benefits-by-design

How To Avoid High Medical Bills

Wed, 01 Apr 2026 00:16:30 GMT

When people sign up for a new health insurance plan—whether it’s an employer-sponsored plan or one purchased through the Affordable Care Act (ACA) exchange—they are often confused about when coverage starts, what services are covered, and how much they will need to share in the cost of care.

The Kaiser Family Foundation recently compiled a list of seven takeaways from stories about people who ended up paying large out-of-pocket expenses for medical care. Reviewing these tips can help health plan enrollees better understand their coverage and avoid unexpected financial surprises.

1. Most insurance coverage doesn’t start immediately

Many new plans include waiting periods, so it’s important to maintain continuous coverage until your new plan takes effect. Usually, health insurance starts on the first of the month and ends on the last day of the month.

There are special circumstances when someone loses job-based health coverage. In that case, they may elect COBRA or purchase a plan through the ACA marketplace.

With COBRA, once payment is made, coverage applies retroactively—even for care received while someone was temporarily uninsured.

Losing employer coverage qualifies someone for an ACA Special Enrollment Period , which generally allows them to enroll in a Marketplace plan up to 60 days before or 60 days after their employer coverage ends. If someone enrolls before their job-based coverage ends, their new plan can usually begin right away and help prevent a gap in coverage.
If someone enrolls after their job-based coverage ends, Marketplace coverage usually begins on the first day of the month after enrollment, so they could experience a short coverage gap before the new plan starts.

2. Check coverage before checking in

Some health plans include restrictions that may not be obvious at first. These restrictions can affect coverage for services such as contraception, immunizations, and cancer screenings.

Before receiving care, enrollees should contact their insurance company (or for job-based insurance, their human resources or retiree benefits office) to confirm coverage. Ask whether there are exclusions for the care you need, whether there are limits per day or per policy period, and what out-of-pocket costs you should expect.

3. “Covered” doesn’t always mean insurance will pay right away

It’s important to read the fine print about network gap exceptions, prior authorizations, and other insurance approvals. These requirements may apply only to certain doctors, services, or dates.

In addition, even if a service is covered, the insurance company may not pay for it until you have met your deductible or other cost-sharing requirements.

4. Get estimates for non-emergency procedures

Before scheduling a non-emergency procedure, patients may be able to compare prices among different providers. Request written estimates whenever possible.

If the cost seems too high, it may be possible to negotiate the price before receiving care, or find an alternate provider.

5. Location matters

The cost of care can vary significantly depending on where services are performed.

For example, if blood work is required, ask your doctor to send the order to an in-network lab. Sometimes a doctor’s office affiliated with a hospital system will automatically send samples to a hospital lab, which may result in higher charges if the lab is out of network.

6. When hospitalized, contact the billing office early

If you or a loved one is admitted to the hospital, speaking with a billing representative early in the process can help prevent confusion later. Consider asking questions such as:

Has the patient been fully admitted, or are they under observation status?
Has the care been classified as “medically necessary”?
If a transfer to another facility is recommended, is the ambulance service in-network—or can one be selected?

7. Ask for a discount

Medical charges are often higher than the rates insurers typically pay, and providers frequently expect some level of negotiation. Patients may also be able to negotiate their own bills. In addition, uninsured or underinsured patients may qualify for self-pay discounts or financial assistance programs such as charity care.

If you need assistance with your health insurance in California, contact Benefits By Design Insurance Services in San Diego. www.benefitsbydesignca.com or email admin@benefitsbydesignca.com.

Open Enrollment for Individual Family Plans and Covered California

Sun, 26 Oct 2025 14:49:41 GMT

Here Is What You Need to Know

Open Enrollment for Individual Family Plans (IFP) Starts November 1st.

Review your notices from your Health Insurance Company and see if you are ok with just letting your current plan renew or do you want to look at alternative options. Please reach out to schedule an appointment with Pam Morton to discuss it if needed.

What do you need to know if you are enrolled in Covered California about open enrollment for 2026?

If you enrolled in health insurance through Covered California, you should be receiving a notice in the mail or by email soon if you have not gotten it already.

As of 10/26/2025, the enhanced subsidies are still in limbo, pending action from Congress on whether they will be continued into 2026.

Important Information

If you are enrolled in a Silver 73 plan, that is a cost reduction plan only available through Covered California. If you will not qualify for financial assistance in 2026, that plan will no longer be available to you. People who fall into this category will be automatically enrolled in another plan with less rich benefits and a much higher monthly premium unless you take steps to change your plan.

The Open Enrollment Period is November 1 through January 30th. If you make enrollment changes before December 31st, the effective date will be January 1st. You can still enroll or make changes up to January 30, 2026, but the effective date will be February 1st.

What is in your Covered California Renewal Notice?

Changes in your monthly premium
Updates to your deductible or copays
Whether you’ll be automatically renewed in your current plan
Estimated subsidy amounts based on your latest income information

It's your preview of what’s ahead for the next plan year — from a subsidies, rates and benefits perspective. If you have not received your notice, you can call Covered California or go online to review your account.

The phone number for Covered California member customer service is (800) 300-1506 . The service center is available Monday through Friday from 8 a.m. to 6 p.m.. For TTY users, the number is (888) 889-4500.

. How do I read it?

Your notice will explain:

Whether your current plan is being offered again
What your new premium and out-of-pocket costs will be
Whether your premium tax credits are changing (based on income)
Your current plan will be renewed automatically if it is still available in 2026.

What should I look for?

Check the following:

Will your monthly premium change significantly?
Are your doctors and prescriptions still covered?
Are your income and household details up to date?
Are you in the right metal tier (Bronze, Silver, Gold, Platinum)?

Even if your plan will auto-renew, it’s important to update your income. Outdated income information could lead to incorrect subsidy amounts, which could affect your tax refund or tax bill.

Final Tip

Your Marketplace renewal notice is your heads-up to make sure your plan still fits your life and your budget. Use it as your cue to compare options and update your information — especially if your income, household size, or health needs have changed.

If you do nothing, you may be re-enrolled automatically — but that doesn’t mean it’s still your best option.

If you need help understanding your options, we are always here to help!

Give us a call or send us an email, and we will ensure we find the right solutions for you. Let’s make sure you head into 2026 with the right coverage and peace of mind.

Benefits by Design Insurance Services

www.benefitsbydesignca.com

Pam Morton, Agency Owner and Broker

admin@benefitsbydesignca.com

760-696-3573

What Californians Need To Know If The Enhanced Subsidies Are Not Approved for 2026

Fri, 03 Oct 2025 04:34:34 GMT

How Might This Effect Me If I Get My Health Insurance Through Covered California?

For the past several years, millions of Californians have benefitted from enhanced federal subsidies that lowered the cost of health insurance purchased through Covered California. These expanded subsidies, first introduced under the American Rescue Plan and extended through the Inflation Reduction Act, have helped reduce premiums for individuals and families across all income levels.

Unless Congress acts again, these enhanced subsidies will expire on December 31, 2025 . That means starting in 2026, subsidy rules would revert to the old (pre-2021) formula. For many households, this could mean significant changes in what you pay each month.

What Could Happen to Premiums in California

Analysts and policymakers warn of sharp cost increases if the subsidies are not extended:

Premiums could rise by 66% on average for many Covered California enrollees 【sfchronicle.com】.
About 1.7 million Californians could see higher costs, with some middle-income households losing subsidies entirely.
The return of the “subsidy cliff” means that people earning above 400% of the Federal Poverty Level may no longer qualify for any financial help, regardless of how much their premiums are.
California is considering whether to step in with its own state-level subsidies, but nothing is guaranteed, and the funding gap is estimated in the billions 【calmatters.org】.

Why This Matters for You

If you or your family rely on Covered California, here are the main takeaways:

Sticker shock is possible. Without federal help, many Californians will see their net premiums more than double.
Plan choices may change. Some households may have to move from gold or silver-level plans to bronze-level coverage to keep premiums affordable.
Budgeting is critical. Knowing what your plan could cost without subsidies will help you prepare for the worst-case scenario.
If you currently have a Cost Sharing Reduction plan (CSR), such as the Silver 73 plan, you may no longer have access to that plan for 2026 if your income is above the threshold to qualify for it.

What You Can Do Now

While we wait to see what Congress decides, there are practical steps you can take today:

R enewal information will be available on the Covered California Portal on October 15th. Utilize the Shop and Compare tool on the main page at coveredca.com.
Check your income level. If you’re close to or above 400% of the Federal Poverty Level, you’re most at risk of losing subsidies.
Model your costs. Tools like KFF’s premium calculator can show what your premiums could look like without subsidies.
Plan for flexibility. Be prepared to adjust plan levels (for example, from gold to silver, or silver to bronze) if necessary.
Stay informed. Watch for updates from Covered California and state policymakers. California may create new state subsidies, but those decisions won’t be finalized until later in 2025.
Get professional help. Working with a licensed broker can make the process easier and ensure you understand your full range of options.

Final Thoughts

The uncertainty around subsidies may feel unsettling, but the best approach is to stay informed and be prepared . Even if Congress ultimately extends the enhanced subsidies, reviewing your options during Open Enrollment is always a good idea.

As always, we are here to be a resource for you and help you navigate these changes. If you’d like to review your coverage or talk about possible scenarios for 2026, please reach out — together we can make sure you’re ready for whatever comes next. Benefits by Design Insurance Services at admin@benefisbydesignca.com or 415-524-8959 or 760-696-3573.

What's New for 2026 with Medicare Part D Prescription Drug Plans

Fri, 03 Oct 2025 04:06:44 GMT

Know The Changes

In 2026, Medicare beneficiaries with Part D prescription drug coverage will see major changes—thanks to the continued rollout of the Inflation Reduction Act (IRA). These changes are designed to lower out-of-pocket drug costs, improve predictability, and increase access to lifesaving medications.

Here’s what Part D users can expect in 2026:

1. Out-of-Pocket Costs Capped at $2,100 (Adjusted for Inflation)

In 2025, the annual cap on out-of-pocket drug costs is set at $2,000. In 2026, that cap will increase slightly to $2,100 , as indexed for inflation.

Once you reach this threshold, you will pay $0 for covered Part D prescription drugs for the rest of the year—no coinsurance or copays.

What this means for you:

Predictable yearly drug costs
No more catastrophic phase or the so-called “donut hole”
Major savings for those with expensive medications
If you have medications that are not on the formulary, they do not apply to the maximum out of pocket limit.
If you need suggestions on how to purchase high cost medications outside of your plan, contact your insurance broker for suggestions.

2. Medicare Will Start Negotiating Drug Prices

Starting in 2026, Medicare will implement its first negotiated drug prices for certain high-cost medications covered under Part D.

These will initially include 10 brand-name drugs with the highest total spending in the Medicare program.

The first 10 drugs selected for Medicare negotiation are: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, Fiasp / NovoLog.

These drugs were selected because they account for billions in Medicare spending each year, and do not yet have generic alternatives.

What this means for you:

Lower out-of-pocket costs if you take one of these drugs
Improved transparency around drug pricing

The negotiated prices will take effect January 1, 2026 . Additional drugs will be added to this list in the years to follow.

3. Monthly Payment Option for Out-of-Pocket Costs

If paying up to $2,100 all at once sounds daunting, you’ll have another option.

In 2025, Medicare introduced the Prescription Payment Plan (PPP) , which allows you to spread out your Part D out-of-pocket costs across the calendar year .

What this means for you:

You can choose to make monthly payments instead of large up-front costs
Easier to budget and manage finances throughout the year
Enrollment is optional—you can opt in or out as needed
Starting in 2026, if you are enrolled in the PPP, you will automatically be enrolled in the PPP the following year.

4. Insulin and Vaccine Cost Caps Continue

Even as the broader cap changes with inflation, these key protections remain in place:

The insulin cap in 2026 will be the lowest of $35, 25% of negotiated price, or 25% of maximum fair price
CDC-recommended adult vaccines (like shingles and Tdap) stay free with no copay or deductible.

5. Stricter Limits on Price Increases

Drug manufacturers will now face penalties if they raise prices faster than the rate of inflation for Medicare-covered drugs. This rule began in 2023, but will have stronger visibility and impact by 2026.

Coming Down the Road After 2026:

More drugs will be added to Medicare’s negotiation list annually.
By 2029 , up to 60 Part D and Part B drugs may have negotiated prices.

If you have questions, ask for help from Benefits by Design Insurance Services at admin@benefitsbydesignca.com or you can call us at 415-524-8959 or 760-696-3573.

Do you need to have Critical Illness Insurance?

Thu, 04 Sep 2025 00:06:42 GMT

A Real Life Example

A heart attack, stroke, or major organ failure can strike without warning, changing life in an instant. At first, it’s a struggle for survival. If the person survives, the next challenge is often financial—managing the staggering costs of treatment and recovery.

While maintaining good fitness and health is the best prevention, statistics remain sobering: in the U.S., someone experiences a heart-related event every 34 seconds, and someone has a stroke every 40 seconds.

Many people assume their standard health insurance plan will protect them. Unfortunately, the high costs of treating life-threatening illnesses often exceed what insurance covers. Beyond deductibles and copays, patients can face out-of-network fees, specialized procedures, travel and lodging costs, rehabilitation services, childcare, and lost income while recovering. For families without substantial savings, these expenses can be devastating.

This is where critical illness coverage makes a difference.

What a Critical Illness Plan Offers

Critical illness insurance supplements your major medical coverage by providing a lump-sum benefit. This benefit can be used for both direct medical expenses and the indirect costs of recovery.

Typical conditions covered include heart attack, cancer, stroke, end-stage kidney failure, and coronary bypass surgery. Depending on the plan, coverage may extend to other serious illnesses and even preventive services, such as health screenings or cancer vaccines.

The flexibility of how benefits can be used is one of the greatest advantages. Some individuals apply funds toward advanced medical treatments or services not covered by traditional policies. Others use them to cover daily living expenses, transportation, home modifications, or even a restorative vacation with loved ones. Ultimately, the coverage provides peace of mind—allowing patients to focus on recovery rather than financial stress.

How It Works

Critical illness policies vary by insurer and benefit level. Smaller policies, often called “guaranteed issue” plans, usually require no medical exam. Higher benefit amounts may require underwriting.

Premiums are generally tied to age brackets, increasing as you move into a new range. Some insurers raise rates annually. After age 65, many plans reduce benefits—often by half—under what’s known as the age reduction schedule. Most policies expire entirely by age 70 or 75.

Benefit amounts typically range from $10,000 to $50,000, paid in a single lump sum.

A Real-Life Example

Consider Brenda, who suffers a heart attack. Her employer-sponsored health insurance does not cover her testing and angioplasty procedure, but her critical illness policy does. In addition:

During recovery: She uses part of the payout to follow her doctor’s advice, joining a gym and taking a stress-relieving vacation.

For prevention: She also begins getting an annual stress test, covered by her health screening benefit.

Brenda’s story highlights the value of critical illness coverage. It fills the financial gaps left by traditional insurance, supports recovery, and even helps prevent future health crises.

Final Thought

No one expects a critical illness, yet the risk is real and the costs can be overwhelming. Having a critical illness plan in place ensures that when life changes in an instant, you’ll have the financial support you need to focus on what matters most—your health and recovery.

If you would like more information about Critical Illness coverage, just reach out.

Pamela Morton
Benefits by Design Insurance Services
Phone: (760) 707-9868
Email: pam@benefitsbydesigninsurance.com
Website: www.benefitsbydesigninsurance.com

Do I Need Travel Insurance for Medical Care Abroad?

Wed, 03 Sep 2025 23:54:48 GMT

When Travel Insurance is Recommended

Every so often, I get asked a question like this:

"Do you have any resources or recommendations regarding insurance coverage in the event someone has an accident or illness while traveling outside the USA? I know some travel companies offer policies, but I don’t know much about this type of coverage. We have clients traveling all over the world, and I understand that it can be quite expensive to get medical care abroad in the absence of insurance coverage."

It’s a great question—and one worth asking before you head off on your next trip.

Why Consider Travel Insurance?

Medical care abroad can be expensive, and in some places, you may be required to pay for services upfront before receiving care. U.S.-based health insurance, including Medicare, generally offers limited or no coverage outside the country. That’s where travel insurance comes in—it can give you peace of mind knowing you’ll have support in case of an accident or illness while you’re away.

When Travel Insurance is Recommended

If your trip is arranged by a travel agent or tour company , review the travel insurance they offer. These policies often cover the entire trip and can be competitively priced.

If you’re planning your own travel , consider a few factors before buying coverage:
Where you’re going, and whether local medical facilities are accessible and reliable
Whether language barriers or unfamiliar medical systems could pose challenges
Activities planned—like hiking, biking, or excursions—that might carry a higher risk
Whether you want just emergency medical coverage or a broader package (trip cancellation, baggage loss, etc.)
The length of your trip

What Travel Insurance Costs

The cost of a travel insurance policy depends on many factors—destination, trip length, your age, and the level of coverage you choose. Some clients have found medical care abroad surprisingly affordable, while others have been faced with high out-of-pocket costs. Travel insurance helps protect you against the unpredictable.

How Can I Help?

I work with several travel insurance companies and can provide quotes tailored to your trip. All I need to get started is:

The primary country you’ll be visiting
Your dates of travel

From there, I’ll share options so you can select the coverage that’s right for you.

Final Thoughts

Traveling abroad should be exciting, not stressful. Taking the time to set up proper coverage ensures you’ll be protected if something unexpected happens.

If you’d like to learn more, start by visiting the Travel Insurance section on my website: https://www.benefitsbydesignca.com/life-insurance , or reach out directly. I’d be happy to walk you through the options and provide quotes for your next adventure.

Need coverage for your next trip?

I can provide personalized travel insurance quotes and help you compare your options so you can travel with confidence.

Pamela Morton
Benefits by Design Insurance Services
Phone: (760) 707-9868
Email: pam@benefitsbydesigninsurance.com
Website: www.benefitsbydesigninsurance.com

What's Changing in 2026 with HRA's and HSA's?

Sat, 02 Aug 2025 21:31:11 GMT

What Employers Need To Know

HRAs and HSAs in 2026: What Employers Need to Know After the One Big Beautiful Bill

Health Reimbursement Arrangements (HRAs) have long been a flexible, tax-advantaged option for employers to support their teams’ healthcare needs. And now, with the passage of the One Big Beautiful Bill Act (OBBBA) in July 2025, Health Savings Accounts (HSAs) are seeing some of the most impactful updates in years.

While HRAs remain unchanged under the new law, HSAs are gaining new flexibility, offering expanded eligibility and enhanced coverage options that could reshape how employers structure their benefits in 2026 and beyond.

What Are HRAs?

Health Reimbursement Accounts (HRAs) are employer-funded arrangements that reimburse employees for qualified medical expenses and, in some cases, individual health insurance premiums. Two of the most common types are:

Individual Coverage HRA (ICHRA): Available to employers of any size, this reimburses employees for individual market health insurance premiums and other eligible expenses.

Qualified Small Employer HRA (QSEHRA): Limited to businesses with fewer than 50 full-time employees, this provides a fixed, tax-free monthly allowance to help cover medical costs or premiums.

HRAs give employers cost control and design flexibility while offering employees more choice in their healthcare options.

HRA & HSA Tax Advantages

For Employers: Contributions to HRAs and HSAs are typically tax-deductible.

For Employees: HRA reimbursements (when used correctly) and HSA contributions, earnings, and withdrawals for qualified expenses are all tax-free—making these tools highly efficient.

