Viewing posts from: December 2017

Happy Holidays, From Our Team to Yours!

Posted December 22, 2017 by Megan DiMartino

US House and Senate Pass Tax Cut and Jobs Act of 2017

Posted December 20, 2017 by PHaynes

Yesterday the House of Representatives voted along party lines today to pass H.R. 1, the Tax Cut and Jobs Act of 2017, by a vote of 224-201. This followed Senate passage last night by a party-line vote of 51-48. with Sen. McCain not voting while recovering in Arizona from cancer treatments.  The President is expect to sign the legislation this week.

HR1 makes significant changes to individual and corporate provisions of the U.S. tax code, including a reduction in the corporate tax rate to 21%, down from 35%, beginning in 2018. The bill includes permanent effective repeal of the Affordable Care Act (ACA) individual mandate, requiring individuals to purchase and maintain health coverage, by zeroing out the penalty beginning in 2019. For 2018, most individuals are still required to maintain coverage or pay a penalty when they file their 2018 federal income tax return.

The legislation avoids taxing employer-sponsored health insurance benefits. In addition to the individual mandate repeal, this legislation restores cost-sharing  payments to insurance companies, reforms the 1332 (state flexibility) waiver process (the so-called Alexander/Murray legislation), and create a federal reinsurance pool (the Collins/Nelson legislation).

It is neither clear when a vote on these ACA fixes being sought by Sen. Collins will happen in the Senate nor certain if the House will even consider it. The fate of Alexander/Murray and Collins/Nelson remains a sticking point in final legislation to avoid a government shutdown this week. As of today, the Senate appears poised to consider the legislation in its funding package, while House conservatives remain opposed to any effort to shore up the Affordable Care Act.

Meanwhile, House Leadership separately plans to move legislation to further delay the Cadillac Tax by one year and create a moratorium on employer mandate penalties from 2015-2018. The moves are significant for Council members as the IRS began imposing significant penalties last month for violation of the employer mandate

HR1 changes how certain tax thresholds will be indexed for inflation. Affected provisions, including the ACA “Cadillac” Tax (scheduled to take effect in 2020), will now be indexed to the Chained Consumer Price Index (CPI) instead of the regular CPI (the previous metric). That change makes it likely that more employer-sponsored plans would trigger the Cadillac tax sooner.   Accordingly, other legislation calls for a further delay on the Cadillac Tax until 2021 (the tax is currently scheduled to be effective in 2020, and the legislation introduced this week would implement the excise tax in 2021).  That legislation could be included in an end-of-year omnibus bill that could also repeal the medical device tax for five years, eliminate HSA restrictions for over the counter purchases for two years, repeal the Health Insurance Tax for some plans in 2018 and all plans in 2019, and reauthorize the Children’s Health Insurance Program.


Compliance Strategies to Help Curb FMLA Abuse

Posted December 15, 2017 by Megan DiMartino

We’ve done numerous blogs regarding the Family and Medical Leave Act (FMLA) and it always seems to revolve around truly understanding what FMLA covers and how employees are able to utilize it. So, to start off, let’s go over what FMLA covers:

  • FMLA provides certain employees with up to 12 workweeks of unpaid, job-protected leave per year
    • Employers can allow for FMLA leave in the shortest period of time should their payroll system permit it, provided it is one hour or less
  • FMLA allows employees to take leave in consecutive days, “intermittently,” or on a “reduced leave schedule”
    • Intermittent Leave – this is when FMLA is taken in separate blocks of time for a single illness or injury
    • Reduced Leave Schedule –  this is when an employee’s usual number of working hours per workweek, or per workday, are reduced for a period of time. Usually from full-time hours to part-time hours.
      • These leaves may be taken when medically necessary:
        • To care for a seriously ill family member
        • Because of the employee’s serious health condition
        • To care for a newborn or newly placed adopted or foster care child with the employer’s approval

These types of leaves can be troublesome for an employer’s scheduling and production, and can also lead to leave abuse by employees. Here are a few compliance strategies to help curb employee abuse of FMLA:

  1. Address scheduling issues early in the process. Have employees that need foreseeable medical treatment schedule their leave in advance so as not to disrupt the employer’s operations. Let it be known to these employees requesting intermittent or reduced schedule leave to work with the employer to properly request and schedule time off.
  2. Provide the healthcare provider with necessary information. Let their healthcare provider know of the employee’s job duties and inquire if there are any accommodations you can make that would allow them to better perform these functions.
  3. Recertify FMLA leave every six months. FMLA allows an employer to recertify the FMLA qualifying condition every six months. Be sure to keep precise records of the employee’s use of FMLA and submit it to their physician to determine if their use of leave was consistent with their need for leave of the qualifying condition.
  4. Enforce company call-in policies and procedures. Employers can instill the use of a standard company call-in procedure when using FMLA leave. Applying a company wide call-in policy would be beneficial to all employees as well. Elements of a good notice procedure include:
    1. Submit requests for foreseeable leave in writing
    2. Use a uniform call-in number to notify the employer of absences that are unforeseen
    3. Require unforeseeable absences to be reported within a definite time window
    4. Have requests for leave be reported to a designated individual
    5. Ensure that proper FMLA medical certification forms are used, provided to, and returned by employees who make a request for leave
  5. Consider a transfer when appropriate. An employer may transfer an employee to an alternative job with equivalent pay and benefits to accommodate their recurring periods of leave. This helps keep the productivity of both jobs at a high while accommodating the employee’s need for leave.

Source: Business Advocate | Employment Law Q&A: 5 ways to address intermittent leave under the FMLA

For more information contact The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

HRCI & SHRM Pre-Approved Crawford Webinar | Santa has Diabetes & the Elves have Osteoarthritis? Managing Risk Within a Unique Population

Posted December 7, 2017 by Megan DiMartino

Within every population there are unique challenges and situations that drive plan utilization and spend. No matter your group’s size, demographics, industry or other variables, each situation is unique. Understanding what sets your population apart from the rest and how to take advantage of the information available to you will help you optimize your plan’s performance and drive more predictable and stable spend over time.

AP Benefit Advisors’ Director of Data Analytics, Scott Mayer, will take you on a tour of an extremely unique employer and employee population, and share with you the ways that you can better analyze and understand the risk within your plan in this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar. You will also learn how to turn information into action with unique strategies designed to create lower cost for your plan members, lower cost for your plan, better member experience, and better member outcomes.

Topics include:

  • Stratifying Risk Within a Population
  • Lifestyle and Wellness
  • Clinical Risk and Gaps in Care
  • Utilization Risk
  • Network Strategy
  • Centers in Excellence
  • Bundled Payments
  • Site of Care Optimization
  • Formulary Analysis

Webinar Details:

  • Wednesday, December 13, 2017
  • 2:00 – 3:00pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals, but not to brokers, agents, TPAs and PEOs.

*The use of this seal confirms that this activity has met HR Certification Institute’s (HRCI) criteria for recertification credit pre-approval. This activity has been approved for 1 HR (General) recertification credit hours toward aPHR, PHR, PHRca, SPHR, GPHR, PHRi, and SPHRi recertification through HRCI.

**AP Benefit Advisors is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit

For more information contact The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

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