14 Feb

Happy Valentine’s Day!

Happy Valentine’s Day from your friends at Truss!

valentines day

10 Feb

How to Avoid Wasteful Care and Beat the System

Adam KroegerBy Adam Kroeger, Truss
Client Executive, Benefits

“Hospitals look at primary care as loss leaders to act as feeders. They are more interested in sick patients filling hospitals than well ones being well managed by primary care.” –Jordan L. Shlain, M.D.
San Francisco

I recently visited Valvoline with my “$15 Oil Change” coupon in hand, feeling pretty great about myself.  My wife always gives me a hard time about not using coupons when I go shopping, and this was finally my chance to show her how financially responsible I’ve become. Common sense probably should have told me that four quarts of oil and a filter would cost around $25, but I was anxious to pay my $15, and go home. Sipping on lukewarm coffee and watching “The Price is Right” in the waiting room, I stood up as the mechanic called my name. Imagine my surprise when he pulled out a clipboard and said:

“Mr. Kroeger, did you know your windshield wipers need to be replaced?” My heart sank.
“… and you need a new serpentine belt,”
“… and your coolant needs to be flushed.”
And you get the picture. Before I knew it I was $225 in the hole!

Wasteful Care

Does this story sound familiar? You buy cheap products all the time that lead you into opportunities to buy more expensive products. We call these cheap services, loss leaders.

Unfortunately, we have loss leaders in healthcare as well: Primary Care Doctors. Primary Care Doctors are the “$15 Oil Change” of the medical industry. Especially those that work for major hospital systems.  As profit margins have shrunk over the years, doctors have been forced to rely on their ability to recommend more expensive services to bring in income.

This type of incentive system causes an incredible amount of wasteful, unnecessary care. It’s estimated that as few as 44 percent* of all knee replacements are considered “appropriate”.  Patients who receive physical therapy have better outcomes and higher satisfaction than those who go under the scalpel.

There is a solution

There are several simple ways around this expensive and wasteful issue.  Here are just a few:

  • Always require a second opinion from an independent outside physician. Independent physicians have no incentive to recommend unnecessary, expensive services. This is because they are an unbiased third party and they do not work for a hospital system. Independent physicians will use clinically proven recommendations to get the greatest results for the patient.
  • Add an on-site or near-site health clinic. Having an independent clinic that employees have access to is a fantastic way to influence employees to receive inexpensive primary care without the incentive of a large hospital system.
  • Use a Direct Primary Care provider. Direct Primary Care providers are an alternative to the typical “fee for service” models where doctors are forced to rush from patient to patient. Patients typically pay a monthly, or annual fee, and all primary care services are on retainer.

At Truss, our proven money-saving strategies can be seamlessly inserted into a healthcare plan with little to no employee disruption. For more information, please contact Adam Kroeger at 913-312-5955 or akroeger@trussadvantage.com.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4186920/

30 Dec

Surety Frequently Asked Questions

Surety bond vs Insurance: What’s the difference?
For many businesses, both surety bonds and insurance are needed for obtaining license, or to be in compliance with local laws. So what’s the difference? Simply put, insurance protects a business against loss, while a surety bond protects a third-party from a breach of contract from said business.

Here are some of our most commonly asked questions – with answers for you!

How does it work? A surety bond is a third-party guarantee that a business will meet their legal and contractual obligations. It is guaranteed by a bonding company on behalf of the issuer, but does not protect the purchaser of the bond; it is similar to co-signing on a loan. The bonding company guarantees that the business will fulfill their obligations. Insurance is a two-party agreement, where the risk is transferred from the insured to the insurance company.

How do I know if I need a bond? If you are completing a large scale construction project, especially any kind of public works project, it is likely that you will be required to obtain a bond guaranteeing completion of the project. While surety bonds are most common in the construction industry, customers can acquire bonds for a variety of reasons including licensing, utility deposit, tax guarantees, court bonds (probate and appeal), and Contractor’s Performance and Payment Bonds. The contractor bonds specifically are required on all public construction projects. A Performance Bond guarantees the completion of a project according to the terms outlined in the contract.

What should I look for when selecting a surety agent? There are two aspects you need to evaluate before you hire any surety agent. First, they must possess the knowledge to be your business partner by providing you with advice, suggestions and feedback on many aspects of your business. This would include accounting, operations, internal controls, business perpetuation and more. Their knowledge ensures you will be properly represented as the agent seeks surety support on your behalf in the market.

Second, because every surety is different, your surety agent must have detailed knowledge of the various surety markets. A knowledgeable surety agent with strong connections across multiple markets will be able to match you to the best surety partner for your required bond needs.

There are four things you should do when interviewing a potential agent:

  1. Ask them about their relationships within their surety markets.
  2. Test their accounting and business law skills.
  3. Obtain a list of client contractor referrals.
  4. Ask your other valued business partners (such as your attorney, banker, or CPA) about the agents you are considering.