Why Employers Are Still Considering HRAs

Even without changes in the new legislation, HRAs remain a strong alternative to traditional group health insurance, thanks to:

Flexible Plan Design: Tailored reimbursement structures
Cost Predictability: Employers set contribution limits
Employee Choice: Workers select coverage that fits their needs

What Did Change: Key HSA Updates for 2026

While many HRA-related proposals were ultimately excluded from the final bill, the OBBBA made several meaningful updates to HSAs, effective January 1, 2026:

1. Expanded HSA Eligibility

Employees enrolled in ACA Bronze-tier or catastrophic plans will now qualify to contribute to an HSA—broadening access beyond traditional high-deductible health plans (HDHPs).

2. Telehealth Permanence

The temporary allowance for first-dollar telehealth services has been made permanent. HDHPs can now offer telehealth before the deductible without disqualifying HSA contributions.

3. Direct Primary Care (DPC) Compatibility

HSAs can now reimburse up to $150/month for individuals or $300/month for families for Direct Primary Care memberships—a popular option for preventive and low-cost care.

What Was Not Included in the Final Bill

Some widely discussed proposals did not make it into the final version of OBBBA:

No ICHRA integration with Section 125 cafeteria plans

No new HRA-specific tax credits

No dual-offering changes for ICHRA and group plans

No income-based HSA caps or fitness reimbursements

These remain on the table for future legislation, but are not part of the 2026 landscape.

Employer Action Plan for 2026

To stay ahead of the curve, employers should:

Review Benefits Strategy: Explore whether HSA-compatible plans align with workforce needs, especially given new ACA plan eligibility.

Update Plan Documents: Make necessary adjustments for telehealth, DPC coverage, and new eligibility rules.

Educate Employees: Prepare for open enrollment with clear materials outlining HSA advantages and new qualifying plans.

Coordinate with Advisors: Work with brokers and benefits partners to implement compliant and competitive plans.

Final Thoughts

The One Big Beautiful Bill makes HSAs more versatile, especially for employees enrolled in ACA plans or seeking telehealth and DPC access. While HRAs did not receive direct updates, they remain a valuable option for employers seeking flexible, budget-conscious benefit strategies.

By taking steps now, businesses can position themselves to offer more flexible plan designs heading into 2026.

Need help researching options? We are here to help you choose the plan (or strategy) that works for your health, your needs, and your budget. There’s no cost to have a conversation with us.

San Diego Office: 760-696-3573

Marin County Office: 415-524-8959

Email: admin@benefitsbydesignca.com

Website: www.benefitsbydesignca.com

#healthinsurancebrokerCarlsbad #healthinsurancebrokerMarin #healthinsurance

#savemoneyonhealthinsurance #askpam #employeebenefits #smallbusinesshealthinsurance #hsa #hra

Should You Buy Dental Insurance? Is It A Value to You?

Sat, 02 Aug 2025 21:16:34 GMT

What to consider when purchasing dental insurance

If you're under 65 and don’t get dental insurance through your job, you might be wondering whether it’s worth buying your own dental plan. The truth? It depends on your dental health, budget, and how comfortable you are with unexpected out-of-pocket costs. Here's how to decide what's best for you.

(More information on dental insurance is available on our website at www.benefitsbydesignca.com on the Dental Insurance tab.)

Why Dental Insurance Isn't Always a No-Brainer

Roughly one in four Americans has no dental coverage, and many who do have it get it through their employer. When you’re on your own, you might pay $20 to $80 a month in premiums for a plan with a $1,000–$2,000 annual cap. That may not go far if you need a crown or root canal. And if you only need cleanings and occasional X-rays, you might actually spend more with insurance than without.

But there are good reasons to buy coverage:

· You’ve had big dental bills before and want predictable costs.

· You're likely to need major dental work.

· You avoid the dentist unless you have insurance.

What to Know Before You Shop

Marketplace Plans: If you’re shopping through the ACA Marketplace, dental insurance is available as a stand-alone plan or bundled with your health coverage. Typically, they would be purchased at the same time you buy or renew your health insurance. These come in two coverage levels:

· High coverage: Higher monthly premiums, but lower out-of-pocket costs.

· Low coverage: Lower premiums, but you pay more when you get care.

Private Plans: If you’re not buying through the ACA Marketplace, you can still shop for dental insurance directly from private insurers like Delta Dental, Ameritas, Met Life, Guardian, and others.

At Benefits by Design, we also recommend you consider buying dental insurance from your health plan for ease of administration and having it through a company you are already familiar with.

These private plans typically fall into two main types:

1. DHMO (Dental Health Maintenance Organization)

· Usually the least expensive option in terms of monthly premiums
· Requires you to use a specific network of dentists, and usually one primary dental office
· Services may require referrals and pre-approval
· No out-of-network coverage, so flexibility is limited
· Often no deductible or annual maximum, which is a plus for basic, predictable care
· Best for: People who are okay sticking with one dentist and want low upfront costs for routine care.

2. DPPO (Dental Preferred Provider Organization)

· Offers more freedom to choose your dentist, including out-of-network providers
· Typically comes with higher monthly premiums and an annual benefit cap
· You’ll pay less when you use in-network providers, but still have flexibility
· Most plans include a deductible and some cost-sharing for services like fillings or crowns
· Best for: People who want to keep their current dentist or need flexibility for specialty dental work.

Compare Before You Commit

Here’s what to look for when comparing plans:

· Monthly premiums

· Deductibles ($50–$100 typical)

· Annual limits (most capped at $1,000–$2,000)

· Coinsurance (what percentage of costs you pay after the deductible)

· Waiting periods for major services

· Provider network size

Bottom line: If dental insurance makes you more likely to get preventive care, it may pay for itself. But if your teeth are healthy and your needs are low, self-pay and savings options might work better.

Need help researching options? We are here to help you choose the plan (or strategy) that works for your health, your needs, and your budget. There’s no cost to have a conversation with us.

San Diego Office: 760-696-3573

Marin County Office: 415-524-8959

Email: admin@benefitsbydesignca.com

Website: www.benefitsbydesignca.com

#healthinsurancebrokerCarlsbad #healthinsurancebrokerMarin #healthinsurance

#savemoneyonhealthinsurance #askpam #dentalinsurance #dentalinsurancebroker

Sources:

Consumer Reports

MouthHealthy.org (American Dental Association)

Healthcare.gov Website

3 Ways You May Be Able To Reduce The Cost Of Your Health Insurance

Sat, 19 Jul 2025 18:50:09 GMT

Want to Save Money on your Health Insurance? Ask Pam.

Health insurance is a big investment — and it can be a big expense if you’re not making the most of your options. Here are three ways you may be able to reduce your health insurance costs without giving up the coverage you need.

1. Consider a High Deductible Health Plan (HDHP) Paired with a Health Savings Account (HSA)

An HDHP combined with an HSA can be a smart strategy for:

• Business owners looking for tax savings

• Individuals or families who are generally healthy and don’t visit the doctor often

• Anyone who prefers to cover minor expenses out of pocket while protecting themselves against major medical costs

HSAs allow you to save money tax-free for future healthcare expenses — and you can even use it as a long-term savings vehicle.

2. Explore Different Provider Networks with Your Current Insurance Carrier

You may be able to lower your premiums by switching to a different provider network — even within the same insurance company. Often, your doctors participate in multiple networks, so you could take advantage of a more affordable option without changing providers.

3. Ask Yourself: Do You Really Need a PPO?

PPO plans offer flexibility, but they come at a higher cost. If you’re not seeing specialists out of your area and are happy with your current primary care providers, an HMO plan could make more sense — and save you money.

I’ve had clients save over $1,000 per month by switching to an HMO plan that included the doctors they knew and trusted.

If you’d like help reviewing your options or want a second opinion — reach out! There’s no cost to have a conversation with me.

San Diego Office: 760-696-3573

Marin County Office: 415-524-8959

Email: admin@benefitsbydesignca.com

Website: www.benefitsbydesignca.com

#healthinsurancebrokerCarlsbad #healthinsurancebrokerLarkspur #healthinsurance #savemoneyonhealthinsurance #askpam

Did You Know? Working with a broker doesn't cost extra?

Fri, 18 Jul 2025 23:18:10 GMT

Are You A Small Company That Does Not Have An HR team? We can help!

If you're a business owner or administrator, you know that managing employee health insurance can take up a lot of your time. What you might not know is that working with a licensed health insurance broker doesn’t cost you anything extra.

Brokers are paid by the insurance carriers — as part of the plan’s administration costs — whether you use a broker or not. That means you have access to professional advice, plan comparisons, and personal support without any added fees.

Why not make the most of it?

Work with a broker who can handle enrollments, terminations, and plan questions
Get expert advice on plan design and benefit options
Build a relationship with a trusted local resource — not just a 1-800 number
Save valuable time for yourself or your administrator
Access a variety of plans from multiple carriers, not just one company

If you already have benefits in place but aren’t working with a broker, we’d love to connect. Reach out to us at Benefits by Design Insurance Services — we’re here to help!

760-696-3573 San Diego office or 415-524-8959 Marin County office or at admin@benefitsbydesignca.com . Ask for Pam Morton!

Take a look at our website at www.benefitsbydesignca.com.

#GroupBenefits #GroupHealthInsurance #LocalHealthInsuranceBroker #CarlsbadHealthInsuranceBroker #MarinCountyHealthInsuranceBroker

6 Health & Wellness Subscription Boxes You'll Love!

Fri, 20 Jun 2025 23:23:04 GMT

New And Fun Subscription Boxes

It’s like getting a Christmas gift every week or month. It’s the newest trend in health and beauty called subscription boxes. Like the jelly of the month clubs of old, now you can sign up to receive a special delivery from your subscription box full of goodies to support your lifestyle. There are many to choose from but we found 6 health and wellness subscription boxes that you’ll love!

1. Tasty All-Organic Snacks and Treats

For just $8 per month, you can have all organic snacks sent to you from Lovewithfood.com . Or, for $12 a month, Graze.com offers you over 100 products to choose from for your monthly delivery.

2. Great Vegan Boxes

Vegans have a hard enough time finding food at the grocery store that they can eat. Hang on to your tofu burgers, there are several great subscription boxes made for the vegan lifestyle. UrthBox for one gives you an assortment of full-size vegan-friendly drinks, snacks and shakes that are both good for you and conveniently delivered to your front door.

Finding food is one thing; finding specialty vegan treats that are animal-free is another. For only $20, Vegan Cuts offers tasty treats that are vegan approved. Need makeup that isn’t animal tested? Love Goodly sends out two boxes a month that are eco-friendly and packed with animal-safe makeup, toothbrushes, protein shakes and snacks.

3. Perfect Meat Eaters’ Delights

On the other end of the spectrum, if you love meat but prefer humanely raised and hormone-free meats, Butcher Box is the answer. Though pricey at $129 per month, you get enough meat to make 20 dinners and it includes different cuts of high quality beef, pork and chicken.

4. For Those Who Don’t Want to Take Chances

If you want snacks delivered to your door but don’t want to be surprised, Naturebox offers a 40% discount on over a hundred different yummy snacks including nuts, veggie chips and jams. Subscriptions are only $5 per month and you get to pick and choose what gets delivered each month.

5. Beauty Boxes

Let’s not forget about the beauty subscription boxes. To maintain your physical beauty and health, there are several options like Birchbox , Glossybox and FabFitFun . FabFitFun, for instance, sends you $200 worth of full-size beauty and fashion products for only $50 per month. Each season they offer a brand new surprise mix of glamorous products for your beauty.

6. Active Lifestyle Boxes for Fitness

Lastly, there are subscription boxes for the active lifestyle. If yoga is your bag, check out the Yoga Lifestyle Box from Yogi Surprise, full of vegetarian-friendly products and yoga accessories.

Even Adidas is in the subscription box business now. They recently unveiled their Avenue A subscription box service packed with hundreds of dollars' worth of top of the line sports gear sent out every month. One of their boxes came with:

A Fit Smart Watch
Running Shoes
Running Shorts
A Breathable Tank Top
Shower Shoes
And a Sporty Headband

That’s $500 worth of gear for just $150 per month. Look for more subscription box services to come online over the next year.

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Bring Your Pet To Work?

Fri, 20 Jun 2025 23:16:41 GMT

Pet Peeves, Permissions and Policies

According to the American Society for the Prevention of Cruelty to Animals, 23 million households acquired a four-legged companion during the COVID-19 pandemic. Now that many workers have returned to in-house or hybrid jobs, their employers must consider how to approach new household members.

Joys and frustrations

Humans generally have a benign view of pets, especially their own. (As with children, they might not be quite so well disposed toward other people's offspring.) The U.S. Chamber of Commerce reports from a 2021 study that 94% of those surveyed described a positive and permissive attitude about dogs in the workplace. Cats garnered 84%, and even fish got a robust 36%. But there are equally strong reasons why it may not be practical to welcome Rover, Daisy and Max to the office.

Pet proponents would point out that animal-friendly policies are useful to companies for attracting and retaining talented personnel. Many candidates even regard a company's pet-friendly policy as a key criterion for accepting a job and plugging away at it. Workers who are allowed to bring their pet to work are likely to be more productive and consistent and less inclined to arrive late or leave early to walk or feed their critters. It may help improve the overall work/life balance and reduce stress, particularly because taking short strolls outside with pets breaks up the day and increases owners' energy.

Pets may become the adhesive that glues team members together when they can bond over a favorite beast. Interoffice relationships thereby grow more familial, which promotes collaboration and innovation in the ranks.

Yet there are negatives and nuisances. Many people are allergic to dog and cat dander, the dandruff-like shedding. While you can address this to some extent with dog-free areas or HEPA filters, remember that asthma and allergies qualify as an official disability under the Americans with Disabilities Act.

Other nasties to watch for are:

Zoonotic diseases that spread from animals to humans
Salmonella in birds, reptiles and amphibians
Tripping on leashes
Injuries from bites, slips and falls
Noises like barking and whining
Odors
Landlord restrictions
Unsanitary conditions
Fights with other pets
Damage to furniture, equipment and employees' possessions

Fellow workers will not appreciate it if their favorite shoes or handbags are chewed to a pulp. Even curious bunnies are known to have gnawed through electrical cords.

Enforcing the rulebook

Pet owners can be hypersensitive about their animals and quick to snarl at any criticism or rebuke. If you decide to allow pets on office premises, codify the do's and don'ts in writing. First, service animals, belonging to people with disabilities, have special exemptions. Make it clear that they are distinct from emotional support or therapy animals, which receive no legal protections.

Many companies have been revisiting all their policies since the pandemic. Pet workplace policies most typically address dogs.

Consider implementing some of these rules:

Have health and hygiene protocols — e.g., handwashing, deworming, pet vaccinations — up to date and confirmed with HR.
Post a warning to other employees on the pet owner's desk.
Limit leash lengths.
Require that pets be house-trained and of some minimum age and have no history of aggression.
Require that owners keep pets with them at all times.
Make owners responsible for cleaning up messes.
Exclude certain breeds of dog or types of animals, such as snakes or miniature pigs.
Have off-limits areas, like meeting rooms, restrooms and kitchens.
Employees must not feed other people's pets.

You will also need some form of complaint process, as well as consequences for infractions or annoying behavior.

Animal welfare

Pets need protection too. Dog beds, along with toys, treats and water, should be positioned next to owners' desks. Cats need accessible litter boxes. Respect their schedules: Dogs normally sleep 12-14 hours a day, while cats are most active at dawn and dusk.

Noise can be very disturbing to some animals. Make sure dogs are given adequate breaks outdoors. Be patient when you introduce them to new surroundings.

If you want to show solidarity and inspire loyalty, consider providing pet insurance and stipends, as well as bereavement time off when Rover goes to meet his maker.

Employee Benefits

Fri, 20 Jun 2025 23:07:24 GMT

Employee Benefits You Need To Consider

Nontraditional employee benefits have expanded well beyond a break room stocked with snacks and cappuccinos. Businesses must be more creative to lure desirable employees to the workplace. While at first glance it may seem as if unique perks only benefit employees, on closer inspection it makes great business sense. Perks build employee morale, loyalty and satisfaction, which translates into less turnover and greater retention. Nontraditional perks also promote a positive corporate culture that helps burnish the company's image.

Here are some creative perks that have both employees and employers giving two thumbs up.

Family First. New baby bonuses are made available to those welcoming a new child into the family. Parents know the emotional and financial stress that having a baby brings. Family-friendly companies are stepping in to share the burden.

Similarly, for employees wanting to start a family but needing access to fertility treatments, many companies are helping offset expenses not covered by insurance. Some organizations will also contribute toward surrogacy costs or egg freezing if that's a viable option.

Once the baby arrives, many companies provide private lactation rooms for expressing health-promoting breast milk. Another perk offered to new parents is a family and parental leave policy that allows them to take the time they need without repercussions. On-site day care or discounts for child care are perks that any parent can appreciate. And when the child is ready for college, companies may offer college cost assistance for those who cannot afford it.

Additionally, elder care is a crucial and time-consuming task for anyone involved in the care of an older loved one. Some companies offer on-site eldercare on a weekly or daily basis to take some of the stress off their exhausted employees facing this challenge.

Education Opportunities. Employees are looking for organizations that are willing to invest in their careers. According to one study, 94% of employees would stay longer with a company if it helped foot some or all of the cost of tuition. Employees who are willing to put in time to train or learn new skills are worth the investment.

Mentally and Physically Fit. Wellness programs that provide subsidized gym memberships and access to massage therapy or acupuncture are highly valued perks. Some companies offer on-site treadmills, yoga mats, and healthy eating options in the cafeteria.

Mental health is a top priority, with more than 25% of Americans suffering from mental health issues each year. It makes sense for companies to step up and assist their employees who need reduced-cost counseling sessions, online therapy services or confidential consultations with a psychiatrist.

Forward-thinking businesses are setting the pace for what nontraditional perks employees can expect to see at their own workplaces. It may not be long before pet sitters, house cleaning services or discounted internet plans become commonplace perks.

Helping Employees Find Supplemental coverage

Fri, 06 Jun 2025 21:06:27 GMT

Why Supplemental Coverage Matters

Helping Employees Access Supplemental Insurance

When it comes to employee benefits, small and mid-sized businesses often face a balancing act between providing meaningful coverage and managing limited budgets. With core health plans taking priority, many employers find themselves unable to offer ancillary options like dental, vision, disability, life insurance, and others.

Yet, these are benefits your employees still want—and in many cases, need. Fortunately, just because your organization doesn’t sponsor these plans doesn’t mean you can’t help employees access them. With a proactive approach and the right resources, HR professionals can serve as trusted guides, connecting their teams to affordable, supplemental coverage options.

Why Supplemental Coverage Matters

Benefits like dental, vision, accident, critical illness, disability, and life insurance are more than just “nice to have.” They fill important gaps that traditional health insurance doesn’t cover and offer protection from unexpected financial strain.

Employees increasingly expect holistic coverage—and not having access to these benefits can negatively affect morale, retention, and productivity.

Common Gaps in Employer-Sponsored Coverage

Even the most well-intentioned employers sometimes can’t offer a full suite of benefits. Common coverage gaps include:

Dental and Vision Insurance

Short-Term and Long-Term Disability Insurance

Life Insurance (beyond basic employer-paid policies)

Accident Insurance

Critical Illness or Hospital Indemnity Insurance

So how can HR leaders support employees in finding these types of benefits when the company doesn’t provide them directly?

1. Partner with a Licensed Insurance Broker or Consultant

One of the most efficient ways to help employees explore supplemental options is to connect with a licensed insurance broker or agency that specializes in individual and voluntary benefits.

