District Court Vacates Parts of ACA Section 1557 Nondiscrimination Rule

Any programs administered by the Department of Health and Human Services (HHS) or any health program or activity administered by an entity established under Title I of the ACA falls under Section 1557 of the ACA. Recently, the U.S. District Court for the Northern District of Texas (District Court) vacated portions of the current rule implementing Section 1557. Read this blog post from UBA to learn more about this compliance update.


As background, the Patient Protection and Affordable Care Act (ACA) Section 1557 provides that individuals shall not be excluded from participation in, denied the benefits of, or be subjected to discrimination under any health program or activity which receives federal financial assistance from the Department of Health and Human Services (HHS), on the basis of race, color, national origin, sex, age, or disability. The current rule applies to any program administered by HHS or any health program or activity administered by an entity established under Title I of the ACA. These applicable entities are “covered entities” and include a broad array of providers, employers, and facilities. On May 13, 2016, the Department of Health and Human Services (HHS) issued a final rule (current rule) implementing Section 1557, which took effect on July 18, 2016.

On October 15, 2019, the U.S. District Court for the Northern District of Texas (District Court) vacated portions of the current rule implementing Section 1557 that prohibit discrimination on the basis of gender identity and pregnancy termination. The District Court remanded the vacated portions of the current rule to HHS for revision. While those portions of the current rule have been vacated, covered entities subject to Section 1557 may still face private lawsuits for discrimination based on gender identity and pregnancy termination.

Employers who are subject to Section 1557 should stay informed on this litigation because it is anticipated that the District Court’s ruling will be appealed to the Fifth Circuit Court of Appeals.

SOURCE: Hsu, K. (21 November 2019) "District Court Vacates Parts of ACA Section 1557 Nondiscrimination Rule" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/district-court-vacates-parts-of-aca-section-1557-nondiscrimination-rule


Key factors in choosing your benefits during open enrollment

Even if your employees are veterans when it comes to open enrollment, the employer-sponsored benefits landscape is shifting. With the number of benefits that are now available to employees, how do employees select the right benefits for them? Read this blog post from Employee Benefit News for a few key factors to consider when choosing your benefits during open enrollment.


Even if you are a veteran in choosing employer-sponsored benefits, the landscape is shifting. Over the past years, we’ve seen changes to mental health counseling stipends, extended maternity/paternity leave and family building. Companies across industries are realizing that in order to attract and retain talent, they need to provide best in class benefits that save employers unforeseen costs in the long run, and shows employees that their employers are invested in their well-being — in and out of the office.

With all these available options and only a short window to select what’s right for you, here’s what should you look out for during open enrollment.

Which benefits matter to me?

The beauty of a diverse workforce is that employees may represent various walks of life. However, this means that not all benefits make sense for every person. Perhaps your boss is prioritizing childcare for his toddler while your colleague is looking to refinance student loans. Whatever your life circumstance, ask yourself, “Which benefits are most pertinent to my life and life goals in the coming year?”

For instance, fertility benefits may not be immediately attractive at first glance, even if you’re actively thinking about starting a family. But 1 in 8 couples will be impacted by infertility and treatment without coverage can be wildly expensive. It’s important to make sure you’re thinking critically and getting all the necessary information when browsing for your benefits. Rule of thumb: if this could impact you in the coming year, even if you’re not 100% sure, opt-in for coverage.

What’s actually covered?

During open enrollment, be sure to ask your benefits team about how robust each offering is and what’s included. A particular benefit may look like it has a lot to offer, but after further investigation, you may uncover restrictions, unforeseen out of pocket costs and other obstacles that may make it harder for you to utilize the benefit.

With fertility benefits, many conventional carriers offer coverage with a dollar maximum, meaning you’d max out on coverage before completing a full IVF cycle. Plus, there are additional costs outside of the basic IVF procedure, like diagnostic testing, medications, and genetic testing which may come with a hefty price tag you’d have to pay for. Without adequate coverage, many people have to make cost-based decisions, forgoing the technology they need to reach a successful outcome.

As an alternative, Progyny’s coverage is bundled, meaning your entire treatment event is covered and you do not have to worry about what is or is not included, or fear running out of coverage mid-way through. Many vendors have similar disruptive solutions to ensure they’re not leaving their members high and dry during difficult times.

When sifting through options, be sure you’re asking what’s covered and not covered under your plan. A lot of benefits may seem expansive, but make sure you’re getting the most out of the coverage that’s available to you. Ask: Are the best clinics in your area included in your plan as “in-network”? Do you have to meet medical necessity requirements before being allowed to access your benefits?

Which benefits are supported?

Once you’ve opted in for benefits during open enrollment, how do you access your benefit? How do you move forward with treatment? Does your benefit provide access to the doctors in your area? Since many of these offerings are complex and without proper onboarding, how can you be expected to understand the next steps?

With the growing emphasis on mental health and concierge member experience, companies like Progyny try to eliminate some of the member’s burden and create an easy to use benefit model that provides member support. For example, our dedicated Patient Care Advocates — a concierge-style fertility coach — helps members navigate the clinical and emotional aspects of your fertility treatment, making a difficult process a bit easier.

