Qualifying Life Events: When to Update Your Benefits

For most benefits, you elect to have the benefit for the entire plan year, with changes typically made during the next enrollment period. However, there are exceptions allowing you to make changes to your benefits outside of your enrollment period, known as qualifying life events (QLEs) or qualifying mid-year events.

What Are Qualifying Life Events?

Qualifying life events are specific circumstances, as defined by the Internal Revenue Service (IRS), that allow you to make changes to your benefits outside of the annual enrollment period. Common QLEs include marriage, divorce, birth, or adoption, and retirement. If you think you might need to make a change to your insurance coverage, review the list below to see if any of these events are applicable to your situation. It is important to note that “applicable” refers to a change that is directly related to the individual experiencing the QLE; changes based on financial reasons alone are not allowed under current IRS regulations; and documentation to confirm changes may be required.

List of Qualifying Life Events

Dependent Changes

  • Birth, Adoption, or Foster Care Placement: Add a new dependent to your benefits within 30 days of the birth, adoption, or placement date. Required documents may include a copy of the birth certificate, adoption decree, or official state agreement for placement and the dependent’s social security number.
  • Dependents Aging Out: Different policies have different age restrictions for dependent coverage, such as 18, 21, or 26 years old. Check your policy and notify the provider when a dependent has aged out to adjust your deductions.

Household Changes

  • Marriage: Add a new spouse to your policy within 30 days of the marriage date, requiring a copy of the marriage certificate.
  • Legal Separation: Remove a spouse from your policy within 30 days of the legal separation date, requiring a copy of the separation agreement or affidavit.
  • Divorce: Remove a former spouse from your policy within 30 days of the divorce date, requiring a copy of the divorce decree.
  • Death of a Spouse or Dependent: Remove a spouse or dependent from your plan within 30 days, requiring a death certificate.

Health Coverage Changes

  • Loss of Employer-Sponsored Health Coverage: If you or a spouse loses health insurance coverage sponsored by your employer, you or your spouse may qualify to join the other’s health plan. Employees, along with their spouse, former spouse, and/or dependents, may have the opportunity to maintain their group health insurance coverage for 18-36 months under COBRA (Consolidated Omnibus Budget Reconciliation Act).
  • Loss of Eligibility for or Entitlement to Medicare, Medicaid, or CHIP: If you, your spouse, or dependent becomes entitled to or ineligible for Medicare or Medicaid, or another similar government or state-sponsored program like CHIP, you qualify to adjust your health coverage accordingly.

Employment and Leave Changes

  • FMLA Leave: A leave of absence covered under the Family & Medical Leave Act (FMLA) qualifies you to make changes to your benefits if needed.
  • Non-FMLA Leave: A leave of absence not covered by FMLA that is for an applicable QLE qualifies you to make changes to your benefits if necessary. However, if a leave of absence occurs for an event not considered an eligible QLE, you will have to wait until the next annual enrollment period to enroll in or make changes to your coverage.
  • Retiring: If you are retiring, you are eligible to make changes to your insurance coverage and may be eligible for government or state-sponsored coverage.
  • Part-Time to Full-Time or Vice Versa: If you are transitioning to full-time, you may qualify for more benefits. If transitioning to part-time, you may need to update your coverage and stop deductions for benefits for which you may no longer be eligible for.
  • Change in Spouse’s Employment or Coverage: If your spouse accepts a new position or changes coverage due to a change in residence or income, they are eligible to make changes to their benefits and may now be eligible to join your coverage.

Pierce Group Benefits (PGB) Accounts

  • Transferring Employers: If you are transferring from one employer to another and both are PGB clients, you may be eligible to transfer your supplemental benefits. Please call our Service Center for assistance.
  • New Hire: If you are joining an employer who is a client of PGB, please review the new hire eligibility and enrollment information found in your benefits guide or on your employer’s benefits microsite.
  • Retiring: If you are retiring from an employer who is a client of PGB, many of your supplemental benefits are portable and can be moved from payroll deduction to direct billing or bank draft. Please call our Service Center for assistance.

Consequences of Inaction on Qualifying Life Events

If you do not take action following a qualifying life event, you will miss the opportunity to adjust your benefits to better suit your new circumstances. This could result in inadequate coverage or unnecessary expenses. For example, failing to add a new dependent within the required timeframe could leave them without essential coverage. Similarly, not removing a dependent after they have aged out could lead to continued deductions for someone no longer eligible for coverage. In essence, neglecting to act on a QLE can lead to financial inefficiencies and gaps in coverage, potentially impacting you, your spouse, and your dependents’ well-being. Therefore, it’s crucial to promptly address any QLEs to ensure your benefits align with your current life situation.

