HRCI & SHRM Pre-Approved Webinar | Voluntary Benefits: Life Insurance with Long-Term Care – The Overlooked Lifetime Benefit

Posted August 13, 2019 by Megan DiMartino

The life insurance market has changed dramatically in the last 20 years and that is nothing compared to what has happened in the long-term care (LTC) market. Almost every employee has some personal financial risk (many are great) with the potential costs of an extended long-term care situation.

Join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as our Director of Voluntary Benefits, Stephen Ivey, discusses the changes in the markets, the new definitions and features of LTC, and how these new types of plans are becoming much more important as a benefit offer.

Webinar details:

  • Thursday, August 22, 2019
  • 2:00pm – 3:00 pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*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.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

2019 2nd Quarter Compliance Update

Posted July 17, 2019 by Megan DiMartino

Topics include:

  • Expanded HRA Options
  • Form 5500 is Due by July 31
  • President Trump’s Latest Executive Order
  • HDHP/HSA Limits Increase for 2020
  • New EEOC Wellness Rules Expected by December
  • ACA Limits, Penalties and Fees
  • And more!

Read Now


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 and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

HRCI & SHRM Pre-Approved Webinar | 2019 Mid-Year Review – Your Compliance Checkup!

Posted June 19, 2019 by Megan DiMartino

Benefits WebinarsJoin us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as our General Counsel and VP of Compliance, Patrick Haynes, reviews the first-half of 2019 and provides a compliance checkup that you won’t want to miss.

Patrick will cover:

  • Changes to the Affordable Care Act (ACA)
  • ERISA/Section 125 Best Practices
  • Federal Government’s Approach to Health and Wellness Plans
  • “Working Wounded” – those employees and plan participants that no longer work the ACA-minimum required 30 hours per week, but are still on your plans

Webinar details:

  • Friday, June 28, 2019
  • 12:00pm – 1:00 pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*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.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

Individual Coverage and Extended Benefit HRAs Are in Play for 2020 Plan Start Dates

Posted June 14, 2019 by Patrick Haynes

On June 13, the U.S. Departments of Health and Human Services, Labor and Treasury issued a final rule that creates two new kinds of Health Reimbursement Arrangements (HRAs) – the Individual Coverage HRA (ICHRA) and the Extended Benefit HRA – effective for January 1, 2020 effective dates.

This final ruling is in response to the Trump administration’s October 2017 executive order on healthcare choice and competition.

Individual Coverage HRA

The ICHRA allows employers of all sizes that do not offer a group coverage plan to fund an HRA for employees to buy individual-market insurance, including insurance purchased on the public exchanges formed under the Affordable Care Act (ACA).

Currently, qualified small-employer HRAs (QSEHRAs) that were created by Congress in December 2016, allow small businesses with less than 50 full-time employees (FTEs) to use pre-tax dollars to reimburse employees who buy non-group health coverage. This ICHRA rule goes even further and doesn’t cap employer contributions. As a result, employers with less than 50 FTEs will have two choices – a QSEHRA or an ICHRA – with some regulatory differences between the two.

The departments posted an FAQ on the new rule that includes a model ICHRA employee notice and attestation form that complies with the new rule’s disclosure provision and aims to explain the type of HRA being offered and communicate that individuals may become ineligible for a premium or tax subsidy when participating in an ACA exchange-based plan.

If employers choose to offer this new ICHRA benefit in 2020, they will need to take action before then, including the required notice for eligible participants. Employees who want to take advantage of an ICHRA in the new year must enroll in an individual health plan during the open enrollment period (unless they have Medicare) that runs between November 1 and December 15, 2019.

Extended Benefit HRA

The Extended Benefit HRA will increase flexibility for employer-sponsored insurance. It can be offered in addition to a traditional group health plan to permit employers to finance up to $1,800 (pre-tax) of additional medical care (such as copays, deductibles, premiums for vision, dental, COBRA and short-term insurance coverage), even if the employee has declined enrollment in the traditional group health plan.

Anticipated Impact

These HRA rules will provide hundreds of thousands of businesses a better way to offer health insurance coverage so that millions of workers and their families can obtain the best coverage for their needs.

The ICHRA will help small employers compete for talent as they have typically faced unaffordable costs that prevent them from offering a traditional group health plan, and, in particular, the Extended Benefit HRA will benefit the growing number of employees who have opted out of their employer’s traditional group health plan because their share is too expensive.

The departments estimate that these HRA rules will help 800,000 employers insure more than 11 million employees and family members of which 800,000 were previously uninsured.

Should you have additional questions or comments, please contact your Sales Executive or Account Manager.  Thank you.

