About Us

About Us
Midwest Group Benefits, Inc. was founded by Loren Kiel in 1984 as Third Century Financial Corporation. The company began with an emphasis on investments and group health insurance. We sold our first fully insured health plan in 1984 and our first self-funded plan (administered by an outside source) in 1987.

In 1985 Group Benefits Consultants, Inc. was established for the administration of flexible benefits plans and retirement plans. Our first flexible benefits plan was sold in 1985 and our first retirement plan was sold in 1986.

In 1991 Midwest Benefits, Inc. was incorporated and this eventually replaced the name Third Century Financial Corporation. Midwest Benefits, Inc. operated as the marketing side of our company while Group Benefits Consultants, Inc. continued to be the administration company for our clients.

In 2003, the two corporations (Midwest Benefits, Inc. and Group Benefits Consultants, Inc.) were combined to form Midwest Group Benefits, Inc. following the transfer of ownership from Loren Kiel to Rock Tuchek, a long-time employee of the company. Loren continues to be an integral part of our company, focusing his time on marketing and customer-relations.

Our combined experience over the years has allowed Midwest Group Benefits, Inc. to be a leader in employee benefits in Northeast Iowa.

Flexible Benefit Programs

Flexible Benefit Programs
As benefit costs continue to rise, more employers are turning to flexible benefit plans for a new approach to cost control. Flexible benefit plans can give employers control of the overall benefit program and employees control over their personal benefit plans.

Midwest Group Benefits Flex Plan allows employers to offer employee benefits under an IRS-qualified cafeteria plan. This cafeteria plan offers both employers and employees savings in payroll taxes through the payment of qualified employee benefit expenses with pre-tax dollars.

When employees' taxable income is reduced by the cost of eligible benefit expenses, the employer's taxable payroll is reduced. This means substantial tax savings for the employee in federal, FICA and, in most cases, state taxes.

Premium Only Plan

Premium Only Plan
The Flexible Benefits Program allows employees a choice of paying for their share of employer-sponsored health, dental, vision, disability, supplemental insurances and group term life insurance up to $50,000 with pre-tax payments from their pay.

Paying Premiums for Employer-Sponsored Insurances with Pre-Tax Dollars
Employees who are enrolled in their employer-sponsored insurances can have their premiums paid with pre-tax dollars from their pay or with after-tax dollars.

When employees pay for employer-sponsored insurance premiums with after-tax dollars, the employee pays taxes first and then pays for their insurance premiums.

However, when your employees pay for their premiums with pre-tax dollars, the insurance premiums dollars are taken out of their pay before taxes. Because those dollars go for benefits instead of into their paycheck, the Internal Revenue Service does not consider them part of taxable income. As a result, your employee's taxable income is less. When taxable income is less, federal and state income taxes will be reduced and that means more take-home pay for your employees!

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Who Can Sponsor a Premium Only Plan?

Regular corporations, partnerships, S corporations, limited liability companies (LLCs), sole proprietors, professional corporations and not-for-profits can all save money on payroll taxes by establishing a Premium Only Plan. While regulations prohibit a sole proprietor, partner, members of an LLC (in most cases), or individuals owning more than 2% of an S corporation from participating in the Premium Only Plan, they may still sponsor a plan and benefit from the savings on payroll taxes.

Contact Us Today

Setting up a Premium Only Plan is an easy and cost effective way to enhance your employees benefits program. Request a Proposal and see how easy it is for you and your employees to save tax dollars!

Flexible Spending Account Plan

Flexible Spending Account Plan
Flexible Spending Accounts allow your employees to reimburse themselves tax-free for certain expenses:
  • Healthcare expenses not covered by your group health insurance plan. 
  • Qualified Medical Expenses
  • Work-related expenses for dependent care of children under 13, as well as the care for certain other dependents.
    • Allows reimbursement for work related, dependent care expenses of children under the age of 13, as well as the care of certain other dependents.
    • Employees may be reimbursed for charges by a licensed daycare center, as well as charges for a caregiver in an employee's home. Caregivers cannot be:
      • An Employee's Spouse
      • An Employee's child under the age of 19
      • Anyone who can be claimed as an Employee's dependent
  • Estimate Dependent Care Expenses

HRA Plan

HRA Plan
Health Reimbursement Arrangements (HRA'S) are employer funded accounts that provide reimbursements to employees for qualified medical expenses (defined by section 105 and 106 of the Internal Revenue Code).  HRA plans, by employer choice, can permit a rollover feature.  Distributions are tax free and claims do not have to be incurred in the coverage period.

With the implementation of the Affordable Care Act, HRAs were considered group health plans are are subject to PHSA (Public Health Service Act) regulations effective January 1, 2014.  In September 2013, the three Federal Agencies released guidance regarding ho HRAs could be designed to be allowable and "excepted" from the market reforms.

Effective January 1, 2014 per IRS Notice 2013-54 the following three plan types are allowable:

  • Integrated HRA
  • Dental and/or Vision HRA
  • Retiree Only HRA

Integrated HRA

For an HRA to be considered integrated with a group health plan, the HRA must benefit only employees who are covered by primary group health plan coverage that meets the requirements of PPACA and is provided by the employer.  HRAs may be offered to employees that do not enroll in the employer's group health plan, but are enrolled in other non-HRA group coverage (such as a plan maintained by the employer of the employee's spouse).

An employer sponsored HRA CANNOT be integrated with individual market coverage's or with employer plans that provide coverage through individual policies.

Dental and/or Vision HRAs

Dental and/or Vision HRAs are still allowable as an excepted benefit as long as the plan follows these guidelines:
  • Benefits provided are under a separate policy, certificate or contract of insurance
  • The Plan is not an integral part of a group health plan

Retiree HRAs


Separate retiree only plans can continue in 2014 and beyond.  Retiree HRAs are excepted from market reforms.  If funds from the HRA are used to purchase a health plan on the Exchange, the individual will not be eligible for a premium tax credit or subsidy.

HRA 2014 and beyond

IRS Notice 2013-54 requires that all excepted benefit HRAs must allow participants to opt out of coverage and waive the right to future reimbursements.  At termination, any funds remaining must be forfeited back to the employer.  This provision is necessary to allow an employee to purchase coverage on the Exchange.

The Benefits of an HRA:

  • Flexibility in plan design
  • Ability to "roll over" unused money from one plan year to the next
  • No "use it or lose it" rule
  • Reimbursement for medical expenses does not have to be within the covered plan year. (For example, if an employee was a participant in the HRA in 2002 and 2003, they could submit a claim for an expense incurred in 2002 in the 2003 plan year).
  • Compliments a Flexible Spending Account Plan – An employer can offer both plans to their employees
  • Former employees, including retirees (by plan design) can have continued access to their unused funds.

How do I implement an HRA?

There are a few items that will need your consideration before implementing an HRA. You will need to determine the following:
  • Eligibility
  • The Employer Contribution
  • Optional features you will want to offer
    • Whether funds roll from year to year
    • How to handle terminated employees and retirees
    • Which pays first, the FSA or the HRA (if the employer sponsors both plans)
Upon plan implementation, the Employer will need to adopt a formal plan document and distribute Summary Plan Descriptions to all eligible employees.

Who Can Sponsor an HRA?

Regular corporations, partnerships, S corporations, limited liability companies (LLCs), sole proprietors, professional corporations and not-for-profits can all save money on payroll taxes by establishing an HRA. While regulations prohibit a sole proprietor, partner, members of an LLC (in most cases), or individuals owning more than 2% of an S corporation from participating in the plan, they may still sponsor a plan and benefit from the savings on payroll taxes.

Contact Us Today

Setting up an HRA is an easy and cost effective way to enhance your employees benefits program. Request a Proposal and see how easy it is for you to save tax dollars!

Retirement Plan

Retirement Plan
In today's job market, it makes more sense than ever for employers to offer their employees a retirement plan. Offering employees the option to enroll in a retirement plan is not only a great benefit for the employee, but it also helps the employer. A retirement plan can help the employer to:
  
  • Attract and retain quality employees
  • Reward key employees
  • Grow their own personal retirement savings
  • PLUS save money in payroll taxes!

