Compliance Recap - July 2019

July was a busy month in the employee benefits world.

The Internal Revenue Service (IRS) released a notice that expands the list of preventive care benefits a high deductible health plan can provide without a deductible or with a deductible below the annual minimum deductible. The IRS also released the indexed affordability percentage for plan years beginning in 2020.

The U.S. Preventive Services Task Force (USPSTF) published an “A” rating final recommendation. The Department of Health and Human Services (HHS) released an update to the notice requirements for plans using the HHS-administered federal external review process.

A U.S. District Court upheld the 2018 short-term, limited-duration insurance final rule. The Third Circuit Court of Appeals affirmed a federal district court’s preliminary injunction regarding contraceptive coverage exemptions.

The Department of Labor (DOL) released an advisory opinion regarding association health plans (AHPs) and multiple employer welfare arrangements (MEWAs). The Fifth Circuit Court of Appeals held oral arguments for the case challenging the ACA’s constitutionality.

HHS and the Food and Drug Administration (FDA) published a Safe Importation Action Plan regarding potential drug importation from other countries.

UBA Updates

UBA released one new advisor: New HDHP Preventive Care Benefits

UBA updated or revised existing guidance:

IRS Expands Benefits That Can Be Provided Before HDHP Annual Minimum Deductible Is Met

The Internal Revenue Service (IRS) released a notice, effective on July 17, 2019, that expanded the list of preventive care benefits that a high deductible health plan (HDHP) can provide without a deductible or with a deductible below the annual minimum deductible.

Preventive Care for Specified Conditions For Individuals Diagnosed with
Angiotensin Converting Enzyme (ACE) inhibitors Congestive heart failure, diabetes, and/or coronary artery disease
Anti-resorptive therapy Osteoporosis and/or osteopenia
Beta-blockers Congestive heart failure and/or coronary artery disease
Blood pressure monitor Hypertension
Inhaled corticosteroids Asthma
Insulin and other glucose lowering agents Diabetes
Retinopathy screening Diabetes
Peak flow meter Asthma
Glucometer Diabetes
Hemoglobin A1c testing Diabetes
International Normalized Ratio (INR) testing Liver disease and/or bleeding disorders
Low-density Lipoprotein (LDL) testing Heart disease
Selective Serotonin Reuptake Inhibitors (SSRIs) Depression
Statins Heart disease and/or diabetes

The services and items listed above are treated as preventive care:

  • only when prescribed to treat a person diagnosed with the associated chronic condition listed in the table’s second column, and
  • only when prescribed for the purpose of preventing the chronic condition’s exacerbation or a secondary condition’s development.

Read more about the expanded list of preventive care benefits.

IRS Releases the Indexed 2020 Affordability Percentage

The Internal Revenue Service (IRS) released the indexed affordability percentage of 9.78% for plan years beginning in 2020. An employer uses the affordability percentage to determine whether it has offered affordable coverage under the Patient Protection and Affordable Care Act’s employer shared responsibility provisions to avoid Penalty B.

Read more about the affordability percentage.

USPSTF Issues a Final Recommendation Giving PrEP an “A” Rating

The U.S. Preventive Services Task Force (USPSTF) published a final recommendation that gives an “A” rating to preexposure prophylaxis (PrEP) treatment. This means that the USPSTF recommends offering PrEP with effective antiretroviral therapy to people at high risk of HIV acquisition.

Group health plans and insurers subject to the preventive services coverage mandate must provide coverage for evidence-based items or services with an A or B rating recommended by the USPSTF without imposing copayments, coinsurance, deductibles, or other cost-sharing requirements when delivered by in-network providers. Group health plans and insurers subject to the preventive services coverage mandate generally must cover preventive services that are recommended by the USPSTF one year after the recommendation is issued.

HHS Releases Updated Notice Requirements for the HHS Federal External Review Process

On July 12, 2019, the Department of Health and Human Services (HHS) released updated requirements for notices that self-insured non-federal governmental health plans and health insurance issuers – using the HHS-administered federal external review process – must provide to their plan participants and beneficiaries.

District Court Upholds Short-Term Limited Duration Insurance Final Rule

As background, on August 1, 2018, the Internal Revenue Service (IRS), the Department of Health and Human Services (HHS), and the Department of Labor (DOL) (collectively, the Departments) released a final rule that amended the definition of short-term, limited-duration insurance (STLDI). HHS also released a fact sheet on the final rule. The final rule allows consumers to purchase STLDI policies that are less than 12 months in length and may be renewed for up to 36 months.

