March 2018 Compliance Recap

From UBA Benefits, here is your March 2018 Compliance Recap - everything you need to know that's been happening in the employee benefits world.

March was a quiet month in the employee benefits world.

The Internal Revenue Service (IRS) released a bulletin that lowered the family contribution limit for health savings account (HSA) contributions. The U.S. Department of Labor (DOL) updated its model Premium Assistance Under Medicaid and the Children’s Health Insurance Program notice (CHIP notice).

The IRS issued its updated Employer’s Tax Guide to Fringe Benefits, issued transition relief regarding HSA eligibility of individuals with health insurance that provides benefits for male sterilization or male contraceptives without a deductible, and issued its updated Guide on Health Savings Accounts and Other Tax-Favored Health Plans.

UBA Updates

UBA released two new advisors:

UBA updated existing guidance: 2018 Annual Benefit Plan Card

IRS Releases Adjusted Annual Inflation Factor

The Internal Revenue Service (IRS) released its Internal Revenue Bulletin No. 2018-10 that adjusted the annual inflation factor from the Consumer Price Index (CPI) to a new factor called a chained CPI. This is retroactively effective to January 1, 2018.

As a result of the change, the family contribution limit for Health Savings Account contributions is lowered to $6,850 from $6,900. Individuals with family coverage who planned to contribute to the full family amount should decrease their contributions going forward.

Review our updated 2018 Annual Benefit Plan Card and read more.


DOL Updates Employer CHIP Notice

The U.S. Department of Labor (DOL) updated its model Premium Assistance Under Medicaid and the Children’s Health Insurance Program notice (CHIP notice).

Employers that provide health insurance coverage in states with premium assistance through Medicaid or the Children’s Health Insurance Program (CHIP) must provide their employees with the CHIP notice before the start of each plan year. The CHIP notice provides information to employees on how to apply for premium assistance, including how to contact their state Medicaid or CHIP office. The DOL usually updates its model CHIP notice biannually.

IRS Issues Updated Employer’s Tax Guide to Fringe Benefits

The Internal Revenue Service (IRS) issued its 2018 Publication 15-B which contains information for employers on the employment tax treatment of fringe benefits. The guide is updated to reflect, among other items:

  • The suspension of qualified bicycle commuting reimbursements from an employee’s income for any tax year beginning after December 31, 2017, and before January 1, 2026.
  • The suspension of the exclusion for qualified moving expense reimbursements from an employee’s income for tax years beginning after December 1, 2017, and before January 1, 2026. However, the exclusion remains available for a U.S. Armed Forces member on active duty who moves because of a permanent change of station.
  • Limits on the deduction by employers for certain fringe benefits, such as meals and transportation commuting benefits.
  • The definition of items that aren’t tangible personal property for purposes of employee achievement awards.

The guide lists fringe benefits’ tax treatment in its Table 2-1 “Special Rules for Various Types of Fringe Benefits.”

IRS Issues Transition Relief Notice for Plans with Male Sterilization or Contraceptive Benefit

Recently, some states adopted laws that require certain health insurance policies to provide benefits for male sterilization and male contraceptives without cost-sharing.

However, under health saving account (HSA) eligibility requirements, a high deductible health plan (HDHP) generally may not provide benefits for any year until the minimum deductible for that year is satisfied. Although an HDHP may provide preventive care without a deductible or with a deductible that is below the minimum annual amount required by HSA eligibility requirements, male sterilization and male contraceptives are not considered preventive care under the Social Security Act or any Treasury Department guidance.

The Internal Revenue Service (IRS) released its Notice 2018-12 (Notice) to clarify that if a health plan provides benefits for male sterilization or male contraceptives before satisfying the minimum deductible for an HDHP, then the plan is not an HDHP, regardless of whether state law requires coverage of such benefits. Further, an individual who is not covered by an HDHP with respect to a month is not an HSA-eligible individual and may not deduct contributions to an HSA for that month. Similarly, HSA contributions made by an employer on behalf of the individual are not excludible from income and wages.

To allow states time to change their laws so their residents will be able to purchase health insurance coverage that qualifies as an HDHP, the Notice provides transition relief for periods before 2020 to individuals who are, have been, or become participants in or beneficiaries of a health insurance policy that provides benefits for male sterilization or male contraceptives without a deductible or with a deductible below the minimum deductible for an HDHP.

During the transition relief period, an individual with this type of health insurance policy will not be treated as HSA-ineligible, merely because the policy fails to qualify as an HDHP.

IRS Issues Updated Guide on Health Savings Accounts and Other Tax-Favored Health Plans

The Internal Revenue Service (IRS) updated its Publication 969 for taxpayers to use in preparing their 2017 returns. The publication explains health savings accounts (HSAs), medical savings accounts (Archer MSAs and Medicare Advantage MSAs), health flexible spending arrangements (FSAs), and health reimbursement arrangements (HRAs).

Question of the Month

  1. How does a person who is 65 years old or older maintain HSA eligibility and continue working? Also, when the person plans to retire, what should the person do about HSA contributions to avoid IRS penalties?
  2. To maintain HSA eligibility, an individual who is working and age 65 or older must:
  • Not apply for or waive Medicare Part A, and
  • Not apply for Medicare Part B, and
  • Waive or delay Social Security benefits.