Partnering with Pierce Group Benefits

We understand that life doesn’t always follow an insurance plan year, and changes to your benefits may be necessary. It’s important to review the policies of your employee benefits and adjust as needed to ensure you, your dependents, and others covered under your plan are adequately protected, and that you’re not paying for those who are no longer eligible for coverage. For more information on QLEs, speak with your PGB Account Executive or get in touch with a PGB Representative at partnership@piercegroupbenefits.com.

Employee Assistance Programs: Support for Hurricane Helene Recovery

Natural disasters can strike unexpectedly, like the flooding and landslides caused by Hurricane Helene in our home state of North Carolina, bringing destruction and uncertainty. This natural disaster has created a significant need for mental health, financial, and legal guidance, as well as resources for home and life management. During this challenging time, Employee Assistance Programs (EAPs) play an important role in providing support and resources to help you navigate the aftermath.

What is an EAP?

An Employee Assistance Program (EAP) is a company-sponsored, confidential program designed to help you and eligible dependents connect with external professionals and resources to address personal or work-related issues that may impact your job performance, health, and overall well-being.

EAP Resources for Hurricane Helene

EAPs provide essential support and referrals in the aftermath of Hurricane Helene, tailored to help you connect with professionals to manage the unique challenges and stresses that arise as you recover and rebuild. These services can include:

Counseling Services

EAPs offer confidential counseling to help you process experiences, manage emotions, and build resilience, tailored to the trauma and impact from Hurricane Helene, including support for:

  • Trauma, Loss, or Grief
  • Anxiety, Depression, or Stress
  • Alcohol/Substance Use
  • Behavioral Change

Financial and Legal Guidance

  • Financial Consultations: Financial coaches assist with reorganizing the family budget and managing a financial crisis caused by Hurricane Helene.
  • Legal Services: Access legal documents such as power of attorney, and call for a free legal consultation with licensed attorneys who can assist with legal challenges arising from the natural disaster.

Care Resources

  • Elder and Adult Care Resources: Receive referrals for the elderly, disabled adults, and their caregivers during your consultation with our specialists, including finding temporary care solutions and support services.
  • Childcare Resources: Consultants advise on how to select childcare centers, in-home care, after-school care, and disability resources, especially important when regular care arrangements are disrupted by Hurricane Helene.
  • Pet Care Referrals: Consultants offer comprehensive referral services to assist with veterinary selection and boarding for pets affected by the natural disaster.

Home and Life Management Services

  • Home and Transportation Resources: Obtain information and referrals for household repairs, transportation, and housing rental searches, particularly useful when dealing with property damage and displacement caused by Hurricane Helene.
  • Identity Theft Resources: Access resources to protect and recover your identity if it has been compromised during a natural disaster, a common issue when personal documents or information are targeted by phishing scams posing as financial aid or donation requests.

Accessing Your EAP Services

If you are enrolled in an EAP through Pierce Group Benefits, contact the EAP by navigating to the provider’s contact information in the benefits guide on your organization’s custom microsite. Contacting an EAP service is free and confidential, with 24/7 availability and additional online resources on their websites.

Partnering with Pierce Group Benefits

In the wake of Hurricane Helene, the well-being of both employers and employees is paramount, highlighting the necessity of robust support systems to aid in recovery. Partnering with Pierce Group Benefits (PGB) provides access to comprehensive EAPs designed to offer support during these challenging times. For more information on EAPs, speak with your Pierce Group Benefits Account Executive or get in touch with a PGB Representative at partnership@piercegroupbenefits.com.

IRS Increases ACA Affordability Percentage to 9.02% for 2025

The IRS has announced an increase in the ACA affordability percentage to 9.02% for 2025, as per Revenue Procedure 2024-35 issued on September 9, 2024. This adjustment, up from 8.39% in 2024, impacts the affordability of health insurance plans starting on or after January 1, 2025.

Defining Affordable Coverage Under ACA

The Affordable Care Act (ACA), enacted in 2010, requires applicable large employers (ALEs) with 50 or more full-time equivalent employees to offer affordable health insurance to their full-time employees.

In 2025, affordable coverage means the employee’s share of the premium for the minimum value plan can’t exceed 9.02% of their household income. For employees, coverage is affordable if the cost for the minimum value plan for employee-only coverage doesn’t exceed this percentage. For spouses and dependents, coverage is affordable if the cost for the minimum value family coverage plan meets the same percentage criteria.

