Tag: Wellness

Counting Employees under the Affordable Care Act’s Pay-or-Play Provisions

Employers subject to the Affordable Care Act’s Employer Shared Responsibility provisions may be assessed a penalty if they do not offer affordable health coverage that provides a minimum level of coverage to their full-time employees and their dependents. Whether an employer is subject to these pay-or-play provisions depends on the number of people it employs. When counting employees, however, there are specific rules that must be followed.

An employer is generally considered an “Applicable Large Employer” subject to the pay-or-play provisions if it employed an average of at least 50 full-time employees, including full-time equivalent employees (FTEs), on business days during the preceding calendar year. To determine whether an employer is considered an Applicable Large Employer for a calendar year:

  • Add the total number of full-time employees for each calendar month in the preceding calendar year, and the total number of Full Time Equivalent employees for each calendar month in the preceding calendar year.
  • Divide the sum by 12.
  • If the result is not a whole number, round it down to the next lowest whole number

If the result of this calculation is less than 50, the employer is not considered an Applicable Large Employer for the current calendar year. If the result is 50 or more, the employer is an Applicable Large Employer for the current calendar year.

[Note that transition relief was provided to qualifying employers with an average of 50-99 full-time and full-time equivalent employees on business days during 2014, so that they will not be assessed a penalty in 2015.]

The first step to counting employees is identifying full-time and full-time equivalent employees. A full-time employee, with respect to a calendar month, is an employee who works an average of at least 30 hours per week, or 130 hours in a calendar month. A full-time equivalent employee isn’t an actual person. Rather, it’s a term used to describe the combination of all non-full-time employees who are counted as the equivalent of a full-time employee.

The number of FTEs for each calendar month in the preceding calendar year is determined by calculating the aggregate number of hours of service for that calendar month for non-full-time employees (but not more than 120 hours of service for any employee) and dividing that number by 120. Fractions may be rounded to the nearest one hundredth.

For example, assume that during each calendar month of 2015, Employer W has 25 employees averaging 35 hours of service per week and 40 employees each of whom averages 90 hours of service per calendar month. Each of the 25 employees averaging 35 hours of service per week count as one full-time employee, so Employer W has 25 full-time employees for each calendar month in 2015.

To determine the number of FTEs for each calendar month, combine the hours of service of the 40 non-full-time employees (40 employees x 90 hours) and divide that number by 120. This calculation (40 x 90 = 3,600, and 3,600 / 120 = 30) shows that Employer W has 30 FTEs for each calendar month in 2015. Since Employer W had 55 full-time and full-time equivalent employees during each calendar month in 2015, Employer W will be considered an Applicable Large Employer for 2016.

The regulations contain a number of specific rules, methods and exceptions that must be considered when counting employees. For example, in some cases an employer may not have to include seasonal workers when counting employees. Given the complexity of some of these rules, methods and exceptions, employers should consult with an attorney to make sure they’ve counted correctly.

At Setnor Byer Insurance & Risk, we are committed to guiding you through the changes coming in 2014. Check back with us periodically for future informational updates about the Affordable Care Act. If you have specific questions about the Act or if you are ready to take action and would like to see how Setnor Byer Insurance & Risk can help, contact us.

If you’d like to subscribe to our weekly newsletters please click here.

Convenience vs. Accessibility. Are we sabotaging our businesses?

In an effort to avoid annoying and unnecessary communication, are we insulating ourselves from opportunity?

Take this situation that happened just yesterday. I had a lead for someone and didn’t have his email address. I called the receptionist to get it. She, rather unpleasantly, answered, “That information’s not available.” Not available? There were several more gracious ways she might have handled the situation, but in an effort to protect her boss from the inconvenience of an unsolicited email, she lost him a great lead. Why would I refer business to a company with a culture that doesn’t welcome communication?

It got me thinking about all the times I’ve unsuccessfully dealt with automated receptionists, voice mail hell and websites that offer only an automated contact form or a general email address. Any company that won’t let me communicate with someone personally tells me their convenience is more important than my business.

By contrast, I applaud websites that list everyone’s name, title, extension and email, including the customer service people and CEO. That’s a company that wants to do business with me on a personal level and makes it easy to connect with them.

It’s time to reframe the issue of communication. Have we forgotten it’s the lifeblood of our businesses? We spend thousands of dollars creating websites, brochures and Facebook pages that advertise our companies, yet when someone actually tries to communicate with us, we make it difficult. Does that make any sense at all?

Think of every phone call and email as a potential opportunity. Sure, it might be a vendor that can be a bit annoying, but have you considered, that with a little nurturing, even a vendor you don’t do business with can be a potential ambassador for your company? By avoiding communication, you could be missing leads, a great new employee, the opportunity to build a beneficial relationship or simply the chance to tell someone more about your company, thereby spreading the word.

