Roast Spatchcock Turkey with Hierl

Welcome to our monthly Dish segment. This month, we’ve provided one of our favorite holiday dishes. We hope you have a safe and happy Thanksgiving!


Roast Spatchcock Turkey

Ingredients

  • 1 (10 pound) whole turkey
  • 1/2 cup olive oil
  • 1 tablespoon salt
  • 1 tablespoon chopped fresh sage
  • 1 tablespoon fresh thyme leaves
  • 1 tablespoon finely chopped fresh rosemary
  • 1 teaspoon crushed black pepper

Directions

  1. Preheat oven to 350 degrees F (175 degrees C). Place a roasting rack on a baking sheet.
  2. Turn the turkey over, breast-side down. Using a pair of sharp heavy-duty kitchen shears, cut along one side of the backbone. Repeat on the other side of the backbone. Reserve the backbone for making turkey stock for gravy. Press firmly down onto both sides of turkey to flatten.
  3. Tuck the wing tips under the turkey and place on the roasting rack. Pat skin dry and rub olive oil over the entire turkey; season with salt, sage, thyme, rosemary, and black pepper.
  4. Bake in the preheated oven for 1 hour 30 minutes, rotating baking sheet every 30 minutes. Increase temperature to 400 degrees F (200 degrees C) and roast until skin is crisp, about 15 minutes more. An instant-read thermometer inserted into the thickest part of the thigh should read 165 degrees F (74 degrees C). Remove turkey from the oven, cover loosely with a doubled sheet of aluminum foil, and allow to rest for 10 to 15 minutes before slicing.

This recipe was provided by AllRecipes. If you’d like to visit the original source, please click here.


**Holiday Hours

Our offices will be closed Thursday, November 22 and Friday, November 23 and will reopen Monday, November 26. All of us at Hierl wish you a happy Thanksgiving filled with family, friends and good food.

Thank-you for joining us for this month’s Dish! Don’t forget to come back next month for a new one.


Why You Should Be Benchmarking (and How Hierl Can Help)

As an employer, you have more than likely heard the term ‘benchmarking’ thrown around. It is becoming a critical tool in the development of competitive benefits programs, often helping drive down costs. At Hierl, we are strong advocates for benchmarking. Why? We believe good business decisions can only be made with accurate, meaningful information. Benchmarking is a fantastic way for us – and you – to measure where you stand in all aspects of your benefits against your industry’s standards and competitors. That’s why, in this installment of CenterStage, we interviewed our Executive Vice President, Scott Smeaton.

From an Employer's Eyes - The 3 Scenarios

“When we meet with a business that has not done benchmarking, we are sure to complete that process for them, showing them where they stand in their marketplace,” explained Scott. He emphasized that there are three scenarios that can happen once great advisors, such as those at Hierl, step in and get those results for the employer:

(1)The employer sees that everything around them has changed, they haven’t kept up with the times, and they’ve left money on the table.

(2)The employer is having a difficult time attracting and retaining key employees. With benchmarking, they can view where they should enhance their benefits to be more competitive in their marketplace.

With unemployment as low as it is, many businesses we meet with come from a third, different mindset:

(3) They want to look at their benefits from a total reward or total compensation strategy, where the benefits and the costs of providing benefits become part of a larger picture – time off, vacation, wages, etc.

These three approaches to benefits strategy are why, at Hierl, we strive to blend any and all concerns into a benefits plan strategically designed to get our clients where they need to be to compete for labor. “With a recent client of ours, they were specific about wanting their plans to be in the top 25% of all the plans out there – from a plan design perspective and from a premium cost-share perspective. Using benchmark, we were able to illustrate to this client what they needed to do to accomplish that goal specific to their industry and geographic location,” Scott explained. Benchmark is a powerful tool that can be in any employer’s toolbox, if only you partner with someone like Hierl.

He continued, “When we do our clients’ benchmarks, we take the results further than simply a generic comparison against their competitors. We look at our clients’ specific plan designs, analyzing their deductibles, their coinsurance, their out-of-pocket maximums, their prescription drug copays, and other specifics, as well as how much of the premium the employees must pay out of their paycheck to have coverage. We break down each into five competitive areas: national, regional, state, industry, and employers of similar size.”