For example, if a person delays Social Security benefits and delays Medicare Part A and B, retires at the end of April at the age of 65 or older, and applies for Social Security benefits and Medicare on May 1, 2018, then the general rule is that the person’s Social Security entitlement and Medicare Part A coverage will be retroactive for six months, meaning that the benefits would be retroactively effective as of November 2017.

IRS regulations state that a person can’t contribute to an HSA when the person has Medicare, so a person would need to stop contributing six months in advance of applying for Social Security benefits and Medicare. If a person contributes to an HSA after Medicare coverage begins, then the person may be subject to IRS penalties.

4/3/2018


Change to 2018 HSA Family Contribution Limit

Yesterday, the IRS released a bulletin that includes a change impacting contributions to Health Savings Accounts (HSAs).

 

  • The family maximum HSA contribution limit has decreased from $6,900 to $6,850.
  • This change is effective January 1, 2018 and for the entire 2018 calendar year.
  • The self-only maximum HSA contribution limit has not changed. 
  • This means that current 2018 HSA contribution limits are $3,450 (self-only) and $6,850 (family).

 

Why is the change happening so abruptly?

 

The IRS continues to make adjustments to accommodate the new tax law that passed at the end of 2017. Tax reform updates require the IRS to implement a modified method of calculating inflation-adjusted or cost-of-living-adjusted limits for 2018. The IRS is now using a different index (Chained Consumer Price Index for All Urban Consumers) to calculate benefit-related inflationary adjustments.

 

Typically, the IRS adjusts the HSA limits for inflation on an annual basis about six months before the start of the impacted year. For example, the IRS established the 2018 limits in May 2017. Today’s bulletin supersedes those limits.

Resource:

• IRS Bulletin IRB 2018-10March 5, 2018


Getting to Know HSAs, FSAs, and HRAs

This month’s CenterStage features Hierl Benefit Advisor, Tonya Bahr, discussing the differences, similarities, and customizations of HSAs (Health Savings Accounts) versus FSAs (Flexible Savings Accounts), as well as how HRAs (Health Reimbursement Arrangements) may be a great add-on.

About Tonya

Tonya Bahr has 15 years of 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.

So, which is better for you: a FSA or a HSA?

Comparing the Differences

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) are two popular ways employers can help their employees pay for out of pocket expenses associated with their healthcare costs. Both offer pre-tax advantages, which make them attractive. However, the names of these accounts really do distinguish their purposes. One is a SAVINGS account while the other is a SPENDING account.

Here are some tips and advice Tonya says to keep in mind when choosing between an HSA or FSA:

1.    Unlike the FSA, an HSA is portable and flexible. You can never lose the money in the account (both employee and employer contributions) so if you change jobs, change plan types, or don’t use the money in a given year, it all goes with you. The amount you can contribute toward an HSA is greater and the balance in the account earns interest.

2.    With an FSA, you can use the entire contribution amount upfront even if you haven’t contributed the full amount.

3.    With an HSA, you can only use the money actually in the account, but the FSA allows you to use the full contribution amount elected.

4.    You cannot contribute to an HSA and a full FSA at the same time. However, you can have an HSA and Limited FSA. Limited FSAs can only be used toward dental and vision expenses; whereas HSAs and full FSAs can be used toward medical, prescription, dental, and vision. HSA dollars can also be used to pay Cobra premiums, Long Term Care premiums, and Medicare premiums. Once an individual reaches age 65, money in an HSA can be spent on anything. The money is no longer earmarked for qualified medical expenses.

5.    HSAs are only available with High Deductible Health Plans (HDHP). HDHPs can seem a little intimidating at first given employees are responsible for the deductible before copays apply. However, they offer lower premiums, which is money in an employee’s pocket, which can in turn be used to start funding an HSA.

 

HRAs

Health Reimbursement Arrangements (HRA) are a vehicle used to offset increased plan design changes and employee’s out of pocket responsibility. Under an HRA, an employer purchases a plan design (typically a higher deducible option or out of pocket maximum), but they offer their employees a different plan. The difference is paid by the HRA. Employees submit their claims to a third party who manages the HRA and then in turn sends the employee funds to cover the cost of care. This type of scenario can work well for groups that have a healthier population and don’t experience high claim costs.

The savings is in the premium reduction for going with a higher deductible option and the gamble that employees won’t meet the limits of the HRA. Employers take on a risk with this type of arrangement because if a lot of members experience high claims and meet the HRA limits, the employer is the one paying to fund the HRA.

To conclude, employers can have an HRA with either an FSA or an HSA, but there are restrictions on how far down a qualified HDHP can go and still be HSA-qualified. Tonya’s suggestion is to avoid this risk by contacting her and discussing your options. You can contact Tonya Bahr at 920.921.5921 for more information.

Download The Full Article


HRL - White - House

4 Main Impacts of Yesterday's Executive Order

Yesterday, President Trump used his pen to set his sights on healthcare having completed the signing of an executive order after Congress failed to repeal ObamaCare.