As important as a retirement plan is, constant IRS, DOL and privacy act changes make it one of the most complicated plans to administer. Midwest Group Benefits is a full service retirement plan administrator. When you allow us to administer your plan, we provide you with:

  • Plan Design — An experienced representative from Midwest Group Benefits, Inc. will assist you in choosing the type of retirement plan that will work best for your company to help all employees achieve their retirement goals.
  • Implementation —  Midwest Group Benefits, Inc. will guide you through the necessary steps to get ready for the start of your plan. This includes completing the forms needed to set up your plan with the investment company and also completing the checklist to produce your plan documents.
  • Reporting — We take care of the preparation of the IRS Form 5500, required of retirement plans. We also produce a Summary Annual Report detailing the changes in the plan's assets over the plan year.
  • Compliance — Our Third Party Administrators stay informed of IRS and DOL requirements and will help you to operate your plan in compliance with these regulations.
  • Quality Investment Products — We work together with reputable investment companies to bring you and your employees the best investment options available.
  • Staff Development — Our Benefits Administrators stay updated on changing Federal regulations by attending seminars, continuing education courses and by subscribing to trade publications and journals.
  • Staff Availability — We are a local company that can assist employers and employees through Enrollment and Employee Meetings and also can provide personal service on site.
  • State of the Art Software — to assist in processing and reporting
  • Experience — Current administration has an average of 15 years of experience with retirement plans
  • Outstanding value — Midwest Group Benefits, Inc. provides an overall package of value that is simply unsurpassed.

Midwest Group Benefits is a locally owned company who is committed to your success through honesty, integrity and hard work. We pride ourselves on an unsurpassed level of personalized service you can only get from a hometown business that really cares about your future.

Other Plans

Other Plans
Other plans we provide include Disability, Dental , Vision  and Life. In cases where an employer's group benefits package appears complete, the addition of one or many of these ancillary benefits can complete the program. These various benefits can be included at the time of developing the benefits program or they can be added at any time to an existing program. Many of these products can be also be purchased on a voluntary basis by individual employees through their employer.      
            

Disability Plan

Short Term Disability (up to one year) or Long Term Disability (up to age 65) is an inexpensive and necessary coverage for employees. One of the toughest things for an employer to do is to write the last paycheck to a disabled employee. Disability coverage can be tailored to your needs

Other Plans

Other Plans
Other plans for which we provide self-funded administrative services include Disability, Dental and Vision. In cases where an employer's group benefits package appears complete, the addition of one or many of these ancillary benefits can complete the program. These various benefits can be included at the time of developing the benefits program or they can be added at any time to an existing program. Many of these products can be also be purchased on a voluntary basis by individual employees through their employer.

Dental & Vision Plans

It is not mandated for companies to offer their employees Dental or Vision coverage, however, this is an easy way to encourage employees to maintain their overall health.  Self-funded dental and vision plans provide employers with flexibility in plan design, allowing the plans to be structured to provide the benefits the employer deems to be beneficial for its employees.  In addition, self-funded dental and vision plans generally have lower administrative costs and, like the self-funded health plan, claims are paid as they are incurred.

Group Health - FAQ

Group Health - FAQ<a name='top'></a>








Q: Why can I only go to certain Providers?
A: It is the Covered Person's choice as to which Provider to use, however, when a Covered Person uses an In-Network Provider (Preferred Provider), that Covered Person will not be subject to possible additional UCR charges that they likely would be if an Out-of-Network Provider (Non-Preferred Provicer) was used.
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Q: What is UCR or U & C?
A: A Usual and Reasonable charge is the amount being used by the majority of the providers in the same area.  Typically, on your Explanation of Benefits, if you see that something is not covered because it is over U&C, it means that the Provider is charging more than the Usual, Reasonable, and Customary amount for that service.
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Q: What does it mean when charges are applied to my deductible?
A: A deductible is a set amount that must be paid by you before the plan will make any payment.  Usually one person must meet their individual deductible and any of the other family members can combine to meet the family deductible.  So when charges are applied to deductible, the charge was covered but is the patient responsibility with no payment by the plan for that service.  The deductible generally runs from January 1 to December 31.
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Q: I'm not happy with how a claim was paid, what do I do?
A: When a claimant receives an adverse benefit determination, the claimant has 180 days following receipt of the notification in which to appeal the decision. A claimant may submit written comments, documents, records, and other information relating to the Claim. If the claimant so requests, he or she will be provided, free of charge, reasonable access to and copies of all documents, records and other information relevant to the Claim.The period of time within which a benefit determination on review is required to be made shall begin at the time an appeal is filed in accordance with the procedures of the Plan. This timing is without regard to whether all the necessary information accompanies the filing. An outline of the appeal process is in the plan document.
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Q: You are my insurance company, aren't you?
A: NO - Midwest Group Benefits, Inc. is not an insurance company. We provide Third Party Administration Services. We administer and process claims on behalf of your employers Self –Funded group Health Plan.
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Q: Why do you need information about my prior coverage?
A: When you are new to a plan, the first thing requested once a claim is received for you is that you send us a certificate showing any prior coverage you and your dependents (if applicable) had for one full year before coming on with the new insurance. For example, if you obtained coverage effective June 1, we would need information for all prior insurance you had going back to June 1 of the previous year. This could just be one plan or with several different carriers. The certificate can be obtained by contacting the carrier of the plan(s). If you had no insurance or had a lapse in coverage of 63 days or more, than we will investigate for pre-existing conditions, the definition of which is provided in your policy.
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Q: I am traveling out of the country; will I still be covered by my plan?
A: YES - However, if you receive medical services while out of the country, you will need to pay for them at that time. We suggest paying for them by credit card, which will convert the currency, then submit the bill and credit card statement, along with a description of the reason for the service and what services were provided, to us upon your return for processing.
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Q: What do you mean by my Out-of-Pocket?
A: Out-of-Pocket refers to the total of covered charges you pay. As you incur charges, those that are applied to your deductible or coinsurance are your responsibility, and accumulate towards your out of pocket maximum. Once you reach the established out-of pocket maximum, the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unless stated otherwise.
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Q: Why does the cost of my health insurance continue to rise?
A: Higher utilization, physicians charging more due to the increase in demand for their services, new and sophisticated medical treatments, the need for training of doctors/physicians to attain new skills to offer the latest in medical treatments, physician malpractice costs, litigation and fraud, having to help compensate the health care system for people who cannot pay for their own services and poor Medicare reimbursement are just some of the reasons why costs continue to rise.
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Q: What can I do to help control the cost of health insurance?
A: Be a better consumer and become more cost conscious of what you are being charged, choose generic drugs, know your benefits, and take an active role in your care and practice prevention.
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Q: Is there an option for students no longer eligible on their parents' group plan?
A: Yes, depending on the situation that applies, COBRA is an option, individual Short-Term policies or separate individual permanent policies.
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Q: How can my provider obtain claims status and/or benefit information?
A: We have adopted a faxing procedure to accommodate our providers who are requesting claims status or benefit information. We ask them to fax us the request on their letterhead, with the name of the person requesting the information, the name of the patient and the insured, ID number, date of service, claim amount and return fax number. They can fax us a copy of the original claim if they prefer. We will then fax back the claim status or benefit information. If pre-certification is required, the necessary information is provided on our return fax.  In certain circumstances the calls are referred to specific claims analysts.
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Q: Why don't you tell my provider if my deductible or co-insurance is met?
A: We do not provide this information to our providers. With claims being processed every day, the amount continuously changes.
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Q: How do I find out if a procedure is covered or if I need to pre-certify?
A: First check your plan document to see if the procedure is listed as covered or if pre-certification is needed.  If you cannot find information specific to your question, you can call our office and speak with a claims analyst.
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Q: How do you determine how a claim is paid?
A: A claim is processed according to the specific plan language. Each plan is structured differently, so a claim paid one way for an insured of one group may not be paid the same way for an insured of another group. If questions exist, you can call your claims analyst for further details.
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Q: Who can obtain my plan information (ex: claims, benefits, pre-certification)?
A: The rules of who can obtain this information have changed significantly due to recent legislation (HIPAA). We will provide this information only to those listed as covered under the plan. If you would like somebody in addition to those covered to have access to this information, a form is available for you to complete. For example, if your spouse or dependent is not covered under your plan and you would like him or her to have access to this information, this form must be completed and on file in our office.
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Q: How does the mail order RX program work?
A: It's quite simple. You will need to complete a mail order form that can be obtained from our office or your human resources contact.  Once you complete the form, you will have to attach the written prescription along with your payment and forward the information to your pharmacy program provider (ex: AdvancePCS).
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Q: Why did my prescription drug co-pay go up?
A: Many times it's because the drug you are currently taking may have been removed from the formulary list or the price of the medication has gone up.
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Q: Why do drugs go off the formulary list?
A: A newer, safer more effective medication has replaced the old one, the medication was recalled, if a medication becomes generic and it is more cost effective to cover the generic and/or the medication is discontinued by the manufacturer.
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Q: Who decides what drugs will be deleted from the formulary list?
A: The Pharmacy and Therapeutic Committee (P & T) made up of Physicians and Pharmacists.
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Retirement/401k - FAQ

