WHITE PAPER. Key Strategic Differences in PEOs

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1 WHITE PAPER Key Strategic Differences in PEOs

2 TABLE OF CONTENTS Introduction 3 SECTION 1: Employee Benefits 4 PEO checklist - benefits 8 SECTION 2: PEO Billing Methods 9 PEO checklist - billing methods 11 SECTION 3: PEO Stability 12 PEO checklist - stability 16 Conclusion 17 About Nextep 17 nextep.com phone page 2

3 INTRODUCTION The increasing complexity of employer-related responsibilities and costs has resulted in more and more small businesses turning to Professional Employer Organizations (PEOs) for human resource activities such as employee benefits administration, payroll tax compliance, workers compensation management, and state unemployment insurance claims. PEO clients have higher growth rates than other small businesses. 1 PEOs provide a single provider platform to administer employeerelated responsibilities in one bundled and cost-efficient outsourced solution, offering business owners the chance to focus their energies back on the business and growing profitability. With a PEO, business owners have access to better and more affordable benefit and retirement plans than they might be able to obtain on their own. They can also utilize the expertise of dedicated, certified professionals in each of the PEO s core areas, expertise which is cost prohibitive to small business owners if attempting to hire in-house experts in these areas. Because of these many advantages, PEO clients have higher growth rates than other small businesses. 1 When evaluating Professional Employer Organizations (PEOs), business owners should consider three critical factors: Employee benefits services Billing methods The PEO s stability This white paper focuses on those three key differences, how to identify best practices within the PEO industry, and their financial implications on businesses. 1 National Association of Professional Employer Organizations (NAPEO). (2013). Professional Employer Organizations: Fueling Small Business Growth [White Paper]. Retrieved from NAPEO gathered data from independent third parties and found that companies working with PEOs have higher participation in retirement plans, have access to a broader selection of services at a lower price than they would find on their own, experience lower HR administration costs, and grow approximately 4% faster than other companies. nextep.com phone page 3

4 SECTION 1 Employee Benefits Services A key factor in choosing the right Professional Employer Organization (PEO) is the employee benefits design and the PEO s benefit planning services. Access to large group medical benefit plans is one of the largest reasons companies have turned to PEOs for a solution and competitive advantage. There are key benefits to being a part of a PEO s large multi-employer medical plan. A major advantage is the large-group buying power that can insulate the plan from losses and result in lower costs. Not all PEO providers have sufficient capabilities to structure and manage a large multi-employer plan. PEO evaluations should consider the organization s ability to obtain highly robust plan options at competitive costs. The ideal PEOs will be staffed with benefits experts who will work with the business owner to develop a long-term benefits strategy that fits the company s unique needs. Advantages to large-group benefit plans offered by PEOs include: Better premiums than small employers may be able to get on their own No exposure to community-based ratings based on the Affordable Care Act (ACA) Medical loss ratio (MLR) of 85%, rather than 80% Multiple flexible plan designs to choose from, including PPO, HDHP, HMO, and more Tracking and maintaining employee benefit information electronically Fully administered plans, including management of deductions, billing, payments, and COBRA Maintaining 100% compliance with the latest ACA regulations The PEOs that offer the large multi-employer medical plans have a unique advantage for their clients in these key areas and take on the regulatory and compliance challenges with the Affordable Care Act (ACA). nextep.com phone page 4

5 Does the PEO have a large multi-employer medical plan? Not all large group health plans available through PEOs are created equal. Out of pocket costs for emloyees may vary greatly among isurance providers and plan offerings. Some PEO medical plan designs allow the office visits and prescription copays to apply to the deductible as well as the maximum out-of-pocket costs, helping the employee achieve coinsurance sooner. An important distinction lies in whether the large group plan is average, or the best in its class. Best-in-class PEOs excel in finding consumer-driven solutions to control benefit costs. They offer a combination of flexible plan options from which clients may choose, including a range of deductible and coinsurance options. Not all large group PEO health plans are created equal. Out of pocket costs for emloyees may vary greatly. The following industry averages were found among PPO health plans in a study of companies with employees: Average Plans: Best in Class: Deductibles are most often over $2,500. Most plans offer coinsurance of 80%. Out-of-pocket max avg is $3,500 to $4,000. Prescription drug copays are $0-$49. Reactionary approach to health, paying for sickness at the minimum allowed rate, but failing to focus on solutions that help maintain the workforce s overall wellness. A range of deductibles and plan choices. Coinsurance is 80% to 100%. Out of pocket max average is $2,000 to $3,500. Prescription drug copays are $0 - $40, are not subject to the deductible, and offer significant discounts for mail order services. Focus on overall wellness, incentivizing doctors to monitor and maintain health. nextep.com phone page 5