Addressing Employers’ Fear of Cost

Some employers may not want to see the results because their current offering isn’t competitive, and it would cost money to adjust their programs to be closer to market. If getting closer to market to compete for labor is their goal, we work with them to create a three- to five-year plan to get there, making incremental adjustments each year. Another common finding is that employers are paying more of the premium than their competitors. Some acknowledge that’s what they want to be doing; others appreciate the information and adjust their cost share so they can reallocate those premium dollars to other benefits, wages, or expenses. This can be an eye-opener, and they likely would not have realized the difference without doing a benchmark test.

Another benefit of benchmarking is how we use the information to educate and engage employees, helping them understand the effort their employer is making to be competitive in the market and how fortunate they are to have the benefits they do compared to others. We use the data during employee meetings to drive the point home. The response is often amazing. We’ve had employees go to their employers and thank them after the employee meetings admitting that they didn’t realize how competitive their benefits are. This also highlights that their employer cares about its employees’ needs and wishes with their benefits, helping the employer retain their key talent.

Partner with Advisors that Listen

If your benefits program isn’t up-to-par – or you’re not even sure where it stands against others in your marketplace – then benchmarking is something you should seriously consider. Even more so, partner with advisors that will want to improve employee perception of your benefits as much as you do. Everyone at Hierl is extremely passionate about helping employers – large or small – identify what it takes to build a successful employee benefits program. To do that, we use the data and listen to the direction the employer wants to go, while also keeping in mind what the employees are looking for. Something we offer to our clients is to survey not only their company through benchmark but to also survey their employees, regarding how they feel and engage with their benefits. Every other year, we go in and do this test with our clients’ employees to ensure the benefits plans we design for our clients are fully comprehensive and hitting every mark. We’re not your traditional broker. We bring tools and resources to the conversation that make a difference. We’re driven to educate and improve both the employer and employee experience, driving down the overall cost of benefits at the same time.

To learn more about Hierl’s services or to begin your benchmark process, please contact our Executive Vice President, Scott Smeaton, at 920.921.5921 or ssmeaton@hierl.com.


What's in a Password?

What's in a Password?

Most websites and services encrypt passwords before storing them on their servers. As a result, even if hackers were to gain access to the password, they wouldn’t have access to the actual text that makes up your password.

Once criminals gain access to an encrypted password, they can use sophisticated programs to quickly guess every combination of letters, numbers and symbols until your password is cracked. As a result, longer passwords and those that contain a large variety of characters will be very difficult for programs to guess.

However, just because effective passwords should be complex, doesn’t mean that they should be difficult to remember.

The next time you need to think of a unique password, try using a favorite song lyric or quote. This will make a password that’s long and difficult for hackers to crack, and has the added benefit of being very memorable.

Turning a simple phrase like “your guess is as good as mine” into “yourguessisasgoodasmine” actually makes for a strong, and in this case ironic, password! However, be sure to add a capital letter or special character as well to make your password that much stronger.

A Balancing Act Between Memorable and Complex

Thinking of a new password can be frustrating—every service and website seems to have different requirements about length, complexity and special characters. In order to secure yourself against hackers, it’s important to think of a password that’s both memorable and complex.

Helpful Hints

Your password will only remain secure if you take steps to protect it. Be sure to never write your password down and leave it where someone can see it. Instead, consider using a password management tool. These online services will store all of your login IDs and passwords for you, but you should do some research and make sure that the service you use is reputable.

Provided by: Hierl's Property & Casualty Experts

Download the PDF.

What are the 25 most commonly stolen passwords?

Download the PDF.

Construction Risk Advisor - October 2018

Preparing for Hurricane Season: 5 Tips for Contractors

The 2018 hurricane season is here, and it’s time for contractors to prepare for emergency weather situations that can not only disrupt current projects, but also hamper recovery efforts. Heavy rain and winds, surges in demand for labor and materials, and job site hazards in storm-damaged areas can create dangerous and expensive risks for contractors.

