Make sure to stay up-to-date with the most recent changes to the ACA, thanks to our partners at United Benefit Advisors (UBA).
In March, the employee benefits world watched as the House Speaker unveiled a proposal to replace parts of the Patient Protection and Affordable Care Act (ACA) with the American Health Care Act (AHCA). The AHCA bill was withdrawn from consideration by the full House on March 24 because it appeared that there would not be enough votes to pass the AHCA.
On March 13, 2017, the U.S. Senate approved Seema Verma as the new administrator of the Centers for Medicare & Medicaid Services (CMS), which spends more than a $1 trillion annually on health care programs.
The IRS updated its Q&As to address whether family members of an employee who declines employer-sponsored coverage would be eligible for a premium tax credit for Marketplace coverage. The IRS updated its Publication 969 regarding health savings accounts and other tax-favored health plans. The IRS released its Information Letter regarding the treatment of cafeteria plan forfeitures. The Department of Labor (DOL) released an advisory opinion on whether an association’s administrative services program was an ERISA employee welfare benefit plan or a multiple employer welfare arrangement (MEWA).
UBA released one new resource in March: Important News Regarding the Employer-Tax Exclusion for Health Insurance
UBA updated existing guidance:
IRS Updates Guidance on Premium Tax Credit Eligibility When Employer-Sponsored Health Plan Coverage is Offered to an Employee’s Spouse and Children
The IRS updated its Questions and Answers on the Premium Tax Credit. Specifically, Q&A 15 addresses a situation in which an employer offers minimum value, affordable coverage to an employee, the employee’s spouse, and the employee’s children. The plan only allows the spouse and dependent to enroll if the employee enrolls. The employee declines to enroll.
The IRS determined that all three family members are not eligible for a premium tax credit for Marketplace coverage because they could have enrolled in the employer-sponsored coverage through the employee’s coverage and the coverage would have been minimum value and affordable.
IRS Updates Its Publication 969
The Internal Revenue Service (IRS) updated its Publication 969 Health Savings Accounts and Other Tax-Favored Health Plans for use in preparing 2016 tax returns. The publication describes HSAs, MSAs, FSAs, and HRAs, including eligibility requirements, contribution limits, and distribution information.
IRS Releases Information Letter
IRS released Information Letter Number 2016-0077, in which it explains how an employer may dispose of a flexible benefit plan’s unused funds when an employer ceases business operations and terminates a plan and when a participant forfeits funds to an ongoing plan.
The plan documents will determine how an employer may dispose of unused funds when a cafeteria plan terminates. Unused funds will not revert to the U.S. Treasury.
The IRS explained that the Internal Revenue Code (IRC) Section 125 rules apply to funds forfeited by a participant in an ongoing plan. Per IRC Section 125, the participants’ forfeited funds may be:
Finally, the IRS explained that when an employee terminates employment, IRC Section 125 prohibits the plan from reimbursing health care expenses incurred after the employee terminates employment and no longer participates in the plan.
DOL Issues Advisory Opinion
On January 13, 2017, the Department of Labor (DOL) issued Advisory Opinion 2017-01A. The DOL determined that an association’s administrative services program for its members’ employee benefits plan is not an ERISA employee welfare benefit plan and not a multiple employer welfare arrangement (MEWA).
As background, the association is comprised of large employers that sponsor self-insured benefit plans through administrative services only (ASO) agreements with insurance companies. The association has a member-owned and member-funded cooperative that analyzes health care spending, utilization, and outcomes; however, the association does not and will not provide insurance services to its members; determine benefit levels, administer plans, benefits, or claims; facilitate payment of ASO fees to insurers; or file or process claims.
The DOL determined that the program is not an ERISA employee welfare benefit plan because it has no employee participants and it does not offer or provide benefits to employees or their dependents.
The DOL determined that the program is not a MEWA because it is not an arrangement established or maintained to provide welfare benefits to employees of two or more employers. Further, the DOL determined that the program does not operate as a MEWA because no component of the program underwrites or guarantees welfare benefits, provides welfare benefits through group insurance contracts covering more than one employer, pools welfare benefit risk among participating employers, or provides similar insurance or risk spreading functions.
