What You Need to Know About the Affordable Care Act

We have already seen so many changes in the United States due to the enactment of the Affordable Care Act. The new law enforced nume495559275_fd6961c670rous changes that affected everyone who wanted or has health insurance. Today we have seen only a fraction of the true impact of healthcare reform.

Many in the small business community took advantage of the early renewal program that many carriers offered to their clients in 2013, which provided clients the opportunity to move their renewal date to December 1st. This in turn provided clients another year to “stall” the implementation of an ACA plan.

In a turn of events, President Obama had to reorganize with insurance carriers to allow employers the ability to keep their coverage that was in existence prior to January 1, 2014. Therefore, in 2014, employers have the ability to keep the coverage they had prior to 1/1/2014 or move to an ACA compliant plan.

Our goal is to highlight a few changes that you need to be made aware while reviewing your renewal.

  • Under an ACA Compliant plan, co-payments, deductibles and coinsurance will apply towards the out-of-pocket maximum.
  • ACA compliant plans, under the “small group market (under 50 lives)) have a deductible limit of $2,000 and the out-of-pocket max cannot exceed $6350.
  • Some carriers have structured the prescription drug card under ACA compliant plans to be less affordable as there is an additional cost to the insured if generic prescriptions are available, but a brand name drug is purchased instead.
  • There are limited plans which mean less mitigation techniques to help lower increases.
  • The rate structure for small groups (less than 50 lives) have age-banded rate tables in lieu of composite rates (tiered: Employee; Employee/Spouse; Employee/Child(ren) or Family.
  • Pediatric dental and vision services are included under the “small group” ACA compliant plans.
  • ACA prohibits health plans from imposing pre-existing condition exclusions.
Winter Maintenance Tips

Winter Maintenance Tips

Prevent Frozen Pipes:

Protect your home or business and avoid an indoor winter storm that can cause expensive damage. Water expands as it freezes and puts significant pressure on the metal or plastic pipes that hold it. Pipes that are exposed to extreme cold can burst when water expands; these include outdoor hose bibs, swimming pool supply lines, water sprinkler lines and water supply pipes.

Frozen pipes, both copper and PVC, can cause a lot a damage to your business. Pipes can burst and cause water to leak on interior walls and floors, causing expensive water damage that can go far beyond just the expense of repairing the pipes. A three millimeter crack in a pipe can disperse up to 250 gallons of water a day and creates an electrical safety concern.

Check all faucets in your establishment. When you turn on a faucet and only a trickle comes out, a frozen pipe may be at fault. Make sure that all employees know how to turn off the water valves in case a pipe does burst.

Products to Prevent Freezing

Spray Foam: Foam is sprayed into the wall to fill cavities around pipes where they may expand. It also will insulate walls and block airflow from them. When using spray foam, make sure you also caulk exterior joints on the outside wall near pipes.

Heat Tape: The tape plugs into a grounded outlet and is then spiral wrapped around pipes. Tapes have a built in thermostat that automatically call for power when the temperature drops near freezing and will power off when the temperature rises.

In-pipe Heating Elements: Devices are placed in water and sewer pipes and conduct heat directly into the pipe as needed.

Valve Units: Products are screwed onto faucets (usually outside) an prohibit water from going through when temperatures are too low. The valve sensor detectors low and high temperatures. When the low temperature is detected, the sensor opens a micro-valve to produce heat. As the temperature rises, the valve closes.

Additional Winter Maintenance Tips:

Add these supplies to your winter emergency kit:

  • Rock salt or more environmentally safe products to melt ice on walkways
  • Sand to improve traction
  • Snow shovels and other snow removal equipment
  • Sufficient heating fuel properly and safely stored

Additionally, you should create an emergency communications plan to know how to contact one another when disasters arise and what to do in case of an emergency.

    Other tips that can reduce your exposure to element risks include:
  • Awareness: Listen to a NOAA Weather Radio or other local news channels for critical information from the National Weather Service.
  • Minimize employee travel and ensure each company vehicle has an emergency supply kit with blankets and items to keep them warm if they experience a break down.
  • Winterize your building by clearing rain gutters, repair roof leaks and clear large tree branches that could break off and fall on the building or in areas people walk.
  • Caulk or put weather strips in doors and ensure maintenance is up to date on all heating equipment. Ensure chimneys have recently been inspected and cleaned.Make sure fire extinguishers are available and all employees know how to use and find.
  • If using heating devises, ensure there is proper insulation and placed in a safe location far from flammable objects. Ensure all carbon monoxide detectors/alarms have fresh batteries. To avoid carbon monoxide poisoning, do not use a generator, grill, or other gasoline, propane, natural gas or charcoal burning devise inside your business, garage, basement, crawlspace or any partially enclosed area. Also, locate the unit away from doors, windows and vents that could allow carbon monoxide to come indoors.
  • Insulate pipes with insulation or newspapers and plastic and allow faucets to drip a little during cold weather to avoid freezing. Running water, even a trickle will help to prevent pipes from freezing.

