Tag Archives: 401k

‘Alexa, What Is My Deductible?’

When it comes to adoption of technology, simple is most often better than complex. Steve Jobs and Apple went to great lengths to make their products simple. Without user adoption, products fail. Current technology trends continue the move toward simplicity with the advent of artificial intelligence and personal assistant tools like Amazon’s Echo and the Google Home. Before you know it, these tools will enter the benefits world. The question is, who is going to be first and best? And if I am a benefits broker, how does this affect my business?

While many brokers are aware of the vendors that call on them or have booths at industry conferences, I believe the benefits technology race is going to heat up, with new competition entering the market. These new competitors see the market opportunity to automate large segments of our economy, including health insurance and healthcare. You may have heard of some of these companies, like Microsoft, Google, Salesforce.com and Apple. This would be in addition to current leaders such as ADP and Paychex. The stakes of the game will change, and the price of entry, from an investment standpoint, is in the hundreds of millions of dollars. Those with the capital will quickly outpace those with less capital.

Don’t be surprised when you start to see major mergers and acquisitions in the HR and benefits space. Could Microsoft buy Ultimate Software? Why not? Microsoft already purchased LinkedIn and recently hinted at getting deeper into the HR space.

See also: Could Alexa Testify Against You?  

When I look at products like the Amazon Echo and Google Home, I see products that have very quickly grabbed market share, with high rates of adoption. My wife, who is not an early adopter of technology, quickly became a user of Google Home. Why? Because it is easy. Would she have a better understanding of her health insurance if she could simply ask Google? Absolutely!

Benefits technology, on the other hand, has not had broad adoption by employees. Yes, employers have bought systems or brokers have given them away, but when you look at utilization on the employee side it is abysmal. I believe the reason for this is because there is not enough value as a stand-alone solution to generate broad adoption. Keep in mind that the majority of people hardly use their healthcare in a given year, so there is little need to access such a system. I don’t know about you, but I can hardly remember the login to my computer, never mind something I may not use for six months.

The next generation of technology in the HR and benefits area is going to have broader and “everyday” value, while being much easier to use. Market-leading vendors, especially those with a great deal of capital, will invest in the latest technologies to try to win the technology race and gain more customers. And before you know it, you will be saying the following:

“Alexa, is Dr. John Smith from Boston in the Blue Cross network?”

“Ok, Google, request Friday off from work.”

“Hey, Siri, how much does the average office visit cost?”

“Alexa, what is the balance of my 401k?”

“Ok, Google, transfer $500 from my savings to checking.”

The advancement of technology and artificial intelligence has enabled many to have more personalized user experiences. Your Amazon Echo will “get to know you.” Maybe in the near future your doctor will get to know you a little better, too.

Many benefits brokers have chosen some technology vendor with a mission of putting as many clients on the system as possible. This is a risky position competitively as more advanced solutions from highly capitalized companies come along. I don’t know many sales people or business owners in any industry who like running around with the eighth best product. Even more so when it is not necessary. The market and your customers do not care if you have invested thousands of dollars on some technology that may quickly fall out of favor.

One should take the advice of Jack Welch, ex- CEO of General Electric, who once said,

“If the rate of change on the outside exceeds the rate of change on the inside, the end is near.”

For those who have purchased the Amazon Echo or Google Home, you don’t have to look far to see that the outside world is changing faster than the inside. The health insurance and healthcare industries often feel like they are moving at a snail’s pace. Private exchanges were lauded as change, when they really are a reincarnation of cafeteria plans from the ’80s.

See also: Why 2017 Is the Year of the Bot  

With the Trump administration, changes in health insurance legislation may create a shift that empowers the consumer. The industry may need an army of people on the front lines to help the industry move to a whole new paradigm. The vendors will need help and the employers, and employees will need it, too. The technology is there. Alexa is ready. Are you?

3 Money Mistakes Newlyweds Make

Being a newlywed is awesome. I reflect on that season of my life as one filled with joy and anticipation. Sure, that first year of marriage was full of challenges, enormous adjustments and unexpected changes, but on the whole it was great.

We found such relief in finally being married and out of engagement. Engagement is a funny time. You often take on new priorities and responsibilities you’ve never had before (like part-time event planner), and that can wear on you and the relationship after awhile. Engagement is meant to be a temporary phase in life, and most friends I know, myself included, have been thrilled to see an end to it — the lists, planning, preparation, etc. In the midst of all of the planning and celebrating, the topic of money is often overlooked (aside from the wedding budget). Yet studies tell us money is a top cause of conflict and divorce among couples. Money can be hard to talk about. Our culture has made money-talk a taboo subject, which can make it all the more difficult to start talking about money (regularly) with another person, especially if you were used to keeping your money matters private for so many years.