On July 18, 2019 the U.S. District Court for the District of Columbia (court) upheld the STLDI final rule. The court found that the final rule did not exceed the regulatory authority that Congress delegated to the Departments to define STDLI as a category of insurance that is exempt from individual insurance regulations. Employers should keep apprised of potential future developments as the case may be appealed.

Read more about the STDLI final rule.

Recent Litigation on the Contraceptive Coverage Exemption Rules

As background, the Department of the Treasury (Treasury), Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively, the Departments) published two final rules on November 15, 2018, regarding contraceptive coverage exemptions, to be effective on January 14, 2019. On January 14, 2019, the U.S. District Court for the Eastern District of Pennsylvania (Pennsylvania Court) granted a nationwide preliminary injunction that prohibits the implementation of the two final rules.

On July 12, 2019, the Third Circuit Court of Appeals (appeals court) affirmed the Pennsylvania Court’s preliminary injunction that prohibits the two final rules’ enforcement nationwide. The appeals court found that, until the final rules’ legality is decided, the injunction will allow states to avoid the imminent financial burden of subsidizing contraceptive services, providing funds for medical care associated with unintended pregnancies, and absorbing medical expenses that arise from decreased use of contraceptive medications for other health conditions.

The appeals court decision means that the Departments are prohibited from implementing and enforcing both final rules nationwide.

Read more about the status of the ACA contraceptive coverage mandate and exemption.

DOL Releases Advisory Opinion on AHPs and MEWAs

The Department of Labor (DOL) released an advisory opinion that analyzed a large retailer’s proposed group health plan to determine that the plan would be an association health plan (AHP) and a multiple employer welfare arrangement (MEWA) under ERISA. Although the advisory opinion can only be relied on by the retailer who requested it, the opinion gives employers an overview of the criteria that the DOL reviews when determining whether a plan fits the AHP definition that existed before the DOL’s 2018 AHP final rule. The opinion also provides a summary of the criteria that the DOL reviews when determining whether an arrangement is a MEWA.

Read more about AHPs.

Status of Court Case Challenging ACA Constitutionality

As background, in February 2018, twenty states filed a lawsuit asking the U.S. District Court for the Northern District of Texas (Court) to strike down the Patient Protection and Affordable Care Act (ACA) entirely. The lawsuit came after the U.S. Congress passed the Tax Cuts and Jobs Act in December 2017 that reduced the individual mandate penalty to $0, starting in 2019.

On December 14, 2018, the Court issued a declaratory order that the individual mandate is unconstitutional and that the rest of the ACA is unconstitutional. The Court granted a stay of its December 2018 order, which prohibits the order from taking effect while it is being appealed in the Fifth Circuit Court of Appeals (appeals court).

On July 3, 2019, the Department of Justice filed its supplemental brief to assert that the court decision striking down the ACA should not apply beyond the 18 plaintiff states. On July 9, 2019, the appeals court held oral arguments.

HHS and FDA Release Safe Importation Action Plan

The Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) issued a Safe Importation Action Plan that overviews two pathways that could permit drug importation from foreign countries. HHS also issued a press release.

Under the first pathway, HHS would propose rules to allow states, wholesalers, and pharmacists to submit demonstration project plans designed to: import Canadian-approved drugs that are versions of FDA-approved drugs; meet certain conditions such as drug quality, record keeping, testing, and protections against counterfeiting; and significantly reduce consumer drug cost.

Under the second pathway, manufacturers of FDA-approved drugs could import versions of FDA-approved drugs that they sell in foreign countries, if they establish with the FDA that the foreign version is the same as the U.S. version.

Question of the Month

Q: What if a plan sponsor fails to file or pay the PCORI fee?

A: Although the PCORI statute and its regulations do not include a specific penalty for failure to report or pay the PCORI fee, the plan sponsor may be subject to penalties for failure to file a tax return because the PCORI fee is an excise tax.

A plan sponsor should consult with its attorney on how to proceed with a late filing or late payment of the PCORI fee. The PCORI regulations note that the penalties related to late filing of Form 720 or late payment of the fee may be waived or abated if the plan sponsor had reasonable cause and the failure was not due to willful neglect.

If a plan sponsor already filed Form 720 (for example, for a different excise tax), then the plan sponsor can make a correction to a previously filed Form 720 by using Form 720X.