Minimize your risks during hurricane season with these five tips:

  1. Identify the potential for flooding. Take steps to prevent on-site flooding, including installing drainage systems, moving large equipment and waiting to install finished products until the building is watertight.
  2. Protect your cranes. Lower any cranes before weather events, if possible. Consult with the manufacturer or a professional engineer regarding how to best lower and secure cranes.
  3. Create an employee communications plan. Devise an action plan with a list of contact information and a log of on-site workers so you can account for everyone if a storm hits.
  4. Check your business continuity plan. Make sure employees understand their roles, and regularly review, update and test your continuity plan for business disruption.
  5. Review your insurance coverage. Work with your insurance carrier or broker to make sure your business is adequately protected.

Assess whether a project will be affected by hurricane season, and weigh the risks before agreeing to a contract. Consider whether or not you have enough qualified staff to handle the work post-storm, as well as the materials needed to complete the job, so you’re prepared in case of supply shortages.

Newsletter Provided by: Hierl's Property & Casualty Experts

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Manufacturing Risk Advisor - May/June 2018

Mixed Reaction to New Steel and Aluminum Tariffs

The Trump administration recently announced a 25 percent tariff on steel and 10 percent tariff on aluminum in order to discourage imports of these materials. The administration also stated that the tariffs are part of an effort to increase jobs and protect U.S. businesses from foreign competition.

While the tariffs were established to help U.S. businesses, manufacturing experts believe that they may increase the price of new products and that sales will likely decrease as these costs are passed onto consumers. Although the tariffs only apply to imported materials, many U.S. steel and aluminum producers have raised prices in order to account for increased demand.

The Commerce Department also announced an exclusions process for the tariffs. However, businesses must first prove that they’re unable to obtain the materials from domestic sources.

For more information on the manufacturing industry, call us at 920-921-5921 today.

How Blockchain Technology Can Improve Supply Chains

Manufacturers need to rely on a consistent supply chain in order to operate. However, a lack of transparency between vendors and the use of separate management systems often leads to confusion, delays and lost business.

To solve these problems, many businesses have turned to blockchain technology—a platform that works by recording a separate record, or “block,” every time a supply chain progresses. This record is then encrypted and used to verify all subsequent blocks, which prevents any alterations to records.

Here are some of the potential benefits of a blockchain recordkeeping system:

  • Flexible scalability—Blockchain systems can be used internally to track projects and other workflows. Multiple organizations can share the platform to organize large-scale operations.
  • Security—Records that use blockchain are encrypted, verified and shared between all users. As a result, blockchain is very secure against tampering and cyber attacks.
  • Transparency—Advanced sensors and other tracking technology can update blockchain records to give businesses an ongoing view of a supply chain without fear of human error or biased reporting.
  • Innovation—New services are beginning to automate complex systems like contractual obligations, employee security credentials and personal data protection using blockchain technology.
  • Detailed analytics—Businesses can track individual products to gather important information at any time, such as the origin of a dysfunctional product or a food item’s expiration date.


Safety Focused Newsletter - August 2018

Lower back injuries caused by improper lifting are some of the most common work-related injuries.

Safety Tips for Proper Lifting

Lifting is a common activity in the workplace—an activity that can be potentially dangerous if the proper techniques are not used. In fact, lower back injuries caused by improper lifting are some of the most common work-related injuries.

In order to protect yourself when lifting heavy items in the workplace, do the following:

  • Look over the load. Decide if you can handle it alone or if you need assistance. When in doubt, ask for help. Moving an object that is too heavy or bulky can cause severe injury.
  • Clear away any potential obstacles before carrying an object.
  • Use good foot positioning. Your feet should be shoulder-width apart.
  • Bend your knees. Bending over at the waist to reach for an object you want to lift puts strain on your back, shoulder and neck muscles.
  • Keep your arms and elbows as close to your body as you can while lifting.
  • Use your feet to change direction. Don’t twist your body.

Responding to a Workplace Accident

Accidents in the workplace can occur without warning, and it’s important to respond quickly to help those in need. In some cases, supervisors may not be around to provide the proper response guidance, and it’s up to employees to take action.

The following are some general tips to keep in mind if a co-worker is involved in a workplace accident:

  • Take control of the scene and try to restore order.
  • Call for emergency services if needed. Provide any immediate first aid, if you are qualified to do so.
  • Protect co-workers from potential secondary accidents. You can accomplish this by dismissing unnecessary personnel and denying access to the area.
  • Identify people at the scene. If they witnessed the incident, be sure to make a note of their names, as they can provide a report on what happened at a later date.
  • Notify upper management of the issue.
  • Do not put yourself in harm’s way.

