Legal Alert: Updates to the Consolidated Appropriations Act (CAA) from 2021

| November 21, 2024
US Capitol Building - IRS Adjustments

Don’t Forget About Your Gag Clause Attestations

When the Consolidated Appropriations Act, 2021 (the “CAA”) was enacted on December 27, 2020, it included a provision that prohibits group health plans and health insurance carriers from entering into certain agreements that, either directly or indirectly, restrict the release of certain information related to provider networks and de-identified encounter data, among other things. Such restrictions are commonly referred to as “gag clauses.” The CAA also requires plans and carriers to attest annually that their agreements do not include such impermissible gag clauses.  

The first gag clause attestation was due on December 31, 2023, with the next one coming due by December 31, 2024, which covers the period between the last attestation and the date this year that the attestation is submitted. The attestation was modified somewhat for 2024, including, among other things, a new requirement to include an attestation year (i.e., the year the attestation is submitted), a new requirement to include the attestation period (i.e., the date range for the attestation, which is the period between when the last gag clause attestation was submitted and the current gag clause submission), and a section to include the plan type (ERISA plan, non-federal governmental plan, or church plan).  

Key gag clause attestation requirements and considerations are described below, though more extensive FAQs can be located (along with the instructions, forms, and user manuals for submitting the attestations) on the CMS website.

What is a gag clause?

Under the CAA, a gag clause is defined as:

  • restrictions on the disclosure of provider-specific cost or quality of care information or data to parties such as the plan sponsor, participants, beneficiaries, or referring providers;
  • restrictions on electronic access to de-identified claims and encounter information or data for each participant, beneficiary, or enrollee upon request and consistent with HIPAA, GINA, and ADA privacy regulations, including, on a per claim basis—
    • Financial information, such as the allowed amount, or any other claim-related financial obligations included in the provider contract;
    • Provider information, including name and clinical designation;
    • Service codes; or
    • Any other data element included in claim or encounter transactions;
  • or restrictions on sharing information or data described in (1) and (2), or directing that such information or data be shared, with a business associate.  

The gag clause provisions of the CAA (specifically Code section 9824, ERISA section 724, and PHSA §2799A-9(a)(1)), generally prohibit plans and carriers from entering into agreements with providers, TPAs, or other service providers that include such provisions.  

Where would I typically find a gag clause?

Gag clauses in this context might be found in agreements between a plan or carrier and any of the following parties:

  • a health care provider;
  • a network or association of providers;
  • a third-party administration (“TPA”) or pharmacy benefits manager (“PBM”);
  • or another service provider offering access to a network of providers.  

Thus, a group health plan should confirm that its carrier, TPA and/or PBM agreements do not contain prohibited clauses. These clauses would typically be found in confidentiality or other privacy provisions of the agreements, though it is important for the agreements to be thoroughly reviewed. We would suggest working with your counsel to review the agreement to determine whether it impermissibly restricts access to specific information that would be otherwise covered under the gag clause provisions, or whether there is language that only restricts access to such information in conformity with the gag clause requirements of the CAA or other applicable state or federal law.

To which plans do the gag clause restrictions apply?

All group health plans (excluding FSAs, HRAs or other excepted benefits such as dental or vision) and insurance carriers are subject to these prohibitions. This includes self-funded and fully insured plans and grandfathered plans, as well as non-ERISA plans sponsored by non-federal governmental employers (i.e., state and local governmental employers), and church plans subject to the Internal Revenue Code.  

What is the attestation requirement?

The CAA required group health plans and health insurance carriers to attest annually to the government that they have no “gag clauses” in their contracts. Plans and carriers must complete the GCPCA form electronically using the form provided by the Agencies.  

When is the attestation/GCPCA form due?

The attestation is due on or before December 31, 2024, and covers the period since the last preceding attestation.  

Who is responsible for completing the attestation for our group health plan?

That depends on whether the plan is fully insured or self-funded and your contractual arrangement with the carrier or TPA. While both the carrier and group health plan are required to submit a GCPCA with respect to a fully insured plan, a carrier may submit a GCPCA with respect to a fully insured plan that will satisfy the plan’s obligation. We expect that most carriers will agree to complete the attestation for their fully insured plans. Self-funded plans can contract with their TPA and/or their PBM to complete the attestation on behalf of the plan; however, the plan is ultimately responsible for ensuring the attestation is timely completed. It is important to communicate with your carrier or TPA before the December 31, 2024 deadline to determine who will be completing the attestation on behalf of the plan. We recommend ensuring that responsibility for completing the GCPCA is assigned well before the December 31st deadline so there are no surprises. The Agencies released an instruction manual for the webform to assist with completing the attestation, when ready for filing. Note, entities reporting on behalf of multiple responsible entities are required to also submit an excel spreadsheet.  