What they offer:

Guidance on the best plans available in your state or region

Access to group voluntary benefits with no employer contribution required

Educational sessions or Q&A forums for your employees

Assistance with enrollment, claims, and customer service

Brokers can also provide insight into compliance, contribution strategies, and pre-tax options if you choose to offer a platform for voluntary enrollment.

2. Offer Voluntary Benefits via Payroll Deduction (If Feasible)

If you’re unable to contribute financially, offering voluntary benefits through payroll deduction is a great way to expand your benefits package at no additional cost to your organization.

You can:

Make benefits more accessible by offering group-rate premiums

Provide convenience with automatic payroll deductions

Strengthen your company culture by demonstrating commitment to employee well-being

This approach works well for benefits like dental, vision, accident, life, and disability coverage.

3. Create a Resource Hub for Individual Coverage Options

If payroll deduction or a group plan isn’t feasible, HR can still empower employees by curating a benefits resource hub with vetted information on:

Private dental and vision plans (e.g., from carriers like Delta Dental, VSP, or Guardian)

Disability and life insurance policies available directly from insurers

Critical illness, accident, and hospital indemnity plans through reputable providers

The key is to make sure your team knows where to look and how to evaluate their options—ideally with help from a licensed advisor.

4. Educate Employees on How to Evaluate Plans

Most employees are unfamiliar with how to compare insurance plans—or even what types of coverage they need. HR can fill that knowledge gap by offering:

Lunch-and-learns or webinars on key insurance topics

FAQs and checklists for plan comparisons

Decision-making tools (such as cost calculators or needs assessments)

Providing education not only helps employees make better decisions—it builds trust in your leadership.

Final Thoughts: Guiding Without Sponsoring

You don’t have to offer every benefit directly to support your employees’ financial well-being. Sometimes, being a guide is just as valuable as being a provider. By connecting your team to trusted resources, sharing expert-backed education, and facilitating access to supplemental coverage, you demonstrate that your company truly cares—even when budgets are tight.

Your role in HR isn’t just about administering benefits—it’s about helping employees live healthier, more secure lives. And that starts with access.

Finding the best Medicare coverage with the most value

Sat, 24 May 2025 18:43:46 GMT

The government has divided the criteria into several areas. If you go over them carefully,

you can find the best one for you.

You want the best Medicare possible—but it's hard to point to one arrangement of choices and say, "This one is the best." However, the government has divided the criteria into several areas. If you go over them carefully, you can find the best one for you.

Consider costs

How much are your premiums, deductibles and other costs for each of your choices? How much do you pay for services like hospital stays or doctor visits? Are you bound by a yearly limit on what you could pay out-of-pocket for medical services? Read the details to make sure you know what you'll pay. Understand that in "Original Medicare" there’s no limit on how much you pay out-of-pocket per year unless you have supplemental coverage. However, "Medicare Advantage"

plans have a yearly limit on your out-of-pocket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year. This option may be more cost effective for you.

Look at the extent of coverage

Original Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care facilities. Services are either covered under Part A or Part B. Medicare Advantage

Plans must cover all of the services that Original Medicare covers. Some plans offer benefits that Original Medicare doesn’t cover like vision, hearing, or dental. Many Medicare Advantage plans offer vision, hearing, and dental—read the fine print.

You may decide you only need a Medigap plan, which helps fill "gaps" in Original Medicare and is sold by private companies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance and deductibles. Do not confuse this with Medicare Advantage Plans, however. Indeed, you cannot have both.

If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you're still with employment-related coverage, talk to your benefits administrator or insurer before making any changes.

Keep your choices in mind

How important is it to you if you want to use specific doctors and hospitals? There may be limitations. Do the doctors you want accept the coverage you have? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?

Read the details of the plans available and consider what's important to you. This is the best way to ensure you'll have what is truly the "best plan."

For more information on Medicare products, contact Pam Morton at Benefits by Design Insurance Services at PamM@benefitsbydesignca.com or 760-696-3573.

Health Savings Accounts: How Do They Work?

Sat, 24 May 2025 18:31:41 GMT

What are the tax advantages to having or offering a Health Savings account?

Health savings accounts can be advantageous when your goal is to recruit new hires or improve existing employees' job satisfaction. They are an incredible benefit that you can offer to people who work for you.

Your employees will have the opportunity to save pretax dollars and put them toward qualified medical expenses, including copays, prescriptions, dental care, contacts, eyeglasses and X-rays, as well as retirement.

Are HSA contributions tax-exempt?

Yes! HSA contributions are tax-exempt. This means you will not have to apply any payroll tax laws to any of the money that you deposit into each employee's HSA. And because these are considered pretax contributions, they also lower how much your employees will owe in taxes on the federal level.

How can you utilize HSAs as an employer?

HSAs let you contribute — either with or without an IRS Section 125 cafeteria plan — benefits employees choose from, such as life insurance, adoption or dependent care assistance, and accident benefits. You can even offer an HSA as a separate benefit, meaning you will decide how contributions will be made.

For example, you can contribute a lump sum of money at the start of the year to your employees' HSAs or you can spread out your contributions by breaking them down into a percentage of the grand-total contribution each pay period.

There's also the hybrid approach. In this situation, you would deposit 40% to 50% as a lump sum and then make smaller contributions every pay period. This scenario can reduce your administrative burden while protecting you from employees who quit immediately after receiving the lump-sum contribution.

What if employees don't need the money in their HSAs?

If employees do not need the money in their HSAs because they do not have any immediate medical expenses to pay for, they can choose to save or invest their HSA funds until they need them.

This is how HSAs differ from flexible spending accounts, which must be spent by the end of the plan year. FSA funds cannot be invested nor can they be carried over when workers are no longer employed by you.

How does offering HSAs as an employer benefit you from a tax perspective?

By offering HSAs to your employees, you can lower your total payroll taxes. Since your contributions are both tax-free and exempt from FICA taxes, you will save an additional 7.65% per tax year. Additionally, you can deduct post-tax contributions from your employees' HSAs.

Ultimately, your contributions to your employees' HSAs can be viewed as 401(k) matches for their health. Even though your employees will not receive a tax deduction due to your contributions to their HSAs, the extra money that you extend to them can be invested, which is another avenue for financial growth.

Why are HSAs considered tax-advantaged for employees?

HSAs are considered tax-advantaged for employees because contributions reduce their taxable income. This is true even if the money in the HSA account earns interest or investment returns over time. As long as the funds are used for qualified medical expenses, employees will not owe taxes when they withdraw money from their HSAs.

Now, HSAs coincide with an HSA-eligible health plan, and together they create a cash cushion that offsets the higher deductibles that most HSA-eligible health plans usually have. As early as the age of 65, employees will not face any penalties if they use money in their HSA for nonqualified medical expenses.

That said, they may have to pay income tax under the following circumstance: Prior to the age of 65, people who withdraw from their HSA and use the money for nonmedical expenses will face a 20% penalty as well as be responsible for any applicable taxes on said withdrawal.

Under what conditions can employees contribute to an HSA?

Even if your employees are enrolled in an HSA-eligible health plan, they might not be eligible to contribute to an HSA. One exception is if your employees are not enrolled in a health plan that is sponsored by a spouse or parent who is not part of an HSA-eligible health plan.

Contributions can also be made if your employees are not enrolled in Medicare or if those who work for you cannot be claimed as a dependent on another person's tax return.

What are the financial advantages of HSAs?

Employees can deduct contributions from their taxes if they contribute to their HSAs with after-tax dollars during the tax year and claim a tax deduction when it's time to file. If contributions are made through payroll deductions, your employees will also avoid paying Medicare and Social Security taxes on the money put into their HSAs.

Furthermore, HSAs allow employees to invest a portion of their funds, which can help grow their savings over time. This can be especially helpful for employees who are concerned about how they will cover their medical expenses later in life. It's also an opportunity to build a financial emergency fund for any health-related needs that arise over time.

Unlike other financial accounts, HSAs do not have a "use it or lose it" rule. In other words, employees can carry forward any unused funds year after year, so they will not lose money that is not spent within a given year.

Additionally, you can offer FSAs alongside HSAs. For example, a limited-purpose FSA can be used to pay for dental- or vision-related expenses while the funds in an HSA can be put toward other medical expenses.

When you decide to offer HSAs as part of your company's benefits package, you, as an employer, will lower your total health insurance premium expenses. This is because the premiums for HSA-eligible high-deductible health plans tend to be less costly than premiums for other health plans.

From there, you can use the funds you save on premiums to contribute to your employees' HSAs.

Life Insurance: What Are Your Choices?

Sat, 24 May 2025 18:22:23 GMT

Which Type of Life Insurance Has The Most Value For You?

There are many different types of life insurance options. Not every option makes sense for every situation, so it's important to ensure your life insurance plan makes sense for your overall estate plan.

Whole life insurance

As long as you continue to pay your bill, whole life insurance pays your benefit no matter when you pass away. With whole life insurance, you can benefit from a savings component that a portion of your premium will pay into. Plus, the savings aspect of whole life insurance has a fixed interest rate, meaning you can build the cash value of your insurance policy over time.

It's important to note that whole life insurance policies are more expensive than term life insurance, the latter of which provides coverage for a set number of years. That's the main reason term life insurance is more affordable; you can lock in your rate for the entire term period of a term life insurance policy.

However, with whole life insurance policies, you can withdraw a portion of the cash value as a life insurance loan. That said, as with any loan, you'll need to pay it back along with any interest that you accrue. If you pass away before paying back the life insurance loan, the loan amount plus any interest will be withdrawn from the account prior to your beneficiaries’ receipt of their payout.

Universal life insurance

Also known as adjustable life insurance, universal life insurance offers more flexibility than whole life insurance. For instance, universal life insurance gives you the option to increase or decrease your death benefit. Sometimes you can even elect to adjust your monthly premium if not refrain from paying it altogether.

Keep in mind that the interest rate of universal life insurance is not fixed. In other words, the rate at which your cash value builds may change over time because it depends on ever-changing market conditions. The cash value of your policy can grow and result in zero-cost, which is another way of saying that the premiums will be paid from built-up value.

Variable life insurance

There are two forms of variable life insurance:

As long as you regularly paid all your premiums, a face-value death benefit is paid out to your beneficiaries when you pass away.
You can opt in to variable life cash value as part of your death benefit, though it's important to understand that a variable cash value rises and falls based on two factors: the payments you make and the performance of your investments.

Final expense insurance

Another name for final expense insurance is burial insurance because it offers a more affordable death benefit specifically designed to help your loved ones cover your end-of-life expenses. These include but are not limited to funeral costs, unpaid medical bills and outstanding debt in your name.

Term insurance

As one of the most simplistic and least expensive insurance plans, term insurance policies are designed to last for a limited number of years. The cost of a term insurance policy will likely increase as you get older.

Also, term insurance policies have no cash value. So this type of insurance is more beneficial if you are relatively young and want to have a policy in place to ensure your children will be taken care of should you pass away. Once your children start taking care of themselves as adults and the term insurance premiums begin to increase in price, you can look into canceling your term insurance policy.

The basic premise of life insurance is simple: It's a means by which you can extend financial support to your family in the event that you pass away. Not only will it give you peace of mind in knowing that your family is financially taken care of in your absence but life insurance gives family members a lot of comfort as well.

When you consider which type of life insurance you should purchase, look for options that suit your situation while offering the flexibility to improve your family's financial security. Most importantly, compare the many life insurance policy options and speak with a professional to understand which option fits with your overall estate plan best.

For more information and a personalized quote, contact Pam Morton at Benefits by Design Insurance Services at pamM@benefitsbydesignca.com or at 760-696-3573.

Think Your Business Doesn't Need an Employee Handbook? Think Again!

Sat, 24 May 2025 18:05:10 GMT

An Employee Handbook is now regarded as a protection tool for the business or the organization

The employee handbook is no longer viewed as just a communication tool for employers. It's now regarded as a protection strategy as well. The handbook can be your recipe for onboarding success and your legal knight in shining armor, regardless of your business size.

Your recipe for onboarding success

Consider the following basic information that's typically given to new hires during onboarding:

Company mission, values and culture.
Employment policies, including termination of employment.
Workplace conduct, such as standards of conduct and disciplinary actions.
Compensation, including pay raises.
Employee rewards program.
Performance review standards.
Mandatory and voluntary benefits.
Time-off policies.
Technology policy, such as computer usage and social media guidelines.
Office security, such as emergency action plan.
General policies and procedures, such as attendance, timekeeping, overtime, health and safety, personnel records, and inclement weather.

The employee handbook enables you to assemble this data into one convenient package, thereby streamlining the onboarding process. A well-designed handbook also helps new hires understand their responsibilities, lowering the odds of them jumping ship because of unclear expectations.

Your legal knight in shining armor

Employment-related lawsuits are consistently frequent in America, and the employee handbook can be a defensive bulwark for employers.

The Equal Employment Opportunity Commission (EEOC) reports that 72,675 charges were filed by the agency for discrimination relating to sex, color, age, disability, retaliation and equal pay in 2019, the most recent year for which the agency has statistics.

By including EEO and other employment-related topics in the handbook, you can tangibly prove in legal disputes that you informed your employees of their rights and responsibilities.

HR best practices dictate having employees sign a statement acknowledging receipt of the handbook. But what if they refuse to sign? According to the Society for Human Resource Management, you cannot force employees to sign for the handbook. But you can:

Have the employee state in writing his or her refusal to sign.
Have a representative from your company state in writing that the employee refused to sign for the handbook. Then, have the representative and a witness sign and date the statement.

This way, if a legal battle arises, you can show that the employee was aware of the handbook but refused to sign the acknowledgement form.

Why business size does not matter

If you have only a few employees, you might think that you don't need to develop an employee handbook. But when you consider that the handbook works as both a communication and a compliance tool, it's easy to see that the size of your business is irrelevant.

Even if you have only one employee, that employee still needs to know the fundamentals of your company and his or her employment rights and responsibilities. The simplest way to funnel this information is via the employee handbook. Once your business starts growing, you'll likely need to hire more employees, at which point the need for an employee handbook will become even more pressing. So it makes sense to view the employee handbook as a cornerstone of your business right from the start.

The work-from-home change

Starting with Covid, and continuing to the present, more companies are allowing employees to work partially or entirely from home. HR departments are racing to keep up with the corresponding policy changes. For example, companies will need to clarify how flexible they will be about work-at-home.

When employees are remote, will the company expect them to be available the same hours as when they were in the office? Businesses may want to mandate remote workers have a quiet, private workplace to properly focus.

Indeed.com recommends a detailed outline of scope, clearly stating who is eligible for remote work, the availability policies, and both the regularity and speed of communications. Also, what tools will the employer provide and what will the employee be responsible for? The more specific you are, the less likely there will be problems later.

Of course, with remote work issues, as with any other policies, consult qualified professionals to avoid vioilating any laws or regulations.

If you need suggestiions on how to create an employee handbook for your organization, contact Pam Morton at Benefits by Design Insurance Services at pamM@benefitsbydesign or 760-696-3573

Thinking Inside The Box

Sat, 24 May 2025 17:49:04 GMT

Bring Back The Old Fashioned Suggestion Box

In A New Format

Admittedly, suggestion boxes have become something of a joke in contemporary workplaces, where they may be an invitation for facetious observations or even catty criticism, but these simple tools can sometimes provide unexpected benefits.

The box can be a physical object, located in a break room or lobby or any central area. Modern equivalents are more likely digital mobile-friendly software platforms on online portals to which workers can submit from any device. The latter are faster to operate, especially using QR codes, and can reach more people. Examples like Trello, Survey Monkey or Officevibe all use specialized software.

Make it accessible

To encourage participation visibly, you need to display and promote "the box." The goal is to establish an open flow of communication to management. You can apply what is captured in the box for many purposes, such as for feedback before making firmwide or team changes or to elicit employees' opinions on new products or services. Here are some starter tips:

Use the suggestions to determine long-term goals.
Track the most popular ideas.
Display the top suggestions publicly and rotate the list.
Test software before implementation and support it continuously.
Add a regular section in the company newsletter to highlight feedback.
Advocate both interdepartmental ideas and department-specific suggestions.
Monitor the collected data for abuse or negative language and insist on a respectful attitude.
Offer rewards and incentives, such as gift cards or time off.
Use gamification, which should depend on clear and fair rules and be open to all.
Promote the box with reminders such as posters, emails or social media channels.
Request practical details for implementation.

Follow-up is critical. Without any accountability or tracking, the whole exercise will seem pointless and even demoralizing. (You might be better off simply brainstorming.) If your box is not anonymous, respond and thank contributors for each suggestion. It all adds up to help create an employee ownership culture.

Good things come in small boxes

Team members may be eager to give feedback but lack a platform. A suggestion box could furnish that outlet for opening up a channel to management.

Team leaders could use their observations to help spot inefficiencies or resource wastage. So many small expenditures tend to get swept under the rug when nobody takes the initiative to point them out. Another subtle benefit is the opportunity to take preemptive measures to preclude minor issues from escalating.

Are you looking to stimulate a more innovative culture? Do you want to boost engagement and morale? The humble suggestion box can be particularly helpful for empowering shy or introverted team members who might otherwise be inhibited from voicing their valuable ideas. In an extreme case, it may serve to protect whistleblowers as a first route for stepping forward.

An anonymous refuge

You must decide whether to give cover by making your box anonymous. If you do so, participants need not provide their names and can feel secure in knowing their locations and IP addresses will not be disclosed. If you are using an online system rather than a physical box, dedicated software is available to prevent recording any personally identifiable information. In any case, employees should be urged to take their observations directly to management if they do not feel comfortable using any type of suggestion box.

There are advantages to anonymity. Although it is true that it makes it harder to track down discussions, it is simultaneously much more likely to prompt candid feedback, as there will be no concern over retaliation. At the same time, employees will probably be willing to engage, providing a more inclusive set of views.

The box may expose significant hidden issues, such as workplace safety concerns. Again, management must commit to reviewing and acting upon any viable information. If they neglect to follow through, they risk losing credibility.

If you do go the anonymous route, however, it is imperative to preserve strict confidentiality. There must be no leaks or traceable input. Otherwise, the entire initiative may backfire or, worse, cause irreparable harm to employee relations.

Creating Good Vacation Policies

Fri, 11 Apr 2025 22:52:03 GMT

How much vacation time do your employees get?

Start with the idea that 30 days of leave are the bare minimum for staff. These days of leave include vacation days, sick days, holidays and other personal days.

Typically, U.S. employers grant 10 days of paid vacation time — two full weeks — per year to each full-time employee. Holidays, roughly 10 per year, are defined as national or state holidays that everyone takes off.

For private industry workers, paid vacation time is allocated by experience — the more time someone spends with a company, the more vacation days they're given. On average, a person who has been with a company for one to five years receives 10 days. Employees who have been with the business for five to 10 years receive an average of 15 days for vacation. Employees who have worked at a business between 10 and 20 years receive, on average, 17 days, while a tenure of 20 or more years comes with an average of 20 vacation days.

When creating your vacation policy, you may want to establish rules based on answers to the following questions:

Should employees give you a certain number of days of notice before taking paid vacation?
Should employees be limited to a specific number of days off at one time?
Should there be a limit to how many employees can take the same day off?
Should employees be allowed to "cash in" a specific number of unused vacation days for money at the end of the year?
Should employees be restricted in the number of days they can carry over from year to year?

