Minimum Value: HRA Contributions and Flex Credits

Original post ubabenefits.com

The Internal Revenue Service (IRS) recently issued a final rule that clarifies various topics relating to the Patient Protection and Affordable Care Act (ACA) and premium tax credit eligibility provisions. Mirroring guidance from IRS Notice 2015-87, the final rule clarifies that health reimbursement arrangement (HRA) contributions by an employer that may be used to pay premiums for an eligible employer sponsored plan are counted toward the employee's required contribution, subsequently reducing the amount required for their contribution.

Similarly, an employer's flex contributions to a cafeteria plan can reduce the amount of the employee portion of the premium so long as the employee may not opt to receive the amount as a taxable benefit, the flex credit may be used to pay for the minimum essential coverage (MEC), and the employee may use the amount only to pay for medical care. If the flex contribution can be used to pay for non-health care benefits (such as dependent care), it could not be used to reduce the amount of the employee premium for affordability purposes. Furthermore, if an employee is provided with a flex contribution that may be used for health expenses, but may be used for non-health benefits, and is designed so an employee who elects the employer health plan must forego any of the flex plan's non-health benefits, those flex benefits may not be used to reduce the employee's premium for affordability purposes.

Read more here for an explanation of minimum value rules related to child income, wellness incentives, continuation coverage, and mid-month enrollment.


Compliance Recap: January 2016

Original post ubabenefits.com

January was a very quiet month for compliance, on the heels of the multitude of delays that came at the end of December 2015. The IRS updated its FAQs related to 6055 and 6056 reporting under the Affordable Care Act (ACA).

UBA Guides and Compliance Documents

UBA updated the popular "Play or Pay Penalty and Counting Employees Guide" to reflect updates to affordability percentages; indexed penalty amounts; expiration of certain transition relief; information for educational institutions; clarifications on how disability and workers' compensation is factored into full time status determination; inclusion of flex credits, HRAs, and opt-out waivers when calculating affordability; and clarification on how to factor wellness incentives or penalties into affordability.

UBA created a reference chart on the applicable 2015 and 2016 ACA affordability percentages and indexed dollar amounts.

UBA updated the previously shared template letter that employers may use to draft written communication to employees regarding what to expect in relation to IRS Forms 1095-B and 1095-C, and what employees should do with a form or forms they receive.

UBA created a template consent form that employers may provide to employees, so that employees may consent to receive their employer-provided 1095-C or 1095-B forms electronically.

UBA has updated a previously-written guide on how to handle leaves of absence under the ACA rules for applicable large employers.

IRS Updates FAQs

The long-standing IRS FAQs related to reporting under sections 6055 and 6056 on requirements provided by the Patient Protection and Affordable Care Act (ACA) have been updated in January 2016 to reflect new information. Final instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in September 2015, as were the final forms for 1094-B, 1095-B, 1094-C, and 1095-C. On December 28, 2015, in Notice 2016-04, the IRS extended the information reporting due dates for insurers, self-insuring employers, other health coverage providers and applicable large employers. The updated FAQs take the information from Notice 2016-04 into account.

The 6056 FAQ, which discusses information reporting for applicable large employers (ALEs), and the6055 FAQ, which discusses reporting on minimum essential coverage (MEC), clarify that the deadlines for fixing mistakes on forms has been extended due to the overall extension for information reporting. For statements furnished to individuals under sections 6055 and 6056, any failures that reporting entities correct by April 30 and October 1, 2016, respectively, will be subject to reduced penalties.

The 6056 FAQ also clarified that an employer may only issue one 1095-C per full-time employee.

Question of the Month

Q. May an ALE use wellness incentives when determining its plan's affordability?

A. When calculating affordability of employer coverage when incentives or penalties are offered through a wellness program, employers must assume each employee fails to satisfy the requirements of the wellness program, unless it is a non-discriminatory wellness program related to tobacco use. For nondiscriminatory tobacco use incentives, the affordability calculation can assume all employees earn the incentive or are not charged the penalty.

The Dish with Tonya Bahr

February's Dish serves up Hierl's Tonya Bahr's favorites.

"Every Friday night is pizza and movie night with the kids," Bahr shared. "We put a blanket down on the living room floor and create a picnic while watching a movie. It’s a great family tradition we’ve been doing for years and I hope my kids will continue it, or perhaps a healthier variation, with their families in the future."

Bahr said the family isn't picky about their pizza.

"Sometimes it’s homemade, sometimes it’s delivered, and sometimes it’s frozen from the freezer."

For the nights out, Bahr recommends Osaka Japanese Steakhouse & Sushi, but don't ask her to pick a favorite sushi roll.

"It's all heaven in your mouth," Bahr said.

If you're not a sushi person, Bahr said you can't go wrong with the lamb chops at Ruth's Chris Steak House.

"So tender and delicious!"


ACA Makes Tax Season Tougher For Small Companies

Original post insurancenewsnet.com

As more requirements of the health care law take effect, income tax filing season becomes more complex for small businesses.