Following an accident, follow up with your supervisor to ensure the appropriate paperwork is completed. Supervisors may require you to file an accident report or further detail what happened.

If you have any ideas of how the accident could have been avoided, share them with your supervisor or at a safety meeting. If your workplace does not have a first responder program in place, it may a good idea to suggest it to your employer.

Trained first-aid responders can provide immediate care to workers who become ill or injured on the job. The quick response and training of these individuals can make all the difference following an accident.

Common First-Aid Kit Supplies

  • Sterile Saline Solution
  • Antibiotic Ointment
  • Gauze and Wraps
  • Scissors
  • Tweezers
  • Disposable gloves
  • Asprin

Newsletter Provided by: Hierl's Property & Casualty Experts

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CenterStage: Distracted Driving Awareness Month

Distraction is Deadly: April is Distracted Driving Awareness Month

In 2015 alone, 3,477 people have died and another 391,000 have been injured due to distracted driving.

Not only is distracted driving hazardous to your life, but it can negatively impact the drivers’ lives that surround you. Distracted Driving Awareness Month is an effort by the National Safety Council to help recognize and eliminate preventable deaths from distracted driving. In honor of Distracted Driving Awareness Month, this month’s CenterStage features Cathleen Christensen, Vice President of Property & Casualty at Hierl Insurance, who will provide safe driving practices and how companies can ensure their employees are using them.

What is Distracted Driving?

Distracted driving is a public health issue that affects us all. According to the National Safety Council, distracted driving is any activity that diverts attention from driving, including talking or texting, eating and drinking, talking to people in your vehicle, adjusting stereo, entertainment or navigation systems. You cannot drive safely unless your attention is fully focused on the road ahead of you, any activity that you partake in simultaneously provides a distraction and increases the risk of a crash.

Awareness for Awareness

Bringing awareness to distracted driving is essentially bringing awareness to awareness. There are three main types of distraction:

  1. Visual – taking your eyes off the road
  2. Cognitive – taking your mind off driving
  3. Manual – taking your hands off the wheel

These days, it’s so easy to be a distracted driver – from texting, to talking on the phone, or even using a navigation system. The biggest one, texting, is especially dangerous because it involves committing all three types of distraction. Some studies even say texting and driving is worse than driving under the influence. So, how can you keep your employees aware while driving?

“Several studies believe, as well as myself, that employers should prohibit any work policy or practice that requires or encourages
workers to text and drive.”

– Cathleen Christensen, VP of Property & Casualty at Hierl

But how can you really get your employees to commit to your ‘No Distracted Driving’ policy? It’s as easy as providing education and solutions. Sometimes, it’s especially effective to have your employees sign a contract stating if they need to use any form of a hand-held device, they must pull over to the side of the road. Remind your employees to drive with their devices off or on silent to keep the urge under control. Plus, several cellular devices have come out with ways to set phones to driving mode, leaving a custom voicemail to anyone who calls while an employee/employer is driving, letting the caller know they will call the caller back later.

Companies suffer from great financial loss yearly due to distracted driving. By putting these safe driving practices in place, you will save lives AND money. If you’d like to get more help on implementing a safe driving policy within your workplace, please contact Cathleen at 920.921.5921.


Compliance Recap September 2017

Download the full Compliance Recap here.

September was a quiet month in the employee benefits world.

The Internal Revenue Service (IRS) issued final Forms 1094/1095, special per diem rates for 2017-18, and
guidance on the tax treatment of leave-based donation programs. The Centers for Medicare and Medicaid
Services (CMS) announced a Medicare special enrollment period for individuals impacted by recent
hurricanes. A U.S. District Court remanded a payment rate rule to the IRS, the Department of Health and
Human Services (HHS), and the Department of Labor (DOL) for further explanation of their rule.

UBA Updates

UBA released one new advisor in September: IRS Releases Draft Forms and Instructions for
2017 ACA Reporting.

