Compliance – the Difference between Profit and Loss

In today’s business climate, who can afford not to be compliant? One incident can potentially wipe out all profits, if not shutter your doors forever.

If you’re concerned with keeping up with the ever-changing regulatory landscape, Sequoyah Group can help. We track changes in health care reform and publish them on our site to help you keep up with the latest employer requirements.

  • Healthcare Reform and ACA Reporting
  • Medicare/Medicaid Notifications and Filings
  • Carrier Required Notifications
  • COBRA Notifications
  • Form 5500 Series Filings
  • SPD and WRAP plan documentation
  • ERISA required documentation
  • FMLA and HIPAA
  • Cafeteria Plan Documents
  • Discrimination Testing
  • Specified Disease Policies and Guidance

Frequently Asked Questions

Q: What constitutes a full time equivalent employee (FTE)?

A: Employees who work, on average, at least 30 hours per week are considered full-time.

Full-time equivalent (FTE) employees are calculated by adding all hours worked by non full-time employees in a calendar month (but not exceeding 120 hours for any individual employee) and dividing by 120.

Example: 6 PT employees work 20 hours for 4 weeks. (6 x 20 x 4)/120 = 4 FTE’s

Q: Can I buy my own health insurance plan, even if my employer offers major medical?

A: If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.

Q: What is The Marketplace?

A: The Marketplace (also known as “the exchange”) is an online resource where individuals, families, and small businesses can learn about their health coverage options; compare health insurance plans; choose a plan; and enroll in coverage. In some states, the Marketplace is run by the state. In others it is run by the federal government. The Small Business Health Options Program (SHOP) is a program that simplifies the process of buying health insurance for small businesses. SHOP is designed for small employers with 50 or fewer full-time equivalent employees. With one online application, employers can compare price, coverage, and quality of plans in a way that’s easy to understand.

Q: Can I use an agent or broker to buy insurance in The SHOP Marketplace?

A: You can continue using your current licensed agent or broker to buy health insurance in the SHOP. The premiums you pay will be the same with or without the help of agents or brokers. Agents and brokers are usually paid by the insurance companies whose policies they sell.

Do you have more questions about the Affordable Care Act or group insurance plans?

Call Sequoyah Group – 865-687-3088 or 866-216-6038 – for answers or assistance with SHOP Marketplace. Or bypass the exchange and let us help you compare premiums and coverage off the marketplace.

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