The landscaping industry is highly underserved. There is a ton of opportunity for employee benefits advisors to bring real value and help employees of these companies get access to quality healthcare.

There are over 1.2 million employees in the landscaping industry. That’s a massive opportunity. There are over 604,000 landscaping companies in the United States, many of them highly concentrated in the states of Florida, California, and New York, and with many opportunities remaining in other states, it’s well worth your consideration.

The average salary is $35,400 for a landscape employee, and the average employee is in their mid-40s. Why is this important? Because when you’re in your mid-40s you need to stay on top of your health. We’re not young and invincible any longer.

If the employers of these landscape businesses knew there was a way to provide affordable healthcare to their employees, they would jump on it.

It’s your job as an employee benefits advisor to bring solutions, and it’s my job at Evolved Benefits to show you how to get in front of these companies and have meaningful conversations.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

We are continuing our series on industries we work well in, and this week we’re highlighting the Home Healthcare Workforce.

The home healthcare workforce is also referred to as assisted living workers, and these companies have a lot of part-time, variable-hour employees. I believe this industry presents an excellent opportunity for you as an employee benefits advisor.

First, the population of older people over the age of 65 will nearly double from 47 million to 88 million very quickly. And if you double the number of the folks that need assisted living, you need to more than double the number of people that work to care for these people.

It’s predicted that the home healthcare workforce will be up to 2.2 million employees by next year. That is a massive opportunity for benefit advisors.

Many of these employees do not have access to employer-provided benefits. They make minimum wage, they work part-time, and their salaries don’t justify paying for a major medical plan. And often, the employer can’t justify even paying half of a bronze-level major medical plan.

Take a minute to think about what these folks do for a living. They take care of older people. And they need to be healthier than the people they’re serving. We need to provide them affordable access to quality care.

Another issue these companies have is compliance. Many of them have no idea that because they have over 50 employees, they are considered an applicable large employer and are subject to ACA reporting. This is a conversation you can have with any employer, but especially those in the home healthcare industry.

Evolved Benefits has solutions for you to bring these employers. We can help you serve more people than you are today and grow your business.

If you want to learn more, message me on LinkedIn, give me a call, or email me!

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

New week, new industry to shine a spotlight on: the assisted living industry.

This is another area in which our products fit very well.

Major medical health plan premiums can be anywhere from $400 to $500 a month, and in the assisted living industry, the employees just don’t make the income that justifies the premium for a fully insured plan.

Not only do these workers have low incomes, but because of the nature of the business, there is also a very high turnover rate.

As an employee benefits advisor, this presents a challenge.

It’s one thing to offer a health plan to a company. It’s a whole other thing to administer that health plan on the back end when there is high turnover.

That’s something Evolved Benefits does very well.

The assisted living industry has about 420,000 employees. And within that, there are almost 300,000 employed full time. That is a big opportunity.

We can help you develop the industry understanding to speak to the owners of these assisted living companies so they have confidence that you can help them provide their employees an affordable health plan.

If you’re an employee benefits advisor looking to break into the assisted living industry, or if you’re already working in this industry, call us. We serve this industry very well, and we can teach you how to provide even more value to your clients.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

There are a lot of great opportunities out there for benefit advisors to break into, and the franchise industry is one of them.

The most recent statistic shows there are 8.25 million employees in this space.

This is a massive opportunity for you!

We recently worked with a business owner who had purchased multiple pizza parlors and 7-Elevens across Washington and Oregon. As the common owner of all of these, he was now subject to the applicable large employer status because he had way more than 50 full-time equivalent employees.

And the broker was having difficulty finding a health plan for the new group because every carrier was declining to quote since there was no participation to look at from a previous health plan.

The broker connected with me.

The first order of business was getting the franchise owner on the phone with our ACA compliance partners and getting him compliant. They were able to look back to when he had first purchased the establishments, and now they are on an excellent compliance program going forward.

And we were able to offer the employees some very affordable health plans.

I speak with benefit advisors every day, and one of the common things I hear is, “I don’t know where to find business.”

The franchise industry has millions of employees who don’t have a health plan because benefit advisors in their area don’t know about our solution.

Give me a call and let me show you this deep blue ocean of opportunity that we’re swimming in.

Book a consultation: https://www.evolvedbenefits.com/contact

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

This week I want to continue my Industry Series and highlight the Construction Industry, which we do very well in by offering solutions for the employees and helping the Employee Benefits advisors that work with these types of companies.

According to Zippia.com, these are current statistics from the industry. There are well over 800,000 employees legitimately employed at construction companies, and the average salary in most states is just under $30,000. A couple of States pay higher, for example, New York, which has an average salary of around $46,000, but for the most part, the average wage in America is about $30,000 a year.