IRS Issues Forms 1094/1095
The IRS issued Forms 1094-B, 1095-B, 1094-C, and 1095-C for the 2017 tax year. Coverage providers
use Forms 1094-B and 1095-B to report health plan enrollment. Applicable large employers use Forms
1094-C and 1095-C to report information related to their employer shared responsibility provisions under
the ACA.

IRS Issues 2017-18 Special Per Diem Rates
The IRS issued Notice 2017-54 to provide special per diem rates for taxpayers to use in substantiating
the amount of ordinary and necessary business expenses incurred while traveling away from home on or
after October 1, 2017.

IRS Provides Guidance on Tax Treatment of Leave-Based Donation Programs
Some employers adopted or will adopt leave-based donation programs to provide charitable relief for
victims of Hurricane and Tropical Storm Irma. These leave-based donation programs allow employees to
forgo vacation, sick, or personal leave in exchange for cash payments that the employer will make to
charitable organizations described under Internal Revenue Code Section 170(c).

The IRS’ Notice 2017-52 states that the employer’s cash payments will not constitute gross income or
wages of the employees if paid before January 1, 2019, to the Section 170(c) charitable organizations for
the relief of victims of Hurricane or Tropical Storm Irma. Employers do not need to include these
payments in Box 1, 3, or 5 of an employee’s Form W-2.

CMS Announces Special Enrollment Period for Hurricane Victims

CMS established a Medicare special enrollment period for individuals affected by Hurricanes Harvey, Irma,
and Maria. The special enrollment period will allow individuals to enroll, dis-enroll, or switch Medicare health
or prescription drug plans from the start of the incident period through the end of 2017.

Court Remands Regulations to HHS, DOL, and IRS

The United States District Court for the District of Columbia held that the Departments of Health and
Human Services, Labor, and the Treasury (the Departments) acted arbitrarily and capriciously by failing to
seriously respond to comments and proposed alternatives as part of the notice and comment process for
the Departments’ rule on how much plans are required to pay out-of-network physicians for emergency
health care services.

Under the Patient Protection and Affordable Care Act (ACA), group health plans cannot impose a higher
copayment or coinsurance rates for participants who receive emergency medical treatment from an out-of-network
provider.

Pursuant to that ACA provision, the Departments issued an interim final rule to establish that “a plan or
issuer satisfies the copayment and coinsurance limitations in the statute if it provides benefits for out-of-network
emergency services in an amount equal to the greatest of three possible amounts—

(1) The amount negotiated with in-network providers for the emergency service furnished;
(2) The amount for the emergency service calculated using the same method the plan generally uses
to determine payments for out-of-network services (such as the usual, customary, and
reasonable charges) but substituting the in-network cost-sharing provisions for the out-of-network
cost-sharing provisions; or
(3) The amount that would be paid under Medicare for the emergency service.”

Despite extensive public comment, the Departments issued the final rule without substantive revision. A
college of emergency physicians was dissatisfied with the Departments’ response to public comments
and filed suit against the Departments.

Although the court determined that the Departments failed to seriously respond to public comments, the
court declined to vacate the rule. The court remanded the case to the Departments for further explanation
of their rule.

Question of the Month

Q. How does the new child age rating structure affect employers in the small group market who are in
states that adopt the new age band?

A. The new child age rating bands will likely result in an increase in 2018 premiums.

As background, in December 2016, the Department of Health and Human Services (HHS) issued a final
rule that creates multiple child age bands rather than a single age band for individuals age 0 through 20,
for plan or policy years beginning on or after January 1, 2018.

Per HHS, establishing single-year age bands starting at age 15 will result in small annual increases in
premiums attributable to age for children age 15 to 20, which will help mitigate large premium increases
attributable to age due to the transition from child to adult age rating at age 21.

States are not required to adopt these new age rating bands. However, for employers in states that adopt
these new age rating bands, employers will see an increase in 2018 premiums at renewal if they have
employees or dependents who fall within the 14-20 age range.

Download the full Compliance Recap here.


Whitepapers: Making Wellness Programs Work, from United Benefit Advisors

Great article from our partner, United Benefit Advisors (UBA) by Bill Olson

UBA Announces New Resources for Employers Covering the Latest Trends and Legal Requirements for Wellness Programs

Two-thirds of employers believe that good benefits increase employee productivity, according to the 2016 United Benefit Advisors Benefits Opinion Survey of employers. Given the ever increasing cost of health care, UBA finds that one of the best long-term cost-containment strategies available to employers today is an effective wellness program that strives to keep low-risk individuals from becoming high-risk, and helps high-risk individuals reduce their need for medical services.