Here’s a quick dig into some of what this order means and who might be impacted from yesterday's signing.

A Focus On Small Businesses

The executive order eases rules on small businesses banding together to buy health insurance, through what are known as association health plans, and lifts limits on short-term health insurance plans, according to an administration source. This includes directing the Department of Labor to "modernize" rules to allow small employers to create association health plans, the source said. Small businesses will be able to band together if they are within the same state, in the same "line of business," or are in the same trade association.

Skinny Plans

The executive order expands the availability of short-term insurance policies, which offer limited benefits meant as a bridge for people between jobs or young adults no longer eligible for their parents’ health plans. This extends the limited three-month rule under the Obama administration to now nearly a year.

Pretax Dollars

This executive order also targets widening employers’ ability to use pretax dollars in “health reimbursement arrangements”, such as HSAs and HRAs, to help workers pay for any medical expenses, not just for health policies that meet ACA rules. This is a complete reversal of the original provisions of the Obama policy.

Research and Get Creative

The executive order additionally seeks to lead a federal study on ways to limit consolidation within the insurance and hospital industries, looking for new and creative ways to increase competition and choice in health care to improve quality and lower cost.


New House Healthcare Proposal a Mixed Bag for Employers

The House of Representatives has just introduced their new bipartiasn plan for healthcare reform. Find out how this new healthcare legislation will impact your employers' healthcare in this great article by Victoria Finkle from Employee Benefit News.

A new bipartisan healthcare plan in the House contains potential positives and negatives alike for employers.

The plan could provide much-sought relief to small and medium-sized businesses with respect to the employer mandate, but it could also institutionalize the mandate for larger firms and does little to reduce employer-reporting headaches. Critics say it also fails to endorse other employer-friendly reforms to the Affordable Care Act.

The Problem Solvers Caucus, a group of more than 40 Republicans and Democrats led by Reps. Tom Reed, R-N.Y., and Josh Gottheimer, D-N.J., unveiled their new plan last week to stabilize the individual markets, following the collapse of Senate talks that were focused on efforts to repeal and replace the Affordable Care Act last month. The proposal would be separate from an earlier bill that passed the House to overhaul large swaths of the ACA. Congress is now on recess until after Labor Day, but talks around efforts to shore up the individual markets are likely to resume when lawmakers return to Washington this fall.

PaulThe House lawmakers introduced a broad set of bipartisan principles that they hope will guide future legislation, including several key tweaks to the employer mandate. This plan includes raising the threshold for when the mandate kicks in from firms with 50 or more employees to those with at least 500 workers. It also would up the definition of full-time work from those putting in 30 hours to those working 40 hours per week. Among changes focused on the individual markets, the proposal would bring cost-sharing reduction payments under the congressional appropriations process and ensure they have mandatory funding as well as establish a stability fund that states could tap to reduce premiums and other costs for some patients with expensive health needs.

Legislative talks focused on maintaining the Obamacare markets remain in early stages and it’s unclear whether the provisions targeting the employer mandate will gain long-term traction, though lawmakers in support of the plan said that their proposed measure would help unburden smaller companies.

“The current employer mandate places a regulatory burden on smaller employers and acts as a disincentive for many small businesses to grow past 50 employees,” the Problem Solvers Caucus said in their July 31 release.

Observers note that raising the mandate’s threshold would likely have few dramatic effects on coverage rates. But critics argued that while the plan would eliminate coverage requirements for mid-size employers — a boon for smaller companies — it could ultimately make it more difficult to restructure or remove the mandate altogether.

“It would provide relief to some people — however, it will enshrine the employer mandate forever,” says James Gelfand, senior vice president of health policy at the ERISA Industry Committee. “You are exempting the most sympathetic characters and ensuring that large businesses will forever be subject to the mandate and its obscene reporting.”

The real-world impact of the change would likely be limited when it comes to coverage rates, as mid-sized and larger employers tend to use health benefits to help attract and retain their workforce. Nearly all firms with 50 or more full-time employees — about 96% — offered at least one plan that would meet the ACA’s minimum value and affordability requirements, according to the Kaiser Family Foundation/Health Research & Education Trust employer health benefits survey for 2016. Participation was even higher — 99% — among firms with at least 200 workers.

“At the 500 bar, realistically, virtually every employer is offering coverage to at least some employees,” says Matthew Rae, a senior policy analyst with Kaiser Family Foundation.

Gelfand notes that under the proposed measure, big businesses would still have to comply with time-consuming and costly reporting requirements under the ACA and would continue to face restrictions in plan design, because of requirements in place that, for example, mandate plans have an actuarial value of at least 60%.

“Prior to the ACA, big business already offered benefits — and they were good benefits that people liked and that were designed to keep people healthy and to make them productive workers,” he says. “[The ACA] forces us to waste a boatload of time and money proving that we offer the benefits that we offer and it constrains our ability to be flexible in designing those benefits.”

