To The Point Podcast: Recent Episodes
Lipscomb and Pitts Insurance, Sarah Gillespie | Producer: Andrew Bartolotta
The Lipscomb and Pitts Insurance Compliance Director, Sarah Gillespie and a first class ERISA attorney share key Affordable Care Act and compliance hot topics all in 15 minutes or less.
This podcast gives interested individuals a short nugget of information on specific benefits compliance items or ACA related topics that will help them better do their job or understand the requirements. Our topics will be specific and brief, and guidance will be provided by a first class ERISA attorney. And of course being podcasts, people can learn on the go.
These changes specifically impact the Form 1095-B & Form 1095-C distribution deadline and good faith transition relief. Be sure to listen in to the important information shared in this podcast.
Join us and listen to this podcast for reminders on what needs to be done before the end of 2021, and how to start preparing for specific tasks in 2022.
Tuning-in, you'll hear from two speakers on trending topics and more.
Bob Radecki is president, senior regulatory and public policy analyst at Benefit Comply, LLC, an employee benefits compliance consulting firm. Bob will discuss the end of the 100% COBRA subsidy authorized under the American Rescue Plan Act, health cost transparency rules and surprise billing regulations, vaccine incentives and mandates, and more opportunities for consideration of Individual Coverage HRAs (ICHRAs).
Joel Wood is the senior vice president for government affairs of The Council of Insurance Agents & Brokers and also oversees CouncilPAC, the association’s political action committee. Joel will share his unique perspective on the Supreme Court’s ACA decision and thoughts on the Biden Administration’s health insurance goals, public options at the State Level, 2022 Elections and possible outcomes’ impact on legislation, as well as comment on cost transparency related to health cost transparency rules and recent surprise billing regs.
Productivity Consultants & Career Support Services (PCCSS) was founded in 1999 as an image-consulting firm that focused on career and personal branding. Since then, the organization has evolved into a boutique human capital and career development firm designed to facilitate change management for individual and organizational clients.
Based on the belief that human learning, training, and performance improvement initiatives should lead to quantifiable outcomes, the organization focuses on analyzing the performance challenges for individuals and within private and non-profit organizations as they relate to productivity and success.
Learn more: https://productivityconsultants.org/index.php
Listen in to this episode as we discuss what can and cannot be part of an employer’s vaccine policy, where restrictions or limitations may exist and, surprisingly, where they do not, and other considerations to take into account.
At OneVillage, they provide a space for everyone that has been touched by cancer.Over the course of their lifetime, 40% of people will be diagnosed with cancer, and the remaining 60% will support at least 4 loved ones through cancer. OneVillage is one place to find the resources, products, community, and support you need when cancer enters your life.
Learn more: https://onevillage.io/
As a result, Congress enhanced the FFCRA leave under ARPA to include paid leave related to the vaccine, among other enhancements, and extended the payroll tax credits even further. Listen to this conversation to learn how else the FFCRA was updated and what you need to know.
The subsidy will cover the full cost of COBRA or state continuation premiums from April 1st, through Sept. 30, 2021 if the employee lost or loses group health insurance due to a reduction in work hours or an involuntary job loss. Be sure to listen to this episode to better understand who is eligible and the various employer obligations associated.
Let’s face it – navigating the HR technology market is complex. Advisors need help educating and guiding employers. With BTR’s Core Service offering, they aim to increase your agency’s tech “fluency” and provide the technology foundation you need to empower and educate your client base.
ENGAGEMENT
- CE-accredited webinars tailored for employers
- Agency-specific learning workshops
- Dynamic communication campaigns & client-facing marketing materials
- Preferred access to Consulting and Benefits Administration services
KNOWLEDGE
- Access to BTR’s centralized database for competitive technology and vendor intel
- Vendor summaries, conference recaps, blog posts, and white papers
- Quarterly technology updates
- Showcase of agency’s ROI via monthly utilization reports
STRATEGY
- Assigned, dedicated HR technology consultant and project manager
- Monthly collaborative strategy calls
- Market research
- Strategy discussions with prospective clients
This gives companies an enticing benefit that uniquely serves every employee in the organization. And it all works within the system you have in place today.
It’s savvy to reduce PTO balance sheet liabilities while enhancing talent recruiting and retention. In simple terms, it pays off for both HR and Finance. Both will appreciate the returns for enhancing PTO benefits and reducing corporate liability.
To learn more, please contact Lipscomb & Pitts Insurance's Director of Client Engagement, Betsy Kamler at betsyk@lpinsurance.com or 901-321-1000.