Employers must ensure their health plans comply with the new ACA affordability rates to avoid penalties under IRC Section 4980H(b). They are not required to offer affordable coverage to spouses and dependents and can require employees to pay the full cost of premiums for their family members’ coverage. If the employer’s health insurance is deemed not affordable, employees and their family members may qualify for subsidies to help pay for health insurance through the Health Insurance Marketplace.

Safe Harbors for Employers

Safe harbors are provisions that help employers determine if their health plans meet the ACA affordability criteria, providing clear guidelines to avoid penalties. Because employers may not have access to an employee’s total household income, coverage is deemed “affordable” if the required employee contribution satisfies at least one of the three available safe harbors:

Partnering with Pierce Group Benefits

The new ACA affordability rates for 2025 are crucial for both employers and employees, as staying informed ensures better health insurance decisions and compliance with the ACA. For more information on the impact of this change, contact your PGB Account Executive or email a PGB Representative at partnership@piercegroupbenefits.com.

Planning for the Future with Long-Term Care Insurance

As individuals age or face a major illness or disability, many will find themselves needing long-term care to assist with essential daily activities. These services include tasks like dressing, eating, and moving around, and can be provided at home, adult day cares, assisted living facilities, or nursing homes. With increasing life expectancy, the likelihood of requiring long-term care rises, as nearly 70% of people over 65 will need some form of assistance during their lifetime, and about 35% will require care in a nursing home. Planning ahead for these services is vital in ensuring comfort, safety, and quality of life.

Financial Protection with Long-Term Care Insurance

Long-term care (LTC) insurance offers protection from the high costs associated with long-term care resulting from a covered illness or injury, such as heart disease, stroke, or broken bones and fractures. Most long-term care claims are filed between the ages of 80 and 89. The benefits from an LTC insurance policy typically pay towards expenses of home care aides, assisted living, and nursing home stays, up to the policy’s limit.

Without long-term care insurance, the costs can be staggering. Even a relatively short stay in a nursing home can cost, on average, between $8,000 and $10,000 per month. Having an LTC policy in place can help safeguard your savings, retirement, and other assets in the event of long-term care.

Additional Benefits of Long-Term Care Insurance

  • Dual Benefits Option: In some hybrid LTC insurance and life insurance policies, the LTC insurance will pay for long-term care expenses first. If there is any benefit amount remaining, or if the long-term care is never needed, it can pay out like a life insurance policy.
  • Fixed Premiums: Certain policies offer fixed premiums, meaning your costs won’t increase over time.
  • Fully Portable: These policies can be fully portable, meaning you can keep your coverage even if you change jobs or retire.

Planning for long-term care is about more than just peace of mind; it’s about protecting your future financial health. Since most people will need some form of long-term care in their lifetime, considering LTC insurance can be an important step in your long-term financial strategy.

Partnering with Pierce Group Benefits

For employers, partnering with us to offer long-term care insurance shows your commitment to your employees’ future financial security by helping them manage the rising costs of long-term care. Our plans can enhance your benefits package and support employee retention and satisfaction. Employees can easily enroll in our LTC insurance plans and start planning for their long-term care needs today. To learn more, contact your Pierce Group Benefits Account Executive or email partnership@piercegroupbenefits.com for further guidance.

Important Changes for Employers Offering Prescription Drug Coverage: Medicare Part D in 2025

If you’re an employer sponsoring a group health plan that includes prescription drug coverage, it’s important to understand your responsibilities around credible coverage, especially with upcoming changes to Medicare Part D in 2025. While you’re not required to offer creditable prescription drug coverage, you must determine if your coverage is creditable and commute the results annually to employees and the Centers for Medicare & Medicaid Services (CMS).

Why Does Creditability Matter?

Creditable prescription drug coverage helps Medicare-eligible individuals make informed decisions about whether to enroll in Medicare Part D. Failing to do so within 63 Days of losing credible coverage can result in penalties for employees later enrolling in Medicare Part D.

Changes Under the Inflation Reduction Act (IRA)

Starting in 2025, out-of-pocket prescription drug costs for Medicare Part D will be capped at $2,000. This change may affect whether your group health plan still qualifies as creditable. Employers who assumed creditable status previously should re-evaluate their plans for 2025 to ensure compliance.

