Stay up-to-date with the latest compliance recaps from our partners at United Benefits Advisors (UBA).
Under the Patient Protection and Affordable Care Act (ACA), applicable large employers (ALEs) may use either the monthly or look-back method to determine whether an employee on average works 30 or more hours per week, and for whom a penalty may be owed if adequate health coverage is not offered. Under the look-back measurement method, an employee generally is treated as a full-time employee for each month during the following stability period if the employee averaged 30 or more hours of service per week during the measurement period. Employers have asked questions about how to handle employees who move among positions with differing look-back periods (start dates or lengths or both). The Internal Revenue Service (IRS) has now issued Notice 2014-49 which provides a proposed method of handling these transfers. Although this method is still proposed, employers may safely use it through 2016. As of the end of 2016, no further guidance was provided for the IRS. Until it is provided, employers can continue to refer to this notice for guidance.
Under the proposed approach, if the measurement period for an employee changes because the employee transfers from one position to another with the same employer or to an employer within the controlled group and the positions do not use the same measurement period, if the employee is in a stability period (or an administrative period related to completion of an initial measurement period) for the first position as of the date of transfer, the employee’s status as a full-time or non-full-time employee for the first position would remain in effect until the end of that stability period. If the employee is not yet in a stability or administrative period, the employee’s status as a full-time or non-full-time employee would be determined under the look-back measurement method for the second position, and the employer would include all hours of service in the first position when determining the employee’s average hours worked. In all other respects, the rules generally applicable to the look-back measurement method would continue to apply.
If the employer uses different methods of counting hours of service, such as actual hours versus weekly equivalency, the employer may either count all hours of service in both positions under the counting method used with the first position, or recalculate the hours of service in the first position under the counting method used with the second position. The employer must use the same method of converting hours of service with all similarly situated employees.
Additionally, an employer may change the measurement period or method (from or to the monthly measurement method, or in the length or start date) for one or more categories of employees. (The permitted categories are hourly and salaried, under a bargaining agreement or not under a bargaining agreement, covered under different bargaining agreements, and located in different states.) Employers that plan to change the dates of their measurement and stability periods must inform employees of the upcoming change, but cannot make the change until the stability period following the upcoming stability period.
If the employer changes the measurement method, the transition rules for employees who are moved between the monthly and look-back measurement methods must be applied to all employees affected by the change. Basically, the status of each affected employee as full time or not full time is determined as if, on the date of the change, the employee had transferred from a position to which the original measurement method applied to a position to which the revised measurement method applied, using the process described above.
The IRS has also clarified that if entities with different measurement periods are involved in a merger, acquisition, or similar corporate transaction, the surviving entity may continue to use the existing method for acquired employees until the end of their current stability period. If the acquired entity uses the monthly measurement method with respect to a category of employees, the monthly method may be continued until the last day of the first calendar year that begins after the date of the transaction.
Download the release here.
Interesting article about emerging trends in employee benefits for 2017 by Marlene Satter
As the old year ticks down toward a new year filled with a drastic change in Washington that will no doubt have plenty of ripple effects throughout the country, the employee benefits sector will also be in for plenty of changes.
Based on its 14th Annual U.S. Employee Benefit Trends Study and other industry indicators, MetLife has prognosticated five trends it believes will be key in 2017.
There are no silver bullets and the health system as structured today cannot pivot effectively. But there are some strategies…
Employers might be surprised by some, and are probably already wrestling with others—but here’s what to watch for in the year to come.
If there’s one thing that’s clear in benefits, it’s that everybody is not happy with the same cookie-cutter benefit package.
And as the job market improves and employers have to work harder to attract and retain top talent, one way to do that is to provide benefits that satisfy needs that might be a little out of the ordinary. Employers that can satisfy their employees’ diverse needs, the study found, “will emerge clear winners in the talent war.”
What’s more, employees are becoming more focused on specific benefits.