Are there penalties if our group health plan does not complete the attestation?

There are no specific penalties outlined in the CAA; however, in the FAQs, the Agencies indicate that failing to submit the attestation by the deadline may subject the plan or carrier to enforcement action. In such cases, it’s possible for the Agencies to assess a penalty of up to $100 per day per affected individual.  

Where can I find more information on gag clauses and completing the attestation?

The FAQs are a good place to start, as well as the HIOS GCPCA User Manual, which explains how to use the GCPCA module within the Health Insurance Oversight System (“HIOS”).  

Next Steps for Employers

In preparation for submitting their attestations, employers should consider the following:

  • If you have a fully insured plan and the carrier is the same carrier as last year, you may want to confirm the same process will be used again this year (e.g., the carrier files the attestation for you or provides you with certification that the plan is in compliance and you submit your own attestation). If it is a new carrier, then you should consult with the carrier to determine whether they will be submitting the attestation for the plan.
  • Similarly, if your plan is self-funded, and you have the same TPA as last year, you may consider confirming that the TPA will use the same process again this year (e.g., the TPA files the attestation for you or provides you with certification that the plan is in compliance and you submit your own attestation). If it is a new TPA, then you should review the TPA contract and/or consult with the TPA to determine whether they will be submitting the attestation for the plan.
  • If you have separate TPAs, such as a TPA for medical and a PBM for prescription drug benefits, then you will want to ensure the process each of the TPAs will use.
  • If your arrangement with your carrier, TPA, or PBM is such that you will be responsible for filing the attestation, ensure you have read all of the instructions for submitting the attestation and that you have completed the registration process. We recommend registering in advance of the filing deadline to be safe.
More Information

For additional information, contact our Employee Benefits team.

This alert was prepared for OneGroup by Barrow Weatherhead Lent LLP, a national law firm with recognized experts on the Affordable Care Act. Contact Stacy Barrow or Nicole Quinn-Gato at sbarrow@marbarlaw.com or nquinngato@marbarlaw.com.

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers, or our clients. This is not legal advice. No client-lawyer relationship between you and our lawyers is or may be created by your use of this information. Rather, the content is intended as a general overview of the subject matter covered. This agency and Barrow Weatherhead Lent LLP are not obligated to provide updates on the information presented herein. Those reading this alert are encouraged to seek direct counsel on legal questions.

© 2024 Barrow Weatherhead Lent LLP. All Rights Reserved.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Cyber Threats in Construction

| November 14, 2024
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Enhancing Your Cyber Hygiene Can Protect Your Business

By Dennis Ast, CPCU, CCIC

October was Cybersecurity Awareness Month. This year’s theme, “Secure Our World,” resonates across many industries, but arguably none more so than the construction industry. The construction sector continues to be a prime target for cyber criminals due to its unique vulnerabilities. Cyber-attacks can strike a construction company from various fronts, including software breaches, phishing, fund transfer fraud, and ransomware.

The construction industry faces unique exposures because of the vast amount of sensitive information involved in any project, such as contracts, financials, building plans, and the significant funds transferred electronically between businesses.

So, how can a construction company protect itself and minimize the impact of cyber threats? There are several best practices to consider, including elevating your cyber hygiene and resiliency, training employees on cyber awareness, and having a recovery plan in place should a cyber incident occur.

How does your organization increase its cyber hygiene and resiliency?

First, you need to conduct a vulnerability assessment and potentially a penetration test to identify and resolve any weaknesses. Ensure you are doing all you can to protect the data related to your company, employees, and clients. Implement Multi-Factor Authentication (MFA) for email, privileged users, and remote access to make it harder for cyber criminals to access your system.

Next, implement Endpoint Detection and Response (EDR), or better yet, Managed Detection and Response (MDR) or Extended Detection and Response (XDR). These applications monitor all your endpoints (laptops, desktops, printers, servers, etc.) for any unusual or suspicious activities, allowing your cybersecurity teams to respond promptly and appropriately to minimize any impact on your company. Maintain a regular patching schedule to keep all your systems and applications up to date and replace or remove any end-of-life or unsupported software.