Let’s consider this scenario we are currently in, where most employees cannot afford a regular, fully-insured health plan. The premiums tend to be too high for their income to justify the cost. Typically, they probably can only afford a Bronze plan at that average salary, so it doesn’t make sense to have the more expensive health plans.

Many of these construction companies fall into being applicable large employers and then get penalized because they have well over 50 employees. Still, they can’t get a proper health plan in place or prove that they have offered minimum essential coverage at that status.

So there’s another scenario that construction companies find themselves in, and that’s a prevailing wage scenario. Luckily at Evolved Benefits, we can partner with you on these affordable health plans and ensure that you are ACA compliant. Specifically, we can partner with you in a prevailing wage scenario in the construction space and offer you and your clients prevailing wage consulting. We have an in-house company called Prevailing Wage Partners, and this incredible team of women is the best in the business. They have unique proprietary software that is an excellent value to the employers that end up using our services, and they provide a great value. Many brokers locally in San Diego partner with them because they work with construction companies and understand the prevailing wage. They work with prevailing wage partners to ensure that part’s done right.

So all around in the construction industry, I believe we provide a great solution. We are a solid partner; if these are the type of industries you’re going after, or if you are one of those employee benefit advisors that’s very frustrated that every group you try to reach out to has a single-digit renewal, they’re not going to move. Your value proposition isn’t enough to move the needle. Then I would consider reaching out to me and jumping on a call to learn how you can best serve this industry and others.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

Welcome to week 2 of our industries series. This week, we are discussing staffing agencies. At Evolved Benefits, we provide tremendous help and resources to the companies themselves and the employee benefits advisors that serve them.

At Evolved Benefits, we are the inside sales arm for SBMA, which stands for Staffing Benefits and Administration. SBMA is built on staffing companies first and foremost; we found that it is one industry that’s been heavily underserved. This is because most Employee Benefits advisors focus on major medical. They look for groups that can get a lot of participation and have more employees enrolling in the major medical wellness staffing companies. Usually, there’s a core group of the office staff that they can put on a major medical plan, but everybody else hasn’t figured out how to solve and Evolve Benefits with SBMA have done a great job at providing a solution there.

So now, let’s talk about some current statistics in the staffing industry. Right now, there are around 3 million employees per week that are employed by staffing industries across the boards in different industries. There are also 16 million employees staffed throughout the year on an annual basis in America as temporary employees. So what happens with a lot of these companies is they don’t understand that they’re prey to the employer mandate, which is Penalty A and Penalty B. They’re subject to ACA filing reporting, and many of them don’t realize that they’re out of compliance. Secondly, many of them are looking for a way to be more competitive, especially if they’re in a concentrated area with more staffing companies. They need some edge to make them more competitive for their clients.

So, for instance, I drove up to Bakersfield a couple of months ago accompanied by an employee benefits advisor. We sat down with a staffing company, and they had probably one of the greatest problems a staffing company could have. They grew very quickly, and they were about to make a second location a little further up north. Sitting down with them and making a little discovery, we found out that they were out of compliance. Then we talked about the type of health benefits that we can provide, our minimum essential coverage plan coupled with some limited medical plans, and some other worksite benefits that marry up very well and make it affordable for these folks to access quality health care. So the first order of business was getting on the phone with our HCA accounting partner to solve the compliance issue. And then we turned around and enrolled every single one of these folks on one of our plans that they chose the base plan. The feedback I got from the staffing company owners during that first meeting was something that I always say just because I understand how this works, but it means so much more when you see a company say this because the light bulb goes off in their head.

They say, “Hey, you know what? We don’t want to offer your minimum central coverage plan. We want to provide your dental, vision, and limited medical plan. We want to go to our clients and say, hey, you know if you send your employees through us, we’re going to pay for a health plan, right out of the gate. These folks will have some health coverage. And in the state of California, for instance, the individual mandate is being enforced. So they helped these employees beat the penalty that they would be having for not having health insurance, but they also provided them a better dollar spend for those dollars instead of paying the penalty to the Franchise Tax Board.

So for all you Employee Benefits advisors out there, Evolved Benefits does very well with staffing companies. And if you haven’t looked into this industry, give me a call. Let’s set up a meeting to discuss certain talk tracks. I’ve got plenty of case studies from SAP and companies I’ve been involved in. And of course, I look forward to talking to all of you very soon.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

This week we are kicking off a series highlighting different industries we work well with, not just for the owners of these particular companies but also because we provide many solutions.

So let’s highlight the valuable grocery store chain industry.

Here are some brief statistics to better comprehend the industry and where advisors can help. First of all, there are almost 3 million people employed in the grocery store industry, and the average employee is about 37 years old.