The study revealed that 28 percent of all generations agree that critical illness insurance is a must-have, but it doesn’t stop there—different generations want different things. For instance, about 14 percent of millennial employees consider pet insurance a must-have benefit.
And don’t forget about benefits communications. No rubber-stamp information wanted here—employees want communications about their benefits customized to them.
Here’s an area where employees are not happy—so change will have to come if the situation is to improve.
The study found that only about a third of employees say that their company’s benefit communications are easy to understand—and that leads many to assume they don’t need many of the benefits they’re offered. That’s definitely not a good situation.
The good news: 71 percent of employers say that by working with an enrollment firm they were able to improve communication, including explaining and clarifying nonmedical benefits.
For employers to stay ahead of the curve, they’ll have to join the movement to better educate their employees on enrollment.
The biggest single source of stress for employees is financial stress, which weighs not only on employees but on employers’ bottom lines as well. And that situation screams to be addressed.
While financial wellness programs help employees to better manage their personal finance situations, cutting stress as a result, employers so far haven’t jumped on the bandwagon.
In fact, some of the few who offered them have quit doing so, with just 31 percent of employers having provided financial wellness programs this year. That’s down from 39 percent last year, according to the study.
If employers wise up and provide help with financial wellness, employees will sleep better at night and work better during the day. And so will their employers.
Whether it’s hackers or phishers, more threats to data security arise every day—not just for consumers but for companies and their employees.
Losses from hacked, hijacked or ransomed data can drive a company out of business, but employers also have to be as protective of their employees’ data as they are of their customers’.
One way to do that, the study pointed out, is to shore up the digital support chain by moving to a single benefits carrier; that can help to limit the exposure of employee data.
With the average cost of a large-scale data breach sitting at approximately $4 million, according to a study conducted by the Ponemon Institute, it’s a smart investment.
If you’re looking for a new lure to attract top talent, this could be your ticket. MetLife has characterized legal services as the “best-kept secret of benefits.” SHRM adds that it has doubled in popularity over the past 10 years.
At some point, the study pointed out, just about everyone is going to have to deal with a legal issue. Major life events, such as buying a home, getting married, having a baby or caring for an aging parent, all have important legal implications.
According to MetLife insights, “For about $20 a month, a legal plan can help,” adding that the benefit is of particular importance to millennials. Of adults that are offered a legal plan through work, a Harris poll found that nearly 70 percent of those aged 21–34 are enrolled.
See the original article Here.
Satter M. (2016 December 7). 5 employee benefits trends for 2017[Web blog post]. Retrieved from address http://www.benefitspro.com/2016/12/07/5-employee-benefits-trends-for-2017?page_all=1
Updated January 4, 2017
Make sure you are up-to-date with the IRS new rules on 6055/6056 from our partners at United Benefits Advisor (UBA).
Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers are required to report on the health coverage they offer.
Final instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in September 2016, as were the final forms for 1094-B, 1095-B, 1094-C, and 1095-C. In December 2016, the IRS updated its longstanding Questions and Answers about Information Reporting by Employers on Form 1094-C and Form 1095-C.
When? Which Employers?
Reporting will be due early in 2017, based on coverage in 2016. All reporting will be for the calendar year, even for non-calendar year plans. The reporting requirements are in Sections 6055 and 6056 of the ACA. Draft instructions for both the 1094-B and 1095-B, and the 1094-C and 1095-C were released in August 2016. The final instructions are substantially similar to the draft instructions.
6055 Requirements: Forms 1094-B and 1095-B
IRS Form 1095-B is used to meet the Section 6055 reporting requirement. Section 6055 reporting relates to having coverage to meet the individual shared responsibility requirement. Form 1095-B is used by insurers, plan sponsors of self-funded multiemployer plans, and plan sponsors of self-funded plans that have fewer than 50 employees to report on coverage that was actually in effect for the employee, union member, retiree or COBRA participant, and their covered dependents, on a month-by-month basis. Filers use Form 1094-B as the transmittal to submit the 1095-B returns.
