Tag Archives: Human Resources

Open Enrollment Series Part 2: What’s a Deductible Anyway? And 4 Other Health Insurance Terms You Need to Know

Now that the election is over, it’s time to turn the focus back to YOU as you begin to make decisions for your 2017 health benefits.  As I mentioned in the last blog, this series is about YOU and your Open Enrollment.

Certainly, anyone who has ever had health insurance is familiar with the term, deductible. However, I find that many people do not fully understand what a deductible is or how it impacts their health insurance plans, premiums and overall out-of-pocket costs. Today, I would like to review deductibles and four other frequently used health insurance terms.

  1. Deductible

The deductible is the amount you will need to pay for health insurance services before your health insurance begins to pay towards your healthcare services.  The deductible may come in at any point depending on what type of health insurance plan you have.  Some plans, specifically high deductible plans (see below), do not pay anything until the deductible has been entirely met, with the exception of some services such a preventative care.  Once you have paid your plan deductible, your health insurance will then cover the costs, and you will only have to pay the required copays or co-insurance.  Your plan’s Summary of Benefits will detail which type of payment is required.  On the Summary of Benefits, you may see the following: X-Rays and Lab Work – $0 after deductible.  This means that you must first pay your deductible, then, you will not have to pay for x-rays and lab work.

Example: Deductible = $2000. The cost of an x-ray is $150. If you have not paid any of your deductible, the cost of the X-Ray to you will be $150. However, if you have already paid your deductible, your cost for the X-ray would be $0.

It’s also important to note that your prescription plan may have separate deductibles from your medical plan.

Example: Medical Deductible – $2000; Prescription Plan Deductible – $100 (this means that you must pay $100 towards your prescriptions before your prescription plan begins to cover your medications.)   Some drugs are covered at no cost.

  1. Copayments (Copays)

Not to be confused with coinsurance, mentioned below, is the amount that you agree to pay as part of the service that you receive.

Example: A visit to your Primary Care Physician may have a visit co-pay of $20. Even if you’ve already met your deductible, $20 is your co-payment.  If you have not met your deductible, you will pay the co-payment + the allowable cost of the service.

  1. Co-Insurance

Similar to copays, except co-insurance is typically detailed in percentages.  Co-Insurance is the proportion of costs that you pay after your deductible is paid.

Example: The allowable fee for a service in your plan is $100, if the co-insurance is 20%.  You would pay $20 – once your deductible is paid.  If your deductible has not yet been satisfied, the amount you would be responsible for is $100.

  1. Flexible Spending Accounts (FSA)

A Flexible Spending Account is an account that you set up with your employer to put aside pre-tax money for qualified medical expenses and reimbursement.  Why should I do this? These funds you set aside for medical expenses are not taxed. Therefore, your overall taxable income is lower.  Below is an illustration from Benicomp.com of how you may benefit from enrolling in a Flexible Benefit Account.

 FSA Tax Savings Example
With FSA Without FSA
Annual Pay $35,000 $35,000
Pre-tax contribution to reimbursement account -$1,500 $0
Taxable income $33,500 $35,000
Federal income and social security taxes -$7,107 -$7,597
After-tax dollars spent on eligible expenses $0 -$1,500
Spendable income $26,393 $25,903
Tax savings with the FSA $490 $0

Before you go crazy with allotting funds to your flexible spending account, keep in mind that this money is not refundable and is forfeited if not spent by the end of the year (some plans offer the opportunity to carry-over a small amount – check with your Flexible Spending provider).  Therefore, it’s important to estimate your qualified medically related expenses before determining an amount to contribute.  FSA’s are great if you have predictable expenses such as maintenance drugs, glasses, contacts, braces, copays, coinsurance, deductibles, etc.  If you are unsure of what items are covered under a qualified medical expense, click here for a full list of what’s acceptable according to the IRS.