6 Employee benefit strategy managers PEO providers should serve as the client s benefit consultant. This is not always a common service, and not all PEO providers have the expertise in more sophisticated financial modeling using Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs). HRAs have been increasing in popularity and can be coupled with HSAs to craft a money saving benefit strategy. Health Reimbursement Arrangements Many companies have found success by offering plans with higher deductibles at lower premiums, but shielding employees from those deductibles using a combination of Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs). HRAs have proven to be a highly effective strategy for many companies in reducing overall costs in medical benefits while having the flexibility in determining the deductible. National averages of people that actually meet their deductibles are surprisingly low: 32% don t spend anything 72% spend less than $500 81% spend less than $1,000 88% spend less than $2,000 A simplified scenario will add some clarification using a 20 employee group (see Table 1): Premium Costs: Annual premiums, $1000 deductible: $120,000 Annual premiums, $5000 deductible: $60,000 In this example, the company utilizes the $5000 deductible plan and offers an HRA to cover $4000 of the deductible. The company immediately saves 50% on premiums by opting for the plan with the $5000 deductible, but the employee s actual exposure is still only $1000. Potential HRA Costs: HRA liability at 20% utilization: $16,000 HRA liability at 40% utilization: $32,000 HRA liability at 60% utilization: $48,000 This illustrates that over 60% of the entire workforce would need to utilize their full deductible in a calendar year before the company would be liable for the same costs of just purchasing the $1000 deductible plan. Most companies are over spending on their benefits based on true utilization data. Surprisingly, few PEOs are helping their clients design better benefit strategies with the use of these effective products. nextep.com phone page 6

7 $120,000 Potential costs: 60% HRA utilization $100,000 Potential costs: 40% HRA utilization $80,000 Potential costs: 20% HRA utilization $60,000 Annual costs: $1,000 deductible Annual costs: $5,000 deductible $40,000 $20,000 Table 1 The table illustrates the potential estimated cost difference between purchasing a plan with a $1,000 deductible versus a plan with a $5,000 deductible. By purchasing the $5,000 deductible plan, the employer immediately saves 50% in premium costs. The employer can then use that savings to fund a Health Reimbursement Arrangement (HRA) to assist employees with deductible costs. Even with 60% full utilization of the deductible, which is rare since 88% of people spend less than $2,000 annually towards their deductibles, the employer s out of pocket costs are still $12,000 less than the plan with the $1,000 deductible. Embedded deductible One of the vast differences in how much out-of pocket health care costs an employee will experience lies in whether the deductible is embedded or aggregated. It is important to understand how the medical plan s deductibles work because there could be unforeseen financial exposure. Some plans utilize aggregate deductibles, which can impose a much larger financial burden on employees with dependent plans. Aggregate deductibles require the entire family deductible to be met before the co-insurance takes effect, even if just one family member is treated. This is often the case with high deductible health plans (HDHP), making up for the reduced premiums by withholding coinsurance for a longer period of time. Embedded deductibles provide less financial burden on the family. With an embedded deductible, the individual deductible is assigned to each family member. Once that family member has met his or her individual embedded deductible, co-insurance is activated for that person. The covered person won t have to wait until the entire family deductible is met before co-insurance is paid, which can mean significant savings for employees with their out-of-pocket health care costs. nextep.com phone page 7

8 Control and flexibility in benefit design Some PEOs take a controlling position in which ancillary benefits must be purchased in conjunction with other benefits. For example, the medical plan must include the life insurance or other products in the PEO s benefit offering. A PEO that is the best in its class offers medical and ancillary products that stand independently and allow the company and employees to choose which products best serve their needs. PEO checklist - benefits When evaluating PEOs, use the checklist to determine whether the PEO in question offers the most competitive employee benefits options for your company. Does the PEO have a large multi-employer plan? Does the PEO Offer health benefits with a national carrier, such as Aetna or UHC? Do copays and coinsurance go toward the annual maximum out-of-pocket? Does the PEO have experts who can help your company craft a benefits strategy? Does the PEO have HRA administrative expertise? Is the deductible embedded? Are benefits packages and offerings flexible? nextep.com phone page 8