Rain provides a modern approach to payroll for mid-sized organizations, a benefit that has already been rolled out for companies like Walmart and Uber. Their mission is to regrow individual freedom by giving people control over their income and finances.
Rain is killing predatory financial products like payday loans and overdraft fees. They're backed by QED, a leading venture capital firm based out of Alexandria, Virginia, who has invested in notable companies like Credit Karma, ClearScore, Creditas, and many more.
Rain's founders are highly experienced and excited about bringing greater financial freedoms to American workers and being a large part of the movement to end payday loans with high interest rates. Last year, Americans spent $170B while waiting for their next paycheck. Fees for payday loans, credit cards, overdrafts, and low balances add up.
72% of Americans who are living paycheck-to-paycheck are stuck in this debt trap and could benefit from early wage access. How does Rain work? Rain is easy for employers to implement. When an employer agrees to work with Rain, employees are invited to download the free Rain Instant Pay app from the Apple or Google app store. The employees will have early access to portions of their wages.
Alcohol is the most used substance by youth and adults in the United States. According to the National Institute of Health’s 2020 Monitoring the Future Survey, 55.3% of high school seniors used alcohol in the past year. Results of the 2019 National Survey on Drug Use and Health (NSDUH), demonstrated that 85.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 69.5 percent reported that they drank in the past year; 54.9 percent reported that they drank in the past month. In 2019, 25.8 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 6.3 percent reported that they engaged in heavy alcohol use in the past month. Alcohol is the third leading cause of preventable death in the United States. About 95,000 Americans die from alcohol-related causes each year.
While the Consolidated Appropriations Act (CAA) favorably addressed options for employers to extend to employees with year-end balances in their health and dependent care flexible spending accounts, the Act left many questions unanswered in regard to the mechanics and potential tax consequences of these accommodations.
However, in true government fashion, on the last business day before Feb 28th, the DOL released clarification of their guidance indicating that the timelines actually apply on a case-by-case basis. Listen in while our ERISA attorney unpacks what this means and how employers should handle it.
Every March, Lipscomb & Pitts Insurance recognizes Colorectal Cancer Awareness Month. In the United States, colorectal cancer is the third-leading cause of cancer-related death in men and women. This cancer affects adults of all racial and ethnic groups, however, it is most often diagnosed in people who are over the age of 50. Colorectal cancer is treatable when it is discovered early.
Learn more at www.westcancercenter.org
Many American households have at least one pet. In any given year, one in three of these beloved family members will need costly veterinary care, even if it is for routine exam visits and vaccinations. Should a pet become severely ill and need emergency care, costs can sometimes be more than pet owners can bear. However, if they have pet insurance, owners will never have to make a decision about their pets wellbeing based on cost.
Though pet insurance is a nontraditional benefit and is generally paid for by the employee, it is becoming increasingly popular in the workplace to help employees care for their pets without going bankrupt. This benefit is particularly valuable, as pet care is increasingly expensive. In fact, offering insurance for man’s best friend is a great marketing and PR initiative for companies that want to add to their image of being a great place to work.
Pets typically visit the vet for the following reasons:
- Accident care
- Illness care
- Routine preventive care
- Lab work
- X-rays
- Surgeries
- Diagnostic testing
- Prescription therapy
These services are the same or similar to the reasons why you or your employees would visit the doctor, and often carry a steep price tag. Specifically, here are the typical costs for the following common pet injuries and illnesses:
- Dog involved in a motor vehicle accident = $4,890
- Dog or cat ingesting a foreign body = $4,280
- Dog cancer treatments = $3,570
- Dog bladder infection treatment = $2,760
- Dog hip dysplasia = $2,390
- Cat fractured leg = $2,300
- Cat pneumonia treatment = $1,900
- Cat diabetes treatments = $1,740
Coverage Details
- Employers sign up for a group discount code that can be used by their employees, typically without a minimum enrollment number required. Then, pet owners can select a coverage percentage or monthly premium that will work best for their budget and needs. Under the policy, the pet must have an annual examination and the owners must adhere to the recommendations given by the veterinarians to remain covered. Beyond that, most policies do not cover existing conditions or injuries but do assist in paying for the following:
- New accidents and injuries
- X-rays
- Surgeries
- Cancer care
- Prescriptions
- Hospitalization
- Vaccinations
- Heartworm therapy
- Flea control
- Urinalysis
- Dental care
- Spay/neuter
Compare Your Options
If your organization is considering this benefit for your employees, consider asking the pet insurance companies the following questions before making your selection:
- How long has your company been in business?
