What Is A Narrow Network?

Since the Affordable Care Act or "Obamacare" the conversation around narrow networks continues to increase.  We are often asked what is a narrow network and why?
A narrow network simply describes the number of providers and hospitals that are in the network. Narrow networks are nothing new to the marketplace.  They are often referred to in different terms; PPO, HMO, and EPO are all technically a form of narrow networks.
The next question I often get is why do a narrow network?  This is simple - to control costs and help improve care.
By limiting the number of network providers and hospitals, you are able to improve the continuum of care and offer deeper negotiated discounts.  Groups utilizing these types of arrangements beat the national averages when it comes to cost and trend.  
With self-funding your benefit plan, you have the flexibility to look at network alternatives.  Your group health plan may already have the best fit based on your location and benefit plan design, but I encourage you ask the question.  
If you have questions please contact Forrest Williamson at

Unified in the Community

Unified in the Community

Many of us go home after a long day of work to receive unconditional love from our pets! This is why our Unified Cares Community Project for this quarter is promoting the Madison County Humane Society!

MCHS is a no-kill cat and dog receiving shelter funded by donations, fund-raising efforts & nominal fees; they receive no taxpayer monies. MCHS shelters more than 100-115 homeless animals every day and often has some in foster care.

Our team at Unified held a soup luncheon, raffled off some gift baskets, gathered supplies and collected more than $450 in donations!

The Madison County Humane Society and shelters in your area are always looking for volunteers and assistance. If you are interested in adoption, donating or learning more, please click on the link below to locate a humane society near you.


Three Tips for Establishing a Wellness Program at Your Company

Three Tips for Establishing a Wellness Program at Your Company

There’s more to a wellness program than simply providing your employees with pedometers and doing wellness screenings on an annual basis. Here at Unified we have integrated our wellness program to become part of our culture. This has been successful on many fronts including, lowering employee BMI, cholesterol and blood pressure; encouraging the addition of exercise as part of a daily routine; and increasing overall employee happiness.

If you are looking to establish a wellness program at your company, or simply build on an existing program, here are some tips to consider based on our own experiences.

  1. Assign someone to manage the wellness program – Employees are bound to have questions, which is great because they’re engaging in what you are offering. Having a dedicated wellness person or team will provide an expert to track metrics you are measuring, monitor progress, and provide encouragement to your staff. Our certified wellness team at Unified helps our employees by sending out weekly quizzes, recipes, and updates us on the progress of our group as a whole.
  2. Offer incentives – Engagement increases when you use a carrot rather than a stick! During our Summer Super Challenge at Unified, employees earn wellness points. At the end of the challenge, points can be redeemed for cash or prizes! Plus the program is seeing results, which is the ultimate goal of all wellness programs. Just be careful if you are considering incentives such as premium discounts; there are certain parameters that must be followed to keep your program compliant.
  3. Keep programing new and exciting – Variety is the spice of life! It’s important to keep your employees motivated, so keep your programming fresh on a quarterly basis. Everyone has different tastes and motivations, and by rotating your campaigns you can keep engagement high. At Unified, the “Colorful Choices” component of our wellness program encourages the addition of fruits and veggies – adding various colors to your plate – to increase the nutrient value. Right now, our employees are also doing a Chug-A-Jug challenge to track water intake. Each week, we prepare new flavors of infused water to make drinking water a little fruitier! Our most popular flavor is pineapple mango!

If you are looking to create a culture of wellness within your organization, you don’t have to do it alone!  Our team here at Unified can sit down with you to discuss office demographics and goals for your wellness program. We can customize a plan to meet the needs of your population and budget necessary to execute the plan.

No matter what path you choose for your corporate wellness needs, by increasing the well being of your employees, you can ultimately reduce unnecessary claim costs and potentially eliminate the need for ongoing maintenance medications. Help your waistline and your bottom line!

Take the Worry out of Compliance!

Whether you are a large or small employer, have one benefit plan design or multiple networks, Compliancedashboard® and the team at Unified can reduce the workload and burden of upcoming compliance responsibilities.

Through employers have access to the Compliancedashboard®. All obligations based on your plan year and company size are categorized in a timeline for the upcoming year.

  • Your time is valuableCompliancedashboard® provides a calendar to outline your responsibilities and provides educational materials in clear and understandable formats. Email reminders are sent out on both long-term and time-sensitive subjects.
  • Who is responsible – Tasks can be assigned to designated HR staff and require those individuals to respond once they are completed. This eliminates the discussion breakdown of who in the department needs to distribute notices or manage reporting. If a task is past due, reminder emails will be sent out to make sure that notices are not overlooked.
  • Audit Trails – Employers need the ability to show their compliance actions and procedures. Many employers cannot provide this information when requested for either internal or external review. Compliancedashboard® keeps record of all compliance actions with dates, names and acknowledgments. These reports are always available and can show an employer’s good faith efforts to comply with rules and regulations.