UBA finds that wellness programs have evolved substantially since they first appeared on the market, and today announces a new Whitepaper: Wellness Programs — Good for You & Good for Your Organization, to educate employers about the latest trends in wellness program success.

“Wellness programs were initially tacked on to an employee’s benefits and consisted of just the basics — physical activity, nutrition, and smoking cessation,” says Travis Horne, MBA, and Director of Health & Well-Being at Massachusetts-based UBA Partner Firm, Borislow Insurance.

“But there’s been a shift: the new thought is that it’s more important to target the solution for a client, rather than just putting something fun in place,” says Horne. “Employers are taking the holistic view of the employee so that there is meaningful change. Basically, there are five different elements — physical, financial, workplace, community, and mind/spirit. Some employers may only focus on three, but the majority focus on all five elements in order to create a culture of health & wellbeing, change unhealthy behaviors and develop a sustainable wellness program.”

According to UBA, some of the latest wellness program trends, include:

  • Comprehensive health evaluations and physician verification forms to identify (and provide early interventions to) chronic conditions before they become catastrophic
  • On-site health clinics
  • Wellness committees made up of both healthy and unhealthy employees

In UBA’s new Whitepaper: Wellness Programs — Good for You & Good for Your Organization, readers will learn which aspects of wellness programs are finding the most success and the most critical five steps to making any wellness program work.

Download UBA’s Whitepaper: Wellness Programs — Good for You & Good for Your Organization, athttp://bit.ly/wellness-whitepaper.

Compliance Advisor: Understanding Wellness Programs and their Legal Requirements

One of the main reasons employers are slow to adopt wellness programs is a lack of time and resources, startup costs, and not knowing the legal requirements, finds UBA.

The new Affordable Care Act (ACA) Compliance Advisor paper from UBA, “Understanding Wellness Programs and Their Legal Requirements,” reviews the five most critical questions that wellness program sponsors should ask and work through to determine the obligations of their wellness program under the ACA, HIPAA, ADA, GINA, and ERISA, as well as considerations for wellness programs that involve tobacco use in any way. With over 20 pages of comprehensive guidance, examples and frequently asked questions, this is an invaluable employer resource.

Download the UBA Compliance Advisor, Understanding Wellness Programs and their Legal Requirements at http://bit.ly/wellness-requirements (free registration required).

“Employers are starting to recognize that promoting healthy behavior internally is also a way to educate and change behavior at home and in families,” says Les McPhearson, CEO of UBA. “When it comes to reducing health care premium costs, wellness is one area that employers cannot afford to ignore.”

See the original article Here.

Source:

Olson, B. (2016 September 8). Whitepapers: making wellness programs work, from united benefit advisors. [Web blog post]. Retrieved from address http://blog.ubabenefits.com/news/whitepapers-making-wellness-programs-work-from-united-benefit-advisors


Counting Employees Doesn't Always Add Up

Original post benefitspro.com

Employee counts are used to determine what laws, rules, fees and penalties apply to a health plan and/or the employer sponsor. But the methods for counting employees are as varied as the laws that affect them. This creates confusion and frustration among employers and can significantly hinder their compliance efforts. To make sense out of all this, we have put together a synopsis of 12 counting methods that employers must utilize to properly administer their health plans. Read on to find out how to stay compliant as you move forward.

Employers with at least 15 employees

Law or compliance requirement applied:
Title VII of the Civil Rights Act, as amended by the Pregnancy Discrimination Act (PDA): Employers may not consider a person’s race, color, sex (including sexual orientation), national origin, religion, or pregnancy in determining eligibility for, amount of, or charges for employee benefits. Denying coverage for a condition or treatment that disproportionately affects members of a protected group is also considered a violation of Title VII.

Americans with Disabilities Act (ADA): An employer may not deny an individual with a disability equal access to insurance, or require such an individual to have terms and conditions of insurance different than those of employees without disabilities. The ADA also applies to wellness and disease management programs.