8/1/2019


Commercial Risk Advisor - August 2019

Dress Code Policy Considerations

Clothing and fashion choices can be a fun way for your employees to express themselves while also helping them feel comfortable. But, not all types of expression and comfort are appropriate for the workplace.

The reasons for establishing a dress code can vary, whether maintaining professionalism or guaranteeing safety. Regardless of why your company might need one, it’s important to put thought into crafting your dress code.

Think about these five considerations when putting together a fair and appropriate dress code:

  • Safety—Keep the work environment free of any unnecessary hazards. For example, do not allow employees working with machinery to wear loose jewelry. Also, require appropriate footwear when necessary, such as steel-toed boots or non-slip shoes.
  • Equality—Your employees may come from a wide variety of backgrounds. Make sure that your dress code does not discriminate when it comes to race, religious beliefs and employees with disabilities. Apply the same standards for men and women.
  • Culture—When drafting your dress code, be consistent with the culture and image that your company projects. An organization that claims to be casual and relaxed should think twice before implementing a formal dress code.
  • Balance—You want your workplace to be professional, but you also want your employees to be comfortable. It makes sense to ask employees to wear a suit if meeting with a big client, but otherwise, consider letting them dress down.
  • Current social norms—Understanding current social norms are important. For example, in today’s society, many candidates may have tattoos or piercings. Talk about what is acceptable for your company. A dress code that is too strict can have a negative effect on your organization recruiting top talent.

Four of the 10 costliest hurricanes in U.S. history have occurred in the past decade.

Preparing for Hurricane Season

Hurricane season runs from June through November and brings plenty of risks. Threats relating to hurricanes don’t only apply to homeowners and aren’t limited simply to physical damage either.

There are plenty of ways that a storm can blow away your business. According to FEMA, over 40% of small businesses never reopen after a disaster, and 90% close within a year if they aren’t able to reopen within five days.

An organization that claims to be casual and relaxed should think twice before implementing a formal dress code.

Protect your company and your employees by taking these steps to be as prepared as possible:

  • Reinforce your workplace from weather hazards with things like window shutters to block flying debris, and sandbags to absorb floodwater.

  • Have an emergency response plan in place and make sure that your employees are trained to follow it. Emergency response plans can include steps such as establishing warning and evacuation procedures, ensuring reliable means of communication, and having supplies such as food, water, flashlights and batteries on hand.
  • Beyond protecting your employees and your physical workplace, it is also important to ensure that your business can function following a hurricane. Back up your data off-site regularly, and test the recovery process to make sure that everything is working properly.
  • Make sure that you are prepared to contact the correct people to get back on your feet. Try to connect with a contractor or restoration company before a hurricane strikes.
  • Even if your business is prepared for a hurricane, others might not be. Companies that you partner with or rely upon could be damaged and hinder your own ability to function. Talk to other businesses that you work with and make sure that they have contingency plans.

An organization that claims to be casual and relaxed should think twice before implementing a formal dress code.

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Trucking Risk Advisor - August 2019

CVSA Brake Safety Week: Sept 15-20

The Commercial Vehicle Safety Alliance’s (CVSA) Brake Safety Week is scheduled for Sept. 15-21. Roadside safety inspections on commercial motor vehicles will be conducted throughout North America by law enforcement officials. Brake Safety Week is an initiative by the CVSA in an effort to lessen the severity and number of crashes caused by faulty brake systems.

Although all components of a motor vehicle’s brake system are crucial to overall safety and function, the inspectors will be paying close attention to a vehicle’s brake hoses and tubing this year. The result of last year’s three-day International Roadcheck enforcement campaign showed that brake system violations made up 45% of all out-of-service violations.

If your commercial vehicle fails to meet the CVSA braking standards or any other inspection item, your vehicle may receive a violation that will result in traveling restrictions until the violation has been corrected.

Inspectors will be looking at four main factors when checking the hoses and tubing of a commercial motor vehicle’s brake system, checking to make sure they are:

  • Undamaged
  • Properly attached
  • Leak-free
  • Appropriately flexible

In order to pass the inspection, all commercial trucks and combination vehicles over a gross weight of 10,000 pounds must have a braking efficiency of at least 43.5%. In 14 jurisdictions, this calculation will be determined by using performance-based brake testers (PBBT), which calculate overall brake efficiency and force over the total gross weight.

Avoid violations during this year’s inspection by conducting regular maintenance on all vehicle operational systems.

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Supporting Mental Health in the Workplace

Within the past five years, employers have more aggressively worked to inform employees about what resources are available to them in regards to mental health. Continue reading this blog post from UBA to learn more about supporting mental health in the workplace.