6056 Requirements: Forms 1094-C and 1095-C
IRS Form 1095-C is primarily used to meet the Section 6056 reporting requirement. The Section 6056 reporting requirement relates to the employer shared responsibility / play or pay requirement. Information from Form 1095-C is also used to determine whether an individual is eligible for a premium tax credit. Employers with 50 or more full-time or full-time equivalent employees complete much of Form 1095-C to report on coverage that was offered to the employee and eligible dependents. In addition, to save large employers that sponsor self-funded plans from having to complete two forms, a Part III has been included in Form 1095-C. Large employers with self-funded plans use that part of the form to report information about actual coverage that otherwise would be reported on Form 1095-B. Employers with 50 or more full- time or full-time equivalent employees with fully insured plans will skip section III, and their carrier will complete a separate B series form to report that information for them.
Form 1094-C is used in combination with Form 1095-C to determine employer shared responsibility penalties.
Employers with 50 or more full-time or full-time equivalent employees must provide Form 1095-C to virtually all employees who were full time (averaged 30 hours per week) during any month during the year, even if coverage was not offered to the employee or the employee declined coverage. (If the full- time employee never became eligible during the year, most likely because the employee is a variable- hours employee in an initial measurement period, the form does not need to be provided).
The 2016 instructions for Forms 1094-C and 1095-C include some form revisions and code changes. The Qualifying Offer Method Transition Relief is not applicable for 2016. Clarification language was added to remind filers of the definition of “full-time employee” and to inform recipients that the form should not be submitted with their returns. New codes 1J and 1K were added to address conditional offers of spousal coverage.
For the 1094-B and 1095-B forms, there are a few form revisions. Clarification language was added to remind recipients that the form should not be submitted with their returns. Also, the form is updated to reflect the rule that a taxpayer identification number (TIN) may be entered.
1094-C and 1095-C Highlights
1094-B and 1095-B Highlights
Intriguing article from Benefits Pro by Marty Traynor
Walk around any workplace and unless there’s a safety issue, almost every employee under 50 is wearing earbuds and remains focused on their own personal music zone. What a perfect metaphor for the barriers we must overcome to gain the attention we need for benefit purchase decisions.
With the fall enrollment season approaching, let’s consider some of the ways we should work to “remove the buds” and focus employee attention on the process of benefit enrollment.
Good luck with your fourth quarter enrollments. Earbuds are not noise cancelling headphones, so there is still a great opportunity to break through to employees and make your benefit communications campaigns your best to date.
Traynor, M. (2016 September 13). Take out the earbuds. [Web blog post]. Retrieved from address http://www.benefitspro.com/2016/09/13/take-out-the-earbuds?slreturn=1474041704
Original Post from HRMorning.com
By: Tim Gould
Here are a few stats that really drive home just how critical benefits communication is for HR pros.
When employees that were offered rich employer benefits received poor communication, just 22% of those workers reported being satisfied with their benefits.
On the other hand, when employers with less-rich benefits communicated those benefits effectively, 76% of workers reported being satisfied with their employers’ benefit offerings.
These stats were part of a recent study by Towers Watson WorkUSA.
At the 2015 Mid-Sized Retirement & Healthcare Plan Management Conference in San Diego, Benefits Strategist Julie Adamik used those surprising stats as an opening to launch into a presentation about effective benefits communication.
During the presentation, Adamik covered some of the most common — and costly — benefits communication mistakes, which included:
1. Holding a boring benefits presentation. There’s a common misconception among workers that anything about benefits is going to be boring. But when HR pros don’t make the effort to make their benefits presentations interesting, the message is bound to be lost on employees.
2. Letting Legal draft all of your benefit communications. When employers let a legal department write all your benefits communications, there’s a very good chance the documents will be littered with legalese that confuses employees, bores them to the point of tuning out or both.
