What Makes a Health Plan Enrollment Successful?

Its not an easy task to hold open enrollment meetings for your employees, and its also not easy for your employees to make decisions regarding their health plan choices.  Most employees are nervous about making a  decision, since their election must remain in place for the entire plan year.  Wouldn’t you be nervous too?

Below are some suggestions to assist you and your employees in making the best decision(s) regarding plan choices at open enrollment:

  • Allow employees adequate time to think about the choices and/or discuss the options with their family or providers.  One day or a weekend simply isn’t enough time.  Studies suggest that employees who are given three weeks to make a choice are 50% more likely to remain satisfied with their decision.
  •  Hold open enrollment meetings as far in advance as possible to the plan or carrier change.
  • Provide enough information regarding the plan choices available.  Research shows that employes can make an informed decision once they have an effective benefits education, with their personal questions addressed.  If at all possible provide printed information or access to information online.
  •  Personalized benefit statements can also help an employee to determine the amount they spend on insurance, and if this needs to be adjusted in light of their health care needs.
  •  Give employees the opportunity to ask personal or specific questions related to their health care needs.  Perhaps the enroller can remain on site to answer questions, or the employees can contact someone on their own time to ask questions.  Make someone available to your employees.

Our staff at HealthPlansOnline.com can assist you and your employees with health plan choices and enrollment.  Please contact us at (888) 474-6627.


How to find the actual cost of your prescriptions

Everyone needs to reduce health insurance costs, and have been presented with a Health Savings Account option.  It may save you money, but if you take prescriptions, you will have to pay the full price of the prescriptions to satisfy a high deductible.  Insureds who are coming off a plan with prescription copays do not know the actual cost of their prescriptions.  They just know the $30 prescription copay.  PillBot.com is an excellent resource to identify the actual cost for your prescriptions.

Searching for the “Best” Rx price has never been easier! Simply visit www.PillBot.com and type the name of the medication in a box like below and click submit. You may also conduct your search alphabetically at PillBot.com.

I did a search on the cholesterol drug, Zocor.  Here are the results.  The first line  shows 30 pills each 80 mg for $115.87 or $3.82 per pill.

New Small Group Rate for Blue Shield in July 2011

New Small Group Rate for Blue Shield in July 2011

Blue Shield Group Rate ChangeThank you for your continued support of Blue Shield. Now more than ever, Health Plans Online is committed to helping you manage and grow your business. To help you prepare for the third quarter renewal period, we’ve outlined below some key details:

  • February 18  a rate pass for new second quarter business. In addition, Blue Shield offered renewal date change options for your second and third quarter new and renewing groups.
  • The second and third quarter renewing groups may choose between two specific medical contract/policy (“contract”) terms. New business has contract term choices as well.
  • For the July 2011 rate cycle, your small group rates will increase, however, the average increases are lower than previous cycles with rate actions. Below are some highlights of this quarter’s rate increases1 :
Plan Rate increase
PPO (other than HSA-compatible)
Dental, vision or life2
  • Detailed rates can be found obtained by contacting Health Plans Online.
  • By popular demand,  the RAF program is extended until December 15, 2011.
  • There will be no new benefit changes to medical or specialty products for third quarter 2011.

For the latest information on our July 2011 rate cycle, please contact your Health Plans Online.


Beginning in tax year 2011, the Affordable Care Act (PPACA) requires employers to report the value of the health insurance coverage provided to employees on each employee’s annual Form W-2. This reporting is for informational purposes only, to show employees the value of their health care benefits. The amount reported does not affect tax liability, as the value of the employer contribution to health coverage continues to be excludible from an employee’s income and it is not taxable.

For taxable years beginning after December 31, 2010, employers will be required to calculate and report the aggregate cost of applicable employer-sponsored health insurance coverage on employees’ Form W2s. 1 This new reporting requirement applies for employees’ tax years beginning after December 31, 2010. Because employees are entitled to request their Form W2 early if they terminate employment during the year, payroll systems need to be updated for this change by January 2011.

While most W2s for tax year 2011 will be issued in January 2012, W2s reflecting the new health insurance information must be available no later than February 1, 2011 for any terminating employee. It is important to note that the aggregate cost of an employee’s health benefits will not be included in the employee’s taxable income. The W2 reporting will be a way to track coverage values for the 40% excise tax (starting in 2018) on “high cost” employer based medical coverage above certain thresholds (the so called “Cadillac plan tax”) The coverage costs (whether under an insured or self insured plan) that must be reported under the new requirement include:

• Medical plans

• Prescription drug plans

• Dental and vision plans, unless they are “stand alone” plans (i.e., an employee may elect only dental or only vision and is not required to also enroll in medical coverage)

• Executive physicals

• Onsite clinics if they provide more than de minimis care (The term de minimis means (as provided by IRC Sec. 132(e)(1)) any property or service, the value of which is (after taking into account the frequency with which similar fringe benefits are provided by the employer to the employer’s employees) so small as to make accounting for it unreasonable or administratively impracticable. In other instances where the IRS was interpreting whether a medical clinic provided de minimis benefits, an on-site nurse who provided emergency services was considered a de minimis benefit, while a clinic at a hospital that provided full scale medical treatment was not considered de minimis).

• Medicare supplemental policies

• Employee assistance programs

If an employee enrolls in employer sponsored health insurance coverage under multiple plans, the aggregate value of all such health coverage (except certain benefits, discussed in section below) must be disclosed. For example, if an employee enrolls in employer-sponsored health insurance coverage under a major medical plan, a dental plan and a vision plan, the employer is required to report the total value of the combination of all of these health related insurance policies. For this purpose, employers generally use the same value for all similarly situated employees receiving the same category of coverage (such as single or family health insurance coverage).

Employers will not be required to provide a specific breakdown of the various types of coverage, but must only report an aggregate cost. For example, if an employee enrolls in medical, dental and prescription drug coverage, the employer only has to report the total value of all coverage, not a value for each individual benefit.

Benefits Exempt from Form W2 Reporting Requirements

The following employer provided benefits are not required to be reported on Form W2 under the new health care law:

• Long term care, accident or disability income benefits

• Specific disease or illness policies (such as cancer policies), and hospital (or other) indemnity insurance

policies where the full premium is paid by the employee on an after  tax basis

• Archer MSA or HSA contributions of the employee or the employee’s spouse

• Salary reduction contributions to a Health FSA

To determine the value of health insurance coverage, the employer will calculate the applicable premiums for the taxable year for such health coverage for the employee under the rules for COBRA continuation coverage under IRC Sec. 4980B(f)(4) (and accompanying Treasury regulations). The value that the employer is required to report is the aggregate premium calculated under the COBRA rules, not the portion of the premium that the employee has to pay. If the employer’s plan provides for the same COBRA continuation coverage premium for both individual coverage and family coverage, the employer plan would be required to calculate separate individual and family premiums and the employer would report the value of the coverage the employee received. For example, if one employee received family coverage, the employer would report the premium amount for family coverage for that employee. For another employee that receives individual coverage, the employer would report the premium amount for individual coverage.

This information is for educational purposes only.  Please refer to your tax advisor for additional infirmormation or guidance.