Mental Health Month in May each year is a campaign to raise overall awareness about mental health in America that started in 1949. The effort to bring mental health to the forefront of employee wellness conversations is relatively new. According to Employee Benefit News, it’s only been in the last five years that employers have more aggressively worked to inform employees about what help is available and also encourage employees to get help, putting mental health treatment in the same space as any health concern.

Work-related stress, ranging from pressure of our always-connected culture to burnout, impacts absenteeism and performance. So, too, does non-work-related stress, like personal and financial worries, health challenges, and even the current political climate, says HR Executive. Anxiety and depression diagnoses are up by double-digit percentages, per another article in HR Executive. Additionally, the link between mental health and physical health is clear. Anxiety and depression are risk factors for health concerns like heart disease and stroke. With more than three in four employees saying they’ve struggled with a mental health challenge, this is not an issue concerning only a small minority of employees.

For many, fear about discrimination from peers, managers, or leadership, the stigma surrounding mental health in general, as well as specific concerns about job protection make sharing a diagnosis or seeking help unappealing. This is an organizational challenge and requires an organizational response. Since culture starts at the top, this must include an accessible plan visibly championed by leadership, who help create a workplace culture that supports mental health, offers comprehensive programs and benefits, recommends resources engages employees at all level in decision-making and more.

HR departments need to promote and share the services that are available via health insurance plans or employee assistance programs. Additionally, HR teams, or perhaps all employees, need training on how to recognize symptoms of a mental health challenge and respond by offering resources. Even simple steps like encouraging mindfulness about language or jokes that call out mental health can also help create a climate that encourages openness and support.

As we learn more about the spectrum of mental health, and how often and fluidly individuals move between fully functional and a crisis, the more important empathic, proactive support will be. Many companies have worked to bolster mental health offerings and de-stigmatize seeking help when a crisis strikes. The next step, according to HR experts, is to offer preventative or proactive resources to help employees build resiliency and learn stress management techniques, says Harvard Business Review.

Beyond traditional components like talk therapy and medical interventions as part of health plans or employee-assistance programs, many companies are turning to tech resources, like apps for meditation or tools that gamify or encourage exercise and sleep as well as content on demand, like webinars on parenting, stress reduction, and other relevant topics.

Higher employee assistance plan utilization leads to lower short-term and long-term disability claims, according to HR Executive. Leaders concerned about employees seeking treatment and taking time away from work can look to data like this that shows returns on an investment in employee mental health. Beyond being the right thing to do for employees, it’s often the right thing to do for the bottom line.

Read more:

7 Ways to (Effectively) Address Mental Health in the Workplace

5 Ways Bosses Can Reduce the Stigma of Mental Health at Work

The Case for Supporting Mental Health in the Workplace

Use these Innovative Strategies to Improve Mental Health

It’s Time to Remove the Barriers, Stigma Around Mental Healthcare

SOURCE: Olson, B. (2 July 2019) "Supporting Mental Health in the Workplace" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/supporting-mental-health-in-the-workplace


Compliance Recap - June 2019

June was a relatively busy month in the employee benefits world. The Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Department of Treasury published final rules that removed the prohibition against integrating a health reimbursement arrangement (HRA) with individual health insurance coverage and recognized certain HRAs as limited excepted benefits.

A U.S. District Court issued a permanent injunction against the Patient Protection and Affordable Care Act contraception mandate. The President signed an executive order directing federal agencies to issue guidance and regulations regarding high deductible health plans with health savings accounts, Section 213 medical care expenses, flexible spending arrangements, health plan communication of out-of-pocket costs, and surprise billing.

The Department of Health and Human Services’ Office for Civil Rights (OCR) issued frequently asked questions (FAQs) regarding HIPAA compliance for health plans during care coordination and continuity.

UBA Updates

UBA released a new Advisor: Tri-Agency Final Rules on Health Reimbursement Arrangements

UBA updated or revised existing guidance: Contraception Mandate Rolled Back for Employers

DOL, HHS, and Treasury Publish Final Rules on Health Reimbursement Arrangements

On June 20, 2019, the Department of Labor (DOL), Department of Health and Human Services (HHS), and the Department of Treasury (Treasury) (collectively, the Departments) published their final rules regarding health reimbursement arrangements (HRAs) and other account-based group health plans. The DOL also issued a news release, frequently asked questions, model notice, and model attestations.