Here are a few money mistakes I see newlyweds make. Regardless of how long you’ve been married, though, it’s always important to check in and make sure you’re not letting the important things fall by the wayside.

1. Forgetting to Update Important Plans and Documents

When you start a job and enroll in your employer’s various benefits, you are prompted to assign beneficiaries to things like your 401(k), group life insurance, even an emergency contact in some instances. Getting married means it’s time to review these beneficiary designations.

You should also review current insurance policies and see if you need to add your spouse to the plan or review your coverage entirely. If you are both on individual health insurance plans through work, it’s worth comparing the cost of keeping your individual plans versus one of you joining the other’s plan. It’s possible you’ll save money by being on the same plan. When evaluating the cost, consider monthly premiums, deductibles, co-insurance and co-pays.

If you happen to have estate-planning documents like wills, health care proxies, living wills, etc., these documents also warrant review and updating when you get married.

2. Overlooking the Need to Get Organized

I know, it’s one more administrative thing that’s not fun to think about or act on, but it is important to be organized. If you don’t talk about it, habits will naturally form, and you’ll likely end up with unnecessary confusion and stress, which can lead to conflict. Don’t be scrappy with your finances. I survive by being scrappy as a parent (I’m a mom of two toddlers). But this ability doesn’t translate as well with finances.

Try this: Sit down and list out all the accounts each of you have and then talk about which accounts you want to join, leave separate, combine, close, etc. Simplicity is a wonderful thing. Decide which account(s) you’ll use for routine expenses, where you’ll keep your emergency savings, longer-term savings and investments. Even if you plan to keep accounts separate, have this conversation so it’s intentional and there’s no confusion about how bills and shared expenses will be handled.

You can also make your credit reports a part of this process — so you both have an understanding of each other’s credit history, and create a plan for building better credit, or maintaining your great credit if you have it. If you’re not familiar with your credit reports, you may find them to be overwhelming at first — here’s a guide to deciphering your credit report. You can get your free credit reports once a year from each of the three major credit reporting agencies, and you can get a free credit report summary on Credit.com, updated monthly.

3. Avoiding Money Talks

Money is a leading cause of conflict and stress for couples, which can be enough to discourage some people from discussing the topic at all. If you learn to talk about money early on (especially when times are good and emotions aren’t running high), you’ll be prepared when money issues arise.

Talking about money feels like creating a new habit. Sometimes you just have to start doing it, even before you’re comfortable doing so, and allow the habit to take shape.

Here are a few starting points for your conversations about money:

  • Your history with money (What lessons about money did you learn as a child?)
  • Current stress points with money
  • Goals you hope to achieve with your money
  • Expectations for your current lifestyle and how you want to use your money
  • Spending habits (Where do you spend money the easiest, with most resistance?)

A Word of Encouragement

Financial unity and stability with your spouse is a process. You don’t have to have all the answers or all of the kinks worked out from the beginning.

If you and your spouse have different approaches to money, (how you spend versus save, what you value, etc.), this doesn’t have to mean never-ending conflict. It’s possible you both need to learn to compromise, and pushing each other toward a middle ground may be the healthiest thing for both of you. And that’s one of the great benefits of marriage — the messy but beautiful process of refining each other and growing together in ways you never could alone.

This article originally appeared on Credit.com and was written by Julie Ford.

A Crucial Role for Annuity ‘Structures’

Every year millions of injured Americans confront critically important financial decisions as their personal injury litigation draws to a close. In planning the path forward and beyond their injuries, the stability and security of ongoing, lifelong income from their settlement, judgment or award proceeds becomes absolutely paramount. The money simply needs to last.

Only one post-injury investment option – – structured settlement annuities or “structures” – – provides a continuing tax exemption for the growth of such benefits.  If the injured individual agrees to a lump sum settlement, the tax exemption for lifelong income disappears.

As of 1983, the Periodic Payment Settlements Act (see also IRS regulation Sec. 104(a)(2)) has made all income from a structured settlement annuity over the lifetime of that individual entirely, unequivocally and absolutely tax-free. Contrasted with a lump sum payment in which only the initial payment is tax free and all subsequent earnings are subject to all applicable forms of state and federal taxation, the structured settlement is considered an insurance policy for payments rather than asset to be taxed upon growth. This view, accepted by Congress in that 1983 Act, makes the value of a structure staggering.