Question of the Month
Q. What obligations does an employer have when it receives returned Form 1095-Bs marked as undeliverable by the U.S. postal service?
A. Under IRS guidance, the employer fulfills its responsibility to furnish the statement to an individual if it mails the statement to the recipient’s last known permanent address (unless the recipient affirmatively consented to receive the statement in electronic format).
Practically speaking, the employer should keep the mailing which shows that the employer sent the statement to the recipient’s last known permanent address and that the statement was returned undeliverable. That way, the employer has proof that it mailed the statement to the recipient’s last known permanent address.
To download the full recap click Here.
Did you know that there is a direct corelation between financial and physical health? This article from Benefits Pro is a great read explaining the link between an employee’s financial and physical health by Caroline Marwitz
LAS VEGAS — Are poor physical health and poor financial health connected? The benefits industry is making the link, if you consider how many deals between health-related benefits companies and retirement providers have occurred lately.
Obviously, the poor, at least in America, have a more fragile state of health than the more affluent. And as we age, the potential for unplanned health events to hurt us financially increases — and that’s important for retirement advisors and plan sponsors to remember. But what about your typical employees who are neither poor nor elderly?
A study in the journal Psychological Science looked at worker attitudes and actions to find out whether poor physical health and poor financial health might be linked, and how.
The researchers studied employees who were given an employer-sponsored health exam and were told they needed to change certain behaviors to improve their health. Which employees made the changes and who blew them off?
The researchers accounted for external factors such as different levels of income and physical health, and differences in demographics. Yet the results were still startling:
“Employees who saved for the future by contributing to a 401(k) showed improvements in their abnormal blood-test results and health behaviors approximately 27% more often than noncontributors did,” the researchers concluded in Healthy, Wealthy, and Wise: Retirement Planning Predicts Employee Health Improvements.
The employees who made the behavior changes to better their physical health were also the ones who were taking action to better their financial health.
Employee attitudes about the future and how much control they have over it affect whether they take care of their physical health and their financial health. That sense of control, or conversely, that feeling of no control, and thus, no investment in long-term results, is one reason why some employees might not participate in retirement plans, and, maybe, wellness and well-being programs.
What if, along with the retirement health-care cost calculators many retirement plan providers offer, there was a fatalism calculator too? That way you could see right away each person’s sense of control or feelings of inevitability about their future and help them more efficiently.
Because if someone is more fatalistic, telling them about their 401(k) match or pension options isn’t going to make them enroll in a retirement plan. Scaring them with statistics about the high costs of health care in retirement isn’t going to do the trick either. Instead, consider the following points for such employees:
Look behind employee behavior for the unexamined biases and long-held assumptions that are causing it. If they can see that it’s not who they are that determines their future but what they do, it’s a start.
See the original article Here.
Marwitz C. (2017 March 19). Employee financial health connects to physical health [Web blog post]. Retrieved from address http://www.benefitspro.com/2017/03/19/employee-financial-health-connects-to-physical-hea?ref=hp-top-stories
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Do you know which question you can ask any employee requesting FMLA leave? Look at this great article from HR Morning about what employers can and cannot say to an employee on FMLA leave Christian Schappel
You know when employees request FMLA leave, those conversations have to stick to the facts about what the workers need and why. The problem is, a lot of managers don’t know that — and here’s proof some of their stray comments can cost you dearly in court.
Three employers are currently fighting expensive FMLA interference lawsuits because their managers didn’t stick to the facts when subordinates requested leave.
The real kick in the pants: Two of the lawsuits were filed by employees who’d received all of the FMLA leave they requested — and the courts said the interference claims were still valid. How’s that even possible? Keep reading to learn about the latest litigation trend in the FMLA world.
Here’s what happened in each case (don’t worry, we’ve cut to the chase in all of them) — beginning with the words/phrases managers must avoid when a worker requests leave:
James Hefti, a tool designer, was in hot water with his company, Brunk Industries, a metal stamping company.