Links

ACA Limits, Penalties and Fees – 2014-2019

Posted June 14, 2019 by Megan DiMartino

Employer Shared Responsibility (Employer Mandate)

Plan Years 2019 2018 2017 2016 2015 2014
Affordability Safe Harbor Percentage 9.86% 9.56% 9.69% 9.66% 9.56% 9.50%

Employer Mandate Penalties – Calendar Year

Penalties 2019 2018 2017 2016 2015 2014
Tier One: Failure to offer coverage or to offer to 95% of employees (70% for 2015) $2,500 $2,320 $2,260 $2,160 $2,080 $2,000
Tier Two: Failure to offer coverage that is affordable and meets minimum value $3,750 $3,480 $3,390 $3,240 $3,120 $3,000

Market Rules

Account Limits 2019 2018 2017 2016 2015 2014
Health Care Flexible Spending Account (FSA) $2,700 $2,650 $2,600 $2,550 $2,550 $2,500
Dependent Care Flexible Spending Account (FSA) $5,000 $5,000 $5,000 $5,000 $5,000 $5,000
Health Spending Accounts (HSA)
High Deductible Health Plan Annual Deductible Minimums (Self-Only/Family) $1,350
$2,700
$1,350
$2,700
$1,300
$2,600
$1,300
$2,600
$1,300
$2,600
$1,250
$2,500
Annual Out-of-Pocket Maximums (Self-Only/Family) $6,750
$13,500
$6,650
$13,300
$6,550
$13,100
$6,550
$13,100
$6,450
$12,900
$6,350
$12,700
Maximum Contribution (Self-Only/Family) $3,500
$7,000
$3,450
$6,850/$6,900
$3,400
$6,750
$3,350
$6,750
$3,350
$6,650
$3,300
$6,550
Transportation
Parking (per month) $265 $260 $255 $255 $250 $250
Mass Transit (per month) $265 $260 $255 $255 $250 $130

Fees – Paid by Health Plan (per Covered Life)

Fees 2019 2018 2017 2016 2015 2014
Transitional Reinsurance Fee N/A N/A $0 $27.00 $44.00 $63.00
Patient-Centered Outcomes Research (PCORI)
Plan Years Ending 1/1 – 9/30 $2.45 $2.39 $2.26 $2.17 $2.08 $2.00
Plan Years Ending 10/1 – 12/31 N/A $2.45 $2.39 $2.26 $2.17 $2.08

 

2020 HSA Limits were made available on May 28, 2019.  Please see those details here:  https://www.apbenefitadvisors.com/2019/05/28/irs-releases-2020-limits-for-hsas/

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 and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

IRS Releases 2020 Limits for HSAs

Posted May 28, 2019 by Patrick Haynes

On May 28, 2019, the IRS released Revenue Procedure 2019-25 It provides the 2020 inflation-adjusted amounts for HSA-qualified high deductible health plans (HDHPs).

The inflation-adjusted increases for 2020 are:

  • HSA-Qualified HDHP Self Coverage: Annual deductible must be $1,400 or more in 2020 (up $50 from 2019), and annual out-of-pocket expenses cannot exceed $6,900 (up $150 from 2019).
  • HSA Contribution Limit for Self Coverage: Increases to $3,550 in 2020, up $50 from 2019.
  • HSA-Qualified HDHP Family Coverage: Annual deductible must be $2,800 or more in 2020, up $100 from 2019, and annual out-of-pocket expenses cannot exceed $13,800 (up $300 from 2019).
  • HSA Contribution Limit for Family Coverage: Increases to $7,100 in 2020, up $100 from 2019.
  • No change to the Age-55+ HSA catch-up limit.  That value remains at $1,000 per year.

Please contact your Sales Executive or Account Manager for additional details about how this may affect your 2020 HDHP-HSA offerings.    And, don’t forget to review our 2020 non-HDHP plan limits here.

Contribution and Out-of-Pocket Limits
for Health Savings Accounts and High-Deductible Health Plans
2020 2019 Change
HSA contribution limit (Employer + Employee) Self-only: $3,550
Family: $7,100
Self-only: $3,500
Family: $7,000
Self-only: +$50
Family: +$100
HSA catch-up contributions (age 55 or older) $1,000 $1,000 No change
HDHP minimum deductibles Self-only: $1,400
Family: $2,800
Self-only: $1,350
Family: $2,700
Self-only: +$50
Family: +100
HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums) Self-only: $6,900
Family: $13,800
Self-only: $6,750
Family: $13,500
Self-only: +$150
Family: +$300

Links:

HRCI & SHRM Pre-Approved Webinar | Association Health Plans – Is There a Pathway Forward?

Posted May 21, 2019 by Megan DiMartino

For supporters of “Association Health Plans (AHPs),” it has been a year-and-a-half roller coaster. It all started with excitement over President Trump’s Executive Order in October 2017, culminating in proposed Department of Labor (DOL) regulations issued in January 2018. Once the DOL regulations were finalized in June 2018, a good number of organizations immediately took steps to establish AHPs in accordance with the final rules (known as Pathway #2 AHPs), which kicked off coverage starting January 1, 2019. All was going well in the AHP-world!