The final rules’ goal is to expand the flexibility and use of HRAs to provide individuals with additional options to obtain quality, affordable healthcare. According to the Departments, these changes will facilitate a more efficient healthcare system by increasing employees’ consumer choice and promoting healthcare market competition by adding employer options.

To do so, the final rules expand the use of HRAs by:

  • Removing the prohibition against integrating an HRA with individual health insurance coverage (individual coverage HRA)
  • Expanding the definition of limited excepted benefits to recognize certain HRAs as limited excepted benefits if certain conditions are met (excepted benefit HRA)
  • Providing premium tax credit (PTC) eligibility rules for people who are offered an HRA integrated with individual coverage
  • Assuring HRA and Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) plan sponsors that reimbursement of individual coverage by the HRA or QSEHRA does not become part of an ERISA plan when certain conditions are met
  • Changing individual market special enrollment periods for individuals who gain access to HRAs integrated with individual coverage or who are provided QSEHRAs

The final rules will be effective on August 19, 2019, and generally apply for plan years beginning on or after January 1, 2020.

However, the final rules under Section 36B (regarding PTCs) apply for taxable years beginning on or after January 1, 2020, and the final rules providing a new special enrollment period in the individual market apply January 1, 2020.

Read more about the final rules.

District Court Issues Permanent Injunction against ACA’s Contraception Mandate

On June 5, 2019, the U.S. District Court for the Northern District of Texas issued a permanent injunction against the Patient Protection and Affordable Care Act (ACA) contraception mandate. The injunction prohibits the federal government from enforcing the contraception mandate against an employer, group health plan, or health insurer that objects, based on sincerely held religious beliefs, to establishing, maintaining, providing, offering, or arranging for coverage or payment for some or all contraceptive services. The injunction also exempts objecting entities from the accommodations process.

The permanent injunction also prohibits enforcement of the contraception mandate for individuals who object to coverage or payments for some or all contraceptive services based on sincerely held religious beliefs and who are willing to obtain health insurance that excludes coverage for payments for some or all contraceptive services.

Employers who object to contraceptive coverage based on sincerely held religious beliefs are no longer required to comply with the ACA’s contraception mandate for those contraceptives to which they object.

Read more about the contraception mandate and court case.

Executive Order on Improving Healthcare Price and Quality Transparency

On June 24, 2019 President Trump signed an executive order directing federal agencies to increase healthcare quality and price transparency. The executive order does not create any new laws or regulations.

The executive order directs the Department of Treasury to:

  • Issue guidance that would expand individuals’ ability to enroll in high deductible health plans that can be used with a health savings account to cover low-cost preventive care before the deductible is met
  • Propose regulations that would treat certain expenses associated with direct primary care arrangements and healthcare sharing ministries as Section 213 medical care expenses
  • Issue guidance that would increase the amount of flexible spending arrangement funds that can be carried over to the next plan year without penalty

The executive order directs the Department of Health and Human Services to:

  • Seek comments on a proposal to require health insurance issuers and self-insured group health plans to provide or give patients access to expected health care out-of-pocket costs before receiving care
  • Report steps that can be taken to implement principles announced in a fact sheet on protecting patients from surprise billing

HHS Issues HIPAA FAQs

The Department of Health and Human Services’ Office for Civil Rights (OCR) issued two frequently asked questions (FAQs) clarifying how the Health Insurance Portability and Accountability Act (HIPAA) privacy rules permit health plans to share protected health information (PHI) for care coordination and continuity.

If certain conditions apply, a health plan may disclose PHI, without an individual’s written authorization and subject to the minimum necessary standard, to another health plan for its own health care operations purposes, or for the other health plan’s health care operations. OCR provides two examples:

  • If Covered Entity A provides health insurance to a person who receives access to the provider network of another plan provided by Covered Entity B, Covered Entity A is permitted to disclose the person’s PHI to Covered Entity B for care coordination.
  • If a person was enrolled in a health plan of Covered Entity A and switches to a health plan of Covered Entity B, Covered Entity A can disclose PHI to Covered Entity B to coordinate the person’s care.

If certain conditions are met, HIPAA permits a covered entity to use PHI in its possession about individuals to inform them about the availability of other health plans it offers, without the person’s authorization. For example, when Plan A discloses a person’s PHI to Plan B, Plan B is permitted to send communications to the person about Plan B’s health plan options that may replace the person’s current plan, if Plan B receives no remuneration for sending the communication and complies with applicable business associate agreements. 

