Viewing posts from: December 2014

Popular Employee Benefits Blogs

Posted December 30, 2014 by Megan DiMartino

Employee benefits stands among the most complex and relevant issues in the business world. Failure to understand the implications of benefits offerings can prove costly in a variety of ways, from employee retention and absenteeism to regulatory fines and penalties. To learn more about benefits principles, services, and regulatory updates, check out a few of our most popular recent blogs:

New SBCs for 2015 – for use on/after September 1, 2015

Posted December 29, 2014 by PHaynes


The Departments (Departments of Health and Human Services, Labor, and the Treasury) released proposed changes to the regulations regarding SBCs (Summary of Benefits and Coverage) and the uniform glossary that goes with it. These proposed regulations amend the final regulations that were published on 02/14/2012 (the 2012 final regulations) and includes revisions to the templates, instruction guides, uniform glossary, and other supporting materials for compliance with the regulations.

Today’s proposed rules generally address the requirements for SBCs and uniform glossaries that, if finalized, would be available to consumers (more…)

TIPA (the Tax Increase Prevention Act) and your 2014 Transit Plan

Posted December 29, 2014 by PHaynes

congress2On December 19th, President Obama signed TIPA (The Tax Increase Prevention Act) into law.  This law began as a bill on December 1st, passed the House on December 3rd and the Senate on December 16th.  While it attempts to do many things, this post will focus on what it does and doesn’t do for Employer-Sponsored Pre-Tax Transit plans [such as allowing transit plans to have the same dollar limit as parking plans for 2014 (equalized/same-level)].

What does “equalizing” mass transit and parking mean?

It means that the $130/month limit on transit-benefits can be raised to the level of parking benefits at $250/month.


When is this effective?  12/19/2014, and retroactive to 1/1/2014.

What does this mean for ER-sponsored-transit plans?  For most of them—nothing. There’s no way to prospectively take more monies out of your remaining 2014 paychecks and spend them (in each month of 2014) subject to the new monthly limits.

So, no one can benefit from this?  Well, I suppose that if you allowed transit-plan-participants to make $130/month pre-tax transit election and another $120 post-tax-election for the purchase of transit passes/etc. then, the extra $120 of deductions could now be “switched” in your payroll systems so that they would enjoy a pre-tax status. Other than that, rare scenario, most Employer-sponsored plans won’t be able to take advantage of this.

But, doesn’t this mean I can increase my 2015 transit elections?  No. TIPA only took the tax benefits that expired on 12/31/2013 and extended them until 12/31/2014. So, unless and until Congress acts for 2015’s limits, we will have no choice but to hold Parking & Transit limits at their current levels.

Didn’t Congress just announce the 2015 Parking & Transit limits back in OctoberYes, they did. With IRS Revenue Procedure 2014-61 they announced:

  • the monthly limitation under § 132(f)(2)(A) for transportation in a commuter highway vehicle and any transit pass is $130
  • the monthly limitation under § 132(f)(2)(B) regarding the fringe benefit exclusion amount for qualified parking is $250.

Should you have any follow up questions or concerns, please contact your Account Manager or Sales Executive.

Employee Communications in Large-Scale Business Models

Posted December 29, 2014 by Megan DiMartino

employeeCommEffectively communicating an employee benefits package to potential and current employees is essential to attracting and retaining talented employees. This is especially true for large employers. Every step in the communication process adds complexity to an already challenging process. Communicating new benefits plans and offerings while addressing issues as they arise is a critical component of any modern large business.

Benefits plan documents can be very confusing and complex. Streamlining information and putting it in laymen’s terms greatly increases the odds that employees will understand their options and make informed decisions. If you’re only providing insurance carrier booklets, you may be missing an opportunity to better communicate your program, especially the features that help control costs. Effective communication is vital if you want to see a return on your group health benefit investments and retain top talent.

Services/tools relevant to the task include:

  • Employee benefit and enrollment guides
  • Benefits Enrollment Forms
  • Frequently Asked Questions
  • Instruction sheets
  • Postcards
  • Posters
  • Payroll stuffers
  • Personalized benefit statements
  • Newsletters

Is your business prepared for what lies ahead? Contact us to learn how the creation of benefit materials can help you prepare your employees for the inevitable changes reaching businesses throughout the nation.