Retirement/401k - FAQ<a name='top'></a>




Q: What is a SIMPLE 401(k) Plan?
A: A SIMPLE 401(k) Plan is a 401(k) plan where the employer no longer has to be concerned with discrimination testing or top heavy rules. In order to maintain a SIMPLE 401(k) plan, the employer must have 100 or fewer employees with at least $5,000 of compensation in the preceding calendar year. As a "trade off" for not having to worry about testing, employers that maintain a SIMPLE 401(k) Plan must make one of the following contributions to the accounts of their participants: (1) a dollar for dollar match on all employee deferrals up to 3% of compensation; OR (2) a 2% nonelective contribution to all eligible employees. Also, all employees are immediately 100% vested.
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Q: What is a Safe Harbor 401(k) Plan?
A: A safe harbor 401(k) plan is a 401(k) plan where employee deferrals and employer matching contributions are no longer subject to nondiscrimination testing.  Beginning in 1999, employers were able to adopt this type of plan and it is available to new and existing plans.  With a safe harbor 401(k) plan, the plan must provide for 100% vesting of the safe harbor contributions.  The safe harbor contributions are equal to either (1) a dollar for dollar match on all employee deferrals up to 3% of compensation and a 50 cents per dollar match on deferrals between 3% and 5% of compensation; OR (2) A 3% nonelective contribution to all eligible employees.
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Q: What is a Key Employee?
A: A key employee is any employee who at any time during the plan year is: (1) An includible officer; (2) For plan years beginning before January 1, 2002, a top ten owner; (3) A 5% owner; or (4) A 1% owner with annual compensation greater than $160,000.
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Q: What is a Highly Compensated Employee (HCE)?
A: Membership in either of the following two groups will cause an employee to be considered a "highly compensated employee":  (1) An employee who is a 5% owner at any time during the plan year or the 12 month period immediately preceding the plan year; or (2) An employee who receives compensation in excess of $110,000 (may be adjusted by the IRS) during the 12 month period immediately preceding the plan year and, at the election of the employer, is a member of the top-paid group during the prior plan year.
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Q: What is the max that can be deferred into a retirement plan?
A: The 401(k) deferral limit for 2010 is $16,500.  The deferral limit for a SIMPLE 401(k) in 2010 is $11,500.  These dollar limitations apply to both Pre-Tax and Roth contributions and may be increased by the IRS for cost of living adjustments.
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Q: What is a Catch-Up Contribution?
A: "Catch-Up" Contributions are a provision of EGTRRA that allow older employees to defer amounts in excess to the otherwise applicable deferral limits set by the IRS. If the plan permits, participants who are age 50 or older may make these additional contributions.  The catch-up limits for 2010 are $5,500 to a traditional 401(k) plan and $2,500 to a SIMPLE 401(k) plan.
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Q: What is the difference between "Pre-Tax" and "Roth"?
A: Pre-Tax contributions are deducted from an employee's compensation before Federal and State taxes are calculated. An employee's pre-tax contribution is still subject to Social Security and Medicare Taxes. Roth contributions are deducted from an employee's compensation after all payroll taxes are calculated.
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Q: What is the Maximum Deductible Limit for an employer sponsoring a plan?
A: The deductible limit is 25% of eligible compensation.  This limit applies to Employer Contributions only (employee Pre-tax and Roth contributions are not considered in this calculation).  Prior to 2002, the maximum amount that an employer could deduct for contributions to a 401(k) or profit sharing plan was 15% of total compensation of plan participants and for a money purchase plan the limit was 25% of total compensation of plan participants.
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Q: When can an employee take a distribution from the plan?
A: The IRS limits the events which cause a distribution to the following: Termination of Employment, Death, Disability and Retirement. Employees are also able to take a loan from the plan or a "Hardship Withdrawal" if the plan permits these types of distributions.
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Q: What type of plan(s) can a terminated employee roll their money into?
A: An employee can "roll" their money into any type of qualified retirement plan (for example, a distribution from a 401(k) plan can be rolled into a 403(b) plan).
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Q: How are distributions taxed?
A: Employees who take their distributions as cash are subject to a 20% federal tax withholding.   In several cases, if your distribution is subject to federal tax withholding, your state will require state withholding as well.  In addition, if the employee is less than age 59 ˝, they will be subject to a 10% excise tax when they file their taxes for the year of the distribution. Employees can avoid taxes by rolling their money into another qualified plan or into an IRA.
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Q: An employee wants to take a loan from the plan. What are the requirements?
A: First of all, the plan has to allow for loans.  Plans are not required to offer employee loans as a provision.  If the plan offers loans, generally an employee is able to take a loan of up to 50% of their vested balance.  Loans have to be paid back in 5 years (unless it is for the purchase of a primary residence) at a reasonable rate of interest with at least quarterly payments.  There are other factors that are specific to each plan such as the maximum number of loans an employee can have outstanding at one time or the minimum amount of loan available.
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Q: What is a Hardship Withdrawal?
A: A hardship withdrawal is a distribution from the plan (which is not paid back) resulting from an employee's financial hardship. Hardship withdrawals are not required to be offered by plans and if a plan offers both hardship withdrawals and loans, the employee must exhaust all of the available loans before a hardship withdrawal is an option. Many plans use a "safe-harbor" definition of hardship to determine when an employee can take a hardship withdrawal. These "safe-harbor" reasons are as follows: (1) to pay for medical expenses for the participant, his/her spouse or children; (2) to purchase a primary residence; (3) to prevent the eviction or foreclosure on the mortgage of the residence; (4) to pay for expenses related to secondary education for the participant, his/her spouse or children; (5) to pay for funeral expenses for your spouse, parent, child or tax dependent and (6) to pay for repair to your primary residence for expenses that would qualify for the casualty deduction under Internal Revenue Code Section 165. These distributions are taxable distributions and are also subject to the 10% early withdrawal penalty.  Employees are required to stop making their employee deferral contributions for 6 months following a hardship withdrawal.
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Q: What are the Actual Deferral Percentage & Actual Contribution Percentage Tests?
A: The ADP and ACP tests ensure that Highly Compensated Employees (HCEs) are not benefiting from the plan at a rate higher than the Non Highly Compensated Employees (NHCEs). The ADP and ACP are the average of the actual deferral ratios of the eligible employees for each group (HCE & NHCE). The ADP and ACP of the eligible HCEs cannot be more than a certain percentage greater than the ADP and the ACP of the eligible NHCEs or the test fails.
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Q: My ADP or ACP test failed. Now what?
A: When your ADP or ACP tests fail, you have a couple of options to correct the failure. (1) The Employer can make contributions to the accounts of NHCEs which will make the test pass; (2) Excess contributions are recharacterized; (3) Excess contributions and allocable income are distributed to the HCEs until the total excess contributions have been distributed.
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Q: I've been told that my plan is Top Heavy. What does this mean?
A: A plan becomes top heavy if the value of all assets for key employees is more than 60% of the value of assets for all employees. When a plan becomes top heavy, non-key employees must be provided with a minimum contribution. Generally, this contribution will be equal to 3% of compensation.
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Q: What is GUST stand for?
A: GUST is an acronym for the combined legislative changes made by the following: Retirement Protection Act of 1994 adopted as part of the General Agreement on Tariffs and Trade (GATT); Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA); Small Business Job Protection Act of 1996 (SBJPA) and the Taxpayer Relief Act of 1997 (TRA '97).
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Q: What is EGTRRA?
A: EGTRRA is an acronym for Economic Growth and Tax Relief Reconciliation Act which was signed into law on 6/7/01 by President Bush. In addition to reducing marginal tax rates, the Act includes a number of changes that affect retirement plans effective in 2002 or are phased-in beginning in 2002.
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Q: What is a "Restatement"?
A: A restatement is a modification of the written plan documents to incorporate the provisions needed to satisfy revised tax and pension law requirements.  Periodically, the IRS approves entirely new plan documents containing the necessary amendments and each employer who sponsors an existing prototype, volume submitter or individually designed plan will need to adopt and sign the new document to retain the tax advantages of the Plan.
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Q: Why did we have to restate our plan's documents?
A: The IRS has made several changes to the pension laws over the past several years.  The IRS requires that Plan Sponsors completely rewrite their plan documents to reflect these regulatory and legislative changes.  The most recent changes were brought about by the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA). The restatement process will become more routine and will generally be required every 6 years for Plans using prototype and volume submitter documents and every 5 years for individually designed plans.
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Q: What happens if we did not restate our Plan?
A:
If you did not restate your plan timely, you will no longer be in compliance with the Federal tax law's qualification requirements.  This means that your plan will no longer qualify for favorable tax treatment for both the Plan Sponsor and its participants.  In addition, the Plan Sponsor and the employees may be subject to additional taxes, interest and penalties.  If you did not restate your plan timely, you should talk to your TPA about correcting the failure under the IRS's Voluntary Correction Program (VCP).

