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“Pay or Play” Penalties. Is Your Church or School Growing?

When schools first closed their doors to in-person learning in the Fall of 2020, no one could have predicted just how the pandemic would impact the educational system. From Spring 2020 through Fall 2022, schools, teachers, students, and caregivers had to navigate masking, social distancing, and testing protocols, as well as the constant rotation of closing and reopening of schools.

By the 2020-2021 school year, many private schools began seeing dramatic growth. A recent Christian Headlines article shares that since the beginning of the pandemic, nearly 80% of private Christian schools have seen increased enrollment. With the uncertainty of the pandemic and the reality of the public school curriculum, many parents and caregivers decided to enroll their children into private and Christian schools. 

Now, as we continue into the new school year, both private and Christian schools are still seeing significant increases in enrollment. 

With an influx of new students ready to begin the year, additional staff must be hired to support them, driving these schools towards a new category of employers – an applicable large employer (ALE). This title, given by the Affordable Care Act, comes with employer-shared responsibilities that could be challenging for nonprofit Christian schools as well as smaller private schools to follow.

The provision includes nonprofit organizations.

The “Pay or Play provision,” requires certain employers to offer affordable, minimum value coverage to full-time employees. An employer is subject to the rules if they employ at least 50 full-time employees in a calendar year, including full-time equivalent employees. As seen below:

  • A full-time employee is one who works 30 or more hours each week. In a calendar month, per the Affordable Care Act, 130 hours is considered the equivalent of 30 hours a week.
  • Hours worked by part-time employees, or employees who work less than 30 hours per week, are counted and divided by 120 per month. This number will determine how many full-time equivalent employees a company has.
  • If the total of full-time employees and full-time equivalent employees are over 50, a company can be considered an applicable large employer.

Many schools will now need to determine if they qualify as an applicable large employer. Many details within the provision can make this a difficult task. For example, calculating hours worked for each employee includes non-working hours such as vacation and leave of absence.

Employers who do not offer their employees a health plan and are considered a large employer are subject to paying costly penalties. Schools need to work with their advisors to ensure they are in compliance with the Affordable Care Act as the penalties have recently increased

Tuition vs Enrollment vs Budget

Small private and nonprofit schools that have grown in size may find themselves in a difficult position. Often, these schools don’t have the ability to support a health plan due to limited budgets. Those who charge tuition could consider raising the cost to help support affordable coverage, however raising fees could affect enrollment, creating a challenging cycle. 

At City on a Hill, we work directly with private and nonprofit schools. We have unique solutions that can help. We can help schools deliver affordable health plans, designed for their unique workforce, even with zero budget. Options are available. After analyzing plan data we can develop a three to five year strategic plan.

A plan can be designed to complement your budget, from zero dollars to full coverage, allowing schools that have grown over 50 employees to avoid or minimize harsh penalties. If you have questions about Pay or Play penalties or need help to determine whether you are an applicable large employer, let’s chat.

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Support Employee’s Mental Health with Unique Benefit Solutions

Rising staff shortages and mental health concerns may have contributed to a challenging recruitment process for many organizations this summer. Now, as we begin the new school year, ensuring your employee benefit programs complement a supportive and encouraging environment is essential. 

The ongoing effects from the pandemic has left teachers and staff feeling exhausted and overwhelmed. A survey from the National Education Association (NEA) shows educators feel burnout is a top concern, with “67% reporting it as a very serious issue and 90% a very serious or somewhat serious issue.” These concerns need to be addressed by schools now in order to prevent the possibility of teachers leaving their field.

Staff shortages and the pandemic are listed as leading contributors of stress and although the worst of the pandemic appears to be behind us, educators may have to navigate long-term mental health effects, not only for themselves, but the students they teach.

To address burnout, those surveyed shared they are strongly in support of schools hiring more teachers and support staff to ease additional workload. As well as options to provide mental and behavioral health support for students. NEA members also expressed an interest in increased wages and while that request could be in the budget for some schools, finding and allocating these additional funds can be extremely difficult for smaller or private Christian schools

Providing support may be key for recruitment and retention this year

In these cases, schools can offer support to their staff by looking at their benefits program in a more strategic way. Making meaningful changes within your plan can improve employee experience and reduce stress that causes burnout. An important part of assessing your benefits program is to ensure employees can access programs easily and affordably. For example, reducing co-pays for mental health programs or spreading awareness using monthly email campaigns.

Advisors, like us, can help you make important data-based decisions and develop strategies that can support your people, financially and emotionally. Whether that means providing new programs or investing in current ones.