- Is coverage available in our area?
- Is coverage available where our employees may travel?
- Can employees use any veterinarian and animal hospital?
- Do you offer discounts for multiple pets?
- What are your customer service hours and availability?
- What are the coverage plan options available to employees? What are the deductible options?
- What is the average annual premium increase?
- Can our company lock in a premium rate?
- Is there a penalty for changing plans?
- Is preapproval for services required?
- What are the limits to the policy? Lifetime caps?
- Can employees find out the insurance reimbursement before authorizing their pet’s veterinarian to perform procedures?
- Do reimbursement amounts vary depending on the specific veterinarian’s fees?
- Can pets be dropped from the coverage? If so, why?
- What is the claims filing process?
- How long does it typically take to receive payment for a claim?
- How are claim disputes resolved?
- How does the policy determine reimbursement for claims?
- Is there a maximum amount paid per procedure? Per calendar year? Per disease?
- What diseases are excluded from the policy coverage?
- Are there breed-specific diseases excluded from the policy coverage?
- Are pre-existing conditions covered after a certain amount of time?
- Are alternative medicine techniques covered?
- Are consultations with specialists covered? Second opinions? After-hours emergency care?
- Does the policy provide coverage for behavioral problems?
- Is preventive care covered (vaccinations, heartworm testing, spaying/neutering, dental work, flea/tick control, microchipping, etc.)?
If you are considering offering this benefit to your employees, visit www.petinsurance.com.
Sometimes it can trigger a COBRA event, but other times it may lead to early termination of COBRA. If the steps aren’t ordered correctly, employees may unknowingly make decisions that could cause a loss of family coverage. Listen to our conversation to gain a better understanding of it all.
2020 has been a difficult year, to say the least. Employers have had to face new challenges never seen before and quickly adapt to operating a business during a pandemic, while also navigating new legislation because of it. We also had an election, and the Supreme Court heard the ACA case.
Betsy Kamler, Director of Client Engagement sits down with Dustin Johnson, Sr. Broker Account Executive with Jellyvision to discuss how ALEX can serve as a virtual benefit advisor to help drive greater benefit understanding and help employees make smarter decisions.
Betsy Kamler, Director of Client Engagement sits down with Shaletha Colbert, National Account Executive with Allstate Identity Protection to discuss why an employer should consider offering identity theft protection and how the COVID pandemic has impacted Identity theft risks.
Betsy Kamler, Director of Client Engagement sits down with Amy Glynn, Financial Strategist with Global Retirement Partners to discuss the benefits of offering a financial wellness program and why it is important to offer this program during our current COVID-19 pandemic.
On August 3, 2020, a New York federal district court vacated portions of Department of Labor regulations under the Families First Coronavirus Response Act (FFCRA). While the decision is binding over employers with employees working in southern New York, the order does not specifically address the scope of its application over the rest of the country. For that reason, it may be helpful to familiarize yourself with these updates.
It’s August 2020 and time for many kids to go back to school. However, school looks very different this year for so many, and parents are left scrambling to try to figure out once again how to balance life as both an employee, and a parent to a child whose school or daycare may not be open.
Understanding Suicide & Mental Health
Having a mental illness issue does not guarantee you will be suicidal. However, depending on the illness, it can make positive thinking much harder. The CDC describes mental illness as “conditions that affect a person’s thinking, feeling, mood or behavior.” Common types of mental illness include depression, anxiety and personality disorders.
By current estimates, about 1 in 5 Americans are living with a mental illness. This dispels the idea that mental health is something that can be willed away. Chances are that you personally know someone with a mental illness or at least work with an individual who has one. It’s important that you take meaningful steps to help people with these conditions, not just pretend they do not exist. In fact, inaction is a large part of the problem.
What Employers Can Do
Companies cannot expect employees with mental illnesses to simply “snap out of it” or wipe away thoughts of self-harm. Employers need to acknowledge that mental illness comes in many forms and that it probably affects more of their employees than they know. This is why employer-sponsored assistance programs are so important.
Employers should foster a safe environment that encourages employees to speak up if they’re feeling overwhelmed by work, as this is a significant stressor for depression and other mental illnesses. Beyond reassessing company culture, organizations can offer referrals or access to mental health professionals through their employee assistance program. One of the most effective ways to reduce suicide is by being there for someone in need. With this in mind, consider empathy training for managers so they can recognize the warning signs of severe depression and can address them with the individual.
