Compliance Webinar | Medicare: a Timeless Topic

In 2018 an estimated 36 million workers, or about 23% of the US labor force, continued working past age 65, according to recent data published by the US Dept. of Labor’s Bureau of Labor Statistics (BLS).

By 2024, baby boomers (born between 1946 and 1964) will reach ages 60 to 78, many of whom will continue working even after they qualify for Social Security retirement benefits (and Medicare).  As compared to 2014 labor force data, BLS projects that the number of older workers (aged 65 and older) will increase by 10.9%, compared to a projected 5% increase in the entire US labor force.

With these changes to employee demographics, employers face challenges and are increasingly asked to provide employees with information about how Medicare eligibility and entitlement affect group health plans.

This 1-hour webinar, presented by Hays Companies Research and Compliance Department, covers Medicare: a Timeless Topic.

Other topics addressed include:

  • What are the various components of Medicare, and what are the costs?
  • When can/should disabled individuals and individuals who are age 65 or older enroll in Medicare?
  • For active employees, does eligibility for Medicare affect group health plan coverage?
  • How do the plans coordinate benefits?
  • How does Medicare entitlement affect eligibility to contribute to an HSA?
  • Does gaining new Medicare entitlement permit employees to change their health coverage elections?
  • How does Medicare entitlement impact eligibility for COBRA continuation coverage?
  • When employees have coverage under our health plan and are also eligible for or covered by Medicare, what are our reporting and disclosure obligations as the employer/plan sponsor?

Please click here to watch the webinar. 

Please contact your Hays Companies representative for further information. 

Compliance Webinar: FMLA and its Impact on Health and Welfare Benefits

The Family and Medical Leave Act (FMLA) has been around since 1995.  On February 6, 2013, the United States Department of Labor (DOL) published final regulations that expanded the protections under the FMLA.  Although many employers understand the job protection aspect of FMLA, protecting and maintaining employee welfare benefits during FMLA leave can be just as, if not more, challenging.

This 1-hour webinar, presented by Hays Companies Research and Compliance Department, covers FMLA and its Impact on Health and Welfare Benefits

Other topics addressed include:

  • What employers are subject to FMLA?
  • What employees are eligible for FMLA?
  • What rules specifically apply to military service members and airline personnel?
  • What are the job protections under FMLA?
  • What are the proper steps to ensure benefit protections during and after an FMLA leave?

Please click here to watch the webinar.

Please contact your Hays Companies representative for further information. 

Quick Reference Guide: 2018 ACA Employer Reporting Requirements

The Hays Research and Compliance Team has assembled a quick reference guide for 2018 calendar year reporting. This guide is specifically relating to 2018 ACA Employer Reporting Requirements.

 


Section 6055 & 6056 Reporting

Non-ALEs sponsoring insured plans are not required to report
under either Section 6055 or Section 6056

 


Forms

Forms 1094-A & 1095-A
  • Marketplace (exchange)
Forms 1094-B & 1095-B
  • Issuers, non-ALE (less than 50 FTE) that are self-insured
Forms 1094-C and 1095-C
  • Applicable Large Employer (ALE)

 


Due Dates

Form 1095: March 4, 2019
  • Paper delivery
  • Electronic only if the individual has consented to electronic delivery of the 1095 (in writing)
Form 1094: February 28, 2019
  • April 1, 2019 if filing electronically
  • Electronic filing required for ALE with 250 or more 1095s

 Employers may file for an automatic 30 day extension via Form 8809

 


Form 1095-C Line 14 Codes

1A     Qualifying Offer: MEC/MV offered to employee, self-only coverage < than 9.56% single – 2018 federal poverty line and at least MEC offered to spouse & dependent(s)

1B     Minimum essential coverage providing minimum value offered to employee only

1C     MEC/MV offered to employee and at least MEC offered to dependent(s) (not spouse)

1D     MEC/MV offered to employee and at least MEC offered to spouse (not dependent(s))