Another important factor to consider when shopping for benefits is access to care where you live — are the doctors that your insurance covers close by and easy to get to? When choosing your benefits, look out for any information about access to support. The goal of a benefit is to make your life easier, not leave you feeling confused and stressed in times of need.

What do I do if I’m unhappy with the benefits offered during open enrollment?

Often times, employers are unaware of what an employee wants until it’s brought to their attention. If you are unhappy with the benefits offered, raise the issue with your HR team! You are your own best advocate and change begins with you.

Not sure where to start? If you are comfortable, speak with your colleagues. Seek out a company resource group to see if others have similar needs. This way you can help form a plan or a way to approach HR. Once you have an idea of what you need, talk to HR to explain why the proposed benefit would be pertinent to you and your colleagues. Employers understand that the key to keeping good talent is making sure they’re happy.

Open enrollment can be overwhelming but take advantage of the resources you have. Ask questions, do your research, and discuss the options with experts in your office. With an arsenal of helpful information at your disposal, open enrollment should be stress-free and get you excited for all of the incredible employer-sponsored benefits in your future.

SOURCE: Ajmani, K. (25 November 2019) "Key factors in choosing your benefits during open enrollment" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-to-choose-benefits-during-open-enrollment


DOL, HHS, and Treasury Release Final FAQs on Mental Health / Substance Use Disorder Parity

The DOL, HHS and Treasury have released final FAQs regarding mental health and substance use disorder parity implementation and the 21st Century Cures Act Part 39. Read this blog post from UBA to learn more about these FAQs.


The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the “Departments”) released final FAQs About Mental Health and Substance Use Disorder Parity Implementation and the 21st Century Cures Act Part 39. The Departments respond to FAQs as part of implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Patient Protection and Affordable Care Act (ACA) and the 21st Century Cures Act (Cures Act). The FAQs contain a model disclosure form that employees can use to request information from their group health plan or individual market plan regarding treatment limitations that may affect access to mental health or substance use disorder (MH/SUD) benefits.

The DOL also released an enforcement fact sheet summarizing the DOL’s closed investigations and public inquiries regarding mental health and substance use disorder during the 2018 fiscal year.

SOURCE: Hsu, K. (14 November 2019) "DOL, HHS, and Treasury Release Final FAQs on Mental Health / Substance Use Disorder Parity" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/dol-hhs-and-treasury-release-final-faqs-on-mental-health-/-substance-use-disorder-parity


Implementing Auto Safety in the Workplace

Driving requires concentration and awareness. It only takes one distraction to lose control of your vehicle and crash. Most drivers overlook the importance of keeping their eyes on the road with a significant number attempting to text while driving. In this article, Cathleen Christensen, the Vice President of Property & Casualty at Hierl Insurance, sheds light on this issue and highlights some measures employers can take to curb such accidents.

After falling from 42,836 deaths in 2004 to 32,744 in 2014, fatalities are on the rise again and stand at 37,133 for 2017. The number one cause of all car accidents is distracted driving. “These crashes are largely due to drivers’ negligence,” Cathleen explained. A car traveling at about 55 miles per hour takes approximately five seconds to cover the length of a football field. Five seconds is also the average duration it takes to read a text. At work zones, the few seconds it takes for a driver to get distracted are enough to have them crashing into the work zone. In fact, distracted drivers are 29 times more likely to crash in work zones.

Insurance Losses

Insurance companies are taking the brunt of the financial consequences of drivers’ carelessness by paying for serious losses. The 2016 industry-wide commercial auto combined ratio reached a 15-year high of 110.4%, and the segment has produced an underwriting loss for six years running after years of underwriting profits. According to Cathleen, “One of the primary causes of the industry losing money is distracted drivers. These are drivers who are either talking on the phone or texting while driving. The real consequences are higher insurance premiums for our business customers.”

Measures Employers Should Take to Avoid Losses

Everyone needs to be aware of these measures to minimize accidents caused by distracted driving:

  • Better public education – Drivers need to be educated on the dangers of using their mobile devices while driving.
  • Implement safety policies and make sure employees understand them. These policies include making drivers aware of speed limits, checking their speed gauges and locking their vehicles when they are away from them.
  • Implement a policy regarding the use of phones while driving. Consider using an app that will help keep this policy in place. Employers should prohibit any work-related activity that requires drivers to text or make calls while driving.

Commercial drivers should not be left behind when developing new safety standards for your workforce. Some great recommendations are the following:

  • Review driving records
  • Review and inspect equipment for commercial drivers on a regular basis
  • Implement a sleep safety policy – truck drivers are especially prone to falling asleep while driving due to fatigue as a result of driving very long distances without rest
  • Educate employees on these requirements

What Can Hierl Do to Help?

At Hierl, we listen to clients’ needs and learn about their business to create programs that meet or exceed their expectations. We continuously work with customers to ensure driver safety and provide them with a matrix to help them have an objective measure to look at driving records. We also provide employers with communication material to keep their drivers aware of issues and concerns related to their safety as a prevention measure.

