Viewing posts from: July 2012

U.S. Department of Labor Publishes Employee FMLA Guide

Posted July 18, 2012 by Megan DiMartino

As part of the Department’s continuing effort to spread the word about the FMLA and make the FMLA more accessible, WHD is releasing an Employee Guide to the FMLA, a 16-page, plain language booklet designed to answer common FMLA questions and clarify who can take FMLA leave and what protections the FMLA provides.

The Employee Guide specifically addresses:

  • Who can use FMLA? (Coverage and Eligibility)
  • When can I use FMLA? (Qualifying reasons to take FMLA)
  • What can the FMLA do for me? (FMLA rights and protections)
  • How do I request FMLA leave?
  • Communication with Employer (Employer and Employee Notices)
  • Medical Certification
  • Returning to Work (Reinstatement rights)
  • How to File a Complaint

Additional information is available on the DOL website.


CDC Report: Obesity Rates to Increase Over Next Two Decades

Posted July 16, 2012 by Megan DiMartino

By Melissa Healy, Los Angeles Times

Obesity in the United States is projected to continue its rise over the next 18 years, extending to 42 percent of Americans by 2030, according to a study released by the Centers for Disease Control and Prevention. That expected growth in the proportion of obese Americans — up from 34 percent– contained good news and bad: Obesity’s growth has slowed from the record-setting pace that has marked most of the last three decades. At the same time, the numbers of the severely obese — those carrying 80 or more pounds more than the healthy, normal weight for their height — is expected to grow by 130 percent.

The continued growth in obesity will be expensive, said CDC statisticians. Additional spending on healthcare for Americans who will join the ranks of the obese in the next 18 years was projected to reach $549.5 billion over the next two decades. By the most current obesity statistics, 35.7 percent of American adults — 78 million people — and 16.9 percent of U.S. children and adolescents — 12.5 million kids — are obese, meaning their body-mass index is 30 or over.

The new projections capture several trends in American society, including the swelling population of Latino adults, among whom obesity is a growing problem, the transition into adulthood of a population of obese children — especially African American boys — who stand a high likelihood of becoming obese adults, and the aging of overweight and obese adults, who are far more likely to take on more weight than to lose as they get older. In a bit of good news, the obesity rate among women was flat. Currently, 35.8percentof American women are considered obese, and the forecast does not predict a significant change in that level.

Still, the projected 33 percent rise in obesity is rosier than the 51 percent rise that had been projected by statisticians assuming a continued level of the roaring growth seen in the 1980s, 1990s and early 2000s. “This and other forecasts likely overstate future obesity prevalence given the recent evidence of slower growth,” wrote Duke University global health professor Eric A. Finkelstein and co-authors in a forecast of the nation’s weight problem close to 20 years out.

In a news conference that was the centerpiece of a second annual “Weight of the Nation” conference in Washington, D.C., Finkelstein said it was unclear whether the galloping rate of growth has slowed because of public policy initiatives aimed at preventing child obesity, greater societal awareness of obesity’s risks, or because Americans have hit the maximum level of fatness a population can sustain. “The slope has changed,” he said. “Statistically,” he noted, “it doesn’t take much” for obesity prevalence to rise from 34 percent to 42 percent in 18 years.

By the same logic, the authors of the projection noted that even small successes in anti-obesity efforts — new, more effective weight-loss drugs, communities and campaigns designed to encourage more exercise and healthier eating, work-site health-promotion policies — could flatten the upward curve. “Even small improvements in obesity prevalence … could result in substantial savings,” they added. The projected $549.5-billion healthcare bill represents the difference between providing healthcare for a population with 34 percent obesity and a population whose obesity prevalence has risen to 42 percent.

The CDC forecast took into account a host of factors thought to influence Americans’ eating and exercise habits, including the cost of groceries, the density of restaurants, rates of unemployment, Internet access and the price of gas. Most important, however, was the aging of the population, which tends to nudge many overweight adults into the obese category, and to push a growing number of those who are already obese into “severely obese” territory.