Reason: Let’s just say he called a lot of people at work “my b____.”
After he ignored multiple warnings from management to stop using obscenities at work, the company planned to fire him. But it didn’t pull the trigger immediately.
Then, just prior to his termination, Hefti requested FMLA leave to care for his son, who was suffering from various mental health problems.
His manager, upon hearing of Hefti’s request, told him Brunk paid for his insurance and thus expected him to be at work.
When Hefti was fired a few days later, he sued for FMLA interference.
The company tried to get the suit thrown out, claiming his conduct and ignorance of repeated warnings gave it grounds to terminate him. But it didn’t win.
The court said the manager’s interactions with Hefti did raise the question of whether he was fired for requesting FMLA leave, so the judge sent the case to trial.
Cite: Hefti v. Brunk Industries
Lisa Kimes, a public safety officer for the University of Scranton’s Department of Public Safety, requested FMLA leave to care for her son, who had diabetes.
Kimes was granted all the time off she requested. But in a meeting with her supervisor she was told that since the department was short staffed it was “inconsiderate” of her to take time off.
When her relationship with the department soured, she sued claiming FMLA interference.
The department tried to get her suit tossed before it went to trial. It had a seemingly reasonable argument: She got all of the leave she requested, so it couldn’t have interfered with her FMLA rights.
But Kimes argued that her supervisor’s comments prevented her from requesting more FMLA leave – thus the interference lawsuit.
The court sided with Kimes. It said she had a strong argument, so the judge sent her case to trial as well.
Suit: Kimes v. University of Scranton
Judy Gordon was an officer with U.S. Capitol Police when she requested intermittent FMLA leave for periods of incapacitating depression following her husband’s suicide.
But before Gordon used any FMLA leave, a captain in the police department told her that an upper-level manager had said he was “mad” about FMLA requests in general, and he’d vowed to “find a problem” with Gordon’s request.
Then later, when she actually went to take leave, her manager became irate, denied her request and demanded a doctor’s note. He later relented and granted the request.
In fact, she was granted all the leave she requested.
Still, she filed an FMLA interference suit. And, again, the employer fought to get it thrown out before a trial on the grounds that Gordon had no claim because all of her leave requests were granted.
But this case was sent to trial, too. The judge said her superiors’ conduct could have a “reasonable tendency” to interfere with her FMLA rights by deterring her from exercising them — i.e., the comments made to her could’ve persuaded her not to request additional leave time to which she was entitled.
Suit: Gordon v. United States Capitol Police
Based on a thorough read-through of the court documents, each of these employers appeared to have a pretty good chance of winning summary judgment and getting the lawsuits thrown out before an expensive trial — that is, if it weren’t for the managers’ stray comments in each.
These cases have created two important teaching points for HR:
The best way to stay safe: Re-emphasize that managers must stick to the facts when employees request FMLA leave, as well as keep their opinions and other observations to themselves.
Schappel C. (2017 March 17). 3 things managers can’t say after FMLA requests [Web blog post]. Retrieved from address http://www.hrmorning.com/3-things-you-cant-say-after-fmla-requests/
Great article from our partner, United Benefit Advisors (UBA) by Danielle Capilla
Entities such as employers with group health plans that provide prescription drug coverage to individuals that are eligible for Medicare Part D have two major disclosure requirements that they must meet at least annually:
Because there is often ambiguity regarding who in a covered population is Medicare eligible, it is best practice for employers to provide the notice to all plan participants.
CMS provides guidance for disclosure of creditable coverage for both individuals and employers.
Who Must Disclose?
These disclosure requirements apply regardless of whether the plan is large or small, is self-funded or fully insured, or whether the group health plan pays primary or secondary to Medicare. Entities that provide prescription drug coverage through a group health plan must provide the disclosures. Group health plans include:
Health flexible spending accounts (FSAs), Archer medical savings accounts, and health savings accounts (HSAs) do not have disclosure requirements. In contrast, the high deductible health plan (HDHP) offered in conjunction with the HSA would have disclosure requirements.
There are no exceptions for church plans or government plans.