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Premium-Only Plan (POP) - FAQ

Premium-Only Plan (POP) - FAQ<a name='top'></a>






Q: Why do I need to pre-tax my premiums?
A: By having your employer pre-tax your premium, you will save on Federal, State and FICA taxes on those premium dollars.
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Q: Can I stop pre-taxing my premiums at any time?
A: "No. You cannot change your election at any time, however you can change your election at the beginning of a plan year or if have an eligible change of status. A change in status would be one of the following events:
  • Marriage
  • Birth or Adoption of a child
  • Divorce, Legal Separation or annulment
  • Death of Spouse and/or dependent
  • Termination of employment by employee
  • Termination or commencement of employment by your
  •  spouse or your dependent
  • You or your spouse take an unpaid leave of absence
  • You, your spouse or dependent are switching from
  •  part-time to full-time (or vice-versa)
  • A significant change in your family's health
  •  coverage attributable to your spouse's employment
  • Dependent ceases to satisfy the requirements for
  •  unmarried dependents due to the attainment of age, student status or any similar circumstances as provided under the accident or health plan under which the employee receives coverage
  • A change in the place of residence or worksite of the employee, spouse or dependent
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Q: What types of premiums can be pre-taxed?
A: "The following premiums can be pre-taxed (as allowed by the plan):
  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Supplemental Benefit Premiums (if there is no cash value) 
  • Group Term Life Insurance (for the employee up to a $50,000 policy)
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Q: Which premiums should not be pre-taxed and why?
A: "The following premiums should not be pre-taxed because if the premiums are pre-taxed, any benefit paid to the employee will be subject to income tax withholding:
  • Long-term Disability
  • Short-term Disability
  • Some Cancer Insurances
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Q: Which premiums are not allowed by the IRS to be pre-taxed?
A: Dependent Life Insurance and Long Term Care Insurance premiums are not allowed to be pre-taxed at this time.
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Welcome

Welcome
Since 1984 Midwest Group Benefits has been a leader in employee benefits. Although benefits options continue to change, one thing remains the same -- our commitment is to customer service and our clients.

The Mission is Customer Driven

At Midwest Group Benefits, Inc., our goal is to dramatically increase the value of each employer's benefit dollar by managing costs, providing proactive services and offering a full range of quality products and services.

What We Do For Our Clients


  • Midwest Group Benefits is a full-service employee benefits organization that specializes in helping companies select, develop and maintain a group benefits plan.
  • Midwest Group Benefits provides administrative services, including claims processing, eligibility, implementation, day-to-day service, reporting and compliance in the most professional and cost-effective way possible for your organization.
  • Midwest Group Benefits solves short-term problems in the most timely and cost-efficient way while maintaining focus on delivering long-term benefits.
  • Midwest Group Benefits will focus on solutions that resolve existing problems or shortcomings in employee benefit programs to achieve bottom-line results for our clients to gain better value from their benefit

Flexible Spending Account (FSA) - FAQ

Flexible Spending Account (FSA) - FAQ<a name='top'></a>








Q: Why should I participate in a FSA when I already have health insurance?
A: You can use this account to reimburse yourself for expenses that are not covered by your insurance. For example, your plan may not cover eye-exams, glasses, orthodontics, so you can pay for these expenses pre-tax through the FSA.
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Q:  Is there a tax-advantage for participating in an FSA?
A: Yes, the contributions into a FSA come out of your paycheck "pre-tax". This means that these dollars are not subject to Federal, State or FICA taxes.
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Q: Can I enroll in my company's FSA even if I am not on their health plan?
A: Yes, you may still participate as long as you have met the eligibility as set out in your plan's documents.
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Q:  Can I change my contributions during the plan year?
A: Only if you have a change in status. A change in status would be one of the following events:
  • Marriage
  • Birth or Adoption of a child
  • Divorce, Legal Separation or annulment
  • Death of Spouse and/or dependent
  • Termination of employment by employee
  • Termination or commencement of employment by your spouse or your dependent
  • You or your spouse take an unpaid leave of absence
  • You, your spouse or dependent are switching from part-time to full-time (or vice-versa)
  • A significant change in your family's health coverage attributable to your spouse's employment
  • Dependent ceases to satisfy the requirements for unmarried dependents due to the attainment of age, student status or any similar circumstances as provided under the accident or health plan under which the employee receives coverage
  • A change in the place of residence or worksite of the employee, spouse or dependent
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Q: Can I only submit claims for eligible expenses incurred for myself?
A: No, you can submit claims for eligible expenses for yourself, your spouse and your dependents.
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Q: How do I get reimbursed for my expenses?
A: You must complete a claim form (which is available on this web-site or from your Plan Administrator). Once the claim form is completed and all supporting documentation is attached, mail or fax your form to our office and your claim will be processed. Be sure to sign and date your form!
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Q: How often are my claims processed?
A: Claims are processed weekly on Wednesdays. Claims must be received by our office by noon on Tuesdays.
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Q: How do I know if you have processed my claim?
A: You can check the status of paid claims on www.myflexonline.com or you can always call our office.
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Q: How do I know how much is available in my account?
A: Each time you receive a reimbursement, the check stub will show the amount you have set aside as well as the amount you have been paid to date. You can also check your account balance on www.myflexonline.com or call our office and we would be glad to provide you with this information.
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Q: To make a claim, do I have to wait for the money to be deposited in my account?
A: The amount you set aside each year for the FSA is available to you at any time throughout the plan year. The amount available to you from your Dependent Care Account is the amount you have contributed to date.
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Q: What happens to my account if I terminate my employment?
A: You will be able to request reimbursement for healthcare and dependent care expenses that you incurred prior to your termination date.
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Q: What if I don't use all of my account balance by the end of the plan year?
A: It is important to carefully estimate your expenses for the year in an FSA. Generally after the end of the plan year a plan has a "grace period" in which you can still submit claims for the prior plan year. If after the grace period you still have money in your account, it will be forfeited.
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Photo Gallery

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Photo Gallery
Midwest Group Benefits 10th Annual Golf Outing
July 15, 2010

HSA Plan

HSA Plan
Health Savings Accounts (HSAs) were created by the Medicare bill signed by President Bush on December 8, 2003 and are designed to help individuals save for future qualified medical and retiree health expenses on a tax-free basis.

An HSA is an individual IRA type account that is established by an eligible individual to pay for qualified medical expenses. The HSA stays with the account holder when changing jobs and upon retirement. It is a healthcare reimbursement account that rolls forward, is portable, and can be offered through a Section 125 Cafeteria Plan. 

Who can Establish a Health Savings Account?