With the help of your compliance team at Unified, and access to Compliancedashboard® you can proactively receive notifications for responsibilities and ensure you get the information you need at the time you need it. Staying on track with ERISA, HIPAA, Health Care Reform and other federal regulations is easy to do all in one place with Compliancedashboard®.


Wellness Incentives

Let’s face it…incentives are about getting people to do things they would not otherwise do! Like it or not, people frequently do not do what will help them stay healthy and live longer. Changing this situation is what wellness is fundamentally about. With a multitude of factors affecting our behavioral choices, health behavior is extremely difficult to change.

Why use incentives?

We often get asked this question from employers…Why should I use incentives in my wellness program? We believe there are many reasons, but a portion of the response is related directly to the fundamental nature of “wellness”. Wellness is defined as “An organized set of activities designed to help individuals and their family members make and/or maintain voluntary behavior change(s) that help reduce their health risks and/or enhance their ability to function.”

The focus on “voluntary” behavior change at the center of this definition of wellness emphasizes our need to continually examine the factors that influence behavior change. “Voluntary” by its very nature means at the volition or choice of the individual. It is not automatic, but must continually be selected by an act of will on a moment-by-moment basis. Carefully designed incentives help to influence this longitudinal expression of will leading to behavior change.

On May 17, 2016, the EEOC (Equal Employment Opportunity Commission) issued a final rule that describes how employer-provided wellness programs can comply with the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA). The final rules, which went into effect January 2017, applies to all workplace wellness programs, including those in which employees or their family members may participate without also enrolling in a particular health plan. The rule embraced the HIPAA/ACA approach to incentives, limiting incentives for wellness programs including disability-related inquiries or medical examinations to 30 percent of the total cost of employee-only coverage. The ruling allowed incentives to rise to 50 percent of the total cost of employee-only coverage for programs not asking disability-related questions targeting tobacco use. However, where an employer requires any biometric screening or other medical procedure that tests for the presence of nicotine or tobacco, the rule’s 30 percent incentive limit applies. Outcome based programs that require an individual to attain or maintain a specific health outcome (such as not smoking or attaining certain results on biometric screening) in order to obtain a reward must offer a reasonable alternative to earn the incentive. Learn more by going to:


Terri Vetor

Wellness & Consumer Products Coordinator

Unified Group Services, Inc.

Unified in the Community

From our humble beginnings 21 years ago, Unified is proud to participate in events throughout our community.  This is driven by our local workforce, and causes are promoted and fundraisers coordinated on a quarterly basis. We would like to highlight these organizations in the hopes that you may be encouraged to pay it forward as well.

Most recently, Unified partnered with The Christian Center in Anderson, Indiana. The Christian Center provides shelter, food and companionship for those in need. They have found that a plate of food and a few minutes of fellowship can have a significant impact. 

Unified’s employees chose to donate through a soup and sandwich luncheon, and raffle.  Our team stepped up and generously raised more than $700 in food donations.  In addition, we are collecting necessities to help them fill their pantry during these cold winter months. 

There are many ways that you or your organization can help too! Learn more by visiting

Level Funding

With the constant conversation of healthcare in the news, health benefits have become a mainstay discussion for most Americans.  Benefits are becoming more and more important in recruiting and retaining top talent and business owners are searching for ways to continue offering competitive benefits.

I have found this is even more troubling to the small to midsize business owners.  Healthcare continuously ranks in the top 3 expenses for employers of all sizes, not just large companies.  This has caused business owners to start to look at alternative solutions to providing healthcare for their employees.  While there are many solutions in the market one of the most popular is self-funding.  Self-funding in itself can be a scary word for most employers.   In the past self-funding was for larger companies, but this has changed with time and many small employers have migrated to self-funding.

Why self-fund? 

  • Self-funding gives you predictability, control, protection, speed, flexibility, and savings potential.
  • Small employers who are used to seeing renewal after renewal with 10-15% premium hikes without justification; self-funding may be right for you. 
  • Small and midsize companies looking for the same pieces of information that a large company gets; self-funding may be right for you. 

While all this sounds attractive for small and midsize business owners, cash flow can be a tricky subject.  In traditional self-funding arrangements this could’ve been an issue causing the companies to remain fully-insured in the past.  Today, there are contracts in the market that allow the employers to take the rollercoaster effect of claims out of the picture.  I refer to the concept as level-funding.  With level-funding, an employer pays a fixed amount per month similar to a fully-insured scenario.  The difference for an employer is 100% of the claim funds not used at the end of the contract is theirs to keep.  This is a great scenario for the employer because they not only get the benefits of self-funding, but are protected from cash flow issues.  Most importantly in a good claims year the employer retains the reserves.