Who to count: Employees working 20 or more calendar weeks in the current or preceding calendar year.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: The EEOC may bring an action in court, and individuals may file private lawsuits to correct violations and obtain appropriate legal or equitable relief (including attorney’s fees and other costs).

Employers with at least 20 employees

Law or compliance requriement applied:
Genetic Information Nondisclosure Act (GINA): Group health plans may not discriminate against individuals based on genetic information and may not use this information in underwriting or determining premiums or contributions. It also restricts questions that can be asked on a Health Risk Assessment (HRA) if an incentive is offered for its completion.

Age Discrimination in Employment Act (ADEA): Benefits provided to older workers (40 years and older) must be the same as those provided to younger workers in all respects, including payment options, types of benefits and amount of benefits (although certain exceptions may apply).

Who to count: Employees working 20 or more calendar weeks in the current or preceding calendar year.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: The DOL may assess special penalties and the EEOC may bring an action in court against a plan sponsor for violations. Individuals may file private lawsuits to correct violations and obtain appropriate legal or equitable relief (including attorney’s fees and other costs).

Employers with at least 20 employees

Law or compliance requriement applied:
COBRA: COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates.

Who to count: Employees (in all commonly-owned businesses) on more than 50 percent of the typical business days in the previous calendar year.

How to count: Count each full-time employee as one. Each part-time employee counts as a fraction, with the numerator equal to the number of hours worked by that employee and the denominator equal to the number of hours that must be worked on a typical business day in order to be considered full-time.

Consequences of noncompliance: COBRA compliance failures can result in excise taxes and statutory penalties. Qualified beneficiaries may also file private lawsuits to correct violations and obtain appropriate legal or equitable relief (including attorney’s fees and other costs).

Employers with 20 or more employees

Law or compliance requriement applied:
Medicare Secondary Payer (MSP) rules based on age: A group health plan is the primary payer and Medicare is the secondary payer for individuals age 65 or over if their group health coverage is by virtue of the individual’s (or his/her spouse’s) current employment status.

Who to count: Employees on each working day in at least 20 weeks in either the current or the preceding calendar year. The 20-employee test must be run at the time the individual receives the services for which Medicare benefits are claimed.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: Medicare can collect any incorrect claim payments directly from the employer, regardless of whether the employer’s plan is fully insured or self-insured.

Employers with at least 50 employees

Law or compliance requriement applied:
Family and Medical Leave Act (FMLA): FMLA requires employers that sponsor group health plans to provide group health plan benefits to employees on an FMLA leave. Please note that public agencies and public and private schools are covered regardless of the number of employees.

Who to count: Employees working 20 or more weeks in the current or preceding calendar year within a 75 mile radius of the applicable work location.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: The EEOC may bring an action in court and individuals may file private lawsuits to correct violations and obtain appropriate legal or equitable relief (including attorney’s fees and other costs).

Applicable Large Employers (ALEs)

Law or compliance requriement applied:
Shared responsibility provisions of the Affordable Care Act (ACA): ALEs must offer minimum essential coverage that is “affordable” and that provides “minimum value” to their full-time employees, must report to the IRS information about the health care coverage, if any, they offered to full-time employees, and must provide a statement to employees.

Who to count: Full-time employees and full-time equivalent (FTE) employees in each month of the preceding year. Divide this number by 12, and if the result is 50 or greater, the employer is an ALE for the current year.

How to count: Count full-time (30 or more hours per week determined on a monthly basis) and FTE employees as one. Aggregate part-time hours (no more than 120 hours per employee) and divide by 120 to determine FTEs. Special counting rules apply with respect to special situations, such as teachers, seasonal workers, etc.

Consequences of noncompliance: ALEs are subject to a penalty if one or more full-time employees are certified to the employer as having received an applicable premium tax credit or cost-sharing reduction, and either: 1) the employer fails to offer to its full-time employees (and their dependents) minimum essential coverage; or, 2) the employer’s coverage is deemed to be unaffordable or does not provide minimum value (as defined by the ACA). Failure to file a return with the IRS or furnish a statement to employees can result in penalties up to $250 per return/statement, with a maximum penalty of $3 million.