Resources Employers Can Use

Employers have several tools and resources available to help manage the process of determining and communicating creditable coverage:

  1. Insurance Carriers and Third-Party Administrators (TPAs): Many insurance carriers and TPAs provide detailed information on whether your prescription drug coverage is creditable. If your plan doesn’t automatically offer this, reach out to your carrier or TPA for assistance. They can also help with determining if any plan design changes may be necessary for 2025.
  2. CMS Model Notices: The Centers for Medicare & Medicaid Services (CMS) provides model notices for informing employees about their plan’s creditable or non-creditable status. These notices can be customized to fit your organization’s communication needs. Visit the CMS website to access these templates: Model Notices.
  3. Simplified Determination Guide: Employers may be able to use the simplified method for determining creditable status. The criteria and process are outlined in CMS’s simplified determination guide, available at CMS Creditable Coverage Simplified Guide.
  4. CMS Reporting System: Employers are required to report their plan’s creditable and non-creditable status to CMS annually. The online form and instructions for this reporting can be found at CMS Creditable Coverage Disclosure. The user manual provides detailed guidance, including screenshot, to assist with reporting: CMS Creditable Coverage User Manual.

By utilizing these resources, employers can ensure they are prepared for the upcoming changes and fulfill their obligations to both employees and CMS.

Partnering with Pierce Group Benefits

Please contact your Account Executive or a PGB Representative at partnership@piercegroupbenefits.com at for additional information to ensure your prescription drug coverage meets federal guidelines. Our professionals can help navigate the nuances of the Medicare Part D changes in 2025 and beyond, ensuring that your plan stays in compliance with all requirements.

Employee Benefits Strategy: Trends and Considerations for the Upcoming Year

In the coming year, 81% of organizations plan to add or enhance employee benefits to recruit and retain employees. This strategic move highlights the importance of a well-rounded benefits package to meet the evolving needs of today’s workforce.

Emerging Benefit Trends to Watch

Employers seek to address a broader range of employee needs through innovative and supportive benefits.

  • Pet Insurance: According to Nationwide, 69% of employees rank pet insurance as the most significant voluntary benefit provided by organizations, reflecting the growing importance of pets in employees’ lives and their desire for comprehensive care options.
  • Long-Term Care: As the population ages, long-term care benefits are becoming crucial for employees who need to plan for their future healthcare needs, ensuring they have support for extended medical care and daily living assistance.
  • Student Loan Assistance: With the burden of student debt affecting many employees, offering student loan assistance helps alleviate financial stress and supports employees’ financial well-being, making it a highly valued benefit.
  • Employee Assistance Programs (EAPs): These programs provide essential mental health and counseling services, helping employees manage personal and professional challenges.
  • Legal and Identity Theft Benefits: Providing legal and identity theft protection helps employees feel secure and supported in managing legal issues and protecting their personal information, addressing growing concerns about privacy and security.
  • Benefits for Part-Time Employees: Extending benefits to part-time employees demonstrates a commitment to supporting all workers, enhancing job satisfaction and loyalty among a broader segment of the workforce.

Strategic Considerations for Employers Navigating Employee Benefits Trends

Considering current employee benefit trends, it’s important for employers to be strategic about their offerings. Here are some considerations:

  • Flexibility and Customization: Implement flexible benefit offerings that provide employees with tiered options or a variety of choices to best meet their individual needs and budgets.
  • Employee-Centric Approach: Regularly seek and incorporate employee feedback to ensure benefits offerings remain relevant and appreciated.
  • Holistic Well-being: Support employee well-being with programs that support financial wellness, mental health support, and wellness initiatives to meet a variety of needs.

Partnering with Pierce Group Benefits

At PGB, our team is a strategic partner for helping employers navigate the benefits landscape. For more insights and resources in optimizing your employee benefits strategy, connect with your dedicated Pierce Group Benefits Account Executive or reach out to a PGB Representative at partnership@piercegroupbenefits.com for further information.

How to Use Your HSA in Retirement

Health Savings Accounts (HSAs) are a powerful tool for managing healthcare expenses, particularly during retirement. If you’ve been contributing to an HSA, here are some strategies to help you make the most of this benefit once you’ve retired:

Understand the Basics of Your HSA

An HSA is a tax-advantaged account designed to help you save for medical expenses. Contributions are tax-deductible, the funds grow tax-free, and withdrawals for qualified medical expenses are also tax-free. In retirement, these benefits can be incredibly valuable.

Use HSA Funds for Qualified Medical Expenses in Retirement

In retirement, you can use your HSA funds to pay for a wide range of qualified medical expenses, including:

  • Doctor visits and hospital stays
  • Prescription medications
  • Dental and vision care
  • Long-term care services
  • Medicare premiums and out-of-pocket expenses

By using your HSA for these costs, you can reduce your taxable income and stretch your retirement savings further.

Consider Using HSA Funds for Non-Medical Expenses in Retirement

After age 65, you can withdraw HSA funds for non-medical expenses without facing a penalty. However, these withdrawals will be subject to regular income tax. This can be a useful option if you need additional funds for living expenses, but it’s generally recommended to use HSA funds for qualified medical costs to take full advantage of the tax benefits.