Question of the Month

  1. Which group health plans must file a Form 5500 and when is it due?
  2. Currently, group welfare plans generally must file Form 5500 if:
  • The plan is fully insured and had 100 or more participants on the first day of the plan year (dependents are not considered “participants” for this purpose unless they are covered because of a qualified medical child support order).
  • The plan is self-funded and it uses a trust, no matter how many participants it has.
  • The plan is self-funded and it relies on the Section 125 plan exemption, if it had 100 or more participants on the first day of the plan year.

There are several exemptions to Form 5500 filing. The most notable are:

  • Church plans defined under ERISA 3(33)
  • Governmental plans, including tribal governmental plans
  • Top hat plans which are unfunded or insured and benefit only a select group of management or highly compensated employees
  • Small insured or unfunded welfare plans. A welfare plan with fewer than 100 participants at the beginning of the plan year is not required to file an annual report if the plan is fully insured, entirely unfunded, or a combination of both.

A plan is considered unfunded if the employer pays the entire cost of the plan from its general accounts. A plan with a trust is considered funded.

A plan’s Form 5500 must be filed electronically by the last day of the seventh month after the close of the plan year. The filing date is based on the “plan year,” which is designated in the Summary Plan Description (SPD) or other governing document. If a plan does not have an SPD, the plan year defaults to the policy year.

For calendar year plans, the due date for Form 5500 is July 31. Employers may obtain an automatic  2-1/2 month extension by filing Form 5558 by the due date of the Form 5500.

7/3/2019


Move over, financial wellness. It’s time for financial flexibility

Despite the fact that Americans have recovered from the Great Recession, most employees today live paycheck-to-paycheck, leaving many employees stressed out about their finances. Read this blog post to learn more about financial flexibility.


It’s somewhat hard to believe that most employees today continue to live paycheck-to-paycheck. Despite the fact that Americans have recovered from the Great Recession a decade ago and that the unemployment rate is the lowest it has been in many years, employees are essentially making the same amount of money they did during the pre-recession “good days” many years ago. Of course, living costs have gone up in this same period.

That means employees are stressed about their finances. They don’t have enough emergency savings for unexpected expenses and struggle to make minimum monthly payments on credit cards and loans. And the problem is bigger than that because their financial stress also distracts them at work. Whether it’s student loans, car payments, mortgage/rent payments, credit card debt, an unexpected expense or some other financial matter that they are worried about, the bottom line is they are spending time at work on these issues rather than doing the job employers are paying them to do.

Thus, employees’ personal financial stress affects employers as well. When employees bring that financial stress to work, it results in low productivity, absenteeism and, in many cases, higher healthcare costs.

Today’s employees want to make their money to do more. Financial flexibility can help them get there.

So what is financial flexibility? It’s the ability to manage expenses and make everyday life affordable. It’s the financial stage beyond living paycheck-to-paycheck. It means being smart about how we use our monthly income and finding ways to make our money do more so that we are able to pay bills on time, take a vacation, have an emergency fund for unexpected expenses and perhaps splurge on something small occasionally. Financial flexibility is the stage between living paycheck-to-paycheck and financial security (a level few employees ever achieve).

Being financially flexible means finding ways to make our money do more by following a monthly budget, being wise shoppers and taking advantage of employer-offered financial wellness tools and voluntary benefits such as financial counseling, student loan refinancing programs, employee purchase programs and payroll-deducted savings programs.

Providing financial flexibility at work

Financial education benefits can help employees with budgeting and debt reduction needs, and over the past several years, growing numbers of employees have begun using the services their employer provides to assist them with their personal finances.

But it takes more to have financial flexibility. While financial education benefits can help employees with budgeting and debt reduction needs, employers should adopt additional voluntary benefits that provide employees the opportunity to have some financial flexibility.

Among these are:

  • Low-interest installment loans and credit that help employees avoid payday loans and cash advances from credit cards when they have emergency needs such as unexpected out-of-pocket medical expenses.
  • Student loan repayment benefit programs in which employers are making contributions to loan balances or providing methods for employees to refinance their debt.
  • Automated savings programs that encourage employees to start taking control of their financial future by saving money each month from their paycheck. Many employees don’t have $1,000 or more in savings to use for emergencies and saving a little each month can help build that emergency fund.
  • Employee purchase programs that allow workers to purchase consumer products and services through payroll deduction when they are unable or prefer not to use cash or credit. The program is an alternative to high-interest credit cards and other sub-prime financing options for customers desiring to pay for a purchase over time.
  • Bill payment programs that empower employees with debt paydown strategies and the ability to make recurring bill payments on-time each month through payroll deduction

Today’s employees want — and need — their money to do more so they aren’t living paycheck-to-paycheck. Employees who are less financially stressed are happier. That results in more engaged, productive workers and an increased bottom line for employers. The new normal is financial flexibility. And there’s a role for voluntary benefits in helping employees get there.