For example, if the injured individual deposits the lump sum settlement proceeds in a bank account, any interest earned would be taxed accordingly. If the injured individual invests the money in taxable bonds or stocks, the interest and dividends would also be classified as taxable income. However, with structured settlement annuity payments, neither the growing COLA payments nor the lump sum scheduled payments, nor the payments beyond life expectancy are ever taxable. If the injured party were to decide on an annuity payout after receiving the funds, the tax benefit would be lost because the funds were accepted separately from the settlement. The critical element is that the structure must be accepted as the payout vehicle initially.

The Tremendous Value of Tax-Free Status

The tax-free effect is quite dramatic. Consider an injured individual in the 28% tax bracket with a 2% fee for a traditional, market-based investment portfolio. In addition to having the risk of a significant reduction or entire loss of funds, the individual’s income from the investment when they are successful will face federal taxes that can reduce actual net income by 30% before accounting for state and local taxes that could tack on another 5% reduction. None of these risks or reductions exists with income from a structured settlement.

For an individual in the 10% tax bracket, earning a 4% return would have the equivalent pre-tax return of 4.44%, and a 15% tax bracket would mean an equivalent pre-tax return of 4.7%.

While a peripheral advantage, the tax-free nature of the structure payout means the individual recipient is not required to deal with the timing and accounting issues associated with the need to pay estimated taxes on this money. With a taxable event, the taxes would be the quarterly responsibility of the recipient. An error in dealing with the estimated taxes could create recurring tax problems.

Therefore, structures not only safeguard the injured individual from the volatility of the stock market, they provide continuing income that one can count on down to the penny and to the day. No wild, market-swing surprises. No reductions in income for taxes. No tax filings and accounting homework.

The Gift That Keeps Giving (and Gives in Other Ways)

In addition to the tax-free opportunity, there are other critical reasons to value the structured settlement for the injured individual. First and foremost, the structure enables the individual to couple the tax advantages with the capacity to schedule weekly income and significant payouts for any future expenses like college tuition, wedding costs or retirement needs to the day and to the penny without any worry about market or 401(k) performance. In addition, because structures are considered a policy for payment rather than an asset, such proceeds generally do not affect eligibility for needs-based public assistance programs like AFDC or Medicaid, as lump sums do. Even if the injured individual is not on Medicaid at the time of the injury, eligibility for many programs — in-facility care, for example — often requires the absence of any significant assets.   As a policy rather than an asset, structure income would be immune from eligibility consideration. Lump sums such as an investment account or a bank account are highly likely to be considered assets that must be eliminated for Medicaid eligibility.

Quite simply, structures may very well be the best way to make sure that the money is peace-of-mind predictable, maximizes other income and benefits and lasts for a lifetime. However, with only 5% of eligible dollars placed in structured settlement annuities, billions in tax exemptions — as well as the opportunity for continuing income security — are squandered every year.

Is a Post-Injury Financial Portfolio “Balanced” Without a Structured Settlement?

While frequently considered an all-or-nothing option, the structured settlement annuity can be used for whatever portion of the settlement, judgment or award that the injured individual chooses.  As with all responsible portfolio plans, balance is a critical value.

With a structure, an injured individual can tailor and fund her entire financial future. In addition to continuing payments, what is scheduled today will be there, exactly as needed, for a lifetime of tomorrows. It is possible to establish a college fund, for example, as part of the settlement that would both schedule and quantify tuition — all tax-free.

Given its value, security and stability, is any post-injury financial plan truly “balanced” without taking advantage of structured settlements? As a highly unusual, tax-free, benefits-exempted gift from the U.S. Congress to the nation’s injured individuals, structures should be a critical feature to secure their financial futures.

Promoting Peace of Mind in Work Comp

An employee’s peace of mind is equal in concern with the physical injury when it comes to a worker’s comp claim. An upset employee can lose motivation, incur a bad attitude and rationalize the over-use or abuse of WC benefits. I am adamant that employee satisfaction is as key a factor in WC claim outcomes as it is in overall employee productivity and job performance.

It is not the adjuster’s primary role to manage an employee’s peace of mind at the start of a new report. While we expect good “bedside manner” from an adjuster, she must reserve a defensive position and be a “bad-cop” if necessary. An astute employer sees the opportunity in meeting an employee’s concerns at the time of an injury. It is like adding another critical brick to strengthen the foundation of employee satisfaction.

The immediate task can be simple. A little bit of confident communication goes a long way. Step one is to put yourself in the injured employee’s shoes and imagine being faced with an inability to work. It is not a comfortable feeling.