Ensure you have regular, encrypted, air-gapped, and tested backups. To minimize the potential for fund transfer fraud, implement policies that verify (dual control) initial or changes in payment information from or to vendors and employees. It’s better to take the time to verify payment information than to risk paying the wrong party.

How can you minimize the risk of a cyber breach?

Another key to minimizing your organization’s risk of a cyber breach is to educate your employees, as they are your first line of defense. Since 95% of cybersecurity issues are caused by human error, it’s crucial to start with a comprehensive cybersecurity policy. Help employees understand cybersecurity and the critical role they play. Make following the policy a priority and provide regular training and updates to keep them engaged.

Train your employees on how to spot and report suspicious activity. Most importantly, encourage communication and open dialogue about cybersecurity. You want your employees to feel comfortable coming to you with concerns, without fear of negative repercussions.

Finally, an organization needs to have a Cyber Incident Response Plan. There are many templates available from both government sources and cyber carriers. A well-written plan will help your organization identify exposures and determine the best way to respond and recover from an incident, minimizing the impact on the organization. Without a plan, many organizations struggle with what to do if they suspect a cyber-attack, leading to high costs and damage.

By taking a proactive approach to cybersecurity and implementing the best practices outlined above, you can help protect your organization from a cyber attack and minimize the impact if one occurs.

For more information please contact Dennis Ast, Senior Account Executive Cyber Risk Specialist at or DAst@Onegroup.com

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Do your Employees Understand How Much You Invest in Them?

| November 8, 2024
A Group of People Looking at a Laptop

Many employees are unaware of the extent of their employer’s investment in them.

It’s easy to focus solely on the paycheck, but employee benefits often go well beyond pay. In this article, we’ll highlight some benefits your employees may not be aware of, and explain how a total compensation statement can help. 

6 often-overlooked perks

1. Health insurance

This is often the most expensive benefit for employers. In fact, for many organizations, the cost of providing employee health insurance is the second-highest expense after salaries.

2. Retirement contributions 

Many companies offer 401(k) or other retirement plans, and often match a percentage of the employee-contributed funds. This is free money that adds tremendous value to employees’ retirement savings.

3. Bonuses and profit sharing

Some companies offer bonuses, stock options or profit-sharing plans. When the company succeeds, employees benefit too.

4. Training and development

Employers often invest in career development for their staff through training programs or tuition reimbursement. Many employees overlook this investment. 

5. Paid time off

Employees might take their paid vacation and sick days for granted, but these are expensive benefits. Often, employees don’t think of these days in dollar terms until they separate from their employer and cash out. 

6. Additional benefits

Depending on the job, benefits might also include life insurance, disability coverage, parental leave, commuting support, wellness programs or other perks. Many voluntary benefits (like pet insurance) are available to employees at rates far below what they would pay as individuals on the open market.

What can you do?

Obviously, a heavy-handed announcement that employees are taking you for granted will not be well-received! Instead, consider issuing a total compensation statement.

A total compensation statement comprehensively summarizes all the direct and indirect benefits you provide to employees. Total compensation statements inform employees about the overall value of working for you, beyond their salary. These statements can even improve loyalty, satisfaction and retention. 

Not sure where to start with your total compensation statement? Reach out to our Employee Benefits team and we’ll be happy to help.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Written content in blog post: Copyright © 2024 Applied Systems, Inc. All rights reserved.

OSHA Proposes New Heat Illness Standard to Protect Workers 

| November 7, 2024
Tired worker, headache hot weather over heat unhealthy engineer working in heavy industry factory.

The Occupational Safety and Health Administration (OSHA) has proposed a new standard, “Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings.”

This new OSHA Standard would apply to general, construction, maritime and agriculture employers.

Public comments on OSHA’s proposed heat illness standard

You can submit comments on OSHA’s proposed heat illness standard (OSHA-2021-0009) before Dec. 31, 2024. Click the “Docket Documents” tab to read other public comments or submit your own. Rule making agencies like OSHA consider public comments when writing the law. Your comments are visible to everyone, so don’t include personal information about yourself or others.

You can read the complete text of the proposed standard on the Federal Register’s website. 