  1. High Deductible Health Plan (HDHP)

A High Deductible Health Plan (HDHP) is a plan with a higher deductible than traditional health insurance plans.  With HDHPs, typically, you are required to pay the deductible before any claims are covered. An exception may be preventative treatments and appointments that are 100% covered. The benefits of an HDHP are that you may use them in conjunction with a Health Savings Account (HSA) – not to be confused with an FSA, as mentioned above.  If you are interested in learning more about an HSA plan and what to consider in determining if this is the right choice for you, check out this article on MyFabFinance.com.

Today’s health insurance is not your parents’ insurance.  Gone are the days of health insurance plans with $0 deductibles, $0 co-pays and $0 co-insurance.  Those plans still exist, but they’re also extremely expensive.  It’s time to take ownership of your health insurance and shop it with the same research and intensity as any other major purchase.

Are there any other health insurance terms that confuse you? Sound off in the comments section below!

Check out Healthcare.gov for a glossary of terms related to your healthcare.                                                                                  

Photo copyright:http://www.episcopalhealth.org/en/blog/articles/do-you-really-understand-health-insurance-terms/

5 Things You Need to Know about the Affordable Care Act (ACA)

Happy November! We’ve successfully made it to Fall. This time of year means the changing of the leaves, pumpkin EVERYTHING, and for many of us, Open Enrollment for our benefits. Like me, many of your employer’s benefit plans begin on January 1st, which means that within a few short weeks, your employer will start to bombard you with emails, flyers, presentations, and fairs – all related to choosing your benefits for the upcoming year.

For some, this time is easy, perhaps you are still part of the group who can, thanks to President Obama, stay on your parents’ insurance until 26, or, you’re a dependent on your spouse’s or partner’s plan. For you, this time of year does not mean as much, although I encourage you to check out what your employer is offering. You may find that it’s a better option for you and your family. One of the things that I’ve found as both an in-house HR practitioner and as a consultant is that selecting your health insurance is a complicated and confusing process for many – even the smartest of us all. Therefore, over the next week, this blog will be devoted to Open Enrollment and to removing (hopefully) some of the intimidation from the process.

The first post in this series is related to health insurance and the Patient Protection and Affordable Care Act of 2010 AKA Obamacare.

If you read the paper or watch the news, you’ve heard of Obamacare. Obamacare, technically titled the Patient Protection and Affordable Care Act (ACA) is a law that was passed by President Obama in 2010. One of the main goals of the Affordable Care Act was to ensure that all citizens have access to quality, affordable health insurance coverage. In this political season, the ACA is something that we hear about almost daily, but I’ve found many people do not understand the law or how it relates to them. I hope this post will help to demystify the ACA and offer a better understanding.

5 Things you should know about the Affordable Care Act:

1) Affordability
You may be thinking that affordability is relative. However, when it comes to health insurance, the ACA has defined it for us. Under the ACA, affordability is no more than 9.5% of your monthly salary. That is, your employer must offer you a plan in which your monthly contribution to the premium is not more than 9.5% of your monthly salary*. If your plan is not affordable, you may shop for a plan within the Marketplace, where if there no affordable plans, you may apply for an exemption.

*If your employer’s plan is not affordable, the company may be subject to IRS penalties.

2) The Marketplace
Typically, the term Marketplace would have a lovely connotation. I picture Etsy, with beautiful handmade jewelry, clothing, and other artistic flares. However, when referring to the Health Insurance Marketplace, it can seem a little intimidating – but it shouldn’t be. It is exactly how it sounds. A place where you can purchase the health insurance of your choice based on your and/or your family’s needs.

Why would you need to go to the marketplace if your employer offers benefits? There may be a few reasons 1) Your employer’s plan is not affordable (see definition above). 2) If you do not meet your employer’s eligibility 3) You are unemployed.

Some states have their own Health Insurance Marketplace, others, defer to the federal Marketplace. You can access your state or federal marketplace here.

