Updated/Current Healthcare Reform Timeline

Posted August 15, 2018 by Megan DiMartino

Healthcare Reform Timeline – Perpetual timeline of all healthcare reform updates from 2010 to 2020 (and 2022 – when the Cadillac Tax is scheduled to “begin”).

 

 

 

 

 

 

 

 

 

 

HC_Reform_Employers_V19e_05-14-2018

If you have any questions or concerns, please contact your Account Manager or Sales Executive.


For more information, contact info@apbenefitadvisors.com. 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.

House Passes Enhanced HSA Bills

Posted August 10, 2018 by Megan DiMartino

​​​​​​​Breaking news from Washington, D.C. confirms the House of Representatives adopted two health care bills in late July 2018. In general, if these bills are passed they would allow for more flexibility in the definition of a High Deductible Health Plan (HDHP) and how healthcare consumers can spend their savings for medical related requirements.

The bills, H.R. 6199 and H.R. 6311, expand tax-advantage health care accounts, inclusive of Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs). These bills are broader than the versions passed by the House Ways and Means Committee recently as they also include aspects of other bills that had been previously approved by the Committee. The bills presented also received significant democratic support.

Here’s a breakdown of the two bills:

The Restoring Access to Medication and Modernizing Health Savings Accounts Act, H.R. 6199, was passed by a margin of 277 to 142.  This bill would:

  • Allow individuals to purchase over-the-counter medical products by reversing the Affordable Care Act’s (ACA’s) prohibition on using tax-favored health accounts. And, prescriptions would not be required for eligibility purposes.
  • Treatment of menstrual care products as qualified medical expenses with all tax-advantaged health care accounts.
  • Treatment of certain sports and fitness expenses – including gym memberships and costs associated with participation in certain physical exercise programs. These items would be recognized as qualified medical expenses up to a limit of $500 per year for individuals and $1,000 per year for a family.
  • Allow HDHPs coverage up to $250 for individuals and $500 for families on an annual basis for non-preventive services not currently covered as pre-deductible. Limited coverage outside the deductible would be allowed, i.e., for chronic condition treatments and telehealth services.
  • Allow individuals with HSA-qualifying family coverage to make contributions to an HSA if their spouse is enrolled in a medical FSA, which is currently not permitted.
  • Permit the use of employer-sponsored onsite medical clinics and other employment-related health services without imposing a risk to HSA eligiblity, as long as significant benefits are not provided.
  • Recognize direct primary care (DPC) provider fees as covered with HSAs and capped monthly at $150 per individual and $300 per family.
  • Shield HSA-eligible individuals who participate in a DPC from losing their HSA eligibility.
The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act, H.R. 6311, passed by a margin of 242 to 176. This bill would allow the ACA’s premium tax credit to apply for low and moderate earners when buying lower-premium, “catastrophic” copper plans, allows individuals over the age of 30 to buy copper plans, and allows copper and bronze-level individual and small-group market plans to qualify for HSA contributions. The bill also includes the following tax modifications for tax advantaged accounts:
  • Increase HSA 2018 annual contribution to $6,650 for individuals and $13,300 for families. This represents the 2018 combined annual limit on out-of-pocket and deductible expenses under an HSA qualified insurance plan.
  • Allows HSAs to cover qualified medical expenses at the start of the HDHP coverage if accounts are opened within 60 days after coverage under an HDHP begins. This proposal includes a reasonable grace period between the timeframe the HDHP coverage starts and the set-up of the HSA.
  • Allow employees with an FSA or an HRA who enroll in a qualifying HDHP with an HSA to transfer balances from their FSA or HRA to their HSA. Transfers would be capped at $2,650 for individuals and $5,300 for families. This option is offered at the employer’s discretion.
  • Allow for health FSA balances to carry over to the following plan year. The carry over option could not exceed 3 times the annual FSA contribution limit.
  • Allow for spouses 55 years of age and older (currently only available for account holders) to make an annual catch-up contribution to an HSA that’s linked to a health plan providing family level coverage. The extra contribution amount cannot exceed $1,000.
  • Permit working seniors who participate in Medicare Part A and covered by a qualifying HDHP to contribute to an HSA.

What to expect next?

Senate approval is needed by year-end for both bills to become law. Analysts predict the likelihood of that happening to be challenging. Also, on the horizon – in September 2018, the House is also expected to vote on several of the other ACA related measures that were previously passed by the Ways and Means Committee. These bills include H.R. 4616, which is designed to delay the Cadillac Tax until 2021 and to also suspend the ACA employer mandate penalties for plan years through 2018.