Heat is dangerous 

Heat is the leading cause of death among all weather-related events. Without swift treatment, excessive heat can cause heatstroke and even death. Employers are required to protect employees from unsafe work conditions, like excessive heat.

However, OSHA doesn’t have a dedicated heat illness standard. Instead, it cites employers under the General Duty Clause of the Occupational Safety and Health Act. And since there is no standard, issuing a preemptive citation to prevent heat illness is difficult. Citations usually happen after a worker has been hurt. OSHA aims to protect lives, not merely cite employers for wrongdoing. A heat exposure standard would help their efforts.

OSHA’s proposed standard would require employers to create a plan for evaluating and controlling indoor and outdoor heat hazards. It would obligate employers to protect employees from heat hazards, inside and outside. Some OSHA state plans, like California’s Cal/OSHA, already have a heat exposure standard. Federal OSHA will likely follow Cal/OSHA’s lead.

Without a plan, workers risk getting sick from the heat indoors and outdoors. In addition to weather-related heat, heat-generating machinery can threaten indoor workers. Heat-producing machines include:

  • Ovens
  • Grills
  • Furnaces
  • Kilns
  • Dryers
  • Die casting machines
  • Steam-powered machines
  • Autoclaves
  • Distillation apparatuses
  • Reactor vessels
  • Heat exchangers
  • Hot oil systems
  • Engines
  • Power generators
  • Boilers

Excessive heat worsens existing health conditions like asthma, diabetes, kidney failure and heart disease. Pregnant and older workers have a higher risk for heat illness. All workers are at risk during the first few weeks of work while they get used to the environment.

Get ahead of heat illness 

If you don’t have a heat illness plan, make one. It’s good for you and your employees. Heat-related illness is preventable. Here are some tips for creating a heat illness prevention program:

  • Identify someone to oversee the heat illness prevention program.
  • Develop a plan to allow workers to acclimate to the heat. Include new hires, temporary workers and workers returning from absences.
  • Create water and shade breaks. Make sure fresh water is always available.
  • Be aware of heat indices.
  • Revise schedules to avoid outdoor work during the highest heat hours, usually 10 a.m.- 4 p.m.
  • Train workers on the stages of heat illness.
  • Create a first-aid plan for responding to each stage of heat illness. Rehearse the plan with your workers.
  • Isolate heat-generating equipment to limit prolonged exposure to heat sources.
  • Ventilate work areas to expel hot air from the environment.
  • Use dehumidifiers indoors to reduce the air’s moisture and heat index.
  • If working in high heat is unavoidable, use the buddy system. Train workers to look out for one another.
  • Instruct workers to wear light-colored, loose-fitting clothing on hot days. If you require uniforms, have different uniforms for different weather.

OSHA has detailed heat exposure information and resources for employers. OSHA can still cite you for exposing workers to high heat. The best way to handle the heat is to have a safety plan and stick to it. By the time OSHA passes the official standard, you’ll be ready.

Contact Us

For more information about this prosposed standard, please contact our Risk Management team.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Written content in blog post: Copyright © 2024 Applied Systems, Inc. All rights reserved.

Best Practices with Employee Reassignment

| November 4, 2024
New joiner to fill in team and solve problem, teamwork to get solution, put right man in the right job to fit job description concept, businessman hand HR put new joiner to connect jigsaw puzzle.

Employee reassignments have gained new fame by joining the “quiet” trend. 

This trend already includes quiet quitting, quiet vacationing, quiet hiring and quiet firing. The Wall Street Journal coined the term”quiet cutting” to describe what happens when employers reassign rather than terminate an employee.

According to Inc. magazine, what you call it isn’t nearly as important as your reasons behind the move. The effectiveness of reassigning an employee depends on your motivation.

Let’s examine the wrong reasons for reassigning an employee, the right reasons and tips for reassignment.

The wrong reasons

Companies sometimes reassign employees in hopes of getting them to resign. This tactic can reduce the administrative challenges of performance improvement plans, unemployment expenses and severance pay. However, Inc. notes that it can create more significant problems, including decreased morale, increased turnover, a toxic workplace culture and lawsuits.

Moving an employee to a less desirable or ill-fitting role can negatively affect performance and surrounding colleagues. The downstream effects can even drive good employees out of your company.