Enter stage left…a DC District Court ruling invalidating the final AHP regulations on March 28. In the wake of District Court ruling, the AHP-world has crumbled, aided by the Department of Justice’s (DOJ’s) decision not to request a “stay” of the ruling, which prompted the DOL to issue guidance informing existing Pathway #2 AHPs that they cannot expand their coverage to new participants, and existing participants may not re-enroll in their AHP plan for the 2020 coverage year. The DC Circuit Court of Appeals is not scheduled to uphold or overturn the District Court ruling in September or October of this year, with the Supreme Court’s consideration waiting in the wings. Meanwhile, AHPs that are formed under the DOL’s guidance issued prior to the release of the final AHP regulations (referred to as Pathway #1 AHPs) are unaffected by the District Court ruling, which means Pathway #1 AHPs can still be formed in most States with the State’s permission.

Join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Christopher E. Condeluci, Principal and Sole Shareholder of CC Law & Policy, discusses in-depth about Pathway #1 and Pathway #2 AHPs, the DOL’s recent non-enforcement and Pathway #1 clarifying guidance, recent State activity, and the DC Circuit Court’s review of the District Court ruling.

Webinar details:

  • Thursday, May 30, 2019
  • 2:00pm – 3:00 pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*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.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

Reminder: PCORI Fees Last Installment Due this July*

Posted May 17, 2019 by Megan DiMartino

*Note-this is the final year for 2018 calendar year plans.  Plans that end between Jan 1, 2019 and October 1, 2019 will owe again, next year.  Please see our multi-year reference chart here.

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 31.

PCORI fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return). The applicable PCORI fee you pay each July is based on when your plan year ended.

  • $2.26 for plan years ending between January 1, 2017 – September 30, 2017
  • $2.39 for plan years ending between October 1, 2017 – September 30, 2018
  • $2.45 for plan years ending on/after October 1, 2018, but before October 1, 2019
  • Please see our multi-year reference chart here

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. 

Please see the following IRS resources for more information on the ACA’s PCORI Fees:
IRS Notice 2018-85 (released 11/5/2018)
Final Regulations on the PCORI Fees
PCORI Fee Overview Page
PCORI Fee: Questions and Answers
IRS Form 720 and Instructions
PCORI Fee Due Dates and Applicable Rates
Chart of Health Coverage and Arrangements Subject to PCORI Fee
AP Benefit Advisors’ Multi-Year PCORI Fee Reference Chart


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 and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

Is Transparency Coming to Big Pharma? More after these messages…

Posted May 15, 2019 by Megan DiMartino

Author: Scott Mayer, Director of Data Analytics at AP Benefit Advisors

HHS Secretary, Alex Azar, informed the public this week that starting sometime during the summer of 2019, pharmaceutical companies will have to include pricing information in their television advertisements. This rule applies for any medication where the manufacturer set pricing is greater than $35 for one-month’s supply.

Johnson & Johnson has even been proactive, complying with the regulations on ads for their brand drug “Xarleto” starting this year. Here’s what their advertisement looks like: https://www.ispot.tv/ad/IXmo/xarelto-selective-cost

If this advertisement is any indication, then the new regulations will prove to be much ado about nothing. Just examine the image from the advertisement that includes the pricing disclosure and you will see why:

First and foremost, looking at this screen, is there really an indication of the cost of the medication to a specific member? The list price apparently is $448, yet most patients will pay between $0 and $47? What’s the difference and what’s my cost? That depends on my PBM arrangement, my plan design, my pharmacy or specialty pharmacy, possibly my provider, etc. There are so many variables and the manufacturers will be able to exploit this intentional opacity to provide no real clarity or insight into medication costs for the consumer.

Now take a look at Xarelto claims from a one-week period in AP Benefit Advisors’ book of business:

The ingredient costs are very much in line with the $448 disclosed in the advertisement, but member-paid amounts range from as low as $0 to as high as $441.47. The fact is, much like hospitals being required to publish their “chargemasters,” this disclosure of information is essentially worthless to the consumer with no additional context.

Hopefully, disclosing the list pricing will give the public some insight into the “true” cost of some of these medications compared to their actual out-of-pocket expenses. This may work to enhance the value perception that people have when it comes to their prescription drug benefits. And yes, perhaps this information will foster a growing push to come up with ways to better manage and possibly regulate prescription drug pricing practices. However, it is also possible that these disclosures will end up being just like the fast talk, ignored, unintelligible disclosures that we hear after car ads, financial planning ads, and so many others where we have already tuned out waiting for the TV program to resume.

Source: Scott Mayer | Is Transparency Coming to Big Pharma? More after these messages…


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 and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.