By: Cindy Wagner, AP Benefit Advisors’ Director of HR Professional Services

For additional information, visit:
GovTrack – H.R. 6199 & H.R. 6311
Congress.gov – H.R. 6311 & H.R. 6199
For more information, contact info@apbenefitadvisors.com. 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.

SHRM Pre-Approved Webinar | Voluntary Benefits: Best Practices for Communication and Enrollment

Posted August 9, 2018 by Megan DiMartino

What are employers doing to stay on the cutting edge to ensure that employees fully leverage their benefits offering? There are several tools to achieve this while making the process proactive and engaging. We will review industry standards from employee polls regarding open enrollment processes to make sure the information is simple and clear as well as enrollment studies from our carrier partners to help re-invent the enrollment experience. With early campaigning, clear messaging and engagement tips to use available technology for all demographics, the enrollment experience can be enhanced for all parties involved.

Please join us for this SHRM* pre-approved, complimentary, one-hour webinar as our Director of Voluntary Benefits, Stephen Ivey, walks through best practices for communication and enrollment within the voluntary benefits marketplace.

Topics include:

  • State of the Industry
  • Essential vs. Fringe
  • Communication Studies
  • Millennials
  • Technology
  • Different Strategies
  • Integration

Webinar Details:

  • Wednesday, August 22, 2018
  • 2:00pm – 3:00pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

 

*AP Benefit Advisors, LLC 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 shrmcertification.org.


For more information contact info@apbenefitadvisors.com. 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.

AssuredPartners’ Webinar | HRCI & SHRM Pre-Approved – HIPAA Privacy Rule & Security Rule Risk Analysis

Posted July 18, 2018 by Megan DiMartino

The standards for Privacy and Security of Individually Identifiable Health Information establish a set of national standards for the protection of certain health information impacting covered entities. These standards are better known as the Privacy Rule and the Security Rule. Are YOU a covered entity? Do you know your duties as a covered entity? Now let’s say you’ve been following a thorough, detailed set of written security measures that you found on the internet and tweaked to fit your organization. Unfortunately, according to the HIPAA Security Rule – it’s not enough. Under the Security Rule, the process a plan uses to decide what it needs to do to protect electronic protected health information (ePHI) is just as important as the policies and procedures themselves. Enter: the risk assessment.

Please join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as our speaker, Olivia Ash, MS, Compliance Consultant with Compliancedashboard, walks through what employers really need to do to be compliant with the HIPAA Privacy and Security Rules.

Webinar Details:

  • Tuesday, July 31, 2018
  • 3:00pm – 4:00pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Presenter bio:
Olivia Ash worked the last fifteen years in roles ranging from account management to business development contracting. After graduate school, Olivia spent ten years creating and implementing employer wellness programs. Within the past five years, Olivia has focused her career in the fields of law and compliance. She’s a licensed teacher with experience in higher education, presently serving as adjunct faculty for a local university. Olivia writes Compliancedashboard’s blog content as well as the activity content on the dashboard.


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.
**AP Benefit Advisors, LLC 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 shrmcertification.org.
For more information contact info@apbenefitadvisors.com. 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.

2nd Quarter Compliance Newsletter

Posted July 6, 2018 by Megan DiMartino

In this quarter’s Compliance Newsletter:
  • Embedded Out-of-Pocket Maximums
  • Where Are We with Wellness?
  • Calendar Year Plans Must File Form 5500 by July 31, 2018
  • PCORI Fees Due July 31, 2018
  • Proposed FAQs on Mental Health and Substance Use Disorder Parity
  • 2019 HSA and HDHP Amounts
  • IRS Continues to Issue Employer-Shared Responsibility Payment (ESRP) Letters
  • Final Rules for Association Health Plans Released by the DOL
Please contact your AssuredPartners’ Sales Executive or Account Manager for any further questions or assistance.

For more information, contact info@apbenefitadvisors.com. 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.

*NEW* FSA Website Update

Posted July 2, 2018 by Megan DiMartino

The website-interface that our clients’ employee-plan-participants use to submit reimbursement claims for their healthcare FSA, Dependent Care Reimbursement Accounts, HSAs, and/or HRAs has been moved to https://apbenefitadvisors.wealthcareportal.com.

This was necessary due to several system enhancements that participants will come to enjoy. All login credentials, transaction and claims history, direct deposit information, etc., remains in-tact.

Please bookmark the new URL for quick access.

Please contact your AP Benefit Advisors’ Account Executive or Account Manager for any further information or questions.

Thank you!


For more information, contact info@apbenefitadvisors.com. 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.