9 SECTION 2 PEO Billing Methods There are two basic PEO billing methods: the bundled approach and the transparent approach. Bundled billing has historically been used by PEOs in an effort to consolidate costs into one line item, with the intention of simplifying the various charges. In reality, though, PEOs have the potential to use this bundled approach to obfuscate and inflate charges, preventing the business owner from knowing exactly where and how their dollars are being spent. When searching for a PEO, the transparent billing approach better allows companies to manage their costs. This transparency allows business owners and the PEO to work together to find opportunities for savings. They can begin by ensuring that all applicable tax cutoffs are being honored, such as those paid under the Federal Insurance Contributions Act (FICA), the Federal Unemployment Tax Act (FUTA), and the State Unemployment Tax Act (SUTA). The PEO Consultant can then target the benefits expenses and collaborate with the business owner to find creative strategies that contain costs while maintaining the same level of coverage. The bundled and transparent billing approaches can be better understood through invoicing examples. Bundled billing The bundled approach combines all of the PEO services and costs into a single percentage based on the annual wages. These costs include all of the various components involved in employing people, including workers compensation, state and local payroll taxes, state and federal unemployment taxes, administrative fees, retirement plan contributions, and employee benefits. The various costs are added together, averaged, and represented as a single percentage indicative of aggregated charges. The invoice line item often appears as follows: Administrative Costs $4, When these components are bundled together, it is difficult to truly understand the individual costs. To obfuscate the numbers further, some PEOs include employer benefit costs in the total percentage. In the age of vast reform to health care regulations and plans, it is vital that owners of small and medium-sized businesses truly understand their benefits-related costs in order to develop a long-term solution that mitigates the sharp rate increases that some companies are experiencing. nextep.com phone page 9

10 Transparent billing The transparent approach simply breaks down all of the PEO s costs and shows client fees allocated appropriately. Nextep utilizes a transparent billing method, allowing clients full knowledge of fees. The invoice line items often appear similarly to the following example: Gross Wages Workers Compensation FICA - OASDI FICA - Medicare FUTA SUTA Administrative Fee 401k Medical Benefits Dental Benefits Life Insurance Subtotal, TX Office $3, $57.46 $ $52.53 $21.74 $97.81 $34.51 $82.40 $ $18.50 $12.75 $4, Flat rate administrative fee vs. a percentage of payroll Bundled and transparent billing options typically charge using either a flat rate or by calculating a percentage of the gross payroll. Flat rate simply means that the PEO charges a fixed dollar amount per employee per paycheck (for example $45) vs. a percentage of wages. Generally, the flat rate is easier to understand and often saves money when clients give their employees raises or bonuses. A $5,000 bonus, for example, would only be subject to the $45 flat rate administrative fee, as opposed to $165 when billed at a percentage rate of 3.3%. nextep.com phone page 10

11 The example below further illustrates the difference between the annual costs for percentage vs. flat rate billing when employees receive a cost of living increase. Percentage Billing: Flat Rate Billing: Q Q # of employees: 35 Annual Payroll: $1,400,000 Admin Percentage: 3.3% Cost of Living Increase: 3% Annual Admin Fee Increase: $1,386 Q Q # of employees: 35 Annual Payroll: $1,400,000 Admin Flat Rate: $45 Cost of Living Increase: 3% Annual Admin Fee Increase: $0 In the example above, a 3% cost of living increase to employees causes the annual payroll amount to also increase. Since the percentage method of billing is based on the payroll amount, a higher annual payroll means a higher administrative fee. In the example with the flat rate, the administrative fee is not based on annual payroll amounts. Therefore, the cost of living increase has no bearing on the flat rate administrative fee; it remains stable. A reputable PEO works to make the client s process of understanding current labor costs as simple and painless as possible. PEO checklist - billing methods When evaluating PEOs, use the checklist to determine whether the PEO in question offers the most competitive billing options for your company. Is the PEO s billing transparent? Is the administrative fee a flat rate? nextep.com phone page 11