1E     MEC/MV offered to employee and at least MEC offered to dependent(s) and spouse

1F     MEC but NOT MV offered to employee, or employee and spouse or dependent(s), or employee, spouse and dependents

1G     Offer of coverage to employee who was not full-time for any month of the calendar year and who enrolled in self-insured coverage for one or more months of the calendar year

1H     No offer of coverage (or employee offered coverage that is not MEC)

1I     Reserved

1J     MEC/MV offered to employee and at least MEC conditionally offered to spouse (but no MEC offered to dependents)

1K    MEC/MV offered to employee and at least MEC offered to dependents and at least MEC conditionally offered to spouse

 


Form 1095-C Line 16 Codes

2A     Employee not employed during the month

2B     Employee not a full-time employee

2C     Employee enrolled in coverage offered

2D     Employee in a section 4980H(b) Limited Non-Assessment Period

2E     Multiemployer interim rule relief

2F     Section 4980H affordability Form W-2 safe harbor

2G     Section 4980H affordability federal poverty line safe harbor

2H     Section 4980H affordability rate of pay safe harbor

2I     Reserved

 


COBRA

COBRA for terminated employee:
  • Coverage goes to end of the month in which employee terminates (1E, 2C)
  • Coverage does not go to the end of the month in which employee terminates (1H, 2B)
  • All months following the month in which the employee terminates (1H, 2A)
  • COBRA participants who have not been employed at any time during the calendar year (1G)
COBRA for drop in hours:
  • For a person who had family coverage and was therefore offered COBRA for self, spouse and dependents: (1E, 2C) fill in line 15
  • For a person who had self only coverage and was therefore offered COBRA for self only: (1B, 2C) fill in line 15
  • For a person who had coverage for self and a dependent and was therefore offered COBRA for self, and their dependent: (1C, 2C) fill in line 15
  • For a person who had coverage for self and their spouse and was therefore offered COBRA for self and their spouse: (1D, 2C) fill in line 15

Use 2B if COBRA is not elected

 


Self-Insured Employers

Former Employees and Other Non-Employees
  1. Retirees
  2. COBRA beneficiaries
  3. Non-employee directors
    • No requirement to certify OFFER of coverage, but still must report coverage provided
      • Self-insured sponsors may use either Forms 1094/1095-C or Forms 1094/1095-B
      • If using 1094/1095-C, use Code 1G on line 14

Code 1G goes in all the 12 months column on line 14

 


Special Rules for HRAs

Self-insured major medical plan and an HRA
  • Report only the major medical plan information
Insured major medical plan and an HRA
  • Not required to report if the individual is eligible for the HRA because the individual enrolled in the insured major medical plan
Part III
  • HRA must be reported in Part III for any individual who is not enrolled in a major medical plan of the ALE Member
  • Applicable to the employers with less than 50 FT/FTEs too

 


Resources

2018 Instructions for Forms

2018 Form 1095-C

2018 Form 1094-C

 


Disclaimer:

These quick reference materials are provided for general information purposes only and should not be considered legal or tax advice or legal or tax opinion on any specific facts or circumstances. Readers and participants are urged to consult their legal counsel and tax advisor concerning any legal or tax questions that may arise.

Any tax advice contained in this communication (including any attachments) is not intended to be used, and cannot be used, for purposes of (i) avoiding penalties imposed under the U.S. Internal Revenue Code or (ii) promoting, marketing or recommending to another person any tax-related matter.

3 Simple Steps to Tidy Up Your Benefits Communications (Marie Kondo Style)

There’s a reason Marie Kondo’s Netflix Series, Tidying Up, is the first bingeable sensation of 2019. It’s fun to watch other people wade through years of collected items, but there’s also an underlying current of shared understanding—that feeling of being so overwhelmed that you simply don’t know where to begin. If you’ve ever felt that way about your employee benefits communications, you’re not alone!