3) Minimum Essential Coverage (MEC)
Minimum Essential Coverage is the coverage you will need in order not to receive a fee for lack of insurance. To be in compliance with the law you must maintain minimum essential coverage throughout the year, get an exemption, or pay a fee for each month you go without it (although you are allowed less than three months in a row each year without coverage, due to a coverage gap exemption). You’ll report minimum essential coverage on your Federal Income Taxes for each month you or a dependent had coverage.[1]

4) No Cost Preventative Care
All health insurance plans must coverage certain preventative treatments at no cost. Therefore, procedures such as pap smears, annual physical, and mammograms are covered for free. This is an important part of the ACA to note. Many people choose their plans based on the co-pays, co-insurance, etc. However, if you’re a person who typically only uses insurance for annual check-ups, exams, and procedures, you may not have as many out-of-pocket costs as estimated.

5) The Law Holds Health Insurance Companies Accountable
To ensure premium dollars are spent primarily on health care, the law generally requires that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80% of the premium must be spent on benefits and quality improvement. If insurance companies do not meet these goals, because their administrative costs or profits are too high, they must provide rebates to consumers.[2]

Did you receive a rebate from your health insurance provider last year? This could be why.

I hope this short list helped to take some of the mystery out of the Affordable Care Act. Of course these “5 things” are just a few highlights of the Affordable Care Act. If you’d like to read the law, you may do so here.

Next up in this series related to Open Enrollment: What’s a deductible, anyway?

More information related to the Affordable Care Act can be found at the Health and Human Services website. http://www.hhs.gov/healthcare/about-the-law/read-the-law/

[1] http://obamacarefacts.com/minimum-essential-coverage/
[2] http://www.hhs.gov/healthcare/facts-and-features/key-features-of-aca-by-year/index.html
Photo Copyright: <a href=’http://www.123rf.com/profile_ismagilov’>ismagilov / 123RF Stock Photo</a>

Which Mask Are You Wearing?

Happy Halloween! While I have pumpkins in my entry way and will take the child out for treat-or-treating, I can’t say I’m a person who’s really into Halloween. There are some who goes “all out” for this holiday. However, coming up on Halloween made me think about masks and the ones we wear daily – and we all wear them. I don’t mean to imply that we are not always attempting to be our authentic selves, but there are definitely times when I feel like I’m wearing a mask – especially at work.

I don’t think that in wearing a mask, you’re completely inauthentic or fake. However, I do feel that when you don’t work for yourself and are representing someone else’s brand/image/product, you are wearing a mask of sorts. Also, let’s face it, these masks are often required if we want to sustain our livelihood. For many people, donning this mask is why they often branch out on their own and do things such as consult, open their own business or switch professions altogether.

Wearing a mask at work may simply involve selling a product that you don’t believe in, or the more extreme, not being able to be who you truly are. Some people are closeted at work or, some individuals feel that they cannot celebrate their cultural heritage and identity at work. These are more extreme cases of mask wearing, but you would be surprised how many people are wearing such a disguise.

In honor of Halloween (or maybe reverse Halloween ☺), I’d like to recommend that we take the masks off! Can you imagine how awesome our work environment would be if instead of wearing the masks we think are required, we were our true selves? What a culture of diversity and truthfulness it could bring?!

Are you wearing a mask? What mask are you putting on each day? What’s your scariest professional story? Feel free to share in the comment below!


Photo Copyright: tatyanagl / 123RF Stock Photo

It’s Never Too Late

I am the queen of saying “In my next life, I’m going to do…”. Recently, I’ve found myself saying it more often. Whether it refers to some small choice I’ve made related to the type of vehicle I drive, or, city living vs. suburbia. However, mostly when I say this, I’m referring to my career choices. I love what I do, but I often wish there was a different way for me to apply my experience. That’s part of the reason why I started this blog. I wanted to mesh my knowledge and passion about Human Resources (yes, I have a passion for HR) to my love of giving advice and helping people solve their personal problems.

