurance plan

    When are QSEHRAs available?

    Employers may start offering QSEHRAs on or after Jan. 1, 2017. Employers must notify their workforce by March 12, 2017 for 2017 plans and upon eligibility for individuals who become eligible during the year.

    Are there administrative requirements for QSEHRA?

    Yes. Employers must provide a written notice to their workforce 90 days before the start of the plan year with the following information:

    • Amount in the QSEHRA benefit
    • Informing employees to notify the exchange of the QSEHRA if they apply for a subsidy
    • Consequences of not getting MEC, which may result in taxes and the inclusion of reimbursements in their gross income.  

    Employers must also include the amount of available QSEHRA benefits on their employees’ W-2s at the end of the year.

    Additionally, in order to be reimbursed for medical or insurance expenses, employees must provide “proof of coverage” to their employer. 

    Are there any charges for GMS to administer the QSEHRA?

    At this time GMS is not charging a setup or HRA document fee to PEO clients. As the details of employee and employer reporting are released by the IRS, GMS may need to charge employers an administrative cost to process the required reporting at the end of the year. Contact us today to learn more about how the 21st Century Cures Act and a QSEHRA can affect your business.