With five generations of Americans in the workforce, each with their own communication preferences, it can be complex to engage and target your audience. Granted, Kondo wasn’t thinking about healthcare when she created her now famous method of organization, but many of her rules apply to how you communicate your benefits.

Kondo teaches us that decluttering—lovingly letting go of items that no longer spark joy—is one way to help us understand more about what’s essential in our lives. Employee Benefits and the communication methods associated with them can be approached the same way. There are so many plans out there, so many options to communicate your benefits to employees – mobile, video, webinars, face-to-face, email, intranet, social media, phone, text message, printed guidebooks, direct mailers, etc.—that your benefits communications can get cluttered quickly.

While multiple channels and tactics are good, it’s all about aligning a clear message to the right audience through the correct channels. Which is why you should tidy up your benefits communications from time to time. That way you can reevaluate how you’re reaching your employees and whether you’re doing so effectively.

So, what should you keep and what should be thrown away? That all depends on your company and benefits goals and objectives.

Commit yourself and do the prep work

Marie Kondo is all in, and she urges her clients to think of tidying up as a commitment, not a cleanup job. The same goes for reorganizing your benefits communications. Constructive changes don’t happen overnight, and if your goal is to reduce the cost of healthcare while still offering benefits your employees want, you’ll need an annual communication plan.

Consider this part the prep work. Start with a goal and defined key communications objectives. Perhaps you want your employees to better understand when to access the proper care—whether through telemedicine, urgent care or the ER. Or your members need to better understand and control rising pharmacy costs. When you focus on a few key communication goals, you commit to sending a focused message that people understand.

Imagine your ideal benefits

We all have a best life, and Kondo thinks decluttering helps you find your ideal self. All you need to do is see it and work towards achieving it. Her method might seem idealistic, but it does suggest that a clear vision is required for success. Tidying—or optimizing—your benefits can’t happen unless you have a clear idea of what you want to offer and how you want to communicate with your employees. That’s why setting your annual goals is so important.

Follow the right (communications) order

The best benefits communications suite for your organization starts with understanding your employees. By taking the time to curate your messaging to your audience and align communications with organizational goals, you can tidy up your communications channels and focus on the greater benefits objectives. Knowing that you are communicating topics that align with your goals, you’ll have a far easier time tidying up your communication channels and focusing on what matters and to who.

Interested in learning more about tidying up your employee benefits? Hays Companies is here to help you KonMari your way to a better benefits communication! Contact us today for more information.

Compliance Webinar | Employer Reporting: a 1094-C and 1095-C Refresher

2018 marks the fourth year for which Applicable Large Employers (ALEs) must report offers of health coverage to full-time employees to the IRS on Form 1094-C and provide Employee Statements (Form 1095-C). The deadline for providing Form 1095 to employees is March 4, 2019. Employers must file Form 1094-C and copies of Form 1095-C by February 28, 2019 if paper forms are filed, or April 1, 2019 if the forms are filed electronically. Final forms and instructions have been released by the IRS. This webinar will provide a refresher intended to help employers complete these forms.

This webinar, presented by Hays Companies Research and Compliance Department, covers Employer Reporting: a 1094-C and 1095-C Refresher

Other topics this webinar will address include:

  • Employers subject to reporting
  • Deliver and filing requirements
  • General reporting method and required information
  • Reporting codes
  • Reporting scenarios

You can watch the webinar here.

Please contact your Hays Companies representative for further information. 

Updated DOL Guidance on Indexed Statutory Penalties for ERISA Plans

On January 15, 2019, the US Department of Labor issued pre-publication guidance on the indexed statutory penalties for certain violations applicable to ERISA welfare plans, under the Civil Penalties Inflation Adjustment Act. The 2019 inflation-adjusted penalties that are applicable to health and welfare plans for 2019 include (but are not limited to) the following key compliance items:

The DOL inflation-adjusted penalties for violations of various other labor and employee benefits laws are also addressed in the updated guidance and will be published shortly in The Federal Register. These include, but are not limited to, the following:

  • Federal Mine Safety and Health Act
  • ERISA (with respect to qualified retirement plans)
  • Occupational Safety and Health Act (OSHA)
  • Wage and Hour (Fair Labor Standards Act, Immigration & Nationality, Public Service Contracts Act, FMLA)
  • Office of Workers Compensation Programs (OWCP)

Hays Companies is here to help with your compliance needs. If you have any questions, contact your Hays representative or get in touch with us today.