Susan Combs, founder of insurance brokerage Combs & Co., says that changing the definition of full-time employment from 30 to 40 hours per week could have a bigger impact than raising the mandate threshold, because it would free up resources for employers who had laid off workers or cut back their hours when they began having to cover benefits for people working 30 or more hours.

“Some employers had to lay off employees or had they to cut back on different things, because they had to now cover benefits for people that were in essence really part-time people, not full-time people,” she says. “If you shifted from 30 to 40 hours, that might give employers additional remedies so they can expand their companies and employ more people eventually.”

Two percent of firms with 50-plus full-time workers surveyed by Kaiser in 2016 said that they changed or planned to change the job classifications of some employees from full-time to part-time so that the workers would not be eligible for health benefits under the mandate. Another 4% said that they reduced the number of full-time employees they intended to hire because of the cost of providing health benefits.

Gelfand calls the provision to raise the definition from 30 to 40 hours per week “an improvement,” though he said a better solution would be to remove the employer mandate entirely.

He added that he would like to see any market stabilization plan include more items employers had backed as part of the earlier repeal and replace debate. While the House plan would remove a tax on medical devices, it does not address the Cadillac tax on high-cost plans, one of the highest priority items that employer groups have been working to delay or repeal. It also doesn’t include language expanding the use of tax-advantaged health savings accounts detailed in earlier House and Senate proposals.

“There’s not likely to be another healthcare vehicle that’s focused on ACA reform, so if you have a reform vehicle that goes through and it doesn’t do anything to give us tax relief and it doesn’t do anything to improve consumer-driven health options, like HSAs, and it doesn’t do anything to improve healthcare costs — wow, what a missed opportunity,” he says.

See the original article Here.

Source:

Finkle V. (2017 August 10). New house healthcare proposal a mixed bag for employers [Web blog post]. Retrieved from address https://www.benefitnews.com/news/new-house-healthcare-proposal-a-mixed-bag-for-employers


How to Explain HSAs to Employees Who Don’t Understand Them

HSAs can be a very effective tool for employees looking to save for their healthcare and retirement. But many employees are not knowledgeable enough to fully utilize their HSAs. Here is an interesting column by Eric Brewer from Employee Benefit News on what you can do to help educate your employees on the impartance of HSAs.

High-deductible health plans with health savings accounts are becoming more popular as benefits consumerism increases throughout the country. Enrolling your employees in HDHPs is one way to educate them on the true cost of healthcare. And if they use an HSA correctly, it can help them better manage their healthcare costs, and yours.

But understanding how an HDHP works and ensuring your employees will get the most out of an HSA can be tricky. In fact, a recent survey by employee communication software company Jellyvision found that half of employees don’t understand their insurance benefits. And choosing a benefits plan is stressful for employees because it’s a decision that will impact them for a long time. This is further complicated by the trend toward rising employee contributions and the issue of escalating healthcare costs. Employees are taking on more cost share — and that means plan sponsors have a greater responsibility to do a better job of educating them to make the best decision at open enrollment.

HSAs benefit the employee in a number of ways:
· Just like a retirement plan, HSAs can be funded with pre-tax money.
· Employees can choose how much they want to contribute each pay period and it’s automatically deducted.
· Employers can contribute funds to an HSA until the limit is met.

These are important facts to tell employees. But there’s more to it than that. Here are some tips on how to best explain HSAs to your workforce.

The devil is in the details: discuss tax-time changes

Employees using HSAs will see an extra number or two on their W-2s and receive additional tax forms. Here’s what to know:

· The amount deposited into the HSA will appear in Box 12 of the W-2.
· Employees may also receive form 5498-SA if they deposited funds in addition to what has been deducted via payroll.
· Employees must submit form 8889 before deducting contributions to an HSA. On the form they’ll have to include their deductible contributions, calculate the deduction, note what you’ve spend on medical expenses, and figure the tax on non-medical expenses you may have also paid for using the HSA.
· Employees will receive a 1099SA that includes distributions from the HSA.

Importantly, most tax software walks employees through these steps.

Dispel myths

A lot of confusion surrounds HSAs because they’re yet another acronym that employees have to remember when dealing with their insurance (more on that later). Here are a few myths you should work to dispel.

· Funds are “use it or lose it.” Unlike a flexible spending account, funds in an HSA never go away. In fact, they belong to an employee. So even if they go to another job, they can still use the HSA to pay for medical expenses tax-free.

· HDHPs with HSAs are risky. There are benefits to choosing an HDHP with an HSA for both healthy people and those with chronic illnesses. Healthy people benefit from low HDHP premiums and can contribute to an HSA at a level they’re comfortable with. On the other hand, people with chronic illnesses will likely hit their deductible each year; after that time, medical expenses are covered in most cases.

Help employees understand they’re in control

High-deductible plans with an HSA might seem intimidating, but they put employees firmly in control of their healthcare. This is increasingly important in today’s insurance landscape. When employees choose an HSA, healthcare becomes more transparent. They can shop around for services and find the best deal for services before they make a decision.

HSAs also give you control and flexibility over how and when employees spend the funds. Users can cover medical costs as they happen or collect receipts and get reimbursed later. Finally, employees don’t have to worry about sending in receipts to be reviewed. This means they must be responsible for using the funds the right way, or face tax penalties.