How is bond eligibility determined? A company’s bond eligibility is based on its solvency and project history. A bonding company will go over the applicant’s financials and credit report, banking financials, and history of project completion to determine eligibility.

How does surety pricing work? It depends on the situation and many factors affect pricing. If you upgrade your financial statement presentation as part of the bonding process, it may affect your rates favorably. A new company may have more challenges acquiring rates than a more established one. The quality of your agent is also an important factor. An agent who has good working relationships with markets will be more likely to place you in a better market.

What happens if a claim is filed against a surety bond? Depending on the type of bond in question, the bonding company will either pay the bill, arrange for the completion of the project or provide payment of suppliers. Unlike insurance, the bonding company will then seek compensation from the corporate and personal assets of the bonded company.

For more stories, please visit our news section: In The News.

More questions on assessing your surety team can be found here: http://trussadvantage.com/our-services/surety-bonds/

28 Dec

Have you received a final “Marketplace notice”?

Employers are receiving notices from the various Marketplace exchanges informing the employer that its employee (or former employee) has been granted a Marketplace subsidy.  The reason the employer receives a notice is because the employee (or former employee) informs the Marketplace that his or her employer has either:

  • Failed to offer the employee health coverage; OR
  • Offered health coverage, but the coverage was not affordable and/or did not provide minimum value.

And if either of these conditions apply, the employee or former employee may be entitled to a subsidy through the Marketplace.

If your employer/client receives a Notice, should it be appealed?

Yes, appeal if one of the following applies:

  1. Any individual for whom the client made an offer of affordable and minimum value coverage for the period of time the individual is shown as having received a subsidy (because the employee/former employee is not eligible for a subsidy if affordable/minimum value coverage was offered and declined).
  2. Any individual who lists your client as its employer but who was not an employee for the period of time listed.

Don’t appeal these categories (because individuals in these categories may be eligible for the Marketplace subsidy):

  1. Any individual who was not eligible to participate in the client’s health plan during the period he/she received the subsidy; or
  2. Any individual who was offered coverage in the client’s health plan, but the coverage was not affordable; or
  3. Health coverage was offered, but the coverage did not provide minimum value.

Here is the longer explanation from our friends at Hayes Benefits for why these categories should or should not be appealed.

  1. Some commentators suggest that an appeal may not be worth the time and effort.  They give two reasons:
  • First, an appeal to the Marketplace, if successful, does not prevent the pay/play penalties from being assessed.  That’s because the assessment is determined by the IRS, which is true; and
  • The IRS will have information about the individual receiving a subsidy regardless of the appeal because the Marketplace will have already furnished that information to the IRS on a Form 1095-A prior to the Marketplace receiving the client’s appeal and stopping the subsidy.
    – That’s also true, and even if the client successfully appeals the Marketplace determination, the client may still need to address a subsequent IRS challenge.
  1. But here is why we believe the appeal is important for those employees who were made an offer of affordable and minimum value coverage:
  • First, the employee receiving the Marketplace subsidy may return to the same exchange in 2017 and again apply for the subsidized coverage.

– Absent information from your client that the employee does not qualify for the subsidy (because he/she was offered affordable coverage), the employee’s subsidy will continue.

– As a result, your client could again deal with the IRS for this employee in 2017 when the matter could have been resolved in 2016.

  • Second, not appealing sets bad precedent if the employee was offered affordable/minimum value coverage (and is therefore ineligible for the subsidy).

– Even though it is the IRS who assesses the pay/play penalties (and not the Marketplace), a favorable decision by the Marketplace might assist in any appeal of an IRS assessment.

– As such, and whether an appeal ultimately helps the client’s position with the IRS is an uncertainty, but it causes us concern if the client does not appeal in these situations.

  1. Here’s the rationale for appealing the situation involving a former employee who terminated employment (for example, an employee who terminated in 2015, but the Marketplace subsidy is for 2016):
  • Even though the client should have no IRS exposure to this employee, we believe that the more prudent action is to appeal.

– First, the record should be set straight that your client was not the employer for the time period in question.

– Second, the reason the client has no exposure is because the individual (who terminated in 2015) will not be on the census of employees reported to the IRS on Form 1095-C for 2016 (and the 1095-A filed by the Marketplace does not identify the employer, only the employee).  As such, there should be no information available to the IRS that would link the individual to the client for 2016.

  • Nevertheless, and even though this should have no IRS bearing, we believe the better approach is to appeal so that the record of employment is documented with the Marketplace (in case the Marketplace does somehow share this information with the IRS).
  1. Here is the rationale for the recommendation as to the categories that should not be appealed:
  • An employee who was ineligible to participate in the client’s health plan.

–  This one is fairly obvious because individuals in this category should be eligible for Marketplace coverage, and depending on their income, may qualify for a subsidy.  As such, there is no basis to appeal.

  • An employee who is offered coverage, but for whom the coverage was not affordable.  [Note that “affordability” is based solely on the rate for employee-only coverage (not family coverage)].