Companies required to offer health insurance have new forms to complete providing details of their coverage. Owners whose payrolls have hovered around the threshold where insurance is mandatory need to be sure their coverage — if they offered it last year — was sufficient to avoid penalties.

Here are some of the issues related to the health care law that small businesses need to be aware of:

HOW MANY EMPLOYEES DO YOU HAVE?

Companies with 100 or more workers were required to offer affordable health insurance to employees and their dependents, but not their spouses, starting in 2015. Businesses with 50 to 99 workers must offer coverage starting this year; those with under 50 are exempt.

Owners who were on the hook for affordable insurance last year but didn't provide it may face thousands of dollars in penalties — $2,000 per employee per year, not counting the first 80 employees for the 2015 tax year, and the first 30 for 2016. So it's critical for them to know what their head count was — and many may not realize the calculations are based on a company's 2014 payroll, not 2015.

Here's where it gets complicated: Part-time workers and those fired during the course of the year can all be counted toward the threshold where coverage is required. So can some seasonal workers.

Part-timers work fewer than 30 hours a week under the health care law. They must be counted toward what are called full-time equivalent workers. If, for example, a company has two people who each work an average 15 hours a week, they count as one full-time equivalent employee working 30 hours. A company with 30 full-timers and 40 part-timers who average 15 hours a week each has 50 full-time equivalent workers and is required to offer insurance.

Another wrinkle: Owners with multiple companies that combined have 50 or more workers may be required to offer insurance, even if each of the individual companies has fewer than 50.

NEW TAX FORMS

Starting this year, businesses required to comply with the health care law must complete forms that detail the cost of their coverage and the names and Social Security numbers of employees and their dependents. The government will use the information to determine whether a company provided coverage that was affordable under the law, or whether it must pay a penalty.

Accountants have described the forms as labor-intensive, because they require information from a number of sources including payroll and health insurance records. Many companies have had to hire workers or payroll services to complete the forms.

The IRS, recognizing the forms' complexity, has extended the deadlines for the forms to be filed. Forms 1095-B and 1095-C, which must be given to workers, are now due March 31. Forms 1094-B and 1094-C, required to be filed with the IRS, are due by May 31 if they're not being submitted on paper, and June 30 if filed online.

WELL-INTENTIONED BUT ILLEGAL

Some employers with fewer than 50 workers and who don't offer insurance have tried to help staffers with the costs of coverage by giving them money toward their premiums, with the intention that the money will be tax-free. That could get owners into expensive trouble with the IRS — they can be fined $100 per day per employee receiving the money, a total of $36,500 per year for each worker.

The problem is that some employers treat this money as a health benefit, but it's not coverage that complies with the law. So they can be penalized.

Companies can help employees with their premium costs by giving them a raise or a more traditional bonus, says Mark Luscombe, a tax analyst with the business information company Wolters Kluwer. That means withholding income and what's known as payroll taxes — Social Security and Medicare — from employees' paychecks, and for companies to pay their payroll tax share.


How Do Your Copays and Deductibles Stack Up? Benchmark Your Employees' Out-of-Pocket Costs

Original post ubabenefits.com

As many analysts projected, premiums continue to rise, forcing many employers to manage this expanding price tag by shifting costs to their employees. As UBA reported in its breaking news, this cost shifting took the form of higher deductibles, out-of-pocket maximums, and copays for both singles and families.

According to the 2015 UBA Health Plan Survey, median in-network deductibles for singles increased 33% in the past year, while in-network deductibles for families remained unchanged. Interestingly, we observed the reverse for out-of-network deductibles, where the cost for families increased 16.7% and costs for singles remained unchanged.

Significant increases in median in-network out-of-pocket maximums are of note for both singles (14.3%) and for families (8.8%); however again for out-of-network costs, families are bearing larger dollar increases ($2,000) versus singles ($1,000).

Average in-network and out-of-network deductibles, out-of-pocket maximums, copays, and prescription copays for 2014 and 2015 are as follows:

uba chart 1

©2016 Copyright United Benefit Advisors. All rights reserved

The 2015 increases in out-of-pocket and deductibles for both singles and families noted previously are indicative of the skyrocketing cost trends that we have seen over the past five years. Median in-network single deductibles have doubled, and employees’ median out-of-network deductibles increased 50%. The median in-network deductible for families increased 33% and the out-of-network deductible increase was a whopping 75% in just five years. Single employee out-of-pocket maximums for in-network increased 33% and out-of-network increased 50%, while in-network maximums for families rose 45% and out-of-network rose 50%. Because out-of-network expenses are not subject to ACA limitations, we expect to see a similar increase in costs in the future.

uba chart 2

©2016 Copyright United Benefit Advisors. All rights reserved


Here are the top 10 most costly U.S. workplace injuries

Original post lifehealthpro.com

Workplace injuries and accidents are the near the top of every employer’s list of concerns. Here is the countdown of the top 10 causes and direct costs of the most disabling U.S. workplace injuries. The definitions and examples are found at the BLS website.