To address burnout and build retention and recruitment strategies this year, employers should consider:

  • Providing mental health programs such as workplace Chaplain services or Employee Assistance Programs that offer confidential support for employee concerns.
  • Focusing on financial well being by offering life insurance options, financial well being programs, disability or Flexible Spending Accounts.
  • Providing job and classroom flexibility for teachers. Creating more time for teachers to prepare lessons, grade work and organize student activities.
  • Concentrating on school culture and mission can be an effective way to help your people feel valued. 
  • Offering education programs to help employees achieve personal goals and develop skills.
  • Conducting regular surveys and speaking with employees one-on-one can help you better understand how your programs are working and where improvements need to be made. 

Any changes made to your benefits programs can be done slowly over time. Using change management strategies that allows teachers and staff to become accustomed to differences in their plans without feeling overwhelmed. This can be especially important due to the high level of stress teachers are feeling.

Help teachers focus on inspiring students by giving them the support they need.

Educators often choose their profession because they want to make a difference in the lives of others. By making a genuine effort to support them in that journey you can alleviate their stress and increase their satisfaction. Recruitment and retention are closely associated. When you focus on taking care of the people you have, you can inadvertently attract more talent by word of mouth and reputation. 

At City on a Hill, we understand how important your people are. We want to help you manage your benefit program in a way that gives you more control over costs. Allowing you to provide comprehensive, supportive programs to teachers during these difficult times.

If you’re worried about your teachers and staff experiencing burnout, let’s chat.

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Change Management and Your Benefits Program

Where change presents itself, uncertainty follows. Yet, in a time where employee wellbeing and health is a top priority, adjustments to benefits may be necessary to support them. Changes that can reduce costs and improve employee experience can make a big difference for employees.

Recently we discussed a place for innovation in your benefits plan, and organizations are responding. Innovation can promote a positive workplace culture, help avoid employee burnout, and generate cost savings for your organization. But once employers have taken the first step— deciding to make a change—how do you overcome the risks and anxieties of that uncertainty?

Change Management

Employers often receive large increases from their insurance carriers, many times with no explanations as to why. This leaves employers with one option: to try to argue down the cost. While a lesser increase is a great place to start, employers really need to ask themselves if their carriers are truly looking out for their best interests. Increases year after year with no options to improve your program can become unsustainable, which can negatively affect your organization and employees. 

This is especially important for small churches and Christian schools, who sometimes have limited budgets to work with. Partners that are more aligned with your mission are better able to support you.

We have a client who is insured with a larger carrier and is interested in making changes to their plan but doesn’t want to transform the plan entirely. For these clients, we were able to save them money for the current year by uncovering and alleviating immediate high costs within the plan. This led to reduced rates and a better ability to manage changes appropriately and allow transition slowly the following year.

Flipping all the switches at once is not required. 

Currently, over 70% of employers are worried about stress and burnout affecting their business, according to MetLife’s 29th Annual U.S. Employee Benefit Trends Study. With numbers like these, any changes made to a benefits program need to be done deliberately and carefully.

Strategically, we will do what we can to keep your organization with the same carrier and your employees with the same doctors. We make changes step by step to avoid stress for employees and ensure we stay within budget. If you have a preferred network and are comfortable, we can work to keep you there. 

At the same time, we recognize that circumstances and priorities can shift, the recent pandemic is a great example of how quickly those factors can change. Bumps in the journey are often preventable, but where they aren’t, we have a suite of solutions and partners we can leverage to address them. Where change is the smart option, how we implement that change is often as important as the change itself.

For example, changing networks, even when employees have access to the same doctors, can create discomfort. HR staff, who are used to operating a certain way and employees who are accustomed to the way their insurance works often need time to adjust and familiarize themselves with new processes. They need to be led into a new system with ease, allowing time for education, training and support, which is why our process includes making adjustments over time, to give employers and employees more runway to work through.

Alleviate unnecessary stress to you and your people.

A gradual change allows for innovation and improves efficacy. We design the pathway with you. Starting with small, intentional adjustments to manage costs and reduce risk. Our three-year pathway can look something like this:

Year 1: Manage the initial changes. We strategically design a 12-month runway with employers. Time is taken to discuss options and answer questions. We recommend a minimum of 4-6 months to introduce changes to those employees who will be impacted, whether that’s a few individuals or the entirety of your workforce.

Year 2: Expand on those changes. To reduce disruption to the organization, data-based decisions and pathways are continued. Valuable data, such as plan usage or sources of costs, is pulled and analyzed. If employers have concerns, we are able to provide appropriate solutions for those concerns as well. 