Recently, I’ve received several signs from the universe that I simply can no longer ignore. I stumbled across an old Business Insider article which detailed several famous individuals; artists, authors, actors and many other known successful people who achieved success or switched careers later in life. Warning: later in life often refers to life after 30 (yikes).  Then, I ran across this quote: It is never too late to be what you might have been – George Eliot.

It finally occurred to me that while I had been saying it jokingly, the reality is that there isn’t another life (as far as I know). I only have one. I am not super-young, but, hopefully, have plenty of years ahead of me. Moreover, while I did not necessarily start the process when I wanted, there’s no reason why my goals must disappear, simply because I’m starting 15 years later.

It was not my intention to share this personal epiphany with the blogosphere. However, there are so many of us who stop short of our dreams because we got married, got divorced, had children, didn’t finish school, ran out of money, the task seemed too daunting, and countless other reasons why our goals may have been deferred. Contrary to what Drake told us, if you’re reading this it’s NOT too late. There are a million other mantras and clichés that say some form of the same thing. The point is, we only have one life. I’ve decided that instead of talking about what I could have done, I’m just going to do it – or die trying. I recommend you do the same.

— Andrea

New Overtime Regulations: What’s it to you?

Overnight, you may have seen in the news that President Obama will be signing into law new Overtime Regulations under the Fair Labor and Standards Act (FLSA) today. The FLSA, in addition to many other things, outlines overtime regulations.

What does this mean for you? If you are currently exempt from earning overtime payments – which is typically 1.5 times your hourly rate for any hours worked over 40 hours per week, you may now be eligible – if your current salary is less than $47,476.

But before you head out to buy those new Louboutins with your extra overtime dollars, please note that this law is not effective until December 1, 2016. This time gives your employer the opportunity to assess their current compensation strategy. Maybe they don’t need you to work those extra hours you’ve been putting in over 40 per week, and they’ll implement a no overtime rule, or perhaps they’ll bump your salary up to the $47,476 threshold, or pay the overtime. This change may have an enormous impact on your employer, and they will have to make adjustments.

This brief post details only a portion of the FLSA and the key provisions of the final rule.  If you are interested in learning more about the new FLSA Overtime Regulations, pop over to the DOL website for more information. overtime-rule-explanation

Number of workers impacted per state. 

Overtime updates will extend protections to 4.2 million workers across the country. *Infographic courtesy of http://www.dol.gov/featured/overtime.

Get Your Apple On

The iPhone® 6 is here! Or at least it will be on 9/19.  With much anticipation, earlier this week, Apple’s CEO, Tim Cook announced the release date of the latest iPhone model and the debut of the Apple watch. My crystal ball is in the shop, but I can pretty much guarantee that there will be a mile long line outside of every Apple® store filled with people clamoring for the tech maker’s newest gadget.  The marketing behind Apple and its products is brilliant. There are not too many other companies where people wait with bated breath to hear what’s coming next. People stalk the website, pontificating on what the next product will be, worshiping all that is Apple. It makes me wonder. What can we learn from Apple? Below is a list. 🙂 

Three things we can all learn from Apple and apply to our career or just everyday life:

1. Be so fantastic that whatever you do people expect it to be great. There are better phones than the iPhone, right? At least that’s what I’ve heard. Still what other phone has people glued to their monitor waiting to stream the announcement  of the newest update to the item and then line up for hours just to get one. Let’s face it; there are better tablets too, for less money even, yet, last year (2013), according to NPD, iPads held 59% of the tablet market in the U.S.

2. Be ready on your time and be worth the wait. Apple is somewhat behind in the “smart watch” game. However, they’ve felt no pressure to beat LG or Samsung to the punch, both LG and Samsung debuted watches last year. Apple waited to unveil the much hyped Apple watch, and it is still not scheduled for release until next year. The verdict is still out on the newly unveiled watch, so whether it’s worth the wait is unknown, however, if it follows Apple’s pattern – it will be. Which leads me to my last example…

3. Be consistent. This doesn’t mean be boring or completely predictable. After all, I encouraged you to unleash your Beyoncé. But, if we’re consistent in who we are and true to our personal brand, we can build trust with others.