Holidays are treated differently than vacation days. According to the Bureau of Labor Statistics, 79% of all private industry workers have paid holidays; 83% of workers in service occupations receive paid holidays; and 96% of management, business and financial occupations receive paid holidays.

Rethink PTO policy

Instead of giving separate allocations for vacation, sick and personal days, you may instead choose a paid time off policy. With a PTO policy, your employees have a fixed number of days that they can use for any personal reason.

Under a PTO policy, an employee might accrue four hours of PTO for every 40 hours worked (meaning one day is accrued every two weeks worked). The accrual rate may change the longer the employee is with the company. This policy motivates employees to work to earn their PTO and results in a sense of accomplishment when they do. But it also can encourage workers to come into the office when they are sick because they don't want to "waste" their hard-earned PTO on illness but would prefer to save it for vacation. Similarly, the policy can feel discouraging to new employees, who start with zero days.

An alternative to this traditional PTO is an open or unlimited PTO policy. It allows employees to take as much PTO as they want; there's no cap on PTO as long as work gets done and the policy isn't abused. Unless the employee is taking several days off in a row, an open PTO policy doesn't require that the employee provide a reason for taking the days. Such a policy shows that work–life balance is a priority for your company. Still, many employers worry that the policy will be taken advantage of.

One difference between PTO and traditional vacation/sick/holiday plans is how unused PTO is paid. When an employee quits or is laid off, you're not required to pay out any unused PTO; this is different from the requirement under traditional plans to pay unused vacation days. If an employee doesn't use all their PTO by the end of the year, you have to consider state law. Most states have a use-it-or-lose-it policy in place saying that employees need to take PTO days or forfeit them.

On average, paid leave accounts for $2.59 of the average cost of an employee per hour or 7% of a business's total employee costs. It's important to consider what you can afford when deciding which type of time-off policy is right for your business. Still, when a time-off policy is comprehensive, generous and flexible, employees feel valued and cared for, which increases their loyalty to your company and can increase productivity.

Dental Coverage: Giving your Employees a Reason to Smile

Fri, 11 Apr 2025 22:47:22 GMT

Dental Insurance is one of the top five must-have Employee Benefits

According to Metlife’s 15th Annual U.S. Employee Benefit Trends Study , dental insurance is one of the top five must-have employee benefits, along with medical insurance, prescription drug coverage, and others. Still, group dental insurance remains elusive for some employees, with company size playing a significant role in whether the benefit is offered. Research indicates that smaller companies operating on a tight budget are much less likely to offer dental insurance than companies with 500 or more employees.

The reality is that offering dental insurance gives you a leg up on other businesses competing for the same talent and makes it harder for your competitors to snag your top recruits.

A Great Smile Does Wonders

A growing body of evidence connects oral health to emotional health. For example, according to Guardian’s 5th Annual Workplace Benefits Study, individuals who receive periodic teeth cleanings and dental exams report better oral health and emotional wellness, Oral health also can be linked to self-esteem. A survey by the American Dental Association’s Health Policy Institute found that 28 percent of young adults felt that the appearance of their mouth and teeth affected their ability to conduct a job interview. The survey further revealed an association between oral health and income, as one in five low-income adults say that their mouth is in poor condition. These individuals likely would visit the dentist more regularly if they had the means.

As noted in Guardian’s survey, people with employer-sponsored dental coverage are twice as likely to frequently visit the dentist. Still, there’s the matter of employer cost.

Factors That Determine Coverage

The decision to offer dental insurance is a financially serious one and should be enacted only after careful consideration. Focus your research on your company’s size, industry, and budget as well as what your competitors are offering. Geography is also important, as employers in certain regions are more likely to offer dental insurance than employers in other locations.

You will find that the cost of providing dental insurance depends on various factors, including the number (and ages) of employees, coverage type, and business location. Generally, though, compared with many other benefits, including health insurance, dental insurance typically falls on the lower end of the expense scale. Therefore, don’t just assume that dental coverage will be too expensive or out of budget.

Coverage Within Financial Reach

According to the National Association of Dental Plans (NADP), the average monthly cost of premiums for employees with individual dental coverage in 2016 was $14 to $30.50. Per the NADP, the typical plan covers preventive care, such as X-rays and periodic exams; basic procedures, such as office visits and fillings; and major procedures, such as crowns and bridges. Ultimately, your employees’ costs will depend on how much you contribute to their plan.

Not every business needs to provide dental insurance to thrive. But, if you are seeking a smiling, confident workforce, dental coverage can help you find it.

For more information about providing dental coverage, contact us today. Dental insurance can be employer paid or Employee Paid. Ask me how.Pam Morton, Agency Owner and Broker, Benefits by Design Insurance Services, pamM@benefitsbydesignca.com or at 750-696-3573.

What's New with 401(k) and Similar Plans?

Fri, 11 Apr 2025 22:41:14 GMT

SECURE 2.0 Act Impacts

A 401(k) plan is an employer-supported way for employees to put money toward retirement in a tax-advantaged manner. For years, employees have saved money for their future via 401(k) plans, but ever since the SECURE 2.0 Act, a handful of changes to 401(k) plans significantly assist both employers and employees alike.

What are the up-to-date rules? Let's take a look at the different types of 401(k) and retirement account options.

529 plans and Roth individual retirement accounts

Any funds that are placed in a 529 plan are eligible for transfer into a Roth IRA without any tax responsibilities or penalties. However, please note that this only applies to 529 plans that have been open for a minimum of 15 years. Additionally, the money you plan to roll into the Roth IRA must have been held in the 529 plan for no fewer than five years.

Also, keep in mind that any money that you roll over from a 529 plan into a Roth IRA is subject to the annual Roth IRA contribution limit. It is also subject to a lifetime cumulative maximum of $35,000 of transfers from a 529 plan to a Roth IRA.

Ultimately, rolling over money from 529 plans to Roth IRAs is intended to make it easy for people who have 529 plan money that they do not need to put toward educational plans after all. Instead, you can simply apply it to your retirement savings balance without having to pay income taxes or 10% of the amount in tax-related penalties.

Starter 401(k) plans

Starter 401(k) accounts streamline the cost of establishing 401(k) accounts and handling the administration process for small businesses because they exist as an option for those that want to extend retirement savings opportunities to employees. Additionally, there is no employer contribution requirement, but there is a $6,000 annual limit paired with a $1,000 catch-up contribution, which is applicable at the age of 50.

Note that your business is able to open a starter 401(k) even if your company once offered 401(k) plans prior to terminating the offer and you have yet to reinstate a 401(k) benefit within the past 12 months, or your firm previously had an IRA via a mandated state-sponsored retirement program that you found to be far too complex to manage.

401(k) withdrawal penalties

When you withdraw money from a 401(k) account, you often have to accept a 10% penalty if you take out the money before you are 59-1/2 years old. You will also owe taxes on the funds you withdraw.

However, if employees have experienced a personal or family finance-related emergency, they can withdraw up to $1,000 per year while simultaneously avoiding the regular 10% penalty imposed on early 401(k) withdrawals.

They also have to repay any withdrawals they took out, though it is important to note that withdrawals under these circumstances are still subject to taxes. For survivors of domestic abuse who are under the age of 59-1/2, a withdrawal limit of either $10,000 or 50% of the total amount of money in their 401(k) account applies for those who wish to take out money without paying the 10% early distribution penalty fee.

If you have employees who make post-tax Roth IRA contributions and have no more than $2,500 in their account, you can extend an automatic enrollment offer for an emergency workplace account. Eligible employees may make withdrawals from this account at least once per month without needing to prove that an emergency has popped up prior to making the withdrawal.

Annual savings limits

In 2024, employees can now contribute up to $23,000 per year toward their 401(k) accounts. The annual limit was $22,500 as of 2023, but the IRS increased the maximum savings contribution by $500 this year.

Employees who contribute to other workplace savings plans — including 403(b) plans, most 457 plans and the federal government's Thrift Savings Plan — can also take advantage of this higher ceiling. Keep in mind that limits change year to year, so this may not be true come 2025.

Even so, currently, the total amount of employer and employee contributions is the lesser of 100% of your compensation or $69,000. Also, if you, as an employee, earn no more than $60,000 per year, you can benefit from 3% cash back on employee contributions, with a minimum of $100 and a maximum of $250.

Employer-matching 401(k) plans

Employers can now match 401(k) contributions for employees who are actively paying off student loans. This new rule also applies to 403(b) and 457 plans — both of which are commonly used by public and nonprofit workers — as well as Savings Incentive Match Plan for Employees IRAs.

For SIMPLE IRAs, employees can contribute up to $16,000 annually, with an additional $3,500 allowed for those 50 and older as a catch-up contribution. Employees making payments toward qualified student loans, such as tuition and fees, can now receive matching contributions from their employers to their retirement accounts.

Previously, only employees who were actively contributing to their retirement plans could receive these employer matches. Now, employees can focus on paying down their loans while still benefiting from their employer's contribution to their retirement savings. This addendum helps those who find themselves torn between paying off student debt and saving for retirement.

State-sponsored retirement plans

As times goes on, more and more states are extending state-sponsored retirement plans for private workers who would not otherwise have access to an employer-sponsored 401(k) account. Many of these retirement plans are IRAs that combine both automatic enrollments and payroll deductions, which employees can choose to opt out of if they wish.

Thanks to the changes introduced by SECURE 2.0, you, as an employer, now have more ways to help your employees prepare for their retirement years. Retirement programs are far more forgiving to people than they used to be, and it's now more possible than ever for employees to catch up on their savings.

If you are looking for resources to connect with Financial Planners that can help you set up or manage these accounts, let me know, and I connect you with someone that can help. Pam Morton at Benefits by Design Insurance Services at pamM@benefitsbydesignca.com or 760-696-3573.

Parental Leave Policies: Rules and Options

Fri, 11 Apr 2025 22:33:43 GMT

Developing a Policy

An inclusive parental leave policy can signal that you care about your team's happiness, which helps retain workers, which in turn boosts your company's bottom line. So even though offering paid parental leave as part of your employee benefits package costs money, the price of losing top talent, which could ripple across your company and damage your reputation, is well worth the investment.

Paid parental leave is already available to federal employees, while nongovernmental companies with 50 or more employees are required to comply with the Family and Medical Leave Act. The FMLA requires that companies give new parents 12 weeks of unpaid leave during a 12-month period before or after a child's birth, adoption or foster care placement. Employees must have worked 1,250 hours prior to requesting the leave.

But for many people, three months without a paycheck is not financially feasible. Additionally, employees in companies with 49 or fewer employees are not covered by the FMLA.

Therefore, your company may want to write its own policy.

Developing a policy

Here are some tips for developing your own leave policy:

Don't assume your policy has to follow anyone else's; let your team be creative. Instead of 12 weeks of paid leave, your company might offer:
A small portion of paid leave, with the balance to remain unpaid.
The chance to elect a three- or four-day workweek, with one or two days off.
The option to postpone leave until the employee's co-parent's leave ends.
A leave-share program in which parents who work for you give their leave to their partners who do not have leave coverage from their employer.
Define who gets to take advantage of parental leave (and ask what happens if both parents work for your company). You might define "parent" as:
A biological mother or father, gender-neutral partner, or same-sex partner
A stepparent
A foster parent
An adoptive parent
Create a transition program to help new parents return to work, which will increase the odds that they will. (The FMLA stipulates that employees are entitled to return to their previous position or to an equivalent role with the same pay and benefits.) Consider:
Sponsoring an in-house or community-based parental mentoring program in which parents who have already returned to work mentor parents-to-be or new parents on questions related to juggling parenting and career.
Allowing new parents to work from home or work part time, easing their way back to a full-time schedule.
Because every family is different, be sure the policy's language and rules apply regardless of gender, sexual orientation, or family composition or structure.

Above all, be sure to tell your employees that you encourage parental leave. Your leave policy should be included in your employee handbook and updated periodically.

As a final step, refer to the Bipartisan Policy Center guide to determine whether your state has a stricter parental leave policy that supersedes other leave regulations.

Workplace Wellness Programs Are Thriving

Fri, 11 Apr 2025 22:10:46 GMT

Best Practices on Wellness Programs

TIn its seventh annual Employee Wellness Industry Trends Report, Wellable tracked the best practices for corporate wellness programs. This information guides human resources managers on how to plan and implement wellness initiatives in their own workplaces. What is clear is that companies are continuing to expand their wellness programs as a way to attract and retain top talent. In 2023, the corporate wellness market was valued at $61 billion. By 2030, the number is expected to grow to $85 billion.

Mental health remains at the core of corporate wellness programs as companies recognize the benefits in increasing employee productivity, job satisfaction and sense of well-being. Companies are subscribing to the old adage that you need "a sound mind in a sound body" by offering employees both physical and mental fitness programs.

There is a movement away from office-based programs as hybrid working arrangements gain popularity. Some companies are shedding investments in physical fitness classes, biometric screenings and free healthy food options. What is taking their place are flexible lifestyle spending accounts, which allow employees to focus on what is important to them — such as gym memberships, at-home fitness equipment, mental health services and nutrition counseling. Employees like the autonomy of being able to choose the right direction for their wellness journey.

Take the long view

A well-balanced wellness program takes a holistic approach and addresses all the lifestyle components that ensure an employee's well-being. This includes physical, financial, emotional, social, intellectual and, of course, mental health. All companies, no matter their size, should have a mental health resource component. Such a program should include counseling sessions, online mental health services and workshops on mental health. These programs help employees manage their stress, anxiety, depression and other mental health challenges. Some companies include on-site or remote mindfulness classes, which are geared specifically toward a corporate audience. Some of the classes include chair yoga, how to build boundaries between work and home (sounds very "Severance"), benefits of journaling and stress reduction.

There are those who argue that wellness programs are not yielding the results they want. This can be explained by the fact that these programs center on the individual and do not address what is causing them to have mental and physical stress in the first place. What seems to be a major cause of this stress? As you might guess, it is often the office environment itself that is the root cause. Without taking a hard look at the corporate culture and management style of the company's leaders, wellness programs cannot be effective. Employees who feel stressed due to excessive or unrealistic workloads will not benefit from wellness programs. Even though companies offer access to online therapy sessions, employees' mental health improvement will be negligible — as the stressors are still in place — unless there is a change in the work environment. What is needed is employer buy-in to bring about the change they want to see in their world.

Wellness programs will continue to proliferate with substantial corporate investments made to fund them. There is no question that these programs are intended to have positive results; however, corporations need to walk the walk, not just talk the talk, in fostering wellness in the workplace.

HSAs - What are they and Triple Tax Benefits

Sat, 05 Apr 2025 18:07:44 GMT

Eligibility, Contributions and Flexibility

A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals with high -deductible health plans (HDHP) save for qualified medical expenses. It combines health insurance with a savings tool that offers significant tax benefits.

How an HSA Works with Health Insurance

1. Eligibility: To open an HSA, you must be enrolled in a High Deductible health plan (HDHP), which typically has lower premiums but higher deductibles than traditional health plans. For 2025, the minimum deductible for HDHPs is $1600 for individuals and $3200 for families.

2. Contributions: Both individuals and employers can contribute to the account. For 2025, the contribution limits are $4,300 for individuals and $8,550 for families, with an additional $1,000 catch-up contribution allowed for those aged 55 or older.

3. Flexibility: Funds in an HSA can be used to pay for qualified medical expenses, such as deductibles, copayments, prescription drugs, dental care and vision care. Unused funds roll over from year to year and remain with the account holder even if they change jobs or health plans.

Triple Tax Savings Benefits

HSAs offer three key tax advantages that make them unique among savings accounts:

Tax Free Contributions:

· Contributions to an HSA are made pre-tax (if through payroll deductions) or are tax-deductible (if made directly by you), reducing taxable income

Tax-Free Growth:

· The funds in the account can be invested (once the account has enough funds to invest), and any interest or investment earnings grow tax-free over time.

Tax-Free Withdrawals:

· Withdrawals used to pay for qualified medical expenses are not taxed. This applies even years later, making HSA’s a powerful tool for both current healthcare costs and long-term retirement planning.

Additional Benefits

· Portability: The account remains yours even if you change jobs or retire. If you set up the account with your employer, you can take it with you and keep it.

· No “Use it or Lose it Rule: Unlike Flexible Spending Accounts (FSAS), HSA funds roll over indefinitely.

If you want to learn more about High-Deductible Health Plans that can be used with a Health Savings account, contact Pam Morton at Benefits by Design Insurance Services.

Pam Morton, Agency owner

pamM@benefitsbydesignca.com

760-696-3573

Visit our website: www.benefitsbydesign.com

Using Home Equity to Build a Business

Sat, 15 Mar 2025 18:16:16 GMT

Have You Always Dreamed of Owning Your Own Business?

While it is possible — and sometimes desirable — to use a business loan to start a business, you can also use your house for the seed money. Two options are a home equity line of credit or a home equity loan:

A HELOC is a debt secured by your home. It is similar to a mortgage.
Home equity loans involve borrowing against your equity stake in your house. Your equity stake is the portion you own outright; depending on the lender, you may be able to borrow up to 80% of this equity.

Exploring the differences

With a HELOC, you can use the funds, repay them and then borrow again. The period during which you can borrow (or "draw") money is often 10 years. After that, you enter the repayment period. During this phase, you can't withdraw funds, only repay your debt. The repayment period lasts up to 20 years. HELOCs typically offer variable interest rates.

Additional features of a HELOC:

You can repay interest first.
You pay interest only on the money you withdraw.
Repayments can vary with fluctuating interest rates.

By comparison, a home equity loan lets you borrow a specific amount that you receive in one payment. You don't replace your original mortgage; instead, the loan becomes a second lien on your property. Home equity loans often have long terms — 10 to 20 years — but a fixed rate of interest.

Both HELOCs and home equity loans have:

Relatively simple application processes.
Possible tax deduction of loan interest if you build a home addition for your business.

Both also involve the risk of losing your home. Because your house is the collateral for the loan, if you stop paying, you could fall into foreclosure. Additionally, if your house declines in value, you could owe more than the house is worth.

Other options

Another possible source of funds is a cash-out refinance. This is a new, bigger mortgage on your house, replacing your current mortgage. You take the difference between the old mortgage and the new one in cash. How much cash you can access depends on the equity you have in the home.

Among the pros of a cash-out refinance:

You may be able to change your mortgage length, term of repayments or even interest rate.
You avoid adding a second lien on your home.
You'll have one payment a month (rather than both a mortgage and a loan payment).

Among the negatives:

Like your first mortgage, the cash-out mortgage has a time-consuming application process.
You may end up with a larger monthly payment — especially if the current interest rate is higher.
You'll have to pay closing costs and other fees.

Another route to raising funds is a shared-equity agreement. It is more like an investment than a loan. In it, an equity-sharing company pays you for a portion of your home's future value, to be repaid when the agreement expires or when you sell the house. This means that the company will own a stake in your home. Typically, at payback time, you return the initial investment, plus a percentage of the home's appreciation.

Making the decision

Speak with legal and financial professionals to see which option is best for you. In general, leveraging your home's wealth for entrepreneurial success is fine as long as you understand the risks and want a straightforward funding option. Just get all the facts first.

Make Employees Mental health a Priority

Sat, 15 Mar 2025 18:12:00 GMT

Mental Health for Your Employees

Rising stress levels, anxiety and depression all contribute to the growing issues of workplace mental health. In 2019, the World Health Organization found that some 19% of working adults were diagnosed with a mental disorder. Post-pandemic, that number has risen to 25%. The mental well-being of employees impacts company productivity, morale, turnover rates and absenteeism, all issues that need to be addressed for the overall health of the company and its employees.