Capilla D. (2017 March 01). Medicare part D: creditable coverage disclosures [Web blog post]. Retrieved from address http://blog.ubabenefits.com/medicare-part-d-creditable-coverage-disclosures-1
Change is on the way for employees who get their healthcare through their employer. Take a look at this great article from Employee Benefit News about the mandatory genetic testing that employers can impose on employees on the employer health plan our partner by Richard Stolz
Employers with ambitious health promotion programs may get a break from a thicket of conflicting federal regulation that, critics argue, is discouraging their efforts to address employee health issues holistically.
The “Preserving Employee Wellness Programs Act”— or HR 1313 — cleared an important legislative hurdle March 8 when a majority of members of the House Education and The Workforce Committee, in a party-line vote (22 Republicans in favor, 17 Democrats opposed), approved the measure.
HR 1313’s basic purpose is to clarify that employers can obtain biometric information from employee family members who participate in incentive-based wellness programs using financial incentives without violating the Generic Information Nondiscrimination Act of 2008 (GINA). That is, the incentives don’t amount to unlawful coercion.
The bill still must be approved by more committees before being voted on by the full House of Representatives, and then the Senate. However, given Republican control of Congress, its prospects appear to be strong, unless it becomes bogged down in a larger battle over the Republican Affordable Care Act replacement legislation.
And, it looks promising for employers.
HR 1313 has been supported by, among other groups, the American Benefits Council and the Society for Human Resource Management.
Key language of HR 1313 states the following: “The collection of information about the manifested disease or disorder of a family member shall not be considered an unlawful acquisition of genetic information with respect to another family member as part of a workplace wellness program…”
Testifying in favor of the measure on behalf of the American Benefits Council, Allison Klausner warned that without such legislation, “the future of workplace wellness programs are at risk.”
“Employers… face complex and inconsistent regulation for the design and administration of [wellness] plans, most recently as a result of regulations relating to wellness programs finalized by the EEOC,” stated Klausner, who also serves as Chair of ABC’s Policy Board of Directors.
SHRM lobbyist Chatrane Birbal expressed similar concerns. She believes HR 1313 will “alleviate the confusing and conflicting requirements for wellness programs and provide employers the legal certainty they need to continue to offer employee wellness programs.”
However, the measure is not without detractors. As noted, all 17 Democrats on the Committee opposed the measure. They have found arguments by opposing groups, such as the American Society of Human Genetics, persuasive. “If enacted, this bill would force Americans to choose between access to affordable healthcare and keeping their personal genetic and health information private,” according to Derek Scholes, director of science policy fir the organization.
The fear is that certain health conditions that can be revealed in biometric testing administered in conjunction with incentive-based wellness programs, especially when both employees and their spouses submit to the testing, give employers ammunition to discriminate against employees deemed to pose a serious risk of future high medical claims, either with respect to themselves, or dependents.
Given the simplicity of HR 1313, it could be enacted as-is, unlike the multifaceted Republican ACA-replacement, American Health Care Act, whose fate will not be determined quickly.
Stolz R. (2017 March 10). New bill would allow employers to force genetic testing on workers [Web blog post]. Retrieved from address https://www.benefitnews.com/news/new-bill-would-allow-employers-to-force-genetic-testing-on-workers?brief=00000152-14a7-d1cc-a5fa-7cffccf00000
Interesting article from the Society of Human Resources about the benefits of leveraging caregiving benefits in your employee benefits program by Hank Jackson
Whether caring for an aging parent, welcoming a newborn child or handling family medical situations, life events can create some of the most stressful and demanding challenges in our personal and work lives. For those without employer-provided paid leave, the burden is even heavier. People often need extended periods of time off to cover responsibilities at home, but many are forced to rely on the federal floor of unpaid leave guaranteed by the Family and Medical Leave Act.
High costs are cited as the biggest barrier to paid leave, but now, more than ever, companies risk losing great talent to rivals with more robust policies—here and abroad. In addition, employers struggle with a growing patchwork of state and local leave laws that hinder innovation and add compliance costs. This is why SHRM is advocating for public policies that would provide relief to employers while guaranteeing paid leave and expanded flexibility options for full-time and part-time employees. The issue of paid leave is a hot one—featured during the presidential campaign and poised to be a focus of congressional consideration in 2017.
