Capstone Group Recognized as an Inc. 5000 Fastest-Growing Company
NEW YORK, August 18, 2021 – Inc. magazine today recognized Capstone Group on its annual Inc. 5000 list, the most prestigious ranking of the nation’s fastest-growing private companies. The list represents a unique look at the most successful companies within the American economy’s most dynamic segment—its independent small businesses. Intuit, Zappos, Under Armour, Microsoft, Patagonia, and many other well-known names gained their first national exposure as honorees on the Inc. 5000.
Not only have the companies on the 2020 Inc. 5000 been very competitive within their markets, but the list as a whole shows staggering growth compared with prior lists as well. The 2020 Inc. 5000 achieved an incredible three-year average growth of over 500 percent, and a median rate of 165 percent. The Inc. 5000’s aggregate revenue was $209 billion in 2019, accounting for over 1 million jobs over the past three years.
Complete results of the Inc. 5000, including company profiles and an interactive database that can be sorted by industry, region, and other criteria, can be found at www.inc.com/inc5000. The top 500 companies are also being featured in the September issue of Inc., available on newsstands August 18.
“The companies on this year’s Inc. 5000 come from nearly every realm of business,” says Inc. editor-in-chief Scott Omelianuk. “From health and software to media and hospitality, the 2020 list proves that no matter the sector, incredible growth is based on the foundations of tenacity and opportunism.”
The annual Inc. 5000 event honoring the companies on the list will be held virtually from October 23 to 27, 2020. As always, speakers will include some of the greatest innovators and business leaders of our generation.
More about Capstone Group
Capstone Group is an independent risk management, employee benefits, and insurance brokerage firm. Headquartered in the suburbs of Philadelphia, serving clients across the United States.
Founded in 2013, Capstone embraces the idea of being an emerging firm in a mature industry, focused on providing results-driven solutions that transcend what people and organizations have come to expect from traditional insurance and benefits brokers.
In a world defined by uncertainty, we partner with our clients by adhering to our foundation of values:
We are people-focused and motivated by a genuine compassion for our employees, our customers and their employees, and our community at large.
CONTACT:
Home Office: 215-542-8030
General Inquiries: info@capstonegrp.com
Website: www.capstonegrp.com
More about Inc. and the Inc. 5000
Methodology
The 2020 Inc. 5000 is ranked according to percentage revenue growth when comparing 2016 and 2019. To qualify, companies must have been founded and generating revenue by March 31, 2016. They had to be U.S.-based, privately held, for profit, and independent—not subsidiaries or divisions of other companies—as of December 31, 2019. (Since then, a number of companies on the list have gone public or been acquired.) The minimum revenue required for 2016 is $100,000; the minimum for 2019 is $2 million. As always, Inc. reserves the right to decline applicants for subjective reasons. Companies on the Inc. 500 are featured in Inc.’s September issue. They represent the top tier of the Inc. 5000, which can be found at http://www.inc.com/inc5000.
About Inc. Media
The world’s most trusted business-media brand, Inc. offers entrepreneurs the knowledge, tools, connections, and community to build great companies. Its award-winning multiplatform content reaches more than 50 million people each month across a variety of channels including websites, newsletters, social media, podcasts, and print. Its prestigious Inc. 5000 list, produced every year since 1982, analyzes company data to recognize the fastest-growing privately held businesses in the United States. The global recognition that comes with inclusion in the 5000 gives the founders of the best businesses an opportunity to engage with an exclusive community of their peers, and the credibility that helps them drive sales and recruit talent. The associated Inc. 5000 Conference is part of a highly acclaimed portfolio of bespoke events produced by Inc. For more information, visit www.inc.com.
For more information on the Inc. 5000 Conference, visit http://conference.inc.com/.
Cyber Threat: What is "Social Engineering"?
Insight Provided by NortonLifeLock
Most cybercriminals are master manipulators, but that doesn’t mean they’re all manipulators of technology — some cybercriminals favor the art of human manipulation.
In other words, they favor social engineering, meaning exploiting human errors and behaviors to conduct a cyberattack. For a simple social engineering example, this could occur in the event a cybercriminal impersonates an IT professional and requests your login information to patch up a security flaw on your device. If you provide the information, you’ve just handed a malicious individual the keys to your account and they didn’t even have to go to the trouble of hacking your email or computer to do it.
As with most cyber threats, social engineering can come in many forms and they’re ever-evolving. Here, we’re overviewing what social engineering looks like today, attack types to know, and red flags to watch for so you don’t become a victim.
Thomas Fox named as Risk Management Advisor
We are pleased to announce the promotion of Thomas Fox to the position of Risk Management Advisor within Capstone’s Commercial Property & Casualty division, effective March 1st, 2021.
Since joining Capstone in 2019, Tom has been an integral part of Capstone’s client services team, serving as both an Assistant Account Manager and an Account Executive. In those roles, Tom was responsible for overseeing the day-to-day insurance and complex risk management needs of corporations and non-profit organizations of all sizes.
Through his training and experience, Tom has developed a skillset that makes him an asset to Capstone’s current and prospective clients, including but not limited to: safety & risk assessments, contract reviews, claims management, cost & coverage analysis, and carrier negotiations.
In his new capacity as a Risk Management Advisor, Tom will be responsible for business development and identifying organization that would benefit for the products and services offered by Capstone’s Commercial Property & Casualty division. In addition to making connections within his personal network, Tom will also represent Capstone within the many organizations and associations the firm currently supports, including the Philadelphia Chamber of Commerce, the MidAtlantic Employers Association, and Life Sciences PA.