Resist ‘insurance speak’

As an HR professional, you may not realize how much benefits jargon you use every day. After all, you deal with benefits all the time, so using industry terms is second nature. But jargon, especially the alphabet soup of insurance acronyms that I mentioned earlier, is confusing to employees.

One tip is to spell out acronyms on the first reference. Second, simplify the explanation by shortening sentences so that anyone can understand it.

Here’s an example of a way to introduce an HSA:

A health savings account, also called an HSA, is a tax-free savings account. An HSA helps you cover healthcare expenses. You can use the money in your HSA to pay medical, dental and vision costs for yourself, spouse and dependents who are covered by your health plan. You can use HSA funds to pay for non-medical expenses, but you will have to pay taxes on them…

You get the idea.

As responsibility continues to shift to employees, they may need more education in small chunks over time to reinforce their knowledge. As the employer, it’s in your best interest to help employees choose the best plan and use it the right way.

See the original article Here.

Source:

Brewer E. (2017 August 4). How to explain HSAs to employees who don't understand them [Web blog post]. Retrieved from address https://www.benefitnews.com/opinion/how-to-explain-hsas-to-employees-who-dont-understand-them?feed=00000152-18a5-d58e-ad5a-99fd665c0000


Government and Education Employers Offer Richest HSA Plans

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

Across most industries, HSA contributions are, for the most part, down or unchanged from three years ago, according to UBA’s Health Plan Survey. The average employer contribution to an HSA is $474 for a single employee (down 3.5 percent from 2015 and 17.6 percent from five years ago) and $801 for a family (down 9.2 percent from last year and 13.7 percent from five years ago). Government and education employers are the only industries with average single contributions well above average and on the rise.

Government employees had the most generous contributions for singles at $850, on average, up from $834 in 2015. This industry also has the highest employer contributions for families, on average, at $1,595 (though that is down from 1,636 in 2015). Educational employers are the next most generous, contributing $636, on average, for singles and $1,131 for families.

Singles in the accommodation/food services industries received virtually no support from employers, with average HSA contributions at $166. The same is true for families with HSA plans in the accommodation/food services industries with average family contributions of $174.

Retail employers also remain among the least generous contributors to single and family HSA plans, contributing $305 and $470, respectively. This may be why they have low enrollment in these plans.

The education services industry has seen a 109 percent increase in HSA enrollment since 2013 (aided by employers’ generous contributions), catapulting the industry to the lead in HSA enrollment at 23.8 percent. The professional/scientific/tech and finance/insurance industries follow closely at 23.3 percent and 22.1 percent, respectively.

The mining/oil/gas industry sees the lowest enrollment at 3.8 percent. The retail, hotel, and food industries continue to have some of the lowest enrollment rates despite the prevalence of these plans, indicating that these industries, in particular, may want to increase employee education efforts about these plans and how they work.

 

See the original article Here.

Source:

Olson B. (2017 July 27). Government and education employers offer richest HSA plans [Web blog post]. Retrieved from address http://blog.ubabenefits.com/government-and-education-employers-offer-richest-hsa-plans


Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

With the Senate's plan for the repeal and replacement of the ACA failing more Americans are hoping for Congress to move on to more pressing matters. Find out how Americans really feel about the ACA and healthcare reform in this great study conducted by the Kaiser Family Foundation.

KEY FINDINGS:
  • The August Kaiser Health Tracking Poll finds that the majority of the public (60 percent) say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. Since then, President Trump has suggested Congress not take on other issues, like tax reform, until it passes a replacement plan for the ACA, but six in ten Americans (62 percent) disagree with this approach, while one-third (34 percent) agree with it.
  • A majority of the public (57 percent) want to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law, while smaller shares say they want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). However, about half of Republicans and Trump supporters would like to see Republicans in Congress keep working on a plan to repeal the ACA.
  • A large share of Americans (78 percent) think President Trump and his administration should do what they can to make the current health care law work while few (17 percent) say they should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively). Moving forward, a majority of the public (60 percent) says President Trump and Republicans in Congress are responsible for any problems with the ACA.
  • Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces. The majority of the public are unaware that health insurance companies choosing not to sell insurance plans in certain marketplaces or health insurance companies charging higher premiums in certain marketplaces only affect those who purchase their own insurance on these marketplaces (67 percent and 80 percent, respectively). In fact, the majority of Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.
  • A majority of the public disapprove of stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and disapprove of the Trump administration no longer enforcing the individual mandate (65 percent). While most Republicans and Trump supporters disapprove of stopping outreach efforts, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.
  • The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support using whatever tactics necessary to encourage Democrats to start negotiating on a replacement plan. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support these negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).
  • This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability of nine percentage points since the 2016 presidential election as well as an increase of favorability among Democrats, independents, and Republicans.

