Creditable Coverage notice is an annual CMS requirement

Creditable Coverage notice is an annual CMS requirement
Deadline for distribution is October 15; second disclosure deadline linked to plan year

White-Collar Exemption Salary Requirements Enforced Starting December 1

Annual income threshold lower for non-HCE workers than proposed

IRS Announces 2017 Health Savings Account Contribution Limits

The IRS has announced the 2017 Health Savings Account (HSA) maximum contribution limits detailed in the newly released Revenue Procedure 2016-28. HSA contribution and plan limits will remain mostly unchanged for 2017, with only the individual HSA contribution limit increasing by $50.

White-collar exemption coming soon

The much-talked-about changes affecting the white-collar worker exemption are expected to be released sometime this summer.* The final rule was released mid-March by the U.S. Department of Labor to the White House Office of Management and Budget (OMB). The OMB has up to 90 days to review the rule. Once approved, the rule will be published in the Federal Register. It appears the DOL’s earlier estimate of a July release date is likely to be met.

Taxpayers beware; email phishing schemes on the rise

The Internal Revenue Service renewed a consumer alert after seeing an approximate 400% surge in phishing and malware incidents so far this tax season. The emails are designed to trick taxpayers into thinking they are receiving official communications from the IRS or others in the tax industry, including tax software companies. The phishing emails ask taxpayers about a wide range of topics related to refunds, filing status, personal information, ordering transcripts and verifying PIN information.

Pay equity drives new EEO-1 reporting requirement

Starting in 2017, employers required to complete an EEO-1 form must also submit W-2 earnings and hours-worked data.

The EEO-1 form must be provided by private employers with 100 or more employees and certain federal contractors each year to the Equal Employment Opportunity Commission (EEOC). Today, employers submit data about employees’ ethnicity, race and gender by job category. The reporting deadline is September 30.

DOL to release new fiduciary standard

The financial services industry is eagerly awaiting the release of the Department of Labor’s (DOL) final rule on a revised fiduciary standard. According to the Wall Street Journal, the final rule will be unveiled April 6. The Department’s initial draft of the rule was met with controversy resulting in thousands of written comments by interest groups, advisory firms, Congressional members, and concerned citizens. Bukaty Companies’ comments were submitted this past July.

Humana reimbursement changes affect Medicare-eligible members

Medicare primary payer rules affect groups with fewer than 20 employees

Effective July 1, 2016, Humana will reduce a Medicare-eligible member’s benefits by the amount that would have been covered if the member were enrolled in Medicare Part B. Those impacted have been notified of this change in a letter from Humana distributed late in 2015.

IRS to adjust affordability percentage and penalty amounts

The IRS announced in Notice 2015-87 that it intends to increase the percent used in each of the three affordability safe harbors to 9.66% for plan years beginning in 2016.

The safe harbors are used to determine if an employer meets the Affordable Care Act (ACA) affordability requirement to provide coverage at a cost not to exceed 9.5% of one of the following:

ACA Reporting Deadline Extended

The IRS released Notice 2016-4 on Monday giving employers and insurers additional time to meet the ACA reporting deadline

2016 payroll tax unchanged; retirement limits slightly affected

A low cost-of-living index is keeping the 2016 Social Security tax rate unchanged and retirement plan limits remain largely unchanged.

Wages subject to the Social Security tax in 2016 remain at $118,500. Wages that exceed the amount are not subject to the Social Security portion of the payroll tax.

FICA Rates
Social Security and Medicare payroll taxes are combined as the Federal Insurance Contributions Act (FICA) tax.

The chart below identifies the rates.

Reminder: Large employers must report health care value on Form W-2

Only employers who issued more than 250 Form W-2's in 2014 need to comply

The aggregate cost of employer-sponsored health insurance must be reported on 2015 Form W-2s for employers who issued more than 250 Form W-2s in 2014. The reporting requirement is a provision established by the Affordable Care Act. Small employers (those who issued fewer than 250 Form W-2s in 2014) are temporarily exempt from the requirement until the IRS revokes the interim relief.

Humana announces prescription drug changes for 2016

Effective January 1, 2016, Humana will update its prescription drug list (PDL) for small groups 2-99. The changes can range from complete removal from the list of covered drugs, or new requirements impacting quantity, type and authorization.

How to read the annual Drug List change:

Coverage status (CVG):

Certain medications that were previously not covered by your plan will be added to your Drug List for 2016, while other medications will be removed.