Employees are starting to recognize the importance of addressing mental health in the workplace. According to a 2023 SelectSoftware Reviews study, nearly a quarter of U.S. office workers reported facing high levels of stress in their jobs, with 39% indicating moderate stress levels. Deadlines, pressure from managers and coworkers, job uncertainty and high workloads all are contributing factors. And these factors lead to burnout and stress, which lead to poor job performance.

Business response

Employers have responded to declining employee mental health by taking positive steps toward bringing work-life issues into balance. Examples of these measures include mental health days or weeks, four-day workweeks and expanded counseling benefits. Major companies are currently investing time and money in creating a working environment where mental wellness is a priority. Among these industry leaders are Unilever, Johnson & Johnson and Samsung. To date, Unilever has trained over 4,000 employees worldwide as "mental health champions" designated as the first line of defense in identifying employees who are struggling with mental health issues. These champions can make recommendations referring their colleagues to mental health professionals.

In the case of Samsung, employees have access to mental health care at a counseling center during the workday. Employees can take advantage of online and in-person activities such as mindfulness meditation, body scan meditation and breathing meditation to restore mental clarity and balance. These industry leaders have not only improved the lives of their employees but also have secured the overall success of their companies.

Employers need to build trust with their workforce by understanding the many roles and stressors that their employees juggle, both at and outside work. To this end, some companies have given employees autonomy as to where and how work is performed. Family-friendly policies such as hybrid work schedules, flexible start and end times, and respect for the boundary between work and home all are ways to reduce employee stress.

One of the biggest hurdles to overcome in treating mental health is the stigma associated with having mental health issues in the first place. Employees may be hesitant to reveal their struggles to their employer and choose to "tough it out" instead. One expert, Leah Weiss, a Stanford University-based researcher and teacher, has written the following regarding mental health stigma: "The most crucial step in creating a culture that supports mental health is to frame mental wellness as a process that requires active engagement for everyone throughout their lifespan. People who struggle with maintaining mental health are no different from us; they are us. We all need to engage with mental/physical well-being efforts throughout our lives." What is needed is for companies to normalize mental health issues so that employees feel empowered to reach out and seek help.

Helping employees

Mental health care is becoming a key part of employee benefits. While many companies have stepped up to offer mental health support to their employees, there is still a long way to go for others. It is reported that about a quarter of employees are unsure about what mental health resources are made available to them by their employers. Employers that fail to make mental health care a part of their benefits package will find it difficult to attract and retain top talent.

The bottom line is that addressing mental health concerns is good for business. There is a cost to companies that do not provide resources. Companies with stressed or depressed employees without mental health care eventually see increases in their medical costs as well as higher turnover rates. In the long run, employees will seek employment with companies that prioritize mental health. It only makes good business sense to make employees' mental health the priority it needs to be.

The Power of a Power of Attorney Document

Sat, 15 Mar 2025 18:04:47 GMT

Different Types of Power of Attorney Documents and Why You Need Them

No one likes to think about having someone else act on their behalf, but there may come a time when, due to illness or other incapacity, you cannot act for yourself. That is why it is important to have powers of attorney in place, one for general and financial concerns and another for medical and health care matters.

A POA gives one person, termed the agent, the legal power to act for another, termed the principal, when making decisions about the principal's property, finances or medical care.

POAs are legal documents that may be drafted in one of two ways:

General or durable. Both general and durable POAs expire upon the principal's death, and both can limit the agent's decision-making powers. The critical difference between them is that general POAs expire if/when the principal becomes incapacitated, while durable POAs remain in effect until the principal's death. Many states do not consider POAs to be durable unless they specifically state that they are.
Immediate or springing. Immediate POAs become enforceable the moment they are signed. Springing POAs do not become enforceable until/unless the principal becomes incapacitated.

It's important to remember that for a POA to be valid, the parties must comply with the resident state's requirements for signatories. Some states require the document to be notarized, some require witnesses and others require both.

Health care POAs

All 50 states allow living wills (aka medical directives, health care proxies or advance health care directives) that allow you to appoint someone to make medical decisions for you in the event you cannot make them for yourself. However, these documents cannot possibly envision all potential scenarios. In addition, some states limit the extent to which they will honor health care directives from other states; that is, they will accept documents only as far as they comply with their own laws. Having a health care POA in addition to a living will is one way to bridge these gaps. The person with the health care POA will be able to act in circumstances that the living will does not cover and in situations when the living will may not be honored.

Financial POAs

A financial POA has some limitations, especially when it comes to the agent gaining access to bank accounts. Because of the prevalence of fraud and elder abuse, many banks, especially those in states that do not have statutory forms, are hesitant to recognize durable POAs without having them reviewed by the bank's legal department.

Another issue is "stale" documents. Some banks are unilaterally declaring that documents more than 10 years old are void. While this is not backed by law and in fact runs counter to the purpose of a durable POA, nothing has yet stopped the practice. One way to avoid the problem is to put the POA on file with the bank or other financial institution while the principal is healthy. That way, all parties can be sure the document complies with the bank's requirements.

Digital assets

Many existing POAs were created before the reach and value of digital assets were understood. As a result, because these assets are not specifically named in the POA, the agent may not be able to access them. Given the prevalence of digital assets, it is a good idea to update your POA. Keep in mind that any updates must be made according to state law.

What if a POA is not accepted?

If a bank or other financial institution refuses to accept a POA, taking the institution to court may be the best option. Alternatively, the agent can ask the court to declare the principal legally incapacitated. However, if the court agrees to do so, the principal's affairs would be put into court-ordered conservatorship, which would entail lifetime probate; in other words, court conservatorship is exactly what a POA is meant to avoid.

Uniform Power of Attorney Act

POAs are governed by state law. To standardize these laws across the U.S., more than half the states have enacted the UPOAA. The laws in UPOAA states will match each other in specific areas, including compensation for the services an agent provides and how the agent-principal relationship can be terminated. This is only true, however, if all jurisdictions involved have adopted the UPOAA.

POAs are an important part of comprehensive estate planning. The best solution to the potential risks inherent to POAs is prevention. Consult an estate planning professional who understands the nuances of drafting a POA that is compliant with the laws of the state(s) where the principal resides and with the banks and other financial institutions where the principal transacts business.

Medicare - Watch for your Annual Notice of Change Mailing each September

Sat, 15 Mar 2025 17:49:38 GMT

It may look like junk mail, but it is very important to carefully read your Annual Notice of Change from your Medicare Advantage or Medicare Part D Prescription Drug company

This is a helpful reminder for Medicare beneficiaries to review their Annual Notice of Change (ANOC) mailings and prepare for the Annual Election Period (AEP) from October 15 – December 7 .

Key Points to Watch For:

✔ Plan Changes for 2026 – Look for updates on premiums, copays, covered medications, and network changes.
✔ Potential Cost Increases – Some plans may see adjustments due to the Inflation Reduction Act of 2022 .
✔ $2,000 Out-of-Pocket Cap – This is great news for those with high prescription drug costs

What Should You Do?

�� Review Your ANOC Letter – Make sure your plan still meets your needs.
�� Compare Plans – If your prescriptions or medical needs have changed, you may benefit from switching plans.

�� Ask for Help – If you need assistance reviewing your options, reach out.

�� Call 415-524-8959 or 760-696-3573
�� Email pamm@benefitsbydesignca.com

Benefits by Design Insurance Services – Helping you navigate Medicare, Part D, Medicare Advantage,dental insurance and vision insurance .

What is an ICHRA vs. QSEHRA what are the differences between them?

Sat, 15 Mar 2025 17:49:36 GMT

Key Differences

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COBRA - Make sure you are in Compliance

Sat, 15 Mar 2025 17:49:28 GMT

Make Sure You Are In Compliance

The Consolidated Omnibus Budget Reconciliation Act provides employees with continued access to health insurance coverage, helping them bridge the gap between losing employer-sponsored health coverage and finding alternative plans. COBRA is used so that employees can continue with insurance under circumstances — job loss, reduction of hours worked or transition between jobs — where the coverage otherwise would end. COBRA is helpful for employees if they'd like to continue to receive the same health plan benefits even though their employment may have changed.

COBRA benefits are time limited and apply only to group health plans sponsored by employers with 20 or more employees in the prior year. While COBRA helps employees avoid a lapse in coverage, there are some details they need to pay attention to:

Employees have 60 days to enroll in COBRA once their employer-sponsored benefits end. Once COBRA is elected, they'll be covered by COBRA starting the day their employer-sponsored coverage ended.
COBRA benefits last for only 18 to 36 months, depending on the reason for COBRA and the employer's health insurance plan. In other words, there is limited time to research and find another health insurance option.

COBRA benefits are also available to an employee's family under these circumstances:

The death of a covered employee, resulting in the loss of coverage for their dependents.
Divorce or legal separation of the covered employee if their spouse loses coverage due to the change in marital status.
Loss of dependent-child status. When a dependent no longer qualifies for coverage under the employer health plan, that child may be eligible for COBRA coverage.

COBRA coverage isn't free. If employees elect to keep insurance coverage under COBRA, they're responsible for paying the full cost of their premium (the premium the employer previously paid) plus an administrative fee; the total could be up to 102% of the cost of the plan (the extra 2% being the administrative fee).

COBRA requirements

Employers are required to issue notices about COBRA availability to employees and their qualified beneficiaries. The details in these notices must be wholly correct. Employers are also responsible for offering coverage identical to the coverage provided to active employees and their dependents.

Additionally, employers must:

Ensure the premiums charged for COBRA coverage are reasonable and reflect the full cost of the plan.
Maintain accurate records related to COBRA, including documentation of notices sent, enrollment information and payment of premiums. Proper recordkeeping demonstrates compliance for addressing any potential audits or inquiries.
Allow each qualified employee to independently elect COBRA coverage.
Allow a covered employee to elect COBRA for any dependent children or qualified beneficiaries.

Penalties for not being COBRA compliant can vary:

The Department of Labor can impose the maximum penalty for a single violation, upward of $110 per day per affected beneficiary.
There may be legal consequences. Lawsuits may award monetary damages to beneficiaries who were denied their COBRA rights or who experienced harm due to noncompliance. You may be responsible for the legal fees associated with such a lawsuit.
You may be required to reinstate coverage retroactively, which could result in increased costs and administrative burden.

COBRA responsibilities

Employers play a crucial role in ensuring COBRA compliance and providing eligible individuals with access to continued coverage. Seek compliance guidance from legal and HR professionals who specialize in employee benefits.

Common mistakes employers make when it comes to COBRA include:

Inadequate or late notice. As a rule of thumb, send out a COBRA notice the day you terminate an employee.
Misunderstanding eligibility criteria. If you don't know who is eligible, you might fail to offer continuation coverage. Be well informed about both qualifying events and the individuals who are entitled to COBRA coverage.
Insufficient training and knowledge. Ensure compliance by investing in appropriate training and staying up-to-date with the latest COBRA requirements.

During transitional periods, COBRA provides employees with a safety net to help maintain continuity of coverage, protecting them against sudden gaps in health insurance. Employers must do their part to provide this important benefit.

Finally, keep in mind that regulations can change over time, often with little notice, so be sure to keep in touch with your technical advisors.

What is an HSA plan and who is a good fit for one?

Sat, 15 Feb 2025 22:04:23 GMT

Is a Health Savings account with a high deductible plan the right fit for you?

A Health Savings Account (HSA) plan is a tax-advantaged savings account paired with a High Deductible Health Plan (HDHP) . It allows you to save and invest money tax-free to pay for qualified medical expenses.

Key Benefits of an HSA Plan:

✅ Tax Advantages – Contributions are tax-deductible, grow tax-free, and withdrawals for medical expenses are tax-free.
✅ Lower Monthly Premiums – Since HSAs are paired with HDHPs, premiums are typically lower than traditional plans.
✅ Rollover Savings – Unused funds roll over each year (no "use it or lose it" rule).
✅ Investment Growth – Many HSAs allow you to invest funds in mutual funds or stocks, helping your savings grow.
✅ Long-Term Benefits – HSA funds can be used for retirement healthcare costs tax-free. After age 65, withdrawals for non-medical expenses are taxed like regular income (similar to a 401(k) or IRA).

Who is a Good Fit for an HSA Plan?

✔ Healthy individuals & families – If you have minimal medical expenses, an HSA helps you save on premiums while growing tax-free savings.
✔ Those who want tax savings – High earners benefit from the tax deductions and investment growth.
✔ Self-employed or small business owners – HSAs offer flexibility and tax advantages without requiring an employer-sponsored plan.
✔ Long-term planners – If you want to save for future healthcare expenses or retirement , an HSA is a great tool.
✔ People who can afford a higher deductible – Since HSAs pair with HDHPs, you need to be comfortable covering costs until the deductible is met.

Who Might NOT Be a Good Fit?

❌ Those with frequent medical needs – If you have chronic conditions or require frequent care, a lower-deductible plan with copays may be more cost-effective.
❌ People who struggle with high upfront costs – If meeting a high deductible would be difficult, a traditional plan may be better.
❌ Anyone enrolled in Medicare – You cannot contribute to an HSA if you have Medicare Part A or B (but you can still use existing HSA funds for medical expenses).

Want to See if an HSA Plan is Right for You?

�� Call 415-524-8959 or 760-696-3573
�� Email pamm@benefitsbydesignca.com

Benefits by Design Insurance Services can help you explore HSA-compatible plans and look at other options based on your needs and your budget.

Health Insurance Options for Very Small companies

Sat, 15 Feb 2025 21:54:04 GMT

What are the options and what is required

Health Insurance Options for Business Owners

As a business owner, you have two main options for securing health coverage:

1. Individual Health Insurance

If you're a sole proprietor or have no employees, you can purchase a personal health plan through:

✔ State of California marketplace (CoveredCA.com) – May qualify for subsidies based on income.
✔ Private insurance companies – Offers more plan options but without government subsidies.

2. Small Group Health Insurance

If you have at least one W-2 employee (other than a spouse or related family member), you may qualify for a small group plan with benefits like:

✔ More affordable rates – Group plans often cost less than individual plans.
✔ Tax advantages – Premiums may be deductible as a business expense.
✔ Attract & retain employees – Offering health benefits makes your business more competitive.

Ways to Set Up a Small Group Plan:

✔ Traditional group health insurance – Coverage from major carriers with employer/employee contributions.
✔ Small Business Health Options Program (SHOP) – Covered California Small Business marketplace plans for businesses with up to 50 employees .

✔ Health Reimbursement Arrangement (HRA) – Employers reimburse employees for individual plan premiums tax-free .

✔ Professional Employer Organization (PEO) – Outsource HR to access larger group insurance rates.

Need help finding the right plan?

�� Call 415-524-8959 | 760-696-3573
�� Email pamm@benefitsbydesignca.com

Benefits by Design Insurance Services – Helping business owners navigate health, dental, vision, group life and group disability options .

Getting Ready for Medicare - Choosing the right plan

Sat, 15 Feb 2025 21:53:30 GMT

What will work best for you?

Getting Ready for Medicare: Choosing the Right Plan

What is Medicare?
Medicare is a federal health insurance program for individuals 65+ or younger people with certain medical conditions. Enrollment begins three months before your 65th birthday and ends three months after .

The Four Parts of Medicare

✔ Part A (Hospital Insurance) – Covers inpatient care, short-term nursing, and hospice. Most people don’t pay a premium.
✔ Part B (Medical Insurance) – Covers doctor visits, outpatient care, and medical equipment. Monthly premium: $174.70 (2023) . Covers 80% of costs ; a Medigap plan can help cover the remaining 20%.
✔ Part C (Medicare Advantage) – Alternative to Original Medicare, often including vision, dental, hearing, and drug coverage. Some plans offer $0 premiums .
✔ Part D (Prescription Drugs) – Private plans covering medications. A Part D plan is required to avoid lifelong penalties.

Original Medicare vs. Medicare Advantage

Original Medicare
➜ No limit on out-of-pocket costs (Medigap can help).
➜ Covers 80% of medical expenses , leaving you responsible for 20%.
➜ Requires a separate Part D plan for prescriptions.

Medicare Advantage
➜ Caps out-of-pocket expenses annually.
➜ Often includes extra benefits (vision, dental, hearing, drugs).
➜ Lower premiums but may require network restrictions & referrals .

Need help choosing the right plan?
�� Call 415-524-8959 | 760-696-3573
�� Email pamm@benefitsbydesignca.com

Benefits by Design Insurance Services – Your expert guide to Medicare, health, dental, vision, life, and travel insurance .

Benefits by Design - Case Study #1 Private School with 55 Employees

Sat, 15 Feb 2025 21:51:35 GMT

Goal: Shift resources from high-cost benefits to expanded options at a lower cost

Case Study #1: Private School with 55 Employees

Goal: Shift resources from high-cost benefits to more options at a lower cost

Our Free Benefits Analysis Identified Savings Opportunities:

Initial Results:

✅ More Carrier Options – Expanded medical plan choices beyond a single provider.
✅ Cost-Effective Employer Contributions – Based on an anchor plan with identical benefits to the previous plan.
✅ Flexible Employee Choices – Employees could buy up or down while employer costs remained fixed.
✅ Major Savings Achieved – $20,000 saved per month → Over $200,000 per year in reduced costs.

Update (2 Years Later):

✅ Life & Disability Benefits Market Review – Found another carrier offering identical coverage for $4,000 less per year .
✅ Negotiation Success – The current insurer matched the lower rate , saving money without switching carriers .

Results:

�� Significant cost savings without reducing benefits.
�� Better plan flexibility while controlling employer expenses.

Want a free benefits analysis for your organization?

�� Call: 415-524-8959 | 760-696-3573
�� Email: admin@benefitsbydesignca.com

Benefits By Design Case Study #2 - Expanded benefits at no extra cost

Sat, 15 Feb 2025 21:51:07 GMT

Profile: Accounting and Consulting Agency

Goal: To Improve benefits without increasing the cost

How: Benefits by Design Insurance Services conducted a complimentry analysis of current benefits

How We Improved Benefits Without Increasing Employer Costs

Challenge: A company offering Kaiser medical and dental plans wanted to improve benefits without raising costs .

Our Free Benefits Analysis Led to These Improvements:

✅ More Health Plan Choices

�� Replaced the Kaiser-only plan with a small group exchange , allowing employees to choose from five different health insurance companies while keeping Kaiser as an option.
�� The employer’s contribution was based on a similar Kaiser plan , leading to cost savings on medical benefits .

✅ Better Dental Coverage at Half the Cost

�� Switched from a limited-network HMO dental plan to a small group specialty benefits exchange , cutting costs by 50% .
�� Employees could upgrade to a PPO dental plan with more provider options.

✅ Expanded Benefits at No Extra Cost
�� The new exchange included vision, chiropractic, acupuncture, and life insurance options—giving employees more choices while lowering employer costs.

Result: More benefits, lower costs, and happier employees!

Want a free benefits analysis for your company?

�� Call: 415-524-8959 | 760-696-3573
�� Email: admin@benefitsbydesignca.com

When is it cost-effective to Buy Individual Dental Insurance?

Sat, 15 Feb 2025 21:50:21 GMT

How to get the most value out of Dental Insurance

People often ask me which dental insurance I recommend, and my answer is: It depends.

To get the best value from individual dental insurance, consider:

�� Does Your Dentist Accept Insurance?

✔ If they participate in a network , your costs will be lower.
✔ If they accept PPO plans but aren’t in-network , you may pay the difference between what they charge and what insurance covers.

