Phrases Made Easy: “Full Time Equivalent Employees”

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Welcome back to another edition of “Phrases Made Easy.” This series at our blog aims to help make all of those long, drawn-out insurance phrases easier to understand. One thing we notice when talking about health insurance (and health benefits in general) is that the concepts can be “wordy” and boring. We emphasize fixing that here! Our biggest goal is to help you tune in, understand, and put this knowledge to work for yourself or your company. We’re firm believers that informed consumers can make a really-really big difference in our industry.

Here we go: today’s phrase is “Full Time Equivalent Employees.” *Note: this is a SUPER important concept for employers with regard to healthcare reform. That’s the overwhelming reason we picked this phrase today. You’ll want to understand this one in 2013 (ie: BEFORE 2014 gets here). So highlight it, share it, pass it along, circle it in red, underline it, etc. Do what you need to do to make sure that you “get it”… and help others get it too.

Phew… after that, you’re wondering: “WHY is this one so important?” That’s the best question we’ve heard all day. Here’s why:

  • “Full Time Equivalent Employees” is extremely important because it is the sole factor in healthcare reform that determines which employers are mandated to provide health insurance coverage, and which employers are not mandated to provide health insurance coverage. 

As a business owner, this is one that can cost you money if you don’t get it right (ie: tax penalties that can be fairly sizable). We won’t get into details here, but we’re talking thousands of dollars (and in larger cases, even hundreds of thousands of dollars). You want to make sure that you get this one right so that you’re: A) avoiding tax penalties, and B) planning correctly and efficiently. That’s why there’s more of a sense of urgency in this post.

Question: What are “Full Time Equivalent Employees?”

Answer: Full Time Equivalent Employees (FTE) are employees that do not work full-time (defined as 30 or more hours per week) in your business or organization, but do count towards the full-time equivalent employee count. In other words, YES… part-time employees do count towards your overall employee grand total.

Question: Why is this so important when it comes to healthcare reform?

Answer: As mentioned above, the “Full Time Equivalent Employee” count is what matters when deciding which employers are mandated to provide health insurance coverage to their employees. Furthermore, employers with 50 or more “full time equivalent employees” must provide adequate health insurance coverage to their employees.

Question: OK got it. So how do I calculate how my part-time employees count towards this “full time equivalent employee” total? 

Answer: The following is an example of how this is calculated. For sake of simplicity, this example uses part-time employees that work year round (seasonal employees working 120 days per year or less do not count towards the employee count). Here you go:

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ABC Corp has 42 full-time employees (each working +30 hours per week)

ABC Corp also has 18 part-time employees (these 18 employees work 15 hours per week)

To calculate part-time workers’ full-time equivalent status, you add up all of the part time employees’ monthly hours, and divide by 120. So in this example:

  • 18 part-time employees x 15 hours per week = 270 total part-time hours per week in the company.
  • Then, 270 part-time hours x 4 weeks in the month = 1080 part-time hours per month in the company.
  • So, 1080/120 = 9

In this example, this company has 9 additional “full-time equivalent employees” through their part timers. Add 9 to your full-time employees (42+9), and you have 51 FTE employees. So although they only have 42 full time employees, they have 51 “full-time equivalent employees” based on their part-timers’ hours, and would be required to provide coverage.

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The moral of the story: part-time employees DO count towards your employee grand total, when you apply the phrase “Full Time Equivalent Employees.” If you have further questions about this concept please contact us any time. It’s extremely important for businesses that are at (or near) 50 “Full Time Equivalent Employees” status to understand it. Please share this blog post with companies you think would find this information important.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

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Phrases Made Easy: “Indemnity Insurance Policy”

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Welcome back to another addition of “Phrases Made Easy” at our blog. Our goal with this blog series is to take all of those confusing and complicated insurance words, and make them easier for you to understand. At Policy Advantage Insurance Services, we feel that informed consumers can make a really big difference in our industry.

Today’s phrase is “Indemnity Insurance Policy.” The words “Insurance Policy” are easy to understand, but it’s the word “Indemnity” that has a tendency to hang people up. You’ll see it in many different insurance products; that’s one of the reasons we’ve selected this phrase. And we’ve got good news for you: this phrase is really simple.

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So here we go. Here’s “Indemnity Insurance Policy” made easy:

An Indemnity Insurance Policy is an insurance policy that pays cash either directly to you (the policyholder), or to the provider (ie: someone like a doctor, dentist, or hospital). That’s all it is. It’s a cash payment from an insurance company.

There are various types of  insurance products that function as “Indemnity Insurance Policies.” We won’t list them all, but here are a few of the more common ones:

  • Dental Insurance: some dental plans will have a value assigned to each procedure. For example, a crown may pay $250. This would be the amount paid to either you, or the dentist.
  • Supplemental Health Insurance: many supplemental health insurance plans are written as “Indemnity Insurance Policies.” For example, a supplemental cancer plan may pay the policyholder $300 per day that they’re confined to a hospital in a cancer situation.
  • “Mini-Med” or Hospital Indemnity Insurance: these are insurance plans that are not comprehensive major medical plans (ie: an HMO or PPO). They are plans designed to reimburse the policyholder (or hospital) in the event of a hospitalization. For example, a “Hospital Indemnity Policy” may pay the policyholder $1000 per day that they are confined to a hospital. This money can help offset some of the expenses associated with a hospital stay.

Here are a few additional important notes about “Indemnity Insurance Policies”:

  • In most cases, the cash benefit needs to be assigned to either the policyholder or the service provider (ie: the dentist, doctor, hospital, etc).
  • The cash benefit may pay for all, or only a portion of the bills. For example, some dental indemnity plans may pay the entire bill from the dentist. However, in many cases, a hospital indemnity plan will not cover the entire cost of a hospital stay.
  • When it comes to indemnity insurance policies, there are typically no networks. This can be especially nice in dental situations, because the policyholder can select any dentist of their choice.

Thanks again for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

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Insurance Alphabet: Letter E

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E is for:

“Exchange”

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Exchange: When used as a noun, an exchange is a place where goods or services are bought or sold. In this blog post, we’re specifically referring to exchanges that sell major-medical health insurance policies. These are otherwise known as health insurance exchanges.

The reason that we’ve selected this topic is because you’re going to hear a lot about “exchanges” over the next few years (and into the future in general), when it comes to health insurance. There are two types of health insurance exchanges:

  1. Public Health Insurance Exchanges
  2. Private Health Insurance Exchanges

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A Public Health Insurance Exchange is an exchange that is set up, funded, and administered by the government. There are a combination of ways that this takes place:

  • A) State-only administered exchanges.
  • B) Joint state/federally administered exchanges.
  • and C) Exchanges administered by the federal government only.

Public Health Insurance Exchanges were a large part of healthcare reform (ACA/Obamacare). These are the new exchanges that are mandated by the law. The purpose of these exchanges is to help expand affordable coverage to the uninsured. The state exchange in California is called “Covered California.”

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A Private Health Insurance Exchange is an exchange that is set up, funded, and administered by private parties. In other words, the government is not involved (examples of private parties: employers and their employees).

There are a number of different strategies when setting up a Private Health Insurance Exchange. Most of these strategies revolve around the “defined contribution” health planning concept that we’ve discussed in past blog posts. This concept (defined contribution) is gaining importance as we move forward in health benefits planning. Third party administrators (or TPAs) facilitate the administration of Private Health Insurance Exchanges.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com