  • An individual covered by a High Deductible Health Plan (HDHP)
    • HDHP is defined by the IRS, the plan has minimum deductibles, limits on out of pocket expenses, and the plans can have NO first dollar benefits except for wellness.  Cost of living adjustments (COLAs) are made annually to the minimum deductible and out of pocket limits.
  • An individual under age 65
  • An individual who is not claimed as a dependent on another person's tax return
  • An individual who is not also covered by a low deductible health plan, except for certain permissible benefits
  • Special Rules apply for married couples  - see Forms and Documents above

Benefits of a Health Savings Account


  • Amounts in the HSA build up on a tax-free basis
  • HSA deposits can earn interest
  • Distributions for qualified medical expenses are not taxed
  • HSA's are owned by the individual. They are portable and can be passed on to your beneficiary in the event of your death
  • Long term care premiums can be paid from your Health Savings Account

Businesses


  • If an employer contributes toward an HSA and/or offers the HSA under a Cafeteria Plan the employer gets a deduction
  • Amounts contributed are excluded from the employee's taxable income, up to certain limits (see above – HSA Contributions)
  • Amounts in the HSA build up on a tax-free basis

Note: Excess Contributions may be assessed a 6% excise tax unless the excess contribution and any net income are returned to the individual before the last day of the period for filing the individual's tax return.
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HSA Contributions       

  • Contributions can be made by the employer or employee "pre-tax"
  • Contributions to a HSA must be held by a qualified custodian
  • Maximum contribution limits are set by the IRS and have annual cost of living adjustments (COLAs)
  • Individuals over age 55 can make additional "catch up" contributions of $1,000. Amounts are doubled is the account holder is married and both spouses are 55 years of age.
  • Employer contributions must be "comparable" in order to be excludible from income
  • Medicare individuals cannot make contributions to an HSA


HSA Distributions

  • Distributions from the HSA are excludable from income to the extent that they are used for "qualified medical expenses." A "qualified medical expenses" is generally an amount for medical care as defined in Code Section 213(d), examples of which are on the opposite page. These expenses include medical care for the account holder, and their spouse and dependents.
  • Health insurance may not be purchased from the HSA, except for COBRA continuation premiums or for health insurance coverage while an individual is receiving unemployment compensation.
  • Long-term care insurance premiums may be paid from the account and at the individual's retirement age, any health insurance premium may be paid with HSA funds (with the exception of a Medicare supplement).
  • If a distribution is made from the HSA for other than a qualified medical expense, the distribution is included in the account holder's gross income and is generally subject to a 10% penalty. Effective January 1, 2010 the penalty increases to 20%.

Request A Proposal

Request A Proposal

Thank You

Thank You
Thank you for contacting us, we will be contacting you shortly.

Request A Proposal

Request A Proposal

Retirement Plan

Retirement Plan

Group Health Plans

Group Health Plans
Midwest Group Benefits provides administration services for two basic types of health plans:
  • Partially self-funded health plans - this option provides an innovative alternative to a traditional, fully-insured health plan.  This is accomplished by first purchasing a fully-insured plan from a quality carrier and then working with your health insurance agent and our experts in tailoring the plan's co-pays, coinsurance, deductible limits, etc. to best fit your organization and its employees' needs.  The monthly fully-insured premium is paid to the carrier and any additional claims under the partially self-funded plan are paid as they are incurred.  
  • Self-funded health plans work well for employers with more than 50 employees in any state.  We can administer a self-funded health plan that is protected with re-insurance for large claims.  Unlike the fully-insured plan, you only pay for claims incurred, administrative fees and reinsurance premiums.  For cost effectiveness and outstanding employee service, this approach is hard to beat.

Meet the Staff

How May We Help You?

Meet the Staff
The staff at Midwest Group Benefits is dedicated to personal customer service. Get to know us and we look forward to the opportunity to get to know you.

401(k) Links

401(k) Links

Check Health/Request ID Card

Check Health/Request ID Card

NOTE FOR FIRST TIME USERS:
Your User I.D. is your Social Security Number (all nine digits, no dashes or breaks.)
Your Password is your birth-date (MMDDYYYY).

Upon access, we strongly recommend that you go to My Info & change your password for security reasons.

Service that Exceeds Your Expectations

Service that Exceeds Your Expectations
Our management team is actively and directly involved in meeting your needs. We exceed your expectations by providing fresh thoughts and ideas, by suggesting innovative approaches and by alerting you to hidden opportunities. Once you've worked with us, you'll know we really do care about your success.

Midwest Group Benefits has operated in this market for more than two decades, providing various administrative services to our clients. We have a thorough understanding of area providers and their strategies.  As a local employee benefits firm with local relationships, we are able to provide services to truly exceed your expectations

Flex/HRA Tools

Flex/HRA Tools

Northeast Iowa Schools Insurance Trust

Northeast Iowa Schools Insurance Trust
Welcome to the Northeast Iowa Schools Insurance Trust. The information found on this site will help to inform you about the benefits offered for your health insurance plans, life and disability insurance benefits, and other benefit information useful for you and your family through Midwest Group Benefits, Inc. who serves as your NEISIT Consultant and Administrator.

 A Midwest Group Benefits staff member can be reached toll free at 800-344-3766 or by email:  info@midwestbenefits.com

History of the Northeast Iowa Schools Insurance Trust

History of the Northeast Iowa Schools Insurance Trust
The Northeast Iowa Schools Insurance Trust began with a single school - the Allamakee Community School District during the 1986-1987 school year. Dr. Joseph Schmidt was the Superintendent of the Allamakee Community School District.  It was the goal of Dr. Schmidt to offer this opportunity to the rest of the Northeast Iowa Conference Schools for that year. Three schools - Decorah, Howard-Winneshiek and Oelwein joined with Allamakee to make up the Schools Insurance Trust. At that time two trustees were employed to manage the program. It was their decision to consolidate the four existing programs into one package - taking the best parts of each program into a self-funded health plan.

After remaining at four until the 1997-1998 school year, NEIC Insurance Group added Starmont to the program during the 1998-1999 school year. During that time other schools were contacted and four more schools were added for the 1999-2000 school year - making a total of nine schools. The new schools were Eastern Allamakee, New Hampton, North Fayette and Postville.

The Board decided in July 2002 to change the Third Party Administrator from CDSI to the current TPA, Midwest Group Benefits.

During the 2004-2005 school year NEISIT allowed North Winneshiek and South Winneshiek to join the group. The following year Turkey Valley was added. This brought the total to 12 schools in the trust.

During the spring of 2008 the board decided to look at consolidating the number of plans. They set up a steering committee and they recommended to reduce the number of plans from 9 to 3. They also recommended getting quotes for self-funded, partially self funded and fully insured plans. The Trust's Board of Directors elected to terminate the self-funded health plans, effective, July 1, 2009.  The health plans for the NEISIT were changed to partially self-funded plans, using fully insured health plans through Wellmark  Blue Cross/Blue Shield.  Midwest Group Benefits, Inc. was retained as the administrator for the partial self-funding.

Eastern Allamakee and Turkey Valley decided to leave the trust as of July 1, 2009. So the trust currently consists of 10 schools.

The current Board consists of the 10 Superintendents who are also the Trustees of the Trust.  Each Superintendent serves a one year term as the President of the Trust, rotated alphabetically by school.  Midwest Group Benefits, Inc. serves as the Trust Consultant and Administrator.  Each year it is the responsibility of the Board to determine the benefits, rates, third party administrator and fully insured carrier.

As a result of moving to partial funding in July 2009, the Trust has maintained a healthy fund balance and reserve.  Due to their size and the partial funding, the Trust is able to design and administer benefits that accommodate the needs of the Districts.