Attitudes Towards Recent “Repeal and Replace” Efforts

In the early morning hours of July 28, 2017, the U.S. Senate voted on their latest version of a plan to repeal and replace the 2010 Affordable Care Act (ACA). Known as “skinny repeal,” this plan was unable to garner majority support– thus temporarily halting Congress’ ACA repeal efforts. The August Kaiser Health Tracking Poll, fielded the week following the failed Senate vote, finds that a majority of the public (60 percent) say it is a “good thing” that the U.S. Senate did not pass a bill aimed at repealing and replacing the ACA, while about one-third (35 percent) say this is a “bad thing.” However, views vary considerably by partisanship with a majority of Democrats (85 percent), independents (62 percent), and individuals who say they disapprove of President Trump (81 percent) saying it is a “good thing” that the Senate did not pass a bill compared to a majority of Republicans (64 percent) and individuals who say they approve of President Trump (65 percent) saying it is a “bad thing” that the Senate did not pass a bill.

The majority of those who view the Senate not passing an ACA replacement bill as a “good thing” say they feel this way because they do not want the 2010 health care law repealed (34 percent of the public overall) while a smaller share (23 percent of the public overall) say they feel this way because, while they support efforts to repeal and replace the ACA, they had specific concerns about the particular bill the Senate was debating.

And while most Republicans and supporters of President Trump say it is a “bad thing” that the Senate did not pass ACA repeal legislation, for those that say it is a “good thing” more Republicans say they had concerns about the Senate’s particular legislation (21 percent) than say they do not want the ACA repealed (6 percent). This is also true among supporters of President Trump (19 percent vs. 6 percent).

WHO DO PEOPLE BLAME OR CREDIT FOR THE SENATE BILL FAILING TO PASS?

Among those who say it is a “good thing” that the Senate was unable to pass ACA repeal and replace legislation, similar shares say the general public who voiced concerns about the bill (40 percent) and the Republicans in Congress who voted against the bill (35 percent) deserve most of the credit for the bill failing to pass. This is followed by a smaller share (14 percent) who say Democrats in Congress deserve the most credit.

On the other hand, among those who say it is a “bad thing” that the Senate did not pass a bill to repeal the ACA, over a third place the blame on Democrats in Congress (37 percent). About three in ten (29 percent) place the blame on Republicans in Congress while fewer (15 percent) say President Trump deserves most of the blame for the bill failing to pass.

HALF OF THE PUBLIC ARE “RELIEVED” OR “HAPPY” THE SENATE DID NOT REPEAL AND REPLACE THE ACA

More Americans say they are “relieved” (51 percent) or “happy” (47 percent) that the Senate did not pass a bill repealing and replacing the ACA, than say they are “disappointed” (38 percent) or “angry” (19 percent).

Although two-thirds of Republicans and Trump supporters say they feel “disappointed” about the Senate failing to pass a bill to repeal and replace the ACA, smaller shares (30 percent and 37 percent, respectively) report feeling “angry” about the failure to pass the health care bill.

MAJORITY SAY PRESIDENT TRUMP AND REPUBLICANS IN CONGRESS ARE RESPONSIBLE FOR THE ACA MOVING FORWARD

With the future of any other replacement plans uncertain, the majority (60 percent) of the public say that because President Trump and Republicans in Congress are now in control of the government, they are responsible for any problems with the ACA moving forward, compared to about three in ten Americans (28 percent) who say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it. Partisan divisiveness continues with majorities of Republicans and supporters of President Trump who say President Obama and Democrats are responsible for any problems with it moving forward, while large shares of Democrats, independents, and those who do not approve of President Trump say President Trump and Republicans in Congress are responsible for the law moving forward.

Moving Past Repealing The Affordable Care Act

This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability since Congress began debating ACA replacement plans and a nine percentage point shift since the 2016 presidential election.

The shift in attitudes since the 2016 presidential election is found regardless of party identification. For example, the share of Republicans who have a favorable view of the ACA has increased from 12 percent in November 2016 to 21 percent in August 2017. This is similar to the increase in favorability among independents (11 percentage points) and Democrats (7 percentage points) over the same time period.

NEXT STEPS FOR THE ACA

The most recent Kaiser Health Tracking Poll finds that after the U.S. Senate was unable to pass a plan to repeal and replace the ACA, the majority of the public (57 percent) wants to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law but not repeal it. Far fewer want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). About half of Republicans (49 percent) and Trump supporters (46 percent) want Republicans in Congress to continue working on their own plan to repeal and replace the ACA, but about a third of each say they would like to see Republicans work with Democrats on improvements to the ACA.

Six in ten Americans (62 percent) disagree with President Trump’s strategy of Congress not taking on other issues, like tax reform, until it passes a replacement plan for the ACA while one-third (34 percent) of the public agree with this approach. Republicans and Trump supporters are more divided in their opinion on this strategy with similar shares saying they agree and disagree with the approach.

MOST WANT TO SEE PRESIDENT TRUMP AND REPUBLICANS MAKE THE CURRENT HEALTH CARE LAW WORK

Regardless of their opinions of the ACA, the majority of the public want to see the 2010 health care law work. Eight in ten (78 percent) Americans think President Trump and his administration should do what they can to make the current health care law work while fewer (17 percent) say President Trump and his adminstration should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively).