3. Not allotting enough of the budget to the benefits communications. Upper management often doesn’t have a handle on just how much solid benefits communications are going to cost — at least not in the same way HR does.
Benefits communication must be more detailed than standard inter-office communications, so it’s likely to take more time to prepare and produce.
4. Relying on workers will bring their benefits info home and discuss it with their family members.Effective benefits communication should always try to include spouses and family members.
5. Assuming employees will simply act on the messages in the benefit communications. It’s up to HR to specifically tell staffers what they should do with the benefits info as well as why.
6. Thinking workers will read their open enrollment materials cover to cover on their own time. The more HR can go over during the actual open enrollment meeting, the better. Of course, enrollment time shouldn’t be the only time benefits info should be addressed. Communication should be a year-long process.
7. Opting for “professional-sounding” language instead of simple “plain-speak” English. Sure, HR pros’ world is filled with jargon, buzzwords and benefits-related acronyms, but rank-and-file employees’ worlds are not. Keep the benefit communications as simple as possible.
8. Covering too much info. It’s only natural to try and cram everything possible into your open enrollment materials, but when there’s just too much being thrown at employees, they suffer from information overload — and retain little (if any) of what was covered.
Remember, continuous education is a proven way to improve employees’ decision-making regarding their benefits, which should be the goal of every communication effort..
Adapted from “Effective Benefit Communications” by Julie Adamik, CEBS, CCP, CBP, as presented at the 2015 Mid-Sized Retirement & Healthcare Plan Management Conference in San Diego.
Original post benefitspro.com
Even employees covered by an employer-sponsored health plan remain confused about the benefits that are free of charge to them under health care reform law. But employers say that they often don’t have the resources or effective communications tools to fully explain these benefits to the workforce.
This finding emerged from a small sample study by the Midwest Business Group on Health, which surveyed 53 workplaces, more than half of which had 5,000 or more employees in their plans.
The survey indicated that progress is being made: 62 percent said they were aware of all the free services, which include vaccinations, maternity and pregnancy related services, pediatric services and others. But another 36 percent admitted they weren’t aware of the full spectrum of these free benefits. (Just 2 percent pleaded complete ignorance of the benefits.)
The survey said that larger employers that often use participation incentives to increase benefits usage had higher rates of preventive service use compared to small- to mid-sized employers, with larger ones reporting about 60 percent participation and small-to-mid-sized around 50 percent. Overall, 53 percent said they offer such incentives.
“In addition,” the report said, “outside of the flu vaccination, survey respondents indicated they are not promoting important adult vaccinations, and for those that do, employee use is low.”
Digging deeper into the benefits available to workers, the study found that 58 percent of respondents offered vaccines only to those covered and their dependents. A small number — 42 percent — included retirees in the coverage.
The flu vaccine was far and away the most prevalent benefit for employers with onsite or near-site clinics, offered by 70 percent. Vaccinations for hepatitis B were the second most common, at 41 percent, with hepatitis A found in 39 percent of plans. Vaccinations for diseases such as HPV, shingles, pneumonia, measles and others were in the 27 percent to 37 percent range. Nearly half of plans (43 percent) covered all vaccinations costs.
Increasingly, larger employers, and even some with fewer employees, are turning to onsite service centers to encourage greater use of free preventive benefits. Nearly half reported having an onsite clinic, 21 percent said they use a near-site clinic, and 7 percent reported using a mobile van.
While overall, employers felt their benefits communications strategies were working fairly well, a major area where they are not finding success is in encouraging employees to choose a specific location to receive vaccines. This indicates that the employer-led national effort to attempt to steer workers to centers of excellence, or at least of cost efficiency, is not yet working well.
The MBGH has created a preventive benefits “toolkit” designed to help employers spread the word about free benefits and increase participation in them.