Invest Your HSA Wisely

Many HSAs offer investment options, allowing you to grow your savings over time. In retirement, it’s important to review your investment strategy to ensure it aligns with your risk tolerance and financial goals. Consider consulting with a financial advisor to make informed decisions about your HSA investments.

Keep Track of Your Medical Expenses

Maintaining detailed records of your medical expenses is vital. This will help you substantiate your HSA withdrawals and ensure you’re using the funds appropriately. Keep receipts, invoices, and any other documentation related to your healthcare costs.

Plan for Long-Term Care

Long-term care can be a significant expense in retirement. Fortunately, HSA funds can be used to pay for long-term care insurance premiums and services. Planning ahead for these costs can help you manage your healthcare expenses more effectively.

Stay Informed About HSA Rules and Regulations

HSA rules and regulations can change, so it’s important to stay informed about any updates that may affect your account. Regularly review IRS guidelines and consult with a financial advisor to ensure you’re making the most of your HSA.

By understanding how to use your HSA effectively in retirement, you can enjoy greater financial security and peace of mind. Whether you’re covering medical expenses or planning for long-term care, your HSA can be a valuable resource in your retirement toolkit.

Partnering with Pierce Group Benefits

If you’re a client’s employee with a HSA, be sure to look up your plan’s provisions on your organization’s custom microsite to fully utilize your funds before the plan’s annual deadline. To make your shopping experience even better, we offer our clients’ employees enrolled in an HSA exclusive savings: receive $20 off any order of $150+ with code PGB20HSA at the HSA Store (one use per customer).

For employers interested in incorporating HSAs in their employee benefits package, learn more about these benefits by consulting with your Pierce Group Benefits Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com.

How Voluntary Benefits Can Enhance Employee Retention

Voluntary Benefits for Employee Retention

A comprehensive benefits package, including voluntary benefits, is a powerful strategy for employee retention. According to a study by the Society for Human Resource Management (SHRM), 60% of employees view employee benefits as extremely or very important when deciding whether to remain with their current employer.

Let’s explore the compelling advantages of voluntary benefits that can enhance your employee retention strategy.

The Perks of Voluntary Benefits

  1. Enhanced Financial Security: Voluntary benefits like accident, cancer, and life insurance provide employees with an extra layer of financial protection. This security can alleviate stress and allow employees to focus more on their work, knowing they and their families are covered in case of unexpected events.
  2. Improved Health and Well-being: Benefits such as vision and dental insurance contribute to overall health and well-being. When employees have access to comprehensive health care, they are more likely to stay healthy and maintain higher productivity levels.
  3. Increased Job Satisfaction: Offering a variety of voluntary benefits shows employees that their employer cares about their personal needs and well-being. This can lead to higher job satisfaction, as employees feel valued and appreciated.
  4. Flexibility and Personalization: Voluntary benefits allow employees to choose the coverage that best fits their individual needs. This flexibility can lead to greater satisfaction, as employees feel they have control over their benefits and can tailor them to their personal circumstances.
  5. Boosted Morale and Engagement: When employees feel supported through a comprehensive benefits package, their morale and engagement levels tend to rise. This can result in a more positive work environment and higher levels of employee loyalty.

Retaining employees through voluntary benefits involves fostering a supportive and engaging workplace where they feel appreciated and valued. By strategically implementing a comprehensive benefits package that includes voluntary options, organizations can build a loyal and motivated workforce, driving long-term success.

Partnering with Pierce Group Benefits

To learn more about how we can support your organization, connect with your PGB Account Executive or reach out to a PGB Representative at partnership@piercegroupbenefits.com for further information.

Personalizing Your Employee Benefits Offerings

In today’s multi-generational workforce, employees have a wide range of health and financial wellness needs. One effective way to address these varied needs is by personalizing your employee benefits offerings. By tailoring benefits to meet the diverse needs of your workforce, you can enhance job satisfaction, boost morale, and increase employee retention. Here are some strategies to help you personalize your employee benefits:

  1. Understand Your Workforce: Every employee is unique, with different needs, priorities, and goals. Conduct surveys and focus groups to gather insights into what benefits your employees value most. This information will help you design a benefits package that resonates with your team.
  2. Offer Flexible Benefits Plans: Flexible benefits plans allow employees to choose from a menu of benefits options. This approach gives employees the freedom to select the benefits that best suit their personal circumstances. For example, younger employees might prioritize wellness programs, while those nearing retirement may focus on financial planning.
  3. Focus on Financial Wellness: Financial stress can significantly impact an employee’s overall well-being. Provide benefits that help employees manage their finances, such as retirement plans, financial planning services, and student loan repayment assistance. These benefits can help employees feel more secure and focused at work.
  4. Maintain Ongoing Conversations: As employees progress in their careers and experience life changes, their benefits needs will evolve. Maintain ongoing conversations with your employees to ensure your benefits offerings remain relevant and valuable. Regularly solicit feedback and be open to making adjustments as needed.