 In addition to insuring your valuables, SIA Group is committed to helping you and your business stay safe before disasters strikes.

Understanding Insurance Requirements on Construction Agreements

Understanding Insurance Requirements on Construction Agreements

By Sherry Whaley, Commercial Account Manager

On a daily basis, many contractors are required to create and sign several contracts in addition to submitting several bids to various contractors for work.  Once the job is awarded, the next step is to obtain an insurance certificate from their agent.  Along with obtaining the insurance certificate, the contractor needs to review the contract, submit W-9’s and a multitude of other items that need to be submitted before work can begin.

As an account manager and trusted adviser for my clients, I typically review the insurance requirements and begin analyzing the insurance portion of the contract to see what is required of the general contractor.  Below, is a review of insurance terms that are listed as requirements in most contracts.

Additional Insured Status:  The general contractor is asking to be included as additional insured, along with the project owner and other parties included in the contractual requirements.  The additional insured request may be requested on the general liability and the automobile liability. There are many additional insured endorsements to choose from, however, most contracts will require additional insured including completed operations coverage.

Waiver of Subrogation:  Waiver is a relinquishment of a known right.  The general contractor may request waiver on the general liability, automobile liability and the workers compensation policies.  Waiver of subrogation with respects to your general liability, auto liability and workers compensation, basically is stating that coverage will not be jeopardized if the insured has waived in writing prior to a loss any rights of recovery from a party responsible for the loss. This basically means if you request waiver of subrogation before a loss occurs, your insurance carrier may not subrogate (go back against) the general  contractors’ insurance coverage.

Primary and Non-Contributory: This is when the general contractor is requesting to transfer the financial consequences of legal liability arising out of the business relationship with the named insured. That means that in order to function effectively as a risk transfer technique, coverage that comes by way of additional insured status must respond first to a covered claim –before the additional insured’s own liability policy is called on to pay. The non-contributory wording is stating the general contractor is not wanting their insurance coverage to contribute to the loss.

Per Project Aggregate: The limit of liability would respond per project instead of applying per policy.

Cancellation Provisions:  Often times the general contractor will require 30 days cancellation guaranteeing return receipt, certified mail.  All policies will need to be endorsed to give 30 Days Notice of Cancellation for non-payment of premium if this provision is required.

Umbrella Policy- Normally an umbrella policy will be required by most general contractors.  The umbrella policy is excess coverage that follows form to your underlying policies: General Liability, Auto Liability & Employers Liability.  An umbrella policy would respond when your underlying policy limits have been exhausted.

Other insurance Requirements:

  • Pollution – Normally the contract will state the limit required
  • Mold- Normally the contract will state the limit required
  • Workers Compensation to be endorsed with special endorsements: US Longshore & Harbor(required when working over or near navigable waters), Jones Act, Admiral Act

This is of course not all of the items we see in construction agreements.  There are still other items you may be required to carry. Please feel free to call me on my direct line at 910-478-3316.

Umbrella Policies, Protection from any Storm

Umbrella Policies, Protection from any Storm

Sherry Whaley, AAI, CRIS, PWCA

Commercial Lines Account Manager

When most Americans think of an umbrella, they are more than likely to think about protection. Although, most assume the discussion involves weather, they are unaware of the significant “protection” they can receive from an umbrella insurance policy.

While many purchase an umbrella to protect their clothing from rain, too many are hesitant, or unaware of the value of protection they can purchase for their business or personal liability exposures. Simply put, insurance umbrella coverage offers an extension to underlying policies to manage additional expenses once funds from the policy have been exhausted. An umbrella policy can be written to go over just one line of coverage, or it can be written to go over commercial auto liability, general liability and employer liability.

It is necessary to learn about common claim severity cases related to your business or personal expenditures to ensure that you are aware and prepared for any incident. Several cases prove that a fall from a visitor at your business location or home can accrue costs from a large financial settlement that can easily surpass the primary liability limits of your existing business insurance policy, leaving you responsible for the rest.