“Employers are the primary purchasers of health care for employees and families, so it’s important that these benefits are effectively understood and appropriately used,” said Larry Boress, MBGH president and CEO. “Otherwise, consumer engagement levels suffer, resulting in millions of benefit dollars being wasted each year. Many employers don’t know where to start or how to effectively communicate available preventive care benefits to their covered population. That’s why we’re launching an employer toolkit to help employers do a more effective job.”
Originally posted on June 15, 2015 by Marty Traynor on benefitspro.com.
Perhaps you saw the Time magazine cover, featuring a cherubic baby and the caption, “This baby could live to be 142 years old—Dispatches from the frontier of longevity.” The articles describe several of the advances being made in extending the human life span well beyond the three score and 10 cited in Psalm 90.
The article got me thinking about the potential impacts of extended life spans on benefits. In today’s world, we’ve begun to identify life cycle needs of employees and their families. We in the voluntary business have been doing this in enrollment meetings for many years.
Technology hasn’t changed the messages, just refined them. Voluntary enrollment systems and exchange systems are being built with life cycle logic in them. In the end, people with young families tend to need lots of term life insurance; people approaching retirement are in need of asset preservation products like long-term care and critical illness, and so on. What will our messaging be, though, in the world of a life expectancy at birth nearly double today’s?
Today’s millennials are putting off such decisions (and triggers for benefit needs) as marriage, home purchase and raising a family. In the future, it’s likely that the waiting period between education and commitment will continue to increase. Surely accident coverage will be more emphasized than today, since most diseases will be cured or prevented by enhanced treatments in the future and the greatest perceived risk to good health will be accidents. In fact, life insurance rates will probably approach today’s AD&D rates into a person’s 40s and it will hardly make sense to discuss “permanent” life insurance until a person is 50 or so.
Plus, the entire concept of retirement is likely to change, as people begin to experience multiple careers. Government benefits like Medicare and Social Security will change radically. Longer life expectancy will mean these programs will need to be able to pay benefits for decades more than their current design anticipates.
Insured benefits will need to change as well. Disability benefits based on retirement at age 65 with reduced benefits for those working after age 65 will become obsolete. Group life insurance reduction schedules will be, again, obsolete. For retirement planning, products in the immediate annuity family need to be revised.
But the biggest change will be the expectations and attitudes of individuals. While we don’t need to start planning benefit products that provide 142 years of benefits quite yet, the probability is high that our current portfolio will change significantly as we look forward, as will our generational messages to employees during enrollment.
Originally posted September 12, 2014 by Andrea Davis on http://ebn.benefitnews.com.
Joanne Burke can’t count the number of hours she spent researching special-needs law and preparing for meetings with educators and therapists about her daughter Gabby’s individualized education plan. Gabby, eight, was born with spina bifida, a birth defect that happens in utero when a baby’s still-developing spinal column doesn’t close all the way. When she was four, Gabby was also diagnosed with a rare form of epilepsy, which caused steep cognitive regression. Today, Gabby primarily uses forearm crutches to get around and attends third grade at a public school.
It is families like Burke’s that led Adam Goldberg to launch myEdGPS, a company that helps parents of children with special needs map out an education plan for their child. It’s a program that can be offered as a standalone employee benefit, and it is also being offered through Bright Horizons, a provider of child care services as part of that company’s suite of employer offerings. The Bright Horizons program, Special and Exceptional Needs, powered by myEdGPS, will be exclusively offered to companies with more than 3,500 U.S. employees by College Coach, a division of Bright Horizons specializing in providing answers to education concerns.
Burke’s employer, an automotive parts supplier based in Michigan where Burke lives with her husband and Gabby, has been supportive of her need for flexibility. They’ve offered Burke a flex-time schedule where she starts at 6:30 a.m. and leaves the office by 2:30 p.m. to collect Gabby from school. And, when she returned to work after Gabby was born, she was able to work from home on days when Gabby had multiple medical appointments. Still, when Gabby was ready to go to school, Burke spent countless hours attempting to figure out the family’s options. While she investigated sending Gabby to a private school, in the end, the private school could not handle Gabby’s multiple needs. Through the public school system, Gabby has access to physical and occupational therapy, as well as speech therapy.