Personalized Benefits Examples:

  1. Alleviate Financial Stress for Recent Graduates: This benefit can be particularly attractive to recent college graduates who are burdened with student debt. By providing student loan assistance to help them manage their loans, you can alleviate financial stress and improve their overall job satisfaction.
  2. Bridge Insurance Gaps with Additional Coverage: Voluntary benefits policies, such as cancer insurance, accident insurance, and medical bridge insurance, can help fill gaps in health insurance. These policies provide financial support in the event of specific health-related incidents, offering peace of mind and financial stability. Many of these benefits are guaranteed renewable, ensuring continued coverage year after year. Additionally, some policies may be portable, allowing employees to retain their benefits even if they change jobs or retire.
  3. Access Mental Health and Counseling Support: Offering Employee Assistance Programs (EAPs) provides access to mental health support, counseling services, and other resources to help employees manage stress and personal challenges. EAPs can be a valuable resource for employees dealing with mental health issues or other personal concerns.

Personalizing your employee benefits offerings is a powerful way to show your employees that you value their individual needs and requirement. By implementing these strategies, you can create a happier, healthier, and more engaged workforce.

Partnering with Pierce Group Benefits

To learn more about how we can support your organization, connect with your Pierce Group Benefits Account Executive or reach out to a PGB Representative at partnership@piercegroupbenefits.com for further information.

How an Insurance Brokerage Empowers Solo HR Professionals

Being the sole member of a human resources department can be as challenging as it is rewarding. As an HR department of one, you are responsible for a multitude of tasks—from recruitment and compliance to employee engagement and benefits administration. One of the most complex aspects of this role is managing employee benefits. Partnering with an insurance brokerage can be a game-changer, helping you plan, select, and administer these benefits more effectively.

Here’s how working with a brokerage can transform your approach to benefits management.

Why Partner with an Insurance Brokerage?

  • Informed Guidance: Insurance brokers bring a wealth of knowledge and experience in benefits solutions that can be crucial for smaller organizations or solo HR practitioners. They stay updated on the latest trends, laws, and products, ensuring that you can provide competitive and compliant benefits packages to your employees.
  • Customized Solutions: Every organization has unique needs, and a broker will tailor the benefits packages to align with your organization’s goals and budget. This personalized approach helps in offering packages that are both attractive to employees and feasible for the organization.
  • Administrative Support: Specialists at an insurance brokerage provide significant administrative support. They assist with the paperwork, manage relationships with providers, and sometimes even assist with claims and billing issues, reducing the burden on your shoulders.

How an Insurance Brokerage Can Enhance Benefits Management

Streamlining New Hire Enrollment

  • Setup and Support: Brokers can help set up a streamlined enrollment process tailored to your organization’s workflow. They often provide tools that facilitate the collection and processing of new hire information.
  • Education: They can also assist in educating new hires about their benefits options, which is crucial in ensuring that employees understand and utilize their benefits.

Managing Open Enrollment

  • Strategic Planning: With a broker, open enrollment becomes less about administrative stress and more about strategic planning. They can analyze previous years’ data and predict future trends to advise on the best plans for your employees.
  • Communication Tools: Brokers often provide communication materials and sessions to help explain changes or new options during open enrollment, ensuring that employees have all the necessary information to make informed decisions.

Answering Day-to-Day Benefits Questions

  • First Point of Contact: Employees often have numerous questions about their benefits. Brokers can serve as the first point of contact for these queries, providing accurate and timely information, which can significantly reduce your workload.
  • Regular Updates and Information Sessions: Regularly scheduled sessions and updates provided by brokers can help keep everyone informed and engaged with their benefits.

For the HR department of one, partnering with an insurance brokerage can transform the daunting task of managing employee benefits into a more manageable and strategic part of your role. Not only does it help in offering competitive benefits and compliance, but it also enhances your capacity to focus on other critical HR functions, ultimately leading to better overall performance and employee satisfaction.

Partnering with Pierce Group Benefits

With over 50 years as an industry leader in employee benefits, Pierce Group Benefits (PGB) helps HR professionals tackle the complexities of benefits management. By leveraging our extensive experience and industry connections, we ensure that even the smallest HR departments can offer top-tier benefits without administrative overload. To learn more about our services, contact a PGB Representative at partnership@piercegroupbenefits.com.