Resources For Employers
This section includes resources that you are encouraged to share with employees. Anyone can access this information, but, as an employer, you have the opportunity to proactively share these links with employees. Take a look at the information and consider sending an email or hosting a meeting to discuss this serious topic.
The CDC offers a number of resources aimed at addressing and preventing suicide resulting from mental illness. Below are some of their most robust resources:
- “Preventing Suicide: A Technical Package of Policy, Programs, and Practices” (www.cdc.gov/violenceprevention/pdf/suicideTechnicalPackage.pdf)
- Important information about suicide in the U.S. (www.cdc.gov/vitalsigns/suicide)
The Depression and Bipolar Support Alliance offers services, training and education on depression and bipolar disorder. Learn more about these services on their website, www.dbsalliance.org.
The National Suicide Prevention Lifeline is another organization committed to suicide prevention. They created the “Be The 1 To” campaign to educate people about helping those who suffer suicidal thoughts. Their website (www.bethe1to.com) provides more information about how to help.
The group also offers a free, 24/7 phone and chat service for those experiencing suicidal thoughts or advocates who need resources to help a loved one. The calls are confidential and are well-regarded as helping the individuals who call. Here is their contact information:
- Website: www.suicidepreventionlifeline.org
- Telephone: 1-800-273-8255
What is an opioid?
An opioid is a type of drug found in prescription pain medicine. It is also found in “street drugs” such as heroin. Prescription opioids can help with pain when used under a doctor’s order. They may be addictive and cause side effects and even death when used incorrectly. prescription opioids include: Hydrocodone (Vicodin®), Oxycodone (OxyContin®), Oxymorphone (Opana®), Codeine, Morphine, Methadone, Fentanyl
How is treatment provided?
Treatment is typically provided on an outpatient basis. In some cases, it is also provided at a residential program. Both programs often use medications to help get patients off opioids.
Talk with your doctor or other health care professional about the options. Check with your insurance provider for what they cover, as costs can vary.
How can I get someone to seek help?
When a person with an opioid use disorder is ready to get help, they need help right away. But they also need to want to participate. This can be hard for friends and family members if the person does not want help. If you have questions, you should talk with your doctor or health care provider. What you tell your doctor is private and should not be shared without your permission.
How successful is treatment?
Some patients will need to repeat treatment before beating addiction. Their surroundings, including family or friends, can play an important role.
Research has also shown that patients with depression and those who use other substances such as alcohol are more likely to struggle with substance use disorders. Treatment for both mental health and substance use disorders should be completed together for treatment to work.
What Increases My Risk of Overdose from This Medication?
Overdose risk increases when your opioid medication is combined with: Alcohol, Benzodiazepines (also known as “benzos,” including diazepam and alprazolam). Other sedatives, Other opioids (prescription or illicit, including heroin)
It is very dangerous to combine opioids with other drugs, especially those that cause drowsiness. Risk of opioid overdose and death increases at higher dosages, and when taken for longer periods of time or more often than prescribed.
Talk to your doctor about any other medications you are using. Work out a plan to call your doctor if you continue to experience pain. Also ask about the serious side effects. Talk to your doctor about any other medications you are using. Work out a plan to call your doctor if you continue to experience pain. Also ask about the serious side effects (like excessive sleepiness or craving more of the medication) so you and your family know when to call a doctor or go to the hospital.
What are the warning signs of opioid abuse?
Someone struggling with an opioid use disorder may not show signs right away. Over time, there may be some signs they need help.
Changes in sleep habits, weight loss, flu-like symptoms and decreased libido may be physical signs they are struggling. Changes in the way they act — such as cutting off relationships with family or friends, spending too much money, stealing, changes in exercise habits or not bathing — may also be signs.
Betsy Kamler, Director of Client Engagement sits down with Hayes Stevens of Benefit Technology Resources to discuss what to expect when you decide to vet out a new solution.
Betsy Kamler, Director of Client Engagement sits down with Hayes Stevens of Benefit Technology Resources to discuss the purpose of a Human Capital Management System and the pitfalls of not having it within your company.
Betsy Kamler, Director of Client Engagement sits down with Hayes Stevens of Benefit Technology Resources to discuss the importance of technology in your workforce, the cost savings and how it can impact your company’s culture.
Tune in to listen to our ERISA counsel explain how the deadlines have been extended, and for a word of caution about delaying premium payment.
While this cost reduction is certainly a positive gesture, to the extent that the refund or credit is considered a plan asset, it must be used in accordance with ERISA and fiduciary obligations. Listen to learn more about determining whether your credit is a plan asset, and your options from there.