“It’s just a lot of juggling. It’s almost like having two full-time jobs at once,” says Burke. “The case management aspect of it can be pretty heavy at times. It’s not all the time, but if there’s any sort of medical issue going on, it can take up a lot more time and effort to manage all of that at once.”
After years of providing private consulting services to parents who could afford to pay for it, Goldberg, who holds a masters’ degree in education with a concentration in assessment, realized that “we were turning away 95% of folks who couldn’t afford to pay for these types of private services,” he says. “This really was the manifestation of my burning desire to democratize the model and be able to scale it through technology so that we could have an impact on millions of children and their families out there.”
One in five children struggle with some type of special or exceptional need and Goldberg estimates that translates into an impact on 10% or more of the workforce. Working parents lose up to five hours a week running around to various doctor, therapist and teacher appointments, to say nothing of the hours they spend filling out paperwork and figuring out who’s paying for what.
Goldberg likens myEdGPS to TurboTax for special education because when parents first enter the online system, they’re asked a series of questions, a virtual intake of sorts. Then, depending on how far long parents are in their journey, the system serves up a series of roadmaps designed to guide parents and give them the necessary information, depending on what their needs and goals are.
They system also includes a virtual binder that can be accessed on any mobile device to help manage and store all the documentation involved. There’s also a calendar feature, which Goldberg says is particularly useful since different states have different timelines for when certain documentation needs to be provided and to whom.
“Once the system knows your child is being educated in Ohio, for example, and you request an evaluation, the system knows to alert you that within X number of school or calendar days, based on Ohio regulations, that you should expect to hear a response back from the school and then it goes to the next step in the timeline,” he explains.
The system also includes a behavioral tracking journal for parents and a letter generator “so that you can get it right the first time when you’re requesting an evaluation from the school or an independent evaluation of the school, or requesting a team meeting to address an issue,” says Goldberg.
Bright Horizons is currently piloting the program with a handful of companies, says CEO David Lissy. It’s included in the company’s core offerings but employers can also customize the program to include in-person education onsite and/or live webinars.
And apart from helping employers with productivity issues, Goldberg says myEdGPS offers the opportunity for tangible savings on health care expenses.
“What most people don’t know — including parents, administrators, and especially employers — is that the knee-jerk reaction is to go to the medical plan if you suspect something’s going on with your child, without any knowledge that you can actually get some of these same exact services from a school,” he explains. “That’s a federally mandated system. The two systems [health care and education] really don’t talk to each other that well. What we’re doing is we’re helping empower these parents to be able to understand what their rights are and how to go about it, step by step, finding the right help in the right ways through schools.”
For example, an employee has a five-year-old child who may not be hitting certain developmental milestones. The parent’s first instinct is to take the child to the pediatrician, who then refers the child to a series of specialists. Each visit requires the parent to take time off work, the medical plan incurs costs and the employee may have co-pays to deal with.
“The reality is, at the very beginning you should also be requesting an evaluation through school, because it’s free if you ask for it in the right way,” says Goldberg, adding that there’s a whole host of related services, including speech language therapy and some behavioral therapies, that are within the legal construct of the Individuals with Disabilities Education Act.
“All of this fundamentally is supposed to be free and in very many cases overlap with those medical services,” he says.
For Joanne Burke, who researched all of daughter Gabby’s educational and therapeutic needs herself, a service like myEdGPS would have been invaluable. “If I had access to a resource like this it would free up valuable time to address other issues,” she says. “The law is complex and learning how it affects our daughter as well as learning about accommodations and assistive technology is constantly in the back if my mind.”