Helping you make sense of ACA compliance

43953625 - procedure and policiesThe fact is, if you are a business operating in the American marketplace, no matter your size and type, you are likely subject to mandates associated with the Affordable Care Act (ACA). It doesn’t matter if you are a small mom-and-pop shop or a multi-national corporation, ensuring you are fully in line with ACA compliance should be one one of the core operating principles of your operation.

Yet the voluminous complexities surrounding ACA compliance make it difficult for just about anyone to offer the guidance your company needs on their own. Considering you are required by law to offer and manage health care plans for your employees, ensuring ACA compliance is at the front of your mind is critical to avoiding hefty fines and taking care of your people.

Why you need an ACA compliance expert

When it comes to staying compliant, the federal government compels businesses through the use of penalties and punishments. In some cases, penalties can be so severe that unprepared businesses may be forced to shut down. The last thing you or your business needs is the IRS slapping you with a hefty fine over something you should have been able to manage.

Consider that the ACA text comprises around 20,000 pages, and it isn’t difficult to see where it can be quite tough determining which parts of the law are applicable to your company. For sections that do apply to your operation, it can be even more difficult to figure out the intricacies of the application.

What should you expect from an expert?

There is so much to know regarding ACA compliance, that even dedicated legal and HR departments can have a tough time making sense of it all. This is why a dedicated ACA compliance expert can be the real game-changer your business needs. Partnering with or hiring a company to help you navigate the complex health insurance landscape might be one of the best decisions you can make.

A skilled compliance expert will not only help determine policies, procedures, and responses but will know the warning signs if you are in danger of a violation or hefty fine. They can also assist you in finding solutions that match your business need all while ensuring compliance and improving process efficiency.

Compliance in the era of big data

Partnering with an ACA compliance expert provides your business with an experienced professional who knows how to properly sort out the massive amounts of data generated, especially when those data points are coming from so many different sources.

Interoperability between legal, HR, and ACA systems can also be quite a challenge. When systems cannot communicate with each other – or when too much data makes it impossible to determine a procedure – your company could be exposed in a potentially expensive way. Working with an ACA compliance expert ensures the proper data is gathered and sent to the correct federal agencies.

Compliance experts have procedures in place to ensure a system of record is created and kept. Not only can they help you navigate the details of record keeping itself, but in doing so create a paper trail that will be a huge help if the IRS or another agency ever decides to put your operation under a microscope.

If you are looking for an ACA compliance expert that you can count on, a partner who can offer you comprehensive, effective, and proven solutions, then it is time to give your friends at Hays Companies a ring. You deserve to sleep well at night! With our team at your side, you can feel confident knowing you’re in IRS compliance, and your employees are insured. Call us at (801) 505-6500.

How does value-based health care design work?

22040027 - close up image of human hand holding electrical bulb in darknessCurious about value-based health plan design? If you’re looking for a better way to keep your employees healthy and manage your health insurance costs, it’s definitely worth learning more.

Value-based design is different from the design of traditional health plans. With many traditional plans, for example, consumers pay the same deductible and/or copayment for a variety of health services.

With value-based plan design, however, this cost-sharing between the consumer and the insurance company varies. What employees pay out-of-pocket in copayments or deductibles, for example, is often reduced or even eliminated for ‘high-value’ care.

That’s care by high-quality providers that research shows is likely to have the best health outcome(s) for a particular patient AND prevent future (and more expensive) health problems. An example would be a health plan that has no out-of-pocket costs for physician visits and medication designed to control chronic health conditions such as high blood pressure, high cholesterol, diabetes and other conditions that if not properly managed can become very costly to treat.

Likewise, value-based plan design increases cost-sharing for care considered low-value or care provided by low-quality providers. One key part of value-based plan design is to steer away from costly treatments and services that have been shown to be no more effective than less expensive options.

These two themes of value-based health plan design work together to steer consumers toward the successful management of their health conditions. It’s also designed to promote the most efficient care — not the most expensive. Questions about value-based plan design? We’re here to help you.

Held Hostage by your Renewal?

Did your rates go up and you feel like there’s nothing you can do?
Stop feeling powerless! There’s something you CAN do and we can help.
We’ll talk plan design, strategy, and analytics to keep your rate trend flat. It’s what we do.

Why an elevated employee benefits plan matters

15813496 - file folders with benefits package textAre you looking for a new way to deliver employee benefits? The fact is, the human resource and insurance industries are changing and legacy methods for interacting with patients and delivering a comprehensive employee benefits plan are going the way of the dodo bird. Fortunately, this is a good thing.

Here at Hays Companies, we specialize in providing health insurance, employee benefits and risk assessments for companies in both Utah and Idaho. When it comes to caring for your people, we offer solutions that simply can’t be beat.