The most professionally run companies make sure correspondence of any kind is addressed. They understand the need to create a great impression through responsiveness. Even small businesses with limited resources need to take that lesson and run with it.

Sometimes, business leadership becomes so removed from office processes, they don’t even realize what’s happening. That’s no excuse. Test your own company’s friendliness quotient: Anonymously call in to your office to connect with various people and departments. You might be surprised how difficult it is.

Check your website. Are key contacts available? Even customer service contacts should have a name so people feel a personal connection.

Make sure your employees are trained to deal with any type of phone call in a warm and welcoming fashion. Simply transferring someone to another voice mail is not an acceptable solution.

Yes, accessibility takes a little effort and might be inconvenient. But your reputation as a responsive and open business is worth it.

PS – I am shocked at how many voice mail messages say “I’ll get back to you at my earliest convenience.” When did doing business become about your convenience?

 

Angel Cicerone

angel@angelcicerone.com

Safety in Numbers: Monitoring Your Health

The numbers don’t lie: According to PricewaterhouseCoopers’ Health Research Institute, medical costs for 2009 will increase by almost 10 percent, significantly outpacing the current rate of inflation. In response to these skyrocketing costs, the Institute also reports on the increasing popularity of workplace wellness programs, which not only lower insurance costs but boost productivity and improve morale. Here is some vital information that you and your employees need to know about staying healthy and keeping healthcare expenses down.

More and more, we have come to accept the fact that good health is largely a matter of individual responsibility. An important step toward fulfilling that responsibility is to monitor those numbers that are essential for maintaining good health. With that in mind, do you know the significance of the following numbers to your health:

  • 120/80?
  • 30?
  • 2400?
  • 8?
  • 40 and 35?

Knowing what these figures mean and taking the necessary steps to get those numbers within a healthy range are essential for reducing the risk of cardiovascular disease, a leading cause of death.

Perhaps the most important numbers of all are those that make up the ratio 120/80; according to the American Heart Association, the optimal blood pressure for adults should be below 120/80. Blood pressure, the measure of the force of the blood through the artery walls when the heart is pumping and relaxing, may be thought of as a water balloon. The water in the balloon creates pressure inside the balloon walls. At a certain point, the water compromises the integrity of the wall, and the balloon bursts. Sustained high blood pressure, known as hypertension, is a known risk factor for heart attack and stroke. That’s why individuals should monitor their blood pressure and make sure it stays under the 120/80 limit.

“30” is the minimum number of minutes of daily exercise that experts recommend for maintaining cardiovascular health, with more recent studies suggesting that 60 minutes of brisk exercise on most days of the week is optimal. Remember, though, that some exercise is always better than no exercise, so don’t get discouraged if you find that you can’t reach the 60-minute threshold. And if you have difficulty squeezing in a 30-minute block of exercise into your busy schedule, get your exercise in 3 10-minute sessions, making sure to work at a brisk pace each time.

Because salt intake is a risk factor for high blood pressure, medical professionals recommend that an individual’s daily salt intake not exceed 2400 milligrams. “Salt” goes by many different names, so be sure to read carefully the lists of ingredients on the foods you eat (particularly processed foods) to check for salt’s many “aliases”: sodium chloride; sodium caseinate; halite; monosodium glutamate; trisodium phosphate; sodium ascorbate; sodium bicarbonate; sodium stearoyl lactylate; and other sodium-containing ingredients. Try to stay below that figure of 2400 milligrams per day.

Are you getting 8 hours of sleep every night, the number that has long been considered optimal for the body to sufficiently rest? The right amount of sleep each night allows the body to repair and rebuild muscle, including the body’s most important muscle – the heart. Tips for getting a good night’s sleep include the following:

  • Avoid caffeine three hours prior to bedtime.
  • Keep your room at a comfortable temperature.
  • Use room-darkening shades that keep out excess light.
  • Stick to a ritual of going to bed at the same time each night.
  • Avoid alcohol.
  • Keep a pencil and paper at your bedside to make lists of those “busy” items that can run through your head at night and keep you awake.
  • Choose healthy foods, such as milk, apples, and peanut butter, as bedtime snacks.

A simple tape measure is not just an essential tool for tailors and dressmakers; men and women should keep one handy to measure their waist lines. Recent studies suggest that the circumference of a man’s waist should be below 40 inches, a woman’s below 35 inches, to lower the risk of high blood pressure, diabetes, and heart disease. To accurately determine your waist size, place the tape measure directly over your belly button – and don’t pull it too tightly to get a lower number!

Keeping track of these numbers that are essential for good health should be on every individual’s “to do” list. To the extent that good choices can make a difference in improving health, doing what we can to keep our numbers within the normal range may increase the quality of our lives and spare us the physical, emotional, and financial costs of getting sick.

® 2008, Summit Health. Reprinted with permission.