As the economy shows a slow recovery, claim severity has continued to increase and has displayed no sign of slowing down. Such statistics and cases demonstrate more need to afford the additional coverage so that your business can focus on increased revenue versus recovery from a down economy in addition to a gap in coverage that failed to pick up where your business policy ended.

When revenues are down, it is the most important time to make certain that you are not neglecting insurance needs. According to Investopedia, businesses that are underinsured, or without broad, proper and adequate coverage, such as an umbrella, are taking needless risks that can lead to serious financial problems.

An umbrella insurance policy provides an additional layer of security to those who are at risk for being sued for damages to other people’s property or injuries caused to others in an accident. Such a policy is very helpful when the insurance owner is sued and the dollar limit of the original policy has been exhausted.

As with any storm, it is best to purchase the appropriate gear, such as an umbrella, to ensure that you are not only properly protected, but also fully prepared to endure any situation.

New Hospitality Carbon Monoxide Detector Regulation

New Hospitality Carbon Monoxide Detector Regulation

Cliff Patterson, Vice President Sales Executive

Cliff Patterson

The safety and security of hotel guests are one of the most important priorities of SIA Group. Carbon monoxide has killed nearly 400 people throughout North Carolina since 2011 according to a Charlotte Observer report. Although North Carolina is among the 27 states that require carbon monoxide alarms in new homes, it did not mandate detectors in hotels.

Months after three carbon monoxide poisoning fatalities in Boone, NC, Rep. Becky Carney, D-Mecklenburg, together with the NC Restaurant and Lodging Association and Building Code Council, persuaded legislative leaders to require North Carolina hotels to install carbon monoxide detectors near fuel-burning appliances.

Effective October 1, under Section 19 of House Bill 74, The Regulatory Reform Act, requires the North Carolina Building Code Council to adopt new code provisions requiring carbon monoxide detectors in certain places within every North Carolina lodging property. Lodging establishments must install carbon monoxide detectors in any enclosed space having a fossil fuel burning appliance, heater or fireplace and in any room that shares a common wall, ceiling or floor with an enclosed space with a fossil fuel burning appliance, heater or fireplace.

Some national hotels chains such as La Quinta Inn & Suites already require alarms to be installed at every location where there are pools with gas-fired equipment. Marriott also mandates detectors are to be placed wherever fuel-burning equipment is located within the hotel.

Smaller, or individually owned and operated establishments typically require each hotel to comply with federal, state and local laws and standards, including those related to health and safety and this change will have a direct impact on  such smaller establishments. Most mid-size hotels average two to three monoxide sources. Common examples of these appliances include water heaters and gas appliances in the hotel kitchen.

It is necessary to ensure the carbon monoxide detectors installed meet new code requirements:

  • Can be battery-operated or electrical
  • Can also be combined with smoke detectors so long as the smoke detector complies with the above mentioned requirements and compliant with ANSI/UL217.
  • Must be installed in accordance with either the standard of the National Fire Protection Association or the minimum protection designated by the manufacturer’s instructions.

Carbon monoxide is known as “the silent killer,” a colorless and odorless gas that is known to cause death or illness in minutes. SIA Group fully supports this new regulation and will continue to aim to keep our clients and each guest they serve safe throughout their hotel stay.

Injuries and Associated Costs

Injuries and Associated Costs

By Janet Srock, Commercial Lines Account Manager

Most employers have experienced staff members lose time and incur expenses due to work related injuries. Injuries often lead to surgery with periods of follow-up recovery and some form of physical therapy.

A recent study revealed surgery and follow-up treatment costs when paid under a workers compensation policy, averages 14 percent higher than when paid under private insurance. The same injury, the same severity, yet regardless of state in which the incident occurred, workers compensation costs will average 14 percent higher.

Employers understand how each workers compensation experience modifier is directly affected by the costs paid for treatment. Certainly, every employer wants to ensure injured employees receive proper care and attain a full recovery, however, at the same time, they need to control expenses that can affect the business and its overall finances.

The two can coexist and one of the best ways to eliminate costs are having knowledge of preventable risks and ensuring you are well equipped to eliminate such casualties. In order to ensure that employees receive proper care or treatment, it is beneficial to stay in touch with those injured while they are recuperating. Such communication can encourage employees to feel welcome to return to work as soon as authorized.

One way to assist a comfortable and earlier return is to develop a “light duties” program that will allow employees to return to work, in a limited capacity, while he or she completes the recovery process. The employer will pay a portion of wage while the workers compensation carrier pays the balance and associated cost.