Tom is a graduate of St. Joseph’s University in Philadelphia and currently resides in the city’s Fairmount neighborhood. He is passionate about expanding his knowledge and following trends of the evolving insurance industry and was recently awarded the Commercial Lines Coverage Specialist (CLCS) designation.
For Immediate Release: PRMA Announces Pennsylvania Chapter
Capstone is proud to announce that Colin Williams, Private Client Advisor, has been named Chair of the newly-formed Pennsylvania chapter of the Private Risk Management Association (PRMA). This recognition is a testament to Colin’s dedication to advancing Capstone’s capabilities within the personal insurance marketplace and to protecting his client’s assets and standards of living.
Colin Williams - Private Client Advisor
Email: cwilliams@capstoneinsgroup.com
2021 Benefits Compliance Guide
To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2021. Employers should review their plan documents to confirm that they include these required changes.
In addition, any changes to a health plan’s benefits for the 2021 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM).
Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, when applicable—for example, the summary of benefits and coverage (SBC). There are also some participant notices that must be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.
Can We Require Employees to Get Vaccinated for COVID-19?
Author: Amy G. McAndrew, Esq. - MidAtlantic Employers Association
Almost a year into the COVID-19 pandemic, there is a light at the end of the tunnel. Vaccinations began going into arms this week in the United States. As a result, many employers are asking whether they can make the COVID-19 vaccine mandatory for their employees. The answer is not clear and may depend on many factors. In making the best decision for your workplace, consider the following.
The ADA
Under the Americans with Disabilities Act (ADA) and corresponding state law, employers have the right to establish legitimate health and safety requirements that are job-related and consistent with business necessity. This may include immunization requirements in businesses that deal with the public. Healthcare organizations (hospitals, doctor’s offices, retirement communities, etc.) traditionally have required mandatory flu vaccines, and those same employers likely will mandate COVID-19 vaccines. Keep in mind that some employees will have legitimate reasons for refusing the vaccine, and employers must consider reasonable accommodation on the basis of disability and religion.
Availability
The Centers for Disease Control and Prevention (CDC) and state Departments of Health (DOH) have recommended that certain groups receive the vaccine first, and the vaccine likely will not be available to the general population until sometime next spring. An employer cannot mandate a vaccine that is not available to its employees.
Is the Workplace Unionized?
Workplaces with labor unions may have other considerations, such as whether the employer can issue a vaccine mandate without first bargaining with the union.
Safety Concerns
Even in non-union settings, employees have the right to engage in protected concerted activity under the National Labor Relations Act (NLRA), in addition to the right to protest unsafe working conditions. This could extend to vaccination requirements. For example, if employees band together to express safety concerns over the COVID-19 vaccine and refuse to be vaccinated, they may be protected under the NLRA as well as state and federal laws that prohibit retaliation for raising workplace safety concerns.
Are You Prepared to Terminate Employees Who Refuse Vaccination?
If the employer mandates the COVID-19 vaccine, it needs to be prepared to terminate employees who refuse vaccination. Particularly given the current economic climate, employers should consider whether they are willing to see talent walk out the door and expend the time, energy and money it will take to recruit, onboard and train replacements.
Do You Want to Be the Test Case?
Without a doubt, a number of employers will mandate the COVID-19 vaccine, and there likely will be legal challenges. One of the additional considerations, therefore, will be whether an employer wants to turn itself into a test case in the court system.
Given the above, an employer may want to consider a carrot rather than a stick approach to COVID-19 vaccination. This means making it as easy as possible for employees to get vaccinated by: educating employees about the importance and safety of the vaccine, using available CDC and DOH information; confirming insurance coverage and informing employees of the cost of getting vaccinated; once the vaccine becomes available to your workforce, explaining to employees where and when they can get vaccinated; and giving employees ample time (consider an hour of paid time) to get vaccinated.
Employers should consult with experienced human resources professionals and/or labor and employment counsel with any questions regarding pandemic-related policies or practices. For MEA members, the Hotline and a Member Legal Services attorney are available to provide this assistance.
Guidance provided by:
Amy G. McAndrew, Esquire
Director of Legal and Compliance Services
MidAtlantic Employers' Association
800-662-6238
*This Alert is provided for general informational purposes only and does not constitute legal advice.
Health Insurance & The COVID-19 Vaccines
As we step closer to the availability of the vaccine to the general population, employer groups will be considering many variables for their employees, including the availability of the vaccine, how their workforce fits into the phased rollout, vaccine costs, and what can be done now to prepare. In an effort to help local organization navigate these topics within the framework of their employer-sponsored medical plans, the Capstone Benefits Team has consolidated the most recent guidance being provided by the largest health insurers in our area:
Independence Blue Cross:
IBX does not specifically address how the plans will cover vaccinations, however the federal government has committed to providing the vaccine itself to the American public at no cost)
Click to Read More: IBX COVID Vaccine Update
Aetna:
Aetna will cover the cost of COVID-19 vaccines and their administration without cost sharing for Aetna members in all plans. Our coverage aligns with requirements in the CARES Act and the recent federal regulation. The requirement also applies to self-insured plans.
COVID-19 vaccinations will be available at pharmacies, including CVS, as well as doctors’ offices at other clinical sites of care. HHS recently announced a federal government partnership with large pharmacy chains and community pharmacies to access and administer COVID-19 vaccines as they become available.