Year 3: Continue to build. Every year provides new opportunities and challenges, but by this stage in the plan, your organization and its members are in a position to adopt aggressive cost-saving measures because we have trained them, educated them, and prepared them for this new way of approaching benefits. Not all aggressive options make sense for every organization, of course, but we have managed change in such a way that you can make those choices with less anxiety.

Improve your plan with your mission in mind.

Change management, when done in this manner, can produce cost savings and improve employee satisfaction. Adding new processes too quickly or without proper planning can cause confusion for employers and employees, which is why change management is important.

We have niche solutions for the schools and churches we serve, specifically tailored to their needs. Our process is different from other advisors because of the relationship we have with our partners and how we can leverage opportunities for savings and improvement. We believe in the benefits of data-based decision making and long-term planning.
Our goal is to be able to help all organizations thrive. We work with schools of all sizes and budgets. If you are interested in discussing unique options for your business, let’s chat!

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Signs There May Be Lost Revenue in Your Benefits Plan

Most schools have been at a standstill over the past two years, hesitant to make huge adjustments to their benefits plan, due to the pandemic. But with rising healthcare costs, increased student enrollments, and the uncertainty of the Great Resignation, now may be the best time to make meaningful changes.

Schools have been in a state of day-to-day survival mode, switching to hybrid models and remote learning, conducting contact tracing, juggling mask mandates, and attempting social distancing in busy classrooms. 

Parents with children who were in Zoom meetings all day saw an unsustainable way of life and went looking for better in-person learning options. 

This created growth in private and charter schools, causing expansion and space concerns in conjunction with COVID constraints. We often hear that with an enrollment of an additional seven to eight students requires an additional staff member, leaving these schools trying to hire more people.

On top of that, the Great Resignation is also putting pressure on schools to hire new teachers and retain current ones. Teachers have already been burning out prior to the COVID-19 era, with little support and stagnant pay. 

By using your benefits spend more effectively, you can free up more budget to better compensate staff, helping to fight trending resignations.

There is revenue trapped in a bad benefits plan. 

Signs you may have hidden revenue lost in your plan:

  • If you haven’t looked at your benefits in a few years, you are almost certainly missing opportunities to uncover lost revenue. The pandemic has caused a dramatic shift in current benefit trends, with a focus on the well-being of individuals and their families. Your benefits plan should reflect this change.
  • If your employees are paying more than 25-30% of the total premium (especially in child and family tiers) or a deductible over $3000. There are ways to manage the cost of your plan more effectively, benefiting your school and your staff.
  • If your employees can’t afford a surprise medical need, like a surprise knee surgery that hits their deductible. With their salary and your benefits plan, could they afford it? If not, you have a problem.

The benefits you offer could be your path to competing with other schools. If your teachers are pulling together every penny they have to make things work and they’re hit with a surprise $5000 deductible, the benefits aren’t really working for them.

You can change that.

If you have a better benefits plan, you can improve employee experience and free up capital for compensation. Salary and benefits are key factors for most employees when considering job opportunities, with many looking for employers who invest not only in their work lives, but their personal lives as well. 

Now is not the time to stand still.

You can use your benefits to help solve these problems and significantly improve your school’s ability to attract and retain talented, motivated teachers and staff. The first step is to design a strategy that builds a solid benefits plan, one that can help your school thrive. 

There is room for adjustments within your plan, even if those adjustments are minimal to start. Working towards better, more competitive benefits can help your school overcome the challenges that the pandemic has caused. 

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There is a Place For Innovation in Your Benefits Program.

We often ask employees to be innovative. To develop and implement new ideas and concepts so we can promote growth in our schools and churches. We want our students and community to know that change doesn’t have to be scary but empowering.

But when it comes to healthcare insurance and employee benefits this strategic asset can be overlooked. In fact, we come across many opportunities to improve program designs but are met with employers who are hesitant to make changes, despite the cost-saving potential.

Sympathizing with the challenges of change. 

Employers can feel hesitant to make changes to their benefits programs for a variety of reasons. Some feel changes to the program will be too time-consuming or the disturbances caused by a change, big or small, may outweigh the advantages. Others may worry about how change could affect employees and company culture.

Those employers who are interested in innovative solutions to better their program may have brokers who aren’t. Brokers who are more comfortable being reactive with plans and sticking with what they know, instead of being proactive and producing a strategy that better fits the needs of the organization.

This can make even the most innovative employers reluctant to change.

Recently we were able to improve a client’s plan by coming in 20% below the broker’s current rate. We were able to strengthen their plan and reduce the costs by using a unique solution their broker was not aware of, leaving the current broker at a loss because the new strategy was better in every regard.