Second, the average salary is just under $26,000 per year now. It’s easy to believe that somebody’s probably living paycheck to paycheck or they must have multiple jobs. They certainly can’t afford a major medical plan considering that the average premium is anywhere from $450 to $500, depending on your state.

This is where many grocery store chain owners fall into a bit of a predicament as they expand and become what is called an applicable large employer because they have more than 50 employees. When those are run through an FTE Calculator, they’re out of compliance because they are not offering at least minimum essential coverage to these employees.

So right here in California, we recently helped a client who has two grocery store chains in a massive market with lots of employees. He found himself out of compliance, but he also wanted to make sure he was taking care of his employees because he cared about them and said he treated everyone in his stores as a key employee. So he wanted everybody to have something, but no one had brought this particular opportunity to the table. Interestingly enough, I was brought into that opportunity; through a partnership, there was a payroll rep, and then there was also an employee benefits advisor. And together, they realized that they could not help this store out with the major medical plan. So they called me, and he bought benefits. We went to the store and had this conversation. The store paid for one of our low-cost base plans, which cost less than the penalty for not having insurance. Then it allowed the employees to buy up to a better plan and even achieve some hospital indemnity and dental and vision, and so fast forward, we put that plan in place.

This occurred about 18 months ago, and everything’s going well. We developed a good rapport with the store owner, and we text back and forth once in a while to see how each other’s doing. He says that his employees are pleased with the health coverage. It’s straightforward for them to find their doctors and urgent care; they’re getting the prescriptions they need to accept.

So all your employee benefits advisors out there, I know you don’t usually target or even look at grocery store chains because you don’t see how they fit your pay profile. I will go after this type of company because we will write a substantial major medical plan. Millions of employees don’t make the kind of salary that justifies a major medical plan. That means millions of employees work for store owners that need you and employee benefits advisor to come and bring them solutions.

Please reach out to me via email, message me on LinkedIn, and let’s schedule a call.

I’ll talk to you about the talk tracks and how we usually communicate with these grocery store owners, and maybe we can help you expand your book of business chances if you haven’t worked with these types of companies, and we do an excellent job there.

So until then, I look forward to talking with you very soon.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

Over 10 years after the ACA was first signed into law, the reporting requirements under the ACA’s Employer Mandate have proven challenging and time-consuming for most. But quick-service restaurants have it harder than others.

Minimizing costs and increasing employee retention in the restaurant space is difficult already. Add the administrative burden of the ACA to a restaurant owner’s to-do list and you’re looking at another full-time job.

With so many intricacies and nuances surrounding the ACA, there is a lot of room for error.

Below are five common mistakes restaurant owners make in their efforts to comply with the ACA’s Employer Mandate, as well as guidance on how to avoid them, regardless of your industry.

Mistake 1: Believe full-time employees work 40 hours a week

It is commonly believed that full-time employees work 40 hours a week, but that’s not the case under the ACA. To be full-time under the rules of the ACA, employees only need to work 30 hours a week or 130 hours a month.

We’ve seen restaurants make this mistake time and time again. And when they inaccurately set this hourly requirement for being full-time, many employees get incorrectly grouped into the wrong designation.

Mistake 2: Extend health coverage offers late

Time is of the essence when extending an offer of health coverage and there is a window for when a full-time employee must receive an offer of health coverage.

Depending on the measurement method used to determine full-time status, an employee hired with the understanding that he or she will be working full-time designated hours by an employer may be required to receive an offer of coverage by the first day of the fourth calendar month from their date of hire. For instance, someone hired on March 6, may need to receive an offer of healthcare benefits by June 1.

While it’s true Limited Non-Assessment Periods provide employees with more time for not offering coverage, restaurant owners frequently apply them incorrectly and subsequently miss the window for offering coverage.

Mistake 3: Offer Unaffordable Plans

Offering health insurance to 95% of your full-time workforce is one piece of the puzzle. Ensuring the plan is affordable and meets Minimum Value is the other. And too often we see restaurant owners create their own methods for demonstrating affordable coverage.

Instead, they should leverage IRS safe harbors. These IRS-sanctioned methods prove affordability and there are several types, including the Federal Poverty Level Safe Harbor, The Rate of Pay Safe Harbor, and the W-2 Safe Harbor.

Mistake 4: Keep disorganized payroll records

If you haven’t already done so, now would be a good time to perform some general cleanup on your record keeping. Messy payroll data can result in inaccurate employee classification. Disorganized time and attendance records can result in employers failing to identify full-time employees correctly.

With inaccurate employee classifications, employers are putting themselves at greater risk by potentially failing to extend offers of coverage to eligible employees. Organized payroll and time and attendance records are critical for business success for more reasons than one. Don’t sleep on this one.