The easiest way that an employer can better understand best practices to manage claims, is to utilize the services the case manager assigned by the insurance company provides. They understand the medical terminology, know how to communicate with both the care provider and injured employee and can also offer practical suggestions about the recovery process.

These three steps offer the opportunity to assist with controlling claim payments by the insurance carrier that can lead to a positive impact when experience modifications are recalculated.

For more information, contact your SIA Group agent or account manager. We are here to serve your insurance needs.

Commercial Cell Phone Policies

What you Need to Know About Employees Who Drive with Cell Phones

By Janet Srock, AAI, CISR, Commercial Lines Account Manager

Woman Driving a Car and Wearing Earphones --- Image by © Royalty-Free/Corbis

Virtually everyone makes use of cell phones or other portable communication devices daily.  But, do you do so when driving?

A recent study by the Insurance Institute for Highway Safety noted the potential for automobile accidents increases by 44% if the driver is using a mobile communication device.  Have you ever noticed the number of drivers who are engaged in some form of cell phone use while driving?

If you are one of the on road users, you place not only your personal safety and other vehicle occupants, at risk, but you place your personal and business assets at risk if you are the cause of an accident.

Does your business have a policy which restricts the use of cell phones while vehicles are being operated?  And, if you do, is it enforceable and observed by those driving on your business’ behalf?

If you own a business which employs on-the-road vehicle operators (drivers, sales personnel, or delivery name just a few), then your business assets are at risk.  It matters not whether they are operating a vehicle owned by your business or their own personal vehicle, in the event of an at-fault accident, the injured party attorney will be naming any and all parties involved and pursuing their assets.

We live in a lawsuit happy society.  Serious, at-fault accidents can result in multi-million dollar judgments and defense costs in our court system.  Since you cannot predict when or where an accident may occur, you must take the necessary steps to protect yourself, your business, and your assets.

Do you have an excess liability policy?  If you do, is the limit merely $1,000,000?  In our court system, that may prove inadequate.  If you do not have such a policy, you are at extreme risk.

Start that conversation with your current agent to be sure you have the correct preventative solutions in place to reduce your risk of a cell-phone related accident as well as the proper coverage should an accident occur.

Successful Productivity

Successful Productivity

Tosha Revell, Benefits Consulting Account Manager

Managers continually seek new ways to increase productivity in the workplace. One of the most successful methods is to provide positive reinforcement to employees and make certain they understand how valuable their role is to the company.

Overall well-being and performance is generated from the environment in which you work. As a manager, you have learned your position requires more than just instruction, observation and evaluation. Although such practices are necessary, successful managers understand that productivity in the workplace depends in large part on keeping employees motivated. By providing positive reinforcement, workplace morale will improve in conjunction with productivity.

Good communication between management and employees is another necessary contributor to better productivity. When managers effectively relate qualities and discuss areas of improvement in a constructive way, it can contribute to the development of informed employees who are better equipped to follow targeted incentives. Such efforts will assist managers to better lead employees to develop personal ownership and strive to assist efforts to meet the set goals of the company.

Consistent motivation is another key factor to help facilitate a healthy work environment.  If an employee feels hopeless from continual negativity, it is likely they will not care to increase productivity and may even try and find employment elsewhere.

Make opportunity to give praise, even for small achievements. Ensure that constructive criticism also provides direction on how they can better accomplish assigned tasks.  Employees need to be made aware of their success alongside areas of improvement.

Recognition for a good deed can boost willingness to work harder. Managers should understand how to effectively delegate responsibilities, ask for help and team opinion when making decisions. This can be accomplished during frequent meetings where your team can discuss progress and issues. This is the best way to enhance communication and will assist with building a stronger team. Such efforts develop stronger relationships and create a more enjoyable workplace. Successful meetings keep all employees engaged and informed about company changes, provide clear expectations and ask for feedback when discussing procedures.

Cross training is also important so employees do not feel less knowledgeable than others. All employees should have a general idea of the majority of employees and their responsibilities. Some can even be trained to provide assistance in the absence of others. In addition to cross training, product training will also enhance quality customer service. Employees who are knowledgeable are much more helpful and efficient. This will reflect positively on the company as a whole.

Taking these small steps to ensure your staff appreciates and understands your goals is a great starting point to help get better results, enhance productivity and meet goals.

Man’s Best Friend, or Insurance Carrier’s Worst Enemy?

Man’s Best Friend, or Insurance Carrier’s Worst Enemy?