An Elevated Employee Benefits Program

The fact is, there are a great many ways to measure the success of your people and have an impact on their lives, whether it be the number of ideas in the pipe, revenues, profits or otherwise. Yet, one of the best ways to recognize them for being a valuable part of the team is to offer a generous employee benefits package.

Yet, for many CFOs and business planners, the thought of setting up a beefed up (and potentially expensive) employee benefits package is daunting. Packages also have a tendency to rise as time goes on, but of course no one wants to yank a benefit just because of changing economic conditions.

Still, an elevated benefits package is what will help you recruit and retain the best talent. That’s where we come in. We specialize in designing benefits packages that fit your specific organization. There is no once-size-fits-all approach and we completely get that.

Managing HR, Benefits and Payroll Technology Solutions

What many HR and operations departments fail to remember – or understand – is that human resource duties, employee benefits packages and payroll technology solutions are all related.

When you are running a finely tuned human resource operation, consistent payroll delivery, fair HR policies and comprehensive employee benefits packages are all one in the same. They help drive overall employee morale and create a sense of satisfaction within your workforce.

Part of designing a comprehensive benefits package for your organization includes a risk analysis, which allows us to determine which options are best for your organization.

Why Every Benefits Package Should Include Wellness

If there is one thing that modern-day employees appreciate, it is when their employer puts an emphasis on their own health and well being. Not only does it help keep them happy and motivated, but it also helps keep your overall health costs low.

Working with us on your employee benefits package includes not just the package itself, but everything that comes from partnering with Hays Companies. As we design your program, we keep HIPAA Privacy and Security in mind.

Rather than hiring an army of experienced professionals to manage all the moving parts with you, we can manage every aspect of your package while keeping rules, regulations, policies and procedures in mind.

Our edge comes from the professional and third-party partnerships we have with industry-leading human capital consulting firms. When we – and our partners – handle the heavy lifting for you, it frees you up to focus on other aspects of your business.

What Should You Keep in Mind?

Of course, the largest part of your employee benefits package is the one that is the hardest to manage: health insurance. But rather than drop health insurance, depriving you of a valuable tool, there are a number of options available to businesses to lower costs while increasing levels of care.

We have spent many, many years making sure we are well aware of these options and the minutiae of the American health care system. When it comes to developing marketable plans for businesses, we are experts.

Are you looking for a solid provider of employee benefits in Salt Lake City Utah? If so, simply follow this link to our website to learn more.

Christmas Lunch Celebration

Thanks @CafféMolise for hosting our Hays Office Christmas lunch! Our group works hard but we can laugh even harder!

Reducing Financial Barriers and Providing Positive Incentives

The first component of a VBBD strategy is to reduce financial barriers to high value services or provide positive incentives for making lifestyle changes. High value services are those that comparative evidence analyses have demonstrated to be effective in improving the health or well-being of an individual.
The most commonly used approaches to removing financial barriers currently used are –
 • reducing co-payment amounts for prescription drugs and equipment (e.g., glucose test strips and needles) used to treat a specific condition, such as diabetes;
• reducing co-payment amounts for specific prescription drugs or equipment used to treat a specific condition when the individual participates in a disease management  program;
• reducing co-payment amounts for office visits billed as wellness visits;
• modifying deductibles for completing a personal health assessment (PHA);
• modifying deductibles for participating in a disease management or wellness programs;
• modifying co-pays or deductibles for completing a shared decision tool before proceeding with preference-sensitive treatments, and
• reducing co-payment amounts for using high quality providers.
Beyond gift certificates and discounts for services or goods (which are structured independent of the insurance design), the most commonly used approaches to providing positive incentives for making lifestyle changes are –
• reducing premium contributions for completing a PHA;
• reducing premium contributions for smoking cessation;
• reducing premium contributions for participating in either a disease management or wellness program;
• making a contribution to an employee’s Health Savings Account (HSA) for completing a PHA, and
• making a contribution to an employee’s HSA for participating in a disease management or wellness program.
Extracted from: Value-Based Benefit Design: A Purchaser Guide, National Business Coalition on Health,

Employers are committed to offering health insurance coverage

17340339 - portrait of confident employees looking at document at meetingHealth insurance coverage is expensive and the costs are increasing every year. Yet large U.S. companies are even more committed to offering health insurance coverage to their employees.

The share of large companies in a recent survey that say they are ‘very confident’ they will still be offering a job-based health plan to their employees 10 years from now rose to 65 percent this year. That’s up from only 25 percent of employers in 2014.

Just a few years ago, many companies were contemplating their options for no longer offering employer-sponsored health insurance coverage. There are many reasons companies are now moving away from that idea. Uncertainty over the future of Affordable Care Act’s marketplaces, a stronger economy, low unemployment and more competition for employees have all played into companies’ decisions to keep offering a health plan.