This month’s survey also includes questions about specific actions that the Trump administration can take to make the ACA fail and finds that the majority of the public disapproves of the Trump Administration stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and no longer enforcing the individual mandate, the requirement that all individuals have insurance or pay a fine (65 percent). While most Republicans and Trump supporters disapprove of President Trump stopping outreach efforts so fewer people sign up for insurance, which experts say could weaken the marketplaces, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.

The Future of the ACA Marketplaces

About 10.3 million people have health insurance that they purchased through the ACA exchanges or marketplaces, where people who don’t get insurance through their employer can shop for insurance and compare prices and benefits.1 Seven in ten (69 percent) say it is more important for President Trump and Republicans’ next steps on health care to include fixing the remaining problems with the ACA in order to help the marketplaces work better, compared to three in ten (29 percent) who say it is more important for them to continue plans to repeal and replace the ACA.

The majority of Republicans (61 percent) and Trump supporters (63 percent) say it is more important for President Trump and Republicans to continue plans to repeal and replace the ACA, while the vast majority of Democrats (90 percent) and seven in ten independents (69 percent) want them to fix the ACA’s remaining problems to help the marketplaces work better.

UNCERTAINTY REMAINS ON WHO IS IMPACTED BY ISSUES IN THE ACA MARKETPLACES

Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces which has led some insurance companies to charge higher premiums in certain marketplaces.  Six in ten Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.

There has also been news about insurance companies no longer selling coverage in the individual insurance marketplaces and currently, it’s estimated that 17 counties (9,595 enrollees) are currently at risk to have no insurer on the ACA marketplaces in 2018.2 The majority of the public (54 percent) say health insurance companies choosing not to sell insurance plans in certain marketplaces will have no impact on them and their family. Yet, despite the limited number of counties that may not have an insurer in their marketplaces as well as this not affecting those with employer sponsored insurance where most people obtain health insurance, about four in ten (38 percent) of the public believe that health insurance companies choosing to not sell insurance plans in certain marketplaces will have a negative impact on them and their families.

The majority of the public think both of these ACA marketplace issues will affect everyone who has health insurance and not just those who purchase their insurance on these marketplaces. Six in ten think health insurance companies choosing not to sell insurance plans in certain marketplaces will affect everyone who has health insurance while about one-fourth (26 percent) correctly say it only affects those who buy health insurance on their own. In addition, three-fourths (76 percent) of the public say that health insurance companies charging higher premiums in certain marketplaces will affect everyone who has health insurance while fewer (17 percent) correctly say it will affect only those who buy health insurance on their own.

MAJORITY SAY PRESIDENT TRUMP SHOULD NOT USE COST-SHARING REDUCTION PAYMENTS AS NEGOTIATING STRATEGY

Over the past several months President Trump has threatened to stop the payments to insurance companies that help cover the cost of health insurance for lower-income Americans (known commonly as CSR payments), in order to get Democrats to start working with Republicans on an ACA replacement plan.3 The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support President Trump using whatever tactics necessary to encourage Democrats to start negotiating. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).

See the original article Here.

Source:

Kirzinger A., Dijulio B., Wu B., Brodie M. (2017 Aug 11). Kaiser health tracking poll-august 2017: the politics of ACA repeal and replace efforts [Web blog post]. Retrieved from address http://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2017-the-politics-of-aca-repeal-and-replace-efforts/?utm_campaign=KFF-2017-August-Tracking-Poll&utm_medium=email&_hsenc=p2ANqtz-9GaFJKrO9G3bL05k_i4GzC04eMAaSCDlmcsiYsfzAn-SeJdK_JnFvab4GydMfe_9iGiiKy5LR0iKxm6f0gDZGbwqh-bQ&_hsmi=55195408&utm_content=55195408&utm_source=hs_email&hsCtaTracking=4463482c-5ae1-4dfa-b489-f54b5dd97156%7Cd5849489-f587-49ad-ae35-3bd735545b28


Employers Spend $742 per Employee for Wellness Program Incentives

Are you looking for new incentives to help your employees participate in your wellness program? Check out this interesting article by Brookie Madison from Employee Benefit Advisor on how employers are offering financial incentives in order to increase participation in their wellness programs.

Wellness programs are popular with employers but employees continue to need motivation to participate. Seventy percent of employers are investing in wellness programs, while 73% of employees say they are interested in wellness programs, but 64% of employees undervalue the financial incentives to join the wellness programs, according to UnitedHealthcare’s Consumer Sentiment Survey entitled “Wellness Check Up.”

Only 7% of employees understand the four basic terms of health care —premium, deductible, copayment and coinsurance — which is why UHC didn’t find it surprising that workers underestimate their financial incentives in wellness programs, says Rebecca Madsen, chief consumer officer for UnitedHealthcare.

Despite this disconnect between what employers are offering to help ensure their employees’ health and what employees are willing to do to maintain a healthy well-being, the most appealing incentives to employees for wellness programs are health insurance premium reductions (77%), grocery vouchers (64%) and health savings accounts (62%).