SOURCE: Halkos, E. (23 April 2019) "Move over, financial wellness. It’s time for financial flexibility" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/use-voluntary-benefits-to-help-employee-financial-wellness


Tri-Agency Final Rules on Health Reimbursement Arrangements

Final rules regarding health reimbursement arrangements (HRAs) and other account-based group health plans were recently released by the Department of the Treasury (Treasury), Department of Labor (DOL), and Department of Health and Human Services (HHS). Read this compliance update to learn more.


The Department of the Treasury (Treasury), Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively, the Departments) released their final rules regarding health reimbursement arrangements (HRAs) and other account-based group health plans. The DOL also issued a news releasefrequently asked questionsmodel notice, and model attestations.

The final rules’ goal is to expand the flexibility and use of HRAs to provide individuals with additional options to obtain quality, affordable healthcare. According to the Departments, these changes will facilitate a more efficient healthcare system by increasing employees’ consumer choice and promoting healthcare market competition by adding employer options.

To do so, the final rules expand the use of HRAs by:

  • Removing the prohibition against integrating an HRA with individual health insurance coverage (individual coverage HRA)
  • Expanding the definition of limited excepted benefits to recognize certain HRAs as limited excepted benefits if certain conditions are met (excepted benefit HRA)
  • Providing premium tax credit (PTC) eligibility rules for people who are offered an HRA integrated with individual coverage
  • Assuring HRA and Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) plan sponsors that reimbursement of individual coverage by the HRA or QSEHRA does not become part of an ERISA plan when certain conditions are met
  • Changing individual market special enrollment periods for individuals who gain access to HRAs integrated with individual coverage or who are provided QSEHRAs

The final rules will be published in the Federal Register on June 20, 2019, be effective on August 19, 2019, and generally apply for plan years beginning on or after January 1, 2020.

However, the final rules under Section 36B (regarding PTCs) apply for taxable years beginning on or after January 1, 2020, and the final rules providing a new special enrollment period in the individual market apply January 1, 2020.

An HRA is a type of account-based group health plan funded solely by employer contributions that reimburses an employee for Section 213(d) medical care expenses incurred by the employee, or the employee’s spouse, dependents, and children who are not age 27 as of the end of the taxable year, up to a maximum fixed-dollar amount during a coverage period.

These reimbursements are excludable from the employee’s income and wages for federal income tax and employment tax purposes. An HRA can allow amounts that remain at the end of the year to be available to reimburse medical care expenses incurred in later years.


CMS Publishes 2020 Benefit Payment and Parameters Final Rule

The Centers for Medicare and Medicaid Services (CMS) has released its final rule and fact sheet regarding benefit payment and parameters for 2020. Read this blog post from UBA to find out which topics this final rule addresses.


The Centers for Medicare and Medicaid Services (CMS) published its final rule and fact sheet for benefit payment and parameters for 2020. Although the final rule primarily affects the individual market and the Exchanges, the final rule addresses the following topics that may impact employer-sponsored group health plans:

  • The 2020 maximum annual limitation on cost sharing is $8,150 for self-only coverage and $16,300 for other-than-self-only coverage.
  • For fully-insured plans, any indication of a reduction in the generosity of a benefit for individuals that is not based on clinically indicated, reasonable medical management practices is potentially discriminatory.
  • Amounts paid toward cost sharing using direct support by drug manufacturers (for example, coupons) to insured patients to reduce or eliminate immediate out-of-pocket costs for specific prescription brand drugs that have a generic equivalent are not required to be counted toward the annual limitation on cost sharing.
  • Federally Facilitated Small Business Health Options Programs (FF-SHOPs) may operate a toll-free hotline rather than a more robust call center.

The final rule is effective on June 24, 2019. The final rule generally applies to plan years beginning on or after January 1, 2020.