Last year, more than two dozen large U.S. employers—including American Express, Deloitte, Ernst and Young, Campbell’s, First Data and Etsy—announced they would significantly strengthen paid family leave benefits. Their approaches vary, ranging from extending the time employees can take paid leave to broadening categories of eligible individuals and covered situations. But in all instances, a powerful business case was behind the decision. They believe it is a winning strategy and are promoting it widely to stakeholders and shareholders.
A carefully analyzed and applied family leave benefit can be a differentiator in today’s hyper-competitive talent marketplace. Even medium-sized and small enterprises can offer budget- and family-friendly policies, such as flexible schedules. The important thing is to develop a workplace where an employee’s work-life needs are valued and supported, balanced with the right benefits, rewards and adaptability across an employee’s life cycle.
Paid parental leave and other work-flexible programs are not only about competing or compliance. They are about doing the right thing for the organization and the employee. As HR professionals, it’s up to us to help our organizations grow a culture where both employees and employers win. This is part of the compact to create the 21st Century workplace employees of all ages want—innovative, fair and competitive with other businesses.
Jackson H. (2017 March 09). Caregiving benefits can sharpen your competitive edge [Web blog post]. Retrieved from address https://blog.shrm.org/blog/caregiving-benefits-can-sharpen-your-competitive-edge
Great article from our partner, United Benefit Advisors (UBA) about the changes coming to employee benefits by Pat McClelland
There is no denying our industry is changing rapidly, and it’s not about to slow down. Combined with disruptive advances in technology and evolving consumer expectations, we’re seeing consumer-driven health care emerge. Take, for example, the fact that employees now spend more than nine hours a day on digital devices.
There’s no doubt that all this screen time takes a toll.
Employees are demanding visibility into health care costs and transparency in the options available so they can take control of their own health. Consumers are more knowledgeable and sensitive to cost, and as a result becoming very selective about their care.
Lack of preventive care
Preventive screenings are a crucial piece of overall health and wellness. In fact, the largest investment companies make to detect illnesses and manage medical costs is in their health plan. But if employees don’t take advantage of preventive care, this investment will not pay off. Only one out of 10 employees get the preventive screenings you’d expect during an annual medical visit2.
It’s a big lost opportunity for organizations that are looking for a low-cost, high-engagement option to drive employee wellness.
How a vision plan can help
The good news is that the right vision plan can help your employees build a bigger safety net to catch chronic conditions early. It all starts with education on the importance of an eye exam.
Eye exams are preventive screenings that most people seek out as a noninvasive, inexpensive way to check in on their health; it’s a win-win for employers and employees.
By screening for conditions like diabetes, high blood pressure, and high cholesterol during eye exams, optometrists are often the ones to detect early signs of these conditions and put the patient on a quicker path to managing the condition. In a study conducted in partnership with Human Capital Management Services (HCMS), VSP doctors were the first to detect signs of3:
McClelland P. (2017 March 02). The changing Landscape of Employee Benefits [Web blog post]. Retrieved from address http://blog.ubabenefits.com/the-changing-landscape-of-employee-benefits
There are many different ways to attracted new talent to your workplace. Take a peek at this freat article from Employee Benefits Advisors about which benefits are best for attracting new talent by Paula Aven Glagych
Live trees indoors, pets at work and an in-office happy hour. Underground Elephant is very forward-thinking when it comes to how it treats its employees and the benefits it offers.
From its fun headquarters space in the east village of San Diego to its outside-the-box thinking on workplace benefits, the digital marketing company “wants to really create an environment where employees want to come to work every day and feel like they are being rewarded,” says Amy Zebrowski, HR business partner at Underground Elephant. “It is a very challenging and fast-paced environment.”