Janet Srock, AAI CISR, Commercial Lines Account Manager 

“Man’s Best Friend.” That’s how the majority of people feel about their faithful, cuddly dog.  Owners consider them to be a loyal and loving family member that always greets them at the door with a wagging tail.

Your insurance carrier may not share that sentiment about your furry canine friend.

A recent report from the Insurance Information Institute noted that annually, approximately 16,000 pet related homeowner insurance liability claims are reported and damages are paid.  That number has remained relatively constant for the past ten years.

However, the amounts being paid by insurance carriers have not remained constant.  In 2003, the average amount paid on a dog bite claim was $19,162. In 2012, the average amount paid was $29,752.  That is an increase of 55% and far outpaces the rate of inflation.

In total, the insurance industry paid $490 million in 2012 for dog-bite related claims versus $324 million in 2003.   That $490 million accounted for 40% of all homeowner insurance liability claim payments in 2012.

Insurance companies do take note of such trends when formulating underwriting standards and base rates. That being said, does owning a dog affect your homeowner insurance premium?  Generally speaking, there is not a dog rating factor or surcharge.  Unless, of course, your dog has bitten someone or is of a breed deemed unsafe by the insurance industry.  Unsafe breeds can include Rottweilers or Pit Bulls.  For a complete listing of breed restrictions, contact your agent or carrier directly.

In the majority of states, including North Carolina, insurance companies can use a dog’s breed or history of biting to deny an application for homeowner insurance or to non-renew an existing policy.  When that happens, your agent often must look to an excess or surplus lines market for replacement coverage. This can result in either a higher premium, higher deductible or limits on coverage or all of the above.  Effectively, your homeowner insurance costs rise.

Considering the addition of a dog to the family circle?  Are you facing the replacement of the family pet due to age or poor health?  Give your agent a call to determine what impact, if any, this new family member may have on your homeowner insurance.

Such exposure also can impact a Commercial Lines policy as well.  Recently, during a review of a hotel and its loss runs, a guest suffered a dog bite from another guest who brought their dog inside. The carrier provided a $15,000 Open Reserve, an estimated cost to cover the loss accrued from this event. Such reserve may need to be used to possibly defend or pay for medical costs associated with the dog bite. Business and home owners both need to be aware of this commonly overlooked risk that can raise insurance expenditures.

Don’t Miss Out on Social Media

Don’t Miss Out on Social Media

Tosha Revell, Benefits Consulting Account Manager

Social media platforms provide valuable resources to increase consumer reach. Smaller businesses have started to integrate such methods along with use of traditional marketing tools. Social media proves to be one of the best and most cost effective ways to connect to people who were formally unreachable. Such new technologies enable companies to bond with new customers in a more personable way through networking and promotion by friends or other trusted sources.

Not only are these platforms being used more and more throughout the United States, but growth has extended to reach and develop quickly in other countries.  In the past, most consumers shopped at mom-and-pop stores that offered most services and products to local residents only. It was more difficult for smaller businesses to connect to consumers outside the area. New technology not only enhances the reach of products and services to consumers seeking, but also provides users with a low cost marketing solution and alternative to help them become more competitive in the marketplace.

Insurance is seen as a service-oriented industry.  How might social media be used to advertise an industry such as this? If we take a look at larger businesses, we can learn how they have restructured the way to manage social media. Such changes include new concepts and ways to provide the best service using the most convenient tool to communicate to customers. Some have even encouraged employees to use Facebook while at work to promote company interaction on the web.  This is a significant change since it was previously against corporate policies and heavily frowned upon.

Social media was thought of by many professionals as a personal tool. As society changes and these sites become more commonly used, it is now necessary to use in the business world.

Here are some ways social media can impact and grow business:

  1. Customer Support
  2. Public Relations
  3. Market Research
  4. New Product Development
  5. Sales
  6. Consumer education
  7. Promotion
  8. Advertising

A majority of people need fast solutions, services and products that are easy to find and also meet personal style and quality requirements. As consumers are becoming more acclimated to such on-demand techniques, they have started to expect it for all their shopping experiences. In order for businesses to remain competitive, they will need to provide relatively the same information as before, but in much shorter intervals. Social sites are one of the best ways to produce such material.  This can be accomplished through several methods such as mobile phone application, a post on Facebook or pictures on Instagram or Pinterest. Such innovative and instant connections are helping companies cater to a more targeted audience who have select preferred content that they offer.

As a business owner, it is imperative that marketing efforts remain creative to gain a presence in the social media scene.  Every business should find its own way to successfully adapt to this trend, or it is proven they will miss out on being noticed.