2012 Revised Healthcare Reform Timelines, Version 7.0

Posted July 10, 2012 by PHaynes

If you want to see 10 pages of health reform in a 1 page timeline (well, 1 page for Employers and 1 page for Employees) then please visit our website (

But, if you are looking for details specific to just a certain year or plan, then you can’t do better than this implementation timeline from The Kaiser Family Foundation.

AP Benefit Advisors’ Timelines

Kaiser Family Foundation Implementation Timeline


Additional Clarity? Certainty? Or, just more guidance to help Employers/Plan Sponsors avoid fines?

Posted July 6, 2012 by Megan DiMartino

Patrick C. Haynes, Jr., Esq., LL.M.

The Department of Labor (DOL) issued additional guidance on May 11, 2012. Clarifying some points, federal regulators made clear(er), that they will not be imposing financial penalties on employers that do not “fully comply” with the Affordable Care Act’s new requirements to distribute SBCs (Summaries of Benefits and Coverage), provided they continue to make “good faith efforts” to comply. In their FAQ, series (Part 9), they update us all regarding:

  1. Electronic distribution?
  2. Triggering events for SBC distribution?
  3. Question – is there a need to reissue an SBC upon application (if the SBC remains unchanged)?
  4. Issue SBCs to people that are only “shopping” the coverage?
  5. Can the SBCs guide people to documents other than an SPD?
  6. Can SBCs contain electronic features (like scrolling, etc.)?
  7. Can SBCs be combined with other documents/materials?
  8. Circumstances under which penalties can be imposed?
  9. Safe harbor calculator for the first years’ examples?
  10. Any obligation to describe carved-out coverages within the SBC?
  11. Where can written translations of the SBC’s uniform glossary be found? Does that include Spanish, Chinese, Tagalog and Navajo? Yes. English is available here. To request either the SBC or Uniform Glossary in Spanish, Chinese, Tagalog or Navajo, contact to request copies.
  12. Do carriers have to issues SBCs for insurance products that are no longer being offered?
  13. Can expatriate plans/policies be shown some leeway for the first year of SBC compliance?
  14. Other than the FAQs, are there any other updates to the SBC templates? Yes. The updated versions of these documents are labeled “corrected on May 11, 2012” in the lower right corner of the first page and are available at and These three documents replace the prior versions issued contemporaneously with the final regulations in February 2012.

For Clients & Friends of AP Benefit Advisors: If you need additional help/assistance with your SBCs please contact your Sales Executive or Account Manager. Thank you.

Obama to Veto FSA, HSA Legislation

Posted July 2, 2012 by Megan DiMartino

by Jerry Geisel

WASHINGTON—President Barack Obama will veto legislation that would ease a 28-year-old Internal Revenue Service rule that requires forfeiture of unused flexible spending account balances and eliminates restrictions on using FSAs and health savings accounts to pay for over-the-counter medications, the administration said Wednesday.

Under the measure headed for a vote this week on the House floor, employers could amend their FSAs to allow employees to withdraw as taxable cash up to $500 in unused balances remaining at the end of the plan year or at the end of an FSA grace period, if an employer has that feature. If passed, the measure would be considered by the Senate.

OTC medications

In addition, H.R. 436 would overturn a health care reform law provision that allows FSA reimbursement of OTC medications without a prescription and imposes a 20% federal tax on HSA distributions for OTC medications obtained without a prescription.

Those provisions are part of a broader bill, H.R 436, that would repeal a provision from the Patient Protection and Affordable Care Act that imposes new federal excise taxes on medical devices and boosts repayments of federal premium subsidies provided to low-income and middle-class uninsured individuals in situations in which the subsidies turn out to be higher than the individuals were entitled.  It is those provisions that the administration opposes.

“This excise tax is one of several designed so that industries that gain from the coverage expansion will help offset the cost of that expansion,” the Office of Management and Budget said in a statement.

“In sum, H.R. 436 would fund tax breaks for industry by raising taxes on middle-class and low-income families. Instead of working together to reduce health care costs, H.R. 436 chooses to refight old political battles over health care. If the president were presented with H.R. 436, his senior advisers would recommend that he veto the bill,” OBM said.

Subscribe to Our Blog