Click to Read More: Aetna Vaccine FAQs
Cigna:
Will the vaccine be considered a preventive service waiving cost share for an employer’s workforce?
Any vaccine that receives FDA approval and is recommended by CDC (in partnership with guidance from ACIP), will be covered as a preventive service.
Will my health plan with Cigna cover the cost of a COVID-19 vaccine?
The vaccine will be covered as a preventive service. Initially, the cost of the vaccine serum will be paid by the government. We expect that providers’ charges for administering the vaccine will be paid under your Cigna medical plan, the same as any other immunization administration charge. We also expect that members enrolled in plans that cover preventive services at 100% will incur no additional cost.
Click to Read More: Cigna - Understanding COVID19 Vaccines
United Healthcare:
When COVID-19 vaccines are authorized by the FDA, members will have $0 cost-share (copayment, coinsurance or deductible), no matter where they get a vaccine, including when two doses are required, as outlined below:
Employer and Individual health plans: Members will have $0 cost-share at both in- and out-of-network providers through the national public health emergency period. This applies to fully insured and self-funded commercial health plans.
Click to Read More: UHC Preparing for COVID-10 Vaccine Authorization
For more information or company-specific questions, please contact Sr. VP of Benefits, Joseph Fox:
Email: jtfox@capstoneinsgroup.com
Update: Workers Compensation Coverage for COVID-19
The COVID-19 pandemic has brought the discussion of “presumption laws” to the forefront, as states examine whether workers’ compensation should cover workers if they contract COVID-19 on the job.
What is a “presumption law”?
A presumption law describes the conditions where an employee injury is presumed to have happened on the job and should be compensable under workers compensation coverage. The burden of proof for most work-related injuries typically rests on the injured worker. However, under presumption laws, the burden falls on the employer.
What is changing due to COVID-19?
A key exclusion for nearly all presumption laws in the past is that they have not covered infectious diseases, since proving that a person was infected on the job is typically very difficult. With so many frontline healthcare and other essential workers infected with COVID-19, many states are moving to add the infectious disease to their list of presumptions, especially for certain occupations.
State Updates: (As of 10/10/20)
California (CA) - Recently passed legislation establishes a rebuttable presumption that all employees who are diagnosed with COVID-19 acquired the illness at work. Updated guidance now requires CA employers to report all COVID-19 employee incidents to their workers’ compensation carrier, regardless of occupation. Employers who fail to report “may be subject to civil penalties of up to $10,000.”
Updated FAQ: Workers’ Compensation Presumption (SB 1159) Frequently Asked Questions
New Jersey (NJ) - Recently passed legislation dramatically expands access to workers’ compensation benefits for “essential workers” infected with COVID-19. Retroactive to March 9, 2020, COVID-19-positive workers in New Jersey who qualify as “essential employees” are now entitled to a rebuttable presumption that the employee’s infection is causally related to the employee’s employment, so long as the infected individuals worked somewhere other than their own residence at the time of infection.
Other states with updated WC guidance addressing COVID-19 :
Alaska, Arkansas, California, Connecticut, Florida, Illinois, Kentucky, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, North Dakota, Utah, Vermont, Wisconsin
States with legislation still pending:
Massachusetts, Michigan, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Virginia
If you have any questions regarding your obligations under these updated or proposed guidelines, please contact us:
Business Insurance: commercial@capstoneinsgroup.com
General: info@capstoneinsgroup.com
Home Office: 215-542-8030
Update: Business Interruption Claims Due to COVID-19
By Michael Bentivegna of EisnerAmper
Over the past several months, business owners, lawyers and accountants across the country have been questioning if insurance companies would pay on business interruption insurance claims on damages related to COVID-19. The insurance companies are stating that the lack of “direct physical loss or damage” to insured property forms the basis for their denial of these claims. This has led to a surge in insurance claims turning into lawsuits, with more than 800 as of the first week in August 2020. An alarming statistic is that for hurricanes, business interruption cases often spike between one and three years after the event. COVID-19 continues with no definite end in sight, and the 800 suits filed have already surpassed the number of cases filed for hurricanes Ike, Sandy, Irma and Harvey combined. Of course, hurricanes often only affect certain areas, whereas this pandemic has affected the world. The University of Pennsylvania is tracking the litigation numbers on its COVID-19 Coverage Litigation Tracker.
Hartford Financial Services Group (130-plus), Cincinnati Financial Corporation (80-plus), Travelers Companies, Inc. (45-plus), Zurich Insurance Group Ltd (40-plus), and Erie Insurance Exchange (35-plus) are the top five insurance groups being sued, accounting for more than 40% of the cases.
Business income (700-plus), extra expenses (615-plus), and civil authority (600-plus) are the three most sought-after coverages.
The week of May 4, 2020, saw the highest increase in weekly filings, approximately 80 suits.
The three most frequent industries are food services and drinking establishments (295-plus), ambulatory health care services (115-plus), and personal and laundry services (45-plus), accounting for more than 55% of the cases.
Some state representatives have initiated legislative action to try to help business owners, specifically small businesses, recover money from their insurance providers. On March 16, 2020, New Jersey lead the charge, proposing Bill A-3877 concerning business interruption insurance related to the 2019 coronavirus state of emergency. This bill states that “every policy of insurance insuring against loss or damage to property, which includes the loss of use and occupancy and business interruption in force in this State on the effective date of this act, shall be construed to include among the covered perils under that policy, coverage for business interruption due to global virus transmission or pandemic, as provided in the Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020 concerning the coronavirus disease 2019 pandemic.”