When you add up organizational reputation, workplace culture, performance loss, client risk and potential legal fees, avoiding difficult conversations and terminations is often more costly than administrative headaches and a severance package.

Moreover, Inc. notes it’s not an effective way of dealing with ineffective employees. When someone is wrong for your organization, it’s better to terminate. According to the International Risk Management Institute, warning signs for termination include:

  • Negative attitude
  • Bad work ethic
  • Poor performance
  • Sudden declines in productivity
  • Regular tardiness or unexcused absences
  • Mistreatment of coworkers or clients

When employees fitting these descriptors are reassigned, it’s the motive that’s flawed. In these cases, reassignment will postpone the main issue. It can also cause additional problems

The right reasons

When done correctly, reassigning employees allows you to retain valuable talent. When a good employee is in the wrong role, reassignment can be positive for the employee and the organization.

The HR management software firm Eddy highlights situations where reassignment makes sense. Examples include:

  • Eliminating an employee’s position for business or market reasons
  • Evolving job responsibilities that no longer match the employee’s job description or skill set
  • Needing to permanently fill their role due to hardships stemming from a leave or accommodation request (in this situation, consult with counsel to ensure compliance with all applicable employment laws)
  • Relocation or other geographic issues

Inc. notes that skills can be taught more easily than cultural fit, hard work, commitment, positive influences on colleagues and other intangible qualities. These traits define the employees you hope to find and retain.

In these cases, there are several advantages of reassignment, according to Eddy:

  • Retaining good employees who need to move from their current role
  • Reducing costs related to recruiting, hiring, onboarding and training new employees
  • Improving workplace culture by demonstrating investment in talent
  • Caring for employees by more effectively navigating layoffs and increasing retention
Tips for employee reassignment

Even with good intentions, an employee may not be interested in a new role when being reassigned. Offer them a choice between reassignment and termination. Provide severance if you can afford it.

When reassigning an employee, start by explaining your reasons for the move. Employees understand factors such as changing market forces, department reallocations and skill mismatches. And they will appreciate your transparency.

Highlight the opportunities for personal and professional growth. Explain your plan for transitional support and training.

Set performance expectations for the new role. A reassignment is typically not a promotion, but it shouldn’t feel like a punishment.

Give the employee time to assess the proposed change. Listen to their concerns about the reassignment. When possible, address their worries with a step-by-step plan. Seeing details and feeling support will reduce their fears about change.

Need more information?

For support on this topic contact OneGroup HR Consulting at HR Consulting at hrconsulting@onegroup.com. They can provide best practices on reassignment, including planning, training, communication, and compliance.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Copyright © 2024 Applied Systems, Inc. All rights reserved.

Legal Alert: IRS Adjusts Health Flexible Spending Account and Other Benefit Limits for 2025

| October 31, 2024
US Capitol Building - IRS Adjustments

On October 22, 2024 the IRS released updates effecting FSAs and other benefit limits in 2025.

On October 22, 2024, the Internal Revenue Service (IRS) released Revenue Procedure 2024-40, which increases the health flexible spending account (FSA) salary reduction contribution limit to $3,300 for plan years beginning in 2025, an increase of $100 from 2024.  Thus, for health FSAs with a carryover feature, the maximum carryover amount is $660 (20% of the $3,300 salary reduction limit) for plan years beginning in 2025. When carrying over funds from 2024 to 2025, 20% of the $3,200 salary reduction limit for 2024 is $640.

The Revenue Procedure also contains the cost-of-living adjustments that apply to dollar limitations in certain other sections of the Internal Revenue Code. 

Qualified Commuter Parking and Mass Transit Pass Monthly Limit

For 2025, the monthly limits for qualified parking and mass transit are increased to $325 each, an increase of $10 from 2024.

Adoption Assistance Tax Credit Increase

For 2025, the credit allowed for adoption of a child is $17,280 (up $470 from 2024). The credit begins to phase out for taxpayers with modified adjusted gross income in excess of $259,190 (up $7,040 from 2024) and is completely phased out for taxpayers with modified adjusted gross income of $299,190 or more (up $7,040 from 2024).

Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) Increase

For 2025, reimbursements under a QSEHRA cannot exceed $6,350 (single) / $12,800 (family), an increase of $200 (single) / $350 (family) from 2024.