+ CVG (addition); CVG (no change); -CVG (removal)

ACA auto-enroll provision repealed

Employers with more than 200 full-time employees won’t be required to auto-enroll full-time employees into a health plan following a repeal of the Affordable Care Act (ACA) provision.

The ACA requirement was shelved as part of the recent budget deal – the Bipartisan Budget Act of 2015 – signed into law earlier this month. The deal followed weeks of negotiations between Congressional leaders and the White House to avoid a government shutdown.

President signs PACE Act

Late yesterday, President Obama signed into law a measure allowing states to decide whether groups with 51-100 employees are subject to the small-group community rating structure defined by the Affordable Care Act (ACA).

In a rare bipartisan effort, the Protecting Affordable Coverage for Employees (PACE) Act was overwhelmingly approved by both the House and Senate and sent to the President earlier in October. 

Transition reinsurance fee submission deadline looms

The form self-insured health plan sponsors need to submit the transition reinsurance fee, mandated by the Affordable Care Act, is now available on pay.gov. The deadline for submitting the completed online form is November 15, 2015. 

Proposed salary revisions to affect white-collar worker exemption

Proposed changes by the Department of Labor (DOL) will extend overtime pay to millions of white-collar workers who historically don’t receive additional pay when they work more than 40 hours in a workweek.

The Fair Labor Standards Act, created in 1938, sets specific wage and duty tests that must be met to qualify for exemption from minimum wage and overtime pay. Exemptions apply to qualified executive, administrative and professional (EAP) positions.

Opposition to Cadillac Tax grows

The Cadillac Tax is one of a limited number of Affordable Care Act provisions yet to be implemented. Slated for adoption in 2018, the 40% nondeductible excise tax would be imposed on annual health insurance premiums that exceed $10,200 for individual coverage and $27,500 for family. The amounts, for both insured and self-funded plans, will be indexed for inflation after 2018.

Creditable Coverage notice is an annual CMS requirement

Deadline for distribution is October 15; second disclosure deadline linked to plan year

Employers have an annual obligation to issue a Creditable Coverage notification to all plan participants who are Medicare eligible, including dependents and retirees. The notice informs Medicare-eligible participants whether their prescription coverage is at least as good as Medicare’s.

Employers must follow guidelines when issuing MLR rebates

Distribution of rebates varies depending on plan type

Area insurers are beginning to issue 2014 plan year Medical Loss Ratio (MLR) rebates. The Affordable Care Act requires insurers to meet MLR requirements each year. If an insurer doesn’t meet the minimum MLR (spend 80 to 85 percent of its premium dollars on health care or activities that improve health care quality), then the insurer must issue a rebate to the affected individual and group policyholder by August 1, 2015.

EE0-1 filing deadline September 30

Employers with 100-plus employees subject to reporting

Each year by September 30, private employers with 100 or more employees and certain federal contractors must provide the Equal Employment Opportunity Commission (EEOC) with employee demographic information.

Weed Out Bad Hires

The consequences of making even one bad hiring decision can be tremendously costly to your company’s bottom line. Theft, sexual harassment, workplace violence, and fraudulent or exaggerated workers’ compensation claims create management distraction and increase operating expenses.

One of the most effective pre-employment testing tools you can use is an integrity test, often referred to as “entitlement testing.” A well-designed test can reduce your workers’ compensation loss rates by as much as 60% and unemployment expense payouts by up to 30%.

Greece Explained in Four Paragraphs

Markets have been rattled by the most recent Greek drama unfolding as negotiations over another bailout have stalled. If, as seems increasingly likely, Greece defaults and exits the Eurozone, the ramifications for the world economy should be fairly modest.

Employers should prepare now for new IRS reporting requirement

Employers will soon face a major ACA compliance deadline, and this is not one to postpone till the last minute.

Organizations that averaged more than 50 full-time equivalent employees (FTEs) in 2014, as well as self-insured groups, must file information returns with the IRS in early 2016.

“The reporting requirements are onerous and depend on data that employers should start gathering now,” said Mary Amundsen, PHR, PPACAP.

PCORI fee due July 31

Self-insured health and HRA plans must file form; carriers pay fee on behalf of fully insured plans

Employers who are responsible for paying the annual Patient-Centered Outcomes Research Trust Fund fee should use the updated Form 720. The fee is an Affordable Care Act provision to help fund the Patient-Centered Outcomes Research Institute (PCORI), which aims to help patients better understand the prevention, treatment and care options available and the science behind them.