Summer Vacations Are Upon Us! Are Your PTO Policies Up-to-Date?

Posted June 26, 2018 by Megan DiMartino

Summer is here and that means summer vacations! Your employees will begin requesting more time off for vacation, so this is a good time to review your vacation policies and procedures to ensure they are legally compliant and work with your business needs.

For the most part, employees aren’t promised paid vacations unless employers agree to provide paid vacation through a policy, practice or contract. Exceptions include some state or local paid sick leave laws. But once an employer decides to offer paid vacation then there are important factors that need to be considered when addressing their vacation policy:

  • Use of vacation time – There should be guidelines and restrictions when it comes to the use of vacation times. Such things as advanced notice, management approval, and scheduling conflicts. If these guidelines are not set in place then too many employees could take vacations at the same time and not leave enough coverage at the workplace.
  • Approving and denying vacation requests – Vacation requests should be upheld to a nondiscriminatory approval/denial process so as not to show any form of favoritism. A good way of doing so would be approving/denying by seniority or by timing of the notice.
  • No working during vacation – In any circumstance that a non-exempt employee is called upon for any work (be it through telephone calls, text message or email on their mobile device), they are to be compensated for the work in lieu of their vacation time.
  • Accrual limits – Place a limit on the amount of vacation time that can accrued if employees are allowed (or entitled by state law) to roll over their vacation time from year-to-year.
  • Comply with state laws – Ensure compliance with state laws: (1) prohibit forfeiture of accrued and unused vacation, (2) require employers to provide a reasonable opportunity for employees to take vacation, or (3) require payment of accrued and unused vacation upon termination.
  • Allowing vacation advances – If allowing advancement on paid vacation that has yet to be accrued, provide precise guidance on doing so as not to allow employees to take advantage of such advances. Paid vacation time taken before being accrued can make it difficult to deduct advances from wages or an employee’s final pay upon termination.
  • Other guidance – Provide guidance on whether employees may or may not receive pay in lieu of vacation, whether vacation time must be taken in specified increments, if vacation time will not continue to accrue during unpaid leaves of absence, whether an employee who becomes ill during vacation leave can treat the period of illness as sick leave instead, and whether a holiday that falls during a vacation period will be treated as a vacation day.
  • Leave laws – Fully explain the use of vacation time in conjunction with the Family Medical Leave Act (FMLA) or any other leaves laws, including equivalent state laws.
Please stay compliant and seek legal assistance when revising or updating any of your personnel policies.

Source: Foley & Lardner, LLP | Summer (and with it, summer vacations) is coming!

For more information, contact info@apbenefitadvisors.com. 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.

PCORI Fees are Due Soon

Posted June 12, 2018 by Megan DiMartino

Applies to: Self-Insured Health Plans, including HRAs & FSAs

Employers who sponsor self-insured health plans must pay their annual Patient-Centered Outcomes Research Institute (PCORI) fees by July 31st!

PCORI fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return). The applicable PCORI fee you pay this year, by July 31, 2018, is based on your plan year end date in 2017:

As a reminder, the PCORI fees are based on the average number of covered lives under the plan or policy. This ordinarily includes employees and their enrolled spouses and dependents. Individuals who are receiving continuation coverage (such as COBRA coverage) must also be included in the number of covered lives under the plan in calculating the fee. Plan sponsors of self-insured health plans must use one of the following three methods to determine the average number of lives covered under a plan for the plan year:
  1. Actual Count Method: A plan sponsor may determine the average number of lives covered under a plan for a plan year by adding the totals of lives covered for each day of the plan year and dividing that total by the total number of days in the plan year.
  2. Snapshot Method: A plan sponsor may determine the average number of lives covered under an applicable self-insured health plan for a plan year based on the total number of lives covered on one date (or more dates, if an equal number of dates is used in each quarter) during the first, second or third month of each quarter, and dividing that total by the number of dates on which a count was made.
  3. Form 5500 Method: An eligible plan sponsor may determine the average number of lives covered under a plan for a plan year based on the number of participants reported on the Form 5500, Annual Return/Report of Employee Benefit Plan, or the Form 5500-SF, Short Form Annual Return/Report of Small Employee Benefit Plan.
HRAs and Health FSAs
Health Reimbursement Arrangements (HRAs) and health Flexible Spending Accounts (FSAs) are not completely excluded from the obligation to pay PCORI fees. However, two special rules apply for plan sponsors that provide an HRA or health FSA. Under these special rules:
  1. If a plan sponsor maintains only an HRA or health FSA (and no other applicable self-insured health plan), the plan sponsor may treat each participant’s account as covering a single life. This means that the plan sponsor is not required to count spouses or other dependents.
  2. An HRA is not subject to a separate research fee if it is integrated with another self-insured plan providing major medical coverage, provided the HRA and the plan are established and maintained by the same plan sponsor and have the same plan year. This rule allows the sponsor to pay the PCORI fee only once with respect to each life covered under the HRA and other plan. However, if an HRA is integrated with an insured group health plan, the plan sponsor of the HRA and the issuer of the insured plan will both be subject to the research fees, even though the HRA and insured group health plan are maintained by the same plan sponsor.