On May 12, 2020 the IRS finally issued long-awaited relief for employers and employees regarding medical election changes and other new allowances for cafeteria plans, health FSAs, and dependent care accounts. Tune in to learn more about these changes and for some Q&A on how they will work.
Stress in the workplace can have many origins or come from one single event. It can impact on both employees and employers alike. It is generally believed that some stress is okay (sometimes referred to as “challenge” or “positive stress”) but when stress occurs in amounts that you cannot handle, both mental and physical changes may occur.
The majority of employees experiencing burnout will remain at work. Being aware of changes in attitudes and energy can help with early identification. Employees may not realize that they are dealing with burnout and may instead believe that they are just struggling to keep up during stressful times. Stress, however, is usually experienced as feeling anxious and having a sense of urgency while burnout is more commonly experienced as helplessness, hopelessness, or apathy.
Employees may not be aware of the negative impacts on their performance that this can have, such as increased errors or lower productivity. Employers and co-workers may attribute the changes to a poor attitude or loss of motivation. The negative effects of burnout can increase significantly before anyone recognizes or addresses the problem and unaddressed burnout can increase the chance of developing clinical depression or other serious conditions.
Some of the signs and symptoms that an employee experiencing burnout may exhibit include:
- Reduced efficiency and energy
- Lowered levels of motivation
- Increased errors
- Fatigue
- Headaches
- Irritability
- Increased frustration
- Suspiciousness
- More time spent working with less being accomplished
Severe burnout can also result in:
- Self-medication with alcohol and other substances
- Sarcasm and negativity
- Debilitating self-doubt
Employers Can PROMOTE Awareness About the Importance of Mental Health and Stress Management
Workplace health promotion programs have proven to be successful, especially when they combine mental and physical health interventions.
The workplace is an optimal setting to create a culture of health because:
- Communication structures are already in place.
- Programs and policies come from one central team.
- Social support networks are available.
- Employers can offer incentives to reinforce healthy behaviors.
- Employers can use data to track progress and measure the effects.
Action steps employers can take include:
- Make mental health self-assessment tools available to all employees.
- Offer free or subsidized clinical screenings for depression from a qualified mental health professional, followed by directed feedback and clinical referral when appropriate.
- Offer health insurance with no or low out-of-pocket costs for depression medications and mental health counseling.
- Provide free or subsidized lifestyle coaching, counseling, or self-management programs.
- Distribute materials, such as brochures, fliers, and videos, to all employees about the signs and symptoms of poor mental health and opportunities for treatment.
- Host seminars or workshops that address depression and stress management techniques, like mindfulness, breathing exercises, and meditation, to help employees reduce anxiety and stress and improve focus and motivation.
- Create and maintain dedicated, quiet spaces for relaxation activities.
- Provide managers with training to help them recognize the signs and symptoms of stress and depression in team members and encourage them to seek help from qualified mental health professionals.
- Give employees opportunities to participate in decisions about issues that affect job stress.
Every 65 seconds someone in the United States develops the disease and Alzheimer's is the 6th leading cause of death in the U.S.
The IRS is sending penalty letters to certain large employers they believe didn’t fulfill their obligation within the employer shared responsibility provision of the ACA, or because they didn’t complete the ACA reporting at all.
Be sure to tune into this podcast for a review of some of the compliance milestones of 2019 and their implications. Sarah and Stacy also discuss some expectations for 2020.
Tune in as we discuss the if an ROI can be achieved in a wellness program and what you need to make it profitable for you and your employees.
Employers are often unsure what to do with them, or aren’t aware that the DOL has issued guidance to help plan sponsors decide how to handle their rebate. Listen in to a conversation between our Compliance Director and our ERISA attorney that will help explain employers’ options.
Many medical carriers offer their own wellness programs or there are many stand alone wellness programs offered by various vendors. Tune in to learn the difference between the two and what might be best for company.
Employers with group health plans must generally extend coverage to the children of an employee when a state court or agency issues a qualified medical child support order. Listen to this podcast to better understand your obligation as an employer and to help answer a variety of “what if” questions often encountered upon receiving an order like this.
Listen to learn what additional services are now included in the preventive care list for HSA-qualified HDHPs and how to implement them.
There are many pieces that go into communication, incentives and getting senior leadership on board. Tune in to learn what you need to make your wellness program successful.
The new rules will allow employer funded HRAs to be used to pay for individual health insurance policies and create a new type of stand-alone HRA. However, there are a lot of details to consider before diving in. Listen in to learn more about these new options.