In these situations, brokers often engage with employers, telling them to remain skeptical while they search for answers. This can be confusing and stressful for employers and can cause them to question their decisions, delaying or even denying changes to their program that can improve employee experience and lower costs.

Helping employers feel more comfortable in these scenarios is important. Innovation comes naturally in all areas of our workplace, except when it comes to healthcare and employee benefits. This is a problem.

The proposed changes will save this organization money. And because costs aren’t getting passed onto employees, their employees will save money too. There are no holes in what we do. We were able to offer rebates, contracts, and bulk purchasing to help lower costs. With bulk purchasing you can save up to 10 to 15%, which was a big part of the savings we established for this organization.

We are confident in our strategies and we are used to discovering innovative, effective benefit solutions. We also know how important culture and mission are for employers and how difficult change can be. Managing your benefits program in a different way can be intimidating, especially if your broker isn’t familiar with the mechanisms.

Gain the confidence you need to improve your benefits program.

If you find yourself in this scenario and are worried about a new solution for your program, there are steps you can take to ensure you’re decision: 

  • Talk to your broker and/or advisor about the benefits and risks until you truly understand the strategy. 
  • Talk to your peers who are trying this kind of innovation and see what results they are getting with their plans. 
  • Ask for references. An advisor or broker who is suggesting an innovative change should have case studies, success stories, and clients who are willing to share outlooks. 

Being innovative with your benefits program can be intimidating. Talk to your peers, talk to your advisor and when you have the information, data, and references you need, take another look. Improving efficiency, lowering costs, and gaining a competitive advantage can be done with appropriate changes.

If you are looking for more information about innovation in your benefits program, let’s chat. We want you to feel comfortable with all of your benefit decisions.

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Your Mission is an Important Ingredient in Your Benefits Program

Offering healthcare insurance is an important decision for any business. Designed with your organization’s unique qualities in mind, your plan needs to protect the health and wellbeing of your people and their families. Ideally, offering the best coverage available, while aligning with your organization’s financial goals.

For many small churches and Christian schools, the importance of optimizing every benefit dollar is essential. Even small increases in costs can mean dramatic changes for these organizations. To recover from unexpected expenses churches need to rely on an increase in donations or look for alternative sources of income and schools often need to increase tuition, which directly affects the families and students who attend.

You need flexibility in your benefits program.

Some churches are being led incorrectly by advisors who feel restricted by rules and regulations that other businesses need to adhere to. These advisors may not be aware that churches have certain regulations that don’t apply to them, or if they are aware, they don’t want to put in the effort to make those changes. This is an area that is often overlooked, that flexibility needs to become a reality for these churches.

Your advisor needs to know the variables that come into play when designing an insurance plan for your church or school. For example, some schools will pay teachers throughout the summer, while others don’t. This can impact policies and payrolls. It is critical your advisor understands these intricacies ahead of time.

When expanding into full benefits your advisor should be familiar with regulations for disability policies, enhanced benefits, cost-sharing options, and more. These options are very unique to schools and churches and need to be strategically planned and implemented. 

In these types of environments where your culture or mission is what attracts your workforce, not necessarily your payroll, it is important to ensure you know your options.

We have talked with schools where their families are paying $2000 a month in insurance because the organization has tried to go the route of a traditional business. That’s $24,000, when they may only make $30,000 a year in salary. This is unsustainable, unreasonable and can impact your organization’s ability to retain and recruit top talent. 

You need long-term solutions for your people. 

You need to work with an advisor that knows your organization from the ground up, that can come in from your standpoint. You need an advisor who knows your organization’s financial status and can help ensure you are offering the most appropriate, effective, and affordable benefits to your people. 

Specialty advisors, like us, know how churches, Christian schools, and universities work. We can recommend unique solutions to provide cost-effective and sustainable solutions for you and your employees. Solutions that can: 

  • Help protect your organization from the effects of unexpected cost increases.
  • Provide transparency so you can take back control of your healthcare spend.
  • Generate cost savings that can be used for your school, teachers, church, and/or community.
  • Create competitive benefits programs that work for your unique workforce, while maintaining affordability.
  • Support you and your people in every aspect of the program, so you can focus on teaching the next generation.

Your mission is important. 

The value of working with someone that has a similar mind and framework is unmeasurable. Tactically speaking, any advisor can figure out the system. They can offer a complete health insurance program for your organization, but if they don’t truly understand the nuts and bolts of your church or school, can you trust they are doing everything they can to protect your mission? 

We understand your finances and understand what your people go through on a day-to-day basis. Your benefits should be as unique as your organization.

We can create an ecosystem that helps you at every turn, we plan for the future and take care of the present so you can focus on helping your people and leading your organization.

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