Reminder: 2025 HSA Contribution Limits and HDHP Deductible and Out-of-Pocket Limits

Earlier this year, in Rev. Proc. 2024-25, the IRS announced the inflation-adjusted amounts for HSAs and high-deductible health plans (HDHPs).

2025 (single/family)2024 (single/family)
Annual HSA Contribution Limit$4,300 / $8,550$4,150 / $8,300
Minimum Annual HDHP Deductible$1,650 / $3,300$1,600 / $3,200
Maximum Out-of-Pocket for HDHP$8,300 / $16,600$8,050 / $16,100

The ACA’s out-of-pocket limits for in-network essential health benefits have also been announced and have decreased for 2025. Note that all non-grandfathered group health plans must contain an embedded individual out-of-pocket limit if the family out-of-pocket limit is above $9,200 (2025 plan years). Exceptions to the ACA’s out-of-pocket limit rule are available for certain small group plans eligible for transition relief (referred to as “Grandmothered” plans). While historically CMS has renewed the transition relief for Grandmothered plans each year, it announced in March 2022 that the transition relief will remain in effect until it announces that all such coverage must come into compliance with the specified requirements.

2025 (single/family)2024 (single/family)
ACA Maximum Out-of-Pocket$9,200 / $18,400$9,450 / $18,900
ACA Reporting Penalties (Forms 1094-B, 1095-B, 1094-C, 1095-C)

The table below describes late filing penalties for ACA reporting.  The 2026 penalty is for returns filed in 2026 for calendar year 2025, and the 2025 penalty is for returns filed in 2025 for calendar year 2024.  Note that failure to issue a Form 1095-C when required may result in two penalties, as the IRS and the employee are each entitled to receive a copy.

Penalty Description2026 Penalty2025 Penalty
Failure to file an information return or provide a payee statement$340 for each return with respect to which a failure occurs$330 for each return with respect to which a failure occurs
Annual penalty limit for non-willful failures$4,098,500$3,978,000
Lower limit for entities with gross receipts not exceeding $5M$1,366,000$1,329,000
Failures corrected within 30 days of required filing date$60$60
Annual penalty limit when corrected within 30 days$683,000$664,500
Lower limit for entities with gross receipts not exceeding $5M when corrected within 30 days$239,000$232,500
Failures corrected by August 1$130$130
Annual penalty limit when corrected by August 1$2,049,000$1,993,500
Lower limit for entities with gross receipts not exceeding $5M when corrected by August 1$683,000$664,500
Failure to file an information return or provide a payee statement due to intentional disregard$680 for each return with respect to which a failure occurs (no cap)$660 for each return with respect to which a failure occurs (no cap)
More Information

For additional information, contact our Employee Benefits team.

This alert was prepared for OneGroup by Barrow Weatherhead Lent LLP, a national law firm with recognized experts on the Affordable Care Act. Contact Stacy Barrow or Nicole Quinn-Gato at sbarrow@marbarlaw.com or nquinngato@marbarlaw.com.

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers, or our clients. This is not legal advice. No client-lawyer relationship between you and our lawyers is or may be created by your use of this information. Rather, the content is intended as a general overview of the subject matter covered. This agency and Barrow Weatherhead Lent LLP are not obligated to provide updates on the information presented herein. Those reading this alert are encouraged to seek direct counsel on legal questions.

© 2024 Barrow Weatherhead Lent LLP. All Rights Reserved.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Understanding Contract Surety Bonds

| October 23, 2024
Low Angle Photography of Orange Excavator Under White Clouds

In the realm of construction and development, contract surety bonds are indispensable tools that ensure the successful completion of projects.  

Contract surety bonds can be categorized into four primary types:

  1. The Bid Bond – ensures that a bidder will enter into the contract and provide the necessary performance and payment bonds if awarded the contract.
  2. The Performance Bond – guarantees the project’s completion according to the contract’s terms and conditions.
  3. The Labor & Material Payment Bond – ensures that subcontractors and suppliers are compensated for their work and materials.
  4. The Subdivision Bond – guarantees that developers will complete improvements in line with local government specifications.

Underwriting contract bonds is a meticulous process based on three critical factors:

  1. Character – involves evaluating the business and personal background of the company principals, including any prior bankruptcies. 
  2. Capacity – assesses the organization and key personnel, as well as the type, size, and location of previously completed projects. 
  3. Capital – reviews fiscal year-end financial statements prepared by a third-party financial professional.