Key Factors to Consider When Choosing a Dental Plan:

✅ Is your dentist in-network?
✅ Annual maximum payout – The most the plan will cover in a year
✅ Deductible – What you pay before insurance kicks in
✅ Preventive care coverage – Many plans cover cleanings 100%
✅ Waiting periods – Some plans require waiting before covering major work
✅ Exclusions & major services – Are crowns, root canals, and implants covered?

�� Pro Tip: If your dental work costs over $100, ask for a predetermination of benefits to see what insurance will pay before treatment.

Need help finding the right dental plan?

�� Call: 415-524-8959 | 760-696-3573
�� Email: admin@benefitsbydesignca.com

Let Benefits by Design Insurance Services simplify your dental insurance decision!

Is it Worth It to Purchase Vision Insurance?

Sat, 15 Feb 2025 21:49:52 GMT

Before you buy Vision Insurance, here are things to consider

It depends on your needs. If you buy expensive glasses or contacts regularly, a vision plan can be a great value. But before purchasing, consider these factors:

�� Check Discount Programs

Many optical centers (like Costco or LensCrafters) offer built-in discounts, which may save you money without vision insurance.

�� Does Your Health Plan Offer Vision Benefits?
Some health plans, like Kaiser, cover eye exams and offer optical discounts—no separate vision plan needed!

�� What to Look for in a Vision Plan:

✔ Frame & contact lens allowance
✔ Exam & eyewear frequency
✔ Lens enhancement discounts
✔ Retail, online & doctor’s office options

Most people bundle vision with dental insurance, but shopping around is key!

Need help finding the right plan?

�� Call us: 760-696-3573 | 415-524-8959
�� Email: admin@benefitsbydesignca.com
⏰ Monday – Friday | 9:00 AM – 5:00 PM

Let Benefits by Design Insurance Services research and compare options for you at no cost!

5 Things Start-up Companies need to get Group Health Insurance

Sat, 15 Feb 2025 21:49:22 GMT

You may already have everything you need in place to purchase small group Health Insurance

Are you a startup company trying to figure out what you need to have in place in order to get group health insurance? Benefits by Design Insurance Services has answers.

Many small and startup companies come to us to help them decide what type of group health insurance to provide their employees. Many small businesses don’t realize that they need to have a number of things in place before they can consider offering insurance.

If you are thinking about getting small group health insurance for your company, here is what you need to have in place first:

Worker’s Compensation insurance for all employees – Worker’s Compensation insurance provides wage replacement and medical benefits to employees who are injured in the course of employment. In California an Owner, Partner or Sole Proprietor are exempt from needing Worker’s Compensation insurance. Everyone else (employees) need to be covered by it. If the company is incorporated, however, all employees, owners and partners need to be covered by Workers Comp because everyone is considered an employee.

DE9 form from your payroll - Every quarter, California employers are required to complete a Quarterly Contribution Return and Report of Wages (DE 9), which is used to reconcile California payroll tax payments and the total subject wages reported for the quarter.

Some carriers have owner/partner forms that need to be completed, if the owner/partner does not have a DE9 form.

Your company has to be registered as a business that is able to do business in CA. Most carriers will check out a company on the California Business Portal .

Your company has to have a business bank account, a business check, or a letter from your financial institution indicating that the account you are using to pay your premiums is a business account.

Insurance carriers may ask for additional items as well, in order to verify your company’s eligibility.

Benefits by Design Insurance Services can help you understand everything you need to do in order to get group health insurance. Please call 415-524-8959 or 760-696-3573 email admin @benefitsbydesignca.com for more information.

Are You Like my Dad or my Grandma When Choosing Health Insurance?

Sat, 15 Feb 2025 21:48:50 GMT

This is a subtitle for your new post

When people ask me which health insurance plan to choose, my answer is always: “It depends on your needs and budget.”

Take my Grandma and Dad , for example—they have very different priorities:

�� Grandma’s Approach :
✔ Healthy lifestyle, rarely visits the doctor
✔ Prefers low monthly premiums with higher out-of-pocket costs
✔ Can afford occasional medical bills if needed

�� Dad’s Approach :
✔ On a tight budget, wants predictable costs
✔ Prefers higher monthly premiums to keep doctor visits & hospital bills low
✔ Wants minimal surprise expenses

So, which one are you?

When choosing a health plan, consider:

✅ What you can afford monthly
✅ What you can handle in worst-case scenarios
✅ Your expected healthcare needs

Good News!

✔ Every year, your out-of-pocket max resets
✔ ACA-compliant plans have unlimited lifetime benefits

Still unsure? We’re here to help!

�� Call: 415-524-8959
�� Email: pamm@benefitsbydesignca.com
�� Visit: www.benefitsbydesignca.com

Benefits by Design Insurance Services —Helping individuals & businesses find the right coverage, including health, Medicare, life insurance, dental insurance, vision insurance, and travel insurance.

Are you Maximizing Your Employee Benefits?

Sat, 15 Feb 2025 21:47:26 GMT

What should we be thinking about to get the best value at the lowest cost?

If you’re an HR Manager, CFO, Head of Schools, or Benefits Administrator , ask yourself:

✅ Are you getting the best value for your employee benefits?
✅ Do you have the best benefits at the lowest cost ?
✅ When was your last market review ?
✅ Is it time for a fresh perspective on your benefits strategy?

We Offer a Free Benefits Review!

At Benefits by Design Insurance Services , we help businesses save money and optimize benefits at no cost to you.

Recent Successes for Our Clients:

✔ Finding affordable benefits in rural areas
✔ Offering low-cost dental plans with employee upgrade options
✔ Managing Kaiser plans —saving HR time and effort
✔ Reducing payroll taxes with a Section 125 Premium Only Plan
✔ Setting up health reimbursement accounts for out-of-state employees
✔ Finding the same benefits at a lower cost with different carriers

Let’s Find Your Best Options!

�� Call Pam Morton: 760-696-3573 | 415-524-8959
�� Email: pamM@benefitsbydesignca.com
�� Visit: www.benefitsbydesignca.com

Health Insurance for Private Schools

Sat, 15 Feb 2025 21:45:55 GMT

Is it time to explore other options for Employee Benefits for your Private School?

If you are a Human Resource Manager, a CFO, a Head of Schools or anyone who manages Employee Benefits, here are some questions for you!

● Are you getting the most value out of your Employee Benefits?

● Have you asked yourself if you have the best benefits for the least cost?

● When was the last time you did a market check to find out?

● Have you had the same employee benefits broker for a long time?

Benefits by Design Insurance Services works throuhout California and is prepared to offer you a review of your Employee Benefits at no cost to you.

Some of our recent challenges we worked through for clients:

Finding lowest cost benefits and available providers in a rural area
Finding lowest cost dental HMO and PPO plans with the strategy of the employer paying for the lowest cost plan and letting the employees buy up to a more expensive plan if they want one
Are you managing Kaiser for your employees and finding that it takes time away from other things you need to do? You can have your Kaiser plan managed by Benefits by Design at no monthly cost to you.
Lowering payroll costs for employers by having them use a Section 125 Premium Only Plan (POP) for the employees to take money from their paycheck and pay for benefits on a pretax basis
Setting up a health reimbursement account for employees that live in states where the company’s health plan doesn’t work well for them
Finding ways to offer the same benefits with a different carrier at a lower cost

If any of these strategies sound attractive to you, contact us at Benefits by Design Insurance Services and we’ll provide a complimentary, no obligation review of your current employee benefits.

�� Call us: 760-696-3573 | 415-524-8959
�� Email: admin@benefitsbydesignca.com

#employeebenefitspecialist

#employeebenefitsconsultant

#employeebenefitsbroker

#carlsbadchamberofcommerce

#smallbusinesssandiego

#privateschoolsca

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COBRA vs Individual Health Plans - What you need to know

Sat, 15 Feb 2025 21:45:22 GMT

Does COBRA - Continuation of your benefits from work seem expensive?

COBRA vs. Individual Health Plans – What You Need to Know

Most people choose COBRA because employer health plans often offer better benefits for the cost. However, COBRA can seem expensive since you’ll pay the full premium without employer contributions.

Key Factors to Consider:
✔ Your Current Plan – Coverage & benefits
✔ Monthly Cost – What you’ll pay
✔ Deductible & Out-of-Pocket Maximum – How much before insurance kicks in

Individual health plan costs vary by age, location, and family size, while employer plans typically have the same cost for all employees.

If you’re older, COBRA may be a better deal.

Need help deciding? Health insurance brokers don’t charge fees—we’re paid by insurance companies at no extra cost to you!

�� Call us: 760-696-3573 | 415-524-8959
�� Email: admin@benefitsbydesignca.com

Can I Buy Health Insurance now?

Sat, 15 Feb 2025 21:44:41 GMT

When you can purchase Health Insurance outside of open enrollment?

Can I buy health insurance even though it is not open enrollment? The answer is maybe.

When it is not open enrollment, there are many life changes that would allow consumers to enroll in quality health coverage.

Gaining a dependent or becoming a dependent through birth or adoption
Getting married
Applicant or dependent lost minimum essential coverage due to termination or change in employment status
Cessation of an employer's contribution toward an employee or dependents coverage
Death of the person through whom the applicant was covered
Entitlement of benefits of the subscriber under Title XVIII of the Social Security Act (Medicare), resulting loss of coverage to the dependents
Dependent child's loss of dependent status under the applicable requirements of a group plan, such as reaching age 26
Loss of minimum essential coverage excluding the loss of termination due to failure to pay premiums or situations allowing rescission
Gains a dependent or becomes a dependent through marriage or partnership
Dependent is mandated to be covered pursuant to a valid state or federal court order
Legal separation or divorce through whom the applicant was covered as a dependent
Loss of coverage under the Access for Infants and Mother's Program and Medicaid share of cost program
Loss of HMO coverage benefits as the individual no longer lives or works in the HMO service area
Applicant became a permanent resident of California during a month outside of open enrollment period
Applicant returns from active military duty
Applicant is released from incarceration

Reach out to us today and see if we can help you.

Health Insurance brokers do not charge fees to their clients. They are paid by the health insurance companies at no extra fee to the consumer.

By email at admin@benefitsbydesignca.com or call us at 760-696-3573 or 415-524-8959

Basics of Medicare and Enrollment Periods

Sat, 15 Feb 2025 21:42:30 GMT

Medicare Part A, B, C & D

During Medicare's open enrollment period, which runs from Oct. 15 to Dec. 7, beneficiaries — seniors, younger people with disabilities and individuals with end-stage renal disease — can choose plans for next year. Options include traditional Medicare from the government or a wide array of Medicare Advantage plans, which are private insurance products that encompass similar benefits.

The parts of Medicare

Medicare has four main components:

Part A is hospital insurance. You don't usually pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working.
Part B is medical insurance.
Part C is Medicare Advantage — private plans that use managed care models, such as HMOs and PPOs.
Part D is prescription drug coverage.

In general, you are automatically enrolled in Part A and Part B at age 65. Many enrollees find they need extra insurance and sign up for Medicare Supplement Insurance, also known as Medigap. Medigap is purchased from a private health insurance company and helps cover out-of-pocket expenses like copayments, coinsurance and deductibles.

Medigap rules can be restrictive and complex. Your best chance to get Medigap is when you first join Medicare as a senior, after you turn 65. You have a six-month window when you can buy a Medigap policy and insurers can't turn you down or charge you more because of your health conditions.

Medicare Advantage — be careful

Medicare Advantage can be useful, but it's not always perfect. Among the disadvantages of Medicare Advantage are limited networks, requirements for prior approval, delays and denials. You can switch from Medicare Advantage back to the original Medicare during open enrollment or the Medicare Advantage open enrollment window.

Your drug coverage can come through a stand-alone Part D plan, needed if you are in traditional Medicare, or included as part of Medicare Advantage. Use Medicare.gov to see if your prescriptions are included.

If you missed your Part B enrollment window — three months before your 65th birthday and three months after — you'll face a late enrollment penalty when you sign up. The penalty equals 10% of the standard monthly premium for each 12-month period you delayed enrollment. You also may have to pay a late enrollment penalty if you didn't sign up for Part D or if your prescription drug coverage didn't meet Medicare's minimum standard. You may not be taking prescription drugs now, but consider signing up for a Medicare drug plan or a Medicare Advantage plan with drug coverage to avoid a penalty later.

Medicare has an online tool that makes it easier to comparison shop. Log in to Medicare.gov and select the link for "Find health & drug plans." Also, you can get guidance from Medicare by calling 1-800-633-4227. You can turn to a broker, a navigator or an enrollment counselor for help.

If you're at that time of life, let us know how we can help you make a smooth transition. Give us a call at Benefits by Design Insurance Services or send us an email to schedule a time to talk and we'll be happy to help you get ready for Medicare. Our phone numbers are 760-696-3573 in Carlsbad or 415-524-8959 in Larkspur, California. You can also email us at admin@benefitsbydesignca.com.

Building a Healthy Work Life Balance

Sat, 15 Feb 2025 21:41:38 GMT

How to find the right balance

The COVID-19 pandemic shifted norms for the division between labor and leisure. As many office workers embraced new work-from-home practices, they experienced both gains and losses. On the one hand, many dispensed with a tedious and time-consuming commute; on the other hand, they found their work schedules blurring into evening and weekend hours. Feeling obligated to check emails at all hours, they became trapped in pervasive business routines.

Finding the right balance

Managers pay increased attention to promoting an appropriate mix of work and outside individual activities. Employees with well-rounded lives are expected to devote time and effort to many demands: family, community, social occasions, health, wellness, hobbies and cultural exposure. It is becoming accepted that employees and employers should both benefit from the integration of personal and professional spheres.

Productivity tends to diminish drastically after about 50 hours of work per week, so an optimal sweet spot might be working no more than 38 to 45 hours a week. Current models propose a holistic framework that incorporates multiple aspects, leveraging on one another. They no longer describe the day as one unit, with distinct slices allotted to work or private interests. The concept of knowledge work is based on the principle that various inputs, like ideas, analysis and data, are combined with outside activities, like intellectual exploration, experiences and communication. And then a physiological transformation occurs — more neural pathways in the brain are activated to promote innovation and creativity.

A successful work/life balance is not simply an even division between one's job and hobbies. It is more constructive to aim for a relationship between achievement and enjoyment, where neither side is sacrificed for the other. In a wider framework, the aim is to create priorities for how to spend time, which is always a precious commodity.

A happy medium

Keeping work and life in proportion is a cooperative effort; both employers and workers share the responsibility. Managers must pay attention to the individual needs of those who work for them and learn at least enough about their outside lives to accommodate where appropriate.

It is also incumbent on them to lead by example. That means refraining from dashing off nonurgent emails 24/7 or scheduling weekend or evening calls. Post-pandemic, the WFH practice is not a green light to usurp every moment of free time. Give your subordinates some leeway so they do not always feel compelled to ask permission or explain trivial activities.

But it is ultimately up to the workers to make and follow their own rules, such as:

Set manageable, realistic goals.
Don't procrastinate. Stick to the to-do list.
Ask the boss for flexibility when it is really needed. Compromise and suggest proactive alternatives.
Tackle daunting projects by dividing them into smaller tasks.
Take regular breaks. A person can fully concentrate for only about 90 minutes at a time.
Don't overcommit. Learn to say no. Establish boundaries.
Enlist moral and practical support from friends, family and co-workers.
Know their hours for peak productivity.
Take vacations and staycations and enjoy at least one social event each week.

Drawn into the danger zone

Diverse motives drive employees to struggle to maintain an optimal work/life balance. Many assume it is in their professional interest to be seen as "hardworking." Industrious souls who burn the midnight oil are most likely to earn raises and promotions. Others who are compulsive by nature find it hard to power down until they have crossed off the final item on their to-do list.

Small-business owners in particular tend to overwork; they should consider delegating tasks such as:

Bookkeeping.
Data entry.
Invoicing.
Deliveries.
Technical support.
Paying bills.
Making bank deposits.
Travel arrangements.
Ordering equipment/supplies.

Imbalanced work stress can trigger physical and emotional symptoms, including burnout. Back-to-back meetings, being constantly "on" and open-floor-plan offices may not be worth the toll they exact on employees. Workers must learn to juggle competing pressures, and managers must cooperate.

Voluntary Accident Insurance As An Employee Benefit

Sat, 15 Feb 2025 21:40:59 GMT

Different Types of Voluntary Accident Insurnance

Voluntary accident insurance provides funds to pay for additional costs incurred from injuries. If you've ever seen an Aflac commercial—with the duck that keeps repeating the name of the product—you get the idea that supplemental insurance provides coverage for bills that your major medical plan doesn't cover. You can see how this is an attractive option to catch the attention of top talent.

What else should you know?

This coverage is an extra benefit. Supplemental insurance doesn't take the place of workers' compensation coverage or short- or long-term disability plans.
The payouts can help cover household bills and replace missed wages.
Cash benefits are paid for covered hospital stays, ambulance bills and other treatments or services.
This benefit can include worldwide travel assistance for emergency medical, travel and pre-trip information services.
The employee usually pays for 100% of the cost, but you can provide a company-paid policy as a supplemental insurance benefit. Employees can make premium payments through payroll deductions.
Benefits can extend to sports accidents or emergency room treatments for employees and their dependents.
Once covered, employees submit proof of out-of-pocket costs to the accident plan for reimbursement, up to the plan's maximums.
Many employees like that benefits are paid directly to them so they can use the money where it is needed.
The benefits can be customized for your employees' specific needs, catering to diverse vocations, stages of life, locations and lifestyles.
Plans often have maximum dollar limits that they'll pay. Some plans have maximum benefit caps that apply to certain services, including emergency room visits, urgent care visits and procedures such as stitches.

In the past, supplemental accident insurance was seen as a significant administrative expense that involved seeking out options, driving enrollment and dealing with payment of benefits. But companies may find that it's a simpler process today. Voluntary worksite benefits can be offered via payroll deductions and cover therapies, surgeries and other costs associated with treatment or recovery from an injury. The injury or condition doesn't have to be work-related for benefits to be paid out—indeed, you should remind employees this is not a form of workers' compensation.

Great for employees

Voluntary accident insurance gives you an opportunity to offer employees coverage that pays for the out-of-pocket expenses that can result from an accident—and often apps make it easy to submit a claim on a 24/7 basis. And with group rates, the coverage can be made more affordable, especially if voluntarily obtained with payroll deductions.

See this benefit as a way to level the playing field for your business and show that you care about your employees' well-being. Unexpected accidents can lead to financial strain and possibly a reduction in workplace productivity—accident insurance can provide a financial cushion. In a competitive job market, benefit options that offer increased protection can help improve employee satisfaction and become a key part of your employee recruitment strategy.

Voluntary insurance offers flexibility for your employees to personalize their coverage to meet their needs. Your team members may see workplace benefits as more valuable today than before the pandemic because they provide another layer of protection.

The Importance of Offering an Employee Satisfaction Survey

Sat, 15 Feb 2025 21:40:29 GMT

If you are considering doing an Employee Survey, ask for a reccomendation from Pam at Benefits by Design Insurance Services for someone to create it for you

How would you define an engaged workforce? You might say it’s an environment where everyone involved feels valued and supported.

Workplace engagement is a crucial aspect of business success. In fact, it’s so imperative that employee engagement has been shown to affect metrics like productivity, retention, and customer service.

However, unfortunately, recent statistics indicate that only a mere 30% of employees are actively engaged with their place of work. Meanwhile, a total of 17% of employees are not engaged at all.

