4 Point Compass Spring 2024

Chicago rookery building

What’s your group size?

Over many years, the Employee Benefits industry and Labor & Health insurance laws have created several “company size thresholds”, which should be monitored by employers and, in most cases, reported to their insurance carriers (as well as State & Federal governments).  The specific size thresholds for many of these laws/requirements vary and the measurement/calculation of these thresholds also vary, so an employer needs to follow the “counting methodology” (can be current or prior calendar year or averages) for each law/requirement.  The most common employee thresholds (and some applicable laws) to monitor: 

  • 10 employees – eFiling IRS returns or statements
  • 15 employees – American with Disabilities Act, Pregnancy Discrimination Act, Genetic Information Nondiscrimination Act
  • 20 employees – Medicare/Group health plan coordination, COBRA, Age Discrimination in Employment Act
  • 50 employees – Family Medical Leave Act, Applicable Large Employer (ALE) determination, ACA 1095 filing, health plan “Community rating” vs. “Experience rating” for certain states (including Illinois)
  • 100 employees – Medicare/Group health plan coordination, EEO-1 reporting, 5500 filing, Medical Loss Ratio segment, health plan “Community rating” vs. “Experience rating” for certain states 

At the end of each year, and/or prior to their health insurance anniversary date, Employers (both stand-alone, and those aggregated with other employers under common control) should maintain an accurate monthly headcount of full-time & part-time employees, follow the applicable counting methodology, determine if any threshold has been crossed, and prepare to alert the insurance companies and/or employees of any changes.

Zywave (formerly HR360) Resource available

Employee benefit & labor laws continue to provide human resources & compliance challenges to employers, so we wanted to remind you of a free service that Stumm Insurance provides to you.  All Stumm clients have access to the Zywave Portal – a website which provides a vast library of HR resources and guidance on issues such as compliance, benchmarking, legal questions, labor law, and many other areas.  Another popular feature is a library of video modules to use for employee training.  The video topics include:  Harassment & Violence, Drugs & Alcohol, Diversity, Hiring & Termination, Cybersecurity, Ergonomics, OSHA Compliance, HIPAA Compliance, Employee/Manager Success, Safety (including Workplace, Restaurant & Food, Transportation, Fire, and Health Care), and many more.  All information in the Zywave portal is accessed with a “search engine” function – think of it as a “Google for HR”.  If you have not previously taken advantage of this great resource (or do not have your log-in information), please contact your Stumm Representative to obtain a username and password.

Reminder:  Summary Plan Descriptions & Plan Documents necessary

Since its passage in 1974, ERISA requires employers with a benefit plan to maintain and distribute a Summary Plan Description (SPD) & Plan Document.  While the likelihood of being found without them is minimal, failure to have and provide these documents to employees (or to government agencies if audited) could result in a substantial penalty.  Many companies mistakenly assume that insurance contracts, certificates of insurance, benefits summaries and/or SBCs fulfill the ERISA requirements, but they do not include the required provisions that protect the employer completely.  Typically, these documents would be written by an Attorney or Third-Party Administrator.  Stumm Insurance may be able to help resolve this problem using an ERISA-compliant system that can create a customized “Wrap” SPD and Plan Document for your company, which wraps around your existing insurance carrier documents to comply with ERISA.  Please contact your Stumm Representative to initiate a discussion on steps to be taken if you do not have these documents currently or may have outdated documents. 

Crain’s Chicago Business, Best Places to Work 2023

Stumm Insurance is proud to announce that our company was, once again, selected as one of the top 100 companies in Crain’s Chicago “Best Places to work” list in 2023!  We are honored to be recognized, but truly acknowledge it is our employees that make working at Stumm such a positive experience.  That positivity directly stems from working with all of you, our great clients, on a daily basis.  So, we thank each and every one of you for helping us together achieve a spot on this esteemed list.

Should you have any further questions, please feel free to contact your Stumm Insurance Client Service Team.