Avoiding a workers' compensation audit

If you’ve never endured a workers’ compensation audit, then you're among the lucky. Preparations can help avoid the arduous process. One key is to think about how you’d prepare for an audit before the possibility ever arises.

Good documentation and recordkeeping will allow you to respond to an audit request quickly and efficiently.

Dan Bukaty, president of Bukaty’s Property & Casualty division, has walked dozens of customers through the audit process.

Coming soon:  Proposed white-collar exemption rules
By the end of March, the Department of Labor is expected to release proposed rules that address the classification requirements for a professional exemption under the Fair Labor Standards Act (FLSA).
IRS provides transition relief for some employer payment plans

Over a year ago, the IRS issued Notice 2013-54 stating that employer payment plans that reimburse an employee for some or all of their health insurance premiums did not comply with Affordable Care Act provisions.

The IRS warned that employers who sponsor such plans would be subject to an excise tax of $100 per day for each affected individual. A new IRS Notice 2015-17 issued last month provides limited transition relief for select employers.

The relief applies to health care arrangements that constitute:

DOL revises FMLA definition of spouse

A new rule entitles all workers in legal, same-sex marriages to protected job leave to care for a spouse with a serious health condition.

Previously, spousal care leave under the federal Family and Medical Leave Act (FMLA) was limited to opposite-sex couples or to same-sex couples living in states where gay marriage is legal.

Effective March 27, 2015, eligible employees may take FMLA leave for spousal care, regardless of state residence.

The U.S. Labor Department revision to the FMLA is consistent with the U.S. Supreme Court ruling in United States v. Windsor.

Save money with Humana's paperless billing option

Offer available for groups under 100

Starting with April 2015 invoices, Humana will waive a new monthly administrative fee for eligible groups that enroll in paperless billing and set up automatic payments. Monthly savings can be as much as $25.

To register, login to the secure employer portal on www.humana.com and go to “Billing.” For those who continue receiving invoices by mail, a $25 administrative fee may be added to the monthly invoice.

IRS reporting updates following form and instruction release

Employer health plans must meet new IRS reporting guidelines for 2015

Large employers, those with 50 or more full-time equivalents (FTEs), and sponsors of self-insured plans are required to file information returns to share with employees and the IRS. The reports are effective for coverage offered in 2015 and must be given to employees by January 31 of the year following the coverage year (2016) and must be filed with the IRS by February 28 (March 31 if filed electronically).

Medicare Part D disclosure required annually

Calendar-year plan deadline is March 1.

Employers who provide prescription drug coverage to Medicare-eligible individuals must disclose each year to the Centers for Medicare & Medicaid Services whether that coverage is “creditable” or “non-creditable.”

This disclosure requirement must be completed online no later than 60 days from the beginning of a plan year. Calendar-year plans must complete the disclosure to CMS by March 1, 2015. Non-calendar-year plan deadlines vary throughout the year.

Blue Cross Blue Shield of Kansas City announces prescription drug changes

Effective March 1, 2015, Blue Cross Blue Shield of Kansas City will update its prescription drug list (PDL) for group members on the Blue-Care (HMO), Preferred-Care (PPO), and Preferred-Care Blue (PPO) plans. Current members will receive communications from BlueKC within the next couple weeks.

Prescriptions moving from Tier 2 to Tier 3

  • Jentadueto (Type 2 diabetes)
  • Tradjenta (Type 2 diabetes)

Prescriptions moving from Tier 3 to Tier 2

Form W-2s must report value of employer-sponsored health insurance

Requirement only affects employers who issued more than 250 Form W-2s in 2013

This bulletin serves as a reminder of the employer Form W-2 reporting requirement under the Affordable Care Act.

Those not required to comply with the reporting requirement for 2014 include: 

Retirement plans must recognize same-sex spouses
Following the U.S. Supreme Court’s ruling against the Defense of Marriage Act (DOMA) in 2013, under federal law employers must treat same-sex couples as married for all federal tax and ERISA Title 1 purposes.

Employers who sponsor qualified retirement plans, such as a 401(k), must recognize a legally valid same-sex marriage, even if the couple resides in a state that doesn’t recognize same-sex marriage.
Serving alcohol at the company party? 10 ways to manage risks

You want employees to have fun at the company party — just not too much.

Employers have a liability when serving alcohol at the company party. Help manage employee safety and reduce your risks by following these tips.

1. Check your insurance coverage for exclusions for alcohol.

2. Hire a professional bartender who is trained to limit harm and liability, and make plenty of food available.

3. Offer taxi service or reduce hotel rates for those who imbibe.
2015 Flexible Spending Account contribution limit increases

Yesterday the IRS announced that the annual FSA election cap will rise to $2,550 per employee in 2015. The $50 increase reflects a cost-of-living adjustment.