A Shopper’s Guide to the FSA and HSA Stores

As we navigate through the year, it’s essential to make the most of every opportunity to save money and stay healthy. One often overlooked avenue is the efficient use of Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA). With the FSA Store and HSA Store, you have a variety of eligible products that can be paid for with your pre-tax funds.

What Can You Buy with FSA and HSA Dollars?

The range of products available is vast and varied. From prescription medications and first-aid supplies to sunscreen and orthopedic supports, your FSA and HSA dollars can go further than you might think. To help you understand what’s eligible, visit the FSA Eligibility List and the HSA Eligibility List.

How Much Can You Save?

Both FSA and HSA accounts offer tax advantages that can lead to significant savings. Use the FSA Calculator and HSA Tax Savings Calculator to estimate your potential savings.

Learning and Planning

Educating yourself on the best ways to use your FSA and HSA is key. The FSA Learning Center and HSA Learning Center are fantastic resources to plan your spending throughout the year.

PGB’s Exclusive Discounts for the FSA and HSA Stores

To make your shopping experience even better, we’re offer our clients’ employees enrolled in a FSA or HSA exclusive discounts:

  • Enjoy $20 off any order of $150+ with code PGB20FSA at the FSA Store (one use per customer).
  • Get $20 off any order of $150+ with code PGB20HSA at the HSA Store (one use per customer).

Don’t let your hard-earned dollars go to waste. Explore the FSA Store and HSA Store today and start saving while supporting your health and wellness.

Partnering with Pierce Group Benefits

If you’re a client’s employee with an FSA or HSA, be sure to look up your plan’s provisions on your organization’s custom microsite to fully utilize your funds before the plan’s deadline. For employers interested in incorporating HSAs or FSAs in their employee benefits package, learn more about these benefits by consulting with your Pierce Group Benefits Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com.

Recognizing Men’s Mental Health Awareness Month

June is recognized as Men’s Mental Health Awareness Month, an opportune time to focus on a critical aspect of men’s mental well-being. As an employee benefits company, we understand the importance of mental health and the significance of resources like Employee Assistance Programs (EAPs) in supporting men’s mental health.

Understanding the Stigma

Societal norms often discourage men from discussing their mental health, creating a culture of silence. In a professional setting, this can lead to decreased productivity, increased absenteeism, and a negative impact on overall team morale. It’s time to break these barriers and foster a supportive work environment.

EAPs: A Valuable Resource

EAPs are employer-sponsored programs designed to alleviate these issues. They offer a variety of services, including mental health counseling, stress management, and resources for dealing with life’s challenges. By providing confidential and easily accessible support, EAPs can play a pivotal role in promoting men’s mental health.

Benefits of EAPs

  1. Early Intervention: EAPs provide early support to employees facing mental health issues, preventing these problems from escalating.
  2. Improved Productivity: By addressing mental health issues, EAPs can help improve focus, engagement, and overall productivity.
  3. Reduced Absenteeism: Employees with access to mental health support are less likely to take leaves of absence.
  4. Positive Work Environment: EAPs contribute to a healthier, more positive work environment by promoting mental well-being.

Encouraging Utilization

It’s important to encourage employees to take advantage of EAPs if this resource is offered by your organization. Regular communication about the availability and benefits of EAPs, along with reassurances about confidentiality, can increase utilization.

Partnering with Pierce Group Benefits

Men’s Mental Health Awareness Month serves as a reminder of the importance of mental health in the workplace. As an employee benefits company, we are committed to helping employers improve the mental health of their workforce by tailoring benefit plans to meet the evolving needs of your employees. For more information about the specific health and wellness options available or how to maximize these benefits, speak to your dedicated Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com.

IRS Announces Updated HSA and HDHP Limits for 2025

On May 9, 2024, the Internal Revenue Service (IRS) released its annual procedure outlining the adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPS). Revenue Procedure 2024-25 introduces significant changes that will take effect on January 1, 2025, influencing healthcare expenses and benefits.

Maximum HSA Contributions Limit

The maximum HSA contribution limit will rise in 2025 to $4,300 for individuals with self-only HDHP coverage, compared to the current limit of $4,150. For those with family coverage under an HDHP, the maximum HSA contribution will increase to $8,550, up from $8,300. This adjustment allows individuals and families to allocate more funds into their HSAs, enabling them to better manage and cover their healthcare expenses.

Minimum Deductible Amount for HDHPs

In 2025, the minimum deductible amount for HDHPs will undergo adjustments, with an increase from $1,600 to $1,650 for individuals and from $3,200 to $3,300 for families. This change emphasizes the high-deductible nature of HDHPs, requiring individuals to meet these thresholds before their insurance company covers any claim.