Bill A-3877 would apply for any loss sustained during the declared state of emergency for companies with less than 100 eligible employees (full-time, working 25 hours or more per week) and is retroactive to March 9, 2020, for policies in force on that date. Over the course of March and April, nine other states also introduced similar bills regarding business interruption coverage and COVID-19, including New York (Assembly Bill A10226B), Pennsylvania (Bill 2372), South Carolina (Bill S 1188), Massachusetts (SD 2888), Rhode Island (H 8064), California (Assembly Bill 1552), Ohio (House Bill 589), Michigan (H 5739), and Louisiana (House Bill 858 and State Bill 477). Although these bills are similar to New Jersey, there are slight variations relating to number of employees. South Carolina would apply to businesses with 150 employees, while New York increases the number of employees to 250. Funding for reimbursement also varies. New Jersey states an insurer that indemnifies an insured who has filed a claim pursuant to its provisions may apply to the Commissioner of Banking and Insurance for relief and reimbursement from funds collected by all licensed insurers. Rhode Island would collects funds from insurance companies “other than life and health insurance companies.” Another variation among the bills relates to retroactivity. New Jersey’s bill would be retroactive to March 9, 2020, while Pennsylvania would be retroactive to March 6, 2020. Although Louisiana House Bill 858 failed, the remaining bills are still waiting approval, and insurance companies have time to make their cases as to why this would be so damaging to their industry.
There have been some early rulings on a few court cases that appear to be moving the needle in favor of the insurers. On July 2, 2020, a Michigan judge ruled in favor of the insurance company in Gavrilides Management Company, et al. v. Michigan Ins. Co. Gavrilides attempted to claim the loss of access was caused by government orders instead of the virus. The judge ruled ““direct physical loss or damage” requires more than mere loss of use or access, and that the virus exclusion clause excluded coverage caused by the impact of COVID-19. Judge Joyce Draganchuk of Michigan’s 30th Circuit Court ruled that some tangible alteration to a property is required to trigger coverage. In Washington, DC, a superior court judge also ruled in favor of the insurer, dismissing a restaurant’s business interruption claim. In Rose’s 1 v. Erie Indemnity, Associate Judge Kelly Higashi noted that the mayor’s orders were not a physical intrusion, therefore the orders “did not effect any direct changes to the properties.”
In Pennsylvania, Berkshire Hathaway filed a motion to dismiss a restaurant’s suit, arguing the virus exclusion "plainly applies" to the restaurant's claims. 1 S.A.N.T. Inc., the Town & Country Bar and Grill in New Castle filed suit against Berkshire Hathaway and the National Fire & Marine Insurance Co. The restaurant claimed the exclusion policy for loss due to contamination by virus was invalid because in 2006—when the Insurance Services Office Inc. received approval to put virus and bacteria exclusions into their policies—the state regulators misrepresented this as something that would not limit their coverage.
The early returns appear to be in favor of the insurer, as judges have been strictly citing the plain language of the insurance policies regarding viruses. However, it cannot hurt to be prepared for a shift in court decisions. To learn more, check out the following articles prepared by EisnerAmper’s FLVS team regarding how to prepare for and file a business interruption claim with your insurance provider.
National Public Health Emergency Extension Benefit Plan Impact
On July 23, 2020, the Secretary of Health and Human Services (“HHS”), Alex Azar, declared the Public Health Emergency, scheduled to end on July 25, 2020, will once again be extended for an additional 90 days and as a result, numerous temporary benefit plan changes remain in effect.
Business Income & Interruption Insurance - What Now?
Business Income & Interruption Insurance - What Now?
Over the past month, it’s been made clear that commercial insurance policies as currently written provide little to no coverage to help reimburse businesses for lost income or a decline in sales due to the Coronavirus shutdowns. The “Business Income” or “Business Interruption” coverage found in commercial insurance policies seemed like a logical place to start. However, in nearly all instances, these commercial property coverage provisions are only triggered by “direct physical damage” to property. Another hurdle for policyholders hoping to obtain claims dollars from their commercial policies are the common “Exclusion for Loss Due to Virus or Bacteria” endorsements. This has been a grim and frustrating reality for business owners and leaders across the country. But the fight is far from over. The sections below provide an update of issues, ongoing efforts, and our professional guidance for navigating these uncharted waters.
The American Property and Casualty Insurance Association (APCIA) estimates that the closure of small businesses is resulting in losses of approximately $431 billion per month. Given the substantial amount of dollars involved, it’s no surprise that attorneys and lobbying groups are confronting the issue head-on. Early this week, Pennsylvania joined a host of other states including New York, New Jersey, Massachusetts and Louisiana in introducing a bill that would force insurers to retroactively cover business interruption claims for small businesses (under 100 full-time employees). This move comes as insurance carriers are maintaining their stance that mandated coverage for the pandemic would threaten the solvency and stability of the entire insurance industry, as current premium volumes pale in comparison to the estimated monthly losses tied to this pandemic as projected above by the APCIA.
There are several other ideas and proposals currently being brought to the table in addition to the state-specific efforts that would force insurers to pay claims. These include:
Federal Backstop - The introduction of a Federal backstop program similar to the Terrorism Risk Insurance Act (TRIA), which would provide a transparent system of shared public and private compensation for insured losses resulting from a pandemic, as opposed to acts of terrorism. This approach may be more palatable to insurance companies if they know they are sharing in the financial responsibility to pay claims.