Employees find the financial incentives of the wellness programs appealing, yet only 24% of employees are willing to give up one to three hours of their time per week to exercise, attend wellness coaching sessions or research healthier recipes to eat.

“Unwilling to engage is part of the problem why a third of the country is obese and another third is overweight. We have a real problem in terms of keeping people healthy and that’s what we want to help address,” says Madsen.

Madsen recommends that employers promote their wellness programs and incentives multiple times throughout the year. Gift cards, reduction of premiums and contributing to health savings accounts are leading ways to reward employees. “Incentives on an ongoing basis get people engaged and motivated to participate for a long period of time,” says Madsen.

Wellness programs also provide a way for employers to adjust their benefit packages to be customized and be more than a ‘one size fits all’ approach. “Look at your insurance claims, work with insurance providers and identify common health challenges. See where you have prevalent healthcare needs and who your high risk populations are to develop programs that target those results,” suggests Madsen.

Wellness programs need endless support from advisers, insurance providers, consultants, consumers, friends, family members and employers in order to encourage employees to live healthy lifestyles, according to UnitedHealthcare.

Madsen suggests that employers have onsite biometric screenings. “Helping people know their numbers will help them understand where they have an opportunity to improve their health, which would make them motivated to engage more,” says Madsen.
New trends of wellness programs incorporate the use of activity trackers. Twenty-five percent of employees use an activity tracker and 62% would like to use one as part of a wellness program.

See the original article Here.

Source:

Madison B. (2017 June 28). Employers spend $742 per employee for wellness program incentives [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/employers-spend-742-per-employee-for-wellness-program-incentives


HSAs and 401(k)s are Becoming More Closely Linked

As HSAs continue to grow, more employers are starting to work HSAs into their retirement programs. Take a look at this great article by Brian M. Kalish from Employee Benefit News and see how employers are using HSAs as a tool to help their employee plan for their healthcare cost in retirement.

There has been progress among leading-edge advisers and employers to more closely link HSAs and 401(k)s in order to allow employees to use a health savings account to save for healthcare expenses post-retirement.

Eighty percent of Americans have a high concern about healthcare costs in retirement, according to Merrill Lynch, and healthcare is the largest threat to retirement savings and the most important part of a retirement income plan, according to Fidelity, which is why there has been a recent push to more closely link HSAs and 401(k)s, or health and wealth.

HSAs are triple tax-free, Brian Graff, CEO of the American Retirement Association, an Arlington, Va.-based trade group said at a recent event hosted by AFS 401(k) Retirement Services

The fact of linking health and wealth “is a big idea and there is some continued focus on it moving forward,” says Alex Assaley, managing principal of Bethesda, Md.-based financial services advisory company AFS 401(k).

“There is a lot more interest in HSAs by pretty much everybody,” explains Nevin Adams, chief of marketing and communications at the American Retirement Association.

According to the Employee Benefit Research Institute, nearly 30% of employers offered an HSA-eligible health plan in 2015 and that percentage is expected to increase in the future both as a health plan option and as the only health plan option. Most of the growth has been recent as more than four-in-five HSAs have been opened since the beginning on 2011, according to EBRI.

At an event hosted by Assaley’s firm in 2016, he said there was not a lot of traction around the idea of using HSAs to save for healthcare expenses post-retirement. But, now, there is a bigger push.

As HSAs continue to grow, employers, employees and advisers are “understanding there is an ability to accumulate money in the HSA and use that for healthcare or something [employees] want to set aside because they are not sure what their healthcare cost situation in the future is going to be,” Adams explains.

Assaley adds that there has “definitely been a good deal of refinement and evolution in the HSA marketplace [recently], whereby … you are now seeing more companies offering HSAs as a part of their medical and retirement strategy. You are also seeing more employees thinking about HSAs as part of their overall holistic fin wellness program.”

In one-on-one coaching sessions with employees, conversations are becoming more prominent, as advisers help employees, “understand how all employee benefits tie together to make wise financial decisions today, tomorrow and for their retirement,” Assaley says.

“With certainty, there has been a great deal of growth in the marketplace and evolution in how HSAs and 401(k)s are starting to interlock together,” he adds.

Saving for the future
Looking down the road, Assaley expects the linking to continue, especially if proposals to alter the maximum accounts that can be contributed pre-tax to an HSA is tweaked, as has been proposed by legislators on Capitol Hill. Some proposals shared amongst the industry, Assaley says, propose doubling the pre-tax amount.

“If that happens or there is any sort of meaningful increase, then I think you will see an exponential growth in the numbers of HSAs,” he says.

For advisers, the work is not done as they need to help employees better understand how a HSA works and from there help employees understand the benefits of a HSA and the different ways to structure one, Assaley explains.

“Even today, there is a large knowledge gap on what an HSA is, how it works and how someone can use one as part of health and retiree healthcare needs,” he says.

See the original article Here.

Source:

Kalish B. (2017 July 5). HSAs and 401(k)s are becoming more closely linked [Web blog post]. Retrieved from address https://www.benefitnews.com/news/hsas-and-401-k-s-are-becoming-more-closely-linked?feed=00000152-18a4-d58e-ad5a-99fc032b0000