I’m not suggesting that Apple is perfect; I’m still trying to figure out how to manage my cloud without sharing my hair salon selfie with the entire blogosphere.  Nevertheless, Apple is clever in how it manages its brand; we could all take a page from their iBook.

Now that the kids are back-to-school, what about you?

I’m not suggesting that you go back to school – unless you want to – but, I know many of you have school fatigue after completing bachelors, masters and terminal degrees. However, unless you know it all, and some of you do ;-), what are you doing about your own personal, professional development? For many of us who hold professional licenses and certifications, we often roll our eyes at the thought of attending one of these mandatory professional development courses just to receive our required CEU’s. However, professional development does not have to be mundane and can give you an opportunity to step away from the day-to-day, give yourself an opportunity to network with people in your field, and step out of your comfort zone.

Professional development doesn’t necessarily mean attending a training course. You can make it whatever you want. It’s YOUR development. It can range from a shadowing exercise to reading a book. Personally, I like to read books in my field by new thought leaders. It’s easy to get into the habit of doing things the way you’ve always done them, however, hearing some of the new theories, techniques, and thoughts related to your profession can be quite refreshing – even if you don’t agree with them. I also find it interesting to read and hear speakers from other industries. Listening to how the tech innovators approach particular issues helps me think about things from a more systematic perspective.  This does not come natural for me. It is far from my comfort zone, but allows me to approach HR matters from a new angle.

For me, September always feels like a fresh start. It’s the end of summer and for many years it was the beginning of a new school term. The beginning of the school year is so exciting because it means you can put away last year and look forward to the full potential of the days ahead. There’s no blueprint to your career. This time of year is perfect for people to plan out their professional development activities. You can make it whatever you choose, and by taking advantage of professional development opportunities, you have a chance to create a career path that’s unique to you. In the words of my favorite poet, “Remind yourself, nobody is built like you. You design yourself.” – Jay-Z

Picture used by permission of Getty Images

Employer a Racist? Are you surprised?

In light of the recently released, racist comments made by Clippers’ basketball team owner, Donald Sterling, I decided to share my thoughts on working for an employer whose values do not align with your own. This post is not another commentary about Donald Sterling’s rants – I believe his comments speak for themselves. However, many people have commented on how his employees, the players, coaches, and everyone else associated with the Clippers, should have reacted. Some think the players should have boycotted by not playing, others believe their silent protest was enough. I truly feel bad for all of those who have to make decisions on how to continue their relationship with this business, something that could have an effect on their families, even considering the penalty that was issued to Sterling, he is still the team’s owner.

I am a novice basketball fan at best. However, my husband and many others like him who follow the sport are not the least bit surprised by the comments made by Donald Sterling. Apparently, he has a history of racist remarks and actions. Remarks that are documented and recorded, remarks that were said in the presence of the former NBA Commissioner, David Stern. Additionally, after a two second Google search, anyone can get a pretty good glimpse of his discriminatory past, including a lawsuit brought by the federal government for numerous violations of fair housing practices, one of the largest lawsuits ever by the federal government. My point is I can understand the frustration of the Clippers’ franchise employees, however, Donald Sterling’s behavior, opinions and comments are not new – or a secret.

As a prospective employee, it is your right and responsibility to research the company that you are interested in, or that is interested in you. With the tools (read: internet) that are available to us today, a quick Google search may help you understand more about the company you choose. Many CEO’s and companies have made their views and values very public. From the political candidates they support to the stance they take on various social issues. You may choose to work for a company that is very vocal about their values and beliefs because they align with your own or you may want a company that is less polarizing, only you can decide what the potential deal breakers are. Not all companies have vocal CEO’s or board members, but you can also follow the money. One thing that may give you a glimpse into the values of the company is where they donate their money and make contributions. Please remember the money trail can be slightly misleading. Donald Sterling was set to receive his second NAACP award for contributions he has made to the organization. However, most companies contribute their money to organizations that have missions they support.