12 SECTION 3 PEO Stability While most PEO menus of services are fairly similar, there are several factors that can separate the best in class in the industry from those who may not be as reputable. NAPEO offers information that can aid in the selection of a PEO, including the following points 2. Determine if the PEO has a history of adhering to professional industry standards, such as those put forth by the Employer Service Assurance Corporation (ESAC) and Certification Institute (CI). Determine if the PEO s workforce can adequately meet your company s goals. Investigate the staff s level of expertise, professional designations, and alignment of service priorities in relation to your own. An additional point to consider is the PEO s technology platform. Business owners should ensure that the PEO is capable of providing a powerful yet simple technology interface that all employees can access. In evaluating a PEO s stability, the business owner can pay particular attention to ESAC accreditation, service teams, and technology. Employer Services Assurance Corporation (ESAC) ESAC is the PEO industry s nationally recognized accreditation and financial assurance program. Similar to FDIC for banks, ESAC is an independent nonprofit corporation that verifies different areas of a PEO to ensure that the organization is financially and ethically stable. Specifically, ESAC ensures: The PEO has ongoing financial stability. The PEO s procedures are in compliance with federal and state government regulations. The PEO employs ethical business conduct. 2 National Association of Professional Employer Organizations. (2014). Selecting a PEO. What is a PEO? Retrieved from NAPEO also recommends that companies ask for professional references, determine if the PEO is a member of NAPEO, understand the funding of employee benefits (fully insured or self-funded), review the CSA carefully, and ensure that all state regulations are met. nextep.com phone page 12

13 PEOs must withstand regular rigorous third-party audits confirming their adherence to these standards in order to earn and maintain ESAC accreditation. The best PEOs hold ESAC accreditation. 3 ESAC provides financial protection to PEO clients with a $1 million surety bond per PEO and $15 million in excess coverage, as well as quarterly verification of compliance with timely payment of state and federal payroll taxes, contributions to employee retirement plans, and payment of health insurance premiums. The best PEOs hold ESAC accreditation. 3 This assurance means that the organization has done considerable work to ensure the financial stability, regulatory compliance, and ethical business practices not only for the PEO, but also for the benefit of all of the PEO s clients. If researching a PEO that lacks this accreditation, ESAC recommends that the business owner seek the services of a CPA or attorney to evaluate the PEO s most recently audited financial statements and verify that the PEO is in good standing with any state registration or licensing requirements if applicable. 4 To find a PEO that is ESAC accredited, visit 3 Worth, J. (2014, May 1). Take a Load Off Your HR. Entrepreneur. Retrieved from This article describes PEOs and the ways that they can help small businesses, including using economies of scale to obtain more affordable and robust benefit plans, experienced professionals to handle administration of HR, benefits, workers compensation, and payroll, and regulatory compliance. 4 Employer Services Assurance Corporation. (2014). How to Choose a Reliable PEO. Retrieved from peo-selection-criteria. In addition to verifying recently audited financial statements for non ESAC-accredited PEOs, ESAC recommends that the business owner or proxied attorney or CPA request a letter from the PEO s auditor certifying that the financial statement(s) cover all entities under common ownership in order to deliver a complete and accurate picture of the PEO s financial stability. ESAC s financial guide at accessesac.org/business/standards-and-procedures?t=financial offers additional screening criteria if examining a PEO that is not ESAC accredited. ESAC also recommends that PEOs be in current good standing with the Certification Institute (CI), certifying the organization s workplace safety and workers compensation experience. For more information about CI, visit nextep.com phone page 13

14 Designated service team It is important to have a dedicated service team that has an intimate understanding of each company s unique operations, rather than a randomly-assigned call center. The team should include account managers in each of the core areas the PEO serves, including benefits, human resources, risk, and payroll. The designated account manager acts as the primary source of contact to serve as the company s point person. The Service Team will differ from one PEO to another, but in general, the service team may look similar to below. New Client The New Client team proficiently implements new groups as they sign on with the PEO. The New Client representative acts as the point of contact during the first weeks or months of the PEO relationship, ensuring each client is transitioned efficiently and given specialized attention to ensure a flawless conversion. Benefits Benefits representatives are experts in employee benefits and health care reform. Best-in-class PEOs have one or more Affordable Care Act-certified employee(s) on staff. Benefits representatives administer benefits plans and answer any benefits questions brought forth by the client or client s employees. A best-in class benefits team works with the client to develop a long-term employee benefits strategy tailored to each company s needs, performing on-site benefits orientations to educate and enroll employees in their new benefits plans. Human Resources Human Resources (HR) representatives stay up-to-date with the latest employer regulations and best practices and are available to consult with clients on matters of compliance or employee-related questions and tasks, including employee discipline, hiring, termination, policies, FLSA legislation, and more. Best in class PEOs include HR team members that hold Professional in Human Resources (PHR), Senior Professional in Human Resources (SPHR) accreditation from HRCI, or Society for Human Resource Management - Certified Professional (SHRM-CP) or SHRM - Senior Certified Professional (SHRM-SCP) accreditation. Risk Management Risk Management, or workers compensation, representatives specialize in reducing risk and preventing injuries for clients and their employees. Best in class PEOs are workers compensation certified through The Certification Institute (CI), meaning they implement and abide by Best Practice Techniques in the areas of loss prevention and claims management for each client location. nextep.com phone page 14