Maximum Out-of-Pocket Expense Limit for HDHPs

Alongside the minimum deductible, the maximum out-of-pocket expense limit for HDHPs will also increase. For self-only HDHP coverage, the maximum amount that individuals are required to pay out-of-pocket will increase from $8,050 to $8,300, while family coverage will rise from $16,100 to $16,600. Once the total out-of-pocket expenses reach this limit, the insurance plan typically covers 100% of the remaining eligible medical costs for the rest of the year, effectively serving as a cap on the financial responsibility individuals or families may incur for healthcare services under their HDHP.

HSA Contribution Limits for Individuals Age 55+

There will be no changes to the HSA catch-up limit rules for individuals aged 55 and above. The annual catch-up contribution remains at $1,000, allowing individuals closer to retirement the ability to save additional funds in their HSAs. This provision provides them with the opportunity to bolster their savings and better prepare for healthcare expenses during their later years.

HRA Inflation Adjustments

Revenue Procedure 2024-25 also addresses excepted benefit health reimbursement arrangements (HRAs) by setting the maximum amount at $2,150 in 2025, an increase from $2,100. The adjustment allows participating employers to provide their employees with a higher level of reimbursement for eligible healthcare expenses.

Contribution & Out-of-Pocket Limits for HSAs and HDHPs

2025
2024
Change
HSA Contribution Limit
Self-Only: $4,300
Family: $8,550
Self-Only: $4,150
Family: $8,300
Self-Only: +$150
Family: +$250
HSA Catch-Up Contributions
(Age 55+)
$1,000
$1,000
No Change
HDHP Minimum Deductibles
Self-Only: $1,650
Family: $3,300
Self-Only: $1,600
Family: $3,200
Self-Only: +$50
Family: +$100
HDHP Maximum Out-of-Pocket Amounts
(Deductibles, Co-payments and other amounts, but not Premiums)
Self-Only: $8,300
Family: $16,600
Self-Only: $8,050
Family: $16,100
Self-Only: +$250
Family: +$500

Recommended Actions for Employers

Please contact your Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com at for additional information about how this may affect your 2024 – 2025 HDHP/HSA offerings.

National Women’s Health Week

National Women’s Health Week serves as a pivotal time to focus on the specific healthcare needs and challenges predominantly faced by women. At Pierce Group Benefits (PGB), we are acutely aware of these unique challenges, which include breast cancer, osteoporosis, heart disease, and more. To address these medical conditions, we have meticulously designed our employee benefits plans to provide comprehensive access to preventive care and specialized services.

Our commitment extends beyond just meeting basic health and wellness needs. We are dedicated to providing women with the essential resources required to effectively manage their care. During National Women’s Health Week—and throughout the year—our team is devoted to guiding our current and prospective clients through tailored solutions that bolster women’s health, thus laying a strong foundation for a woman’s healthcare journey.

For more information about the specific health and wellness options available or how to maximize these benefits, speak to your dedicated Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com.

Understanding Critical Illness Benefits

As an employer, understanding critical illness benefits is crucial for ensuring the well-being of your employees. These benefits are designed to provide a lump sum payment, which can be a financial lifesaver for your employees when faced with the high costs associated with critical illnesses.

The Role of Critical Illness Insurance in Employee Benefits

Unlike regular health insurance, which typically covers medical bills and ongoing treatment costs, critical illness insurance pays out upon the diagnosis of certain severe conditions listed within the policy. These conditions often include, but are not limited to:

  • Heart Attack
  • Stroke
  • Coronary Artery Disease
  • Major Organ Transplant
  • Kidney Failure
  • Coma
  • Benign Brain Tumor
  • Loss of Hearing, Sight, or Speech

Please note that the specific conditions covered can vary between different insurance policies. Always check the terms and conditions of a policy for the complete list of covered illnesses.

Flexibility of Critical Illness Benefits for Employees

The funds from critical illness benefits can be used at the discretion of the employee, offering flexibility during a challenging time. This can cover out of pocket expenses from medical treatments not covered by traditional health insurance, to daily living expenses, or even travel costs for treatment at specialized facilities. It’s a layer of financial protection that can help maintain your employees’ standard of living and allow them to focus on recovery, rather than financial strain.

Partnering with Pierce Group Benefits

Offering critical illness benefits can provide a robust safety net for your employees in the face of life’s uncertainties. To learn more about incorporating critical illness benefits in your organization’s employee benefits package, speak to your Pierce Group Benefits Account Executive or contact a PGB Representative at partnership@piercegroupbenefits.com.