NEISIT Board of Directors

NEISIT Board of Directors
Allamakee Comm. Schools
1059 3rd Avenue NW
Waukon , IA 52172
Jamie Curtin
jcurtin@allamakee.k12.ia.us
563-568-3409
FAX 563-568-2677
Supt. Jay Mathis
jmathis@allamakee.k12.ia.us
Decorah Comm. Schools
510 Winnebago Street
Decorah, IA 52101
Darlene Woodhouse
dwoodhouse@decorah.k12.ia.us
563-382-4208
FAX 563-387-0753
Supt. Michael Haluska
mhaluska@decorah.k12.ia.us
  
Howard Winneshiek Schools
1000 Schroder Drive
Cresco , IA 52136
Robyn Lane
rlane@howard-winn.k12.ia.us
563-547-2762
FAX 563-547-5973
Supt. Ted Ihns
tihns@howard-winn.k12.ia.us
New Hampton Schools
710 West Main Street
New Hampton, IA 50659
Sue Bouska
s_bouska@new-hampton.k12.ia.us
641-394-2134
FAX 641-394-2921
Supt. Jay Jurrens
j_jurrens@new-hampton.k12.ia.us
  
North Winneshiek Schools
3495 North Winn Road
Decorah , IA 52101
Wendy Twait
wtwait@n-winn.k12.ia.us
563-735-5411
FAX 563-735-5430
Supt. Tim Dugger
tdugger@n-winn.k12.ia.us
Oelwein Comm. Schools
307 Eighth Avenue SE
Oelwein , IA 50662
Joan Loew
jloew@oelwein.k12.ia.us
319-283-3536
FAX 319-283-4497
Supt. Josh Ehn
jehn@oelwein.k12.ia.us
  
Postville Comm. Schools
314 W. Post
Postville , IA 52162
Melissa Fettkether
mfettkether@postville.k12.ia.us
563-864-7651
FAX 563-864-7659
Supt. Timothy Dugger
tdugger@postville.k12.ia.us
South Winneshiek Schools
304 S. Webster St. Box 430
Calmar , IA 52132
Kris Smith
ksmith@swinn.k12.ia.us
563-562-3269
FAX 563-562-3260
Supt. Kris Einck
keinck@swinn.k12.ia.us
  
Starmont Schools
33202 40th Street
Arlington , IA 50606
Robyn Faust
rfaust@starmont.k12.ia.us
563-933-4598
FAX 563-933-2134
Supt. Troy Heller
theller@starmont.k12.ia.us
North Fayette Schools
105 East Main Street
West Union, IA 52175
Sue Thoms
sthoms@nfv.k12.ia.us
563-422-3851 x127
FAX 563-422-3854
Supt. Duane Willhite
dwillhite@nfv.k12.ia.us

NEISIT: Medical

We Offer (3) Different Plans

NEISIT: Medical
These 3 documents are the Outlines of Coverage for NEISIT Plan 1, 2 & 3.

NEISIT: Dental

NEISIT: Dental
This document is a description of Northeast Iowa Schools Insurance Trust Employee Dental Plan Plan (the Plan). No oral interpretations can change this Plan.

Life Insurance & Long Term Disability

Life Insurance & Long Term Disability
Chris Hoover (South Winneshiek) - President 563-562-3269
Midwest Group Benefits - Consultant 563.382.9611 or 800.344.3766
Email: info@midwestbenefits.com

In order to view/print a policy or a form just click on the item below your school.

NEISIT Consultant/Third Party Administrator

NEISIT Consultant/Third Party Administrator
Mailing Address:
Midwest Group Benefits, Inc.
PO Box 408
Decorah, IA  52101


Physical Address:
Midwest Group Benefits, Inc
2316 Sweet Parkway Road
Decorah, IA 52101

Phone: 563.382.9611
Toll Free: 800.344.3766
Fax: 563.382.9613

For more information or general questions please contact info@midwestbenefits.com.

Phone: 563.382.9611 x 103 | Toll Free: 800.344.3766 x 103 | Email Rachel
Phone: 563.382.9611 x 105 | Toll Free: 800.344.3766 x 105 | Email Pam

Secure File/Document Retrieval

Secure File/Document Retrieval
To retrieve a shared file(s), please enter your username and password in the fields below.

Links

Links

Affordable Care Act (ACA)

Affordable Care Act (ACA)
In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA), into law. The law makes preventive care—including family planning and related services—more accessible and affordable for many Americans.  While many provisions of the law have already taken effect, several more provisions will be implemented in the coming years. 

Questions about the ACA?   Call Midwest Group Benefits, Inc. at 800-344-3766.  We are  YOUR LOCAL RESOURCE for ACA compliance with certified Marketplace Agents on staff.


Contact Us

Contact Us
Mailing Address:
Midwest Group Benefits, Inc.
PO Box 408
Decorah, IA  52101



Physical Address:
Midwest Group Benefits, Inc
2316 Sweet Parkway Road
Decorah, IA 52101


Phone: 563.382.9611
Toll Free: 800.344.3766
Fax: 563.382.9613

Our Work Ethic

Our Work Ethic
Midwest Group Benefits is a full-service benefits organization that specializes in helping companies select, develop and maintain a group benefits plan.

We provide administrative services, including claims processing, eligibility, implementation, day-to-day service, reporting and compliance in the most professional and cost-effective way possible for your organization.

Midwest Group Benefits possesses the knowledge to undertake and solve your short-term problems in the most timely and cost-efficient way while maintaining focus on delivering long-term benefits.

The distinguishing characteristic of our organization is the focus on solutions that resolve existing problems or shortcomings in employee benefits programs. The bottom-line result for our clients is better value from their benefit programs.

For more information or general questions please contact info@midwestbenefits.com, or contact us by department.

By Department:

Flex/HRA/HSA Department

Rachel Narum - Marketing/Administration
Nancy Hager - Claims Processor/Service

Pension/Retirement Plans

Sara Hotvedt - Marketing/Administration   
Kelly Elsbernd - Administration

Medical Claims Department

Deb Decker - Claims Processor
Barb Moore - Claims Processor
Wendy Ney -  Eligiblity
Pam DePuew - Claims Supervisor

Prescription

Pam DePuew

COBRA

Wendy Ney
Nancy Hager

Payroll Services

Kelly Elsbernd
Sara Hotvedt


TPA Administration

Pam DePuew

Accounting

Kelly Elsbernd

NeuBridg

Sara Hotvedt
Kelsey Einck




Managed Care

Managed Care

Preferred Provider Networks

Midwest Group Benefits contracts with Midlands Choice to help our clients effectively manage the quality and cost of their health benefit program.

Midlands Choice is a regional preferred provider organization (PPO) with a healthcare network of more than 20,000 physicians and other healthcare professionals, 300 hospitals, and 1,300 other healthcare facilities.  By contracting with Midlands Choice, these providers agree to perform healthcare services at a reduced fee.  Consumers with coverage through one of our 150 payer partners have lower out-of-pocket costs for healthcare services when they use network providers.

If you would like more information on Midlands Choice, please visit their website at:
www.midlandschoice.com


Managed Healthcare Services
An international and independent leader in personalized managed healthcare, Hines and Associates provides the following on a contract basis to Midwest Group Benefits, Inc.

  • Pre-Certification
  • Utilization Reviews
  • Case Management
  • Disease Management


Hines' Specialty Case Management Overview:

  • BABEsm Maternity Management:  Targeted to women with special needs during pregnancy.
  • Dialysis Management Program: Renal/Dialysis nurses with an average of over 10 years of clinical experience.
  • Oncology:  Hines provides a family approach to case management during what can be a difficult and emotional time.
  • PsychiatricThe complexities of today's healthcare system are more easily navigated with the aid of our psychiatric specialty case managers.
  • Transplant ProgramCases are assigned early during the critical pretransplant period.  Hines' nurse specialists continue with the patient, providing continuity of care and expertise.


When employees participate in a Flexible Spending Account:

When employees participate in a Flexible Spending Account:
  • They contribute pre-tax dollars in advance to an account in their name. You as the employer hold the employee's contributions until the money is requested by Midwest Group Benefits.
  • Later, when they have eligible expenses, they can be reimbursed from their account. Employees may submit for reimbursement as often as they like. Claims are processed in our office weekly.
  • Click here to complete or print a Flexible Spending Claim Form.
  • Employees may withdraw the total amount of their Medical Spending account election at any time during the plan year once they have incurred reimbursable expenses
  • For the Dependent Care Account employees can only be reimbursed for amount that they have contributed to date.
  • The general calculation for tax savings is to multiply the amount of money an employee will redirect by their tax rate. Here is an example:




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Who Can Sponsor a Flexible Spending Account Plan?