That is the bad news. But the good news is that there are steps you can take as a company to revamp the workplace and transform it into a culture that cultivates engagement. On that note, one of the most helpful techniques you can implement is an employee satisfaction survey.

A few caveats of employee engagement satisfaction surveys

There are three rules that you should abide by when putting together an employee satisfaction survey. For starters, not only should all responses be recorded anonymously but you must also reassure your employees that you promise to maintain anonymity.

Also, keep your emotions out of the equation when gathering responses and documenting the results. Last but not least, no matter the outcome of the surveys, it is important to use the results as a way to take action and make change.

Questions to ask yourself when drafting an employee engagement satisfaction survey

Here are a handful of questions you should keep in mind when preparing to pass out employee satisfaction surveys to those who work for your company.

What is the goal of your employee satisfaction survey?
Are you going to hire a writer for your employee satisfaction survey or have an internal employee write it?
How will you let your employees know about the employee satisfaction survey?
Who will you ask to participate and fill out the survey?
How much time will you give your employees to respond to the survey?
Are you planning to send out reminders? If so, how frequently will you send them?
Can employees fill out the satisfaction survey online or will you conduct interviews in person?
Who will you appoint to collect the surveys and calculate the results?
How will you decide what to change after analyzing the results of the employee satisfaction survey?
How will you let your employees know how you plan to change things according to the outcome of the survey?

Other details to consider when creating your survey

Have you thought about how you’ll structure your employee engagement satisfaction survey? Think about whether you want to use open- or closed-ended questions. While closed-ended questions are easier to record and quantify, open-ended questions mean your employees can be more in-depth about how they feel when answering the survey.

Also, consider how long the survey will be. Note that the length of the survey is an important factor that should not be overlooked In fact, the Society for Human Resources Management has suggested that employers keep surveys short enough to complete within 30 minutes or less.

Last but not least, when deciding on a layout for your employee satisfaction survey, it’s recommended that you cluster related questions. In other words, ask similar questions one after the other to keep things simple without confusing your employees. together.

Once you send out your surveys and receive them back, it’s time to collect responses. From there, you can use the responses to determine how to improve the workplace based on the feedback from your employees.

Look for trends, like how many employees strongly agree or disagree with certain topics. Keep an eye out for gaps in data as well, like instances where there’s a high number of neutral responses or outliers. Sometimes, these discrepancies hold the key to improved employee satisfaction.

Medicare Advantage Plans

Sat, 15 Feb 2025 21:38:44 GMT

Understanding How Medicare Advantage Plans Work

Advantage Plans are offered by private companies, such as UnitedHealthcare and Humana, approved by Medicare. They are all-in-one programs that may appear to provide advantages over original Medicare, such as reduced or nonexistent premiums. But it is a balancing act, as they may require higher copays and out-of-pocket costs and may have a more limited number of providers.

You must research carefully to match plans with your individual needs. The catch is that nobody knows the future; you will have to guess the amount of health care you will need. Will you become unhealthy? Have an accident? Might you suddenly require expensive treatments? Your long-term health affects your Medicare decision.

Limited choice of services

Many Medicare recipients find their more limited choice of physicians and medical facilities is the chief shortcoming of Advantage Plans, which require patients to use a doctor within a prescribed network. Some Advantage Plans charge higher fees for out-of-network care or refuse coverage outright. The most restricted Advantage Plans work like HMOs; Advantage PPO plans allow more flexibility but cost more.

Original Medicare, however, allows you to see any doctor who accepts Medicare, which would include over 90% of U.S. primary care physicians.

Network limitations might give pause to customers with specific needs, as the ideal specialists, or even a particular doctor to whom you may already be committed, might not be in network.

Furthermore, patients who live in rural areas may be frustrated by more limited networks. (They are most likely to switch to original Medicare.) In any case, if you are considering an Advantage Plan, start by checking with all your regular health providers as to their network status. And keep checking, as networks change their doctors from year to year.

Another key distinction is that Advantage Plan networks, particularly the HMOs, are usually connected to certain geographic areas. If you are outside that area, you may not be covered for nonurgent, nonemergency care. However, some Advantage Plans might offer extra benefits (at a price) for international travel. Again, check with your plan to avoid nasty surprises.

Authorizations and denials

Other main drawbacks of Advantage Plans are requirements for referrals from PCPs, as well as the potential denial of benefits for care deemed not medically necessary. About 80% of the plans insist on prior authorization for services, such as those involving more expensive equipment, certain drugs and in-patient hospitalizations. Preventive services also may not qualify. Other types of services requiring prior authorization might include X-rays, CT scans, MRIs and stress tests. (Some rural hospitals, out of overall concern for patients' health, actually absorb the costs of such services themselves.)

Denials and delays may prove disastrous if patients become unexpectedly ill midyear. After the open enrollment period is over, it is probably too late to change plans or add Medigap (extra insurance coverage). Furthermore, waiting through the prolonged process resulting from denials of service can worsen patients' health conditions.

You can appeal a denial of service, but do not assume that you will necessarily win, even with the full support of your loyal PCP. According to a Kaiser Family Foundation report, in 2021, over 35 million requests for preauthorization were filed with insurance companies. About 6% of them were denied, although a ray of hope is that most of those who appealed eventually won. Be aware that the insurers who make the decisions need to justify denials with a reason, such as inadequate documentation.

The Advertising Blitz

The incessant stream of ads for Advantage Plans kicks off as soon as enrollment season opens. Not only are the ads annoying, they also can be misleading. They fail to explain Advantage Plans clearly and sound as if they come from the government. They don't!

The ads emphasize perks such as free vision, hearing, dental and/or fitness coverage but neglect to discuss higher copays. For example, daily copays apply immediately upon hospital admission, compared to original Medicare which allows the first 60 days free.

Your adviser should be able to help you decide whether Advantage Plan limitations justify the cost savings.

Compliant Background Checks

Sat, 15 Feb 2025 21:38:08 GMT

This is a subtitle for your new post

According to the National Association of Background Screeners, 95% of U.S. employers use background checks when hiring employees. Background checks cannot look at medical history or genetic information, but they are legal for assessing a person's work history, education, criminal record, financial history or social media use.

However, employers must comply with certain legal requirements regarding background checks.

To remain in compliance with Federal Trade Commission regulations, employers must get written permission from the applicant or employee before running a background check.
Equal Employment Opportunity Commission regulations state that when using background checks, employers may not discriminate on the basis of race, color, national origin, sex, religion, age (if 40 or older), disability or genetic information.
Before deciding not to hire, keep or promote an applicant or employee because of something found during the background check, employers must provide the person with a copy of the report and a “Summary of Rights” detailing the applicant's or employee's rights under the Fair Credit Reporting Act.

Companies must also comply with state law and in some cases international law.

Some states limit the lookback period for criminal checks to seven years, while other states have longer lookback periods. Some states additionally have “ban the box” laws that make it illegal for employers to ask about criminal history on job applications.
Countries other than the U.S. have their own laws, so companies operating in foreign countries, or having remote workers who reside in foreign countries, need to be aware of those laws.
Recently companies have been moving away from routinely testing for marijuana use. Additionally, some states that have legalized marijuana for medical and recreational use have made it illegal to screen for marijuana except in regulated industries (such as transportation, nuclear energy and military contracting). Note that these laws vary by municipality.
What records must be stored and how they are stored, also known as record retention laws, vary across different jurisdictions. It's important to be aware of what's applicable to your company.

Reference checks must also comply with the regulations outlined above. Questions such as “In what capacity did you work with our job candidate?” and “What were our applicant's responsibilities?” are fine, as are questions about dates of employment and job title(s). Questions, whether direct or indirect, about a person’s race, national origin, gender or gender identity, sexual orientation, religion or religious affiliations, age or date of birth, marital status, disabilities and health, criminal background, height and weight or genetic information are not allowed.

Because many companies now have employees who work remotely, it's important to determine whether the location of those employees affects the regulations your company must comply with. The location of remote employees may also impact your selection of a background check provider.

Beyond background checks

Over 70% of employers screen applicants' social media. One study reported that 57% of employers interviewed said they'd found something on an applicant’s social media that made them decide to not hire that person. Employers also now often monitor their employees' online reputation or changes in the records for which they initially screened. These both involve ongoing checks. However, social media screening, whether before or after hire, has some risks, including violating the FCRA.

Companies that use noncompete clauses should be aware that the FTC recently issued a final rule banning most new noncompete clauses and making many old noncompete clauses unenforceable. (It remains to be seen what legal challenges the rule may face, particularly in light of the recent overturn of Chevron.) Companies that have nontransparent pay scales should also stay current with changing practices and regulations.

Before you run background checks, you should consult an employment professional so they can be sure you are complying with all relevant laws. Or better yet, give us a call and let us help you do this efficiently and legally.

How To Know When It's Time To Retire

Sat, 15 Feb 2025 21:36:55 GMT

Consider what needs to be in place before you retire

The decision to retire is not an easy one, and there are many important considerations to take into account, including financial security. Additionally, your emotional and mental health are key factors to be carefully looked at. For most people, this decision starts to take shape as we get closer to our 65th birthday.

The transition to retirement is not without stress, and feeling financially and emotionally ready are key. For many people, their job is a big part of their identity. Giving up that identity and redefining a future one for yourself may take an emotional toll as you navigate through this new period in your life.

Here are some key signs to help you know when it's the right time to retire:

You're financially set — This is probably the most important aspect for most people. You are not ready to retire unless you have adequate savings and a plan for early and late retirement. You will need to have enough money to last you through the rest of your life. Create a budget that includes your expected expenses during retirement. Take a look at the income you expect to receive from retirement savings and other investments. Factor in fixed-income sources such as pensions and Social Security to see whether your income can cover the expenses outlined in your budget. If not, you may need to work a little longer to reach your goal. Make every effort to pay down any debt so you do not carry it into retirement.

Your health care costs are covered — When you turn 65, you qualify to receive Medicare health insurance. However, you will still need to pay the monthly premiums for Medicare Part B. If you purchase Medicare Advantage (Part C) or a prescription drug plan (Part D), there will be additional costs involved.

You're emotionally ready to leave the workforce — If most of the people in your social circle are those you see at work every day, you need to recognize that you may not be able to maintain those close ties. This is an opportunity for you to think about your future and how you want to spend your time. Having social interactions is especially important as we age. LeAnn Erenberger, senior vice president and wealth management adviser at U.S. Bancorp Investments, tells us that “not knowing how you will spend your time can have negative health effects, both physical and emotional.” This is the time to start doing the things you have put off for too long. Start a new hobby, travel, learn a new language, take up an instrument or volunteer, while making new friends along the way.

You're feeling burnt out — Work should give you a sense of purpose not just a paycheck. If you have come to the point in your career where work feels physically or emotionally draining, then it's time to retire. Too much stress at work can have a direct impact on our health, including causing hypertension, heart attack and stroke. Staying at a job that is no longer fulfilling is a good reason to leave.

The time to plan for your retirement is now. Envision the life you want to live in retirement and work toward that goal while you are still working. The day will come, and you will be financially and emotionally prepared to move on. Contact a financial planner for more advice on retiring comfortably.

The Power of a Power of Attorney

Sat, 15 Feb 2025 21:36:24 GMT

Learning about the value of a Power of Attorney

A POA gives one person, termed the agent, the legal power to act for another, termed the principal, when making decisions about the principal's property, finances or medical care.

POAs are legal documents that may be drafted in one of two ways:

General or durable. Both general and durable POAs expire upon the principal's death, and both can limit the agent's decision-making powers. The critical difference between them is that general POAs expire if/when the principal becomes incapacitated, while durable POAs remain in effect until the principal's death. Many states do not consider POAs to be durable unless they specifically state that they are.
Immediate or springing. Immediate POAs become enforceable the moment they are signed. Springing POAs do not become enforceable until/unless the principal becomes incapacitated.

Health care POAs

Financial POAs

Digital assets

What if a POA is not accepted?

Uniform Power of Attorney Act

How to choose an Executor

Sat, 15 Feb 2025 03:20:22 GMT

Who would make a good Executor

for your Trust or Will?

An executor is responsible for ensuring your assets are distributed according to your wishes — a responsibility that introduces an element of legal and financial exposure. So choosing an executor is a serious decision. The person you select should have strong skills in at least some, if not all, of the following.

The potential executor should have organizational capabilities . These include the ability to act responsibly, to follow schedules and to understand financial matters. This does not mean that your executor has to be an expert in everything or fulfill all responsibilities personally. Executors can hire professionals — lawyers, accountants, real estate agents and even cleaning services — to help with different aspects of the estate. However, executors are expected to manage the process in a timely and ethical manner.

The potential executor should be in good health . Update your will if your chosen executor becomes unable to do the job or passes away.

Location is an important consideration. It is easier for an executor to administer the estate if they live close to your residence and physical possessions.

The potential executor should have a good credit rating . It is delicate to ask about this while you are making your choice, but it may help to explain that an executor bond may be required. The bond guarantees that the executor will administer the estate according to your will and the law, and it ensures that assets go to the beneficiaries. Someone with a less-than-solid credit rating could have difficulty and additional expense in obtaining the bond.

The potential executor should have solid communication skills . Executing your will can be difficult. Heirs and other interested parties may become anxious if they don't know what's happening. It can be very helpful if the executor can communicate well to keep everyone calm and satisfied.

Above all, the potential executor must be honest . Having fiduciary responsibility means acting ethically and following all applicable laws. Government agencies may have to be notified. Your residence may have to be emptied and sold. Your debts may have to be settled. Your taxes will have to be filed. Your assets will need to be distributed to heirs. All this exposes the executor to legal and financial risks. Failing to act can bring stiff penalties, including, in extreme cases, jail time.

Who's right for you?

It's a common practice to choose an adult child or a sibling to serve as executor. Some people select a parent or an aunt or uncle. Talk with several possible executors to ensure that they not only meet the criteria above but also understand what the role entails. It's not an easy job and could possibly involve many hours of work — though it's a job they may be honored to do for you.

It is a good idea to name alternate executors if your choice is unable or chooses not to serve. This will ensure that there's still someone to manage your affairs who is trusted and who you think can handle the responsibilities. Another option is to name multiple executors. This can be helpful for having all your children feel included and for spreading the burden of executorship.

Don't dismiss the idea of having a professional serve as your executor. Professionals already know the process and can ensure all applicable rules are followed. Of course, a professional might not be expected to care as much about your legacy or your heirs as a close friend or family member would. Additionally, they will expect to be paid for their work.

In many states, nonprofessionals also may be paid a fee. Approaches to fees vary. Sometimes it is a percentage — maybe 1% to 5% — of the size of the estate; sometimes it is an hourly rate or a flat fee paid from the estate's assets. Nonprofessional executors may also choose to waive payment either out of respect for you or for their future relationships with your heirs.

It is a good idea to prepare prospective executors for the role; share resources with them so that they can learn about the responsibilities. When an individual agrees to serve, modify your will to explicitly add their name. You may give the newly chosen executor a copy of your will or disclose its location for when it's needed. By making a considered decision about your executor and providing that person with the estate particulars, you will help ensure a smooth transition after your death.

Using Home Equity to Fund a New Business

Sat, 15 Feb 2025 03:13:41 GMT

Have you thought about how to fund a new business?

A HELOC is a debt secured by your home. It is similar to a mortgage.
Home equity loans involve borrowing against your equity stake in your house. Your equity stake is the portion you own outright; depending on the lender, you may be able to borrow up to 80% of this equity.

Exploring the differences

Additional features of a HELOC:

You can repay interest first.
You pay interest only on the money you withdraw.
Repayments can vary with fluctuating interest rates.

Both HELOCs and home equity loans have:

Relatively simple application processes.
Possible tax deduction of loan interest if you build a home addition for your business.

Other options

Among the pros of a cash-out refinance:

You may be able to change your mortgage length, term of repayments or even interest rate.
You avoid adding a second lien on your home.
You'll have one payment a month (rather than both a mortgage and a loan payment).

Among the negatives:

Like your first mortgage, the cash-out mortgage has a time-consuming application process.
You may end up with a larger monthly payment — especially if the current interest rate is higher.
You'll have to pay closing costs and other fees.

Making the decision

Blue Zone Seniors May Live Longer

Sat, 15 Feb 2025 03:03:11 GMT

Where are the Blue Zones?

Researchers have combed through data, from the U.S. and other countries, to learn more about the relationship between location and length of life. Results have been inconclusive, but environmental and lifestyle factors do emerge. Should you consider them when you are deciding on your ideal forever home?

What's up with blue zones?

The intriguing concept of blue zones was popularized by Dan Buettner, an explorer and a National Geographic Fellow who led a project to Okinawa, Japan, in 2004. Drawing on demographic work of earlier scientists who had recognized the high number of male centenarians in Sardinia, Italy, Buettner's teams identified other places associated with long lives and their common characteristics. They labeled their top five "blue" zones (because they used blue pens to mark them on their maps): Okinawa; Sardinia; Ikaria, Greece; Nicoya, Costa Rica; and Loma Linda, California.

The scientists observed that those residents surpassed world life expectancy by 10 years. Seeking clues that might connect such far-flung spots, they discovered themes of community support, a diet of locally produced foods and daily exercise. Movement might consist of gardening, walking or chores. A sense of purpose and de-stressing routines also appeared significant. A plant-based diet typically also involved eating earlier in the day.

Specifically, the Greeks consumed olive oil, red wine and copious vegetables; the Sardinians performed heavy farm work into old age; the Okinawans ate soy and practiced tai chi; the Costa Ricans fed on beans and tortillas; and the vegetarian Loma Lindans lived in a tight-knit Seventh Day Adventist community that proscribed smoking, alcohol and caffeine.

However, some of the research has been reevaluated due to insufficient scientific proof. Moreover, life expectancy in Okinawa has subsequently reversed.

U.S. versions of blue zones

Most American retirees are not ready to move as far as Italy or Japan. Researchers have now turned their focus to U.S cities and states. Note that findings vary constantly from year to year and reflect diverse databases — not only do they fluctuate, but they may also encourage false precision. So take the list below with a pinch of salt!

That said, certain states and regions do conform to the blue zone principles. Residents of Vermont support farmers’ markets and exhibit community spirit. Walk scores and pedestrian friendliness rank high in New York. Inhabitants of Connecticut, Massachusetts and Rhode Island consume ample fruits and vegetables. People are less active in New Hampshire but sleep a solid seven hours a night. Oregonians are likewise good sleepers. Yet Hawaii, a winning state for centenarians, reports less sleep and walking. In Maine and California, people tend to follow a plant-heavy but diversified diet.

The University of Wisconsin Population Health Institute provides the following statistics for life expectancy:

San Jose/Santa Clara, California (83.3).
Honolulu (82.4).
Fort Myers, Florida (82.4).
Oxnard, California (82.3).
Los Angeles (82.1).
Bridgeport/Stamford/Norwalk, Connecticut (82.1).
San Diego (81.8).
Denver (81.8).
Miami/Fort Lauderdale (81.6).

Relocating to bluer-type areas shows significant causal effects. MIT researcher Amy Finkelstein has analyzed Medicare records for 6.3 million beneficiaries from 1999 to 2014. Migrating to New York, San Francisco, Miami and Chicago proved positive, while moving to Alabama, Arkansas, Louisiana, Texas, Oklahoma, New Mexico and Arizona generated poorer health results. In short, health capital (bad habits like smoking and overeating) accounts for 70% of the difference and location for 15%.

Compiling a checklist

It is easier to find superior medical care near cities or teaching hospitals. Large centers and suburbs also offer access to home care providers. Climate plays a role, too: cold, dry conditions may exacerbate joint pain.

