E to E...by Employers for Employers E to E provides information from a business perspective that will educate regional employers about significant healthcare issues to help them make decisions benefiting their organizations and employees.

 Sponsored by Northern Illinois Health Plan

October 2016 Issue


A Benefits Season With Less Stress And More Success

Help Employees Understand Benefit Language

New Telemedicine Service Popular With Employers And Employees Alike

Reminder: Transitional Reinsurance Fee Coming Up Soon

Did You Receive A Marketplace Exchange Subsidy Notice? - What To Do Next

Quick Poll – Review

April Quick Poll – Vote

Contact Information




When October rolls around, employers are often scrambling to get their benefit materials finalized and communicated. Here are ten tips to you help you prepare for a smooth enrollment season.

Ten tips for employers:

  1. Learn from last year. Remember the issues that slowed you down and devise a strategy to minimize them this go round.
  2. Communication is key to making the benefits season successful. Start early, keep sharing, and test that your information is clear and concise. Consider a year-round strategy to take the pressure off of signup time and encourage ongoing learning.
  3. Keep track of common questions and work extra hard to answer them. You'll likely notice trends early, giving you a unique opportunity to provide clarity and calm the onslaught of queries.
  4. Provide a variety of resources. Some people like to go online. Others want mobile access. Even more prefer one-on-one communication. By sharing information in a multitude of formats and vehicles, you appeal to a broad range of employee preferences.
  5. Articulate the practical and financial value of benefits. Both should be shared…and understood.
  6. Offer a broad range of benefits so employees have the freedom to customize part of their package. According to a recent MetLife survey, 70% of employees say having this option increases their loyalty to their employer.
  7. Transition non-essential activity to another time of the year. Focus as much as possible on enrollment-related issues.
  8. Avoid surprises! Establish clear expectations with vendors and employees, review responsibilities and timeframes, and provide reminders when possible.
  9. Involve IS, IT, and other strategic partners early on. Their buy-in and partnership can greatly impact your success.
  10. Encourage employees to login to the enrollment portal ahead of time, if you have one, or at least review materials before sign-up. It is a problem if employees spend too much time trying to figure out the system instead of focusing on their choices.

Need help implementing your enrollment strategies? Call NIHP for more tips and tactics.


With nearly half of employees saying they feel stressed by the enrollment process and only half feeling confident in the benefits decisions they made last year (according to MetLife's 14th Annual U.S. Employee Benefit Trends Study), it makes sense to provide your workforce with reference tools that can help relieve some of their anxiety and increase their confidence. An easy choice? This glossary of important terms that can help them sort out the difference between an HRA, HRP, HAS, and FSA.


NIHP now has access to a new telemedicine service that provides virtual care…anywhere. Contracted through MD Live, it provides convenient and affordable access to U.S. board-certified doctors, pediatricians, and therapists 24 hours a day, 7 days a week. Both employers and employees have given us very positive feedback on this new benefit.

An inexpensive alternative to the emergency room or urgent care center for conditions like earaches, pinkeye, respiratory problems, or sore throat, this service is especially helpful for employees on vacation or out-of-town trips for work. Providers are available over the phone or through secure video on a computer or smartphone. Access is prompt…usually less than a ten-minute wait.

MD Live, our preferred provider, or any other telemedicine service you may choose, does not replace the primary care physician but can be a useful and affordable tool to treat certain conditions on a timely basis. Employers can select to cover this benefit at 100%. For more information on this handy telemedicine option, give us a call or send us an email.


It is almost time to file for and pay your final ACA transitional reinsurance fee of $27 per covered life. The fee was assessed on health insurance issuers and plan sponsors of self-funded health plans in 2014 and 2015, and will be for the last time in 2016.

The ACA Transitional Reinsurance Program was designed to provide funding to insurers that incur high-claim costs for enrollees in the individual marketplace, to more evenly spread the financial risk of issuers. It is deductible as an ordinary and necessary business expense. You must file no later than November 15, 2016. The 2016 ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission form is available here.

Contributions can be made:

  • In one lump sum of $27 per covered life - due by January 17, 2017.
  • In a two-part payment of $21.60 per covered life (first payment due January 17, 2017) and $5.40 per covered life (second payment due no later than November 15, 2017)

This handy chart helps tell the story:

Chart Regarding Transitional Reinsurance Fee Coming Up Soon
The Center for Consumer Information & Insurance Oversight, cms.gov

Note: If you chose to pay last year’s transitional reinsurance fee in two parts, the second payment deadline of November 15, 2016 is approaching.

NIHP will calculate, collect, and remit the fee for groups that we administer medical plans for, as we have in previous years. Let us know if you need help!


Did you offer your employees affordable health coverage that met the minimum value standard of the ACA, yet still receive a Marketplace Exchange Subsidy Notice saying that you may need to pay a fee called the Employer Shared Responsibility Payment?

The notice informs you that one or more of your individual employees received a subsidy during the federal marketplace open enrollment period for 2016, indicating that he or she either:

  • Worked for you and didn't receive an offer of health care coverage
  • Did have an offer of health care coverage, but it wasn't affordable or did not provide minimum value
  • Were in a waiting period and unable to enroll

If yes, you may choose to file an appeal. What should you do?

  1. Double check your documentation to make sure the employee is still employed by you. (If they are not, or they are a part-time employee, no appeal is necessary.)
  2. If they are a full-time employee, go to How to Appeal a Marketplace Decision to file an Employer Request Appeal Form. And be sure to act quickly. Employers have 90 days from the date stated on the notice from the Marketplace to file an appeal. Likewise, the exchange must make a decision on the appeal within 90 days.


An Employer’s Guide to Marketplace Exchange Subsidy Notices by Tango Health

A Quick Review of Last Issue's "Quick Poll"

In the April 2016 issue of E to E we asked readers, "Do you offer a wellness program to your employees?" Specific survey results are noted in the chart, below.

April Quick-Poll Summary

October Quick Poll – Vote

Are you interested in our new telemedicine benefit?
(Click a response to vote. Answers are strictly anonymous.)

Then, visit the NIHP website to view this issue's quick poll results.

For more information contact us at:
(800) 723-0202 or NIHPCustomerService@nihp.com

Northern Illinois Health Plan

773 W. Lincoln Blvd., Suite 402, Freeport, IL 61032

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