Underground Elephant, which was founded in 2008, provides marketing and technology services to financial service and insurance companies. It offers staffers healthcare and retirement benefits but wanted to show them that it is invested in their education and their family’s education by offering a choice between three non-traditional benefits. People who have worked for the company for one year can choose between a student loan repayment program through Student Loan Genius; a 529 college savings plan through Gradvisor; or $2,000 in company stock options.
If they choose the student loan or college savings plan options, Underground Elephant will contribute $1,500 a year to the program.
Gradvisor founder and CEO Marcos Cordero had wanted to offer a student loan reimbursement program for a couple of years. The company hires many entry-level employees straight out of college, trains them and helps them build their careers at the company.
“We know a lot of employees with student loan debt. We wanted to help them address that and support their financial wellbeing. We didn’t want to exclude employees who don’t have student loans. Our goal was to create a more inclusive program,” Zebrowski says.
Student Loan Genius’ platform allows employees to explore different loan repayment options and to find the one that best fits their situation. Employees can also have their student loan payments taken directly out of their paycheck each month.
The Gradvisor 529 college savings plan helps parents and grandparents save money for future educational expenses.
The cost of college
Cordero says that his 529 platform is popular because recent Gallup data shows that “for employees with children under 18, this is their number one financial concern. It supersedes retirement and unexpected medical bills.”
He added that the cost of college is rising faster than any other expense in the home and millennials, in particular, are feeling the pinch. Many of them left college with huge student loans and they want to make sure their children don’t fall into the same trap. Baby Boomers are also intrigued by the 529 plan because they have “more disposable income to help grandchildren save for college,” Cordero says.
He believes that this benefit will continue to grow over the next decade, but currently “more employers offer pet insurance than college savings.” That is in large part due to the state-by-state complexity of the programs. Each state offers a different 529 plan.
The Gradvisor platform takes into consideration an employee’s risk tolerance, financial situation and household tax filing when determining the best 529 plan for them. The company serves as a fiduciary so it takes “all of those inputs and recommends the most suitable and best fit investment option and asset allocation for the client. We don’t get any commissions or sales charges from the 529 plan. Our advice is 100% objective,” he says. Companies pay to offer the program on a per user per month basis.
“If you look at our stats, our customers tend to save earlier. We’re rolling out this really intuitive step-by-step platform that takes a lot of that fear or intimidation away,” Cordero says.
The average parent who takes advantage of Gradvisor starts saving when their child is five years old, compared to seven in the general population, which adds a couple more years of compounded growth. They also save twice as much as the average person.
Both the student debt repayment and college savings benefits programs were introduced to the company’s employees in January for implementation in March.
“The response has been great. All of our employees are excited about it. It can be a huge help with financial expenses if you are paying toward a student loan it is reducing the overall interest of the life of the loan. Overall it is very positive,” Zebrowski says.
The company’s primary goal in offering these three benefits was to retain good employees and to “show we are invested in their education and their family’s education and financial wellness,” she says.
Based on the company’s younger employee base, there are more participants in the student loan program, but there’s also a lot of interest in the 529 plans.
“I think a lot of people are conscious of the future and saving for families down the line. We’ve had a good response to both,” Zebrowski says.
The company offers a 1% employer match on all employee contributions to its 401(k) plan. The company employs 55 people currently and has been listed as one of the fastest-growing companies in its industry.
The benefit of perks
Underground Elephant wants to be innovative with its benefits because California’s tech industry is very competitive. Many people want to live in San Diego, so “attracting talent, in addition to that retention piece, that certainly factors in,” she says.
The company’s new headquarters building is unique in that it has live trees in the middle of the work space.
“The idea is to make it more open to give people the feeling of being connected to the outdoors,” she says. It has pool, ping pong and is setting up a new game room so employees can get together and have fun. It also has an onsite bar where the company offers regular happy hours.
Employees can bring pets to the office and it has a snack area where the company provides breakfast or lunch once a week.
For the past couple of years, the company has participated in a forum program where the company is divided into groups of eight to 10 employees and these groups participate in challenges throughout the year, including cultural challenges, scavenger hunts, community and charitable events.
“Each year we reevaluate our cultural programs to see what is working and what isn’t working; what people enjoy. The goal is to create as much engagement as possible,” she says.