State Legislation - In addition to Pennsylvania’s recent introduction of House Bill 2372, which would mandate insurers to pay claims, PA legislators also introduced House Bill 2386, which would issue emergency grants to businesses that have had a business interruption claim denied by insurers. This is an interesting tie-in to the small business relief provisions found in the CARES Act and an avenue that could potentially be explored at the Federal level in additional stimulus measures.
Relief Fund - The establishment of a massive relief fund in the mold of the 9/11 victim’s compensation fund. The fund would be overseen by a court-appointed official and the claims would be administered by a carefully selected panel of individuals from varying backgrounds.
Litigation - Insurers are bracing themselves for lawsuits being brought against them from all angles. These suits will undoubtedly result in new case law that will impact future rulings as well as insurance guidance moving forward.
Emerging Coverages – The Insurance Services Office, Inc. (ISO) is widely considered as the leading source of statistical and underwriting information for the Property & Casualty industry. In response to COVID-19, ISO has created two new business income endorsements that could be the model for providing coverage to businesses in response to future pandemics, if they are first adopted by individual carriers. These endorsements would not provide coverage for the current outbreak, but is one example of the many changes we expect to see in our industry as a result of the COVID-19 pandemic.
Additional Stimulus - The potential for a “Phase 4” stimulus package that would include additional relief for businesses and may further address the items mentioned above.
While insurers have been digging their feet in on many fronts, they have been accommodating in other areas. Most of the largest Property & Casualty insurers have announced extended grace periods, more flexible payment schedules, and the waiving of fees and cancellation notices for nonpayment. Some are also loosening up underwriting guidelines to provide coverage for incidental exposures that arise from pivoting business models, such as curb-side pickups and the use of personal vehicles for delivery. More recently, we are seeing some personal auto insurers stepping up to reimburse their policyholders directly for the overall reduction on auto-related claims being reported to the sharp decline of drivers on the road.
Summary of Guidance:
Capstone is committed to providing real-time guidance during this evolving crisis. While our initial interpretation of common insurance policy language still stands true today, the extended timeline of the shutdown and increasing scale of damages continues to open doors to alternative outcomes that will undoubtedly impact our recommendations to business owners, executives, and nonprofit leaders.
If your business has experienced or is currently experiencing a financial loss, directly or indirectly related to the pandemic, we recommend you speak to your insurance advisors about submitting a claim. In most instances, these claims will be denied immediately. However, as we’re seeing from the bills being introduced especially here in PA, legislators are hoping to either reverse those decisions or provide additional relief to businesses that have already been denied.
If your business is currently unable to pay monthly insurance premiums, we recommend you speak to your insurance advisors to discuss payment flexibility options that may be available to you. Our insurance carrier partners are considering these options on a case-by-case basis.
For regularly updated information on these topics, please visit our COVID-19 Resource Center.
If you have any additional questions, please reach out to a member of our team directly, call our primary office number or send us an email to our general inbox below.
Contact: Capstone Group
8 Spring House Innovation Park, Suite 202, Lower Gwynedd, PA, 19002
P: 215-542-8030
F: 215-542-8080
COVID-19 Resource Center
Last Update: February 3, 2021 | 08:30am
Most Recent Updates:
OSHA Issues Worker Safety Guidance for Coronavirus Protection Programs
Capstone Guidance - Health Insurance & The COVID-19 Vaccines
Updates from: Aetna, Cigna, Blue Cross, and United Healthcare
Update: Workers Compensation Coverage for COVID-19
State-specific updates as of 10/10/20
New $484 billion stimulus bill passed Tuesday, April 21, 2020. What’s In It?
Business Income & Interruption Insurance – What Now? (Published 4.9.20)
Personal Auto Insurance Refunds and Credits:
COVID-19: Capstone Client Guidance & Resource (UPDATED 3.30.20)
MEA Weekly Update (Webinar Recording 4.7.20)
CARES Act - Legal Perspective
CARES Act - Tax/Accounting Perspective
More information on FFCRA and updated FMLA guidance
Independence Blue Cross (IBX) Offering Payment Flexibility for Employer Plans, fully insured under 500 employees - Press Release
COVID-19 Stimulus Package - The CARES Act
Trump signs coronavirus relief measure ensuring paid sick, emergency leave
Free COVID-19 testing
Expanded food aid
Bolsters unemployment insurance
Outlines Paid Sick Leave and Family Sick Leave requirements,
Requirements vary based on number of employees (500+, 50-500, and under 50)
Outlines tax credits for employers under the Act
Notice from PHL Chamber of Commerce: Federal, State & Local Action
Mental Health Resources During COVID-19: Provided by Neuroflow
Navigating COVID-19’s Impact on Business:
Commercial Insurance & Employee Benefits Guide
A simple Google search of “coronavirus business insurance” results in millions of recent press releases and articles providing information from various sources on how corporate insurance policies and employee benefit programs will respond, or not respond, to claims related to the novel coronavirus, COVID-19. The intent of this post is to provide our clients, partners and community with a centralized location to find updated resources, guidance and best practices to help enable them to make the most educated business decisions possible during these uncertain times.
Disclaimer: Please keep in mind this is a fluid and unprecedented situation. The guidance offered is based on information available today, but this global event will likely result in case law that will set new precedents in our industry.
Update: Due to feedback from business owners, non-profit executives, and other insurance professionals kind enough to share their experiences, we have included a “Questions/Comments/Feedback” form at the bottom of this post. Please utilize this form if you would like to share your thoughts and experiences.