New AP Benefit Advisors Webinar Available On-Demand: Wellness Plans On Trial

Posted December 19, 2014 by Megan DiMartino

dec 2014 webinar thumb smAP Benefit Advisors General Counsel and Vice President-Compliance, Patrick Haynes, reviews the EEOC’s litigation against employer’s wellness plans. Wisconsin based Orion Energy Systems is accused of violating federal law by requiring an employee to submit to medical exams and other inquiries that, according to the EEOC, were not consistent with business necessity as part of a “wellness program”. When they subsequently fired the employee who objected to the program, the EEOC filed a lawsuit. The EEOC maintains that Orion’s wellness program violated the Americans with Disabilities Act (ADA) and further asserts that Orion interfered with the employee’s exercise of federally protected rights to not be subjected to unlawful medical exams and disability-related inquiries. Topics discussed include:

  •  EEOC vs. Orion Energy Systems
  •  EEOC vs. Flambeau Inc.
  •  EEOC vs. Honeywell
  •  Compare/Contrast those cases to bona-fide HIPAA/PPACA Compliant Wellness Plans
  •  Strategies for implementing plans that make sense and avoid litigation

View the webinar at

What Is the Advantage Program?

Posted December 15, 2014 by Megan DiMartino

Consulting-and-BrokerageThe Advantage Program is designed to identify opportunities to increase ROI or identify risks with regard to regulatory compliance and other benefits-related issues. A unique, consultative approach to analyzing benefit plans is fundamental to this process. We have identified 11 critical indicators that differentiate a “high performing” employee benefit plan from a “non-high performing” plan.

The Advantage provides a clear picture of a company’s current plan, its challenges, strengths and opportunities, and a strategy for its future; while giving a potential client the opportunity to take a virtual test drive of Crawford’s intellectual capital.

It begins with the completion of The Starter Kit, followed by a 90 minute, fact-gathering workshop we call “Discovery” and culminates with a customized benefits strategy and executable timeline – the BluePrint. The BluePrint will help you focus on the current circumstances of a company’s current situation and provide opportunities for enhancement, showing the tools needed to implement them. It has consistently proven a rewarding process.

The Advantage is performed completely on our dime, producing tangible results. To learn more, contact us.

Final Individual Mandate Regulations Explain How Employer Contributions Affect Affordability of Employer-Sponsored Coverage

Posted December 4, 2014 by Megan DiMartino


The IRS has issued final regulations on health care reform’s individual mandate—the requirement for individuals to either maintain minimum essential coverage (MEC) or pay individual shared responsibility penalties, unless an exemption applies. The regulations provide further guidance on the exemption that applies when employer-sponsored MEC is considered unaffordable. For this purpose, affordability is based on whether the employee’s “required contribution” for coverage would exceed 8% (subject to indexing adjustments) of household income. (The 8% standard is related to, but distinct from, the affordability threshold that applies under Code § 36B when determining eligibility for premium tax credits and liability for employer shared responsibility penalties.) Largely following proposed regulations that were published earlier this year, the final regulations address how the following employer contributions factor into employees’ required contributions:

HRA Contributions. Amounts newly made available for the current plan year under an HRA will reduce an employee’s required contributions if (1) the HRA would be “integrated,” as provided in IRS Notice 2013-54, with a primary plan sponsored by the same employer if the employee enrolled in that plan; (2) the amounts can be used for premiums for the primary plan or for premiums plus cost-sharing or benefits not covered under the primary plan; and (3) the amounts are required under the plan’s terms or otherwise determinable within a reasonable time before the employee must decide whether to enroll. According to the preamble, the IRS anticipates adopting this same rule under Code § 36B. Thus, for employer shared responsibility purposes, HRA amounts that can be used only for cost-sharing will count only for minimum value purposes, while amounts that can be used only for premiums (or premiums and cost-sharing/benefits) will count only for affordability.

Wellness Incentives. Nondiscriminatory wellness program incentives that affect premiums (whether through discounts, rebates, or surcharges) are treated as earned if they relate exclusively to tobacco use. If a wellness incentive is unrelated to tobacco use—or if an employee must complete a wellness program related to tobacco use and a program unrelated to tobacco use to receive an incentive—the incentive is treated as unearned. The IRS also anticipates adopting these rules under Code § 36B.

Cafeteria Plan Contributions. The employee’s required contribution is reduced by any employer contributions made available for the current plan year under a cafeteria plan that (1) may not be taken as a taxable benefit, (2) may be used to pay for MEC, and (3) may be used only to pay for Code § 213 medical care. The preamble explains that it is appropriate to treat these amounts as reducing employees’ required contributions because they represent a real reduction in the cost of purchasing MEC. In contrast, where use of the employer’s contribution is not limited to medical expenses, “it cannot be assumed that the employee will use the contribution for purchasing [MEC].” [EBIA Comment: The preamble does not indicate whether the IRS anticipates adopting this rule under Code § 36B, but we do not see a reason why a different interpretation would apply. Further guidance on this issue would be welcome.]

The final regulations also address when certain non-comprehensive government-sponsored coverage will not qualify as MEC, and the process for claiming exemptions from the individual mandate. Separately, the IRS has issued Notice 2014-76 to identify the hardship exemptions that individuals may claim on their federal tax returns without obtaining a hardship exemption certification from an Exchange.

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