Mistake 5: Forget to make offers at the start of every plan year

Oftentimes employers think that once they extend an offer of healthcare, it’s good forever. The reality, however, is that the offer is only good for the duration of the plan year. It is important to re-offer healthcare benefits at the beginning of every plan year.

With the right information, the requirements of the ACA can be one less thing to worry about. If you’re looking to mitigate risk, don’t overlook these five common mistakes.

In fact, now is a perfect time to make some changes in how you undertake ACA compliance activities. With the 2021 ACA filing period officially behind us now, consider getting your ACA Vitals to learn about any potential hang-ups in your ACA compliance process.

This week, we discuss the third and final safe harbor calculation called FPL Safe Harbor or Federal Poverty Level Safe Harbor.

The Federal Poverty Line (FPL) Safe Harbor is a method for proving ACA affordability based on an employee’s annual household income, which is a function of that employee’s household size and is adjusted yearly.

The Department of Health and Human Services (HHS) publishes the annual FPL. In the following example (for the 2022 tax year), the 2021 mainland FPL for a household size of 1 is used to prove that an employer offers affordable coverage.

Here’s the 2022 FPL Safe Harbor formula: $12,880 x 9.61% / 12 = $103.15.

Step 1. Take the 2021 FPL for a household size of one, $12,880, and multiply it by 9.61%.

Step 2. Next, divide the product by 12(the number of months in a year).

If the employee contribution for self-only coverage meets or is below $103.15, then the FPL Safe Harbor is completed, and the coverage offered is affordable for the 2022 tax year.

ALEs should note that the FPL Safe Harbor is arguably the simplest to administer because contribution rates can be standardized across entire employee groups.

However, using the FPL Safe Harbor for providing ACA affordability may cost ALEs more due to the monthly premium contribution amount for employees being lower than calculating individual contributions on a per-employee basis.

Several factors can affect the affordability of a plan. Opt-out payments, wellness plans, flex credits, and Health Reimbursement Arrangements (HRAs) are some of the more common considerations that may either increase or decrease the affordability of an employer-sponsored health plan.

If your organization has components like these, you may want to seek an outside expert to help you make sure that the contributions identified on Line 15 of Form 1095-C are accurate.

Choosing an IRS safe harbor for proving ACA affordability can be difficult. Still, employers should know that they do not need to apply one safe harbor across their entire workforce; they should choose what makes the most sense for their organization.

Understanding these 3 Safe Harbor calculations is essential to proving ACA affordability, so please, I encourage you to reach out to me today so that I can go over these calculations with you. You can find all of my contact information on LinkedIn.

When you reach out to me, I will share a cheat sheet with you that you can use to understand and identify the different Safe Harbor calculations.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]

This week we will be discussing the second Safe Harbor, W-2 Safe Harbor, and explain how employers use this specific calculation to prove to the IRS that the healthcare plans they are offering to their workforce are affordable under the ACA.

Providing affordability is critical for complying with this law, and failing to do so can lead you to potential penalties.

We have broken down the W-2 Safe Harbor into examples and provided general formulas to help you calculate ACA affordability accurately.

The W-2 Safe Harbor is a method for proving ACA affordability that involves using an employee’s W-2 Box 1, gross income. 

To calculate ACA affordability using the W-2 Safe Harbor, use the following formula: W-2 Box 1 Wages multiplied by 9.61% with an adjustment for partial year coverage.

We demonstrate the W-2 Safe Harbor measure using a clear and concise example:

Johnny earns an annual salary of $50,000 as a manager at Parker’s Pizza. He worked at Parker’s Pizza for 9 out of the 12 months during the 2022 tax year and received an offer of coverage on his first day of employment.

So, here’s the calculation: $50,000 x 9.61% = $4,805.

Next, multiply $4,805 by the product of the number of months of coverage offered (9) by the total number of months in the year for partial coverage (9/12). 

This gives you $3,603.75, the maximum annual amount that Johnny’s employer can make him pay for self-only coverage. 

To determine the amount per month, divide the total by the number of months Johnny received coverage (9). 

This will get you $400.42 per month.

Johnny can’t pay more than $400.42 per month for his health insurance coverage to be considered affordable.

The assorted wages and rates employers disburse to their employees will be a factor in your result calculation. 

Be able to answer yourself when you ask the question, ”Can I clearly explain the different calculations if I am in front of an employer with various ways of paying their employees?”.

Hopefully, now you have a better understanding of how to calculate ACA affordability using the W-2 Safe Harbor measure so that you can estimate your health insurance affordability with confidence.

Tommy Gaffney

VICE PRESIDENT OF SALES

Tommy is a Vice President of National Sales with over 17 years experience in healthcare, commercial, and personal lines markets. Connect with Tommy
📞 (888) 447-9994
in https://www.linkedin.com/in/tommygaffneyrsm/
✉️ [email protected]