Commercial Insurance Policies
As businesses and non-profit organizations turn to their property & casualty insurance policies to review coverage for incidents and claims stemming from the COVID-19 virus, there are specific policies and limits that are called into question. Here we review how losses might be treated under those policies:
Commercial Property Insurance - Business Income, Interruption, Extra Expense
In an effort to prevent the spread of COVID-19, businesses have been forced to voluntarily or involuntarily suspend their operations. Many have asked whether their commercial insurance will provide Business Income, Interruption or Extra Expense coverage. It is important to note that these coverages are ordinarily found under a business’s property insurance policy. Most property coverage forms state that the loss of income due to the suspension of business operations must be caused by direct physical loss of, or damage to, property at the insured location or at a location that the insured is dependent upon (i.e. a supplier). Because the virus is not causing a direct loss to physical property, the Business Income/Interruption/Extra Expense coverage would not be triggered. Likewise, the “Civil Authority” clause of most commercial property policies, which extends business income coverage in the event that a Civil Authority prohibits access to your premises, must be initiated by a direct physical loss of or damage to your insured property.
Other business income coverages such as Contingent Business Income, Ingress/Egress, and Supply Chain Disruption will also likely be examined in the wake of this global event, however these provisions also generally require that the loss of income must stem from physical loss or damage.
Workers Compensation
Domestic workers compensation insurance provides coverage to U.S.-based employees for both bodily injury by accident and bodily injury by disease. However, any bodily injury by disease must be caused or aggravated by the conditions of employment. Therefore, with the exception of healthcare professionals treating individuals infected with the COVID-19 virus, it is unlikely that a workers compensation policy will provide coverage for COVID-19 claims. Global organizations should review their foreign voluntary workers compensation policies for more information regarding specific state or country-of-hire benefits.
Commercial General Liability
As the incidences of COVID-19 related illness increase, businesses—particularly those in the healthcare or hospitality industry—could also face claims brought by infected patients or guests alleging the company’s failure to exercise reasonable care in guarding against, or warning of, the risk of exposure to COVID-19. Intended to protect businesses against third-party claims for bodily injury resulting from exposure to harmful conditions, commercial general liability insurance policies should respond with coverage for these claims.
Our commentary above is a general interpretation of common insurance policy provisions.
We strongly recommend that businesses currently being negatively impacted by the effects of this pandemic take the following measures:
Review your current policies in detail. Consult with your insurance advisor to understand each policy’s unique features: endorsements, enhancements, exclusions etc.
Document everything! Take a detailed account of every potential claim or loss scenario.
Consult with your business’s insurance or benefits advisors to determine if and when claims should be submitted.
While there is no guarantee that something will be done, it is conceivable that as this global situation advances, special government loans or subsidies may emerge in which case this detailed information would be critical. If, at some point in the future, any type of Federal or State government subsidy program becomes available that might provide reimbursement for a portion of these expenses and lost revenues, only clients with accurate, detailed and well-documented records will be considered. This should be part of the steps you are taking as a response to this crisis.
Employee Benefits, Human Resources & Compliance
Group Medical Insurance
As COVID-19 continues to spread, many employees are wondering whether there is coverage under their company-sponsored medical plan. The following provides some high-level information intended to address these inquiries. This information is up to date (as of March 16, 2020) is general in nature, and subject to change. According to the CDC, individuals who feel sick with fever, cough, or difficulty breathing, and have been in close contact with a person known to have COVID-19, or who live in or have recently traveled from an area with ongoing spread of COVID-19, should call their healthcare professional, or utilize the TeleHealth or virtual care services available to them via their medical insurance carrier. The healthcare professional will work with the state’s public health department and the CDC to determine if the individual needs to be tested for COVID-19.
Is the COVID-19 Test Covered?
In most traditional group health plan arrangements, testing for COVID-19 should be covered like other diagnostic tests (e.g., the flu test or rapid strep test) when medically necessary. Non-traditional group health plans (e.g., skinny plans, some reference-based pricing arrangements, and short-term limited duration insurance) may not provide coverage.
Please see below links for more detailed information on how each medical insurance carrier is covering diagnostic testing and ongoing care specifically related to COVID-19:
Aetna
AmeriHealth
Cigna
CareFirst
Horizon BCBSNJ
Independence Blue Cross
UnitedHealthcare
Group Short-Term Disability Insurance
Will a COVID-19 diagnosis trigger a short-term disability benefit?
Per the CDC, reported illnesses associated with COVID-19 range from mild symptoms to severe illness. Therefore, each employee will need to be evaluated on a case-by-case basis, depending on the individual’s condition and the definition of disability under the terms of the plan. For example, someone who is asymptomatic but asked to stay home may not be eligible for disability benefits while someone who is hospitalized would be eligible. Employees in California, Hawaii, New Jersey, New York, Rhode Island and Puerto Rico have access to state mandated disability leave.
The specific contract provisions within group short-term disability policies can vary greatly based on group size and carrier. Please consult with your company HR resource or your health insurance broker for information or questions concerning your specific policy.
COVID and the Family and Medical Leave Act (FMLA): On March 14, 2020, the U.S. House of Representatives passed the Families First Coronavirus Response Act (“Act”) by a vote of 363 to 40. It requires employers with 500 or fewer employees to grant FMLA leave due to COVID-19 and up to two weeks of paid sick leave for absences related to COVID-19. To help employers pay for it, the Act grants employers refundable tax credits. The Act also expands unemployment benefits due to COVID-19. It will sunset at the end of 2020. Click here for more info
Assistance Programs for Businesses
As the pandemic forces businesses to limit or completely cease operations, federal and local governments are providing and proposing additional financial assistance aimed to help relieve the burden of sharp revenue declines currently being felt by businesses across all industries.