Quick Tip: Prepare a “Top-10” Information Sheet for Quick Use

Concept: Include a quick-reading “Frequently Asked Questions” checklist as part of an overall information packet for new WC claimants.

Suggested Top 10 and Recommended Answers:

1) Which doctor do I use? – Identify the preferred list, contracted clinic or emergency facility. Explain degrees of employee choice if any does exist in your jurisdiction.

2) What if I can’t do my job? – “If the doctor determines you cannot perform your job, we will try to match you with a temporary alternate assignment. If there is no ability for you to work, your wages will be paid as a WC benefit.”

3) How much will I be paid? – Provide the statutory calculation formula for the comp rate and specify that the employee’s specific rate will be determined by the claims adjuster within 48-72 hours.

4) When do I start getting checks? – Explain the jurisdictional waiting period.

5) How do medical bills get paid? – “All bills will be paid directly to the doctors/providers. You do not pay any bills for accepted and covered treatment.”

6) Do I need an attorney? – “We will help facilitate your benefits. An attorney is not necessary unless you face a disputed issue and want it to be heard by a judge. However, it is your option and right to consult an attorney at any time.”

7) What do I do next? – Explain any other internal steps and forms; explain that an adjuster will make contact and go over additional information. If you have a designated adjuster, provide a name and contact info.

8) What about my health benefits / 401k contributions, etc? – Explain your policies and the jurisdictional requirements that continue benefits during a WC claim

9) Will I lose my job or be fired? – Explain that filing a WC claim is not a basis for termination but also reserve the right for progressive discipline because of safety violations, attendance, job abandonment, fraud and any internal policies that might relate to WC situations.

10) What if I have other questions? – Provide a designated internal WC contact with an open-door policy.

Stepping Over Dollars to Pick Up Pennies

The U.S. Department of Labor (DOL) is determined to establish regulation over excessive loads and charges built into and sometimes hidden inside 401(k) plans. The costs are known as basis points, called “Bps” (Bips) in the industry, and they represent hundredths of a percent. For example, a load of 60 basis points equals 0.6%, and 100 basis points equals 1%. The DOL’s logic is that trustees and plan fiduciaries are too often oblivious to the excessive costs built into the plan and the resulting reduction in the investment performance for the plan participants.

But why are we being distracted about 401(k) pennies when the real culprits have created a healthcare system where hundreds and thousands of excessive cost “Bps” are annually overcharged to plan participants and employers?

Where is the outrage over the lack of transparency for disclosing fees, charges, expenses and loads built into the healthcare system and health plans offered to employers by insurance companies and HMOs?

Why is no one demanding accountability for massive claim payment errors, overcharges, hidden charges and compensation, excessive fees, hidden spread pricing or medical errors?

Health plan fiduciaries are typically oblivious to the true costs hidden inside their plans in the same way they don’t understand the all-in costs of their 401(k) plan. The major difference is that healthcare waste can easily be 10 times greater than the “Bps” being scrutinized inside 401(k) plans.

Imagine if the plan sponsor was held accountable to a fiduciary standard when managing the health plan. Ignorance is not a defense available to a fiduciary.

How will you change the way you manage healthcare when the DOL’s Employee Benefit Security Administration declares that health plans are subject to 408(b)(2) regulations?

Do you know what questions to ask? Here are a few to think about. See if you know the answers. If you don’t know the answers, then ask yourself, why not? Are you going to wait until regulations mandate that you act in a prudent manner in the best interest of the plan and the participants?

  1. What is the claims payment error rate by your insurance company, health maintenance organization (HMO) or third-party administrator (TPA)? What’s the impact when 3% to 10% of plan expenses are errors?
  2. How much does spread pricing by the pharmacy benefits manager (PBM) cost the health plan participant?
  3. Which physicians are the bad actors whose practice patterns are more than 300% outside established medical evidence protocols?
  4. Which hospitals charge 1000%-plus above Medicare payment rates?
  5. How much did iatrogenic disorders cost the plan?
  6. What percentage of readmissions were preventable?
  7. How much are labs, urgent care, MRIs and Emergency Departments upcoding and overcharging the health plan? What happens when you are accountable because your health plan and participants are paying four to 10 times more for the exact same services?

Health plan court cases about violating ERISA and fiduciary standards are starting to attract the attention of the DOL. Plan sponsors need to change their focus and look at what is really happening inside their health plan(s) and the all-in costs of their providers, just like they are doing now with the pennies in the 401(k) plan.

The dollars you are stepping over will have a dramatic impact on the bottom line of the health plan and its participants. Be prepared in the not too distant future to manage healthcare to a fiduciary standard. But, what you should be thinking now is, why wait?