Is your company contemplating whether to offer health insurance? Not sure if an existing health plan is the right one for your company and employees? Tired of large premium increases each year? At The Hays Companies, we have market leverage from being one of the largest employee benefit practices in the country. We can help you balance the goals of offering quality coverage to your employees and managing costs. As an extension of your internal Human Resources team, we do the hard work on our end to make your health insurance decisions easier.

What does an insurance broker do?

33186456_MYou have likely heard the term before, but do you know what it means? In the modern era, insurance is as ubiquitous as sliced bread, but the people that make the insurance industry hum are far less known. So many experienced, talented individuals work within the insurance industry, but what exactly do some of them do? Today we will talk about the insurance broker.

An insurance broker serves a very critical role in the insurance industry. Large companies and other business entities utilize insurance brokers specifically to offer a level of risk management and special insurance product. Brokers are specifically trained to act on behalf of their clients. They provide advice in the best interest of their clients.

The ins-and-outs of an insurance broker’s job

An experienced insurance broker should be able to help you identify business risks and solutions to inform your decision on what insurance products to purchase. They may also be able to provide you with solutions on how to manage risk in other ways.

An insurance broker may specialize in your industry specifically, or they may deal with many different industries and insurance types. Another area where an insurance broker can offer assistance is through technical advice. This is especially useful if you are in a position where you need to make a claim.

When it comes to utilizing particular aspects of your various insurance policies, it may sometimes be difficult to know the terms, conditions, benefits, and exclusions. A qualified insurance agent should have no problem helping you navigate the wide range of options available to you. Depending on your circumstances, together you can make the most of your insurance budget.

Why should you bother with a broker?

Insurance brokers are extremely knowledgeable about the industry they work in. They often have access to many different policies and insurance agencies. This means they may be aware of policies that are not normally available to most customers.

Some insurance policies can also be quite complicated. When you are working with figures, numbers, and policies you are not familiar with, having a partner who can navigate the insurance waters with ease may be just what you need.

Insurance brokers also do a great job at landing you a good deal for your money. Since they have an in-depth understanding of your unique business needs, they have an advantage when negotiating terms on your behalf.

Another, oft-overlooked area of what a broker does is that of risk management. A risk management program puts some of the responsibility for prevention and loss where it should be, which often results in lower premiums. Loss reduction is key to many businesses.

Where payment is concerned, an insurance broker might charge a fee for their services or receive a commission from the insurance company once the ink has dried. Whatever their fee or payment model, they are required under the law to make it clear to you before any negotiating is done.

Just as you would ensure your due diligence when choosing an insurance plan, the same should be true of finding an appropriate broker. You will need to be able to count on that person to come through with advice or other information when the time comes.

Fortunately, that’s where Hays Companies comes in. For an insurance broker in Salt Lake City Utah that you can rely on for all your insurance and risk management needs, we offer a level of customer service and industry knowledge that is hard to beat. Why put your business in the hands of a company you can’t be one-hundred percent certain has your back? Contact us today. We can help.

Happiness = Productivity

How do you know if your employees are happy? How do you know if you’re happy with the way things are?
“We do not believe in Gross National Product. Gross National Happiness is more important.” – King of Bhutan, Jigme Singye Wangchuck
The concept of Gross National Happiness was first enacted in 2008 by Jigme Singye Wangchuck in the Kingdom of Bhutan, as a philosophy that values collective happiness as the role of government and leadership.
If happier employees make more productive employees, shouldn’t the happiness of your employees be the center of focus? What do your employees want? Better benefits. Lower costs.
Value-based benefits are designed for that purpose exactly: increase benefits while decreasing overall costs. That’s our goal here at Hays.

Value-based health insurance, explained

46606566 - torn paper with word valueHave you heard about value-based health insurance? Count on hearing a lot more about this innovative approach to providing health care to your employees. Value-based insurance plans are designed to increase health care quality and lower costs by using financial incentives to promote cost-efficient health care services and healthy consumer choices.

Think of the value-based concept as a proactive approach to providing better and more efficient care rather than simply reacting to costly health problems. These types of plans encourage the adoption of healthy lifestyles, such as smoking cessation and/or increased physical activity. Employee wellness is a big component of value-based health insurance. These types of plan also cover preventive care, wellness visits and treatments such as medications to control blood pressure or diabetes at low or even no cost.

A focus on wellness and no- or low-cost doctor visits and treatments to control chronic health issues has been shown to lower total health care costs because of fewer surgeries, hospital stays and emergency department visits. Healthier people miss fewer days of work and school because of illness and often have higher levels of satisfaction with their health care and employer.

Want to learn more? At The Hays Companies, we’re here to help our clients create the best benefits programs they can. Call us toll-free at 800-700-3324 or send us an e-mail at for more information.