This unfortunate incident with the Clippers is another opportunity to highlight the fact that not only should prospective employers conduct background investigations on candidates, but also prospective employees should do a little investigating of their own. I understand that someone cannot possibly find out everything there is to know about a company and/or their leadership and many times selecting a company can be a gamble. We can only make decisions with the information that is available – and accurate (there’s plenty of false information available too). In this day and age there is no excuse for an employee to work for a business without knowing anything about them. Of course I understand that many people may not be in a position to decline an offer from an organization simply because they do not agree with the organization’s values, and that is completely understandable. However, many of the Clippers’ players and coaches had options. The reality is people have a right to believe and think what they want. The beauty is you do not have to work for anyone you don’t choose to – for any reason. Taking a few moments to research the company may prevent a lifetime (or duration of your employment) of animosity for your employer. Or, at least when you do hear the tapes of a racist rant from your company’s owner – you won’t be surprised.

Where’s Your Beyoncé

Back in mid-December 2013, Beyoncé “surprised” the world and dropped an album in the middle of the night. The big surprise was that there was no marketing, promotion or hype around the diva’s 5th album release. She dropped the album via iTunes at the stroke of midnight. In one day, the album sold over 617,000 copies and in three days over 800,000 copies of the self-titled album had sold.

As news spread across Twitter and Facebook, I was impressed with the fact that at 8 am, Mrs. Carter was the talk of social media, not just entertainment, but mainstream news too. I’ll be the first to admit that I am a Beyoncé fan. I’m not one of these tears at a concert; stand out in the cold fans. However, I certainly appreciate her talent, drive, and the lady can put on a show! But this was a game changer. In an era when artists go on full promotional tours, and billboards are purchased to entice the purchasing public to buy the latest pop sensation, it was quite refreshing to see someone go a completely different route – and with success.

This latest action from Blue Ivy’s mom made me wonder where my inner Beyoncé was hiding. At work, it’s so easy to get caught up doing the same thing, the same way. Why rock the boat? How many of us have great ideas that we’ve been twirling around in our head about how to improve a process or a new solution to a problem. Instead of stepping out of our comfort zone, we end up following the same protocol we’ve always followed, often with the same outcome that we’ve always received.

I’m not suggesting that you completely buck the system. But, when is the last time you took a calculated risk at work? Let’s be honest, as much as this was a risk for Beyoncé, I’m sure her team put their heads together and realized that this was a risk worth taking. According to her record sales – it was. Even if this midnight album drop was a failure, what a statement!

Are you ready to make a statement at work? Or, are you waiting for new music Tuesday to drop your album with the rest of the pop stars?

This Blog is for you!

Welcome to the HR Trendster Blog.

What’s a Trendster?

There doesn’t seem to be a good definition for the word. However, I can tell you – it’s me! I follow (and comment) on what’s current and hip in the world of Human Resource Management. I offer knowledge, opinions, and advice on the subject. I’m a trendster!

Who’s the audience?

You. This blog is for anyone in the Human Resource profession, those who have Human Resource-related questions, managers with a desire to do what’s right, or anyone who has ever known or seen a Human Resource professional (that covers nearly everyone). Mostly, this blog is for those of you who have questions, and are looking for a little advice. I don’t have all of the answers, but I’m a certified Senior Human Resources Professional (SPHR), (the HR folks really like the certification thing), with more than 10 years of Human Resource experience in a variety of industries and positions. Currently, I am the Director of Human Capital Management for a non-profit.

In other words, try me out!

Pop in to read a post, ask a question, or stalk my page.  Everyone’s welcome.

Send your questions to the HR Trendster.