For contracts generally valued at $1 million or less, the underwriting process is simplified. This transactional bond underwriting relies on the personal credit history of the construction company principals, without requiring company financials. The bond rate typically ranges from 2.5% to 3%, and personal guarantees are required from owners and their spouses. This process can apply to a single contract or multiple contracts totaling $1 million or less.

For larger contracts, a more detailed underwriting process is followed. The underwriting process involves an evaluation of character, capacity, and capital. It includes a detailed assessment of the business and personal background of company principals, an in-depth evaluation of the organization and key personnel, and a comprehensive review of financial statements, including the quality of presentation and the basis of revenue recognition.

Specific financial analysis factors under capital underwriting considerations include the company’s history of profitability, working capital, corporate equity, total debt to equity, surety credit limits, and the availability of bank credit.

The surety industry plays a vital role in the construction sector, emphasizing its importance in risk management and insurance. A thorough understanding of contract surety bonds, their types, and the detailed underwriting processes involved is essential for anyone involved in construction and development projects, ensuring they are well-equipped to navigate the complexities of surety bonds.

Ron Metcho is a surety specialist at OneGroup with over 40 years of experience, and serves as a resource to organizations for all surety-specific questions and concerns. OneGroup has a team of specialists, dedicated to risk management and construction industry specific insurance issues. Our team takes great pride in being at the forefront of industry trends and assisting others where we can. You can find out more about us here.

For more information please contact Brett Findlay, Senior Vice President Business Risk Specialist at (315) 280-6376 or BFindlay@OneGroup.com 

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

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Welcome Melissa Zornes to OneGroup!

| October 18, 2024
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Get to know the latest addition to our leadership team.

We are excited to share that Melissa Zornes has joined OneGroup as our new Senior Vice President and Employee Benefits Practice Leader.

Melissa brings two decades of experience and extensive knowledge of leading diverse teams, employee benefits, and organizations to OneGroup. Melissa has held numerous leadership positions within the insurance industry, demonstrating a collaborative approach that has driven positive company performance and innovation.

As Senior Vice President, Employee Benefits Practice Leader at OneGroup, Melissa is leading the expansion of the employee benefits division across the company’s entire footprint. She is developing and implementing a multi-year strategic plan to grow the division both in size and expertise. Melissa is dedicated to making a positive impact within the company, benefiting its clients, team, and the broader community.

Melissa Zornes, SVP Employee Benefits Practice Leader

Melissa Zornes, SVP Employee Benefits Pratice Leader

“We are thrilled to have Melissa join our team,” said Pierre Morrisseau, Chief Executive Officer at OneGroup. “Melissa’s experience and leadership are invaluable as we expand and enhance our employee benefits offerings. Her guidance will elevate our capabilities and enrich our collective expertise. We are on the brink of an exciting new chapter, ready to deliver outstanding service to our employees and clients with unwavering dedication and excellence.”

Melissa holds an MBA from Georgia College and State University and is a board member of the Applied Client Network.

For more information

If you’re interested in connecting with Melissa, she can be reached at MZornes@OneGroup.com. If you would like to learn more about health and benefits solutions, reach out to our Employee Benefits team.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

Preparing for Medicare Part D Changes

| October 14, 2024
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Updates from OneGroup’s Medicare Team 

As we approach Medicare Annual Open Enrollment (October 15 – December 7), it’s important to be aware of potential changes that could impact your healthcare coverage.  

What is Medicare Part D? 

Medicare Part D assists with the cost of prescription drugs. It is available to anyone who has Medicare and can be added to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Medicare Part D is offered through private insurance carriers that follow Medicare guidelines. Each plan has a drug coverage list (formulary) that can vary by carrier and year. 

Anticipated Changes 

This year, we expect to see one of the most substantial changes to Part D in recent years. These changes could impact many aspects of your prescription drug coverage, including monthly premiums, deductibles, and drug copays. 

Stay Ahead of Changes 

Our Medicare team is dedicated to helping you navigate these changes. We can price your medication list, tell you what your cost will be, and confirm if the Part D coverage you have is still the best option for 2025.   

For more information

Click here to get in touch OneGroup’s Medicare team for more information. 

We are not a government agency. We are licensed insurance agents who discuss insurance programs such as Medicare Advantage, Medigap, and Medicare Part D Prescription Drug Coverage. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

How First-Time Managers Impact Organizational Success

| October 12, 2024
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Most first-time managers are not prepared for their new role.