Legal activity regarding the ACA continues to make its way through the courts. With the 2020 election on the horizon and healthcare still a hot topic, we expect to see an uptick in attempted legislation and efforts in both directions. Tune in to hear a discussion on ACA updates.
www.lpinsurance.com
Recently, a federal judge ruled that parts of the Trump administration’s 2018 final rule on association health plans were invalid. The court then directed the Department of Labor to reconsider how the remaining provisions of the final rule are affected. The court called the final rule an “end-run” around the Affordable Care Act and said that the DOL exceeded its authority under ERISA. And then just last week the DOL responded in disagreement with the court’s ruling and the DOL filed a notice of appeal. Listen to this podcast to find out what parts of the rule were struck down, and how the DOL’s response may impact the future of AHPs.
www.lpinsurance.com
Did you know that a rehired employee cannot be asked to re-satisfy a waiting period for benefits eligibility if they return to work with 13 weeks of their termination date? Tune in to learn the rules surrounding rehired or reinstated employees and where exceptions may exist.
As health costs and employer expenditures increase, more employers are considering innovative strategies to help lower health care costs. As with any new strategy, it is important for employers to do their homework and thoroughly evaluate options before jumping in. This podcast offers a discussion of the potential benefits and pitfalls for employers to consider.
On December 20, 2018 the Federal Register published the final rule from the EEOC removing the part of the regulations related to incentive limits for medical questions and exams under a wellness program. If this sounds familiar to what we heard from the Court in Dec 2017, that’s because it is. But does the absence of any limit mean employers shouldn’t incentivize wellness programs any longer? Tune in to find out.
In October 2017, President Trump issued an Executive Order calling on the departments to take action on a handful of specific tasks, one of which was to expand the use of Health Reimbursement Arrangements (HRAs). We finally saw proposed guidance on this in late October 2018 when two new types of HRAs were introduced. Listen in to learn more about these proposed HRAs and how they might impact employers.
Listen to our year-end podcast for a review of the major 2018 benefits compliance milestones and a look forward to 2019, including a discussion on the recent ruling by the federal judge in Texas who declared the ACA unconstitutional.
The Tax Cuts and Jobs Act created a general business tax credit for eligible employers of all sizes that provide paid family and medical leave to their employees for tax years 2018 and 2019 only. For employers that already provide paid short term disability, this might be low hanging fruit, and that’s why we’re addressing this as part of a benefits podcast.
On Nov. 7, 2018, the Departments of Labor, Health and Human Services, and the Treasury finalized two rules expanding certain exemptions from the ACA’s contraceptive coverage mandate. The first final rule expands the exemption for employers that object to providing contraceptive coverage based on their sincerely held religious beliefs. The second final rule provides an exemption for certain employers that object to providing contraceptive coverage based on their non-religious moral convictions. Listen in to learn more about these final rules and their implications.
Open enrollment is such an important time of year! Don't overlook some important compliance reminders. Listen to this podcast for a few dos and don'ts to help make sure your company is all set for a new plan year.
Learn more: www.lpinsurance.com
This question comes up often. Before extending these type programs to your non-medical plan participants, be sure to listen to this podcast to become aware of reasons this could be potentially problematic, and to learn a couple solutions.
www.lpinsurance.com
The House Ways and Means Committee recently approved 11 bills that increase the flexibility of HSA and FSA plans and also focus on delaying the implementation of some of the provisions of the Affordable Care Act. Employers may need to be ready to act nimbly should these bills come to fruition by the end of 2018. Listen in to learn what might be impacted.
In October 2017, President Trump issued an Executive Order including 3 things aimed at unraveling pieces of the Affordable Care Act when efforts in Congress failed to do so. One of those items was to seek more relaxed regulations on association health plans as a way to allow individuals and businesses the opportunity to purchase policies across state lines and avoid some ACA requirements. However, there are a few things employers should understand before forming or jumping into an association. Tune in to this podcast to learn more.
The IRS recently released the HSA contribution limits, HDHP deductible and out of pocket limits, and the ACA out of pocket limits for 2019. The interaction of these limits can be confusing due to embedded OOP requirements and other considerations. Tune in for a brief explanation from our ERISA attorney on how to design a compliant plan with these new limits in 2019.
Learn more: www.lpinsurance.com
There has been an uptick in the volume of DOL audits in recent years. The timeframe to respond to an audit notice is short and it is important to be prepared. Tune in to this podcast to learn how to be ready and to debunk some DOL audit myths.