For more information regarding this issue, you can contact Cathleen Christensen at 920-921-5921 or by email at cchristensen@hierl.com.


How to Handle Pay-History Inquiries —The Right Way

Is your hiring team educated and up to date on pay-history regulations? Currently, there are 17 state-wide and 19 local bans that prevent potential employers from inquiring about a candidate's pay history. Read this blog post from UBA to learn more.


We’ve all been there. You’ve gotten deep into the job interview process, and then you’re face-to-face with the awkward question: would you share your previous salary?

Whether the question rears its head in a digital application or during initial in-persons, none of us like answering it. Many people, especially young people, are less committed to their employers and seek new jobs every few years in order to rapidly spike their salaries, yet having to confront the pay question is never comfortable.

Why Pay-History Bans Exist

To date, there are 17 state-wide bans on potential employers inquiring about pay history, as well as 19 local bans. The goal of these bans is to end the cycle of pay discrimination, as well as the cycle of low-earning and poverty.

Everyone knows that it has long been illegal for employers to pay different wages to men and women for the same work, but despite this, the wage gap between men’s and women’s earnings persists. One 2019 PayScale report found that women still make only $0.79 for each dollar men do. A Bureau of Labor Statistics (BLS) analysis discovered that in 2018, median weekly earnings for female full-time wage and salary workers was 81% of men’s earnings. When it comes to minority women and women of color, the pay gap is even more pronounced. The salary history ban is designed to put a stop to that, and begin to repair the damage it has caused.

Pay-history bans allow people who have experienced historically low pay or pay discrimination to have a fresh start when they come in to interview. Some bans go even further than merely blocking pay history questions. A few also prohibit an employer from relying on an applicant's pay history to set compensation if discovered or volunteered; others forbid an employer from taking action against employees who choose to discuss pay with coworkers.

Navigating Pay History

It’s important to ensure your hiring team is educated and aware of pay-history regulations. Read on for thought-starters on what your team can do to make sure you are compliant with these laws.

  1. Audit and review recruiting materials. The first step for many employers is to audit and remove any recruiting materials that ask salary-history questions in states where this is illegal. This includes but is not limited to digital applications, printed materials, and interview scripts.
  2. Develop alternate methods for assigning salary. Your HR and recruiting teams should be focused on finding the right candidate for the job, not necessarily the one who has the right salary profile or history. Asking questions about a candidate's comprehensive experience, previous tenure, and education can be smarter ways to determine what is fair when discussing salary. Using a junior, mid-level, senior, coding model can help your team develop salary ranges that are fair.
  3. Foster a culture of transparency. If it makes sense for your organization, it’s not a bad idea to share salary ranges for each job internally. This will help employees feel confident that their compensation is fair in relation to their colleagues’.

SOURCE: Olson, B. (12 November 2019) "How to Handle Pay-History Inquiries —The Right Way" (Web Blog Post). Retrieved from http://blog.ubabenefits.com/how-to-handle-pay-history-inquiries-the-right-way


IRS increases retirement contributions for 2020

Workers who contribute to 401(k), 403(b), 457 and the federal government’s Thrift Savings Plans will be able to contribute up to $19,500 in 2020, according to a recent announcement from the Internal Revenue Service (IRS). Read the following to learn more about this increase in retirement contributions.


The IRS said this week that workers contributing to 401(k), 403(b), 457 and the federal government’s Thrift Savings Plans plans can add $19,500 next year, an increase from $19,000 in 2019.

The move could help workers save more for retirement, but it may be inconvenient for employers who’ve already started open enrollment, experts say. Employees are now able to set aside $500 more for retirement.

“Every penny counts when you’re saving for retirement, and the higher contribution limit is definitely going to help,” says Jacob Mattinson, partner at McDermott, Will & Emery, a Chicago-based law firm. “But since companies are in the midst of open enrollment, employers may have to go back in and change the entries for employees who want to contribute the max.”

There are about 27.1 million 401(k) plan participants using roughly 110,794 employer-sponsored 401(k) plans, the Employee Benefit Research Institute says. Ninety-three percent of employers offer a 401(k) plan, and around 74% of companies match workers’ contributions, according to data from the Society for Human Resource Management.

While the vast majority of employers do offer retirement savings plans, employees may still be struggling to sock away money. Around 70% of workers say debt has negatively impacted their ability to save for retirement, EBRI says.

“Thirty-two percent of workers with a major debt problem are not at all confident about their prospects for a financially secure retirement, compared with 5% of workers without a debt problem,” says Craig Copeland, EBRI senior research associate.

The IRS also upped contribution limits on Savings Incentive Match Plan for Employees plans, or SIMPLE retirement accounts, to $13,500 from $13,000. The agency did not change the contribution limits to IRAs, which remain at $6,000 annually.

SOURCE: Hroncich, C. (7 November 2019) "IRS increases retirement contributions for 2020" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/irs-increases-retirement-contributions-for-2020