Hays Companies Employee Benefits Presents: Upcoming Webinars in 2019

We are pleased to announce the upcoming Hays Companies Webinar schedule for the first half of 2019. Registration information for each webinar, actual dates, and complete details will be made available closer to the event.

As always, please reach out to your Hays Companies representative with any questions.

Date Topic
January Employer Reporting: a 1094-C and 1095-C Refresher
February FMLA and its Impact on Health and Welfare Benefits
March Medicare: a Timeless Topic
April ERISA: Why Does Everyone Keep Talking Wrap Documents?
May Planning for Mergers and Acquisitions
June HIPAA: Protecting Your PHI and Protecting You From Penalties

Note: additional webinars may be added due to legislative changes, rulings, guidance or other developments impacting employee benefits.

Topics and dates are subject to change due to unforeseen circumstances

Biometrics: The Inside Story

In this age of technological and scientific breakthroughs, the most revealing medical insights may come from a single drop of blood. Biometric screenings provide employees with a detailed analysis of their current state of health, as well as insights into what the future might hold. By understanding potential issues, blood screenings could help address concerning health complications before they become serious problems.

There’s a data set in blood that is ten times—even 100 times—more interesting than that in the genome.”

Dr. Eugene Chan

Every drop of the 1.5 gallons of blood flowing through the human body teems with data. By matching blood samples to height, weight and BMI, screenings can help identify health conditions such as diabetes and heart disease.

The future of biometrics

Blood samples are currently an effective measure of health, but scientists and entrepreneurs are taking steps to advance the capabilities of biometric screening. No longer satisfied with the simple metrics of today’s tests, doctors like Eugene Chan, CEO of the DNA Medicine Institute, want to take testing to the next level. “There’s a data set in blood that is ten times—even 100 times—more interesting than that in the genome,” he told Time Magazine.

Chan’s work taps into the vast potential in blood to indicate what illnesses may be lurking in the body. Chan believes that in the future, blood screening could detect early signs of breast cancer and Alzheimer’s, increasing the likelihood that treatment begins before toxic changes start attacking the brain and increasing the potential for successful recovery.

Health through awareness

While Chan is certainly forward-thinking, today’s biometric screenings can still improve health through awareness. By providing a snapshot of overall health, blood testing can uncover potentially unknown conditions, such as high cholesterol or blood pressure, which can be managed with simple lifestyle changes if detected early enough. Those small choices could have a big impact; biometric screening may help lower worker’s compensation costs and reduce the number of large claims.

According to the Center for Disease Control (CDC) and International Monetary Fund (IMF), more than $225 billion is lost every year because of absenteeism, which includes employees with illnesses and those who suffer from chronic diseases. Blood tests performed during a biometric screening can identify what the CDC found to be the most expensive health conditions in the US: high blood pressure, heart disease and diabetes. Often these illnesses can be managed by creating more informed employees who understand the risks associated with not taking care of their health. Biometric screening may be the wakeup call many need to create lasting lifestyle changes.

More about wellness

There are many paths a company can take to develop a wellness program. A carefully designed multi-dimensional program can lead to long-term results and a healthier workforce.

Contact us to learn more about how Hays can help build a targeted wellness program right for your organization.

Entire ACA Ruled Invalid

On December 14th, a judge in the United States District Court for the Northern District of Texas, Fort Worth Division, ruled that the Affordable Care Act’s (ACA) individual mandate is unconstitutional and that the remaining provisions of the ACA are inseverable and therefore invalid.