  1. Repetitive motions involving micro-tasks

Some of these tasks may include a word processor who looks from the computer monitor to a document and back several times a day or the cashier at the local grocery store who is scanning and bagging groceries for several hours at a time.

  1. Struck against object or equipment

This category of workplace injury applies to workers who are hurt by forcible contact or impact, for example, an office worker who bumps into a filing cabinet or an assembly line worker who stubs a toe on stacked parts.

  1. Caught in or compressed by equipment or objects

These workplace injuries result from workers being caught in equipment or machinery that’s still running as well as in rolling, shifting or sliding objects.

Picture the scene in a movie in which wine barrels topple over, catching the bad guy beneath them, only in this case, it’s the employee whose job it may be to stack the barrels. Perhaps it’s the experienced worker who removes a machine guard to dislodge material that’s stuck and gets a finger caught when the machine starts moving again.

  1. Slip or trip without fall

Occasionally, workers do slip or trip without hitting the ground. Think of the employee entering the workplace who slips on icy stairs but is able to grab the handrail to prevent hitting the ground. But the action of grabbing the handrail may cause the employee to injure his shoulder or wrench her knee.

  1. Roadway incidents involving motorized land vehicle

The worker may be the driver, a passenger or a pedestrian, but the cause of the injury is an automobile, truck or motorcycle.

  1. Other exertions or bodily reactions

These motions include bending, crawling, reaching, twisting, climbing or stepping, according to the BLS. Consider, for example, a roofing contractor’s employees who are continually climbing up and down ladders.

  1. Struck by object or equipment

This category covers a range of possible injuries, from being struck by an object dropped by a fellow worker to being caught in a swinging door or gate. Picture the construction worker on a scaffold dropping a hammer on the worker below.

  1. Falls to lower level

The roofer could fall to the ground from the roof or ladder, or an office worker standing on a stepstool, reaching for a heavy file box, could fall to the floor.

  1. Falls on same level

The second most costly workplace injury, surprisingly, is a fall on the same level. Picture the employee who is walking through the office and falls over an uneven floor surface or someone leaning too far back in an office chair and toppling over.

  1. Overexertion involving an outside source

The BLS explains that overexertion occurs when the physical effort of a worker who lifts, pulls, pushes, holds, carries, wields or throws an object results in an injury.

The object being handled is often heavier than the weight that a worker should be handling or the object is handled improperly. For example, lifting from a shelf that’s too high, or in a space that’s cramped. Within the broad category of sprains, strains, and tears caused by overexertion, most incidents resulted specifically from overexertion in lifting.

Risk managers should work with their carriers and workplace safety specialists to minimize injuries, lost work days and workers’ compensation costs. With a little effort, employers can understand more about the causes of accidents and injuries in their organizations, identify the appropriate actions to reduce the number of injuries and minimize employee disabilities from workplace accidents.

 

 

Workplace injuries and accidents are the near the top of every employer’s list of concerns. Here is the countdown of the top 10 causes and direct costs of the most disabling U.S. workplace injuries.


Client Service Agent Pennie Hildebrant completes continuing education requirement

Congratulations to Client Service Agent Pennie Hildebrant of Hierl Insurance. She successfully completed the annual continuing education requirement of the Society of Certified Insurance Counselors.

Pennie earned the prestigious designation by attending 5 courses covering all phases of the insurance business and passed 5 comprehensive examinations. Additionally, the National Alliance requires annual attendance in the program to maintain the designation.

Pennie, a 22 year veteran of the industry, has been a CISR and CIC since 2003 and 2006, respectively.

Pennie believes the insurance profession is best served by those who acquire and maintain a high standard of professionalism by meeting the continuing education requirements of the Certified Insurance Counselors Program.


HR Marathon a hit for Hierl at SHRM Conference

Hierl Insurance had a successful week at Wisconsin's SHRM Conference held in Wisconsin Dells.

The theme of the conference at the event was HR's marathon: Settng the Pace for the Future.

As part of their promotion, Hierl Insurance advisors handed out running bibs to attendees. Those spotted wearing the bibs during the conference had a chance to win a prize.

A highlight of the Hierl Insurance booth was the 'Minute to Win It' Contest. Attendees were asked questions related to benefits, wellness and more. The top two with the most correct answers received gift cards to Dick's Sporting Goods.

For more on the conference click here.


Hierl Welcomes Tonya Bahr to the Team

Tonya Bahr has joined Hierl Insurance, Inc. as a Benefits Advisor. She has 15 years experience in human resources and benefits. Throughout her HR career, Tonya has been involved in benefit plan designs, wellness program implementations, and open enrollment facilitation. She has a passion for educating employees and business owners on benefit options, helping them make decisions that best fit their personal and financial objectives. Tonya graduated from the University of Wisconsin - Oshkosh with a B.S. in Journalism and a minor in Human Resource Management. She is currently a national and local member of the Society for Human Resource Management and holds her SPHR certification.

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