They often are either stressed and anxious but afraid to show it or overconfident and dismissive of their role as a leader. And their struggles often translate to lower-performing teams and higher organizational turnover.

That ominous news comes from the human resources association SHRM. However, strategies exist to reverse this trend. Mentorships, training and feedback can give new managers the resources they need to succeed.

Identify a talent pipeline

According to Gallup, organizations promote the wrong person to a managerial position more than 80% of the time. Inc. magazine notes that employees most often get promoted to a managerial position because of tenure or their success as an individual contributor.

The challenge is neither of these factors translates to how an individual will perform as a manager. Being with an organization for a long time doesn’t mean employees have adequate managerial skills. And many supervisors struggle with delegating tasks if they have spent their careers as individual contributors.

Instead, organizations must identify employees with leadership skills and provide them with mentoring, training and feedback. Freelance workers who believe their rights have been violated may now file a complaint with the New York State Attorney General. 

Mentoring

First-time managers often fear making mistakes or looking foolish in front of their employees. Mentorships provide a safe space for managers to ask questions and learn about their new roles and responsibilities.

Internal mentors understand your workplace and may offer critical insights into managerial expectations, team dynamics and office culture. External mentors may provide specific expertise and fresh perspectives.

Managing is a skill that needs to be continually developed. Find a mentor who can regularly meet with a first-time manager, provide evenhanded guidance and be a sounding board as they grow. According to Inc., managers should learn to:

  • Communicate an inspiring mission and vision
  • Engage employees through collaboration and innovation
  • Listen and respond to employees’ needs
  • Give employees the tools to succeed and hold them accountable for reaching goals
  • Model the behaviors they want to see in employees, including being respectful and handling pressure
  • Demonstrate trust, transparency and respect
  • Put productivity and team goals ahead of workplace politics
Training

In addition to mentorships, training is crucial. According to Gallup, only 10% of people have a natural aptitude for managing employees.

Too few first-time managers receive formal training. And when they do, it’s often inadequate for the longterm, reports SHRM.

This lack of training creates a stressful transition for managers and their teams.

Observing and speaking with good managers is a start. But Inc. notes first-time managers also need leadership training, detailed processes and time to practice what they’ve learned.

Training options include one-on-one coaching, group sessions, role-playing classes and online courses. Potential training topics include:

  • Clearly communicating goals and expectations
  • Managing time and delegating responsibilities
  • Running meetings and performance reviews
  • Enhancing group and interpersonal communications
  • Defusing workplace conflicts
  • Coaching employees, from struggling workers to high performers
  • Providing constructive and motivational feedback

Training shouldn’t be a one-off effort. Managing is an ongoing skill that needs to be cultivated, updated and adapted to changing circumstances. Providing various learning formats and topics throughout the year supports continual learning and demonstrates a commitment to managerial development.

Feedback

According to Gallup, managers don’t receive proper feedback on their performance. This issue can lead to a disconnect between first-time managers and their employees in key areas like response times, approachability, motivation and recognition.

Forbes reports only 50% of employees think their supervisor cares about their well-being. Even worse, close to 33% of employees say speaking with their manager causes the most stress in their day. For these workers, tension with supervisors tops issues such as child care, financial challenges, commuting and work deadlines.

Feedback from direct supervisors and company leaders can support first-time managers through missteps. As long as errors aren’t egregious, discriminatory or harassing, they are essential to the learning process. Constructive guidance instills a growth mindset and models psychological safety for managers and their teams.

Providing feedback to managers also teaches them how to guide their employees. According to the Harvard Business Review, employees want frequent and constructive feedback. Teaching managers how, when and why to provide input can create cascading benefits throughout your organization.

Discover actionable support

Your managers are crucial to individual and organizational success. According to the management consulting company DDI, 57% of employees have left a job because of their manager. Another 32% have considered it.

For more information on fostering and supporting first-time managers, talk to your benefits adviser. They can help you explore opportunities to implement or improve mentorships, training programs and feedback policies for your management talent.

Need more information?

For more information on fostering and supporting first-time managers, contact HR Consulting at hrconsulting@onegroup.com. They can help you explore opportunities to implement or improve mentorships, training programs and feedback policies for your management talent.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

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