The same analysis applies to health FSAs that do not qualify as excepted benefits.

Please contact your AssuredPartners’ Sales Executive or Account Manager for any further questions or assistance.


For more information, contact info@apbenefitadvisors.com. 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.

AP Benefit Advisors Webinar Series | HRCI & SHRM Pre-Approved – Total Rewards Strategies: Getting the Most from Your Rewards Dollars

Posted June 8, 2018 by Megan DiMartino

Total rewards is an approach and framework for managing the elements of the employment interface between the organization and its workforce. As a strategy, it provides a vehicle for:

  • Identifying value-added employment-related factors;
  • Prioritizing the organization’s human resource investment;
  • Rationalizing different components of the employment interface; and
  • Communicating the alignment between rewards and business strategy.

Please join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Dan Ripberger, Managing Director of RSC Advisory Group, discusses total rewards in the context of business strategy and employment value proposition. RSC Advisory Group is a management advisory and consulting firm specializing in pay performance. The RSC team has worked with clients in a multitude of market sectors and geographic areas. Their work has spanned start ups, high-performing organizations and those going through re-invention – all who need advice and guidance specific to their situation.

Participants will learn a top-down approach to developing a reward framework that is aligned with short- and long-term business and mission needs. After participating in this webinar, participants will be able to:

  • Define the difference between and integration of employment value proposition and total rewards strategy;
  • Understand how business drivers influence total reward strategy; and
  • Begin to determine which reward elements have the greatest impact on specific people and reward objectives.

Webinar Details:

  • Thursday, June 21, 2018
  • 2:00pm – 3:00pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

For more information contact info@apbenefitadvisors.com. 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.


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.
**AP Benefit Advisors, LLC 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 shrmcertification.org.

New Jersey Becomes the 2nd State to Enact an Individual Health Insurance Mandate Tax

Posted June 7, 2018 by Patrick Haynes

On Wednesday, May 30th, NJ Governor, Phil Murphy, signed into law a bill that will require all New Jersey residents to have health coverage or pay a tax (penalty), making NJ the second state to enact an individual health insurance mandate.

Massachusetts, the first state to enact such a mandate, began taxing its citizens in 2006, and their approach served as a model for PPACA (aka “The Affordable Care Act”).  Massachusetts reports, as of the end of 2016, that 97% of its residents were insured for that year, and they had the lowest percentage of uninsured in the United States.  By contrast, the US Census reflects that 92% of NJ residents were insured in 2016.

Meanwhile, NJ Democratic lawmakers drafted the bill, NJ A3380 (18R), in response to Congress’ decision to repeal the federal mandate established under the Affordable Care Act (ACA). The repeal, the New Jersey lawmakers feared, would drive healthier people out of the state’s Healthcare.gov marketplace and cause premiums to spike.

“The individual market would descend into a death spiral if not for this legislation,” said State Sen. Joe Vitale (D-Middlesex), the prime sponsor. “This helps to keep people insured and keeps that market healthier.”

Will Vermont join their ranks?

Vermont Gov. Phil Scott, a Republican, signed a bill on May 28th that would establish an individual mandate, but the details, including the financial penalty and enforcement mechanisms, will be determined during the 2019 legislative session. The Vermont mandate won’t go into effect until January 1, 2020.

When will this new tax (NJ Mandate) take effect?  And, how much will it be?

The Mandate is really a tax and it closely mirrors the federal ACA tax structure.  So, when a NJ resident files his/her state income tax return, the resident will owe a penalty for themselves, their spouse and each of their dependent children that is uninsured (or has coverage that doesn’t meet federal MEC (Minimum Essential Coverage) guidelines).

The tax will be the greater of:

  • $695 per adult, and half of that ($347.50) per child; OR
  • 2.5% of the taxpayer’s income

New Jersey’s mandate is scheduled to take effect January 1, 2019, which gives state officials seven months to get the word out to residents about the new requirement.

 


For more information, contact info@apbenefitadvisors.com. 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.