Learn more: www.lpinsurance.com
The IRS recently lowered the maximum annual HSA family contribution limit for 2018 to $6,850, a $50 decrease from the prior limit of $6900. Listen to learn why this happened and what action needs to be taken by employers and any individuals who may have already or intend to max-fund their account.
The DOL has been talking for a while about applying new claims regulations to ERISA covered disability plans. These regulations were originally to apply to claims filed on or after January 1, 2018, but a 90 day delay modified the effective date to April 1, 2018. To learn what these new regulations are, what plans are impacted and what action employers need to take, be sure to listen to this podcast.
On Jan. 22nd President Trump signed into law a continuing spending resolution to end the government shutdown and continue funding through Feb. 8, 2018. This particular resolution also impacted three taxes under the Affordable Care Act (ACA): the Cadillac Tax, the Health Insurance Providers fee and the Medical Device tax. Listen in to learn how these taxes were impacted and what employers should watch for in their health premiums.
Learn more: www.tothepointpodcast.com
Do you as an employer allow for pre-tax contributions through a Section 125 plan or cafeteria plan? Do you have an FSA or Dependent Care Account? Do you have a self-funded health plan? If you answered yes to any of these questions then you should be having nondiscrimination testing performed annually. Listen to learn more about what nondiscrimination testing is, why it is important, and what to do if your plan fails.
Learn more: www.tothepointpodcast.com
On Dec. 20, 2017, the Court chose to vacate key provisions of the EEOC’s final rules for employer-sponsored wellness plans effective Jan. 1, 2019. Unless the EEOC reconsiders and clarifies its position related to incentives for wellness programs with medical testing and medical questions involved, employers will need to make some changes to these type of wellness programs. Listen in to learn more about why this happened and what employers should do next.
Learn more: www.tothepointpodcast.com
The IRS recently updated its list of Frequently Asked Questions related to the ACA’s Employer Mandate where they indicated that penalty letters for calendar year 2015 would start to go out in late 2017. Tune in to learn about IRS Letter 226J and how to quickly respond.
The 2017 year has been full of ups and downs in the world of benefits compliance and the Affordable Care Act. There has been a lot of activity in Congress, though none that has changed the current landscape for employers so far. Listen in for a review of this year and a look forward to 2018.
On Oct. 13, 2017, the IRS reversed a recent policy change in how it monitors compliance with the ACA’s individual mandate. For the upcoming 2018 filing season (filing 2017 tax returns) the IRS will not accept electronically filed tax returns where the taxpayer does not certify whether the individual had health insurance for the year. Also, paper returns that do not certify compliance with the individual mandate may be suspended pending receipt of additional information, and any refunds due may be delayed. Tune in to learn how taxpayers should handle their 2017 returns.
On October 12, 2017, President Trump signed an Executive Order directing the federal agencies in charge of implementing the ACA to propose new regulations or to revise existing guidance to expand access to association health plans, short term insurance plans, and HRAs. Separately, the President issued notice to stop the government’s reimbursement of cost-sharing reduction payments made by insurance carriers that participate in the ACA’s Health Insurance Marketplaces. Is this the beginning of the end for the ACA? Tune in to learn why these things make a difference to the future of the ACA.
On October 6, 2017, The U.S. Departments of Health and Human Services (HHS), Treasury, and Labor (the “Departments”) released interim final regulations allowing employers and insurance companies to decline to cover contraceptives under their health plans based on a religious or moral objection. The new rules are effective immediately and scale back Obama-era regulations under the ACA that require non-grandfathered group health plans to cover women’s contraceptives with no cost-sharing, with limited exceptions for non-profit religious organizations or closely-held for-profit entities. Tune in to learn which plans qualify and whether or not your plan could or should take advantage of this change.
Employer sponsored wellness programs put in place with the best of intentions can easily be found non-compliant if the program falls into any of these 4 main compliance pitfalls. Listen in to learn what they are and how to avoid them.
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After voting to open up ACA repeal legislation for debate and amendments on July 25, 2017, the 20-hour debate ended on July 28, 2017 with a rejection of the “skinny” repeal bill. Is that the end for ACA repeal? Tune in to learn what happened and if we will see any further repeal attempts.
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Employer sponsored wellness plans are a great way to help instill a culture of health and wellbeing in the workplace. However, a bona fide wellness program is subject to regulations under HIPAA, the ACA, the ADA and GINA, and so offering a program requires some forethought and planning to remain compliant. Listen in to learn more about wellness plan regulations and how they apply to your program.
