Questions regarding Health Benefits Advisors Inc.

HBA is a full service Medical Benefits Broker/Consultant for employer based employee benefits plans. Ever since last year’s renewal of your health care plans, you have been wondering if your broker was really working for your interests and brought you the best deal. We offer a due diligence checklist that you can use to evaluate and decide if your broker is the right one for you and is providing all of the services you need to keep your HR department and your employees as productive as possible. Some of the items on our checklist

1. Are your employee benefits and contribution policies in line with critical benchmarks?

2. Do you have in place the right employee “wellness strategies”to assure highly productive “at work” employees?

3. How current is your broker on HC Reform legislation?

4. Is your broker considered a valued team member by your HR professionals?

And more… give us a call for a free due diligence checkup!

  • HBA provides access to ThinkHR for all of our customers and at no additional cost for the service.
  • We provide ThinkHR for when our customers have tough HR questions. Normally employers do not know how difficult the issue may be and arenot sure about where to go. Should they contact their a lawyer or is the issue less complex and not require the expertise and cost of a lawyer? Many options cost too much or leave employers with incomplete answers. HR databases help greatly but can only go so far - with complex questions, there is no substitute for talking to a Human Resources expert. ThinkHR Live gives our clients a comprehensive solution including everything needed to establish and maintain HR compliance at the most effective cost.

Yes, we market our clients for all carriers that provide coverage in the area where the clients employees reside. This is the case for medical, dental, vision, life insurance and all other group medical products.
Based on the need of individual clients, we can assist in the outsourcing of all necessary administrative services.
Health Benefits Advisors Inc. was incorporated in 2011.

Questions from Employers

The Affordable Care Act is the nation’s healthcare reform law enacted in March 2010
Obamacare is the name many use for the ACA. Obamacare and the ACA are one and the same.

  • If you have fewer than 50 full time equivalent employees, there are only a few requirements to be in compliance.
    • You must enroll new employees within 90 days of hire (within 60 days of hire in California).
    • You must inform all employees of the availability of the insurance exchanges (Covered California in California). This responsibility is in place even for employers that do not offer employees a group insurance plan.
    • If you offer employees a group health plan, you must provide a coverage opportunity for all employees who work an average or 30 hours or more. There are exceptions for variable hour employees and seasonal employees and a formula is available to calculate which bucket employees fall into.
  • If you have 50 or more fte’s, you are affected by the ACA in very specific areas that can expose an employer to significant financial penalties if out of compliance.
    • The fte calculation is answered later, however, it is the combination of full time employees (working 30 hours or more a week) and a number that represents your full time equivalent of employees. If the total of both numbers is 50 or more, you are subject the pay or play penalties of the ACA.
    • The penalty calculation was recently changed for 2014 and you will need to contact us for an update on how you may be impacted if you have between 50 and 99 fte’s. Basically, the penalty phase is delayed until 2016 and the data compilation of employees hours starts in 2015.
  • Full time is defined as employees that work on average 30 hours or more per week. There is a special calculation to identify variable hour and seasonal employees and once identified, the variable hour and seasonal employees are not considered in the fte calculation.
  • Full time equivalent (fte) employees are based on the total number of part time hours worked for all part time employees. When the total hours worked is applied to a defined formula, a fte number is derived.
  • There is no penalty if you have less than 50 fte’s
  • There is a roll-up provision for companies with common ownership (similar to the 401k roll-up provision used by the IRS. If your total employees in commonly owned companies is 50 or more, you are subject to pay or play penalties and affordable care penalties.
  • If you have 50 or more FTE’s, you are subject to a penalty of $200 per employee per month times the number of full time employees (minus the first 30 full time employees).
  • The ACA law requires all employers (that offer group plans to their employees) to cover all employees that work 30 hours or more.
  • The employer is required to contribute only toward the premium of employees that work 30 hours or more.
  • The ACA requires that dependents be offered coverage but does not require employers to contribute toward the cost of dependents coverage.
  • The ACA law requires that all new hires must be eligible to enroll in the group plan within 90 days of their original hire date. In California, a separate state law requires new employees to be enrolled within 60 days of hire.
  • The ACA only addresses coverage for the medical plans.
  • The ACA law does not define the contribution amount required. This is normally set by the carriers being offered and is normally never less than 50% of the employee’s monthly premium.
  • The ACA allows for the development of exchanges on a state level where carriers can participate in the marketing to all individuals and groups that want to enroll in coverage.
  • Individuals are only eligible for Premium Subsidies (based on total family income) if enrolled through the state exchanges.
  • Employers are only eligible for tax subsidies if enrolled through the state exchanges.
Covered California is the name of the government based insurance exchange available to California residents.
The Marketplace is a term that identifies the exchanges in each state.
Healthcare.gov is the federal exchange available in all States that did not develop their own state based insurance Marketplace.
No more than 90 days after their date of hire except for California employers are required to provide coverage within 60 days of date of hire.
  • Until their 26th birthday.
  • Question. Our adult daughter will turn 26 in September. We were told we can make no changes to our policy until open enrollment the following year. How will this affect her? Will she need to seek other coverage?
  • Eventually she’ll have to get her own plan, but first check with your husband’s employer to find out exactly when your daughter will lose her coverage. Some plans terminate coverage on the 26th birthday, and others will retain coverage through the end of the plan year,”. If your daughter wants to keep her coverage through your plan after she “ages off,” she may be able to extend it for up to 18 months under the federal law known as COBRA. But she would be responsible for paying the entire cost. If she doesn’t have access to good coverage through her own job, she can also check out individual plans on your state health insurance marketplace. Because she’s losing her coverage under your plan, she’ll be eligible for a special enrollment period. If her income is between 100 and 400 percent of the federal poverty level (currently $11,490 and $45,960 for an individual), she could be eligible for premium tax credits to make coverage more affordable. If her income is less than 138 percent of the federal poverty level ($15,856 for an individual) and you live in one of the roughly half of states that have expanded Medicaid to cover childless adults, she may be eligible for that coverage. Check out your state’s health insurance marketplace for more information.

Health Benefits Advisors

31194 La Baya Drive, Ste 100
Westlake Village, CA, 91362

Ph: 949-636-3601
This email address is being protected from spambots. You need JavaScript enabled to view it.

6285 E. Spring Street Box 273
Long Beach, CA 90808

Ph: 562-384-5125
This email address is being protected from spambots. You need JavaScript enabled to view it.

HBA Newsletters

View and Download HBA's quarterly newsletter. Stay up to date on what's happening in healthcare.
May 2014