Researchers compare such factors as:

Ratio of seniors to the overall population.
Average life expectancy.
Average retirement income.
Percentage of seniors in the Medicare program.
Poverty levels.
Senior living centers per capita.
Doctors per capita.

Where you are born impacts life expectancy differently from where you end up. Many original natives of mountain regions, like those in Montana, Utah, Colorado and Wyoming, go on to live long lives. Perhaps fresh air and a rugged spirit promote longevity.

Of course, many factors can affect longevity, such as family history and lifestyle choices. There is no guarantee. (And it's beyond reckoning that Keith Richards is still performing at 80.) However, it may be a good idea to consider how where you settle will affect your life.

The Most Unusual Benefits

Fri, 14 Feb 2025 17:50:00 GMT

The Most Unusual Benefits

So, your company wants to differentiate itself from the pack. That’s smart, but how do you craft a benefits package that establishes your business as a destination place of employment?

It all comes down to showing that you are supportive of your employees. You can’t put a price tag on that, and it will appeal to those in search of somewhere to work.

Ultimately, a one-size-fits-all approach to benefits is no longer sustainable. It may have worked in years prior, but nowadays it’s important to recognize that you are hiring people from all types of backgrounds, from a wide array of cultures and from a range of age groups.

As a result, your benefits package should be as adaptable and diverse as your staff members.

What benefits are at the forefront of employees’ minds?

From pharmacy benefits to personal time for nonwork-related responsibilities, many employees are eager for accessible and affordable benefits that make them feel like you see them as people.

Before the pandemic, perks such as free lunches, fitness centers and Ping-Pong tables were appealing in their own way. However, today’s distributed workforce demands benefits that actually improve their lives on a grander scale. It’s become normal to expect more innovation when it comes to the benefits that are offered, and this change in the tides will influence how much people believe your company cares about its employees.

Your company can do something about the frustration that many workers experience as a result of sub-par benefits. In turn, you will draw more attention from candidates in search of a company that understands how to support its workforce.

Benefit ideas that your employees will actually appreciate

Here are a handful of ways you can effectively express your appreciation for your employees in the modern workplace:

Financial planning and advice

Financial planning goes beyond just offering a 401(k). It can also help employees manage debt, budget for everyday expenses and save for larger purchases. This type of program can have a significantly beneficial impact on your employees, especially because financial stress is known to affect people immensely.

Financial stressors not only negatively impact work performance but also hurt the physical health, mental well-being and interpersonal relationships of your employees. When you offer finance-related advice and educational opportunities on topics such as home buying and identity theft protection, you can empower your employees to make informed decisions.

Additionally, student debt is a growing concern for many. However, with a financial planning program, you can assist your employees by helping them manage their own debt or preventing them from falling into more debt while trying to get out of their current situation.

Professional development budgets

A professional development budget, such as an education stipend, is another way to show that you are committed to your employees’ growth. This type of stipend has the power to pay for an array of educational opportunities, such as online courses, in-house training, mentorship programs or attending industry events. You can also support employees who want to obtain English as a Second Language certification, earn their high school diploma or pursue an advanced degree.

Mental health perks

Mental health perks are a great way to support your workforce. Examples include offering extra vacation days, extending the weekend to three days and providing time off for birthdays and half-days throughout the summer.

Consider adding therapy sessions, mindfulness apps and meditation classes to the mix. You can also extend your employee assistance program to include counseling for anxiety, grief, trauma or substance abuse, among other difficulties that your employees may face.

Healthy meal deliveries and fitness app subscriptions

An amazing way to encourage your employees to maintain peak physical health is by equipping them with subscriptions for healthy meal delivery services, coupons for local fitness classes, or reimbursements for physical activity and wellness programs.

Providing personal training at gyms or supporting family-planning options, such as fertility treatments and adoption assistance, are other ways to show that you care about the holistic well-being of those who work for you.

Solid opportunities for families

As a way of supporting those employees who are also parents, why not offer a childcare allowance? Flexible work arrangements and on-site childcare options can also make a big difference for parents who work for your company.

Access to help for remote and hybrid employees

For remote and hybrid employees, lack of socialization is a common issue. Creating interactive spaces, such as Slack channels, virtual game nights or annual trips for team bonding purposes, can help bridge that gap. Telehealth and on-demand apps for stress management are also valuable resources.

Voluntary benefits

Voluntary benefits, such as pet insurance, long-term care insurance and discounts, can give your employees the flexibility they need to choose what matters most to them while opting out of benefits that may not apply to their lives.

Addressing gaps that have existed in previous benefits packages, such as fertility support, student debt assistance and paternity leave, can make your company’s benefits appear more well-rounded. Attention to these opportunities for improvement can also serve as a way of showcasing your support for your employees as people, not just workers.

From self-improvement and career mobilization to tuition reimbursement and certifications, there are many ways to demonstrate that you believe in advancing and developing the careers of your employees. Just remember: The more you can contribute to your employees’ sense of fulfillment, the better.

How to Address the 7-Year Itch

Fri, 14 Feb 2025 17:47:46 GMT

Things to consider about a Sabbatical

What would you do on the first Monday of your sabbatical?

Be clear about what you expect to achieve. You might want to include a secondary goal, such as starting to write a book or blog or learning a language. Not only will you make personal discoveries, but you will also establish a project to continue working on when you return to your regular life.

Adjusting balance is key to better physical and spiritual health. Your time off can provide you the chance to reduce stress and reassess your life, as well as for realizing aspirations. So how should you set an ideal date and time frame for your adventure?

First, forget traditional notions. Your sabbatical can last a week, a month or a year, as long as you structure it around a beginning, middle and end, plus deadlines. You could even occasionally go into your office to attend to a matter. You might leave a short window of time in case you truly need to delay your plans, but once you set the plan in motion, you must protect it.

If your business or company experiences extra active seasons, you may want to consider scheduling the sabbatical to coincide with a less busy interval. For instance, accountants recognize that client work tends to wind down after April 15. Or, as an entrepreneur running your own business, you will expect typical cycles. Alternatively, your dates might coincide with projects, such as the ideal travel season in locations you want to visit. Moreover, if your plan includes a partner or spouse, you may need to coordinate with them.

Making the case for your me-time

When the moment comes to negotiate with your CEO, manager or business partner, you need a strategy to convince them why and when you are leaving. You might ask for paid leave (although there are advantages to unpaid time too, including less pressure) or you may be looking for confirmation that your job will still be there for you on your return.

Build a case for why leaving may help you become a better employee, whether through increasing your productivity and engagement or addressing your possible burnout and diminishing returns. Although it may be difficult to create a tangible metric, the bottom line usually comes back to the retention of your talent. From the employer’s side, the most compelling argument is competition within an industry, such as technology or consulting, especially if others are awarding free-time benefits.

Some companies offering sabbaticals include:

PayPal (four weeks every five years).
Deloitte (three to six months at reduced pay).
BetterUp (one month after five years).
Citi (up to 12 weeks of leave, with a portion of base pay and benefits).
Intel (eight weeks after seven years; four weeks after four years).
McDonald’s (eight weeks every 10 years).
Morningstar (six weeks every four years).

Planning your exit strategy

Reentry mode must be managed, too. Maintain any professional licenses and keep in touch with your company. Particularly toward the end of your break, communicate your timeline, reach out to industry contacts, and update your resume and your digital presence. Come back onto the scene gradually. It’s not like turning on a light switch. You might benefit from taking a few final days to reflect on how your experience has changed your life.

Unless your employer is willing to subsidize your time off, you must make careful financial plans, both to cover any loss of income and to pay for extra expenses such as travel. Health care will be a priority; confirm whether you need to purchase your own insurance for the duration of your leave. If you are a parent, you might also require child care or, if you are leaving town, caretaker services for your home’s upkeep.

Add up all those charges and take them to your financial planner to run the numbers in order to calculate both short- and long-term impacts.

9 Types of Yoga Decoded: Which one is Right for You?

Fri, 14 Feb 2025 16:48:09 GMT

Yoga for Wellness

1. Hatha Yoga – One of the more well-known versions, hatha yoga is defined as any yoga that teaches physical postures. It’s a gentle way to learn the basics like poses, breathing and pacing.

2. Vinyasa Yoga – This type of yoga refers to a series of poses where your movements match your breaths. It’s an effective way to keep moving throughout a sequence of poses while boosting your heart rate.

3. Lyengar Yoga – This type is focused on achieving the right alignment during each pose for a more meticulous practice. It’s a convenient way to slow down and improve your posture on your day off.

4. Yin Yoga – Yin yoga helps you find your zen by improving the connection between your body and your mind. It’s a relaxing way to hold poses for several minutes while also focusing on meditation.

5. Hot Yoga – This type is practiced in a heated room, and the instructor is encouraged to shake up the sequence of poses. It’s perfect for days when you need a deeper stretch, as the heat loosens your muscles.

6. Ashtanga Yoga – Stemmed from ancient yoga techniques, Ashtanga yoga offers a more rigorous approach to the practice. It’s a helpful way to link your movements and your breath as you perform the same sequence of postures every time.

7. Bikram Yoga – This type is designed to make you sweat with a specific series of 26 poses that take place in an artificially heated room. It’s a useful way to master a sequence and stick to it for all of your practices.

8. Kundalini Yoga – Based on discovering self-awareness through a more spiritual practice, Kundalini yoga is recommended to challenge yourself physically and mentally while tapping into your inner energy with a combination of exercising and breathing.

9. Restorative Yoga – This type is oriented around helping and healing the body throughout your practice. It’s a great way to give your body a break and enjoy some well-deserved relaxation.

Now that you're familiar with 9 popular types of yoga, it's time to figure out which one is right for you. Whether you crave a session with vigorous sweating or peaceful stretching, try your hand at one or more variations of yoga to challenge your body and your mind.

Employer-Sponsored Educational Assistance - Tuition Reimbursement

Fri, 14 Feb 2025 16:42:24 GMT

Tuitition Assistance and Tuitition Reimbursement as an Employee Benefit

Section 127 of the Internal Revenue Code allows employers to provide eligible employees with educational assistance of up to $5,250 tax-free annually. The amounts paid under Section 127 may be deducted as a business expense.

An educational assistance program is any form of instruction or training that improves or develops the employee's capabilities or skills; the definition does not limit the employee to job-related courses or degree programs. Employers can furnish assistance independently, in conjunction with other firms or through a third party such as an educational institution.

Professional development courses are also covered, but only if they generally relate to improving or maintaining skills for the employee's current job.

What's covered

Covered expenses can include tuition, fees, books, supplies and equipment. Until Dec. 31, 2025, you also may help cover any qualified education loans incurred by your eligible employees by making principal and/or interest payments directly to the lender, a third-party servicer or the employee. Employees must be prepared to substantiate all expenses.

To qualify as a Section 127 educational assistance program, you need a written plan. The IRS provides a sample plan that you can tailor to include:

Conditions for eligibility
Definitions for when participation begins
Prorated benefits for part-time employees

The program cannot discriminate in favor of officers, shareholders, highly compensated employees or self-employed individuals. The educational benefits must be incurred by the employee; the plan's benefits cannot be used for the education of a family member (such as a spouse or dependent).

Educational assistance doesn't include:

Meals, lodging or transportation
Payments for a computer or laptop or other equipment that employees keep after the course
Courses involving sports, games or hobbies unless they have a reasonable relationship to the business or are required as part of a degree program; for example, athletic supplies would qualify if they were bought for a course in health or physical education

The terms of your plan may further limit the types of assistance provided.

The financial terms

Employer-provided tax-free educational programs have some financial restrictions for employees:

Any assistance provided above the cap of $5,250 is taxable as wages.
Expenses must be incurred in the same calendar year as the reimbursement.
Any unused portion of the $5,250 annual limit cannot be carried forward to subsequent years.
The reimbursed educational expenses cannot be used to claim the Lifetime Learning Credit on the individual's tax return.

For more information, see IRS Publication 15-B , Employer's Tax Guide to Fringe Benefits. Also, Chapter 10 in Publication 970 , Tax Benefits for Education, provides details on what qualifies as a student loan. The IRS has also published a helpful FAQ about educational assistance programs.

We can help you to learn more about your options for offering tuition reimbursement to your employees as a benefit. Contact us at Benefits by Design Insurance Services at 760-696-3573 or 415-524-8959 or at admin@benefitsbydesignca.com .

Getting Ready For Medicare Meetings in 2025

Fri, 14 Feb 2025 00:57:07 GMT

The next meeting will be on Friday, March 7th at 10 a.m.

When: Every 1 ^st Friday of the month, except during a week with a holiday

Time: 10:00 a.m.

Where: On Zoom

Agenda

Getting Ready for Medicare -

· When and how to sign up for Medicare

4 Parts of Medicare - A,B,C,D
· How Medicare Part D Prescription Drug Plans work
· Medicare Supplement/Medi-gap plans vs. Medicare Advantage
· How to select your Medicare Insurance Plans
· Veterans & Medicare
· What to do, when to do it, and where to go for help

This will be an educational meeting.

To RSVP: send an email to admin@benefitsbydesignca.com and we’ll send you the Zoom link.

For more information, you can email admin@benefitsbydesignca.com. Or call 415-524-8959 or 760-696-3573.

Speaker: Pam Morton

Pam has more than 20 years of corporate health insurance background, working with Medicare products. Her roles included Staff VP Leadership for group Medicare Advantage, product development, compliance, sales and marketing. Pam has been the agency owner of Benefits by Design Insurance Services since 2017

Section 125 Plans

Fri, 14 Feb 2025 00:38:55 GMT

How Do Section 125 Plans and HSA's Work Together?

A cafeteria plan is a reimbursement plan governed by IRS Section 125, allowing employees to contribute a certain amount of their gross income to a designated account or accounts before taxes are calculated. Another kind of plan is the health savings account, which lets employers and employees make tax-free contributions to pay for certain out-of-pocket medical expenses.

Can these two plans work together to maximize their benefits to a company and its workers? Yes, if it's done right. If you decide to offer a Section 125 plan and an HSA to employees, you'll need to include the plans as part of your annual enrollment period so that eligible employees can sign up, maximize usage of your benefits and save money on taxes.

You can withhold employee pretax earnings and have employees contribute them to their HSA. This is a cafeteria plan — the funds are the employee's and are a part of his or her paycheck. You enable the contribution through your payroll system.

There are numerous benefits to cafeteria plans. Among the advantages of saving in an HSA is that cafeteria plans reduce the amount of taxes paid by employees. Employees file Form 8889 to be credited for income tax they paid. HSA contributions are taken automatically from paychecks, so by offering a cafeteria plan, you give employees pretax payroll deferrals to their HSAs. It's inexpensive and can be an option for employees. You benefit by not having to pay payroll taxes on your employees' HSA contributions.

Employees can make HSA contributions through payroll deferral on a pretax basis.
Employees may pay their share of insurance premiums on a pretax basis.
You and your workers save payroll taxes.

Contributions to HSAs under Section 125 plans are subject to nondiscrimination rules — the plan cannot favor highly compensated or key employees. Violations generally do not result in plan disqualification, but the value of the benefit may become taxable for highly compensated or key employees.

If your goal is to save payroll taxes, then offering cafeteria plans governed by Section 125 for HSA contributions is the way to go. With a small additional investment of money and time, you can add a Section 125 plan allowing for pretax deferrals. Besides, you save on your share of payroll taxes for the pretax amounts taken, which will likely offset the costs of setting up the plan.

It is always a good idea to have counsel review the documentation.

Employees keep a larger slice of their earnings, while you benefit by not having to pay payroll taxes on the employees' HSA contributions. HSA contributions aren't counted as income for federal and, in most cases, state income taxes. Setting up automatic payments generally simplifies and improves employee savings.

If you have additional questions about a Section 125 plan, please contact us at 415-524-8959 or 760-696-3573 or at admin@benefitsbydesignca.com

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How To Avoid High Medical Bills

1. Most insurance coverage doesn’t start immediately

2. Check coverage before checking in

3. “Covered” doesn’t always mean insurance will pay right away

4. Get estimates for non-emergency procedures

5. Location matters

6. When hospitalized, contact the billing office early

7. Ask for a discount

Open Enrollment for Individual Family Plans and Covered California

Here Is What You Need to Know

What Californians Need To Know If The Enhanced Subsidies Are Not Approved for 2026

How Might This Effect Me If I Get My Health Insurance Through Covered California?

What's New for 2026 with Medicare Part D Prescription Drug Plans

Know The Changes

Do you need to have Critical Illness Insurance?

A Real Life Example

Do I Need Travel Insurance for Medical Care Abroad?

When Travel Insurance is Recommended

What's Changing in 2026 with HRA's and HSA's?

What Employers Need To Know

Should You Buy Dental Insurance? Is It A Value to You?

What to consider when purchasing dental insurance

3 Ways You May Be Able To Reduce The Cost Of Your Health Insurance

Want to Save Money on your Health Insurance? Ask Pam.

Did You Know? Working with a broker doesn't cost extra?

Are You A Small Company That Does Not Have An HR team? We can help!

6 Health & Wellness Subscription Boxes You'll Love!

New And Fun Subscription Boxes

Bring Your Pet To Work?

Pet Peeves, Permissions and Policies

Pet Peeves, Permissions and Policies

Employee Benefits

Employee Benefits You Need To Consider

Helping Employees Find Supplemental coverage

Why Supplemental Coverage Matters

Finding the best Medicare coverage with the most value

The government has divided the criteria into several areas. If you go over them carefully,

﻿ you can find the best one for you.

Health Savings Accounts: How Do They Work?

What are the tax advantages to having or offering a Health Savings account?

Life Insurance: What Are Your Choices?

Which Type of Life Insurance Has The Most Value For You?

Think Your Business Doesn't Need an Employee Handbook? Think Again!

An Employee Handbook is now regarded as a protection tool for the business or the organization

Thinking Inside The Box

Bring Back The Old Fashioned Suggestion Box

In A New Format

Creating Good Vacation Policies

How much vacation time do your employees get?

Dental Coverage: Giving your Employees a Reason to Smile

Dental Insurance is one of the top five must-have Employee Benefits

What's New with 401(k) and Similar Plans?

SECURE 2.0 Act Impacts

Parental Leave Policies: Rules and Options

Developing a Policy

Workplace Wellness Programs Are Thriving

Best Practices on Wellness Programs

HSAs - What are they and Triple Tax Benefits

Eligibility, Contributions and Flexibility

Using Home Equity to Build a Business

Have You Always Dreamed of Owning Your Own Business?

Make Employees Mental health a Priority

Mental Health for Your Employees

The Power of a Power of Attorney Document

Different Types of Power of Attorney Documents and Why You Need Them

Medicare - Watch for your Annual Notice of Change Mailing each September

It may look like junk mail, but it is very important to carefully read your Annual Notice of Change from your Medicare Advantage or Medicare Part D Prescription Drug company

What is an ICHRA vs. QSEHRA what are the differences between them?

Key Differences

COBRA - Make sure you are in Compliance

Make Sure You Are In Compliance

What is an HSA plan and who is a good fit for one?

Is a Health Savings account with a high deductible plan the right fit for you?

Health Insurance Options for Very Small companies

What are the options and what is required

Getting Ready for Medicare - Choosing the right plan

What will work best for you?

Benefits by Design - Case Study #1 Private School with 55 Employees

Goal: Shift resources from high-cost benefits to expanded options at a lower cost

you can find the best one for you.

for your Trust or Will?