Here is a link to an Inc. Magazine article that will be continually updated as additional resources become available: Click here for more info
Fed will help businesses get funding in the short-term borrowing markets amid coronavirus crisis
Facebook announces $100 million program for small businesses impacted by coronavirus
Additional Resources:
Questions about emergency SBA loans? Join a daily interactive webinar on this and other cash-flow management advice, starting 12 p.m. Eastern Tuesday, March 17
Webinar – Tuesday 3/17, 11AM - HR, Legal & Compliance FAQs for Employers: https://zoom.us/webinar/register/WN_33i8n7S7Tl-RmTzOUP0A-Q - RECORDING COMING SOON
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Summary of the 2019 Employer Health Benefits Annual Survey
Each year, the Kaiser Family Foundation and the Health Research & Educational Trust conduct a survey to examine employer-sponsored health benefit trends. This document summarizes the main points of the 2019 survey and suggests how they could affect employers.
Health Insurance Premiums
In 2019, the average premium rose 4% for single coverage and 5% for family coverage. The average premiums were $7,188 and $20,576 respectively.
However, premiums for high deductible health plans with a savings option (HDHP/SOs) were noticeably lower than the average premiums. HDHP/SOs’ annual premiums for single and family coverage were $6,412 and $18,980, respectively.
Worker Contributions
The average worker contribution toward the premium was 18% for single coverage and 30% for family coverage. Although, employees at organizations with a high percentage of lower-wage workers (where 35% make $25,000 or less annually) made above-average contributions—19% and 41% of the premium for single coverage and family coverage, respectively.
In terms of dollar amounts, workers contributed $1,242 and $6,015 toward their premiums for single coverage and family coverage, respectively. Workers enrolled in HDHP/SOs contributed less on average, paying $1,072 for single coverage and $4,886 for family coverage.
Plan Enrollment
The following were the most common plan types in 2019:
· Preferred provider organizations (PPOs)—44% of workers covered
· HDHP/SOs—30% of workers covered
· Health maintenance organizations (HMOs)—19% of workers covered
· Point-of-service (POS) plans—7% of workers covered
PPO enrollment has decreased by 14% over the last five years, and enrollment in HDHP/SOs has risen by 10% over the same period.
Employee Cost Sharing
Most workers must pay a share of their health care costs, and the average deductible for all workers was $1,655 in 2019. Over the past five years, the average annual deductible has increased 36%. The prevalence of HDHP/SOs has contributed to the increase of deductible amounts. The percentage of covered workers with a general deductible of $2,000 or greater has increased from 18% to 28% in the last five years.
Beyond deductibles, the vast majority of workers cover some portion of the costs from their health care services. For example, 66% of covered workers have coinsurance and 14% have a copay for hospital admissions.
In addition, nearly all workers are covered by a plan with an out-of-pocket maximum (OOPM), but the costs vary considerably. Among covered workers with single coverage, 12% have an OOPM of less than $2,000, and 20% have an OOPM of $6,000 or more.
Availability of Employer-sponsored Coverage
Similar to the last few years, employers offer health benefits to at least some workers. Only 47% of very small employers (three to nine employees) offer benefits, while nearly every large employer (1,000 or more employees) offers coverage.
Health and Wellness Promotion Programs
Wellness programs help employees improve their lifestyles and avoid unhealthy habits. Fifty percent of small and 84% of large employers offer at least one wellness program. Of these large employers, 41% offer participation incentives like gift cards or merchandise. Programs vary in topic and include subjects like smoking cessation, weight management and lifestyle coaching.
Telemedicine
More than two-thirds of employers with 50 or more workers have embraced telemedicine, with 69% offering health care services through this method. Of these employers, 48% offer financial incentives to receive health care services this way, opposed to an in-person physician visit.
Self-funding
Similar to the previous year, 17% of workers with small employers are elected in plans either partially or entirely self-funded, compared to 80% of workers with large employers. In the past few years, level-funded plans have become more popular. Level-funded plans are health plans provided by insurers that include a nominally self-funded option for small or mid-sized employers that incorporates stop-loss insurance with relatively low attachment points. Of the employers with fewer than 200 workers, 7% reported that they had a level-funded plan.
Conclusion
This year continues a period of a stable market, characterized by relatively low-cost growth for employer-sponsored coverage. While premium growth continues to exceed earnings and inflation increases, the differences are moderately small. Additionally, while there have been some changes in terms of employer-sponsored health benefits, no trends have gained significant traction.
The recent trend of raising deductibles to offset premium increases is popular, but its growth has slowed. A reason for the slowed growth is that health benefits are a highly effective attraction and retention tool, especially in a strong economy and tight labor market, and employers want to recruit and retain top talent.
Looking forward, employers should begin to identify tools and resources they can use to offset higher premium growth. As costs continue to rise and possible political changes ensue, employers and employees may begin to see increased market movement.
For more information on benefit offerings or on what you can do to control your health care costs, contact Capstone Group today.
October is National Breast Cancer Awareness Month
October is National Breast Cancer Awareness Month
Breast cancer is the second-leading cause of cancer deaths for women in the United States. To help spread awareness of this disease, October is recognized as Breast Cancer Awareness Month.