Learn more: www.lpinsurance.com
A Section 125 cafeteria plan allows employers to extend an opportunity to employees to purchase certain benefits on a pre-tax basis. Section 125 plan rules are governed by the IRS and pre-tax benefit elections are irrevocable except for reasons permitted under the IRS Code. Listen in to this podcast to learn about permitted election changes and hear a few real life scenarios employers have asked our L&P team.
The Senate’s proposed health bill, known as the Better Care Reconciliation Act (BCRA), struggles to gain enough support to pass. Tune in to learn some of the key provisions of the bill and thoughts on its future.
Telemedicine programs are increasing in popularity, and for good reason. They offer a way to reduce employee stress associated with long doctor wait times and time out of the office, increase employer productivity for similar reasons, and can positively impact medical claim experience by keeping claims separated from the major medical plan. However, there are a couple key pitfalls employers should be sure to avoid when implementing these plans. Listen in to learn what they are and what solutions we suggest.
Each year the IRS releases an updated index of the contribution percentages for the purposes of determining affordability of an employer’s plan under the Affordable Care Act (ACA). For the first time since these affordability percentages were introduced, we are seeing a decrease in the amount an employer can charge employees for health coverage. Some employers may need to reduce their employee contributions for 2018 to meet the adjusted percentage. Listen in to learn what the percentage amount has been proposed to be for plan years beginning in 2018.
PCORI Fees, also known as the Patient-Centered Research Outcome Institute fees, are due July 31, 2017. While carriers will pay these fees directly for fully insured plans because they are built into the premium, self-funded medical plans, HRAs that integrate with a fully insured medical plan, and self-funded minimum essential coverage (MEC) plans must pay them directly to the IRS via Form 720. Listen in learn more about these fees and how to calculate and pay them.
On May 4,2017, by a vote of 217 to 213 (with 20 Republicans voting against the bill), the U.S. House of Representatives passed an amended version of the American Health Care Act (AHCA), which repeals and replaces significant portions of the Affordable Care Act (ACA). Tune in to this podcast to learn more about the amendments that made enough difference to allow the bill to pass, its impact on employers, and its future in the Senate and beyond.
The Family Medical Leave Act is a federal law that applies to all employers with 50 or more employees in a 75 miles radius. Tune in to learn the qualification criteria for employees to take this leave, how premium payments should be handled, and what to do if the employee can't or doesn't return at the end of leave.
Forgot to file a line of coverage on your last 5500 or just realized that 5500s have never been filed for your company’s health and welfare plans? Steep penalties will apply if caught by the DOL. Listen in to learn about how the Delinquent Filer Voluntary Compliance Program (DFVCP) can seriously limit your penalty liability by filing as soon as you learn of the offense.
Employers of all sizes offering health and welfare plans to employees are subject to ERISA laws with few exceptions. One of these laws requires a plan document and summary plan description per line of coverage (medical, dental, vision, life, etc.). A wrap plan document is an attorney created document that wraps around all of an employer’s health and welfare plans to effectively create one ERISA plan. An employer’s carrier provided documents like the booklet, contract or evidence of coverage often do not include all items required under ERISA to qualify as a true summary plan description, so the creation of a wrap plan document can help ensure compliance with ERISA as well as streamline an employer’s 5500 reporting. Listen in to learn more.
On March 24, 2017 a vote was scheduled to take place on the House floor regarding the Republican proposed American Health Care Act, but it didn’t happen. This podcast will review why not, what alternative measures may be used to attempt repealing or amending the current law, and advice to employers on what to do next.
Section 125 plans provide a simple and effective way to add employee benefits, especially for businesses with a number of employees who regularly have medical and childcare expenses. Employees can deduct their insurance premiums pretax and set aside pretax funds to use toward qualified medical and dependent care expenses. Business owners can experience decreased company payroll and tax liabilities for social security, Medicare, and unemployment. But, before you start pre-taxing, be sure to have the right documents in place!
In January 2017, the IRS Office of Chief Counsel issued a memorandum clarifying the tax treatment of certain types of fixed indemnity plans offered by employers. Since the memorandum was released, several fixed indemnity plan insurance carriers have pushed back, stating that the interpretation of the IRS memo was too broad and should not affect the taxation of such plans. Listen in to learn how and if this affects various types of hospital and critical care reimbursement plans, cancer and accident plans, and other similar type lump sum reimbursement arrangements.
Overview of the American Health Care Act, the Republican proposal to replace Obamacare. Impact on employers and suggestions for the near future.