Regular corporations, partnerships, S corporations, limited liability companies (LLCs), sole proprietors, professional corporations and not-for-profits can all save money on payroll taxes by establishing a Flexible Spending Account. While regulations prohibit a sole proprietor, partner, members of an LLC (in most cases), or individuals owning more than 2% of an S corporation from participating in the plan, they may still sponsor a plan and benefit from the savings on payroll taxes.

Who Can Participate in a Medical Flexible Spending Account?

The IRS issued guidance for Health FSAs in September 2013 in Notice 2013-54.  This Notice requires that to be eligible to participate in a Health FSA, the employee must be "eligible" on the employer's group health plan.  The employee does NOT, however, have to be enrolled on the group health plan to participate.

IRS Notice 2013-54 also clarified limitations to what employers could contribute on behalf of employees to a Health FSA.  Employer credits to Health FSAs must limit the maximum payable to 2 times the participant's salary reduction or, if greater, the participant's salary reduction plus $500.  What does this mean?  Simply that Health FSAs can include employer contributions of $500 or up to a dollar for dollar match of each participant's salary reduction.


The IRS

  • There are several 'rules' the IRS has implemented for Section 125 participants that you should be aware of: 
    • Plan Year. Only expenses incurred during the plan year are reimbursable (though payment of these expenses can be carried over for a short time.)
    • Separate Accounts. Un-reimbursed medical expenses and dependent care expenses are treated as separate accounts. The IRS does not allow employees to transfer money between those accounts.
    • Family Status Changes. Once you make your decisions on how much you redirect into your spending accounts, this cannot change… except for changes in your family status which include: Marriage, divorce, death of a spouse or child, birth or adoption of a child, or change in your spouse's employment status from full-time to part-time or vise versa.
    • Forfeiture of Unused Balance. If expenses you incur for the Plan Year are less than your contributions for that same Plan Year, you will forfeit the unused balance. With wise and conservative planning most participants do not forfeit any money.
           

Contact Us Today

Setting up a Flexible Spending Account Plan is an easy and cost effective way to enhance your employees benefits program.  Request a Proposal and see how easy it is for you and your employees to save tax dollars!

Tools & Helpful Documents

Tools & Helpful Documents

HSA Tools & Helpful Documents

HSA Tools & Helpful Documents

What Our Clients Say About Us

What Our Clients Say About Us
"I have worked with Midwest Group Benefits for several years now and have been extremely pleased with the services they offer. They definitely take a lot of the pressure off when it comes to the administration of a plan. I can always count on them to keep me up to date with compliance issues and to answer any questions I may have. Their customer service is top notch, always friendly and very professional. I am very thankful that I can turn to Midwest Group Benefits for any needs I may have knowing that they will help me out."
Heather Mount
Director of Human Resources
Iowa Rotocast Plastics, Inc.
Decorah, IA

Deb Decker | Medical Claims Department

Phone: 563.382.9611 x 113 | Toll Free: 800.344.3766 x 113 | Email Deb
Deb has worked with Midwest Group Benefits since 2000.  She processes claims and is the stop/loss coordinator.

Customized Products & Plans

Customized Products & Plans
Group Health Insurance
Flex Plans
HRA Plans
HSA Plans
Group Retirement Plans
Group Disability Insurance
Group Dental and Vision Insurance


Consulting Services

  • Employee Benefit Philosophy
  • Benefit Audits/Design Analysis
  • Benefit Plan Design/Implementation
  • Plan Cost Projections
  • Regulatory Compliance

Employee Benefit Administration

  • Medical, Dental & Vision Administration
  • Pension Plan Administration
  • Flexible Benefits Plan Administration
  • HRA Administration

Your Complete Employee Benefits Specialist

Midwest Group Benefits, Inc. is your advocate, advisor, and coordinator for your employee benefit plans. We will provide you with the best possible value in employee benefits by seeking the right combination of services and price.  Discover the Midwest Group Benefits difference for yourself.

Contact us today. Toll free:  800-344-3766 or 563-382-9611
Online at www.midwestbenefits.com
Find us on Facebook

News

News
Midwest Group Benefits publishes an email newsletter to update and educate our clients and vendors about health care issues and the latest news on health care reform . If you are interested in finding out the news at  Midwest Group Benefits or in Employee Benefits, we invite you to browse through our e-news.

Click Here to Read Our Current Newsletter


Pharmacy Management

Pharmacy Management
Midwest Group Benefits also contracts with MagellanRx, CVS/Caremark and NPS/National Pharmaceutical Service to provide our clients with a cost effective solution to pharmacy benefits.

Pharmacy Partners

At Magellan Rx, we're providing a smarter approach to pharmacy benefits. Our integrated solution combines our pharmacy benefit and specialty pharmacy expertise into an organization, allowing us to leverage our collective scale and experience in managing total drug spend, while ensuring a clear focus on the specific needs of each of our individual customers.  By truly understanding your needs, we empower you with easy-to-use tools and insightful cost savings solutions that improve member health and help you make more informed decisions.
  • Customer First Culture
    • Our strong focus on the customer will continue with an even greater emphasis on solutions and innovations that benefit our clients.
  • Trusted Scale and Resources
    • Magellan manages $15B in annual drug spend.  This adds additional scale and resources to the existing PBM efforts you've come to trust.
  • Unparalleled Experience
    • With over 40 years of Medicaid-focused experience, serving over half the nation's programs, our depth of health plan and State Medicaid experience gives you a highly-qualified team to manage successful implementations and ensure a seamless transition.
  • Integrated Specialty Pharmacy
    • We'll now be able to bring you an industry leading, patient-focused specialty pharmacy, featuring proven cost savings by integrating medical and pharmacy data for improved compliance and treatment outcomes.

At Magellan Rx, we provide proven cost-savings options, the knowledge for better decision making, and a partnership culture that uniquely adapts to the needs of our clients. It's an innovative pharmacy benefit approach that leads to more efficient cost control, improved outcomes and increased member satisfaction. 

Welcome to a unique vision of care.  Welcome to Magellan Rx.

CVS/Caremark provides pharmacy benefit management for plan sponsors seeking pharmacy and health care savings, better health outcomes and a more desirable plan member experience.  Plan sponsors and members have access to CVS Caremark mail service and specialty pharmacies and a network of approximately 60,000 retail pharmacies.

Together, Midwest Group Benefits and CVS/Caremark manage your prescription plan, benefit administration and eligibility.  They also perform ad hoc reporting and provide consistent customer care so that you can focus on your core business objectives.

Plan sponsors and members alike consistently give CVS/Caremark
high satisfaction scores:
  • 2009 client satisfaction: 98%
  • 2009 member satisfaction with mail pharmacy, Customer Care and specialty: 96% or better
Members can learn more about their prescription benefits by calling CVS/Caremark Customer Care toll-free or by visiting www.caremark.com

NPS/National Pharmaceutical Services  is a division of PTI, Pharmaceutical Technologies, Inc. formed in 1992 by a group of pharmacists in Omaha, Nebraska with an idea that was surprisingly simple:  change the way managed pharmaceutical healthcare operates. 

The top three reasons for choosing NPS/National Pharmaceutical Services as your pharmacy benefit provider are:
  • Value:  Services are priced fairly with no hidden transaction fees; Nationwide pharmacy network with 24-hour customer service and mail order program
  • Innovation:  Real-time reports; Custom designed plans; Claim activity tracking for more effective plan modeling
  • Trust:  Alignment with the "risk" entity, not pharmaceutical manufacturers; Data secure

And NPS/National Pharmaceutical Services also provides "Snapshot Reports" which are easy to understand; Clinical Program Services to assist clients in all aspects of plan; Communication to Members through the Prescription Drug Explanation of Benefits (EOB) report which assists members in determining level of accuracy of their claims and offers alternative drug products information.  To access the NPS website click here:  www.pti-nps.com




Midwest Group Benefits Flex Plan Offers Your Company Two Options:

Midwest Group Benefits Flex Plan Offers Your Company Two Options:

  • Premium-Only Plan — This plan enables employees to pay for their premium portion of employer-sponsored insurance benefits on a pre-tax basis. This amount is automatically deducted from the employees' salaries before taxes, thus reducing taxable income while increasing the employees' take-home pay. Click here for more information.
  • Flexible Spending Account (FSA) — This plan allows employees to pay for dependent care and/or out-of-pocket health care expenses not covered by insurance with pre-tax dollars. The FSA works as a budgeting tool to enable employees to plan for their out-of-pocket dependent care and/or health care expenses for the year and be able to pay for those out-of-pocket expenses before taxes. Click here for more information.
  • With Midwest Group Benefits Flex Plan everyone wins. Payroll taxes are reduced for the employer, while more take-home pay goes to employees.