SOURCE: Hsu, K. (13 June 2019) "CMS Publishes 2020 Benefit Payment and Parameters Final Rule" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/cms-publishes-2020-benefit-payment-and-parameters-final-rule


Safety Focused Newsletter - June 2019

Emergency Preparedness During National Safety Month

It’s always important to take a proactive approach to safety in the workplace, but sometimes an emergency can arise at a moment’s notice. Taking some time to plan before an incident takes place can help you take action quickly and ensure the safety of yourself and your co-workers. And, because the National Safety Council organizes National Safety Month every June, it’s a great time to review emergency preparedness in various workplace settings.

Here are some strategies to help ensure you’re ready to respond to an emergency in the workplace:

  • Check workplace policies—There may already be plans in place for how to respond to an emergency, but they’ll only be effective if you and your co-workers follow them. These plans may also include evacuation routes or strategies to help contain a hazard.
  • Stay focused and calm—You may not have time to react to an emergency, so you should always be ready to get to safety at any time. Try to keep essentials on hand so can take them with you, as you should never go back to a dangerous area to gather your belongings.
  • Have a communication plan—After you’re in a safe area, you should have a plan to communicate with your manager, co-workers or emergency responders. Try to meet in a designated location that’s established by a workplace policy and give an update on your status as soon as possible.
  • Help others when possible—Make your own safety a priority during an emergency, but offer any help you can if there aren’t any hazards present. It may be a good idea to check the locations of first-aid kits in your workplace if you need to treat an injury.

According to the Centers for Disease Control and Prevention, there are about 330 heat-related fatalities every year.

5 Tips for Outdoor Heat Safety

The hot summer months can cause body temperatures to rise to unsafe levels, especially when combined with strenuous work. Outdoor workers are also be vulnerable to heat-related illnesses since they spend long periods in direct sunlight.

There are many types of heat illnesses, such as heat stroke, heat exhaustion, dehydration and heat cramps. Each of these conditions have various symptoms, but they commonly cause dizziness, weakness, nausea, blurred vision, confusion or loss of consciousness.

Here are some tips for staying safe in the heat while working outdoors:

  1. Wear loose, light-colored clothing so your skin gets air exposure.
  2. Shield your head and face from direct sunlight by wearing a hat and sunglasses.
  3. Take regular breaks to rest in a shaded area. If you’re wearing heavy protective gear, consider removing it to help cool off even more.
  4. Ease into your work and gradually build up to more strenuous activity as the day progresses. You should also avoid overexerting yourself during the hottest hours of the day.
  5. Drink water frequently, even if you aren’t thirsty. Experts recommend drinking at least eight ounces every 20 to 30 minutes to stay hydrated. Stick to water, fruit juice and sport drinks and avoid caffeinated beverages, as they can dehydrate you.

Employees should take care to monitor themselves and their co-workers on hot days. If you notice any signs of heat illness, notify your on-duty supervisor immediately.

Heat illnesses can usually be treated by being moved to a cooler area and drinking cool liquids. In extreme cases when heat illnesses cause unconsciousness, health care professionals should be alerted immediately.

Taking some time to plan before an incident takes place can help you take action quickly and ensure the safety of yourself and your co-workers.

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Construction Risk Advisor - June 2019

Trenching and Excavating Safety

Excavations are any man-made cuts, cavities, trenches or depressions formed by earth removal. Of these, trenches—narrow excavations made below the surface of the ground—create the most significant workplace hazards, particularly as they relate to:

  • Cave-ins
  • Hazardous atmospheres (e.g., carbon monoxide, noxious gas, vapors or a lack of oxygen)
  • Falls (e.g., a worker accidently falls into a trench and injures themselves)
  • Floods or water accumulation
  • Mobile equipment (e.g., equipment operated or stored too close to the excavation site falls into the trench)

Above all, cave-ins present the greatest risk in trenching and are more likely to result in worker fatalities than any other excavation-related accidents. In fact, one cubic yard of soil can weigh as much as a car, leading to serious injuries or even death in the event of a trench collapse. In order to keep workers safe, employers must consider one or more of the following protective systems:

  • Shoring involves installing aluminum hydraulic or other types of supports to prevent soil movement and cave-ins. Shoring systems typically consist of posts, wales, struts and sheeting.
  • Benching/sloping is a method of protecting workers from cave-ins by excavating the sides of an excavation to form one or a series of horizontal levels or steps, usually with vertical or near vertical surfaces between levels. Sloping, if done correctly, removes the risk of cave-ins by sloping the soil of the trench back from the trench bottom.
  • Shielding protects workers by using trench boxes or other types of supports to prevent soil cave-ins.

For more information on construction safety, contact Hierl Insurance Inc. today.

Newsletter Provided by: Hierl's Property & Casualty Experts

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