The conversation of healthcare cost is not going away; we need to turn to looking at solutions that are outside of the norm.  Introducing different financing and management strategies for healthcare can help you take back control of your benefit plan expenses.  If you have been facing these issues, please reach out to Unified and learn more about the solutions that we offer.

Forrest Williamson

Sales Executive

Unified Group Services, Inc.

Noncompliance Fines & Penalties

As a customer of Unified Group Services you have access to tools and resources to ensure that your benefit plan is compliant. Our compliance team will advise on benefit recommendations, and you can proactively address responsibilities through Compliancedashboard®. Noncompliance can result in hefty fines and penalties. Learn more about these consequences by viewing this Compliancedashboard® penalty chart.

Download Fines and Penalties PDF

Celebrating 20 Years

Feb. 1 marked Unified Group Services’ 20th anniversary, a milestone we are very proud of! Our commitment began 20 years ago in an effort to provide customer service excellence for self-funded group health plans.

Unified’s co-founders, Richard Mousty and Faith Hailey started the company in the sunroom of Rich’s home. Our very first customer, Hillcroft Services, took the leap with us and remains a valued customer to this day. From that point, Unified began to grow and moved to a new location in Pendleton. After outgrowing the building, Unified relocated to Anderson in 2004. In the spring of 2008, we expanded the footprint of our office to 22,000 square feet. Currently, Unified has 100 full-time employees that all work on-site.

As we’ve grown, we’ve also given back—through blood drives, annual donations to Second Harvest Food Bank and collecting school supplies for our local corporations. By growing organically and providing careers for local residents, we invest both in our customers and our employees. There is value and pride in community and Unified has been blessed to see growth and received accolades over the past 20 years.

On Monday, Feb. 1, we held a celebration to commemorate this achievement and honor our employees for their dedication, longevity, hard work and commitment to providing outstanding service to our customers and partners. Most importantly, we want to thank you for allowing Unified to service your group health plan. We greatly appreciate our relationship with our customers and look forward to many more prosperous years together.

Navigating Through Healthcare Reform (Pay or Play Penalties)

At the top of the long list of Affordable Care Act (ACA) regulations are the taxes and penalties that can be passed on to employers for not offering minimum essential coverage. Employers will need to determine whether they want to “Pay or Play.”

Unfortunately, determining whether you are considered a large or small employer, or even how to calculate the number of full-time employees you have is not as simple as counting the number of people on your payroll.

How to Determine Full-Time Equivalent (FTE)

Full-time equivalent (FTE) employees equal the number of employees on full-time schedules plus the number of employees on part-time schedules converted to a full-time basis. To determine full-time equivalents (FTE):

  • Look at all part-time employees (those working up to 120 hours/month); take the total number of hours worked by all part-time employees per month divided by 120. This equals your Total FTE for a calendar month
  • Add together the number of full-time employees and your FTE total. This equals your monthly total
  • Add all of the monthly totals together to get an annual total, divide by 12 to determine your yearly average of full-time employees

Now...What's A Full-Time Employee

A full-time employee is defined as an employee working an average of 130 hours or more throughout a measurement period. The government has established measurement periods so that eligibility determinations do not have to be made on a monthly basis.

Three Measurement Periods

  1. The 1st period is called the Standard Measurement Period. During this period the employer calculates the number of hours each employee works per month to determine full time status. The standard measurement period can be no shorter than three months and no longer than 12 months.
  2. The 2nd period is called the Administrative Period. During this period the employer averages the hours of each employee, makes a determination of eligibility, and offers coverage to those eligible. This period can be no longer than 90 days.
  3. The 3rd and final measurement period is called the Stability Period. During this period the employees that were determined to be full time or part time maintain their eligibility status for health benefits regardless of hours worked. This period can be no shorter than the longer of: Six calendar months or the Standard Measurement Period.

If you opt to “Pay” rather than “Play,” your penalties will be based upon the number of full-time employees you have on your payroll, and don’t forget about hidden factors such as tax implications and recruitment challenges. Even if you are thinking about dropping coverage because of the amount of calculations and paperwork involved, think again – you will still be subject to reporting to the government and exchange programs.

What should you do?

Talk to the professionals. If you are faced with the decision to “Pay or Play” contact your financial advisor, broker or account executive at Unified Group Services. We can discuss how to look at restructuring your benefit plan design to reduce cost and maintain affordable coverage for your employees.

This information is provided by Unified Group Services, Inc. for informational purposes only and is not to be construed as legal advice.