Before 2013, employers, rather than the law, set FSA limits. The change for 2015 marks the first inflation increase since the federal cap has been in place.

Despite no increase, last year the IRS made a landmark modification to the Flexible Spending Account “use it or lose it” rule. Employers may now allow employees to carry over up to $500 of unused amounts left in their health FSA expenses in the new year.

Great-West Financial Becomes Empower Retirement

Last April, Great-West Financial announced a merger with Putnam Investments, and days later the company acquired JP Morgan Retirement Services.

Today, Great-West has clarified its moves with the announcement of one unified brand, Empower Retirement (www.empower-retirement.com).

Great-West assumes the new name effective immediately. Empower is now the second largest retirement services provider in the United States.

Transition reinsurance form available on Pay.gov

Deadline for submission is November 15

Today, the long-awaited form self-insured plans sponsors need to submit the transition reinsurance fee, mandated by the Affordable Care Act, was posted on pay.gov. The deadline for submitting the completed form to the Centers for Medicare and Medicaid Services (CMS) is November 15, 2014.

IRS allows additional mid-year cafeteria plan changes

Participants in a section 125 cafeteria plan generally are unable to make mid-year plan changes without experiencing a qualified change in status such as marriage, the birth of child or a change in employment status that affects benefit eligibility.

Given these restrictions, new coverage requirements under the Affordable Care Act (ACA) posed challenges for employees who pay health insurance premiums with pre-tax dollars through a premium-only plan. The IRS has addressed those challenges in Notice 2014-55.

ACA requires self-insured plans to secure health plan identifier (HPID) and certify compliance with electronic transaction requirements

ACA requires self-insured plans to secure health plan identifier (HPID) and certify compliance with electronic transaction requirements

A provision within the Affordable Care Act requires the Department of Health and Human Services (HHS) to develop new requirements for electronic transactions sent between Covered Entities and a method to certify compliance with the new rules.

Have you considered earthquake coverage?

Blame it on hydraulic fracking, global warming, or the large fault lines we live on, but Midwestern earthquakes are on the rise.

From January 1 to June 30, 2014, the U.S. Geological Survey recorded 764 earthquakes within a 500-mile radius of Lebanon, Kansas, the geographic center of the United States. By comparison, only 292 total earthquakes occurred in this same area for all of 2013.

IRS increases affordability percentage for 2015

Employers subject to the shared responsibility penalty within the Affordable Care Act (ACA) must ensure that the health coverage they offer to employees provides minimum value and is affordable.

For 2015, employers will satisfy the affordability requirement if the amount of premium employees pay for the lowest-cost, self-only coverage does not exceed 9.56% of the employee’s household income, up from 9.5% in 2014. The increase was released recently in IRS Revenue Procedure 2014-37.

Large employers subject to new IRS reporting requirements

IRS releases draft forms

Two new IRS reporting requirements will be used by the Internal Revenue Service to determine if individuals and employers are in compliance with Affordable Care Act (ACA) provisions.

4 reasons to outsource your payroll headaches

To control costs, some organizations want to do as much as possible in-house. But here are four smart reasons to consider outsourcing payroll:

1)      Save time. Getting payroll calculated, processed, and distributed takes countless hours. Computer glitches, power outages, time off the job, and other unforeseen problems can make it take even longer. Your time and resources can be better used doing what you do best.

Employers must follow guidelines when issuing MLR rebates

Distribution of rebates varies depending on plan type

Area insurers are beginning to issue 2013 plan year Medical Loss Ratio (MLR) rebates. The Affordable Care Act requires insurers to meet MLR requirements each year. If an insurer doesn’t meet the minimum MLR (spend 80 to 85 percent of its premium dollars on health care or activities that improve health care quality), then the insurer must issue a rebate to the affected individual and group policyholder by August 1, 2014.

Is your small business eligible for health care tax credits in 2014?

As most know, January 1, 2014, marked the launch of many key Affordable Care Act (ACA) provisions. Two big ones:  the opening of the Health Insurance Marketplace and rating changes.

Under the new community-rating rules, small-group health plans are no longer subject to medical underwriting, and premium rates can only vary based on age, tobacco use, and geographic location.

To avoid drastic premium increases, most small employers with fewer than 50 full-time equivalent employees took advantage of the opportunity to renew coverage before the new 2014 rating rules.