15 Payroll Payroll representatives utilize skill, experience, and sharp attention to detail in administering payroll for clients. This department is responsible for processing and distributing checks and garnishments, managing direct deposits, and delivering customized reporting to suit each company s requirements. Best in class PEOs include Payroll team members who hold American Payroll Association s (APA) Fundamental Payroll Certification (FPC) or Certified Payroll Professional (CPP) accreditation. Human Resource Information System (HRIS) technology A cloud-based HRIS provides online access for both the business owner and his or her employees. It provides secured, online access to the company s HR account, payroll, and benefits information and reports. The PEO s HRIS also provides employees with individual online access to their own personal payroll and benefits information, as well as important company documents such as company policies, benefit materials, and the employee handbook. The PEO s HRIS should offer multiple functionality to both the business owner and employees, including: Client HRIS capabilities: Input payroll hours Access account information Hire and terminate employees View benefits information View and edit 401(k) account information View, download, and approve payroll reports Assign appropriate security levels Access forms View and download HR reports View PTO balances Adjust pay rates Input, edit, and store employee information Access electronic pay stubs Manage labor allocations Employee HRIS capabilities: View personal pay information and download electronic pay stubs Edit personal information View and edit 401(k) information Access benefits information and complete benefit enrollments. Access the company s employee handbook View and reprint W2 Complete new hire forms online View PTO balances Manage direct deposit accounts nextep.com phone page 15

16 Security and continuity are two very important factors in evaluating a PEO s HRIS platform. To ensure the safety of sensitive information, data should be password-protected with limited access and secured with an enterprise-level firewall infrastructure and data encryption. To ensure business continuity and timely paycheck delivery, the PEO should have technology built into and heavily utilized in its emergency backup plan, including off site work capabilities and system back-up in real time to a fortified off site FEMAcertified and seismic-rated bunker. A live web demo can help business owners evaluate the match of the HRIS platform to the company s needs, including integration of all modules, customization capabilities, and functionality with more complex business operations. PEO checklist - PEO stability: When evaluating PEOs, use the checklist to determine whether the PEO in question offers stability, security, and longevity. Is the PEO accredited by ESAC? Are there designated account managers who are familiar with your company? Does the PEO have professionally-accredited employees in each of the core service areas? Does the PEO s HRIS include robust, secured functionality for both clients and employees? Does the PEO have a disaster recovery and business continuity plan in place for the HRIS? Does the PEO offer web access for client adminitrators and employees? Is the PEO s technology platform and sensitive employee information robustly secured? Does the PEO utilize a paperless environment? Has the PEO demonstrated successful business longevity? nextep.com phone page 16

17 CONCLUSION While PEOs can offer numerous advantages to small and medium-sized companies, it is important to ensure that the PEO offers the benefits, transparency, and stability that today s business owners need. In summary, business owners should consider the following factors when evaluating PEOs: Employee benefits services should include best-in-class, flexible plan offerings that are compliant with current and upcoming Affordable Care Act regulations. A strategic benefits partner can find innovative ways to offer robust plan options that save money for both the business owner and for the employees. Billing methods can illuminate or obfuscate a company s true costs for employee benefits, human resources services, workers compensation insurance, and payroll. Choosing a PEO with transparent billing allows business owners to see the costs for each component and budget accordingly. PEO stability is important in protecting the client company from liability. At a minimum, business owners should ensure that the PEO holds all of the legally-required licenses, offers a tightly secured HRIS, and has a business continuity plan in place. Utilizing the checklists at the end of each section can assist in determining whether the PEO meets the necessary business needs and excels as an industry leader. All material Nextep, Inc All rights reserved. Although we go to great lengths to ensure that our advice and information is accurate and useful, it is not legal advice and is not intended to create a lawyer-client relationship between Nextep, Inc. and the receiver of this transmittal. nextep.com phone page 17

18 ABOUT NEXTEP Nextep is a full-service, professionally accredited Professional Employer Organization (PEO) that has been serving the needs of small businesses across a broad range of industries throughout the country since Nextep collaborates with clients to manage administrative tasks, allowing business leaders to focus on the company s bottom line. Nextep s dedicated team of experts in human resources, benefits, risk management, and payroll will meet the organization s unique needs while offering consistently exceptional customer service. National Technology Center Norman, OK + Nextep, Inc. + nextep.com + + Phone

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