The ruling is based upon the change to the individual mandate contained within the 2017 tax reform bill that eliminated the individual mandate’s tax consequences. Under the new law, people who decide against insurance coverage no longer must pay a fine. The District Court’s decision hinged on that change.

While the ruling puts the ACA’s future in jeopardy, the federal government is making no immediate changes to laws and regulations. According to a statement from the Department of Health and Human Services (HHS), the government “will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision. They added that the decision “does not require that HHS make any changes to any of the ACA programs it administers…at this time.”

In short, it’s business as usual until Judge O’Connor’s decision makes its way through the court system. A group of states led by California vowed to appeal the ruling and the issue will most likely make its way to the Supreme Court.

The ACA was previously upheld as constitutional by the Supreme Court in 2012. However, the same result is not certain today given the changes in individual mandate laws and a more conservative court.

That said, businesses should continue to comply with the various requirements under the ACA including 1095 reporting, W-2 reporting and minimum essential coverage offerings that meets the value and affordability requirements under the ACA.

IRS Announces Employee Benefit Plan Limits for 2019

Highlights

  • The IRS recently announced cost-of-living adjustments to the annual dollar limits for employee benefit plans.
  • Many of these limits will increase for 2019.
  • In 2019, employees may contribute more money to their HSAs, health FSAs and 401(k) accounts.

Overview

Many employee benefits are subject to annual dollar limits that are periodically increased for inflation. The Internal Revenue Service (IRS) recently announced cost-of-living adjustments to the annual dollar limits for various welfare and retirement plan limits for 2019. Although some of the limits will remain the same, many of the limits will increase for 2019.

The annual limits for the following commonly offered employee benefits will increase for 2019:

  • High deductible health plans (HDHPs) and health savings accounts (HSAs);
  • Health flexible spending accounts (FSAs);
  • Transportation fringe benefit plans; and
  • 401(k) plans.

Action Steps

Employers should update their benefit plan designs for the new limits and make sure that their plan administration will be consistent with the new limits in 2019. Employers may also want to communicate the new benefit plan limits to employees.

HSA and HDHP Limits

HSA Contribution Limit
Limit 2018 2019 Change
Self-only HDHP coverage $3,450 $3,500 Up $50
Family HDHP coverage $6,900 $7,000 Up $100
Catch-up contributions* $1,000 $1,000 No change

*Not adjusted for inflation

HDHP Limits
Limit 2018 2019 Change
Minimum deductible Self-only coverage $1,350 $1,350 No change
Family coverage $2,700 $2,700 No change
Maximum out-of-pocket Self-only coverage $6,650 $6,750 Up $100
Family coverage $13,300 $13,500 Up $200

FSA Benefits

FSA Limits
Limit 2018 2019 Change
Health FSA (limit on employees’ pre-tax contributions) $2,650 $2,700 Up $50
Dependent care FSA (tax exclusion)* $5,000 ($2,500 if married and filing taxes separately) $5,000 ($2,500 if married and filing taxes separately) No change

*Not adjusted for inflation

Transportation Fringe Benefits

Transportation Benefits
Limit (monthly limits) 2018 2019 Change
Transit pass and vanpooling (combined) $260 $265 Up $5
Parking $260 $265 Up $5

Adoption Assistance Benefits

Adoption Benefits
Limit 2018 2019 Change
Tax exclusion (employer-provided assistance) $13,840 $14,080 Up $240

Qualified Small Employer HRA (QSEHRA)

QSEHRA
Limit 2018 2019 Change
Payments and Reimbursements Employee-only coverage $5,050 $5,150 Up $100
Family coverage $10,250 $10,450 Up $200

401(k) Contributions

401(k) Contributions
Limit 2018 2019 Change
Employee elective deferrals $18,500 $19,000 Up $500
Catch-up contributions $6,000 $6,000 No change

Resources

This Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.