Prevalence of Breast Cancer
About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime. While there are some breast cancer risk factors that you can’t control, these prevention strategies can help you reduce your risk:
Maintain a healthy weight.
Exercise regularly.
Abstain from drinking alcohol or limit intake to one drink per day.
If you’re concerned about your personal risk of developing breast cancer, call or visit your doctor.
Breast Cancer Awareness Month and You
There are a variety of ways that you can support Breast Cancer Awareness Month. Here are just a few ideas:
Participate in a fundraiser event, like a walk or run, to help raise money for breast cancer research.
Donate to a charity that provides support and services to women and families that are affected by breast cancer.
Learn about the signs, symptoms, risk factors and screenings for breast cancer.
Spread awareness about this disease to help educate friends and family.
For more information on breast cancer, visit the National Cancer Institute’s website.
Don’t Let These Devices Steal Your Sleep
If you have trouble falling asleep, your phone may be to blame.
Researchers at Harvard found that using your phone, or any electronic device, before going to bed can derail your sleep schedule and prevent a good night’s sleep. More specifically, using your electronic device before bed can disrupt your body’s REM sleep cycle and production of melatonin, a sleep-promoting hormone.
To reduce the sleep-stealing effects of electronic devices:
· Check your device’s settings for a “nighttime” mode, which adjusts the screen lighting to promote sleep.
· Refrain from using your phone for at least an hour before bed.
· Set your device’s sound settings to “silent” so that you won’t be woken up by texts or emails while you’re trying to sleep.
Did you know that nearly 25% of adults reported that their phone was the last thing they saw before they fell asleep?
We're in!
Check out our new office, located in the Spring House Innovation Park!
We are thrilled to announce the relocation of our headquarters to the newly-developed Spring House Innovation Park (SHIP). The SHIP is a premier, 133-acre multi-use campus, with a host of on-site amenities designed to elevate the work-life experience. As the Capstone Group continues to expand our organization and service offerings, we recognized the need for a home base that better reflects the way we live and work as a team.
The SHIP is only a few miles away from our previous headquarters, which has been our home base since Capstone was founded in 2013. This close proximity, coupled with the increased space and amenities offered by our new location, made it a perfect fit to cater to our loyal team members and will allow us to continue to grow. It has been an exciting 6 years for the Capstone Group, and we look at this new location as the start of another chapter in our history.
Effective September 1st, 2019, our new address will be as follows:
Capstone Group
8 Spring House Innovation Park, Suite 202
Lower Gwynedd, PA, 19002
Boost your physical and psychological well-being
Boosting your overall health may be a bit easier then you think.
A recent study published in Scientific Reports revealed that spending 120 minutes a week outdoors can improve your health and psychological well-being. Remember, well-being refers to feeling good and living both safely and healthily. And, the concept of well-being can have implications on your overall quality of life, health and happiness.
What are the benefits of spending time outside?
Exercising in nature has been proven to improve one’s mental and physical health. Being outside also helps to promote higher vitamin D levels, a vitamin the body makes when skin is directly exposed to the sun. Many people are deficient in vitamin D, so exercising outside can be a great way to correct that.
In addition, outdoor activity can help you maintain a healthy weight, boost immunity and lower stress. Exercising outside can feel less routine than working out in a gym.
What counts as spending time outdoors?
Visiting town parks, greenspaces, woodlands and beaches all count as spending time outdoors. Here are two simple activities that you can do outside:
· Walking or hiking—Hiking and walking have been proven to improve heart health and can help you maintain a healthy waistline.
· Riding your bike—Riding a bike helps improve balance and endurance, and it’s an exercise that’s easy on your joints.
Be Prepared
Before you head outside and start improving your health today, you need to make sure that you’re properly prepared. This means that you should pack water, first-aid supplies, sun protection and, if you’re spending a significant amount of time outside, a healthy snack to help you refuel.
The Value of an HRA
Health Reimbursement Arrangements are more valuable then you may realize.
Here are 3 reasons to love your HRA:
Reduced health care costs.
An HRA can help pay out of pocket expenses, and they have much lower premiums then traditional health plans.
Tax Advantages
Since your employer’s contributions do not count as income, they are not taxed like income
Freedom to budget and choose when to use your HRA funds.
These funds don’t get lost if they are unused, they will roll over to the next year, so you have the freedom to budget annually or monthly.
7 Tips For Avoiding Heat Illnesses This Summer
The hot summer months can cause your body temperatures to rise without warning, especially when combined with activities like sports or yardwork. And, while it’s tempting to spend as much time outside as you can during the summer, you need to take measures to avoid heat illnesses.
Here are some tips for staying safe when you’re out in the heat:
1. Wear loose, light-colored clothing so your skin gets air exposure.
2. Shield your head and face from direct sunlight by wearing a hat and sunglasses.
3. Avoid spending time outdoors during the middle of the day, when temperatures are highest and the sun is directly overhead.
4. Take regular breaks in a shaded area if you’re involved in a strenuous activity.
5. Drink water frequently, even if you aren’t thirsty. Experts recommend drinking at least 8 ounces every 20 to 30 minutes to stay hydrated. Stick to water, fruit juice and sport drinks while avoiding caffeinated or alcoholic beverages that can dehydrate you.
6. Monitor children and seniors carefully, since they can get dehydrated more easily.
7. Call 911 if someone exhibits symptoms of heat stroke, such as flushed skin, rapid breathing, a throbbing headache or confusion.