Flex Tools & Helpful Documents

Flex Tools & Helpful Documents

Agents

Agents
In addition to our in-house staff, Midwest Group Benefits works with a number of outside agents to help serve our clients. The following local agencies have partnered with Midwest Group Benefits, Inc., to be able to offer our services.
A & J Petersburg Agency, Decorah IA
Mark DonhoweBushman Insurance and Real Estate, Ossian IA
Normie FerrieFinancial Decisions Group, Oelwein IA – Neil Wilkinson
Tom BushmanCIA Insurance, Cresco IA

Email Newsletters - Archives

Email Newsletters - Archives

Pam DePuew | Group Health/Claims/TPA Admin

Phone: 563.382.9611 x 105 | Toll Free: 800.344.3766 x 105 | Email Pam
Pam has been employed by Midwest Group Benefits since August 2009.  She has 15 years combined experience in the insurance, claims processing, account review, and customer service business.  Pam is a Licensed Agent for in P & C, and Life & Health.

Important Links for NEISIT

Important Links for NEISIT

Wellmark Link
Click on the link above.  The Wellmark page will appear.  Set up a username and password for yourself (See upper right hand corner of page to do this initial setup).  Keep the username and password in a place you can access should you forget.

Flex Link (if you have a Flex Plan)
Click on link above.  A screen will appear titled MyFlexOnline.  Set up a username and password for yourself.  Keep the username and password in a place you can access.  If you forget the password you can call Midwest Group Benefits @ 800.344.3766 toll free or 563.382.9611.  They can reset the password in real time.

Partial Funding Claims Information Link
Click on link above.  A screen will appear titled Webeci.  Your login will always be your social security number.  Your first login password is your birthdate in this format mm//dd/yyyy. After this, you will go to a new screen to set up your permanent password.  If you forget your password, you can call Midwest Group Benefits @ 800.344.3766 toll free or 563.382.9611.  They can reset the password in real time.


Plan 1

This document is a description of Northeast Iowa Schools Insurance Trust Employee Healthcare Plan (the Plan). No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses.

All Schools (Life & Disability Claim Forms)


Secure File Upload

Secure File Upload
The below form allows you to safely and securely upload and share your files/documents with our representatives. Please select from the recipients below, complete the form and then click one of the 'Browse' buttons to locate the files stored on your computer. You can attach and send several files at once by selecting the additional available 'Browse' buttons. Once you have satisfactorily completed these steps, select the 'Upload Files' button to submit your files.

Flex Tools & Helpful Documents

Flex Tools & Helpful Documents

News Links (...read on) articles

News Links (...read on) articles

Wellmark Plan Document (Plan 1)

This Wellmark Plan Document (Plan 1) is used for our partially self funded NEISIT Plans 1 & 3.

Plan 2

This document is a description of Northeast Iowa Schools Insurance Trust Employee Healthcare Plan (the Plan). No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses.

Allamakee Comm. Schools


Marketplace Exchange Notices

Marketplace Exchange Notices

On May 8, 2013 the DOL Employee Benefits Security Administration provided temporary guidance for employers on this exchange notification requirement in Department of Labor Technical Release 2013-02.  The technical release provides information for employers about the requirement that it notify employees by October 1, 2013 about coverage options in exchanges or health insurance marketplaces.  The technical release also contains two alternative model notices that employers may (but are not required to) use to provide notification.  We have provided the notices below for your convenience.



NOTE: The DOL released FAQ on September 11, 2013 stating that although employers SHOULD provide the Exchange Notice, there will be no fine or penalty under the law for failing to provide it.


Kelsey Einck |  Supplemental Unemployment Benefit (SUB) Plan Administration

Phone: 563.382.9611 x 104 | Toll Free: 800.344.3766 x 104 | Email Kelsey
Kelsey has been employed with Midwest Group Benefits since the Summer of 2014.  She provides customer service to our SUB plan clients and their employees.  Kelsey graduated from Northeast Iowa Community College in May 2015 earning her Associate of Applied Science in Administrative Office Management degree.

Kelly Elsbernd | Chief Operating Officer |Pension/Retirement/Accounting

Phone: 563.382.9611 x 109 | Toll Free: 800.344.3766 x 109 | Email Kelly
Kelly has been employed at Midwest Group Benefits since 2007 and is the Chief Operating Officer.  She has a degree in Business Management and earned her APA (Accredited Pension Administrator) designation in 2012.

Wellmark Plan Document (Plan 2)

This Wellmark Plan Document (Plan 2) is used for our partially self funded NEISIT Plan 2.

Nancy Hager | Flex/HRA/HSA Department

Phone: 563.382.9611 x 112 | Toll Free: 800.344.3766 x 112 | Email Nancy
Nancy has been employed at Midwest Group Benefits since 2008.
She has over 20 years experience in the HR/Benefits industry and in 1998 received the Franciscan Skemp Wellness Award on behalf of her company.

Plan 3

This document is a description of Northeast Iowa Schools Insurance Trust Employee Healthcare Plan (the Plan). No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses.

Decorah Comm. Schools


Affordable Care Act Tax Provisions

Affordable Care Act Tax Provisions
The Affordable Care Act contains many tax credits and other provisions for both individuals and employers.  The IRS administers the tax provisions contained in the law.  Below is a link which provides more information on the various tax provisions.

Payroll

Payroll

Sara Hotvedt | Chief Executive Officer |Pension/Retirement

Phone: 563.382.9611 x 108 | Toll Free: 800.344.3766 x 108 | Email Sara
Sara is the Chief Executive Officer of Midwest Group Benefits.   Sara has specialized in the retirement plan administration area since 1999 and is involved all aspects of plan administration.  She is a Luther College graduate with a BA Degree in Accounting and also earned her APA designation in 2002 from the National Institute of Pension Administrators.

Wellmark Plan Document (Plan 3)

This Wellmark Plan Document (Plan 1) is used for our partially self funded NEISIT Plans 1 & 3.

Howard Winneshiek Schools


NEISIT Partial Self Fund Summary Plan Description

NEISIT Partial Self Fund Summary Plan Description
This document contains a description of the Northeast Iowa Schools Insurance Trust Partially Self Funded Plan.  No oral interpretations can change this Plan.  The Plan described is designed to protect Plan Participants against certain catastrophic health expenses.

Plan Comparisons

Plan Comparisons
This document contains a description of Northeast Iowa Schools Insurance Trust Employee Healthcare Plan (the Plan). No oral interpretations can change this Plan. The Plan described is designed to protect Plan Participants against certain catastrophic health expenses.

New Hampton Schools


Barb Moore | Medical Claims Department

Phone:  563.382.9611  x 111    | Toll Free:  800.344.3766 x 111  | Email Barb
Barb has been employed with Midwest Group Benefits since June 2011.  She earned her Associate of Applied Science and Coding Specialist Diploma from NICC in May 2011.

North Fayette Schools


Rachel Narum | Group Health/Consulting

Phone: 563.382.9611 x 103 | Toll Free: 800.344.3766 x 103 | Email Rachel
Rachel is a CPA, and Licensed Insurance Agent.  She has been employed with Midwest Group Benefits, Inc. since 1999.  Her duties include Benefits Administrator, Consultant and Marketing for group health clients.

North Winneshiek Schools


Wendy Ney | Eligiblity & COBRA Coordinator / Administrative Assistant

Phone: 563.382.9611 | Toll Free: 800.344.3766 x 101 | Email Wendy
Wendy has been employed with Midwest Group Benefits since August 2016.  Wendy is the Eligibility Coordinator for our Partially and Fully Self Funded Clients and is also the administrative contact for our COBRA clients. 

Oelwein Comm. Schools


South Winneshiek Schools


Starmont Schools


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