Law or compliance requriement applied:
Mental Health Parity and Addiction Equity Act (MHPAEA):Group health plans that provide mental health coverage must provide parity between medical/surgical benefits and mental health/substance use disorder benefits.

Who to count: Employees on business days during the preceding calendar year.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: Individuals and the DOL may use ERISA’s civil enforcement provisions to file lawsuits to enforce the MHPAEA’s requirements. In addition, noncompliance with the MHPAEA can trigger an IRS excise tax.

Employers with 100 or more employees

Law or compliance requirement applied:
Medicare Secondary Payer (MSP) rules based on disability:A group health plan is the primary payer, and Medicare is the secondary payer for individuals under age 65 entitled to Medicare on the basis of a disability, if their group health coverage is by virtue of the individual’s (or his/her spouse’s) current employment status.

Who to count: Employees on at least 50 percent of regular business days during the previous calendar year.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: Medicare can collect any incorrect claim payments directly from the employer, regardless of whether the employer’s plan is fully insured or self-insured.

Welfare plans that cover at least 100 employees

Law or compliance requirement applied:
Form 5500: Employee benefit plans must file the Form 5500 reporting and disclosure document on an annual basis with the Department of Labor (DOL). Please note that the Form 5500 requirement applies to ERISA plans only.

Who to count: Employees enrolled in the plan at the beginning of the plan year.

How to count: Count each full-time and part-time employee as one.

Consequences of noncompliance: The penalty for failing to file a Form 5500 is $1,100 per day, which is cumulative from the filing deadline. Lesser penalties may be assessed for incomplete or otherwise deficient Form 5500s.

Employers that filed 250 or more W-2s 

Law or compliance requirement applied:
Reporting the cost of health benefits on W-2: The Affordable Care Act (ACA) requires employers to report the total cost of employer-provided health coverage on Form W-2.

What to count: W-2s filed with the IRS in the preceding calendar year.

How to count: W-2s for full-time and part-time employees count as one.

Consequences of noncompliance: Penalties for compliance failures range from $30 to $250 per form.

All self-insured medical plans

Law or compliance requirement applied:
Transitional reinsurance program fee: The ACA requires self-insured group health plans to make contributions to help stabilize premiums for coverage in the individual market during the years 2014 through 2016.

Who to count: Covered lives, which includes both employee and dependent lives.

How to count: The fee is calculated based on the average number of covered lives, which can be determined using one of the following four methods:

  • Actual Count: Add the total number of lives covered for each day of the first nine months of the calendar year and divide that total by the number of days in the first nine months.
  • Snapshot Count: Add the total number of lives covered on any date during the same corresponding month in each of the first three quarters of the calendar year, and divide that total by the number of dates on which a count was made.
  • Snapshot Factor: Use the Snapshot Count method, except the number of lives covered on a given date is calculated by adding the number of participants with self-only coverage to the product of the number of participants with coverage other than self-only coverage and a factor of 2.35. This method can be used to estimate the number of total lives included in coverage that is not self-only coverage.
  • Form 5500 Method: The number of participants as of the beginning and end of the plan year as reported on Form 5500 for the last applicable time period.

Consequences of noncompliance: As with any amount owed to the federal government, an unpaid/underpaid Reinsurance Program Fee will be subject to federal debt collection rules.

All self-insured medical plans

Law or compliance requirement applied:
Patient-Centered Outcomes Research Institute (PCORI) fee:The PCORI fee supports the Patient-Centered Outcomes Research Trust Fund and will be imposed for each policy year ending on or after October 1, 2012 and before October 1, 2019.

Who to count: Covered lives, which includes both employee and dependent lives.

How to count: The fee is calculated based on the average number of covered lives, which can be determined using one of the following three methods:

  • Actual Count Method: Add the total lives covered for each day of the plan year and divide that total by the total number of days in the plan year.
  • Snapshot Method: Add the total number of lives covered on one date during the first, second or third month of each quarter, and divide that total by the number of dates on which a count was made.
  • Form 5500 Method: The number of participants as of the beginning and end of the plan year as reported on Form 5500 for the last applicable time period.

Consequences of noncompliance: As with any amount owed to the federal government, an unpaid/underpaid PCORI Fee will be subject to federal debt collection rules.