Underground Elephant offers a full suite of health benefits, including full medical, dental and vision, long and short term disability and voluntary life insurance.
“We want to prepare people for success here or outside the company. Ultimately, the goal is to give people the skills and experience to promote within Underground Elephant or to transfer to other jobs as well,” she says. “Our people tend to be very successful.”
Glagych P. (2017 February 28). Progressive benefits are the lure for new talent [Web blog post]. Retrieved from address http://www.employeebenefitadviser.com/news/progressive-benefits-are-the-lure-for-new-talent?feed=00000152-1377-d1cc-a5fa-7fff0c920000
Does the implementation of the AHCA have you worried about your employee benefits? Take a look at this great article from Employee Benefit News about what the implementaion of the AHCA will mean for employers by Joel Wood.
In breaking down the Congressional Budget Office’s assessment of the proposed American Health Care Act, let’s look at the impact of the AHCA on employer-sponsored plans. The CBO estimates that 2 million fewer Americans will have employer-sponsored coverage in 2020, growing to seven million by 2027. Here’s CBO’s rationale:
These are valid points. The CBO experts are basing their estimates on sound economics and inside the constraints of their authority, and so of course we worry about any proposal that devolves employer-sponsored care. But, we also have to note that the CBO said much the same about the Affordable Care Act, which largely didn’t happen. And CBO notwithstanding, we at the Council of Insurance Agents & Brokers, too, feared something of a death spiral after the ACA was enacted.
The ACA’s employer penalties were very small in comparison to premiums, and it made sense that many would dump their plans, give their employees cash, and send them to the subsidized exchanges. Also, the subsidies were pretty rich — graduating out at 400% of the poverty line. That’s more than $90,000 for a family of four.
What we didn’t take into account in reference to the ACA were a number of things:
So employer-sponsored health insurance has, well, thrived since the enactment of the ACA — perhaps in spite of it, not because of it.
If the CBO is correct and seven million people lose ESI over the next decade, that’s problematic. But it ignores other opportunities that are being created through the proposed GOP bill and Trump Administration executive actions.
Republicans propose significant expansion of HSAs that will compliment higher-deductible ESI plans. They want work-arounds for state mandates on essential health benefits, even though their goal of “buying across state lines” can’t be realized through the tricky budget reconciliation process. And, ultimately, Republicans want to realize the potential for the ACA wellness provisions that have been eviscerated through years of EEOC/ADA/GINA conflicts. That would be a big win for employers.
The most important tradeoff between the “discussion draft” of a few weeks ago and the AHCA is that GOP House leaders junked their plan to tax 10% of employee contributions for ESI plans, in favor of pushing the Cadillac tax out five more years, to 2025.
Personally, I figure I’ve got another decade left in me to lobby for this industry, and that would get me eight years along the way. That’s a terrific tradeoff in my book, especially as Ways & Means Chairman Kevin Brady (R-Texas) emphasized he never intends for that tax to go into effect — it’s purely a budgetary gimmick. And, it’s a ridiculous “score” from CBO anyway. Everybody knows that no employer is going to pay that tax; they’ll work their plan design to get under the numbers.
Where does Donald J. Trump stand on parental leave, minimum wage and other important workplace issues? Here’s what employers need to know.
My conclusions at this moment in time, thus, are:
Sometimes, when lobbying blank-faced Republican leaders on the importance of ESI, I feel like the old BB King lyric: “Nobody loves me but my mother, and she could be jivin’, too.”
But because of, or in spite of, current legislative efforts that are dominating the headlines, I feel relatively well-poised for ESI to continue to be the means through which a majority of Americans receive the health insurance they like and they want to keep. Our job is for them to keep it. Notwithstanding lots of obstacles, we will.
Wood J. (2017 March 21). CBO estimate of AHCA impact on employer-sponsored benefits is off the mark [Web blog post]. Retrieved from address https://www.benefitnews.com/opinion/cbo-estimate-of-ahca-impact-on-employer-sponsored-benefits-is-off-the-mark