– An example is a part-time employee who has an option to elect client health coverage (but must pay the entire premium).

  1. One final suggestion — for those employees for whom the client receives a Marketplace Notice, we recommend that that your client review the Form 1095-C to determine how the employee was reported to the IRS.
  • The client will want to insure that any appeal is consistent with the information reported on the Form 1095-C.

– For example, the client should confirm that the 1095-C Form reports that affordable coverage was available to the employee (or that the employee was part-time, not employed, etc.).

  • If the 1095-C reporting is not consistent with the actual situation, an amended 1095-C may need to be filed (especially if this could result in a penalty for the affected employee).

 

 

27 Dec

Truss, Lever1 form Strategic Partnership to Help Clients

This article originally appeared on September 19, 2016 in the Kansas City Business Journal.
by James Dornbrook

kcbizjournallogoTwo Kansas City companies formed a strategic partnership to offer each others clients a wider variety of streamlined and efficient business solutions.

Overland Park-based Truss LLC, formerly known as Cretcher Heartland/Power Group, is the second-largest independent insurance brokerage based in Kansas City, with 170 employees and more than $450 million in premium volume. The company is teaming up with Kansas City-based Lever1, a professional employer organization (PEO) that offers outsourcing services for human resources, payroll, employee benefits and workers’ compensation.

An example of combined services Truss and Lever1 are now offering is a benefit package designed to help business owners find the best solutions for the upcoming health care renewal season.

“We’ve been talking for about nine months about how the success and growth of Truss could benefit from adding a PEO into its fold of service offerings,” said Lever1 President Erica Brune, a 2016 Women Who Mean Business honoree. “Historically, PEOs and insurance brokers have thought of each other as competitors, but we’re going to do more than just share leads. By partnering, we’re going to have a unique relationship where we’ll both be servicing our same set of clients, just doing it together.”

Original press release: Truss Lever1 Press Release

22 Dec

Happy Holidays!

Happy Holidays!

Wishing you Happy Holidays and a Wonderful New Year! As a reminder, Truss will be closed on Friday, December 23rd, Monday, December 26th, and Monday, January 2nd. Thank you for a wonderful 2016 and we look forward to serving you in 2017!

 

 

 

20 Dec

Truss Presents: Affordable Care Act Year One Review

aca-webinarPlease join us for a lively discussion and review of the Affordable Care Act 2015 as we revisit the processes that were undertaken to comply with ACA. We will share what we learned throughout 2015 – including successes, challenges, vendor reviews and – most importantly- what adjustments may need to be made for 2016 to help the process run more smoothly and how to address any inquiries you receive from the IRS.

Tuesday, October 11, 2016 10:30 – 11:30 a.m. CST / 11:30 a.m. – 12:30 p.m. ET
Guest Speaker: Scott Millson, Principal with MillsonJames and creator of DIY1095
Sign-up today!
https://attendee.gotowebinar.com/register/196993278704022785

16 Dec

Truss CEO Talks Business on The Grill Nation Show

2On February 6, our CEO Steve Nicholson sat down to talk with Jason Grill about all things Truss.

Lucky for you, you can still listen to the Grill Nation Show here!

Click on the 02.06.16 Grill Nation podcast; Steve’s segment begins at the 21:30 mark.

15 Dec

ACA Deadline Extended

The IRS has released a notice that they are extending the deadline to send 1095-B/1095-C forms to your employees (applicable individuals) from January 31, 2017 to March 2, 2017. This does not affect the actual filing deadlines, which remain February 28th for paper, and March 31st for e-file. 

Additionally, “good faith effort” is being applied this year, just as it was last year. If an employer is deemed to have made a “good faith effort,” then they will not be subject to fees or penalties. Incomplete or inaccurate forms will not be subject to a penalty, as long as they were filed on time and the filer was acting in good faith. For more information visit: www.irs.gov.

13 Dec

DEPARTMENT OF LABOR FINAL OVERTIME RULE REMINDER

Early this year the U.S. Department of Labor (DOL) announced its final Overtime ruling. As a reminder, the purpose of this new rule is to modernize the regulations that govern the exemption of “white collar” employees – executive, administration and profession (EAP) – from the minimum wage and overtime protection of Fair Labor Standards Act (FLSA). The changes made to the three tests required for the FLSA’s EAP exemption to apply include:

  1. Salary base test
      With the new rule the standard salary level will increase from $455 to $913 per week and the highly compensated employees (HCE) total annual compensation requirements will raise from $100,000 to 134,000.
  2. Salary level test
      The new rule allows employers to use nondiscretionary bonuses and incentive payments (including commissions) to satisfy up to 10 percent of the new standard salary level.
  3. Duties test
      No changes made.

This new rule does take effect on December 1, 2016. Automatic updates will happen to the thresholds ever three years starting on January 1, 2020. While additional legislation or judicial action is being considered which may alter or delay this timeline, we recommend preparing as though this rule will take effect December 1, 2016.