Insights Employee benefit strategies at work for you by connecting your business to the insurance resources that you need to attract and retain talented employees… Our Philosophy The current healthcare system is broken; cost from insurance carriers are skyrocketing, regulatory agencies are engaged in compliance chaos, and brokers lack a strategy or the resources to build a better healthcare model. WNC Health Insurance is different. WNC Health Insurance can help your employees and your business navigate a defective system with a better model that delivers superior outcomes. The WNC Health Insurance approach looks at how healthcare is accessed and delivered to your employees and the underlying financial framework that funds the employee benefit plan. Based on our review, WNC Health Insurance will match the most beneficial funding model with innovative benefit designs. WNC Health Insurance will implement unique pathways to access healthcare which deliver lower costs to employees and employers. Addressing the source of healthcare access and delivery is the first step to building a sustainable employee health plan. WNC Health Insurance can help you take that first step in the creation of a flexible solution for your business needs. Our Story WNC Health Insurance is a privately owned and independent firm headquartered in Asheville, North Carolina. We currently serve over 300 employers in North Carolina.

We have sustained double digit client growth for the last five years by embracing change, predicting outcomes, and acting nimble.

We provide our clients with as much information as they need to proactively adjust to a dynamic employee benefit environment.

We serve clients operating in Medical Care and Delivery, Legal and Tax Services, Manufacturing, Food Service, Brewing, Hospitality, Non-Profit Community Service, Information Technology and many more.

We are contracted with ALL major health and ancillary insurance providers and have access to unique health plans and health insurance quotes that are ONLY available to us. We design and implement health plans specific to a client’s appetite for risk to create an affordable healthcare model. Compensation Transparency Insurance Consulting Services For employers with more than 100 full time employees, agency fees are an add-on to the monthly billed insurance rates or a flat fee payment made by employer on a monthly or quarterly basis. Fees are disclosed, negotiated and approved by employer. Insurance Brokerage Services For employers with less than 100 full time employees, insurance carriers pay agency fees, not the employer. Fees are either a percentage of premium or a “Per Employee Per Month” (PEPM) Fee. Ready for a Conversation?

Financial Platforms Which platform will best meet your needs… Fully Insured Group Health Plans With a fully insured group health plan, the employer pays a fixed monthly premium and the insurance carrier assumes all claim liability risks. Major Insurance Carriers (i.e. Blue Cross NC, United HealthCare, Aetna) administer fully insured health plans for all sizes of employers. Plans are subject to all federal & state taxes and regulations. Level Funded Health Plans A level funded health plan is a partially self-funded plan with a fixed monthly premium. If the actual claims for the plan year are lower than expected, then the employer shares the savings with the insurance carrier at the end of the year. The employer retains a portion of the claim liability and contracts with the insurance carrier to cover excess claim liability. These plans are administered by major insurance carriers (i.e. Blue Cross NC, United Healthcare, Aetna) and employers must have more than 25 full time eligible employees and 20 employees enrolled in the plan to be eligible for coverage. These plans are exempt from many federal & state taxes and regulations. Self-Funded and Partially Self-Funded Group Health Plans The employer pays a variable premium subject to claim utilization, retains a portion of the claim liability and contracts with a reinsurance carrier to cover the excess claim liability. Partially Self-Funded Plans are administered by an insurance carrier or third party administrator and employers must have more than 50 full time employees to be eligible for coverage. Partially Self-Funded Plans provide extensive claims data which allows employers to customize their benefits to realize significant cost savings. These plans are exempt from many federal & state taxes and regulations. Variations of Partially Self-Funded Plans: Captives, Administrative Services Only (ASO) Plans, Association Plans, Multiple Employer Welfare Agreement Plans(MEWAs) & Cooperatives. Direct Primary Care Model Within a Self-Funded or Partially Self-Funded Group Health Plan How providers are paid matters. With this hybrid Self-Funded or Partially Self-Funded Plan, an employer contracts directly with primary care providers to achieve additional cost savings on claim utilization. The employer pays a variable premium subject to claim utilization, retains a portion of the claim liability and contracts with a reinsurance carrier to cover the excess claim liability. Partially Self-Funded Plans are administered by an insurance carrier or third party administrator and employers must have more than 50 full time employees to be eligible for coverage. Partially Self-Funded Plans provide extensive claim data which allows employers to customize their benefits to realize significant cost savings These plans are exempt from many federal & state taxes and regulations. Professional Services Organization (PEO) The employer contracts with a PEO to provide outsourced services in payroll, human resources, employee benefits, and tax compliance. Depending upon the cost savings per service, an employer can implement some or all the PEO’s services. A Co-Employment Arrangement is established creating shared liability allowing the employer to focus on their core competencies. The PEO manages all federal and state employee-related compliance including payroll taxes, human resource assistance, OSHA, and ACA. Ready for a Conversation?

Benefits & Services Employee Benefits Medical

Dental

Life

Short Term Disability

Long Term Disability

Vision

Critical Illness

Accident

EAP

GAP

Section 125 Premium Only Plans

FSA

HSA

HRA

COBRA Administration Bernie Portal On-Boarding and Benefit Administration System COBRA administration

Online personalized employee benefit enrollment process

24/7/365 employee access

Benefit statements

Payroll deduction reports

ACA reporting and compliance

PTO Tracking

Time and Attendance

API (real time) integration with leading payroll providers Legal, Regulatory & Financial Compliance Solutions Is your company in compliance? Let us help with… COBRA Employers must ensure all employees are aware of COBRA and its limitations. Businesses who fail to comply with all aspects of COBRA can face legal issues and financial penalties. IRS penalties include fines of $100 a day, per beneficiary, for noncompliance. ERISA Providing plan participants with important information such as the major features of the plan and how the plan is financed. (Plan documents & SPDs.) Fiduciary duties for those who manage assets covered by a plan. Setting up procedures for employee grievances about the plan, as well as an appeal for those grievances. The fines may not exceed $1,000 per day for each violation, for noncompliance. ACA The fines ARE $100 per day per beneficiary for each violation, for noncompliance. FMLA An employer may be liable for compensation and benefits lost by reason of the violation, for other actual monetary losses sustained as a direct result of the violation, and for appropriate equitable or other relief. IRS If 100 or more of your employees participate in a health and welfare benefits plan, you must complete IRS Form 5500. Failure to do so can mean possible criminal penalties for deliberate failure to report, and fines of up to $1,100 a day (per employee) for missing or incomplete information. HIPAA HIPAA violations are expensive. The penalties for noncompliance are based on the level of negligence and can range from $100 to $50,000 per violation. Medicare Part D Employers who sponsor group health plans must provide prescription drug coverage to Medicare Part D-eligible individuals. Insurance carriers certify whether or not a health plan is creditable; however, employers are responsible for the actual notifications and liable for con-compliance penalties. Non-Discrimination Testing Employers are obliged to ensure that their Flexible Spending Arrangements (FSAs), Health Reimbursement Arrangements (HRAs), Group Term Life Insurance, and Self-Insured Medical Plans do not discriminate in favor of Highly Compensated Individuals. The penalty for failure to meet the nondiscrimination tests is that the plan sponsor must pay an excise tax equal to $147 per day per non-highly compensated employee who is discriminated against, to a maximum of $500,000 per taxable year for inadvertent failures. Thus, for each employee affected, the annual penalty on the employer will be $36,500, subject to the annual cap of $500,000. CHIPRA Employers are responsible for the CHIP Notice which must be sent annually – not just to plan participants but also to each employee who is or might become eligible for employer group health benefits & should be part of annual open enrollment packet. Noncompliance could result in a penalty from the Department of Labor (DOL) of $100 per day per non-notified employee. Ready for a Conversation?

Employee Benefits Industry Partners Insurance / Benefits



























Benefits Administration

Payroll / HR / Employee Leasing







Legal, Regulatory and Financial Compliance



Advocacy

ACA Outreach & Education Advocacy for Individual North Carolinians We have partnered with Mission Hospital, Federally Qualified Health Centers (WNCCHS/Minnie Jones), and Buncombe County Health and Human Services to provide education, outreach, and an insurance home to those individuals without health insurance in Asheville, WNC, and throughout North Carolina. Ready for a Conversation?

Health Insurance for Asheville

and all of North Carolina since 1994

As local Asheville health insurance agents, we are here to help you find the best health insurance options available. Our agents are knowledgeable in health care enrollment requirements, and can help you find the right coverage for you and your business. WNC Health Insurance is here to serve as an Asheville health insurance resource. We are your one stop shop for the best health insurance in Asheville and all of North Carolina. Come and visit us at our Asheville health insurance store. We are the largest health insurance agency in Asheville and Western North Carolina. Our Asheville based health insurance agents have over 100 years of combined experience providing health insurance quotes, solving problems and exceeding expectations.

WNC Health Insurance is proud to work with many health insurance carriers, including but not limited to: Blue Cross Blue Shield of North Carolina® (Blue Cross NC), Aetna, Cigna, United Healthcare (UHC), Sun Life Financial, Healthgram, Principal, Crescent Health Solutions, UNUM, North Carolina Medical Society Employer Benefit Plan, Lincoln Financial Group, Guardian, The Hartford, and Delta Dental of North Carolina. We serve as agents and consultants that help individuals, families, and small to medium sized businesses in North Carolina, when they need direction regarding health insurance, employee benefits, financial platforms, small business health insurance, group health insurance, self funded health insurance, employer health insurance, small business group health insurance, and more.

We are your best source for Asheville health insurance! Call us now at (828) 681-8223